Chinese Medicine and Daoism
Is Chinese medicine rooted in Daoism? Are all of the classical texts essentially Daoist ideas of the body and disease? Many teachers and authors support this idea and base many of their teachings on the idea that Chinese medicine has Daoism at its core. As much as I wish this were the case, I see very little evidence for this in the classics (as hard as I have tried to find it).
We Westerners like Daoism. I like Daoism. The Dao De Jing is the most translated book into English and therefore celebrated as one of the classics of Chinese culture (even though most people in Chinese speaking countries have never read it and have no interest in it). This does not make it central to the ideas contained in classical Chinese medical texts. In fact, even the term Daoism (Taoism) is problematic. For more on this, I highly recommend this article by Nathan Sivin.
If I were to narrow down any one philosophical thought as predominate in the earlier classics, I would have to say Legalism takes the prize. The zang-organs are given categories that correspond to government posts. The character 治 is used for the verb “to treat”; this is the same verb used to represent “to govern.” There are countless essays that equate treating disease with managing the affairs of the state.
This is not likely to be a poplar stance, as most of the modern teachers who have a following use Daoism as the basis for what they teach. I think there is nothing wrong with this, and I am attracted to such things myself. The difference, for me personally, is that I see this as a modern interpretation of classical medicine which often superimposes ideas on to texts. We want there to be a Daoist basis of the medicine, so we see it even when it is not there.
When I first embarked on the journey of learning to read classical Chinese medical texts, I also believed that Chinese medicine was rooted in Daoism; in fact, I had always been under the impression that it snubbed Confucianism and Legalism. This idea hampered my progress. I was always looking for something that wasn’t in the texts, therefore I didn’t understand the texts. It wasn’t until I started exploring Chinese philosophy in depth that I realized that Chinese medical writers were versed in all classics of philosophy. Very few medical writers snubbed any one tradition, and they often used aspects of all philosophies including “Daoism.”
I do not want to discourage people from developing interest in a Daoist Chinese medicine. There are certainly examples of Daoism in medicine, it’s just that they do not exist everywhere. I simply want to encourage people to become much more versed in philosophy and Chinese history so that they can have a better grasp of the texts they are learning to read.
Thanks for making an excellent point Richard. You have to get into the depth of Chinese philosophy and read all round the subject..to fully taste the strong flavour of Chinese Classical medicine.
Look at the title of Chapter 8 of the Su Wen. ‘Secret Treatise of the Spiritual Orchid’. The Chinese character for orchid is a gateway with a fence (bamboo strips bundled together). The image is of a ‘holy of holies’. Look beyond the superficial Confucian/Legalism window dressing and you will find the fundamental basis of a very different way of looking at Chinese Medicine; i.e. than the received teachings of Zang/Fu theory. Consider the statments as a priori statements rather than subsume them under Zang/Fu theory; e.g the Bladder stores the body-fluids and is responsible for Qi Transformation (one really has to compress the meaning to make that urinary excretion). It suggests that the Bladder is representative of what is called Kidney Yang in the recieved teachings of modern TCM. I like to think of this Chapter as the ‘secret teachings’ hidden in plain view. The title is a bit of a giveaway!
Hi Andrew,
I agree that this chapter, along with the rest of the Nei Jing, is best read without projecting modern Zang/fu theory onto them. I am not arguing that Legalism is the basis for the medicine, but rather admitting that I see a lot of Legalist terminology. For me, all of these terms are problematic: what is Legalism? Confucianism? Daoism? Why do we feel the need to put things into such categories? Without the categories, it becomes much easier to just read what a book has to say.
I do not find any of Su Wen Ch. 8 to be a superficial window dressing. The idea of the heart as ruler, etc, becomes the basis for later explanations of how disease is manifested and transmitted. I am not following your idea that the character for orchid means “holy of holies.” There is a plant radical over a character which means “to block.” With the fire radical, it means to fester or to be awful. With the wood radical, it means a fence.
I agree with your comments regarding labels, but of course that is the central paradox of Daoism – that language cannot express it but we are forced to use language. So one always has to consider if a person is using language with an awareness of its limitations or not.
You particularly alluded to the idea of ‘officials’ and this idea is very particularly derived from Chatper 8 of the Su Wen. When someone recently said to me that Chapter 8 of the Su Wen is very Confucian I had to step back and think about this. I recognized what they mean’t but to me this was such a superficial reading it had not even occured to me. Your comment made me realise that a lot of people may be missing the full understanding of ‘Twelve Officials Theory’.
