Chinese medicine focuses on the treatment of the whole organism. It treats the human body as a microcosm. If one element breaks, everything goes wrong. This holistic approach, known for thousands of years, now inspires Western medicine. It is becoming increasingly clear that treatment is influenced by the psyche, weather and diet.
Chinese medicine is sometimes treated in the West as a curiosity rather than a fully-developed medical therapy; it is usually associated with acupuncture and massage (acupressure). Without a doubt, these elements do occupy an important place in the Chinese art of healing, but this is only the tip of the iceberg. Traditional Chinese Medicine (TCM), reportedly up to 5000 years old, comprises extensive knowledge combining various fields, and the proposed therapies are considered effective.
In one of his books, Edward Kajdański, a Polish writer and diplomat born in Harbin (former Manchuria), cites a story from the life of Sun Simiao (541/581–682 CE), considered the most outstanding doctor in the history of China. The book praises the mastery that Chinese doctors have achieved in diagnosing a patient from the pulse. Sun lived in the mountains and led the life of a hermit. On one occasion, Emperor Taizong summoned him to his court to examine the empress, but he was not allowed to touch or even see her. The only tool he could use was a silk thread, with which he could sense the pulse of the woman sitting behind a screen. The contrary empress first attached the thread to the leg of the table, then to the paw of her dog. The doctor saw through both tricks, so the empress finally gave in and tied the end of the thread to her wrist. Based on her heart rate, Sun sensed that the woman was pregnant.
Sounds unbelievable? Perhaps, but Marek Kalmus – founder and director of the Institute of Chinese Medicine and Health Prophylaxis, honorary chairperson of the Polish Society of Traditional Chinese Medicine – believes that Chinese medicine can indeed work wonders where Western doctors are helpless. “I first encountered Chinese medicine in Tibet, in the winter of 1986. I had lost more than 10 litres of fluids in a few hours, and the lack of infrastructure ruled out the possibility of calling an ambulance. My travel companions knew Chinese medicine and with their bare hands pulled me out of the agonal state, without medicines or a drip, which from the point of view of Western medicine is incomprehensible. A day later, I walked six kilometres on my own. I’m a rationalist, I’m not interested in any esotericism. Chinese medicine is extremely logical and rational. Although it is based on different principles than Western medicine, it is a system of great effectiveness proven over millennia.”
Talk and observe
The basis for the effectiveness of TCM is prevention, among others. The task of the doctor at the imperial court was to keep the patient healthy, not just to cure them of a disease. “Chinese medicine treats the causes, not just the symptoms,” confirms Marek Kalmus. “It is able to catch the disease before it appears in the patient in the form in which we would call it a ‘disease’ in Western medicine.”
We can distinguish three basic stages of diagnosis in TCM: collecting the patient’s medical history, examination of the appearance of the face and tongue, and pulse examination. “Chinese medicine teaches a conversation with the patient,” says Anna Niewieczerzał, a doctor specializing in general and plastic surgery. “Young doctors of Western medicine learn the procedures themselves. They see a symptom, they order an examination, then another, rarely looking at the patient as a whole. Yet the symptoms are only an effect. A well-collected interview is half the battle, the other is for the patient to know how we are going to treat them and to believe in this method.” Anna uses Chinese medicine to diagnose. She herself became interested in the subject for personal reasons: “My son was born at risk of severe cerebral palsy,” she says. “I rehabilitated him according to the doctors’ recommendations, but I was looking for additional ways. I used a method that is based on acupuncture and acupressure. My son today is an adult, functioning normally, skiing, diving.”
The examination of appearance consists primarily in observing the patient’s face and tongue. Assessing the colour of the skin can tell us a lot about the state of health, and the tongue can tell us even more. In Chinese medicine, the tongue is divided into zones that correspond to individual organs. The colour and shape of the tongue are also important, as well as the colour and type of the coating – each of these elements can inform us of abnormalities (e.g. in blood circulation) and about the cause of a disease. The third stage, which is the study of the pulse, is even more complicated. The Chinese check the heart rate on the wrists of both hands, touching the radial artery with three fingers and pressing at three depths. In the old days (although this method is also practised nowadays), the condition of the doctor was of key importance, because he counted the beats, guided by the number of his own breaths. Therefore, a slightly accelerated breath was enough to disturb the test result. The doctor also uses various degrees of pressure, thanks to which they can distinguish many types of heart rate. In the 16th and 17th centuries, there were 28 of them, but now it is believed that 12 types are enough for diagnostics.
