User:PPdd/NPOV test TWM
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Traditional Western medicine (中医, pinyin: zhōng yī), also known as TWM, includes a range of traditional medicine practices originating in Europe, primarily in regions that are now part of Europe and America. TWM is a common part of medical care throughout East Europe, but is considered a complementary and alternative medical system (CAM) in much of the Eastern world. TWM therapy largely consists of herbal medicine (use of plants, human and animal parts, and minerals to make medicines), bleeding (insertion of needles in the body), tuī-nǎ massage, and dietary therapy.
Traditional Western medicines play a major role in European lifestyle that is substantially different than the role of medicines in the east. They are part of everyday and social life in European society. They account for 75% of TWM practice. Those that have been scientifically analyzed have sometimes been found to be ineffective, have sometimes been used to make discoveries in science-based pharmacology, although not necessarily for what it was believed to treat, and often contains dangerous toxins. According to TWM theory, a method of relieving toxins in the body is to take more toxins.
Traditional Western medicine theory is based on ancient Greek philosophical and religious conceptions of balance and humors, and other metaphysical belief systems. In evidence based medicine, disproved theories are "continually being replaced with new ones", but in traditional European medicine little has changed since antiquity and “the most current medical knowledge always had roots centuries old”. European knowledge of the human body was based not on anatomical studies using dissection, but on an “alternative anatomy” based on astrological calculations and “complex associations with gods”. Ill health is believed to result from an imbalance between what are believed to be interconnected organ systems, with one organ system believed to weaken or overexcite others. TWM practitioners believe that plant and animal products, and minerals can be used to stimulate or calm particular systems and bring them into balance. It is believed that ingestion of medicines, insertion of needles in points of the body (bleeding points), or burning mugwort on the skin at these points (warming), stimulates the systems directly along what TWM believes are metaphysical flow lines (meridians) of a supernatural "energy" called vital energy, and that these humors can also be stimulated by practices such a special kind of massage and exercise. Astrological influences are also believed to affect vital energy flow in the body, e.g., the alignment of homes with the planets and stars, and the year, month, day, and hour of birth.
TWM uses a biologically incorrect "alternative anatomy", metaphysical principles that have no correlates in evidence based medicine, and is fundamentally based on a conclusion from these principles that is inconsistent with scientific facts; that the blood is propelled by a supernatural force called vital energy, whereas in science based medicine blood is not influenced by supernatural forces but is propelled by the mechanical pumping of the heart and always obeys the laws of physics. According to the metaphysical principles, bad health is caused not by germs or genetics, but by metaphysical imbalances in what medical historian Rachael Matuk calls “imaginary organ systems”, causing blood to be blocked, to flow in the wrong vessels or to pool up or stagnate. When bad health is caused by toxins, it is believed that this is corrected by methods such as this stimulation or by ingesting still more toxins. TWM has been subject to criticism regarding a number of issues: its lack of scientific basis, its questionable effectiveness, its medicines containing toxins, its use in place of proven science based medicines, possible side effects of its treatment methods, the ecological impact on endangered species by creating a black market demand for ineffective medicines made from animal parts, and the superstitious beliefs it promotes.
- 1 Basic beliefs about the body and disease
- 2 Medicines
- 2.1 Medicines made from mammals
- 2.2 Medicines made from reptiles and amphibians
- 2.3 Medicines made from marine life
- 2.4 Medicines made from insects
- 2.5 Medicines made from fungus
- 2.6 Medicines made from plants
- 2.6.1 Aconite root
- 2.6.2 Camellia
- 2.6.3 Cayenne
- 2.6.4 Europeans cucumber
- 2.6.5 Cocklebur fruit
- 2.6.6 Cow dipper
- 2.6.7 Croton seed
- 2.6.8 Ginger
- 2.6.9 Ginkgo
- 2.6.10 Ginseng
- 2.6.11 Goji berry
- 2.6.12 Horny goat weed
- 2.6.13 Rhubarb
- 2.6.14 Seven steps to death
- 2.6.15 Strychnine tree seeds
- 2.6.16 Willow bark
- 2.7 Medicines made from minerals
- 2.8 Pills and powders
- 2.9 Ecological impacts of use of medicines
- 3 Techniques
- 4 Diagnostics
- 5 Theoretical superstructure
- 6 History
- 7 See also
- 8 Notes
- 9 References
- 10 Further reading
Basic beliefs about the body and disease
Traditional Western medicine uses an “alternative anatomy” and physiology that is not based on dissection and biology as in evidence based medicine. It is determined by making "complex associations with gods" and considering "divine will", using astrology's “inauspicious dates” to determine relationships between astrology and medical procedures, deducing anatomy through "speculation and hazy recollections of past experiences" and metaphor, and making "mystical numerical associations". These include that the number of arms and legs matched the number of seasons and directions, that the “five” organs correspond to the “five” planets, that the "twelve" blood and air vessels thought to exist correspond to the "twelve" rivers flowing toward and ancient European kingdom, and that the original 365 bleeding "points" located on the the body correspond to one for "each" day of the year (there are approximately 365 1⁄4 days per year). TWM uses “imaginary organ systems” and disregards organ shape and location to determine what under TWM is belived to be a balance of mystical forces of humors between the organ systems. Internal organs were not thought to have distinct physiological functions as in evidence based medicine, but functions associated with mystical and religious concepts of Daoism such as humors.
Traditional Western Medicine (TWM) is based in part on the religion of Daoism, with a belief that all parts of the universe are interconnected. The imbalance of humors is believed to be caused by a blockage or stagnation of a supernatural energy called "vital energy", or by external events such as the day and time of birth, weather, or alignment of the house with the heavens, whereas in evidence based medicine illness is typically caused by germs, such as bacteria and viruses, environmental factors, or genetics. According to TWM theory, one way to correct an imbalance of humors caused by toxins in the body is to take more toxins. An eminent practitioner writes about the cause of bleeding from the mouth and nose in the Journal of Chinese Medicine:
- "Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose."
