Understanding TCM

A. TCM Terminology
Central concepts of Chinese Medicine include terminology of

1. Yin/Yang
Yin and yang are the principles used in Traditional Chinese Medicine to explain human physiological functions and pathological changes. Yin and yang express a system of relationships, patterns and functions with regard to a dynamic equilibrium. Yin is the feminine and Yang is the masculine side of nature. Yin signifies female attributes, such as passivity, darkness, cold, and moistness. Yang signifies male attributes such as light, activity, warmth, and dryness. Yinand Yang are opposite forces, that, when balanced, work together. Nothing in this world is completely yin or yang. Everything has an internal, negative, quiet, or cold (yin) aspect while also possessing an external, positive, active, or hot (yang) aspect. Simultaneously, these two phases of one’s being continually interchange and complement one another. When the yin and yang are in balance there is harmony in the universe and a healthy state of the body, mind, and spirit. Any upset in the balance will result in natural calamities (such as tornadoes, droughts, and hurricanes), and disease in human beings.

In Chinese medicine the body is perceived as a balance of yin and yang. For instance, when one’s yin or negative energy decreases, one’s yang or positive energy increases. TCM practitioners attempt to balance these two forces using acupuncture, acupressure, and herbal medicine. For instance, when one is depressed, the forces of yin are inevitably greater than that of yang. Hence, the doctor would concentrate his or her efforts on enhancing the patient’s yang. If the reverse situation were true (yang forces overshadow those of yin), then the TCM practitioner would advocate nourishment of yin with herbs and food, acupuncture, acupressure, and other natural means.

2. Qi
Qi is the word used for the flow of the body’s energy. It is the energetic force that activates, enlivens and animates the body. Qi is received from the heavens, inherited from our parents and absorbed from the food and water we take. Qi is also absorbed through specialized points in the skin known as acupuncture points. The acupuncture points exist along meridians that serve as circulatory pathways within the body connecting qi energy to specific organ systems and external surface. Chinese medicine modifies the flow of qi through the insertion of acupuncture needles at particular points of the body or through administering herbs pertaining to one or more of the meridians or organs. The chief functions ofqi are to nourish, protect, and warm the organism. Hence, the function of various organs is expressed in terms of qi. For instance, if one’s heart qi is inadequate, then the person will probably suffer from heart problems if the condition exists over a long period of time.

The energetic currents of qi can even be detected with special frequency devices that are alerted when energy is concentrated in one part of the body or if it is deficient in another area. Furthermore, qi works in the same manner as yin and yang in that if it is excessive or scare in a part of the body, then that particular region is prone to illness. On the other hand, qi, unlike yin and yang, can become blocked and the stagnation of energy will also cause discomfort.

3. Jing
Jing is the essence of the living body as it oversees the transformation of a being from a fertilized egg, embryo, fetus, infant, child, adolescent, and finally into an adult. TCM believes that Jing consists of matter within the nervous system, bone marrow, and reproductive substance such as hormones. Thus, it also governs our ability to reproduce. Since Jing is not as easily generated as other bodily fluids, it must be preserved. In fact, according to TCM, Jing conservation is intricately related to longevity and the anti-aging process. Jing disorders are often severe problems involving growth and development, inherited disorders, and infertility.

4. The Meridian System
In Chinese medicine, it is believed that qi or energy travels through the body by way of channels on the body surface. These channels called “meridians” run through the body and nourish the tissues. They form a network and link the tissues and organs into an organic whole. The Meridian System is an interconnection of pathways for qi and blood flow between the circulatory, nervous, and lymphatic systems. Its apparent manifestations are similar to that of the nervous system. However, the meridian system is far more complex as it transports both basic circulatory substances such as blood and less tangible substances such as qi energy. Acupuncture points are places along the Meridians that give access to energy streams. The meridians act to circulate Qi and blood throughout the body, protecting and nourishing the appropriate meridians to restore the body’s harmony. For some especially sensitive people, their meridian systems can even be detected with x-rays.

