Traditional Chinese Medicine

[Orion]

Hello everyone!

As some of you may or may not know, I am a practitioner of Traditional Chinese Medicine (TCM) here in Canada and have been for the past 3-4 years or so. I've studied in China as well as in Canada and although I have a lot of experience, I consider myself to still be a novice in terms of the greater world of natural medicine!

Over the next little while I am going to be writing up some introductory material so that you can all get an idea of what the foundational principles of TCM are. If you have any questions please post them! In the mean time, please be patient as I continue to add to this thread. Thank you!

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Basic Principles
Holism: TCM is an ancient Chinese practice that focuses on holism within the body. What does this mean exactly? It means that a problem in any area of the body is interrelated to every other part.

For example, if you suffer from skin problems such as eczema, in TCM we do not simply provide a remedy for the skin. We would examine your nutrition and the state of your other organs based on our diagnosis methods to determine the root of the problem. Your skin problem could be due to a deficiency in your digestive system, resulting in not enough nutrients reaching the skin, causing a decline or dysfunction in your immune system; or maybe you have a blood circulation problem, which means that although you have good nutrition, it may not be reaching the skin level. There could be many reasons and there is no one universal cause.

And now, some badly drawn graphics! (Bear with me here!)

SCENARIO A

There are two island nations, A and B. B is coming under attack by a fleet of particularly powerful pirates. The pirates will destroy everything, loot the land, and take whatever they can. Since nations A and B are in alliance, nation A decides to attack the pirates in order to help its friend out. It sends its ships to B's waters even though it's not very familiar with them; it puts mines in the water, creates a blockade so that the pirates can't get through, and sends ships to attack the pirates directly. It calculates the exact trajectory of the pirate ships, infiltrates their vessels to find out who the pirates are and where they came from, what their strengths and weaknesses are, what language they speak, what they want, etc. This intelligence takes some time to gather but they do it anyway.

The pirates eventually spot the blockade as well as the mines in the water. Some of their ships get blown up and some get destroyed by the blockade, but eventually the rest break through and Island B, which is quite vulnerable, comes under attack and has to defend itself. Incidentally, the placement of Island A's weaponry was not perfect, and there was some collateral damage to Island B even before the pirates landed on shore.

SCENARIO B

The same scenario is presented but instead of attacking the pirates, Island A sends all of its aid and resources directly to Island B, who then in turns uses those resources as it sees fit. Because Island B knows its own territorial waters and land better than Island A ever could, it uses the resources more efficiently and knows exactly where it needs to fortify in order to prevent the pirates from entering and destroying its livelihood.

You may find yourself asking, "Is Orion really a pirate and not a TCM practitioner? What is he on about? Let me explain!

The pirates represent a foreign invader like a virus or bacterium. Island B represents your body and its immune system. Island A represents the approach of the medicine. SCENARIO A is western medicine. SCENARIO B is TCM.

Western medicine studies the virus intensely, decodes its RNA, tries to manufacture a vaccine, and needs to output new versions each year in order to keep up with viral mutations. It focuses all of its efforts on what the virus is doing and how to stop it.

The problem is that organisms like bacteria are becoming more and more resistant to our direct attacks and so we only have a few choice antibiotics left to treat the most resistant kinds. This is what happened when the SARS virus (Severe Acute Respiratory Syndrome) entered the scene in 2004. Because it is a virus you cannot use antibiotics on it, and this particular corona virus was completely immune to typical anti-viral drugs like ribavirin. Not only that, it managed to achieve worldwide infection within only a couple of months.

Western medicine uses concentrated chemical formulas and extractions that are not natural to the body and so they do not interact with it in a way that is 100% effective. Not only that, but many of those chemicals simultaneously damage the body and weaken one's immune system further, all in the single pursuit of the invader. Just like Island A does not fully know the lay of the ocean around Island B, Western Medicine can never hope to fully mimic the body's functions when fighting disease. For this reason, it is useful in alleviating symptoms and in emergency situations that require immediate intervention, but it is not effective in addressing chronic disease or drug-resistant organisms.

