Chinese Herbal Medicine

In this article
- What is chinese herbal medicine?
- History of chinese medicine
- What ailments can chinese herbal medicine treat
- What are the philosophies of chinese herbal medicine
- Chinese herbal medicine and its treatments (ie. acupuncture, herbs etc.)


What is Chinese herbal medicine?

Many people are a bit confused about just what is Chinese herbal medicine. Increasingly we are seeing it in our communities. Let’s find out some more about it. Chinese herbal medicine is part of a larger healing method called Traditional Chinese Medicine (TCM).TCM includes acupuncture, massage, dietary advice, supplementation and exercise. The underlying principles of TCM differ greatly from traditional Western concepts of health and Illness. TCM takes a wholistic approach to understanding normal function and disease processes and focuses as much on the prevention of illness as it does on the treatment

TCM has roots in an understanding of meridians that run through the body of humans. These meridians are invisible and transmit energy known as Qi (pronounced “chee”). This energy can become unbalanced for many reasons, including poor environment, stress, emotional pressures and overwork. Balancing and normalizing can be achieved by the administration of Chinese herbs by a practitioner of TCM. Restoration of the energies facilitates harmony, balance and order to the person.

History of Chinese Medicine

Traditional Chinese Medicine has an uninterrupted history of development in China and other parts of East Asia dating back thousands of years. This makes it one of the longest serving bodies of knowledge about human well being with many years of research.

For thousands of years there was the development of Classical Chinese Medicine that dominated the Chinese health treatment landscape. In many ways Classical Chinese Medicine (CCM) is notably different from Traditional Chinese Medicine (TCM). However the Chinese Nationalist government elected to abandon and outlaw the practice of CCM as it did not want China to be left behind by scientific progress. For 30 years, CCM was forbidden in China with people being prosecuted by the government for engaging in CCM. In the 1960's, Mao Zedong finally decided that the government could not continue to outlaw the use of CCM. He commissioned the top 10 medical doctors to examine CCM and create a standardized format for its application. This standardized form is now known as TCM.

The English phrase "TCM" was created by the PRC in order to export Chinese medicine.

In Victoria, Australia, the Chinese Medicine Registration Act came into being in 2000. The Act regulates the practice of Chinese medicine through the invested powers of the Chinese Medicine Registration Board. The major objectives of the Board are to protect the public from unprofessional conduct and to help maintain the standards of education of the people who want to call themselves Chinese Medicine practitioners. It also presides over any situations that members of the public find grievance with.

What ailments can be treated by TCM?

Chinese herbs are commonly used to treat disorders such as:

What are the philosophies of TCM?

Yin and Yang

The ancient Chinese proposed that every life is achieved by a balance of opposing energy forces called Yin and Yang. The resulting energy is the Qi traveling through the meridians. Different organs and meridians are controlled by different organs so that an imbalance in Yin or Yang will impede the flow of Qi and so raise the possibility of disease.

The five elements

The TCM philosophy proposes that everything including organs of the body - is composed of the
five elements: fire, earth, metal, water and wood. The herbs are similarly classified into the five
tastes - sweet, salty, bitter, pungent and sour - which correspond to the five elements, for
example, since the skin is classified as a metal element Yang organ, it would be treated with a pungent herb.

Herbs

Chinese herbal medicines are predominantly plant based with some preparations being based on mineral or
animal product. They can be incorporated into powders, pastes, lotions or tablets to suit the task required.
Different herbs have different properties and so are used to balance different
parts of the body. Thus the prescription of a particular regime of herbal remedies must take into account the state of the patient’s Yin and Yang, and the elements that are governing the organs in question.

What is the approach to disease?

Traditional Chinese medicine has a "macro" or holistic view of disease. A well-balanced human body can resist most everyday bacteria and viruses. Infection, while having a proximal cause of a microorganism, would have an underlying cause of an imbalance of some kind. If this were not the case the infection would not gain a foothold in your body. TCM treatment would target the imbalance, not the infectious organism. There is a popular saying in China as follows: Chinese medicine treats humans while western medicine treats diseases.

In a traditional TCM diagnostic system a practitioner might give very different herbal prescriptions to patients affected by the same type of infection. A different person will have different imbalances and different symptoms.

Modern Western medicine treats infections by targeting the microorganisms directly, whether preventively (through sterilization of instruments, hand washing, and covering bandages), with antibiotics, or making use of the immune system through vaccines. While conventional medicine recognizes the importance of nutrition, exercise and reducing stress in maintaining a healthy immune system (and thus preventing infection), it also faces problems with antibiotic resistance caused by overuse of chemical agents and the high mutation rate of microorganisms. The modern disaster of Methicillin-Resistant-Staphylococcus-Aureus (MRSA) and other so-named “superbugs” is powerful evidence.

