Learn about Chinese Medicine

The History | Yin Yang | Diagnosis

The beauty of Chinese Medicine is its ability to get to the root of the problem in addition to working on the symptoms. Its techniques are just as effective today as they were 2,000 years ago when they were conceived.

The large difference between Western and Eastern Medicine stems right back in history to their belief systems and how society evolved from there. In the West everything is segregated and compartmentalised. Religion and Science especially are at opposite ends of the spectrum. In the East, their idea of “religion” is very different from ours. It is more a philosophy of living in balance with the universe, and how by understanding how the universe works, we can then better understand how our bodies work. Therein lies the key difference, in Chinese Medicine, everything is connected, and its the relationships that matter. In the West it’s about understanding each component, how they interact as a whole is a distant second. Thus Chinese Medicine can be viewed more as a lifestyle medicine designed for the individual, whereas Western Medicine was designed for the masses. Both obviously have their benefits and weaknesses. It’s this individualised approach the medicine takes that allows it to develop a unique treatment plan for every individual. Even when two people are suffering from what is commonly known as the “flu”, their presentation will differ as no two people react the same. This means that their diagnoses will be different and therefore an individualised treatment plan is tailored to meet their individual needs.

One might question how such an ancient form of medicine can still be so effective in today’s world. The answer is simple. Below is a small extract from one of the oldest books written about TraditionalHuang Di The Yellow Emperor Chinese Medicine called the “Huang Di Nei Jing” (The Medical Canon of the Yellow Emperor). Scribed over 2000 years ago, this record of the dialogue between the ruler (‘Huang Di”) and his chief medical advisor (“Qi Bo”) remains a wealth of knowledge on diagnosis, treatment and the laws of the universe.

This exert is from the first page of the first chapter of the book:
“These days, people have changed their way of life. They drink wine as though it were water, indulge excessively in destructive activities, drain their jing -the body’s essence that is stored in the kidneys- and deplete their qi. They do not know the secret of conserving their energy and vitality. Seeking emotional excitement and momentary pleasures, people disregard the natural rhythm and order of the universe. They fail to regulate their lifestyle and diet, and sleep improperly. So it is not surprising that they look old at fifty and die soon after.”
From “The Yellow Emperor’s Classic of Medicine” (1995)
By Maoshing Ni, PH.D.

Despite being written two millennia ago, the way of life then mirrors modern existence. While our technology and knowledge have advanced, the basics of life remain a constant, explaining why the medicine has survived over 2,000 years of scrutiny.

The chinese character for qi

What is Qi (Chi)?

Pronounced “chi” it is often translated into English as “energy”, but this definition is quite poor. There is no single word to describe the meaning of Qi, as each Chinese character tells more of a story than a definition.

The modern character for Qi describes the steam coming off a bowl of rice and floating up into the heavens to become clouds. This symbolises that Qi is something both nourishing and transforming, it can be both solid and insubstantial.

To the Chinese Qi is what makes up the universe, everything we see, experience or feel is a manifestation of a form of Qi.

Within our body there are many manifestations of Qi; Heart Qi, Spleen Qi, Liver Qi, Zhong Qi, etc…
To say these are different forms of Qi is false as they are all the same Qi, but as the Qi passes through each organ it assumes a different role. It is the same principle for Qi within the universe and the world around us.

There are two components to Qi, Yin Qi and Yang Qi. This is the “Yin and Yang” that everyone knows about. Some say it is the interplay between Yin and Yang which creates Qi.

diagram of yin yang

Yin Yang

Before the universe existed it was said that Yin and Yang where separate entities, their union created Qi and the Universe.  They are two forces which compliment, sustain and nourish each other.  The Western perception of them being purely in “opposition” is a very limited view of their incredibly dynamic relationship.

