Sometimes it’s hard to keep your feet firmly on the ground, especially when you’re a student approaching a Master, and think you know your stuff. Certainly, that is true for the ‘physical’ martial arts. It is no less true for martial art of the spirit.
What is “martial arts of the spirit?”
Martial artists of the spirit, like their physical martial arts ‘cousins,’ train an individual’s awareness to be awake and alert. Further, both types of martial arts support individuals to cultivate their awareness to grow more grounded — strong and secure. Yet, while a usual martial artist directs that awareness to some physical acts, the martial artist of the spirit devotes his or her awareness specifically toward rooting out unconscious identification with his or her own projections of static point of view. Wow that’s a mouthful! I’ve written at some length about the process of transcending one’s ‘usual’ perception through symbolic thinking; that is a long journey, which requires considerable attention. Yet, only liberation from one’s automatically projected interpretations allows one to begin perceiving phenomena as they are, and thereby begin to discern the subtle dynamics of Dào (道).
In our initial training, all acupuncturists learn to categorize a patient’s overt expressions of distress into zàngfǔ (臧府) syndromes, which differentiate excesses and deficiencies of various humors (blood, qì (氣), fluids, and eventually yīn (陰) and yáng (陽)). While this is a start, it is far from the perfect differentiation for most patients. Let us say, for instance, that a person has many signs of dampness with overt stagnation in the abdomen, such as fatigue, a sense of heaviness, bloating after eating, digestive irregularities, etc. Does that necessarily mean this patient has spleen qì (氣) deficiency with qì (氣) stagnation of the middle jiāo (焦) leading to dampness (possibly secondary to food stagnation, so ask about the patient’s eating habits)? Well, it might mean that, though there are myriad other causes for blockage of an individual’s fluid system, which can then ‘back up’ into the spleen and stomach — the individual’s ongoing source of fluids through the ingestion and digestion of water and foods. One might primarily have:
- a lung qì (氣) deficiency, which inadequately disseminates qì (氣) and fluids, and might specifically
- descend inadequate fluids to the kidney and urinary bladder to differentiate and eventually eliminate waste
- a blockage of wèiqì (衛氣) in:
- the còulǐ (腠理) — I’ve found this is VERY common among contemporary people, probably secondary to our local climate control and sedentary lifestyles
- the sinews — of course this is also fairly common, and it’s not always easy to differentiate whether the sinew blockage is primary or secondary to some internal imbalance
- a blockage of the urinary bladder by damp-heat or cold, or
- other blockages of the lower jiāo (焦), such as the liver by cold
And, this is only a partial list!
But, wouldn’t these other causes overtly express themselves? They certainly might, though the expression of those ‘primary causes’ may not be any more clear than the symptoms mentioned above. In that case, the clinical doctrine of modern Chinese medicine teaches us to simply add suitable ‘imbalances’ of physiological distress registering in manifest symptoms or signs to the diagnosis. Of course, those added syndromes may or may not capture the dynamics that create that patient’s clinical expression.
But, why doesn’t the primary cause show the strongest? There are many reasons for that peculiarity, though perhaps the primary one is that the ‘primary cause’ has been (or may still be) relatively well maintained. What the heck does that mean?
Let us say, for instance, that our patient is a middle aged woman, who had a history of several urinary tract infections during her teens. She took anti-biotics for those infections, and each promptly went away. She learned to drink a lot of water, and she drinks tea, but not many other drinks. Whenever she feels mild symptoms in her lower abdomen near her urinary bladder, she drinks cranberry juice and an herbal product originally give by a practitioner whom she consulted ten years ago when she had a rare infection. Now, she doesn’t get urinary tract infections, perhaps mostly due to her care in preventing them — drinking lots of water generally helps people with a tendency toward urinary tract infections, and tea is somewhat diuretic, so at the very least drinking it helps her manage a slight excess of fluids. One may or may not believe the other remedies allow her to treat incipient infections; it doesn’t really matter, because patients who have learned to manage their ‘primary’ pathological processes abound, and this woman’s mild fluid excess was apparently managed until:
- it has simply overwhelmed the spleen and stomach, or
- some other factor, such as a blockage in the còulǐ (腠理), precipitates the eventual manifest stagnation
There is almost always a process, and I believe our job is to clarify it. When a practitioner can identify a patient’s specific block(s) clearly enough, then he or she can develop a treatment strategy according to the principle of ‘moving a thousand pounds with four ounces of force’ to stimulate profound transformation of the patient’s physiological process. Thereby, one can stimulate the resolution of pathology, rather than simply learning to classify the expression of distress, and working to find ways to control it. While one may find effective management for a chronic pathology, we limit our potential to participate in the profound healing of our patients when we conflate effective management with ‘cure.’ True cure entails resolution.
How do practitioners learn to discern key blocks, so they can develop strategies to stimulate their patients to resolve their diseases rather than maintaining them?
It’s a process, though it begins by setting aside the projections we all learned from the contemporary clinical doctrine of Chinese medicine. Those ideas aren’t ‘wrong,’ though the diagnostic process of differentiating the (already) manifest expression of distress is inherently limited. Pathologies grow and develop; the first thing to remember is that each human life is tasked with survival, and they find many different ways to fulfill that imperative. Each individual compensates and adapts to various challenges, adjusting to circumstances and events to secure the basic requirements of life. While a person with the manifest symptoms listed above appears to have a spleen qì (氣) deficiency with qì (氣) stagnation in the middle jiāo (焦), that is only where their distress manifests. Although it is certainly overwhelmed, the spleen may not even be deficient; when the ‘core’ block is cleared, the spleen’s adequate function may be restored without any further attention.
