Note: As always, if you’d like to book an online appointment with me, click here or respond to this email and I will be more than happy to connect.
Hello Everyone,
It is a misty morning here in the mountains of Southern Vermont. The trees are still leafless, though the signs of spring are beginning to emerge and buds are just starting to open. This is one of my favorite seasons—there is a feeling of new beginnings and as-yet-unexpressed potential.
In June I will be fully opening my private practice in Wilmington, a cute small town nestled in the Deerfield Valley. As many of you know, I have practiced in a number of different settings over the years—in busy clinics, substance abuse centers, hospice care facilities, homeless shelters, community clinics, and in house calls in Southeast Asia. In my new practice, I am going to be working with a new model for seeing clients. I will be working in a way that is slower, more methodical, and less rushed, seeing one person at a time, with ample space to let the healing process unfold, giving each client my fullest attention.
This way of working will allow me to give greater focus to some of the foundational tenets of Chinese medicine; specifically, its orientation around preventative care. Beyond treating people who have fallen ill, Chinese medicine excels at helping people to optimize their health and well-being, so that they may be able to address patterns of imbalance before they ever manifest as life-interrupting symptoms.
Here are a few thoughts about the way that Chinese medicine understands this process:
Three Levels of Treatment
The central importance given to living a healthy lifestyle in the Chinese medical tradition is affirmed by its understanding of the hierarchy of medical intervention, which is clearly articulated in the classical texts. The highest form of medical practice is preventative, and we are told in text after text that the superior practitioner treats disease before it even manifests, by keeping someone in a robust, healthy state. Using another plant metaphor, the Neijing Suwen states that "the superior practitioner stops [a disease's] sprouts ...the inferior practitioner stops what has already fully developed." In the earliest Materia Medica of the tradition, the Shen nong ben cao jing, herbs are classified with reference to this idea, with the highest level herbs being primarily used to promote wellness and spiritual elevation, the middle level with the prevention of illness, and the lowest level herbs with the direct treatment of disease.
In this Materia Medica, the upper herbs are generally prescribed in smaller quantities and taken over long periods of time to supplement the body's qi,lightening the body and lengthening the lifespan. These herbs do not actually treat illness, but rather promote health. In this way, they are used almost as dietary supplements. The second tier of herbs, the 'middle herbs,' treat deficiencies that may allow illnesses to enter the body, as well as hold back illness or keep it from progressing. Whereas the top grade herbs promote health, the middle-grade herbs help to prevent illness. The third class of herbs, the 'lower' herbs, are those that actually treat illness, halting its progression and reversing its course. The text of the Shen Nong Ben Caotells us that the upper herbs 'nourish vitality,' the middle 'nourish physicality' and the lower 'treat illness.' The reason that the upper herbs are given such high esteem is clear: if one utilizes them to great effect, nourishing their vitality properly, one can prevent the development of imbalances that would require the use of the middle-grade herbs, and the lower-grade herbs become completely irrelevant.
It was this same principle that motivated the organization of the imperial medical hierarchy as far back as the ancient ZhouDynasty, which lasted from 1046 to 256 BCE. During that time, the imperial doctors were divided into three classes. The highest-level practitioners were dietitians, the mid-level practitioners acted as general doctors, and the lowest-level practitioners were surgeons. The logic of this hierarchy is found in the fact that if you can rectify an imbalance with dietary changes, it will never progress to the point of having to be treated with medicines, and if it is properly treated with medicine, it will never develop into such a severe state that surgery will be necessary.
This hierarchy of treatment is, notably, the exact opposite of the medical hierarchy in modern Western medical culture, in which surgeons are given the most prestige, make the most money, and are most highly respected, whereas nutritionists and dietitians are barely considered full medical practitioners. Sadly, today it is extremely uncommon for MDs to place great emphasis on diet over and above intervention with pharmaceutical medications or surgery. This is a general reflection of the ethos of modern Western medicine, which is focused on treating illness but far less on actively promoting wellness. Unfortunately, the emphasis on preventative healthcare has been diminished in modern forms of Chinese medicine as well. This is because many in the field are trying to integrate their work with the dominant medical paradigm of our time, finding ways to fit Chinese medicine in with Western medicine. Because Western medicine does not place as great an emphasis on the cultivation of health in everyday life, modern forms of Chinese medicine are increasingly neglecting this essential aspect of the tradition.
Whether one is seriously ill or enjoys relatively robust health, bringing the inner ecology of the body into greater harmony will help support their life. Unfortunately, modern treatments for most types of illness often do not place enough emphasis on optimizing various facets of lifestyle to promote this kind of internal harmony. In my clinical experience, however, such intervention is often necessary to get reliable and lasting relief. In modern society, we have been conditioned to think that all medicine must come in the form of a drug, but often the best medicine comes from the food we eat, the rest we get, the way we move our bodies, and the mindset we cultivate.
Note: As always, if you’d like to book an online appointment with me, click here or respond to this email and I will be more than happy to connect.
Aidan Keeva, DACM, L. Ac.,
Doctor of Acupuncture and Chinese Medicine