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East Meets West


Traditional Chinese Medicine (TCM) History
TCM Concepts
Anatomy According to TCM
TCM Healing Process
Modern Interpretations of Acupoints and Meridian
Circadian Cycle, East and West
TCM Modernization

Traditional Chinese Medicine (TCM) History

The Chinese outlook of the world has largely been modeled by the 易經 (I-Ching : Book of Changes) about 3000 BC (before the recorded history in Figure 38, 中國歷史). Since there was no way to examine everything closely with microscope or telescope, it has to be a holistic view, which can comprehend only the coarse features missing many details and also rather subjective (such as imposed by authoritative figures).
Chinese History The same kind of world philosophy was also prevailing in Western cultures such as the Greek's. The departure occurred around the Renaissance in 14-16 centuries, when European started to adopt to the more liberal view and examine the surroundings with the method of reductionism. Meanwhile, China was content with its old way of doing things resulting in a long period of stagnation including the advance of medicine.

Figure 38 Chinese History [view large image]

TCM Classic 2
  • A-B Classic of Acupuncture (針灸甲乙經) - This book was written in ~ 250 AD, it supplements the acupunctural part of the Huangdi's Internal Canon . It is divided into theoretical and clinical sections. A bronze statue with all the meridians and acupunctural points was commissioned by the North Song government as shown in Figure 40a.

  • Compendium of Materia Medica (本草綱目) - It is compiled by Li Shizhen (李時珍) in 1578 AD (during the Ming Dynasty). This is the most comprehensive documentation of the use of medicinal herbs, minerals and animal parts including 1892 drugs, 1109 illustrations, and 11096 herbal formulas. An one page sample is shown in Figure 39d.
  • Figure 40 TCM Classic 2 [view large image]

    The Qing Dynasty collapsed in 1911 and replaced by the Republic of China. Foreign powers had a big influence during the early 20th century. All kinds of Western thing were introduced to China including medicine. Western medicine with its more advanced diagnosis and effective medications gradually suppressed the TCM as the preferred medical treatments. No hospitals allow the use of TCM, which survives mainly on its relatively low fee, and as the last resort for patients who are not susceptible to Western medicine.


    TCM Concepts


    Anatomy According to TCM

    TCM Anatomy Modern Anatomy
    • Organs (Zang-Fu) - TCM defines the organs in terms of five Zang (臟, the solid storage organs) and six Fu (腑, the hollow circulating organs) as shown in Figure 44. This arrangement is very close to the modern anatomy (Figure 45), if the spleen and kidney-bladder are replaced by the pancreas and rectum respectively. Modern Embryology reveals that there are three major tubings developed in the fetus - the neural, gut and heart tubes. The hollow organs in TCM are those parts of the gut tube from mouth to rectum, while the solid ones belong to three branches out of the gut tube, the pump in the heart tube, and the kidney is related to one more tubing developed from mesoderm. Many organs such as the brain, uterus, the nervous and immune systems ... etc. are missed out in the Znag-Fu definition, some

    Figure 44 TCM Anatomy
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    Figure 45 Modern Anatomy
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    of them are collected into the "exotic" catalogue. Table 08 lists some properties of the Zang-Fu accordibg to TCM.
    A translation for meridian naming scheme : fore (太陰,陽明), mid (厥陰,少陽), aft (少陰,太陽); see pictorial explanation in Figure 51a.

    Phase Zang (Meridian) Fu (Meridian) Opening Manifestation(s) Function
    Wood Liver (foot-mid-ying) Gall-bladder (foot-mid-yang) Eye Sinews Defence
    Fire Heart (hand-aft-ying) Small Intestine (hand-aft-yang) Tongue Blood Endocrine
    Earth Spleen (foot-fore-ying) Stomach (foot-fore-yang) Mouth Muscles Digestive
    Metal Lung (hand-fore-ying) Large Intestine (hand-fore-yang) Nose Skin, hair Respiration
    Water Kidney (foot-aft-ying) Kidney-bladder (foot-aft-yang) Ear Bone, sex organs Circulatory

    Table 08 List of TCM Organs

    This is a holistic view of life in TCM. There were many attempts to provide some details for these terms. Usually the explanations are laden with mystic language ruining the simple idea originated in more ancient time. Modern research would rather skip arguing about such concepts. More efforts are spent in understanding the acupoints and meridians, which seem to have some clinical values as explained in another section.


