TCM for Life Cultivation and Rehabilitation

Life cultivation is to achieve the purposes of conserving health, preventing diseases, enhancing health, and prolonging lifespan by means of various healthcare measures such as cultivating the mind, regulating the diet, exercising the body, moderating sexual life, adapting oneself to cold and heat, and utilizing acupuncture, moxibustion, tui na (Chinese medicine manual therapy), herbal medicine, and cupping. In short, all the activities of promoting health and prolonging lifespan belong to that of health preservation.    

Rehabilitation is to improve the life quality of patients suffering from sequelae of an illness and people with disabilities by treating the functional decline or dysfunction of the body due to various congenital or postnatal factors by way of mental regulation, proper diet, physical training, and Chinese medicine treatment modalities such as those mentioned above (i.e. acupuncture, herbal medicine, etc.).

Health and Longevity is the purpose of Life Cultivation and Rehabilitation.

So how does TCM achieve this? To answer that question, we have to first look at what affects our health and longevity.

TCM theory believes that humans and the universe (nature) are one and therefore one’s vital functions (physiology) are inevitably influenced by the environment. That is why all activities of the human body have formed a pattern similar to that found in nature. Hence TCM life cultivation and rehabilitation follow the pattern of natural changes to adjust to the changes in time, space, seasons, climate, etc. 

The environment that we are talking about here is not just limited to the natural environment but also a social environment. This is related to how the spirit and physical body cannot be apart. The mental stress that comes from being in a disharmonious relationship with other human beings can eventually affect our physical health. This is also why TCM regulates psychological disorders via visceral movement. Likewise, physical illnesses may be treated with psychological therapeutic methods.

TCM theory stresses the significance of harmony and balance. With TCM life cultivation there are various methods, but it emphasizes comprehensive utilization of all of them so that there is a balance (no partiality). Therefore harmonization of clothing, shelter, and food are all important in the prevention of and rehabilitation from diseases.

In talking about lifespan, we need to talk about what is essential to life.

This constitutes Jing (Essence), Qi (Flow of Energy), and Shen (Spirit). These are basic substances essential to the vital activities of humans.

Jing is the basic material constituting the physical body, it also governs the growth and development of the human body and is involved in vital functions of the body and the mind. Jing is divided into congenital Jing and acquired Jing. Congenital Jing is inherited from the parents. After birth, the nutrition coming from food creates the acquired Jing. Congenital and acquired Jing can transform into each other. If Jing is deficient, vital functions of the body decline because Jing transforms into marrow which fills our brain and the bones. With a lack of brain marrow, one’s mental function declines. With a lack of bone marrow, one’s physical function declines. As Jing also governs the growth and development of the human body, without Jing one cannot reach sexual maturity and thus reproduce.   

Qi belongs to the classical philosophical category, where it is referred to as the basic element which constitutes everything in the world. It is, however, different from atoms which the modern world thinks is the basic constituent of things. Personally, I understand Qi as a “flow of energy”, as opposed to something that is stagnated or immobile. The sufficiency or deficiency of Qi determines the strength of the life force and the length of the lifespan. So when we say that you are Qi deficient, it means that you are lacking stamina or energy. When we say that you have Qi Stagnation, it means that Qi flow within you is inefficient and because Qi governs the flow of your Blood too, it can result in something like a circulatory system disorder.  

Shen is a term which is used to describe the manifestation of your vital activity that results from Jing and Qi. This manifestation includes all that has to do with your mental activity, such as consciousness, thinking, judgement, comprehension, and memory. Blood, which was not mentioned yet also forms the material foundation of Shen. Sufficient Jing and Qi bring on clear Shen which can be observed from the eyes and the way one expresses oneself. When treating dementia, the theory of Shen is used to explain and come up with treatment principles. 

When all of Jing, Qi, and Shen are harmonious and they form the basis for your visceral function, your body is healthy, ageing is delayed, and thus lifespan is extended.

According to the biological laws found by observation of animals, ancient medical professionals believed that the normal life span of humans is between 100 – 120 years. This was based on the calculation that the lifespan of mammals is 5 – 7 times the period of growth. The period of growth is defined to be until the emergence of the last tooth (the last molars or the wisdom teeth grow out around the age of 20 – 25).

However, we know that most people don’t live that long. The shorter lifespan can be attributed to natural and anthropogenic calamities, poverty, and diseases. Out of these, disease is the main factor affecting the lifespan. Therefore, preserving and restoring health from diseases is the essence of longevity.

We can judge whether one’s body is healthy or not by inspecting their Shen (spirit). The signs of “having a spirit” are sturdy appearance in general, neither fat nor thin body shape, black and lustrous beard and hair, ruddy complexion with delightful expression, expressive eyes full of vividness, calm respiration which is neither rapid nor slow, good appetite for three meals in a day, hard and rooted teeth without cavities and injuries, accurate sense of hearing without tinnitus, loud and clear voice, flexible waist and legs without pain or soreness, smooth urination and defecation with normal discharges, red tongue with a thin tongue coat, and an even and slow pulse. We can see here that a good spirit in TCM is not just limited to the psychological state, but also a physiological one. There is a close relationship between the two states. In fact, we see seven emotions to be an etiology to visceral pathology and we attribute emotional regulation and happiness to good visceral functions.

