AN INTERVIEW WITH Z’EV ROSENBERG

By Micah Arsham

Abstract
Z’ev Rosenberg is one of the first generation of American practitioners of traditional East
Asian medicine. With a background in macrobiotics and shiatsu, he began practicing
acupuncture and herbal medicine in 1983, and has been active in the profession since.
Regarded as an experienced clinician, teacher, and scholar, Z’ev was a professor at at
Pacific College of Oriental Medicine for twenty-four years; he currently teaches at the
Xinglin Institute, where is a senior researcher. In this interview, Z’ev talks about topics
from his two forthcoming books, Return of the Yellow Emperor: Ecological Medicine for
the 21st Century and Healing the Broken Vessel. These works call for a reevaluation of
our approach to healing and describe the intersections between classical East Asian
medicine and contemporary approaches to health and wellness.

Keywords: Z’ev Rosenberg, chronobiology, acupuncture, nourishing life, Su Wen (Plain

Questions), autoimmune disease, ecological medicine

Sitting down with Z’ev Rosenberg to talk with him about his book projects, it’s hard not
to get distracted by all the interesting material in his library: one can find the latest East
Asian medical history and medical anthropology books, next to art books, next to books
on science and health. Z’ev’s journals, essays, and lectures show how classical texts are
the foundation of clinical practice, but the importance of keeping ‘the classics’ in mind is
only one message he hopes to convey to the next generation of acupuncturists and
herbalists. His current research focuses on the relationship of ecology to medicine,
specifically, how the internal environment and external environment constitute and
influence one’s health.

MA: Why did you choose to settle in San Diego? How does the climate influence what
you see in your clinical practice?

ZR: I came to San Diego when I was offered a position at Pacific College of Oriental
Medicine (PCOM) here. They needed an herbal medicine teacher—which were hard to
find in those days (24 years ago)—so Ted Kaptchuk, who was returning Boston,
recommended me. I had never been here before, but got to love the place, and it was a
great town to raise kids. Even though San Diego has one of the best climates in the world,
there are lots of different conditions to treat with Chinese medicine. There are seasonal,
though subtle, changes in this Mediterranean climate. Surprisingly, there is a lot of
respiratory stuff in the fall through early spring, which is largely because San Diego sits
open to the relatively cold Pacific Ocean, and winds off the ocean can trigger wind strikes
and cold damage disorders.

MA: When you diagnose a patient, what is essential to your thought process? What is the
best way to unlock difficult cases?
ZR: In Chinese medicine, we do not rely on machines for diagnosing, and the diagnosis is
more qualitative than quantitative. So one uses all of the senses, and then puts all that
information into one's mind and heart to synthesize the diagnosis. Experience and
repetition makes diagnosis a yogic process. After awhile, feeling the pulse, looking at the
tongue, palpating, hearing the voice, looking at the complexion, and smelling the patient
tells you a great deal—and from this you already know what needs to be done. In terms
of information, based on the Nan Jing (Classic of Difficulties), I use what I call the 'time
line' method, which I first learned from Michael Broffman, where one looks back through
cyclic periods in peoples lives (more or less seven years for women, eight for men
according to Chapter 3 of the Su Wen [Plain Questions]), and looks for effects of change
of residence (such as immigration), divorce, family issues, major illnesses, long-term use
of medications, trauma, or repetitive illnesses that add up to chronic, complex
conditions.

MA: What is chronobiology and how does it relate to traditional East Asian medicine?

ZR: Fully one third of the Su Wen (Plain Questions) is devoted to the theory of ‘five
movements six qi’ (五運六氣 wu lun liu qi), or chronobiology (捲 juan), as in chapters
69-77. One of the greatest secrets of classical Chinese medicine is that it is largely the
practice of medicine through working with time. For example, acupuncture and
moxabustion largely heal by changing the patient’s perception of time, and by allowing
body systems to ‘catch up’ with themselves, so that they slow down or go faster, thus
synchronizing bodily time as if fixing a watch. Through chronobiology as explained in
the Su Wen (Plain Questions), we can calculate the best times to treat, the best methods to
use according to time of day or season, and choose points appropriate to the time of day.
Even more important than these are the chapters that explain how to predict epidemics
and trends of disease by calculating the stems and branches of particular years and their
intrinsic ‘qualities.’

MA: One topic in your upcoming book is ‘ecological medicine.’ What does this term
mean?

