With a rich and varied history spanning over five thousand years, Chinese medicine is perhaps both the oldest and most widespread form of medicine practiced in the world today. It is a dynamic, living system that continues to grow and evolve while remaining true to its ancient roots.
Many Westerners are interested in the different perspectives of Asian culture, its spiritual philosophies, and strikingly unusual health and medical practices. Some are fascinated by, while others are skeptical about, the promise of greater health that Chinese medicine can provide. Before that promise can be fully and accurately evaluated, a significant challenge must first be recognized and overcome.
Chinese medicine has rigorous, well-defined methodologies to preserve health and to diagnose, treat, and prevent illness, but its principles and paradigms are vastly different from those commonly followed in the West. It needs to be understood, accepted, and applied completely on its own terms, adhering to those intrinsic paradigms and principles. This takes an open mind, some effort, and a level of trust, since it will require learning new concepts, new terminology, and some new ways of thinking as well as stepping outside of the comfortable familiarity of Western medical conventions. Only then can it be used optimally, as it has been designed and practiced for millennia in China and in many other countries, to achieve its expected and sometimes nearly miraculous health benefits.
Branches of Chinese Medicine
• Acupuncture and adjunctive acupuncture modalities
• Chinese herbal medicine
• Qigong, Taiji, and other active physical therapies
• Tuina, acupressure and other passive physical therapies
• Lifestyle considerations
Each branch of Chinese medicine is introduced here separately. Many Westerners may think of each branch as complete and separate from the others, but each is part of a cohesive whole. In order to most quickly and thoroughly restore a healthy balance when injured or ill, and to maintain or increase optimal health otherwise, all branches should be integrated. Throughout this book, we’ll examine their interrelationships and provide ways for you to incorporate them into your daily life.
Almost everyone has heard of acupuncture, the branch that is most familiar in the Western world. It’s been researched by Western science and has been reported on frequently in the popular media, leading many people to believe that acupuncture is the totality of Chinese medicine. Although the landscape is changing, for a time many Chinese medical colleges in the United States only taught acupuncture, contributing to that popular misconception. Of course, Chinese medicine is not just acupuncture, but rather a network of many complementary branches that work synergistically to produce the most desired therapeutic outcomes. While each will be examined in great detail throughout the book, the following is an introduction to the various branches. Any unfamiliar terminology is defined later within its related topic.
Acupuncture involves the insertion of very fine, sterile needles of surgical quality into acupuncture points specific to each patient’s individual needs. Those points are located along well-defined energetic pathways found throughout the body called “meridians” or “channels.” Each meridian is associated with a primary organ, influencing its function. Many points on a single meridian also influence the functions of organs secondary to the primary organ being addressed.
Acupuncture’s main strength is in moving Qi (the vital energy of life), stimulating its flow when it’s weak, redirecting it to areas that are more in need while drawing it away from areas that are in excess, and opening up obstructions so it can flow freely. This improves the functionality of the treated Organ Systems, which include the associated meridians and the whole body by extension.
An acupuncturist may choose to use various adjunctive therapies to augment the benefits of the acupuncture treatment. The most commonly employed are electroacupuncture, moxibustion, and cupping. They are discussed in Chapter 12.
Chinese herbal medicine is older than acupuncture and central to the practice of Chinese medicine. Although plant sources make up the largest part of its pharmacopoeia, substances from the animal and mineral kingdoms are also used.
With thousands of years of research and development, it’s a highly refined and most elegant branch of Chinese medicine, taking into account more variables than are considered when employing acupuncture alone. Each herb belongs to one of over thirty categories, groupings of herbs indicating their overall qualities and main purpose. The unique therapeutic effects of each herb are defined by their taste, their temperature (Qi), and the channel(s) that the herb enters. These are discussed in Chapter 15. Also taken into account are the herb’s effective range of dosages, functions, and clinical usage, herbs it may most typically be combined with, and cautions or contraindications in certain health conditions. Used this way, herbal medicine is very safe, is very effective, and produces no side effects.
Qigong, Taiji, and Other Physical Therapies
In the context of Chinese medicine and natural healing, physical therapies can mean that a patient passively receives a treatment, such as acupressure or Tuina, which are different types of Chinese medical massage therapies; bone-setting, which is a sort of Chinese chiropractic; or medical Qigong, an energy healing modality in which a Qigong doctor directs his own Qi to manipulate the Qi of a patient in a way very similar to acupuncture, frequently with little or no physical contact involved.
