Following the first day lecture on Philosophy of Chinese Medicine 1 for the Global University for Sustainability, Keekok Lee continued on a second day on some topics:

• Anatomy as structure; physiology as function (and process);
• Process ontology, and thing ontology;
• Qi ju as qi-in-concentrating mode, and qi san as qi-in-dissipsating mode; and
• the 4 P’s of Chinese medicine.

20210617 SSFS8 LEE Kee Kok – Philosophy of Chinese Medicine 2

Again, this online web video lecture is a complement (and update) to two prior books:

• Lee, Keekok. 2017. The Philosophical Foundations of Classical Chinese Medicine: Philosophy, Methodology, Science. London: Lexington Books. https://rowman.com/ISBN/9781498538886/The-Philosophical-Foundations-of-Classical-Chinese-Medicine-Philosophy-Methodology-Science.
• Lee, Keekok. 2018. Classical Chinese Medicine: Theory, Methodology and Therapy in Its Philosophical Framework. Newcastle upon Tyne, UK: Cambridge Scholars Publishing. https://www.cambridgescholars.com/product/978-1-5275-0397-7.

Highlights from the transcript from the Youtube recording are provided below, in the interest of scholarship.

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[0:24] Now then, where we stopped yesterday, as far as i can recall, is that I was stressing on thing ontology in biomedicine. The emphasis is on the notion of the body as machine, if you remember. Now because you are talking about the body particularly as machine, you are therefore talking about structure. And structure is a subject which is very dear to the heart of engineering. So take a watch when you from the engineering part of your watch is: what is a watch? You could take a watch to pieces, you know, the spring, and the handle at the hands of the clock, the frame, the metal frame, or whatever, and so you can split it up, deconstruct it, into its component parts. But in engineering, what you have decomposed you can also reassemble. So engineering implies also the concept of reverse engineering. You can both construct and deconstruct.

[1:58] Now because you’re talking about structure, where this kind of thinking is then applied in the context of medicine to understanding the body, because the emphasis is of the body, the thing, there, then you are emphasizing anatomy.

[2:21] Because anatomy is what occupies space, right? Now so that is why it might be sound a bit of a caricature to say that modern, that BioMedicine, is actually based on autopsy.

[2:44] In other words you learn the medicine initially by doing the section on the cadaver, on the corpse. So all medical students as far as i know, even today i believe, have to do the initial training in the path [pathology] lab. You’ve got to do a certain amount of dissection, because without dissection you cannot know about the body, how the body as a machine is structured, and held together the component parts.

[3:24] Now, another emphasis because of this ontology of body …. It also means that surgery plays a very important part in BioMedicine. So if you have structure you also have surgery.

[3:52] A medical scientist and philosopher in the 16th century called Ambroise Paré, he laid down five functions of surgery. And to this day, those five functions remain correct. So he was very perceptive and insightful.

[4:21] So what are these five functions of surgery?

[4:28] He said first, to remove what is superfluous. Now, that is quite true. Biomedicine for a long time today it might have shifted its position a little bit./ But for a long time it says your appendix is superfluous. So, when it gets inflamed, you’ve got to get rid of it. So some people jump the gun and say, why wait for it to get inflamed before we remove it? It’s superfluous anyway let us choose a time and place of our own convenience have a surgical operation and remove it.

[5:08] The same thing with tonsils for a long time, at least Americans, middle class … Americans thought that the tonsils were superfluous. So they got their children, have the operation, remove the tonsils. Appendix, tonsils, all superfluous. So that’s rule that is one function to remove what is superfluous.

[5:30] Then, the second function is to restore what has been dislocated.

[5:39] Now that can be quite helpful, I do admit. For instance, if you twisted your waist, or what we call the hips, or whatever, and it’s painful, right? So sometimes you do need an operation to readjust the dislocated hip. So i grant that that’s very useful.

[6:00] And then, the third is you remove what has been, you divide or separate what has been conjoined Now this, for a long time, was very difficult and didn’t come to pass. But I believe, in December 2020, that surgical operation was performed, a spectacular surgical operation, which involves separating two conjoined twins. So the surgeon, marvelous people, needed to divide the children, and the children survived. So that is another function.

[6:45] And then, a function is …. Suppose you sever your finger in an unfortunate, when you’re chopping on the chopping board — the Chinese use a cleaver especially not a simple small cleaver, chop chop chop chop and you chop up your finger — then you carry the finger quickly to the hospital and the surgeon can reattach the finger, right? Or a severed limb in an accident at a factory. So that is also very useful, so you see.

[7:17] And then the final function is that you also do what I call cosmetic surgery, not in the vain sense, in the sense of vanity to look good, but because it becomes a disability itself. For instance people who are born with a hair cleft. you know where the ren zhong, the philtrum had not occurred. So you know, so that’s not mere vanity, to have it stuck together, stitched together in a surgical operation. And so that is very, very important, as well.

[8:02] So there you are, you see. Paré puts forth these five functions of surgery. they remain true today.

[8:07]Now, I’m talking about the ren zhong on this point. I might as well make a point which is relevant to our understanding of Chinese medicine to BioMedicine.

[8:23] The ren zhong is simply that bit of the anatomy where unfortunately in the case of some people something happened to your prenatal development and the two bits never met.

[8:36] So now we have the technology to stitch them together so that’s wonderful. That’s fine, and one is grateful for people being restored in this way to wholeness.

[8:50] But to the Chinese, the philtrum or the ren zhong is not simply an anatomical bit. It is a cosmological site because it is the place where tian, heaven, meets earth, di.

[9:06] Tian, as we know stands for yang, and di stands for yin. So this is the place where yin yang meets. And according to qian ren xiang ying — the mouthful, macro micro cosmic wholism — unless you have zhang and jing in yourself in a microcosm, you wouldn’t be a proper person. You wouldn’t be functioning properly. You won’t be whole.

[9:34] So that is why, to the Chinese, it’s a cosmological site.

[9:41] And so, it’s not simply a piece of anatomy, it’s a very, very important site.

[9:48] So okay … Now then so, Chinese …. Western medicine and BioMedicine emphasizes structure that, therefore, surgery.

[10:00] Now, if you look at Chinese medicine, surgery I wouldn’t say plays no role, but it plays a very minor role, historically.

[10:11] So I wouldn’t want to say that Chinese medicine never took any interest in anatomy and therefore in surgery. But the anatomy was downplayed and the surgery was minor. There was a very minor surgery. And I believe in the Huangdi Neijing, there are several passages especially in the lingshu. which is the spiritual pivot, or the luminous pivot. References to anatomy — so there you are, so just make the picture correct — it’s not that Chinese medicine is not interested in it, but the role played by anatomy is somewhat minor let us say.

[10:59] So what is the polar contrast to structure and anatomy? It will be function. So Chinese medicine stresses on function. How parts of you, from the component parts which form a whole function. How your organ systems — what yesterday i called organ systems — such as your piwei [spleen-stomach system], your zangfu [the yin and the yang visceral organ-systems] — how they function. How one zangfu functions as a whole. How several zangfu in us, as a living individual, functions with other zangfu. And this is how the function works.

[11:43] So, when you’re talking about function, you’re therefore talking about physiology not anatomy.

[11:50] So to me, then, Chinese medicine following this line of exploration talks therefore about physiology, or at least the Chinese understanding of physiology.

[12:07] Now, if this is so, then i think various consequences follow.

[12:21] Now I would like to draw your attention to some of these differences very, very radical differences between BioMedicine on the one hand, and Chinese medicine on the other.

[12:42] Now, one of these differences is that — which i have just alluded to in fact — is between structure anatomy on the one hand, and function physiology on the other. I’ll come back to this point, later but let’s just call this is a fundamental difference.

[13:06] So any system of medicine which does not emphasize structure and anatomy, to BioMedicine, they would consider as an absurdity.

[13:19] So you can say, absurdity 1, according to the understanding of BioMedicine with regard to Chinese medicine is that it fails to talk to emphasize fully of structure and anatomy. So how can we take seriously a system of medicine which ignores such two important concepts structure and anatomy? So it’s not a serious thing, right? Okay, absurdity number 1.

[13:49] Absurdity number 2 is that BioMedicine takes a very very very drastic distinction between what may be called today’s medical texts, which medical students at a medical school study, as opposed to historical medical texts.

[14:14] Now, it is not part of the training of a medical student, in a modern medical school, to go and look at historical medical texts. You’ll be laughing stock if you make your students look at historical medical texts.

[14:36] So you’re not a medical student, I’m not expected to go about by Hippocrates writing, you know, we would go back to the ancient Greek because the western civilization claims to have its roots and ancient Greek stuff. But he wouldn’t ask you to read Hippocrates, Galen or any of these nonsense. And never mind that it wouldn’t even ask you to, in spite of his heavy emphasis on anatomy and structure, it wouldn’t ask medical students to look at Berzelius, who in the 16th century wrote the definitive, put modern, put study of, anatomy on the modern basis as it were. Oh, no, no, no. They are for fuddy duck people like myself, philosophers and historians of science and medicine, who may be interested in these ancient tones

[15:37] So, these are museum pieces for them. So today in fact, as far as I know, you have to have the latest medical knowledge. And where do you find your latest medical knowledge? Not even in a textbook, because today, textbooks, hard copy, take a long time to be produced. the latest is to be found online. Online publications.

[16:07] So if I want to be really at the cutting edge of modern western medicine, I would have to be constantly on, and find out who has said what. What are the latest experiments, etc etc.

[16:21] And every day, the revision goes: what was extant knowledge at time t1 is no longer extent knowledge at time t2. And the difference the the difference between time t1 and time t2 maybe indeed yesterday and today. So there’s a tremendous pressure to keep up with the latest development, it does. So no museum pieces anything which reaches beyond the present. The present moment is really ancient knowledge. We don’t want to know. It might be knowledge in the past, and we may deign to call it ancient knowledge, but it’s not present knowledge, and not extant relevant knowledge. So we move on.

[17:08] So I look at the Chinese. What do they do? If you want to learn Chinese medicine, what do your master, your shifu, tells you to do? Go and study the Huangdi Neijing. The Shanghan Lun. If you don’t know .… First of all, you have to know this by heart, best of all. Otherwise you know you don’t really know your text. Having learnt it by heart, you must always carry it in your mind. Never mind carrying your mind, you consult it if you come across problems in your clinical experience. so if you’re puzzled by a patient and you diagnose, right, you say, ooh, this sounds a bit odd.

