Maintaining a balance between Yin and Yang within the macrocosm and microcosm is the key to a person’s health according to Chinese traditional understanding. This article will examine the traditional Chinese understanding of health in comparison with Hindu thought.
Oriental people have always been holistically minded in terms of what is health. Often people mistaken health as the absence of diseases. Not so according to Oriental tradition that sees person as a combination of body, mind and spirit. Any off-balance of this integral unity, a person will feel sick, therefore, a person must maintain a harmonious relationship within himself and his surroundings. The concept of the harmony and unity of Yin and Yang reflects this understanding.
2. Integrative medicine
Integrative medicine seeks to integrate the whole person, including the person’s physical symptoms, social environment, and inner state of being, into the process of diagnosing and treating illness. This unique approach has often been associated with complementary and alternative medicine. If health is to be understood as “a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity” , , this approach should be introduced into all healthcare. Health is about the complete person and not just the condition of the body. Therefore integrative medicine urges caregivers to pay attention not only to physical problems, but also to the psychological wellbeing and social factors that may have caused or contributed to a person’s illness.
This emphasis on a holistic approach has always been the focus of Asian traditional medicine, and it has gradually gained acceptance in the Western developed world. For instance, George Engel’s medical paradigm has upheld biopsychosocial factors in health. The number of hospitals in the United States that offer complementary and alternative therapies has more than doubled in the last 10 years. A person should be seen as a whole person rather than being dichotomized and fragmented into body and soul, or physical and mental. The medicine that heals should be integrative and holistic.
Holism or being holistic is defined as “A philosophical theory according to which a fundamental feature of nature is the existence of wholes which are more than the composite assembly of the parts and which always tend to become more highly developed and complex” . A holistic concept involves all possible human components, how they interact, and how they fit into total existence. The medicine that treats should therefore treat the whole person and not only the physical condition. A Taiwanese saying that “an inferior physician treats symptoms, the average physician treats illness, and the superior physician heals the whole person” reflects the nature of this integrative medicine.
3. Why a person becomes sick from Asian perspectives
Traditionally, Asians, such as Chinese or Hindu individuals, believe that people are sick because their inner and outer forces are out of balance. According to the Chinese approach, the purpose of medicine is to restore the balance of Yin and Yang within a body. The Hindu approach will strive to restore the harmony among the mind, body, and spirit systems. The ancient Chinese believed that all things are composed of the two integrating forces of Yin and Yang. If the balance between these two is broken, disease will occur. “Yin and Yang and the four seasons are the beginning and end of all things, the root of life and death. To go against them is injurious to life, to go with them prevents serious diseases from arising”. Hinduism’s Ayurveda depicts the mind, body, and spirit as a tripod supporting the world structure. Seeking a balance within this tripod and between an individual and the rest of the world is the key to a healthy and good life.
Although Chinese and Hindu individuals use different expressions to describe the basic structure of the universe, they both pinpoint the importance of balance of the external and internal forces of the microcosm within the macrocosm. Their medicine systems are undoubtedly integrative, in that they see a person and illness from a holistic perspective.
4. Preservation of health in Chinese traditional medicine
According to Chinese traditional medicine, to maintain good health, one has to enhance physical fitness in order to prevent diseases, postpone aging, and prolong life. To achieve these, one must follow a healthy living style, spiritual toning, and other methods in order to keep all factors in life in balance. In normal circumstances, a harmonious balance between all the elements is maintained. When Yin is calm and Yang is sound, the spirit is smooth. Any disruption of the physiological or physio-environmental balance is the starting point of all diseases, e.g., lack of restraint in daily life, dietary irregularities, mental or physical overexertion, and sexual intemperance. Three key concepts are important in maintaining the balance of living and harmony of life, namely, Yin–Yang, Five Elements and chi (qi).
4.1. Yin and Yang
The Chinese believe that all things in the world can be divided into Yin and Yang, which rise and fall by restricting each other to achieve a dynamic balance. If this balance is damaged, disease will be produced.
The totally balanced system of life has equal amounts of Yin and Yang, and neither could exist in isolation. For instance, there is always some Yin in Yang, and some Yang in Yin. Balance is maintained by mutual antagonism, yet there is also mutual dependence. For example, for life to exist, it needs a balance of sunlight and darkness. If there were perpetual sunlight or perpetual darkness, life on the planet could not be sustained. In the same way, Yin or Yang cannot exist in isolation. They need each other and they change into each other. The circle is complete, without beginning, middle, or end.
