Suwen 5 and Seeking the Root
Originally published March 5, 2021
This blog post was inspired by a challenge I posted in the super fun advanced Classical Chinese class that I just started teaching a couple of weeks ago. Without telling the students where it was from, I asked them to translate the very beginning of Suwen 5, which I published as Humming with Elephants a few years ago.
Here is the excerpt, literally, from the book, including the “Discussion” part for just that one line that I want to investigate, with apologies for loss of formatting. If you have read this already, feel free to scroll down and skip to the last part of this blog, under the heading “CORRECTION,” which is a small but important update. I invite your comments!
Section One
黃帝曰︰陰陽者，天地之道也，萬物之綱紀，變化之父母，生殺之本始，神明之府也。
Huángdì yuē︰Yīn yáng zhě, tiān dì zhī dào yě, wàn wù zhī gang jì, biàn huà zhī fù mǔ, shēng shā zhī běn shǐ, shén míng zhī fǔ yě.
The Yellow Emperor said: “Yīn and Yáng! They are the Dào of Heaven and Earth! They are the guide ropes and connecting threads of the Myriad Things, the father and mother of Alterations and Transformations, the foundation and beginning of giving birth and taking life, and the Palace of the shén míng.
治病必求於本。
Zhì bìng bì qiú yú běn.
To treat disease, you must seek it in the basics.
Commentary by Zhāng Jièbīn 張介賓：
本，致病之原也。人之疾病，或在表，或在裡，或為寒，或為熱，或感於五運六氣，或傷於臟腑經絡，皆不外陰陽二氣，必有所本。故或本於陰，或本於陽，病變雖多，其本則一。知病所從生，知亂所由起，而直取之，是為得一之道。譬之伐木而引其柢，則千枝萬葉，莫得弗從矣。
“Basics” means the source that caused the disease. Human diseases, whether located in the exterior or in the interior, whether consisting of Cold or of Heat, whether contracted from the ‘five movements and six Qì’ or through injury to the Zàng and Fǔ Organs or channels and network vessels, never fall outside these two Qì of Yīn and Yáng and hence must be based in either of them. As such they can be based in Yīn or they can be based in Yáng, but regardless of how numerous the pathological alterations are, the basis is always this single [cause]. Knowing where disease sprouted from, and knowing where disorder arose from, and then directly seizing that, this is the Dào of “Obtaining the One.” By analogy, if you fell a tree and pull out its taproot, none of the thousands of branches and tens of thousands of leaves are able to survive independently.
Discussion
This famous line, often cited out of context as one of the great truisms of Chinese medicine, is usually translated along the lines of “To treat disease, seek the root.” In comparison with my version above, that rendition serves as a concise and far more elegant way of summarizing Chinese medicine, especially in contrast to biomedicine, which is often said to merely address the symptoms. Given the continued centrality of this short and seemingly simple statement in Chinese medicine both in East Asia and the West, I have intentionally chosen a different version, to alert the reader to two fine points. In spite of the title of this book, the following discussion on “trunks” has nothing to do with elephant anatomy, or with men’s swimwear for that matter.
Grammatically, the presence of the preposition yú 於 (in, on, at, by…) is significant and must not be ignored. Like the English “seek,” the Chinese verb qiú 求 has a direct object, which in the present line is left out, as is often the case in literary Chinese when a word is considered obvious and therefore unnecessary to the author and readers. In English, grammar rules force us to complete such gaps, which I have done by adding “it.” Because of the preposition yú 於, the noun běn 本, here translated as “basics,” cannot function as the direct object of “to seek” but must describe a location or direction, to specify where the search for the disease should take place. I will return to the possible significance of the difference between seeking the disease in the basics versus seeking the basics and to the possible meanings of “basics” here below.
Moreover, the noun běn 本 can certainly carry the metaphorical meaning of “root” and tends to be translated as such in English translations of medical literature. More strictly speaking, however, and in contrast with the more specific term gēn 根, which does literally refer to the roots of a tree, běn also refers to the trunk of the tree, or perhaps when we consider the pictograph directly, the totality of the tree at its core that stretches from the very top through the branches all the way through the surface down to the roots. This is nicely reflected in the compound biāo běn 標本, which is usually translated in medical literature as the “root and tips” or “cause and symptoms” of a disease. Nigel Wiseman paraphrases “root and tip” as “primary and secondary aspects of disease,” and explains: “The word ‘root’ is used in opposition to ‘tip’, the two terms being of varying significance according to context. Root refers to 1 the essential nature of the disease, when tip is the signs; 2 the cause of disease, when the tip is clinically observable changes in the body; 3 right qì, when the tip is the evil; or 4 the primary condition, when the tip is the resulting secondary condition.” In this compound, we are however not literally looking at the top of the tree and the root in a top-down model, but rather at the tips of the branches, the most outward and visible manifestations, and the tree’s trunk in the sense of its durable core in the middle.