[17:54] And you could make sense of, you know, the results of the four methods of diagnosis in chinese medicine. So the moment you have the time, you go and turn over the pages of your Neijing to find the relevant pages and to hope to get inspiration and wisdom for it. You’ll meet up with a fellow, a group of fellow physicians, and you discuss this. And you go through the pages of the Neijing and the Shanghan problem.

[18:29]. And so now, if you have the mentality of BioMedicine you would consider this as a ludicrous, absurd, activity. Why do you want to look at ancient texts? They’re museum pieces. “They’re not relevant to your present preoccupation.

[18:46] An, no, the Chinese say this: you don’t understand what we are doing. So, talking a conversation between the deaf and the dumb, as it were. So you get nowhere.

[19:05] Another absurdity, which follows from the second absurdity, would be that, naturally, you use the prescriptions which physicians used more than 2 000 years ago, to try to apply it in your clinical, in your clinical case, the case before you, it you know, in your consultation room now.

[19:44] To BioMedicine, this again is simply absurd. Simply absurd. Now to see how absurd it is, let me give you a small history of modern of biomedicine from the point of view of treatment. And then you could begin to see how absurd it is.

[20:12] Now, the treatment modern western medicine began, let us say, roughly from the time of the Ascanius, and slowly, slowly, it built up to today. So the theoretical understanding to, up to a point, was well in advance of its ability to offer treatments to patients who are, who were, ill.

[20:41] Now what did … It was not until in a sense, as late as 1945, the second, post-second World War, that biomedicine had efficacious treatment for a lot of disease. Now you may be surprised to hear this. Now this is not a fantasy of mine. I’m going to back it up with with evidence now.

[21:10] Now before that moment, what did people do? What did the biomedical — so we didn’t call them biomedical physician, then, we just called them the doctor, right — the medical doctor. The doctor, the doctor had two ways of coping, probably three.

[21:30] But two important ways. One is what is called venisection, I’ll explain what that means. And the second is leeching.

[21:47] Now, what is venisection? That is, I do know that there is a very important distinguished journal in BioMedicine which is called a Lancet. Now why is it called a lancet? Now it’s called The Lancet, because people before the end of World War II, they use a little knife, I suppose a scalpel called a lancet in order to cut away, then a section, cutting a vein, in order to draw blood from it. Because they believed that the blood is no good. I mean, this is putting it simplistically. We have no time to go into the detail. So you drain the blood, as it were. And after draining the blood, you’ll be fine, they think, right?

[22:42] So the other instead of cutting your vein, and draining the blood with the lancet, the other thing is by leeches. Leeches. You know little little creatures called leeches. Now, medicine, modern medicine, used up so many leeches, that the leeches of the uk were used up. So they imported from France. And france also used leeches at that time as well, right? So leeches became almost extinct in Western Europe.

[23:21] So they had got to go to Turkey to import leeches. So there you are, you say, these were two modes.

[23:27] Now back to venisection first. Now venisection, in the end, killed a lot of people.

[….]

[24:20] So that were the two main techniques. And the third one, which they also used, and which Chinese medicine also — I mean not that chinese medicine didn’t use venisection and leeching, they did, but on a very very small scale, right? And also the third method, which were used by western medicine, was also used, occurred in Chinese medicine, but again on the small, not on the large scale, but on a small scale. So it was cupping, right?

[24:54] Ba guan. So it was cupping. So, in fact it’s some chart in some French novels, in the early 20th century the late 19th century, stories of rural France you can still read, you know, the doctors doing cupping and things like that. So today, I think it has probably fallen out of use in western medicine but it remains one of the methods in Chinese medicine.

[25:28] But chinese medicine includes a whole suite of treatments, of which the two main ones, as we know, like acupuncture and decoction. Using medicinals to decoct and make up a brew, and then to drink the very unpleasant liquid from such a decocted material.

[…]

[27:54] Modern practitioners in Chinese medicine, admittedly use the prescriptions in what they call a linghua manner. Linghua, I suppose can be translated in a sensitive nuanced manner. You make modifications, but in a nuanced sensitive manner, in the light of your actual clinical assessment of the patient in your consultation role. So you adjust the ancient prescription formula, in order to address the peculiar characteristics of the individual in front of you in a consulted role. But that is how China medicine is so obviously is a piece of nonsense according to BioMedicine.

[28:50] Now, the fourth absurdity I would like to draw your attention to about Chinese medicine, in the eyes of BioMedicine is, I think, even more nonsensical than the other three that i’ve mentioned. Why is it so nonsensical? Because it amounts to a boasts if you like. And what is this boast of chinese Medicine? It boasts that Chinese medicine can cure any illness, of course, in principle,

[29:37] In principle, I’m not saying every Chinese practitioner can cure it but in principle it has the intellectual resources to cure any illness which the patient presents him — I’ll use the plural — presents themselves, right, so that’s not to be gender biased.

[30:12] So, now that is obviously ludicrous. How can you, in principle, cure whatever illness is presented by the patient in your consulting room? Even in principle, this is absurd, without knowing “the cause” in biomedical understanding of what is “the cause” of the disease suffered by the patient.

[30:43] Now what is the biomedical understanding of “the cause” suffered by the individual patient in front of you as the practitioner as the medic.

[31:00] Take Covid-19. According to biomedicinem all diseases are caused by either a bacterium, a virus, poison, a prion — a prion is a piece of protein — or today, since the human genome project of genomics, a piece of the effective gene through you, right? So your illness is caused by one of these five things.

[31:43] So, some of these things, we can do something about as biotechnology improves. And other things in the past, you can’t do anything about.

[31:56] Today, we can do something about your faulty genetic sequence. Not all genetic sequences can be so easily cured by biotechnology unfortunately but a very limited amount one can do. For instance, in single gene defect you can do it. But not many diseases are caused by single genes defect. So having said that, you’ve got to hand it to BioMedicine, that in very limited cases, it can even fiddle with your genome, with your individual genome, to remove the offending bit of DNA sequence which you happen to have inherited from both your parents, right? So that is what, precisely what, it claims to to be able to do.

[32:52] Whereas, Chinese medicine is totally different.

[33:01] One doesn’t assess, analyze disease. We don’t call it disease in chinese medicine, anyway. We call it an illness because a disease presupposes that that variable, the relevant variable, is an entity. But as I say, Chinese medicine is not based on thing ontology.

[33:28] It is based on both process ontology and thing ontology. So it is a functioning of both right now.

[33:42] This now leads me to cover a gap which, something which I left out yesterday, because it was inconvenient and to reintroduce that matter. But now I think I will. Now yesterday I say that chinese medicine is Daojia medicine, Daoist philosophical medicine, medicine based on Daoist philosophy. And I said a YjJing is a daoist text, that the DaoDeJing of the Laozi is definitely a daoist text. That is a Daoist philosophical text.

[34:21] But there is also another text, which is the Zhuangzi. The Zhuangzi is also a Daoist philosophical text. Now yesterday, I said the DaoDeJing or the Laozi, although it did not never mention the word yinyang, nevertheless, you’ll never be able to understand yinyang, unless you have the concept of yingyang.

[34:50] Because it presupposes that everybody knows about the concept of yinyang, so he didn’t bother to set it out, all over again. And also the concept of what I called dyadism, and not dualism. So it also presupposes that but anyway.

[35:08] So the missing element comes then from the Zhuangzi. The Zhuangzi, of course, is later than the Laozi, but in the Zhuangzi, there is a very important distinction made and about qi. As you know that the fundamental category, in Daojia philosophy, in Chinese philosophy in general, is qi.

[35:38] Now qi, as i say, if you want me to explain what qi is, you probably have to have another 10 lectures on the subject, so I’m not going to attempt. All that I say is to rely on one’s intuitive understanding of what yang qi, as opposed to yin qi, right? That’s all I want to say because one has just about no time. But anyway if you think of yang qi or yin qi, or whatever it is that the qi, according to the Zhuangzi, occurs in two forms in the macrocosm, as well as in you, the microcosm. It is qi ju, and qi san.

[36:30] Now qi ju, I have personally myself translated as qi-in-concentrating mode, and qi san as qi-in-dissipating mode.

[36:50] Now in the macrocosm, of course, there is qi-in-concentrated mode, because qi-in-concentrating mode, in the abiotic world, in the world of the of nature which is non-organic, such as rocks, primarily — that’s the most obvious example of qi-in-concentrating mode in nature. Mountains made of rocks, et cetera, right? Now that is qi-in-concentrating mode, it exists as a thing. The Himalayas exist as a thing. But the Himalayas is very very tall.

[….]

[38:10] The Himalayas will become shorter and shorter and shorter, because erosion will have taken place, weathering would have taken place. And as a result, what was concentrated in the concentrating mode has become qi-in-dissipating mode.

[38:35] Now, in the laws of thermodynamics, in the modern laws of thermodynamics, we talk of the production of entropy. Now, of course, the Chinese have no equivalent direct equivalent concept of entropy, but I think if you read between the lines, the implications of qi-in-concentrating mode qi ju, as opposed to qi-in-dissipating mode, which is qi san, then you begin to grasp that the chinese do have some implicit understanding of what entropy could be.

[39:15] Because entropy is just simply, you know, an object like a table, no longer exists as the table. It exists as bits of wood, and from bits of wood, eventually become atoms and molecules of all bits, of standing for, bits of … I don’t know what they are.

[39:34] But anyway you can imagine what the physics of that may be.

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The ideas of qi-in-concentrating mode and qi-in-dissipating mode are more fully explained in Keekok Lee’s 2018 book. Here’s a table.

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[39:40] So, this is what it is about now. Then, in Chinese medicine, of course, you use we use the decocted, we use medicinals, which are qi ju, qi-in-concentrating mode.

[40:02] We use bits of plants, bits of animals and you’ll be putting them together put some water in it — water is also qi-in-concentrating mode — put them together, put the fire underneath, and you decoct and and you drink, right?

[40:18] But surprise, surprise, of the two medicines and there are various domains of Chinese medicine but primarily you can say — Efrem may may correct me in this if i’m wrong — two forms:

[40:37] One is decocted material that you drink, qi-in-concentrating mode. And the other you don’t use medicinals which consists of things, of things.

[40:5t] What you do is acupuncture.

[41:02] Now, ironically, ironically, acupuncture seems to go down better in the west today, than decoction.

[41:16] Now,l this to me is a puzzle. It’s very very strange. Because acupuncture is primarily about qi-in-dissipating mode.

[41:31] Medicinal decocted medicines treat the ill patient, the patient, via qi-in-concentrating mode, via things. But in acupuncture you are treating the patient not via things, but via qi-in-dissipating mode.

