Fundamental Characteristics of Chinese Medicine

There are many important characteristics in Chinese medicine (CM), such as the concepts of yin-yang, five elements, meridian channels, zang xiang, jing, qi, shen, pulse, tongue, etc. However, among all these characteristics, only two are so significant that they are singled out and given the status of fundamental characteristics of Chinese medicine. The first characteristic is the concept of holism. The second characteristic is bian zheng lun zhi. These two fundamental characteristics permeate every field of Chinese medicine and differentiate Chinese medicine from Western medicine and all other medicines. These two characteristics lay out the foundation of Chinese medicine.
: 1. Concept of Holism

1.1 Introduction

The concept of holism views the various parts of the human body as an organic whole, emphasizes the harmony and coordination of the internal organs among one other and with other parts or structures, and also stresses the unity of the human body with the external environment. Structure and function are two basic properties of all CM concepts. The concept of holism is no exception. Therefore, the concept of holism can be further decomposed into two parts – structural completeness and functional unity.

* Structural Completeness -- Completeness addresses the structural aspect of the concept of holism. It requires that all parts and components of a system must collectively be taken into consideration in studying the system. It allows us to view the structure of the system as a whole. Without completeness, the holism will not exist.

* Functional Unity -- Unity addresses the functional aspect of the system under study. It requires that the composing components of the system should act synergistically. In other words, unity tells us that all components of the system function simultaneously and affect one another. It allows us to view the function of the system as a whole. Without unity, the holism also will not exist.

Structural completeness and functional unity collectively form the concept of holism. Holism and its constituent parts--unity and completeness--are the reflection of ancient Chinese Materialism and Dialectics philosophies (see chapter two for detailed information on Materialism and Dialectics). Chinese medicine became holistic as a result of Chinese philosophy.

Holism is the most fundamental leading concept in Chinese medicine. Holism directs CM diagnosis, treatment, and all other CM procedures. Holism lies at the core of CM methodology and epistemology. It exists in CM physiology, pathology, diagnosis, differentiation, treatment, and all other CM concepts and theories. In application, the concept of holism can be further broken down into two areas. The first is the holism within the human body. The second is the holism between the human body and nature.

1.2 Holism within the Human Body

When the concept of holism is applied to the human body, it stresses that all organs and constituents of the human body are not isolated. These organs and constituents will influence each other in physiological conditions and pathological processes. When one part of the body becomes diseased, other parts of the body or even the body as a whole will be affected. As mentioned above, the holism within the human body also can be decomposed into two parts. The first part is the static structure of holism, and the second part is the dynamic function of holism.

(a) Structure of Holism within the Human Body

The static structure of holism within the human body is achieved by several structures within the body. The first structure is the communication structure. In Chinese medicine, the human body is composed of a very complicated network of connections, which spread throughout the entire body. This network of connections is comprised of channels, collaterals, and their branches. Channels are analogous to interstate highways; collaterals are the local roads. They share the function of distributing qi and blood throughout the body. The human body has twelve regular channels and thousands of collaterals.

Channels distribute qi and blood to the main parts of the body; collaterals cross-link each other and distribute the qi and blood to the smaller areas all over the body. Channels and collaterals have many functions inside the human body. The twelve regular channels route and connect the upper and lower parts of the body. They also link the interior and exterior parts of the body. The channel and collateral system provides the foundation of communication structures for holism within the human body.

The second structure of holism within the human body is the organ structure. In Chinese medicine, the organs of the human body are classified into two categories. Some organs are classified as zang organs[1]; others are classified as fu organs. The zang organs include the liver, heart, spleen, lung, kidney, and pericardium. The fu organs include the gall bladder, small intestine, stomach, large intestine, urinary bladder, and tri-jiao[2].

Different organs play different roles in the holistic structure of the human body:

* The five zang organs stand as the center of the body's holistic unity structure. .

* The peripheral structures of holism include the six fu organs; the five body constituents (tendons, vessels, muscles, skin, and bones); the five sense organs (eyes, tongue, lips, nose, and ears); the orifices[3] (two eyes, two ears, two nostrils, the mouth, the urethra, the anus, and the vagina); the four extremities (the limbs); and the skeleton and bones, etc.

