Prior to beginning Chinese medicine studies, my school recommended I read a book called “The Web That Has No Weaver’. This book is considered the reader’s companion to the introduction to the origins, philosophy, art, and science of Oriental Medicine. Many times, when I am explaining to my patient’s my rationale behind their treatment prescription and recommendations, I wish that they had read this book, just like I did, before I knew anything about Chinese medicine.
So, if you’re a patient of mine and would like to gain a better understanding of my practice or considering trying Chinese medicine through acupuncture of herbs please take a moment and read this excerpt from chapter 1 of the book, “The Web That Has No Weaver” called, “Medicine East and West: Two Ways of Seeing, Two Ways of Thinking and the Landscape Patterns of Nature and Humans”, the author Ted J. Kaptchuck, O.M.D., (Oriental Medicine Doctor), explains the differences between the Chinese Medicine-approach and the Western medicine-approach.
East Asian medicine has made a dramatic and unlikely migration. No longer confined to locations such as Shanghai, Seoul, or Singapore, it has become a vibrant component of health care from Sidney to Seattle to Stockholm. Chinese medicine is now international. Acupuncture and Oriental herbalism have become as commonplace and “indigenous” in Boston as in Beijing. This movement of healing techniques, clinical skills, revered literature, traditional knowledge, and distinctive philosophy has been unusually rapid. This swiftness has meant that thoughtful and critical examination can be in short supply.
As a result, many Westerners have strange notions about Chinese medicine. Some of them see it as hocus-pocus, the product of primitive or magical thinking. If a patient is cured by means of herbs or acupuncture, they see only two possible explanations: Either the cure was a placebo effect, or it was an accident, the happy result of hit-or-miss pin-sticking that the practitioner did not understand. They assume that current Western science and medicine have a unique handle on Truth-all else is superstition.
Other Westerners have a more favorable but equally erroneous view of Chinese medicine. Deeply and often unjustifiably disturbed by many of the products of Western science and culture, they assume that the Chinese system, because it is felt to be more ancient, more spiritual, more holistic, is also more “true” than Western medicine. This attitude threatens to turn Chinese medicine from a rational body of knowledge into a religious faith system. Both attitudes mystify the subject-one uncritically undervaluing it, the other by setting it on a pedestal. Both are barriers to understanding.
Actually, Chinese medicine is a coherent and independent system of thought and practice that has been developed over two millennia. Based on ancient texts, it is the result of a continuous process of critical thinking, as well as extensive clinical observation and testing. It represents a thorough formulation and reformulation of material by respected clinicians and theoreticians. It is also, however, rooted in the philosophy, logic, sensibility, and habits of a civilization entirely foreign to our own. It has therefore developed its own perception of health and illness.
Chinese medicine considers important certain aspects of the human body and personality that are not significant to Western medicine. At the same time, Western medicine observes and can describe aspects of the human body that are insignificant or not perceptible to Chinese medicine. For instance, Chinese medical theory does not have the concept of the nervous system. Nevertheless, evidence exists demonstrating Chinese medicine’s capacity to treat some neurological disorders. Similarly, Chinese medicine does not perceive an endocrine system, yet it treats what Western medicine calls endocrine disorders. Nor does traditional Chinese medicine recognize Streptococcus pneumonia as a pathological cause of pneumonia, yet before the discovery of antibiotics, its treatments seemed to offer a reasonable and relatively effective response.
Chinese medicine also uses terminology that is strange to the Western ear. For example, the Chinese refer to certain diseases as being generated by “Dampness,” “Heat,” or “Wind.” Modern Western medicine does not recognize Dampness, yet can treat what Chinese medicine describes as Dampness of the Spleen. Modern Western medicine does not speak of fire, but can, from a Chinese perspective, stoke the fire of the Kidney or extinguish excess fire raging out of control in the lungs. In Western medicine, Wind is not considered a disease factor; yet Western medicine is able to prevent Liver wind from going to the head, or to extinguish rampaging Wind in the skin. The perceptions of the two traditions reflect two different worlds, but both can affect and often heal human beings regardless of their cultural affiliation.
