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 19th and early 20th 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.