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American Chinese Medicine American Chinese Medicine Tyler Phan A thesis presented for the degree of Doctor of Philosophy Supervised by: Joseph Calabrese Vivienne Lo Department of Anthropology UCL April 2017 I, Tyler Phan confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. Tyler Phan April 2017 2 Abstract This thesis explores the power structures which shape Chinese medicine in the United States. Chinese medicine had two incarnations: migrant Chinese practice and its professionalized form. From the 1880s to the 1940s, Chinese medicine was practiced by the Chinese diaspora to serve their communities and non-Chinese settler populations. From the 1970s onward, Chinese medicine professionalized under the agency of acupuncture. Through the regulation of acupuncture, groups of predominately white Americans began to create standards of practice based on the enactment of what I have referred to as “orientalized biopower.” Orientalized biopower is the process where America’s predominately white counterculture began to encompass an orientalism which romanticized a form of Chinese medicine constructed in the 1950s by the People’s Republic of China called Traditional Chinese medicine (TCM). With the adoption of TCM in the United States, they also formulated measures which marginalized Asian Americans practitioners. The profession then labelled itself as “Oriental Medicine” embodying Edward Said’s concept of Orientalism. Along with this form of orientalism, the counterculture used the State to push for a standardized epistemology of TCM. In return, the State encompassed standardized Chinese medicine as element of biopower. My research is informed by a cross-country ethnography of schools, regulatory bodies, and private practices around North America. Through my investigation, I discover the power structures of Chinese medicine, contained within the regulatory bodies and schools, are mostly dominated by white Americans. Combined, they construct a profession and determine the “legitimate” and “illegitimate” forms of Chinese medicine, which constitutes the criteria for who can and cannot practice legally in the country. 3 Table of Content Abstract 3 Table of Content 4 List of Illustrations 6 Acknowledgments 8 Chapter 1 Introduction 9 1.1 Method of Application 10 1.1.1 Position of Research 10 1.1.2 Chinese Medicine 14 1.2 Contributions to the Field 17 1.3 Limits of Research 20 1.4 Outline of Chapters 26 Chapter 2 Historical Context 29 2.1 Orientation of Orientalism 29 2.2 Patrician Orientalism: Chinoiserie and Acupuncture 31 2.3 Migration and Medicine 34 2.4 Commercial Orientalism 37 2.5 Pacific Coast 40 2.5.1 San Francisco and Oakland, California 41 2.5.2 Los Angeles, California 45 2.6 Rural Encampments 47 2.6.1 Fiddletown, California 48 2.6.2 John Day, Oregon 48 2.6.3 Boise, Idaho 49 2.7 Political Orientalism: Labor, Racism, and Chinese Exclusion 51 2.8 “Regular” and “Irregular” Medicine 62 2.9 Chinese Medicine’s Persecution 71 2.10 Conclusion 75 Chapter 3 Orientalized Biopower 77 3.1 The Construction of American Chinese Medicine 77 3.2 “In the Right Place at the Right Time” or Opportunism? 81 3.2.1 The Spread of the UCLA Cohort 84 3.3 Orientalized Biopower 87 3.3.1 Counterculture Orientalism 92 3.3.2 Biopower 105 3.4 Chinese Medicine as Cultural Appropriation? 113 3.5 Conclusion 117 4 Chapter 4 Professionalization 119 4.1 Chinese Medicine as a Profession 119 4.2 History of National Regulatory Bodies 121 4.3 NCCAOM 129 4.4 ACAOM 133 4.5 CCAOM 143 4.6 California 146 4.7 Nevada 153 4.8 Maryland 157 4.9 Conclusion 159 Chapter 5 Traditions 163 5.1 Traditional Chinese Medicine (TCM) 163 5.1.1 Herbs 182 5.1.2 Acupuncture 185 5.2 J.R. Worsley’s Five Elements 195 5.3 Classical Chinese Medicine (CCM) 212 5.3.1 Nguyễn Văn Nghị and Sean Marshall 213 5.3.2 Heiner Fruehauf 217 5.3.3 Jeffrey Yuen and Jade Purity 220 5.4 Conclusion 223 Chapter 6 Decoding Chinese Medicine (Conclusion) 224 6.1 Who Practices American Chinese Medicine? 224 6.2 Standardize a School’s Legitimation 228 6.2.1 First-Professional Doctorate (FPD) 230 6.3 Titles in the Profession 236 6.4 Debt and Gainful Employment 239 6.5 Is Dry Needling Acupuncture? 244 6.6 Community Acupuncture and Liberation 251 6.6.1 Lincoln Detox Center 254 6.6.2 Taiwanese Traditions 258 6.6.3 Combating the Financial Bubble 260 6.7 Solutions from Britain? 262 6.8 Final Thoughts 264 Bibliography 265 5 List of Illustrations Figures Fig. 2.1 Fortified Door and Wooded Block Embedded in the Floor at Kam Wah Chung Fig. 4.1 NCCAOM’s Governance Fig. 4.2 The Evolution of Regulatory Bodies Fig. 5.1 “Pattern differentiation” (bianzheng) according to the Outline of Chinese Medicine Fig. 5.2 Six Sections of the Tongue Fig. 5.3 Pulse Positions Fig. 5.4 “Big Picture” Fig. 5.5 Steps of a Practitioner for Diagnosis and Treatment Fig. 5.6 Comparison Between Honma Shohaku’s Five Element Chart (Left) and J.R. Worsley’s Five Element Chart (Right) Fig. 5.7 Basic Model of Five Elements from Five Element Tradition Fig. 5.8 Five Element Based on the Five Antique Points Within an Element: Worsley (Left) and Honma (Right) Fig. 5.9 Three Levels of the Body Tables Table. 