Pastoral Psychology

, Volume 61, Issue 5, pp 959–974

Spirituality in Traditional Chinese Medicine

Authors

    • Beijing Normal University
  • Chenguang Zhang
    • Southwest Minzu University
Article

DOI: 10.1007/s11089-012-0480-x

Cite this article as:
Shi, L. & Zhang, C. Pastoral Psychol (2012) 61: 959. doi:10.1007/s11089-012-0480-x

Abstract

In today’s world, Western medicine has a dominant place in most people’s lives, and that is true in contemporary China. However, many Chinese people also seek healing from Chinese medicine. Although it is an old method of medical treatment, Chinese medicine still maintains its vitality. Some Chinese people tend to believe that some illnesses can only be cured by Chinese medicine. How has Chinese medicine maintained its vitality for thousands of years? The reason may lie in its roots, roots full of spiritual nourishment. In this article, we propose that traditional Chinese medicine (TCM) is a medicine that takes care not only of persons with illness; it is concerned about people as a whole. In the theory of TCM, the mind and the body of a person are inseparable; to have good health one must have good spirit and pay attention to cultivating one’s spirit. TCM is a field that is profoundly influenced by traditional Chinese philosophy and religion. In many TCM classic writings, we can find religious concepts and practices. This article examines six aspects of TCM: the history of TCM; fundamental beliefs of TCM; spirituality in traditional Chinese healing rituals; spirituality in the traditional Chinese pharmacy; spirituality in health maintenance theories; and the spirituality of master doctors of TCM.

Keywords

Traditional Chinese medicineSpiritualityPsychologyZhu You technique

In a classic Chinese book Garden ofAnecdotes, there is a story about the great doctor in ancient times whose name is Miao Fu. The story tells us that when Miao Fu was treating his patients, he used to sit on the Jian grass and use livestock grass as an offering; he faced north and prayed just ten sentences, then the patients who came with the help of others, or were carried in, all recovered. (Liu 2009a, p. 95)

In the history of Western psychoanalysis, similar stories exist. Many patients, lying on stretchers or supported by complex devices, were taken to the French doctor Jean-Martin Charcot. Charcot asked them to get rid of any supporting equipment and to start walking. For instance, Charcot asked a young woman who had been paralyzed for years to stand up and walk. To the surprise of her father and the director of the convent where she had once stayed, the woman stood up and walked. Another young woman with both legs paralyzed was also taken to Charcot. Charcot didn’t find any injury to her body. Before the end of her session, the woman stood up and walked to the door. The driver who was waiting for her took off his hat in surprise while making the sign of the cross on his chest (Bankart 2006, p. 23).

Although the French doctor Charcot, who in his time was called the “Napoleon in psychoanalysis” (Bankart 2006, p. 5), and Miao Fu, the ancient master of traditional Chinese medicine (TCM), used different methods in dealing with patients, the “magical effects” of their treatments are surprisingly the same. Unfortunately, the TCM represented by Miao Fu and the technique of hypnosis represented by Charcot have shared a similar fate; in the history of scientific development both practitioners were accused of being “swindlers” or of practicing “witchcraft.”

Given the highly developed medical techniques of today, rational scholars reading these anecdotes from earlier times may feel the stories are talking about something as unreal as magic. However, it may be this mysterious quality that makes Chinese medicine different from Western medicine. Chinese medicine is a discipline with a long history, and it is influenced very much by religion and spirituality.

Definitions of religion and spirituality vary among scholars. Usually religion is defined as the organizational structures, practices, and beliefs of a religious group and spirituality is defined as the experiential and personal side of people’s relationship to the transcendent or sacred (Nelson 2007, pp. 24–25). Sometimes religion and spirituality are used interchangeably, since both are related to belief in and relationship with the transcendent or sacred. In this article we will examine the influences of both religion and spirituality on TCM.

The history of scientific development has gone through a period of skepticism characterized by attempts to remove anything that is dubious or unscientific. However, many scholars have begun to pay attention to the “illusory” metaphysics of TCM (e.g., Lin and Zheng 2007, p. 7). The research findings in the field have not only astonished people, but have also let scholars know that while we are making great efforts to develop modern science and technology, we are ignoring and losing too many “treasures”—treasures that are very closely related to national welfare and people’s livelihoods. Chinese scholars in different fields have appealed to us to let go of our arrogance and, with deep reverence, find wisdom in the old languages and rituals of our ancestors. In modern times, seeking wisdom from our ancestors may be imperative.

Medicine in many countries seems to have originated in shamanism. However, in the journey out of the “forest of witchcraft,” the medicine of the East may have walked one step slower than West. This is especially true with TCM. To date, modern science has not been able to explain the mechanism or the effects of TCM. The popular healing methods in folk culture, such as “talking about diseases” (a method used by certain folk medical practitioners who can talk away illnesses) and “number therapy” (a therapy based on the Eight Diagrams, which represent eight elements of nature), have resulted in more confusion, since these therapies seems to have magical healing effects and the theories are not understandable by common people.

Although science is so advanced in today’s world, Chinese medicine still maintains its vitality, like a new branch bursting out of an old tree. Why is this so? The reason may lie in the ancient roots of Chinese medicine, roots full of spiritual nourishment. In this article, we will see that TCM is a medicine imbued with spirituality in many respects.

History of TCM

Why is the water so clear in the dyke,

For the fresh water comes from the springhead.

From the above poem by Chinese scholar Zhu Xi, written about ten centuries ago, we can see the academic custom of the ancient Chinese—everything has an historical origin. Therefore, before we analyze TCM, we need to have a systematic look at its history.

