What is Traditional Chinese Medicine?

Traditional Chinese Medicine (TCM) is a complete medical system that has been used to diagnose, treat, and prevent illnesses for more than 2,000 years. TCM is based on a belief in yin and yang, defined as opposing energies, such as earth and heaven, winter and summer, and happiness and sadness. When yin and yang are in balance, you feel relaxed and energized. Out of balance, however, yin and yang negatively affect your health.

Practitioners also believe that there is a life force or energy, known as qi (pronounced "chee"), in every body. For yin and yang to be balanced and for the body to be healthy, qi must be balanced and flowing freely. When there is too little or too much qi in one of the body's energy pathways, called meridians, or when the flow of qi is blocked, it causes illness.

The ultimate goal of TCM treatment is to balance yin and yang by promoting the natural flow of qi. In an interesting analogy, often used to explain its nature, qi is described as the wind in a sail, we do not see the wind directly, but we are aware of its presence as it fills the sail.

What is the history of TCM?

The first writings about TCM date back to 200 BCE. Herbal medicine and acupuncture, including theory, practice, diagnosis, and treatment, were recorded in classical Chinese texts and refined over many centuries.

The practice of TCM stayed in Asia for centuries. Chinese immigrants had been practicing TCM in the United States since the mid-19th century, but its existence was unknown to most Americans before 1971. That year, New York Times reporter James Reston, who was in China covering former President Nixon's trip, had to have an emergency appendix operation. After the operation he received acupuncture for pain, and his stories about this experience with TCM fascinated the public. Since then, TCM has gone on to become a mainstream alternative medicine practiced all over the world.

How does TCM work?

Disease, alterations in the normal flow of qi such that yin and yang are imbalanced, is thought to have three major causes: external or environmental factors, your internal emotions, and lifestyle factors, such as diet. Through the use of its therapeutic modalities, TCM stimulates the body's own healing mechanisms. Practices used in TCM include:

• Acupuncture and acupressure
• Moxibustion, burning an herb near the skin
• Herbal medicine
• Nutrition
• Chinese massage, called tui na
• Exercise, such as tai chi and qi gong which combine movement with meditation

In TCM, the body's internal organs are thought of not only as individual structures but also as complex networks. According to TCM, qi flows through organ systems, the kidneys, heart, spleen, liver, lung, gallbladder, small intestine, and large intestine, by way of meridians. Despite their specific names, these 5 systems correspond to more than individual body parts. The kidney, for example, represents the entire urinary system along with the adrenal glands, located on top of the kidneys. The heart, meanwhile, represents both the heart and the brain.

What should I expect on my first visit?

The TCM practitioner will ask you questions about your medical history and do a physical exam to look for signs of imbalance. The TCM practitioner will examine your skin, tongue, and hair, as well as other parts of your body, from the brightness of your eyes to the color of your nails, and check 6 pulses on each of your wrists. The practitioner will also listen to your voice to assess your shen (spirit), and will work to determine if one or more of your organ networks are affected. The practitioner then tries to correct imbalances in your body by providing a combination of the therapies discussed above.

What is TCM good for?

Over the centuries, TCM has been used to treat countless conditions. Western scientists are still studying its effectiveness for various diseases. For serious conditions, make sure you are working with a conventional doctor along with a TCM practitioner. Always let everyone on your health care team know about any medicines, herbs, or supplements you are taking. Some of the conditions for which TCM is known to be helpful include:

• Obesity
• Diabetes and its complications, such as retinopathy (damage to the retina located in the back of the eye)
• High cholesterol
• Depression
• Arthritis
• Back pain
• Male and female fertility disorders
• Alzheimer disease
• Parkinson disease
• Digestive disorders such as irritable bowel syndrome
• Recurrent cystitis, inflammation of the bladder
• Nausea and vomiting
• Heart disease

TCM may also be an effective treatment for the following ailments:

• Allergies
• Asthma
• Cancer, especially colorectal cancer
• Stroke
• Sinusitis
• Addictions
• Pain, including childbirth and abdominal
• Menopausal symptoms
• Osteoporosis
• Infections (respiratory, bladder, vaginal)
• Sleep problems
• Stress
• Constipation
• Diabetic neuropathy
• Epilepsy

Is there anything I should watch out for?

You should not take Chinese herbs without supervision, especially if you are pregnant or breastfeeding. Chinese herbal products, particularly those manufactured outside of the United States, are often poorly labeled, and important information may be missing. Some Chinese herbal products contain drugs not listed on their labels. For example, some Chinese herbal creams that are used to treat eczema contain steroid medications. Also, be on the alert for Chinese herbal medicines containing aristolochic acid. This acid, derived from an herb, has been linked to cases of kidney failure, and even cancer. Also, some Chinese herbs have been reported to contain heavy metals, such as lead, cadmium, and mercury. Adverse reactions from Chinese herbal medicine and TCM have increased in recent years. Acute liver injury caused by Chinese herbal medicine accounts for almost 22% of total injuries.

A trained and certified TCM practitioner can identify herbs that are safe to take. The practitioner should also explain the potential side effects of the herbs they prescribe. Always tell your doctor about any herbs or supplements you are taking.

How can I find a qualified TCM practitioner?

The following organizations can help you locate a qualified practitioner in your area:

• The American Association of Acupuncture and Oriental Medicine -- www.aaaomonline.org
• The National Certification Commission for Acupuncture and Oriental Medicine -- www.nccaom.org
• The Institute of Traditional Medicine -- www.itmonline.org

What is the future for TCM?

