Blurred Boundaries between Food and Medicine: Traditional Chinese Medicine and Its Impact on Contemporary Chinese Self-Care

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Introduction

When Chinese children ask their mothers “Why do I have to eat this? I want something else!” A typical response is, “You have to eat this because it’s good for your body and health!” Mothers (and caregivers) teach their children that good health comes from good eating habits, an idea that is deeply rooted in Chinese people’s minds. Moreover, although globalization and westernization has led to an abundance of nutritional supplements on the market, modern Chinese people still prefer to obtain nutrition from whole foods rather than vitamin pills.¹ This preference can be attributed to Traditional Chinese Medicine’s (hereafter referred to as “TCM”) influence on the cultural and social heritage of China.

Based on the theoretical structure of TCM, the boundaries between food and medicine are difficult to define. This makes it tough to separate the act of eating from the act of healing by way of knowing and practicing TCM. A focal point of the blurred boundaries is how they influence Chinese people’s self-care behavior, especially regarding food consumption. According to the World Health Organization, self-care is “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider.”² This ability is not universal but is subject to the cultural and social habitus shared within specific communities.³ Knowledge about diseases and remedies differs based on the cultural heritage in certain regions. In anthropologist Gilbert Lewis’ words, “[i]deas about illness and what to do when ill vary with culture.”⁴ As a well-accepted cultural code in Chinese society, TCM exerts an invisible but formative influence on people’s understanding of self-care.

On one hand, while biomedicine is acknowledged, the common daily eating habits of Chinese people reflect the imperceptible influence of TCM. The way people combine ingredients when cooking and the tendency to choose certain types of food according to season (jieqi 节气) in the lunar calendar reflect TCM’s deep infiltration into China’s everyday eating practices. On the other hand, the information prevalent in advertisements, news, and articles on social media (such as WeChat⁵ ) constantly reinforce TCM concepts and the significance of this discipline in promoting a healthy lifestyle among the Chinese masses. Thus, in order to understand the cross-cultural differences in perceptions of self-care, this research is guided by the following questions: (1) How do common Chinese people learn about TCM since this subject is only taught at vocational colleges specializing in TCM teachings? (2) If ordinary Chinese understand the basic principles of TCM, do they follow TCM’s teachings for their everyday intake of foods? (3) How does TCM shape Chinese understanding and practice of self-care?

This study attempts to fill this gap by incorporating interviews with young Chinese people, specifically graduate students who have lived and studied abroad for a significant period of time, and exploring their unique understanding and practice of self-care under the influence of TCM. The rest of the paper is organized into three sections. After a summary of TCM in part one, part two presents a brief overview of the basic principles and existing literature on the discourse of TCM, foods, and medicines that have been published in both English and Chinese. Part three incorporates the results of my research fieldwork, which reveals participant’s reflections on health-related questions. The paper will conclude with a summary that integrates these findings and offers an analysis of the importance of TCM on eating practices in China today.

Topic Overview

TCM is one of the oldest medical systems in the world, with a history of at least 2,200 years. The implicit acceptance of TCM among Chinese people and its essential role in the shaping of self-care behaviors in society can be observed through many aspects. TCM contains so much knowledge on living and healing that when considering how to practice it in modern times, we first need to ask where we want to start.⁶ Intending to explore its significance in contemporary Chinese people’s interpretations of self-care, this paper begins with TCM principles of dietetics and nutrition. The terms, “dietetics” and “nutrition” are Western-centric concepts. In TCM they are combined together and described by the term, yangsheng 养生. It is difficult to find one English word to use to translate the exact meaning of yangsheng, which refers to a lifestyle, an ideology, and a practice of nurturing physical health and mental well-being, all at the same time. According to TCM’s theories, foods, as “an important and inexpensive source of therapy for sustaining health and treating disease,” are regarded as one vital type of healing medicines in the process of pursuing yangsheng.⁷ Renshen 人参 shown in Figure 1 is one of the most expensive TCM herbal medicines. Even people who are not sick use it to make soup, tea, wine, and other types of dishes for the purpose of yangsheng. Figure 2 and 3 present a range of common TCM herbs that are used by Chinese people to cook soup, which is also believed to have a positive effect on maintaining one’s health.

