Dr Jiang’s thoughts on treating the exterior

Like so many foreigners, soon after I first got to  Taiwan I experienced the joy of illness in a strange land. The lungs are my weak organ system, and given the Brillo pad atmosphere of Taipei, intensely cold AC mixed with murky heat and subtropic humidity, and stress of calling a very foreign country “home” it is not surprising that I came down with one frighteningly nasty respiratory condition.

It is hard enough to stand outside oneself and get enough perspective on how to treat your own condition, and it is even worse when your Americanized “pinyin-speak” rings nothing but confusion into the ears of the local herb store laoban. Luckily a friend, who was also there to study medicine, suggested we go to see this “old doctor” that a friend had recommended. We rode the subway to the “Eternal Harmony” district in search of a cure for my uncommon cold.

Like most Taiwanese clinics it is a storefront affair. Sandwiched in between a tiny lumber shop and bakery on a scooter littered sidewalk we found Dr. Jiang’s clinic, took a number and waited on the bowling alley-like plastic chairs. The TV blared pop Taiwanese music and news. I thought for sure I was going to end up in some hospital.

What little language study I had had in the States was completely useless in Taiwan. Classroom mandarin and real life full tilt language are two completely different animals. My friend translated my discomfort and fever to Doc Jiang. He wrote notes in what I would later come to recognize as a grass style type calligraphy, even the Taiwanese have a hard time reading his writing. I understood nothing of the exchange. It was his assistant that helped me to translate the formula into a language I could understand. And when I did I thought for sure this old doc should have been put out to pasture years ago.

What he prescribed was nothing like I’d been taught in school.

Doc Jiang’s idea of treating a Taiwanese cold was to prescribe, in granule form, five different complete formulas, which were then modified with several single herbs. Had I come up with a formula like that at school I would have had my tuition refunded. I considered flushing those herbs down the toilet, but then figured I was in Taiwan to learn something new about medicine. That this doc’s formula was off my radar was not necessarily a bad a thing. It was just…different…and different is no fun when you are sick. I took the herbs and went to sleep. Slept through the night, and woke the next day feeling 80% better and coughing slippery, wet phlegm from my lungs. I’m the guy who gets the dry cough. Clearly, this doc had a perspective that was worth exploring.

In the years that followed, I would spend a lot of time with Dr. Jiang. I came to find that his way of using herbs was a cross between what he learned from his father on the mainland, and the Japanese influence that is so intertwined with Taiwanese culture.

I came to see that he used formulas much how we would think of individual herbs. And that when treating almost any condition that involved the respiratory system he would see there being some kind of tai yang involvement. There were five herbs that he liked to use to resolve the exterior and clear toxin: jing jie, fang feng, bai zhi, yu xing cao, and a little bitty pinch of xi xin. This was added to any formula that he used to treat colds or allergies. In his way of thinking, opening the exterior would open the Lung. Indeed, there were many cases where I would have focused on clearing Lung heat, or nourishing Lung fluids, but he would simply resolved the exterior and give the qi mechanism a little push. The patient’s own zheng qi would take over and set them right. Elegant!