There is a very interesting discussion going on over at Richard Goodman’s blog – He explains…
“…Ling Shu Chapter 55
The superior physician treats that which is not yet ill. The inferior physician treats that which is already ill.
This is a fairly famous statement, which is often interpreted to be a call to preventative medicine. Modern physicians often complain that patients come in with specific complaints and it is impossible to treat what is not yet ill. I find this stance strange, as if we are to believe if someone has a disease which has already become manifest, the practitioner is prevented from treating what is not yet ill.
At any rate, the following quote from Nanjing has a completely different interpretation of the above passage:
Treating what is not yet ill means that when one sees illness in the liver (for example), this (can be) transmitted to the spleen. First fill (shi2) the spleen qi so that there is no way for it to accept the liver’s evil qi. This is what is called treating what is not yet ill.
As you can read, the writer of the Nan Jing felt that the meaning of treating what was not yet ill did not mean some psychic rendering of signs and symptoms, but a way of treating a person who comes with a specific complaint. “
Talking with my friend and colleague Michael Givens, he stated his conviction that this Classical passage tells us succinctly how we must proceed as Classically trained physicians. I agree! When a patient comes in to see us, we must be doing a number of things simultaneously. We must see the present complaint as it is an express of physiology gone awry, and we must situate that within a matrix of time and space that helps us understand the root of the disease as well as its potential for adverse development. While your chronic cough may be easy to ignore and seemingly innocuous, not to mention related only to the “Lung,” as Classically minded practitioners, we need to see under, around, beyond and between that.
This asks a lot of practitioners. We need to understand physiology in all of its manifestations, with all of the conceptual systems we have to understand them. This is particularly true of the six conformations, as they are the broadest, most comprehensive, and least misleading structures we have available. But, we must also know the five element model (and all of the interrelationships therein), the complexity of the channel system (from minute luo to cutaneous regions), and yes, we can also take into account the Zangfu information (particularly as contained in the Neijing and other Classical texts) and everything else we have learned. It is my preference to stick with the six conformations and five elements, and others may have other preferences.
We need to understand the manifold ways that physiology can be disturbed, and understand the diverse ways this can express in patients. We must understand how disease progresses through time, and what factors might upset the “normal” progression.
This is to say nothing of all we must know for treatment. This is to say nothing of the intense rectification of the self that must take place in order for our true healing power to come forth. It is to say nothing of a lot of things, but a lot about a little. And that little is critically important, so important that it was enshrined in the foundational texts of our medicine.
I don’t know if I will ever “be” a superior physician – it seems to me the kind of thing that one continually strives for, a moving target that helps to keep the thirst for excellence alive. But, I do know that the rest of my life will be devoted to attempting to understand the above, and attempting to let that understanding flow into my treatment, and to let my treatment be of service to my patients.
What about you? How do you understand the above line? Do you feel prepared to strive for the “rank” of superior physician? Discuss here in the comments or on Richard’s fine site.
Eric
Tags: study, lingshu, Learning, ccm, physician
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Michael,
I have never read that text, so it definitely is not where my understanding of Dao comes from. Believe it or not, I would say The Bible is where my original understanding of Dao comes from, before I first read the Dao De Jing. All it took was for me to read the first chapter of the DDJ once after studying The Bible for many years, and I instantly found a new spirituality that fit me better.
I was not trying to give the impression that I am one with the Dao at all times, but merely my understanding of Dao and glimpses of being one with Dao is what makes me strive to try and always want to be in the flow of it. It is something you can alway strive for, but will most likely never truely attain. Much in the same way a CM practitioner must always strive to to be a high level doctor, even if you will never be able to become one. Calling myself a Daoist does not mean I am always in a state of harmony and Oneness with the Dao, but rather that this is what I seek.
Delli,
I am jumping in on this conversation a little late, but I am quite disturbed by some of the things you have said. I wish I could share Eric’s enthusiasm about this conversation, but I find what you are saying disheartening.
1. You offer us an interpretation of the line Richard gave and then say it is a translation. You ignore the grammar and don’t bother with a couple of characters in your ‘translation.’ You also add things that are not there, for example talking about the time clock. This is interpretation, not translation. You then give a text that is a couple of hundred years older, ie someone else’s interpretation, as a claim that it proves your interpretation? The original article also uses commentaries, but notice the difference in tone-you are convinced that the commentary you offer is “the same thing”, while the original articles is simply offering perspectives.
2. I’m curious how you reconcile an open mind and heart to get at the deeper meaning while being 100% convinced that your current view is correct? Can you provide us, for example, a commentary that shows your ideas about prevention were what the original text meant? Even if you can, are you so willing to dismiss the other commentaries above? Or are you just so convinced that your view is the same as the Ling Shu that you are going to read it that way no matter what? As a student, you believe you have the BEST way to learn this medicine? Another thing you know to be 100% true?
