Traditional Chinese Medicine (TCM) is a holistic, comprehensive health care system that has diagnosed, treated, and prevented illness for over 2500 years. Using diet and exercise, massage (Tui Na, Shiatsu, and other forms of Asian bodywork therapy), acupuncture, and herbal medicine, TCM can correct disorders, alter the states of mind, enhance immunity and increase our capacity for creativity, work and pleasure. It is one of the most popular forms of alternative medicine in the world today.
- Philosophy and Theory
- TCM Keywords
- TCM in USA
Traditional Chinese Medicine (TCM) is based on the observation of nature and natural phenomena. TCM views humans as a microcosm of the universe that surrounds them. Humans, and all life forms, are seen as inseparable from the nature. Humans represent the juncture between the cosmos and the earth, a fusion of cosmic and terrestrial forces. Sustained by the power of earth and transformed by the power of the cosmos, humanity cannot be separated from the nature.
As all things are seen as being interconnected, TCM postulates that what is good for nature is good for humanity, what is good for the mind is good for the body, and so on. To harm a part is to harm the whole; what is bad for the heart is bad for the body: nothing exists in isolation. This philosophy also implies that what harms one person damages all people and what injures the earth injures us all. TCM practitioners are practitioners of the "vitalist doctrine", which states that "man assists, but nature heals"; as opposed to the "doctrine of specific cause", which postulates that a single micro-organism could produce specific symptoms in healthy organisms.
Whereas Western medicine takes a structural view of the human system, TCM emphasizes a functional approach. The traditional Oriental view of human physiology is based on a concept of energy fields, a view comparable to the modern concept of an energy field that has arisen in contemporary physics. According to this idea, matter and energy are inseparable, dependent on each other and defined by each other. The separation of matter and energy, inner and outer, physical and mental is not realistic, as they are the same phenomena viewed from different perspectives. We use these opposing concepts merely to enable us to conceptualize the dynamic interplay, or cosmic dance, constantly going on around and within us, and with which we are intricately involved.
This "functional" approach of TCM is very different from Western allopathic medicine's "structural" view of health and disease. In allopathic medicine, disease is something alien to the person, something that must be killed or removed (the "doctrine of specific cause"). Western treatment tends to be geared towards treating a specific ailing organ or fighting an alien invasion. "Health" is then the absence of disease: in a simplistic manner, disease is only recognized when an outside pathogen invades the organism, or when there is structural damage to an organ: very little consideration is given to the lowered immune system that allowed the pathogen to invade, or the years of deterioration of the organ before structural damage was evident.
The functional approach of TCM views life as a dynamic process involving the interaction of forces and energies both within and outside the individual. These external forces are the climate, pathogenic factors, and the total environment outside our body. Internal factors include our genetic background, constitution, and our emotional, mental, and spiritual aspects.
TCM views well-being as a dynamic balance between these internal and external forces. Health is seen as the ability of an organism to respond appropriately to a wide variety of challenges in a way that insures maintaining equilibrium and balance. An imbalance may cause a disharmony in the system and, unless corrected, may eventually lead to a disease. "Disease" represents a failure of the organism to adapt to a challenge, a disruption of the overall equilibrium. The goal of TCM is to maintain this balance, or to assist the individual to return to a state of dynamic balance, enabling him or her to achieve their optimal level of well-being. This state of well-being differs for everyone, and differs for everyone at different stages of life: even in the grips of terminal disease, there is a state of well-being that you can attain.
As a microcosm of nature, a cosmos in miniature, we are propelled by the same forces that are found in nature and follow the same cyclical patterns and processes. According to the ancient Chinese art of practical ecology, known as Feng Shui, the earth has veins of energy that course through it, hold it together, and act as a grid from which all life derives its power. In a similar manner, all living beings have a grid, the meridians, through which life energy (Qi) flows. These meridians, or energy grids, also contain points on them that affect the meridians. Many of these acupressure points are located in areas that are particularly difficult for Qi to pass through. Acupuncture points also have specific energetic functions that affect specific organ meridians or the system as a whole.
Asian bodywork therapy, acupuncture, and Chinese herbal medicine use this meridian system and the corresponding acupuncture points to communicate with the innate healing abilities of the living organism. The goal of all Oriental therapies is to return the individual to a state of dynamic balance, enabling him or her to achieve their optimal level of well being.
