Full transcript Below:

• • [Doc] People are making decisions based on their understanding of life, and sometimes those decisions are causing the problems that they come in to complain about. As Confucius will say 2,500 years ago now, many problems are caused by a misunderstanding of how life works. So what we’re looking at in this class is the development and evolution of Chinese thought, the how life works and how to have a productive relationship with it. This is literally the sea in which our medicine swims. Again, remember 2,000 years ago, our medicine was called Yang Sheng, which is nourishing life. It’s not about just fixing problems. This is not a cult. It’s just a way of, you know, a series of lenses that we look at things and then being able to understand phenomena in such a way as we can begin to engage skillfully and rectify the imbalances that may lead to digestive issues, cancer, whatever have you. Sprained ankles, low back pain, menstrual difficulties, emotional problems, all the above. So that’s what this medicine is about. So on that note, I always start classes with a reflection. What did you think about class last week? I don’t remember your name.

• • [Lauren] Me? Lauren.

• • [Doc] I’m looking at you. Yeah, sorry.

• • [Lauren] It opened my eyes to a lot of differences in like ways I might have to.

• • [Doc] My bad.

• • [Lauren] Thinking, you know like coming from a Western perspective. It also just made me really excited to learn more about history of this and the evolution. I was saying that last class made me excited to study the evolution of an indigenous culture. One that has evolved in harmony with nature and one that has a written record of it. You know, ’cause most indigenous western cultures, we don’t have written records of, you know, their musings and of the history. It makes it a little more inaccessible.

• • [Doc] Very good.

• • [Lauren] Just hearing everything you said last class made me excited.

• • [Doc] What she said was that she was excited to study, and I’m paraphrasing here, the evolution of thought in a literate culture. What we have with a lot of indigenous cultures is no written history, really, a lot of it oral tradition. And that with the Chinese, you literally have a literate conversation that is, you know, going on 3,000 plus years old, which is phenomenal. The same characters are still being used as were found on the bone oracles, you know, and what you’re going to be seeing as the Confucians become the dominant model in the bureaucracy, the literate model. You see them maintaining this library and this conversation around the same subjects. You know, sort of who are we and what are we doing? How does reality work? How does nature work? Keep in mind that the reality of indigenous cultures is that they lived in direct concert with nature. This is an agrarian culture. They are not sitting around in their cubes bereft of any kind of weather influences. They are having to deal with harvest. They’re having to deal with pestilence and barbarians invading. And so it’s real time. You know, I think modern society often is divorced, modern civilizations in general are often divorced from having to relate to this. We think we can kind of invent how the world works and tell it how it should and you’ll find it in Chinese thinking, they gave that up a long time ago ’cause it just doesn’t work. The language itself, as you mentioned last week, is very descriptive. It is not based in abstractions like verbs and nouns like we have. It’s very descriptive. So when you read some of the original source text in that main book in the readings that I’ve, you know, encouraged you in, you will see that. It’s very interesting stuff. You know, I find it anyhow, just speaking personally. So who else? Comments? Yes.

• • [Student] Just kind of building off that last lecture. There was a couple of kind of things that stuck with me. The first being medicine is a skillful and compassionate response to suffering, emphasis kind of on compassionate approach to that, which I think is lost in our kind of Western civilization. Like you were saying, Western doctors are almost bragging about how they can filter in so many people. Whereas it kind of goes back to covering up the symptoms rather than addressing the group problem. And that kind of ties into what Lauren was saying about being in touch with nature and what you’re trying to be told. So yes, you covered up the symptom, but what’s going to keep on coming back there?