    TCM Healing Process

    Figure 54 illustrates the healing process in TCM. The routine is very similar to that in Western medical clinic, however the details are very different as described briefly in the followings. It should be emphasized that while the physicians in the West has to go through rigorous training
    Healing Process in medical school; until very recently, the TCM counterparts inherited the know-how mostly from family or through apprenticeship. Thus, the quality of TCM service varies making the treatment even less reliable. Anyway, the principles of the TCM healing process is outlined below :

    Figure 54 TCM Healing Process [view large image]

    TCM 4 Diagnosis Tongue Symptoms TCM 8 Principles TCM Syndromes

    Figure 55 TCM 4 Diagnosis
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    Figure 56 Tongue Symptoms [view large image]

    Figure 57 TCM 8 Principles [view large image]

    Figure 58 TCM Syndromes
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    See "Enter the Clinic" for a feel of TCM treatment.


    Modern Interpretations of Acupoints and Meridians

    This is a controversial subject in Western medicine although the concept of acupuncture points and meridians in Qigong has been explored in China for two thousand years. Figure 51a depicts the 12 meridians and the acupuncture points along the pathways. The physical base has not been identified until some measurements were conducted in the 1970s. The followings outline some modern researches on the subjects.


    Circadian Cycle, East and West

    Circadian Cycle, East and West The modern version of circadian cycle in the West goes by the title of "Biological Clock". It has been found that the sleep-wake states are determined by a cluster of nerve cells in the suprachiasmatic nuclei (SCN), which secrete the melatonin hormone to induce drowsiness at night. Other organs operate under their own clock, which are set by mealtimes, and working hours (Figure 66a). Recent investigations show that symptoms of some diseases (such as Alzheimer's and Parkinson's) seem to tie with the circadian rhythms as described by Meridian Flow (子午流注) in Huangdi's Internal Canon (黃帝內經) more than 2000 years ago.

    Figure 66a Circadian Cycle, East and West [view large image]

    It should be emphasized that the clocks can be reset according to the daily routines. The peripheral body clocks can be adjusted quicker than the brain's master clock.

    Mouse Clocks Then a studies on "Daily Gene-oscillation in Mice" published in 2014 reveals the circadian rhythms of its 12 organs (Figure 66b). Actually, it is found that nearly half of all genes in the mouse genome oscillate on a 24-hour schedule somewhere in the body. It is suggested that drug could be dispensed more efficacious if it is delivered at the peak of the cycle. This is the same idea expounded 2000 years ago in the Huangdi's Internal Canon. However, comparing the mouse clock with the Meridian Flow chart shows that only the liver peaks at about the same time. The difference could be related to the peculiar lab setting in the experiments.

    Figure 66b Mouse Clocks [view large image]

    It is reported that the mice were entrained to a 12h:12h light:dark schedule for 1 week, then released into constant darkness.
    Figure 66a shows the 12 organs in the Meridian Flow sequentially in 24 hours. Some modern interpretations are injected to indicate the kinds of activities during each period.



    Table 09 below is a summary of the differences between TCM and Western medicine mentioned in the previous sections.

    Subject Traditional Chinese Medicine Western Medicine
    Philosophy Holistic Reductionist
    Evolution No evolutionary change Modernized from Renaissance onward
    Treatments Originated from statistical trials and errors Based on analyzing cause and effect
    Learning Embracing classical texts New knowledge from modern researches
    Teaching Inherited from family, apprenticeship National Institutions
    Anatomy Following traditional definitions Learning from surgeries
    Consciousness Origin from the heart Origin from the brain
    Clinical Practice Keep on using old concepts New discoveries for improvement
    Medication Try to heal the body, multiple ingredients Try to eliminate the disease, single ingredient
    Specialized In keeping healthy body In curing the disease
    Meridians etc. Physical base is not important Research into the basic components
    Circadian Cycle According to Meridian Flow Determined by biological clocks

    Table 09 Comparison between Traditional Chinese Medicine and Western Medicine


    TCM Modernization

    East Meets West A causal observation in Table 09 would make it obvious that the two schools of medicine are very different in most aspects . TCM seems to be in a state of stagnation not keeping up with advanced knowledge. One advantage is the relatively low cost in TCM practice. The PRC has been trying to integrate both TCM and Western medicine into the medical schools with varying degree of success. For too many years in the past, TCM seems to be lingering on the verge of irrelevancy because there is no regulations to control the practice, and the patients lost confidence in the treatments. Harmonization is impossible because the two systems have different philosophy. Figure 67 is a group photo of Chinese medical students with their Western teachers in front of the "First Chinese Medical School" circa 1920.

    Figure 67 East Meets West
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    Then along comes the "White Knight" in the form of a Chinese government's plans to modernize traditional medicine. The purposes are to improve affordable public healthcare and to export traditional remedies to the West. It has allocated hundreds million US dollars for the initiative. The progress has been reported in a 2013 review article : "The quest for modernisation of traditional Chinese medicine".

    Finally, see "TCM : Made in China" with a different perspective about TCM, and "Will the sun set on Kampo ?" for the Japanese version.

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