Related Terms

• Asian medicine, Chinese medicine, Eastern medicine, traditional Chinese medicine (TCM).

• For more information on specific topics, please see Natural Standard's Herbs & Supplements Database and Complementary Practices Database.

Background

• Asian medicine is a term that encompasses a whole system of medical practices performed in different countries in Asia, which include acupuncture, martial arts, herbal medicine, Feng Shui, and massage (i.e. shiatsu). Of these therapies, acupuncture and Chinese herbology are the most popular in the United States. Some additional therapies include diet, nutrition and lifestyle counseling, as well as tai chi and qi gong (physical exercise), and Tui'na (manual therapies). Since many of the Asian medicine therapies are rooted in the Chinese philosophy and the principles of Chinese medicine, the monograph focuses mainly on Chinese medicine.

• Asian medicine describes a system of healthcare and maintenance comprised of an array of treatment modalities and interventions. At its most basic level, Asian medicine includes the use of acupuncture, Chinese herbal medicine, manual therapies, dietary guidelines and meditative exercises. These distinct modalities and treatment techniques share a theoretical framework defined by the interdependent relationship of yin and yang and arise from theories put forth in the canon of Chinese medical texts. Each technique is used to achieve a specific aspect of the treatment strategy, which is determined as part of the diagnosis at the onset of the session.

• The concept of health in Asian medicine can be defined as the dynamic balance of yin and yang within the individual and between the individual and his or her environment.

• The concept of illness in Asian medicine suggests a body's inability to respond and adapt to changes in the environment, diet, aging/development, or an inability to rid the body of an attacking pathogen. In Asian medicine, patterns of disharmony are used to diagnose illness.

• General history of Chinese medicine: Chinese medicine has a history of thousands of years. Ancient herbology in China focused on potions whose function was part medicinal and part magical, and it lacked a substantial theoretical base. Sometime between the 2nd Century B.C. and the 2nd Century A.D., the theoretical foundations of traditional Chinese medicine were laid, but the focus was more on acupuncture than on herbs.Only by about the 12th century A.D. were the deeper principles of Chinese medicine fully applied to herbal treatment, forming a method that can be called traditional Chinese herbal medicine.

• Chinese medicine continues to evolve over the centuries. Herbal medicine reached a high point during the Ming Dynasty (1368-1644), which is considered one of the most prosperous time periods for China.

• This was further refined and elaborated during various periods of active theorizing in the 14th through the 19th Centuries.

• The cultural revolution in China, which began in 1966 and lasted until 1976, also had a major impact on Chinese medicine. During the ten-year revolution, medical schools ceased to exist and did not admit new students. No formal medical training was given to students. When medical schools reopened in 1970, a new philosophy emerged. Students were now trained based on a curriculum that focused primarily onpolitical ideology and practical training over basic science.

• Western disease concepts entered the picture in the 20th Century, leading to further changes.

• According to the World Health Organization (WHO), traditional Chinese medicine (TCM) is fully integrated into the Chinese health system as 95% of Chinese hospitals have special units for traditional medicine. Chinese herbal medicine is used alongside western medicine.

• Transmission of Chinese medicine to other parts of Asia: In the sixth century, Emperor Liangwu sent medical doctors to Korea, thus officially introducing acupuncture and moxibustion outside of China. China reached out to Japan when the Chinese Government presented the book Canon of Acupuncture to the Mikado of Japan in 552 A.D. Also in the sixth century, Mi Yun from Dun Huang of China's Gansu Province introduced Hua Tuoís therapeutic methods and prescription to the Daochang State of north India.

Technique

• Acupuncture: Acupuncture was originated in China and involves the insertion and manipulation of needles at specific points along the body to regulate the flow of qi and restore the balance of yin and yang. qi, or vital energy, is believed to flow throughout the body and is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin (negative energy) and yang (positive energy).

• In acupuncture therapy, special needles are inserted into various points on the body's surface, with the intention of altering the flow and distribution of chi and setting it back on its proper course. Over 650 acupuncture points have been recognized, although only about 140 are used.

• Moxibustion: Moxibustion is a traditional Chinese medicine technique that involves the burning of mugwort, a small, spongy herb, to facilitate healing. Moxibustion has been used throughout Asia for thousands of years; in fact, the actual Chinese character for acupuncture, translated literally, means "acupuncture-moxibustion." The purpose of moxibustion, as with most forms of traditional Chinese medicine, is to strengthen the blood, stimulate the flow of qi, and maintain general health. It is applied when warmth is needed in a particular area. If warmth is needed at a deep point within the body, the moxibustion cone can be placed on top of an acupuncture needle.