• • [Doc] Well, that’s true. So his comment was about the, in the written material and the commentary last week, was in the medicine being the skillful and compassionate response to human suffering. We’re all human beings, you know, we’re all in this soup together. And one, if we can’t get along, we have, which has been the history of humans, you know, we kind of want to minimize that me versus you kind of thing. But compassion is really, it’s necessary and it’s important. And I will tell you that, you know, as a clinician being able to awaken that every day, you show up and it’s like, oh, here’s Mrs. Smith who whines incessantly. I mean, she’s here for digestive issues, but she complains incessantly about her husband the whole time. Well, you’re going to have to like, how does your heart open to that kind of complaint? And what might you offer to her, you know, suffering that’s, in many ways, self-created? You know, again, a lot of times people are victims of their own decisions. Orthopedically, well you know, you could say running is not good for the knees after a certain point if you’re not careful. You need to be really, really careful. So we’re going to look at the evolution of, you know, compassion as being a big part of medicine. Because actually that is not literally entering until the Buddhist era, which is quite a ways down the road. Okay, so more comments?

• • [Student] I was thinking a lot about the language and how you were saying last class, how descriptive it is. And in our other classes there’s, we’re reading a book, it’s the foundations book, And on the first page it’s concerned, well, not in the first page, there’s like a preface that’s going over how they chose the language for the book. And I found that to be very helpful and interesting in terms of the linguistic theory model. I’m wondering if this book, if you have any knowledge kind of outside the book of how they’re translating the words that they’re using like for instance, the word ritual or like I was reading that that could be all these different things. And when you’re speaking in Chinese language, it’s understood in that moment all the meanings at once. So then when you have a direct translation and you’re like, I noticed with the oracle bones, it was very stripped down in terms of this is a ritual, or this is a right or this is a cult. And it had me thinking, well, what else is it that is not on the page in terms of context?

• • [Doc] Well, so if I can paraphrase that, I’m speaking to the group here.

• • [Student] I have mic on.

• • [Doc] Oh, you do have your mic. Oh good. I was thinking this is a tough one.

• • [Student] I think we’re good.

