TCM Explained is a series in which experts and practitioners break down the inner workings of traditional Chinese medicine, in their own words.
From a Chinese medical perspective, the Lungs are one of the most delicate organ systems in the body — so much so that they’ve been referred to as jiao zang, or “delicate organ,” since the twelfth century C.E.
The role that the Lungs play in drawing atmospheric qi into the body makes them uniquely vulnerable to harm. Wrote one Qing dynasty scholar-physician: “[The Lungs] are averse to cold, heat, dryness, and dampness; and most fear fire and wind.”
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Nowadays, the Lungs face a new and even more pernicious enemy: wumai (雾霾), the smog that has descended heavily year-round across China in the past few decades.
A classmate of mine at the Beijing University of Chinese Medicine, originally from Hebei province, can’t even remember hearing the word during his childhood. Now, as factories creep outwards from Beijing and nearer to his hometown, wumai has become next to universal.
Investigative journalist Chai Jing’s documentary Under the Dome, which went viral in 2015, marked a turning point in public discussion of wumai. Though Chinese citizens had been accustomed to breathing smog for years, Chai’s documentary traced its structural causes and revealed the extent of the harm pollution could cause to the millions of people inhaling it daily. The Chinese government has since taken action to reduce smog. A recent study by researchers at the Chinese University of Hong Kong suggests, however, that the danger remains: each year, an average of 1.1 million people die prematurely of causes related to air pollution. Many more fall ill, and a good number of these people turn to Chinese medicine for treatment.
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Combatting wumai with Chinese medicine first involves figuring out what smog is. For many physicians, this means not only reading up on scientific research determining the particulate components of smog, but also returning to classical Chinese texts. (One mentor explains to me that the value of these lie in their universal applicability: we can use ancient works like the Yellow Emperor’s Inner Canon to understand any worldly thing.)
This perspective holds for contemporary Chinese-medical interpretations of smog: many physicians translate between the modern wumai and terms for pathogenic qi — wind, heat, cold, damp, dryness, fire, poison, pestilence — that make up the framework of Chinese-medical pathology. A group of physicians based at the Beijing University of Chinese Medicine suggest that smog comprises a mixture of Damp qi, toxic qi, and Dry qi, which produce a dangerous combination of heat, poison, phlegm, and stagnation in afflicted patients’ Lungs.
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Chen Dongmei and Wang Xinpei, of the Chinese Academy of Chinese Medical Sciences and the Beijing University of Chinese Medicine, argue instead that the Spleen is at least partly to blame. They classify smog-induced pharyngitis as a case of hou bi, or “throat obstruction,” in which Dampness produced by a weakened Spleen and Stomach combines with turbid, smoggy Damp qi to produce phlegm and inflammation in the throat. From each assessment of smog’s Chinese-medical makeup arises a different strategy and prescription chosen from the hundreds preserved in classic texts.
Put simply, there’s no Chinese-medical consensus on how to treat smog-related illnesses. This is often the case, though, in a world where physicians marshal classical resources to develop understandings of and treatments for diseases that emerge through the biomedical looking glass.
But plurality has its advantages: if one doctor’s treatment doesn’t work, a patient can find a second doctor with a different interpretation of wumai, and a third, and so on, settling finally on a translation that sticks.
Wumai also illuminates a major challenge facing contemporary Chinese medicine: how can Chinese medicine adjust to a world that is by all accounts rapidly deteriorating?
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TheYellow Emperor’s Inner Canon — a foundational text of Chinese medicine — describes how in the ancient past, people lived in harmony with the Way of Heaven, while today, people live indulgently and irresponsibly, causing irreparable damage to their bodies. It explains that one must live in step with the gradual passing of the seasons, adjusting to the unbroken cycle of spring, summer, autumn, and winter; birth, flourishing, gathering in, and storing. Illness emerges when humans and the natural world fall out of rhythm.
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Our increasingly sweltering summers, our winters that fail to freeze, the smog that clings at our throats — all this bears testament to a new degree of disharmony. As human industrial activity distorts the seasons and endangers our bodies, what will it take to make us — and our world — well?
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