In TCM, health and disease relates to balance of the functions. Health is not static, but rather the ability to maintain balance between the Zang Fu organs and tissues of the human body, as well as between the human body and natural environment. All are in a relatively balanced state in order to maintain the body's normal physiological function. When this balance is destroyed disease results.
Through long term clinical practice, the ancient Chinese realized that there are many factors which may bring about imbalances in the human body and thus disease. These factors are categorized as six exogenous factors, pestilential factors, seven emotional factors, and other pathogenic factors.
1. Six Exogenous Factors
The six exogenous factors, wind, cold, summer-heat, fire, dryness, and fire, are the six variations in the climate of the four seasons. They are also known as the "six external evils", and they can appear in combination or alone. Under normal condition, the human body has the ability to adapt to climatic variations. However, when bodily resistance is too weak to adapt to climatic changes or if there is an abnormal altering of the weather which surpasses the body's adaptability, the six external evils can penetrate the body and cause an imbalance. If our defensive system is strong, it simply repels the invasion or adjusts to the sudden changes; if the defensive system is weak or the evils unusually strong, an illness develops and may go progressively deeper in the body.
2. Pestilential Factors
Pestilence factors are kind of strong infectious pathogenic factors which are the source of epidemic diseases. The nature or pestilence factor is similar to pathogenic heat and summer heat, but more serious than the pathogenic heat in toxicity; it is usually accompanied by pathogenic damp. Pestilential diseases are epidemical and dangerous, with rapid drastic changes as seen in facial erysipelas, mumps, pestilent dysentery, diphtheria, scarlet fever, smallpox, cholera and plague.
3. Seven Emotional Factors
Traditional Chinese medicine emphasizes the relation between diseases and mental activities. Emotional mental activities are categorized as the seven emotional factors: joy, anger, melancholy, worry, grief, fear, and fright. They are the main pathogenic factors of endogenous diseases.
The seven pathogenic emotions are physiological reflections of the human mental state or are induced by various environmental stimulations. Under normal conditions these physiological phenomena will not cause disease. However, if the emotions are too stressful and constant, or the patient is too sensitive to stimulation, then they may induce acute and long-standing changes which result in diseases.
Different pathogenic emotional factors also selectively damage certain Zang Fu organs. For example, anger injures the liver, over-joy injures the heart, grief and melancholy injure the lung, fright and fear injure the kidney, and over-thinking injures the spleen.
Pathogenic emotional factors are considered capable of disturbing the functional activities of Qi. For example, according to an ancient saying, "Excessive anger drives Qi upward, excessive joy slows Qi down, excessive anxiety inhibits Qi, excessive worry or over-thinking leads to Qi stagnation, excessive grief drives Qi downward, and fright scatters Qi."
4. Other Pathogenic Factors
Besides the previously mentioned pathogenic factors, there are also pathogenic factors relating to weak constitution, irregular diet, over-strain and stress, insufficient physical activity, excessive sexual activity, traumatic injuries, parasites, and pathological products such as phlegm-humor and blood stasis.
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TCM diagnosis emphasizes the interrelatedness of all aspects of physiology and pathophysiology. Rather than focus on discrete disorders (headache, indigestion, infertility), systems (cardiac, pulmonary, renal), or conditions (Diabetes, Hypertension, Addiction), TCM practitioners examine the relationship of multiple systems in order to make an accurate diagnosis and treatment plan.
Diagnostic methods in TCM include four basic methods: inspection, auscultation and olfaction, inquiry and palpation.
- Inspectionobserve the entire body, which includes the tongue, complexion, body shape, posture, movement and vitality
- Auscultation and Olfactionobserve the smell of body odors, excretions and secretions; listen to the voice, tone, and sound of respiration or cough
- Inquiryquestioning about the main concerns or complaints, the onset and duration of the problem, and relevant medical history and symptoms
- Palpationfeeling and evaluating the pulse by pressing on certain parts of the body such as the skin, muscles, acupuncture points, limbs, chest, abdomen and other areas.
