About Chinese Medicine
- Foundational Paradigms
- Clinical Theories
- Zangfu (Internal Organ Theory)
- Jingluo (Acupuncture Channel Theory)
- Five Phase/Element Theory
- Yin-yang Theory
- What Is Acupuncture?
- What is Chinese Herbal Medicine?
- What Can Chinese Medicine Treat?
- What to Expect
- Acupuncturist Training
IntroductionChinese medicine is a wholly unique system of health and healing, where foundational theories and paradigms are concerned. To gain an appreciation for this medicine and its uniqueness, it helps to take a close look at our understanding of the current dominant medical system, what is generally referred to as 'Western' or ' allopathic' medicine.
The theoretical foundations of Western medicine, root paradigms such as reductionism and materialism, are so common and prevalent throughout modern society that they are taken for basic facts of life, health, and the human being. For example, the areas of study of chemistry and biology tend to be understood as 'the way things are'. The ubiquitous nature of these paradigms tends to obscure the fact that they are models of the world, of reality. They are mental constructs we create and evolve over time to help us understand and work with the human body in health and illness. We have become so used to a certain way of seeing the world, we have mistaken that perspective for the 'world', itself.
The danger of mistaking a model for reality is that we automatically dismiss other models, other systems, that are dissimilar from the one we know. Chinese medicine, for example, is based on a different understanding of the human being and illness. It uses different theoretical constructs for dealing with disease and illness. Unfortunately, Chinese medical theories are generally compared against Western for the sake of validating the former. The accuracy of Chinese medical ideas and approaches to medicine are judged, if subconsciously, by their similarity to their Western counterpart. This is unfortunate for many reasons. Most importantly, it misses the purpose and true criteria for evaluating the usefulness of a theory of medicine - the end clinical effect.
Therefore, to understand Chinese medicine we must, first, reveal the basic nature of Western medical theory as one possible approach to understanding and treating disease. This is necessary so that we can 'clear the stage' and become open to a different possible approach. Only then will we truly be able to learn about Chinese medicine and all it has to offer.
I leave the clearing of the stage to you and offer the following as education about a whole different way of health and healing.
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Foundational ParadigmsAll branches are reflections, derivations of the root. All end clinical theories, the ones that are most directly involved in treatment, are extensions of the fundamental paradigms they are based on. This is exactly the place where the two medical systems discussed above deviate most drastically.
Chinese medicine, as classically practiced, understands the human being as a whole entity, made up of both physical (bones, muscles, etc.) and non-physical (mood, intellect, etc.) aspects of that entity. Further, it perceives the patient as a constantly evolving process, both reflective of and influential upon its material and non-material environment, including physical surroundings, season, relationships, and so on.
Diagnosis is less a snapshot of a given state of an isolated part of the patient, and more a dynamic understanding of the nature of that patient and their life, with emphasis on their reported current complaint. Treatment, then, in its ideal form, is a combination of physical intervention to combat pathological influences and assist intrinsic 'righting' tendencies of the human being, and non-physical intervention, akin to counseling, to increase awareness on the patient's part to stimulate conscious healing movement.
Chinese medicine not only often appears as fundamentally different, but also as an outright paradox. For example, I am often asked what X symptom means, as in "I have a headache. What does that mean, or what's causing it?", and often times there simply is no answer. The complexity of Chinese medical theory infuses its clinical perceptive ability with a tremendous degree of individualization. Symptoms can only be truly understood within a given context. This context can be relatively simple and straightforward, for instance with a short time-line of symptom manifestation, or quite complex incorporating the patient's overall health, mood, and diet. The richer the context the more powerful the diagnosis and more effective the treatment. Two different patients can, and quite often do, present with similar surface symptoms, but different contexts, and thus varying diagnoses and treatment plans. This holds true even for patients with identical Western medically defined diseases, such as 'glaucoma' or 'diabetes'. (In fact, such Western disease labels are of minimal importance, ultimately, to the Chinese medical practitioner, as the practitioner will have to re-evaluate the patient from the Chinese medical perspective and within its theoretical framework.)
