How to Deepen Your Study of Chinese Medicine

How to Deepen Your Study of Chinese Medicine

Dr. Li Xin

Translated from the original Chinese by Bryan McMahon

 

What is the source of traditional medicine? What are its defining features?

 

For those who wish to deepen their study of Chinese medicine or increase clinical efficacy, studying classical texts is essential. The development of traditional medicine has a source, a main stream and peripheral branches. Amidst the infinite manifestations of qi, pre-Han and Tang culture was enraptured in the integrated nature of organic life, the mutual influence between Heaven and humanity, and the unity of body and spirit. The movements and transformations of the human energy system were appreciated through the lens of Spirit and qi mechanics. Herbs were used in accordance with the eternal laws of Nature to protect the Middle, with respect to the excess, deficiency, opening and closing of vital qi, appreciation of the advance and retreat of the disease process and understanding of the dynamic properties, direction, and level of the various herbs.

During the Song and Jin dynasties, further evolution of human consciousness and cultural diversification led to individual lineages of transmission and many different schools. However, they remained connected to their original source. From the Ming and Qing dynasties onward, the many branches became overgrown with established doctrine, leading to specialization in specific diseases and formulas. Focus shifted to the functions of herbs and differentiation of disease patterns. And in the modern period, we have witnessed the rise of pattern differentiation according to microscopic evidence, the integration of Chinese and Western medicines, and the direct correlation of symptoms and formulas…

These all represent developments in the field of medicine in accordance with their respective times. They are the sum of the concerted efforts of each generation of physicians to discover a way forward. At the same time however, we need to stop and reflect: what is the source of traditional medicine? What are its defining features?

The Yellow Emperor’s Internal Cannon, Shanghanlun, Divine Husbandman’s Classic of Materia Medica, Essential Formulas Worth a Thousand Ducats, Spleen Stomach Treatise, The Great Compendium of Materia Medica, Wenbing Tiaobian – here we will find answers.

If we quiet the mind, deeply experience our own body and the Heart within, resonate with the changes of Heaven and Earth through the four seasons with the emergence and withdrawal of the flowers, birds, fish and insects; feel the interactions of yi, qi, shen and body, outwardly welcome all forms, inwardly welcome all sensations – here we will find answers.

In Zhuangzi, Laozi, The Diamond Sutra, The Great Learning, The Collected Works of Nan Huaijin – here we will find guidance, to prepare for a meeting of the Heart.

 

What books should I start with to improve my clinical efficacy?

 

Friends often ask me what books to read in order to deepen their understanding of Chinese medicine and improve their clinical efficacy. My recommendation is to begin with the following very short volumes: Dr. Li Dongyuan’s Treatise to Clarify Patterns of Internal and External Damage, Spleen Stomach Treatise, Guidelines for Herbal Categories, and The Heart Method of Using Medicine. These can help us understand the views of ancient practitioners on human life, the diagnostic process and use of herbal medicine.

If we then apply these views to the observation of human life, diagnosis of our patients and a reexamination of the textbooks we originally studied, we may discover both new insights and further questions. Continue with the study of Dr. Zheng Qinan’s Complete Integration of Medical Law and True Transmission of Medical Principle.

Once you have comprehended these two works, you are now ready to study the Shanghanlun and Wenbing Tiaobian. Though unique in nature, the rationale behind both Cold and Warm is the same. Different historical periods, different physical constitutions, different diseases produced by the different expressions of wuyun liuqi, naturally give rise to different symptomology.

Having said that, the mechanisms of qi and disease must always be defined in terms of “hot – cold, yin – yang, excess – deficiency, opening – closing”;[1] the battle between vital and pathogenic qi must always be defined in terms of “advancing – retreating, ordered flow – counter flow, exiting – entering, exterior – interior”.[2] When observing individuals, we must pay close attention to the appropriate selection of herbs and their combination based on the qualities of “hot – cold, opening – closing, thick – thin, moving – gathering”.[3] First, temporarily forget about the functions and indications of individual herbs; put aside all those years spent memorizing textbook definitions of “zangfu pattern differentiation” and “internal medical treatments”. They will be of use again later on.  