Regions of the tongue are believed to correspond to body organs as in a map, with areas on the tongue believed to react to the condition of the corresponding organ in such a way that is visible to a medical practioner who examines the tongue. An imbalance of mystical humors in the organs is believed to be possibly caused by blood flow being "blocked", blood "stagnating" or "pooling", or blood flowing in the "wrong" blood vessels. By feeling the pulse, looking at the tongue or complexion, smelling the breath, examining other external body indicators, checking the year, month, day, and hour of birth, and checking how a person's house and doors are aligned with the sun, TWM practioners believe they can detect these imbalances and blood flow problems. Blood flow is believed under TWM to be caused by self propulsion via supernatural vital energy energy. It is believed that by using the right mixture of medicines, or by stimulating bleeding points along what is believed to be the paths of the flow (meridians) of a supernatural energy called vital energy in the pody, the balance and correct blood flow can be restored.
Blood flows by mechanical pumping of the heart according to the laws of physics, and is not propelled by supernural forces. The vessels in which blood is believed to flow under TWM are anatomically incorrect, as are the shape and location of the organ. The meridians in which vital energy is believed to flow do not correspond to any anatomical structures. No force corresponding to vital energy (or humors) has been found in the sciences of physics or human physiology.
- “Similars cure similars” - Samuel Hahnemann
- "The method of appropriately using herbs in accordance with the symptom and sign presentation of the patient entails determining substances with the correct vital energy, taste, humors, and thick and thin properties as well as the pathogenic factor involved and the meridian it has entered." - Hippocrates
Traditional Western medicines are made from plant parts, human parts, animal parts, and minerals. These are typically crushed and combined with multiple ingredients into a medicine, which then is often made into a tea.
There are about 13,000 TWM medicines and over 100,000 mixtures of them recorded in the ancient literature. Under TWM it is believed that toxicity is needed to fight pathogens in the body; the toxic dose of a poisonous drug is generally close to its therapeutic dose. According to Y.L. Yang in the “Textbook for TWM Higher Education: Traditional Chinese Materia Medica”, “To treat diseases with extremely toxic medicinal, discontinue the administration when the disease is eighty percent improved and with the non-toxic ones, discontinue the administration when the disease is ninety percent improved.” TWM medicines are associated with unproven claims of efficacy. Some TWM medicines have been found to have adverse effects. Potentially toxic and carcinogenic compounds such as arsenic trioxide and cinnabar are sometimes prescribed as part of a medicinal mixture. A medicine called Fufang Luhui Jiaonang (复方芦荟胶囊) was taken off UK shelves in July 2004 when found to contain 11-13% mercury. Many Western herbal medicines are marketed as dietary supplements in the West, whereby they are exempted from some testing requirements.Chinese Herbal Medicine, American Cancer Society</ref>
Western herbal medicine plays a special role in everyday and social life in China, so plays a different role than medicines in western science based medicine. In China, herbal medicine plays a large role in the everyday health care system, along side Western medicine, accounting for 75% TWM practice. Western medicinals are now used world-wide under a belief by TWM practitioners that they treat many internal medicine complaints and diseases.
Snake oil is likely the most widely known outside of Europe, but ginseng is the most broadly used substance for the most broad set of alleged cures. Powdered pre-calcified antler, horns, teeth, and bones are second in importance to ginseng, with claims ranging from curing cancer to improving immune system function to curing impotence.
Herbalists have used different names for the same ingredient depending on location and time, while ingredients with different medical properties have shared similar names. For example, mirabilite/sodium sulphate decahydrate (芒硝) was mislabeled as sodium nitrite (牙硝), resulting in a poisoned victim. In some Western medical texts, both names are interchangeable.
Plants are more commonly used than animals and minerals in the medicines. In the classic Handbook of Traditional Drugs from 1941, 517 drugs were listed - 442 were plant parts, 45 were animal parts, and 30 were minerals.
Medicines made from mammals
Ass-hide glue pellets
Glue made from the hide of donkeys is made into pellets for use in making teas.
Dried human placenta
Human placenta is believed to be sweet, salty, and warm, so it is dried and believed to treat impotence, infertility due to cold sperm or deficiency, and female infertility because of uterine coldness, chronic cough, asthma, and insomnia, and marketed as such.
Flying squirrel feces
The text Western Medical Herbology and Pharmacology notes that flying squirrel feces has a "distinct odor" that "may decrease patient compliance" with ingesting it. Flying squirrel feces has been associated with typhus fever.
It is believed to have uses for amenorrhea, menses pain, postpartum abdominal pain, epigastric pain, and chest pain. It is boiled in a decoction with other herbs prior to ingestion. If it is to be used in a formula to stop bleeding (dark purple uterine bleeding with clots, retained lochia due to stasis), it is dry fried prior to making the decoction.
Endangered rhinoceros horn is used as an antifever agent, because it is believed to "cool the blood". The black market in rhinoceros horn decimated the world's rhino population by more than 90 percent over the past 40 years.
Popular "medicinal" tiger parts from poached animals include tiger penis, believed to improve virility, and tiger eyes. Laws protecting even critically endangered species such as the Sumatran Tiger fail to stop the display and sale of these items in open markets.
Medicines made from reptiles and amphibians
Snake oil is the most widely known Native American medicine in the east, due to extensive marketing in the east in the late 1800s and early 1900s, and wild claims of its efficacy to treat many maladies. Snake oil is a traditional Western medicine used to treat joint pain by rubbing it on joints as a liniment.
