Acupuncture not only cools hot flashes that occur as a result of breast cancer treatment but may offer a host of other benefits to boost women’s well-being.

A new study shows acupuncture was as good as drug therapy with Effexor (venlafaxine) at easing hot flashes in breast cancer patients, but it also improved sex drive, energy levels, and clarity of thought.

“Acupuncture offers patients a safe, effective and durable treatment option for hot flashes, something that affects the majority of breast cancer survivors. Compared to drug therapy, acupuncture actually has benefits, as opposed to more side effects,” researcher Eleanor Walker, MD, division director of breast services in the department of radiation oncology at Henry Ford Hospital in Detroit, says in a news release.

According to the National Cancer Institute, one in eight women will develop breast cancer in her lifetime. Typical treatment for breast cancer involves chemotherapy and five years of hormone therapy that often causes unpleasant side effects, such as hot flashes, night sweats, and decreased sex drive and energy levels.

Researchers say these side effects of breast cancer treatment significantly decrease a woman’s quality of life and may cause some women to discontinue treatment.

Acupuncture has already been shown to reduce hot flashes in menopausal women, but researchers say this is the first study to compare acupuncture to drug treatment in easing hot flashes in breast cancer patients. The results appear in the Journal of Clinical Oncology.

Fifty breast cancer patients were randomly assigned to receive either acupuncture or drug treatment for 12 weeks. The acupuncture group received acupuncture treatments twice per week for the first four weeks and then once a week for the remaining eight weeks; the drug group received 37.5 milligrams of Effexor each night for the first week and then 75 milligrams per night for the remaining 11 weeks.

All participants stopped their treatment after 12 weeks and kept a diary to record the number and severity of hot flashes; they were surveyed about their overall physical and mental health for one year.

Both groups experienced a 50% decline in hot flashes and symptoms of depression, but the acupuncture treatment appeared to have more lasting effects with fewer side effects.

For example, two weeks after the treatments stopped, the drug therapy group experienced an increase in hot flashes; the acupuncture group did not experience any increase in the frequency of their hot flashes until three months after treatment.

In addition, the Effexor group reported 18 instances of negative side effects, including nausea, dry mouth, dizziness, and anxiety, compared with no adverse side effects reported among the acupuncture group.

Most breast cancer patients treated with acupuncture also reported an improvement in their energy, clarity of thought, and sense of well-being. About 25% of women in the acupuncture group also reported an increase in their sex drive.

The fabulous five are research superstars

The British journal Acta Pharmacalagia Sinica, reports a study by the Cancer Biomarkers and Prevention Group at the University of Leicester in the UK. Researchers noted that intake of these phytochemical compounds is typically studied in artificial (in vitro) environments using high-dose single treatments. However, in humans (in vivo) the exposure to the compounds is persistent low-doses. They designed their study to reflect human exposure by investigating anti-tumor activity of these five phytochemicals in breast cancer cells exposed in long-term culture to typical low doses.

They found that curcumin, EGCG and I3C inhibited clonogenic growth by 55% to 60% and induced 1.5- to 2-fold higher levels of the basal caspase-3/7 activity. No changes in expression of cell cycle-related proteins or survivin were found; however, I3C reduced epidermal growth factor receptor expression, contributing to apoptosis (appropriate programmed cell death). Because some phytochemicals are shown to inhibit DNA histone modification, modulation of expression by the agents in a set of genes was compared with changes induced by inhibitors of DNA methylation or histone deacetylation. The phytochemicals modified protein and/or RNA expression of these genes, with EGCG eliciting the least and DIM the most changes in gene expression. DIM and curcumin decreased activator levels correlated with increased cell motility. Curcumin, DIM, EGCG, and genistein reduced cell sensitivity to radiation-induced DNA damage without affecting DNA repair.

The researchers concluded that this model has revealed that apoptosis and not arrest is likely to be responsible for growth inhibition. It also implicated new molecular targets and activities of the phytochemicals under conditions relevant to human exposure.

What are these compounds?

Each of these compounds is a phytochemical component of a superfood that has been found to confer great overall health benefits to those who consume it.

