TCM W2D1

Today was my first introduction into TCM in the context of a hospital.  I don't plan on practicing Chinese medicine when I become a physician. However, it is such a big part of the Chinese culture that it would be a huge disservice to future patients to dismiss it. The Taiwanese see TCM as less damaging to the body than Western medicine because there is a perception that it is more natural. TCM is everywhere in Taiwan - there are herb shops, acupuncture and tui-na clinics, and herbal medicine coexisting side by side with over the counter western medicine. It is part of tradition and deeply rooted in history. Dr. Liao said that if you got rid of TCM, you would have to get rid of the food that you eat, because even food can be classified into medicinal categories.

TCM and Osteopathy have a lot in common when it comes to the philosophy of looking at the patient as a whole. Many of the points that need to be memorized for acupuncture remind me of the counter strain points in OMM.

And you thought the CS posterior pelvis points were bad.

TCM doctors use the same EMR and smart card system that the other doctors use. They note CC, PMH,  and objective findings through physical exam. Their ROS questions are, "Do you often feel cold? Do you often feel hot? Does your breath smell? Do you sleep well? Are you often thirsty?" Furthermore, it is not the physical that I am used to seeing in our doctoring class. Instead, they feel the radial pulses, look at the tongue, and in the nose. Pulse diagnosis is important in TCM: one can categorize the pulse as 'floating', 'sinking', 'rapid', 'slow', 'hesitant', 'slippery', 'tight', and 'wiry' and with each category further qualifying factors. Palpation skill is important here. Dr. Liao said that there are additional "Oh, yes" points in which the patient claims that a certain spot that isn't exactly a TCM point is tender. It reminds me of when we test for counterstrain points and put them in positions that may not be classical, but altered to suit the patient's comfort. Like Dr. Kuo said, novices follow the textbook. It takes an experienced doctor to tailor treatment to the patient.

The way herbal medicine is given is usually in cocktails. One pill can have many different herbs ground into it. Dr. Kuo presented a couple of these pills to me:

For osteoperosis, the "concentrated pill"
- ginseng, ground turtle shell, deer horn (increases bone density) but does not create the risk for renal stones like calcium tablets do.

There are many different ways to prepare herbal medicine - decoction, powder, pills, paste, ointment, wine, lozenges and so on. It seems like a lot of memorization for TCM doctors.