ZR: Ecological medicine, as conceived in the Su Wen (Plain Questions), is defined as

health of the individual, family, society, and natural environment gained from living by
the laws of heaven and earth. When humanity lives according to the four seasons,
weather changes, work, rest, diet and exercise according to the laws of yin and yang and
the five phases, good health is the result. But just as the air, water, and soil are damaged
by pollution due to war, over-population, poor farming practices, pesticides, coal-fired
power plants and other byproducts of our technologically-advanced civilization, our
human ecology is also damaged by these things. So working outwards, we should
promote clean air, water, and soil; alternative energy sources such as solar and wind; and
organic farming…this is the outward manifestation of cultivating one’s own health and
nourishing life (養生 yang sheng).

MA: What is bioregional herbalism? Why is it important?

ZR: While all traditional herbal medicine use imported ingredients to some degree,
including China, India, Japan and Tibet, the core of all indigenous medical traditions is
based on local medicines that grow in one’s own region. It is important to know the
medicinal plants that are found where one lives, and to learn how to locate them in the
wild, grow them, harvest them, and prepare them in order to have a broader-based
knowledge of herbal medical practice. I marvel at the medicinal power of fresh, locally
grown herbs.

MA: What constitutes a healing diet, and how important is patient compliance? What is
the ‘clear and light’ diet espoused by traditional Chinese medicine?

ZR: The ‘clear light (bland)’ (清淡 qing dan) diet of Chinese medicine was defined by Li
Dong-yuan and Zhu Dan-xi during the Jin-Yuan dynasty. They emphasized the avoidance
of strong flavors and additives such as excessively spicy, salty, bitter, and pungent flavors
(such as vinegar); rather, one should eat foods in their natural state as much as possible,
and use simple food combinations, based largely on grains and vegetables, with small
amounts of fruits and animal products. This diet was elaborated in depth in 18th century
Japan by a samurai/physician, Ekiken Kaibara. His work has been translated as Yojokun (
養生論 Yang Sheng Lun), or Treatise on Nourishing Life. It also is the root of George
Ohsawa’s macrobiotic teachings, since ‘macrobiotics’ is just another translation of ‘yang
sheng.’

MA: Is it important for students of traditional East Asian medicine to study Chinese
language (or Japanese, Korean, Sanskrit, etc.), at least the medical terms? Why is a
reading knowledge of Chinese helpful, and what effect has it had on your clinical
practice?

ZR: Learning an Asian language is absolutely essential to study traditional East Asian
medicine, at the very least medical Chinese, Korean, Sanskrit, etc. Otherwise one cannot
adequately penetrate the logic of the language itself, which contributes greatly to
understanding medical theory. My observation after twenty-five years of teaching is that
without some Asian language knowledge, it is difficult for students to penetrate and apply
the logic of five-phase theory, yin-yang theory, six-channel theory, and other
foundational concepts of Chinese medicine. For me, even a basic knowledge of medical
Chinese allowed me to access dictionaries, check translations, and greatly deepened my
understanding of the medicine. It was if a veil was removed from my eyes.

MA: Which scholars have influenced you the most? How does the work of medical
anthropologists, Sinologists, and translators change the way you think about traditional
East Asian medicine? How exactly is such scholarship related to clinical practice?

ZR: For me, what helped me transcend my original education (in acupuncture college)
was being exposed to the works of medical anthropologists such as Paul Unschuld (the
Medicine in China series), Nathan Sivin, Manfred Porkert, and Joseph Needham (the
Science and Civilization in the History of China series). Having a historical perspective is
essential to understand a medicine that is two thousand years old, and furthermore, it
exposes you to possibilities in clinical practice that surpass the limitations of textbook
protocols that are relatively one-dimensional. Terminology is also crucial, and Nigel
Wiseman gets my vote for his A Practical Dictionary of Chinese Medicine and for
several works that teach how to read medical Chinese language. High quality translation
is essential, and fortunately the level of Chinese medical literature has risen in the last
few years, thanks to more practitioners learning medical Chinese, and thanks to great
translators such as Sabine Wilms, Eran Evan, Sharon Weizenbaum, Chip Chace, and a
few others.

MA: Often Sinologists specialize in one time period, such as medieval literature, or Han
dynasty works. Are students of traditional East Asian medicine expected to grasp the
entire history of medicine, from oracle bones to the global expansion of Traditional
Chinese Medicine (TCM)? Do students have enough classes on the history of traditional
East Asian medicine, and if not, what should they learn?