When we look at the definition of a good spirit, and therefore a healthy body, it is the opposite of ageing precisely. While ageing is the natural law of the human life course, reasonable health preservation measures can delay physiological ageing to prolong the lifespan. As we mentioned above, health is the key to longevity. Then the things that stray us away from health are the catalytic factors of ageing. These factors will be described from here on.

A deficiency of Jing (essence) and Qi (flow of energy) will imperatively lead to premature ageing because of their involvement in vital activities. Jing and Qi can be deficient from congenital insufficiency (didn’t receive a lot from one's parents to begin with), or become exhausted from excessive sexual intercourse, diseases, physical overstrain/overwork, etc.

Malnutrition can cause a deficiency of Qi and Jing as they both become generated from some form of material or fuel, like food. Malnutrition actually includes two aspects. One is insufficient ingestion of food, the other is malabsorption of nutrients. In modern developed countries, the former is rarely seen, and the latter is more common.

Each organ inside our body is responsible for specific functions of the body. This is why we often give the location of the Qi and Essence pathologies in the name of an organ. E.g. Heart Qi Deficiency. Impairment of organs therefore impedes the function of our body and leads to premature ageing. The heart houses the Shen and its Qi governs the blood circulation. Therefore if the heart suffers from disease, blood circulation and mental function will be affected. The liver stores Blood, regulates its volume, ensures control of emotions, and promotes digestion by regulating/freeing the Qi movement. If the liver suffers from a disease, the physiological functions of Blood, emotions, and digestion will all be affected. The lung dominates the Qi of the whole body. This is different from the liver’s function of regulating its movement as it governs the direction of the Qi movement. Therefore lung disease will impact the function of the entire body, causing symptoms like lack of endurance to physical labour and gradual functional decline of respiration and blood circulation.  

As mentioned above, emotions can be an etiology of diseases. Persistent emotional stimuli or a sudden, traumatic type of stimuli can cause disorders of Qi and Blood, as well as directly disturb the organs.

The imbalance of work and rest can also cause premature ageing. Overstrain and overrest are both harmful to health. Overstrain refers to all of excessive mental labour, physical labour, frequent sexual intercourse, excessive food intake, excessive recreation, and excessive exercise. As we know from medical news these days, too much rest without stimulating mental and physical activities is also not helpful for our health.

The environment that we live in is also important to our health as was mentioned in an earlier post. This includes both the physical environment and the social environment. Historically, TCM scholars have observed that residents in mountainous regions with cold climates have a longer life in general than those who live in flatlands/low-lying lands and regions with tropical climates. This is related to how we see a tree’s annual ring is larger on the south side. People grow older faster when exposed to more sun. Whether one lives in a city or rural area should also be considered. Various forms of pollution in cities (air, soil, noise pollution) harm the human respiratory system, disturb neural activities, deteriorate hearing and so on. The social environment which can pose stress is another factor in premature ageing. Negative social environments such as poverty, low social status, warring state, competitive work or study environment, complicated interpersonal relationships, etc. can cause harm to our viscera via their relationship with emotions.

In TCM, the holism concept of seeing humans and the universe as one is important. According to this concept, all human vital functions are closely related to nature (nature affects what goes on in our body). A man should keep harmony with nature at all times. As a result, all the methods in life cultivation are the embodiments of conforming to nature, such as conforming to seasonal and climatic changes as well as geographical differences, etc.

Each season influences our body differently. In spring and summer, Yang Qi is released, and Qi and Blood tend to reach the bodily surface easily. Because of this surfacing, skin becomes looser which allows sweat to come out. These points can be viewed as Yang in property. In autumn and winter, Yang Qi becomes constricted and stored in contrast. Then Qi and Blood tend to go inwards and so our skin becomes tight, making sweat scanty, and the urine becomes profuse instead. These points can be viewed as Yin in property. According to this seasonal pattern, one should avoid eating too much hot-natured, spicy food during the spring and summer as that could lead to the overrising of Yang, and likely avoid eating too much cold-natured, raw food during the autumn and winter as that could lead to excessiveness of Yin. Seasons also directly influence our organs. This looks like a relative excess of Qi and Blood in specific organs and their directly linked meridians & collaterals in different seasons. For example, in spring, there is a relative excess of Qi and Blood in the liver. In summer, the relative excess is in the heart. In late summer, this is in the spleen. In autumn, in the lungs. Lastly, in winter, it is in the kidneys. Application of this principle can double the result while halving the effort for life cultivation or rehabilitation treatment. Therefore, seasonal changes should be taken into account for modifying the herbal medicine or selecting acupoints for acupuncture/moxibustion/tui na to achieve more effectiveness.

As we know the climate differs with differences in geography, geography also affects the principle of life cultivation and treatment that should be applied. Treatment in accordance with geographical conditions is also important because people in different regions differ from one another in physique and susceptibility to diseases due to their adaptation to their specific geography.