• • [Doc]This is a tough one. No, thank you. I’d appreciate it if you would do that too. There is a dictionary of Chinese medicine. I highly recommend you get it. One of the leaders in the field of linguistics and translations is a guy by the name of Nigel Wiseman. Nigel Wiseman, I mean it’s a dictionary, I have it. It’s about this thick, it’s a big book, but it goes into the specifics of each thing. So when one of the, say right up on top of the pile of things to discuss right now is the Chinese word, xu. And please correct me if I’m, she speaks Chinese natively. I don’t, as I mentioned, I mangle tones, but so xu technically in Chinese means empty. But in Chinese thinking, there’s no such thing as emptiness. Emptiness cannot exist. So what it means is something was there and it’s not now, and it’s being missed. So there’s actually the better translation, according to Wiseman, is vacuity. There’s a vacuum, there’s something missing. And so this is actually a very important word ’cause you’re going to see spleen qi xu up there. Xu, spleen qi xu means there is a vacuity of the transformative process of signification, your body, the functional capacity of bringing something in is lacking to the point where it’s evidenced, it’s noticeable. The word shi, again these are, Chinese thinking is very binary as we talked about a little bit last week, but shi actually is often translated as excess. But when you look at the processual understanding of life that underpins the view, what I call the view, shi actually means replete, full to the point of overflowing. So it’s a dynamic, it’s not a static thing, it’s a dynamicism that is inherent in this view. And so it’s huge. You know, when you look at the impact of language, there’s a school of thought that I was studying in my way back undergraduate work called the Sapir-Whorf linguistic hypothesis about relativity so language actually provides a framework, an unconscious framework that sort of hmm, affects how we think about things, the questions you might ask. Now, there’s a lot of controversy around this, Wittgenstein and these other linguists don’t like really agree to it. But practically speaking, for example, I come home late at night and in English my wife says, “Well, who are you out with?” And I say, “Oh, I was out with a friend.” Pretty much end of conversation. Well, in the romantic languages like French, Spanish, Latin, I would have to add a gender to that. Imagine the complications. I was out late with una amiga. Well, the questions that follow were going to be considerably different. I can only imagine having been married for 40 years now. It opens another series of questions. So when I’m looking at the word xu, I say, “Well, it’s deficient.” Well, that’s kind of a static understanding of life. When you look at a processional understanding of acuity, it’s like, well, you know, there’s a series of things that are going to feed into that, including dietary choices, you know, cognitive processing, you know, making the right choices, quality of foods, you know, what is it that’s being transformed? If you’re eating, you know, garbage food, there’s not much in it. You’ll find many Chinese doctors saying donuts aren’t really bad for you. It’s just that you spend energy digesting ’em and there’s nothing in there for you. It’s just that simple. There’s really nothing nutritious there. Well, okay, sugar and butter. Okay, okay. So yeah that’s kind of, linguistics are really important. I will tell you that my interest in Chinese medicine came through the native indigenous cultures because to your point, it’s illiterate. There’s nothing written. I spent a year south of the border banging around in the ruins down there talking to the curanderos in the marketplaces. And you know, it’s very, very regional. There’s no overlying sort of paradigm that they all share. It’s very remedial, oh, these herbs are there, good for the stomach. It’s like, well, how? Oh, they’re very good for the stomach, you know? But there’s no underlying philosophy or theory behind it is what their grandmother told them. So oral traditions aren’t nearly as well developed. What we’re seeing with the Shang dynasty, and we’ll go into this in more detail, but people live in myth when you begin to write myth down, you can step back and talk about it and then discourse begins. And that’s what we’re going to be seeing with the literate culture and the development of Chinese thought. The evolution of Chinese thought that in many ways, I think culminates or reaches a rather dramatic apex in the, I would say about after the Tong dynasty, late Tong, early Song dynasty with the Neo-Confucian movement, where we’re going to see the amalgamation of Taoism, Buddhism and Confucianism, social modeling, understanding of personal reflection and understanding of how constructs affect perception and cognition and you know, introspection. And that had a huge impact on the development of our medicine. You know, that was like a thousand years ago. So, and then you see this chewed over and these people are, they’re not just coming up with new ideas, it’s not their progressives. What they’re doing is looking at the past and bringing the past forward and looking at it in a more modern context, because China’s expanding at this period, meeting new peoples, you know, the Silk Road is opening up and so they’re having to deal with all these weird guys in Europe and stuff like that, soon to be, okay? So yeah, you know watching this reflective capacity evolve over the years socially in the context of war, in the context of art, in the context of science, in the context of medicine, you know, it’s all part of this underlying view. What you’re learning in this medicine is actually part of how they think about everything. It’s not just a little bubble over there. So it’s how mothers are, you know, going to treat their children. There’s a movie, “The Last Emperor,” it’s about Pu Yi, who was the last Imperial emperor. It’s a Bertolucci film, it’s actually quite done. I don’t know, it’s pretty historically accurate. But there’s this one scene, Pu Yi was the last emperor and he basically was enthroned during the latter years before the nationalist party took over Sun Yat-sen and then actually China and was invaded by the Japanese. And it was a very sad story, he had a very tragic life. But there’s this one scene where he’s newly born and he’s in the wife’s chamber and the kid has a poop and it’s in this bowl. And immediately the bowl is handed over to these four older gentlemen and they all look at it and they smell it and they discuss it, and then they make advisements. Because in that world, you know, my job as a clinician would be to keep you healthy. So we can see how that individual’s health is, and digestion is like extremely important for children of that age but the advice on what foods to begin feeding him or what might be withdrawn was very important to the nourishing of his destiny as the emperor and the entire throne and the entire realm of China. So it’s a very, very interesting way of thinking about things. It’s very new to Westerners. We think we just kind of make up life and that’s how nature should work. But it doesn’t really work that way in Chinese thought. So, and language is huge. It’s very huge. And not to belabor the point, but there may be in the library, if you have access to the five branches library, there is a dictionary of Chinese medicine and it’s like, oh wow. So yeah, one character can mean 30 different things or maybe 20, and it really doesn’t mean anything until you put it up next to something else and that’s relational. Same way we see an individual. You just can’t look at a person in a vacuum with a reductionist model like modern science can or modern medicine can. You have to look at them and how they’re relating to their environment so emotions, you know, that a person has about the world around them, how they’re responding to it actually is going to impact different organ systems and their health. You know, over time it just adds up. Each emotion like anger has a particular affinity, I should say a relationship, with the liver. Fear has a particular relationship with the kidneys. Worry and or cognitive rumination has a particular relationship with what we would call spleen, stomach. Grief has a particular relationship with lungs. So excessive emotions processing them tend to impact health in these organ systems. But you see each organ system is in relationship with all the other organ systems. So a lot of anger is definitely going to injure the stomach, or excuse me, injure the liver. But when the liver is overactive, you will learn that it often affects digestion. And when digestion is weakened, it will weaken blood because you’re not transforming and transporting your nutrients properly. And when that happens, your head may not work right, so you’re going to be making lousy decisions or your emotions are going to be unstable. So that ability of what sits in the heart, the xin, the emperor, you know, is not going to be able to see clearly.

