THE WEB THAT HAS NO WEAVER Understanding Chinese Medicine “The Web That Has No Weaver opens the great door of understanding to the profoundness of Chinese medicine.” —People’s Daily, Beijing, China “The Web That Has No Weaver with its manifold merits … is a successful introduction to Chinese medicine. We recommend it to our colleagues in China.” —Chinese Journal of Integrated Traditional and Chinese Medicine, Beijing, China “Ted Kaptchuk’s book [has] something for practically everyone . Kaptchuk, himself an extraordinary combination of elements, is a thinker whose writing is more accessible than that of Joseph Needham or Manfred Porkert with no less scholarship. There is more here to think about, chew over, ponder or reflect upon than you are liable to find elsewhere. This may sound like a rave review: it is.” —Journal of Traditional Acupuncture “The Web That Has No Weaver is an encyclopedia of how to tell from the Eastern perspective ‘what is wrong.’” —Larry Dossey, author of Space, Time, and Medicine “Valuable as a compendium of traditional Chinese medical doctrine.” —Joseph Needham, author of Science and Civilization in China “The only approximation for authenticity is The Barefoot Doctor’s Manual, and this will take readers much further.” —The Kirkus Reviews “Kaptchuk has become a lyricist for the art of healing. And the more he tells us about traditional Chinese medicine, the more clearly we see the link between philosophy, art, and the physician’s craft.” —Houston Chronicle “Ted Kaptchuk’s book was inspirational in the development of my acupuncture practice and gave me a deep understanding of traditional Chinese medicine. This new edition is essential reading for all those who wish to learn about and practice acupuncture. Dr. Kaptchuk’s understanding of traditional Chinese medicine and the way he is able to capture and express concepts within the text make learning about acupuncture a wonderful and inspiring experience.” —Dr. George T. Lewith, Honorary Senior Research Fellow, Honorary Consultant Physician, School of Medicine, Respiratory, Cell & Molecular Biology Research Division, University of Southampton “This revised version of an essential classic on Traditional Chinese Medicine is a gift for all who share an interest in deep understanding of healing. Ted Kaptchuk is a unique figure in complementary medicine. His combination of scholarship, wisdom, and compassion provides a remarkable window into one of the greatest of all healing traditions.” —Michael Lerner, President, Commonweal, a California Nonprofit Corporation, author of Choices in Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer “Ted Kaptchuk is without question one of the most innovative thinkers in the area of Traditional Chinese Medicine. This new edition is a brilliant synthesis of traditional and scientific knowledge. It is compulsory reading for anyone with a serious interest in this area.” —Professor Edzard Ernst, M.D., Ph.D., Director, Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter “In the 20th century, modern China rescued its traditional medicine from oblivion at the cost of removing its soul; in the 21st century, Dr. Kaptchuk has put the ancient discussion of soul back into Chinese medicine. This new edition integrates the seemingly opposing paradigms of ancient Chinese medicine and modern biomedicine and interprets the classical Chinese views on spirit in relation to the medical and existential aspirations of modern humankind.” —Giovanni Maciocia, Honorary Lecturer, Nanjing College of Traditional Chinese Medicine and author of The Foundations of Chinese Medicine THE WEB THAT HAS NO WEAVER Understanding Chinese Medicine TED J. KAPTCHUK 2nd Edition McGraw-Hill New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Library of Congress Cataloging-in-Publication Data Kaptchuk, Ted J., 1947–. The web that has no weaver: understanding Chinese medicine / Ted J. Kaptchuk. — 2nd ed. p. cm. Includes index. ISBN 0-8092-2840-8 1. Medicine, Chinese. 2. Medicine, Chinese—Philosophy. I. Title. R601.K36 2000 610'.951—dc21 98−53193 CIP Dedicated to the memory of Ted Gold, my grandparents, and relatives who died for the Sanctification of the Name Copyright © 2000 by Ted J. Kaptchuk. