Prelude
Why are foods classified hot or cold? What does Yin and Yang mean? Traditional Chinese Medicine (TCM) is the cornerstone of nutrition in the east. Yet, it is often misunderstood, or simply not understood, and often times being ridiculed even by the Chinese themselves as "backward" superstitions. As I attempt to gain some insight to this over 2000 year old system of medicine, I consider my mind to be the biggest hindrance of all.
Repeatedly, I found myself not comprehending what I have just read, then having to reread passages and concepts several times over, not because I was illiterate (at least not more than I already am normally!), and most certainly not because the authors of my reference book were insufficiently eloquent on the subject. On the contrary, I have adapted very closely to the book (at times, to the point of ad verbatim) because I found myself incapable of a more erudite account.
The real difficulty lay in the inability of my westernized mind to grasp the abstract, the circular reasoning, and the auto pilot mechanism to try and file everything into neat, organized categories. I do not consider this is to be a particular shortcoming, or virtue, of mine. It is just an acknowledgement of a fact.
Let me be clear that I do not tout TCM as panacea. At the same time, I would like to add that I have utmost admiration for the advancements and discoveries made within the field of western medicine. I do, however, apply principles of TCM, along with principles of western nutritional science, to my own life and diet. I also admit that I have never felt prouder of my Chinese ancestry than now, given a deeper understanding of the wisdom of my Chinese forefathers.
I hope it will be beneficial to my readers, and especially to those who are keen to integrate TCM into their lives and diets, to approach the subject with an introduction to eastern philosophy, a few basic theories and concepts that could be instrumental in helping you understand TCM, as well as compare and contrast eastern philosophy with the western view, which is more familiar territory to most of us.
I would also like to acknowledge that in assembling this article, my friend and trusted Chinese physician, Jennifer Cheung, was truly invaluable, just as she has always been sending me the proverbial "charcoal in the snow storm", during times of my medical needs. Depth of her knowledge is a humbling reminder that "one mountain is higher than another." Through her treatments, I am reassured that clarity in thought and expression are attainable by all those who aspire for it. I thank her for her openness and generosity in teaching me without ever being condescending.
Introduction to Chinese Philosophy
While Western philosophy tends to draw clear boundaries between man and nature, mind and body, disease and health, life and death, Traditional Chinese thoughts do not draw such sharp lines of distinction.
In the practice of Traditional Chinese Medicine (TCM), there is no separation of the objective world from its living subjects, and our universe exist as an interwoven web of processes, linked to each other in circular fashion. In this reality, Mankind are a part of the universe that surrounds them. This unified wholeness is the Tao, where there is no separation of mind from body, and man from nature. Solutions do not exist as fixed answers; the truth is always relational, conditional and contextual.
Traditional Chinese Viewpoints on Healthcare
In TCM, the best cure for sickness is believed to be prevention. The Nei Jing, a medical classic written in the second century B.C. states:
"Maintaining order rather than correcting disorder is the ultimate principle of wisdom. To cure disease after it has happened is like digging a well when one already feels thirsty, or forging weapons after the war has already begun."
Moreover, Chinese physicians embrace the idea of balancing power between caregiver and receiver. Western medical doctors are usually assigned more powerful, top down roles; and at the same time, their patients are more passive in receiving instructions. In contrast, Chinese physicians believe in enabling ordinary people with the ability to control their own healths; they portray the role of teachers in sharing knowledge and power with their patients and create the favorable conditions in which human life can flourish.
The Body as a Machine in Western Medicine
Western science is premised on analytic, logical reasoning and fixed, unchanging laws. Only tangible and quantified evidence are sought. In addition, man and nature are viewed to be distinctly separate, and there is also a clear division between mind and matter. Everything can be broken down into its individual parts, like machines. Hence, western medicine, accordingly, is the study of the human machinery and how it works; and when people are perceived to be like machines, doctors behave like mechanics.
