Restoration of Health and Family Harmony

After that detour into the history and concepts of Chinese medicine, I want to come back to my narration of our family’s story. As I noted in my first post on Chinese medicine, we moved to California in the mid-1990s. At that time, I could not find a nearby practitioner of Chinese medicine who was able to help me. I went to a friend who is a Western medicine doctor, and he wanted to do exploratory surgery, which our insurance refused to cover without two second opinions, that we would have had to pay for ourselves. We did not have the money, and so upon the recommendation of a friend, I began using homeopathy. My homeopath was quite skilled, and I began to recover my health.

Our relatives in Taiwan had been extremely worried about me, especially when our Western doctor friend mentioned a possible diagnosis of cancer. As I regained my health, the relatives in Taiwan felt it was a total miracle. Pa had developed an eye problem where he could not keep his eyelids open without holding them up with his fingers. He was unable to find a cure through Chinese medicine. He had also gone to one of the big hospitals in Taipei where the doctors gave him Botox injections to keep his eyes open. Then he was unable to completely close his eyes when he wanted to sleep. And so, the Western doctors in Taiwan had prescribed very addictive sleeping pills for him. He was extremely uncomfortable from the side effects of both medications. Since I had had such good results with homeopathy, he and Ma came to visit us so that we could take him to see the homeopath.

My homeopath lived in the Bay Area and only came to southern California on school vacations. Pa and Ma came in the middle of the school year. Yuni was incredibly busy with a large construction project, and so I rallied my southern California friends to help Pa. I have a friend who is a family doctor. She looked at Pa’s medications and said that he should not be on them any longer because the sleeping pills were highly addictive. After Pa was weaned from his sleeping pills, he felt much better, but his eyelids were still a problem. I took him to see another friend, who is an eye doctor, but all she could offer was perhaps better skill at Botox treatments. Pa was not interested in those. That night, when Yuni got home for dinner, Ma and Pa broke out their best guilt-tripping skills to get Yuni to take us up to the Bay Area so that Pa could see the homeopath. Yuni finally gave in and asked me to set up an appointment. The homeopath was very busy, but we were able to get an extra-long introductory appointment for two weeks after that date. I would do the interpreting for homeopath, and then we would take Pa and Ma sightseeing in San Francisco while we were there. Yuni was relieved to have two weeks in which to arrange for the time off from work.

Homeopathy is a holistic system of medicine that uses very mild natural remedies. The initial appointment consists of a long interview in which the homeopath seeks the physical and psychological roots of the problem, which are found in the patient’s constitutional indications. Over the course of the interview, I learned that Pa had had surgery as a young man in which almost two thirds of his stomach was removed. We also learned that he had been unable to eat well due to his emotional upset over the situation with Elder Sister, the problem between Yuni and my father, and my own illness. Instead of treating his eyes, the homeopath treated his stomach and prescribed a remedy that would calm his nerves and help him better absorb the nutrients from his food. Within a few weeks, his eyes were much improved. The trip to the Bay Area restored harmony to Yuni’s relationship with his parents. They went home happy with an admonition from the homeopath to return in six months for a follow up appointment.

Six months later, Pa, Ma, and Yuntian all came to the US to get treated by the homeopath. Pa was feeling better than he had felt in years. Ma and Yuntian wanted help with their chronic health issues, too. We made appointments spaced over the course of two days for all of them. The homeopath was able to prescribe helpful remedies for Ma and Yuntian, and she made some slight adjustments on Pa’s dosages. Ma and Yuntian also responded well to their remedies. Pa and Ma did not stay too long after their health appointments. We all took a few day trips with Yuntian to Disneyland, Sea World, and Tijuana, Mexico. Pa was much happier on these visits to Disneyland and Sea World than he had been on his previous visits to them.

Yuntian had been authorized upon entry to stay in the US for four full months, and he decided to make the most of his visa permission. Pa then mentioned to Yuni that Elder Sister’s family desperately needed money. He had sold our house in Chungli and had paid off our debts to the other sisters, but he was only able to repay part of what we owed Elder Sister from our share of the proceeds of the Chungli house. Pa had taken his share of the money and bought a cheaper house out by Yuni’s old military camp where there was more room. The neighborhood around our old house had been completely built up, and Pa needed elbow room. Our tenants in Washington told us that they would only be renting for another six months, and so we decided to put that house on the market. The house needed reroofing before we could sell it. Yuntian decided that he would stay with us to help reroof our house, and in the process he would get a sightseeing trip up the coast and then down the mountain range between southern California and Washington State.

It had been three years since I had had contact with my father, and I decided that this was the time to insist on a visit with him while we were in the Seattle area. I knew what I needed to do as a Chinese wife, even though I really do not like using guilt trips and histrionics to get my way. I much prefer straight forward discussions and good-faith negotiations. But I also knew that since I had helped his parents and had just recovered from a severe illness, I was at a prime time for pushing my point, especially since Yuntian was there to back me up. There is a certain ritual to these intra-family dealings in the Liu family's culture.

