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Letter from Beijing
E D I T O R I A L
Letter from Beijing Late November in Beijing is cold. The city sits on the northern edge of a sprawling plain, backed up against a range of gritty mountains that from the air appear to scrawl their way into Mongolia and beyond. After an 11-hour flight from Vancouver, we’re relieved to hear the captain announce that in a few minutes we’ll be able to see the Great Wall from the left hand side of the aircraft. A few minutes later, touchdown. It’s cold. The wall that is a symbol of the country and of the indomitable spirit of her people has never really worked very well for its intended use. It didn’t keep the northern barbarians from invading. Perhaps it slowed down a few of the less intent. But it’s never done anything to keep out the Siberian cold. Annually and for months on end, the Northern Capital is the capital of the empire of the cold. And now we are its citizens, and this is our report. It is prompted by an urge to put the material in the current issue into proper perspective, and it concerns the character of knowledge and its transmission in traditional China. The meeting which took place in early July of 2001, organized by Stephen Birch and his colleagues to discuss a range of issues related to the scientific investigation of acupuncture, produced some valuable progress in the direction of establishing viable guidelines for future research. The bulk of this issue is devoted to several summary papers that emerged from this meeting, which this journal co-sponsored along with a number of other agencies, organizations and individuals who all share a common concern for the future of Oriental medicine. We hope that this meeting will be followed by more and that a growing number of researchers and scholars will meet to consider the critical issues, challenges and opportunities that today face the field and demand higher standards for research to support the growing practice of Chinese and Oriental medicine around the world. These papers speak to the potential of a strong positive impact on the quality of design and reporting of future clinical trials of acupuncture as well as the importance for the profession of better quality research that increasingly reflects the real world clinical practice of acupuncture and Oriental medicine. In serving as one of the principal sponsors of this meeting we aim to seek out and form partnerships with other organizations and individuals who share these concerns. We encourage you to contact us to pursue this discus-
sion. And we suggest that you see to it that copies of this issue are made available to any and all students, practitioners, researchers, educators and associated professionals in the field who should be made aware of the work underway. Likewise, if you have feedback to the Exeter papers or to any of the other articles that appear in these pages, please take the time to sit down, write it up, and send it in. As we continue to pursue our objectives along these and related lines, we believe that it is critically important that we bear in mind the importance of the continuing influence of the generative matrix of cultural and epistemological factors from which the subject matter, as well as the spirit of the subject, emerges. To this end, then, we offer up the following thoughts on the nature of knowledge and learning in traditional China and the importance that these factors bring to bear on understanding and development of Chinese and Oriental medicine in the 21st century. Our first day in Beijing, we rose early to practice tài jí quán. A little before seven, we were done with the morning practice and headed out to find a place to get some breakfast. Walking south from the New Pine Guest House of Beijing Normal University, we passed by the entrance to the library. There we were met by a curious site. A crowd of close to 200 students had assembled at the front door. They stood in the cold, restless, moving from foot to foot, pushing and shoving each other, trying to stay warm, trying to get closer to the front of the mob. We stopped and watched for a minute. One young man pushed back the thick sleeve of his down jacket and glanced at his wristwatch. Then he began to pound on the side of the building. But as the big red LED display inside changed to 7:00, the doorkeeper dutifully unlocked the single door and the mass of bodies began to stream in. Once inside the students began to run to the hallways that extend off in opposite directions from the main entrance hall. ‘What are they running for?’ ‘Desks, chairs, books, warmth, light, space . . .’ Knowledge. How can we understand the attitudes about knowledge that have long attended the process of study and education in China? How can we come to appreciate and understand the traditional character of Chinese intellectual life? What importance does this have on the work we do in the contemporary
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
2
Clinical Acupuncture and Oriental Medicine