Western medicine visualized a human body that can be divided into individual constituents, and a diseased component, or organ, as a defective part of the machine that is removed, or can be treated on its own, apart from all other structures of the body. Furthermore, western medicine doctors frequently believe that disease within the human body is caused by an external source, for e.g. germs; and that the cure for such disease should also be applied externally. Thus, there is more focus on intervention rather than prevention. The western doctor, like a mechanic, performs regular maintenance but more often, is being called upon to attend to emergency repairs when things have broken down.
In this schema, both inward self understanding and the body's own healing abilities are often overlooked. People believe that the power to get rid of the disease can only present itself from a foreign source that lies outside of the body, for e.g., drugs or surgery. Moreover, death is seen as an evil that must be overcome. Emphasis is therefore placed on keeping bodies alive rather than on enriching life.
The Body as a Garden in Chinese Medicine
As previously stated, Chinese philosophy envisaged the universe as a circle of life, the Tao, which embodies both the opposing, yet complementary, forces of Yin and Yang. Within the Chinese model, everything is interconnected and interdependent, hence nothing should be considered separately.
What is good for one is good for all, and vice versa. One damaged organ is bad for the whole body; what is harmful for one person harms everyone; when the earth is injured, then so is the individual. Hence, to bring about well being within one's body and mind equals forging the same on earth and all life surrounding us.
Ancient cultures such as the Chinese, survived by cultivating land, and depended on their harvests for sustenance. They viewed the world, nature and all of its living beings as gardens, and desired peace and balance within. When people are likened to gardens, the role of the doctors is like a gardener's - to cultivate and to enrich life.
Additionally, nothing is perceived as absolutes in the Chinese purview. Being wholly relative, life and death are not intrinsically good or evil, but simply viewed as an occurrence that happens within the cycle, and along the wave of a continuum that is always in motion.
The Concept of Qi
Life's essence or our life force is known as "Qi" in TCM. Immaterial, yet essential, Qi is the basis on which all material world is formed. It animates life.
Unlike in western science, where the human body is broken down, or made up of, building blocks such as cells, tissues and other structures, chinese medicine regards the body as one large complete system made up of smaller, subunits within. These small subsystem interact within themselves, with each other, and with the larger whole. None of them can perform in isolation.
The body takes the shape of our emotions, while generating feelings. The liver drives the state of our heart, and the heart in turn motivates the expression of one's personality. Thus, within each person as a whole unit, there is a constant flurry of cross relationships between the subunits; and "Qi" acts as the medium linking up these relationships. Consequently, the flow of Qi determines the expression of all physical and mental activity of the human body.
Qi is not air, but air has Qi. Qi is also in food. Upon entry to the body, the Qi of air and the Qi of food together makes up the Qi of the body as one entity. Qi, or life force, can also be defined to include blood and moisture. Just as ice, water and steam are three different states of the same entity, blood, moisture and Qi are three manifestations of the same life force. However, Blood in itself, governs the tissues which form the material body. Qi governs the activity and processes of the body. Moisture, "the ocean of the body", is the intermediary between blood and Qi.
The Theory of Correspondence
Before a larger system can be harmonized, TCM postulates that the smaller units must first be in order individually, and also in synchrony with each other. Health is defined as an individual's ability to respond and adjust to the threats posed which disrupts the body's state of equanimity.
Disease is symptomatic of a system of subunits that are out of sync with each other. Chinese medicine is of the view that if such disharmonious interactions are rectified to become more balanced and smooth, then the cause of disease would cease, because the breeding ground for disease would not be present.
Hence, in TCM, "The Man is not sick because of his illness, but has an illness because he is sick":
Yin and Yang : A Theory of Relativity
Within the unity and completeness of the Tao of life, therein lies the principles of Yin and Yang; its forces swinging to and fro like a pendulum - opposing and canceling each other out. They are as polar as they are mutually dependent; inseparable as they constantly strive to counterbalance each other, in order to reach, or maintain, equilibrium. Therefore, Yin-Yang is, essentially, a symbolism of the Chinese worldview that portrays life as a dynamic, ever-changing, constant flux of motion, rather than a still and fixed frame of picture.
