Can Western medicine learn a thing or two from the East? With escalating rates of heart disease, obesity, diabetes, cancer and depression, is it time to integrate aspects of Chinese medicine for better health? Many Western societies now have the first generation of children who may not outlive their parents due to diabetes and its consequences. Despite our vast knowledge and abundance of medication and diagnostic tests we may be living less well and for less time. Do patients want to follow their doctor’s advice? Does it suit the patient’s expectations of treatment? With Western medicine’s simplified approach being “Have a problem? Take a pill”, many patients are becoming more and more disillusioned with treatment and are therefore increasingly noncompliant with their doctor’s “advice”.
A visit to the Chinese medicine doctor starts with a lengthy and very detailed intake of all of one’s complaints. All ailments are considered and none are dismissed as either psychosomatic or irrelevant. As there is no requirement to make an immediate “diagnosis”, all presenting symptoms are considered rather than just those that would seemingly fit a specific or particular Western diagnosis.
Following the history, a physical exam is conducted which relies on key features to elucidate imbalances in the body. The body is assessed for its spirit (mood), colour (hue of the skin), form (size), bearing (posture), as well as an extensive tongue examination (with over 50 features being evaluated). Following inspection, the pulse and skin are palpated for further clues to the inner state. Finally there is an auscultation of the organs. This examination yields an appraisal of one’s qi (vital energy).
With qi fully assessed, a “prescription” is given to balance qi and the entire system and incorporates most or all of the following:
Chinese herbal medicine (中藥)
Chinese food therapy (食療)
Tui-na (推拿) - massage therapy
Die-da (跌打) – a bone setter
Qi-gong (氣功) - related breathing and meditation exercise
Physical exercise such as T'ai Chi Ch'uan (太極拳) and other Chinese martial arts
Mental health therapy such as Feng shui (風水) and Chinese astrology
Herbal medicine has been in use for thousands of years and is both praised and criticised by the West. With some herbs gaining recognition for effectiveness against cancer and undergoing Western designed controlled trials, other herbs are deemed “toxic” or thought to be laced with cure-all steroids. Many Western drugs have been developed from herbs, such as treatments for asthma and hay fever from Chinese ephedra, hepatitis remedies from schizandra fruits and licorice roots, and a number of anticancer agents from trees and shrubs.
One concept that is central to Chinese medicine that the scientific world is still struggling to accept is an internal substance that the Chinese call qi (pronounced "chee"). Acupuncture seeks to treat health on the level of qi. There are pathways in the human body wherein this qi flows. Needles are used to open or close specific points grouped along certain lines of energy flow called meridians, which go deep into the body. Disease is prevented or treated by stimulating or reducing the flow of qi through specific points in the body. One’s vital energy is either strengthened or sedated, monitored, and balanced to achieve the desired result. Needles can also work on specific areas of pain that may not be associated with internal problems; sport injuries, for example. A needle inserted near the area of a pulled tendon or overstrained muscle will increase the flow of qi to that area which removes pain and quickens the healing process.
The effectiveness of acupuncture remains controversial in the scientific community, according to a review by Western medicine physician Edzard Ernst and colleagues in 2007, which found that the body of evidence was growing, research is active, and that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions." There may be a sound physiological explanation for acupuncture in treating pain by extinguishing or dampening down pain signals by creating new pathways. Furthermore, a review of neuroimaging research suggests that specific acupuncture points have distinct effects on cerebral activity in specific areas that are not otherwise predictable anatomically. Researchers using the protocols of evidence-based medicine have found good evidence that acupuncture is moderately effective in preventing nausea and headaches. There is conflicting evidence that it can treat chronic lower back pain and moderate evidence of efficacy for neck pain. The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have also studied and commented on the efficacy of acupuncture. There is a general agreement that acupuncture is safe when administered by well-trained practitioners, and that further research is warranted.
