Diagnosis

Yin and yang are opposite but complementary energies that balance to create
Qi
7
. The basis of treatment and diagnosis in TCM is balancing a persons yin
and yang. If there is an imbalance of yin or yang within the body, it will
manifest certain symptoms. The condition will then be treated to increase the
lacking energy. Some examples of associated symptoms are outlined in table 1.


Traditional Chinese Medicine (TCM) and Suggestions for Integration
into Modern-Day Western Practice

Ryleigh M. David and Erin K. Navarro

Saginaw Valley State University, University Center, MI










Crystal M. Lange
College of Health and
Human Services
Objective
Introduction to TCM
Interprofessional Application to
Practice
Comparisons between US and
Chinese Medicine
Opportunities for Healthcare
Improvements
Table 1. Elements of Yin and Yang.
Yin Yang
Chronic Disease Acute Disease
Sleepiness Restlessness
Cold Limbs and Body Hot Limbs and Body
Pale Face Red Face
Weak Voice Loud Voice
Pale Urine Dark Urine
Loose Stool Constipation
Pale Tongue Dark Tongue with Yellow Coating
Traditional Chinese Medicine is an ancient medical system of diagnosis and
treatment that has been practiced for over 2000 years
8
.
It has been used in the United States by Chinese immigrants since the 19
th

century. It was unknown to most Americans before 1971, when a New York Times
reporter received TCM on a visit to China
8
. Since then it has risen in popularity
among Americans, and in 1997 it was estimated that 10,000 practitioners used
TCM to treat more than 1 million patients per year in the US
4
.

The principles of TCM are founded on the concept of qi. Qi is defined as the
vital energy source or life force.
2
Qi is created when there is a balance between
yin and yang energies.

One difference between TCM and Western Medicine is the definition of health.
The Chinese believe health is an ongoing process of maintaining balance and
harmony in the circulation of qi.
4
Meanwhile, Western Medicine defines health
as the state of well-being and optimal functioning.
2


The purpose of this poster is to introduce principles of Traditional Chinese
Medicine to readers and identify ways in which it might be integrated into the
practice of Western Medicine in the United States.
Practitioners specializing in Traditional Chinese Medicine primarily use four
diagnostic techniques to evaluate a persons condition: observation,
hearing/smelling, inquiry and palpation. Similarly, practitioners specializing in
Western Medicine use inspection, auscultation, percussion and palpation.

The main approach in TCM of diagnosing internal phenomena is judging the
interior from the exterior.
1
It is believed that whatever occurs on the inside is
manifested on the outside. For this reason, observation is a very important part
of TCM diagnosis.

An example of the use of observation in TCM is inspecting the tongue. Certain
characteristics, such as color, shape or coating can reveal an imbalance in a
persons yin or yang.
Treatment Modalities
ACUPUNCTURE
Acupuncture is a traditional Chinese treatment commonly used in China.
The purpose of acupuncture is directly related to qi. Qi is the energy that
runs through the body on pathways called Meridians. The theory behind
acupuncture is that small needles relax energy blockages along the
meridians, and help qi run smoothly through the body
3
. For this reason,
acupuncture is used to treat a wide variety of health concerns, such as
trauma, pain or internal issues
6
.

In modern-day China, the acupuncture needles are usually manipulated by
electrical stimulation. The electrical current helps trigger the flow of qi,
more efficiently than needle stimulation alone.

In the United States, we use a technique similar to this to manage pain,
called a transcutaneous electrical nerve stimulation unit (TENS). ATENS
unit uses a mild current of electrical impulses delivered through electrode
pads. These impulses stimulate the muscle and replace the pain signal with
a tingling sensation, resulting in a reduction of pain perception.

HERBALTREATMENTS
In China the primary method of treatment has been herbal remedies. There
are hundreds of different materials used. Almost every part of a plant may
be used, such as the seeds, leaves, roots and flowers. Animal products are
also used, such as rhino horn and snake bile
5
. Each material is used for the
treatment of a specific condition. These materials can be prescribed as teas,
powders and capsules.

In the United States herbs are rarely prescribed by practitioners. Instead,
different medicinal drugs are prescribed to help with a condition. Similar to
TCM, each drug has a specific intended purpose. However, these drugs are
typically not found naturally, and are scientifically created. Most western
drugs are prescribed as capsules or fluids that are either injected or
delivered intravenously.
Combining treatment methods of TCM and Western Medicine may improve
healthcare opportunities and outcomes for patients in both the US and China.

