Neijing says: Yes, your doctor should be meditating

It’s possible that some of you don’t agree that the personal character of your doctor has a lot of impact on her effectiveness. Even those of you who know Chinese medicine well may not think that character matters. I disagree. I think it is fundamental.

As Chinese medicine physicians, we take the canonical literature to be our foundation. This goes for learning the arts of diagnosis and treatment, as well as in grounding our practice in theory. But does it stop there? Should we discard the rest of what the classics have to tell us? I don’t think so. In the Huangdi Neijing in Ch 14, translated in my copy as “The Art of Medicine,” there is a discussion about what is needed to effect cures, particularly in complex diseases of contemporary times. Keep in mind that “contemporary” for the Neijing was some 2000 years ago.

An ancient conversation about the worsening health of the general population

In Chapter 14, our favorite conversation partners, QiBo and HuangDi, discuss the differences between being a doctor in their time and being a doctor before their time. QiBo posits that originally doctors only had to use teas and herb wines – because people were living in harmony with nature and disease rarely struck, when it did strike, it wasn’t very severe. He contrasts this with some time later (still long ago from our standpoint) when people began to lose the natural Way of living and thus they were ill more frequently, so wines/teas were used more frequently – but disease was still cured. However, QiBo laments, modern patients (still long ago from our standpoint) disregard completely the Way of health and are ill frequently, the illness are complicated and often terminal. So doctors must use herbs, acupuncture, moxibustion and other related arts to help people.

If people were that sick 2000 years ago - what about now?

We can see Western medicine for some patients who, perhaps, have lost the way even than the “modern” patients spoken of in the Neijing as the next stage in a natural progression. The problem is that not everyone is in that situation. For the most severe diseases, perhaps it makes some degree of sense to use the most toxic substances – hope that the body recovers before it is killed by the substances (think late stage cancer and chemotherapy). This is particularly the case for a patient who has lived far outside the Way.

But Western medicine wants to treat all disease and all people that way. They want to take even people who have lived in relative accordance with the Way (which is to say, in harmony with nature) and give them similar treatments to patients who have not. Most of the time they simply don’t take into account the differences between people, always seeking to emphasize the structural and chemical similarities.

What does this have to do with my CM doctor’s character?

But QiBo goes further, indicating that even with these more severe (from a CM perspective) treatments patients will suffer from Qi and Blood deficiency. Why? Because of the quality of the doctor – patient relationship. There seem to be two elements here. First and foremost, the doctor must possess the qualities I have already discussed as being central: “the correct attitude, sincerity, compassion and a sense of responsibility.” Then, the doctor must come into good relationship with the patient and help them to learn how to pay attention to their own bodies. “When doctor and patient are in a state of harmony, the illness will not linger or become terminal,” QiBo says.

The five requisites for an effective practitioner as discussed in Chapter 25 of the Neijing

1) One must have unity of mind and spirit with undistracted focus
2) One must understand and practice the Dao of self-preservation and cultivation
3) One must be familiar with the true properties and actions of each herb
4) One must be proficient in the art of acupuncture
5) One must know the art of diagnosis

Notice the order.

The first two are related to the internal life of the practitioner, the last three are related to skill and technique. The first two are both the foundation for the second three and also are capable of making the second three obsolete. How? When one truly has unity of mind and spirit, which comes through the practice of the Dao of self-preservation and cultivation – one may no longer need to diagnose using pulse and tongue, one may no longer need to treat with needles and herbs.

But none of us in contemporary times are likely to reach that exalted state. So what will self-cultivation do for us in the meantime? Make us more accurate in our diagnosis, make us more effective in our treatment. Lift us up close to the level of the superior physician. Eventually.

What does this mean for contemporary CM practitioners? Perhaps more importantly for me, personally, what does this mean for me as a student? Even asking it this way it has relevance for people who are already licensed and practicing, insofar that entering into the profession of Chinese medicine means a life of learning.

Pursuing the first two goals: Unity of mind and spirit with undistracted focus (via practicing the Dao of self-preservation and cultivation)

What does it mean to understand and practice the Dao of self-preservation and cultivation? Well, certainly, there are specific practices discussed in various Chinese classics and by contemporary masters. First and foremost, the study of Qigong and Taiji forms that are still growing firmly from their ancient roots. These practices inevitably assist in the goal of self-preservation and cultivation. One might also consider meditation part of this rubric – learning to settle the mind on one thing, or on no thing – will surely help to bring about undistracted focus. There are many practices, in fact, that might help one to get to a unity of mind and spirit - but the most important point I am trying to make is that it is important to attend to this goal. More important (or, at least, AS important) as learning the nuts and bolts of the medicine itself.

To be fair, I believe that pursuing the latter three goals ARE just as important - and in fact studying the basic diagnostic and treatment techniques of Chinese medicine may be a way of achieving unity of mind and spirit. Further, for students and beginning practitioners - mastering the basic theory and skills necessary to be competent in the medicine should take priority over almost anything else. The first two goals may have been listed first simply because they are easiest to neglect and can bear such fruit if taken seriously.

What do you think? Have you had the experience of a doctor who was clearly attending to their self-cultivation and had the opportunity to compare that to a doctor who was not?

Eric Grey

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