Prof. Volker Scheid PhD, FRCHM, FBAcC is an internationally known practitioner, teacher, and scholar of Chinese medicine. He was Director of EASTmedicine at the University of Westminster, a trans-disciplinary research centre for the study of East Asian medicines, from 2004 to 2018, and is now a Visiting Researcher at the China Centre, University of Kiel. His latest book, Searching for the Dao of Medicine: Landscapes of Thoughtful Practice in Late Imperial Study (Berghahn 2026), explores different pathways to clinical virtuosity proposed by physicians and medical writers in China between the fourteenth century and the present.

In 1941, Ho Kai Cheong (何繼昌), a Guangdongese herbalist born in Malaya, established a modest tea stall in Ipoh, which eventually grew into Ho Yan Hor (何人可), today’s most iconic Chinese herbal tea brand in Malaysia. Rooted in a multi-ethnic community and shaped by an industry-driven economic context, the brand has evolved over 84 years from a local enterprise into a heritage icon and a leading pharmaceutical company with a global presence (Ho Yan Hor Museum, 2025). Despite the long-standing presence of Chinese herbal tea in Malaysia, research on its cultural heritage and social impact remains limited.

Tin and Tea: Creating Wealth and Health in Perak

Located on the west coast of the Malay Peninsula in Malaysia, Perak’s prominence began with the discovery of tin in Larut in 1848. This discovery catalyzed rapid development as mining activities proliferated throughout the 19th century, attracting significant Chinese immigration (Khoo and Abdur-Razzaq 2005, 15–20). Under colonial administration, Perak emerged as a leading tin producer, contributing over half of Malaya’s tin output and accounting for a quarter of global production. Tin mining brought significant prosperity and population growth to the region. In addition to tin, rubber played a crucial role in shaping Perak’s economy and attracting a large influx of laborers. By 1947, the Chinese diaspora in Perak had reached 444,509, constituting 46.6% of the state’s total population and surpassing both the Malay and Indian populations (Economic History n.d.). The Chinese maintained a high percentage among the ethnic groups for the following decades.

The 19th century witnessed the concurrent development of traditional and colonial healthcare systems in Malaya. Indigenous and folk medicine practices were prevalent throughout the peninsula. Traditional Chinese medicine (TCM) has long been an integral part of local community in Malay Peninsula. In 1879, Eu Kong, a native of Guangdong, established the first Chinese herbal medicine shop, Yan Sang, in Gopeng, Perak. It subsequently evolved into Yu Yan Sang (餘仁生), a highly esteemed listed company specializing in the production and sale of traditional Chinese herbs and medicines (Yeung 2004, 138). The practice of traditional Chinese medicine continued to grow, and in 1925, the Perak Chinese Herbal Medicinal Hall was established in Ipoh, further advancing its accessibility and influence in the region (Wong et al. 2019).

During World War II, Malaya, which included the state of Perak, underwent significant economic, social, and political transformations. The conflict resulted in widespread poverty, scarcity of resources, and severe health issues, burdening the population’s access to healthcare services. Government records show that public health deteriorated seriously in 1940s. Malaria was the great killer, although dysentery and malnutrition probably contributed to a significant portion of the mortality (Annual Report 1947, 68). After the war, the Perak Chinese Physicians Association and the Perak Chinese Physicians and Druggists Association were established, reflecting the growing demand for traditional Chinese medicine (Wong et al. 2019). In 1947, the Perak Choong Wah Hospital (霹靂中華醫院) was established by the Association to provide charitable, non-profit healthcare for the underprivileged (Perak Choong Wah Clinic 2025).

Chinese herbal tea, a folk healing tradition also known as “cooling teas,” was introduced to British Malaya alongside the introduction of Chinese medicine. Typically, a Chinese physician prescribes a remedy in the form of a formula consisting of multiple components. These formulas are usually boiled for a specified duration to produce a medicinal liquid known as a tang (湯), or decoction. In contrast, Chinese herbal tea uses much simpler formulas with only a few ingredients, which are typically local and readily available plants (Zong and Liscum 1996, 2). Chinese herbal tea has been popular in Southern China for centuries and are celebrated for their distinctive abilities to clear heat and detoxify. These teas come in a variety of formulations, each containing a broad spectrum of bioactive compounds (Liu et al. 2024). It is tailored to address common ailments such as dyspnea, rapid breathing, cough, or phlegm-related conditions. In early 20^th century, Chinese herbal tea shops were promoted in Southeast Asia and other countries. Among these, the most renowned was Wong Lo Kat herbal tea (Guo 2024).

The Legacy of Ho Yan Hor

The history of Ho Yan Hor herbal tea traces back to the 1940s, originating on Treacher Street in Ipoh, Perak. Ho Kai Cheong, the founder of Ho Yan Hor, was born in 1910 in Kati, Perak. His parents, who hailed from Panyu, Guangdong, operated a dim sum café in Kuala Kangsar. Ho was sent to his ancestral hometown, Panyu, in 1918 to further his education, returning to Malaya in 1924 (Ho Yan Hor Museum 2025). His early exposure to traditional learning and subsequent experience working at a Chinese medical hall nurtured his lifelong interest in Chinese medicine. Inspired by his passion for Chinese Medicine, Ho pursued further studies at the Ganton Wah Lam National Physician’s School in Hong Kong, from which he graduated in 1940, obtaining professional training in Chinese medicine (Fig. 1).

Ho began his career as a Chinese physician in 1941, but ceased due to the Japanese occupation. Following the war, miners in Perak began rehabilitating their mines and sought workers to resume operations. Ho Kai Cheong realized that many Chinese colliers suffered from colds, runny noses, and fevers due to body heat. This rekindled his passion for Chinese medicine, and he developed a flu remedy based on a carefully formulated blend of Chinese herbs, including those for dispelling body heat and Eight Formula sugar cane extract, which helps to dispel exogenous influences.

With an initial modest capital of $4, Ho Kai Cheong established his first tea stall on Teacher Street, offering the herbal remedy as a natural solution to alleviate these conditions (Fig. 2). Timing his sales to coincide with the return of coolies and workers in the afternoon and into the night, he was surprised when the herbal tea sold out at 5 cents a glass within less than an hour. His tea went on to eventually gain widespread popularity in the community.

Typically, Chinese herbal preparations involve processing dried herbs into powdered, coarsely ground, sliced, or fragmented forms, while fresh herbs are sliced or torn to maximize their surface area (Wu et al. 2018). In 1947, Ho Kai Cheong introduced an innovative concept: packaging Ho Yan Hor Herbal Tea for sale in coffee shops and Chinese medical halls (Fig. 3). Priced at ten cents per pack, the tea became a popular remedy among the local residents. Ho soon became known publicly as the “King of Herbal Tea.”

As indicated in Table 1, Ho Yan Hor herbal tea is formulated with a combination of various herbs traditionally used in Chinese medicine. Unlike common herbal cooling teas in Guangdong, such as Wong Lo Kat and the popular “Twenty-Four Flavors,” which mainly include herbs like chrysanthemum, honeysuckle, prunella vulgaris, and licorice, the Ho Yan Hor formula features a broader array of potent medicinal ingredients (Guo 2024). The formula incorporates potent heat-clearing and detoxifying agents, such as scrophularia, gardenia, and rhubarb, as well as herbs that dispel wind and dampness to alleviate symptoms of external colds and body aches. Additionally, it contains ingredients like atractylodes lancea, which dries dampness and supports the spleen, and licorice root to harmonize the potent medicinal properties. This creates a balanced remedy that maintains wellness by addressing both acute external symptoms and chronic internal imbalances. In times when aspirin and antibiotics were not readily available, it served as a highly effective treatment for such ailments (Ho 2009, 691).

Table 1. Ho Yan You Herbal Tea Formula in the 1940s.

Commercialization and Globalization

Building on the success of Ho Yan Hor herbal tea, the Ho Yan Hor Medical Hall was officially established in 1948. Several signature Chinese medicine products had been developed, including Ho Yan Hor Oil (何人可油), Ching Tim Kam Jik San (清甜疳積散), and Ko Kou Tan (可口丹). The continual growth reflected the local demand for traditional remedies.

In 1957, the Asian Flu spread rapidly across the globe (Honigsbaum 2020). During this time, Ho Yan Hor herbal tea gained popularity as an alternative remedy to Western medicine, valued for its perceived effectiveness in relieving symptoms such as fever and dizziness, promoting self-healing, and providing accessible household relief from influenza. The Ho Yan Hor factory, established in 1954, employed workers in the manufacturing process, marking the beginning of its modern commercialization. Recognizing the importance of marketing, Ho utilized innovative strategies, such as equipping his distribution vehicle (a Fordson van) with loudspeakers to advertise the benefits of his products across neighborhoods.

In the 1960s, Ipoh was home to numerous herbal tea vendors, many of whom hired young women known as “herbal tea ladies” (leong char mooi) to attract customers. Large Ho Yan Hor tea stalls also sprouted across the country. Leveraging his strong connections with Hong Kong, Ho Kai Cheong capitalized on the widespread popularity of Guangdongese opera and Hong Kong cinema among Chinese communities in the 1950s and 1960s. Famous performers from Hong Kong, including actress Tang Pik Wan (鄧碧雲) and TVB actor Cheng Gwan-Yin (鄭君綿), were invited to visit Ipoh for promotional events. Ho Yan Hor has consistently produced a series of advertisements in major newspapers across the country, with small-sized ads that consistently convey a continuous message to reinforce consumers’ brand recognition (Vijayan 2022). It registered its trademark and officially established its first overseas brand in 1960. By the 1970s, the brand had expanded its sales to include other countries such as the United States, the United Kingdom, and New Zealand (Fig. 4).

Since the 1980s, the depletion of Perak’s tin reserves and the global downturn in natural rubber demand have ushered in a period of economic transition. In response, the state government pursued diversification by promoting manufacturing as a new growth engine, supported by expanded infrastructure and industrial development. Industrial estates were progressively established across Perak (Perak Investment Management Centre 2025). Ho Yan Hor has responded by introducing new herbal varieties tailored to specific health needs, modernizing packaging, and rebranding to attract younger consumers while maintaining its heritage.

The original recipe has since undergone systematic refinement and expansion to include 31 herbs to maximize the therapeutic value and health benefits of the herbal tea (Table 2). The new formula is crafted to clear heat, dispel dampness, regulate qi, and alleviate pain. It is conveniently packaged in aluminum cans. Additionally, the introduction of these new products and packaging has reinforced the brand’s message of promoting herbal wellness among all Malaysians.

Table 2. Ho Yan Hor Herbal Tea New Formula

The Malaysian herbal tea market has experienced significant growth in recent years, fueled by consumers’ increasing preference for natural, health-promoting alternatives to caffeinated drinks. The market showcases innovations in herbal blends, sustainable packaging, and convenient wellness products (Mobility Foresights 2025). Amidst growing competition and changing consumer lifestyles, Ho Yan Hor has adapted by introducing functional teas such as Gold Tea, Night Tea, and the Everyday Series, thereby maintaining its position as Malaysia’s leading brand with the most diverse range of herbal teas, the evolution of its manufacturing and packaging not only demonstrates the brand’s progression through different historical stages but also reflects Malaysia’s broader industrialization and shifting consumer market trends.

Cultural Heritage and Medical Transition

Malaysia, with its rich biodiversity and multicultural traditions, fosters the development of a dynamic Chinese herbal tea and medicine sector. Remedies based on local flora are still prevalent in households and present significant potential for the creation of new herbal products. After the war, Perak experienced significant political and economic transformations that facilitated modernization and rapid development. The ascent of Ho Yan Hor, established in Perak during the 1940s and later expanding nationwide, coincided with these broader economic and industrial changes. The increasing popularity mirrored robust local demand for healthcare and the adaptation of traditional remedies to evolving social contexts. Despite the creation of Western health institutions, traditional medical practitioners maintained a dominant role within local communities (Mohd Sukri 2020). By 2024, the number of Chinese medicine practitioners had continued to grow, with 402 Chinese medicine halls and 482 registered physicians, though the actual figures are likely even higher (FCPMDAM, 2016).

Herbal tea remains highly popular in Malaysia, reflecting both enduring cultural traditions and increasing health awareness among consumers. Market analyses project that Malaysia’s herbal tea industry will expand from USD 1.2 billion in 2025 to USD 2.7 billion by 2031, registering a compound annual growth rate of 14.3% (Mobility Foresights 2025). Rich in bioactive compounds, herbal teas possess antioxidant, anti-inflammatory, antiviral, and hepatoprotective properties, and are traditionally valued for their ability to clear heat, reduce fever, soothe the throat, and relieve coughs (Lin, Li, and Huang, 2024).

Notably, significant ethnic differences exist in the knowledge and consumption of Chinese herbal tea across Malaysia. A survey in Kedah, northern Malaysia, found that many Chinese consumers maintain this practice as a cultural tradition, motivated by its perceived safety and health benefits (Teh, Jaafar, and Asma 2020). Over the past century, herbal tea has become not only a cultural emblem but also a prosperous business sector. Chinese entrepreneurship has been pivotal in shaping Malaysia’s societal and economic development. Perak has rapidly evolved from its traditional economic foundation of tin mining and related industries to a diversified array of manufacturing and service sectors, ranking as the seventh-largest by economic size and contributing 5.5% to the national GDP in 2020 (Zafri and Morhalim 2022). As of 2020, the Chinese community in Perak numbered 643,627, constituting 27.22% of the state’s population, with the highest concentration in Ipoh (Jiao and Singh 2024).

Since the 1980s, the narrative of Ho Yan Hor has embarked on a new chapter, characterized by a shift from traditional remedies to modern pharmaceutical manufacturing. Following the succession from Ho Kai Cheong to his son, David Ho, the family business evolved into a research-driven pharmaceutical enterprise. Upon his return in 1980, equipped with professional training in pharmacy, David Ho established Hovid Berhad, bringing innovation, scientific production, and modern management practices. By the 1990s, Ho Yan Hor had evolved from a traditional herbal brand into a GMP-certified and Halal-accredited pharmaceutical manufacturer with an expanding international presence. Importantly, while numerous traditional herbal products exist, few have successfully transitioned from folk remedies to high-value modern biomedical brands. Thus, the case of Ho Yan Hor and Hovid presents a particularly significant and insightful example of this evolution.

Conclusion

The historical trajectory of Ho Yan Hor embodies the post-war evolution of Chinese herbal tea cultural heritage in Malaysia within the socio-economic transformation of Perak. This traditional herbal beverage adapted to processes of industrialization and commercialization, reflecting the broader modernization of traditional Chinese medicine in the country. The sustained success of Ho Yan Hor demonstrates how traditional Chinese medical knowledge can be reinterpreted and institutionalized within modern pharmaceutical frameworks. By fusing heritage-based practices with Western scientific production, marketing strategies, and regulatory standards, the company has evolved from a local family enterprise into a modern pharmaceutical corporation of both national and global relevance, serving as a model of cultural continuity amid technological and economic change.

As one of Malaysia’s most prominent functional herbal teas, Ho Yan Hor’s legacy extends far beyond being “just a cup of tea”; it is a testament to the enduring value of Chinese herbal medicine and its seamless integration with modern consumption advancements. Its evolutionary journey reflects how traditional remedies can evolve through innovation while retaining their cultural essence. This synthesis not only strengthens the brand’s position in the industry but also serves as an inspiring model for the broader healthcare sector, offering insights into how traditional and modern medicine can work in harmony to meet evolving health needs.

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Authors

Corresponding author: Dr. Su Qiuyang, mysunnysu@gmail.com

Su Qiuyang (https://orcid.org/0009-0005-4541-0681; BA, Sun Yat-sen University; MBA, Peking University; PhD Candidate, University of Malaya) has worked in the healthcare sector for many years as a senior manager and has authored a series of articles, interviews, and in-depth reports on culture and healthcare reform. Her current doctoral research at the University of Malaya focuses on the history of traditional Chinese medicine and its development among Overseas Chinese communities in Malaysia.

Prof. Danny Wong Tze Ken (https://orcid.org/0000-0002-4357-7753) is Professor of History at the Department of History, Faculty of Arts and Social Sciences, Universiti Malaya where he teaches history of Southeast Asia and History of China. His research interests include the Chinese in Malaysia, China’s relations with Southeast Asia and History of Sabah. He is currently Dean of the Faculty of Arts and Social Sciences, Universiti Malaya. He was Director of Global Planning & Strategy Centre, Universiti Malaya and former Director of the Institute of China Studies and former Head of the Malaysian Chinese Research Centre at the same university.

Dr. Tan Miau Ing (https://orcid.org/0000-0001-9129-6641; PhD Saharan Cina Malaysia, Universiti Malaya; M.Econ and B. Econ, Universiti Kebangsaan Malaysia) is Senior Lecturer of Department of History, Faculty of Arts and Social Sciences, University of Malaya. She is also the Head of Malaysian Chinese Research Center (MCRC) of UM.

What happens when we use the same English term to translate ideas from different Asian medical traditions? Conflating concepts coming from different medical and cultural contexts can lead to confusion that severely compromises our understanding and appreciation of the differences between medical systems.

One pernicious example of this is how common it is even among seasoned Chinese medicine practitioners in the West to say that their theory is based on the “five elements.” This phrase is using a term from the European cultural context to fundamentally misrepresent the basic worldview of Chinese medicine.

Let’s pick this apart together in order to see why this mistranslation matters. . .

Our starting point is to understand that, in the ancient period, traditions of medicine originated in relative isolation from one another on opposite sides of the Eurasian landmass. Historical texts dating from the last few centuries BCE show us that the Chinese medical tradition that had taken form at one end and the Indo-European medical tradition at the other were based on fundamentally different ideas.

On the eastern side, foundational medical texts written in Chinese such as the Inner Canon of the Yellow Emperor (Huangdi neijing 黃帝內經) talked about Wood, Fire, Earth, Metal, Water being “five phases” (wuxing 五行). The key character 行 is based on a pictogram that originally depicted a crossroads or footsteps, and its core meaning is the noun “steps” or the verb “to walk.” It is associated with movement, directionality, and change over time.

On the other side of Eurasia, the Ancient Greek Hippocratic corpus that formed the basis of Greek and Roman medicine named Earth, Water, Air, and Fire the “four elements” (στοιχεῖα, stoicheia). Philosophers often added Void (αἰθήρ, aithḗr) to this list when signifying the absence of the other elements. There are also descriptions of these same elements (in India called mahābhūta) in Buddhist texts, such as the Great Elephant Footprint Simile (Maha-hatthipadopama-sutta), orally transmitted in the Pāli language since the last centuries BCE. They also appear in Sanskrit medical texts, such as the Āyurvedic classics Caraka’s Compendium and Śusruta’s Compendium (Caraka-saṃhitā and Śusruta-saṃhitā), that can be dated to roughly the same period. Whether these elements originated in India or Greece has been debated, but the fact that the elemental schema was shared between Europe and India is not disputed.^⁠1

In most schools of early Indo-European thought, the material elements of Earth, Water, Fire, and Wind are considered to be ontologically real substances that arise within the Void. They are the four fundamental building blocks of all material reality. This stands in marked contrast to Chinese cosmology, where everything that exists (i.e., the ”ten thousand things,” wanwu 萬物) are composed of the unitary substance of qi. In Chinese thought, the five phases thus are not separate ontologically existing things, but rather processes, patterns of change and transformation in how qi manifests in time.^⁠2

These philosophical and cosmological distinctions provide different starting points for East Asian and Indo-European forms of medicine. In Chinese medicine, where the human body, like all physical material, is composed of qi, the default state of the human being is one of wholeness, health, and harmony. It is only through error, or deviating from the Dao, that one deteriorates into sickness. Indo-European texts, in positing four primordial building blocks instead of one, present a less harmonious picture. The elements are not only distinct, they are often mutually incompatible, which is a persistent source of suffering for humans. Buddhist discourses on the body, for example, say that the relationship between the elements is like four venomous snakes trapped in the same basket. Their mutual antagonisms and perturbations cause disease, and inevitably in old age, they finally fall apart completely.^⁠3

If these differences between the Chinese phases and the Indo-European elements are so clear, then why do we find slippage between them today? Western-language translations equating phases and elements can be traced as far back as Matteo Ricci (1552-1610), the Jesuit envoy to the Chinese empire who first translated between European and Chinese philosophical and religious ideas. Ricci and other writers of his time were cognizant of the differences between elements and phases, defining the elements as “structural” (ti 體, yuan 源) and the phases as “processual” (yong 用, liu 流).^⁠4 Nevertheless, Ricci’s decision to translate the Greco-Roman elements as “the four phases” (sixing 四行) allowed later practitioners to elide these important distinctions and make simplistic equations between elements and phases.

Fast forward to the 1970s, when a modern style of practice called “Five Element Acupuncture” became central to the popularization of Chinese medicine in the English-speaking world. This system was primarily developed and promoted by the British physiotherapist and acupuncturist J.R. Worsley (1923–2003), and many acupuncture practitioners active in Europe and North America today trace their lineage to him.

Ricci’s and Worsley’s equation of phases and elements promoted the widespread misunderstanding that the wuxing can be thought of as ontologically existent “things,” but they are not. The phases should be understood as qualities rather than essences. They are adverbs or adjectives rather than nouns. Rather than thinking in terms of Wood, Fire, Earth, Metal, Water per se, we should think in terms of Wood-like, Fire-like, Earth-like, Metal-like, or Water-like qi. The noun is always qi because in Chinese thought that’s the only substance there ever is.

Clarifying these concepts has clinical implications, but is also important because of how metaphors structure our experience of ourselves and the world we inhabit.^⁠5 It’s one thing to live in a fractured body in a universe where competing substances vie for primacy. It quite another to be embedded in a unified whole where body and cosmos are composed of the same primordial stuff. It’s one thing for one’s idea of health and illness to be organized around the inevitability of disintegration, and quite another for it to be based on an assumption of harmonious oneness.

The stakes of this mistranslation extend far beyond academic pedantry. When we impose the language of “elements” onto Chinese medical concepts, we inadvertently import a Western metaphysical framework that is fundamentally at odds with the Chinese worldview. We lose sight of the dynamic, processual nature of the phases and replace it with an ontology that belongs to a different tradition entirely. Better historical understanding helps us to resist the temptation of false equivalences and to preserve the conceptual integrity of the traditions we study.

¹ Filliozat, J. (1964). The Classical Doctrine of Indian Medicine: Its Origins and Its Greek Parallels. Delhi: Munshiram Manoharlal; McEvilley, T. (2002). The Shape of Ancient Thought: Comparative Studies in Greek and Indian Philosophies. New York: Allworth Press, 300–309.

² Jones, CB. (2016). Creation and Causality in Chinese-Jesuit Polemical Literature. Philosophy East and West 66(4), 1251-1272. https://dx.doi.org/10.1353/pew.2016.0090.

³ Salguero, CP. (2018). “This Fathom-Long Body”: Bodily Materiality & Ascetic Ideology in Medieval Chinese Buddhist Scriptures, Bulletin of the History of Medicine 92.2: 237–60. https://muse.jhu.edu/pub/1/article/698172.

⁴ Hsu KT. (1997). “The Transmission of Western Four Elements Theory in Late Ming China.” Tsing Hua Journal of Chinese Studies n.s. 27.3: 347-380. https://thjcs.site.nthu.edu.tw/p/406-1452-41461,r2974.php

⁵ Lakoff, G, and M Johnson. (2003 [1980]). Metaphors We Live By. Chicago: University of Chicago Press.

Herbal drugs have long been valued not just for their effects, but where they come from. The origins of drugs are thought to be important indicators of their quality and their efficacy, and scholars and pharmacists around the world have paid attention to this for centuries. It is thus rare to find new data that allows us to rethink the early tradition in fundamental ways. An article of mine titled Mapping the Bencao, recently won an academic prize, so I thought I would write a brief summary of the article and its implications.

The study uses Digital Humanities to produce new data that challenges long-held assumptions about the origins and geography of Chinese materia medica. By digitally tagging a critical edition of an early Chinese pharmacological text, I was able to analyze its contents in new ways. In particular, by tagging it with historical GIS points, and rendering them in open-access platforms, I was able to produce maps of the locations where drugs were produced in early imperial China.

The practice of reading maps is very different from the way we encounter drug locations in a text. When reading a text, names pop up that may sound familiar or jog the memory, but for the most part, they fall into the background. You don’t get a sense of where they’re from, just the significance of the name of the place. The digital map however, reveals the geographic distribution of Chinese drug cultures in a way never before seen. It brings the drug locations into relationship with one another, and also in relationship to the local landscape. In particular, it showed a surprising fact—that almost all sites of production described in the texts were located on rivers or lakes, not on mountains, as imagined in the tradition.

At the heart of this study is the bencao 本草 tradition — China’s vast pharmacopoeia literature — and its multiple textual layers, especially the Materia Medica of the Divine Farmer, the Supplementary Records by Famous Physicians, and Tao Hongjing’s 陶弘景 Collated Annotations. Together with a team of colleagues, students and research associates, at the Max Planck Institute for the History of Science, National Taiwan University, Dharma Drum Institute of Liberal Arts and Nanyang Technological University, we created a digital, searchable edition of this layered text with the MARKUS and DocuSky platforms. Each entry is tagged for properties like taste, temperature, toxicity, preparation, and—crucially—place of origin. These tags were then matched to historical maps and GIS data from Academia Sinica, allowing researchers to visualise where drugs were sourced over time.

The resulting images tell a story that textual readings alone cannot. While scholars like Yamada Keiji had previously identified the loess plateau as the origin of Chinese drug lore, this map reveals a dense corridor of medicinal activity stretching along the Yellow River from the Bohai Sea through Chang’an (modern Xi’an), and into the Sichuan basin. This “Yellow River Corridor” turns out to be a riverine highway of drug trade and knowledge, connecting regions once thought peripheral to the canonical centers of Chinese medicine.

This view allowed me to rethink early drug lore not as a product of isolated Daoist mountain sages, but as a vibrant, decentralised network of drug production and exchange along rivers, mountains, and trade corridors. Because these sites were locations of trade rather than fixed points of botanical origin, the paper reimagines these locations as “drug production” sites — nodes of social-technological activity where wildcrafting, preparation, and trading translated these “wild objects”, or raw materials, into culturally legible medicinal products. Some places, like Taishan and Songshan, have long been famous in Daoist or medical traditions, but others — such as Hanzhong and Jianping — emerge in this study as waypoints in the drug trade. These places acted as bottlenecks or crossroads, showing that pharmacological knowledge flowed along human routes of exchange rather than solely sprouting from mountain hermitages or elite academies.

One particularly important case study is the recently excavated medical texts from Laoguanshan 老官山, near Chengdu in southwestern China. Though geographically distant from the central plains, the herbal repertoire of this tomb text is particularly concentrated in east and northeast China, especially Shandong province. This challenges assumptions about regional isolation and suggests that even in the 2nd century BCE, medical knowledge travelled widely. By comparing drug names in the Laoguanshan text with those found in the digitised bencao corpus, the paper argues that the Laoguanshan text reflects an eastern herbal vocabulary, perhaps preserved through trans-regional networks that may have navigated along the Yellow River.

One takeaway is that digital tools can radically transform how we understand traditional medical knowledge. Not only do they allow for granular philological tracking of drug names and their changes over time, but they also help visualise sociotechnical systems of exchange. I argue for moving beyond elite literary imaginations that saw drug knowledge as flowing from Confucian doctors or Daoist adepts. Instead, I encourage readers to see pickers, traders, sellers, and users — actors often marginalised by Confucian social mores —as part of a complex polyglot system where knowledge was dynamic, negotiated, and deeply embedded in place.

I also argue that this open-source data could be used for other kinds of research. For example, to look again at concentrations of regional trade, or to geo-locate literature, like poems or strange tales, that favour drugs from particular regions.

This work also speaks to present-day concerns in ethnopharmacology, bioprospecting, and data equity. Just as ancient Chinese physicians debated drug authenticity, modern researchers must wrestle with how traditional knowledge is extracted, named, and validated — often by those with the most institutional power. Through careful data stewardship and open-access publication, we can provide a more ethical and inclusive way to explore and share historical medical data.

Ultimately, Mapping the Bencao is more than a historical study. It’s a compelling case for how digital humanities can not only preserve the past but reconfigure our understanding of it. The rivers and roads that once carried herbs and recipes are now mirrored by data pathways and linked ontologies — but the questions remain the same: who knows what, where does knowledge live, and how do we value it?

This is an excerpt of The Spirituality Gap: Searching for Meaning in a Secular Age by Abi Millar. It has been slightly edited for AMZ, removing references to information found elsewhere in the book or inserting a few words in brackets to give needed context.

‘It’s an often overlooked fact that mindfulness, the way that it’s taught in all of these apps, is a practice that derives originally from Buddhism,’ says C. Pierce Salguero, transdisciplinary scholar of health humanities at Abington College, Penn State University, when we talk.[1] ‘But it has also undergone a pretty thorough transformation, to be turned from a more religious or spiritual practice into a secularised medical or mental health practice.’

As an expert in Buddhism and medicine (although, interestingly, not a Buddhist himself), Salguero has a lot to say about how mindfulness-for-health fits into its historical context. In his book Buddhish: A Guide to the 20 Most Important Buddhist Ideas for the Curious and Skeptical (2022), he explains how Buddhism itself has been reimagined in the West, laying the groundwork for the present mindfulness boom. Historically speaking, Buddhism has involved a rich tapestry of traditions, some of which are flagrantly religious or magical in hue. By contrast, the Buddhism many of us in the West recognise, in which the Buddha was something like an ancient psychologist, designing an empirical ‘science of mind’, emerged little more than a century ago.

‘At the time, European discourse was talking about how backward the Asians were, and Buddhism was held up by colonial authorities as a prime example of superstition,’ says Salguero, echoing what Shreena Gandhi told me about yoga. ‘Buddhist authorities all over Asia engaged in a project of reimagining Buddhism in a more secular and scientific way, moving away from magical practices and rituals and emphasising the practice of meditation as a psychology and a philosophy.’

European and North American intellectuals, drawn to this rejigged form of Buddhism, started promoting meditative practices at home. Meditation became widespread, and with it, the perception of Buddhism as somehow more objective or empirical than other religions. When [Jon Kabat-Zinn, founder of the modern MBSR mindfulness protocol] set to work on making mindfulness ‘commonsensical’, the earlier colonial push to secularise Buddhism surely helped him along the way.

It isn’t clear, though, that the endgame of a Buddhist mindfulness practice is quite the same as the endgame for MBSR. As Salguero explains in his book: ‘Buddhist trainings that emphasize concentration often focus on generating what in the Pali language is called jhana, advanced states of absorption in which you become so concentrated on the object of meditation that the rest of the world melts away … Trainings emphasizing insight, on the other hand, focus on perceiving your chosen object of meditation as a manifestation of suffering, impermanence, and non-self.’[2] In either case, the idea is to deconstruct our usual habits of mind and see ‘reality as it is’, as opposed to reducing anxiety or fostering calm.

‘In general, the idea that Buddhist meditation is going to lead to inner peace is a misunderstanding,’ says Salguero. ‘What it does give you is the tools to be able to deal with a whole range of different kinds of experiences in a more detached and neutral way.’

At the bare minimum, he adds, you’re going to experience sore knees and a sore back. People might also experience latent traumas and other kinds of negative emotions. ‘If there’s any inner peace to be had, it takes the form of your being able to sit there with equanimity while the emotional and physical pain pass through your body and mind.’

Salguero’s description resonated with me, and even felt somewhat validating. Unlike the other routine self-care practices I am somehow not too busy for (exercise, taking a bath, brushing my teeth), meditation strikes me as an unknown quantity, and that’s why I’m often reluctant to go there. For me at least, the benefits have never emerged in anything like a linear, predictable way.

Sure, sometimes it’s relaxing, as the apps would have it. Sometimes I can see that it’s helping train my concentration and focus, as any corporate mindfulness programme would have it. Other times, though, the experience is more complicated and confronting. I may find myself crying. I may find myself racked with existential confusion. I may find old issues resurfacing or new aggravations arising, or I may just sit there feeling frustrated and bored.

I’ve had powerful meditations too, in which new insights have bubbled up prolifically, or long-buried emotions have found release. On one occasion, I was trying to ‘be present’ with an overwhelming feeling of rage. Rather than getting lost in my thoughts about the rage, I tried to pay attention to the original feeling and how it hunkered in my body. I noticed my heartbeat, more emphatic than normal, and the coiled spring of my muscles primed for action. The feeling in its distilled form was not purely negative. It was powerful. It reminded me of fire — raw, amoral, magnificent, full of destructive potential. Afterwards, I felt something toxic had left my system for good.

Experiences of this nature have left me in a conflicted place. On one hand, I’m intrigued by meditation. I’ve tasted some of the possibilities on offer. I like a challenge, and there’s a swashbuckling part of me that’s fully on board with a quest through the gnarlier regions of the mind. On the other hand, if I’ve got ten minutes to spare for mental and spiritual maintenance, I’m going to default to something that reliably makes me feel safe or calm or connected. If you’ve ever tried meditating and felt less than beatific, it’s easy to conclude that you’re failing at it, or that the concept has been mis-sold.

‘Maybe some strategic misinformation is being promoted about mindfulness, that it’s just going to make you happy,’ says Salguero. ‘But if you practice mindfulness seriously, it’s going to make you experience all your suffering in a way that is much rawer. You’ll develop a lot more equanimity, maybe more bravery, because you’re not fighting those forms of suffering as they come up. But it’s certainly not going to make those kinds of things go away.’

In more recent years, the ‘underbelly of the mindfulness movement’, as Salguero described it to me, has attracted more attention. One powerful critique comes from Ronald Purser, an ordained Buddhist teacher and management professor at San Francisco State University. In his book McMindfulness: How Mindfulness Became the New Capitalist Spirituality(2019), he makes the case that mindfulness has been hijacked by consumerist culture. It has been reduced, he thinks, to an individual coping mechanism, engendering a passive acceptance of the systems that have caused our stress in the first place. This is particularly the case when corporations get involved, offering up mindfulness to their workers as opposed to improving their working conditions. For instance, Starbucks attracted ire in 2020 when it gifted its overstretched employees a Headspace subscription.[3]

As for the ways that mindfulness has taken off in Silicon Valley, there is clearly a stark contradiction in executives using a Buddhist-derived practice to get ahead in business. In Purser’s view, practices like MSBR are being used to uphold the neoliberal status quo, masking the revolutionary potential of Buddhist teachings.

‘Mindfulness has been oversold and commodified, reduced to a technique for just about any instrumental purpose,’ he writes. ‘It can give inner-city kids a calming time-out, or hedge fund tracers a mental edge, or reduce the stress of military drone pilots. Void of a moral compass or ethical commitments, unmoored from a vision of the social good, the commodification of mindfulness keeps it anchored in the ethos of the market.’[4]

Purser’s tone is trenchant. After attending an MBSR programme, he does concede that ‘MBSR is a saving grace for many people … The course was accomplishing exactly what it was intended to do: teach people how to reduce their stress and anxiety, cope with pain, and live a more mindful life.’[5] But nevertheless, he contends, mindfulness stands to make us ‘better adjusted cogs’, docile in the face of exploitation.

His book is a bracing read and I found myself nodding along in places. That said, I sensed he didn’t give the average Western meditator enough credit. Sure, meditating tech bros are a thing — microdosing, biohacking and breath-working their way towards corporate dominance. At the same time, there are many people whose inner explorations will lead them far off the beaten path of capitalism. To my mind, just sitting and being and doing ‘nothing’ is an inherently anti-capitalist practice, the antidote to our obsession with chasing future rewards. It is very likely to bleed into something spiritual too, even if that isn’t always the terminology the practitioner would choose.

‘Ron is articulating one response that Buddhists have had to the mindfulness movement, but the Asian Buddhist communities that I’ve been involved with have actually had a different response to Ron’s,’ Salguero says. ‘The one I’ve heard most frequently is: the more people who practice mindfulness, the more wellbeing we’ll have on the planet. The more people who practice mindfulness, the less suffering there will be across humanity. And moreover, the more people who practise mindfulness, the more people might be exposed to Buddhist ideas. For me, I think there’s truth in both these responses.’

Jiva Masheder goes further, remarking that Purser has fundamentally misunderstood MBSR. As she sees it, his mistake is to conflate acceptance with resignation, which mindfulness teachers have never promoted. If there’s any truth in his argument, she thinks it lies in his observation that mindfulness has been reduced to an individual coping mechanism. Traditionally, Buddhism would have been practised in a community setting (the Sangha) with a teacher, and MBSR courses are based on the same model. She thinks you’re unlikely to get the full measure of mindfulness if you’re doing it at home on your own.

