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An Appreciation of Chinese Medicine
Western Medicine
Chinese Holism
T'ai Chi
Clinical Problems

A contribution by Dr E. K. Ledermann to the graduation ceremony of the Chinese Medical Institute and Register at the Royal Free Hospital, London, 3 February 2001

Published in 'The Syndrome', The Newsletter of The Chinese Medical Institute and Register, Summer 2001 in the International Journal of Acupuncture. Vol. 4. Issue 1 & 2, 2001

Western Medicine

Western medicine is scientific-mechanistic; physiology studies normal mechanisms, pathology abnormal ones. These mechanisms involve an acceptance of determinism or necessity and they further entail a concentration on specific parts which are identified in the diagnosis of a particular disease.

The treatment consists in counter-mechanisms. For instance, pneumonia is an inflammation affecting the mechanisms in a lung. The antibiotic is the treatment; it provides another mechanism which corrects the pathological one.

Western medicine is dominated by Cartesian doctrine. Descartes declared that there are only two fundamental substances in the universe: corporeal (res extensae) and mental (res cogitantes). Patients are therefore diagnosed as sufferers from either bodily or mental diseases. Treatments are designed to correct these.

Western scientific medicine has been very successful in the prevention and treatment of diseases and further successes can be expected. But millions of people are turning to complementary medicine. They are looking for treatments that do not fragment the sick person and that do not ignore the spiritual, individual and subjective sides of human life. Many people prefer a Holistic Medicine. Chinese medicine is an outstanding example of Holism.

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Chinese Holism
the meridians yin and yang

Chinese holism takes different forms. It accepts a whole and integrated natural universe, pervaded by energy, called Qi; the substratum of the universe is also the substratum of human life which interacts with the natural environment. Qi manifests itself in a material-physical and in a spiritual form. Qi is in constant flux and assumes different forms. It circulates in channels, called meridians. It nourishes body, mind and spirit; its smooth flow ensures health, its obstructed flow spells disease.

As a doctor, I am especially interested in the wholeness of body, mind and spirit, affirmed by Chinese medicine. Here we have a fundamental extension of the Cartesian dualism of body and mind. The spiritual dimension has entered the wholeness of the human person. It does not stand for necessity or determinism for body and mind which is assumed by science. The spiritual dimension stands for ethical freedom.

I can explain the meaning of this freedom by the difference between an angry animal attacking and wounding a person and an angry person attacking and wounding another person. The animal is put down to protect the public, but this is not punishment, as it is not guilty. The human aggressor is found guilty by a Court. He or she ought to have manifested his or her ethical freedom and ought to have resisted giving vent to anger.

For many years I have accepted the need to assume the existence of the spiritual dimension in medicine. One of my books, published in 1984, is entitled Mental Health and Human Conscience: the true and the false self. I developed a form of psychotherapy, called "true-self psychotherapy" which is based on a recognition of conscience, as our arbiter of right and wrong.

In Chinese medicine there is no place for such special recognition. The spiritual dimension is an integral part of the meridians which represent the functioning of our organs. Any disturbance in the channels is liable to cause a physical, mental and spiritual disturbance. Acupuncture corrects the bodily, mental and spiritual aspects.

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the meridians

    For instance, the gall bladder meridian enables us to make decisions, a vital spiritual act which our conscience expects from us. If a patient finds that he is not making vital decisions, his spiritual fault may be corrected by needling gall bladder 40 which, at the same time, may also correct the associated bodily liver disturbance which has resulted in migraine headaches.

    The kidney meridian not only promotes our water metabolism; it also promotes our ability to persevere with essential tasks. Any such inability causes anxiety, as the person knows that he ought not to procrastinate. By needling kidney 3, the water metabolism and the perseverance of essential work can be normalised.

    The stomach meridian ensures that food is properly digested. A fault in the flow of energy may cause an overloading of food, leading to indigestion, but also causes such an accumulation of ideas and duties that the patient suffers from spiritual indigestion and loses self-confidence. Needling stomach 45 may calm his stomach and his spirit.

    The liver meridian provides a supply of blood to the whole body. If the patient has suffered severe emotional deprivation, a stagnation of liver Qi causes epigastric pain and severe depression so that creative spiritual activity is made impossible. