Traditional Chinese medicine

Traditional Chinese medicine (TCM) also known simply as Chinese medicine (Chinese: 中药, zhōngyào) or traditional Oriental medicine, is the name commonly to a range of traditional medical practices originating in China.

Uses

In the West, TCM is usually regarded as a complementary and alternative medicine. For example, modern applications of TCM include claims of alleviating the side effects of chemotherapy when treating cancer patients, helping drug addicts get clean and treating a variety of chronic conditions that conventional medicine is ineffective against.

In China, practitioners of Chinese medicine tend to perform functions which would in the West be performed by allied health professionals such as nutritionists, pharmacists, nurses, and rehabilition specialists. Chinese medicine hospitals also perform some emergency medicine such as prevent and treating shock.

The general distinction that Chinese in China make is that Western medicine involves cutting while Chinese medicine involves manipulation. Hence medical procedures such as bone setting or chiropratic spinal operations tends to be seen as Chinese, while surgery tends to be seen as Western.

In sharp contrast to Western practitioners of Chinese medicine, Chinese medicine practitioners generally are not hostile to Western medicine, and there has been much interest among Chinese medicine practitioners in introducing some Western techniques such as double-blind trials of medicines and publication in peer reviewed journals. There is also intense interest in China in recent Western advances in biochemistry which holds the promise of helping to understand how Chinese medicine works.

TCM techniques

TCM utilizes numerous techniques or healing modalities to achieve the desired balance of Yin and Yang as well as Qi, blood, bodily fluids, and spirit. These include:

Acupuncture
Herbology
Moxibustion
Nutrition or food therapy
Cupping
Qigong exercises and Medical Qi Gong
Gua Sha or coin-rubbing
Plum Blossom or seven-star
Acupressure and various styles of massage such as Tuina
Sonopuncture or phonophorese--the use of sound vibration on acupoints
Auriculotherapy
Dit Da or Tieh Ta (跌打 literally, fall and strike) - Practitioners who specialize in healing trauma due to sports injury, such as bone fractures, cuts, bruises etc. It is not strictly a branch of Chinese medicine but more a spin-off from a long history of Chinese martial arts. However, these specialists may also use more typical Chinese medical therapies if internal injury is involved.

TCM theory

Traditionally, chinese medicine was based on the belief that the body will recover from illness when the person's Yin and Yang energies and Qi are in balance. The foundational principle is that if all these energies are in balance, the body heals as a natural outcome.

Although the names qi, yin and yang come from Daoism, the degree to which TCM practioners regard them as metaphysical concepts varies widely. Within the West, there is a tendency to think of qi, yin and yang as metaphysical, special energies unamenable to scientific explanation, and to attribute special powers to them.

This view is much less common in China, most traditional Chinese medicine practitioners in China now think of Qi and Yin and Yang as metaphors for how the body reacts to outside agents such as viruses, medicines and herbs, and it is much less common to believe that the energies and elements of Chinese medicine are esoteric forces unamenable to scientific explanation.

TCM is based on the idea that the human body contains energies and elements. The foundational principle is that if all the energies are in balance, the body heals as a natural outcome. While some practitioners of TCM, especially in the West, believe that these energies and elements are unknown to science, most, especially those in China, believe that the energies and elements are based on physical processes and may be simply be metaphors for biochemical processes, and there are extensive peer-reviewed efforts in China to attempt to link Chinese concepts of qi, ying, and yang to Western medical notions. One example where there is a link is in situations such as SARS and AIDS where the Chinese theory of transmission via evil qi, corresponds well with Western explanations of transmission.

The validity of the principles on which TCM is believed by its practitioners to work has not been put on a firm scientific basis. TCM practioners in the West tend to eschew science and often argue that the energies within TCM are not amenable to scientific study. By contrast, most advanced TCM practioners in China believe that Chinese views of medicine can be reconciled with Western views of medicine, and that the energies and elements in TCM theory can be linked to scientifically observed biochemical process.

Within China, there has been a great deal of cooperation between TCM practitioners and Western medicine, especially in the field of ethnomedicine. Chinese medicine includes many compounds and techniques which are unused by Western medicine, and there is great interest in those compounds and the theories which TCM practioners use to determine which compound to perscribe and which action to take. For their part, advanced TCM practioners in China are extremely interested in statistical and experimental techniques which can better distinguish medicines that work from those that do not. One result of this collaboration has been the creation of peer reviewed scientific journals and medical databases on traditional Chinese medicine.

