Before we get into details the crux of this article can be summed up in one statement... Chinese Medicine treats patterns of illness that can contain any number of symptoms/western conditions whereas generally western medicine is symptomatic/condition based. This is an important distinction to have in mind when you are are considering using Chinese Medicine (acupuncture, herbal medicine, tuina massage, etc.) for your ailments.
It is very common when patients are new to acupuncture that they ask for specific conditions to be treated. They generally assume that, as with Western Medicine, we have treatments for individual conditions and that it is unlikely or cumbersome even to treat more than one symptom at a time. Then they get concerned that they will run out of time and money until we get through all of them! Lucky for them, and for practitioners, Chinese Medicine does not treat conditions. That’s right, technically speaking there are no acupuncture treatments for back pain, arthritis, depression, fertility or anything else. Yet all of these conditions and far more are treated with success on a daily basis in Chinese Medicine clinics around the world.So What -does- Acupuncture Treat?
In Chinese Medicine we treat patterns. These patterns can be thought of simply as treating the root and connections between your conditions/symptoms - even treating causal factors before you experience a stronger condition. Treating the path towards thyroid problems, for example, while you only have mild symptoms and your western blood work is still fine. This opposed to chasing after each individual symptom which often ends up in a barrage of uncoordinated medicinal attempts at bringing all of your symptoms under control.
A very important aspect of the diagnostic and treatment process within Chinese Medicine is to note that you can treat conditions -before- they come to fruition - the ultimate in prevention so to speak. Part truth and, undoubtedly, part folklore stories about historical village doctors in China go like this -- doctors were only paid when the villagers were well, once someone was sick they were not paid until they were better again... The development of Chinese Medicine certainly took these precautions to heart and the system of diagnostic patterns allows for both remedial and protective measures to be taken.
We see this clinically, for example, when a patient will come for a specific condition such as knee pain and find that when their knee is better, their digestion is also improved, they are sleeping better, and their blood pressure is down - often without even telling the practitioner about those symptoms! This a direct result from treating their overall pattern.What is a Pattern?
Traditional Chinese Medicine diagnostic patterns (or, simply, “patterns”) are descriptions of how illness arises, proceeds, comes to fruition and affects other systems. When patients see a practitioner of Chinese Medicine the practitioner will take note of all of their symptoms, conditions (both past and present), lifestyle habits, dietary habits, and other information such as that derived from tongue and/or pulse diagnosis, facial diagnosis, etc.. When all of this information is assimilated they will come to an overall diagnosis (i.e. your “pattern” or “patterns” as you can have multiple ones).
Often these patterns are a web of inter-relationships and inter-woven histories of actions and results than can be difficult to distill down to one causal pattern - particularly as we age. This is where all of the years of training is spent within Chinese Medicine. Chinese Medicine properly applied requires constant study and development on the side of the practitioner to fully appreciate the nuances of all of these patterns and to properly diagnose and treat - there are no shortcuts. The needling techniques used within acupuncture are fairly trivial to learn, but what points to use and why is where the “magic” is and where the results are derived from.What Are Some Examples of Chinese Medicine Diagnostic Patterns?
Before we get into specific examples, a note about the naming of Chinese Medicine patterns is called for. Examples of some patterns are Kidney Yin Deficiency, Heart Qi Deficiency, Spleen Yang Deficiency and Liver Yang Excess. An important point is that generally there is nothing physically wrong with your “spleen”, your “kidneys” or your “heart” - although there can be. Those terms simple describe a system of functions within the body that at times only marginally involve the named physical organ. (See the five element intro article, and the organ system specific introductory articles - “My Heart?”, “My Liver?”, "My Spleen?", "My Kidneys?", and "My Lungs?" for more information).
As we have touched on previously, patterns arise from a combination of life events, environmental causes, habits and circumstances. Take for example Spleen Qi Deficiency:
Spleen Qi Deficiency can be associated with some or all of the following symptoms/conditions: digestive issues, bloating, gerd, anxiety, depression, poor memory, inability to focus, low energy, muscle weakness, chronic fatigue, insomnia, add/adhd, and more.