Conforming to society is another principle of conforming to nature. Healthy and long-living people have been shown to have an optimistic and positive perspective of the world. Having a pessimistic view of the world will cause anger in us, which in turn damages our organs. In fact, there even is a saying in the classic Yang Sheng Yao Yu (Essential Words for Life Cultivation) which says “If one smiles, one will become a little younger. If one is angry, one will become a little older. If one struggles with others, one will get a little thinner. If one yields, one will become a little stronger.”

When we talk about holism, we also cannot exclude the unity of physique and spirit. Physique & spirit or body & mind have a mutual relationship where they supplement each other. Physique is the material base of spirit. This is because TCM theory states that the five types of spirits (spirit is divided into vitality, soul, vigour, will, and consciousness) and five of the seven emotions (joy, anger, sorrow, anxiety, and fear) originate from the five zang organs (liver, heart, spleen, lung, kidney). Spiritual disorders are treated based on the five zang organs. Spirit - specifically cardiac spirit - on the other hand, is the commander and coordinator of the physique. The functions and principles of vital activities are coordinated by the spirit. Hence methods of life cultivation that involve the regulation of the mind are used to treat physical diseases. Conclusively, due to their mutual relationship, people should tend to both their physical and spiritual health.  

Getting back to conforming to nature, a common pattern that is frequently observed in nature is the interdependence of aspects that are opposite in quality. Yang and Yin is the perfect example. When we try to specify what belongs to Yang and Yin, we can see that organs belong to Yin because they are motionless, and the functional activities of these organs belong to Yang because they are marked by movement. However, a harmony of movement and motionlessness/rest need to be achieved for the human body to complete its vital functions like transportation and transformation of food, absorption of nutrients, circulation and metabolism of water, flow of Qi and Blood, and transportation and excretion of digested food. One of the two aspects may be given a relative emphasis according to each case, but TCM holds that concurrent movement and motionlessness are important for life cultivation and rehabilitation. On the extension of this balance, there are many other theories of coordinative balance for life cultivation, such as the need for alternation of physical labour and mental one, treating diseases in the upper by managing the lower and vice versa and treating the diseases in the left by managing the right and vice versa.

Within nature, ecological balance is maintained by the relationship of inter-promotion and -restraint of the five elements. Likewise, such a relationship exists within the human body for the physiological balance. This is why each organ belongs to a specific element and the syndrome differentiation method according to five elements exists. This syndrome differentiation method is based on the principle that the imbalance of elements inside our body should be rectified in order to maintain physiological coordination and health. In addition to this connection with nature, the human body also requires chemical elements from nature for its function. Imbalance of such chemical elements can give rise to illnesses, as we can see in iodine deficiency resulting in thyroid enlargement and zinc deficiency to infertility.       

The principle of holism applies to various concepts within TCM. It says that the human body is an organic whole where all components should be harmonious with each other between organs and organs as well as between physique and spirit. It also says that humans are one with nature and society. This is an important principle in life cultivation and rehabilitation and where the emphasis on restoring balance and “harmony” when there is a disease of the body, as well as caring for both physique and spirit is based.

As a unity with nature, humans should conform to seasonal changes which progress from germination, growth, and reaping, to storing in order to maintain the relative balance of Yin and Yang inside and outside the body. This balance is what keeps up the health and ultimately achieves longevity. Humans are inevitably affected by the environment because it is a part of the universe. The natural environment can give rise to endemic diseases such as goitres due to regional iodine deficiency, bronchial asthma from poor air quality, etc. The social environment affects one’s health too as we can see how an increase in workload and pressure with social development, industrialization, and urbanization have given rise to “modern civilization diseases”. Some examples of these diseases are coronary arterial disease, hypertension, and peptic ulcer. As a result, guiding patients to prevent environmental pollution that can negatively impact their health, and teaching them how to adapt to the changes of society in order to avoid falling into bad lifestyles and habits form important components of TCM life cultivation and rehabilitation.  

As with TCM treatments for rehabilitation, life cultivation also calls for applying principles that correspond to the result of syndrome differentiation. During the convalescent period of diseases, rehabilitation with TCM treatments can be enhanced by adopting life cultivation measures that can help restore organ functions. In addition to focusing on specific organs, life cultivation measures that support the functional state of Qi may be embraced. Physiological activities of the human body rely on ascending, descending, entering, and exiting of the Qi which is the functional state that Qi should be in. Therefore, attention should be paid to the movement of the body to promote the circulation of Qi and harmonization of the organs and tissues. The healthy body and spirit that results from them ultimately will help us in adapting ourselves to individual life, family and social life, and professional work.

Lastly, before ending this introductory steam to life cultivation, I need to emphasize the life quality. One may live a long life even when they are sick and bedridden. This is all the more possible because of the advancements in medical equipment used to sustain life. However, this is not what we are striving to achieve with life cultivation. Instead, we want to have viability -the ability for daily living and professional working. This ensures that we have a quality life which makes each second of our life meaningful.