Eastern and Western Approaches to Medicine Notes

Eastern and Western Approaches to Medicine

Julia J. Tsuei's article compares Eastern and Western medicine to evaluate Oriental techniques like acupuncture.

Introduction

  • Objective comparison is needed to validate Oriental medical techniques.
  • Nevada and Hawaii regulate acupuncture independently.
  • Other states like Oregon and California allow acupuncture with supervision or referral.
  • Diverse opinions on acupuncture exist within the medical profession.
  • An objective comparison may integrate Oriental medicine into modern practice.

Contrasting Methodologies

Western Medicine
  • Hypothetical deduction: statements result from fact probings.
  • Hypothesis derived from observations, research plan designed, and conclusions drawn from statistical evaluations.
Eastern Medicine
  • Inductive method: records practical experience accumulated over thousands of years.
  • Format of recording is a result of direct observation.

Health and Disease Concepts

Western Approach
  • Divides health from disease.
  • Emphasizes the individual body.
  • The environment is only one factor affecting the body.
  • Responsibility is shared by professionals in several disciplines, such as physicians for acute care and other professions for health promotion and disease prevention.
  • Team approach is community-minded, yet the objective is still individual well-being.
Eastern Approach
  • Health and disease are two sides of a coin.
  • Individuals are in a state of balance between external insults and internal defenses.
  • Illness occurs when insults outweigh defenses.
  • Individuals are considered microcosms in a macrocosm.
  • A physician's duty is to strengthen defenses and adaptation to maintain balance and health.

Treatment Philosophies

Western Medicine
  • Involves changing the environment via shelters with temperature control and antibiotics.
  • Uses artificial limbs, organs, synthetic hormones, and vitamins.
  • Aims to prolong life and improve functioning for the handicapped.
Eastern Medicine
  • Emphasizes strengthening internal defensive powers to accommodate physical or mental stress.
  • Aims for balanced, comfortable body and a happy person.

Learning Systems and Terminology

Western Medicine
  • Detailed study from microscopic to macroscopic views, including biology, embryology, histology, microbiology, chemistry, physics, anatomy, and physiology.
  • Training and practice tend to be segmented due to the large field of knowledge.
Eastern Medicine
  • Learning begins with the universe and laws of nature paralleling bodily phenomena.
  • Students learn astronomy and geography.
  • The body is classified differently.
  • Causes of disease are divided into six environmental insults and seven internal insults.
  • Diseases represented by symptom groups or syndromes.
  • Emphasizes environmental health, surface anatomy, functional physiology, neurophysiology, and psychosomatic aspects.

The Chinese Concept: Microcosm and Macrocosm

  • Humans are small universes with correlated anatomical structures and physiological functions.
  • Perfect health is when everything coexists in harmony.
  • Constant readjustments maintain balance.
  • Disturbance of balance leads to illness.
  • The ancient Nei Ching states:
    • "Man is nothing but a creature living between heaven and earth."
    • Life is a product of interaction between the atmosphere of Heaven and the produce of Earth.
    • Wisdom involves living in accord with the seasons, climates, and inner peace.

Yin and Yang

  • Basic fundamentals of ancient Chinese philosophy from I Ching.
  • Represent duality of positive and negative power.
  • Equal in value, balanced, and interdependent.
  • Describe equilibrium within the body, organs, functions, and environment.
Examples
  • Origin of Life: Yin (female) and Yang (male).
  • Structure of the Body: Exterior is Yang, interior is Yin; back is Yang, front is Yin; solid organs are Yin, hollow organs are Yang.
  • Heaven is Yang, Earth is Yin; body above the waist is Heaven, below is Earth.
  • Meridians: Outer surface is Yang, inner surface is Yin.
  • Activities of the Body: Yang is active, strong, fast, positive; Yin is passive, weak, slow, negative.
  • Diagnosis of Diseases: Hypofunction is Yin, hyperfunction is Yang; chronically inactive is Yin, acutely active is Yang.
  • Treatment: Treat Yin diseases with Yang and Yang diseases with Yin.
General Principles
  • Everything is classified by Yin and Yang components.
  • Yin/YangYin/Yang have a name but no form, extending from 1 to 10,000, embracing all things.
  • Yin contains Yang and Yang contains Yin, illustrated by a symbol with a black dot in the white half and a white dot in the black half.
  • Similar to positive and negative electrical charges, levorotatory and dextrorotatory chemical compounds, acid-base balance, and the hypothalamic-pituitary-gonadal axis.
  • Example: androgens in women, estrogens in men.

Anatomy in Chinese Medicine

  • Divides the body by functions rather than structure.
  • Anatomical, physiological, and psychological components are linked by meridians.
  • The Yellow Emperor's book states:
    • Embryo is formed by Yin and Yang energies.
    • Marrow in the brain and bones are formed to support the body.
    • Meridians transmit energy and blood.
    • Tendons sustain bones, muscles form walls, and skin solidifies.
    • The stomach takes in food, meridians function, and blood/energy circulates.
  • Standards exist for measuring body size, pulse, and dissecting the body.