"If Yin is a noun, then Yang is a verb, and Life would be a complete sentence." Health is optimized when Yin-Yang is in harmony; and disease presents itself when the balance is tilted. Over engaging in Yang forces runs Yin down. By the same token, a person who is well fed and massive (Yin), and yet lacks energy (Yang), will be lethargic, inert. In order to attain balance, one must be flexible, diverse, moderate, adept and in tune with one's own harmony and needs. Chinese medicine makes use of acupuncture, herbs, diet, physical exercise, massage, mental discipline to reach this state of harmony.
"If Yin is a noun, then Yang is a verb, and Life would be a complete sentence." Health is optimized when Yin-Yang is in harmony; and disease presents itself when the balance is tilted. Over engaging in Yang forces runs Yin down. By the same token, a person who is well fed and massive (Yin), and yet lacks energy (Yang), will be lethargic, inert. In order to attain balance, one must be flexible, diverse, moderate, adept and in tune with one's own harmony and needs. Chinese medicine makes use of acupuncture, herbs, diet, physical exercise, massage, mental discipline to reach this state of harmony.
Yin-Yang Classification of the Human Body & its Functions
Classification of Yin-Yang is purely relative and depends entirely on the point of view of the observer. Relative to each other, Yin is dense, quiescent, static, and contracting, whereas Yang is dynamic, active, expansive and dispersed. Yang motivates movement and instigates Yin; whereas Yin provides the foundational substance for sustaining the activities of Yang.
To provide a clearer idea of Yin and Yang principles, here are a few examples of bodily substances and processes that are considered to be Yin or Yang, relatively speaking :
Generally, people can be classified as being more Yin or Yang, based on the physical forms of their body and character. Yet, it is common to manifest qualities of both, such as inhabiting a relatively Yin body with a more Yang personality. Additionally, we are quicker, more erratic and lighter in our youth, and therefore are more Yang. In our older years, we tend to be more Yin because we are slower, more deliberate, and persevering. The lower part of the body, which is closer and more sunken in the ground, is more Yin, compared to the Yang upper body, which has more mobility. The exposed part of the body (e.g. skin, hair) forms external protection and is therefore Yang, the hidden internal structures (e.g. organs, bones etc) are the basis of sustenance and are therefore Yin.
Yin or Yang classification should not be taken to mean strength or weakness, health or disease in a person. Being aware of our Yin-Yang tendencies provides some insight as to how we might become ill; and in addition, could help us in applying the right treatment. The real key is in achieving balance - When Yang is in excess, Yin is depleted, and vice versa. Using the analogy of a battle front, Yin is the fort that provides substance that sustains Yang activity. Without substance, activity is weakened; without activity, substance is insecure and unprotected.
The Five Organ Network
Furthermore, our internal organs can be distinguished according to their physiological functions. Yin organs, i.e. Liver, Heart, Spleen, Lung, Kidney, perform the functions of assimilation (anabolic) and store the energy derived from substances generated from the Yang organs. On the other hand, Yang organs, i.e. Gallbladder, Small Intestines, Stomach, Large Intestines, and Bladder, perform functions of digestion and elimination (catabolic) and transform movement into energy. However, Yin and Yang are relative, and not absolute categories. For e.g., the Heart is a Yin organ and yet, its actions of squeezing blood through the vessels is Yang. This is the definition of "Yang within the Yin".
Paired Yin and Yang organs together make up the Five Organ Networks each identified by names of the Yin Organs. The system consists of Liver-Gallbladder, Heart-Small Intestine, Spleen-Stomach, Lung-Large Intestine, and Kidney-Bladder.
Dissonance in the Organ Network
All Organ Networks are interconnected - hyperactivity in one network will result in depletion of some, and trigger hyperactivity of others. However, an Organ Network that is overly controlled will collapse, and that triggers a different pattern of depletion.
In the view of TCM, a simple yet chronic state of disharmony of one Organ Network prolonged over time, could develop into more complications, and eventually lead to disease. Furthermore, patterns of disharmonies from one network usually affect another, and often involve a few Organ Networks on top of the one which is primarily out of sync.