DIM and I3C

Diindolylmethane (DIM) and indole-3-carbinol (I3C) are components of cruciferous vegetables such as broccoli and cabbage, kale, cauliflower, radish, collard greens, Chinese cabbage, Brussel sprouts, kohlrabi, bok choy, turnip greens, rutabaga, arugula, water cress, rapeseeds and mustard seeds.

DIM has been documented as effective against cancer through several actions. It stops tumors from establishing their own blood supply necessary for their continuation of growth. It reduces cancer cell viability and causes cell growth inhibition and apoptosis. DIM down regulates both the ligand and the receptor in breast cancer cells as well as in ovarian cancer cells at the transcriptional level and in an estrogen-independent manner. The potential for chemotaxis and invasion is inhibited by DIM, thereby lowering the invasive and metastatic potential of cancer cells. DIM us able to act independently of Her-2 or estrogen receptor status. It has been shown to be a preventative and/or therapeutic agent in prostate cancer, and is able to induce the release of pro-inflammatory mediators in macrophages.

DIM is nature’s hormone modulator. The metabolism and growth promoting activity of estrogen is modified by the intake of milligram amounts of dietary indoles from cruciferous vegetables. DIM is formed from its precursor indole, indole-3-carbinol (I3C), after the enzymatic release of I3C from parent glucosinolates found in these vegetables. DIM is unique among the phytonutrients with regard to its ability to favorably modify estrogen metabolism in the direction of greater 2-hydroxy estrogen production. Improper metabolism of estrogen allows damage to DNA and cancer promotion to take place.

Societies with low consumption of cruciferous vegetables have a high prevalence of estrogen related diseases, particularly breast and prostate cancers. Supplementing with DIM can restore and maintain a favorable estrogen metabolism and greatly lessen the risk for breast and other cancers. Addition of a DIM supplement ensures the hormones used in bioidentical hormone replacement are metabolized down the proper metabolic pathways. DIM has no estrogenic activity. It balances the natural response to estrogen. In dividing cells the growth promoting signal from estrogen is limited by the reduction of the activity level of the estrogen receptor system.

Supplements of I3C are available, but the compound is unstable in the body. I3C is a precursor indole, with little action in the body until it is converted to DIM by stomach acid.

DIM is the better choice for pre and post menopausal women and men interested in supplementing rather that getting these compounds directly from food. Although obtaining nutrients from food is always preferred, the amount of cruciferous vegetables needed to provide the benefits of DIM frequently make supplementation a better choice. Although there are several DIM products available, BioResponse DIM complex, a patented from of DIM offers enhanced bioavailability. DIM-Plus, the version of DIM made by Nature’s Way, contains BioResponse DIM and is an economical choice, offered online at Vitacost.

ECGC

Epigallocatechin-3-gallate (ECGC) is a particular type of polyphenol found in green tea, a substance shown to be a cure and preventative for many of the ills of mankind. In addition to being a powerful agent in the prevention and cure of cancer, it is an antioxidant, promoter of glucose tolerance, protector of the liver and detoxification system, and benefactor of the cardiovascular system.

Recent research has documented a 54% reduction in risk of ovarian cancer in women who reported drinking green tea. Another study found green tea to have therapeutic cancer effects through induction of apoptosis in colorectal cancer. It is also one of the few effective treatments for pancreatic cancer. As a preventative for all cancers, ECGC is able to penetrate the body’s cells and shield DNA from the potent free radical hydrogen peroxide.

Green tea also lowers cholesterol levels, and reduces the clotting tendency of blood. It shows promise as a weight-loss aid that can promote the burning of fat and the regulation of insulin levels and blood sugar.

There are many green tea supplements on the market. Some of these contain the whole plant, while others contain extracts. Whole plant supplements are usually preferable because they are backed by the integrity of the whole plant. Many green tea extract supplements are standardized to provide a quantified amount of ECGC.

Curcumin

Curcumin is the active ingredient in the bright yellow spice turmeric. It is one of nature’s most powerful healers, having revealed its wonders over centuries. Numerous studies have shown curcumin to be as potent against inflammation as hydrocortisone, phenylbutazone, and over the counter NSAID drugs like Motrin, without the side effects. Its powerful antioxidant effects make it a popular natural therapeutic agent for diseases such as arthritis, where free radicals cause joint inflammation and damage. Studies have linked frequent use of turmeric to lower rates of breast, prostate, lung and colon cancer. It can prevent tumors from forming, and can slow the progression of cancer that is already present. Recent studies have documented that curcumin can slow the spread of breast cancer cells to the lungs. Turmeric acts as a transcription factor, a master switch for gene regulation. When genes are switched off, the growth and invasion of cancer cells is halted.

