When people begin treatment with acupuncture and Chinese medicine, there is naturally an assumption that all symptoms will be discussed and treated in order of priority. This is only partially true. This perspective largely arises from the standard approach of conventional Western medicine, which is to administer separate treatment for each condition.
Chinese medicine considers each symptom in relation to each other, and to the underlying imbalances that generate them. When it comes to treatment, each symptom cannot be considered as independent and unrelated to the rest of the body; in Chinese medicine everything is related to everything else.
Chinese medical treatment requires strategizing. I need to fully evaluate my patients, understanding the complex relationships of each aspect of physiology that underlie symptoms. Diagnosis in Chinese medicine is never one word or phrase; it is at best a short paragraph. Once physiology is understood and imbalances identified, treatment needs to be strategized. First, there are certain symptoms that always require immediate attention and thus take priority in treatment. These include abnormal bleeding, sweating, diarrhea, vomiting, and urination. When any of these events are present, a person loses vital energy and is at risk for worsening health. In addition, treatment will not work if these are present and not attended to. Furthermore, acute symptoms cannot be bypassed. Chinese medical treatment is responsive to changing aspects of health, disease, internal states, and external weather; you can’t just ignore what is taking place as if it does not matter.
Another aspect of strategizing involves consideration of short, medium, and long-term goals. This primarily refers to purposefully addressing imbalances and symptoms in a way that produces movement and leads to resolution. In the same way that when cooking or baking you cannot just throw everything in the pot and expect a good dish to result, you cannot just randomly administer treatment without consideration of the trajectory over time. For example, it rarely makes sense to supplement Yang Qi in the body if there are latent heat pathogens present. Or to say it more colloquially, you have to clear before you tonify. I find that people routinely take vitamins and supplements and herbs to increase energy, when the more fundamental problem is a variety of obstructions and pathogens that first need to be addressed. If you don’t do things in the right order, you get nowhere. The result is that a person may spend months or years receiving treatment, but not progress in any way. It just becomes temporary symptom management.
One example of this is treatment of allergies. Seasonal allergies are one of the most common complaints in my practice. It is not generally difficult to manage allergy symptoms with acupuncture, herbs, and dietary changes. The issue is that without treating the underlying causes and imbalances, symptoms will return again the following year. To properly resolve seasonal allergies, treatment should be administered throughout the year at the change of seasons, and then again for a few weeks or months prior to the primary allergy season (for example, spring allergies). It is necessary to balance the body so that the patient moves through each season without significant illness or imbalance. If these do arise, they need to be treated. After a full year of intermittent treatment, allergies may be successfully treated and resolved. Chinese medicine describes longer term considerations for illness and treatment that are not generally understood in our conventional medical system.
There is also consideration of right and wrong, or correct and incorrect, aspects of treatment. For example, people will commonly ice their back when there is back pain. This is always, without exception, wrong in Chinese medicine. The cold causes stagnation and while it may feel good temporarily, it results in long-term sacrifice. Short term relief often compromises long term resolution. It is true now more than ever that there are many perspectives on any given topic…ice or heat, coffee is good for you one day and bad the next, it’s ok to eat eggs and then it is not; this is the result of a still immature and not time-tested approach to health. Chinese medicine is ancient and the methods of treatment have been validated through over 2,500 years of continuous use and study by high level physicians. Opinions on what is good and bad for you do not change. Interpretations vary with modern understanding, but fundamental principles themselves do not.
Strategizing also applies to more superficial aspects of treatment, such as working with muscular pain. A person may have a knot in the neck that causes pain. That knot can be related to other muscles that extend even into the low back, and that may have connection to internal factors of stress and diet. If you only treat the local area without working on the related factors, relief will only be temporary.
The most important thing to understand is that pain and illness are complex and layered. Proper, successful treatment takes time and vision. Treatment without a purposeful, strategic approach may bring quick temporary relief, but compromise long-term resolution and cure.