• Cupping: Cupping is the application of a heated cup over an area of the body. As the air inside cools its volume decreases, it creates a slight suction on the area that stimulates blood circulation.

• Chinese medicine: There are about 80 types of Chinese herbal medicines, most of which are plants. However, many Chinese medicines come from animals, minerals and fungi. During the Han Dynasty (before 2nd century AD), 365 medicines were recognized. By the Ming Dynasty (14th century AD) that number had increased to 1,892. Today, there are more than 5,000 Chinese medicines. The Chinese medicine practitioners will prescribe based on their diagnosis, which is typically followed by an in-depth interview of the patient, examination of the patients' pulse, smelling of the breath and inspection of the condition of the tongue.

• Manual therapies: Manual therapies provide additional hands-on techniques integral to the practice of Asian medicine. Massage-like procedures are used to increase circulation to body tissues, loosen joints and relax muscles in specific areas. One popular manual therapy used in Asian medicine is Tui Na, a classical Chinese massage. Tui Na involves the stimulation of acupoints and areas of the body with the practitioner's hands and massage tools. Other Asian bodywork therapies such as Shiatsu or traditional Thai massage, extend the acupuncturist's treatment options for many musculoskeletal, structural and traumatic injuries.

• Acupressure and shiatsu: These are both names for a technique of massage involving the use of finger pressure on acupuncture points (rather than using needles). Based on Chinese medical theory of the human energy system, acupressure and shiatsu seek to stimulate the flow and circulation of chi (vital energy, life force) through the person's meridian system (system of pathways of circulation of chi through the body). These techniques are used mainly by massage therapists and not commonly practiced by practitioners of the other main methods of Chinese medicine.

• Dietary guidelines: Diet is a vital aspect of healing and health maintenance in East Asian Medicine. As with Chinese herbs, foods are categorized according to their actions in the body, as well as by predetermined values (e.g., hot/cold, yin/yang, building/clearing).

• Meditative exercise: Meditative exercises were originally developed as a way to cultivate one's qi - for personal health, for improving one's ability to treat others, and for defensive purposes. External exercises, or the martial arts such as Kung Fu and Wushu, have long been a familiar practice in the West. Internal exercises such as tai chi and qi gong (also chi kung) are comprised of slow, graceful movements and breathing techniques which help to improve balance, strengthen the body and promote a general sense of well-being.

• Tai chi: It is a system of movements and positions believed to have developed in 12th Century China. Tai chi techniques aim to address the body and mind as an interconnected system, and are traditionally believed to have mental and physical health benefits to improve posture, balance, flexibility and strength. Tai chi is taught in classes or can be practiced alone. Classes often include fewer than 20 people. Instructors guide pupils through movements, encouraging them to keep their bodies stable and upright while shifting weight. A high level of concentration is usually involved, and sessions are intensely focused and quiet. Exercises can also be practiced alone daily for 15 to 20 minutes, often in the morning.

• Qi gong: It is a type of traditional Chinese medicine (TCM) that is thought to be at least 4,000 years old. There are two main types of qi gong practice: internal and external. Internal qi gong is a self-directed technique that involves the use of sounds, movements, and meditation. Internal qi gong actively engages people in their own health and well-being, and can be performed with or without the presence of a Master instructor. It may be practiced daily to promote health maintenance and disease prevention. External qi gong, also known as qi emission, is performed by a Master using his or her hands on a patient, with the aim to project qi for the purpose of healing. There are many different styles of performing qi gong, and the Chinese government has reported over 5,000 types.

Theory/Evidence

• In theory, Asian medicine can address all possible physical, psychological, and spiritual problems. In the West, it is primarily used to treat long-term chronic conditions (e.g., rheumatoid arthritis and menopausal symptoms), as well as some acute conditions that are not life threatening (such as menstrual pain and colds and flu). TCM is also widely used to promote wellness and prevent disease.

• See individual monographs for more in depth information.

Safety

• Acupuncture: Relatively safe form of medicine as long as it is practiced appropriately. It should be avoided in the following conditions: valvular heart disease, known bleeding disorders, use of anticoagulant drugs, unstable medical condition or infection, pregnancy (may induce unwanted labor and possible miscarriage), systemic or local infection, pain of unknown medical origin, medical condition of unknown origin such as dermatologic lesions, neurologic patients (e.g., severe polyneuropathy or paraplegia, or following certain forms of neurosurgery), areas that have received radiation therapy.

