Integrated Chinese Medicine
Traditional East Asian Medicine is a coherent body of knowledge. There are differing styles and approaches, particularly in regard to acupuncture, but they are all, at least potentially, part of one complete system. Ultimately all Chinese natural philosophy is based upon a remarkably consistent philosophy, numerology and cosmology; and yet it is not homogenous. In the modern world and particularly in the West we have a great deal of difficulty in reconciling the apparent contradictions. How far these apparent contradictions were reconciled in the minds of the ancients is a question that is often missunderstood. There is a fundamental challenge that may be a good starting point for understanding how these schools and sects arise.
Apparent contradiction and inconsistency is tolerated in East Asian thought. For example The Dao De Jing (Tao Te Ching) famously says, "the Dao (Tao) that can be spoken of is not the constant Dao (Tao)". This has not stopped many speaking or writing of the Dao; but particularly in the practical applications of Chinese thought we have to put these ideas into words. Alan Watts in 'Tao, The Watercourse Way' talks about this dilemma. According to Alan Watts, the poet Chu-I wrote:
Those who speak know nothing.
Those who know keep silence.
These words were spoken by Lao Tzu.
But if we are to believe that Lao Tzu,
Was himself one who knew,
How comes it that he wrote a book
Of five thousand words?
This is the same dilemma that we face in all the practical applications of Chinese natural philosophy, including traditional East Asian medicine. The Chinese especially have always been considered very pragmatic and seemed to have no problem with the transition from the philosophical to the practical. Recognizing that these two are ultimately different. As the Tao Te Ching says:
Ever desireless, one can see the mystery.
Ever desiring, one can see the manifestations.
There is a tendency to a dichotomy within Eastern thought; at worst this seems to become 'lip service' to the principles and philosophy, and a gulf between the philosophical and practical. I suggest that the philosophical and the practical can be brought closer together. One way of understanding the gulf between so called Classical Chinese Medicine and Traditional Chinese Medicine is to see CCM as intending to follow more strongly the idealism of the Classics, and modern TCM as more practical and pragmatic.
I use the word 'intending' because we live in a dualistic world we cannot completely attain the ideal; wholistic is an aim, but we necessarily have to exist in the dualistic world. Our language is based in the dualism. The Heart Sutra of Buddhism has an expression. "Going on beyond, always becoming Buddha". The idea here is that CCM is a journey that we are on and ideal we are aiming for but that we cannot arrive at in the mundane world.
Daoism (Taoism) has been described in terms that contain a contradiction 'dualistic monism', it contains a fundamental holistic view of the universe and an understanding of the universe that is based on the apparent contradiction of dualistic principles of Yin and Yang. The reconciliation of these two viewpoints has been symbolized in esoteric thought as 'squaring the circle'; the square representing the 'four square' Earth, the circle representing the unitary Heaven. Similarly in Chinese numerology the odd numbers are Heavenly and the even numbers Earthly. East Asian science uses many models that are developments of the yin/yang principles, and because some of these are based upon odd numbers and some even, they can not be made totally congruent. In the West we are used to assuming that we have to choose between two theories, or systems or arrive at a synthesis; just as Western scientists are at present trying to reconcile relativity and quantum theories into a 'grand unified theory'. The Eastern system allows that differing viewpoints cannot be completely reconciled, and yet both can be true. In other words to make a 'square peg fit a round hole' perfectly would only be achieved by some damage to one or other. The Chinese system of knowledge has been described as syncretic, from this viewpoint, it may not be possible to reach a 'grand unified theory. In Chinese medicine a model based upon Two (Yin & Yang), and Five (Elements/Phases) are both seen as correct, and yet cannot be entirely congruent. From the number two the Earthly world's complexity extends in symmetrical way: Four Emblems (Seasons), Six (paired) Channels, Eight Trigrams.
East Asian thought is often described as seemingly lacking in logic, critical thinking and dialectics. As if it is simply an accumulation of models. Richard Nisbett in The Geography and Thought and Amir D. Aczel, in Finding Zero: A Mathematicians’ Odyssey to Uncover the Origin of Numbers both describe the different form of critical thinking in East Asian thought. Aczel quotes Chapter 18 Verse 8 of the Mulamadhyamakakarika bu Nagarjuna in the second centry CE:
Anything is either true,
Or not true,
Or, both true and not true,
Or neither true or not true.
This is the Lord Buddha’s teaching.
Perplexing as these statements seem at first, Aczel explains them very clearly with a few examples. It seems that most of our mathematics is based upon Aristotles categories or ‘a’ or ‘not-a’ and thus there is a principle called the ‘excluded middle’. However, there have been mathematicians who have included these extra categories. One everyday example is that if one puts a little bit of sugar in ones coffe one might describe it as ‘not not-sweet’. And indeed in English we might say of someone that they were ‘not un-attractive’. Aczel says that if we do indeed develop quantum computers they will use these extra logic positions and so they are not weird philosophical ideas removed from the real world either. Stephen Hawking in The Grand Design describes modern science as also moving towards a Multiple Model Theory: "It could be that the physicists’ traditional expectations of a single theory of nature is untenable, and there exists no single formulation. It might be that to describe the universe, we have to employ different theories in different situations. Each theory may have its own version of reality, but according to model-dependent realism, that is acceptable so long as the theories agree in their predictions whenever they overlap, that is, whenever they can both be applied." (68-9) I believe that this is implicit in the system of critical thinking of East Asian thought. What East Asian thought is not but is commonly mistaken for is extreme pluralism and relativism.
Without the rigor of the East Asian system of logic and Critical Thinking the medicine has tended to become a main dichotomy and a great variety of approaches, potentially with every individual having their own perspective and understanding. Whcih is not to say that there is one dogmatic correct model, pluralims up to a point is a strength of our age. However, extreme pluralism and relativism is undermining the foundations.
About the Author
I originally trained to practice Five Element acupuncture with J.R. Worsley. I studied widely, especially TCM texts, and more recently as Clinical Director of the Jung Tao School of Classical Chinese Medicine I have been exposed to other non-TCM teachings. I have not found anything yet that, however different it may appear at first sight, can not be reconciled. I would like to mention that I am not a sinologist, my study of Chinese characters is mainly with the works of Claude Larre on one side of me, and various resources on Chinese characters and etymology on the other. I see this exploration and integration of the traditions of acupuncture as a 'work in progress', and I would especially recommend for reading ' Five Element Constitutional Acupuncture', the work of John & Angela Hicks and Peter Mole founders of the College of Integrated Chinese Medicine in Reading UK.
The following are a series of discussions about the various viewpoints found within Chinese Medicine. The numerology and cosmology contained therein is an overview of a more comprehensive work that I am engaged in at present. This is my own understanding of these subjects and how the apparent contradictions may be reconciled - as such I could have titled this page "towards an integrated Chinese medicine".