[41:54] That I find it very, very strange, that the most difficult concept from the BioMedical point of view, for some odd reason, the West buys much more, and much happier with it, than the other version. It fits in better with its metaphysics.

[42:18] Now, I see why the west buys acupuncture, which is the difficult notion as opposed to a decocted medicine which is metaphysically the easiest thing to cope. I express it in terms of geopolitics, and economics.

[42:38] First the geopolitics. Why is it that it goes down so well and that has something to do with Nixon. If you remember Nixon and Kissinger were the ones who broke the ice with China, with communist China in the 1970s.

[….]

[44:06] And the other is, this is also economics. Because, imagine you are an American. In america where there’s no national insurance, no free medicine, you’ve got to buy your own insurance, right? Now, for people who have no insurance then you cannot go to a consultant– a grand consultant, a BioMedical consultant — if you have an illness because you haven’t got the insurance to cover you, and you are suffering. So you realize maybe I could consult a bumble jumble man he costs less. So you go to your Chinese practitioner who probably charges you one-twentieth of what, or one-thirtieth of, what the grand consultant, you know, at the John Hopkins hospital, or wherever, whatever, or the Mayo Clinic would charge you.

[45:00] So, it’s both a geopolitical reason, and for economic reason, that acupuncture has become better acceptable, accepted in the west, than decoction.

[45:24] But in terms of metaphysics, it’s a very, very, difficult concept, it seems to me. Because you’re now talking about qi when the acupuncturist sticks the needle in you, in the jingluo, in the network of the jingmai, you are fiddling with qi-in-dissipating mode, in order ultimately to affect qi-in-concentrating mode.

[45:58] Now how is this done? This is done via a fundamental postulate methodological postulate which I will now introduce.

[46:28] And in Chinese it reads bu tong zhi teng, tong zhi bu teng. Now that sounds like a mouthful, because they all sound alike, you know, in Chinese, right?

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Here’s a helpful translation from Don Tai, on appreciating the Chinese language.

These are opposites and say the same thing:

• bu4 tong4 zhi2 teng4 不通只疼 If there is a blockage then there is pain;
• tong1 zhi3 bu4 teng2 通只不疼 if there is a clear path then there is no pain.

This is some word play she is doing.

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[46:33] So let me explain a bit. The first bu tong zhi teng, the bu tong here means a blockage. No passage. No right through passage. A blockage.

[46:48] So, if there is other words … At the second bu tong zhi tong, the second tone — although it sounds the same to a person who doesn’t know Chinese — the character is the << ? >> because the second tone means pain.

[47:09] So, bu tong zhi teng, means if there’s a blockage — blockage of what? — of qi, if there’s a blockage you’ll feel pain.

[47:18] Now the second bit tong zhi bu teng, the first tone in the second part is, if there’s no blockage, there is no pain.

[47:33] So the whole thing, bu tong zhi teng, tong zhi bu teng, translated it means, if there’s << spot? >> blockage, there’s pain.

[47:52] If there’s no << pop with? >> blockage there’s no pain.

[47:57] So in other words, then what does acupuncture actually tell us, when the patient comes to your consulting room, if you were a Chinese practitioner, medical practitioner? Ah, you will say, where’s the pain, right?

[48:12] Oh, of course, the patient is usually voluble, and can tell you without prompting, even, and so says, oh it hurts here, or it hurts there, or it hurts somewhere, pointing to a bit of the anatomy.

[48:25] And, of course, the Chinese medical practitioner would then take the pulse, ask questions, look at your complexion, and with these four diagnostic methods, pseudo, he would come to an assess, or she will come to an assessment, of what is wrong with you.

[48:44] And then, ah, then the practitioner would say, right, if I’m an acupuncturist — you need acupuncture. He might prefer to use medicinals but imagine, like Ephraim, who prefers presumably to choose acupuncture. I don’t know, I’m attributing it to him.

[49:03] He will then work out which is the right place to poke, you know, to stick the needle in, which is the correct xuewei of the jingmai, on which jingmai, you know, which will then unblock the blockage of qi. And once he unblocks the blockage of qi, there’ll be no more pain, right.

[49:26] So that is why, to me, this methodological postulate is very important. Because it directs the clinician’s attention to how to treat the patient.

[49:38] So your attempt is simply to unblock the blockage of qi, and when you have unblocked the blockage of qi, that lo and behold, the patient will tell you, ah daifu, there’s no more pain, right? No, if not immediately, at least a few days, or after a few sessions. It doesn’t mean that after one session you might be cured.

[50:13] Sometimes it requires a few sessions before you can tackle the business. So anyway, that is that.

[50:20] So, that’s a fundamental distinction very radical distinction between these two sets of medicines. And nothing presents the difference quite so drastically as in the notion of acupuncture. Because in acupuncture — as i keep repeating, and it may bear laboring the point — you are dealing with qi-in-dissipative mode.

[50:52] That’s why one owes it to the Zhuangzi, the Zhuangzi, for drawing attention to the distinction between qi ju and qi san.

[51:03] I don’t normally see this distinction much talked about, even in medical texts today in Chinese, written in Chinese. I’ve come across it before, but it’s not as often emphasized as you might think. So I think to pay a due respect and acknowledgement, we should put it Zhuangzi for having drawn our attention to these two modes of existence of qi.

[51:36] So that is why Chinese philosophy and Chinese medicine is not simply about the body, the physical body here. Never mind understanding the body as a machine. But just this body is not simply understanding around this body but understanding the qi circulating in this body as well.

[51:58] And so that is why in Chinese philosophy and medicine, nobody would be interested very much, in what a corpse is. Because a corpse has no live qi.

[52:17] So admittedly, and Ephraim will remind me of this, I’m sure, when a person dies, for a first few hours, the relatives people around the dead person wouldn’t notice much change. Quite often, the dead look as if they’re asleep, right? But if you don’t bury the dead straight awa,y after a few hours, and leave it lying about for seven days ah then it’s a different matter.

[52:49] It is no longer a qi-in-concentrating mode, a thing in the body, but the body, you know, becomes qi-in-dissipating mode, and you wouldn’t like that.

[53:03] And so, as a result, Chinese medicine doesn’t pay any attention to the corpse, because a corpse exquisite, has no qi-in-dissipating mode flowing through it, running through it.

[53:22] Whereas BioMedicine say, you cannot kill people, we cannot give you certificate to certify you as a proper doctor if you didn’t know your anatomy, if you didn’t know your bits of your skeleton, bits of your tissue, and now bits of your DNA, as well.

[53:41] So they are concentrating on single ontology and qi-in-concentrating mode at the expense of qi-in-dissipating mode.

[53:57] But in Chinese medicine you are concerned with both, because if something is wrong with your qi-in-dissipating mode, it will express itself as felt pain in a part of your body. And your body is qi-in-concentrating mode.

[54:18] So it marries, as I say before, thing ontology and process ontology, because qi-in-dissipating mode is about physiology. it is about function, and function is a process not a thing.

[54:43] So it marries the two: thing ontology with process ontology.

[54:53] So, in this sense I think, if you go back to acupuncture, you will see how this works … you can work out for yourself, those of you who know more about acupuncture than I. How qi-in-dissipating mode, in which you emphasize on, but not necessarily to the expense of qi-in-concentrating mode, you try to to combine both modes in your practice, in your theory and your practice.

[….]

[55:52] I’ll move on to a slightly different, though related, topic right now.

[55:59] I want to show that how Chinese medicine operates in practice, because i’ve been talking about high theory quite often. Too much so, according to some people. Now let me descend to the ground a bit more.

[56:19] And that is to talk about what sometimes is now called the four P’s in medicine.

[56:28] I don’t want for the moment to talk about the analogous four P’s is in BioMedicine which has developed,just eight or nine years ago, but I talked about the four P’s of chinese medicine.

[56:47] That chinese medicine is predictive, << modern? >> P; preventive, second p; personalized, third P; fourth P, participatory medicine. So four P’s, right? So what do I mean by the four Ps?

[57:14] Prediction. I’ll just do prediction and prevention together, because according to Chinese medicine, which is again absurd to modern BioMedical ears, if you know how to diagnose, your diagnosis will immediately lead you to an understanding on how to treat the patient. So I’m going to treat the two P’s prediction and prevention.

[57:51] Now I will choose an example which I have already used yesterday, because I think it’s good. It refreshes people’s mind. And I don’t have to cope with more examples. So I’ll use an old example which I used.

[58:05] If you remember yesterday, I said from the writings of Liu Lihong, I have got this particular narrative, this particular story, and that is that a particular, very distinguished, therefore excellent Chinese practitioner physician, who is therefore a shang gong and not a xia gong. A xia gong is not a very competent practitioner. A zhong gong, which most practhitioners are, they are competent but not really distinguished. But this is a genuine shang gong, really very distinguished, I’m told anyway.

[58:51] So this particular very distinguished practitioner took the assessed, the mai profile of a particular patient. And he said that, look there’s something wrong with you, because it is now winter and you are not presenting a mai profile which is consonant with the season of the year, because it is not a winter mai that you are showing, it is a summer mai.

[59:25] So qian ren xiang yin, macro micro cosmic wholism, means that you are out of synch with. Your microcosm is out of synch with the macrocosm. The macrocosm out there is winter, but your microcosm is overpowering already. Whereas in winter, yang qi is very subdued.

[59:48] So he diagnoses, and therefore he predicts, that if you don’t do something about it, come this summer, bring the yang qi in summer is at its maximum, and added to your own disorder already, you add to the yang qi from the outside world, oh you’ll be a goner he said.

[1:00:14] This man was very stubborn. He says no, there’s nothing wrong with me, he said. I don’t believe in your bumble jumble anyhow. You’re not scientific. I believe in Western medicine. Western medicine isn’t wrong but we haven’t been through all the tests. So if I’m fine, fine, fine. Nobody can force another person to have treatment, anyway.

[1:00:32] And so, okay come this summer, the following summer, indeed the daughter of this chap then rang up the physician who had diagnosed her father, and said, I’m afraid father had gone because the yang qi was overwhelming. I think he had a heart attack of some kind. So he was gone. Right, you say.

[1:00:55] So you say prediction, diagnosis, … prediction and prevention go together. So he knew that his prognosis would be correct and and so on.

[1:01:10] Now that personalized medicine …. I’ll give you a story, this time not from Liu Lihong, but from another very very distinguished writer, a practitioner, a scholar, scholar practitioner, called Hao Wanshan. Now I think Hao Wanshan is today acknowledged in China as an authority on the Shanghanlung. So I’m only borrowing from him. I take it he is the authority, to which I bow lower deeply, and so this is what he tells me.

