Treating Autoimmune Disease with Chinese Medicine Wanzhu Hou, Guanpi Xu and Hanjie Wang Published by Churchill Livingstone, 2011 Hardback. 320pp. ISBN 97804443069741 Price: £43.36
Shen’s Textbook on the Management of Autoimmune Diseases with Chinese Medicine Shen Pi’an Published by Donica, 2012. Hardback. 774pp. ISBN 9781901149098 Price: £62.00 (on offer, usually £69.00)
(Reviewed by Dr Ming Zhao Cheng, EJOM Vol. 7 No. 2)
In this day and age, many acupuncturists are trying to ’specialise‘ in a chosen field of interest in their practice. To meet the needs of these practitioners, more and more works in some particular fields have been published.
Before the publication of these works, there were few books specialising in the treatment of autoimmune diseases with traditional Chinese medicine (TCM). In 2011, ‘Treating Autoimmune Disease with Chinese Medicine’, by Chinese –American medical practitioners Wanzhu Hou, Guangpi Xu and Hanjie Wang, was published by Churchill Livingstone. This book is a very good start, as for the first time, it gives TCM practitioners in the West a glimpse of this field. This book introduces basic immunology and immune system disorders to the readers. An overview of Chinese medicine and autoimmune diseases is discussed. Although the authors emphasise the aspect of yin deficiency, which they discuss in some detail in chapter 2, the amount of Western medical influence on the book is quite obvious. They state that in treatment of these diseases ‘we must follow the Chinese medical theory of differentiation of symptoms and signs’, but at the same time, ‘we must also know more about research on single herbs and acupuncture points’ and ‘more importantly we must understand the significance of pathological changes according to Western medicine’ (p41)
Based on this philosophy, the authors try to equate some TCM syndromes in autoimmune diseases to some Western diagnoses, and try to give some justifications. For example, in Sjogren’s syndrome, they state that the disease damages glandular tissue that has a moistening function. The consequence of this is a yin deficiency syndrome (p41). In rheumatoid arthritis, ‘the proliferative synovial cells secrete more and more fluid, if the condition exists mainly with inflammation, we call it Cold-Damp Bi syndrome’ (p19). In each of the 13 chapters dealing with 13 autoimmune diseases, the authors firstly introduce Western medical aetiology, pathology and diagnosis, followed by TCM aetiology and pathology. General treatment principle is followed by a list of differentiation and treatment. In some chapters, there is then a curiously named Appendix. Case studies are quite useful for the practitioner, with analysis of the cases trying to sum up different syndromes in TCM regarding the disease. All chapters end with lifestyle prescriptions and health issues. There are a few references in each chapter, although they do not seem to appear in the texts frequently.
Generally, the sections on Western Medical Aetiology and Pathology and Diagnosis by Western Medicine give each disease a brief list of causative and diagnostic factors in Western medicine. Although not many references are listed, which makes it difficult for the readers to follow up their reading, it does give readers a fairly good idea of what the authors are discussing. In the Chinese Medicine Aetiology and Pathology section, the main points made by the authors are clearly discussed. Attempts are made to find similar descriptions from some classical texts, although they are quite brief. In the Differentiation and Treatment section, common TCM syndromes pertaining to a Western disease category are listed as well as clinical symptoms, treatment principle, herbal treatment, acupuncture and the curiously termed ‘supplementary treatment’.
The herbal treatment of each syndrome is expressed as a prescription in pin yin and Latin with dosages and a very brief instruction as to how to decoct and take the herbs. The acupuncture treatment is simply a list of chosen acupuncture points (pin yin and number). There is no explanation of the roles of the herbs and acupuncture points in the formulae.
The case studies are generally quite chronological, with details on the patient’s medical history, Western physical examination, followed by a description of TCM symptoms, tongue and pulses. Results of laboratory tests which are relevant to the patient’s disease are given in good detail. This could be very helpful to TCM practitioners who are not familiar with the Western diagnosis.
The book ends with a very useful Glossary of Immunology (Western medical terms) and the Index of Chinese Herbal Formulas.
The main problem for me as a reader of this book is that it lacks illustrations, and in some chapters there are not many references. But nonetheless, it is a very good attempt to initiate a specialism in TCM treatment of autoimmune diseases, and it would be a very good starting point for aspiring practitioners in this field.