A different kind of critique comes from Willoughby Britton, who made a splash in 2017 with a paper on the potential negative effects of meditation. Britton, who is a clinical psychologist and a professor of psychiatry and human behaviour at Brown University, was interested in experiences that could be ‘described as challenging, difficult, distressing, functionally impairing, and/or requiring additional support’. Her team interviewed ninety-two Western Buddhist meditators who had reported these kinds of outcomes.

The resulting study, called The Varieties of Contemplative Experience, identified fifty-nine categories of negative experience, ranging from ‘loss of the basic sense of self’ to ‘changes in motivation’, ‘the re-experiencing of traumatic memories’ and even ‘gastrointestinal distress’. A whopping 88 per cent of the meditators said their challenging experiences had spilled over into their everyday life. Shockingly, 17 per cent had felt suicidal and another 17 per cent had required inpatient hospitalisation. [6]

As the paper explains, many Buddhist traditions ‘acknowledge periods of challenge or difficulty associated with the practice of meditation’. It adds that: ‘Given that some of these effects might even run counter to the dominant paradigm of health and well-being, it is critical that the range of effects associated with Buddhist meditation be investigated in the modern Western context.’

For sure, these study participants aren’t representative of the average person who downloads the Calm app. They were serious meditators, who had been selected for the study precisely because they’d had a tough time. Such experiences might be extraordinarily rare — the functionally impaired exception that proves the happy, healthy rule. But for researchers like Britton, they’re too important to be ignored. Today, she offers trauma-informed mindfulness trainings called ‘First Do No Harm’, and provides support services to people who’ve run into meditation-related difficulties. As she remarked in a 2014 Atlantic article: ‘As much as I want to investigate and promote contemplative practices and contribute to the well-being of humanity through that, I feel a deeper commitment to what’s actually true.’[7]

Britton is not the only researcher to probe the dark side of meditation practice. As I have argued, there is a tension between mindfulness as a spiritual practice, and mindfulness as a tool for personal thriving. According to Salguero, this very tension can sometimes cause people harm.

‘A small minority of people are interested in meditation for health and wellbeing purposes, who do some intensive practice or go on a retreat,’ he says. ‘They don’t know about the Buddhist concept of non-self and they don’t know that this is a practice designed to trigger those kinds of realisations. So, when they experience some of these effects, they don’t have the context to understand what they’re experiencing.’

It seems there are documented cases of people who have practised secular meditation and inadvertently ‘cracked open the fiction of self’. We’re talking about the kind of ego death experience we explored with the neuroscientist, Dr James Cooke, earlier in this book. For Cooke, this was a positive occurrence, but others are more panicked or perturbed by it. In some cases, they might call on a mental health professional, who is no more schooled in Buddhist frameworks than they are.

‘They’re diagnosed in many cases with serious psychiatric diagnoses like depersonalisation and derealisation,’ Salguero remarks. ‘If you read the symptoms, this sounds exactly like what Buddhists are going for with loss of self.’

Back to that Trojan horse: might someone who innocently downloads a meditation app independently reach some Buddhist realisations? After all, these apps have been stripped bare of any theoretical underpinnings. They don’t purport to explain why you’re calm, why you’re relaxed (or as the case may be, why you’ve wound up re-evaluating your basic concept of personal identity). Any explanations you might find will likely be couched in physiological terms: you are calm because meditation calms your nervous system, not because you’ve happened across a truthful and spiritual insight.

Buddhist meditations, by contrast, are meant to guide you towards a particular way of seeing the world. It is intriguing to consider that the practical techniques adopted by MBSR might succeed in doing the same thing, even minus the supporting philosophy.

For that reason, Salguero thinks that meditators, however secular their inclinations, should be aware of the possible outcomes. In common with Britton, who came up with the idea, he thinks meditation ought to ‘carry a warning label’.

‘You can take the practice out of the temple, and you can secularise it, reinterpret it and put it into the hospital setting,’ he says. ‘But the practice was designed to produce these kinds of experiences. If you don’t know anything about emptiness or non-self, then these experiences can be really disorienting.’

[1] Interview with C. Pierce Salguero, conducted by author — Over Zoom, 8 May 2023

[2] Salguero, C. Pierce, Buddhish (Beacon Press, Boston, 2022), p. 64. Kindle Edition.

[3] Kaori Gurley, Lauren, ‘Starbucks Workers Want More Hours. Instead They Got a Meditation App’, Vice (8 January 2020), https://www.vice.com/en/article/z3bxn3/starbucks-workers-want-more-hours-instead-they-got-a-meditation-app.

[4] Purser, Ronald E., McMindfulness: How Mindfulness Became the New Capitalist Spirituality (Watkins Media, London, 2019), p. 17. Kindle Edition.

[5] Ibid p104

[6] Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE, 12(5), e0176239.

[7] Rocha, Tomas, ‘The Dark Knight of the Soul’, The Atlantic (25 June 2014), https://www.theatlantic.com/health/archive/2014/06/the-dark-knight-of-the-souls/372766/.

The following is part of a series of experiments using A.I. for a range of academic tasks. In this case, I have used Claude 3 Opus (set to “formal” style) to summarize a recent publication of mine. Unlike in other instances where I found A.I. to be incapable of performing basic humanities research tasks, I think that Claude did a decent job of summarizing various specialized academic texts I gave to it. Its outputs never capture the author’s tone or style, but they do usually convey the main ideas or major take-aways of the content accurately.

Given its strengths in this area, I think one helpful application might be for academic authors to use Claude to summarize academic content that is published in venues that are prohibitively expensive for non-academic readers to access, and/or that is written in extremely inaccesible ways due to the use of field-specific jargon and dense academic writing style. I have looked into the copyright status of doing this, and believe that summaries such as this one are covered by the doctrine of “fair use.” The piece below is substantially different than the original. I have not included the statistical details presented in the original, ensuring that any scholar who uses this research in their work will need to access the original and thus avoiding competition with the original work.

Readers who are interested in chasing down citations or gaining more precise information about the study can access the published paper here: C. Pierce Salguero, 2024, “American Buddhism and Healthcare.” In Scott Mitchell and Ann Gleig (eds.), Oxford Handbook of American Buddhism, pp. 318–34. New York: Oxford University Press.

(Energy usage disclosure: According to Claude.ai’s own reporting, generating this summary used as much electricity as conducting 15 standard web searches.)

A.I. Summary of “American Buddhism and Healthcare”

This article examines the current state of American Buddhist healing based on ethnographic interviews with 36 practitioners across the US. I map out the key demographics, practices, and contexts shaping how Buddhism is used for health and well-being in the U.S. today. My central argument is that the landscape of American Buddhist healing is far more diverse than is typically recognized, extending well beyond the medicalization of meditation practices such as mindfulness that receives the most attention in the media and from scholars. By identifying four distinct "positionalities" or overarching approaches taken by contemporary Buddhist healers, the article provides a framework for understanding this diversity and points to promising directions for further research. In shedding light on the many ways American Buddhists pursue health and healing outside the mainstream medical context, this article makes the case for a more expansive and nuanced discourse around Buddhism's role in the U.S. healthcare ecosystem.

Historical Background & Previous Literature

An interest in the relationship between mind, body, and liberation has been central to Buddhism since its very origins. Early Buddhist texts contained extensive teachings related to health and prescribed specific practices for preventing and treating illness, including meditation, moderation in diet and lifestyle, ritual chanting, and other religious observances.

As Buddhism spread throughout Asia in the premodern period, these practices were adapted to local cultural contexts. For example, Buddhist healers in China tended to frame their work in terms of indigenous concepts like qi, while those in Tibet developed a unique synthesis of Indian, Chinese, and local medical ideas known as Sowa Rigpa. This points to a consistent pattern of "domestication" whereby Buddhist notions of health were reinterpreted and recontextualized in light of the prevailing cultural worldviews and medical theories of each culture Buddhism encountered.

This cross-cultural exchange was not merely a one-way process of Buddhist ideas being modified by their new environments. Rather, the encounter with Buddhism also thoroughly transformed and revitalized many local healing traditions, with Buddhist philosophy and cosmology coming to serve as the foundation for the development of new medical systems in regions as diverse as Sri Lanka, Myanmar, Thailand, Tibet, and Mongolia. Many of these Buddhist-influenced healing traditions remain widely practiced in Asia and around the globe today.

The modern integration of Buddhist practices, especially meditation, into healthcare in the contemporary Western context has involved an ongoing dialogue and mutual influence between Buddhism and science. Buddhist concepts of mind and mental training have influenced research in fields like psychology and neuroscience while also undergoing medicalization and secularization to fit modern clinical frameworks. Ultimately, the current landscape of American Buddhist healing must be understood as a continuation of Buddhism's longstanding pattern of medical integration and innovation across cultural boundaries. This is not a modern anomaly, but rather a defining feature of Buddhism's long history of promoting health and well-being globally.

At the same time, a detailed examination of how this cross-pollination is unfolding in the context of the modern American healthcare ecosystem has yet to be thoroughly examined. There is limited existing scholarship on connections between Buddhism and healthcare in the United States. In one key study, Wu Hongyu (2002) found that 100% of the 19 respondents believed Buddhism was beneficial to health. Another important study is Paul Numrich's 2005 research involving interviews with 30 American Buddhists. Numrich found marked disinctions between “culture Buddhists" and “convert Buddhists” in terms of their use of “folk healing,” complementary and alternative medicine (CAM) practices, and biomedicine.

While Wu and Numrich paint generalized pictures of Buddhist communities, much more robust individual detail is provided by Kin Cheung's research on the practices of a Cantonese-speaking community healer in Brooklyn, NY, who uses an eclectic mix of Buddhist, Daoist, medical and folk practices. My own previous work has included a comprehensive ethnographic study conducted from 2015-2020 on the lived experience of 45 Buddhist organizations in the area. I also recently published results of a survey of American Buddhists from various backgrounds about their attitudes toward health and healing. The main findings in both of these studies is that Buddhism is playing a larger than recognized role in shaping American healthcare attitudes in contemporary times, and I argued that the full breadth of practices deserves further study.

Overall, the existing literature demonstrates that while research on Buddhism and health in the U.S. remains limited, existing scholarship consistently points to the importance of Buddhism in shaping American healthcare in ways that go beyond the typical focus on meditation alone. The studies span different communities and methodologies but converge in suggesting many American Buddhists view diverse Buddhist practices as legitimate, effective means of promoting well-being. The full scope of American Buddhist healing merits expanded academic attention.

Survey of American Buddhist Healers

My research assistants and I conducted a survey between 2015 and 2019 involving extensive interviews with 36 American Buddhist healers. The sample included a mix of races, genders, ages, geographic locations, sectarian affiliations, and cultural origins in an effort to capture a representative cross-section. All interviewees were long-term Buddhist practitioners involved in healing others or teaching self-healing using Buddhist techniques.

The survey of American Buddhist healers (n=36) included a diverse sample across dimensions of race, age, gender, geography, immigrant status, Buddhist sect, cultural lineage, and primary practitioner role. However, the sample overrepresented certain groups, such as white (55.5%), Generation X (58%), and female practitioners (56%). The most common primary occupations were professional healers (31%), monastics (19%), and priests (19%). While not a perfectly representative sample, the diversity of participants provides insight into the breadth of the American Buddhist healing landscape and the variety of ways Buddhism is being integrated into health and wellness-related work. (For more specific data, see Table 1 in the published piece.)

The survey found large majorities were in favor of the statement that Buddhism has a connection with mental health (89%) and physical health (76%). Respondents identified “meditation” as the practice most commonly associated with mental and physical health (86% and 73% respectively). Other practices frequently mentioned as health-promoting included “participation in Buddhist groups, cultural activities, or social gatherings,” “chanting,” “attending specific healing rituals, classes, or activities,” “visualization,” and “vegetarianism.” (For more specific data, see Table 2 in the published piece.)

With regard to specific reasons or mechanisms whereby Buddhism promotes health, an analysis of the open-ended responses showed a number of common themes mentioned across the interviews. Among these, the most frequently mentioned were “emotion regulation (e.g., management of stress, anger, etc.)” (61%), “mind-body connection or body awareness” (52%), and “social connection” (51%). (For more specific data, see Table 3 in the published piece.)

These findings notwithstanding, I argue that the most meaningful patterns discovered in the study were not demographic but rather based on the "positionality" of each healer - their role and approach to integrating Buddhism with healing. The paper identifies four distinct positionalities:

1. Incorporating Buddhism into mainstream healthcare

2. Integrating Buddhism with traditional Asian medicine

3. Optimizing Dharma teachings for health outcomes

4. Eclectically mixing religion, spirituality and healing

Each of these positionalities involves distinct professional settings, practitioner backgrounds, and target populations. This taxonomy cuts across demographic categories, capturing shared perspectives and practices based on the healers' roles and community contexts.

Incorporating Buddhism into Mainstream Healthcare

This group included chaplains serving in hospitals, hospices, and similar settings, as well as a leader of a Buddhist charity providing free medical clinics. Although their chaplaincy training discouraged overt religious content, they all reported drawing on Buddhist practices for patients' and their own well-being.

Key characteristics of this positionality:

• Emphasized values like equanimity, generosity, and forbearance as inherently healing for patients and protective for healthcare workers

• Downplayed need for complex ritual, instead stressing simplicity and seamless integration of basic practices (breath awareness, simple chanting/mantras, metta) into healthcare settings

• Prioritized non-judgmental presence as the essence of their work

Integrating Buddhism with Traditional Asian Medicine

Composed of practitioners of various Asian medical modalities (e.g. acupuncture, Sowa Rigpa, Thai massage, yoga therapy), this group actively integrated Buddhist practices with their therapeutic work and self-care routines.

Key characteristics of this positionality:

• Emphasized traditional training and lineage authenticity for both Buddhist and medical learning; saw both as complex lifelong paths

• Offered treatments combining physical and spiritual elements, e.g. bodywork with blessings, herbs empowered by mantras

• Used Buddhist practices for their own protection and well-being in clinical work

Optimizing Dharma Teachings for Health Outcomes

This group consisted of Buddhist clerics and community leaders who, while not primarily identifying as healers, reported regularly teaching their communities how to modify Buddhist practices to improve health.

Key characteristics of this positionality:

• Emphasized the preventive and curative potential of dedicated, long-term lay Buddhist practice; many discussed advanced meditation attainments

• Commonly taught specific chants, prayers, and rituals for healing, especially related to Bhaiṣajyaguru (i.e., the Medicine Buddha) and Avalokiteśvara (i.e., Guanyin)

• Also focused on benefits of practice for social and communal well-being

Eclectically Mixing Religion, Spirituality, and Healing

A group of Buddhist-inspired healers who offered unique blends of therapies drawing from multiple traditions, often in private practice settings.

Key characteristics of this positionality:

• Emphasized the healer's individual attainments and special abilities to perceive and manipulate subtle energies for diagnosis and treatment

• Employed eclectic and idiosyncratic methods including channeling deities, crystal healing, and Buddhist-derived rituals

• Conceived of disease and treatment in spiritual/energetic rather than biomedical terms

Conclusion

In summary, the positionalities identified in this article provide a bird’s-eye-view map the complex ways American Buddhist healers are integrating Buddhist practices and principles with other therapeutic modalities and applying them in different community settings. By identifying overarching orientations cutting across individual demographics, this framework provides a nuanced view of how Buddhist healing takes shape "on the ground." The diversity of approaches points to the need for further research exploring how American Buddhist healing extends beyond the medical mainstream. Please see the published article for more details.

I first traveled to Southeast Asia in 1990 to serve as a Peace Corps volunteer in Thailand. While studying Traditional Thai Massage or Nuad Boran at Wat Po Temple in Bangkok, I saw the Reusi Dat Ton (Traditional Thai Yoga) statues on the two Rishis’ Mountains on the temple grounds and became fascinated with this practice. I have now been a student of Thai Reusi Dat Ton and Indian Hatha Yoga for over 30 years.

During that time, I have traveled throughout Thailand, mainland Southeast Asia, and South Asia researching and studying yoga with dozens of teachers at various temples, ashrams, schools and institutes. In addition, I have visited numerous universities, libraries, museums, temples, caves and ancient archaeological sites on a quest for historical evidence of yoga poses in traditional texts, iconography, and artwork across Southeast Asia. In this article, I will share with you the best of what I have discovered.

Early Yoga Poses in SEA Art & Architecture

The earliest artistic depiction of a yoga pose I have found to date is at Sambor Prei Kuk in Kampong Thom, Cambodia, dated to about 600 AD. Sambor Prei Kuk was a capital city of the pre-Angkorian Chenla Empire and is one of the oldest surviving temple complexes in Cambodia. On an outside wall of the Yogi’s Tower or Prasat Asram in Sambor Prei Kuk, one can still discern a yogi in what is known in India as sopāśrayāsana pose, i.e., squatting while tying the back and the two legs with a piece of cloth. I found similar figures at Yasodharapura, an early capital of the Khmer Empire, in Roluos, Cambodia. Here, yogis in sopāśrayāsana pose can also be seen on the outside walls of the Lolei Temple, dated to about 893.

During my journeys across Southeast Asia, I have found images of yogis and gods in various yoga poses carved into stone at several ancient temples dedicated to Siva. In Southern Laos, in Champasak Province at the base of Lingaparvata Mountain, is the vast Vat Phu temple complex, dated to about 500-1100. Also known as the “Mountain Temple,” Vat Phu has traditionally been a special site for asceticism since ancient times. It was originally occupied by the Chams, then the Chenla and finally the Khmer who all continued the traditional worship of Siva at the site (Albanese p 283).

Outside and behind the central shrine carved into a rock face at the base of a cliff are the three gods of the Hindu trimurti, one of whom is performing a seated twisting pose similar to techniques practiced today in Reusi Dat Ton. In addition, numerous yogis in squatting poses, including sopāśrayāsana, are carved into stone on the base colonettes of doorways of numerous buildings throughout the Vat Phu temple complex.

In Northeast Thailand, in Buriram Province, atop an extinct volcano sits Prasat Phanom Rung “Big Mountain Temple,” constructed around 1100. Prasat Phanom Rung is a classical Khmer Temple that represents Siva’s home on Mount Kailasa. The temple is dedicated to the Pasupata sect of Hinduism and its concept of “formless yoga” (Srisuchat, 148). At base of the Principal Tower at Prasat Phanom Rung, carved into two stone colonettes at the bases of doorways are images of yogis practicing poses including utkutikasana, “the tight squatting pose” (Srisuchat, 154). These poses are also similar to techniques still practiced today in Thai Reusi Dat Ton.

Last but not least, I include a statue from Vietnam. While I found this one in a museum, not a temple, it’s one of my favorite early images of yogic postures because of how well it is preserved. The Museum of Cham Sculpture in Danang, Vietnam, houses a fabulous collection of stone sculptures recovered from various ancient Cham archaeological sites in southern and central Vietnam. One of the highlights of the museums collection is a sculpture of an apsara, a mythological celestial dancer in the “graceful three-bends posture (tribhanga)” (Museum of Cham Sculpture in Danang, Vietnam). This pose is nearly identical to a technique in Reusi Dat Ton known as “Gazing at the Stars.” This statue, dated around 1000, was originally from Tra Kieu, Simhapura, the first capital of the Hindu Cham Kingdom.

Nineteenth Century Examples

While the earliest artistic depictions of yoga techniques I was able to find in mainland Southeast Asia are primarily squatting, in later centuries, there appear a increasing number of more complex poses. This trend culminates in the 19th century with a sudden and vast proliferation in the sculpture and murals depicting yogic poses and exercises closely related to the Thai practice of Ruesi Dat Ton. In this section, I will give you some of my favorite examples from this era.

Advanced yoga practitioners are said to be able to develop various supernatural powers known as siddhi in Sanskrit and iddhi in Pāli. Among these powers are laghima, the ability to become weightless and fly. An example of artwork depicting this can be seen in Siam Reap, Cambodia, at the Buddhist Temple, Wat Bo. Inside the central shrine room high up on the inside walls are murals painted approximately 1800, depicting scenes from the Indian epic the Ramayana, known in Cambodia as the Reamker. One scene depicts four Yogis flying thru the sky. The abbot of the temple told me that the pose these Yogis are using is a special pose specifically used for flying. Indeed, during my travels throughout South and Southeast Asia, when I saw flying beings depicted in traditional artwork, they were almost invariably in an identical or very similar pose. This pose also appears in Ruesi Dat Ton practice.

In 1836, the Thai king Rama III commissioned the creation of 80 statues depicting some of the techniques of Reusi Dat Ton. About 20 of the original statues have survived and can be seen on the two Hermit’s Mountains or Khao Mor, at Wat Phra Chetupon (“Wat Po”) in Bangkok. Inscriptions describe the statues as “postures of yogic exercise invented by siddhas for remedy of illness… due to the malfunctioning of internal air or wind” (Srisuchat, 172). Along with each statue, there was also an accompanying tablet upon which was etched a poem describing the technique and its therapeutic effect.

In the Southern Thai provincial capital of Songkhla, there is a temple known as Wat Machimawat. On the temple grounds is the Reusi Dat Ton Pavilion, Sala Reusi Dat Ton. High up on the inside walls of the pavilion are two murals originally painted in 1863, depicting 40 different Reusi Dat Ton techniques along with the accompanying poems that describe the therapeutic benefit of each technique. I had seen photos of this mural in an old book in the National Library in Bangkok. In the book, the mural looked to be considerably damaged and many of the images were fading. When I arrived at the temple, the abbot informed me that my timing was excellent as just the week before a team from the Thai Fine Arts Department had finished repairing and touching up sections of the murals. I was able to borrow a ladder and spent the next day photographing the two newly restored Reusi Dat Don murals.

In Reusi Dat Ton, there is a series of six poses based upon the temple guardians, known as yakshas. One of these poses, known as the “Giant Holding up the Roof” can be seen at the base of the Phra Suvarnachedi tower on the grounds of the Temple of the Emerald Buddha, Wat Phra Kaew, in Bangkok, Thailand. The temple was constructed circa 1783 and the guardian giants were added sometime during the Reign of King Rama V (1868-1919) A similar pose is also found in Indian Hatha Yoga where it is known as “the Goddess.”

References and Further Reading

Albanese, Marilia (Author,) A.B.A.-Milan (Translation.) 2006. Angkor, Splendors of The Khmer Civilization. Bangkok: Asia Books.

Bassoul, Aziz. 2006. Human and Divine: The Hindu and Buddhist Iconography of Southeast Asian Art from the Claire and Aziz Bassoul Collection. Beirut: Cedar of Lebanon Editions Publisher.

Bunker, Emma C. 2003. Tantric Hinduism in Khmer Culture. Asian Department, Denver Art Museum. Published in www.asianart.com/articles/bunker/index.html.

Chandler David P. 1983. A History of Cambodia. Boulder: Westview Press.

Conti, Pia Tantric Buddhism in Phimai: A New Reading of its Iconographic Message. https://angkordatabase.asia/publications/tantric-buddhism-in-phimai-a-new-reading-of-its-iconographic-message.

Griswold, A.B. 1965. The Rishis of Wat Po. In Felicitation Volumes of Southeast Asian Studies. Presented to His Highness Prince Dhaninivat Kromamun Bidyalabh Brindhyakorn. Bangkok: Siam Society.

Matics, Kathleen Isabelle. 1978. An Historical Analysis of the Fine Arts at Wat Phra Chetuphon: A Repository of Ratanakosin Artistic Heritage, PhD Dissertation, New York University, New York.

Matics, K.I. 1977. Medical Arts at Wat Pha Chetuphon: Various Rishi Statues. Journal of the Siam Society, 65:2: 2: 145-152.

Museum of Cham Sculpture, Visitor Information Display at The Museum of Cham Sculpture in Danang, Vietnam.

Powell, Seth. 2018. The Ancient Yoga Strap: A Brief History Of The Yogapatta. Published in TheLuminescent.blogspot.com16 June 2018 (v2).

Srisuchat, Amara. 2004. Yoga Philosophy in Secondary Thought: Tracing Back to Yoga in Thailand’s Past. PhD Dissertation, Department of Oriental Languages, Silpakorn University, Bangkok.

Suebsantiwongse, Saran. 2023. The Thai Body: Understanding the Principles of Medicine, Physiology, and the Massage Tradition through Inscriptions, Texts, and the Material Culture of Wat Phō. in Part 4 of The Rutledge Handbook of Religion and the Body. Edited by Yudit Kornberg Greenberg and George Pati. London: Taylor & Francis Publishing.

Trà̂n, Kỳ Phương, Văn Thắng Võ and Peter D. Sharrock. 2018. Vibrancy in Stone: Masterpieces of the Đà Nẵng Museum of Cham Sculpture. New York: River Books.

Wells, David. 2012. “Reusi Dat Ton: The Thai Hermit’s Exercises” Yoga Mimamsa, Volume 44, No. 1: 1-18.

Wells, David. 2016. Self-Massage and Joint Mobilization of Traditional Thai Yoga: Reusi Dat Ton Part 1 Handbook. North Charleston: CreateSpace Independent Publishing Platform.

David Wells, E-RYT500, YACEP, C-IAYT, CAS, works as a yoga therapist in an interdisciplinary pain management clinic and conducts continuing education workshops for yoga teachers, yoga therapists, and massage therapists. He received advanced yoga certifications from the Kaivalyadhama Yoga Institute, the Sivananda Yoga Center, and the Yoga Institute in Mumbai in India. He served three years in Peace Corps Thailand and received Thai Massage and Reusi Dat Ton certifications from the Wat Po School of Thai Traditional Medicine and the Thai Ministry of Education. He also studied with Reusi Tevijjo and the late Ajhan Pisit Benjamongkonwaree in Thailand. He is also a graduate of the California College of Ayurveda. Contact: david@wellsyoga.com and www.wellsyoga.com.

The twenty-minute film Traditional Medicine in Southern Laos: A Documentary tells the stories of traditional medicine practitioners in the lowlands of Champasak Province in the far south of Laos, mainly through their own words. It features the places and people where I conducted ethnographic fieldwork during 2015–16 as part of my PhD in anthropology.^[1] Since then, I have regularly visited, shooting this video footage in 2019 and eventually completing the documentary in 2023.

The three elderly men featured in the film are at the center of both the research and the film—as teachers, guides, and collaborators. While staying in their homes or the nearby village or health facility, I learned about their medical practices, recorded herbal prescriptions, collected plants during trips to the forest and in their gardens, observed them create medicines, interact with patients, and conduct rituals—and had long talks about their approach to work and life.

All are from the same generation, born before the revolution when Laos was still in the process of gaining independence from French colonial rule. Po Nueang and Ajan Vilaysack^[2] describe themselves as traditional healers (mo ya phuen mueang), while Dr. Outhai is a retired medical doctor who previously managed the small traditional medicine department in the provincial hospital. The film highlights the similarities and differences in how they approach and think about traditional medicine and examines several intersecting issues through their words and practices. These include the role of traditional medicine for people seeking care, the various methods of creating medicines, formulating treatments and transmitting knowledge, approaches to medicinal plant conservation, the incorporation of magical or spiritual principles into treatment, and the urgent need for more research and documentation.

The first scene, shot at the home of Po Nueang, features a young girl who is receiving treatment for a sprained ankle and has also taken medicine for diarrhea. Po Nueang explains that the girl and her mother had traveled from several villages away and had already tried going to the hospital to receive injections and intravenous fluids (popular forms of allopathic medicine). However, it had not helped, so she had come to consult him. This story is representative of the often complex treatment-seeking routes taken by people and their families to deal with illness, where they may use multiple medical modalities to deal with uncertainty.^[3]

Indeed, although traditional medicine has long been used as primary healthcare for simple ailments in Laos, it is now more commonly turned to in cases of chronic illness. Later in the film, Ajan Vilaysack describes his journey as a traditional medicine practitioner, explaining that “in the past, we didn’t have enough medicine or doctors—people lived in the forest and had to help themselves.” But these days, he mainly sees patients with illnesses such as liver disease (a common problem due to high rates of hepatitis and alcohol and raw pork consumption), thyroid, digestive and skin disorders, weakness, and paralysis. He argues that he can treat these conditions more effectively and cheaply than the hospital, which sometimes even sends him patients.

While healthcare integration is government policy, this shows how, in reality, integration still happens primarily at an individual, informal level. In Laos, traditional medicine was, as in neighboring revolutionary nations, promoted as an inexpensive, low-tech, and culturally appropriate medicine.^[4] In the context of an under-resourced state biomedical system and given the weak influence of colonial healthcare, there was perhaps less impetus to create a national medicine, and so locally practiced medical forms in Laos have undergone little transformation or standardization, with no centralized knowledge source and few official treatment facilities or training courses.^[5] In the far south of Laos, traditional medicine may incorporate Tai, Buddhist, Ayurvedic, Khmer, and even Chinese influences.^[6] Southern medical practices are closely linked to those in culturally similar areas of northeastern Thailand and northern Cambodia.^[7]

These influences are shown in the healers’ use of medicines. The combination of plant parts shown by Po Nueang, including roots, woods, barks, and other woody parts, together with some shells and animal horns, make up the ingredients of ya fon, a common medical practice of southern Laos that may be linked to ancient Khmer influence.^[8] This is a technique in which a root, bark, mineral or animal product is ground against a smooth stone (hin sa) into cool water, creating a thick brown liquid that is drunk without boiling. As Po Nueang describes, it is considered a cooling medicine and is thus especially useful for fever, an ever-present condition in the heat of the southern lowlands. He demonstrates how he combines these medicines into recipes for different symptom patterns, including fever types such as chronic intermittent fever (khai sam huea), shivering cold fever leading to convulsions (khai nao san), fevers with gastrointestinal issues such as vomiting and diarrhea, those described as malaria that descends to the intestines (khai nyung long lamsai), and fever with yellow skin (khai piu lueang nang lueang). Po Nueang describes these as being forms of “the disease we now call malaria,” showing how he incorporates both traditional and biomedical explanations of disease and reflecting the variable symptom patterns of malaria that have been endemic during his lifespan, including when he was a military health worker in the 1970s.^[9]

Collecting and formulating personalized prescriptions is crucial to treating illness successfully. However, while healers may follow similar principles, Lao traditional medicine knowledge is highly heterogeneous; even the oldest textual sources, such as palm-leaf manuscripts (bailan), contain discrete sets of information.^[10] Po Nueang shows a book of herbal recipes (tamla) that belonged to one of his teachers and describes the learning process. Traditionally, this involves apprenticing to one or more older healers and learning certain spiritual practices to maximize the efficacy of the medicine. Ajan Vilaysack explains, “This is our secret—we use medicine and also magic to treat patients.” He demonstrates the technique of blowing (pao) to treat a man with a headache, who describes the effect afterward as “I feel cool, and I have more strength.” When blowing, the healer also mouths a healing mantra (mon).^[11] In the southern lowlands, these incantations are usually spoken in Pali and, if written, inscribed in tham script. Still, they may also include Sanskrit, Khmer, and Lao words, reflecting the multidimensional origins of healing power and the layered religious history of the south of Laos, including the expansion of the Khmer empire and the relatively late arrival of Theravada Buddhism and its absorption of Hindu/Brahmanical and indigenous spiritual practices.^[12]

Another distinguishing characteristic of traditional medicine in Laos is its reliance on wild harvested plant materials. Laos is highly diverse, with an estimated 8000–11,000 plant species, of which ethnobotanical studies have identified a significant number showing promising actions against disease^[13] and with no previous medicinal uses recorded.^[14] While Po Nueang uses mainly small pieces of roots or bark to make ya fon, Ajan Vilaysack’s medicine store contains large quantities of plant materials used for making decoctions or steam sauna, some of which he has harvested in high altitude areas; an apprentice healer “must love to go to the forest,” but it is not easy. He explains that it is very important for this medicine to be used when fresh (no more than a month old) for maximum potency, which presents a challenge because of the difficulties involved in sourcing materials. However, while walking around his land, he also observes that “everything here is a medicine,” pointing out the many uses of each herb, demonstrating how using plants as medicine is also flexible and circumstantial. This ability to recognize plants is the first step in learning traditional medicine. Po Nueang says, “If I have an apprentice, I must take him to dig up the plants first; he must collect and sort all kinds of plants.”

Traditional principles prohibit the overexploitation of plants; as Po Nueang explains, it is very important never to cut the main root so the tree does not die and can continue growing—and based on astrological principles, only one part of the plant can be harvested at a time. This approach is related to a wider “grammar of healing”^[15] in which astrology is applied to diagnosis and treatment, and an ethical framework based on local cosmologies that governs how the healers interact with patients and medicines. Ajan Vilaysack says, “You must avoid destroying or selling plants without a good reason.” This refers to the rule that the healers cannot directly charge money for their services and must rely on donations given according to Buddhist principles, in comparison to medicine sellers (mo khai ya), who they regard as inferior, and non-Buddhist practitioners, who are not subject to the same restrictions.^[16] The healers explain that adherence to these rules is essential for their medicine to be effective and for them to practice safely.

However, factors outside the healers’ control, such as deforestation and illegal exports, have led to a loss of plant biodiversity, a matter of great concern for them as it is becoming increasingly difficult to find the materials they need. Dr. Outhai recommends creating medicinal plant gardens and teaching students how to cultivate and use them. Some conservation efforts are in place; the Institute of Traditional Medicine oversees a network of medicinal plant preserves across the country, although lack of funding and protection makes these difficult to maintain.^[17] Ajan Vilaysack has dedicated part of his land to cultivating medicinal plants, but the difficulty of ensuring water sources limits it. He has also created a small house for people with chronic illnesses to stay free of charge. Despite being in high demand by his patients, he also farms rice, coffee, and cassava with his family and has responsibilities as the village head; like most healers, he cannot depend on practicing traditional medicine to make a living.^[18]

These combined challenges mean that transmission of medicinal knowledge through apprenticeship is now very low, and as these are likely the last generation of traditional healers in Laos, new forms of learning and practice will need to emerge for the future. Dr. Outhai describes his education on medicinal plants during his time at medical college “using books and a system,” which he says is a more sustainable learning method than the long process of memorization required by apprentice healers. Lao government institutions such as the Institute of Traditional Medicine and the Faculty of Pharmacy are making efforts to research, document, and create training programs, but there is much more to be done. These institutionalizing processes will inevitably alter the forms in which Lao medicine is taught and practiced; for example, the influence of staff trained in China, Thailand, or Vietnam and the emphasis on pharmaceutical evaluation and production. However, perhaps contrary to stories of resistance against state power, the healers are not against government regulation but instead frequently express the desire for their medicine and work to be recognized and documented.^[19] Ajan Vilaysack advocates for a scientific approach to discover the full potential of Lao medicine; “I would like Lao medicine to be recognized internationally and researched so that we know what each part of the plant is good for . . . how many diseases can one tree treat?” He concludes with his hopes for the future: “This is my idea of how to preserve medicines for the rest of my life.”

Bibliography

Alvesson, Helle M., Magnus Lindelow, Bouasavanh Khanthaphat, and Lucie Laflamme. 2013. “Coping with Uncertainty during Healthcare-Seeking in Lao PDR.” BMC International Health and Human Rights 13, no. 1: 28. https://doi.org/10.1186/1472-698X-13-28.

Brun, Viggo, and Trond Schumacher. 1994. Traditional Herbal Medicine in Northern Thailand. Bangkok: White Lotus.

Coderey, Céline. 2017. “The Buddhist Grammar of Healing: Building Efficacy in the Pluralistic Therapeutic Context of Rakhine, Myanmar.” Asian Medicine 12, nos. 1–2: 233–64. https://doi.org/10.1163/15734218-12341394.

Dubost, Jean Marc, Chiobouaphong Phakeovilay, Chithdavone Her, Audrey Bochaton, Elizabeth Elliott, Eric Deharo, Mouachan Xayvue, Somsanith Bouamanivong, and Geneviève Bourdy. 2019. “Hmong Herbal Medicine and Herbalists in Lao PDR: Pharmacopeia and Knowledge Transmission.” Journal of Ethnobiology and Ethnomedicine 15, no. 1: 27. https://doi.org/10.1186/s13002-019-0307-2.

Elkington, Bethany G., Kongmany Sydara, John F. Hartmann, Bounhong Southavong, and D. Doel Soejarto. 2013. “Folk Epidemiology Recorded in Palm Leaf Manuscripts of Laos.” Journal of Lao Studies 3, no. 1: 1–14.

Elliott, Elizabeth M. 2021. “Potent Plants, Cool Hearts: A Landscape of Healing in Laos.” PhD thesis, University College London, UK.

Elliott, Elizabeth M. 2024. “Protecting the Body, Living the Good Life: Negotiating Health in Rural Lowland Laos.” In “The Good Life in Late Socialist Asia: Aspirations, Politics And Possibilities,” edited by Minh T. N. Nguyen, Phill Wilcox, and Jake Lin. Special issue, positions: asia critique 32, no. 1: 151–70.

