CHINESE TRADITIONAL MEDICINE

An Alternative and Complementary Medicine Resource Guide

Contents:

 Introduction
  A Brief History of Traditional Chinese Medicine
  Basic Principles
     Acupuncture
    The Five Element Theory
    The Eight Guiding Principles
    Diagnosis
    Chinese Herbs
    Massage
    Diet and Exercise
 Books
Journals
Professional and Referral Organizations
 Training and Treatment Centers
Web resources

INTRODUCTION

A BRIEF HISTORY OF CHINESE TRADITIONAL MEDICINE

The roots of Chinese Traditional Medicine (also referred to as TCM) date back more than 2000 years.  Its rich history tells of the many influences on its development, including the Japanese, Europeans, and the Communist revolution.   The changes that followed these influences explains why both terms--Traditional Chinese Medicine and Traditional Oriental Medicine (TOM)--are seen in the literature.  Although these two terms are sometimes used interchangeably, TOM generally refers to the system of Chinese medicine practiced until the early 1900s.   Up until this period, Chinese medicine had witnessed great growth, but also decline, as Western influence expanded and the training of traditional medicine grew poorer and more limited.

The Communist party of China was formed under the leadership of Chairman Mao in 1928 and took over power in 1949.  The Communits realized that there were little or no medical services and actively encouraged the use of traditional Chinese remedies because they were cheap, acceptable to the Chinese, and used the skills already available in the countryside.  In 1940, Yang Shao proposed to "scientificize" and "popularize" Traditional Chinese Medicine.   Since then, this resurgence has opened facilities in China to provide, teach, and investigate Chinese Traditional Medicine.  While both Western and Chinese medicine have been practiced in China since the late 1800s, the traditional Chinese approach to medicine began to grow in popularity in the West in the 1970s, when ties to China opened.

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BASIC PRINCIPLES

Acupuncture is the practice that most often comes to mind when thinking of Chinese medicine, but TCM represents a much broader system of medicine that includes herbs, massage, diet and exercise therapy. The underlying basis of TCM is that all of creation is born from the interdependence of two opposite principles, yin and yang (see the Eight Guiding Principles below).  These two opposites are in constant motion, creating a fluctuating balance in the healthy body.   Disease results when either yin or yang is in a state of prolonged excess or deficiency.

One of the body constituents is Qi (pronounced "chee"), which is the energy that gives us the ability to move, think, feel, and work.  Qi circulates along a system of conduits, the principle ones being channels or meridians.  There are twelve principle bilateral channels of Qi, each intimately connected with one of the viscera of the body, and each manifesting its own characteristic Qi (e.g. Liver Qi, Gallbladder Qi, etc.).  When the flow of Qi becomes unbalanced through physical, emotional, or environmental insults, illness may result.

TCM practitioners are trained to view the body, mind, and spirit as one system, as opposed to Western medicine practitioners, who are taught to regard each of these elements as separate.  Despite TCM's dramatically different approach, Westerners have been drawn to its practice because of its emphasis on healing the whole person and seeking the root cause of illness.  However, Westerners do often find it difficult to translate a TCM diagnosis or remedy into the western practice of medicine with which they are familiar.  For example, there is no direct translation for how a TCM practitioner might explain a patient’s condition as "cool with dampness," or an "imbalance in water," with a need to "tonify the kidneys" or "replenish Qi".

Traditional Chinese Medicine is a complex system that requires many years of training to master.  This guide serves as an introduction to the practice of TCM, providing additional resources for your research.

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ACUPUNCTURE

Acupuncture is the insertion of needles into the skin at specific points in order to affect the flow of energy.  Although acupuncture is the practice most often associated with Traditional Chinese Medicine, it is not limited to the Chinese culture.  The Japanese and Koreans developed their own form of acupuncture with modifications, such as needle-less and trigger-point acupuncture.

Because of the breadth of the practice of acupuncture, a separate guide has been developed (see Acupuncture Resource Guide).

