Traditional Chinese medicine

Traditional Chinese medicine (TCM) also known simply as Chinese medicine (Chinese: 中醫學 or 中药学, zhōngyào) or traditional Oriental medicine, is the name commonly given to a range of traditional medical practices originating in China thousands of years ago. Primary medical theoretical foundation of TCM includes that of Five Elements and Yin-yang. Treatments are done with reference to this philosophical framework. \n\n

Table of contents

1 Uses 2 TCM theory 3 TCM diagnostics 3.1 Diagnostic techniques 4 TCM treatment techniques 5 TCM and science 5.2 Does it work? 5.3 How does it work? 6 Western medicine and traditional Chinese medicine 7 See also 8 References 9 External links

Uses

In the West, \nTCM is often considered alternative medicine, while in both Mainland China and on 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 Chinese\nMedicine to refer to the standardized set of theories and practices\nintroduced in the mid-20th century under the government of Mao, as\ndistinguished from other theories and practices such as Worsley's\nFive Element Acupuncture or the kyo/jitsu theory of Shizuto \nMasunaga's Zen shiatsu. However we use the more general sense here.) TCM developed as a form of pre-modern therapeutic intervention (also described as\nfolk medicine) or traditional medicine, rooted in ancient religious belief systems. Chinese medical practitioners before the 19th century relied essentially on observation, trial and error. Like their counterparts in the West, they had a very different understanding of infection which predated the discovery of bacteria, viruses (germ theory of disease) or cellularular structures and little knowledge of organic chemistry, relying mainly on a medical theory describing the nature of infections and remedies as well as tradition to guide their courses of treatment. Unlike these 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. There are thousands of years of empirical knowledge about TCM on its own terms, and in recent decades there has been an effort to place traditional Chinese medicine on a firmer Western scientific empirical and methodological basis as well as efforts to integrate Chinese and Western medical traditions. 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. In the West, TCM is usually regarded as a form of alternative medicine (CAM). 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. TCM has also been used to treat antibiotic-resistant infections. In China, practitioners of Chinese medicine tend to perform functions which in the West would be performed by allied health professionals such as\nnutritionists, pharmacists, nurses, chiropractors physical therapists and other rehabilition specialists. Chinese medicine hospitals also perform some emergency medicine such as prevention and treatment of shock and seizure. The general distinction made by Chinese in China is that Western medicine\ninvolves cutting while Chinese medicine involves manipulation. Hence\nmedical procedures such as bone setting or chiropractic spinal manipulation\ntends to be seen as Chinese, while surgery tends to be seen as Western.

TCM theory

TCM is based on the philosophical concept that if balance is restored, the person heals. TCM seeks to balance yin and yang, Qi, Blood, Jing, Body fluids, the Five Elements, the emotions, and the spirit (Shen). There are different schools of thought within TCM theory, including Five Element theory, Zang Fu theory, and Japanese acupuncture theory such as Meridian Therapy. TCM has a unique model of the body which is different from the models in other traditions.

TCM diagnostics

Because traditional Chinese medicine predates the more invasive medical testing used in conventional Western medicine, TCM requires skill in a range of diagnostic systems not commonly used outside of TCM. Much of this diagnostic skill involves developing the abilities to observe subtle appearances; to observe that which is right in front of us, but escapes the observation of most people.

Diagnostic techniques

• Palpation of the patient's radial artery pulse in six positions\n* Observation of the appearance of the patient's tongue\n* Observation of the patient's face (shen)\n* Palpation of the patient's body (especially the abdomen for tenderness\n* Observation of the sound of the patient's voice \n* Observation of the surface of the ear\n* Observation of the vein on the index finger on small children\n* Anything else that can be observed without instruments and without harming the patient

TCM treatment techniques

TCM utilizes numerous techniques or healing modalities to achieve the\ndesired balance of Yin and Yang as well as Qi, Blood, Jing (Body Fluids),\nand Shen (Mind/Spirit). These include:\n*Acupuncture\n*Herbology\n*Moxibustion\n*Nutrition or food therapy\n*Cupping\n*Qigong exercises and Medical qigong\n*Gua Sha or coin-rubbing\n*Plum blossom or seven-star\n*Acupressure, and various styles of massage such as Tuina\n*Sonopuncture or phonophorese--the use of sound vibration on acupoints\n*Auriculotherapy\n*T'ai Chi Ch'uan and other Chinese martial arts. Die-da, Dit Da or Tieh Ta (跌打): practitioners who specialize in healing trauma injury such as bone fractures, sprains, bruises etc. 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.

TCM and science

There are two questions about TCM which can be investigated scientifically:

• Does it work?\n* How does it work?

Does it work?

Most scientific research in the West about TCM has focused on acupuncture. The National\nInstitutes of Health\nConsensus\nStatement on Acupuncture summarizes research on the efficacy of\nacupuncture as follows:

\n...promising results have emerged, for example, efficacy of acupuncture in\nadult post-operative and chemotherapy nausea and vomiting and in\npostoperative dental pain. There are other situations such as addiction,\nstroke rehabilitation, headache, menstrual cramps, tennis elbow,\nfibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel\nsyndrome, and asthma for which acupuncture may be useful as an adjunct\ntreatment or an acceptable alternative or be included in a comprehensive\nmanagement program. Further research is likely to uncover additional areas\nwhere acupuncture interventions will be useful.\n

Much less work in the West has been done on Chinese herbal \nmedicines, which comprises much of TCM in China. It is clear, however, that many if not most of these medicines do have powerful biochemical effects. An example is the herb ephedra which was introduced into the West as a stimulant, and later banned in the United States after deaths were attributed\nto its use. In the West, many Chinese medicines have been marketed as herbal supplements and there has been considerable\ncontroversy over the regulatory status of these substances. TCM practitioners have no philosophical objections to scientific studies on the effectiveness of treatments. The main barrier to the adoption of Chinese \nherbal medicines into Western practice is economic. It requires a large amount of expertise and money to conduct, for example, a double-blind drug trial, making it a large venture to test even one of the thousands of compounds used by TCM. Because these compounds cannot be patented, there is\na distinct lack of a self-interested party to sponsor such expensive protocols.

