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Chinese Medicine: Getting a Clue (Part 1)

After three years of:

  • Our Chinese friends blaming everything from sore throats to acne on their bodies’ ‘fire’ being too hot,
  • Discovering that they’re afraid to drink chilled water,
  • Walking past acupuncture and reflexology charts in storefronts,
  • Coming across medicine for apparently common ailments that I’d never heard of (like “receiving wind” and getting an upset stomach from going out in the cold?)
  • Noticing how therapies like fire-cupping are normal and popular but being unable to imagine how giant hickeys could possibly be good for you,
  • etc.,

…I’ve decided I want a basic understanding of Chinese medicine so I can at least have a clue about where our Chinese friends are coming from.

They all believe that traditional Chinese medicine and treatment works more or less, though they sometimes don’t believe in the theories behind it. One Mainlander I know in Vancouver says the explanations are nonsense, but that years of observation have led to some effective treatments. A friend in Taipei let us observe his visit to a traditional Chinese doctor and gave us a full debriefing afterward; he uses both Western and Chinese medicine.

I was running some questions past some medical friends while writing a “Fire-Cupping & Guasha for Dummies” article, and one of them put me on to Ted Kaptchuk’s The Web That Has No Weaver: Understanding Chinese Medicine. This is supposedly the classic explain-Chinese-medicine-to-Westerners book, and I’ve started reading it.

I’m a couple chapters in and it’s definitely illuminating, but it’s not what I’d call an easy read. It’s not poorly written or too academic, but the author is trying to communicate concepts that are difficult to express outside of Chinese languages and worldview, especially using English within a Western worldview. Depending on the presentation, Chinese medical theory in English can either sound like total nonsense, or it can seem too easily understood and just look like a trendy, exotic branch of Western medicine. Neither does justice to Chinese medicine; they both miss the spirit of it.

For Westerners to “get” Chinese medicine, we have to think outside of our thought categories. But that’s not easy, because anything outside our thought categories naturally sounds like nonsense.

Our background in intercultural studies makes us sensitive to the cross-cultural dynamic where ideas can easily become “lost in translation,” and Kaptchuk seems to appreciate that as well. He starts his 500-plus page introduction to Chinese medicine by discussing basic Chinese philosophy and general worldview fundamentals.

Chinese and Western medicine are different at their respective roots, and highlighting points of contrast is helpful, as is explaining how Western medicine would interpret what Chinese medicine does in a given situation. Kaptchuk starts this process early on in Weaver:

To Western medicine, understanding an illness means uncovering a distinct entity that is separate from the patient’s being; to Chinese medicine, understanding means perceiving the relationships among all the patient’s signs and symptoms in the context of his or her life [p.6].

A Chinese physician examining the same patient must discern a pattern of disharmony made up of the entire accumulation of symptoms and signs.*

*From a biomedical [Western] standpoint, the Chinese physician is assessing the patient’s specific and general physiological and psychological response to a disease entity [p.7].

I suspect that a decent understanding of Chinese medicine — for a layman, at least — is something “better caught than taught;” you absorb the meaning and understanding implicitly over time through exposure to the ideas and practices, rather than only by reading a well-categorized explicit explanation of what everything means and how everything is supposed to work. Chinese medical theory seems by its very nature to resist the kind of definition and clarity that Western medicine considers essential to the entire medical enterprise.

Particular body parts and fluids like kidneys or blood can’t even be translated directly across. Kaptchuk capitalizes words like “Blood” to indicate when he’s writing of them in the distinct Chinese medical sense. For example (p.53):

Obviously, the Blood of Chinese medical terminology is not the same as what the West calls blood. Although it is sometimes identifiable with the red fluid of biomedicine, its characteristics and functions are not so identifiable.

Blood moves primarily through the Blood Vessels, but also through the Meridians. Chinese medicine does not make a clear distinction between Blood Vessels and Meridians. The Chinese rarely concern themselves about precise inner physical locations — the Stomach Qi “goes upward,” or the Blood “circulates,” but it is seldom entirely clear what internal paths they travel or where, precisely, they go. The physical pathway is less important than the function. This tendency not to fix sites for things is contrary to the Western approach, but it is inevitable with Chinese medical theorizing, which emphasizes process over fixed entities.

