RICHARD BERTSCHINGER ESSENTIAL TEXTS in Chinese Medicine The Single Idea in the Mind of the Yellow Emperor FOREWORD BY ALLEN PARROTT LONDON AND PHILADELPHIA First published in 2015 by Singing Dragon an imprint of Jessica Kingsley Publishers 73 Collier Street London N1 9BE, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www. singingdragon. com Copyright © Richard Bertschinger 2015 Foreword copyright © Allen Parrott 2015 Library of Congress Cataloging in Publication Data Bertschinger, Richard, author. Essential texts in Chinese medicine : the single idea in the mind of the Yellow Emperor / Richard Bertschinger. p. ; cm. Translation of and commentary on the Nei jing zhi yao of Ming doctor and scholar Li Zhongzi, alongside the original Chinese, with a number of additional texts from the Huang di nei jing. Includes bibliographical references. ISBN 978-1-84819-162-4 (alk. paper) I. Li, Zhongzi, 1588-1655. Nei jing zhi yao. II. Li, Zhongzi, 1588-1655. Nei jing zhi yao. English III. Huangdi nei jing. Selections. IV. Huangdi nei jing. English Selections. V. Title. [DNLM: 1. Huangdi nei jing. 2. Medicine, Chinese Traditional--history. 3. Medicine, Chinese Traditional--methods. 4. Manuscripts, Medical--history. WZ 294] R127. 1 610. 951--dc23 2014021760 British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 978 1 84819 162 4 eISBN 978 0 85701 135 0 Printed and bound in Great Britain At the stillpoint of the turning world… Gia-fu Feng The Tao gave birth to One, One gives birth to two, Two gives birth to three, Three gives birth to the ten thousand things. The ten thousand things all bear Yin on their backs And embrace the Yang, Infused with a single breath they form an easy harmony. Laozi, Chapter 42 CONTENTS Foreword by Allen Parrott. . . . . . . . . . . . . . . . . . 11 A NOTE ON THE TEXT . . . . . . . . . . . . . . . . . . . . . . . . 13 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . 15 1. The History of the Yellow Emperor’s Medical Classic. . . . . . 16 2. Philosophical Roots in the Neijing . . . . . . . . . . . . . . 17 3. Yinyang and Wuxing. . . . . . . . . . . . . . . . . . . . . 23 4. Li Zhongzi, His Compilation and the Quietly Enquiring Mind 31 5. A World Refracted through Chinese Language. . . . . . . . . 38 6. Claude Levi-Strauss and the Untamed Mind . . . . . . . . . 42 7. A Logic of Tangible Qualities. . . . . . . . . . . . . . . . . 45 8. Conclusion: A Divide in Medical Thinking. . . . . . . . . . 49 Characters in the Introduction . . . . . . . . . . . . . . . . . 51 I The Arts and Ways of a Good Life . . . . . . . . . . 52 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 1. The Yellow Emperor Questions his Counsellor. . . . . . . . . 54 2. A Message from the Ancients . . . . . . . . . . . . . . . . . 56 3. They Represented the Arts and Ways of Life . . . . . . . . . . 58 4. The Rhythm of the Seasons . . . . . . . . . . . . . . . . . . 62 5. The Energy of the Yang Stored up. . . . . . . . . . . . . . . 67 6. The Practice of Advancing the Yang. . . . . . . . . . . . . . 70 7. Taoist Yoga . . . . . . . . . . . . . . . . . . . . . . . . . 73 8. The Sages Treated those Well, not those Sick . . . . . . . . . . 75 9. The Character of the Malign Xie or Thief-Wind. . . . . . . . 76 Questions for Review of Chapter I. . . . . . . . . . . . . . . . 78 Characters in Chapter I. . . . . . . . . . . . . . . . . . . . . 79 II Yin and Yang . . . . . . . . . . . . . . . . . . . . . 80 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 1. Yin and Yang, the Way of the Skies and Earth. . . . . . . . . 81 2. Yin and Yang, Water, Fire, Qi and Flavours . . . . . . . . . 85 3. Left and Right as different as North and South . . . . . . . . 92 4. Yin and Yang in the Skies and Man . . . . . . . . . . . . . 94 5. The Crucial Importance of the Yang Needing Rest. . . . . . . 97 Questions for Review of Chapter II . . . . . . . . . . . . . . . 