TCM Knowledge  

3. Introducing Traditional Chinese Medicine 

    Some people radiate health. Their hair, skin, and nails shine. Their eyes are clear. They have a good energy level combined with an even emotional state. Others don't radiate health. They may catch colds frequently or have a hard time getting through a day because of poor energy. They may have chronic pain or poor digestion. If this kind of person goes to an allopathic physician (a Western-trained M.D.), the physician will probably run a number of blood tests, do a thorough physical, and occasionally will find that "nothing is wrong." The state of health of the person who does not look or feel well is considered the same as that of the person who clearly looks and feels healthy.

    Many people who seek out "alternative medicine" have had this experience. Others have been diagnosed as having illnesses that have limited treatments according to allopathic medicine or whose treatments consist of continuous medicating with drugs that may have short-term or long-term side effects.

    But is Traditional Chinese Medicine (TCM) "alternative"? It is in the sense that it can be used as an alternative to allopathic medicine and more and more people are choosing TCM throughout the West. It is alternative in the sense that TCM's explanation of the body and its processes is very different than allopathic models. Also, TCM's methods of diagnoses are largely unlike those used by allopathic practitioners.

    In many ways, however, it is incorrect to consider TCM "alternative." Given its history and scope, it is far less "alternative" than the medicine that is considered conventional in the West. The roots of TCM extend back over 2500 years. There is an extensive medical literature dating back to this beginning. Chinese medical scholars familiarized themselves with this literature and then built on it based on their own clinical experience and research. For thousands of years TCM has been the basis of patient care throughout the East. Even in China today, allopathic medicine and TCM are used together in practice. A part of their medical school training, Chinese physicians must learn both medicines. In this sense, TCM is hardly "alternative."

The Difference Between Allopathic Medicine and TCM

   Allopathic medicine is mainly focused on structures and materials. When we think about the body from an allopathic perspective, we think about things that can be seen and quantified. For example, when we think about blood, we talk about white cell counts or hemoglobin levels. We talk about the material aspects of blood. In TCM, we are most concerned with function. TCM practitioners focus on Qi (vital energy) activity and consider its movement. When all areas of the body are in proper balance and Qi flows smoothly, evenly, and calmly, a person will be healthy. If, for instance, the movement of Qi gets stuck in a particular area or if there is a Deficiency of Qi, there will be problems. Qi cannot be quantified. There is no blood test or x-ray that can detect Qi. Rather, the TCM practitioner must use other methods to detect if something is wrong.

   When a TCM practitioner refers to Liver or Spleen, people unfamiliar with TCM picture the actual organ liver or spleen. But when a TCM practitioner says that something is wrong with Liver, this does not mean that the organ liver is necessarily sick. The Liver system in TCM covers a much greater area of the body than simply the actual organ and the TCM practitioner is once again more focused on function than structure.

   Allopathic medicine and TCM are very different paradigms. It is very difficult to translate between the two. This is why the diagnosis a person receives from an allopathic physician is often of little consequence to the TCM practitioner. For example, if you tell the TCM practitioner you have migraines, he or she must still ask many questions. Where is the pain exactly? How long have you had the problem? How would you describe the pain? What other symptoms accompany the pain? The answers to these and other questions plus TCM methods of diagnosis (pulse, tongue, nails, etc.) help the TCM practitioner understand the underlying condition. There are many different parameters the TCM practitioner uses to arrive at the underlying condition. This underlying condition (e.g. Blood Stagnation, Qi Deficiency, Damp-Heat, etc.) is what is treated. Thus the purpose of treatment is not simply to control symptoms but rather to restore balance and therefore eliminate symptoms altogether. This is the main reason it is very difficult to self-treat and self-diagnose in TCM. It takes years of training and practice to understand the diagnostic and treatment principles of TCM. A trained TCM practitioner is best able to diagnose and treat you effectively.

