The Lily and the Rose is a symbol attributed to the Rosicrucians. It represents the integration of six and five. This seemed an appropriate symbol for the idea of reconciling the apparently contradictory models within Chinese medicine. Six is a number important in Yin-Yang doctrine (as are all even numbers) and five represents the five elements. To the left is the Five Elements and to the right the Ba Gua (Eight Trigrams). The Tai Ji (Yin-Yang diagram) is appropriately in the centre of both. The motto below the Lily and Rose is an alchemical saying: "Igne Natura Renovatur Integra", By Fire is Nature Renewed Whole' or 'The Whole of Nature is renewed by Fire'.

Integrated Chinese Medicine

Introduction

Traditional East Asian Medicine is a coherent body of knowledge. There are differing styles and approaches, particularly in regard to acupuncture, but they are all, at least potentially, part of one complete system. Ultimately all Chinese natural philosophy is based upon a remarkably consistent philosophy, numerology and cosmology; and yet it is not homogenous. In the modern world and particularly in the West we have a great deal of difficulty in reconciling the apparent contradictions. How far these apparent contradictions were reconciled in the minds of the ancients is a question that is often missunderstood. There is a fundamental challenge that may be a good starting point for understanding how these schools and sects arise.

Apparent contradiction and inconsistency is tolerated in East Asian thought. For example The Dao De Jing (Tao Te Ching) famously says, "the Dao (Tao) that can be spoken of is not the constant Dao (Tao)". This has not stopped many speaking or writing of the Dao; but particularly in the practical applications of Chinese thought we have to put these ideas into words. Allan Watts in 'Tao, The Watercourse Way' talks about this dilemma. According to Allan Watts, the poet Chu-I wrote:

Those who speak know nothing
Those who know keep silence.
These words were spoken by Lao Tzu.
But if we are to believe that Lao Tzu,
Was himself one who knew,
How comes it that he wrote a book
Of five thousand words?

This is the same dilemma that we face in all the practical applications of Chinese natural philosophy, including traditional East Asian medicine. The Chinese especially have always been considered very pragmatic and seemed to have no problem with the transition from the philosophical to the practical. Recognizing that these two are ultimately different. As the Tao Te Ching says:

Ever desireless, one can see the mystery.
Ever desiring, one can see the manifestations.

There is a tendency to a dichotomy within Eastern thought; at worst this seems to become 'lip service' to the principles and philosophy, and a gulf between the philosophical and practical. I suggest that the philosophical and the practical can be brought closer together. One way of understanding the gulf between so called Classical Chinese Medicine and Traditional Chinese Medicine is to see CCM as intending to follow more strongly the idealism of the Classics, and modern TCM as more practical and pragmatic.

I use the word 'intending' because we live in a dualistic world we cannot completely attain the ideal; wholistic is an aim, but we necessarily have to exist in the dualistic world. Our language is based in the dualism. The Heart Sutra of Buddhism has an expression. "Going on beyond, always becoming Buddha". The idea here is that CCM is a journey that we are on and ideal we are aiming for but that we cannot arrive at in the mundane world.

Daoism (Taoism) has been described in terms that contain a contradiction 'dualistic monism', it contains a fundamental holistic view of the universe and an understanding of the universe that is based on the apparent contradiction of dualistic principles of Yin and Yang. The reconciliation of these two viewpoints has been symbolized in esoteric thought as 'squaring the circle'; the square representing the 'four square' Earth, the circle representing the unitary Heaven. Similarly in Chinese numerology the odd numbers are Heavenly and the even numbers Earthly. East Asian science uses many models that are developments of the yin/yang principles, and because some of these are based upon odd numbers and some even, they can not be made totally congruent. In the West we are used to assuming that we have to choose between two theories, or systems or arrive at a synthesis; just as Western scientists are at present trying to reconcile relativity and quantum theories into a 'grand unified theory'. The Eastern system allows that differing viewpoints cannot be completely reconciled, and yet both can be true. In other words to make a 'square peg fit a round hole' perfectly would only be achieved by some damage to one or other. The Chinese system of knowledge has been described as syncretic, from this viewpoint, it may not be possible to reach a 'grand unified theory. In Chinese medicine a model based upon Two (Yin & Yang), and Five (Elements/Phases) are both seen as correct, and yet cannot be entirely congruent. From the number two the Earthly world's complexity extends in symmetrical way: Four Emblems (Seasons), Six (paired) Channels, Eight Trigrams.

East Asian thought is often described as seemingly lacking in logic, critical thinking and dialectics. As if it is simply an accumulation of models. Richard Nisbett in The Geography and Thought and Amir D. Aczel, in Finding Zero: A Mathematicians’ Odyssey to Uncover the Origin of Numbers both describe the different form of critical thinking in East Asian thought. Aczel quotes Chapter 18 Verse 8 of the Mulamadhyamakakarika bu Nagarjuna in the second centry CE:

Anything is either true,
Or not true,
Or, both true and not true,
Or neither true or not true.
This is the Lord Buddha’s teaching.