There are more than 50 Oriental medicine training programs in the United States. Future research studies and clinical trials on TCM are needed to find out exactly how it works, and its effectiveness, safety, and cost.

Ahn AC, Bennani T, Freeman R, Hamdy O, Kaptchuk TJ. Two styles of acupuncture for treating painful diabetic neuropathy -- a pilot randomised control trial. Acupunct Med. 2007;25(1-2):11-7.

Allen JJ, Schnyer RN, Chambers AS, et al., Acupuncture for depression: a randomized controlled trial. J Clin Psychiatry. 2006;67(11):1665-73.

Casimiro L, Barnsley L, Brosseau L, et al., Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005;(4):CD003788.

Chen KW, Hassett AL, Hou F, Staller J, Lichtbroun AS. A pilot study of external qigong therapy for patients with fibromyalgia. J Altern Complement Med. 2006;12(9):851-6.

Efferth T, Li PC, Konkimalla VS, Kaina B. From traditional Chinese medicine to rational cancer therapy. Trends Mol Med. 2007; [Epub ahead of print].

Ernst E. Methodological aspects of Traditional Chinese Medicine (TCM). Ann Acad Med Singapore. 2006;35(11):773-4.

Ezzo J, Streitberger K, Schneider A. Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting. J Altern Complement Med. 2006;12(5):489-95.

Ferro MA, Leis A, Doll R, Chiu L, Chung M, Barroetavena MC. The impact of acculturation on the use of traditional Chinese medicine in newly diagnosed Chinese cancer patients. Support Care Cancer. 2007; [Epub ahead of print].

Guo XY; Liu J, Liu J, et al. Use of traditional Chinese medicine in Chinese patients with coronary heart disease. Biomed Environ Sci. 2013;26(4):303-10.

Hijikata Y, Yasuhara A, Yoshida Y, Sento S. Traditional Chinese medicine treatment of epilepsy. J Altern Complement Med. 2006;12(7):673-7.

Huang ST, Chen AP. Traditional Chinese medicine and infertility. Curr Opin Obestet Gynecol. 2008;20(3):211-5.

Kennedy S, Jin X, Yu H, Zhong S, Magill P, van Vliet T, Kistemaker C, Voors C, Pasman W. Randomized controlled trial assessing a traditional Chinese medicine remedy in the treatment of primary dysmenorrhea. Fertil Steril. 2006;86(3):762-4.

Lahans T. Integrating Chinese and conventional medicine in colorectal cancer treatment. Integr Cancer Ther. 2007;6(1):89-94.

Leung AY. Traditional toxicity documentation of Chinese Materia Medica -- an overview. Toxicol Pathol. 2006;34(4):319-26.

Li Q, Zhao D, Bezard E. Traditional Chinese medicine for Parkinson's disease: a review of Chinese literature. Behav Pharmacol. 2006;17(5-6):403-10.

Li X, Brown L. Efficacy and mechanisms of action of traditional Chinese medicines treating asthma and allergy. J Allergy nd Clin Immunol. 2009;123(2).

Liu HX, Wang SR, Lei Y, Shang JJ. Characteristics and advantages of traditional Chinese medicine in the treatment of acute myocardial infarction. J Tradit Chin Med. 2011;31(4):269-72.

Qunli W, Zhicheng L. Acupuncture treatment of simple obesity. J Tradit Chin Med. 2005;25(2):90-4.

Ratcliffe J, Thomas KJ, MacPherson H, Brazier J. A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis. BMJ. 2006;333(7569):626.

Ried K, Stuart K. Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility; a systematic review. Complement Ther Med. 2011;19(6):319-31.

Shi J, Liu YL, Fang YX, Xu GZ, Zhai HF, Lu L. Traditional Chinese medicine in treatment of opiate addiction. Acta Pharmacol Sin. 2006;27(10):1303-8.

Tan KY, Liu CB, Chen AH, Ding YJ, Jin HY. Seow-Choen F. The role of traditional Chinese medicine in colorectal cancer treatment. Tech Coloproctol. 2008;12(1):1-6.

Tong XL, Dong L, Chen L, Zhen Z. Treatment of diabetes using traditional Chinese medicine: past, present and future.Am J Chin Med. 2012;40(5):877-86.

Wang J, Zhou C. Research progress of Chinese herbal medicine and traditional Chinese medicine resulting in liver injury. Zhongguo Zhong Yao Za Zhi. 2011;36(23):3371-4.

Wayne PM, Krebs DE, Macklin EA, et al., Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study. Arch Phys Med Rehabil. 2005;86(12):2248-55.

Wu B, Liu M, Liu H, Li W, Tan S, Zhang S, Fang Y. Meta-analysis of traditional Chinese patent medicine for ischemic stroke. Stroke. 2007;38(6):1973-9.

Xu L, Lao LX, Ge A, Yu S, Li J, Mansky PJ. Chinese herbal medicine for cancer pain. Integr Cancer Ther. 2007;6(3):208-34.

Yang KH, Kim YH, Lee MS. Efficacy of Qi-therapy (external Qigong) for elderly people with chronic pain. Int J Neurosci. 2005;115(7):949-63.

Yang YF. Cohort study on the effect of combined treatment of traditional Chinese medicine and Western medicine on the relapse of the metastasis of 222 patients with stage II and III colorectal cancer after radical operation. Chin J Integr Med. 2008;14(4):251-6.