Figure 1. Renshen [人参]. https://pixabay.com/photos/ginseng-product-yellow-grass-1848305/

Figure 3. Easily Accessible Herbs in the TCM Shop. https://pixabay.com/photos/hong-kong-herbs-chinese-food-4771899/

Although it appears that both TCM and nutritional science agree on the importance of foods for self-care, the Chinese holistic classification system is fundamentally different from western theory. The latter categorizes foods by the contents of proteins, carbohydrates, and fats, while in TCM, foods are classified into categories based on their different innate qualities, including thermal nature (xing 性, consisting of hot, warm, neutral, cool, cold), flavor [wei 味, including sweet, acrid, sour, bitter, salty), and other medical properties.⁸ For example, according to the Dictionary of Chinese Medicine, apples belong to the categories of “cool” and “sour” while watermelons belong to the categories of “cold” and “sweet”.⁹ The determination of these innate qualities is not based on an individual’s tastes but the orthodox rules that originated thousands years ago and have remained unchanged since. Meanwhile, TCM also holds the view that different people have divergent body properties. For example, people who have diabetes possess a “hot” body type (tire 体热), while those who are obese possess a “cold” body type (tihan 体寒). For different body properties, the way of yangsheng and the advice on recommended food intake vary accordingly. Hence, the self-care method suitable for each individual differs from person to person in TCM’s system of health and wellness.

TCM asserts that what and how you eat in everyday life relates directly to the condition of your health. China’s “King of Medicine”, Sun Simiao, wrote in his notable Qian Jin Fang about 1400 years ago that “for the body to retain its balance and harmony requires only following a proper diet.”¹⁰ It implies the significance of the right choices on the intake of foods in every meal based on individuals’ health conditions. For instance, eating ginger is good if you have symptoms of a “cool stomach” (weihan 胃寒) since ginger, as one type of significant and functional herb in TCM, is “warm” and “acrid”.¹¹ This holistic ideology has been implicitly, if not explicitly, passed down from generation to generation in China and still dominates the conventional sense and the mainstream practice within the society and its people.

For example, my previous research, “Modernized Traditions: ‘Foxi Yangsheng,’ Decoding the Phenomenon in Contemporary China,” described Foxi Yangsheng 佛系养生 (Buddhist Nurturing Lifestyle), a contemporary cultural practice of TCM in China among young adults. Large numbers of young practitioners combine their modern lifestyle with TCM theories, when they add different herbs to drinks, mix and match various types of foods based on their properties, as if every follower knows the appropriate diet advocated in TCM. Moreover, this observation is not limited to this cultural phenomenon. Numerous advertisements, newspaper articles, and internet blogs provide information on how to maintain one’s health using jargon from TCM without explanation, assuming that their audiences have already grasped the terminology. The slogan of one of the most popular tea drinks in China is “Pa shanghuo he Wanglaoji 怕上火喝王老吉” (Afraid of flaming fire, drink Wanglaoji (the brand of the drink)).¹² Flaming fire (shanghuo上火) describes a type of illness determined by TCM, but with no explanation of the illness or the meaning of the term in the slogan. It implies that the manufacturer of this type of tea assumes that their audiences understand illnesses according to TCM. As one of the most popular soft drinks in China, Wanglaoji achieved more than 20 billion RMB in annual sales according to Li Chuyuan, the chairman of manufacturing.¹³ Its popularity proves that Chinese consumers not only understand but also accept this TCM terminology without need of clarification.

