No one likes to be wrong. No one likes to admit that his or her
medicine is not the best. When a patient walks into the room
seeking treatment, we each want to be the one to say, "Yes, we can
help you." While acupuncture has successfully treated the masses
for thousands of years, and has been recommended by the World
Health Organization for dozens of conditions and diseases, it's not
the only tool in the shed in 2015.
On Thursday at Cook County Hospital, I sat at the computer in a
treatment room entering the subjective information from an existing
patient presenting with a new chief complaint -- left calf pain.
We'd treated her in the acupuncture wing of the outpatient pain
clinic before, but her chief complaint was usually lower back pain.
Initially, I thought "another case of sciatica," as I worked
through her SOAP note and mentally scanned the best acupuncture
points for the job.
"Sharp pain in the back of my leg," she said, gingerly touching
her left calf. I asked, "When did it start, and have you had this
pain before?" "Yesterday, and NO," she snapped back at me. "It's so
swollen and the pain is sharp right here," she added. She confirmed
that there had been no trauma to the area, and I released my grip
and let the pack of needles slide deeper down into my lab coat
I'm kind of new here, and I readily admit that my weakness as an
acupuncture intern is ruling out contraindications and sorting out
red flags before I start sticking needles into the patient. Can I
still needle you if your blood pressure is 150/90? Some books say
yes, some sources say no. Acupuncture lowers blood pressure, so
shouldn't we go ahead and do it? Refer out! Confusion. "It's
normal," everyone assures me. "You'll gain that confidence through
clinical experience over time." Well, as a third year acupuncture
student, I don't feel like it's been enough time. I walk into the
head clinician's office and start presenting the case. Something
just feels...off...with this patient.
The beauty of my internship at Stroger Hospital is that although
it's not set up to be an integrative treatment experience for each
patient, it can transform into one in under 60 seconds. Our calf
pain patient came into the acupuncture wing of the pain clinic, but
upon suspicion of an emergency situation (yes, we were all thinking
"Deep Vein Thrombosis" or "DVT" at this point in the show), we went
two doors down the hall and snagged an MD intern to evaluate her
presentation from a western perspective, too.
He quickly assessed her signs and symptoms and agreed that we
needed to rule out a DVT before moving ahead with her regularly
scheduled acupuncture treatment at that time. Within seconds, our
integrated team had changed course, explained the testing process
to the patient, called over to the ER, and had a nurse transport
For thousands of years the expansive Chinese empire developed
what we now call "Traditional Chinese Medicine," or "Oriental
Medicine," of which acupuncture and herbs form the foundation. A
complete and effective medical system, the doctors not only placed
needles, administered herbal formulas, gave hands-on manipulations,
moxibustion, and cupping treatments, but also did bone-setting and
any other emergency medicine that was required. Today, in the
United States, our scope of practice is generally not so extensive
as to include bone-setting, but we respect the completeness of the
TCM system in its entirety.
This does not mean, though, that we ignore the
advancements of other medical systems or technologies. It means
that instead of blindly accepting the often too-invasive and
side-effect ridden treatment plans of the mainstream western
medical system, we utilize only the elements that we see as truly
necessary or complementary to a holistic treatment plan. In short,
I LOVE DIAGNOSTIC IMAGING. Sure, it's wrong sometimes, giving false
positives and false negatives alike, but overall it gives us a
somewhat clearer look inside the human body than what we can piece
together by looking at a patient's tongue and feeling her
I'm not saying that modern diagnostic imaging is necessary for
an acupuncturist to be effective in treating modern patients, but
it is another tool in the shed nowadays. The shed has grown larger
in the past 50 years, but it's also full of a lot of junk. Often
the expert walks in, picks up the best tool for the job -- the one
he's trained to use most confidently -- and steps over the rest.
The skill is being adept in choosing those tools that are best
suited for the situation, even if they aren't from the same
"The doctor of the future will give no medication, but will
interest his patients in the care of the human frame, diet and in
the cause and prevention of disease." Thanks, Thomas A.
