Traditional Chinese Medicine Treatment and Integration of Chinese and Western Medicine

 

Dr. Yu Chau Leung Edwin
Honorary President of the Hong Kong Association for Integration of Chinese - Western Medicine
Registered Doctor
Registered Traditional Chinese Medicine Practitioner

 

Host: Ms. Wong Wing-chen, Janet

 

 

 

Introduction: In this interview, Dr. Yu analyzes the differences in philosophy between Western medicine and Traditional Chinese medicine, including the differences in the treatment of cancer. At the same time, we also discuss a most popular topic among cancer patients - "diet".
 

Part One - Basic Concepts
Part Two - Differences in Philosophy between Western Medicine and Traditional Chinese Medicine
Part Three - How Traditional Chinese Medicine and Western Medicine Understand Cancer
Part Four - Nutrition and Diet Therapy
Part Five - Psychological Perspective

 

Part One - Basic Concepts

Wong: The topic we are going to discuss today is the integration of Western medicine and Traditional Chinese Medicine. I am very pleased to invite Dr. Yu, Chau-leung, Edwin to accept my interview.

Dr. Yu, thank you.

Yu: You're welcome.

Wong: I understand you are a specialist in pediatrics as well as a registered Chinese medicine practitioner. I would like to discuss with you the similarities and differences between Chinese medicine and Western medicine.

Perhaps we can start from the basics. Let's talk about the basic philosophy of Western medical treatment?

Yu:

Western Medicine

Western medicine is the mainstream medicine for disease treatment today. Its basic foundation includes:

・Anatomy,

・Embryology,

・Physiology,

・Biochemistry,

・Pharmacology, etc.

Whether in diagnosis or treatment, Western medicine emphasizes precise detection and treatment of the symptoms.

In terms of diagnosis - doctors look for specific and direct "detectable" causes of disease, disease location, etc. as "targets" for treatment. At the same time, clinical observation and the use of instruments, biochemistry, and testing are used to investigate the pathology of the disease.

In terms of treatment - surgical removal, replacement, drugs, biology, anatomy, physics and other methods are used.

The advantage of Western medical treatment is that it is standardized and precise, and because it is standardized, it is convenient for follow-up.

Chinese Medicine

Wong: What about Traditional Chinese medicine?

Yu: Traditional Chinese medicine collects various information, starting with the four diagnostic methods of inspection, listening and smelling, inquiry, and palpation, （望聞問切）considering both the "specifics" (the organ of the patient that is sick) and the "holistic" (the patient's overall health condition).

Wong: Can you explain the process in greater detail?

Yu: There are probably the following main elements:

- The medical system of traditional Chinese medicine is based on the theory of Yin, Yang, and the Five Elements（陰陽五行）, combined with the characteristics of the essence, qi（氣）, and spirit of the human body, which generate and restrain each other, and interact with each other;

- Through the "four diagnostic methods of inspection, listening and smelling, inquiry, and palpation", the Traditional Chinese Medicine practitioner identifies the cause of the disease, the nature of the disease, the location of the disease, and analyzes the condition; and

- According to the changes in the five internal organs, meridians and joints, and qi, blood and body fluids of the human body, the Traditional Chinese Medicine practitioner identifies the evil, the positive, the consumption, and the growth, and then finds out the cause of the disease, summarizes the syndrome, and treats the disease according to the syndrome.（根據人體內五臟六腑、經絡關節、氣血津液的變化、判斷邪、正、消、長，進而得出病因，歸納出証型，辨證施治。）

 

Part II - The Differences in Philosophy between Western Medicine and Traditional Chinese Medicine

Wong: Traditional Chinese medicine and Western medicine are of course very different, can you briefly introduce the most important differences to us?

Yu: Traditional Chinese medicine and Western medicine have their own strengths and focuses.

Western medicine emphasizes the analysis of diseases from exogenous problems. Over the years, through in-depth analysis/understanding of the environment with technology, subdividing categories, it has become the major stream in the world, clearly dealing with disease factors caused by the environment, such as bacteria or chemical pollution, etc.

At the same time, Western medicine is more focused on finding problems in a certain part or organ, so the thinking framework is more "localised".

