Out of this comes the concept of “holism” where to a western trained physician, seemingly unrelated complaints and “signs and symptoms of incidental finding and questionable diagnostic significance” are weaved as components of distinct patterns of disharmony.

Thus one disease entity, i.e. peptic ulcer, can be discerned into several patterns of disharmony, each requiring different treatment. The science of western medicine strives for standardized care while the art of TCM yields individualized treatment plans.

One or Many, of the Central Importance of Qi

Upon to this point you may think TCM is just a method of classifying diseases into endless categories of disharmonies. But nothing can be further from the truth. TCM deals with Qi, the vital energy and general guiding principle that drives and controls every process in the body.

The definition of Qi usually encompasses 5 functions:

1. Warming and Moistening Aspect that nourishes the viscera, muscles and sinew, skin and hair and keeps the body’s constant temperature
2. Holding Aspect that keeps everything in its place---blood in vessels, urine in the bladder, tear in the eyes, saliva in the mouth, organ in its proper location
3. Protecting Aspect that fends off external evils (roughly the western equivalent of the immune system)
4. Transforming Aspect that assimilates nutrients (roughly the western equivalent of the digestive system)
5. Moving Aspect that regulates and controls movement of all types in the body—i.e. heart Qi for circulation, lung Qi for breathing, bladder Qi for urination, and most importantly, kidney Qi for the life cycle (birth, growth, maturation, reproduction, aging and dying.)

To illustrate the utility of Qi in both diagnosis and treatment, let’s examine a pattern of disharmony in TCM called Collapsed Qi, where the energy of the patient gets so weak such that it loses its holding action and patient’s blood seeps out of the blood vessels.

At the same time the patient may also suffer from any of these symptoms: fatigue, weight gain, shortness of breath, low soft voice and little desire to speak, spontaneous sweating, coldness in body and limbs, stiffness and pain in muscles and joints, dry skin and brittle hair, excessive tearing or dryness of the eyes, dry mouth or excessive drooling, chronic diarrhea, incontinence, hemorrhoids/prolapsed rectum, or prolapsed uterus.

If we take the subspecialty mentality of western medicine to the extreme, this patient would need to see a hematologist for his bleeding disorder, internist or endocrinologist for sweating, fatigue and weight gain, psychiatrist for the lack of desire to speak or move about, fatigue and weight gain, rheumatologist or orthopedist for joint pain, physiatrist for muscle pain, dermatologist for skin and hair, opthomologist for eye complaints, otolaryngologist for dry mouth or drooling, pulmonologist for SOB, gastroenterologist for diarrhea, urologist for incontinence, proctologist for hemorrhoids and OBGYN for prolapsed uterus.

But to the TCM doctor, all these symptoms are just different manifestation of a single entity---Collapsed Qi---which can be treated effectively with a single formula.

Silver Bullet vs Teamwork, of Cars and Herbal Medicine Formulae

Now let’s talk about how herbal medicine works. Chinese medicine does not talk about bacteria, yet it has combinations of herbs called formulae that can be used effectively to treat ailments from bacterial endocarditis to skin infection.

The oldest formulae are more than 3000 years old and the newest ones are several hundred years old. This is a remarkable feat when we consider the fact that in western medicine, a new generation of antibiotics would encounter resistance in 10 to 20 years.

The secret for herbal medicine’s longevity lies in the combination---Each herb may have hundreds of active compounds. When that herb is mixed with ten or so other herbs (each with its hundreds of active compounds) in a hot water solution, they can combine and generate thousands upon thousands of new compounds that no bacteria would have the enzymatic machinery to inactivate them all.

Each herbal medicine could have several actions, but to treat a particular ailment, we need to use only one or two but not all of its actions. That’s where the formulae come in.

Just like the Chinese culture is a culture that emphasize hierarchy and order and TCM stresses the pattern of discord, the TCM formulae are the model of balance and harmony.

A typical formula consists of one or two emperor herbs that have main action, several assistants herbs that augment the action of the emperor herbs, several minister herbs that curb the unwanted actions of the emperor herbs and finally one or two ambassador herbs that bring the entire formulae to the proper meridian and general location of the body.

Thus herbs function in teams, each one playing its part to achieve the purpose of restoring balance. To take the metaphor of a car, engine (the emperor herb) is arguably the most important part of the whole system, but it needs fuel pump and gas tank (the assistant herb) to provide it with fuel, radiator (minister herb) to cool the engine block to prevent overheating, steering wheel and tires (ambassador herb) to take the car to its destination. To talk about a single herb for a particular condition makes as much sense to a TCM practitioner as a person taking out the engines of several cars and expecting them alone to take him to his destination faster than an intact car.

Instead of asking what herb would alleviate my insomnia, a more fruitful way of inquiry may be what disharmony in my body that is causing the insomnia as my major presenting symptom.


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