Chinese Medicine Update

The bulk of my time in Nanjing has been spent studying Traditional Chinese Medicine (TCM) every morning in a class of 3--two German women and myself. We have an interpreter, Chris, (on the right) and our professor, Dr. Lu (center). September through December, we studied the theory and philosophy behind Chinese medicine and began diagnosis principles.


In January, we began studying herbal medicines, of which there are many, each with a very distinct function and properties. Part of our time is spent in the pharmacy of the clinic, getting to know each medicine in its partially-processed form.




Most of the medicines come to the pharmacy in dried form. After the diagnosis of the patient, the doctor will write a prescription (usually a decoction of around 12-16 herbs) of the necessary herbs needed for the patient's syndrome. TCM assigns a temperature quality to most medicines and symptoms, for example, a "heat syndrome" will be treated with a cold medicine and a "cold syndrome" will be treated with a warm medicine. A very simplistic example might be a sore throat with fever would be treated with cool medicine, like mint and pears, whereas a cold with congested nose would be treated with a warm medicine, like ginger.



Additionally, each syndrome is connected to specific meridians in the body that bring "qi" (pronounced "chi" and defined as the energy that propels all body functions) and body fluids to the organs and each medicine acts on specific meridians. So, a blocked liver meridian that causes PMS would require an herb that clears the liver meridian to allow free flow of qi and body fluids and resolve PMS symptoms. It is a very different approach from Western medicine. TCM seeks to treat the underlying issue leading to disease, rather than treating the symptoms. Herbal medicines often take longer to work but hopefully patients will see better, long-lasting results with fewer side effects. My goal is to look for ways that Eastern and Western medicine can complement each other for optimal patient care.

Once a prescription has been written for the patient, they have several options. They can have the clinic "cook" the decoction (boiling the herbs into a concentrated extract) and prepare the medicines for the patient, or the patient can buy the herbs and prepare the medicine at home. The end result is usually a very strong-smelling, bad tasting potion that the patient drinks 100 ml twice a day. Some have described the medicine as "pond scum." Yum!

Grace and I have both taken medicine for various issues and we can testify that it is disgusting...but hopefully worth it! I am continually amazed at the recorded information of each herb (or animal part). The "materica medica" for TCM includes when the herb should be harvested, which part is most effective, and how it should be processed. Specific qualities of each herb are listed as well as precautions.

Diagnosis is much different than Western medicine. The basic approach to diagnosing each patient involves looking at the patient's appearance, taking the patient's pulse on both wrists, looking at the tongue, and asking questions. Here we are learning about the tongue and how it's appearance is connected to what's going on in the body. TCM believes the function of the organs are reflected on the tongue, so tongue coatings (ewww!) are a critical piece of the puzzle. The color (white is a cold syndrome; yellow is a heat syndrome) and texture of the coating, as well as the color, shape, and size of the tongue all give information to the doctor for diagnosis.

I will spare you the close-ups of the tongue photos! As far as pulses go, the TCM dr. checks pulses on both wrists using 3 fingers, distinguishing the quality of each place, including strength, depth, texture (such as "wiry" or "floating" or "hollow"), and rate. On the right side, the 3 places correspond to the heart, liver, and kidney. On the left, the 3 places correspond to the lung, spleen (and stomach) and the kidney. Learning to take the pulse and interpret it correctly is key to the overall diagnosis and is somewhat of an art form.

Our favorite part of our day is when patients come in and we get to check tongues and pulses and listen to the symptoms and make our "guess" of what is going on with the patient. Then we sit with Dr. Lu and get her diagnosis and go over what herbal medicines she prescribed and why.

We have seen a 5-yr old boy who has Type 1 diabetes and is being treated with a small amount of insulin and herbs and has his blood sugar under control. We are watching the progress of a woman with chronic health issues (possibly arsenic poisoning from the long-term use of paint) being treated with herbal medicine and acupuncture. The "western" diagnosis is not needed to proceed with treatment because the doctor is treating based on the information from the examination: pulses, tongue coating and shape, questions, visual examination, etc.

Beginning in April, we will continue with a 6-week course in acupuncture. We will have another professor who usually teaches at the TCM University in Nanjing as Dr. Lu does not practice acupuncture. After the 6-week course, I will have completed my studies in TCM. My classmates, Rita and Michela, plan to continue studying TCM next year.