Dao of Chinese Medicine : Understanding an Ancient Healing Art
by Donald Edward Kendall, published by Oxford University Press, USA (2002-08-15)
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Dao of Chinese Medicine is the first Western text to shed light on the reality of the ancient healing arts of China, revealing that Chinese medical theories are based on important physiological findings. This is in contrast to the Western interpretation, popularized since the 1940s and 50s
that Chinese medicine and acupuncture involve undefined energy and blood circulating through imaginary meridians. Unfortunately, the energy-meridian idea condemned Chinese medicine to be viewed in terms of metaphysical beliefs, limiting its acceptance into mainstream health care. It also led to a
growing frustration to reinvent acupuncture in Western terms before understanding the true way (dao) of Chinese medicine. Dao of Chinese Medicine sets the record straight, explaining how ancient Chinese physicians developed a physiologically based medicine with the theories supported by human
dissection studies and how Chinese medical theories are consistent with 21st century explanations about how acupuncture works.
As an acupuncturist and MD I am certainly interested in ideas about how acupuncture works. But I do not expect someone to tell me that his view of acupuncture is the 'true way' or therefor all other ideas about acupuncture, including the 'meridian' idea and the 'energy' idea are wrong. And that is exactly what Donald Kendall does.
Acupuncture in its various forms has always been very opportunistic in the good sense of the word: when an idea works it is a good idea (even if it is 'wrong'), if it doesn't work it is not a good idea, (even if is 'right').
So: it is very interesting to read that Chong Mai is in fact the aorta, Ren Mai the vena cava and so on, but this does not help my patients. Abolishing the concept of 'qi' as 'energy' circulating through 'meridians' certainly harms my patients, because in my practice this concept is extremely useful, versatile and elucidating. And so are the 'metaphysical' aspects of Chinese Medicine.
It is certainly possible to research the working mechanisms of acupuncture and the correlations to Western anatomy and physiology while retaining the 'meridian' concept. Outstanding examples of this approach are "Hara diagnosis - reflections on the sea" by Stephen Birch and Kiiko Matsumoto, and "Chasing the Dragons Tail" by Yoshio Manaka, Kazuko Itaya and Stephen Birch. Those are books I do read over and again and still find new insights and am invited to find out my own 'Dao'. I don't expect I will ever read Donald Kendalls book again, although it certainly did help me in finding out why trying to find one-to-one correlations between Chinese and Western medical concepts is not part of my 'Dao'."Why does anyone care whether Chinese anatomy and physiology are explained as energy flowing through meridians, or by the circulation of blood, nutrients, other vital substances, and vital air (qi) through the vascular system? The answer to that lies in the moral obligation of every practitioner to provide each patient with the latest medical understanding available. The need to continually search for the truth is the most fundamental principle of science and medicine... Research so far shows that the true concepts of Chinese Medicine operate under known physiological principles, involving the complex organization of the neural, vascular, endocrine, and somatic systems, sustained by the circulation of nutrients, vital substances, and oxygen from vital air."
- Donald E, Kendall, "Dao of Chinese Medicine" (2002).
Kendall makes excellent points, but I just want to clarify a few things.
I think people care about using "energy" concepts as opposed to anatomy/physiology, apart from the mere functional clinical usefulness of using the "energy" model as generally understood in Western TCM, because the idea of Qi and Yin and Yang helps to connect us with some sort of universal Spirit and sense of belonging. But we must distinguish very carefully between the type of "scientism" that explains something in material and physical terms and attempts to reduce it to merely that and denies any reality to anything else, and the type of science that looks for the mechanisms for exactly how Spirit is allowed to operate in the manifest realm.
Let us imagine a hypothetical situation in the future (or near-future, if Kendall is to be believed) where biomedical science had advanced to the point where everything in TCM physiology was explained in biomedical terms, in a non-reductionist way that took the big picture and Bian Zheng into full account. The process would have meant, inevitably, that some things TCM held to be true are thrown out, and some things are added.