Energy constantly flows up and down these pathways. When pathways become obstructed, deficient, excessive, or just unbalanced, the qi that runs through the meridians is like a dam that backs up the flow in one part of the body and restricts the flow in other parts. This causes illness, as yin and yang are thrown out of balance. Chinese medicine restores the balance of yin and yang in the body by manipulating the qi in the body along the Meridian system.

5. Etiology of TCM: Deficiency and Excess, Stagnation and Imbalance
Deficiency and excess, stagnation and imbalance constitute the principal terms used in Chinese medicine to explain etiology and pathogenesis. Deficiency refers to the diseased condition of the patient due to decreased Qi (energy) in the body. For example, vertigo caused by fatigue or anemia, or a sallow and pale complexion and excessive thirst due to dehydration are examples of deficiency.

Excess refers to the manifestation of symptoms produced when the body is attacked by the pathogenic factors, and the struggle between the pathogen and body’s own defenses. Some examples of excess are high fever, pneumonia due to viral infection, diarrhea caused by improper and unclean food, and constipation resulting from indigestible foods.

Yin, yang, deficiency and excess are also applied to the functioning of the various organs. For example if one’s heart yang is lacking or heart yin is immoderate, then one is more likely to suffer from palpitation or other heart conditions in the long term.

Stagnation is the state of blockage caused by the inability of qi, blood, or other bodily fluids to circulate in the body. Some examples of blockage are distention caused by qi stagnation, pain due to blood stasis, and edema caused by stagnant bodily fluids. Some symptoms due to stagnation in the body would include cramps when one’s blood flow is irregular, bloating when one’s qi flow is hindered, and inflammation when one’s bodily fluids are immobile.

Finally, imbalance refers to the condition of disequilibria between yin and yang within the body. The imbalance of yin and yang within one’s organ is likely to affect the condition of the whole organism as the body is closely joined by the meridian system.

6. Diagnosis (Sher-Mai or Tongue and Pulse)
In order to develop an accurate picture of a patient’s whole being, the Chinese medicine practitioner will use the traditional method of diagnosing their patients based on the four examinations:

  1. Looking: Through inspection, the Chinese medical practitioner will determine the patient’s overall constitutional state, physical appearance and complexion and the patient’s spirit. The practitioner will examine the patient’s tongue to gather information about the state of the internal organs. The tongue is considered the mirror of the body. Harmony and disharmony are reflected in the tongue’s color, moisture, size, coating and the location of abnormalities.
    The Chinese medical practitioner will look at the color of the tongue, its size and shape, the color and thickness of its coating or fur, location(s) of abnormalities, and moistness or dryness of the tongue body and fur. These signs reveal not only overall states of health but correlated to specific functions and disharmonies, especially in the digestive system. A normal tongue is pinkish red; neither too dry nor too wet; fits perfectly within the mouth; moves freely; and, has a thin white coating.
  2. Listening/Smelling: Through auscultation and olfaction, the practitioner will listen to the quality of the patient’s voice, listen for the five tones, determine the five odors, etc. The sound of the patient’s voice, breathing, coughing (if present), and the sounds that express pain and discomfort reflect the state of qi. Verbal expression and response to questions reflect the state of the patient’s spirit.
  3. Questioning: Through inquiry, the practitioner will take a complete health history, asking numerous questions about current complaint(s), relevant medical history, general symptoms, and the presence of internal or external pernicious influences.
  4. Palpating: The Chinese medical practitioner’s physical examination includes analysis of the pulse, and palpation of the abdomen and/or meridians. Pulse diagnosis is based on the principles of qi and blood flow circulating in the body. The practitioner takes the pulse on the wrist along the radial artery. Pulses are evaluated at superficial, middle and deep levels. The strength, rate, rhythm, and size of the pulse express the conditions of the internal organs. The left side pulse stands for heart, liver, kidney (yin) while that of the right side represent the function of lung, spleen, and kidney (Yang).

B. TCM Therapies

1. Acupuncture:
Acupuncture is one of the more familiar therapies of Chinese Medicine. It refers to the insertion of fine, sterile needles along the body in order to control the flow of qi (energy) through pathways of body. Often acupuncture is combined with moxibustion therapy, and the two are known as acu-moxa therapy.