When a TCM practitioner looks at a sick person, they are not looking at the source of the disease. They do not need to know what species of virus or bacteria you are infected with. They do not need lab tests in order to know if certain organs in your body are suffering from deficiency or excess. As an example: in liver enzyme testing (done by blood), you can receive a passing mark even if your liver is 70% inoperative, which means that by the time a lab test comes back showing problems your liver could already be in serious trouble. TCM can detect organ imbalances long before they are detected on the radar of lab tests, and move to correct them as prevention.

All TCM practitioners care about is balancing the body. Once the body is balanced, the illness resolves because the body now has the proper resources to restore itself to equilibrium. It is for this reason that TCM is also effective preventative medicine, as you can come in for a check up even if you feel perfectly fine.

Some people ask me, "Why is it that some people can be in a room full of people who have the common cold, but never get it, while others do everything they can do avoid getting sick (like washing their hands, covering their mouths, not sharing drinks, etc.) yet still get sick?" The answer is the balance of one's body. Viruses and bacteria are opportunistic by nature. Your body is covered in bacteria from head to toe and you routinely come into contact with them in your day to day life. They can only invade you if your immune system is weakened, and you are only weakened if you are imbalanced.

In the winter of 2008, Beijing hosted a joint Western Medicine and TCM conference in order to discuss approaches to H1N1. Western researchers came to China because TCM practitioners were demonstrating the ability to prevent H1N1 at a quarter of the cost of the tamiflu vaccine as well as increase the recovery time of those infected, and they wanted to know what the secret remedy was. They became confused when confronted with the notion of holism. There is no universal remedy for H1N1, but rather each individual's body must be balanced according to its needs. Once the body is balanced, it can fight off H1N1.

In western medicine, if you have a headache you take tylenol, or aspirin; in TCM your headache could have many different causes. Instead of treating your routine headache pain, your body imbalances are corrected and you never have headaches again.

To simplify this, I will translate a TCM proverb for you:
"Two people with two different diseases receive the same treatment;
Two people with the same disease receive two different treatments."

What this means is that two people with two different diseases may receive the same treatment because the nature of their imbalance is the same; whereas two people with the same disease (like H1N1) may receive two completely different treatments because their source imbalances are different. Just because two people have H1N1, does not mean that the imbalance that allowed an opportunistic infection to enter their body is necessarily the same.

When presented with this knowledge, it created heated arguments and the conference ultimately broke down. The western researchers argued that knowing more about H1N1 - like its viral RNA sequence, its origins, how it infects cells, and that creating a vaccine - is more important. Western medicine focuses strictly on the pathology only and so the methodologies were too incompatible.

I myself believe both approaches are useful. WM analyzes diseases while TCM brings the body itself into health, but preventative medicine is extremely important in removing the opportunity for infection in the first place, and for this TCM is more skillful.

(To be continued...)

 

[Slartibartfast]

I would probably be willing to give that sort of approach a go. I have a skin disorder that all I can get for is a topical cream that I will have to use probably for the rest of my life. I would be happy for it to be gotten rid of.

 

[WI Crippler]

Personally, I have no problem with what we consider "alternative" medicine, or practices. Although I support the capitalist approach to providing healthcare, I am not a fan of the US pharmaceutical system as it relates to healthcare. Too many drugs that present more side effects than they actually treat. That is why I chose to go into physical therapy when I was mulling over a career in healthcare. I wouldn't have to administer medications, but I would still be working in a field of healthcare that is widely recognized and respected, and getting the opportunity to help people use their own functional capabilities to restore some or all of their previous function.

Now that being said, my wife is a neuro-trauma ICU nurse, and the one upside to many of these drugs that are developed is that they do save lives. Western medicine is great for trauma, and high level disease processes. The holistic approach I feel is better off for general wellness and prevention of illness as Orion stated. The body has tremendous recuperative abilities, some of which many in the west ignore or don't allow to occur as they medicate at the first sign of pain or sickness, and then do nothing else. But the body is limited in what it can do, and that is where western medicine shines.

