What is - Traditional Chinese Medicine

With a history of 2000 to 3000 years, Traditional Chinese Medicine (TCM) has formed a unique system to diagnose and cure illness. The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromess

The TCM approach treats Zang--fu organs as the core of the human body. Tissue and organs are connected through a network of channels and blood vessels inside human body. Qi (or Chi) acts as some kind of carrier of information that is expressed externally through Jing-Lou system. Pathologically, a dysfunction of the zang-fu organs may be reflected on the body surface through the network, and meanwhile, diseases of body surface tissues may also affect their related zang or fu organs. Affected zang or fu organs may also influence each other through internal connections. Traditional Chinese medicine treatment starts with the analysis of the entire system, and then focuses on the correction of pathological changes through readjusting the functions of the zang-fu organs.

Evaluation of a syndrome not only includes the cause, mechanism, location, and nature of the disease, but also the confrontation between the pathogenic factor and body resistance. Treatment is not based only on the symptoms, but differentiation of syndromes. Therefore, those with an identical disease may be treated in different ways, and on the other hand, different diseases may result in the same syndrome and are treated in similar ways.

The clinical diagnosis and treatment in Traditional Chinese Medicine are mainly based on the Yin-Yang and Five element theories. These theories apply the phenomena and laws of nature to the study of the physiological activities and pathological changes of the human body and its interrelationships. The typical TCM therapies include acupuncture, herbal medicine, and Qi-gong exercises. With acupuncture, treatment is accomplished by stimulating certain areas of the external body. Herbal medicine acts on zang-fu organs internally, while Qi-gong tries to restore the orderly information flow inside the network through the regulation of Qi. These therapies appear very different in approach yet they all share the same underlying sets of assumptions and insights in the nature of the human body and its place in the universe.

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THE THEORY OF YIN/YANG

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The philosophical origins of Chinese medicine have grown out of the tenets of Daoism (also known as Taoism). Daoism bases much of its thinking on observing the natural world and manner in which it operates, so it is no surprise to find that the Chinese medical system draws extensively on natural metaphors. In Chinese medicine, the metaphoric views of the human body based on observations of nature are fully articulated in the theory of "Yin-Yang" and the system of "Five" Elements?

The direct meanings of yin and yang in Chinese are bright and dark sides of an object. Chinese philosophy uses yin and yang to represent a wider range of opposite properties in the universe: cold and hot, slow and fast, still and moving, masculine and feminine, lower and upper, etc. In general, anything that is moving, ascending, bright, progressing, hyperactive, including functional disease of the body, pertains to yang. The characteristics of stillness, descending, darkness, degeneration, hypo-activity, including organic disease, pertain to yin. The function of yin and yang is guided by the law of unity of the opposites. In other words, yin and yang are in conflict but at the same time mutually dependent. The nature of yin and yang is relative, with neither being able to exist in isolation. Without "cold" there would be no "hot"; without "moving" there would be no "still"; without "dark", there would be no "light". The most illustrative example of yin-yang interdependence is the interrelationship between substance and function. Only with ample substance can the human body function in a healthy way; and only when the functional processes are in good condition, can the essential substances be appropriately refreshed. The opposites in all objects and phenomena are in constant motion and change: The gain, growth and advance of the one mean the loss, decline and retreat of the other. For example, day is yang and night is yin, but morning is understood as being yang within yang, afternoon is yin within yang, evening before midnight is yin within yin and the time after midnight is yang within yin. The seed (Yin) grows into the plan (Yang), which itself dies back to the earth (Yin). This takes place within the changes of the seasons. Winter (Yin) transforms through the Spring into Summer (Yang), which in turn transforms through Autumn into Winter again. Because natural phenomena are balanced in the constant flux of alternating yin and yang, the change and transformation of yin-yang has been taken as a universal law. Traditional Chinese medicine holds that human life is a physiological process in constant motion and change. Under normal conditions, the waxing and waning of yin and yang are kept within certain bounds, reflecting a dynamic equilibrium of the physiological processes. When the balance is broken, disease occurs. Typical cases of disease-related imbalance include excess of yin, excess of yang, deficiency of yin, and deficiency of yang.

