Adjusting Traditional Chinese Medicine (TCM) Practice

to Meet Americans Needs and Expectations

--- A summary of ten years practicing TCM in the United States

Introduction

TCM practice in China

In China, outpatients generally receive acupuncture treatment once a day over months while inpatients receive treatment twice a day in order to attain optimum results. Chinese patients are also typically prescribed a week’s supply of herbs at a time: 6 to 7 one-pound bags of raw herbs, one bag for each day of the week and return for more, usually repeated for months or even years. Chinese patients understand that healing takes time and effort so they willingly spend hours every day cooking and preparing the herbs which invariably permeates their homes with strong odors in the process. They faithfully tolerate the taste of the herbal concoction twice daily for as long as it is needed. They wait patiently for the herbs and acupuncture treatments to take action, understanding that it may take months to see results. These routines are inherited from our TCM ancestors and are so deeply rooted in our minds that we naturally believe that they are absolute procedures standard for T CM practice. There is no reason to question it; every doctor and patient in China understands and accepts the philosophy.

Challenges of practice TCM in America

Should we expect American patients to follow the same traditions and routines in TCM clinics in the U.S.A.? Yes, of course! What else can we do to provide quality treatments? Unfortunately, the American people have been raised in a different way. None of the TCM routines get a positive response from American patients. The American culture, diet, and lifestyle are completely incongruent with traditional applications of TCM in the United States .

Firstly, the average American cannot receive acupuncture treatment every day no matter how sick they are. This is primarily because of financial issues; they cannot afford the payment ranging anywhere from $50 to $150 for each acupuncture treatment. TCM is still not well-received in the western medical community, therefore, most major health insurance plans still don't cover TCM. Furthermore, Americans are not used to pay for doctors visits out of their own pockets. Naturally, they routinely seek medical treatments covered by their health insurance. There is also a time issue. The competitive business and work world very often keeps them working late. Social engagements are also a priority which occupies their time. Moreover, American parents are very involved with their children, attending school activities, especially sports. All this puts severe time constraints on their daily life.

Secondly, Americans absolutely do not want to spend time to cook the herbs, nor can they tolerate the unpleasant smell. Most Americans favor sweet tastes so they find the herbal concoction very unpleasant.

Thirdly, Americans expect a quick fix that has been conditioned by a quick response to medication. Most of Americans are used to the instant gratification of symptom relief that a pill can provide for them. Therefore, instant results are also expected from TCM. There is no doubt that advanced technology has spoiled the average American which makes it very difficult for them to accommodate the TCM procedures.

American diseases and related situations

There is no doubt that different lifestyles and diet create different diseases. Many TCM practitioners that trained and practiced in China came to the United States a decade ago and were surprised to see very different types of diseases that they had seen rarely in China, but were rampant in America. Depression, anxiety, and insomnia, followed by heart disease have plagued American life. Twelve million Americans suffer the anguish of depression according to Center for Diseases Control and Prevention, CDC (1).

With westernized lifestyle: fatty foods, lack of exercise and obesity are common; all of which may also raise the incidence of breast cancer.(2) In a study released in July 2007, scientists traced the eating habits of 3,000 Chinese women, ranging in age from 25 to 94. Half of the group ate a 'meat sweet' diet of Western cuisine, rich in red meat, shrimp, fish, candy, desserts, bread, and milk. The second half sample stuck to more traditional Asian fare of tofu, vegetables, sprouts, beans, fish and soy milk. Post-menopausal women in the meat-sweet group showed a 60% greater risk of developing the most common kind of breast cancer. (3) Breast cancer is not a simple disease; instead, it is originates within the existence of many other chronic illnesses in the body.

Most Americans handle their health problems by taking drugs. The average elder American, 65 years or older, takes an average of 15 medications a day. The April 15, 1998 Journal of the American Medical Association reported that there are more than 2,000,000 adverse drug “reactions” annually in the United States and that more than 100,000 of those reactions are fatal. This makes prescription drugs the fourth leading cause of death in America , (6) which compels the American public to raise their awareness of natural healing. As a result, TCM is gaining greater attention, popularity and demand in America .

Comprehension

During my practice in America I have learned a great deal about my patient’s diet, habits and personal life. With more American women joining the industrialized workforce, additional pressure and nervous tension has been created in the American family. Insecurity and anxiety from competition, the need to succeed, and numerous organizational affiliations, generates a large stress load day after day, with hardly any relief. This constant worry directly affects digestive function, which is described in The Basic Theory of Traditional Chinese Medicine as “Wood Overacting on Earth”. In TCM, the wood refers to Liver, and it houses the mental state, while the earth refers to digestive system, spleen and stomach.