I think that as holistic approaches become more studied and accepted by the public in general, a blending of the two systems could give us the best healthcare and wellness options of anywhere. Like many things, there is more than one path to the results we want. Pigeonholing ourselves into one or the other limits us.

 

[Orion]

WI Crippler, you raise some excellent points. Western Medicine is bar none when it comes to trauma care and illnesses at the critical stage. While it is possible to say, recuperate a wound with necrotic tissue in TCM (because TCM had to do this before western medicine ever developed), it is not the best choice in today's world. Part of the training I received in both Canada and China is knowing when to refer patients to western medicine. If they are nearing the critical stage of an illness, it is better for western medicine to treat it and then they can return to us later to strengthen their bodies as part of the recovery process. In other words, western medicine is better at acute, serious conditions.

It is my experience that TCM is better for chronic, non-life threatening conditions than western medicine is. The majority of the complaints coming from people's first hand experience with western medicine relates to the management and maintenance of their ongoing diseases, but not really curing them. They are told that there are no cures or that the reasons for the disease are unknown without ever mentioning to patients that there may be alternative approaches.

I also believe that a synergy of western and eastern medicine would be in the best interest of everyone, but one of the main problems with doing so is that the foundational theories in the two systems are completely incompatible. How TCM arrives at a diagnosis is completely different than WM. They would have to learn to work side by side than to integrate, IMO. In China, there are TCM hospitals, WM hospitals, and then there are hospitals that combine the two. The latter is a more recent development. They have departments for chronic care and for acute care. You can use either and both refer patients to one another.

A good example of a synergistic approach is using chemo therapy to aggressively fight cancerous tumors in the body while using TCM to balance the body and offset the harmful effects of the chemo.

 

[MKULTRABOY]

Im not gonna read what everyone wrote because Im a lazy asshole. But Im gonna say that acupuncture cured my duodenal hyperacidity, and now Im going to use it to quit smoking.

So meesays I likez it.

 

[WI Crippler]

A good example of a synergistic approach is using chemo therapy to aggressively fight cancerous tumors in the body while using TCM to balance the body and offset the harmful effects of the chemo.

I recently did a clinical rotation at a sub-acute geriatric rehabilitation clinic. The therapy team always made it a point to monitor how much pain medicine the patients were on, even though we have no business administering it. Particularly early on when they had just arrived from an acute care site. In the beginning, it was paramount that these people had their pain pills/shots. Pain control is a top priority early on in rehab. When we would get patients that hadn't taken it, it made it more difficult to work with them. But over time, we could work with them on less and less pain medication, as their surgery or trauma healed and physical therapy activities increased. Without early pain management strategies, doing therapy would be monumentally difficult and without movement, people could develop things like adhesive capsulitis in joints staying at rest, not to mention other pathologies that creep in with extended bed rest.

Within the field of physical therapy, there is a trend towards preventative therapy in a limited scope. There are pre-pregnancy programs designed for women to prevent things like imbalance due to joint laxity, pelvic floor dysfunction, etc... as well as pre-surgery therapy to get a patient in the best physical shape/situation prior to surgery to make post-surgical recovery more effective. We also always do a fall prevention program with any elderly person regardless of fall risk, as well as home assesments to see what they can do at home to prevent injuries or falls. The results of those programs(which are reimbursed by third party payers) have been very positive. Hopefully we'll see a trend towards prevention in our healthcare system. There are programs out there available, but people are typically ignorant of them and don't take advantage. Prevention in the US seems to be more of a personal responsibility, which is fine, but the education on prevention is lacking(although I would say its improving over the last 10 years or so).