Elliott, Elizabeth, François Chassagne, Agnès Aubouy, Eric Deharo, Outhay Souvanasy, Phaiboun Sythamala, Kongmany Sydara, et al. 2020. “Forest Fevers: Traditional Treatment of Malaria in the Southern Lowlands of Laos.” Journal of Ethnopharmacology 249 (March): 112–87. https://doi.org/10.1016/j.jep.2019.112187.

Finot, Louis. 1917. “Recherches sur la littérature laotienne.” Bulletin de l’École française d’Extrême-Orient 17, no. 1: 1–218. https://doi.org/10.3406/befeo.1917.5323.

Grabowsky, Volker. 2007. “Buddhism, Power, and Political Order in Pre-Twentieth Century Laos.” In Buddhism, Power and Political Order, edited by Ian Harris, 121–42. London: Routledge.

Libman, Amey, S. Bouamanivong, B. Southavong, K. Sydara, and Djaja Djendoel Soejarto. 2006. “Medicinal Plants: An Important Asset to Health Care in a Region of Central Laos.” Journal of Ethnopharmacology 106, no. 3: 303–11. https://doi.org/10.1016/j.jep.2005.11.034.

Monnais, Laurence, C. Michele Thompson, and Ayo Wahlberg. 2011. Southern Medicine for Southern People: Vietnamese Medicine in the Making. Newcastle upon Tyne: Cambridge Scholars Publishing.

Pottier, Richard. 2007. Yû dî mî hèng. Etre bien avoir de la force : essai sur les pratiques thérapeutiques lao. Monographies 192. Paris: Ecole française d’Extrême Orient.

Salguero, C. Pierce. 2016. Traditional Thai Medicine: Buddhism, Animism, Yoga, Ayurveda. 2nd rev. ed. Bangkok: White Lotus Press.

Soejarto, Djaja Djendoel, C. Gyllenhaal, M. R. Kadushin, B. Southavong, K. Sydara, S. Bouamanivong, M. Xaiveu, et al. 2012. “An Ethnobotanical Survey of Medicinal Plants of Laos toward the Discovery of Bioactive Compounds as Potential Candidates for Pharmaceutical Development.” Pharmaceutical Biology 50, no. 1: 42–60. https://doi.org/10.3109/13880209.2011.619700.

Soejarto, Djaja Djendoel, Kongmany Sydara, Bethany G. Elkington, Bounleuane Douangdeuane, Onevilay Souliya, and Mouachan Xayvue. 2023. “Conservation of Medicinal Plants of Laos.” In Medicinal Plants of Laos, edited by Djaja Djendoel Soejarto, Bethany G. Elkington, and Kongmany Sydara, 52–71. Boca Raton: CRC Press.

Sweet, Kathryn Dawn. 2015. “Limited Doses: Health and Development in Laos, 1893–2000.” PhD thesis, National University of Singapore.

Thompson, C. Michele. 2015. Vietnamese Traditional Medicine: A Social History. Singapore: National University of Singapore Press.

Vidal, Jules. 1958. “La thérapeutique par les plantes au Laos.” Journal d’agriculture et de Botanique Appliquée 5, no. 10: 601–16.

Acknowledgments

The author would like to acknowledge the assistance of the Faculty of Pharmacy at the University of Health Sciences, the Institute of Traditional Medicine, and Champasak Regional Hospital for administrative support during fieldwork. The Asia Research Institute of the National University of Singapore provided financial support to edit the documentary, and the Institut de Recherche pour le Développement in Laos provided videomaking equipment. This documentary was funded by the Global Traditional Medicine Grant (Award 73578).

^[1] Elliott 2021.

^[2] Po and Ajan are titles meaning “Father” and “Teacher/Scholar,” respectively.

^[3] Alvesson et al. 2013.

^[4] Monnais, Thompson, and Wahlberg 2011; Thompson 2015.

^[5] Sweet 2015.

^[6] Salguero 2016.

^[7] Brun and Schumacher 1994.

^[8] Vidal 1958.

^[9] An analysis of the plants used in these recipes showed a high use correlation with species used cross-culturally to treat malaria, several of which have shown promising results in pharmacological studies such as Amorphophallus paeniifolius (Dennst.) Nicolson and Alocasia macrorrhizos (L.) G. Don. See Elliott et al. 2020.

^[10] Elkington et al. 2013; Finot 1917.

^[11] Pottier 2007.

^[12] Grabowsky 2007.

^[13] Soejarto et al. 2012.

^[14] Libman et al. 2006.

^[15] Coderey 2017.

^[16] For example, ethnically Hmong medicine sellers (Dubost et al. 2019).

^[17] Soejarto et al. 2023.

^[18] Elliott 2024.

^[19] This is likely also to reflect their status as Buddhist, lowland, male practitioners; this may be different for other healers from non-Buddhist minority groups.

More than many other places in the world, Covid-19 vaccines and other mitigation efforts were notably controversial in the United States, deepening political divisions across American society. During the 2020–2023 period, practitioners of Asian medicine in the US became fractured by these controversies. Rancorous arguments festered on social media platforms and divided Asian medicine classrooms and clinics around the country. At the time of this writing, the authors are unaware of any study that has attempted to systematically gauge attitudes toward Covid-19 prevention, treatments, or vaccines among this community. This paper reports on a survey of US-based practitioners of Asian medicine conducted in late 2022 to early 2023 at the height of the controversy over vaccines in the US. The study questions were designed to explore divisions over these issues and the underlying causes of those divisions. We had hypothesized that differences between practitioners’ attitudes — and, in particular, their opinions about vaccines — would be connected with epistemological factors related to Asian medicine methodology and body concepts. However, after analyzing our data for a number of epistemological, demographic, and social correlations, we concluded that the main influences underlying the divisions in the Asian medicine field in the US ultimately have to do with political affiliation. 

Literature Review 

As far as we are aware, at the time of this writing in April 2023, there is no previous scholarship specifically measuring attitudes toward Covid-19 vaccines among US practitioners of Asian medicine. Nevertheless, the present study intersects with several related topics that have been previously investigated by scholars, some highlights of which can be mentioned in brief.

The first is Covid-19 vaccine hesitancy in the US more generally. Studies on this topic have found that demographic factors play a role in shaping attitudes toward vaccines. In a national survey conducted in the first half of 2021, for example, Kricorian et al. (2021) noted that those who doubted the Covid-19 vaccine was safe were on average “less educated, lower income, and more rural than people who believed the vaccine is safe.” Later that year, a survey by Hamel et al. (2021) looked at race, education level, age, health insurance status, and political affiliation. One of their major takeaways was that political “partisanship and vaccination status continue to loom large as factors in how the public views both the U.S. vaccination effort and the government’s response to the pandemic in general.” Shortly afterwards, a survey by Frisco et al. (2022) examined racial and ethnic factors underlying vaccine hesitancy. They found that “U.S.-born Black adults are more vaccine hesitant than U.S.-born White adults,” that “U.S.-born Hispanic adults are less vaccine hesitant than U.S.-born White adults,” and that “there were not significant differences between foreign-born Hispanic and U.S.-born White adults in vaccine hesitancy.” 

A second area of relevant scholarship is vaccine hesitancy among practitioners prior to the pandemic. While not specifically focusing on traditional Asian medicine, Wardle et al. (2016) provides a critical review of 39 studies conducted between 2000–2015 measuring vaccine hesitancy among practitioners and users of “complementary medicine.” These authors found that the use of childhood vaccines was less prevalent among this population; however, respondents’ attitudes “may be confounded by other factors,” including “higher income, higher education or distrust of the medical system.”

A third related area is the attitude toward traditional Asian medicine for both prevention and treatment of Covid-19 among specialists and the general public. A number of qualitative studies on this topic have been conducted outside of the US, most notably in China. Pu et al. (2021), for example, surveyed about 400 medical professionals in Sichuan and found that over half agreed that Traditional Chinese Medicine (TCM) “can be used for the prevention and treatment of Covid-19.” Nguyen et al. (2021) surveyed members of the general public in Vietnam and found that “the use of herbal medicine during the Covid-19 pandemic was a common practice among Vietnamese people.” D’Arqom et al. (2022) found that, among Indonesian mothers with school-age children, 65.6% consumed a mix of “medications, vitamins/minerals, and herbs/natural products” to ward off the virus. In Western countries, Bourqui et al. (2022) surveyed 320 practitioners of TCM in Switzerland about the traditional medicine treatments they administered to Covid patients. Additionally, Kong et al. (2021) surveyed over 750 Chinese immigrants in Canada about their attitudes, finding that “TCM was widely believed by Chinese immigrants in Canada to be an effective means of preventing Covid-19 and many also stated they would use it if they were experiencing symptoms of Covid-19.” 

A final area of previous research that may be interesting to readers of the current paper is detailed historical and ethnographic studies of traditional medicine practice in the US. These studies have largely focused on Chinese medicine, including works by Wu (2013), Pritzker (2014), and Phan (2017). While produced in the pre-Covid era, this scholarship can give us a sense of the cultural and social dynamics among communities of Asian medicine practitioners in the US, which can help to contextualize the findings in our own survey. Lastly, while comprehensive demographic data is not available for all types of traditional Asian medicine in the US, some professional organizations maintain statistics that may be useful to compare to the data from our survey. These include studies from the National Certification Commission for Acupuncture and Oriental Medicine (Ward-Cook 2017) and Yoga Alliance (2016). 

All of the mentioned publications notwithstanding, the overall point is that previous research has not directly attempted to measure attitudes toward Covid-19 vaccines among American practitioners of Asian medicine as we are attempting to do in this study.

Our Survey and Respondents

Asian medicine practitioners were invited to participate in our survey through announcements we made in three large international English-language Facebook groups dedicated to Asian medicine. These groups had a notably apolitical stance on Covid-19, and our invitation to participate in the survey did not reveal that we would be asking about potentially contentious issues. 

The survey (see Appendix below) included multiple choice, multiple selection, and open-ended questions. It was made available to participants via Qualtrics from December 2022 to January 2023. We received a total of 145 responses, the largest cohort of which (n=81) were those based in the United States. We had initially intended to conduct a comparative international survey; however, as we did not receive enough responses from any other country to make meaningful comparisons, only responses from the US have been considered in this report.

Our survey results are reported in full in the appendix. To summarize some of the key points here, the respondents were diverse in terms of race, religion, location within the US, and their chosen field of Asian medicine practice. The majority was female (representing 63% of all responses), white (77%), native speakers of English (99%), and well-educated (69% had a master’s or doctoral degree of some kind), and most commonly identified themselves as practitioners of some kind of “Chinese medicine or TCM” (72%). Level of experience in the practice of Asian medicine was generally high, with 51% having a graduate degree in Asian medicine and 58% having spent more than 10 years working in the field. A majority of the respondents (52%) were full-time practitioners, 28% were teachers, and 73% identified Asian medicine as their primary source of income. Given these patterns, we feel that the survey likely is not representative of the practitioner community in the US. In particular, our survey is lacking any respondents under 25 and has very few non-native English speakers. Thus, it fails to capture the opinions of the youngest generation of practitioners, the large number of immigrants working in the massage industry or as community healers in Asian American neighborhoods, and other important populations of practitioners in the US. These omissions notwithstanding, we nevertheless believe that the survey results can be useful to better understand a segment of the Asian medicine community’s attitudes and opinions.

In addition to demographic questions and questions about their practice of Asian medicine, we had respondents rate a list of words in terms of their relevance for prevention and treatment of Covid-19. In an effort to include the widest possible range of interventions that are meaningful to our practitioner population, these interventions included conventional public health practices, Asian medical approaches, lifestyle choices, as well as what might be characterized as more spiritual or religious practices. The most highly rated (8 out of 10) interventions were sleep, personal hygiene, and herbal medicines. The lowest (5 out of 10) were prayer and luck/fate/karma. Interventions such as masking, social distancing, and vaccines fell in-between.

We also asked respondents to rate a list of words that could describe Covid-19 vaccines in positive or negative ways, ranging from “important” and “beneficial” to “toxic” and “dangerous.” Salient data from this portion of the survey that caught our attention included the fact that only 7% of respondents said that Covid vaccines are incompatible with Asian medicine. However, 26% of respondents said that vaccination is ineffective, and 33% of respondents said that the vaccines are dangerous. These beliefs about the vaccine correlated with behavior: 24% reported being completely unvaccinated, in contrast with the 63% of respondents who had received 3 or more doses at the time of the survey. 

Our survey included open-ended questions to elicit more detailed opinions about prevention and treatment. Respondents in the unvaccinated cohort responded to these questions with dismissive comments about the severity of Covid-19, calling it “a type of common cold” with a “low death rate” that “mostly affects the elderly.” They denigrated vaccines, saying that they are “highly problematic,” that there is “no difference in transmission rates or severity of symptoms,” and that getting a shot results in “a range of health concerns and death.” On the other side of the fence, one respondent wrote that “acupuncturists being anti-vax and Covid conspiracy theorists is an embarrassment to the profession, and I am ashamed to be associated with them.” Numerous other respondents wrote in support of vaccines as being effective in preventing serious illness and as important tools for community or public health.

On this basis, we concluded that our anecdotal observations were true: there were indeed divisions within the community in terms of attitudes toward Covid prevention and treatment, including strong divergences in opinions about vaccination. Having established this fact, we then turned to try to discover the likely source of these divisions. 

Are Epistemic Strategies to Blame for Polarization?

David G. Robertson has written that “the dominant forms of epistemic capital in the contemporary world are scientific, tradition, experience, channeled, and synthetic knowledge” (2021: 29; Robertson & Amarasingam 2022). These “epistemic strategies” struck us as being potentially quite relevant for understanding differences between practitioners of Asian medicine. We hypothesized that the epistemological commitments and assumptions of practitioners of various kinds of Asian medicine would exert a major influence upon their ideas about Covid-19.  In order to test this hypothesis, we asked our respondents to score each of these strategies from 1 (“completely irrelevant”) to 10 (“absolutely fundamental”) based on their “importance in your practice of Asian medicine when diagnosing/assessing patients.” The survey described these epistemic strategies as follows, in an attempt to explain Robertson’s categories in terms that would be accessible to our respondents:

1. Scientific (methods based on clinical trials, using evidence-based research)

2. Traditional (methods based on established norms that are common to a particular lineage of practice)

3. Individual experience (methods using “felt sense,” intuition, or personal experience as primary criteria)

4. External powers (methods such as divination; channeling or engaging with deities, spirits, ancestors, or any other external entities)

5. Synthetic (putting together clues and evidence in a unique or novel way that doesn’t privilege any of the abovementioned methodologies)

The five different approaches were rated by our respondents in the following order: “traditional” (average score 8 out of 10), “individual experience” (7), “scientific” and “synthetic” (tied at 6 each), and “external powers” (4). This general pattern of preferences held surprisingly steady across the majority of respondents with only slight variances.

We noticed that enthusiasm for each of these epistemic strategies correlated with certain demographic features. Practitioners who rated their enthusiasm for “scientific methodologies” at 7 or above were twice as likely on average to vote for the Libertarian party and three times as likely to identify as politically conservative. Those who rated methodologies related to “individual experience” highly had considerably less experience as practitioners. Those who favored methodologies related to “external powers” were far less likely than the average respondent to have completed a graduate degree and were much more likely to currently be a student. These respondents were much more likely to be Asian, to vote Democrat, and to report have recently tilted in a more liberal or progressive direction. Finally, those who thought favorably of “synthesis” had much more training in Asian medicine than the norm but much less experience working in the field, and much more likely to have earned a graduate degree in science. 

What about the hypothesis that practitioners’ strategic preferences would correlate with their attitudes toward prevention and treatment of Covid-19 as well as their vaccination behavior? We had expected, for example, that respondents who subscribed to scientific methods would be much more likely to endorse vaccines and conventional public health measures than those who subscribed to traditional strategies. In sorting through the data, we did indeed find that those who favored “scientific” methodologies were somewhat more likely to be vaccinated. In addition, those expressing enthusiasm for “external powers” expressed much more enthusiasm for energy practices, meditation, prayer, and luck/fate/karma than the others. However, while such findings are interesting and perhaps warrant further research, we felt that these correlations were not strong enough for us to conclude that epistemic strategies were strongly predictive of attitudes toward Covid-19 vaccination.

Are Body Concepts to Blame?

When designing the study, we had also hypothesized that the different conceptions of the body that are taught in different Asian medical systems may be another important distinction between Asian medicine practitioners. We developed the following list of body concepts that are prevalent in different Asian medicine traditions as well as in the religions that inform various types of Asian healing, and asked respondents to rate each one on a scale from 1 (completely irrelevant) to 10 (absolutely fundamental) based on “their importance in your clinical practice of Asian medicine”:

1. The body is a material structure.

2. The body is explainable through the fields of modern scientific anatomy, physiology, and biochemistry.

3. The body is a web of energy.

4. The body is constantly being affected by the energies of the natural world, such as the seasons, the stars, animal, and plant life.

5. The body is inhabited by divine powers or entities.

6. The body is itself a manifestation of the divine or cosmic reality.

7. The body is empty, insubstantial, immaterial, or mirage-like.

8. The body is an illusion that appears only in one's thoughts.

9. The body and mind are completely intertwined with one another, or are not even separate entities.

10. The body is multilayered or like “nested dolls,” with all of the above qualities being paradoxically true at the same time.

The overall respondent pool strongly approved of seven of these options (score ≥7), giving a mid-range score for “divine powers/entities” and low scores for “the body is empty” and “an illusion.” Again, we noted correlations between body concepts and certain demographic features. Asians were more enthusiastic than other racial groups about the notion that “the body is empty.” The 26-35 age group was more likely to endorse the statement that the body is “inhabited by divine powers or entities,” as were respondents who identified as Christian. Atheists predictably were the least likely to say that the body is a “manifestation of divine or cosmic realities”; however, the more education a respondent had, the more likely they were to rate that concept highly.

Such differences notwithstanding, there turned out to be no statistically coherent pattern between body concept preference and attitudes toward Covid-19 prevention, treatment, or vaccines. While we had theorized that a practitioner’s understanding of the body would play a major role in influencing their approaches to Covid, we concluded that this hypothesis was false. 

What else might be a factor? 

Having disproven our hypotheses that epistemological factors were to blame for practitioners’ polarization over Covid vaccines, we then began to look for patterns in the data related to field of specialization, position in the industry, demography, and other social factors. Education did not play any role in vaccination behavior: respondents with a doctorate degree were as likely to be unvaccinated as they were to have received 4 or more doses, and it made no difference if their graduate degree was in a science field. Nor did the location where practitioners had trained make any difference. Years of experience, whether or not Asian medicine represented the main source of income, and status in the field (teacher, student, full-time, part-time, etc.) were all statistically insignificant. 

We did note some demographic correlations of minor magnitude. Although the numbers were tiny (n=6), all of the Black and Hispanic/Latinx respondents in our data pool had received 3 or more doses at the time of the survey. Christians were likely to have had more vaccines than the other religions. On average, women had received slightly more vaccines than men. Nevertheless, as the magnitude of these differences was small, we again found such patterns to be insufficient to explain the strong polarization of Asian medicine practitioners’ attitudes and behaviors.

While drilling down to examine the unvaccinated cohort more closely, we were interested to find that some of the open comments from this group framed resistance to vaccines and other public health measures in terms of a defense of science. For example, one respondent lamented the “eroding of public trust in science” caused by the US government’s response to the pandemic. Rather than appeal to historical Asian medicine epistemologies or doctrines, these respondents equated Asian medicine with contemporary science, calling their own treatment plans “scientifically based schematics,” “process science,” and “evidence-based medicine.” This attitude seems to suggest that at least some of this cohort believed that Asian medicine approaches to Covid prevention are superior to biomedical approaches not because they are less scientific, but because they are more so. While this was the opinion of a small minority of practitioners, it may be a phenomenon that warrants more research.   

All of the above is interesting but does not clearly explain the strong divisions in the Asian medicine field. However, during this phase of our data analysis we did find one correlation that jumped out to us as a strongly predictive factor of Asian medicine practitioners’ attitudes toward Covid prevention and treatment, including their opinions about vaccines. That correlation was political party affiliation.

Politicization

When we zoomed in to look at participants’ political affiliations, we discovered two very different kinds of practitioner, which we might call “left-leaning” vs “right-leaning.” The left-leaning group, by far the larger of the two, was made up of Democrat and Green Party voters (n=49, i.e., 61% of the whole). These respondents were older, more female, and whiter than the overall pool. They had slightly more experience in the field but were more likely to be working part-time rather than full-time as an Asian Medicine practitioner. 

The smaller right-leaning group of Republican and Libertarian voters (n=11, i.e. 14% of the whole), on the other hand, were much younger and much less wealthy. They were also more likely to be female than the overall respondent pool. In the aggregate, they were less educated, with less chance of having completed a doctorate or master’s degree, and they had much less exposure to science (40% chance of never having taken a university course on any scientific subject). Right-leaning practitioners were likely to have less experience in the field than the overall respondent, and less likely to be a teacher. While the vast majority of left-leaning respondents reported not having shifted their voting patterns in recent years, the right-leaning ones were more likely to have shifted more conservative in recent years, and to identify the U.S. government’s Covid-19 policies as the reason for that shift. In terms of preventing and treating Covid-19, they had far less enthusiasm for masking, social distancing, vaccination, and ventilation machines than the overall average. 

Upon analysis, practitioners’ left- or right-leaning political affiliation turned out to be the single most significant correlation with attitudes toward vaccination. In the word association question, those on the left showed more support for positive descriptions of vaccines (i.e., natural, safe, beneficial, important) than the overall respondents and less support for negative words (i.e., ineffective, artificial, unsafe). Those on the right were the mirror opposites, exhibiting more support for negative descriptions of vaccines and less support for positive words. These attitudes also translated into actions. Left-leaning practitioners were 84% likely to have gotten 3 or more doses of the Covid vaccine with only an 11% chance of being unvaccinated, while those identifying as right-leaning were only 11% likely to have gotten three doses with a 67% chance of being unvaccinated. 

Conclusion

While the number of right-leaning practitioners is dwarfed by the left-leaning ones, the differences in attitudes between these two groups could not be starker. In the words of one of our respondents, such polarization made the issue of vaccination “confusing and difficult to discuss” among the community. The vast majority of our respondent pool signaled that they felt this way. When one of our word association questions asked them to rate a list of words that could be used to describe Covid vaccines, by far the top choice across all demographic and social groups was “politicized.” On this one point, it seems, everyone can agree.

Perhaps these findings should not have surprised us. We have known about the politicization of American attitudes toward Covid vaccines since soon after they first became available (e.g., Hamel et al. 2021). However, our research team had expected that the specific type of Asian medicine one practiced, differences in these traditions’ epistemological strategies and body concepts, or other professional or demographic factors would account for some of the differences in attitudes and behavior toward Covid-19 among practitioners. After exhaustively searching for these other factors, however, we were forced to conclude that the single most influential explanation of practitioners’ attitudes and behaviors was voting patterns. Sometimes, it just comes down to politics. 

References 

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Appendix: Asian Medicine & Covid-19 Survey

Part 1. General Demographic Information

Select the types of Asian healing practices that you engage in [check all that apply] (n=81)

• ·    Ayurveda, 7%

• ·    Chinese Medicine/TCM, 72%      

• ·    East Asian Medicine, 39%  

• ·    Mindfulness or Meditation of an Asian lineage, 26%

• ·    Qigong, 34%

• ·    Reiki, 18%

• ·    Shiatsu, 7%

• ·    Sowa Rigpa, 1%

• ·    Taiji/Tai Chi, 21%

• ·    Thai Massage/Medicine, 32%

• ·    Yoga/Yoga Therapy, 21%

• ·    Other Asian or Asian inspired body work, 13%

• ·    Other Asian or Asian inspired energy work, 7%

• ·    Other Asian or Asian inspired martial arts for therapeutic effect, 7%

• ·    Other Asian or Asian inspired spiritual healing practices, 9%

• ·    Other practices not listed above, 9%

Sex/Gender (n=76)

• ·    Male, 33%

• ·    Female 63%

• ·    Non-binary/Other 4%

Age (n=76)

• ·    26-35, 13%

• ·    36-49, 42%

• ·    50-69, 42%

• ·    70+, 3%

Race/Ethnicity [check all that apply] (n=78)

• ·    Asian/Pacific Islander, 8%

• ·    Black, 4%

• ·    Hispanic/Latino, 4%

• ·    Native American/Indigenous, 1%

• ·    White, 77%

• ·    Other, 11%

Zip code range (n=65)

• ·    Northeast, 31%

• ·    West coast, 31%,

• ·    Midwest, 12% 

• ·    Rockies and Southwest, 3% 

• ·    Southeast, 23%

Primary language (n=76)

• ·    English, 99%

• ·    Other, 1%

Individual income (n=75)

• ·    Less than $25,000 per year, 8%

• ·    $25,000 – $50,000 per year, 27%

• ·    $50,000 - $75,000 per year, 31%

• ·    More than $75,000 per year, 35%

Religion [check all that apply] (n=79)

• ·    Buddhist, 25%

• ·    Christian, 18%

• ·    Hindu, 0%

• ·    Jewish, 10%

• ·    Muslim, 0%

• ·    Spiritual/Non-religious, 40%

• ·    None/Atheist, 8%

• ·    Other, 22%

Highest level of education completed (n=75)

• ·    Highschool, 8%

• ·    2-year college, 7%

• ·    4-year university, 15%

• ·    Master’s Degree, 33%

• ·    Doctorate Degree or equivalent, 36%

• ·    None of the Above, 1%

Political party you tend to vote for most often (n=72)

• ·    Democrat, 63%

• ·    Republican, 7%

• ·    Green, 3%

• ·    Libertarian, 8%

• ·    Independent, 13%

• ·    Other, 7%

Political self-assessment 

• ·    Very conservative, 4%

• ·    Conservative, 3%

• ·    Moderate, 31%

• ·    Liberal/Progressive, 31%

• ·    Very liberal or very progressive, 17%

• ·    Other, 15%

Have you changed the political party you vote for or your political orientation since 2020?

• ·    Yes, I moved in the direction of more conservative, 14%

• ·    Yes, I moved in the direction of more liberal/progressive, 4%

• ·    No, I stayed about the same, 82%

Was this change due to the government’s Covid-19 policies?

• ·    Yes, 21%

• ·    No, 79%

Part 2. Asian Medicine Practice

What is your level of training in your primary Asian medicine practice [check all that apply]? (n=85)

• ·    Doctorate, 24%

• ·    Master’s degree, 27%

• ·    Professional Training, 29%

• ·    Apprenticeship, Informal, or Family-based Training, 11%

• ·    Self-Study, 9%

Where did you study your primary healing practice? (n=80)

• ·    Asia, 19%

• ·    Canada, 1%

• ·    UK, 1%

• ·    US, 73%

• ·    Other, 6%

How many years have you been practicing your primary healing practice? (n=67)

• ·    Under 5, 24%

• ·    5 – 10, 18%

• ·    10 – 20, 22%

• ·    Over 20, 36%

What level of training do you have in biology, chemistry, biomedicine, or any other modern scientific disciplines? (n=66)

• ·    Never took a university class, 15%

• ·    Took some classes in university, 55%

• ·    Majored in a science field in a university, 17%

• ·    Completed a graduate degree in a science field, 13%

Is Asian Medicine your main source of income?

• ·    No, 27%

• ·    Yes, 73%

What best describes your role in Asian Medicine [check all that apply] (n=80)

• ·    Hobbyist, 7%

• ·    Student, 12%

• ·    Part-time practitioner, 34%

• ·    Full-time practitioner, 52%

• ·    Teacher, 28%

• ·    Retired, 3%

Please give each of the following methodologies a score based on their importance in your practice of Asian medicine when diagnosing/assessing patients? Rate each item rated on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=66)

• ·    Scientific (methods based on clinical trials, using evidence-based research), average rating 5

• ·    Traditional (methods based on established norms that are common to a particular lineage of practice), 8

• ·    Individual experience (methods using “felt sense,” intuition, or personal experience as primary criteria), 7

• ·    External powers (methods such as divination; channeling or engaging with deities, spirits, ancestors, or any other external entities), 4

• ·    Synthetic (putting together clues and evidence in a unique or novel way that doesn’t privilege any of the abovementioned methodologies), 6

Please give any additional details or clarifications you wish about your response to the previous question.

[Open responses]

Please give each of the following views of the human body a score based on their importance in your clinical practice of Asian medicine. Rate each item rated on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=65)

• ·    The body is a material structure, average rating 8

• ·    The body is explainable through the fields of modern scientific anatomy, physiology, and biochemistry, 7

• ·    The body is a web of energy, 8

• ·    The body is constantly being affected by the energies of the natural world, such as the seasons, the stars, animal, and plant life, 8

• ·    The body is inhabited by divine powers or entities, 5

• ·    The body is itself a manifestation of the divine or cosmic reality, 7

• ·    The body is empty, insubstantial, immaterial, or mirage-like, 3

• ·    The body is an illusion that appears only in one's thoughts, 2

• ·    The body and mind are completely intertwined with one another, or are not even separate entities, 8

• ·    The body is multilayered or like “nested dolls,” with all of the above qualities being paradoxically true at the same time, 7

• ·    Other, 6

Please give any additional details you wish to about your response to the previous question. (Open response)

Part 3. Asian Medicine and Covid-19

Please score the following when it comes to the prevention of Covid-19. Rate each item on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=63)

• ·    Masking, average rating 7

• ·    Social Distancing, 6

• ·    Vaccines, 6

• ·    Diet, 7

• ·    Exercise, 7

• ·    Sleep, 8

• ·    Personal hygiene, 8

• ·    Herbal medicines, 8

• ·    Energy practices, 6

• ·    Meditation, 6

• ·    Prayer, 5

• ·    Luck, fate, and/or karma, 5

Please score the following in the order of importance when it comes to the treatment of Covid-19. Rate each item on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=61)

• ·    Pharmaceutical drugs, average rating 6

• ·    Ventilation machines, 7

• ·    Diet, 7.

• ·    Exercise, 7

• ·    Sleep, 8

• ·    Personal hygiene, 8 

• ·    Herbal medicines, 8

• ·    Energy practices, 6

• ·    Meditation, 6

• ·    Prayer, 5

• ·    Luck, fate, and/or karma, 4

Which of the following words do you associate with Covid-19 vaccines? [check all that apply] (n=61)

• ·    Natural, 7%

• ·    Artificial, 36%

• ·    Organic, 0%

• ·    Chemical, 28%

• ·    Safe, 31%

• ·    Dangerous, 33%

• ·    Effective, 56%

• ·    Ineffective, 26%

• ·    Unsafe, 33%

• ·    Beneficial, 51%

• ·    Toxic, 23%

• ·    Important, 51%

• ·    Waste of resources, 16%

• ·    Politicized, 72%

• ·    Incompatible with Asian medicine, 7%

• ·    Compatible with/complementary to Asian Medicine, 54%

How many Covid-19 vaccinations and/or boosters have you received personally? (n=62)

• ·    0, 24%

• ·    1, 5%

• ·    2, 8%

• ·    3, 26%

• ·    4, 34%

• ·    More, 3%

What other vaccines do you remember receiving? [check all that apply] (n=56) 

• ·    Annual flu shot, 48%

• ·    Chicken pox/shingles, 27%

• ·    Diphtheria (DTaP), 55%

• ·    Hepatitis, 66%

• ·    HPV, 5%

• ·    Measles, Mumps, and Rubella (MMR), 84%

• ·    Polio, 68%

• ·    Pneumonia, 13%

• ·    Tetanus, 93%

• ·    Tuberculosis (TB), 46%

• ·    Other, 9%

We are interested in how practitioners of Asian medicine think about the prevention and treatment of Covid-19. Please share your thoughts with us and provide as much information as you would like to on this topic. The more information you share, the more you will help our study. (Open response)

A movement is afoot to replace the word "oriental" in AOM schools and organizations. How much do practitioners wish to engage in the work of examining Orientalism within our field - self and public perceptions - along with changing its presently Orientali

Orientations:

Beginning in the wake of the protests memorializing George Floyd, Breonna Taylor, and too many others in summer 2020, two movements began to address a related issue of racism within our own scholarly and professional field. At the grassroots level, Influential Point launched a petition and campaign requesting that the U.S. acupuncture and oriental medicine (AOM) community remove this racist word from our professional discourse. At the administrative level, Dr. David Lee, the Academic Vice President of Alhambra Medical University in California, initiated a campaign among his peers to “repeal and replace” the word “oriental,” school by school, in school names and degree titles, with the goal of carrying this momentum forward into pressuring ACAOM and NCCAOM to do the same. Collectively, it would seem, the moment has come for making long-overdue, necessary change.

But after determining to not use this word, what other word should we use? And more importantly, how do we make that choice? How might we, the professionals impacted by the name and public face of our craft get a say in making it? If practitioners wish to have a voice in the decision about how we redefine the AOM profession to patients and our broader communities, step one is educating ourselves about the pros and cons of commonly proposed alternative names.

This list of terms, and breakdown of some of their more salient associated issues, is by no means exhaustive. This paper presents a starting point for opening an informed discussion based on something other than personal opinions. It is further my hope that it will help readers cultivate an appreciation for the many different filters through which different people can see the world, let alone a single word. For this reason, each term needs to be looked at from many possible perspectives. One person’s opinion is not going to decide this for us. Nor should it.

I am a clinician, philologically trained translator of classical Chinese, and historian-in-training. This is to say that I have spent countless hours researching and thinking closely about exactly what a word means, or what is the best way to translate X concept into Y language, or for Z type of audience. At the most fundamental level, any alternative would be better than the deeply embarrassing, racist word that we currently use. That said, how we choose our marginally better word matters, too. It is an opportunity not only for learning and self-reflection about the word “oriental” that we seek to replace. It is also an opportunity to recognize some of the many ways in which our field is Orientalist - perpetuating a reified notion of an exotic, but ultimately undifferentiated or falsely uniform, "alternative" or "other-than” medical culture.

How much do we wish to engage in the work of examining Orientalism within our field - self and public perceptions - along with changing its presently Orientalist name?

To change the broader dynamics (removing Orientalism), rather than only the most visible external manifestation of those dynamics (removing only the word oriental), are two separate things. In my opinion, we should not neglect the former opportunity in our rush to correct the latter problem. The work of examining the Orientalism that permeates our field is important work because it can help us to clearly define and create a professional community. At present, the AOM field in the United States, with its crazy-quilt patchwork of organizations, state practice scopes, regulatory agendas, and heterogeneity of training, entirely lacks professional cohesion. Such fragmentation prevents us from standing united against threats to our scope of practice, such as dry-needling, let alone advocating more strongly for our potential role as first point of contact providers of healthcare in a country desperately in need of primary care providers.

How might we use the process of reflecting on replacement terms as a kind of professional praxis, forcing us to confront the ways in which words matter because words connote as well as denote, delimit, and define?

The idea that the name or definition of something matters - that a name should accord well with the thing it names - is not a new or radical one. Rather, we know that Confucius himself advocated for the “Rectification of Names," warning against the confusion and social unmooring created by the drift between signs (names) and the things they signify. As we come together as a collective in exploring the full context of each possible term, we are also forced to open a conversation about what values undergird our selection strategy. Naming ourselves presents an opportunity to better define the dynamics of our profession as a whole, our individual positioning within these dynamics, and a collective re-envisioning of how we wish to define ourselves and our practice.

Articles in this four-part series were published simultaneously on AMZ and Medium.com.

My last three posts have dealt with meta-level epistemic questions in the study of Asian medicine. It is now time to focus in on how these big-picture concerns play out in day-to-day decision making in the clinic. This post explores in more depth the concept of polyperspectivalism. I discussed previously how polyperspectivalism is a key to developing more productive collaborations with colleagues. Here, I argue that it also leads to greater conceptual flexibility, and therefore more clinical options, when treating patients.

Polyperspectivalism is the ability to allow multiple, mutually-incommensurable perspectives to coexist and inform your practice. It is like picking up multiple camera lenses to view an object using a variety of different perspectives, without feeling the need to stitch those perspectives into a single coherent image. It’s not about trying to square what you see through one lens with what you see through another; rather, it’s about using each lens in turn to discover what it reveals or conceals.

An example of incommensurability

Polyperspectivalism is a critically important strategy for overcoming one of the central problems in the contemporary practice of traditional Asian medicine: the cognitive dissonance caused by incommensurable interpretations. For purposes of illustration, let me use an example from my own experience that I think will be generally recognizable by practitioners of all forms of traditional Asian medicine.

My own career as a practitioner lasted for about 10 years before I abandoned it to become a full-time academic. In the early portion of that time, I spent two and a half years in Thailand studying a variety of traditional healing practices. Circulating between classes in traditional medicine clinics, apprenticeships with individual healers, and retreats at Buddhist monasteries and meditation centers, I was exposed to a very wide range of healing techniques and approaches. All of these were deemed “traditional” by the practitioners who were teaching me.

