A Basic Primer: Acupuncture and Traditional Chinese Medicine
Oct 01, 2015 11:12PM
By Jody Eisemann, LAc
Traditional Chinese Medicine (TCM), of which acupuncture is just one part, is a comprehensive and multi-pronged approach to health and well-being. Acupuncture is probably the best known component of TCM in the U.S., but TCM also encompasses many other modalities including herbs, moxa (heat therapy), cupping, massage, dietary therapy and others. In America, acupuncture has primarily been perceived and used as a successful way to treat pain. However, acupuncture and the other TCM modalities represent a philosophy and a complete medical system with few or no side effects.
TCM has evolved over 3,500 years and is medicine based on observation, meaning it has been learned and improved by practice over time rather than based on theory. Over time, the medicinal value of herbs was learned and codified, acupuncture meridians or pathways were mapped out, and the numerous and complex protocols comprising TCM were developed.
In comparison, Western medicine is just a few hundred years old and not tested by thousands of years of observation. It is true that in emergency situations, Western medicine excels and saves lives. When it comes to chronic low-grade health conditions, acupuncture and other TCM modalities can treat both symptoms and the underlying cause of a condition, looking at the person as a physical, emotional and psychological whole. Unlike conventional, symptom-based Western medicine, TCM is not focused on structural or biochemical constraints. Instead, TCM is an energetic understanding of medicine that focuses on blockages in body’s energy flow known as qi, the vital force of the body.
Acceptance of acupuncture and other TCM modalities continues to grow exponentially each year in this country, largely driven by patient demand. Every year more American hospitals embrace acupuncture to treat chemo side effects, help with infertility, assist turning breach births and expedite labor and delivery. Even major league sports teams like the New York Mets use cupping for pain.
It can take three to four years to receive a master’s degree in the U.S. to learn TCM’s philosophy and systems. Licensed TCM practitioners must take a national exam and are the only professionals licensed by the state to use acupuncture. Licensed TCM practitioners are required to take continuing education to maintain their national license.
TCM practitioners do receive different training and have a range of skills; thus their treatment of patients can vary widely. Typically, a TCM practitioner treats patients using a combination of acupuncture points, herbs, lifestyle suggestions and other techniques based on the individual’s specific presentation and needs.
TCM Diagnostic Approach
Whereas current Western medicine relies heavily on technology and blood testing for diagnosis and focuses primarily on individual symptoms, TCM physicians (acupuncturists and herbalists) developed a complex and specific diagnostic system based on patterns and using a patient’s pulse and tongue. Each wrist has three pulses and three depths that correspond to different organ systems. The quality of the pulse indicates more information about the health of the organ system as well, such as forceful, tight, weak, hidden or ropey.
In tongue diagnosis, the TCM practitioner observes the color, surface texture, degree of moisture, color and quality of tongue coating, and shape to further determine the patient’s overall health. Both pulse and tongue change over time based on the person’s health.
Initial patient diagnosis is made using the Eight Parameters (patterns) that are dual in nature and are compared to one another in order to aid in restoring balance and health:
• External/Internal: External (exterior) and internal (interior) indicate the location of the disease process in the body. Skin and muscles are considered the body’s exterior elements and interior imbalances of the body have more to do with organ-related symptoms.
• Hot/Cold: Heat conditions – such as a fever or inflammation – can come from external invasions like a bacteria or virus. Another hot condition could be from too much internal yang energy like drinking too much alcohol, which can cause a red face and headache. Internal-generated heat can show up as an energetic deficiency, such as in menopause where there is not enough yin (yin lubricates and cools the body), creating a “false heat.” In this situation, the condition should be nourished versus calmed in the case of an external fever or inflammation.
• Excess/Deficiency: A disharmony (or disease) can be classified as either an excess or a deficient condition. An example of an excess condition is when a flu or virus attacks the body and the body’s defenses go onto high alert and protects with a high fever. Such excess can cause energy blockages (i.e., clogged sinuses), giving rise to different types of pain. Such acute conditions are considered excess in nature. Deficient conditions tend to develop because of inherent chronic weakness in the person’s overall health or the body’s qi. Symptoms of deficiency include weak movements, a pale face and/or pale tongue, and a weak pulse.
• Yin/Yang: Using yin and yang diagnostically is the most general of all the TCM diagnostic categories and considered a shorthand summary of all the other categories. Heat, excess and external invasions are yang conditions while cold and internal organ imbalances are defined as yin conditions; most conditions are a mixture of yin and yang that need to be balanced.
A good example of how to apply these TCM diagnostic principles can be seen in the case of two patients diagnosed with high blood pressure. One patient was a 42-year old that presented as an angry, red-faced, sweaty and overweight man while the other was a thin, timid, pale, chilly 65-year-old woman. Western medicine would generally prescribe both individuals the same blood pressure medication(s), irrespective of such observational differences. TCM sees the two as virtual opposites; the man would be viewed as having an excess imbalance while the woman would be considered a deficient and weak imbalance. Their conditions would be treated with differing approaches.
Five Element Theory
Another key diagnostic paradigm of TCM is the Five Element Theory. This theory applies the relationships between the wood, fire, earth, metal and water elements to the human body. These elements are constantly moving and are both interdependent and nourishing as well as act as mutual restraints to keep overall balance.
Each of the five elements diagnostically describes an organ system and its functions, how the organs interact with each other and the outside world, and illustrates different organ systems’ patterns and imbalances. For example, the spleen organ – considered expendable in Western medicine – is seen as integral in TCM. According to TCM, the spleen is an earth-element yin organ; since its function is to transport and transform food and fluids, any spleen disharmony will affect the digestion.
In TCM, the spleen controls the muscles and sends food qi to the four limbs; tiredness is a very common symptom of a spleen deficiency. There are at least 10 types of spleen organ disharmonies: from cold damp invading the spleen, spleen qi deficient, to spleen and liver blood deficiency. Cooked and warm foods like meat, ginger and pepper benefit the spleen, whereas cold raw foods like salad, most fruit and cold drinks are damaging to people with weak digestion.
Five Element Theory can be used in a more reaching manner to understand how an individual functions in the larger world. Besides describing deeper organ dysfunctions, Five Element Theory can also describe climate, seasons, foods, tastes, smells, emotions and speech. Having grown up with these principles embedded in their vast and ancient culture, Chinese people would never consider eating ice cream in the dead of winter (it’s too cold and milk makes phlegm) and believe strong emotions, especially anger, will damage the liver’s function. Many forms of meditation and martial arts were developed in that part of the world to redirect such strong emotions to help develop a peaceful, harmonious and balanced culture.
TCM core principles to treat illness and promote well-being differ greatly from Western medicine’s single symptom focus; TCM has much to offer Western medicine that has yet to be tapped. As more people continue to try and get good results with acupuncture and TCM, hopefully Western and Eastern medicine will continue to integrate as they have most notably in China and Cuba.
Jody Eisemann, L.Ac., NCCAOM, of Acupuncture Healing CT, has more than 20 years experience treating all kinds of conditions with acupuncture. She sees patients in Norwalk, Southport and Trumbull. Call 203-216-2548 or visit AcupunctureHealingCT.com for more information. See Community Resource Guide listing, page 80.