 

[digsbe]

I think TCM can have its benefits. But as a premed student I would prefer western medicine. Western medicine also focuses on being holistic. We have immune boosting drugs and encourage people to eat foods with vitamins that boost the immune system. The body's immune system is truly a spectacular and powerful thing, but sometimes it needs help. Many diseases such as cancer will not be cured by eating the right foods or powering our immune system. People with allergies suffer from an over active immune system. Although there are natural anti-inflammatory substances in nature, drugs and treatments still work better. Essentially what I am saying, is that what Eastern medicine brings us, Western medicine can do better. Although on a practical and daily level, I would say TCM has more of an advantage in that you don't need manufactured drugs or expensive equipment. I respect TCM and recognize the benefits, but in my opinion, western medicine has it beat by far.

 

[Orion]

(Basic principles cont'd)

Syndrome differentiation: treatment based on this is the distinguishing feature of TCM, and represents the application of the theory into clinical practice. It is also the manifestation of the philosophy of dialectic materialism. Syndrome differentiation refers to analyzing and summarizing the relevant information gathered from the four primary diagnostic methods: inspection, auscultation (listening to bodily sounds), olfaction (smelling), interrogation (what the client tells us), feeling pulses, and palpation (touching). All of these are non-invasive and do not require lab testing to have effectiveness. Another distinguishing method in diagnosis in TCM is tongue inspection. The reason is that your body's physical state, whether it is too hot, too cold, too dry, too damp, malnourished, retaining too much water, is suffering from poor circulation, etc., is all reflected in the tongue. There are approximately 700 types of tongue appearances that can be looked at in TCM in order serve as one effective method of knowing what is happening in the body. Each tongue can also be explained using western science for why it looks the way it does. Some western medicine diseases look at the tongue, such as in rheumatic fever where the tongue appears bright red, but it is not used as a primary diagnostic technique.

Other sub-sets of the syndrome differentiation philosophy are:

(I) The body as an organic whole: the body has many different parts but they are all related, connected, and integrated with each other in physiology and pathology. It is therefore not possible in TCM to isolate one part of the body for diagnosis and treatment while ignoring the activities and functions of the others.

(II) Each organ has a partner (traditionally called the husband-wife pair, or an internal-external pair) and the functions of one directly affect the functions of the others. The pairs are: liver and gallbladder, kidney and bladder, heart and small intestine, stomach and spleen*, lung and large intestine. So for example, the early signs of an oncoming pneumonia will be diarrhea because the lungs and large intestine are connected; digestive problems in the small intestine can branch out to the heart causing bodily pain, etc. The relationships are complex and I won't have time to talk about them all here.
* PLEASE NOTE: There was a translation problem many years ago and the Chinese word 脾 got translated as spleen, but it is actually the pancreas. So in TCM when we say "spleen" it actually means "pancreas", the organ responsible for insulin and digestive enzyme production.

(III) The principle basis of TCM diagnosis is that internal change must exhibit external manifestations, and in seeing these external manifestations we will know how to identify the syndromes and in turn the disease.

(IV) The human world and the natural world are united. Not only is a body itself organic and whole, but one's body and the natural world demonstrate the integral relationship of unity of opposites. This means that things like the seasons, the climate zone you live in, your pace of life, the foods you eat, the people you associate with, the activities you engage in, and all other external factors are related to what happens inside of your body.

You may be wondering how TCM arrived at these conclusions about the body, such as the organ relationships. The answer is time and astute observation. In ancient times, traditional knowledge was mostly gathered and accumulated in family lineages. Each family knew a piece of the puzzle about the human body as well as remedies and techniques for treating it, but these were closely guarded. There wasn't a unified body of work until the first century BCE when the Yellow Emperor's Classic (黄帝内经） was created under the Yellow Emperor. It contained the most accurate model to date of the human body, the energy pathways within it, and a base of a few hundred herbs and acupoints for treating the body. Most now believe that this was not the work of one man but a large group of doctors over the course of many decades, but nonetheless it constituted the first major work in TCM history. Over the next 1500 years, people began to test the theories found in the Yellow Emperor's Classic through clinical trials and observations.