ZR: As Robert Plant sang, “There are two paths you can go by in the long run.” A
Chinese medicine physician can work within a lineage, such as the Tian/Zeng lineage of
Shang Han Lun (On Cold Damage) taught by Arnaud Versluys, but even then, one learns
that to truly understand it, one needs to have a broader base in Han dynasty medical
canons, such as the Su Wen (Plain Questions), Ling Shu (Spiritual Pivot), Shen Nong Ben
Cao Jing (The Divine Husbandman's Herbal Foundation Canon), Tang Ye Jing
(Decoction Classic), and Nan Jing (Difficult Classic). A historical perspective is a must,
to understand the full ‘time line of development’ in the East Asian medicine, but one can
certainly focus at a particular point on a specific current or approach, such as, for
example, Li Dong-yuan’s Spleen-Stomach School, or Nan Jing (Difficult Classic)
approaches to acupuncture and moxabustion.

MA: How would you describe ‘integrative medicine’ as the public and Western medical
establishment sees it? What is the best role for traditional East Asian medicine to have in
relation to biomedicine?

ZR: I think the ‘integrative medicine’ movement was premature, as our profession is still
very young in the West, and too few of us have the experience, depth of knowledge, or
clinical skill to interact on an even level with biomedicine. We grew up in a culture quite
familiar with biomedicine, where any layperson can point and click any procedure or
medication on Google and find a huge amount of information. At the opposite end of the
spectrum, without Chinese language skills, quality information about Chinese medicine is
much more difficult to access. I think we need to strengthen our profession first, be more
grounded, and interact with other health professionals, biomedical or otherwise, as equals
in aligned professions, not as a new type of physician’s assistant that just carries out a
doctor’s orders.

MA: At the Cleveland Clinic they now offer ‘Chinese Herbal Medicine’ as part of their
wellness services. Is this the future, or will herbs always be marginalized? How is
Chinese herbal medicine understood, and how is it misunderstood, by the public and by
many biomedical professionals?

ZR: While I applaud the developments at the Cleveland Clinic, it will take a sea change
of consciousness for herbal medicine to become mainstream, as it will never make as
much money as the pharmaceutical companies need to see in profit, although growing
and harvesting herbs is a great potential growth industry in the U.S. It is a nine or ten
figure industry in China! The public on one hand sees herbs as food supplements, safe to
use, and some herbs such as jujube, licorice, astragalus, ginger, and cinnamon are
relatively safe in this way. Other people see herbal medicine as toxic substances that
could interact with pharmaceuticals, and avoid it out of fear. Some herbal imports have
been found with excessive levels of pesticides and heavy metals, which doesn’t help the
situation. But herbal medicine must be taken on its own terms and cannot be understood
by pharmacology alone without delving into the logical system that governs the harvest,
preparation, and combining of herbal medicinal substances into formulas, formulas that
are then used according to a specific system of diagnosis and treatment.

MA: Some pharmaceutical treatments for autoimmune diseases can have many side
effects. Does traditional East Asian medicine have the upper hand when treating
autoimmune disease? How is the approach different from that of biomedicine? Do you
think autoimmune diseases are increasingly common? In which other specialties, such as
dermatology, gynecology, or pediatrics, might traditional East Asian medicine have an
advantage, and if so, why?

ZR: The real key in choosing to use biomedicine or alternative systems such as Chinese,
Ayurvedic, or Tibetan medicine in autoimmune disease is how far along the disease track
patients are. In early stages, East Asian traditional systems can manage a host of
autoimmune disorders quite well. In middle to later stages, patients can either transition
off of toxic pharmaceuticals to herbal medicine, along with dietary changes and
acupuncture treatments, or use these to compliment the biomedical treatments. In later
stages, the progression of the disease is quite difficult to reverse, and biomedicine is
necessary to control the disease, and sometimes, to keep the patient alive. This is very
general; as there are several diseases that are considered as ‘autoimmune’ today, from
diabetes to allergies to lupus to multiple sclerosis, and each have their own
understanding, names, diagnoses, and treatments in both traditional medical systems and
biomedicine. Autoimmune problems are increasingly common as a result of dietary and
environmental degradation, including: exposure to toxic chemicals in the environment,
overdoses of pharmaceutical drugs, the sterilization of private and public sectors through
the use of anti-bacterial soaps and chemicals, and high levels of emotional stress. Many
people are living beyond the capacity of their bodies to survive on junk food and little
sleep, and end up living counter-intuitively according to deadlines and ‘clock time’ rather
than paying attention to their biorhythms. Traditional medicine systems can give great
benefits to nearly all medical specialties, since traditional medicine systems are grounded
in understanding the nature of human beings and their different phases of life, such as
early childhood, pregnancy, post-partum, middle age, menopause, and old age.
MA: Volker Scheid leads cutting-edge, interdisciplinary research at EASTmedicine (East
Asian Sciences and Traditions in Medicine) at Westminster University in London. Could
that kind of interdisciplinary research occur in the United States, and if so, are there
funding sources? Where in the U.S. do the most exciting applications of traditional East
Asian medicine occur, and who are the leaders in the field?

