By Brian Keenan ND, MAc, BSHs
The medical arts of Chinese medicine* and Ayurveda are often seen as wholly separate disciplines. In many ways this is true, but the similarities quickly begin to outweigh the differences when the links between these cultures, as well as they information they shared, are viewed from a historical perspective. The beauty of this lies in how study of these two disciplines as related can lead to inspiration and new lenses with which to approach patients—especially patients whose conditions, or responses to treatment, may have become vexing. Moreover, it also creates a sense of confidence and awe at the reality that is nature itself. These two cultures may have interacted in ancient times, often earlier than originally thought by historians; nevertheless, both cultures already had their own medical systems and beliefs about the functioning of nature and its impacts on human health. From examining the interactions and similarities between Ayurveda and Chinese medicine, it can be inferred that there was agreement, albeit with some semantic distinctions, on the essential functions of nature and the human body. It is not uncommon for students and scholars alike to have doubts or confusion about energetic medicine, in this modern scientific era that can be particularly critical of these medical disciplines, often hand-waving away the millennia of development, innovation, and pattern recognition. Perhaps by looking back, and seeing the camaraderie of these two medical disciplines, we can reassure ourselves of the very ethos that calls us to these kinds of medicines: that nature exists within each of us, from which we are not separate. By harnessing the healing power of nature, we can affect healing in our patients, in ourselves, and therefore, the world at large.
There is evidence that China and India had contact as early as the first half of the Zhou dynasty (roughly 700 BCE); carnelian beads associated with the Indus Valley have been found in Chinese archaeological sites. Moreover, Indian literature uses the name “Cina” which scholars believe may have been derived from Qin state, which later became the Qin dynasty. This is of note because it predates the introduction of Buddhism, which would establish itself in China sometime during the Han dynasty (206 BC-220 AD), following the Qin. As a result, outside of spiritual and cultural mixing, it is extremely likely that mixing of medical and herbal traditions followed as well. This is of course confirmed from the 1st century CE onwards, where there was a robust trade of scholars between the nations, but the archeology suggests a much longer relationship of trade.
The aspects that tie Ayurveda and Chinese medicine that are often comingled in the minds of the public include a belief that practitioners of these disciplines treat some aspect of the energetic body, and that there is a tendency to treat the whole person, as opposed to an individual symptom or disease. While perhaps an oversimplification, these aspects are certainly shared between the two systems. In Ayurveda, prana is the lifegiving force that flows through the body and is what allows for the interactions and transformations of the five elements of nature; Chinese medicine’s qi is also described similarly. Moreover, they both flow through channels in the body and require the breath in order to be sustained in the human body. Prana literally means breath, and in Chinese medical physiology, it is da qi is processed by the lungs, along with gu qi of digestion and our essence, jing, to form zhen qi, also known as true qi.
Other important philosophical similarities lie in the five elements of nature; however, here a clear difference appears, with Chinese medicine positing that the five phases of nature are Earth, Fire, Water, Wood, and Metal, whereas Ayurveda states that they are Earth, Fire, Water, Air, and Ether (often understood as “the space between matter”). Yet when we look at the associations related to the elements, we once again see there are more similarities than differences. In Ayurveda, Air dominates the joints and promotes movement; the Wood element of Chinese medicine does the same, and is also associated specifically with Wind, a clear manifestation of kinetic Air. In Chinese medicine, the Metal element is associated with spaciousness, purity, and the heavens—not dissimilar from Ether’s concepts of space. Some differences, however, certainly exist; for instance, Ether is associated with the ears, hearing, and essence, which in Chinese medicine are more closely tied to the Water element. With this many similarities, an expert in one can look to the other discipline for inspiration and novel considerations when trying to further their study of their medical art.
Beyond shared philosophical concepts, the daily work of the doctor also displays many similarities, but with more distinct executions. Both types of practitioners ask questions focused on hot/cold, excessive/deficient, interior/exterior coupled with tongue and pulse evaluation, and odor, and palpate affected areas. This is of course done in conjunction with the season and other external considerations to make diagnosis and treatment plans.
Where they differ strongly, though, is in the diagnosis and the classification of disease. In Chinese medicine there is channel theory, Five Element theory, and zhang/fu patterns that classify disease through various lenses. In Ayurveda, the paramount focus is on balancing the three dosha of which we are composed. In this way, to the Chinese medical practitioner, Ayurveda most closely resembles Five Element theory. The three dosha are vata, pitta, and kapha, dynamic forces whose interplay governs all aspects of human physiology: body, mind, and spirit. Vata governs all movement of the body, from locomotion to electrolytes moving in and out of the cell, and is associated with the mind and intestines. It is born from the elements of Air and Ether, which combine to form vata when a human is conceived. Pitta, made of Fire and Water, controls the body’s heat and all aspects of digestion and transformation. Lastly, kapha governs all fluids, lubrication, and growth of the body, and is the product of Water and Earth. While this is a greatly simplified overview of Ayurvedic diagnosis, it should be somewhat familiar to those who work with Chinese medicine’s Five Element theory in its approach to the constant dynamic motion of the elements and their roles in governing growth, development, and eventually death.
