開光 Kāiguāng—Opening the Light: Reflections on Chinese Medicine from China

As soon as we talk, it’s all contradiction.  As soon as we think, it’s all confusion. – Jigme Lingpa

The Chinese term 開光, Kāiguāng, meaning to open the light, is a Daoist term for ritually consecrating sacred objects, breathing the light of Dao into practice.  I have returned from pilgrimage in China to Mount Wŭdāng, and I feel the living presence of this great place has opened a light in me that I have been looking for in a time of darkness.  You may ask—what light?

I have been studying Chinese Medicine in school now for two years.  It has been a challenging journey, filled with great revelation and frustration.  While my frustrations with the study of medicine are complicated, they boil down to a simple discord between my intuition about the nature of the medicine itself and the pedagogy of modern TCM.  I believe they are at odds with one another, and the result is a systemic confusion. 

In short, I believe, and (re)discovered in China, that the essence of Chinese Medicine is profoundly simple, and I would like to share this simplicity with you.  However, the focus of modern TCM is remarkably complicated and perhaps overly concentrated on misleading details.  It is obsessed with symptoms and defines everything in terms of pathology.  CCM, unfortunately, is not much different, except that it adds an academic obsession with symbols, language, and textbooks on top of an already bloated system of diagnosis. 

If you’re like most people, you probably associate medicine with pathology.  In other words, medicine is something you take when you’re sick, so obviously medicine must be about understanding illness—how and why things “go wrong.”  Rarely do you hear medicine defined in terms of health.  Liu Ming used to ask rooms full of western doctors to define health, and none could do it.  In fact, they rarely understood the question, for it seemed “philosophical,” and medicine is “science.”     

Our culture is now going through a profound change, and we are seeking out “wellness.”  But whether it is through herbs, acupuncture, massage, or any of the many other healing modalities found in “alternative medicine,” our training is still largely focused on seeking out and diagnosing symptoms and pathologies.  We look for problems and solutions.  I have been in Chinese medical school for two years now, and with a few exceptions, I have heard no consistent definition of health.     

I had hoped that my school, which prides itself on being “Classical Chinese Medicine” or CCM, as opposed to TCM or Traditional Chinese Medicine, a byproduct of Communist China, would offer a different path, but alas, this has not been the case.  The presentation of CCM is, as far as I can tell, a convoluted mess, and my school is struggling very hard to define its identity among many differing styles and in many conflicting conversations, all exploring and asking—what does it mean to be “Classical?”  And it is asking this question in an environment where TCM is the dominant paradigm that standardizes the education and determines licensure, hence limiting the conversation to a battle between spiritual idealism and legality. 

Don’t get me wrong; I’m profoundly grateful and love my school.  But, after two years of exploring this question at NUNM, I have so far been disappointed in the response, because it goes against everything my teachers taught me, which was the inspiration that brought me here in the first place.

My teachers taught me that medicine can be a path, and that path is founded on health and basic sanity.  They taught me that medicine and astrology are one expression of the fundamental laws of nature—time and space.  The laws of nature and the principles of medicine/astrology contain no problems, no pathologies, no mistakes, and no illnesses.  The laws of nature are immortal and contain no birth or death, only a cyclical, self-resolving movement we call qì/prāṇa. 

Furthermore, they taught me that there are no answers in books.  Books are helpful, but we learn from people.  Lineage is held by people, not books.  Wisdom is non-conceptual, unmediated, direct.  A book is like a signpost that points beyond itself.  It is dangerous to mistake symbols for reality. 

Don’t get me wrong, I love books and literature, but in relation to medicine, the history of books is flimsy.  And as far as I can tell, in the current discussion, CCM is defined by its textbooks.  Many people claim “lineage,” but as this is mostly nonsense from a traditional point of view.  In other words, what makes CCM “classical,” as opposed to TCM, is that it is derived from “classical texts,” such as the Nèijīng, the Shānghánlùn, and the Yìjīng, rather than from modern texts.  Either way, it’s all about the books.  Textbooks and a lot of eloquent talk about “self-cultivation” and Qigong—this is what modern Chinese Medicine boils down to.  I call bullshit.  And I would explain why.

First, however, I ask you to contemplate the following quote by Ted Kaptchuk, a modern popularizer of TCM,

The literate medicine of China may not have been available to most Chinese people throughout history.  Paul Unschuld estimates that “the history of high medicine in China was never the medicine of ninety percent of the population.”  In the rural areas of China, literacy was extremely rare and health care was primarily in the hands of various magico-religious practitioners or folk herbalists.  Even in the cities, during every epoch this was true.    

In other words, most doctors and patients in China did not read, so how can we define the medicine of China in terms of books?  Most people in human history have been illiterate, and the history of literature is the history of a small but powerful elite.  For the most part, the elite were men, and they wrote books on men’s medicine.  The medicine of the people was, then, carried on in oral traditions by folk healers, midwives, shamans, and family doctors. 

