Traditional Chinese Medicine (TCM) is one of the most ancient systems of treatment known to mankind.  The origins of Chinese medicine date back at least 2,000 years ago when the first Chinese texts were written.  The fact that it still survives to this day gives credence to its efficacy.

TCM offers a whole spectrum of treatments such as herbs, massage (known as Tuina meaning “lift and squeeze”), exercise, diet and Acupuncture.  As well as looking at what TCM is, I am going to discuss specifically what Chinese massage and Acupuncture are and how they work.

WHAT ARE THE ESSENTIAL INGREDIENTS OF HEALTH?

To answer the question, what is TCM, we first need to understand what the nature of “optimal health” is.  Once we understand this, we can then move on to see how TCM helps to restore us to optimal health.

Most of us want to be healthy but we may not know what to do in order to be healthy.  Most often, we might wait until sickness strikes before we even start thinking about living a healthy lifestyle.

This may be because we are increasingly having to deal with different responsibilities and activities, we may be lazy about healthy habits - thinking it will require too much effort or maybe (probably for most of us!), we simply want a quick fix.  Perhaps healthy habits are finally forced on us when we find that we can no longer enjoy our excesses freely!  We might find at that point that any hope of finding a cure for our sickness turns into despondency as we realise we have done irreparable damage to our bodies.  There may be no easy or short term solution to our problem as Western doctors, although they have many answers, simply cannot cure everything.

In addition to this, as a society, we have grown increasingly confused about what health is and what it is not!  This is due, in part, to the information overloaded society in which we live.  We are somehow driven to keep on trying an ever-growing number of cure-all remedies, supplements, exercise regimes and diets.  This has contributed to us not understanding our common needs as part of the natural world.  TCM sees that our bodies have individual needs that stem from the fact that we are all born with our own specific constitutional traits.  These needs hold the key to our personal health maintenance.

When we are in a state of balance, the body is strong and all its functions occur naturally and without interruption.  This can only happen if there is plentiful nourishment and moisture to provide substance to the organs, body structure and fluids (Yin); and there is enough warmth, movement and energy to fuel the activities and functions in the whole body (Yang).

This idea of balance is also referred to in Biology as Homeostasis which is “the ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes”.  The body constantly gives feedback about its balance via hormones and other chemicals so that ideal conditions can be restored and maintained.

This Homeostasis can only be maintained if the body’s basic needs are met - these are the necessary requirements for optimum functioning of the body.  If these needs are not met, over long periods of time, the result will be impairment of bodily functions which may, in turn, lead to disease or the development of chronic, often incurable conditions.

The essentials of health in TCM are seen to be:

* Good nutrients

* Fresh air

* Water

* Sleep

* Adequate (but not too much) exercise and

* Relaxation (both physical and mental).

GOOD NUTRIENTS

We need to consume unprocessed, unharmed foods that don’t contain toxic substances in order to maintain optimal health.  TCM theory explains that the body makes Qi (vital energy) and Blood from the food that we consume. Qi and Blood are two of the essential substances of the body.  The function of all systems of the body depend on plentiful Qi.  Plus, the nourishment and lubrication of all cells and tissues also depend on a steady supply of Blood. As the quantity and quality of our Qi and Blood depend on the quantity and quality of the nutrients we consume, what we eat has a direct impact on how well our body works.

FRESH AIR 

In Chinese medicine, air is a necessary ingredient for the making of vital energy or Qi. In the cycle of Qi production, the Lungs extract nourishment from the Air and this nourishment gets combined with that extracted from the food and drink by the digestive system. As air and food come together, they are transformed into “Chest Qi”, which fuels the functioning of the Heart and Lungs.  It then gets further refinement to become the particular type of Qi that will provide strength to all organs and also protect us from disease.

WATER - In Chinese Medicine, water is seen as the main component of Body Fluids (Jin Ye), which is an essential substance made up of not just water but also nutrients extracted from the food and drink that we consume. Body Fluids have the function of moisturising, lubricating, and helping to  cleanse all bodily tissues; as well as being the watery component of Blood.

SLEEP - Enough sleep is an absolute necessity for the body. It is during our sleep that the energies of Yin and Blood can grow and nourish the body at the deepest level, toxins and waste products get removed, and the mind and emotions get soothed and settled. Lack of sleep has a direct impact on the Heart and can affect Heart functions including Blood circulation, mental acuity, and emotional balance. 

EXERCISE - The Chinese view our need for exercise in a far more holistic way than we do in the West. It is far more than just training our heart and lungs, weight loss or building muscle strength or bulk.  They think in terms of optimising oxygenation.  As we move, especially outdoors, we get more air in our Lungs and this strengthens Lung function and the production of vital energy.  This also enhances the circulation of Blood and Body Fluids as movement makes Blood and Qi move more freely increasing oxygenation to every part of the body.  This then aids in the removal of waste products, prevents stagnation of fluids, encourages digestion and helps out the Heart so it doesn’t have to work so hard.

