Chinese Medicine: The Medicine of Harmony and Balance

I felt to post this tonight as the situation across the planet is not unlike the human body. All is interconnected and when imbalance occurs there is dysfunction. We can see that with climate change as strange climatic conditions occur. I felt it as fever, in some moments you go cold and then burning hot. I feel that as the bush fires and the cold snaps. In Melbourne this week they had hail stones as big as tennis balls, here in Perth it was 38 degrees and hot with bush fires around. In the Northern Territory they had floods and bushfires. So balance and harmony is the mirror for humanity if it is to rejoin its true nature. I always have felt our solutions will come from nature, as that is who we are.

http://en.wikipedia.org/wiki/Traditional_Chinese_medicine

Traditional Chinese Medicine (TCM) (simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōng yī: “Chinese medicine”) refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage (Tui na), exercise (qigong), and dietary therapy.[1] These practices are a common part of medical care throughout East Asia, but are considered alternative medicine in the Western world.[1]

The doctrines of Chinese medicine are rooted in books such as the Yellow Emperor’s Inner Canon and the Treatise on Cold Damage, as well as in cosmological notions like yin-yang and the Five Phases. Starting in the 1950s, these precepts were modernized in the People’s Republic of China so as to integrate many anatomical and pathological notions from scientific medicine. Nonetheless, many of its assumptions, including the model of the body, or concept of disease, are not supported by modern evidence-based medicine.

TCM’s view of the body places little emphasis on anatomical structures, but is mainly concerned with the identification of functional entities (which regulate digestion, breathing, aging etc.). While health is perceived as harmonious interaction of these entities and the outside world, disease is interpreted as a disharmony in interaction. TCM diagnosis consists in tracing symptoms to an underlying disharmony pattern, mainly by palpating the pulse and inspecting the tongue.

History

The first traces of therapeutic activities in the territories that are now considered China date from the Shang dynasty (14th-11th centuries BCE).[2] Though the Shang did not have a concept of “medicine” as distinct from other fields,[3] their oracular inscriptions on bones and tortoise shells refer to illnesses that affected the Shang royal family: eye disorders, toothaches, bloated abdomen, etc.,[4] which Shang elites usually attributed to curses sent by their ancestors.[3] There is no evidence that the Shang nobility used herbal remedies.[5]

Stone and bone needles found in ancient tombs have made Joseph Needham speculate that acupuncture might have originated in the Shang dynasty.[6] But most historians now make a distinction between medical lancing (or bloodletting) and acupuncture in the narrower sense of using metal needles to treat illnesses by stimulating specific points along circulation channels (“meridians”) in accordance with theories related to the circulation of Qi.[7] The earliest evidence for acupuncture in this sense dates to the second or first century BCE.[8]

The Yellow Emperor’s Inner Canon, the oldest received work of Chinese medical theory, was compiled around the first century BCE on the basis of shorter texts from different medical lineages.[9] Written in the form of dialogues between the legendary Yellow Emperor and his ministers, it offers explanations on the relation between humans, their environment, and the cosmos, on the contents of the body, on human vitality and pathology, on the symptoms of illness, and on how to make diagnostic and therapeutic decisions in light of all these factors.[10] Unlike earlier texts like Recipes for Fifty-Two Ailments, which was excavated in the 1970s from a tomb that had been sealed in 168 BCE, the Inner Canon rejected the influence of spirits and the use of magic.[11] It was also one of the first books in which the cosmological doctrines of Yinyang and the Five Phases were brought to a mature synthesis.[10]

The Treatise on Cold Damage Disorders and Miscellaneous Illnesses was collated by Zhang Zhongjing sometime between 196 and 220 CE, at the end of the Han dynasty. Focusing on drug prescriptions rather than acupuncture,[12] it was the first medical work to combine Yinyang and the Five Phases with drug therapy.[13] This formulary was also the earliest Chinese medical text to group symptoms into clinically useful “patterns” (zheng 證) that could serve as targets for therapy. Having gone through numerous changes over time, it now circulates as two distinct books: the Treatise on Cold Damage Disorders and the Essential Prescriptions of the Golden Casket, which were edited separately in the eleventh century, under the Song dynasty.[14]

In the centuries that followed the completion of the Yellow Emperor’s Inner Canon, several shorter books tried to summarize or systematize its contents. The Canon of Problems (probably second century CE) tried to reconcile divergent doctrines from the Inner Canon and developed a complete medical system centered on needling therapy.[15] The AB Canon of Acupuncture and Moxibustion (Zhenjiu jiayi jing 針灸甲乙經, compiled by Huangfu Mi sometime between 256 and 282 CE) assembled a consistent body of doctrines concerning acupuncture;[16] whereas the Canon of the Pulse (Maijing 脈經; ca. 280) presented itself as a “comprehensive handbook of diagnostics and therapy.”

