Traditional Chinese Medicine (TCM)
What did physicians do before Big Pharma? What did ancient societies depend on before there were pills, capsules, tablets or shots?
The leading cause of death in the ancient world was infections—infections with bacteria, parasites, viruses and other microbes. Injuries, violence and childbirth (often because of infections) were other leading causes of death.1 So, physicians throughout the centuries had to find ways to deal with many different sorts of infections. Today, by the way, the leading causes of death according to the CDC are heart disease, cancer, accidents and chronic respiratory diseases.2
We also tend to think that ancient humans lived very short, dangerous and sickly lives while modern medicine has provided us with longer lives, but this is not entirely true—one study indicated that the median age at death before 100 BCE (Before Common Era—or about 2100 years ago) was 72 years while the median age of death between 1850 and 1949 was 71 years.3 Currently, in the US, the median lifespan is 78.6 years as compared to 84.2 years in Japan, 82.0 years in Canada and 81.1 years in Germany. The main point here is—since the median life span hasn’t changed by a huge number of years—it is reasonable to think that physicians throughout the ages had at least some tools to deal with the leading causes of death—infections by various microbes.
How did they treat infections? One of the main approaches was by using plant medicines. Plant medicines—herbal medicine—has been used by ancient societies ranging from the Sumerians to the Egyptians—and by practitioners of Traditional Chinese Medicine (also known as TCM) for thousands of years. They likely discovered which plants and herbs were good for different disorders by a process of trial and error and refined different combinations of these natural medicines over the centuries, discovering which mixtures were most effective for each condition.
The Philosophy Behind TCM
Modern medicine has a philosophy behind it—and so does TCM and other traditional medical systems. TCM has a very complex set of theories and philosophies that have been developed over the many centuries—the earliest writing on TCM is from the 15th century BCE4, more than 3,500 years ago!
TCM focuses on what the ancient practitioners called "qi" (pronounced "chee") or life energy. Qi was believed to circulate through the body and any form of disease was thought of as a blockage, immobility (stagnation) or deficiency of qi at some point along the routes of circulation—the meridians. TCM also thought of qi as a balance between or a harmony between two types of energy—Yin and Yang.
Yin and yang represent opposing forces including life/death; male/female; dark/light; hot/cold and wet/dry. In health, yin and yang are balanced and energy/qi flows freely through the meridians. Disease results because that free flow of energy is somehow blocked or reduced. All TCM approaches, including herbal medicines, are believed to work by re-balancing qi by removing or reducing any blockage in that flow or qi. Herbal medicines may, in TCM terminology, reduce stagnation, decrease dampness, increase heat or increase strength.
Five Elements Theory
TCM philosophy also includes characterization of anatomy, though these don’t necessarily correspond to the way western medicine thinks of anatomy—TCM characterizes what are considered the important human organs as the 5 elements—fire, earth, metal, water and wood.
Each element is associated with organ systems (though these are not necessarily equivalent to anatomical organs), emotions, one of the senses, a direction, a color and temperature or weather. For example, water is associated with the kidney and bladder, with fear, cold and with hearing and balance. Wood is associated with the liver and gallbladder, with anger, wind, and with seeing.
TCM looks at the body holistically, seeing which elements are in or out of balance, weighing all aspects of a person.
Each modality then uses its particular tools to re-balance your whole body, mind and spirit.
TCM uses herbal medicine, acupuncture, cupping therapy, massage, exercise (qigong), and dietary therapy along with techniques like lymphatic brushing.
In herbal medicine, herbs are combined to produce the desired effect—to balance or re-harmonize the flow of qi. Often 7 or 14 herbs are used, but there is no set number of herbs—many traditional formulas have fewer or more herbs included. These herbs are known to have specific actions—and many of these actions have been validated using western scientific techniques.5, 6, 7 Biology and evolution tend to conserve the things that work across many different forms of life—in other words, what functions well in a plant may have a similar function in other organisms. Many herbs, for example, have anti-microbial properties because plants need a defense against microbes just as humans and other animals do. While plants don’t have a cardiovascular system, they do have vessels which carry water and nutrients to various parts of the plant—and these vessels need to be strong enough and contain enough water pressure to ensure that all parts of the plant receive these nutrients. Some of the substances plants use to maintain water pressure in their vascular systems may also help maintain healthy pressure in human vessels.
There are many studies examining TCM herbal preparations and many of these have indicated that these herbs are safe and effective. It is VERY important, however, to buy herbs from reputable practitioners or reputable companies. There have been cases of impurities in some herbal preparations—so make certain you check that the company from which you purchase has a good, solid reputation and any practitioner you visit has either appropriate training or licensure.