Practitioners of TCM are not limited to Chinese people. Numerous academic works have presented the significance of incorporating TCM into mainstream healthcare when discussing public health in many Asian countries. For example, Tat-Leang Lee addressed the common usage of TCM in Singapore and its indispensable role in the country’s medical system. He believes that any discourse on public health in Singapore cannot overlook the significance of TCM. Asserting that, “[i]gnoring CAM (complementary-alternative medicine), in particular TCM, is not an option.” Lee advocates for doctors to learn more about other medical systems besides conventional western medicine, in order to “understand their patients better and to guide them effectively in their healthcare choices.”¹⁴ His discussion concurs with Gilbert Lewis’ work, with both arguing that cultural understandings of illness are significant in introducing treatments in different societies. Through case studies in New Guinea, Lewis illustrated that the mainstream classification of illness in western medicine is not working but rather hindering the process of healthcare and treatment, and therefore of self-care, in various culturally distinctive localities.¹⁵

More specifically, other literature emphasizes the continuum between food and medicine in, but not limited to, TCM. In several of her publications, Nancy Chen articulates that “[r]ecognizing the innate quality of foods and matching these to the needs of the patient whose body was out of balance was integral to all three systems (Chinese, Ayurvedic, and Greco-Islamic medicine).”¹⁶ Unlike common western views, food is considered to be “a critical component of maintaining well-being.”¹⁷ Together with Kwang-Chih Chang, their detailed discourses on this topic contribute the theoretical basis to my research that decodes food through “a cultural, rather than chemical, process.”¹⁸ Chang clearly expresses how Chinese people attribute special beliefs to food, that what and how one eats directly relates to one’s health. When “[f]ood not only affects health as a matter of general principle, the selection of the right food at any particular time must also be dependent upon one’s health condition at that time. Food, therefore, is also medicine.”¹⁹

Two teams of researchers, led by Helen Chan and Rong Nie respectively, have contributed qualitative research on Chinese cancer patients in Hong Kong and type 2 diabetes patients in Wuhan, China. Chan finds that “the philosophy of TCM had been deeply integrated by Chinese cancer patients into their self-care. While Western medicine is the mainstream cancer treatment, Chinese cancer patients also practiced various TCM-supported self-care activities.”²⁰ This supports my argument on the prevalent acceptance of TCM among Chinese people and its essential role in the shaping of self-care behaviors in society. On the other hand, Nie emphasizes the cross-cultural perception of illness and its relationship to self- care behaviors, suggesting the significance of integrating different cultural perceptions into illness prevention programs.²¹

While presenting interesting results, neither Chang nor Chen has provided Chinese individuals’ articulations on the topic of food and medicine, let alone the discourse on self- care. Besides, Chang limits her major arguments within the field of food without expanding to TCM. The respective research projects of Chan and Nie mainly focused on Chinese patients’ health-promoting behaviors. The laypersons’ reflections upon self-care behaviors and the influence of Chinese medicine are missing in the existing literature.

Ethnographic Research

Voices from people who have not systematically studied TCM present the most explicit responses to my research questions. The parallels and differences within responses contribute to the thesis with great significance. First, their feedback is largely missing in the existing literature, but they provide valuable information about the cultural interpretation of self-care from ordinary Chinese people. Second, compared to a physician's expert knowledge, the reflections of lay people bring “[t]he dual awareness of members and outside audiences”²² to the research topic.

Herein lies the motivation for choosing Chinese students who have studied overseas as my target research group. My initial plan only incorporated interviews with TCM physicians with questions centered on the emphasis on self-care through everyday diet. When asked “What do you think of the relationship between food and medicine in our daily lives?” Yang responded by asking me, “How can you separate these two?”²³ His in-depth understanding of TCM has already shaped his mindset on self-care and any other health-related topics. Hence, I decided to use college students as my interviewees. First, they have been well educated on the subjects related to western medicine, science and biology, and also have been exposed to western cultures during their time studying abroad. Therefore, their interpretations and preferences on self-care are more persuasive compared to those of older generations and other students who are limited to Chinese traditions and cultures. Second, since they hold diverse family backgrounds, common ground within students’ answers to similar questions would also achieve more objective results to the research questions.