Philosophical background

Traditional Chinese medicine (TCM) is based on Yinyangism (i.e., the combination of Five Phases theory with Yin-yang theory),[17] which was later absorbed by Daoism.

Yin and yang
Main article: Yin and yang

Yin and yang are ancient Chinese concepts which can be traced back to the Shang dynasty[19] (1600-1100 BC). They represent two abstract[20] and complementary aspects that every phenomenon in the universe can be divided into.[19] Primordial analogies for these aspects are the sun-facing (yang) and the shady (yin) side of a hill.[21] Two other commonly used representational allegories of yin and yang are water and fire.[20] In the yin-yang theory, detailed attributions are made regarding the yin or yang character of things:

Phenomenon Yin Yang
Celestial bodies moon sun
Gender[22] female male
Location[22] inside outside
Temperature[22] cold hot
Direction[23] downward upward
Degree of humidity damp/moist dry

The concept of yin and yang is also applicable to the human body; for example, the upper part of the body and the back are assigned to yang, while the lower part of the body are believed to have the yin character.[24] Yin and yang characterization also extends to the various body functions, and – more importantly – to disease symptoms (e.g., cold and heat sensations are assumed to be yin and yang symptoms, respectively).[23] Thus, yin and yang of the body are seen as phenomena whose lack (or overabundance) comes with characteristic symptom combinations:

Yin vacuity (also termed “vacuity-heat”): heat sensations, possible night sweats, insomnia, dry pharynx, dry mouth, dark urine, a red tongue with scant fur, and a “fine” and rapid pulse.[25]

Yang vacuity (“vacuity-cold”): aversion to cold, cold limbs, bright white complexion, long voidings of clear urine, diarrhea, pale and enlarged tongue, and a slightly weak, slow and fine pulse.[26]

TCM also identifies drugs believed to treat these specific symptom combinations, i.e., to reinforce yin and yang.

Five Phases theory

Five Phases (五行, pinyin: wǔ xíng), sometimes also translated as the “Five Elements”[28] theory, presumes that all phenomena of the universe and nature can be broken down into five elemental qualities – represented by wood (木, pinyin: mù), fire (火pinyin: huǒ), earth (土, pinyin: tǔ), metal (金, pinyin: jīn), and water (水, pinyin: shuǐ).[29] In this way, lines of correspondence can be drawn:

Strict rules are identified to apply to the relationships between the Five Phases in terms of sequence, of acting on each other, of counteraction etc.[29] All these aspects of Five Phases theory constitute the basis of the zàng-fǔ concept, and thus have great influence regarding the TCM model of the body.[28] Five Phase theory is also applied in diagnosis and therapy.[28]

Correspondences between the body and the universe have historically not only been seen in terms of the Five Elements, but also of the “Great Numbers” (大數, pinyin: dà shū)[37] For example, the number of acu-points has at times been seen to be 365, in correspondence with the number of days in a year; and the number of main meridians – 12 – has been seen in correspondence with the number of rivers flowing through the ancient Chinese empire.

TCM model of the body

TCM’s view of the human body is only marginally concerned with anatomical structures, but focuses primarily on the body’s functions[40][41] (such as digestion, breathing, temperature maintenance, etc.):

“The tendency of Chinese thought is to seek out dynamic functional activity rather than to look for the fixed somatic structures that perform the activities. Because of this, the Chinese have no system of anatomy comparable to that of the West.”