[1:01:54] Personalized medicine he said during a particular flu epidemic in Beijing, some time ago — not this epidemic but another earlier epidemic — a couple came along to see him. And this couple then said to him – the woman was obviously the person who wore the pants in the household, right, in this couple — so she says, daifu, we have been to see the medical, the BioMedical doctors. And they say that we have the same virus, it’s flu. So you just give one prescription that will do duty for both of us. Because they suffer from the same thing.

[1:02:48] So Hao Wanshan was quite shocked by this, and patiently explained to the couple, the patients. He said look, this is you’re giving me an account of the illness from the BioMedical point of view, but I’m not a BioMedical doctor, I am a Chinese physician, and so I diagnose differently. I have to diagnose each of you separately, because it is personalized medicine that I do. I don’t do, you know …. Of course, this is not to say there is no mass produced formula in Chinese medicine but it’s always a faute-de-mieux, faute-de-mieux, because you have no time in an epidemic, you suddenly have no time to see individual patients, so you do have, you know, mass produced stuff.

[1:03:36] But ideally it’s personalized medicine. So, in the end, what it turns out is, the woman wore the pants. She was the extrovert. She was a person who dictated terms to the husband. The husband was a mouthy fellow. An introvert. And so the physician, Hao Wanshan, diagnosed accordingly. One was an extrovert. The other was an introvert. But therefore the personal condition was totally different according to Chinese medicine. But to cut a long story short, he had to give them two separate different types of medicinals, in order to cope with that, with their situation. And it turned out why the woman was so keen that they share one prescription [was] because her workplace had covered her with work insurance. So she said, whereas if the hospital knows i had a separate prescription he won’t be covered, then we’ll have to pay out of our own pocket. So why not save costs, so by asking for one prescription. So that was her thinking. So that was very funny. So that is you know what is meant by personalized or individualized medicine.

[1:04:56] Each person, technically, from the BioMedical point of view, you may have the same virus in you.

[1:05:03] So today a SARS-COV-2 might come along. Yeah, indeed, one has SARS-COV-2 but it doesn’t mean that your COVID-19 is the same as somebody else’s COVID-19.

[1:05:15] According to the Chinese practitioner, you’re one, you need a different types of treatment, all together, right? That’s it.

[1:05:22] Now participatory medicine. What could that mean? Hao Wanshan also gives, what I think is, a very a lovely example of what the Chinese practitioner means, medical practitioner means, by participatory medicine.

[1:05:41] He describes a client, a patient. This woman came in one day, looking very, very, cross very very angry. And then she also said she had a stabbing pain in the throat. Pain in the stomach.

[1:06:08] Well, anyway, she was all worked up. She couldn’t sleep. Insomnia was what she suffered from, as well. So she couldn’t sleep at all, right? Et cetera, et cetera.

[1:06:21] Now, Hao Wanshan then probed her, through the technique of asking the patient, wen,

[1:06:28] So through asking, the asking technique, he got her to put in the story of why she’s so angry. It turned out that a woman, her neighbor, wanted to build a kitchen against her external wall, by the side. And in digging up, to make the extension, the woman discovered that it was a huge boulder which came out from the ground. So the woman tried, the neighbor tried, to remove it. And she and others in the neighborhood, in the community, only managed to move the stone so much, and no further because, you know in Beijing, as those of you who have been to beijing know, these passages the huatong, are very narrow.

[1:07:29] So the neighbor only managed to move the large boulder, to a certain extent, of the huatong, of the narrow passage, but couldn’t get it out any further. And it just happened that the boulder stopped in front of this woman’s house. So this woman was irate. And she was even, because she said every day when she comes with her bicycle, she had to carry the bicycle inside into her house, carry a bicycle out of her house, over the boulder.

[1:08:02] That was, of course, inconvenient. And furthermore, she said when she got very angry with the neighbour, the husband tried to calm her down and said you cannot blame the woman, you know, our neighbor. She did ask for permission. She did ask me, and I said there was no problem about her building an extension leaning against my external wall.

[1:08:26] And it’s not our intention to block the passage. [It] just happens that the boulders too large to be to be carried, to be carried out. And this irate woman then said, of course, this is your story, but I know that you fancy her anyway, because she’s prettier than I, and she should play the role of the jealous housewife, she says. You can see all these going through, all these emotions. And in the end she had a terrible complexion. She suffered from insomnia and all other ills.

[1:09:00] And so finally Hao Wanshan diagnosed that there was hua, that there was this heat in her liver, because liver is the seat of of heat you say. And Hao Wanshan, however resorted to the means or technique in Chinese philosophy, and which is in certain circumstances you do not describe medicinals nor do you do acupuncture. You use other means. What other means did Hao Wanshan, non-medical means, altogether, to cure, to treat this patient?

[1:09:44] He asked questions about where she lived. And bells began to ring in his mind. He said, ah, you probably lived in a place which was, once upon a time, occupied by a very high Manchu official who had a vast garden. And, of course, Chinese rich people, including, you know, scholar officials and so on officials, they import into the gardens boulders, rocks, which, from the aesthetic point of view, they think it improves the garden. Whether modern people think so, it’s another matter. But they did, right?

[1:10:30] So Hao Wanshan deduced that it must be that this important official, whose ancient residents these characters are now living nearby, introduced this great big boulder. So he deduced it must be a very beautiful piece of boulder, too. So he said, may I come along to your house to see what the boat is like? So he went along to the woman’s house. The woman showed him. Ah, he said, that’s right, it’s a beautiful boulder. You can’t get it out. It’s obstructing the way. The woman is angry. No amount of medicine, in form of acupuncture or decoction, would help such a person. Let me transform the landscape for her.

[1:11:19] So, this is participation. That’s a huge answer. He said, now look, he said, let’s get the young men in the neighborhood with strong arms. We will shift the stone in a way, as far as we can, and in a position from which you can appreciate it best of all, from your window, or from your door when you open the door each morning when you get out to work. And he’s got the young men to do that. Then he got the young man to scrub clean because it was covered with soil, and filth for many many decades, like a century, a century, if not more.

[1:12:00] Scrubbed it lovely and clean, a beautiful boulder. The grain of this rock becomes clear. And so then he suggested, now then, why don’t we buy some plants, lovely plants, and plant them with soil, around the border of the stone. And he says now, in a few months time, I’ll come again and see what the new landscape would be. Oh, he said, even before he could go and see the patient’s house himself, the patient’s burst in one day looking a totally changed person. This time, no more anger on her face, smiling, looking, complexion looking good, and the moment he walked into his consulting room he said, she said to him, they said, oh it’s looking beautiful now! He said, you have transformed the whole landscape. It’s beautiful! They said, you know, daifu, today at night, I don’t even close the door. I sit, you know, with the open door to admire the landscape as long as I can, before I go to bed. And it’s so soothing, and so lovely so nice.

[1:13:25] And so Hao Wanshan went along to see it. Indeed it looks very beautiful because the << palms? >> had gone. The plants were flowering. So, he had to produce a different landscape for her to enjoy, a pleasurable landscape. So he used no medicine. He cured the woman.

[1:13:40] So this kind of participation, such as it is, peculiar to Chinese medicine, I cannot see, you know, my doctor, my brother BioMedical doctor, coming around and prescribing things like that to me.

[1:13:58] The most they might say, oh well, your job is very stressful. Change your job. Well telling people to change that job is easier said than done. I mean, where would you get your a new livelihood just changing your job?

[1:14:10] So this neither here nor there. But that’s a limit to the extent they will ask, they will use non-medical intervention, to solve your problem. But this one, actually, designed a landscape for the patient, and participation.

[1:14:29] So that’s why, I think, it’s very a lovely story to tell. “And it’s a very nice story to tell./

[1:14:34] So, these are the four P’s of Dhinese medicine.

0210617 SSFS8 LEE Kee Kok – Philosophy of Chinese Medicine 2

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The philosophy of science underlying Classical Chinese Medicine, in this lecture by Keekok Lee, provides insights into ways in which systems change may be approached, in a process ontology in contrast to the thing ontology underlying Western BioMedicine. This online web video lecture is a complement (and update) to two prior books:

• Lee, Keekok. 2017. The Philosophical Foundations of Classical Chinese Medicine: Philosophy, Methodology, Science. London: Lexington Books. https://rowman.com/ISBN/9781498538886/The-Philosophical-Foundations-of-Classical-Chinese-Medicine-Philosophy-Methodology-Science.
• Lee, Keekok. 2018. Classical Chinese Medicine: Theory, Methodology and Therapy in Its Philosophical Framework. Newcastle upon Tyne, UK: Cambridge Scholars Publishing. https://www.cambridgescholars.com/product/978-1-5275-0397-7.

Highlights from the transcript from the Youtube recording are provided below, in the interest of scholarship.

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[0:40] Now, what I’m going to talk about basically is, as [Kho] Tong Yi has introduced me, from this vantage point of a philosopher trained in the analytical school of philosophy, but who has taken an interest, first of all in the philosophy of biology, then in the philosophy of genetics, in the philosophy in ecological studies, etc.

[1:10] And so, with that background, I then turned my attention, naturally, to the philosophy of of medicine.

[1:20] Now, for the purpose of, I mean, as you know, the subject is immensely complex and immensely large, so to narrow down somewhat, what I propose to do in these two days exploration with you, is first is really to concentrate on the philosophical framework in which the medicine is embedded.

[1:48] And having excavated the philosophical framework some of the major concepts in which the philosophy in which the medicine is embedded, then I will, later on, probably tomorrow, in the second exploration to talk about the methodological implications of such a body of philosophical medicine.

[2:24] So, basically, that’s the rough outline of what I’m going to do.

[2:30] Now, first of all, too, let me, as a philosopher it’s in my DNA to start everything off by defining my terms.

[2:40] So, I better get it off my chest before I say anything else.

[2:45] And now, how do I use the term Chinese medicine in these two explorations I hope to do with you, to share with you?

[2:58] First of all I am simply referring to that system of medicine which is, in the sense you can say, is by large indigenous to china and the chinese culture and civilization, as far as I know that is.

[3:19] Obviously, I don’t know everything about this subject, because as subject is very vast and very complicated and very large, and historically it has lasted I think probably more than 2,000 years.

[3:32] So, obviously there’ll be large gaps in my own knowledge.

[….]

[5:33] Now, the next big point I want to draw your attention to, is that in my understanding of philosophy, and its implications for other disciplines and domains of intellectual activity, it is this, I am what may be called a practical philosopher.

