1. Dr. Angeli Chitale Naturopathic Doctor
Women’s Health, Thyroid and Endocrine Health
www.restorativemedicine.ca
drangeli@restorativemedicine.ca
Beginners Mind: Using TCM in Naturopathic Practice
Traditional Chinese Medicine needs no introduction to
ND’s. TCM offers an effective means of treating both
simple and especially difficult cases provided the
overlay of symptom patterns can be identified and
treated systematically. Yet ,post­graduation how many
of us actively apply TCM in practice? This article is
intended to provide a practical approach to guide and
inspire the use of TCM into your Naturopathic practice.
Guided by the Naturopathic Principle:​ tolle causum, ​we
aim to identify and treat the cause. How do we
understand the cause? When examining a case, it is important to look at both ​ultimate
and ​proximate ​causation. In other words, the cause ​over time​. How many cases have
we seen where, Initially the illness begins with trauma ­OA for example,sparked by
torsion to the knee joint, tearing a meniscus ligament and over time, repeated tears,
patellar afflictions, and acute flare ups continue to affect function and further degrade
components of the knee structure. Illness then, follows a path of cause ­ effect ­ cause ­
effect cause over time. In Homeopathy, we describe this as the onion skin ­ layers of
cause and effect have to be removed for a cure to emerge. It is the same for TCM. We
start with the “presentation layer” and progress one step at a time.
TCM is about understanding the interdependence of causation ­ the components of the
body and mind, as well as symptoms relative to one another. For example, the first
week of TCM class, we were asked: Which is more Yang? Qi, Blood or Essence? The
answer is ​relative​: While Qi is more yang than Blood, Blood is more yang than Essence.
Yang and Yin are relative terms referring to both the presence and relative proportion of
qualities. In other words, to see the valley, one must also see the hill.
As ND’s we are well trained and hence adept at gathering patient and symptom
information in detail. TCM checklists for clustering symptoms reveal imbalances in
organ or organ systems, especially when there are many overlapping symptoms
present.Understanding which general function is affected helps orient treatment
approach:
● Is that which moves or responsible for motion affected? (Qi)
● Is that which nourishes and is fluid in nature affected? (Blood)
● Is that which is the reserve material and energy affected? (Essence)

2. Dr. Angeli Chitale Naturopathic Doctor
Women’s Health, Thyroid and Endocrine Health
www.restorativemedicine.ca
drangeli@restorativemedicine.ca
Treatment Approach: Root ​or​ Branch or. ​Root
and Branch​?
According to Naturopathic Principles of ​treat the cause​, we
know treating the symptoms alone (branch) is ineffective if
the cause persists (root). For example, a case of repeated
acute infections (including dysbiosis) due to lowered immune
function (Wei Qi). The root ­ depleted Kidney Qi from a
hectic lifestyle., persists . The branch must be treated first, the infection as
tonification of Kidney Qi at this stage will result in concurrent tonification of the
pathogen as well (and the immune system will remain vulnerable) if the pathogenic
factor is not cleared first.
Case: 33 year old female, presents with persistent bloody diarrhea with concurrent
severe and debilitating cramping lasting for up to 9 hours at a time, daily. Onset:
Daily 3­4 hours after eating. Symptoms appear to be provoked by intestinal
peristalsis from food or any irritation to the GI as in a GI scope/biopsy procedure.
Menorrhagia for up to 5 weeks. Patient reports there is respite from the abdominal
cramping during this time. All blood tests are normal, stool analysis indicate no
ova/parasites. Diet reduced to broth of meat and vegetables only once a day out of
fear of pain . Emaciation and fatigue are significant. Symptoms have been on and
off for the past 9 months., which started 2 months after returning from trip to Asia.
Medical diagnosis pending, as all tests are normal.
Tongue: pale, thin, dry, no coating, red sides with teeth marks Pulse: Deficient / weak
Sample Checklist of some presenting symptoms in the following case (bold = symptom
present)
SP Function LV Function ST Function KI Function
Prolapsed organs Bloodshot / dry eyes Large Appetite Cavities
Abrupt Weight Gain Itchy Skin Bad Breath Cold Knees
Pensive / Worry Diarrhea/Constipation Acid Regurgitation Back Pain
Low appetite Muscle Spasms Heartburn BL infection
Abdominal Gas Neck / Shoulder Tension Ulcer Nocturia
Hemorrhoids Seizures Hiccough Hair Loss
Over thinking Anger Easily Swollen gums Startles

3. Dr. Angeli Chitale Naturopathic Doctor
Women’s Health, Thyroid and Endocrine Health
www.restorativemedicine.ca
drangeli@restorativemedicine.ca
Here it becomes apparent symptoms are clustered in SP, LV and KI organ systems.
General Treatment Approach:
1. Stop blood/fluid loss ­ treat branch based on the acute symptom picture.
2. Establish harmony in the acutely affected organs in this case, liver and spleen.
3. Reinforce/strengthen weak spleen in this case (or in case of Excess, Reduce)
4. Ultimately treat the root – in this case, correct QI and Yin deficiency from chronic
fluid loss.
Specific Treatment Approach:
1. Halting fluid loss takes priority since blood loss, and fluid loss in general, as
persistent diarrhea, proteinuria, excessive sweating, urination, vomiting is loss of yin
& essence. Treat with moxa to stop bleeding when applied to SP1, ST 25, and lower
abdomen CV points) Acupuncture to regulate channels (stem the flow) and
strengthen the Spleen 2X weekly. Patent Formula: Yunnan Bai Yao red pill to stop
bleeding.
2. Correct deficiency (or excess), remove stagnation to establish harmony in
affected organs.Treat SP deficiency ito reduce diarrhea, improve fluid
control/retention in the proper channels. Release LV stagnation to reduce intense
cramping pain with acupuncture 2X weekly. Reinforce acupuncture treatment with
classic formula: Xiao Yao Wan (Bupleurum and Tang Kuei) to release liver qi
stagnation and establish LV/SP harmony.
3. Once SP/LV harmony established, reinforce or strengthen weakened organ. In
this case, the spleen. Acupuncture and Jian Pi Wan ­ literally “Spleen Strengthening
Pill” is the present treatment.
4. Treat the root, this can be organ, qi, blood or essence tonification to recover
depletion. In this case, eventually reinforcing KI through tonification when patient
reports no diarrhea or cramping for 6­8 weeks and presents with KI deficient
symptoms.
Chinese Herbal Formulas reinforce acupuncture treatment benefits between sessions
and are an essential component of therapy. Treating according to principles with clarity
can yield successful outcomes in a relatively short time for the practitioner who is
guided by “beginners mind” at every stage in their practice. For more information visit:
http://restorativemedicine.ca/tcm­and­acupuncture.html