scientific investigation and the modern adaptation of traditional Chinese ideas about the body and its care? Consider this passage written in 1947 by one of modern China’s most notable scholars, Lin Yu Tang. It is taken from a biography of the great Song dynasty poet and statesman Su Tung Po (Su Dong Bo). In describing the character of the imperial examinations for which Su had to sit in order to enter the realm of the learned aristocracy that ruled over China throughout two millennia of Imperial dynasties, Lin Yu Tang gives us a penetrating insight into the character of the knowledge that was learned and tested by dint of these exams. ‘To meet the official tests, the students had to cover in their reading all the ancient classics, history and poetry, and selected prose. Naturally they had to commit the classics to memory, and recitation in class consisted in repeating the passages by heart, with the student’s back turned towards the teacher to prevent him from looking at the book lying open on the teacher’s desk. The more ambitious ones would memorize whole chapters from the histories. It was not only the contents and information that were important but also the language and phraseology, which were to become elements in a writer’s vocabulary. The use of a famous phrase or of an allusion without indicating the source aroused an aristocratic and egoistic pleasure in the learned reader. It was a kind of coterie language; the reader conceived a respect for the writer for writing it and for himself for understanding it. It worked by suggestion and the association of ideas, and was always more effective than an explicit statement that lacked the charm of suggestion.’ We see in the crowds of students at the entrances to the libraries of colleges and universities around Beijing and all across China that this spirited approach to education has survived and thrives in modern China. Until today, successful candidates in college entrance exams as well as the endless series of exams that follow, are successful in large part due to having remembered vast amounts of information on a large number of subjects, very much including the Chinese language and its literary traditions. This long-standing pattern of study and teaching of intellectual standards consists of many fascinating aspects, far more than we can comfortably include in a brief discussion such as this. But it is nevertheless important to bear in mind that the doctors and scholars who have developed and transmitted Chinese medicine throughout the past 2000 years have done so in an intellectual atmosphere that conforms to the images presented above. The normative
progression of ideas throughout Chinese history has proceeded accordingly, and this all-embracing pattern of intellectual life has profoundly influenced the meaning and character of Chinese medical theory and thus its clinical applications. As we watched the students again on the second morning, again after tài jí practice in the cold of Beijing’s pre-dawn hour, we wondered how to illustrate something of the internal nature of one Chinese literary tradition that is not altogether unrelated to Chinese medicine. The following lines come from a loosely defined collection of Tài Jí Classics. The two passages quoted below both convey important principles for the tài jí student. For nearly 10 years we’ve wandered around China bumping into tài jí people here and there and always exchanging notes and practicing together. All can agree on the importance of the following: Be still as a mountain. Move like a great river. And Use four ounces to deflect a thousand pounds. By taking a few minutes to examine the meaning of these two passages and particularly how that meaning has been recorded and how it should be retrieved and understood, we hope to illustrate one particular aspect of the nature of traditional knowledge and provide an insight into the challenges facing those who seek to incorporate such knowledge into their study, practice, and research of traditional Chinese medicine. We thereby hope to shed a little light on the question of what constitutes knowledge in traditional China and, in particular, how did those who come into possession of such knowledge seek to pass it on to their descendants, long a principal concern of Chinese thinkers . . . how can we make the knowledge last? At first glance, we might characterize the first passage as a poetic metaphor. It does indeed employ a literary device that we recognize at once as metaphor; we are advised to be as still as if we were a mountain and to move as if we were a great river. This approach to the understanding of the line might lead us to conjure up images of mountains and rivers and to fill our minds with these while we practice so that we might enjoy whatever benefit derives from this kind of mental imaging. But this would be a great mistake that would lead the most sincere students, in the words of another classic, to throw up their hands and sigh. Why? This passage employs a characteristic Chinese literary device whereby information that is meant to be understood in a precise and concrete way is presented in the form of a metaphor. Of course this type
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
Editorial
