Traditional Chinese Medicine (TCM) is a relatively complex, codified healing system of medicine that dates back to the Western Han Dynasty (206 BC - AD 24) and beyond. It has always survived, no matter what political regimes prevail during a given time period. In the  first decade of the 21st century, the world-wide concept and challenge of integration pertains to the judicious combination of the best out of many medicines, including TCM and Western therapeutic systems and modalities.

Diagnostically, the TCM integrative initiative entails combining the various diagnostic techniques (such as the basic four qualitative approaches: inquiry, observation, palpation and ausculatation/olfactory) together with the normal biomedical procedures and protocols, including laboratory and scientific tests and specific measurements of a quantitative nature.

TCM is best known in Western settings through medical acupuncture. This therapy entails the freehand insertion of needles at specific locales on the surface of the human or animal body. Insertion is gentle and relatively shallow and almost innocuous, averaging 1.0-2.0 cm in depth in an oblique or perpendicular manner. Insertion may be accompanied by manipulations such as delicately tapping, twirling or vibrating the needles in order to attain various tonifying or sedating harmonizations.

The needles are a pre-packaged, sterilized, immediately disposable product. They are solid and filiform (thread-like), varying in length from 15-150 mm - 0.45-0.23 mm in gauge. The needles are smaller, thinner and much less invasive than the long, hollow biomedical hypodermic syringes. Due to their thinness and solidity, acupuncture needles create minimal soft tissue irritation and damage after being inserted, and there are few, if any, iatrogenic side-effects. Certainly, like all used medical products, they must be recycled in an environmentally safe manner according to the legal standards of the community.

The basic theory encompassing acupuncture therapy is the complementary opposition between Yin<=>Yang. Yin is cool and structural, manifested in the six 'solid' Zang organs<=>meridians (Heart, Pericardium, Liver, Spleen, Lung and Kidney), while Yang is warm and processual, manifested in the six 'hollow' Fu organs<=>meridians (Gallbladder, Stomach, Small and Large Intestines, Bladder and the Triple Energizer-upper, middle and lower central  body cavities). It is a system of Qi (vital energy) correspondences whereby the Zang and Fu are conjoined with and impact upon one another in terms of their internal physiological functions in transporting and transform-terms of human emotions in relation to the environment.

This entire, complex system of correspondences is generally known as the Five Elements theory. For example, the Heart (Zang) corresponds with the south, growth, Heat, Fire, red, bitter taste, summer, the tongue, joy and its Fu organ meridian (Small Intestine). It would certainly take any interested and devoted student several years of intensive study to appreciate and understand the permutations of this system.

Therapeutically, acupuncture and related techniques such as acupressure (application of finger tip pressure to acupoints), moxibustion (application of herbal heat to acupoints for tonification), cupping (application of suction cups to acupoints for sedation) and laser acupuncture (application of a concentrated but harmless beam of light to acupoints, which is a less invasive approach for those who fear needles). Acupoints are the gates on each organ<=>meridian where the Qi flow may be adjusted-either tonified or sedated-as necessary for each diagnosed condition or syndrome (pattern of Qi imbalance).

Generally, within the context of the TCM system, acupuncture works from the superficial level of the meridians to the deep level of the Zang Fu organs. Thus, it is an excellent approach for symptom/pain control and relatively rapid energy balancing. Dietetics and herbology work more slowly, from the deep level of the major internal (Zang Fu) organs to the superficial level of the meridians and their acupoints. Other approaches, notably Qi Gong and Tai Chi Chuan involve physical, mental and spiritual exercises that work from both directions at once.

TCM comprises a complex system of qualitative medicine which has passed the test of time. It is practised today as a vi-able complementary, integrative model. It is a holistic, natural approach, which is oriented toward self-care and preventive initiatives. Moreover, it encourages us to be more aware of nature and the positive energy of our natural surroundings, which is termed Feng Shui-TCM environmental medicine.

In the TCM system and in terms of the general integrative approach, patients are regarded as vital, equal partners in the healing endeavor. In TCM, integration involves judicious application of the central therapies such as acupuncture for pain control and energy balancing, dietetics to guide patients to eat properly according to the season and their physiopathological condition, herbology to maintain, strengthen and harmonize the Zang Fu, Qi Gong to realign the body mind and spirit, Tai Chi Chuan to balance one's total energy flow, An Mor Tui Na  massage/manipulation) to stimulate energy exchange between the patient and therapist and Feng Shui to enhance our appreciation of living in harmony with Mother Nature.

Overall, TCM looks at human health within the context of the healers and patients working together to balance the macro and microsystems of human energy in a harmonious spirit of symbiosis, mutual respect and compassion.

Dr Steven KH Aung is a geriatric and family physician and a Traditional Chinese Medical (TCM) practitioner and teacher. At the University of Alberta, Dr Aung is an associate clinical professor in the Departments of Medicine and Family Medicine and an adjunct Professor at the Faculty of Extension/Rehabilitation/Pharmacy. He is a World Health Organization advisor on TCM. Dr Aung was awarded a Professional Excellency from the Académie Diplomatique de la Paix in 1986, the Alberta Order of Excellence in 2002, and the Order of Canada in 2006. His primary interest is the integration of TCM and Western biomedicine within the context of a more natural and compassionate approach to primary health care.

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