Traditional Chinese medicine also pays attention to exogenous problems, the so-called "avoiding the wind when the body is weak"（虛邪賊風，避之有時）, but there is no concept of inflammation, bacteria, and viruses. Moreover, traditional Chinese medicine practitioners believe that it is often the body that has problems first, which leads to the invasion of external evils.

The treatment of traditional Chinese medicine focuses on "endogenous", functional—-the concept is to dredge the meridians, remove blood stasis, balance yin and yang. In terms of health, it emphasizes the harmony between the five internal organs and the natural world.

Wong: Can Western medicine and traditional Chinese medicine be combined to bring greater benefits to patients?

Yu: If we can combine "Western medicine diagnosis" and "traditional Chinese medicine syndrome differentiation" to diagnose diseases for patients then we can combine the "holistic" subjective cognition of traditional Chinese medicine with the "local" precise measurement of Western medicine.

If we do not totally segregate Chinese and Western medicine, instead combine their strengths, to understand the nature of the disease, resolve any contradictions, judge the situation, and treat patients with each stream’s strengths and avoid each stream’s weaknesses, it will bring the greatest benefits to patients.

Discuss with eczema as an example

Wong: Dr. Yu, you are a pediatrician, let's discuss a disease that often troubles children, that is, "eczema".

Yu: Okay.

Western Medicine

Wong: How does Western medicine understand eczema?

Yu: "Eczema" generally refers to some acute and chronic skin inflammations.

The basic cause is "polymorphic skin damage", that is, the skin presents different states of rashes (polymorphic), first there is the damage or exudation state of acute dermatitis, and then the thickening and roughening of chronic skin. Eczema can be further subdivided according to different etiologies or rash manifestations.

The characteristics of eczema are symmetric distribution (symmetric), polymorphic damage, severe itching and recurrent attacks.

Among them, "atopic dermatitis" is related to allergic propensity and changes in the skin barrier due to a genetic factor.

In terms of treatment, "external treatment" is the main method, which is to apply moisturizing ointment to allow the skin to absorb beneficial lipids and moisture, thereby reducing the chance of allergen invasion. When the skin is red and inflamed, the doctor will control it with appropriate ointment (can be steroids or non-steroids). Sometimes patients can also take antihistamine drugs with anti-allergic and anti-itching effects to control the disease.

As for the most severe and stubborn eczema, doctors can use immunosuppressants, or even biological agents.

In addition to drug treatment, Western medicine can also use laboratory test to help patients identify their allergens, so that patients can avoid contact as much as possible in future and reduce the chance of onset.

Chinese Medicine

Wong: What about Chinese medicine?

Yu: Chinese medicine looks at eczema and believes that it is mostly related to the patient's congenital endowment (such as genetic allergies). The patient's skin is not dense, and the external defense function is not solid (that is, the protection ability is poor), and it is easy to be invaded by external qi such as wind, dampness, and heat, and gather on the skin to cause disease.

Spleen and stomach dampness and heat is also a common cause of eczema, or lung qi wind toxin, with wind evil, evil poison residing in the skin. Simply put, there are problems with the digestive system and respiratory system.

External causes are mostly related to geographical location, climate factors, and the evil qi of the four seasons of wind, cold, heat, dampness, dryness, and heat. So some patients have no big problem in Hong Kong, but their condition is much worse after moving to the UK.

From the perspective of Chinese medicine, eczema can be divided into two major categories: one is "wet" and the other is "dry". It can be caused by dampness, heat, cold, blood deficiency, wind dryness, etc.

"Wet" patients are mostly children, and the rash is mostly pinhead-sized papules and vesicles, some of which merge into pieces, with mild infiltration, mostly concentrated in the elbow and popliteal fossa. And "dry" or blood dryness patients are mostly adults.

In terms of treatment, Chinese medicine "treats both the symptoms and the root cause", mainly focusing on internal treatment as the fundamental, supplemented by external treatment methods.

For "internal treatment", it generally involves clearing heat and cooling blood, dispelling wind and dampness, and moisturizing dryness to stop itching. The goal is to regulate the functions of the internal organs, restore the normal functions of the lungs, spleen, and kidneys. When the water and dampness are metabolized, the body will returns to a balanced state, and eczema will be alleviated or disappear.