It can also mean the patient is taught to perform an active practice combining physical and energetic aspects of healing. Chinese healing exercises can be combined prescriptively to treat a wide range of health conditions. Most Qigongs have, or can be modified to have, a specific purpose that targets a particular organ, illness, imbalance, or disharmony. In its original long forms, Taiji is a more complex practice. However, it too can be modified, and many short forms have been created for targeted healing purposes when it may be best suited to address a patient’s needs. In most cases, the patient is instructed to perform those practices daily to most effectively treat health challenges.
Foods have properties similar to herbs—including taste, temperature (Qi), and channels entered—so they may be used in a similar way. The therapeutic effects of foods are often weaker than those of herbs, but because we eat every day, foods have a cumulative effect over time on our overall health. Chinese medical professionals have analyzed the properties of foods, adhering to the same principles that are used in categorizing medicinal herbs, so a diet can be tailored to an individual like an herbal formula is prescribed. Certain foods may need to be added to your diet to help improve your health, and some foods should be avoided when facing specific health challenges, just as some pharmaceutical drugs may be contraindicated for some people or conditions.
While nutritional supplementation is not traditionally included in the practice of Chinese medicine, some practitioners in the West choose to include it as part of their therapeutic strategy. In that case, supplements need to be personalized, as herbs are. Apart from standard nutrition from carbohydrates, fats, and proteins and basic vitamin and mineral content, there are principles drawn from herbal medicine that determine the best diet and the most helpful supplements for any individual. As an obvious if simple example, someone who is underweight will have different dietary, caloric, and nutritional needs than someone who is overweight.
Lifestyle factors need to be examined and improved to whatever extent may be possible if necessary. Many of these things are common sense, no matter what style of medicine you employ or what health practices you follow. There are simple changes you can make to support good health, like getting adequate fresh air, sunshine, exercise, and rest. Achieving or maintaining a healthy weight, improving the quality of relationships with family, friends, and colleagues, and having satisfying and meaningful work all reduce stress and contribute to better health. It’s equally important to limit or eliminate factors that obviously contribute to poor health, such as smoking (including secondhand smoke) and the use of alcohol and recreational drugs. If actively dating, it’s important to employ safe-sex practices. These relatively simple considerations are crucial for anyone interested in enjoying a long and healthy life.
Chinese medicine takes a few additional lifestyle factors into account, which may be less easy to understand at first glance. While briefly introduced in the following paragraphs, some are discussed in greater detail later in this book.
To achieve optimal health, it’s necessary to maintain emotional balance. Every emotion we experience is appropriate when circumstances arise to elicit that emotional expression. This includes emotions we may not like or may interpret as negative, like anger, frustration, grief, or fear. Once the triggering circumstance is gone, we must be able to resolve the emotion and return to a state of equanimity and balance. Similarly, a prolonged or overly intense experience and expression of emotions we may regard as positive, like joy or exuberance, can be equally destabilizing and cause health problems over time.
Every emotion, whether interpreted as positive or negative, is linked with a particular internal organ, and the prolonged experience of any emotion will tax the related organ and diminish its functional energy, setting the stage for various diseases. A lifestyle that supports emotional balance, which can include the addition of practices that help regulate those emotions (meditation, Qigong, some types of yoga, aromatherapy, etc.), will promote health. We may not be able to control all the circumstances of our life, but we can learn to control our response to those circumstances. Emotions are discussed with their related organs in Chapter 5 and Chapter 6 and as pathological factors in Chapter 7.
Environmental factors, present both in your immediate living quarters and in your general geographical region, play a significant role in overall health. For example, a person may be either constitutionally Damp or may have a health condition that has created Damp within them. Damp is one pathogenic factor in Chinese medicine and can manifest as low energy or lethargy, excessive body fat, chronic diarrhea, or chronic sinus congestion with mucus or phlegm. A person with a Damp condition should not live in a damp environment. A basement apartment is a typical example of damp living quarters, and beachfront property, as appealing as it might otherwise be to some, is a damp geographical location. Those environments will worsen the health of someone suffering from a Damp condition or constitution.
