Traditional Chinese Medicine

Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is one of the great herbal systems of the world, dating back to the 3rd century BC. Yet throughout its history it has continually developed in response to changing clinical conditions, and has been sustained by research into every aspect of usage. This process continues today with the development of modern medical diagnostic techniques and knowledge.

A.       Comparison between Traditional Chinese Medicine and Western Medicine

Firstly of all, traditional Chinese medicine and Western medicine use different ways of organizing the information based on the same symptoms, same signs and same patient. Let me take an example. Diagnosing the same patient with a lump in her breast, a Western doctor will see a cyst, lesion, fibroid or cancer whereas a Chinese medical doctor will see a stagnation of Qi, Blood, or Phlegm. The Western doctor will seek to prove the diagnosis with a biopsy of the hardened tissue. The practitioner of Chinese medicine will feel the unique quality of the pulse at the radial artery which may feel "wiry" or kind of hard, like a guitar string bouncing up and down beneath your fingers (as opposed to other pulses that can feel softer and more flowing), observe the color and shape of the tongue looking for purple in particular, with possibly a thick yellow coating. Also used for diagnostic purposes will be seemingly unrelated symptoms such as a sensation of constriction in the chest, abdominal bloating, heightened emotional sensitivity and a tendency to be easily angered and frequent headaches at the  or the sides of the head. This will allow the doctor of Chinese medicine to sum up with a diagnosis of "Qi, Blood or Phlegm stagnation."

Secondly, what Western medicine tends to diagnose and treat is the effect that the disease state has on the body itself. The Practitioner of Oriental medicine diagnoses and acts upon the energy that creates the disease state. In other words, some believe that the greatest strength of Western medicine is in its trauma care and therapies for acute problems, while Chinese medicine excels in the areas of chronic problems and preventive medicine. Focus of Chinese medicine that the scientific world is still struggling to accept is an internal substance that the Chinese call "Qi". In the West it could be described as bio-electric energy. Acupuncture seeks to treat health on the level of Qi. There are pathways in the human body wherein this Qi flows. Western medicine can see and measure certain changes in the body's chemistry and functional activities with these conditions, but cannot act upon these changes for lack of understanding of their cause. The symptoms are too divergent and unrelated from a materialistic standpoint. But when you factor in Qi energy and its properties, all these conditions make perfect sense.

Thirdly, another aspect of the difference between Chinese and Western medicine can be described as Chinese treats the Yang and Western treats the Yin. Everything in the universe can be described in terms of Yin or Yang. This is one of the underlying philosophies of Traditional Chinese Medicine. When applied to medicine in general, Western medicine acts upon the Yin of the body, the substance of the body, the actual cells and chemicals. Traditional medicine works more on the energy that animates those cells.

Last but not the least, the concept of "side effects" is not recognized as such in Chinese medicine while in Western medicine bases on chemical materials and its side effects are sometimes stronger than the therapeutic roles. The toxic effects of certain Chinese medicines is recognized according to degree, and if it is necessary to use a 'toxic' substance medicinally, it will be prepared in a special manner or combined with other medicines to reduce or eliminate toxicity if possible. Traditional Chinese medicine is based on natural plants and its comprehensive and flexible treatment strategies always bring about fantastic treatment result. So more and more people in the world are interested in traditional Chinese medicine, and it is becoming a major medical stream in the world.

B.      Four Diagnostic Methods of Traditional Chinese Medicine  

Bianque, who regarded as the god doctor in Chinese medicine, applied the comprehensive diagnostic techniques of traditional Chinese medicines, namely, the four diagnostic methods: observation, auscultation and olfaction, interrogation, and pulse-feeling and palpation. "Observation" means looking at the appearance and tongue fur. "Auscultation and olfaction" refers to listening to the sound of the patient's speech and breath. "Interrogation" refers to asking about the patient's symptoms and "pulse-feeling and palpation" is just in the literal meaning that feel the pulse by fingers' touch.

C.      Popular and Useful Treatment of TCM   

Moreover, Bianque's ways of treatment varied into more branches, such as acupuncture, moxibustion, herbal medicine, acupressure, cupping, therapeutic exercise and nutrition. Traditional Chinese medicine is a complete medical system that is capable of treating a very wide range of conditions.

a)       Acupuncture 

Acupuncture is practiced medical treatments that are over 5,000 years old. Very basically, acupuncture is the insertion of very fine needles, (sometimes in conjunction with electrical stimulus), on the body's surface, in order to influence physiological functioning of the body.

Acupuncture can also be used in conjunction with heat produced by burning specific herbs, this is called Moxibustion. In addition, a non-invasive method of massage therapy, called Acupressure, can also be effective.

