Traditional Chinese Medicine (TCM)

With a history of 2000 to 3000 years, Traditional Chinese Medicine (TCM) has formed a unique system to diagnose and cure illness. The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromes.

rural China

The TCM approach treats zang-fu organs as the core of the human body. Tissue and organs are connected through a network of channels and blood vessels inside human body. Qi acts as some kind of carrier of information that is expressed externally through jingluo system. Pathologically, a dysfunction of the zang-fu organs may be reflected on the body surface through the network, and meanwhile, diseases of body surface tissues may also affect their related zang or fu organs. Affected zang or fu organs may also influence each other through internal connections. Traditional Chinese medicine treatment starts with the analysis of the entire system, and then focuses on the correction of pathological changes through readjusting the functions of the zang-fu organs.

Evaluation of a syndrome not only includes the cause, mechanism, location, and nature of the disease, but also the confrontation between the pathogenic factor and body resistance. Treatment is not based only on the symptoms, but differentiation of syndromes. Therefore, those with an identical disease may be treated in different ways, and on the other hand, different diseases may result in the same syndrome and are treated in similar ways.

The clinical diagnosis and treatment in Traditional Chinese Medicine are mainly based on the yin-yang and five elements theories. These theories apply the phenomena and laws of nature to the study of the physiological activities and pathological changes of the human body and its interrelationships. The typical TCM therapies include acupuncture, herbal medicine, nutritional therapy, massage (Tuina Anmo) and qigong exercises. With acupuncture, treatment is accomplished by stimulating certain areas of the external body. Herbal medicine acts on zang-fu organs internally, while qigong tries to restore the orderly information flow inside the network through the regulation of Qi. These therapies appear very different in approach yet they all share the same underlying sets of assumptions and insights in the nature of the human body and its place in the universe. Some scientists describe the treatment of diseases through herbal medication, acupuncture, and qigong as an "information therapy".

chinese pharmacy

Yin or Yang

Yin and yang (Pinyin: yinyáng) are generalizations of the antithesis or mutual correlation between certain objects or phenomena in the natural world, combining to create a unity of opposites. Liang Yi, also known as Yin-Yang or heaven and earth, have a similar meaning.

The dual concepts of yin and yang - or the single concept yin-yang - originated in ancient Korean philosophy and metaphysics, which describe two primal opposing but complementary principles or cosmic forces said to be found in all non-static objects and processes in the universe. This paradoxical concept is the cornerstone of Taoism and traditional Chinese medicine.

Yin ("shady place, north slope, south bank (river); cloudy, overcast"; Japanese: in or on) is the dark element: it is passive, dark, feminine, downward-seeking, and corresponds to the night.

Yáng ("sunny place, south slope, north bank (river), sunshine"; Japanese: yo) is the bright element: it is active, light, masculine, upward-seeking and corresponds to the daytime.

Yin is often symbolized by water and air, while yang is symbolized by fire and earth.

Yin (dark) and yang (light) are descriptions of complementary opposites rather than absolutes. Any yin/yang dichotomy can be viewed from another perspective. All forces in nature can be seen as having yin and yang states, and the two are in constant movement rather than held in absolute stasis.

(Yang light and Yin dark, both carry the symbol of the other in the middle = dark or light dot, indicating the mutual dependency)

Yang light and Yin dark, both carry the symbol of the other in the middle = dark or light dot, indicating the mutual dependency

Five Goings - Wu Xing

The theory of the five goings is the core of Chinese philosophy. This model began gaining importance from the beginning of 3rd century before Christ for the understanding of the dynamic development.

In traditional Chinese philosophy, natural phenomena can be classified into the Wu Xing (Pinyin: wuxíng), or the Five Elements: metal (Pinyin: jin), wood (Pinyin: mu), water (Pinyin: shui), fire (Pinyin: huo), and earth (Pinyin: tu). These elements were used for describing interactions and relationships between phenomena. Five Phases is the more appropriate way of translating wuxing - literally, "five goings". Traditional Taijiquan schools relate them to footwork and refer to them as five "steps". The original foundation is based on the concept of the Five Cardinal Points.