Spleen Qi Deficiency, generally speaking, arises from irregular and/or rushed eating patterns, eating too much and/or poor food choices over time, having a lack of exercise and true relaxation, and overthinking - among other causes (sound familiar?!?). These habits will weaken the spleen system and when this happens the role it serves in converting food into useful energy (i.e. qi and blood) for our body will not happen. When our qi and blood is weakened our muscles are not nourished, our digestive system does not function well, our mind is not clear, our energy is not vibrant and balanced. As this pattern continues the symptoms/conditions that we experience get more obvious and perhaps more numerous as well. Further these patterns can deepen into other patterns, such as Spleen Blood Deficiency, for example, where the person may experience all of the above symptoms but also with the possibility of amenorrhea, anemia, constipation, palpitations and other related symptoms/conditions.
Even with that relatively simple example you can see the progression and inter-relationships that are observed, respected, and worked with in Chinese Medicine. Again, understanding the development and flow of these patterns is where all of the “magic” of Chinese Medicine is found as well as the key to the best clinical outcomes of treatment.Why Is Pattern Diagnosis and Treatment Important?
Well in effect pattern differentiation is the crucial point of Chinese Medicine - it is exactly what distinguishes it from western forms of linear cause-effect based medicines. Patterns in effect are what allow us to treat the increasingly complex relationships of illnesses and symptoms that we see today - many of which are poorly understood in western terms such as any variety of auto-immune conditions, cancer, valid explanations of how depression and anxiety arise, “unexplained” fertility problems, people just plain feeling “lousy”, etc.
On a more direct note, however, it is important for the public to understand to some degree the complexity of Chinese Medicine. In part this is to avoid it getting lumped into any variety of “alternative techniques” - most of which having none of the clinical and research behind them that Chinese Medicine has. Also to avoid people trying to treat themselves with Chinese Medicine, perhaps more particularly with Herbal Medicine. While some formulas such as Yin Qiao for colds, or Bao Ji Wan for overating/mild digestive problems are somewhat symptom based. By that I mean, very generally speaking, if you have those symptoms you have the patterns for which those formulas are appropriate. However as you get into more complicated conditions such as insomnia with anxiety and palpitations, for example, you cannot apply the correct formula without a clear diagnosis. Why? well the short answer is that if there are 7 formulas for insomnia, for example, for a particular person 4 might make then worse or at best do nothing at all, a couple might help and 1, possibly 2, will be perfect for them. Furthermore, as treatment is intended to resolve (i.e. not manage) the issues the treatments are a sort of moving target, so one approach might be used for a couple weeks until certain changes happen and then another after that. With a clear diagnosis and proper treatment resolution of peoples issues is much faster, more reliable and safer.Importance of Resolution/”Cure” vs. Symptomatic Care:
On a broader note, treating patterns in Chinese Medicine is again a way of avoiding further illnesses in the future which also means limiting the chances of recurrence of previous symptoms in the future as well. That is, from a Chinese Medicine perspective when you treat the underlying causal factors of disease you should in effect no longer experience any of the symptoms that prompted you to obtain treatment. Treatments, then, are intended to lead the patient to the place where they no longer experience symptoms and (most importantly) no longer require treatment. This opposed to managing symptoms by taking medicines for years, decades or even a life-time. While there are places where this is appropriate and western medicine offers some amazing medications and advances, it is generally not the course of action that leads to resolution of the underlying causal factors. Further by ignoring our inter-related nature, the western symptom based medicinal approach opens up the way for more side effects and even other conditions such as cancer arising from hormonal replacement therapy, or psychological issues from taking sleep medicines, etc.
Both systems of medicine have their place but we cannot disregard what our bodies are telling us. Even such a relatively mild issue as a dull daily headache should be properly treated and resolved and not masked over time with ibuprofen for example. If we listen to our body and our environment and act accordingly we will go a long way towards living vibrant and healthy lives. While none of us can escape death and most of us will experience at least some times of illness, what we do with the rest of the time is entirely up to us. Chinese Medicine operates entirely within the realm of appreciating our inter-relatedness and working within the natural order of things. There is much we can learn from this approach, even if all we learn is how to get our back feeling better...
For further exploration, read "How Does Acupuncture Work?".
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