China is
the only country in the world where Western medicine and
traditional medicine
are practiced alongside each other at every
level of the health care system.
Traditional Chinese
medicine has a
unique theoretical and practical approach to the treatment of disease,
which has
developed over thousands of years. Traditional treatments
include herbal remedies, acupuncture,
acupressure and
massage, and moxibustion.
They account for around 40% of all health
care delivered in China. The current government policy of
expansion of traditional facilities and
manpower is being questioned
because many hospitals using traditional Chinese medicine
are
already underutilized and depend on government subsidies
for survival. Research priorities
include randomized controlled
trials of common treatments and analysis of the active agents in
herbal remedies. As more studies show the clinical effectiveness
of traditional Chinese medicine,
an integrated approach to
disease using a combination of Western medicine and
traditional
approaches becomes a possibility for the future.
The
practice and teaching of acupuncture
and Chinese herbalism has a 5000 year old history in China. The
earliest text on the subject, the Huang Ti Nei Jing Su Wen Ling Shu'
(The
Yellow Emperor's Classic of Internal Medicine), ascribed to the 2nd and
1st centuries BC, is still relevant to the teaching of acupuncture and
Chinese herbal medicine today. Certainly scientific investigations over
the past 300 years have added to our understanding of the physiological
mechanisms that may contribute to the acupuncture effect, and to our
understanding of the pharmacological basis of Chinese herbal medicine,
but the unifying framework of this form of holistic therapy was
developed and refined during 5000 years of clinical application in
China and Japan.
The major theoretical foundations of this science remain unchanged. Its
continued evolution as a therapeutic system, in view of the impact of
Western medical practices, attests to the effectiveness of this method
of treatment and the soundness of the ancient theoretical basis of
diagnosis and practice that are used by the traditionally trained
practitioner.
In the
early 1950s it was feared that traditional Chinese medicine would be
superseded
by the "more modern" Western medicine. To counter this, a systematic
assessment
of the effectiveness of the traditional treatments was thought
necessary. So thousands of
experiments and clinical studies were carried out during the 1950s.
Most were case series of
patients with a specific Western disease who were then treated with
traditional
techniques—for example, a series of 112 cases treated for angina
pectoris and another of
121 cases of bronchial asthma treated with subcutaneous acupuncture.
The result of all this
research activity was that in 1958 it was declared that traditional
Chinese medicine and Western
medicine should be given equal respect and place in the health care
system. 1 Since then
there has been a consistent policy of support for the
traditional system.
The
introduction of acupuncture to the West
came late in its history and the early transmissions of information
were fragmented. European understanding has grown gradually over the
past 300 years. Recent contact with China has accelerated the knowledge
and acceptance of acupuncture in the West.
Concepts of the body
Chinese medicine is closely linked
to Daoist philosophy, which holds that the universe exists because of
two great
opposing yet interdependent creative forces, yin and yang.
The body is viewed as a microcosmic
universe and the inner organs and their functions are classified
according to
their yin and yang properties. The relationship between the organs, and
all
natural phenomena, is described in terms of the five phases or elements
(wu
xing): wood, fire, earth, metal and water.
The
inner organs are paired off
according to their yin and yang characteristics and ascribed an
element. For
example, the kidney and urinary bladder form a pair and are linked to
the water
element. These relationships form the basis of diagnosis and treatment.
For
example, water quells fire, so if there's a heart (fire) problem,
underlying
kidney deficiency may be diagnosed and treated.
Another central concept is that of
'chi' or vital energy. This is said to flow through a network of
channels,
known as meridians, to vitalize the inner organs. Chi also influences
jing
(essence) and shen (spirit) and is seen as the link between the
physical body,
the mind and higher consciousness.
When chi flows freely, there's a
good balance between yin and yang in the body and good health. If chi
becomes
blocked or deficient, owing to dietary, lifestyle or other factors,
disease
will ensue.
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Diagnosis
Diagnosis is based on four types of
examination (si zhen):
- Observation (wang zhen) - includes
tongue analysis and observation of facial characteristics, skin and gait
- Listening (wen zhen) - relates to
the patient's voice and respiration
- Questioning (also wen zhen) -
covers diet, sleep, excretion and symptoms
- Palpation (qie zhen) - involves
taking six pulses on each wrist, one for each inner organ, and
interpreting the depth, speed, strength and quality of each
Diseases are classified according
to
eight principles:
- The degree of excess (shi) or
deficiency (xu) of pathogenic factors
- The yin or yang stage of the disease
- Symptoms of hot or cold
- The external or internal depth of
the disease
Treatment
The best treatment is prevention.
Ancient Chinese physicians were expected to keep their patients in good
health
and to lead by example by living in harmony with the seasons, eating a
balanced
diet and exercising regularly. Preventive treatments include dietary
and
lifestyle advice, and energetic exercises such as qigong and t'ai chi.
Once
disease has manifested,
therapies such as acupuncture, acupressure, moxibustion and herbal
medicine are
used.
Chinese medicine is used to treat a
wide range of disorders, such as eczema, asthma, menstrual problems,
insomnia,
digestive disorders and joint pain.
Source:
Health
in China: Traditional Chinese medicine: one country, two systems
Therese
Hesketh,
research
fellow,a
Wei Xing Zhu,
programme
manager, East Asia ba Center for
International Child Health, London WC1 N1EH,
TCM
Schools
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