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Posts Tagged ‘Chinese Medicine’

Research Headache

February 22nd, 2012 4 comments

Greetings all! I know it’s been a while since I’ve blogged, so here we go – merry christmas, happy hanukah, happy new year, happy chinese new year happy valentine’s day yada yada been there done that.

What I wish to write about to day is a sharing of a personal experience with some research I’m involved with in the Philippine General Hospital, teaching hospital of the University of the Philippines College of Medicine.

Yes, skeptics, there IS research being done in reputable state universities.  Then again the skeptics have already ignored the research done at the University of Vermont and the University of  Munich (click the links!) so why won’t they ignore this one?

Anyway, the research is supposed to be a cross-sectional study comparing the preventive effects of acupuncture versus propranolol in the treatment of migraine.  What I would like to comment on is the initial procedure that the residents wanted to do.

Initially, the idea of the other researchers was to pick a set of points and use that same set of points on EVERY PATIENT.  Following the principles of traditional chinese medicine, I said that that shouldn’t be the case.  I understand that their objective was to standardize the treatment.  I pointed out that chinese medicine emphasizes the root cause of the headache/migraine and address those causes.  The points to be used depend on those factors, as well as the location and nature of the pain.

wei shengchu 60 displays acupuncture needles in hi 2172839354 300x200 Research Headache

This is NOT how to treat headache using acupuncture.

In the end, what the protocol we submitted (which was subsequently approved by the appropriate committees) was that we would come up with a POOL of points to choose from.  Other factors would be there would only be ONE acupuncturist to diagnose, select from the pool and insert/manipulate the needles.  That will try to eliminate skill variation in practitioners.

When that study gets published, you guys will be the first to know about it!

 

P.S. – Gotta love this study

http://www.healthcmi.com/index.php/acupuncturist-news-online/495-acupunctureceusbrainstrokerepair

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Dear President Aquino

February 16th, 2011 3 comments

I would like to point out a slight error in your statements as quoted here: http://www.gmanews.tv/story/213171/chinese-embassy-court-sustains-death-sentence-on-3-pinoys

“(A Chinese ambassador told me that) they are very, very strict when it comes to drug laws because it’s a major concern of theirs. Iyung sa shabu, iyung ephedrine is a natural, comes from a plant that grows primarily in China. Mas malaki ang problema nila doon, they have a bigger populace, and they have syempre the history of opium from before,”

Why the heck is ephedrine mentioned in the same breath as methamphetamines and opium?  Again this is due to Ephedra’s bad rep as it is banned in the United States.  I shan’t repeat myself, but I would like to refer our President to my articles about Ephedra:

“News Bias Continues: Ephedra’s True Story” http://qi-spot.com/2010/02/01/news-bias-continues-ephedras-true-story/

.581px Ephedra andina 1 290x300 Dear President Aquino

A quote:

Herba Ephedrae or Ma Huang is usually the first herb one would see in a typical textbook of Chinese herbal medicine.  It is usually used to clear early symptoms of flu, and not ALL kinds of flu.  ANY look at the texts will give SPECIFIC indications for it’s use.  However, western herb enthusiasts had, according to the article, “converted from an herbal treatment for diseases to an energy stimulant and a weight-loss product.”

What are it’s classic textbook uses?

Actions: induces diaphoresis, resolves surface, ventilates the lungs to relieve asthma, regulates water metabolism.

Applications: febrile diseases due to exterior-excess, fever, chillphobia [aversion to cold], anhidrosis [lack of perspiration], ostealgia [bone pain], arthralgia, cough with dyspnea, edema, edema due to wind.

From this, it becomes obvious that Herba ephedrae is meant to be used in actual illness, not in a healthy person just trying to get a kick or lose weight.  The weight loss aspect is gleaned from it’s strong diaphoretic effect.  However, a basic look at any  Chinese herbal textbook will show that administration of ma huang should stop WHEN PERSPIRATION BEGINS, whether or not the flu has dispersed.

Again, if the patient has external symptoms (chills, slight fever, arthralgia, muscle pain) with no sweating, ma huang may be given AS PART OF A FORMULA to mediate effects (see ma huang tang, among others) and should be STOPPED when sweating begins.

Also, it should not be used as a tonic.  Many of the early ma huang/ephedra “supplements” were mixtures of ephedra and other tonics (including caffeine!)  Disaster waiting to happen.

How does that compare with western enthusiasts taking the herb individually for what we MDs would term as “off label use” contrary to all warnings?

OF COURSE they’ll get sick.  A professor of mine in China warned against yin collapse (shock due to blood or fluid loss) after using too much sweat-inducing herbs.

“The Art of Chinese Medicine” http://qi-spot.com/2010/11/15/the-art-of-chinese-medicine/

My point, Mr. President, is that Ma Huang or ephedra, the source of ephedrine, is a very valuable medicinal material in China and is banned in the US only because SOME IDIOTS misused it for off-label purposes.  It does not deserve to be compared to real dangerous drugs

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Explaining Qi to MDs

January 26th, 2011 No comments

It is but natural for many people to consider their personal philosophies and worldviews as the standard against which others must measure their versions.  I recall an incident from my first year in college.  For me, it was my first time to have classmates who did not know any Chinese, and for them, it was their first exposure to someone (there were two of us, actually), who used a language using a non latin alphabet.  (Filipino, while a malay language, currently uses a latin alphabet).

I wrote some characters on a blackboard.  My newfound friend asked, “so is there like, one character per english letter?” (the answer was no)

I hope you get the idea – for someone exposed ONLY to latin alphabets, it is assumed that the latin alphabet is the standard from which others are based.  Another example:

Zentradi Alphabet 300x122 Explaining Qi to MDs

The Zentraedi Alphabet by Kazutaka Miyatake

The Zentraedi are a fictional alien race in Japanese cartoons, particularly the Macross series by Tatsunoko Productions.  So, an alien race who who have no concept of culture, much less a culture like ours, have an “alphabet” that corresponds one-to-one with English.  Who would have thunk it.

