CHINESE TRADITIONAL MEDICINE

Chinese traditional medicine comprises four interrelated therapies: Zhong Yao (herbal medicine), Zhen Jiu (acupuncture and moxibustion), Qi Gong (vital energy exercises), and Tui Na (therapeutic massage), although some purists prefer not to include the latter two theories. There is no distinct demarcation between clinical medicine and public health practice. Chinese traditional medicine considers a person's well-being physically and mentally. It approaches health with due consideration to nature in all its complexity and multidimensionality. Enhancing natural healing is central to Chinese medical practice. The basic concepts underlying all Chinese medical therapies are the Taoist doctrine of yin and yang (the theory of opposites); the five elements (metal, wood, water, fire, and earth); and "Qi" (pronounced chee), the vital energy of life that circulates in the human body via a system of pathways.

Traditional Chinese medicine has a different paradigm from that of Western biomedicine, and the world depicted in the former is not easily translated to the latter. Chinese medicine treats the body as a microcosm that follows macrocosmic laws and is continually influenced by macrocosmic factors, such as the seasonal patterns created by conjunctions of sun, moon, and stars. It defines health as the process of refining body essences, cultivating vital and spiritual forces, and maximizing physiological functions. Generally, biomedicine treats the body as a sovereign entity and sees health as the absence of pathology.

In China today, there is an effort to integrate Chinese traditional medicine and biomedicine in clinical practice and research. Doctors trained in biomedicine regularly prescribe herb-based antibiotics, and traditional doctors often depend on X-rays and scientific instruments for their diagnoses and treatment of injuries.

HERBAL MEDICINE (ZHONG YAO)

The earliest known work on Chinese herbs appeared as early as 100 b.c.e. Li Shih-chen's (1386–1644) chronicle of herbal medicines (1578), which has been used for the last four centuries, consists of 52 volumes, cataloging 1,898 herbs or substances and a total of 11,096 separate prescriptions. The Encyclopedia of Traditional Chinese Medicinal Substances, published by the Jiangsu College of New Medicine in 1997, identifies 5,767 substances. The majority of Chinese traditional medicines are of herbal origin, but minerals and animal parts are also included in Zhong Yao pharmacopoeia. Prescriptions usually comprise four or more herbs, with interaction among them for complementary and synergistic pharmacology. They are boiled as medicinal tea or processed into pills for oral ingestion. Some of these substances are also formulated as paste or plaster for external application.

In herbal medicine, there are four main diagnostic methods: visual inspection, inquiry, auscultation and smelling, and pulse diagnosis. The pulse reveals specific aspects of a person's health. Taking a pulse is, therefore, one of the diagnostic acts of a Chinese herbalist doctor. The doctor tries to identify the psychosocial, environmental, and dietetic causes of symptoms, and prescribes remedies, including advice on psychosocial issues.

Another belief is that the use of medicines must be assisted by nourishment of the body. Herbal therapies often provide nutrients for the body to overcome illness and to build up the body's defense against disease. Good medicines and nutrients replenish and strengthen the essence of "Qi." When Qi, which flows through channels and collaterals (jing and luo) in the body, is blocked or out of balance, illness or pain ensues.

ACUPUNCTURE/MOXIBUSTION (ZHEN JUI)

Zhen Jiu consists of acupuncture and moxibution, both of which have been practiced as therapeutic techniques in China for more than 2,000 years. They are used to induce stimulation in various locations of the body to treat ailments and relieve pain. The practice requires a thorough knowledge of anatomy and physiology as well as the system of Qi flow. There are fourteen channels and numerous collaterals under the body surface, which connect the body surface to various internal organs. Along the channels and collaterals are more than 360 acupoints and a number of extraordinary acupoints.

Acupuncture (the use of needles), and moxibustion (the use of heated herbs), aimed at specific acupoints along the pathways (channels and collaterals) in the body, can correct the flow of Qi and blood to restore optimal health and to block pain. Such stimulation can prompt a cascade of chemicals in the muscles, spinal cord, and brain to release the body's natural painkilling endorphins (a morphine-like substance generated by the body) and can impact on Qi, blood circulation, and various body functions. Magnets, mild electric current, manual pressure, or even low frequency lasers can also stimulate these acupoints to the same effect. These trigger points are rich with nerve endings that are linked to various parts of the human body. Some of the sensitive points that affect various body functions are located in the ear and on the sole of the foot. Acupuncture's painkilling effect has been used successfully for anesthesia in surgery, including thyroid surgery and some thoracic procedures.