Hot on the heels of this book, Donica Publishing and PMMP have published a more complete textbook specialising in autoimmune diseases in the field of TCM. This book, Shen’s Textbook on the Management of Autoimmune Disease with Chinese Medicine, was written by Professor Pi’an Shen, Director of Shanghai TCM Hospital’s Rheumatology and Immunology Department, but many doctors from his department who specialise in autoimmune diseases make great contributions to the book. Professor Shen himself has specialised in the treatment of autoimmune diseases for more than 50 years, using TCM as the main treatment method but in combination with Western medicine. Over this long period, he has kept up with developments in TCM and Western medicine. He has accumulated thousands of cases and gathered a vast amount of experience in the aetiology, pathology, diagnosis and clinical treatment of autoimmune disease. Doctors and TCM practitioners of Professor Shen’s department are very lucky to be able to follow him on a daily basis. For practitioners elsewhere who want to share his experiences and to specialise in the treatment of autoimmune disease with TCM, this book would be a very good starting point.
The book has five chapters which lay the foundation for practitioners to build up their knowledge of autoimmune diseases. The first chapter looks at the human body’s immune function from a Chinese medicine perspective, while the second chapter looks at it from a Western medicine perspective. The third and fourth chapters are devoted to setting out systematically the aetiology, pathology and main treatment methods in TCM. There are ten main treatment methods, and each one has not only a group of Chinese herbal medicines and formulae, but also a group of main acupuncture points. This is helpful indeed, as explanations are given in detail and combinations are suggested. Furthermore, other TCM treatment methods are mentioned, some in good detail. These include external treatment, tui na, cupping, exercise, diet therapy. The relationship between food and autoimmune diseases and their symptoms is described, with suggestions of beneficial and detrimental food to some common symptoms.
In the fifth chapter, the author discusses at length the integration of Chinese and Western medicines in the treatment of autoimmune disease. This is very practical. The advantages and disadvantages of both systems are compared. The examples given of the integration of Chinese and Western medicines, including the use of Chinese herbs and acupuncture with Western medicines in acute and chronic conditions are really a breath of fresh air. Many Chinese medicines counter the side-effects of Western medicines. Many Chinese medicines enhance adrenocortical function, regulate the functions of the immune system, inhibit inflammation, improve circulation and reduce common symptoms of many autoimmune diseases.
These introductory chapters should help to build the confidence of TCM practitioners and make them want to learn more about the specific diseases dealt with in the next 16 chapters. Each chapter lays out the clinical manifestations, differential diagnosis, aetiology and pathology, pattern identification and main TCM treatments, including Chinese herbal medicine prescription and acupuncture prescriptions, and incorporate herbal medicine and acupuncture as well as diet therapy. There are many formulae that have been designed and trialled by Professor Shen over the last 50 years. For example, hong ban tang appears a total of 47 times in the book. Many modifications are described according to differences in the manifestation of symptoms.
The book is also rich in case studies. These extensive and informative selections of case histories demonstrate how Professor Shen and his team translate theory into practice. Many cases were treated successfully. Although they may not be cured, the patients can live a normal life.
Another impressive feature of the book is that it contains many references, demonstrating a wide spectrum of up-to-date clinical experience from highly regarded Chinese sources. In many cases, these references were quoted and the reader can find the original articles, broadening the information available to practitioners outside China. One could wish that there were more such references from outside China, but this could only happen when practitioners outside China become specialists in this particular field.
There are more than 40 colour photos, illustrating symptoms of some autoimmune diseases, although one might wish that there were more.
All in all, this pioneering work draws on the extensive experience of Professor Shen and his team to provide an in-depth analysis of a highly practical approach to the treatment of the main autoimmune diseases, making it an indispensable companion for all Chinese medicine practitioners and all health professionals with an interest in understanding how Chinese medicine can help their patients. It presents an authoritative and comprehensive overview of autoimmune diseases from a Chinese medical perspective. In addition, it provides a step-by-step methodology for the evaluation and combination of Chinese herbal medicine and acupuncture and other TCM therapies in the management of these conditions, particularly when the patients are taking Western medicine.
Both of these books highlight the fact that when one wants to specialise in a particular field with Chinese medicine, one must not only understand it from the Chinese medicine perspective, but also, importantly, from the Western medicine perspective. There are strengths and weaknesses in both systems, but one can complement the other, as demonstrated in these books. TCM practitioners and students should always bear this in mind. Both books are of great value. There are many cases of autoimmune diseases out there and not many of us are experienced in the treatment of them.
Dr. Ming Zhao Cheng Dr. Ming Zhao Cheng is a principal lecturer in Traditional Chinese Medicine at Middlesex University, where he has led the development of TCM courses since 2000. Ming started practising TCM in 1975 as an apprentice to a famous practitioner in China. After qualifying in both Chinese and Western medicine (Guangzhou TCM University) he practised and taught at its affiliated hospitals. He has been practising Chinese medicine and acupuncture in the UK since 1987 and is a graduate of Oxford and London universities (Masters and PhD in Medicine, 1991 and 1995 respectively). He has published many research papers, teaches widely and is a member of the Dept of Health’s Working Group, BAcC’s Governing Board and the ATCM council.