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Advancements in Bioequivalence & Bioavailability
Cautions for Learning Traditional Chinese Medicine and Acupuncture
Tong Zheng Hong*
Department of Health Sciences, Taiwan
*Corresponding author: Tong Zheng Hong, Department of Health Sciences, Taiwan
Submission: September 19, 2018;Published: December 10, 2018
Volume2 Issue2 December 2018
Abstract
Understanding and accurate interpretation of the acupuncture and TCM terms are required for learning acupuncture and TCM. Some cautions like the understanding of Yin-Yang, the importance of processing of Chinese herbs are closely associated with the treatment outcomes are presented. With the scientific evidence, it seems promising for the integration of the Western medicine with acupuncture and TCM.
Keywords: Yin-Yang; The five element; Processing of material medica
Introduction
For over thousand years acupuncture and traditional Chinese medicine (TCM) have been the components of the mainstream health system in China, the Chinese communities, and Asian countries, such as Taiwan, Hong Kong, Macau, Japan, and Korea. Acupuncture recommended by the WHO for pain management has established its status in the West, even though it’s at present seen and classified as primarily the complementary or alternative medicine. Concerns like safety and effectiveness seem to hinder people from accepting and using either acupuncture or TCM without enough evidence verified scientifically.
The philosophical and abstract concepts, such as Yin-Yang, the Five Element, Qi, Blood, pattern identification, and Wei-Qi-Ying- Blood sequence, for learners are not easy at all, to some extent, to catch the whole picture of the functions broader than the concrete anatomical knowledge of the Western medicine.
On the other hand, the historical development of acupuncture with TCM plays a key to learning and understanding acupuncture and TCM, which may confuse learners and those who are interested in acupuncture and TCM.
The inductive logic thinking approach of Chinese is the foundation for developing acupuncture and TCM, which is totally different from the deductive approach in the West and leads to the similarity-centered theories of Ying-Yang, the Five Element, the meridian systems, and Six-meridian identification, etc. Overall, Qi, Blood, Essence, and fluids are the fundamental materials as the foundations for organs’ functions. Liver, Heart, Spleen, Lung, and Kidney are five Ying Zang organs that co-work through the meridian systems with the six Fu Yang organs Gall Bladder, Large Intestine, Stomach, Small Intestine, Sanjiao, and Bladder to connect all the body systems.
Huangdi Neijing (Inner Canon of the Yellow Emperor) presumably published in the Warring States period (475-221 BC) has been viewed as the fundamental and key classic in acupuncture and TCM as the Bible in the Christianity. Concepts presented in this classic, to some extents, deserve attentions for discussions when verified by scientific evidence. This paper aims to present cautions that acupuncture and TCM learners need to know in order to gain the correct concepts.
Yin-Yang
Yin-Yang imbalance is understood to cause the diseases, reflecting the disharmony between Qi and Blood. Recent researches have suggested that Yin-Yang seems to be logical. Both plus (+) and minus (−) are used as the electric charge symbols of the primary ions of electrolytes, which is closely associated with the electrolyte balance between the extracellular and intracellular environments for activating neurons and muscles.
One of the scientific explanations of the Liver qi stagnation pattern in the TCM indicates that the autonomic nervous system functions with the enough levels of electrolytes to control lymphocytes and granulocytes, and the ratio of these two cells is viewed as the presentation of Yin and Yang [1]. Blood is classified as Yin, which refers to material, while Qi viewed as Yang, which are the materials for the functions of Zang-Fu organs. The well-known quotation Qi is the commander of Blood; Blood acts as the mother of Qi highlights the collaboration of Blood and Qi, which may cause diseases when the Yin and Yang are imbalanced [2].
The five element
The regulation of Blood and the dispersion of stagnated Qi rely on the smooth flow of Liver qi [3]. Cough is the common symptom in the infections that can be understood to be the result of insulting sequence of the Five Element. The experimental result indicates the neurotransmitter signaling can be dysregulated when the biochemical processing to transform macronutrients into molecules malfunctions with stagnated Liver qi. The production of mitochondrial ATP of neurons is disrupted with the insufficient deliverer of molecules, which is regulated by Liver qi. If Liver qi spreads freely, Blood circulates normally to nourish the nerve system. In this theory, Lung overacts Liver. On the other hand, the Liver meridian passes the Lung area, and stagnated Liver qi can impair Qi to circulate with Blood to nourish Lung to cause Lung to malfunction without the signals from the nerve systems [4].
The Five Element theory provides a critical concept to show that Liver pertains to Wood which can overact on Stomach and Spleen classified as Earth. This Wood overacting Earth pattern is the most common pattern in clinic that can be presented with symptoms like fullness, distending or stabbing pain in the epigastric region and hypochondriac regions, which are commonly observed in digestive diseases like peptic ulcer. Liver stores Blood in this theory, and Stomach cannot digest foods with insufficient Blood distributed and transported by Liver [5].
In terms of the Generating Sequence of the Five Elements, Kidney is the mother of Liver, which suggests that Kidney’s problems can affect its child Liver. The maximum oxygen is delivered when the hematocrit value remains at 45%. The number of red blood cells can be promoted by Kidney that produces Erythropoietin to increase the capacity of the blood to carry oxygen. The production is determined by tissue oxygen pressure closely associated with the oxygen circulation in the Kidney [6].
