Brief bio sketch

Lloyd Haft (1946- ) was born in Sheboygan, Wisconsin USA and lived as a boy in Wisconsin, Louisiana and Kansas. In 1968 he graduated from Harvard College and went to Leiden, The Netherlands for graduate study in Chinese (M. A. 1973, Ph. D. 1981). From 1973 to 2004 he taught Chinese language and literature, mostly poetry, at Leiden. His sinological publications include Pien Chih-lin: A Study in Modern Chinese Poetry (1983/2011; published in Chinese translation as 发现卞之琳: 一位西方学者的探索之旅 in 2010) and Zhou Mengdie’s Poetry of Consciousness (2006).

He has translated extensively into English from the Dutch of Herman Gorter and Willem Hussem, and from the Chinese of various poets including Lo Fu, Yang Lingye, Bian Zhilin and Zhou Mengdie.

Since the 1980s he has also been active as a poet writing in Dutch and English. He was awarded the Jan Campert Prize for his 1993 bilingual volume Atlantis and the Ida Gerhardt Prize for his 2003 Dutch free-verse readings of the Psalms (republished by Uitgeverij Vesuvius in 2011). His most recent book of poems (in Dutch) is Deze poelen, deze geest (2008). His newer poems are published (some republished) on this blog.

After early retirement in 2004, for a number of years Lloyd Haft spent much of his time in Taiwan with his wife Katie Su. In addition to writing and translating, his interests include Song-dynasty philosophy and taiji quan. He sings in the choir of a Roman Catholic church of the Eastern Rite in The Hague.

Monday, November 26, 2012

Confucianism and Chinese Medicine

(Scraps from a Sinological Scrapbook 漢齋閒情異誌, fragment 22)

The Influence (?) of Confucian Philosophy on Chinese Medicine[1]

 Popular Western books on Chinese medicine, and on Chinese body-related disciplines like tai chi and qigong, often claim that traditional Chinese medicine takes a Daoistic view of human life and health, encouraging us to ‘follow nature’ and to abstain as far as possible from ‘unnatural’ medication or other ‘manipulative’ modes of treatment. These Western sources often contrast this supposedly ‘natural’ or ‘wu wei’ approach with mainstream Western medicine which, they suggest, views the human body as something to be controlled rather than trusted.
        At least two leading Western authors, however, have challenged this idea. They assert that traditional Chinese medicine is actually more Confucianist than Daoist in its concept of the human being and body. Paul Unschuld (author of several acclaimed books in both German and English, including Medicine in China: A History of Ideas) and Giovanni Maciocia (whose 2009 The Psyche in Chinese Medicine followed a series of earlier works)[2] both emphasize that in the textual tradition of Chinese medicine, there is little or no notion of the human body as a self-healing, self-organizing entity. On the contrary, the concept of (in politics ‘to govern,’ in medicine ‘to treat or cure’), in medicine as in politics, implies active control and regulation in order to prevent or suppress disorder which would naturally arise without it. Similarly, the contrasting concepts of zheng and xie can be used to mean either the ‘orthodox’ or ‘righteous’ as opposed to the ‘immoral’ in a political-social sense, or the ‘proper’ or ‘healthy’ state as opposed to the ‘unhealthy’ or ‘pathological’ in a medical sense.[3]
        Unschuld’s intriguing thesis is that starting with the unification of the Chinese Empire under Qinshi Huangdi and the subsequent Confucian-oriented Han dynasty, the political concept of the Empire as a unified state with a central government carried out by ‘officials’ was also applied to the human body in which the heart was the ‘emperor,’ other organs were the ‘officials’ (), and so on. As Maciocia explains it,

the first Qin emperor...initiated a huge program of road building and canal digging. Another important innovation of the Qin dynasty was the fostering of trade among the various regions of China on a huge scale...The Qin dynasty therefore provided the first model of a unified state with an emperor, a central government, local officials, a unified economy and a state-wide irrigation system.[4]

Macicia goes on to explain the parallel with medical theory, saying that in this model ‘...the body’s physiology is the unified economy and the acupuncture channels are the irrigation canals.’[5]