At the same time, Chinese medicine also emphasizes dietary restrictions for patients.

For "external treatment", Chinese medicine external washes/ointments are used, or combined with acupuncture, to enhance the unblocking of meridians, enhance the dampness-dispelling channels, and help the body expel pathogens.

Wong: Western and Chinese medicine have different emphases, can they be combined?

Yu: Western and Chinese medicine can treat eczema and resolve skin problems from multiple levels. Chinese medicine practitioners focus on improving the overall physical condition of the patient.

You can use "Western medicine to identify diseases" (skin lesions), plus "Chinese medicine to identify syndromes" (that is, understanding the overall state of the body) to diagnose diseases.

When the skin is infected, if the condition is severe, the symptoms are mainly treated with Western medicine to reduce inflammation, such as using antibiotics as needed, and then supplemented with Chinese medicine treatment.

Part Three - How Chinese and Western Medicine Understand Cancer

Wong: Now let's talk about cancer. How do Western and Traditional Chinese medicine understand cancer? Let's talk about Western medicine first.

Western Medicine

Yu: Cancer is a disease in which cell growth and reproduction are out of control. When the body reproduces new cells, the mechanism has become abnormal, causing cells to divide and proliferate uncontrollably, forming tumors. And these proliferating cancer cells can invade surrounding tissues and even other organs in the body (i.e. metastasis).

So why has the mechanism become abnormal? This can be due to congenital or acquired factors. In terms of congenital factors, it can be due to inherited defective genes. In terms of acquired factors, it can be due to smoking, obesity, poor diet, and other factors.

There are two types of genes related to the formation of cancer, the first is oncogenes; the second is tumor suppressor genes. The formation of cancer is often accumulated by the activation of several oncogenes or the loss of function of several tumor suppressor genes.

Wong: Knowing the cause, how about treatment?

Yu: From a Western medicine perspective, the most direct way is to eliminate the cancer. The main methods are resection (i.e., surgery), chemotherapy, radiation therapy, hormone therapy, etc.

Pain control and symptom control are also important elements in cancer treatment. Palliative care is very important for patients with advanced cancer.

Chinese Medicine

Wong: What about Traditional Chinese medicine?

Yu: From the perspective of Traditional Chinese medicine, the onset of cancer is mainly due to the imbalance of the viscera, yin and yang, and qi and blood. On the basis of "Zheng Xu"（ 正虛 ）, external evils invade; or phlegm, dampness, qi, and stasis knot for a long time, and accumulate and stagnate.（發病主要是由於臟腑陰陽氣血失調，在「正虛」的基礎上，外邪入侵；或痰、濕、氣、瘀等搏結日久，積滯而成。）

Chinese medicine also says that if poor diet or emotional factors exist for a long time, it can cause the body's yin and yang imbalance, the decline of Healthy Qi, and create the conditions for the growth of cancer. The rapid development of cancer further consumes Healthy Qi, causing the viscera, qi and blood to be out of balance, and produces some pathological factors, such as phlegm knot, dampness gathering, qi obstruction, blood stasis, depression and heat.

That forms a vicious circle, making cancer difficult to cure.

From the perspective of Chinese medicine, cancer patients can be divided into different "syndrome types", such as: heat and poison accumulation type; qi stagnation and blood stasis type; damp phlegm accumulation type; visceral imbalance type, etc. （分為不同的「症型」，例如：熱蘊毒聚型；氣滯血瘀型；濕痰蘊結型；臟腑失調型等。）Different syndrome types have different treatment methods.

Wong: What about treatment?

Yu: Chinese medicine treats diseases based on syndrome differentiation, aims to improve the patient's own immune function (Healthy Qi), adjust the internal balance of the human body, thereby enhancing the ability to resist cancer and control the development of tumors. This is "reinforcing the healthy qi"（扶正祛邪）.

In addition, Chinese medicine also hopes to directly eliminate cancer to some extent, which is "eliminating the pathogenic factors".

But how to determine the priority of " reinforcing the healthy qi" and " eliminating the pathogenic factors" depends on the patient's physical strength and the early or late stage of the disease:

• Early stage cancer: when attacking evil is the first, use heat-clearing and detoxifying, blood-activating and stasis-dispersing or phlegm-removing and knot-attacking drugs as the main.
• Late stage cancer: evil qi does not decrease, Healthy Qi is weak; or after radiotherapy, chemotherapy, surgery, the big evil is eliminated, use qi-nourishing and yin-nourishing, qi-replenishing and blood-replenishing drugs, appropriately combined with evil-attacking drugs.

