How a Harvard-trained doctor began to appreciate Traditional Chinese Medicine, TCM.
As a child growing up in China, I was always aware of Traditional Chinese Medicine (TCM). TCM is what we refer to as Eastern medicine, in contrast to the Western medicine we know from U.S. hospitals. I never understood much about TCM, only that it somehow involves herbs and that many Chinese people used it. The more I progressed in my medical training in major U.S. academic centers, the more distanced I felt from TCM. Why should I learn about something that lacks evidence, when there’s so much to know about for which there is good research?
Last fall, I went to China on a research trip. While my study is primarily on its Western medical system, I was so fascinated by what I learned of Eastern medicine that I spent many free evenings observing TCM practitioners. There is so much I didn’t know. As a discipline, TCM is far too complex for me to understand in my short observation, but there are some very important “lessons from the East” that are applicable to our Western medical practice:
#1. Listen—really listen. The first TCM practitioner I shadowed explained to me that to practice TCM is to “listen with your whole body”. Pay attention and use every sense you have, he said. I watched this doctor as he diagnosed a woman with new-onset cervical cancer and severe anemia the moment she walked into his exam room, and within two minutes, without blood tests or CTs, sent her to be admitted to a (Western) medical service. I’ve seen expert clinicians make remarkable diagnoses, but this was something else!
“How could you know what you had and that she needed to be admitted?” I asked.
“I smelled the cervical cancer,” he said. “I looked and saw the anemia. I heard her speak and I knew she could not care for herself at home.” (I followed her records in the hospital; he was right on all accounts.)
#2. Focus on the diagnosis. I watched another TCM doctor patiently explain to a young woman with long-standing abdominal pain why painkillers were not the answer.
“Why should we treat you for something if we don’t know what it is?” he said. “Let’s find out the diagnosis first.” What an important lesson for us—to always begin the diagnosis.
#3. Treat the whole person. “A big difference between our two practices,” said one TCM doctor, “Is that Western medicine treats people as organs. Eastern medicine treats people as a whole.” Indeed, I watched her inquire about family, diet, and life stressors. She counseled on issues of family planning, food safety, and managing debt. She even helped patients who needed advice on caring for the their elderly parents and choosing schools for their child. This is truly “whole person” care!
#4. Health is not just about disease, but also about wellness. There is a term in Chinese that does not have its exact equivalent in English. The closest translation is probably “tune-up to remain in balance”, but it doesn’t do the term justice, because it refers to maintaining and promoting wellness. Many choose to see a TCM doctor not because they are ill, but because they want to be well. They believe TCM helps them keep in balance. It’s an important lesson for doctors and patients alike to address wellness and prevention.
#5. Medicine is a life-long practice. Western medicine reveres the newest as the best; in contrast, patients revere old TCM doctors for their knowledge and experience. Practicing doctors do not rest on their laurels.
“This is a practice that has taken thousands of years to develop,” I was told. “That’s why you must keep learning throughout your life, and even then you will only learn just a small fraction.” Western medicine should be no different: not only are there new medical advances all the time, doctors need to continually improve their skills in the art of medicine.
#6. Evidence is in the eyes of the beholder. Evidence-based medicine was my mantra in Western medical training, so I was highly skeptical of the anecdotes I heard. But then I met so many patients who said that they were able to get relief from Eastern remedies while Western treatments failed them. Could there be a placebo effect? Sure. Is research important? Of course. But research is done on populations, and our treatment is of individuals. It has taken me a while to accept that I may not always be able to explain why—but that the care should be for the individual patient, not a population of patients.
“In a way, there is more evidence for our type of medicine than for yours,” a TCM teacher told me. “We have four thousand years of experience—that must count for something!”