Despite the Thai government’s recent efforts to develop an integrated system officially called “Thai Traditional Medicine” (abbreviated TTM in obvious mimicry of China’s TCM), traditional medicine in Thailand is not a unitary or coherent system. The government has created various regulatory schemes for herbal medicine since the early 20th century and for massage beginning in the early 21st, but there has to this day been little success in producing an overarching systematization or codification on the ground. In the 1990s, Thai medicine was even less homogeneous than it is today. Someone like myself learning from a variety of sources invariably encountered not only a wide range of different practices, but also radically different theoretical justifications—even completely different models of health, disease, and the body—from the teachers we learned with.

Take lom ลม, a concept that is often said to be central to the practice of traditional Thai bodywork.This is a common Thai word that means wind, air, breath, or gas. In the specialized context of bodywork, however, I heard this word interpreted in various different ways:

• From some teachers, I learned that lom was the last of the four elements (i.e., earth, water, fire, and wind), a term that referred to the breath and the mobility of the physical body. These teachers would say that Thai bodywork focuses on pressing and manipulating the material or physical aspect of the body (i.e., the earth element) in order to achieve fluidity of lom (i.e., the wind element). Saying that Thai bodywork helps with lommeans simply that it is intended to improve the mobility of the physical body.

• Meanwhile, other teachers said that lom is a kind of energy or vital force that animates the body. It flows from the core to the extremities along invisible pathways, and ultimately connects the individual body to the mind and the rest of the world around us. The therapist’s focus on lom, according to these teachings, is not about mobility of the physical body per se, but rather the vitality of the underlying subtle body or energy system. In fact, addressing a problem with lom might not involve working with the physical body at all. I was taught to work directly on the system of wind-energy pathways through visualization and meditation practices that were integrated into the bodywork session.

• In addition to these two perspectives, I briefly studied with a teacher who taught that lom was interchangeable with the Chinese concept of qi. She also taught movements that would generate or dissipate lom from the specific organs, in order to tonify or regulate the body’s overall level of yin and yang energy.

• There was another teacher I worked with who refused to say anything concrete about lom—or any other concept for that matter. If I asked any questions about the theoretical side of the bodywork, she would tell me to stop worrying about such things and instead to pray to Jīvaka, the “father doctor” of medicine and the Buddha’s doctor. I was told I should stop trying to use thought to figure out what to do, and instead to let his spirit enter into my body to guide my hands during the massage himself.

• One teacher I was acquainted with, when questioned about lom, insisted to me that all of the above was a load of superstitious nonsense. In her view, massage therapists should focus strictly on physical, anatomical, fleshly realities: pressing the muscles, nerves, tendons, flesh right in front of our eyes and beneath our thumbs. Nothing more, nothing less.

• Finally, several years later after I had left Thailand and was conducting research for my Masters thesis, I learned that the Thai word lom is used as a translation term for various different concepts. On the one hand, it can be a translation of the Pāli term vāyu, the wind element, which is integral to early Indian medical and cosmological theory and entered into the Thai lexicon via Theravāda Buddhism. But, it can also translate the Sanskrit term prāṇa, which is associated with Indian tantric or yogic practices that circulated widely in Southeast Asia in the late medieval period and that are becoming increasingly popular today. And, I learned that in certain cases lom can also be a translation for the Chinese notion of qi. Because these concepts are all translated with the same word, I began to see that lom could have completely different cultural resonances and clinical implications to different teachers. I also began to see that differences in how people thought about lom often depended on specific social factors such as the teachers’ level of formal education, status in the community, gender, religious commitments, and ethnic affinity.

Before I continue, let’s just stop for a moment to appreciate the fact that, on their face, the six different interpretations of lom above are truly incommensurate. Either lom refers in a general way to the breath and the mobility of the physical body, or it’s a complex system of specific energy channels that lies beyond the physical body. Either it’s the central concern of the therapist, or it’s superstitious nonsense. Either practitioners should intentionally understand how to work with lom, or we should stop thinking about it. Either this is a natural feature of how the human body works, or a sociocultural construct. Confronted with these divergent interpretations, it may be possible for me to create a theory where some—or even all six—of these perspectives are integrated into a coherent framework, but that would be my interpretation and none of my Thai teachers would have subscribed to it. Likewise, it may be possible for the Thai government or another organization intent on systematizing to step in and mandate some compromise or orthodoxy, but again that would be their interpretation and not my teachers’.

How do you navigate differences?

Whether you practice Chinese medicine, Ayurveda, Sowa Rigpa, therapeutic yoga, Buddhist healing meditation, or any other tradition, I think all practitioners of Asian medicine will recognize the underlying issues here. Even if you don’t know anything about lom or Thai medicine, I’m sure you have encountered similarly fundamental differences between schools, texts, lineages, or teachers that cannot be reconciled with one another in your own tradition. You no doubt have yourself grappled with how to navigate those differences in different educational settings, and how to decide which approach to take in the clinic.

When presented with incommensurate interpretations such as these, practitioners often feel forced to commit to one viewpoint—or to integrate several of them together if possible—and to jettison the ones that can’t be made to fit. This impulse is understandable, as it is a way of minimizing the cognitive dissonance that comes from incompatible truth-claims. But, how do you decide what to keep and what to discard? In a previous post, I outlined three different “epistemes” or worldviews that many practitioners can get locked into when making these decisions.

When I was first starting out, like many practitioners of Thai medicine Western and Thai alike, I was convinced that the only legitimate place to look for the answer to what lom “really is” is within the tradition itself. In other words, back then I subscribed to what I now call the “traditionalist episteme.” Traditionalists agree that the definitive source that will solve the problem for once and for all will be a text, a book, or a teaching by someone inside the tradition; however, they differ vociferously on which exact source they deem most authoritative. One may feel that the answer is to be found in this or that particular manuscript, while another may feel that Dr. So-and-So is the most knowledgable authority. In Thailand, well-respected teachers routinely scoff at the interpretations being offered by other equally well-respected teachers, and many of these animosities have developed into high profile feuds between their students around the globe. The stakes in these debates seem high because traditionalists in one camp feel that the others are misunderstanding, misrepresenting, or even disgracing the tradition. They likely disagree about what exactly “the tradition” even means. But, ultimately, they are all seeking the resolution of the problem from within the tradition, however they define or understand that term.

Someone who subscribes to the “modernist episteme,” on the other hand, would base their decision about what lom “really is” upon which interpretation is most compatible with modern science or biomedicine, or has the most empirical evidence behind it. Many modernists feel that the entire tradition as a whole is scientifically justifiable. Others argue that the tradition “gets it” even better than biomedicine. Modernist Thai medicine is the form of practice with the most official support, funding, and institutionalization both in Thailand and globally. Proponents of the Thai government’s officially sanctioned version of TTM, for example, offer modernist reinterpretations of Thai tradition in Thailand. Scientists at Thai universities conducting research on traditional medicine and publishing their results in internationally circulating journals also subscribe to this episteme. Western-trained massage therapists with strong backgrounds in the medical sciences also have been popularizing a modernist view of Thai massage in North America and Europe.

Finally, the “postmodernist episteme,” as I have defined it in previous posts, describes a stance that is most common among academic scholars of Asian medicine who are typically themselves not practitioners. Postmodernists have a different approach to incommensurability, in that they are not necessarily interested in “solving” the problem by determining which of the various interpretations is right. For example, I mentioned above that once I became an academic, I became more interested in investigating how context shapes practitioners’ interpretations of lom than in finding the one correct definition of the term. For an academic scholar, identifying the cultural settings, local histories, social positions, identity politics, and other similar factors behind the differing opinions is in itself a satisfying explanation. It resolves the question of incommensurability by placing all of the options into a larger intellectual framework. Of course, few practitioners would agree that these are satisfying answers, and they usually caricaturize postmodernists as irrelevant denizens of the “ivory tower.”

As an active participant in the westward spread of Thai massage and medicine in the 1990s and 2000s, and as an academic observer of this process since then, I have watched as adherentsof all three of these epistemes have struggled to discuss the question of lom and other similar conundrums in a constructive, productive, or even collegial way. In my view, conflicts between and among proponents of these different epistemes are preventing most practitioners from taking advantage of the full range of possibilities in their practice.

Is there a better way?

Polyperspectivalism is a new approach to the problem of incommensurability. Instead of looking through just one lens or trying to combine what you see through different lenses into a coherent picture, polyperspectivalism is about allowing all of the competing lenses to stand on equal footing as viable alternatives. Applied to the example of lom we have been talking about, a polyperspectival approach would mean acquiring as many different interpretations of this term as you can, studying them all as deeply as possible so that they can all become tools within your healing repertoire.

Rather than trying to smooth over differences between these lenses, the goal of polyperspectivalism is to learn from their juxtaposition. A temporary shift to a different conceptual system might clearly reveal what has been rendered invisible by the lens you’ve been accustomed to looking through. But, you can only see what has been hidden in plain sight if you fully remove your current lens and try a different one. Polyperspectivalism is therefore different than translation or “medical bilingualism.” When you translate something, the assumption is that there is a meaning that stays stable as you move from one language to the next. Polyperspectivalism has nothing to do with trying to keep anything stable across the epistemological divides. Rather, you could say, it is about intentionally looking for what is untranslatable within each episteme.

One of my recent posts described how this approach can also lead to more flexible collaborations with colleagues who don’t share our own particular worldview. When we encounter other practitioners who exhibit strong differences with our own understandings, rather than perceive them as misguided, threatening, or just plain wrong, we can approach them with deeper curiosity and perhaps even gratitude. What new lens might I pick up from someone with such a radically different interpretation than mine? What might their perspective illuminate that mine doesn’t? What might I be overlooking or misinterpreting that their lens can bring into focus? 

However valuable it may be for collaborations, in this post, I am focusing on how polyperspectivalism can be an asset in clinical practice. I’ll give two brief examples of polyperspectival approaches to lom in order to illustrate the value of the approach. Even if you’re not a practitioner of Thai bodywork, I think you will see clear parallels with your own practice.

Two examples of polyperspectivalism

The first example involves the so-called “blood stop” (also known as “opening the wind gates”), a maneuver that was common in bodywork circles in Thailand in the 1990s. I was taught by multiple traditionalist teachers that the principal way of opening up the flow of lom in the body is to release lom from the limbs into the abdominal cavity. This was done, I was taught, by placing your hands on the patient’s femoral and brachial arteries, and pressing down with enough force to stop or severely curtail the blood flow. You held the pressure for up to 10 heartbeats, and then released. You knew you had done it with enough pressure if the patient’s limbs went numb during the press and tingled strongly with “pins and needles” after the release.

There were some differences in how this step was performed. Different practitioners held the press for different amounts of time. Some teachers taught it should be done with the open palms, while others taught that it should be done with the fingertips while the hand was held open rigidly. One teacher taught me that the “blood stop” should be done on the carotid arteries as well as the arms and legs. A purely traditionalist viewpoint would try to figure out which of these methods was the most “authentic” while staying within the traditionalist episteme. You might decide which technique to use on the basis of which teacher was the most respected, the most wise, or the most authoritative. Or, if you thought historical antiquity was the main criteria for authenticity, you might try to consult ancient manuscripts to find a description of how this step was performed in the past.

By staying within the tradition, however, you would forever miss the crucial fact that this maneuver is extremely dangerous from a biomedical perspective. As soon as you switch to looking at this step through a modernist lens, the risks to the cardiovascular system become glaringly obvious. Seeing in this new way opens up a set of questions beyond just which teacher’s method is the most authentic. You might now find yourself wondering if you should discard the “blood stop” altogether. Or, you might decide to depart from tradition and invent a compromise in order to make the maneuver safe from a modernist perspective while still fitting within an energetic interpretation of lom.

A second example of how polyperspectivalism might open up new areas of inquiry is the teaching that you should always begin bodywork on the left-hand side when working on women, and on the right when working with men. I heard this countless times when I was studying in Thailand, and there are all kinds of traditionalist reasons why this makes sense that have to do with solar and lunar influences on the body. If we apply the modernist lens, as we did in the previous example, this time we will see that biomedicine has no opinion whatsoever on this question. But, as soon as we apply a postmodernist lens, we suddenly find a whole new dimension immediately comes into focus. What do maleness and femaleness actually mean in Thai culture? What are the implications of this male-female gender binary being mapped onto the body in this way? How do these left-right associations change if the patient is gay, transgender, or gender fluid? Do these distinctions make sense in my own culture? Do I want to be reinforcing traditional Thai gender norms through my own bodywork practice? What other connotations are there in Thai culture that I might be unconsciously inscribing onto my patient’s body during a massage session?

Again, my point here is not to answer these specific questions or to tell you what to do in the clinic. I just want to underscore how previously hidden dimensions of inquiry become glaringly obvious when you start looking through other lenses. Once you’ve seen these incommensurabilities you have the ability (and, of course, the responsibility) to make new clinical choices in light of these insights.

You’re no doubt already polyperspectival, so just embrace it already!

If you are a traditionalist in any Asian medicine tradition, ask yourself how would you respond to these two examples? Can you imagine yourself respecting your teachers’ traditionalist interpretations of lom, but discarding or modifying the “blood stop” because you take the biomedical understanding of the contraindications seriously? Can you see yourself also breaking with your teachers’ left-right protocol in order to accommodate a fluid postmodern stance on gender? If your answer to either one of these questions is “yes,” then you are already doing polyperspectivalism. If you can see the value of the new perspective brought by non-traditionalist epistemes in either these two examples, then you’re obviously not completely locked into a traditionalist stance. You are willing—at least on occasion—to oscillate into other epistemes, and to allow them to take precedence over traditionalist sources of wisdom.

Most contemporary practitioners I know would in fact respond “yes” to those questions and would in fact have no problem deviating from tradition in these two cases. However, in my experience, many of these same people would in the very next breath boldly declare on social media that “allopathic medicine is a big scam” or “academics are parasites who don’t know anything about practice” or “doctors and scholars may have one or two good ideas but most of what they say is complete bullshit.” (These are paraphrases of comments I have actually received on Facebook about some of my previous posts). I don’t think that this is necessarily intentional hypocrisy, but it certainly suggests a lack of self-awareness and a lack of appreciation for where some important correctives to their practice have come from. And it also is clear evidence that they are willfully shutting themselves off from vast areas of learning that they already know from experience will expand, enrich, or enliven — not “corrupt” — their practice.

I’ve used traditionalists as the example here, but the same conclusion applies if you are clinging to the modernist or postmodernist epistemes. A practitioner who is completely locked into scientific approaches or a scholar who is completely locked into postmodern frames of analysis is equally selling themselves short. My question for all such individuals is: why insist on epistemological purity when you already know that other viewpoints can be beneficial? Instead of all the posturing and fighting with your colleagues from other fields, why not embrace the different lenses they are making available to you, which in fact you are already using? Why not read and study as many traditional perspectives from as many teachers as possible? Why not read the science related to your practice—especially the studies that raise problems with it? Why not read the academic literature that deconstructs and critiques your tradition (Thai practitioners click here)? Why not lean into these differences, and see what new vistas some new lenses might reveal?

Once you are no longer limited by self-imposed epistemological constraints, you will find that you have many more options for how to think and act in the clinic than you previously thought. One day, a patient might present with a set of symptoms that seem not to make sense within one way of looking, but then they may cohere together when seen through another lens. You might treat one person with an entire protocol that is based on an energetic interpretation of lom, and treat the next with a strictly mechanical approach that was concerned only with the body’s anatomical structures. You might be in the middle of a difficult session that is grounded in the four elements theory, and suddenly throw up your hands in despair and channel the “father doctor” for inspiration. You might be planning out your protocol for working with lom to help manage the patient’s anxiety, and spontaneously be inspired to take a closer look at how the space you are practicing in is signaling cultural appropriation, white supremacy, or ableism. You might, instead of seeing these approaches as conflicting models, come to understand them as a set of diverse interpretive tools that are all equally available for you to draw upon, to selectively and skillfully meet different clinical situations as they arise.

On not being “right”

While in other fields, fundamental discrepancies can be treated more casually, in medicine it’s a matter of grave ethical responsibility to “get it right” — possibly even a matter of life and death. When there is an incommensurable difference of opinion over what should be done and why, the anxiety to cling to the tried-and-true is understandable. To me, though, the high stakes of the endeavor is all the more reason that polyperspectivalism is needed in the clinic. In my opinion, rather than being afraid to get it wrong, the bigger danger is thinking that you’ve got it right!

For anyone to think that they have found one episteme, viewpoint, or system that contains all the answers is, I have argued, sheer hubris. There is always something to learn from another viewpoint, and chances are it could be vitally important. To remain committed to a single episteme may seem safer, but like in the example of the blood stop and the left-right binary your blind spots are likely to be undermining the wellbeing of your patients in subtle or not-so-subtle ways. Given the complexities we are responding to in the clinic, how could trying on a variety of different lenses possibly be wrong?

Human health is a multidimensional, mysterious and unpindownable thing that cannot be reduced to a single narrow way of thinking. We already know this, so let’s just embrace it.

Articles in this four-part series were published simultaneously on AMZ and Medium.com.

Imagine you are some kind of super-intelligent alien located on a planet way out in the furthest reaches of the galaxy. You are looking out through a high-powered telescope, and have found this little planet called Earth. Your civilization’s advanced technology allows you not only to see across the vast expanse of space, but also to look across time. Through your telescope, you witness the birth of the planet, and see its whole history play out in fast-forward.

As you watch, the approximately 4.5 billion years of the Earth’s history unfolds before your eyes. First, the planet is born in an explosive galactic collision. As the fiery, gaseous heap of stone gradually cools, microscopic prokaryotes emerge and develop into multicellular organisms. Gradually, more and more complex plant and animal life takes form and populates the planet, transforming its atmosphere. From way out in space, the details of these lifeforms can’t be made out too clearly. In a seeming blur, one species after another evolves, thrives for a time, and then recedes again. Life organizes and collapses and reorganizes over and over again in a fractal pattern of near-infinite complexity. You can see all of these countless living beings constantly killing and birthing each other, eating and defecating out one another, as one throbbing blob of biological matter and energy. Sometimes you think you can make out some kind of cosmic order in all of it—at other times, it just seems like random chaos.

Somewhere along the line, human beings become visible as part of this mass. At this resolution, individual people are impossible to make out, but humanity as a whole is clear, its collective bioenergetic presence writhing, contorting, and pulsating across the planet. Cities, states, and empires burst in and out of existence, now burning each other to the ground, now swallowing each other up. Occasionally, viruses (also part of the whole of life) or some other momentary blip wipes out large portions of the population in a flash. But humanity bounces back, growing even larger and more vibrant, as if driven by a higher — or perhaps a sinister — intelligence. As you watch, lifeforms, the atmosphere, the planet as a whole is transformed again and again in a sometimes interdependent and sometimes antagonistic dance alongside human life.

Let’s say you also have a transgalactic microphone that allows you to hear the babble of this human biomass, as it talks to itself incessantly. You hear the cries of pain of billions upon billions of its voices, a sound that is matched by the same volume of joyous laughter. The soft words of kindness spoken by mothers and lovers are blended together with the words of violence and hate hurled at enemies and combatants. And through it all, the constant drone of the questions that arise from humanity: What’s happening here? Who are we? What does this all mean?

And then, after all of this raucous hurly-burly—one might even say this Carnaval-like cacophony if one had read the previous posts in this series—you arrive at the present. You now take the opportunity to zoom your lens all the way to the limits of its power, right down to the level of an individual person. You carefully tune your microphone as well, in order to pick one voice out from the crowd. For just a moment, you decide to give this person your full attention, letting them occupy center stage in this epic cosmic drama. Straining your eyes and ears across the light-years, you listen intently. And, ringing out across the universe, you hear:

Listen up, people! All of reality is described in this book that was written 2000 years ago. This particular book contains the truth, and anyone who disagrees with it is wrong.

Wait, what? you ask yourself. Am I hearing this right? You tune your equipment and listen in again, this time letting your instruments focus on another person nearby. Again, you pick up words loud and clear:

No, you’re wrong! This is all really just the interplay of inert physical matter. This is plain as day to see, and anyone who disagrees with this is ignorant.

In disbelief, you readjust and pick out a third person, listening in one more time:

You’re both fools! Truth is merely a social construct, contingent on historical and cultural factors. Anyone who disagrees with this analysis is just being naïve.

Alas! you think to yourself, if only my equipment could broadcast and not just receive signals. If only I could reach these people across the galactic airwaves. I would tell them about all of the details of the combusting, writhing, frothing vibrancy I’ve witnessed throughout this planet’s history. I would communicate the infinite complexity I’ve seen in the processes of birthing, dying, becoming, and changing. I would share the sorrow and the beauty, the suffering and the redemption, I’ve witnessed throughout the story of the Earth.

Oh, well, you think to yourself, I guess they’re on their own. And you move your gaze to a different far-off corner of the galaxy.

*

In the weeks since I wrote the first two posts in this series on “meta approaches” to Asian medicine, I’ve heard feedback from a variety of people who fall across the traditionalist, modernist, and postmodernist epistemes or worldviews suggested in the parable above (see definitions in post #1). Some readers have pointed out that a specific detail about one or another thing I’ve said is incorrect. Many have felt I’ve overstated the differences between these three groups, or ignored the cases where they genuinely have gotten along with one another or produced true insights. Others have responded by doubling-down on their own native episteme, upset that I’m just not getting why their perspective is actually the right one.

Regardless of the particulars of their responses — more than a few of which have been perfectly valid critiques — many of the people who have written or commented to me have expressed unease about my three core arguments: abandoning the need to integrate these epistemes, letting them co-exist as incommensurable approaches, and allowing ourselves to productively oscillate between or among them. Whatever the specifics of their position may be, most seem to agree that this would be radically destabilizing.

Exactly what would be destabilized has varied — for some it’s their professional identity, for others their beliefs or values, and for still others it’s the integrations and syntheses they have worked so hard to build up. Some respondents have seen the potential for the destabilization of their very conception of self. As one emailer put it: “I don’t agree with the incommensurability [of the three epistemes], for if I did I would be suffering from a triple split personality.” Another person shared the reaction of a family member: “If I let myself think about that, the whole world that I based my life upon would fracture. I can’t go there.” Someone else wrote that “one first has to have a fully developed identity before one can disassociate from or transcend it, and I don’t see most humans fully developing [to that level].”

To be clear, my proposal is indeed intended to be destabilizing in precisely those ways. I am indeed inviting us to fracture our selves: not just to triple-split, but maybe even to shatter into a million disparate pieces. Indeed, one way my position could be summarized is that an overly ossified sense of self is the problem. The self-assuredness that one of these epistemes has enabled us to arrive at the truth, or the belief that the synthesis of two or three of these will someday enable us to do so, or even the very idea that there is an ultimate truth that one could someday arrive at in the first place, is the problem. The notion that any ultimate truth could actually be captured by any particular paradigm is very much the problem. The three partisans in the parable above are laughable caricatures precisely because they’re three puny “blind men” groping at a cosmos-sized elephant. They are each totally convinced that they’ve got the one solution to the mystery, complexity, and enormity of the whole of reality… and that they’re going to tell us all about it.

In fact, every one of the epistemes we’re discussing recognizes that reality simply cannot be fully understood in that way. Each acknowledges that a deep mystery lies at the very core of existence. Postmodernism wears its uncertainty principle on its sleeve, seeing all “facts” as contingent and relative, constantly changing in response to social and cultural forces. In traditionalist terms, at the bottom of every form of Asian medicine I know of is the Dao that can’t be spoken, the ineffability of the cosmic Being, the emptiness of all dharmas, and so forth. Even the hardest of sciences knows that, at the highest resolution, everything solid dissolves into quantum probabilities and paradoxes. Deep down, these epistemes know themselves to be nothing more than approximations —useful perhaps, but always temporary, unstable, and partial. Each warns against the hubris of reductionism and totalization.

In other words, it’s not the epistemes themselves that are to blame for the self-assuredness of the blind men. Rather, it’s the rigidity with which they adhere to their convictions, the arrogance with which they inflate their disciplines into totalizing explanatory frameworks. It’s the earnestness with which they tell themselves comforting mythologies, and the violence — metaphorical and, all too often, actual — with which they bludgeon dissenting voices to prevent being challenged by other equally mythological stories.

My proposal for a metamodern and metadisciplinary approach is also a proposal for a metamorphic approach. Meta meaning beyond, and morphe meaning shapes or forms. An approach beyond forms. An approach that doesn’t need to create and defend stable shapes. An approach that oscillates or bounces or flows from one perspective to another without seeking a stable position. Whether we move through these fluctuations with fluidity or with abruptness, with grace or with jerkiness, is not important. What matters is that we never allow ourselves to fall into the trap of thinking that we’ve discovered a final answer to what all of this really means, or how all of this really works, and that we thrive on the uncertainty.

To be clear, I am by no means arguing that different types of thought haven’t made contributions to human understanding. Each of the three epistemes is an exceedingly valuable lens that reveals much about the world, and to argue otherwise is patently ridiculous. If you think I am arguing that tradition or science or academic postmodernism are “wrong,” then you have misunderstood what I’m saying in these posts completely. It is, in fact, critical to my argument to recognize the truth-value of all three epistemes. Each is equally right within its own domain of expertise. But, it is equally critical to recognize that they are all incomplete in their understandings of the whole. They each grant us an accurate but partial view of reality, revealing some truths while obscuring others. It is also critical to my argument to accept their incommensurability: that they do not fit together like neatly aligning puzzle pieces, and that their synthesis is highly problematic. If you don’t agree with these basic premises, which were argued in more detail in the previous posts, then this final post probably won’t make much sense.

Moreover, agreeing with these premises doesn’t invalidate the innate human curiosity that makes us want to understand our place in the universe. Metamorphosis doesn’t invalidate seeking knowledge for practical purposes. However, it does involve realizing that we could spend our whole lives — or, indeed, millennia — trying to figure out reality, only to find that we simply will never be able to comprehend it in its totality. Metamorphosis accepts this as a built-in limitation of our human minds, and knows that every seemingly stable position we could possibly come up with could only ever be just another hypothesis. That any new model we could possibly ever produce would always continue to have uncertainty at its core. That no matter how much conceptual knowledge we ever compile, we’re always going to be trying to name the Dao that can’t be named.

Life-energy, electromagnetism, or social construct from early China? Some combination of the three? Or, just maybe, none of the above!

Celebrating both the inevitability and the futility of our quest for truth, a metamorphic approach allows us to dive into epistemes and disciplines, to milk them for all they’re worth, all the while knowing that none of them will ever be fully and totally right. It demands that the moment we find ourselves settled into any one particular way of thinking, we start challenging our own core tenets. As soon as we start to feel like “I’ve got it,” we start destabilizing that coziness by thinking about all the ways that we could be — must be—missing the bigger picture.

By eschewing fixed forms and static positions, we leave behind a rigid or one-dimensional sense of self and become shape-shifters. Treating our convictions as lightly as Carnaval masks may indeed initially feel threatening or uncomfortable, and perhaps there are good reasons that this approach is not for everyone. But, the feeling that your whole life will lose its meaning if your worldview is challenged can only be true if your have overly identified yourself with your thoughts, beliefs, and stories. In these three posts, I’m suggesting that rather than cracking under the pressure of confronting one another’s truths, we might instead find a way to to allow ourselves to metamorphose into new and unfamiliar selves with every new encounter.

Once we’ve unwrapped ourselves from our conceptual cocoons, we can start encountering former rivals across the seminar table with vulnerability and compassion rather than defensiveness and enmity. Rather than donning our disciplinary war-paint, we instead can look each other nakedly in the eyes as fellow human beings. Only then can we extend a hand and join together in solidarity as we all blindly feel our way around this elephant together.

*

Not too much later, you’re able to find those three Earthlings in your telescope again. Thanks to a recent update to your equipment, you now are able to broadcast a message to them from your vantage point way on the other side of the galaxy. You tune your signal, clear your throat, and then begin to beam your message down to Earth….

What will you say? Will you pick a side in their debate? Will you play the peacemaker, seeking a comfortable détente between them? Or, will you perhaps decide to leave the Dao unspoken after all, and just sit back and enjoy the cosmic show?

Articles in this four-part series were published simultaneously on AMZ and Medium.com.

Interdisciplinarity has failed as a model for collaboration in the study of Asian medicine. Here, I propose the new model of “metadisciplinarity” as a means of bringing people together in more productive and more generative ways.

In my last post, “A Metamodern Approach to Asian Medicine,” I discussed a major communication problem within the study of traditional Asian medicine. I outlined the three major groups that dominate this field: the distinct and occasionally overlapping social groups of practitioners, scientists, and academic scholars. I introduced the epistemes or worldviews each group subscribes to, which I called “traditionalist,” “modernist,” and “postmodernist.” I described the stereotypes the proponents of each episteme have of one another, and the disciplinary rules and norms that are used to maintain and police the boundaries between them. I finished up with a proposal for how we can achieve more fruitful and more constructive co-existence, based on some ideas drawn from the theory of “oscillatory metamodernism,” as recently developed by scholars of aesthetics and religious studies.

While the last post focused on diagnosing the problem and laying out the bigger picture, here I want to explore in specific detail how we can achieve better communication Below, I will argue that our primary model for collaboration — interdisciplinarity — has failed to produce genuine dialogue across the epistemes. I then propose a new model I’m calling “metadisciplinarity” as a means of bringing people together in more productive and more generative ways.

Different types of collaborations

Before discussing the failure of interdisciplinarity, let me first define how I use this term, and related words, so that we’re all on the same page:

To begin with, I use the term disciplinarity to refer to a process of entrainment that involves steeping oneself in and taking on board the primary episteme of a particular discipline — including all of its the methodologies, assumptions, worldview, and truth claims. This is a crucial part of professional formation for traditionalist practitioners, modernist scientists, and postmodernist scholars alike. For each of these groups, cultivating disciplinarity involves internalizing a particular set of knowledge and practices, taking on a new professional identity, and learning to conform to the rules of the game as they pertain to the particular community.

Multidisciplinarity, then, is a form of collaboration in which practitioners or adherents of two or more disciplines with divergent perspectives come together to discuss or address a common problem. The problem is explored from different directions or through different lenses, but synthesis or mutual learning is not expected as an outcome. For example, imagine a conference panel on mindfulness that includes a Buddhism monastic, a neuroscientist, and a historian of religion. An event designed to be multidisciplinary might involve each presenter speaking for 20 minutes, and then the floor being opened up for comments and questions. In this case, the traditional, modern, and postmodern epistemes are given equal voice, but they are not expected to achieve true dialogue. (Multidisciplinarity, like the rest of the terms on this list, can also take the form of a single practitioner, in this case one person who juxtaposes two disciplinary perspectives without blending them together.)

Interdisciplinarity, on the other hand, is when those collaborators have the intention that each participant’s understanding will be enriched and expanded by interacting with the other. An interdisciplinary collaboration ideally should generate integration — some kind of novel approach or perspective that combines or synthesizes the disciplines. For example, if the panelists at the mindfulness panel are all aiming for interdisciplinarity, they will come to the event with the intention to learn from one another in order to find common ground. They would probably also organize the event as a dialogue instead of as a series of lectures or presentations.

A variation on interdisciplinarity is transdisciplinary, where the interdisciplinary collaboration is aiming to somehow transcend the original disciplines altogether — for example, aiming to discover a new field of research, or to bring new stakeholders into the conversation. If the interdisciplinary mindfulness event just described was also intending to inform public healthcare policy, or if it included politicians, healthcare workers, and/or members of the public in the conversation, it could be called transdisciplinary.

The failure of interdisciplinarity

It is important for me to distinguish these different terms in order to clearly state what I see as the problem. In the field of Asian medicine, interdisciplinarity (and, more recently, its variant transdisciplinarity) has been tasked with bridging the gaps between the traditional, the modern, and the postmodern. It has been touted as the tool or method by which these three epistemes will finally be combined together, and their adherents finally reconciled. The much hoped-for end is an “integrative” or “integrated” approach, which will be a synthesis of the most beneficial perspectives of all three and which will unlock all sorts of utopian health outcomes.

This sounds nice, but the problem is that almost every attempt to generate interdisciplinary collaboration of which I am aware has failed to achieve the holy grail of epistemological integration. Sooner or later, these interdisciplinary efforts have (1) failed to produce any collaboration at all, (2) devolved into multidisciplinarity, or (3) come to be dominated by one episteme or another. We’ll go through these scenarios one by one:

1.) Failure to launch

Interdisciplinary collaboration is often doomed to failure right from the beginning by the fact that some or all of the participants in the collaboration refuse outright to participate. While they may pay lip service to interdisciplinary goals, they either explicitly or implicitly refuse to buy into the idea that cross-epistemic conversation is actually worthwhile. This was the scene at the Third International Congress of Traditional Asian Medicine (ICTAM) in Bombay in 1990, described in an essay by Lawrence Cohen that I discussed in the previous post. Sponsored by the International Association for the Study of Traditional Asian Medicine (IASTAM), this conference had the stated purpose of bringing together practitioners and scholars of Asian medicine. Yet, despite the efforts of the organizers, the dividing lines between these two groups proved insurmountable. As Cohen described it, the separation was not only epistemological but also physical. Not seeing enough common ground to even begin the conversation, each group self-segregated into their separate corners of the venue. Ensconced within their own worldviews and paradigms, each group was unable to understand the value of even venturing over to the other side of the building.

Lest you think this is just an isolated example from many years ago, I will point out that such self-isolation continues to play out in many contemporary forums for traditional Asian medicine today. Take a look at any of the major Facebook groups in our field, and tell me which one sees active engagement and dialogue across epistemes!

2.) Bait and switch

Since the 1990s, organizations like IASTAM, their journal Asian Medicine (of which I am the editor in chief), and other smaller-scale efforts (such as this blog and the Asian Medicine Zone FB group) have succeeded in bringing traditionalists, modernists, and postmodernists together into the same space for the purpose of dialogue and exchange. Even when participants have been willing, however, they all too often have been unable to break out from their own disciplines and epistemes. Unwittingly and despite their own best intentions, they often wind up speaking past one another, and the interdisciplinary fantasies soon enough devolve into multidisciplinary realities.

Often, participants in such exchanges may not even realize that this is what is going on. To give an example, I was recently asked to keynote at a conference at a college that was launching an integrative medicine program. The intention of the meeting was to bring scholars and practitioners of complementary and alternative medicine together for mutual edification. My keynote (which was actually an early draft of my previous post on metamodernism) encouraged participants to let loose and enjoy the cognitive dissonance that comes from crossing epistemological boundaries. In the end, however, the conference consisted entirely of talks and panels that were each firmly grounded in one or another episteme. It was a diverse multidisciplinary array of presenters and audience members, to be sure — with lectures from reiki masters, nurse-practitioners, historians of Korean medicine, and many more. But with no structure in place to create dialogue between them, these groups were ships passing in the night. In the concluding plenary session at the end of the day, a spokesperson for the hosting organization proudly congratulated the audience on how much we had all learned from our cross-epistemological collaboration. The audience clapped enthusiastically, wholly unaware of the fact that little to no epistemological cross-fertilization actually had taken place.

3.) One episteme to rule them all

At times, there have been important breakthroughs in our field that appear to have come from successful collaborations between epistemes. Perhaps one of the most high-profile examples is the research done by Tu Youyou, who won a Nobel Prize in 2015 for her work on artemisinin as a novel therapy for malaria. The crucial moment in her discovery came, she says, when she discovered how to extract the compound using a traditional method that was recorded in a fourth-century text by the Chinese physician and alchemist Ge Hong (ca. 283–343 CE).

At first glance, using an ancient medical text to inform contemporary Nobel-Prize-winning scientific research seems to be a textbook example of the benefits that can come from cross-epistemic dialogue. However, alas, there is actually no interdisciplinarity going on here either. Rather, knowledge from one episteme is simply being absorbed or co-opted by another. In this case, Tu appropriated knowledge associated with the traditional episteme for modernist purposes. Extracting Ge Hong’s traditional method from its original cultural context, she repurposed the technique in order to produce knowledge that could be understood, valued, and utilized within scientific, medical, and public health frameworks.

Please don’t get me wrong: I am not for a moment criticizing Tu’s work, which has been more beneficial to humanity than everything I’ve done in my own life put together. I’m not even criticizing this kind of research strategy. The same basic approach has led to many healthcare interventions — such as Mindfulness-Based Stress Reduction, yoga therapy, medical qigong, and all kinds of other traditional-modern hybrids — that have been therapeutically important in the past 50 years. This kind of approach is extremely useful and should continue; however, my point is that it is not actually an example of epistemological border-crossing. It is one-way translation, not a conversation between equals. It strengthens disciplinarity, not dialogue.

