Learning From
China
By Anne Underwood
NEWSWEEK, December 2, 2002
A Western doctor would say you are perfectly healthy, but “you are
not!” proclaims Nan Lu, a doctor of traditional Chinese medicine in New York’s
Chinatown. Dr. Lu has just examined my tongue and taken my pulse—or rather my
pulses, one for each of 12 organs. The diagnosis: an “energy leak” from the
heart, causing insomnia. “The heart governs the mind,” Lu explains. “You have
too many thoughts. You can’t get them out of your brain when you want to
sleep.” This feels like a palm reading, but the doctor’s description is accurate.
OK, I reply. What’s the remedy? According to Lu, it will require acupuncture, qigong (Chinese yoga), meditation, dietary modifications and herbal remedies—in
short, major lifestyle changes. I leave with three herbal formulas containing
green orange peel, sour-date seed and licorice root along with dozens of exotic
ingredients, and I promise to come back for a qigong class. Acupuncture? I’ll
think about it.
WESTERN RULES OF EVIDENCE
If traditional Chinese medicine feels unscientific
to the Western mind, that should come as no surprise. Its foundations were laid
down more than 2,000 years ago in The Yellow Emperor’s Classic of Internal
Medicine. Yet modern science is starting to verify that some of these age-old
remedies really work. A major conference in Beijing in September brought
together 1,500 researchers from 28 countries. Together the scientists presented
more than 1,000 research papers, most of them relying on strict Western rules
of evidence to evaluate the safety, efficacy and biological mechanisms of
traditional Chinese treatments. The beauty of the research is that it seems
strongest in areas where Western medicine is weakest—namely, chronic
illness. “Even in China, no one says ‘Get me to an herbalist’ after a car
crash,” says Dr. David Eisenberg, director of Harvard Medical School’s Osher
Institute for complementary and integrative medicine. But the Chinese do
routinely seek out traditional cures for recurring migraines, arthritis,
menopausal symptoms, chronic digestive disorders, even inoperable cancers. The
evidence is promising enough that Western researchers have begun looking to
China for potential new therapies.
That the two systems can find common ground for
dialogue at all is remarkable. Traditional Chinese medicine is grounded not in
biochemistry or pathology but in concepts of balance and harmony—between yin
and yang, the “five elements” (wood, fire, earth, metal and water), the “six
pathogenic factors” (cold, wind, dryness, heat, dampness and fire) and the “seven
emotions” (joy, anger, anxiety, obsession, sadness, horror and fear). Excesses
or deficiencies can cause illness, according to Chinese medical theory. So can
too much or too little food, drink, work or exercise. In addition, good health
requires the life force or vital energy that the Chinese call qi (“chee”)
to flow smoothly through the body along 14 major channels, or “meridians.” Put
this all together, and it means that a traditional Chinese doctor wouldn’t
diagnose peptic ulcers, but “deficient yin of the stomach,” “damp heat
affecting the spleen” or “disharmony of the liver invading the spleen.”
Acupuncture or herbs might be needed to unblock “stagnant qi.”
TESTED, WITH MIXED RESULTS
Of all the Chinese treatments, acupuncture has been
the focus of the most research in the West. It has been tested, with mixed
results, for conditions ranging from asthma to ringing of the ears. So far, the
strongest evidence is that it relieves pain and nausea. Numerous lines of
research show that it boosts levels of the body’s own opiates, called
endorphins. This would help explain its effect on pain. It also appears to
increase the brain chemical serotonin, which confers a sense of well-being. At
the September conference, Dr. Han Jisheng of Beijing University presented a
study suggesting that acupuncture could even lessen drug cravings. In a study
of 611 Chinese heroin addicts in rehab, acupuncture with low-level electrical
stimulation reduced the relapse rate to less than 80 percent after nine
months—compared with nearly 100 percent for most Chinese addicts.
