One of the courses I completed recently is “Everyday Chinese Medicine” from The Chinese University of Hong Kong, available on Coursera (along with many MOOCs from other universities and companies).
A necessary disclaimer here: I am not a practitioner of Traditional Chinese Medicine and this topic is definitely outside my “circle of competence” (see The Great Mental Models – General Thinking Concepts), so be magnanimous if I write something wrong, in case please correct me with a comment, I will be happy to make the changes 🙂

There can be an initial difficulty while approaching this matter, since we tend to translate some new concepts through the lenses of our logic and models acquired as children in our civilization – this explains why it can be so difficult to understand, for example, non-dual Buddhist logic if we think in terms of Aristotelian and Western logic in general. It helps a lot to adopt a “non-judgmental mindset”, with the curiosity of the “inner child”.
Remember that models are not reality, just as the map is not the territory (this, in turn, one of the most famous mental models).
One model does not exclude the other, as is the case with wave and particle models in the explanation of light: light is always the same, it’s our way of interpreting and explaining that changes… and they coexist at the very same time.

We need a model to make sense of reality and exchange it with others, bricks to build something more complex in our never ending search within and outside ourselves, as well as to modify (but not necessarily) what we have now.
Structure and functionality can be explained either in the terms in which we are used to thinking in the West, or in an integrated system (“holistic,” as has been fashionable to say for the past few decades), considering that philosophy, science and religion in some parts of the world tend to be a kind of complex system, a “framework” that also contains the elements to give everything a higher meaning, which can also help us in our “search for meaning” (thank you Viktor Frankl for your books) and serenity (also because the brain bad tolerates uncertainty).
Moreover, when we think we are closer to the truth (leaving aside all the talk about the impossibility of seity knowledge, as explained by physicist and inventor Federico Faggin in his book “Irreducible”), we just have a “delusion of reality” (I won’t quote Paul Watzlawick here, since I already quoted him in my homepage :D) and we are at least at one degree of separation from it. For example: the greatly celebrated fMRI (the animations you can see on brains while someone is performing some activities) is not a direct measurement, the images we see undergo several steps, they are space-temporal representations of a physical quantity that measures a “second/third order” effect; brutally wrote: with the BOLD contrast imaging, we’re tracking oxygen, through electromagnetic responses over 3D-voxels small cubes over time – oxygen which we assume is highly correlated with brain activity in a certain area, together with glucose consumption (I hope that this explanation won’t revoke my 4-courses specialization on “Neuroscience and Neuroimaging Specialization” by Johns Hopkins University on… yes, you guessed it, Coursera). Same applies to a lot of instrumental diagnostics, giving us the impression to have direct access to the mind and body (keep it in mind, next time you deal with responses of chemical reagents on blood samples, ultrasound scans, auscultations, electrical tracings, …).

it is necessary to go well beyond superficiality to master the concepts: to be able to find analogies, for example, between interbeing and quantum entanglement (here Faggin can help us again, but you can go deeper with University of Edinburgh course on religion and science (click for my post about it)), one needs to have well understood both concepts (as best as we can, since we cannot say that we have really understood quantum physics, as Feynman said on the one hand, nor that we can perfectly understand interbeing, if we have not achieved “enlightenment” on the other hand… and I do not consider myself a Bodhisattva among you, really far from that).
It is no coincidence that “serious” TCM courses are open (if one wants to become a practitioner) only to physicians, who can seriously understand the human body also in the modern scientific way – I think it’s also a matter of being able to operate safely: if something goes wrong, a seasoned MD knows how to react quickly according to Western standards, which by the way are also the ones that cover one’s a*s in legal proceedings).

Adopt a “scout mindset” (as Julia Galef would say) instead of the defensive soldier mindset, thinking that other cultures are necessarily worse than ours. And don’t justify yourself by saying that “once/now our culture is the one dominant” because there are so many complex factors that make a certain culture rise in a given area, we’re taking into consideration only one aspect (please don’t fall in fundamental attribution bias). At the same time, proceed with caution and with healthy skepticism (as Carl Sagan would have recommended), but nonetheless with open-mindedness, especially at the initial stage. Listen and understand, before judging/evaluating – fundamental activities that are observed less and less, in these times in which we want to express ourselves after hearing 30 seconds of a TikTok video or reading half a “tweet”, since it’s encouraged by (“social”?) media, destroying the critical thinking from deep work that instead allowed us to get to the progress where we are today.