[5:54] I don’t know whether other people have ever called themselves a practical philosopher. I know that some people have called themselves an applied philosopher, but I’ve not an applied philosopher. I am, I think, a practical philosopher, in the sense I take an activity such as medicine or such as ecology or whatever it is that one is looking on, and then as a philosopher having been trained in analytical school or philosophy, I then use certain methods of understanding the subject.

[6:32] So I use a set of methodological tools if you like, upon the first order activity with which I am commenting on, so in that sense then I call myself a a practical philosopher and not an applied philosopher.

[…]

[7:56] Now, I would like to introduce it by, as I say, relating it to a general philosophical framework, so that philosophical framework will then lead me into talking about certain major texts in Chinese philosophy, in order to show in what way Chinese medicine is embedded in such a larger philosophical context.

[8:26] So now then the characterization, in a nutshell that I would give, if you press me at this moment in time, is to say that I would characterize chinese philosopher medicine as “yi dao yi”.

[8:46] Now the first yi is the yi of the YiJing.

[8:52] Dao is the dao of Laozi.

[8:59] And yi, the third syllable, as they were, the third character of the “yi dao yi” is medicine.

[9:10] So in other words, yi dao yi, which the chinese call << ko yi?> bai, themselves call it bai, is therefore embedded in the central philosophical concepts of the heating, of of the DaoDeJing or Laozi.

[9:33] And the ancient chinese have, I suppose if you like, combine these ideas into a systematic whole, if you like, so that in the end you’ll have a system of medicine which we today call chinese medicine and which they themselves call yi dao yi.

[….]

[11:43]
Take Aristotelian science, which is medieval western science. Because, to remind you audience very quickly, first of all, in the western tradition you have the ancient Greek philosophers.

[….]

[13:17] Now then, if you want to understand Aristotelians, Aristotle, science, particularly science of biology, you’ve got to understand Aristotle’s four main causes. The four main causes are being: material, formal, efficient and final.

[13:40] Now take a statue. Say we have a statue. of … Alexander the Great perhaps, riding on his horse Bucephalus.

[13:56] Now, the material course is quite clear. It’s probably made of bronze or stone or whatever fancy material people might like to make a statue of.

[14:07] The efficient cause are the sculptors themselves, or a sculptor who done it.

[14:11] Then, the formal cause is, he must carry in his head and blueprint, if not actually on a bit of paper in front of him, he carries in his head, of what Alexander he thinks might look like, what his horses might look like, what someone riding our horse might look like, the posture of the horse, and so on. So that is the of formal cause.

[14:36] And then the final cause is the reason why he’s sculpturing it, why he was doing the sculpture. And it could be because his society, of which he’s a part, has commissioned him to do it, because his community likes the idea of Alexander the Great being a cultural hero. And to celebrate a cultural hero, you’ve got to put up a statue in your town square or plaza or something.

[15:01] So, you have four main causes, right?

[15:05] Now, come after the enlightenment, come modern western science, and modern western philosophy, to back up the modern science, Aristotle’s four causes were pared down to two. We got rid of two of them. The two of them which were not acceptable — they were considered to be metaphysical in the abusive sense of the word metaphysics — because they intervened a philosophy called positivism.

[15:36] And positivism does not like metaphysics in the abusive sense, because they equate it with unintelligibility, with absurdity, with nonsense.

[15:46] So what are the two causes that they found metaphysical and therefore offensive and acts from aristotle’s schema of explanation? And that is: the final cause, and the formal cause, they say no good, we don’t want to investigate into people’s thoughts you know, subjective stuff, not objective. Modern science, you must remember is very objective and quantitative, so no, no, no good.

[16:15] So formal causes, axed. Final cause, also. We don’t care, you know, natural phenomena has no final cause anyway.

[16:28] So, what we are left with is the material cause, and the efficient cause. So, that is how we understand modern science, how we understand natural phenomena today following this kind of philosophical framework.

[16;50] Now, so that is so to give you just one example ,…

[16:58] Now, in Aristotelian science, particularly during the medieval period of european science and philosophy and history, how do you explain the law of accelerating, or of acceleration? If you would throw a stone on the top of the tower of Pisa, let us say you’ll find that the object falls faster and faster, as it reaches the ground.

[17:24] Now, an Aristotelian physicist then explains this in this way. You see every object has its own natural home.

[….]

[18:07] Now then, so a stone is a heavy object, so if you throw a stone from the Tower of Pisa, let us imagine, that heavy object falls to the ground, because the home is the ground. So Aristotelian physicists tend to interpret the speed of acceleration in the following manner. They say: imagine yourself, you’ve been a long way visiting, as a tourist going around the world, and you’re now finally at the end of your trip, and you’re coming home to see your family, your loved ones. So as you got out of the plane your heart thumps, you walk a bit faster ….

[….]

[19:20] So finally, when we get out of the taxi in front of our home, and the door opens, that is when we get really the most excited. And so that is why you walk faster and faster. You run faster and faster as you reach home. So it’s the same with the stone. The ground is its home. So it’s joyful, and as it is because it’s joyous, and a joyful thing to do, it goes faster and faster so that is how Aristotelian medieval physics explain itself.

[19:58] Now, to a modern physicist,. that is a piece of nonsense, because a natural phenomena has no feelings. It has no thought. Nothing like that. It’s all objective quantitative science that we are doing.

[20:15] So therefore, we don’t need the formal cause. We don’t need the final cause.

[20:22] All that we need is the material cause. So the material cause, in this case, is the stone, right? And it has certain characteristics, as I say. It’s heavy. It has a certain mass. It has a certain density, etc. etc. If the stone is not of that character, then, but it’s more like a feather, then it wouldn’t fall faster and faster as it reaches the ground, right?

[20:53] And the efficient cause, the efficient cause has nothing to do with mental characteristics which the investigator have. It is to do with what we will say you know the the atmospheric pressure, the signs of friction. All these things are signs of aerodynamics.

[21:17] All these factors will then, you know, influence or impact upon the way that the stone falls to the ground, or a feather floats in the air, or whatever it is we are trying to explain. So, that is it.

[21:34] Now then, so this is modern science, and modern, embedded in modern philosophy.

[21:41] Now if you look at Chinese medicine which is the science — as at least I claim it is a science — if you look at it, it has nothing to do, you know, with our understanding of modern physics or modern biomedicine. So how would we understand what the chinese themselves call yi dao yi. So to understand yi dao yi, I have very quickly then to tell you what the basic philosophical texts are in which the medicine derives itself from.

[22:24] So the yi of the YiJing, let’s start with that now. For the English speakers maybe I should also call it the I Ching.

[….]

[23:10] I prefer to talk of the I Ching, for the simple reason that, in the history of of the YiJing as a text in chinese understanding, there are various versions of it because, come the Zhou, from the Han dynasty, the Han people, the Han scholars, added a part to it called the Ten Wings, or whatever it’s called, and then it became it came to be called the ZhouYi, right?

[23:41] So I’m not talking about the ZhouYi, because the ZhouYi has a modern part to it.

[23:45] For my purpose, the Han yi is already too recent. You’re going to go back to the really old parts of the YiJing. So that’s, I think, the oldest part of the YiJing, you know. It’s the YiJing, not the ZhouYi.

[24:01] That’s why I call it the YiJing.

[24:05] Now, if you ask me how I get the YiJing, again, you know, I don’t want to go into a long history about the history, the historiography, because we are not here to talk about historiography, but i’ll simply say that Chinese scholars themselves, probably, would put it somewhere during the warring states period which will mean that it is, at least, as a mature text, as a mature text, you know, something like, over 2000 years ago. So let’s be as vague as that, so no need to be more precise.

[24:49] Now, I’ll come back to this point in a minute, but let’s move on a little. So what is peculiar about the YiJing, now? To those of us who already know something about the YiJing, the teaching is commonly understood as a divination text. Now, it’s very strange to think that a divination text could possibly have anything to do with a thing called Chinese medicine, which I claim to be a science. So, a mystery about that.

[25:27] So let me quickly explain away some of the puzzling features of this, of this plan.

[25:35] Now, although it began as a divination text — filled out it was — it began its life as a divination text, I think Chinese scholars are, on the whole, convinced that very soon it was not simply a mere divination text in the normal understanding of the term, because officials and scholars worked upon the text to turn it into a set of as a set of diagnostic and predictive tools if you like, and prognostic tools, diagnostic and prognostic.

[26:17] A set of tools, analytical tools, which can then be used to explain various domains of phenomena. Of course, one domain of phenomena the Chinese people were very interested in, was in the art of ruling. So as you can say, then it is used in political discourse.

[24:40] Another area is is in medicine, because we need help to know how to diagnose and prognosticate, you know, the trajectory of an illness etc., etc.

[26:53] So, it is in this context, then, that I say that it is a set of diagnostic tools, analytical and diagnostic tools, to understand phenomena, medical phenomena, as well as enable us to prognosticate.

[27:15] Now, why is the YiJing so helpful? To understand that, you’ll have to say, in that sense too, I’ll have to break in at this at this moment in time, a point made implicitly by the DaoDeJing, by Laozi, because Laozi, the texts go out, didn’t actually use the term yinyang, as far as I know. But you can never, you would never, understand the text itself, without having the concept of yinyang, so when all is said and done, the YiJing and the DaoDeJing are really talking about the basic metaphysics of Chinese thinking, Chinese culture, and Chinese civilization, and that is yinyang.

[28:14] And because we are talking about yinyang, now, and I would be emphasizing this you are really talking about, you know, wholism in what sense then is this committed to wholism and therefore never to reductionism as a methodological postulate.

[28:44] So, now let’s just go back to the YiJing. The YiJing, as we all know has got the bagua. The bagua is normally translated as the eight trigrams, right? And if you have eight trigrams, if you were to do a quick permutation of the eight trigrams, I think mathematically — I am no good at maths, but I trust other people’s calculations — the permutation will turn out to be 64 hexagrams. So you have eight trigrams and 64 hexagrams.

[24:29] Now, if you look at a trigram, a trigram is, what in Chinese, what in English I would say have three components parts. That’s why it’s called tri, it is three parts. And in Chinese terminology, they’re called the three yao [lines]. So one yao, two yao, three yao.

[29:52] Now, a yao is — consists of — two possible types of constructions. One is what may be called an unbroken line. The unbroken line stands for yang, and the broken line stands for yin,. So that is why yinyang.

[30:21] So now, I think at this stage I may have to go into a diagram.

[….]

20210616_3130_SS8_LeeKeekok_PhilChineseMedicine1.png

[31:26] If you concentrate on this, this is one yao [line], two yao, three yao, Usually we start from the bottom, but it doesn’t matter for my purpose where we start from. So this unbroken [line] is a yang yao. This broken one [line] is the ying yao. So it forms, later on we shall see, it forms the whole, right?