The difference between the two medicines, however, is greater that between their descriptive language. The actual logical structure underlying the methodology, the habitual mental operations that guide the physician's clinical insight and critical judgement, differs radically in the two traditions. What Michel Foucault says about medical perception in different historical periods could apply as well to these different cultural traditions: “Not only the names of diseases, not only the grouping of systems were not the same; but the fundamental and perceptual codes that were applied to patients’ bodies, the field of objects to which observation addressed itself, the surfaces and depths traversed by the doctor’s gaze, the whole system of orientation of his gaze also varied.”
The two different logical structures have pointed the two medicines in different directions. Biomedicine, a more accurate name for Western medicine, is primarily concerned with isolable disease categories or agents of disease, which it zeroes in on, isolates, and tries to change, control, or destroy. An ontologically circumscribed entity is the privileged ideal of the system. The Western physician starts with a symptom, then searches for the underlying mechanism-a precise cause for a specific disease. The disease may affect various parts of the body, but it is a relatively well-defined, self-contained phenomenon. Precise diagnosis frames an exact, quantifiable description of a narrow area. The physician’s logic is analytic-cutting through the accumulation of bodily phenomena like a surgeon’s scalpel to isolate one single entity or cause.
The Chinese physician, in contrast, directs his or her attention to the complete physiological and psychological individual. All relevant information, including the symptom as well as the patient’s other general characteristics, is gathered and woven together until it forms what Chinese medicine calls a “pattern of disharmony.” This pattern of disharmony describes a situation of “imbalance” in a patient’s body. Oriental diagnostic technique does not turn up a specific disease entity or a precise cause, but renders an almost poetic, yet workable, description of a whole person. The question of cause and effect is always secondary to the overall pattern. One does not ask, “What X is causing Y?” but rather, “What is the relationship between X and Y?” The Chinese are interested in discerning the relationships in human activities occurring at the same time. The logic of Chinese medicine is organismic or synthetic, attempting to organize symptoms and signs into understandable configurations. The total configurations, the patterns of disharmony, provide the framework for treatment. The therapy then attempts to bring the configuration into balance, to restore harmony to the individual.
This difference between Western and Eastern perception can be illustrated by portions of clinical studies done in hospitals in China. In a typical study a Western physician, using upper gastrointestinal x-rays or endoscopy by means of a fiberscope, diagnoses six patients with stomach pain as having peptic ulcer disease.From the Western doctor’s perspective, based on the analytic tendency to narrow diagnosis to an underlying entity, all these patients suffer from the same disorder. The physician then sends the patients to a Chinese doctor for examination. The following results are found.
Upon questioning and examining the first patient, the Chinese physician finds pain that increases at touch (by palpation) but diminishes with the application of cold compresses. The patient has a robust constitution, broad shoulders, a reddish complexion, and a full, deep voice. He seems assertive and even aggressive. He seems to be challenging the doctor. He is constipated and has dark yellow urine. His tongue has a greasy yellow coating; his pulse is “full” and “wiry”. The Oriental physician characterizes this patient as having the pattern of disharmony called “Damp Heat Affecting the Spleen.”
When the Chinese physician examines the second patient, he finds a different set of signs, which indicate another overall pattern. The patient is thin. Her complexion is ashen, though her cheeks are ruddy. She is constantly thirsty, her palms are sweaty, and she has a tendency towards constipation and insomnia. She seems nervous, fidgety, and unable to relax and also complains of feeling pressured. In her life, sheis constantly on the go and has been unable to be in a stable relationship. Her tongue is dry and slightly red, with no “moss”; her pulse is “thin” and also a bit “fast”. This patient is said to have the pattern of “Deficient Yin Affecting the Stomach,” a disharmony very different from that of the first patient. Accordingly, a different treatment would be prescribed.
