Traditional Chinese Medicine
Traditional Chinese medicine (also known as TCM or T.C.M., Simplified Chinese: 中医学; Traditional Chinese: 中醫學; pinyin: Zhōngyī xué) is a range of traditional medical practices used in China that developed during several thousand years. These practices include herbal medicine, acupuncture, and massage. TCM is a form of Oriental medicine, which includes other traditional East Asian medical systems such as Japanese and Korean medicine. TCM says processes of the human body are interrelated and constantly interact with the environment. Therefore the theory looks for the signs of disharmony in the external and internal environment of a person in order to understand, treat and prevent illness and disease. TCM theory is based on a number of philosophical frameworks including the Theory of Yin-yang, the Five Elements, the human body Meridian system, Zang Fu theory, and others. Diagnosis and treatment are conducted with reference to these concepts. TCM does not usually operate within a scientific paradigm but some practitioners make efforts to bring practices into an evidence-based medicine framework.
History of TCM
Much of the philosophy of traditional Chinese medicine derived from Taoist philosophy, and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales. These causative principles, whether material, essential, or spiritual, correlate as the expression of the fates decreed by heaven.
During the golden age of his reign from 2696 to 2598 B.C, as a result of a dialogue with his minister Ch'i Pai, the Yellow Emperor is supposed by Chinese tradition to have composed his Neijing Suwen (內經 素問) or Basic Questions of Internal Medicine, also known as the Huangdi Neijing. Modern scholarly opinion holds that the extant text of this title was compiled by an eponymous scholar between the Chou and Han dynasties more than two thousand years later than tradition reports, although some parts of the extant work may have originated as early as 1000 B.C.
During the Han dynasty, Chang Chung-Ching, who was mayor of Chang-sha near the end of the second century AD, wrote a Treatise on Typhoid Fever, which contains the earliest known reference to Neijing Suwen. The Chin dynasty practitioner and advocate of acupuncture and moxibustion, Huang-fu Mi (215-282 A.D), also quotes the Yellow Emperor in his Chia I Ching, ca. 265 A.D. During the Tang dynasty, Wang Ping claimed to have located a copy of the originals of the Neijing Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the eleventh century A.D., and the result is our best extant representation of the foundational tradition of TCM.
Contact with Western culture and medicine did not displace TCM. While there may be many sociological and anthropological factors involved in the persistent practice and, in recent decades, the westward spread of TCM, two reasons are most obvious. Firstly, TCM practices are often very effective, sometimes offering palliative efficacy where the best practices of Western medicine fail, especially for routine ailments such as flu and allergies, and manage to avoid the toxicity of chemically composed medicines. Secondly, TCM provides the only available care when resources are inadequate to import Western medical technologies.
Traditional Chinese medicine formed part of the barefoot doctor program in the People's Republic of China, which extended public health into rural areas. A large motivation behind the interest in traditional Chinese medicine by both individuals in China and the PRC government is that the cost of training a traditional Chinese medicine practitioner and staffing a TCM hospital is considerably less than that of a practitioner of Western medicine, hence TCM has been seen as an integral part of extending health services in China.
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 dialectical 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. Modern Chinese descriptions of traditional Chinese medicine tend to deemphasize the cosmological aspects of TCM and emphasize its compatibility with modern science and technology.
Uses of TCM
In the West, traditional Chinese medicine is often considered alternative medicine; however, in mainland China and Taiwan, TCM is widely considered to be an integral part of the health care system. The term "TCM" is sometimes used specifically within the field of modern Chinese medicine to refer to the standardized set of theories and practices introduced in the mid-20th century under the government of Mao, as distinguished from related traditional theories and practices preserved by people in Taiwan, Hong Kong and by the overseas Chinese. The more general sense is meant in the article.
TCM developed as a form of noninvasive therapeutic intervention (also described as folk medicine or traditional medicine) rooted in ancient belief systems, including traditional religious concepts. Chinese medical practitioners before the 19th century relied on observation, trial and error, which incorporated certain mystical concepts. Like their Western counterparts, doctors of TCM had a limited understanding of infection, which predated the discovery of bacteria, viruses (germ theory of disease) and an understanding of cellular structures and organic chemistry. Instead they relied mainly on observation and description on the nature of infections for creating remedies. Based on theories formulated through three millennia of observation and practical experience, a system of procedure was formed as to guide a TCM practitioner in courses of treatment and diagnosis.