Participants

The sample group consists of fifteen Chinese overseas students (eight women and seven men) and three TCM physicians (one woman and two men). The physicians are located in three different cities in mainland China, namely, Beijing, Shenzhen, and Xupu. They all passed the National Qualification Examination for Medical Practitioners, which is a requirement for TCM physicians and biomedicine doctors to legally practice in China, and hold at least a Bachelor’s degree in TCM. Half of the students are currently studying in graduate schools outside China, while the rest have graduated from institutions in the U.S., U.K., Germany, and other foreign countries. All of them hold at least a Bachelor’s degree from various disciplines. The participants include my classmates at the University of San Francisco, the University of Durham, and the City University of Hong Kong, in addition to others who were introduced to me by classmates as snowball sampling. Every participant was interviewed using multiple questions chosen from the questionnaire (see Appendix 1). Questions for each individual differ slightly, but those in bold font were answered by every interviewee. Students located in San Francisco completed the interview in person with the author, while others who reside in China did the interview through online video meetings and voice calls. Four of them participated in focus group interviews, and the remainder were done through one-on-one interviews. All informants were aware of the purpose of the research and gave consent for their responses to be used in this paper or in my future research. All questions and responses were provided in Chinese and translated into English by the author.

Findings

All informants recollected that they had first been taught about TCM practices at an early age by their mothers or other immediate family members. Their replies confirm my hypothesis regarding the transmission of TCM from mothers to their children, and its social heritage in China. What student Wang shared further supports the fundamental impact of TCM:

My mom is a biomedical doctor. But she took me to see a TCM physician when I had the measles (zhenzi 疹子) when I was a child. I asked her why we couldn’t go to her hospital. She said that Western medicines were not helping with these symptoms, and some illnesses could only be treated by Chinese medicines. I’ve remembered her words until today. That’s why I always seek TCM help first if I feel sick.²⁴

Student Wang’s narratives provide a great example of a typical reaction of Chinese parents to their unwell child. They tend to choose herbal tea treatments in TCM more than medications or intravenous drips/injections because they believe the former has fewer side effects. Student Niu described a similar situation when he was young, where instead of taking him to the doctor for his constantly recurring bellyache, his parents gave him Chinese medicine because “our body has the capability of healing itself with natural foods.”²⁵

The interviewees provided rich and controversial responses to the same questions: “What do you think of TCM?” and “How does it influence your life?” All of them immediately began to tell me their thoughts without asking for any further explanations on the definition of TCM. Through in-depth conversations that normally lasted about one hour, each participant’s understanding of TCM appeared to be very similar to that of other interviewees. Some started with specific examples of behaviors that they consider to be manifestations of the impact of this traditional medical discipline. For example, student Xiao told me, “Since I’ve known and believed in TCM I quit eating ice cubes. You have to know that’s my favorite food!”²⁶ Student Mi recalled “I don’t remember the last time I had iced alcohol in a nightclub. Nowadays I only order room temperature drinks there [laughs out loud].”²⁷ Their descriptions are in accord with a foundational TCM principle, which claims that in general “warm” foods are better for human bodies. In contrast, “coldness”, as one type of the innate qualities of foods, is considered harmful to one’s internal organs, no matter their body type.

More importantly, the interviewees showed an increasing awareness of self-care through their daily practices. Student Xin articulated her life-changing experience with the help of TCM:

A year ago, I felt terrible when I followed my German friends’ habit of drinking cold beer every day and eating fast food. Both my body and mind were in bad shape. I lost my energy and always had dark circles under my eyes every day. My complexion was dark and yellow [qise fa hei fa huang 气色发黑发黄]. My body was cold [tihan 体寒]. I caught the flu easily compared to them [German friends]. I felt like I was dying. According to Western medical standards, there was nothing wrong with me. Doctors would advise me to do more exercise. But that’s not enough, you know? We have all grown up with TCM. One day I woke up and just decided to change my way of eating. I guess everyone has a different body type. What works for them might not work for me. I think TCM makes a lot of sense, so I’d like to follow what it says and suggests. I bought a slow cooker and began making five cereal congee [wu he zhou 五谷粥] as TCM advocates. I quit drinking cold beer and other cold drinks… And now I feel awesome every day. My body felt better, and my energy came back. I don’t care whether my German friends no longer want to hang out with me anymore. Now, I have a healthy body to do the things I want to do.²⁸