Metadisciplinarity

If we are interested in cross-epistemological dialogue — and, indeed, I recognize that not all of us may be — my proposal is not going to be that we get better at interdisciplinarity. Given our track record, I think interdisciplinary collaborations are largely destined to continue to fail. Rather, I am proposing an altogether new framework for cross-epistemological collaboration that I will call “metadisciplinarity.” If you have read the previous post you will recognize that this new framework draws from the theory of oscillatory metamodernism I discussed there. To use the metaphor from that essay, you could say that metadisciplinarity is a set of specific practices that can help to bring us together in a more productive and generative conversation. They also can help point the way beyond awkwardness and contentiousness, toward the joyous Carnaval-like atmosphere of metamodern oscillation.

In practice, metadisciplinarity involves at least three fundamental shifts in how collaborations across epistemes are oriented:

1.) From integration to polyperspectivalism

Our first order of business is to abandon the goal of integrating the three epistemes, to accept that their synthesis or reconciliation into a larger whole is a pipedream. A metadisciplinary collaboration instead begins with the premise that the traditionalist, modernist, and postmodernist approaches to Asian medicine are incommensurable. We understand that these are not different ways of seeing the same thing, but rather different ways of seeing different things.

Instead of striving for integration, a metadisciplinary collaboration makes space for the simultaneous presence of irreconcilable perspectives co-existing together within a single social frame. (By a “social frame” I mean anywhere where people and their ideas are gathered together, for example, a conference, a journal issue, a website, or a social media feed.) Participants in a metadisciplinary collaboration cultivate the ability to hear the unspeakable being spoken inside of that frame without the need to defend their turf. Participants learn to listen not with a cynical ear that is ready to attack and defend, but with a genuine appreciation — even enthusiasm — for radically alternative viewpoints that emerge through the conversation. We work to abandon the fragile mindset that must translate everything into our own language in order to make it sit more comfortably. We instead work on embodying a cognitive flexibility that welcomes being knocked around by new ideas, that finds creativity in the oscillation between different worldviews, and that experiences excitement or even joy at the chaos and dissonance that can result.

2.) From making truth claims to making meaning

If our social frame has any chance of becoming a tolerant space for that kind of polyperspectivalism, each participant is going to have to agree to refrain from making or defending ontologically strong truth claims. Recognizing that we will never agree across epistemes on what constitutes truth — or even what kinds of evidence are admissible in our quest for truth — we abandon trying to convince each other of any specific positions on it. Releasing ourselves from the burden of arguing over truth claims, we instead focus our energies on working together to explore what is meaningful to the group as a whole. Shifting from truth claims to meaningfulness allows each participant’s viewpoints to be heard not as threats or absurdities, but as valuable contributions to our collective meaning-making project.

Sometimes this can be no more difficult than changing how we turn our phrases. For a practitioner participant to turn to their historian colleague and say “I have direct experience working with qi, and I think my experience can contribute something to our current conversation” is a different statement than if they said “qi is real, and anyone who is sensitive enough can feel it.” The latter makes a black and white assertion from the perspective of one particular episteme, and closes down further dialogue. The former, on the other hand, opens us up a space for sharing, storytelling, and mutual listening.

3.) From disciplinarity to disciplinary transparency

All too often, the participants in cross-epistemic collaborations operate from a set of assumptions that are so well-known and obvious within their home disciplines that they go unspoken. We tend to forget that these assumptions we have internalized are not natural ways of being, but rather are the result of study, memorization, and embodiment through many years of training and practice. These assumptions remain inscrutable for outsiders unless they are made explicit, and they can easily become major obstacles for anyone trying to engage with us on our topics of expertise.

In a metadisciplinary collaboration, each participant in the dialogue therefore commits to being transparent about the disciplinary tools they are deploying at any given moment, and to making their unspoken epistemological assumptions explicitly visible to all participants at all times. The focal point of the collaboration shifts from trying to “solve the problem” or “arrive at the right answer” toward the sharing and refining of a meaningful collection of methods, tools, and insights. Drawing these equally from across the different disciplines and epistemes represented in the collaboration becomes a central concern of the collective meaning-making project.

New possibilities

These three shifts — welcoming polyperspectivalism, focusing on collective meaning-making, and a focus on explaining and sharing disciplinary tools — take us away from policing, defending, and strengthening the epistemic divides that keep us separated from one another, and instead provide a framework for entering into productive dialogue and collaboration across disciplines and across epistemes. But we must resist the impulse to make metadisciplinarity into a new systematization. Remember, oscillatory metamodernism is not about integration, it’s not about organizing everything into some kind of stable hierarchy, and it’s not about splitting the differences between us. Likewise, a metadisciplinary collaboration is not about producing some kind of harmonious stasis. In fact, if a collaboration finds itself in a peaceful stasis, it’s a sign that it’s not metadisciplinary enough! This is not about finding our common ground, but rather finding joy and making meaning in the cacophonous, unstable juxtaposition of incommensurable viewpoints.

To make this more concrete, imagine this scene from a hypothetical conference: An interdisciplinary panel session is put together with three presenters. A practitioner of Thai massage walks the audience through a “traditional treatment to clear the chakras.” A physician presents on how there is no scientific basis whatsoever for the concept of chakras. An academic then presents on how this particular model of chakras has nothing to do with traditional Thai culture, but rather was invented by a guy from Germany in the 1990s. Chaos ensues.

Where do we, the participants in this panel, go from here? Do we cringe and avoid eye-contact? Do we muddle through our presentations and then go our separate ways? Do we publicly duke it out to see whose perspective will win the day? Rather than any of those options — which have become our normal responses to epistemological disagreements in our field — I’m suggesting that we start by explicitly accepting that we will never see eye to eye with our co-panelists. But yet, we still commit to engaging with one another in good faith, at least so long as we are in the shared social frame of the panel session. I’m suggesting we use the allotted time for our panel to create a genuine dialogue where the main focus in not on figuring out which of these viewpoints is right, but rather on figuring out what value there is in one another’s approaches. I’m suggesting we can find joy in experimenting and investigating how we three can make meaning together, while still appreciating the incommensurability of our perspectives.

What would the result of such a collaboration be? Who knows! Metadisciplinarity is fluid, emergent, and unpredictable, and depends entirely on the specific participants gathered together. But, one thing I am certain about is that overcoming the current stalemate in our field depends on whether proponents of the three epistemes can learn to enjoy being jostled together in this way. If you read the previous post, you know that I believe that this kind of opening up to one another is what is needed both in our field and also in the world at large as well.

This is important, so let’s work on it together — no matter which social group or episteme you primarily affiliate with. I’m looking forward to the conversation, and hope that maybe we’ll actually hear each other for the first time.

Articles in this four-part series were published simultaneously on AMZ and Medium.com.

The traditional Asian medicine community has a communication problem. We know it all too well. Lawrence Cohen identified it decades ago when he wrote about the Third International Congress of Traditional Asian Medicine (ICTAM) in Bombay in 1990. He observed that conferencegoers who were practitioners were congregating in certain parts of the conference talking among themselves, while the scholars occupied their own separate spaces. This divide was not only physical but also intellectual: each community’s conversations inhabited radically different conceptual worlds. Cohen wryly summed up the scene as an “epistemological carnival.” [1]

I have been for the past 25 years or so a practitioner, teacher, and scholar of traditional Asian medicine (below abbreviated TAM, by which I intend to include acupuncture, Sowa Rigpa, hatha yoga, Thai massage, mindfulness meditation, qigong healing, and all the other contemporary Asian healing systems that claim to have premodern origins). Having attended numerous conferences and gatherings on both sides of that aisle (including several ICTAMs of my own); having edited an academic journal on TAM, and a Facebook group for both communities, I can attest to the fact that there have been an increasing number of interdisciplinary collaborations in our field since Cohen wrote his piece (such as this one). However, I all too often have also seen practitioners and scholars speaking past one another. All too often, to quote Cohen again, the air has still been “thick with colliding assumptions and bad tempers.”

Irreconcilable epistemes

Below I’ll introduce a way forward, but first, in order to understand the rancor that still persists, I think we need to take the time to appreciate where the participants in this carnival are coming from. My assessment is different than Cohen’s in that I see not two but three groups, but I agree that each is beholden to its own episteme (or, you might say worldviews or paradigms, let’s not get too hung up on the terminology). For purposes of our conversation here (and again, let’s not focus on the terminology), we’ll call these three groups “traditionalists,” “modernists,” and “postmodernists.”

The first group, the traditionalists, are characterized by a deep commitment that their particular brand of TAM is a genuine font of wisdom. The knowledge carried by their traditions transcends historical epochs and geography. It is possible to practice these ancient traditions today because they have been handed down by a continuous lineage of masters and through authoritative texts. Because the biggest danger to the authenticity of these practices is the corruption of tradition by misunderstanding or modification, tradition must be preserved and continue to be handed down in a pristine way. The traditionalists see themselves as doing precisely that. (As did I when I started out in the practice of Thai medicine, meditation, and yoga.)

The highest status among traditionalists — if one is not a wizened practitioner from Asia oneself — comes from having a reputation for being able to access such people. Better yet, being authorized by such people to share the inner teachings of the tradition. Or, at the very least, being able to read ancient texts that have a quasi-sacred status within the community. But, gaining support from science or academia is helpful. Traditionalist practitioners often appeal to contemporary scientific or academic concepts, and they may even avidly follow these literatures.

The traditionalists’ claim to authenticity is established, conferred, and reinforced largely via non-scientific and non-academic media ecosystems, such as social media, YouTube videos, trade journals, and various other popular media. Professional accolades, membership in certain professional bodies, and personal websites are also often important, although all of these are always secondary to claims of direct access to the “true” tradition.

The second group, modernists, are far less concerned with tradition and authenticity than with empiricism and universality. For them, TAM practices also transcend time and place — not because of the continuity of lineage, but because of their ability to be scientifically verified. The modernist is convinced that the active ingredient in any given TAM intervention can be isolated. Whether it’s a chemical derived from an herbal medicine or the proper “dosage” of mindfulness, once it’s identified, it can be explained, understood, and practiced independently from the “cultural trappings” of the tradition of origin. Also, once extracted in this way, it can be studied in the lab.

The modernist is fully confident in the power of science, biomedicine, and public health to explain the efficacy of TAM. But, this does not mean the modernist is necessarily a scientist. Of course, there are scientists, medical researchers, and others who investigate TAM in labs around the world who win accolades and legitimacy by publishing novel findings in research journals, landing prestigious postdocs, and even winning Nobel Prizes. A quick PubMed search will reveal that these individuals are responsible for a robust and growing scientific literature on all manners of TAM.

But, there is also a sizeable swathe of non-scientist TAM practitioners — acupuncturists, massage therapists, herbalists, and others — who also prioritize science over tradition even if they personally have never looked through a microscope. They justify their acupuncture practice not with ancient texts but with modern kinesiology, say, thinking primarily in terms of fascia and electromagnetic fields rather than channels of qi. For these practitioners, success comes when an inscrutable TAM practice is made legible to modern medicine, when it can be bottled (literally or metaphorically) and spread far beyond its original cultural milieu, and when it finally becomes recognized by international healthcare regulators.

The third group of participants in our carnival are the postmodernists. Postmodernists style themselves as observers of TAM instead of practitioners of it. Most are scholars trained in Western universities, or they are analysts who primarily take this scholarly approach. In actual fact, a good number of postmodernist scholars (present company included) either were or still are practitioners, but, if so, these two sides of their life are well compartmentalized. The central questions of the postmodernists are not about how to tap into an authentic tradition or how to scientifically prove that TAM works. Instead, they are interested in how power dynamics, discourse analysis, nationalism, gender, race, class, identity, and a number of other historical and sociocultural forces shape the practice of TAM. Scholars may indeed talk about tradition or empirical proof — but only about how these concepts are socially constructed.

The intellectual and disciplinary underpinnings of the postmodernist are similar to what you would find in other academic fields. Injected with a critical edge by post-Foucaultian histories and anthropologies of medicine, the academic study of TAM is housed within the fields of Anthropology, History, and Religious Studies, and comprises a group of scholars whose primary commitments are to those fields.

Though gaining increasing recognition as a legitimate area of study since the 1990s, the study of TAM is still quite marginal within the academy more broadly. When not among their fellow TAM enthusiasts, the postmodernist scholar is therefore likely to be found in a defensive crouch, constantly deconstructing the other epistemes in order to demonstrate to the broader academy that they too belong at the seminar table.

An increasing number of scholars of TAM can be found attending academic conferences, publishing in the journals, and professionally affiliating with this field, and so its profile has grown a bit since Cohen published his write-up of ICTAM. Works by these scholars are consequently coming to be more accessible to traditionalist and modernist practitioners; nevertheless, for the most part, non-scholars tend to continue to hold the postmodernists at arm’s length, if they notice their presence at all.

Let the jousting begin!

While individual members of these three groups have often played nice together in the TAM field, these three factions just as often have expressed — how shall we put it? — a rather low estimation of each other. For example, the most withering critiques of traditionalists made by those outside the episteme center on their extreme naïveté and blind faith in the wisdom of the ancients. Their fetishization of Asian tradition smacks of orientalism and cultural appropriation.

The modernist, on the other hand, is quickly accused of scientism. The detraditionalization of thousands of years of cultural production, boiling it all down into a synthetic pill or an 8-week practice protocol is laughably reductionistic. The ease with which the modernist tells us “what is true” about the tradition smacks of arrogance and neo-colonialism — not to mention that many of them are complicit in the actual colonialism of bio-prospecting.

Often it’s the postmodernists who are lobbing these very accusations. But of course, to anyone outside of academia, the ivory tower has its own obvious flaws. Like traditionalists, the postmodernists have the habit of fetishizing their Asian culture of choice, and eternally dwell on the narcissism of minor differences. The moral relativism and the hermeneutic of suspicion behind the academic stdy of TAM is also seen as leading to paralysis: steeped their privilege and hopelessly aloof from the real world, the professors have no reply to the needs of the present moment.

To be clear, what I’m presenting here are the negative stereotypes. These are the maximally uncharitable views each of the epistemes have expressed about the others, and I’m overstating their differences to make my point. But only slightly.

In addition to stereotyped views of each other, each episteme is continually policed against intrusions. Each of the three factions has its own well-defined body of “unmentionables,” things that simply cannot be said in polite company because they would undermine the principal commitments of the episteme. For example, it is allowable for a Western-trained historian of Japanese medicine returning from a Reiki conference to admit to colleagues that they “enjoyed doing field work.” But, would they wax poetic about the scientific evidence for ki-energy at the seminar table during a job interview for a history department? Likewise, would a student in a yoga therapy program vocally protest the Western yoga industry’s rank orientalism, cultural appropriation, and neo-colonialism? Would a qigong master with a strong traditionalist following highlight the fact that they simply invented their routine last Tuesday based on reading kinesiology textbooks? Not if they don’t want to commit professional suicide.

In practice, it is clear that some territories are more vehemently guarded than others. The grant proposal and the conference panel are especially well-defended, for example. The parameters dictating what’s allowable are also well-fortified in departmental policies, peer review processes, international healthcare policy debates, and other institutional structures. And thus they inescapably shape the limitations of our professional identities, our research agendas, and our collaborations with one another. There are some individuals who appear to be able to successfully navigate between two or more of these worlds with a certain amount of “medical bilingualism.” But, more often than not, such people have had to learn to self-silence, to edit themselves, or to code-switch in different environments. For the most part, our disciplinary rules limit our abilities to speak, or eventually to even think, across the epistemic boundaries.

A metamodern solution

So far, I have only been speaking in relation to TAM, but the reader may already have intuited that the stakes are so much bigger than that. For, doesn’t the basic problem of irreconcilable epistemes apply to every aspect of twenty-first century life more generally? Isn’t this the same exact impasse that prevents us from developing any solutions to climate change, to economic inequality, or to global armed conflict? Isn’t the fundamental problem behind all of these issues — and all the other huge unsolvable problems — that we simply do not know how to engage in productive dialogue with people who see the world drastically differently than we do?

Surely we must see by now that consensus on any of these truly tough problems simply cannot be won by argumentation. Let’s make no mistake: the epistemes are irreconcilable. When I find myself operating from a different epistemic perspectives than someone else, no matter how logical my arguments seem to me, they will fall on deaf ears. I may tell myself that my interlocutor is too stupid to understand what I’m saying, but the true barrier is that my ideas literally make no sense within their worldview. My words are unspeakable, my ideas unthinkable within the reality they inhabit.

How to communicate across epistemes and achieve mutual understanding is, you might say, the central question of the era of globalization. Recently, the word “metamodernism” has been floated as a name for the solution to this kind of epistemological impasse. I am going to use that term here as well, although I need to introduce a caveat, because there are at least two drastically different interpretations or approaches to metamodernism. On the one hand there are models associated with Hanzi Frienacht, Integralism, and the likes, which arrange divergent epistemes hierarchically and developmentally (i.e., modern is more advanced than traditional, postmodern is more advanced than modern, metamodern most advanced of all). That form of metamodernism has all kinds of issues, and is in fact the antithesis of what I’m advocating here.

What I am interested in is what we might call the “oscillatory” model of metamodernism that the Dutch academics Timotheus Vermeulen and Robin van den Akker proposed in a 2010 paper, in this follow-up piece, and in a 2017 volume co-edited with Allison Gibbons. This form of metamodernism has been used by scholars of aesthetics and media studies, as well as by artists and commentators, to describe a wide variety of global cultural forms, particularly in the realm of film, art, and popular media. What makes a work metamodern, in their estimation, is the juxtaposition of postmodern and modern elements, not resolved within some larger hierarchical scheme, but rather coexisting in an unreconciled tension. Having both the naïve emotionality of the modernist and the cynical deconstruction of the postmodernist equally prominent within the same frame could potentially be jarring or even disorienting for the viewer, but the hallmark of metamodernism is that this juxtaposition is emotionally rich, exuberant, heartfelt, and most of all, fun.

The theory has also been taken up by religious studies scholar Linda Ceriello to discuss the “productive destabilizations” available by juxtaposing traditional and modern visions of Asian mysticism, among other things. Although all of its main proponents have been adamant about this form of metamodernism being a descriptive term for a “structure of feeling” in culture and the arts, and not a cultural or social program of any kind, here I am going to extend their model in a prescriptive direction. Essentially, I’d like to argue that, in order for genuine constructive dialogue between different players in the TAM space to emerge, we need to start intentionally fostering a metamodern sensibility. That is to say, we need to combine the naïve convictions of the traditionalist and modernist practitioners with the cynicism of the postmodernist academics within a single social frame (such as an ICTAM conference) in a way that is both productive but also fun.

I’ll get into more specifics about how precisely to make these changes in Part II of this series. For now, I’ll simply emphasize that approaching TAM in this spirit would lead practitioners and academics alike to be able to oscillate among epistemes with a lightness of being, without feeling tied down by any particular disciplinary restrictions. We would become able to appreciate the paradoxes that arise from the juxtaposition of different truths, without feeling the need to resolve those tensions. A practitioner of qigong, for example, may learn to entertain serious doubts about the Daoist origins of this practice that is so meaningful to them, even while simultaneously being at one with the Dao when they practice it. Or, a scientific researcher of mindfulness may find themselves genuinely excited about the potential health benefits of our mindfulness practice, while also having strong objections to the way that mindfulness science is appropriating and commodifying Buddhist meditation practices. Or, a scholar may find themselves believing they have the power to communicate with disease-causing ghosts even while knowing perfectly well that that spirits are just social constructs.

From carnival to Carnaval

In the end, of course, all of this is not just about improving our collaborations in TAM; it’s also about each of us learning to to enhance our own cognitive flexibility, to transgress the limits places on our thinking by our professional identities, and to expand our imaginations beyond our self-imposed boundaries.

Cohen’s notion of the carnival was meant to draw attention to the negative consequences of miscommunication. When cross-epistemic translation fails, it’s a Tower of Babel, it’s chaos and disappointment. If there is any conversation at all, it is contentious cacophony. Each faction competes to have the loudest voice, each striving to enforce a master perspective that can “make sense of it all,” while in actual fact just speaking past one another.

What is needed is not a louder voice in the mix, or a bigger and better master perspective. A oscillatory metamodern approach would instead allow us to celebrate our radical differences without being threatened by the dissonance. Yes, there would be cacophony, but we would experience it as a joyous and party-like atmosphere. The competitive carnival would be transformed into the playful spirit of Carnaval (please read that word with a Spanish accent).

Carnaval, as we know, is a time for feasting and revelry. It’s a time when the usual social norms are suspended, when roles are reversed, when the “unmentionables” that usually are hidden from polite society are embodied and put on full, garish display. Carnaval is an invitation to temporarily cease grasping so tightly to what we normally hold to be right and true. For a limited time, we don our feathered headdresses and besequinned masks, taking on alternate identities. (We might even drop all of our defenses altogether, nakedly hurling ourselves into the festivities with drunken abandon!)

Carnival vs Carnaval: is this a distinction without a difference? I don’t think so. When we are able to hold our disciplinary identities as lightly as if they were Carnaval masks — to switch masks midstream, or to discard them altogether — we become able to experiment with different ways of knowing and different ways of being. When we stop taking ourselves so seriously — or better yet, throw away our rigid concepts of self altogether — I think we will become light and experimental and non-self-serious with each other and with ourselves. We will not need to identify so strongly with any one way, and will value plurality more than ever. I am certain we will have better interactions with others in our field, and we will all definitely have more fun. Who knows, together we might even find ways to solve much bigger problems… or maybe even save the world.

Oh, sorry, was that too naïve?…. well, feliz carnaval!

[1] Lawrence Cohen, “The epistemological carnival: meditations on disciplinary intentionality and Āyurveda,” in Don Bates, ed., Knowledge and the scholarly medical traditions, Cambridge UP 1995.

Modernity’s Mechanical Metaphysics

Modernity, which had its originary moment as a European phenomenon in 1492^[1]  is a historical epoch characterised by the emergence of capitalism, industrialism, ratio-legal bureaucracies, and state control of military power and surveillance. Icultural dimensions include discourses of rationality, scientism (‘an uncritical faith in science’)^[2] and progress through economic development, objectivity, and in the field of medicine the culture of the randomised controlled trial (RCT). In his book Cosmopolis the Hidden Agenda of Modernity (1990), Stephen Toulmin aptly describes the cosmology of ‘High Modernity’ as one ‘which saw nature and humanity as distinct and separate’.^[3] This cosmology in turn gave rise to the Cartesian credo of ‘I think, therefore I am’^[4] which opened the way to the mechanical metaphysics of dichotomising the mind from the body, theory from practice,^[5]‘heaven’ from ‘man’.^[6]‘God the father’ from ‘Mother Earth’,^[7] ‘space’ from ‘time’ and a ‘gulf’ or a ‘divide’ between ‘people’s expectations and their daily experiences of real life’. ^[8]

One of the consequences of the 1911 revolution (xinhai geming) in China was the political demise of the traditional Chinese calendar (li fa).^[9] On 1 January 1912, Sun Yat-sen announced the establishment of the Republic of China in Nanking, and was inaugurated as the provisional president of China’s first republic. In the ‘Inaugural Announcement of the Provisional President’, the unity of the ‘Chinese races as one’ was greatly emphasised. Subsequently, on 2 January 1912, Sun Yat-sen informed all provinces that participated in the uprising against the Qing imperial rule that ‘the Yin calendar yin li陰曆 (lunar calendar) or Xia Calendar xia li 夏曆,^[10] has been abolished and replaced by the yang calendar’^[11] (yang li).^[12] The ‘fourth year of the Xuantong emperor (1911), calculated using the lunar calendar, will be followed by the first year of the Republic (1912), calculated using the solar calendar’.^[13] The Era of the Republic of China was promulgated, and 1912 was officially declared the first year of this historical period, with 1 January 1912 officially the first day of the Republic and years to be counted successively from 1912.^[14] After 1949, the People’s Republic of China in Mainland China adopted the Western Gregorian Calendar.^[15] Hence, since 1912, as China adopted the Gregorian Calendar and Greenwich Mean Time, the modern Western time system replaced the pre-modern Chinese time system. The traditional Chinese calendar was hegemonically translated i.e. one-sidedly rendered into the image of the ‘universe’ of the Western Gregorian Calendar and Greenwich time. The ‘primordial unity of the system of space with the system of time’ (yu zhou) was replaced by the Newtonian doctrine of absolute space and time. According to Shu-hsien Liu, this doctrine never developed in pre-modern China.^[16] Instead, Shu-hsien Liu (quoting the late Chinese contemporary philosopher Thomé H. Fang) saw 

The ‘Universe’ or ‘Cosmos’, as expressed in Chinese, is ‘Yü-Chou’, designating Space and    Time. What we call ‘Yü’ is the collocation of three-dimensional spaces; what we call   ‘Chou’ is constituted by the one dimensional series of changes in succession—the past continuing itself into the present and the present, into the future. Yü and Chou, taken together, represent the primordial unity of the system of Space with the system of Time. Yüchou without a hyphen, is an integral system by itself to be differentiated, only later on, into Space and Time. The four-dimensional unity of Minkowsky and the ‘Space-Time’^[17] of S. Alexander even cannot adequately convey the meaning of that inseparable connection between Space and Time that is involved in the Chinese term ‘Yüchou’. The nearest equivalent to it would be Einstein’s ‘Unified Field’. ‘Yü-Chou’, as the Chinese philosophers have conceived it, is the unified field of all existence. 18 

In the pre-modern Chinese time system (which is the traditional Chinese calendar), Shu Hsien Liu contended that ‘space and time are not to be separated from the actual content or happenings of the world, material and spiritual’. ‘The ‘universe’ or Yuchou ^[18] is seen by the Chinese philosophers to embrace within itself a physical world as well as a spiritual world, so interpenetrated with each other as to form an inseparable whole. It is not be bifurcated, as is done in Western thought into two realms which are mutually exclusive or even diametrically opposed.’ I believe these ‘two realms’ refer to the ‘realm of the abstracted theoretical world’ (theory) and the ‘realm of the real world’ (practice). 

In essence, the political demise of the traditional Chinese calendar in 1911 fractured the ‘unified field of all existence’ i.e. the ontology and epistemology of various pre- modern traditional Chinese natural studies and their corresponding practices including traditional Chinese medicine (TCM) chuan tong zhong yi, chrono-acupuncture zi wu liu zhu, astronomy tian wen xue, calendrical studies li fa, geomancy feng shui, organic farming, traditional Chinese sexual practices fang zhong shu, ancient Chinese divination zhan bu 占卜and traditional Chinese prognosticational yu ce 預測 systems of foretelling major climactic events (floods, droughts) epidemics, natural disasters like earthquakes etc.^[19]

Modernity: New Technologies, New Media and ‘New Modes of Existence that Replace Former Ways of Inhabiting Space and Experiencing Time’

To operate within modernity according to Sharon L. Snyder also meant to participate in the belief that one finds bold contrast between modern conceptions of the cosmos and the worldview of premoderns or “ancients.”^[20] In the field of philosophy, premodern beliefs yielded to modern dismay about how social systems determine a great deal of life experience for any one individual. German philosopher Friedrich Nietzsche  proposed that modernity is typified by crises in systems of morality, so that once belief is lost, there can be no restoration. He also noted that many of these crises in self-perception occur because of advancements in knowledge and an uncritical embrace of new technologies. ‘Modern’ technologies^[21] themselves participate in the decentring^[22] of human confidence in perception^[23] and planning. Modernity as a historical coordinate, a marker in a chronology of named epochs, depends on the distinction between new modes of existence as well as new perceptions of a self that attends to transport, architecture, mass events, and media^[24] that replace former ways of inhabiting space and experiencing time. Thus, some scholars will even go so far as to locate modernity with the advent of the printing press and the mass circulation of print information that brought about expanded literacy^[25] in a middle class during the 15th century. The printing press are machines by which text and images are transferred to paper or other media by means of ink. Although movable type, as well as paper, first appeared in China, it was in Europe that printing first became mechanized. The earliest mention of a printing press is in a lawsuit in Strasbourg in 1439 revealing construction of a press for Johannes Gutenberg and his associates. The invention of the printing press itself obviously owed much to the medieval paper press, in turn modelled after the ancient wine-and-olive press of the Mediterranean area. A long handle was used to turn a heavy wooden screw, exerting downward pressure against the paper, which was laid over the type mounted on a wooden platen. In its essentials, the wooden press reigned supreme for more than 300 years, with a hardly varying rate of 250 sheets per hour printed on one side.^[26]

The Hegemonic Scientific Translation of  the Chinese word Qi 氣:  The  Calendar Case , The Hou Qi  ‘Watching the Ether’ Controversy and the Inroad  of ‘Western Learning’ and  Modernity into China

As modernity xiandaixing or xiandaihua or ‘Western Learning’ or ‘Western culture’^[27]  or ‘Western science and technology’^[28] sat foot in late Ming (1368-1644)  and early Qing  (1644-1911) China  xixue dong jian西學東漸 i.e. as ‘Western learning spread to the East” , the polysemic Chinese word qi  ‘lost’  its premodern metaphysical meaning  which saw the  natureworld and the humanworld as  organically linked by one  cosmic breath  qi   tianren tongqi. ^[29] By the late Ming and early Qing, Western scholars like Johann Adam Schall von Bell while adopting mechanistic metaphysical values which dichotomizes the natureworld from the humanworld,  mind from  body; space from time, as well as theory from practice, encountered problems in  ‘seeing’ and ‘watching the ether’ qi氣 i.e. ‘watching for the rise of the invisible qi 陽氣and visible matter’陰氣.^[30]

Johann Adam von Bell (1592-1666), whose Chinese name was Tang Ruo-wang湯若望 assumed directorship of China’s Astronomical Bureau during the Ming-Ch’ing transition. Beginning in the second year of  the Shun zhi 順治reign (1645), Schall reinstated the yearly excursion to  Shun-tien prefecture to watch the ethers (qi) during the five days preceding the onset of the Li Chun 立春 forthnightly period (jie qi 節氣). Perhaps as a proleptic gesture to silence possible mutterings, which could have led to undesirable confrontations, the Jesuit sent an official from the Calendrical Office (li ke 歷科); one from the Clepsydra Office  lou ke ke漏刻科) and such local officials as timekeepers (si chen 司晨) to perform the traditional operations. However, perhaps because the operations of hou chi 侯氣 ^[31] were unverifiable, these officials did not normally bother to make actual measurements and instead thje timekeeper si chen  simply submitted a false report stating that the c’hi  (qi 氣) had manifested itself. The day before the arrival of  li Chun 立春forthnightly period (‘Spring Begins,’ author) the pitch pipes were put away and a report made to the effect that some or all of the ashes had flown…The astronomical Bureau charged with making the yearly calendar, had the formal responsibility of ensuring the precise timing of Li Chun…When Adam Schall assumed the directorship of the bureau, he deliberately forced out those astronomers who had been trained in traditional Chinese and Muslim astronomy. However, he had underestimated the tangled intertwining of astronomy and yinyang numerology shuli tianwenxue fangfa  数理天文学方法. The old method numerologists had used in telling fortunes were undermined when Schall ‘changed the (spacetime) sequence of  Zi 觜(the twentieth of the 28 constellations) and shen 參(the twenty first of the 28 constellation) ; ‘transposed luo hou 羅睺 (Rahu) and ji du 計都 (Ke tu) and obliterated zi qi 紫氣 ( the auspicious purple cloud) in his new calendar 新法. ^[32]The reaction to this was intense, recriminatory outcry from conservatives. Yang Guang-Xian 陽光先(1597-1669) , in order to uphold tradition, brought a suit against the Jesuits in 1664— this was the so called ‘Calendar Case.’ In the midst of this conflict, the attitudes of the Catholic astronomers toward hou-chi 侯氣 (‘watching the ether’) came to be the focus of the attacks of the Chinese conservatives.”^[33]

The 12 Pitch-pipes as Instruments that Validated the Existential and  Metaphysical Values of the Invisible Cosmic Breath  Qi    

‘During the Han Dynasty (202 BC-AD 220), when the pitch-pipe lore was greatly elaborated, the dimensions of  the primary huang chung tube was also made the basis for deriving the standard measures of length, capacity and weight. In view of this central importance of  the pitch-pipes for music, the calendar, and the system of weight and measures alike, it is not surprising that they should come to be regarded as instruments whereby to observe the cosmic movements’^[34] yu zhou yunxing i.e.spacetime motion of the yin (visible matter) and yang ethers (invisible qi)” 

Performing ‘Watching the Ether’ hou qi  

[Bodde, “Chinese Cosmic Magic  1981,353]

Water Clock <https://www.metmuseum.org/art/collection/search#!?q=China&perPage=20&sortBy=Relevance&offset=0&pageSize=>>0

The Twelve Pitch-pipes十二侓

1. Yellow Bell        黃鍾  

2. Big Bell 大呂

3. Great Foliage 太簇

4. Pinched Bell  夾鍾

5. Maiden Purity 姑洗

6. Median Regulator 中呂

7. Fringe Guest  蕤賓

8. Forest Bell  林鍾 

9. Tranquil Pattern  夷則

10. Southern Regulator 南呂

11. No Discharge  無射

12. Responsive Bell 應鍾

Provenance: Joseph Needham &Wang Ling. Science and Civilization in China Vol. 4 ‘Physics and Physical Technology. Cambridge University Press,1962,174.

“At all times, in recording data or information for a new  traditional Chinese Calendar, numbers are used to calculate it 推之; the celestial phenomena to fathom it 測之; the waterclock (clepsydra) lou 漏to verify it kaozhi考之; and the presence (existence) of the ‘ether’  陽氣 (invisible qi)) to validate it yanzhi驗之... Hence the  clepsydra must be checked and tested  so that it runs 100 ke 刻 a day. Then the  pitch-pipes are placed inside the triple-walled chamber to observe the phenomena of the arrival of  the ‘ethers’ 陽 氣 (invisble  qi) i.e. ascertain the exact time when the reed ashes (‘visible matter’) 陰氣came out of the corresponding  pitch-pipe tube. In this way one can  determine and calculate whether this is  the exact time or day when the sun has entered the 1st or 15^th degree of  one of the 12 zodiacal signs (each forthnightly  period or solar term  jie qi 節氣) being given an appropriate name indicating the obvious changes in nature at the time it comes around) or not 以知推算之時刻分秒與天地之節氣合與不合. ^[35]

Nowadays, (Schall) relies only upon his own calculations and has abolished those offices that used this old system… [When ]the pitch-pipes used by the Lou-k’ o Office are abolished and no consideration is given to their flying ashes, even if people go so far as to violate the hou-ch’i   in its very chamber and celestial aberrations appear, who will dare to speak up? Thus will Schall deceive the whole world  in order to present his new method.”  -Yang Guang Xian 陽光先.^[36]

Reconstructing A New Metaphysical Spacetime Cosmic Order

Having restored the metaphysical value of the cosmic breath qi to the real world , let us now proceed to a reconstruction of a new metaphysical spacetime cosmic order in the emerging era of transmodernity.^[37]

According to Ian Coulter, metaphysics are ‘broad generalisations about the nature of the world and are usually ontological (about the ultimate nature of reality). Unlike thories that try to make sense of observations, metaphysics are a priori   in that they provide schemes in terms of which reality can be approached before we even begin to think about theory. Examples of metaphysics in science include mechanism, dualism, realism, idealism, materialism and reductionism. These are all fundamental presuppositions whose truth or falsehood cannot be established empirically through observation. They are also fundamental in the sense that the purpose of research done under their guidance is not to question or test these assumptions. To this extent, they are taken-for-granted guidelines for investigations. If they are challenged, it will be through appeal to an alternative metaphysics. So for example, Descartes challenges the extreme notion of mechanism, and rescues mechanism by establishing a dualism to deal with the order of the mind. Current chaos theory challenges the metaphysic of determinacy.’ Yan Fu 嚴複 (1854– 1921) was one of the first generation of Chinese translators of European texts who used the Chinese term xing er shang 形而上 to translate Aristotle’s metaphysics. ^[38] Thomas Michael believes that the domain of metaphysics begins with the question of ontology: ‘what is there in the universe?’ (minds? Bodies? Stuff? Ghosts?Spirits?Angels?). It then asks the question of cosmogony: ‘whatever there is in the universe, how did it originate?’ (Genesis? Brahma? Shunyata?). It finally asks the question of cosmology: ‘Whatever there is in the universe, how do the pieces of it relate to each other?’ (Mind body problem, how many angels dance on the head of the pin, reductionism). Theology adds a further consideration with its soteriology: ‘Whatever there is in the universe, where does it lead?’ (Salvation or damnation? Utopia? Democracy, theocracy, or socialism?. ^[39]

Ian Coulter pointed out that Joseph Agassi in 1964 proposed that metaphysics play a dominant role in working out which scientific or technoscientific problems at any given time will be engaged with by scientists, a role given to paradigms in Thomas Kuhns [1962) theory. ^[40]

 The Discourse of Modernity: A Standard Representationalist View in Science 

And according to associate researcher fellow at the Institute of Modern History, Academia Sinica, Taiwan, Sean Hsiang Lin Lei, central to this ‘discourse of modernity’ is what philosopher of science Ian Hacking referred to as the “representationist conception of reality”^[41] or the standard representationalist view in science which upholds the universalizing role of theory in knowledge production. It puts theorizing forward as the main activity of value in knowledge production. That is to say, all knowledge is a mere abstraction of the objective world. Joseph Rouse in emphasizing science as a field of practice said that “action has its own kind of understanding which cannot be reduced to theoretical representations.” ^[42]

I would like to suggest a way of ‘healing’ this fractured metaphysics that separates the realm of ‘the abstracted theoretical world’ (theory) from ‘the realm of the real world’ (practice ). In its place I propose the performative metaphysical paradigm of theory-as-practice which holds a ‘macrocosmic (yin)-macrocosmic (yang) view of the living human  being as the universe contained in the individual [Yinyang PMPTAP. ^[43]The interaction between the yin visible material cosmos and the invisible yang cosmic breath qi brings about life in our universe. And ‘the Five Elements wu xing,  are  encompassed by  the  two Yin and Yang Qi (invisible yang cosmic breath qi  and the yin visible material cosmos and the five ascending, floating, descending,  sinking  and centering space-time-matter-in-motion.

