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What Is Traditional Chinese Medicine? ⋅ Treating the Whole Person
The Body According to TCM:
Qi (“chee”) ⋅ Meridians ⋅ Organs ⋅ Blood and Other Fluids ⋅ Temperature
The Tools of TCM:
Acupuncture ⋅ Diet ⋅ Herbs ⋅ Bodywork
When Sandra Struthers was in her 30s, she suffered from chronic urinary-tract infections (UTIs). She saw a string of doctors and specialists who performed numerous tests, yet the problem persisted: No amount of cranberry juice, supplements, or behavior modification helped. “They told me it was likely a persistent, low-grade infection that never cleared and was becoming resistant to antibiotics, and that I’d probably be incontinent by the time I was 50,” she recalls.
That’s when she decided to try acupuncture, a key modality of Traditional Chinese Medicine (TCM). “I went every week for two to three months, and it just . . . fixed it,” says Struthers, now 49 and a clinical intern in marriage and family therapy in St. Paul, Minn. “I haven’t had that kind of chronic UTI issue since.”
She also turned to acupuncture to address her insomnia and poor temperature regulation, and credits her acupuncturist with helping her identify her specific constitution.
“A lot of Western-medicine doctors are quick to offer prescriptions for drugs, but my Chinese-medicine doctor was the first one to explain to me, ‘This is how your body is built, and this is what it needs to function optimally.’ She was able to help me understand and accept the body I was given instead of fighting against it.”
Western medicine is ideal for acute health issues, such as a heart attack, infection, or injury. “But a lot of chronic disorders are really disorders of poor communication, coordination, and synchronization,” says Jill Blakeway, DACM, LAc, founder and director of the Yinova Center in New York City and the author of Energy Medicine: The Science and Mystery of Healing. “Chinese medicine lives in that area.”
Complex conditions such as chronic pain, hormonal imbalances, reproductive health issues, autoimmune disorders, digestive problems, migraines, and mood disorders are all good candidates for TCM.
“If someone feels that something’s not right within their body, mind, emotions, or spirit, I would recommend they give TCM a shot and see if this is something that can help,” says Megan Odell, LAc, MS, acupuncture lead at the Penny George Institute for Health and Healing.
What Is Traditional Chinese Medicine?
A system of thought and practice that originated in China, TCM has evolved over at least 3,000 years. Acupuncture may be its best-known element, but TCM also encompasses medicinal herbs, dietary and lifestyle recommendations, bodywork, and movement modalities such as tai chi.
Some of the earliest writings on medicinal herbs appeared in a classical poetry text called Shi Jing, from the Western Zhou dynasty period of roughly 1,046–771 BCE. Later, around 300 BCE, accumulated knowledge of diagnostic practices and treatments, including acupuncture, was recorded in foundational texts such as the Huangdi Neijing (The Yellow Emperor’s Classic of Internal Medicine).
Today, TCM and Western medicine are practiced alongside each other in many hospitals and primary-care settings in China. There are also TCM-specific medical schools and hospitals where illness is treated with herbs, acupuncture, diet, massage, and mind–body practices.
In the United States, acupuncture and tai chi are now recognized by the National Institutes of Health (NIH) as effective complementary modalities. The Cleveland Clinic, Minnesota’s Allina Health System, and other medical centers have incorporated elements of TCM into their services.
Between 2002 and 2012, the number of acupuncture users in the United States increased by 50 percent. In 2012 (the most recent year for which data is available), 6.4 percent of American adults said they had used acupuncture, and 1.7 percent had used it in the past year.
TCM has undergone some of the most thorough testing of all complementary and alternative therapies, and a large and growing evidence base supports its efficacy.
TCM’s principles can sound pseudoscientific to someone accustomed to a Western medical approach. But TCM has undergone some of the most thorough testing of all complementary and alternative therapies, and a large and growing evidence base supports its efficacy.
In 1997, the NIH acknowledged acupuncture for its value in relieving pain and for providing relief from nausea after surgery or chemotherapy. It also noted that it “may be useful as an adjunct treatment” for addiction, stroke rehabilitation, headache, menstrual cramps, pain, osteoarthritis, and asthma.
