The foundations of Traditional Chinese Medicine (TCM) are very different from those of Western medicine. It is a medicine that favors analogies, which has a broad and integrated vision of what it means to be healthy, and whose foundations were established long before the advent of scientific thought.

But, paradoxically, we have started to discover, in recent years, all kinds of concordances between the millennial empirical observations of TCM and the explanations of modern science, for example with regard to anatomy (interdependence of Organs, action of points acupuncture, etc.) and the determinants of health (diet, emotions, lifestyle, environment, etc.).

The methodology specific to TCM belongs to the approaches of the pre-scientific era which combined at the same time observation, deductions and intuition. TCM is therefore essentially based on an abundant literature exposing clinical cases and their resolution, on the clinical experience of practitioners, on the enlightened reflections of certain physicians and on various “consensus” between clinicians through the ages.

Despite the efforts made over the past thirty years to corroborate traditional assertions in the light of scientific research, we are far from having at our disposal all the elements to confirm or deny the results obtained by the traditional approach.

In the eyes of the scientist, the so old theoretical bases of TCM may seem naive and anachronistic. However, many concepts such as Theories on Substances, Viscera and Meridians remain perfectly useful and relevant in modern practice. In addition, several theories continue to progress and we obviously do not treat today in the same way as 3 years ago …

The naturalist schools behind TCM believed that the same basic building blocks weave the entire universe, and that the same laws govern both the organization of the human microcosm and the dynamics of the macrocosm around us. Chinese medicine has therefore applied itself to transposing the rules that it observed in the environment to the body. She identified correspondences and affinities between the organization of Climates, Flavors, Organs, emotions, etc .; for example, such Climate or such Flavor seeming to make react more particularly such organ or such tissue.

TCM has created empirical models that it has clinically tested and validated over time. She has developed a set of theories characterized by a certain syncretism, that is to say, a conception of reality as a whole rather than fragmented; an approach that is often very useful, but, it must be said, sometimes more or less coherent …

The richness and complexity of the links envisaged between all the elements that make up our world have led TCM to favor a systemic approach:

• comprising multiple grids which classify the influences of the environment and the components of our body according to their affinities;
• defining laws likely to describe, or even predict, the evolution of relations between our organism and its environment.

The Theories of Yin Yang and the Five Elements are the two cornerstones of this long process. But these are not strictly “medical” theories. They are part of a philosophy and a way of seeing the world with broad cultural, spiritual and social foundations. TCM has used these bases to develop its own theories regarding Meridians, the physiology of Organs and Substances, causes of disease, diagnoses and treatments. To use an image, let’s suggest that the Yin Yang and Five Elements Theories are two ways of transposing reality like a photographer would: Yin Yang in black and white, the Five Elements in color!

The Yin Yang approach proposes to represent reality as the play of two forces, light and shadow, which create infinite shades of gray. These two forces, one active and emitting (Yang), the other passive and receiving (Yin), oppose and complement each other as well in the human body as in the rest of the universe. Their opposition is the driving force behind all the changes we see. Their relations evolve cyclically, in a more or less predictable way, according to an alternation of phases of growth and decrease, like the light which increases from dawn to noon, then decreases until sunset. Applied to medicine, this theory describes the homeostasis of the organism in terms of opposing and complementary components, the disturbances, excess or insufficiency of which cause the appearance of symptoms of diseases. (See Yin Yang.)

Just as light can decompose into complementary colors, the Theory of the Five Elements suggests that we look at reality through five specific filters. All reality and all part of reality, from the alternation of seasons to the diversity of flavors, including the organization of Organs, can be seen through these filters. In the extension of Yin Yang, the Theory of the five Elements makes it possible to refine the study of the dynamisms present within the organism and to better describe the influence of the environment on our internal balance. This theory describes five seasons, five flavors and five climates which stimulate or attack the five organic spheres (the five great sets of organs and their spheres of influence) responsible for homeostasis in our body. (See Five Elements.)

TCM has never lingered on “dismantling” life, as scientific research has undertaken for several centuries, separating and isolating each part of the mosaic from living things as one dismantles and classifies the parts of a gigantic mechanism. TCM has privileged the general description of the movement of living systems which it tries to predict and influence changes to keep the patient in a state of dynamic equilibrium. The global vision that it has maintained – while pursuing rich and varied clinical experiments – remains surprisingly simple. It contrasts with the Western medical view where knowledge is so fragmented and complex that it is almost impossible for a single individual to grasp all of it.

We could say that today the challenge is not so much to prove the scientific value of Chinese medical theories, but to assess the relevance of the discoveries they have made it possible to make in the art of treating, curing. , to stimulate self-healing, to strengthen the organism, to compensate for deficiencies and to drive out certain pathogenic factors.

Of course, the diseases of the 100st century are not necessarily those described in ancient texts. AIDS, cancers, allergies, resistant bacteria and new viruses have taken place in our daily lives. The effect of drugs unknown even XNUMX years ago, such as vaccines, antibiotics, anti-inflammatory drugs or anti-anxiety drugs have helped many people, but have also created their own perversities through their sometimes abusive or reckless uses. The industrialization of food production methods, the diseases they create in animals (which are sometimes transmissible to humans), the unknown effect of genetically modified or artificially preserved foods, all of these new parameters are modifying the diseases that affect us. affect and question the relevance of a traditional approach such as that of TCM.

However, the solution to the disease invariably seems to lie in strengthening the immune system, good breathing, a varied and natural diet and exercises tailored to individual needs. In this area, TCM has not lost any of the relevance of its interventions, since Confucius valuing the preventive approach and the empowerment of the patient. The human body has changed little physiologically despite the dramatic changes in the environment. The stimulating action of massage, needles, heat, meditation, Foods or herbs (to name a few) still remains valid to strengthen the body’s responses and help it maintain its balance. .

Since the middle of the XNUMXth century, we have witnessed a modernization of TCM and the emergence of medical acupuncture which is developing in a Western and scientific context. This medical acupuncture is still very young, but is based on rigorous clinical research. These come from scientists who favor, among other things, neurophysiology to understand the regulatory processes triggered by acupuncture. These researchers describe the action of acupuncture according to models very different from those of traditional theories.

For example, the discovery of Clement and Jones1 in 1979 on the release of opioid peptides made it possible to explain the anti-inflammatory and pain-relieving properties of acupuncture other than according to the traditional model which states that the stimulation of certain points “unblocks the circulation of Qi and Blood in the Meridians ”. The work of various researchers has made it possible to describe several of the actions of acupuncture on the nervous and endocrine systems. Important syntheses report the results of this research2 to 4.

According to the modern biomedical model, most diseases are the result of a set of factors: harmful environmental influences, nutritional problems, psychological stress, hereditary predispositions, etc. Currently, several researchers hypothesize that acupuncture acts mainly on psychological stress. It would make it possible to modulate certain regulatory mechanisms such as the activity of the autonomic nervous system (sympathetic and parasympathetic) or of the hypothalamus, and to release neuropeptides, for example.

The decoding of the mechanisms triggered by the stimulation of the skin and subcutaneous areas through acupuncture is still in its early stages. An urgent need for clinical proofs must distinguish between what, in the action of acupuncture, relates directly to the physical stimulation of certain points of the body or then to the placebo effect. Research needs are enormous and the difficulty of finding funds remains the main obstacle to the advancement of knowledge.