The Essence of Chinese Medicine
A uniquely poetic & comprehensive introduction for anyone.
PREFACE & INTRODUCTION
Ancient Daoists learned and theorized the philosophy of Chinese medicine through the careful observation of the nature of our inner & outer worlds. Nature is our ultimate teacher, and in the same way, I have developed the introduction that follows as my method of explaining ancient concepts to modern audiences. That said, I obviously do not rank myself along with Daoist masters, I only suggest that this wisdom is available to us all, by deeply listening to the nature of things — as they are — but a little training obviously helps! This introduction is often not how standardized TCM textbooks teach these ideas and is thus subject to copyright.
Note that this is a dynamic document, I will keep editing and adding as I see fit. At first, I was going to keep the conversation rather simple, but to honour the medicine I have added more detailed language in this version. I will be instead of making a more distilled video & slideshow version in the future. This was more comprehensive than I planned, yet it is still only scratching the surface on how much deeper this discussion will go. While this will be certainly sufficient for most; for others, I ask you to bear with me as there will certainly remain questions & confusions for more strictly Western/science-minded types. As well, extensive citation will follow in future editions.
Estimated reading time: 20–30 minutes. Last review/edit: 5/25/23
TABLE OF CONTENTS
- HISTORY & PHILOSOPHY
- Yin, Yang & Qi
- The Five Phases
2. THEORY IN ACTION
- TCM Physiology
- The Organ Systems
- The Four Precious Principals & Their Status
3. TREATMENT & CONCLUSION
- Diagnosis & Treatment Approach
- Our Body, Our Earth
One: History & Philosophy
Chinese Medicine is a multiple thousands of years old unbroken medical tradition. Ancient doctors would see dozens upon dozens of patients a day, diagnose and treat them using acupuncture & moxibustion, massage (Tuina, known as the “mother of all massage” forms), nutrition, and herbal medicine, along with numerous other modalities. Discovering what worked and what didn’t through trial and error, this information was then passed on from master to apprentice, for countless generations of refinement. It remains a thriving medical tradition today, now overlaying its theories onto new discoveries through modern diagnostic tools as scientific understanding advances.
Chinese medicine represented one of the first medical breakthroughs from the previous dominant “shamanistic” worldview of diseases being caused purely by spirits or a lack of appeasing the gods. Instead, it presented a model of rational and predictable cause and effect, much like today’s scientific approach.
When our modern world uses the term “TCM” it is referring to a specific clinically focussed form of the medicine which unites multiple regional traditions. These were standardized by Mao during the Cultural Revolution. Due to this standardization, much of the psycho-spiritual facets (some of high value, others more superstitious), as well as what I consider to be highly more refined acupuncture techniques of the medicine have been suppressed in the mainstream practice to make it a ‘palatable’ export for Westerners.
In an attempt to merge the numerous theoretical lenses, the modern practice of acupuncture has largely been reduced to an herbal model approach (this herb/point for that imbalance) and not the original dynamic “Channel Theory” in which the channels have independent physiological functions in themselves. That said, the various pre-Maoist forms of the medicine are indeed alive and well, and instead often fall under the term “Classical Chinese Medicine” (CCM).
Chinese medicine is a tradition that is rooted in the premise that we are not separate from nature; that the same forces which exist outside and around us, also manifest or mirror within our bodies, minds, and hearts, as well. Disease arises when we break the laws set forth by our natural world — and separate ourselves from its natural rhythms. For literally thousands of years it has carefully observed, analyzed and modified its theories on how we adapt and react to our ever-changing environments, both internal and external. This includes the relationships between the ‘weathers’ of emotions, mind-states, traumas, the foods that course through our bodies, seasonal climates, time of day, and the literal day-to-day weather itself. This is a traditional representation of what we now might call “Systems Thinking” or “Systems Theory”.
Before looking at how this philosophy is applied to medicine, we must first examine the philosophy itself.
YIN, YANG, and QI
We begin with the observation of the basic appearance of the duality of nature, crystalized in the well-known principles of Yin and Yang. These aspects are apparent everywhere we look: dark/light, night/day, water/fire, winter/summer, active/receptive, body/mind, death/birth, cold/hot, and onwards. In our modern medicine, we see the parasympathetic/sympathetic nervous system, sleep/wake cycles, and pH balance as examples of this. There are obviously innumerable others.
