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Traditional Chinese Medicine – a universe within

Traditional Chinese Medicine, also known as TCM (simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōngyī), includes a range of traditional medical practices originating in China. Although well accepted in the mainstream of medical care throughout East Asia, it is considered an alternative medical system in much of the western world.

TCM practices include such treatments as herbal medicine (中药), acupuncture, dietary therapy, and both Tui na and Shiatsu massage. Qigong and Taijiquan are also closely associated with TCM. TCM claims to be rooted in meticulous observation of nature, the cosmos, and the human body, and to be thousands of years old. Major theories include those of Yin-yang, the Five Phases, the human body Channel system, Zang Fu organ theory, six confirmations, four layers, etc. Modern TCM was systematized in the 1950s under the People’s Republic of China and Mao Zedong.

History

Much of the philosophy of traditional Chinese medicine derives from the same philosophy that inform Taoist and Buddhist thought, and reflects the classical Chinese belief that the life and activity of individual human beings have an intimate relationship with the environment on all levels.

In legend, as a result of a dialogue with his minister Qibo (岐伯), the Yellow Emperor (2698 – 2596 BCE) is supposed by Chinese tradition to have composed his Neijing: Suwen or Inner Canon: Basic Questions (《内经·素问》). The book Huangdi Neijing’s (黄帝内经, Yellow Emperor’s Inner Canon) title is often mistranslated as Yellow Emperor’s Classic of Internal Medicine. 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. Also another Chinese index book of herbs is “Ben Cao Gang Mu” (本草纲目) written by Li Shi Zhen.

During the Han Dynasty (202 BC –220 AD), Zhang Zhongjing (张仲景/張仲景), 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. Another prominent Eastern Han physician was Hua Tuo (c. 140 – c. 208 AD), who anesthetized patients during surgery with a formula of wine and powdered marijuana. Hua’s physical, surgical, and herbal treatments were also used to cure headaches, dizziness, internal worms, fevers, coughing, blocked throat, and even a diagnosis for one lady that she had a dead fetus within her that needed to be taken out. 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 (甲乙经/甲乙經), ca. 265 AD. During the Tang dynasty, Wang Bing 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.

There were noted advances in Chinese medicine during the Middle Ages. Emperor Gaozong (r. 649–683) of the Tang Dynasty (618–907) commissioned the scholarly compilation of a materia medica in 657 that documented 833 medicinal substances taken from stones, minerals, metals, plants, herbs, animals, vegetables, fruits, and cereal crops. In his Bencao Tujing (‘Illustrated Pharmacopoeia’), the scholar-official Su Song (1020–1101) not only systematically categorized herbs and minerals according to their pharmaceutical uses, but he also took an interest in zoology. For example, Su made systematic descriptions of animal species and the environmental regions they could be found, such as the freshwater crab Eriocher sinensis found in the Huai River running through Anhui, in waterways near the capital city, as well as reservoirs and marshes of Hebei.

The term “TCM” describes the modern practice of Chinese medicine as a result of sweeping reforms that took place after 1950 in the People’s Republic of China. The term “Classical Chinese medicine” (CCM) often refers to medical practices that rely on theories and methods dating from before the fall of the Qing Dynasty (1911). Advocates of CCM portray it as less influenced by Western and political agendas than TCM.

Theory

Traditional Chinese medicine is largely based on the philosophical concept that the human body is a small universe with a set of complete and sophisticated interconnected systems, and that those systems usually work in balance to maintain the healthy function of the human body. The balance of yin and yang is considered with respect to:

  • Qi (“breath”, “life force”, or “spiritual energy”)
  • Blood, jing (“kidney essence”, including “semen”)
  • Other bodily fluids,
  • The Wu Xing
  • Emotions
  • The soul or spirit (shen)

Theories in TCM describing human body are:

  • Meridians (经络, 經絡)
  • Wu Xing (五行) – Wood(木), Fire(火), Earth(土), Metal(金), Water (水)
  • Qi (氣/气)
  • Three Burners (三焦) – Upper Jiao(上焦), Middle Jiao(中焦), Lower Jiao(下焦)
  • Yin (阴 or 陰) and Yang (阳 or 陽)
  • Zang and Fu  (脏腑 or 臟腑)

The Yin/Yang and five element theories may be applied to a variety of systems other than the human body, whereas Zang Fu theory, meridian theory and theree burners (Triple warmer) theories are more specific.

There are also separate models that apply to specific pathological influences, such as the Four stages theory of the progression of warm diseases, the Six levels theory of the penetration of cold diseases, and the Eight principles system of disease classification.

Diagnostics

Following a macro philosophy of disease, traditional Chinese diagnostics are based on overall observation of human symptoms rather than “micro” level laboratory tests. There are four types of TCM diagnostic methods: observe (望 wàng), hear, smell (闻/聞 wén), background (问/問 wèn) and touch (切 qiè). The pulse-reading component of the touching examination is so important that Chinese patients may refer to going to the doctor as “Going to have my pulse felt”.

Traditional Chinese medicine is considered to require considerable diagnostic skill. A training period of years or decades is said to be necessary for TCM practitioners to understand the full complexity of symptoms and dynamic balances. Modern practitioners in China often use a traditional system in combination with Western methods.