Perplexing as these statements seem at first, Aczel explains them very clearly with a few examples. It seems that most of our mathematics is based upon Aristotles categories or ‘a’ or ‘not-a’ and thus there is a principle called the ‘excluded middle’. However, there have been mathematicians who have included these extra categories. One everyday example is that if one puts a little bit of sugar in ones coffe one might describe it as ‘not not-sweet’. And indeed in English we might say of someone that they were ‘not un-attractive’. Aczel says that if we do indeed develop quantum computers they will use these extra logic positions and so they are not weird philosophical ideas removed from the real world either. Stephen Hawking in The Grand Design describes modern science as also moving towards a Multiple Model Theory: "It could be that the physicists’ traditional expectations of a single theory of nature is untenable, and there exists no single formulation. It might be that to describe the universe, we have to employ different theories in different situations. Each theory may have its own version of reality, but according to model-dependent realism, that is acceptable so long as the theories agree in their predictions whenever they overlap, that is, whenever they can both be applied." (68-9) I believe that this is implicit in the system of critical thinking of East Asian thought. What East Asian thought is not but is commonly mistaken for is extreme pluralism and relativism.

Without the rigor of the East Asian system of logic and Critical Thinking the medicine has tended to become a main dichotomy and a great variety of approaches, potentially with every individual having their own perspective and understanding. Whcih is not to say that there is one dogmatic correct model, pluralims up to a point is a strength of our age. However, extreme pluralism and relativism is undermining the foundations.

About the Author

I originally trained to practice Five Element acupuncture with J.R. Worsley. I studied widely, especially TCM texts, and more recently as Clinical Director of the Jung Tao School of Classical Chinese Medicine I have been exposed to other non-TCM teachings. I have not found anything yet that, however different it may appear at first sight, can not be reconciled. I would like to mention that I am not a sinologist, my study of Chinese characters is mainly with the works of Claude Larre on one side of me, and various resources on Chinese characters and etymology on the other. I see this exploration and integration of the traditions of acupuncture as a 'work in progress', and I would especially recommend for reading ' Five Element Constitutional Acupuncture', the work of John & Angela Hicks and Peter Mole founders of the College of Integrated Chinese Medicine in Reading UK.

The following are a series of discussions about the various viewpoints found within Chinese Medicine. The numerology and cosmology contained therein is an overview of a more comprehensive work that I am engaged in at present. This is my own understanding of these subjects and how the apparent contradictions may be reconciled - as such I could have titled this page "towards an integrated Chinese medicine".

Articles: all the followign are works in progress and subject to amendment from time to time.

Preface: an introduction to Integrated Chinese Medicine: A discussion of Classical Acupuncture, especially the teachings of J.R.Worsley.

East/West. The worldview of the east and west have long been thought to be different. Richard Nisbett in The Geography of Thought has identified these differences. These are applicable to understanding Chinese medcine and especially Classical Chinese medicine.

Numerology and Traditional Oriental Medicine: a brief synopsis of the principles of numerology in particular reference to Chinese Medicine. Understanding the underlying cosmology and numerology can help resolve some of the apparent contradictions within Chinese medicine and reveal its cohesiveness. And even lead us to understand why the differing models and viewpoints within Chinese Medicine can all be true (as with the proverbial elephant and the blind men).

Chinese Characters applicable to Chinese Medicine. One thing that distinguished Classical Acupuncture and systematized Chinese Medicine is the interpretation of Chinese characters as having multi-layered and metaphorical meaning in the former and more technical and circumscribed meaning in the latter.

J.R.Worsley and the Classics: A look at the origin of many non-TCM principles and practices, especially those of J.R.Worsley, in the classic texts of the Nei Jing and Nan Jing.

Diverging traditions in Chinese medicine: An examination of the history of Oriental medicine especially the divergence between China and Japan that may account for the main differences in modern approaches.

Diverging traditions in pulse examination: An examination of the development of the two main traditions of pulse examination (especially in relation to the pulse positions) that distinguish modern TCM and Five Phases. One model is derived from the Classic Nan Jing, the other was developed later. These differences in some ways represent the different emphasis of the two models.

Mind and Spirit in Classical Chinese Medicine: An examination of the mind and spirit in modern TCM and Classical Chinese Medicine.

Discussion on the Emotions as described in Chinese Medicine: Different traditions have differing descriptions of the main emotions, and even TCM texts vary in their understanding of these. In particular J. R. Worsley and others have described the specific emotion of Earth as sympathy. This article looks at the classic texts of the Nei Jing and Nan Jing and attempts to clarify the understanding of this.

Chinese Medicine and Systems Theory: Chinese medicine's understanding of the body-mind is a wholistic inter-relational model. This explains some of the differences between the Chinese concepts and modern anatomy.

