fundamental Chinese worldview remains intact after five millennia. This
worldview is the force that has shaped the development of Chinese medicine.
Chinese medicine, like much of Chinese culture, is based upon the sci-
ence of Daoism. Daoism (Taoism) is the cosmological basis of Chinese
medicine. It is scientific in that it is based on observation, states regulari-
ties, and is both explanatory and predictive. Daoism provides functional
descriptions of the relationships among phenomena. It recognizes the un-
derlying compositional unity of all things (wan wu[1]), which have quali-
ties and functions differentiated on a continuum, much as colors are dif-
ferentiated on a spectrum. There is no absolute differentiation between
“this” and “that.” These notions are defined on the basis of both sensed
qualities and function. This view provides for a mutual, organic association
among all entities, even among those that are in opposition.
In both theory and application, the most important term in Daoism is
qi[2]. Qi is both that which “glues” and that which is “glued.” Qi simul-
taneously fulfills the dual roles of constituting and directing the stuff (or
essence) of the universe. All manifestations of qi are described relative to
their unique admixture of the basic contrasting pair: yin [3] and yang [4].
This pair is unitary. One could not exist without the other. The central
theme of Daoism and thus Chinese medicine and the martial arts is that all
things are conditions for the existence of all other things. Therefore, there
is no ultimate creation or destruction, only change. In Chinese, this is de-
scribed as change-transformation without impoverishment [5].
The Yijing(I Ching), or Book of Changes, states, “Unceasing life, call it
‘change’” [6]. Life is a constant process of transformation, of which creation
and extinction are secondary manifestations. Whereas these categories are
value neutral—neither creation nor extinction is viewed as inherently good
or evil—this process has a natural progression. It is this progressive order
that is the focus of the Chinese physician’s attention. The physician views the
normal state of a system as one in which transition is simultaneously unim-
peded and well regulated. Disease is identified in a system that does not meet
these conditions, resulting in either systemic or regional surpluses or deficits
of qi. Simply stated, order (zheng[7]) is “good.” Disorder (luan[8]) is “bad.”
The practice of Chinese medicine has two interrelated aspects. The
first is diagnosis. Zhenduan(diagnosis [9]) is the accurate perception of re-
ality: recognition of the actual admixture of yin and yang. The second as-
pect, therapy (yi zhi[10], literally, “to heal, to put into order”), is the re-
sponse to that diagnosis. Therapy is the manipulation of yin and yang. The
goal of this manipulation is to restore the life-promoting balance between
these two vital forces. Both excess and deficiency result in a tendency to-
ward extinction, which in turn is the cusp of creation.
The doctor must decide if a situation deserves restoration. This in-328 Medicine, Traditional Chinese