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HEALTH MAGAZINE

TCM approach to specific problems
As stated before, the three functions of herbal medicine are treatment, recovery, and health maintenance. Generally speaking, herbs can be taken for many kinds of illness. Also, many kinds of western drugs have an herbal alternative. Because it is natural therapy, most herbs do not cause side effects. Those side effects that do occur can be easily counteracted with other herbs. Herbal medicine is simply gentler and safer than chemical medicine. For these reasons, people turn to herbal therapy for a number of indications.

To treat a chronic illness - Many people with chronic illness take a number of different drugs. Those who are looking for a natural alternative for those drugs switch to herbal therapy. According to current practice in China, and classical Chinese medical teachings, there are many herbal remedies for pain syndromes, gastrointestinal disorders, neurological disorders, stress related syndromes, respiratory disorders, heart problems, sexual dysfunction, allergies and immune system deficiencies, as well as alternatives for antibiotics and anti-inflammatory drugs.

To reduce side effects - Herbs can be taken to reduce the side effects of other medication. Antibiotics weaken the immune system. Herbal therapy can strengthen the system. Also, during chemotherapy, the white blood cell count drops, causing fatigue, lack of energy and appetite. Herbal therapy has proven quite successful in relieving the side effects of chemotherapy.

For prevention - Herbs are often taken as a method of prevention. For a person suffering from frequent headaches, taking herbs to prevent the headache from ever starting is a much better option than taking a pain reliever after the fact. Herbs are also used to prevent the flu, menstrual cramps and pre-menstrual syndrome, among other things.

For health maintenance- Herbal therapy can also be used for general health maintenance. Tonic herbs are used to increase energy and to slow the aging process. They are also used for enhancing sexual energy and for cosmetic purposes.

Herbs are also used to treat minor symptoms that are not severe enough for heavy chemical drugs, symptoms that cannot be diagnosed by Western medicine, and symptoms and illness that are not easy to treat, such as mononucleosis and immune system deficiencies.

Dysmenorrhoea (Period Pain)

Dysmenorrhoea (Period Pain) is a common gynaecological problem. Some women consider it normal but they are unaware that it is a condition that does not have to be tolerated and that traditional Chinese medicine is an ideal way to treat it.

First we must establish whether the condition is Xu or Shi and formulate the appropriate treatment program. A combination of herbs, acupuncture and lifestyle modifications is the best way to approach the problem.

In TCM Dysmenorrhoea is Divided into 4 types:

Shi or Excess Syndromes: i) Qi stagnation and blood stasis ii) Accumulation of Cold and Dampness

Xu or Deficient Syndromes iii) Deficiency of Qi and Blood iv) Liver and Kidney Disorder/ Deficiency

Other treatments a.Ear sensitive point pressure b.Herbal spirits c.Massage for dysmenorrhoea

TCM APPROACH TO SPECIFIC PROBLEMS

The following articles are of general interest about the TCM approach to specific problems.

Arthritis Constipation Acne Ageing Chronic fatigue Sinusitis and hayfever Menopause Hypertension ARTHRITIS

Arthritis is the inflammation of one or several joints, accompanied by pain, swelling and changes in structure. The distance between the two bones within the joint becomes narrower, and the special cartilage that forms a smooth lining at the ends of the bones becomes thinner and irregular. There is restriction in the range of movement together with the characteristic cracking and creaking noises that are caused by the rubbing together of the two irregular surfaces. The affected joints usually feel stiff after periods of immobility, such as in the morning after sleep, and become freer after a period of normal activity.

There are two major types of arthritis: osteoarthritis and rheumatoid arthritis. Rheumatoid is more severe with the development of marked deformity and loss of function. Osteoarthritis is more common and is thought to result from the effects of wear and tear. It tends to affect joints that have been subjected to overuse, trauma or excessive weight bearing.

Traditional Chinese Perspective

In traditional Chinese medicine (TCM) arthritis is classified as 'Bi Zheng' which means 'painful obstruction'. There is a blockage in the normal free flow of blood and Qi (energy) in the body. The Chinese were aware of the distribution of both blood and energy throughout the body via an intricate network of vessels. In health there is a free flow and normal distribution of these substances to all parts of the body. Disease is seen as a disruption to this flow by various agents. In the case of arthritis, the Qi and blood are obstructed by the invasion of climactic influence from the environment such as wind, cold, heat anddampness. These factors usually gain access to thbody because of a pre-existing weakness or imbalance. In this way the environmental influences become lodged in various places in the body. The combination of factors from the outside with imbalances within the body causes the Qi and blood flow to become blocked in some of the joints. Each person's particular symptoms give an indication of the type of pathogens that are present. Pain that moves from one location to another is due to wind; fixed pain with numbness and heaviness is due to dampness; inflammation with red and hot joints is due to heat; severe pain without redness or heat is due to cold.

