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With a history of 2000 to 3000 years, Traditional Chinese Medicine (TCM) has formed a unique system to diagnose and cure illness. The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromes.
The TCM approach treats zang--fu organs as the core of the human body. Tissue and organs are connected through a network of channels and blood vessels inside human body. Qi (or Chi) acts as some kind of carrier of information that is expressed externally through jingluo system. Pathologically, a dysfunction of the zang-fu organs may be reflected on the body surface through the network, and meanwhile, diseases of body surface tissues may also affect their related zang or fu organs. Affected zang or fu organs may also influence each other through internal connections. Traditional Chinese medicine treatment starts with the analysis of the entire system, then focuses on the correction of pathological changes through readjusting the functions of the zang-fu organs.
Evaluation of a syndrome not only includes the cause, mechanism, location, and nature of the disease, but also the confrontation between the pathogenic factor and body resistance. Treatment is not based only on the symptoms, but differentiation of syndromes. Therefore, those with an identical disease may be treated in different ways, and on the other hand, different diseases may result in the same syndrome and are treated in similar ways.
The clinical diagnosis and treatment in Traditional Chinese Medicine are mainly based on the yin-yang and five elements theories. These theories apply the phenomena and laws of nature to the study of the physiological activities and pathological changes of the human body and its interrelationships. The typical TCM therapies include acupuncture, herbal medicine, and qigong exercises. With acupuncture, treatment is accomplished by stimulating certain areas of the external body. Herbal medicine acts on zang-fu organs internally, while qigong tries to restore the orderly information flow inside the network through the regulation of Qi. These therapies appear very different in approach yet they all share the same underlying sets of assumptions and insights in the nature of the human body and its place in the universe. Some scientists describe the treatment of diseases through herbal medication, acupuncture, and qigong as an "information therapy".
Double Diagnosis
TCM and Western medicine are different medical systems. With different methodology, each of them develops their own diagnosis and treatment. Both of them have their advantages and disadvantages.
X-ray, ultrasound, blood test, endoscope and biopsy, etc. are diagnostic methods of Western medicine, which mainly focus on aetiology and pathology, organic structural changes on micro level, diagnose physical “diseases” of human being, such as gastroduodenal ulcers, etc.
Through observation, interrogation, tongue and pulse diagnosis, etc., TCM mainly looks at patients on macro level, which “TCM diseases” were diagnosed, such as “Liver Qi stagnation”, etc.
There are at least four major factors involving in the onset of diseases. They are: 1. aetiology and pathology, organic structural changes; 2. functional disorders, 3. constitutional factors and 4. mental status. They have close relationship and influence each other. Western medicine mainly look at aetiology and pathology meanwhile TCM illness are more including functional, constitutional and mental disorder, they are clinical conditions which need to be treated although some of these diseases are so called sub-clinical conditions.
Western medicine can diagnose such as cancer, gastric ulcers, gall bladder stone, hepatitis C, etc. which TCM can not do so. On the other hand, TCM can diagnose such as Liver Qi stagnation, Spleen deficiency, Yin deficiency with hyperactive Yang, and Blood stagnation, etc. which western medicine can't.
The above diseases diagnosed by the two systems are all clinical conditions which need to be treated. With the differing advantages and disadvantages of the both medical systems, none of the current medical diagnosis is able to provide a full picture of a patient, which means that any single diagnostic method is insufficient and incomplete. Therefore effectiveness of treatments is negatively influenced by the incompletion of the diagnosis.
Conclusion:
Double diagnosis for a patient with both western medicine and TCM provide clearer understanding and complete medical condition of a patient.
- Clearer diagnosis increases clinical effectiveness of treatment.
- Thus double diagnosis should be conducted for every patient.
- Only TCM practitioners can have double diagnosis in this stage.
What is TCM – Studying TCM in Sydney Institute of Traditional Chinese Medicine (TCM)
Interview with Yifan Yang, principal of Sydney Institute of Traditional Chinese Medicine (Australian Chinese Daily, Nov, 2007)
I: Interviewer, Y: Yifan Yang
I: As TCM being taught in many
university of
Western countries, why is the formal scientific medical academy paying such attention to a field that seems so old fashioned?
Y: The rapid development of TCM in
Australia in the last 2 decade has drawn the attention of mainstream medical practice and academia. With more and more cases of successful TCM treatment, the benefits of TCM should not be dismissed by Western medicine society in
Australia.
