CTM: A Clarification of Key Blood-Building Strategies

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http://www.acupuncturetoday.com/archives2000/aug/08becker.html

 

 

Commentary: A Clarification of " Key Blood-Building Strategies "

 

By Simon A. Becker, Dipl. Ac., CH (NCCAOM)

 

Chinese herbal medicine is an exceedingly difficult field to study and

master. This is why I worry when I read articles such as Andrew

Gaeddert's " Key Blood-Building Strategies, " which appeared in the June

issue of Acupuncture Today. I would like to make some clarifying

statements as to what I felt was confusing information about the

prescriptive methodology underlying professional Chinese herbal

medicine vis-ö-vis the treatment of anemia.

 

Mr. Gaeddert's article talked about blood-building strategies,

addressing treatment methods to deal with anemia. Hence, when I read

the article, I assumed he was referring to the Western medical concept

of blood and a lack thereof (anemia). However, he then advocated the

use of ba zhen tang (eight gem decoction) for anemia, saying that it

" has been used for thousands of years to treat anemia, fatigue, pale

complexion, cold limbs, post-menstrual depletion, amenorrhea and

uterine bleeding. " He thereby intermingled the different concepts of

blood in Western and Chinese medicine and equated blood vacuity, a

Chinese medical concept, to a lack of blood (anemia), a Western

medical concept.

 

Anemia as such does not exist in the Chinese medical literature (and

therefore, the above quoted statement that ba zhen tang has been used

for thousands of years to treat anemia is certain to be wrong; it may

have been used for thousands of years for symptoms commonly associated

with anemia, but certainly not with anemia as such). As a matter of

fact, even Western medicine does not recognize anemia as a disease

,but rather considers it to be a symptom or description of an

underlying pathology leading to a lack of blood. Furthermore, anemia

is differentiated into many different types (aplastic, megaloblastic,

iron deficiency, hemolytic, etc,) and may manifest with such different

symptoms as fatigue, acute hemorrhaging, high fever, or even jaundice.

 

Chinese medicine is characterized by its unique method of classifying

diseases and then differentiating patterns for such disease

classifications. Because most Chinese disease classifications

originated before the introduction of Western medicine into China, and

because Chinese medicine regards the body as a microcosm in which

internal changes will affect and manifest as symptoms that can be

recognized without looking into or extracting fluids from the body,

Chinese disease names are mostly based on symptomatology and never on

blood or laboratory values. Hence, the different types of anemia fall

into such Chinese medical disease categories as vacuity taxation (xu

lao), blood vacuity (xue xu), bleeding conditions (xue zheng),

jaundice (huang dan), etc., depending on the presenting symptoms at

the time of diagnosis. For example, a case of aplastic anemia may be

diagnosed as vacuity taxation at one point and as bleeding condition

at another.

 

Having said all this, I must add that in the hematology departments in

modern-day China, such disease classifications are no longer recorded

into the patients' medical charts by Chinese doctors. Rather, Western

disease names are used to define and distinguish the condition.1

However -- and this is where the strength and uniqueness of Chinese

medicine sets in -- all diseases are then differentiated into

patterns, and the administration of Chinese herbal medicine is based

on these patterns, not the diseases. For example, the most common type

of anemia, iron deficiency anemia, can be differentiated into the

following seven patterns: spleen-stomach vacuity weakness; qi and

blood dual vacuity; liver blood insufficiency; spleen-kidney yang

vacuity; blood vacuity with fire and dryness; liver-kidney depletion

and detriment with non-transformation of blood by essence; and

accumulation and lodging of intestinal worms.

 

Symptoms vary according to pattern. For example, pattern one is

characterized by spleen and stomach vacuity signs such as loose

stools, reduced appetite, lack of strength in the limbs, etc., whereas

pattern two is characterized by blood vacuity signs such as dizziness,

a somber white complexion, palpitations, etc. Herbal prescriptions for

all seven patterns vary greatly, ranging from relatively slimy yin

nourishing formulas to strongly spleen fortifying decoctions.

 

My point in explaining all of the above is that simply taking one or

two Chinese medicinal formulas and saying that they treat anemia (a

term referring to a Western medical disease category which may

manifest with a wide range of very different symptoms) is not

practicing Chinese herbal medicine. Professionally administered

Chinese herbal medicine bases its treatment on treatment principles

derived from a pattern discrimination which itself is based on the

patient's individual symptom complex, not his or her disease.

Furthermore, it needs to be pointed out that anemia (literally meaning

a lack of blood) is a Western term and is not synonymous with the

Chinese concept of blood vacuity.

 

To illustrate this more clearly, it should be considered that the most

common symptoms of anemia, fatigue and shortness of breath, are signs

of qi vacuity, not blood vacuity. For a Chinese medicine practitioner,

the fact that a patient presents with laboratory values reflecting an

anemic state is not of great significance.2 What matters most are the

presenting signs and symptoms which help the practitioner to

discriminate the pattern.

 

Chinese herbal medicine is so uniquely effective exactly because it

discriminates and treats different patterns of a disease rather than

the disease itself. Similarly, Chinese medicine can be ineffective or

even have adverse side effects if not administered correctly. Articles

such as the one quoted above and coming from a respected herbalist

such as Andrew Gaeddert are sure to confuse readers and create a

wishy-washy system of Chinese herbal medicine nowhere near as

effective as potentially possible.

 

References

 

1. However, for anyone practicing Chinese medicine and researching its

literature, the original disease classifications are of paramount

importance since they are still very commonly used in the Chinese

medical discussion of biomedically defined and named diseases. For

example, most textbooks are still organized by traditional disease

classifications rather than biomedical disease names.

 

2. Of course, knowing that a patient suffers from a specific type of

anemia may influence the treatment strategy as a whole, i.e., if a

patient suffers from iron deficiency anemia, iron rich foods and

possibly iron supplements should be consumed. However, even in such a

scenario, if the patient suffers from the spleen and stomach vacuity

weakness pattern of blood vacuity, iron supplementation plays only a

secondary role; the fortification of the spleen and stomach are

primary. As long as foods are not absorbed correctly, no iron

supplement will be of any help. This explains why certain iron

deficienct anemia patients fail to improve even though they are on

megadoses of iron.

 

Simon A. Becker, Dipl. Ac., CH (NCCAOM)

Asheville, North Carolina

 

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