Methods of Diagnosis

   Asking -- A TCM practitioner wants to know about every symptom you feel. Sometimes this is a difficult task for patients who are used to seeing allopathic practitioners that do not require or ask for the same information. There is no such thing as an insignificant symptom or problem in TCM. Your TCM practitioner may ask you whether you have a tendency to feel hot or cold, whether you tend to have a certain taste in your mouth, about the quality of your sleep and digestion, about the quality of your stools and urine, whether you have a tendency toward a certain emotional state (e.g. sadness, depression, anxiety), whether you have any pain or swelling. Remember that TCM and allopathic medicine have different ideas about what is normal. In allopathic medicine, it is considered within normal limits for a woman to have strong menstrual cramps for two days during her period. In TCM, this is a significant symptom that offers the practitioner important information.

   Looking -- A TCM practitioner can tell many things about a person simply by looking. A TCM practitioners looks at:

   Mental Energy (Shen) -- by noting complexion, eyes, state of mind, breathing

   Body -- including general body shape (that which we're born with), long-term constitutional changes (weight and shape, e.g. heavy or thin? barrel chest?), and short term changes (e.g. skin tone changes or muscle weakness)

   Demeanor -- general bodily movement and movement of body parts

   Hair, Face Color, Eyes, Nose, Ears, Mouth and Lips, Teeth and Gums, Limbs, Skin -- The surface of the body offers information about inner health. For instance, red eyes, dry lips, or thinning hair, all provide information. Numerous books have been written on such practices as hand diagnosis and ear diagnosis in TCM; extensive information about a patient's health history and current health can be gathered simply by examining the hands or ears. While ethnic and racial diversity means that people will have different characteristics and features, the TCM practitioner looks for what transcends the range of normal. For obvious reasons, it is best to avoid makeup when visiting a TCM practitioner.

    Tongue -- An extremely important aspect of TCM diagnosis, tongue observation offers the TCM practitioner vital information. The TCM practitioner observes the color, shape, and coating of the tongue in order to learn about the patient's overall condition as well as information about digestion, circulation, general energy and more. It is best to avoid consuming anything other than water one half-an-hour before your visit with a TCM practitioner.

    Nails -- Another very important tool for TCM practitioners, nail observation offers important information regarding general health condition, emotion, circulation, etc. The practitioner observes the color of the skin behind the nails, sheen, texture, quality, and the moons. If you wear nail polish, it is best to remove it before your visit.

   Hearing and Smelling -- The quality of the patient's voice and breathing may offer the TCM practitioner clues. Likewise, body smells, such as breath smells, also provide information. It is best to refrain from using perfumes or colognes when visiting a TCM practitioner.

   Pulse -- Perhaps the most difficult method of diagnosis in TCM, pulse diagnosis provides the practitioner with key information. Whereas, in allopathic medicine the pulse may be taken to identify its rate and whether it is weak or strong, in TCM, there are 28 different qualities that may describe a pulse. Also the pulse is taken at three different positions in both wrists and at three different levels (superficial, middle, and deep). The right side offers different information from the left and the six different positions and three different levels correspond to various areas of the body. Pulse diagnosis is an extremely intricate method of diagnosis. It is said that pulse diagnosis takes about ten years to learn.

    Methods of diagnosis must be used together in order to create a whole picture of a person's health condition. As mentioned before, this idea of a health condition is very specific to TCM. In allopathic medicine, we think mainly about symptoms and diseases. For instance, an ulcer is a disease that causes the symptom of burning pain. In TCM, we must discover what the underlying condition is that causes the ulcer in the first place. If we treat the underlying condition, not only will the ulcer heal, but we will prevent the likelihood of an additional ulcer or other problems relating to the underlying condition occurring in the future. Let us consider another example. In allopathic medicine, a malignant tumor is the disease that needs to be treated. In TCM, tumors are just a symptom, thus if you remove or destroy the tumor through surgery, radiation, or chemotherapy, you have not treated the underlying condition that caused the cancer in the first place. If the underlying condition is treated successfully, not only will the current symptoms resolve, but the chance of recurrence or metastases will be dramatically reduced.

