Introduction
Modern medical science is based on the premise that the human being is separate from nature and can be viewed as a machine. A machine can exhaustively be broken down into its component parts and their respective functions; similarly, the dominant approach to clinical research and treatment assumes the human body can be broken down and analyzed in terms of its component parts and their respective functions. The modern physician, in this paradigm, is like a mechanic. Eastern medical philosophy is based on the premise that the human being is a microcosm of the universe and inseparable from nature. From this perspective, the human being is like a garden, which must be cultivated and is a part of its environment. The Eastern medicine practitioner, then, is like a gardener. The purpose of this article is to explore the metaphor of the human being as a machine and as a garden as well as the modern physician as a mechanic and the Eastern medicine practitioner as a gardener.
The Machine and The Mechanic
In the seventeenth century, René Descartes ushered in the scientific revolution in the West. He introduced analytic, reductive reasoning as the basis of a new philosophy of science, which also became the philosophy of modern medicine. Within this paradigm, natural phenomena and human beings are simply machines governed by mechanical laws (Figure 1). When people are viewed as machines, physicians take on the role of mechanics. The mechanic evaluates the machine in terms of its working and non-working parts, fixing or replacing the non-functioning parts and putting the machine back into working order. [1] Similarly, the modern physician evaluates each part of the human machine separately and fixes or replaces the non-functioning elements. When a patient is evaluated and treated in such a manner, the result is that the patient often “leaves the office medicated, frequently overmedicated, sometimes with completely unnecessary surgical procedures scheduled.” [2] While such interventions may be medically necessary in certain serious or life-threatening cases, more often than not, more conservative treatment options are appropriate. Furthermore, a patient’s state of health is evaluated for functionality; so long as the body is functioning properly and no serious symptoms are exhibited, the patient is considered to be healthy. Allopathic diagnosis is centered around the identification of disease based on physical examination, laboratory findings, and imaging studies. While these methods are extremely powerful for diagnosing and monitoring diseases, they do very little to prevent them. Patients are considered to be in good health so long as they do not present with any significant symptoms and their vital signs and laboratory findings are within the normal ranges. However, once a condition has progressed to the point where it can be detected by these tests, prevention is already out of the picture (for more information, see our article “Preventive Medicine – The True Power of Eastern Medicine").
Figure 1. The human machine. [1]
The Garden and the Gardener
When a gardener evaluates the health of a garden, he or she will examine the symbiosis among the various plants growing in the garden and how the plants interact with their environment. If a garden is showing abnormal signs (e.g., malformation, discoloration, etc.), the gardener will consider the soil quality, the water supply, the weather, the light distribution, the existence of pests, the plant spacing, and other environmental factors and then make the appropriate adjustments. Similarly, an Eastern medicine practitioner will evaluate the health of a patient by assessing the state of balance of each Internal Organ*, the functional relationships among the Internal Organs, and a person’s state of health within the context of his or her environment. In Eastern medicine, the human being’s internal environment is subject to the same forces and relationships observed in nature (as seen in the Yin Yang and Five Elements theories), and one’s state of health is also dependent upon one’s interactions with one’s ecosystem (i.e., interpersonal relationships, environmental factors, etc.) (Figure 2).
* Note that the Internal Organs in traditional Chinese medicine (TCM) differ from the conventional understanding of internal organs; the Internal Organs each represent a complex of functions and physiological processes. For example, the Kidneys in TCM may include the functions of the kidneys, adrenal glands, and other organs, as well as a multitude of physiological processes that are involved in water regulation, genetics, bone health, etc. In this article, I will differentiate the TCM Internal Organs from conventional organs by capitalizing the TCM Internal Organs.
Figure 2. The human garden. [1]
Eastern medicine is based on a system of balance. When a system is balanced, it is considered to be in a state of health; when a system is unbalanced, it is considered to be in a state of disorder. In TCM, diseases and disorders are categorized according to the Eight Principles and the Internal Organs. The Eight Principles consist of four pairs of opposing categories: Yin/Yang, excess/deficiency, hot/cold, and interior/exterior. The Internal Organs consist of five Yin Organs – Lung, Spleen, Heart, Kidney, and Liver – and six Yang Organs – Large Intestine, Stomach, Small Intestine, Bladder, Triple Burner (三焦, San Jiao), and Gall Bladder. Patients are assessed using the diagnostic methods of inquiring, inspection, auscultation, olfaction, and palpation. Based on the patterns of symptoms observed, TCM practitioners determine the nature of the disorder and which Internal Organs and/or meridians are affected. To determine the root cause of the disorder, a wide variety of factors are considered, including lifestyle (e.g., diet, exercise, sleep habits, etc.), emotional state, interpersonal relationships, pathogenic factors, and environmental factors (e.g., weather, climate, seasons, etc.).