In practice, arthritis is mainly due to wind and dampness. In many cases cold or heat are also involved. The individual's overall state of health plays an important part, and if the blood, the Qi, the liver or the kidneys are in a weakened condition, this will predispose an individual towards the invasion of the external pathogens and allow them to take hold.

Treatment is usually a combination of acupuncture and Chinese herbal medicine, to restore the normal flow of Qi and blood and to strengthen any underlying weaknesses. This provides the quickest and most complete approach to the relief of pain and the healing of damaged tissues. Some form of exercise will also be recommended, along with specific changes in diet and life-style.

Things to do for yourself

There are several things that you can do to assist the treatment. These include dietary and life-style changes:

Avoid any activities that place too much stress on particular joints.You will usually notice that certain movements or postures will cause a worsening of your condition and these should be avoided. This may involve a change of occupation or hobby and correction of posture.

Take gentle daily exercise for the whole body, including gentle stretching. The joints should be taken through their whole range of movement and stretched as far as possible within your tolerance of pain.

Certain foods may aggravate arthritis, the common ones being tomatoes, eggplant, capsicum, spinach, rhubarb, gooseberries, black and red currants. These should be avoided for several months and then reintroduced gradually. If you notice a worsening of the condition, then the offending food should be omitted entirely. Foods which produce a strongly acidic reaction in the body should be minimised or avoided. These include red meat, eggs, most cheeses, vinegar, pickles, white flour, white sugar, coffee, tea and alcoholic beverages. Any foods which cause digestive problems such as heartburn, wind, diarrhea or constipation should also be avoided. Inorganic minerals such as table salt and some spring waters (with a high mineral content) should be minimised or avoided. It is important to maintain your correct body weight and reduce if necessary as this will help to relieve the stress on the weight–bearing joints.

CONSTIPATION

Constipation is defined in two ways. There is longer than 48 hours between bowel movements, or there may be difficult bowel movements with hard, dry stools. Constipation is not a disease in itself, but is the symptom of an underlying problem. It may be due to inapropriate diet, a lack of regular bowel habits, general weakness, sedentary lifestyle, stress, and over-reliance on laxatives. A sudden or recent change in the frequency of bowel movements may be a sign of a more serious disease such as cancer.

Although there is a very wide variation in what may be considered healthy and normal, most traditional systems of healing stress that the bowels should move daily in order to rid the body of waste products and prevent their reabsorption. Prolonged constipation can have serious consequences on the general health such as headaches, poor sleep, low energy, hemorrhoids, acne and other skin conditions, appendicitis, and diverticulitis. It also predisposes to the development of bowel cancer and aggravates other diseases such as high blood pressure and heart disease.

Traditional Chinese Perspective

According to traditional Chinese medicine (TCM), constipation occurs as a result of the interaction between a person's lifestyle, diet and habits on the one hand, and their basic body constitution on the other. We are all born with certain tendencies towards imbalance and these will influence the types of diseases that we develop. These different strengths and weaknesses form the basic constitution, which is the background upon which the day to day changes in our health and well-being are superimposed.

The TCM approach is to look at the whole person, not just the distressing symptoms, in order to find the constitutional imbalances from which the symptoms arose. This is referred to as the 'Ben' or root, while the manifest symptoms are the 'Biao' or branches.Generally speaking, there are five types of underlying imbalance that may give rise to constipation: Qi deficiency, Qi and Blood deficiency, Liver Qi stagnation, Kidney Yin deficiency and Kidney Yang deficiency. These are syndromes or groups of symptoms that form a meaningful pattern in terms of TCM theory, and may not necessarily have a direct relationship to Western anatomy and physiology. When diagnosing the Biao (in this case, the constipation), TCM recognises nine different types. This is because all of the associated symptoms and signs are taken into consideration.

The TCM practitioner will take a detailed case history and carry out the standard TCM examination, which will include pulse and tongue diagnosis. Once the underlying pattern and the disease pattern have been determined, treatment will begin with both Chinese herbal medicines and acupuncture. Appropriate changes to diet and lifestyle will be recommended, some of which are outlined below. Specific treatment of the underlying constitution is given together with treatment for the constipation and the former is usually continued for several months after the bowel movements have become regular.