TCM originated in the pre-Qin period, yet its theoretical system didn’t come into existence until around the time of the Warring States Period (476 to 221 B.C.E.), Qin and Han dynasties. The entire theoretical system of TCM was established through thousands of years of medical practice, reflection, and literature collection under the guidance and influence of traditional Chinese philosophy and culture.

The birth and development of the theoretical system of TCM has everything to do with a classic book, Zhouyi (The Book of Changes). Zhouyi, written during the early Western Zhou Dynasty, mainly documents the practice of divination. The classic book of Chinese medicine, The MedicalClassic ofthe YellowEmperor, which was completed in the Han Dynasty, was a comprehensive compilation of TCM theories after its separation from witchcraft. However, owing to Yizhuan, a book in the Warring States Period that expounded on Zhouyi, people realized that Zhouyi was more philosophy than divination. The concepts in Zhouyi, such as Ying Yang, Ji (extremes), Tao, Shen (spirit), Shu (technique), and others, had a profound influence on the content of The MedicalClassic ofthe YellowEmperor.

The MedicalClassic ofthe YellowEmperor drew upon previous achievements in astronomy, calendar systems, meteorology, mathematics, biology, geography, and other fields and, under the guidance of the monism of Qi and the theories of Ying Yang and Five Elements, it summarized the medical achievements and treatments in the Spring and Autumn Periods and the Warring States Period. The book established the principles of TCM and systematically expounded on many subjects, including physiology, pathology, Jingluo (energy channels), anatomy, diagnosis, treatment, and preventive medicine. It established a unique theoretical system that constituted the theoretical foundation and source of TCM. Therefore, the writing of The MedicalClassic ofthe YellowEmperor signifies the establishment of the theoretical system of TCM.

In the history of its development, TCM has gone through three stages as a medicine of shamans, a medicine of Tao, and a medicine of techniques.

Medicine of shamans

It is indisputable that the early form of human medicine in China was shamanism. In the pre-Qin period (before 1644 C.E.), shamans played the role of doctors, so in the historical literature, cases often occur where shamans are mentioned together with the treatment of illness; some commentators even use the term “medicine” to explain the work of shamans. In ancient Chinese characters, the word “doctor” was written in a way that combined the character for “patient” and the character for “healer,” so the relationship between medicine and shamans is clearly seen.

After the Warring States Period, and with the emergence of medical doctors, medicine and pharmaceutics started to become a profession. The hegemony in the medical field enjoyed by shamans was being greatly challenged. For example, Bian Que, a famous doctor of the Warring States Period, claimed that there are six kinds of people that he could not treat, one of which included the people “who believe shamans but not doctors”. In the late period of the East Han Dynasty, along with the development of Taoism and the importation of Buddhism, Taoist priests and monks also joined in the medical field. In the period of “hundreds of ideological schools,” all kinds of medical treatments were purged and TCM was upgraded and refined.

Medicine of Tao

According to the study of Chinese characters, which gives multiple meanings to one character, we can understand the medicine of Tao in two ways, as a Taoist medicine and as a medicine with emphasizes Taoism. To a certain extent, TCM grew out of the medicine of Tao, so in China there is a saying that “medicine and Taoism are the same” (Wang 1996, p. 10). We can glean some evidence from the early classics of TCM about the influence of Taoism on TCM.

The MedicalClassic ofthe YellowEmperor contains many discussions of “immortals” and the “virtuous man” that were later collected in the Taoist classic, Collected TaoistScriptures. In the book Shen Nong’sHerb Classic, which is as famous as The MedicalClassic ofthe YellowEmperor, it is mentioned that the “the high class pills” enabled one to be immortal. In this book, one can find writings related to immortality in many places. Therefore, one can see that both classics take Taoist thinking as their basic medical philosophy, because they considered immortality and virtuosity as the highest pursuits of a person.

Confucianism, Buddhism, and Taoism have all played a significant role in every sector of traditional Chinese culture, especially the medical realm. For instance, during the Jin and Yuan dynasties, the Hejian and Yishui schools and the four great doctors during this time who were influenced by the neo-Confucianism that had prevailed since the Southern Song Dynasty started the reform of the medicine of Taoism. They did so by introducing neo-Confucianism. For example, Li Dongyuan described “going beyond the medicine targeted five organs, and applying four Qi to diagnosis and soul treatment.” Apart from this, TCM was also affected by Buddhism, Mahayana Buddhism in particular, as it is said in Ben CaoJing Shu that people get ill because they have devalued life, abused fortunes and living beings, engaged in despicable undertakings, cruelly tormented the innocent, or committed other harmful actions. Such discourse on pathogens obviously reflected the Buddhist perspective on karma. Meanwhile, TCM also introduced praying with incantations, fasting, and other treatments with characteristics of Mahayana Buddhism (Tong 2003).

The idea of “preferring Tao to technology,” embraced by Chinese Confucianism, Buddhism, and Taoism, has consistently dominated the development of TCM. As an early “science” of naïve materialism, TCM could have conducted actual research on human bodies, but instead it pursued the metaphysical Tao, with its followers exploring diagnosis, prescription, and treatment under the guidance of the subtle Tao in their hearts. From its birth to the late Qing Dynasty, for over two thousand years, TCM never paid attention to the field of anatomy. This clearly demonstrates that TCM is a medicine that laid great emphasis on Tao.

