What follows is a walk through my first year learning Chinese medical theory. This is an invitation to join me on the wooded paths, past ferns, and birds, with an owl calling in the distance. Join me as the path emerges near a river. The apple trees are in bloom despite leaves on the ground from last winter. These thoughts come from my notes, as taken from Dr. Livingston’s talks. It was an honor and a pleasure to listen to him and learn from him, and I am grateful for the knowledge that has been passed to me. I humbly request your presence on this walk. Please join me.
Imagine an early Friday morning in September in the Pacific NW. The sun was just beginning to burn the fog from the nearby river. I sat to the right-back of the classroom at the Oregon College of Oriental Medicine (OCOM) called “the great room.” It wasn’t my first class at OCOM, but it was my first week of classes. And I was really excited to learn theory. The whole room buzzed with a sense of anticipation; we were all ready for this moment. I personally was hungry for the mental stimulation I was sure this information would bring, as had all my past academic experiences. Shortly into the lecture, my theory professor, Greg Livingston, told our class, “If you’re going to practice Chinese medicine, practice Chinese medicine. Get really good at this one thing.” I was thinking, that is forcing; that's not a higher teaching of yoga ~ stay open and learn. Someone had asked a biomedical question, naturally trying to fit this new theory into an existing biomedical framework. My professor responded by urging us not to bring biomedical ideas into the framework of Chinese medical theory. It won’t make sense that way. It has a truth on its own, and both can exist as incomplete ideas about the nature of existence and reality. They are complementary and not mutually exclusive. While there are overlaps in some concepts (like the kidney-lung connection), trying to fit each into the framework of the other is like rowing a boat with one foot sticking out and using a half-broken paddle. It doesn’t work well.
Yet, I was so frustrated by his comment. Disappointed. As a science and environmental educator for almost 18 years who emphasized the creative processes in learning ~ exploratory, emergent, hands-on, experiential ~ I felt that his comment limited me and my classmates. I thought we had all moved beyond the “just memorize it” mindset; I was ready for the experiential learning, the synthesis. The yoga of Chinese medicine. All the teachings. I wanted to live my truth. I was unsure if this memorization viewpoint would satisfy my craving to truly learn this medicine with every fiber of my academic background in biology and my beating physiological heart. Would it keep me from asking questions, and put the proverbial lid on my imagination, creativity, and eagerness to excel in my learning? I wanted to understand all there is to know from the most complex details with biochemistry to the vast, expansive, encompassing, poetic aspects of Chinese medicine. I wanted the science and the art to merge, integrating fully with my philosophical training in yoga and meditation so that I could understand everything more clearly and basically reach nirvana then and there, or at least during the 3 years of my program. And despite this momentary daydream, the lecture continued. The synthesis I was looking for would take more time than a short yet intense 3-year program. It might take a lifetime or two. And it wasn’t going to happen there in that classroom, during the first week of my first quarter of Chinese medicine school. To learn Chinese medicine, I needed to simply learn Chinese medicine. And that included theory – – the foundations.
An Introduction to Chinese Medical Theory
There are 4 basic characteristics of Chinese medicine: wholism, perpetualism, pattern differentiation and treatment determination, and “li fa fang yao” or “theory method formula herbs.”
Wholism “zheng ti guan nian”
The concept of wholism in Chinese pinyin (English letters that make the sounds of Chinese characters representing these concepts) can be understood as “zheng ti guan nian” meaning “organic, whole view or perspective.” Quite simply, this mean that there is a unity of mind and body and that these are always in relationship to one another as one. The 5 zang organs form the center of the whole. The jing-luo, or meridians/channels/vessels/collaterals, connect all organs to the whole body. Humans and the natural world are interconnected. We are microcosms of the whole, down to our cellular structure, genetic structure, atomic structure, and beyond, and the whole is a reflection of us (nature, planetary, universe, and beyond). We live within and dependent upon the natural world. The natural world directly affects the physiology of living creatures. Regional variations in climate (dry, wet, hot, cold) affect human health. “Humans are connected to heaven and earth, and the sun and moon affect them.”
Perpetualism “heng dong guan nian”
The concept of perpetualism, or “heng dong guan nian," means that everything is in a constant state of change. All things are in a constant state of movement, transformation, and development. Nothing is static. Physics agrees.
Differentiation of pattern and determination of treatment “bian zheng lun zhi”
The phrase “bian zheng lun zhi” literally means “differentiate pattern determine treatment.” This is an idea unique to Chinese medicine and sets it apart from other forms of medicine. The manifestation of human sickness indicates the nature, location, and cause of the sickness. “Bing” or differentiate: in Chinese medicine the concept of “asthma” for example, doesn’t go far enough. Differentiation is needed. Does the person who is experiencing asthma have signs of “excess” or “deficiency,” of “heat” or “cold,” of an “external pathogen” or internal pathogen?” Chinese medicine practitioners are doing pattern differentiation during the interview - gathering information through observation of sight, smell, touch, and sound. Our main purpose as practitioners is to “bian zheng” - differentiate patterns. After this, treatment can be determined, treatment given, and the results observed to assess accuracy or need for adjustment. To clarify the concept of disease “bing” versus pattern “zheng” consider these examples. Examples of diseases include headache, hypertension, back pain, anxiety. Examples of patterns include exterior wind-heat, wind-cold damp stagnation, yin deficiency heat. These concepts will be elucidated more in future posts. Basically, diseases have many causes; the same disease can have different causes and different diseases can have the same cause. The saying goes, “same disease, different treatment; different disease, same treatment” or “tong bing yi zhi, yi bing tong zhi.” Forgive me if my Pinyin is off; this was literally my first week of Chinese medicine school when these notes were taken.
Theory, Method, Formula, Herbs “Li Fa Fang Yao”
This concept represents the fundamental methodology of Chinese medicine. Theory: the intake, analysis, and diagnosis is grounded in theory. How are the body systems working together with each other and part of the whole? How are they changing over time (perpetualism)? How are they manifesting in the present moment and over time (pattern differentiation)? Method: the treatment method is chosen based on theory. What treatment is best for this pattern? Fang, or formula, can be chosen to treat the pattern (or we can understand this in reference to acupuncture, massage, food, or movement therapies as well). Yao means to select the proper dosage, which once again can refer to herbs, or to any of the aforementioned treatments.
The 4 basic characteristics of Chinese medicine: wholism, perpetualism, pattern differentiation and treatment determination, and “li fa fang yao” or “theory method formula herbs” can be represented by the concept of yin and yang, the taiji symbol. Taiji means “great ultimate.” It is representative of the whole and everything in it, the unity of this whole, the interchanging and ever-changing nature of everything, how we as humans are connected to nature and the universe “between heaven and earth,” and how our relationship to everything manifests in signs and symptoms of the body and mind that can be treated with herbs, acupuncture, massage, nutrition, and movement. It’s beautifully simple and simply beautiful. It’s simple but not easy. That we will learn as we continue our walk together. For now, let’s stop and take a break. There is a lovely bench there by the river. Won’t you join me?
~ with grateful thanks to the Wise Old Owl,
my grandfather, who encouraged me to write,
because words are gold~
notes taken Sept 13, 2017
written Feb 5, 2022
-kelly a ilseman
L.Ac., M.Ac.O.M., M.S., M.Ed.
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