Materialist Thinking in Chinese Medicine

Founders note: This post is from a new contributor, Jonathan Edwards, a student of Chinese medicine at NCNM and man of unbridled herbal enthusiasm.  He runs a fantastic blog, particularly interesting to the herb nerds among us, over at Roots of Nourishment.  Check him out – and make sure to leave him comments so he’ll be so stimulated by the discussion, he can’t help but contribute again!

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Chinese medicine pop quiz: what do yin, yang, and qi have in common? I’ll give you a couple minutes.

All right, I admit–it was a trick question. Because from my point of view, the only thing yin, yang, and qi share is that they don’t exist. What?? Absurd! These are some of our most fundamental concepts, after all. But before you brand me as a heretic, allow me to make my case.

Does imagination exist? Does ephemerality? Of course they do–in a sense. In another sense, they don’t. There’s no “there” there. Nothing to point to, nothing to measure or to catch in the act. These are useful concepts, but let’s not let the fact that they are nouns dupe us into thinking they have tangible referents. The philosopher Ludwig Wittgenstein pointed this out in the mid 20th Century: that even as it allows for communication and conceptual thinking, the structure of our language traps us in a web of our own devising.

We name abstract ideas so as to pin them down and be able to talk about them, then convince ourselves these concepts have an objective existence. It’s a sort of circular reasoning.

I know only the smallest snippets of Chinese, but I would venture that the ancient Chinese, especially, had less of an issue here. The classical Chinese language’s fluidity between nouns and verbs must have instilled a conceptual fluidity as well. The thinking in the Neijing, for instance, is more associative than both English and modern Mandarin, and less materialistic. The ancients have bequeathed to us the inestimable treasure of a time-based medicine that focuses on change and transformation instead of fixating, x-ray like, on one’s physical state at a particular moment in time.  We risk throwing it away if we see this emphasis on change as a liability and insist on pinning everything down to a material form.

So what about yin and yang and qi? I don’t deny that these are essential concepts for us, and highly practical ones. That doesn’t mean that there’s such a thing as yin or yang, or indeed qi. They’re not things; these terms are best understood as descriptions of processes.

They have as much to do with time as with space.

Maybe this seems like pedantic hair-splitting. But I’ve recently become aware of just how much our unconscious materialist conceptions influence our understanding and, ultimately, our practice of the medicine. TCM talks constantly of “yin deficiency,” “yang deficiency,” and “qi deficiency.” I do not aim to ridicule these notions, as no doubt they can be useful clinically. But it’s worth considering what we’re really talking about. These terms can easily foster the image of the patient as a vehicle with separate tanks for yin, yang, and qi.

In this metaphor, the physician becomes little more than a technician, topping up whatever fluid is looking a little low. This picture is especially absurd when it comes to yang and qi, as these terms refer to specifically to immaterial processes. Yin can be understood as form, yang as function; in modern terms we might look to our metabolism and body temperature, what the Ayurvedic tradition calls our “digestive fire” (agni) as manifestations of yang. Seen this way, our yang–our level of vital warmth–can indeed by deficient.

But yang is not a fluid to be topped off, a tank that needs filling. Simply giving yang-tonifying herbs may not do the trick, since healthy yang relates to the functionality of the body as a whole. Perhaps we should hear the “yang” in “yang tonic” as an adjective: these are tonic herbs of a yang sort, as opposed herbs that tonify the yang.

Qi is in some ways a more difficult concept–and a topic for another article.

Suffice it to say that we might start paying more attention to the quality of the qi and less to its quantity. A diagnosis of “qi deficiency” should alert us to qualitative dysfunction at the level of the zang or the channels, not cause us to search for some way to “boost” the qi without taking care of the underlying disharmony. (The Nei Jing gets much mileage out of the word tiao, to tune or harmonize.) When obstructions are removed, the qi will flow. Each of us has the potential to serve as a conduit for as much qi as we could possibly need; my feeling is that the problem is never as simple as “there is not enough qi to go around.”

Analogous points can be made for the five phases as well. Calling them “phases” rather than “elements” helps remind us that they are steps of a cyclical process. and as such cannot themselves be “excessive” or “deficient.” I would go as far as to propose that we rename wood, fire, earth, metal and water “sprouting,” “flourishing,” “pivoting,” “gathering” and “storing.”

No one is likely to start talking about “sprouting deficiency!”

To close, most of the materialism so rampant in Chinese medicine is not the result of any deliberate ideological stand, just a by-product of our everyday, materialism-infused conceptions. This makes the situation more difficult to deal with, as it’s bound up with the very structure of our language and thinking. But re-examining our Chinese medical terminology offers us a starting point for moving closer to the roots of the medicine.



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About Jonathan Edwards

I eventually found my way to Portland and NCNM’s Classical Chinese Medicine program and am now happily settled into the world of the 5 phases and 6 conformations. Alongside my focus on Shanghan Lun herbalism and Japanese meridian therapy, I continues to immerse myself in Western herbal traditions and mysticism, with a recent focus in Afro-Brazilian religion and plant spirit medicine. Learn more about Jonathan

View all posts by Jonathan Edwards - Website: http://www.rootsofnourishment.com

Mauricio says:
09/27/2012

Nice article, an excellent debut, and a wonderful opportunity for thinking about these central concepts. However, i would like to split some hairs with you, if you’ll bear with me.