of literary conceit is not unique to the Chinese. But in any language or literature one has to be familiar with the stylistic particulars in order to correctly interpret the intended meaning of writers. And in this case we discover that the writers of this passage were most definitely engaged in a stylistic pose that was intended to convey to the reader not the suggestion of metaphoric images but a precise instruction as to how to use the body correctly. To understand the nature of this precision, a student has to be guided to ask the right questions of him or herself when studying these lines . . . as well as countless others. Therefore, how is a mountain still? How does a great river move? The answer may come soon or late, but eventually one is led to realize that what the writers of these lines were talking about was gravity, the force of mass attraction that so profoundly influences every step we take throughout our lives, whether or not we ever stop to acquaint ourselves with the implication of this fact in terms of our own kinesthetics and, indeed, consciousness. At once when it is understood that the tài jí masters who wrote and handed down these lines meant to offer them as a piece of anatomical and physiological advice to students of the future who might discover their true meaning, we can understand this meaning a bit more clearly. In other words, this passage does not suggest that we use the mind as a generator of images and seek thereby to convince ourselves or our opponents that we are capable of being profoundly still or profoundly moving. What it states is that we must learn to motivate the body using only those means available to a mountain or a river, i.e. by means of gravity alone. For surely there is no intentioning or imaging within the boulders and earth that constitute a mountain. Nor is there mindfulness in the waters of the river that, seeking only the lowest place they can find, bring about the rushing torrents all hurrying seaward. Every stone, every pebble, every atom that makes a mountain yields its mass to the surrounding aggregate; all yield to the vast earth on which the mountain rests. Every drop of water similarly yields to the irresistible forces of gravity that draw the river down and down until at last it rests in the sea. With this understanding of the passage, one can enter the method of practice of tài jí, namely the loosening of the body, first and foremost at its principal joints and the relaxation of the sinews and channels that connect the body into a unified whole. Nor is the mind burdened with needless images, and it can therefore, like the body, relax. The importance of this cannot be overemphasized for those who seek to acquire and practice the internal method of tài jí. When asked if he had a secret that he had not revealed to his students, the late Professor Zheng
3
Man Qing replied, ‘Yes. There is a secret. But though I tell them every day, students must not believe me or understand. You must relax the body and the mind completely.’ On another occasion, Prof. Zheng was asked how a student could tell whether or not their practice was proceeding correctly. And to this he replied that one must read the classics and compare what one is doing to what the classics advise one to do. Of course, in order to do this, one must first develop a way of understanding how the knowledge contained in those classics was recorded and how it is meant to be retrieved and understood. To further illustrate, consider the second passage. Unlike the first, it is not presented in metaphoric terms. It appears as a simple instruction: use four ounces to deflect 1000 pounds. A sincere student confronted with this instruction could not be faulted, if the meaning were thereby completely contained, in working to develop a precise awareness of the relative weight of one’s own body compared to an opponent’s. But is there true efficacy in this approach? Is this the way to practice to develop the described ability? Certainly the successful tài jí student attains a certain lightness of being and motion, but the same body of classics contain a relevant line that says, ‘heaviness is the root of lightness.’ And this, on its surface, would appear to conflict with the idea of using the lighter weight or force to move the heavier one. Again we find that a literary device is in play here whereby we are guided to understand and interpret the passage in question not as a specific concrete instruction but as a metaphor despite the fact that it is not written out that way. We need to know, in other words, according to a more fundamental familiarity with the broad literary context in which such works as the tài jí (as well as the medical) classics exist, how to read the various phrases and terms and when to think of statements as they are written and when to bring into association with them other modes of thinking as well as other ideas. As Lin Yu Tang pointed out, it is a context that works by suggestion and the association of ideas. In order for this method of transmission of data to succeed, those who use it must know what ideas to associate as well as when and how. In order to appreciate how such factors come to bear on the understanding, transmission, and reception of traditional Chinese medical knowledge, consider the vast array of passages similar to the character of those quoted above that constitute the Chinese medical classics in which we find the roots of the theories and methodologies of traditional Chinese medicine. What this suggests is that as well as a systematic arrangement of theoretical and clinical data, traditional Chinese medicine also presents
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
4
Clinical Acupuncture and Oriental Medicine