If the manifesting channel (or zàngfǔ (臧府)) is not the source of one’s pathology, as for the spleen in this example, treating it will become an ongoing process of management. Sometimes, such strategies don’t work at all, and at best they provide temporary relief, until they stop working. This is the most common scenario when one treats the manifesting expression of an individual’s pathology, rather than identifying and addressing its roots (etiology) and pathological process.
So, this process of differentiating an individual’s dynamics comes down to letting go of projections, and that brings us back to ‘martial arts of the spirit.’ When one brings fixed projections, based in modern Chinese medicine (a.k.a. TCM), any other doctrine of Chinese medicine, or most especially modern ‘scientific worldview’ to the study of Nèijīng (內經), one either:
- misses many of the classic’s most subtle and profound teachings, or
- simply gets confused — tumbled and disoriented, like being thrown for a triple somersault with two twists.
Most often, people experience a combination of both, when confronted with the ‘jumble’ of ideas and concepts in Nèijīng (內經). As the clinical science of Chinese medicine grew and developed, there was a massive proliferation of information, but the breadth and depth of its classical source faded. Each school of thought chose to emphasize those portions of doctrine from “the classic” that support their approach, regardless of the context of those ideas. Thus, Nèijīng (內經) became the source of many contrary doctrines, and its deeper stream of coherent inquiry was largely lost in the confusion.
How might we ‘reclaim’ the classic texts of Nèijīng (內經)? Well, that process certainly starts with considerable study. Neijing study presents many challenges, because their tapestries of chapters were sacred texts rather than textbooks. They were intended as poetic inspiration for those who had already received teachings through personal instruction; the texts by themselves were never meant to provide systematic instruction. Perhaps seeking lineage instruction could help one decipher the texts of Nèijīng (內經), and thereby uncover more of their practical application.
But, how can we evaluate the legitimacy of a purported ‘lineage’? This is a BIG challenge, though there may be several clues:
- cogency and philosophical depth, especially concerning the nature of life in health and disease, which may be challenging to find due to:
- an element of ‘martial arts of the spirit’ to stimulate one to transform one’s point of view, rather than just adding new doctrine
- clinical efficacy
- finding one’s teachings in the texts, especially being able to identify some of the many ‘conundrums’ in Neijing
Unfortunately, one cannot evaluate a purported lineage based on doctrine alone, as the classic includes so many contrary ideas. Very different schools of thought could develop with different emphasis, yet still both be based on Nèijīng (內經). However, one distinctive feature of Nèijīng (內經)-style Chinese medicine is the use of the entire channel complexes, beyond the primary channels as conduits to the zàngfǔ (臧府). Perhaps the best measure of a lineage is to work diligently with its teachings, and then study Nèijīng (內經). If one’s experience informs and elucidates the texts in ways that provide practical value for practitioners, then at least that individual has found value in his or her lineage.
A Key Question: Why aren’t there more people at Jeffrey Yuen’s classes?
Lilly Moon, M.D. posed that question, when I met her a few weeks ago at Jeffrey Yuen’s class in the Bay Area. She has been his student for a few years, is very stimulated by his teachings, and seems to wonder why they haven’t taken over the entire profession. While Jeffrey is well known and widely respected, he doesn’t draw large crowds like some teachers, especially ones who give very specific instructions on how to treat, either for specific conditions or more general instruction that is easy to apply clinically. So, it might be that other teachers just make their instruction easier to apply, so they attract more participants, but I think it’s more than that.
Jeffrey Yuen teaches Chinese medicine as martial arts of the spirit, and he does it so smoothly that many participants aren’t completely aware they’ve been sent reeling many times during a lecture, until they emerge feeling somewhat overwhelmed and confused. Everyone responds differently to his classes. Some participants are very stimulated, follow him avidly, and each receives surprisingly individual teachings within the context of his seminars. Jeffrey teaches broad principles of many historical ideas and approaches to Chinese medicine, and generally doesn’t explain how it all fits together. He teaches how to develop strategies for treating patients, based on identifying their personal blocks, rather than protocols for treating patients with particularly disease expressions. While this may seem a subtle difference, his classes leave his students A LOT of work learning to apply them clinically. Doing that work to integrate and apply the teachings is how to make them one’s own.
A few practitioners become agitated and upset by Jeffrey Yuen’s teachings, and many of these question the legitimacy of his lineage and teachings. After all there is now such a vast literature of Chinese medicine to study, including both exhaustive textbooks and myriad case studies to illustrate various theories and key differentiations. Why should we even consider a lineage important? Some people, imbued with our contemporary egalitarian standards, demean the idea of personal transmission of lineage teachings in learning Chinese medicine; instead, they seem to believe all teachings are available simply by buying and studying books (or even watching DVDs). Many others come to a few of his classes, and seem to feel overwhelmed by the enormity of the teachings; they simply don’t choose to devote the time and energy to work with them.
So Lilly, I guess that after finishing professional school and passing licensing exams, most practitioners just want to practice. They want specific tools that will help them practice more effectively, rather than a life long journey of martial arts of the spirit. I suppose most practitioners are satisfied with the modern clinical doctrine, based on differentiating syndromes of the zàngfǔ (臧府) and then treating them with the primary channels. Why not? It’s what we’ve all been taught.