This past April, my
Chinese teacher, Jin Li, along with her friends Margaret, and Mr. Liu, drove Wendy
and me about an hour east of Xi’an to visit a traditional Chinese medicine
doctor, Dr. Zhang. He lives in a two-story
concrete home in the countryside, outside of the small village of Lian Tian, “Blue
Field”. The entrance to his place is
right along a narrow paved dusty lane.
On each side of the doorposts of his house are red Chinese scrolls with
Christian messages. Dr. Zhang, along with my teacher and her
friends, are devout Christians.
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| His backyard: and the loo... |
Dr. Zhang, is between 70 and 75, has
silver hair, and is very talkative and quick to smile. I understood virtually
nothing he said.
I think he was speaking
heavily accented Mandarin and not a local dialect.
He invited us into his living room where he
prepared tea and snacks.
His home is
simple with very few amenities.
There is
no running water and the only “bathroom” is a privy out back.
There is no central heating; a massive old wood burning stove in the
kitchen provides heat in the winter.
There are fields on both sides and his nearest neighbors are
about 100 yards away.
The fields extend
for at least 5 miles behind his home and border on some distant hills.
Jin Li explained that Dr. Zhang is
a medical college graduate and used to perform surgery. Somewhere along the way, he became both a
Christian and started practicing traditional Chinese medicine. He no longer performs surgery. Instead, he enjoys growing herbal remedies,
performing acupuncture and doing clinical evaluations. He works for free.
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| Traditional Chinese Medicine Doctor at Work |
Jin Li told us that Dr. Zhang comes
from a long line of healers going back to the Qing (1644-1911) emperors.
His ancestors attended court concubines.
Naturally, my teacher said, these
practitioners were famous for their knowledge of “women’s problems”.
My mind gravitated to the Chinese costume dramas
I have enjoyed, like “Empresses in the Palace”.
In those shows you can see handsome court doctors earnestly checking the
pulses of concubines, usually suffering from the effects of pregnancy, anxiety
or some rival’s poison.
The physicians,
always mindful of their patients’ modesty would put a piece of cloth on the
women’s wrists before feeling for the pulse, thus ensuring that there would be
no direct skin contact.
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| Growing herbs |
Dr. Zhang explained that the first
step in traditional Chinese medicine is to check the patient’s pulse.
There is a tremendous amount of technique
involved in examining a patient’s pulse.
There are 28 different kinds of pulses that may be identified and they vary
depending on location, depth and side of the body that is being evaluated.
This seems impossible until you consider that
a cello fingerboard is home to hundreds of notes of varying pitches
and timbers that can only be elicited by a practiced and skilled musician.
Both require years of practice.
Dr. Zhang gave both Jin Li and
Margaret informal examinations. He
started with Jin Li. He used the first
three fingers on his right hand to check her right radial pulse. Normally talkative, he was silent and held
her wrist for a good minute. He then
asked some questions. Finally, after
about 4 or 5 minutes he pronounced that she appeared to have an infection in
head somewhere, possibly her ear. She
said that she was being treated by her dentist for a dental infection. Like many of the people here of a certain
age, her teeth are in poor condition.
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| Growing herbs |
Next, he examined Margaret in the
same way, by checking her pulse.
He
asked if she was having trouble sleeping and she replied that she was.
She seemed both surprised and pleased that he
had found this problem.
He went on to
discuss potential herbal remedies and other things she could do to help
herself.
These informal demonstration
examinations pleased patients and doctor alike.
Before we left his place, he had Jin Li and Margaret take away several
plastic bags filled with various herbal remedies.
He wouldn’t take any money.
Everyone was smiling.
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| View outside the doctor's house |
Naturally, living in China, I have
become more curious about traditional Chinese medicine.
I have discovered an excellent book on Kindle:
“The Web that has no Weaver: understanding Chinese medicine” by Ted J Kaptchuk.
(1)
This very comprehensive text has
more details than the general reader might need, but is certainly a great reference
book.
Traditional Chinese medicine
differs from Western medicine in many ways, but I think the most significant
are that Traditional Chinese medicine is highly individualized and experience
based, whereas Western medicine is highly standardized and evidence based.
Certainly, the Western reductionist
biologically based approach has brought incredible advances in medicine.
However, patients in the West complain that
they feel that they are just “a gallbladder in room 301” or “heart attack in
room 4”.
They feel their individuality
has been ignored and lost.
In Chinese medicine it is most
important for the doctor to understand the problems and symptoms in terms of
who the patient is. In Chinese medicine,
the role of the individual in their illness is paramount. William Osler, the father of modern clinical
medicine in North America said, “It is
much more important to know what sort of a patient has a disease than what sort
of a disease a patient has.” He certainly realized the importance of individualizing
care.
Having the time and taking the time
to touch the patient, to hear what the patient is saying, are key to helping patients with their
problems. Finally, both are central to
patients’ and clinicians’ satisfaction with the clinical encounter.
References:
(1)
Kaptchuk TJ. The Web that has no Weaver:
understanding Chinese medicine. New York: Congdon and Weed, 1983. 2nd US
edition, Chicago: Contemporary, McGraw-Hill, 2000.
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