Again, in two key passages by Unschuld:

One may well conclude that all these structural changes that accompanied the unification of China were sufficiently innovative to supply intellectuals of that time with the concept of an integrated complex system, the individual parts of which can function only as long as their relations with the remaining parts are not disturbed...The structure of the human organism and the functions assigned to its individual elements reflect a complex social organism founded on the wide-scale movement of goods.[6]

During the course of the last three centuries BC, unknown authors began to develop a system of healing whose theoretical principles corresponded closely to the socio-political order advocated during the same period by Confucian political ideology. As a consequence, this system of healing was continuously dependent on the interests and fate of Confucianism itself. With the elevation of Confucianism to orthodox political doctrine by the Emperor Wu, the Han period theoretical foundations of this ideology remained fixed for a long span of time.[7]

The same model which described society as a well-governed whole was also used as a symbol of the human body. The parallel between the political and the medical model comes out well in a quote from the authoritative Chinese medical classic Huangdi Neijing 黃帝內經: ‘The sages do not treat those who have already fallen ill, but rather those who are not yet ill. They do not put their state in order only when revolt is under way...’[8]
        This notion of quasi-bureaucratic control and governance as a basic principle of the human organism comes out in much detail, for example, in Ted J. Kaptchuk’s The Web That Has No Weaver,[9] which since its first publication in 1983 has been a very widely read Western source on Chinese medicine. Discussing the internal organs in order, Kaptchuk quotes from traditional Chinese sources, mostly the Su Wen 素問 (the more theoretical section of the Huangdi Neijing), as to their traditional rulerships.[10]
        Traditionally, according to the Su Wen, ‘The Heart rules the Blood and Blood Vessels.’ Adding his own amplification, Kaptchuk says the heart ‘regulates’ the flow of blood.
        Again, according to the Su Wen, ‘The Lungs rule Qi.’ Kaptchuk’s explanation in this case says that the lungs ‘administer’ respiration and ‘regulate’ the ‘Qi of the entire body.’ The Su Wen also says the lungs ‘move and adjust the Water Channels.’ In Kaptchuk’s simpler amplification, the lungs ‘move water’ – shades of Unschuld’s ‘irrigation canals’!
        As for the Spleen, traditional sources say it ‘rules transformation and transportation.’ Again, ‘the Spleen governs the Blood’ – in the sense, according to Kaptchuk, ‘that it keeps the blood flowing in its proper paths.’[11] The Spleen also, in the Su Wen, ‘rules’ the muscles, flesh and limbs.
       The Liver, in Tang Zonghai’s 唐宗海formulation as quoted by Kaptchuk, ‘rules flowing and spreading.’ In the Su Wen, it is compared to ‘the general of an army.’
        In the Su Wen, the Kidneys ‘rule water.’ In the face of what might seem to be a contradiction in light of the Lungs’ ‘adjusting’ the Water Chanels, Kaptchuk explains that the Kidneys ‘are the foundation upon which this entire process of Water built.’ In addition to this, according to Su Wen, the Kidneys ‘rule the bones.’
        Another well-known Western work, Between Heaven and Earth by Harriet Beinfield and Efrem Korngold,[12] sets out the ‘governmental’ or ‘bureaucratic’ structure of the organism even more strikingly. In it, we read (on pp. 138-157) that the Liver is ‘like a general working out strategy and tactics...’; the Heart is ‘like an enlightened monarch, omniscient and ever-present, sharing his wisdom unconditionally for the benefit of the Whole’; the Spleen is ‘like a minister of agriculture, watching over production and distribution...’; the Lung is ‘like a minister of state, determining the territorial boundaries’; and the Kidney is ‘like a minister of the interior, conserving the natural resources...’