Pharmaceutical treatments also sometimes have side effects, the most severe of which are seen in regimens used to treat otherwise fatal illnesses, such as chemotherapy and radiotherapy for cancer, and antiretroviral drugs for HIV/AIDS.

The holistic approach of traditional Chinese medicine thus makes all practitioners generalists. Western medicine has general practitioners who dispense primary care, but increasing reliance is placed on specialists who have expertise in treating only certain types of diseases. Primary care physicians often refer patients to specialists. Disease is then treated more as an isolated and singular entity by people who have a diagnosis as the primary objective.

TCM and diagnostic techniques

Consistent with the macro philosophy of disease, traditional Chinese diagnostics are based on overall observation of human symptoms rather than "micro" level laboratory tests. There are four types of TCM diagnostic methods:
In contrast to a conventional laboratory test which gives a quantitative result TCM requires considerable art to appreciate the subtleties that make a good practitioner.

Treatment

Modern TCM treatments consist of herbal medicine or acupuncture as the primary method, with other methods such as massage, qi gong, or food therapy playing a secondary role. Illness in TCM is seen as a lack of harmony, and the goal of all traditional treatment is to assist the body to regain balance and achieve homeostasis. The modern practice of traditional Chinese medicine is increasingly incorporating techniques and theories of Western medicine.

Cautions

Herbs are being used as a medicine and like any drug have the capacity for making changes in a persons system. In some cases doses could lead to toxicity or allergic/hypersensitivity reactions. Take only as prescribed and avoid self diagnosis and administration. Be in close communication with your practitioner and other health advisers.

Acupuncture

Acupuncture can be considered as a part of how TCM can treat a person. Acupuncture is an effective, natural and increasingly popular form of health care that is being used by people from a wide range of backgrounds.

Acupuncture treatment involves the insertion of fine, sterile needles into specific sites (acupuncture points) along the body's meridians to clear energy blockages and encourage the normal flow of qi through the individual.

The practitioner may also stimulate the acupuncture points using other methods, including

As a natural form of healing, acupuncture has the following benefits:
 Acupuncture is known to treat a wide range of disorders including:

Neurological conditions such as headaches and migraines.

Cardiovascular disorders such as high or low blood pressure, fluid retention, chest pain and poor circulation.

Respiratory conditions such as bronchial asthma, , acute tonsillitis, sinusitis, hay fever, chronic cough, laryngitis, influenza and the common cold.

Digestive system disorders such as toothache, post-extraction pain, gingivitis, mouth ulcers, hiccough, gastric and duodenal ulcers, gastritis, flatulence, colitis, diarrhoea, constipation, haemorrhoids, liver and gall bladder disorders, and weight control.

Urogenital disorders such as cystitis, prostatitis, orchitis, low sexual vitality, urinary retention, kidney disorders, nocturnal enuresis, and neurogenic bladder dysfunction.

Gynaecological and obstetric disorders such as premenstrual tension, painful, heavy or irregular, or the absence of periods, abnormal uterine bleeding or discharge, hormonal disturbances, disorders associated with menopause, prolapse of the uterus or bladder, difficulty with conception, and morning sickness.

Skin conditions such as eczema, dermatitis, psoriasis, nerve rash, herpes zoster, acne, scar tissue and resultant adhesions, hair loss and dandruff.

Eye conditions such as visual disorders, red, sore, itchy or watery eyes, conjunctivitis, simple cataracts, myopia in children, and central retinitis.

Musculoskeletal disorders such as osteoarthritis, sciatica, low back pain, rheumatoid arthritis, gout, tenosynovitis, shoulder and neck pain, "frozen shoulder", and "tennis elbow".

Sporting injuries such as sprained ankles and knees, cartilage problems, corking and tearing of muscles, torn ligaments and bruises.

Psychological conditions such as depression, phobias, emotional disturbances, anxiety, nervousness and addictions such as smoking.

Please contact AACMA if you would like further information on acupuncture, or if you would like the contact details of qualified acupuncture practitioners in your local area.

Some orthodox views on the efficacy of TCM

Much of the scientific research about TCM has examined the role of acupuncture. Scientific concensus these days uses evidence-based medicine as its gold standard. Two players who have positioned themselves into leading roles are the Cochrane Collaboration and Bandolier . Using evidence-based protocols acupuncture has largely shown a lack of effectiveness or lack of well-conducted clinical trials. Some efficacy has been found for headacjes and nausea. However, many disagree on what is acceptable evidence and on how to interpret it. They do agree that it is safe and that further study is warranted.