The case history, symptoms and signs gained through those four diagnostic methods are analyzed and generalized to find the causes, nature, and interrelations of the disease, and to provide evidence for the further differentiation of syndromes. The four diagnostic methods are therefore indispensable and important steps in the differentiation and treatment of syndromes.
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Based on its philosophy, TCM emphasizes a holistic approach that treats 'the whole person', rather than attempts to treat 'a disease', isolated and separated from a person. TCM treatment aims to initiate natural healing process of human body by supporting its needs. The goal of Chinese Medicine is to prevent diseases from arriving, to maintain optimal health and well-being by smoothing out obstructions and restoring balance, and to prevent diseases from occurring.
Treatment plan for each patient is established considering the patient's presenting symptoms as well as underlying cause of the disease and constitution. Generally, if the disease is at acute stage, the treatment is focused on the symptoms (branch); if the disease is at chronic stage, the treatment is focused on the underlying cause of the condition (root). If the patient's resistance against disease is strong enough, the treatment is aimed to dispel the pathogenic factors (called evil qi); if the patient's resistance is weak, the treatment should involve strengthening the body's resistance and dispelling the pathogenic factors at the same time.
Climatic and seasonal conditions and geographic localities are also considered in treatment. Disease is the outcome of the struggle between body's resistance and pathogenic factors. Therefore certain factors and conditions, such as time (seasonal and climatic conditions), place (geographical location and environment), and personal characteristics (living customs, age, sex, and body constitution), should be considered in the treatment of a disease. In the clinical application of medicinal herbs these factors are also very important. This is an important therapeutic principle guiding clinical practice in traditional Chinese medicine.
The most commonly used treatment modalities of TCM are:
Chinese medicine uses unique vocabulary to describe its concepts which is different from Western medical terminology. Here are some of the most common Chinese medical terms that you may hear from your acupuncturist.
- Five Elements
- Zang Fu (Organs)
- Jing Luo (Meridians)
- Fundamental Substances
In Chinese philosophy, everything in the universe exists as two opposing yet interdependent forces, Yin and Yang. They are two opposites of a whole which cannot exist without each other. Literally translated as "the shady side of the mountain", Yin manifests as substance, darkness, coldness, and quiescence. Applied on the human body, the material substance of the body, which includes tissue, blood, fluid, and internal secretions are considered Yin. Literally translated as "the sunny side of the mountain", manifests as form, light, warmth, and activity. In the human body, Yang includes the functional activity of the body, and the generation of metabolic heat.
Yin and Yang are metaphorical images used to express constantly transforming interactions. They have no fixed, precise definition. Rather, they describe two broad categories of complementary concepts including the relationships of positive and negative, dynamic and inert, creative and destructive, gross and subtle, and kinetic and potential.
In TCM, the Yin Yang concept is applied to understand the complex interconnections and constant changes in the human body. TCM views the human body as an integrated whole, where all organs and systems are interconnected and interdependent of each other. Generally, when Yin and Yang are in balance, our body is healthy; but if one force dominates the other, pain and illness will arise. TCM uses the Yin Yang concept to diagnose patterns of disharmony and determine treatments to restore balance.
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The Five Elements theory posits wood, fire, earth, metal, and water as the basic elements of the material world. Each represents different properties, functions or appearances under which all things in the universe can be classified. This concept is used to describe interactions and relationships between all natural phenomena.
The Five Elements interact with one another in two cycles, mainly the enhancing and destructive cycle. In the enhancing cycle, each elemental phase is assisting one another by boosting their ability to transform, whereas the destructive cycle exerts its effect by keeping each elemental phase under control to ensure balance and harmony.
In TCM, Five Elements theory is used to interpret the relationship between the physiology and pathology of the human body and the natural environment. The balance between generation and control of the Five Elements is important for health maintenance.
Five Element Associations
In TCM, the human body consists of the five Zang and six Fu organs. The five Zang organs are: the heart (including the pericardium), lung, spleen, liver, and kidney. The six Fu organs are the gall bladder, stomach, large intestine, small intestine, urinary bladder and the San Jiao (three areas of the body cavity). Zang and Fu are classified by the different features of their functions. The five Zang organs mainly manufacture and store essence, Qi, blood, and body fluid. The six Fu organs mainly receive and digest food, absorb nutrient substances, transmit and excrete wastes.