Acupuncture uses very fine needles to—in theory—help open the meridians to allow for the free-flow of qi. We don’t yet know how acupuncture works—there are various theories including mechanical and biochemical signaling—but we have lots of evidence that acupuncture does work in many different areas of health—it can be used to treat muscle pain, nausea, migraines, anxiety, depression and infertility to name a few.8 It has also been shown to benefit menstrual cramps, asthma, arthritis and has been used to treat addiction.9
Cupping creates suction on points of the body usually over a meridian and is used to relieve swelling, remove toxic wastes, and to help clear meridians for the free-circulation of qi. It is used for many different conditions including muscle pain (especially low back and neck pain), arthritis, skin diseases, to treat high blood pressure and to stimulate the immune system. There is less evidence of the benefits of cupping as compared to the TCM herbal medicines and acupuncture, but there is some evidence for pain, skin infections and when used in combination with other techniques.10 11
Qigong is an exercise form that uses slow, gentle movements that benefit mind-body-spirit health by "integrating posture, movement, breathing technique, self-massage, sound, and focused intent."12 There are many different "forms" or series of movements and many different styles of Qigong, but broadly, these have been shown to benefit overall health and have specific benefits for cardiovascular health, cancer treatment, arthritic disorders, reducing falls in older adults and benefits for mood disorders.13
Does TCM Work?
The simple answer is yes—TCM has been found to be effective over the thousands of years that it has been developed and refined. After all, would people be using it for thousands of years if it didn’t work?
Western scientific methods have also proven that TCM modalities are effective for pain management, a wide range of health conditions, preventive medicine and to maintain overall health.14, 15 The World Health Organization (WHO) has recently recognized TCM as a viable alternative approach to health care.16
Since TCM uses a quite different philosophy to develop its herbal medicines and other healing modalities, it has often been difficult to "translate" these into Western thinking and Western languages. Nonetheless, science has validated, and continues to validate, various herbal medicines, acupuncture, Qigong and all the other approaches used in TCM. There is lots more to do on that front, but as a great ancient philosopher, Lao Tzu, said "A journey of a thousand miles begins with a single step". Research validating TCM approaches is constantly being produced—and more is coming...one step at a time!
- Montagu JD., Length of Live in the Ancient WorldL A Controlled Study, J Roayl Soc Med, 87, January 1994, 25-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1294277/pdf/jrsocmed00089-0029.pdf
- Lao L, Xu L, Xu S. Traditional chinese medicine. InIntegrative pediatric oncology 2012 (pp. 125-135). Springer, Berlin, Heidelberg. https://link.springer.com/chapter/10.1007/978-3-642-04201-0_9
- Chen RQ, Wong CM, Cao KJ, Lam TH. An evidence-based validation of traditional Chinese medicine syndromes. Complementary Therapies in Medicine. 2010 Oct 1;18(5):199-205. https://www.sciencedirect.com/science/article/pii/S0965229910000737
- Liu Z, Zhao J, Li W, Shen L, Huang S, Tang J, Duan J, Fang F, Huang Y, Chang H, Chen Z. Computational screen and experimental validation of anti-influenza effects of quercetin and chlorogenic acid from traditional Chinese medicine. Scientific reports. 2016 Jan 12;6:19095. https://www.nature.com/articles/srep19095/
- Chassagne F, Huang X, Lyles JT, Quave CL. Validation of a 16th century traditional chinese medicine use of Ginkgo biloba as a topical antimicrobial. Frontiers in microbiology. 2019 Apr 16;10:775. https://www.frontiersin.org/articles/10.3389/fmicb.2019.00775/full
- Cao H, Han M, Li X, Dong S, Shang Y, Wang Q, Xu S, Liu J. Clinical research evidence of cupping therapy in China: a systematic literature review. BMC complementary and alternative medicine. 2010 Dec;10(1):1-0. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/1472-6882-10-70
- AlBedah A, Khalil M, Elolemy A, Elsubai I, Khalil A. Hijama (cupping): a review of the evidence. Focus on Alternative and Complementary Therapies. 2011 Mar;16(1):12-6. https://www.academia.edu/download/53950911/j.2042-7166.2010.01060.x20170723-2777-1j85stx.pdf
- Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A comprehensive review of health benefits of qigong and tai chi. American Journal of Health Promotion. 2010 Jul;24(6):e1-25. https://journals.sagepub.com/doi/pdf/10.4278/ajhp.081013-LIT-248
- Eng YS, Lee CH, Lee WC, Huang CC, Chang JS. Unraveling the molecular mechanism of traditional chinese medicine: formulas against acute airway viral infections as examples. Molecules. 2019 Jan;24(19):3505. https://www.mdpi.com/1420-3049/24/19/3505/pdf
- Chao J, Dai Y, Verpoorte R, Lam W, Cheng YC, Pao LH, Zhang W, Chen S. Major achievements of evidence-based traditional Chinese medicine in treating major diseases. Biochemical pharmacology. 2017 Sep 1;139:94-104. https://www.sciencedirect.com/science/article/pii/S0006295217304471