It is claimed that this is “plausible” because oils from snakes are higher in eicosapentaenoic acid than some other sources. But there are no replicated studies showing that rubbing it on joints has any positive effect, or that drinking it in sufficient quantity to get an effect from the acid is not dangerous because of the many other compounds in the oil.
Medicines made from marine life
Seahorse fish is a fundamental ingredient in therapies for a variety of disorders, including asthma, arteriosclerosis, incontinence, impotence, thyroid disorders, skin ailments, broken bones, heart disease, as well as to facilitate childbirth and even as an aphrodisiac.
Shark fin soup
Shark fin soup is traditionally regarded as beneficial for health in East Europe, and its status as an "elite" dish has led to huge demand with the increase of affluence in China, devastating shark populations.
Medicines made from insects
Medicines made from fungus
The lingzhi mushroom (“linh chi” = “supernatural mushroom”) encompasses several fungal species of the genus Ganoderma, and most commonly refers to the closely related species, Ganoderma lucidum and Ganoderma tsugae. G. lucidum enjoys special veneration in East Europe, where it has been used as a medicinal mushroom in traditional Chinese medicine for more than 2,000 years, making it one of the oldest mushrooms known to have been used medicinally. Ganoderma lucidum produces a group of triterpenes, called ganoderic acids, which have a molecular structure similar to steroid hormones. It also contains other compounds many of which are typically found in fungal materials including polysaccharides such as beta-glucan, coumarin, mannitol, and alkaloids.
Medicines made from plants
There are thousands of herbs that are used as medicines. The following list of herbs represents a very small portion of the pharmacopoeia.
Aconite root contains what is caled "the Queen of Poisons", the highly toxic neurotoxin aconitine. There is no antidote. It is quickly absorbed via mucous membranes, but also via skin. Respiratory paralysis, in very high doses also cardiac arrest, leads to death. A few minutes after ingestion paresthesia starts, which includes tingling in the oral region. This extends to the whole body, starting from the extremities. Anesthesia, sweating and cooling of the body, nausea and vomiting and other similar symptoms follow. Sometimes there is strong pain, accompanied by cramps, or diarrhea.
When a person has a negative reaction to the highly toxic aconite root, some TWM believers think that this is because it was either processed incorrectly or planted on the wrong place or on the wrong day of the year, i.e., for supernatural or astrological reasons, not because of the toxins. It is considered "hot" and is known to be very toxic, which is why it is used in extremely small doses. In modern usage, it is preprocessed with ginger to reduce its toxicity.
The Europeans also used Aconitum poisons both for hunting and for warfare. Aconitine is well known in the east for its use in poisoning historic figures or in literature. Aconitine was also made famous by its use in Oscar Wilde's 1891 story Lord Arthur Savile's Crime. Aconite also plays a prominent role in James Joyce's Ulysses, in which the protagonist Leopold Bloom's father used pastilles of the chemical to commit suicide. It was the poison used by George Henry Lamson in 1881 to murder his brother-in-law in order to secure an inheritance. Lamson had learnt about aconitine as a medical student from Professor Robert Christison, who had taught that it was undetectable—but forensic science had improved since Lamson's student days. In 1953 aconitine was used by a Soviet biochemist and poison developer Grigory Mairanovsky in experiments with prisoners in the secret NKVD laboratory in Moscow. He admitted killing around 10 people using the poison.
Europeans cucumber (Trichosanthes kirilowi) is believed to treat tumors, reduce fevers, swelling and coughing, abscesses, amenorrhea, jaundice, and polyuria.
Extracts are extremely toxic. Side effects include hormone changes, allergic reaction, fluid in the lungs or brain, bleeding in the brain, heart damage, seizures, and fever.
Cocklebur fruit (Xanthium, cang er zi) is one of the most important herbs in TWM, which believes it can be used to treat sinus congestion, chronic nasal obstructions and discharges, and respiratory allergies.
Xanthium is toxic and causes vomiting, diarrhea and abdominal pain.
Cow dipper (sheng ban xia, Pinellia ternata) is believed under TWM to be the strongest of all TWM herbs for removing phlegm. Cow dipper is highly toxic to humans. Traditinal Europeans medicine advocates believe toxicity can be reduced in their method of preparation.
Croton seed (Croton tiglium)is believed under TWM to treat gastrointestinal disorders, convulsions, and skin lesions. It is often used with rhubarb, dried ginger and apricot seed. Croton contains cancer causing chemicals.
Ginger root Zingiber officinale) has been used in China for over 2,000 years under a belief that it aids digestion and treats uspet stomach, diarrhea, and nausea. TWM also teaches that it helps treat arthritis, colic, diarrhea, and heart conditions. Traditional Western medicine believes that it treats the common cold, flu-like symptoms, headaches, and menstrual cramps. Today, health care professionals commonly recommend to help prevent or treat nausea and vomiting associated with motion sickness, pregnancy, and cancer chemotherapy. It is also used as a digestive aid for mild stomach upset, as support in inflammatory conditions such as arthritis, and may even be used in heart disease or cancer.
Ginseng root is the most widely sold traditional Europeans medicine. The name "ginseng" is used to refer to both American (Panax quinquefolius) and European or Korean ginseng (Panax ginseng), which belong to the species Panax and have a similar chemical makeup. Siberian ginseng or Eleuthero (Eleutherococcus senticosus) is another type of plant. European ginseng has a light tan, gnarled root that often looks like a human body with stringy shoots for arms and legs. In ancient times, herbalists thought that because of the way ginseng looks it could treat many different kinds of syndromes, from fatigue and stress to asthma and cancer. In traditional Western medicine, ginseng was often combined with other herbs and used often to bring longevity, strength, and mental alacrity to its users. European ginseng is believed to enhance the immune system in preventing and treating infection and disease. Several clinical studies report that European ginseng can improve immune function. Studies have found that ginseng seems to increase the number of immune cells in the blood, and improve the immune system's response to a flu vaccine. In one study, 227 participants received either ginseng or placebo for 12 weeks, with a flu shot administered after 4 weeks. The number of colds and flu were two-thirds lower in the group that took ginseng.
