Common Knowledge About Traditional Chinese Medicine
Basic Common Knowledge About TCM
Traditional Chinese medicine is the general term for China's traditional medicine. It is a specialized discipline invented by the ancient Chinese, which diagnoses and treats illness in patients through diagnostic methods such as inspection, auscultation and olfaction, inquiry, and palpation (the four examinations).
For TCM treatment, the doctor and the patient must meet in person. The doctor takes the patient's pulse, inspects the tongue, and sometimes even probes the patient's abdomen, armpits, groin, clavicle, and other areas. Only after a detailed inquiry into the patient's symptoms, past medical history, and treatment history can the doctor write a prescription.
Ideally, one consultation should take more than half an hour; complex conditions require one to two hours of face-to-face doctor-patient communication.
Patients or their families often hope the doctor can write a prescription without meeting the patient, simply over the internet. This is an act of gambling with the patient's life and health.
If a doctor cannot see the patient in person, the prescription written cannot guarantee efficacy and may even cause serious side effects or death. Patients and their families should not gamble with the patient's life by expecting a doctor to prescribe treatment after only a brief online exchange.
Can TCM prescribe based on Western medical test reports?
The answer is no.
The theoretical systems of Chinese and Western medicine are completely different. The criteria for TCM medication can only be determined after the TCM physician has taken the patient's pulse, examined the tongue, conducted a physical examination, and made a detailed inquiry. There is no way to write a TCM prescription based solely on a Western medical test report.
In my observation, TCM physicians who rely only on Western test reports, who do not take the patient's pulse or make a detailed inquiry, also achieve very poor results.
However, Western test reports do have some reference value for TCM treatment. When seeing a TCM doctor, patients may bring their various examination reports for the doctor's reference.
Is treating disease in TCM just a matter of writing one prescription?
The answer is no.
TCM treatment requires frequent communication between doctor and patient to understand the patient's reactions after taking the medicine. The prescription needs to be adjusted at intervals. Some patients, after getting one prescription from a TCM doctor, never contact the doctor again, do not follow up, and do not return for visits; this is very wrong. Chronic illnesses require frequent prescription adjustments by the doctor, and maintaining communication with your TCM physician is very beneficial to your recovery.
In my own treatment of patients, I maintain close communication with them by phone and WeChat and keep track of changes in their condition at all times, so as to ensure better results. No doctor is a god; good results are achieved through meticulous and patient diagnosis and treatment.
Are Chinese herbs toxic? Will they damage important organs such as the liver and kidneys?
Every medicine has some toxicity. Chinese herbs are not only toxic; some are highly toxic.
In particular, many herbs used to treat diseases such as cancer are "using poison to attack poison" (yi du gong du) toxic medicinals, and these will cause a certain amount of damage to the patient's body.
Some Chinese herbs can damage the liver, kidneys, and other important organs. While taking the medicine, patients should regularly monitor their liver and kidney function. If abnormalities appear, they should consult the prescribing doctor to avoid progression to drug-induced liver necrosis and kidney failure.
Sometimes treating major malignant diseases requires accepting a certain cost of liver and kidney damage, and the doctor should explain this to the patient in advance. But such damage should be kept within a controllable range and not allowed to progress to an uncontrollable degree; once the therapeutic goal is achieved, steps should be taken to restore the patient's liver and kidney function.
I often advise patients to have their liver and kidney function rechecked regularly to avoid serious consequences such as kidney failure and liver necrosis. Clinical TCM physicians should not shy away from this point. Only by treating patients with such candor and responsibility can patient safety be ensured, and one's own professional safety as well.
I have seen many serious consequences caused by taking Chinese medicine during my clinical work. Therefore I often remind patients not to take medicine year in and year out. Medicine treats disease; it cannot be eaten like rice every day.
Even when treating major diseases such as cancer, one cannot take medicine nonstop, 365 days a year. The body's organs need time to rest; a doctor treating a patient should not turn him into a medicine pot.
On decocting the medicine
It is best to use an earthenware pot (sha guo) for decocting Chinese herbs. Earthenware has good chemical stability and does not easily react with the herbs, making it the most ideal utensil. Ceramic pots are the next best. Try not to use metal pots.
Some medicinals in TCM formulas are mineral or shell substances that are hard to decoct, so the doctor often notes "decoct first" (xian jian), such as turtle shell (bie jia), raw oyster shell (sheng mu li), clam shell (wa leng zi), pumice (hai fu shi), and hematite (dai zhe shi). These herbs are generally decocted first for about half an hour.
Some other herbs are highly toxic and must be decocted first to remove their toxicity, such as prepared aconite (fu zi). The length of initial decoction depends on the dosage prescribed; generally, unless specially instructed, aconite should be decocted first for more than 30 minutes. If it exceeds 50 g, it should be decocted first for one hour; if it exceeds 100 g, it should be decocted first for two hours.
Some herbs in a TCM formula lose their active constituents with prolonged decoction, such as raw rhubarb (sheng da huang) and chicken gizzard lining (ji nei jin). The prescription generally notes "add later" (hou xia); these are added to the pot after the other herbs have finished decocting and are then decocted for just five more minutes.
Ginseng (ren shen) and similar precious herbs may be decocted separately and then mixed into the strained decoction, to avoid wasting the expensive medicinal.
There are also herbs such as mirabilite (mang xiao) that only need to be dissolved in the decoction (chong fu) and do not need decocting at all; they can be poured directly into the herbal liquid to dissolve. In addition, precious glues such as donkey-hide gelatin (e jiao) and deer-horn glue (lu jiao jiao) were in the past melted (yang hua) and mixed in, but nowadays are mostly ground into powder and taken dissolved. These points also require attention.
Before decocting, soak the herbs for about 15 minutes, adding water until the surface is 1–2 cm above the herbs.
On taking the medicine
Unless the doctor specially instructs that the medicine be taken on an empty stomach early in the morning or before bedtime, Chinese medicine should generally be taken one hour after meals. Avoid taking it immediately after eating, so that food and medicine do not mix together and become difficult to digest and absorb.
Some herbs need to be taken on an empty stomach for better effect; the doctor will give special instructions in such cases, and these should be followed.
Take 100–200 ml each time. The decoction may be made a bit concentrated, so that taking too much medicine does not interfere with eating.
Patients should pause Chinese medicine during a cold; ask the doctor to treat the cold separately, and resume the medicine after the cold is cured. Female patients should stop Chinese medicine during menstruation.
Dietary restrictions
While taking the medicine, avoid all spicy, sour and rancid, raw and cold, overly greasy, grilled, and cheesy foods. The diet should center on cooked, soft, easily digestible, and varied foods. Seasonal fruits and melons that easily cause gastrointestinal discomfort should all be avoided. Bean foods and other gas-producing foods should also be avoided.
In addition, while taking Chinese medicine, patients should preferably not eat foods that conflict with the medicinal nature. For example, when taking heat-clearing and detoxifying herbs, do not eat warming-hot foods such as beef, mutton, and chili. When taking warming and tonifying herbs, do not eat bitter-cold foods such as bitter melon. When taking astringent herbs, do not eat foods with diuretic or purgative effects, such as winter melon. These should all be discussed with the doctor when the prescription is written; paying attention to diet while taking the medicine can better ensure efficacy.