Xin’s statement received support from student Mi and student Jia when the three of them had the focus group interview together. They all attended the same graduate school in Germany. Student Jia further emphasized that “foods are very important in our lives. ‘We are what we eat,’ I read this somewhere and I think it’s absolutely right. Since then I have always paid attention to what and how I eat.”²⁹ When questioned about which standard he follows for health maintaining eating habits, Jia said, “Yangsheng 养生 (nurturing lifestyle) in Chinese medicine is the diet we Chinese people should follow. I agree with Xin’s view that everyone has a different body type. It’s stupid to discard our ancestors’ intelligence on this and to follow western people who have limited ideas of us [Chinese].”³⁰ Although he was radically supporting TCM’s classification of the body type and speaking in a general way against the western medicine, Jia’s responses explicitly show that TCM theories are deeply rooted in many Chinese people’s minds and instruct their daily eating habits. As he implies, TCM philosophy believes that everyone has a different body from others, not in the sense of the biological structure but in the holistic way of knowing. Xiang Qi 相气, one of the diagnostic methods in TCM, refers to the determination of one’s health condition and disease by examining one’s qi, which is an abstract concept that has not been observed or understood by Western medicine.³¹

Both students Xin and Jia used many TCM terms in their narrations, such as 气色 qise (a broader type of complexion], tihan 体寒 (a type of body property), yangxu 阳虚 (the imbalance of yin and yang within body resulting from yang vacuity), a subconscious behavior that appears in every participant’s interview. These interviews show that all the student participants have a good understanding of the discipline and its philosophy. When asked about certain symptoms (see the questionnaires in the appendix), each participant related mouth ulcers and skin acne to a TCM-defined illness, shanghuo 上火 (flaming fire), and the majority of them would adjust their choices of daily food intake in order to alleviate the condition. Student An would stop eating spicy and strong-flavored foods and instead try to consume more “cool” and “cold” types of foods according to TCM standards in his meals. Some informants mentioned that they would actively search for more TCM-recommended solutions, including herbal medicines to cure themselves of the shanghuo symptoms and further enhance their health conditions. “I start drinking chrysanthemum and goji berry tea (both are TCM herbs) at the beginning of fall every year. England is very dry, especially with the heater on inside the room. So, I drink the tea to prevent shanghuo,” said student Liu, a female graduate from the University of Durham who currently works in London.³²

Another notable common response from the women in the interview group is the impact of TCM on their behaviors during menstruation. Each reported that they would eat certain foods, such as Chinese dates and goji berry, and practice certain routines. “I f** hate jujube (Chinese dates), but I eat them and drink the tea made from it during menstruation because my mom told me it’s good for my body,”³³ said Student Li with a frown during the focus group interview, to which Student Hu nodded in agreement. They shared details on their unique eating practices during menstruation and how it would differ occasionally. Student Hu is on a special weight-loss diet, following an American blogger and being very restrictive in her daily nutrition and calorie intake. However, while menstruating, she would abandon all of the diet’s rules and drink hot hongtang shui 红糖水 (water mixed with a traditional type of brown sugar). “I think it helps with my period pain. If I don’t drink it, I will suffer.”³⁴ I asked her whether she has tried not drinking it during her period, because Hu really wants to lose weight. She shook her head and said, “No, and I won’t. I do want to be slimmer but being healthy is more important. Hongtang shui is very good for us women; that’s what TCM says and also what my mom says. I’m willing to accept the consequence of eating extra sugar.”³⁵ Her answers to my question represent many young Chinese women’s mentality at present. They believe in TCM when practicing self-care behaviors in their daily lives even if they are following other trends or practices. For instance, Student Du told me that “I take vitamin pills from time to time, but the priority is to balance my diet. As TCM suggests, five grains nurture people (wu he yangren 五谷养人), hence I try to eat some grains every day. I think that’s more important.”³⁶

The reflections from students show the significant influence of TCM upon their daily eating choices related to healthcare and their reactions to illness. All female participants confirm that they change their usual eating behaviors during menstruation except for one person, Student Wang. Her explanation is that “I know everything other girls said about how to take care of myself during my period and hands down agree with them on the significance of yangsheng (nurturing lifestyle), but I’m just too lazy to make any changes.” She laughed and continued, “However if I have painful periods, to the point where I’m considering taking painkillers, I’d definitely choose to change my eating habits rather than take medication.”³⁷ Her preference for treating her symptoms with food rather than Western medicine gained support from the majority of the group. More than half of them explicitly expressed concern about the side effects of Western medication and approved of TCM’s philosophy that foods are natural medicines that help us in achieving the goal of self-care.