Medicine of techniques

A medicine of techniques is the opposite of a medicine of Taoism. The beginning of the medicine of techniques started with an emphasis on anatomy. Tang’s work Five Kinds of Medical Books (1892), which combined East and West medical knowledge at the end of the Qing dynasty, and Zhang Xichun’s work Emphasis onTCM andLearning Fromthe West (2006) can be seen as the beginning of the period of a medicine of techniques. At the end of the nineteenth century and the beginning of the twentith century, Western churches started to build medical schools in China to train people in Western medical practices on a massive scale. At this stage, the field of TCM became Westernized. The focus of treatment deviated from Taoism to the pursuit of technology, even to the abandonment of Taoism and the worship of technology. This trend has continued into modernity.

As we have stated, TCM grew out of shamanism and religious medicine. It is influenced very much by religion and spirituality. For various reasons, in the process of breaking away from shamanism and religion, TCM did not do this as thoroughly as Western medicine did. So, TCM still has imprints of shamanism and religion at different levels. In the following sections, we will discuss spirituality in TCM in terms of its cognitive style, basic beliefs, treatment rituals, pharmacy, and spiritual concerns in its regimen.

Fundamental beliefs in TCM

The dominant thinking of TCM practitioners in various dynasties exhibits the strong flavor of shamanism and religion, which can be classified as the cognitive style of making analogies between objects, observing the outside of a person to find the inside, and observing the inside of a person.

Analogy between objects

Analogy between objects is a cognitive style that assumes two objects with similarity in certain respects may have something in common in other aspects as well. So, TCM practitioners deduced the characteristics of the objects being studied by looking at an already known similar object (Meng and Cui 2008). This kind of cognitive style comes from the exaggeration of similarity among physical objects by ancient peoples. It is a unique thinking style in ancient China, which can be seen in various fields of traditional culture.

For instance, in the Chinese pharmacy, it is believed that the fruit known as dates are good for blood since the two have a similar color. From a modern perspective, this is an exaggeration of the similarity between dates and blood, expanding the similarity in color of the two objects to other functions. Other examples of making an analogy between objects include beliefs that eating walnuts is good for one’s brain and that eating beans is good for one’s kidneys, since the two objects in each pair are similar in shape.

Essentially, the cognitive style using the method of analogy comes from the “telepathy” often mentioned in shamanism and religion, namely, that physical objects have an influence and produce results through telepathy because they have similarities in appearances (such as color, shape, or flavor). Obviously, this is an unscientific, illogical, and mythic style of thinking.

Observing the outside to discover the inside

Observing the outside to find the inside is a style of cognition that allows one to speculate about the conditions and changes inside a person by observing their outside appearance. In traditional Chinese culture, this kind of cognition, as well as sayings like “The falling of one leaf heralds the coming of autumn,” belongs to a holographic theory, since it reflects the thinking that the whole is composed of different parts and each part has the whole in it. The cognitive style of observing outside to find inside is widely used in TCM diagnosis through methods such as assessing the pulse, ears, tongues, and lines on one’s palm. Obviously, these methods helped TCM develop quickly in ancient times when other diagnostic technologies were not yet available. At the same time, the methods helped develop occupations with the flavor of religion and shamanism, such as the occupations of palmistry and facial observation.

As discussed above, thousands of years of the practice of the “medicine of Taoism” has kept TCM’s theories about internal organs separate from anatomy and modern assessment approaches. Thus, all of its theories are based on the practice of “observing outside to find inside.” Such mysteries, yet to be explained by the scientific research method, are readily associated with certain practices in Taoism, Buddhism, or Qigong, and in retrospect they can be seen to reflect spiritual practices such as mindfulness training.

Observing inside

In Li Shizhen’s work A Studyon theEight Extra-Channels (2007), he claimed that “The inside channels can only be observed by those who have practiced the method of observing inside” (yinqiao channel). From this claim, one can feel the strong influences of religion and shamanism, since observing inside is a common practice of Buddhism.

Spirituality in the theory of TCM

Yin Yang and Five Elements theory originated with The Bookof History, which was the theoretical and logical basis of TCM. For example, in TCM the five organs of humans are believed to correspond to the five elements, and the relationships between the five organs are determined correspondingly. Also, by applying the theory of Yin Yang to concepts such as “outside and inside” and “cold and hot,” the analysis and differentiation of pathological conditions in accordance with the eight principles (the principles using the concept of “outside and inside” and others to analyze and classify illnesses) in TCM were developed. Other concepts such as “three Yin and three Yang,” “left rise and right down,” and the “theory of Qi” all had religious origins (He 1994, p. 31).

The role of Yin Yang and Five Elements theory in traditional Chinese culture is as important as mathematics in Western sciences. It is also very important in Taoism. Various related professions developed from Taoism, such as divination, anthroposcopy, geomancy, and blessing, and they were all based upon this theory. Now, let’s take a closer look at these theories and the influence of religion on them.

Qi monism

The view of life in Taoism, which is derived from Lao Zi’s concept of life, explicitly puts forward the idea that “life originates from Tao” and “Tao gives birth to One; One gives birth to two things, three things, up to ten thousand” (Kai 2010, p. 53). Lao Zi believed that all the creatures in the universe are derived from Tao. Tao, which is “the mother of the universe,” creates “One” in the movement which is Qi in the chaos; and “One” produces Yin and Yang—the two opposing principles in nature—Yang, light and clear, goes up to be the Heaven; Yin, heavy and turbid, falls down to be the Earth. Yin and Yang, together with Heaven and Earth, interact with each other and then produce “Three,” which refers to “harmony.” All things in the universe came into being in this “harmony,” so Lao Zi says that “Three creates all the creatures.” He believes that “Tao is great; Heaven is great; Earth is great; and the sage is also great. Man takes his law from the Earth; the Earth takes its law from Heaven; Heaven takes its law from Tao” (Kai 2010, p. 35).