Interdependence is the notion that Yin and Yang are mutually indispensable and emerging. Yin exists by virtue of Yang, and Yang exists by virtue of Yin. In medicine, the concept of interdependence of Yin and Yang is widely used in physiology, pathology, and treatment. Blood and chi, two fundamental elements of the body, provide an example here: blood is Yin, and chi is Yang. Blood formation relies on the power of chi to move and transform: chi moves the blood as the blood circulation relies on the warming and driving power of chi.
Another example is seen in the development of diseases. What is detrimental to Yin affects Yang, and vice versa. Without Yang, Yin cannot be born. What is termed high blood pressure is the result of hyperactivity of Yang caused by a lack of Yin. In therapy, if a disease is caused by the heat pathogen, it is treated with cool or cold agents according to the principle that cold can counteract heat. Similarly, disorders caused by cold pathogens are treated with warm or hot agents since heat can overcome cold. This mutual generating and counterbalancing theory can be seen in the concept of the Five Elements.
4.2. The Five Elements
Similar to the theory of Yin and Yang, the Five Elements, namely, wood, fire, earth, metal and water, are ancient Chinese philosophical concepts used to explain the composition and phenomena of the physical universe. In traditional Chinese medicine, the theory of the Five Elements is used to interpret the relationship between the physiology and pathology of the human body and the natural environment. According to the theory, the Five Elements are in constant movement and change. The interdependence and mutual restraint of the Five Elements explain the complex connection between material objects as well as the unity between the human body and the natural world.
These Five Elements generate and counterbalance each other. For example, wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and water promotes wood. By the same token, wood is conquered by fire, fire by water, water by earth, earth by metal. In this mutually promoting and conquering relationship, the world moves on. If there is no promoting, there is no birth and growth. If there is no restraining, there is no change and development to maintain normal harmonious relations. Thus, the movement and change of all things exist through their mutual promoting and restraining relationships.
These Five Elements also represent different human body organs: the heart (fire), kidney (water), liver (wood), spleen (earth), and lung (metal). The liver (wood) is said to be the “mother” of the heart (fire), and the kidneys (water) the mother of the liver. This can be understood by deducing that wood produces fire, yet fire is extinguished by water. The key observation is that conditions such as kidney deficiency affect the function of the liver because, without sufficient moisture, the tree cannot grow. In this case, when the “mother” is weak, she cannot support the child. However, the kidney controls the heart, so the kidney is said to restrain the heart.
Furthermore, the function of these Five Elements is to organize, regulate, store, and distribute the five constituents, namely, shen, jing, blood, moisture, and chi. These body organs assume primary responsibility for the vital living of life. For example, the kidney stores the jing (essence), while the heart houses the shen (mind). The kidney includes but extends beyond the job of managing fluid metabolism—it governs the will, growth, development, reproduction, and regeneration, as well as the bones and marrow. Problems such as retarded growth, ringing in the ears, infertility, low back pain, and apathy or despair are viewed as dysfunctions of the kidney system.
In addition to propelling the blood, the heart sustains the higher functions of the central nervous system, including internal and external perception and communication. The liver stores and governs the blood, tendons, and nerves, the volume, pressure, and evenness of circulating chi, and blood, temperament and judgment. The lung governs respiration, circulation, and the distribution of moisture and chi, as well as maintaining the skin and other defensive boundaries of the body. The spleen assumes responsibility for digestion, assimilation, and the distribution of fluids, maintains stability, density, and viscosity of the tissues and fluids, generates muscle and flesh, and holds the blood within the vessels.
4.3. Chi, the flow of energy
According to Chinese understanding, chi is the basic element by which all movements and mutations of all phenomena in the universe arise. In the context of medicine, chi moves the energy of the vital substance of life throughout the whole body. All movements, either internally or outwardly, are due to the circulation of chi. The easiest way to understand this is, for instance, that if a person sprains his ankle, he will suffer from pain and limp when he walks. This is because the chi that circulates to the ankle has been blocked. Once this blockage is removed, the individual will recover.
