Chinese Medicine and the Inner Dialogue


Forbes contributor John Balzano wrote this week about China’s new safety regulations that aim to clarify the distinction between food and traditional chinese medicine, also known as Zhongyi or “Chinese medicine.” These regulations, he says, display the government’s concern for public health yet need to be more specific.

Some of the new policies are very good, but this lack of specificity does not help resolve one of the major issues confronting Zhongyi today. Namely, a lack of clarity regarding its effectiveness, and at the heart of the debate concerning its effectiveness lies a certain degree of confusion about the nature of the practice itself.

Zhongyi is more than a system for treating ailments. It’s also a philosophical approach to well-being. The great Huangdi Neijing (Yellow Emperor’s Inner Dialogue), Zhongyi’s foundational text, recommends a healthy diet and balanced lifestyle as opposed to ritual magic. Part medical reference and part Daoist treatise, the Neijing is China’s oldest medical text, written some 2,300 years ago, and takes the form of a dialogue between the Yellow Emperor and his physicians, defining health in Daoist terms involving concepts such as Qi, Yin-Yang and the five elements – all of which place emphasis on living a balanced life.

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Hua Tuo, the greatest figure in Zhongyi history, so revered that calling a doctor “Hua Tuo reincarnated” remains a massive compliment, believed the best way to avoid illness was through regular exercise and eating well. Sun Simiao, the Medicine King, author of the “Chinese Hippocratic Oath,” which advises every physician to “always act as if he were thinking of his close relatives,” also felt exercise was one of the best ways to stay healthy. And Li Shizhen, author of the Bencao Gangmu, an intricately organized reference of 1,892 drugs that took 27 years to write and remains the herbalist’s definitive guide, felt the best approach to healthcare was not through herbal curatives but healthy living.

This may sound unimpressive but these elements – a balanced lifestyle, good diet and regular exercise – are things Westerners have only recently adopted: the first dietitians emerged in the 1700s and exercise wasn’t popularly practiced until its influence on cardiovascular health was proven in 1952. A systematic approach to biology partly inherited from Aristotle’s Historia Animalium, written around the same time as the Neijing, and a departure from Church authority that didn’t develop until after Galileo’s feverish death in 1642, laid the groundwork for scientific medicine while improvements in lab equipment and new medical institutes in Paris, Vienna and Berlin enabled scientists like Schwann, Pasteur and Koch to establish the field of microbiology.

These events helped nurture evidential medicine in the West, but are not a part of Chinese history. There is no evidence for Qi or meridians, Zhongyi doctors show no consensus regarding diagnostic methods or treatments, and some Zhongyi practices are derided as medieval. There are moral concerns too. The Chinese market for exotic medicines is devastating populations of elephants, pangolins, tigers, monkeys etc. Not to mention bizarre cases like the China Urine Therapy Association. This is not to say Zhongyi is a sham. It can be helpful, but it lacks scientific rigor. So why hasn’t it changed or been forsaken?

Some have forsaken it, such as the great Lu Xun who called Zhongyi doctors swindlers, or Chairman Mao who, Alan Levinovitz writes, didn’t believe in it but promoted it anyway, or more recently, the scholar Zhang Gongyao. But  nevertheless Zhongyi survives partly as a matter of national pride. It belongs to an inner dialogue, or neijing, about what it means to be Chinese. Medicinally, it is unscientific, though not worthless. Philosophically, it boasts a rich heritage. Socially, it is a patriotic symbol. As pop singer Jay Chou declares in his song “Bencao Gangmu”: “if Hua Tuo was reincarnated, people who blindly worship foreign things will be cured […] look at me pick up some Chinese medicine. Take a dose of pride.”

Consider the following. An old Chinese man visiting America gives his sick grandson a massage, a type of Chinese effleurage that leaves red marks later to be mistaken for signs of child abuse by a racist nurse and ignorant authorities. So begins Gua Sha, a 2001 film named after the massage technique involved. The film is really about a family forsaking its heritage in order to join mainstream American society. They speak English at dinner, alienating the grandfather, and do not use chopsticks, even when eating Chinese. The grandfather, representing Old China, seems to have no place in their world. And this captures a poignant truth that strongly resonates with Chinese today, not only that Western reactions to such techniques can be racist and ignorant but that the techniques themselves, like a grandfather’s touch, are not simply medical treatments.

David Volodzko has provided cultural analyses for various publications including the Washington Monthly,openDemocracy, and 10 Magazine.

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