They also view exercise as vitally important to settle the mind and emotions.  They would therefore advocate gentler types of movement such as Qigong, Tai Chi or Yoga.  They see these as powerful to help us in this way as they involve deep breathing which in itself has great calming qualities.

RELAXATION - this is the opposite of tension and is a term used to describe techniques that allow the release of tension at a physical, mental, emotional and even spiritual level.  

HOW THEN DOES TCM WORK TO MAINTAIN THIS BALANCE?

TCM likens the human body to a highly complex electrical circuit. Like any electrical circuit it must be kept in good working order if it is to function effectively, and if the circuit breaks down the result is illness. 

When the body moves from its “balanced state”, then sickness or disease ensues.  The Chinese would say that that sickness or disease is due to an internal imbalance of Yin and Yang. This imbalance leads to a blockage in the flow of Qi (vital energy) along the pathways in our bodies known as Meridians.  It is essential for Qi, as well as Blood to circulate in a continuous and unobstructed manner within these Meridians for good health of the mind and body. 

There are 12 main channels in the body and these channels are paired with the Organs.  For example, the Stomach is connected with the Spleen, the Gall Bladder with the Liver, the Heart with the Small Intestine and so on.  The 12 main channels are all connected to each other and the Qi flows through each channel once every 24 hours, taking two hours to pass through each one.

There are also other channels and networks that can be compared to the blood circulatory system with its network of blood vessels.  These channels act as reservoirs and ensure you have sufficient Qi circulating in your body.  They also circulate your “Jing” (or life essence) and help to regulate your immune system.

Most of the body’s Acupuncture points lie along 12 main channels and 2 other channels which cover the front and back of the body.  Points are best imagined like small whirlpools or cortices that are formed where the flow of Qi is disrupted. They are often found at prominences or indentations along the pathways such as where a bone flares at a joint , where there is a notch in a bone or where two muscles meet.  This is similar to the way small whirlpools are formed when the smooth flow of a stream or river is disrupted.

These points are used in treatment to either strengthen or unblock the Qi in the channels.  By stimulating the points with a needle or massage, the flow of the Qi is altered.  The Qi can then reach a better balance and flow unimpeded to the Organs, allowing their functioning to improve.  Hence you can regain your health.

There are approximately 365 points on the body and each has an individual use.  Sometimes the points are used in combination to create a more powerful effect and at other times points are chosen individually.

Some channels have more points than others.  For example, there are 67 points on the Bladder channel, while there are only 9 each on the Pericardium and Heart pathways. Points are identified by their name and number and also by their associated Organ.  The points are found by accurately locating specific landmarks on the body and also by locating which areas are most tender.  

To locate specific points, Chinese medical doctors invented a clever method of finding points by using the patients own measurements.  It is therefore possible to always locate the points precisely no matter the person’s size or shape.

WHAT IS CHINESE MASSAGE (TUINA) AND HOW DOES IT WORK?

Tuina dates back to 1700BC and is the parent of most modern Asian bodywork.  All Chinese medicine suffered in China during the political and social upheavals of the 20th century.  Unfortunately, in 1929, the Chinese government instituted a policy eliminating the “old” medicine.  In 1936, Chinese Medicine was completely denounced as having no scientific foundation and its practice was banned!

Tuina did survive however as a popular form of Healing among the general Chinese population and after the Communist Revolution in 1949, the policy against traditional medicine was changed and the tradition of Chinese medicine was encouraged once again.  

The style of Tuina practiced in China today is closer to the work of chiropractors, osteopaths and physiotherapists than to that of traditional massage therapists.  In China it is taught as a separate but equal field of study in schools of TCM as Acupuncture and herbalism.

As Tuina has migrated to the West and become popular, the style has been modified but Tuina can still be thought of as a therapeutic extension of western massage with an emphasis on restoring and balancing energy.

Tuina is a hands on body treatment that uses Chinese taoist principles as outlined above to bring the body into balance.  Tuina is currently a standard treatment used in Chinese hospitals with specialization for infants, orthopedics, rehabilitation and sports medicine.

The term “tui” means “to push” and “na” means “to lift and squeeze”.  Thus, the practitioner may brush, knead, roll, press and rub over the meridian points and channel pathways, pushing, lifting and squeezing, in order to get the energy moving throughout the body.  

Unlike Western massage techniques, Tuina uses a rhythmic rocking movement to gently warm and manipulate the muscles.  Once the muscles are thoroughly warmed, other techniques may be employed with varying motion ranges and with or without traction. Some of the techniques such as tapotement (percussion), gliding (or effleurage), kneading (or petrissage), frictions and vibrations are quite similar to Western styles.  The difference with Tuina massage is that the focus is always on stimulating the Acupressure points.