3. I find your discussion of 法 and the water radical an astounding misunderstanding of Chinese. Studying radicals to understand characters is important, but I do not follow your logic. The flow of water is a Daoist idea? Which means that the use of 法 contains a Daoist idea? When I see phrases like “I think anyone who has studied classical Chinese culture can tell you that the flow of water is a Daoist idea,” I am at a loss for words. I thought the flow of water was a natural phenomenon that writers throughout Chinese history have used in analogies. I would say most people who have studied Chinese culture seriously would make such a simplistic statement.
4. For how long have you been studying classical Chinese? Chinese medicine? You are a student, and instead of asking questions of someone who is recognized as an expert in reading the classics, you offer up an interpretation masked as translation and then believe that your ideas are better than (your words) someone with much more understanding of the language than you have demonstrated here. What exactly are your translation qualifications? Ever had a class in translation theory? Linguistics? Even a basic sinology course? How many classical courses have you taken? You are a student with access to a couple of the best teachers in the US at your school, and yet you show them very little respect here by judging their work in ways that I cannot even comprehend. You say you are not questioning or insulting them even as you do so. You say you respect them as you qualify their work as belonging to the category of mediocre physician.
5. You have decried history as incomplete but then use mythical figures as historical ones. We have a lot of great historical information, and you are right, it will never be complete because we will discover new things. I agree that we shouldn’t be waiting for historical proof (whatever that might mean), but I would also add that doesn’t mean we should fill in the cracks by just making it up. This is why people who are more knowledgeable write knowing that anything they write is only one perspective. I prefer to work with incomplete, but still very valuable, historical information than cooking up my own ideas and seeing if I can find them in the medicine.
6. Believe it or not, there are plenty of people who can read classical texts who were not born in China. They do not translate first, but actually read the Chinese. I can do this, and I know a lot of other people who can. I’m surprised you don’t think this is possible…it is. Classical Chinese is its own distinct language from modern Chinese, and trust me-most people in China cannot read the classics either. I also find the number of Chinese practitioners interested in the classics is far less than you would imagine. If you read the classics through your own translations and never really learn to read the language, then are you reading the classics or just expounding your own ideas?
7. I agree with Eric, and respect his humility, when he says “that the best we can possibly hope for is to ask questions, to have profound experiences that we can reflect upon, and to ask more questions. Anything else is likely either mental masturbation, appalling hubris or both.” Why not take advantage of being a student and ask questions instead of trying to provide so many answers?
Time to take a deep breath anyone!
M. Bayh does make valid points, but complains about the tone of Delli, but I am afraid the tone of this response was also somewhat heated.
I have several translation of the Nei Jing and Nan Jing and all have numerous red marks and footnotes, that I have inserted that denote omited characters, differing terms standardized to one translation, words added, often to make the passage conform to modern recieved understanding, and explanatory/interpretive translations even complete inversions of meaning in some cases to try and make sense of what appear to be conflicting ideas – and these are published folks – not bungling amateurs like myself.
M. Bayh,
I wish I had time to respond in depth to this, but I don’t have the time to do so. Apparently, you have greatly misunderstood me as well. Aren’t all translations an interpretation of the classics? That is why they are so varying. I am not sure what the difference is because they both seem to meld together. I was actually trying to have a discussion with Richard about the lines. I was not trying to dismiss his ideas completely or say that my translation is correct. I translated those in a matter of minutes, so I am sure it is not completely correct, or the best translation. The organ clock idea, was in paranthesis because it was my idea, not in the text. I guess, this is what I would call an interpretation. The rest is what I would call a translation. You will have to explain the difference to me.
2. This is obvious to me. I don’t know what to tell you or how to make it any more clear. Yes, this I know to be 100% true. 12 years of studying natural medicine makes this evident. Sorry, I don’t have time to answer this question in detail, and I feel like I have commented on this enough that my POV is clear.
3. Perhaps, I may be way off on this one. I didn’t research that well. It makes sense to me though. Yes, the DDJ always refers to the Dao as being like flowing water. It is the ultimate earthly symbol of Dao in ancient China. That is the association I was making reference to with that.
4. I have taken almost every class at NCNM offered on CCM at this point. I am a 5th year student focusing on my thesis and internship now. Well, my teachers in my classical texts classes seem to agree with most of my translations in class, so I must be doing something right.
You know, I was never big on asking questions until the last year. That is not how I like to learn. It seems like asking questions often times doesn’t help me much, so it is not very important to my style of learning. (hey, just being honest)
Sorry for disheartening you, but I like to tell it like I see it. I am not always right, but I am seldom wrong. Wish I had time to say more, but I have to study and work on translating the Fuxing Jue. I am NOT an expert translator by any means, so my translation will definitely be guided by Dr. Fruehauf once I get past the first round on my own. I am sorry if I mislead anyone into believing I am proficient translator/interpretor or reader of classical Chinese. I have much work to go in that department still. I also don’t feel the need to defend myself against such criticism anymore either. It is just plain silly and a waist of time. All I ask is that you respect my POV and I will do the same. Afterall, I am just the ignorant student, so you might as well just laugh or dismiss my ideas anyway since they are bound to change once I get into practice, right?
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