From the view that Qi is the origin of the universe and the element of all the creatures, TCM holds that Qi is also the origin of life and the basic element that constitutes life. Thus, according to the The YellowEmperor's Classicof Medicine, “Life is from the earth and depends on heaven. When heaven and earth combine, Qi is produced, and it is man” (Liu 2009b, p. 64). “At the beginning of mankind, Qi generates man. Between heaven and earth, there is the human being. Starting from Qi, humans get their shapes later. Parents give birth to children and have the offspring” (Chen and Ji 2010, p. 22). The human body is an organic body constantly undergoing the movement of rising and declining, coming in and out. A person’s illness and death are due to Qi. So we have the comment: “Man’s life and death depends on Qi. Gather Qi together to be life. Strengthen Qi to be healthy. Weaken Qi to be weak. Deplete Qi to be dead” (Huang 2008, p. 20). “Man’s life is just Qi. Qi generates the characteristics, the heart in the inner body and the appearance on the outside. Qi fills the body and becomes the vital part of the heart” (Zhang 2010a, b, p. 2). Man’s body and spirit are the result of Qi, so “The shape of a man depends on Qi. When Qi gathers, the shape exists, when Qi is depleted, the shape disappears” (Xue and Yang 2000, p. 18), which means that a person’s body is made of Qi, and his or her mental activity is also a kind of Qi movement. So, “appearance is the home of life, Qi is the basis for life, and spirit is the controller of life. Appearance is filled with Qi and illness is due to the exhaustion of Qi. Spirit depends on Qi and exists because of Qi” (Yang 2011, p. 1). “The five internal organs produce five Qi, to generate happiness, anger, sadness, worry, and fear” (Liu 2009b, p. 145).

Theory of Yin and Yang

Yin and Yang theory, based on Qi monism, holds that “Yin and Yang are Heaven and Earth. They are the discipline of all the things, parents of change, and beginning of life and death” (Liu 2009b, p. 19). The yin and yang nature of specific things is not absolute but relative.

In Chinese medicine, Qi can be divided into Yin and Yang according to its characteristics: Yang plays a role in promoting the warmth of the human body and Yin has the function of nourishing the human body. “The human body is nothing but yin and yang” (The YellowEmperor’s Classicof Medicine, p. 64). In Chinese medicine, Yin and Yang theory is applied to analyze the contradiction between health and disease and to aid in maintaining the proper balance between yin and yang in the human body. When yin and yang are balanced in a person’s body, as well as between the body and the environment, then the person can be healthy.

Theory of five elements

According to the Five Elements theory, all the things in the universe are made of five elements—gold, wood, water, fire, and earth. All change and development in nature results from the constant motion and interaction of these five elements. The order of all things is subject to the law of the inner restriction relationship between the five elements, maintaining a harmonious balance in the mutually promoted and restricted movement.

Chinese medicine applied the theory of the five elements in the medical field, observing the body in terms of its structure and explaining the organic connections between parts and the body and also the link between the whole body and the external environment. In Chinese medicine, Qi has the nature of yin and yang, and Qi has five elements, so the five elements also contain the nature of yin and yang. The five elements have the nature of promotion and restriction, and the rule is as follows: wood restricts earth, earth promotes gold, and gold restricts wood; and fire restricts gold, gold promotes water, and water restricts fire; and earth restricts water, water promotes wood, and water restricts earth; and gold restricts wood, wood promotes fire, and fire restricts gold; and water restricts fire, fire promotes earth, and earth restricts water. Table 1 lists the relationship of promotion and restriction of the five elements. The table shows that restriction does not occur only at the level of organs, but also at the psychological level (i.e., the five emotions in the table). The YellowEmperor’s Classicof Medicine states that the “five internal organs of humans are divided into five Qi to generate five emotions—happiness, anger, sadness, worry and fear” (p. 145).
Table 1

Relationship between the five elements in TMC

Five elements

Five internal organs

Five emotions

Restriction between five elements

Fire

Heart

Happiness

Fear wins over happiness

Wood

Liver

Anger

Sadness wins over anger

Earth

Spleen

Sadness

Anger wins over happiness

Gold

Lung

Worry

Happiness wins over sadness

Water

Kidney

Fear

Sadness wins over happiness

Summary

The basic theory of Chinese medicine reflects an overall constantly dynamic and dialectical way of thinking. In the whole universe, all things mutually reinforce and neutralize each other, which is a kind of continuous process. The same source of all the creatures is Qi, which is divided into two natures as Yin and Yang to achieve balance in the interaction process. The promotion and generation of all the creatures will become the five elements, and the promotion and restriction of the five elements have the nature of yin and yang, so all creatures are composed of the five elements. A human body, divided into the five elements and born from the five elements, can be seen as one part of all the creatures in the universe.

Spirituality in traditional Chinese healing rituals

Zhu You, a technique using words and rituals to cure diseases, began in ancient times and has continued to be used up to the present. From the existing old scriptures, the word Zhu You first appeared in The YellowEmperor’s Classicof Medicine, in the chapter “Su Wen—Theory of Transferring Energy to Breath,” where it says: “I heard of that in ancient times, a method of transferring energy to breath was used to cure the patients, which was just Zhu You” (p. 35).