Acupuncturists can use as many as nine types of Acupuncture needles, though only six are commonly used today. These needles vary in length, width of shaft, and shape of head. Today, most needles are disposible. They are used once and disgarded in accordance with medical biohazard regulations and guidlines. There are a few different precise methods by which Acupuncturists insert needles. Points can be needled anywhere in the range of 15 degrees to 90 degrees relative to the skin surface, depending on the treatment called for. In most cases, a sensation, felt by the patient, is desired.

b)       Moxibustion

Another popular treatment method is Moxibustion, which is the treatment of diseases by applying heat by burning specific herbs to Acupuncture points. Acupuncture and Moxibustion are considered complimentary forms of treatment, and are commonly used together. Moxibustion is used for ailments such as bronchial asthma, bronchitis, certain types of paralysis, and arthritic disorders.

c)        Acupressure

One of the most popular alternatives to Acupuncture is Acupressure. This is simply Acupuncture without needles. Stimulation of the Acupuncture points is performed with the fingers or an instrument with a hard ball shaped head. Another variation of Acupressure is Reflexology (also called Zone Therapy). This is where the soles of the feet and the posterio-inferior regions of the ankle joints are stimulated. Many diseases of the internal organs can be treated in this manner.

d)       Cupping

Cupping is another type of treatment. This is a method of stimulating Acupuncture points by applying suction through a metal, wood or glass jar, in which a partial vacuum has been created. This technique produces blood congestion at the site, and therefore stimulates it. Cupping is used for low backache, sprains, soft tissue injuries, and helping relieve fluid from the lungs in chronic bronchitis.

e)       Herbal Medicine and Modern Pharmacology

There is a growing body of research which indicates that traditional uses of plant remedies and known pharmacological activity of plant constituents often coincide. However, herbal medicine is distinct from medicine based on pharmaceutical drugs. Firstly, because of the complexity of plant materials, it is far more balanced than medicine based on isolated active ingredients and is far less likely to cause side-effects. Secondly, since herbs are typically prescribed in combination, the different components of a formulae balance each other. They undergo a mutual synergy which increases efficacy and enhances safety. Thirdly, herbal medicine seeks primarily to correct internal imbalances rather than to treat symptoms alone, Therapeutic intervention is designed to encourage a self-healing process.

Chinese herbal medicines are very safe when prescribed correctly by a properly trained practitioner. Over thousands of centuries experienced doctors have compiled detailed information about the pharmacopoeia and placed great emphasis on the protection of the patient. Allergic type reactions are rare, and will cause no lasting damage if treatment is sped as soon as symptoms appear. 

D.      Functions of Traditional Chinese Medicine 

Chinese medicine can be utilized to treat allergies, arthritis pain, weight control, quitting smoking, back injury pain, musculoskeletal pain, fatigue and stress. Other illnesses and conditions that can be helped with Chinese medicine are digestive problems, menstrual problems, and urinary problems. Chinese doctors greatly emphasis on lifestyle management in order to prevent disease before it occurs. Chinese medicine recognizes that health is more than just the absence of disease and it has a unique capacity to maintain and enhance our capacity for well being and happiness.

E.       Well-known Doctors of Traditional Chinese Medicine

a)       Bianque

Bianque, whose surname was Qin and original given name was Yueren, was born in Bohai (now Renqiu County of Hebei Province) in the Spring and Autumn and Warring States Period (770-221BC). When he was a child, he learned skills of Chinese medicine from an old folk doctor, Mr. Changsang. He mastered Mr. Changsang's diagnosis method and treatment techniques and became the most famous doctor in his time, and was an outstanding representative of medical experts in the Pre-Qin Period (before 221BC). He could diagnose diseases accurately, cure patients miraculously and bring the dying back to life. As a result, people respected him as a legendary god doctor and simply called him Bianque.

After Bianque became famous, he toured all the kingdoms to cure more diseases and relieve more people from suffering. His areas of treatment often changed due to different regions. In Handan, he heard that most patients were women, so he worked as a "Daixia Doctor" (doctor specializing in gynecology); when he passed by Luoyang, he saw that elders were highly revered there so he became a doctor mainly treating diseases of the old such as the trouble in the ear or the eye; when he reached Xianyang, he became a pediatrician for people of the Qin Kingdom regarded children as the most important. In his practice of diagnosis, he had already applied the comprehensive diagnostic techniques of traditional Chinese medicines, namely, the four diagnostic methods: observation, auscultation and olfaction, interrogation, and pulse-feeling and palpation. At that time, Bianque called those techniques "Wangse (observing the color of the patient), Tingsheng (listening to the voice), Xieying (drawing a primary conclusion of the symptoms) and Qiemai (feeling the pulse)". Bianque's ways of treatment varied, such as acupuncture, adhibition of medicine, operation, medicine taking and so on.

