WHAT IS TRADITIONAL CHINESE MEDICINE (TCM)?
Acupuncture, Chinese Herbal Medicine, Traditional Chinese Nutrition, Qi Gong and Tuina are the tools of the Medicine the Chinese have used for at least 2000 years. There is enough historical evidence to prove that rudimental forms of it already existed 6000 years ago.
How is illness diagnosed and treated?
Before performing any form of treatment, Traditional Chinese Medicine relies on the investigation of the root(s), of the mechanism(s) and of the signs of a disease. For the TCM therapist, the symptoms are nothing else but a 'crying child looking for attention’. As nobody would muffle a crying child, but attempt to know what is needed and why s/he is crying so, a good TCM therapist, relaying on the four diagnostic tools (look, hear/smell, ask, palpate), assesses the positioning and nature of the disease (external-internal, hot-cold, excess-deficiency, Yin-Yang etc.), uncovers the underlying causes of a disease, the mechanism(s) and the level(s) of its manifestation(s), individuates the syndrome(s) resulting from the imbalance and, only then, formulates the principle(s) of treatment, selects the suitable treatment.
Where is it taught and practiced in China?
Traditional Chinese Medicine is practiced all over China in especially appointed hospitals, it is regulated by the Chinese Health Authorities and is taught in TCM Universities where students can obtain their Bachelor Degree first and where, those who wish to continue their studies, can follow thereafter a Master Degree and a Doctorate Degree. Western Medicine is also taught at a level considered adequate for TCM students, although it does not involve the full range of subjects and depth needed for the preparation of MDs.
Foreigners who wish to study TCM in China, can do so. Universities run one year courses (taught in English or in Japanese) for foreign students. In this period of time, students learn the Foundation training considered indispensable to anyone who wants to be involved in the practice of TCM. This program, normally, prepares students to handle basic clinical cases with acupuncture or herbal medicine. Students who want to study in China and obtain there their Bachelor Degree can do so, but so far these courses are not offered in English. A Chinese language test for which an application has to be made in due time are required.
Students who have already undertaken their education in TCM in Europe, have a Bachelor Degree and want to further their studies in China, besides having to submit a certificate of Chinese Language Proficiency, must also take an entry examination in Traditional Chinese Medicine.
Traditional Chinese Medicine Doctors enjoy full recognition in China and do not need to be Graduated doctors of western medicine.
Where is it taught in Europe?
Traditional Chinese Medicine in Europe is taught generally by private institutions, except for some, but still too few, Universities (e.g. Westminster University, Middlesex University and York University in the UK, Antwerp university in Belgium etc, where a specific curriculum for TCM students is designed without expecting them to have previously completed a Western Medicine degree. Normally, students must posses a certificate of completion of secondary education.) In the Medical University of Milan (Italy), among others, doctors can obtain a Master Degree (only) in Traditional Chinese Medicine. Its curriculum follows the prescriptions of Bologna (and the next ones) of: 60 ECTS in 500 contact hours.
What is Acupuncture (Zhenjiu針灸)?
Acupuncture is one of the methods of therapy of Traditional Chinese Medicine and it is, perhaps, the most well known in the Western world. According to historical records, the first needles ever used were made of stone. A Chinese legend recalls a famous doctor, Yu Fu, who used this kind of needles successfully to treat many diseases. According to archaeological excavations, the first metallic (bronze) needles appeared in the 16th-18th century BC during the Shang and Chou dynasties. In the following centuries, with the discovery of other metals, needles quality varied accordingly. Nowadays, needles are made of stainless steel. Although, traditionally, there were 'nine needles' which were selected according to different therapeutic needs, in contemporary practice, the filiform long needles are the ones mostly used. Acupuncturists are obliged to use disposable needles.
Acupuncture needles are inserted more or less deeply into a selected point of the skin and are manipulated according to the diagnostic findings. There are in total about 360 points used for needle insertion, but every year, thanks to the research of dedicated Chinese scholars, new ones are added.
Each acupoint has a name, which describes either its anatomical location or its functional action. The 'point' name refers to the tiny geographical surface location of insertion of the needle and not the nature of the anatomical area where it is found, which is, in fact, more similar to a small cavity deep under the skin surface. Needle insertion is forbidden for some points and, in some circumstances, as for instance in pregnancy. It is avoided also for points which normally do not have any contraindication.
Points are grouped, according to common functions and properties, along more or less orderly lines called 'channels' or 'meridians'. This arrangement was possible as the experience of the forefathers of Traditional Chinese Acupuncture proved that all points belonging to a specific 'channel' along the body had therapeutic effects on a specific organ (Zang Fu). In this way, organs (Zang Fu) and meridians have become indissolubly associated: a problem of the organ (Zang Fu) would give signs (such as pain) to certain acupoints of the associated meridian and the insertion and manipulation of needle in certain points along a meridian would relieve the organ problem.
