Traditional Chinese Medicine (TCM) and Modern Clinical Practice

What Is Traditional Chinese Medicine?

Traditional Chinese Medicine (TCM) is a system of medicine with its own concepts of physiology, psychology, patterns of disharmony, methods of assessment, and approaches to treatment. Acupuncture is one treatment modality within TCM, not a synonym for the entire system.

TCM considers the person as a whole. A practitioner looks at the relationships among symptoms, functional patterns, daily habits, environment, and the person's overall presentation. Two people with a similar complaint may receive different treatments because their underlying patterns differ.

Foundational Concepts

These concepts provide the vocabulary for understanding TCM. They are interconnected, but each has a distinct meaning.

Qi: A foundational concept describing vital activity and function in traditional Chinese medical theory. There are many different forms of Qi (sometimes spelled Chi). In other healing systems it is called Prana, Ki, Subtle energy, etc. Types of Qi in TCM include:

• Yuan Qi (Original Qi / Source Qi) derived from Jing
• Gu Qi (Food Qi / Grain Qi) what we eat and drink
• Wei Qi (Defensive Qi) our immunity
• Zong Qi (Gathering Qi / Ancestral Qi) from the chest and heart
• Zhen Qi (True Qi / Primordial Qi) which is refined from Yuan and Zong Qi
• Ying Qi (Nutritive Qi / Nutrient Qi) which is derived from Zhen Qi
• Organ Qi & Zheng Qi the combined Qi of Wei Qi and Ying Qi that determine the total strength of the body

Yin and Yang: Complementary, interdependent aspects used to understand relationships such as rest and activity, interior and exterior, and cooling and warming. Yin and Yang are not fixed, they are always in relationship to each other. Yin engenders Yang and Yang engenders Yin. Black is Yin to white which is Yang. Gray is Yin to white but Yang to black. They do not stand alone but are always in relationship to each other. The Yin/Yang balance is important in restoring and maintaining health.

Jing: Often translated as essence, a concept associated in TCM with constitutional resources, growth, development, and reproduction. Pre-Heaven (Prenatal) Jing and Post-Heaven (Postnatal) Jing are the two types. The prenatal is what you are born with and when it runs out it cannot be replenished. Postnatal Jing is replaced by your diet and lifestyle.

Ming Men: Commonly translated as the Gate of Life, an important concept in classical discussions of the body's foundational vitality and warming function. It is the Root of Yuan Qi, considered the storehouse and root of Yuan Qi (Original or Source Qi). This is where Fire and Water balance is maintained. It warms the body and strengthens the constitution

Five Elements (Five Phases): Wood, Fire, Earth, Metal, and Water. These are foundational relationships used to describe cycles and correspondences. They also underpin a distinct Five Element approach to assessment and treatment. In Ayurvedic medicine they are called Aether/Spirit, Fire, Earth, Air, and Water. Each element has its own properties of color, temperature, the element they control, the element they generate, the season of the year, and many other attributes that are considered when analyzing patterns and their possible impact on a person.

Shen and the five spirits: Traditional descriptions of the psycho-spiritual dimensions associated with the organ systems, including Shen, Hun, Po, Yi, and Zhi.

• Shen (神): Heart, fire element, also called Spirit, mind, soul, and overall consciousness. This is the emotional center and the Emperor of the body
• Hun (魂): Liver, Wood element, and affects the dreams, planning. Also known as the Ethereal soul and travels outside of the body during sleep.
• Po (魄): Lungs, Metal (Air) element, this is the Corporeal or physical soul and is present during sleep. It is associated with grief and sadness.
• Yi (意): Spleen, Earth element, and is associated with intellect, memory, worry, studying, and over thinking.
• Zhi (志) Kidneys, Water element, this is the source of your purpose, courage, determination, and constitutional Jing. It is associated with Fear which damages it.

Channels and vessels: The pathways and relationships used in traditional theory to understand the movement and regulation of Qi and Blood. Throughout these articles, I use the terms channels and vessels, rather than “meridians.” The Extraordinary vessels are very important in my work and are the main points used with Tuning Forks. The literal translation from Chinese is vessels. In addition to the 12 Primary Channels (Jing Mai), TCM recognizes several other important channel and vessel systems:

