I Need a Doctor!

A subscriber wrote:  “So you need medical attention.  Where would you rather be?  In China or the U.S.?”

Within 12 hours of my family’s arrival in China we were sitting in a medial clinic in Beijing, my youngest daughter, then 4 years old, sobbing uncontrollably from the pain in her ears.  Turns out she had just endured a 14 hour plane ride with a double ear infection.

Within 3 months of my own arrival I was in immediate need of a hernia operation and simply did not have the time, being new on the job, to return to the U.S. for it.  So under the knife of Dr. Chen I went.

I’ve also had teeth extracted, a colonoscopy, and the usual battery of human illness and my daughters have had concussions, athletic injuries, and the normal array of fevers, skin irritations, and general maladies of youth.

So, yes, I feel qualified to blog on the topic, although it is a broad and comprehensive topic and will require more than one blog as I fear I already push the limit of my readers’ patience.

The back wall of a traditional Chinese pharmacy.  These drawers contain an abundance of common and exotic products of nature that are used in Traditional Chinese Medicine.
The back wall of a traditional Chinese pharmacy. These drawers contain an abundance of common and exotic products of nature that are used in Traditional Chinese Medicine.

Broadly speaking there are three medical systems in China.  The first is Traditional Chinese Medicine, or TCM, which has been around for thousands of years and which is the form of medical care that first comes to mind for many Westerners when thinking about China.  It remains widely practiced and utilized but it is by no means the only form of medical care available in China.

The other two are simply two variations on the theme of Western medicine (although the term ‘Western’ is admittedly a bit presumptive on my part) practiced around the world.  The difference between these two ‘Western’ medical worlds is strictly a function of how much you can afford to pay, although I would be careful about drawing inferences of quality from that distinction.

In this blog I will concentrate on TCM, since that is uniquely Chinese.

The very traditional Chinese character for qi or life force.  I don't know about you but I can definitely see the resemblance to my own life.
The very traditional Chinese character for qi or life force. I don’t know about you but I can definitely see the resemblance to my own life.

TCM, as does Western medicine, works at many different levels, from seasonal soups to keep you healthy (Hong dou and Lv dou in winter and summer, respectively), to acupuncture to address more serious illness and affliction.  At every level, however, the focus is the same – ‘qi’, the natural energy or life force that circulates through the body in channels called meridians.

TCM was built on various philosophical and Taoist interpretations of nature.  By definition, therefore, it is all-natural.  The emphasis is not on repair or adaptation, but restoration.  ‘Cures’ seek to remove barriers to flow or to accelerate flow but not to modify or alter the qi itself.  That, after all, would be playing with the essence of life.

Yin yang theory is based on the inseparable but conflicting interplay of opposing forces.
Yin yang theory is based on the inseparable but conflicting interplay of opposing forces.

As a mirror to the universe, TCM operates on yin yang theory, the inhibitory and physical being the yin and the active and excitatory being the yang.  They are opposing but inseparable, each acquiring meaning and definition only relative to the other.

TCM is not fringe medicine.  It remains very much mainstream in China, often preferred by even the most educated and urbane of Chinese.  And while many Westerners consider it to be unsupported by modern science, we must remember that science is merely a methodology for explaining reality.  It is not a body of knowledge unto itself.  Something is unscientific by definition if it merely cannot be explained using the Scientific Method.  But since the Scientific Method is built on the exclusive foundation of deductive reasoning that precondition excludes a lot of what is otherwise very observable and very real.

When most Westerners think of TCM they think of acupuncture but the practice of inserting sharp needles into the skin which most Westerners are familiar with is only one form of acupuncture.  All are designed to promote the normal flow of qi and bring the yin yang back into harmony.  How that is done depends on the ailment but the subtly and complexity of the process has led to the identification of 400 primary acupuncture points, or holes, along the 12 main meridians.

Cupping looks a lot more painful than it is.  The marks disappear in just a few days.
Cupping looks a lot more painful than it is. The marks disappear in just a few days.

Cupping is another common form of acupuncture practiced here.   It commonly involves lighting a cotton swab soaked with alcohol, holding it inside a small glass designed for the purpose, removing the swab, and placing the glass upside down on the bare skin, normally the back.  The cooling air inside the glass creates a vacuum that in turn sucks blood and harmful bodily fluids to the surface.  (Non-thermal forms of cupping are also now available although fire cupping remains the standard here.)

There is no bleeding per se and the glass is not hot enough to burn, but the process does leave a bright red circle on the skin that takes several days to go away.  And since the process typically involves a number of glasses up and down the back and shoulders, it can be a bit shocking the first time you encounter someone whose cupping marks are visible.

There are many tools available for gua aha.  The polished horn of a water buffalo is the most common.  The open end, if you're wondering, is the working end of the horn.
There are many tools available for gua sha. The polished horn of a water buffalo is the most common. The open end, if you’re wondering, is the working end of the horn.