These people learned their craft through apprenticeship and by following a living example.  Lineage, in this context, which was often familial, was private, secretive, and initiatory, meaning to study required supplication, ritual initiation, and vows/commitment, which is why “lineage” today is mostly a joke.  No one does this anymore.        

Furthermore, every textbook has been corrupted by time.  They have been copied, lost, edited, interpreted, and altered to suit the changing fashion of the times.  The Chinese have argued, bickered, and disagreed for a millennium on the meaning and practices found in textbooks.  They have written commentaries upon commentaries upon commentaries about commentaries.  This mess has only ever been sorted out by having a living teacher and lineage, for the Chinese have never been concerned with anything “making sense” in the western sense of the word, although many Germans have really tried to make it make sense.

So, now back to China.  After some delirious travels, I found myself in the misty mountain temple complex called Wŭdāng Shān.  There are five sacred mountains in Daoism, each dedicated to the Five Elements.  Wŭdāng is the manifestation of the Water Element, and the spirit of the Mountain is called Xuánwŭ (玄武), the Dark Warrior, the Black Tortoise of the North, also called Zhēnwŭ (真武), which happens to be a patron deity of the Liu Family.  So, for me this was an important pilgrimage.  My intention was to connect to the spirit of the medicine in its direct, non-conceptual form, outside the confines of textbooks, and to connect to the spirit of the Daoist tradition I profess to practice.

During the trip, I had the privilege to study with three remarkable teachers, and each of them confirmed my intuition about Chinese Medicine in different ways.  Essentially, I was looking for some confirmation that the Classical Tradition was not about textbooks but rather about a state of being, which happened to be prevalent in medieval China, a view which produce medical practitioners who became immortals.  According to my teachers, this state of being is defined as the “View,” and this was the essence communicated during my time in China.     

So, the definition of “Classical Medicine” in my own terms, as I learned it from Liu Ming and Dharma Bodhi, has nothing to do with books.  Rather, the term Classical refers to a period in which a certain “View” of reality was predominant.  This View, of course, produced the books, but the books are really besides the point.  To practice Classical Medicine, then, is to live in the state of being described by these view teachings.  The methods of medicine become an expression of that view.  The fruition of applying those methods to patients, and to yourself, affirms the view as a coherent expression of the nature of reality. 

The living embodied expression of view is what is transmitted through lineage.  So, although textbooks are, in a sense, dead, a lineage is something alive and unbroken.  The problem with modern CCM is that many people are, to no fault of their own, trying to revive this living expression through dead books without receiving the living view, the ritual initiations, and so on, and many are trying to do so intellectually, inferring and imputing their own views from and onto classical Chinese characters.  Most are doing so simply because the Communist reformation of China destroyed many of its traditions, and the books are all we have left. 

Furthermore, many are adding extraneous elements from other traditions to fill in the gaps that would have been provided by a teacher.  Hence, we get Chinese Medical practitioners using tuning forks, singing bowls, Tibetan mantras, and so on, while sticking crystals up their patients noses and praying to Mother Mary.  Not that there is anything wrong with that, per se, but it’s simply not Chinese (except in the sense of being syncretic).    

The three teachers I studied with in China each expressed a part of the View of Chinese Medicine that matches the Classical View I received from Liu Ming and Dharma Bodhi, as relating to three principals respectively, which I inferred—time, space, and light.  You will probably not find this definition in the textbooks; it comes from the Siddha traditions of India, and it is my way of organizing the transmission of essential knowledge on how to practice.

The first teacher, Dr. Su Xinghua, taught us a system of numerology applied to clinical practice that essentially boiled down to the aspect of medicine called Time.  In fact, he has been the first medical teacher to discuss the relationship of Time to healing in an honest and realistic way informed by Astrology.  Astrology has been altogether lost in modern TCM.  Many have academic knowledge of the subject, but I have yet to hear ANY teachings on Astrology in school aside from an academic description of symbols.  Symbols are interesting, but how do we use them?     

From what I learned, Astrology and Medicine are the same subject, approached from different perspectives.  Details aside, Dr. Su began the teaching by saying that people heal when it’s time for them to heal.  We can treat them and help alleviate symptoms, but in the end, healing is beyond our control.  It’s up to the cycles of Time, and any notion otherwise is arrogance.  The timeliness of illness and recovery, then, has two aspects, that of the calendar and that of one’s personal/natal astrology. 
  
While he admitted that Natal Astrology is useful, Dr. Su focused on the aspect of the calendar called, 節氣, Jiéqì, or “Qì Nodes,” the 24 Seasons of the Chinese Calendar, specifically on what Liu Ming called the “8 Gates,” the 4 Solstices/Equinoxes and the respective beginning of the Four Seasons, which fall between them.  These are powerful times for healing and meditation, transitions where the Qi of each Season is most accessible.    

Dr Su offered several stories describing unsuccessful treatments that turned around when the Qì of the Season became available.  In other words, human beings are not separate from nature; we are nature, even if we live in cities, stare at smart phones, and shop at Walmart.  We are Time, and on Earth, Time expresses through the flow of the seasons.  All this week, for example, as the leaves are beginning to change, I have been getting a dry, scratchy throat, a perfect expression of the dry, metal of Autumn.