There is another category of organs called the extraordinary Fu organs which include the brain, marrow, bone, vessels, gall bladder, and uterus. They are named Fu, but their functions are similar to that of the five Zang organs.
In TCM, the Zang and Fu organs are not simply anatomical substances, but more importantly represent the generalization of the physiology and pathology of certain systems of the human body. So, please remember that when your acupuncturist mentioned one of the organs is out of balance, it does not refer to your anatomical organ has been damaged. For example, if your acupuncturist said that you have 'kidney deficiency', it does not mean you have kidney diseases, such as kidney infection or renal failure.
In TCM theory, the body is crisscrossed by a network of channels through which flow the Qi, blood, and other material and immaterial substances that sustain us. These myriad pathways are collectively known as Jing Luo, the channels and collaterals, or simply as the meridians.
The meridians are the main channels of communication and energy distribution in the body. They connect the upper to the lower parts of the body, the internal to the external aspects, the organs to the vessels to the muscles, tendons, bones, skin, etc. Together, they integrate the various parts of the body into an organic whole and provide a network of communication, transportation, assistance, and regulation that keeps our systems running smoothly.
There are twelve Primary Meridians, corresponding to the twelve Zang Fu organs, and the Qi flows through them (and thus their respective organs) in the following order:
Lung → Large intestine → Stomach → Spleen → Heart → Small intestine → Urinary bladder → Kidney → Pericardium → San Jiao (Triple Warmer) →Gall bladder → Liver
In addition, there are the eight Extra Meridians (Du, Ren, Chong, Dai, Yin Qiao, Yang Qiao, Yin Wei, and Yang Wei) and multitudes of smaller collateral vessels. Of the eight Extra Meridians, only the Du and the Ren have acupuncture points of their own, running up the midline of the back and front of the torso, respectively.
TCM techniques such as acupuncture, Tai Chi and Qi Gong achieve their effects by manipulation and, ideally, balancing of the energy running through a network of complex bodily patterns.
Qi, blood, and body fluid are fundamental substances of the human body which sustain the normal physiological functions of the Zang Fu organs and tissues.
The word Qi means the vital energy or life force that circulates in the body through a system of pathways called meridians. It is a refined substance produced by the internal organs, to nourish the body, mind and spirit (its form varies according to its location and function). Qi is also used to mean the complex of functional activities of a given internal organ. Therefore, health is an ongoing process of maintaining balance and harmony in the circulation of Qi.
In TCM, blood is the densest of the vital substances, flowing through the vessels. Blood is transformed from the essence of food via the digestion and absorption of the spleen and stomach. Blood circulates incessantly throughout the body to nourish the Zang and Fu organs, skin, muscles, tendons, and bones in order to moisten and nourish them and to maintain their normal physiological activities.
Blood is also related the mental health, since it houses the Shen (Mind). Blood is the substantial basis for mental activities. Only when there is abundant Qi and blood, there can be high spirits and clear minds. Pathological changes of blood can cause symptoms of palpitation, insomnia, unconsciousness, delirium, etc.
Body fluid in TCM is a general term for all normal liquid in the body including saliva, gastric fluid, intestinal fluid, joint cavity fluid, tears, nasal discharge, sweat, urine, etc.
Body fluid is derived from food and drink which is digested and absorbed by the spleen and stomach. It exists in the blood, tissues, and interstices of joints. Jin fluid, a lucid and thin fluid, permeates the muscles and skin in order to warm and nourish the muscles and to moisten the skin. Ye fluid, a turbid and viscous fluid, supplies the joint cavities, brain, and body orifices to lubricate the joints, tone the brain, and moisten the orifices.
Essence is the refined and precious substance that is the material basis for all life. It influences our constitution, reproduction, growth and development, and our longevity. It is the foundation for the production of Qi and aids in the production of marrow.
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.
According to the 2007 National Health Interview Survey, which included questions on the use of various CAM therapies, an estimated 3.1 million U.S. adults had used acupuncture in the previous year. In addition, according to this same survey, approximately 17 percent of adults use natural products, including herbs, making it the most commonly used therapy.
In another survey, more than one-third of the patients at six large acupuncture clinics said they also received Chinese herbal treatments at the clinics.