Looking into the scriptures of the ancient pre-Qin Dynasty, we can easily find evidence of Zhu You technique. For example: “Mr. Zhou prayed for King Wu’s illness, and then he recovered,” in the book Shang Shu (Hong 2008, p. 3); in the Analects ofConfucius (chapter Shu Er), it is written, “Confucius was ill, and Zilu (his student) prayed for him,” and Confucius added, “He had prayed for a long time”! Obviously, Zhu You technique was very prevalent in the ancient pre-Qin days. In the most ancient medical formulary, Prescriptions forFifty-two Diseases, unearthed in Mawangdui in Changsha province, as many as 30 methods of Zhu You treatments were described, including treatments for 13 diseases that accounted for a large proportion of known illnesses.

The Zhu You technique was relatively prevalent during the Han Dynasty. There is a story that Emperor Wu of the Han Dynasty was greatly pleased and proclaimed a general amnesty because a shaman cured his disease with Zhu You. This was described in the book Xiao WuBen JiFeng ShanShu, theSixth. We can see that the doctors at that time were very skilled at using the Zhu You technique and, to some extent, the appreciation of the Emperor prompted the development of the technique. By the Sui and Tang dynasties, Zhu You technique was prevalent in the folk culture and was gradually recognized by the authorities. According to the records in Sui ShuBai GuanZhi, there were two Zhu Jin doctors in the imperial medical department, and the Zhu Jin branch was specially selected. At that time, Zhu You was added to the national medical authority. With the appearance of the book Zhu YouThirteen Branches in the Song Dynasty, the Zhu You technique was promoted even more broadly. Some strictly medical books (like Ge ZhiYu Lun) in the Jin and Yuan dynasties also contained, more or less, the Zhu You technique. After the Ming Dynasty, the Zhu You technique was gradually used less in official medical departments, and eventually it was popular only in folk culture. As Zhang Jiebin, a great doctor in the Ming Dynasty, said in Lei Jing·LunZhi Lei·ZhuYou (2005), “Now massage and Zhu You failed to be inherited, and they only exist in folk culture” (ch. 12, part 16). In the late Qing Dynasty, the definition of Zhu You technique in the books of scholars was changed from medical skill to magic. Today there are still Zhu You doctors who flourish in some rural areas of China.

Zhu has the same meaning that shaman did in ancient times. Song Yu noted in The Odesof Chu, “Male shaman is Zhu,” and a note in Li Ji·ZengZi Wen stated, “Zhu, is the one who contacts gods.” The author of Shang Shu (p. 72) noted, “The person who speaks to gods is Zhu.” So, Zhu mainly refers to the communication with spirits and gods through language in worship activities. Therefore, we can conclude that Zhu is a kind of shaman as well as also another kind of religion. Actually, almost all the ethnicities had shamanic activities that communicated with and made requests of the gods in early culture. For example, in the Aibo SiCursive Paperof Egypt, from the 18th–20th centuries BC, a curse was one of the important means of curing diseases; the treatment was a systemic one that could cure chronic and difficult illnesses in different parts of human bodies (Gridney 1988).

The role of the Zhu, besides “speaking good words to please gods,” is also to invoke curses or “invite[e] ghosts and gods to add disasters on others.” In ancient China, the Zhu was connected to curses. In Shangshu·Wuyi, it said, “Curse Zhu, was to report to gods, to add disasters to enemies” (Hong 2008, p. 56). The concepts of Gu Du (a disease due to noxious agents) and Gu Huo (to bewitch) still exist among the ethnic minorities in the southwestern areas (such as the Miao nationality; there is even a saying that the great doctor Miao Fu is their ancestor). According to the book Shi Ben, “If the shaman curses trees, the trees will wither; if cursing birds, the birds will fall down” (Lin and Zheng 2007, ch. 1, part 2). In the eyes of the ancients, the shaman spoke in voices of spirits and gods through the Zhu Curse, which could reflect the will of ghosts and gods, and so he had much power. Therefore, the words of the Zhu could not only predict the good and bad aspects of the future, but could also get rid of disasters. The Zhu could make people “get possessed” or “get poisoned.” Zhu You in TCM treatments mainly plays the role of avoiding disasters.

You had two meanings. Wang Bing in the Tang Dynasty explained Zhu You as “Zhu can tell the cause of diseases, so needles are not needed.” This explanation was accepted by medical practitioners for many dynasties. For example, in the book Su WenAnnotation, Zhang Jiebin, a writer during the Ming Dynasty, noted “You is where diseases come from.” But Zhang Zhicong of the Qing Dynasty pointed out in Collected Annotationof SuWen, “You is yielding. Language can connect Zhu to gods, so the diseases can be cured” (Xu 2009, p. 1). These two views co-existed for a long time. We think the former is more reasonable because it clearly specifies the purpose of Zhu and the basis of curing diseases.

Ling Shu·Zei Feng, a chapter in The YellowEmperor’s Classicof Medicine, states: “The ancient shamans knew about various diseases, and firstly they knew what caused the diseases, that was just because they knew about Zhu” (p. 375). This, on the one hand, provides the basis for the idea that “You is the cause of diseases,” and on the other hand, it gives an explanation of why Zhu You can cure diseases from the perspective of the ancient people. In the thought of the ancient people, hundreds of diseases are caused by the influence of spirits and gods, and the ghosts and gods can defeat and restrict each other. Therefore, if we know where diseases come from (know which ghosts and gods cause the diseases), we will get to know which ghosts and gods can restrict and defeat the ones causing the diseases. So, if Zhu can defeat the ghosts and gods that cause the diseases, then the diseases are expected to be healed.