1.1 Treatments at Different Sites Table. 4.1 NCCAOM’s Pre-Graduation Hour Requirements for Taking Examinations Table. 4.2 NCCAOM’s Content Outline Table 4.3 ACAOM’s Master’s Degree/Master’s Level Table 4.4 ACAOM’s Master’s Degree/Master’s Level Program Length Table 4.5 ACAOM’s Postgraduate Degree Programs Table 4.6 Comparison of CALE Content Percentage Table 5.2 Zangfu matched with the Corresponding Phases Table 5.2 Pulse Qualities Table 5.3 Ten Interview Questions Table 5.4 Commonly Used Texts for Exams and Curriculum from 1980s- 1990s Table 5.5 Zangfu Pattern Differentiations with Acupuncture & Herbal Treatment Table 5.6 Herbal Actions/Strategies Table 5.7 Formula Strategies of CALE Table 5.8 Classical Order-Circulation, Phase, and Number of Points on Each Meridian Table 5.9 Worsley’s Numeric Organization of the Officials (Zangfu) Table 5.10 Five Antique Element/Phase Correspondence Table 6.1 Class Demographics of Chinese Medicine Schools Table 6.2 ACAOM’s Fees for Accreditation Table 6.3 Doctoral-level Schools in the United States Table 6.4 Common Title Abbreviations of Chinese Medicine Practitioners 6 Table 6.5 Profession’s Title Table 6.6 Gross Annual Income Table 6.7 Satisfaction of Chinese Medicine School Preparing Students for a Career Table 6.8 Chinese Medicine Schools Listed as “Fail” but the U.S. Department of Education “Debt-to-Earnings” Criteria Table 6.9 Herbal Formula Prescribed Graphs Graph. 6.1 Racial Demographic for Chinese Medicine Practitioners in the United States Graph. 6.2 Gender Demographic for Chinese Medicine Practitioners in the United States Graph. 6.3 Age Demographic for Chinese Medicine Practitioners in the United States Graph. 6.4 Student Loan Debt Among Graduates 7 Acknowledgments None of my research could have been possible without the support of my wife Lilith and son Ashoka. Lilith’s sacrifice and intellectual companionship has allowed me to follow my dream, making a contribution to the fields of Medical Anthropology and Acupuncture. My wife and son inspire me to create a better world for future generations. I also want to thank my supervisor Joseph Calabrese and Vivienne Lo for their comments and insight to help me navigate the thesis. The editing of Phoebe Adams has gone above and beyond what anyone could ask for. Thanks is due to my friend Chuck Marcus, whose sleuthing shed light on California’s unique legal history of acupuncture. The ethnography could have not been possible without the houses and guest beds of our family and friends. 8 Chapter 1. Introduction This thesis focuses on the power structures which shape Chinese medicine in the United States. It begins with my own experience as an acupuncturist when I realized the insertion of hair-thin needles into someone for therapeutic value involves multiple systems of control. The mechanism of this system led me on a four-year journey through a compulsory education, followed by a year preparation for a national board examination, and thousands of dollars in debt. Once finished, I found myself in a world my school did not prepare me for, small business ownership. In hindsight, the vast majority of my educational experience did not relate to the safety of the patients, as often boasted by state1 licensures and regulatory bodies. I was expected to memorize and reiterate abstract medical theory based on orientalist assumptions and translations of Chinese ideas such as qi or shen. The frustration I and many others encountered was the inability to relate the information from the national boards examination to live patients. Years later, this disconnect resurfaced in academia as an anthropologist. Viewed through the lens of the social sciences, many of what my Chinese medicine friends and colleagues deemed as “political,” were issues concerning culture, society, technology, and economics. The tedious process I experienced as a young adult led me to interrogate the process anthropologically and examine the cultural and historical significance of the medicine. As an alternative system of care, Chinese medicine has always been positioned as a healing modality different from the conventions of allopathic biomedicine.2 Through self-reflection and critical analysis of what would 1 Capitalized “State” refers to as the organized political community living under a single system of government or used in “United States.” It can be synonymous used as “government.” Lowercase “state” or in the rare case “State of…” refers to the constituent political entity of the United States.
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