Schools of Thought in Traditional Medicine

by Adam Tate, 2012



Introduction

In Traditional Medicine there are various Schools of Thought governing the practices of the disciples of that School. These generally go back to an idea put forward by a well respected classical Physician or Philosopher, such as Hippocrates or Mesue. Each School proposes a specific aspect as being most important in the treatment of disease in general–a bias, we can call it. And this bias changes the way they view the disease, and what is required in the treatment of disease.

The Schools

1. PURGING SCHOOL ‘He who purges well, cures Well’. Perhaps the most ancient of all the Schools of thought was the purging school. In ancient times, strong purging medicines were seen to have a sudden, miraculous effect, and were often credited with curing serious symptoms very quickly. Purging is intimately connected with the Humoral theory as purging aims to carry off excesses of the Humors. This is why TCM has relatively little regard for purging medicine. Purging aims to clear excess Humors and foulness from the body in order to both clear the pathogen, as well as freeing the system up in order to help it.

Traditionally it was said that to purge in excess or obstruction was to tonify.

Purging may include different applications such as Bloodletting, Vomiting, promoting Urine or Menstruation, or Sweating. However, most typically it refers to purgative medicines.

The Western Tradition, and especially the Arab-Unani aspect of that tradition, places great importance on purging. Mesue in particular created many, great purgatives for each of the Humors which were widely used for centuries after him. Mesue was called ‘The Physicians Evangelist’, as his formulas and prescriptions in the treatment of diseases were so certain.


2. ‘EARTH SCHOOL’

‘All diseases begins in the Stomach’.

The ‘Earth School’ is another ancient foundation of treatment which focuses heavily on digestion (the system related to the Earth Element within the body).

As Hippocrates said 2400 years ago, ‘All diseases begins in the Stomach’. Digestion, according to the Humoral systems of the Greeks and Indians, produces the Humors. Therefore, if they are out of balance, Digestion (and Diet) is generally the origin. And in any case, ALL imbalance and diseases in the body should first be treated by diet therapy, both the restriction of that which will increase the imbalance, the the application of foods that will help correct the imbalance: ‘Let your Food be your Medicine, and your Medicine, Food’ (Hippocrates).

So a great focus on proper digestion has long been the focus in Traditional systems.

In their own way, each system can be said to be partly of the Earth System. Hippocrates stated ‘All diseases begins in the Stomach’; the Indian Tradition places great emphasis on stoking the digestive Fire to create effective digestion with a reduction in Ama, the toxic residue of undigested food. TCM likewise puts great importance on the digestive system as a whole, and there is a strong ‘Earth School’ following in TCM.

3. WARMING SCHOOL

‘Always cherish the Natural Heat’

In most of the ancient medical systems, there is a great focus on warming medicines. They were applied to quicken and promote both digestion and circulation, and thereby, work to help the body help itself. The Warm School is in a way a by-product of the Earth School, because digestion, assimilation and distribution of nourishment, all depend greatly on Natural Heat. Ancient Philosophers realised that warmth equated with human life and coldness with death. Therefore, cherishing the Natural Heat was of paramount importance.

Many of the Greek and Indian formulas rely heavily on heating, pungent spices, often even when treating Heat diseases!

The Shang Han Lun (Treatise on Cold disorders) is one of the seminal texts of TCM, and has the premise that Cold and Yang deficiency is the origin for many diseases, esepcially acute diseases. The recent popularity of the Chinese ‘Huo Shen Pai’ (‘Fire Spirit School’) from Sichuan in far western China also supports this general belief. There, the restoration and regulation of the bodies Yang Qi is regarded as the principle of treatment for almost all disorders.


4. OPENING SCHOOL

‘All diseases begins with Obstruction’.

A fundamental tenant in Traditional Medicine is the concept that disease cannot remain in the body if there is no obstruction. Or, to put it another way, it is an obstruction within the body which allows a diseases process to be initiated and progress.

And where does this obstruction come from in most cases? Digestion. Therefore, the opening School has a certain amount in common with the Earth School of thought, and also with the Purging School, as purging may often be used in Obstruction.

If we think about a bacteria entering the Bladder, the bacteria itself is not a problem, it is the ability for the bacteria to find a location to multiply. After this, a disease process involving inflammation and immunity is initiated to fight the infection, and symptoms present. BUT, if the bacteria does not have a place to lodge and multiply within the body, it will most likely be passed out of the body, be killed, or die.

