Chinese medicine draws some of its most important images from classical thought. The polar pair of yin and yang has been used since before written language for interpreting the results of divination procedures.
These concepts have continued at the core of historical Chinese attempts to understand the mysteries of the universe, including those within the microcosm of individual human life.
Like many words in Chinese, the written characters for yin and yang consist of multiple primitive radicals. In this case, they share a radical denoting an embankment, such as around a reservoir. That radical metaphorically suggests the boundary of an abstract concept containing many specific examples. The other radicals in their written characters distinguish them from each other, including ones denoting "clouds" for yin and "sunshine" for yang.
The most obvious use of yin/yang contrasts them in characterizing various phenomena. They define scales for measuring qualities relative to each other. Since these basic images are abstractions, they provide a limitless variety of metrics depending on the context of their use. For instance, relative to the degree of illumination: Day is yang and night is yin. On the other hand, "sunny day" is yang and "cloudy day" is yin. This last pair uses the specific imagery of the characters and demonstrates an important principle of yin/yang.
The characteristics of yin and yang can only be determined relative to each other. Using this example, a cloudy day is yin relative to a sunny day, but it is yang relative to night. A cloudy day is neither yin nor yang in itself; only in contrast to something else. The idea that qualities only have meaning relative to each other goes back to the second chapter of Dao De Jing. This is a key point of classical Chinese thought - qualities neither exist in themselves, nor do they belong to objects because they are only recognized relative to circumstances and each other.
Modern science depends on the ability to repeatedly measure various qualities of objects in the same circumstances with the same results. Scientific thought relies on statements of fact that can be tested to be "true" or "false." These statements are considered an objective standard of knowledge that provides a stable conceptual foundation for implying other statements. While this methodology can work fairly well in the physical world, it has grave shortcomings in the inspirited human world.
Chinese medical statements are only truly relative to the specific circumstance of their use. They can't be combined meaningfully to create theoretical structures reflecting material implication, as with modern scientific theories. Chinese medical language reflects the active process of clarifying and focusing awareness to allow practitioners to stimulate the dynamic responsiveness of an inspirited being rather than imposing a measure of control on a person's physical body. There are no general "statements of fact" in Chinese medicine.
While the use of yin/yang in relative opposition to each other is important, it only begins to demonstrate the difference between classical Chinese medicine and modern scientific thought. In addition to opposition, yin and yang exhibit three other key relationships that make this pair of images unique as the foundation of an inquiry into the mysteries of human health and disease. Together, these four relationships show how yin/yang transcends static opposition, as in Aristotelian logic.
Our knowledge of the progression among these four characteristics of yin/yang is intimately related to our experience of physiological function. One example is the embodied spirit's intrinsic response to perverse wind, which clearly demonstrates the dynamic responsive nature of yin/yang:
Opposition - Wind disrupts the free flow of wei qi, which is aroused to oppose the pathogenic factor to attempt flushing it out.
Mutual transformation - Food and drink are processed with the assistance of wei qi into jin-fluids in the stomach. Those fluids are then ascended to the surface by wei qi and transformed into wei qi.
Mutual consumption - The exuberant expression of wei qi consumes jin-fluids, and the accumulation of jin-fluids behind a blockage degrades into dampness. This, in turn, consumes the wei qi that was activated to move it.
Interdependence -The "upright qi" and "pathogenic factors" have become interdependent. Several theories provide ways to "sort out" upright from pathogenic factors contributing to current manifestations. When a portion of the upright qi is lost to entanglement with pathogenic factors, the resulting imbalances in the humors can only be rectified with "balanced" therapies. In order to tonify qi (or blood), one must also circulate qi (or blood).
In looking at the world, people generally focus on the position and qualities of objects, which are understood as fixed. The nature of movement is implied from changes in the specifics of position or quality. Modern science masters movement by understanding the physical rules that govern it, including statistical "rules" of random distribution or even ideas like chaos theory. Yet, none of these approaches accurately reflects the variety and responsiveness of human life. Individually embodied spirits physically and express their own volition through a wide variety of choices and decisions that don't conform to general rules of action or movement.