That’s why I suggest you to learn something outside your usual circles of knowledge; it gives lifeblood to our brain and, in the worst case, we will have taken a journey into the culture of other peoples, not bad at all! So let’s go take a look at this world, how kind and polite observers.

Chinese Medicine 101

This traditional preventive medicine was created around 4000 years ago and evolved experimenting with plants, animals and minerals, as well as hot stones and moxibustion to relieve pain. Meanwhile, they also inferred that when one part of the body is penetrated, a disorder in another part of the body can be relieved (principle behind acupuncture). They conceive the body as a whole, affected by changes in nature (physicians have to know the laws of nature and geographical conditions when diagnosing and treating diseases).
Treatment by Differentiation of Syndromes: Differentiation is a comprehensive analysis to understand a Syndrome (manifested by signs and symptoms) so to choose a Therapy accordingly. You can use different treatments for same disease, e.g. when there are different symptoms. You can also use same therapy for different diseases.

Doctrine of Yin Yang: there 2 fundamental principle forces are used to understand phenomenon. In the Yin Yang theory we find:

• Opposition (heaven/day/movement/exterior/upper/excitement/clear/heat = Yang; earth/night/stability/interior/lower/falling/turbid/cold = Yin);
• Interdependence (there can’t be inside without outside, no day without night – in medicine: functional movement = Yang, nourishing substance = Yin);
• Relative waxing and waning;
• Transformation (They continuously change in each other; They are not absolute, but relative; They can be subdivided = the last part of the day when sun is going down is the Yin part of the Yang);

They are foundation for explaining physiological fx, pathological changes, diagnosis and treatment:

• Yin (produces and) preserves the Essence (Jing);
• Yang transforms the Qi (and decompose substances);
• Without substance/essence (including fluids), no source for function (Yin of the heart can be depleted when there’s structural damage in a myocardial infarction and this will also reduce the ability to pump (that is the heart-Yang)).
• Basic pathogenesis of a disease is the imbalance of Yin / Yang (Interior / Exterior; Cold / Heat; Deficiency / Excess), there’s an issues there’s too much of one above the other.

Zang-fu organs theory: we have 5 Zang organs (preserving vital substances): Heart, Liver, Spleen, Lung, Kidney. And we have 6 Fu organs (transporting and digesting water and food): Gallbladder, Stomach, Large Intestine, Urinary bladder, Sanjiao (that is basically the big part of the body containing the previous organs):

I won’t dig too much in depth, but the main concept behind is that every organ is responsible of managing some functions and is linked to others. Just to give you an idea of the level of depth of the course, this is just the first part of my notes taken while studying the first part of the 5 Zang organs’ descriptions:

Of course, the same it goes for Fu organs. And there’s also relationship between Zang and Fu organs.

The Qi theory. Everything in the universe is result of movement and changes of Qi. Inside us, Qi is the vital substance of human body, maintaining activities. It’s both congenital essence from parents and acquired essence from water, food. Different functions and different kind, I won’t tell here the details, but basically: once Qi movement stops, life ends. We can have issues when we have Qi stagnation, Qi counter-flow syndrome, Sinking of Qi. The main source of blood are kidney essence and food essence from spleen and stomach (the 3 organs make blood circulate). Blood is needed to nourish and moisten the whole body, maintain our normal physiological activities and it poses material basis of mental activities. We also have body fluids, called Jinye that are Jin (the “lighter”/diluted ones) and Ye (the thicker ones).
As you may imagine now, there’s a close relationship between Qi and blood: Qi is the “commander” of blood, while blood is the “mother” of Qi.