Things to do for yourself

Since the basic causes of constipation are to be found in the diet and lifestyle, it is most important to make some constructive changes in these areas:

The diet should include plenty of fruits, vegetables, whole-grain cereals, beans, seeds, honey, and low-fat dairy foods (if tolerated) Increase the daily intake of fluids, such as spring or filtered water, fruit juices, and herbal teas Avoid ordinary tea, refined carbohydrates such as white sugar and white flour and any foods containing them Develop regular habits for eating exercise and moving the bowels Practice deep breathing exercises Cut down and eventually give up the use of laxatives Menopause

GENERAL INFORMATION

The cessation of the monthly cycle is a natural occurrence in women between the ages of 45 and 55. The menses may stop suddenly, there may be a decreased flow each month or the interval between periods may be lengthened, until a final cessation. In most cases this process may last from one to two years. During this time the function of the ovaries is gradually declining, until they eventually stop producing ova (eggs) and the woman is no longer able to bear children.

There is generally a transitional period that varies from several weeks to several decades, during which a woman may experience a variety of uncomfortable physical, emotional and mental conditions while the body is adapting to these changes. These symptoms vary from being barely noticeable to severe. They include hot flashes (flushes), night sweats, insomnia, heart palpitations, anxiety, irritability, dizziness and vertigo, tinnitus, migraine headaches, fatigue, emotional volatility, forgetfulness, hypertension, low back pain, dry vagina and skin irritation.

However, it should be remembered that the menopause is a natural process and therefore any distressing symptoms should be regarded as signs of an underlying imbalance that requires treatment.

THE TRADITIONAL CHINESE MEDICAL PERSPECTIVE

According to Traditional Chinese Medicine (TCM) there are three organ-systems responsible for the onset, maintenance and cessation of a woman's monthly cycle. These are the Kidney, Liver and the Spleen.

The Spleen is in charge of digestion and transformation, producing Blood and Qi (energy) from the daily food. When the Spleen has matured to the stage where it can produce an abundance of Blood, there is sufficient to ensure an even monthly flow from the uterus and menstruation begins. As one ages, the Spleen becomes weaker and is no longer able to produce an oversupply of Blood and this is one reason for the cessation of menstruation.

The Liver is in charge of storing and releasing the Blood. When the body is at rest the Blood returns to the Liver to be released for use when activity begins. Part of this regulating function is the release of Blood to the uterus for the monthly period. The Liver's activity is easily disturbed by stress or emotional problems. This commonly leads to premenstrual tension in younger women and is also one of the contributing factors to the problems associated with menopause.

Underlying both of these processes is the controlling factor of the Kidney, which acts as our 'biological clock'. Thus it controls the orderly processes of growth, development, maturation and decline. The Kidney also has a direct connection with the uterus and sends some of its Essence to nourish it, giving a woman the ability to reproduce. At around the age of 40 the Kidney begins to decline, and by 50 the supply of Essence ceases, bringing about the cessation of a woman's reproductive cycle.

However, this is not the whole story. Nature always creates a balance, and 'where one thing is lost, another will be gained'. Instead of the Blood being directed to the uterus, the flow is reversed, and now the Blood, along with the Kidney Essence goes to nourish the Heart. This has a profound effect on a woman, as the Heart is the seat of the mind and spirit. Now instead of being centred on producing children, her body is focused on the nourishment of consciousness allowing for the growth and deepening of the spiritual side of her nature.

As already noted, things can go wrong in any part of this delicate rebalancing process. These changes are all due to an insufficient supply of various bodily substances, and pathological deficiency states may arise, causing in the classic symptoms of menopause.

During its 5,000-year history, TCM has developed a detailed and precise system of diagnosis and treatment for all types of women's disorders, including those associated with menopause. Both herbal medicines and acupuncture are used to correct imbalances and supplement and strengthen the body. The TCM practitioner will carefully examine the tongue and pulse in addition to taking a detailed case history. If necessary, certain pressure points will be tested to assist the diagnosis. Once the basic type of imbalance has been identified, the treatment can begin. In addition to herbal medicine and acupuncture, certain lifestyle changes will be recommended, some of which are listed below. THINGS TO DO FOR YOURSELF Make sure you have a balanced and nutritious diet with plenty of calcium, vitamins and minerals. Foods such as seaweeds, seeds, nuts and green leafy vegetables should be taken regularly. You should also avoid taking too much raw or cold foods as this can weaken the Spleen and Kidney. If hot flashes are a problem then it is best to avoid strong spices (e.g. chillis) and deep fried foods. Oils and fats should be kept to a minimum and the meals should be small and more frequent if necessary.