There are various forms of chi within the human body. The basic is original chi, which is made up of a combination of three forms, the essential chi of the kidney, the digestive chi of the spleen, and the cosmic chi, the air of the lung. Original chi flows through the whole body and produces the primary movements in the organs. In addition, the blood circulating within the body is more than red fluid—it is the material from which the body grows itself, governed by chi for the distribution and transformation of body substance. In the context of medicine, it is a fundamental constituent of the body. The movement and mutations of chi explain all physiological activities. The Axioms of Medicine says that “Human life depends upon this chi. When chi gathers, so the physical body is formed, when it disperses so the body dies”.
5. The Hindu understanding
Interestingly, Hindu traditional medicine also views a person being grounded in nature as a microcosm within the macrocosm, and as part of an integrated whole. Health is multidimensional and includes physical, mental, social, and spiritual wellbeing through balancing all the relationships into which a person is placed. Therefore, medicine is essentially preventive and promotive, elevating caring above curing, because if one can always maintain a balanced relationship, health and disease, happiness and suffering, and life and death are the consequence of an individual’s karma. Hence, there is an emphasis on human responsibility. Health is thus more than just medicine, being a total lifestyle that carries a person from cradle to death. Longevity is measured not in the number of days but in the quality of time.
The teaching of traditional medicine in India is called Ayurveda. Ayus means life, that is, the conjunction of body, sense organs, mind, and spirit. Obviously, from the Hindu point of view, life is not simply a form of being but the integration of several components. For instance, the body has four basic substances: earth, water, fire, and ether or chi in Chinese thought, the energy or spirit in each individual. The mind is localized in the body. The mind produces consciousness, and spirit is all-pervasive.
This tripod forms the body that represents three expressions of life. For instance, the body or material forces are involved in the maintenance of a tangible healthy state of balance of all expressions of human organisms, and their restoration when deranged. The mind cultivates a rational approach to life, removing ignorance that can harm and keep one from happiness. The spirit provides healthy conditions for the mind and body for the progressive fulfillment of a person’s ability until the human mind realizes its identity with ultimate reality. Ayurveda attempts to coordinate and harmonize body, mind, and spirit for a happy material existence, proper secular conduct, and spiritual salvation through a correct understanding of the true relationship between man, his world, and the ultimate source of his consciousness and existence.
6. The Tao of integrative medicine
Tao is a Chinese concept with a profound meaning. Plainly speaking, it is the way, the truth, the ultimate reality, the course of nature, the reality of things. From the past to the present, Tao has never ceased to be and has been the beginning of all things, having been present before all things came into being. In Hindu terms, it is dharma, the foundational truth, or Brahman, the ultimate reality. Tao is intangible, invisible, absolute, eternal, and unchanging. Lao-tzu said that when you look at it, it cannot be seen for it is beyond form; when you listen, it cannot be heard for it is beyond sound; when you reach for it, it cannot be grasped, for it is intangible. From above it is not bright, from below it is not dark, it is the form of formless, the image of imageless, there is no beginning and no end. The Tao therefore can be interpreted as the foundation of reality, the basic theory of truth. What then is the Tao of integrative medicine?
Integrative medicine takes a holistic approach in an attempt to restore a person’s original harmonious state with life itself. It sees the human body integratively, in that all mechanisms of the human body and everything in the biological environment cannot stand in isolation from each other. All factors, whether internal or external, are mutually related and should be considered simultaneously for a healthy body. We cannot pay attention to one and neglect the others. All are equally important, and each, even the smallest of all, will affect the whole body. In normal circumstances, Yin and Yang, blood and chi, and the organs of the human body will complement and support each other, so that a harmonious balance between all can be maintained in a healthy, harmonious state. Disruption of any physiological or physio-environmental balance is the starting point of all diseases.
In late 20th century, Engel developed a theory of the medical paradigm that indicated man as a unity of mind (spirit) and soma in a psychosomatic paradigm . Body and mind are not two separate entities but interact and interrelate with each other, which influences the harmony of the organism. Psyche influences soma, and soma influences the psyche. This is an interdisciplinary medicine, recognizing the correlation of physiological, social, psychological, and behavioral factors with the health and wellbeing of humans. In other words, health cannot be interpreted as an absence of disease and must be understood holistically.
Before the dawn of psychosomatic medicine, Cartesian dualism, which had dominated Western medical thinking for a long time, assumed that a person would not be sick without being infected by a virus or bacterium. This understanding indicated some truth. Yet modern medicine has moved beyond this understanding toward a new medical paradigm that upholds the interactive functioning of the biopsychosocial approach. In Western holistic concepts, disease seldom arises from a single cause: three or more factors in combination may be needed for a disease to manifest. These factors upset the balance between the external and internal environments and overload the capacity of the adaptive mechanisms.
