The Lingshu and becoming a superior Chinese medicine practitioner
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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
Writing and the formation of a vigorous Chinese medicine profession
So, I passed my thesis defense! I have a few revisions to make – when I’m done with those and have final approval I will (a) breathe a big sigh of relief, (b) begin posting portions of my thesis for discussion on the blog. As I see the topic, particularly of the last half of the document, being the ground for the next decade or two of my intellectual work – it seems prudent to discuss it with as many people as possible. How else am I going to get good ideas? ;)
The thesis process was a good one, overall. I know that most Chinese medicine students don’t have to produce something like a thesis – opting instead to do a final project or something of that nature. If you would have asked me six months ago what I thought about our writing a thesis, I would have given you a pretty negative answer. At that point, I was still pretty freaked out by the clinical aspect of things and I really felt like we should be focusing entirely on the clinic during our final year. I can still see the benefit and wisdom of that idea, but I think I’ve developed a different stance over the last months.
Our program at NCNM is a little different than most in that it expressly intends to develop people who are or can be scholars in the field as well as practitioners. While many great scholars come from programs all over the world, NCNM is the only one that I checked out that actively attempts to develop the scholarly spirit in its students. Now, of course this is not always successful. People come to the program for different reasons, only one of which is to develop that scholarly acumen. It was (and is) definitely a priority for me. Why?
I continue to feel that this is a critical time in the development of natural medicine, including Chinese medicine. Great practitioners are needed. I truly believe that there is a difference between a person who has dedicated their life to the embodiment of the principles underlying Chinese medicine and a person who sees it simply as a career choice or something interesting to do for now. The experience of opening one’s self to the medicine completely and seeing what happens is profoundly moving, profoundly changing. Truly great practitioners emerge from this process. The one-on-one patient-practitioner interactions that these practitioners engage in are doing great work for our medicine as a profession, one changed heart at a time.
However, we also need people who can do more than be practitioners, in my opinion. We need people who can go out into the community at large and talk about health, healing and living in harmony with nature. We need people who do not shy away from difficult conversations about our history and our future. We need people who can write, people who are willing to do cross-pollination between disciplines in an overt and publicly available way, people who aren’t afraid to put themselves out there. We need to develop a vibrant community of people who are practitioners but also thinkers, scholars – people who can engage in well researched, passionate and decently written discourse both internally and externally. While a particular educational program is not necessary for that (may great writers have no particular education), in my case it has been helpful.
I was reminded of how something longer than a blog post is written. Your reading always takes longer than you think it will. You need plenty of time to think about it, between reading and writing and revising and reading and writing and revising. You need time to talk things over with peers and advisors. You will always need to read it many more times than you think. You will always open more cans of worms than you close. You will always go through periods of doubt and despair, punctuated with honeymoons of wild elation. It takes time, it takes energy, and it is so worth it. So, I learned (or relearned) quite a bit.
I also rediscovered and refined my passion for Philosophy and opened my interest into a whole new realm. Somehow, all of this has really improved my love for our medicine and has enhanced my clinical practice. So, it’s good all around.
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Thesis aside – the majority of my time has been spent studying for, and taking, the NCAAOM board exams. I’ve successfully completed the foundations and biomedicine exams already. I found them to be much different from what I was expecting. I know I am not allowed to share much about my experience – but I’ll just say that I don’t think any commercially available study aid helped me…
I’ll talk about this more in my next post. I promise it will be soon. :)
Eric
AAAOM student organization scholarship and reminder of forum discussion opportunity
Hey everyone,
Just two quick items of interest:
1. The AAAOM student organization has just announced a Chinese medicine scholarship opportunity. It appears that this scholarship is intending not just to help some lucky students, but also to continue to cultivate a culture of scholarship. They say,
“A designated exhibition area at the 2009 AAAOM Conference Student Caucus in Sacramento will host this year’s competition entries in the form of table-top and poster presentations. From the entries, three scholarships of $250 each will be awarded in two exhibition categories: Scholarly Projects and Chapter Projects.”
Awesome!
