As a practitioner of Chinese Medicine we often talk about how our medicine is a holistic approach to health and wellness. But what exactly do we mean by that? In my experience, I think there are two primary ways our medicine is holistic; the first relates to the underlying philosophy that defines Chinese Medicine, while the second has more do with the tools we use to inform both diagnosis and treatment. Unfortunately, the second aspect is often left out, at times, to the detriment of our patients.
In the first sense, “holistic” refers to the way in which Chinese Medicine thinks about the body when engaged in diagnosing and treating an imbalance. Chinese Medicine looks for patterns that permeate the entire being, rather than being symptomatic. It is for this reason that classical Chinese Medicine did not develop “Specialties” the way conventional medicine has. When I meet a patient and take a history I am looking at a constellation of symptoms that may even seem unrelated to the patient. This constellation, ultimately, refers back to the very essence of Chinese Medicine – yin and yang, and essential substances like blood and qi as well as other systemic considerations.
That’s not to say that there aren’t practitioners who have specialized (lowercase “s”) in treating certain conditions, such as fertility or pediatrics. In fact, given the vast amounts of modern biomedical concepts modern practitioners sometimes need to master and apply seeing a practitioner who has established a distinct focus to their practice can lead to improved outcomes. In spite of this, however, practitioners of Chinese Medicine assess a person for an imbalance that permeates their entire system, irrespective of the specific chief complaint or symptoms.
For example, I may have a patient who is seeking treatment for chronic headaches. My assessment will not be limited simply to the symptoms of the headaches, but to many other elements of the patient’s condition: how is digestion, sweating, tendency towards getting sick, emotional state, physical appearance, pulse and tongue, physical characteristics, etc.? If the patient is female, gynecological signs and symptoms would be essential as well. All of these give me an indication of the various issues at play and specific patterns of imbalance. But at its root, I am also able to determine very basic themes; is this excess or deficiency (or both); yin or yang,; is it more an issue connected to qi or blood? Once I can make a clear determination, I can prescribe the correct treatment. Since any imbalance affects the entire system (person), selecting the correct treatment will certainly have the benefit of relieving the initial chief complaint, in this case, headaches. However, many patients will also notice the improvement or cessation of other issues, such as poor sleep, menstrual issues, other pain conditions, etc. Again, this is because Chinese Medicine has diagnosed a pattern that is essential to the person, rather than being symptomatic.
It also worth noting that Chinese Medicine not only views the patient in their current state from a holistic perspective, but also applies a holistic approach as it relates to time. Illness or injury is rarely something that happens in the short term (with the exception of acute issues such as accidents). Rather, pre-existing weaknesses or repeated environmental exposures and internal conditions have built a framework in which illness can manifest. This is the patient’s story. With this in mind, a skilled practitioner can also discern the trajectory of disharmony that may eventually manifest if no intervention takes place. In this way Chinese Medicine seeks to be truly preventative.
Now for the second half of the holistic equation: The tools we use in diagnosis and treatment. What does it mean to be holistic in our choice of tools? In ancient times, physicians had a limited set of tools to employ for the benefit of diagnosing and treating their patients. There were no microscopes or MRI machines, X-ray machines or blood tests. Sophisticated surgical procedures, antibiotics, supplements or other treatments had not been discovered or developed. Physicians used whatever knowledge and “technology” was available at the time in order to best inform their diagnosis and treatment within the framework of Chinese Medical theory. I believe this is still relevant to practitioners today.
My training focus is primarily in acupuncture and for some patients acupuncture alone is sufficient to provide relief of their chief complaint. However, I am still aware that some conditions will benefit from additional treatment modalities such as diet, exercise, and herbal remedies. This perspective can also be extended to other medical models, such as conventional medicine. For some patients, receiving conventional medical treatments in parallel to Chinese Medicine can amplify the overall treatment effect and lead to better outcomes.
We can apply diagnostic tools in much the same way. Many diagnostic tests performed by western physicians are still relevant tools for the Chinese Medicine practitioner. The difference lies only in how the practitioner uses these tools. For example, a patient may indicate a diagnosis of anemia through blood tests that show reduced hemoglobin levels. In Chinese Medicine, observation is an important part of our diagnostic toolbox. As such, having access to the results of a blood test can be useful as one aspect of an overall picture of that patient’s pattern. However, it would be a mistake to make anemia our diagnosis and implement a treatment based on that. Within Chinese Medicine there are a number of patterns of illness with anemia-like symptoms, each with different treatments. So while practitioners may be able to use biomedical tools, they must be filtered through the lens of Chinese Medical theory.
Based on the above, it is important for practitioners to consider the many possible treatment options available to a patient and consider those within any treatment plan. For me, if I am unable to provide those treatments myself, then referral is warranted and encouraged. Remember, the goal is to provide the best care possible for the achievement and maintenance of health and wellness. In order to do this we must use the right tools for the job.
Ultimately, the value of looking at patients holistically can’t be over-stated. Patients are more than just their parts or anatomical and physiological systems that can be treated independent of each other. Using the model presented within Chinese Medicine allows for a more balanced and integrated approach to diagnosis and treatment that sees the patient as a unified organism inseparable from his/her environment – past, present, and future.