Regulating work, sleep, and meal times are important for a couple of reasons. First, as the purely physical part of our being, the body likes regularity in the same way domesticated animals like the activities of their day to be regulated. The body will function a bit better when it has set expectations that are met. Less energy is expended as daily rhythms are established. Second, when regulated in the healthiest ways according to the principles of Chinese medicine, activities will be aligned with natural biological rhythms as the Qi of individual related organs achieves prominence at its respective hours of the day.
As a final lifestyle consideration, it’s recommended that sexual activity be regulated, particularly in men, and especially as men get older. The stereotype of a man needing to sleep immediately after having sex demonstrates that more energy has been lost than what can be accounted for from the basic physical activity of sex. If a man has frequent unregulated (here, that primarily means ejaculatory) sex, he expends a great deal of life energy and will age faster, while experiencing the various declines of health that accompany typical aging. Women fare much better during sex and often experience a net gain of energy. They can lose more life energy during pregnancy and childbirth, especially when bearing many children close together.
Chinese Medicine Is Holistic
Most people have heard the word “holism” and have some understanding of the concept because some familiar medical practices are holistic to varying degrees. Homeopathy, naturopathy, osteopathy, and chiropractic are all types of holistic medicine. But what does that mean, and how does that differ from conventional Western medicine?
Chinese medicine is holistic, viewing the whole person as a unique individual and not just a collection of symptoms to be treated. On a physical level, it has its methodologies for observing and assessing the interconnections and interplay among all organs and body tissues, the way the health of one organ may influence the functioning of all the others and everything else in the body. No one body part exists in isolation from the whole body. Diagnostic information is gleaned through all the senses: listening to the quality of the voice and breathing; viewing the tongue, skin, hair, eyes, and nails; smelling body scents; touching the pulses, the skin, and the abdomen; and classically, physicians would sometimes taste the patient’s urine, though this is no longer practiced today. Further, the Chinese idea of holism includes the influence of emotional, mental, and possibly spiritual states and the quality of interpersonal relationships. As we’ve seen, dietary and lifestyle factors are also taken into account.
At deeper and subtler levels, Chinese medicine examines the holistic interrelationships beyond what is present within the body. It looks at environmental factors, our unique interactions and interface with the immediate environment, the energetics of diurnal and seasonal cycles, and celestial events in relation to overall health and wellbeing. Physicians who are Qigong masters might read the Qi that emanates from a patient, outside the surface of their body, as well as the Qi flowing within the body.
The words “holistic” and “holism” have the same root as the word “whole.” In fact, it’s fairly common to see them spelled “wholistic” and “wholism.” As the name implies, any holistic medical practice looks at the whole person (using the criteria relevant to the particular holistic practice) to determine what is out of balance and what body system or systems have been impacted to create the underlying cause of their disharmony or disease. The holistic practice then uses that information to help restore the person to whole health. By treating the whole person rather than the disease, the body’s own natural healing abilities are supported, the body regains a healthy balance, and the symptoms as well as the underlying causes are resolved. If a person is fully restored to a state of harmonious functional balance, the predisposition toward the recurrence of an otherwise chronic condition may at the very least be safely and effectively managed, likely greatly reduced, and often completely eliminated. This includes but is not limited to the Western biological concept of homeostasis.
Homeostasis is the tendency of physiological systems to maintain an internal stability, including psychological equilibrium, usually through various internal feedback controls, against any external stimulus or change that might disturb normal physiological functions or conditions. It helps maintain a constant internal environment, including the optimal functioning of all the internal organs, sense organs, and skin; a constant, stable body temperature; appropriate pH; and so on. This regulation of various metabolic processes arises from the body’s innate natural intelligence. In most people, and under most circumstances, it is beyond conscious control, but it can easily be supported by applying the holistic principles presented in this book.
In contrast to holism, conventional Western medicine, often called “allopathic,” is more accurately a reductionist practice, looking for the smallest physiological or biological unit believed to be responsible for a disease condition. Once found, it can be surgically altered or removed, or drugs may be administered to kill a pathogen, dull the perception of pain, reduce an inflammation, or supply a missing biochemical ingredient, while the body attempts to heal itself and restore homeostasis.
Neither system is inherently better or worse than the other, but each has its primary strengths and weaknesses. Understanding those may make one or the other better suited to treat an individual’s particular health needs or be better aligned with an individual’s way of life. It’s also possible to effectively combine both approaches, as discussed later in the text.
