The Art in ‘the Art of Acupuncture’

(NAJOM Vol 18 No 53, Nov 2011)

Personally I find it quite interesting to consider what it meant by the phrase the ‘art of acupuncture’ or the ‘art of medicine’. Is it at all possible for there to be an art to medicine or even is it morally right that there should be an ‘art’ for if this were to be true, that an art form (albeit a medical one) can affect the health of an individual then the logical implication is that we, as people, are canvasses of sorts even that life itself is an art form. Life likened to art, certainly there is an art to living well but how can the application of an art, techniques performed by an outside party, affect another’s living, breathing, physical form. This kind of thinking is a long way from traditional western scientific thought, but should be explored for its own sake.

Thus I inquire, what is it that is meant by the phrase the ‘Art of Acupuncture’ and why should there be an ‘art’ to the practice? Does ‘art’ make reference to an artistic or aesthetic consideration or is it an allusion to a higher quality of craftsmanship of those who would burn the mugwort and ply the needle. Assumedly it’s the latter, though through my own experience the two are somewhat interconnected as there is a blurring of the line that exists between the ‘art’ and ‘artfulness’ that often transpires. Life is rarely understood in terms of black and white (it’s more like yin and yang).

When Cicero, the Roman senator and philosopher wrote ‘Aegri quia non omnes convalescunt, idcirco ars nulla medicina est’, (because all the sick do not recover, therefore Medicine is not an art) he questioned this very premise of there being an art to healing. Where Cicero saw the world of health in fairly pragmatic terms, our understanding of what both art and medicine is today is obviously different to that of ancient Rome but the human condition and the interaction between doctor and patient nonetheless remains the same. (Somewhat interesting fact- Roman doctors undertook specialised training to ignore the screams from their patients). What is remarkably different in the practice of acupuncture to the medicine of Cicero’s time and that of western medicine, of course, is acupuncture’s Taoist roots.

Where the practice and pursuit of art has suffered its ups and downs, medicine has enjoyed cult like status and has long been heralded as a higher calling. Calligraphy and other Arts may hold high standing in the east and Art in the western culture can also be revered (albeit it’s predominantly posthumously). The practice of art and the artworks themselves can both be connected to the enlightenment process. But when we refer to the ‘art of acupuncture’ we are not talking about aesthetic representations of needling, encapsulated in a painting or sculpture, it is in fact the action of the art that is referenced. The acupuncturist who practices their art is perhaps an artist of the Ki energy balance so to speak. A balancer of Ki and Blood, yin and yang, form and spirit (I could go on).

There is a saying that indicates the enlightening aspects of a true acupuncture treatment.

‘Acupuncture treatments should be like the clouds parting to reveal a bright sunny day.’

The ‘bright sunny day’ speaks of this enlightenment but the part of the phrase which says ‘should be like’ is far more revealing as to the ‘art’ of the treatment. Presumably this is what treatments should be like, but do not by definition necessarily achieve (I am all too aware of this from my personal experience as a practitioner). Surely this is where the ‘art’ of the practitioner comes into play. This artistry is evident to anyone fortunate enough to have experienced the difference between treatments from a master as to that applied by a novice.

In the 61st chapter of the Nan Jing the differences in abilities are explained wherein the hierarchy existing amongst practitioners is extrapolated.

“A Spirit looks at the patient and knows his illness…A Sage looks at the patient and listens to him to know his illness….An Artisan looks at his patient, listens and asks him to know his illness….. A Skilled Workman finally feels the vessels and, in addition, must look at the patient, listen to him and ask him, only then does he know about his illness.”

Nan Jing (Classic of Difficult Issues, translated by Paul U. Unschuld).

In order to attain a Spirit’s flair for treatment requires more than the core set of skills belonging to the ‘Skilled Workman’. It takes an artist’s eye, for it is stated, a ‘Spirit’ is able to determine illness through looking alone. Further into the commentaries of the same chapter, Hua Shou says ‘Spirit implies subtlety and sophistication. Sage implies penetration and understanding’. Subtlety and sophistication transforms the application of penetrative understanding into more effective treatments, into, as the saying goes, ‘the clouds parting’.

The highest ‘art’ of acupuncture practice requires the height of subtlety and sophistication according to Hua Shou. It’s not too hard to imagine that a wisdom comes to us as our medical journey starts with barely being able to thread a needle into a guide tube, working our way up to at least the state of skilled craftsmen. Like any profession, practical skill sets are attained through repetition but with acupuncture and perhaps it is because it is an art; the wisdom to put those skills into practice is achieved primarily through clinical experience mixed with that indefinable element of spirit or heart. One particular pearl of wisdom, illustrating the development of the art of acupuncture put into practice was illustrated on the cover of NAJOM in July 2011, Vol 18, no 52. The calligraphy on the cover art says ‘kokoro waza’ or ‘technique and heart’.

Surely it is that very part of the equation, the spirit or the heart of a treatment that makes our medicine an ‘art’. I know from my own observations of painting and sculpture that it is the sprit/heart of the artwork that makes it great, technical ability alone does not make for great art. The addition of heart to a treatment connects the artist practitioner to their canvass patient; it is what makes a treatment ‘part the clouds to reveal the bright sunny day’. This, I believe is what is meant by the phrase, the art of acupuncture wherein the ‘art’ is in the kokoro waza of the practitioner’s treatment.

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