What’s most puzzling is why the 2,000 acupuncture points on
so-called meridians should be special. Western doctors have long complained
that the meridians don’t correlate to any anatomical structure, such as the
nervous system. But Dr. Helene Langevin from the University of Vermont may have
found the key. In December the journal of the American Association of
Anatomists, The Anatomical Record, will publish Langevin’s cutting-edge research
showing that acupuncture points tend to correspond to areas where connective
tissues are thickest. “Connective tissue forms a web that runs continuously
through the body,” she says. This tissue also contains many nerve endings,
which may explain why a needle in the right hand would affect the left
shoulder.
Does your
family use alternative medicines to treat its illnesses?
* 3481 responses
Yes,
everything from Chinese herbs to massage
29%
A bit, but
mostly vitamin supplements and the like
47%
No, we're
medical traditionalists
23%
Survey
results tallied every 60 seconds. Live Votes reflect respondents' views and are
not scientifically
valid surveys.
Chinese herbology presents its own set of research challenges.
Western trials are set up to study a single medication. But Chinese remedies
are blends of many herbs. “Chinese medicine is not like a tennis match with two
opposing players—disease and drug,” says Lu. “It’s more like a football game,
with many types of players in different roles.” Some herbs might be star
quarterbacks; others are there to boost their efficacy; still others might
tackle toxic side effects. It may be the combination of herbs or their
subcomponents that makes them effective. Take the herb huang lian, which
Dr. Gary K. Schwartz at Memorial Sloan-Kettering Cancer Center is studying as a
potential cancer treatment. The herb contains seven main compounds and 30 minor
ones. Together, they kill cancer cells in the lab by interfering with the
cells’ development. Individually, the compounds don’t have the same activity.
NOT RISK-FREE
Chinese medications tend to have fewer side effects
than Western pharmaceuticals, but they are not risk-free. Anything strong
enough to have pharmacological activity also carries the risk for toxicities,
notes Ted Kaptchuk, a doctor of East Asian medicine who teaches at Harvard
Medical School. In 1996, Australian researchers surveyed the most populous
states in their country for adverse effects from both herbs and acupuncture.
They noted one adverse event for every eight to nine months of a doctor’s
full-time practice, or one problem per 633 consultations. The problems with herbal medicines included allergic reactions and interactions with prescription drugs. Elsewhere, toxic impurities and incorrectly mixed herbs have sometimes
resulted in kidney failure and even death. Still, Western medicine, for all its
efficacy and high standards of purity, is riskier. A 1998 study in The Journal
of the American Medical Association found more than 100,000 fatal drug
reactions among patients in U.S. hospitals in a single year.
Chinese medicine seems likely to find a growing place in Western medical practice, if only due to popular demand. Americans and Europeans are increasingly asking for it—even traveling to China to get it. One traditional hospital in Beijing has a special foreigners’ ward. Other Chinese hospitals are offering medical tour packages. “You can see the Great Wall, the Forbidden City—and get three days’ worth of treatment as well,” says Yianni Solos, a Greek medical student in Beijing. For those not ready to make the journey, China is exporting $500 million worth of herbal medicines annually. And since 1987, more than 20,000 Westerners have studied in traditional Chinese medical academies. Equally important, training programs now exist in the West, along with licensing procedures for qualified practitioners. The result: more Chinese medicine is available stateside.
Those seeking it out include people like research
scientist Amy Howell of Rutgers University. After suffering from West Nile
virus two years ago, Howell began having serious dizzy spells. Western
specialists told her the cause was “probably multiple sclerosis or a brain
tumor,” but they were unable to fix the problem. Finally, in desperation, she
turned to an acupuncturist in Cherry Hill, N.J. He diagnosed “stagnant liver qi” and administered acupuncture and herbal remedies. Seven months later
Howell’s dizzy spells are gone. So are her allergies and a chronic shoulder
problem. “I’m a scientist,” says Howell. “This doesn’t make sense, but there’s
something there.”
If Chinese medicine can help complications of West
Nile virus, can it work for insomnia? The jury is out, but I’m optimistic.
With
Melinda Liu and Paul Mooney in Beijing