• 8 Extraordinary Vessels (Qi Jing Ba Mai): these are the master controlling channels for the Body. The most commonly known are the Du (Governing Channel) and the Ren Conception Channel).
• 12 Divergent Channels (Jing Bie): these are internal channels that connect the primary channels to other parts of the body. They link the primary channels (grouped by Yin and Yang depending the organs they are identified with) and help distribute the Qi and blood. This is why they were initially called vessels.
• 12 Sinew Channels (Jing Jin): these channels follow the primary channels but only on the surface. These channels are used in Tui Na massage Gua Sha (scraping), Cupping, and similar techniques to remove blockages and stimulate the flow of QI and Blood under the skin.
• 15 Luo-Connecting Channels (Luo Mai): these channels connect the Yin organ primary channels with the Yang organ primary channels. These are very important channels with body points. These body points are significant and important in keeping the Yin/Yang balance of energy in the body.
• 12 Cutaneous Regions (Pi Bu): This is the external layer of defense for the body. These channels lay along the surface of the primary organ (Yin/Yang) channels and over the Sinew channels.

Foundational Theory and Clinical Systems

TCM includes several theoretical and clinical approaches. The Five Elements belong in both discussions: they are part of the foundational concepts and also form the basis of a particular approach to diagnosis and treatment.

8-Principles Theory

The Eight Principles organize clinical findings into four pairs: Yin versus Yang, Interior versus Exterior, Cold versus Heat, and Deficiency versus Excess. This differentiation helps the practitioner identify the nature and location of the patterns presented which is the basis of the TCM diagnosis as well as the appropriate treatment plan. There are no diseases in TCM diagnosis so the diseases used by Western doctors do not always translate directly to TCM patterns.

Why is this important? Frequently in TCM diagnosis, especially after testing a person’s pulse, the TCM practitioner may detect an imbalance coming or in its early stages before a Western diagnosis (like a blood test) detects the problem. This is why getting regular checkups with a qualified TCM practitioner (a fully trained licensed acupuncturist with L.Ac. after their name) is important in maintaining optimal health. We see what is coming and can suggest diet, lifestyle changes, herbal remedies and other techniques to prevent the condition from worsening. We also know when to refer you to Western medicine or other health professionals when the condition warrants evaluation that is different from what TCM offers. Herbal remedies are healing and rarely require lifetime use for the same condition unlike many Western medications.

TCM does have a few syndromes such as Lin Syndrome and Xiao Ke.

