Georg Ivanovas From Autism to Humanism - systems theory in medicine
One of the differences between Western and Chinese thinking is the use of analogical concepts. This effect can already be seen in the writing. Western writing is digital, Chinese writing is analogical. As discussed before (chap. 3.7) analogical descriptions are able to express relations, whereas digital descriptions are better for logical operations. Every depicted Chinese word comprises already analogical associations.
The pictogram for CHI
is composed of
steam or vapour and (uncooked) rice
Therefore CHI (life energy) reads: steam over rice.
This seams strange to us and Chinese language is often characterized as rich in imagery. But this is more a problem of the translation. As in Western texts such analogies are only found in poems, Chinese language seems poetic to us. But for the Chinese this is the normal way of reading and thinking.
Analogical expressions are often sought of having more associations. But this is also a misunderstanding. There are not more, but different associations (analogical versus digital).
For us the liver is an organ with an anatomy and physiology. Examining a patient’s liver we might imagine the organ as in the anatomical textbook or in situ, or remember some microscopical preparations. We might think of the table of biochemical pathways every medical student knows. The size and consistence of a liver is important. We try to diagnose or exclude hepatitis or metastasis or anything else we have learned and experienced around the liver.
The Chinese liver (GAN) has different associations: Except of the local symptoms like swelling or pain, the liver is responsible for the digestion (constipation, diarrhoea). Also the desire or aversion for a certain food (fat or sour) is seen as liver-connected. A GAN symptom is the sour smell of the body. Moreover, all symptoms of the circulation, especially of the head with pulsating headache are connected to the liver. GAN influences muscles and tendons and is related to muscular tension, cramps (mainly of the legs) and to tendonitis. Every organ has a related organ. In the case of the liver it is the eye. So all kind of ocular symptoms are a liver sign. furthermore, the liver is connected to certain emotions, especially anger and mental flexibility (and the lack of it). For an orthodox thinking, all this seems to be unrelated. But there is the possibility to build a bridge between such different concepts.
The Chinese model of disease is functional. The disease of an organ (ZANG-XIANG) is not only an alteration of the organ itself. It includes every sign the alteration provokes. ZANG-XIANG has been translated as ‘reflectoral and algetical signs of an inner organ’ (König/Wancura, 1983: 13, my translation). By that it comprises not only objective signs and subjective feelings (König/Wancura, 1979: 121), but all vegetative impacts, neuromuscular relations, the representation on body surface and corresponding emotions, as well (König/Wancura 1979: 216).
A symptom of an organ is therefore (König/Wancura, 1979: 123):
- pain or alteration of the related body surface,
- disorder of the physiological and/or the Chinese organ,
- disorder in an related organ (other as the sick organ),
- certain characteristical feelings,
- characteristical emotional states.
These are (in Western terms) not only somatic, psychosomatic and psychological aspects. The Chinese diagnosis includes also the semiotic aspect. It includes every idea the organ stands for: heart for compassion, breath for immediate life experience, etc.
In Western medicine these are different subjects treated by different disciplines. The physician is mainly concerned with the anatomical and physiological aspect. Reichian psychotherapy and bioenergetics are concerned with the functional aspect, although they seem to match best the Chinese concept of organs. But they still miss the semiotic aspect which is mainly covered by psychoanalysis or Jungian psychotherapy.
What we see here is actually the split between body and mind, between objective and subjective that is inexistent in Chinese medicine.
A digital thinking has to be analytical and has to develop distinctions. This is neither good nor bad. But digital thinking is only one part. In communication it is the analogical expression that defines the meaning. Based on the knowledge of the relation between syntax and semantics it could be expect that Chinese medicine gives meaning to the processes but cannot be operationalised, as it lacks the adequate logical syntax. In my understanding Chinese medicine tries to solve this problem with a very strict structure.
This lack of an analogical thinking in Western medicine does not only distinguish it from its Chinese counterpart. This lack creates also problems. Human communication, dignity, order of life and many other already discussed issues are only understandable when analogical aspects are included. This might be demonstrated with the term heart (XIN). “XIN refers to the physical, emotional, and spiritual heart” (Jarret 1). In contrast, the heart in Western medicine is but a sophisticated pump. But this is not appropriate. The semiotic aspect of the heart is enourmous. Somone with a ‘broken heart’ has more often heart problems (Ebert 2005). And depressed people (where the heart is not able to accommodate SHEN the spirit) have a doubled risk to suffer a hear attack (Melle et al 2004). Of course, this can be attributed to stress (Gianaros et al 2005).
However, even the slightest impairment of the heart might have a lot of functional consequences for the patient. A pain or arrhythmias might cause a change of posture, of feelings and of behaviour. Also the knowledge of having a ‘heart problem’ induces in most patients a change in their behaviour and their life style. For the patient everything is included in this picture of the heart, from the last article in Men’s Health, over the poems and songs on broken hearts, to the picture of a sudden death. The same is true for the physician, he sees plaques, stents, spreading of electrical excitation, and, of course, sudden death, as well. To call this a psychological phenomenon is too restricted. It is the inherent semiotic aspect.