99 Characters in Chapter II . . . . . . . . . . . . . . . . . . . . 100 III Examining the Colour . . . . . . . . . . . . . . . . 101 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 1. Purity, Brightness, Colour and Complexion. . . . . . . . . . 102 2. The Bright-lit Hall, the Physiognomy of Face . . . . . . . . . 105 3. The Basis of Health in the Face. . . . . . . . . . . . . . . . 114 Questions for Review of Chapter III. . . . . . . . . . . . . . . 117 Characters in Chapter III. . . . . . . . . . . . . . . . . . . . 117 IV The Quiet Pulse . . . . . . . . . . . . . . . . . . . 118 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 1. The Method of the Pulse Exam . . . . . . . . . . . . . . . . 120 2. If a Single Pulse Stands Out . . . . . . . . . . . . . . . . . 124 3. The Primacy of the Pulse . . . . . . . . . . . . . . . . . . . 125 4. In Attending to the Pulse. . . . . . . . . . . . . . . . . . . 126 5. In Spring, the Pulse is in the Liver . . . . . . . . . . . . . . 128 6. The Healthy, Sick and Fatal Pulses . . . . . . . . . . . . . . 133 7. The Arrival of the Fatal Pulse . . . . . . . . . . . . . . . . 138 8. The Ultimate Tool . . . . . . . . . . . . . . . . . . . . . . 143 9. A Common Fault in the Pulse Exam . . . . . . . . . . . . . 145 Questions for Review of Chapter IV. . . . . . . . . . . . . . . 146 Characters in Chapter IV. . . . . . . . . . . . . . . . . . . . 147 V The Zangfu and Wuxing . . . . . . . . . . . . . . . 148 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 1. The Offices of the Zangfu. . . . . . . . . . . . . . . . . . . 150 2. The Zang and their Associations . . . . . . . . . . . . . . . 153 3. Directions and Elemental Associations . . . . . . . . . . . . 156 4. Further Elemental Forms and Wuxing Science . . . . . . . . 159 5. The Faculties of the Self, and their Injuries . . . . . . . . . . 167 6. Physical Functions in Life and Death. . . . . . . . . . . . . 170 Questions for Review of Chapter V . . . . . . . . . . . . . . . 173 Characters in Chapter V . . . . . . . . . . . . . . . . . . . . 174 VI Channels and Collaterals . . . . . . . . . . . . . . . 175 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 1. The Form and Length of the Channels . . . . . . . . . . . . 176 Question for Review of Chapter VI . . . . . . . . . . . . . . . 189 Characters in Chapter VI. . . . . . . . . . . . . . . . . . . . 189 VII Patterns of Treatment. . . . . . . . . . . . . . . . . 190 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 1. Yin and Yang, the Rule and Pattern . . . . . . . . . . . . . 192 2. The Seed in Sickness . . . . . . . . . . . . . . . . . . . . . 194 3. Mind, Body and Disease. . . . . . . . . . . . . . . . . . . 196 4. Regional Types, Regional Medicines. . . . . . . . . . . . . . 198 5. Treatment with Herbals, Foodstuffs and Flavours . . . . . . . 202 6. How Foodstuffs and Medicines can do Harm . . . . . . . . . 208 7. Therapeutic Actions, How to Treat . . . . . . . . . . . . . . 209 8. Five Faults Made during Treatment . . . . . . . . . . . . . 212 9. The Ultimate Task. . . . . . . . . . . . . . . . . . . . . . 215 Questions for Review of Chapter VII . . . . . . . . . . . . . . 217 Characters in Chapter VII . . . . . . . . . . . . . . . . . . . 217 VIII The Method of Needling . . . . . . . . . . . . . . . 219 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 1. Origins of Five Element Acupuncture. . . . . . . . . . . . . 221 2. Opening Chapter of the Lingshu . . . . . . . . . . . . . . . 226 3. The Method . . . . . . . . . . . . . . . . . . . . . . . . . 231 4. Acupuncture: Treatment by Sun, Moon and Planets. . . . . . 233 5. He Who Observes the Minutest of Changes . . . . . . . . . . 236 6. Acupuncture: Technique, Reducing and Reinforcing. . . . . . 238 7. Acupuncture: What is Meant by the Spirit . . . . . . . . . . 241 8. Four Common Failings in Treatment. . . . . . . . . . . . . 