That is to say, the liver is responsible for the ascent, descent and harmony of the Qi for the whole body. The normal character of liver is to “flourish” and dislike depression. The liver’s function is to maintain the smooth flow of Qi, which in turn is an important requirement for proper digestive function. Moreover, the liver promotes the secretion of bile which aids in food digestion. Dysfunction of the liver Qi may affect the secretion and excretion of bile, which is especially important for the American diet.

On the other hand, the spleen is known as the “source of the nutritive substances.” Only when the spleen performs its transporting and transforming functions well can the liver work smoothly and be properly nourished by food and nutrition. The patterns of the American way of life, fatty diet and lack of exercise all contribute to the disharmony of liver Qi resulting in various forms of indigestion. I learned this basic understanding about American's health conditions because every day in my American clinic I encountered typical digestion problems such as heart-burn, bloating, diarrhea, constipation, loss of appetite, compulsive eating, diverticulosis, etc.

What I discovered is that the vicious, destructive cycle between the liver and the spleen; mental stress--indigestion--toxicity--reabsorb into the body--further complicate the illness of the liver, the spleen and the brain. Imagine a bag of left over food , tied up, and placed outside on a summer day. What would happen? Putrifaction! This is exactly what takes place in the body. In short, death begins in the colon. 8 “Damp-Heat” as described in Chinese medicine, can be used to describe these symptoms: viscous and odorous stool that is difficult to excrete, weighty feelings and a turbid mind. All symptoms have been witnessed in my clinic every day.

The challenge to be able to truly help Americans to extricate themselves from this predicament has compelled me to seek new and effective ways to practice TCM in America . Finding a TCM formula which is effective, produces instant results, and yet, no bitter taste, and no odor was the core of the challenge. It had to be in the forms of capsule or tablet instead. How many capsules or tablets equal a big bag of cooked herbs? Can TCM work in capsule or tablet form? Can TCM really satisfy American's need and expectations? My answer is YES!

Solutions

1. Purify the Colon

It is clear that detoxification is the first and most crucial step to help Americans get relief from their distress. In 2000, after numerous clinical trials, I created an innovative herbal formula called ‘Body Clean’. This highly effective formula is used very frequently in my clinic. Other physician’s offices, a health food store and a pharmacy close to my office have also stocked it for eight years. In conjunction with acupuncture and other herbal remedies, this formula is my main weapon that has helped and saved thousands of my patients’ lives here in America .

2. Pacify the brain

The second crucial aspect to assist in the health of Americans is to support the brain function. An herbal formula named ‘Serenity’ was created for the purpose and it has gained the respect of my patients because of its effectiveness. Taking five capsules twice a day works for depression, anxiety, panic attacks, insomnia, and similar diseases. It provides improvement the very next day after the first dose. It generates peace of mind and a sense of inner balance.

There are 30 other herbal formulas I have created to fit the needs of Americans. With these effective formulas in hand, I am able to treat Americans just twice a week for a short period of two weeks and get favorable results quickly. I prescribe four acupuncture treatments over the two week period, which is the preferred amount of time and the right amount of money that most American like to spend to get well.

Case Studies

1. Intercostals neuralgia (Shingles)

Kelly, a mother of two young children, was living a healthy, active life when suddenly, in December 2005, she was floored by piercing pains in her shoulders and front rib cage. The agonizing pains persisted over the next several months. Her doctors prescribed pain killing drugs, and eventually even morphine. None of these provided her with relief, so the doctor finally referred Kelly to my clinic.

Kelly was unable to drive her car, nor to continue work. After thoroughly examining Kelly I discovered problems in her digestive system. Kelly was surprised and admitted that she was having intermittent bouts of diarrhea, heartburn and nausea. The “Body Clean” was given to remove the toxins from her body, which strengthened her digestive system significantly. In conjunction with four acupuncture treatments, she excitedly reported that she felt completely pain-free within two weeks.

The catalyst for Kelly's immune system breakdown, that had escalated the attack of shingles, was the toxicity in Kelly's colon. Today, Kelly remains in good health, with no recurring pain or digestive problems. She no longer takes medications nor has to see me. She was reemployed and is functioning in all areas of her life again. Kelly's case illustrated the healing power that we all possess; the innate capacity of the body's immune system to restore itself and overcome illness.