Our Earth can be regarded as Yin, the potential, and as soon as it meets the Sun, Yang, it blossoms into life. When the Sun goes away Yin again dominates, and we sleep or hibernate. Yin is the seed and remains so until awakened by Yang. Yang activates nothing without Yin. They are interdependent.
Yin and Yang are examples of the non-absolute relational nature of reality. For example, the roots of a tree are more Yin in nature when compared to the trunk (underground, lower, cooler vs more upright, higher, warmer, etc). Yet when we compare the trunk to the branches and leaves of a tree, the trunk then becomes more Yin in relation to the branches (below vs. above, condensed vs. expanded appearance and so on — these are detailed in most TCM fundamentals textbooks). These states do not exist in isolation of each other. Instead, the Chinese observed that they are instead polar aspects of a unified whole: this whole is Qi, the third principle.
Qi is akin to the proper physics term of energy — it condenses into matter (Yin) or becomes rarefied into waveforms or light (Yang) — yet all are just gradients of the same thing: energy. The only factors that create the illusion of their separation are perception, and time.
Another way of looking at (as my patients so often hear!) is to see that day does not simply snap into night, and then again vice-versa — instead it is in a constant state of transition. This fundamental movement of reality, this dance as these forces transform into each other and back again in varying degrees is Qi. In this regard, I call Qi “Vital Inertia”. It is the fundamental motive force, the transformation principle of matter through time. The dance of the year, the day, the life, is the dance of Qi as it condenses and expands toward Yin and Yang and back again. If we were to zoom into the very edges of Yin and Yang in the Yin/Yang (Taiji) symbol, we would see all the colours of the rainbow. This is Qi.
“In this regard, I call Qi “Vital Inertia””
THE FIVE PHASES
Looking deeper, we can see that there are relatively distinct stages, movements of Qi, or phases to this transformation of Yin into Yang and back again. Using winter and summer as representative aspects of Yin and Yang respectively, we can now see the additions of spring and autumn. These all form the primary aspects of the Chinese “Five Elements” or more accurately “Five Phases” (Wu Xing) theory. Each was assigned a symbol from nature to capture the essence of the phase.
- Morning/Spring— Wood — Qi expands outwards
- Day/Summer — Fire — Qi ascends upwards
- Evening/Autumn — Metal — Qi contracts inwards
- Night/Winter — Water — Qi descends downwards
So, what or where is the “fifth”?
We have spoken of the movements or transitions of Qi — in the Chinese tradition — the fifth is represented by ‘Earth’, the stable constant. It is Earth that remains stable through the transitions of these seasons around it. The support of Earth gives rise to the others.
Here it is worth a brief deviation to describe the difference between “element” and “phase”. While at first they seem to overlap, they are in fact totally separate systems. In the case of “elements” I think of this literally — in the scientific sense of “states of matter”. Here earth is the solid state, water is liquid, fire is ether, air being gas and last “space” being the vacuum. This “five elements” system is found across many cultures of the world, whereas the Chinese were less concerned with “states”, and more concerned with observing the movements of reality; instead (and if anything more accurately) philosophizing systems around the transient nature of reality, thus describing transitions between the elements — hence the five “phases” or “movements” when translated more accurately into English.
So, returning — Earth is regarded as a special phase; it has a secondary position representing the stage of maturity or the peak of life. This is manifest not only in the peak of each season but also in the peak of the year, regarded as the special season of Harvest. This is the time when life almost reaches its blissful apex, bears its fruit, before beginning its descent back into winter.
The Phases represent a nature-based model of the pure movements/transitions of Qi itself, not necessarily to be taken literally. These then manifest in all the various forms throughout reality. So “Wood” as an example, corresponds to spring, as it does to dawn, to birth, to the sprout, and onwards. I invite you to explore and more importantly experience this for yourself…
Two: Theory in Action
So what does this all have to do with health and medicine? The medical usage of the term Qi can be boiled down to the optimal physiological function of an organism. Its total vitality, and that of all its sub-systems.