Techniques

  • Palpation of the patient’s radial artery pulse (pulse diagnosis) in six positions.
  • Observations of patient’s tongue, voice, hair, face, posture, gait, eyes, ears, vein on index finger of small children.
  • Palpation of the patient’s body (especially the abdomen, chest, back, and lumbar areas) for tenderness or comparison of relative warmth or coolness of different parts of the body.
  • Observation of the patient’s various odors.
  • Asking the patient about the effects of their problem.
  • Anything else that can be observed without instruments and without harming the patient.
  • Asking detailed questions about their family, living environment, personal habits, food diet, emotions, menstrual cycle for women, child bearing history, sleep, exercise, and anything that may give insight into the balance or imbalance of an individual.

Methods of treatment

The following methods are considered to be part of Chinese medicine:

  1. Acupuncture(针灸/針灸) (from the Latin word acus, “needle”, and pungere, meaning “prick”) is a technique in which the practitioner inserts fine needles into specific points on the patient’s body. Usually about a dozen acupoints are needled in one session, although the number of needles used may range anywhere from just one or two to 20 or more. The intended effect is to increase circulation and balance energy (Qi) within the body.
  2. Auriculotherapy (耳灼疗法/耳燭療法), which comes under the heading of Acupuncture and Moxibustion.
  3. Chinese food therapy (食疗/食療): Dietary recommendations are usually made according to the patient’s individual condition in relation to TCM theory. The “five flavors” (an important aspect of Chinese herbalism as well) indicate what function various types of food play in the body. A balanced diet, which leads to health, is when the five functional flavors are in balance. When one is diseased (and therefore unbalanced), certain foods and herbs are prescribed to restore balance to the body.
  4. Chinese herbal medicine (中草药/中药/中藥): In China, herbal medicine is considered as the primary therapeutic modality of internal medicine. Of the approximately 500 Chinese herbs that are in use today, 250 or so are very commonly used.[citation needed] Rather than being prescribed individually, single herbs are combined into formulas that are designed to adapt to the specific needs of individual patients. A herbal formula can contain anywhere from 3 to 25 herbs. As with diet therapy, each herb has one or more of the five flavors/functions and one of five “temperatures” (“Qi”) (hot, warm, neutral, cool, cold). After the herbalist determines the energetic temperature and functional state of the patient’s body, he or she prescribes a mixture of herbs tailored to balance disharmony. One classic example of Chinese herbal medicine is the use of various mushrooms, like reishi and shiitake, which are currently under intense study by ethnobotanists and medical researchers for immune system enhancement.
  5. Cupping (拔罐): A type of Chinese massage, cupping consists of placing several glass “cups” (open spheres) on the body. A match is lit and placed inside the cup and then removed before placing the cup against the skin. As the air in the cup is heated, it expands, and after placing in the skin, cools down, creating a lower pressure inside the cup that allows the cup to stick to the skin via suction. When combined with massage oil, the cups can be slid around the back, offering what some practitioners think of as a reverse-pressure massage.
  6. Die-da or Tieh Ta (跌打) is usually practiced by martial artists who know aspects of Chinese medicine that apply to the treatment of trauma and injuries such as bone fractures, sprains, and bruises. Some of these specialists may also use or recommend other disciplines of Chinese medical therapies (or Western medicine in modern times) if serious injury is involved. Such practice of bone-setting (整骨) is not common in the West.
  7. Gua Sha (刮痧)
  8. Moxibustion: “Moxa,” often used in conjunction with acupuncture, consists in burning of dried Chinese mugwort (Artemisia vulgaris) on acupoints. “Direct Moxa” involves the pinching of clumps of the herb into cones that are placed on acupoints and lit until warm. Typically the burning cone is removed before burning the skin and is thought, after repeated use, to warm the body and increase circulation. Moxa can also be rolled into a cigar-shaped tube, lit, and held over an acupuncture point, or rolled into a ball and stuck onto the back end of an inserted needle for warming effect.
  9. Physical Qigong exercises such as Tai chi chuan (Taijiquan 太极拳/太極拳), Standing Meditation (站樁功), Yoga, Brocade BaDuanJin exercises (八段锦/八段錦) and other Chinese martial arts.
  10. Qigong (气功/氣功) and related breathing and meditation exercise.
  11. Tui na (推拿) massage: a form of massage akin to acupressure (from which shiatsu evolved). Oriental massage is typically administered with the patient fully clothed, without the application of grease or oils. Choreography often involves thumb presses, rubbing, percussion, and stretches.
  12. Some TCM doctors may also utilize esoteric methods that incorporate or reflect personal beliefs or specializations such as Fengshui (风水/風水) or Bazi (八字).

Branches

Traditional Chinese medicine has many branches, the most prominent of which are the Jingfang (经方学派) and Wenbing (温病学派) schools. The Jingfang school relies on the principles contained in the Chinese medicine classics of the Han and Tang dynasty, such as Huangdi Neijing and Shennong Bencaojing. The more recent Wenbing school’s practise is largely based on more recent books including Compendium of Materia Medica from Ming and Qing Dynasty, although in theory the school follows the teachings of the earlier classics as well. Intense debates between these two schools lasted until the Cultural Revolution in mainland China, when Wenbing school used political power to suppress the opposing school.

Modernization

Traditional Chinese medicine has been to some degree modernized by transforming the plants and ingredients to soluble granules and tablets. Modern formulations in pills and sachets used 675 plant and fungi ingredients and about 25 from non-plant sources such as snakes, geckos, toads, frogs, bees, and earthworms. Investigation of the active ingredients in TCM has produced a western style drug: Artemisinin which is now widely used in the treatment of malaria.

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Category: TCM

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