CAM And Traditional Chinese Medicine

Question 1

What does complementary medicine and alternative medicine refer to?
They are used interchangeably with what ?

What is the main healthcare system in Ghana?
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Answer 1

The terms “complementary medicine” and “alternative medicine” refer to a broad set of health care practices that are not part of that country’s own traditional or conventional medicine and are not fully integrated into the dominant health care system.

• They are used interchangeably with traditional medicine in some countries.

Allopathic or orthodox medicine
But it is CAM not traditional medicine

Question 2

What do you think is the situation of traditional medicine in Ghana?
Which directorate is the policy maker of traditional and CAM and which body regulates practice and practitioners in Ghana ?

Answer 2

Allopathic medicine (Western medicine or orthodox medicine) is the accepted form of healthcare delivery in Ghana.
• In Ghana, Traditional Medicine is classified as our indigenous medicine and so is not considered as a CAM system.
• The TAMD- Traditional and Alternative Medicine Directorate is the policy maker of these two broad systems: Traditional and CAMs while TMPC-Traditional Medicine Practice Council regulates the practice and practitioners in Ghana.

Question 3

What are the types of CAM

Answer 3

Five categories of complementary or alternative medicine are generally recognized:
1. Whole medical systems
2. Mind-body medicine
3. Biologically based practices not usually used in conventional medicine
4. Manipulative and body-based practices
5. Energy medicine
• The name of many therapies only partially describes their components

Question 4

What is whole medical system CAM and what is mind-body,medicine CAM based on and give three examples under each
What techniques are used and why in mind -body medicine ?
Why is mind body medicine considered mainstream? And give two examples

Answer 4

Whole Medical Systems
• These are complete systems with a defined philosophy and explanation of disease, diagnosis, and therapy:
oAyurveda, Homeopathy, Naturopathy and Traditional Chinese medicine.

2. Mind-Body Medicine
   • Based on the theory that mental and emotional factors regulate physical health through a system of interdependent neuronal, hormonal, and immunologic connections throughout the body.
   • Behavioural, psychologic, social, and spiritual techniques are used to enhance the mind’s capacity to affect the body and thus to preserve health and to prevent or cure disease.

• Scientific evidence supports its benefits hence are now considered mainstream. E.g. for treatment of chronic pain, coronary artery disease, headaches, insomnia, and as aids during childbirth:

o Biofeedback, Guided imagery, Hypnotherapy, Meditation (including mindfulness) and Relaxation.

Question 5

What are biologically based practices and give three examples of such therapies
What do manipulative body-based practices focus primarily on?
What belief are they based on?
Name five practices under manipulative body based practices
Some of these manipulative body based practices or therapies result in lesions that may be mistakes for what?
These therapies are enough to do what?

Answer 5

Biologically Based Practices
• They use naturally occurring substances to affect health:
o Botanical medicine and natural products
o Chelation therapy
o Diet therapies

Manipulative and body-based practices
• They focus primarily on the body’s structures and systems (e.g., bones, joints, soft tissues). They are based on the belief that the body can regulate and heal itself and that its parts are interdependent:
o Chiropractic, Massage, Reflexology, Cupping, Scraping (e.g., coining, spooning), Moxibustion, Acupuncture is also sometimes considered a manipulative therapy.
• Some of these therapies (cupping, scraping, moxibustion) result in lesions that may be mistaken for signs of trauma or child abuse. These therapies are thought to stimulate the body’s energy and to enable toxins to leave the body. However, very little high quality research has assessed their efficacy.

Question 6

What is energy medicine
All energy therapies are based on what belief?
Historically a vital force was posited to explain what process? As biologic science progressed what was dismissed? Some investigators continue to explore what?
Energy medicine is a component of several therapies including which therapies?(name five)
What is Tai chi?

Answer 6

Energy Medicine
• This manipulates the subtle energy fields (biofields) thought to exist in and around the body and thus affect health.
• All energy therapies are based on the belief that a universal life force (qi) or subtle energy resides in and around the body. Historically, a vital force was posited to explain biologic processes that were not yet understood.
• As biologic science progressed, this force was dismissed. Some investigators continue to explore the existence of the biofield and subtle energies.
• Energy medicine is a component of several therapies, including the following:
o Acupuncture, Magnets, Therapeutic touch, Reiki, Qi gong and Tai chi—components of traditional Chinese medicine using gentle postures, mindful movement, and the breath to bring the patient’s energy into better balance.