us with a characteristic method of knowing and applying those data and that the correct interpretation and application depend extensively upon the correct association of ideas that may come from diverse sources and need to be brought into play in a variety of circumstances in order for the overall outcome to obtain successfully. In both medicine and martial arts, such outcomes involve life and death decisions and actions. We must therefore proceed in a conscientious and comprehensive way when studying and applying the knowledge in these fields. If we consider the use of antibiotics among doctors and patients of modern biomedicine over the past 60 years since their discovery, we can come to appreciate the importance of an accurate understanding of the mode of thought and knowledge of Chinese medicine. Many traditional Chinese medicinal herbs have been discovered to possess ‘active ingredients’ that are antibiotic in nature. Huáng lián is one such herb that is commonly found in formulas for digestive tract problems that are often described in modern medical terms as bacteria infections. The modern medical approach is to treat with antibiotics, following a fundamental strategic principle of allopathic medicine, i.e. to identify and eradicate exo-pathogenic factors resulting in disease. The misguided application of this stratagem has resulted in a crisis of worldwide proportions, as we come to recognize that over the past six decades we have conducted a worldwide breeding program of antibiotic resistant strains of bacteria. Yet despite the presence of antibiotic agents in traditional Chinese medical formulas in continual use for millennia, no such iatrogenic catastrophe ensued in China or other regions where Chinese medicine was adopted and adapted. We suggest that the mode of thinking, the character of knowledge and the nature of its transmission from one generation of medical personnel to the next are largely responsible for this noteworthy difference in public health consequences of clinical strategy. The traditional Chinese approach to the treatment of conditions that modern medicine identifies as resulting from micro-organisms that can be partially eradicated through the use of antibiotics, is not to simply undertake such an eradication but to use a complex and balanced approach that seeks both to eliminate the exo-pathogen and to strengthen the body’s inborn resistance. Doctors of traditional Chinese medicine have recognized, in other words, for generation upon generation that you cannot simply kill disease-causing agents if your aim is the health and well being of your patients. You must work to restore the patient’s balance and guide them in re-establishing themselves in closer harmony with their environment. The correct use of medicinal
herbs in traditional Chinese formulas thus depends upon a vast complex of theoretical considerations that all rely upon the intellectual roots of yı¯n yáng theory, the theory of the five phases, and other patterns describing the systematic correspondence of human anatomy and physiology with the systems of the natural world. In order to understand and apply these theories, a student must come to grasp their particular relevancies and the patterns of ways in which they are to be associated with one another. Failing to do so, one is left with the reduction of the Chinese material medica to simply an inventory of sources for pharmaceutical extractions. Of course, like huáng lián, there are numerous ingredients in the traditional formularies that will yield bountiful sources of various kinds of ‘active ingredients.’ But it is only correctly inspired study of the classic literature, grounded in an appreciation of the context of knowledge in which it was brought into being that will result in successful application of Chinese medicine per se. Think of those students at Beijing Normal University, crowding their ways into the library this morning, like any other morning of any year in years past and for years to come. Think of the poet Su Tung Po sitting for his imperial examination, composing subtle literary allusions to lead his examiners to the obvious conclusion that here was a candidate who thoroughly embodied the spirit as well as the letter of the classics themselves. And think of the generations of scholars and doctors who have passed along the writings and the commentaries and the teachings based upon the classics of the medical literature, each and every one devoted to the survival and future development of their beloved Art of Benevolence. And with these thoughts in mind, ask yourself what the legacy of our own research and study and experimentation in the fields of Oriental medicine will be. Will we have descendants who remember us thankfully as a generation that presided over the successful transmission of the subject from its native spheres to the whole international community of health care professionals who grow ever more interested in the significant potentials that the subject possesses? Or will we be forgotten along with numberless others who failed to divine the essence of the subject and substituted instead idiosyncratic interpretations of theories and terms and passages from classics that they never really came to understand? Only time will tell. But it is time that will pass regardless of what we do and how we do it. The choice, it seems to us, is a clear one. We must recognize the important complex of factors that must be brought to bear on the study and practice of the medicine as well as on the design of clinical inves-
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
Editorial
tigations. With the publication of the material in this issue we hope to provoke a lively discussion of these factors and to help bring about a sustainable pattern of scientific investigation of the various modalities
5
of Chinese medicine that make it of such potential benefit to the modern world. Ken Rose Zhang Yu Huan Editor Assistant Editor
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