Many people make the error of comparing TCM to folk herbal medicine and ethnobotany. It is true that TCM holds its roots in those areas because without the knowledge of local, traditional practitioners and family lineages, it would have taken far, far longer to evaluate the use of herbs for different illnesses; however, the distinguishing factor between folk medicine and TCM is a complete diagnostic system of examining the body, including anatomy, physiology, pathology, treatment, and complex, standardized procedures. All of these pre-date the rise of the school of rationality in Europe and clinical empiricism.

Like most traditional based medicines, results and benefits are based on inductive reasoning. This means that if 1,000 people use herb X to treat disease Y, and 9,500 people recover, then the herb must work. Over time, clinicians would observe closely any other effects that the herbs have other than the known ones, including the most subtle variations. The microbiological interactions of the herb on a chemical level are not important. Despite this fact, TCM developed its own methods of describing the actions of herbs based on their observations, and now many of them reside in trusted materia medica that describe both the use of single herbs, and formulas that combine herbs. (I will describe this more later.)

Western medicine uses deductive reasoning and empiricism to arrive at the validity of medicines. So for example, even if herb X cures 9,500 people and western medicine acknowledges, inductively, that it may hold curative value, it will not achieve widespread clinical use until the fine details of the nature of the herb are known down to the molecular level, including interactions with the body. It is for this reason that western medicine and herbalism in general are at odds right now, because one demands deductive reasoning as its gold standard while the other has relied on time, traditional knowledge, trial and error, and keen observation to accept the benefits. Also, there are discrepancies in the described dangers. In the herbs that western medicine has already tested, it has done so by extracting what it considers to be the active ingredient, concentrating it, and then using that concentrate on lab animals to look for side effects. If there are any adverse reactions, the herb is labeled as dangerous and may be taken off the shelf. The problem with this approach is that no herb in nature exists as a concentrate, but rather the whole plant which contains far smaller amounts of the 'key ingredient' among other substances in the plant that moderate and balance its activation that we don't know about. Our environment was designed to provide us with the perfect levels of medicine in dosages that are generally not dangerous. Not to mention, humans are not rats.

 

[Orion]

Western medicine also focuses on being holistic. We have immune boosting drugs and encourage people to eat foods with vitamins that boost the immune system.

Respectfully, it does not. Take the example I mentioned earlier of a skin condition. If you have eczema, you will be prescribed a topical ointment like hydrocortisone cream in order to alleviate it. Western medicine isolates parts of the body for study and looks for ways to apply treatments that only target the pathology. If you have a skin rash, then the treatment will target the skin rash; if you have a headache, the treatment will target the headache. Even focusing on vitamins and minerals is isolating them from the natural foods that they come from, and eating those foods as nutrition is far more effective for your body than simply taking supplements. When you say western medicine boosts the immune system, that is still isolating the immune system itself and seeing what you can do to stimulate it into action. That is not holism and that is not what TCM does. A boosted immune system may be a byproduct of balancing the body, among other benefits that are not intended as part of the treatment.

For example, someone came into our clinic two months ago seeking weight loss assistance. We said okay, we will look at your body and see what is out of balance, but they wanted an herb to help them diet. We explained that our goal in treatment is not to help you lose weight, but to balance your body. You are obese due to imbalance. In their case, they had a spleen deficiency, which meant that their body was not metabolising nutrients properly, which in turns means that their cells were lacking the key ingredients to purge wastes, burn energy effectively, etc. They are now losing weight rapidly even though they are eating more.

Vitamins and minerals would never solve that problem. TCM has developed treatments that can specifically target and strengthen the spleen. Western medicine would use drugs like stimulants, medications that prevent fat from being metabolized into the body (which actually causes further deficiency in the spleen), and caloric restriction with exercise to force the body to burn more energy. However, the root of the problem is a deficiency in one organ which can easily be solved.

Many diseases such as cancer will not be cured by eating the right foods or powering our immune system.