Your message seemed to be that Legalism was the predominate (your word) language of the Classics and that people tend to read Daoism into them. I would agree that a lot of the classics is much more pragmatic and ‘nuts and bolts’. But there are many passages suggestive of something different behind the scenes.
The character for orchid has the plant radical. 蘭 lan2
The component under the plant radical is a pictorialy a door with a screen, railing or fence. This component is considered the phonetic, but as is often the case the phonetic also appears to have a very clear relevant meaning. Like many passages in the Chinese text a significant character carries an image that relates to the overall idea of the passge.
My dictionary shows this meaning of the component.
闌 lan2 a door curtain or screen / a fence / to block up / to cut off / the end of ( a year, etc. ) / late ( in the night, etc. ) / weakened / withered
I would further speculate (and this is entirely my own speculation) that the feminine nature of the symbolism of the orchid is very clear and very intentional here. And that this very feminine symbolism is a further clue to read this chapter very differently than its supeficial appearance.
Without going into a lot of detail, I have read classical commentaries on Nei Jing Ch. 8 say that 靈蘭 is short for 靈臺蘭室, which is the place the emperor is said to have stored important documents. It is very common for longer phrases to be parsed like this, especially when they are used for a title. A more detailed explanation is that 靈臺 is a common metaphor for the heart (the platform of the spirit). Readers of the time would have also been aware that Confucius in 《孔子家語》 makes reference to “蘭室.” The characters 蘭室 point to true knowledge which lacks nothing or an area for the storage of extremely important material, and sometimes female consorts who were most prized. This is why I encourage people to read extensively outside of medicine, as these metaphors were fairly common. This explanation is by no means definitive, but it does point out that what may seem superficial could very well be rooted in the classics (outside of medicine) that everyone (who could read and write) read during the writing of the Nei Jing.
Claude Larre says that the Spiritual Orchid was the name for the Emperor’s library – I hadn’t actually come accross this anywhere else. Your reference to female consorts was something I suspected but wihout a reference for this I hesitated to go there. If my response to your initial posting seemed a little argumentative it may have been because it seemed to be very much relegating some of this bigger picture (Daoist/Feminine) to the idea that Westerners read into things more than is actually there, and I wanted to make the point that Chapter 8 of the Su Wen (and Chapter 8 of the Ling Shu) point to a very different understanding than the more pedestrian ‘knots and pegs’ of the Ling Shu in particular. We seem to be on the same page in terms of looking at the bigger picture.
There is a book I enjoyed very much called ‘The Valley Spirit’ by Sukie Colegrave that discusses the feminine in Eastern thought. And the paradox of what seems to have been a very patriachical culture for the recorded history that we know of, but that (particularly in Daoism) reveres the feminine. I see the same dichotomy in the medicine. Which raises an intesting question as to whether these ideas were generally recognized in Chinese medicine in the historical period. There is some evidence for a matriarchical culture prior to the literate period, but what is amazing is that these ideas survived so clearly even if their full implications were not commonly recognized by the predominant culture.
I think we are probably more on the same page than it might appear. My only purpose in writing this post was to give people a new perspective on which to enter textual study. My romanticized ideas about Chinese medicine hurt me greatly when I started this endeavor. When I started reading classical texts in history, philosophy, and religion, I found it much easier to grasp medical texts and read the classics. I don’t want people to get stuck, as I was. If someone decides Chinese medicine is Daoist in origin, they will totally miss the lines that make reference to classics outside of Daoism, which can lead to misinterpretation.
The translation of 靈蘭 is a good example of this. I find it interesting that Larre knew this was a reference to the emperor’s library and still translated it as Spiritual Orchid. Translating this way taps into romantic notions of Chinese medicine, but it does not necessarily explain the term well. I’m much more interested in all of the possibilities rather than just one. I wouldn’t throw out anything Larre says either-he was a brilliant guy. Where I’m at now in my studies is: read it, analyze it, and move on without throwing anything I have read before away.
Much enjoyed this conversation.
I may be jumping in a bit late, but I wanted to first thank you for bettering the field of Chinese medicine by addressing one of the core hindrances Westerners have in studying it. I of course was also drawn to study Chinese medicine and Eastern philosophy due to the intrigue of Daoism, and as much as I value Daoism as well as the Daoist cannon, through my studies in philosophy, literature, history and medicine, it has become clear to me that the medical cannon was written during a time when the modern associations with “Daoism” were not at all present.