The 1997 NIH Consensus Statement on Acupuncture summarized research and made a prediction as follows:

...promising results have emerged, for example, efficacy of acupuncture in adult post-operative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma for which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

Evidence-based examination of Chinese herbal medicines has not been performed to a significant level at this stage.

A number of herbs used by TCM practitioners have known active ingredients used in Western pharmaceuticals. For example, ma huang, or ephedra, contains ephedrine and pseudoephedrine. Chinese wormwood (qinghao) was the source for the discovery of artemisinin, which is now used worldwide to treat multi-drug resistant strains of falciparum malaria. It is also under investigation as an anti-cancer agent.

Safety

Acupressure and acupuncture are largely accepted to be safe from results gained through medical studies. Several cases of pneumothorax, nerve damage and infection have been reported as resulting from acupuncture treatments. These adverse events are extremely rare especially when compared to other medical interventions, and were found to be due to practitioner negligence. Dizziness and bruising will sometimes result from acupuncture treatment.

Some governments have decided that Chinese acupuncture and herbal treatments should only be administered by persons who have been educated to apply them safely. "A key finding is that the risk of adverse events is linked to the length of education of the practitioner, with practitioners graduating from extended Traditional Chinese Medicine education programs experiencing about half the adverse event rate of those practitioners who have graduated from short training programs." [13]

Certain Chinese herbal medicines involve a risk of allergic reaction and in rare cases involve a risk of poisoning. These highlight the need to visit practitioners registered by your local or state authorities.

CHINESE MEDICINE BILL in Victoria (2000)


Victorian Parliament Second Reading Speech
Chinese Medicine Registration Bill 2000
The following is the Second Reading of the Chinese Medicine Registration Bill, 6th April 2000
(see Victorian Hansard on the Parliament of Victoria website at: www.parliament.vic.gov.au/hans.html )

CHINESE MEDICINE REGISTRATION BILL

Second reading

Mr THWAITES (Minister for Health) -- I move:
That this bill be now read a second time.
The Chinese Medicine Registration Bill establishes a comprehensive system of
regulation of the practice of Chinese medicine and the dispensing of Chinese herbs.
The purposes of the Chinese Medicine Registration Bill are to minimise the
community's exposure to the health risks associated with the practice of this form of
complementary medicine and to promote consumer choice in access to health care
options.
The review of the practice of Chinese medicine was commenced in 1995, resulting
in the publication of the report Towards a Safer Choice -- the Practice of Traditional
Chinese Medicine in Australia. Since then, a ministerial advisory committee has
advised on required changes to legislation. The final report of the committee was
published in July 1998 and recommended that Chinese medicine should be
regulated in the same way as other registered health care professions.
The prime concern of the government is to ensure that the practice of Chinese
medicine is safe to the public. This requires that:
the training of primary care practitioners be of a high standard;
there be mechanisms for establishing and enforcing clinical standards of practice;
the public and other health care practitioners are easily able to identify those who
are well qualified; and
consumers have access to effective mechanisms for dealing with any complaints
that may arise in relation to their Chinese medicine treatment.
The commonwealth and state health ministers agreed that Victoria should take the
lead in establishing a model of regulation.
An extensive consultation process since 1995 has demonstrated considerable
support for this initiative, and a recognition that the time has come to regulate in the
public interest this growing area of complementary medicines. This legislation will
provide a model for other jurisdictions around the world to follow; Victoria should
be proud that this act establishes world best practice.
The practice of Chinese medicine includes a range of modalities, including Chinese
herbal medicine, acupuncture and Chinese herbal dispensing. There is no intention
to regulate every aspect of the practice, such as Chinese therapeutic massage, food
therapy or exercise therapy, but simply to ensure that those aspects of the practice
which present significant risks to the public are regulated and that those who
provide such services are properly qualified.
The provisions of this bill establish a Chinese Medicine Registration Board with the
power to register suitably qualified practitioners in one or more of the three
divisions of registration:
• Chinese herbal medicine;
• acupuncture;
• Chinese herbal dispensing.