As a Westerner I hear ‘Chinese medicine‘ and I’m automatically subconsciously expecting, assuming, and looking for all kinds of things, like chemicals and cells and body parts and discrete, well-defined categories. But Chinese medicine apparently doesn’t care so much about that stuff, at least not in the ways that Western medicine does. Maybe rather than hear ‘Chinese medicine‘ I ought to think ‘Chinese medicine.’ This is less about medicine and medical stuff in any sense that I’m familiar with, and more about Chinese culture and worldview. I’ll see how my impressions change as I continue reading.

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4 thoughts on “Chinese Medicine: Getting a Clue (Part 1)”

  1. Chinese medication is magic. Once when I was little I had a phyma on my eyelid. It grew again after I had a surgery to cut it. After two or three times of surgery, my mom took me for Chinese medication and have acupuncture on my ears and it disappears gradually and never grow again! Most Chinese believe firmly in Chinese medication and medicine although It’s very difficult to find a good Chinese medicine doctor (and they can be very expensive).

  2. This whole “I can’t explain it in English” thing is exactly what my Chinese-American friend says to me when we have our traditional “Chinese medicine isn’t real science” debate.

    It’s not that I want to shoot down anything under the label Chinese medicine, but if it works then it should be scientifically verifiable.

    Keep up the Chinese medicine investigation, hopefully you can get the bottom of it.

  3. Chinese medicine isn’t science, or scientific. But what does that mean? Some people say it to mean that “Chinese medicine is just anachronistic crock” — that’s an overly simplistic blanket statement, and that kind of meaning is what rubs our Chinese friends’ fur the wrong way (how much of it really ultimately is crock, or placebo, I don’t know). But technically speaking, Chinese medicine isn’t based on or developed by science and doesn’t even try to be scientific. That’s not a diss; that’s just the nature of Chinese medicine, which developed on its own separate from the development of science. If it were scientific, it would be one of the greatest historical coincidences ever.

    The author explains that the concepts and terminology of Chinese medicine are more like a model or grammar for organizing their observations, as if the technical details weren’t ever really the point. Here’s a partial quote from the author (from my upcoming ‘Part 2’ post on Chinese medicine):

    Any attempt to “prove” these organizing principles may be a non sequitur and futile. The represent a worldview that is prior to argument and proof. They may just be another point of departure for approaching the phenomenal world. These ideas are cultural and speculative constructs that provide framework and direction [p.42].

    Sure, people try to use science to validate Chinese medicine, but that’s a whole nother deal.

    Your friend is right that “it can’t be explained in English” — at least in the sense that it can’t be explained within a Western worldview framework. It’s total nonsense when judged according to Western terms. But to hear Chinese medicine on its own terms (to understand it, though not necessarily believe it) requires us to think outside of our own worldview.

    One thing that’s hard for Westerners, due to our own cultural blind spots, is that we have a hard time comprehending the idea “it’s not scientific” with anything approaching fairness and respect for the unscientific thing under consideration. We have a hard time imagining something unscientific that isn’t illogical, primitive, childish, or simply unimportant. In many ways we’re religious about science, and inappropriately so.

    I’m not meaning to be an apologist for Chinese medicine. Actually, I won’t be surprised at all if one day they run real scientific double-blind tests on it and discover that most of it really is useless beyond a placebo effect. I’m only studying it to better understand the world my Chinese friends are coming from.

  4. There is a whole school of scientific research being developed around scientifically verifying/explaining chinese medicine. It’s still in its very infant stages, but there are some interesting results. Maybe later, I can dig up some resources. However, there’s a lot of critics to the movement as well. Some are just critical of trying to science-fy traditional medicine, and think that the spirit of the art and thus its effectiveness would be lost. Others are concerned with the specific methods of the research, since Chinese medicine revolves around “organs” working together, and drug cocktails working together, whereas current scientific methods require that components be separated out, identified, and explained individually. At any rate, looking forward to future discussions about the topic.

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