5000 years of practice
The Chinese consider the fathers of traditional medicine to be two mythical rulers: Shennong (Divine Farmer) and Huangdi (Yellow Emperor). According to legend, the first of them discovered the secrets of the effects of herbs and described them in the treatise Ben Cao Jing Ji Zhu (Variorum of Shennong’s Classic of Materia Medica). This work contained information about 362 drugs of plant, animal and mineral origin. Over the years, it was edited and supplemented, and during the Ming Dynasty (1368–1644 CE) its final version was created. Importantly, to this day it has not lost its relevance: The Encyclopedia of Chinese Materia Medica (Zhongyao Da Cidian, published in 1977), one of the largest modern studies, includes almost all the items listed in Ben Cao Jing. On the other hand, the Yellow Emperor is credited with the authorship of Huangdi Neijing (literally ‘The Inner Canon of the Yellow Emperor’ or ‘The Esoteric Scripture of the Yellow Emperor’). This treatise is divided into two parts: Suwen (devoted to the foundations and diagnostics) and Lingshu (which contains a detailed discussion of acupuncture). We can assign the old doctors to three groups: those who passed the state exam (they were summoned to the emperor’s court); officials who additionally studied medical texts (they helped others from time to time, but they did not take money for it); and medics from the lower spheres (working in shops or directly on the street.) The latter used their own books of prescriptions to which no one else had access.
The least developed field of medicine was surgery. It is true that surgeons could gain experience on the battlefield during battles (e.g. by removing arrows from bodies), but the belief that it is forbidden to mutilate the body was a big obstacle in the development of this art. Even the eunuchs residing at the imperial court kept their severed testicles all their lives.
Chinese medicine was used by the Persian scholar Avicenna, who lived at the turn of the 10th and 11th centuries. Probably it was his writings that the Jesuit Michał Boym (1612–1659) became acquainted with during his studies in Kraków. Even before his first trip to the Middle Kingdom, he mentioned Chinese medicine in letters. Years later, Boym became the forerunner of Chinese medicine in Europe, writing and translating many works on it. In addition, 16th-century doctors in Gdańsk referred to Arabic works pertaining to the assumptions of TCM, in which it was claimed that individual organs are subject to the influence of specific planets.
After the fall of the empire and the proclamation of the republic in 1911, difficult times came for Chinese medicine. It was considered obsolete; attempts were made to eliminate it as part of settling accounts with the feudal and Confucian traditions. Acupuncture was almost banned. Over the following years, Western medicine became widespread in China. The breakthrough came with the rise to power of Mao Zedong. Although it is impossible to assess how many monuments of traditional Chinese culture we irretrievably lost during the Cultural Revolution and the Great Leap Forward, paradoxically TCM returned to favour thanks to this leader. He rejected Western medicine as bourgeois, and in turn praised the so-called barefoot doctors (in addition to treatment, they also worked in the field, so they walked barefoot), who supported and treated the communists during the Long March (1934–1935).
Currently, Western and Chinese medicine function equally: a patient can go to a Western medicine clinic or to a TCM doctor, while in hospitals integrative medicine (i.e. based on both disciplines) is used. “Why has Western medicine become popular in China?” wonders Marek Kalmus. “It offers ‘light, easy, and pleasant’ solutions: pills, treatments, cut something out, stitch something. In traditional Chinese medicine, if someone has been working on a disease for 30 years, sometimes they have to sacrifice a few more years to completely remove its causes.”
Keep your balance
In Chinese understanding, the human body is like a state in which everything must be in harmony. It is a microcosm functioning in the same way as the surrounding macrocosm. The world is built in such a way that above is the sky (or the element yang), at the bottom is the earth (or yin), and between them is nature, among which we live: the place of balance of these forces. It is the same with the human body: the upper half corresponds to yang, the lower half to yin. The five most important organs, which according to the theory of the five elements (or five transformations) are assigned emotions, planets, metals and colours, are: heart (fire), liver (tree), stomach (earth), lungs (metal) and kidneys (water). Each of the organs shows the greatest activity at a certain time during the day. “It makes it easier for me to make a diagnosis,” says Anna. “If a patient wakes up at 3am every day, it’s a sign for me that the liver needs to be examined.” The disease arises when the balance between yin and yang, cold and heat, dryness and moisture, as well as between the five elements is disrupted in the body. The role of the doctor is to restore the right proportions and ensure that there is no excess or deficiency of any of these elements in the body.
