Traditional Chinese medicine (TCM)
Traditional Chinese Medicine (TCM) is a comprehensive healing system rooted in the belief that health is achieved through the balance and free flow of energy, or qi, within the body. This system is multifaceted, encompassing practices such as acupuncture, herbal medicine, dietary modifications, and physical exercises like Tai Chi and qigong. TCM's principles are primarily influenced by Daoist philosophy and emphasize the interplay of yin and yang, as well as five elemental phases—wood, metal, water, earth, and fire—that can affect overall health.
Historically, TCM has evolved over thousands of years, with foundational texts like the "Inner Classic of Medicine" shaping its practices. While TCM is used globally to address chronic conditions and promote wellness, its diagnostic methods differ significantly from Western medicine, focusing on individual imbalances rather than standardized diagnoses. Despite its longstanding history, the scientific evidence supporting TCM's principles remains limited, although some specific treatments have shown efficacy in controlled studies.
In contemporary practice, aspects of TCM are increasingly integrated with Western medicine, particularly in China and Japan, where variations like Kampo have gained popularity. While acupuncture generally has a good safety profile, concerns exist regarding the safety of traditional herbal remedies. Overall, TCM represents a rich cultural tradition with diverse applications and ongoing relevance in modern healthcare.
Subject Terms
Traditional Chinese medicine (TCM)
DEFINITION: A complex healing system that reflects the belief that health exists when the body is balanced and its energy is flowing freely.
Overview
Traditional Chinese medicine (TCM) is one of the most complex and highly developed traditional healing theories in the world, rivaled in its scope only by Ayurveda. TCM comprises several parts: acupuncture, traditional Chinese herbal medicine, dietary interventions, exercise systems such as Tai Chi and qigong, and theories about architecture and interior design known as feng shui. Its principles are essentially Daoist in nature and encompass (in principle) every aspect of human existence.
History
The principles of Chinese medicine developed within the larger sphere of the Daoist religion. Primitive acupuncture needles dating to around 1000 BCE have been discovered in archaeological finds of the Shang 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 b.c.e. during the Han Dynasty. Chinese herbal medicine, however, developed somewhat later. It received its first rudimentary theoretical foundations in the first or second century c.e., but it was not until the twelfth century that the deeper principles of Chinese medicine were fully applied to herbal treatment.
Chinese medical theories involving diet follow along much the same lines as herbal theory. Essentially, each food is an herb and has its own characteristic effects on the body. (A variation of this system known as macrobiotics has become well known.)
The relative importance of the two fields has waxed and waned over time. Herbology reached a state of high development in the fourteenth and fifteenth centuries; acupuncture then reached what might be called a golden age under the Ming Dynasty in the late sixteenth and early seventeenth centuries. Subsequently, herbal medicine gained in importance; by the time acupuncture came back in vogue in twentieth-century China, it had undergone a major transformation sometimes called the herbalization of acupuncture.
The martial arts also developed within the context of Daoism and, therefore, follows principles consistent with Chinese medicine. The healing martial art known as Tai Chi is said to have been invented by the monk Chang San-Feng sometime in the Middle Ages; however, the exact dates (and even the existence of this monk) are disputed.
In twenty-first century China, various aspects of TCM are used with conventional Western medical treatment. Starting in the twentieth century, considerable attempts had been made to subject acupuncture, herbal therapy, and healing martial arts to scientific evaluation; however, most of the published Chinese studies on the subject fell far short of contemporary scientific standards. (For example, they frequently lack a control group.) In the 2010s, researchers defined three periods of TCM's increasing relevance to modern medicine, given its use around the world and potential impact on healthcare, and opportunities for the development of new drug therapies. Between the 1950s and 1970s, TCM higher education, research, and hospital networks developed in China. From the 1980s through the 2000s, legal, economic, and scientific foundations and international networks for TCM developed. Starting in 2011, the scientific basis and clinical practice of TCM began to consolidate across disciplines and regions.
In neighboring Japan, a variation of the traditional Chinese herbal system known as Kampo has become extremely popular, and many Kampo remedies have been approved for medical use by the Japanese health ministry. The scientific basis for these remedies remains inadequate, but several studies of moderately good quality have been reported.
What is traditional Chinese medicine? Traditional Chinese medicine (TCM) is an all-embracing system that, in theory, encompasses all aspects of human existence. Even a basic introduction to its principles far exceeds the scope of this article.
According to the principles of TCM, health exists when the body is balanced and its energy, or qi, is flowing freely. Qi is the life energy that is said to animate the body. The term “balance” refers to the relative factors of yin and yang, the classic Daoist opposing forces of the universe. Yin and yang find their expression in various subsidiary antagonists such as cold versus heat, dampness versus dryness, descending versus ascending, at rest versus active, and full versus empty.
In an ideal state, yin and yang in all their forms are perfectly balanced in every part of the body. However, external or internal factors can upset this balance, which then leads to disease. Chinese medical diagnosis and treatment involve identifying the factors that are out of balance and attempting to bring them back into harmony.
Besides yin and yang, there are five elements or phases that can exist in harmony or disharmony. These are translated into English as wood, metal, water, earth, and fire. Each of these elements has characteristic properties and affects various organs, personality, and overall health in unique ways.
It is important to realize that diagnosis according to TCM differs greatly from Western diagnosis. For example, one patient with a migraine headache might be said to have “dryness in the liver and ascending qi,” while another might be diagnosed with “exogenous wind-cold.” For this reason, there is no such thing as a TCM remedy for migraines per se; rather, treatment must be individualized to the imbalance determined by traditional theory.
Uses and Applications
TCM addresses all possible physical, psychological, and spiritual problems. In the West, TCM is primarily used to treat long-term chronic conditions (such as rheumatoid arthritis and menopausal symptoms) and some acute conditions that are not life-threatening (such as menstrual pain and colds). TCM is also widely used to promote wellness and prevent disease.
Scientific Evidence
There is no meaningful scientific evidence that the overarching principles of TCM reflect true insights into health. There is some evidence, however, that certain TCM therapies may be helpful for specific conditions. Nonetheless, even here there are serious problems. Studies of TCM performed in China generally fell far short of modern Western standards of scientific rigor. Furthermore, even studies performed according to the highest standards have had some inherent problems because of the nature of the treatments themselves.
That being said, the twenty-first century has seen an increase in the scientific understanding and application of TCM-derived therapies for use in evidence-based therapies around the world.
Safety Issues
Acupuncture appears to be a relatively safe form of medicine if practiced appropriately. However, there are serious safety concerns regarding traditional Chinese herbal therapy.
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