Generally speaking, holistic approaches are better at dealing with chronic conditions and often give the person a better chance of recovering from the condition rather than just managing the symptoms. Under the care of a holistic physician, a patient’s imbalance may be observed and never allowed to progress to a disease state or surgical situation, such as the removal of a gall bladder, uterus, or prostate. For example, an inflamed appendix can be treated so that it never approaches rupturing and returns to its normal, healthy state.
Western medicine is better at addressing acute, emergency situations, using what is sometimes referred to as “heroic medicine.” Some examples are complicated or compound fractures, surgical emergencies, gunshot wounds, other massive trauma, or a faltering or stopped heart. In these cases, holistic procedures, at least as they are legally allowed to be practiced in the United States, are often too slow to save a person’s life or to rapidly relieve excruciating pain.
Chinese Diagnosis and Western Diagnosis
Chinese medicine is holistic, taking the state of the whole person—body, mind, emotions, and spirit—into account instead of just the apparent disease. Western biomedical diagnosis is often of limited help in determining a patient’s condition from a Chinese medical perspective, since the biomedically defined disease is just one collection of symptoms among many that may define the particular pattern(s) of disharmony affecting the person. Accordingly, ten people with the same Western diagnosis may be treated in ten different ways with Chinese medicine. Conversely, ten people with very different Western diagnoses may be treated identically with Chinese medicine, if the underlying cause, the pattern of disharmony, is determined to be the same according to Chinese diagnostics. This is often a significant point of confusion, and even consternation, for Western patients who decide to seek help from Chinese medicine. They can be concerned that their “real” diagnosis—that is, the Western, technologically derived diagnosis—is being ignored or overlooked and that the care of their health is being relegated to some primitive, careless, or naive superstition. This is an example of one of the ways a Western perspective must shift and grow if one wants to benefit from Chinese medicine in the fullest way possible.
Integrating the Branches
Like virtually every aspect of Chinese medicine and associated medical and spiritual philosophies, there are many perspectives, sometimes conflicting or contradictory, regarding integration. China is a very large country, and some regions have ways of doing things quite differently from other regions. Similarly, in different periods of Chinese history, some methods of medical practice were officially favored over others, based largely upon the preference of the contemporary emperor. All of those historic and geographical preferences still exist and are practiced, to a greater or lesser degree, throughout China today.
Ideally all of the branches of Chinese medicine introduced above should be employed in a unified and integrated way to bring about the fastest and most complete restoration of health. “Unified and integrated” means either that a single physician makes a diagnosis and treatment plan and applies and/or provides instruction on all the required treatment modalities or two or more practitioners agree upon the diagnosis and treatment plan, with each implementing the component of that treatment in which they may specialize.
Acupuncture and Chinese herbal medicine have their unique strengths and work together powerfully to restore or maintain optimal health. Although each can address the whole body, acupuncture’s focus is more on the functional, energetic, Qi, and Yang aspects, while herbal medicine, also very good at addressing those same aspects, is better than acupuncture at addressing the structural, substance, blood/body fluids, Jing, and Yin aspects. This is because herbal medicine directly adds something tangible and substantive to the body. This can be most useful in building up a body after a debilitating illness or injury, increasing the production of blood and healthy body tissue. It also helps generate other body fluids that may be used to lubricate dry, arthritic joints, boost or balance hormone production, soften tight, achy muscles, or strengthen and heal bones.
Any branch of Chinese medicine can be very effective when used alone, as it frequently is even in China. When acupuncture might be the first treatment of choice, a typical treatment plan involves giving the patient an acupuncture treatment each day or every other day for ten treatments, which constitutes one course of treatment. After a five-day break, another course of treatment is made, and that may be repeated up to three or four times. If the patient isn’t substantially better after three or four courses of treatment, then herbal medicine may be tried. It is usually administered by a different physician, who may make a different diagnosis and consequently create a different treatment plan. This is a sequential use of acupuncture and then herbs: it is not an integrated approach, but it has its adherents and is effective in many cases.