[31:49] So, that is, simplistically, what it is when the Chinese talk of yinyang. They’re actually, I think, talking about yin qi and yang qi.

[32:09] Now, how do we understand yin qi and yang qi? And this takes us into the cosmology and therefore the philosophy of Chinese medicine, behind Chinese medicine. Noow to understand this let me go further, further down.

[32:31] Now, this is the famous iconic figure, right? I don’t need to say any more about this.

20210616_3240_SS8_LeeKeekok_PhilChineseMedicine1.png

[32:37] But if you look at this picture you will find that …

[32:45] Oh, let me go to this one first.

20210616_3255_SS8_LeeKeekok_PhilChineseMedicine1.png

[32:47] You will find that this one is really an attempt to show people about the yin qi and the yang qi.

[32:57] So, start with winter. Now winter is the time where the yang qi stays in the water, according to the Chinese cosmologists, goes into the ocean. Now there’s some empirical evidence for this.

[33:12] I believe, according to oceanographers, actually water retains heat much more than the surface area of earth.

[33:26] So, in that sense, it’s quite correct to say that, you know, the yang qi stays in water, whereas on the surface it evaporates, it vanishes once winter has come.

[33:40] Now if you look at this gua, what you say, it stands for winter.

[33:57] This trigram stands for winter, and so you can see just as winter ends the yang chi starts to rise. So I say ascending spring establishes.

[34:13] So, this is spring and then the yang qi floats up to this gua, which stands for summer so you can see that this gua [trigram] that stands for summer has two yang yao [unbroken lines]. This gua [trigram] which stands for winter has two yin yao [broken lines], so it expresses the difference between the two. And then in the autumn the yang qi starts to descend.

[34:43] In other words you lose the yang qi and the ying qi starts to rise. and then the yang qi sinks and finally sinks back into winter.

[34:53] So it is, in other words then, I would like to draw your attention, to some ears it might sound, it might just feel very strange, that I will refer to Laws of Nature in Chinese science and Chinese cosmology for the simple reason, because normally when people talk about Laws of Nature, they have Newton’s laws of nature in mind, which are quantitative laws, objective quantitative laws.

[35:26] But yet I don’t see why I shouldn’t borrow this use, the same concept about the laws of nature. But this time, in writing, I would put them in an italicized mode. So but when speaking, I will just qualify by saying, bear in mind that I’m talking about Chinese Laws of Nature, which are not quantitative, at all, although I think they are objective but they are not quantitative, whereas the Western laws of nature are quantitative.

[36:00] Right, so I’ll keep on using the Chinese Laws of Nature. Now, the Chinese Laws of Nature basically, some people say, are two. But I think that actually they can be reduced even to one. So whether you’re talking about one or two, it doesn’t matter, because the concept is the same. Now take one of the Chinese Laws of Nature which are commonly called the zhou ye xie lu which translated roughly, would be the daily, the days sequence of, the daily sequence of night following, following day, and day giving way to night again, you know.

[35:58] And if you’re talking about this si shi jie lv, then you are talking about the four seasons in the annual cycle

[37:12] Spring followed, is followed by summer. Summer is followed by autumn. Autumn is followed by winter and then the cycle really could uh continues a deux with spring, blah blah blah blah blah.

[37:30] Now that is why, in the end, there is also another law, which the Chinese seem to have a law of nature which is called zhou er fu shi, which I would translate as cyclic reversion. And this is precisely what I have just said.

[37:52] So when winter arrives, you can expect next year spring will occur, and spring will be followed by summer, summer will be followed by autumn, autumn will be followed by winter. So it’s cyclic reversion, the cycle starts all over again. And that is why it is sustainable. It is sustainable because it’s cyclic reversion, right?

[38:22] It’s the same with daylight, as opposed to night time. The daily sequence starts up all over again. So that is why I think … I’ll mind you …. Before I go on, let me just quickly add the thought which has just occurred to me now in this cyclic reversion.

[38:48] One is not saying that the next winter, which comes, is going to be identical to the last winter, which has just passed. It’s not to say that because there are differences in winter, differences in summer, every year, especially if we live in this island called the UK, which I do.

[39:09] You can begin to see some winters, you know, coming dreadfully cold with frozen ground, thick ice and so on, and another winter that is very mild. So it doesn’t mean that that they are identical. There are tremendous differences, one winter from another winter, but nevertheless there’s continuity as well as change.

[39:35] And so that is why, at this point, you’ve got to go back to the Yijing, because what is the meaning of yi in the Yijing? The term yi in the Yijing means change. Originally, in fact, the Yijing is based on observation of the weather. The weather changes, so the ancient Chinese thinkers build a metaphysics, a cosmology, from their observation of what they see about natural, of natural, phenomena. So the ancient Chinese, after one minute the sun is out, the weather is fine. Another minute, the sun goes behind clouds, it’s no longer fine but dark and gloomy.

[40:28] So when the sun shines and the sky is full of light, well, you call it yang. This is because of the sunlight. The light comes from the sun so it’s yang, taiyang, which means sun. And then yin is the shadow. So where the sun hides behind the cloud or the clouds gets in front of the sun then it’s yin. It’s not fine.

[….]

[41:05] .. from before I said I’m constantly amused why it is that the ancient Britons never tumbled to the Eastern concept of change. Because in Britain the weather is even more changeable than it is in a continental climate like China. But yet, for some odd reason, the ancient Chinese tumbled to it, and the ancient Britons didn’t. So, that’s my joke.

[41:32] Right. So if you have so the yi of the Yijing means change. But bear this in mind Chinese thought is what I call dyadic. In other words, it’s the polar contrast between yin and yang, do not conflict and oppose each other. That is western dualistic thought, the Chinese do not have that. The Chinese have dyadism. So with dyadism, the polar contrast of yin and yang of change, with that, the notion of change, therefore also implies the notion of constancy.

[42:21] So, in spite of change there is also constancy. So it’s this very complex relationship between polar contrasts, the Chinese philosophers, and therefore Chinese medicine, I think, are after. That behind yang is therefore yin. Behind yin is yang. And the two do not clash and conflict following Aristotle’s. Why is it in the west that polar contrasts are treated as [diagonally opposing] diametrically opposing, and conflicting?

[43:02] I think we have to go back to our Aristotle. My famous example is Aristotle’s principle of excluded middle. Aristotle’s principle of exclusive middle, put simplistically, simply runs like this:

[43:16] P, or not-P. Either P is true, or not-P is true.

[43:29] So when you have this, you have conflict. Because… Let’s take a religious example.

[43:37] If I believe in an Abrahamic god, but your god is not Abrahamic, right, so either I’m right or you are right, but both of us cannot be right, because the principal of excluded middle permits only one of the two sides to be correct. So naturally, especially if I am an important economic military power, Ii would say my version of Abrahamic, of religion, is correct. You not out there, you know, no good, you are wrong, and therefore I impose my view on you in the name of truth and validity. And so that’s how you can get really oppositional, a very, very, conflicting and, diametrically opposed answers, that people take.

[44:39] But it’s chinese philosophy, because it doesn’t believe in the dualistic conflicts of that, and the principle of excluded middle, as shown by these trigrams.

20210616_4500_SS8_LeeKeekok_PhilChineseMedicine1.png

[44:45] If you go back to … the trigram. The eight trigrams, the bagua, you can see that there are eight positions, not two. Now , this is the qian gua [south, top of page]. This this is the kun gua [north, bottom of page]. This [qian gua] is the fully yang. This [kun gua] is the fully yin, right? But there are two extremes. But in between, you have a variety of permutations which, in fact, incorporate the yinyang components polar contrast, in somewhat different ways, in each of the two things.

[45:29] So that is why it’s a subject which I can’t talk to you about in great detail, today. That’s why I think that ancient Chinese philosophy are logic — I mean Chinese philosophy has no formal logic, that is quite correct — but having said that, it had an implicit logic. And the implicit logic isn’t the ancient value logic that we take for granted.

[45:56] And don’t talk about the hexagram, right, over 64 values, I can’t cope, I could barely cope. So it is actually an anticipation, of what today, we call fuzzy logic.

[46:13] If you look at logic textbooks today, since the 20th century the latter part of the 20th century, there’s such a thing called fuzzy logic. And fuzzy logic is, in fact, also both sets of logic, a dualistic logic of qian and kun, and couldn’t exist in computer, and in computer logic technology, because the qian, yang gua, is the three yao, is simply represented by one. And the kun qua, the three yin yao represented by zero. So computer technologies one and zero, so it’s really you know these two extremes that you’re using.

[47:01] But fuzzy logic also today uses the rest of these, as may be represented by the other members of the trigram now.

20210616_4720_SS8_LeeKeekok_PhilChineseMedicine1.png

[47:22] So you see how it is that, therefore necessarily, you have to understand yinyang in terms of this, by now very very familiar iconic symbol of the yinyang. I don’t need to go into it in great detail, but just to point out why it is that they form a whole, because the whole of chinese philosophy, cosmology, and therefore of all its activities, including medicine, is a wholistic one.

[47:59] Now another way of putting the point is to say that in chinese philosophy and cosmology, which underpins Chinese medicine, is what, in Sinological discourse, is commonly called correlative thinking.

[48:20] Qian ren xiang yin or qian ren he yi.

[48:38] Qian ren xiang yin I think is found more in medical texts. And and qian ren he yi is found more in other contexts. But I prefer therefore to use qian ren xiang ying which Sinologists translate as co-relative thinking.

[48:59] But that is according to me. I don’t buy the data translation because I think the translation makes it sound like a piece of epistemology, whereas I think it’s a piece of metaphysics. It’s a piece of ontology and that is why I translate it as the macrocosm and the microcosm.

[49:26] There’s a macrocosm out there, in this universe, and there’s a microcosm. But what happens in the macrocosm is in the microcosm, reflected or resides also in the microcosm. So that is why you say, if greater nature of that macrocosm has yin and yang, so in us, the microcosm we must also have yin yang because of qian ren xiang ying.

[50:00] So I call this — this is a mouthful — macro micro cosmic wholism. Macro micro cosmic wholism.

[50:16] Call it what you like. But to grasp what I’m saying, for the moment, for the sake of understanding, what I said you’ve got to work with my understanding that it’s a piece of ontology. It is piece of metaphysics and not correlative thinking. Correlative thinking, I think, don’t capture the the spirits and the essence of of the subject.

[….]