Question 7

What are the Role of CAMs in Public Health?
• What are the Strength, benefits, limitations and Risks associated with
CAMs?
• How Relevant is the study of CAMs to Clinicians like yourselves?
• How does Knowledge on CAMs impact the quality healthcare provided by clinicians?

Question 8

What is Arguably the oldest of the whole healing medical systems in the world?
Since when has it been used?
How many parts is it classically considered?
Why is it seen to have been well established?

Answer 8

Traditional Chinese Medicine
•
• TCM has been used since the 3rd century.
• Classically considered in three (3) parts
• Theory: Ying and yang & Five (5) elements
• Treatment: Herbalism, Acupuncture, Moxibustion,cupping,massage therapy
• Prevention: Qi-gong, Tai-ji, Meditation & Massage
• TCM is seen to have been well established because of the dialectical viewpoint of ancient Chinese philosophical thought.

Question 9

TCM is seen as not just a collection of piecemeal experiences but most experiences have been summed up, forming a theoretic system, both medical and philosophical. True or false
The greatest philosophical background to tradito Chinese medicine are?
What are the five elements

Answer 9

• The greatest philosophical background to TCM are the:
• Essential Qi
• Yin and Yang
• Five Elements

Wood 
Water
Fire
Earth
Metal

Question 10

According to the theory of Qi,ancient Chinese philosophy believes what ?
Which qi is responsible for the composition of the universe?
Movements and changes of the qi produced what? According to the medical classic of the yellow empower where does human life originate from?

Answer 10

Theory of Qi
• Ancient Chinese philosophy believes that the universe originates from Taiji, a synonym for original or primitive qi.
• Out of this primitive qi is the essential qi, responsible for the composition of the universe.
• The movement and changes of the qi produces the different compositions in the world.
• The Medical Classic of the Yellow Emperor: “Human life originates in the qi of Heaven and Earth, and develops according to the normal order of the four seasons.”
• Without the actions and changes of qi there would be no life activities.

Question 11

Which qi is man endowed with?what are based on the actions and the changes of the qi?
The theory of qi is of what kind?
Why is this view central to Chinese medicine
Qi is not just a vital force
True or false
Qi is classified into two main categories name them.
Genuine qi of human beings comes from three sources name them
Genuin qi includes what?
What is harmful to health? What are considered evil qi?

Answer 11

• Man is endowed with the qi of nature.
• All life activities: mental activities such as thought, will, and emotions, are based on the actions and changes of qi.
• The theory of the qi is a kind of materialism.
• Man is derived from the qi of nature.
• Mental activities are explained in terms of objective matter.
• This view is central to Chinese medicine which understands that all psychological activity must be in harmony with nature to ensure health.
• Qi is not just a vital force.
6

 Types of Qi • Classified into two main categories: • The genuine or normal qi. • The evil or pathogenic qi. • Genuine qi of human beings comes from three sources:  • Primordial qi: inborn, inherited from parents • Qi of food essence: acquired • Qi of air: acquired • Genuine qi includes all the materials and energy essential for life activities as well as the body's resistance against disease. • Evil qi is harmful to health.  The various pathogenic agents: abnormal atmospheric changes such as wind, cold, heat, dampness and dryness are all considered evil qi, if they happen in an untimely fashion or in excess.

Question 12

The theory of yin and Yang was originally what?
What do they represent?
What law do they explain?
What is this theory saying?
The theory of yin-yang as what can be applied to any field of medicine?
Give two example

Answer 12

Theory of Yin and Yang
• Originally topographical description of the sunny
and shady aspects of the hill.
• Yin and yang represent two opposites of an object or phenomenon.
• In this theory:
• allthingsandphenomenaintheworldcontaintwo
opposite aspects.
• yin and yang, are in conflict and at the same time mutually dependent (Law of Unity of Opposites).
• The theory of yin-yang as a dialectical way of thinking can be applied to any field of medicine.
• Parasympathetic and Sympathetic
• Testosterone and Oestrogen

Question 13

Is there conflict between the theory of qi and that of yin-yang?
Qi is divine into what?
Which is the material aspect and which is the dynamic aspect?
What does the medical classic of the yellow emperor state?
What has modern physiology shown about the features of life activities?
How are these functions explained under TCM?