• • [Student] That kind of makes me wonder about last class when you were talking about personal agency.

• • [Doc] Yes.

• • [Student] When you’re in that situation and you can’t think clearly and you’re undernourished, and maybe it’s because of your access to certain foods in your family or whatever it may be, socioeconomic status. Like how do you hold the standard of personal agency when someone’s like in that, like someone stuck in poverty?

• • [Doc] Well I think that’s a very good point. Did everybody catch that? Was your computer picking up that?

• • [Student] I think so.

• • [Doc] Everybody hear what she said? So I think that’s a very important question. I think what it will speak to, I mean, simply put, do the best you can with what you have. Now I will say that some of the healthiest people I have ever worked with were migrant farmers who lived on rice and beans and fresh vegetables, small amounts of, but they also did not have the expanded desires that a lot of westerners do in trying to fund ginormous other expenditures. This is what they had to work with and their expenditures were proportionate to what they had to work with. So they did not go into debt. That’s what happens a lot. There are also many of them coming from, I wouldn’t say more tribal, but more rural and more traditional conservative societies where self-discipline was, you know, more of a stoic approach to life. The development of personal character was far more valuable than railing against the injustices of society and that everybody doesn’t have the same thing. I mean, you can throw yourself at the great machine in Washington DC and try to change everything or you can take care of your own business well and skillfully. As a clinician, I will tell you that you’ll get a lot better results with your patients if you help a person understand how to work better with what they actually have. And so, yes, your patients, a lot of them will come from very dysfunctional families. Are you encouraging them in a personal meditative, excuse me, a personal meditative practice where they’re actually valuing stillness, you know, where they’re actually learning to grow flowers, places of beauty in their heart, despite everything. And history has shown us that that’s possible. You have to be disciplined and you have to, you know, work it and you have to avail yourself to some of the, what I would consider the classic texts. What we’re going to see with this Chinese history is a worldview that it is not just a peaceful society. And they did not always live in harmony with nature. You know, you go back to the Taoist Classic 300 AD and you will see admonitions, don’t get an abortion, don’t pee into the stream, you know, don’t cut down the trees to enhance your view. This is like 300 AD they’re writing this stuff down, they had the same problems then. They had barbarians, you know, raiding on a regular basis. How do you deal with that? Well, Confucius came down with the notion that, you know, in a chaotic world, the family is the root of everything. So skillful mentoring, education and nourishment were the role, the responsibility of the mother. I mean, you could say whoever’s going to be mother, but it is a role that needs to be fulfilled. Who is best equipped to do that if everybody is out in the field working? Well, it begs a question, and this is often kind of a, you know, raises the short hairs on, you know, young feminists who go, well, that’s just, you know, misogynistic. You have to, well. If nobody’s doing it, who is going to do it? Do you want to source it out to, you know, minimum wage workers at a daycare center? Eh, remember, those kids are going to be choosing your retirement home. You want them to like you, you want them to be strong, you want them to be smart. You want them to understand how the world works because they may be supporting you. This was retirement for, you know, these old Chinese people. So you wanted to have good mother role. It was just important. It’s functional. Most societies understood that, you know, we’re way off the rails on that personally with understanding what it takes to keep on keeping on these days, that’s my humble opinion. So, okay. Any more reflections? We’ve talked about language, we talked about, we have some, yes.

• • [Student] My personal reflection is the personal virtue is so important in the history of ancient Chinese culture.

