Observing the natural world
Chinese medicine (zhōng yī xué 中医学) developed during a time when people lived in intimate connection with the natural world. They used their five senses to observe the rhythms, patterns, cycles, and vibrations which govern the universe. They rose and retired with the sun, adapted to seasonal changes, and with every breath they felt the vital force, known as qì 氣, coarse through their bodies. They experienced the bright, expansive, enlivening, warming qualities of the rising sun, and the darkening, contracting, introspective, cooling qualities of dusk, embodying the characteristics of yáng 阳 and yīn 阴, respectively. The physicians, natural scientists, and philosophers of ancient China observed that the natural world is in a constant state of change governed by qì, the force of vitality and change which composes everything from dense physical matter to that without form, the shén 神 or spirit. Because human beings are also manifestations of qì, we are subject to the same laws of the universe. Human beings arise from nature, are nourished by nature, influenced by the cycles in nature, and subject to the laws of growth and change in nature. These daily, monthly, yearly cycles of change are described as the ebb and flow of yīn and yáng, and the cycle through the five phases. Chinese medicine encourages the maintenance of health through harmonizing one’s internal condition with the natural ebb and flow of yīn and yáng of the natural world.
In medicine, holism refers to treating the whole person, thereby taking the mental, emotional, and social factors into account, rather than focusing solely on the physical aspects of disease. In Chinese medicine, holism also recognizes that human beings compose a small part of the universe and are in intimate connection with the natural world. The universe is a macrocosm and human beings are a microcosm within it, a fractal of the whole which operates by the same organizing principles. Chinese medicine looks at the physical, mental, emotional, spiritual aspects of a human being, and the external environment which they are an extension of. Because feelings and emotions are at the core of the human experience, Chinese medicine recognizes them as a common cause of disease. Mind and body exist on a continuum, thereby intimately influencing one another. Bìng 病, the Chinese character for disease literally means “ailment of the Heart”, indicating a physical illness due to mental, emotional, or spiritual causes. Chinese medicine does not compartmentalize symptoms or aspects of a human being, instead the organ systems, body tissues, emotional states, acupuncture channels, and sensory orifices compose one vast network of relationships thereby influencing the state of health or dis-ease of each other. If you tug on one side of the web, the other side feels the stretch. If you shine light on one side of the web, it travels to illuminate the other side.
The acupuncture channels (jīng luò 经络) can be viewed as life-sustaining rivers which deliver qì for the body’s activities, and Blood (xuè 血) to nourish the tissues. Rivers flow wider and deeper in some areas, become shallower in others, and branch off into smaller capillary-like streams. The acupuncture channels are the same. The wider, deeper channels branch off into more superficial capillary-like channels, all flowing through and interconnecting the entire body. The flow of a river changes seasonally; during summer it may dry up and cease flowing, in the winter it may freeze and slow, and in the spring the melted snow may fill the riverbed resulting in a more forceful flow. These fluctuations of water flow are like the fluctuations of qì and Blood flowing through the acupuncture channels. Sometimes they are abundantly filled, flowing with ease, and other times the channels are depleted, leaving one susceptible to illness, pain, and fatigue. Sometimes these rivers of qì and Blood get blocked due to emotional stress, lifestyle habits, physical trauma, or external factors. These blockages are like twigs and leaves falling into a creek, hindering the free-flow of water, and sometimes blocking it altogether. In the body this impeded flow of qì and Blood results in physical and/or emotional pain. The areas where qì pools and accumulates along these internal rivers are the acupuncture points. Through needling these points, consuming herbs, and engaging with lifestyle practices, we clear blockages, redirect flow, and replenish these rivers so they may be free-flowing to foster a harmonious state of body and mind.
Yin and yang
The earliest reference to yīn and yáng is in the Yì Jīng 易经 (Book of Changes) in approximately 700 BCE. This theory discusses the two opposing forces in the universe which give rise to everything through their interaction; there is no light without dark, day without night, hot without cold. The physiological functions of the human body, as well as the occurrence of disease, are described due to the waxing and waning of yīn and yáng. Health is defined as a balanced state of yīn and yáng, and illness as an imbalanced state of yīn and yáng. A balanced state is not static but dynamically moving and changing, it is a balanced state of tensions. To maintain health, one should adapt to the ebb and flow of life. A willow tree survives the storm because it bends with the wind; water finds its way by flowing around stony obstacles.
