by Bob Flaws

I believe the single most important class in our entry-level education in Chinese medicine is basic theory. This class is the foundation upon which everything else is built. If you've ever built a house, shed, barn, or even sand castle, not to mention a sky-scraper, you know that if you're off in building the base or foundation, the whole edifice will eventually topple. Each successive level you go upward, the more pronounced the initial error becomes. While you can try to correct the error at higher levels, ultimately the real fix is to go back and start over again from the beginning, from the foundation level. In Chinese medical education, basic theory is exactly like this. If students learn wrong theory (because of improper technical terminology or teacher ignorance or confusion), then this is going to have huge repercussions in terms of correct diagnosis and treatment planning later on. Unfortunately, Honora and I see this all the time in students from a wide variety of North American schools.

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I understand that our schools have limited resources, and it is often tempting to staff beginning courses with recent graduates or recently arrived immigrants. The material may seem easy and not very sexy. So schools often chose to reserve their "big guns," their older, more experienced, more famous teachers for their advanced classes. As the thinking goes, these advanced classes need the advanced knowledge, skills, and experience of their most advanced teachers, and this is not wrong. However, basic theory class also requires the same advanced skill-set if only administrators really understood. Instead, in the case of recent graduates, they simply have not studied and practiced the medicine long enough to be really clear about what they are doing. In the case of recent, non-native English-speaking immigrants, they may know the medicine very well, but they may not know how to express this knowledge in philologically correct English. Further, it is my experience that the basic theory teacher must personally read medical Chinese. You simply cannot really know and understand this medicine the way Chinese do until or unless you can read this material in its original source language. This requirement may make it even more difficult for schools to find truly qualified teachers of Chinese medical theory.

However, difficult or not, unless basic theory is taught correctly, students are not going to learn the rest of Chinese medicine in a correct, authentic way. (There's that word again.) Further, it is important that all the teachers of core, foundational classes teach to the same standards of information. I can't tell you how many times students tell me that they've heard one explanation or theory in one class only to be told by their next teacher something completely different. This lack of consistency is extremely deleterious in the teaching of what is essentially a practical skill. We are not talking about differences of opinion about a painting or a poem here. We are talking about a consistent body of theory and technique which is meant to be put into practice on other living beings. Errors in those theories and techniques may cause the continuance or even worsening of the patient's suffering or, in extreme cases, may lead to permanent disability or premature death.

When I was a student at the Shanghai College (now University) of Traditional Chinese Medicine, I would sometime see my teachers going over their lecture scripts. First of all, they had such scripts. Secondly, they agreed as a group on what those scripts would say. Therefore, there was uniformity and agreement in information from teacher to teacher, class to class. If, by chance, a teacher was sick one day, another teacher could step right in and give the same essential lecture as the missing teacher. I agree that hearing a lecture read verbatim is usually very boring. However, teachers can work out as a group what is going to be taught without necessarily being tied to written scripts. In Chinese, Chinese medicine is written and spoken about in a very standard, formulaic way. Using those same standard formulas, albeit in English, allows the teacher to remain faithful to the tradition while still being free to embroider around those key statements of fact in a personally satisfying and engaging, even entertaining, way.

In my experience, most schools rationalize their non-standard presentation of "Oriental" medicine as exposing students to a diversity of opinions and techniques. They are "broadening students' horizons." However, the truth is that the schools are usually hiring anyone they can at a price they can afford. The fruit of that practice is confusion and the lack of confidence that is a by-product of that confusion.

So what to do if you are a student at such a school and can't transfer to a better one? My recommendation is to buy three books. The first is Nigel Wiseman & Feng Ye's A Practical Dictionary of Chinese Medicine. In this dictionary, you will find standard, technically accurate explanations of all the key terms and theories of Chinese medicine. In a pinch, you could pretty much learn all of Chinese medicine from this one book. The second is Fundamentals of Chinese Medicine by the East Asian Medical Studies Society (i.e., Nigel Wiseman et al.). This is a basic theory book that uses the same philologically correct translational terminology at the Practical Dictionary. And the third is to buy my own Statements of Fact in Traditional Chinese Medicine. This is a listing of all the key statements of fact you need to memorize to really think like a Chinese doctor and make this system work the way Chinese do. Armed with these three books, you can learn on your own basic Chinese medical theory regardless of what is happening in your classroom(s). Then, if you really want to rocket to the head of the pack, begin learning to read medical Chinese. This will help you immediately in class, and it will help you every day in clinic for the rest of your professional life.

What to do if you've graduated from school and realize that you haven't learned the basics the way you should've? My recommendation is that, on your own, you should buy the same three books and also begin learning to read medical Chinese for yourself. For years, every time I had reviewed all the Chinese medicine I had learned up to that time, I would start again right at the beginning and go through it all over again, year after year after year. Basic theory is that important, and it's never too late to lay the proper foundation.

Copyright Blue Poppy Press, 2009. All rights reserved.