These various organs and structures are closely related, orderly, and cooperative. They establish a unity of connection within the body from the external to the internal, from the left to the right, and from the top to the bottom. They maintain the activity of life through the body’s essence, qi, blood, and body fluid. The unity structure maintains the equilibrium[4]between all the yin-yang pairs inside the human body.

The holism within the human body provides a foundation for all the physiological and pathological relationships inside the human body. For example, one internal-external pair in CM is comprised of the liver and eye. The liver refers to the liver system, and the liver opens at the eye. This means that the liver has an orifice at the eye to open to the universe. Therefore, the physiological functions and pathological processes of the eye will be closely related to the liver. Another example of an internal-external pair involves the lungs and the nose, with the lung system opening at the nose. As a result, the physiological functions and pathological processes of the nose are closely related to the lung system.

(b) Function of Holism within the Human Body

Based on the above structural basis of holism, the dynamic, physiological function aspect of holism is achieved in four ways within the human body. First , it is achieved by the physiological function of organs. In other words, the body’s physiological processes are accomplished through the normal functions of each individual organ. Western medicine focuses exclusively on this point. This is the common aspect between Western medicine and Chinese medicine.

Chinese medicine, however, does not stop at the level of the physiological function of each individual organ. Instead, Chinese medicine has gone beyond this level and has included additional, unique properties as described below.

Second, the physiological function aspect of holism is achieved by the synergistic action of organs. In CM, the body’s physiological process is also dependent upon the synergistic action of the zang-fu organs. This is based upon the holistic structure of the human body in CM, in which organ-pairs have very close relationships between each other. Zang-fu organs assist, compensate for, facilitate, and supplement one another to accomplish more advanced physiological functions inside the human body.

Third, the physiological function aspect of holism is achieved by the restriction action of organs. In other words, the body’s physiological process is also dependent upon the restriction action between zang-fu organs. This occurs when organs oppose but complement one another. The restriction function is critically important in balancing the physiological activities in the body, preventing them from over-action, and ensuring the achievement of dynamic equilibrium within the body.

Fourth, the physiological function aspect of holism is achieved by the governing function of heart within the human body. Chinese medicine recognizes that the physiological process of the human body is governed by the heart. In CM, the heart is referred to as the monarch organ. The monarch organ oversees all of the other organs, which further govern the dynamic physiological equilibrium within the human body. In addition to governing all other organs, the heart also governs the mental activities. This reflects the crucial concept of unity between mind and body in Chinese medicine.

Theunique properties enumerated above distinguish Chinese medicine from other medicines, and enable Chinese medicine to become a more complex, more comprehensive, and more advanced holistic medicine. As a result, they provide the basis that allows Chinese medicine to achieve much better therapeutic outcomes in many disease and illness treatments.

(c) Relationship between Holism and other Concepts

The concept of holism, as the most fundamental characteristics of CM, is closely related to the yin-yang, five elements, and all other concepts and theories in CM. Here we will concentrate on its relationship with yin-yang and five elements.

* Yin-yang – In CM, all organs and body components are classified into either the yin or yang category. Yin-yang possesses the properties of mutual oppositeness, mutual dependence for existence, mutual elimination/growing, mutual transformation, and mutual coordinating. These properties ensure that different organs and body components interact with each other synergistically, collectively, and holistically. Therefore, these properties provide the basis for holism within the body.

* Five Elements – In CM, all organs and body components are classified into one of the five element systems, which match the five organ systems. The five elements possess the properties of mutual generation, restriction, subjugation, and reverse restriction. All of the organs share the functions of mutual coordination and mutual restraint. These functions operate in close cooperation. They form a feedback control system that is the foundation of the holism within the body. These properties establish close relationships among the organs, and provide the basis for the holism of the human body in physiological conditions and pathological processes.

The CM concept of holism within the human body has been proven by more and more contemporary sciences. The existence of the feedback control system — one of the foundations of holism – has been proven in modern physiology, immunology, molecular biology, and genetic engineering.