Answer 13

Yin and Yang
• There is no conflict between the theory of qi and that of yin-yang.
• Qi, divided into yin qi and yang qi.
• Yin qi (material aspect), and yang qi (the dynamic aspect).
• The Medical Classic of the Yellow Emperor states: “The clear yang qi ascends to form Heaven, while the turbid yin qi descends to form Earth.“
• Modern physiology has shown that homeostasis, metabolism and adaptability are the three characteristic features of life activities.
• These functions are well explained under TCM.
• Dynamic balance of yin-yang within the body for homeostasis.
• Waxing and waning of yin-yang or transformation of yin-yang for metabolism.
• Adaptable conformity between the human being and the external environment for adaptability.

Question 14

What are the major aspects of the yin-yang theory

Answer 14

Major Aspects of the Yin and Yang Theory
• Opposition of yin and yang.
• Interdependence of yin and yang.
• Inter-consuming supporting relationship of yin and yang (waxing- warning of yin and yang).
• Inter-transformation of yin and yang.
• Infinite divisibility of yin and yang.

Question 15

How is the Yin-yang theory applied in medicine

What did Zhang jingyue say about yin and Yang

Answer 15

Applications of Yin and Yang theory
• All physiological and pathological processes in man can be explained by the yin and yang theory.
• An imbalance results in diseases. All treatments are aimed at balancing the yin and yang.
• Zhang Jingyue in his well-known The Complete Works of Jingyue (1624):
• “Although medicine is complicated, it can be summed up in one word, namely, yin-yang.”

Question 16

Give 11 words for yin and 11 opposite for Yang

Answer 16

Yin:
Feminine
Internal energy
Yielding 
Nurturing
Negative
Night
Passive
Moon
Intuitive
Cold
Soft

Yang:
Masculine
External energy
Dominating
Initiating
Positive
Day
Active
Sun
Logical
Hot
Hard

Question 17

How is the theory of yin-Yang applied to bodily organs?
Which is Yang and which is yin
With reference to the zang-fu organs
Which is yin and which is Yang?(name the organs and if zang is yin or Yang and if fu is yin or Yang)

Answer 17

Yin and Yang and Bodily Organs
• The theory of yin-yang as applied to the organic structure of humans emphasizes that the human body should be viewed as an organic whole.
• Exterior portion = yang; interior = yin.
• Among the zang-fu organs: zang-organs = yin,
fu-organs = yang.
• the zang-organs: the Heart and Lungs (thoracic cavity), pertain to yang, while the Liver, Spleen and Kidneys, situated in the lower portion of the body (abdominal cavity), to yin

Yang:
Exterior (skin,hair,flesh,meridians)

Excess or shi (disease preventing forces (-)
Pathogenic factors increase

Heat :yin deficiency or excess heat

Yin:
Interior: organs,bone marrow,qi and blood
Deficiency (xu):disease preventing forces decrease
Pathogenic factors(-)

Cold: Yang deficiency or excess cold

Question 18

Yin-yang and physiological activity:
• All physiological activity have a material basis, without which there is no physiologic function. Physiological function affords metabolism true or false
What are the two types of pathogenic factors?
Which factors are yin pathogenic and which are Yang pathogenic?
Anti pathogenic factors also include what?
If the disease is due to deficiency of anti pathogenic factors what is seen?
In advanced cases what may be seen?

Answer 18

.
• There are two types of pathogenic factors:
• yin pathogenic factors and yang pathogenic factors.
• Cold and damp are yin pathogenic factors.
• Wind, dryness, heat and fire are yang pathogenic factors.
• Anti-pathogenic factors also include yin and yang, i.e., the material aspect and the functional aspect.
• If the disease is due to deficiency of the anti-pathogenic factors, there are deficiency syndromes.
• In advanced cases, however, deficiency of either yin or yang may lead to the consumption of the other, known respectively as “impairment of yin affecting yang” and “impairment of yang affecting yin.”