There is so much I have not covered about TCM. Its practices vary regionally, and no doubt, there are more and less capable practitioners (as there are in Western medicine). More research into TCM methods will be important. However, regardless of whether we Western doctors want to prescribe TCM treatments, we should recognize there is much to learn from Eastern medicine, including what it means to be a physician to really care for our patients. Upon my return from China, I, for one, have a new found appreciation for Eastern medical practice and a renewed understanding of holistic medical care.
I having been surrounded (quite literally) for the past three days by so called “healthy products”, everything from fortified lolly pops, safer nail polish to every type of infused water possible. I had three days of endless conversations with wellness experts from around the world, Naturopaths, Dieticians, Chiropractors, Acupuncturists, Herbalists, Homeopaths and Bio-Chemists to name a few. Every health professional I spoke to had the same resounding theme, the key to better health is not in any one of these hot new health products that you’ll find at the Natural Products Expo and later on a store shelf. It’s not about curing a disease, it’s about PREVENTING it in the first place. The key is and always has been about PREVENTION.
You might be asking what is sleep hygiene?
Sleep hygiene is a combination of practices to create a restful, rejuvenating night of sleep. If you don’t get restful sleep every night there is an herbal solution to help. This product has over 800 hundreds of years of use and clinical studies backing it’s effectiveness.
Why use an herbal remedy for sleep that has been used for 800 years? Because, it works!
The history of herbal remedies is as old as man. Written first on bones, turtle shells and then bamboo and pryus reeds this sleep remedy has been past down from generation to generation.
There is no guessing.
The herbs used gently calm the mind, stop the over-thinking and allow the body to fall asleep and stay asleep naturally.
We did improve on these herbs by re-packaging them in convenient easy to use individual packets.
Our packets combine the best in pharmaceutical packaging without using fillers or additives.
Our packets are convenient, have no additives, no sugar, no pills and best of all, water is optional.
Try iSleep Herb Pack today not just because it tastes great, but because you deserve a restful night of sleep…
Don’t be fooled by sleep aids today that combine herbs which have no history of ever being used together. That is junk science. It’s similar to the idea of throwing everything in your refrigerator into a pot of soup and hoping it will taste good. We know it doesn’t work that way.
Wouldn’t you rather use an herbal sleep aid that has hundreds of years of use!
Try iSleep Herb Pack today.
Asian countries commonly treat sleeplessness with Chinese herbs more affordably and without the side-effects associated with prescriptions. A study done in Taiwan showed patients complaining of insomnia were successfully treated with Chinese herbs.
This study included 16,134 participants who received a total of 29,801 Chinese Herbal Medicine prescriptions. This large-scale study which used data assembled by the National Health Insurance of Taiwan, evaluated the frequency and patterns of Chinese herbs in treating insomnia.
What’s unusual about this study is not just the sheer numbers of participants but the amount of data collected. Read the full study here.
The reason the study has such a large group of participants is simply that Taiwan has instituted a unique computerized data entry system as part of its health care system. Patients can choose to visit either a Western hospital or a Traditional Chinese Medicine hospital. All data from patient visits are recorded in a national computer database. Because data is readily available in electronic form, large scale analysis is easy. Data in this study covers the course of one year. The numbers reflect the patients who, according to diagnostic codes for insomnia, were treated with Traditional Chinese Herbal Medicine in 2002.
Included in this data are the following:
- How many patients complained of insomnia, demographics on age, sex, etc?
- How many patients were prescribed various Chinese herb formula combinations in packets? (herbal packets are the preferred delivery method of Chinese herbs in Taiwan hospitals and clinics.)
- How many patients were prescribed single Chinese herbs in packets?
- Which Chinese herb formula was the most prescribed?
- Which individual herbs were often added to the prescribed Chinese herbal medicine formula?
The data concluded the most common individual Chinese herbs prescribed for insomniawere Polygonum multiflorum used 23.8% of the time, followed by Ziziphus spinosa (18.3%) and Poria cocos (13.3%). Suan Zao Ren Tan was the most commonly prescribed formula. These are the same Chinese herbal ingredients found in iSleep Herb Pack.
