Traditional Chinese Herbal Medicine (TCM) – A Brief History
The roots of Traditional Chinese Medicine (TCM) date back more than 2000 years. Its rich history tells of the many influences on its development, including the Japanese, Europeans, and the Communist revolution. The changes that followed these influences explains why both terms--Traditional Chinese Medicine and Traditional Oriental Medicine (TOM)--are seen in the literature. Although these two terms are sometimes used interchangeably, TOM generally refers to the system of Chinese medicine practiced until the early 1900s. Up until this period, Chinese medicine had witnessed great growth, but also decline, as Western influence expanded and the training of traditional medicine grew poorer and more limited.
The Communist party of China was formed under the leadership of Chairman Mao in 1928 and took over power in 1949. The Communists realized that there were little or no medical services and actively encouraged the use of traditional Chinese remedies because they were cheap, acceptable to the Chinese, and used the skills already available in the countryside. In 1940, Yang Shao proposed to "scientificize" and "popularize" Traditional Chinese Medicine. Since then, this resurgence has opened facilities in China to provide, teach, and investigate TCM. While both Western and Chinese medicine have been practiced in China since the late 1800s, the traditional Chinese approach to medicine began to grow in popularity in the West in the 1970s, when ties to China opened.
THE FIVE ELEMENT THEORY
The five element theory, also called the five-phase theory, holds that everything in the universe, including our health, is governed by five natural elements: wood, fire, earth, metal and water. This theory underscores the Chinese belief that human beings, both physically and mentally, are intertwined with nature. Although it is difficult for Westerners to relate this philosophy to the Western approach to medicine, it is fundamental to the understanding of Traditional Chinese Medicine.
In the five element theory, each of the five elements has a season and particular organs and senses associated with it, such as taste, colour, sound. The wood element, for example, is associated with spring, the liver, and the gall bladder. Similarly, the fire element is associated with early summer, the heart, and small intestines; the earth element corresponds to late summer, the stomach and spleen; metal is associated with autumn, the lungs and large intestine; and water is associated with winter, the kidneys and bladder.
In contrast to Western medicine's teaching of a separation between the mind and body, TCM views each organ as having particular body and mind functions, as illustrated in the belief that the liver is involved in planning, and in the storage of anger, while the gall bladder is the organ of decision-making.
To determine a patient’s composition of the five elements, a TCM practitioner asks many detailed questions that will provide clues as to the nature of their imbalances. They will ask about the person’s occupation, stress associated with it, what they like to eat, what physical problems they are experiencing, etc. Although a person may be oriented towards a particular element -- a person who is aggressive might be described as having a "wood" personality -- the Chinese believe that aspects of each of the five elements are present in every person at different times.
The diagnosis of a patient’s condition in TCM consists of three activities: an extensive interview, pulse diagnosis, and a tongue examination.
The first step in diagnosing a patient’s condition is an extensive interview by the TCM practitioner. In addition to seeking information about the patient’s complaints, the practitioner will ask detailed questions about such issues as quality of sleep, dreams, appetite, preferred foods, and stress. The practitioner is also trained to use the senses of observation, listening, and smelling. Although smell is often camouflaged in the West by perfumes, deodorants, and breath mints, the Chinese believe it provides further knowledge about a person's health. In the Five Element Theory, each element has a corresponding smell associated with it.
Whereas Western doctors locate one pulse on the radial artery in the wrist, a practitioner of TCM feels for six pulses in each wrist: three superficial and three deep at specific points along the radial artery. The twelve pulses correspond to the internal organs. For example, a deep pulse reading on the left wrist corresponds, top to bottom, to the heart, liver and kidney. Practitioners note the quality of the pulse in terms of frequency, rhythm, and volume and the Chinese have developed an elaborate vocabulary to describe a pulse, such as floating, thready, and slippery. Pulse taking requires years of training to master and is considered one of the most important diagnostic tools in Chinese medicine.
In addition to the pulse, the Chinese believe that the tongue is a strong barometer of human health. They developed an elaborate system to describe the condition of the tongue, including the color, texture, shape, size, and coating. A very red tongue indicates a fever or inflammation and is described in TCM as an excessive internal heat or dampness condition. A white tongue indicates some kind of deficiency of energy (Qi), blood, or moisture. In this system, each part of the tongue corresponds to the condition of an organ. The tip of the tongue, for example, represents the heart and lung organs.
All three diagnostic techniques -- interview, pulse, and tongue -- provide useful information to the TCM practitioner regarding the nature of a patient’s condition.
In China, herbal remedies are used as much as acupuncture to treat energy imbalances and illness. When considering the appropriate herbal remedy for a patient, practitioners of TCM apply medical theory - the Five Elements and Eight Guiding Principles - along with tongue and pulse diagnosis.
Herbs used in Chinese medicine are derived from plant, animal, and mineral substances. Although plant-derived herbs, such as ginseng and ginger, are the most common, minerals and animal parts such as oyster shells, deer antlers, and bear gall bladder are also prescribed. In China, herbs in powder form are boiled and made into a tea. In the West, TCM practitioners often premix the herbal remedy or supply the herb in pill form, especially for those patients who find the bitter taste intolerable.
In creating the herbal formula for a patient, the TCM practitioner considers the effect or outcome of the remedy, such as aiding digestion, clearing mucus, or strengthening the immune system. Applying the Eight Guiding Principles, they also consider the energy of the illness, such as hot/cold, damp/wind, or some mixture of the principles. Like the diagnostic tools of pulse and tongue reading, the prescription of herbal remedies takes a TCM practitioner years to master because it requires a deep understanding of medical theory and the complexity of herbs.
DIET AND EXERCISE
In Traditional Chinese Medicine, diet and exercise play an important role in maintaining good health by contributing to an optimum balance of vital life energy (Qi). In fact, the Chinese believe that diet is one of the three origins (diet, heredity, and environment) or sources of qi. Therefore, according to TCM, the foods we eat directly influence the excesses and deficiencies in our bodies.
Unlike the American diet, which emphasizes a balance of protein, carbohydrates, and fats, the Chinese approach to diet is grounded in the five element and eight guiding principles theory. Foods are seen as having yin and yang, warming and cooling, drying and moistening properties. Certain foods are better for some people than others, depending on their type and condition. A person with a "cold damp" condition should not eat a diet of raw fruits and vegetables (which are yin), because they would further exaggerate the loss of body heat and fluid secretion.
Conversely, foods that are fried, broiled, high fat, or spicy are seen as warming (yang) because they generate heat and stimulate circulation. A person whose diagnosis is "hot dry" should avoid these foods, according to TCM.
In general, the Chinese approach to diet is to optimize digestion and increase qi, moisture, and blood, and aid the organ function. In this sense, it can be seen as an extension of herbal medicine.