needles and herbs

A few months ago I said my goodbyes to Dr Zhu and team, my friends, neighbors and landlord then got on a flight with all my belongings. My destination was home. While China had been an enriching experience for my skills as an acupuncturist and herbalist, as well as being a cultural eye-opener and where I really learnt how to speak Chinese it was time for me to come home.

Since coming home I have re-discovered what its like to be a Chinese Medicine Practitioner in Melbourne. At the beginning I was comparing it with that of the lifestyle of a practitioner back in China. I have now stopped comparing but to put a final end to the comparing would like to share some breif points.

following is how Dr Zhu clears serious damp heat when the patient is not too fragile.

ju hong 桔红 6克
zhi ban xia 制半夏 6克
gan cao 甘草 6克
fu ling 茯苓 30克
huang lian 黄连 6克
huang qin 黄芩 6克
ku shen 苦参 6克
mu tong 木通 6克
sha ren 砂仁 6克,
yin chen hao 茵陈蒿 6克

Dr Zhu regularly treats patients undergoing chemotherapy 化疗. The principal of using Chinese medicine alongside the chemotherapy 化疗 is to lessen the side effects of the drugs.

Dr Zhu always starts the Chinese medicine diagnostic process with observing the face. She is not only looking at the structure of the face, but also weather or not it is swollen, sunken and what the colouring is like.

In the case of patients undergoing chemotherapy 化疗 the complexion is usually greyish in colour 清色 which can be very obvious. It is most evident around the eyes and cheeks, Dr Zhu also often checks the colouring on the palm of the hand especially the thenar eminence This greyness indicates the kidney 肾 has been damaged. She uses du zhong 杜种 to tonify kidney yang，adding bai hua she she cao 白花蛇舌草 to relieve toxicity.

Tang niao bing 糖尿病 diabetes mellitus is similar to a disease known in classical Chinese medicine as xiao ke 消渴 wasting thirsting disorder. Xiao ke 消渴 was first used in the classic Chinese medicine book Huang Di Nei jing 黄帝内径 (400 BC) to describe what closely mimics diabetes mellitus. Xiao ke 消渴 is not directly associate with hyperglycemia the way tang niao bing 糖尿病 is. Tang niao bing 糖尿病is what I am hearing everyday in the hospital. Tang niao bing 糖尿病 literally means sugar urine disease. Thankfully a lot of Chinese diseases are this descriptive. I have decided to write a little bit about it as it is so commonly seen in the hospital especially among people in their late 50s and 60s. Although the Chinese medicine department is exposed to many patients with tang niao bing 糖尿病, this does not mean it is their chief complaint and lots of the time they take western medicine along side Chinese medicine.

Wu ji bai feng wan is a patent Chinese medicine 中成药. Its special because its main ingredient is a type of chicken which has black bones and skin and white feathers. Which is exactly what the name means in Chinese. I have included a picture of the Tong Ren Tang 同仁堂 version, I chose this one because I like the box and its the one Dr Zhu prescribes. In the booklet inside the box it has an ingredient list, where it says black chicken, it also says 'everything but the feathers, claws and intestines' 乌鸡 （去毛爪肠).

As you can see from the poster Dr Zhu put right above the bin about a month ago （禁止吐谈 spitting prohibited), people entering the consultation room are no longer permitted to spit into the bin. However if it is necessary to spit there is a bathroom with a spitting friendly bin at the end of the hall on the right.

If you have ever been to China the frequency of spitting in public places would probably have been one of the first confronting things you noticed. For those of you who have never been here, spitting on the street is still relatively acceptable. From my observation, most commonly committed by older aged men, sometimes women. Less common commited by middle aged men and least commonly by the rest of society.

The weather in Beijing is known for it's harshness, it flips from t-shirt to jacket weather within a week. This doesn't leave much time for the body to regulate itself.

The fast influx of cold last week is definitely a contributing factor as to why a few Australian friends living here have been falling ill with 'wind cold' attacks. We're just not use to changing our wardrobe over so quickly. A wind cold attack in Chinese medicine theory is the situation where a cold pathogen gets into the body and causes many different symptoms including cold and flu symptoms as well as other viral symptoms.

I have tried to be smart about it so instead of walking the 15 minutes from the hospital to the subway I have taken to riding in a bang bang che for five kuai, I consider it a health investment.