I did not bring up anything about reconciling with my dad until we had been out on the road for a couple of days. Then I made a scene and played the guilt-trip card, begging Yuntian to plead my case with his brother. Yuntian and the kids all begged Yuni to let me see my dad. Because I had been so sick and had still found a way to improve the health of his parents and brother, Chinese family customs demanded that Yuni give me some kind of reward. He did it in a way that saved him some face by saying that we could all go to dinner with my dad (Yuni would pay), and if I wanted to spend time alone with my dad and his new wife, that was fine. However, he kept the restriction that the girls could not spend time alone with their grandfather until they were older. When we got to Seattle, I called my dad and made arrangements to spend time with him. I think that eventually, we all went with Dad and his wife to the Seattle Center on my dad’s dime, and then Yuni took us all to dinner.

And so finally, at about the same time that Elder Sister was making headway in her quest to be reaccepted by Elder Brother-in-law’s family, my husband and father were able to begin to resolve their differences, and my life moved onto a more even keel. At least, I no longer felt caught in the middle of a cross-cultural struggle.

While we were on the trip to Washington, Yuntian received a phone call from his girl friend. She was pregnant with his child. Part of the reason Yuntian had wanted to stay behind in the US was that he wanted to wait until he knew if his girl friend was pregnant. Ma did not approve of the girl because she was not a Christian, but according to Yuntian, Ma kept parading fat, pimple-faced Christian women in front of him in her matchmaking efforts. He refused to consider women in whom he had no interest just because Ma liked them. Now he HAD to marry his girl friend because she was carrying his first child. When we got back to California, Yuntian rushed to book his flight home and prepare for his wedding. 

Later Views on Chinese Medicine

After the Han Dynasty, Paul Unschuld says that there were no major changes in Chinese medicine until the Sung Dynasty (960-1279 CE). He has a chapter on how Buddhism entered China, but he does not find much influence from Buddhism in texts on Chinese medicine. During the Sung Dynasty, however, Neo-Confucian scholars worked Yin-Yang Theory and the Five Elements/Five Phases Theory into Confucianism. They also combined these theories together more coherently in the theories of Chinese medicine, and they applied Five Phase Theory to herbs and medicines. They made the entire study of Chinese medicine somewhat more systematic.

Then, during the Ming and Qing Dynasties, scholars felt that the Sung Dynasty Neo-Confucians had gone too far, and for awhile late imperial Chinese scholars tried to take Chinese medicine back to its Han Dynasty beginnings. At least, they did this until China’s defeat in the Opium Wars. After China was defeated by the West, there was a period when Chinese intellectuals wanted to embrace all things modern and Western. Western medicine enjoyed a period of favor in China during the late 19^th and early 20^th centuries until people realized that Western medicine was also limited. At that point, Chinese medicine experienced a resurgence, but there was a concerted effort to make it more scientific and systematic. This occurred both in the Republic of China and in the People’s Republic of China.

Nigel Wiseman has translated many modern TCM textbooks. A good one is Fundamentals of Chinese Medicine (Paradigm Publishers, 1996). Wiseman has also put out a number of books on the vocabulary and concepts of Chinese medicine. These books present a form of Chinese medicine that is more systematic than what went before, but there are still many overlapping concepts from the various schools of thought, which contributed to Chinese medicine over the millennia.

Unschuld’s Life Sciences book contains an excerpt from a 1765 medical treatise that begins: “There are many medical texts under heaven. Some of them cling to only one view, and those who read [only these texts] will not be able to achieve a comprehensive understanding. They have absolutely no [basis to decide] what is right and wrong, and thus, rather than experiencing a benefit from reading books, they only experience harm from reading books” (p. 190).

I think this passage summarizes a common view of knowledge among many Chinese people, especially those of the older generation. My Chinese teacher used to tell us that we should memorize as many Chinese texts as we could, especially the old classics, because then, as we matured and gained life experience, we would have a ready supply of ancient wisdom to apply in each situation. She said that traditional Chinese education did not expect students to understand the things they memorized until much, much later in their lives. Eventually, students with a large reserve of memorized wisdom were thought to be able to master it, apply it and use it as their own.

I am reminded of one of the heroes in Jin Yong’s kung fu novels. Yang Guo of The Giant Eagle and its Companions is quite brilliant. He learns quickly, and by a very young age, he has learned kung fu forms from a number of different schools and has been tutored by many of the top kung fu masters of his day. One day, he seems to fall into a fit where all the forms jumble in his brain. His friend thinks he is crazy, but an older kung fu master tells the friend to leave Yang alone because once he processes the knowledge, he will have moved on to an even higher level of proficiency. Yang Guo spends seven days in a semi-trance, and he even falls unconscious five different times. He comes out of it, when he realizes that he can use all the schools of martial arts as he pleases. “In the future when I meet an enemy, I can use whatever works and apply what seems best in the situation without thinking about where the various moves came from” (Vol. 2, p. 674).

Yang Guo becomes the best kung fu practitioner of his day. But understanding that he can use at will whatever he needs from each school, is actually just the first step of his move into the higher realms of knowledge. Eventually, in middle age, when he has lost both his wife and his right arm, he goes into the wilderness with a giant eagle. The eagle leads Yang to a cave where he finds the diary and practice swords of an ancient kung fu master who had longed for an adversary with the ability to truly challenge him. By this time, Yang Guo understands the ancient master’s sentiments and spends time with the giant eagle in this cave near a waterfall practicing the dead master’s art. In the end, Yang realizes that all the various kung fu forms and all the various weapons and fancy moves are nothing. The only things that matter are his will and his skill. At this point, he has arrived at the highest level, the transcendent level, of martial arts.

