15 November 2020

Good Humour, Good Health: How They Do It in Asia

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Some of those who read my previous post, the one about humoral medicine, may have found some of its tenets strangely familiar. Especially if they had ever dabbled in oriental systems of alternative medicine. That's why today I'd like to follow up on that post with a brief comparison of western humoral medicine with Indian Ayurveda and traditional Chinese medicine (TCM) – particularly in terms of their dietary advice. The foremost difference, obviously, is that both Ayurveda and TCM are still widely practised, while the medical rules invented by ancient Greeks, and later adopted by Muslims and Christians, have been largely forgotten (although not quite in Ibero-American countries).

आयुर्वेद[edit]

Human anatomy according to Ayurveda. Nepal, ca. 1800.

Let's begin with Ayurveda, or literally the "knowledge of longevity". The oldest medical compendia from which Ayurveda took its root, are attributed to Sushruta (ca. 6th century BCE) and Charaka (between 100 BCE and 200 CE), which makes Ayurveda about as old as Greek humoral medicine. If you look at the similarities between the two (as we will in a moment), it's hard to think that they've developed completely independently. But who copied from whom? That's hard to tell.

As the starting point we're going to take, again, the five elements: earth, water, fire, air and aether. However, unlike in Greek thought, where aether only existed in celestial bodies and was thus of little importance to medicine, all five elements are relevant to Ayurveda. Besides, the Ayurvedic counterpart of aether is not so much a volatile substance as it's just vacuum, an empty space with the potential to be filled with something.

When describing the qualities of the Greek elements, we used two axes: hot vs. cold and dry vs. moist. Ayurveda uses ten such axes, but we'll try to simplify it but boiling them down to only three: the two mentioned above plus light vs. heavy. The next difference is that, in humoral medicine, each of the humours was mapped to one of the four terrestrial elements; in Ayurveda, on the other hand, the principal vital forces known as doshas, which roughly correspond to the humours, are associated with pairs of elements. The good news is that there are only three doshas, as not every possible pair of elements has its own dosha.

Elements, doshas and tastes. It's actually more complicated than that, but I'd have to make this infographic at least in 3D to avoid all of the excessive simplification.

Water bounded by earth produces a dosha called kapha (pronounced KAP-hah). Kapha is heavy, cold and moist; in the human body, it's responsible for holding everything together and, when in excess, it manifests itself in the form of phlegm. Fire bound by water is pitta, which is hot, light and… not dry. Wait, what? Well, it's not dry, because it contains water, but it isn't moist either, because the moisture is evaporated by the fire. So what do you call something that's neither dry nor moist? Consider food: if it's too dry, then what you do is baste it with some oil, butter or gravy, right? And this is what pitta is like – fatty, oily, unctuous. In your organism, it keeps digestion running and the associated "humour" is bile. And then there's the third dosha, called vata, which is a combination of air and void. It's dry, light and cold. In your body, it's responsible for breathing and motion, and its excess shows as… not a fluid this time, but something rather gaseous. What you get by combining air and void is wind, and this is exactly what builds up in your colon when you've got too much vata.

Just like in humoral theory, the domination of any one dosha in your organism determines your physique and your temperament. A vata-type person is usually thin and bony, dark-skinned with thin, dry hair, an elongated and wrinkled face, and is quick-tempered, impatient and wavering. If you're a kapha-type person, then you might be heavily built with pale skin, thick, oily hair and a round, soft face, slow, but persistent. And you can tell someone is a pitta-type person by their muscular figure, ruddy complexion, soft hair with a tendency for early greyness and baldness, a face with sharp contours, as well as their high impulsiveness and motivation. But that's not all, for there are also people whose bodies are dominated by not one, but two doshas (vata-pitta, vata-kapha and pitta-kapha types), as well as those who have all three doshas in balance (the vata-pitta-kapha type). This way, there are only three doshas, but as many as seven different temperaments.

If you've read my post about humoral dietetics, they you might have guessed by now that the goal of Ayurvedic diet is to keep the doshas in balance. For example, a kapha-type person should eat foods that decrease kapha, while a dual vata-pitta type should consume things that increase kapha. But how can you tell which foods increase or decrease which doshas? Well, of course, by taste! There are six tastes, each combining the qualities of two different elements. Sweet is combines earth and water, which means it increases kapha; it's the heaviest and moistest, as well as the most widespread of all six tastes. Salty is a marriage of water and fire, so it increases pitta. Sour is fire and earth, and thus decreases vata. Pungent is a combination of fire and air, which makes it the hottest and driest taste, decreasing kapha. Bitter is air plus aether, it's the lightest and coldest of tastes, and it increases vata. And, last but not least, the astringent taste, which combines earth and air, and therefore decreases pitta.

Ghee, the traditional Indian butter, clarified and slightly caramelized, is perfect for balancing the excess of bile (pitta) and wind (vata).

