The Treatment of Disease with Traditional Chinese Medicine

Volumes 1 and 2 (a 3rd volume is now out)
Will Maclean Jane Lyttleton
University of Western Sydney Macarthur
ISBN 1-875760-93-8

The Clinical Handbooks of Internal Medicine are strongly recommended for any practitioner of Traditional Oriental Medicine. From their beautiful covers to the selection and presentation of the material , The Clinic Handbooks embrace the high standards that physicians strive for.
The books are organized into large sections by the organs (liver, heart etc.) and then within those divided by disease patterns (dizziness, hypochondriac pain etc…). Each of these patterns has a Chinese correlative which allows the authors to draw upon both modern sensibility and the rich traditions and wisdom of Chinese literature.
For example, lower back pain is discussed as “yao tong”. The chapter begins with insightful comments about the syndrome and then proceeds into zang-fu differentiation. Those familiar with Chinese language texts will appreciate the approach. There is just enough discussion to be helpful without assuming that the reader needs to be “taught” with unnecessary background about TCM.

For example, the Lung chapter includes: acute exterior disorders (with a discussion of Shang Han and Wen Bing), cough, epistaxis, haemoptysis, loss of voice, sinusitis, rhinitis, sore throat and tuberculosis. Included are appendixes on lung abscess and pediatric asthma. The Heart Chapter includes chest pain, palpitations, insomnia, somnolence, forgetfulness, and anxiety. Again, each of these subsections are broken down into zang-fu diagnosis and treatment.

Each of the sections has comments and treatments for both acupuncture and herbs which are then shown in modification depending on symptomology. The authors are generous in sharing their comments about clinical approaches and expectations as well as citing other practitioners for special formulas and ideas. For example, in discussing Urinary retention they offer some comments about Tui Na : “Ren 6, Ren 5, Ren 4, press from above toward the pubic bone. Be sure to have some implement to contain the urine as this technique may cause immediate release” and electro-acupuncture “St. 28, Sp 6, or Sp 9 with high frequency stimulation. St. 28 should be needled cautiously and superficially in those with very distended bladders.”

They also cross reference to (Western) biomedical diseases give their opinions as to the appropriateness of certain western treatments and the interaction between the two systems. Again, for the urinary retention, they write,

“…it should be remembered that complete retention of urine constitutes a medical emergency and catheterisation is necessary if other therapies fail” and “In cases with severe infection, especially that involving the kidney, antibiotics may be necessary to quickly cool Heat. Once the infection is controlled, treatment may be given to clear Damp.”

The section on Shen disturbance (heart issues) discusses Western anti-anxiety medication and is honest enough to compare their side effects to those of our heavy herbs used for the same disorders. For those of us who do not have our M.D. license yet, this information (closely resembling common sense) is invaluable in assessing our own limitations and insecurities as practitioners in different clinical situations. An interesting section talks about animal products, which ones are endangered and which are “farmed” for their medicinal purposes. Although it may not mean much to your vegetarian patients it may reassure those who are taking turtle shell or Chaun Shan Jia in their formulas.

Listen, I could go on and on about how good these books but it is late and I don’t get paid to write these reviews and I certainly don’t get paid by the word. If you read English and practice TCM then you owe it to yourself to buy these books. I did and I think that these will be two of the most valuable books in the library of any acupuncturist.

review by Douglas Eisenstark L.Ac.

The Art of Palpatory Diagnosis in Oriental Medicine by Skya Gardner-Abbate
forward by Mark Seem
Churchill Livingstone ISBN 0-443-07058.

The Art of Palpatory Diagnosis is an achievement in the English-language writings about Japanese-style acupuncture. The book is organized in a logical manner with a style for being used as a textbook. The section in the book on abdominal diagnosis and the umbilicus forms the core of the book. Even if you don’t follow the treatment protocols the high quality photographs are an exceptionally well done guide to this form of diagnosis. Ms. Gardner-Abbate has been practicing for 15 years and it shows in the practicality and applications of the book in both content and organization. She has successfully created a practical text with solid theoretical underpinnings. There is even one section devoted to office forms for the various modalities discussed in earlier parts of the book.
With the this text along with Birch’s weighty Reflections on the Hara and Eastland Presses’ translation of Shudo Demnei English, language readers can begin see the many dimensions of “Japanese” acupuncture. Of these, The Art of Palpatory Diagnosis may serve as a more useful introductory text for those who are learning without the benefit of a teacher.

