Technical Terminology:

Toward a Deeper Understanding of TCM

I am occasionally invited to speak to groups or audiences about traditional Chinese medicine. Many have a vague understanding of or familiarity with acupuncture. Even fewer recognize acupuncture as part of a formal professional system of traditional medicine known as traditional Chinese medicine (or TCM) which uses and relies upon technical terminology in the same manner as engineering, law, aviation, or similar professions. The current standard professional terminology reference is a 900 page plus volume authored by two scholars; one a Ph.D. linguist (an Englishman), the other a Taiwanese born physician who holds licenses in both Western medicine and traditional Chinese medicine. Proper TCM diagnosis and treatment principles rest upon accurate translation and understanding of both classical (ancient) and modern terms. It is also important to explain technical concepts and terms to patients in a language they can use.

The Chinese thought system is one that emphasizes relationships. The ancient Chinese believed that all creation exhibited two fundamental aspects which they referred to as yin and yang (e.g., night/day; winter/summer; male/female; light/dark; moist/dry; hot/cold, etc.). While this pairing may suggest opposite polarities, each contains aspects of the other. Ancient Chinese culture observed this yin-yang pairing in the natural world. Because humans were seen as “between heaven and earth” (that is, part of the natural world), it was quite normal to observe these same yin-yang relationships in our own bodies and the relationship of our bodies with our environment.

Among the most important of the yin-yang pairings is that of qi and blood. The word “qi” has no direct English translation. But its Chinese character represents the vapor or steam rising from a pot of cooking rice, suggesting a fine, ethereal, subtle force. Qi has five essential functions: it generates (or produces), warms, lifts, moves, and protects (or defends). As the fundamental motive force of the body, therefore, qi supports conception, development, brain activity, digestion, proper immune response, the beating of our heart as it moves blood through the vessels, and many other functional activities.

Qi is function; blood is substance or material. Qi is said to be the commander of the blood, while blood is the mother of qi.

As for blood, we know from Western physiology that blood is composed of specific blood cell types, clotting factors, sugars, lipids, vitamins, minerals, hormones, enzymes, antibodies, and proteins. The primary function of blood is to nourish the whole body through the exchange of these nutrients and gasses (O2 / CO2). Various constituents of blood also protect against allergens, help fight infection, assist clotting, and help wounds to heal.

In TCM terms, blood (or xue) is substantive and viscous, unlike qi which is ethereal and highly refined. Blood is considered a vital substance and, more specifically, a yin fluid. It nourishes, moistens, and cools the body and it keeps the tendons and sinews supple. It is also essential to qi production. From the Chinese perspective, when the blood is sufficient and circulating properly, the complexion has luster, the hair is luxuriant, and there are few body pains. Conversely, withered hair and skin, tendon tightness, muscle spasms, and certain pain syndromes could suggest a pattern of blood vacuity.

Blood is also regarded as the material basis for mental activities (said in TCM to be controlled by the Heart; the term is capitalized here to recognize its different meaning in TCM). The Heart governs the blood and vessels and the mental activities controlled by the Heart mainly take Heart blood for their material basis. For this reason, a pattern diagnosis of blood vacuity might include listlessness, insomnia, dream-disturbed sleep, vague mind (Shen) or other mental disorders.

It is extremely important not to equate a given TCM technical term with its English counterpart because an English translation may or may not have the same meaning as a Chinese concept. In any professional field, terminology supports clarity, precision and a common method of communication. And those are very important in healthcare. With the expansion of TCM to the West, many early Western teachers and practitioners were neither expert speakers nor trained linguists in English or Chinese. As a result, English translation of many of the technical terms was haphazard. Fortunately, there is some good work now being done to correct this in order to make the English translations more accurate and more uniform.

It all gets to the rigor of our processes. I think there is a general misconception that TCM is kind of “new-agey” and mysterious. In point of fact – as is true with Western medicine – TCM rests upon accurate, sound diagnosis or, more specifically, pattern diagnosis. Accurate pattern diagnosis rests upon exact, precise terminology that has very specific meaning and which dictates what the practitioner must do and what he must not do in treating a given pattern. Pattern diagnosis is a distinguishing feature of traditional Chinese medicine.

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