This approach contrasts with modern medicine. For example, a patient who presents with fatigue, indigestion, constipation, loose stools, insomnia, breathlessness, irritability, reduced immune function, coughing, and an aversion to wind may not be considered ill by modern medicine. For this patient, a modern physician would conduct a physical exam and order a series of laboratory tests (e.g., complete blood count, broad thyroid panel, etc.), and, so long as these tests are within normal ranges, the patient may simply be advised to rest and leave the doctor’s office with a handful of prescriptions, one to treat each symptom. In contrast, a TCM practitioner would evaluate the entire pattern of symptoms and determine the patterns of imbalance, which in this case would likely be Spleen and Lung-Qi deficiency, Liver-Qi stagnation, Heart-Fire, and Wind-Cold invading the Lungs. The TCM practitioner would then assess the aforementioned factors in order to determine the root cause of these patterns. Perhaps upon inquiry, this patient was found to have had a particularly stressful December, managing a large project at work and then coordinating family activities during the holidays; stress may be the root cause of the patterns of imbalance, even though the primary symptoms are not directly associated with stress. According to the Five Elements and Internal Organ theories, stress causes the Liver (Wood) to enter a state of excess, which causes the Heart (Fire) to enter a state of excess, resulting in insomnia. The Liver overacts on the Spleen (Earth), which causes it to become deficient, resulting in indigestion and fatigue. The Spleen is unable to nourish the Lungs (Metal), so it also becomes deficient, resulting in breathlessness and a compromised immune system. Because the symptoms began in December, the cold weather also exacerbates this condition. The Heart overacts on and the Liver insults the Lungs, which further compromises the immune system. The Heart insults the Kidneys (Water), affecting water regulation and accelerating the process of aging. The Kidneys insult the Spleen, inhibiting water absorption (for more information on the Five Elements theory, see our article “The Five Elements”). For patients suffering from such a pattern of symptoms, the TCM practitioner would, using a variety of treatment modalities (e.g., acupuncture, manual therapy, herbal medicine, lifestyle modifications, etc.), address the root cause, which, in this case, is stress, while also tonifying the deficient Organs and reducing the excess Organs. Simply treating the symptoms individually will lead to nowhere as long as the patterns of imbalance remain. Just as a gardener ensures that a garden is in a state of harmony within itself and with its environment, the TCM practitioner ensures that a patient is properly balanced internally and is living in accordance with his or her environment; as such, the TCM practitioner’s role is to cultivate health.
A Gardener to Our Own Gardens
Unlike modern medicine, which places the burden of a patient’s health primarily on the physician, TCM emphasizes the role of the patient in his or her own health. In fact, TCM practitioners view themselves as the “second doctor,” secondary to the patient and his or her body. This means that the role of the TCM practitioner is to support and enhance the natural healing abilities of the body through the various treatment modalities and to guide the patient in developing healthful lifestyle habits that are specifically suited to each patient. Therefore, TCM necessitates patients be proactive in their own healthcare. While the specific adjustments that should be made differ with each person, several principles apply universally – balance, harmony, and awareness.
Balance
Balance in life is guided by the overarching philosophy of Yin and Yang, as represented by the famous Taiji symbol (太极图) (Figure 3). Yin and Yang represent the duality and relativity of existence. All natural phenomena have an equal and opposite counterpart: light-dark; hot-cold; good-evil. Additionally, each natural phenomena exists relative to all other natural phenomena; for example, a campfire is hot and, therefore, Yang relative to ice; however, relative to the sun, a campfire is cooler and, therefore, Yin. For more information on the Yin Yang theory, see our article “What is Qi? – A Scientifically-Minded Acupuncturist’s Perspective.” This principle has many applications in daily life. An example of the Yin Yang duality in the human body is the sympathetic and parasympathetic nervous systems. If a person overstimulates the sympathetic nervous system (e.g., overwork, overexcitement, overplay) and does not allow the body to “rest and digest,” then Yang will over-consume Yin, and imbalance will arise. Likewise, if a person does not adequately exercise his or her body and mind, then Yin will over-consume Yang, and imbalance will also arise. This example also highlights the principle of moderation. Work, excitement, play, and rest are not inherently bad; in fact, they are all normal and healthy in moderation. However, in excess, they can be damaging to the body and mind. The relativity aspect of Yin and Yang is also applicable to daily life. For example, in making dietary decisions, a person who has a mild deficiency of Yang, manifesting as symptoms such as cold sensations, fatigue, etc., may want to consume foods that are warm in nature and can tonify Qi and Yang, such as lean red meats and fresh ginger. However, a person who has an excess of Yin, manifesting as symptoms such as chills, runny nose, cough, etc., may want to consume foods that are hot in nature and can expel Wind and Cold, such as cinnamon and garlic. Conducting your life guided by the principles encoded within the Yin Yang theory will lead to balance within your body and mind.