Reviewed by Douglas Eisenstark L.Ac

PEDIATRIC ACUPUNCTURE

The Management of Cancer with Chinese Medicine

by Li Peiwen and Cheng Zhiqiang, Du Xiuping.
Translated by Mao Shuzhang/Bao Liling.

Donica Publishing

The creators of the informative and comprehensive The Management of Cancer with Chinese Medicine have risen to the challenge of making an English Language Chinese Medicine “instant classic”. Li Peiwen and his contributors have created a true ego-less book in that it represents decades of the collective experiences of an entire TCM department in one of the most renowned hospitals in China. The writing here is not simple theory and rhetoric but the praxis of doctors working with the most complex of diseases. The Management of Cancer reflects one of the finest examples of the treatment of a disease category and this book is a sign of achievement in TCM itself.

Anyone, TCM practitioner or not, who sometimes might think that TCM can be simplistic should look at The Management of Cancer If any TCM practitioner wants to treat or has patients with cancer then this book is an absolute necessity. (This is definitely not a consumer level book and I would urge any patients to get Sagar’s excellent Restored Harmony instead.) The principal author of The Management of Cancer has for decades been the director of the oncology department of the China-Japan Friendship Hospital, probably the best hospital (and well funded) in Mainland China. The 590-page book starts with a 10 page introduction to the history of cancer management in Chinese Medicine and subsequent chapters follow a natural progression from etiology to diagnosis to treatment and then management of integration with Western settings.

After the historical chapter the book divides into 3 sections. The first mainly deals with symptoms resulting from both the cancer and the Western therapies that treat cancer. Each of these chapters is prefaced by a short description of the Western Treatment. For most TCM practitioners this will be very useful reading. The shorter second section covers Qi Gong and diet. The weakest link in the book is this 10-page Qi Gong chapter in a nod to the Qi Gong department and the value of relaxation. The Diet chapter however is much more comprehensive although perhaps greater care could be taken with translating Chinese dietary medicinals into practical Western foods.

The third section deals with a dozen types of cancers along with case studies and case management. While at first glance it seems to be organized as a Zang-fu book, closer reading shows it to be a comprehensive look at both patterns and diseases. There are case studies, clinical observation reports and research studies. Compared to most internal medicine books of this nature, it has much appreciated information about acupuncture.

I often tell my students that in Asia for thousands of years Chinese Medicine or one of its regional variations was the only medicine available. When someone was sick anything and everything might be done to help the patient. So when we say that CM ‘treats everything’ we mean that CM has treated everything. When confronted with a cancer patient who may also be enmeshed in the most sophisticated of Western Treatments, the TCM practitioner may be overwhelmed with the case. A book such as this can show the TCM practitioner what the limitations of TCM are but perhaps more importantly what the possibilities. If the practitioner has more confidence in the level of treatment then that can only can be good when transmitted to the patient. All too often we only offer limited care because of the fear of overreaching and doing something wrong either through our treatments or promises.

Each page of the The Management of Cancer is filled with such new and practical information that I needed to sit down and read it from cover to cover. I appreciate the fact that there is a minimum of space explaining simple functions of the herbs and with a section on the less common herbs. There is a fair amount of information about Western Chemotherapy drugs especially within the numerous case studies. Although it is unclear if this book is a translation of an existing book in China or an originally written book it reads as well as if written by a native English speaker. Translators Mao Shuzhang and Bao Liling should be congratulated for a highly readable volume.

Here are two short excerpts:

Discussion: The formation of tumors is closely associated with Blood stasis. Solid tumors are less sensitive to radiotherapy because they are often poorly oxygenated (hypoxic), the consequence of outgrowing the blood supply. In addition, the chemical substances secreted by tumor cells can result in an increase in sensitivity to exogenous and endogenous blood-clotting factor and cause hypercoagulability of the blood by impairing of the blood by impairing fibrinolysis and platelet aggregation. Under these circumstances, material medica for invigorating the Blood and transforming Blood stasis can supplement radiotherapy treatment by increasing local blood flow, reducing hypoxia, and impeding repair of the cancerous cells damaged in radiotherapy by inhibiting the expression of proteins at the cell surface.

