Exploring traditional Chinese medicine
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.
Kheng-Wei Yeoh, house officer, St Thomas's Hospital, London
Email: Kheng_wei@hotmail.com
studentBMJ 2000;08:395-434 November ISSN 0966-6494