This result also corresponds with the three physicians’ feedback. They all confirm that the majority of their patients have at least a basic understanding of TCM and its theories, and that this understanding is beneficial to both diagnoses and treatments. For instance, Physician Qin explained, “many Chinese herbal medicines require the patient to avoid eating certain foods during the treatment period. Because patients understand and believe the principles behind this requirement, it’s easier for them to follow my instructions.”³⁸ Besides, all three physicians claimed that patients prefer Chinese medicine over biomedicine when treating the same illness.³⁹ As Physician Yang described, “the majority of my patients would ask me to prescribe them some Chinese herbal medicine, even though I didn’t think it was necessary at the beginning of the consultation. For example, my advice for patients with the common flu is to rest at home and drink as much water as possible. No need to take any medicine; the flu will disappear after a week. However, they [patients] would ask for herbal medicines for the purpose of yangsheng or improving immunity in the long-term.”⁴⁰

Moreover, the physicians themselves follow the self-care suggestions in TCM, especially in their daily diets. “What our ancestors said a thousand years ago is very incisive and well-founded. We should follow their advice on how to eat and live. Do the right thing; eat the right food at the right time. That’s the secret of longevity.” Physician Feng, who is 65 years old and still sees ten patients on average each weekday, continued, “Young lady, you should learn more about TCM, and you will thank me in the future.”⁴¹

Discussion and Conclusion

As one of the most important elements of the cultural and social heritage in China, Traditional Chinese Medicine (TCM) has a reputation for having researched and influenced every aspect of Chinese people’s daily lives. Even though the discipline and its theories have been established and developed more than 2000 years ago, they still function well in modern society through creative adaptations and inventions. Many restaurants create and promote new dishes that feature herbal medicines during certain seasons. For example, goat and Chinese angelica (danggui 当归) soup is popular in the winter, because TCM says that both goat and angelica are “warm” and able to nourish health during the cold season. Mung bean and lily bulb (baihe 百合) soup is very trendy in the summer since the two ingredients belong to the category of “cool” and help to balance the yin and yang in the body. Meanwhile, with support from the Chinese government, TCM has been well integrated with biomedicine within almost every hospital in mainland China. Polyclinics that adopt and integrate treatments from both TCM and biomedicine are common and accepted in Chinese society. Furthermore, through the promotion of various media channels and oral teachings from senior family members—not just mothers but also other caregivers and relatives—Chinese people are able to preserve the traditional knowledge of TCM and form the habitus around it for generations.

This paper examined the role of TCM in the making of health-promoting self-care behaviors, especially concerning eating habits, by conducting personal interviews with 15 graduate students who have experience studying overseas and three TCM physicians who currently practice within different public hospitals in three Chinese cities, Beijing, Shenzhen, and Xupu. The findings reveal the indispensable role TCM plays in the interviewees’ everyday self-care behaviors, when they consciously apply its standard to their daily eating and prefer TCM treatments to biomedical solutions when dealing with illness. The feedback from participants also reinforces how Chinese traditions are constantly absorbed and reinvented in the present social and cultural environment. It is also important to point out that, during the current COVID-19 outbreak in China, TCM has been used in every Chinese hospital, to fight against the virus together with other potential biomedical vaccines and remedies. The government is actively promoting the usage of TCM for the treatment of coronavirus. According to Yu Yanhong, who is the deputy head of China’s National Administration of Traditional Chinese Medicine, the recovery rate of people who received combined treatments [TCM and Western medicine] is 33% higher than that of people who only received Western medicine in a clinical trial in Wuhan, China.⁴²

Through the lens of cultural analysis and by utilizing the ethnographic method in Anthropological research, the articulation of TCM, an intangible and traditional worldview, can be constructed and delivered to audiences with little or no knowledge of it. The findings reveal the essential role TCM plays in the contemporary Chinese diet. Without receiving formal or structured instruction in TCM, the informants follow certain rules and adopt many self-care eating habits from this system of medicine. Young people apply TCM standards to their dietary practices and prefer TCM food-based treatments over biomedical solutions when dealing with illness. The feedback from participants also presents how Chinese traditions are constantly being absorbed and reinvented today.