Edison. I like that quote. Doctors of Oriental Medicine,
herbalists, and acupuncturists generally give herbs as part of a
complete treatment plan, but giving a pill to pop -- whether
pharmaceutical, peppermint, or deer antler-- is not the only way to
The doctor of the future will be truly integrative. He will
skillfully diagnose the patient's whole body, mind, and spiritual
condition, drawing from both hands-on examination findings and
high-tech imaging of internal structures. In the future, when the
patient presents with the new chief complaint of acute calf pain
and swelling, we can use modern imaging to quickly rule out the DVT
and then use acupuncture to treat her condition and balance her
body. We can give her qi gong exercises and dietary changes to
support her long-term health and wellness. Thomas Edison will be
Further Reading: The Patient Will See You Now: The Future of
Medicine is in Your Hands by Eric Topol
Yep, it's called "peanut butter and
me," not "peanut butter and I," because it's about to be used as
the object of the sentence -- not the subject of the sentence.
Grammar geeks unite! The premise here today is that a line has to
be drawn in the sand between peanut butter and me. If we keep our
breakfast meeting love affair going much longer, an accumulation of
pathogenic phlegm is bound to ruin my life.
Don't go throwing out your peanut butter just yet. It might be
fine for you to gobble down a Tablespoon of that rich creamy
goodness every hour on the hour. Not for me, though. It's not good
for me. One of my favorite parts of Traditional Chinese Medicine is
the individualization for each person. It makes me feel special.
Even though I'm really put off by the idea that I should not be
eating my life-long companion, peanut butter, I still appreciate
that the recommendation is personalized for my exact condition of
I thought I was good to go. A couple of
years ago I honed in on what I thought were the most important
concerns encircling peanut butter and me. I knew I wanted to avoid
pesticides, so I found an organic peanut butter. In my continued
pursuit to ditch all things plastic and sub in glass containers, I
found an organic peanut butter in a glass jar. Just peanuts and sea
salt. Mmmmm, salt. Bonus points for how reasonably priced it was
and how the USDA organic seal means the peanuts were not of the
genetically modified variety. Grand.
Then I went on with my life, pleased with my research and
findings. I smeared my glorious peanut butter on my hearty slice of
organic sprouted grains bread every morning. Starting my day off
right, oh yah! Sometimes I'd add a few slices of bananas and really
pat myself on the back -- three food groups represented, once you
count the liberal pour of cream into my coffee. I should have been
feeling awesome...but I wasn't.
What was happening? I was getting damper and phlegmier by the
day. It couldn't be my precious breakfast turning on me... could
it? I whip out my trusty TCM-friendly food resource, Healing
Whole Foods: Asian Traditions and Modern Nutrition, which I
highly recommend, and I flip to the peanut butter section. It
wasn't fantastic. Tears may have been shed. Here's a summary:
Peanuts are warming and sweet,
affecting the Lung and Spleen systems in TCM; peanuts lubricate the
intestines and harmonize the Stomach. OK, fine so far. Peanuts can
increase the milk supply of nursing mothers, clear blood from the
urine, treat deafness, and lower blood pressure. Great, but not
applicable; moving on. Then the book takes a turn for the worst.
Peanuts "greatly slow the metabolism of the Liver. Therefore they
should be avoided by overweight, damp, sluggish,
yeast-infected, or cancerous persons."
SCREEEEEEEECH, went my brain. I definitely have the damp,
sometimes feel sluggish, and of course lose sleep at night
wondering if I have every cancer under the sun. Maybe I shouldn't
eat the peanut butter? What about moderation? I'm usually on board
with everything in moderation. Even the book says peanuts can be
helpful sometimes, for some people. "Peanuts can benefit the person
with fast metabolism such as the thin, nervous person who digests
large amounts of food rapidly." Well, crap. That's not the loophole
I was hoping to see.
I scan the book quickly, going through the introduction in the
chapter, "Nuts and Seeds," hoping to see any type of justification
for me continuing to scarf peanut butter every morning. What's the
general guideline they give before branching out to discuss each
specific nut? "Nuts all follow a pattern of being rich in fat and
protein and therefore should be used ... to tonify
thedeficientperson; avoid them in cases ofexcess and dampness."
Game over. I, like most overfed, over-stressed, and under-exercised
Americans, am a ball of excess patterns. Stasis, stagnation,
damp-heat, phlegm. Check, check, check, check!
The only passage I liked in the entire section on peanuts was
the justification for eating organic peanut butter. The author
notes "Peanuts are often heavily sprayed with chemicals and grown
on land saturated with synthetic fertilizers. In addition, they are
subject to the carcinogenic fungus aflatoxin. Organic peanuts
should therefore be used -- they contain fewer chemical residues,
and are less subject to aflatoxin."