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THE FIVE ELEMENT THEORY

The five element theory, also called the five-phase theory, holds that everything in the universe, including our health, is governed by five natural elements: wood, fire, earth, metal and water. This theory underscores the Chinese belief that human beings, both physically and mentally, are intertwined with nature. Although it is difficult for Westerners to relate this philosophy to the Western approach to medicine, it is fundamental to the understanding of Traditional Chinese Medicine.

In the five element theory, each of the five elements has a season and particular organs and senses associated with it, such as taste, color, sound. The wood element, for example, is associated with spring, the liver, and the gall bladder.   Similarly, the fire element is associated with early summer, the heart, and small intestines; the earth element corresponds to late summer, the stomach and spleen; metal is associated with autumn, the lungs and large intestine; and water is associated with winter, the kidneys and bladder.

In contrast to Western medicine's teaching of a separation between the mind and body, TCM views each organ as having particular body and mind functions, as illustrated in the belief that the liver is involved in planning, and in the storage of anger, while the gall bladder is the organ of decision-making.

To determine a patient’s composition of the five elements, a TCM practitioner asks many detailed questions that will provide clues as to the nature of their imbalances. They will ask about the person’s occupation, stress associated with it, what they like to eat, what physical problems they are experiencing, etc. Although a person may be oriented towards a particular element -- a person who is aggressive might be described as having a "wood" personality -- the Chinese believe that aspects of each of the five elements are present in every person at different times.

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THE EIGHT GUIDING PRINCIPLES

In addition to the theory of the five elements, TCM practitioners employ the Eight Guiding Principles to analyze and differentiate the energetic imbalances in the body or the nature of a patient’s condition. The eight guiding principles actually consist of four polar opposites: yin/yang, cold/heat, deficiency (xu)/excess (shi), and interior/exterior.

	Cold/Heat: This principle is used to determine the overall energy of the patient. A cold condition would be one marked by a slow metabolism, chills, pale skin, and a low-grade fever, while a hot condition would be characterized by a heightened metabolism, sensations of heat in the body, high fevers, and a flushed complexion.
	Interior/Exterior: This principle describes symptoms in terms of the location of the patient’s problem. Exterior conditions are those caused by the invasion of the body by pathogens, and are usually acute and superficially located with a short duration. Exterior symptoms are those that affect the hair, skin, muscles, joints, peripheral nerves and blood vessels. Interior conditions result from pathogens that enter the interior of the body. Interior symptoms affect the organs, deep vessels and nerves, brain, spinal cord, and bones.
	Deficiency/Excess: This principle describes the strength of an illness. In TCM, a deficient condition would be viewed as a lack of blood (such as in anemia), energy (Qi), heat, or fluids. Chronic illness would fall in this category. An excess condition, by contrast, means that the body has too much of something, such as Qi or blood. In TCM, an acute condition would be seen as an excess condition.
	Yin/Yang: These principles are the generalization of the above principles, and a condition can be categorized in terms of the relative dominance of either yin and yang.  In Chinese medicine, all organisms have both yin and yang qualities and a balance of the two is necessary for good health. In general, yin energy is associated with cold, female energy, and represents the solid organs.  Yang is associated with hot, male energy, and represents the hollow organs.  Chronic illness is seen as yin, while acute illness is seen as yang.

According to TCM, the combination of these principles determine the nature or quality of the three consituents of the body, which are energy (Qi), moisture, and blood.  As described above, Qi is vital life energy.  Moisture is the liquid medium which protects, nurtures, and lubricates tissue, and blood is the material foundation out of which we create bones, nerves, skin, muscles, and organs.

TCM practitioners diagnose health problems using various combinations of the eight guiding principles.  For example, a patient might be diagnosed as having an "internal cold" or "external heat" condition. Used in conjunction with the five element theory, the eight guiding principles give the TCM practitioner a more complete picture of a patient’s energy imbalances and determine the treatment to be pursued through acupuncture, herbs, diet, and exercise.

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DIAGNOSIS

The diagnosis of a patient’s condition in TCM consists of three activities: an extensive interview, pulse diagnosis, and a tongue examination.

