Before Your Treatment

Some clinics incorporate computer programs, muscle testing, energy scans, or Western lab testing to establish a diagnosis.  At our clinic, however, we make our diagnoses using the traditional diagnostic methods.  In order to accurately read the tongue, do not forget that is essential that you do not brush or scrape the surface for at least 48 hours.  Regarding the pulse, stress and physical exertion may alter the pulse image, so please allow adequate travel time to our office so that you arrive in a calm and relaxed state.  For an acupuncture session, appropriate dress is loose fitting clothing but please do not wear short skirts.  Finally, we discourage receiving acupuncture when you are fasting or immediately after a large meal, and sexual activity prior to or following acupuncture is not recommended.  Taking these simple steps prior to treatment will assist us in making each session the best it can be.

We Will Provide You with a Treatment Plan

In all medical systems, the resolution of more complex or chronic issues demands more intensive treatment.  In Western medicine, many conditions require long and aggressive courses of treatment, including surgery with lengthy recovery time, treatment with medications often lasting for years, or months of physical therapy.  Although Chinese medicine does not usually require long or open-ended treatment, it is difficult to solve chronic problems with only one or two short treatment sessions.   Committing to a series of treatments from the beginning allows your practitioner to design a realistic plan aimed at achieving your health care goals.

The Extra Effort is Worth It

Pharmaceutical sales, hospital care, imaging and laboratory testing, and other forms of medical care constitute enormous slice of the American economy.  The profit-driven companies involved in health care aim to attract and satisfy their consumers with simple, convenient treatments.  Chinese treatments, however, do not have a history of trying to appeal to a large consumer market and are only designed to improve health and promote well-being.  As a result, Chinese treatment often demands a bit more involvement from the patient.  Your White Pine Clinic practitioner may ask you if you would be willing to make herbal teas at home, perform simple exercises, or consider some minor lifestyle shifts.  Although you may have to work a bit harder as a member of a cooperative team, the reward of a lasting solution for your medical issues without the dangers of pharmaceutical drugs or surgery is certainly worth the extra effort.

Diseases and Patterns

Almost all forms of medicine treat diseases.  Headache is a good example of a disease identified and treated in many medical systems.  Although the understanding of the cause of the headache differs from one medical model to another, the majority of remedies set relief of the head pain as the basic goal of treatment.

TCM style Chinese medicine, however, does not focus on the headache itself.  Instead, it sees the headache as the main manifestation of a complex of disharmony and aims not for the symptomatic branches but instead targets the root of the disharmony.  The symptomatic manifestations, including the headache, are treated at the same time as the root but are given less attention in the treatment strategy.  The Chinese term for this approach is bian zheng lun zhi or ‘treatment according to pattern differentiation’.

In order to clarify the concept of treatment according to pattern differentiation, let use compare the biomedical and Chinese approaches to a headache case.  Both Western and Chinese doctors begin by collecting data regarding the condition.  The M.D. will ask questions and employ testing and imaging when appropriate to form a differential diagnosis.  Signs and symptoms such as nausea, one-sided loss of vision, disorientation, lethargy, and occipital headache might point to a brain tumor, demanding further investigation such as an MRI, while a history of visual distortion that gives rise to a  severe, one-sided headache lasting for several days suggests migraine headache.  Once all of the other possibilities have been systematically eliminated, a differential disease diagnosis will allow the physician to select an appropriate treatment for the condition.  Correct disease diagnosis is the sine qua non of skillful biomedical practice.

The Difference Between Eastern and Western Diseases

Once an allopathic doctor has ruled out the diagnoses of cancer and other critical ailments, the Chinese doctor can offer a different point-of-view.  Instead of using modern technology to assess the case, the TCM practitioner relies on the traditional methods of tongue inspection, inquiry, and pulse palpation to identify the pattern.  He or she will utilize the Chinese disease of tou tong or headache as a guiding factor but is most interested in the underlying imbalances in the body.  The background is determined according to a broad constellation of signs and symptoms.  For example, a headache that is associated with a traumatic injury and manifests with fixed, stabbing pain, pain worse with pressure, a purple tongue body, and a rough pulse indicates a blood stasis pattern.  On the other hand, a headache with a feeling of tight pressure and distention, nausea and vomiting, profuse phlegm, a slimy tongue fur, and a slippery pulse suggests a phlegm-damp pattern.  For each case, after the primary pattern is identified, additional relevant patterns are isolated and prioritized.  Through this procedure,  a complex picture of an individual case is created.  This is a more patient-centered approach than the methodology used by the M.D.

The biomedical disease diagnosis is crucial for determining prognosis.  Obviously, expected outcomes for the brain tumor patient can be markedly different from the patient with migraine headaches.  The traditional Chinese disease of tou tong headache does nothing to shed light on this difference.  On the other hand, once the headache has been identified as a migraine headache, functional headache, or tension headache by your M.D., the Western medical treatment is determined according to the disease, with little attention paid to distinctions from patient to patient, and options for treatments are limited.  The biomedical treatment for all three of these types of headache, for example, will likely include nonsteroidal anti-inflammatory drugs.  In the case of migraines, research suggests that this approach may actually cause more frequent and more severe pain.  Additionally, NSAID’s are understood only as temporary, analgesic relief, and long-term use of some of the drugs may damage organ function.