VITAL ENERGY (QI GONG)

Qi Gong, as an art of healing and health preservation, dates back to the Tang Yao period, some twenty centuries b.c.e. Dancing and body movements, and various ways of breathing, exhalation, and exclamation were recognized as ways to read-just some functions of the human body and treat diseases.

Medical scholars throughout Chinese history, beginning with the Qin dynasty (200 b.c.e.), have written about Qi and body movements. In the Song and Yuan dynasties (900–1300 c.e.), Taoist and Buddhist priests introduced the importance of cultivating the Tantian (inner elixir). Since 1978, Qi Gong masters have popularized such practice for health preservation and disease prevention.

One of the characteristics of Qi Gong is to allow practitioners to cultivate their demeanor and stamina to enable them to engage in strenuous activities. Another is to cultivate the ability of practitioners to transmit Qi to patients through needles or their hands. Patients are also taught to undertake Qi exercises to maintain health. There are dynamic exercises involving multiple movements of limbs and the body and static exercises that call for simple postures with mind concentration and breathing exercise. After symptoms and signs are analyzed, Qi doctors prescribe specific therapies for problems. Inappropriate Qi therapies can be harmful and Qi exercises need to be adapted and individualized to each person's needs and situation.

MASSAGE (TUI NA)

Tui Na, literally meaning pushing and pulling, refers to a system of massage, manual stimulation and manipulation of muscles, tendons, ligaments, joints, and trigger points. Different schools—each with its own theory, training, style, and practice— have been established in various regions of China. Those in northern China tend to be more vigorous, while those in southern China are more subtle. Some use rolling movements, while others focus on bone setting and digital point pressure. Some aim at health preservation, while others are designed to treat specific ailments.

A distinct aspect of Tui Na is the extensive training of the hands to reach a state of "conditioned reflex," which is necessary to accomplish focused and forceful movements on various areas of the body. Generally speaking, all massage methods promote blood circulation, remove blood stasis, restore and treat injured soft tissues, and correct deformities and abnormal positions of bones and muscles. Dynamic wave signals can influence the physiological function, the pathological state of the body fluid, the balance of yin and yang, Qi blood circulation, and mind and emotion interaction.

The relationship among Qi Gong, acupuncture, and Tui Na are quite close, as they are all based on the same theoretical basis of Chinese traditional medicine.

CHINESE TRADITIONAL MEDICINE IN THE WEST

For some time, the scientific community in the West looked upon traditional remedies in the East with suspicion. The former could not accept the claim of the latter without objective scientific evaluation. In recent decades, however, there has been a healthy crossover from Western biomedicine to Chinese traditional medicine. Pharmacologically, the cross-fertilization came earlier. Aspirin, one of the West's popular pain-relieving compounds, for instance, has its origin in a tree bark.

Biomedicine is increasingly looking toward traditional medicines for possible solutions to some of the intractable chronic illnesses. As life expectancies lengthen, chronic illnesses will increase. As environment-related diseases increase and lifestyle-related illnesses become more prevalent, Chinese traditional medicine, which takes a more holistic view of health and has had thousands of years of empirical successes, should offer different approaches to the treatment of diseases and advice for health preservation and promotion.

At the end of the twentieth century there was an explosion of interest in herbs as food supplements for better health. The trend of self-help for better health fueled this interest. Ginseng is an example of an herb that is widely accepted as an agent to help fight cancer as well as to add vitality to life. While many Chinese herbal medicines have proven to be effective, however, quality and dosage control remains a serious concern.

Pharmaceutical companies have to comply with governmental regulations on the production of drugs, but food supplements are not subject to similar review and control for quality and proper dosage. The perception that all herbs, because they are natural, have no side effects is erroneous and some herbal substances are toxic. It is important therefore to be educated about herbs before consuming them.

Jack Chieh-Sheng Ling

(see also: Acculturation; Barefoot Doctors; Bioculturalism; Cultural Factors; Ethnicity and Health; Holistic Medicine; Immigrants, Immigration; Traditional Health Beliefs, Practices )

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