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Acupuncture Today
August, 2007, Vol. 08, Issue 08
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Beyond Substance to Process

By Steven Alpern, LAc

Chinese medicine is more (and less!) than the symptom-sign complexes used to identify imbalances of the zangfu (vital and hollow organs). Current clinical doctrines arise from several themes of modernization that cloud the eyes of most contemporary people to the magical possibilities for healing discussed during the history of Chinese medicine.

The modern world is so penetrated by wondrous external technologies that many fail to appreciate the equally amazing internal technology presented in the classic texts of Huangdi Neijing (The Yellow Emperor's Classic of Internal [Medicine]).

Modern scientific medicine is interested in a world governed by uniform forces and physical laws. One of its most important research standards is that experiments be repeatable. While modern science has developed very subtle and sophisticated conceptual models, including a touch of fancy in quantum physics, its worldview at the scope of human health remains essentially mechanistic and deterministic. Modern scientific medicine attempts to assert short-term control of disease expression and calls that maintenance a "cure."

The inspirited world of human experience is dynamic and responsive. The internal mechanisms for regulating vital function can be stimulated to fundamentally transform. Habituated physiological patterns that have created disease can be substantially reconditioned to reverse their growth, even when they are generally considered progressive and degenerative. Yet, these transformations require willingness and focus, which renders them unavailable to consumers of health care. Profound healing is not a spectator sport; it requires full contact and participation.

Modern Chinese medical practitioners who accept the scientific (physical) worldview and standards of proof fail to recognize the power of Chinese medicine. Acupuncture and herbs work most effectively when they stimulate profound transformation in a patient's vital processes and allow them to grow out of their ailments. Such work relies on incisive discrimination by the practitioner, beyond the classification of manifestations.

The classic texts of Neijing provide both a language and unique thinking style to facilitate the process of disentangling the factors that create disease. Profound healing arises naturally from an individual's progressive return to wholeness, rather than from the particular constituents of therapy. Diseases generated by progressive accumulation of unresolved physical and experiential material cannot be balanced out of existence. Their true healing requires cathartic release. Balancing simply allows postnatal qi mechanisms to reassert control and puts the accumulated pathogenic factors back into the "closet."

In prior columns (especially August 2006 and June 2007), I've discussed the importance of "sorting out" pathogenic factors from the being's intrinsic responses, rather than simply classifying symptoms and signs as the manifestations of distress. Another aspect of penetrating the veil of modern physical thinking is learning to recognize and visualize process orientation in life. Postnatal energetics is based on the individual's polar interaction with their environment.

Individuals internalize influences from the environment (ying), and the embodied spirit activates to express itself (wei) in movements that support their individual life. There are internal (yin) expressions of wei qi, as one processes input (ying), and external (yang) expressions moving the individual relative to the world. One of the primary internal expressions of wei qi moves the peristalsis of the digestive tract. This is one example of the intimate relationship between ying and wei, because the material one ingests (ying) elicits and requires a response (wei) to process it, and that natural responsiveness (wei) is conditioned by its own actions.

The topic of food stagnation provides an opportunity to explore some differences between the modern physical worldview and the dynamic process orientation of classical Chinese thought. The naïve physical description of phenomena interprets food stagnation as the accumulation of physical material in the stomach and/or intestines. While this physical stagnation in the digestive tract is important, so is the functional "process" stagnation that creates the urge to ingest more food when the individual begins moving and processing previously ingested foods.

Each food elicits the embodied spirit to move in a particular way. Some foods, such as animal protein, stimulate qi to concentrate and consolidate (yang); while others, like refined cane sugar and alcohol, lead it to grow diffuse (yin). Individuals feel these impacts, even when they don't consciously recognize them and cannot articulate their experience verbally. Individuals desire, and even crave, certain foods to satisfy a need to influence their embodied spirits in particular ways.

Of course, within the longer scope of an individual's life, each embodied spirit responds to the initial (primary) influences of the food and drink that each person chooses to ingest most frequently. There are myriad such responses, which lead to individual differences in cultivating one's internal ecology. This terrain provides one of the key factors that lead to the development of various degenerative and disease processes, and each individual has a unique array of other contributing causes. We treat patients most effectively when we address the terrain and the specific factors that induce individuals into physiological distress and emotional struggle.

The classical traditions of Chinese medicine remind us to treat both the individual's terrains (elemental and the accrued impacts of personal history), and the manifestations - the root and branch. While the traditions of Neijing (Inner Classic) and Nanjing (Classic of Difficulties) differ on the precise nature and embodiment of roots and branches, they agree on the principle of addressing both in developing treatment strategies. The best treatments probe the deep roots of disease and help the individual's intrinsic dynamics find specific transformations in qi mechanism that allows their resolution.

People with a "healthy" relationship with food choose input (ying) that supports smooth flow of the mechanisms that generate and regulate postnatal qi. Others choose foods and drinks that distort their qi mechanisms in particular ways that reflect their struggles within the embodied spirit. So-called "comfort foods" displace spiritual/emotional struggle into physical work/struggle in the digestive tract, thus "liberating" the individual's conscious awareness from unresolved conflict. This is considered comforting to the individual's conscious awareness.

While many individuals find other ways to suspend unresolved conflicts in life, comfort foods often play a central role. Many comfort foods provide individuals with substantial challenges to digest and resolve. Cravings for the repeated experience of specific food or drink represent the "process orientation" of food stagnation. This arises from the individual's lack of willingness to be present with their emotional reactions to various experiences (blood stagnation). Thus, repeated indulgence in one's cravings for certain foods provides the medium to embody the individual's experiential blood stagnation, which is unresolved emotional conflict, into physical blood stagnation.

All concepts and theories of Chinese medicine can be interpreted from within a process orientation. Growing out of the limitations of a modern physical worldview facilitates a deeper understanding of the possibilities of Chinese medicine. Since the T'ang Dynasty (A.D. 581-907), there has been an increasing emphasis on treating qi as a physical humor, but we are free to return to a philosophical (or spiritual) approach that emphasizes the dynamic responsive nature of the human universe.

Click here for previous articles by Steven Alpern, LAc.


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