By contrast, the relationship between TCM and Western medicine in the West is far more contentionous. TCM practitioners in the West are far more likely than those in China to attribute non-physical characters to TCM concepts and reject scientific explanations for TCM. For their part, Western doctors and scientists are far more likely to reject TCM as pseudoscience and superstition. This hostility comes from a number of sources. For one, TCM in the West tends to be advocated by those that have completely lost faith in Western medicine, and TCM is often the last resort of those with conditions which Western medicine has deemed hopeless. Many people in the West have a stereotype of the East as mysterious, spiritual, and unscientific which attracts those in the West who have lost hope in science and repels those who believe in scientific explanations.

In addition, unlike in China, Western TCM practitioners are not licensed and regulated by the state and do not have to undergo any set medical training. This makes it possible for a Western TCM practitioner to make extraordinary and esoteric claims. In addition, because Westerners are much less familar with TCM than Chinese, there is much less ability to recognize bad Chinese medicine, and notice the people who tend to make the most outlandish and esoteric claims.

As an example of the different roles of TCM in China and the West, a person with a broken bone in the West would never see a Chinese medicine practitioner to get the bone set, while this is routine in China. As another example of the difference, most TCM hospitals in China have electron microscopes and learning how to use one is common among advance practioners of TCM.

This is not to say that Western medicine considers all practical outcomes of TCM techniques to be worthless. TCM techniques have developed, through a process of trial and error over many centuries, a range of medicines and techniques which can in some circumstances cure some illnesses. The same, however, can be said of pre-modern European medicine, and of the medical practices of India, the Islamic world, pre-Columbian America and the Australian Aboriginal people. Nevertheless, in all these cases therapies have been discovered empirically, without any theoretical understanding of the principles of biomedical science.

Chinese medicine asserts that the body has some special energies and elements. The nature of these elements and forces is a subject of some disagreement. Although some claim to be able to sense these forces directly, most doctors, scientists, and practitioners of Chinese medicine in China do not think that this is possible.

Because traditional Chinese medicine in the West is seen as in opposition to Western medicine and because traditional Chinese medicine in the West is often adopted by people who have given up interest in Chinese medicine, practitioners of TCM in the West are far more likely than their Chinese counterparts to assert that that these energies have metaphysical existence, or properties that cannot be explained scientifically.

Qi

One of these energies is qi (which literally means air). One basic notion of Chinese medicine is that living organisms must circulate qi and that when this circulation stops, disease results, and many of the treatments of Chinese medicine is to get qi to flow, and to prevent qi from being blocked.

As a special non-physical force, qi has never been observed. A few proponents of TCM claim that they can directly detect and manipulate qi, however, they are in a minority among TCM practitioners.

Yang and Yin

Another crucial concept of TCM is that of Yang and Yin which derives from Taoism. Yang is the hot, active, male element, while yin is the cold, passive female element. For health to be maintained, TCM asserts that yang and yin must be balanced. Too much yang manifests itself in fever, irritability, and blood rushing to the skin. Too much yin manifests itself in coldness, lethargy, and paleness. Medicines are classified as to their ability to restore the proper balance of yang and yin.

As with qi, the nature of yang and yin is subject to some controversy. Traditionally, yang and yin were seen as manifestations of the duality of the universe according to Daoist principles. However, TCM practitioners in China today tend not to see yang and yin in these terms. Many practitioners of Western medicine as well as practitioners of TCM see the concepts of yang and yin in Chinese medicine as a distillation of traditional medical knowledge. In this view, the properties of yang and yin are explainable via scientific and rational means and do not have cosmological significance.

Five element theory

The Five elements of TCM are:

Wood
Fire
Earth
Water
Metal

The five element system has been elaborated into a particular school of thought within TCM, appropriately called the Five Element School.

Zang-Fu Theory

The five elements are associated energetically with the following Zang-Fu organs in the same order as above:

Liver and gallbladder
Heart and small intestine (and secondarily, the san jiao and pericardium
Spleen and stomach
Kidneys and bladder
Lungs and large intestine

There is also a school of thought within TCM called the Zang-Fu school. This theory treats each of the Zang organs (the first in the pairs above, the more yin of the organs) as an energy center that runs an entire system. The Zang systems include organs, senses, emotions, and the musculoskeletal system--essentially, the entire person divided into five categorical systems. With a thorough understanding of either of these schools of thought, therapeutic results are achieved accordingly. The theory is always in service of practical, therapeutic application, with the goal of an "elegant" treatment. An elegant treatment uses the least amount of force for the greatest therapeutic benefit, and requires true mastery of the art of traditional Chinese Medicine.