But it's not as simple as that. The amount of each dosha in your body depends on daily and seasonal cycles. Let's take a look at the seasonal one as an example. The Indian climate has not four, but six seasons (kinda like in Poland). Winter is cold and damp, and people tend to be listless and sluggish, so their organisms develop an excess of kapha, which is evident by the build-up of thick phlegm. Cold winds blow at the same time, which makes the air filled with bitterness. When the spring comes, the air becomes astringent, while the phlegm melts down and spreads throughout your body, causing the aggravation of kapha. Aggravation of any dosha is dangerous, so it needs to be mitigated with an appropriate diet to stem the onset of disease. In the summertime it's dry and windy, everything tastes sharper than usually and your body begins to accumulate vata. Then comes the rainy season, which brings strong monsoon winds, heavy rains, slightly lower temperatures and a sour taste permeating the air. In these circumstances, vata has absolutely no idea what's going on and gets aggravated. What's more, pitta begins to build up. Autumn, which is dry, warm and salty, pacifies vata, but aggravates pitta. It's only in the sweet early winter that pitta becomes pacified, but this is also when kapha is slowly starting to accumulated. And so on and so forth.

Therefore, your diet should not only match your own dosha constitution, but also the current season. For example, a kapha-type person in winter should avoid the build-up of phlegm, which is natural for them anyway, by eating foods that are astringent and pungent, warm and slightly unctuous, and – in lesser quantities – sour, bitter, salty and dry. In any case, they shouldn't eat anything sweet, maybe except honey, which is not only sweet, but also astringent and drying. By contrast, a vata-type person, in the same season, should eat things which are sour, salty and oily, and – to a lesser extent – sweet (for example, lots of sesame oil and ghee).

And let's leave it here, because the more I try to fathom this topic, the less sense I make out of it. The Greeks, at least, kept it simple: four earthly elements, four qualities, four humours, four temperaments, four basic tastes and four seasons. Whereas in Ayurveda, there are five elements, twenty qualities, three doshas, seven temperaments, six tastes and six seasons! So let's leave India alone and see what the Chinese came up with on the theme of healthy eating.

中醫[edit]

Understanding what traditional Chinese medicine is all about was made somewhat easier courtesy of Dr. Guta Kulczycka, who explained some of the key concepts to me and recommended the relevant literature.

Clarification of butter in a ca. 1550 illustration to the Food Herbal

The oldest known Chinese medical texts are the Inner Canon of the Yellow Emperor and the Treatise on Cold-Damage Diseases, usually dated to the period of the Han dynasty, that is, the 3rd century BCE. This would make TCM a little younger than the humoral and Ayurvedic theories, although it's possible that it was based on much earlier, but now lost, works. You can tell by the titles alone that TCM probably loses much in translation – if it's translatable at all.

The key concept of TCM is qi (pronounced chee; literally: "air"), a vital substance permeating the entire universe. It comes in various densities or phases (depending on how you want to picture it), from matter to energy to spirit. All processes in the universe may be understood as thickening or rarefying of qi. Chinese philosophy talks of yin whenever qi thickens and yang whenever it becomes rarefied. Yin and yang are a pair of cosmic opposites – with yin being colder, moister and slower, while yang is hotter, drier and quicker – the dark and light sides of the force. Except that, in Star Wars, the two sides of the force are locked in a constant struggle, while yin and yang complement each other in a creative, rather than destructive, way.

From the medical point of view, yin and yang influence the gathering and flow of qi in the organism. Qi is transported around the body along special energy channels, or "meridians", which I won't be talking about here (let me just note that it's along these channels that needles are inserted in acupuncture). Disease, obviously, comes from the lack of balance between yin and yang in your body, and the goal of medicine is to keep or restore that balance. The imbalance may result from too much yin, too little yang, too much yang or (guess what?) too little yin.

Sounds familiar? Okay, but what about elements? Are there any elements in this system or just qi, yin and yang? Don't you worry, of course there are. There's five of them (naturally), but they're a little different from those we already know. They are, namely: tree, fire, earth, metal and water. No air? Well, no; after all, qi already means "air", right? But the chief difference between Chinese and Western elements is that the latter are understood as static substances or states of matter, while the former are more like successive phases of the continuous process of the transformation of qi. This is why the Chinese term wǔxíng (pronounced: woo-sheeng) is better translated as "five movements" than "five elements".

A pot of soy sauce in an illustration from the Food Herbal

The movements of tree and fire are, respectively, the initial and final phases of yang, that is, energy moving upwards and outwards, growth and expansion. The movements of metal and water are the initial and final phases of yin, or energy moving downwards and inwards, condensation and consolidation. And the movement of earth is the axis around which all other movements take place. The five movements are reflected in time and space as the sun's motion in the sky and as cardinal directions: tree – sunrise – east, fire – noon – south, metal – sunset – west, water – midnight – north, and earth is in the middle.

When it comes to human anatomy, the movements are assigned to major internal organs, with the latter divided into zàng organs, which are solid inside (and more yin), and organs, which are hollow (and more yang). Tree corresponds to the liver (solid) and the gallbladder (hollow); fire, respectively, to the heart and the small intestine; earth, to the spleen or pancreas (I never know which is which, and ancient Chinese doctors seem to have also treated them as if they were a single organ) and the stomach; metal, to the lungs and the colon; and water, to the kidneys and the urinary bladder.