In talking to American friends who have studied Chinese medicine, I learned that in the beginning they found things very contradictory and confusing because nothing is truly systematic in the Western sense of the word. One friend told me that she just learned what she needed to know in order to pass the state licensing tests. Since getting her license, however, she has continued to educate herself on many levels. After many years of practice, she has learned how to take techniques from each school of thought in Chinese medicine and make them her own. She uses techniques from each school according to the needs of her patients. She was a Western health professional prior to studying Chinese medicine, and she uses some Western techniques, too, when they seem most suited to her patients’ needs. I think that, like Yang Guo after his week-long trance, she has arrived at the first level of the higher stages of knowledge and practice.

Another Westerner, who has spent many years studying Chinese medicine, has written a book on Five Element/Five Phase theory that does a good job translating it for American readers. I recommend Wood Becomes Water: Chinese Medicine in Everyday Life by Gail Reichstein. There are other books by Western practitioners of Chinese medicine that also make its ideas more accessible to average Westerners. I don’t think anyone of my acquaintance has attained to the highest level of transcendence in practice. But totally transcendent people are few and far between, and they may only exist in novels and legends, kind of like Bian Que.

In conclusion, I would like to add a few comments:

1) Paul Unschuld focuses mainly on ancient texts and vocabulary. He does not see much progress between the Han Dynasty and the Sung Dynasty; however, the practice was being refined, and as the practiced changed, so did the concepts. Unschuld argues that qi means “rarefied essence,” and he uses the etymology of the early texts to prove this. Maybe that was so in the early texts; however, he ignores the influence of martial arts practice on this concept. Many great Chinese doctors and herbal remedies came out of the martial arts tradition because there was a need for healing, as people got injured practicing martial arts and because martial artists used poisons for which they needed remedies. I am not a martial artist, but I did study a little with a martial arts teacher in Taiwan before I got married. I would also go up on the roof and do qi gong exercises with the old ladies from church after they had attended the morning prayer sessions. These people all had a sense or feeling of qi, and it was described to me as a kind of energy. I do not know when this notion of qi as energy came into being, but it is also shared by practitioners of Chinese medicine that I know, especially those who have some background with qi gong. Since Unschuld notes the existence of folk practices in Taiwan and Hong Kong that show traces of ancestor worship and demonology from the Shang Culture and the Zhou Dynasty, I think he should also factor in common practices and feelings among Chinese people in his attempt to understand the vocabulary of the Chinese medical classics.

2) I think that the syncretistic aspect of Chinese thought is a factor that has enabled Chinese civilization to last for such a long time. Because the Chinese are able to accept new ideas and work them into their old thought patterns or to adapt old thought patterns to meet new challenges, their culture has survived for millennia. As their ideas flow out around the world, it is only natural that non-Chinese people, who are exposed to these thought patterns, would absorb them and adapt them to their particular cultures. This is generally the case with all transnational cultural flows, according to Arjun Appadurai and other academic theorists. Modern Chinese have done the same thing with aspects of Western culture that have influenced their society during the modern era. Hence, we have Mao Zedong’s Communism with Chinese characteristics, the Chinese Christianity of indigenous twentieth-century Chinese preachers, and Sun Yat-sen’s version of democratic socialism: the Three Principles of the People. There are also many other examples of cultural hybridity in both the Chinese and US societies today. There really is no pure culture; human societies are in a constant state of flux, and we learn from whomever we meet. 

The Legend of Bian Que

Here is my translation of a story about a famous, ancient Chinese doctor. The original Chinese text is in my old textbook from the NTNU Mandarin Training Center in Taipei: Stories from Chinese History, Volume I. 

The Legend of Bian Que

Bian Que was a famous doctor during the Spring and Autumn Period. At the time, everyone believed that he could immediately heal any difficult illness. But Bian Que did not agree with such praise. He said, “I am not a miraculous doctor, who is able to resurrect the dead; I can only heal those whose lives should not yet end.”

He traveled around healing people, and eventually he came to the State of Qi. Marquis Huan of the State of Qi wanted to see this world-famous doctor, and he sent people to Bian Que to invite him to the Marquis’s home as a guest. When Bian Que saw the Marquis, he discovered that the coloring of the Marquis’s face was somewhat abnormal. After observing him for awhile, Bian Que earnestly said to Marquis Huan of the State of Qi: “I will not lie to you. You are ill now, but fortunately, the illness is not yet serious. The poison is only in your skin. Please allow me to heal you!”

When Marquis Huan heard Bian Que say that he was ill, he became very angry, and he thought that Bian Que was cursing him. Hence, he rudely said to Bian Que: “I am not ill.” Bian Que had wanted to be helpful, but instead, he had been rebuffed. He felt forced to leave quickly. After Bian Que was gone, Marquis Huan proudly told his retainers: “Doctors are all like that. You are not really sick, but they pretend to heal you, so that you will give them money and feel grateful to them.”

After Bian Que had gone home, he worried about Marquis Huan’s illness. Five days later, he went without invitation to visit the Marquis. As soon as he saw Marquis Huan, Bian Que knew that things were not good. He said to the Marquis: “The illness has spread from your skin to your blood vessels. If you do not get treatment, I am afraid it will get worse.” The Marquis thought, “This fellow has come to play that same trick on me.” He impatiently said to Bian Que: “I already told you that I am not ill!”