With improvement in the ability to understand the objective world and increased knowledge of human beings, the explanation based on the “ghosts and gods theory” in Zhu You disappeared gradually from the stage of history and doctors then gave a naturalistic explanation for their work. Just as Zhang Jiebin in the Ming Dynasty pointed out in Lei Jing, the role of the Zhu went from “tell the cause of diseases” to “find out the cause of diseases, and remove the ghosts in their minds” (Zhang 2005, p. 78). As to “ghosts in the mind,” the author of Guan Yinzi believes,”The one who conceals good or bad luck in the mind, the spiritual ghosts troubles him; the one who conceals man or woman things in the mind, lewd ghosts will trouble him; the one who conceals quiet worries in the mind, immersing ghosts will trouble him; the one who conceals immodesty in the mind, arrogant ghosts will trouble him; the one who conceals oath or curse in the mind, odd ghosts will trouble him; the one who conceals allurement in the mind, the material ghosts will trouble him.” “Ghosts in the mind” are not the ghosts and gods in the eyes of the ancients anymore; now they mean the false recognitions, improper moods, and bad living habits of patients themselves. These problems “all come from the mind, and . . . are not really caused by ghosts and gods” (He 1990, p. 125), which is why Chinese people often say “Diseases of the mind should only be cured by the mind itself.” Based on this naturalistic explanation, Zhu You technique is considered to be the origin of Chinese psychotherapy (He 1990, p. 125).

In general, the development of Zhu You technique has gone through two stages. In the first stage, it involved praying to spirits, since at that time people believed in supernatural forces. One definition of Zhu You given by one scholar is “using language by shamans; making use of the supernatural to console and persuade patients; therefore to drive out evil spirits and to heal disease and sickness” (Lu and Xiao 1987, p. 37). The second stage of Zhu You is the stage in which the Zhu determines the causes of illness. At this stage, treatment of illness is neither using herbs or acupuncture nor asking help from the supernatural, but changing the minds of patients and regulating Qi and blood that is in disorder, thereby deciding the causes of illness (Cai 1982, p. 72). Forms of Zhu You include deciding on the causes of illness and using incantation, prohibition, and Taoist talisman.

Since the time of the competition between shamans and medical doctors in the pre-Qin period, the Zhu You technique has developed from the first stage to the second stage. However, the change was slow and relapses happened from time to time. Even today, the Zhu You technique, which uses “praying to spirits,” still exists in some rural areas.

Examining the processes and methods of the Zhu You technique, we speculate that the reasons for the effectiveness of the Zhu You technique may include the following:
  1. 1.

    In the practice of Zhu You, both practitioners and patients are all, to a certain extent, in a condition of “keeping still and in deep meditation.” Therefore, Zhu You greatly increased the power of a focused mind, muscle relaxation, and the parapsychology of patients, and this improved the physical and mental condition of patients.

     
  2. 2.

    The language and behaviors of practitioners of Zhu You produced positive psychological effects for patients by helping them to release fear, stabilizing their emotions and giving them a sense of control and hope.

     
  3. 3.

    The whole process of Zhu You treatment has some effects similar to placebos; the deep trust in the “effects” by the patients may promote recovery from illness.

     
  4. 4.

    Some modes of Zhu You may allow patients to release negative emotions that had been accumulating for a long time.

     
  5. 5.

    Some methods of Zhu You are similar to hypnosis, inducing patients into conditions of mind that allow them to be changed.

     

Spirituality in the traditional Chinese pharmacy

In the important classic of TCM, Treatise onFebrile Diseases, one can find mention of medicinal materials related to shamanism, such as the “ashes of a burned female sanitary belt” or “water with bubbles rolling on the surface” (Tong 2003, p. 52). In other classics of TCM, strange medicinal materials exist as well, e.g., “dust at the end of a widow’s bed,” “dirt on the crossroad,” etc. From the perspective of modern chemistry, there may be no difference in the contents of these medicines, yet they had apparently different treatment effects in TCM. Even more interestingly, according to the classic book of TCM, Compendium ofMateria Medica, recorded medicinal materials related to dirt include more than 50 varieties, including dirt on the east wall, sun dirt, Taoist hot dirt, dirt underneath shoes, and dirt on top of a grave.

This kind of pharmacy had no scientific basis and was based on the thinking of shamanism that “everything has spirits,” which humanized the medicinal materials. Just as different life experiences result in humans having different personalities, physical objects retain different treatment effects as medicine because of their “experiences.” The humanizing of the medicinal materials is typically represented in the matching of materials in a prescription. In TCM, different materials have different roles and places in a prescription. Generally they can be classified into four categories: “monarchs,” “lieges,” “assistants,” and “envoys.” Obviously, in the eyes of traditional Chinese medical practitioners, medicinal materials were not just physical objects; they also possessed spirituality, which was considered to be possessed only by humans, the wisest of all creatures.

In the folk culture, some TCM doctors require the family of patients to boil the medicine first and then to pour the concentrated medicine onto a road intersection. In fact, this kind of behavior has the same meaning in shamanism as that of A WaKe Fan in the shamanism of the Uyghur nationality, which is that of expressing some “good” desires through symbols—in this case, a passerby will take away the dregs of the medicine on his or her shoes and thus take away the patient’s disease (Xia 1995, p. 92).

Spirituality in health maintenance theories

Dual cultivation of mind and body, led by cultivation of mind

Traditional Chinese medicine devoted particular care to the cultivation of health. The practices included cultivation of both mind and body. TCM integrated various ways of cultivating the mind drawn from Daoism, Confucianism, and Buddhism. These notions emphasized that cultivation of the mind is more important than that of the body and that reaching the goal of health and longevity must come through practices of nourishing the heart and the cultivation of personality.

