When man is serene, the pulse of the heart flows and connects, just as pearls are joined together or like a string of red jade, then one can talk about a healthy heart.
The Yellow Emperor’s Canon of Internal Medicine, 2005 BC
A Brief Overview of Traditional Chinese Medicine
How does one approach a brief overview of a system of medicine that reaches back far before recorded history? Tenderly and with much humility, and in so saying an admittance that this is a lay persons version of a complex system that has evolved over much time. I am grateful to Elizabeth Nachtwey, Licensed TCM Dr. and Body-Mind Counsellor, for reading over my simple rendition, offering corrections and giving it her stamp of approval.
Traditional Chinese Medicine is a body of knowledge and practice dating from about 1250 BC, which has seen a resurgence of interest and respect in the Western world in the past few decades.
“Traditional Chinese medicine is the fruit of various millenniums of research and experimentation of various disciplines such as acupuncture, massage, moxibustion or pharmacopoeia. On the international scene, Chinese medicine, has the World Health Organization (WHO) endorsement and is now completely incorporated in various systems of public health.”
Complementarity examples from the World Health Organization
Source: World Health Organization, May 2003
The Roots of Traditional Chinese Medicine (TCM)
One can find the earliest roots of Chinese medicine in the Shang dynasty (1523-1027BCE). In this time nature and illness were considered closely tied to the relationship between the living and the dead, and the work of the shaman was to remediate these relationships. The oldest known book about Chinese Medicine, The Yellow Emperor’s Inner Classic, was complied before 2000 BC, and is a summary of the anatomy and physiology of the human body, medical ideas, treatments and techniques that were in use long before the second century BC.
The following is a list of books that form some of the extensive background for TCM:
The Herbal: one of the earliest classics on herbs handed down from the Qin and Han dynasties (221 B.C. – 220 A.D.)
Treatise on Febrile Diseases and Miscellaneous Diseases Zhang Zhongjing. (300 A.D.) Its 269 prescriptions make up the basis for modern clinical practice.
Classic of Acupuncture and Moxibustion Huang Fumi (215 – 282 A.D.)
General Treatise on the Causes and Symptoms of Disease (610 A.D.) Chao Yuangfang, with others. 50 volumes with 67 categories that list 1,700 syndromes.
Prescriptions Worth a Thousand Gold for Emergencies (581-682 A.D.) 30 volumes and 5,300 prescriptions
The Medical Secrets of An Official Wang Tao (752 A.D.) 40 volumes, 6,000 prescriptions
Wang Tao [Wang Tao; ca 702-772 A.D.] – He is famous for writing the book Waitai Miyao (Medical Secrets of an Official), published in 752 A.D. He provided a comprehensive description of medical problems, covering more than 1,000 categories, and discussed over 6,000 herbal prescriptions.
“The body is visible and the body is invisible” common TCM saying
Basic Tenants in TCM
Energy: Chinese medicine is about energy and movement- where it comes from, where it goes, and how it flows.
Qi: The Unifying Principle
Qi (pronounced chee)
Everything in Chinese medicine is seen as a manifestation of the principle of Qi. Qi is a term that encompasses all of ones body’s energies: electrical, chemical, magnetic and radiant. It can be called life force.
“The Chinese see all phenomena as manifestations of Qi, the unifying principle. All form and substance in the universe is the materialization of this energy.” E. Nachtwey
The laws of nature – gravity, time, inertia, friction, yin and yang, rule over our Qi, and affect us on the inside and the outside. Albert Einstein was one of the first western scientists to theorize that energy can only be understood in motion: e=mc. If it is not moving, it is not energy but potential energy. The same is true for Qi, energy is only Qi when it is in movement. The Chinese character for Qi means breath, and when you have some of this you are alive. The character can be described as rice transforming into air. The energy of movement, as we know from physics, creates warmth, and this is true for Qi. Qi makes heat, and warms the body.
In the human body there are many kinds of Qi, some is coming and some is going, some is protective and some perverse. Each organ has its own Qi, and it is Qi and the blood that nourish the body. Qi is Yang, and blood is Yin. It is the Qi (Yang) that moves the blood (Yin), but the blood (Yin) is the mother to the Qi (Yana). The flow of Qi and blood are the basics of good health on every level of the human experience. When Qi and blood are abundant and flowing, there is vibrant health. When blood or Oi are stuck or weak, we become ill.