I think I explained in another thread a while back about what cancer actually is from a holistic medicine perspective. It is your own body's cells not receiving all of the necessary factors of life. So while I do agree that not all cases of cancer can be cured with dietary changes, many can because that is the root of the individual's imbalance which lead them to having cancer in the first place. As well, I do believe that cutting edge research in western medicine right now is mostly focusing on gene therapy as well as immuno-modulation in order to shrink cancer cells.

People with allergies suffer from an over active immune system. Although there are natural anti-inflammatory substances in nature, drugs and treatments still work better.

Again, the goal of TCM is not to simply provide an anti-inflammatory or an anti-histamine, as that is treating the symptom, not the root. As I said before, even though I cannot say there is one fixed reason for why a person's immune system is over active, one of the popular reasons I have noticed in my clinical practice is a TCM syndrome called "blood deficiency". It does not refer to a lack of blood volume but blood quality. When your white blood cells are not properly nourished, either from improper diet, improper circulation, or problems in the liver causing it to not release enough immune factors, they behave eradically and will create histamine reactions where normally they aren't necessary. Typically we treat the spleen (which generates blood) and the liver (which stores and releases blood) in the case of dysfunctional immune systems, but there can also be other causes. Stress as well as emotions such as angered are big factors because they cause the liver to not flow smoothly, and blood quality drops. The western disease called "anemia" also correlates to blood deficiency, and in TCM we often treat the liver for that too.

Essentially what I am saying, is that what Eastern medicine brings us, Western medicine can do better. Although on a practical and daily level, I would say TCM has more of an advantage in that you don't need manufactured drugs or expensive equipment. I respect TCM and recognize the benefits, but in my opinion, western medicine has it beat by far.

I don't think you can make such a sweeping statement, given that it really depends on the kind of disease we're talking about and the individual being treated. A lot of people, for example, are extremely sensitive to western medications and suffer adverse effects. There are diseases I would refer people to western medicine for, while there are others I would vehemently state that TCM should treat first. And, respectfully, based on your demonstrated understanding of the concept of holism, I don't think you really know enough about eastern medicine to be saying that western medicine is "beating it". That kind of competitive rivalry is not beneficial to the welfare of society because there are pros and cons to both approaches. Rather than white wash one over the other, it is important to evaluate which has a superior effect for which illness. Healing is the ultimate goal and if I think a western practitioner would benefit my client more, then I would encourage them to go that route. I have no room for egos in my practice. I want my clients to get better.

 

[Orion]

(Basic principles cont'd)

Five Elements Theory

In classical China, the five elements theory was used as a philosophy to describe the interactions of nature. Because the outside world is connected to our inner bodies, it was adapted for the same purpose. Here is the diagram, and I will explain what it means:

The outside represents the generation cycle, or the mother-son cycle:
- Wood is the mother of Fire (self-explanitory)
- Fire is the mother of Earth (when forests burn down they provide nourishment for the land)
- Earth generates Metal (Metal is elements of the Earth under high pressure)
- Metal generates Water (a bit obscure, but basically in ancient times, if people were able to find large mineral deposits in the ground, it would usually be near a water source; also, water condenses onto metal so it gives the appearance that the metal is generating it)
- Water generates Wood (trees need water)

In TCM philosophy, if the mother is sick, then the child will also be sick because it is not being provided for; likewise, if the child is sick, then the mother will be overburdened trying to care for the child.

The inside arrows represent the cycle of restriction or control:
- Wood controls Earth (without trees, the soil can be prone to flooding, erosion, and land slides)
- Earth controls Water (think about sand bags during a flood; Earth absorbs water)
- Water controls Fire (self-explanitory)
- Fire controls Metal (Metal under high heat will melt)
- Metal controls Wood (an axe chops wood)

If the one being controlled is sick, it may become over-restrained. If the one doing the controlling is sick, it will not properly restrain its target, and the one that should be restrained may become out of control. A good example is the liver. If the lungs (metal) become weak, they may no longer properly restrain the liver (wood), and the liver in turn may counter-restrain the lung, or attack nearby organs.

