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Archive for the ‘Eastern and western medicine compared’ tag

Infertility and TCM: Part 9: Tong Bing Yi Zhi.

By David Kreiner MD

June 29th, 2014 at 8:34 am

 

image courtesy of stuart miles/ freedigitalphotos.net

According to Western Medicine, a particular disease is caused by a specific pathogen and the Western Medicine treatment is directed at that pathogenic factor. However, Traditional Chinese Medicine (TCM) recognizes that two people may react differently to that same pathogen.  They refer to this as Tong Bing Yi Zhi.  For example, in one individual the symptoms may appear as Damp heat syndrome and in another as Yin deficiency with false heat syndrome. In TCM, despite the common pathogen, patients would be treated differently depending on the syndrome identified. Syndrome identification is based on 4 diagnostic methods: inquiring, palpation, inspection and listening/smelling. This information is gathered and analyzed to identify the syndrome that a patient is experiencing.

 

On the other hand, two people with two different Western diagnoses such as menopause and hyperthyroidism may experience the same TCM syndrome from their respective pathologic conditions, Yin deficiency with false heat. This is also referred to as Tong Bing Yi Zhi.  In this case it refers to treating different diseases the same because they result in the same TCM syndrome.  In the first case TCM treats the same disease differently because as a result of the varying natures and constitutions of patients the symptoms resulting from the same pathologic condition often varies. To clarify, we do not need to know in TCM what diseases the patients have. We treat them according to TCM by their syndrome diagnosis.

Syndromes are differentiated based on several different factors. There are eight principles of paired opposing conditions including; Exterior and Interior, Cold and Heat, Deficiency and Excess, and Yin and Yang. These general principles are the basis for categorizing all the syndromes. The other syndromes are differentiated according one of the following  theories such as; Qi, blood and body fluids, the theory of the Zang-Fu organs, the theory of the six channels or meridians of Qi, the four levels of heat invasion, and the three burners or sections of the body.

It is through the four diagnostic methods above that the practitioner identifies the syndrome affecting the patient. He/she will choose the particular treatment specific for the syndrome modified by the age and health of the patient. This can include Tui-Na massage, acupuncture, moxibustion, cupping, and herbal medicine all directed at specific points in the body depending on the syndrome.

To me, as a Western physician trained to direct treatment for a particular pathogen or disease, I am very attracted to differentiating treatment based on its specific effect on the individual patient. We know that the same disease can have different resulting effects on people and that different diseases can affect some individuals in the same way. Therefore, the concept of directing therapy based on the effect the pathogenic factor has on the individual appears to me to be an effective way to treat a patient. If a physician were to combine the Western pathogen-directed therapy with TCM treatment based on the syndrome affecting the individual then the East-West combination therapy I believe should be most ideal.

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Does the Western pathogen-based treatment plan seem sufficient or does the idea of blending it with Eastern principles of syndrome-based treatment seem like it’d be a complementary bonus?

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TCM and Infertility Part 6: TCM Pathogens of Wind, Cold, Heat, Dampness, Dryness, Phlegm and Emotion

By David Kreiner MD

April 18th, 2014 at 10:27 pm

 

credit: stuart miles/freedigitalphotos.net


Welcome, to my new world where I often feel like Robert A. Heinlein’s “Stranger in a Strange Land”.  

UnIike Heinlein’s protagonist, I am not accustomed to eating the bodies of the dead (though some natural holistic purists may consider this act the ultimate in sustainability.)  But to the previously unexposed who’ve been brought up from a Traditional Chinese Medicine (TCM) perspective, perhaps some of the Western Medical physicians’ practices may appear a bit barbaric.

In our recent Western Medical history such practices as lobotomy for psychological disorders, certain hard core diet therapies including high risk bowel resection surgery, and nearly routine hysterectomies for perimenopausal women would be considered potentially dangerous malpractice today.  However, if we thought drastic high-risk unnecessary medicine were a thing of the past, then consider the fact that excessive plastic surgery and some other unnecessary current Western therapies are more common now and have resulted in occasional deaths and disfigurement. 

Greed is a strong motivator and is one of the ills pervading our society… and the health care field has not been immune to its seduction.  Greed too often factors into determining the direction of treatment for individuals today.  Corporate greed is the reason insurance companies fail to cover many in need of health care and force physicians to see more patients than they have time to care for.  It is also a reason some providers order and perform some expensive and potentially risky tests and procedures.  

Western Medicine has had its share of iatrogenic disasters, yet I have seen many ill or infertile patients reap the benefits as a result of modern Western Medicine.  Even so, I as well as other physicians am left without answers all too often to explain or cure some of the complaints we hear from our patients.  For this reason I study TCM to learn its explanations and its treatments for some of these common ailments and complaints that elude the expertise of the Western physician.

I have been involved in the health care field for 37 years and I am quite comfortable communicating about pathogens such as bacteria and viruses and parasites and about pathophysiologic processes such as atherosclerotic heart disease, hypertension, diabetes mellitus, pelvic inflammatory disease and endometriosis to name a few.   Today, as I study Traditional Chinese Medicine, I now read and speak an additional language.  

The pathogens of TCM are Wind, Cold, Heat, Summer Heat, Dryness and Dampness, Phlegm and an individual’s emotions.  They may attack from outside the body such as wind cold (the equivalent to the common viral cold) or internally as a result of a disharmony among one or more of the organ systems.  Emotions such as Grief and sadness, anger, fear, worry and even joy according to TCM can be pathogenic when carried to an excess and lead to a disharmony of an organ system or to a blockage of the flow of Qi which can result in dampness and other pathologic events or pathogens. 

These pathogens are the “root” cause of the individual’s disharmony resulting in the manifestations or symptoms.  For example, complaints such as fever, cough, sore throat, vomiting, diarrhea, constipation, bloating, etc. ., are the result of these pathogens.  Interestingly, ancient Chinese texts refer to insects or bugs as being carried by the wind as a cause of some syndromes such as the Wind Cold referred to earlier.

There are also multiple ways to categorize and classify pathologic syndromes. They may be classified as cold or hot, internal or external, excessive or deficient or yin or yang conditions.  They may be identified as affecting one of the organ systems which are defined more based on their physiologic role from a traditional Chinese perspective rather than by their Western anatomic and physiologic identity that we learn in medical school.  There are four different layers of pathogenic attack from the most superficial to the deepest and most internal. There are even other theories of disease which may be used to classify pathology usually described as a disharmony affecting one or more organ systems.

The treatment prescription is based on the identified syndrome(s) and may be geared towards eliminating the root cause of the disease as well as the clinical manifestations and associated symptoms.  One may use acupuncture to tonify a particular weakened organ or Qi, yin or yang.  Acupuncture can eliminate heat or cold from one or more of the channels of Qi.  Or there may be excess body fluids in the form of edema, dampness or phlegm that needs to be eliminated.  Chinese herbal prescriptions are often given as an adjunct to the acupuncture to improve the efficacy of an individual’s treatment.

It does sound bizarre to this Western-trained physician, but I am impressed that the science of TCM has lasted thousands of years.  I imagine there must be something to this needling patients to modify the Qi in the body that has some benefit to the patients’ health and well-being.

I look forward to new adventures and greater understanding as I become more familiar navigating this strange land.

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Do you believe that TCM pathogens could be impacting your fertility?

 

 

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