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Chinese medicine primer for the uninitiated

What veterinarians need to know

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Have you been curious about Chinese medicine? Have you considered hiring a Traditional Chinese Veterinary Medical (TCVM) provider? Do you pride yourself on inviting diversity into your practice and enjoy the prospects of introducing something new and exotic, even though you don’t really understand it?

If so, you may want to first familiarize yourself with some of the terminology and precepts that TCVM practitioners hold dear.

Qi (Chi)

TCVM providers refer to “qi” as one of the most fundamental components of life and a central player in acupuncture treatment. They may refer to qi as “life energy” that mysteriously circulates through invisible pathways called “meridians.” Acupuncture needles come to the aid of qi that found itself stuck behind imaginary obstacles.

The problem is the energy- meridian idea has been debunked as the working matrix of acupuncture,1 replaced by tangible anatomic structures that constitute the acupuncture channels.2 Chinese medicine scholars and historians have cited the early 20th-century mistranslation of the word qi into “energy” as a pivotal event that led to widespread confusion and misinformation.

Chris Kresser put it well in his six-part series of articles, “Chinese Medicine Demystified”3 when he stated, “[T]he commonly accepted idea in the West that Chinese medicine is an energetic, metaphysical medicine was single-handedly created by a French bank clerk with no training in medicine or ancient Chinese language. It is neither historically accurate nor consistent with modern scientific understanding of the body.”

Are there acupuncturists who have transcended reliance on intangible, untestable concepts to describe acupuncture? Yes. Scientific acupuncture practitioners, also called contemporary medical acupuncturists, long ago discarded ideology-driven notions such as qi and replaced it with rational explanations.4

Most simply put, acupuncture normalizes neural function. More precisely, the physiologic changes during and after acupuncture arise in large part from somatic afferent neural stimulation (i.e., needle stimulation). This incites a panoply of local, spinal and brain-based reflexes that impel the nervous system to a more appropriate homeostatic setting through a process called neuromodulation.

Yin and Yang

Yin and yang are “the most fundamental concepts in Traditional Chinese Medicine (TCM)” and “the foundation of diagnosis and treatment.”5 Essentially, yin and yang vaguely refer to dualistic properties of existence—e.g., darkness and light, water and fire, interior and exterior, deficiency and excess. TCVM practitioners rely on their interpretations of the “yin-ness” or “yang-ness” of a patient in order to counterbalance an imbalance with more “yang-ness” or “yin-ness.”

As a case in point, Xie and Preast wrote, “A TCVM practitioner returns yin and yang to their normal, balanced state by selecting treatment which can adjust yin and yang in the desired way. The treatment is based on the diagnosis. If a disease is caused by excessive amounts of yin or yang, the basic treatment principle is to dispel (remove) the Excess. If a disease is caused by inadequate amounts of yin or yang, the treatment is to tonify (nourish and reinforce) the deficient yin or yang.

“Treatments, such as herbs and acupuncture points (acupoints), have unique properties that can affect yin and yang according to the yin-yang principles. For instance, herbs with Cold properties … will dispel (clear) the extra Heat in an Excessive Heat Pattern. Yin-enhancing herbs would add more yin to the yin-yang relationship, thus correcting a deficient yin Pattern.”

How do TCVM practitioners decide how much yin or yang a patient has? They do so by relying heavily on the outcomes of their assessments of the appearance of the tongue and “quality” of the pulse. Both are seen as reflecting the locations and causes of disease and, thereby, informing care.

In tongue diagnosis, one examines the color, cracking, moistness and coating and notes where abnormalities on the surface occur in order to ascertain organ dysfunction and health. In TCVM, the tongue has a map of the body applied to it in the same way that the foot does in reflexology. Abnormalities in one area of the tongue supposedly indicate illness in an associated area on the body just as tender locations on the bottom of the foot are thought to relate to bodily dysfunction. Unfortunately, neither body-mapping system has shown validity.

Pulse diagnosis is even more subjective in that one palpates the cardiac impulses along a tiny strip of artery and makes inferences about multiple organs’ health status.

Researchers have failed to convincingly demonstrate the validity and reliability of either tongue or pulse diagnosis for humans despite intensive efforts. Nonetheless, TCVM practitioners have extrapolated these assessments to veterinary patients, basing diagnoses and treatments on shaky, pseudoscientific analyses.

The Last Word

How does this all play out in the clinic? A dermatologic problem,7 for example, in a TCVM practitioner’s eyes could be “qi stagnation,” “blood stasis,” “yin deficiency” or “yang deficiency.” “Fire” in the “meridians” can cause chaos and qi that stagnates in the liver attacks a weak spleen. A Chinese herbal prescription would call for products that quell fire, move qi, and support the spleen. Confused yet?

The TCM view of cancer sounds similar to the aforementioned dermatologic disturbances—throw in some yin and yang imbalances, qi or blood deficiencies, stagnation, and some phlegm, dampness or toxins, and there you have it: cancer.8 In fact, TCVM pattern differentiation essentially distills everything from itchy skin to osteosarcoma into permutations of yin and yang.

Things would be simple if it was true, but science has shown that the actual causes and effective treatment of disease are more complex than black and white, i.e., yin and yang.

Is there another way? Yes. Both acupuncture and herbal medicine can be taught and practiced scientifically. Students can learn about facts and evidence instead of metaphysics and metaphors. Research can be performed based on tangible anatomic structures and objectively quantifiable physiologic changes.

Now is the time for veterinary educational institutions, licensing boards and continuing education accrediting bodies to stand up for safe, rational and effective medicine and adopt a more discerning attitude on what has thus far passed for acceptable education in integrative medicine.

References

  1. Kendall DE. “Energy-Meridian Misconceptions of Chinese Medicine.” Schweiz. Zschr. GanzhietsMedizin. 2008;20(2). Accessed at http://www.tedpriebe.com/documents/Kendall_SJIM_meridians.pdf on 08-31-16.
  2. Robinson N. Interactive Medical Acupuncture Anatomy. Jackson, WY: Teton NewMedia Press, 2016.
  3. Kresser C. “Chinese Medicine Demystified (Part III): The ‘Energy Meridian’ model debunked.  Accessed at https://chriskresser.com/chinese-medicine-demystified-part-iii-the-energy-meridian-model-debunked/ on 08-31-16.
  4. White A and Editorial Board of Acupuncture in Medicine. 2009;27(1):33-35. 
  5. Sacred Lotus Chinese Medicine website. “Yin and Yang in Chinese Medicine.” Accessed at https://www.sacredlotus.com/go/foundations-chinese-medicine/get/yin-yang on 08-31-16.
  6. Xie H and Preast V. “Traditional Chinese Veterinary Medicine: Fundamental Principles, 2nd Edition.” P. 9. Accessed at http://www.tcvm.com/portals/0/doc/book/redbook_2ndedition_chapter1-2.pdf on 08-31-16.
  7. Battistella MS. “TCVM: Pattern Differentiation in Dermatology.” IVC Journal. Accessed at http://ivcjournal.com/tcvm-pattern-differentiation-in-dermatology/ on 08-31-16.
  8. Yamate MS. “Treating Cancer With TCVM (Proceedings).” DVM360. April 1, 2009. Accessed at http://veterinarycalendar.dvm360.com/treating-cancer-with-tcvm-proceedings on 08-31-16.

Dr. Narda Robinson, MS, Dipl. ABMA, FAAMA, is president and CEO of CuraCore Integrative Medicine and Education Center in Fort Collins, Colo. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News. 

Originally published in the October 2016 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today! 

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