Some drugs used in chemotherapy such as vincristine (Oncovin), vindesine, vinorelbine (Navelbine), cisplatin (cis-disaminodichloroplatinum), doorucric (Adriamycin), mitromycin, and mustine hydrochloride (nitrogen mustard) can give rise to numbness in the extremities and scorching pain in the hands and feet since these drugs can cause neuropathy. Pain due to radiotherapy can occur immediately or many years after treatment and is caused by inflammatory edema of local tissue and mucosa characterized by scorching pain, dryness, bleeding, edema, exudation and ulceration. This pain is often seen in oral, esophageal, nasopharyngeal and bladder cancer. A continuous dull pain often occurs as a result of changes in the fibrous tissue due to radiotherapy and is commonly seen in the treatment of lung cancer.

I would consider The Management of Cancer by Li Peiwen one of the most complete discussions of modern TCM methods in English. This is an astounding compilation of 40 years of experiences in a top oncology department. When people with this much experience imparts information then one had better listen.

Douglas Eisenstark L.Ac. 2004

Diagnosis in Chinese Medicine Giovanni Maciocia
Churchill Livingstone 

Practical Diagnosis in Traditional Chinese Medicine Tietao Deng-Churchill Livingstone

Diagnosis in Traditional Chinese Medicine 
Ping Chen-Paradigm Publications

Since I wrote this review another book from Eastland Press appeared from Yi Qiao and Al Stone. Below is a short review of that book.

Traditional Chinese Medicine Diagnosis Study Guide – Eastland Press
Qiao Yi with Al Stone

437 pages, 8-1/2″ x 11″
ISBN: 0-939616-64-5
978-0-939616-64-0

“Qiao Yi and Al Stone, both veteran educators, have risen to the task of explaining TCM diagnosis in both overview and its intricate details. This Study Guide goes beyond simply translating and reiterating what has already been written in other texts by showing diagnosis as an interactive process with zang-fu and TCM theory. The authors’ years of experience in teaching this material which has been peer reviewed by leading scholars of Chinese medicine is reflected in both the content and its presentation. More than just a dry compilation of facts, this book clarifies many of the ambiguities left by other TCM texts. Highly recommended for both beginners and experienced practitioners.”

_________________________

Diagnosis is the key. Those four words are the most important in all of clinical medicine. Everything else falls by the way side. If you don’t have the correct diagnosis then the strongest herbs or drugs or surgeries or acupuncture needles will help you. Despite this Chinese Medicine is notorious for having an ambiguous approach to diagnosis. Equally talented practitioners can create effective treatment by jumping into the circle at an infinite number of points. The roads to a diagnosis are just as endless. Some practitioners favor the pulse, some the tongue, some put great emphasis on questioning and some on facial reading. While there are many effective diagnoses, a definitive one is an oxymoron.

Here we have three books that approach the subject of diagnosis as differently as those who favor the pulse and those who might favor the tongue. The first two books (and from the same publisher) on the same subject begs a comparison and they stand as the Yin and Yang of previously unavailable texts in English. I was frankly prepared to favor Deng’s book over Giovanni. Deng would seem to be more ���authentic�� coming from a Chinese author and translated by the superb scholar and acupuncturist Marnae Ergil. Giovanni should be well known to all who know anything about English language books on Chinese Medicine. The Giovanni weighs in at over 1100 pages while the Deng book is half the amount.

Students (and practitioners) of Chinese Medicine often are confused about the dichotomy between the classroom and clinic. ���Statements of Fact�� are the building blocks that clinical medicine manipulates. Know these invariable rules backwards and forwards and then bend them in the clinic. So what if the patient does not conform to the textbook? The Western student often wants to jump ahead to the exceptions and the Giovanni text stands as the answers to the eager ‘problem student’ in the back of the room. This student asks, “But what if…”.

This is the difference between the two books. The English version of Deng is a translation of his book that is a nationwide standard in China and is best seen as a classroom text for students and practitioners. The Deng gives us the rules and the authority of consensus of the TCM establishment while the Giovanni book is a generous helping of one practitioner and his experience. From the lavender cover and highlights to the rich details of diagnosis, Giovanni aims straight at the practicing Western acupuncturist, as if acutely aware of what they might face day to day in the clinic. Giovanni has never been so open about the non-mainstream influences of the now late John Shen nor the help of his translators. Unfortunately, one is never sure about the sources of his statements and so issues of consensus, classic integrity and contextualization become problematic. Although there is a bibliography, the book is rather thin in it�۪s footnoting. So although I am skeptical of aspects of the Giovanni book I can appreciate his experience of diagnostic possibilities.

