What is Traditional Chinese Medicine & How Does it Work?

Have you ever heard someone say they feel like their Qi (pronounced chi) is off? Have you ever seen the Yin-Yang symbol? If you said yes to either of these questions, then you’ve already heard of traditional Chinese medicine!

Traditional Chinese medicine (TCM) is a comprehensive and complex, holistic form of medicine that analyzes multiple aspects of a patient and their relationship with Nature. While Chinese medicine texts date back to around 300 BC to 100 BC, key aspects of traditional Chinese medicine date back even further, emerging during the Zhou Dynasty in 1000 BC. (1) Though ancient in its roots, traditional Chinese medicine theory mirrors many aspects of conventional medicine and addresses some of the same modern health issues of today such as chronic pain and kidney disease. (7)(2)(3)

What is traditional Chinese medicine?

Traditional Chinese medicine (TCM) includes a variety of treatment methods, including acupuncture, cupping (the use of suction and heat to decompress muscle and tissue), moxibustion (the burning of the dried herb, mugwort, close to the skin), Chinese herbal medicine, Asian bodywork therapy such as acupressure (using manual pressure in lieu of needles on acupuncture points), as well as other common integrative modalities such as nutrition, exercise, and meditation. There are a few key principles involved with understanding TCM, such as:

• The theory of Yin-Yang
• The theory of the Five Elements
• The theory of Qi (1)

Yin and Yang

The concept of Yin-Yang represents balance, complementary, and equally important yet opposing forces in TCM. Generally speaking:

• Yin cools the body, while Yang warms it up.
• Yin lets us rest, while Yang helps us move.
• Yin relates more to the internal aspects (organs) of the body while Yang relates more to the external aspects (skin and muscles).
• Yin is more feminine in quality, whereas Yang is considered more masculine.

In TCM, Yin and Yang have many applications, each pertaining to different aspects of the body and corresponding functions of the Internal Organs (Zangfu). In the TCM theory of the Internal Organs, there are six solid Yin (Zang) organs, which are the Spleen, Heart, Kidneys, Pericardium, Lungs, and Liver, and six hollow Yang (Fu) organs, which are the Stomach, Small Intestine, Urinary Bladder, Triple Burner (San Jiao), Large Intestine, and Gallbladder.

TCM and Western medicine share many similarities when describing the functions of the human anatomy, however TCM has some unique theories when considering how the Internal Organs interact and in describing characteristics of the Internal Organs, such as color, smell, taste, and emotion. The main function of the Yin (Zang) organs is to store and nourish the vital substances of the body, including Qi, Blood, Essence (Jing), Body Fluids, and Mind (Shen). The main function of the Yang (Fu) organs is to transform these substances via different bodily processes.

The application of Yin and Yang extends even further into Nature and the seasons, with summer being more Yang in nature and winter being more Yin. Like the seasons, TCM explains that the two are constantly changing. It is when Yin and Yang shift out of balance that sickness or changes in health can occur. These imbalances are represented as being deficient (xu) or excess (shi) in Yin or Yang. (1)

Xu Yin or Empty Heat

This occurs when a person becomes deficient in Yin. Because the Yin is not adequate to balance the Yang, an individual may feel more Yang symptoms than usual due to the lack of Yin. The person may present with flushed cheeks, a low-grade fever, night sweats, or other symptoms depending on the organs involved. Menopausal hot flashes are considered to be due to Kidney Yin deficiency, for example. (4)

Xu Yang or Empty Cold

This occurs when a person becomes deficient in Yang. Because the Yang is not adequate to balance the Yin, they may feel more Yin symptoms than usual, though typically not to the same severity as a full cold. They may feel cold and notice that their symptoms improve with rest.

Shi Yin or Full Cold

This occurs when someone becomes excess in Yin. Because there is too much Yin, the Yin symptoms may overpower the Yang. They may feel tired, cold, and want to curl up and stay still.

Shi Yang or Full Heat

This occurs when someone becomes excess in Yang. Because there is too much Yang, the Yang symptoms may overpower the Yin. They may have a high fever, feel hot during the day, and may have a desire for cold drinks.

TCM aims to harmonize the Yang and Yin in patients by tonifying or increasing in conditions of deficiency, and expelling or decreasing in conditions of excess.

Did you know?
In TCM, each Internal Organ has a specific time of day when its energy is most active. For example, irregular heart beats, elevated blood pressure, and cardiac events (all related to the Heart) may be more likely to happen between 11:00 AM to 1:00 PM. (8) This Organ Clock helps TCM practitioners understand which Internal Organ is afflicted based on the time of day of symptoms.