Stress reduction is very important and there are a variety of approaches that may be suitable, such as meditation, relaxation techniques, changes in routine, biofeedback etc. If stress and anxiety are severe then professional help such as counselling or psychotherapy should be sought. Although our culture doesn't value the elderly, and a woman may feel that she is no longer useful or needed, it is important to maintain a positive outlook on life by developing new interests and remaining or becoming involved in the community.

Regular and gentle exercise is recommended (e.g. walking, swimming, tai chi, qi gong or yoga) as this will help to maintain circulation, promote appetite and generate a feeling of well being.

CHRONIC FATIGUE SYNDROME

Chronic fatigue syndrome (CFS) is a condition of incapacitating fatigue that may last for several months to several years. During this time the person may be completely bed-ridden, finding the smallest task to be totally exhausting. The main symptoms that accompany this are sore throat, muscle aches, and reduced mental functioning, with poor concentration and memory loss. There may also be mood changes such as irritability and depression. Often sensitivities to certain foods will develop along with reduced tolerance to common environmental pollutants such as tobacco smoke and car exhaust fumes.

The cause of CFS is not known.The syndrome is believed to result from an abnormal response to a virus or some other trigger factor. Often it is preceded by a viral infection such as glandular fever, Ross River fever or hepatitis, and there is frequently evidence that the immune system has become overly sensitive. Western medicine is currently unable to offer a satisfactory treatment, apart from analgesics, antidepressants and sedatives to relieve some of the symptoms. Traditional Chinese Perspective

In traditional Chinese medicine (TCM) this syndrome is regarded as a 'deficiency' type of illness. This signifies that there is reduced energy available to maintain normal functioning of the internal organs and also that insufficient amounts of certain bodily tissues and substances are being produced. In the majority of cases there is a deficiency of Qi (vital energy) and Yin (vital essence) together with impairment to the free circulation of the Qi, which becomes stagnant. Qi deficiency is characterised by fatigue, weakness, poor appetite and digestion, shortness of breath, weak and low voice, and excessive sweating. The lungs, stomach and spleen, which are the organs concerned with the production of the body's energy, are functioning at a reduced level.

Yin deficiency gives rise to emaciation, dizziness, flushing, hot sensations in the palms, soles and centre of the chest, dry mouth, dry throat, and night-sweats. In this connection, the 'Yin' is a general term for all the nourishing fluids in the body. It also denotes the capacity of the body to 'hold' its nourishment in the form of bodily tissues. This is in contrast to the 'Yang', which refers to the functional activity of the organs and tissues. When there is insufficient Yin there will be symptoms due to the lack of fluids and tissue substance. There will also be signs of Yang hyperactivity because of a lack of the counterbalancing effect of the Yin. This will give rise to sensations of heat, irritability, insomnia and sweating at night.

When the Qi doesn't flow smoothly and evenly through the body, the liver, muscles, emotions and digestion will be affected. There will be pain with a sensation of swelling below the ribs (in the region of the liver), muscular aches, irritability, depression, disturbed appetite and poor digestion. TCM treatment is directed at restoring the normal circulation of the Qi, building up the level of Qi, nourishing and supporting the Yin, and subduing the hyperactivity of the Yang. Acupuncture is used along with Chinese herbal medicine. The acupuncture is effective in restoring the normal circulation of the Qi and reducing the hyperactive Yang, while the herbal medicines are able to build up the Qi and Yin. Treatment should be continued for several months along with changes to the diet and lifestyle. Your practitioner will be able to recommend the most appropriate things for you to do. Things to do for yourself Some of the important lifestyle changes that will assist in the recovery from CFS include the following: Avoid any known allergens. This is mostly done by trial and error over several months. Every substance in the diet and environment should be considered The diet should be easily digestible and nourishing Stress should be reduced or avoided Adequate rest should be taken. However, bed rest should be restricted to that required for sleep as too much will only lead to further weakness and muscle wasting Take as much time outdoors in the fresh air as possible and follow a gentle, graded exercise program. Walking, qi gong, tai chi, yoga and swimming are all suitable and should be done for short periods, slowly increasing the time as strength returns.