Integrative Medicine

[Guest guest]

We are in complete agreement in all counts except possibly on the Wiseman terminology as a standard which I would really hate to see.

alon

 

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cha

Sunday, August 27, 2000 10:31 AM

integrative medicine

Alon, et. al.While I have been taking the largely classicist side in this debate, Iwanted to share my vision of medicine in the future. I envision theeventual demise of both TCM and modern medicine as they now exist, to bereplaced by a holistic integrative medicine. This integrative medicinewill be essentially a bian zheng style biomedicine (but it will not useTCM jargon at all). I certainly do not envision a return to low techpreindustrial lifestyles. Modern research is already beginning to usethe human genome as the basis for such a bian zheng biomedicine. TCMhas much to offer to this evolution, but I think it requires two things,at least:1. rigorous study of the classical foundations; otherwise we havenothing to offer them.2. rigorous study of modern science, especially cutting edge ideas,like systems science and chaos, but also more mundane stuff likebiochemistry (my undergrad is in Bio, excuse my bias)Conversely, we need to steer clear of pseudoscience. I recently sawacupuncture described as "a quantum hyperdimensional modality". Whatthe hell does this gibberish mean? People who actually study modernbiology know there are both holistic and reductionistic aspects to it.People who do not study biology deeply do not penetrate to the holisticlevel. They are left with the impression that biology is reductionisticand turned to half baked ideas called "energy medicine", borrowing termsfrom physics that make almost all physicists wince (with the obviousexception of new age marketeers like Capra).--DirectorChinese Herbal Medicinehttp://www..org(503) 771-9599Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

On Sunday, March 3, 2002, at 10:35 AM, wrote:

 

> I am curious why some people are comfortable with integrative medicine

> that involves combining western allopathic drugs with TCM, but not

> comfortable with allopathic use of herbs? 

 

The issue is actually much more complex than it looks on the surface. I

think a lot of the muscle behind this view of integrative medicine has

to do a great deal with socio-economic realities, rather than

philosophical or clinical superiority. Despite my feelings about the

need for combined therapies with many situations, especially since we do

not have in-patient CM facilities in the West or developed educational

models for critical care, the fact remains that a good percentage of

what we treat is biomedical iatrogenesis.

>

> 1.  If using chemo with herbs to treat cancer is more effective than

> using TCM alone, then it follows that the allopathic model has a valid

> role to play in modern holistic medicine.

 

Again, this is possible, but I see the situation as much more

complicated. The present cancer epidemic is largely a result of

environmental toxins from chemical pollution, and must be addressed to

lower cancer rates. Also,the modern lifestyle of poor diet, sedentary

living habits and high stress contributes to this epidemic. People

often are diagnosed at late stages of development of cancer when extreme

measures are necessary to save life.

 

There are herbal protocols for cancer treatment, but we presently don't

have the legal freedom or protection to try these out. I would like to

see some clinical trials done. There are indications in some studies in

China that herbal medicine can be quite effective in primary care cancer

treatment.

 

>

> 2.  If the allopathic model has a valid role to play, then it would

> follow that the allopathic use of herbs and other supplements also has a

> place in modern holistic medicine.

 

I think the problem is not using a bian bing/disease differentiation

model with herbal medicine, but that it is done in a systematic matter.

There is a place for more aggressive therapies with herbal medicine, but

the problem is the increase in iatrogenesis. We must always weigh

factors of time, constitution, and the weight of the disease in doing so.

>

> I don't understand why it is acceptable to use toxic drugs

> allopathically in combination with a TCM bian zheng approach, but it is

> not acceptable to use nontoxic herbs in any other fashion besides bian

> zheng.

 

There are studies that indicate that indiscriminate use of herbs

according to a disease model can be counterproductive. For example, in

the warm disease literature it states that using large amounts of bitter

cold medicinals can 'freeze' the disease evil, locking it in the

interior. One Chinese case study I read was of a patient who had a

cold. Western physicians gave him a sputum test and determined that he

had a virus. A TCM physician, based on this information, prescribed

Isatis root tincture. The patient became much worse and developed

bronchial pneumonia, with severe cough and copious white sputum, and was

very chilled. The tongue had a thick white coating and was pale. The

patient was referred to another physician who determined that it was a

wind-cold attack that was driven deeper by using a bitter-cold

medicinal, so he treated the patient with moxabustion and warming

medicinals to cure the patient.

>

> To elaborate, if one is comfortable with giving chemo drugs to destroy a

> tumor, what is the problem with using herbs that are known to have

> antitumor effects even if they are not matched to the patient according

> to bian zheng?  I mean, the chemo drugs are not matched this way either.

