Chinese
medicine
What Is It?
Traditional
Chinese medicine (TCM) is a system of health care based on the
late-twentieth-century standardization of medical practices that originated in
China some 2500 years ago. Two classic medical texts, the Nei Jing
(compiled from 100 B.C. to 100 A.D.) and the Nan Jing (written circa 100
to 200 A.D.) were important early documents that presented the core concepts of
TCM, and they have informed generations of scholars and practitioners ever
since. These core concepts suggest that disease is the result of imbalances in
the flow of the body's vital energy, or qi (pronounced "chee"), and that
the human body is a microcosm of the basic natural forces at work in the
universe.
As TCM evolved
over the centuries, it came to include treatment of disease using acupuncture,
herbal medicine, dietary principles, physical manipulation of the body tissues,
therapeutic exercise and movement (tai chi), and the mind-body practice of
qigong. TCM reached its apex during the Ming dynasty (1368-1644) then gradually
declined to the status of a folk practice until 1949. It was then that the
government of the People’s Republic of China began to exploit the remaining TCM
practitioners as a means of making health care accessible to a suffering and
underserved population.
While TCM was
fading in China it was nevertheless migrating to the rest of the globe as
traders, missionaries, and diplomats visited East Asia in the 17th and 18th
centuries and returned home with reports and texts of the classical practices.
Chinese immigrating to the United States in the 19th century brought other
components of traditional practice with them.
It wasn't until
1971, however, that U.S. citizens really became aware of TCM--and of acupuncture
in particular. This came about because James Reston, a New York Times
reporter became stricken with appendicitis while doing a story on a ping-pong
tournament in Beijing, and was treated for post-surgical pain with acupuncture.
In a front-page Timesstory he wrote, "I've seen the past, and it works!"
This exposure came at a time when many Americans were looking for a more
holistic, naturalistic approach to health care, and caused quite a stir among
the Western medical community. Since then, acupuncture has become a widely
accepted form of treatment in the U.S., and other aspects of TCM are gaining
supporters as well.
How Does It
Work?
Practitioners of
TCM seek to promote or restore health by diagnosing and treating "disharmonies"
or imbalances in the qi, or natural vital energy of the body. A typical
TCM evaluation will include three components:
·
The first assesses the balance between yin and yang--complementary but opposing
qualities that represent the natural dualities of the world, such as
male/female, day/night, and hot/cold.
·
The second considers the correspondence of the ailment to the five Chinese
elements--wood, fire, earth, metal, and water. It is believed that each internal
organ and body system is related to an elemental quality and that the body
reflects the natural world in this way.
·
The third determines which organ or metabolic system requires the most support
from therapy.
Because of this
ancient symbolic method of describing the body in natural terms, a TCM diagnosis
can sound like a weather report. Colds and flus may be described as "wind-heat
invading the lungs," or "wind-cold affecting the stomach." Some kinds of
endometriosis could be described as "damp-heat " in the "lower burner." An
asthma patient might have "a failure of the kidneys to moisten the lungs." These
descriptive diagnoses can lead some conventional physicians to conclude that TCM
is "unscientific," whereas the actual practice of TCM is a sophisticated system
based on the practical science of observing and altering the natural functions
of the body.
Practitioners of
TCM use tools such as acupuncture, massage, qigong, and herbal medicine to
restore balance and health to the body. A change in diet may also be
recommended. For example, if someone's condition is showing too much dampness
and cold, the practitioner may suggest cutting out cold foods such as salads,
and recommend drying and warming herbs for dietary support. If the condition is
more a physical problem, such as an injury, the treatment may focus on the
muscles, nerves, tendons, and circulation at the site of the injury, with
acupuncture, massage, and anti-inflammatory herbs all being prescribed.
In fact, Chinese
herbs are prescribed in most TCM practices. These remedies are often
sophisticated and complex mixtures that were developed for organ imbalances and
disease support--and standardized--centuries ago. Those most often used today
have been carefully formulated to have minimal side effects.
Chinese herbs
are available in the U.S. in liquid, tablet, or powder form and can be
prescribed by practitioners familiar with the proper diagnosis of a particular
condition. In China, some TCM practitioners specialize in herbal medicines and
are expert at modifying and individualizing the classical herbal formulas. These
practitioners can artfully construct a mixture from raw herbs or powders to
treat disharmonies of the organs as well as any current symptoms.
If you plan to
take Chinese herbs, make sure any mixtures you use have standardized content and
are processed under the direction of a licensed health professional familiar
with their medicinal effects. Individualized herbal mixtures should be
prescribed only under the advice of a TCM practitioner who has training in
herbal drug compounding. A TCM herbal mixture could be as safe as an
over-the-counter cold and flu drug mixture, or as powerful as a strong
prescription drug.
What You Can
Expect
A TCM
examination is thorough, but noninvasive. The practitioner will take a careful
medical history, noting your body's reaction to stress and your tendencies
toward illness symptoms. He will observe the color and form of your face and
body, note the condition of your skin and nails, check how your breath and body
odor smells, and look at your posture and demeanor. The condition of your
tongue--its shape, color, and coating--also provides important data on the way
your circulation and metabolism is affecting your internal organs. Your pulse
will be felt at three different points on each wrist, each location
corresponding to a different part of the body. Considered together, this
information gives the practitioner a sense of your body's current functioning.