2. Hot Flashes (menopause)

Carmen began experiencing intense hormonal swings on a daily basis over ten years. Every night, she was bombarded by hot flashes, which jarred her awake, and woke her up again and again every time she drifted back to sleep. Recalled Carmen, "I was suffering from severe hot flashes ... It was one hot flash after another. It was really bad."

American medical professionals estimate that eighty-five percent of menopausal women in the U.S. experience hot flashes in varying degrees, with forty percent of them suffering from symptoms severe enough to seek medical attention. Most researchers concur that hot flashes are the body's response to fluctuating hormone levels, especially estrogen, which naturally diminishes in women as they approach midlife. Therefore, hormone replacement therapy, or HRT, is considered the most immediately effective method in the U.S. for treating hot flashes. In recent years, however, scientific investigations have yielded additional ominous findings that linked estrogen therapy to an increased risk for strokes and for breast, ovarian, and endometrial cancers.

Carmen determined to find an alternative therapy. When she discovered that one of her friends had found relief for her hot flashes through acupuncture treatments with me, Carmen immediately scheduled an appointment at my clinic. As is my routine, I started by checking her digestive system function. Carmen had bowel movements two to three times each day and showed no problem in her digestion. I gave her an herb called “Kidney Yin Tonic” in conjunction with acupuncture, but her symptoms did not change within a week or so. When I switched to “Body Clean”, her hot flashes diminished quickly within two weeks.

It is well known that hot flashes result when the kidney is in yin deficiency in TCM. What I discovered is that colon and overall body toxicity could dominate the whole body function in the case of severe hot flashes. In other words, the colon's state of health influences estrogen levels. How? Perhaps the hormone receptors that exist in the digestive tract needed to be exposed in order to fully perform their function. Perhaps it is the toxicity in the body that disturbs the function of estrogen and creates an imbalance. It could be both or other mechanisms that need to be explored further.

In fact, hot flashes are a much more complicated process than simply the result of low estrogen levels in the body, because hot flashes occur in women who have high levels of estrogen during the last trimester of pregnancy, while hot flashes do not occur in pubescent girls, whose estrogen levels are still low. In summary; the hot flash is very much related to digestive system and its function. The bodies toxins play an important pathogenic role in forming hot flashes.

3. Chronic obstructive pulmonary disease COPD

David had even started planning his own funeral arrangements since he feared that he had only a few weeks to live. His physical condition had been gradually deteriorating, due to his forty-three years of grueling work, and inhaling dust particles and industrial fumes as a general contractor in the construction industry. He was diagnosed with COPD for the past four years, and on top of that, he was diagnosed with congestive heart failure (CHF) two years ago. David's doctor told him he had to have heart bypass surgery. The operation was a risk to his life, but was desperately needed. He survived the surgery, but it seemed to further debilitate his body.

David was placed on daily inhaled steroid treatment with a nebulizer, oxygen, as well as other respiratory medications but his condition continued to deteriorate. David was referred to my clinic by his doctor. Upon his arrival he could only walk a few steps before he was out of breath. After examining David, I immediately performed XinNao KaiQiao* acupuncture on him to enhance his vital-energy and circulation in order to revitalize his body function. I gave him the “Body Clean” to address his lung health in the context of the colon's health since the lungs and colon function together as a paired-organ, according to TCM.

After two weeks of four acupuncture treatments David stated that he felt 80% better. He was able to get around better than he had in the past four years. After three months, David climbed one-and half miles up a trail in the Smoky Mountains and went white-water rafting with his son’s family. A dream has come true for a man who worked so hard throughout his life. David and his wife still come to see me once a month for maintaining good health. In summary: Western medicine focuses on each symptom independently, while Chinese medicine emphasizes the interplay between all the symptoms, and all the other contributing variables.

4. Chronic Fatigue Syndrome CFS

CFS is characterized by incapacitating fatigue (experienced as profound exhaustion and extremely poor stamina) and problems with concentration and short-term memory.

Sue is an office worker in her late forties who was so tired that she had to rest all weekend in order to work the next week. She had a list of things in her mind that needed to be done but she had to drop it. She had been tired for about five years, but had recently worsened.