Acupuncture can support mental health as well. A 2013 study found that electroacupuncture (in which mild electric currents are transferred through the needles) was as effective as the antidepressant medication Prozac in easing symptoms of depression and that it acted more quickly. MRIs have shown that acupuncture can lead to observable changes in the brain, with certain acupuncture points correlating with specific cerebral areas.
The choice between Western medicine and TCM is not a binary one; these two approaches can be potent in combination.
And Odell often cares for patients who are undergoing cancer treatment. She describes this work as complementing the protocols used by her oncology colleagues.
The choice between Western medicine and TCM is not a binary one; these two approaches can be potent in combination. “TCM doctors aren’t competition for Western doctors,” Blakeway notes. “We’re both part of the jigsaw puzzle of healing.”
Treat the Whole Person
Western medicine often trains its sights on agents of disease that need to be vanquished, such as viruses or cancer cells, while TCM considers the entirety of a person’s body, mind, and spirit. “Doctors of Chinese medicine look at illness and disharmony in the context of the whole body,” Blakeway says.
Conventional Western medicine offers a reductive way of thinking about the body, Odell notes, which can be helpful in a crisis like a rampant infection or stroke. “Western medicine says, ‘We’re going to wean out all this stuff we don’t care about and winnow down to clarity on this specific thing that’s going on.’”
Yet a narrow focus isn’t as effective for health conditions involving multiple bodily systems, which make up the majority of what ails us.
“Chinese medicine tips the conventional Western approach on its head,” says Odell. “We look at everything that’s going on with someone — their mood, digestion, sleep, and symptoms — and say, ‘What’s the pattern?’”
“Chinese medicine tips the conventional Western approach on its head,” says Odell. “We look at everything that’s going on with someone — their mood, digestion, sleep, and symptoms — and say, ‘What’s the pattern?’”
Blakeway describes a plane flying toward its destination: “It doesn’t fly in a straight line. The pilot course-corrects to respond to wind and weather. Your body course-corrects like that all the time, and for the most part, it does an excellent job.”
Still, the body may need guidance to get back on track. That’s where TCM comes in.
Chinese-medicine practitioners frame imbalances in the body using eight principles: hot and cold; internal and external; deficient and excessive; and yin and yang.
Yin, for instance, describes all the body’s qualities that are receptive, cooling, and nourishing, Blakeway explains, while yang is all the ways the body is active, warming, and able to create change. If yin is deficient, one might get overheated and dry. Deficient yang might manifest as poor circulation and excessive cold.
“You want to have yin and yang in a dynamic balance — that’s the aircraft course-correcting as it flies toward the airport. It’s what your body is doing all day,” says Blakeway.
The Body According to TCM
These are other key concepts that inform the TCM understanding of the body.
Qi
Some have speculated that the concept of the Force in Star Wars is based on qi (pronounced “chee”). Qi is a life force — the intelligent consciousness of the cosmos itself. “Mountains, plants, and human emotions all have qi,” explains Ted Kaptchuk, OMD, author of The Web That Has No Weaver: Understanding Chinese Medicine.
“Qi is the basic building block of existence,” Odell adds. Many TCM practices focus on “building qi” and ensuring it behaves properly to support overall health.
Qi initiates and accompanies all movement, protects and warms the body, and ensures stability. A healthy body has not only enough qi but qi that flows in the right direction. “It needs to be flowing smoothly through the body in the directions it’s supposed to be moving,” says Odell. Nausea might represent rebellious stomach qi, for instance — energy moving up when it’s supposed to move down.
“Qi can get stuck, stagnated, or weak,” adds Di Guan, LAc, DAOM, who practices acupuncture and Chinese medicine at Shén Acupuncture and Meditation Studio in Minneapolis. “Qi stagnation can lead to pain, irritability, anxiety, depression, or poor sleep. Qi weakness or deficiency might show up as heart palpitations, shortness of breath, poor digestion, or fatigue.”
Meridians
During an acupuncture treatment, a practitioner places needles in the body along energetic channels called meridians. They form an invisible lattice that links all the organs and parts of the body; qi and blood travel through these channels.
“You can understand meridians as highways inside our body,” Guan explains. “We have more than 400 acupoints on our body, including acupoints that are on meridians and some extra points that are not.”