When the human body is diseased, the qi and blood that flow along the meridian pathways get blocked or depleted. Meridians can be influenced by acupuncture needling, unblocking the obstruction within the meridian circulation and releasing the regular flow ofqi, blood, fluid, and moisture. According to Chinese Medical theory, puncturing a needle at specific points can clear the meridians and cure disease.

Acupuncture is normally applied to the body, scalp, and ear. Needles penetrate the skin at varying lengths from millimeters to a few inches depending on the thickness of flesh and muscle at a given location. Needles inserted into the body have the largest clinical application. The head or scalp needles are mostly adopted in the treatment of nervous system diseases and pain management, while ear acupuncture is often used in the treatment of endocrine system diseases and psychological problems. In recent years, ear acupuncture, also known as auriculotherapy, has been used for weight control, smoking cessation, and detoxification.

With vast nerve and blood supply to the face, eyes, hands, feet, wrists and ankles, these areas indicate connections to the whole body. Acupuncture points in these areas correspond to many parts and organs of the body and are often treated for different conditions. These micro-system modalities have their own unique indications and are used in different cases in the clinic according to the practitioner’s discretion.

Acupuncture therapy can also include electro-stimulation, the use of mild low-voltage electrical stimulation on acupuncture needles. This method is generally used for analgesia.

The primary concern of many patients is usually the following question: Is acupuncture painful? Since acupuncture needles have very thin gauges compared to hypodermic needles, only a minimal pinch is felt as the needle breaks through the skin. After the needles are inserted to the proper depth, the patient may feel tingling of the skin, distention, soreness or pressure radiating from the acupuncture point. In fact, the correct needle sensation creates a dull, heavy distention, which even children can handle. Patients’ fears usually subside after their first treatment. Of course, laser, electrode and finger acupuncture can be applied instead of needles for some very sensitive patients. For children under 10 years of age, acupressure often replaces acupuncture to achieve the same therapeutic effect.

2. Tuina/Acupressure
Tui-na/acupressure is Chinese bodywork therapy that dates back more than 4,000 years. It is another therapy that is essential to Traditional Chinese Medicine (TCM). The foundations of Tuina/acupressure date back even further than acupuncture. Before people learned to use needles, pressure was applied to certain areas of the body to relax muscles, relieve pain and enhance body energy.

In comparison to Swedish massage or Japanese shiatsu, tui-na/acupressure is a therapeutic method based on Chinese medical theory accompanied by qi-gong and daoying exercises. Tui-na is a physical expression of the flow of qi from one human being to another. When done with correct intent, the strokes and techniques stimulate an exchange of Qi energy between the practitioner and the patient. Tui-na/acupressure practitioners who apply qi-gong in the treatments generate quicker healing results.

Tui-na includes the use of twelve different hand techniques that vary in degrees of strength, size of contact areas, and their purpose of tonification or reduction. Hand manipulations and techniques are adjusted to suit the patient’s tolerance level. Tui-na/acupressure manipulations directly affect the flow of qi at acupuncture points, meridians and large muscle areas to massage the body. External herbal liniments, salves, and compresses are also used to enhance the therapeutic effects.

3. Chinese Herbal Therapy
Chinese Herbal Therapy is the use of plants, minerals and animal substances for healing. This form of therapy dates back thousands of years when herbs were used to remedy a wide range of diseases and disorders. It is one of the oldest healing arts and is actually the forerunner to Western pharmacology.

The Chinese apothecary includes barks, roots, flowers, seeds, plants, minerals and animal substances that the body assimilates through its digestive, respiratory, and cutaneous tissues. Herbs are used for both prevention and cure – like vitamins or food supplements, they maintain our health and, when used medicinally, they redress acute and chronic ailments.

There is a repertoire of more than 500 classical prescriptions that can rebalance various disharmonies in the body. These prescriptions are classified in the great Chinese medicinal pharmacopoeias and herbal manuals that have been tested over the past centuries of Chinese medical history.

Herbs are usually combined in prescriptions. Herbal preparations come in the form of tea, powder, or pills. They are designed to treat specific health problems or correct imbalances in the body. In general herbs tend to have a slower and gentler effect than refined chemicals used in drugs.