The interest that Chinese Medicine aroused in the Western world since the late '70s, its propagation and the following studies on its "scientific" significance, if on one hand promoted its development and allowed millions of people to benefit from it, on the other hand deprived it of its extraordinary cultural heritage. Once again, Western scientists stole an archaeological relic and brought it to a laboratory, overlooking the importance of the finding site.
Wrongfully identified with acupuncture, which represent only a small part of it, Chinese Medicine needs today a historical and cultural recovery. Not only for the sake of intellectual fairness, but also to know it better, and to understand its profound meaning.
It is almost impossible to try to understand the importance of far-eastern medical arts without investigating the ancient Chinese thought and penetrating a concept of body, balance and health quite different from the Western one; on the other hand, it is not easy to find one's way in the boundless ocean of a six thousand-year-old culture, that invented print and the binary system, used magnetism, excelled in hydrological engineering, built watertight compartment ships, and studied seismology. This is why any approach to the study and understanding of Chinese medical science cannot (and should not!) be but multidisciplinary and integrated.
When we discover these therapeutic methods, we tend to forget the cultural obligation they have towards a perspective of the world and universe which, far from being a key to a few limited areas of the human knowledge, actually directed all kinds of investigation. In the end, we forget how much medicine owes to ancient Chinese thought, and to Taoism in particular [1].
In the ancient Chinese view, the human body is like a country: there are mountains, rivers, villages and inhabitants; just like a state, it is governed by lords and officers. We find this typical Taoist perspective in the main text on medical theory, the Huangdi Neijing (the Classic of Medicine of the Yellow Emperor): “The heart is the prince who governs through Shen, the lungs are his officers and promulgate laws, the liver is a general who works out strategies…” [2].
Body functions are managed by administrators who govern (well or badly) like imperial officers do, and it is worth noticing that ancient texts use the character Guan, literally "officer", to indicate both meanings [3].
This concept takes us directly to a fundamental principle: man and environment are closely related, and all and any changes the latter undergoes bring necessary consequences for the former: “In hot regions people die young, while in cold places life is longer... a fertile land induces goodness... the central region gave birth to many wise men. This happens because [men] are an image of their breath [the environment], because everything belongs to its category” [4]. When human beings modify things around them, forcing or interrupting the man-environment circuit, imbalances will follow which affect the natural flow of universal changes: we find ourselves in front of an "ecologic" perspective par excellence, of an idea of humanity very far from that of the modern alien animal; in this environment men are not alone, but find themselves in continuous relationship with the surrounding world. This ancient symbolic view of the body is already reflected in the first chapters of the Chuang-tzu [5], which date back to the IV century b.C.
But if the relationship between internal and external, man and environment is by nature inseparable and eternal, another fundamental principle emerges: a dynamic vision of reality. All that exists undergoes continuous transformations and is subject to the constant flow of the Qi [6], the vivifying moving force that expresses itself through Yin/Yang polarity, through rarefaction and condensation (but this is not all!) [7].
These concepts, so widely used in therapeutic practice as to become essential principles of the whole Chinese medical theory, give TCM (Traditional Chinese Medicine) some of its basic features. First of all, the idea of illness as it is conceived in Western medicine is absent here: there are only “clinical pictures”, and since every symptom must be evaluated in its context, such pictures may be used only after assessing a patient's biotype [8]. Then, since everything is thought of in terms of rarefaction and condensation of Qi, there is no dichotomy between res cogitans and res extensa, between mind and body, between organic function and psyche: we are in front of a psychosomatic and somatopsychic approach par excellence. In a very modern way, psychic disorders are considered able to affect the functionality of an organism, and they are recognized as the cause of its malfunction [9]. This is a completely new vision, that has reached the Western world only in the last years, thanks to psycho-neuro-endocrino-immunologic studies [10] (PNEI).
But if human beings are in constant relationship with the outside world, if they are affected by changes and transformations caused by the dynamic flow of the Qi, and feel emotions which, if excessive, may lead to functional disorders [11], then what is illness in the last analysis? How can we cure it?
Many know the old story according to which, in ancient China, the family physician was dismissed if one of the family members fell ill; this happened because in its traditional form, medicine was mainly preventive. The Huang Di Nei Jing [12] states it explicitly: “Ancient men followed Yin and Yang… They ate with moderation, slet regularly, were never too fatigued. This is why spirit and body where integral and complete, and they lived all the years they were meant to live and died at over a hundred years old...”
Once again, the leitmotiv is harmony between men and environment, and the idea of a life lived according to the rhythm of the universe and the flow of the Qi that regulates it. On this basis, illness is considered a deviation from the natural flow of the Qi which, as it regulates the functioning of the universe, also governs bodily functions. This vision is often described in terms of macrocosm (universe) and microcosm (man), but it must be noted that, though this comparison is effective, the ancient texts make no mention of it.