Yet another form of acupuncture is called gua sha and traditionally involves scraping the back in long brisk strokes using the polished horn of a water buffalo.  Again the idea is to promote the flow of qi through the meridians, restoring the proper balance of yin yang in the body and drawing blood and harmful fluids to the surface.  It, too, however, results in sub-cutaneous blemishing or ecchymosis which, to put it simply, makes it look like you’ve endured a very painful thrashing.

But I have experienced gua sha first hand and it is only mildly uncomfortable.  I underwent the procedure both out of curiosity and a desire to get over a nasty cold, the most common ailment for which gua sha is prescribed, although I have also heard the Chinese say that it is good for releasing anger as well.

Does TCM work?  I am but a glassmaker and a relatively healthy one at that.  But I do, scientific or not, buy into the idea that most things in life come down to a question of balance and that science has done an incomplete job of explaining the reality we experience firsthand.

Many medicinal products available at a traditional Chinese pharmacy are packaged very much like their Western counterparts.
Many medicinal products available at a traditional Chinese pharmacy are packaged very much like their Western counterparts.

And the one aspect of TCM that I believe is indisputable is the inseparable nature of health and illness.  If we live healthier lives we will, on balance, suffer less illness.  Both deductively and inductively that seems rational to me.

And in this respect I believe the Chinese are well ahead of the West.  Organic is mainstream and has been for some time.  It is Westerners who are introducing the Chinese to processed and packaged foods.  As one Western NGO worker who has been here for 25 years noted, when he first arrived the only consumer goods on the shelves were Coca-Cola and Nutella.  Everything was sold bulk – and unprocessed.  Now, however, the shelves are lined with the same processed snack foods, candies, and sugar-laden drinks you will find in Frankfurt or Saint Louis.

To enhance absorption the Chinese never add ice to their drinks.  The most common drink in winter is plain warm water.  It is actually very soothing.
To enhance absorption the Chinese never add ice to their drinks. The most common drink in winter is plain warm water. It is actually very soothing.

One area where I have come to totally endorse Chinese thinking is in the use of ice to cool beverages.  The Chinese never put ice in a beverage.  They prefer, in fact, not to drink it even cold or chilled.  The most common drink in China, particularly in the winter months, is plain warm water.

And it’s not out of concern for the quality of water that goes into the ice.  They don’t use ice because the Chinese have known of the need for hydration for generations and they know that the key to hydration is absorption.  (The problem with most health supplements, you may know, is that they never get absorbed.  They get ingested and then eliminated, having had almost no helpful effect along the way.)  And the key to absorption, the Chinese believe, is thermal consistency.

The Chinese, in other words, believe that all beverages should be as close to body temperature as possible.  That, in turn, will facilitate the absorption process.  And that, I have to say, makes a world of sense to me, no matter which worldview you bring to the process.

(As a quick aside, there is a material environmental issue relating to the use of ice to cool drinks as well.  Just think of how much energy is consumed in the United States alone on the production of ice for beverages.  It has to be huge.  And you can, I will attest, get quite used to the idea of drinking beverages at room temperature although I admittedly have yet to convince my daughters of that.)

Some of the ingredients used in Traditional Chinese Medicine may not appear appetizing to the Western eye but they are all natural.
Some of the ingredients used in Traditional Chinese Medicine may not appear appetizing to the Western eye but they are all natural.

And, as noted in prior posts, many of the cultural norms that so offend Westerners traveling in China are, in part, based on the Chinese perspective on health.  The act of clearing your throat of phlegm and spitting it out, as an example, is not designed to gross out foreigners.  It’s done because the Chinese believe that the phlegm and mucous caught in the throat is full of harmful bacteria and should be eliminated from the body as soon as possible.

And while they don’t cover their mouths when they sneeze they do not do so, in part, because it grosses them out to think of depositing those germs on the back of the hand or into a handkerchief that will ultimately be comingled with their intimate clothing for washing.  (I have also read accounts from Western doctors that caution against restraining a sneeze too forcefully.)

On balance, I have found the Chinese to be more concerned with health than many Western cultures, including my own.  This contrasts sharply with the public environment in which they live, but is, I think, a natural expression of the Chinese worldview, based as it is on a foundation of yin yang theory.

Balance.  It makes sense to me.

More on the Western medicine practiced here in my next post.

The Tong Ren Tang pharmacy in Beijing has been in existence for more than a century longer than the United States itself has existed.
The Tong Ren Tang pharmacy in Beijing has been in existence for more than a century longer than the United States itself has existed.

Copyright © 2013 Glassmaker in China

Notice:  The views expressed in this post are strictly those of the writer acting in a personal capacity.  They are not in any way endorsed or sanctioned by his employer or any other individual with which he may be personally or professionally affiliated.