Chinese herbal medicine
In addition to language barrier of understanding Chinese characters, the nick name of a Chinese herb is the challenge. The Chinese term Mugua (木 瓜) refers to Chinese herb Fructus Chainmail’s and the fruit papaya. In other words, the confusing situation like this Chinese herb occurs quite often to TCM and acupuncture learners. Radix Bupleuri (Chaihu), mainly derived from Bupleurum Chinese DC. and Bupleurum coroner folium Wild, has been used as a traditional Chinese herb for long to treat hepatitis, jaundice, fever, menstrual disorder, bitter taste, influenza, and hypochondriac pain. The significant difference between Bupleurum Chinese DC. and Bupleurum scoroner folium Wild lies in the indications. Dispersing stagnated Liver qi is the indication of Bupleurum Chinese DC. and Bupleurum coroner folium Wild is used to raise Yang Qi in the pattern of Middle Jiao deficiency [7].
The processing with honey, wine, vinegar, rice water, ginger, and brine is a pharmaceutical technique that can change the nature and indications of Chinese herbs for the required actions in treatment. Scientific studies show the effect of Chaihu baked with Vinegar is stronger than the crude Chaihu for soothing stagnated Liver qi and relieving depressed Liver [8]. Duzhong (Eucommia ulmoides) processed with brine can be transported easily and quickly to the Kidney meridian for the better improvements of the low energy syndrome with the function of tonifying Kidney [9].
In the different material medica classics, properties, channels, actions, and indications of a Chinese herb may be greatly different. In Compendium of Materia Medica (Bencao Gangmu), for example, the indications of Fangfang (Radix Ledebouriellae Divaricatae) include constipation, headache, and night sweat with the actions to expel the external evil qi Wind. However, indications like blurry vision, vertigo, aversion to Wind, and sweating are discussed in The Classic of Herbal Medicine (Shennong Bencaojing) [2]. Gancao (Licorice root) is the good example to highlight that the collecting time of the herbs cannot be ignored. With the properties of neutral and sweet, it is usually used to tonify the Spleen qi and strengthen the Spleen functions for bronchitis, sore throat, infections, and cough. Literature shows the autumn is the best time to collect and dry Licorice root two to three years after planting [10], but no detailed information is provided for the reasons. The possible explanation for the cultivation time or the harvest time may be that temperature, moisture, and sunshine can vary the constituents [2]. In addition, ration of the herbs in a preparation is the concern that must been considered. Liu Yi San (Six to One Powder) highlights that the ratio of Licorice root (Radix Glycyrrhizae) and Talcum must remain 6:1 to clear Heat and drain Dampness effectively. Dosages adjustment in practice depending on the patient’s conditions is indeed the most difficult issue. This is not easy at all to learn and understand because it requires the experiences of acupuncturists or TCM doctors without any golden rules to follow at all, and dosage-effect is difficult to be verified with quantitative analysis [2].
Acupuncture
The same situation of the nick names occurs to acupoints. The nickname of KD3-Taixi is Lvxi alternatively used in many of the acupuncture classics. On the other hand, the nickname of HT7 is Zhongdu that is completely identical with LV6 in Chinese. In addition, the name of Guangming can be found either in the extra acupoint of the Tung’s acupuncture or on the Gall bladder meridian as the 37th acupoint. Yin-Yang imbalance leads to disease. However, this concept cannot be applied to extra acupoints simply because they’ve not been incorporated into the traditional twelve meridians.
The understanding of the real meanings in Chinese of an acupoint plays a key to learning acupuncture. ST29-Guilai, for example, literally in Chinese means return and the indications of prolapse of dysmenorrhea, menstrual irregularity, and uterus are often considered in the clinical use [2].
Discussion
Constitution has been the one of the key concerns in the acupuncture and TCM, which has the high similarity to genes discussed in the Precision Medicine at present. Through the analysis approach, this concern has been analyzed, organized, and discussed in Yin-Yang and the Five Elements with other components, such as Blood, Qi, fluids to investigate the causations of disease. The abstract concepts of acupuncture and TCM are understood gradually with the scientific evidence to some extent, which can be beneficial to the integration of the Western medicine with acupuncture and TCM.
However, it is vital to take side effects and interactions into consideration when it comes to the integration of the Western medicine with acupuncture and Chinese herbs. As discussed above, crude or processed Chinese herbs may bring about the different outcomes. Therefore, it is an issue that deserves attention in clinic to use the right herbs together with the Western medications. Acupuncture and TCM theories are discussed and presented in a philosophical way in the ancient China. Both are developed with the observations of the nature, which makes it more difficult for contemporary learners to understand with the environmental changes with time.
The Chinese history shows that a civil war roughly occurred every two to three years, which caused the loss of Classics and cultural gaps to result in the possible misunderstanding of the classics. There is no doubt that the language barriers keep learners from understanding the lexical meanings, which suggests that even Chinese learners cannot really catch the whole picture of the theories discussed in the TCM classics with the lexical changes.
Conclusion
It is noted that language seems to be the key to understanding and learning acupuncture and TCM, may explain why there are masters of different schools in acupuncture and TCM. Experimental evidence provides the explanations of the abstract concepts, which presents the direction for the accurate interpretations of the acupuncture and TCM terms. However, whether acupuncture with TCM and the Western medicine can co-work with each other for the better healthcare needs more attentions and efforts.
References
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- Donnelly S (2001) Why is erythropoietin made in the kidney? The kidney functions as a critmeter. Am J Kidney Dis 38(2): 415-425.
- Ya Z, Feng LM, Liu LJ, Zhang X, Zhao RZ (2017) Clerosterol from vinegarbaked radix bupleuri modifies drug transport. Oncotarget 8(13): 21351- 21361.
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- Weng ZB, Yan CP, Wu Y, Cai BC, Chen ZP, et al. (2014) Study of the effect of salt-roast processing product of Eucommia ulmoides Oliv. on osteoporosis in ovariectomized rats. Chinese Journal of Osteoporosis 20: 1457-1463.
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© 2018 Tong Zheng Hong. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.
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