Traditional Chinese Medicine

Traditional Chinese medicine (TCM) also known simply as Chinese medicine (Chinese: 中醫學, zhōngyī xué, or 中药学, zhōngyaò xué) is the name commonly given to a range of traditional medical practices used in China that have developed over the course of several thousand years of history. It is also known as oriental medicine, a term which may include other traditional Asian medical systems such as Japanese, Korean, Tibetan, and Mongolian medicine. Chinese medicine principally employs a method of analysis and synthesis, inquiring on a macro-level into the internal systems of the human body and their mutual relationships with the internal and external environment in an attempt to gain an understanding of the fundamental laws which govern the functioning of the human organism, and to apply this understanding to the treatment and prevention of disease, and health maintenance. TCM is rooted in a unique, comprehensive and systematic theoretical structure which includes the Theory of the Five Elements, the human body Meridian system and Yin-yang. Treatment is conducted with reference to this philosophical framework.

Uses

In the West, TCM is often considered alternative medicine; however, in mainland China and Taiwan, TCM is widely considered to be an integral part of the health care system. The term TCM is sometimes used specifically within the field of Chinese medicine to refer to the standardized set of theories and practices introduced in the mid-20th century under the government of Mao, as distinguished from related traditional theories and practices preserved by people in Taiwan, Hong Kong and by the overseas Chinese. The more general sense is meant in this article.

TCM developed as a form of noninvasive therapeutic intervention (also described as folk medicine or traditional medicine) rooted in ancient belief systems, including traditional religious concepts. Chinese medical practitioners before the 19th century relied essentially on observation, trial and error. Like their counterparts in the West, they had a very different understanding of infection which predated the discovery of bacteria, viruses (germ theory of disease) or cellular structures and little knowledge of organic chemistry, relying mainly on distinctly personal medical theory describing the nature of infections and remedies. Traditions, and observations based on their theory, along with three millenia of practical experience guided their courses of treatment and instruction in diagnostic principles.

Unlike other forms of traditional medicine which have largely become extinct, traditional Chinese medicine continues as a distinct branch of modern medical practice, and within China, it is an important part of the public health care system. There are thousands of years of empirical knowledge about TCM on its own terms, and in recent decades there has been an effort to place traditional Chinese medicine on a firmer Western scientific empirical and methodological basis as well as efforts to integrate Chinese and Western medical traditions.

That this effort has occurred is surprising to many for a number of reasons. In most of the world, indigenous medical practices have been supplanted by practices brought from the West, while in Chinese societies, this has not occurred and shows no sign of occurring. Furthermore, many have found it peculiar that Chinese medicine remains a distinct branch of medicine separate from Western medicine, while the same has not happened with other intellectual fields. There is, for example, no longer a distinct branch of Chinese physics or Chinese biology.

In the West, TCM is usually regarded as a form of alternative medicine (CAM). TCM is used by some to treat the side effects of chemotherapy, treating the cravings and withdrawal symptoms of drug addicts and treating a variety of chronic conditions that conventional medicine is claimed to be sometimes ineffective in treating. TCM has also been used to treat antibiotic-resistant infections.

In China, practitioners of Chinese medicine tend to perform functions which in the West would be performed by allied health professionals such as nutritionists, pharmacists, nurses, chiropractors, physical therapists and others. Chinese medicine hospitals also perform some emergency medicine such as prevention and treatment of shock and seizure. The general distinction made by Chinese in China is that Western medicine involves cutting or acute care while Chinese medicine involves manipulation or chronic care. Hence medical procedures such as bone setting or chiropractic spinal manipulation would be seen as Chinese, while surgery tends to be seen as Western.

TCM Theory

There are many schools of thought on which TCM is based. Because of this, the foundation principles of Chinese medicine are not necessarily uniform. Received TCM can be shown to be most influenced by Taoism, Buddhism, and Neo-Confucianism.

For over 3000 years (1200 BC - present), Chinese academics of various schools have focused on the observable natural laws of the universe and their implications for the practical characterisation of humanity's place in the universe. In the I Ching and other Chinese literary and philosophical classics, they have described some general principles and their applications to health and healing:

There are observable principles of constant phenomenal change by which the Universe is maintained.

Man is part of the universe and cannot be separated from the universal process of change.

As a result of these apparently inescapable primordial principles, the Universe (and every process therein) tends to eventually balance itself.