Cultivation of shen (spirit)

In Chinese medicine, shen has three meanings. First, it refers to the functions and laws of the dynamic natural world. In The MedicalClassic ofthe YellowEmperor, it is written, “shen means that one cannot predict Yin and Yang” (ch. 66). Second, and more broadly, shen means the external manifestation of a person’s overall life activities, such as body image, complexion, expression in one’s eyes, language, questions and answers, and body postures—all are within the scope of shen. Third, shen means human spirit, mind, and thinking activities. This is the narrower meaning of shen.

The human body is the material base of shen, which is composed of jing (essence) and qi (air). Shen is born when the body is born. Shen is born, develops, and dies along with the life course of the individual. Shen gets birthed by natural jing and qi; it is born when the embryo is created. During the development of an individual, shen must grow on food and protein, as stated in The MedicalClassic ofthe YellowEmperor: “shen, spirits of water and rice” (p. 333). In Chinese medicine, all cognitive activities are reflections of physical activities of the human body. Practitioners believe that the heart controls the mind and that shen stays in the five organs of the human body. Shen is divided into five aspects and is affiliated with the five organs. “Shen stays in heart, po (soul) stays in lungs, hun (spirit) stays in liver, mind stays in the spleen, and zhi (will) stays in kidneys” (The MedicalClassic ofthe YellowEmperor, p. 62). Although cognitive activities belong to the five organs, they mainly are the physical functions of the heart. “Heart is the matter of the mind, where spirits come from” (The MedicalClassic ofthe YellowEmperor, p. 27).

In Qigong, a traditional Chinese health maintenance practice, there are three kinds of adjustments: of the heart, one’s breath, and the body. In the three adjustments, the most important thing is to adjust the heart. Here the “heart” is not the anatomical heart, but the “spiritual heart,” so to adjust the heart is to adjust the soul. The essence of adjusting the heart is to adjust Qi through adjusting thought. As Qi flows through the whole body, it connects mind and body into a closely integrated whole. This Qi connects with heaven and earth, so humanity and heaven unite into a whole. The purpose of adjusting the heart is to obtain peacefulness. In this state, disorder and cluttered thoughts become orderly activities. When one gets into a truly peaceful state, one’s mind has something to rely on; it becomes focused, not slack, so one can better adjust and control mind and body. TCM’s emphasis on adjusting Qi and practicing peaceful mind are well accepted by today’s psychology. Modern mindfulness techniques are based on this kind of thinking and practices.

Cultivation of “heart”

Buddhism originated in ancient India and later spread into China; the combination of medicine and Buddhism also spread from India into China. Some theories and techniques of Buddhist medicine were assimilated into Chinese medicine. In Buddhist medicine, illnesses are caused by the “four great discordants” (earth, water, fire, and wind) that can cause 404 kinds of illnesses. Illnesses are divided into two large categories in Buddhist medicine: physical and mental. Mental illnesses include greed, obsessions of the mind, terror, depression, hate, silly wishes, and many other distresses. The main concern of Buddhist medicine is the mental illness of people. According to Buddhism, evils are produced from the heart, and demons are made of people. All kinds of human misfortunes can be simplified into three worries: “greed, anger, and obsession,” which may cause “illnesses of evil.” Buddhism examines human existence from a holistic perspective of the integration of three elements: “root” (physical), “dust” (social), and “cognition” (mind). The three elements cannot be separated, and they influence each other. When people have something that worries them in their heart, it is not only an expression of the illness in the heart, or mental illness; it can also lead to physical maladjustment and physical illness. To cure mental illness, Buddhist medicine believes that “When the heart is clear, the blood is clean; when the blood is clean, the complexion is clean” (Wang 2008, p. 115). Buddhism promotes mysterious and mindful practices as methods of heart cultivation to obtain inner power and, in the end, to cure mental and physical diseases.

The theory of Buddhist medicine is similar to the theory that “emotion causes diseases” in Chinese medicine. In his book, Mr. Sun’sSong ofHealth, the famous doctor of the Tang Dynasty, Sun Simiao, translated his ideas of health into a poem. “If people want to know how to live a good life, one needs to have stable emotions and not be angry, with sincere heart and honest mind worries will be less, cultivate body with truth and distresses will be cut” (He 2007a, b, p. 18). Therefore, to maintain health one needs to abstain from desires and to prevent and cure illnesses through peacefulness and cultivation of mind and spirit.

Cultivation of Qi

In the period of MengZi (372–289 B.C.C.), one of the great Confucianists, Qi was a popular concept. In the books of MengZi, Zhuangzi, and “Guan Zi,” Qi is mentioned in many places. Zhuangzi says, “The birth of a human is the assembling of Qi. When Qi assembles it is birth, when Qi disassembles it is death . . . therefore, we say: throughout the whole universe it is one Qi” (Zhuangzi, ch. 22, Knowledge Travels North). Qi is mentioned in the book of “Guan Zi,” where it means vital essence: “With this essence, things give birth, it gives birth to grains in our world, and gives birth to stars in heaven. When Qi is traveling between heaven and earth, we call it spirits; when Qi is staying in one’s heart, we call the person a wise man” (Long 2002, p. 29). Of a person, it is stated: “When a person is born, heaven gives him vital essence, earth gives him a body, combining both it becomes a person” (Li 2009, p. 23) The approach to obtaining and keeping Qi is to have “correct” morals and a peaceful mind. Correct morals means “abstinence from five desires (desires from ears, eyes, mouth, nose, and heart); getting rid of two evils (delight and anger), thus one can be correct”; peacefulness means being peaceful at heart and having peaceful Qi, getting rid of distracting thoughts, “not disturbing the five sense organs by materials from ourside world, not disturbing the heart by the five sense organs” (Yue 2003, p.51).

