Traditional Chinese Medicine: Three Thousand Years of Evolution
Traditional Chinese medicine (TCM) is the contemporary version of the three-thousand-year-old medical practice of China. TCM is a complete theoretical and therapeutic system, and includes a variety of carefully formulated techniques, such as acupuncture, herbal medicine, massage, Qi Gong, and nutrition.
Presently, about one-quarter of the world's population uses TCM. In various forms, TCM has spread to Japan, Korea, Southeast Asia, Europe, and the Americas. In the United States, some twelve million people currently go to TCM practitioners. Out of the estimated $14 billion a year that Americans spend on alternative medicine, TCM accounts for $1 billion, 75 percent of which goes for acupuncture.
Developing out of shamanic and tribal origins, Chinese medicine evolved with Chinese culture. Early written accounts of TCM, dating from 180 BC, describe herbs that are still used extensively. At about 100 BC, the doctrines of TCM were codified in a series of classic texts, including The Yellow Emperor's Classic of Internal Medicine. Subsequent practitioners expanded on these texts.
By the time of the 1949 Communist revolution, China had been significantly westernized, and TCM was not widely relied upon. However, faced with severe public health crises, the Communist regime reintroduced TCM, purging it of ineffective measures and pragmatically developing interventions that worked. Chinese TCM medical colleges updated their curricula, and researchers were sent into the Chinese countryside to interview traditional peasant healers. This led to the widespread introduction of many new remedies.
Today, practitioners of TCM in China are trained in well-organized schools and practice TCM in conjunction with Western medicine. Similarly, many conventional Japanese physicians also now prescribe traditional herbal formulas.
Chinese medicine was originally introduced into the United States during the 1700s by French-trained European practitioners. In the 1800s, Asian immigrants brought Chinese medicine with them to America. In the 1970s, with the normalization of United States-Chinese relations, new enthusiasm for TCM was created, especially for acupuncture. Currently, about fifty colleges of acupuncture and TCM exist in America and have licensed about ten thousand practitioners. Chinese medicine has been embraced by many American CAM practitioners, including a number of naturopathic and chiropractic physicians who employ elements of TCM in their eclectic mix of interventions.
Even when applied by Western doctors, though, TCM differs markedly from Western medicine in its philosophy and practice. With historical roots in Taoism, Confucianism, and Buddhism, TCM emphasizes the wholeness of body, mind, and spirit, and the unity of the individual with the natural environment. In contrast, the Western rational tradition tends to separate body, mind, and spirit, and to discount the importance of a patient's physical as well as psychosocial environment.
TCM does not conceptualize diseases as they are understood in the West. Whereas Western medicine focuses on the diagnosis and treatment of specific diseases, TCM focuses on the patient, identifying patterns of disharmony and imbalance that may ultimately lead to disease. Rather than addressing individual organ systems and the symptoms that arise in them, the TCM practitioner looks at the interplay among the symptoms and among the organs, defining a comprehensive syndrome that represents the state of the whole person. Thus, in TCM, people who have similar symptoms may be diagnosed as having completely different syndromes.
Central to Chinese medicine is the concept of qi (pronounced chee), which is the vital energy, or life force, that animates all living beings and the entire universe. According to Chinese medicine, qi travels through a system of energy channels, or meridians, which flow along the surface of the body and through the internal organs. In Chinese medicine, a balanced, harmonious flow of qi naturally creates a state of health. Illness results when qi is blocked or unbalanced. Thus, TCM emphasizes prevention and health promotion, rather than disease intervention.
Of central importance to TCM is the polarity of yin and yang, the feminine and masculine entities. Yin is associated with the feminine, passive, dark, and inner qualities, and yang with the masculine, active, light, and outer qualities. Yin and yang must be in balance for health to be present. Yin and yang influence and evolve into one another, so that by acting on the yang, TCM can change the yin, and vice versa. Acupuncture, as one modality of TCM, seeks to balance yin and yang by influencing the flow of qi energy through the body.
Another way of viewing the relationship between yin and yang is by considering the Five Elements, which represent successive phases in the transformation of yin and yang, in an eternal cycle. These Five Elements are fire, earth, metal, water, and wood. According to the Five Element theory, each of these elements (or different expressions of the balance of yin and yang) are reflected by specific seasons of the year, and by specific organs of the body. For example, water is the elemental energy state of extreme yin, and predominates during the winter, when the energy of nature is withdrawn. Within the body, water is associated with the kidney as a solid, or yin, organ, and with the bladder as a yang, or hollow, organ.
Patterns of disharmony within the individual are also described in terms of the Eight Principles, or four pairs of complementary opposites. These four opposites are interior-exterior, cold-hot, deficiency-excess, and yin-yang.
Overall, TCM views health and illness in very different terms from Western medicine. However, even though TCM clinicians employ a vastly different healing system, they often achieve results that are similar to those achieved by Western doctors.
From THE BEST ALTERNATIVE MEDICINE: WHAT WORKS? WHAT DOES NOT? by Dr. Kenneth R. Pelletier.
Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.
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Dr. Kenneth R. Pelletier. All Rights Reserved.