Letter from Beijing Late November in Beijing is cold. The city sits on the northern edge of a sprawling plain, backed up against a range of gritty mountains that from the air appear to scrawl their way into Mongolia and beyond. After an 11-hour flight from Vancouver, we’re relieved to hear the captain announce that in a few minutes we’ll be able to see the Great Wall from the left hand side of the aircraft. A few minutes later, touchdown. It’s cold. The wall that is a symbol of the country and of the indomitable spirit of her people has never really worked very well for its intended use. It didn’t keep the northern barbarians from invading. Perhaps it slowed down a few of the less intent. But it’s never done anything to keep out the Siberian cold. Annually and for months on end, the Northern Capital is the capital of the empire of the cold. And now we are its citizens, and this is our report. It is prompted by an urge to put the material in the current issue into proper perspective, and it concerns the character of knowledge and its transmission in traditional China. The meeting which took place in early July of 2001, organized by Stephen Birch and his colleagues to discuss a range of issues related to the scientific investigation of acupuncture, produced some valuable progress in the direction of establishing viable guidelines for future research. The bulk of this issue is devoted to several summary papers that emerged from this meeting, which this journal co-sponsored along with a number of other agencies, organizations and individuals who all share a common concern for the future of Oriental medicine. We hope that this meeting will be followed by more and that a growing number of researchers and scholars will meet to consider the critical issues, challenges and opportunities that today face the field and demand higher standards for research to support the growing practice of Chinese and Oriental medicine around the world. These papers speak to the potential of a strong positive impact on the quality of design and reporting of future clinical trials of acupuncture as well as the importance for the profession of better quality research that increasingly reflects the real world clinical practice of acupuncture and Oriental medicine. In serving as one of the principal sponsors of this meeting we aim to seek out and form partnerships with other organizations and individuals who share these concerns. We encourage you to contact us to pursue this discus-
sion. And we suggest that you see to it that copies of this issue are made available to any and all students, practitioners, researchers, educators and associated professionals in the field who should be made aware of the work underway. Likewise, if you have feedback to the Exeter papers or to any of the other articles that appear in these pages, please take the time to sit down, write it up, and send it in. As we continue to pursue our objectives along these and related lines, we believe that it is critically important that we bear in mind the importance of the continuing influence of the generative matrix of cultural and epistemological factors from which the subject matter, as well as the spirit of the subject, emerges. To this end, then, we offer up the following thoughts on the nature of knowledge and learning in traditional China and the importance that these factors bring to bear on understanding and development of Chinese and Oriental medicine in the 21st century. Our first day in Beijing, we rose early to practice tài jí quán. A little before seven, we were done with the morning practice and headed out to find a place to get some breakfast. Walking south from the New Pine Guest House of Beijing Normal University, we passed by the entrance to the library. There we were met by a curious site. A crowd of close to 200 students had assembled at the front door. They stood in the cold, restless, moving from foot to foot, pushing and shoving each other, trying to stay warm, trying to get closer to the front of the mob. We stopped and watched for a minute. One young man pushed back the thick sleeve of his down jacket and glanced at his wristwatch. Then he began to pound on the side of the building. But as the big red LED display inside changed to 7:00, the doorkeeper dutifully unlocked the single door and the mass of bodies began to stream in. Once inside the students began to run to the hallways that extend off in opposite directions from the main entrance hall. ‘What are they running for?’ ‘Desks, chairs, books, warmth, light, space . . .’ Knowledge. How can we understand the attitudes about knowledge that have long attended the process of study and education in China? How can we come to appreciate and understand the traditional character of Chinese intellectual life? What importance does this have on the work we do in the contemporary
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
2
Clinical Acupuncture and Oriental Medicine