Figure 3. The Taiji symbol represents the opposing, interdependent, mutually-consuming, and intertransforming relationship between Yin and Yang.
Harmony
While achieving a state of balance internally is critically important, it simply is not possible without living in harmony with our external environment, as we do not exist in isolation. We must conduct our lives in accordance with our individual ecosystems. This means that we must adapt our lifestyles to environmental factors, such as climate, geography, seasonal changes, and local produce, and cultivate harmonious interpersonal relationships. The climate and geography of where you live will greatly dictate your lifestyle. For example, those living in a hot, humid climate may need to consume more foods that clear Heat and resolve Dampness (e.g., cucumber, Chinese yam), whereas those living in a cold, dry climate may need to consume more warming and moisturizing foods (e.g., fresh ginger, pears). Also, those living at sea-level may need to do more cardiovascular exercise than those living at higher elevations in order to develop the same level of cardiovascular efficiency. Seasonal changes also greatly affect lifestyle. For example, during the summer, you may need to eat more cooling foods (e.g., cucumber, mint), whereas during the winter, you may need to eat more warming foods (e.g., lean red meat, ginger). Also, it is important to consume foods that are in season. While supermarkets have made most foods available year-round, for many reasons, you should primarily consume locally-grown produce that are in season. First, foods that are not in season are not as nutrient-dense as foods that are in season. This is evident in the fact that produce that are in season are much more flavorful than those that are out of season. Second, foods that are not in season where you live (even if they are in season where they are produced) are often out of balance with the seasonal climate. For example, watermelons, which are cold in nature, grown in Central America during the winter likely are not appropriate for someone living in the Pacific Northwest. Third, because our bodies have adapted to the environment in which we were raised, we are able to better digest locally-grown produce. In the same vein, our ancestral environment also influences our dietary needs. For example, those with a southern-Asian (i.e., southern China, southern India, Southeast Asia, etc.) heritage may be better adapted to consume rice than wheat, whereas those with a northern-Asian heritage may be better adapted to consume wheat than rice. Similarly, those with a European heritage may be better adapted to consume dairy products than those with an Asian heritage are.
Living in harmony with our individual ecosystems also means cultivating healthy and harmonious relationships with those around us. However, before we can cultivate our interpersonal relationships, we must first cultivate ourselves. Only when we are healthy, happy, and emotionally centered do we have the foundation to build beneficial relationships with others. This can be done by regulating our lifestyles and engaging in activities that cultivate both the body and mind, such as Zhan Zhuang (for more information on Zhan Zhuang, see our article “The Rise Approach to Health”). Once you have become physically and mentally grounded, interpersonal relationships will naturally become harmonious.
Awareness
To be in control of your own health requires that you be ever-aware of your current state of health. You must learn to listen to your body. Pay attention to the signs and symptoms that your body displays, no matter how insignificant they may seem, and respond accordingly. For example, if you are feeling fatigued, rest more and evaluate your diet and lifestyle for any imbalances; if you are feeling stressed, practice meditative exercises and identify and eliminate the source of your stress. In the West, people tend not to seek medical intervention until serious symptoms arise. When you are unsure about your current state of health and/or are having trouble identifying the patterns of imbalance, it is important to seek evaluation from both modern and Eastern medicine.
The Bottom Line
Both the modern physician, as a mechanic, and the Eastern medicine practitioner, as a gardener, play an important role in healthcare. The mechanic fixes or replaces the non-functioning elements in the body when they are beyond the point of recovery by natural means. The gardener cultivates the body and mind in order to minimize the chance of reaching that point. However, they are both secondary to the “first doctors,” ourselves. We must all be proactive in our own healthcare, the gardeners to our own gardens. This can be achieved by living in balance within our bodies and minds and with our external environments. That being said, this is easier said than done. If you could use some help cultivating your garden, we may be of service. At Rise, we are committed to providing our patients and clients with a holistic and effective approach to healing, as well as the knowledge to proactively prevent illness and injury. We work tirelessly to ensure that our patients and clients receive the care, tools, and knowledge to restore balance to their lives. We take pride in going above and beyond for those who choose us as their healthcare and wellness providers. As a result, we are ideally suited to help you identify and correct any patterns of imbalance as well as establish and implement healthful lifestyle habits that are tailored to you. Please contact us to request an appointment.
References
[1] Beinfield, H., & Korngold, E. (1991). Between heaven and earth: A guide to Chinese medicine. New York: Ballantine Books.
[2] LeShan, Lawrence L. (1982). The mechanic and the gardener: Making the most of the holistic revolution in medicine. New York: Henry Holt & Co.