Now, in a more metaphorical sense in many contexts, this concept of “trunk” is used to refer to the “foundation” of things, which is most certainly a common meaning of the character běn already in literary Chinese. In most such texts, běn is thus quite accurately translated with the more elegant English term “root.” It may strike the cursory reader as splitting hairs, but in my mind, perhaps based on many years of caring for an orchard full of old trees, there is in fact a distinction to be made between looking for disease in the trunk and looking for it in the root, or even looking for the root itself. To cite just one obvious application, one can saw off a large branch or root, perhaps to isolate some rot there, without killing the tree. But a treatment for the trunk is of quite a different nature. To follow the lead of the Yellow Emperor and play out this agricultural metaphor for dealing with disorder in the body, treating disease in the biāo, i.e., the very ends of a tree’s branches, might mean pruning those diseased parts or applying pesticides or fertilizer to the foliage. Alternately, it could also mean to allow nature to take its course and wait for the leaves to fall and winter storms to blow off the weakened twigs, thereby getting rid of the affliction. In many cases, these approaches are perfectly appropriate responses to a superficial and passing problem. Treating a problem with a tree’s health through the roots, on the other hand, might mean to improve the soil that surrounds the tree, irrigating and feeding the tree through the roots, and adding mycorrhizae and fungi to enrich the tree’s ability to absorb nutrients from the soil. Treating the roots alone would be a bit more limiting perhaps but certainly related, since the roots feed the trunk and thereby the entirety of the tree. The distinction between “root” and “trunk” may thus offer precious insights as we contemplate the deeper meaning of the pair biāo and běn 標本, found in the common treatment principle “simultaneous treatment of biāo and běn” (biāo běn jiān zhì 標本兼治) and in the line above, about managing disease by “seeking it in the basics.”
In addition, in terms of diagnosis, might there be a difference between looking for the disease in the roots, or trunk, and looking for the root of the disease? And whose “trunk” are we even talking about? For an answer, let us return to the line as a whole in its present context. The specific meaning of the term běn 本 here is not as obvious as it might appear at first glance and has been subject to much scholarly and clinical debate. To give just two examples of how this line has been understood throughout history, it can refer to the six Qì 六氣 (the six climatic factors of Wind, Cold, Summerheat, Dampness, Dryness, and Fire), or to chronic, old conditions as opposed to newly emerging and passing “tip” (biǎo 標) manifestations. This is presumably how most modern practitioners of Chinese medicine understand this line when it is used out of context.
Many commentators on this particular chapter, however, do rightly emphasize the importance of the context and therefore the connection of the statement to the previous line and the chapter topic as a whole. I have attempted to do the same with my translation of běn as “the basics.” As such, we might explain this “trunk” here as the foundation of all disease, which must be sought in the cosmic interplay of Yīn and Yáng. The Qīng-dynasty author Gāo Shìzōng 高士宗, for example, leaves no doubt on his reading of the line: “Where the shén míng resides, this then is the basis of [the disease in] Yīn and Yáng. Hence to treat disease, you must seek it in this basis” (神明所居，乃陰陽之本，故治病必求於本。). My reasons for going into such detail here are that this line, in the present context, appears to go much further and entail much more than most modern Western practitioners are prepared to read into it. Rather than merely advising physicians to look for the root cause of symptoms in the body and address the underlying chronic conditions of imbalance rather than just the temporary manifestations of illness, this line reminds us of the need to study Yīn and Yáng as “the Dào of Heaven and Earth,… the guide ropes and connecting threads of the Myriad Things, the father and mother of Alterations and Transformations, the foundation and beginning of giving birth and taking life, and the Palace of the shén míng.” In other words, this line sets the stage for connecting our pursuit of health in the human body with sagely insight into the macrocosmic dimensions of change through the prism of Yīn-Yáng dynamism as the Dào of Heaven and Earth. To prevent, diagnose, and treat disease in the body, whether our own as concerned individuals or that of our patients as professional healers, we must therefore cultivate our vision, our míng 明 in the sense of the ability to perceive the Dào, and learn to align ourselves and those around us as humans with the natural “Alterations and Transformations” between Heaven and Earth.
SECTION ONE, CONT.
故積陽為天，積陰為地。陰靜陽躁，陽生陰長，陽殺陰藏。
Gù jī yáng wéi tiān, jī yīn wéi dì. Yīn jìng yáng zào, yáng shēng yīn zhǎng, yáng shā yīn cáng.
Thus, accumulated Yáng becomes Heaven; accumulated Yīn becomes Earth. Yīn stills and Yáng agitates; Yáng gives life and Yīn promotes growth; Yáng takes life and Yīn withdraws into storage.
