Chinese medicine is a literate, professionally practiced system of medicine that dates back over 2500 years. The term Chinese medicine refers to the various styles and modalities that have evolved in China during this time period. Because China is a very large land mass, with culturally diverse regions and a long history, there is not one style or concept or method or modality that defines Chinese medicine.
Chinese medicine is one of the oldest, continually practiced systems of medicine in the world. It is utilized by more people than any other system of medicine. Chinese medicine has origins that date back thousands of years. As a coherent, literate style of medicine, Chinese medicine is 2500 years old. Some of the oldest written medical texts belong to Chinese medicine, and are still available and in use today.
Chinese medicine is a large topic to explain, and it is worth saying something about this. Chinese medicine has evolved over a long time, in the very culturally diverse and vast landscape of China. The study of Chinese medicine involves understanding the theories and premises not only of the medical system, but also of Chinese philosophy, thought, and logic, and the context in which these have arisen. There is no one thing that is Chinese medicine. What we lack in the West is familiarity with all of this. We have familiarity with, not understanding of, our own medical system. This too, is subject to historical development and built in cultural assumptions that we do not even realize we have. When someone has a set of symptoms, and they are given a diagnosis of diabetes, for example, they feel comfortable that they have an explanation. They probably do not know what a pancreas is, what the Islets of Langerhan do, the details of glucose metabolism, the biochemical structure of a carbohydrate, etc. But they do have familiarity with the language, and that is all that is needed. The same is true with Chinese medicine; familiarity with the technical language of Chinese medicine makes it more accessible. Because Chinese medicine seems foreign, most people have a desire to understand it more, and that is a good thing.
There are two main pieces of information I feel that people need to understand at the beginning. First, Chinese medicine is different than modern western medicine. This is true not just because acupuncture needles and herbs are used instead of pharmaceuticals and surgery, but because Chinese medicine thinks differently than western medicine. The concepts of physiology, health and disease, organ function, diagnosis, treatment strategies, etc., are all different. Not better or worse, just different.
Second, Chinese medicine diagnoses and treats people not only according to disease diagnosis, but also according to pattern diagnosis. Diseases are culturally determined, and change with time and knowledge. This is not widely understood by the general public, but it is true. Chinese medicine recognizes many of the same diseases as western medicine, but each system considers diseases that the other does not. Most treatment in western medicine is based on disease discrimination. That is, if a person has a certain disease, they receive a certain treatment for it.
Chinese medicine also considers pattern discrimination. Patterns are fundamental disease mechanisms, not limited to the specific symptom being treated. They describe basic physiological imbalances that are responsible for producing diseases. There are often many possible patterns for a given disease, and they occur in different combinations for different people. This means that Chinese medicine has a very individualized system of diagnosis, and thus treatment, for what can appear to be the same problem in different people.
Chinese medicine is a collection of theories that have evolved over time, and today are collectively part of a coherent system of medicine. The most important part of practicing Chinese medicine is accurate diagnosis. The process of Chinese medicine begins with gathering information. This is done through a specified system of diagnosis that includes observation through history taking, physical observation and examination, and Chinese pulse and tongue examination. This information is processed through the diagnostic filters of Chinese medicine to arrive at the appropriate disease and pattern diagnoses. From these diagnoses logically follows a discussion of causality, treatment principles, treatment strategies, and finally, treatment.
Treatment is divided into two categories. The category of remedial care is what most people come for – this is the treatment that gets done to you. This includes some of the modalities described below. The other category is self-care. The discussion of causality in Chinese medicine leads to appropriate recommendations that people can follow at home. The primary role of a Chinese medical practitioner is to teach people why they are sick, and how to take care of themselves so that they can get better and stay well. Traditionally, preventative treatment was the main function of Chinese doctors. Treatment was administered only if relief could not be achieved by self-care remedies.
Acupuncture is the primary modality of Chinese medicine that is known in this country. It is very important to understand that acupuncture is not just a technique. It is not a set of tricks that you add to what you do to fix problems. Acupuncture is a treatment modality that is part of the larger system of Chinese medicine. Treatment is the last step of the way in Chinese medicine, after the other diagnostic work has been performed. The three primary treatment modalities of Chinese medicine are acupuncture, herbal medicine and dietary therapy.
It can be difficult to understand the various terms that are used when referring to Chinese medicine. The only term that is technically correct is “Chinese medicine”.
- TCM, or Traditional Medicine, is the most common style and term that people will encounter. The history of Chinese medicine is long and complex. What is important to understand is that TCM is a specific style of Chinese medicine that developed during the 1950’s in China. This was done largely under the direction of Mao Zedong, and represents an attempt to create a standardized, modernized, Westernized approach to Chinese medicine. While there were certainly benefits, much of Chinese medicine was banned and destroyed, stripping it of thousands of years of depth and diversity that led to clinical effectiveness.
- Traditional Acupuncture. There are various locations for this term. The primary one in the West arose from the similarly named European system, which has strongly influenced the practice of Chinese medicine in America primarily through one of the older and now renamed schools in America – The Traditional Acupuncture Institute. This style is a highly psychologized system, reflecting modern Western psychology and not Chinese medical understanding. There are many other settings where the term “traditional” is used, but it is rarely appropriate.
- Classical Chinese Medicine. This is perhaps most reflective of Chinese medicine as it was practiced 2000 years ago. Now it has become a term used to describe differing approaches from the classical period. Still, as a style the term “classical” is most representative of authentic Chinese medicine.
- Other Systems. Chinese medicine is large. There is Japanese acupuncture, Korean acupuncture; the list is endless. It is important from a patient perspective to have at least some understanding of the approach that is being utilized. As long as someone benefits from treatment, the style does not matter. However, sometimes choice of an appropriate style can make the difference for clinical efficacy.