The third patient reports that massage and heat somewhat alleviate his pain, which is experienced by a minor but persistent discomfort. He is temporarily relieved by eating. The patient dislikes cold weather, has a pale face, and wants to sleep a lot. His urine is clear and his urination is frequent. He appears timid, shy, and almost afraid. He seems unable to look the physician in the eye, and his head seems to hang in despair. His tongue is moist and pale, his pulse “empty.” The patient’s condition is diagnosed as the pattern of “Exhausted Fire of the Middle Burner,” sometimes called “Deficient Cold Affecting the Spleen.”
The fourth patient complains of very severe cramping pain; his movement and affect is ponderous and heavy. Hot-water bottles relieve the pain, but massaging the abdomen makes it worse. The patient has a bright white face and a tendency toward loose stools. He is forty years old and came to the appointment with his mother with whom he still lives. His passion is a world-class stamp collection, which he constantly studies and wants to talk about. His tongue has an especially thick, white, moist coating; his pulse is “tight” and “slippery.” These signs lead to a diagnosis of the pattern of “Excess Cold Dampness Affecting the Spleen and Stomach.”
The fifth patient experiences much sour belching and has headaches. Her pain is sharp, and, although massaging the abdomen makes it diminish, heat and cold have no affect. She is very moody. Emotional distress, especially anger, seems to precipitate attacks of pain. She feels frustrated and stuck in many of her life activities. During the discussion she says her husband is always distant and detached. Strangely enough, the patient’s tongue is normal, but her pulse is particularly “wiry.” The physician concludes that she is affected by the pattern of “Disharmony of the Liver Invading the Spleen.”
The sixth patient has extremely severe stabbing pain in the stomach that sometimes goes around to his back. The pain is much worse after eating and is aggravated by touch. He has had episodes of vomiting blood, and produces blackish stools. The patient is very thin and has a rather dark complexion. His eyes furtively and suspiciously dart around the room, as if to detect a hidden threat. He had been physically abused as a political prisoner. His tongue is a darkish purple and has markedly red eruptions on the sides. His pulse is “choppy.” The Chinese physician describes the patient’s problem as a “Disharmony of Congealed Blood in the Stomach.”
So the Chinese doctor, searching for and organizing signs and symptoms that a Western doctor might never heed, distinguishes six patterns of disharmony where Western medicine perceives only one disease. The patterns of disharmony are similar to what the West calls diseases in that their discovery tells the physician how to prescribe treatment. But they are very different from diseases because they cannot be isolated from the patient in whom they occur. To Western medicine, understanding an illness means uncovering a distinct entity that is separate from the patient’s being; to Chinese medicine, understanding means perceiving the relationships among all the patient’s signs and symptoms in the context of his or her life. When confronted by a patient with stomach pain, the Western physician must look beyond the screen of symptoms for an underlying pathological mechanism-a peptic ulcer in this case, but it could have been an infection or a tumor or a nervous disorder. A Chinese physician examining the same patient must discern a pattern of disharmony made up of the entire accumulation of symptoms and signs.
The Chinese method is based on the idea that no single part can be understood except in its relation to the whole. A symptom, therefore, is not traced back to a cause, but is looked at as part of a totality. If a person has a complaint or symptom, Chinese medicine wants to know how the symptom fits into the patient’s entire being and behavior. Illness is situated in the context of a person’s life and biography. Understanding that overall pattern, with the symptoms as part of it, is the challenge of Chinese medicine and what makes it a holistic medicine; a medicine for the whole person. The Chinese system is not less logical than the Western, just less analytical.
I hope this was an informative summary for you Stay tuned for more posts from “The Web That Has No Weaver” by Ted J. Kaptchuck, O.M.D. (Oriental Medical Doctor). If you're interested in exploring the benefits of Chinese medicine on your health call Innovate Acupuncture today for an appointment or schedule online.
The web that has no weaver: understanding Chinese medicine
Kaptchuk & Kaptchuk - McGraw-Hill - 2008
Even Bart is open to Chinese medicine