 

I am personally not comfortable with giving chemo drugs to destroy

tumors. But, again, it depends on the situation, lifestyle, and other

factors in a patient's life. And, again, we are crippled in training

and legal freedom to use alternative methods without chemo. I have

cases where chemo drugs have shortened the lives of patients. I don't

think killing tumors is necessarily curing cancer, I think it is buying

time (except, perhaps in certain leukemias or lymphomas). Sometimes,

however, it is the necessary way to go. And Chinese medicine and other

'alternative' methods can be very supportive in those cases.

 

I think natural medicinals, which are generally more complex

pharmacologically than drugs, and generally milder in action, metabolize

differently, and, therefore, are not as suitable to the biomedical

model. There is also a lack of standardization of dosage and active

ingredients relative to pharmaceutical drugs. It is much more difficult

to prescribe herbs allopathically as a result. So, even if a substitute

for insulin was produced, it would be difficult to keep an herbal

medicinal in the blood at controllable levels to protect the patient. .

..the same with potential thyroid substitutes. While these are areas we

might explore, we are not there yet.

>

> Or if one is OK with diabetics taking hypoglycemic drugs, then what

> about chromium and niacin?  It would seem to me if the allopathic

> approach is acceptable in integrative therapy, this should extend to the

> allopathic use of supplements, as well.

 

This is not an area that I have expertise in. . .I'll be interested to

see others' comments. Michael Broffman and Miki Shima, two teachers I

look up to, do use supplements in their treatment plans.

>

> I suppose that this is another area that needs to be studied, whether

> combining naturopathy with TCM is more effective than either alone.

 

That would be quite interesting. I have tremendous respect for

naturopathy, having gone to a early naturopathic school for two years in

the 70's.

 

 

[Guest guest]

My two cents on Integrative Medicine and Western Vs. TCM: IMO the better way to

frame the issue is to clearly acknowledge that there are two primary methods of

healing; one that seeks to take over for or replace one's natural healing

ability and another that seeks to facilitate/enhance/encourage one's natural

healing ability. Once we frame the issue in this light, we can better address

the difficult questions about integration. Both approaches have their relative

strengths and weaknesses. Unfortunately, modern medicine has so convinced itself

that taking over for the body's (body/mind/spirit) natural healing ability is

the only legitimate form of medicine that it never even considers that the other

method is a viable possibility (the possible exception to this being the use of

vaccinations). Acupuncture clearly works by stimulating the body's natural

healing ability. Chinese herbs and related natural substances however, run the

range from those (majority) that stimulate natural healing processes to those

(minority) that act like drugs and take over for natural healing processes. One

of the strengths to the approach of taking over for the body is that this

approach tends to have a more direct and dramatic effect on the disorder. This

approach is also relatively easier to study. Its weakness is a higher rate of

adverse reactions (side-effects). The strengths and weaknesses of the approach

that aids the body's natural healing abilities is the mirror-opposite of the

intervening approach: less direct and dramatic effects but with little or no

adverse reactions (indeed, often additional positive reactions) but also more

difficult to study (in a mechanical manner).

 

 

 

Considering the above, whenever evaluating any patient we can ask ourselves -

will this person's condition be better managed by the intervening or natural

healing approach? Life threatening conditions usually need dramatic intervention

while many other conditions could be managed better by aiding the body's natural

healing ability. Of course, whenever you frame an issue with two opposite

(yin/yang) extremes there will be some circumstances that fall between the two.

Some conditions may be best managed with a integrated combination approach. It

is also often difficult to know with certainty if any given patient (condition)

can be successfully managed by one approach or the other. Acupuncture, for

example, is very good at speeding healing of an open wound. But will acupuncture

always help heal the open wound on the lower extremity of a diabetic? Sometimes

it will, sometimes it won't. Can acupuncture, herbs, and diet always be counted

on to manage the care (save the life) of a diabetic? Often it can, sometimes it

cannot.

 

 

 

I wholeheartedly agree that, on the whole, modern medicine carries unforgivable

risks and I also believe that Oriental medicine constitutes the Granddaddy of

all natural healing approaches. But, until we clearly recognize we are dealing

with two distinct healing approaches and begin to frame debate about patient

management and overall healthcare policy with these in mind, we will lose

ourselves in rhetoric over eastern vs. western or traditional vs. modern , etc.

In the U.S. during the 19th century, these two healing approaches were

recognized as the " Eclectic vs. the Allopath " approach and a common joke during

this era was that the eclectic cure was too weak so the disease killed you while

the allopath cure was too strong and so the cure killed you. It is sad to think

we have not made much progress integrating these two approaches over the last

two centuries and that this joke can still apply today.