(this is a short excerpt from a forthcoming text on Chinese medicine. This section is taken from the introduction)

Before studying the subject of Chinese medicine we should understand a little about the background philosophies that have influenced its development. There is a tendency within Chinese medical thought to incorrectly view more contemporary forms of Chinese medicine as largely being Communist in nature and everything from before the development of TCM as being Daoist in nature. Whilst these two different schools of thought have indeed had a major impact upon Chinese medicine to see things in this way is a major oversimplification. There are in fact five key schools of thought have dictated the development of Chinese medicine and we can still see their influence upon modern practice. These five schools of thought are:

  • Confucianism
  • Daoism
  • Authoritarianism
  • Buddhism
  • Western biological medicine

I have not listed them in any specific order as each of these influential schools came into and out of fashion within Chinese medical thought at various stages in its development.

On top of these four, the advent of Communism then caused the theoretical basis of the tradition to viewed through a somewhat distorted lens. Some theories were seen as outdated and overly superstitious which caused them to be adjusted somewhat or else removed from the subject altogether.

Confucianism

The overall concept behind Confucianism is that all of humankind should learn to live in harmony with one another. Nobody was seen to exist as an entity in its own right and the focus of this idea was upon the nature of society. Confucian thought was primarily concerned with the relationship between people as well as the nature and importance of hierarchy and respect for such systems. In many ways Confucianism is in direct conflict with the ideas of Daoism and yet in other ways we can see a sharing of certain concepts. Confucianism has long been one of the most important philosophical influences upon Chinese culture; this served to make it into a highly civilized and well-structured society far earlier in its development than many other cultures. The key arguments against the philosophy and its teaching contained within the analects are that it is an extremely disempowering school of thought if you are lower on the socioeconomic scale. As a philosophy, it also states that men are born in a state of imbalance and far from a refined level of being. The personal cultivation of the individual within society must we worked on through study and intellectual development; this is the way to refinement.

Daoism

There are disagreements over the historical origins of Daoism. Mostly these disagreements arise due to trying to pinpoint exactly when the name of ‘Daoism’ was first used. Some link the name to the teachings of Laozi and the primary text attributed to him, the Dao De Jing whereas others state that Daoism really started when it became a formalized religion. It is my personal opinion that the timing of the name itself is rather irrelevant and really the development of the tradition is really where its historical origins lay. If we look back at the Wu people of ancient China we can see early esoteric and shamanic practices being carried out as far back as several thousand years. It was these practices that developed and evolved over time until they morphed into Daoism and all of its associated manifestations. The philosophical and transformational teachings of Laozi had a great influence upon this evolving lineage and thus we get the resulting tradition that we are familiar with today. Due to its long history, Daoism influenced Chinese culture massively; Chinese medicine included in this.

Daoism is based around the core principle that human beings exist as integral parts of the wider universe. This is encapsulated into the statement that human life sits between Heaven and Earth.  It is this belief that greatly influences the concept of the exterior pathogenic factors, essentially environmental causes of disease. Ancient forms of acupuncture and herbal practice also take the movement of the stars and planets into consideration as well. Often stripped out of contemporary Chinese medicine practice are the Heavenly stems and the Earthly branches, a model of the fluctuating cosmological patterns of Yin and Yang which are used in both diagnosis and treatment. All of this hails from the Daoist tradition.

A second key concept that epitomizes Daoism is the idea of freeing the body up of stagnation. Stagnation prevents ‘flow’ and without flow there is disease. Remove the obstacles causing stagnation and free flow will be returned. This is a key method of restoring health to patients in all forms of Chinese medical practice.

Though there are countless influences upon Chinese medicine from Daoism the final one I wish to bring to your attention is the concept of Pu or ‘simplicity’. According to the traditions teachings, in order to cultivate the true nature of a person we should look to ‘forget’ or ‘shed’ those aspects of ourselves we have acquired over the years. The true practitioner of self-development looks to simplify him or herself and drop the ‘baggage’ for want of a better word. Once this can happen a state of inner stillness should naturally start to develop; this in turn leads to the manifestation of the virtuous De. This theory is in direct contrast to Confucianism, a tradition that seeks to ‘add’ layers to a person in order to cultivate refinement. With regards to the application of the Daoist theory of Pu I generally adhere to this concept when working on cognitive or spiritual elements of a patient’s health. Later in these lessons we will discuss exactly what this means to practice.