scientific investigation and the modern adaptation of traditional Chinese ideas about the body and its care? Consider this passage written in 1947 by one of modern China’s most notable scholars, Lin Yu Tang. It is taken from a biography of the great Song dynasty poet and statesman Su Tung Po (Su Dong Bo). In describing the character of the imperial examinations for which Su had to sit in order to enter the realm of the learned aristocracy that ruled over China throughout two millennia of Imperial dynasties, Lin Yu Tang gives us a penetrating insight into the character of the knowledge that was learned and tested by dint of these exams. ‘To meet the official tests, the students had to cover in their reading all the ancient classics, history and poetry, and selected prose. Naturally they had to commit the classics to memory, and recitation in class consisted in repeating the passages by heart, with the student’s back turned towards the teacher to prevent him from looking at the book lying open on the teacher’s desk. The more ambitious ones would memorize whole chapters from the histories. It was not only the contents and information that were important but also the language and phraseology, which were to become elements in a writer’s vocabulary. The use of a famous phrase or of an allusion without indicating the source aroused an aristocratic and egoistic pleasure in the learned reader. It was a kind of coterie language; the reader conceived a respect for the writer for writing it and for himself for understanding it. It worked by suggestion and the association of ideas, and was always more effective than an explicit statement that lacked the charm of suggestion.’ We see in the crowds of students at the entrances to the libraries of colleges and universities around Beijing and all across China that this spirited approach to education has survived and thrives in modern China. Until today, successful candidates in college entrance exams as well as the endless series of exams that follow, are successful in large part due to having remembered vast amounts of information on a large number of subjects, very much including the Chinese language and its literary traditions. This long-standing pattern of study and teaching of intellectual standards consists of many fascinating aspects, far more than we can comfortably include in a brief discussion such as this. But it is nevertheless important to bear in mind that the doctors and scholars who have developed and transmitted Chinese medicine throughout the past 2000 years have done so in an intellectual atmosphere that conforms to the images presented above. The normative
progression of ideas throughout Chinese history has proceeded accordingly, and this all-embracing pattern of intellectual life has profoundly influenced the meaning and character of Chinese medical theory and thus its clinical applications. As we watched the students again on the second morning, again after tài jí practice in the cold of Beijing’s pre-dawn hour, we wondered how to illustrate something of the internal nature of one Chinese literary tradition that is not altogether unrelated to Chinese medicine. The following lines come from a loosely defined collection of Tài Jí Classics. The two passages quoted below both convey important principles for the tài jí student. For nearly 10 years we’ve wandered around China bumping into tài jí people here and there and always exchanging notes and practicing together. All can agree on the importance of the following: Be still as a mountain. Move like a great river. And Use four ounces to deflect a thousand pounds. By taking a few minutes to examine the meaning of these two passages and particularly how that meaning has been recorded and how it should be retrieved and understood, we hope to illustrate one particular aspect of the nature of traditional knowledge and provide an insight into the challenges facing those who seek to incorporate such knowledge into their study, practice, and research of traditional Chinese medicine. We thereby hope to shed a little light on the question of what constitutes knowledge in traditional China and, in particular, how did those who come into possession of such knowledge seek to pass it on to their descendants, long a principal concern of Chinese thinkers . . . how can we make the knowledge last? At first glance, we might characterize the first passage as a poetic metaphor. It does indeed employ a literary device that we recognize at once as metaphor; we are advised to be as still as if we were a mountain and to move as if we were a great river. This approach to the understanding of the line might lead us to conjure up images of mountains and rivers and to fill our minds with these while we practice so that we might enjoy whatever benefit derives from this kind of mental imaging. But this would be a great mistake that would lead the most sincere students, in the words of another classic, to throw up their hands and sigh. Why? This passage employs a characteristic Chinese literary device whereby information that is meant to be understood in a precise and concrete way is presented in the form of a metaphor. Of course this type
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
Editorial
of literary conceit is not unique to the Chinese. But in any language or literature one has to be familiar with the stylistic particulars in order to correctly interpret the intended meaning of writers. And in this case we discover that the writers of this passage were most definitely engaged in a stylistic pose that was intended to convey to the reader not the suggestion of metaphoric images but a precise instruction as to how to use the body correctly. To understand the nature of this precision, a student has to be guided to ask the right questions of him or herself when studying these lines . . . as well as countless others. Therefore, how is a mountain still? How does a great river move? The answer may come soon or late, but eventually one is led to realize that what the writers of these lines were talking about was gravity, the