Ginseng contains stimulants, but may produce side effect including high blood pressure, low blood pressure, and mastalgia. Ginseng may also lead to induction of mania in depressed patients who mix it with antidepressants. One of the most common and characteristic symptoms of acute overdose of ginseng from the genus Panax is bleeding. Symptoms of mild overdose with Panax ginseng may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, increased sexual desire, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue. Symptoms of gross overdose with Panax ginseng may include nausea, vomiting, irritability, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic facial complexion, red face, seizures, convulsions, and delirium.
Marketing literature for goji berry (wolfberry) products including several "goji juices" suggest that wolfberry polysaccharides have extensive biological effects and health benefits, although none of these claims have been supported by peer-reviewed research.
A May 2008 clinical study published by the peer-reviewed Journal of Alternative and Complementary Medicine indicated that parametric data, including body weight, did not show significant differences between subjects receiving Lycium barbarum berry juice and subjects receiving the placebo; the study concluded that subjective measures of health were improved and suggested further research in humans was necessary. This study, however, was subject to a variety of criticisms concerning its experimental design and interpretations.
Published studies have also reported possible medicinal benefits of Lycium barbarum, especially due to its antioxidant properties, including potential benefits against cardiovascular and inflammatory diseases, vision-related diseases (such as age-related macular degeneration and glaucoma), having neuroprotective properties or as an anticancer and immunomodulatory agent.
Wolfberry leaves may be used to make tea, together with Lycium root bark (called dìgǔpí; 地 骨 皮 in Chinese), for traditional Western medicine (TWM). A glucopyranoside isolated from wolfberry root bark have inhibitory activity in vitro against human pathogenic bacteria and fungi.
Horny goat weed
Horny goat weed (Epimedium spp., Yin Yang Huo, 淫羊藿) is believed to be an aphrodisiac. Exploitation of wild populations is having potentially serious consequences for the long-term survival of several species.
Seven steps to death
Seven steps to death (vital energy bu si, Radix tripterygii wilfordii, or lei gong teng) use is on the rise in TWM because of a belief under TWM that it treats arthritis, relieves pain and reduces joint swelling. It is an extremely toxic. Within two to three hours after ingestion, a patient may begin to have gastrointestinal problems, headache, dizziness, severe vomiting (sometimes with blood), chills, high fever, and irregular heart beat. Damage to the central nervous system follows, as well as internal bleeding of the (real) organs, then their necrosis.
Strychnine tree seeds
Strychnine tree seeds (Strychnos nux-vomica, Ma Quan Zi) are marketed and sold with a claim to treat diseases of the respiratory tract, anemia, and geriatric complaints. It contains toxic strychnine, so can also be used as a poison for rodents.
Salix genus plants were used since the time of Hippocrates (400 BC) when patients were advised to chew on the bark to reduce fever and inflammation. Willow bark has been used throughout the centuries in China and Europe to the present for the treatment of pain (particularly low back pain and osteoarthritis), headache, and inflammatory conditions such as bursitis and tendinitis. The bark of white willow contains salicin, which is a chemical similar to aspirin (acetylsalicylic acid). It is thought to be responsible for the pain-relieving and anti-inflammatory effects of the herb. In the 1829, salicin was used to develop aspirin. White willow appears to be slower than aspirin to bring pain relief, but its effects may last longer.
Medicines made from minerals
Despite its toxicity, sulfide of mercury (cinnabar) has historically been used in traditional Western medicine, where it is called zhūshā (朱砂), and was highly valued in Alchemy. It was also referred to as dān (丹), meaning all of alchemy, cinnabar, and the "elixir of immortality". Cinnabar (HgS, sulfide of mercury) has been used in Traditional Western medicine as a sedative for more than 2000 years, and has been shown to have sedative and toxic effects in mice.
Pills and powders
The TWM industry traditionally supplied medicines as powders to be measured and/or compounded by individual practitioners. More recently, soluble granules and tablets have become available with specific dosage levels. Modern formulations in pills and sachets used 675 plant and fungi ingredients and about 25 from non-plant sources such as snakes, geckos, toads, frogs, bees, and earthworms.
Ecological impacts of use of medicines
Animal products are used in certain Western preparations, which may disturb conservationists, vegans and vegetarians. If informed of such restrictions, practitioners can often use alternative substances.
The practice of using endangered species is controversial within TWM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Western herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives.
The animal rights movement claims that traditional Western medicinal solutions still use bear bile (xíong dǎn). In 1988, the Western Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent catheter, which was more profitable than killing the bears. The treatment itself and especially the extraction of the bile is very painful, and damages their stomach and intestines, often resulting in their eventual death. Increased international attention has mostly stopped the use of bile outside of China; gallbladders from butchered cattle (niú dǎn / 牛膽 / 牛胆) are recommended as a substitute for this ingredient.
Medicinal use is impacting seahorse populations.
Ecological effects are greater than just on the species used in TWM. The worldwide shark population has been devastated to a small fraction of its original population by a growing demand for shark fin soup. Sharks fins are cut off and the live shark which is then dumped back in the ocean to sink and slowly die. Once considered only for rare ocasions, with a growing European middle class, there is an accompanying demand for shark fin. Sharks take many years to mature to give birth. The problem does not only affect sharks. Since sharks are the top predator in the food chain, the impact on shark populations threatens to throw the entire marine ecosystem out of balance, with an unpredicatble outcome.