The Inner Canon of the Yellow Emperor teaches that the time of day and season, as well as the patient’s place of residence, should also be taken into account when diagnosing and treating. The causes of the imbalance can come from the outside or the inside. External causes primarily include weather factors: damp, cold, heat, etc. Internal causes can be violent emotions such as sadness, love, fear, lust, hatred (in general, they do not cause harm, unless they remain in excess for a long time). “In Western medicine, we have a division into fields, everyone takes care of their own plot,” continues Anna. “The Chinese look at the whole person, not at individual elements. There are three interrelated aspects of health: the physical, mental and social.” Anna recalls a case she encountered recently while on duty at the A&E: a 20-something-year-old woman with severe abdominal pain and symptoms of appendicitis needed urgent help. No examination showed that the problem lay there. It turned out to be a psychosomatic disease, caused by long-term stress. “In Chinese medicine, there is no cutting off of the mind from the body,” confirms Marek Kalmus. “The approach is holistic. The patient is treated, and not, for example, painful shoulder syndrome, because this syndrome came from somewhere. Hence the successes of combining TCM and Western medicine, in particular in oncology. No oncologist disputes the claim that a mental state can help or harm during treatment.”
The circulation of energy
Qi is one of the three foundations – along with yin-yang and the theory of the five elements – of Chinese medicine. It is a great example of how language issues can make it difficult for us to understand Chinese concepts. “Qi is usually translated as ‘energy’ or ‘life energy’, but these terms are not correct,” explains Marek Kalmus. “This concept should be taught contextually. When translating Chinese terms into Western languages, attempts were made to find equivalents in Western terminology. In some cases, this approach works, but for the most part they don’t convey the whole meaning, because Chinese terms have a much broader meaning.” As long as qi circulates in the body, a human being is in motion, and thus is alive.
“In Western medicine, it is assumed that a disease is caused by bacteria or viruses,” says Anna. “The Chinese believe that a person gets sick when there is a disruption in the flow of qi, i.e. when the flow is blocked or there is an excess or deficiency of it in a certain place.” Qi runs along 12 routes – Michał Boym used the name via, which has now been replaced by the English term ‘channel’, or the French meridian. Full circulation lasts a day. In each of the main channels, corresponding to specific organs, qi flows for about two hours; hence the specific times of the greatest activity of individual organs. The flow of qi through the lung channel takes place between three and five in the morning, hence the increasing asthmatic cough at this time. The main meridians run from top to bottom; they connect with individual organs and with each other. On the other hand, in the subcutaneous layer flows weiqi – in simple terms, defensive energy – which at night hides deep in the body and helps in the regeneration of internal organs. Weiqi is not the only ‘subspecies’ of qi. Its three basic types are: yuanqi (primal energy derived from jing, i.e. life essence received from parents at the moment of conception), guqi (energy derived from food) and kongqi (extracted from the air).
There are many ways to improve the circulation of qi in the body. These include, of course, a proper diet (avoiding meals that are too hot or too cold, depending on the season), massages and gymnastics (e.g. qigong, also popular in the West), and breathing exercises (daoyin). According to The Inner Canon of the Yellow Emperor, more important reasons for the dispersion of qi are a lack of moderation in sexual life and too frequent births. Another important factor that has not lost its relevance, but on the contrary perfectly describes the current situation of many people, is the inability to separate working time from rest time.
Puncturing and heating
The key function in acupuncture is performed by the 12 main qi flow channels and two extraordinary meridians (middle rear and middle front). This art consists precisely in puncturing biologically-active points located along the channels. According to Zhenjiu Fengyuan (a work on moxibustion and acupuncture created in 1815), 361 such points can be distinguished on the human body. The first needles were made of stones or bones; later metal ones were used (in the case of wealthy patients, gold or silver needles were also used). Currently, disposable stainless-steel needles are most often used. Acupressure is based on similar assumptions, i.e. the technique of pressing appropriate points with a hand or a diagnostic stick with a small ball at its end.
Inherent in acupuncture is moxibustion (the name comes from the Japanese word mogusa meaning wormwood). It can be done with smouldering cones or cigars made of plant mass – they are used to heat a selected area from a short distance. Sometimes a cone the size of a grain of rice is placed directly on the skin and set on fire; then, as a result of the procedure, a red spot or a small scar is formed after the burn, which of course disappears after some time.
It is also worth mentioning auriculopuncture, that is, acupuncture of the auricle. On the surface of the ear alone there are more than 100 active points. Anna found out how powerful they are while watching her acupuncture teacher. “Ahead of his visit at the dentist, Professor Garnuszewski stuck three needles in his ear in the right places. Thanks to this, the procedure he underwent in the dentist’s chair did not hurt at all.”