[51:20] So you can see yinyang is at the top, and the yinyang is presiding over this via qian ren xiang ying macro micro cosmic wholism

[51:35] Now then, as you can see to understand this, I’m afraid we have now got to mention — only mention because I have no time to go into it in detail — a very important concept and that is wuxing, which is can be translated as five transformational phases.

[51:59] There are other interpreter ways of transliterating it, but I think that comes nearest to it. It’s is a phase. It’s not about entities, although the chinese like to use the words: wood, fire, earth, water, metal, water. But it’s not.

[52:18] It is actually, wood stands for the qi, for rising yang qi because in spring plants as organisms start to grow. And so you use wood to stand for the rising yang qi of spring. Fire, you just use to stand for the even greater amount increasing amount of yang qi of summer.

[52:57] And then you come to metal where the yang qi begins to abate, and the yin qi begins to increase, at the expense of the yang chi in the autumn. And you use water as I said before to stand for the maximum amount the amount of yin qi, come the winter.

[53:28] Now these relationships that you see in the outer diagram here, this is sometimes called, they call it, nourishment, mutual nourishment cycle. Other people call it the another thing but it doesn’t matter.

[53:46] You can say that one promotes the other, right? Now the funny thing is, I can’t explain in detail, because we have no time, but the funny thing is there’s only four seasons as represented by metal, water, wood, and fire. But wuxing has got five phases in it. So where does the fifth phase come from? Now the rich Chinese put in earth because earth is a kind of equilibrating process, if you like. And so, it pulls, you know, the the lot together, in my understanding, that is. Other people may do a different account of the function of, you know, the role of earth played in wuxing.

[54:40] So now then, if you then go back, and these are the antagonistic relationships, so as can be shown by these arrows, so again there’s no time to talk about the details of wuxing, and you’ll probably need at least five hours to sort it out. So we have no time.

[55:00] So having drawn your attention very quickly into it, we now go back to how we understand qian ren xiang ying as, that is, macro microcosmic wholism.

[55:17] When that is imposed upon the macrocosmic map is imposed on the microscopic map, that is so this is an attempt to present the imposition of the one upon the other. So you can see that the liver has been assigned, you know, it’s the wood phase. And then fire is the heart phase. Water is the kidney phase. And metal is the lung phase.

[….]

[57:26] Now just to say a quick word. Why is earth necessary? if you look at the spleen, the spleen and the stomach form a zhang fu, right? Now if you think of it, the Chinese are very practical people as some as the westerners like to tell us. We are always thinking of eating. It’s always thinking of food, primarily because if you do not eat you, do not survive.

[….]

20210616_3255_SS8_LeeKeekok_PhilChineseMedicine1.png (again)

[59:09] So we must always bear in mind that, what is in the macrocosm, is always is a microcosm in us. Now just to give you one example of all of this. Now as you can see, in the summer, then the li gua [south, at top of page], has two yang yao in it. That means it has got a lot of heat in it. Whereas the kan gua [north, bottom of page] that will be standing for winter and the north, therefore has got two yin yao [broken lines] in it with only one yang yao [unbroken line]. So obviously, the yin yao is on the ascendant and the young dao is a bit subdued.

[1:00:00] So as a result, imagine yourself to be a physician ….

[1:00:15] Imagine that you have been asked to see a patient and you take the mai [meridian], …

[1:00:30] Now in the winter because the macrocosm out there has … maximum amount of yin qi in it, so your mai should not have a predominance of yang qi in it, so to speak.

[…]

[1:01:21] This man is storing up trouble, if I don’t do something to intervene. He’s got too much yang qi in him, for the season in the year, because this is winter. He shouldn’t have so much, it should be more a reflection of the macrocosm out there, in his microcosm. But unfortunately it isn’t, it seems to be the other way around.

[1:01:51] So the physician then prognosticates that unless he intervenes, gives a medication to lower the yang qi in the microcosm of the patient, in the summer, come the summer, when the yang qi is at its maximum with two yang yao in the gua, something definitely is going to happen to him. He probably would have a heart attack or something, and he will be dead in no time.

[1:02:10] So okay, this is a a true story which I think I’ve got from Liu Lihong … , and he said that in fact this was a real patient. … The patient was very stubborn. He didn’t believe in in Chinese medicine anyway. He was a top, I think, a top CCP cadre at the time and he didn’t believe in all this. His daughter did, but he didn’t. And so the physician then wrote out a prescription with heat reducing, yang qi reducing, medicinals in it. The daughter persuaded him to take it, the father to take it. The father refused. The daughter couldn’t do anything.

[1:03:13] It was reported promptly the next summer, the coming summer, the father died of a bad heart attack, or something to do with the heart, because he was overwhelmed by yang qi. He was already full too much of yang qi in him in the winter. Come this summer, where the macrocosm has yang qi as maximum, this added up together would do him no good.

[…]

20210616_6430_SS8_LeeKeekok_PhilChineseMedicine1.png

[1:04:15] I would then end up by talking about Chinese medicine as ecosystem thinking or ecosystem science, right. So very quickly, I would say look at this system, I put up here. That’s the host, which may be called ecosystem 1. There’s the agent, ecosystem 2. And there is the environment, ecosystem 3.

[1:04:50] Now imagine that the host, since we are living still in the pandemic of Covid 19, ecosystem 1, let us say, is that naughty virus, the difficult virus called SARS-COV-2 sitting there. And the agent, that’s ecosystem 2, is the poor victim who is harboring the thing, and which may either be asymptomatic, or symptomatic, if you are unlucky. It might be symptomatic but whatever it is. Imagine the symptomatic case rather than asymptomatic case, the agent carrying the SARS-COV-2 virus. That person is living in environment, in the outer environment called ecosystem 3.

[1:05:48] Imagine that person, unfortunately, to be a front line, public, worker in the public building, either as a health care worker or as a security officer. I believe that they’re very exposed. Or as a nurse, someone working in a care home, or whatever. You are in the front line because you see a lot of people who are victims of SARS-COV-2, right. So your environment is not very good. So your macrocosm is not helpful. But if you have a concentric circle, then the one affects the other. so ultimately whether you are going to get it or not depends on the interaction between all these ecosystems.

[1:06:54] And so, in other words, then unlike modern Western BioMedicine the causal relationship is what I call a monogenic causal relationship — that is the cause here, there’s the effect here, one cause one effect — this kind of medicine, which is yidaoyi type of medicine, we are talking about ecosystem nesting. One ecosystem within, embedded within another ecosystem, which in turn is embedded in yet another ecosystem.

20210616_4720_SS8_LeeKeekok_PhilChineseMedicine1.png (again)

[1:07:38] So you’re talking of a multi-factorial causal framework and a multi-factorial causal framework, if you recall the yinyang, the wuxing diagram up here, that are very complicated relationships between all these things.

20210616_6430_SS8_LeeKeekok_PhilChineseMedicine1.png return

[1:08:00] So, one way, very quickly of understanding ecosystem thinking, and therefore also of wuxing, is to say that ecosystem thinking that wuxing is really talking about an ecosystem and the relationship between the components of an ecosystem.

[1:08:29] Because in ecosystem thinking you have what I call both negative feedback loops and positive feedback loops. So you’re talking about positive feedback loops and negative feedback loops.

[1:08:45] Now, negative feedback loops are easier to understand than positive feedback loops. The standard example of a negative feedback loop is to use your air conditioning system, right? You set the temperature on your machine at x. Now, if the outside temperature is higher than x, then your machine will start releasing cold air until the set temperature is reached.

[1:09:23] So, it always brings you back to the starting point, in other words. So that is a negative feedback system in our body. The famous example would, of course be, how we control the heat inside our body in the wind, when it’s very cold outside. Our body, our physiology, is primed or evolved in such a way, as an organism — we are evolved with an ecosystem with a system, physiological system, in such a way — that it gets very cold, our pores close up.

[1:10:00] When our pores caught up, less heat, is less out of our body, so we retain the heat and we maintain homeostasis. And when it’s very hot, our pores open up to let out the yang qi, so to speak, and then we cool ourselves down by the sweat.

[1:10:18] So, that is a negative feedback system;

[1:10:24] A positive feedback system is when several factors act together in a synergistic manner, so that — let’s put it this way.

[1:10:40] If you are talking of a simple-minded causal relationship, if I have three things contributing, three variables contributing, to the effect simple-mindedly, I can work out what the effect of this first variable is, what the effect of the second variable is, and what the effect of the third variable is. Then I add them all up, and I say that is the causal outcome. That is totality of effect. If I have three variables each contributing to the outcome.

[1:11:24] Now, under multifactorial ecosystemic relationship, it’s not like that at all. If I’ve got three factors one contributing, the second also contributing, the thirds contributing, but they act synergistically — that is they act together, they are not separate things they act together — my three fingers are therefore together — and when these are three [fingers] together, then you’ll find that in a synergistic outcome that effect is greater — that the first outcome where you are measuring this separately from that [finger], from that [finger], and just adding up the three effects. So that is why it’s very powerful.

[1:12:15] So with synergistic effects, you can flip very quickly, from one system to another system. So that is why some people think that, why is it that suddenly we flip so quickly?

[1:12:27] We don’t actually flip very simply. It looks as if we flip, the system flips, simply, because you’re using the wrong causal model. But if you have the right causal model, you can explain how it flips. And you can predict, even. So anyway, that is ecosystem thinking.

[1:12:46] Now I have two diagrams, two figures, here in terms of ecosystem nesting, using concentric circles.

[….]

20210616_7315_SS8_LeeKeekok_PhilChineseMedicine1.png

— end paste for digression —

David Ing’s note: In Keekok Lee’s 2018 book, is Figure 4.1 with 10 concentric circles.

Figure 4.1: Ecosystem-nesting in terms of concentric circle

• 1 Cell;
• 2 Tissue;
• 3 Organ-system, such as the Spleen-stomach/㝮㛳 organ-system;
• 4 All visceral organ-systems (Wuzang-liufu/ӄ㜿ޝ㞁);
• 5 Entire material parts and total functioning of the person including emotions;
• 6 Qi in yuzhou (Macrocosm) as well as the Jingmai via the Jingluo network of the person-body (Microcosm);
• 7 Immediate external environment, in which a person lives (air, water, food, shelter, climate….);
• 8 Social/cultural environment (tribes/ethnic groups/polity);
• 9 Larger physical/social environment, in which a person lives (plants/animals/rivers);
• 10 Cosmological environment, in which a person lives (Sun/Moon/Earth….).

In this 2021 presentation, the 10 concentric circles are different.