	Interview: The first step in diagnosing a patient’s condition is an extensive interview by the TCM practitioner.  In addition to seeking information about the patient’s complaints, the practitioner will ask detailed questions about such issues as quality of sleep, dreams, appetite, preferred foods, and stress.  The practitioner is also trained to use the senses of observation, listening, and smelling.  Although smell is often camouflaged in the West by perfumes, deodorants, and breath mints, the Chinese believe it provides further knowledge about a person's health.  In the Five Element Theory, each element has a corresponding smell associated with it.
	Pulse Diagnosis: Whereas Western doctors locate one pulse on the radial artery in the wrist, a practitioner of TCM feels for six pulses in each wrist: three superficial and three deep at specific points along the radial artery. The twelve pulses correspond to the internal organs.   For example, a deep pulse reading on the left wrist corresponds, top to bottom, to the heart, liver and kidney. Practitioners note the quality of the pulse in terms of frequency, rhythm, and volume and the Chinese have developed an elaborate vocabulary to describe a pulse, such as floating, thready, and slippery. Pulse taking requires years of training to master and is considered one of the most important diagnostic tools in Chinese medicine.
	Tongue Examination: In addition to the pulse, the Chinese believe that the tongue is a strong barometer of human health. They developed an elaborate system to describe the condition of the tongue, including the color, texture, shape, size, and coating.  A very red tongue indicates a fever or inflammation and is described in TCM as an excessive internal heat or dampness condition. A white tongue indicates some kind of deficiency of energy (Qi), blood, or moisture. In this system, each part of the tongue corresponds to the condition of an organ. The tip of the tongue, for example, represents the heart and lung organs.

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CHINESE HERBS

In China, herbal remedies are used as much as acupuncture to treat energy imbalances and illness. When considering the appropriate herbal remedy for a patient, practitioners of TCM apply medical theory - the Five Elements and Eight Guiding Principles - along with tongue and pulse diagnosis.

Herbs used in Chinese medicine are derived from plant, animal, and mineral substances.  Although plant-derived herbs, such as ginseng and ginger, are the most common, minerals and animal parts such as oyster shells, deer antlers, and bear gall bladder are also prescribed.  In China, herbs in powder form are boiled and made into a tea.  In the West, TCM practitioners often premix the herbal remedy or supply the herb in pill form, especially for those patients who find the bitter taste intolerable.

Herbs have four basic qualities and properties: nature, taste, affinity, and primary action.

	Nature: An herb's nature is often described as cooling or heating, but it can also be described as moistening, relaxing, and energizing. The peppermint herb, for example, has a cooling energy, and is used to lower the metabolism or reduce gas and bloating.
	Taste: Herbs are categorized by five tastes -- sour, bitter, sweet or bland, spicy, and salty, and herbs representing different tastes are used to treat different conditions.  Dandelion and goldenseal are two bitter herbs used for their drying properties in treating upper respiratory conditions.
	Affinity: This property refers to the affinity that an herb has for a particular organ network.
	Primary action: This property refers to the effect of a particular herb.  An herb may be used to dispel (move), astringe (restrain), purge (expel), or tonify (strengthen).

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MASSAGE

All hospitals in China that are devoted to Traditional Chinese Medicine include a massage clinic along with acupuncture and herbal medicine. Chinese massage was developed over 2,000 years ago and was popular in the Tang, Ming, and Qing dynasties. The Chinese call this therapeutic bodywork tui na, which literally means "push" and "pull".

Tui na works with the energy system in the body (Qi), which flows through channels called meridians.  By stimulating or subduing the energy in the body, practitioners help bring the patient’s body back into balance. To determine what meridians need work, tui na practitioners feel the patient’s wrist pulse.   Because it is based on the same meridian points as acupuncture, tui na is often called "acupuncture without needles."

Two popular styles of tui na practiced today are the rolling and one-finger methods.

	Rolling Method: This style was developed in Shanghai and is used for joint and soft tissue problems, as well as insomnia, migraines, and high blood pressure.
	One-Finger Method: This style is similar to shiatsu, practitioners push points along the meridians with the tip of the thumb or finger. This method is often used for chronic and internal problems, pediatrics and gynecological problems.

