Introduction to Chinese Medicine

Traditional Chinese medicine has an essential role to play in our healthcare system for two major reasons:

1. It provides the best, most user-friendly explanation of what 'being healthy' actually is. (Part One)
2. It provides simple, straightforward knowledge and techniques for acquiring, regaining and maintaining that health.
   (Part Two)

Part One

It Takes Two to Play

According to Chinese medicine, being healthy is living in harmony with 'the way things are.' In English we would say 'in harmony with the natural order.' But what is the natural order?

In the deepest and most meaningful way, the natural order is the balance between activity and receptivity. Existence, life, health can all be described and explained by the interplay of these two complementary opposites. Although this description of the nature of reality may seem poetic and unscientific, it is completely compatible with the fundamental scientific concepts of energy and matter.

This duality is evident in the structures and activities of living beings. Living beings, like humans, need to nourish and maintain a physical body. We also need to be able to interact with the world we find ourselves in.

Two complementary abilities are required to accomplish these tasks. On the one hand we need to be able to transform the resources that we find in the natural world into bone, muscle, brain, blood, blood sugar, fat. On the other hand we need to be able to acquire food, water, air by exposing ourselves to other beings, forces and material objects. So we can describe an inner process focused on maintaining the immediate needs of being alive, such as breathing, digesting and energy production. And we can describe the outer body as it engages the world around us.

This division between inner and outer is recognized in conventional medicine in the use of such terms as 'internal organs' and 'internal medicine.' In Chinese medicine this division is central to an understanding of (human) nature and health.

The difference and interdependence of the internal task of maintaining essential life processes and the external task of movement and manipulation are built into the basic fabric of our bodies. One of the best ways to appreciate this difference is by examining the human nervous system. Anatomists have long been aware that the nervous system is divided into two major subdivisions.

One of the divisions is called the autonomic nervous system. In evolutionary terms it is older and for that reason is sometimes referred to as the 'old nervous system.' Its job is primarily to monitor and direct the transformative activities of the body such as digestion, blood flow, growth, detoxification, metabolism, etc. For the most part this older nervous system operates without conscious control.

The other division, the 'new nervous system,' is called the voluntary nervous system. As the name suggests this system allows us to exercise control. What is it that we control? Basically, our voluntary nervous system allows us to control what we do, i.e. how we move. Although some of the activities of the voluntary nervous system are unconscious, the major function of that system is to choose and implement movement. [For this reason the challenge of deciding what to do, i.e. how we move, is the origin of awareness, including self-awareness.]

Internal Transformation, five phases

One of the two essential tasks of living beings, including humans, is to transform natural resources, e.g. food and air into our own physical body and fuel. The ancient Chinese sages found five phases through which this transformation takes place: Taking in/letting go, processing, storage, distribution and expression. As we shall see this five-phased functional description of our internal experience has profound consequences to our understanding of our selves and our health.

These five processes move in an orderly fashion from more external to deep within the body and back to more external. The following explanation will clarify this.

In order to meet our physical needs we must take in resources from outside of our bodies. This is accomplished by breathing and eating. Both activities create a bi product that must be eliminated. These activities are accomplished by the trachea, lungs and esophagus, located in the thoracic cavity. The lungs in particular are identified with this phase.

The second phase of resource transformation is processing: transforming food, air and water into usable form and separating that from unusable waste. This process occurs primarily in the upper abdomen and is accomplished by the pancreas, small intestine, gallbladder and large intestine. The liver plays a role in this phase as well.

We can see here that function is more important in organizing Chinese medical thinking than the physical structure of the particular organs. For some reason this function has been associated with the spleen. While the spleen as an organ is involved with reprocessing old red blood cells and making cells for the immune system, it is not the primary locus of digestion. This is however should not be considered an error, but rather an example of the central importance of function in Chinese medical understanding.

From the processing organs located in the upper abdomen, the purified product is transferred to the lower abdomen for storage. The location of the lower abdomen as the site of energy storage does not make sense from the perspective of conventional physiology. Energy is stored as fat throughout the body and as glycogen in the liver and muscles.

But the identification of the lower abdomen as the site of energy reserves is based, like most of the insights of Chinese medicine, on the experience of using energy and observing where that reserve feels like it comes from. What is experienced as stored energy is not glycogen or fat. It is what the Chinese call 'qi.' The practice of the Chinese martial arts, which have the same theoretical foundation as Chinese medicine, is in large part learning to concentrate 'qi' in and direct it from the lower abdomen. The rightness of this identification is apparent to anyone who has ever practiced qi gong or tai ji.

The function of energy storage is associated with the kidneys but also includes the adrenal glands and the connective tissue containing the 'gut.'

When required, energy (qi) stored in the 'kidneys' is distributed. The organ associated with this activity is the 'liver' through its association with the blood. This involves a return of the now transformed energy (qi) back through the upper abdomen to the' heart.'

The 'heart' is located in the thoracic cavity. Its function is to return the energy received from the external world as a new meaningful expression, the culmination of the transformative process which began with the inspiration of air. This also makes sense as the heart is the part of the body where we experience and determine what has worth.

Qi

Qi is a fundamental concept in Chinese thought. In order to appreciate the utility of Chinese medicine it is necessary to understand what is meant by qi (pronounced 'chee'). We can do this in two ways. First we can try to translate the word into an equivalent English word. This presents us with the difficulty of translating an idea from a culture with no known shared linguistic history with our own.

'Qi' is often translated 'vital force' or 'life force.' The use of the word 'force' implies that the essential nature of life is power, the potential of living beings to change their surroundings. The capacity to perform work is more important than any specific example of work. From this perspective the potential to do something is more descriptive of human nature than what someone actually does. 'What man can conceive, man can achieve.'

But qi is not a 'force.' It is the means by which the actual doing of the task gets done. The 'doing' has an observable nature. Essential to this nature is (the flow of) qi. Qi flowing is 'how things get done.'

An example will make this clearer. What makes a tent? The purpose of a tent is to create a refuge from the weather typically using light-weight materials that can be transported. So a tent is made of some kind of fabric and something to support that fabric. But, if you have ever tried to set up a tent you know, what really allows a tent to be a tent, i.e. to do its job, is tension. That's why it's called a 'tent.'

Similarly what makes a basketball player? A basketball player (usually) has to be tall, able to shoot, dribble, rebound etc. But what really defines a basketball player is the intention to play basketball. When that intention infuses his or her every move during a game, we call that 'being in the zone.' The 'ten-' in tension and the '-ten-' in intention are essentially the same. That 'ten' is what is meant by 'qi.'

Admittedly there is a difference in the two examples. The tension of the tent maintains the structure of the shelter. The intention of the ballplayer both directs his movement and maintains his/her readiness for action.

The difference between water and money as a way of understanding qi

The challenge to understanding qi is that it pervades everything that is. Usually we can get an idea of something by comparing its presence and absence. One way we can gain an understanding of qi is by comparing water and money.

First the similarities. Both flow. In both cases this flow obeys certain 'laws.' Water 'obeys' the law of gravity in combination with the physical laws that determine porosity of soil, temperature of evaporation, condensation and freezing point, etc. Money 'obeys' the law of supply and demand. In a capitalist economy, the flow of money is certainly 'how things get done,' at least superficially. And it would be fair to say that water is the currency of life for every instance of life that we know of.

Part Two

To be continued