This article and the next will serve to introduce the practice and clinical range of Oriental Medicine: what one may expect to find upon a visit to a practitioner. This, in turn, will pave the way for discussing the treatment of specific disease in subsequent articles.
First, how does someone become a practitioner of Oriental Medicine?
In China, there have traditionally been two routes: apprenticeship and schooling. The oldest schools date back over 1000 years, while the apprentice system is many more millennia old.
In the US, traditional Oriental medicine has been practiced as long as there has been migration from the Orient. Today the practice is regulated by a national agency, the National Committee for the Certification of Acupuncture and Oriental Medicine (NCCAOM), and also by individual states. Most schools offer three or four year Masters level programs, similar to western medical schools, while two Doctoral programs are freshly underway in California and Washington. Currently, there are two areas of certification: acupuncture and Chinese herbal therapy; adjunct therapies, of which there are many, generally fall under acupuncture licensure. In addition, there is an extensive curriculum of continuing education courses and conferences.
Apart from traditional training, there are also ‘Medical Acupuncture’ schools in the US that are open only to western physicians. These programs generally avoid in-depth discussion of the philosophy and theory of Oriental Medicine, in favor of focusing on the techniques used, in particular acupuncture. Most programs are relatively short, and are separately regulated by the AMA, with their own licensing requirements and exams.
How might a practitioner diagnose a dis-ease?
Oriental Medicine makes use of nearly all the senses to put together a picture of who sits in front of them. The practitioner looks: to see how the client holds herself, i.e., where the tension or trauma is held, and what emotions are displayed on the face and in the mannerisms; to see the tongue as it is a mirror to the internal organs and the state of energy, blood flow, and fluids; and to examine the body for markings, broken vessels, or discolorations.
Next, touch may be used: to feel the pulse at the wrist, as a tributary of the greater internal circulation; to palpate the body along its meridians (where the /qi/ flows) and over sights of trauma, for heat or coolness, tightness or looseness, etc.
The practitioner listens: to the client’s complaints, her story and history; to the tone and quality of her voice. The client is also asked specific questions to fill in threads of the web being woven during the examination.
That web is then illuminated through one of the many lenses available to the medicine. There are common lenses, like /yin /and /yang/ (a filter of two), used to differentiate excess from deficiency, hot from cold, acute from chronic, etc. And then there are more highly developed filters, like the five elements or phases, corresponding to the natural cycles of life.
There are also special lenses for certain areas of medicine, e.g., traumatology, which may appear more like modern physical medicine, or pediatrics, as children’s bodies and functions are different from adults.
Whichever filters a practitioner may use will help the client understand his disease process, and then lead both practitioner and client to an appropriate treatment strategy.
What techniques are used in the treatment?
When it comes to technique in Oriental Medicine, it generally follows from /yin/ to /yang/, slow to quick, easy to complex, soft to hard (there are exceptions, e.g., in acute cases or trauma, where abrupt technique is called for). The first set of techniques, being the most highly regarded, focus on lifestyle: rest and relaxation, body and mind motion (‘e-motion’ simply displays itself through the body), the act of eating, and finally spiritual issues, or the process of distilling the essence of life.
In the event of a breakdown in the fluid cycle of these events, the remaining techniques may be performed on or prepared for the client. These proceed from bodywork and other ‘surface’ techniques (a huge area of medicine) to the more exacting methods of herbs and acupuncture.
Next month’s article will describe the techniques themselves to round out the introduction.
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This article completes the introduction to the clinical side of Oriental Medicine, briefly describing its main techniques.
/Qigong/ (pronounced ‘chee gung’) may be used to show how relaxation and movement blend together harmoniously. Qigong basically means working consciously and patiently with life’s forces. It includes aspects of awareness, posture, and breath; any human act that blends these things is qigong. A good practitioner will help the client become aware of ways she already does these things and work to enhance or expand them. Also, qigong is an art and science itself, and can be taught for health and well being, or prescribed to treat dis-ease (similar to physical therapy).
Eastern nutritional counseling may be used to bring balance and harmony to the act of eating. Instead of, or in addition to, looking at the chemical parts of food (i.e., proteins, carbohydrates, vitamins, etc.), Chinese Medicine looks to the essential nature of food relative to its thermal qualities and tastes, each with predictable effects on the body. This way provides for common-sense analysis of food. Perhaps even more importantly, eating habits and the psychology of those habits may be clearly explained. As one becomes more aware of one’s motivations, they become easier to change at will.
This brings us to spiritual concerns. Help in this area is a natural consequence of working with the body and mind and our relationships to things. In addition, the Chinese philosophy of the /Tao/, to which Chinese Medicine owes a great deal, offers a simple and organic perspective that can enhance or help develop any spiritual or religious beliefs.
Rounding out lifestyle issues is attention to one’s environment. /Feng shui/ is a specific term referring to the Chinese art of placement. In general, however, it may refer to how the home, work, and climatic environment affect one’s health. Simple suggestions may be made, as certain conditions may fail to respond if one’s environment is at odds with healing.
The remaining techniques are performed on or for the client in the clinic, and include bodywork, herbs, and acupuncture.
The methods of external bodywork include traditional medical massage, bone-setting, and topical herbal applications, as well as more modern techniques like electromagnetism and laser therapy. There are also less common, yet traditional, techniques involving scraping or cupping of the skin, and the use of various vibrational healing mediums like tuning forks, light spectrums, and even music or natural sounds. In addition to these, qigong may be used as a medical technique in itself; the qigong practitioner may perform simple movements above or around the body to influence the flow of qi.
Chinese herbalism is a highly specialized form of dietary therapy, where use is made of relatively strong tastes and natures of substances, or simply more of them, to produce a relatively quick result. The Chinese process plant, animal, and mineral substances in a tightly controlled and traditional way for stocking raw in pharmacies, or for further processing into pills, powders, or extracts. Herbal medicine is best prescribed and rendered by a licensed practitioner, rather than simply researched and purchased in a store. The commercial herbal industry is /not/ Chinese Medicine. Rather it is the use of herbs singly or in general formulations that likely are not appropriate for one’s individual needs and come with no guidelines for use. Also, processing and potency may not be subject to traditional medical controls.
Finally, acupuncture is the insertion of fine gauge needles just beneath the skin, or into the tissues, to harmonize the flow of qi. There are many styles of acupuncture, yet all have in common the central aim of removing blockages to the free flow of qi, whether that qi is of an emotional or physical nature. For example, an injury to the upper back and neck, unresolved, may lead to chronic hunching over, collapse of the chest, and mental depression; the same scenario can occur in reverse, with depression leading to a disposition of the spine and pain. Acupuncture could be applied in both cases to encourage the relaxation and harmonization of the tissues that are maintaining the poor posture; the depression responds as the posture improves. In addition, acupuncture could be applied to calm the mind and promote a feeling of well being, allowing greater ability for the client’s physical injury to heal.
As such, acupuncture, as well as all the Oriental Medical techniques, strives to reconcile the physical (yin) and emotional (yang) aspects present in all disease. This distinguishes the medicine from other forms of therapy that may focus on one or the other problem. This way makes for effective, and gentle, treatment.
In the next series of articles, we shall get to know the techniques more deeply in relation to areas of health and disease. Next month we will focus on treating common childhood issues and illnesses with Chinese herbs and bodywork techniques.