We thought we'd use this post to give folks who are interested a little background on the basic theories behind Traditional Chinese medicine (TCM). Granted, this is just a smattering of facts and interesting tidbits - information to help you, our patients, have a better understanding of how we devise our acupuncture and herbal treatments here at Stepping Stone.
In TCM theory, health is a condition of balance between Yin and Yang within the body. In general, Yin pertains to darkness, cold, moisture, grounding, feminine energy, inward reflection, rest whereas Yang pertains to daylight, movement, heat, outward and upward movement, masculine energy, growth, etc. An imbalance in Yin and Yang can result in an extreme of one set of these conditions. For example, an individual with a Yin deficiency is seen as having a relative excess of Yang signs and symptoms - he or she feels too warm, ungrounded, irritable, and/or may have difficulty relaxing or sleeping because of the lack of Yin energy. Yin deficiency is actually a common TCM pattern for perimenopausal women experiencing hot flashes and night sweats.
Another important concept in TCM is that of Qi - a difficult to translate concept that pervades TCM philosophy and is commonly translated as "vital energy". Qi is immaterial and considered "Yang"; its "Yin", or material, counterpart is Blood (capitalized to distinguish it from our Western definition of the blood that flows through our bodies). In this case, Blood is just a different type and level of energy in the body.
Qi and Blood come from our genetics, the food we eat, and the air we breath. They can be used up with vigorous exercise, lifestyle, stress, injury, chronic disease, etc. If Qi or Blood are used in excess and not replenished, deficiencies can result. For example, a person who works 80 hours a week, runs 5 miles each day, and does not eat a sufficient, healthy diet most likely has a Qi deficiency. Symptoms of Qi deficiency include fatigue, a pale face, weak digestion, frequent illnesses, and more.
Another important aspect of Qi is that it is happiest (and we feel happiest) when it is flowing freely. When a person is healthy and balanced, Qi flows freely and smoothly. In states of imbalance or disease or excess stress or worry, Qi can become blocked or stagnated. Qi stagnation, commonly seen as a result of our high stress lifestyles, can be manifest as headaches, irritability, anger, digestive problems, menstrual problems, pain, muscle tension, and many more symptoms. Almost every patient we see has some aspect of Qi stagnation. It is an unfortunate side effect of living in modern times.
Acupuncture treatments work by regulating the flow of Qi (and Blood), tonifying where there is deficiency, draining where there is excess, and promoting free flow where there is stagnation.
TCM treats the human body as a whole that involves several functional systems (eg, Lung, Heart, Liver, Kidney, Spleen) that are named after our physical anatomical organs, but not associated with how we view the organs in Western medicine. In order to distinguish functional systems from physical organs, we capitalize the first letter of the TCM functional systems.
Disease is understood as a loss of balance of Yin, Yang, Qi, and Blood (which bears some resemblance to homeostasis) in the body in general, as well as within each of the functional organ systems. So, depending on signs and symptoms, a person can be diagnosed with both a general Qi deficiency, as well as a Liver Blood deficiency. Treatment of disease is attempted by modifying the activity of one or more functional systems through the placement of tiny acupuncture needles, pressure, heat, etc, on specific acupuncture points that fall along acupuncture meridians.
Most of the main acupuncture points are found on the "12 main meridians" and two "extra meridians" - a total of "14 channels", which are described in TCM texts as pathways through which Qi and Blood flow. There also exist "extra points" not belonging to any channel. Other tender points (known as "ashi points") are not named points, but may also be needled as they are believed to be where stagnation has gathered.
Treatment of acupuncture points may be performed along the 12 primary channels, or mai, located throughout the body. The first twelve channels correspond to systems of function: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, San Jiao (an intangible, also known as Triple Burner), Gall Bladder, and Liver. Other pathways include the 8 Extraordinary Pathways, the Luo Vessels, the Divergents and the Sinew Channels. Ashi (tender) points are generally used for treatment of local pain.
As acupuncturists, we decide which acupuncture points to treat by observing and questioning each patient (at each visit) in order to make a diagnosis. In TCM, there are four diagnostic methods: inspection, auscultation and olfaction, inquiring, and palpation.
TCM treatments are based on balancing "patterns of disharmony" rather than targeting a symptom associated with a biomedical diagnosis. A given TCM pattern of disharmony may be reflected in a certain range of biomedical diagnoses: the TCM pattern called Spleen Qi Deficiency could manifest as chronic fatigue, diarrhea, or uterine prolapse. Likewise, a population of patients with a given biomedical diagnosis may have varying TCM patterns. These observations are encapsulated in the TCM aphorism "One disease, many patterns; one pattern, many diseases".
At Stepping Stone Acupuncture, our treatments are highly individualized and based on a combination of subjective and objective impressions, feedback from treatment to treatment and, as it becomes more common and available - clinical evidence. Depending on a patient's diagnosis and our prognosis for improvement, we will suggest whether we recommend acupuncture alone, or the addition of Chinese herbal medicine.
We recommend treatment frequency based on a number of factors - the diagnosis itself, the chronicity of the imbalance, the nature of the imbalance, and patient compliance with treatments and recommended lifestyle modifications. Our goal is to get our patients well in as few treatments as possible and to have them take away information that they can use to maintain health outside of the treatment room.