Bianque had nine disciples in his life who contributed to hand down his high medical skills from generation to generation. Till the Han Dynasty (206BC-220AD), his well-preserved works included nine volumes of Internal Canon of Medicine, twelve volumes of External Canon of Medicine, and thirteen volumes of Bianque's Prescriptions Approved by First Yellow Emperor, etc. The extant medical book of the Han Dynasty, Canon of Medicine of Difficult Diseases , is a work compiled on the basis of Bianque's medical skill, especially his knowledge on pulse-taking. Bianque was memorized and respected by Chinese people forever. Many basic theories of the traditional Chinese medicine, which is still playing a great role in the health service of mankind, are closely originated from or related to Bianque.

b)       Hua Tuo

Hua Tuo, with a style name Yuanhua, also called Fu, was born approximately at the beginning of the second century AD and died before the 13th year of the Jian'an reign (208). He was an outstanding and eminent medical scientist in the Eastern Han Dynasty (25-220), especially good at surgical operation using anesthesia.

When Hua Tuo was young, he studied in Xuzhou City of Jiangsu Province . He was skilled in several branches of learning and famous for his eminent performance. But he declined the conscription of the court to work as an officer and kept practicing medicine among the common people for a long time and his footprints covered many places including present Anhui , Shandong , Jiangsu , Henan and other provinces. He was deeply respected and loved by common people. In his late years, he was summoned by Cao Cao , a prominent legislator during the Three Kingdoms Period (220-280), to Xuchang of Hannan Province to treat the latter's wind syndrome of the head. Unwilling to work as Cao Cao's private doctor, Hua Tuo found an excuse to ask for leave and return to his home. He refused several times to come back to Xuchang, which angered Cao Cao. Finally , Cao Cao found an excuse to kill him.

Hua Tuo advocated cure illness through exercise. He insisted that physical exercise was the key to strengthening the body, and movement could promote blood circulation and speed up metastases. And he used the sport of five animals created by himself to cure illness.

c)        Li Shizhen    

Li Shizhen(1518-1593),whose style name was Dongbi, also called Binhushanren (Person of the Mountain by the Lake ) in his late years. He was from Jizhou (now Jichun County of Hubei Province) of the Ming Dynasty (1368-1644). His grandfather was a doctor, and his father Li Yanwen was also a famous doctor in the local place. As a child, Li Shizhen began to read some medical classics systematically. When his father went out for patients, he often went together with him to assistant for treating diseases and copying prescriptions. However, doctors' social position was low at that period so Li Yanwen did not hope Li Shizhen to take medicine as his occupation and asked him to take imperial examinations. For the sake of imperial examinations, he took Li Shizhen to Gu Riyan, a successful candidate in the imperial examination. Gu Riyan had a large collection of books, so Li Shizhen had the chance to read many rare classics.

At the age of 17, 20 and 23, Li Shizhen went to Wuchang to take the imperial exam at the provincial level, but failed every time. Hence, he gave up the imperial examination and determined to follow his father to learn medicine. He lucubrated at medical knowledge, spared no pains to take in the predecessors' experiences in medical treatment and was good at giving play to his own creativity. Coupled with his high sympathy for patients, he did not only show good curative leechcraft but also high medical ethics in his practice. He won high prestige just in a few years. Particularly, his curing of a weird disease of children called "worm addiction" in the Royal Family of Chu made his reputation rise rapidly, and he was employed by the royal family as "fengcizheng"(an official title), in charge of affairs in the "liangyisuo" (Office of Good Doctors). Later, he was recommended to the " Hospital of Imperial Physicians " in Beijing to work as the "yuanpan" (chief doctor). However, he was not interested in it and resigned on the pretext of illness after working only for a little more than one year.

In his medical practice, Li Shizhen found many mistakes, repetitions or omissions in medical books available, feeling it was a great problem that affected the health and life of patients. So he made a decision to compile a new comprehensive book specializing in medicines again. From the age of 34, he started this project. In addition to summing-up of predecessors' experiences and accomplishments, he learned extensively from medical farmers, woodmen, hunters, fishermen and other laboring people. On the other hand, he often went to deep mountains and fields to observe and collect all kinds of samples of plants, animals, minerals and so on. He cultivated medical herbs himself and tried them on his own body so as to get the right knowledge of the herbs.