1.3 Holism between the Human Body and Nature

Human beings do not live in a vacuum, but in an environment. The interaction between the environment and the human body plays a very important role in determining a person’s health condition. Nature is the source of life. According to CM, human beings live on the qi from heaven and earth, and on the foodstuff and food essence. Any change in nature will directly or indirectly affect the human body.

Holism not only concentrates on the inside of the human body, but also on the human body and the nature as a whole system. At this higher level, holism focuses upon the interaction between the entire organism and the environment. Holism pays great attention to the body's overall function and reaction capability. Reaction capability is the body's response to outside information, energy, or material inputs.

The holistic relationship between human and nature has been reflected in CM meteorology, CM time biology, CM geography, CM universe medicine, etc.

(a) CM Meteorology

CM meteorology is a branch of Chinese medicine concentrating on the effects of the climate and weather on the physiological functions and pathological processes of the human body. Based on CM meteorology, diseased conditions will change according to the four seasons, weather, and climatic conditions, etc. This provides us with more clear patterns of different disease activities under different meteorological situations. For example, according to CM meteorology, asthma more likely occurs in the winter.

(b) CM Time Biology

CM time biology is a branch of Chinese medicine concentrating on the effects of different times on the physiological functions and pathological processes of the human body. CM has divided the century, year, month, and day into different yin and yang categories. For example, the time period from sunset to midnight is considered the yin of the yin. The time from midnight to dawn is the yang of the yin. The time between dawn and noon is the yang of the yang. The time from noon to sunset is the yin of the yang. This provides us with more clear patterns of different disease activities at different times. For example, according to CM time biology, heart attacks are more likely to occur in the early morning.

(c) CM Geography

CM geography is a branch of Chinese medicine concentrating on the effects of different locations on the physiological functions and pathological processes of the human body. Based on CM geography, people living in different areas will generally have different tendencies in contracting various diseases. This is actually the pioneer of environmental medicine. CM geography includes not only the common living environment, but also all other geographic factors that might affect a person’s health. This provides us with more clear patterns of different disease activities at different locations or in different environments. For example, people living in an inland area tend to experience a higher incidence and prevalence of goiter than people living close to the sea.

(d) CM Universe Medicine

CM universe medicine is a branch of Chinese medicine concentrating on the effects of astronomic phenomena and activities on the physiological functions and pathological processes of the human body. Based on CM universe medicine, the astronomic activities of the universe will affect the earth environment, which in turn will affect the physiological functions and pathological processes of the human body. This provides us with more clear patterns of different disease activities under different stages of astronomical activities. For example, some mental diseases more easily occur during an eclipse.

The holism between human and nature is unique to Chinese medicine. It has provided the basis for the establishment of very important therapeutic principles in Chinese medicine: treatment based on time, location, and the individual. This last therapeutic principle--treatment based on the individual--has lead to another fundamental characteristic of Chinese medicine: bian zheng lun zhi, which will be discussed in section 3.2.

In contrast to the Chinese medical viewpoint, which embraces holism, the Western medical approach is primarily analytical. An analytical approach is by nature reductionistic. Both holistic and analytical approaches have their advantages and disadvantages. Great gains have been made in Western medicine by way of the analytical approach. However, when the Western medicine becomes reductionistic, it loses holism. As a result, Western medicine has lost many of the significant advantages that the holistic approach and the holistic medicine can offer.

Chinese medicine, however, has provided many of the advantages of holistic medicine. As the most time-tested, systematic, comprehensive, and complete holistic medicine in the world, Chinese medicine has influenced the development of most branches of Complementary and Alternative Medicine (CAM) in the world. For this reason, Chinese medicine is in a special leadership position in the CAM family.

2. Bian Zheng Lun Zhi

In addition to the concept of holism, bian zheng lun zhi is another fundamental characteristic of Chinese medicine. It is the fundamental principle permeating throughout CM diagnosis and treatment. In fact, all CM clinical processes can be summarized as bian zheng lun zhi. Bian zheng lun zhi does not exist in other medicinal systems. It is a very unique fundamental characteristic of Chinese medicine. In order to understand bian zheng lun zhi, it is first necessary to introduce several basic CM concepts.