After another five days, Bian Que could not resist going to see the Marquis again. The Marquis’s illness was visibly worse than it had been previously. Bian Que begged the Marquis: “Get treatment soon! The poison has entered your inner organs, but you still can be healed with great difficulty.” Marquis Huan completely ignored Bian Que; with a flourish of his sleeves he went into his chamber. Bian Que had to leave the place.

Because of his sense of responsibility, Bian Que still felt forced to visit the Marquis after yet another five days. As soon as he walked through the door, he saw Marquis Huan and was astonished. He turned around and walked out. Marquis Huan felt that this time there was something strange, and so he sent a messenger to ask Bian Que. Bian Que said to the messenger: “When an illness is in the skin or blood vessels, it can be healed with medicine or acupuncture. Even when the illness has progressed to the inner organs, I can still think of ways to heal it. But now the illness has entered the bones and marrow; there is no way to cure it. Therefore, I have nothing to say to Marquis Huan. It was best for me to leave immediately.”

Five days after this, Marquis Huan of the State of Qi felt very ill. He sent people to invite Bian Que to examine him, but Bian Que had secretly departed many days previously. Soon after this, Marquis Huan died, as expected. 

Early Views on Systematic Correspondence in Chinese Medicine

If you read Volume I of Fung Yu-Lan’s A History of Chinese Thought, which I mentioned in my last post, you will find that much of Chinese philosophy developed during the end of the Zhou Dynasty in the Spring-Autumn Period (770-476 BCE) and the Warring States Period (476-221 BCE). Another spurt of philosophical development came during the Han Dynasty (206 BCE-220 CE). During these times, Chinese philosophers developed the Yin-Yang Theory, which I discussed in earlier posts with respect to its influence on gender roles and women. They also developed the Five Elements or Five Phases Theory (五行，wu xing) that categorizes natural phenomenon into the five elements of wood, fire, earth, metal, and water. These five elements or phases move according to the cycle of the seasons. Paul Unschuld’s Medicine in China shows how these theories gave rise to the theories of systematic correspondence that form the basis for TCM today. Unschuld prefers the term Five Phases for wu xing because the Chinese term implies process or motion. These five notions are not static materials as the word “element” might suggest.

Unschuld also traces the development of the concept of meridians along which the qi or vapor of life flows. In medical texts found in the Ma-huang-dui, there are eleven disconnected meridians, and it seems that acupuncture and moxibustion are recommended for aiding the flow of qi. Later, in the Huang-di-nei-jing (Yellow Emperor’s Inner Classic), the eleven meridians have been augmented into a system of twelve meridians which connect the various organs of the body. These organs are divided into two groups, the depots and the palaces, and it seems that the entire economy of a healthy body is characterized by the metaphor of a healthy united empire with canals and roads for transporting food, with storage depots for holding supplies, and with factories for processing metals and making salt. There is a hierarchy among the organs, similar to the hierarchy of officials in the empire. The heart is considered to be the ruler or jun. Grains are eaten and are processed in the stomach to become qi. This qi nourishes the blood, which circulates, and the qi itself also circulates to all parts of the body. The various parts of the body absorb whatever elements of the qi they need for their functions, and the dregs are moved to the lower parts of the body from which they are eliminated. The qi going up to supply the body is called pure qi, and the depleted qi going down for elimination is called turbid qi. Herbs, food, life-style, acupuncture, and moxibustion are all recommended to help maintain the proper balance and functioning of the organism.

In addition to these theories, Unschuld describes how the religious Daoists contributed greatly to the knowledge of herbal properties, as they conducted alchemical experiments in their pursuit of immortality. They, too, became a school of medical practice in Chinese antiquity.

The following are three of the early Chinese medical texts with Paul Unschuld’s translations from his Chinese Life Sciences: Introductory Readings in Classical Chinese Medicine (Paradigm Publishers, 2005). I have chosen three that I think give a basic overview without getting into too much detail. They are a few of my favorite texts in the book.

黃帝內經，素問2

四氣調神大論

從陰陽則生。逆之則死。從之則治。逆之則亂。反順為逆。是謂內格。是故聖人不治以病治未病。不治已亂治未亂。此之謂也。夫病以成而後藥之。譬如渴而穿井。鬪而鑄錐。不亦晚乎。 (Unschuld 2005, p. 10)

Huang Di Nei Jing, Su Wen  2

Comprehensive Treatise on the Regulation of the Spirit in Accord with the Four Seasons

If one follows yin and yang, then life results; if one opposes them, then death results. If one follows them, then order results; if one opposes them, then disorder results. To act contrary to what is appropriate, this is opposition. This is called inner obstruction. Hence, [when it was said] “the sages did not treat those already ill, but treated those not yet ill; they did not regulate what was already in disorder, but regulated what was not yet in disorder,” then this expresses the meaning of that [what was said above]. Now, when drugs are employed for therapy only after disease has become fully developed, when [attempts at] restoring order are initiated only after disorder has fully developed, this is as if a well were dug when one is thirsty, and as if weapons were cast when the fight is on. Would this not be too late, too? (Unschuld 2005, p. 12)