Let’s get this straight, the east is the east and the west is the west.  There is no “gold standard”.

So, this is the mindset people have to overcome.  When inquiring about Qi, therefore, the western mind is looking for a cultural and linguistic equivalent based on the western paradigm.  It’s like an Englishman looking for a Japanese letter representing the sound made by the letters “L” and “R”.  There isn’t any.  There’s a combination of both into one sound but that’s it.

Failing to find a single one-to-one correspondence for the meaning of the word “Qi”, the westerner ends up disappointed and skeptical.

The failure lies in those who are unaware of how to explain Qi, particularly to MDs.

Here is something I wrote in an email about this topic:

“I would start off by saying that most MD’s do not want to hear anything that sounds vaguely “supernatural”.  Of course, to folks like us, Qi isn’t supernatural, it is in fact the basis of everything – hence nature – but that’s not what it SOUNDS like to them.
So I always start by asking members of the audience to explain what they think Qi is, while gently correcting.  I then also show that Qi has a wide variety of meanings depending the context.  I use “sheng qi” (get angry), to explain that in this sense, qi is physiology as the blood rises to the head when one gets angry as sheng qi literally means bring forth qi.  ”Tian Qi” or weather, to imply that Qi has a “communication” and “status” aspect (status as in state of being) as tian means heaven and so tian qi can mean the state of the heavens or the nature of the heavens at a given time.  Qi has a breath or air aspect as when we say hot air balloon or qi qiu (qi ball).
Once that fundamental is established, I then narrow it down to medical terms.  Qi therefore has something to do with physiology, a state of being, a breathing or dynamic aspect.  Hence, when we say “qi flows” it means natural function is present.  If qi is blocked, then function is impaired.”
When asked to elaborate, I answered:

“(Instead of sounding New Agey by going through the philosophy of Qi is, we can simplify it by just saying)… that “Qi” has many meanings in english, just like the greeks had about seven or so different words for one english word love.  One meaning of Qi with most relevance to the body is physiology.  Acupuncture has been proven to release NO (nitrous or nitric oxide, I forget) which is a vasodilator, making blood vessels larger and facilitating better blood flow – that’s why acupoints with needles turn slight red.  Hence, when we say Qi is unblocked, in biomedicine we can say the physiology is facilitated or made more efficient.  Nothing supernatural, nothing gimmicky, just proper translation of terms.”

Again, this is not a comprehensive explanation of exactly what Qi is, but it is my personal method of explaining it to MDs in such a way as to make the concept more relevant to them.

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“Warning Issued On Chinese Medicine”

November 17th, 2010 1 comment

Yes, that’s the title of an article published today in the Philippine Star.  (http://www.philstar.com/Article.aspx?articleId=630865&publicationSubCategoryId=63)

The way the headline is written, one would think that the warning issued was against Chinese Medicine as in Chinese Medicine the tradition, such as the medicine I practice.  It does not say “Warning Issued On Chinese Medicines” or “Warning Issued on Fake Chinese Medicine”.  No, it uses the general term “Warning Issued on Chinese Medicine”.

I will quote the article in full here:

MANILA, Philippines – People are urged to exercise caution when taking Chinese medicine.

Speaking to reporters, Leonila Ocampo, Philippine Pharmaceutical Association (PPA) president, said many Chinese medicinal and herbal products are not registered with the Food and Drug Administration (FDA).

Therefore they are considered counterfeit, although legitimate in the country where they were manufactured, she added.

Under Republic Act 8203, or the Special Law on Counterfeit Drugs, fake medicine pertains to unregistered imported drug products, Ocampo said.

Dr. Minerva Calimag, Philippine Medical Association (PMA) food, drugs and cosmetics committee chairman, said security in the country’s coasts is weak, enabling smugglers to bring in counterfeit medicine.

“If fake drugs are coming from outside (the country), our problem is how to secure the borders because there are many channels through which it could come into the market,” she said.

The government must be able to prevent the entry of counterfeit drugs into the country, Calimag said.

The PPA and PMA are members of Samahan Laban sa Pekeng Gamot.

It has been estimated that one of every 10 drugs in the country is fake, based on the cases reported to the FDA.

The country’s pharmaceutical market is steadily growing, making it a target of counterfeiters.

In its website, Samahan has identified Binondo, Manila as among the hotspots for counterfeit medicine.

The funny part is, I actually AGREE with most of what is said in the article.

Yes, there are tons of smuggled Chinese medicine products of questionable integrity.  I am the FIRST to admit that probably half of all over the counter drugs sold in Chinese drugstores are of poor quality or fake.

But in NO WAY should that merit a headline that passes judgment on the Chinese medical tradition as a whole!

Now for the one part of the article I don’t agree with: the idea that if a Chinese materia medica does not pass through the FDA, it should not be used at all.

Hence, let’s ban drinking tea for health purposes.

Let’s ban the use of ginger tea or salabat to relieve sore throat.

Let’s ban the use of eating watermelon to keep cool.

Why? Because those are all examples of using materials in the Chinese tradition, as per my previous post.

Shall I go on?  Let’s not use tawas or alum to relieve body odor.  That’s a materia medica used in Chinese medicine, to relieve Heat which manifests as body odor.

Let’s not massage using ginger oils for body aches, let’s ban medicinal massage, let’s ban…

You get the idea.

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The Art of Chinese Medicine

November 15th, 2010 No comments

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?

No.

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.

pixel The Art of Chinese Medicine
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