In modern physiology we can see this dynamic balance being maintained by opposing forces such as the sympathetic and parasympathetic functions of the autonomic nervous system, muscle contraction and relaxation, estrogen and testosterone, coagulation and anticoagulation, left brain and right brain, analytical thinking and intuition, and so on. Maintaining a dynamic balance of opposing forces is a fundamental aspect of life activities.
the five phases
The theory of the five phases (wǔ xíng 五行) states that the natural world is composed of Fire (huǒ 火), Earth (tŭ 土), Metal (jīn 金), Water (shuǐ 水), and Wood (mù 木), each symbolizing five inherent states of the natural world. Changes in nature, human physiological functions, and pathological changes are all explained through the constant motion and interaction of these phases. They inform the physiological and pathological functioning of the body, guide diagnosis and treatment of disease, thereby making them a fundamental aspect of Chinese medical theory. These phases represent the five fundamental resonances of qì within the universe. Things with the same resonance will be related to each of the five phases. For example, the Fire phase co-resonates with the Heart and Small Intestine organs, the emotion of joy, the colour red, the summer season, the tongue as the sensory organ, and so on. They are all manifestations of the same energy, the same resonance, the same frequency. These phases are in a constant state of change, and mutually depend upon each other. For example, Fire burns to ash which gives rise to the Earth phase, but Fire is controlled by the Water phase so it does not burn excessively which would result in a pathological presentation in body and mind.
Visceral manifestations (zàng xiàng 藏象) refers to the internal organs which hide inside of the body, but their physiological and pathological states manifest on the outside of the body. The body is an integrated whole, connected through functional relationships encompassing bodily functions, emotional states, mental activities, tissues, sensory organs, as well as environmental influences. The human being is a spectrum of condensations of qì. The physical body represents qì aggregating into dense physical matter, and the emotional, mental and spiritual aspects being a dispersed aggregation of qì. In Chinese medicine the internal organs are more than their physical form, but also their energetic structures with corresponding emotions, tissues, sense organs, climates, colours, tastes, smells, the five phases, mental-spiritual states, and so on. While the internal organs all translate into the same names as Western anatomical organs, rarely is a Chinese medicine practitioner discussing your physical liver when they discuss a diagnosis of Liver qì stagnation (gān qì yù 肝气郁). The internal organs are categorized into yīn and yáng organs, also called zàngfǔ 脏腑. The yīn organs are deeper, solid, and store vital substances, whereas the yáng are hollow, filled and emptied, and correspond more to function. The yīn organs which govern structure are paired with the yáng organs which govern function. In this relationship they mutually cooperate to complete a function, and pathological changes of either organ can affect the other.
roots and branches
The first step in administering a Chinese medicine treatment is collecting information to reveal a diagnosis. This involves discussing ones physical, emotional, and mental states, as well as diet and lifestyle. It also includes feeling the radial pulse at the wrist, observing the tongue, and palpating the acupuncture channels. The collected information begins to paint a picture of the underlying disharmony an individual is experiencing. Chinese medicine does not see symptoms as separate entities, but as a constellation of manifestations of an underlying pattern. This is called root and branch; the underlying pattern is like the root of a tree, and the health of the root is represented in the branches which are the symptoms. Chinese medicine practitioners are a lot like gardeners; our primary concern is nurturing life. We assess the state of your roots and branches, how you are blossoming, how much sunlight and water you are getting, the state of the soil you are growing in, and any factors influencing the health of this soil. In most cases, treating the tree at the root by nourishing the soil or resolving pathogens will influence the health of the branches. In the words of inspirational speaker Alexander Den Heijer, “When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.” However, sometimes you prune the branches in autumn so the tree can grow better in the spring. Treatments in Chinese medicine are not ‘one-size-fits-all’, but are crafted for how an individual is presenting in the present moment.