From this
examination, the practitioner will consider the patterns of imbalance in your
body and will choose the proper type of treatment for you. Depending on the
training of the practitioner, treatment may consist of acupuncture, massage,
change in diet, herbal remedies, qigong, or any combination of these.
Duration and
frequency of treatment depends on the ailment and the person being treated.
Acute problems may require one to three visits over two weeks, whereas a course
of acupuncture for a chronic problem may require 12 treatments in three months
to see positive results. Herbal tonics for restoring healthy internal organ
function may require weeks of use, whereas herbs for colds and flu can show good
results in hours. Practitioners with other skills in addition to their TCM
training, such as chiropractic, homeopathy, Western physical medicine, and drug
therapy, may integrate these treatments with the TCM program.
Health Benefits
The various
techniques used in TCM can address a wide range of illnesses. Acupuncture has
been shown to be particularly effective in relieving chronic pain--caused by
such ailments as arthritis, sinusitis, headache, PMS, and back pain--and has
aided postoperative pain as well. It can also ease nausea and other discomforts
associated with cancer treatment. In addition, acupuncture has been beneficial
in rehabilitation for certain neurologic problems such as stroke. It is also
used in treating addiction to cigarettes, alcohol, and other drugs.
Chinese herbal
remedies are often used to treat acute ailments such as the flu and the common
cold, and are also recommended for chronic conditions such as fibromyalgia,
migraine headaches, and irritable bowel syndrome.
Chinese massage
techniques, such as anmo and tuina, utilize the same points as acupuncture to
unblock qi and ease the stress and tension that often accompanies illness. Anmo
involves pressing and rubbing motions; tuina is a thrusting and rolling type of
massage.
Many research
studies of the various types of TCM are currently ongoing. A 1999 study
published in Clinical and Experimental Obstetrics and Gynecology showed
that acupuncture eased pain following breast cancer surgery. Another recent
study in Alternative Therapies in Health and Medicine found that
practicing tai chi helped improve mobility for people with multiple sclerosis.
A 1998 study
published in the Journal of the American Medical Association showed that
Chinese herbal medicine helped improve the symptoms of irritable bowel syndrome.
A group of 116 patients were divided into groups: One group was given an
individualized Chinese herbal treatment, one group was given a standard Chinese
herbal formulation, and the third group was given a placebo, or dummy pill. The
two groups who received the herbs experienced significant improvement in their
symptoms (the individualized group maintained the improvement longer), as
compared to the placebo group.
Preliminary
studies have also been conducted on Chinese herbal treatments and skin
conditions. A study published in Lancet found that 31 patients with
atopic dermatitis appeared to be helped by Chinese herbal therapy. A review of
clinical trials in the British Journal of Clinical Pharmacology found two
trials that showed Chinese herbs as a more effective treatment than a placebo
for treating eczema. More study is needed in this area, however, because some
adverse reactions have been reported to the treatment.
How To Choose a
Practitioner
In the United
States, practitioners typically specialize in a particular component of TCM,
such as acupuncture, herbs, or massage, rather than the entire discipline. The
regulation of TCM varies from state to state. Acupuncturists are licensed in
many states and Doctors of Oriental Medicine (O.M.D.) are licensed in some
states to prescribe herbal remedies as well as acupuncture treatments. Many
biomedically trained doctors, naturopaths, osteopaths, and chiropractors have
studied acupuncture and other branches of TCM and incorporated them into their
practices.
Mastering the
full range of Chinese medicine is a complex process that requires many years of
study and practice. However, medical personnel with less training may still be
able to perform acupuncture and herbal medicine safely, by working according to
protocols designed by TCM practitioners. As you would with any health provider,
check into your TCM practitioner's training and background.
Cautions
·
If you have a chronic condition or a new acute problem that is seriously
disabling you, get a diagnostic evaluation from a conventional primary-care
physician before consulting an acupuncturist.
·
Plan on coordinating your care between your biomedical doctor and your
acupuncturist. If they won’t work together, find ones that will.
·
Be sure your acupuncturist uses sterile, disposable needles.
·
As
with any health practitioner, if the condition is not improving in a reasonable
time, get a second opinion. There are increasing numbers of practitioners
familiar with both Western and traditional Chinese medicine, should you need a
re-evaluation.
·
Acupuncturists in California and Nevada must take an exam in order to dispense
Chinese herbs. In other states, herbal certification is voluntary. Ask if your
acupuncturist has passed the National Certification Commission for Acupuncture
and Oriental Medicine herbal exam.
·
Herbal remedies are regulated as "foodstuffs" under current Federal laws. This
means that the Food and Drug Administration (FDA) has not evaluated their
effectiveness and safety as therapies. Be sure to work only with a licensed and
certified practitioner to ensure that you get the best care
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