All medical theory according to ancient peoples can be summarized in two words: qi transformation. While modern textbooks are replete in theory, strategies, medicines and formulas, they are incomplete when it comes to consideration of qi transformation and qi image.[4] Without the study of classical texts, they cannot be learned; without a quiet Heart and personal realization, they cannot be truly understood.

Once you have developed the inner vision of the Heart able to recognize the qi image that precedes the physical onset of disease and the subtle indications of qi transformation, you are ready for medical case studies. Begin with Case Studies of Wu Peiheng, Case Studies of Pu Fuzhou; Selected Cases of Li Dongyuan, and Xue Ji’s Essentials of Internal Medicine.

The method for studying classical medical case studies requires us to first put aside the modern concepts of Chinese medicine we may have learned.

  1. Key Principle: the coordination of the qi mechanism and pathological mechanism with the dynamic properties and image of the formula.
  2. No matter what the disease, both the qi mechanism and pathology mechanism must always be defined in terms of hot – cold, yin – yang, excess – deficiency, opening – closing; the battle between vital and pathogenic qi must always be defined in terms of advancing – retreating, ordered flow – counter flow, exiting – entering, exterior – interior.
  3. Formula composition must be understood primarily through the four natures, five flavors, and the qualities of hot – cold, opening – closing, thick – thin, moving – gathering. This is what is meant by the dynamics or image of an herbal formula.
  4. Examine classical case studies to see whether the qi and pathology mechanisms match the formula dynamic and image.
  5. Next study modern case studies, ignoring the explanation of the formula and pattern differentiation principles. Do not look first at the commentary. Examine the disease history, description of symptoms, treatment history and formula to see whether the qi and pathology mechanisms match the formula dynamic and image.

 

Slowly over time, you will begin to naturally visualize the posture of the qi mechanism, its opening and closing, the advance and retreat of the pathology mechanism, and the exiting and entering between exterior and interior. Begin to experience the Heart of the true physician where “the one qi circulates without limitation”.[5] The role of the physician is to simply smooth the posture of the patient, grasp the mechanics at play, encourage their movements, gauge the correct degree, and preserve the root.

Using acupuncture and herbal medicine requires one to first understand their underlying principles. Needles allow one to utilize their own shen and qi in order to adjust the shen and qi of another. Medicinal preparations use the shen and qi of the herbs to assist the excessive or deficient aspects of qi transformation of the human body.

Reading classical texts helps shed light on the underlying principles of all things. If you have not grasped these underlying principles, you will not know how to take appropriate action. This leads to no end of confusion. When you understand the underlying principles, your Heart will be at peace. You will understand the depths of these classical texts and in turn, the excess and deficiency of what the person in front of you is describing. Anxiety and doubt during the diagnostic process will decrease significantly. If the disease is cured, you still see room for improvement; if the disease is not cured, you know the reasons why.

You can keep a copy of The Divine Husbandman’s Classic of Materia Medica and The Yellow Emperor’s Internal Cannon on your nightstand and flip through them when you have free time and mental space. In this way, you will inadvertently begin to internalize them.

Works like Zhuangzi, Laozi, The Diamond Sutra, The Great Learning, The Collected Works of Nan Huaijin can introduce us to the Heart of the ancients and help obtain the source of their wisdom.

The scope of medicine is vast like an ocean. Out of compassion for all those suffering from disease, the sages of the past have left behind invaluable instructions on the Path. All of the works mentioned above can help beginners stay the course and discover the healing light cast by the lamp of the medical tradition.

These are my own humble opinions. I welcome thoughts and responses from my fellow practitioners.

 August 10, 2014                                                    

Notes

[1] 寒熱,陰陽,虛實,開闔 hánrè yīnyáng xūshí kāihé

[2] 進退,順逆,出入,表裡 jìntuì shùnnì chūrù biǎolǐ

[3] 寒熱,開闔,薄厚,走守 hánrè kāihé báohòu zǒushǒu

[4] 氣化 qìhuà and 氣象 qìxiàng

[5] 一氣流通,無所不至 yīqì liútōng wúsuǒ bú zhì

Leave a Reply

Your email address will not be published. Required fields are marked *