Through observation, the ancient Chinese realized that organs fit seamlessly into this system:

- Liver is generated by the Kidneys and restrained by the Lungs
- Heart is generated by the Liver and is restrained by the Kidneys
- Spleen is generated by the Heart and is restrained by the Liver
- Lung is generated by the Spleen and is restrained by the Heart
- Kidney is generated by the Lung and is restrained by Spleen

We don't strictly rely on the 5 elements theory for every aspect of diagnosis in TCM, but it provides some guidance in certain situations. For example, if someone has a lot of chronic phlegm in their lungs or suffers from routine bronchitis, we will strengthen the the lungs by tonifying the spleen. If the liver becomes too stagnant, either from alcoholism, stress, or excessive emotions like danger, it can counter-control the lung and cause breathing issues, and it can over-restrain the spleen and stomach causing big digestive problems. If the heart is weak, it will fail to provide warmth and support to the spleen (the digestive system), and nutrients will not be absorbed as effectively.

We learn the 5 elements theory because it is one of the foundational principles of TCM that guided its original work, but in the modern world we rely on many other factors too.

 

[Orion]

Yin-Yang Theory

TCM was influenced by Daoism, especially in the Tang Dynasty (618-907 AD). The foundational theory of the Yin-Yang involves the following:

1) Unity of opposites.
2) Yin and Yang represent not only two inter-opposite things or forces, but also the two inter-opposite aspects within one object or person.
3) The relationship between the two must possess both relativity and balance of properties. (Explained more in depth later.)
4) It is an intrinsic law of movement and change of things in the universe and natural world.
5) They are mutually opposing and restricting, yet mutually integrating and generating; this makes them mutually dependent.
6) They cannot exist without each other. When yin separates from yang in the body, death occurs.
7) They have a wane-wax equilibrium, which means one may become temporarily larger than the other, and in illness this is the case. They will arrive at a different equilibrium depending on the strengthening or weakening of one or both. (Explained more later.)
8) They are mutually transforming. For example, long term deficiency can transform into excess. Likewise, long term excess can transform into deficiency (i.e. high fever for pro-longed periods transforms to cold when the body functions decrease).

The most important things about Yin-Yang Theory you can remember are:
1) Generality - Yin and Yang are in all things.
2) Relativity - They are constantly changing.

Qualities of Yin and Yang

At the most basic level, Yin is water, and Yang is fire. All of the qualities residing in both can be expanded upon.

Yang: male, ascending, light weight, top, upper, light weight, outer, extroverted, excitation, aggressive, fast, bright, loud, excess, sharp pain, activity, function, forceful, hot, spring and summer.

Yin: female, descending, down, lower, bottom, heavy, material, inner, inhibited, introverted, quiet, deficiency, dull/empty pain, inactive, passive, cold, fall and winter.

You can practice finding yin and yang in your world. In your bedroom, the ceiling is yang, the floor is yin; the dark colours are yin, the light colours are yang; sources of flowing air are yang sources; sources of dampness or humidity are yin sources; if your room is too hot there is too much yang; if it is too cold there is too much yin. Balance of both means health and stability.

If you take two people, a man and a woman, and stand them side by side, we can say, based on appearances, that the man is yang and the woman is yin; however, you can take the man aside, and he has both yin and yang within him too. Then you can look at his organs and divide them into two groups. Some organs open to the outside (like the stomach and lungs) while others do not, and these are yin or yang organs. Each individual organ too has yin and yang: its material substance (yin), and its function (yang). The worlds of yin and yang can go down to the most micro level, or expand to the most macro (the whole universe). There is yin within the yin, and yang within the yang; there is yang within the yin and yin within the yang.

