Preventing pasteurised qi
by Mattie Sempert
The Lantern: Volume II, Issue 3 - Article #13
Since reading “The tyranny of the microscope - the allure of certainty” in The Lantern1, I’ve been standing up straighter and with more confidence in my comfortable acupuncturist shoes. In my fourteen years of practice, the article’s canny and gutsy directness prodded me into realizing that I have been passively tolerating patronizing pats on the head as a practitioner in a field that lacks the ‘credibility’ of western medicine.
Well, not that passively tolerating. I’ve been quietly seething for years.
It also became clear that what was underlying my conflicted complacency is the accepted world-view in the West that we are conditioned to treat Science as a sort of deity. To question it is a form of heresy. Science will give us the facts, the answers; it will placate our fears, leading us out of the spooky dark unknown and into the light of certainty, of rational truth.
Few in our profession would contest that Chinese medicine (CM) is now on the global radar screen, particularly in technologically advanced, consumer-driven Western urban societies. And the pressure’s on for proof. Yet despite our busy clinics pouring out countless satisfied customers, the onus is on us to adapt to the dominant paradigm, ‘evidence-based’ medicine.
Our model, our foundation, is about complex dynamic systems that swirl around in a complete whole. We gather our information and construct our treatments based on subjective findings. We develop sharp astute senses: looking, palpating, smelling, listening and asking directed questions to formulate pattern identification and a treatment plan. Ungraspable, elusive qi drives the system and keeps it glued together. When I needle, I carefully find the right spot to make the point come alive, to contact qi. My mind’s intent is inseparable from that action. In a Chinese herbal formula, it’s the synergy between the herbs that provides the mechanism for change. As one of my teachers’ put it early on in my acupuncture schooling: “it’s about the multiplicity of phenomena occurring simultaneously.”
To ignore the nature of qi, of vitalism, is to deny the nature of traditional Oriental medicine. What Yoshio Manaka called “the hidden implicate order” or what Georg Groddeck (a little known contemporary of Freud) called “The It.” We are more than the sum of our part. We come from a rich, ancient tradition steeped in mystery and paradox, something the Western mind finds difficult to grasp. To hone in on a particular aspect, that reductionistic knee-jerk reaction, loses sight of the whole. It fragments and is gone.
Recently I attended a public lecture at the University of Melbourne’s medical school, entitled “The Convergence of Eastern (read Chinese) and Western Medicine” (2) Professor Yean L Lim, director of Cardio-Vascular Therapeutics at nearby Western General Hospital, delivered the lecture.
Prof Lim’s assertion is that CM (specifically herbal medicine) and WM are on the cusp of “fusing” into a single medicine, an occurrence he predicts will take place soon in the 21st century. “For a given realm of knowledge or practice, there comes a point when the differences in different cultures converge and the knowledge of the two cultures would coalesce. The point one overtakes the other is termed Trans-current Point and the point when the differences completely vanished is called the Fusion Point.”
To lay the groundwork to support such a vision, he started with comparative histories of both medicines, marking the rise of modern, scientific medicine in 17th century Europe, which eventually led to “the current modern era of molecular biology and genomics.” CM on the other hand, “remained stagnant in its concepts until Traditional Chinese Medicine (TCM) was declared a medical legacy of the motherland by the Chinese Government in 1954 and paralleled development of Western and Chinese practices was encouraged.” For the complete convergence to take place, “a more scientific, molecular approach to CM is needed.”
Still preoccupied with that “point when one overtakes the other,” my full attention returned when he provided a definition for qi (Ted Kaptchuk’s: “Matter on the verge of becoming energy, or energy at the point of materializing”) as well as a dizzying overview of qi dynamics. But I flinched when he make the quantum leap from “the still medieval” practices of CM to the need for “DNA fingerprinting herbs” and “bio-assay directed fractionation and structural chemistry to determine bioactive ingredients to determine the mechanisms of action of the active ingredients.” According to Prof Lim, “if the fusion of the two approaches occurs under the strict scrutiny of mainstream science, a brave new world in medicine could be discovered.”
I looked around the mostly full lecture hall (ironically many of whom were of Asian backgrounds, presumably medical students), and wondered if my fellow attendees were lured into Prof Lim’s polemics, his apparently progressive vision of a new generation of medicine.
What about qi? What about that elusive space in-between where healing takes place and is impossible to measure?
A distinction is very important here. Prof Lim failed to make clear that he is referring to Modern Chinese medicine, which had its birth during the Maoist regime. That’s a nano-second in historic terms. China is now undergoing staggering changes: a burgeoning middle class, demographic shift (from rural to urban areas), an economic boom that’s led by China becoming a major world player, just to name a few. To continue the boom, Prof Lim pointed out that “the Chinese Government, owner of the majority of Chinese herbal remedies has realized the potential of its vast and rich herbal resources and promised to fund Traditional Chinese research to a level of 1.5 billion Yuan (.25 billion Australian dollars) over the next 5 years.”
Is it too alarmist of me to claim that the canary in the coal-mine has gone quiet? Does conforming to an evidence-based scientific approach to understanding and explaining what we do risk breeding out tradition, as though it is a weak gene that needs to be gotten rid of? How to measure intention? Is it possible to develop a research method (double-blinded placebo controlled) that can hold infinite variables that are constantly shifting and changing? How to figure in a sigh, a dull stare, rigid posturing, a burnt smell, a gummy texture above a knotted muscle?
Are we not in a period when it is crucial to claim our well-earned place (clinical results speak volumes) and space (we have a very old, time-tested tradition) in the medical community, and not kow-tow to the demands for a more “scientific approach”? To be a valued and respected participant in the global village, CM and WM need to come to understand and appreciate the particular perspective of the other. Yes, the pressure is on us to adapt if we want to exist alongside WM. But I do think that we have more to say than we think as to how we adapt. This is not easy, especially with the looming presence of corporate health management models, and third party payers who are increasingly demanding clinical outcome measures from us to justify payment for our work.
Our models are drastically different, like the proverbial square peg in the round hole. For vitalism to stay alive and well, for qi to continue to flourish and not get pasteurized out, a fit just cannot be forced into the Western medical paradigm. Our medicine could go sour.
I believe that in order to prevent this from happening one thing we need to do is stand more firmly planted and with steady confidence beside our traditional principles and continue to use the strict scrutiny of our own methods.
We have a lot to offer the health care needs of our respective communities. Our credibility is reflected through our busy clinics, in the steady flow of word-of-mouth referrals; it is found in the patient who shrugs off their physician’s “there’s no evidence to support………” parting comment and come to our clinics anyway. And most especially, our credibility is expressed through those who recover their vitalism, oftentimes long lost, along with the increased ability to move with change and live more comfortably, and hopefully more enjoyably, in the uncertain flux of living.
1. The Lantern, Volume 1, Number 2, May 2004 (page 2-3)
2. March 22, 2005
Sunderland Lecture Theatre, Faculty of Medicine, University of Melbourne
To view Professor Lim’s presentation and notes, go to www.mdhs.unimelb.edu.au and click of the Dean’s Lecture Series
Mattie Sempert is a graduate of The New England School of Acupuncture (Boston). Her evolving treatment style is drawn mostly from palpation-based Japanese approaches. She practices in Melbourne.
