Jade Acupuncture Clinic

Introduction to TCM

The goal of acupuncture and Chinese herbs is to rebalance the body by treating the meridians. Here is how that works:

Qi, (also spelled Chi, and pronounced "Chee"), is the life force energy. There are 12 major meridians and 8 extra meridians through which the Qi circulates.
Meridians are like rivers which distribute Qi throughout the body. If any of these meridians have a blockage that causes the energy to not flow properly, problems develop, such as illness, swelling, and pain.

There are several factors that can affect the flow of Qi through the meridians. For example, weather, your mood, foods eaten, and much more effect the flow of Qi. Acupuncture is used to stimulate the flow of Qi through some meridians, and to inhibit the flow of Qi in other channels (meridians) to restore balance.

When the Qi is balanced, you're healthy. Too much Qi in one area and not enough in other creates an imbalance which causes health problems.

The basic principle of TCM is to restore balance.
If a disease is due to an excess, that excess must be drained.
If it is due to a deficiency, that deficiency should be tonified.

If the problem is due to heat, that heat should be cooled.
If the problem is due to cold, that cold should be warmed.

If it is due to dryness, that dryness should be moistened.

And, if it is due to dampness, that dampness should be dried.

(Of course, in reality, you'll often have a combination of several factors combined.)

A few definitions:
(Note that the upper case on words such as Blood, Liver, etc. are to clarify that the Chinese Medicine usage is implied, rather than the usual English word.)

The root cause for the occurrence and development of disease in Chinese medicine is imbalance between Yin and Yang. Yin and Yang are opposite forces, that when balanced, work together. Examples of Yin are water, passive, slow, night, and moon. Examples of Yang are fire, active, fast, day, and sun.

Causes of diseases:

- External Causes
- There are 6 External causes of disease:
Wind, Cold, Damp, Dryness, Heat and Fire, and Summer Heat.
(By the way, wind includes things like air conditioning, for example. It doesn't have to be a natural source.)
Summer Heat is associated with the height of summer, and with very hot and humid climates. It readily depletes the Qi and Body Fluids leading to exhaustion and dehydration.

- Internal Causes
There are Seven Emotions:
There is disagreement in various translations on what the exact Seven Emotions are, but Anger, Joy, Grief, Fear, Worry or Pensiveness, Anxiety are pretty constant. Fright is often the translation for the seventh emotion.

The translation of Chinese into English is often not precise. Joy, for example, does not really refer to great pleasure, but to a state of over-excitement.
Pensiveness is the result of over-thinking, or too much mental and intellectual stimulation.
Anger is associated with the Liver, the Lungs' emotion is Grief, Joy is associated with the Heart, the Kidneys' emotion is Fear, and Worry or Pensiveness is associated with the Spleen.

- Misc. Causes of disease:
Constitution, diet, exercise, rest, trauma, and so on.

There are Eight Principle Patterns of Disharmony (4 pairs of polar opposites):
Yin and Yang
Interior and Exterior
Cold and Hot
Deficiency and Excess
These principles often appear in combinations, as well.
An Exterior condition has a sudden onset, is an acute disorder, is caused by an invasion of external pathogens, (such as Cold, Heat, Damp, etc.).
An Interior condition relates to chronic problems, with the interal organs effected.
A Cold condition, in general, has the following symptoms:
pale, aversion to code, slow, deliberate movement, heat helps the problem, clear urine, pale tongue, slow pulse.
A Heat condition, in general, has as symptoms:
reddish complexion, fever, rapid movement and speech, dislike of heat, cold helps the problem, thirst, dark urine, reddish tongue, fast pulse.
A Deficiency shows itself as:
tiredness and lethargy, weak, insipid movement, weak breathing, quiet voice, pressure can relieve discomfort, poor appetite, pale tongue, empty pulse.
An Excess condition has the following symptoms:
heavy movement, loud voice and breathing, pressure exacerbates discomfort, thick tongue coat, large pulse.
A Yin condition is a mixture of Interior, Cold, and Deficiency characteristics.
A Yang condition is a blend of Exterior, Heat, and Excess characteristics.

The organs in the body work in pairs of Yin and Yang:
Lung and Large Intestine
Stomach and Spleen
Heart and Small Intestine
Bladder and Kidney
Pericardium and San Jiao
Gall Bladder and Liver

The Yin organs of the body are:
Heart, Spleen, Lungs, Kidneys, Liver, Pericardium.
These are called the Zang organs. They are deeper in the body and concerned with the manufacture, storage, and regulation of the fundamental substances.

The Yang organs of the body are:
Small Intestine, Stomach, Large Intestine, Bladder, Gall Bladder, and San Jiao, (also known as Triple Burner, or Triple Heater, or Triple Warmer).
These are called the Fu organs, and are considered to be closer to the surface of the body. They have the functions of receiving, separating, distributing, and excreting body substances. They are not storage organs, but the organs have ongoing movement and change.

