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Introduction to Traditional Chinese Medicine

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Chinese healers began the development of Traditional Chinese Medicine (TCM) more than 3,000 years ago. As a comprehensive health system, it has a range of applications from preventive health care and maintenance to diagnosis and treatment of acute and chronic disorders. Find out all about TCM in this sample chapter.
This chapter is from the book

In This Chapter

  • The history and philosophy of Traditional Chinese Medicine

  • Theories of illness and health in Traditional Chinese Medicine

  • Diagnostic and therapeutic techniques in Traditional Chinese Medicine

  • Learning about and trying Traditional Chinese Medicine

Chinese healers began the development of Traditional Chinese Medicine (TCM) more than 3,000 years ago. As a comprehensive health system, it has a range of applications from preventive health care and maintenance to diagnosis and treatment of acute and chronic disorders. Its treatments and diagnostic methods focus on balancing internal and external energies through diet, herbal treatments, acupuncture, and breathing techniques. Chinese healing practices have also spread, with variations, throughout other Asian countries, particularly Japan, Korea, Tibet, and Vietnam. In a few millennium of practice, TCM practitioners have evolved a system both subtle and dramatically effective, and one that, in China, is given as much if not more respect than Western medicine.

What Is Traditional Chinese Medicine?

Shen Nong the Fire Emperor, said to have lived from 2698 to 2598 BC, is considered the founder of herbal medicine in China. The written history of Traditional Chinese Medicine is more than 2,500 years old, starting with the text on internal medicine from Huang Di, the Yellow Emperor. Written long before the birth of Hippocrates, the father of Western medicine, the Huang Di Nei Jing (Yellow Emperor's Inner Classic) covers such principles as yin and yang, the five phases, the effects of the season, and treatments such as acupuncture and moxibustion (the burning of mugwort over inflamed and affected areas of the body).

TCM is associated with early Taoists and Buddhists who observed energy within themselves, in plants and animals, and throughout the cosmos. Based on a belief in the natural order of the universe and the direct correlation between the human body and the cosmos, this philosophy stresses the constant search for harmony and balance in an environment of constant change. By the close of the Han era (220 AD), the Chinese had a clear grasp of the nature of disease, preventive medicine, first aid, and dietetics, and had devised breathing practices to promote longevity.

During the fourth and fifth centuries AD, China's influence spread throughout Asia, and both Taoism and Buddhism had a marked impact on ideas about health. Sun Si Mian (581–682 AD), a famous physician, established himself as China's first medical ethicist. He advocated the need for rigorous scholarship, compassion toward patients, and high moral standards in physicians. In the eleventh century, TCM began to focus more on social phenomena, especially human relations and ethical behavior. Initially this orientation resulted in increased scientific medical study and publications.

As TCM developed further, however, people began to take for granted that a breakthrough in one realm of knowledge would eventually solve all problems of human existence. (As in the West, some assume that advances in technology will solve all problems.) Eventually, sociological methods were applied to medical problems, and clinical and empirical research reached a low point. Fortunately, the core of the scientific system was never obliterated, and this century has seen a worldwide revival of Traditional Chinese Medicine.

In China today, TCM is practiced in hospitals alongside Western medicine. Physicians not only study principles of anatomy, histology, biochemistry, bacteriology, and surgery but also acupuncture, acupressure, and herbal medicine. Patients can choose TCM or Western approaches alone or in combination to treat their particular problem.

TCM's development over thousands of years has yielded multiple philosophies, convergent concepts, and varied practices and treatments. It's impossible to separate the individual concepts and specific treatment approaches from the philosophy of the entire system. Prevention, diagnosis, and treatment of diseases are based on the concepts of chi, yin and yang, the five phases, the five seasons, and the three treasures. Often only isolated fragments of TCM emerge in the West, which may prevent more complete understanding and acceptance there.

Chi: The Energy in You and Me

The concept most central to TCM is chi (pronounced chee, and also spelled qi), which is translated as energy. Chi represents an invisible flow of energy that circulates through plants, animals, and people as well as the earth and sky. It is what maintains physiologic functions and the health and well-being of the individual. In TCM theory, energy is distributed throughout the body along a network of energy circuits or meridians, connecting all parts of the body. Obstructed chi flow in the human body can cause problems ranging from social difficulties to illness. Its effects are very individual—a person gets sick, has problems at work, or fights with family—and depend on each individual's unique chi. Certain TCM treatments such as meditation, exercise, and acupuncture are ways of enhancing or correcting the flow of chi.

Yin and Yang: Two Parts of the Whole

In the Taoist philosophy, wholeness is composed of the union of opposites—dark and light, soft and hard, female and male, slow and fast, and so forth. These opposite but complementary aspects are called yin and yang. Originally the terms designated geographical aspects such as the shady and sunny side of a mountain or the southern and northern bank of a river. In modern terms, they are used to characterize the polar opposites that exist in everything and make up the physical world. The traditional representation of the union of yin and yang is shown in Figure 3.1

Figure 3.1Figure 3.1 Yin and yang: inseparable parts of the whole, each containing part of the other.

From the health perspective, the basis of well-being is the appropriate balance of yin and yang as they interact in the body. The imbalance of yin and yang is considered to be the cause of illness.

Yin is the general category for passivity and is like water, with a tendency to be cold and heavy. Yin uses fluids to moisten and cool our bodies. It provides for restfulness, as the body slows down and sleeps. Yin is associated more with substance than with energy. Things that are close to the ground are yin or more earthy. Yin is associated with the symptoms of coldness, paleness, low blood pressure, and chronic conditions. People with excess yin tend to catch colds easily, and are sedentary and sleepy.

