Traditional Chinese Medicine, or TCM, is one of the oldest medical systems with a written history dating back almost 2,500 years. Traditionally, there are several branches of Chinese medicine including: meditation, diet, exercise, massage, acupuncture, moxa and herbal medicine. This system of medicine was created by some of the best educated and brightest scholars in Chinese history who have recorded their theories and clinical experiences from generation to generation in literally thousands of books. It is estimated that there are between 20-40,000 books still existing on Chinese medicine that were written before the turn of the century. Since then, thousands more books and articles in professional journals have been written and published in China, Taiwan, Singapore and Hong Kong. Currently one quarter of the world's population uses Chinese medicine.

As a holistic medicine, TCM strives to understand the relationship between the parts as well as the parts to the whole. Health and disease are considered within the context of the entire person including physical health, emotional well-being, lifestyle, environment and family history. TCM is based on the belief that the person is an energetic system which can be in constantly fluctuating and varying degrees of harmony and disharmony. Energy pathways called meridians or channels run throughout the body circulating vital "qi." This qi or chi, is also associated with the body's organs and can become Deficient, Excess, Stagnant or Rebellious.

TCM also recognizes that one's body is a part of nature and always in relationship to its environment. As in nature, the body's environment can be determined as too Hot or Cold, Dry or Damp, suffering from Summer Heat or Wind Invasion — the Six Pernicious Influences. TCM also considers the emotional landscape as a major factor in the body's energetic balance. Joy, Anger, Worry or excessive Thinking, Grief, Sadness, Fear and Fright — the Seven Emotions — have significant influence on a person's health. All of these things affect the balance of yin and yang in the body and the condition of blood and fluids and are all parts of the whole which the TCM practitioner carefully observes in perceiving a client's pattern of disharmony.

HOW DOES A TCM PRACTITIONER DIAGNOSE?

The TCM practitioner relies on the Four Examinations — looking, listening, asking, and touching — to diagnose patterns of disharmony. This is how signs and symptoms particular to each client are uncovered. Looking refers to all visual observation of the body's appearance and posture, facial color, skin condition, tongue shape, color and coating as well as observation of the client's "shen" or spirit.

Listening refers to the feeling of what is being said and how, to references and inferences, to what is not being said, to the feeling of what is being shared, to the way the client presents him or herself. It is an important job of the practitioner to truly listen to the experience of the client.

Asking refers to specific questions designed to give information about not only the condition but also possible disharmony patterns. For instance, "Are you hot or cold? Thirsty or never drink? Sweating? Evening or day? Have headaches or dizziness? Sleep soundly or wake at a certain time or can't get back to sleep?" There are just a few of the questions asked.

Touch refers to palpation of the abdomen (or "hara" as it is called), "alarm" points, acupuncture points, meridians, but primarily pulse reading. In TCM taking the pulse is a rather intricate art which can take a life time to perfect. It involves the feeling of energetic pulses — six on each wrist — as they correspond to the 12 Regular Meridians and 12 Organs. In feeling the quality of each of the pulses, if they are Full or Empty, Wiry or Thin, Floating or Deep, the practitioner gains further information about the energetic quality of the client's condition. While all of these Four Examinations are important, pulse taking and tongue diagnosis are considered the Two Pillars of examination.

Each branch of TCM, while sharing the same concepts, has its own art of technique and practice. In Five Element shiatsu a treatment plan is designed to respond to the dynamic of the disharmony pattern. Certain meridians, acupuncture points and combinations of techniques are chosen to help tone deficiencies, sedate excesses, and release stagnation of qi to build blood and/or to balance yin and yang. A shiatsu practitioner learns many standard forms of treatment for various disharmonies — treatment to build kidney yin, to smooth liver qi stagnation or to tonify lung qi, for example. These forms are used to treat conditions but also as beginning forms which are modified to suit the specific and changing patterns of the client. The shiatsu practitioner may use his or her hands, forearms, knees or feet to apply gentle pressure and stretching. Thumb pressure, palming and holding certain points along a handful of chosen meridians stimulates the body's energetic system to return to the smooth and harmonic flow of vital qi throughout the body. In this way, the natural healing abilities of the body are supported and encouraged. Healing can take many forms, expected and unexpected, in the physical, emotional and psychological realms. It may happen slowly or quickly. The TCM modality is not one of curing so much as one of collaborative discovery and support of the client's own healing process. The shiatsu treatment itself is generally very comfortable, gentle, relaxing and restorative. It is given with the client fully clothed, on a floor futon mat and takes about I and 1/2 hours including intake information.

The Five Elements or Five Phases refers to an additional way of thinking and diagnosis. In this system, the TCM practitioner considers the balance and interplay of these five energetic phases in the body: Fire, Earth, Metal, Water and Wood. Each of the Five Elements have many correspondences in the body: with the meridians, the yin/yang organ pairs, seasons, color, climate, a particular emotion and much more

These elements are seen as both qualities and functions in the body which, when in harmony, are equally balanced. When there is disease or disharmony in the body, it can be recognized as an imbalance between the elements. So, it is said that in health Fire nurtures Earth, Earth nurtures Metal, Metal nurtures Water, Water nurtures Wood, and Wood nurtures Fire, thus completing the Nurturing Cycle. Controlling and Insulting cycles are also recognized as well as specific patterns of disharmony. When a practitioner describes an illness as Liver Wood Invading Earth or Metal Failing to Nurture Water or Water Insulting Fire, they are thinking in Five Element terms. It is important to note, however, as in most TCM theory, the use of Five Elements theory is just one tool used by a practitioner to understand what is happening energetically with a client. It is not applied rigidly and is not always useful nonetheless, it can be an invaluable and even poetic way of observing the whole body of a client. Here are just a few of the classical Five Element correspondences:

Earth Spleen — Stomach, Yellow, Late Summer, Damp, Flesh, Pensiveness

Metal Lung — Large Intestine, White, Autumn, Dry, Skin, Grief

Water Kidney — Bladder, Black, Waiter, Cold, Bones, Fear

Wood Liver — Gallbladder, Green, Spring, Windy, Tendons, Anger

Fire Heart — Small Intestine. Red. Summer. Hot. Blood. Joy

For example, a client observed with a pale/white complexion, thirst, brittle hair, weak voice and difficulty breathing is likely exhibiting a Metal disharmony, and with further investigation the symptoms may have coincided with the death of a loved one. While this example is overly simple and neat, real people with real problems rarely are. In practice, the use of the Five Elements is a more richly textured and subtle investigation into the relationship and function all the Five Elements particular to each individual client.

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