Curcumin is even being used effectively to treat Alzheimer’s disease due to its ability to cross the blood-brain barrier. Alzheimer’s disease is thought to occur when a fragmented protein accumulates in brain cells producing oxidative stress and inflammation, and forming plaque between nerve cells in the brain that disrupt function. Turmeric may prevent the oxidation of cholesterol in the body, thereby preventing damage to blood vessels and causing build up of plaque that can result in heart attack or stroke.

Dried turmeric is widely available. Organically grown turmeric is preferable. Frequently spicing your cooking with turmeric is one option for consuming curcumin. It can be easily mixed with rice, egg salad or into the cottage cheese flax oil mixture that is the basis of the Budwig diet. Turmeric capsules are available. Nature’s Way makes a turmeric capsule that is free of magnesium stearate, but it’s not organic. Organic turmeric can be found in the spice department of health food stores such as Whole Foods, or ordered online in powered or capsule forms. Most naturopaths suggest starting with a dose three times the normal dosage suggested in order to quickly bring inflammation under control. Then proceed with the standard dose to maintain.

Genistein

Genistein is an isoflavone found primarily in soybeans and traditional foods produced from soybeans like tofu and miso. In addition to being an antioxidant, genistein is a phytoestrogen, a plant compound that mimics the actions of estrogen and interacts with estrogen receptor in the human body.

Genistein removes damaging free radicals and reduces lipid peroxidation. By preventing the oxidation of LDL cholesterol, genistein helps reduce the risk for arteriosclerosis, and prevents the formation of heart attacks and strokes by acting as an anti-clotting agent. It increases the activity of other antioxidant enzymes such as glutathione peroxidase, superoxide dismutase (SOD), and glutathione reductase. It can also influence the growth of cells that are not hormone-dependent. Genistein inhibits the rate of cell growth through its ability to inhibit tyrosine kinase.

Studies have shown that genistein reduces the risk for the hormone related cancers, breast and prostate, by binding with estrogen receptors, preventing estrogen from binding. Consumption of traditional soybean products in China and Japan is linked with low incidence of these cancers. And since genistein imitates estrogen, it may be protective against osteoporosis. It is frequently used to ease menopause symptoms such as hot flashes.

Before genistein can act, it must be released from its precursor. This normally happens in the stomach and intestine through hydrolysis. Some genistein supplements contain genistein that has been hydrolysed in processing.

Two Chinese dietary staples – mushrooms and green tea – may have the power to ward off breast cancer, mounting evidence suggests. A study of over 2,000 Chinese women in the International Journal of Cancer found large quantities of both in the diet slashed cancer risk by up to 90%.

Research suggests chemicals in the foods block tumour growth and boost the body’s natural defences against cancer. But experts say it is unclear whether the benefits will apply to all women. It is known that the rate of breast cancer in China is four- to five-times lower than rates typically seen in developed countries, although this is changing as women are adopting Western diets rich in meat and dairy – and piling on the pounds.

Powerful extracts

Researchers have been hunting for what the Chinese secret might be. Extracts of the mushroom Phellinus linteus have been used for centuries in Easter Ancient medicine where it is believed to refresh bodies and extend life. And scientists in California have been doing a trial to see if taking a mushroom extract twice a day for a month helps breast cancer survivors remain free of the disease after work showed the extract could halt the growth of breast cancer cells.

The new study of Chinese women, by a team at the University of Western Australia in Perth, found that women who ate at least 10g – around a third of an ounce – of fresh mushrooms daily were 64% less likely to develop breast cancer.  Dried mushrooms had a slightly less protective effect, reducing the risk by around half. And women who combined a mushroom diet with regular consumption of green tea saw an even greater benefit.

The risk among women in this group was reduced by almost 90%. Green tea contains antioxidant compounds called polyphenols that have been shown to fight breast tumours in animals. Black tea, although made from the same plant called Camellia sinesis, is not believed to have the same properties because the leaves are processed differently. Black tea leaves go through a fermentation process that strips the plant of its natural polyphenol compounds.