Yang is the general category for activity and aggressiveness. It is like fire with its heating and circulating characteristics. Associated with things higher up or more heavenly, yang is the energy that directs movement and supports its substance. Symptoms such as redness in the face, fever, high blood pressure, and acute conditions are associated with yang. People with excess yang tend to be nervous and agitated and cannot tolerate much heat.

It must be understood that yin and yang cannot exist independently of each other. Nothing is either all yin or all yang. They are complementary and depend on each other for their very existence—without night there can be no day, without moisture there can be no dryness, and without cold there can be no heat. It is the interaction of yin and yang that creates the changes that keep the world in motion; summer leads to winter, night becomes day. Yin and yang are used in both the diagnosis and treatment of illness. For example, if a person is experiencing too much stress, usually understood as an excess of yang, more yin activities, such as meditation and relaxation, are the appropriate treatment.

The Five Phases: An Internal Cycle in Balance

As they studied the world around them, the Chinese perceived connections between major forces in nature and particular internal organ systems. Seeing similarities between natural elements and the body, early practitioners developed a concept of health care that encompassed both natural elements and body organs. This theory is known as the Five Phases Theory (wu-hsing). Five elements—fire, earth, metal, water, and wood—represent movement or energies that succeed one another in a dynamic relationship and in a continuous cycle of birth, life, and death. These elements do not represent static objects, since even mountains and rivers change constantly with time. In the Five Phases Theory, it is not the substances themselves that are important, but rather how they work together to make up the essential life force or chi.

The rhythm of events resembles a circle known as the Creation Cycle. In this cycle, wood burns to feed fire; fire's ashes produce earth; earth gives up its ore to create metal; metal causes condensation to bring forth water; and water nourishes and creates plants and trees, creating wood. Each element is related to a specific bodily system, as well as to a pair of internal organs—you guessed it, a yin organ and a yang organ. The yin organ is solid and dense, like the liver, while its yang partner is hollow or forms a pocket, like the gallbladder. Remember, no one element is the beginning or end—they flow together in an endless loop. It is the proper interaction of the organ partners that influences how well the entire body functions. The elements and their related systems and organs are shown in Table 3.1.

Table 3.1 Elements, Systems, and Organs of the Five Phases

Element

System

Yin Organ

Yang Organ

Wood

Toxin processing

Liver

Gallbladder

Fire

Circulation of blood, hormones, and food

Heart

Small Intestine

Earth

Digestion

Spleen & Pancreas

Stomach

Metal

Respiration and Elimination

Lungs

Large Intestine

Water

Elimination

Kidneys

Bladder


The Five Seasons: Balanced on the Outside

Just as the internal world of systems and organs is linked to the Five Phases, so too is the external world, specifically, the seasons and points of the compass. "But wait a minute," you say. "There are only four of each of those!" Remember, though, that the Chinese name for China means "The Middle Kingdom," and the fifth direction, the center, becomes obvious. Just as the center of the compass has a distinct identity in TCM, so does the center of the year—the late summer, when the agricultural cycle is at its peak, and after which most living things begin to decline into their Winter states.

The Chinese compass differs from the Western compass in one other way: Chinese culture places so much importance on the direction south that it, rather than north, is placed at the top of maps and compass roses. Just as south rules the top of the compass, it also represents summer, the "high noon" of the year and is linked to fire. West, the direction of the setting sun, is associated with autumn and metal, which is used to make tools for harvesting. North is linked to winter and water, the opposite of the element of fire and is seen as a period of dormancy. East, the direction of the rising sun, is associated with spring and with wood, which represents all growing things. The fifth and central element, earth, is related to the late summer season and a time of maturity. These relationships are shown in Figure 3.2.

Figure 3.2Figure 3.2 The Chinese compass rose gives not only direction, but also seasons, elements, and phases of the year.

Traditional Chinese Medicine traces the causes of disease to imbalances in these sets of five—elements, organs, seasons, and directions. If one component is overbearing and excessive, the system is thrown out of balance, and another component becomes weak and debilitated. It is a complex system of checks and balances that is often not easily grasped by those with a Western perspective. Diagnosis and treatment of illness depends on understanding the five elements, seasons, and directions and how they interact.

The Three Vital Treasures: Building Blocks of Life

The Chinese believe that a combination of life force elements make up the substance and functions of the body, mind, and spirit, which are fundamentally all one and the same. One way to understand this connection is to think of water with its wet, fluid nature. Compare that to ice, which not only appears different but feels hard and cold, and steam with its hot, gaseous nature. Despite the differences in appearance, the molecules are the same, they are simply in three different states. In the same way, body, mind, and spirit can be seen as different expressions of the same individual.

The Taoists call body, mind, and spirit the three "vital treasures." They are jing, meaning basic essence, chi meaning energy or life force, and shen meaning spirit and mind. The balance of their abundance or deficiency influences the state of health.

Jing is the essence with which people are born, similar to Western concepts of genes, DNA, and heredity. Essence is the gift of one's parents; it is the basic material in each cell that allows that cell to function. It is the bodily reserves that support life and must be restored by food and rest. Chi, as described previously, is the sustaining energy of all life. The vital treasure known as shen is the gift of heaven and represents spiritual and mental aspects of life. Shen comprises one's emotional well-being, thoughts, and beliefs. It is the radiance, or inner glow, that can be perceived by others. In order for people to be healthy, their physical, emotional, mental, and spiritual aspects must be balanced.

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