Thinking about Chinese medicine

There is a substantial gap in the various approaches that we take to thinking about (and teaching) Chinese medicine theory. There are four principle areas that overlap with one another in any discussion of the body from a Chinese medical perspective, and in TCM theory we only really pay attention to 2 of them, while the Shang Han Lun model (and a big swath of herbal theory) tends to address the other two. I would lay it out like this:


The four categories are SPACE, PATHOLOGICAL SUBSTANCES, NORMAL SUBSTANCES, and ORGAN FUNCTIONS


ORGAN FUNCTIONS: This reflects the organic movements of qi in the body, their interactions to generate NORMAL SUBSTANCES and their relationship to SPACES in the body. Through their dysfunction we come to understand how PATHOLOGICAL SUBSTANCES are formed.


NORMAL SUBSTANCES: These are qi blood body fluids, yin and yang, etc. They fill the SPACES and are integral to the composition and function of the ORGANS. They can become pathological when they come out of right relationship with the normal substances and functions.


PATHOLOGICAL SUBSTANCES: These are environmental pathogens, internally generated disturbances, wind, accumulations, phlegm, static blood, etc. They fill SPACES and have actions that they perform on their surroundings. These might include emotional states if they are considered pathological.


SPACES: These are the areas where the business of the body gets done; some are defined by relationships with organs (e.g. eyes and vertex for liver) milieus for movement (san jiao, channels, etc). Critically, they also include the organs themselves, as they “store” a substance, and are consequentially spatial in nature…this will let us understand some of the stranger aspects of heat clearing therapies and the tendency to drain while supplementing...


I think that TCM theory focuses on ORGANS and NORMAL SUBSTANCES and touches on PATHOLOGICAL SUBSTANCES, and does not think about space at all. This leaves much of the logical grace of SHL theory outside the understanding of TCM and attempts to shoehorn it in as a system tends to meet with blank looks.


SHL focuses almost exclusively on PATHOGENIC SUBSTANCES and SPACES; when we look at many of the SHL formulas in this context they start to make much more sense. There is little or no mention of organ function per se in SHL, and certainly not the type of thinking that corresponds with modern TCM ideas of ORGAN function.


The irony of this is that herbal therapy is using a very different perspective on the information than they started with, while acupuncture gets shafted because the SPACE and PATHOGEN idea is really quite effective for them as well... and it encourages palpation and physical assessment and conceiving of a physical and spatial body as opposed to the western "energetic" made up hoo ha.