Points on Chinese Medicine

The following are notes based on a talk given by my teacher, Dr. Arnaud Versluys, Founder and Managing Director of the Institute of Classics in East Asian Medicine. The topics covered here are often brought up when discussing the rich history and fundamental principles of Chinese Medicine with patients and Western medicine colleagues. Each point below can be understood on its own, as they are taken out of a larger discussion for the sake of simplicity here.​

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• The history of Chinese Medicine predates even writing itself. During the Han Dynasty (206 B.C. - 220 A.D.) all of the traditional medical principles and procedures that had existed as separate family lineages of folk medicine were codified and written down for the first time. What came from this is considered to be the original style of what we call Chinese Medicine today; it is the source, the root, from which we draw constant nourishment and guidance. ​

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• Chinese Medicine was developed empirically. First, treatments were performed, and then the understanding as to why the intervention worked or not for this particular patient in this particular setting came forth on its own. By contrast, Western medical science first develops a test, which is based on a specific goal, and then later the treatment method comes forth. Chinese Medicine is experience-based, whereas Western medicine is experiment-based. The older the style of medicine, the more robust its evidence base is, i.e., the efficacy of the system is built into, and comes out of, its history.

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• For practitioners of Chinese Medicine, our diagnostic tools are not external sources like imaging machines and blood tests. Chinese Medicine practitioners are taught to understand these tests, but when it comes down to making clinical decisions we rely on the parameters of our medicine, which are based on the observation of the patient as a whole, palpation of the patient's body, asking the patient very specific questions in order to help guide our treatment and narrow down what the best intervention is at this time, etc. Western medical diagnostic tools, useful as they are in helping one to develop a more complete understanding of the patient's condition, are not designed to guide Chinese medical treatments -- acupuncture therapy and herbal prescriptions. 

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• Our goal in Chinese Medicine is not to diagnose a specific disease, as Western medicine does -- to give a name to the cluster of symptoms that the patient is experiencing. Rather, we look for patterns of imbalances in the functioning of the body, from the skin and superficial tissues all the way down to the organs themselves. These patterns are descriptive of systems in the body that have lost their ability to function properly. The clinical presentation -- the symptoms -- may very well be the same or quite similar from one patient to the next, but the underlying mechanisms for each person's symptoms are likely different and will require a treatment designed specifically for them; not a treatment designed for a named disease or symptom.

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• This holistic, personalized, and longstanding method of treating patients in Chinese Medicine is exactly what makes it difficult to analyze from a Western medicine point of view. Quite often, an individual herb, or even a single chemical component of one herb, is studied in isolation, outside of the human body where they function most importantly. Chinese medical doctors have spent centuries studying the effects of using herbs in combination as formulas, not individual herbs or their chemical components, on human illness. To use herbs in combination with others helps to mitigate any potential side effects of any one of the herbs in the formula, thus increasing the therapeutic effects of one or more herb while being able to use it at a lower dose, ensuring that we stay as far away from a potentially dangerous dose of an herb as possible. Prescribing formulas rather than individual herbs also allows us to treat a variety of symptoms and pathomechanisms at the same time. When we attempt to study one herb on its own, or even multiple herbs in a formula, using the Western scientific method of analysis, we will, without doubt, come to incorrect conclusions. Single herbs are made up of many different chemical compounds, and to isolate just one of them already invalidates the test because Chinese herbs are always used whole. Then, when herbs are combined into formulas, mixed with water and boiled, or otherwise prepared (and altered) in a traditional way, the many variables that come about due to changes in the chemical makeup of the herbs are too vast to be able to account for each.

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• In the early 1900s, China was very much embracing Western medical science, and the traditional medicine was all but thrown out. By the 1950s the practice and teaching of Chinese Medicine was allowed again, but only that which fit into the mechanical, linear-thinking model that had been adopted. Many traditional principles, terms, and practices were intentionally left out of this new westernized Chinese Medicine, which was termed, ironically enough, "Traditional Chinese Medicine." The practice of acupuncture suffered during this time (and since, frankly) more than herbal medicine because acupuncture is even harder for the scientific model to study. There are numerous studies proving that acupuncture does in fact work; the question of acupuncture's efficacy has been answered. Scientific studies on acupuncture using Western medical models now attempt to identify both what it can be used for, and of course, how it works. These studies have found many, many mechanisms that are at work whenever an acupuncture treatment is performed, which range from the release of endorphins in the brain to increased microcirculation and blood flow to the manipulation of local tissues and how that effect is transferred throughout the entire body via bioelctrical and biochemical signals along tissue planes. The fact is that ALL of these mechanisms, and more, are involved with acupuncture's functioning and success rate. Still, attempts remain to identify one main driving force behind these mechanisms. In both China and the West, herbal medicine is more heavily emphasized and studied than acupuncture. Herbs are material things that we can see, smell, taste, and touch. They are also an important commodity, and thus their production and sales helps to generate tax revenue for the government. Herbs are also emphasized in both research and practice because they are physical, and don't seem to represent some energetic phenomenon as is often cited when discussing acupuncture treatments, which couldn't be further from the truth.