Promoting Optimal Health with Traditional Chinese Medicine

Traditional Chinese Medicine’s View of Health and Health Promotion

Traditional Chinese Medicine (TCM) is identified by the National Institutes of Health/National Center for Complementary and Alternative Medicine as a whole medical system, a complete system of theory and practice that has evolved over time. Many whole systems were developed by early non-Western cultures, including TCM, which began as a primitive ethnic healing system approximately 3600 years ago. Early therapeutics included complex combinations of herbal remedies and acupuncture that were heavily influenced by cultural beliefs about the supernatural. Practitioners were shaman-like mediators between the person and supernatural forces. The current cohesive TCM system of care was not codified until the 1950s.¹

In all systems of care, beliefs about health, acceptable healing practices, and culture are inextricably entwined; TCM is no exception.² Significant philosophical influences include Taoism, Confucianism, and Buddhism which posit that human beings are a microcosm of the larger universal macrocosm, existing within and intimately connected to heaven and earth. An elaborate system of correspondences describes life’s natural order, dictating behaviors, societal roles, and expectations, including those linked to health. Chinese medicine views health as ‘life in balance’, that manifests as lustrous hair, a radiant complexion, engaged interactions, a body that functions without limitations, and emotional equipoise. Health promotion encourages healthy diet, moderate regular exercise, regular meditation/introspection, healthy family and social relationships, and avoidance of environmental toxins such as cigarette smoke.

Health and Illness in TCM

Harmony and balance in every aspect of life is the key to health. This is illustrated in the Taoist concept of yin and yang, represented by the tai ji or yin yang symbol.

At first glance, the two seem to be dualistic, yet they are interdependent; as one becomes more prominent, the other decreases. Within each is a seed of the other; the two emerge into and out of each other.

According to TCM theory, patterns of disharmony are not the cause of disease. Rather, disease is caused by imperfect lifestyle habits, invasion of pathogenic influences, or basic constitutions that lead to excesses or deficiencies that must be tempered and rebalanced. Excesses and deficiencies ultimately lead to disruption of vital energy, qi, which then compromise the body-mind- spirit of the person. Emotional excesses specifically target and damage individual yin organs (Liver, Spleen, Heart, Lungs, and Kidney). In turn, when the organ is dis-eased, the emotion can be affected. For example, the liver is associated with anger. If one is excessively angry, the liver will be unable to fulfill its role spreading qi smoothly. This will lead to stagnation of qi and resultant problems. Conversely, if one drinks alcohol to excess, liver injury occurs, resulting in a tendency to anger quickly, compromising qi flow. The seven emotions and their organs include anger (Liver), joy (Heart), worry (Spleen), fear (Kidney), grief/sadness (Lung), pensiveness/worry (Spleen) and shock (Heart/Kidney).³

External disruptions or excesses (Wind, Cold, Summer-Heat, Dampness, Dryness, and Fire) also affect normal qi flow. Primarily linked to weather and climate, they reflect patterns such as Wind-Cold, Wind-Heat, or Fire-Toxin. The body’s ability to respond to these disruptions relies on the strength of its wei-qi (defensive qi) which is dependent on a balanced and healthy host. Influenza is the classic example of a Wind-Heat invasion that may penetrate deep into the yin organs, primarily the Lung, sometimes with fatal results.³

Additional causes of disharmony include congenital weak constitutions (birth defects), trauma, over-exertion, excessive sexual activity, poor quality diet, parasites and poisons, and iatrogenesis². A child with a weak constitution may be more vulnerable to Wind-Heat pathogen than a child who has a strong constitution. Similarly, an adult who is over-worked, drinking excessive amounts of alcohol, and smoking is more vulnerable than an elite athlete.

Health Promotion Strategies

In TCM, the key to good health is quite similar to what your mother has been telling you since you can remember! Eat a balanced diet in moderation; get plenty of rest; avoid excessive amounts of hard physical labor; exercise regularly; enjoy harmonious and appropriate relationships with family, friends and co-workers; and avoid extreme climate exposures without appropriate clothes, and avoid excessive amounts of alcohol or other poisons/toxins.

In situations where disharmony is manifested, the primary goal of TCM is to restore balance by manipulating the multiple forms of the body’s qi using acupuncture needles; herbal remedies; and lifestyle modifications that address dietary excesses/deficiencies, exercise requirements, balancing work and relaxation, problematic relationships, and identifying stress and making positive changes to decrease it. Dietary modifications most commonly include fewer sweets, fatty foods and calories, but occasionally will include specific recommendations like small amounts of meat for vegans or vegetarians to ameliorate deficiencies.

When patients seek Chinese Medicine, NPs should query patients about the herbal remedies that have been prescribed, mindful of possible drug-herb interactions, especially with antiretroviral and anticoagulant therapy.⁴ Further, interventions such as meditation, mindfulness, lifestyle moderation can be reinforced and encouraged. While acupuncture is not completely risk-free, evidence suggests that with licensed practitioners it is safe.⁵

Summary

Nurse practitioners and TCM providers often embrace a similar holistic view of health and wellness. Both recommend health promotion and recognize that disease prevention requires harmony, balance, and moderation in diet, exercise, work-play, relationships, rest/sleep. In order to protect from external causes of disease, the host must be strong, fortified, and resilient – all of which results from harmonious and mindful living. Patients requesting TCM interventions should be referred to a qualified practitioner found at http://www.nccaom.org/find/index.html.