The initial and core focus of Chinese medicine differentiates the dynamics of movement and process. The six divisions of yang and yin form an analytic system for identifying and differentiating the nature of all human movements. This system analyzes complex movements into components, much as the system of x and y coordinates in analytical geometry identifies specific points on a plane. However, the Chinese medical system fundamentally differs from the familiar mathematical one in analyzing the components of movement, rather than the components of position. The classical Chinese approach based in Neijing looks directly at flux, rather than merely implying it from changes in status.
In exploring the physical world, scientists generally imply process from the changing specifics of status as a derivative. Much of modern science is based on this fundamental mathematical operation. It "derives" movement from functions that report the changing status of one metric relative to another (which is often "time"). While modern science looks for rules that govern movement, classical Chinese medicine differentiates various movements directly within each individual.
Unfortunately, the power of this difference largely is lost to practitioners of modern Chinese medicine. While the six divisions of yin/yang continue to appear prominently among the information of Chinese medicine, the meanings assigned to them relate only to static "positions," rather than dynamic movements. What does it mean, for instance, that the heart protector is jue yin or the small intestine is tai yang?
The two main uses of the six divisions in modern Chinese medicine occur in the names of the channels and the absorbed theory of Shang Han Lun. In the names of channels they are, at worst, simply denotations without meaning. At best, they are regions on the surface of the body, as in tai yang (occipital) or shao yang (lateral) headaches.
The modern interpretation of Shang Han Lun considers them six stages in the penetration of centralizing wind (zhong feng) or attack by cold (shang han). Each stage represents a different depth of penetration. In this view, each stage is characterized as a symptom-sign complex. This clinical methodology absorbs Shang Han Lun into modern doctrine, but it also sacrifices much of the original tradition's power.
According to the classical interpretation, the six divisions represent the canonical primitive movements of postnatal qi as the individual interacts with the environment. The embodied spirit naturally prioritizes the movements it activates in addressing pathogenic factors. The individual's failure to implement one movement, generally due to overwhelm, allows wind and/or cold to penetrate deeper, which necessitates more desperate responses from the embodied spirit.
Muscular actions physically move the individual's body relative to the outside world. They consist of combinations of the three yang divisions:
tai yang (greater yang) - moving forward and outward, releasing and/or expelling through passage of fluids (sweat or urine);
yang ming (yang brightness) - stopping, grasping, internalizing and reacting - the source of heat, holding and forming, polarity switch to release and/or expel solid waste; and
shao yang (lesser yang) - rotation, choice of direction (decision/indecision, which suspends whatever isn't resolved), clumping to prevent further penetration when unable to expel, and the interface between internalization and externalization.
Internal movements convey the individual's experience of phenomena. Individuals internalize physical and experiential material to process it. The results of that process are either expelled or accumulated within the being. The three yin divisions are:
tai yin (greater yin) - contact with internalized influences through the medium of (jin-type) fluids and absorption;
shao yin (lesser yin) - activation of internal process, pulsation and internal rhythm; and
jue yin (absolute yin) - binding flow into stasis or imprinting of processed (digested) experience onto physicality.
All movements in life are combinations of these basic "axes" of movement - the six divisions of yang and yin.
For instance, the basic acts of eating and digesting eventually includes a sequence of all movements. An individual reaches out and opens the hand (tai yang) to grasp (yang ming) a spoon, then rotates (shao yang) the hand to scoop some food onto the spoon, which is brought to the mouth to internalize (yang ming). Food that is in the mouth is chewed and swallowed (yang ming) to enter the interior at the stomach, where initial reactions (yang ming) occur. These are released to the interior, making contact (tai yin) with further digestive process.
Some of the material is absorbed (tai yin); one portion (gu qi) makes further contact (tai yin) with oxygen from the air to generate zong qi; and the other portion (the red substance) is further processed (shao yin) to form blood by imprinting (jue yin) emotional reactions onto it. The physical results of that process are differentiated (shao yang) into three parts. One is integrated (jue yin) into the being, another is filtered out of the blood (shao yin) and excreted with fluids (tai yang), and the last is suspended (shao yang). The portion that had remained in the alimentary canal moves forward (tai yang) through the small intestine to the large intestine, where it is held and formed (yang ming) then released to the exterior.
Classical Chinese thought differs from modern scientific thought in large part because its core concepts function so differently. These profound differences lead their respective inquiries in diverging directions to very different opportunities. The more deeply we delve into the most central ideas of Chinese medicine, the more of its "magic" we discover.
Click here for previous articles by Steven Alpern, LAc.