2.1 Zheng

Zheng is a pathological summary of the body’s health condition at a certain stage in the disease process. Zheng is not limited merely to signs and symptoms. It includes all signs and symptoms and many other significant aspects of the disease process. Concretely speaking, it includes all clinical information of the disease at the disease’s particular stage, such as the disease’s cause, mechanism, location, nature, and developmental tendency, in addition to all the signs and symptoms. Signs and symptoms reflect a disease's phenomena. In comparison, zheng reflects the body's overall self-regulating ability and its relationship with the outside world. Zheng is more complete, systematic, fundamental, and accurate in revealing the essence of the pathological process of a disease.

2.2 Bian Zheng

The bian zheng is to analyze and summarize the information obtained from the four diagnostic methods (inspection; auscultation and olfaction; interrogation; pulse-feeling and palpation[5]); differentiate the disease's cause, nature, location, and the relationship between xie and zheng qi; and generalize and conclude the specific type of zheng. In Chinese, xie means “evil.” Xie includes any pathogenic factors that can cause disease, such as mood (i.e. anger), exopathogens, or internal causes of disease. Zheng qi is the body’s capability to defend itself from contracting a disease. It is a concept broader than the immune system of Western medicine.

2.3 Lun Zhi

The lun zhi aspect of bian zheng lun zhi has the function of establishing therapeutic principles and treatment methods based on the result of bian zheng. Bian zheng is the premise and basis for lun zhi. Lun zhi is the goal, the realization, and the test of bian zheng. Bian zheng and lun zhi are two closely correlated, inseparable steps used in diagnosis and treatment. In combining bian zheng and lun zhi together one will get bian zheng lun zhi, the second fundamental characteristic of Chinese medicine.

2.4 Bian zheng lun zhi

Bian zheng lun zhi is the summary of the complete process of diagnosing, analyzing, understanding, and treating a disease in Chinese medicine. In practice, it is the concrete application of various CM procedures including both CM theory and methodology. The therapeutic outcome can test whether or not the bian zheng and lun zhi are correct. If either bian zheng or lun zhi is incorrect, the outcome will be incorrect.

2.5 Properties of Bian zheng lun zhi

There are four primary properties of bian zheng lun zhi in diagnosis and treatment: (a) patient differentiation, (b) stage differentiation, (c) method differentiation, and (d) disease differentiation.

(a) Patient Differentiation

Bian zheng lun zhi requires that each individual patient should be diagnosed and treated individually. It focuses upon patient individuality, and stresses the significance of differences between each individual patient. It pays much attention to the special conditions of each individual patient, including both the specific disease and the specific zheng.

This custom-tailored diagnostic and treatment approach of bian zheng lun zhi ensures that CM will achieve much better therapeutic outcomes when the bian zheng lun zhi are carried out appropriately.

(b) Stage Differentiation

Bian zheng lun zhi requires that the same patient should be diagnosed and treated differently at different stages of the disease process. It stresses that different patients will have different zheng at different stages, and thus the treatment should be adjusted accordingly at different stages. Thus, it emphasizes the dynamic property of Chinese medicine. This dynamic property of Chinese medicine ensures that the patient will receive the most effective and safest treatments when the bian zheng lun zhi are carried out appropriately.

(c) Method Differentiation

In CM, every disease classified by Western medicine will be further classified into different types and subcategories. Bian zheng lun zhi requires that the doctor of Chinese medicine (CMD) may have to use different methods to treat the same disease. This is by virtue of the fact that the diseases are more distinctly differentiated through a more comprehensive and detailed process in CM. This property also reflects the fact that Chinese medicine provides a detail-oriented and very accurate medicinal system.

(d) Disease Differentiation

Bian zheng lun zhi stresses that, when applicable, it is appropriate to treat different diseases with the same therapeutic principle. This is because when diseases are differentiated as having the same zheng, they can be treated with the same therapeutic principle. This property is unique to Chinese medicine. It reflects the flexibility and versatility of Chinese medicine in disease diagnosis and treatment.