Twelve Officials and Five Zang & Six Fu: An examination of the different traditions of acupuncture in relation to the main functional units of the body-mind. In Five Phases greater emphasis is based upon the broader non-physiological aspects of the 'officials' and in modern TCM the more pragmatic functionality is emphasized. The TCM model also divided internal organs into 'viscera' and 'bowels', with the latter having a more secondary or mundane role than the former. In Five Phase understanding the so called 'bowel' actually represents a broader range of 'yang' aspects of the Phasic attributes.

Orbs and Organs: Although the functional components of the body as described in Chinese medicine are transliterated into the name of an organ as understood in Western medicine, these are by no means equivalent. For this reason, Manfred Porkert has coined the term 'orb' to refer to the Chinese concept. My main criticism of (my own) Five Element training would be that in the absence of Zang-Fu theory the tendency was to equate the Western understanding of the organ to the 'orbs' assigned to the phases, rather than the Eastern. I am told that this important distinction is not necessarily taught or understood even within TCM training.

What's in a Name? The functional entitiy known as the Pericardium in modern TCM has the distinction of being referred to by various names in the classic texts: Xin Bao Luo, Xin Zhu, Dan Zhong. In European texts including the teachings of J. R. Worsley this was referred to a Circulation/Sex. Examining the implications of these various names Pericardium would appear to be a poor translation, and also represents a simplification and limiting of the understanding of this function.

Aggressive Energy and Evil Heat : TCM writers often comment on the apparent complexity of the average patient in a Western acupuncture practice. One of the most common complexities is the presence of heat signs and symptoms in many patients. Two theories serve to explain this, Law of Similar Transformation and Yin Fire Theory. The close connection of these theories to J.R.Worsley's concept of Aggressive Energy is very clear.

The Law of Husband Wife: This is a discussion of the teachings of Felix Mann and J. R. Worsley and the foundations of this concept in the classic texts.

Element within Element: Emphasized within Constitutional Five Element diagnosis. This article is the author's suggestion of a way that this can be understood at least intelectually as having a shared underlying idea with syndromic diagnosis.

The Medical Masters of the Jin-Yuan Important changes took place in the Jin-Yuan dynasty. Including: The Attacking School, The Supporting the Yin school, Supporting the Earth School, Yin Fire theory, Law of Similar Transformation, Six Depressions (stagnations). Some of these are central to understanding the diverging approaches within traditional Chinese medicine. Some are important developments especially in understanding fire and heat pathology.

The Direct and Indirect methods of Needling The basic principles of needling appear to be defined differently in the Su Wen to modern ones. And indeed a change in definition of these terms can be seen in chapters of the Su Wen that are known to have been added at a later date than the main material. The difference between the minimalist approach to needling found in Japanese and especially Five Element practice and more forceful mainstream practice can be understood by the classical principles.

Select Bibliography:

Hawking, Stephen & Mlodinow, Leonard; The Grand Design, Bantam, 2010

Hawking, Stephen & Mlodinow, Leonard; The Grand Design, Bantam, 2010

Nisbett, Richard: The Geography of Thought, Free Press, 2003

Aczel, Amir D.; Finding Zero: A Mathematicians’ Odyssey to Uncover the Origin of Numbers,

Further Glossary and Bibliography

Thes following are miscellaneous articles:

Acupuncture and the 50 minute hour. This is a response to an article written by Bob Flaws in Acupucnture Today in which he criticised the common practice of treating patients once a week. This practice is common in Five Element approach and is found to make a great deal of sense in western clinical practice.

This Channel Discusssion article by John McDonald is good in parts and I agree with several points and disagree with others. I agree that Westerners may have emphasized too strongly the separation of the channel system and the blood vessels. I also agree that the generic term jing-luo may have led to confusions over the idea of luo channels specifically and the idea of the luo as generic of all the collaterals - (channels and vessels). However, the discussion on the idea of energic transfers appears to be missing the Nan Jing. There are several passages in the Nan Jing that support the idea of balancing the full and empty. Question 76 and several others that follow. Balance is not exactly the same as 'transfer' but the implication is very clearly an idea of Shi and Xu that is not the same as the modern received teachings.

External Links:

There is a website devoted to Classical Chinese Medicine

I particularly recomend the works of Heiner Fruehauf.

Chinese Character links:

Zhong Wen

Zhong Wen is a particularly good resource. Traditionally characters have been classified under radicals. This author has developed family trees of characters based upon their various components. It is mainly common characters, and so is not comprehensive.

Chinese Etymology

The author has assembled a very comprehensive site that enables one to view up to date etymology and very comprehensive of older and less common characters.

Note the etymologies in the above two resources often differ from older explanations and from each other. Examination of the older examples in the latter site enables us to compare the merits of the various ideas.

Unihan Database

This resource of characters included in the modern unicode based computer fonts. Very comprehensive, but often there are no definitions given for many uncommon characters.

©Andrew Prescott 2006

Do give me your feedback and comments.

Contact: B.Ac.(UK), Dipl.Ac(NCCAOM), L.Ac.(NC)