force of mass attraction that so profoundly influences every step we take throughout our lives, whether or not we ever stop to acquaint ourselves with the implication of this fact in terms of our own kinesthetics and, indeed, consciousness. At once when it is understood that the tài jí masters who wrote and handed down these lines meant to offer them as a piece of anatomical and physiological advice to students of the future who might discover their true meaning, we can understand this meaning a bit more clearly. In other words, this passage does not suggest that we use the mind as a generator of images and seek thereby to convince ourselves or our opponents that we are capable of being profoundly still or profoundly moving. What it states is that we must learn to motivate the body using only those means available to a mountain or a river, i.e. by means of gravity alone. For surely there is no intentioning or imaging within the boulders and earth that constitute a mountain. Nor is there mindfulness in the waters of the river that, seeking only the lowest place they can find, bring about the rushing torrents all hurrying seaward. Every stone, every pebble, every atom that makes a mountain yields its mass to the surrounding aggregate; all yield to the vast earth on which the mountain rests. Every drop of water similarly yields to the irresistible forces of gravity that draw the river down and down until at last it rests in the sea. With this understanding of the passage, one can enter the method of practice of tài jí, namely the loosening of the body, first and foremost at its principal joints and the relaxation of the sinews and channels that connect the body into a unified whole. Nor is the mind burdened with needless images, and it can therefore, like the body, relax. The importance of this cannot be overemphasized for those who seek to acquire and practice the internal method of tài jí. When asked if he had a secret that he had not revealed to his students, the late Professor Zheng
3
Man Qing replied, ‘Yes. There is a secret. But though I tell them every day, students must not believe me or understand. You must relax the body and the mind completely.’ On another occasion, Prof. Zheng was asked how a student could tell whether or not their practice was proceeding correctly. And to this he replied that one must read the classics and compare what one is doing to what the classics advise one to do. Of course, in order to do this, one must first develop a way of understanding how the knowledge contained in those classics was recorded and how it is meant to be retrieved and understood. To further illustrate, consider the second passage. Unlike the first, it is not presented in metaphoric terms. It appears as a simple instruction: use four ounces to deflect 1000 pounds. A sincere student confronted with this instruction could not be faulted, if the meaning were thereby completely contained, in working to develop a precise awareness of the relative weight of one’s own body compared to an opponent’s. But is there true efficacy in this approach? Is this the way to practice to develop the described ability? Certainly the successful tài jí student attains a certain lightness of being and motion, but the same body of classics contain a relevant line that says, ‘heaviness is the root of lightness.’ And this, on its surface, would appear to conflict with the idea of using the lighter weight or force to move the heavier one. Again we find that a literary device is in play here whereby we are guided to understand and interpret the passage in question not as a specific concrete instruction but as a metaphor despite the fact that it is not written out that way. We need to know, in other words, according to a more fundamental familiarity with the broad literary context in which such works as the tài jí (as well as the medical) classics exist, how to read the various phrases and terms and when to think of statements as they are written and when to bring into association with them other modes of thinking as well as other ideas. As Lin Yu Tang pointed out, it is a context that works by suggestion and the association of ideas. In order for this method of transmission of data to succeed, those who use it must know what ideas to associate as well as when and how. In order to appreciate how such factors come to bear on the understanding, transmission, and reception of traditional Chinese medical knowledge, consider the vast array of passages similar to the character of those quoted above that constitute the Chinese medical classics in which we find the roots of the theories and methodologies of traditional Chinese medicine. What this suggests is that as well as a systematic arrangement of theoretical and clinical data, traditional Chinese medicine also presents
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
4
Clinical Acupuncture and Oriental Medicine