You are correct, in my opinion, to emphasize Legalist language and categorization, as well as structural understanding implicit in medical theory. I think that Westerners would greatly benefit in studying the Confucian cannon to better understand Chinese medicine. However, even the dichotomy between Confucianism and Daoism is a modern concept; these distinctions also do not necessarily play a role in the development of the Neijing. I’m not saying that there wasn’t a distinction between the 100 schools and more of thought, but that the distinctions made today between Confucianism and Daoism are not relevant in understanding the philosophical discussions going on during the Han dynasty.
Let’s not forget the significance of the Huainanzi on the Neijing, or the Tangye jing on the Shanghan lun though.
I am greatly appreciative of your contributions to classical studies!
Michael Givens
Hi Michael,
Thank you for your comments. I agree very much with everything you wrote. You bring up a lot of important distinctions as well, especially about people in the Han being pretty much clueless to the categorizations we use today. They saw texts not as belonging to a school, but as a group of works that belonged to one greater body of work. I hope you don’t mind if I copy your comments and put them on my personal blog so that others can see them.
Cheers,
R
Heiner Fruehauf has contributed a great understanding of what distinguishes the Classical perspective from modern TCM. There seems to be arguments being made here and elsewhere suggesting that these princples are a gloss introduced by Westerners and that Chinese medicine is essentialy more technical and reductionist. Apologies if I have missunderstood.
One consideration that I think would add another layer to your scholarly understanding is that the medical Classics probably represent the earliest written form of what was already a highly developed body of teachings that were transmitted oraly. The evidence for this is that early writings of this type often appear to have a different structure, that became obscure to the literate culture: See Mary Douglas – ‘Thinking in Circles’. Very quickly people lost the ability to understand this structure and hence the ‘Systematic Classic’. Appeared within 100 years of the Classics.
Identifying this structure reveals the important points being made in texts that we identify as Daoist, or that I have called feminine that are retained but poorly understood during the historical period.
So I would agree that Classical Chinese medicine may have not been practiced by the mainstream in its idealized form for most of the historic period.
I’m sorry I don’t have time to respond thoroughly, but maybe I will get to it later. I think this quote from Nathan Sivin summarizes my thoughts on the issue perfectly:
“A quiet revolution is remaking the study of cosmology, ethics, and other intellectual issues in early China. Those who have not noticed it still lecture their students about new ideas resulting from debates between such schools as the Confucians, Taoists, and Legalists in such academic locales as the Jixia Academy. Over the past fifteen years, a no longer tiny group of innovative scholars, mostly in dissertations, have demonstrated that the notion of “school” as sinologists conventionally use it has no social meaning at all, that there existed no such collectivity in any sense as the Legalists, that “Taoist” has so many meanings that without explicit definition it communicates nothing at all, that only modern fantasy makes the residential area near the Ji Gate of the Qi capital an academy, and that “debate” as historians of philosophy normally understand the word was remarkably scanty in early Chinese thought.”
If your response is to me, then I am well aware of that the Chinese situation was not the same as the Greco-Roman regarding ‘schools’. In using the terms Daoist, Legalist and such like, I am addressing your initial comments and assuming that you would understand that my use of these terms was a qualified usage is in the context you describe, just as I assumed that you were aware of the facts that you describe.
The response was specifically at the distinctions made about CCM and TCM. I think the ideas behind Sivin’s quote work in this case, as well. Trying to define classical Chinese medicine, with its long history and diverging texts, strictly in relation to TCM and with labels such as ‘Daoist’ is far too simple for me when I consider the research methodologies being offered by other scholars. My point was not to label Chinese medicine as Legalist, Daoist, etc. My point is that we can take any of the “-isms” and find traces of them in ancient texts. To me, this points to a body of work by authors who were well versed in all of their own classics.
I am sorry I am still not quite clear. Are you in fact questioning the idea of Classical Chinese Medicine, and seeing it as a Western interpetation or overlay?
What I would suggest is that Heiner’s terms ‘CCM’ and ‘TCM’ (which he puts in quotes) represent a range of ideas that can be found in or at least traced to the Classics. That the classics can be seen to be the basis of both a very pragmatic and a more idealistic approach to Chinese medicine. And here lies the real possibility of seeing Chinese medicine as a coherent body of knowlege with a range of ideas and principles to fit the various needs of the patients. But we need to be inclusive in order to realise this.