• • [Doc] Very.

• • [Student] And the personal virtue in combination with their relationship with their community.

• • [Doc] Excellent.

• • [Student] What I found very interesting is they understand they are their own individual. They’re responsible for their own personal growth. At the same time, they do not eliminate their relationship with their people, their neighbors, because they understand their neighbor won’t be helping them on the farm if their ox is, you know, need help from their ox or whatnot. So I think that is a very different society relationship that we see today. And when you’re talking about mother, I was just thinking about the word tiger mom, right? It has to come from somewhere.

• • [Doc] It does, that’s where it comes from. So her point is very well taken. We’re going to see a couple, as we move farther up into Confucian thinking into the Han dynasty thinking. There are some words that are just, they’re going to keep coming with us. So de is called virtue. Virtue is often considered integrity. But literally there’s a saying in the Suwen, which is one of our classics of medicine, but says, heaven in me is virtue. So that when you are in alignment with the principles of heaven, you have virtue and you collect virtue through personal cultivation, with not only your own personal resources, but your community in how you engage skillfully with compassion and with a sense of uprightness, the people around you. Honesty and integrity are really, well it’s what the sages will call authenticity. Authenticity is an irreducible relationship with life. No artifice, just the basics. You know, what’s really needed, what’s at the root of all things and getting along with others is really, really, really important. So we’re going to be looking at, that’s the Confucian social model. And it’s morality, but morality for the Chinese is being in alignment with heaven. Heaven is yong. Yong and heaven is sort of like the unalterable movement of the planets and the stars. It’s huge. It’s big. It’s out there, it’s just the way it is. And the words are going to be tian. Tian means, it means heaven, but heaven is not like a Judaeo Christian Heaven. Heaven is like, it means nature. Not only the parts, but all the processes inside. It’s everything. It’s also in Taoist terminology, often called Tao. And I talked about Tao as it’s often referred to as path, but you know, the character is a head with a foot looking on a path. So it actually has to do more with way making if you look at it linguistically. Skillful way making within the context of nature. Nature is just this ongoing flux. You have to skillfully deal with it. That’s your challenge in life. And that requires not only you pay attention to the realities of your biology, if we will, but the realities of community relationships, including most importantly, family. So yeah, that’s where this class starts, is looking at how the whole evolution of thought encompasses all that. And so imbalances that we treat as medical issues are often at some level part of that earlier story, you know, literally when we get to Han Dynasty, we’re going to find that doctors didn’t really have much of a reputation because the discomfort you’re feeling is either due to your violating the laws of nature, so to speak, or violating the social constructs and relationships with others. And your discomfort is the motivation to get you back on path. And if I, as a really good doctor can take that away, that’s not necessarily the good thing. You don’t want to encourage that kind of behavior because not only does it make you sick, but as you get sick, you start dragging down your clan. If you’re a mentally aberrant individual and you cause the family troubles, there was no police in old China, the clan would take care of you because we’re talking substinence farming. There wasn’t a whole lot of space for people that did wonky things. Artisans, theater people were kind of at the lower end of the social order because they really didn’t contribute anything. There’s going to be a whole movement in Han Dynasty to disallow merchants from holding any kind of public office. There’s going to be a movement to make everybody a farmer because they’re the only true productive people on the planet. So I mean, then compare, I encourage you to compare that to our modern values around athletes and rock stars, you know, and people who pontificate without really any relationship to organic reality. All you got to do is go on social media. No shortage of those people out there. So but that’s, as a role of the doctor, we’re looking at a very different world. We’re looking at a world that’s really based in survival. And so that’s where Chinese medicine takes off. You know, dealing skillfully with what you have to work with and helping people find their way back. Herbs are very, very important. This what you see on the board right here is a breakdown of a case. Not to go long into it, but I brought it up. A 42 year old woman who right after the holidays, went for a walk in the rains, sprained her ankle and got a cold and looking at all the presenting signs and symptoms. She’s stressed, she has a couple of teenage kids. She likes salads, she drinks a couple glasses of wine at night. She’s not sleeping well and yada, yada, yada. A whole bunch of other details. But they lead us to an evaluation of what are the underlying patterns, what are the roots of her issues? And so the spleen qi xu is leading to blood vacuities. She’s not eating well, she’s undernourished, she’s weak. The cold wind gets inside, caused an upper respiratory condition. Wind cold from the outside is going deeper into another layer. And so you break it apart like this. And what that’s going to do is lead you to, this is a description, this is a description of the phenomena going on with her. This is the treatment principle. This is how we engage skillfully. A vacuity means you boost and supplement it and her blood is weak, so you need to nourish the blood. And then when things get to this level, there’s a whole principle of treatment called harmonization that we’re going to be using. So to allow to help the body with this particular formula. Adding to the energy, helping the body be able to push it back out again. Releasing that and then dealing with the hot phlegm, the yellow sticky phlegm that keeps her coughing all the time. The sprained ankle, you can see this is a channel blockage. The damage in the flow of qi results in the invasion of external influences, specifically cold. So there’s a contractual quality, so there’s not good circulation there. And this is a persistent injury with her. So we’re going to be using the same kind of logic, this is way above your pay grade right now, by the way. So don’t worry about it but it’s going to lay the groundwork for this kind of inquiry. Again, what I hope you get out of this class is this interest and this enthusiasm to engage life and continue to watch it unfolding and learn how to deal with it skillfully, both personally, but professionally as a doctor, compassionately and maintain your strength. You know, pick up that Taoist model of a frugal husbanding of your available resources. Frugal means you don’t spend any more than you have. Don’t go into debt too much. Keep it in mind. And husbanding is like, it’s a farmer’s term. You husband the chicken flock because you want the flock to grow, but you’re still eating them. You’re consuming them. Yes.