The Five Phase Theory
Just as the Yin-Yang theory symbolizes the relationship between bipolar and complementary forces, the Five Phase Theory is a metaphoric representation of the stages of the human life. Five Phase thinking proposes that everything that is created in the body, either physical or otherwise, can be categorized into the following elements : Wood, Fire, Earth, Metal and Water.
In TCM, there is no dissection of the seen and unseen within the human being. Therefore the same forces that manifests as the material and physiology of an individual, also organizes the person’s emotions, intellect, and psychology. Hence, people can generally be classified into different character types according to their Five Phase elements.
Moreover, each of the five phases can be experienced at any given human life process, and each phase acts as a restraint and yet, gives rise to the next. In our Wood phase, we are expansive and that fuels the Fire phase, which causes energy to spread. Metal is our contraction phase, culminating in the phase of the Water, which in turn control our Fire phase, and yet nourishes germination. Our Earth phase centers and stabilizes us.
The Five Climates : Symptoms and Conditions of Disease
When a person is symptomatic of a state that imitates a particular climate, TCM postulates that a person has that condition, i.e. that climate exists internally within the body. An adverse internal condition may not necessarily correspond to the existing external weather. The Five Climates are:
- Wind : causing erratic, unpredictable movement and sudden, rapid change in location.
- Heat : accelerates metabolic activity, increases circulation, rising and outward movements.
- Dampness : dense, stagnates, accumulates, feelings of fullness and heaviness that is usually accompanied by Cold, Heat or Wind.
- Dryness : dehydrates, withering and shriveling.
- Cold : decelerates movement by chilling.
Conclusion
As a consequence of differences in world views, philosophy and science, geographical and climatic limitations as well as other factors which affect our food sources, it is no wonder that nutrition would differ between the Western and Eastern world.
In the west, a food's value and nutrition is determined by individual components of proteins, carbohydrates, fats, vitamins, minerals. Foods that contain similar quantities and proportions of these nutrients are considered equivalents in biological value. Accordingly, a bowl of spaghetti with tomato sauce could be equivalent to a two-egg omelet. In addition, people are assumed to be the same physiologically, so the choice of diet is simply picking within the quantitative boundaries of each nutritional component regardless of who we are.
In contrast, nutrition in the east adopts the view that who the individual is determines what is most beneficial for that person to eat; and that what we eat becomes who we are. According to the eastern view, there is no universal model of "a good diet". One size does not fit all because each of us have different constitutions and hence, not everyone will benefit in the same manner from similar nutrient intake.
All foods and people have to be considered within the context of Yin-Yang and the Organ Networks. Appropriateness of foods is based on their properties, and how they affect Qi, Moisture and blood, modified by climate, the season, and presence of illness. For e.g. Although the bittergourd is proven to be beneficial for helping with blood sugar control, it might not be suitable for a diabetic individual who also displays a cold-damp condition, because the bittergourd is considered to be a cold food and would exacerbate the adverse climatic conditions in that individual.
Today, many factors, including trade, travel and globalization, have all played a huge and influential role in bridging the divide between Western and Eastern diets. Many eastern traditions have also been eroded. Nonetheless, the perception of food as nourishment for the human body still lies somewhat discrete between the Western view vs the Eastern view. However, I do not view them as contradictions but rather, as two totally different systems with different perspectives.
TCM is not based on western science. It is a completely different practice that exists on its own set of principles and theories. In spite of its many limitations and constraints, it is a complete, wise and coherent system of medicine and healing that has withstood the test of time. Yet, it is more than a system of medicine and healing. It is also a system of philosophy, beliefs and teachings. Indeed, the true purpose of TCM is to teach a way of life, how to live enriched; and not simply to prolong life or the avoidance of death.
Source:
Harriet Beinfield, L.Ac. and Efrem Korngold, L.Ac., O.M.D., (1991), Between Heaven and Earth, A Guide to Chinese Medicine, Ballantine Books, New York.