The Chinese believe that tui na regulates the nervous system so that Qi flows properly, boosts the immunological Qi of the body, and flushes metabolic waste out of the body.  It is a popular part of the practice of TCM in China because it is both comfortable and effective.

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DIET AND EXERCISE

In Traditional Chinese Medicine, diet and exercise play an important role in maintaining good health by contributing to an optimum balance of vital life energy (Qi).  In fact, the Chinese believe that diet is one of the three origins (diet, heredity, and environment) or sources of qi.  Therefore, according to TCM, the foods we eat directly influence the excesses and deficiencies in our bodies.

Unlike the American diet, which emphasizes a balance of protein, carbohydrates, and fats, the Chinese approach to diet is grounded in the five element and eight guiding principles theory.  Foods are seen as having yin and yang, warming and cooling, drying and moistening properties.  Certain foods are better for some people than others, depending on their type and condition.  A person with a "cold damp" condition should not eat a diet of raw fruits and vegetables (which are yin), because they would further exaggerate the loss of body heat and fluid secretion.

Conversely, foods that are fried, broiled, high fat, or spicy are seen as warming (yang) because they generate heat and stimulate circulation. A person whose diagnosis is "hot dry" should avoid these foods, according to TCM.

In general, the Chinese approach to diet is to optimize digestion and increase qi, moisture, and blood, and aid the organ function. In this sense, it can be seen as an extension of herbal medicine.

In addition to diet, TCM includes a form of exercise called Qi gong, which is believed to optimize the flow of Qi in the body.  Qi gong incorporates posture, movement, breathing, meditation, visualization and conscious intent in order to cleanse or purify the qi.

There are two types of Qi gong practiced: internal and external.

Internal Qi gong: Used by individuals to maintain health by regulating Qi and harmonizing the internal energy of the body.  Internal Qi gong uses certain movements and breath work or visualization to gather and circulate Qi in the body.

External Qi gong: The practice of transferring the practitioner’s Qi to another person for healing purposes. This form of Qi gong is similar to other body work modalities in the West, such as therapeutic touch.

The movement postures of internal Qi gong have become the most common form of practice today and have been used as the basis for Tai Chi and other martial arts practices.

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NOTE: The following resource listings are not intended to be comprehensive, nor to be used as a guide for treatment.  They are provided for information only.  The resources are selected and categorized to help you with your own research.

BOOKS

Book Contents:

General Titles
Acupuncture
The Five Element Theory
Tongue and Pulse Diagnosis
Chinese Herbs
Massage
Diet and Exercise

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GENERAL TITLES

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ACUPUNCTURE

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THE FIVE ELEMENT THEORY

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TONGUE AND PULSE DIAGNOSIS

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CHINESE HERBS

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MASSAGE

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DIET AND EXERCISE

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JOURNALS

Acupuncture Journals
http://www.amfoundation.org/acupuncture.htm
See our resource guide on Acupuncture.

American Journal of Traditional Chinese Medicine and
Chinese Journal of Integrated Traditional and Western Medicine
http://www.relaxingnaturalhealth.com/
This site lists two research journals and one newsletter on clinical practice in which abstracts have been translated from the Chinese.

Chinese Medical Sciences Journal
http://www.tandf.co.uk/journals/tf/10019294.html
The journal publishes original research papers, review papers and short communications on almost every branch of basic and clinical medicine, pharmacology and traditional Chinese medicine.

Clinical Acupuncture and Oriental Medicine
http://www.harcourt-international.com/journals/caom/
The first international peer-reviewed quarterly journal to provide clinical information on the clinical practice, research, research reviews, educational issues, and management of clinical problems of acupuncture and oriental medicine.

Journal of Chinese Medicine
http://www.jcm.co.uk/
This quarterly English language journal provides professional and student-level information on the field of Traditional Chinese Medicine, including treatment of diseases, Chinese medical theory and practice, case reports and analysis, and book reviews.

