Tag Archives: oriental medicine

Confessions of an Acupuncturist

Pulse DiagnosisI am a former practitioner of Oriental Medicine.  In Japan I ran my own clinic where I both prescribed herbal medicine and did acupuncture and moxa.   This is an index post of my experiences and thoughts about Oriental Medicine (AKA: Traditional Chinese Medicine).

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Orthodoxy in Oriental Medicine

Zhang Zhongjing (150 - 219 AD) Author of the 傷寒論

This weekend I was sorting through dozens and dozens of my old Japanese Oriental Medicine (OM) texts that I hope to sell to clear up my basement shelves –anyone interested? 🙂  One of those OM texts was the 傷寒論 (Treatise on Cold Injury), a classic Chinese text.  As I flipped through its pages, I reminisced of my OM days and of the many of the controversies between the various schools of OM.

Comparing different cultures, languages, governments, religions and medical philosophies has taught me much about the human mind.  By the time I studied Oriental Medicine (OM), I had already left Christianity.  So I had one clear model in my head of how people fight over “orthodoxy”.   But when I began my Oriental Medical studies, I had no idea that there would be controversy here too.  I naively did not expect to find many different, contrary schools of thought.  I had instead hoped, in my perennial idealism, to find “true” medicine — real knowledge of the natural wisdom of the body (arrrghhh, that was painful to write, but that was once me).  Anyway, I soon found out that OM was as divided as Christendom.   What humored me was watching how each school of thought berated the others — I had seen this somewhere — oh, yeah, in Christianity.

Just as lineage is important to many Christians, I found it in OM too.  Heck,  I saw lineage stressed in all the Japanese and Chinese schools:  martial arts, tea ceremony, Ikebana, calligraphy, Buddhism, Shintoism.  The mistaken notion of “older is better and wiser” was a common fallacy employed.  It struck me as particularly funny in medicine where it would seem that empirical results would be all that mattered.  But careful empirical results were not tested in OM.  Thus, without measurable verification,  a plethora of dogmatic, contrary schools of thought can survive for centuries — both in OM and Christianity or in any of the schools mentioned above.

Controversies in OM include Yin-Yang theory, Five Element Theory, Channel Theory and many more.  In addition to controversial theories, controversy over source material is also common.  As I browsed the Treatise on Cold Injury I again saw pages discussing the controversy of “correct translation” of the text.  For just as in Christianity, since older is better, then a correct translation of an older text [scripture] takes us back closer to the truth.  Oh how common are the foibles of all cultures.  But when you don’t have empirical testing, lineage and revelation are important life rafts.

Comparative studies are a fantastic way to see behind our assumptions and to begin to understand how humans “think”.  But for people who never leave Kansas, this may be hard to imagine.

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Treat the patient, not the numbers

In Oriental Medicine and in Homeopathy, we would not run any laboratory tests before treating a patient.  Information was solely gathered by physical observation and the interview process.  So detailed and careful were those exams that they put Allopathic Medicine (“Modern Medicine”) to shame.  So, by the time I studied Allopathic Medicine in PA school (22 years ago), I was ready to learn that observing the patient in front of you is often more important than a measurement or lab test.

Below are a few classic examples:

High Blood Pressure

At my first job out of PA school in an ER, providers will still treating high blood pressure reflexively.  If a patient’s blood pressure was high, they popped a few pills into the patient to bring it down to “normal” quickly.  I had learned that such a practice was dangerous but it took me three months to get the ER staff to change their old habits.  If someone has had high blood pressure for a long time, they probably need that pressure to keep both their heart and brain perfused with blood.  We now know that lowering chronic hypertension abruptly can lead to ischemic disasters.

Low Oxygen Levels

Pulse Oximetry is a gentle finger clamp that uses a laser to measure how much oxygen is in your blood.  When these first came out, if someone had low oxygen levels, they reflexively supplemented their oxygen with an oxygen mask.   But ironically, if a pt has acute exacerbation of  Chronic Obstruction Pulmonary Disease (COPD) high levels of uncontrolled oxygen can result in respiratory failure!  For unlike healthy patients whose respiratory reflex is triggered by high CO2 levels, in these patients it is low O2 levels that trigger the response which you can blunt by supplying uncontrolled oxygen – thus ironically killing someone using oxygen.  This problem was later solved with special delivery systems.

High Temperature

The old school ideology was that body temperature needs to be brought down to normal range.  In Japan and China, a person with a fever is made to sweat more — their high temperature is raise further.  The body produces a fever to kill bacteria.  It is true that only some organism are killed or slowed down by high body temperatures and that the response is non-specific, but you should usually give fever a chance to work.  But in the ERs where I first worked, nurses would not give blankets to patients with fevers even if they had the chills in fear of raising their temperature.  And they would always give Tylenol or Motrin for any temperature over 100 deg C.  It took me 1 year to get that practice changed.  I had to print out article after research article and finally present them to the medical group.

Well, those are only a few examples to a principle which I will quote in an up-coming post.

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