To be sure, there are aspects of Chinese medical theory that seem to accord very well with the popular image of a Daoist lifestyle. But as Maciocia points out, many Daoist ideas were later incorporated into Chinese medical theory during the Song and Ming dynasties when the dominant philosophy of neo-Confucianism imposed its own interpretations. Maciocia cautions that in reading old Chinese medical texts like the Huangdi Neijing, we must never assume that the word Dao is always being used in an old Daoist meaning. In Confucianism or neo-Confucianism, it can often be equivalent to ren or li , both words having everything to do with the individual’s social adjustment and deportment.[13] I would add that more generally, in neo-Confucianism the word Dao is very often used to mean ‘the teachings,’ ‘the Tradition,’ or ‘the proper behavior’ – contrasting thoroughly with the Dao that according to Zhuangzi 莊子 ‘can be passed on but not taught’ 可傳而不可授, and with Laozi’s 老子 cautions against taking social discourse seriously. In this context, it is revealing that some of the best-known Chinese Bible translations have used Dao for ‘the Word’, rendering ‘In the beginning was the Word’ as tai chu you Dao 太初有道.[14] Perhaps the early translators, like the later scholar and sociologist Marcel Granet 葛蘭言whose La Pensée chinoise [Chinese Thought, 1934] became one of the classics of twentieth-century European sinology, wished to emphasize Dao’s quality as an ordering element which makes things be as they are.[15]
        Even aside from neo-Confucianism, we can raise the question of whether the Dao concept really implies that the surrounding social discourse, be it ever so restrictive, is irrelevant or secondary. Chad Hansen, in his A Daoist Theory of Chinese Thought, even says the archetypal Daoist writer Zhuangzi, ‘like the rest of the classical tradition, uses dao as a concept of guidance rather than a reality concept.’[16] In another context, he calls Dao ‘the sum of all discourse inputs.’[17]
        Be this as it may, the neo-Confucian stress on a discourse of social adjustment sometimes supplied contemporary Chinese authors with what must have seemed convincing arguments applying to the medical sphere. A frequently quoted example, cited also by Maciocia, is from the writings of the Song-dynasty neo-Confucianist philosopher Cheng Hao 程顥. It involves a pun on ren (often translated ‘benevolence’ or ‘humanity,’ but which I prefer to translate ‘responsiveness’) and bu ren 不仁 (seemingly ‘not benevolent or humane or responsive,’ but also in a physiological sense ‘numb’):

In medical writing the term ‘lack of humanity’ [bu ren] is used for numbness of the hands and feet...A man of ren regards Heaven, Earth and the myriad things as one substance, and there is nothing that is not himself. Recognizing all things in himself, will there be any boundary for him? If things are not parts of the self, naturally there will be no connection between them and himself, just as in the case of numbness of the four limbs...[18]

As Maciocia explains, ‘...a person of ren is someone who regards others as extensions of himself, like his limbs. Such a person is naturally sensitive to the needs and feelings of others...’[19]

Perhaps the Western ‘debate’ (if that is what it is) between the ‘Confucian’ and ‘Daoist’ views of Chinese medicine is mainly a quibble about terminology – or about what Western writers think ‘Dao’ means. This in turn may be related to what motivated these particular writers to study Chinese medicine in the first place. For a long time now, many Western students of medicine have been dissatisfied with what they perceive as Western medicine’s non-unitary, over-specialized character. Feeling that Western medicine encourages too much isolated attention to specific details rather than to the organism or the person as a whole, they have been attracted to what is often called ‘holistic’ medicine. In circles involved in these studies, the Chinese concept of Dao is often considered a positive alternative: because it is often interpreted to imply release from restriction, constriction, or static social definition of persons and their situations.
        Kaptchuk, for example, at the end of his first chapter stresses

...the very important evolution in the last few decades [in the West] toward interdisciplinary and integrative medicine, and the even more recent development of “holistic” medicine. A modern hospital’s medical team employs a wide variety of approaches that go far beyond the late nineteenth century biochemical models. For example, a pain unit may include rehabilitation, occupational, and physical therapists, a nurse, a psychiatrist, a social worker, art, movement, or music therapists, a relaxation counselor, and a nutritionist...The newer concepts of holistic health are an extension of the current Western concern to go beyond a reductionist model. Indeed, this book itself can be viewed as part of the growing holistic interest.[20]

But Kaptchuk takes a nuanced view of all this. Though he stresses and discusses Daoism in his book, in an interview in the magazine MD he cautioned against the ‘ overvalue Chinese medicine because it is holistic and spiritual,’ saying this attitude was a ‘barrier to a genuine understanding.’[21] He does not present Chinese thought as believing in an always-liberating, ever-free flow. On the contrary, he astutely states that

