Integration and Independence of TCM within today's medical environment

Chinese Medicine and Acupuncture are often associated with being an ‘ancient medicine’, perhaps just a step above voodooism, placebo effect, pseudoscience or straight-up snakeoil quackery among the skeptics. It is indeed ancient, having 5000 years of continuous development history puts it as one of the oldest forms of medicine in the world today. It is therefore difficult to imagine how something like this can survive in the modern era and more importantly how it would establish a niche for itself in the today's medical environment wherein technology reigns supreme.

The truth is, this medical system was originally used in ancient China to treat real conditions that afflicted people. This is surprisingly something that many people do not know or admit for some odd reason, because the ancient literature describes in very fine detail what it was used for in the distant past. These conditions are essentially the same things people suffer from today. Today in China, Chinese Medicine and its various modalities are used in formal hospitals to treat modern verifiable diseases either as stand-alone therapy or in conjunction with modern medicine—and this is for both chronic and acute conditions. Based on current clinical insights from modern Chinese medical literature since the 1900s, many Chinese Medicine ‘diseases’ (that is conditions with names specific to how Chinese Medicine calls them) have been mapped across as ‘XYZ disease’ or ‘ABC syndrome’ equivalents; examples include ‘xiao ke’ for diabetes and ‘xiong bi’ for coronary heart disease. Today TCM has essentially merged with modern medicine as part of its natural growth progression in the new century.

Likewise, modern lab reports and imaging results are not foreign to TCM practitioners such as myself who have to read these on a daily basis. For example, thyroid disorders often show abnormalities in TSH and T3/T4 while colitis shows problems with calprotectin. Blood pressure is measured by systolic and diastolic pressures while diabetes is monitored by changes in blood glucose and A1C just to name a few. About 50 percent of my patients come in with actual medical diagnoses in addition to the symptoms they are experiencing alongside the lab and imaging reports they bring along. Part of my job is to obviously use Acupuncture and Chinese Medicine to improve their symptoms but also integrate the tests they provide in order to add further insight to my TCM diagnosis. This is pretty standard practice in China and Taiwan these days already. For example, back pain, shoulder pain and neck pain imaging results complement very well with our hands on approach when we are feeling these areas for tenderness. In fact, this is what is actually done in Chinese hospital's orthopedic and Tui-na departments. (That being said it is not necessarily the case such reports have to be provided but they do add another layer of useful information).

That being said, unfortunately, at least in the West, TCM and Acupuncture often have a reputation for being mainly for ‘relaxation’, ‘pain management’ or other similar, undefinitive associations. These are not false of course; but they are putting TCM in a box really, a box too small for its actual size. These associations have become rather fixed in the psyche of mainstream thinking; kind of like saying Daniel Radcliffe is only suitable for portraying Harry Potter (and frankly speaking a lot of people probably really think this way, and would have difficulty in knowing what other roles he has portrayed beyond Hogwarts). In this sense, it means the word ‘medicine’ should not even be used as a label then for TCM (Traditional Chinese Medicine). And yet it remains—so is this a misnomer or actually fully entitled?

The breadth of medical exams and lab tests is obviously beyond the scope of the discussion here, but any medical condition can be imagined as a forest. There are many angles to look at the forest, and depending on what angle and distance you take, you will develop a very different impression of what the forest is. At that point however, that is only an ‘opinion’ of what you think the forest is. It is not necessarily what the forest actually is. That is not our aim here. TCM’s aim is to combine all clinical information, East or West, so we know everything about the forest; near far, left-right, top-bottom; that is the spirit of Chinese Medicine when looking at all conditions of the body. Whereas Chinese Medicine typically takes a systems macroscopic view of problems, Western Medicine takes often a close up view. Both are obviously important, and that is why lab tests provide a view of the trees inside the forest which you would not know if you were looking from the outside. But Chinese Medicine has its way of understanding the other areas of the forest, something you wouldn’t know if you only inspected that one tree. In fact, Chinese Medicine offers an explanation of the relationship of other parts of the forest to that only one tree so you know why that tree is what it is: why it is of such height, why it’s straight or crooked, how much foliage it has and why certain bugs crawl around it, etc. This is the idea of yin-yang in clinical practice; opposites are not really opposites because they are part of the whole Taichi circle—’the big picture’.

For example, a patient may come in with digestive issues. In TCM there is a general understanding that digestive issues are frequently not really digestive issues in themselves. They are typically 'liver' issues. These are, in the point of view of modern medicine, actual issues with the liver organ, or autonomic problems---aka 'stress' problems. The former, you can typically find problems with liver enzymes if problems are severe enough, otherwise ultrasound may review fatty liver sometimes. The latter is usually harder to verify because it is mental in nature. Unfortunately for modern medicine they will typically refer to GI specialists who do not typically think about liver issues. This is irregardless of whether or not endoscopy will find anything (h.pylori, gastritis, etc)---because the problem could be beyond just the stomach. In reality, digestive issues as understood as 'liver' issues is really icing on the cake in terms of how complex it could get, but this illustrates the multi-system approach that TCM takes to assess problems, meaning that if TCM is equipped with the modern diagnostic tools (which in China they do but sadly not here), the range of lab and imaging requests would be very different.

Thus, Chinese Medicine offers an additional lens to interpret symptoms in light of lab and imaging reports— why they are what they are in addition to what doctors may or may not have told you. However, it is important to understand that TCM is independent. It does not necessarily have to rely on modern diagnostics to do treatment. Why? Because TCM stresses the importance of 'qi', vital energy, which is the initial manifestation of disease, and which is almost 100% non detectable by modern diagnostics---it is purely symptomatic. Symptomatic without verifiable lab and imaging proof is often regarded as 'its all in your head', but in TCM this is the initial disease state already. Therefore, as I see it, lab and imaging reports simply provide a more nuanced form for what Chinese Medicine may have already found.

So do not hesitate to bring in your lab reports because reading them and integrating them into my TCM practice, while an evolving style to be honest, is now part of daily practice and one which more and more new patients are doing these days actually. Realistically, this cannot be avoided in light of the complexities of modern conditions people suffer. It is not totally necessary of course to bring these things during the visit but they are not against TCM practice (at least for me) if patients ever had that thought.

FAQ

1. What lab reports do you typically come across?
---As of current, typical reports I come across are full blood panels that assess parameters for red and white blood cells. This also contains information about various other organ systems, typically liver, kidneys and thyroid. For more specific issues there may be other tests that assess more specific biomarkers for things such as the prostate and colon. For women's issues they would include hormone panels although frankly speaking I find this less useful than basal body temperature and ovulation test kits which assess LH and other hormone levels.

2. What imaging reports do you come across?
---Typically imaging reports are for orthopedic issues, usually for spine problems from the neck all the way to the lower back. At times there are also reports for joint problems as well such as rotator cuff problems.

3. Do I have to bring lab reports and imaging results?
---This is not necessary although would be helpful. At this point in time I honestly cannot say how much of a help such things actually contribute to my TCM work barring certain very odd issues or very severe issues but they certainly would add further insight. So it is ultimately up to you whether you want to bring them or not. They add another layer of information to TCM but is not entirely necessary, but would otherwise be helpful if available.