Tuesday, December 13, 2011

The Wellness Renegade: Is Traditional Chinese Medicine To Woo For You?

I’m an acupuncturist, and while I actually enjoy my job, if I had to choose between treating patients and going surfing (and making a living wasn’t an issue), surfing would win every time.
I guess what I’m getting at is I’ve never been an acupuncturist that is a “champion for the cause.” I don’t go to health fares or make presentations about how great Traditional Chinese Medicine (TCM) is. I also don’t intend this blog to be a forum entirely about it either (but I will draw from my experience).

So a few days ago I was reading the current post on one of my favorite blogs, Evolvify. While the article was not explicitly about TCM, Andrew did work this line into his text (a quote by Melisa Mcewen (HuntGatherLove) in her post The Middle Way):

“I’m a little dismayed that Chinese Medicine has somehow crept in and become tolerated.”
I thought that seemed a little harsh, so I’ve decided to pick up my sword (or needles?) and lead the charge with my TCM flag flying.

As I stated in my comment on Andrew’s post, TCM is probably a lot less woo than you think. But, people are often skeptical when they hear words like qi, yin, liver yang rising, etc. And understandably, the red flags really go up when these terms and explanations of how TCM “works” can’t be defined adequately with biomedical terms.

Here are the reasons, as I see it, that TCM might seem too woo for you:
  • The language and terminology sounds idiotic and can’t be defined well with biomedical terms.
  • “there also seems to be a tendency among woo-inclined westerners to gravitate to ‘eastern philosophies’ from a motivation that looks more like craving for mystery, reactionary self-loathing, or the ‘grass is always greener on the other side of the hill’ effect. Other underlying tendencies also tend to map rather well to most psychology of religion theories.” This point was also made by Andrew from Evolvify, and is why his “skeptic shields will remain in full-force.”
  • A lot of “gurus” and people like Deep-Pockets Chopra (ok, I actually like Deepak) throw around Chinese medicine terms because this type of mysticism sells books and workshops.
I’ll address the last point first. Rarely are these talking heads that spout the new age garbage actually acupuncturists. This being said, there are many nut jobs that begin TCM College hoping to learn the mystical ancient Chinese secrets. Many drop out or are disillusioned when they realize the Chinese professors have no tolerance for this.

The new agers that do make it through the schooling (a 4-year master’s degree program and national/state boards exams) rarely are successful in clinical practice.

TCM is not scientific nor is it pseudoscientific, but it is extremely methodical and logical

The framework of TCM is based upon on a system of differential diagnosis (or syndrome diagnosis). Syndromes are patterns of commonly occurring signs and symptoms. Here is an example of how that works (this is regurgitated from my comment on Evolvify):

If you came in to see me, I would begin a whole series of questions much like the “review of systems” in western medicine. Let’s say from my questions and your complaints we determine that the predominant symptoms you are experiencing are fatigue, gas, bloating, loose watery stools, mild headache, poor appetite, abdominal discomfort that is better when pressure is applied, and general weakness.

Let’s say I also notice you have a pale complexion, and upon examining your tongue I notice it’s pale, puffy, and has slightly scalloped or swollen edges. After feeling your radial pulse, I determine that it has a “weak quality.”

My diagnosis would be spleen qi deficiency. And I think almost any TCM practitioner would agree with me, as these are the classic symptoms for this syndrome. There is a common Chinese herbal formula used for this syndrome Si Jun Zi Tang (Four-Gentlemen Decoction). The four different herbs in this formula both individually and synergistically affect this syndrome. In addition to herbs, I would do a series of acupuncture points that are commonly used for this syndrome.

There are hundreds of syndromes and almost always a combination of a few at a time. On top of this there are at least 500 commonly used herbs, thousands of formulas, and endless combinations depending on the mix of syndromes. Same goes with the acupuncture points.

The Chinese also used terminology and named these syndromes in a way that made sense to them at the time (at least 1,500 years before the advent of modern science, medicine, and nutrition) – so the names sound weird.

And while I can understand why it is important to a patient to understand what these terms and syndromes mean in a “language” that has meaning to them, the truth is nobody truly knows how it exactly works from a biomedical standpoint (but there is a lot of research to try and lots of studies proving its efficacy).

Most of the “mystical” sounding terms in TCM are actually metaphors for physiological processes or a state of being, not actually something concrete.

Let’s use the term qi (pronounced chee) for example, one that most have heard of. Qi is energy, right? You might be asking then why is it so hard for scientists to detect it? How can you base a whole medicine on something that may not exist?

One of the syndromes in TCM is Stomach Qi Uprising; some of the common symptoms include hiccough, belching, acid reflux and vomiting. So does this mean there is a current of electricity that begins at the stomach and travels up a conduit (a meridian)? I have no idea, but I think most would agree that the nature of these symptoms have an upward “energy” that originates from the stomach.
How about Liver qi stagnation? Some of the symptoms of this syndrome include stress and muscle tension, clenching of the jaw, distension in the right flank (over where the liver is), and constant sighing in order to relax. Is a current of energy stuck in the physical liver? I don’t know, but maybe you can see how the “clenched, uptight, and stuck” nature of these symptoms in combination with a distended feeling where the liver is would aptly be described as liver qi stagnation.

I also practice the woo martial art Qi-gong. I do exercises that “build my qi,” and I’m ok with that description. Does it mean that I acquire more watts of electricity in my body (or whatever)? I have no way to measure that, but I do feel stronger, more focused, clear headed, and more energized (which is opposite of the symptoms of qi deficiency syndrome).

The dynamic nature of TCM terms along with the very definition of a syndrome makes it very difficult to explain in biomedical terminology. I hope, however, you can see there is a logic and methodology to it.

Is Chinese Medicine to woo for you? Did this article shed some light on TCM (or did it confuse you more)? Does this mean Chris Kesser of The Healthy Skeptic (also an acupuncturist) is kicked out of the “Paleo diet” club? Please leave your comments below!

(The Wellness Renegade is Barra's very own Doug Grootveld. A licensed acupuncturist of ten years, Doug offers unconventional advice on health, wellness, and happiness based on information from expert practitioners of varied disciplines and from the experience he has gained with working with thousands of patients.)