Note that the organs do not correlate directly to the Western idea of our organs. There is no such thing as San Jiao in Western medicine, for example. Western medicine is concerned with how our organs function when normal, and trying to restore a malfunctioning organ to working order. Chinese medicine, however, is concerned with how the Yin and Yang organs ensure the constant ebb and flow of the fundamental substances in our body. Illness is a process of disharmony that needs alleviating, and not a "machinery breakdown" that requires fixing.
Here is a very general idea of how the organs function:

The Heart controls and regulates the flow of blood through the vessels of the body.
The Heart also houses the Shen. Shen is defined as: consciousness, thoughts, emotions, and senses.
Shen is transmitted into a fetus from both parents, and must be continually nourished after birth.
Shen can be called our very spirit itself. It's so light and refined that it needs Blood to keep it in place. If our Blood becomes weakened, our Shen becomes disturbed and we become anxious, jumpy, lacking in concentration, and possibly have difficulty sleeping.
If the Heart is out of balance, the emotion of Joy will also be out of balance.

The Spleen, in Chinese Medicine, is the primary organ of digestion. The Spleen extracts nutrients from food in the Stomach, creating Food Qi, which is later transformed into Qi and Blood.
The Spleen has to send the Food Qi up to the Chest. This is one reason why the Spleen is said to control the raising of Qi. Spleen Qi normally flows up: if it flows down, the food is not transformed properly and there will be diarrhea.
The Spleen also transforms and transports fluids throughout the body, keeps Blood in the vessels, ensures that the muscles and limbs have good tone and shape, holds the internal organs in place, and houses Thought, (the ability to think clearly and concentrate well.)
A healthy Spleen will mean good appetite, digestion, energy, and muscle tone. If the Spleen is impaired, it can lead to fatigue, abdominal distension, poor digestion, diarrhea, edema, obesity, and phlegm-related disorders.

The Kidneys store Jing, which is the essence of life.
Jing is the fluid that nurtures growth and development.
Prenatal or Congenital Jing is inherited from our parents, and, along with Original Qi, defines our basic constitution.
Acquired Jing is transformed from food by the Stomach and Spleen, and constantly replenishes the Prenatal Jing, which is consumed as we age.
The Kidneys are responsible for the production of Marrow. Marrow is the essential element of bone, bone marrow, the spinal cord, and brain structure. Healthy Kidney Jing results in strong bones and teeth and efficient brain function.
The Kidneys also regulate fluid balance in the body. If the Kidneys are functioning well, they send clear fluids back
to the Lungs and excrete the dirty fluids through the Bladder.
The Kidneys control the reception of Qi. The Lungs descend Qi, and the Kidneys have the function of holding the Qi
down, facilitating the healthy breathing process.
The Kidneys nourish the ears, and if this is lacking, it can lead to tinnitus and deafness.
The Kidneys also nourish the hair. With proper nourishment, the hair is healthy. If there is a deficiency, the hair will be dull, lifeless, and brittle. It can also lead to premature graying and thinning.
The Kidneys also house our will power and control fear.

The Lungs govern inhalation of pure Qi from the air, and exhalation of impure Qi.
The Spleen sends the Qi extracted from food, (Food Qi), up to the Lungs, where it combines with the pure Qi inhaled in the air to form Zong Qi, (Gathering Qi), which is the aspect of Qi that ensures that the Lungs spread Qi to all parts of the body. If there is an imbalance in the Lungs, this can lead to general symptoms of Qi deficiency, affecting the whole body and causing general weakness and tiredness.
The Lungs disperse Wei Qi, (Defensive Qi), and body fluids through the superficial layers of the body. If the Lungs are healthy then this keeps the body at an even temperature and also protects the body from invasion by external pathogens.
If the Lung Qi is weak, the body is liable to be very susceptible to disease.
The Lungs send Qi down to the Kidneys, where it is "held down." If the descending function is impaired, this may lead to chest problems such as coughing, congestion, and asthma.
The Lungs play a role in dispersing body fluids throughout the body. Impaired Lung function can lead to retention of urine or edema. The Lungs influence the skin. If the Lungs are impaired, this may lead to rough and dry skin.
General body hair, (but not the hair on our heads), is also under control of the Lungs.
The Lungs are also responsible for the extent to which we make healthy and constructive connections with the world in which we live. Impaired Lung function can lead to a sense of alienation.
Grief is the emotion associated with the Lungs. If the Lungs are healthy, we deal with loss and change in a healthy way. If the Lungs are impaired, we may find it difficult to work through grief and cope with change.

A major function of the Liver is to regulate the amount of Blood in circulation. The Liver stores excess Blood until it is needed.
The Liver controls the smooth flow of Qi. If the Liver Qi is stagnant, this can contribute to many other disharmonies.
If there is anger or frustration, this can lead to stagnation of Liver Qi.
The Liver controls the tendons, and ligaments, and is manifested in the nails. If Liver Blood is healthy, the nails will be strong and moist. If Liver Blood is not healthy, this leads to thin, brittle, pale nails.
The eyes require the nourishment of the Liver Blood in order to see clearly, making the condition and health of the eyes dependent on the health of the Liver.
When the Liver is balanced, we can exercise effective control over the events in our life and we respond to sudden changes in a flexible manner. If the Liver function is impaired, we may be over controlling, rigid and inflexible, or may be under controlling.