黃帝內經，素問77

疏五過論

聖人之治病也。必知天地陰陽。四時經紀。五藏六府。雌雄表裏。刺灸砭石，毒藥所主。從容人事。以明經道。貴賤貧富。各異品理。問年少長勇怯之理。審於分部。知病本始。八正九候。診必副矣。(Unschuld 2005, p. 16)

Huang Di Nei Jing, Su Wen 77

On the Five Errors

When the sages treated a disease, they certainly knew the yin and yang [qi] of heaven and earth and the invariable rules followed by the four seasons; the five depots and six palaces (1), female and male, exterior and interior, [as well as] piercing, cauterization, pointed stones, and toxic drugs with all [the diseases] they master. Their approach to the human affairs was natural, thereby understanding the Way laid down in the classics. The noble and the common, the poor and the wealthy, they all [represent] a structure of different ranks, [and the sages] inquired [from the parents] whether they [belonged to] the order of youth or adulthood, of courage or timidity. They investigated [all the] parts and sections [of the human body] and they knew the root and the beginning of the diseases [to be treated]. As for the eight cardinal [turning points] (2) and the nine indicators, in their examinations they were of definite help [too].

(1) The acknowledgement of the yinyang dualism as one of the pervasive structuring principles of all existence required the identification of two types of organs. The designations chosen were metaphors borrowed from the realm of social institutions, i.e. fu 府 in the sense of a storage unit where items are kept only temporarily before being emitted again, and zang 藏 in the sense of an inner-most storage unit where items are kept for a long time, if not forever. The former, including small and large intestines, urinary bladder, gallbladder, stomach, and heart enclosure (pericardium), were identified as yang, signifying notions such as “outer” and “passage”; the latter, including lung, heart, spleen, liver, and kidneys, were identified as yin, signifying notions such as “interior” and “tranquility”. However, a second metaphorical usage of fu 府 identified small and large intestines, urinary bladder, gallbladder, stomach, and heart enclosure (pericardium) as “palaces” housing the zhu  主, “rulers”, lung, heart, spleen, liver, and kidneys, respectively. Thus, in ancient Chinese medical literature, the term fu 府 is encountered in two different kinds of social metaphorical contents. In my translations of the terms zang 藏 and fu 府, I render the former as “depot”, thereby referring to the storage unit metaphor, and the latter as “palace”, thereby referring to the ruler-palace metaphor. A clear identification of each usage of the term fu 府 as either “palace” or “short-term storage unit” appears impracticable.

(2) A reference to the qi at “the eight seasonal turning points”, i.e. the two solstices, the two equinoxes, and the four first days of the four seasons. These are critical terms in the course of each year. (Unschuld 2005, pp. 18-19)

黃帝內經，太素 2

調食

黃帝曰: 願聞穀氣有五味。其入五藏。分別奈何。伯高曰。胃者。五藏六府之海也。水穀皆入於胃。五藏六府皆高於胃。胃受水穀。變化以滋五藏六府。五味各走其所喜。穀味酸。先走肝。穀味苦。先走心。穀味甘。先走脾。穀味辛。先走肺。穀味鹹。先走腎。穀氣津液已行。營衛大通。乃化糟粕。以次傳下。(水穀化為津液。清氣猶如霧露。名營衛。行脈內外。無所滯礙。故曰大通。其沉濁者。名為糟粕。泌別汁入於膀胱。故曰以次傳下也。) 黃帝曰。營衛之行奈何。伯高曰。穀始入於胃。其精微者。先出於胃之兩焦。以即五藏。別出兩行於營衛之道。(精微。津液也。津液資五藏已。衛氣出胃上口。營氣出於中焦之後。故曰兩行道也。) 其大氣之搏而不行者。積於胸中。命曰氣海。出於肺。循喉嚨。故呼則出。吸則入。(搏。聚也。穀化為氣。計有四道。精微營衛。以為二道。化為糟粕及濁氣并尿。其於精下傳。復為一道。搏而不行。積於胸中。名氣海。以為呼吸。復為一道。合為四道也。) (Unschuld 2005, p. 55)

Huang Di Nei Jing, Tai Su 2

To Balance Nourishment

Huang Di: I should like to hear [about the following]. The qi of the grains have five flavors. When they enter the five depots—according to what [kind of criteria] are they separated?

Bo Gao: The stomach is the sea for the five depots and six palaces. All the water and grains [that man consumes] enter the stomach. The five depots and six palaces receive all their supplies from the stomach. (The stomach receives the water and the grains; it transforms them to nourish the five depots and six palaces.) The five flavors move each to [the one depot] which they prefer. The sour flavor of the grains moves first into the liver. The bitter flavor of the grains moves first into the heart. The sweet flavor of the grains moves first into the spleen. The acrid flavor of the grains moves first into the lungs. The salty flavor of the grains moves first into the kidneys. As soon as the qi of the grains and all the liquids have begun their passage [through the organism], and when the camp and guardian [qi] penetrate the entire body, dregs result from transformation and are transmitted downward step by step. (The water and the grains are transformed into liquids. There are clear qi resembling mist and dew; they are called camp and guardian [qi], and they proceed inside and outside the vessels. There is nothing that could obstruct [their flow]. Hence, [the text] states “penetrate the entire [body].” Those that sink down and are turbid are called dregs. They gush, as separate juices, into the urinary bladder. Hence, [the text] states: “are transmitted downward step by step.”)

