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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