After 27 years of efforts, with reference to more than 800 kinds of literature and based on Jingshi Zhenglei Beiji Bencao (a book on materia medica) by Tang Shenwei in the Song Dynasty (960-1279), he completed his monumental work in pharmacy, Compendium of Materia Medica, in the sixth year (1578) of the Wanli reign of the Ming Dynasty (1368-1644) at the age of 60, after he did a great deal of collation and supplementation, added many of his own findings and views, and carried out three important revisions. Li Shizhen will never be forgotten by people for his great contribution to traditional Chinese medicine.

F.       Medical Classics

a)       The Yellow Emperor's Internal Classic

The Yellow Emperor's Internal Classic, or Internal Classic for short, whose author is unknown, is the earliest medical classic in China .

It includes two parts: Plain Question and Acupuncture Classic, each of which comprises 9 volumes. The 18 volumes originally consist of 162 articles, even though some of the chapters have been lost with the lapse of time. In a question-and-answer format, Plain Question recounts the discussion between the Yellow Emperor and his royal physician Qi Bo. It mainly sets forth the basic theories of physiology and pathology of the human body. Acupuncture Classic dwells upon acupuncture and moxibustion, main and collateral channels as well as hygiene and health care.

Internal Classic lays the foundation for the theoretical systems of traditional Chinese medicine, which has long guided the clinical practice of Chinese medicine and played an important role in China 's medical history. It has great significance both inside and outside China . Parts of the book have been translated into Japanese, English, German and French. Many treatises on Internal Classic have been published in Japan .

b)       Compendium of Materia Medica( Ben Cao Gang Mu )

Recorded in the 1.9-milions-words, 52-chapters, and 16-volumes are 1.897 varieties of medicines grouped under 60 categories. All the recorded medicines were in actual application and have proved effective by the author's time. Besides Chinese herbal medicine, they include animals and minerals for medication. In addition, the book contains 11,096 prescriptions and 1,160 illustrations. Such enormous contents enable the book to be the greatest treatise of material medica in history.

Compendium of Materia Medica is more than a masterpiece of pharmaceutics, as it has also contributed to the human knowledge of biology, mineralogy and chemistry.

Compendium of Materia Medica spread to Japan in 1606, then to Korea and Vietnam , and later to Europe around the 16th and 17th centuries. The book is now available either in whole or in excerpts in Latin, French, German, English, Russian and other languages. The world famous scientist Charles Darwin once consulted the book for historical data on the formation of skin colors of gold fish to demonstrate the artificial selection process of animals and gave high comments on it.

c)        Prescriptions Worth a Thousand Pieces of Gold for Emergencies

Beiji Qianjin Yaofang (Prescriptions Worth a Thousand Pieces of Gold for Emergencies), also called Qianjin Fang (Precious Prescriptions for Emergencies) or Qianjin Yaofang, was edited by Sun Simiao in the year 652. As Sun Simiao said, "Human life is of paramount importance, more precious than a thousand pieces of gold; to save it with one prescription is to show your great virtue", thus, 'gold" is used in the name of the book.

From the Tang Dynasty (618-907) to the modern time, Beiji Qianjin Yaofang has had more than 40 versions at home and abroad, which are roughly divided into two categories.

The book is in 30 volumes. Volume 1 is the pandect of medical science, including medical ethics, materia medica, pharmacy and so on; Volume 2-4 are on gynecopathy; Volume 5 on pediatrics; Volume 6 on diseases of the seven orifices; Volume 7-8 on dermahytosis of all kinds; Volume 9-10 on febrile diseases caused by cold; Volume 11-20 on viscera diseases; Volume 21 on diabetes and similar diseases; Volume 22 on skin and external diseases; Volume 23 on hemorrhoid; Volume 24 on disintoxicating and various treatments; Volume 25 on techniques for emergencies; Volume 26-27 on dietetic therapy and cultivation of mental poise; Volume 28 on normal pulse; and Volumes 29-30 on acupuncture and moxibustion. There are totally 233 categories, containing more than 5,300 articles. It has set up the format for compilation of prescriptions.

A systematic summing-up of the accomplishments in medical science was concluded in this book before the Tang Dynasty. Its sources are extensive and its contents are abundant, covering all clinical sectors and many aspects such as acupuncture and moxibustion, dietetic therapy, medicament, prevention, hygiene and so on. It is the first comprehensive monumental works of medical science in China , another conclusion of Chinese medicine after Treatise on Febrile Diseases Caused by Cold and Miscellaneous Diseases by Zhang Zhongjing, and is praised as the earliest encyclopedia of clinical medicine in the Chinese history.