Huang Di: How do the camp and guardian [qi] move [through the body]?

Bo Gao: The grains first enter the stomach. Their essential and subtle components leave the stomach first through two of its burners [before] they nourish the five depots. They leave [the stomach through two] separate [openings], and proceed through the two paths of the camp and guardian [qi, respectively]. (The essential and subtle [components] are the liquids. After the liquids have nourished the five depots, the guardian qi leave through the upper opening of the stomach; the camp qi leave from behind the central burner. Hence, the text states “proceed through two paths.”) Those major [portions of] the qi which are seized and do not move on, they are collected in the chest, and this is called the “sea of qi”; its outlet is through the lungs, via the windpipe. Hence, to exhale [causes the qi] to leave; to inhale [causes them] to enter [the body]. (“Are seized” stands for “are accumulated.” The grains are transformed into qi. Altogether there are four paths [for the qi to enter and leave the body, and pass through it]. The essential and subtle [components, i.e. the] camp and guardian [qi] occupy two paths. The transformation into dregs and turbid qi, and also urine, and the passage downward together with the semen, that constitutes yet another path. [Those qi that are] seized and do not move on, and which accumulate in the chest, they are called the “sea of qi”. From this originates inhalation and exhalation, which constitutes yet another path. Together these are four paths.) (Unschuld 2005, pp. 58-59)

More on Chinese Medicine

It has been almost three months since my last post, mainly because I have a book on Chinese medicine that I wanted to read and incorporate in this series of posts. It is a comprehensive, scholarly overview of Chinese thoughts on healing and medicine beginning with the Shang Culture (1556-1056 BCE) and continuing up through the Maoist Era (1949-1976 CE). It took me longer to get through the book than I had expected. It is an excellent book; I highly recommend it: Medicine in China: a History of Ideas by Paul U. Unschuld (University of California Press, 1985). The appendix has numerous translations of ancient Chinese medical texts, and Dr. Unschuld has put out another book called Chinese Life Sciences: Introductory Readings in Classical Chinese Medicine (Paradigm Publications, 2005), in which he presents sixty Chinese medical texts with Chinese-English vocabulary and an English translation of each text. I had read through that book first, and its introduction suggested the Medicine in China book for people who wanted to gain a deeper understanding of the concepts. I did not realize how much I had to learn.

I think the deepest impression that I received from Medicine in China corresponds to the experiences that I described in my last post: Chinese medicine is NOT really systematic. There have always been many schools of thought, which have existed simultaneously. The medicine practiced by learned scholars has been very different from the folk remedies found among the peasant population. Unschuld explains this by saying that traditional Chinese thought, in general, has always been syncretistic. Seemingly contradictory systems of thought exist side-by-side in the culture, and over the centuries, average Chinese people seem to have developed a habit of picking and choosing which method or concept best meets the specific need at this moment in time. The best example is the multitude of philosophies that have existed in and influenced Chinese life since antiquity. The main three are Confucianism, Daoism, and Buddhism, but there are also the Legalists and other schools of thought that resurface time and again throughout history. Fung Yu-Lan’s A History of Chinese Thought (Princeton University Press, 1952) gives a comprehensive survey of the various schools of philosophy and how they have influenced one another and Chinese society over the centuries. Such a mindset is very different from our emphasis on the RIGHT WAY to do things or view things in the West. We tend to think there is only one way. According to Unschuld, the Chinese historically seem to have preferred a variety of options, and are comfortable with more than one way, as long as none of the methods harms anyone.

In the earliest days of the Shang Culture (1556-1046 BCE), the king would use tortoise carapaces and ox shoulder blades to practice divination. In the practice of divination, the king would ask a question of his ancestors, the shamans would apply heat to the shell or bone, and the cracks would answer the questions. The questions and answers would be scratched into the bone. You can see lots of these artifacts in the National Palace Museum in Taipei. Scholars have unlocked the oracle bone script, which is an early form of pictographs and is related to modern-day Chinese characters. From the oracle bones, we know that many of the divination questions were related to illness. It appears that the Chinese of the Shang Culture believed that angry ancestral spirits caused illnesses and that the way to end illness was to appease the angry ancestor. Unschuld notes that the Shang Culture did not see a real separation between the living and the dead. There seemed to be a contract between the living and the dead; the living would provide the dead with sacrifices, and the dead would protect the living from harm. Unschuld further comments that such a mindset can still be found in Taiwan and Hong Kong. That reminded me of the time Pa got a speeding ticket on the way to sweep the family tomb…

A few months after Yuni, the girls, and I had moved to the United States, we got a phone call from the family in Taiwan berating Yuni for getting caught driving down the shoulder of the road by one of the cameras along the highway. A traffic ticket had come to the family home in Chungli. Yuni did not remember driving along the shoulder of the highway illegally, when we went on our tour of the island to say good-bye to friends and relatives, but he was not sure. So he gave Ma the password for his bank account and told her to take the money to pay off the ticket. He also told her to keep the traffic ticket photo because he wanted to examine it. The next summer, we went back to Taiwan for a visit, and Ma pulled out the photo, which she had duly hidden in a secret place in her bedroom. Yuni looked at the date and announced that this could not have been him driving because it was taken several months AFTER we had moved to the US. Pa said that he had not driven on the highway because all his work was local, but then he remembered something. He asked for the date again and checked the Chinese lunar calendar. It turned out that Pa had been driving down for the family tomb sweeping ceremony, and the picture was of him. There was a traffic jam on the freeway, and he had driven along the shoulder in his efforts to be on time for the sacrifice to the ancestors. He had been the one to get the ticket.