Bian zheng lun zhi lays out the right direction for CM diagnosis and treatment. It provides great advantages, and allows Chinese medicine to diagnose and treat diseases at a holistic level. This in turn provides the basis for Chinese medicine to achieve better therapeutic outcomes than can be achieved by purely sign-and-symptom oriented medicines. Therefore, bian zheng lun zhi is a concept unique to CM that differentiates Chinese medicine from Western medicine and many other medicines. Bian zheng lun zhi also reflects the CM principle of combining together theory and practice. Chinese medicine is not just theory alone or practice alone. CM is a medicine that combines both theory and practice together for diagnosis and treatment of diseases. All theory in CM has come from practice, and all theory is applied back to practice. No theory in CM was developed for theory's sake. The combination of theory and practice is one of the historical reasons that CM never decayed in its long history. Instead, CM continues to thrive and become more and more effective, popular, and influential.

During its long history, CM has influenced the development of many medicines around the globe. Most medicines in Asian regions (e.g. Japan, Korea, Tibet, Vietnam, Taiwan, Hong Kong, Singapore, Mongolia, Malaysia, Philippines, etc.) were directly branched from or influenced by CM. Through the Silk Road and other cultural exchanges, CM has been exported to Europe and other continents hundreds and thousands of years ago, and influenced the development of medicines (e.g. Chiropractic, Physical Therapy, Homeopathy, Naturopathy, etc.) in regions outside Asia.Due to this reason, Chinese medicine is in a unique position in the Complementary and Alternative Medicine (CAM) family.

3. Conclusion

The concept of holism is the dominant premise of Chinese medicine. The bian zheng lun zhi is based on and developed from the concept of holism. However, due to its special importance, bian zheng lun zhi has been singled out from all other CM characteristics and given a position parallel to that of holism.

The concepts of holism and bian zheng lun zhi are cornerstones of Chinese medicine. They have laid down the foundation for CM to become a complex, integrative, and dynamic medicinal system, as opposed to an analytical, simple, and static medicinal system. The two fundamental characteristics of CM, holism and bian zheng lun zhi, enable Chinese medicine to endure the test of time, adapt to new challenges (such as AIDS, as well as many challenges in the long history of CM), and remain an outstanding medicinal system in the world for thousands of years. Holism and bian zheng lun zhi are the quintessence of Chinese medicine.

Acknowledgements
　
The author would like to thank Dr. Chun-Su Yuan, MD, PhD, Director, Tang Center for Herbal Medicine Research, University of Chicago for valuable feedback on the article. Thanks also to Mr. Hovey Williams, III, M.S., L.P.C., The Safe, for editing the article.

[1] In Chinese medicine, the pericardium is regarded as an attached organ to the heart. Therefore, zang organs are usually referred to as the five zang organs. In actuality, there are six zang organs corresponding to six fu organs.

[2] The tri-jiao is a special organ in Chinese medicine that is not recognized in Western medicine. The tri-jiao is a product of holism. The tri-jiao is the entire organ system considered collectively. Since all of the organs function interdependently according to holism, and each organ affects all of the other organs, one must also consider the whole organ system as an organ. This total organ is called the tri-jiao.

[3] For historical reasons, in most Chinese medical textbooks, the orifices are usually referred to as the ‘nine orifices.’ There are ten orifices for women, however, with the inclusion of the vagina. The authors have chosen to eliminate the number altogether, and to simply refer to the ‘orifices,’ in order to include both men and women, with the understanding that men have nine orifices and women have ten.

[4] In most English translations of CM textbooks, the term ‘balance’ is used. ‘Balance’ implies a stasis state. The actual process in Chinese medicine, however, is a dynamic state. Therefore, the term ‘equilibrium’ is more accurate in describing this dynamic process because it connotes the activity of constant change, which results in a dynamic equilibrium.

[5] Due to historical reasons, Chinese medicine named the diagnostic methods as “four diagnostic methods” because “auscultation” and “olfaction” are one word in Chinese, and “pulse-feeling” and “palpation” are also one single word in Chinese.


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