This is, of course, why certain people are prone to infection, while others avoid infection, even when exposed. It is often nothing to do with a weakened immune system as is so often stated by Naturopaths, but rather, from obstruction.

Likewise with Rheumatism. Ayurveda terms Rheumatism Ama-Vata (Ama, meaning the toxic residue or undigested food, and Vata, meaning Wind). Similarly, TCM regards Rheumatism to be caused by Wind and Damp (the Damp being analogous to the Ama of the Indian system). In these concepts, Damp is the obstruction, fed by faulty digestion. Wind, or nervous dysfunction, facilitates the disorder.

So in these examples, and many others, obstruction is the initiating cause of illness. In this School of Thought, the body is kept ‘open’. This refers to keeping the body ‘soluble’ by keeping the bowels open, and also to the use of Opening Formulas, generally formulas that may clear Cold / Wind / Damp and/or Phlegm, while activating Qi / Blood / Digestion and/or Circulation.

5. TONIFYING SCHOOL

‘All diseases begins with Deficiency’

Another School of thought proposes that (nearly) all illness comes from Deficiency. Or, to put it another way, nothing will penetrate the bodies initial defenses if the body is strong enough.

Actually, it is more like a set of scales. If the pathogen ‘weighs’ 5, but the bodies vitality ‘weighs’ 7, the body will beat the pathogen. BUT, if the pathogen is 11, and the bodies defenses are at 10, the pathogen will win, even though the body is not weak.

This School of Thought is especially important for the old, the young, the weak, and those with chronic illness.

It could be said that TCM is, generally, of the Tonifying School in that TCM places more importance on tonifying and strengthening the body than humoral systems. Modern TCM especially has been geared to support deficiency and the tonic herbs are in general some of the most used medicines.

In practical application, we are of course often supporting the body while attacking one or more pathogens.


6. HARMONIZING SCHOOL

‘Health is the state of Balance, Balance is achieved with Harmonizing’

This school of reasoning is principally to be found in TCM, but interestingly, is also found in the Western Graeco-Arab system.

In TCM, Harmonizing formula usually refers to Harmonising the Liver and Spleen. The implications of this are quite profound. The Liver is associated with the Air Element (Wood in TCM), the Spleen, with Earth. So the balance and control of the Nervous system is greatly related to the balance between these two organs. If someone is not ‘grounded’, they are often referred to as ‘Air-heads’, or are said to have their ‘head in the clouds’. Thus, strengthening the Earth Element helps to ground them.

Further, being of the Earth Element, our Spleen is greatly associated with our Mind and Mental body, while the Liver (Air-Wood Element) is associated with our Emotions and our Emotional Body. Like the Earth, our Mind is rational and stable; like the Wind, our Emotions are flippant, quick-changing, and often irrational. So the balance between our mind and our emotions is centrally rooted in the fine balance between the Liver and Spleen, the Elements of Earth and Air.

But Harmonising is not only associated with the Liver and Spleen. We may say all formulas that promote harmony between the opposites are Harmonising. So the balance between the Heart Fire and Kidney Water, and the Balance between Yin and Yang are all associated with Harmonisation.

Further, Harmonising can even refer to Harmonising the Surface and Interior of the Body, or Harmonising the Qi and Blood, for example.

Conclusion

In the end, we will often use all the above Schools of Thought in different areas of our practice. But it is good to reflect on the different concepts of treatment in order to apply a different tactic if the one we are using is not working in a particular case. And it is good to realise that any one person or type of condition could be treated by each School in a radically different way, and perhaps with similar benefit.

Further, it is worth noting that in chronic, complex and obstinate cases, it is common to have to use most or all of the above strategies, either at different phases of treatment, or in some cases, simultaneously.

The classic examples of these are the Tibetan Jewel Pills. These large and complex formulas are specifically aimed at chronic and obstinate diseases. These are diseases where all the Humors are affected, all organ-systems involved, and there are opposing forces that need to be simultaneously treated. Therefore these Pills combine both hot and cold medicines, strengthening and draining medicines, consolidating and dispersing medicines, along with medicines that strengthen digestion and promote circulation.

The icing on the cake is the addition of gem stones which are credited with correcting the Qi of the organs, harmonising Planetary imbalances (as seen in the Natal chart) and consolidating the Spirit, therefore correcting severe imbalances and curing otherwise incurable diseases.