Pa was quite upset at the ancestors for not protecting him while he was on the way to offer the yearly sacrifice. He said that the ancestors must not be very efficacious, since they could not even keep him from getting a traffic ticket. Ma later told me that from that time forward, Pa stopped going to the tomb sweeping ceremony. He would send money to Eldest Paternal Uncle and have him buy a chicken for the ancestors to offer in Pa’s name, but Pa himself stopped going up to the tomb. In 1999, there was a large earthquake in Taiwan. Pa and Ma were visiting us in the US, and all their children in Taiwan had called in reporting that they were safe, except for Eldest Sister, who lived closest to the epicenter. Pa went out into the garden and began praying to Jesus for her safety. I heard him, but I did not interrupt. Later, after Eldest Sister got through to us, I asked Pa about his prayers. He told me that in his heart he was a Christian, but because he had not been able to obtain permission from his parents to NOT practice ancestor worship, he did not feel free to join in Christian practice. He did, however, give his blessing to his children to practice Christianity and to refrain from worshiping him after his death. To Pa, at least, this contract with his parents was very real, and he would not breach it, even though he did not believe that they could adequately protect him from the spirit world.

After discussing Shang Culture and ancestor worship, Unschuld moves on to discuss the changes in beliefs about healing that occurred during the Zhou Dynasty (1100-221 BCE). In the Zhou Dynasty, the ancestors gave way to demons, and demonology became prevalent. Unschuld again notes that certain segments of the population still practice a form of demonology against illness, especially in Taiwan and Hong Kong. When some Chinese get sick, or at least this was true still in the 1980s when I lived in Taiwan, they go to a temple or to a shaman and have him write a fu, a magical symbol. They then take this paper with the symbol and burn it. They mix the ashes with warm water and drink it as medicine. Although I never met him, Ma and Yuni both told me that Grandpa Chu was able to write fu. Yuni said that he can remember drinking warm water with ashes from a fu when he got colds as a young child. Many of the taxis in Taiwan also hang from the rearview mirror protective fu written on yellow paper, which are sometimes folded up in a red silk bag. Teacher, too, told us stories about drinking the ashes of fu when she got sick as a child. As an adult, she believed that the efficacy of the fu lay in the large glass of warm water and in the fact that you were then supposed to go to bed to sleep off the illness. She felt that the warm water had a purgative effect and the bedrest allowed your body to heal itself.

The scholars of the Qin and the Han Dynasties seem to be the ones who developed the various theories of systematic correspondence, which make up the theoretical basis for TCM today. I will discuss those in another post. 

Chinese Medicine in Lieu of Good Insurance

If you remember, when I gave birth to my youngest child, Peace, something went wrong during the surgery. In 1994, after all the stress of Eldest Sister’s hospitalization and caring for three children in Seattle while Yuni worked most of the year in California, the problems from that surgery began acting up. I went to an urgent care facility because we no longer had comprehensive insurance after Yuni began his own contracting business. The doctors were nice, but they could not figure out what was wrong with me, and I could not afford more extensive testing. In the end, I called a Chinese friend from church who had studied Chinese medicine. He came to my home and took my pulses. Then he wrote me up a prescription. The girls and I took the bus to the International District in Seattle and got bags of herbs that we boiled to make decoctions for me to take several times a day. Our whole house smelled of the medicine. This particular friend was quite skilled; his prescriptions worked well. I took the herbs for several weeks and felt fine.

My experience helped one of our American friends, who is a recovering heroin addict. He had slipped on some ice, shattering his elbows, and needed non-opiate pain medication. Since I knew a good Chinese doctor, I was able to introduce my American friend to Chinese medicine. This time, my American friend’s wife drove us to the International District, and we got the bags of herbs. His prescription included a whole beetle in each bag. I taught my friends how to boil the herbs to make the bitter brown liquid that would help with the pain. It worked quite well, although my friend’s wife crushed the beetles inside the bags before she put the herbs into the pot because she was afraid her husband would not take the medicine, if he knew what was in it.

Later, we moved to California, and I was not so lucky with my next flare up of the side effects of surgery. I got a referral from Chinese friends to a Chinese medicine doctor near our southern California home, and her medicine made me worse than when I started. This can be a real problem with Chinese medicine, especially with practitioners outside of licensed Traditional Chinese Medicine or Classical Chinese Medicine schools. In the mid-1990s, when these problems occurred, Chinese medicine was not so popular outside the Chinese-American immigrant community, and there were no state licensing requirements. It was really a hit or miss kind of process. People would get referrals from friends and try the medicine. If they felt better, they would go back. If they didn’t, they would try another doctor. Some doctors were well-trained; others had a little knowledge and just passed themselves off as Chinese doctors because they could not get better work in America. Such "Mongolian doctors" still exist in the Chinese immigrant community, but they usually work from the back room of a shop that sells herbs and other Chinese knick-knacks. They are less apt now to put themselves forward as Chinese doctors. They frequently claim to have a special family recipe for a great herbal remedy. 