The Classic diagram of Yin and Yang shows that they are a part of each other, with a small piece of Yin within Yang and vice versa. Yin is described as being more substantial and heavy, Yang is more pure and light. Yang relates to such things as; Heat, Summer, Man and Movement. Yin relates to such things as; Cold, Winter, Woman and Stillness. Remember that one can’t exist without the other, it’s the relationships which are key not the singular definitions. Yin and Yang is very much a mind map of duality that helps explain the workings of the world around us.

To quote the Nei Jing “In nature, the clear Yang forms heaven and the turbid Yin Qi descends to form Earth.  The earthly Qi evaporates to become clouds, and when the clouds meet with the heavenly Qi, rain is produced”.

This constant interplay very much sums up the difference between the Western and Eastern mind set. To the Chinese everything in life, health and illness is about relationships, the Western perspective is more focused on dissection, classification and definition.

Perfect health is when Yin and Yang are in balance, and Qi and Blood are plentiful.  This is the state I strive to return each patient to whilst treating them.

Originally the five elements system was used in predicting social trends and politics in ancient China. Over time the model was also integrated into the system of medicine as a theory of explaining organ interaction. It was found that certain organs, foods, seasons, smells etc related to one of the five elements. This is known as the “Table of Correspondence”

Wood Fire Earth Metal Water
Season Spring Summer Late Summer Autumn Winter
Direction East South Central West North
Climate Wind Heat Damp Dry Cold
Yin Organ Liver Heart Spleen Lung Kidneys
Yang Organ Gall Bladder Small Intestine Stomach Colon Bladder
Tissue Tendons Blood Vessels Muscles Skin Bone
Orifice Eyes Tongue Mouth Nose Ear
Flavour Sour Bitter Sweet Pungent Salty
Injured By Over use of Eyes Over Walking Over Sitting Over Lying Down Over Standing

In the Detailed view of the five elements, you can see how all the Yang organs are on the outside and the Yin organs are on the inside. This is because the Yang organs are considered more “external”, meaning they protect their Yin partner and are always affected by exogenous pathogens first. If a pathogen gets through to the Yin organs it is called an “internal” condition, as it has managed to penetrate through the body’s protection and reached the deeper energetic levels. These types of conditions are considered more serious. The Sheng Cycle (blue lines) is the nourishing cycle, showing how wood flows on to nourish fire, fire to earth and so on. In turn it explains how a deficiency in one organ can directly affect the next in line. The Ke Cycle (orange lines) describes the controlling cycle. Think of it as an older brother keeping an eye on his younger sibling to ensure s/he doesn’t misbehave. However it can have a negative impact if one element over-controls another. For example; wood is easily upset by stress and anger, this can cause it to over-control the Earth and bring about digestive problems.

This is a much older model of the Five Element relationship.  The primary difference here is the Earth (Spleen/Stomach) is the centre, supporting and nourishing all the other elements.  It also shows that the Earth is a bridge of communication between the elements.

Water (kidneys) is the reservoir of all yin and yang, it is the base or root of the diagram representing its role as the foundation of the whole system (and body).

The heart (fire element) is the most yang organ, and is associated with the emperor who is in charge therefore it sits at the top. Fire and water have a Yin Yang relationship so they are at opposite ends. Water flows up to nourish the heart, and fire goes down to control the kidneys.

Wood and metal are at either side working to support and control each other, as wood energy naturally expands and metal energy naturally contracts.

This model easily explains how a deficient or damaged Spleen and Stomach (digestion) can have a massive  effect on the entire body. The body will lose its ability to support itself (both physically and emotionally), and the organs will have great difficulty communicating with each other.  This demonstrates the importance of the old saying how any structure must have a strong centre (Earth) in order to function and survive.

The Yin organs are considered “solid”, meaning they store a form of refined Qi (essence).  They are related mostly to the production and storage of Qi and blood.