The Five Elements

In TCM, the Five Elements represent Nature, its various states, and how they are reflected in the human body. The Five Elements correlate to the seasons and one pair of Zangfu organs, with the exception of the Fire Element which houses two pairs of Zangfu organs. Similar to how the Organ Clock helps TCM practitioners understand the pathology based on the time of day of symptoms, the relationships between the Five Elements help to understand when Organs are likely to cause problems based on their season and qualities, or which organs may be playing a role in underlying dysfunction. The Five Elements are Earth, Metal, Water, Wood, and Fire. (1)

Earth

This element houses the Spleen and the Stomach. It corresponds to the season of late summer, which can often change quickly and is considered a damp climate. Given this, the Spleen and Stomach are particularly sensitive to Dampness, and are likely to be associated with digestive symptoms and weight imbalances. Earth is associated with a taste quality of sweet, the color yellow, and the emotion of worry or overthought. (1)

Metal

This element houses the Lungs and Large Intestine. It corresponds to the season of autumn, a period of harvest where Yang transforms into a subtle form of Yin. Autumn is considered a dry climate, thus the Lungs and Large Intestines are incredibly sensitive to Dryness and prone to symptoms such as cough, fatigue, constipation, and respiratory or skin conditions. Metal is associated with the taste quality of pungent, the color white, and the emotion of grief. (1)

Water

This element houses the Kidneys and Urinary Bladder. It corresponds to the season of winter, a period where Yin dominates over Yang. In TCM, winter is a time of rest where we should conserve our energy; it is portrayed as a cold climate, thus the Kidneys and Urinary Bladder can easily become afflicted when exposed to too much internal or external Coldness. Water is associated with a taste quality of salty, the colors blue and black, and the emotion of fear. (1)

Wood

This element houses the Liver and Gallbladder. It corresponds to the season of spring, a period of birth. Spring is portrayed as a windy climate thus the Liver and Gallbladder are exceptionally susceptible to Wind. Wood is associated with a taste quality of sour, the color green, and the emotion of anger. Based on its Internal Organs, imbalances in the Wood element can cause headaches, high blood pressure, and menstrual cycle irregularities. (1)

Fire

This element houses the Heart and Small Intestine, as well as the Pericardium and San Jiao. It corresponds to the season of summer, a season with ample sunshine. Summer is portrayed as a hot climate, thus its organs are sensitive to Heat. Fire is associated with a taste quality of bitterness, the color red, and the emotion of ‘joy’. Note that in TCM, ‘joy’ refers more specifically to a state of being overly excited. Signs of problems in the Fire element may include heart palpitations, sleep disturbances, and anxiety. (1)

Did you know?
The Five Element theory in TCM can be used to analyze people as it extends to our body structure, temperament, and even to our personalities. If you have a round face, yellowish complexion, singsong voice, are prone to worry, crave sweets, enjoy helping others, and like to feel needed, then you just may be an Earth type! (6)

Qi and the meridians

The third tenant of TCM is the theory of Qi. Qi is a concept that has no exact English translation, though it can roughly be defined as the ‘energy’ or ‘vital force’ that is continuously circulating throughout our bodies. It is derived from the food we consume, the air we breathe, and the Qi we received from our parents. It flows along meridians or channels which are nourished by the Yin and correspond to the different Zangfu organs. Meridians and Qi comprise the backbone of acupuncture as its primary goal is to optimize the flow of Qi and influence organ function by stimulating various acupuncture points. While there are many channels and vessels involved in the flow of Qi, there are twelve primary or Zang-fu meridians with six of the Yin and six of the Yang organs. (1)

Did you know?
Chronic obstructive pulmonary disease, including emphysema and chronic bronchitis, is considered a Lung and Spleen Qi deficiency in TCM. (9)

Qi is responsible for many functions. It helps transport energy, holds fluids and structures in their proper place, and protects the body from external pathogens. There are numerous types of Qi, and disharmony of Qi can result in a multitude of ailments. For example, our Wei Qi is our ‘Defensive Qi’, helping to keep out unwanted microorganisms, thus deficiencies in Wei Qi may result in susceptibility to infections, often of the respiratory system as the Wei Qi is controlled by the Lungs. Qi disorders include deficiency, which can result in collapse, stagnation (e.g. blood clotting) in which Qi is not properly moving, and rebellion where Qi flows in the wrong direction (e.g. hiccups). (1)

Who practices TCM, and what should I expect at my appointment?

There are several types of practitioners who practice TCM. These include doctors of Chinese medicine, Oriental medicine, or TCM, acupuncturists, and other practitioners depending on their level of training and the state or provincial regulations. To find a licensed acupuncture practitioner in the United States, you can visit the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Certification and/or examination by the NCCAOM is used by all states in the United States, except for California, which has its own licensing examination, as well as South Dakota, Oklahoma, and Alabama, which have no licensure requirements. Naturopathic medical doctors are also trained in acupuncture as TCM supports the philosophy of naturopathic medicine, though their scope of legal ability to practice varies based on state jurisdictions.

At your TCM appointment, expect a very thorough examination. Given that this medicine emphasizes a holistic approach, a practitioner may ask you several questions regarding your symptoms, medical, family, and social history which may be more in-depth than a more conventional appointment. You can expect the practitioner to inspect, palpate or touch the body, listen tentatively to your voice quality, and they may even ask you to open your mouth for a tongue inspection all to better understand the clinical and energetic picture. TCM practitioners are also trained in pulse diagnosis, so don’t be surprised if they palpate your wrists with their fingers. As with any medical appointment, keep an open mind and be sure to discuss any concerns you may have with your practitioner.