Chinese Medicine and Cosmology

Element	Wood	Fire	Earth	Metal	Water
Direction	east	south	center	west	north
Planet	Jupiter	Mars	Saturn	Venus	Mercury
Zang (yin organs)	liver	heart/pericardium	spleen/pancreas	lung	kidney
Fu (yang organs)	gall bladder	small intestine/San Jiao	stomach	large intestine	urinary bladder
Emotion	anger, frustration	over-excitation	worry, anxiety	grief, sadness	fear, lack of will
Finger	index finger	middle finger	thumb	ring finger	little finger
Sensory organ	eye	tongue	mouth	nose	ears
Sense	sight	speech	taste	smell	hearing
Taste	sour	bitter	sweet	pungent	salty
Heavenly creature	Azure Dragon	Vermilion Bird	Yellow Dragon or Yellow Qilin	White Tiger	Black Tortoise
Livestock	dog	sheep/goat	cattle	chicken	pig
Fruit	plum	apricot	jujube(dates)	peach	chestnut
Grain	wheat	beans	rice	hemp	millet
Season	Spring	Summer	Change of seasons (Every third month)	Autumn	Winter
Life	birth	youth	adulthood	old age	death

Circadian or Diurnal Cycle and Other Cycles

According to Chinese medical theory, each organ is associated with one of the Five Phases. It is believed to be more efficacious to treat an organ during a particular time period appropriate to it. The citation order of the Five Phases, i.e., the order in which they are cited in the Bo Hu Tong and other Han dynasty texts, is Metal, Wood, Water, Fire, and Earth. The organs are most effectively treated, according to theory, in the following four-hour periods throughout the day, beginning with the 3 a.m. to 7 a. m. period: Metal organs (see the list), Earth organs, Fire1 organs, Water organs, Fire2 (the "non-empirical" Pericardium and Triple Burner organs), and Wood organs, which is the reverse of the citation order (plus an extra use of Fire and the non-empirical organs to take care of the sixth four-hour period of the day). These two orders are further related to the sequence of the planets going outward from the sun (Mercury, Venus, Mars, Jupiter, Saturn, or Water, Metal, Fire, Wood, and Earth) by a star diagram similar to the one shown below.

Therapy

Pulse and Tongue are the diagnostic tools to evaluate the underlying syndrome. The TCM knows many ways of treatment. Acupuncture (or heat application with Moxa), Massage (e.g. Tuina, Gua Sha), Phytotherapy, Nutrition and Exercises (e.g. Taijiquan, Yoga und Qigong) are used to harmonize the unbalanced goings (Water, Earth, Wood, Fire, and Metal).

Acupuncture

Most of the main acupuncture points are found on the "twelve main meridians" and two of the "eight extra meridians" (Du Mai and Ren Mai) a total of "fourteen channels", which are described in classical and traditional Chinese medical texts, as pathways through which Qi and "Blood" flow. There also exist "extra points" not belonging to any channel. Other tender points (known as "ashi points") may also be needled as they are believed to be where stagnation has gathered.

Treatment of acupuncture points may be performed along several layers of pathways, most commonly the twelve primary channels, or mai, located throughout the body. The first twelve channels correspond to systems of function: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, San Jiao (an intangible, also known as Triple Burner), Gall Bladder, and Liver. Other pathways include the Eight Extraordinary Pathways (Qi Jing Ba Mai), the Luo Vessels, the Divergents and the Sinew Channels. Ashi (tender) points are generally used for treatment of local pain.

Of the eight extraordinary pathways, only two have acupuncture points of their own: the Ren Mai and Du Mai, which are situated on the midline of the anterior and posterior aspects of the trunk and head respectively. The other six meridians are "activated" by using a master and couple point technique which involves needling the acupuncture points located on the twelve main meridians that correspond to the particular extraordinary pathway.