According to Traditional Chinese theory there are 12 main channels and their 'subchannels', such as: 12 divergent channels (which create six pairs of channels), 15 connecting channels and 8 extraordinary channels. The above interconnect amongst themselves as converging and diverging rivers, leading to and moving away from gathering pools (organs and viscera) which this very network sustains. In addition, the channels serve the function of linking the organs and the body surface, the four limbs and the head, the front and the back into an integrated whole.
How is Acupuncture practiced?
Before embarking on treatment, acupuncture relies on the investigation of the root(s), of the mechanism(s) and of the signs of a disease .
For the acupuncturist, the symptoms are nothing else but a 'crying child looking for attention'. As nobody would muffle a crying child, but would, instead, attempt to know what is needed and why s/he is crying so, a good acupuncturist, relaying on the four diagnostic tools (look, hear/smell, ask, palpate), assesses the location(s) and nature(s) of the disease(s): (external-internal, hot-cold, excess-deficiency, Yin-Yang), uncovers its underlying causes, the mechanism(s) and the level(s) of its manifestation(s), individuates the syndrome(s) resulting from the imbalance and, only then, formulates the principle(s) of treatment, selects the meridians and the points needed and applies therapy by needling. In some cases, when a symptom is particularly severe, the acupuncturist can choose to alleviate it, without however neglecting, in the end, to correct the syndrome(s) responsible for the imbalance.
WHO guidelines for Acupuncture practice
The World Health Organization (WHO) has also released a report, in which the guidelines suggested for the formation of fully qualified Acupuncturists are specified.
According to it we can distinguish the below categories:
a. Non-MD aspiring to graduate as fully qualified Acupuncturist (employable in primary health care): they must to follow a course of "not less than 2500 hours, of which 500 hours should be devoted to western science". Specified curriculum.
b. MDs aspiring to above mentioned position should follow, however, a training ('not less than 1500 hours'). Specified curriculum.
a. MDs and other health care professionals who want "to use acupuncture as part of their primary activity": as they are not aspiring to graduate as fully qualified acupuncturists the hours of training are greatly reduced but not less than 200 hours, although the curriculum is clearly specified.
3rd category: other health care professionals " As they are not aspiring to graduate as fully qualified acupuncturists, the hours of training are greatly reduced, even though the curriculum is clearly specified according to how they want to apply their studies. It is recommended that they are trained in acu-pressure, rather than acu-puncture.
The guidelines also give specific suggestions as to how needles' sterilisation should be carried out. For more information please visit here.
CHINESE HERBAL MEDICINE
What is Traditional Chinese Herbal Medicine 中藥?
Chinese herbal medicine uses a large amount of herbs, minerals and animal products for therapeutic purposes. All these substances have an intrinsic temperature, taste and direction of action (up, down etc). In addition, all of them have a specific resonance with one or more channels.
Herbs are grouped in various categories, in which the above qualities are matched with the intrinsic action of each herb (mineral, animal product), e.g.: 'warm free the exterior', 'cold free the exterior', 'dispersing phlegm' etc. Normally, various substances are given together to form a harmonious and balanced prescription, in which they interact synergistically, so that their chemical components are balanced. Furthermore, a good herbal recipe always includes herbs which protect from a damage that can be caused by the general ‘tone’ of the other herbs, for instance, a very warm recipe should be accompanied with herbs that ‘protect the fluids’.
Traditionally all the ingredients were either boiled together or pounded and then mixed with honey and compressed to form small or larger pills. These days they are offered on the market also in soluble powder or as dry compresses form.
It is important to stress that the best way for a prescription to be assumed by the patient is when all the ingredients are boiled together as in this way their potential negative actions are neutralized. It follows that even soluble powder extracts should undergo this process before being turned into powder.
It is extremely important that patients seeking this form of treatment see a specialized practitioner who can prove that s/he has undergone at least three years of training in Chinese Medicine and has a specialisation in Chinese Herbal Medicine.
Chinese Herbal Medicine has had a significant amount of 'bad press' in recent years yet, though it is absolutely safe in the hands of scrupulous and well trained practitioners who use it within the logic of the diagnostic and treatment methods of the classical Chinese Medicine.
How is it prescribed?