No ’super food’

Researcher Min Zhang and colleagues stressed that their study does not prove cause-and-effect. Although they did account for other known risk factors for breast cancer, such as the women’s weight, education level, and exercise frequency and smoking habits, there could be other factors that explain the findings.

Dr Julie Sharp of Cancer Research UK said: “Both green tea and mushrooms have previously been reported to lower cancer risk and while this study adds to the evidence, more research is needed to confirm these observations and find out if they are relevant to UK women.

“It is important to remember there is no one particular ’super’ food that will protect you from cancer.

“Large scientific studies have proven that the best way to reduce your risk of many cancers is to eat a healthy balanced diet.” Dr Sarah Cant of Breakthrough Breast Cancer said: “Breast cancer incidence rates do vary in different countries and China has lower rates than the UK.

“However, this is likely to be due to cultural and lifestyle differences such as having children earlier or exercising more for example, and is unlikely to be solely due to diet.

“We still aren’t sure which individual food types influence the chance of developing this disease.”

A research article to be published on September 28, 2009 in the World Journal of Gastroenterology addresses this question. The research team, led by Prof. Zong-fang Li from the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, investigated the effects of Chrysanthemum indicum extract (CIE) on inhibition of proliferation and on apoptosis, and the underlying mechanisms, in a human HCC MHCC97H cell line.

They examined viable rat hepatocytes and human endothelial ECV304 cells by trypan blue exclusion and MTT assay, respectively, as normal controls. The proliferation of MHCC97H cells was determined by MTT assay. The cellular morphology of MHCC97H cells was observed by phase contrast microscopy. Flow cytometry was performed to analyze cell apoptosis with annexin V/propidium iodide (PI), mitochondrial membrane potential with rhodamine 123 and cell cycle with PI in MHCC97H cells. Apoptotic proteins such as cytochrome C, caspase-9, caspase-3 and cell cycle proteins, including P21 and CDK4, were measured by Western blotting.

The results showed CIE inhibited proliferation of MHCC97H cells in a time- and dose-dependent manner without cytotoxicity in rat hepatocytes and human endothelial cells. CIE induced apoptosis of MHCC97H cells in a concentration-dependent manner, as determined by flow cytometry. The apoptosis was accompanied by a decrease in mitochondrial membrane potential, release of cytochrome C and activation of caspase-9 and caspase-3. CIE arrested the cell cycle in the S phase by increasing P21 and decreasing CDK4 protein expression.

The researchers drew a conclusion that CIE exerted a significant apoptotic effect through a mitochondrial pathway and arrested the cell cycle by regulation of cell cycle-related proteins in MHCC97H cells without an effect on normal cells. The cancer-specific selectivity shown in their study suggests that the plant extract could be a promising novel treatment for human cancer.

A UK charity said the tea might help men manage low-risk tumours. Although previous studies have shown benefits from drinking green tea – including some positive findings in relation to prostate cancer, there have been mixed results. In this study, Philadelphia-based researchers tested a compound called Polyphenon E.

They were looking for a number of biomarkers – molecules – including vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) which are indicators of developing cancer. They also looked for prostate specific antigen (PSA) – a protein only found in the prostate. Levels can rise if cancer is present.

Polyphenon E (12 cups of tea)

The study included 26 men, aged 41 to 72 years, who had been diagnosed with prostate cancer and who were scheduled for radical prostate surgery. Patients took four capsules containing Polyphenon E for an average of 34 days, up until the day before surgery – the equivalent of around 12 cups of normally brewed concentrated green tea.

The study found a significant reduction in levels of HGF, VEGF and PSA, with some patients demonstrating reductions of more than 30%.

Dr James Cardelli, from the Feist-Weiller Cancer Center, who led the study, said the compound, which was provided by the company Polyphenon Pharma, “may have the potential to lower the incidence and slow the progression of prostate cancer.” There were only a few reported side effects associated with this study, and liver function remained normal.

Dr Cardelli said: “We think that the use of tea polyphenols alone or in combination with other compounds currently used for cancer therapy should be explored as an approach to prevent cancer progression and recurrence.” “There is reasonably good evidence that many cancers are preventable, and our studies using plant-derived substances support the idea that plant compounds found in a healthy diet can play a role in preventing cancer development and progression.”