When the notion of meridians was introduced to the West, people thought they were a kind of imaginary construct, says Blakeway. “But these days, we know that the body communicates electromagnetically internally. And in fact, meridians follow the path of the fascia plains.”
Fascia is the connective tissue that surrounds all the body’s vital organs, muscles, bones, and nerve fibers; researchers have explored this network as the anatomical basis of meridians. “Fascia has a high water content, so it’s electroconductive, and it can create charge too. This is one of the ways the body communicates internally,” she explains.
Blakeway notes that embryos form through electromagnetic communication — even before the formation of the nervous system. “While the embryo is constructing itself, it forms these little nodes that are more electroconductive than the tissue around it. It turns out the major acupoints are in the same places as these embryological nodes. This slightly more electromagnetic tissue that was used to create us can also be used to maintain us.”
Organs
TCM takes a broad view of the body’s organs. Rather than considering the liver a fixed mechanical structure, for instance, TCM defines it by the activities and qualities associated with it as well as by the way it interacts with other organs, such as the spleen, kidneys, lungs, and heart.
TCM sees the liver as responsible for the smooth flow of all the emotions, qi, and blood, and holds that it suffers under excessive mental stress. When the energy of the liver is stagnated, it causes downstream problems for digestion, among other things.
It can also correspond to excessive anger, which is the emotion associated with the liver in TCM. A treatment plan for digestive issues accompanied by irritability might consist of stimulating the liver with herbs and diet as well as encouraging the healthy expression of anger.
Blood and Other Fluids
As with the organs, TCM understands blood differently from Western medicine. Blood is the nurturing yin counterpart to qi’s motivating yang; it’s the fluid that moistens and maintains the body.
“TCM pays a lot of attention to the quality of the blood because it’s what nourishes all the other tissues. Diet is a big factor in the quality of the blood, and we have a whole category of herbs called blood tonics,” Blakeway says.
TCM also categorizes lymph, phlegm, mucus, saliva, and sweat as fluids that, like blood, help keep tissues flexible and balanced. They can also become stuck or stagnated.
Along with jing, or essence (the subtle substance responsible for our growth and development), and shen (our consciousness or spirit), blood, fluids, and qi represent the “five substances” in TCM.
“The five vital substances contribute to each other, and they can actuate or transform into each other,” Guan notes. “By regulating qi, we can regulate the others as well.”
Temperature
“Ancient Chinese culture was largely agrarian, so they used a lot of words and concepts that were important to an agrarian society, like cold, dampness, wind, and heat,” Odell explains.
Symptoms of a common cold might translate to symptoms of wind and heat in TCM. Wind opens the pores of the body, allowing a pathogen to enter. And heat might express itself as yellow phlegm that looks like it’s been cooked down or as a burning sensation in the throat.
Using the principles of yin and yang, balance is restored by introducing the opposite qualities. “If someone is presenting in that wind and heat way, we’d have them eat foods that are more cooling in nature,” Odell explains. “Their friends might be telling them to eat chili peppers and ginger, but if their cold is actually in the heat territory, they should be having cool things like peppermint.”
There are also colds that fall under the “cold” category, according to TCM, and those do benefit from stimulating spices. (For more about treating colds with TCM, see “11 Foods to Eat When You Have a Cold.”)
The Tools of TCM
TCM practitioners use a range of tools to remove obstacles and help reestablish balance in the body.
Acupuncture
If the meridians are the body’s highways, Guan says, then acupuncture needles are like traffic conductors. Acupuncturists insert thin needles (usually painlessly) into specific points to help direct blood, fluids, and energy where they need to go.
“We want to keep traffic flowing smoothly and evenly,” she explains. “Whenever we feel there’s a qi deficiency, we use needles to direct qi toward that area to ‘tonify’ it. Where there’s a stagnation, we use needles to disperse it.”
Acupuncture treatments are highly customized and are tailored to the patient’s pattern of imbalance. Still, not every pattern is unique, and some are especially common. As a student, Odell observed a professor from China sigh deeply after a busy day of seeing patients. “Why does everyone here in the United States have the same pattern?” he asked.