Qi: The Journal of Traditional Eastern Health and Fitness
http://www.qi-journal.com/
A quarterly publication distributed internationally, specializing in Eastern healthcare practices.  This website has a complete and categorized listing of research links-click on "Research & Links."

The following alternative and complementary medicine journals contain occasional relevant articles:

Alternative Therapies in Health and Medicine
http://www.alternative-therapies.com
A bimonthly clinical research journal with particular emphasis on mind/body approaches to wellness.

Journal of Alternative and Complementary Medicine
http://www.liebertpub.com/publication.aspx?pub_id=26
This peer-reviewed journal includes clinical trials, observational and analytical reports on treatments outside the realm of allopathic medicine.

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PROFESSIONAL AND REFERRAL ORGANIZATIONS

American Association of Oriental Medicine (AAOM)
http://www.aaom.org/
433 Front Street
Catasauqua, PA 18032
Toll-Free: (888) 500-7999
Phone: (610) 266-1433
Fax: (610) 264-2768
Email: aaoml@aol.com
The AAOM was formed to be the unifying force for practitioners of Oriental medicine in the U.S., and pledges to honor and support  the integrity of Oriental medicine by advocating excellence in professional standards.  Click on "Referral List" to see a state-by-state list of practitioners.

American Oriental Bodywork Therapy Association (AOBTA)
http://www.healthy.net/pan/pa/bodywork/
1010 Haddonfield-Berlin Rd, Suite 408
Voorhees, NJ 08043
Phone: (856) 782-1616
Fax: (856) 782-1653
Email: AOBTA@prodigy.net
The AOBTA is a national non-profit professional association of practitioners of Bodywork Therapies of Asia, including Five Element Shiatsu and Tuina.

Community Acupuncture Network
www.communityacupuncturenetwork.org
P.O. Box 18157
Portland, OR 97218
Email: info@communityacupuncturenetwork.org
CAN's mission is to make acupuncture more affordable and accessible by promoting acupuncture clinics around the country that provide low-cost acupuncture services. The organization has hundreds of acupuncturist members, and dozens of clinics are listed on its website.

National Academy of Acupuncture and Oriental Medicine (NAAOM)
http://www.naaom.org/
44 Linden Street
Brookline, MA 02146
Email: info@naaom.org or acupuncture@mercynet.edu
The NAAOM aims to provide a common forum for discussion and development of research, education, and scientific excellence in acupuncture and oriental medicine.

National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
http://www.nccaom.org/
11 Canal Center Plaza, Suite 300
Alexandria, VA 22314
Phone: (703) 548-9004
Fax: (703) 548-9079
Email: info@nccaom.org
This organization is responsible for managing a national certification examination, a requirement for licensure in the majority of states.  The site provide information on the examination and a searchable data base of practitioners.

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TRAINING AND TREATMENT CENTERS

Academy of Oriental Medicine at Austin (AOMA)
http://www.aoma.edu
2700 W. Anderson Lane, Suite 204
Austin, TX 78757
Phone: (512) 454-1188
Fax: (512) 454-7001
Email: admissions@aoma.edu
The goal of the academy is for the students to understand the philosophies of Western and Oriental medicine as they develop their intuitive healing skills.  AOMA strives to graduate dedicated and integrated healers, who will balance their strong didactic education and extensive clinical training with compassion and sensitivity toward their patients.
Offers degree: Master of Acupuncture and Oriental Medicine.

American College of Acupuncture and Oriental Medicine (ACAOM)
http://www.acaom.edu
9100 Park West Drive
Houston, TX 77063
Phone: (713) 780-9777
Toll-free: (800) 729-4456
Fax: (713) 781-5781
Email: acaom@compuserve.com
Offers an M.S. in Oriental medicine.

American College of Traditional Chinese Medicine (ACTCM)
http://www.actcm.edu/
455 Arkansas Street
San Francisco, CA 94107
Phone: (415) 282-7600
Fax: (415) 282-0856
Email: info@actcm.edu
The ACTCM is a private independent graduate school preparing candidates to enter the practice of traditional Chinese medicine, instilling in graduates the theoretical structures and analytical abilities necessary for continued professional learning through their practice, and providing graduates with an understanding of bioethics and professional responsibilities.

