There is a Rhyme and a Reason
December 8, 2008 at 12:54 am | In Chinese Medicine, Herbal Medicine, Modern Research, Science | Leave a CommentTags: Chinese Medicine, Herbal Medicine, jargon, Skepticism, Theory
While I don’t like to go on about reductionism and its assumed evils and so forth, there are grains of truth in these criticisms.
There is a difference between a complex, open (interconnected) system and a small, (relatively) closed system – the former is like the weather, and the latter is like a motor vehicle. I believe we are all familiar with the viscissitudes of weather forecasting, and yet, on the other hand, how generally reliable and unperplexing our vehicles are.
In essence, the first system cannot be reduced without losing its essential complexity and interrelatedness, while the second one can (for a deeper discussion on the relative aspects of this idea, click here). This means that in order to understand a complex, open system, it must be met in its arena of effect. Reducing the arena changes the game and damages the data irretrievably.
In a previous post (Herb Comparable to Prednisone), I wrote about how the oversimplification of Chinese Medical principles tended to damage the effectiveness of the intervention, sometimes completely, and how it was important to understand that in Chinese Medicine we do things for a reason.
More careful research can illuminate some of these reasons, and I would like to provide you with a brief glimpse into one of these investigations:
Chinese Medicine almost always uses herbal combinations rather than single herbs, not only because a single herb has a weak effect, but because herbs can act in synergistic or antagonistic ways to each other (amongst other effects). Thus a properly constructed formula with the individual patient in mind provides a superior effect than the administration of a single herb, or of a non-individualised formula.
The following graph from the Biological and Pharmaceutical Bulletin (2003;26(7):911-919) dramatically illustrates this phenomenon:

The blood concentration of wagonoside from HuangQinTang was twice as high as that of HuangQin alone.
HuangQin Tang is a Chinese Herbal Combination, Huang Qin is merely the lead herb.
HuangQin Tang contains: huáng qín, huáng lián, gé gēn, and zhì gān cǎo.
This type of investigation makes two points:
1. There is a reason that herbal combinations are the standard of care in CM.
2. Deconstructing an open, complex system is fraught with dangers if the aim is to illuminate the true mechanisms or energetic dynamics of said system.
In the western world, and even the eastern world, too much effort has been spent on “identifying” the one herb in a formula which provides the effect, and then further “isolating” “active ingredients” in order to provide the end-user with a “real” medicinal in a “more potent” form for, ostensibly, superior clinical effect.
It’s as if a scientist wanted to provide us with a better vehicle, and decided the active ingredient was the piston, made us a big giant piston to use and acted all proud.
It is my hope that our understanding of the ancient and wise medical systems of this world becomes much more mature in the next short little while.
Incidentally, HuangQin Tang is primarily used for something called “Damp-Heat in the Lower Burner”, one manifestation of which is dysentery. Years ago, a chemical called “berberine” was isolated from another herb in this formula, huáng lián, and used in cases of dysentery. And yes, you guessed it, it doesn’t work as well as HuangQin Tang for the indicated condition.
Oh well.
Diagnosis
November 13, 2008 at 4:45 pm | In BioMedicine, Chinese Medicine | Leave a CommentTags: jargon, Terminology
Question: Does anyone know what Trichotillomania is? My daughter was diagnosed with this recently. Any help is appreciated.
Response: Oh gosh. Trichotillomania. How obscenely stupid. I wonder if this syndrome is further differentiated based on whether it is the left or right hand that’s doing the pulling, or if there is a naming convention that takes into account how many strands of hair are in each fistful, and how many, thereof, are dyed, split-ended or glossy?
There is one good thing about this obsessive compulsion to give long, stupid names to diseases, and that is that the name for fear of long names is Hippopotomonstrosesquippedaliophobia.
Anyway, on to something useful, I hope:
Apart from being all technically technicacious about our patients, we shouldn’t forget to be human. While we must be very careful to mind our manners, ethics, scope of practice and personal limitations, be not afraid to be human. If someone is pulling their hair out, ask yourself, what in god’s dreaming heaven would cause ME to pull out my mane. Start from there, and you may find a way to delicately tease out (part, just enough) of a painful story to inform your pattern diagnosis, and perhaps give the girl and her family a better result than something who blindly, meaninglessly tries to treat for liver qi, or phlegm misting the heart.
In a case like this, it might be most important to find out what started it. I just had a patient in the other week with bad chest pain who responded not at all to western medicine, a very competent naturopath or a very heartfelt osteopath, and yet responded in my clinic (with a 100% reduction in pain after 20 minutes), in my humble opinion, because I asked her what was going on when this started (thirty years ago when she was 17). And when she said “nothing”, I gently said, “something”. And eventually she “mentioned”, by the by, that her boyfriend, when she was 16, had tried to kill her. I gently, over the course of our conversation, explained about some possible connections, placed some needles in her, and she seemed to relax, cry, and begin a new stage in her life. Not my credit, I credit it to being human, and trying to keep the old sages in mind.
(excerpted from an online forum conversation)
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