Unlike other forms of traditional medicine which have largely become extinct, traditional Chinese medicine continues as a distinct branch of modern medical practice, and within China, it is an important part of the public health care system. In recent decades there has been an effort to integrate the discoveries made by traditional Chinese medicine with the discoveries made by workers in the Western medical traditions. One important component of this work is to use the instrumentation and the methodological tools available via Western medicine to investigate observations made and hypotheses raised by the Chinese tradition.
That this effort has occurred is surprising to many for a number of reasons. In most of the world, indigenous medical practices have been supplanted by practices brought from the West, while in Chinese societies, this has not occurred and shows no sign of occurring. Furthermore, many have found it peculiar that Chinese medicine remains a distinct branch of medicine separate from Western medicine, while the same has not happened with other intellectual fields. There is, for example, no longer a distinct branch of Chinese physics or Chinese biology.
TCM is used by some to treat the side effects of chemotherapy, treating the cravings and withdrawal symptoms of drug addicts and treating a variety of chronic conditions that conventional medicine is claimed to be sometimes ineffective in treating. It has also been used to treat antibiotic-resistant infection.
A report issued by the Victorian state government in Australia describes TCM education in China:
- Graduates from TCM university courses are able to diagnose in Western medical terms, prescribe Western pharmaceuticals, and undertake minor surgical procedures. In effect, they practise TCM as a specialty within the broader organisation of Chinese health care.
In other countries it is not necessarily the case that traditional Chinese and Western medicine are practiced concurrently by the same practitioner. TCM education in Australia, for example, does not qualify a practitioner to prescribe scheduled pharmaceuticals, nor to undertake surgical procedures or diagnose in Western medical terms.
Diagnostics
Following the macro philosophy of disease, traditional Chinese diagnostics are based on overall observation of human symptoms rather than "micro" level laboratory tests. There are four types of TCM diagnostic methods: observe (望 wàng), hear and smell (聞 wén), ask about background (問 wèn) and read the pulse (切 qiè).
Systems of diagnosis include:
- Yin or Yang
- Five elements
- Eight principles
- Zang Fu theory
- Meridian (Chinese medicine)
- Six levels
- Four stages
- Three jiaos
Modern practitioners in China often use a traditional system in combination with Western methods.
Traditional Chinese medicine is considered to require considerable diagnostic skill. This often depends on the ability to observe what are described as subtle differences. This may be contrasted with a straightforward laboratory test which indicates an unambiguous cause. A training period of years or decades is said to be necessary for TCM practitioners to understand the full complexity of symptoms and dynamic balances. According to one Chinese saying, A good (TCM) doctor is also qualified to be a good prime minister in a country.
Diagnostic techniques
- Palpation of the patient's radial artery pulse in six positions
- Observation of the appearance of the patient's tongue
- Observation of the patient's face
- Palpation of the patient's body (especially the abdomen) for tenderness
- Observation of the sound of the patient's voice
- Observation of the surface of the ear
- Observation of the vein on the index finger on small children
- Comparisons of the relative warmth or coolness of different parts of the body
- Anything else that can be observed without instruments and without harming the patient
Treatment techniques
Historically, eight branches comprised Chinese medicine treatment:
- Tui na (推拿) - massage therapy
- Acupuncture and Moxibustion (針灸)
- Chinese herbal medicine(中药)
- Chinese food therapy (食 疗)
- Qigong (氣功) and related breathing and meditation exercise
- T'ai Chi Ch'uan (太極拳) and other Chinese martial arts
- Feng shui (风水)
- Chinese astrology
Today, all of the above except Feng shui and Chinese astrology are routinely used as part of TCM treatments.
Specific treatment methods are grouped into these branches. Cupping and Gua Sha (刮痧) are part of Tui Na. Auriculotherapy (耳燭療法) comes under the heading of Acupuncture and Moxibustion. Die-da or Tieh Ta (跌打) are practitioners who specialize in healing trauma injury such as bone fractures, sprains, and bruises. Some of these specialists may also use or recommend other disciplines of Chinese medical therapies (or Western medicine in modern times) if serious injury is involved. Such practice of bone-setting is not common in the West.
Modern TCM treatments consist of herbal medicine or acupuncture as the primary method, with other methods such as massage, qi gong, or food therapy playing a secondary role. Illness in TCM is seen as a lack of harmony, and the goal of all traditional treatment is to assist the body to regain balance and achieve homeostasis.
The modern practice of traditional Chinese medicine is increasingly incorporating techniques and theories of Western medicine in its praxis. |