The Pericardium protects the Heart from invasion by external pathogenic factors, such as high fever.
The Pericardium also guides us through life to experience joy and pleasure in a manner that is balanced.

Gall Bladder:
The Gall Bladder stores bile, which is excreted into the digestive tract to aid digestion.
The Gall Bladder also impacts our ability to make decisions. If the Gall Bladder is impaired, it can lead to an inability to make decisions, or lead us to make poorly thought out decisions.
The Gall Bladder is also responsible for courage.

The Stomach receives food, and separates out the pure from the impure. The pure essence is passed along to the Spleen where it is refined into Gu Qi (Food Qi), and the impure is passed along to the Small Intestine for eventual excretion.
Stomach Qi should descend. If Stomach Qi rebels upward, it leads to belching, hiccups, regurgitation, nausea, and vomiting.

Small Intestine:
The Small Intestine receives partially digested food from the Stomach and separates the pure from the impure. The impure is passed to either the Large Intestine or the Bladder for excretion.

Large Intestine:
The Large Intestine receives the impure from the Small Intestine. It then further refines it to extract any further pure fluids or essences, and excretes the impure as feces.

The Bladder receives waste body fluids from the Lungs, the Small and Large Intestines, and under the influence of the Kidneys, it stores and excretes this as urine.

San Jiao:
The functions of the San Jiao are to administer the circulation of the Qi and help fluid metabolism of the body.
There are 3 parts to San Jiao:
Upper Jiao:
The Upper Jiao disperses and vaporizes the Body fluids of the upper body. It encompasses the functions of the Lungs and Heart.
Middle Jiao:
The Middle San Jiao digests food and drink (rotting and ripening), and it's functions are those of the Stomach and Spleen.
Lower Jiao:
The Lower San Jiao transforms, separates and excretes fluids.
Its functions are those of the Bladder, Kidney, Small and Large Intestines.

The details of digestion and metabolism may be governed by one organ or another, but the whole operation is orchestrated by the San Jiao, which is responsible for not only the production of all types of post-natal Qi, but also for its free circulation, from the deepest level to the most superficial.

There are Four Exams in Chinese Medicine, which determine which imbalance (or imbalances) exist:
Looking, Listening/Smelling, Asking, and Touching/Palpation.

The individual's general physical appearance is observed, including overall complexion, the tongue, the eyes, hair, nails, gait, and emotional demeanor.
Specific changes in the tongue's color, shape, and coating are important. For example, a pale, swollen tongue with teeth marks and a thick white coat may indicate a deficiency of Qi.

The location of disturbances on the tongue indicates where imbalances are located.
Heart:  Tip of the tongue
Lungs:  Between the tip of tongue and the center of the tongue
Stomach/Spleen: Center of the tongue
Liver/Gall Bladder: Sides of the tongue
Kidneys/Bladder: Back of the tongue
In general, a red tongue is associated with Heat, a pale tongue indicates a Deficiency, a bluish/purplish tongue is an indication of a pathology caused by Cold or by a stagnation of the Blood, and a yellow tongue is associated with excessive Heat and Damp.

The eyes can also indicate where an imbalance exists.
The corners of the eyes are related to the Heart, the upper eyelid to the Spleen, the lower eyelid to the Stomach, the sclera to the Lungs, the iris to the Liver, and the pupil to the Kidneys.

This examination relates specific sounds and smells of an illness to a specific Pattern of Disharmony. It's important to listen to the individual's breathing, to listen to their voice, and to note any body odors and the odor of the breath. As an example, a loud barking cough indicates an Excess condition, whereas, a weak cough indicates a Deficient condition.

A series of questions are asked about sensations of hot and cold, level of thirst, appetite, and bowel movements. Information is also collected on diet, exercise, lifestyle, work habits, and exposure to Pathogenic Factors, (such as Wind, Cold, Damp, or Heat.)

This includes touching the body to determine temperature, moisture, pain or sensitivity, and the taking of the pulse.
The Chinese medicine method of pulse taking involves placing three fingers on each wrist to measure a total of 12 pulses, each associated with a corresponding meridian. Fourteen different pulse characteristics (slow, rapid, full, empty, etc.) are
compared with each of the 12 pulses, and are used to determine which organ is not working properly.

All of the above is used to arrive at a diagnosis. The signs and symptoms will point to a pattern, or combination of patterns, for which a treatment plan is then developed. If, for example, you have Spleen Qi Deficiency with Damp, it would be necessary to tonify the Spleen Qi and drain Damp. There are specific herbs that can be used for this purpose, as well as specific acupuncture points that can be used. If there is something like Spleen Qi Deficiency with Damp, along with Liver Qi Stagnation, it's necessary to decide which is the primary problem, and which is secondary, and choose the herbs and points in the right combination accordingly.


Copyright 2008 by
Jeri Petz, MSOM, L.Ac., Dipl. Ac.(NCCAOM), Dipl. OM (NCCAOM)
Jade Acupuncture Clinic Ltd.