The point is, if a great majority of what the ancient Chinese discovered so long ago, through their own senses and their understandings of the relatedness of things on the micro and the macro levels, is confirmed in physical mechanistic terms by the very latest in scientific understanding, this actually has the effect of elevating the Spirit rather than dragging it down. How could anyone continue to believe in an uncaring world of dead particles bumping randomly into each other, when the said dead particles accidentally reflect the principles of Yin/Yang in the body/mind and its relationship to its environment? Instead of, as we might have feared, science having the effect of flattening everything into existential meaninglessness, it would instead illuminate how all (even when modelled with precise mathematical equations) is actually alive with the numinous!
At the present moment clearly, the predominant belief system in the scientific community is not yet ready to encompass and be able to accept such a reality. That itself is a very good reason to hold on to the classical Qi physiological concepts, because they are the best models we have to repeat the empirical experience of the Zhongyi that precede us in treating those that seek our aid now. Since the classics are written in pre-modern language, learning Qi physiology properly on its own terms is also vital to get access to this wealth of knowledge and experience. Also the fact is that Qi/Yin/Yang will always be more accessible to the individual than the minutiae of endocrine, neurological, connective tissue and vascular response mechanisms, and therefore 1) always a useful lens with which to translate clinical reality, 2) more understandable to the average patient that wants to regulate their own life and 3) good news for the aspiring practitioner that simply does not have the intellectual/rational capacity to think in biomedical terms, but have talents elsewhere that more than make up for it.
But holding onto classical Qi physiology does not and should not mean turning a blind eye to the latest discoveries in science, and not encouraging further understanding in this area. Also in my opinion, only science has the power to translate the important insights of Chinese Medicine into changing the way medicine is practiced on a societal or even world scale - quasi-mystical and ethnocentric concepts, however functional and "real", do not.
TCM and modern biomedical science have great potential to extend and improve each other, working side by side for the benefit of all. But for integration to happen whilst fully honouring the truths each has to offer requires a new outlook transcending both existing Western and Eastern epistemology. If you want to have some sort of idea of what the kind of rigorous science that has the capacity to fit Spirit, Qi, Yin/Yang and consciousness into its framework could look like, I highly recommend reading "Marriage of Sense and Soul" by Ken Wilber, and looking into http://www.integralinstitute.org/ .I'm an acupuncturist, AND an author who puts Chinese medicine (CM) into layman's terms (see PulseMed.org). One of the most difficult things to explain is "What is qi?" and it's not fun responding to objections that Chinese medicine is unscientific or even occultic.
Kendall's book is an academic and scientific answer to these problems, a more accurate revision of our Western understanding of Chinese medicine, and a resource for all future western improvements on this ancient system.
As Philippe Sionneau says, and Kendall echoes, we must know Chinese medicine - what it really was in the past - before we can innovate intelligently.
Both Kendall and Paul Unschuld are doing a great service to English-speaking acupuncturists by using their scholarly skills to uncover more truths about Chinese medicine, and to question some of the popular conceptions of CM in the West. Of course, I don't take everything they say as gospel - I wonder about Unschuld because it's said he doesn't really like Chinese medicine, and we know he doesn't practice it. Yet, Unschuld's being an outsider can be a good thing, because criticism often leads to "iron sharpening iron," an improvement in our knowledge and understanding, or at least in our ability to cogently argue one side of an issue. Kendall, on the other hand, has practiced and taught Chinese medicine for decades.
I think some people in my profession will hate this book. Many of the "traditional" acupuncturists in America, as in France, are hopelessly enamored with the false idea of energy circulating in meridians, and some have even made this an integral part of their personal spirituality. They may not listen to Kendall's findings.
Some of my peers do not embrace "medical" acupuncture, an approach that Kendall claims and I agree is common sense: that we should learn Chinese medicine, then understand its parallels in Western medicine, and even subject CM theories to scientific validation.