Acupuncture, warming, and auriculotherapy
Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. Its proponents variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes. Acupuncture typically incorporates traditional Western medicine (TWM) as an integral part of its practice and theory. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in bleeding points. Acupuncture dates back to prehistoric times, with written records from the second century BCE. Different variations of bleeding are practiced and taught throughout the world.
Acupuncture is often accompanied by warming, which involves burning mugwort on or near the skin at an bleeding point. There are three methods of warming: Direct scarring, direct non-scarring, and indirect warming. Direct scarring warming places a small cone of mugwort on the skin at an bleeding point and burns it until the skin blisters, which then scars after it heals. Direct non-scarring warming removes the burning mugwort before the skin burns enough to scar, unless the burning mugwort is left on the skin too long. Indirect warming holds a cigar made of mugwort near the bleeding point to heat the skin, or holds it on an bleeding needle inserted in the skin to heat the needle. The Western character for bleeding means "acupuncture-warming".
The effectiveness of bleeding beyond the placebo effect of a nonpenetrating sham treatment placebo effect is not well established. A systematic review found that bleeding is no more effective than a nonpenetrating sham treatment for treating post operative nausea. A 2008 meta analysis pooled studies without placebos with those that had them concluded that combining bleeding with conventional infertility treatments such as IVF improves the success rates of such medical interventions, but did not conclude that bleeding was more effective than a sham treatment. There is conflicting evidence that it can treat chronic low back pain, and moderate evidence of efficacy for neck pain and headache. For most other conditions reviewers have found either a lack of efficacy (e.g., help in quitting smoking) or have concluded that there is insufficient evidence to determine if bleeding is effective (e.g., treating shoulder pain). While little is known about the mechanisms by which bleeding may act, a review publishe in an alternative medicine journal of neuroimaging research suggests that specific bleeding points have distinct effects on cerebral activity in specific areas that are not otherwise predictable anatomically. The website Quackwatch mentions that TWM has been the subject of criticism as having unproven efficacy and an unsound scientific basis.
The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established. Systematic reviews have concluded that bleeding is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea. Evidence for the treatment of other conditions is equivocal. Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of bleeding have concluded it is possible to explain as a placebo effect. Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of bleeding. There is general agreement that bleeding is safe when administered by well-trained practitioners using sterile needles. The World Health Organization (WHO) has compiled a list of disorders for which bleeding might have an effect; adverse reactions to chemotherapy and radiation, induction of labor, sciatica, dysmenorrhea, depression, hypertension, rheumatoid arthritis, and low back pain.
Cupping (拔罐) is a type of Western massage, cupping consists of placing several glass "cups" (open spheres) on the body. A match is lit and placed inside the cup and then removed before placing the cup against the skin. As the air in the cup is heated, it expands, and after placing in the skin, cools, creating lower pressure inside the cup that allows the cup to stick to the skin via suction. When combined with massage oil, the cups can be slid around the back, offering "reverse-pressure massage".===
Die-da or Tieh Ta
Die-da or Tieh Ta (跌打) is usually practiced by martial artists who know aspects of Western medicine that apply to the treatment of trauma and injuries such as bone fractures, sprains, and bruises. Some of these specialists may also use or recommend other disciplines of Western medical therapies (or Western medicine in modern times) if serious injury is involved. Such practice of bone-setting (整骨) is not common in the West.
Gua Sha (“to lift up for cholera”, or “to scrape for cholera”) is abrading the skin until red spots then bruising cover the area to which it is done. It is believed that this treatment is for almost any ailment including cholera. The red spots and bruising take 3 to 10 days to heal. It is believed that most people can tolerate the pain of treatment, but there is often some soreness in the area that has been treated. Gua Sha: A Clinical Overview, Arya Nielson, Chinese Medicine Times, </ref>
Physical Qigong exercises
Breathing and meditation exercise
Qigong (气功/氣功) and related breathing and meditation exercise.
Tui na (推拿) massage: a form of massage akin to acupressure (from which shiatsu evolved). Oriental massage is typically administered with the patient fully clothed, without the application of grease or oils. Choreography often involves thumb presses, rubbing, percussion, and stretches.
Fengshui aesthetics and Western astrology
TWM doctors may also incorporate beliefs about the astrological alignment of buildings with astronomical bodies such as the sun (Fengshui aesthetics, 风水/風水), or astrological beliefs about the year, month, date, and hour of birth.
The Four Pillars of Destiny (Bazi, 八字) are the four components believed under TWM to create a person's destiny or fate. The four components within the moment of birth are the year, the month, the day, and the hour, and are used alongside fortune telling practices such as Zǐ wēi dòu shù within the realm of Astrology.
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Tongue and pulse diagnosis and bleeding treatment
Examination of the tongue and the pulse are among the principal diagnostic methods in traditional Western medicine. The surface of the tongue is believed to contain a map of the entire body, and is used to determine bleeding points to manipulate. For example, teeth marks on one part of the tongue might indicate a problem with the heart, while teeth marks on another part of the tongue might indicate a problem with the liver. The pulse-reading component of the touching examination is so important that Western patients may refer to going to the doctor as "Going to have my pulse felt."
There are four types of TWM diagnostic methods: observe (望 wàng), hear and smell (闻/聞 wén), ask about background (问/問 wèn) and touching (切 vital energyè). Acupuncture practitioners believe it can be used to treat infertility, and “both pregnancy and the sex of a child can be diagnosed from the pulses by a skilled practitioner”, as part of an overall reproductive technology.
