The Art of Chinese Medicine
The past month has been brutal, scheduling wise. I shan’t bore my handful of readers with the details of the non-essentials. One of the things keeping me busy though, is having a 4th year medical student rotate with me in Traditional and Integrative Medicine. For a whole month, I have a future M.D. to “convert” to Chinese medicine heh heh.
Anyway, during one of our rounds, she mentions to me that the subject of Chinese herbal medicine was brought up during her rounds with another doctor. This other doctor encouraged her to study Philippine herbs instead of Chinese herbs because obviously, using indigenous resources is more cost-efficient than importing from China. Also, indigenous materia medica would also be more apt and appropriate for the environment in which it grows. Ma Huang works well in northern China for example, but not in tropical Philippines.
This got me thinking. Just what IS the essence of Chinese medicine? When I talk to most westerners about Chinese materia medica, most people think of stuff like Ginseng or Cordyceps. In other words, they think about the individual materials. Some folks with more experience might think of individual formulas – I know of a local nephrologist who actually tells patients with stones to take an over the counter stone “melting” formula from China with much success.
But is that what Chinese medicine is? The individual materia medica? The Formulae?
The World Health Organization defines traditional medicine as “the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses.” If used outside it’s indigenous culture, it is termed alternative or complementary medicine. (http://www.who.int/mediacentre/factsheets/fs134/en/).
Hence, the idea of medicine is not the drugs, not the acupuncture, not the materia medica. I’ve even given this example to medical students – if for example, a person takes a certain common antibiotic but uses it for “off-label” purposes (as is rampant in the Philippines), is that person practicing medicine? Sure, that person is using a medical tool, but not based on the knowledge, skill, and practice on which the art of medicine is based.
Chinese medicine, it can be imputed, is not about the individual materia medica. It is about the unique theory that the practice is based on. In particular, Chinese herbal medicine is not about the individual materia, it is about how they are used and the framework in which they are used.
Ephedra has it’s specific indications in Chinese Medicine. Weight loss is not one of them. Therefore, using ephedra in weight loss - even if the ephedra is a commonly used Chinese materia medica – is not practicing Chinese medicine.
American Ginseng is grown in Wisconsin in the United States. Frankincense and Myrrh are more associated with the Middle than the Far East. Yet all are used in Chinese herbal medicine so long as they can be made to fit within the tradition.
So how do I reconcile my student’s story with this?
Philippine herbs can be studied and classified according to the system of Four Natures and Five Tastes. Once this is done, it is a matter of substituting appropriate local medicinals for the imported ones, but STILL WITHIN THE FRAMEWORK OF CHINESE MEDICAL THEORY. Let’s take a formula – Dang Gui Bu Xue Tang – with two ingredients Dang Gui and Huang Qi. What if we can find two local materials that can be used to replace either one (with dose adjustments of course). We could help more people at less cost.
That would be a true integration of cultures.