Parsimony—and Big Fat Yellow Worms
About 1,000 local Renoans recently traveled to China on eight Chamber of Commerce sponsored trips. My friend Kathy went, and everyone had a great time. One stop on the tour of Beijing was at the government owned Tongrenblueg herbal pharmacy, where men in white coats offered to do tongue and pulse diagnosis and sell herbal formulas. Young girls came out to translate. Kathy said about 60% of her group was diagnosed with something and bought formulas.
The doctors were baffled that a woman of a certain age, which Kathy is, would have no troublesome heat symptoms. In fact she says she is completely asymptomatic.
Ever the ambassador of goodwill, Kathy wanted to thank them for their time and effort by making a purchase, so she bought a one-month supply of herbs (two bottles of teapills and two bottles of herbs in capsules) even thought they recommended a three-month supply.
So what did Kathy end up with?
Translating the pinyin on the bottles reveals that she got some teapills for digestion (tiny bb’s of pressed herbs—very weak—but probably not a bad idea for a foreigner traveling in a foreign land) and some dong chong xia ciao (cordyceps sinensis, a fungus that grows on the hepialus varians larva, plus the larval bodies).
Nobody asked if Kathy was a vegetarian before prescribing dong chong xia ciao which Bensky describes as: “Good quality is intact with a short stick-like fungus and a bright yellow, fat, full, and round insect part with a yellowish white cross-section.” [Yep, Kathy’s eating big fat yellow worms. I wonder if I should tell her…] Old time Chinese doctors are pretty authoritarian guys—it’s a cultural thing, and besides, they don’t have time for chit-chat since acupuncture is free in China and they’re pretty much overwhelmed with patients. This also accounts, in part, for traditional Chinese needle technique—very heavy (painful) stimulation and very fast treatments (20 minutes). And they just assume you’ll put up with bugs and reptiles, insects and squirrel feces in your formula, so it doesn’t dawn on them to check it with you beforehand.
The Chinese rarely prescribe a single herb—Chinese Herbology is a very precise, elegant, 3,000-year-old, time-proven system of blending the yin and yang, hot and cold, tonifying and reducing properties of different herbs. Kathy’s single herb formula is indicated for Kidney yang deficient back pain and Lung yin deficient bloody phlegm. This seems to be a curious prescription for her, but then again, she was very likely working with a master diagnostician—some of these guys can feel what you had for breakfast in your pulse (I’m only half-kidding), and they probably detected something telling in her pulse, maybe even predicted and averted impending symptoms.
I practice a hybridized form of Chinese, Japanese, and Taiwanese acupuncture, simply because that’s what I’ve found works best clinically. I take a full hour (or more if the patient has more to tell) to get a complete medical history, then I do traditional tongue and pulse, and then I check myself with a computerized Electro Meridian Image graphing of all the major organ source points of the body. And I repeat tongue and pulse and a brief history before every acupuncture treatment or herbal consult. For me, it’s a cultural thing—we Americans love graphs and the relative certainty of being double-checked. And I always discuss treatment with my patients (because Americans are getting less passive about health care)—from the amount of qi stimulation they are comfortable with to the kinds of herbs they want to ingest. You can always work within a patient’s comfort zone and still get good results. My treatments last 40-45 minutes; some Taiwanese treatments go a full hour—it all depends on the patient’s needs.
Frequency of treatment averages once a week for the first month; then frequency is adjusted according to need. If I’m treating an acute injury, you might need to come in twice a week—the trick is to break the cycle of pain as soon as possible and treat again before it comes back full-force. For internal disorders, or pain that’s under control, most can stretch that out to once every two weeks or even every three weeks if they supplement with an herbal formula. The Chinese laugh at us for parsimoniously offering acupuncture without the support of a formula, but then, remember, acupuncture is free in China—where for 3,000 years the two modalities have always been used together (which begs the question: why didn’t they offer acupuncture treatments while they were selling herbs?).
Kathy has just finished her course of herbs and feels no different (at least until she reads this). But a friend of hers bought a three-month course of herbs to treat insomnia, and he’s sleeping much better. What should he do when he runs out of herbs, or if his energetic imbalance shifts and he needs his herbal formula modified? A three-month course of herbs is just a start in reversing a severe, chronic energy imbalance—and his results would almost certainly come better and faster and stick longer with the addition of acupuncture.
To the estimated 600 or so people who bought herbs in Beijing recently, you might want to find a reputable local Chinese herbalist, certified by the NCCAOM, to take a detailed history to find out if they’re right for you. If they are you might want to consider some acupuncture; if they’re not working, most likely the formula can be modified so it is effective.
– Dr. Gary Danchuk