What is Traditional Chinese Medicine (TCM) ?

What is Traditional Chinese Medicine?

Traditional Chinese Medicine (TCM) is a well of medical knowledge gained from over 4,000 years of observation, investigation and clinical experience. TCM has evolved as an empirical science and its theories and treatments have been repeatedly in use and refined over this long period of time.

History

The development of TCM can be traced back to the New Stone Age over 10,000 years ago. TCM practices developed in an empirical manner through the observation of the effects they produced on certain parts of the body and on specific ailments. Early acupuncture was carried out using sharpened bone fragments prior to the development of other tools. The first and most important classic text of TCM had been completed in about 200 BC. This book, known as the Yellow Emperor’s Classic of Internal Medicine , discussed the theory and philosophy of TCM as well as the therapeutic benefits of acupuncture, herbs, diet and exercise. By the Han dynasty (206 B.C. – 220 A.D.), another valuable classic, the Treatise on Diseases Caused by Cold Factors (Shang Han Lun) had been written by Chang Chung-ching. This classic is an authoritative practical guide to the treatment of illness even to the present day. Another well-known Chinese medical works is the Materia Medica (Pen Tshao Kang Mu), compiled in the Ming dynasty (1368- 1644 A.D.) by Li Shih-chen. This encyclopedic work includes descriptions of almost 2,000 different kinds of medicines and forms an important framework for TCM herbology.

The Basic Principles Behind TCM

Yin and Yang

Yin and Yang is an important and fundamental concept in TCM.

The Chinese character for Yin translates literally as the ‘dark side of the mountain’ and represents such qualities as cold, stillness, passive, dark, interior, below, front and so on.

The Chinese character for Yang translates literally as the ‘bright side of the mountain’ and represents such qualities as warmth, activity, light, exterior, above, back and so on.

TCM views the body in terms of Yin and Yang aspects. The healthy state is characterized by a dynamic balance between the Yin and Yang aspects of the body and, by implication, an unhealthy state is characterized by some imbalance between the Yin and Yang of the body.

Excess of Yin – will be characterized by extreme cold symptoms

Excess of Yang – will be characterized by very full heat symptoms

Relative Deficiency of Yin – will be characterized by internal heat and lethargy symptoms

Relative Deficiency of Yang – will be characterized by general coldness and lethargy symptoms.

Yin and Yang in dynamic equilibrium – ideal balance state of health.

Five Elements

The five elements emerged from the observation of the various groups of dynamic processes, functions and characteristics in the natural world. They are:

1. Water: wet, cool, descending, flowing, yielding

2. Fire: dry, hot, ascending, moving

3. Wood: growing, flexible, rooted, strong

4. Metal: cutting, hard, conducting

5. Earth: productive, fertile, potential for growth

Each Element is seen as having a series of correspondences relating both to the natural world and also the human body. Each is linked with a season, a climate, a taste, a colour, a sound, an emotion, an odour, an movement, a sense organ, a body part, a Yang organ and a Yin organ.

TCM uses a system of inter-relationships between the Five Elements in order to understand how the various processes of the body support and control each other. Because of these inter-relationships, when one of the organs and its associated Element is out of balance, the other elements are also affected. This imbalance will manifest in the individual with many different signs and symptoms. It may show in the facial colour, the sound of the voice, a change in the emotional state as well as disharmony in the functioning of the connected organs.

The Vital Substances

TCM views the human body as an energy system in which various substances interact with each other to create the physical organism. These basic substances are Qi, Jing, Blood and Body Fluids.

Qi

usually translated as ‘energy’ or ‘vital energy’, is the energy that underlies everything in the universe. The Qi inside our bodies is created from the combination of the food we eat and digest via our Stomach and Spleen and the air we breathe into our Lungs. It is the source of body activity and movement, protects us from illness and keeps our bodies warm. If the Qi becomes deficient or blocked, this will result in an inability to transform and transport our food and drink, an inability to keep warm, and a lack of resistance to diseases and depleted energy.

Jing

usually translated as ‘essence’, is crucial to the development of the individual through life. It is inherited at birth and is stored in the kidneys and allows us to develop from childhood to adulthood and then into old age. It governs growth, reproduction and development, promotes kidney Qi and works with Qi to help protect the body from external factors. Any developmental disorder such as learning difficulties and physical disabilities in children may be due to a deficiency of Jing. Other disorders such as infertility, poor memory and chronic tendency to external disease and allergies may also be due to deficient Jing.

Blood

in TCM is not the same substance that is recognised in Western medicine. In TCM, Blood means the fluid that nourishes and moisturizes the body. It also houses the Shen (or spirit) and aids in the development of clear and stable thought processes. Disharmonies of Blood include deficient Blood, which typically lead to pale complexion, dry skin and dizziness; stagnant Blood causing sharp and intense pain or even the development of tumour; and heat in the Blood causing bleeding symptoms such as uterine haemorrhage or nosebleeds.

Body Fluids

called Jin Ye in Chinese, are considered to be the organic liquids that moisten and lubricate the body in addition to Blood. These fluids moisten and nourish the skin, muscles, hair, joints, brain, spine and bone marrow. Deficiency in body fluids can lead to various forms of dehydration such as dry skin and constipation. If fluids accumulate and get stuck, this can lead to problems of dampness and phlegm in TCM and may manifest as symptoms like lethargy and a feeling of heaviness in the body.