The ancient Chinese were aware of this unity of the psyche–soma and of the interdependence of organs and emotions. Disorders of the heart may influence the kidneys and lungs, and vice versa. Disorders of the liver and gallbladder may influence the stomach. Chinese medical philosophy developed a complete schema of interdependence between the organs.
There is considerable agreement between the progressive, holistic Western concept of health and the ancient Chinese concepts of disease. In both philosophies, any dietary, medical, physical, psychological, or other treatment that restores the balance between the external and internal environments will automatically restore health. Certainly, there are exceptions in cases where irreparable damage has occurred, such as the death of nerve cells, inoperable malignant cancer, or extensive fibrosis of the liver or kidneys, or where physical damage makes self-healing impossible.
Ancient Chinese medical philosophy states that “Man stands between heaven and earth.” In modern concepts, this can be translated as: “The organism is the product of heaven (spirit, mind, non-material forces) and earth (food, physical environment, material forces).” It can also be translated as: “The organism is influenced by spiritual, psychic and non-earthly forces (cosmic, solar, and lunar forces) as well as forces in its immediate environment (nutrition, climate, electromagnetic and geophysical forces)”.
Health in man may be defined as harmony within the internal environment and with the external environment. The organism has responded lucratively to the internal and external environment, and can carry on its natural functions in a variably changing world. Thus, health is not an absolute state; it is a relative state that depends on the environment. Disease arises when there is disharmony or imbalance between the internal and external environment, or within the internal environment, and can be treated by removing the causes and/or by enhancing adaptive mechanisms.
Just as man is in unity with nature, so integrative medicine links the living body with the mind. When vitality is gathered, the patient is likely to be cured, but when chi disperses, recovery will be difficult. The Tao of integrative medicine therefore is that it is holistic, naturalistic, relational, and responsible in all mechanisms.
In terms of medicine being holistic, people are not isolated beings. They are linked to the environment in which they are placed, and thus any problem that occurs must be examined from all aspects. When a person is ill, the cause cannot be simply physical factors. Catching a cold, for example, represents more than just an immune weakness—it can also occur because one’s living environment causes the onset of disease. Therefore, we have to view a person in terms of his interaction with the environment and also in terms of his biological make-up.
Second, this approach to medicine is naturalistic. Health is part of the natural processes of life, and healing is simply finding ways to empower those processes. Life and death are parts of natural processes. When the time comes, a life is born, and then a life dies. In the process, a person needs to live in harmony with other people, with his surroundings, and with himself.
Next, relations between the patient and the social world, including the healer, are all a part of the process of healing. We must, however, bear in mind that individuals have multiple relations—with nature, with others, with themselves, and also with ultimate reality.
The final characteristic of this integrative medicine is that it is responsible. Living according to the way of Tao is imperative to maintain good health, but all individuals are also given a duty and ability to respond appropriately to the surroundings in which they are placed. Therefore, integrative medicine is also preventive medicine.
Biochemical measurements should not be the only criteria to determine whether a person is sick or healthy. Even when all pathogens have been overcome during an illness, healing is still not complete. True healing requires mental and spiritual care as much as it requires physical treatment.
Our understanding of what a person is subject to change as medical findings advance. What is health and what is a happy life can also vary. All medical systems confront a changing world, even if they stay within their native culture. The arrival of Western medicine in Asia has challenged Asian traditional care systems to the point that they are losing their influence. The more we ponder and attest to the foundational theory of Asian traditional medicine, however, the more we are convinced that the balance of the forces of Yin and Yang is indeed a harmonious and happy way of life. Arthur Kleinman pointed out that traditional healing practices should not be removed from their social structure and cultural contexts.
Integrative medicine that echoes the Asian approach supports the importance of a holistic approach to health. The more we understand humans, the more the complexity of the body unfolds, the deeper we find the meaning of life, and the more we know of the harmonious relationship of man with himself, with others, with his environment and with ultimate reality.
A human is a being of body, mind, and spirit or, in Chinese expression, a composition of Yin and Yang. Healing cannot be isolated by a specific physical method. Instead, any illness must be understood and treated holistically and in balance.
Source: Science Direct