By including aspects of TCM into modern western practice in the United States,
several potential outcomes may be achieved. First, it gives practitioners the
opportunity to treat their patients more holistically. It gives them more options for
treatment and diagnosis. Incorporating the diagnosing principles of TCM with
Western Medicine principles can give practitioners a more complete view of their
patient and their ailments.

Another potential outcome of using TCM in the United States is the opportunity
for practitioners to treat their patients in a more natural way. Western Medicine
uses different chemicals and materials that sometimes have unknown effects on
the body. Using a combination of western and traditional Chinese medicine
allows the practitioner to offer their patients the option of herbal remedies and/or
acupuncture as natural remedies. Due to the diversity of American culture, there
is a need for medicinal alternatives that give patients more options on the way
they wish to treat their condition.

Alternatively, using Western Medicine in China can also help practitioners treat
their patients more holistically. While they base their practice on historical
principles, combining their treatment with Western Medicine would allow them to
use science-based diagnoses and treatments alongside their current tradition.
By incorporating Western Medicine in China, it gives practitioners a larger
variety of treatments and medications that can be offered. If their patients are not
responding to traditional treatment, Western Medicine techniques can be used as
an alternative.
Due to the broad, all-encompassing nature, the use of TCM in the United States
has potential for application in interprofessional practice. From physical and
occupational therapy to nursing and nutrition science, TCM may be a useful
therapeutic modality.

For example, the use of acupuncture can be used in physical therapy or
occupational therapy to help treat a variety of conditions. Patients experiencing
pain can be given acupuncture as an alternative, or in conjunction with other
treatments. It can give therapists another treatment method if their patients are not
responding to current therapy. Nurses can work together with therapists to educate
patients on the option of acupuncture, and to monitor a patients progress while
they are being treated.

Recommendations for Integration
into Western Practice
Even though TCM has centuries of research to support it in China, TCM is not
widely known or practiced the US. Due to the population diversity in the United
States, care givers need a broad understanding and an open mind to deliver
culturally sensitive, optimal patient care.

For this reason, it is important for practitioners to not only have an awareness of
the system but to have a basic understanding of TCM. Now more than ever,
there is a need for healthcare students to be educated in other modalities such as
TCM.

In addition, further research needs to be done in the US on TCM treatments and
their combination with Western Medicine. It is important to evaluate the drug
interactions and dosing levels when combining western drugs with TCM herbs,
in order to be able to safely treat patients.

In conclusion, Western Medicine and TCM both have value.
The modalities are quite different, but can be used in concert to provide
culturally sensitive patient care.

Nutritionists and dieticians can work collaboratively with nurses and physicians to
suggest food and herbal options based on the TCM principles and diagnoses.
If nutritionists and dieticians have an awareness of TCM, they can help nurses and
physicians educate patients on the benefits of consuming certain foods to help treat
their condition.
References

1. Cheung, T. (2000). The difference and similarity between traditional Chinese and western medicine.
Chinese Journal of Integrative Medicine, 6(1), 68-70.
2. Craven, R. F., & Hirnle, C. J. (2009). Fundamentals of nursing: Human health and function. Philadelphia:
Wolters Kluwer Health/Lippincott Williams & Wilkins.
3. Mayo Clinic. (2012). Acupuncture. Retrieved from
http://www.mayoclinic.com/health/acupuncture/MY00946
4. National Center for Complementary and Alternative Medicine (2010). Traditional Chinese medicine: An
introduction. Retrieved from http://nccam.nih.gov/health/whatisca/chinesemed.htm
5. Still, J. (2003). Use of animal products in traditional Chinese medicine: environmental impact and health
hazards. Complementary Therapies in Medicine, 11(2), 118-122.
6. Traditional Chinese Medicine World Foundation. (2013). TCMhealing modalities. Retrieved from
http://www.tcmworld.org/what-is-tcm/tcm-healing-modalities/
7. Traditional Chinese Medicine World Foundation. (2013). Yin and Yang Theory. Retrieved from
http://www.tcmworld.org/what-is-tcm/yin-yang-theory/
8. University of Maryland Medical Center. (2011). Traditional Chinese medicine. Retrieved from
http://www.umm.edu/altmed/articles/traditional-chinese-000363.htm.
Photograph by Chelsey Perry, 2013
Photograph by Chelsey Perry, 2013