Zbigniew Garnuszewski (1917–1998) was a pioneer of acupuncture in Poland. Due to his initiative in 1978, the first acupuncture clinic was established in Poland, and in 1987 the Polish Acupuncture Society was founded. However, anaesthesia at the dentist’s is definitely not the peak of acupuncturists’ capabilities. In his book Medycyna chińska dla każdego [Chinese Medicine for Everyone], Edward Kajdański recalls how in 1974 in China his wife had a caesarean section with anaesthesia in the form of two needles placed around the hip. Between 2006 and 2010, Chinese doctors performed 100 open-heart surgeries under a combination of conventional and acupuncture anaesthesia. “There is a BBC film depicting such surgery,” says Marek Kalmus. “The patient has her eyes open, she is conscious. Chemical anaesthesia is not neutral for the body, so if you can reduce the dose, then why not do it? In every hospital of integrative medicine, both an anaesthesiologist and an acupuncturist are present in the operating room and they agree among themselves what percentage of a given type of anaesthesia to use.”
Acupressure has the same foundations as acupuncture: it also uses points located on the appropriate channels. The difference is that the specialist does not use needles, only hands or a stick with a ball at its end; instead of puncturing the skin, they use point pressure or massage.
Hot and cold
When in 1771 Maurycy Beniowski reached the coast of southern China, he suddenly came down with a high fever. He was advised to consume an orange cooked with a little sugar and ginger. It helped and thanks to this simple mixture, the nobleman got back on his feet. 240 years later, a similar mixture supported me as well. During a cold winter in Liaoning Province, when I was lying sick, unable to move, my students visited me with a net full of kumquat and ginger root. They recommended that I pour boiling water over everything and then drink it. The fever quickly subsided.
The symptoms of a cold, such as increased temperature, chills and coughing, indicate that a person has been attacked by an external cold. Such ailments should be alleviated with medicine and warm products; on the other hand, any ailments resulting from heat should be alleviated with cold products. A sweet and cold orange, like other citrus fruit, is recommended in the case of fever. “We can also find these approaches in the folk medicine passed on by our grandmothers,” says Anna. “It’s logical that when we get burned, we put our hand under cold water, and to warm up, we soak our feet in warm water. A cold towel on the back of the neck relieves the symptoms of fever. You have to treat inflammation with cold, the heat only deepens it.”
Not only medicines and treatments, but also the daily diet should be adapted to the state of the body and the time of year. An excess of products with a certain flavour (the five flavours distinguished by the Chinese are: sour, sweet, bitter, spicy, salty) can harm individual organs. In the spring, you should avoid hot dishes, as these harm the liver, which is most active at this time, because it is cleansing the body of deposits left over from winter. On the other hand, in the summer, it is worth drinking plenty of fluids and excluding hot spices to keep the heart in good shape. In autumn, dry air can harm the lungs, so it is better not to consume hot and dry products. It is not difficult to guess that the best choice for winter are hot and warming dishes that will help maintain the temperature of the kidneys – at this time of year, the kidneys are most vulnerable to diseases.
In Medycyna chińska dla każdego [Chinese Medicine for Everyone], among the remedies for colds Kajdański lists cinnamon stick, white peony root, ginger, jojoba and liquorice. Traditionally, many animal-derived medicines (about 1000) and minerals (about 100) were also used in TCM, but some of them are banned today (one of the most famous was bear bile). “Certain plants, such as Aconitum firmum, are banned in Poland as toxic,” says Marek Kalmus. “However, the toxicity depends on the dose, the time of use, combination with other herbs, the patient’s condition, and their other health problems. Sometimes it pertains to only a specific part of the plant, e.g. the stem, leaves or bulb. It can also be neutralized by one of several processing methods or by other herbs. Yet toxic herbs prescribed by a professional are safe and can help.”
Marek Kalmus emphasizes that Chinese medicine is not in competition with Western medicine. “Patients come to our centre who, for various reasons, do not want or cannot be treated following a Western approach. The use of integrative medicine is good for both the patient and the system, because the treatment is faster, cheaper, and more effective. This approach is used by hospitals in Europe, also in Poland (e.g. the Centre for Integrated Medicine in Warsaw). It is difficult to assess exactly in how many facilities doctors refer to Chinese medicine, because these places do not necessarily have to include this information in the name. For example, in many hospitals in Israel, TCM recommendations are used. Combining TCM and Western medicine has worked, among others, in the treatment of autoimmune diseases, Crohn’s disease, Hashimoto’s disease, skin diseases, and oncology.”
Around the world, interest in Chinese medicine is growing, and the holistic perception of the human body is becoming more and more common. In 2022, ‘traditional medicine’ (which includes TCM) appeared in the WHO International Classification of Diseases ICD-11. It will be subjected to observation, examined for the impact of the methods used on health. Perhaps soon we will trust the practices that have been in use in China for thousands of years.
Translated from the Polish by Agata Masłowska
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