Authoritarianism

Generally known as ‘authoritarianism’, the actual name of this philosophical tradition is Fa Jia; this can be translated as meaning the ‘school of thought concerning principles/laws’. This tradition was developed during the Han dynasty as a theoretical way of developing the emperors rule and all associated political systems. The principles were then passed down into the rest of society where they essentially became a way of developing law, power, crime and punishment. As with many things from far back in Chinese history, authoritarianism was not just a way of ruling but also a deep conceptual way of understanding the power dynamics existing within a politically governed society. If we simplify the tradition down to its absolute basics we can say that there are three main components to its teachings. These are Shi or ‘positional advantage’, Fa or ‘method’ and Shu or ‘appropriateness’.

Shi states that the ruler has no power whatsoever. It is actually the position and title that they carry which has the power. This was an important teaching applied to Chinese rule as it showed the emperor that they had to apply themselves to their position rather than simply using their status to consider themselves godlike and infallible.

Fa is the application of rules, crime and punishment. Fa states that the law is absolute and must be upheld at all times. Those who do not obey the rules will be punished in order to maintain harmony.

Shu This gives the ruler the right to employ whatever methods he or she wishes in order to maintain the law. Adjustments may be made to law at any time and the rulers methods do not have to follow the usual rule of transparency as is the case with all other members of the society.

This tradition obviously went on to govern politics throughout China; at first glance, it appears similar to the rule of law employed by all nations but the real difference lay in the fact that it was a philosophical tradition as well as a purely intellectual exercise in maintaining rule. When this tradition is combined with the principle of microcosm and macrocosm being one and the same (interestingly a Daoist principle) we can see authoritarianism being applied to Chinese medical teachings. In this way, many states of Qi within the body are seen almost as ‘crimes’ that must be dealt with. The offending pathogens must be shed from the body; order must be restored and only then will be right with the patient’s health. This idea can often sound very ‘abrasive’ to many practitioners of Chinese medicine who instead adhere to the idea’ of helping the body to heal itself when it is ready’ but in actual fact if we look at the nature of treatment and the terminology used in the classical texts it is clear that a more assertive approach is often recommended.

Buddhism

The fourth tradition to influence Chinese medicine is Buddhism. Buddhism was introduced into China from India comparatively late in its spiritual history and yet as soon as the Chinese encountered Buddhism they incorporated many aspects of the tradition into their way of thinking. It is often difficult to divide out the Buddhist and Daoist teachings because within China the two traditions interwove with one another. Chan () Buddhism is a Chinese form of Buddhism that incorporates many aspects of Daoism whilst Northern sect Daoism in particular has huge amounts of Buddhist influences; especially when looking at the manner in which they understand the human spirit, a concept which expresses itself within the model of the Wu Shen ().

One of the major shifts in thought that came from the merging of Buddhism with Chinese medicine was the shift of the seat of consciousness. Prior to Buddhism’s influence it was within the brain that consciousness was said to reside. After encountering Buddhist thought the theories were adjusted and consciousness was now seen as residing within the ‘space’ of the Heart.

Western Medicine

The fifth and final major influence upon Chinese medicine is obviously western medicine. One of the major factors in the development of post-cultural revolution TCM was that China wished to present a less esoteric and more scientific form of medicine practice to the rest of the world. It was felt that by bringing Chinese medicine into line with western medicine it would be received in a more open manner. Old ‘superstitions’ were removed from the practice; astrological influences were ignored and the spirit was relegated to a minor part of the practice. All of this helped to create a concise form of medicine that was easy to learn and efficient to practice but now it was slightly devoid of its cultural roots.

In contemporary Chinese medicine, you will see many influences from western biological sciences which include organ functions, teachings around the development of disease and now also western-style disease names. Whilst none of this is inherently negative, it enables Chinese and western medicine to work alongside each other, it does run the risk of negating some of Chinese medicines strengths with regards to working with the more spiritual and esoteric aspects of the human condition.