Certainly, a comparison of Ayurveda and Chinese medicine must discuss the robust meridian systems that they share. In Ayurveda, the channels themselves are referred to as srotas (or, in certain traditions, nadi) while in Chinese medicine they are referred to as the jing luo or meridians. Both disciplines use terminology associated with waterways, such as rivers and oceans with distinct pools of energy, or places where energy can be influenced known as marma points, or in Chinese, xuè dào. There are differences however; Chinese medicine’s system includes the 12 primary channels, the 12 divergent channels, and the 8 extraordinary channels that are often complemented by the 15 luo-connecting channels and 12 sinew channels. Meanwhile, in Ayurveda, the srotas are divided into channels based on the physical substance they carry or the tissue type the channel nurtures, such as transporting water (udaka vaha srotas) or supplying nutrition to the bones, nerves, and brain (majja vaha srotas). Lastly, three srotas are devoted to the elimination of metabolic wastes: one each for feces, urine, and sweat. All said, there are between 13 and 16 srotas, depending on the text consulted.
As for the number of points, again, Chinese medicine has the larger number, with 361 points being the most commonly cited number, while Ayurveda lists only 107 marma points—although again there is not a clear consensus on the total number of points. Perhaps scholarly debate over the channel system is just another shared similarity between these two ancient and respected medical traditions.
Shared Herbal Energetics
As can be expected in any transaction between cultures, medicinal plants and knowledge about them was certainly traded. The way that herbs’ medicinal qualities are categorized is strikingly similar. For instance, the flavor categories, which go beyond gustatory information and encrypt medicinal actions, are identical between the two disciplines. All flavors have a direction, common actions, and relate to one or more of the elements that command the body. Bitter descends, Sour astringes, Pungent disperses, and so on. A darling of the herbal world, licorice root, also known as gan cao in the Chinese tradition and mulethi in the Ayurvedic, is an excellent example. In Chinese medicine, licorice is considered an herb that tonifies qi, and is sweet and of neutral temperature (when not honey prepared, such as in zhi gan cao, which gives it a warming quality). In Ayurveda, it is also sweet, and it balances vata and pitta; as vata is cold and pitta warming, the resulting temperature is neutral.
There are also interesting differences between the disciplines. While most herbs share flavor and temperature as well as use in common conditions, such as coughs, there is a focus in Ayurveda on what is called “post digestion flavor”, called vipaka, wherein the Ayurvedic texts describe the flavor actions of the herb transforming via actions of the body on the herb. The change in flavor will denote an additional consideration in application of that herb. Meanwhile, Chinese medicine discusses specific channels and zhang fu organs with which the herb interacts. This, too, is where nuanced decisions on applications will be made in consideration of the state of the patient. Shatavari, also known as tian men dong (Asparagus racemosus) is another example worthy of comparison. Both disciplines agree that it is of cold potency. In Chinese medicine, its flavor is sweet and bitter, and it nourishes the yin; in Ayurveda, the bitter flavor is mentioned, but the herb’s vipaka, or post digestion flavor, then becomes sweet, and it moistens and nourishes the vata dosha. This demonstrates that, while there are some classification disparities and considerations, these may be more semantic differences than philosophical disagreements. For the acupuncturist, this is important and useful as it becomes relatively easy, once you understand Ayurvedic foundations, to translate the properties of some unique herbs of the Ayurvedic tradition, such as neem (Azadirachta indica), which is not often mentioned in Chinese medicine outside of the modern era and is also not included in the classics. In Ayurveda, neem is bitter and cold, becoming pungent post digestion. It balances the kapha and pitta doshas; that is, the combination of water and earth elements and water and fire elements. It was used for all aspects of heat, including rashes and gastric distress. We might translate this as an herb that cools the blood, is bitter and cold, resolves fire toxins, and goes to the lungs, which governs the skin, as well as the stomach and large intestine organs which, when in rebellion from heat pathogens, can cause various digestive and elimination symptoms that neem will resolve.
There is no question that the number of similarities between Ayurveda and Chinese medicine is indeed myriad. This list of similarities with slight differences is as endless and fascinating as the individual disciplines themselves. Moreover, where larger differences seem to appear between the two, these differences tend to evaporate with deeper and deeper study. The beauty of these agreements is that it creates a sense of certainty amongst practitioners that these are indeed the best attempts made by man to understand the fundamental functions of life itself. While it becomes obvious that there was clearly a sharing of ideas that molded both cultures, it also shows that these two advanced civilizations were essentially more or less in agreement with each other. In the modern day, where students and practitioners alike can feel overwhelmed by the aggressive certainty of the current (yet ever evolving and shifting) scientific paradigm, refuge can be taken in knowing ancient civilizations dedicated thousands of years of observation in vastly different parts of the world only to find a consensus on life, healing, and existence that has remained unchanged for thousands of years.
Brian Keenan is a naturopathic doctor, acupuncturist, and herbalist. He received his bachelor’s in herbal science and doctorate of naturopathic medicine at Bastyr University, before attending Maryland University of Integrative Health to complete his master’s in acupuncture, specializing in Five Element theory. He is the education manager of Ayush Herbs and runs a small clinic specializing in herbal medicine and acupuncture in Columbia, MD.
*Author’s note: Today, the term “TCM” which stands for traditional Chinese medicine, is often used as an umbrella term that includes all East Asian medical systems. In modern times, there is an effort to use East Asian medicine or EAM in place of TCM to be more inclusive of the diverse cultures and disciplines that evolved their systems uniquely and should not always be directly associated with China. However, this article was intended specifically to examine the relationship between China and India and the impacts this relationship had on their respective medical paradigms, which is why the term Chinese medicine was used, as the article is specific to that branch of EAM.
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