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THE THEORY OF FIVE ELEMENTS

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Similar to the theory of yin-yang, the theory of five elements (wood, fire, earth, metal & water) was an ancient philosophical concept used to explain the composition and phenomena of the physical universe. In traditional Chinese medicine the theory of five elements is used to interpret the relationship between the physiology and pathology of the human body and the natural environment. According to the theory, the five elements are in constant move and change, and the interdependence and mutual restraint of the five elements explain the complex connection between material objects as well as the unity between the human body and the natural world.

In traditional Chinese medicine, the visceral organs, as well as other organs and tissues, have similar properties to the five elements; they interact physiologically and pathologically as the five elements do. Through similarity comparison, different phenomena are attributed to the categories of the five elements. Based on the characteristics, forms, and functions of different phenomena, the complex links between physiology and pathology as well as the interconnection between the human body and the natural world are explained.

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

The aspects involved in each of the five elements are follows:

Fire: draught, heat, flaring, ascendance, movement, etc.

Wood: germination, extension, softness, harmony, flexibility, etc.

Metal: strength, firmness, killing, cutting, cleaning up, etc.

Earth: growing, changing, nourishing, producing, etc.

Water: moisture, cold, descending, flowing, etc.

Between the five elements there exists close relationships that can be classified as mutual promoting and mutual restraining under physiological conditions, and mutual encroaching and mutual violating under pathological conditions. By mutually promoting and restraining, functions of the various systems are coordinated and homeostasis maintained. By encroaching and violating, pathological changes can be explained and complications predicted.

 

The order of mutual promoting among the five elements is that wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and promotes generates wood. In this way each of the five elements has this type of mutual promoting relationship with the other, thus promoting is circular and endless. According to the order of mutual restraining, however, wood restrains earth, metal restrains wood, etc. Each of the five elements also shares this restraining relationship with the other. Mutual promoting and mutual restraining are two aspects that cannot be separated. If there is no promoting, then there is no birth and growth. If there is no restraining, then there is no change and development for maintaining normal harmonious relations. Thus the movement and change of all things exists through their mutual promoting and restraining relationships. These relationships are the basis of the circulation of natural elements.

Encroaching and violating are the pathological conditions of the normal mutual promoting and restraining relationships. Encroaching denotes that the restraining of one of the five elements to another surpasses the normal level, while violating means that one of the five elements restrains the other opposite to the normal mutual restraining order.

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YANG FU (internal organs) SYSTEM

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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 Xin-Bao (Pericardium), not described in Western physiology, is also considered as a Yin organ (Zang). In general, TCM considers the Zang to stay deeply 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 is also correspondent 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 not described in Western physiology)

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

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The Causes of Disharmony (pathogenesis) 

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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, odour of breath, skin

Interrogation/asking: current complaints, health history, family health history, patterns of sleep, appetite, digestion, bowel movement, bladder, sweat, pain, emotional features, lifestyle features and gynaecological features

Touching: palpation of the body to discover body temperature, body moisture, pain; and taking of the pulse (pulse reading)

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TREATMENT MODALITIES

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Acupuncture-

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The practice of acupuncture and moxibustion is based on the theory of meridians. According to this theory, qi (vital energy) and blood circulate in the body through a system of channels called meridians, connecting internal organs with external organs or tissues. By stimulating certain points of the body surface reached by meridians through needling or moxibustion, the flow of qi and blood can be regulated and diseases are thus treated. These stimulation points are called acupuncture points, or acupoints.

Acupoints reside along more than a dozen of major meridians. There are 12 pairs of regular meridians that are systematically distributed over both sides of the body, and two major extra meridians running along the midlines of the abdomen and back. Along these meridians more than three hundred acupoints are identified, each having its own therapeutic action. For example, the point Hegu (LI 4), located between the first and second metacarpal bones, can reduce pain in the head and mouth. The point Shenmen (HT 7), located on the medial end of the transverse crease of the wrist, can induce tranquilization.

In acupuncture clinics, the practitioner first selects appropriate acupoints along different meridians based on identified health problems. Then very fine and thin needles are inserted into these acupoints. The needles are made of stainless steel and vary in length from half an inch to 3 inches. The choice of needle is usually determined by the location of the acupoint and the effects being sought. If the point is correctly located and the required depth reached, the patient will usually experience a feeling of soreness, heaviness, numbness and distention. The manipulator will simultaneously feel that the needle is tightened.