The bill also includes amendments to the Drugs, Poisons and Controlled Substances
Act to establish a new schedule of Chinese herbs.
The provisions will allow access by qualified endorsed Chinese medicine
practitioners and Chinese herbal dispensers to herbs that have therapeutic properties
but are considered potentially toxic and dangerous unless prepared, prescribed and
supplied correctly. Medical practitioners and pharmacists will also be able to have
access to these herbs if their own registration board is satisfied that they have
satisfactorily completed a course of study or training which qualifies them to do so.
There are professional level courses in Chinese medicine provided by several
Victorian universities and by accredited private providers. In preparing this
legislative proposal to enable the establishment of minimum qualifications and
practice standards, the Department of Human Services has worked closely with the
department of education, which has responsibility for accrediting higher education
courses offered by private providers. The Chinese Medicine Registration Board will
have a role in approving such courses for the purposes of registration of their
graduates.
There are other traditions of acupuncture which have derived from the Chinese
tradition, such as Japanese acupuncture. It is intended that the board will have
responsibility for registering practitioners from any of these traditions who are not
registered under another health practitioner registration act. In such instances, the
prime concern of the board should be to ensure that these practitioners are safe and
competent to practise within their own tradition of acupuncture, without requiring
an understanding of the full body of Chinese medicine knowledge.
It is not, however, intended that the board will regulate the practice of veterinary
acupuncturists. This role should continue to reside with the Veterinary Practitioners
Registration Board.
Registered veterinary practitioners should not be considered to be in breach of the
Chinese Medicine Registration Act for using the title veterinary acupuncturist on
condition that they treat only animals and operate within the requirements of the
Veterinary Practice Act 1997.
There are also unregistered practitioners who practise other types of herbal
medicine. These provisions are not intended to prevent, for example, Western
herbalists from practising within their tradition and using the term 'herbalism' or
'herbalist' to describe their practice. They should not be required to register with the
new board unless they wish to adopt the protected titles or hold themselves out as
being qualified to practise Chinese medicine.
There are many registered health practitioners such as medical practitioners, nurses,
chiropractors and physiotherapists who are adopting Chinese medicine modalities,
particularly acupuncture.
The bill provides for amendments to the relevant registration acts to exempt these
practitioners from the requirement to register with the Chinese Medicine
Registration Board in order to use protected titles, if they have satisfactorily
completed a course of study or training which, in the opinion of their own board,
qualifies them to practise Chinese medicine.
The legislation is also not intended to regulate unregistered practitioners of other
forms of complementary medicine, except where they make claims to be qualified
to practise Chinese medicine, or where they wish to prescribe and dispense Chinese
herbs which have been included in schedule 1 of the poisons list under the Drugs,
Poisons and Controlled Substances Act.
The new Chinese Medicine Registration Board is to have nine members -- six
Chinese medicine practitioners, a lawyer and two persons who are not Chinese
medicine practitioners.
The board will be an incorporated body and independent of government. It will be
responsible for assessing and approving appropriate qualifications which lead to
registration. The board will be responsible for the registration of Chinese medicine
practitioners and Chinese herbal dispensers, and for investigations into the
professional conduct of practitioners who have been registered by it.
The bill includes a comprehensive outline of what constitutes unprofessional
conduct and contains wide-ranging disciplinary powers for the protection of the
public. It enshrines the board's ability to promulgate codes of practice to enhance
the best quality provision of Chinese medicine.
There are herbal dispensers who may choose not to register with the board if they
do not wish to use the protected title 'Chinese herbal dispenser' or dispense Chinese
herbs that have been included in schedule 1 of the poisons list in the Drugs, Poisons
and Controlled Substances Act.
Such practitioners are free to carry on their business without seeking registration.
The amendments to the Drugs, Poisons and Controlled Substances Act are intended
to provide controls at the point where Chinese herbal medicines containing
scheduled herbs are supplied to patients or supplied by one registered practitioner to
another registered practitioner. It does not regulate the activities of importers and
wholesalers of scheduled Chinese herbs. The board will have the power to issue
codes of practice in relation to the preparation, storage, labelling, prescribing and
issuing to patients of Chinese herbal substances, including scheduled herbs.
The bill makes it an offence for anyone who is not a registered Chinese medicine
practitioner or Chinese herbal dispenser to use titles which suggest that they are
registered in any of the divisions of the register when they are not.
Such title protection is the established method by which the government can protect
the public from unregistered people practising Chinese medicine.
A further measure to enhance public safety is the board's ability to issue and publish
codes of practice. These codes may outline what is acceptable Chinese herbal
medicine, acupuncture and Chinese herbal dispensing practice. Codes of practice
are intended to provide guidance to practitioners about the standards recommended
by the board relating to the practice of Chinese medicine. They will be developed in
consultation with registered practitioners and may be considered by the board in
investigating possible misconduct.
Where an unregistered person breaches the scheduling requirements of the Drugs,
Poisons and Controlled Substances Act, investigation and, if necessary, prosecution
of such breaches will rest with the Drugs