Based on the participants’ narratives, this paper argues that young Chinese people not only understand the basic principles of TCM but also follow TCM’s standards for their everyday intake of foods despite the fact that no one seems to be able to explain where exactly they acquired knowledge of TCM. Although my research group only consisted of eighteen people, three physicians helped to incorporate a broader picture of Chinese people’s everyday eating, since their responses contained synthesized observations of their patients who have visited and shared different ways of practicing TCM. The well-embedded practices of TCM in the young people’s self-care behaviors shed light on the cultural centered perspective of wellbeing and illness. This broader perspective will also provide more relevant directions for future studies.

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Appendix 1: Questionnaire

1. Do you consider yourself mentally and physically healthy?
你觉得自己健康吗？（心理？生理？）

2. Do you have any chronic diseases or uncomfortable symptoms?
你有任何慢性病或者是不舒服的症状吗？

3. What remedies have you tried to decrease the symptoms?
你尝试过用什么解决方法去缓解症状吗？

4. If suddenly you have symptoms of mouth ulcer, sore throat, skin acne, what do you think is the cause of that?
如果你突然长口腔溃疡，咽喉肿痛，或者皮肤长痘，你觉得是因为什么原 因？

5. What do you think of TCM?
你对中医的看法是什么？

6. How does it influence your life?
你觉得中医对你生活有什么影响？

7. When did you know that you should start practicing TCM?
你从什么时候接触然后实践中医理论的？一点点都算。

8. Do you have any daily healthy habits or routines?
有什么跟中医有关的生活习惯是你每天都做的？

9. (Only for women) Do you follow any unique practices only during menstruation?
(只问女性) 有什么事是只有经期你才会做的？

10. (Only for women) Are you willing to take painkillers for dysmenorrhea?
(只问女性) 你痛经的话愿意吃止痛药吗？

11. (Only for men) Do you know anything that is unique to women’s menstruation?
(只问男性) 你知道女性经期的时候有哪些事能做哪些不能做吗？

Endnotes

¹ Nancy Chen, Food, Medicine, and the Quest for Good Health (New York: Columbia University Press, 2009), 5.

² World Health Organization, Health Education in Self-care: Possibilities and Limitations (1984), http://apps.who.int/iris/handle/10665/70092?locale1/4en.

³ Habitus, the Latin word for habit, represents a concept from the field of Sociology proposed by French sociologist Pierre Bourdieu. In his book, Outline of a Theory of Practice, habitus refers to “a subjective but non-individual system of internalized structures, common schemes of perception, conception and action, common to all members of the same group or class, and constituting the precondition of all objectification and apperception.” See Pierre Bourdieu, Outline of a Theory of Practice (Cambridge: Cambridge University Press, 1977), 86.

⁴ Gilbert Lewis, “Cultural Influences on Illness Behavior: A Medical Anthropological Approach,” in The Relevance of Social Science for Medicine, Culture, Illness, and Healing, ed. Arthur Kleinman et al. (Leon Eisenberg and Arthur Kleinman. Dordrecht, Holland: D. Reidel Publishing Company, 1981), 151.

⁵ The most popular social media application on mobile phones in the Chinese market.

⁶ Trina Ward, “Multiple Enactments of Chinese Medicine” in Integrating East Asian Medicine, ed. by Volker Scheid and Hugh MacPherson (Edinburgh, Scotland: Churchill Livingstone Elsevier, 2012), 55.

⁷ Joerg Kastner, Chinese Nutrition Therapy: Dietetics in Traditional Chinese Medicine (TCM) (Stuttgart, Germany: Georg Thieme Verlag, 2009), 21.

⁸ Ibid.

⁹ The Dictionary of Chinese Medicine, 2nd ed. (Shanghai Scientific and Technical Publishers, 2006).