I believe that both CCM and TCM are modern interpretations, not necessarily only Western. Everything I’ve seen written or discussed about “Classical Chinese Medicine” is in direct reaction to the development of TCM. Everything I have read about CCM is reactionary and much of it is ahistorical. This happened in classical times too, especially with the Han Xue movement. I agree that both the modern CCM and TCM movements can be traced to the classics, it’s just that I see each as being very selective in the texts they choose to represent their ideas.
Hi,
Sure, you are welcome to share my thoughts on your blog.
I have a few comments regarding the “CCM” vs. “TCM” discussion…
It is true that “CCM” is a modern (and perhaps a recurring) reaction to “TCM.” Nonetheless, reactions such as these point to useful flaws in both sides of any situation. It would be a great flaw of any “school” of thought which idealizes an era or a “development” in such a way that is “ahistorical.” A romantic view of the classics would inevitably lead to this type of a flaw; however, the real problem lies in the school that does not know that it is romanticizing or is ahistorical.
“Chinese Medicine” as it is practiced and taught in its normative form of today falls into this category. There is an underlying (romantic) belief that the medicine (as well as human understanding) has become better and better and more complex over time, as if all things evolve in a linear fashion, while at the same time this romantic notion CM’s roots in “Daoism” we have been discussing, are also present. My experience with CCM (being that I am a student of Heiner’s and and alumni of NCNM in Portland), is that it, very much unlike the Hanxue movement, establishes an emphasis on scholarship and study of all classics; as is the newer movement over at Arnaud Versluys’s forum, I would have to admit that the term “Cannonical” is more fitting.
Nonetheless, “classical” has many roots in western culture that provide a clearer meaning for us. Take for instance the Perennialist school of thought in Western education. There the term “classic” refers to the true teacher, the source of all lineages, and thus all students must rely upon primary sources for their education. Perhaps we could see the “classical Chinese medicine” school of thought here in the West as a branch of the “perrenialist’ movement. My other alma matar, St. John’s college, is another example of this approach, for it follows the Socratic method of teaching and requires students to personally engage with the classical texts.
We should define what the cannon is for our medicine though, and this has been debated frequently. Clearly a great codification of all systems of thought occurred during the Han dynasty which should be at the very least held as the original teaching of our medicine.
Thanks for the discussion,
Michael
Thanks both Michael and Andrew for your recent comments.
I want to be clear that I respect Arnaud Versluys and Heiner Fruehauf a lot. I think those of you who graduate from that school are very lucky, as are the people who go to SIOM. There are a lot of high quality teachers in the US (and other places) now, and I consider both of them to be really great teachers.
Something I struggle with every time I write an article or a response is, how do I hold the value of every single person who contributes to a discussion while at the same time use critical analysis? For instance, my article about Leon Hammer’s statements about the classics was not meant to be aimed at him at all. I also feel inspired by some of the writings of Claude Larre, and other times I roll my eyes at some of the stuff he writes. My comments about CCM are the same; to me, it’s not so much about any one teacher (some have been talking about CCM longer than the current groups), but looking at such things from a variety of perspectives.
The bigger question for me is, how do I maintain a highly critical look at what people say without being critical of them. There are a couple of people in Chinese medicine who I ignore completely because their work does not contribute at all to the issues I’m interested in. Most people are critical of things they want others to dismiss; I ignore the things I think need to be dismissed and look for a deeper discussion into the things I am interested in, sometimes through critical analysis. This feels like a razor’s edge to me constantly, so I wanted to be clear that it is never my intention to criticize anyone personally.
Firstly I want to say that I understand the struggle you describe. It is a challenge for us all.
Secondly I want to state that CCM is not a reaction to modern TCM. Historically this is not true. In the UK, most of the few people who became teachers of acupuncture in the 70s had learned in Japan and Taiwan and Hong Kong before mainland China became accesible. Five Phases figures more prominently in their practices. In France the legacy of Chamfrault and Van Nghi was strong and although there was more contribution from mainland China it mainly came from Classical studies and so also differs from the mainstream of modern TCM practice.
I originally trained in the UK in the 70s, you might describe me as second generation. I have of course studied TCM over the years, and in more recent years I am clinical director at a school of CCM that is particulary insired by the work of Van Nghi. Although all these approaches have their differences and even apparent contradictions all are based in the Classics which can be quoted to support or critique all of these approaches. What a challenge we all face to truly understand this medicine in a comprehensive way.
I’m talking about the more recent discussions of CCM being in reaction to TCM. I have to admit I have been out of the US for some time and have no connection to any of the schools, so I’m sure there are discussions I am not at all aware of. I’m talking about the stuff that gets the most airtime and that I have access to here in my little corner of the world. Every article I have read that seeks to define CCM does so only in relation to TCM. If you have any articles that do not do this, I would love to read them.