The third book on diagnosis, Diagnosis in Traditional Chinese Medicine by Ping Chen shows the range of how a practitioner can approach the subject. Diagnosis Of Chinese Medicine is basically a study guide of tables of various symptoms and complaints. I had seen it in a bookstore but had bought it on line not realizing what book I was to receive. At first I was a bit disappointed but looking at it again I can see it’s value in both the clinic and classroom. Dr. Chen says that she made the book because students were confused by narrative diagnostic descriptions. For me, the narrative is exactly what I miss about most of TCM literature. Oh well… for a student (and/or their teachers) this book may be a god-send. The information is sound and more comprehensive than most guides on the same subject. So, after all, the Deng Guide may be the first diagnosis book one should buy. Every student and practitioner should have this material down cold before proceeding to the others.

Applied Channel Theory in Chinese Medicine

Wang Ju-Yi’s Lectures on Channel Therapeutics

Wang Ju-Yi and Jason Robertson

Eastland Press.

The short description of this book might be, “An acupuncture doctor with 45 years experience tells what he has learned to one of his students”. What this doesn’t tell you is how this has happened in the most fortunate of circumstances. Applied Channel Theory is the work of a (relative) beginner (Robertson) transcribing and exploring the mind of an accomplished and experienced practitioner (Wang). Wang has an inquisitive mind, a great sense of humor, has spent decades studying the Neijing and other classics as well as applying those styles in a very busy clinical career. Robertson graduated from a Western TCM school, speaks and reads Chinese fluently and also has an inquisitive mind and a great sense of humor. Where Wang has the ability to pull the different elements of classic studies into a coherent form, Robertson has ingeniously put Wang’s words into a very readable and cohesive narrative.This is material that should be discussed in every acupuncture school, here and in China. Wang and Robertson have created one of the most important books about Chinese Medicine to appear in 30 years.

From looking at classic texts, the material moves from theory into practical application and the relevance and significance of the book only gets deeper as one continues to read. Wang has taken the challenge to delve into the most difficult yet basic concepts of Chinese Medicine and Robertson has the confidence to ask the “simple questions” that illuminate throughout the book. These are not issues of “translation” or cultural misunderstanding but concepts debated for many millennia in China. Yet these two manage to get the points across in a coherent manner. Robertson is a clear and confident writer and Wang produces the answers. As my colleague said when she read the book, “This is actually written in English!”.

The book really lets us know that as Chinese Medicine was created on the backbone of the channels, then knowing (or at least trying to understand) this theory will only strengthen all of TCM, be it acupuncture or herbs. Wang writes in the Preface: “…in order to dramatically improve one’s theoretical grasp of any of the field of Chinese medicine, one must delve as deeply as possible into basic channel theory.” Obviously this is a concern of not just Wang but of many traditional Chinese practitioners and teachers whether they reside in China or in the West.

As one gets further and further into Applied Channel Theory, this theme of the essence of the classics emerges and is then re-explored all through an interlocking discussion of Yin and Yang, 5 element, zang fu and channel theory. Each of these get in depth looks. If you thought you knew these subjects you might be surprised, if not amazed, at how Wang and Robertson approach them.

Many of the chapters are taken from lectures and workshops that Robertson organized with Wang. There is a consistent thread of questions that pull the reader back to the basics just as the ideas start to spin in complexity. The book has 20 chapters but has many threads. The first thread is a long discussion of each of the organs from the perspective of the 6 channels and an extended discussion of Ministerial Fire. This concept of the Ministerial will come back again and again throughout the book. It becomes especially evident in the 30 pages they devote to the Shao Yang. Another thread concerns the nature of the points as concepts and as functional processes. Robertson asks some basic questions that we often think of but never ask. “How does energy move through the channels?” “Does the qi from the limbs inward or outward to the limbs?” (Answered in an incredibly sophisticated manner by Wang.) “What does reinforcing and dispersing really mean?” “How do the five transport/antique/ting points work?” And Wang is not simply regurgitating texts, these are his unique explorations. By giving them full weight of his consideration it is apparent that the questions are neither stupid nor had Wang not thought that they needed answering. When Wang doesn’t have an answer for a question he responds that he truly doesn’t know. Robertson plays off his own naiveté as a recent graduate to extract these answers from Wang. Toward the end of the book there is a lengthy discussion about point combinations. Interspersed throughout are observations by Robertson about both the process of writing the book and the experience of Beijing. These digressions make the book more readable but lets us know that the book is not the final word about acupuncture but is itself an exploration. Its an ingenious (and time tested) form for a book.

