Holistic Concept of Chinese Medicine
In Western medicine, doctor looks for specific causes of diseases, and focuses on particular body components to treat. Traditional Chinese medicine (TCM) doesn't work in this way. There are fundamental differences in principles, diagnosis and treatment approaches between Western medicine and Chinese medicine.
|Ancient Chinese believed that their existence was closely tied with the universe, where they were located in the center with the heavens positioned above and the earth positioned below. The concept of the universe was used to explain the laws of nature, and relationships were formed between the cosmos and humans. For example, the skin of the human body corresponded with the flat texture of the earth, the five internal organs corresponded to the five elements of wood, fire, water, earth, and metal, and the eyes and ears related to the sun and moon in the heavens. The world is a harmonious and holistic entity, no single being or form could exist unless it was seen in relation to its surrounding environment. This concept became the basic idea of Taoism, a philosophical and religious tradition of China.
Taoism helped shape the practice of Chinese medicine, which is based on the beliefs that everything is interdependent and mutually interactive in the universe. Man is part of the holistic entity, and should be analyzed or interpreted with reference to the whole. TCM holistic concept includes integrity of the body and its relationship with the outer world.
The body's systems are one integrated and balanced whole
The body is an organic whole, all the component parts are interconnected, they dependent and restrict each other physiologically, influence each other pathologically. The five organs act as the core functional units, and through the linking of the meridian system, a complex set of interrelationships is formed within the body. Every part of the body has special relationships with the five organs, and the five organs themselves are interrelated too.
The five organ systems of the body
||Dominated body tissues
||Openings on the head
||Outer manifested regions
Furthermore, qi (vital energy), blood and body fluids are the material basis for various body functions; they flow through the body to facilitate all parts of the body working together and to ensure the unity and harmony inside the body.
|Physiological aspect: Each organ not only performs its own individual functions; it also complements other organs and even the entire internal system to perform life activities. For example, although nutrient essence is transformed in the spleen, but the transforming process also involves nourishment of the heart blood, regulation of the liver and promotion of the kidney. A harmonious and coordinated relationship between the organs is essential for normal life activities.
|Pathological aspect: Attention is paid to the interrelation and interaction between localized pathology and the whole body, TCM holistic approach always associates localized pathology with overall body reactions. Physicians not only concern about local pathology and its corresponding internal organ, they also consider the influence on unaffected body parts, so as to predict the disease progression. The clinical manifestations of disease are a result of the overall body reactions. For example, in case of damp-heat irritating the liver and gall bladder, not only these two organs are affected, it may also affect the spleen, stomach, heart and kidney, leading to nausea, no appetite, diarrhea, insomnia, lumbar soreness, knee weakness and fatigue. In case of liver blood deficiency, there may be symptoms like blurred vision (openings of the liver), dizziness, pale nails (outer manifested region of the liver), muscle or tendon spasms (dominated tissues of the liver), limb weakness, scanty menses and even missed periods (the Conception Vessel and Thoroughfare Vessel are controlled by the liver). Disorders of internal organs, qi, blood and body fluids can be manifested on the superficial body, while a localized or regional pathology can affect the whole body and cause extensive dysfunctions.
|Diagnostic aspect: The Four Diagnostic Skills and correlations made between internal and external body are concrete samples of TCM holistic concept. Since the organs and tissues of the body are interdependent physiologically and mutually affected pathologically, physicians are able to assess the status of internal organs and construct a detailed picture of the patient's disease based on the symptoms, pulse and tongue signs of the patient, laboratory tests or other modern diagnostic technologies are rarely used. For example, the tongue has special relationships with the internal organs. The tongue body and its coating create the tongue signs, which are an important factor in diagnosis. Changes in the tongue signs reflect changes of organ functioning, blood and qi activities, body fluid metabolism, and progressing direction of diseases. In addition, it is a routine practice of TCM to associate a patient's condition with external influences and personal details. Factors like weather, season, lifestyles, eating habit, mental state, body constitution, age, gender and career are usually taken into account in TCM diagnosis, they help provide a full evaluation and design the most appropriate treatment plan to the patient.
Divisions of tongue surface
Therapeutic aspect: TCM treatment focuses on the overall disharmony of the body rather than specific organ or body region. Most of the time, remedies are designed to restore the balance of the whole body, and are through comprehensive therapeutic effects to achieve the healing propose. A disharmony pattern is the general conclusion of the cause, pathological changes, developmental stage and overall body reactions to a particular disease. Treatment based on syndrome differentiation (identifying disharmony pattern) implies the holistic concept of TCM, which has made use of the organic wholeness and interrelationships of the body. When there is an organ disorder, physicians may not target on one organ only and even not treat the affected organ, they can achieve a healing result by treating other seemingly irrelevant organs. For example, stomach problems can be solved by treating both stomach and spleen; respiratory problems may be treated by both spleen and stomach instead of treating the lungs. More remarkably, for many localized or superficial conditions, physicians will treat the corresponding internal organs and even the entire body is treated. For example:
|Symptoms and signs
||Excessive fire in the liver
||Clear liver fire
|Painful and swollen gum
||Warm up the kidney
|Digital necrosis of the feet
||Activate blood and warm up the meridians
|Chronic ulcers and abscess
||Blood and qi deficiencies
||Replenishing blood and qi
|Headache and runny nose in common cold
||External invasion of wind and coldness in the lungs
||Disperse pathogens in the lungs
|Hair loss and hearing decline
||Exhaustion of kidney essence
||Replenish essence and invigorate the kidney
The body should be in tune with the external environment
The body communicates with the external environment constantly, factors such as weather, geographic location, working and family environments can all affect our health. External changes cause the body to respond physiologically or pathologically, which reflects the united relationship between human and the outside world. We should live in harmony with nature, other people, and the immediate environment. When changes occur in external environment, and the body fails to adapt to the changes, diseases are likely to occur.