Question 19

How is diagnosis done in yin-Yang and what is the cause of disease in yin-Yang? The key to clinical diagnosis is what?
With regards to yin-Yang how is treatment done?
What is the target ? In deficiency syndromes how are they treated? How is a complicated or advanced case treated?

Answer 19

• Yin-yang and diagnosis:
• Diseases or syndromes can be classified into yin and yang according to their
nature.
• The root cause of the occurrence and development of disease is imbalance between yin and yang.
• The key to clinical diagnosis is correct differentiation of the yin and yang nature of the disease as well as determination of the imbalanced condition of yin and yang.
• Yin-yang and treatment:
• “Replenish what is in deficiency,” “reduce what is in excess,” “treat cold with
warming measures” and “treat heat with cooling measures“
• Target is to achieve a balance.
• In deficiency syndromes, replenishing or reinforcing measures are indicated.
• In complicated case it may for example become necessary to treat the yin in a yang syndrome or vice-versa.

Question 20

What is the theory of the five elements
What are the properties of each element

All materials be classified into five categories according to their properties and actions, each category pertaining to one of the five elements. True or false

Answer 20

Theory of the 5 Elements
• This theory holds that the natural world is made up by five elements, namely, wood, fire, earth, metal and water.
• The ancient Chinese recognized that each element had its own properties:
• wood (trees) tends to spread out freely
• metal is the material for manufacturing weapons
• fire tends to flare upwards
• earth produces myriads of things
• water tends to flow downward.
•

Question 21

What relationship is there between the five elements? What system was formed due to the relationship between the five elements? State the five core zang organs.
A systemic way of classification was developed based on what? Give an example
Which system is fire? Which is water? Which is wood ? Which is earth?

Answer 21

Theory of the 5 Elements
• There are various interrelationships among the five elements, so that they are all linked together, making the world a unified entity.
• A theoretic system of physiology and pathology was thus formed with the five zang-organs:
• Liver, Heart, Spleen, Lungs and Kidneys, as the core.
• A systematic way of classification developed based on similarities between the organs and the elements.
• e.g. the Liver corresponds to wood because it promotes the spreading of qi and blood like a tree spreading out freely.
• The eyes and tendons all pertain to wood, because the condition of the Liver can be reflected in the eyes, and the Liver controls the tendons.

Fire-endocrine
Defense-wood
Circulatory-water
Respiratory-metal
Digestive-earth

Question 22

The interrelationships of the five elements include what four things? Give the sequence for each of them

Answer 22

Correlation between elements in different categories is existent.
• The interrelationships of the five elements include inter-promoting (producing), interacting (checking), overriding and counteracting.
• The promoting or producing sequence is: wood → fire → earth → metal → water → wood
• The acting upon or checking sequence is: wood → earth → water → fire → metal → wood
• The overriding sequence is the same as the acting upon sequence;
• The counteracting sequence is opposite to the acting upon sequence, i.e., wood → metal → fire → water → earth → wood.

Question 23

What do the interrelationships between the five elements explain
Give two examples of this

Answer 23

This interrelationships explain the correlation between the various parts of the human body as well as the correlation between the human body and the natural environment.

• Examples:
• Water nourishes wood.
• This figuratively denotes that a sound Liver needs adequate nourishment of Kidney yin.
• If Kidney yin is insufficient, usually there is a deficiency of Liver yin accompanied by exuberant Liver yang, manifested by dizziness, tinnitus and blurred vision.
• In the latter case, the pathogenesis is attributed to “failure of water to nourish wood,” and the treatment is “replenishing water to nourish wood,” i.e., replenishing Kidney yin as the major therapeutic measure.

Examples 2:
• Wood acts on earth.
• This explains the physiological relationship between the Liver (wood) and the Spleen and Stomach (earth).
• However, if the Liver is diseased (e.g., depressed or stagnated), it may act on the Spleen and Stomach excessively, causing dysfunction of the latter. This is called the “overriding by wood of earth.“

Question 24

What is the theory of the zang and fu organs
State the zang organs
State the fu organs
What are the functions of the zang organs? Functions of fu organs?