CORRECTION
Okay, now do I have your attention? And apologies for this long introduction but I want you to see the full context of that pesky little line 治病必求於本. “To treat disease, you must pursue …” and then what? First of all, to make the English grammar work, you have to add the implied direct object “it,” which presumably refers to the disease. And then comes the fun part: 於本 “in the běn, the “foundation,” or more specifically, as obvious from the context, “in THIS foundation,” namely in Yin and Yang. This is how the line has been read historically by Chinese commentators of this chapter, and this is how it MUST be read, as part of this paragraph, I feel quite strongly.
Now, I have to admit that I got a little carried away with the whole long paragraph above about the difference between the “root” and the “trunk” of the tree, as one of our Classical Chinese class members ever so politely pointed out to me. I love it when my “students” are advanced enough and trust me enough to correct me, applying the very lessons I have taught them! This is something that Sharon Weizenbaum and I have talked about extensively, namely the need for us as a profession, and for those of us who are (for better or for worse) leading voices in the Western interpretation of this long deep wise tradition that we treasure so much, to embody humility in the pursuit of lifelong learning. Chinese medicine is so much bigger and deeper and more complex than any one of us could ever “master”! So here I am, showing you, in my own example, I hope, how easy it is to fall prey to getting carried away, to invest too much in a beautiful story that your listeners enjoy and that allows you to shine and sparkle at your personal best. In my case, I used to be a farmer, and I LOVE talking about farming. Put me in rubber boots and let me dig irrigation ditches or give me a pruning saw or shovel to muck out, and I am in my element. Lecturing in fancy clothes at a big conference, or even worse, teaching to an invisible crowd through zoom is so far out of my comfort zone! So I love relating Chinese medicine back to my experience as a simple farmer.
And yet, in this particular case, I got carried away and overdid it. My best guess is that this sloppy mistake probably snuck in many years ago when I was quickly preparing a weekly lecture, just checked out Wenlin, came up with what I thought was a great theory to set myself apart from other translators, and then never bothered to dig more deeply when writing the book. I did exactly what I have been warning generations of students against, namely to look at the pictorial representation of the character and go wild with the invented or assumed etymology because it APPEARS to tell a story I can relate to…It is a nice humbling experience when I catch myself in this. Let me show you what happened. First off, here is character that I based my whole great story on, which I got from the early version in the Wenlin app:
In my self-defense, you can see how it is easy to jump from this early version, and the modern character 本, as opposed to the regular tree 木, to the conclusion that we are talking about the trunk instead of the root, right? HOWEVER….as my dear “student”-teacher-colleague-hero pointed out, if you check out a basic site like hanziyuan.net (click on the link to see lots of versions), you find earlier versions that are quite different:
Can you see how in these versions a) the tree already has the line for the ground in it and b) IN ADDITION how the main feature of the character is indeed the roots? So basically, I take the whole thing about the trunk back. End of story. Yes, there are other words for “roots” BUT the earliest and key meaning of this character 本 was indeed most likely the roots as the most important element of the totality of the tree. Sorry! And yes, I do feel terrible about this! BUT this is not the end of the story. Now comes the fun part:
Sitting back, and rethinking my whole point about the importance of reading this line properly, does it really change the clinical meaning whether we think of Yin and Yang as the “foundation,” or the “basics” (as my published translation does), or the “root” versus the “trunk” of the tree of life? Actually, when I stare at these beautiful images of the early versions of 本, to me, this sentence only becomes more powerful and even more inspiring. On the surface, my main point still holds, about the importance of reading the line in its context and about it not meaning “seeking the root of the disease” but to “pursue the disease in THIS foundation [of Yin and Yang].” And to me, the grandness of these giant roots, whether as giant hooks anchoring the tree in the ground or as these triangular taproot-like spears going deep down, or as the interconnected nodules that look uncannily like the mycelial network that forest ecologists are all excited about these days, only make a stronger argument for the whole point of this introductory paragraph to a “Treatise on the Resonant Manifestations of Yin and Yang.” What do you think?
I also want to emphasize that the lesson here is that we all need to stay open to learning and being corrected. That none of our knowledge is ever enough, that we all make mistakes, and that we all must create and maintain and nurture a learning environment that facilitates this sort of mutual collaboration. And that we must hold each other accountable, and that that our goal must be not to make ourselves right and the other person wrong but to learn from and with and for each other, for the benefit of the greater good.
To me, Sharon Weizenbaum’s White Pine Circle, Michael Max’ Qiological Podcast, and the innovative collaborative and cross- or meta-disciplinary conference and class formats that many of us are exploring right now, these are all examples that give me hope that we can grow as a profession into a structure for transmitting, producing, exchanging, and developing knowledge that truly honors the meaning of the word “doctor” both in its academic usage as a professional title and in its vernacular meaning as “physician.”
