Class Thread

As I have taught Chinese medicine over the last two decades, I have come to more deeply realize the importance of the Chinese cultural context that informs the thought and practice of our medicine. Without exposure to and understanding of the literate history and philosophy of the culture, Chinese medical theory and practice stand adrift; another series of techniques, orphaned from their roots and bereft of a recorded and winnowed understanding of life evident. This has led to students and many practitioners becoming inventive, and even hostile, to the deep considerations drawn, not from the well of human imagination, but from lived existential realities accumulated, noted, and codified over millennia of recorded Chinese history.

Exposure to this comprehensive worldview that is rooted in both existential survival and flourishing gives context to the clinician’s possibility as medicine is more than mere techniques for the docere, the scholar clinician. It is a way of seeing life. This view, this history, has been largely eradicated in education in China since Mao in favor of promoting European dialectical thought.

Chinese medicine swims in an understanding of life, the foundations of which, permeate the culture from historical politics and sociology, to warfare, music, literature, medicine, and much more. This understanding of processual Nature, both internal and external, has led to the study of patterns/principles, occurring regularly, and unfolding in time much like the unfolding of seasons. This is Nature/Tian/Dao as understood in historical literature. All the common ground of understanding historical Chinese culture roots here.

This class is a study and research of the literate history of this dynamic process, all rooted in the observations of how life works and how to develop a skillful and productive relationship with it. The scholarly literature, historical and modern, is noted in the class syllabus and reflects inquiry into this phenomenon.

Each patient visit reflects the commonality of something amiss in life. Internal system dysfunction is illness inviting attention. Unskillful engagement with the unavoidable field of Nature and its processes often creates or enhances illness. Understanding the principles underlying Nature’s processes as they apply to all life, both focus and field, gives the clinician a deeper potential and understanding of personal agency when treating patients.

To paraphrase Confucius, “Many problems are caused by a misunderstanding of how Nature works”.

This class is designed accordingly, to “point to” the developed thread of continuity that leads to this applied philosophy called Chinese medicine. This thread, these notions, from the earliest Shang divinations and through the millennia of dynasties has been winnowed through the great struggles of life and recorded by the Sages and scholars.

The class culminates in the Song dynasty’s search for enduring values and the intellectual amalgamation of Daoism, Confucianism, and Buddhism that will become known in the West as the Neo-Confucian movement. It becomes the educational model that will dominate education in Asia for the subsequent seven hundred years. The focus of this story, in this field, is this class design; an engaged and scholarly walk-through historical literature and its considerations for the doctoral scholar clinician.

And as designed, this class is reminiscent of Docere, the root of the modern English word “doctor” which means “teach”. It is this potential gift of understanding of life’s field and focus to patients that differentiates the technician from the doctor. And it is this thought and this thread that informs class assignments and discussions.

The development of thought and winnowing of notions to what becomes Neo-Confucian influence on TCM today is the foundational “Path of the Sage”, rooted in the personal cultivation and the “investigation of things”. This tradition, as advocated by Zhu Xi and the great thinkers of the Song/ Yuan dynasty, is where much of our current understanding of Chinese medicine roots. It is this investigation of both field and focus that became the foundation for the education of scholar clinicians when emperor Renzong decreed that doctors would need the training and literate competency of the Ru scholars.

Some highlights from the class outline pertinent to modern clinical practice:

Shang Dynasty

·       The Shang divinations of “bone cracking” was an inquiry “beyond the veil of the visible” to ask the dead, “those who are in charge”, for insights as to supportable and viable paths of decision-making. The value of experience in what was an agricultural society was immeasurable.

·       Disease came from the “curse” of an ancestor. Personal disasters, health concerns, poor harvest, and military misfortune were often all due to a curse from the ancestors who “disagreed” with the choices made. Curses were vested on those who do not follow in the “path” of elders, dissatisfying the dead, i.e., those who have experience and could “see” the whole story. Skillful decision-making, and its success, led to survival, both personal and communal.