In most Chinese hospitals, patients will more typically be treated with acupuncture and take herbs simultaneously. The physician will first examine the patient and make a diagnosis. If trained and experienced in both acupuncture and herbal medicine, as most of the best doctors are, they will give the patient the acupuncture treatment and then write up an herbal prescription that the patient will get filled at the on-site pharmacy, in much the same way as a Western doctor will prescribe a pharmaceutical drug. This is the simplest and most common integrated method, in which the acupuncture treatment and herbal formula mutually support each other based on the diagnosis made by a single physician.
Depending on the condition being treated, a patient may receive a Tuina treatment, either instead of or in addition to an acupuncture treatment. While Tuina may have a superficial resemblance to a conventional spa type of massage, it has many specific therapeutic variables and techniques, following exactly the same principles that underlie every other branch of Chinese medicine. Accordingly, a Tuina practitioner will give a treatment in keeping with the diagnosis made by the primary physician.
China has a huge population, and like the United States it has an overburdened medical system. In the early 1990s, one of my Qigong teachers told me that in the most crowded regions, except in cases of an emergency or immediately life-threatening condition, once a patient has received a treatment and gotten their herbal prescription, they would be given a punch-card and told to attend Taiji or Qigong classes with a specified master instructor. The instructor would punch the card for each lesson attended. After a certain number of lessons, usually ranging between five and ten, the patient would then be allowed to receive their next treatment at the hospital. This is another way that an integrated treatment approach is used, while helping to relieve an overwhelming patient load. The patient is required to take personal responsibility for their health by being actively engaged in their self-care through learning a Qigong practice suited to their medical diagnosis, which supports and enhances the acupuncture and herbal treatments.
In all cases, patients are instructed about healthy modifications to their diet and lifestyle in accordance with their particular needs, based upon their diagnosis. This becomes the most complete type of integrated practice, in which acupuncture, herbs, physical therapies (Qigong or Taiji in these examples), diet, and lifestyle are all addressed with a single, unified purpose.
Another aspect of integration involves the use of Chinese and Western medicine combined in ways that follow the principles of Chinese medicine as closely as possible. In China, Chinese and Western medicine are practiced equally in most large hospitals, and this may be a truer form of complementary medicine than is found in the United States and other Western countries, where Chinese medicine is often treated as a subsidiary adjunct to Western medicine. That has placed China in the unique position of being able to evaluate the relative effectiveness of Chinese and Western medicine side by side in treating the same conditions.
While I was still a student in Chinese medical college, one of my teachers told me he did half of his clinical internship at a hospital in China that specialized in cancer treatment. There, they found that the five-year survival rate, the gold standard used to determine the effectiveness of any cancer treatment, from treatments using only Chinese medicine was virtually equal to those using only Western medicine. But when practiced together, in a unified, integrated manner, the five-year survival rate more than doubled. Unfortunately, it will be some time before we see that type of integration and the spectacular results it can yield in most Western countries. That is because while contemporary Chinese doctors fully understand Western medicine and can perform all surgical procedures and apply radiation and chemotherapy, Western doctors do not similarly understand the use of Chinese herbs and acupuncture and do not even have a working concept of Qi, which is integral to the practice of every aspect of Chinese medicine.
Integrated Practices in Western Medicine
While not applied holistically, the concept of integrated health care should be familiar to most people, as it is a staple of Western medicine, and unified according to its own criteria. Western medicine includes surgery, pharmacology, radiology, nuclear medicine, orthopedics, physical therapy, and other branches that are frequently used together to achieve the best therapeutic outcome.
Radiology may be used as the primary diagnostic method, often in preparation for surgery. The surgical procedure often simultaneously makes use of pharmacology in the forms of anesthesia to render the patient unconscious, analgesics to reduce pain, and antibiotics to reduce the risk of peri- and postoperative infection. Postoperatively, pharmacology may be the modality of choice. Antibiotics and analgesics may be continued, anti-inflammatories may be added, and other pharmaceutical substances may be recommended to speed recovery or provide the patient with needed enzymes, nutrition, hormones, or other drugs. Physical therapy might be included to more fully restore functionality and strength. For general diet and lifestyle considerations, a physician may recommend that you get more rest, exercise, lose weight, drink more water, or eliminate salt or junk foods from your diet.
Many people still don’t expect that same integration in Chinese medical practices, due to the previously mentioned emphasis that the popular media has placed on acupuncture. This book dispels that misconception and will provide you with both a new, more complete understanding and many integrated tools and practices you can incorporate into your daily life.