If somebody's balance is already altered and prevention cannot be applied, the physician can diagnose a disease (conceived as a syndrome [13]) using eight codified systems (Ba Gang) [14]. The physician may also employ two extremely important semeiotic methods, namely glossoscopy (tongue examination) and sphygmic diagnostics (radial pulse examination): the latter appears in texts dating back to the III century b.C. as the result of a long, slow development, and requires years of study and observation [15]. Diagnosis is followed by a therapeutic approach that may employ methods that, in spite of their different forms and origins, all pursuit the same goal to the same extent: to re-establish normal circulation of the Qi within the organism, to restore the circuit that was interrupted and to protect the body from external pathogenic agents.
The birth of acupuncture, the most popular of these methods (but only in the Western world!), seems to be but the final stage of a development that went on for thousands of years, and originated from techniques that have nothing to do with the insertion of needles for therapeutic purposes. Practices like Daoyin [16], Tuina [17], moxibustion [18] and the administration of medicinal plants prepared after the principles of decoction [19] were the ancestors, still alive and active, not only of this famous practice, but of the whole theoretical and methodic systematization that emerged after observation and convalidation of empirical data. For instance, the theory of the "energetic channels", worked out to explain how Qi circulates in the organism, probably derived from the observation of Daoyin practice, which seems to allow the practitioner to feel it flowing.
As these basic information highlight, it is difficult for Westerners to enter such a manifold and complex culture, where even the Chinese cannot easily navigate; moreover, concepts so different from our own in terms of health, medicine and research methods, lead Enlightnement scientism to reject all that could not be proved in a laboratory with our research criteria. Nevertheless, many years have gone by since Voltaire said: “Among them, the theory of medicine is nothing but ignorance and error; however, Chinese physicians show some practical talent…” [20], and we will hopefully be able to study and integrate a knowledge which has been the wealth of one third of humanity for thousands years from a perspective that won't subject it to certainties we have worked out and established since the Age of Enlightenment. Only if we work with this in mind, we might be able to fully understand the meaning of a notion of health and illness that, thousands of years after its birth and a few centuries after its discovery, continues to fascinate and astonish the “Barbarians coming from the West” [21].
NOTES
1 To read more about the history of Taoism, see Fung Yu-Lan, Storia della Filosofia Cinese, Mondatori, 1975, pp. 52-57,77-94. Chow Yi-Ching, La Filosofia Cinese, Garzanti, Milano. Marcel Granet, Il Pensiero Cinese, Adelphi Milano, 1971.
2 Huang-ti Nei-ching Su-wen 8, p.1°-b
3 Chuang-tsu, 14, p. 507.
4 Huai-nan tsu, 4.
5 This is a collection of several Taoist texts dating from different periods, compiled in the III century A.D. by Guo Xiang.
6 Uncorrectly translated as “energy”, this ideogram has a much more complex and exhaustive meaning. In this context we may define it as "vital breath”.
7 To read more about the concept of “Qi”, see Giulia Boschi, Medicina Cinese: la radice e i fiori, 2003, Milano Editrice Ambrosiana, cap.8.
8 A basic text for the study of TCM is Giovanni Maciocia, I fondamenti della Medicina Tradizionale Cinese, Milano ,1996, Editrice Ambrosiana.
9 See Yves Raquena, Agopuntura e Psicologia, Palermo, 1989, Ipsa.
10 Gugliemo Lauro, Ottavio Iommelli, Il modello della PNEI, La mandorla, anno IV, n. 15, sett. 2001, www agopuntura.org/rivista.
11 Emotions are neither positive nor negative, they simply exist; but when they are in excess, or one is predominant, they may cause an imbalance.
12 The origin and date of this text are controversial; it is a collection of writings coming from different schools and belonging to different periods. The most ancient part may be dated back to the years between 400 b.C. and 260 A.D. The whole work was compiled around the III century A.D.
13 This basic concept follows the typical method of Chinese naturalism, which investigates not only causes but also relationships.
14 This systemization is very late and appears only partially in the Neijing. These rules are based on the four couples of opposed elements: yin-yang, hot-cold, outside-inside, empty-full.
15 Tradition includes 28 types of pulse.
16 Literally “guide and lead”, it refers to respiratory, meditational and physical exercises aimed atdirecting and modulating the flow of Qi within one's body.
17 Traditional Chinese Massage; sophisticated and complex, it has a wide range of therapeutic indications.
18 This technique includes the use of artemisia cigars that are lighted and used to "heat" specific areas that require treatment.
19 Decoction is the most ancient method for the administration of medicinal plants. It probably originated from sciamanic rituals.
20 See D. and M.J. Hoizey, Histoire de la médecine chinoise, Parigi, Payot 1988, p.180.
21 This is how the Chinese called Westerners, that were considered rough and ignorant. The culturalist and ethnocentric position of a country that defines itself “zhongguo” (the Middle Kingdom) are well known and documented.
|