243 Questions for Review of Chapter VIII . . . . . . . . . . . . . . 245 Characters in Chapter VIII . . . . . . . . . . . . . . . . . . . 245 IX Pathology. . . . . . . . . . . . . . . . . . . . . . . 246 Key Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 246 1. A Typology of Conditions. . . . . . . . . . . . . . . . . . . 248 2. Elemental, Seasonal and Dietary Injuries. . . . . . . . . . . 251 3. Elemental Forms and Body Isomorphism . . . . . . . . . . . 254 4. A Complete Explanation of the Full or Weak . . . . . . . . . 259 5. Cold and Heat, Yin and Yang, Inner and Outer . . . . . . . 262 6. The Five Full, the Five Weak. . . . . . . . . . . . . . . . . 265 7. On the Temperament. . . . . . . . . . . . . . . . . . . . . 267 8. How Heat Represents in the Face. . . . . . . . . . . . . . . 270 9. On the Progression of Fevers . . . . . . . . . . . . . . . . . 272 10. On Various Kinds of Pain. . . . . . . . . . . . . . . . . . 275 11. On Bi Immobility Syndromes. . . . . . . . . . . . . . . . 279 12. On Dreaming 1 . . . . . . . . . . . . . . . . . . . . . . 282 13. On Dreaming 2 . . . . . . . . . . . . . . . . . . . . . . 284 14. Times of Dying: Channel Collapse . . . . . . . . . . . . . 288 15. Times of Dying: Seasonal Collapse. . . . . . . . . . . . . . 292 16. The Collapse of the Channels . . . . . . . . . . . . . . . . 294 Questions for Review of Chapter IX . . . . . . . . . . . . . . . 296 Characters in Chapter IX. . . . . . . . . . . . . . . . . . . . 297 APPENDIX A: CLINICAL COSMOLOGY . . . . . . . . . . . . . . . 298 APPENDIX B: XUE SHENGBAI’S DISCOVERY OF LI ZHONGZI’S WORK. . . . . . . . . . . . . . . . . . . . . . . . . 303 SELECT BIBLIOGRAPHY AND SOURCES. . . . . . . . . . . . . . . 307 NOTES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 List of Tables Fundamental Chinese Virtues in Medicine . . . . . . . . . . 21 Correspondences with Nature. . . . . . . . . . . . . . . . . 25 Human Body Correspondences . . . . . . . . . . . . . . . . 26 Elemental Yijing Trigrams . . . . . . . . . . . . . . . . . . . 27 Eulogy on Humankind . . . . . . . . . . . . . . . . . . . . 61 Rhythm of Life . . . . . . . . . . . . . . . . . . . . . . . . 66 The Yinyang . . . . . . . . . . . . . . . . . . . . . . . . . . 84 A Vigorous Fire, a Lesser Fire . . . . . . . . . . . . . . . . . 91 Yinyang in the Heavens . . . . . . . . . . . . . . . . . . . . 95 Yinyang in the Human Body . . . . . . . . . . . . . . . . . 96 Flowering of the Qi . . . . . . . . . . . . . . . . . . . . . . 104 Physiognomy of Face . . . . . . . . . . . . . . . . . . . . . 113 Fatality in the Face and Eyes. . . . . . . . . . . . . . . . . . 116 The Pulse . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 The Seasonal Pulse. . . . . . . . . . . . . . . . . . . . . . . 132 Ministries of the Zangfu. . . . . . . . . . . . . . . . . . . . 152 Traditional Correspondences of the Zangfu . . . . . . . . . . 155 Pentatonic Tone, Element and Aspect . . . . . . . . . . . . . 165 Five Directions with Traditional Associations . . . . . . . . . 166 The Yin and Yang . . . . . . . . . . . . . . . . . . . . . . . 193 Propriety of the Cure . . . . . . . . . . . . . . . . . . . . . 197 Treatments Tailored to Locality and Background . . . . . . . 201 Herbal Actions Must Accord . . . . . . . . . . . . . . . . . 206 Acting in Accord with the Condition . . . . . . . . . . . . . 207 The Resonance of Sky and Earth . . . . . . . . . . . . . . . 235 A Simple Pathology . . . . . . . . . . . . . . . . . . . . . . 250 Five Elemental Forms of People . . . . . . . . . . . . . . . . 258 Qi Strata. . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 Weakness Results in Dreaming . . . . . . . . . . . . . . . . 283 Fullness Results in Dreaming . . . . . . . . . . . . . . . . . 287 The Reversing Qi Results in Dreaming . . . . . . . . . . . . 