• Moxibustion: Use caution with patients with neuropathy. Avoid face, head, nipples and genitals, skin adhesions, points where needling is contraindicated for the individual patient, in patients with any kind of "heat syndrome" according to acupuncture theory, in patients with strong heat signs - high fever, etc., on or near inflamed and/or red areas of the body, and in patients with diabetic neuropathy or in any situation where the patient may not respond to the sensations of heat.

• Cupping: Avoid the abdomen/sacral area during pregnancy, contraindicated acupuncture points, during high fever, during convulsions or cramps, over allergic skin conditions or ulcerated sores, over an inflamed organ, over inflamed areas in general (can cup distally and/or around the area), in patients with cardiac disease and/or aneurysms, in patients with extreme fatigue and/or anemia, in patients who have just finished exercising or taking a hot bath or shower.

• The abdominal area and the lower back during pregnancy are traditionally avoided in both cupping and moxibustion practice out of concern for adversely impacting the uterus or fetus, although there are no published reports of related adverse effects.

• Acupressure: With proper training, self-administered acupressure and that performed by an experienced therapist appear to be generally safe. No serious long-term complications have been reported in the scientific literature. Forceful acupressure may cause bruising.

• Shiatsu: With proper training, self-administered acupressure and that performed by an experienced therapist appear to be generally safe. No serious long-term complications have been reported in the scientific literature. Hand nerve injury and herpes zoster ("shingles") cases have been reported after shiatsu massage. Forceful acupressure may cause bruising.

• Chinese herbal medicine: There have been reports of manufactured or processed Chinese herbal products being tainted with toxins or heavy metals or not containing the listed ingredients. Recent years have seen efforts on the part of the Chinese government and manufacturers of herbal products to improve quality and assure safety of the products. However, herbal products should only be purchased or accepted from reliable sources.

• Tai chi: Adverse effects of tai chi are rarely reported, and may include sore muscles or sprains. Tai chi should be avoided by people with severe osteoporosis or joint problems, acute back pain, sprains, or fractures. Advancing too quickly while studying tai chi may increase the risk of injury.

• Qi gong: Qi gong is generally considered to be safe in most people when learned from a qualified instructor. In theory, underlying psychiatric disorders may worsen with unsupervised internal qi gong practice. An allergic skin reaction was reported in one group of qi gong students, but the cause was not clear. In cases of potentially serious conditions, qi gong should not be used as the only treatment instead of more proven therapies, and should not delay the time it takes to see an appropriate healthcare provider.

Author Information

• This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Agarwal, A., Ranjan, R., Dhiraaj, S. et al. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia 2005;60(10):978-981. View Abstract

2. Allison D, Kreibich K, Heshka S, et al. A randomised placebo-controlled clinical trial of an acupressure device for weight loss. Int.J Obes.Relat Metab Disord. 1995;19(9):653-658. View Abstract

3. Bhatti T, Gillin JC, Atkinson JH, et al. T'ai chi chih as a treatment for chronic low back pain: a randomized, controlled study [abstract]. Alternative Therapies 1998;4(2):90-91.

4. Chan, K., Qin, L., Lau, M., et al. A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch.Phys.Med.Rehabil. 2004;85(5):717-722. View Abstract

5. Ernst, E. and White, A. Life-threatening adverse reactions after acupuncture? A systematic review. Pain 1997;71(2):123-126. View Abstract

6. Klein J, Griffiths P. Acupressure for nausea and vomiting in cancer patients receiving chemotherapy. Br J Community Nurs. 2004 Sep;9(9):383-8. View Abstract

7. Stenlund, T., Lindstrom, B., Granlund, M. et al. Cardiac rehabilitation for the elderly: Qi Gong and group discussions. Eur.J Cardiovasc.Prev.Rehabil. 2005;12(1):5-11. View Abstract

8. White AR, Abbot NC, Barnes J, et al. Self-reports of adverse effects of acupuncture included cardiac arrhythmia. Acupunct Med 1996;14(2):121.

9. White A, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000009. View Abstract

10. Yip Y. and Tse S. The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial. Complement Ther.Med. 2004;12(1):28-37. View Abstract