In short, start from improving the patient's physical condition and treating the disease symptoms.

Part Four - Nutrition and Diet Therapy

Wong: Dr. Yu, I believe that as a Chinese medicine practitioner, you must often have patients asking you about "diet" issues. In fact, Chinese medicine and Western medicine do have different theories on nutrition and diet.

Can you explain the differences between Western nutrition and Chinese diet therapy?

Western Nutrition

Yu: Nutrition is indeed an important consideration. Whether it's traditional Chinese medicine or Western medicine, for the health of the patient, there are things that should and should not be eaten, that is, the so-called "suitable food"（宜食）and "taboo food"（忌食 ）.

Balanced diet is the basic principle： grains, meat, fish, eggs, beans, milk are important nutrients. In addition, micronutrients including vitamins and minerals are very important to the body, so eat more fresh vegetables and fruits.

If the patient's body changes due to illness or treatment, such as oral ulcers, diarrhea, gastrointestinal stagnation, etc., the caregiver needs to prepare food for the patient according to the relevant situation.

Chinese Medicine Diet Therapy（中醫食療）

Chinese medicine is based on syndrome differentiation and treatment（辨證論治）, looking at the patient's physical condition to determine the need for food, and adding different ingredients to strengthen the body to fight cancer.

At the same time, Chinese medicine diet therapy also emphasizes "dietary restrictions"（戒口）

Wong: Maybe we can discuss some specific examples.

For example, we often hear that seafood is "inflammatory", but Western medicine thinks that seafood can provide a lot of valuable protein. How should we understand this?

Yu: "Inflammatory food" （發物）can be said to be an ancient Chinese folk saying, there is no scientific research showing that "inflammatory food" will affect the disease, and Western medicine naturally does not have this concept.

As a Chinese medicine practitioner, I don't think seafood is "inflammatory". However, some cancer patients are sensitive to seafood, and eating seafood may worsen the disease.

At the same time, the cooking method is very important. For example, some people add lots of hot spices when cooking seafood, which is not good for cancer. For example, if the shell is cooked during cooking, the patient eats not only the "meat" of the seafood, but also eats the internal organs or other contaminants causing adverse reactions in the body.

Wong: What about meat? For example, Chinese medicine says that it is not good for cancer patients to eat beef?

Yu: It may be because beef, chicken, crab, etc. contain high fat and high protein, Chinese medicine believes that they are "hot food"（熱物）, and believes that cancer patients should not eat too much "hot food". Sometimes, according to the patient's specific situation, there are indeed some special considerations in choosing food.

But one thing I want to say is: when a cancer patient goes to see a Chinese medicine practitioner and is told to quit beef; but when he sees another Chinese medicine practitioner, he says to quit pork or chicken; and then a friend tells the patient not to eat seafood—- as a result the patient will have nothing to eat.

In the end, we should adopt a balanced diet and the doctrine of the mean, being too extreme is not good.

Wong: Traditional Chinese medicine has the concept of "hot and cold", what does it mean? How does Western medicine understand this concept?

Yu: The concept of cold and heat in traditional Chinese medicine is an important concept in the "Eight Guidelines"(八綱) and "Yin and Yang, Exterior and Interior, Cold and Heat, Deficiency and Excess"，（陰陽表裡寒熱虛實 ）.

"Cold syndrome"（寒證 ） refers to the symptoms manifested by exposure to cold pathogens or the predominance of Yin and deficiency of Yang. Specifically, cold syndrome refers to a group of symptoms and signs with cold manifestations.

(Clinical manifestations are divided into exterior cold, interior cold, deficiency cold, and excess cold, so the manifestations of various cold syndromes are not exactly the same. Patients generally have the characteristics of insufficient warming of Yang Qi - aversion to cold and preference for warmth, pale complexion, cold limbs and curled up, pale mouth and no thirst, phlegm, saliva, nasal mucus, clear and thin stools, pale tongue and moist coating, etc.)