Every person has their own constitution, in which one or two movements dominate, which, of course, determines what they look like, how they behave and what kinds of disease they are prone to. A fire-type person is tall and broad-shouldered with long limbs and neck, a triangular face, wide forehead, ruddy skin and loud voice, and is bossy and smart. A tree-type person is well-built, muscular, supple, with olive skin, a trapezoidal face with a pointed chin and thick eyebrows, is friendly, seductive and impatient. A person in whom the earth movement dominates is stocky, strong and slow, has a square face with thick lips and nose, as well as a sense of humour and a friendly temperament. You can tell a metal-type person by their tall and rigid body, narrow shoulders, a long face with prominent teeth and nose, and being slow, meticulous and cautious. And finally, the water type with their short, round body, an oval face with puffy eyes, hesitation in their voice, shyness and apparent helplessness. Like in Ayurveda, mixed types also exist.

Selected food products classified according to the five movement and their yin and yang qualities

In order to keep the right yin-yang balance in your body, you need, naturally, to follow a well-balanced diet. We can classify all foodstuffs in two ways; first, there are some with a warming quality, which increase yang, other are cooling and increasing yin, while other still are neutral. From the point of view of humoral dietetics, this is nothing new. But, secondly, different foodstuffs affect various internal organs with different strength, so we can assign to each food the movement which corresponds to the organs it affects the most. Alright, but how can you tell, in everyday life, which food belongs to which movement? I suppose you already know that. That's right, by the taste! For example, sour foods, which tend to pull qi downwards and inwards, have the strongest effect on the liver and the gallbladder, so they belong to the tree movement (even though, as we remember, it channels qi upwards and outwards). Sour foods are typically cooling or, at most, slightly warming. Green herbs and veggies belong to the tree movement as well, even if they're no really sour. The bitter taste belongs to the fire movement and usually corresponds to the warming quality. Anything that is sweet or just mildly flavoured (such as dairy and eggs) belongs to earth; pungent, to metal; and anything that is salty or comes from water (including fresh water), to the water movement.

Every meal should contain a little of each taste, but the proportion of tastes in what you eat should take into account your constitution, age, your current maladies, and season. In the spring, the tree (that is, sour foods) should dominate; in the summer, fire (bitter – but, preferably, not too warming – foods); in the autumn, metal (pungent); and in the winter, water (salty, but not too cooling either). The earth movement has been assigned to transition periods in between the seasons, but in any case, sweets are what your body needs the most throughout the year.

And now a few words about five-movement cooking. The best way to cook is by doing it in accordance with the natural cycle of movements. The sequence goes like this: the tree is consumed by fire; the fire leaves ash, that is, earth; earth is where you can find metal; a metal bucket carries water; water helps the tree grow; and so on, and so forth. You can arrange the movements in other cycles too, but this one is enough for our purposes: tree, fire, earth, metal, water. You don't have to always start with the tree; just keep the same sequence.

Let's take some simple example to see how it works in practice. Say we're preparing scrambled eggs. We're gonna start with the fire movement.

1 Fire movement First, quite literally, light a fire on the stove and heat up the pan.
2 Earth movement Put a piece of butter on the pan and let it melt.
3 Metal movement Add some chopped onion. But here comes a twist: fresh onion has a pungent taste, so it belongs in the metal movement, but when sautéed, it becomes mild and sweet, which takes us back to the earth movement.
4 Earth movement Take advantage of getting back to this movement by breaking in a few eggs. Stir.
5 Metal movement You can't skip it now, so we need to add something pungent again. Add some freshly ground pepper.
6 Water movement This is easy, you need to add something salty, so just sprinkle in a pinch of salt.
7 Tree movement Finally, garnish your scrambled eggs with some chopped parsley leaves.

Thus, we have gone through the whole cycle and the breakfast is ready! Of course, when cooking more involved dishes, you might have to go through the cycle a couple of times.



As you can see, despite some obvious differences, there is also much that humoral, Ayurvedic and traditional Chinese medical theories have in common. People used to find connections between elements and seasons, human temperaments and stages of life, internal organs and bodily fluids, diseases, tastes and warming or cooling qualities of foods and drinks in most diverse civilizations. And in all civilizations, these ideas influenced what people ate and how they cooked it.

And in the next post we shall return to Europe, to investigate a certain puzzle which will takes us to Poland, Austria, France and Britain.

Bibliography[edit]

  • Ayurveda
  • Chinese medicine
    • Hamid Montakab: Medycyna chińska w praktyce: Teoria, diagnostyka i terapia w rozumieniu zachodnim [Chinese Medicine Revisited], Polish transl. Marta Nizioł-Wojniusz, Michał Iwanicki, Łódź: Galaktyka, 2017
    • Barbara Temelie, Beatrice Trebuth: Gotowanie według Pięciu Przemian: 184 przepisy dla wzmocnienia duszy i ciała [Das Fünf Elemente Kochbuch], Polish transl. Anna Krochmal, Tomasz Twardowski, Gdańsk: Czerwony Słoń, 2007


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