Many patients claim to experience the sensations of stimulus known in Chinese as de qi ("obtaining the Qi" or "arrival of the Qi"). This kind of sensation was historically considered to be evidence of effectively locating the desired point.

puppet with meridians

Phytotherapy

In TCM applied medications are individually composed for each patient, depending on the diagnosed syndrome. The herbs are administered as tea or decoction. Medications as well as food stuffs are attributed as either cold, cool, neutral, warm and hot according to their energetic potential and they are also divided regarding their taste (sweet, salty, bitter, sour, hot or neutral). The medication is selected regarding the desired characteristics.

classical herbal preparation in a chinese pharmacy

History

Much of the philosophy of traditional Chinese medicine derived from the same philosophical bases that contributed to the development of Taoist philosophy, and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales.

During the golden age of his reign from 2698 to 2596 B.C, as a result of a dialogue with his minister Ch'i Pai, the Yellow Emperor is supposed by Chinese tradition to have composed his Neijing Suwen or Basic Questions of Internal Medicine, also known as the Huang di Neijing. Modern scholarly opinion holds that the extant text of this title was compiled by an anonymous scholar no earlier than the Han dynasty just over two-thousand years ago.

During the Han dynasty, Zhang Zhong Jing, the Hippocrates of China, who was mayor of Chang-sha toward the end of the 2nd century AD, wrote a Treatise on Cold Damage, which contains the earliest known reference to Neijing Suwen. The Jin dynasty practitioner and advocate of acupuncture and moxibustion, Huang-fu Mi (215 - 282 AD), also quoted the Yellow Emperor in his Jia Yi Jing, ca. 265 AD. During the Tang dynasty, Wang Ping claimed to have located a copy of the originals of the Neijing Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the 11th century AD.

Huang di, the yellow emperor

Classical Chinese Medicine (CCM) is notably different from Traditional Chinese Medicine (TCM). The Nationalist government elected to abandon and outlaw the practice of CCM as it did not want China to be left behind by scientific progress. For 30 years, CCM was forbidden in China and several people were prosecuted by the government for engaging in CCM. In the 1960's, Mao Zedong finally decided that the government could not continue to outlaw the use of CCM. He commissioned the top 10 doctors (M.D.'s) to take a survey of CCM and create a standardized format for its application. This standardized form is now known as TCM.

Today, TCM is what is taught in nearly all those medical schools in China, most of Asia and Northern America that teach traditional medical practices at all. To learn CCM typically one must be part of a family lineage of medicine. Recently, there has been resurgence in interest in CCM in China, Europe and United States, as a specialty. For example, see the program of Classical Chinese Medicine at National College of Natural Medicine. See also [http://www.classicalchinesemedicine.org Heiner Fruehauf's website covering topics related to Classical Chinese Medicine.

Contact with Western culture and medicine has not displaced TCM. While there may be traditional factors involved in the persistent practice, two reasons are most obvious in the westward spread of TCM in recent decades. Firstly, TCM practices are believed by many to be very effective, sometimes offering palliative efficacy where the best practices of Western medicine fail, especially for routine ailments such as flu and allergies, and managing to avoid the toxicity of some chemically composed medicines. Secondly, TCM provides the only care available to ill people, when they cannot afford to try the western option. On the other hand, there is, for example, no longer a distinct branch of Chinese physics or Chinese biology.

TCM formed part of the barefoot doctor program in the People's Republic of China, which extended public health into rural areas. It is also cheaper to the PRC government, because the cost of training a TCM practitioner and staffing a TCM hospital is considerably less than that of a practitioner of Western medicine; hence TCM has been seen as an integral part of extending health services in China.

There is some notion that TCM requires supernatural forces or even cosmology to explain itself. However most historical accounts of the system will acknowledge it was invented by a culture of people that were already tired of listening to shamans trying to explain illnesses on evil spirits; any reference to supernatural forces is usually the result of romantic translations or poor understanding and will not be found in the Taoist-inspired classics of acupuncture such as the Nei Jing or Zhenji Dachéng. The system's development has over its history been skeptically analysed extensively, and practice and development of it has waxed and waned over the centuries and cultures which it has travelled - yet the system has still survived this far. It is true that the focus from the beginning has been on pragmatism, not necessarily understanding of the mechanisms of the actions - and that this has hindered its modern acceptance in the West. This, despite that there were times such as the early 18th Century when "acupuncture and moxa were a matter of course in polite European society".

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