I was just re-reading my last post (I know, I know – I’m gazing at myself again). And I realized that, in that post, I appear to be fairly open to Chinese medicine. But being open to it does not necessarily mean that I embrace it completely. I’m pretty much a doubting Thomas when it comes to alternative medicine. You gotta’ show me before I’ll believe. And by show me, I mean the usual peer reviewed controlled clinical trial.
Sure, I can tell you anecdotes about how I’ve seen Chinese medicine work. I once had a patient who failed to conceive with modern infertility treatment but became pregnant after only one treatment with acupuncture. Another whose baby was overdue and who actually broke her membranes and went into labor while at her first acupuncture treatment (I remember asking her just where the doc put the needle.) I saw the video made in China by one of my medical school professors, showing a man undergoing major abdominal surgery with acupuncture as the only anesthetic. And I even had a patient cure her migraines with Chinese herbs.
I do believe that acupuncture taps into some very real physical phenomena. The latest thinking is that accupuncture affects the release of neurotransmitters and neurohormones that mediate pain, blood pressure, and other bodily functions. It doesn’t work for everything, though, and needs verfication in clinical trials. But I’ll admit that I’ve toyed around with the thought of getting formal training in acupuncture and trialing it in my menopausal patients.
But you know what? I don’t think I could stand take sitting for hours in a classroom with a straight face listening to someone talk about the flow of Qi (pronounced Chi). I’m sorry, but the way Chinese medicine explains itself is still too steeped in non-scientific silliness for me to completely embrace its teachings. Don’t tell me my Qi is blocked – Talk to me in real biologic terms. It’s not meridians, and it’s not Yin and Yang. It’s neurotransmitters and antibodies and cytokines and calcium channels and renal tubule function and LH and FSH and estrogen receptors. And if you dont know how it works, that’s okay. I can handle that.
I always say that the human body is the car we’re being asked to repair without ever having a manufacturer’s manual. But Chinese medicine teaches like they have the manual, and the manual says that the engine runs on Chi. ‘Cmon, guys. It’s the 21st Century. Can you at least try to make it relevent to what we’ve learned about the human body since you came up with this stuff in the 5th century?
Now, Chinese medicine uses herbs a lot. And it’s no suprise that they have found, as has Western medicine, that certain plants have medicinal properties. This is good. But they still have to prove that they work. Of course I have no way of knowing if they’ve proven anything, because we really don’t have access to the Chinese medical literature. And if I did, who knows if it would be filled with well done clinical trials, or just lots of articles about Qi.
I do know that some of the plants and compounds we use in the West are actually quite similar to those in Eastern medicine. For example, some Chinese herbal remedies used to treat menopausal symptoms, when analyzed, are found to have estrogen in them. Black Cohosh, an herb used in China as well as in the West, probably helps hot flashes. But just try to find out what’s really in the mixtures the Chinese practitioners hand out.
It’s not that I distrust Chinese practitioners themselves. I believe that, for the most part, traditional Chinese practitioners are sincere and ethical in their practice. And I don’t think they’re in it for the money. They don’t overcharge their patients for saliva hormone levels and hair metal screens, or try to sell them thousands of dollars worth of vitamins and powders. And they don’t do infomercials.
But their way of practicing is based on traditional mixtures, mixtures that vary from province to province. You can never really know what you are getting, even if they tell you the name, because every area has it’s own recipe for that name. (Sort of like Gumbo in Louisiana.) And honestly, I’m not sure that the Chinese docs themselves know what’s in their mixtures. And that’s a little scary.
It makes no sense to me that here in America, where every food manufacturer is required to list ingredients on the package, Chinese practioners are allowed to hand out medicinal herbs without regulation. And Americans are more than willing to take them. Usually the very same Americans that are screaming at the FDA about Vioxx. (Not that I’m defending Merck. No, no. One of these days I’ll post on what I really think about Big Pharma.)
It’s the complete blind faith that some of my patients have in Chinese remedies, when it is accompanied by complete distrust of anything Western medicine has to offer, that irks me. Nothing drives me crazier than to sit and have a patient grill me for a half hour about the potential side effects of anything I prescribe, then tell me she’s taking Chinese herbs whose name she doesn’t even know.
Let me warn you. Chinese herbs have been found to be tainted with poisonous heavy metals. One Chinese herb, Aristolochia, has been found to cause kidney failure, kidney cancer and death. If you are going to use Chinese medicine, please, please ask your practitioner for a detailed list of what he’s giving you. If he can’t do it, don’t take it. And unless you can tell me exactly what you are taking, don’t ask me to support you in using it. If I don’t know what’s in the bottle, I can’t recommend it. Sorry.
The NIH now has an office of complementary medicine, and clinical trials using chinese herbs and acupuncture are being published everyday. I have no doubt that some treatments will prove to be as, or more, effective than Westen medicine for some conditions. I’m just going to wait for a little more objective data before I climb on board.
Look, you want to try acupuncture? Go ahead, knock yourself out. It won’t hurt, and it may even help. And one day, who knows? It might even be me who’s sticking the needles in you. Just don’t let it keep you from getting the health care you need.
Picture Credits: Li Shih-Chen, 1518-1593. From the National Library of Medicine, Classics of Traditional Chinese Medicine, an Online Version of an Exhibit held at the NLM , NIH , October 19,1999-May 30, 2000. Gwyneth courtesy BBC. Category: Second Opinions