Pathogenesis depends on 6 external pathogens (if extreme or variations fast): wind, cold, summer-heat, dampness, dryness, fire. In particular, some combinations may lead to specific effects, e.g.: Wind+Cold = Flu; Dampness+Heat = Diarrhea; Wind+Cold+Dampness = Arthritis. That’s not all: they can be also endogenous if arising from Zang Fu organs dysfunctions (but in that case they are differentiated, called “Endogenous 5 Evils”, 6-1 since summer-heat is external only). Along with these pathogens, there are also internal injuries by 7 Emotions (endogenous) going extreme. They are associated with organs as well:

Pathogenesis continues with improper diet (including abnormal ingestion, unhealthy diet ,poor food preference) and maladjustment of work and rest (over rest, excessive mental and physical overstrain, sexual indulgence).
Pathogenesis is seen as conflict between vital-qi (normal physiological function and resistance and recovery capacity) and evil-qi (the external and internal factors we’ve just seen), causing imbalance of Yin and Yang and/or isturbances in ascending and descending of Qi in the human body.

Diagnostics in traditional chinese medicine is made by:

• Inquiry (asking about disease onset, progress, history and so on);
• Inspection (observation of skin color in facial complexion, observation of body shape and movement, observation of tongue
• Listening (voice, respiration and cough);
• Palpation (using 3 fingers to check the pulse, that is governed by heart).

You can easily imagine that there are chapters for each one of the items, for example tongue (that has a close relationship with Zang Fu organs) is examined in color (e.g.: pale, red, dark) and coating (e.g.: thick and white or yellow, absent, bruised spots and patches).

Diagnosis of disease leads, as written before, to differentiation of syndrome. A disease can manifest through several symptoms. Syndrome differentiation provides basis for guiding treatment decision. For example:

The casuistry here explodes exponentially, as you can imagine the combinations that it’s possible to observe.

Obviously, there’s really much more, but this post is just to understand the main concepts of something we usually never heard during our (occidental) education and even after, with a few exceptions for people that want to try “alternative medicine” (and, of course, people who want to become a MD specialized in this particular field). Again: I hope I wrote all the discussed points in a decent and correct way, but don’t trust the information here too much, please refer to the original course, explained by asian university professors.

My final considerations

There is scientific evidence of some methods (to be honest: sometimes not so strong) and there are also critics (e.g.: https://quackwatch.org/related/acu/), but let me tell you my point of view: that kind of culture has to be interpreted; it is not to be understood literally, there’s no 1:1 relationships/translation with “normal (mainstream official) medicine”. We know that in the head there is not a “reservoir of bone marrow”, but the brain, about the functioning of which, even in the Western world today, we know very, very little (think of the default mode network and all that we think of as “noise” in a rest state, as also we still reason in “areas”, not in extremely precise points, because of limits of spatial and temporal resolution, I recommend you to follow the neuroimaging course I mentioned at the beginning, really great if you want to understand more about methods to understand the brain). Also compare some concepts like “blood as material basis of mental activities” with normal medicine, where the Circle of Willis distributes blood (which carries oxygen+sugar) to make the brain work (and survive).

In any case, the historical legacy must be considered: attributing for example 7 emotions to 5 organs, seems to me like when the ancient Greeks attributed some powers and influence of their lives and the world to the deities (and the whole system and stories they had built on top of them), also to give meaning, explanation and morals to follow, as well as the reverential fear of not angering them, but rather pleasing them. Again for the talk of connecting with nature, seeing excesses of external factors or their fast variability, with the 6 external factors and everything… it’s something I really appreciate, since too often in Western world we tend to forget we’re part of the Universe – if you don’t want to believe in panpsychism, you may simply think in terms of matter and energy. And speaking of energy, if the concept of Qi seems strange to you, call to your mind the principles of conservation of energy and what Lavoisier enunciated.

Recall that even modern Western medicine has gone through primordial models such as “humoral theory“, so there are many shared points, later (luckily) revisited.

As an engineer, I struggle in not finding any quantitative measure (e.g.: “pale face”, “red face” how much? compared with which palette? OK, now it’s the photographer in me speaking, with the medium gray in mind to compare white balancing), but that’s why a strong and long practice is requested. After all, even the Artificial Intelligence-aided modern medicine requires sometimes “non only quantitative” analysis and decisions, that’s why medicine is not (yet) a “perfect hard science”.

Finally, would you feel like ignoring the importance given to lifestyle (what has been summarized as work, rest, diet), not so far from latest research shown in The Science of Well-Being by Yale University? Everything that help us to feel better and stay stronger, while also helping us in make questions and finding answers should be taken into account.

I’ll write to you after the next book or course! 🙂