CCM

1. Tissue
2. Organ-system, such as the Spleen-stomach organ system (㝮㛳 piwei)
3. All visceral organ-systems (Wuzang-liufu/ӄ㜿ޝ㞁)
4. Entire material parts and total functioning of the person including emotions
5. Qi in yuzhou (Macrocosm) as well as the Jingmai via the Jingluo network of the person-body (Microcosm);
6. Immediate external environment, in which a person lives (air, water, food, shelter, climate….);
7. Social/cultural environment (tribes/ethnic groups/polity);
8. Larger physical/social environment, in which a person lives (plants/animals/rivers);
9. The Cosmological environment, in which a person lives (Sun/Moon/Earth … our Solar System, as shown in the Laws of Nature, such as zhouye jielu, sishi jielu, zhou or fu shi which together focus on Timespace rather than Spacetime)
10. Process-ontology cum Think-ontology

— resume paste —

[1:13:06] Now, just concentric circles. I have said it. One, two, three, four, five, six, seven, eight. Unfortunately, I didn’t do my diagram very well, because I’ve got to skip that and look at this.

20210616_7325_SS8_LeeKeekok_PhilChineseMedicine1.png

[1:13:27] How biomedicine may be interpreting that circle, that nesting of circles. So circle 1, which is the innermost circle, I would put it down, that they put in DNA, RNA, i.e molecular genetics.

[1:13:52] The next circle is 2. That is 2. They might put genes there so these are genetic sequences. These are the whole genes.

[….]

[1:15:11] So the body, the human body, the physical body, is then made out of 1 to 6, in my understanding.

[1:15:20] So the body’s immediate external environment, which is 8, I put down as 8 here, that’s 8. And I just simply put down, we need air to breathe, containing oxygen to survive. We need you know wholesome water to drink, pure water to drink, pure, or purish at least, water to drink, in order to survive. We also need food, nutritious food, to survive.

[1:15:52] So that’s the body’s immediate external environment, what we introduce into our system.

[1:15:58] Now, and then embodied in that, that body, is then in 9, which is understood in biomedical terms — this is knowing there, that the body is machine, not organism.

[1:16:18] So I said it performs an ontological volte-face, because up to the 16th 17th century, even , let’s say 16th century, body is always organism. But now there’s a sudden change in Western philosophy. Body is no longer organism. Body is machine. Now, machine is an artifact. We humans create machines. I know that other animals create, we may not call machines, but they certainly create artifacts. Ants create nests. Bees create beehives. So, they are artifacts. But they are animal artefacts, not human artifacts.

[1:17:13] But we human have a peculiar kind of consciousness which enables us to design things called machines. As the chinese say ren shi wan bu zhi ling, that means we human beings have got a very peculiar, a very peculiar kind of consciousness.

[1:17:39] Our consciousness, unlike other animal consciousness — mammalian consciousness, they too are very clever — but we go one level beyond. And what is that level beyond? That level beyond is that we are capable of having abstract thoughts. Animals, as far as we know, do not have what we call abstract thoughts. We can actually commit our abstract thoughts to a bit of paper, in terms of symbols, when we do maths. An algorithm, you know, that sort of thing. We can have writing, commit our thoughts to writing etc, etc.

[1:18:20] So because we have this peculiar uh type of consciousness that is why the Chinese cosmology called that man is wanwu zhi ling, that it means that it has the most evolved — not advanced, advanced is not right — the evolved kind of consciousness.

[1:18:47] Now, when the Chinese say say ren shi wan bu zhi ling, do not mistake what the ancient Chinese are saying to be an anthropocentrist.

[1:19:00] Anthropocentrism in the west is understood differently. Anthropocentrism in the west has a built-in hierarchy of superiority of inferiority to it. So we humans, according to western anthropocentrism, we are the superior to everybody else.

[1:19:24] And as a result, we look down on animals. The west looks down on animals, they’re not as good as us. They are inferior beasts, they are called, right? And so whereas the Chinese has no built-in inferiority and superiority, it just simply means we are different. We share a lot of things in common with them. For instance, a lion, a cheetah is very smart indeed. We do share things in common with a cheetah, but nevertheless we have a type of consciousness which is also different from that of the cheetah or the lion or or whatever other animal that you care to think of. So every animal has its own peculiar kind of consciousness, but we humans are pretty peculiar, and so in that sense, we are wan wu zhi ling, because we can do abstract thinking. We can have language which is a form of abstraction. Different types of languages mathematical languages the languages we speak in terms of our mother tongues that sort of languages etc etc.

[1:20:49] And we can do metaphysics. We can do philosophy. Et cetera, et cetera.

[1:20:55] So now then, because western thought is based on the body as machine, not an organism, a machine is an artifact. And an artifact is a thing.

[1:21:11] So, ever since Julien Offray de La Mettrie, when he wrote man, L’homme machine, that book which he published I think in the 16th century, you know, it has shifted to thing ontology. No longer an organismic ontology, as Aristotle did, but a thing ontology. A thing ontology as artifacts, thing.

[1:21:44] So a thing occupies space, you see what I mean. And that is why I say it focuses primarily on space. Newtonian science and Newtonian cosmology. Now, of course, I know after Newton came Einstein several centuries late, and Einstein actually added the temporal dimension, so it is space time today. But actually the space time even of Einsteinian relativity physics is very different from what I called a time space in Chinese cosmology.

[1:22:30] Because if you go back to this chart.

[….]

20210616_3255_SS8_LeeKeekok_PhilChineseMedicine1.png (again)

[1:22:44] You’re talking of the sun up there, in the summer. The sun up there, in the summer, at its height of yang qi, maximum yang qi, is actually casting its rays down on earth.

[1:23:03] But the relationship for the Chinese is not so much the emphasis on space, of what is happening on earth, but of the relationship of the seasons of time, because summer winter autumn spring or whatever is actually referring to time, the passage of time. So its emphasis is on time rather than on space. And of course, it has to shine on the earth. The earth is space. So that is that is why I put the difference as time space. Because time …. It’s a focus more on time than space, whereas in this system, the western system, the emphasis is more on space rather than than time, because you’re talking about thing ontology. So anyway so that is why I say that, you know, it focuses primarily on space.

20210616_7325_SS8_LeeKeekok_PhilChineseMedicine1.png (again)

[1:24:05] Now if you look at this nesting of ecosystems, under Chinese medicine, we don’t talk about the 1, 2 and the 3 under the BM system here.

[1:24:26] The 1 for chinese medicine is a tissue. That’s the lowest level of reductionism, if you like. I don’t think it’s good to tolerate, but the lowest level of understanding is the tissue.

[1:24:41] Then after this tissue, you have an organ system. The Chinese do not understand every organ individually. It passes up, as the zangfu. So you if you were talking about the spleen, then you’re talking the spleen-stomach organ system, the piwei system.

[1:25:04] And all these systems constitute the wuzang-liufu. And so we are talking about entire material parts, and total functioning of the person.

[1:25:21] And the person includes the emotions.

[…]

[1:25:38] Now [CCM] 4, when you are talking about the human person, which possesses all these things, you are really talking about a human person with emotions.

[1:25:53] Whereas the body down here [BM 7], you’re talking about has no emotions. You’re not concerned with emotions. So that is why BM has great difficulty about the placebo effect and considered it is so anathema versus chinese — well it’s part of natural, of phenomena, if we are humans we have emotions.

[1:26:18] So in emotions, wrestling beliefs, depending on your belief, you believe that what you are swallowing is poison, it can have an effect on you. If you believe that what you are swallowing, just because it also has an infection. One is called the placebo effect. The other is called the nocebo effect, if you want to put it in modern tone. But we are essentially beings with emotions. So emotions are not taboo subject. Emotions are part of the individual person,

[1:26:51] So when the Chinese talk of shenti, it is not the body of BM here [BM 7]. It’s not this body you’re talking about. It is why I put it as a person-body [CCM 4]. It is the whole person where the body is. But today, I don’t have time to go into any great detail.

[1:27:15] So let’s look at qi [CCM 5]. Now this is the tianren-xiangying. So the qi in yuzhou — yuzhou is the universe — the macrocosm, as well as the jingmai, via the jingluo network of the person-body, which is a macrocosm.

[1:27:36] So when a Chinese physician ascertains << nuo? >> mai, he’s actually ascertaining this << nuo? >> mai jingluo yingyang profile in the person-body. That is what he’s doing. And when he ascertains that, the yinyang profile in your person-body, then he knows how to diagnose what’s wrong with you. And because he knows how to diagnose what is wrong, and he can also prescribe you with the medicinals to help you get over the hump that you are confronting, and which leads to your illness, right?

[1:28:12] So then [CCM] 6 is your immediate external environment, in which you live, << true? >>. Like BM, it recognizes air, water, food, shelter, climate, all these are important.

[1:28:28] But it [CCM 7] also specifically recognizes a social cultural environment in which the person-body, the person is embedded in. So you can talk of tribes, groups, ethnic groups, poverty or whatever.

[1:28:47] Then [CCM] 8, you have a larger physical and social environment in which the person lives, which includes the plants, the animals, the rivers, the air, around you, etc.

[1:28:57] And the biggest of all [CCM 9], the cosmological environment, in which the person lives. Then you have at least to talk about the heavenly bodies and their relationship to each other, at least within our own solar system.

[1:29:18] I know that there are plenty of solar systems today, out in the world, in this universe, but the ancient Chinese only knew about our own solar system, they didn’t know so many others. But minimally, you must at least know about your own solar system. So our solar system.

[1:29:38] So it it is then captured by the Chinese laws of nature such as the zhouye jielu, the sishi jielu, the zhou or fu shi which together, as I say, focus on Timespace rather than Spacetime.

[1:29:56] And standing behind all this, is then what I call Process Ontology cum Thing Ontology. In BM, as you can say the emphasis is on space. It focuses or highlights thing ontology. But because the Chinese way of looking is dyadic and so, process ontology can coexist with thing ontology, these polar contrast can coexist, as as a whole. like linjiang itself.

[1:30:40] So our physiological understanding — when we talk about physiology how a person functions — you’re talking about process. When you’re talking about whether a person is thin or fat, and you’re talking about the thing, the figure that you see as the person enters the room. But the Chinese thought the two are linked, because then particularly in chinese medicine, the two are linked.

[1:31:13] So you have process ontology and thing ontology. You cannot understand the thing without understanding the process behind this thing, and you cannot understand the process of course without the thing, right?

[1:31:32] So I think that more or less sums up what I really want to say.

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A second day of lecture follows, as 2021/06/17 Keekok Lee | Philosophy of Chinese Medicine 2