On the Concept of Shen (Spirit) in Chinese Medicine
By Eric Brand
Shen is a concept that is elusive to a single definition. Like many Chinese words, its meaning varies depending on context and the characters that it is combined with. Generally translated as “spirit,” shen has many different contexts of use in Chinese medicine. The two most prevalent concepts relating to shen in day-to-day Chinese medical practice revolve around shen in the sense of general vitality, and shen in the sense of the spirit that is stored and governed by the heart. However, the use of the word shen in Chinese medicine extends beyond these two primary meanings, and a brief survey of definitions from Chinese medical dictionaries helps to elucidate these wider meanings.
Arguably the widest meaning of the word shen is seen in one of Chinese medicine’s most foundational texts, the Huang Di Nei Jing Su Wen (“Yellow Emperor’s Inner Canon, Simple Questions”). Here, the text states: “…that which cannot be fathomed [in terms of] yin and yang is spirit” (陰陽不測謂之神. Chinese medical dictionaries interpret this statement by suggesting that one meaning of the word shen is related to the manifestations and natural laws regarding substance, movement, and change in the natural world. This is a very broad range of use and there is an inherent ambiguity of meaning present in the original statement; thus, such statements are challenging to translate and provide little ground for drawing firm conclusions.
A far more common and straightforward meaning is reflected in the use of the word shen to refer to the outward manifestations of life and activity in the human body. In this context, shen is used to describe the complexion, the “spirit” in the eyes, language use and responsiveness, and activity and posture. Here, shen is similar to a sense of vitality or general animation, and its presence or absence is important in prognosis. It is worth noting that some Chinese texts define shen simply as jing shen, literally “essence-spirit.” Jing shen is used as a general word in the Chinese language that means energy, vigor, vitality; to have good jing shen is to be full of life. Note that because essence (jing) is the material foundation of shen, the shen is affected by changes in bowel and visceral function or other conditions of exuberance and debility that disrupt normal physiology.
Yet another meaning of the word shen relates to its broader use as a governing force over all other physiologic and mental activity. The heart stores the shen, and the shen ultimately presides over all other activity in the human body.
Still another use of the word shen can be seen in the context of vessel qi. When discussing pulse diagnosis, we speak of stomach, spirit (shen), and root. Here, these three factors are used as general prognostic indicators, since the three together form the basic features of a healthy pulse. Stomach qi is evident when the pulse is smooth, harmonious, and regular, while spirit is seen in the pulse by its suppleness and strength. Root is said to be present when the pulse can be felt at all three positions, particularly at the deep level.
The final major use of the word shen relates to thought and consciousness. The heart in Chinese medicine is the principle organ related to mental activity and it presides over the emotions. The heart governs the spirit-mind, and under normal physiologic conditions the mind is clear, vital, and responsive to the outside world. When there is pathology, the result is insomnia, forgetfulness, heart palpitations, or other signs of disturbance of the heart spirit.
Despite my above summary of five meanings of shen as found in Chinese medical dictionaries, the word goes on and on in contexts beyond Chinese medicine. For example, the deities and immortalized figures seen in temples are all shen, though in English we usually refer to them as gods. The traditional supernatural protectors responsible for patrolling the neighborhood are also shen. The most famous of the lower-level supernatural police are the type of shen known as tu ti gong, and their shrines are found even within major metropolitan areas like Taipei. Nonetheless, to my knowledge the tu ti gong and their pantheon of associates remain largely uninvolved in the affairs of medicine.
Posted in Eric Brand’s Blog June 5, 2009