Traditional Chinese Medicine

What is it?

Traditional Chinese Medicine (TCM) is the modern term for a medical system originating from approximately 2500BC. It comprises five areas of intervention:

• Diet;

• exercise (T’ai Chi or qigong);

• massage (acupressure or Tui Na);

• acupuncture;

• Chinese herbal medicine. [end bullets]

Although originating in China it has spread throughout Asia and is now used by about one quarter of the world’s population. Variations can be found in Japan, Vietnam and Korea.

Diagnosis

This involves four areas:

• Inspection: visual inspection including mental state (spirit) and excretions. Tongue diagnosis is also undertaken.

• Listening and smelling: listening to the patient, including breath and heart sounds as well as smelling the breath, body and excreta odours.

• Inquiry: Includes taking a comprehensive medical history. This covers sensations of hot and cold, perspiration, diet, excreta, headache, body aches, chest, thirst, previous illnesses and medications.

• Palpation: palpation of acupuncture points, general palpation of the body including pulse diagnosis.[end bullets]

Treatment

This follows three principles:

• Treating the disease from the root cause;

• eliminating evil influences (external pathogens);

• restoring the balance of Yin and Yang. [bullets]

The aim of treatment is the rebalancing of disharmonies within the body specifically the opposing elements of Yin and Yang by the harmonising of the vital force, Qi within the body.

Disharmonies may present as excess/deficiency or stasis and can be caused by internal factors such as the seven emotions (anger, joy, sadness, grief, pensiveness, fear and fright) or external factors such as wind, cold, damp, fire and heat.

Treatment includes

• Reducing excess;

• correcting deficiencies;

• expelling external factors;

• eliminating stasis by removing blockages.

TCM also subscribes to the five element theory, in which the human body is regarded as a microcosm of the universe and patients may be treated according to their affinity with a key element.

A range of interventions such as acupuncture, moxibustion, herbal remedies, diet and exercise might be used as appropriate.

Evidence base

Evidence for the efficacy of TCM is predominantly based on tradition and empirical observation but also, more recently on clinical trials which support its effectiveness in the treatment of eczema (Chen, 2007), cancer pain (Xu et al, 2007) and chronic prostatitis (Chen and Hu, 2006).

Safety

Contra-indication/interactions may occur with orthodox medication/treatment.

Some Chinese herbal products may interact with each other, and many interact with conventional pharmacological medication. Of particular concern are the safety standards of imported herbs and there have been a number of adverse reports either because the herb was toxic or it had been mixed with conventional drugs (Batra, 2006; Berrin et al 2006l; Abt et al, 1995; Dickens et al, 1994).

Training

TCM is a six-year medical degree and is available at a number of universities in the UK. For accredited courses see Association Traditional Chinese Medicine www.atcm.co.uk

References

Abt, A. et al (1995) Chinese herbal medicine induced acute renal failure. Archives of Internal Medicine; 155: 2, 211-212.

Batra, S. (2006) Serious cutaneous adverse reactions to traditional Chinese medicines. Singapore Medical Journal; 47: 7, 647.

Berrin, Y. et al (2006) Multi-organ toxicity following ingestion of mixed herbal preparations: an unusual but dangerous adverse effect of phytotherapy. European Journal of Internal Medicine; 17: 2, 130-132.

Chen, H. (2007) Treating eczema with traditional Chinese medicine. International Journal Clinical Acupuncture; 16: 3, 201-204.

Chen, J. Hu, L. (2006) Traditional Chinese Medicine for the treatment of chronic prostatitis in China: a systematic review and meta analysis. Journal of Alternative and Complementary Medicine; 12: 8, 763-769.

Dickens, P. et al (1994) Fatal accidental aconitine poisoning following ingestion of Chinese herbal medicine: a report of two cases. Forensic Science International; 67: 1, 55-58.

Xu, L. et al (2007) Chinese herbal medicine for cancer pain. Integrative Cancer Therapies; 6: 3, 208-234.

Further reading

Maciocia, G. (2007) The Practice Chinese Medicine (2nd ed). Edinburgh: Churchill Livingstone.

Maciocia, G. (1989) The Foundations of Chinese Medicine. Edinburgh: Churchill Livingstone.

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