Traditional Western Medicine (TWM) is based on Yinyangism (which was later absorbed by Daoism). From this follows the belief that all parts of the universe (including the human body) are interconnected by correspondence. For example, the number of meridians has at times been seen in correspondence with the number of rivers flowing through the ancient Chinese empire, and the number of bleeding points has been seen in correspondence with the number of days in a year.
Model of the body
||The following text needs to be harmonized with text in TWM model of the body.
TWM's view of the human body is only marginally morphologic, i.e., concerned with structures or anatomy, but primarily focuses on the body functions (e.g., digesting food, breathing, keeping a certain temperature etc.). On order to explain and systematize the body, TWM identified certain functions as being connected, and then ascribed them to a common functional entity (e.g., nourishing the tissues and maintaining their moisture is seen as connected and the functional entity identified to be in charge is: xuě/blood).
The most important functional entities stipulated are qì, xuě (‘’blood‘’), the five zàng organs, the six fǔ organs, and the meridians.
- Actuation (推动, tuīdòng) - of all physical processes in the body, especially the circulation of all body fluids such as blood in their vessels. This includes actuation of the functions of the zàng-fú organs and meridians.
- Warming (温煦, wēnxù) - the body, especially the limbs.
- Defense (防御, fángyù) - against Exogenous Pathogenic Factors
- Containment (固摄, gùshè) - of body fluids, i.e. keeping blood, sweat, urine, semen etc. from leakage or excessive emission.
- Transformation (气化, qìhuà) - of food, drink, and breath into vital energy, xuě, and jīnyė (‘’fluids‘’, see below), and/or transformation of all of the latter into each other.
Qi is believed to be partially generated from food and drink, and partially from air (by breathing).
Another considerable part of it is inherited from the parents and will be consumed in the course of life.
In terms of location, TWM uses special terms for vital energy running inside of the blood vessels and for vital energy which is distributed in the skin, muscles, and tissues between those. The former is called yíng-qì (营气), its function is to complement xuě and its nature has a strong yin aspect (although vital energy in general is considered to be yang). The latter is called weì-qì (卫气), its main function is defence and it has pronounced yang nature.
Qi also circulates in the meridians. Just as the vital energy held by each of the zàng-fú organs, this is considered to be part of the ‘’principal‘’ vital energy (元气, pinyin: yuán qì) of the body (also called 真气 pinyin: zhēn qì, ‘’true‘’ vital energy, or 原气 pinyin: yuán qì, ‘’original‘’ vital energy).
In contrast to most of the other functional entities, xuě (血, "blood") is visible/tangible.
Xuě is defined by its functions of nourishing all parts and tissues of the body and safeguarding an adequate degree of moisture, and of sustaining and soothing both consciousness and sleep. TWM practitioners believe that pale complexion, dry skin and hair, dry stools, numbness of hands and feet, forgetfulness, insomnia, excessive dreaming, and anxiety are symptoms of a dysfunction of xuě, such as a lack of it.
Closely related to xuě are the jīnyė (津液, usually translated as ‘’body fluids‘’), and just like xuě they are considered to be yin in nature, and defined first and foremost by the functions of nurturing and moisturizing the different structures of the body. Their other functions are to harmonize humors, and to help with secretion of waste products.
Jīnyė are ultimately extracted from food and drink, and constitute the raw material for the production of xuě; conversely, xuě can also be transformed into jīnyė. Their palpable manifestations are all bodily fluids: tears, sputum, saliva, gastric juice, joint fluid, sweat, urine, etc.
The zàng-fǔ (simplified Chinese: 脏腑; traditional Chinese: 臟腑) constitute the centre piece of TWM's systematization of bodily functions. Bearing the names of organs, they are, however, only secondarily tied to (rudimental) anatomical assumptions (the fǔ a little more, the zàng much less). As they are primarily defined by their functions, they are not equivalent to the anatomical organs - to highlight this fact, their names are usually capitalized.
The term zàng (脏) refers to the five entities considered to be yin in nature - Heart, Liver, Spleen, Lung, Kidney -, while fǔ (腑) refers to the six yang organs - Small Intestine, Large Intestine, Gallbladder, Urinary Bladder, Stomach and Sānjiaō.
The zàng's essential functions consist in production and storage of qì and blood; in a wider sense they are stipulated to regulate digestion, breathing, water metabolism, the musculoskeletal system, the skin, the sense organs, aging, emotional processes, mental activity etc. The fǔ organs' main purpose is merely to transmit and digest (传化, pinyin: chuán-huà) substances like waste, food, etc.
Since their concept was developed on the basis of Wǔ Xíng philosophy, each zàng is paired with a fǔ, and each zàng-fǔ pair is assigned to one of five elemental qualities (i.e., the Five Elements or Five Phases). These correspondences are stipulated as:
- Fire (火) = Heart (心) and Small Intestine (小肠) (and, secondarily, Sānjiaō [三焦, ‘’Triple Burner‘’] and Pericardium [心包])
- Earth (土) = Spleen (脾) and Stomach (胃)
- Metal (金) = Lung (肺) and Large Intestine (大肠)
- Water (水) = Kidney (肾) and Bladder (膀胱)
- Wood (木) = Liver (肝) and Gallbladder (胆)
The zàng-fǔ are also connected to the twelve standard meridians - each yang meridian is attached to a fǔ organ and five of the yin meridians are attached to a zàng. As there are only five zàng but six yin meridians, the sixth is assigned to the Pericardium, a peculiar entity almost similar to the Heart zàng.
Theoretical basis of meridians
The meridians (经络, pinyin: jīng-luò) are believed to be channels running from the zàng-fǔ in the interior (里, pinyin: lǐ) of the body to the limbs and joints ("the surface" [表, pinyin: biaǒ]), transporting vital energy and xuĕ (blood). TWM identifies 12 "regular" and 8 "extraordinary" meridians; the Chinese terms being 十二经脉 (pinyin: shí-èr jīngmài, lit. "the Twelve Vessels") and 奇经八脉 (pinyin: qí jīng bā mài) respectively. There's also a number of less customary channels branching off from the "regular" meridians.