¹⁰ Sun Simiao, Qian Jin Fang千金方 [Valuable Prescriptions Worth a Thousand Gold Pieces for Emergencies], reprint (Beijing, 1992).

¹¹ The Dictionary of Chinese Medicine. “Cool stomach” refers to a certain type of illness in TCM. Its symptoms include nausea, pale tongue with white coating, slow pulse, and more.

¹² “Wong Lo Kat,” Wikipedia, accessed December 6, 2019, https://en.wikipedia.org/wiki/Wong_Lo_Kat.

¹³ “The Sale of Wanglaoji Bypassed that of Coca-Cola, Will the Next Richest Chinese Man Rise from the Health Industry?” JRJ.com, November 30, 2018, accessed March 17, 2020, https://finance.jrj.com.cn/2018/11/30164525428240.shtml.

¹⁴ Tat-Leang Lee, “Complementary and Alternative Medicine, and Traditional Chinese Medicine: Time for Critical Engagement,” Annals of the Academy of Medicine, Singapore 35, (2006): 751.

¹⁵ Lewis, “Cultural Influences on Illness Behavior,” 160-161.

¹⁶ Jessica Mudry et al., “Other Ways of Knowing Food,” Gastronomica 14, no. 3 (2014): 31. https://www.jstor.org/stable/10.1525/gfc.2014.14.3.27.

¹⁷ Ibid.

¹⁸ Kwang-Chih Chang, Food in Chinese Culture: Anthropological and Historical Perspectives (New Haven: Yale University Press, 1977), 4.

¹⁹ Ibid., 9.

²⁰ Helen Chan et al., “Exploring the Influence of Traditional Chinese Medicine on Self-Care among Chinese Cancer Patients,” European Journal of Oncology Nursing 18 (2014): 445. http://dx.doi.org/10.1016/j.ejon.2014.05.005.

²¹ Rong Nie et al., “Illness Perception, Risk Perception and Health Promotion Self-Care Behaviors among Chinese Patient with Type 2 Diabetes: A Cross-Sectional Survey,” Applied Nursing Research 39 (2018): 95. https://doi.org/10.1016/j.apnr.2017.11.010.

²²  Robert Emerson et al., Writing Ethnographic Fieldnotes (University of Chicago Press, 1995), 169.

²³ Physician Yang, interview with author, October 30th, 2019.

²⁴ Student Wang, interview with author, December 6th, 2019.

²⁵ Student Niu, interview with author, November 17th, 2019.

²⁶ Student Xiao, interview with author, November 12th, 2019.

²⁷ Student Mi, interview with author, November 16th, 2019.

²⁸ Student Xin, interview with author, November 16th, 2019.

²⁹ Student Jia, interview with author, November 16th, 2019.

³⁰ Ibid.

³¹ Xuemei Zhou et. al., “Overview of Traditional Chinese Medicine of ‘Xiang Qi’ Theory of Origins,” Zhonghua Yishi Zazhi 48, no.3 (2018), 153-154. doi: 10.3760/cma.j.issn.0255- 7053.2018.03.004.

³² Student Liu, interview with author, December 5th, 2019.

³³ Student Li, interview with author, November 20th, 2019.

³⁴ Student Hu, interview with author, November 20th, 2019.

³⁵ Ibid.

³⁶ Student Du, interview with author, December 5th, 2019.

³⁷ Student Wang, interview with author, December 6th, 2019.

³⁸ Physician Qin, interview with author, November 8th, 2019.

³⁹ In China, TCM physicians have the right to prescribe western medication.

⁴⁰ Physician Yang, interview with author, October 30th, 2019.

⁴¹ Physician Feng, interview with author, December 8th, 2019.

⁴² Nectar Gan and Yong Xiong, “Beijing is Promoting Traditional Medicine as a ‘Chinese Solution’ to Coronavirus. Not Everyone is on Board,” CNN, March 16, 2020. Accessed March 16, 2020, https://www.cnn.com/2020/03/14/asia/coronavirus-traditional-chinese-medicine-intl-hnk/index.html.