The Western notion of the four elements of fire, air, water and earth is comparable to the five elements wu xing of TCM: mu  (wood), huo  (fire), tu  (earth), jin  (metal) and shui  (water)—in the sense that in both philosophical systems, the elements constitute the ultimate roots of all natural things. In the atmosphere (of the universe), there are four basic chemical elements i.e. oxygen yang, hydrogen qing , nitrogen dan  and carbon tan .There are numerous chemical elements in the athmosphere. Aside from these four elements which accounts for the most numerous, other elements do not affect the integrity of human life. Oxygen moves upwards; hydrogen floats upwards; nitrogen moves downwards while carbon sinks downwards. These four elements combine making it impossible to differentiate one from the other thereby neutralizing or counterbalancing each other zhong he in the course of their cyclical motion. The quickest upward motion ‘floats’ fu. The most rapid downward motion ‘sinks’ chen ^[44]

‘It is also important to realise that the basic elements necessary for life as we know it - carbon, hydrogen, oxygen and nitrogen exists throughout the heavens, and that amino acids have been found in meteorites. Given the proper environmental conditions, these molecules may join to form proteins and RNA of living cells, which can then replicate themselves. Such action would signify life.’^[45] As Paul Pitchford pointed out in 2002, “in ancient Chinese therapeutics, jing  contains growth and development, including genetic codes  and networks ( RNA/DNA) . In many practices of ancient China, people would actively strengthen their jing  with appropriate foods, herbs and awareness practices.”^[46] And this jing精is refined qi undergoing transformation ab initio.

Metaphysics As A ‘Unified Field of All Existence’

Chen Dingsan (1875–1960), a classicist Chinese medicine practitioner from China’s Sichuan province and author of the book Exploring the Origins of 

Medicine,^[47] drew a circular and quadratic diagram^[48] that explored the metaphysics or ‘unified field of all existence’ of the various traditional Chinese natural studies and practices. The circular diagram represents temporality or ‘time’ (yang) while the square or quadratic diagram represents ‘space’ (yin) 圆图为时间方图为空间. The two Chinese scripts 地方 di fang may lend themselves to be translated into English as ‘the square Earth’ while the two Chinese scripts 天圓 tian yuan may be translated into ‘circular sky’. And the ‘square earth’ is the yu 宇or ‘space’ or yin ; while the ‘circular sky’ is the zhou 宙 or ‘time or temporality’ or tian or yang . My view on this matter was confirmed by Zu Xing in his book Pictorial Explanation of the Book of Change which was published in 2007. Zu Xing in explaining the picture of the 64 hexagrams arrayed in a circular manner with another set of 64 hexagrams arrayed in eight columns horizontally and vertically thereby forming a square figure inside the circle of the other 64 hexagrams concluded that ‘the circular diagrams represents temporality or time while the square diagram formed represents space’ ^[49]圓為時間，方為空間.^[50]

In performing the metaphysical paradigm of theory-as-practice which holds a ‘macroscopic (yin) -microscopic (yang) view of the living human being as the universe contained in the individual,’ in localities of the northern hemisphere, spatial positions or cardinal directions like the northern cardinal direction, simultaneously indicate the temporality of the winter season; the sub-seasonal phase or jie qi of the winter solstice 冬至, the month of December; or the zi two-hour period (23:00–01:00 ). And in the Southern Hemisphere localities, the reverse of this is true.^[51] And zi 子 as one of the twelve terrestrial branches, together with ‘eight of the ten heavenly stems (tian gan ) and four of the ba gua 八卦 from the Yijing (the si wei 四維, four directions namely gen 艮, xun 巽, kun 坤, and qian 乾 for the inter- cardinal points’ form the ‘twenty-four compass-points ershisi fang , ershisiwei , ershisi xiang, or in geomantic parlance ershisi shan and set at 15° intervals. And the geomantic compass (luopan ^[52]) evolved from the Han diviner’s board (shi 式 ) from which the mariner’s compass (zhinanzhen ) evolved^[53] And the diviner’s board is also referred to as the ‘cosmic clock’ or ‘cosmograph’.^[54] This ‘diagram’ has  now evolved into the Transnational Elemental  Stems and Zodiacal Branches (Northern and Southern Hemispheres). 

The Transnational Elemental Stems and Zodiacal Branches Calendrical Clock (Northern/Southern Hemispheres)

The Transnational^[55] Elemental Stems and Zodiacal Branches Calendrical Clock TESZBCC (Southern and Northern Hemispheres) is a new global space time system whereby the 60 (sexagenary) ten elemental stems shi tian gan and twelve zodiacal branches shi er di zhi cyclical symbols representing the flow of the lunar years, months, days and 12 two-hour time periods of the traditional Chinese calendar are arrayed in tandem with the years, months and days of the Western Gregorian calendar and the 24-hour system of the Coordinated Universal Time. The TESZBCC is a heterogeneous assemblage of nature, people, places and practices which are site and time specific and thus inhabits a spacetime. This shared spacetime metaphysics or ontic-epistemic imaginary entities/beings  or  ‘unified field of all existence’ is sustained by the social labour of creating equivalences and connections, i.e. spacetime equivalences and connections in and between various time zones in all hemispheres of the globe. When varying knowledge traditions are performed in this spacetime way, an emergent local (time), national and transnational real world comes into existence.^[56]

In the paradigm of theory-as-practice, space time qi or cosmic breath [Tiquia, ‘Paradigm’, 2015, 215] is ̳forever flowing without beginning or end‘. And ̳traditionally, it is customary for the Chinese people to use the Gan-Zhi (ten elemental celestial stems and twelve zodiacal terrestrial branches) system [^[57]to mark the passage of spacetime [Shu-hsien Liu, ̳’Time and Temporality” 2]. There are ten celestial elemental stems shi tian gan and twelve terrestrial zodiacal branches shi er di zhi. An alternating and sequential combination of the two sets of Chinese scripts make a cycle of sixty (sexagenary) lunar years, months, days and two-hour time periods in a day.^[58]

According to Thomas Michael, time and space in early China tend more towards cyclicity than unilinearity’ [Michael, Pristine Dao, 6]. In his master‘s degree thesis (2004), Li Shao Yao from Taiwan Xuan Zang Institute of Humanities and Culture argued that the ten celestial elemental stems gan and the twelve terrestrial zodiacal E branches zhi constitute a system of spacetime codes^[59] or symbols. He said: 

The celestial elemental  stems  symbols are: Jia 甲, yi 乙, Bing 丙, Ding 丁, Wu 戊,  Ji 己,  Geng 庚, Xin辛 , Ren 壬, and Gui 癸. While the twelve terrestrial zodiacal  branches symbols zhi are Zi子, Chou 丑, Yin寅 , Mao 卯, Chen 辰, Si 巳, Wu 午 , Wei 未, Shen 申, You 酉, Xu 戌, and Hai 亥. The [elemental stems and zodiacal branches are symbols or codes that the ancient people in China used to record the passing of time as well as one‘s spatial position (cardinal direction) in the universe ji shi he ji fangwei de fuhao. ^[60]

In the Transnational Elemental Stems and Zodiacal Branches Calendrical Clock (Northern and Southern Hemispheres), yin embraces yang, one element embraces the other four elements/agents/phases and one trigram and hexagram embraces the other seven trigrams and sixty three hexagrams of the Book of Changes; north embraces south, east embraces west, the heart-mind embraces the body while the physical embraces the spiritual;^[61] the 24-hour astronomical time system embraces the twenty four  solar terms; the Gregorian Calendar months embraces the sexagenary lunar months of the traditional Chinese calendar and the human endogenous organ systems and their corresponding merdian/acutracs  embrace the triad of the Earth, Heaven and Humanity. In this way, the performance and mapping of the cosmic breath (qi) in a four-dimensional process encompasses the three spatial dimensions of length, breadth, depth and the fourth dimension of time^[62] can be realised, i.e. the realisation of space embracing time. 

The basic unit for measuring time is the second. The second multiplied evenly by 60 gives us minutes, or by 3600 gives us an hour. The length of days, and even years, is measured by the basic unit of time, the second.^[63] 3600 multiplied by 2 gives us 7200 seconds in a ‘ two-hour time periods.’ 7200 multiplied by 12  gives us 86,400 seconds in a day. Eighty six thousand 86,000 multiplied by 30 gives us 2,592,000 seconds  in one month. And finally 2,592,000 multiplied by 12 gives us 31,104,000 seconds  in one year. 

The Southern Hemisphere Calendrical Clock has two hands: a shorter hour hand as well as a longer second hand that both turn in a counter-clockwise direction. This is the directional flow of the motion and transformation ab initio of spacetime qi 時空之氣in the Southern Hemisphere [Tiquia, ‘Paradigm,’ 212]. To complete an hourly cycle, the longer second hand of the SHCC has to move round the clock in a counter-clockwise direction in 3600 seconds <https://www.youtube.com/watch?v=aey1oJiiP-8> Accessed December 24, 2019. The Northern Hemisphere Calendrical Clock NHCC also has an hour and a second hand as well that move in a clockwise direction. This is the directional flow of the motion and transformation ab initio of spacetime qi in the Northern Hemisphere. This sequence is used to explain the principle of spacetime qi motion and transformation in the Northern Hemisphere universe yuzhou and was the basis for the development of the Chinese calendar in the Northern Hemispherical region of China.^[64] To complete an hourly cycle, the longer second hand of the NHCC has to move round the clock in a clockwise direction in 3600 seconds <https://www.youtube.com/watch?v=Z0QvXc8yLTQ> Accessed December 24, 2019

As an ̳assemblage, the Transnational Elemental Stems and Zodiacal Branches Calendrical Clock (Northern and Southern Hemispheres)  are at the same time a translation media, i.e. a transcription media upon which an equivalent version of an entity is rendered or performed. It is made up of letters, characters, phonemes, ideograms, tongue, mouth, throat, teeth, pin yin, books, discrete signals, computers, the internet and so on. In this assemblage, the performative nature of qi, i.e., the binary yin ̳0‘ (space) and yang ̳‘ (time)^[65], i.e., spacetime sequences of the sexagenary year, lunar months, days and two-hour time periods of the Transnational Elemental Stems and Zodiacal Branches Calendrical Clock is translated or transcribed into an equivalent digital version^[66] of the UTC (Coordinated Universal Time i.e. temps universel coordonne).^[67]

The system of ‘Coordinated Universal Time’ (UTC) has now replaced Greenwich Mean Time (GMT). With UTC, time (in various spatial zones on earth) is coordinated or synchronized well within 100 nanoseconds or 100 billionths of a second. Time is synchronized or coordinated through a network of 24 satellites that emit signals as they “orbit the earth at the height of 20,200 km in six fixed planes inclined 55 ̊ from the equator. The orbital period is 11 h 58 min, which means that a satellite will orbit the earth twice per day”. A GPS (global Positioning System) transceiver (mobile phone, computer) receive these signals from the satellites which then specify its position with an uncertainty of <10 meters.

Using the enabling capacity of the internet, I am developing the Transnational Elemental Stems and Zodiacal Branches Calencdrical Clock (MNorthern/southern Hemisphere) into an i-phone appliance that can translate the traditional Chinese sexagenary time system of the Lunar Years Nian/Sui, Lunar Month Yue, Days ri and ‘Two-hour time periods’ shi chen into the different times zones of the world. This project can facilitate the reconstruction of the ‘unified field of all existence’ of the various pre-modern traditional Chinese art and practices in a transmodern^[68] world like the traditional Chinese chronomedicine, chronoacupuncture,  feng shui, traditional Chinese organic farming, and the traditional Chinese prognosticational system of foretelling major climactic events (floods, draught), epidemics, natural disasters like earthquakes etc. in various localities of both hemispheres of the globe [Tiquia, “1911 Revolution,” 2012]

For the years 2016 and 2017, 2018 and 2019 I have manually translated and transcribed data on the years, lunar months, days , and the twelve two-hour time periods of the traditional Chinese sexagenary time system on to my personal computer Google Calendar with its settings fixed on GMT+ 11:00 AEST Melbourne, State of Victoria, Australia. Now, I am proposing to extend this to all time zones in all hemispheres of the globe thereby developing an i-phone appliance that can generate an equivalent UTC (Coordinated Universal Time) version of the traditional Chinese sexagenary time system of the years, lunar months , days and ̳two-hour time periods  in various times zones of the world.

 The Invisible Yang Cosmic Breath as an Ontological, Cosmological, Cosmogonical, Soteriological, Astronomical and Meteorological Force in the Universe

The metaphysical i.e. ontic-epistemic imaginary being cosmic breath qi  as an ontological, cosmological, cosmogonical, soteriological, astronomical and meteorological force in the universe drives the flow of the oceanic wave of “current and surf ( the swell of the sea bouncing on the shore of the reefs or the effervescence produced by this). The skill of the surfer lies in knowing at what time and in what direction to catch a wave.^[69] The prowess of a traditional Chinese medicine practitioner or feng shui or yinyang master rest in knowing when i.e. choosing the most auspicious Yang day ze ri  and time ze shi  and in what spatial orientation to perform a given act or construct a building^[70] i.e. to collect, concentrate and accumulate the universal energy of life or yang cosmic breath, and in the process hamonise and match space yin and time yang [Tiquia, “Paradigm,” 2015,220]. And in this regard, to successfully surf the oceanic wave of the invisible yang cosmic breath in various timezone localities in both the Northern and Southern Hemispheres, one needs the services of a new global time system — The Transnational  Elemental Stems and Zodiacal Branches Calendrical Clock. And in Melbourne, Australia, this new global time system is currently being used in locating effective acupuncture points (chronoacupuncture) in dealing with difficult clinical conditions^[71] as well as in adapting to dire climate changes we are experiencing globally by aligning our spacetime Qi  with the flow of season and time.

Conclusion

Adopting a new metaphysical world view i.e. a performative metaphysical paradigm of theory-as-practice which holds a ‘macroscopic (yin) -microscopic (yang)

perspective of the living human being as the universe contained in the individual [Yinyang PMPTAP], a critique is made of modernity’s. mechanical metaphysics. In the process, a new metaphysical spacetime cosmic order emerges thereby narrowing the gulf between nature and humanity; body and mind; theory and practice; God the Father and Mother Earth . The metaphysical values of the Cosmic Breath Qi and the Transnational Elemental Stems and Zodiacal Branches Calendrical Clock (Northern and Southern Hemisphere) are reconstituted. Consequentially, these will  interrupt the decline of traditional Chinese Medicine and other Chinese technoscientific practices and their respective prognosticative power as mobile bodies of local knowledge while ensuring  their continued innovation and regeneration.

Endnotes

^[1] David Turnbull in his book Masons, Tricksters, and Cartographerst highlighted the fact that the South American historian Enrique Dussell’s perspective that ‘ modernity had it’s originary moment as a European phenomenon in 1492, when Europe defined itself as the centre of world history in it’s encounter with the non-European other --an alterity it has erased’ [David Turnbull, Masons, Tricksters, and Cartographers (Australia: Harwood Academic Publishers, 2000), 227.

^[2] Professor Benjamin A. Elman pointed out in 2003 that scientism influenced a number of influential Chinese scientists trained abroad as well as other intellectuals like Chen Duxiu and Ba Jin (Li Feigan), who in his 1931 novel Family attacked ‘premodern Daoism 道教 and traditional medicine 中醫 as haven of superstition and backwardness’, Benjamin  Elman, ‘Rethinking the Twentieth Century Denigration of Traditional Chinese Science and Medicine in the Twenty-First Century’, paper presented at the Sixth International Conference on the Significance of Chinese Culture in the Twenty-First Century: The Interaction and Confluence of Chinese and Non-Chinese Civilisation’, International Sinological Center, Charles University, Prague, 1–2 November 2003, 20. 

^[3] Stephen Toulmin described ‘High Modernity’ as an age ‘which saw nature and humanity as distinct and separate’ giving way to an epoch of ‘humanised Modernity’ or postmodernity ‘which reintegrates nature and humanity’: Stephen Toulmin, Cosmopolis: The Hidden Agenda of Modernity (New York: Free Press, 1990), 182–3. Arguing for a sympathetic understanding, continuation and development of the northern hemispherical ancient Chinese geomantic practice of ‘wind and water’ 風水 from a local knowledge perspective into the southern hemisphere, Michael Paton and Zhang Chengmin pointed out that ‘in the large-scale social, political and environmental evolution in the global economy we need to be careful not to wage war on nature by remembering that the earth is one connected life system’: Michael Paton and Zhang Chengmin, ‘Southern Culture and the North/South Divide: More Than a Metaphor’, JOSA 46 (2014): 26–40. 

^[4] .J. Chan and J.E. Chan, ‘Medicine for the Millennium: The Challenge of Postmodernism’, Medical Journal of Australia 172:7 (2000): 332–4.

^[5] R. Tiquia, ‘Constructing a Non-Hegemonic, Interactive Space for Traditional Asian Medicine’, paper presented at the Seventeenth Biennial Conference of the Asian Studies Association of Australia ‘Is This the Asian Century?’, Monash University, Melbourne, 1–3 July 2008: <http://artsonline.monash.edu.au/mai/files/2012/07/reytiquia.pdf>, accessed 14 October 2013. 

^[6] Li-chen Lin from National Taiwan University in looking at three ancient Chinese scholars’ (Meng Hsi, Wang Pi and Chu Hsi) interpretations of the Book of Changes concept of ‘time’ and ‘position’ (cardinal direction) concluded that ‘all three upheld the unity of heaven [i.e. nature] and man, and denied that heaven and man constitute two distinct realms’. Li-chen Lin, ‘The Concepts of Time and Position in the Book of Changes and Their Development’, in Time and Space in Chinese Culture, ed. Chun-chieh Huang and Erick Zürcher (Leiden: Brill, 1995), 112–13. 

We can also say that the European colonisation of the Australian continent signalled the fracturing of the ‘Dreamtime’ metaphysics of the indigenous people. ‘Dreamings’ are the ‘secrets’ of the ‘country’ which is a ‘complex of myth, ritual, and local knowledge, binding man and nature in a living, personal relationship’, A.P. Elkin, The Australian Aborigines (Sydney: Angus & Robertson, 1976), 43. 

^[7] “ If Western thinking arrived at a dualism of “God the Father” and “Mother Earth,” Chinese elixirists strove to transcend the yin materiality of earth and rise to the yang spirituality of heaven.  The drive for  transcendence is one for Christian and Taoist, but for Christian it was an act of faith backed up by will and mental concentration, whereas for the later Taoists the substance of the body itself could be transmuted.”  Douglas Wile, Art of the Bedchamber: The Chinese Sexual Yoga Classics Including Women’s Solo Meditation Texts (Albany, NY: State University of New York Press, 1992), 71.

^[8] Chang-Tze Hu, ‘Historical Time Pressure: An Analysis of Min Pao (1905–1908)’ in Huang and Zürcher, Time and Space in Chinese Culture, edited by Chun-chieh Huang and Erik Zürcher.Leiden; New York: E.J. Brill , 1995,  329. 

^[9] Li fa refers to the traditional Chinese Calendar in contemporary times. The character li 曆 is translated into English as ‘calendar’ and ‘astronomy’, see L. Weiger, Chinese Characters (New York: Paragon, 1965), 618. Li fa is defined as ‘the method of calculating the motion of the sun, moon, stars and planets as well as the flow of the seasons’: <http://chardb.iis.sinica.edu.tw/search.jsp?q=曆 &x=33&y=19&stype=0>.

^[10] The Xia Calendar  夏历 “which embody the astronomy and reality in the locality of the  Xia Dynastic Kingdom”was the calendrical system constructed through the auspices of the  Taosi Astronomical Observatory 陶寺观象built during the late neolithic era in the north central China plain. The Taosi site is located in  N35° 52’  55.9’’  E  111°29’   54’’  in Shanxi Province, 5.5 km from the Fen River to the west and barely 10 km from Ta’er Mountain to the east. According to historical accounts and local tradition, this area was the heartland of the first dynastic polity in Chinese history, the Xia, which ruled the north central China plains along the Yellow River from ca 2100  to ca 1600 BCE. The Taosi astronomical observatory is identified in ancient sources as the location of the capital of Emperor Yao, the semi-legendary hero whose sagely government supposedly played a crucial role in the  formative period of Chinese civilisation [David Pankenier, Ciyuan Y. Liu, Salvo de Megs, “ The Xiangfen, Taosi Site: A Chinese Neolithic ‘Observatory’, Archaeologia Baltica 10 <<https://en.wikipedia.org/wiki/Taosi>> Accessed April 28, 2017. [R. Tiquia, Project proposal to hold a workshop in China : “Restoring the Chinese Calendar 历法 and the Cosmic Breath 宇宙之氣 to the Real World：From the Xia Calendar 夏历 to the Stems & Branches Calendrical Clock : North/South Hemispheres) 天干地支 历法时钟(南北半球) submitted to the International Research and Research Training Fund(IRRTF), University of Melbourne, 2017]. 

^[11] Li fa is also referred to as yin li 陰曆 and xia li 夏曆 while the Western Gregorian calendar is referred to as yang li 陽曆, gong li 公曆, and ge lili 格里曆 Gregorian Calendar.

^[12] Li Chien-Nung, The Political History of China, 1840–1928, trans. and ed. Ssy-Yu Teng and Jeremy Ingalls (Princeton, NJ: Van Nostrand, 1965), 256. Also see <http://en.wikipedia.org/w/index.php?title=Xinhai_Revolution&useskin=monobook>.

^[13] Henrietta Harrison, Inventing the Nation China (London: Arnold, 2001), 158. Similar dates for these events are in Huang Qiu 黃秋 et al., Shiyong wannianli 實用萬年曆 (Practical Chinese perpetual calendar) (Beijing: Zhongguo Zhongyiyao chubanshe, 1994), 315.

^[14] Hence, 1913 is min guo er nian, 1914 is min guo san nian and min guo 89 would be the year 2000, Endymion Wilkinson, Chinese History: A Manual (Harvard University Asia Center, 2010), 185.

^[15] ‘In their desire to abolish ancient customs, the Communists did not wish to create a new era (at least in the calendar) and they adopted instead the Western calendar. But till now, they have not been able to eradicate the old system; and thus, after several attempts to suppress the traditional dates in the newspapers (as happened at the beginning of 1977), they have returned once more to the solution of citing concurrently both calendars, the “common” calendar and the “peasant” calendar’, see Jean- Michel Huon de Kermadec, The Way to Chinese Astrology: The Four Pillars of Destiny (London: Unwin, 1983), 23.

^[16] Shu-hsien Liu, ‘Time and Temporality: The Chinese Perspective’, Philosophy East and West 24:2 (1974): 145–53.

^[17] The relativity revolution...dates from1905and1915...While struggling with puzzles involving electricity, magnetism and light’s motion, Einstein realised that Newton’s conception of space and time, the cornerstone of classical physics, was flawed. Over the course of a few intense weeks, in the spring of 1905, he determined that space and time are not independent and absolute, as Newton had thought, but are enmeshed and relative in a manner that flies in the face of common experience. Some ten years later, Einstein hammered a final nail in the Newtonian coffin by rewriting the laws of gravitational physics. This time, not only did Einstein show that space and time are part of a unified whole, he also showed that by warping and curving they participate in cosmic evolution. Far from being rigid, the unchanging structures envisioned by Newton, space and time in Einstein’s reworking are flexible and dynamic. The two theories of relativity [specific in 1905 and general in 1915] are among humankind’s most precious achievements, and with them Einstein toppled Newton’s conception of reality. Even though Newtonian physics seemed to capture mathematically much of what we experience physically, the reality it describes turns out to be not the reality of our world. Ours is a relativistic reality.’ Brian Greene, quoted in Alan Atkinson, The Europeans in Australia (Sydney: UNSW Press, 2014), 31. The ‘unified field of all existence’ is also referred to these days as the unified theory which is an ‘all-encompassing framework capable of embracing all of nature’s laws’ which today ‘ranks among the most important problem in theoretical physics’, Brian Greene, The Fabric of the Cosmos (Melbourne: Penguin, 2008), 16. 

^[18] Yuchou is the Wade-Giles romanisation, rendered in pinyin as yu zhou.

^[19] Weng Wenbo 翁文波 and Zhang Qing 張清 (1993). Tian gan dizhi li yu yu ce 天干地支歷與預測 (The elemental stems and zodiacal branches sexagenary cyclical calendar and prognostication). Beijing: Shiyou gongye chubanshe,

^[20]According  to Marshall McLuhan in his book The Gutenberg Galaxy The Making of the Typographic Man (1962), preliterate or premodern cultures ‘depended primarily on face-to-face forms of communication in which all the senses –sight, smell, touch, taste and hearing—were simultaneously in play. Early forms of literacy, in which most reading took the form of reading out loud in a variety of social and public contexts, similarly involved seeing, speaking and hearing. Print culture, by contrast, abstracted the eye from the other senses and subjected it to a distinctive form of training by obliging it to follow each letter and each word, in their sequential toil across the page, then on the next line, and so on. The social consequences of this were, in McLuhan’s assessment, pretty well unlimited. The abstraction (‘disassociation’ , Merriam-Webster) of the eye from other sensory and other tactile forms of involvement paved the way for perspective art and for abstract numerical forms of calculation that proved crucial to the development of modern states and markets. Print, in encouraging silent and solitary reading, also played a key role in the development of modern forms of private life. And unlike manuscript culture, in which each letter is unique, the uniformity of print provided a model of visual repetition for the development of standardised forms of commodity production’ [Tony Bennett, “The media sensorium: cultural technologies, the senses and society,” in Mary Gillespie (ed) Media Audiences. Berkshire, England: Open University Press, 2005,51-96; 52-53]. 

Jack Goody in his book The Domestication of the Savage Mind (1977) claims that “the shift from  writing and then to print must be considered of critical importance in both formalising and increasing the flow of information that has been the precondition of many of the features that differentiate the prehistoric societies of the Neolithic and Paleolithic from the ‘modern’ civilizations that followed.” But it also crucially changes the kind of thinking and the kind of knowledge that is possible. “ Writing puts a distance between man and his verbal acts. He can now examine what he says in a more objective manner.”  Writing accounts for the difference between the open and the closed, between the rational and traditional, because it permits a different kind of scrutiny of current knowledge:” “Writing enables you to talk freely about your thoughts.” Writing allows for lists, formulae, classification, record keeping recipes, logic and formal texts of instructions. Thus, according to Goody, “Traditional societies are marked not so much by the absence of reflective thinking xingsi省思(‘examine oneself critically’ Plausible Labs Cooperative,PLECO)  as by the absence of the proper tools for constructive rumination. PLECO). This is because words assume a different relationship to action and to object when they are on paper than when they are spoken. They are no longer bound up directly with ‘reality’; the written word becomes a separate ‘thing’, abstracted to some extent from the flow of speech, shedding its close entailment with action, with power over matter’ [Turnbull,Mason, Trickdsters, 2000, 151].

^[21]   Premodern technology which is referred to as  ji shu 技術in Chinese, is a body of knowledge, skills and operational techniques  that humanity directly applies and uses in their practical life activities.  Ji shu 技術 人類在實踐活動中直接應用·的知識， 技能 和操作方法   Gu Hanyu Da Cidian古漢語大辭典,Shanghai, Lexicographical Publishing House, PLECO) . The Classical Chinese script  ‘ji ‘ 技  means ‘qiao’ 巧  (‘skillful’) . Cong shou從手 (manage with the hand)，支聲 (phonetics  zhi  ).《漢語大字典》p. 770. While shu 術 translates into English as ‘art’, ‘skill’‘way’ ,  ‘technique’, ‘method’ or ‘tactics’. Hence, premodern Chinese technology refers to is a body of knowledge, skills, techniques, methods, or tactics that humanity directly applies in their practical life activities  which involves skilful use of their hands. Premodern Chinese technology then is a combination of ‘technology’ or technique and a practice-based sciential  body of knowledge or ‘Technoscience’. 

^[22] ‘Decentering’ means to cause one to lose or shift from an established center or focus, especially to disconnect from practical or theoretical assumption origin, priority or essence [Merriam Wesbster]. 

^[23] ‘Perception’ refers to an awareness of the elements of environment through physical sensation [Merriam-Wesbster

^[24] In 2005, Arthur Asa Berger defined ‘media’ as the plural of the term ‘medium.’ And he saw a ‘medium’ as a “means of sending communicating messages, information, or texts of one kind or another, from one person to another or, in the case of mass media, to many people… Media communicate texts for the most part. For example, speech is a medium we use in conversation with one another; it is a personal medium. The mass media are generally held to include books, and other kinds of printed works, radio, film, television, CDs, DVDs, and the Internet. With the mass media, large numbers of people are involved as audiences in the communication process… As many commentators have pointed out, the purpose of television shows–as far as the television industry and advertisers are concerned—is to deliver audiences to advertisers. The obsession radio and television stations have with obtaining money from advertising helps shape programming. The same applies to all media” [ Arthur Asa Berger (ed), Making sense of media : key texts in media and cultural studies. Malden MA USA: Blackwell Pub, 2005, 4-5]. 

^[25] “The dissemination of printing to Europe terminated the monopoly of clergymen of the right to learning and higher education. It provided important conditions preparatory to the whirlwind advance of science following a long period of medieval darkness and to the Renaissance movement. In his letter to F. Engels in January 1863, Karl Marx referred to the discovering of gunpowder, the compass and printing as “prerequisites of bourgeois development,” a remark that places the art of printing in its properly significant role” [ Chinese Academy of Sciences, Ancient China’s Technology and Science, 1983, 391]. 

^[26] “Modernity” Encyclopedia Britannica <https://www.britannica.com/contributor/Sharon-L-Snyder/9421972>Accessed: July 2, 2017<<https://www.britannica.com/technology/printing-press>> Accessed July 2, 2017.<https://www.britannica.com/technology/printing-press>Accessed October 15, 2019; Tiquia, Rey, “Restoring the Metaphysical Values of the Cosmic Breath Qi 氣  to the Real World.” Powerpoint  presentation  at the 15^th Biennial Conference of the Chinese Studies Association of Australia (CSAA ) Macquarie University, Sydney, Australia, 10th -12th of  July <<https://www.researchgate.net/publication/318876769_Restoring_the_Metaphysical_Values_of_the_Cosmic_Breath_Qi_qi_to_the_Real_World_to_Realize_a_global_harmonisation_of_space_and_time_laishixianshikongdatong

^[27] Advocating digital minimalism and living better with less technology, Cal Newport expressed deep concern about  modernity  being at odds with solitude i.e.‘a subjective state in which one’s mind is free from input from other mind.’Quoting Anthony Starr who stated that “ contemporary Western culture makes the peace of solitude difficult to attain. He pointed to Muzak  and the recent invention of the “car telephone” as the latest evidence of this encroachment of noise into all parts of our lives.” [Cal Newport, Digital Minimalism, UK: Penguin Business, 2019, 99, 93. 

^[28] “ In the 17^th century, Western science and technology began flowing into China via the Jesuit missionaries. Some 200 years later towards the end of the Qing dynasty, the feudal rulers who have panicked before imperialist gun-boats suddenly turned from xenophobia to blind worship of anything foreign. This latter type of delusion infected certain influential people, who advocated “wholesale Westernization” even after the patriotic May 4^thMovement of 1919. China was submerged in Western science and technology at the cost of almost total obliteration of her own fine traditions” [Institute of the History of Natural Sciences , Chinese Academy of Sciences, Ancient China’s Technology and Science,Beijing: Foreign Languages Press, 1983,2]. Endymion Wilkinson refers to this Western European colonization of China as “The Transplantation of Modern Science” into China [ Wilkinson,2000,674-679]. 

^[29] Chen Dingsan 陳鼎三 and Jiang Ersun 江爾孫, Yixue tanyuan 醫學探源 (Sichuan: Kexuejishu chubanshe, 1986, 16). 

^[30] “For humans are endowed with the Six Qi from Heaven which in turn generates the Six endogenous fu organs 六腑. He/she is also endowed with the Five Elements which in turn generates the Five endogenous Zang organs 五脏. The Six endogenous fu and Five endogenous zang organs generate the twelve acupuncture meridians, the Five Sense Organs 五官 (eyes, ears, lips. nose, tongue), the ‘nine body openings’ 九窍, the four extremities, and the ‘hundred bones’. These are all categorized under ‘visible matter’ you xing zhi zhi有形之卮. None of these are unconnected with Heaven and Earth. The visible matter or substances in turn generate the ‘invisible qi sheng wuxing zhi qi生无形之气. On the other hand, the invisible qi moves the visible substances, none unconnected with Heaven and Earth. When the yin and yang qi move in harmony, then all the natural things multiply and thrive. And when the six qi flow in harmony, then all the acupuncture meridian pathways in the human body are not blocked, while human logic li 理and emotions manifest naturally. Otherwise, people become sick.” [Chen Ding San, Jiang Er Sun (ed. 1985), Yixue Tanyuan 医学 探源 (Sichuan: Sichuan kexue jishu chubanshe, 1985), p. 236.] R. Tiquia, “Constructing a Symmetrical Translating Knowledge Space between Traditional Chinese Medicine and Western Scientific Medicine in Australia.” In Complementary Medicine and Culture: The Changing Cultural Territory of Local and Global Healing Practices, edited by Tass Holmes and Evan-Paul Cherniack  161-189. New York: Nova Science Publishers, 2017,182-183; Rey Tiquia, “Restoring the Metaphysical Values of the Cosmic Breath Qi 氣  to the Real World.” Powerpoint  presentation  at the 15^th Biennial Conference of the Chinese Studies Association of Australia (CSAA ) Macquarie University, Sydney, Australia, 10th -12th of  July <<https://www.researchgate.net/publication/318876769_Restoring_the_Metaphysical_Values_of_the_Cosmic_Breath_Qi_qi_to_the_Real_World_to_Realize_a_global_harmonisation_of_space_and_time_laishixianshikongdatong

^[31] According to Huang Yi-Long and Zhang Chih-ch’eng, hou qi 侯氣(watching the ethers) was a method used to calculate the seasons. It embodied the premodern Chinese concept of unity of Heaven, Earth and Man. The practice of hou qi involved the burying of twelve musical pitch pipes of graduated lengths in a sealed chamber while filling the pipes with ashes produced by burning the pith of a reed (Phjragmites communis). People during premodern China believed that when the sun entered the second forthnightly (ershisige jie qi 二十四個節氣 or twenty four subsdeadsonal phases or ‘climactic periods) in any given month, the Earth’s qi would rise and expel the ashes from the pipes [Huang Yi-Long and Chang Chih-ch’eng, (1996) “ The Evolution and Decline of the Ancient Chinese Practice of Watching for the Ethers”, Chinese Science, No. 13,pp. 82-106, p. 82]. 

.”

^[32]The Chongzhen Chinese Calendar is a Western Astronomical Encyclopaedia. It’s first part included theories of Western astronomy and a compilation of astronomical tables (ephemeris). These tables were never recorded in the traditional Chinese Calendrical System 中國傳統曆法. They were hanged inside the offices of the Chinese Astronomical Bureau 钦天監. Hence, ordinary people could not see them [Jiang Xiao Yuan 江晓原, Xu Guang Qi yu Chongzhen Li Shu 徐光啓與崇禎曆書 (Xu Guang Qi and the Chinese Almanac),  2005年11月8日在“徐光启研讨会”上的演讲 (A speech delivered on the occasion of a symposium on Xu Guang Qi held on Novem ber 8, 2005)  , <<http://shc2000.sjtu.edu.cn/0512/xvguangq.htm>>Accessed, June 28, 2017]. The Chongzhen calendar (Chinese: 崇禎暦; pinyin: Chóngzhēn lì) or Shixian calendar (Chinese: 時憲暦; pinyin: Shíxiàn lì) was the final lunisolar Chinese calendar. It was developed by the Jesuit scholars Johann Schreck and Johann Adam Schall von Bell from 1624 to 1644, and was dedicated to the Chongzhen Emperor but he died a year after it was released, so it was propagated by the Shunzhi Emperor in the first year of the Qing dynasty who changed its name to Shíxiàn calendar <<https://en.wikipedia.org/wiki/Chongzhen_calendar>> Accessed December 22, 2019. 