I: There has been a long debate that TCM lacks of scientific evidence. How could it be accepted by the Australian medical community, which only accepts evidence based medicine?
Y: This is a good question. From the perspective of modern science, TCM is far from a scientific medical system. I think this is well acknowledged by medical academics. But the key point is that more and more Australians seek TCM services for their health problems, and are finding satisfactory results where conventional medicine has not been effective. This has been the feedback received by many GPs and hospitals from their patients. From the perspective of medicine, clinical effectiveness is more important than scientific evidence. Western medicine could not ignore the development of TCM practice in
Australia, and has thus commenced clinical evaluation of TCM with scientific researches. It has been reported that the majority Australians are seeing non-medical practitioners and are receiving natural or herbal treatment. Thus it is important for future medical doctors to have an understanding of what their patients are taking. Medicine is mainly for public health and diseases, in this sense, scientific evidence comes second.
I: You mentioned that TCM is developing rapidly in
Australia?
Y: Firstly, the registration of TCM in
Victoria has been the first TCM Act outside
China. Now the nation-wide registration is on its way, producing a legal basis for practicing TCM in
Australia. Many universities set up courses of TCM at bachelor, masters and Ph D degree levels. Currently there are 6 universities with this degree course in
Australia. Many pharmaceutical research organizations and hospitals are also doing TCM researches. The government has also started funding for the TCM researches. More and more health funds are accepting TCM and acupuncture. In
China, TCM doctors and Western doctors enjoy the same treatment and work together in hospitals. This has become a trend in the development of health systems in many western countries.
I: What about your school, there are many universities around, how can your advanced diploma school survive?
Y: Our institute has been established for 21 years. At the beginning, many Australians went to
China to study Acupuncture and TCM, who came back to practice and started the school. In the 1990s, many Chinese TCM graduates migrated into
Australia and joined the teaching, which strengthened the TCM education quality. Currently we have developed into Advanced Diploma of TCM course (and Diploma of TCM remedial massage) which has enjoyed very good reputation with a large number of graduates opening their clinics around
Australia. They are accepted by complimentary or TCM associations and are recognized by health funds. Our single unit certification courses also attract interests. We provide practical course with a flexible timetable. Our students are mainly adults or practitioners from other modalities. We also have some overseas students who came from European countries,
Taiwan,
Hong Kong,
Korea and other Asian countries, about 70% are Caucasian and 30% with Asian background. We have been doing what the universities can not do with competitive tuition fees. The interesting thing that should be noted is that in
Korea and
Taiwan, enrolment into Medical schools in TCM requires a higher entrance score than in Western medicine.
I: The Australian health system is the Medicare Card health system equipped with a modern western medical system. What do you think about the future of TCM in
Australia?
Y: It is a very interest fact that people would choose to pay to see TCM practitioners rather than going to a GP where they just need to swipe their Medicare card. Looking at the last 20-30 years in major western countries such as the
USA,
UK,
Germany,
Australia and
Canada, it has been reported that the practice of TCM has expanded more than 100 times with more than 100,000 medical acupuncturists who mainly practice acupuncture. Australia and UK has about 3000 TCM clinics, and in USA, registered TCM practitioners has reached 17,000, with Chinese Herbal Medicine being approved by the FDA for use in hospitals for clinical trial and for medical use as “Drugs”. It has also been found that people are using more herbal medicines than pharmaceutical drugs, 4 times in
Australia and 5 times in
Germany. The US governments’ funding for complementary and TCM increased to $120 millions in 2006 comparing to $50 Million in 1996. every medical graduates is required to pass a TCM examination to become a licensed medical doctor in Japan starting in 2007 and the Hehuang group in Hong Kong allocated $US 5 billion to establish an TCM empire. In
Australia, many education and research organizations set up TCM courses or research organizations. The government, for the first time, has also allocated $4 million specific for TCM researches… At this stage, we are still in the early stage of TCM development. Our graduates might be working in hospital as normal doctors in future, as what they have been doing in
China.
I: Even I want to learn! But I am already 40.
Y: Even though long term practices are required to become good TCM practitioners, many famous TCM doctors in history started learning TCM during middle age. We saw so many TCM professors still seeing patients in their 80s even 90s. It is puzzling why I could hardly find western doctors practice in this age.
I: What can I learn in your course?
Y: We offer an Advanced Diploma of Traditional Chinese Medicine 91133NSW (4 years course) and a Diploma of TCM Remedial Massage HLT50107 (2 years course)
I: Thank you.
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