The needles are usually left in situ for 15-30 minutes. During this time the needles may be manipulated to achieve the effect of tonifying the qi. Needle manipulations are generally involved with lifting, thrusting, twisting and rotating, according to treatment specifications for the health problem. Needling may also be activated by electrical stimulation, a procedure usually called electro-acupuncture, in which manipulations are attained through varying frequencies and voltages.

Treatment protocols, frequency and duration are a matter of professional judgment of the practitioner, in consultation with the patient. A common course of treatment may initially involve between ten and fifteen treatments spaced at approximately weekly intervals, and spread out to monthly later in a program.

A professional practitioner will always warn the patient of the possibility of exacerbation at the start of a course of treatment. The patients may find that in the short term after treatment, the symptoms may in fact get worse before an improvement sets in. This is a quite common feature of acupuncture treatment.

Patients should inquire about types of needles used prior to treatment. Most practitioners now use pre-packed and sterilized disposable needles that are only once. If re-useable needles are being used patients should ask to see the sterilization procedures that the practitioner adopts.

The effectiveness of an acupuncture treatment is strongly dependent upon an accurate Chinese medical diagnosis. The needling skills and techniques of the practitioner will also influence greatly the effectiveness of the outcome.

Acupuncture can be remarkably effective in many conditions, but in the West, patients often use acupuncture as the last option for their long-term chronic problems. Therefore we sometimes see the treatment as slow and in some cases of marginal benefit. With the gradual establishment of acupuncture as the treatment of choice for many people, the effectiveness of the approach with acute as well as with more chronic conditions is being recognized. Acupuncture is often conducted in combination with Moxibustion. Moxibustion is the process where moxa sticks, made of dry moxa leaves (Artemisia vulgaris) is ignited and held about an inch above the patients’s skin over specific acupuncture points. Moxa is available in a loose form that can be used for making moxa cones. Alternatively, moxa is packed and rolled in a long stick like a large cigar, about 15-20 cm long and about 1-2 cm in diameter. The purpose of this process is to warm the qi and blood in the channels. Moxibustion is most commonly used when there is the requirement to expel cold and damp or to tonify the qi and blood. A single treatment of moxibustion usually lasts 10-15 minutes. Needle-warming moxibustion combines needling and moxibustion by attaching a moxa stub (about 2 cm long) to an inserted needle. This method enhances the effects of needling and is often used to treat chronic rheumatism and rheumatoid arthritis.

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TUINA

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Tuina is Chinese therapeutic massage. The word 'Tuina' actually means 'pushing & grabbing'. Some of the common techniques include rolling, pushing, grasping, kneading, rubbing, nipping, vibrating, chopping, revolving, pinching and pressing, etc. 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 also help many other disorders.

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CUPPING

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The drawing of the skin inside the cups increases blood flow to the area and has long been used in Traditional Chinese medicine and other ancient healing systems.

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It stimulates the flow of vital energy (also known as Qi) and blood, and helps correct any imbalances arising from illness or injury. Usually combined with acupuncture, or other additional therapies to promote the flow of energy.

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The practitioner creates a vacuum by placing a flammable substance (such as alcohol on a cotton ball inside each glass cup and then ignites that

substance, the cup is then placed on the body.

 

Practitioners use a manual or electric pump to create the vacuum, or use self-suctioning cupping sets. After the cups are in place, they are usually

removed aprox 10 min. (Practitioners may practice "flash" cupping by quickly placing then removing the cup repeatedly.) or moving cupping

applying massage oil and then attach the cups, sliding them around the body rhythmically for a massage-like effect.

In a procedure known as "wet cupping," the skin is punctured prior to treatment. This causes blood to flow out of the punctures during the cupping procedure, which is used to clear toxins from the body

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Cupping  therapy is used for these conditions: 

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• Back pain

• Headache or migraine

• Knee pain

• Muscle pain and soreness

• Neck and shoulder pain

• Sports injuries and performance

• Bronchial congestion due to the cold or asthma

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