History of Traditional Chinese medicine

Many of the concepts of Chinese medicine derived from Daoist concepts and reflect the classical Chinese belief that the affairs of men had cosmological significance. Hence there was an impulse to place medical observations within a unifying cosmological context.

With contact with the West, many expected TCM to disappear completely and be replaced with Western medicine. That this has not happened and shows no sign of happening strikes many as surprising especially since indigenous medical traditions have been supplanted in other areas, and also because there is no separate Chinese branch in other fields of science.

There have been much speculation as to why this is so. One factor may be that for routine medical conditions, for example the flu and allergies, the treatments offered by Chinese medicine may has as much efficacy as those offered by Western medicine. Another factor is that doctors trained in Western medicine were less common, and therefore more expensive or in some cases non-existent.

Attitudes toward traditional Chinese medicine in China have been strongly influenced by Marxism and the May Fourth Movement. The notion of supernatural forces runs counter to the Marxist belief in dialectic materialism and strikes many Chinese as feudalistic and superstitious. At the same time, there is the notion of learning from the masses, and traditional Chinese medicine is seen as the distillation of thousands of years of experiences which should be respected and understood. Unlike descriptions of Chinese medicine in Western sources, Chinese descriptions of traditional Chinese medicine tend to deemphasize the cosmological aspects of TCM and emphasize its compatibility with modern science and technology.

Western Medicine and Traditional Chinese Medicine

Although Westerners associate traditional Chinese medicine with herbs and medicines, TCM practioners in Chinese societies will often perform medical activities such as setting broken bones or treating sprains and dislocations. Most Chinese generally see traditional Chinese medicine as a complement to Western rather than as an alternative. In Mainland China, there has been a very strong effort to merge Chinese and Western traditions of medicine, and this has resulted in things such as peer reviewed scientific journals and medical databases devoted to Chinese medicine.

In the West, Chinese medicine is largely regarded as antagonistic to Western medicine and as a alternative medicine to be used when Western medicine has proven unsatifactory. In most Western areas, Chinese practioners are not licensed and are not permitted to perform certain basic medicial procedures such as setting broken bones or treating burns and sprains.

Most Chinese in China do not see traditional Chinese medicine and Western medicine as being in conflict. In cases of emergency and crisis situations, there is generally no reluctance in going using modern medicine. At the same time, belief in Chinese medicine among remains strong in the area of maintaining health and wellness. To put it simply, you see a Western doctor if you have acute appendicitis, but you take Chinese medicines to make your body strong enough so that you don't get appendicitis and so that you recover quickly from the surgery. Very few practitioners of Western medicine in China completely reject traditional Chinese medicine, and most doctors in China will use some elements of Chinese medicine in their practice. The converse also holds true.

Viewed from the perspective of Western medicine, TCM developed as a form of pre-modern medical practice (also described as folk medicine), based on observation and experiment over a long period of time, but lacking a basis in biological science. Like their counterparts in the West, Chinese medical practitioners before the 19th century had no understanding of bacteria, viruses or cells and little knowledge of anaesthetics and relied mainly on trial and error. At the same time many of the theories and practices of traditional Chinese medicine produced actions that correspond to modern concepts of hygiene or public health. For example, some diseases were thought to be caused by evil qi which could be spread from one person to another, and this called for people with those diseases to be isolated from each other.

TCM has developed, through a process of trial and error over many centuries, a range of medicines and techniques which can in some circumstances cure some illnesses. The same, however, can be said of pre-modern European medicine, and of the medical practices of India, the Islamic world, pre-Columbian America and the Australian Aboriginal people. Nevertheless, in all these cases therapies have been discovered empirically, without any theoretical understanding of the principles of biomedical science. Unlike these other forms of medicine, which have largely become extinct, Chinese medicine continues as a distinct branch of medicial practice, and within China, there has been an effort to place traditional Chinese medicine on a firmer empirical and methodological basis and integrate Chinese and Western medical traditions.

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