I don’t think that it is accurate to just say that yin, yang, and qi “do not exist”, because it belies the same kind of materialistic thinking that you’re trying to veer your readers away from. Moreover, it invites other, more insidious, materialistic notions to the discussion. Chinese Medicine is constantly under attack from the hard-liner “science” camp, who have a field day waving away Chinese medicine as New Age balderash precisely by arguing that yin, yang, and qi “do not exist”. Granted, they come from a much different angle than you are in your article, but the net result is the same.

I think that the elusive nature of these (and other) concepts in Chinese Medicine is the fact that they refer to relationships, rather than “objects”. However, relationships between things do exist, and are tangible, after a fashion. The ancients who wrote the tracts that became the Neijing were trying to describe relationships and processes they observed happening in the body; not abstract ideas or made-up concepts.

yinyang (one word, there is a reason for this) refers to a universal standard of quality that describes the relationship between two opposing and complementary parts of one whole. It is a relational concept, just like “hot” or “cold”. When we say that something is yang, the next logical question should be “compared to what?” Same as with cold or hot, light and dark, etc. One cannot (or rather, should not) speak of yang without speaking of yin, and then certainly not without answering the question, “the yang and the yin of what?”

The same goes for qi. qi is a concept that refers to the relationship created by the interaction between two things. “Between Heaven and Earth is qi and all its interactions”. The Chinese sage who wrote that passage of the Daodejing wasn’t being metaphorical… he was attempting to express, in succinct language, the unifying nature of all the processes in the world that he could see. Abstract thinking? You betcha. Nonexistent? Hardly. Similar to yinyang, when someone talks about the qi of something, my next question is “in relationship to what?”

In terms of the body, qi, yin, and yang refer to specific aspects of the processes and relationships that happen within us. yang is frequently shorthand for “function”, and yin for “substance”, but this is just Western (materialistic?) reductionist thinking. When someone speaks of a yang deficiency, we are likely entitled to ask “compared to what?” Then what we’re talking about becomes significant and important. When talking about a surplus of qi, we also need to know what relationship are we talking about. Is it the relationship of this patient to the weather? Their lifestyle? What they ate last night? Their constant fighting with their boss? These are the kinds of thoughts and questions that we should be trying to answer, as clinicians, when dealing with our patients. We are talking about the way we interact, process, and move through life; calling it qi reminds us that we recognize the universal quality of relationship: creating connections between things that allow them to exist.

I agree with you that the risk of thinking that we have “tanks” of yin and yang and qi that need filling or emptying is real: I know many people that think in this way, superimposing a crude grid of abstract concepts onto people’s conditions. However, I would invite you to go deeper and see these concepts as more than mere intellectual constructs. They are the finger, pointing at the moon, yet they’re also potentially a paradigm shift that allows us to truly see deeper into the phenomena of the body.

KYL

Reply
09/27/2012

Thanks for the thoughtful, articulate, and insightful comment, Mauricio.

I absolutely agree with your emphasis on relatedness/relationship; we never have yin without yang and vice versa. As I’m sure you picked up on, I don’t really believe that yin and yang (or rather, yinyang) don’t exist; I was being somewhat hyperbolic and perhaps a tad sensational. My opening challenge was a rhetorical maneuver designed to grab some attention for what could seem like a rather dry topic. But clearly the level of discourse on this site is too high for such cheap tricks, and I’ll keep that in mind in the future!

As for the ontology of Chinese medical concepts, I do feel that many of them fall into the same category as the abstract nouns I mentioned–or, from another perspective, as all ideas, physical objects, relationships, everything. Here I am influenced by the Mahayana Buddhist doctrine of the “two truths,” which maintains that everything both exists at a conventional level and fails to exist at an ultimate one. It’s no good to say that my chair doesn’t exist at all–what else am I sitting on?–but from an analytic perspective it is a dependent, relational, ever-changing phenomenon with no essential nature. I don’t mean to put yin and yang and qi on a level with physical objects; the point for me is rather that everything, including non ‘things,’ is like this, i.e. without self-nature. So the aim of my hyperbolic statement that “yin, yang, and qi don’t exist” was to jolt people out of our ingrained mental habit of essentializing, that is assuming there is something, some material (or even some immaterial but still independent nature) at the heart of phenomena, when all there is is relationship. I believe this is part of the genius, the true wisdom, of Chinese medicine–that it puts relationship and change at the heart of the story.

Reply
Kristy says:
12/31/2012

I quite enjoyed this article, especially the bit about “The Nei Jing gets much mileage out of the word tiao, to tune or harmonize”
I have been using this idea for quite some time in my acupuncture treatments, feeling the pulses and adjusting the needle *very* subtly to adjust the pulse where I want it. When my bf commented it was like I was tuning a guitar or a radio it was a “Eureka!” moment. That’s exactly what I am doing!
I also like what you said about “I would go as far as to propose that we rename wood, fire, earth, metal and water “sprouting,” “flourishing,” “pivoting,” “gathering” and “storing.”” Of course it won’t happen, but it really hits home the spirit of these concepts that we get so used to hearing used in these concrete ways as tho they are different kinds of food in the fridge.

Cheers,
Kristy

Reply
Eric Grey says:
12/31/2012

Agreed, Kristy, about the “flourishing” “pivoting” “gathering” and “storing.” Even just thinking about the concepts in this way can help rattle home some harder to grasp aspects. It certainly rejuvenates ME to think of them this way. Thanks for the great comment!

Reply

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