Western medicine, introduced to China by 16th-century missionaries, gradually threatened to overtake traditional healing. However, the establishment of the People's Republic in 1949 led to a revival of herbalism, acupuncture, and other ancient medicinal skills, known collectively as Traditional Chinese Medicine. In China, TCM is now taught at universities and practiced in all hospitals alongside Western methods. Its popularity is growing fast in countries with a large Chinese community, such as the US, the UK, and Australia.

KEY PRINCIPLES

 

The concepts of holism, of yin and yang, and of the "five elements" are the three most important principles of TCM.

 

TCM views the body holistically, as an integrated whole, so problems in one area affect other areas, just as treating specific problems benefits the system as a whole. Running through the body are meridians, a network of channels carrying qi, or "life energy". The organs of the body are nourished by the so-called "vital substances": qi, blood, body fluids, and "Kidney essence"; all govern growth and sexuality, and determine the general constitution of each individual. Yin ("moon" or "overcast") and yang ("sun" or "sunshine") symbolize opposing but complementary forces in nature (see opposite and page 91). Each continually changes into its converse, just as day turns into night, and one helps define the other; without day, we would not know what night was. When the dynamic of yin and yang in the body is disturbed and either one becomes excessive, disease or emotional problems follow. Factors that may provoke a disturbance include infection, accidents, emotional states, poor diet, pollution, even the time of year and weather conditions.

Yin and yang can be further divided into interior (yin) / exterior (yang), deficiency (yin) / excess (yang), and cold (yin) / hot (yang). Together, these categories form the eight principle patterns of potential disharmony, a diagnostic framework used to categorize symptoms. For example, a slow pulse is a "cold" symptom. The treatment principle is to "scatter the cold," bringing yin and yang into balance.

 

Another key concept in TCM is that of the five elements or five phases - fire, earth, metal, water, and wood. The qualities represented by the five elements can be ascribed to all things in the universe, including the body's internal organs. The Chinese concept of an organ is broader and less literal than its Western equivalent. Just as one element will support or inhibit the function of another (water dowses fire; fire melts metal), so one organ affects another. The kidneys (water) control the heart (fire); the heart controls the lungs (metal).

 

Herbal remedies are used to rebalance these forces within the body. Herbs are classified under the five elements according to taste, each of which denotes a medicinal action: sweet, sour, bitter, pungent, and salty. The opposing yin/yang qualities of hot and cold are also linked with the action of specific herbs. Baical skullcap (huang quin), for example, is a bitter, "cold" herb, used to lower fever. Each herb is said to work in specific organs and related meridians, and with "tendencies of action": floating and sinking, ascending and descending. An herb with an "upward" action would be used to treat a "sinking" disorder, such as diarrhea.

Extensive clinical trials of various herbs and formulas have been carried out in China. Most persuasive for Westerners, however, has been the recent success of Chinese herbs in treating eczema, described in the British Journal of Dermatology in 1992.

Dr. David Atherton and Dr. Mary Sheehan, consultants in dermatology at the Hospital for Sick Children, London, undertook a study of 47 children with severe atopic eczema. Dr. Ding Ho and another Chinese herbalist, Dr. Guang Xu, devised the standardized herbal formulas prescribed. Most children's eczema showed a 60% improvement within four weeks, with no side effects (despite concern that certain herbs could cause liver damage). Interestingly, some children who did not respond to the standardized remedy proved to be responsive when their formulas were individually adjusted.

 

A further trial with adult atopic dermatitis at the Royal Free Hospital, London, published in The Lancet in 1992, supports these findings.

While interest has been sparked by studies such as those described above, the focus of conventional medicine on the physiological causes and symptoms of illness makes it difficult for doctors to understand concepts such as yin, yang, and qi. Drug companies are seeking to exploit some Chinese herbs, but many doctors are concerned about the possible side effects of certain remedies.

The initial consultation may take as long as an hour. Your health is assessed by means of the "Four Examinations" of TCM: Looking: The practitioner observes all the visible evidence of your state of health, particularly your tongue, the tone of your skin and hair, and the way you move. Listening and smelling: The sound of your voice and breathing is noted, as is any distinctive body odor. Asking: The practitioner asks about your family history, habits, body functions, and any symptoms of poor health. Pulse-taking and touching: The pulse is checked for quality, rhythm, and strength. Areas of discomfort or pain are examined by touch.

 

The diagnosis hinges on your unique pattern of disharmony. While a Western doctor might diagnose many people as suffering from high blood pressure, the TCM practitioner would take into account particular factors such your pulse rate, the condition of your tongue, teeth, and urine, and how well you eat and sleep. On the basis of the diagnosis, she will prescribe an herbal remedy tailored to your individual pattern of disharmony, possibly supplemented with acupuncture.

 

In TCM, herbs are rarely prescribed singly, but are generally taken as a formula - a standard prescription may have 10-15 herbs with a history of treating a particular pattern of disharmony. Each herb in the formula has a different role, and each is classified according to its taste and temperature. Practitioners often adapt a basic formula, adding other herbs to suit the patient's age, constitution, and pattern of disharmony.

 

Remedies are usually taken as herbal teas, prepared in daily doses, but herbs may also be prescribed as pills, powders, pastes, ointments, creams, and lotions.