Britton Mann
Chinese Medicine Philosophy, Western Medicine Perspective
The Internal Landscape
Chinese medicine posits that processes occurring inside the human body
are reflective of and analogous to similar phenomena in the natural world.
We are, after all, natural phenomena. For example, the bones of human
limbs are morphologically similar to the limbs of a tree: both exit the trunk
as one thick structure and then branch into smaller, more specialized, and
more mobile structures. Human limbs branch into fingers and toes, while
tree limbs diversify into twigs and leaves.
The Metolius River, after which my medical practice is named, is in the
high desert of Oregon. The Metolius emerges from one of the largest
natural springs in the United States. As it meanders downhill to merge
with the Deschutes River, it is fed by tributaries, spills over waterfalls, is
pinched by narrow rock walls, spreads onto flatter channels, and becomes
irrigation for farmland. Its water eventually empties into the Pacific Ocean.
Keen observers of nature, Chinese scholar-physicians saw watersheds similar to the Metolius in the
human body. They named these pathways the jing-luo, “channels and networks.” This term is often
translated as “meridians.” Just as a river carries water and nutrients, these channels carry qi (chi),
blood, and vital body fluids crucial for sustaining life.
Terrain Restoration
Just as floods, droughts, dams, downed trees, algae overgrowth, and the like can disturb the smooth
flow of rivers, so can the human channels be disrupted. Aging, poor diet, infection, illness, trauma,
surgery, and emotions can adversely affect the flow of qi and blood in the channels. When smooth
circulation is inhibited, disease is a result.
Chinese medicine has several methods to re-regulate and smooth the flow of qi and blood in the
channels. The primary tools are acupuncture, herbs, diet, cupping, moxibustion, and qigong exercise,
in addition to other lesser-known treatments. As a Chinese medicine practitioner, I diagnose why
and where there is disruption in the natural system, and then I employ the appropriate therapies to
restore function therein.
Chinese Medicine Viewed Through the Lens of Western Medicine
Most people can feel the positive effects of terrain restoration during and after acupuncture
treatment, and a growing western-science evidence base corroborates these effects. Well-designed,
large-scale Western clinical trials and meta-analyses of acupuncture for various Western medical
conditions can be found in highly regarded journals. There is general consensus that acupuncture is
as effective for these conditions as standard-of-care treatments such as medication.
These effects have been understood from the Chinese anatomic and physiologic perspective of
terrain, channels, and networks for thousands of years. Over the past few decades, theories to explain
these effects based on Western anatomy and physiology have been developed from a steady stream of
basic science research.
Biomarkers of acupuncture treatment have been discovered, (meaning that when acupuncture is
given, changes in physiology can be detected). These include:
Regulation of the autonomic nervous and immune systems through the release of antinociceptive
endogenous opiods (the body’s own anti-pain, “feel-good chemicals”) and activity of natural killer
(anti-viral and anti-cancer) cells.
Regulation of gastrointestinal motility and secretions.
Regulation of cardiovascular activity.
Brain activity changes as detected by functional MRI.
Acupuncture has anatomic and physiologic effects local to the site of needling:
Fascia and other connective tissues are manipulated.
Neurovascular bundles are stimulated.
Local neuropeptides (such as calcitonin gene-related peptide) are released.
Acupuncture has effect beyond the local needling site:
Needle insertion at specific places induces segmental anesthesia. This phenomenon disrupts the
ability of certain nerve fibers to transmit pain signals, and explains why needles inserted distant to
sites of injury can reduce pain.
Functional MRI studies have shown that acupuncture produces profound changes in the limbic
system of the brain. This may help explain why acupuncture can help balance the emotions and
ameliorate emotional disorders, sleep issues, compulsive and addictive behavior, and similar
conditions.
The Internal Landscape
Helping you meet your health goals is my top priority. I believe natural medicine has effectiveness for
a wide range of health issues and there are many tools in my armamentarium to help you achieve
these goals.
The perspective of anatomy and physiology held by Chinese medicine is in agreement with that of
western biomedicine. The nomenclature used to describe the body, however, is different. I am
medically bilingual – I understand both Chinese and western medicine. Too often I have heard
stories from patients, family, and friends who feel that their different health care providers are
providing uncoordinated care and, at times, simply contradicting each other—without ever actually
communicating. To this end, I offer patient-centered care, which incorporates the best of what I offer
as a Chinese medicine physician with your existing health and support network.
Other medicines have great value and effectiveness. I will do my best to collaborate with your other
health care providers to ensure that we are all working in the same direction, with your best interests
at heart and in mind. If you have a western medical diagnosis, imaging studies, and laboratory
results, these will be integrated into my Chinese medicine diagnosis and treatment.
My background and training makes me conversant with westerntrained medical doctors (both primary care physicians and
specialists), chiropractors, naturopathic physicians, osteopathic
physicians, massage therapists, physical therapists, psychologists,
and yoga teachers.
In the patient-centered model that I espouse, a mutual
understanding between practitioners about your condition takes
precedence over dogma or identification to a particular type of
medicine. If I cannot help you meet your health goals, I will try
to connect you with a practitioner who can.
I live these values professionally, and also personally. My wife is a
western-trained MD, and we have spent more than a decade at
the dinner table learning about each other’s medicines and
philosophies.
For Further Reading
For further reading into this developing field, below is a sample of articles on acupuncture
effectiveness, proposed mechanisms of action, and issues inherent to acupuncture research:
Vickers, A., et al., “Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis.” Archives
of Internal Medicine. Volume 172, Issue 19, 2012. doi: 10.1001/archinternmed.2012.3654
Lam, M., et al. “Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain.” Spine.
Volume 38, Issue 24, 2013. doi: 10.1097/01.brs.0000435025.65564.b7
MacPherson, H. & Hammerschlag, R. “Acupuncture and the Emerging Evidence Base: Contrived
Controversy and Rational Debate.” Journal of Acupuncture and Meridian Studies. Volume 5, Issue
4, 2012. doi: 10.1016/j.jams.2012.05.001
Napadow, V., et al. “The Status and Future of Acupuncture Mechanism Research.” The Journal of
Alternative and Complementary Medicine. Volume 14, Issue 7, 2008, pp. 861–869. doi: 10.1089/
acm.2008.SAR-3
Langevin, H., et al. “Paradoxes in Acupuncture Research: Strategies for Moving Forward.” EvidenceBased Complementary and Alternative Medicine. Volume 2011, 2011. doi: 10.1155/2011/180805
Meissner, K., et al. “Differential Effectiveness of Placebo Treatments: A Systematic Review of
Migraine Prophylaxis.” JAMA Internal Medicine. Volume 173, Issue 21, 2013. doi: 10.1001/
jamainternmed.2013.10391
Vickers, A., et al., “Responses to the Acupuncture Trialists’ Collaboration individual patient data
meta-analysis.” Acupuncture Medicine. Volume 31, Number 1, 2013. doi: 10.1136/
acupmed-2013-010312