• Lin Syndrome (淋证 — Painful Urinary Syndrome (stones, prostate, urinary infection…). For this condition I would refer the person to Western Medicine. I do have herbs that may help but there are so many different variables and come with significant consequences that it is best that Western Medicine be consulted.
• Xiao Ke (消渴 — Wasting and Thirsting Disorder). In Western Medicine this is called Diabetes. For Type I Diabetes Mellitus only Western Medicine can help as the person is insulin dependent on medication for life.
  There is also Type II Diabetes Mellitus, which results from a combination of genetics and other physiological factors, with diet and lifestyle contributing to an increased risk of developing the condition. That means it is preventable and many times reversible as long as the person has not become insulin dependent. At DBHC many patients have been able to reverse their Metabolic issues and either prevented or reversed their condition. This requires a permanent change in diet and lifestyle which many people are not willing to do. Notice that this syndrome is called “Wasting and Thirsting”.
  There is another condition called Diabetes Insipidus. When a patient presented with clear Xiao Ke patterns I assumed they had Diabetes Mellitus based on their diet, but based on their history this was impossible. We were able to determine that the condition was not Mellitus (the most common type that most people are familiar with) but actually Insipidus and the correct Western doctor was able to help with their condition that had plagued this patient for over 12 years and was never properly diagnosed. This is why using the lens and framework of TCM will help with understanding conditions differently than what we get from only using the Western Medical model. Both frameworks have their uses and function but they see the same pattern differently. That difference supports narrowing down possible solutions that may otherwise not appear.
• Bi Syndrome (痹证 — Painful Obstruction Syndrome) which includes such symptoms like arthritis, rheumatism, and chronic joint pain. At DBHC we have found that these are frequently caused by diet choices. Pain is also relieved with acupuncture and in some cases the addition of herbal supplementation. At DBHC there have been some cases so severe that only Western medical intervention helped but in other cases patients who changed their diets and with a few acupuncture treatments were able to reverse all their symptoms and live a normal life without pain.
• Wei Syndrome (痿证 — Flaccidity or Wasting Syndrome) which is associated with muscle weakness, atrophy, and paralysis. Disorders like ALS, multiple sclerosis, muscular dystrophy, post-stroke paralysis, accidents, and even sarcopenia in old age. Typically patients use Western medical procedures with physical therapy follow up. That said, at DBHC there have been patients with severe conditions that after many surgeries, and physical therapy they were still paralyzed. One particular patient was left paralyzed by an accident. The right hip through foot was numb and there was no longer any muscle. The nerves were no longer being stimulated leaving the patient unable to walk, drive, or have a quality life. After 18 months of weekly treatments and assigned homework the patient had full muscle growth return, use of the entire hip, leg and foot, and about 95% return of most sensations. Peripheral nerves have some regenerative capacity when properly stimulated, it just takes time, proper supplementation to support nerve repair, daily exercise and stimulation (which this patient did at home) and regular acupuncture treatment with e-stim, Gua Sha and other treatments to stimulate the regrowth.
• Tou Tong (头痛 — Headache Disorder) treatment in TCM is very different than in Western Medicine who treats the headache with a pain killer. In TCM the location of the headache, how and when it began are part of the pattern differentiation that we look at. At DBHC we have different treatments for each type of headache and different treatments for Migraines a very debilitating type of headache. In TCM we look at the underlying cause of the headache to prevent future headaches, basic acupuncture treatments will stop the pain but the goal is not just to stop the pain but prevent the pain from manifesting in the first place.
• Xuan Yun (眩晕 — Dizziness and Vertigo) which present as vertigo, dizziness, and equilibrium issues. With any type of condition like this it is suggested that a Western Medical diagnosis be obtained first. There may be an inner ear issue or other condition that is best dealt with right away. It is important to rule out eating habits like skipping meals which can cause dizziness but so can diabetes and other conditions that need to be ruled out first. There have been patients who presented with these conditions at DBHC when Western Medicine could not diagnose a definitive cause. This is where TCM can frequently find the underlying cause by looking at the pattern presented particularly with dizziness. With vertigo, unless it is only a temporary once in a while condition the person will mainly need Western Medicine.
• Bu Mei (不寐 — Insomnia Disorder) is basically a sleep disorder of which there are many forms, causes, and patterns. TCM can usually determine the underlying cause and help. Especially with stress related insomnia. Occasionally the issue may be a blocked nasal passage, sleeping on the back and many other causes. Western medicine does have sleep tests and other tools including surgery to help. This one depends on the pattern. It is worth exploring both TCM and Western medicine as the lack of sleep and poor sleep leads to a reduction in the quality of life and can lead to conditions like accidents, poor decisions, and susceptibility to infections and other stress related conditions.
• Zhong Feng (中风 — Wind-Stroke) this is obviously a severe condition such as Stroke or Cerebrovascular Accident (CVA) and Western Medicine should be consulted first. At DBHC we have helped patients at their health care facility, when they allow an acupuncturist (not all do) to help to stimulate the nerves and reduce the pain. In some cases we were able to use some spiritual healing techniques to help the patient be coherent enough to say their goodbyes to their loved ones. Many times, they are given medication that makes them unable to properly communicate. These treatments are more of end of life support to ease the patients transition.
• Xin Ji (心悸 — Palpitations) in TCM this is where the patient has become consciously aware of their heartbeat. Typically, we do not spend our thought processes on our heartbeat. When we do and it is not a cardiac event needing Western Medical intervention, then in TCM we see it as a sudden fright, deep fluid retention pushing against the chest, or Heart Qi deficiency. Once a Western Medical practitioner has ruled out anything needing immediate attention TCM can look for the underlying pattern and treat the imbalance.

Five Element Theory

Five Element theory examines the relationships among Wood, Fire, Earth, Metal, and Water and their traditional correspondences. In clinical use, this approach can help interpret patterns and inform point selection or other treatment choices. This theory differs from 8-Principle in that it looks mainly at the controlling and the generating cycles. At DBHC we primarily use 8-Principle but occasionally (once or twice a year), a patient will present with a pattern that causes us to switch to 5-element diagnosis. The point locations are slightly different, and the diagnosis descriptions are slightly different, but both systems work. In the US there are both types of schools and the national certifications test for the one we learned. There are occasions where the 5-element pattern is useful but the 8-principle patterns are faster and generally effective. We only switch when the pattern does not fit a known pattern, which is rare.