• • [Student] You talked about how you kind of, or we will kind of work in the role of survival. How do you see a difference between surviving and health?

• • [Doc] Well, I think it’s some very basic, so how do I see the difference between surviving and health? I think surviving is basically making sure you cover the basics, okay? I would consider health more as maintaining the integrity of all those processes and then flourishing. I would add that in there too. You know, how do you build happy, wholesome family that has time for some vacations and interrelationships? How do you develop the arts and theater and music on top of that? But at the basis of it all, I mean, if you are not skillfully engaging the existential realities of life, which are not the shoes you’re wearing, the brand of the shoes you’re wearing or the color of your shirt, they actually have to do with eating, sleeping, moving, digesting, you know, those kinds of things. If you’re not skillfully dealing with those, you will not ever get farther. Problems happen when people put their dreams and desires above those realities and neglect the basics. That’s how I would say it. Does that make sense?

• • [Student] Definitely.

• • [Doc] Yeah. So at the root of medicine, we’re talking medicine here. You know, if you come from theater, you may disagree with me. If you come from, you know, other particular disciplines, you know, in the West we’re way out on the branches, not near the roots. Again, this school is called Five Branches, and it reflects the five levels of engagement. You know, the first one is going to be basically Qigong, which is breath work, learning how to look at life and learning how to have that yin yang pulsation that moves through all your vessels, all your organ system, you know, there’s digestive, there’s food, what you’re choosing to look at and bring in. Remember you bring in nourishment here, but you bring in nourishment here and you bring in nourishment here too. So pay attention to the significant. Watch out for donuts, which look a lot like, you know, some TV shows or some music that we like to entertain and distract ourselves with. You know, acupuncture is you as a patient invite somebody in to touch you and you stimulate different points and the body goes, you know, and starts doing things a little bit differently. Herbs are weird foods, you know, some of these things double as foods. You look at some of the things that you’ll see in Chinese cooking, like the red dates, hong zao, they’re really good in chicken soup. You know, huang chi is really good in chicken soup too. So you see these different additives and they mix and blend and sometimes it’s really hard to tell the difference between a good culinary food and a medical thing. So food as therapy is a huge part of classical Chinese thinking. And then you have tui na or bone medicine where you go deeper with either massage or trauma medicine. So, but that’s, you know, you see this great overlapping with the traditional culture.