We detect its “flow” and state of health similar to observing the patterns (symptoms) made by the wind as it ripples through the trees (our bodies) — the wind invisible, but its effects clear. The nature of Qi is said to flow unimpeded as a river does. When Qi (optimal physiology) flows, our health and experience of life flows with ease as well, we move towards our goals with more grace and natural joy.
And like a river, Qi is known to stagnate, become sluggish, stuck or blocked, implying that on some level the basic function of an organ or system has become impaired — yet may not show up on a lab test.
In this medical sense, I call Qi “Functional Vitality”. How well does the system perform its transformations of Yin to Yang and back again? How well does it adapt to its ever-changing circumstances?
“In this medical sense, I call Qi “Functional Vitality”.”
Because TCM springs from a systems-thinking or wholistic-minded culture, this term Qi is broader than the physics term of ‘energy’ — not only does it loosely describe energy, but also, its quality. It is the animating or enlivening aspect, representing the vitality of life. This is illustrated quite literally in the actual Chinese character of the word Qi : it depicts a bowl of rice below (Yin) with steam flowing from it above (Yang), which together evokes the fresh, nourishing and vitalizing image of Qi.
On the other hand, Qi is nothing more than what you see as what it is. If there is a blockage or suppression in function such as bloating which simply is not detected in lab tests, by definition there is a blockage in Qi. They are the same. We need not paste another layer over this already sacred process by calling Qi a magical healing energy. (As so many new age colonialists too often do). It is what it is, and what it is, is already sacred, already magical. So, let’s stop looking elsewhere.
THE ORGAN SYSTEMS
Returning again to the philosophy that we are not separate from nature; the Chinese “rooted” the Five Phases of the Cycles of Qi into our physical organs. Due to the fact that the ancient Chinese did not yet have modern microscopes or modern surgery, it regarded these “Organs” as the physical embodiments, representatives, or homes of these universal forces in our bodies. As such, the TCM concept of organs is always capitalized to separate them from the literal biological organs. Despite often overlapping however, the functions attributed to these Organs form a significantly broader, more wholistic picture than the modern anatomical view: the Organs are regarded as collections of mind-body-spirit-emotional functions, rather than the viscera of our modern understanding. Let’s take a closer 101 overview of the Organs. (This will be significantly expanded in future editions).
Expands Qi outwards towards the extremities, dilating the acupuncture channels (vascular/nervous/fascial intersections) to ensure the smooth flow of functional Qi in all its forms (digestive, menstrual, emotional regularity). This is the stretching of limbs at dawn and the springtime.
Provides the “light of consciousness”, warms the body via Blood, its channel (along with its paired Kidney channel) is the source of metabolic fire for the body. This is the ability to see with maturity in the broad daylight, in the first signs of adult self-reflective maturity.
Note: In TCM theory, the “Heart” is the seat of Consciousness, while the brain was more of the basic “computer”. Look into the research of HeartMath for some very interesting overlapping ideas.
Responsible for the digestion of food, extracts Qi and nutrition (“Blood”) which is then delivered to all Organ networks. This is the harvest time of late summer, of ripe nutrition, and peak adult years before the descent.
Note: When referring to the Spleen, the Chinese were more accurately referring to the digestive organ the pancreas. The name ‘Spleen’ is a pervasive mistranslation.
Consolidates Qi, air, and fluids, like the canopy of a tree collecting and condensing sunlight and water towards the root system. This is the vital in-breath, the stage of the wisdom of letting go, of the evening, the autumn, and the beginning of the hardening/oxidization of an organism.
Water is the deep, mysterious source of life. The Kidneys are the source and reserve tank of “primal” Yin, Yang, and Qi for the entire system — like a well that draws water up to the surface. This is the quiet of the night, of the elder years, the retreat, descent, decay, and the acceptance of the unknown — this is the evacuation of the bodily fluids — and the Soul.