Other Systems and Techniques

At DBHC our training also includes approaches that focus on particular regions, channel relationships, or methods of point selection. Depending on the person and the clinical findings, we may draw from other approaches to treatment:

• Auricular (ear) Acupuncture: There are several different ways to do auricular acupuncture. There is the basic 8-principle that we learned in school, there is the French version frequently used in Europe, and another is Li-Chun Huang 黃麗春, L.Ac. Auricular examination and acupuncture is the one we use at DBHC. It is very effective and we frequently use additional auricular points to support the body treatment.
• NADA is the National Auricular Detoxification Association that we are certified in and can add that to a basic 5 needle auricular treatment when it is appropriate. This treatment is also very effective for sleep issues due to stress.
• Koryo or Korean Hand Therapy uses the human hand for treating the entire body. This treatment is frequently used for people in a wheelchair or people unable to safely get up and down off a massage table. It is also very effective in treating phantom pain. We have had patients with missing limbs. These patients frequently have phantom pains in the missing part of the body which Western Medicine is not able to treat. Standard acupuncture treatments (either auricular, scalp, or opposite side and other limb is taught as a standard TCM practice. The Koryo hand treatment is actually more effective in these cases.
• Scalp acupuncture is a common form of treating neuropathy and stroke victims. Pain and nerve issues are frequently in the brain. The scalp also represents the entire body so with a few very long needles we can cover large areas of the body with only a few needles. For peripheral neuropathy this style is not as effective as treating the actual feet where the numbness and pain is located.
• Dr. Richard Tan (Balance Method) is a channel-based approach that uses unilateral needling versus bilateral needling with the points alternated by side with each treatment. This reduces the number of needles needed. Some patients are needle sensitive so this style is more effective than using bilateral needling. Dr. Tan’s method also has special points used in combination that are also very effective.
• Master Tung (Tung Ching-Ch'ang) also taught points that are mainly on the arms and legs along the 14 main channels. His combinations are particularly effective. It is where the significance of using the Jing Well points and especially the Yuan Source points to reduce the number of needles needed to get quick, long-lasting and very effective in treating various patterns.

Assessment: How DBHC Identifies the Pattern

TCM assessment is not based on a single test or observation. We combine several methods, looking for patterns and checking how the findings fit together before determining the TCM Pattern Diagnosis and the TCM Treatment Plan based on 8-Principle patterns.

Ten Questions: A structured inquiry into symptoms and everyday functions, including sleep, appetite, digestion, temperature preferences, bowel movements, urine characteristics, time of day issues, feelings, and other relevant experiences.

Tongue examination: Observation of features such as tongue body, color, coating, and moisture in the context of the full assessment. Each area of the tongue represents a specific organ in the body. The tongue coat tells us about your diet and if there is any overgrowth. The scalloping and redness of certain areas also tell us about various conditions in the body. Even the color of both the coat and the tongue itself gives us information. It is a good idea to learn a little about the tongue and start examining our tongue every morning before you brush. It is also important not to scrape your tongue the morning of an acupuncture appointment; we want to see your tongue the way it looks when you first wake up.

Pulse examination: Traditional assessment of pulse qualities and their relationships to patterns of disharmony. There are many different forms of pulse diagnosis. Most use the radial side of the wrist which tells us the current status of your Heart, Lungs, Liver, Spleen, and Kidneys as well as their associated Yang organs. There is also a worry pulse, a low thyroid pulse, and a number of other pulse combinations that tell us about the health of the parts of the body and the organ including the reproductive organs. At DBHC we use Dr. Jimmy Chang’s method of pulse diagnosis, which is a very robust system he learned when he had patients that do not speak his language and all he could go by was feeling the pulse to determine why a person was there. Over the years some of our long-term patients now come in and just present their wrists. Dr. Chang’s method is very effective, and we frequently find issues the patient either forgot to mention or did not think it was important. TCM is a pattern-based medicine so all the various points of the pattern all matter.

Five Element assessment: Interpretation of relationships and correspondences within the Five Element framework. We rarely use this style of assessment, only when it is the best at identifying a condition that does not fit a typical 8-Principles pattern.

Time-of-day patterns: Consideration of the traditional organ-system clock and when symptoms or changes occur. Understanding when a condition occurs tells us a lot about the pattern. For example people who cannot go to bed at 11pm have a Gallbladder energy issue. This does not mean the Gallbladder has a pathology, frequently it is an emotional issue like cannot make or has difficulty making decisions. Another big-time clock event is people who wake up between 1 and 3 am. This is liver time. Many people had “clogged” livers because they need to detoxify because of the environment or their diet, or from drinking alcohol or many other causes.
Here is a chart of the clock times and their meaning:

