| Traditional Chinese Medicine |
| One of the major assumptions inherent in traditional Chinese medicine is that disease is due to an internal imbalance of Yin and Yang; therefore disease can be treated by correcting the Yin Yang imbalance, thereby returning the body to a healthy state. Western medicine tends to approach disease by assuming that it is due to an external force, such as a virus or bacteria, or a slow degeneration of the functional ability of the body. Both Chinese and Western concepts are valid alternatives. Although this chapter is devoted to the philosophy of traditional Chinese medicine it is useful to start by examining briefly some of the assumptions and philosophies of Western medicine. This will provide a useful comparative basis which will elucidate the understanding of both systems. Western medicine is based on the Cartesian philosophy that the body represents one functioning system and the mind another It accepts that each system may affect the other, but essentially it sees disease as either physical or mental. The Chinese assume that the body is whole, and each part of it is intimately connected. Each organ has a mental as well as a physical function, as will be discussed later. Until fairly recently most Western doctors and pharmaceutical companies have worked on the basis that there is 'a pill for every ill'. The philosophical approach behind this idea is that an external force, or chemical, can cure disease, but although some pills are of great value, both the general public and the medical profession have become considerably more skeptical about the widespread use of such chemicals. Traditional Chinese medicine states that the body has the potential to cure its own diseases if pushed (or needled) in the correct way. Some authors, such as Ivan Illich, have been hypercritical of Western medicine and thus some people have looked upon acupuncture as not just an alternative but a superior system of medicine. Acupuncture is just another medical system, with ideas that may be of benefit to the individual patient and Western medicine as a whole, but it cannot be promulgated as either superior or a cure all. The major disadvantage of Western medicine is that it has the potential to cause a great deal of harm. Acupuncture, on the other hand, is most unlikely to cause any serious damage as it is a particularly safe form of therapy; this is undoubtedly one of its main advantages. Even though the traditional Chinese explanations for acupuncture are somewhat enigmatic to the Western doctor, acupuncture does seem to have a clearly validated scientific basis. In spite of their radically different philosophical assumptions it is wiser to look at these two medical systems as mutually beneficial, rather than mutually exclusive. Each system has ideas and therapeutic methods that can be explained both scientifically and philosophically, each can benefit the individual, and together they can broaden the philosophical and ideological basis of medicine.The Balance of Nature The Chinese believe that health is achieved, and disease prevented, by maintaining the body in a 'balanced state'. This concept was applied to both individuals and society at large. In individual terms the ancient Chinese physicians preached moderation in all things, such as alcoholic intake and gastronomic excess. They also stated that daily activities should include mental as well as physical tasks. The wealthier Chinese visited their doctor when they were well, paying a retainer to the doctor to keep them healthy. If they became ill the doctor lost his fee. Such a highly sophisticated and personal system of health care is impracticable within the current limitations of Western society, but the concept behind such ideas represents a radically different approach to health and disease. The Chinese culture was also one of the first to grasp the potential within the broader field of preventative medicine. Many of these ideas were effected in the public health measures, which first began to be introduced during the Warring States period. The body is a delicate balance of Yin and Yang. Yin represents water, quiet, substance and night, whilst Yang represents fire, noise, function and day. The two are polar opposites and because of this one must be present to allow the other to exist; for instance, how can you experience joy if you do not understand misery? The state of the body is determined by the balance of Yin and Yang within it. Each of the organs of the body has an element of Yin and Yang, although one organ may be more Yang in its nature, whilst the other is more Yin. One organ may be more important in its substantive form (Yin) whilst another is more important because of its functional abilities (Yang). When the healthy body is examined as a complete functioning system the Yin and Yang properties within it are in a fluctuating balance. The balance of Yin and Yang is not always exact. Sometimes a person's mood may be more fiery, or Yang, whilst at other times he may be quieter and therefore more Yin. Normally the balance changes from hour to hour and day to day, but if the balance is permanently disordered, for instance if Yin consistently outweighs Yang, then the body is unhealthy and disease results. The Therapeutic Application of Yin and Yang When there is imbalance external agents can invade the body and cause disease, these external agents being called pathogens. The essential principle of Chinese traditional medicine is to decide on the exact nature of the imbalance between Yin and Yang, and the pathogen causing the trouble, and then to correct these pathological processes. As the natural forces of the body return to a normal balance the disease is then cured. The art of traditional Chinese medicine is to particularize the imbalance accurately so that it can be corrected quite specifically The patient is then treated by using specific acupuncture points on the body, or the ear, in order to re-balance the body. This broad system