Just as we have the ‘respiratory system’ and ‘circulatory system’, the Chinese have the Liver system, and the Spleen system, and onwards. All of the total macro physiological functions of our entire organism are described and included in these systems, just simply grouped together under different “headings”, attributed to different networks. A different language to describe the same phenomena. Nothing is lost, just mapped in a different way than our modern medical system, much like the indigenous of North America had different territorial boundaries than the ones colonialists laid down — yet all covered the same inherent landscape. In fact, because these systems also encompass psycho-emotional & spiritual aspects of our whole being, they have a far broader treatment reach than the biomedical systems we are used to. This is due to the fact that from the ground up this system treats the body (Yin) and mind (Yang) simultaneously.
“All of the total macro physiological functions of our entire organism are described and included in these systems, just simply grouped together under different “headings”, attributed to different networks.”
Just as it is hard to translate from one language to another without losing subtle connotations, the same is true for the Organs. We work with the ‘Kidneys’ which are defined in TCM terms, and then use herbs which treat the ‘Kidneys’ which, from a Western point of view may be herbs that act on hormone regulation, cerebral tonics, or tonics which strengthen the bones. The key here is that the tradition defines and dictates the functions of these systems and should at no point be taken out of this context — unless to draw overlapping similarities between the two medical systems.
What makes Chinese Medicine a wholistic medicine is that not only are physical functions of the organism attributed to these Organ Networks, but psychological functions as well. To illustrate this, I use my ‘Garden of Five Flowers’ metaphor. Imagine a garden of five plants. The root structures of the individual plants are intertwined and interdependent, forming networks of shared nutrients and information. The roots here represent the Organs themselves. From each of the roots grows a stalk. This stalk represents the “tissue” the Organ feeds. Let’s use the Liver as the example from here onwards. Due to the nature of Wood/Liver to expand, the Liver “governs” our ability to move in the world — thus it feeds the joints and tendons which allow us to move and stretch outwards.
Each plant then has different leaves, or manifestations — these include a corresponding bodily accessory (the finger/toenails, in the Liver’s case), as well as an associated bodily fluid and numerous others, rooted in the careful observation of the interconnectivity of the being as a whole. The flower represents the sense organ (eyes). The fruit is the corresponding mental-emotional state: a balanced Liver network gives us the capacity to plan and the assertiveness/decisiveness to act on the plan. When imbalanced, we experience disproportionate anger, frustration, resentment or depression when our expectations are not met — all symptoms of our free-flowing creative/generative nature of ‘Wood’ being impeded. Finally, the fragrance is the Spiritual aspect. For the Liver, this is known as the “Hun” which is our creative visionary potential, it is our imagination and brings us our dreams each night.
“The tradition defines and dictates the functions of these systems and should at no point be taken out of this context”
Deeper still, each of the Phases/Organs governs a cycle of time or physiology:
- Wood/Liver — Menstrual cycle, the cycle, and duration of emotions
- Fire/Heart — Moment to moment perception of time, the heartbeat, as well as sleep/wake cycles
- Earth/Spleen — The cycle of digestion from mouth to excretion
- Metal/Lungs — The cycle of breath, the cycle of Qi through the Channels
- Water/Kidneys — The reproduction of life (pregnancy), and the duration of one’s life itself.
These are only a few examples of theories and functions I have chosen out of interest. There are textbooks of others.
So, to bring this all together, Chinese Medicine groups these functions under the umbrella term of each Organ. By treating the root Organ, we see the rest of the system return to health — like watering the roots of the plant to bring lush vitality (Qi) to the leaves. The fact that these systems are not (yet) anatomically or biologically connected in scientific terms is irrelevant, as again, the tradition defines the terms and then treats them accordingly regardless of how they are named.
THE FOUR PRECIOUS PRINCIPLES & THEIR STATUS
Chinese Medicine works in concepts — metaphorical images pointing to reality, and again — treats accordingly. I have come to name these substances not as literal substances, but as “Principles”. Here is where, I argue, that we find the “Four Elements” hidden away in TCM, in contrast to the previous Five Phases.
Yin, Yang, Qi, and Blood (and other lesser substances not relevant to this intro article) flow through and nourish each of the Organ systems, and each take on their own distinct functions and characteristics while within that domain. If we were to imagine Yin as one end of a gradient or spectrum, and Yang at the other end, moving closer to the middle we would have Blood, and Qi respectively. I have organized these principles as follows:
- Yin is the “Cooling, Calming, and Moistening Principle” (Water)
- Yang is the “Principle of Warming & Activation” (Fire)
- Blood is the “Nutritive Principle” (Earth)
- Qi is the “Principle of Vital Function” (Air)
In other words, Qi is “that which provides optimal vitality”, Yin is “that which cools” and can be seen as an anti-inflammatory principle, and onwards. Any physiological functions may fall under these umbrellas and therefore by simply treating these concepts at this broad level, we can treat all functions that fall under them — again, nourishing the roots to sustain the leaves.