How does it work?

The basic mechanism of TCM is akin to treating the body as a blackbox, recording and classifying changes and observations of the patient using a traditional philosophy. In contrast to many alternative and complementary mediciness such as homeopathy, practically all techniques of TCM have explanations for why they may be more effective than a placebo, which Western medicine can find plausible. Most doctors of Western medicine would not find implausible claims that qigong preserves health by encouraging relaxation and movement, that acupuncture relieves pain by stimulating the production of neurotransmitters, or that Chinese herbal medicines may contain powerful biochemical agents. However, these are great oversimplifications of TCM and how or why it works. The metaphors used in TCM theory often concern areas not readily measured or described by Western science. Within China, there has been a great deal of cooperation between TCM\npractitioners and Western medicine, especially in the field of ethnomedicine. Chinese herbal medicine includes many compounds which are unused by Western medicine, and there is great interest in those compounds as well as the theories which TCM practitioners use to determine which compound to prescribe. For their part, advanced\nTCM practitioners in China are 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. The relationship between TCM and Western medicine in the West is more contentious. \nWhile more and more medical schools are including classes on alternative medicine in their curricula, older Western doctors and scientists are far more likely than their Chinese counterparts to skeptically view TCM as archaic pseudoscience and superstition. This skepticism can come from a number of\nsources. For one, TCM in the West tends to be advocated either by Chinese immigrants or by those that have lost faith in conventional medicine. Many people in the West have a stereotype of the East as mystical and unscientific, which attracts those in the West who have lost hope in\nscience and repels those who believe in scientific explanations. There have also been experiences in the West with unscrupulous or well meaning but improperly trained New Age "TCM practitioners" who have done people more harm than good in many instances. As an example of the different roles of TCM in China and the West, a person\nwith a broken bone in the West would never see a Chinese medicine\npractitioner or visit a martial art school to get the bone set, whereas this is routine in China. As another example, most TCM hospitals in China have electron microscopes and many TCM practitioners know how to use one. This is not to say that Western medicine considers all practical outcomes of TCM techniques to be worthless. Many Western hospitals and clinics now offer Tai Chi Chuan or qigong classes as part of their community health programs. As well, TCM techniques have developed a range of medicines and\ntechniques which have been demonstrated to cure some illnesses. The same,\nhowever, can be said of traditional European medicine, and of the medical practices of India, the Islamic world, pre-Columbian America and the\nAustralian Aboriginal people. In all these cases, therapies\nhave been discovered empirically rather than through the scientific method.

Western medicine and traditional Chinese medicine

Most Chinese in China do not see traditional Chinese medicine and Western\nmedicine as being in conflict. In cases of emergency and crisis situations,\nthere is generally no reluctance in using conventional Western medicine. At the\nsame time, belief in Chinese medicine remains strong in the area of\nmaintaining health and wellness. To put it simply, you see a Western doctor\nif you have acute appendicitis, but you take Chinese medicines to make your\nbody healthy enough to prevent appendicitis, or you recover quickly from the surgery. Very few practitioners of Western medicine in China reject traditional Chinese medicine, and most doctors in China will use some elements of Chinese medicine in their own\npractice. It is worth noting that the practice of Western medicine in China is somewhat different than that in the West. In contrast to the West, there are relatively few allied health professionals to perform routine medical procedures or to undertake procedures such as massage or physical therapy. In addition, Chinese practitioners of Western medicine have been less impacted by trends in the West that encourage patient empowerment, to see the patient as an individual rather than a collection of parts, and to do nothing when medically appropriate. Chinese practitioners of Western medicine have been widely criticized for overprescribing drugs such as corticosteroids or antibiotics for common viral infections. It is likely that these medicines, which are generally known to be useless against viral infections, would provide less relief to the patient than traditional Chinese herbal remedies.

See also

\n* History of traditional Chinese medicine\n* Public health in the People's Republic of China\n* I Ching

References

• Kaptchuck, Ted J., The Web That Has No Weaver; Congdon & Weed; ISBN 0809229331Z\n* Maciocia, Giovanni, The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists; Churchill Livingstone; ISBN 0443-039801\n* Ni, Mao-Shing, The Yellow Emperor's Classic of Medicine : A New Translation of the Neijing Suwen with Commentary; Shambala, 1995; ISBN 1570620806\n* Holland, Alex Voices of Qi: An Introductory Guide to Traditional Chinese Medicine; North Atlantic Books, 2000; ISBN 1556433263\n* Unschuld, Paul U., Medicine in China: A History of Ideas; University of California Press, 1985; ISBN 0520050231

External links

\n*National Certification Commission for Acupuncture and Oriental Medicine \n*State Administration of Traditional Chinese Medicine for the People's Republic of China\n*State Administration of Traditional Chinese Medicine for the People's Republic of China (english)\n*Journal of Chinese Medicine\n*China Academy of Traditional Chinese Medicine\n*Five Element Acupuncture Information Site\n*The 5 Elements\n*General information about Chinese Medicine\n*Modern Medicine and Traditional Chinese Medicine - Diabetes\n*Acupuncture. NIH Consensus Statement 1997 Nov 3-5; 15(5):1-34.\n*China, Chi, and Chicanery (a sceptical view) \n\n