ZR: I think Volker’s work is very exciting, but even at Westminster, the budget is quite
small and limits what they can accomplish. We have barely started to develop these
projects in the U.S., but small developments are occurring. I find the work of such
individuals as: Arnaud Versluys at The Institute of Classics in East Asian Medicine; Ed
Neal, Lorraine Wilcox, Stephen Boyanton and myself at the Xinglin Institute; and Sabine
Wilms, Brenda Hood, Heiner Fruehauf and the crew at National College of Natural
Medicine in Portland, Oregon, to be hopeful for the future of our medicine in the West.

MA: You interviewed translator and scholar Paul Unschuld in 2013, and prior to that co-
taught a class with him for PCOM’s doctoral program. What is his legacy, and how do
his publications and perspective differ from those of other scholars?

ZR: Paul Unschuld’s work is highly researched and produced according to the highest
academic and translation standards. His Huang Di Nei Jing Su Wen: An Annotated
Translation of Huang Di's Inner Classic project took twenty-five years to complete,
including an introductory volume, the primary text (with commentaries chosen from a
bibliography of several thousand volumes and articles), a dictionary, and concordance. I
can’t think of any other work to compare with this, and several of his other works are up
to this standard.

MA: What problems haunt the profession? How can we overcome them? What are your
hopes for future practitioners of traditional East Asian medicine in the U.S.?

ZR: The biggest problem in our profession is that the schools need to really ground the
educational system in knowledge of medical Chinese language, classical source texts, and
a broad history of the medicine, and pair this with mentorship upon graduation. But this
is difficult because of licensing boards and their standards. Also, tuitions have soared, but
new graduates find it hard to make a living, much less pay back their student loans. This
makes it difficult to just trust their medical skills, relax, and live traditional East Asian
medicine as a lifestyle practice as well as a profession.

MA: What can you tell us about your new books and works-in-progress?

ZR: Since I am now ‘retired’ from teaching master’s-level classes at PCOM on a weekly
basis, I can focus on more advanced seminars and writing books. I’m planning a retreat
next year in New Mexico for practitioners of Chinese medicine. In addition to studying
Chinese medical classics, including the Su Wen (Plain Questions) and Nan Jing (Difficult
Questions), we will also find and categorize "Chinese" herbs that grow locally in the
mountains and deserts. I have two book projects: one for the general public, called
Healing the Broken Vessel, which explains the core principles of Asian medical systems
and how to apply them to daily life in terms of diet, lifestyle, exercise, daily habits,
managing health and illness, how to choose one’s health practitioners, and living with the
seasons. It is based squarely on the principles in Su Wen (Plain Questions), chapters 1-3,
including the stages of life from birth to maturity to old age. The second book is called
Return of the Yellow Emperor: Ecological Medicine for the 21st Century, and it’s written
for health professionals and interested laypeople. It uses the Su Wen (Plain Questions) as
a base to explain how the Chinese developed a medical system that rightly spread through
the world because it was and is based on timeless principles that respect both the internal
environment of the human bio-organism and the external environment of planet earth.
They are interdependent, and to heal one, we need to heal the other. I’m very excited
about both of these works.

--

Micah Arsham is a licensed acupuncturist, herbalist, and independent scholar, and is the
editor of Z’ev forthcoming books. She holds a B.A. (cum laude) from Columbia
University, and an M.S. from Pacific College of Oriental Medicine, where she is a
teaching assistant. She has studied at Princeton University, the Freie Universität Berlin,
and Liaoning University of Traditional Chinese Medicine.