Active Surveillance

John Neate, chief executive of the Prostate Cancer Charity, said: “There have been several studies into green tea and its potential benefits, but there is, as yet, no conclusive evidence. “The results of this study do suggest that there is merit in further research into the effects of extracts of green tea, both in relation to its impact on the prevention of prostate cancer and in controlling progression in men already diagnosed with the disease, as was investigated in this instance.”

“These initial positive findings could indicate that green tea could have a place in ‘active surveillance’, where a slow-growing, low risk tumour is monitored for changes and men want to take something which could help keep progression at bay. “Potentially, this could mean completely avoiding, in some cases, any of the more usual medical interventions and their associated side effects.”

The results from the Phase I clinical study, a collaborative research project between M. D. Anderson and Fudan University Cancer Hospital in Shanghai, are reported in the online Early View feature of the journal Cancer. The study marks the first time a formal clinical trial has examined the relationship between huachansu dose and toxicity, although the drug is common in China and approved by the Chinese Food and Drug Administration.

Huachansu is widely used to treat patients with liver, lung, colon and pancreatic cancer at oncology clinics in China. Chinese clinical trials conducted since the 1970s have demonstrated the anti-cancer properties of huachansu, citing total response rates of 10% and 16% observed in patients with advanced hepatocellular carcinoma and lung cancer.

“Studying traditional Chinese medicine such as huachansu is new to American research institutions, which have been skeptical and slow to adopt these complementary treatments. However, it is important to understand its potential role in treating cancer,” says Lorenzo Cohen, Ph.D., one of the paper’s authors and director of the Integrative Medicine Program at M. D. Anderson. “We wanted to apply a Western medicine-based approach to explore the role of the toad venom compound in cancer patients and test if it is possible to deliver a more potent dose without raising toxicities or side effects.”

The clinical trial was conducted at the Fudan University Cancer Hospital while M. D. Anderson provided training and ongoing consultation. The institutions collaboratively designed the trial that was approved by both institutional review boards. M. D. Anderson and Fudan University Cancer Hospital signed a sister institution agreement in 2003, creating a framework for research, educational and clinical collaboration.

The typical dose of huachansu used in China is approximately 15 milliliters of drug per meter squared of body mass (mL/m2). In the study, 15 patients with stage III or IV hepatocellular (liver) carcinoma, nonsmall cell lung cancer or pancreatic cancer received one of five dose levels ranging from 10 mL/m2 up to 90 mL/m2 from January 2005 through July 2006. The treatment was repeated daily for 14 days followed by seven days off (one cycle). After two cycles, most patients received other treatments. Quality control methods were put in place to ensure huachansu of a uniform and consistent lot.

While the dose was up to eight times higher than conventional doses used in China, researchers observed only low toxicities or side effects. Eleven (73%) patients had no toxicities greater than the lowest grade measured. Importantly, no significant cardiac toxicity was observed and no significant changes in cancer-related symptoms occurred. Of the 15 patients who completed the treatment, six hepatocellular carcinoma patients (40%) had stable disease for a median of six months. One patient had a 20% reduction in tumor mass that lasted for more than 11 months.

“Even though we saw no complete or partial response (reduction of disease by 30% or more) it is encouraging that the cancer did not progress in a large set of the hepatocellular carcinoma patients,” says Zhiqiang Meng, principal investigator on the trial and an associate professor and deputy chair of the Department of Integrative Oncology at Fudan University Cancer Hospital, “Previous observations from studies conducted in China have shown that huachansu can inhibit tumor cell growth and improve immunologic function3. These findings, coupled with that knowledge, demonstrate the need for further clinical trials of this promising agent.”

A Phase II clinical trial comparing the effects of huachansu combined with gemcitabine (Gemzar®) to gemcitabine and placebo for patients with advanced pancreatic cancer is under way at the Fudan University Cancer Hospital in collaboration with M. D. Anderson. Both trials are part of the International Center of Traditional Chinese Medicine for Cancer funded by the National Cancer Institute. Anhui Jinchan Biochemistry Company, Ltd., provided the drug for this trial.

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.