Optimum health should result from living as harmoniously as possible with the spontaneous process of change tending towards balance. If there is no change (stagnation), or too much change (catastrophism), balance is increasingly lost and illnesses can occur.

Everything is ultimately interconnected.

Always use a systemic approach when addressing imbalances.

TCM is therefore largely based on the philosophical concept that the human body is a small universe with a set of complete and sophisticated interconnected systems. Those systems usually work in balance to maintain the healthy function of the human body. The balance is described as necessarily including qi, blood, jing, bodily fluids, the wu xing, emotions, and spirit (shen). TCM has a unique model of the body, notably concerned with the meridian system. TCM isn't monolithic, however, and there are from minor to significant regional and philosophical differences between practitioners and schools which in turn can lead to differences in practice.

Meridian (Chinese Medicine)

The concept of meridians (Chinese: "jing-luo") arises from the techniques and doctrines of traditional Chinese medicine including acupuncture and acupressure. According to these practices, the body's vital energy, "qi", circulates through the body along specific interconnected channels called meridians. Disruptions of the body's energy flow are thought to cause emotional and physical illness. To release those disruptions, specific points on the meridians called tsubo are stimulated via needles, pressure or other means.

The aligned water theory of meridians conjectures that meridians are made up of clusters of "aligned water" in the body that allow ions, light, and sound waves to flow more readily. Aligned water clusters are said to occur where large numbers of water molecules align electrically to form a stable cluster. These have supposedly been photographed outside the body with an electron microscope by Shui-Yin Lo, who calls them IE crystals. These aligned water molecules are said to flow between the cells, forming a chain that completes a circuit around the body. When these water molecules "fall out of alignment" this supposedly has a negative impact on health.

  
The Chinese meridians have their counterpart in the Mayan acupuncture techniques practiced in the Yucatan. The analogous concept is that of wind channels. Curiously, most of the key points in Mayan acupuncture correspond exactly with key acupuncture points in the Chinese meridian model. (See "Wind in The Blood" by H. Garcia et. al.)

Aside from speculation and ad hoc hypothesising, there is little objective scientific evidence to suggest that meridians or "aligned water" exist, and indeed their existence is not compatible with a conventional understanding of physics, anatomy and physiology. Some experts consider these conjectures to be pseudoscience [1], [2].

Five elements (Chinese)

In traditional Chinese philosophy, natural phenomena can be classified into the Five Elements (Chinese: 五行; pinyin: wǔxíng): wood, fire, earth, metal, and water (木, 火, 土, 金, 水; mù, huǒ, tǔ, jīn, shǔi). These elements were used for describing interactions and relationships between phenomena. Five phases is another way of translating wǔxíng — literally, "five goings". Traditional Taijiquan schools relate them to footwork and refer to them as five "steps".

The doctrine of five phases describes both a generating (生, shēng) cycle and an overcoming (克, kè) cycle of interactions between the phases. In the generating cycle, wood generates fire; fire generates earth; earth generates metal; metal generates water; water generates wood. In the overcoming cycle, wood overcomes earth; earth overcomes water; water overcomes fire; fire overcomes metal; metal overcomes wood.

TCM Diagnostics

The basics of TCM diagnostics are: observe (望 wàng), hear and smell (聞 wén), ask about background (問 wèn) and read the pulse (切 qiè). Then classify the symptoms into different types:

Yin or Yang (yin-yang 陰陽)

Superficial or internal (li-biao 表裡)

Cold or hot (han-re 寒熱)

Deficient or Replete (xu-shi 虛實)

Because traditional Chinese medicine predates the more invasive medical testing used in conventional Western medicine, TCM requires skill in a range of diagnostic systems not commonly used outside of TCM. Much of this diagnostic skill involves developing the abilities to observe subtle appearances; to observe that which is right in front of us, but escapes the observation of most people.

Diagnostic technique
  • Palpation of the patient's radial artery pulse in six positions
  • Observation of the appearance of the patient's tongue
  • Observation of the patient's face
  • Palpation of the patient's body (especially the abdomen) for tenderness
  • Observation of the sound of the patient's voice
  • Observation of the surface of the ear
  • Observation of the vein on the index finger on small children
  • Comparisons of the relative warmth or coolness of different parts of the body
  • Anything else that can be observed without instruments and without harming the patient

This article is part of NCCAM documentation in public domain...