TRADITIONAL CHINESE MEDICINE|
Every culture in the world has had the knowledge of how to treat illnesses and diseases by using herbal remedies and how to practice folk medicine. For the ancient people, illnesses and diseases were believed to have been caused by the gods or the supernatural and treatment for these patients, in many cultures, had a magical-religious feel to it.
In China, the earliest practice of treating illnesses was orally transmitted throughout the generations from different migrating peoples. Some of the knowledge was recorded through other forms, such as folk arts, folktales, and folk dances and songs. Once a writing system was established, folk medicine was recorded. However, there is no knowing how much of the earliest knowledge and practices were lost. One of our earliest sources of Chinese folk medicine comes from inscriptions on oracle bones, shells and other artefacts which describe the min-chien i-hsiieh.
Traditional Chinese Medicine, also known as TCM, includes a range of traditional medicine practices originating in China. Although well accepted in the mainstream of medical care throughout East Asia, it is considered an alternative medical system in much of the Western world, and has been the subject of much criticism as having dubious and unproven efficacy and an unsound scientific basis.
For the Chinese, treatment had a religious and magical element to it and traditional folk medicine has its roots in this, plant lore and the rudimentary medical techniques and faith healings of the Neolithic pastoralists and hunter-gatherers. It was these people who survived wounds and illnesses by relying on the natural world around them. According to Chinese tradition, one cannot achieve a state of good health without first creating a harmonious relationship with nature.
The origins of Chinese folk medicine can be found in the Neolithic period. Here, daily treatment of wounds and common illnesses were treated in accordance to their religio-magical beliefs. Gradually, these practices developed along with their beliefs, each reinforcing the other. Eventually a few people realised that with the assistance of nature they could lead prosperous and decent lives without having to fish and hunt, tend the animals, till the soil, or fight enemies, all of which required significant expenditure of labour in terms of survival.
These select few were known as chen-jen, and were the only ones in the tribe who were able to make diagnoses and prognostications. Although an experienced and skilful person could treat minor wounds and illnesses, it was the chen-jen who were the only ones who could treat uncommon afflictions or diseases. For example, kuei could invade the patient; the hun had left the body leaving its p'o ('carnal soul') unprotected. It was the chen-jen's responsibility to find a way to reunite the ethereal and carnal souls in order to bring the patient back to health.
Over time, new treatments and influences were incorporated into Chinese folk medicine. During the Han Dynasty (25 - 220 CE), Indian medicine was transferred along the Silk Road into China along with Buddhism. It was the Indian knowledge of medicine that had great influence on Chinese medicine.
TCM practices include such treatments as Chinese herbal medicine, acupuncture, dietary therapy, and both Tui na and Shiatsu massage. Qigong and Taijiquan are also closely associated with TCM. TCM claims to be thousands of years old and is rooted in meticulous observation of how nature, the cosmos, and the human body are interacting. Major theories include; Yin-yang, the Five Phases, the human body Meridian/Channel system, Zang Fu organ theory, six confirmations, four levels, etc. Modern TCM was systematized in the 1950s under the People's Republic of China and Mao Tse Tung. Prior to this Chinese medicine was mainly practiced within family lineage systems, although that is not true in every case.
Today, the two major Chinese folk medicine are pulse-taking and acupuncture. Using the pulse as a means of diagnosis, it allowed physicians to identify the causes of illness and then allow them to balance the yin (the negative, dark, feminine, cold, passive element) and the Yang (the positive, light, masculine, warm, active element). Acupuncture uses long, thin needles to vary the flow of ch'i (energy) that travels along invisible channels in the body.
In recent years, traditional folk medicine is gaining popularity in Western users and is still heavily sought after by the Chinese. Although the western model of contemporary medicine is still the most globally dominant, folk medicine has begun to be incorporated into hospitals and medical practices.
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 syndromes.
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 a kind of carrier of information that is expressed externally through the jingluo system. Pathologically, a dysfunction of the zang-fu organs may be reflected on the body surface through the network, and meanwhile, diseases of the 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, 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 elements 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 qigong exercises. With acupuncture, treatment is accomplished by stimulating certain areas of the external body. Herbal medicine acts on zang-fu organs internally, while qigong 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. Some scientists describe the treatment of diseases through herbal medication, acupuncture, and qigong as an "information therapy".
The Theory of Five Elements
The theory of five elements: wood, fire, earth, metal and 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.