·       Healers, the Wu shamans, sought to reintegrate the sufferer with the flow of continuity from the dead with gifts and dance to affect the winds of influence. The job of the living was “to nourish the dead” with gifts. The (important) dead were buried with slaves and wealth in the middle of a cross-shaped excavation that was dug on the north/ south axis. Such central placement of internment was considered the stillness between the directional four winds of influences and a place of stillness and peace. Grave sites from this era are full of bronzeware, much of it artistically and technologically sophisticated, gifts and appeasements to the dead.

·       Calendrical observations of seasons and their rhythmic patterned unfolding was time; not the abstract modern concept, but an unfolding corporal process. Direct (and “authentic/irreducible”) observations of Nature led to the understanding and codification of the essential binary logic of Yin/Yang. With the downfall of Shang and the rise of Zhou, these concrete and observable processes became the study, eventually replacing the “bone cracking” divinations of Shang, and codified as the Yi Jing, the Book of Changes.

Zhou dynasty

·       As the almost 1000-year Zhou dynasty developed, it has been said that the people shifted from ‘dancing for rain” to digging irrigation canals. There was a marked development in the study of nature with its processes, as opposed to the “magical thinking” of the Shang Wu shamans.

·       The study of Nature, its processes, and understanding the role of external influences effecting health grew. Initially, “demonic” influences were discussed as the cause of disease. External agencies, and their agendas, could penetrate (functioning systems) and pervert their viability. This understanding included all living beings and systems. Health cultivation was seen as avoiding demonic influences.

·       Over time, the development of thought from “demonic” influences causing disease and dysfunction coalesced with an understanding of “wind” and environmental influences causing disease. The “demon wind” concept came from an observation of the vector of wind as “change” and the penetration of external influences to a system. Notions of “Xie Qi”, or pernicious influences, developed. Either a very strong external force or an internal weakness or imbalance would result in external agendas affecting the processual integrity of internal systems. This led to disease, personal or communal. One would not want to “Invite Misfortune” with unskillful or arrogant behaviors in this dynamic field of influences.

·       Avoiding “wind” and the personal cultivation such as the Daoyin practices noted in the Mawangdui manuscripts of the early Han dynasty became the personal responsibility of the individual. Personal choices and behaviors could alter one’s destiny. Fate was no longer seen as random. One need not be a victim of circumstance, as one became responsible for their own fate through skillful engagement.

·       The Sages of the Zhou dynasty arose in the turbulent Spring and Autumn and Warring States period. Experiencing the unprecedented social chaos of constant warfare and personal strife, their observations of the foundational realities of survival and flourishing became the basis of future Chinese thought.

·       Laozi wrote of the Way of (Nature’s) Power and Virtue, the Dao De Jing, and its inexorable and patterned movements. Constant flux and process is at the root of all phenomena. Health and well-being were found in acquiescence, wuwei, to this Dao 道, a word that is both a noun and a verb. Skillful and productive “Waymaking” became the study of Yang Shen; nourishing life, the root of our medicine today.

·       Confucius wrote of the Morality of Heaven and the patterning of this in daily life, rooted in the family, the primordial unit of survival. The nurturing and education of children in the rites, the proper advocacies of life, were paramount to a healthy and stable society. Meritocracy, the value of individuals of cultivated moral character and competency, was advocated in a world formally dominated by nepotism and power advocacies.  This powerful notion was rooted in a belief the individual can largely affect their destiny through personal cultivation, despite circumstances, with healthy social mores contributing to personal health. Ren, the practice of humaneness and how to be a better human, was at the heart of this social philosophy.

Qin dynasty

·       Following the turbulence of the end of the Zhou dynasty, the short-lived state of Qin with its centralism and harsh legalism, rose and fell with Shi Huang Di, who (apparently) buried alive the many scholars who disagreed with him. He was eventually buried with the ten thousand terra-cotta warriors, destined to protect him from his many enemies.

·       The Great Wall was consolidated, defining the country from the “outside barbarians” those who did not share the deliberate and processual integrity of “China”.

·       Many thousand miles of roads were built, and currency and writing were standardized, allowing for the integration of the many peoples of the country.

Han dynasty

·       Following the trauma of Qin and its fall led by the peasant Liu Bang, the minimalist government encouraged reflection and healing.