Zeroing In: The TCM Concept of Blood
“Blood” is a very common substance that has not been discussed yet and extremely clinically relevant.
It takes Qi to extract the nutrients and essences out of our foods. The basic building blocks of amino acids, fatty acids, sugars, vitamins, and minerals are all the result of the breakdown process of digestion. Collectively, these pure substances as well as the literal blood itself, are all considered aspects of the TCM concept of Blood.
So, when a TCM practitioner refers to “Blood”, think not only of the blood that flows through our veins, but also of the vital nutrients delivered by it to each cell of our body. When TCM states that an individual is “Blood deficient”, this could mean anemia, or fatty acid deficiency, deficient in a specific vitamin, or any number of nutrients.
Again, the sum-total of these, the Nutritive Principle is what we work with — not isolated bio-chemicals. The individual constituents become more or less irrelevant when working with the broader encompassing term that unites them. This is a case of “a rising tide lifts all boats” as nourishing Blood by definition replenishes any aspects of micronutrition.
Three: Pathology, Treatment & Conclusion
THE “PRINCIPLES” IN DISHARMONY
The fundamental principles, Qi, Blood, Yin & Yang must be abundant and flowing. If their flow or distribution in either the affected organ or the being as a whole is impaired, then by definition there must be a pathogen, an accumulation (a block in the river), or a state of deficiency/leakage which has caused the less optimal state.
A common example is the very commonly diagnosed pattern of “Qi Stagnation”. This is the all-too-common patient who returns with labs tests revealing “negative” (and who are then often told their condition is “all in their head”). Of course the physicians cannot find any specific positive biological markers, despite the patient knowing something is wrong: the condition is not rooted in the physical anatomy — it is a Stagnation of Qi: function.
Thus, TCM essentially boils down all disease patterns into three fundamental imbalances (again an example of Yin, Yang & Qi, in themselves): Excess, Deficiency and Misregulation (aka Stagnation or Constraint depending on presentation).
Let’s take Yin into consideration: its deficiency is a lack of any or all of the defined qualities of Yin: grounding, moistening, cooling, etc. These states can all be excessive as well, think of someone who is too grounded, perhaps even overweight, cold, and/or pathologically slow in their behaviour (chronically late). The body also will reflect corresponding symptoms of these imbalances, detected by the trained practitioner as it is rare if ever a case presents this “purely”.
A common example I use to illustrate this is that if you stay awake for too long (Yang), you are going to need a lot of sleep (Yin) — you have no choice in the matter, it is up to the nature of your body and the irrefutable nature of things. If you are ‘burning the candle at both ends’ (a very Yang term), as many of us are, then you are going to need a lot of Yin rejuvenation — which in today’s modern world may be quite hard to come by without the Yin herbal tonics & appropriate foods which replenish this principle. Without a period of rejuvenation, eventually our minds and bodies will exhibit the classic symptoms of a deficiency of Yin — “burnout”— all meticulously explained by TCM theory.
DIAGNOSIS & TREATMENT APPROACH
So, as you can hopefully see — (it’s complicated, I know!), when we turn the “Liver Blood” system back online, we return the vitality to the other aspects further downstream. Practitioners triangulate an imbalance of the Liver through symptoms such as disturbing dreams, an irregular menstrual cycle, and cracking joints. With correct diagnosis, all of these rejuvenate in an often shockingly short period of time — even for us professionals!
These are akin to the advanced gardener detecting what is going on in the roots of a plant by examining the state of the leaves (you can probably tell this is my favourite metaphor). Yet because of the Systems Thinking nature of Chinese Medicine, one symptom alone will not necessarily point to a Liver imbalance, it is only when they are taken together can they form a Pattern of Disharmony. This is what Chinese medicine diagnoses and treats — rarely outright diseases which curse us for life, simply syndromes of imbalances. The coolest part is that the cure for these “diseases” is implicit in their names: to correct a “Liver Blood Deficiency” pattern, we must simply replenish Liver Blood and the system returns to vitality.