In illness, yin and yang have important applications in medical practice. Here are some illustrations:

A) Yin and Yang are perfectly balanced in the body. No problem.
B) Yin deficiency, which is usually caused by overwork, stress, an excessive sex life, and certain types of diseases. (Chronic fatigue syndrome tends to be related to yin deficiency.) Yin is relatively lower, which means the body is relatively hotter, even though yang is stable.
C) Yang deficiency, which tends to be caused by a long list of different things, but common reasons are a diet with too much cold food (it suppresses yang), hypofunction of the kidneys or heart, or long term yin deficiency. Recall that yin and yang are mutually dependent. This means the decline of one results in the decline of the other. Long term yin deficiency eventually leads to yang deficiency. Yang deficiency displays itself as coldness in the body, and hypofunction of the organs. However, in scenario C, yin is still stable, yang is just deficient, so in this case yin deficiency is not to blame.
D) Yang excess, the body gets hotter, however this time it is not caused by internal deficiency, it is caused by external excess. A foreign invader has entered the body and the patient is experiencing a febrile disease. It could be due to bacteria, an acute allergy, too much sun (heat stroke), etc. Whatever the external reason, the person is hot. Note that yin deficiency and yang excess both present with heat symptoms, but the causes are completely different.
E) Both yang and yin are deficient. The patient may show some deficiency-heat symptoms alongside with some hypofunction. It varies and the presentation is mixed.

It is important to note that in a case of deficiency heat or deficiency cold, the person's measured body temperature would still be stable in western medicine; however, the patient's perception of their own body would be that it's cold or hot. Three people can be in the same room but one can feel too hot, one can feel too cold, and another can feel just right. This all relates to the levels of yin and yang in each of their bodies, even though each of their temperatures would register normally at 37 degrees C.

As I said earlier, the whole body can be seen as yin and yang, but when you go down to the small levels, each organ also has its own yin and yang, and the equivalent problems. Here are some examples:

Heart yin deficiency is caused by too much worrying. The lack of yin in the heart creates a relative excess of heart yang, and the person experiences heat syndromes. Heart yang deficiency is common in people with congestive heart failure, and so heart function is decreased. When you apply the 5 elements theory (heart generates spleen and is restrained by kidney), both the kidney (water metabolism) and lung (breathing) will be affected by heart yang deficiency.

Spleen yang deficiency is caused by ingesting too much cold food, having an improper eating schedule, or an improper diet. The blood vessels in the spleen restrict and digestion is hindered. Over time the spleen itself lacks nutrition and this results in hypofunction. In the 5 elements theory, spleen generates lung and restrained by liver; if spleen yang is deficient, then lung function (breathing) and liver nutrition (blood) will be ailing.

Stomach yin deficiency looks like a lack of stomach acid and moisture. People who suffer from a native invasion of h. pylori and stomach ulcers usually have stomach yin deficiency. The relative excess of yang causes sensations of heart burn, acid regurgitation, and bad breath.

Lung yin deficiency results in a dry, hoarse cough, and is worse at night. The lung is a sensitive organ to changes in moisture, and so lack of yin causes a decline in lung function. Lung generates Kidney and is restrained by Heart. This is important in treating asthma. Asthma patients often have trouble inhaling, and in TCM this is related to kidney function. Tonifying the kidney often resolves asthma and hyperventilation. Likewise, if the lungs are deficient, then the patient will not be able to fully exhale, and so CO2 levels will increase in the blood which can lead to acidosis.

These are some basic examples stemming from yin and yang deficiency. The characteristics of each organ system play a role in how yin and yang is applied to their functions and syndromes. It gets a lot more complicated, but that's why this field takes years to study.

 

[Orion]

This is a lot of material for people to cover and I acknowledge that it might not seem straightforward.

I'll now take the opportunity to field any questions people may have about the things I wrote, or any other general questions you may have about TCM, before I continue!

 

[ludahai]

There is definately a place for TCM as a part of a comprehensive health care system. I have been to TCM doctors (and here, it is common and not considered alternative medicine) and have found it helpful and effective. However, there are also definately times for Western medicine as well -- especially for acute injuries and conditions.