How Is Herbal Medicine Practiced in Modern-Day China?

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A group of 24 East West students, graduates, teachers, and a few of their companions traveled to study herbs in China for 10 days in May. What we found there was most surprising and encouraging. Michael has written much about this in his blog on this topic, so I’ll mention other areas here.

Madeline and Faith, our most senior and junior students!

Firstly, TCMZone, along with Michael and I, developed the specialized herbal training program we attended. They’ve worked with Shanghai University since 2008 bringing groups of acupuncturists, herbalists, and established practitioners to train there. But ours was their first herbal training group, not to mention their largest group as well as including their oldest and youngest students (12 year-old Faith and 88 year-old Madeline Kramer). It was so successful that TCMZone is offering another Chinese herbal studies only program for advanced herbal students again next May.

One of the aspects of this training that impressed me the most was the integration of Eastern Traditional Chinese Medicine (TCM) with Western medicine. Many hospitals offer this in China. In Shanghai, we studied at the Longhua Hospital, associated with Shanghai University. The doctors first train for three years in Western medicine and then continue to 2-3 years of TCM followed by internship and residency. After, each doctor approaches the Western-Eastern medicine integration in their own way, some emphasizing Western medicine and others TCM herbalism or acupuncture.  

We trained in gastrointestinal, respiratory, endocrine, gynecology, oncology, traumatology, cardiology, rheumatoid arthritis, dermatology, and mental disorders specialties. Additionally, we covered digestive disorders, auto-immune diseases and hypothyroidism. We observed doctors treating both in-patient and out-patients. We visited patient in the hospital and the doctors explained their cases and the herbs they were giving. Our group saw 3-5 patients with each doctor in this manner, although other groups may have seen more.

Doctors treating in-patients, however, treated 50-100 in a day. The doctors sat at a desk with a computer and often an assistant. The patients (along with 1 to 5 family members) walked in the door and sat at the doctor’s desk. Often the next patient with their families would be bulging through the doorway awaiting their turn at the same time. The doctors spent around 5 minutes per returning patient and perhaps 7-10 minutes with new patients.

Patients would walk in carrying their own charts in booklet form and handed them to the doctors. The doctor would look at their record and the patient, perform a quick tongue and pulse scan (perhaps 5 – 30 seconds for each), ask questions, and listen to whatever the patient contributed. At the same time they’d inspect the formulas already given on their computer screens (if a returning patient).

In terms of treatment, most doctors would first use Western medicine, typically by requesting lab tests. Then depending on the slant of a particular doctor, they’d either try medications first or go straight to herbs.

As information was assessed or given, the doctor would adjust the herbal formula accordingly, changing dosages of individual herbs or even the herbs themselves, taking some out and adding others in. When done, the doctor handed the patient’s record book back and the next patient (and family) quickly took the empty seat.

A pharmacy attendant prepares a patient's herbal formula.

Behind the scenes, the new herbal formula was sent electronically to the pharmacy on the first floor of the hospital where the patient would next go after seeing the doctor. This is the second thing that impressed me there – the sophistication of their herbal pharmacy. Several pharmacists worked to fill the electronic doctor’s orders, typically using either bulk herbs, if the patient specifically requested teas, or else granulated extracts or actual teas packaged in daily dose bags.

I saw some patients with laundry carts that they’d fill to haul away the huge bags of bulk herbs given. At home the patient would either cook these herbs themselves, or take them to a local factory where they were granulated or made directly into teas.

The hospital also had decoction machines in the basement where they’d prepare patients’ teas to drink. Mainly these were produced for patients staying in hospital but others could take them home, too. Generally, the herbal formula was soaked for a half hour, then decocted for 45 minutes. These were then strained and vacuum-sealed in thick plastic bags. These could be kept refrigerated up to two weeks, although the doctors would typically prescribe formulas in weekly doses.

We also visited Shanghai University’s TCM department where we received our beautiful certificates of graduation in Advanced Chinese Herbal Medicine. This university is almost as big as a city with a fabulous herbal museum finished just 20 days before we arrived. This incredible museum displayed many historical herbal books and items along with an entire floor on herbs.

Samples of rare herbs (plants, animals and minerals) lined walls of cases. There was a room displaying a doctor examining a patient along with its pharmacy. One entire wall held tall glass jars, each filled with an herbal sample. Another display presented pressed herbs while one had dried herbs covered by a plate with holes so one could smell each of them individually. There were also several pulse machines where one could actually feel the varying quality of all the different pulses! That was an incredible teaching tool I wish we had here in the States. A different machine would take a photo of your tongue and give a fairly accurate diagnosis of your health imbalances. Likewise, there were machines for face and body diagnosis pictures and information.

All in all, it was an amazing learning event. I encourage anyone who understands Chinese herbs and theory to attend yourself as TCMZone is offering a similar herbal-training only program again, probably next May. Take advantage of this incredible opportunity!

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