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The Delphic Boat and the Yellow Emperor: thoughts on Chinese medicine An excerpt from "Reflections on the Nan Jing " By Z'ev Rosenberg, L. Ac. I recently bought a DVD of the Crossroads Guitar Festival held in Dallas , Texas in 2004. This concert collected some of the greatest blues performers of all time, from Hubert Sumlin (who played with Howling Wolf) to Eric Clapton. Listening to the unbroken chain of blues performers, one can conclude that the blues has survived intact, even though the deep Mississippi delta culture that inspired the music has virtually disappeared since its golden era. It began during the 1920s and spawned such great musicians as Robert Johnson, Blind Willie McTell, and then on to Muddy Waters and the electric Chicago blues. I feel there is a parallel in the development of Chinese medicine. The civilization and conditions that inspired Chinese medicine have changed immeasurably. However, like the blues, there is a lineage that potentially can carry on the essence of this medicine, a soul to it that continues to be transmitted to practitioners and students. I don't think it has to disappear or be assimilated by modern medicine to survive. In studying the classical texts, and applying one's insights in the clinic, one continues the lineage of Chinese medicine. The essence of Chinese medicine survives in the Nan Jing , Nei Jing and Shang Han Lun . If we do not get caught in the fever of being "modern" and disdain the past, we can find the timeless moment in the present that is inspired by the past and creates the future. The secret of Chinese medicine has to do with the relationship of human beings to the phenomenon we call time. It is right there, but we are moving so fast in the modern world that sometimes we don't see it. By creating space in our clinical environment, by not rushing through our work, we can change our patients' relationship to time. A main cause of disease and poor health in the modern era is stress. We work too hard and too fast, trying to accomplish too much and straining our bodies and minds. Utilizing Chinese medical diagnosis, which is based on palpation of the pulse, sensing its rhythms and shapes, relating it to sound, color, smell and the thoughts of our patients, we can re-contextualize our patients' conditions and restore awareness of their own bodies and minds to them. The Delphic Boat and the Yellow Emperor I'd like to quote a text on genomics that I highly recommend, The Delphic Boat by Antoine Danchin, a French scientist. The book's central metaphor is the Delphic Boat, a vessel that decays through exposure to time and the elements. Its planks rot and are gradually replaced and repaired. Eventually, the original planks are all gone, but the boat looks exactly the same. Is this the same boat? Yes, I recognize it, sitting at the dock. But nothing remains from the original boat, except for the information that created it. If we examine the planks we can say they are pine or oak, but it doesn't tell us much about the boat, since the original planks are gone! Mr. Danchin writes that "the boat is not the material it is made from, but something else, much more interesting, which organizes the material of the plans: the boat is the relationship between the planks . Similarly, the study of life should never be restricted to objects, but must look into their relationships." The body and mind are not just the cells, tissues, and viscera, but the relationship of their parts. Observing these relationships is one of the strengths of Chinese medicine. The phenomenon of qi in medicine is largely about relationships between systems of function. The material component of human life is constantly changing, but the form stays the same. Aristotle called this eidos , the form-giving principle. He defined this principle as something that shapes the embryo, without being changed in the process: It contributes nothing to the material body of the embryo but only communicates its program of development. It doesn't become part of the embryo, just as no part of the carpenter enters into the wood he works; but the form is imparted by him to the material by means of the changes he effects. ( De generatione animalium I, 22, 23). As with the genome, the same is true with medicine. For myself, another one of Chinese medicine's great strengths is its understanding of relationships between phenomena inside and outside the self, and how these phenomena are connected and interact with each other. In terms of therapeutics, this translates into combinations of medicinals in prescriptions or combinations of acupuncture points that interact with the complexity of the human being. In Chinese philosophy, the concept of li , or principle, when extended to Chinese medicine, is expressed as li lun , theory or theoretical foundation. In order to optimally practice Chinese medicine, one has to be constantly in a state of awareness rooted in principle. Otherwise, one is caught in the rebound between symptom identification and choosing treatment based on a simplified view of observed symptoms. While this may be adequate for acute conditions, in long-term cases with complex patterns this is not sufficient. Principle allows one to 'get out of the box', and transcend the limitations of the senses to synthesize clinical data, by applying the appropriate theory to diagnose and treat the patient. This may include five-phase, eight-principle, six-channel or several other problem-solving methodologies embedded in Chinese medicine. What the patient experiences as health or disease, is beyond the flatland of the sense data. The penetrating insight of the physician based on principle divines the pattern, and chooses appropriate treatment. The more the physician is able to do this, the more he can predict the future development of the pattern and divine the roots. The Nan Jing provides a structural design for clinical strategies. Systematic correspondence, rooted in yin and yang and the five phases, is expressed in the channel-network system, divined through pulse analysis, and applied via the therapeutic modalities of acupuncture and moxabustion. The pulse reflects the length, breadth and content of the channels. One can feel and see if they are blocked, flowing, hidden, above or below ground, trickling or rushing. The five transporting points use the metaphors of water, running, trickling, springing and in a lake or sea to reflect the movement of qi and blood through the body. The channels can be replete or vacuous, severed, blocked, biased or dead. Acupuncture and moxabustion are then chosen to regulate the channels. By supplementing or draining them, the practitioner can "fill" or "empty," lengthen or shorten the influences in the channels to correct aberrant conditions affecting the channels, viscera-bowels, sense organs and tissues. When this is done properly, there is a resonance that is experienced by practitioner and patient in the form of wellbeing, balance and equilibrium. When the body and mind are in this state, many conditions will self-correct as the unhealthy biasing that habitually took control of the systems loses its grip on the person's well-being. In other words, we are taking advantage of the body's self-healing mechanisms. Many chronic diseases are habitual. A human being's survival instincts are very powerful, and we will find ways to continue to live in a compromised state. Acupuncture and moxabustion treatment educates the body-mind to re-experience a more healthy and balanced state without the biases of disease. In conclusion, as practitioners of Chinese medicine, we need to subtly alter our clinical perspective to see the relationship of phenomena to the whole when diagnosing and treating our patients. The Delphic Boat is more than its planks and nails, it is the concept itself that needs to be embodied in Chinese medical treatment. This section is quoted from the appendix in The Touchstone of Life by Werner R. Loewenstein, Oxford University Press, 1999.
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