287 Foreword Richard Bertschinger’s work on these important Chinese texts deserves to become an ‘essential text’ for medicine in the 21st century. His book has achieved a rare three-way combination: scholarly for academics, accessible for students, and relevant to practitioners. The entire acupuncture community will be grateful for his labours. But I also believe his mention of Mencius and Confucian thought has lessons for a very different readership. It is more than two millennia since Hippocrates urged doctors to consider the person as a whole, but this wisdom seems to have been lost in modern medicine – or at least temporarily mislaid. Parts of this book should be required reading for the entire body of Western practitioners, because it re-states key human values and consequent approaches to medical practice that are genuinely ‘complementary’ and beneficial to scientific biomedicine. Through personal experience, I have long believed that traditional acupuncture has much that can actually enhance and improve Western medical practice. Richard Bertschinger’s book illustrates conclusively that it has much more to offer than treatment for pain and muscular-skeletal conditions. It articulates some of the ancient wisdom on medical ethics, patient care and practitioner development – ‘rightness in action’ Mencius called it – still needed by healthcare professionals in the 21st century, and which could usefully be the basis of much continuing professional development. The book also provides practitioners with a very useful set of deep metaphors, taken from nature, society, and life as it is lived. It does not start with the human body as a kind of machine or complex set of mechanisms, chemical elements or physical 11 12 Essential Texts in Chinese Medicine forces only properly ‘known’ in the ivory tower of the scientific laboratory. It offers a better approach, therefore, to the messy, real life of medicine where mind and body are inseparable and when the machine metaphor breaks down and fails to deliver. ‘Rightness in action’, indeed. Now that China is set to overtake the USA as the world’s largest economic power, is it so strange to take a lesson from their traditions? Richard Bertschinger’s book would be a good place for Western doctors to start this serious learning process. Allen Parrott Formerly, Lead Accreditation Officer, British Acupuncture Accreditation Board A NOTE ON THE TEXT A differing world-view, a different sensibility in medicine; that is what is presented in these texts. Yet when I first read Li Zhongzi’s Cornerstone to the Neijing (1642) in the summer of 1986, I felt no difference between us, no difficulty in understanding what he was saying. It was as if I had found a friend at my elbow, a trusted guide and mentor by my side. For publication I have abridged his work slightly, notably in the pathology section (Chapter IX), to keep it relevant and accessible to modern practitioners. I have also added a little to the choice of texts; some on acupuncture, on the spirit in needling and diagnosis, on place, and on Five Element typology. I have also leaned heavily on modern Chinese editions of the Huangdi Neijing, as well on the Japanese commentaries of the Tamba family (see Select Bibliography and Sources), and the exacting inspiration of Gia-fu Feng (1919–1985). The enticing animal designs that accompany each translation come from a silk- embroidered altar-cloth found in a Warring States (c. 300 bce) tomb from Hubei Province, contemporary with the Huangdi Neijing. I have also gained support from many, to whom my grateful thanks: Derek Woodward, Professor Man Fong Mei (Benny Mai), Alan Hext, Sara Hicks, Professor Elisabeth Hsu, Dr Tim Gordon, Dr Allen Parrott, Dr Jidong Wu, Russell Chapman, Jane Robinson, Lesley Jenkins, Dr Barry Nicholls, Trish Robinson, Paul Hougham, Dr Charlotte Paterson – none of whom, of course, should be held responsible for my faults and errors, which are entirely of my own making. 13