.

^[33] Huang Yi-Long 黃一農， Zhang Zhi-cheng 張志誠, Zhongguo chuantong houqi shuo de yanjin yu shuai tui 中國傳統侯氣說的演進與衰頹, qinghua xuebao 《清華學報》,23 (2), 1993, 125-146.

^[34] Derk Bodde,”The Chinese Cosmic Magic Known as Watching For the Ethers,” in Essays on Chinese  Civilization,Edited by Charles Le BlancAnd Dorothy Borei, New Jersey, Princeton University Press, 1981,366; refer as well to R. Tiquia, “Restoring the Metaphysical Values of the Cosmic Breath Qi 氣  to the Real World.” Powerpoint  presentation  at the 15^th Biennial Conference of the Chinese Studies Association of Australia (CSAA ) Macquarie University, Sydney, Australia, 10th -12th of  July .<<https://www.researchgate.net/publication/318876769_Restoring_the_Metaphysical_Values_of_the_Cosmic_Breath_Qi_qi_to_the_Real_World_to_Realize_a_global_harmonisation_of_space_and_time_laishixianshikongdatong

^[35] This is this author’s translation of the original Chinese version of Huang Yi-Long and Chang Chih-

ch’eng’s paper.

^[36] Huang Yi-Long and Chang Chih-ch’eng, (1996) “ The Evolution and Decline of the Ancient Chinese Practice of 

Watching for the Ethers”, Chinese Science, No. 13,pp. 82-106, p. 92. 

^[37] David Turnbull quoting Enrique Dussel sees the ‘transmodern’ as a historical era where ‘modernity and its alterity co-realise themselves in the process of mutual creative fertilisation’[ Turnbull, Masons,2000, 227 

^[38] R. Wang, YinYang: The Way of Heaven and Earth in Chinese Thought and Culture (Cambridge University Press, 2012), 66.

^[39] Thoimas Michael, The Pristine Dao: Metaphysics in Early Daoist Discourse (Albany: State University of New York Press, 2005), 6. ; Tiquia, Rey.  “ Restoring the Chinese Calendar Lifa  and the Cosmic Breath Qi to the Real World,”   Proceedings of the  Intelligent Systems Conference,   7-8 September, 2017 , London, UK. <<https://www.researchgate.net/publication/319654236_Restoring_the_Chinese_Calendar_Li_Fa_and_the_Cosmic_Breath_Qi_to_the_Real_World_A_New_Global_Time_System_The_Stems_and_Branches_Calendrical_clock]. 

^[40]Ian Coulter, ‘Integration and Paradigm Clash: The Practical Difficulties of Integrative Medicine’, in The Mainstreaming of Complementary and Alternative Medicine , ed. P. Tovey, G. Easthope and J. Adams (London: Routledge, 2004), 103–21. 

^[41] Sean Hsiang-Lin Lei, Neither Donkey Nor Horse Medicine in the Struggle Over China’s Modernity,(Chicago: University of Chicago Press: 2014), 14 .

^[42] Joseph Rouse, Knowledge and Power: Toward a Political Philosophy of Science, (Ithaca: Cornell University Press, l987), 77].

^[43] And talking about Daoist  cosmology, Chang Chung-yuan (1907-1988) in his book Creativity and Taoism A Study of Chinese Philosophy, Art and Poetry (1963,137-38) pointed out that “Chinese cosmological theories  and the macrocosmic-microcosmic view of man as the universe contained in the individual” sees man/woman  as a “ microcosmic universe reflecting the macrocosmic universe about him. The movement of the inner and outer worlds is intimately correlated. Outwardly, man/woman move with the vast forces of the Heaven and Earth; inwardly there is the functioning of his own organs, following their universal pattern. Thus the physical functions and the structure of the inner organs have their cosmic analogies yuzhou leisi ^[43]i.e. spacetime analogies. It is on these cosmic analogies that the Taoist system of meditative breathing is constructed. 

^[44] Peng Ziyi, Yuan yundong de gu zhongyixue 圓 運動的古中醫學 (Ancient Chinese medicine’s concept of cyclical motion). Beijing: Zhongguo zhongyiyao chubanshe, 2007, 269-270]. 

^[45] Milton D. Heifetz & Will Tirion, A Walk Through the Southern Sky: A Guide to Stars and Constellations and Their Legends, Cambridge United Kingdom: Cambridge University Press,2012,12. Please refer as well to Rey Tiquia, “Translating the Life Energetic Qi, Yin and Yang and the Five Elements as Ontic-Epistemic Imaginary Entities to Interrupt the Decline of Traditional Chinese Medicine and Ensure its Continued Innovation and Regeneration,” powerpoint presentation before Annual Conference of the Society for the Social Studies of Science (4S) , ‘Innovations, Interruptions, Regenrations,’ Sheraton Hotel, New Orleans, Louisiana, USA, September 4-7, 2019. 

^[46] Paul Pitchford. Healing with Whole Foods : Asian Tradition and Modern Nutrition. Berkeley: North Atlantic Books, 2002, pp. 20-22. Refer as well to R. Tiquia “ The Use of Chrono-acupuncture and Chemotherapy in Treating Lung Cancer as Kesou (‘Cough’) in Melbourne, Australia : A Clinical Report, ” in presentation before the  1st International Conference of Advances in Cancer Medical Research (ACMR

2013) . Singapore. November 18-19, 2012 <https://www.researchgate.net/publication/324005558_Cancer_Singapore_Presentation>Accessed:December 22,. 2019.

^[47] Chen Dingsan 陳鼎三 and Jiang Ersun 江爾孫, Yixue tanyuan 醫學探源 (Sichuan: Kexuejishu chubanshe, 1986). 

^[48] This diagram featured in Chen and Jiang, Yixue tanyuan, , is equivalent to a ‘cosmic clock’, a ‘diviner’s board’ 式 or a ‘cosmograph’ which I will elucidate later in the text. 

^[50] Zu Xing 祖行, Tujie yijing 圖解易經 (Xi’an: Shanxi shifan daxue, 2007). 

^[51] R. Tiquia, ‘The Construction of a Chinese Medical Lunisolar Calendar for the Southern Hemisphere’, The Lantern 9:3 (2012): 33–51. 

^[52] ‘The Chinese used the compass less for navigation than for defining on the ground the points of the compass and auspicious and inauspicious influences by a system imaginatively called Feng Shui (Wind and Water). The basis of calculation is essentially the same as that used for the calendar and the establishment of the horoscope’, see Huon de Kermadec, The Way to Chinese Astrology, 52–3.

^[53] Field describes the use of the diviner’s board thus: ‘the cosmographer would orient the board to the cardinal directions, represented by the four sides of the board. Then he would align the number of the month on the heaven disc with the double hour of the day or night from the earth plate. Finally, he would note the constellation on the portion of the disc that fronted the southern edge of the board. These are the asterisms that would appear in the sky in the month and hour of the query.’ Stephen L. Field, Ancient Chinese Divination (University of Hawai’i Press, 2008), 93. 

^[54] Wilkinson, Chinese History, 680.

^[55] The theme of the 2018 annual meeting of the Society for Social Studies of Science -- TRANSnational STS – encourages presentations, panels, and other events that deepen and extend the transnational character of the Society itself, while engaging issues invoked by both the TRANS prefix (across, beyond, to change thoroughly), and by the problematic and evolving status of “nations” - and the reassertion of nationalisms - in processes of global ordering. Leveraging the global scope of Science and Technology Studies (STS), our aim is to intensify connection between conference participants (scholars, practitioners, and students) based in different regions, stimulating conversation about ways 4S and other scholarly societies can provide critical infrastructure for next-generation, transnationally collaborative, intellectual and political engagements. We also aim to encourage consideration of a broad array of concepts that are undergoing – or should undergo – transformation if we are to address key scholarly and practical problems of our times. Current concepts, knowledges, practices, and institutions of “the nation” are exemplary, pointing to a need for radical reformulation of habitual ways of thinking about and organizing governance, bodies and lifeworlds. Expansive reconsideration of other concepts, foundational and emergent (justice, biopolitics, innovation, Empire, and the Anthropocene, for example), are also encouraged. Activities that draw conference participants into issues of special importance in Australia and the broader Asia-Pacific region – indigenous politics, border controls, mining, climate change, and renewable energy, for example -- will be threaded throughout and offered in advance of the conference. The overall goal is to foreground diverse STS genealogies and approaches, leveraging the rich pluralism of STS, attuned to the rich pluralism of the contemporary world.

^[56] 4S Sydney TRANSnational STS Society for Social Studies of Science Annual Conference, Sydney International Convention Centre, August 29- September 1 2018 << https://4sonline.org/ee/files/4S18_web_program_180825.pdf>> 

^[57] Shu-hsien Liu, ̳’Time and Temporality: The Chinese Perspective’,  Philosophy East and West 24:2.

^[58] R. Tiquia, ‘The Paradigm of Theory-as-Practice: TraditionalChinese Natural Studies and the Performance of the Cosmic Breath qi in a New Global Spacetime System, The Journal of The Oriental Society of Australia, Vol 47 (2015), 215-216. 

^[59] Codes‘ are a ̳systematic modification of a language, information into letter figure or symbols for the purposes of brevity, secrecy or the machine processing of information‘ [Lesley Brown (ed) . The New Shorter Oxford English Dictionary vol. I. [Oxford University Press,1993]. 432. 

^[60] Li Shaoyao , Huangdi Neijing yunqixue yanjiu [Research on the Doctrine of Periods and Qi], Master‘s thesis, Centre for Religious Studies, Xuan Zhuang Humanities Institute , Taiwan, 2004, 15.

^[61] R. Tiquia, ‘The Paradigm of Theory-as-Practice: TraditionalChinese Natural Studies and the Performance of the Cosmic Breath qi in a New Global Spacetime System,’ The Journal of The Oriental Society of Australia, Vol 47, 2015, 228.

^[62] R. Tiquia, ‘The Construction of a Chinese Medical Lunisolar Calendar for the Southern Hemisphere.’ The Lantern Journal. 7:33-51. 2012. 

^[63] James Jespersen and Jane Fritz-Randolph, From Sundials to Atomic Clocks Understanding Time and Frequency [ Mineola: Dover Publications, 1999] 23 

^[64] Jou Tsung-Hwa, The Dao of Taijiquan Way to Rejuvenation, ed. Sharon Rose and Loretta Wollering (Scottdale, Ariz: Tai Chi Foundation, 2002), 119. 

^[65] The binary numeral system, or base-2 system , represents numeric values using two symbols, ̳0‘ and ̳1‘...Owing to its straightforward implementation in digital circuitry using logic gates, the binary system is used internally by all modern computers. ‘Binary numeral System’.<< https://en.wikipedia.org/wiki/Binary_number>> Accessed: November 8, 2019.

^[66] Digital |ˈdɪdʒɪt(ə)l| adjective 1 (of signals or data) expressed as series of the digits 0 and 1, typically represented by values of a physical quantity such as voltage or magnetic polarization. Often contrasted with analogue. relating to, using, or storing data or information in the form of digital signals: digital TV | a digital recording.• involving or relating to the use of computer technology: the digital revolution. 2 (of a clock or watch) showing the time by means of displayed digits rather than hands or a pointer. Three relating to a finger or fingers. ORIGIN: late 15th century: from Latin digitalis, from digitus finger, toe‟. [Angus Stevenson and Christine A. Lindberg (eds) New Oxford American Dictionary Oxford University Press, 2010.Accessed November 10, 2016. http://www.oxfordreference.com.ezp.lib.unimelb.edu.au/search?source=%2F1 0.1093%2Facref%2F9780195392883.001.0001%2Facref- 9780195392883&q=digital. 

^[67] M. A. Lombardi,., L. M. Nelson,., A. N. Novick, , & V. S. Zhang, (2001). Time and frequency measurements using the global positioning system. Paper Presented at the Measurement Science Conference, A Walk Through Time. <http://www.nist.gov/pml/general/time/index.cfm>

^[68] David Turnbul quoting Enrique Dussel sees the ‘transmodern’ as a historical era where “modernity and its negated alterity co-realise themselves in the process of mutual creative fertilisation” [Turnbull, 2000]. 

^[69] Thomas E. Aylward, The Imperial Guide to Feng Shui & Chinese Asdtrology The Only Authentic Translation from the Original Chinese.London: Watkins Publishing, 2007, 53.

^[70] Stephen Jones, Daoist Priest of the Li Family :Ritual Life in Village China, St. Petersburg, FL: 2017, 14-15.

^[71] Rey Tiquia, “ The Use of Chrono-acupuncture and Chemotherapy in Treating LungCancer as Kesou (‘Cough’) in Melbourne, Australia : A Clinical Report, ” in Proceedings of the 1st International Conference of Advances in Cancer Medical Research (ACMR2013) . Singapore. November 18-19, 2012 <<https://www.researchgate.net/publication/260423193_The_Use_of_Chronoacupuncture_and_Chemotherapy_in_Treating_Lung_Cancer_as_'Kesou'_'Cough'_in_Melbourne_Australia_A_Clinical_Case_Report>>; Refer as well to Rey Tiquia “Surfing the Oceanic Waves of the Cosmic Breath Under the  Guidance of  the Stem and Branches Calendrical Clock .”.Academic Journal of Feng Shui 1st Symposium – Oceania, University of Technology Sydney, Australia, 13 & 14 May 2017 <<http://ajofengshui.co.nf/wp content/uploads/2017/05/Tiquia_Rey_2017_Surfing_Oceanic_Waves_L_P.pdf>>

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Tiquia, Rey (2008). “Constructing a Non-Hegemonic, Interactive Space for Traditional Asian Medicine.”  paper presented at the Seventeenth Biennial Conference of the Asian Studies Association of Australia ‘Is This the Asian Century?’, Monash University, Melbourne, 1–3 July 2008: <http://artsonline.monash.edu.au/mai/files/2012/07/reytiquia.pdf>, accessed 14 October 2013. 

Tiquia, Rey (2013) “ The Use of Chrono-acupuncture and Chemotherapy in Treating Lung Cancer as Kesou (‘Cough’) in Melbourne, Australia : A Clinical Report, ”  pposerpoint presentation before the  1st International Conference of Advances in Cancer Medical Research (ACMR

2013) . Singapore. November 18-19, 2012 <https://www.researchgate.net/publication/324005558_Cancer_Singapore_Presentation>Accessed:December 22,. 2019.

Tiquia, Rey (2012) “The 1911 Revolution in China, the Chinese Calendar, the Imaginary qi Translating li fa into an Australian Chinese Calendar and into an English Edition of the Northern Hemispherical Chinese Calendar”, Chinese Studies 1:3 (2012): 35.

Tiquia,Rey (2012)  “The Construction of a Chinese Medical Lunisolar Calendar for the Southern Hemisphere,”  The Lantern 9:3.  

R. Tiquia (2013)  “ The Use of Chronoacupuncture and Chemotherapy in Treating Lung Cancer as Kesou (‘Cough’) in Melbourne, Australia : A Clinical Report, ” powerpoint  presentation before the  1st International Conference of Advances in Cancer Medical Research (ACMR 2013) . Singapore. November 18 19,<https://www.researchgate.net/publication/324005558_Cancer_Singapore_Presentation>Accessed:December 22,. 2019.

Tiquia,Rey (2015)  “ The Paradigm of Theory-as-Practice: Traditional Chinese Natural Studies and the Performance of the Cosmic Breath qi in a New Global Spacetime System” The Journal of The Oriental Society of Australia, Vol 47. 

Tiquia, Rey (2017)  “Restoring the Metaphysical Values of the Cosmic Breath Qi 氣  to the Real World.” Powerpoint  presentation  at the 15^th Biennial Conference of the Chinese Studies Association of Australia (CSAA ) Macquarie University, Sydney, Australia, 10th -12th of  July <<https://www.researchgate.net/publication/318876769_Restoring_the_Metaphysical_Values_of_the_Cosmic_Breath_Qi_qi_to_the_Real_World_to_Realize_a_global_harmonisation_of_space_and_time_laishixianshikongdatong

Tiquia, Rey.  “Restoring the Chinese Calendar Lifa  and the Cosmic Breath Qi to the Real World,”   Proceedings of the  Intelligent Systems Conference,   7-8 September, 2017 , London, UK. <<https://www.researchgate.net/publication/319654236_Restoring_the_Chinese_Calendar_Li_Fa_and_the_Cosmic_Breath_Qi_to_the_Real_World_A_New_Global_Time_System_The_Stems_and_Branches_Calendrical_clockAccessed: December 22, 2019. 

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Tiquia, R. (2017) Project proposal to hold a workshop in China : “Restoring the Chinese Calendar 历法 and the Cosmic Breath 宇宙之氣 to the Real World：From the Xia Calendar 夏历 to the Elemental Stems & Zodiacal Branches Calendrical Clock : North/South Hemispheres) 天干地支 历法时钟(南北半球) submitted to the International Research and Research Training Fund(IRRTF), University of Melbourne, 2017]. 

Tiquia, Rey (2019) “Translating the Life Energetic Qi, Yin and Yang and the Five Elements as Ontic-Epistemic Imaginary Entities to Interrupt the Decline of Traditional Chinese Medicine and Ensure its Continued Innovation and Regeneration,” powerpoint presentation before Annual Conference of the Society for the Social Studies of Science (4S) , ‘Innovations, Interruptions, Regenerations,’ Sheraton Hotel, New Orleans, Louisiana, USA, September 4-7, 2019. 

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4S Sydney TRANSnational STS Society for Social Studies of Science Annual Conference, Sydney International Convention Centre, August 29- September 1 2018 << https://4sonline.org/ee/files/4S18_web_program_180825.pdf>>

The Chinese medicine I know and praise, is the “classical Chinese medicine,” a rather different approach from TCM or bio medicine.

Indeed, studying from another viewpoint is always interesting: it questions our convictions, what we too often take as “given,” “natural,” “scientific,” “unquestionable,” “obvious,” or even “the only possibility.” Another way to approach human beings and their health leads us to ask ourselves: How do we know what we know? Where does our knowledge comes from?

This is not about contradicting Western medicine, nor criticizing it; it is rather about extending medicine to areas and in ways which may not have been thought of previously or not given enough consideration. Studying a medicine which for some 2000 years has quite successfully treated billions of people is a good opportunity to deepen and expand Western medicine.

It allows us to change our view on the importance of certain aspects, which are considered as particularly relevant in Chinese medicine:

1) Another view on health and disease.

In Western medicine, a disease is recognizable with a set of symptoms, identified with a name, and can be treated mainly after this official identification, with the appropriate protocol. In the classical Chinese approach, the disease is rather a disorder, an imbalance (in yin yang), with no clear limits between healthy and unhealthy condition other than the seriousness in the lack of equilibrium. It also shows if a person is capable of re-establishing their equilibrium by themselves or if the help of another person is needed. According to the classical Chinese thought, there is no real dichotomy, not even in yin yang.

Health and illness are not considered as two states, with a clear-cut border; one can shift from one condition to the other but - before an illness can be identified with the Western approach - the signs are already there, ready to be read by the penetrating (shrewd) practitioner or understood by the person experiencing the disorder. One can address the situation then, either by themselves or with the help of a therapist. 

And this is strictly connected to the following points:

2) Prevention

Prevention is present at all levels and in every moment. Not only to avoid falling ill––which depends on the personal conduct of life––but, once sick, also to prevent further damage; this belongs to the practitioner’s skill.

3) Nurturing life

The art of nurturing life (yang sheng 養生) is one of the foundations of Chinese medicine, which definitively opts for the care and taste of life rather than focusing on fighting death. Nurturing life is the best possible prevention, especially when it includes an inner work on one’s emotions and spirit.

This is deeply bound to a harmonious relationship with nature. The pattern for the organization of all interactions of the yin yang qi is the natural order. There is a profound analogy between the process of life in natural phenomena and in human beings; therefore, to know, understand and respect the natural order of life is to be aware of our true nature, original organization of qi and also the model for what we ought to be.

Nobody can be really healthy if they are at odds with the environment and their surroundings. It is the function of medicine to help people recognize a toxic surrounding as well as adjust to a viable environment.

4)  Holistic approach

As is widely known, Chinese medicine considers all the aspects of a person: the physical, psychological, mental health are seen as one, responding to the same balance or unbalance in the interaction of Qi.

5) Humaneness

Any therapeutic act is about two human beings interacting with each other. The bond between patient and practitioner takes part – one way or another - in the accuracy of the diagnosis and the effect of the treatment.

To be true therapists, practitioners must constantly work on themselves, to get closer to what it means for them to be a human being, to develop their ability to receive and accept the sick person with all their disorders, without becoming themselves destabilised; thus remaining able to treat them as human beings.

6) Emotions

A human being cannot be considered, treated and cured if the healing transformation does not reach the core of the person, what is usually called the “spirit” (shen 神).

Consequently, emotions are fully integrated in any pathological situation. Emotions, whether at the origin of the disorder, or a consequence of it, or just a customary state of mind (the psychological background of a person), alter the movements of qi. Chinese medicine regulates the movement of qi inside a human being; therefore emotions are part of the diagnosis. A more balanced psychology is normally one of the results of a good treatment. It is radically different from the psychosomatic approach of Western medicine and emphasizes the unity of the human being.

7) Guidance

More than giving simple advice, the practitioner of Chinese medicine educates the patients about what caused the disease and what will restore the balance, so that they may become co-partners in the treatment and even change the conduct of their lives (for instance, through diet or emotion).

8) Diagnosis and treatment

Both diagnosis and treatment are individualised to suit each particular patient; both are an evolving process.

9) Multiple Tools

Chinese medicine combines several therapeutic “tools,” such as pharmacopeia, acupuncture and moxibustion, massages, qigong and Taiji, diet… 

For these aspects of medicine, the Chinese approach is especially rich and interesting. A dialogue between Western and Chinese medicines is therefore highly desirable and advantageous. But a dialogue can only exist when both medicines are fully recognized as such.

Several prerequisites:

• A text corpus, that contains the knowledge, expresses theories and explains patterns to understand how to proceed to make a diagnosis;

• Operating procedures and techniques to treat according to the diagnosis;

• Research based on the corpus and methods of treatment. 

What is often called research on Chinese medicine is in fact research of Western medicine on Chinese medicine. That can be interesting and even fruitful, but it is not real research on Chinese medicine. To scrutinise one aspect of Chinese medicine, with the tools and postulates of Western science cannot qualify––or disqualify––the Chinese approach of health and treatments as true medicine. One medicine cannot receive its value from another but must draw it from itself. 

To continue to study Chinese medicine not only allows the practice of its techniques, knowing how to make a diagnosis and understanding the subsequent treatment, but it also keeps this medicine alive by innovations and renovations that do not alter its essential attributes. 

In summary, here are some reasons to study Chinese medicine:

• It is an efficient method of treatment, with considerably fewer side effects than Western medicine.

• It approaches health and disease from a different angle. This is always necessary but even more mandatory in a field where two (or several) human beings interact. Medicine is a science but it must also remain an art.

• When correctly understood, it offers perspectives and reflections that enrich the whole approach of medicine.

Conclusion

It is vital that classical Chinese medicine should be kept alive and therefore studied seriously.

The study of classical Chinese medicine empowers its own evolution and transformation, but only from its own roots, not as a graft making it merely a scion of Western medicine. 

It allows Chinese medicine to be and remain a true medicine, able to converse with Western medicine (or others).

Not only does it preserve the knowledge, tradition and reflection, but it also contributes to the expansion of human medicine for the future.

If we don’t study (and practice) classical Chinese medicine, it will disappear definitively. It would be a shame not to use its richness to continue to cure people and also to develop the best possible medicine for human beings.

www.elisabeth-rochat.com

The Origins of Āyurveda

At the core of classical Āyurveda stands the aetiological theory of the three doṣas (tridoṣa), broadly defined as defilements of wind (vāta), bile (pitta), and phlegm (kapha). Disease is said to occur when for one or several reasons one or more of the doṣas moves from its seat to manifest someplace else in the body. On the surface of it, since the theory includes three well-defined Sanskrit terms, occurring together, it would seem to be a straightforward exercise to trace this transparent mode of thinking in Indian literature prior to the earliest medical treatises, in which the theory was first fully expounded. However, such has not been achieved and at present two opposing theories have been put forth for the origins of the three āyurvedic doṣas.

One maintains that the theory was wholly indigenous to the subcontinent, being embedded in early ideas of four of the five basic elements (mahābhūta): fire (agni) which characterises bile (pitta) and wind (vāyu), universal form of bodily wind (vāta); and perhaps also water (āp) and earth (pṛthivī), which characterise phlegm (kapha). The fifth element, space (ākāśa) is the realm of sound and does not easily fit to one of the doṣas. Sometimes it is paired with five to give bile. This analysis, however, occurs in the second level compilation found n Vāgbhaṭa’s seventh century Aṣṭāṅgahṛdaya Saṃhitā. It is also the point of view of most Indian scholars, while the other, advocated mainly by western scholars, posits that the theory is related to, if not dependent on, Greco-Roman medicine, since in its fundamental conceptual basis, Sanskrit doṣabears a similarity to Greek chymos, which gives rise to the four humours of black bile (melaina cholē), yellow bile (xanthē cholē), phlegm (phlegma), and blood (haima). While blood (rakta) is not counted in the list of three doṣas, Meulenbeld has shown that blood was considered in the same way as the doṣas in the classical Āyurveda.[1]The only missing pairing between Greek-Roman and Indian medicine is the doṣacalled “wind,” which was not one of the humours, but Greek pneumalike Sanskrit prāṇais found in a medical context.

Although Sanskrit doṣaoccurs in its original meaning of “defilement” or “fault” from the period of the early Upaniṣads (c. 800 BCE), its specific medical sense is first expounded in the Sanskrit treatises of Caraka and Suśruta. The medical notion of doṣacould not have come from nowhere, but from where and how.

Putting aside the two opposing points of view, I shall began afresh, starting with an examination of old literary sources in Sanskrit and working my way forward to the first systematic and composite treatises, the Carakaand Suśruta Saṃhitās, which date from around the first centuries before and after the Common Era.

Vedic Medicine

An early form of medicine was represented in the Vedic Saṃhitās from about 1300-800 BCE. Among these primarily religious treatises, there was no single text devoted exclusively to diagnosis and treatment of illness and malady; but rather randomly placed charms and incantations in verse were embedded in the earliest treatises of the Ṛgvedaand Atharvaveda for use in rituals to heal the sick and the suffering. The lack of a single text or texts dedicated to the subject of medicine indicated that healing was part of the overall socio-religious matrix in the earliest Sanskrit literature. On the other hand, only in its broadest underlying conceptual basis does a form of healing utilising incantations and rituals occur in the earliest āyurvedic treatises, especially in the context of maladies affecting children. Moreover, no direct linguistic parallels exist between the Vedic and āyurvedic incantations. This naturally implies that the āyurvedic aetiology of the three doṣas together with the extensive list of remedies based on it could not have derived solely from the medical theories and practices found in the early Vedas.

It must naturally also come from somewhere else. Could then part of the overall conceptual basis have derived from beyond the orbit of the Indian subcontinent, as several early western scholars of Indian medicine maintained? To try to answer this question, we must take the next histoical step and examine the literary sources composed between the Vedic hymns and the earliest medical works. My study therefore included an investigation of the later Vedic treatises of the Brāhmaṇas and Upaniṣads and the literature related to them. A deep study of these texts is still a desideratum, since I merely surveyed the principal texts. The cursory examination of them, however, revealed that there was little in the way of medicine that differed from that found in the Vedic Saṃhitās; and, moreover, there were still no individual texts devoted exclusively to medicine, with the exception of the formulation of the five bodily winds.

Although not a book per se, the fixed group of five bodily winds (apāna, prāṇa, vyāna, samāna, udāna) is a well-established idea that evolved from yogic practices involving breath control or prāṇāyamafirst mentioned in the early Upaniṣads and later picked up and medically altered by the early āyurvedic authors.[2]  The occurrence of the doctrine of the five bodily winds in the medical treatises is simply not enough information to establish the later Vedic literature as the principle and only source for the three doṣas, and therefore it was not a viable place for further investigation. I turn my attention rather to a more promising literature, not in Sanskrit but in the Middle Indic language of Pāli, in which the earliest Buddhist scriptures were composed.

Buddhist Medicine

The Monastic Code or Vinaya Piṭaka of the Buddhist Pāli Canon contained a large section devoted to medicines, along with numerous references to healing theory and practice throughout the earliest parts of the Canon, which probably took shape some centuries before it was written down in Sri Lanka in about 29 BCE. This would place the Buddhist medical doctrines historically immediately prior to and contemporaneous with the earliest āyurvedic treatises.

In summary, these sources revealed the following major points. Already in Pāli Buddist literature there is found:

1. a presumed understanding of the idea of the three doṣas;

2. a practical approach to healing indicated in case histories and remedies;

3. a legend of a famous healer, Jīvaka, which has travelled with Buddhism throughout Asia; and

4. a clearly defined role of the healing arts in the early Buddhist monastery or Saṅgha.[3]

The content of the Buddhist medical theories and practices points to an important intermediate step in the evolutionary history of Indian medicine from Veda to Āyurveda. Moreover, the medical knowledge was preserved and transmitted not by composers and proponents of Brahmanic doctrines and beliefs, but by knowledgeable and literate ascetics living what appeared for the most part to be a mendicant’s lifestyle. The study of early Buddhist medicine made the Sanskrit tradition that was maintained and transmitted by the Brahmans, even a more unlikely source of early āyurvedic theories and practices.

But, does the Buddhist involvement in early Indian medical history bring us closer to finding the origins of Āyurveda? Only in so far as it localises elements of what later became āyurvedic medicine outside the Sanskritic orbit of brahmanic knowledge. Moreover, it shows that the aetiological tridoṣic theory was already well formulated by the time of earliest Buddhist scriptures. The “smoking gun” that provides the precise origin of the doctrines of Āyurveda is still wanting. So, for time being, we shall have to admit that a direct transmission from one medical text to another may never be found and moreover might never have occurred. Some might say “well then give it up and move on to something else.” I preferred, however, to be more creative and widen the sphere of investigation.

I started to look to other systems of thought and practice that are related but not central to medicine. These include systems of knowledge found in the Indian astral science or Jyotiḥśāstra, especially those parts that have some connection to medicine, such as the divinatory system of human marks or physiognomy.

Although these studies are ongoing, they so far indicate that at least part of the āyurvedic system of medicine in India was shared with other systems of Indian knowledge, which indicate also influence from non-Indian forms of thought in antiquity. Three important points come forth, which show

1. a literary link between information in the early Sanskrit medical treatises and early Sanskrit astral literature;

2. a fundamental similarity to systems of physiognomy from ancient Mesopotamia and from ancient Greece; and

3. a possible dual role played by the Indian doctor as healer and diviner.[4]

Conclusions     

Perhaps we shall never find the precise origins of the āyurvedic theory of the three doṣas and the methods of the cures based on it, but we have come closer to identifying possible, viable places to search for additional information. Moreover, I have become more and more convinced that we should not expect to find a single text or group of texts from which the early Sanskrit medical treatises were translated or on which they were based. Rather we should consider Āyurveda as a medical system that evolved under the influence of fruitful exchanges of important theories and practices of different kinds of healers, such as Jīvaka in the Buddhist legends. It is likely that the exchange continued for centuries at a time when contacts between different healers were possible. This would imply that the interaction was constant and lasted long enough for intellectual exchange and practical learning to take place and be recorded. For the time being, this is perhaps the more realistic approach to the origins of Āyurveda, which could allow us to speculate that the tridoṣa theory resulted from assimilation and adaption, where a Greco-Roman conception of the four humours blended with Indian philosophical notions of the three guṇas or qualities (sattva, rajas, and tamas) and thenfive basic elements (mahābhūta), both of which were well-known among proponents of Sāṃkhya, with whose philosophical notions the composers and compilers of the classical medical texts were conversant. The precise means by which the assimilation took place could indeed be a fruitful topic of exploration.

Bibliography

Meulenbeld, G. J. 1991. “The Constraints of Theory in the Evolution of Nosological Classifications: A Study on the Position of Blood in Indian Medicine (Āyurveda);” in G. J. Meulenbeld, ed. Medical Literature from India, Sri Lanka and Tibet (Leiden: E. J Brill): 91-106.

Zysk, K. 1991. Asceticism and healing in ancient India. Medicine in the Buddhist monastery. New York and Oxford: Oxford University Press. Paperback: New Delhi: Oxford University Press, 1991. Indian edition: Delhi: Motilal Banarsidass, 1997, reprint, 2000. [Vol 2 of Indian Medical Tradition]. Second revised edition under preparation.

—, 1993. "The science of respiration and the doctrine of the vital breaths in ancient India," JAOS, 113.2: 198-213.

—, 2000. “"Did ancient Indians have a notion of contagion?"  in Lawrence I. Conrad and Dominik Wujastyk, eds., Contagion. Perspectives from Pre-Modern Societies(Aldershot, UK: Ashagate), 79-95.

—. 2007. “The bodily winds in ancient India revisited.” Journal of the Royal Anthropological Institute (N.S.): 105-115.

—. 2016. The India System of Human Marks. Text, translation, and notes. 2 Vols.  Leiden: E.J. Brill [Sir Henry Wellcome Asian Series, Vol. 15].

— 2018. “Greek and Indian Physiognomics.” Journal of the American Oriental Society,138.2: 13-325.

Notes

[1] Meulenbeld 1991; cf. Zysk 2000.

[2] Zysk, 1993 and 2007.

[3] Zysk, 1991. I am happy to report that a revised, second edition of this study should be out soon with Motilal Banarsidass.

[4] Zysk 2016.1: 25-53; Zysk 2018.

The standard Chinese word for efficacy is yan 驗 or xiao 効/效. In premodern sources, it carries a strong sense of "having been tested." The word started to appear in the titles of medical works during the Six Dynasties (220-589), especially in the genre of "formula books" (fangshu 方書). The bibliographical records of the official histories offer us the following examples: "Personally Tested Formulas" (shenyan fang 身驗方), "Collected Tested Formulas" (jiyan fang 集驗方), and "Efficacious Formulas" (xiaoyan fang 效驗方).[1] What were the criteria to consider a formula effective is unclear, yet it is evident that medical writers at the time paid attention to the therapeutic outcomes of their remedies.

To further understand yan, I now turn to a formula book in early Tang titled “Essential Formulas Worth a Thousand in Gold for Emergencies” (Beiji qianjin yaofang 備急千金要方, 650s), written by the famous physician Sun Simiao 孫思邈.[2] The book contains thirty scrolls organized by the types of illness. In each scroll, Sun starts with a theoretical discussion of the illness, expounding its causes, symptoms, and bodily dynamics. This is followed by a large number of formulas that treat the illness, ranging from single-drug therapies to enormous prescriptions that use as many as 64 ingredients. Altogether, the book includes a massive number of 4,200 formulas.

In general, Sun follows a set structure in the writing of each formula in his book. He starts with the name of the formula, often with the typical symptoms associated with the illness. He then lists all the ingredients in the formula, specifying the dose for each one. Finally, he advises on how to prepare and administer the medicine. Intriguingly, the formula sometimes ends with the confirmation of the efficacy of the prescription, presented in short phrases such as "numinously efficacious" (shenyan 神驗), "extremely good" (shenliang 甚良), "having efficacy" (youxiao 有效), and "as if to pour hot water onto snow" (rutang woxue 如湯沃雪). These “efficacy phrases” are terse, generic, and formulaic, which probably carry more rhetorical force of boasting the value of the formula than serving as evidence of the remedy’s actual usage.[3] Likely, Sun incorporated certain formulas from earlier sources, including these set phrases, without inserting his own voice. Efficacy was an artifact of copying.

Besides these generic phrases, Sun also offers more specific accounts to show the efficacy of some of his formulas, as exemplified by 25 medical cases spread throughout the book. Significantly, Sun was the first person in Chinese history who included medical cases in formula books, manifesting physicians' rising consciousness of using personal experience to validate the efficacy of medicines during the Tang.[4]

In general, each medical case in Sun's book appears at the end of a formula where Sun presents a specific situation to testify to the efficacy of the remedy. These cases contain some or all of the following components: time, place, the identity of the physician, the identity of the patient, diagnosis, prescription of the formula, and the therapeutic outcome. In what follows, I present three cases to show different meanings of yan in Sun's writing.