The Heart

In Chinese Medicine the heart does a lot more than just pump blood around the body. It is considered the Emperor organ, overseeing the functioning of the entire body both physically and emotionally. The heart houses our “shen” or spirit. The Chinese acknowledge that the brain stores memory and thought, but our emotions and soul are contained within our heart. Our eyes have connects to our heart channel which enables us to see the quality of a person’s shen by observing the vibrance of their eyes. This gives meaning to the ancient phrase “the eyes are the window to the soul”. If there is any emotional upheaval the heart will be always be affected. This is why palpitations are often brought on by a sudden emotional event, as it disturbs the Heart’s Qi and creates a physical symptom. The Emotion associated with the Heart is joy, therefore excess joy injures the heart and scatters the shen. This is why after severe laughter people cannot concentrate and even become dizzy. A normal amount of joy is very good for your heart, so laughter truly is the best medicine.

The Lung

The Lung is said to be a Yin organ with a very Yang function. It controls the immune system (Wei Qi) and is the first to come in contact with airborne pathogens. It commands all of the Qi within the body and controls the bodies water passages. In the traditional Chinese model there was actually only ever one Lung, but thanks to the introduction of Western Anatomy we now know there are in fact two. The air with breathe in through the Lung is called “Da Qi”, it combines with the essence (Gu Qi) sent up by the Spleen to produce Qi and Blood. As it also controls the pores and the skin, deficiencies or pathogens in the lung can appear in our skin as rashes or other disorders. This Chinese medical link between asthma and skin conditions, which Western Medicine is still trying to understand within their own framework.

The Pericardium

The Pericardium is the sack around the heart; it is its protector both physically and emotionally. Think of it as the Emperor’s guardian. It is said that no pathogen can directly affect the Heart, but instead the Pericardium always take the damage on its behalf. The Pericardium has connections with the organs in the middle burner of the body, primarily the Spleen and Liver which too are easily affected by emotions. Therefore I regularly use Pericardium acupuncture points to settle an upset digestion which has been injured by emotional stress.

The Liver

The Liver has several functions. It stores blood, ensures the Qi in the body flows smoothly and aids in digestion, it is also a very emotional organ. Its element is wood, which means its Qi branches out and influences its surroundings, just as trees do in nature. As the Liver is easily affected my stress and other strong emotions, its flow of Qi can easily be disrupted, which in turn causes it to over-control the Stomach/Spleen generating digestive problems (wood->earth relationship). This is how the Chinese Medicine explains conditions such as IBS. The male and female reproductive organs are controlled by the Liver and its meridian system; this is why breast tenderness occurs during menstruation along with PMT, its Qi can stagnate at the onset of the menstrual cycle bringing emotional disturbances and physical symptoms along its pathway. In TCM there is a very strong emotional component to the development of cancers in the body. The combination of the Liver’s susceptibility to stress and emotions, combined with its control over the reproductive regions is how Chinese Medicine explains the development of breast and ovarian type cancers. It is the stagnation and/or rebellion of Liver Qi.

The Spleen

The Spleen is a vital part of your digestive system, it is responsible for providing the base elements needed to produce Qi and Blood. With help from the stomach it breaks down the food and separates the turbid from the clear, this process is called “transformation and transportation”. The clear refined product is sent up to the Lung and Heart to be made into Qi and Blood. The turbid is sent down through the Stomach into the Intestines for further processing, then removed through the bowel. It is also responsible for holding the blood in the vessels, and the organs in place. A weakened Spleen can result in organ prolapse, uncontrollable bleeding, diarrhea and constipation. The Spleen likes moisture but only a little, too much and it fails to separate the clear from the turbid. Instead of sending up a clear refined essence, it instead sends up a turbid substance called damp, causing an impaired production of Qi and Blood. This damp can lodge in several different places causing many different pathologies. For example: damp lodged in the head can cause; difficulty concentrating, compression headaches, sinusitis, depression, mania. Damp lodging in the chest and abdomen can lead to: obesity, bloating, poor digestion, bronchitis. Damp in the lower part of the body can lead to: UTIs, Bladder infections, mucous in the stool, vaginal infections, STDs. Because the Spleen is involved in digestion, it is easily damaged by improper diet. The Spleen likes the sweet flavor, but too much sweet food causes injury. People who have “an uncontrollable sweet tooth” often have an underlying Spleen deficiency.