of traditional medicine applies to all aspects of The Physiology of Traditional Chinese Medicine The physiology of traditional Chinese medicine has many similarities to that of Western medicine. Most of the specific organ functions defined in the Nei Ching Su Wen are astonishingly accurate in the light of modern scientific discoveries. The heart is said to dominate the circulation of the blood. The Nei Ching Su Wen says, 'The heart fills the pulse with blood . . . and the force of the pulse flows into the arteries and the force of the arteries ascends into the lungs'. This seems to be a clear description of the circulation of the blood through the body, via the lungs. The idea that blood circulated in this way was peculiar to Chinese medicine until it was 'rediscovered' by William Harvey in the early seventeenth century. The publication of Harvey's work Du Mote Cordis has subsequently been hailed as one of the great landmarks of Western medicine, although at the time Harvey was thought to be mad, 'inflaming the medical profession by the suggestion of such a preposterous idea'. The Nei Ching Su Wen also makes some surprising observations about the kidneys. It states that the kidneys dominate bone, that they play an integral part in the process of growth and reproduction (in fact the Chinese character for kidney and testicle is sometimes indistinguishable) and that the kidneys control body fluid in concert with the lungs. During the last forty years it has become obvious that vitamin D is a very important factor in bone growth, and if it is not present then rickets results. The exact mechanism of this disease process was unclear as it was not really understood how vitamin D actually worked, but recently it has been shown that the kidney provides the missing link in the control of bone growth and development, by changing the chemistry of vitamin D. The idea that the 'kidney dominates bone' is therefore an accurate, detailed, complex and surprising observation to have been made some 2,500 years ago. Embryology is the study of the growth and development of the foetus in the mother's womb. With the advent of good microscopic technique, in the early part of this century, embryology developed apace. It has been shown, quite conclusively, that both the ovaries and the testicles develop from the same original cells as the kidney. This process begins when the foetus is about five weeks old, (when a baby is born it is said to be in its fortieth week of development). The kidneys therefore, do seem to play an important part in the process of growth and reproduction. The detailed and specific control of body fluid is a very complex chemical system, and one that we are only just beginning to understand properly, but it is quite obvious that the kidney and the lung do work together to control the fluid in our bodies. Most of this information has become available since the Second World War, with the development of complex and expensive machines to look at small changes in the chemicals and fluid within the body. Vital Energy (Qi) and Blood The force behind the biological functions occurring in any living tissue is Qi. Qi represents the vital energy of the body but it also has a material form. It is both substance and function; the substantive or material form of Qi is oxygen (clean Qi) or food, the non-substantive form of Qi is the real but evasive concept of 'vital force'. The idea of a 'vital force' is common to many early, medical systems, but it has been highly developed within the concept of traditional Chinese medicine. If a substance has no Qi then it is dead. The Qi of the liver is the functional ability of the liver, and the Qi of the body is the total vital force of a human being. Qi is disseminated through out the body by the channels. It is also divided into various sub groups such as original Qi, or the Qi with which you are born and nourishing Qi, or the Qi that you gain from the food you eat. Defensive Qi is the Qi that protects the body from invasion by disease, circulating just below the skin and fending off invasion by viruses and bacteria (pathogens). Qi is a very wide concept, difficult to understand in detail, but it is an essential part of the traditional Chinese picture of the body. Blood also exists in the system of traditional Chines medicine, and blood production is said to be dependent on the liver, the kidney and the bone marrow. The modern medical theories on blood production also tie up these three organs as being the functional system for blood production. Modern Chinese Diagnosis Modern Chinese acupuncture differs from the old tradition system. The old traditional system of diagnosis by the 'twelve pulses' takes many years to learn to a standard of competence which allows the acupuncturist to make a clear diagnosis Although there are some people in both China and the West who are able to diagnose by the twelve pulses, they are few in number, and a modified system of pulse diagnosis has therefore been developed by the Chinese. This allows a simple but relatively accurate system of traditional diagnosis to be taught and practiced, quite quickly and proficiently, the mainstays of this 'shorter method' being the use of a pulse generalization and the tongue. The pulse is not felt in any particular position, but for its general character, hence the term 'pulse generalization'. The pulse can be felt at either wrist and classed as generally excessive or deficient. The tongue is also used to give quite specific information about the disease process and, in combination with the history, this system gives much the same answer as the 'twelve pulses'. Proficiency at this method will usually give the same traditional diagnosis as the pulse-recording machine, so the simplification of this system has not caused a significant loss of diagnostic accuracy. |
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| Traditional Chinese Medicine |
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| Dynasty Clinic |