Yin and Yang
Yin and Yang are like day and night. Yin and Yang are like the two sides of a mountain. One side is in the shade in the morning and one in the sunlight. As the day progresses the sides reverse. What was dark becomes light and what was light becomes dark. We see this in the ever changing life of nature. So in time Yang turns to Yin and Yin becomes Yang. Change is a basic law of nature, something that you can count on, dependable like gravity. Just as Yin and Yang support each other they also oppose each other. They live within each other – there is always yin within yang and yang within yin. They can’t exist with out each other.
Yang is active, out going, and dispersive. It is considered male, and is the functioning of the life and of the organs. Yin is reflective, cool, quiet, calm and still, the receptive quality of life that welcomes in nourishment. It is considered female, and is the substance for our organs. Carl Jung (noted psychotherapist) studied the ancient Chinese text the I Ching and described Yang as the conscious mind and Yin as the unconscious mind.
Theory of the Organs
The Zhang / Fu
In TCM the internal organs have the same names as used in western medicine, however the organs are considered to include more than the flesh and blood. Some are seen as performing tasks that are not either understood or perceived by instrumentation used by western medicine.
Let us recall the concept of Qi, as TCM is largely about the flow of this energy through the bodily organs. Many organs are involved in the storage, production and circulation of energy. The flow and creation of Qi is a primary concern for the TCM doctor, more so than the biological functioning. It is thought that when the Qi is functioning normally, the organ will be healthy and behave normally.
There are Yin organs and Yang organs, and Chinese medicine groups the organs into Yin/ Yang pairs The Yin organs, which are dense, are the heart, spleen, lungs, kidneys and the liver, and are called the Zang. They are considered the most important organs as they are primarily responsible for the creation and storage of Qi and blood. The Yang organs are the large and small intestine, stomach, gall bladder and urinary bladder are called the Fu, and are considered less important organs. As hollow organs they are responsible mainly for digestion, transportation and elimination.
Chart of the Functioning of the Organs
The Five Elements – Relationships of the Organs
This part of TCM describes the relationships between the organs as interdependent. For example the heart depends on the lungs for oxygen, and if the kidneys fail the whole body is affected. According to the Five Elements, there are five element Fire, Earth, Metal, Water and Wood that help us to understand these relationships.
Each element is related to a major organ system:
Fire to the Heart
Earth to the Spleen
Metal to the Lungs
Water to the Kidneys
Wood to the Liver
Each organ and corresponding element has a time throughout the cycle of the day of generation and of checking. Disharmony in one element will cause disharmony in the corresponding elements in tune with these cycles.
The Five Emotions
In TCM the emotions mingle with the mind/body connection, and affect both the flow and rhythm of the Qi, which then directly affects the organs. Emotions that are intense change the body in profound ways, and some pervert the Qi create disease. For example, fear or anger that is prolonged or very intense can lead to the constraint of Qi. This can result in depression, stagnation, and a variety of physical aliments such as those that are classified as autoimmune diseases.
The five emotions are:
Joy (lack there of, or over excitement) is associated with the heart (fire)
Sadness (over contemplation) the Spleen/Stomach (earth)
Grief the lungs (metal)
Fear the kidneys (water)
Anger the Liver (wood)
From this very elementary overview of Traditional Chinese Medicine one can see that to the Traditional Chinese Medical Doctor the human being is multidimensional and holistic.
To capture more of the spirit or essence of TCM, I have consulted the work of Claude Larre and Elisabeth Rochat da la Vallee’, in their book Rooted in Spirit.
This book is a sinological interpretation of Chapter Eight of Huangdi Neijing Lingshu, The Yellow Emperor’s Classic of Internal Medicine.
The following is from a conversation from the Huangdi Neijing Lingshu, between The Yellow Emperor and his companion Qi Bo:
Haungdi puts this question to Qi BO
For every needling, the method is above all
not to miss the rooting in the Spirits.
Xue and Mai, Ying and Qi, Jing and Shen,
These are stored by the Five Zang.
If a situation become such that
By a succession of overflowings and total invasion
They leave the Zang,
Then the Essences are lost;
And Hun and Po are carried away in an
uncontrollable agitation,
Will and Intent become confused and disordered.
Knowing-how and Reflection abandon us.
Where does this state come from?
Should heaven be blamed? Is it Man‘s fault?
And what do we call Virtue, Breaths, Life, Essences
Shen, Hun. Po Heart, Intent, Will, Thought Knowing-How, Reflection?
Qi Bo replied:
Heaven within me is Virtue.
Earth within me is the Breaths.