Using Chinese Patterns in the Clinic

On the other hand, once the Chinese doctor has identified phlegm-damp as the primary pattern associated with the issue of headache and has determined, for example, that there is a spleen-kidney vacuity and liver depression qi stagnation,  a specific treatment can be designed to restore normal function.  The treatment, whether acupuncture or herbal, will target the main complaint, the primary pattern, and any other important patterns of disharmony.  This forms a very individualized response with a low risk of adverse effects.  As it is the ‘one-size-fits-all’ model in biomedicine that accounts for a wide variety of responses to medication, using the Chinese medical approach one can generally expect few side effects.  In addition, Chinese treatments are only used until the condition resolves satisfactorily, so patients do not have to be concerned with developing habituation to or dependency on Chinese medications.

Obviously, the public benefits from having access to both professional biomedical and Chinese health care.  Your M.D. will always be your primary health care provider and is the best place to start.  Many conditions, however, are not well-treated with Western medicine alone, and biomedical treatments are often costly and involve risk.  The less expensive, noninvasive, patient-specific Chinese approach may be the best option for your case.  We look forward to helping you make good decisions regarding your choice of treatments so that you can realize your human right to optimal health and well-being.

*The use of pattern differentiation in Chinese medicine has a very long history, dating back as far as the renowned Han dynasty physician Zhang Zhong-Jing (150 CE-219 CE).  According to the translators of this doctor’s famous work, On Cold Damage or the Shang Han Lun, ‘The Shang Han Lun is regarded as the basis of the approach to diagnosis and treatment that in the Qing dynasty came to be called ‘determining treatment on the basis of patterns identified’ which is now considered to be the quintessence of Chinese medical genius‘.

In longer courses of drug treatment, however, failure to address the unique situation of each patient often leads to a range of adverse effects and less than optimal efficacy.  Experts are attempting to solve these problems using more and more sophisticated testing, including genetic profiling, and many medications are increasingly available in a variety of dosage options.  It is also becoming common to combine multiple drugs in a single tablet, creating a compound that better addresses the complexity of real-life patients.  All of these steps are helping to better meet the needs of a spectrum of patients within mainstream health care.  Ironically, although the majority of the biomedical community may be unaware of this, these changes bring the allopathic model closer and closer to the traditional Chinese medical model.

A Tradition of Creating a Unique Solution for Every Patient

Unlike mainstream health care, individualized treatment is nothing new in Chinese medicine.  The 1,800-year-old system of using patterns of disharmony insures that each patient is treated differently from every other.  The focus on treating patients begins with the diagnostic methods of inspecting the tongue, taking the pulse, and inquiring about other symptoms.  This information allows the Chinese doctor to paint a unique picture for each patient that includes all of the relevant patterns of disharmony which are then organized according to priority.  Using this model, the Chinese practitioner determines a strategy for resolution using the conventional methods of treatment.

The methods of treatment lead directly to the selection of an herbal formula.  Formulas are usually selected from an established list in an authoritative formulary.  In many cases, these formulations boast an impressive history of 400 to 500 years of empirical use.  Some Chinese remedies are much older, dating back as much as 1,800 years, while a minority are only a few centuries or even decades old.  The formula will be chosen based on the patterns identified and the main complaint, with other factors such as gender, age, and constitution playing a minor role.

Selection of a formula is, however, not the only task of the Chinese doctor.  There is a final, crucial step in the process of prescribing Chinese herbs.  According to a recent blog entry by the renowned American lao yi sheng or ‘master doctor’, Bob Flaws

Frequently, Chinese medical beginners will ask me whether this or that simple formula is appropriate for their patient. In almost 100% of these cases, the patient described is presenting a combination of patterns, not a single pattern, and, therefore, he or she requires a combination of formulas, not a single formula which addresses only a single pattern. In sum, modification of formulas is at the very heart of the professional practice of Chinese medicine.

In the United States, where acupuncture is utilized more often than Chinese herbal medicine, many practitioners have not had extensive training using Chinese herbal formulas.  Under the laws of many states, having a Licensed Acupuncturist title will allow practitioners to prescribe herbal medications.  Those without extensive training or knowledge will not write prescriptions for a custom herb formulation but will instead recommend tablets or other ready made forms such as tinctures.  In the PRC and Taiwan, it is understood that a master doctor always writes a prescription for a unique formula.  No Chinese doctor would ever establish a good reputation through prescriptions for tablets or pills alone.

Accordingly, the final step in prescribing a Chinese herbal formula is the additions and subtractions.  Your White Pine practitioner will adjust the traditional, time-proven  formulation for your individual case, deleting anything that is unnecessary and adding in those herbs with uniquely beneficial actions to quickly and safely treat your condition.  Since it is estimated that only about 10%-20% of practitioners in the United States are experts at using Chinese formulas and single herbs, a treatment at White Pine Clinic offers the rare opportunity to enjoy the standard-of-care from mainland China right here at home.

To a great extent, this vignette captures the essence of Chinese medicine as experienced by Chinese mainlanders. There is, admittedly, a great deal more to a Chinese hospital of traditional medicine–ranging from MRI’s to acupuncture for post-stroke sequelae–but the earnest work of the outpatient herbal medicine department is the heart and soul of every TCM (Traditional Chinese Medicine) institution. Although the world-renowned art of acupuncture is a vital branch of traditional medical practice in TCM hospitals and clinics, herbal formulas are the unequivocal mainstay of TCM practice in mainland China.  The practice of internal medicine in Traditional Chinese Medicine is, by definition, the work of writing herbal prescriptions.