·       The king of Huinan, Liu An, and his scholars, wrote the classic Huainanzi, a study of the “how” of life, how it hangs together, and “how” to develop a productive relationship with it. He was executed along with his family and cabinet of scholars for this.

·       The Mawangdui burial of Lady Dai and its subsequent discovery in the 1970s with significant burial documents greatly enhanced the historical understanding of thought at this time.

·       Imperial patronage of the One Hundred schools of thought flourished.

·       Huang Lao's syncretic thought and the development of the Han dynasty became the intellectual foundation that would define Chinese thought for millennia evolved.

·       Morals as a reflection of how Heaven/Tian (Nature) works, both in the state and the personal, were noted and codified.

·       Literature, reflecting this codification of life experiences, developed into Systematic correspondences of early medical ideology in the Huang di Nei Jing Ling Shu

·       One of the first codifications of herbal medical methodology was written: the Shan Han Za Bing Lun

·       The introduction of Buddhist thought into China and its monastic contributions to medicine began.

·       Herbal pharmacological ingredients grew as the search for material immortality developed.

·       The dynasty decays with internal corrosion, the rise of corrupt and exploitive eunuchs, and massive taxation driving the people to despair.

·       The fall of the Han dynasty and concurrent rise of Xuanxue practices, (the dark way) and the remedy masters (wizards)

Tang Dynasty

·       The rise and fall of the cosmopolitan Tang dynasty and the growth and increasing influence of Buddhism in personal and communal life. The struggle of Daoists and Confucianists with this growing foreign influence of Buddhism.

·       The lengthy questions and debates of Tang and Song scholars, asking “What are the enduring values over the ages”. Disfavor of highly centralized government grows with increased taxation.

Song Dynasty

·       The contributions of Zhou Dunyi, the Cheng brothers, Zhang Zai, Shao Yang, and the amalgamation of thought by Zhu Xi into what is known in the west as Neo-Confucian thought or “The Path of the Sage”

·       A review of Daoist cosmology, Confucian social values, and Buddhist introspection becomes the basis of the Path of the Sage, an educational model that was to dominate Asia for the next seven hundred years.

·       The development and amalgamation of medical traditions under Song imperial patronage and the elevation of “healer” to ru or the scholar doctor. Medicine flourishes.

Post Song/Yuan

·       The aggressive introduction of mass quantities of opium by the British into China in the early 1800s resulted in mass addiction.  The nationalists' response and effort to eradicate this drug plague led to the two Opium Wars and the disastrous defeat of the Imperial forces.

·       The subsequent rise of the progressives, decay of the imperial court, rise of warlords, and the century of shame.

·       After a bloody civil war, Mao comes to power and introduced Western dialectical thought, Communism, and evicted all the foreigners

·       The central government began the Great Leap Forward with the subsequent mass starvation of more than 20 million Chinese people.

·       To regain political power, Mao began the Cultural Revolution, followed by the unleashed Red Guards and the persecution of Chinese intellectuals and doctors, resulting in the diaspora that created the Chinese medical tradition in the West.

These are some class highlights. There is much more. Discussion is extensive, with personal investigation underpinning writing assignments.

This literate cultural history is the sea in which Chinese medicine swims. Our medicine is not separate from this story and is more than an accumulation of methods to “fix something wrong”. It is something much more for the scholar clinician. This enhancement of the Master/ technician level of practice is now the doctor/docere, a participant in the literate community.

And this legacy of the scholarly observation of life and its inexorable realities is the basis of historical Chinese philosophy and its application; “how” life hangs together and “how” to have a productive relationship with it; all the day to day reality of a clinicians practice.

If our medicine is to thrive with integrity and not be “eaten” by the many competing modern medical product and technique-driven models that abound today, this doctoral level of critical thinking from inside this view, is foundational.

And this is the challenge for the DTCM candidate, to step inside this literate community with a critical investigation of life and advocacy in our fractured world.

It has been written that “It is only the sage that can remember the whole story”. This is our potential and our responsibility.

When the roots are secure, the branches will flourish.

With respect.

As always,

Doc

Doc Mitchell DAOM, LAc., Dipl. OM
408.399.7711 office
docmitchelltcm@icloud.com
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