Meridians

Meridians or channels form a distribution system that carries Qi, Jing, Blood and Body Fluids around the body.

There are 12 main meridians. Branching from them is a network of other smaller channels. Each main meridian is connected to one of the twelve organs and travels along its own route within the body. For example, the Heart meridian travels in a pathway from the heart itself to the armpit and down the inside of the arm to the little finger. This explains why someone with a heart problem often has a tingling feeling running down the arm to the little finger.

The Zangfu System

The term Zangfu is a collective name for the various Yin and Yang organs identified in TCM. A Yin organ is called a Zang and a Yang organ is called a Fu. Each organ is considered to have its own functions, but these functions have a far wider scope than the purely physiological function described in Western medicine.

The Zang consists of the five solid (Yin) organs. They are:

Spleen

Heart

Lungs

Liver

Kidneys

A sixth organ called the Pericardium, unknown in Western physiology, is also considered as a Yin Zang. In general, TCM considers the Zang to be deeper in the body and to be concerned with the manufacture, storage and regulation of the fundamental substances. For example, the Heart makes blood, the Lung governs Qi and the Kidney stores Jing or Essence. Each Zang also connects to a sense organ and have an associated spiritual aspect. For example, the liver connects to the eye and is associated with anger.

The Fu consists of the six hollow (Yang) organs. They are:

Small Intestine

Large Intestine

Gall Bladder

Bladder

Stomach

San Jiao or Triple Burner (also unknown to Western physiology)

In general, Fu organs are closer to the surface of the body and have the functions of receiving, separating, distributing and excreting body substances.

The Causes of Disharmony

TCM divides the causes of disharmony into three main areas:

Internal Causes

which are illnesses caused by emotions. This include anger, sadness, worry, fear, joy, grief, pensiveness and shock and are usually termed as the seven emotions. While these emotions are normal and healthy responses to the many situations we encounter in daily life, they can cause disease when they are intense or prolonged, or are not expressed or acknowledged over a long period of time.

External Causes

which are causes of disharmony that relate to climatic conditions. There are six of these conditions, usually known as the six pathogenic factors or the six outside evils. They are: wind, cold, damp, fire and heat, dryness and summer heat. Different climatic conditions are appropriate during each season and we usually adapt to them as they come and go. However, extremes of weather such as a very cold winter or unseasonal weather such as a warm spell in winter make us more vulnerable to the effects of that climatic condition and consequently to becoming ill. Also, people whose underlying energy is weak are more vulnerable to the effects of climatic conditions than those who have a strong constitution.

Miscellaneous Causes

include work, exercise, diet, sexual activity and physical trauma. TCM thinks that these factors can have a profound influence on our bodies. For example, too much physical work can impair Qi, too much mental activity can damage the Spleen, someone who works outdoors is more liable to be at risk from the six outside evils, excessive sexual activity is considered to be damaging to the Kidney and injuries would make the injured body part more vulnerable to the outside evils.

Diagnosis

In TCM, the diagnostic process is considered in four areas – known as the Four Examinations. These are:

Looking

complexion, eyes, tongue, nails, hair, gait, stature and affect

Hearing and Smelling

sound of voice and breath, odor of breath, skin

Questioning

current complaints, health history, family health history, patterns of sleep, appetite, digestion, bowel movement, bladder, sweat, pain, emotional features, lifestyle features and gynecological features

Touching

palpation of the body to discover body temperature, body moisture, pain; and taking of the pulse

Treatment

Acupuncture

Acupuncture is a form of treatment in TCM. The Chinese words for Acupuncture is ZhenJiu. Zhen means acupuncture and Jiu means moxibustion. Acupuncture is the insertion of various needles into points on the body. These points are located and join together in ‘channels’ or ‘meridians’, along which Qi flows. The points used in treatment are carefully chosen by the TCM practitioner to disperse any blockages and to bring the patient’s Qi into balance.

Moxibustion is the process whereby a dried herb is burnt, either directly on the skin or indirectly above the skin over specific acupuncture points to warm the Qi and Blood in the channels. Moxibustion is most commonly used when there is a requirement to expel Cold and Dampness from the body.

Herbology

Herbal Medicine in TCM describes formulae which are made from the roots, stems, bark, leaves, seeds or flowers of many plants, as well as some mineral and animal parts.

The herbs are usually decocted into a soup. Some come in ready-prepared pill or powder, called ‘patent’ herbal remedies. The herbal medicine are usually taken in the form of a ‘recipe’ called a prescription. To make up a prescription, the TCM practitioner carefully blends together a number of herbs which have specific functions.

Tuina

Tuina is Chinese therapeutic massage. The word ‘tuina’ actually means ‘push grab’. Some of the common techniques include rolling, pushing, grasping, kneading, rubbing, nipping, vibrating, chopping, revolving, pinching and pressing. These techniques are used individually or combined together, and apply on specific acupuncture points, along a channel or meridian, or a whole area of the body.

Although best known for its capacity to heal joint problems and create relaxation, Tuina can help many other disorders.

Qigong

The word Qigong is made up of two words, ‘Qi’ and ‘Gong’. ‘Qi’ usually translated as ‘energy’ or ‘vital energy’, is the energy that underlies everything in the universe. The word ‘Gong’ can be translated as ‘practice’. The word QiGong conveys the meaning of ‘practice concerned with exercising of Qi’. The use of Qigong to improve and maintain health was first mentioned in the Yellow Emperor’s Classic of Internal Medicine, written in about 200 BC.