The order of mutual promoting among the five elements is that wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and water 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.
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.
Together with acupuncture, herbal medicine is a major pillar of Chinese medicine. The Chinese pharmacopoeia lists over 6,000 different medicinal substances in terms of their properties and the disharmonies that they were helpful with. There are about 600 different herbs in common use today.
Herbs are classified in two major dimensions. The first dimension refers to the temperature characteristics of the herb, namely hot (re), warm (wen), cold (han), neutral (ping), and aromatic. The second dimension refers to the taste property of the herb, namely sour (suan), bitter (ku), sweet (gan), spicy (xin), and salty (xian).
The various combinations of temperature and taste give the herb its properties that can influence the yin and yang energy patterns of the body. For example, sour, bitter and salty tastes are related to yin, whereas acrid, sweet are attributed to yang. There are herbs that will warm, herbs that will cool, herbs that will tonify, herbs that will move stagnation and so on. It is also important to understand that herbs do not possess one quality. They are most always a combination of properties and temperatures and may reach one to as many as twelve organ systems. Warm herbs can be used with individuals suffering from Heat disorders, but the herb with warm energy must be mixed with herbs with Cool/Cold energy so that the overall balance of the mixture is on the Cool side. Likewise, Cool herbs can be used with people with Cold disorders as long as the overall balance of the mixture is warm. Neutral herbs are those that are neither hot nor cold, so they are often considered gentle herbs. There are not too many neutral herbs in the pharmacopoeia.
Bitter possesses the function of clearing heat, purging the bowels, lowering the qi, improving appetite and drying dampness or wetness. Bitter herbs are commonly used in fire-heat patterns, such as the acute stage of infectious disease, and the patterns of damp-heat or damp-cold, such as in arthritis or leucorrhoea.
Sweet has the function of toning, improving, moistening and harmonizing many of the important systems of the body, including the digestive, respiratory, immune and endocrine systems. Sweet tastes also relieve urgency and inhibit pain due to the constrictive action of muscles. They are commonly used for treating deficiency patterns such as dry cough, and dysfunction of the gastro-intestinal tract such as spleen and stomach disharmony.
Spicy disperses, circulates qi and vitalizes blood. This group of herbs can stimulate the sweat glands to perspire, circulate qi, activate the function of meridians and organs and vitalize blood to promote blood circulation. As a whole, spicy herbs have the overall effect of activating and enhancing metabolism. Spicy herbs are commonly used in the treatment of external patterns (catching a cold), when the function of the meridian and organs is weakened and circulation of blood has been impeded. In traditional Chinese medical terminology, this is the stage of qi stagnation and blood cloudiness.
Salty herbs have the function of softening firm masses and fibrous adhesions. The salty taste purges and opens the bowels. Salty agents are often indicated in sores, inflammatory masses, cysts, and connective tissue proliferation.
The unique characteristic of Chinese herbal medicine is the degree to which formulation is done. In other forms of herbal medicine, especially western herbal medicine, herbs are often delivered singly or combined into very small formulas of herbs with the same function. In contrast, Chinese herbalists rarely prescribe a single herb to treat a condition. They create formulas instead. A formula usually contains at least four to twenty herbs.
Herbal formulas can be delivered in all manners of preparation. Pre-made formulas are available as pills, tablets, capsules, powders, alcohol-extracts, water-extracts, etc. Most of these formulas are very convenient as they do not necessitate patient preparation and are easily taken. However, the concentration of the herbs in these products is low and don't allow the practitioner to adjust the contents or dosages. These products are usually not as potent as the traditional preparation of decoction.
Decoction is the traditional method of preparing herbal medicine. A decoction is a concentrated form of tea. The practitioner weighs out a day's dosage of each herb and combines them in a bag. A patient is given a bag for each day the herbal formula will be taken. The herbs are then boiled in water by the patient at home. The boiling process takes from 30-60 minutes and the resulting decoction will be consumed several times during the day.
Another modern way of delivering herbs is through granulated herbs, which are highly concentrated powdered extracts. These powders are made by first preparing the herbs as a traditional decoction. The decoction is then dehydrated to leave a powder residue. Practitioners can then mix these powders together for each patient into a custom formula. The powder is then placed in hot water to recreate the decoction. This eliminates the need to prepare the herbs at home, but still retains much of the original decoction's potency.
Traditional Chinese Medicine is a vast subject which cannot be covered completely in these articles. We hope however, that this has given you cause to research the subject further.
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