Chinese Food Therapy restores balance within the body by recognising the energetic properties of food specific for individual constitutions with the seasons. The ideas of yin and yang are used in the sphere of food and cooking. Yang foods are believed to increase the body's heat (raise the metabolism), while Yin foods are believed to decrease the body's heat (lower the metabolism). Yang foods tend to be dense in food energy, especially energy from fat, while Yin foods tend to have high water content. The Chinese ideal is to eat both types of food to keep the body in balance. A person eating too much Yang food might suffer from acne and bad breath, while a person lacking Yang food might be lethargic or anaemic.
Two of the most common medicinal foods are bird nest soup and ginseng. Bird nest comes from oral secretion of swiftlets (a cave bird), collected from the binding material of their nests. The dried material is soaked in water to rehydrate and then cleaned by hand to remove other nest building debris such as grass and feathers.
The bird nest is double steamed with rock sugar as a dessert or with a small amount of pork as a soup. Bird nest soup is thought to promote healthy skin for women and increase vitality by strengthening the spleen and opening up the stomach, thus improving the appetite.
Chinese ginseng is the root of a plant which has Yang properties. It is prescribed to promote circulation, increase blood supply, revitalize, and aid recovery from illness. The ginseng root is double steamed with chicken meat as a soup.
The remainder of the prescription involves advising the patient on relaxation techniques of massage therapy and Qigong therapy, which incorporates special methods of breathing, posture, and mental concentration to cleanse, gather, circulate, balance and strengthen the body's energy system. Feng shui and Chinese astrology are used to calm and restore one’s emotional balance.
In China, Western medicine is offered for emergency situations by trained doctors, whereas Chinese medicine is offered for chronic conditions or preventative health. The two are not a substitute for each other and exist in harmony as their two roles are seen as complimentary. Whereas Western medicine may heroically rescue us from sudden illness or accidents, Chinese medicine can protect and preserve our health on a day-to-day basis. It is not uncommon for many Western trained doctors in China use aspects of Chinese medicine in their practice. In Hong Kong, Chinese Medicine is now a well-established degree programme at both The University of Hong Kong (HKU) and The Chinese University of Hong Kong. The Molecular Chinese Medicine Laboratory at HKU has been established to facilitate research combining basic sciences and sophisticated technologies to study Chinese medicine and enhance the understanding of the underlying mechanisms of action, as well as the optimal way to integrate Chinese medicine with Western medicine. It works closely with the Modernized Chinese Medicine International Association (MCMIA) to globalise Chinese medicine.
In the strict sense, Chinese medicine uses the inductive and synthetic method. Western medicine uses the reductive and analytical method. Chinese medicine is individualised, whereas Western medicine is standardised. Chinese medicine is experience based; Western medicine is evidence based. Chinese medicine is an art; Western medicine is a science. Chinese medicine emphasises the role of the mind in healing; Western medicine is based on medication and procedures. Chinese medicine looks at the behaviour of the system as a whole; Western medicine looks at the structure and function of the parts. Chinese medicine works to maintain health; Western medicine identifies and manages disease.
Chinese medicine strives to retain balance and prevent disease by using routine acupuncture, Chinese herbal teas, vitamins, minerals, antioxidants, food and exercise therapy, and meditation. The Chinese believe that "Waiting until one is ill to see a doctor is like waiting until you are thirsty to dig a well.”
Listening and acknowledging all symptoms. Giving time to voice concerns. Prescribing relaxation techniques. Teaching that moderate exercise is the single most effective way to stave off disease. Shifting the focus to eating (healthy foods) rather than dieting. Acknowledging the state of mind and emotional health. Considering one’s environment and its impact. All are issues we as Western doctors intuitively know are important but are often lost in the Western medicine process.
Journal of Chinese Integrative Medicine
Edzard Ernst MD, PhD, FRCP, FRCPEd, White A. Acupuncture: safety first. BMJ 1997; 314: 1362.
Institute of Chinese Medicine, The Chinese University of Hong Kong (CUHK)
School of Chinese Meidcine, The University of Hong Kong (HKU)
Modernized Chinese Medicine International Association (MCMIA)
G.P.O. Box 5301, Hong Kong Tel 2492-2713 Fax 2906-9330