Case 1: To cure the illness of dragon (jiaolong bing 蛟龍病)

On the eighth day of the second month of 586, someone ate celery and became sick. The symptoms of the person resemble those of bloated abdomen, with the face turning bluish yellow. Upon ingesting cold food and strong sugar, the patient spat out a dragon with two heads and a tail. Greatly efficacious.[5]

The case confirms the efficacy of a food remedy to eliminate a pathological animal inside the body. Sun did not identify who the patient was; he only used the generic phrase “someone” (youren 有人) to refer to him or her, which implies that he had no direct experience of the event described. He may have heard of the story from others and felt the need to include it in his book to validate the formula. Efficacy was disembodied knowledge bolstered by word of mouth.

Case 2: To cure sudden turmoil of abdomen (huoluan 霍亂)

During the Wude period (618-626), a virtuous nun named Jingming had this illness for a long time. Sometimes the illness erupts once a month; sometimes more than once a month. Every time the illness erupts, she almost died. At the time, great court physicians such as Jiang Xu and Gan Chao failed to recognize the disorder. I treated it as sudden turmoil of abdomen and prescribed this formula, which cured her. I thus isolate and record the formula.[6]

Unlike the first case, Sun directly involved in treating the patient. This case particularly emphasizes Sun’s ability to offer correct diagnosis. Revealingly, Sun contrasts his superb skills with the clumsiness of the court physicians, which is a strategy that he uses regularly in his book to elevate his status as a superior healer. Sun’s effective treatment of the patient implies that he had an excellent understanding of the symptoms of the illness and the rationale of the formula. Efficacy was based on personal experience guided by reasoning.

Case 3: To cure sores caused by the urine of earwigs (qusou chong niao 蠼螋蟲尿)

In the sixth month of a year during the Wude period (618-626), I contracted this illness and felt oppressed at the heart after five or six days. I tried other methods to treat it but to no avail. Someone taught me to draw the shape of the bug on the ground, take the soil enclosed by its abdomen, mix it with saliva, and smear the paste onto the sores. It cured me immediately.[7]

This is an example of self-healing, which appears frequently in Sun's medical cases (10 out of 25 cases). The physician regularly tried medicines on himself and used his experience as compelling evidence of a formula's efficacy. After recounting the case, Sun confesses that “myriad things under the heaven resonate with each other, and I do not fathom the reason.” Despite this, he cherished the formula because of its undeniable efficacy.

We find a similar sentiment from another case where Sun tried a panacea called the powder of daphne (yuanhua san 芫花散), a massive formula consisting of 64 ingredients. Physicians at the time did not sanction the use of the medicine, yet upon trying it, Sun found it “numinously efficacious” especially for treating emergencies. He then muses:

“I then realize that the efficacy of numinous things is not bound by common rules. The highest principle and the resonance [between things] cannot be understood by intellect. … This is without understanding why it is so—even sages cannot discern the reason.”[8]

What is striking here is Sun’s ready recognition of the inadequate understanding of why the medicine works (buzhi suoyiran 不知所以然). Yet as long as it could effectively save lives, Sun found no reason not to include it in his collection. Efficacy was based on personal experience without doctrinal understanding.

To sum up, we encounter a wide range of meanings of efficacy in Sun Simiao's formula book. It could be simply a copying artifact manifesting the physician's respect for past knowledge, or word of mouth without direct observation, or attestation based on firsthand experience, or therapeutic success even devoid of understanding the logic behind. In Sun's text, he juxtaposes these various presentations of yan without establishing a clear hierarchy. The new phenomenon of integrating medical cases into formulas in the 7th century, though, does indicate the fledgling effort of using experience, especially personal experience, to verify the efficacy of remedies.

Which brings back the question I raised at the beginning: Does Chinese medicine work? Well, it depends on a miscellany of factors, as Sun Simiao's text reveals. To be clear, 7th-century China is very different from our world today: physicians during Sun's time did not identify themselves as an autonomous, well-defined, and institutionalized social group; they competed with diverse types of practitioners in society such as ritual therapists, drug peddlers, and itinerant healers to gain the trust of patients. Their authority, unlike that of modern doctors, was not a given, but something to strive for. If our understanding of therapeutic efficacy today is heavily informed by scientific evidence and the approval of professionally-trained doctors, we see a different set of criteria used by Sun to promote his formulas and establish his authority. Therefore, what we can learn from Sun's writing is not just a more open, inclusive way of perceiving efficacy but also to understand efficacy as characterized through a dynamic process that ties to text, experience, and the building of a healer's identity.[9]

[1] Suishu 隋書 [Book of Sui], juan 34.

[2] For more information on Sun Simiao, see https://www.happygoatproductions.com/sun-simiao-

[3] On "efficacy phrases," see Claire Jones, “Formula and Formulation: ‘Efficacy Phrases’ in Medieval English Medical Manuscripts,” Neuphilologische Mitteilungen, 99, 1998: 199-209.

[4] On the history of medical cases in China, see Christopher Cullen, “Yi’an 醫案 (Case Statements): The Origins of a Genre of Chinese Medical Literature,” in Innovation in Chinese Medicine, ed. Elisabeth Hsu (Cambridge; New York: Cambridge University Press, 2001), 297-323; on the analogous history of medical cases in Europe, see Gianna Pomata, “The Medical Case Narrative in Pre-Modern Europe and China: Comparative History of an Epistemic Genre,” in A Historical Approach to Casuistry: Norms and Exceptions in a Comparative Perspective, eds. Carlo Ginzburg and Lucio Biasiori (London: Bloomsbury Academic, 2019), 15-43.

[5] Beiji qianjin yaofang, juan 11.

[6] Ibid., juan 20.

[7] Ibid., juan 25.

[8] Ibid., juan 12.

[9] For more discussion on the issue of efficacy in Chinese medicine, see Nathan Sivin, "The Question of Efficacy," Asian Medicine, 10(1-2), 2015: 9-35.

Source of image: https://www.taiwannutrition.com/blog/intermittent-fasting/. Accessed August 5, 2019.

Trendy though it is today, the idea is hardly new . I’ve been reading Chinese and Japanese books from the early twentieth century, and I came across one that radiates very similar enthusiasm for very similar advice: Jiang Weiqiao 蔣維喬’s On Skipping Breakfast for Health and to Prevent Aging (健康不老廢止朝食論). I’ll just call it On Skipping Breakfast from here on, for simplicity. This book claims that by eating only two meals per day, one slightly before noon and one in the early evening, anyone can improve his health and extend his lifespan. Following this advice, it says, can strengthen cases of weak nerves and prevent conditions such as depression, diabetes and obesity, constipation, and even cholera and typhoid. And, as if that weren’t enough, it gives the eater more time, improves his mental clarity, and makes him more successful in his career. When Twitter CEO Jack Dorsey says that intermittent fasting “helps him save time, stay focused, and sleep better at night,” it’s almost as if he’s quoting Jiang.[1]Or actually, quoting Mishima Kin’ichirō 美島金一郎,since Jiang’s book is a modified translation of a Japanese book published a year earlier.

But On Skipping Breakfast is not just an example of biohacking before Silicon Valley. While Mishima’s original text does celebrate the potential to lighten the body and boost productivity, Jiang’s version has higher aims: his ambition is to “arrive at a world of great harmony” by promoting moderate eating.

When the Commercial Press published the book in 1915, Western scientific ideas about eating were beginning to permeate China. Increasingly, diets were defined, measured, and quantified as the concepts of calories, vitamins, and minimum daily requirements took root. Underpinning much of this knowledge was a conviction that Western diets were superior to what people ate in East Asia. Scientists as well as political and cultural leaders decried Chinese diets as deficient—in proteins, in calories, in micronutrients and in just about every other way. Modernizers in China, like those in other weak countries, wanted their people to adopt what Rachel Laudan has called the “power cuisine” of the West, a high-calorie feast featuring meat, wheat, and dairy.[2]The goal was to create a taller, stronger, and generally more “fit” population that could better compete in the nations’ struggle for survival.

On Skipping Breakfast, though, approaches the question of national diet very differently. It’s not that Jiang rejects modern knowledge. By choosing to translate Mishima’s tract in all its scientistic glory, Jiang demonstrates his fascination with then-current physiological and anatomical ideas. The body described in this book is clearly the body of Western science, not the one of classical Chinese medicine: it has blood but no qi, yingyang (營養, the neologism “nutrition”) but no yin 陰 or yang 陽, and a mind-hosting brain instead of a heart-mind (xin 心), among many other marks. The book revels in mechanistic descriptions of digestion and excretion. But Jiang harnesses these ideas to a very different goal from the usual one of bulking up to better compete.[3]

Jiang Weiqiao, from his book 因是子靜坐法 (Shanghai: The Commercial Press, 1922). Available through Hathi Trust.

In a preface added to Mishima’s original text, Jiang affirms the Darwinian premise that all living beings are locked in a struggle for survival. But his response sounds like a Buddhist one:

“if there were a way to make living things able to not rely on food to live, then their conflict and killing one another perhaps could be stopped. If there were a way to … make living things return and not be reborn and not die … [t]he conflict and mutual killing could forever not be aroused.”

Unfortunately, he writes,

“there is not yet a good method of not eating. So we will use eating in moderation to save [people]. When there have been generations who have practiced healthy, anti-aging [practices like these] for a long time, this can build up their self-cultivation and produce wisdom, and engrave the truth of no-rebirth.”[4]

Here the goal is not to win the competition but to transcend it. Rather than improving their stock by eating more animal protein and calories, nations can improve their moral essence by eating in a disciplined and economical pattern. Jiang’s perspective echoes not only Buddhist ideals but also Daoist practices like abstaining from grain. It resonates, too, with what Chinese medical classics say about moderating what you eat and drink.

Despite (or perhaps because of) its ties to traditional culture, On Skipping Breakfast clearly remained a contrarian piece. China did indeed absorb Western “power cuisine.” A century later, the attendant problems of a calorie-dense diet heavier in meat, wheat, and dairy have cropped up there, including rising rates of obesity, diabetes, and high blood pressure. No wonder, then, that these days intermittent fasting is attracting attention in Chinese societies too. Today, though, you’re less likely to hear about its potential to save humanity.

[1] Aria Bendix and Julia Naftulin, “Twitter CEO Jack Dorsey says he eats only one meal a day and fasts all weekend,” Business Insider April 12, 2019 (https://www.businessinsider.com/jack-dorsey-intermittent-fasting-diet-risks-2019-4)

[2] Rachel Laudan, Cuisine and Empire: Cooking in World History (Berkeley: University of California Press, 2013), 255-257.

[3] Hilary A. Smith, “Skipping Breakfast to Save the Nation: A Different Kind of Dietary Determinism in Early Twentieth-Century China,” Global Food History vol.4, no.2 (2018): 152-167.

[4] Jiang Weiqiao, Jiankang bulao feizhi zhaoshi lun [Skipping Breakfast for Health and to Prevent Aging] (Taipei: Xin wen feng, 1980), author’s preface 2 and 5.

This post first appeared on BiblioAsia. It is syndicated here with permission.

Malay ubat-ubatan (medicine) and healing – which spans many centuries and has been passed down through generations either orally or in written form – is a complex and holistic practice.

Traditional Malay medicine incorporates principles and practices of pharmacology that are highly dependent on indigenous flora and fauna found in the wild.¹ Age-old literature and manuscripts – although scarce in number – document the ways in which plants, animals and minerals² native to the Malay Archipelago have been part and parcel of its healing practices. At the heart of Malay ubat-ubatanis the amalgamation of complex Islamic and Hindu beliefs and practices presided over by traditional or faith healers.

Colonial scholars and administrators in 20th-century Malaya were invariably conflicted in their perceptions of traditional Malay medicine. Local sources and interpretations were frequently overlooked, and this has in turn affected the way in which traditional Malay medicine has been studied and understood for decades. Some defined ubat-ubatan as remedies administered according to the principles of chemistry and scientific evidence, while others dismissed such healing practices as belonging to the realm of magic and the supernatural. For the most part, the British regarded traditional Malay medicine with suspicion and antithetic to its Western counterpart.

As a result, the practice and form of traditional Malay medicine underwent dramatic changes under colonial rule. Legislations, for instance – shaped by altruism or bigotry, but more likely a combination of the two – were introduced by the British to stamp out traditional Malay healing practices and regulate village healers.

The Spread of Islam and Malay Medicine

The adoption of Islam in the Malay Archipelago from the 13th century onwards not only introduced a new religious doctrine to the region, but also fostered a pan-Islamic identity and defined new parameters for the spiritual, social and economic way of life of its inhabitants. Gradually, Islam became syncretised with the prevailing belief systems of the Malay world.

Western scholars of the time held the view that the Malay community adopted a hybridised form of Islam. In his address before the Straits Philosophical Society in 1896, English orientalist and linguist Charles O. Blagden postulated that Malays were “only superficially Muhammadan” as their folk rituals were “unorthodox” and “pagan” in relation to the basic tenets of Islam.³ Such an assertion, however, simplifies the complex understanding and expressions of a dynamic and multifaceted faith.

Medicine in Islam is characterised by a history of enquiry, innovation and adaptation. This is reflected in the ease in which indigenous healers adopted and adapted Islamic symbolism in their practices. In the Malay Peninsula, ceremonies overseen by the pawang (or shaman) include Quranic incantations and prayers addressed solely to God, even though most other aspects of the rituals are Hindu-Buddhist or pre-Indic in character.

Although the origins are unclear, the Malay method of healing is mainly administered by the traditional medicine man or bomoh (see text box), who derives his knowledge from either ilmu turun (inherited knowledge) or ilmu tuntut (apprenticeship) and, in some instances, complemented by the Kitab Tibb (The Book of Medicine).

There are numerous versions of Kitab Tibb manuscripts found in the Malay Archipelago. Mostly written between 1786 and 1883, these broadly outline three main types of healing practices: those using natural resources such as plants and herbs; those relying on wafaq (written symbols or amulets); and healing practices using Quranic verses, supplications and salawat (blessings to the Prophet). All these techniques can be used simultaneously or separately.⁴

The earliest edition of the Kitab Tibb was written on 12 wooden sheets, and prescribed medications based on plants, herbs and spices commonly found in the region. The manuscript also includes a list of dietary restrictions and a variety of taboos (pantang larang) the afflicted should observe.⁵ By the 19th century, surviving copies of the Kitab Tibb in the Malay Peninsula were known to contain detailed observations by the bomoh, including visual representations of disease symptoms as well as the appropriate incantations.

Types of Healing

Traditional Malay healing offers a holistic, multifaceted and ecological solution to a multitude of illnesses and ailments. It comprises aspects of the spiritual, such as magic, shamanism and the supernatural, and the empirical, such as dietetics and herbalism, which can be scientifically explained.

Although Islam may have encouraged the use and incorporation of nature in traditional Malay medicine, natural remedies were already widely used in local healing practices and rituals prior to the arrival of Islam in the Malay world. For example, common plants, herbs and spices like bonglai (Zinggibar cassumunar) had been used to treat migraine, cough and gastrointestinal problems for centuries.

As observed by British physician John D. Gimlette in his book, Malay Poisons and Charm Cures (1915),⁶  bomohs used rattan splints for simple fractures and wood ash as an antiseptic dressing. When a baby was delivered by a bidan or midwife, the umbilical cord is cut with a bamboo stem and the stump dusted with wood ash or a paste made of pepper, ginger and turmeric.

Islamic medical science introduced new concepts to the pre-existing knowledge of the human body and the environment. The seeds of Islamic medicine and healing can be traced back to the Quran, the underlying philosophy of using flora and fauna in natural remedies grounded in the belief in Allah as the Creator of Nature. As such, tapping on the healing properties of the earth has been a long-standing aspect of the Islamic medical tradition. One of the verses from Surah An-nahl (16:69) of the Quran reads thus:

“Then eat from all the fruits and follow the ways of your Lord laid down [for you]. There emerges from their (bees) bellies a drink, varying in colours, in which there is healing for people. Indeed, in that there is a sign for people who give thought.”

Ancient medical texts in the Malay world did not have specific titles but were generally referred to as Kitab Tibb and primarily consisted of translations from Persian and Indian sources. Different manuscripts prescribed different courses of treatment even for the same ailments. Interestingly, the vast array of natural sources described in these manuscripts are likely still in use today in the Malay Peninsula, either as supplements or natural remedies.

The Andalusian botanist and pharmacist Ibn al-Baytar’s pharmacopeia, titled Compendium of Simple Medicaments and Foods and published in the 13th century, is still a widely consulted text in the world of Malay healing today. It lists 1,400 plants, foods and drugs, and their uses, organised alphabetically by the name of the plant or plant component.

Apart from their knowledge of humoural theory (see text box) and botany, traditional Malay healers also offered spiritual healing to cure the sick. The belief is that animate and inanimate objects, including the physical body, possess semangat (a vital force or soul). The loss of semangat can be detrimental to one’s physical and mental well-being.

A healer is purportedly able to manipulate and revive the semangat of the sick – particularly those suffering from mental and spiritual ailments. To treat patients who might have been “disturbed” by unseen forces, healers invoke supernatural entities through jampi (incantations), spells and elaborate rituals. Such ceremonies may sometimes take the form of a public event, witnessed by the entire village and accompanied by loud music. The public nature of such rituals was often derided by colonial administrators and scholars, who saw these practices as primitive and irrational or, as Gimlette puts it, “circumvent[ing] Muhammadan tenets”.⁷

The Cultural and Scientific Divide

There is a paucity of comprehensive written records of traditional Malay healing as much of it have not survived the ravages of time. Whatever extant Malay manuscripts – mostly inherited and passed down orally from one generation to the next (ilmu turun) or by way of apprenticeship (ilmu tuntut) – along with books and documents authored by colonial scholars, provide the only window into the ancient practices and beliefs of the Malay world.

In striving to achieve a balance of the body, mind, health and spirit, traditional Malay medicine does not differ much from Ayurvedic, Chinese and Hippocratic traditions that emphasise the same – especially with regard to humoural theory. Colonial writings, however, have tended to focus on Malay folk religion and animism, centering their writing around the use of amulets, incantations, charms and sorcery by the community.

The late 19th to early 20th centuries saw a significant output in research by colonial scholars who studied Malay belief systems and healing practices. The body of ideas and literature generated by these early observers were often biased, filled with racist sentiments or tinged with romanticism, although some scholars were of the view that the sudden rise in writings on Malay magic and medicine was simply an effort at documenting the “primitive” and vanishing aspects of the social and cultural lifestyles of the Malays.⁸

The use of magic and the fervent belief in religion among Malays have often been cited as stumbling blocks to the development and progress of the community. In his September 1896 report from Kuala Langat, Selangor, where he worked in the Straits Settlements civil service, English anthropologist Walter W. Skeat made the overtly racist remark that “indolent and ignorant Malays” needed to be “saved from themselves”, and attributed the “many crippled lives and early deaths” to the “evil influence of the horde of bomors”.⁹ In fact, Skeat believed that increasing “contact with European civilisation” by the local Malay tribes had diminished their use of charms and spells.¹⁰

Biased perceptions of traditional Malay society, such as its healing practices, could have been used by the British to justify its political domination and imperialist motives.¹¹ There were, however, several scholars such as Thomas N. Annandale and John D. Gimlette, who acknowledged the benefits and scientific merit of traditional Malay medicine.¹² Both men were heavily involved in fieldwork and were well known for their research on traditional Malay medicine. Gimlette referenced local sources, including Kelatanese manuscripts, for his book Malay Poisons and Charm Cures (1915), which today remains a classic and definitive reference guide to the practices of Malay healers. As the use of some herbs and plants could lead to fatal consequences, Gimlette’s study of the wild varieties of vegetation in the Malay Archipelago opened up a new field of study for physiologists and pharmacologists.¹³

An attempt to comprehend the Malay pathological framework for medicine and disease is also evident in Percy N. Gerrard’s medical dictionary, A Vocabulary of Malay Medical Terms (1905).¹⁴ As a medical professional, Gerrard’s efforts were borne out of the desire to understand his patients’ medical ssues from a scientific and cultural point of view. This enabled him to treat his patients using Malay herbal medicine whenever necessary. Gerrard drew parallels to Western medicine and, in doing so, lent credibility to Malay practices and beliefs – at least in the eyes of the colonial administrators.

Like Gimlette, Gerrard praised the Malays’ profound understanding of plants and herbs, and highlighted the medicinal value of these untapped sources and the native knowledge of local medicine. Despite his affirmations of the scientific value of herbs in Malay healing, Gerrard felt that the community’s belief in the supernatural was an impediment to British acceptance of traditional Malay medicine and healers.

It is clear that colonial observers of 20th-century Malaya have largely contexualised their understanding and knowledge of Malay medicine against Western markers. This cultural chasm was mainly due to a lack of empathy and the inability to comprehend the complexities behind the religious rituals and healing systems of indigenous groups. For the most part, Malay healing practices were regarded as superstitions and folklore that could not be explained by scientific theories. Hence over time, some traditional Malay healers co-opted the language of religion¹⁵ and, eventually, science into their practice in order to gain wider acceptance by their Western critics.

Legislating Malay Medicine

Although Western medical services were gradually introduced to the local population, most Malays continued to consult their community healers as they allegedly had “complete faith in their own particular charms and cures” and “dread[ed] hospitals, doctors and western medicines”.¹⁶ As traditional healers were also involved in non-medical matters such as state, social and cultural affairs, they occupied an esteemed position in the indigenous communities they served.¹⁷

Healing Practices 

One of the most notable Malay medical manuscripts translated into English is Ismail Munshi’s The Medical Book of Malayan Medicine. Originally written in Jawi (c. 1850), it contains over 550 remedies for maladies ranging from migraines to depression, bloatedness and leprosy.

For Violent Headaches and Loss of Energy For Dizziness and Vertigo For Night Chills Ingredients Cumin seeds (5 cents)Garlic (10 cents)

Indian hemp

Ginger

Smilax china

Mace (35 cents), Nutmeg (5 cents)

Henbane

Javanese ginger

5 young shoots of betel vineRed onion

Fennel seeds

Daun medan (root of an unidentified plant)7 kernels of the fruit of the candle nut Method Pound all ingredients together and mix with honey to form into tablets. Patient to take tablets until course of treatment is complete. Grind finely. Place the pulp on a piece of cloth. Squeeze the juice into the patient’s eyes for three days. Reduce both ingredients to fine pulp. Apply to patient’s head.

Reference

Burkill, I.H., & Ismail Munshi. (1930). The medical book of Malayan medicine. Singapore: Botanic Gardens. (Call no.: RCLOS 615.3209595 MED)

By the turn of the 20th century, the British had become more receptive to Malay healing practices. Although dismissive of the efficacy of traditional Malay medicine, the British were aware that traditional healers formed the backbone of a long-established support system that locals could turn to in times of physical, emotional and spiritual distress.

A significant example would be the role of the bidan, or midwife, in the community. Before the colonial government set up a maternity hospital in 1888, the demands of pregnancy – ranging from prenatal care to actual delivery and postpartum care – were handled by bidans.

Although colonial medical officers acknowledged the importance of bidans, they were concerned that these midwives were operating under unsanitary conditions. In the early 20th century, a surge in the infant mortality rate was mainly attributed to traditional midwifery practices: many babies died from Tetanus neonatorum (umbilical infection).¹⁸  The authorities thought it imperative that bidans be trained and supervised to reduce maternal and infant mortality rates, and to develop trust and spread awareness of Western medical services among Malay mothers.

Under the Midwives Ordinance enacted in the Straits Settlements in 1915, all bidans had to be registered with the Central Midwives Board and undergo in-service training. Local women were also trained in biomedicine, midwifery and nursing in order to replace the traditional role of the bidan. The intention was not to encourage women to deliver in hospitals (due to a lack of beds and facilities), but rather to establish a pool of trained and licensed midwives who could recognise complications during pregnancy and refer the women to the hospitals if necessary. By the 1920s, mobile dispensaries as well as home and school visits were available to communities living in rural areas, and public campaigns were mounted to ensure that people had access to medicine and healthcare.

By 1936, there were 720 trained midwives in Singapore, 574 in Penang and 224 in Malacca. Despite these efforts, traditional bidans were still sought after by Malayan women in the subsequent decades due to the personal nature of the antenatal and postnatal services they provided, including up to six weeks after delivery.

Two other legislations introduced by the colonial government further threatened the existence of traditional healers and the provision of traditional medicine. Under the Sale of Food and Drugs Ordinance that came into force in 1914, the sale of adulterated drugs was deemed an offence “if the purchaser [was] not fully informed of the nature of adulteration at time of purchase”.¹⁹ The second legislation, the Poisons Ordinance of 1938 “regulate[d] the possession and sales of potent medicinal substances, to prevent misuse or illicit diversion of poisons”.²⁰

These laws compromised the role of traditional Malay healers in the community, especially given the latent suspicions surrounding Malay medicine. However, due to the high costs involved in establishing an islandwide public healthcare system, the British authorities were rather lax at enforcing these legislations, and allowed itinerant and home-based traditional healers to continue practising their craft.

With the introduction of Western-style healthcare, including clinics and hospitals, and the increasing availability of over-the-counter medications from the turn of the 20th century onwards, traditional Malay healing played a smaller role in the lives and rhythms of the community.

State controls and the exposure to Western education further put paid to the services of traditional Malay healers. Although their numbers have drastically dwindled over the years, traditional Malay medicine continues to play an ancillary – and occasionally complementary – role to Western medicine today for those who recognise its efficacy in providing ritual care and treating spiritual ailments and conditions not yet acknowledged in Western medical science.

Humoural Theory and Malay Medicine Humoural theory, which is one of the oldest theories of medicine, is organised around the four humours – blood, phlegm, yellow bile and black bile – and is associated with the four elements of earth (flesh), water (phlegm), air/wind (temperament), and fire (blood). The four elements are in turn paired up with the four qualities of cold, hot, moist and dry. Each individual has a particular humoural makeup, or “constitution”. As optimal health is attained when the humours are in harmonious balance, any imbalance of the humours may result in disease and sickness.In one of the earliest Malayan accounts of humoural theory, English scholar Thomas J. Newbold describes Malay medicine as being based on the fundamental “principle of ’preserving the balance of power’ within the four elements, specifically, air, fire, water and earth”.²¹ This ranges from the consumption of certain hot or cold foods (such as meat and fruit respectively), hot and cold temperatures, wind, micro-organisms and supernatural forces. Dry chills and dizzy spells arise when the “earth” element is too strong and from ailments such as cholera and dysentery, which are caused by excessive heat and moisture from the “air”.²² Consuming large amounts of food that contain “air” may cause feebleness in some. The plants and herbs prescribed by Malay healers help to revitalise and restore these imbalances in the human body.

Pawang, Bomoh And Bidan

Traditional Malay healers are the main providers of Malay medicine. To achieve the necessary credentials, some have resorted to living in solitude, spending their time meditating, fasting or putting themselves through strict dietary regimens – all in the name of spiritual cleansing. Healers are also expected to have an extensive knowledge of botany and nature so that they can classify and identify the right plants and herbs as well as their healing properties, and prescribe the correct remedies.

Pawang

A pawang is commonly defined as a shaman or general practitioner of magic who incorporates incantations into his craft. He is usually involved in conducting agricultural rituals and divination ceremonies to sanctify the village. Pawangs have also been referred to as “wizards” by scholars such as Richard J. Wilkinson for their ability to manipulate the course of nature through the use of incantations and divination practices.

Dukun/Bomoh

A dukun or bomoh is a general practitioner who treats fevers, headaches, broken bones, spirit possession and various ailments. The skills and reputation of a dukun/bomoh stem from the person’s knowledge of humoural medicine, the healing properties of local flora and fauna as well as syncretic ritual incantations. Some were well known for their treatment of victims of sorcery. The bomoh akar kayu (the latter words meaning “roots” in Malay) is known for his expertise in gathering and preparing ubat-ubatan from plants and herbs In his book, A Descriptive Dictionary of British Malaya (1894), Nicholas B. Dennys compares the dukun to “being on par with witch doctors of history”. Although the dukun has been generally described in disparaging terms by Western scholars, a small minority saw the merits of these traditional healers. Percy N. Gerrard defines the “doctor” as a bomoh, dukun or pawang in his dictionary, A Vocabulary of Malay Medical Terms (1905).

Bidan

Also known as “Mak Bidan” or “dukun beranak”, these midwives specialise in women’s health matters, including fecundity, midwifery and contraception, along with a variety of beauty-related disorders. Up till the 1950s, it was common for mothers in Singapore to deliver their babies at home with the help of village midwives. Today, the role of these women is limited to providing antenatal and postnatal care, such as confinement services for new mothers or general massage therapies.

References

Dennys, N.B. (1894). A descriptive dictionary of British Malaya (p. 104). London: London and China Telegraph. [Microfilm nos.: NL7464, NL25454].

Gerrard, P.N. (1905). A vocabulary of Malay medical terms (p. 24). Singapore: Kelly & Walsh. (Microfilm no.: NL27512)

Skeat, W.W. (1900). Malay magic: Being an introduction to the folklore and popular religion of the Malay Peninsula (pp. 424–425). London: Macmillan and Co., Limited. (Call no.: RCLOS 398.4 SKE-[GH])

Wilkinson, R.J. (1908–10). Papers on Malay subjects. [First series, 4], Life and customs (p. 1). Kuala Lumpur: Printed at the F.M.S. Govt. Press. (Microfilm no.: NL263).

References

Bala, A. (Ed.) (2013). Asia, Europe, and the emergence of modern science: Knowledge crossing boundaries. Singapore: Institute of Southeast Asian Studies. (Call no.: RSEA 509.5 ASI)

Haliza Mohd Riji. (2000). Prinsip dan amalan dalam perubatan Melayu. Kuala Lumpur: Penerbit Universiti Malaya. (Call no.: Malay RSEA 615.88209595 HAL)

Harun Mat Piah. (2006). Kitab tib: Ilmu perubatan Melayu. Kuala Lumpur: Perpustakaan Negara Malaysia: Kementerian Kebudayaan, Kesenian, dan Warisan Malaysia. (Call no.: Malay R 615.880899928 HAR)

Manderson, L. (1996). Sickness and the state: Health and illness in colonial Malaya, 1870–1940. New York: Cambridge University Press. (Call no.: RSEA 362.1095951 MAN)

Matheson, V., & Hooker, M. (1988). Jawi literature in Patani: The maintenance of an Islamic tradition. Journal of the Malaysian Branch of the Royal Asiatic Society, 61(1)(254), 1–86. Retrieved from JSTOR via NLB’s eResources website.

McHugh, J.N. (1955). Hantu hantu: An account of ghost belief in modern Malaya. Singapore: Donald Moore. (Call no.: RCLOS 398.47 MAC-[RFL])

Mohd. Affendi Mohd.Shafri & Intan Azura Shahdan. (Eds.). (2017). Malay medical manuscripts: Heritage from the garden of healing. Kajang, Selangor, Malaysia: Akademi Jawi Malaysia. (Call no.: RSEA 610.95 INT)

Muhamad Zakaria & Mustafa Ali Mohd. (1992). Tumbuhan dan perubatan tradisional. Kuala Lumpur: Fajar Bakti. (Call no.: Malay RSING 615.88209595 MUH)

Ong, H.T. (Ed.). (2011). To heal the sick: The story of healthcare and doctors in Penang. Georgetown: Penang Medical Practitioners’ Society. (Call no.: RSEA 362.1095951 TO)

Owen, N. G. (Eds.). (1987). Death and disease in Southeast Asia : explorations in social, medical and demographic history. Singapore: Oxford University Press. (Call no.: 301.3220959 DEA)

Mohd. Taib Osman. (1989). Malay folk beliefs: An integration of disparate elements. Kuala Lumpur: Dewan Bahasa dan Pustaka, Kementerian Pendidikan Malaysia. (Call no.: RSEA 398.4109595 MOH)

Tuminah Sapawi. (1997, January 8). Bidan kampung now offers massage and other rituals. The Straits Times, p. 17. Retrieved from NewspaperSG.

Wilkinson, R.J. (1908–10). Papers on Malay subjects. [First series, 4], Life and customs (p. 1). Kuala Lumpur: Printed at the F.M.S. Govt. Press. [Microfilm no.: NL 263].

Notes

1. The World Health Organization defines traditional medicine (also known as folk, indigenous or alternative medicine) as “the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”. Herbal medicines include “herbs, herbal materials, herbal preparations and finished herbal products that contain as active ingredients parts of plant, or other plant materials or combinations”. See World Health Organization. (2018). Traditional, complementary and integrative medicine. Retrieved from World Health Organization website.

2. The Kitab Permata from 19th-century Patani (southern Thailand) discusses the characteristics and medicinal properties of gemstones, minerals and metals. The text is commonly used by traditional healers in the north coast of the Malay Peninsula.

3. Blagden, C.O. (1896, July). Notes on the folk-lore and popular religion of the Malays. Journal of the Straits Branch of the Royal Asiatic Society, 29, 1. Retrieved from JSTOR via NLB’s eResources website.

4. Malay healers used Quranic verses to supplement the efficacy of herbs and medicinal plants. Supplications remain at the heart of Malay healing. A healer may choose to use only plants and herbs with supplications but without wafaq, while another may use fewer plants and herbs and more wafaq in his practice.

5. A prominent Patani scholar, Sheikh Ahmad al-Fathani, laboured his discourse in Islamic knowledge with the science of medicine. His manuscript, Tayyib al-Ihsan fi Tibb al-Insan, which was produced in 1895, was widely consulted by traditional healers in 20th-century Malaya.

6. John D. Gimlette was a physician who resided in the Malay state of Kelantan for many years and was extremely interested in the subject of Malay poisons, sorcery and cures. See Gimlette, J.D. (1915). Malay poisons and charm cures. London: J. & A. Churchill. (Call no.: RRARE 398.4 GIM-[JSB])

7. Gimlette, 1915, p. 106.

8. Winzeler, R.L. (1983). The study of Malay magic. Bijdragen Tot De Taal-, Land- En Volkenkunde, 139 (4), 435–458, p. 436. Retrieved from JSTOR via NLB’s eResources website.

9. Malay “doctors”. (1896, September 22). The Singapore Free Press and Mercantile Advertiser, p. 4. Retrieved from NewspaperSG.

10. Skeat, W.W. (1900). Malay magic: Being an introduction to the folklore and popular religion of the Malay Peninsula (pp. 424–425). London: Macmillan and Co., Limited. (Call no.: RCLOS 398.4 SKE-[GH])

11. Winzeler, 1983, p. 447.

12. Thomas N. Annandale was a Scottish zoologist, entomologist, anthropologist and herpetologist, who became interested in Malay animism, related magical lore and curers.

13. From pineapples (Ananassa sativa) and keladi (Alocasia denudata) to cheraka (Plumbaginasea), the poisons Gimlette examined have been described to contain active ingredients useful in the study of modern medicine.

14. Gerrard, P.N. (1905). A vocabulary of Malay medical terms. Singapore: Kelly & Walsh. (Microfilm no.: NL27512)

15. Anthropologist Thomas Fraser notes that in village processions led by the pawang who is healing a physically ill or possessed patient, the imam(Islamic worship leader) is also involved to officiate the ritual from a religious perspective. This prevents any possible conflict with Islamic beliefs that may border on shirk (idolatory or Polytheism).

16. Why fewer babies are now dying in Singapore. (1935, July 21). The Straits Times, p. 13. Retrieved from NewspaperSG.

17. In the Malay villages, traditional healers were involved in sanctifying the village via ceremonies and rituals, and were also involved in the affairs of the state. Known as the Maharaja Lela in Selangor or Sultan Muda in Perak, a bomoh enjoyed unfettered entry into the palace compounds.

18. Owen, N.G. (Ed.). (1987). Death and disease in Southeast Asia: Explorations in social, medical and demographic history (p. 258). Singapore: Oxford University Press. (Call no.: RSING 301.3220959 DEA)

19. Singapore. The Statutes of the Republic of Singapore. (1987, March 30). Sale of Drugs Act (Cap 282, 1985 Rev. ed.). Retrieved from Singapore Statutes Online website.

20. Singapore. The Statutes of the Republic of Singapore. (1999, December 30). Poisons Act (Cap 234, 1999 Rev. ed.). Retrieved from Singapore Statutes Online website.

21. Newbold, T.J. (2015). Political and statistical account of the British settlements in the Straits of Malacca, viz. Pinang, Malacca, and Singapore, with a history of the Malayan states on the peninsula of Malacca vol, 2 of 2 (p. 242). London: Forgotten Books. (Call no.: RSING 959.5 NEW)

22. Squeamishness, heartburn and fevers arise when the “fire” element is too strong. The “water” element causes damp chills and vomiting.