_____________________________________________________________________________________________ PUBLISHED IN: EVIDENCE-BASED COMPLEMENTARY & ALTERNATIVE MEDICINE CAM Advance Access published online on April 1, 2009 eCAM, doi:10.1093/ecam/nep018 © 2009 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan during 2002 Fang-Pey Chen1,2, Maw-Shiou Jong1,2, Yu-Chun Chen2,3, Yen-Ying Kung1,2, Tzeng-Ji Chen2,3, Fun-Jou Chen4 and Shinn-Jang Hwang2,3 1Center for Traditional Medicine, Taipei Veterans General Hospital, 2National Yang-Ming University School of Medicine, Taipei, 3Department of Family Medicine, Taipei Veterans General Hospital and 4Graduate Institute of Integration Chinese and Western Medicine, Chinese Medical University, Taichung, Taiwan
Chinese herbal medicine (CHM) has been commonly used for treating insomnia in Asian countries for centuries. The aim of this study was to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM use in treating insomnia.
We obtained the traditional Chinese medicine (TCM) outpatient claims from the National Health Insurance in Taiwan for the year 2002. Patients with insomnia were identified from the diagnostic code of the International Classification of Disease among claimed visiting files.
Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM. Results showed that there were 16 134 subjects who visited TCM clinics for insomnia in Taiwan during 2002 and received a total of 29 801 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (25.3%). In addition, female subjects used CHMs for insomnia more frequently than male subjects (female: male = 1.94:1). There was an average of 4.8 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for insomnia. Shou-wu-Teng (Polygonum multiflorum) was the most commonly prescribed single Chinese herb, while Suan-Zao-ren-tang was the most commonly prescribed Chinese herbal formula.
According to the association rule, the most commonly prescribed CHM drug combination was Suan-zao-ren-tang plus Long-dan-xie-gan-tang, while the most commonly prescribed triple-drug combination was Suan-Zao-ren-tang, Albizia julibrissin, and P. multiflorum.
For reprints and all correspondence: Prof. Shinn-Jang Hwang, Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan, ROC. Tel: +886-2-287-57460; Fax: +886-2-287-37901; E-mail: [email protected]
National Institute of Health – PubMed study abstract on Suan Zao Ren Tang
J Biomed Sci. 2007 Mar;14(2):285-97. Epub 2006 Dec 7.
Gamma-aminobutyric acid (GABA) receptor mediates suanzaorentang, a traditional Chinese herb remedy, induced sleep alteration.
Yi PL, Tsai CH, Chen YC, Chang FC.
Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
The sedative-hypnotic medications, including benzodiazepines and non-benzodiazepines, are the most common treatments for insomnia. However, concerns regarding patterns of inappropriate use, dependence and adverse effects have led to caution in prescribing those sedative-hypnotic medications. On the other hand, a traditional Chinese herb remedy, suanzaorentang, has been efficiently and widely used in clinic for insomnia relief without severe side effects in Asia. Although suanzaorentang has been reported to improve sleep disruption in insomniac patients, its mechanism is still unclear. The present study was designed to elucidate the effects of oral administration of suanzaorentang on physiological sleep-wake architectures and its underlying mechanism in rats. We found that oral administration of suanzaorentang at the beginning of the dark onset dose-dependently increased non-rapid eye movement sleep (NREMS) during the dark period, but had no significant effect on rapid eye movement sleep (REMS). Our results also indicated that intracerebroventricular (ICV) administration of gamma-aminobutyric acid (GABA) receptor type A antagonist, bicuculline, significantly blocked suanzaorentang-induced enhancement in NREMS during the dark period, but GABA(B) receptor antagonist, 2-hydroxysaclofen had no effect. These results implicated that this traditional Chinese herb remedy, suanzaorentang increases spontaneous sleep activity and its effects may be mediated through the GABA(A) receptors, but not GABA(B) receptors.