Curious about TCM? Here’s all you need to know about traditional Chinese medicine

I’ve nothing against good old conventional medicine. However, at a time when the phrase «holistic health» is increasingly making the rounds, the lines between medical disciplines are becoming increasingly blurred. Symptoms can often be relieved by way of alternative therapies too. The alternative field distinguishes between traditional natural healing methods and standalone concepts such as anthroposophical medicine, Ayurveda or traditional Chinese medicine (TCM), which are based on a special way of conceptualising humanity, as well as a particular diagnostic system.

Admittedly, TCM is a broad field that’s initially very confusing to anyone unfamiliar with it. One of its fundamental concepts is qi – our life force – which, according to TCM, flows through our meridians. The other is Yin and Yang, a pair of opposites meant to be brought into lasting balance.

TCM? Let’s ask the real experts

On hand to explain what TCM is all about is Ching-Ling Tan-Bleinroth (site in German). As a doctor for general medicine, TCM, acupuncture and naturopathy, she’s a true expert. «I’ve always wanted to discover the medical practices of my ancestors. That’s why I qualified in TCM while I was doing my medical degree. At the same time, I set up a working group for Chinese medicine, which then branched out into a training course that still exists today,» she says.

«As a general practitioner, I combine conventional medicine, Chinese medicine and Western herbal medicine. This combination of different healing methods is also called Integrative Chinese Medicine (ICM). Basically, I use Western, European medicinal herbs according to the criteria of Chinese medicine, which gets a very good response. Another focus of mine is treating gynaecological disorders with TCM, particularly cycle disorders, such as endometriosis and PCOS (a metabolic disorder in women). I also treat infertility and symptoms associated with the menopause.»

In addition, I also quizzed Katharina Ziegelbauer about TCM-suitable diets. As a certified TCM nutritionist and author, she really knows her stuff.

What is TCM?

In ancient China, doctors were paid to keep people healthy, which is why Chinese medicine doesn’t just focus on treating illnesses – it also specialises in maintaining people’s health. This is one of the reasons why TCM has the so-called 5 pillars of healing: nutrition, exercise (e.g. qigong or tai chi), massage (tuina), acupuncture and herbal medicine. In Europe, Chinese medicine gained recognition in the 20th century, particularly around the 1970s, and continues to be very popular today. According to the WHO, it’s the most widely used alternative therapy in the world.

What’s different about TCM is that it’s based on the observation of natural phenomena, which are characterised and used to determine an appropriate therapeutic strategy. Terms such as qigong or Yin and Yang (for example, cold/heat, moisture/dryness) play an important role in this. The term «health» is defined as a dynamic balance of Yin and Yang, as well as a sufficient supply of qi flowing through the body.

Differential diagnosis in TCM: a treatment’s success is down to subtleties

If somebody has too little Yin, for instance, the Yang can be overpowering, manifesting itself in symptoms such as dryness, heat, sleep disorders or simply restlessness. Another example is exhaustion. In the West, we tend to think exhaustion is related to a deficiency of some kind. During a genuine qi deficiency, there really is too little energy, thus tonification work (strengthening of the muscles’ basic tension) needs to be carried out. Qi stagnation, on the other hand, is when a person has enough energy, but is unable to mobilise their qi, leading them to feel exhausted.

One way the latter improves is with physical exercise, as the qi leads to more energy as a result of active movement. Subtleties like these are exactly what characterises differential diagnosis within TCM. If differentiation is carried out in close accordance with the criteria of Chinese medicine, the treatment is much more likely to be successful. Because of this precise differentiation, treatment success is often very impressive; the more targeted the treatment, the more successful the therapy.

In China, every hospital has a TCM department. There, the discipline is just as deeply ingrained as any other medical specialty, and is also held in high regard. During the Covid-19 pandemic, both TCM and conventional medicine were used to treat the illness, with TCM firmly established in the Covid-19 treatment guidelines.

What happens during a TCM treatment?

The basis of any kind of TCM therapy is diagnosis. This is based on a very precise, detailed initial medical history, which is supplemented by tongue and pulse diagnostics. It’s using this foundation that the TCM syndrome and constitution present can be established, as well as the nature of the symptoms. There are more than 100 syndromes described in TCM. The next step is to determine the strategy and type of therapy. Every therapy aims to rebalance the Yin and Yang, and ensure that the patient’s qi or life force is at a sufficient level and free to flow through the body.

Options regarding the type of therapy depend on the person carrying it out. Acupuncture, herbal therapy and Chinese nutritional therapy tend to be the primary methods of treatment used in Europe. One crucial way TCM differs from conventional medicine is that therapy focuses primarily on determining the cause of an illness, not just on results.

Acupuncture involves stimulating so-called acupuncture points with sterile disposable needles. You only briefly feel the prick of the needle – it’s barely noticeable in comparison to being vaccinated or having blood drawn. Occasionally there’s a pulling, tingling or warm sensation. The needles are usually left in place for about 20 to 30 minutes and then removed. Most patients feel very relaxed during the process.

In addition to needle treatment, acupuncture points can also be warmed with moxa i.e. mugwort or stimulated with suction cups. In herbal therapy, medicinal herbs in the form of teas, granules or tinctures are prepared individually according to the patient’s needs and situation. There are special pharmacies for this, which have a section specifically for medicinal herbs.

Chinese nutrition therapy is mostly provided by TCM nutritionists. As is the case with medicinal herbs, they divide every food group according to the same criteria, for example qi or Yin and Yang. Patients are provided with detailed lists of foods beneficial to them and are given instruction on the necessary preparation methods. If sombody opts to get a TCM nutritional consultation, it needs to be made clear that doing so means making some lifestyle changes. After all, these influence our eating habits more than you’d think.