Virtue flows down, the breaths expand, and there is life.
The coming forth of living being indicates the Essences.
The embrace of the two Essences indicates the Spirits.
That which follows the Spirits faithfully in their going and coming indicates the Hun.
That which associates with the Essences in the exiting and entering indicates the Po.
When something takes charge of the beings, we speak of the Heart.
When the Heart applies itself, we speak of Intent.
When the Intent becomes permanent, we speak of Will.
When the persevering Will changes, we speak of Thought.
When Thought extends itself powerfully and far, we speak of Reflection.
When Reflection can have all beings at its disposal, we speak of Knowing-How.
In Traditional Chinese Medicine, all of life is seen as unfolding between Heaven and Earth, and the creation of Heaven and Earth is the prototype of every living being. To build up a capacity to understand the TCM view of the heart I think it is wise to explore the main themes of the ancient question and answer quoted, and to let a picture of the concepts build in ones awareness.
The Six Authorities
Xue and Mai Ying and Qi Jing and Shen
These six authorities make up the life of a being, and are grouped in the above pairs.
Xue Mai: Blood is Xue, and Mai is the animated pathways of the circulation, which is under the direction of the Spirits.
Ying Qi: this is the organization, completion, construction, and the reconstruction of the vitality of a being; Ying Qi is nutritive.
Jing Shen: Shen – the mystery of life that lives through the Spirits, which penetrate Jing – the Essences. They create life and give it duration.
It is through the relationship of Heaven (the Heart) and the Earth (the Kidneys) that this is possible. The kidneys are where the Essences are composed and recomposed, and the heart is where the Spirits dwell.
Virtue De (Te)
Virtue is the integrity and the genuineness of the heart as it moves along. Virtue is most often placed with its homophone de which means to have received, to obtain, to possess, and to attain in deep agreement. It is said that through virtue one may find oneself, and possess oneself, and that knowledge without virtue is worthless. The actions of one who has virtue serve everyone and everything. When the Virtue of the Way fills your heart completely, it will bring to one effectiveness and limitless perception.
Spirits Shen
Spirits, divinities, the vital principle, something utterly marvellous.
The Spirits are considered the alternating expression of natural forces that unfold under the beneficent authority of above. This can be seen as heaven penetrating ones doing this is the way that the Spirits instruct all of human kind.
The spirits of heaven are considered within us, they conduct us and guard us and it is also our task to guard them. Within the realm of Spirits there are sub categories that become more definite in their definitions:
Essences/Spirits Jing Shen (Ching Shen)
This is the animating spirits of the essence, which is described as human vitality at the most subtle of expression. This is the active expression of life vitality expressing as clear and conscious governance in one’s life. The Spirits fasten to the essences and are expressed through them. In return the Spirits free the subtlety of the essences for the higher potentials of life.
(Luminous Radiance of the) Spirits Shen Ming
The Spirits shine through natural Virtue, and bring a brilliant flash to ones conduct. Through this radiance in ones life actions, the presence of the Spirits is observable through virtuous and effective conduct, bright and clear eyes, and a fresh, rosy complexion.
Breaths Qi
Breaths capture the picture of energy rising and moving: exhalation, fluid, vital life force. The Chinese character symbol for this concept shows the grains of rice bursting from the effects of cooking, or digestion, which releases a vapour (steam or nutrition) that rises up and accumulates. Although Breaths are formless, it is they that create, animate, and also maintain all form. They draw their strength and renewal from the energy that is released when matter transforms. Everything is seen as being made by the breaths, and it is not the quantity but the quality of breaths that matters. It is the harmonious distribution of all of the components that must go where they are expected to go that is the key. All of the circulations, exchanges, changes from liquid to vapour, and from vapour to liquid, all of the rhythms of the movements, all of the opening and closings, rely on the breaths.
Jing Shen: Shen – the mystery of life that lives through the Spirits, which penetrate Jing – the Essences. They create life and give it duration.
It is through the relationship of Heaven (the Heart) and the Earth (the Kidneys) that this is possible. The kidneys are where the Essences are composed and recomposed, and the heart is where the Spirits dwell.
Virtue De (Te)
Virtue is the integrity and the genuineness of the heart as it moves along. Virtue is most often placed with its homophone de which means to have received, to obtain, to possess, and to attain in deep agreement.
It is said that through virtue one may find oneself, and possess oneself, and that knowledge without virtue is worthless. The actions of one who has virtue serve everyone and everything. When the Virtue of the Way fills your heart completely, it will bring to one effectiveness and limitless perception.