Meng Zi believed: “Will, is the master of Qi; Qi, is the content of a body. Where the will goes, Qi will go with it” (Zhang 2010a, b, p. 66). Furthermore, he said, “I am good at distinguishing various sayings, I am good at cultivating my vital essence. . . . Qi, is the most great, most strong; if we cultivate it with righteousness and not hurt it, it will suffuse among heaven and earth. Qi has to be with righteousness and morality. Qi is produced by accumulation of righteousness, not obtained through occasional acts of morality. If acts are not from hearts, Qi will be dispirited”. Zhao Qi, a scholar of Confucian classics, when explaining the writings of Meng Zi, said, “Qi has to be with righteousness and morality, if not, it will be dispirited.” He comments, “Meng Zi says that if we cultivate righteousness and act with laws, then Qi can be filled in the five organs; if we do not do so, the stomach will be empty, like a person in hunger” (Huang 1990, p. 28). In his explanation, the vital essence talked about by Meng Zi is connected with Qi in the physical body.

When talking about cultivation of health, masters of Confucian classics in all dynasties mentioned the “vital essence” referred to by Meng Zi. In this regard, Xun Zi offered more explicit discussions. He said:

Whenever we use our emotions, wills, and thinking, they will be amiable and smooth if we follow moral codes and justice, if not, they will be dispirited and deranged. In our diet, clothing, living, acting and relaxing, they will be healthy and proper if we follow moral codes and justice, if not, we will be ill because we violated rules. . . . When there is cultivation of Qi and heart, no methods more direct and efficient than following moral codes and justice, and to have a good teacher; no methods are more magical than practicing good deeds with undivided attention. These are the methods of cultivation of Qi and heart. (Xun 2008, p.77–78).

Spirituality of master doctors of TCM

Doctors of TCM were similar to religious leaders; their life task was to help people escape from bitterness. Their life-long project was to pay attention to people’s life and illnesses. Their lifelong pursuit of the laws of the universe and of human life made some doctors become great scholars. Due to the characteristic of Taoist medicine which gave an emphasis to Tao, theories of TCM were not limited to the areas of physiology and medicine; its ultimate goal was to reach the metaphysical “Tao.” It is said that “medicine and The Bookof Changes are interrelated.” Based on studies of The Bookof Changes, medical practitioners could become great scholars and great statesmen, while great scholars and statesmen could become great doctors. That’s why there is a saying that “If one cannot be a good statesman, one can at least become a good doctor” (Wang and Li 1988, p. 28).

Doctors consider saving the world as the general goal of their life. They see “people,” not “diseases,” making “curing people” and “curing diseases” identical. Doctors may communicate with “diseases” in an unbending manner, but they cannot communicate with “people” in the same manner. So doctors should be equipped with ultimate concern about the whole life and health of human beings, which is called the spiritual concern of practicing medicine in order to help people.

The three main Chinese religions, Taoism, Confucianism, and Buddhism, have achieved different levels of keeping fit and cultivating health, but the starting point of all three religions is to learn how to be a human being. Some researchers put forward that:

to learn Tao is to learn how to be a person at first, to be a good person and to be a gentleman and a wise man. Try to behave properly, so they will not live and die like birds and beasts, and will not rot like grasses and trees, which is the first step of learning Tao, and then learn about immortality, learn about Buddhism and learn to be a saint. Learning about immortality, learning about Buddhism and learning to be a saint, these three have different names but with the same goals, and they have different expressions but with the same Tao. (Xiao 2010, p. 14)

Theories of keeping healthy in TCM have adopted various ideas from the representatives of Taoism, Confucianism, and Buddhism. Both health cultivation and character cultivation are the basic principles of keeping healthy in TCM. Health cultivation is the basis of character cultivation; in return, to promote health cultivation through character cultivation is a higher and more important level. The goal of health cultivation and character cultivation is to achieve a state of “completion,” “harmony between man and nature,” and “harmony between soul and body.”

Conclusion

For various reasons, in the process of breaking away from shamanism and religion, TCM did not break away as thoroughly as Western medicine did. So it still has imprints of shamanism and religion at different levels. This is why some people are vehemently against Chinese medicine. However, the influence of spirituality on Chinese medicine has a positive side, and it makes this field special. What we should get from TCM is its vitality gained from spirituality, that is, the concern for the heart, Qi, and Tao.

We can see from this article that TCM is not just a sophisticated “technique,” but rather contains a deep “Tao.” It is humanistic, but not limited to humans; it pursues harmony of human and universe from the broad perspective of the universe. Therefore, the subject it deals with is not mere illnesses, but people with illnesses. It pays attention to physical pains, and at the same time it is also concerned with spiritual suffering. Therefore, TCM can teach people to be indifferent towards having or not having, to exist with few desires and feel at ease, to keep the body healthy and the mind quiet, and to achieve harmony between the body and the mind and then to achieve harmony with the world and nature.

Good health and longevity are always what we pursue and are also significant and urgent problems. More and more people are concerned about the ways to prevent disease and strengthen their bodies, which is the emphasis of TCM. The ideas of harmony between man and nature, harmony between body and mind, and health cultivation and character cultivation are useful for building a good inner world and achieving the goals of good health and long life.

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© Springer Science+Business Media, LLC 2012