The Chinese world-view is circular and self-contained...The Chinese physician begins with a knowledge of the whole, made up of the countless details codified in traditional medical texts. The movement between...the macrocosm of all bodily phenomena to the microcosm of one unique human being, is mediated by the conceptual framework of the patterns of disharmony.[22]

What is noteworthy here is that the ‘knowledge of the whole’ is not a new knowledge which the current person has somehow attained thanks to his or her unique new place in the flux. The knowledge itself is made up of elements which have long since been ‘codified’ in ‘traditional texts.’ To me, that sounds like a very Confucian idea. True, there is said to be a movement between ‘macrocosm’ and ‘microcosm,’ but again: the movement is not unstructured: it is ‘mediated’ by a ‘conceptual framework of patterns’ – in other words, as I would phrase it, of socially recognized possibilities.
Between Heaven and Earth contains much autobiographical material on its authors’ personal history of attraction to Chinese medicine – too much to be easily summarized here. Again the concept of the Dao plays a prominent role. But it seems to me that the authors are eager to see it as a totality concept, in this sense downplaying its character as a specifically ordering agency. More than once, we read that the Dao is ‘undifferentiated’ or ‘unbroken.’[23] It ‘transcends the illusion of separation’[24] – yet the authors add that it does so ‘within a pattern of indissoluble connections in a circular network.’[25]
        Here once again, we encounter the notion of a ‘net-’ or ‘web-’ like closure lying at the heart of the Chinese health concept. I doubt whether all Western readers would agree as to whether this is a ‘benign’ or somehow an ‘ominous’ notion. Perhaps their choice as to whether it is ‘Daoist’ (i.e., in this context, benign) or ‘Confucianist’ (suggesting social pre-patterning, hence also control) depends on their personal concept of whether ultimate ‘circularity’ is a supportive or a limiting thing.
        Kaptchuk traces the term ‘the web that has no weaver,’ as in the title of his book, to Joseph Needham, and quotes Needham as saying ‘the key-word in Chinese thought is Order and above all, Pattern....’[26] Also from Needham is the explication ‘...The conception...[is] of a vast pattern. There is a web of relationships throughout the universe...Nobody wove it, but if you interfere with its texture, you do so at your peril...’[27]

Coming to this point, I am reminded of a remarkable poem, titled ‘Life’ 生活, by the eminent modern Chinese poet Bei Dao 北島.[28] The poem consists of a single word:

which I think could equally well be translated as ‘net’ or ‘web.’
        Is a ‘net’ a benign thing, as in a ‘social network’ or ‘support network’...or does it trap, capture as a ‘fishnet’ does?
        Is a ‘web’ usefully benign, as for many of us nowadays ‘the web’ is...or is it more in the nature of a ‘spider web’?
        But perhaps it would be too non-Daoistic, certainly too non-holistic, to expect a yes-or-no answer to these questions.