Spirits Shen
Spirits, divinities, the vital principle, something utterly marvellous.
The Spirits are considered the alternating expression of natural forces that unfold under the beneficent authority of above. This can be seen as heaven penetrating ones doing this is the way that the Spirits instruct all of human kind.
The spirits of heaven are considered within us, they conduct us and guard us and it is also our task to guard them. Within the realm of Spirits there are sub categories that become more definite in their definitions:
Essences/Spirits Jing Shen (Ching Shen)
This is the animating spirits of the essence, which is described as human vitality at the most subtle of expression. This is the active expression of life vitality expressing as clear and conscious governance in one’s life. The Spirits fasten to the essences and are expressed through them. In return the Spirits free the subtlety of the essences for the higher potentials of life.
(Luminous Radiance of the) Spirits Shen Ming
The Spirits shine through natural Virtue, and bring a brilliant flash to ones conduct. Through this radiance in ones life actions, the presence of the Spirits is observable through virtuous and effective conduct, bright and clear eyes, and a fresh, rosy complexion.
Breaths Qi
Breaths capture the picture of energy rising and moving: exhalation, fluid, vital life force. The Chinese character symbol for this concept shows the grains of rice bursting from the effects of cooking, or digestion, which releases a vapour (steam or nutrition) that rises up and accumulates. Although Breaths are formless, it is they that create, animate, and also maintain all form. They draw their strength and renewal from the energy that is released when matter transforms. Everything is seen as being made by the breaths, and it is not the quantity but the quality of breaths that matters. It is the harmonious distribution of all of the components that must go where they are expected to go that is the key. All of the circulations, exchanges, changes from liquid to vapour, and from vapour to liquid, all of the rhythms of the movements, all of the opening and closings, rely on the breaths.
Essences Jing (Ch’ing)
This is the most perfect form of something-its quintessential embodiment. To the Chinese character of Breaths is added greenery rather than the rising of steam. This greenery is the colour of a growing plant being pushed upwards by its sap, which is full of life force. The image is of a living being’s life force/vitality being distributed to the most exterior regions of that being.
Essences that are pure and clear are the foundation for each life – both the basis for on going maintenance, and it’s continuation in life. The essences pass from one being to another, as when the plant is digested by the human and then assimilated, providing nourishment. It is the essences that weave together all living things through their vitality.
http://maciociaonline.blogspot.com/2012/11/shen-and-hun-psyche-in-chinese-medicine.html
Hun
The Hun are the breath of the soul, and relates to the western concept of soul or spirit. This is the Yang aspect of the Spirits, which are subtle, light and airy. The Hun faithfully follow the Spirits in their coming and going. It is thought that the Hun enter the body shortly after birth, and leave the body after death, returning to “Heaven” (the ancient Chinese conception of heaven is unrelated to the Christian or western concept – it is a state of non material beings and energies.)
Po
The Po are the Yin aspect of the Spirits, they are less light, less subtle and more earthy. Their firmness allows them to grasp the impulse coming from the Spirits. The Po are associated with the Essences in the entering and exiting.
Heart Xin (Hsim)
The heart is spirit, intimacy, intelligence, thought, mentality, moral conscience, feeling, emotion, humour, intention and attention. The Chinese character that represents the human heart shows the open pericardium above, the organ in the middle and below an indication of the aorta.
The heart is open at the top, and is always open to the communication of Heaven through the Spirits. At the center of the Heart there is emptiness which provides a dwelling place for the Spirits. The heart is what guarantees a persons existence, and is the Sovereign ruler of the body. The blood bears the orders of the heart to the body. The blood carries the reconstituting vitality which is both nutritive and spiritual, and permits the going and coming of information between the inside and the outside. The Heart is master of all emotions, and has the gesture of a flame that rises. This fire dispenses a soft warmth that stimulates the circulation of life through movement that rises up from the depths, spreads out and fills all space. The tongue and the ears are orifices of the heart; the tongue both distinguishes flavours and pronounces judgments, and the ear picks up and receives information for the heart, The sound of the heart is laughter.
Intent Yi (I)
Within Intent rests meaning, significance, intention, idea, opinion, and personal feeling. The intention of the heart is what the thinking, speaking, and acting person puts into what that person produces and releases through sounds, thoughts and actions.
Will Zhi (Chih)
Wish, plan, goal, aspiration.