Climatic Influences: Under normal circumstances, climatic factors do not cause disease, only in extreme changes or when the body is too weak to adapt to climatic changes, they became pathogens that could cause disease. The six climatic influences, which are wind, cold, summer-heat, dampness, dryness, and fire or heat, are considered as the importance external pathogens for disease development, also known as the "six evils" in TCM. The correlations made between the climate and disease development is a particular way for TCM to explore the imbalance of the body. It facilitates physicians to identify the exogenous pathogens based on particular symptoms, regardless of identifying bacteria, viruses, toxins or parasites, and allows for a different approach in disease treatment that has been met with success over the centuries in China. For example, in common cold that has symptoms such as headaches, fever and sticky throat secretions, physicians may diagnose as wind-heat invading the lungs, using herbs such as honeysuckle flower and forsythia capsule can clear the symptoms.
Seasonal Influences: The body makes appropriate physiological responses in accordance with seasonal changes. For example, it opens the skin pores and sweat more in summer, while closes the skin pores and sweats less in winter, thus the body temperatures can be maintained within a normal range. Moreover, the body pulse tends to be taut in spring, surging in summer, floating in autumn, and deep in winter, which reflect the body's blood and qi activities also correspond to the natural world. TCM physicians always consider the seasonal physiological changes when distinguishing the abnormal body signs from the normal ones.
The pathogenic features of the six TCM evils
Seasonal influences are important inducing factors for many diseases too, for example, respiratory infections and nose bleeding are common in spring, heat strokes and digestive problems are common in summer, malaria and dysentery tend to occur in autumn; arthritis and respiratory problems tend to relapse in winter.
|For TCM physicians, seasonal influences on the body are important considerations when making diagnosis, selecting therapies and even suggesting preventive measures. For example, elder people who suffer from chronic cough or panting are likely to feel better in spring and summer, but feel worse in autumn and winter. Their conditions are usually due to weakened spleen and kidney, and warming herbs are indicated, physicians will suggest them to take preventive measures in hot summer, so that in winter, their conditions are less likely to relapse, or the symptoms can be less severe and in shorter duration. In other cases, people with blood deficiency and hyperactive liver are likely to experience dizziness, distending headache, blurred vision, ear ringing and mental fatigue in spring. Winter is the season where the body conserves energy and builds strength as a prelude to spring. TCM will advise the patients eating more nourishing and tonic foods in winter for prevention.
Ephedra Decoction is a common prescription for common cold.
Geographic influences: People in different geographic regions live with different lifestyles, customs and cultures, thus they develop particular body constitutions and susceptible to particular health problems. In Northwestern highlands of China, people tend to have a stronger constitution. When they are sick, their body is likely to be cold outside but heat inside, thus dispersing external coldness and clearing internal heat are often necessary in the treatment. In Southeastern coastal regions of China, people tend to have a weaker constitution, and are particularly susceptible to skin problems and seasonal infections. Physician often consider the geographic and dietary influences on the patient's body when giving a treatment. TCM herbal applications often reflect the geographic differences, take common cold as a sample, in the frigid zone of Northwest China, a larger dosage of potent warming herbs such as ephedra and cassia twig are often used, while in the temperate zone of Southeast China, mild warming herbs such as schizonepeta herb and ledebouriella root are used and the dosage is relative smaller.
Social and life influences: Technology and social progress has created many new health problems, stress is a part of modern life. We are constantly overwhelmed by demands at work and home, and challenged by social turmoil, life changes, financial and interpersonal issues. A combination of these factors puts extra strain on our mind and spirit, and also drains the body's reserves. Health is achieved only when the body is in balance which includes the physical, emotional and mental aspects. Overreacting psychological activities can easily disturb the organ functioning, as time passes some real physical damage will occur. The psychological damage to internal organs and resulting psychosomatic ailments (i.e. insomnia, stomach upset) are of primary concern by TCM physicians.
TCM has a unique concept about mind and body connection, stress and mental distress are considered to be the usual factors that affect disease development. Excess psychological factors are known as the "seven emotions" which include joy, anger, sadness, anxiety, worry, fear and fright. Each of the emotions interacts with particular internal organs and affects qi activities differently, leading to different disharmony patterns. Clinically, patients with mental problems such as depression, insomnia and anxiety often respond to TCM treatment, which may be combined with conventional medication or used alone under proper supervision of physicians.
From the above, we can see that TCM holistic approaches are based on the views of whole-body, whole-person, whole-world. Under the guidance of holistic concept, all aspects must be considered when treating a problem, only a comprehensive analysis on the patients' physical condition, age, lifestyles, medical history, career and mental state can a correct diagnosis be made and then treated properly.
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Li Qizhong (edited & complied), Elaboration of TCM Basic Theories, Publishing House of Shanghai Traditional Chinese Medicine University, 2006.
Qin Bowei (compiled), Elementary Chinese Medicine, People's Medical Publishing House, 2006.
Fang Yaozhong (compiled), Plain Speeches on TCM Basic Theories, People's Medical Publishing House, 2007.
Cai Jianying (edited & complied), Summaries on Ancient and Modern Philosophical Concepts of TCM, Chinese Medicine Science and Technology Publishing House, 2005.
Rose Tse, Integrated Chinese Medicine Holdings Ltd.