Sue’s husband had been treated in my clinic for severe neck and shoulder pain. The amazing result from acupuncture that her husband's severe pain was almost gone within two weeks convinced her that she wanted to get help for herself as well. Sue's tongue looked pale and swollen with a thick, white coat on it, her pulse was weak, and she felt bloating on her stomach area. She had bowel movement about once a day with a strong odor. This is a typical sign of digestive blockage which could be built up by years of undigested food. Her family issues, financial stresses, and her husband's medical problems were big stressors in her life.

After four acupuncture treatments and within two weeks of taking “Body Clean” and “Serenity” twice a day, Sue says she feels a lot better. “ I have more energy on the weekends now and have been doing many things around the house and went shopping. I don't feel as depressed as before, and my moods have been better.” Sue continued, “People are often skeptical of acupuncture and Chinese herbal remedies because they are not used to this kind of medicine. It's been around for thousands of years, but it's not our culture. It's nice to know that there is something else to do for medical problems besides surgery or a pill (medication).”

A reporter asked me why Sue was physically tired even though she did not perform any physically demanding work and why she was being treated for toxicity and depression even though she didn't mention these as her problems at all. I answered that this is a typical predicament that many American’s have. Due to overwhelming daily stress their brain function has been distracted or even suppressed. Complete loss of appetite or becoming a compulsive eater--people eat more than they need because of stress, anxiety, depression followed by indigestion. In turn, the internal organs, especially the brain and the heart, could not get proper nutrition, which causes more setbacks or even crisis in the body. In summary: use acupuncture to quickly revive and re-balance the body function in tandem with the Body Clean to purify the inner organs is a short-cut to achieve quick healing in America.

5. Tourette Syndrome TS

Bobby is a straight A student, and he was diagnosed with Tourette syndrome two years ago. He had constant neck movement and rotating shoulder blades. He had seen three specialists due to severe allergic reactions to the medications he was taking with hives, swelling and difficulty breathing. He was rushed to the emergency room. Both of his parents were my patients and had been seeing me in the past. They brought Bobby to my office on June 23, 2005.

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements. It is estimated that 200,000 Americans have the most severe form of TS. Although the cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and nor-epinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equal complex.

Bobby was heavy and felt hot all year long, he never wore pants, even in the coldest winter. He was a typical “Dam-Heat” patient. XinNao KaiQiao acupuncture treatments and the “Body Clean” helped him greatly. Within two months he had lost 80 pounds and ( after a further two months, he was drug-free, and symptom-free. He has also started to wear more clothes in winter which he had not done in years. In summary: there is always a reason for any symptoms. Sometimes, to skip the symptoms and focus on the body balance is a sure way for healing.

6.Buerger's disease

Buerger’s disease is an inflammatory occlusive disease which involves all layers of medium sized and small arteries of the extremities. Smoking is very closely related to Burger's disease. Gordon was a heavy smoker in his thirties, and he was diagnosed with Buerger's disease 9 years ago. He quit smoking immediately, but it did not save him from the disease. He was also diagnosed with gout, a disease created by a build up of uric acid which is deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream. This provokes an inflammatory reaction of these tissues.

Both Gordon's parents are my patients, and his father is the COPD patient mentioned above, but his father's amazing recovery did not convince him to come for help. Gordon waited until he could not handle his pain any longer. Both of his feet were swollen and discolored. He had so much pain that he could hardly walk. He could not sleep at night due to the severe pain. He was also constipated and the “Body Clean” was not strong enough to help him remove his bowel, so another herbal formula named “Intestinal Clean” was also applied. In conjunction with acupuncture treatment, Gordon's pain was significantly reduced within the first two weeks. Now I see him once a week and his condition is still improving.

Conclusion

The American culture, lifestyle, diet and stress have generated a different set of diseases. In addition, Americans have difficulty to accommodate traditional procedures of TCM. Therefore, the needs and expectations of Americans have to be dealt with differently by TCM practitioners. Wide spread emotional frustrations clearly affect American internal organs, disturb their bodily functions and lead to disease. It especially suppresses their digestive systems. Their weakened digestive systems in tandem with their sweet and fatty diet habits are the core etiologic factors which characterize American health problems. Undigested food accumulates and transforms into ‘Damp-Heat’ becoming the foundational pathogenic feature of American treatment needs. Detoxification is crucial to solve the bulk of America ’s health problems. After adjusting formulae and methods to fit American needs and preferences, Traditional Chinese Medicine can be an excellent complement to Western medicine in treating serious and chronic illnesses rampant in the United States.

Acknowledgement:

Many thanks to Mr. Vern Duiker and Dr. Julian Smith for assisting me to edit this paper.