• 3:00 AM – 5:00 AM (Lungs): Manages respiration and immunity, tied to grief and sadness.
• 5:00 AM – 7:00 AM (Large Intestine): Dedicated to waste elimination and letting go, ideal for morning awakening.
• 7:00 AM – 9:00 AM (Stomach): Handles digestion and nutrient assimilation during the optimal time to eat breakfast.
• 9:00 AM – 11:00 AM (Spleen / Pancreas): Transforms nutrients into Qi and supports mental clarity for mental work.
• 11:00 AM – 1:00 PM (Heart): Supports circulation and vitality during lunch and light socialization.
• 1:00 PM – 3:00 PM (Small Intestine): Sorts nutrition while the body’s energy naturally dips.
• 3:00 PM – 5:00 PM (Bladder): Regulates fluids and metabolic clearing, suited for hydration and finishing tasks.
• 5:00 PM – 7:00 PM (Kidneys): Stores foundational energy and willpower ahead of a lighter dinner.
• 7:00 PM – 9:00 PM (Pericardium): Governs emotional calm and protection as a wind-down period.
• 9:00 PM – 11:00 PM (San Jiao / Triple Burner): Regulates temperature and metabolism while preparing for sleep
• 11:00 PM – 1:00 AM (Gallbladder): Focuses on decision-making, courage, and cellular detox, with resentment as the associated emotion.
• 1:00 AM – 3:00 AM (Liver): Governs blood storage and physical/emotional processing, linked to anger.

To really complicate the time chart, most people notice the issues at night so it may be “clock opposite” that is the problem. Like 1-3 am Liver time may be caused by a 1-3 pm Small Intestine issue. When an organ is at its peak energy, the organ directly opposite it on the clock is at its absolute lowest energy (its "trough"). This relationship is highly significant for diagnosing patterns of imbalance

Face reading: Observation of facial characteristics as one part of the traditional assessment. There are several different philosophies about the meaning of different areas of the face. We learned one system in school. Then another system using Colorpuncture®, and another system for other facial rejuvenation classes. Basically, face reading is an art, but it tells us a lot about serious conditions like Heart, Liver, Stomach, and even about headaches.

Treatment Modalities Within TCM

The assessment helps determine which methods are appropriate. Not every person needs the same modality, and not every modality is suitable for remote instruction

• Acupuncture: Insertion of sterile, single-use filiform needles at selected points by an appropriately trained practitioner. This is an in-person clinical procedure.
• Acupressure: Stimulation of selected points using pressure rather than needles. Some methods can be taught for guided self-care, including online.
• Moxibustion (moxa): The therapeutic application of heat using moxa, including approaches that stimulate points without inserting needles.
• Fire and heat treatments: Traditional methods involving heat or fire, selected and performed with appropriate precautions and training.
• Gua Sha: A manual technique using a smooth-edged tool on the skin.
• Cupping: A technique that applies suction to the skin, with methods selected according to the treatment.
• Tui Na: Traditional Chinese therapeutic manual techniques.
• Chinese herbal medicine: Traditional use of herbal formulas and individual substances, requiring attention to quality, contraindications, and interactions.
• Auricular techniques: Ear-based point stimulation using needles or non-needle methods, depending on the treatment.
• Koryo Hand Therapy and scalp acupuncture: Specialized point systems and treatment methods used when appropriate.
• Colorpuncture® acupuncture: Specialized system of treatment that combines Needles, laser, UV, IR, colored crystals, essential oils, sound, and other techniques. At DBHC we primarily use the Ophtalmotropic Genetic Therapy (OGT) part of this complex system.
• Scalar Energy & Light Therapy: At DBHC we use the Tennant Professional BioModulator®. It is a handheld, FDA-accepted Class II medical device that delivers adaptive microcurrent therapy for chronic or acute pain relief and cellular metabolic restoration.
• e-Stim & Microcurrent Therapies: Electroacupuncture (e-stim) technology connects small electrical clips to traditional acupuncture needles to deliver a controlled, low-voltage current directly into deep muscle and nerve tissue.
  We also use Ion Pumping Cords, invented by the Japanese, for patients who cannot tolerate either e-stim or microcurrent or have implants that might prevent their use.

Training and Clinical Approach

The clinical approach used at DBHC was developed through formal education, continuing education, mentorship, and extensive clinical practice. Training was initially at Southwest College of Naturopathic Medicine (SCNM, now named Sonoran University), continuing at the Phoenix Institute of Herbal Medicine and Acupuncture (PIHMA) receiving a Master’s in Acupuncture in 2008, as well as additional classes online and in person with Michael Tierra’s program in California at the East West School of Planetary Herbology.

Dr. Beverly was a teaching assistant at SCNM working closely with one of her PIHMA teachers, Chris Vedeler, greatly enhancing her understanding of TCM, as well as completing a two-year externship with Dr. Hu. During her first years in practice, she also pursued more than 1,000 hours of continuing education in each of those years.

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