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 19 20 21 22 23 24 25 D0C/D0C 1 9 8 7 6 5 4 ISBN 0-8092-2840-8 Cover design by Monica Baziuk McGraw-Hill books are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more information, please write to the Director of Special Sales, Professional Publishing, McGraw-Hill, Two Penn Plaza, New York, NY 10121-2298. Or contact your local bookstore. This book is printed on acid-free paper. CONTENTS ACKNOWLEDGMENTS FOREWORD BY MARGARET CAUDILL FOREWORD BY ANDREW WEIL AUTHOR’S NOTE THE PINYIN PHONETIC ALPHABET INTRODUCTION TO NEW EDITION I. Medicine East and West: Two Ways of Seeing, Two Ways of Thinking | and the landscape patterns of nature and humans 2. The Fundamental Textures: Qi, Blood, Essence, Spirit, and Fluids | or the basic ingredients of human life 3. The Organs of the Body: The Harmonious Landscape | and on anatomy and its absence 4. The Meridians: The Warp and Woof | and on acupuncture and herbology 5. Origins of Disharmony: Stormy Weather | or when a cause is not a cause 6. The Four Examinations: Signs and Symptoms | and Aristotle and Lao Tzu revisited 7. The Eight Principal Patterns: The Faces of Yin and Yang | the patterns’ basic texture and composition 8. The Patterns of the Human Landscape | the details of the clinical scene 9. Chinese Medicine as an Art | or on the Penetrating Divine Illumination 10. The Web That Has No Weaver—and Mount Sinai | or on the location of truth APPENDIXES A. The Stages of Disease: A Series of Clinical Scenes B. Yang Organs in Disharmony C. Pulses Revisited D. The Curious Organs E. The Scientific Encounter with East Asian Medicine: Efficacy and Adverse Effects F. The Five Phases (Wu Xing) G. Historical Bibliography: Links in the Chain of Transmission H. Selected Bibliography INDEX ACKNOWLEDGMENTS ichael Steinlauf, my oldest friend, who took a series of garbled Mlectures and made them intelligible. Without Michael•s literary help this manuscript might just as well have stayed in Chinese. • Harvey Blume, my oldest comrade, whose poetic and philosophic illuminations are scattered throughout this book. His imprint is especially evident in the remarks on Hegel and Aristotle. • Dan Bensky, my classmate in Macao, who shared my studies and contributed invaluable ideas, writing, and criticism to this manuscript. • Steve J. Bennett, freelance scholar and writer, who helped to clarify the ideas and prose of this manuscript. • Margaret Caudill, my constant medical mentor and collaborator, who provided criticism and stability. • Gretchen Salisbury, for being my editor, and for the enormous work she did to get this book into shape. • Randy Barolet, my teaching colleague, who helped with the writing. • Liz Coffin, June Nusser, and Kendra Crossen for patient editing and rewriting. • Barbara Huntley, who, by her design, transformed an unconventional manuscript into a book. • Satya Ambrose for the illustrations. • Natalia Muina for editorial assistance, and the Jing that helped me to get through the writing of this volume. • Francesca Loporto for criticism and the gift of Spirit. • Kiiko Matsumoto for scholarly archeology in pre-Tang-dynasty texts. • Andy Gamble, Maria Tadd, and Jon Koritz for help with idea development. • Paul and Andy Epstein for help with writing. • Paul Parker and Mark Epstein for criticism and writing. • Noah Weinberg for help in getting down to basics and lighting fires. • Jonathan Lieff for spiritual and medical advice. • Wendy Pomerantz for editorial assistance. • Fred Klarer and Ken DeWoskin for translation suggestions. • Nancy Trichter for being my literary agent and a source of constant encouragement. • Cody for being Cody. • Lieb Scheiner, E. V. Walter, and Steven Klarer for research assistance. • Marsha Woolf, Joyce Singer, Savitri Clark, Paul Shulman, Richard Michael Zucker, Walter Torda, Chou Man-Xing, Sekyo Nam, Martha Katz, Liu YunHua, Giovanni Maciocia, Ellen Pearlman, Janet Generalli, and Susan Zimelis for support. • The friends, acupuncturists, medical doctors, therapists, healers, and students who attended my lectures in the States, Europe, and Australia and asked the many questions that helped to focus this volume. • My teachers of the traditional medicine of China, who gave so unselfishly, especially Yu Jin-niang, Xie Zhang-cai, Ling Ling-xian, Chen Yi-qing, and Hong Yuan-bain. • My patients, who taught me so much, especially that the effort of writing this volume was more than literary or scholarly. • My adoptive godmother, Lam Pui-yin, whose pureness kept me going physically and spiritually during hard times in medical school. • My parents and sister, whose love is always with me. FOREWORD by Margaret A. Caudill arly in the I970s, in the wake of a new politically sanctioned exchange Eof information between China and the United States, there appeared in the press a number