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HistoryThe history of the medicine is another fundamental aspect of Chinese medicine that stands in contrast to modern Western practices. Where contemporary medical care places heavy emphasis on technology and modern scientific techniques for investigating and verifying clinical effectiveness and safety of therapies and treatment, Chinese medicine (up until the 20th century) relied upon the accumulated wisdom from billions of clinical experiences over many millennia. Where modern medicine places trust in strictly controlled clinical research, Chinese medicine has trusted what has worked effectively in actual clinical interactions over generations of practice.
The beginning of Chinese medicine is truly lost in history. Basic concepts, such as 'qi' (aka 'chi', pronounced 'chee') and their role in health and healing go back at least 4,000 years. The foundational text of Chinese medicine, often referred to as the 'bible' of the medicine, the Huang Di Nei Jing, or Yellow Emperor's Classic of Medicine, was written roughly 2,000 years ago. In this text, which is available in translation at most any bookstore, a whole system of medicine is presented and discussed. Clearly, the medicine had already been in existence for centuries prior to the writing of that text. (In many places reference to 'the ancients' is made, and it is even mentioned that information has been passed down for generations).
Since the time of the Nei Jing, practitioners of the medicine have seen billions of patients and have recorded their experiences and passed them on to later generations. Periodically, new styles or sub-systems have been created to meet the unique demands of a given era. These theories would be based on the same foundational principles, but would be adapted to new diseases. An excellent example would be the Wen Bing Lun, a 'new' theory on what would be considered infectious disease by contemporary medical practices.
As the medicine has grown and evolved, it has maintained its grounding in basic philosophical principles and theories, while adapting these to new diseases as they arose. The medicine as it stands currently, is a vast collection of these medical experiences and extensive knowledge of the human being in health and illness.
This is similar in many ways to the collection of medical knowledge in the Western world. However, the Western world relies on rigid, reductionistic inquiry and evaluation to accumulate knowledge of effective treatments. The Chinese used scientific methods (eg. close attention to variables and attributing causal effect to certain therapies), but their investigative methods included much more natural observation (versus manipulation) and occurred primarily in actual clinical settings.
Much of Chinese medicine's claims to efficacy have yet to be validated through modern scientific methods. However, it is this medicine's extensive, almost unfathomably rich, history that gives it its authority and clinical reliability.
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Clinical TheoriesChinese medicine is actually a collection of many varying theories. As it evolved, these theories were created out of necessity to effectively treat the diseases it faced. The modern, standardized version of the medicine, officially labeled 'Traditional Chinese Medicine' (TCM), incorporates several of these theories, including Zang Fu theory (roughly translated as 'Viscera and Bowel', or internal organ theory), Jing Luo (the theory of the acupuncture channels themselves), and the classic theories of Wu Xing or Five Elements/Phases and Yin -Yang theory.
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Zangfu (Internal Organ Theory)Zangfu theory appears to share much in common with modern anatomy and physiology. The zang, or viscera, are the Heart, Spleen, Lungs, Kidneys, and Liver. I capitalize them, here, to indicate we are using the term in a traditional Chinese sense and not modern biological.
The importance of the zang are in the aspects of functioning of the human being they represent. For example, the Spleen zang is that aspect of the system responsible, along with the Stomach fu, for digesting and distributing nourishment. In the clinic, symptoms associated with the Spleen zang include: low appetite, poor digestion, low energy, and also Blood deficiency and organ prolapse. These last two symptoms help reveal the extensive nature of the these organ systems.
Consistent with Chinese medicine's core paradigms, zangfu theory emphasizes function (over material nature/structure) and incorporates physical function, emotional state, and cognitive aspects of being. For example, the Spleen zang system covers not only the physical act of digestion, but also the emotional state of excessive worry, and, cognitively, the ability to maintain focus and 'digest' information. This comprehensive understanding allows the practitioner to diagnose and treat mental and physical states, as well as draw correlations between the two to help educate the patient so they may improve their lives.