Answer 24

Theory of Zang & Fu Organs:
• Internal organs are divided into 5 Zang and 6 Fu organs.
• Extraordinary Fu organs: brain, marrow etc.
• Zang organs: stores the qi of essence (food nutrients)
• Fu organs: transports and transforms food

Question 25

State the fu organs and zang organs ,the governing organ,the opens and the external manifestation

Answer 25

Fu organ-small intestine
Zang organ-heart
Governing -vessels
Opens-tongue
External manifestation-face

Fu organ-large intestine
Zang-lung
Governing-skin
Opens-nose
External manifestation-hair

Gallbladder 
Liver
Tendons
Eyes
Nails

Stomach 
Spleen
Four limbs
Mouth
Lips

Bladder
Kidney
Bones
Ears,external genitals and anus
Hair

Question 26

State the treatments available under TCM

Under herbalism,herbs consists mainly of what? It is believed that herbs can do what?

Answer 26

• Treatments available under TCM comprise:
• Herbalism
• Acupuncture
• Moxibustion
• Cupping
• Massage Therapy
• Herbalism:
• Herbs consists mainly of natural medicinal materials such as plants, animal parts, and minerals of medicinal value.
• It is believed that herbs can help boost Qi and balance Yin/Yang.
• Each ingredient has unique characteristics.

Question 27

What does acupuncture involve
It is understood to flow along what ?
What can trigger illness?
How many nerve rich acupuncture points together create pathways of microcirculation and physiological action? How are blockages released and how is the body’s balance restored

Answer 27

Acupuncture:
• Acupuncture involves the stimulation of anatomical points
on the body with thin needle.
• It is understood to flow along 12to14 pathways called meridians, between and through the surface of the body (skin, fascia, muscle, bone) and its internal organs.
• An imbalance or disruption to this flow of energy can trigger illness.
• Between 365 to 2,000 nerve-rich acupuncture points that together create pathways (meridians) of microcirculation and physiological action.
• Stimulating these acupuncture points, zones and meridians is considered to release blockages and restore the body’s own balance.

Question 28

What is moxibustion? 
What is it’s purpose? 
What kind of methods are there? 
Which people is it used specifically for. 
What is cupping? 
What is their use? 
Give examples of materials used

Answer 28

Moxibustion:
• Moxibustion is a traditional Chinese medicine technique that involves the burning of mugwort, a small, spongy
herb, to facilitate healing.
• The purpose is to strengthen the blood and improve Qi flow.
• There are direct and indirect methods.
• Because it is used specifically for patients suffering from cold or stagnant constitutions, it should not be used on anyone diagnosed with too much heat.

• Cupping:
• Cupping therapy is a form of TCM in which cups are
placed on the skin to create suction.
• The suction of the cups mobilizes blood flow to promote the healing of a broad range of medical ailments.
• Glass, Bamboo, Earthenware

Question 29

Under prevention therapies,how is Chinese massage done and what does it do? What’s the Chinese name for Chinese massage?

What is Qi-gong?
What does it do? What are the types of Qiqong and with each type who performs it?

Answer 29

Prevention Therapies
• Chinese massage (Tui-na):
• Uses wave-like motions to loosen joints and nourish
muscles.
• Stimulates the flow of Qi, blood and body fluids.

• Qi-gong:
• Chinese form of exercise.
• It regulates the mind and breathing to promote the flow of Qi.
• External Qigong is performed on a person by a Qigong master
• Internal Qigong is practiced by oneself.

Question 30

Under prevention therapies,what is Tai-ji quan?
The study of the this therapy primarily affects what?
How long has meditation been practiced? What does it involve?
What is it used for ?
Which part of the world is it popularly practiced?

Answer 30

Tai-ji quan:
• Tai-ji quan is an internal Chinese martial art practiced for
both its defense training and its health benefits.
• The study of Tai-ji quan primarily involves three aspects:
• Health
• Meditation
• Martial art

• Meditation:
• Meditation has been practiced for thousands of years.
• It involves focusing on one thing, such as breathing patterns, while clearing all other thoughts from the mind.
• Meditation is used to replenish the flow of Qi, which helps to ward off illnesses.
• Meditation is also popularly practiced in western countries as a means of stress relief.