Chinese Medicine and the Weather

Chinese medicine is often quite effective for conditions that seem to be affected by the weather. The most common such presentation is arthritis that seems notably worse in cold damp weather and I see lots of patients who come back in the autumn year after year. Arthritis isn’t the only condition affected by the weather. Fibromyalgia is another condition where the weather can make symptoms worse, although the type of weather and its affects may vary between patients. I’ve seen patients with non-epileptic seizures who seem to be adversely affected by hot weather. A slightly tangential case might be insomnia that seems worse around the full moon. This link to the weather isn’t something that conventional medicine pays any attention to but for Chinese medicine its can be an important part of the puzzle. To explore why I thought I’d start by talking about Chinese landscape painting.

I’ve always loved Chinese landscape painting and I’ve used it quite a bit on leaflets and advertising (it just looks more interesting than a picture of a clinic room, or a person with some needles in them). I can be a bit more specific and say what I really like is the ink and wash painting that emerged in the Tang Dynasty (618-907 CE) and particularly that of the Southern Song period (1127-1279 CE), when the use of colour in the painting was pared back to a minimum (although Wang Wei had pioneered ink only monochrome painting during the Tang dynasty) and the composition left more empty space with elements fading into the mist. With some paintings I find I’m drawn into those empty spaces, into the things implied but not shown and for me that’s a lot the beauty of these paintings.

Before I go further I should say I’m not a scholar, not an expert on Chinese art and so I don’t necessarily understand the symbolism and metaphor that fills these paintings. But you really don’t need to in order to appreciate them and that’s not what I want to explore here. What interests me is the philosophies behind them and most particularly Daoism.

There are three major philosophical traditions of China: Confucianism, Daoism and Buddhism, of which Daoism is the oldest, with its roots in earlier Shamanic traditions. The central idea of Daoism is that the ideal life is one lived in harmony with the Dao, the natural spontaneous order of the universe, an order that emerges from the interplay of the forces of Yin and Yang. Buddhism came to China later and in the Tang dynasty it began to take on distinctly Chinese forms, the most famous being Chan Buddhism, which is better known by its Japanese name, Zen. Chan Buddhism was certainly influential during the Tang dynasty but perhaps its success lay in its absorption of many Daoist ideas concerning spontaneity and naturalness.

When one looks are the great Chinese landscape paintings its not hard to see that the painters were trying to capture the emergent Dao in their work. The paintings are often of mountain scenes because what many of the artists aspired to was the life was of a Daoist sage living a simple life away from the constraints of Chinese society. In fact many of China’s most famous artists and poets had retired from positions in the imperial bureaucracy that stood atop Chinese society. Both that bureaucracy and that society were shaped by Confucian morality, of which that hierarchical society was simply a natural expression. So the idea of ‘escaping’ into the wild and uncultivated lands of China was both a literal and metaphorical aspiration.

At the most basic level Yin and Yang can be seen in these paintings in the interaction of water (Yin) and the mountains (Yang), one falling, one rising up. Within these poles other aspects appear, clouds, trees, pools of water, a boat on a river and occasionally a building or a person. Where people do appear in the paintings they are often small, not exactly lost in the landscape but their part doesn’t disturb the broader unfolding of the world. All these aspects seem to frame the empty spaces in these paintings, spaces that while blank always seem to imply another horizon just beyond our view.

The empty spaces in these paintings reflect Buddhist ideas of ‘emptiness’, an unformed 'ground of being' from which all things emerge. There’s a similar idea in Daoism called Wuji, the primordial, undifferentiated state of the universe before the emergence of Yin and Yang. The painted aspects that frame these empty spaces are all manifestations of Yin and Yang and the interactions between them, interactions that produce a harmonious whole. While Yin and Yang are somewhat abstract they can be seen within a landscape in opposing pairs: wet/dry, heat/cold, high/low, exposed/sheltered, movement/stillness, light/dark. In fact the original characters for Yin and Yang depict two sides of a single hill: Yin is the shaded, north-facing side (cool, dark, passive), while Yang is the sunlit, south-facing side (warm, bright, active).

Of course Yin and Yang aren’t static qualities: heat dissipates, the sun warms a cool valley, rain brings moisture to parched fields etc etc. Classical Chinese thought saw the world not as a set of discrete ‘things’ but as a system undergoing an endless process of change and transformation, a process driven by Qi, the animating force of the universe. These ideas of Yin, Yang and Qi underpin all classical Chinese thought and all of existence was seen as an expression of them. As such they suffuse all of Classical Chinese culture, from its cuisine to its martial arts and religious beliefs. The creators of these paintings weren’t just trying to paint a picture, they were painting in order to understand the Dao, to understand how the interactions of Yin and Yang formed the world around them and the ‘ten thousand things’ that inhabit it.

By now you’re probably wondering what any of this has to do with medicine but Chinese medical thought was also built on ideas of Yin and Yang. Just like the world that Daoist scholars and artists studied, the human body was understood as a process which could be explained by the interactions of Yin and Yang and the Qi that drove them.

There’s a famous Daoist diagram of the human body called the Nei Jing Tu, which is engraved on a wall of the White Cloud Temple in Beijing, although its reported to be a copy of an older image. The Nei Jing Tu depicts the body as a landscape, complete with mountains, rivers, forests, paths and stars, the same elements that are found in the landscape paintings discussed earlier.

The Nei Jing Tu belongs to the Daoist tradition of inner alchemy and depicts the internal workings of Qi within the body. While the inner alchemy tradition isn’t well known in the West, practices like Qi Gong and Tai-Chi are and they to are working with Qi and Yin/Yang within the body. Similarly Chinese medicine is premised on an understanding of the movement of Qi within the body and how it drives the interactions of Yin and Yang. Perhaps a very obvious example of this is insomnia where an individual may struggle to fall asleep at bedtime. Sleep is our most Yin activity and an inability to fall asleep might be the result of too much Yang in the body. This might have developed for a number of different reasons – perhaps the use of stimulants, perhaps a Yin deficiency has developed from overwork, or the body is too hot – the exact reasons aren’t important here. What’s important is that the same processes that can be seen in the natural world are also shaping the internal landscape of the body.

While the underlying ideas of Yin and Yang are simple their expression within the world and within in the body are unendingly complex. Unravelling that complexity and trying to see through it to the simplicity beneath means diagnosis is almost always a challenge. Sometimes one’s lost in the small details unable to see the landscape and sometimes its the details that are most important. Which brings us back to where we started, conditions that are affected by the weather. The type of weather which is making the symptoms worse and how those symptoms are worsening are, for Chinese medicine, all part of the diagnostic picture.