If we factor in our Natal Astrology, which dictates personal cycles of Ancestral possession and resolution, then we get a much different image of medicine.  Medicine, from this perspective, cannot function without a practical knowledge of seasonal Qì, of the calendar.  We must know the difference between a winter pulse and a summer pulse.  We must know whether an illness, like my dry throat, is perfectly natural or not.  We must know when and under what conditions a person is likely to heal so that we do not over treat them.  We must also let go of the notion that we in fact “do” anything and let in the possibility that we are vessels for the expression of Time.

The second teacher, Dr. Li Xin, introduced a profound and yet deceptively simple view of diagnosis that essentially boiled down to the aspect of medicine called Space, or direction.  He introduced us to an idea called the 氣機, qìjí, or qì dynamic, which I have yet to hear about at school.  In short, every person, every herb, every acupuncture point, and so on, has a unique Qì dynamic, and medicine is nothing other than perceiving and working with these dynamics. 

Every dynamic in the universe expresses a combination of the Five Movements—Opening, Gathering, Ascending, Descending, and Stillness (or Harmonizing).  This is the profound simplicity of Chinese Medicine that Dr. Li Xin discussed.  We do not need to name every symptom and pathology.  We do not need to complicate diagnosis with endless details.  We need only to perceive the direction/dynamic of Qì, the qìjí in the patient, where and how it is functioning.  On what layer or level is the patient’s qìjí in action?  Where is someone stuck? 

Once we perceive this dynamic, we must have a clear idea about how we want to work with it through the qì dynamics of herbs and acupuncture.  Are we harmonizing and gathering in the middle burner?  Are we descending the qì of the upper burner?  Which herbs do this?  The simpler and more direct the treatment, the more powerful.  If we are moving qì in the right direction, then we are helping the patient.     

Dr. Li is renowned for his capacity to diagnose a patient simply by looking at them.  He showed me that Chinese Medicine can be very simple without losing its efficacy.  And, he affirmed to me that the practice comes from a state of being that perceives everything in terms of direction and movement, without names, without labels, and without pathologies.  In the sense, the practice becomes a non-conceptual dance of direction in space, what Taiji calls “push hands.”  Out of every teacher of Chinese Medicine I have thus far encountered, I most aspire to be and practice like Dr. Li Xin.   

The third teacher, Dr. Sylvie Martin, introduced us to a method of acupuncture practice that essentially boiled down to the aspect of medicine called Light.  Dr. Sylvie has practiced acupuncture for thirty years without ever using needles, with fantastic results, a feat few have accomplished.  How does she do this? 

While I’m somewhat sworn to secrecy, I will say that she does not “do” it.  Sylvie conveyed to me yet again that healers are vessels; we are not technicians.  If we use our will power, we will most certainly interfere, and while we may at times help, in the long run we will only have mixed results.  Healing in the truest sense of the word is not accomplished through skill. 

A doctor must be skilled, knowledgeable, and well trained, but the situation we are in is enormous.  The variables in every encounter are incalculable.  Time and Space are too big for anyone to understand, so we pray to a third factor that I am here calling “light.”  Sylvie told me that although this medicine is about Qì, she does not work with Qì.  She told me that she works with Mind/Awareness and lets the Qì take care of itself. 

The Nature of Awareness is luminosity, or “light.”  Our experience, our perception, is clear and aware, and we call the unity of aware-clarity luminosity.  The nature of our awareness is a naked knowing that illuminates our reality; it never changes, and it is un-conditioned.  This light manifests the appearance of a world in Space, through movement/direction, and in Time.  Everything is a symbol of light upon which we impute mental concepts. 

Dr. Sylvie told me that she believed illness to be a manifestation of conceptual Mind and healing to come directly from pure awareness.  She works directly with source as light, without will, beyond concepts of good/bad, healthy/sick.  She told me that we can open to something beyond everything, and that that beyond will work through us, so long as we do not interfere with our will.  The practice of medicine from this perspective becomes the direct perception of Essence, where our nature and that of the patient remains self-perfected, untouched by illness.  If we can touch this and offer it to patients, it can help with everything from a stomach ache to cancer, and that help will always be what the person needs and receives from Essence, and we don’t get to decide what that looks like.

Coming full circle, returning to Portland and to the study of Classical Chinese Medicine, I have a renewed faith in my decision to become a “doctor.”  The pilgrimage opened a light in me, connecting me to what I believe to be CCM’s original expression, a state of being connected to Time, Space, and Light, which I believe is the heart of Daoist practice.  The power of Chinese Medicine lies in its simplicity, in the direct perception of movement, Qì, with a heart of humility.  
 
While I may sound critical of CCM, because at times it gets lost in a strange obsession with textbooks, I do believe it to be overwhelmingly good.  I hope that others connect to this direct expression of healing practice, and like me learn to relax the academic compulsions toward pathology.