“He was describing liver–spleen disharmony, which is what we often see when people have poor diets, stress, and repressed emotions,” Odell says. Perhaps unsurprisingly, this pattern often exists alongside symptoms of depression and poor digestion.
In TCM, there’s no distinction between the mind and body, and practitioners don’t perceive thoughts or emotions as causing physical symptoms, or vice versa. Instead, mental, emotional, and physical symptoms arise together, like a traffic jam, and acupuncture helps get things moving again.
Diet
As a baseline, TCM generally recommends a “clear, bland diet” to facilitate digestion. “Think of the stomach as a stew pot,” Odell says. Easily digested foods can be “metabolized and transformed into qi, and the waste easily removed.”
TCM mostly eschews cold, raw, processed, fried, and oily foods as too much work for the digestive system. “You want to emphasize broth-based soups, stews, cooked vegetables, a little bit of meat — things that are going to be warm and nourishing,” she notes.
And depending on a person’s specific pattern of imbalance — whether an excess or deficiency of heat or cold — a practitioner may make dietary recommendations for counterbalance. Onion, garlic, ginger, chilies, red meat, coffee, and spices such as cumin, turmeric, cayenne, and coriander are considered warming in TCM. Sweet fruits, bitter greens, leafy vegetables, raw foods, and peppermint are considered cooling.
Herbs
A key component of medicine, herbs are often prescribed in combination with acupuncture to correct imbalances. “We have more than 300 herbs we can use, and each one has its own properties or characteristics, from cold to cool to warm to hot,” Guan says.
Notably, in the TCM context, “herbs” describes more than plants. Herbal formulas may also come from stones, minerals, or animal products, and they typically contain multiple ingredients in synergistic combinations. “We have a thick book of formulas that go back 2,000 years,” Odell says. Practitioners who make their own herbal formulas may tweak them to address the needs of a particular patient.
Bodywork
TCM uses a variety of movement and massage modalities to facilitate the smooth flow of qi, blood, and fluids:
- Qigong integrates posture, movement, breath, and self-massage to promote qi generation and circulation.
- Tai chi incorporates fluid movements to move qi along the meridians.
- Acupressure involves applying manual pressure, instead of acupuncture needles, to acupoints.
- Cupping applies cups to the skin to create suction. It’s like “massage in reverse,” says Blakeway. “It’s pulling up instead of pushing down, lifting the fascia to create more space so fluids can run through and clean out debris.”
- Moxibustion involves heating a sage-like herb called mugwort and holding it above an area of the body to warm it. “Moxa has a very penetrating infrared heat that goes into the muscle and can be particularly relieving,” she explains.
- Gua sha involves rubbing a spoon or specialized stone repeatedly against the skin. The goal is to reduce stagnation and increase circulation of qi, promoting the body’s ability to remove debris and restore tissue.
Give It a Try
A first appointment with a TCM practitioner will have some notable differences from a standard medical visit. You’ll likely be asked to fill out an extensive questionnaire and health history in advance, with questions about your primary complaint, what makes it better or worse, your diet, exercise habits, sleep, stress level, mood, family history, and any other symptoms. The provider will then target specific areas for follow-up questions.
At the appointment, the practitioner will likely observe your complexion, body composition, and the color and coating of your tongue. They may also pay attention to the smell of your breath and the sound of your voice — whether it’s shouty or singsong, forceful or whispery. All these observations offer information on your qi and the balance of yin and yang.
They will also likely feel your pulse. “Each wrist has three sections, and each section has three layers. Every section represents a different organ system,” Guan says. There are 28 pulse types, according to Shicai Li, a Chinese-medicine doctor who lived about 350 years ago; each provides insight into possible excesses or stagnation in the body.
“Combining all the information we get subjectively and objectively from these methods, we diagnose you with your pattern and decide what acupoints and herbal treatments will address that imbalance,” Guan adds.
Many treatment plans call for one to three visits per week for several weeks. Depending on the circumstances, you may notice an improvement in symptoms soon after the first visit, or it may take a few treatments before you feel better. Healing with TCM is like so many things: Slow and steady wins the race.
This article originally appeared as “The Healing Path of Traditional Chinese Medicine” in the July/August 2023 issue.
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Good information.