Tuina is a wonderful complement to traditional Western therapeutic massage with its ability to focus on specific problems, especially chronic pain associated with the muscles, joints and skeletal system.  It is especially effective for joint pain (such as arthritis), sciatica, muscle spasms and pain in the back, neck and shoulders.  It also helps chronic conditions such as insomnia, constipation, headaches (including migraines) and the tension associated with stress.

Tuina does not however, simply work on the muscles, bones and joints.  It works with the energy of the body at a much deeper level.  Tuina is also designed to prevent problems, not just correct them.  By keeping the body’s energy in balance, health is maintained.  This is true not just for physical health but also for mental and emotional well-being as well.

WHAT IS Acupuncture AND HOW DOES IT WORK?

The word “acupuncture” is derived from Latin roots.  The Latin word “acus” means a needle and Acupuncture means “to puncture with a needle”.  Individually wrapped and sterilized fine needles are inserted into various, carefully chosen acupoints along the meridian lines in order to disperse any blockages and bring the Qi into a better balance.  The idea is that the more this balance is achieved and maintained, the healthier you become.

The craft of Acupuncture covers many components.  These include how to interact with people, how to correctly make a Chinese medical diagnosis (which involves looking at the tongue and taking 3 pulses on the thumb side of each wrist).  A Chinese medical diagnosis uses a completely different paradigm from that of a Western diagnosis.  TCM recognizes that all problems or symptoms have an underlying cause.  The aim is to find and treat the root cause of the problem in order to alleviate the presenting condition.  If you only deal with the signs and symptoms, you will only produce a temporary alleviation that won’t last.  Thus the question with Acupuncture is not whether it can provide relief from the symptoms but whether Acupuncture can help the person!

Although an acupuncturist’s diagnosis and treatment is different from that used by Western medicine, that doesn’t mean that Acupuncture cannot have a beneficial effect on many traditionally “named” illnesses.  Indeed, current research into Acupuncture by the World Health Organization (WHO) in 2001 has listed 28 conditions that Acupuncture has been proved to treat effectively.  These conditions include: adverse reactions to radiotherapy and/or chemotherapy, bilary colic, depression, period pains, acute epigastric pain, facial pain, headaches, hypertension, induction of labour, knee pain, low back pain, morning sickness, nausea and vomiting, neck pain, pain in dentistry, post operative pain, rheumatoid arthritis, sciatica, sprains, stroke, tennis elbow and pain in general.

That same report also mentioned 63 conditions where Acupuncture was shown to be effective but further proof (or clinical trials) were needed.  This list included abdominal pain, alcohol dependence, bronchial asthma, cancer pain, earache, eye pain, female infertility, fibro-myalgia, gallstones, arthritis, shingles, insomnia, labour pain, lactation deficiency, male sexual dysfunction, Menier’s disease, nosebleeds, obesity, addictions, PMS, sore throat, spine pain, stiff neck Tourette’s syndrome and whooping cough.

Acupuncture first hit the headlines in the West when President Nixon visited China in 1972.  During his visit, a New York Times reporter had his appendix removed and wrote about the pain relief Acupuncture had given him.  Today, fully conscious patients undergo major surgery with Acupuncture anesthesia as a regular occurrence.  This has fascinated the public and the scientific community alike.  Because of this publicity, initial research was focused on the treatment of pain.

During this research it was discovered that Acupuncture stimulates the secretion of substances called endorphins.  Endorphins are naturally-occurring chemicals that are released in the brain.  They have characteristics similar to pain-killing drugs such as morphine.

Subsequent research has found other effects.  For instance, one study has found that Acupuncture balances the autonomic nervous system (ANS).  The ANS regulates bodily functions that are not under our conscious control such as our heartbeat, intestinal movements and sweating.  This in turn ensures that we can retain a healthy balance between relaxing and digesting our food or being ready for action.

Another study showed Acupuncture affects the circulatory system and enables the blood vessels to constrict and dilate.  This is thought to initiate Healing by affecting the exchange of nutrients and the elimination of waste products within the small blood vessels or capillaries of the body.  It also has an effect on the immune system.

Although it is clear that Acupuncture can have wide and varied physiological effects these studies are still limited as they do not explain its many benefits.

CONCLUSION

Traditional Chinese Medicine clearly has plenty to offer us in terms of Healing both our bodies and minds but also in terms of helping us to live more balanced and productive lives.

Perhaps we will never fully understand why or how Acupuncture (or Tuina to a certain extent) works.  This doesn’t necessarily seem surprising when we consider that we still don’t know why many other medicines (including a simple aspirin) affect our health!  In spite of this, physicists now have a much greater understanding of the important Chinese medical notion of Qi or energy.  It probably won’t be long before this concept is fully accepted among the scientific community.