—Ted Kaptchuk, The Web That Has No Weaver

These functions are aggregated and then associated with a primary functional entity – for instance, nourishment of the tissues and maintenance of their moisture are seen as connected functions, and the entity postulated to be responsible for these functions is xuě (blood)[42] – but this is mainly a matter of stipulation, not anatomical insight.[43]

The primary functional entities used by traditional Chinese medicine are qì, xuě, the five zàng organs, the six fǔ organs, and the meridians which extend through the organ systems.[44] These are all theoretically interconnected: each zàng organ is paired with a fǔ organ, which are nourished by the blood and concentrate qi for a particular function, with meridians being extensions of those functional systems throughout the body.

Qi

TCM distinguishes not only one but several different kinds of qi (simplified Chinese: 气; traditional Chinese: 氣; pinyin: qì).[45] In a general sense, qi is something that is defined by five “cardinal functions”:[45][46]

Actuation (推動, tuīdòng) – of all physical processes in the body, especially the circulation of all body fluids such as blood in their vessels. This includes actuation of the functions of the zang-fu organs and meridians.
Warming (溫煦, pinyin: wēnxù) – the body, especially the limbs.
Defense (防御, pinyin: fángyù) – against Exogenous Pathogenic Factors
Containment (固攝, pinyin: gùshè) – of body fluids, i.e. keeping blood, sweat, urine, semen etc. from leakage or excessive emission.
Transformation (氣化, pinyin: qìhuà) – of food, drink, and breath into qi, xue (blood), and jinye (“fluids”), and/or transformation of all of the latter into each other.

Vacuity of qi will especially be characterized by pale complexion, lassitude of spirit, lack of strength, spontaneous sweating, laziness to speak, non-digestion of food, shortness of breath (especially on exertion), and a pale and enlarged tongue.[26]

Qi is believed to be partially generated from food and drink, and partially from air (by breathing).[47] Another considerable part of it is inherited from the parents and will be consumed in the course of life.[47]

In terms of location, TCM uses special terms for qi running inside of the blood vessels and for qi which is distributed in the skin, muscles, and tissues between those. The former is called yíng-qì (simplified Chinese: 营气; traditional Chinese: 營氣), its function is to complement xuè and its nature has a strong yin aspect (although qi in general is considered to be yang).[48] The latter is called weì-qì (Chinese: 衛氣), its main function is defence and it has pronounced yang nature.[48]

Qi also circulates in the meridians. Just as the qi held by each of the zang-fu organs, this is considered to be part of the ‘’principal‘’ qi (元氣, pinyin: yuánqì) of the body[49] (also called 真氣 pinyin: zhēn qì, ‘’true‘’ qi, or 原氣 pinyin: yuán qì, ‘’original‘’ qi).[50]

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Concept of disease

In general, disease is perceived as a disharmony (or imbalance) in the functions or interactions of yin, yang, qi, xuĕ, zàng-fǔ, meridians etc. and/or of the interaction between the human body and the environment.[70] Therapy is based on which “pattern of disharmony” can be identified.[71][72] Thus, “pattern discrimination” is the most important step in TCM diagnosis.[71][72] It is also known to be the most difficult aspect of practicing TCM.[73]

In order to determine which pattern is at hand, practitioners will examine things like the color and shape of the tongue, the relative strength of pulse-points, the smell of the breath, the quality of breathing or the sound of the voice.[74][75] For example, depending on tongue and pulse conditions, a TCM practitioner might diagnose bleeding from the mouth and nose as: “Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose.”.[76] He might then go on to prescribe treatments designed to clear heat or supplement the Lung.

Disease entities

In TCM, a disease has two aspects: “bìng” and “zhèng”.[77] The former is often translated as “disease entity”,[78] “disease category”,[79] “illness”,[77] or simply “diagnosis”.[77] The latter, and more important one, is usually translated as “pattern”[78][80] (or sometimes also as “syndrome”[77]). For example, the disease entity of a common cold might present with a pattern of wind-cold in one patient, and with the pattern of wind-heat in another.[81]

From a scientific point of view, most of the disease entitites (病, pinyin: bìng) listed by TCM constitute mere symptoms.[78] Examples include headache, cough, abdominal pain, constipation etc.[82]

Since therapy will not be chosen according to the disease entity but according to the pattern, two patients with the same disease entity but different patterns will receive different therapy. Vice versa, patients with similar patterns might receive similar therapy even if their disease entities are different. This is called 异病同治，同病异治 (pinyin: yì bìng tóng zhì, tóng bìng yì zhì,[72] “different diseases, same treatment; same disease, different treatments”).