The Kidneys

The kidney stores Jing, your essence or “life force”. There are two types of Jing: Pre-natal Jing: this is what you receive from your parents, a reservoir of essence which cannot be replaced. Post-natal Jing: This is made from surplus Qi created from the digestive system and added on top of the pre-natal Jing. It is the aim of many forms of meditation and internal martial arts to try and preserve as much pre-natal Jing as possible as when you run out, you die. As we get older, our ability to make fresh post-natal Jing diminishes, so to maintain bodily functions our body uses the pre-natal Jing instead. It is the steady decline in Jing which causes us to age and eventually die. The principle of Jing is the exact opposite to the Western medical theory of aging, but the concept behind them both is quite logical. Western Medicine believes it is the buildup of ‘Free Radicals’ (loose Oxygen molecules) which slowly damages the body’s processes and causes us to age, whereas as Chinese medicine views it as a steady decline in the body’s stored essence. Overwork and damage to the body’s ability to make post-natal Jing can cause people to consume their pre-natal Jing much early then they should. This is how Chinese Medicine explains young people with conditions they shouldn’t naturally develop for several decades; such as premature graying or osteoarthritis. When a child is born with a congenital problem, the Chinese call this “defective Jing”, meaning the Jing which was passed on from the parents was damaged or impure, which has caused the child to develop poorly. Sadly this cannot be cured, but it can be managed.

The Yang organs are considered “hollow” as they fill up and then empty to keep things moving, their primary role is related to digestion and waste removal.

The Small Intestine

Its function is primarily to aid in digestion, continuing to separate the turbid from the clear which it has received from the Stomach. It also plays a role in venting heat from the body through its meridian system, mainly heat generated from the Heart (again from an emotional trigger). It is one of the outermost Yang channels, therefore it is one of the first to come in contact with external pathogens such as wind and cold. Many initial symptoms of a cold or flu are related to the invasion of the small intestine channel by a pathogen.

The Gall Bladder

The Gall Bladder is considered an “Extraordinary Fu”, it is a Yang organ which stores a form of refined essence (like a Yin organ). This refined essence is ‘bile’ which is made from a surplus of Liver Qi. Bile is used to aid digestion (which is activated by the Liver) when we eat. Stress stagnates Liver Qi and generates heat which the Gall Bladder tries to vent. As the Gall Bladder channel runs along the sides of the body, shoulder blades and head; people with high stress levels have tight upper back and neck muscles, they can even suffer digestive problems. Emotionally the Liver and Gall Bladder work together to help us plan and provide courage to follow through with our desires.

The Stomach

The Stomach is described as an emaciation chamber. It is responsible for beginning the breakdown of food to help the Spleen perform its function of transforming and transporting. The Stomach then sends the turbid substances down into the Intestines. When the Stomach is injured instead of sending the turbid down, it can rebel and send it upwards: this leads to nausea, reflux and vomiting. The Stomach prefers dryness and warmth, but too much and it generates excessive heat, this leads to excessive hunger, foul breath and thirst.

The Large Intestine

Here the body has extracted all the nutrients it can from the food we have eaten and is now ready to excrete the waste. It is through the Colon the body also tries to remove pathogens from the body, such as heat, cold and damp. This results in several different pathologies which cause painful diarrhea or constipation. The Colon also plays an important role in skin conditions. It is paired with the Lung (whose corresponding tissue is skin), if the Colon is blocked and unable to remove the waste, it will try and vent these toxins through the lung which results in skin conditions.