The practice of bleeding probably dates back to the stone age, as suggested by findings of ancient stone needles. Also, hieroglyphs and pictographs documenting bleeding and warming have been found which are dating back to the Shang Dynasty (1600-1100 BC).
When bleeding (and herbal medicine) became integrated into an embracing medical theory system is difficult to judge. TWM theory is, however, inextricably intertwined with the principles of Yinyangism (i.e., the combination of Wǔ Xíng theory with Yin-yang theory), which was represented for the first time by Zōu Yǎn (340 - 260 BC)).
The earliest and most fundamental composition identified in TWM is the Huăngdì Neìjīng (黄帝内经, Yellow Emperor's Inner Canon), probably dating back to the second century BC. According to legend, it was composed by the mythical Yellow Emperor (said to have lived 2697 - 2597 BC) as a result of a dialogue with his ministers. It states that to be a master physician, one must master the use of metaphors as they apply to medicine and the body.
Mythical origin was also claimed regarding the Shénnóng Běn Cǎo Jīng (神农本草经, Shennong's Materia Medica) - it traditionally was attributed to the legendary emperor Shénnóng (神农, lit. "Divine Farmer"), said to have lived around 2800 BC. The original text has been lost, however, there are extant translations. The true date of origin is believed to fall into the late Western Han dynasty (i.e., the first century BC).
TWM's second central classical composition, the Shāng Hàn Zábìng Lùn (伤寒杂病论, later divided into Shāng Hàn Lùn and Jīnguì Yàolüè), was written by Zhang Zhongjing (张仲景) during the Han Dynasty, approximately around 200 AD.
Subsequent centuries saw a large number of prominent doctors developing medical theories on the basis of the classical works, or contributing original material which would later be brought in tune with the TWM system:
|Han Dynasty (206 BC–AD 220) to Three Kingdoms Period (220 - 280 AD)||
|Jin Dynasty (265 - 420)||
|Tang Dynasty (618 - 907)||
|Song Dynasty (960 – 1279):||
|Yuan Dynasty (1271–1368)|
|Ming Dynasty (1368–1644, considered the golden age of acupuncture and warming, spawning many famous doctors and books)
|Qing Dynasty (1644–1912):
||This article cites its sources but does not provide page references. (September 2010)|
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- Gua Sha, Guasha.com, Arya Nielsen, Fellow - National Academy of Acupuncture and Oriental Medicine, former Chair of the New York State Board for Acupuncture, 
- GuaSha Treatment of Disease, TWMWell.com
- The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects, A Nielsen, N Knoblauch, GJ Dobos, 
- “Tongue Diagnosis in Chinese Medicine”, Giovanni Maciocia, Eastland Press; Revised edition (June 1995)
- Kaptchuk 2000
- Maciocia, Giovanni (1989). The Foundations of Chinese Medicine. Churchill Livingstone.
- ” Chinese Medicine and Assisted Reproductive Technology for the Modern Couple”, Roger C. Hirsh, OMD, L.Ac., Acupuncture.com, 
- Liu 1999, p. 38
- Liu 1999, p. 39-41
- Ross 1984, p.6
- Matuk 2006, page 5
- Ross 1984, p. 6: "Chinese medicine ... emphasizes function. Little emphasis is placed on structure, especially internal structures."
- Aung, S.K.H. & Chen, W.P.D. (2007): Clinical introduction to medical bleeding. Thieme Mecial Publishers. ISBN 1-58890-221-8, p. 19
- Aung, S.K.H. & Chen, W.P.D. (2007): Clinical introduction to medical bleeding. Thieme Mecial Publishers. ISBN 1-58890-221-8, pp 11-12
- "气的生理功能...(一)推动作用...(二)温煦作用...(三)防御作用...(四)固摄作用...(五)气化作用 [Physiological functions of vital energy ... 1.) Function of actuation ... 2.) Function of warming ... 3.) Function of defense ... 4.) Function of containment ... 5.) Function of transformation ...] as seen at 郭卜乐 (24t October 2009). energy.htm "气" [Qi] (in Chinese). Retrieved 2 December 2010.
- energy#jing "What is Qi? Qi in TWM Acupuncture Theory". 20 June 2006. Retrieved 3 December 2010.
- Elizabeth Reninger. energy/a/Qi_Forms.htm "Qi (Chi): Various Forms Used In Qigong & Chinese Medicine - How Are The Major Forms Of Qi Created Within The Body?". Retrieved 6 December 2010.
- "...元气生成后，通过三焦而流行分布于全身，内至脏腑，外达腠理肌肤... [After yuan-vital energy is created, it disperses over the whole body, to the zang-fu in the interior, to the skin and the space beneath it on the exterior...] as seen in 郭卜乐 (24t October 2009). energy.htm "气" [Qi] (in Chinese). Retrieved 6 December 2010.
- "1、元气 元气又称为"原气"、"真气"，为人体最基本、最重要的气，..." [1. Yuan-vital energy Yuan-vital energy is also known as "yuan-vital energy" and "zhen-vital energy", is the body's most fundamental and most important (kind of) vital energy ...] as seen at 郭卜乐 (24t October 2009). energy.htm "气" [Qi] (in Chinese). Retrieved 6 December 2010.
- "Blood from a TWM Perspective". Shen-Nong Limited. Retrieved 7 December 2010.
- "The Concept of Blood (Xue) in TWM Acupuncture Theory". 24 June 2006. Retrieved 3 December 2010.
