Demystifying Chinese Medicine: understanding its origins, principles, and practice

I am honored to introduce this insightful article, written by my esteemed teacher, Philippe Sionneau, one of the best-known authors, teachers and practitioners  of Chinese medicine in the West.  I would like to express my deep gratitude to him for capturing in words such an eloquent and accessible explanation of what traditional Chinese medicine truly represents. 

In a world where misconceptions and myths about this ancient practice persist, it is essential to bring clarity and respect to a discipline that has been refined over centuries. This reliable medical system has crossed dozens of centuries and is more needed than ever in our modern world.

What is Chinese Medicine? 

What is Chinese medicine? An exotic and outdated medical practice? A superstitious tradition from the past? An ancient Chinese belief irrelevant to the needs of Westerners? I believe that Chinese medicine is still misunderstood, burdened by many misconceptions. Yet, I am convinced it has a significant role to play in public health and in individual well-being. I want to introduce you to a medical system that can offer effective solutions to health problems, a system that goes beyond treating symptoms to harmonize the body as a whole.

For those unfamiliar with me, I have been practicing and teaching Chinese medicine for over 30 years. I hold a degree in Chinese medicine from the Chinese state and have published over thirty books on the subject. Today, I am here to present Chinese medicine through its principles, diagnostic methods, and the treatments it can offer. Together, we will explore how it can be useful to you as a complementary perspective to Western medicine. My goal is to present Chinese medicine as accurately as possible.

Origins and History

What is Chinese medicine? It is a complete and coherent medical system with its own representation of the human being, its functions, and dysfunctions. It originated from observing nature and the experience accumulated over generations of doctors and scholars. The Chinese medicine we know today has been in existence for about 2,500 years. Before that, there were other rudimentary and shamanic medical practices. However, rational and organized Chinese medicine began under the Eastern Zhou dynasty and was further developed during the Han dynasty.

Fundamental Theory

Chinese medicine includes a fundamental theory that explains how a human functions in a state of health, through its unique anatomy and physiology. It identifies the various causes of diseases and their pathological mechanisms, proposing an etiology and pathophysiology. It also has an advanced diagnostic system.

The Four Diagnostic Examinations

The art of diagnosis (zhěn duàn 诊断) in Chinese medicine consists of four main parts: observation (wàng zhěn 望诊), audition/olfaction (wén zhěn 闻诊), palpation (qiē zhěn 切诊), and inquiry (wèn zhěn 问诊). Together, these constitute the four examinations (sì zhěn 四诊). The synthesis of these examinations leads to a diagnosis and the establishment of treatment principles (zhì bìng fǎ zé 治病法则), commonly referred to as therapeutic principles (zhì zé 治则) or treatment methods (zhì fǎ 治法).

Observation (wàng zhěn 望诊)

Observation involves examining specific body parts to draw conclusions about potential dysfunctions. The face and tongue are primarily observed, along with other microsystems such as the hands, nails, eyes, and overall body shape. The appearance of stools, urine, and expectorations is also considered. For instance, a bluish thenar eminence may indicate cold-induced digestive issues, a reddish facial complexion may signal heat-related pathology, and a yellow, greasy tongue coating may suggest damp-heat in the stomach. While describing illnesses in terms of cold, heat, wind, or humidity may seem unusual, it’s essential to understand that Chinese medicine developed with a different framework than contemporary science. It is a distinct way of thinking and interpreting the world and human health. Just as each sport has its unique rules and logic, so do medical systems. The logic of Chinese medicine is unique, and many conventional/Western-trained medical students acknowledge its consistency.

Audition/Olfaction (wén zhěn 闻诊)

Audition/olfaction involves deducing a diagnosis based on the sounds and odors emitted by the patient, such as the smell of stools, urine, breath, sweat, and the sounds of speech, breathing, coughing, or hiccups. For example, foul-smelling diarrhea may indicate damp-heat in the large intestine, while odorless diarrhea may suggest cold-dampness. These conditions would require different treatments. In Chinese medicine, the same illness can have varying causes, different pathological mechanisms, and different natures, necessitating distinct treatments. This principle reflects what is called "treatment selection based on differential diagnosis."

