Chinese Medicine: A Healing Tradition
Traditional Chinese Medicine (TCM) is one of the most complex, highly-developed traditional healing theories in the world. The major components of TCM are acupuncture and herbal medicine. Other aspects include acupressure massage, exercise systems such as Tai Chi (pronounced “tie chee”) and Chi Gung, and theories about architecture and interior decoration known as Feng Shui (pronounced “fung shwee”).
TCM attracts many people today because of its holistic emphasis, its ancient origins, and its Eastern feel. However, as yet there is only limited scientific evidence that it actually works.
History of Chinese Medicine
Primitive acupuncture needles dating back to around 1000 BC have been discovered in archeological finds of the Shan dynasty in China. The theoretical framework underlying the practice of acupuncture was first set forth in the Inner Classic of Medicine, or Nei Jing, first published in 206 BC. Chinese herbal medicine received its first rudimentary theoretical foundations at about the same time, but it was not until the twelfth century that the depth of medical theorizing associated with acupuncture was fully applied to herbal treatment.
Over subsequent years, both acupuncture and herbal medicine evolved greatly, with major changes occurring at different points in history. The 19th century was a time of ferment, and many “traditional” techniques popular today actually originated during that period. A further major revision took place during the Maoist period in China.
Principles of Traditional Chinese Medicine
Traditional Chinese medicine is an all-embracing system that—at least in theory—encompasses every aspect of human existence. According to the principles of TCM, health exists when life-energy (“Qi”) flows freely and the opposing forces of “yin and yang” are balanced.
Exercise systems such as Tai Chi and Chi Gung are said to help maintain this healthy flow. Feng Shui principles are said to provide the proper living environment to enhance health. Acupuncture and Chinese herbal medicine are used to restore balance and free flow of energy when it has become disturbed.
The Practice of Traditional Chinese Medicine
Acupuncture involves the use of hair-thin needles inserted in specific spots on the body called acupuncture points. These points are chosen according to the principles of TCM. Their application is not based on the Western concept of the disease involved. Acupuncture is practiced primarily by certified acupuncturists, although other health professionals may use it as well.
Chinese herbal medicine involves the use of complex, herbal combinations. Again, these combinations are chosen according to the specific pattern of imbalance in the individual. Acupuncturists often prescribe Chinese herbs, and there are also people who practice Chinese herbology alone.
Tai Chi and Chi Gung involve special movements and ways of breathing. These methods are usually taught in group classes, and daily practice is necessary for the best results.
The art of Feng Shui involves arranging the living situation so that the outer circumstances support health. It can be learned in classes or from books. Feng Shui counselors are also available.
In theory, TCM can address all possible physical, psychological, and spiritual problems. It is primarily used to treat long-term chronic conditions (eg, rheumatoid arthritis and menopausal symptoms), as well as some acute or recurrent conditions that are not life threatening (such as menstrual pain, migraine headaches, and colds and flus). TCM is also widely used to promote wellness and prevent disease.
At present, there is no meaningful scientific evidence that the overarching principles of traditional Chinese medicine reflect true insights into health. There is some evidence, however, that certain TCM therapies may be helpful for specific conditions.
Acupuncture in particular has undergone a great deal of study. Reasonably good evidence tells us that acupuncture treatment (or the related therapy, acupressure) can help reduce nausea in certain circumstances. Acupuncture has also done fairly well in a limited number of studies that tested its ability to treat tendonitis and osteoarthritis. For other uses of acupuncture, however, the supporting scientific evidence is incomplete and contradictory at best.
Chinese herbal medicine has undergone much less scientific evaluation. For most conditions studied, at most two double-blind trials have been reported, and even these were generally not up to current scientific standards. Weak evidence of this type hints that Chinese herbal treatment may be helpful for allergies, asthma, constipation, menstrual pain, muscle spasm, and osteoarthritis. Studies conflict on whether Chinese herbal medicine may be helpful for eczema. Evidence suggests that it is not helpful forirritable bowel syndrome.
Limited evidence hints that the practice of Tai Chi and Chi Gung may enhance overall well being, especially in seniors.
Acupuncture appears to be a relatively safe form of medicine as long as it is practiced appropriately. However, there are serious safety concerns regarding traditional Chinese herbal therapy.
Chinese herbal medicine traditionally uses treatments that are now recognized as potentially dangerous, such as mercury, arsenic, lead, licorice, and the herb Aristolochia. In Hong Kong, poisoning caused by the herb aconite (used in numerous Chinese herbal formulas) was sufficiently widespread that public health authorities felt it necessary to launch an information campaign to combat the problem.
Besides toxicity caused by Chinese herbs, other problems have been caused by adulteration of herbal products with unlisted ingredients. For example, the Chinese herbal formula PC-SPES, used for prostate cancer, turned out to contain three pharmaceutical drugs—diethylstilbestrol (DES), warfarin (Coumadin), and indomethacin. In another episode, eight out of 11 Chinese herbal creams sold in the United Kingdom for the treatment of eczema were found to contain strong pharmaceutical steroids.
For all these reasons, considerable caution is advisable when using traditional Chinese herbs.
National Center for Complementary and Alternative Medicine
National Institutes of Health
Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research
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Last reviewed March 2008 by Richard Glickman-Simon, MD
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