The principles of practice and diagnosis used in Chinese Medicine, as described in Acupuncture, also apply to prescribing Chinese herbs. It is important to stress that, due to the intrinsic qualities of each herb, under no circumstances it is admissible to prescribe on the grounds of symptoms alone. For example, two people suffering from stomach ache could be given a different prescription according to the underlying pattern of the disease, differentiated into hot-cold, Yin-Yang etc. Therefore a patient suffering from stomach ache accompanied by signs of cold (lack of thirst, cold extremities etc) should be given a prescription containing mainly warm herbs, whereas a patient suffering from stomach ache accompanied by signs of heat (lots of thirst for cool drinks, great hunger, hot body sensation etc.) should be given prescription containing mainly cool herbs.
TRADITIONAL CHINESE NUTRITION
Traditional Chinese Nutrition does not deal with the chemical ingredients of the nutrition but with their ‘energetic’ qualities and it mainly deals with the preservation of proper health, but also with the necessary nutritional adjustments necessary to ‘reverse’ pathological imbalances that can be the cause of an illness for the body. Traditional Chinese Nutrition is a sector of Chinese Medicine, compilable with the overall theory of Traditional Chinese Medicine and the way which organises the symptoms and the marks of illnesses into syndromes. All kinds of nutrition are classified according to their taste (salty – Kidneys, sour – Liver, bitter – Heart, sweet – Spleen, spicy – Lungs, astringent and of neutral taste) but also according to their temperature (very hot, hot, mild, cold, very cold) and their internal movement (emerging, floating, descendant, sinking, neutral) e.t.c. Therefore, taste can help (although it can also be dangerous if used in abundance) the organ with which it is connected. A traditional Chinese diet based only on taste qualities is fundamentally wrong and could be dangerous . A spicy taste can indeed help the lungs although if it is very hot and emerging, a great amount of it would cause pathological actions.
To preserve a good health we need to eat a variety of food so that all above qualities are absorbed by our body and so that the Qi, the blood and the body fluids are nourished and preserved in a way of structure and function, enforcing the natural movements of the Qi, blood and body fluids accordingly. It is also important to eat according to the change of the seasons.
Traditional Chinese Nutrition Therapy, on the other hand, can certainly limit the kind of food allowed to a certain patient. This is decided according to the nature of certain symptoms. For example, the patient could have headache, red eyes, anger expressions, feeling of heat in the head and thirst. These symptoms and indications could be accompanied with a red tongue and fast pulsation (there are approximately 28 pulsations on both wrists). In this particular case, we do not have to be Chinese Medicals to understand that there is a bulge of heat towards the head. According to the above mentioned nutrition categories, his food should have a refreshing nature, a descendant move and a selected taste according to the syndrome as well as a combination of other characteristics that cannot be explained in this description. Nevertheless, the proper taste should be selected so that the uprising heat is rebalanced.
In conclusion, it is clear that Traditional Chinese Nutrition cannot be used safely and effectively by non-specialists.
Qi Gong is a part of Chinese Medicine and it uses both body and intention 意念 as a primal tool for preventing illness, healing and personal development.
The main target Qi Gong is to develop alertness (of mind, senses and body), In one word, Qigong supports life. As alertness supports self-observation, which this helps the widening knowledge and experience, it is that which enables Qi Gong to be one of the most powerful tools in supporting and maintaining life. Lat but not least, the 'target inside the target' when practicing Qi Gong is that of learning to live in oneness with the world and being in the service of humanity.
The basic criteria necessary to be a good Qi Gong practitioner are: strong self-control, physical and emotional health, endurance, capability, inborn power, Qi , Shen, patience, strong connection with people and things, great moral standards, honesty, clarity of thought and expression, and a lifestyle that aims at developing the spirit.
Besides Acupuncture, Chinese Herbal Medicine, Chinese Nutrition and Qi Gong, Tuina is one more method which follows the principles of physiology, diagnosis and pathology of Traditional Chinese Medicine. The Tuina practitioner, after a full diagnosis of the patient can use manipulation techniques like: rubbing, round rubbing, pressing, pushing, vibration, kneading, rolling, grasping and cross-fibre techniques, percussion pulling etc. to rebalance the health of the patient. A well trained Tuina practitioner usually uses more than one manipulation of the movement and can also combine Qi Gong, that is directing the Qi in the form he/she desires: warming, moving or delaying its flow, balancing this way the condition of the patient.
Traditionally, Tuina has been applied with success to babies and young children, avoiding (when possible) the pain that acupuncture could cause, as well as the non-pleasant taste of the herbs.
Many people think that they can be specialised in Tuina, without having completed a full training in Chinese Medicine (pathology, diagnosis, treatment strategy etc.). Yet, for all Tuina students training in Chinese Medicine is obligatory.