A seller at the traditional medicine market in Anguo (DERMOT TATLOW/PANOS PICTURES)

Khen-Wei Yeoh investigates the variety of traditional medicines

Traditional Chinese medicine adopts a more holistic philosophy than Western medicine. It emphasises the importance of balance in the body and mind and the smooth flow of an optimal amount of energy - blood is the visible form and qi the invisible form - in maintaining health. This is known as the balance of yin and yang. Yin represents water, quiet, substance, and night, while yang represents fire, noise, function, and day. Disorders of this balance may require intervention; these include acupuncture, moxibustion, tai chi, qi gong, and herbal therapy.

The diagnostic and therapeutic principles of yin and yang are based on a system of anatomy and physiology peculiar to traditional Chinese medicine. There are, however, several interesting observations which correlate with Western medicine. Vital energy flows through the different parts of the body (channels) in a well defined circadian rhythm. The lung channel is dominant between 3 00 am and 5 00 am, which is when diseases of the lung are likely to manifest themselves. This corresponds to the agreed Western observation that bronchial asthma is usually worse in the early hours of the morning.

In traditional Chinese medicine the kidney is stated to dominate bone, play an integral role in the process of growth and development, and control body fluids in concert with the lung. This corresponds with Western physiology of the kidney's involvement in vitamin D activation and in controlling body fluids. In the context of mental health, neurotic people are considered to have a disease of the liver or spleen rather than anxiety or depression as in Western medicine. The issue of the stigma of mental disease is thus an important difference and might account for the relatively small amount of "mental disease" in China.

Western and Chinese medicine are practised at Shu Guang

Shu Guang Hospital is an integrated hospital practising Western medicine and traditional Chinese medicine. It consists of a 17 storey building of wards, an outpatients' building, an accident and emergency building, a building for the Chinese pharmacy, and administrative buildings. It has 600 beds and over 1000 staff. It is affiliated to the Shanghai University of Traditional Chinese Medicine.

The distance between our lodgings and the hospital was about 10km - three quarters of an hour in a sardine packed public bus (7p fare) or 20 minutes in a Volkswagen cab (90p fare).

Although we visited other medical institutions during our elective, most of our time was spent at Shu Guang. The time was divided into attending oncology clinics, visiting inpatient wards, acupuncture clinics, and outpatient clinics. A couple of afternoons were also needed to hunt around Shanghai's vast selection of bookshops for dictionaries and books on traditional Chinese medicine.

The variety of conditions that were treated was impressive. They included aplastic anaemia, cerebral palsy, Parkinson's disease, shingles, leukaemia, ear, nose, and throat tumours, diabetes, infertility, cervical spondylosis, asthma, and stroke. Bell's palsy was particularly common. Most conditions were treated with electroacupuncture, where fine needles are placed meticulously along appropriate meridian lines - it was like learning another system of anatomy; not the distribution of the 7th cranial nerve as you might have expected. These needles are then connected to battery operated power sources.

Many satisfied customers We were impressed with the large number of satisfied customers, who had to pay for their treatment. Oncology patients received radiotherapy and were treated with herbal remedies as well. A visit to the pharmacy showed that every patient had their own individual packet containing differing amounts and combinations of the numerous herbs, which are processed and prepared in a building resembling an industrial processing plant. We met some Americans touring the pharmacy at the same time; one of them turned out to be the chief executive of one of Yale's hospitals.

In general, the cross referrals of patients between the two traditions was efficient and sensible; referrals were made when the doctor thought that the patient's condition would benefit more from the other system of intervention.

An eye opener in many ways

It was an eye opener in many ways. We were able to see another system of medicine being practised alongside Western medicine. Patients also had much more choice in terms of disease management. This emphasises the importance of complementary medicine, particularly in chronic illnesses to which current Western medicine has little solution.

Bearing in mind the lack of evidence based medicine being practised in many of the conditions and the language difficulties we had, it was still clear that traditional Chinese medicine benefits a large number of patients.