The Twenty-First Century: Chinese Medicine Meets Post-Modernity
The Sage's Teaching
The earliest extant TCM classic, the Huangdi Neijing, takes as its banner the sage's teaching: "Thus the sages of high antiquity, in teaching those below them, took yin and yang as the rule and harmony with the arts and numbers as their guide…" The sage's teaching, in today's language, is a worldview. This worldview turns its eye on the relation between Heaven and the human, and observes and understands cosmos and humankind by a faith that is integral, relational, and organic. The Daodejing says: "The human takes Earth as the rule; Earth takes Heaven; Heaven takes the Dao; the Dao takes Nature." Heaven, Earth, and human therefore move by one unified Great Dao; the human is born of the Dao gives birth, virtue rears, things shape, momentum completes. The human life is only one of rising and sinking together with the ten-thousand things at the gate of life-and-growth; even the sage can only fulfill his Heaven-allotted years, pass a hundred and depart. Disease is no more than a deviation from the rising-and-sinking of life.
Laozi said: "Dao gives birth to one; one gives birth to two; two gives birth to three; three gives birth to the ten-thousand things." "The ten-thousand things shoulder yin and embrace yang; the rushing qi attains harmony." The Yijing Xici says: "One yin and one yang is called the Dao." The Huangdi Neijing says: "Yin and yang are the Dao of Heaven and Earth, the framework of the ten-thousand things, the parent of change, the root-and-origin of life and death, the storehouse of spirit-brightness." The sage's teaching is, in fact, the fundamental law discovered by turning the heart toward the line between Heaven and human — the dialectical motion of integral yin and yang, and the coordinated harmony between them. This thread runs through the heart of Eastern mysticism.
Worldview is a philosophy. In ancient times, philosophy was also science. So-called natural philosophy in fact tried to solve natural-scientific problems by philosophical reasoning. Yet the essence of science is empirical. How can philosophical reasoning be correctly joined with scientific empirical work to create practical techniques that solve daily problems? Our great ancestors carried out an outstanding construction in the medical field, creating a great miracle — Chinese medicine.
Their method, on the one hand, used the polarity of yin and yang to analyze layer by layer, drawing out one intermediate proposition after another — yin-yang of the four seasons, of day and night, of the body, of the zang-fu and qi-and-blood, of the medicines' nature and flavor, and so on. On the other hand, through deep observation and experience of human physiology, pathology, and the nature and effect of drugs, they synthesized the corresponding images and natures (disease-images, pattern-images, drug-natures) — real knowledge and material means matching the analytic concepts — knitting philosophical reasoning and scientific empirical work into a unique conceptual and material system, and, through countless cycles of theory↔practice testing, feedback, correction, and expansion, growing TCM from a seed bearing a holistic gene into a great tree.
A given philosophy always begets a given epistemology and methodology. The epistemology of ancient Chinese philosophy is one of subject-object as one, of self and world fused, of feel-the-thing-with-heart, of infer-from-outside-to-inside and infer-from-inside-to-outside — so its methodology must be holistic. The TCM conceptual system therefore bears, through and through, the imprint of holism. The line from Heaven-Earth-yin-yang down to kidney-yin-and-kidney-yang is, in theoretical reasoning, analytic; but in conceptual content it is integral and synthetic; it did not really open the black box of the body. From the integral starting point, TCM concepts emphasize function, relation, state — not structure, entity, and result. And precisely because the human-life system is the most complex and most integral of systems, TCM has won its greatest success in using the yin-yang system as coordinates to describe and regulate the deviations the human meets in rising and sinking with the ten-thousand things at the gate of life and growth. Consider that, from 1840, Western medicine has been entering China in volume for only 160 years, and sulfa drugs and penicillin have existed for only 60. Across two-thousand-plus years, what menders of suffering were Zhang Zhongjing's Maxing Shigan Tang, Gegen Qinlian Tang, and Baihu Tang for Chinese with lobar pneumonia, dysentery, or epidemic encephalitis B!
At the moment of stepping into the third millennium of the common era, looking back at TCM's history, we see that what it holds is a worldview, a philosophy, a culture, a methodology, a singular theoretical, conceptual, and technical system — all the fruit of our wise ancestors' turning their hearts to the Heaven-human line and knowing the self by holistic method.
A Hundred-Year Perplexity
The modern science arising in the 17th-century West understood the world by a new worldview. They found that the heavenly bodies follow strict mechanical and dynamic laws, and that the analytic method discloses essence better than Aristotle's predictive method. Reducing the complex to the simple, the manifold to the singular, helped grasp and use the deeper laws. With the surging rise of modern science, the worldview of mechanical reductionism swept the globe and transformed human thought.
Modern science turns its attention to matter and structure; the human stands above the object of study, the master. Conquer nature, transform nature, extract from nature became the modern slogan. Modern medicine, built on modern science, also first studies the human as a biological machine. Guided by the analytic-reductionist method, it works downward, layer by layer — human → system → organ → tissue → cell → molecule → atom — and lets humans know themselves in ever finer detail; with antibiotics, hormones, fluid therapy, and the like, revolutionary change in the health-care problems of humankind has followed.
Faced with the surge of modern science and worldview, Chinese medicine has wandered in seeking high and low: first citing the Western to vouch for the Chinese, then centering the Chinese and consulting the Western, then Sino-Western convergence, then Sino-Western integration, and now TCM modernization. Yet, perplexingly, the TCM worldview-methodology-theory-concept-material-means find no real interpretation in modern science. There is no commensuration, let alone harmony or kindred voice. "When TCM looks around today, it finds that the forest of science and technology has fundamentally changed. Every tree of modern science and technology shares a 'gene' — the scientific norm — that is alien to TCM. If the modern scientific knowledge-background is 'green all around,' TCM is 'a single red in a sea of green'; its color stands in sharp contrast to the background." (1)
We should see clearly: the Chinese-versus-Western difference in medicine is in truth a difference between ancient and modern — and that difference is rooted in difference of worldview and methodology level. But does difference of worldview and methodology level imply difference of merit?
From the standpoint of human cognitive history, ancient sages, facing a complex and strange world, urgently needed an order of ideas. They moved from the simplest particulars (sun, moon, water, fire, light, dark, male, female) to the highest general (the yin-yang doctrine), and then drew out intermediate propositions (qi is yang, blood is yin; pungent and sweet diffusing-and-dispersing is yang; sour and bitter draining is yin). This predictive method was active, effective, necessary, and unavoidable. Aristotle and Huangdi-Qibo were alike in this.
But once the holistic predictive method had been opened to a certain extent, and human knowledge had accumulated to a certain point, the search for deeper, more certain knowledge became necessary. So the analytic method represented by Francis Bacon arose.
Historically, if Aristotle and Huangdi-Qibo stepped out with the first step — the left foot — then Bacon stepped out with the second — the right. By mileage the second is farther; by chronology more modern; but this does not mean left or right is better. So with the Chinese-Western and ancient-modern distinctions in philosophy, epistemology, and methodology.
Eastern civilization, Chinese culture, and Chinese medicine have endured countless trials and live on; their living history proves that they have their own value, vitality, and truth. Mechanism and reductionism, the modern worldview and methodology, cannot contain the traditional worldview, methodology, and the scientific knowledge born of them. TCM's hundred-year perplexity has its root in anxious self-justification by the other — in citing the Western to vouch for the Chinese, in modernizing the ancient — and in forgetting my heart is Buddha and better look to oneself than ask others.
A Footstep in an Empty Valley
(Source text continues in the original on cuiyueli.com.)