Palpation (qiē zhěn 切诊)

Palpation involves using the hands or fingers to feel parts of the body, primarily the arteries, meridians, abdomen, and specific muscular or cutaneous areas. The goal is to detect irregularities that indicate dysfunction. Palpation of certain arteries (mài zhěn 脉诊), especially the radial artery, is the most well-known method. Palpating the meridians and abdomen is less known but equally effective for assessing imbalances.

Inquiry (wèn zhěn 问诊)

Inquiry is the process of gathering detailed information from the patient through targeted questions to make a diagnosis. These questions cover the patient’s medical history, allergies, addictions, and the course of their illness, including the conditions under which symptoms improve or worsen. Questions may explore sensations of heat or cold, sweating, pain, emotional state, sleep, appetite, digestion, urination, bowel movements, and other health aspects. Centuries of observation of illness-related manifestations have refined this inquiry method. In the Superior Academy of Chinese Medicine, this diagnostic art is studied in depth because the more precise the diagnosis, the easier it is to choose an effective treatment. Unlike Western methods, Chinese diagnosis relies on the capabilities of the five senses and does not use advanced biological tests, scans, or MRIs. It is a medicine of what can be seen, felt, and heard by human senses, focusing on perceptible phenomena.

The Four Fundamental Pillars

Chinese medicine's therapeutic system is comprehensive and effective, recognized worldwide. It is based on four fundamental pillars: Chinese pharmacopoeia, acupuncture and moxibustion, massage, and dietary therapy.

Chinese Herbal Formulas (zhōng yào 中药)

Chinese herbal medicine is the primary treatment method, using medicinal substances to address health issues. Though often associated with plants, it also includes minerals and, rarely, animal substances. Today, plants and some minerals are predominantly used. This practice remains widespread in China and throughout Asia.

Acupuncture (zhēn 针)

Acupuncture, well known in the West, involves stimulating specific body areas with fine needles to regulate bodily functions.

Moxibustion (ài jiǔ 艾灸)

Moxibustion is less familiar but equally noteworthy. It involves burning mugwort leaves either near or directly on the skin at targeted points for therapeutic effects.

Chinese Massage (àn mó tuī ná 按摩推拿)

Chinese massage is a form of physiotherapy that aims to restore and enhance muscular or joint mobility. It is effective for back, neck pain, sciatica, and can aid certain organ functions. It can also be used to relieve digestive issues and menstrual pain.

Chinese Dietary Therapy (shí liáo 食疗)

Chinese dietary therapy addresses illnesses through dietary guidelines based on Chinese medicine principles and the medicinal properties of foods.

Conclusion on Chinese Medicine

It is important to understand that Chinese medicine is not a leisure or comfort practice and cannot be compared to spa treatments. It is currently used by at least a quarter of the world’s population, not just in Asia, but globally, proving its efficacy even for severe illnesses.

Some refer to it as "Chinese medicine" and others as "traditional Chinese medicine." Historically, before the arrival of Western medicine in China in the late 19th century, it was simply called "yī" (医 / 醫), meaning "medicine." It coexisted with other healing systems, including shamanism and religious medical practices (wu 巫 or zhù 祝). The boundaries between these approaches were sometimes blurred, and they influenced each other. "Yī" (医) emerged from the philosophical schools of "huáng lǎo 黄老" and the Yì Jīng 易经 (Classic of Changes), incorporating fundamental theories such as yīn yáng (阴阳), the five phases (五行), and qì (气). This rational approach explained diseases and healing as natural processes, without supernatural or religious overtones. This school of thought is the ancestor of what we now call "traditional Chinese medicine," though "Chinese medicine" is a simpler and more appropriate term. The term used universally is "zhōng yī" (中医), with zhōng 中 meaning China or Chinese, and yī 医 meaning medicine.

Thus, the most appropriate term is simply "Chinese medicine."