The Treatment of Modern Western - Biblio.nhat-nam.ru

INTRODUCTION 35and acute diseases and are the most commonly usedform of medicinal administration [read, the standardof care] in China. 36In contradistinction, Xu Ji-qun et al., the authors of Fang JiXue (A Study of Formulas & Prescriptions), the textbook forthis course, have this to say about pills:Pills are slow to absorb. Therefore, their medicinalpower is continuous and enduring. . . .Theyare appropriate for chronic [literally, slow] conditionsand for vacuity weakness diseases. 37This means that, in the People’s Republic of China, pillsand decoctions each have their own particular indicationsand uses. They are not considered interchangeable. This issupported by the fact that the only times we have seenready-made pills prescribed by professional practitioners ofChinese medicine in China was in order to “secure treatmentefficacy” after treatment by decocted medicinals hadachieved the therapeutic effect or when the practitionerwanted to increase the dosage of certain medicinals. Inthat case, pills were prescribed along with decocted medicinalsas if the pills where themselves a single medicinal. 38In other words, ready-made pills are primarily prescribedby professional practitioners for preventive as opposed toremedial treatment. For remedial treatment of active diseaseprocesses, individually prescribed, bulk-dispensed,water-based decoctions are the professional standard ofcare.Further, ready-made pill medicines in China are available“over the counter” without a prescription. Laypeople inChina often attempt to treat themselves with such OTC medicationsthe same way laypeople do here in the West. WhenBob Flaws was an intern in China, he often saw patients whobegan their case history saying that they had used this or thatready-made medicine and that it had not helped or had madethem worse. So now they were there to get a proper professionalprescription. Likewise, Philippe Sionneau has neverseen professional practitioners of Chinese medicine prescribeready-made pills for the remedial treatment of disease, even,as he says, for minor diseases. As Dr. Chen also said in herfang ji xue lectures, many people in China take supplementingready-made pills. However, this is on their own initiativeand does not constitute the professional practice of Chinesemedicine. Rather, it is analogous to how Westerners take vitaminand mineral supplements.COMPLIANCE VS. CONVENIENCEAs every real-life clinician knows, when determining anycourse of therapy, one has to weigh the relative costs versusbenefits (not just risks versus benefits). Ease of administrationhelps insure patient compliance, especially over a protractedcourse of treatment. However, when patients fail tosee results, they do not stay with therapy no matter how easyit is. Many practitioners say that Western patients will nottake decoctions. Although some Western patients will not,most will if A) they are not given a choice in the matter and,B) the decoctions achieve better results than any other treatmentsthey have tried. If practitioners tell patients they caneither take easy pills or somewhat more difficult decoctionsand voice this choice as if these two forms of administrationwere equal, then, of course, patients will chose the easierpills. However, it is my experience that, when patients aretold how much more effective decoctions tend to be, mostpatients want to do what is going to work best.In order to make this choice a realistic one for the patient,the practitioner also has to be willing and comfortable withtaking decoctions. Placebo studies confirm that how a practitionerfeels about a therapy influences how their patientsalso feel. Otherwise, double-blind studies would not be necessary.Practitioners who themselves do not like takingdecoctions will have a hard time convincing their patientsthat they should take decoctions. However, when the practitionerthemself takes decoctions when they are ill and also isfirm in stating that 1) decoctions are the standard of care inprofessional Chinese medicine, 2) they are more effectivethan most pills and powders, and 3) they are no more difficultto make than cooking a pot of rice, then Westernpatients serious about their health are willing to drink badtastingChinese medicinal decoctions.Dr. Christopher, a famous American naturopath in the 1970s,said, “Good doctors require good patients.” Paracelsus, severalhundred years earlier, said, “The good doctor attracts patientswho are ready to be cured.” If a patient refuses to spend thetime and energy on making and taking decoctions eventhough they are more potent and can be tailored to fit theircase exactly, then that patient is not serious about their healthand is probably not going to get a satisfactory outcome anyway.Patients who are unwilling to make and take decoctionsare also not likely to make the substantial, long-term diet andlifestyle changes that are also necessary to get a good result.COMPARING APPLES TO APPLESWhile pills are still the most commonly used form of readymadeChinese medicine, desiccated powdered extracts takenin the form of infused teas or swallowed capsules are alsoextremely popular. However, no matter what the form of theready-made medicine, the single most important question toask is, “What are the dosage equivalencies?” Most Chinesemadepills equal one gram of ground, powdered medicinalsper gram of pills. Thus their equivalency ratio is 1:1. As wehave seen above, that means their daily recommended dose is