Just as a plant rises forth from a seed, the will is a movement that arises from the intent of the heart through persistence.
Thought Si (Szu)
To reflect, consider, remember; conception, worries, concerns to obsessions. The Chinese character of thought shows the heart below the cranial box that contains the brain. When there is good relationship between the spirits that dwell in the heart, with the brain, thought develops. The connection between the heart and the brain may pass through the eye and the tongue.
Thought allows a connecting with and ordering of the elements of reason or contemplation. Thought is related to the spleen, and to the kidneys – the element of Earth. With the brain and heart connected, Earth permits the mixing and communicating of the seeds that have been sown. The matter of the brain is constituted of the most subtle and refined essences, and can be seen to be embodied with the original and hidden power of the kidneys.
Reflection Lü
Meditation, project, theoretical plan; to reflect, consider, speculation, to take to heart, to premeditate, to be careful; worry, preoccupation, misgiving, uncertainty. The Chinese character shows a tiger’s stripes encompassing thought. The tiger leaps mightily and far, landing just where he wants to, pinning his prey to the ground. The two colours of the tiger’s strips show the ability to be in concentrated repose, with the ability to move precisely with great speed. Reflection is connected to the liver, and the element of Wood.
The Hun are sheltered by the liver, and are the force that give reflection, elevation and methodical correctness. In its best aspect of Wood, reflection ignores uncertainties, defies stagnation of thought by endless repetition, and leads to the proper decision.
Knowing-How Zhi (Chih)
Intelligence, wisdom, right timing, aptitude, capacity.
The Chinese Character shows knowledge/awareness above the sun. The sun expresses power, and knowledge is represented by an arrow or a mouth. It is the arrows precision that gives the ability to speak about a subject by going straight to the heart of the matter to the goal. When one knows something, there has been a precision of awareness through the sense organs. One has conceived of what it is in the heart, and then can express it through the tongue and mouth and then manifest it by the light of one’s spirit, which radiates through the heart. When one really knows something, one knows exactly what to do and just how to do it. There is no hesitation, each and every thing and being has been considered and the heart is at peace.
The Mind/Heart Relationship
In TCM the mind, considered consciousness, feeling and thought, is stored in the heart and governs all of the activities of the human organism.
Sound Mind (Heart) = Health
It is the Heart the guides the mind, and takes in the information from the outside environment via the organs.
To preserve a tranquil mind, which preserves good health, TCM prescribes a minimization of the 6 Desires:
- desire for fame and profit
- desire for sex
- desire for wealth
- desire for rich food
- desire for unrealistic fantasies
- desire for what another has – jealousy
To strengthen health it is recommended to be broadminded in ones conduct by:
- setting lofty goals
- cherish ones hopes and love life
- cultivate optimism in ones outlook
- ease and cultivate the mind with worthy deeds
The activities that help one to achieve this are:
– interactions with the natural world, such as gardening, hiking
– relating and creating with art and music
– regulating ones emotions, to catch them before they go to the extreme
The greatest inner threat to our health is stagnating thought patterns. When there is stagnation, the movement of Qi is inefficient or blocked and cannot properly fulfill the transmission of bodily information. Thus stagnation in ones mind leads to stagnation and blockage in the physical body.
TMC offers that the 5 emotions in extreme are the primary cause of disease. Helpful practices to manage these emotions are:
- rational reasoning
- finding outlets for emotions
- consulting with friends and relatives
- divert ones attention with singing, taking a walk, reading poetry
These practices bring balance so that clear thinking can be restored.
The Art of the Heart are calm and quietude, which does not mean the denial of the activities of life. It means a balanced analysis of these movements and ones reactions. The heart can take on the burdens of beings when it does not hold onto thoughts, ideas and emotions, but empties and fills itself with a healthy rhythm.
As Traditional Chinese Medicine has gained in popularity and acceptance in the Western world, the roots of this tradition of medicine have remained intact. When one visits a TCM doctor one is seen as a total being of spirit, soul and corporal body.
Resources:
Larre, Claude & Rochat de la Vallee”, S.J. & Elisabeth. 1995. Rooted in Spirit The Heart of Chinese Medicine. Barryville, New York, Station Hill Press.
Maciocia, Giovanni. 1994. The Practice of Chinese Medicine. New York, N.Y., Churchill Livingston, Medical Division of Pearson Professional Ltd.
Natchwey, Elizabeth. 2004. Unpublished Thesis. TCM And Body-Centered Psychotherapy: A Synthesis
the heart connection to learning and education 