I think it’s important to remember that the changes in Chinese medicine occurred before the cultural revolution. The intellectual environment of China changed rapidly and greatly during the Republican period. Hong Kong and Taiwan were also influenced by these changes. Volker Scheid writes about this in his first book in great detail. I’ve seen the textbooks from that period-they still have them in libraries here-and they are no different from what I can find here today.
I think your last two sentences are right on. The classics themselves are filled with what we would consider contradictions, but the original writers apparently had no problem with this. This is why I am working so hard to get more people to read the classics themselves. Other people’s interpetations are a great resource, but until we have a lot more people looking at the texts and doing deeper studies of them, we are going to be hanging on the interpretations of just a few people.
I am not aware of much of this discussion that you mention, perhaps there are more articles out there than I am aware of. Given that the modern TCM approach is the mainstream or majority approach it seems somewhat understandable that much is written to critique this. One also finds oneself when in the minority having to defend or at least explain ones position. As a practitioner when a patient has had past acupuncture I find myself more likely than not having to explain that what I do is different. And teachers are more likely to explain the differences between what they are teaching and the mainstream approach. I would agree that if much of the discussion of CCM is phrased as a reaction to TCM then it would be good to find CCM explained as if it did not need justification.
Your original comments were one of three links that were sent to me in the last few weeks that all were critical of some aspect of non-mainstream ideas in Chinese medicine.
In the US where the modern TCM model is the clear majority it is also driving decisions and processes within the profession and this ‘tyranny of the majority’ also explains the reactive nature of the CCM movement to some degree.
I do consider modern TCM to be thoroughly grounded in the Classics so I definitely do not argue against TCM, but it is a one sided interpretation and approach. And ever since China became more accesible to Westerners there have been many articles and statements in books suggesting that the non-mainstream ideas are wrong. It seems that we as a profession are struggling with our own bipartisanship issues.
Hi,
This is again me jumping in a bit late over here, but I wanted to say that the discussion that went on over at Deepesthealth really took a turn for the worse and in whatever way I played a part of that, I apologize. I greatly appreciate the comments and discussion going on over here (and usually over at Deepesthealth), and am very happy that you are out there encouraging practitioners and students to engage personally and scholastically with the cannon of our medicine.
Andrew, thank you for offering an historical understanding of the development of the study of Chinese medicine in the west, as it grew somewhere between TCM and CCM in its own unique way. I have great hope for the future of medicine in the west as it finds wisdom in the ancient science of the Neijing and Shanghan lun. I hope we can continue a fruitful dialogue in the future.
Michael Givens
Hi Michael,
I greatly appreciate the comments offered by you and Andrew, both here and over at deepest health. Keep them coming, and I’m sure I’ll be adding more posts in the near future (besides the stuff I’m doing for the class).
I have enjoyed these two somewhat linked discussions. We are all passionate about what we do and can all get (over)heated – I know I can.
@Andrew Prescott:
“Heiner Fruehauf has contributed a great understanding of what distinguishes the Classical perspective from modern TCM. There seems to be arguments being made here and elsewhere suggesting that these princples are a gloss introduced by Westerners and that Chinese medicine is essentialy more technical and reductionist. Apologies if I have missunderstood.”
Andrew, you have understood exactly correctly. I believe Bob Flaws is one of those who takes this position, if I understand various blog posts that he has made on this topic he is saying that people have made too much of the conceptual difference between CCM and TCM. I recently discovered Herr Freuhauf’s writings and would have to disagree with Bob and agree with you.
As a recent graduate of a TCM Medical college, I gradually (in the last few years) became aware of major omissions in the coverage of classical Chinese medical theory and gaps in the theory that were taught which inspired me to search, on my own, for the missing pieces. That search lead directly to CCM and writings such as those by van Nghi. Most unfortunately, van Nghi’s writings seem to be under the control of an institute and a school thus blocking wider dissemination and it becomes necessary to do a hunt across the web and in different languages to acquire the hard to find texts and seminars of van Nghi and Dzung, his protoge’.
My search for a reasonable intro to Classical Chinese language led straight to Richard Goodman’s wonderful introductory books, which should be used as textbooks in every TCM college. I’m fairly certain that my college will be introducing such language training in the near future and I have urged them to adopt Goodman’s texts, though no decision has yet been made.