Causes of Disease

   The TCM practitioner will be able to determine the underlying condition, but what caused the underlying condition in the first place? There are many causes of disease according to TCM. Sometimes it is very clear what caused an underlying condition. For example, if a person caught a cold and following that developed a chronic cough, in TCM terms an exterior attack of wind-cold transformed into an interior Lung condition. However, often the specific cause of disease is unclear, particularly for long-term chronic problems. According to TCM, the various causes that disrupt the body's balance can be divided into three categories ¾ internal causes, external causes, causes that are neither specifically external nor internal.

   Internal Causes -- Any emotion in excess can cause illness. TCM divides emotions into anger, joy, sadness, worry or "thinking too much," fear and shock. It may seem curious that joy could cause illness. But remember, here we are talking about emotion in excess. It is normal to have emotional fluctuations and various stresses in day-to-day living. What is key is how such fluctuations are managed. Excessive sexual activity, poor diet, and over-exertion (mental and/or physical) can also cause illness.

   External Causes -- In TCM, there are six external pathogens that may enter the exterior of the body _ Wind, Cold, Heat, Damp, Dry, and Fire. If treated in a timely and correct way, these external pathogens are easily dispelled. But if not dispelled, these external pathogens may move deeper into the body and cause chronic disease.

   Other Causes -- These causes do not neatly fall into the categories of internal and external. They include: weak constitution, trauma/injury, parasites, poisons, and incorrect treatment.

Methods of Treatment

   In the West, many people think of acupuncture when they think of Chinese medicine. Acupuncture has received much more press than other methods of treatment in TCM. Actually, Chinese herbal medicine and acupuncture are considered equally important treatments in TCM. They are often used together and may be used in conjunction with other TCM treatments such as moxibustion and Tuina. In addition, it is important to recognize the importance of Tai Qi and Qi Gong which are used for health maintenance and treatment as well.

   Herbs - Traditionally, herbs have been administered in a number of different forms. The have been boiled in water and taken as a tea, made into pills, tinctures, powders, and as topical plasters. Today herbal companies have developed other forms (capsules, tablets, granule teas, tinctures) that are more convenient and palatable. Over 1000 herbs are used in TCM. They are overwhelmingly used in formulas rather than individually.

   Acupuncture _ Using very thin, disposable needles, the TCM practitioner will place needles at specific points on the body in order to rebalance and unblock the flow of Qi (vital energy). Used to treat both symptoms and the underlying condition, acupuncture is a powerful medicinal form. When used in conjunction with herbs, acupuncture will strengthen and expedite treatment. The needle insertion feels something like a mosquito bite. Many people find the experience of receiving acupuncture relaxing and pleasurable.
Moxibustion -- Often combined with acupuncture, moxibustion entails the use of bundles of dried mugwort in the form of a cone or stick. The bundles are burned, like incense, and placed at specific points on the body. Moxibustion has numerous functions, including warming the Qi of the body in order to increase its flow.

   Tuina -- A kind of external manipulation employing over a dozen different techniques such as stroking, kneading, rubbing, pressing, knocking, and vibrating, including many of those techniques used in Shiatsu and acupressure massage. Tuina is often used as an alternative to acupuncture. It is based on general TCM theories, including the use of channels and points. Tuina is excellent for both tonifying (strengthening the body's resistance) as well as eliminating pathogenic factors.

   Tai Qi -- Literally translates as "supreme ultimate," Tai Qi is practiced throughout China. There are many forms of Tai Qi, each consisting of a set of fluid movements that help balance the flow of Qi in the body, calm the Shen or mind, and promote good health.

   Qi Gong -- Literally translates as "Qi cultivation," Qi Gong is comprised of static and moving exercises that enable the practitioner to strengthen and rebalance Qi. Qi Gong can take the form of a ritualized daily exercise like Tai Qi or can be executed by a medical practitioner in order to heal patients.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.