Patterns

In TCM, “pattern” (证, pinyin: zhèng) refers to a “pattern of disharmony” or “functional disturbance” within the functional entities the TCM model of the body is composed of.[83] There are disharmony patterns of qi, xuě, the body fluids, the zàng-fǔ, and the meridians.[84] They are ultimately defined by their symptoms and “signs” (i.e., for example, pulse and tongue findings).[85]

In clinical practise, the identified pattern usually involves a combination of affected entities[86] (compare with typical examples of patterns). The concrete pattern identified should account for all the symptoms a patient has.[87]

Six Excesses

The Six Excesses (六淫, pinyin: liù yín,[88] sometimes also translated as “Pathogenic Factors”,[89] or “Six Pernicious Influences”;[90] with the alternative term of 六邪, pinyin: liù xié, – “Six Evils” or “Six Devils”[91]) are allegorical terms used to describe disharmony patterns displaying certain typical symptoms.[92] These symptoms resemble the effects of six climatic factors.[90] In the allegory, these symptoms can occur because one or more of those climatic factors (called 六气, pinyin: liù qì, “the six qi”[93]) were able to invade the body surface and to proceed to the interior.[94] This is sometimes used to draw causal relationships (i.e., prior exposure to wind/cold/etc. is identified as the cause of a disease),[95] while other authors explicitly deny a direct cause-effect relationship between weather conditions and disease,[96][97] pointing out that the Six Excesses are primarily descriptions of a certain combination of symptoms[98] translated into a pattern of disharmony.[90] It is undisputed, though, that the Six Excesses can manifest inside the body without an external cause.[94][99] In this case, they might be denoted “internal”, e.g., “internal wind”[99] or “internal fire (or heat)”.[100]

The Six Excesses and their characteristic clinical signs are:

Wind (风, pinyin: fēng): rapid onset of symptoms, wandering location of symptoms, itching, nasal congestion, “floating” pulse;[101] tremor, paralysis, convulsion.[94]
Cold (寒, pinyin: hàn): cold sensations, aversion to cold, relief of symptoms by warmth, watery/clear excreta, severe pain, abdominal pain, contracture/hypertonicity of muscles, (slimy) white tongue fur, “deep”/”hidden” or “string-like” pulse,[102] or slow pulse.[103]
Fire/Heat (火, pinyin: huǒ): aversion to heat, high fever, thirst, concentrated urine, red face, red tongue, yellow tongue fur, rapid pulse.[104] (Fire and heat are basically seen to be the same)[105]
Dampness (湿, pinyin: shī): sensation of heaviness, sensation of fullness, symptoms of Spleen dysfunction, greasy tongue fur, “slippery” pulse.[103]
Dryness (燥, pinyin: zaò): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools.[106]
Summerheat (暑, pinyin: shǔ): either heat or mixed damp-heat symptoms.[107]

Six-Excesses-patterns can consist of only one or a combination of Excesses (e.g., wind-cold, wind-damp-heat).[101] They can also transform from one into another.[101]
[edit] Typical examples of patterns

For each of the functional entities (qi, xuĕ, zàng-fǔ, meridians etc.), typical disharmony patterns are recognized; for example: qi vacuity and qi stagnation in the case of qi;[108] blood vacuity, blood stasis, and blood heat in the case of xuĕ;[109] Spleen qi vacuity, Spleen yang vacuity, Spleen qi vacuity with down-bearing qi, Spleen qi vacuity with lack of blood containment, cold-damp invasion of the Spleen, damp-heat invasion of Spleen and Stomach in case of the Spleen zàng;[110] wind/cold/damp invasion in the case of the meridians.[111]

TCM gives detailed prescriptions of these patterns regarding their typical symptoms, mostly including characteristic tongue and/or pulse findings.[112][113] For example:

“Upflaming Liver fire” (肝火上炎, pinyin: gānhuǒ shàng yán): Headache, red face, reddened eyes, dry mouth, nosebleeds, constipation, dry or hard stools, profuse menstruation, sudden tinnitus or deafness, vomiting of sour or bitter fluids, expectoration of blood, irascibility, impatience; red tongue with dry yellow fur; slippery and string-like pulse.

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For more information go to wikipedia link http://en.wikipedia.org/wiki/Traditional_Chinese_medicine