The Web That Has No Weaver summary

When you learn to draw, you’re taught to identify negative space – the space around objects. It’s easier to “describe” the vase in front of you, the idea goes, if you pay attention to the space it doesn’t fill. In other words, you understand what an object is by looking at what it isn’t. 

Similarly, the “object” of this Blink – traditional Chinese medicine – may be easier to grasp if we think a little about what it isn’t. Let’s start, then, by looking at Western medicine. 

Western medicine, like Western science in general, understands the world through causation. As Aristotle, the philosopher who laid the foundations for scientific thinking in the West, put it, we don’t think we know a thing until we’ve grasped the “why” of it. In short, if you want to know what a thing is, you first look at what causes it. According to this schema, nature is governed by mechanical laws of cause and effect. Medicine, the science of human health, consequently hones in on causes – the isolated entities we call diseases. The Western physician starts with a symptom and works back to an underlying mechanism. Like a surgeon wielding a scalpel, he cuts through a multitude of bodily phenomena to identify the precise cause of disease.

The Chinese physician works differently. 

She doesn’t hone in on isolatable causes – she looks to the complete physiological and psychological individual. She is interested in that multitude of bodily phenomena – all the signs and symptoms and behaviors that make up a human being with an ailment. Her aim is to weave this information into what Chinese medicine calls a pattern of disharmony. 

To get a better sense of what this approach entails in practice, we can turn to a clinical study cited by the author. In this study, a Western doctor used upper-gastrointestinal x-rays to diagnose six patients with stomach pain as having peptic ulcer disease. From the doctor's perspective, the same underlying entity had been identified in all six patients. When a Chinese doctor examined the same patients, however, a new picture emerged. 

This doctor assembled a different set of signs and symptoms and biographical data. One patient, for example, was assertive and arrogant; he had a robust complexion, a reddish complexion, and a strong pulse; his urine was dark yellow and his tongue was covered in a greasy film. A second patient was timid, thin, and frail; her complexion was ashen and she had sweaty palms; she was constantly thirsty, had difficulty sleeping, and felt stressed due to work. By the time the Chinese doctor had examined all six patients, he had identified six individual patterns of disharmony in place of the single disease perceived by his Western counterpart. 

Like the diseases identified by Western medicine, patterns of disharmony tell the physician how to prescribe treatment. But unlike those diseases, those patterns aren’t isolated from the patient in which they occur. When Western physicians examine patients with stomach pain, they look beyond the symptoms for an underlying mechanism like peptic ulcers. When Chinese physicians examine such patients, they bring symptoms into relation with data concerning the patient’s life and biography. Chinese medicine, then, has a holistic view of the patient, her life, and her complaint: no part can be isolated from the whole. 

A symptom, in this schema, doesn’t lead the physician back to a single cause. The question, rather, is how that symptom fits into a patient’s being and behavior. The challenge of Chinese medicine, simply put, is to understand the overall pattern into which the symptom fits.