Body Components: Five Tsang (Stores)

  • Store life essence and energy (hsieh and chi).
Hsin (Heart)
  • Stores the heart, brain function, and mind.
  • Represents fire.
Kan (Liver)
  • Stores the liver, sensory-motor system, and equilibrium.
  • Represents wood.
P'i (Spleen-Pancreas)
  • Stores the spleen-pancreas, absorption, digestion, distribution, and utilization of nourishment.
  • Intelligence and temper.
  • Represents earth.
Fai (Lung)
  • Stores the lung, respiratory function, and gas exchange.
  • Willpower.
  • Represents metal.
Shen (Kidney)
  • Stores the kidney, endocrine system, and neurohormonal system.
  • Willingness.
  • Represents water.

Body Components: Six Fu (Houses)

  • Transmit and transform matter but do not store it.
Tan (Gall Bladder)
  • Houses the gall bladder.
  • Controls lymphatics and body fluids.
  • Equilibrium and tranquility.
  • Represents wood.
Hsiao Ch'ang (Small Intestine)
  • Houses the small intestine.
  • Absorbs digestive nutrients and transports waste.
  • The mind.
  • Represents fire.
Wei (Stomach)
  • Houses the stomach.
  • Digestion and muscular contractions.
  • Temper and intelligence.
  • Represents earth.
Da-ch'ang (Large Intestine)
  • Houses the large intestine.
  • Self-defense mechanism and immunological system.
  • Willpower.
  • Represents metal.
Pang-kuang (Urinary Bladder)
  • Houses the urinary bladder.
  • Water balance and excretion.
  • Compliance.
  • Represents water.
San-chiao (Triple-Burner)
  • Three functional zones: upper (respiration and cardiovascular), middle (digestion), and lower (excretion).
  • Coordinator of all functions.
  • Represents fire.

Physiology in Chinese Medicine

  • The formula of five elements describes body functions using daily events.
  • Water kills fire, fire melts metal.
  • Damaged kidney affects the heart, heart trouble damages the lungs.
  • Describes the complicated interaction of body functions.
  • Five elements (wood, fire, earth, metal, water) encompass all nature and apply equally to man.

Equilibrium

  • Perfect equilibrium is the goal.
  • Five stores and six houses must be in harmony with each other and the environment.
  • Small and large universes are in harmony.
  • Changes disrupt equilibrium, requiring readjusting power to regain balance.
  • Reactions and counteractions are illustrated by the law of five elements.

Pathophysiology in Chinese Medicine

  • Causes of diseases divided into six physical aspects and seven emotional factors (outer and inner insults).
  • Physical: wind, cold, heat, dampness, dryness, and fire.
  • Emotional: happiness, anger, sorrow, anxiety, sadness, fear, and shock.
  • Wind and cold attack the upper body, dampness attacks the lower body.
  • Emotions affect organs: worry and fear harm the heart, cold harms the lungs.

Psychosomatic Medicine

  • Early recognition by the Chinese.
  • Unskilled physicians focus on the physical; skilled physicians examine emotions.

Maintaining and Promoting Health

  • Good health is equilibrium within the body and with surroundings.
  • Maintain balance of body functions, mind, and environment.
  • Circulation Systems: Chi (air) and Hsieh (blood).
  • Chi is the invisible energy.
  • Hsieh includes visible circulations (cardiovascular, lymphatic, cerebrospinal fluid).
  • Constant balance is required for equilibrium.

Circulating Nourishment

  • Yin-chi (nutritional circulations) and Wei-chi (defensive circulation).
  • Chi is received in food, transmitted to lungs and organs.
  • Food nourishes chi (yin-chi), and the less pure nourishes wei-chi.
  • Chi represents vital energy, nerve impulses, and mental activities.
  • Hsieh represents visible circulations and organs.
  • Balance between functions and organs, mind and body.
  • Adjusting chi and hsieh through meridians balances body and environment.

Meridians

  • Communication routes connecting acupuncture points.
  • Skin is a reactor of the body to the surroundings.
  • Fits Western theories of cutaneous-visceral and viscerocutaneous reflexes.
  • Stimulating homeostasis via cutaneous caresses.

Therapeutic Concept

  • Restoring balance using pharmacological (herb medicine) or physical (acupuncture and moxibustion) approaches.

Preventive Medicine

  • Administering medicine after disease is like digging a well after thirst.
  • Ancient people lived longer by understanding nature and patterning themselves upon Yin and Yang.
  • Modern man drinks wine like water, leads an irregular life, and exhausts vital energy.
  • Ignoring the rules of nature leads to degeneration.
  • Dangers of self-indulgence were documented thousands of years ago.