Since the classic texts, Chinese Medicine was less concerned with the exact (ex. microbial) cause of diseases, as it never attempted to isolate the totality of the world. It saw this endeavor as fruitless since our natural world in its entirety exists interdependently and chose to work with it at this level. To be clear this is not purely “terrain theory” — this is a combination of both germ theory and terrain theory. Even a rudimentary study of their herbal formulas reveals this.
TCM observes the natures of the diseases by their characterization and personality of symptom progression. It then categorizes and treats them accordingly, focussing on the successful treatment from the underlying root causes, and not through treating isolated symptoms. No symptoms exist in isolation. A headache is never just a headache.
Thus, from the ground up this medical system results in a radically different model from our current one — which warrants respect and deeper understanding. This is especially true today, as modern environmental/ecology studies agree on the interdependent nature of Nature itself.
Yet all too often, and for whatever reason, these theories (of interconnection) do not carry over to the practice modern conventional medicine, which instead tends to cling to a primitive, outdated mechanistic model (as strange as that sounds when compared to an ancient worldview!).
On the other hand, there is much to be excited about: new, complex and increasingly wholistic fields are emerging such as “psychoneuroimmunology” — the study of the psychological and nervous system’s complex relationship with the immune system (even my spell checker did not mark that as an unknown word!).
OUR BODY, OUR EARTH
The ancient Chinese viewed the body as a landscape, complete with rivers, caves, fields, mountains, streams, and seas. The view of our body and being is a microcosm of the world that surrounds us… an endless fractal with archetypal principals forming the framework that guides each layer of manifestation. (That new-agey sentence might need a second read, lol).
Even from the pages of the most pivotal TCM text, the Huang Di Nei Jing, essentially the oldest existing medical text on earth, the emphasis throughout — to attain our most optimal state of health is harmony with nature. Disease springs naturally from a deviation of these laws, laws which are ultimately beyond our human reasoning; inherent universal principles, the unspoken nature of things… as they are.
For many years in general ecology, it was believed that we could continuously pollute a stream and like a gradual degrading slope, the system would slowly collapse. Instead, the opposite has now been shown, systems can yes, be gradually damaged, but they will eventually reach a tipping point where the entire system collapses exponentially in rapid collapse. This is what we can see in the world around us today with climate change being the dominant conversation of our generation, if not in the history of our species. And in the same vein, our spiritual-emotional-mental-physical beings can only sustain so much constant pollution before we collapse into a downward spiral of depression and disease. We, like the Earth, are remarkably adaptive — but this ability to adapt has an endpoint: we can only push the system so far before the system reaches its limits.
So, the wholistic discussion of Chinese Medicine as it applies to our bodies and our mental-emotional states, being a tradition firmly grounded in the philosophy that we are not separate from nature, we also find the same principles apply to our natural world around us: Live in balance with the laws of Nature. Observe and respect the natural boundaries. For every action there is an equal and opposite reaction: excessive Yang must be counter-balanced by Yin; excessive destruction, balanced by equal rehabilitation. Even for the most hard-lined skeptic, can we not agree on these basic principles of living on our planet Earth, and then assume that these principles transfer in some degree, to our own human physiological ecosystems?
Can we not respect traditions which are absolutely and completely grounded in this way of living, and have advanced these theories for generations, never deviating from these core truths? And then from this position of respect, can we not take the time to learn to understand them in their own terms, rather than skewering them on the crucifix of science-based-language above all else?
Chinese Medicine is but one of countless traditional medical systems which cannot be isolated from the worldview they spring from. And yet universally these teaching all share the same truth — balance with nature both within our inner environment and in our natural world — leads to stress-free living, a life free from non-congenital disease — and above all attains the goal of a peaceful acceptance and passing of all living things with minimal suffering.
In Health & Inspired Living,
~Matt Walton, R.TCMP, R.Ac 2023
The Essence of Chinese Medicine by Matt Walton R.TCMP is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.