Today we saw a number of patients complaining of sweating disorders 汗出，otherwise known as hyperhidrosis. These patients varied in age, and medical history but sweating somehow played into their complaint. Patients ranged from a 12 year old girl just starting to hit pubity to a 45 year old male who likes to drink alcohol and smoke cigarettes a little too much.

In Chinese medicine sweating has four main mechanisms. All of which are completely different in nature, therefore each treatment is unlike the next. This is a perfect example of why diagnosis is so important in treating with Chinese herbs.

The four main categories of hyperhidrosis and their treatment in a nutshell. Diagnosis based on tongue and pulse.

1. damp heat 湿热 – thick greasy yellow tongue coat, slippery pulse. Formulae used by Dr Zhu is shi wei wen dan tang 十未温胆汤.

Pediatric cough is without a doubt one of the top three reasons children are brought to the hospital, these coughs will without a doubt include phlegm. Doctor Zhu is certain she has never seen a child with cough and no phlegm. Her certainty makes sense to me, in fact children are little snot factories and 正好 perfect timing as I am writing this blog I am listening to my four year old friend/neighbor/frequent visitor's wet, phlegmy cough.

Ma huang is frequently used in the hospital. following is the herb profile, offering a basic foundation. It is Ephedra and in some Chinese medicines used in a similar way that pseudoephedrine is used in western medicine preparations.

Pharmaceutical name: Ephedra Herba

English name: Ephedra Stem

Category: Warm, acrid, release the exterior

Temperature: Warm

Taste: Spicy, slightly bitter

Meridians: Lung, Urinary bladder

Key characteristics: Induces sweating, calms wheezing, promotes urination

Functions: In excess conditions releases the exterior and disperses cold by inducing sweating, circulates and promotes lung qi to move downward in order to stop wheezing, promotes urination to reduce odema

Indications: wind-cold attack with a lack of sweat, wheezing, asthma, acute odema, excess weight

Dosage: 2-9grams

Is used quite lightly by Doctor Zhu amongst people with liver fire. A lot of people are have liver fire this time of year (beginning of Autumn in Beijing). This is a hangover from the summer heat. It is usually marked by the dry dark coloured tongue, irritability and pain in the hypochondriac region.

To be honest whilst I was treating patients in Australia this formula was always used with precaution by me. Mainly using it in times of infection, classically UTIs or herpes. I have now seen it used as a broader formula and am impressed with what I see. Apart from making the bowels a little bit softer and looser than normal, I haven't seen any nasty side effects yet.

It should be noted that Doctor Zhu never uses it for more then two weeks at a time, and usually or almost always prescribes it in the form of granules.

As the only non-Chinese person in the hospital, let alone dressed in a doctors coat I quite often throw people off. They see the unexpected. When these surprised people find out I have an in-depth understanding of Chinese medicine and not only apply it on myself, but also to follow Australians in Australia they start to feel even more suprised, and begin to ask questions. The most amusing question in the top five most frequently asked is ‘does Chinese medicine also work on foreigners?’ my answer use to be ‘of course’, but has recently changed to a more funny answer that always gets a laugh. ‘Does western medicine work on Chinese people?’ and hopefully helps people understand how silly there question sounds to me.

In Chinese medicine the lung and large intestine are associated with Autumn, the function of the lung is to extract qi from air, using it to nourish the tissue and internal processes. Part of this Qi along with Qi from food goes to build defensive Qi (wei Qi). This wei Qi is similar to western concept of the immune system. Because the lung interacts directly with the outside environment, it play an important role in fighting off external pathogens. In Chinese medicine the lung detest dryness, therefore it is important to eat yin rich foods and stay well hydrated during autumn, the driest season.

At the hospital we break from 11.30am until 1.30pm. This long break, plus all the unused acupuncture beds makes for a perfect siesta. This room has five beds in a row and is filled with sleeping bodies from 12.30pm until 1.30pm. My bed is the one in the foreground.

I first came into contact with the lady from Fujian when I was asked to perform blood letting on her thumbs. Blood letting 放血 involves pricking an acupuncture point, usually with a lancet in order to make it bleed. This release of blood draws heat out from the body, thus offering relief to heat disorders. LU11 少商 is often used to clear heat from the throat in cases of acute sore throats.

As it is Autumn in Beijing at the moment every second patient coming to the hospital is complaining of an itchy sore throat. The lady from Fujian complained about her throat more than anyone else, this put her at the top of the list for blood letting. After I assured her five times it wouldn’t hurt I continued with the simple quick process. Pricking the point the corner of her thumb nails on both hands in order to produce few drops of bright red blood.