2. A very enthusiastic and skilled student at my school, National College of Natural Medicine, has put together a great natural medicine forum online. I’ve talked about it before, but I really want to encourage folks to sign up. It has a section for Chinese medicine students and practitioners to talk. I thought it might be a good place for some of the discussions we have here on Deepest Health to continue in an easy to follow format. Come join the discussion!
Enjoy your New Year celebration!
Eric
Are contemporary diet plans compatible with Chinese medical theory?
No.
But, let’s discuss this further. I’ll be brief. Consider, say, Medifast. It’s popular among teenage girls and, apparently, some Chinese medicine students. Perusing the website, it seems like a perfectly reasonable diet plan. Things seem balanced, on the whole. Great, great.
Let me ask you a question – is there something wrong with a basic whole foods diet consisting of whole grains, legumes and/or lean organic animal products, vegetables and fruits? Maybe some exercise? In the form of gentle Qigong, Taiji, walks outside, hiking, playing team sports and the like? Are contemporary people so different from ancient people that we can’t engage in the same activities that they did and manage to stay fit?
No. No, no, no, no, NO.
Medifast, like many of these programs, has you eating the bulk of your foods in the form of highly processed proprietary products. These foods are Qi-less and likely damaging to the Spleen Qi. All the clinical data in the world can’t convince me that these diets make sense, at least not from a Chinese medical point of view. Now, is there anything in the Neijing that says, “Don’t eat Medifast meal replacement bars?” Well, no.
The fact of the matter is that food processed in the way that we know simply didn’t exist in Han dynasty or earlier. But it is clear in many passages throughout the Neijing indicate that food is the source of vitality. We also know through our own experience and reasoning that foods that are closer to their natural state feel more vital and nourish us more deeply. We also have the research of various modern institutes as well as the extensive work done by followers of Rudolf Steiner to help us understand the importance of vital foods more deeply. An excellent book to begin one’s search for a balanced, whole diet is Paul Pitchford’s Healing with Whole Foods.
Many people claim that these kinds of contemporary diets help modern people to be more moderate with their food intake. That may be true. Moderation is a good thing, but moderation should be combined with a whole foods diet and internally directed Qi invigorating activities. Moderation combined with processed crap, reliant on someone else to tell you how much is a good amount to eat is not going to get you very far, not for very long, and not without long-term consequences.
I can hear a few of you out there saying, “But it WORKS!” and “I’ve already lost 20 pounds!” Who cares? At what COST? Are you developing the internal resources necessary to live healthfully? What’s happening to your organ systems? To your Yang? To your Qi and Blood? I find it incredibly inconsistent to be a person who is entering into a field of holistic, functional medicine and NOT asking these questions. More than just asking the questions, I would expect any self-respecting Chinese medicine student to ask the questions, find relevant answers, and order their behavior accordingly. We are the future of healthcare and we have a responsibility to model a lifestyle that runs in accordance with the principles of our medicine.
If someone has asked these important questions and found answers, yet still engages in this kind of contemporary diet program – please do leave your thoughts in the comments. Everyone else, too. :)
Eric
Deepest Health Chinese Medicine Podcast Episode 11 : Interview with Dr. Arnaud Versluys LAc, PhD (Part 1 of 3)
Happy Election day to all of my readers in the United States of America! I’ve cast my vote for Classical Chinese Medicine by publishing the first part of my podcast series with Dr. Arnaud Versluys. :D
This is a pretty brief piece where he answers the question, “What is Classical Chinese Medicine?” I think you’ll find some great information in there about the relationship of the Classical texts to the practice of medicine, the importance of careful study as well as some food for thought regarding the various schools of Chinese medicine. I’ll release the second part of the podcast before the end of the week and release the conclusion, a little vignette about herbal access and herb substitution next week.
Look also for my regular Saturday podcast this week – ok, so it hasn’t been very regular lately, but I hope we can get past that. ;) Enjoy the podcast!
What am I up to?
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Updates from my personal blog (Ericgrey.com)- Some lyrics… May 12, 2009
- A bikeride into God May 8, 2009
- Quiet versus moving Qigong practices March 7, 2009
- A new perspective on the healthcare crisis February 26, 2009