Kendall explains what damage our misconceptions about CM have done to the system itself, and how it has slowed the Western medical community's ability to take it seriously and examine its insights.
I haven't read the whole book yet... indeed, some of it must be studied, and may be beyond those without a good grounding in neuroscience and immunology, but I think learning them in this context is well worth the effort. I'm happy to have a lot of the information about the neuro and immunomechanisms of acupuncture all in one place - I've seen some of this in various essays or studies, but this presentation includes drawings. And that is one strength of the book- most people are visual learners, yet so many books use only words. Kendall includes a plethora of charts and drawings.
This may not make it easier to explain acupuncture, but it will make our explanations a lot more credible. My patients always respond better to my explanation of acupuncture, which is based on neuroscience and PETScan findings, than they do to theories of energy circulation, and those I've told about Kendall's tying meridians/vessels in with blood vessels and qi with nutrients (ying) and oxygen immediately said, "That makes more sense."
Thank you Deke!As a Western-trained biochemist and a critical commentator of Chinese Medicine, I read Donald Kendall's book with keen interest. For more than two decades since the rise of popularity of acupuncture in the West, Chinese Medicine has been regarded as any other folklore medicine derived mainly from empirical experience with little scientific basis, despite the fact that it has been practiced for over two thousand years and has long been the only mainstream healthcare system in China until recent century. Even today, this healing art is still practiced as a complementary medicine in China and in overseas Chinese communities.
In recent years, the quest for herbal-based alternative medicine in the West has made Chinese Medicine increasingly appealing not only to the ordinary populace, but also to western medical professionals. This ancient healing art is said to have embraced the environmental, nutritional as well as emotional influence in its etiology and be capable of providing individualized therapies which could only be realized by the future pharmacogenomic approach.
However, to most westerners Chinese Medicine is as mysterious as the Chinese Ancient Civilization it belongs. The reasons could well be that the classical cannons of this healing art are all written in very concise and hard to understand ancient Chinese, and its underlying therapeutic principles are shrouded in the ancient Chinese worldviews of Five Phases and Yin-Yang. Furthermore, most attempts in the past to interpret the principles of Chinese medicine either do not properly recognize the ultimate consistency of its functional organ concepts with modern physiology, nor all together misunderstand its essential theories of disease etiology and balance of Yin & Yang due to inaccurate translation of the some of the critical concepts. All these have led to the misperception that Chinese medicine is a totally outdated traditional therapeutic system passed down merely by generations of empirical healing experience, with little scientific basis for verification and hard to reconcile with nowadays mainstream western medicine.
It is therefore an intellectual delight to find in Dr Kendall's new book "Dao of Chinese Medicine" a fresh interpretation of this oriental healing art in terms of modern physiology. The content of this book is logically laid-out in fifteen chapters starting from the quest for the Dao, i.e., the way, and the ancient beginning of this healing art, to the interpretation of many important concepts and principles of Chinese medicine, and finally to the different approaches in diagnosis and treatment which were adopted by the Chinese physicians over the centuries and are still practiced today.
From the start, what makes this book different from most existing English texts on Chinese medicine is that Kendall derived his source material by taking on new and more accurate translations of Huangdi Nei Jing, the most reverend cannon of Chinese medicine, and successfully demystifies the misleading idea that Chinese medicine is on based energy circulation through invisible meridians. As the readers will discover, ancient Chinese medicine is not just based on an ancient philosophy of Five Phases and Yin-Yang, but is firmly rooted in empirical physiological studies, which includes, against common customs of the time, post-mortem dissection.
... I consider Dr. Kendall's book a major achievement in introducing Chinese medicine to the West in ways even Dr. Joseph Needham could not achieve in his monumental work of "Chinese Science and Technology". With over 200 citations to more than 80 treatises of the Nei Jing, this book reveals the rational basis of this ancient healing art with modern insight which will be instrumental for future application, research and acceptance of Chinese medicine in the West. The Dao is a must read for students, practitioners of Chinese medicine as well as other health specialists and individuals who would appreciate the fascinating story of the great indigenous medicine of China.