Suggestions abound in this section. Nuts are serious. It states
to only buy nuts in the shell, because nuts lose their nutrients
after being hulled or shelled. Yikes, who's doing that? "Store
hulled seeds in dark bottles in cold places... Do not store in
plastic. Oil-rich food combines with plastic to form plasticides."
Eww. "Toxins tend to accumulate in all seeds, so it is important to
buy organic non-sprayed ones." Got it.
What's the conclusion today? Is it a.) Never eat seeds, nuts, or
nut butters ever again? No, thankfully, I'm not saying that -- to
you or to myself. The better answer is b.) Take your condition into
account and eat smaller, less frequent amounts of organic, non-GMO
options. Balance it out with other foods that drain damp and
transform phlegm. Hint: it's not a banana, unfortunately. Wamp,
Are essential oils (EOs) the answer to the challenging questions
of how to locate, transport, store, and prepare Chinese herbs? I'm
starting to think so. The more I use EOs in everyday life, in
everything from cleaning my kitchen floor to healing skin wounds,
and even to give my beer that summery citrus flavor, the more I see
the large overlap between EOs and Chinese herbs.
As a student of Acupuncture and
Oriental Medicine (AOM), mostly derived from Traditional
Chinese Medicine (TCM), I respect and value the efficacy of a
freshly decocted batch of raw Chinese herbs. I know they work, I've
gained a basic understanding of why they work, but I struggle with
the practicality of using them either for my family now or for a
future patient population.
What are these challenges? First, there are a lot of "herbs" in
TCM's Materia Medica (book of medical substances, whether plant,
animal, or mineral derived). To stock a shoebox-sized amount of
just most of them would require a very large storage room.
Some need to be refrigerated, some need to be pulverized just prior
to use, and some are illegal to use in the United States. No
rhinoceros horn for you!
Finding them--even the
legal ones--presents yet another stumbling block. Should you order
online, feign condition after condition to cache all the prescribed
herbs you can squeak out of your clinician at school? Drive to
Chinatown and take a stab at which shop has fresh, safe and
affordable herbs? Sure enough, within a few days of making each
trip to Chinatown myself I realize, "DOH! Now I need
that other herb, too!" Back in the car....
After a year or so of engaging in this disorderly and expensive
game of cat and mouse, I'd tried all (well, most) of these
tactics--even growing some of my own! All legal, of course. Think
"mint," not "ephedra." So, what's an AOM student to do? For the
past year, this one's been exploring the way that high-quality EOs
could fulfill many of the same needs as our Chinese herbs. How?
Well, I'm not entirely sure that the properties translate exactly,
but many sure seem to do just that. Let's take a look at our good
Chinese name: Bo
he. Common English name: Field Mint. Latin name: Mentha
piperita. Same plant...same medicinal properties? I argue
"yes." Most basically, peppermint is "cold" in nature. Both West
and East agree on that. TCM goes on to add other attributes such as
aromatic, acrid, and thus capable of dispelling the common
wind-heat invasion (think: yellow snot and sore throat). My western
manual of EOs describes peppermint as "anti-inflammatory,
antibacterial and invigorating," with primary uses including
"congestion, fever, influenza, heartburn."
Sure, the harvesting, processing, and distillation processes
change, emphasize, or even exclude some of the chemical
constituents, and the final usable product of dried bo he
differs greatly in appearance from the bottle of peppermint EO.
Does that mean they function differently, though? I used to
harvest, dry, and lightly decoct my own bo he when I felt
a wind-heat invasion coming on. It worked, as long as I was at home
with my own garden and had some time to prepare it all. Lately,
I've been easily reaching into my oils cabinet and tapping two
drops of peppermint EO into a mug of warm water. Instant peppermint
tea? Definitely. Instant medicinal answer to a wind-heat invasion?
I say yes again, based on my own experiences.
I'm not a chemist or a doctor, but in my experience
and increasingly informed opinion, I'm finding that EOs can make a
handy substitute for Chinese herbsin many cases. As with raw herbs,
quality is of upmost importance when selecting an EO company.
Storage, convenience and ease of use are all in favor of EOs, but
they are limited in number. I haven't found one called "gecko" or
"scorpion," or especially "Bear Gall Bladder," all of which are
clutch entries in a TCM Materia Medica.