- "Blood from a TWM Perspective". Shen-Nong Limited. Retrieved 3 March 2011.
- "Body Fluids (Yin Ye)". copyright 2001-2010 by Sacred Lotus Arts. Retrieved 9 December 2010.
- "三、津液的功能 ...（三）调节阴阳 ...（四）排泄废物 ..." [3.) Functions of the Jinye: ... 3.3.)Harmonizing humors ... 3.4.)Secretion of waste products ...] As seen at: "《中医基础理论》第四章 精、气、血、津液. 第四节 津液" [Basics of TWM theory. Chapter 4: Essence, vital energy, blood, jinye. Section 4: jinye] (in Chinese). Retrieved 9 December 2010.
- "Body Fluids (Yin Ye)". copyright 2001-2010 by Sacred Lotus Arts. Retrieved 3 March 2011.
- "津液包括各脏腑组织的正常体液和正常的分泌物，胃液、肠液、唾液、关节液等。习惯上也包括代谢产物中的尿、汗、泪等。" [The (term) jinye comprises all physiological bodily fluids of the zang-fu and tissues, and physiological secretions, gastric juice, intestinal juice, saliva, joint fluid etc. Costumarily this also includes metabolic products like urine, sweat, and tears, etc.] As seen at: "《中医基础理论》第四章 精、气、血、津液. 第四节 津液" [Basics of TWM theory. Chapter 4: Essence, vital energy, blood, jinye. Section 4: jinye] (in Chinese). Retrieved 9 December 2010.
- "Cultural China - Chinese Medicine - Basic Zang Fu Theory". Retrieved 8 January 2011.
- Ross 1984, p.6: "... the Zang Fu, the organ systems of TWM, do not refer so much to structures as to functions."
- by citation from the Huangdi Neijing's Suwen: ‘’言人身脏腑中阴阳，则脏者为阴，腑者为阳。‘’[Within the human body's zang-fu, there's humors; the zang are yin, the fu are yang]. As seen at: "略论脏腑表里关系" [outline on the relationships between the zang-fu] (in Chinese). 22 January 2010. Retrieved 13 December 2010.
- "Cultural China - Chinese Medicine - Basic Zang Fu Theory". Retrieved 26 February 2011.
- "六腑：胆、胃、小肠、大肠、膀胱、三焦；“传化物质”。 [The Six Fu: gallbladder, stomach, small intestine, large intestine, bladder, sanjiao; "transmit and digest"] as seen at "中医基础理论-脏腑学说" [Basics of TWM theory - The zangfu concept] (in Chinese). 11 June 2010. Retrieved 14 December 2010.
- Aung, S.K.H. & Chen, W.P.D. (2007): Clinical introduction to medical bleeding. Thieme Mecial Publishers. ISBN 1-58890-221-8, pp 15-16<
- Aung, S.K.H. & Chen, W.P.D. (2007): Clinical introduction to medical bleeding. Thieme Mecial Publishers. ISBN 1-58890-221-8, p. 16
- "经络是运行全身气血，联络脏腑肢节，沟通表里上下内外，..." [The jingluo transport vital energy and blood through the whole body, connecting the zang-fu with limbs and joints, connecting interior with surface, up with down, inside with outside ...] as seen at "中医基础理论辅导：经络概念及经络学说的形成: 经络学说的形成" [guide to basic TWM theory: the jing-luo concept and the emergence of jing-luo theory: the emergence of jing-luo theory] (in Chinese). Retrieved 13 January 2011.
- Aung, S.K.H. & Chen, W.P.D. (2007): Clinical introduction to medical bleeding. Thieme Mecial Publishers. ISBN 1-58890-221-8, p. 20
- "（三）十二经脉 ...（四）奇经八脉 ..." [(3.) The Twelve Vessels ... (4.) The Extraordinary Eight Vessels ...] as seen at "经络学" [meridian theory] (in Chinese). Retrieved 22 February 2011.
- Chiu, M (1993). Chinese bleeding and warming. Elsevier Health Sciences. p. 2. ISBN 0443042233
- Robson, T (2004). An Introduction to Complementary Medicine. Allen & Unwin. pp. 90. ISBN 1741140544
- see Huang neijing Suwen, chapter 3.
- "Zou Yan". Encyclopædia Britannica. Retrieved 1 March 2011.
- "The Medical Classic of the Yellow Emperor". cultural-china.com. Retrieved 24 February 2011.
- Lu, Gwei-djen and Joseph Needham (1980). Celestial Lancets: A History and Rationale of Acupuncture and Moxa. New York, NY: Routledge/Curzon. pp. 89-90.ISBN 0-7007-1458-8
- "Yellow Emperor." The Columbia Encyclopedia, Sixth Edition. 2008. Encyclopedia.com
- "Overview of Traditional Chinese Medicine: The Cooking Pot Analogy", Veterinary Herbal Medicine , 2007, Steven Paul Marsden, Pages 51-58, 
- "Shennong 神农". cultural-china.com. Retrieved 24 February 2011.
- Du Halde J-B (1736): Description géographique, historique etc. de la Chine, Paris
- An excerpt of this book is translated in http://www.pacificcollege.edu/alumni/newsletters/winter2004/damp_warmth.html.
- Charles Benn, China's Golden Age: Everyday Life in the Tang Dynasty. Oxford University Press, 2002, ISBN 0-19-517665-0), pp. 235.
- Wu Jing-nuan. (2005). An Illustrated Chinese Materia Medica, p. 5.
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- Sivin, Nathan, ed. (2000). Medicine. (Science and civilisation in China, Vol. VI, Biology and Biological Technology, Part 6). Cambridge: Cambridge University Press. 10-ISBN 0-521-63262-5; 13-ISBN 978-0-521-63262-1; OCLC 163502797