--Lloyd Haft

[1] Based on a paper presented on October 25, 2012 at the International Scholarly Conference on Chinese Classics and Culture, Department of Chinese Literature, Central University, Taiwan.
[2] Paul Unschuld, Medicine in China: A History of Ideas, Berkeley: University of California Press, 1985. Giovanni Maciocia, The Psyche in Chinese Medicine, Edinburgh etc.: Churchill Livingstone Elsevier, 2009.
[3] On this opposition, see Unschuld, Das Heil der Mitte –, Theorie und Praxis, Ursprung und Gegenwart der Medizin in China, München/Linz: Cygnus Verlag, 2005, p. 70. Maciocia, in his Pinyin-English glossary, refers to xieqi 邪氣 as ‘pathogenic factor’; the ABC Chinese-English Dictionary (1996) gives as one of its definitions ‘shocking behavior.’
[4] Maciocia, The Psyche in Chinese Medicine, p. 314.
[5] [ibid.]
[6] From Unschuld, Medicine in China: A History of Ideas, quoted in Maciocia, The Psyche in Chinese Medicine, p. 314.
[7] From Unschuld, Medicine in China: A History of Ideas, quoted in Maciocia, The Psyche in Chinese Medicine, pp. 321-322.
[8] Translation in Unschuld, Medicine in China: A History of Ideas, quoted in Maciocia, The Psyche in Chinese Medicine, p. 322. The Huangdi Neijing is far and away the best-known (and still best-read) classical source on medicine. Scholarly opinions differ as to its dating and origins. Many place it, or parts of it, in the first few centuries before the Christian era.
[9] The Web That Has No Weaver:Understanding Chinese Medicine. Chicago: Congdon and Weed, 1983. The book has also been published in Dutch, Italian, German, Hungarian, French, Spanish, Bulgarian, Portuguese and Spanish.
[10] For the full discussion and source references, see Kaptchuk, pp. 54-65. The quotes from old Chinese sources are in Kaptchuk’s translation.
[11] For the particular verb ‘govern’ in this instance, see Kaptchuk, pp. 71-72, note 27.
[12] Original New York: Ballantine Books, 1991. As I do not have the original to hand, in what follows I quote and translate from the 2005 reprint of the German translation Traditionelle Chinesische Medizin, München: Deutscher Taschenbuchverlag.
[13] Maciocia, p. 324. On li in this sense, compare the Internet Encyclopedia of Philosophy’s article on Cheng Yi 程頤 [by Wai-ying Wong, consulted 8 september 2012]: ‘The concept of li is central to Cheng Yi’s ontology. Although not created by the Cheng brothers, it attained a core status in Neo-Confucianism through their advocacy. Thus, Neo-Confucianism is also called the study of li (li xue). The many facets of li are translatable in English as “principle,” “pattern,” “reason,” or “law.” Sometimes it was used by the Chengs as synonymous with dao, which means the path. When so used, it referred to the path one should follow from the moral point of view. Understood as such, li plays an action-guiding role similar to that of moral laws.’ For an excellent study of some of these concepts and their interrelations in neo-Confucianism, see Olaf Graf, Tao und Jen: Sein und Sollen im sungchinesischen Monismus, Wiesbaden: Harrassowitz, 1970. See also various works written or translated by Wing-tsit Chan 陳榮傑, including Neo-Confucian Terms Explained and Reflections on Things at Hand.
[14] On this, see also Lloyd Haft, ‘Perspectives on John C. H. Wu’s Translation of the New Testament,’ in Chloe Starr (ed.), Reading Christian Scripture in China, London: Continuum, 2008.
[15] See Granet’s book as a whole, and especially the chapter on ‘The Dao.’ To my knowledge, this very important book has never been published in an English translation.
[16] Chad Hansen, A Daoist Theory of Chinese Thought: A Philosophical Interpretation, Oxford University Press 2000 [originally published 1992], p. 268.
[17] Chad Hansen, ‘Language in the Heart-mind,’ in Robert E. Allinson (ed.), Understanding the Chinese Mind: The Philosophical Roots, Oxford University Press, 1989, p. 96.
[18] Maciocia, The Psyche in Chinese Medicine, p. 319, quoted from Huang Siu-chi, Essentials of neo-Confucianism. Westport, Conn.: Greenwood Press 1999, p. 93.
[19] Maciocia, p. 319.
[20] Kaptchuk 1983, p. 26.
[21] Quoted in the front matter to his book.
[22] Kaptchuk 1983, pp. 256-257.
[23] In the German edition quoted above, pp. 23, 74.
[24] P. 23.
[25] P. 23.
[26] Original from the second volume of Needham’s monumental Science and Civilization in China; quoted in Kaptchuk, p. 15.
[27] Original from Needham, vol 2; quoted in Kaptchuk, p. 265.
[28] Pseudonym of Zhao Zhenkai 趙振開 (1949- ). The poem, widely accessible on the internet, I believe appeared in Bei Dao’s collection 太陽城札記 (Notes from the City of the Sun – this is also the title of a bilingual edition with translations by Bonnie S. McDougall, Ithaca: Cornell University East Asia Papers: China-Japan Program, No. 34, 1983).