By: Kenneth J.T. Li, Ph.D.,D.Sp.
Former Assistant Director, R&D, School of Chinese Medicine, Hong Kong UniversityWow! What a tour de force...scholarship, readability and impact! Someone finally makes acupuncture and Chinese Medicine REAL! If this were widely read, the medical profession would be more likely to give Chinese medicine the respect it deserves and the public would be even more enthusiastic about it. The western medical profession has largely patronized Chinese Medicine. The Dao of Chinese Medicine makes a strong case that this dismissal of Chinese medicine is misguided, and based upon flawed interpretations. Western writers early on misunderstood the historical origins of Chinese medicine and popularised the idea of an unknown "energy" coursing through imaginary "meridians". Dr. Donald Kendall in the Dao of Chinese Medicine sets the record straight in this refreshing book.
Dr. Kendall has long been respected in the international acupuncture community for his lucid explanation of the physiological mechanisms of acupuncture and for his attempts to bring the educational standards of the western medical model to the profession. Kendall is a scholar who reads the ancient texts in the original Chinese, and a highly successful Chinese Medicine practitioner and teacher. In the Dao of Chinese Medicine, he extends his reach to the full scope of Chinese medical theory and practice. Kendall has the gift the late Isaac Asimov had of making the complex and esoteric understandable. Primarily a textbook for western and Chinese medical students and doctors, it will also find an audience with healthcare decision makers and the public. Those who are inspired by a vision of a healthcare system integrating the best of conventional and traditional medical systems, will find their spirits soaring after reading Kendall's book. Medical doctors, academic and clinical researchers and medical practitioners of every stripe will feel far more confident about the rationale and validity of Chinese Medicine.
This is an academic book but it is also a great story. Kendall's documentation is meticulous and his style is engaging. The Dao of Chinese Medicine reveals an ancient medical system that stands up well to scientific scrutiny. Chinese medicine comes off as the equal of western medicine in many respects, and as its superior in other respects, particularly in its emphasis on prevention through attention to building immune function. Kendall traces the development of Chinese medicine from its roots in physiological studies including post-mortem dissections. This lead to a number of pioneering medical "firsts" including detailed descriptions of the cardiovascular system, the original discovery of blood circulation, the earliest descriptions of the immune system, information about the spinal cord, sensory and motor nerves, and the organization of the musculoskeletal system.
William Harvey's explanation of blood circulation in 1628 is considered the greatest single event in Western medicine. His work led to an era of scientific exploration in medicine and to the rejection of the mistaken ideas of Greek and medieval medicine embodied by Hippocrates and Galen. The fact that Chinese physicians made this discovery two millennia before Harvey does not diminish Harvey's extraordinary breakthrough, but it does put it in historical context.
The Dao of Chinese Medicine repudiates the notion that Chinese medicine is inscrutable, nonsensical or illogical. Kendall accurately translates the original source material and crosschecks it against contemporary scientific research, and so unveils the genius of the ancient Chinese physicians.
HMO administrators, clinical directors, and medical doctors now have the ability to appreciate the expanded range of valid options available for patient care. Other implications are the enhancement of patient choice and reduced healthcare costs, as safe, non-invasive, drugless alternative modalities of Chinese medicine can be justifiably and responsibly selected where they are appropriate. Students of Chinese medicine have a way to explain what they do in terms accepted by the consensus reality and to achieve more consistent and repeatable results through a deeper understanding of how the body and its internal and external aspects interact. The health-conscious public now has available a definitive source for gaining better understanding a medical system which may significantly improve the quality of their lives.
This groundbreaking book serves the international community well and enhances the concept of an integrative "world medicine". Five stars and two thumbs up!
Steve Paine, OMD
Listed Chinese Medicine Practitioner (Hong Kong)
Licensed Acupuncturist (Hawaii)
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