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Jingluo (Acupuncture Channel Theory)Acupuncture channels, or meridians, are similar to the circulatory system of modern medicine. The channels, though not physical structures (again, the emphasis on function over form) effectively connect all parts of the body.
Where the channels run near the surface of the body they can be directly stimulated with acupuncture needles or acupressure (specifically at the acupuncture 'points' laying on the channels). These same channels run deep and pass through internal organs, thus allowing the Chinese medical physician to diagnose and treat internal organ disorders via the channels.
Interestingly, these same channels are those discussed and trained in traditional Oriental martial arts. In my private practice, I treat many students of traditional kung fu. As their training incorporates the acupuncture channels, they are often more sensitive to the channels and can more easily feel the qi move through the channels with acupuncture treatments. Though, most patients eventually feel the qi at the acupuncture point, at least, if not its transit through the channel system.
For the skeptic, channel theory is an excellent place to meet paradox head on. The experience of qi and the channels is relatively easy to attain by anybody and has no physical, material existence. That is, the channels do not 'exist' in a concrete, dissect-it-and-lay-it-on-the-table kind of way (at least not to my knowledge; perhaps such discovery has been made), yet they are clearly real in that anyone can experience them, and they make for a highly reliable medical theory.
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Five Phase/Element TheoryFive Phase theory is a core theory that has applicability not only in medicine but in many areas of life. It is a system of correspondence where any 'thing' or 'event' in the natural world corresponds with one of the five phases. Once you understand the unique nature of these phases and how they interact, you can understand much about the things that correspond with that phase.
For example, in the world of medicine, each phase corresponds with multiple internal organs. The phases have a mother-child relationship, meaning one is responsible for nourishing and providing for another. Translated to medicine, certain organ systems are a 'mother' to other systems, and others play the child role. Clinically, if one system is weak, perhaps functioning poorly, you can treat its 'mother' organ to strengthen that child organ.
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Yin-yang TheoryYin-yang theory is another core theory that is incorporated in many ways in many other theories. The words 'yin' and 'yang' (the 'a' in yang pronounced as in 'father') are descriptions of complementary states of entities or events. There are an infinite number of examples. One example would be in reference to a fire. The yang aspect of the fire would be the flames themselves, the active, transformative, expressive nature. The yin aspect would be the wood as the fuel for the fire, the substance from which the yang is expressed and is dependent upon. Yin is also commonly referred to as the feminine aspect, speaking to the receptive capability and ability/potential for generation and creation.
It is vital to be aware that yin and yang are relative states; they are not static labels. For example, it is often stated that the sun is yang, referring to the extreme heat and light put off by the sun. However, to make this statement accurate we would have to make explicit the comparison of the sun to something cooler and putting off less light, for example the moon. The sun is yang relative to the moon. Now, if compared to a supernova, when a star explodes, the sun is quite yin.
Yin-yang theory can be applied to, literally, anything. One of my Chinese medical professors in California once said that he has never come across any theory in Western medicine that does not correspond to yin-yang theory. There are basic rules of interaction between yin and yang. Once these rules are understood and the yin-yang terms accurately applied, deeper comprehension is gained and accurate predictions can be made.
Medically, understanding the nature of substances, processes, and systems of the human being within the yin-yang paradigm gives an effective model with which to base a diagnosis and plan a course of treatment. The most common example is menopause. Within the Chinese medical framework, menopause is a period of significant loss of yin and subsequent exuberance of yang. A day can be divided into yang-natured day time and yin-natured night time. During menopause, due to the loss of yin, yang is in relative excess. This manifests during the yin phase of the day, nighttime, as yin should be ruling, but is deficient and so yang manifests, resulting in night sweats. Most of the heat signs associated with menopause are due to this yin deficiency, yang excess. The proper treatment, then, is to strengthen yin while reducing the excess yang.
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