Now there are many schools of Chinese medicine in California, and the state of California has licensing exams for acupuncturists and TCM practitioners. TCM or Traditional Chinese Medicine is the form of Chinese medicine practiced in mainland China. It has been updated and made more scientific, but it is still based on the traditional Chinese methods of diagnosis and treatment. Part of the process of making TCM more scientific included the removal of Taoist practices, the I-Ching, and astrology from TCM theory and practice. Classical Chinese medicine is the line of Chinese medicine that retains those parts of the tradition that were excised from TCM as being too “superstitious.” I have seen excellent Chinese doctors in both the TCM line and the Classical Chinese medicine line here in California. I think the best thing to do is to shop around, ask for referrals from friends, and to be sure that the practitioner, at the minimum, has a state license. There is now a Oriental Medicine Doctoral degree (OMD) that further certifies a Chinese doctor’s level of training.

What does astrology have to do with medicine? Why would it be a part of Classical Chinese Medicine? I am not sure, but I did go to a Chinese doctor in Taipei, who cast my bazi (八字，eight character) horoscope as part of my medical history at the first appointment. I got a lot of help from that doctor, and he was considered to be one of the best Chinese doctors in all of Taiwan in the early 1980s. None of the Chinese medicine doctors that I have gone to in America have used astrology in treating me.

All Chinese doctors that I have gone to seem to rely mostly on taking my pulses, asking my symptoms, and looking at my face, eyes, and tongue. Occasionally, they will smell my breath to finalize a diagnosis. When taking the pulses, Chinese doctors use three fingers on each wrist to feel how my blood and qi are moving in each of the main channels. They are not just counting how many times the patient’s heart beats in a minute. They are feeling for the quality of the pulse under each finger. Then they prescribe herbs, which now come in capsules or powders instead of bags to be boiled. They also usually give suggestions as to what foods will contribute to their patients’ health. The food suggestions are tailored to each patient’s body type, and even act as catalysts for some of the herbal medicines. More on all this in upcoming posts… 

Dragon Boat Festival

Today is the 5th day of the 5th month of the lunar year; that means it is the day of the Dragon Boat Festival. In the Chinese lunar calendar, summer runs through the 4th, 5th, and 6th months, and 5/5 is a mid-summer festival. The official name is Duanwujie. Because it’s mid-summer, the poisonous snakes and insects are out (see my earliest posts about the airplane-sized mosquitoes in Taipei during the 1980s). One tradition is to wear colorful bags of silk that are filled with aromatic herbs to keep away poisonous beasties. These bags are called xiangbao. When I was first in Taiwan, I remember the street vendors selling them all over near my school. They were often animal-shaped; you could buy a tiger or a lion or a dragon. The silk bags were strung on a colored silk cord that you would hang around your neck. Other practices include hanging rushes and moxa plants over the doors to your home to keep out the noxious things. Some people drink Xiunghuang wine (rice wine with realgar) to keep summer illnesses and toxins from harming them.

The favorite food of the season is zongzi or sticky-rice tamales. The legend behind this food is that the poet Qu Yuan (343-290 BCE) of the kingdom of Chu got so depressed at the bad state of affairs in his country that he committed suicide by jumping into the river on Duanwujie. He hoped that his death would awaken the king and nobles to the fact that they were harming the country. The people who saw him jump raced out with boats to try to save him, but they were too late. They were unable to recover his body, so they dropped sticky-rice tamales into the river to keep the fish from eating the corpse and as a sacrificial offering to Qu Yuan’s spirit.

In the Liu family, Eldest Sister makes zongzi every year for friends and relatives. She makes a special kind of rice paste tamale with no added flavoring. Instead, you dip them in sugar or peanut powder or soy sauce, depending on your taste. Those kind can be eaten cold. In Taiwan, we also buy zongzi fresh at the market or from street vendors. They usually have sticky rice, a piece of pork, a piece of shitake mushroom, some other pickled vegetables, and a boiled egg yolk in them. They are wrapped in bamboo leaves, tied up with cotton string, and boiled until they’re cooked.

When Pa and Ma were living with us in the US about 10 years ago, we made our own zongzi. We got the bamboo leaves at the 99 Ranch Market. We half-cooked the sticky rice, par-boiled the pork, and soaked the shitake mushrooms. We also stir-fried the veggies to make them taste good. Then we folded the bamboo leaf into a triangle-shaped cone and put in a spoonful of the partially-cooked rice. We added our goodies and put another layer of rice on the top. Then we folded the rest of the bamboo leaf over to make a pyramid-shaped tamale and tied it all up with the cotton string. We tied the whole bunch together and boiled the tamales in the big wok. We stored them in the refrigerator and reheated them by steaming them or zapping them in the microwave for a minute or two. Definitely a delicious treat!

In southern China, where there are lots of streams and rivers, the people celebrate Duanwujie with dragon boat races; hence, the English name “Dragon Boat Festival.” The boat races commemorate the boats racing to save the poet Qu Yuan, and besides, water sports are great fun on a hot summer day. Dragon boat races are now popular outside of China, too. Here in Long Beach, we have our own dragon boat races in July or August (http://www.lbdragonboat.com/). They are not tied to the lunar calendar, and they do not occur on duanwujie, but they are a lot of fun.