Conclusion: If you can manage to live and treat without the more
exotic or illegal Chinese herbs, then EOs might be a practical
substitute much of the time. Imagine the difference between handing
a patient a bag full of raw ingredients, a pictorial instruction
sheet, and a handshake full of hope that they can execute the
cooking process effectively vs. handing the patient a small bottle
of EO and the simple instructions to put two drops into a mug of
Extra considerations abound; this post cannot attempt to cover
every angle or offer every comparison point. Granule or patent
pills can make Chinese herbs more practical, while some EOs are
quite expensive to purchase. Frankincense can easily run $100 per
15 ml bottle. Hey, if it's good enough for the Christ Child, you're
going to have to pay up! There are also some pesky mind-blocks when
trying to move seamlessly from one medical paradigm to the other.
How could a TCM practitioner possibly use hot cinnamon bark and
clove bud for a yellow-snot, sore throat sinus infection? Yet,
that's exactly what the EO prescription is in that case. Homeopaths
have no qualms with the theory of treating heat with heat, but
that's not the plan in AOM!
For now, I'll chalk this entire idea up to just another piece of
evidence that an integrated approach to healthcare is truly the
best option. Taking what works from any and all medical systems
offers our patients the most options for being well. I'm open to
Over the past four weeks in my "Nutrition and Food Therapy of
Oriental Medicine" course, I've been frustrated and slightly
puzzled over the subject matter. I'm usually more a
go-with-the-flow student in class; I'm sure the instructor knows
what we need to cover and how to cover it. This time around, I
still think he knows what we need to cover and how to lay it out,
but I'm not as easy going about the whole thing for some
Maybe it's because it's springtime, so my Liver wind is swirling
and I'm irritable. Perhaps I'm overly critical because dietetics is
my personal favorite element of oriental medicine. Maybe I'm just a
jerk. I don't know. I want to study therapeutic properties of
foods, and I want to right now!
Let me start by saying how much I like this professor and every
class I've had with him to date. The theory behind where we stick
these needles and which herbal formulas we recommend is absolutely
mind blowing. He taught me two years ago that winter has a color
and a flavor -- black and salty, for the record. Yet each week, we
seem to review the basics -- flavors and temperatures of
substances. The course title indicates that the focus of the
classwork will be nutrition and food therapy within the framework
of oriental medicine, so I keep wanting more -- more detail, more
examples, more ideas of how to alter a person's diet in order to
As we approach the famed Week Five Quiz that now makes an
appearance in most classes, I'm starting to second-guess myself.
Have we been just reviewing the basics of five-phase
theory, or did the professor slip pages of new detail into the
lectures when I wasn't looking? I'm sure he worked new information
into the framework so smoothly that my associate learning didn't
even know what was happening.
My frustration with this class is that I love the topic so much
that I can't reach a satiation point. I will never have enough
detail about food therapy to be content. I want more, I want it
now, and I want to share it with everyone I know...and some people
I don't even know yet.
Once again, springtime has
duped me. I'm irritable, I'm impatient, and my Liver is out of
control. Feel my pulse, second position on the left wrist. Can you
As I do from time to time, I realize now it's time to reread the
Dao de Jing, or the Tao Te Ching. Same book. Oh,
pinyin, you are a beast that cannot be pinned down. The point is
that this book, this short, easy to read, little book, can save
your sanity. Whenever I feel overwhelmed, overstressed, over Livery
in any way, I know it's time to pick it up.
Look at this thing. Lao Tzu, you genius!
"Those who know do not
Those who speak do not know."
I, and just about everyone else, could learn a little something
from that eloquent one-liner (two-liner?).
"Rushing into action, you fail.
Trying to grasp things, you lose them.
Forcing a project to completion, you ruin what was almost
I don't even like poetry, but this stuff is literally
So, why I am frustrated in
Nutrition class? Why do I want to rush it? Why am I desperately
grasping at the next piece of information? It's that "forcing a
project to completion" part, that part I love for personal reasons.
My procrastination has been vindicated!
As a professor, I often wait until the deadline to return
students' papers; as a student, I expect my professors to grade my
paper today! Actually, I don't think Lao Tzu would like that
• So What Is Chinese Medicine?
• Jabbing Nerves with Needles
• Mission in Nicaragua
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