The Triple Burner

The “three burning spaces” or “three heaters” is not so much an organ but more a way of explaining how organs in different parts of the body communicate with one another. Along with providing a means for fluid transportation between the different areas of the body. Compared to the other organs whose theory has been around for a thousand years, the San Jiao is considered quite young as it was only included into the general organ theory approximately 500 years ago. It explains how multiple organs can be affected at the same time and how their functions link to one another. The Upper Jiao contains the Heart and Lung The Middle Jiao contains the Stomach, Spleen, Gall Bladder and Liver The Lower Jiao contains the Small Intestine, Colon, Bladder and Kidneys

The Bladder

The Bladder is responsible for the excretion of fluid waste which have been passed on from the small intestine and kidneys. This too is another means whereby the body tries to excrete pathogens from the body like the Colon. UTIs, painful urination and other genital disorders are often viewed by Chinese medicine as Damp or Heat trapped in the Bladder. The Bladder energetically has a very strong connection to reproduction, especially the uterus in women. This is why I use Bladder points to rotate a malpositioned fetus.

The normal tongue should be pink, with a thin white slightly moist coat.

Elements which are observed include:
Colour of the tongue body, thickness/colour of coat, presence of cracks and the overall shape.
Below is a diagram showing the areas which correspond to the organs of the body on the tongue surface.

Like the tongue, the pulse is able to give us a complete picture of the state of Qi within your body. Western medicine primarily pays attention to the rate of the pulse, in Chinese Medicine we observe not only the rate but also the rhythm, depth and quality.

For instance, people who are stressed out usually have what’s called a “string taut” pulse. This feels like a guitar string under your fingers. Pregnant women have whats called a “slippery” pulse, which feels like a pearl sliding beneath your fingers.

A Journal article published several years ago proved this theory, as they used a sonagraph on the radial pulse to monitor the rhythm in which the blood hit the arterial wall. They tested pregnant women as their pulse is consistently described as being “slippery”. The tests showed conclusively that the rhythm in the women’s pulse changed once they became pregnant.

Traditionally there are 28 different pulse types, which can combine in different ways to give a total of over 360 different pulse states.

All this goes together with the other diagnostic methods to provide an overall view of the state of your body. I use all that data to make an accurate diagnosis and then formulate a treatment plan which best suits your disharmony.

detailed areas of tongue diagnosis in chinese medicine

Traditionally in diagnosis there are four key methods:

Inquiry: asking questions about patient history, pain, energy levels, digestion etc.

Looking: Observing the patients posture, skin colour, tongue, eyes, etc.

Smelling and Listening: Any strange odours that suggest illness or infection, quality of the patient’s voice, abnormal breathing sounds.

Palpation: Pulse diagnosis, as well as testing key acupuncture points and areas for sensitivity.

One of the key diagnostic tools in Chinese Medicine is observation of the tongue. In some way all the organ meridians either link or pass through the tongue. As a result, by observing the qualities of the tongue organ disharmonies can be understood.

 

An illness in TCM is described as a “pattern of disharmony”, this is because to the Chinese illness arises when the balance between Yin and Yang is lost, so the return of health is a return to balance. In Chinese Medicine the causes of disease are divided into two categories; external factors and internal factors.

The 6 exogenous factors are: wind, heat, summer-heat, cold, dryness and damp. These can occur singularly or in many different combinations to create a multitude of different disharmonies. The manner in which they occur in nature is a reflection of the affect they have on our body. For instance; just as heat dries up fluids, burns things and makes them brittle in nature, this too occurs within our bodies if we externally contract a heat pathogen.

Primarily wind is always a key factor, as the Chinese say “wind is the spearhead of 1,000 diseases”. This is because wind scatters our defensive Qi (called Wei Qi), leaving us vulnerable for another pathogen to invade.

For example; your caught out in winter under dressed, a stiff cold breeze comes along hitting your body and you feel a severe chill. This is the wind hitting your bare skin first and scattering your Wei Qi, then a pathogen invades your body. The next morning you wake up sick with a “cold”.

Internal causes can result from: emotional upheaval, congenital weaknesses, improper diet, over indulgence in sex or improper lifestyle. These can lead to internal formations of damp, heat, cold, dryness, deficiency or excess.