Applied Channel Theory comes at a time when Chinese Medicine needs a little help. Even as the popularity of acupuncture increases around the world, its roots often seems to have been lost for a practical and expedient functionality. The process started in China over 100 years ago and has been accelerated in all forms of acupuncture education and practice. While some have attempted to tie modern practice to the classics, the original writings have been notoriously difficult texts for ages. Indeed, most of our classics are attempts to explain other writings now either existent or lost. As a result, classical concepts of acupuncture all too often are either fetishized or abandoned as quaint. The latter is perhaps more common where the consensus is that “acupuncture works” but not perhaps in the ways that have been traditionally explained.Wang looks beyond the physiological metaphors and tells us why the ancients may have had it right all along.

Robertson shows Wang to be not only “good with theory” but a practical and concerned practitioner. I particularly was taken by this passage.

In fact, below the surface of the best treatments is a complexity of technique not unlike that learned by professional musicians. Think of the movement of the hand during acupuncture as being somewhat like those of a violinist. There are a wide variety of sounds that a violin can make. You can move the bow with greater or lesser frequency and strength. One might bow loudly or softly with harmonic notes, or instead create a cacophony of contrasting sounds. Sometimes, one might not use the bow at all and instead pluck the strings to get the desired sound. An acupuncturist “plays” the channel system in a similar manner. The next paragraph compares organs to the instruments of an orchestra. It ends with Wang stating: A successful treatment should be like conducting a piece of beautiful music. (p. 548) For those who often talk about the “art of acupuncture”, words like these are a sweet confirmation.

When a chapter from Applied Channel Theory was released to the Journal of Chinese Medicine, I was a bit disappointed as it seems that the book would simply concern the palpation method of finding the points and diagnosis. Nothing could be further from the truth. Applied Channel Theory discusses the roots of acupuncture theory and so bridges the growing gap between acupuncture and herbal treatments. The future of acupuncture is not in another Method be it Tung, Tan or Wang. Applied Channel Theory doesn’t necessarily demand any Method although it does answer how the Neijing might approach it. Instead, the value of the book functions as a follow up to every TCM book we have ever seen. It takes up where Giovanni leaves off and explores what CAM only hints at. It takes Pirog and runs with it.This is one of the few TCM books that I wanted to read from front cover to back. And when I finished it, I started again from the front and reread it. It’s that good. It is that necessary.

Douglas Eisenstark L.Ac.

Los Angeles, June 2008.

• Applied Channel Theory in Chinese Medicine Wang Ju-Yi’s Lectures on Channel therapeutics
• 3 books on Emotions and Shen in Chinese Medicine
• 3 books on Diagnosis in Chinese Medicine by Giovanni Maciocia, Tietao Deng, Ping Chen
• Management of Cancer with Chinese Medicine by Li Peiwan
• Pediatric Acupuncture Dr. May Loo
• Orthopedic Massage, Theory and Technique by Whitney Lowe
• Auriculotherapy Manual Chinese and Western Systems of Ear Acupuncture by Terry Oleson
• The Art of Palpatory Diagnosis in Oriental Medicine by Skya Gardner-Abbate
• Clinical Manual of Internal Medicine Maclean & Lyttleton
• Warm Diseases: A Clinical Guide Guohui Liu
• Clinical Case Studies edited by Dr. Chen Kej
• Pocket Manual to Chinese Medicine by Richard Lee
• A Qin Bowei Anthology translated by Charles Chace & Zhang Ting Liang
• Handbooks of Chinese Herbs and Formulas Him-che Yeung
• The Tao and the Tree of Life Eric Yudelove
• 100 Days to Better Health, Good Sex & Long Life Yudelow
• The Tai Chi Flipbook Craig Balcom
• Educational & Career Opportunities in Alternative Medicine Rosemary Jones
• Meridian Acupuncture by John Pirog
• Chinese Way to Healing by Misha Cohen
• Acupuncture Point Combinations by Jeremy Ross

  computer software and music

• Palm Pilot stuff
• Acubase CD-ROM
• Tunes on Tangs Curcio
• Jai Utall
• other music