Who is TCM suitable for?

People of any age can undergo a TCM treatment or use it as a supplementary therapy. TCM doesn’t just play an important role in disease prevention, it’s part of so-called better ageing too. In China, the basics of TCM nutrition are common knowledge. It’s why, for example, most of its people typically eat hot food in winter and cold food in summer in order to stay healthy. Ways of maintaining health such as exercise are well established in China. You’re especially likely to see this in the mornings, when people take to the parks for qigong or tai chi sessions. In therapeutic settings, acupuncture and medicinal herbs are used especially often.

In which areas can TCM be applied?

An important rule of thumb is to get a conventional medicine diagnosis before beginning a TCM treatment, so that any illnesses that’d require different treatment can be ruled out. In principle, TCM can treat a large number of illnesses or complement conventional medicine. In China, there are specialists in TCM within all medical disciplines.

Here in Europe, acupuncture is best known as a treatment in the field of pain management, including for headaches/migraines or orthopedic complaints such as back or knee pain. But this particular form of needle work, as is the case with herbal medicine, can be used in a multitude of other areas. In gynaecology, it can be used for period pain or conditions such as PMS, endometriosis, PCOS (polycystic ovary syndrome) or menopausal symptoms. As for the respiratory tract, it’s used to treat chronic infections, bronchitis, hay fever or chronic sinusitis (sinusitis). Its dermatological applications include neurodermatitis, and in gastroenterology, it can be used to treat irritable bowel syndrome, chronic constipation or gastritis. However, TCM can also treat or supplement the treatment of exhaustion and sleep disorders.

What are the basics of TCM nutrition?

In a departure from what we’re used to in Western nutrition, in a TCM diet, the focus isn’t on the nutrients i.e. protein, carbohydrates or vitamins. Instead, it’s much more to do with the foodstuff’s energetic effect. It’s questions like: what cools us down and warms us up? Which foods have a moisturising effect and which ones dry us out? What perks us up? What calms us down?

Let’s say you often feel too hot or sweat during the night. In this case, you should avoid hot spices such as pepper or chilli, opting instead for cooling vegetable soups or green salads. The biggest difference to Western nutritional teachings is probably that in TCM, you eat much more cooked food and less raw food and bread. Why? Because of our so-called digestive fire. We can only absorb the nutrients in our food once it’s all been mushed together in our stomach. In TCM, this is when qi (life force) can be extracted from it. If it gets too cold in the stomach, for example due to cold drinks, yogurt and lots of raw food, digestion and thus also our qi, is weakened.

Over time, this results in all sorts of ailments, from flatulence to exhaustion (low qi means low energy), to edema, diarrhoea and frequent colds. The purpose of a TCM diet is to provide sufficient qi, i.e. life energy and to prevent diseases.

The most important dietary advice, which for most people is affordable to follow, is to

eat regular, mostly cooked meals, with more vegetables than usual. Pay attention to your digestion and don’t eat anything that gives you gas or causes other issues. TCM considers cooked breakfast to be especially worthwhile, whether it’s something sweet, such as porridge, or savory, such as eggs with tomatoes and mushrooms.

What does the TCM therapy process look like?

At the beginning of each treatment, a TCM medical history is taken. This is very detailed and usually takes an hour. Tongue and pulse diagnostics should be carried out at every appointment. Following this, the therapy plan is drawn up and there’s a discussion about whether herbal and/or acupuncture therapy is appropriate. An acupuncture session usually lasts about half an hour, with the follow-up conversation, pulse and tongue diagnosis lasting between 45 and 60 minutes. The number of acupuncture sessions varies from patient to patient, depending on the individual’s symptoms and illness. If the symptoms are acute, sessions are planned in quick succession e.g. once or twice a week. If they’re chronic, having sessions three or four weeks apart does the job, especially if medicinal herbs have been prescribed too.

How do I tell whether someone’s a real expert?

These days, numerous institutions offer training in acupuncture, medicinal herbs or TCM nutrition. In German-speaking countries, diplomas recognised by medical associations serve as important quality indicators. It’s also important to see whether a tongue and pulse diagnosis is carried out in addition to a detailed TCM medical history. Knowledge of TCM is in flux, so TCM therapists should be able to demonstrate that they regularly undertake further education and training.

In Switzerland, TCM courses are goal-oriented professional apprenticeships, leading to a qualification as a Naturopath with a Federal Diploma in Traditional Chinese Medicine TCM. According to the professional association for TCM, the federal diploma proves that profound TCM knowledge can be applied in a highly qualified manner. Services are covered on a pro-rata basis by health insurance if the patient has insurance for complementary medicine in addition.

What does science have to say?

A counter question would be: what about? TCM is multifaceted, encompassing fields ranging from exercise to medicine. This aside, even the World Health Organisation (WHO) recognised TCM as an official medical therapy in 2019. In 2015, the Nobel Prize in Medicine was awarded to Chinese TCM expert and pharmacologist Youyou Tu, who developed a malaria drug consisting of the secondary plant compound artemisinin. TCM is now a recognised therapeutic method and the subject of an ever-increasing number of studies.

In particular, there’s increasing scientific evidence for the efficacy of Western medicinal herbs, which are now becoming increasingly important in Chinese medicine. One of the most important books on Western medicinal plants in Chinese medicine was written by the biologist and TCM expert Jeremy Ross (link in German). In A Clinical Materia Medica, the author lists numerous studies for each medicinal herb, tackling topics such as ingredients, effects (including side effects, contraindications and interactions) and scientifically proven indications.

In addition, there’s impressive evidence of efficacy in the areas of fertility, Covid-19, anxiety among Parkinson’s patients, sleep disorders, and the support of breast cancer patients during chemotherapy.