"Heat syndrome" （熱證 ）refers to the symptoms manifested by exposure to heat pathogens or the predominance of Yang and deficiency of Yin. Specifically, heat syndrome refers to a group of symptoms and signs with heat manifestations.

(Clinically, the manifestations of various syndromes are also not exactly the same. Patients generally have the basic characteristics of insufficient fluid damage and heat disturbance of the mind - aversion to heat and preference for cold, pale mouth and preference for cold, red top and red eyes, restlessness, thick yellow phlegm and nasal mucus, short and red urine, dry and hard stools, red tongue with yellow and dry coating, etc.)

Western medicine now accepts "Yin and Yang" more, but still has little understanding of "Cold and Heat".

Wong: I've heard of cancer patients who think they need to eat less to "starve" cancer cells, or even "fast", but won't this cause the patient to lack nutrients?

Yu: On the issue of "starving cancer cells", different people have different understanding. But if you don't eat or drink, the cancer cells won't die, but the person will starve to death first.

Fasting cannot "starve" cancer cells. There is no medical basis for fasting to "starve" cancer cells.

Wong: If a cancer patient wants to choose to be a vegetarian, would you agree?

Yu: If the cancer patient is not a vegetarian, there is no need to become a vegetarian because of cancer. If the cancer patient has always been a vegetarian, they can continue to be a vegetarian, but they need to be aware of possible nutritional imbalance and rapid weight loss. Therefore, vegetarians need to find a nutritionist to review whether the food they eat can provide enough nutrition to maintain a strong body for treatment.

Another point is that when Hong Kong people are vegetarian, they often "have the intention but not the action"（齋心唔齋口） - although they eat plants, they add a lot of spicy spices or additives, which are not good for the body.

Wong: Another issue is "soup". We Chinese people believe in soup, but will there be a problem if a cancer patient drinks too much water? Will the soup occupy most of the patient's stomach capacity, so the patient has no appetite to eat other things?

Yu: There is no problem with the soup itself. Although many Chinese soups do not have high nutritional content.

But soup also has benefits, such as appetizing, or if the patient has a dry mouth due to treatment, drinking soup will make him feel comfortable.

But if the patient himself has a problem (such as the kidney), then it needs to be handled separately.

In the end, it's still that sentence - balance, moderation, don't be extreme.

Part Five - Psychological Perspective

Wong: After talking about the very practical topic of diet therapy, I want to talk about some spiritual aspects.

Yu: Both Western and Chinese medicine agree that a person's emotions can affect their health. The term used in Western medicine is "emotion" (psychological or mental state); the term used in Chinese medicine is "emotion"（情志）.

Wong: If a cancer patient's "emotion" or "emotion" has a problem, how can it be helped from the perspective of Western and Chinese medicine?

Western Medicine

Yu: If a patient has emotional problems, there is a set pattern from a Western medical, which is the Bio-psycho-social Model, which includes "physiological-psychological-social" aspects:

• Physiological - dealing with problems such as constipation, diarrhea, stomach pain, insomnia, decreased appetite, etc.;
• Psychological - dealing with problems such as depression, tension, anxiety, etc. Can be through relaxation exercises/exercise; or find a professional for psychological counseling. When necessary, you can take drugs prescribed by a psychiatrist; and
• Social - family, friends, professionals can respond to the patient's consciousness and values, provide care, comfort, encouragement and care.

In general, it is hoped to help patients regain their autonomy, defeat fear, sadness or mental distress and their huge impact.

Chinese Medicine

From the perspective of Chinese medicine, the "emotion" problem is that the patient's "heart" and "liver" are the main spirits and the poor qi and blood of the five internal organs themselves, and the patient's own seven emotions and six desires react improperly, causing physical and mental illness.

The health of the body and mind is interconnected and inseparable - if the function of the internal organs is abnormal, it will affect the spirit and emotion, and the interaction of the two will cause a vicious circle, aggravating the patient's conditions and affecting the treatment effect.

So traditional Chinese medicine believes that it is necessary to improve the body and mind, viscera, qi and blood, and spirit and will as a whole.

Wong: Dr. Yu, I'm very grateful for your acceptance of my interview today, and for sharing so much with us!

Yu: You're welcome.

(December 2021)