New York College of Traditional Chinese Medicine
http://www.nyctcm.edu
155 First Street
Mineola, NY 11501
Phone: (845) 258-1732
Email: admissions@nyctcm.edu
Offers ACAOM accredited combined Bachelor/Masters degree programs in acupuncture and Oriental Medicine.

Pacific College of Oriental Medicine
http://ormed.edu/
Pacific College is the largest school of Oriental medicine in the nation, offering a four-year Master's degree program.  This school is accredited by the Accreditation Commission for Acupuncture and Oriental Medicine, and its graduates are eligible for state licensure and national certification.

Chicago Campus:
Pacific College of Oriental Medicine
3725 North Southport
Chicago, IL 60613
Toll-Free: (888) 729-4811
Phone: (773) 477-4822

New York Campus:
Pacific College of Oriental Medicine
915 Broadway, 3rd Floor
New York, NY 10010
Toll-Free: (800) 729-3468
Phone: (212) 982-3456

San Diego Campus:
Pacific College of Oriental Medicine   
7445 Mission Valley Rd., Suite 105
San Diego, CA 92108
Toll-Free: (800) 729-0941
Phone: (619) 574-6909
Fax: (619) 574-6641

Northwest Institute of Acupuncture and Oriental Medicine (NIAOM)
http://www.niaom.edu
701 North 34th Street, Suite 300
Seattle, WA 98103-8800
Phone: (206) 633-2419
Toll-free: (877) 207-5875
Fax: (206) 633-5578
E-Mail: folks@niaom.edu, admissions: admissions@niaom.edu
Offers an M.S. in acupuncture and in Traditional Chinese Medicine.

Schools and Institutes of Chinese Medicine
http://www.itmonline.org/pdf/acuskool.pdf
A state-by-state listing of 67 schools and institutes in the U.S. and Canada, all of which have 4 to 18 years of experience.

The Wellspring Center for Eastern Healing Arts and Education
http://www.thewellspring.org
1514 W. Franklin St.
Boise, ID 83702
Phone: (208) 388-0206
Email: wellspring@thewellspring.org
The goals of the Wellspring are to inspire enthusiasm for wellness of body, mind and spirit, to provide education in the theory and practice of wholistic health and Classical Chinese Medicine, and to be a cohesive healthcare community of practice focused on East Asian medical principles.  Some of the services offered include TCM, acupuncture, and Chinese Herbal Therapy.

See our Acupuncture Resource Guide for many more colleges and training centers in acupuncture and Traditional Chinese Medicine.

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WEB RESOURCES

NOTE: Promotional and commercial sites are not included in this listing unless they provide significant impartial information resources.

Chinese Medicine Sampler
http://www.ChineseMedicineSampler.com/
Learn about Chinese medicine principles, such as tongue/pulse diagnosis, the five elements, herbal medicine, and more.   Click on "Diagnostic Questionnaire"  to obtain a mock diagnosis by a USA national board certified M.S. in Oriental medicine for a fee.

Healingpeople.com-Chinese Medicine
http://www.healingpeople.com/ht/topicResults.tmpl?ct=1&tt=chinemed
Formerlly known as acupuncture.com, this site has many useful links to all aspects of Traditional Chinese Medicine.  Click on "Professional and Student Resources" for links to resources on continuing education, professional organizations, schools of chinese medicine, and more.

HealthWorld Online: Traditional Chinese Medicine
http://www.healthy.net/CLINIC/therapy/Chinmed/Index.asp
Comprehensive information on TCM, including the basic principles of yin and yang, anatomy, Qi, methods of diagnosis, the five elements, and the pathogenesis of disease.

History of Traditional Chinese Medicine
http://www.mic.ki.se/China.html
Provides several links to information on TCM.

Oriental Medicine Internet Resources
http://www.holisticmed.com/www/ormed.html
Complete and categorized listing of web resources on TCM.

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