Pain Management Delegation to Chengdu and Lhasa

July 11-22, 2004

Delegation Leader: B. Eliot Cole, MD, MPA

July 15, 2004: Chengdu University of Traditional Chinese Medicine, Thatched Cottage of Dufu and Chinese Opera

The day started at Chengdu University of Traditional Chinese Medicine (CUTCM). CUTCM is one of the oldest and best universities for Traditional Chinese Medicine (TCM) in all of China. It has the following TCM specialties: Chinese Medicine, Acupuncture, Moxibustion and Medical Massage. It also combines Chinese and Western Medicine in orthopedics, ENT, Chinese herbology, nursing management, marketing and Tibetan medical science. The CHTCM boasts 6 institutions, 36 labs, one national clinical pharmacology research center and a Chinese Herb Specimen Center, with the largest amount of species in all of China. The CUTCM also has a very large library containing 400,000 books, which is the largest reference library in southwest China.

We first met with Dr. Li, a professor in TCM who also specializes in diabetes. Dr. Li gave us the philosophy of TCM (TCM should be understood in terms of thousands of years of human experience, and is not based on scientific research; human research and the effectiveness of treatment is based on thousands of years of experience and billions of people treated). Dr. Li emphasized that the modalities of TCM, such as herbs and acupuncture, do not necessarily cure the disease directly; by treating the whole person with various modalities, the disease can be influenced to improve the patient’s disease.

Dr. Li discussed the duality of disease and balance or harmony in wellness. Chinese medicine philosophy practices on the premise that disease occurs when the body is out of balance. Chinese medicine attempts to return the body to a natural balance to prevent or influence disease. For example, cancer results from the body being out of balance. Chinese medicine cannot cure the cancer, but it can teach the person how to return to a better balance to fight the cancer. Traditional Western medicine will use chemotherapy and radiation to eliminate the cancer, however, in the process, the body becomes weak and can develop infections. To the modern TCM practitioner, the Western treatment is appropriate, but he/she will then use Chinese medicine to restore balance more quickly after the chemotherapy or radiation therapy to restore balance and prevent infection.

Chinese Medicine uses duality of good and evil to deal with medical problems. This is based on the well known Chinese philosophy of the ying and the yang: good and evil, male and female, hot and cold, etc. So, for example, in terms of pain, pain is good because it tells the patient there is something bad or evil in the body that tells the organism, the patient to change, get help or adapt. Pain is also bad because it is uncomfortable. Acupuncture can be used for a headache because by using acupuncture the pain is diverted from the head to the acupuncture site.

The five elements of Chinese medicine were briefly discussed. These are: metal, fire, water, wood and earth. Each of these elements applies to the body and disease. The body’s counterparts to these elements are: lungs (metal), heart (fire), kidney (water), liver (wood) and spleen (earth). Chinese medicine places a high level of importance on physical examination based on these elements. TCM practitioners spend time physically examining the patient’s external signs and symptoms. For example, taking the pulse is not just measuring the rate, but it also involves measuring the quality of the pulse, strength of the pulse and other functions. Therefore, the pulse can be used to diagnose strokes, cancer, heart disease and other conditions. Pulse falls under fire or heart. Urine is measured for color, taste (sweet in diabetes) and this falls under water (kidney).

The rest of the morning was spent visiting the specimen museum (Cultural Museum of Traditional Chinese Medicine) affiliated with the CUTCM. Dr. Wong led the group through the museum explaining and highlighting each room. She presented the ancient history of TCM - relics and books showing the history of Chinese medicine from the Han Dynasty. The herb and plant rooms showed many plants, but Ginseng was the highlight. It is the herb that is called the “man shaped root.” A picture of the root in the shape of a man was one of the samples. The Zoological Substance room was shown to us, as well as the Extinct Animal and Plant Room. The Chinese are taking animal and plant reduction and extinction very seriously. Dr. Lu Xian Ming, an expert pharmacologist in ancient Chinese medicinal herbs and zoological substances, provided answers to delegates’ questions.

Lunch was served at Shuping Xuan. Fish, duck and pork dishes were presented. A rice dish, in the shape of ying and yang, and a pork and watermelon dish were favorites.

The group spent an hour at the Cottage of the Poet Dufu on the way back from lunch. After the tour we met at the CUTCM again to have more interaction with the professors. An extensive Q & A session provided interaction between delegates and professors. The discussion took a turn from TCM to insurance coverage, healthcare in the USA, etc. Gifts were exchanged at the end of the session.
The day continued with some of the group going to dinner and some returning to the hotel and later meeting up at the opera (changing faces, spitting fire, singing and puppetry.

Submitted by Daniel Brubaker, M.D.