Fundamentals of Traditional Chinese Medicine

The foundations of Traditional Chinese Medicine (TCM) are very different from those of Western medicine. It is a medicine that favors analogies, that has a broad and integrated vision of what it means to be “healthy”, and whose foundations were established long before the advent of scientific thought.

But, paradoxically, we have been beginning to discover, in recent years, all sorts of concordances between the thousand-year-old empirical observations of TCM and the explanations of modern science, for example with regard to anatomy (interdependence of Organs, action of acupuncture points, etc.) and the determinants of health (diet, emotions, lifestyle, environment, etc.).

A millennial origin

The methodology specific to TCM belongs to the approaches of the pre-scientific era which combined observation, deductions and intuition. TCM is therefore essentially based on an abundant literature exposing clinical cases and their resolution, on the clinical experience of practitioners, on the enlightened reflections of certain doctors and on various “consensus” between clinicians through the ages.

Despite the efforts made over the last thirty years to corroborate traditional assertions in the light of scientific research, we are far from having at our disposal all the elements to confirm or invalidate the results obtained by the traditional approach.

In the eyes of the scientist, the very old theoretical bases of TCM may seem naive and anachronistic. However, many concepts such as Theories on Substances, the Viscera and the Meridians remain perfectly useful and relevant in modern practice. In addition, several theories continue to advance and we obviously don’t treat today the same as 3,000 years ago…

TCM has created empirical models that it has clinically tested and validated over time. She developed a set of theories characterized by a certain syncretism, that is to say a conception of global reality rather than fragmented; an approach that is often very useful, but, it must be said, sometimes more or less coherent…

The richness and complexity of the links envisaged between all the elements that make up our world have led TCM to favor a systemic approach:

  • including multiple grids that classify the influences of the environment and the components of our body according to their affinities;
  • defining laws capable of describing, or even predicting, the evolution of the relationship between our organism and its environment.

The Yin Yang approach proposes to represent reality as the play of two forces, light and shadow, which create infinite shades of gray. These two forces, one active and emitting (Yang), the other passive and receiving (Yin), oppose and complement each other both in the human body and in the rest of the universe. Their opposition is driving all the changes we see. Their relationships evolve cyclically, in a more or less predictable way, according to alternating phases of increase and decrease, like the light which increases from dawn to noon, then decreases until sunset. Applied to medicine, this theory describes thehomeostasis of the body in terms of opposite and complementary components, whose disturbances, excesses or insufficiencies cause the appearance of the symptoms of the diseases. (See Yin-Yang.)

Just as light can be broken down into complementary colors, the Theory of the Five Elements suggests that we look at reality through five determined filters. All of reality and any part of reality, from the alternation of the seasons to the diversity of Flavors to the organization of the Organs, can be seen through these filters. In the extension of Yin Yang, the Theory of the five Elements makes it possible to refine the study of the dynamisms present within the organism and to better describe the influence of the environment on our internal balance. This theory describes five seasons, five Flavors and five Climates that stimulate or attack the five organic spheres (the five major sets of Organs and their spheres of influence) responsible for homeostasis in our body. (See Five Elements.)

A vision still relevant

TCM has never lingered to “disassemble” life, as scientific research has undertaken for several centuries, separating and isolating each piece of the mosaic of living beings as one disassembles and classifies the pieces of a gigantic mechanism. TCM has favored the general description of the movement of living systems whose changes it tries to predict and influence to keep the patient in a state of dynamic equilibrium. The global vision that she has maintained – while pursuing rich and varied clinical experiments – remains surprisingly simple. It contrasts with the Western medical vision where knowledge is so fragmented and complex that it is almost impossible for a single individual to grasp all of it.

One could say that today the challenge is not so much to prove the scientific value of Chinese medical theories, but to assess the relevance of the discoveries they have made possible in the art of treating, curing , to stimulate self-healing, to strengthen the body, to compensate for deficiencies and to drive out certain pathogenic factors.

Of course, the diseases of the 21st century are not necessarily those described in ancient texts. AIDS, cancers, allergies, resistant bacteria and new viruses have taken their place in our daily lives. The effect of drugs unknown 100 years ago, such as vaccines, antibiotics, anti-inflammatories or anxiolytics have helped many people, but have also created their own perversities through their sometimes abusive or inconsiderate uses. The industrialization of food production methods, the diseases they create in animals (which are sometimes transmissible to humans), the unknown effect of genetically modified or artificially preserved foods, all these new parameters are modifying the diseases that we affect and question the relevance of a traditional approach such as TCM.

Acupuncture goes scientific

Since the middle of the 20th century, we have been witnessing a modernization of TCM and the emergence of medical acupuncture which is developing in a Western and scientific context. This medical acupuncture is still very young, but is based on rigorous clinical research. These come from scientists who favor, among other things, neurophysiology to understand the regulatory processes triggered by acupuncture. These researchers describe the action of acupuncture according to very different models from those of traditional theories.

According to the modern biomedical model, most diseases are the result of a combination of factors: harmful environmental influences, nutritional problems, psychological stresses, hereditary predispositions, etc. Currently, several researchers are hypothesizing that acupuncture acts mainly on psychological stress. It would make it possible to modulate certain regulatory mechanisms such as the activity of the autonomic nervous system (sympathetic and parasympathetic) or of the hypothalamus, and to release neuropeptides, for example.

The decoding of the mechanisms triggered by the stimulation of the cutaneous and subcutaneous zones through acupuncture is only in its infancy. There is an urgent need for clinical evidence to decide between what, in the action of acupuncture, is directly related to the physical stimulation of certain points of the body or else to the placebo effect. Research needs are enormous and the difficulty of finding funds remains the main obstacle to the advancement of knowledge.

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