us with a characteristic method of knowing and applying those data and that the correct interpretation and application depend extensively upon the correct association of ideas that may come from diverse sources and need to be brought into play in a variety of circumstances in order for the overall outcome to obtain successfully. In both medicine and martial arts, such outcomes involve life and death decisions and actions. We must therefore proceed in a conscientious and comprehensive way when studying and applying the knowledge in these fields. If we consider the use of antibiotics among doctors and patients of modern biomedicine over the past 60 years since their discovery, we can come to appreciate the importance of an accurate understanding of the mode of thought and knowledge of Chinese medicine. Many traditional Chinese medicinal herbs have been discovered to possess ‘active ingredients’ that are antibiotic in nature. Huáng lián is one such herb that is commonly found in formulas for digestive tract problems that are often described in modern medical terms as bacteria infections. The modern medical approach is to treat with antibiotics, following a fundamental strategic principle of allopathic medicine, i.e. to identify and eradicate exo-pathogenic factors resulting in disease. The misguided application of this stratagem has resulted in a crisis of worldwide proportions, as we come to recognize that over the past six decades we have conducted a worldwide breeding program of antibiotic resistant strains of bacteria. Yet despite the presence of antibiotic agents in traditional Chinese medical formulas in continual use for millennia, no such iatrogenic catastrophe ensued in China or other regions where Chinese medicine was adopted and adapted. We suggest that the mode of thinking, the character of knowledge and the nature of its transmission from one generation of medical personnel to the next are largely responsible for this noteworthy difference in public health consequences of clinical strategy. The traditional Chinese approach to the treatment of conditions that modern medicine identifies as resulting from micro-organisms that can be partially eradicated through the use of antibiotics, is not to simply undertake such an eradication but to use a complex and balanced approach that seeks both to eliminate the exo-pathogen and to strengthen the body’s inborn resistance. Doctors of traditional Chinese medicine have recognized, in other words, for generation upon generation that you cannot simply kill disease-causing agents if your aim is the health and well being of your patients. You must work to restore the patient’s balance and guide them in re-establishing themselves in closer harmony with their environment. The correct use of medicinal
herbs in traditional Chinese formulas thus depends upon a vast complex of theoretical considerations that all rely upon the intellectual roots of yı¯n yáng theory, the theory of the five phases, and other patterns describing the systematic correspondence of human anatomy and physiology with the systems of the natural world. In order to understand and apply these theories, a student must come to grasp their particular relevancies and the patterns of ways in which they are to be associated with one another. Failing to do so, one is left with the reduction of the Chinese material medica to simply an inventory of sources for pharmaceutical extractions. Of course, like huáng lián, there are numerous ingredients in the traditional formularies that will yield bountiful sources of various kinds of ‘active ingredients.’ But it is only correctly inspired study of the classic literature, grounded in an appreciation of the context of knowledge in which it was brought into being that will result in successful application of Chinese medicine per se. Think of those students at Beijing Normal University, crowding their ways into the library this morning, like any other morning of any year in years past and for years to come. Think of the poet Su Tung Po sitting for his imperial examination, composing subtle literary allusions to lead his examiners to the obvious conclusion that here was a candidate who thoroughly embodied the spirit as well as the letter of the classics themselves. And think of the generations of scholars and doctors who have passed along the writings and the commentaries and the teachings based upon the classics of the medical literature, each and every one devoted to the survival and future development of their beloved Art of Benevolence. And with these thoughts in mind, ask yourself what the legacy of our own research and study and experimentation in the fields of Oriental medicine will be. Will we have descendants who remember us thankfully as a generation that presided over the successful transmission of the subject from its native spheres to the whole international community of health care professionals who grow ever more interested in the significant potentials that the subject possesses? Or will we be forgotten along with numberless others who failed to divine the essence of the subject and substituted instead idiosyncratic interpretations of theories and terms and passages from classics that they never really came to understand? Only time will tell. But it is time that will pass regardless of what we do and how we do it. The choice, it seems to us, is a clear one. We must recognize the important complex of factors that must be brought to bear on the study and practice of the medicine as well as on the design of clinical inves-
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.
Editorial
tigations. With the publication of the material in this issue we hope to provoke a lively discussion of these factors and to help bring about a sustainable pattern of scientific investigation of the various modalities
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of Chinese medicine that make it of such potential benefit to the modern world. Ken Rose Zhang Yu Huan Editor Assistant Editor
Clinical Acupuncture and Oriental Medicine (2002) 3, 1–5 © 2002, Elsevier Science Ltd. All rights reserved.