The State of Traditional Chinese Gynecology in the West
In the context of my most recent book publication, a translation and discussion of the first section of an important thirteenth century text on gynecology (read more here), I have been thinking a lot about the current state of clinical practice of what I call “traditional Chinese gynecology” in the West. To be frank, for years now I have been hearing or reading statements that are appalling to me in their arrogance and ignorance vis-a-vis what I consider one of the crowning achievements of traditional (note the small “t”) Chinese medicine. And yet, they claim to represent this grand tradition, to be taught in a formulaic “paint-by-numbers” approach of matching a limited number of formulas and point prescriptions to a few basic symptoms and very rudimentary binary distinctions like hot and cold and full and empty (or deficient and excess).
Indeed, one of the beauties of Chinese medicine is its elegance and simplicity, and yes, once you have learned it, it can from the outside appear very simple and natural, like a dolphin’s swim or a Mongolian kid hanging upside down from a racing half-wild pony (as I witnessed myself), or like making the perfect batch of goat cheese. All it contains is fresh goat milk, a few drops of rennet, and a tiny amount of starter culture. And yet, the end result depends on what the goats ate the day before and what breed they are, where they are at in their reproductive cycle, the health of their rumen, the temperature of the milk, the time passed between milking and adding the culture, the time and temperature during fermentation, the container used to sour the milk, the way you cut the curds and strain the whey, the way you fold the salt in, even the ambient wild cultures in your kitchen and (I swear) the love you dedicate to what is for me a multi-day process.
Easy for me since I’ve been doing it for decades, and yet, I doubt I could teach it to you in a couple of hours. Alternatively I could package my skill in a super expensive 2-week course full of detailed scientific information on this and that, with tables of comparing the reactivity of stainless steel to glass to ceramic containers and analyzing vegetarian versus calf-based rennet etc etc. Neither of these approaches would be completely wrong, and each would be helpful and appealing to some people but not to others.
Chinese medicine is like that as well. Many people love the brainy approach and believe that highly demanding 6-year full-time programs are necessary to raise it to a level where it can be taken seriously by our culture at large as the true powerful alternative to the dominant biomedical paradigm that it deserves to be, along with fancy degrees and huge profits. Others like to simplify it down to a few points or basic rules or substances that can be taught to midwives, nurses, or even people practicing dry needling or dietary consulting. Both approaches have their merits. Chinese medicine has, after all, been large enough historically to accommodate everything from “barefoot doctors” to pharmacists, herb gatherers with a roadside shack, shamans, acupuncturists, midwives and other “troublesome” old ladies, dignified scholar physicians with a crowd of assistants, and professors in university departments.
This said, what I see and experience as being taught, tested, and practiced under the banner of “TCM Gynecology” as supposedly representing the state of the art on traditional Chinese treatments for the female body strikes me as quite inadequate when compared with what this powerful tradition truly has to offer, especially in the context of “attuning” the blood. And this holds true both for the historical literature through the ages ever since the Song dynasty as well as for contemporary practitioners of Chinese medicine in East Asia. There may not be another field in Chinese medicine where I see such a contrast between the teachings and literature and clinical practice in the West, on the one hand, and their equivalent in East Asia on the other. Please correct me in the comments if I am wrong. Of course there are some very notable exceptions, and I am going to prepare a webpage shortly with English-language resources on traditional Chinese gynecology. The purpose of this blog is merely to alert those of you who do not understand East Asian languages that what you have learned or are learning and reading may not be all there is to what Chinese medicine has to offer and that you need to take things with a grain of salt, follow your heart and intuition, and search out those precious resources and teachers that are in fact out there. There is so much that Chinese medicine has to offer in the care of the female body from all its many different angles. Please, let’s all get to work together and tap this amazing potential for the benefit of your female patients, family members, neighbors, and friends! Please try to prove me wrong by sharing worthwhile avenues for education in traditional Chinese gynecology in the comments. I am compiling my own list but I am sure I am missing many voices.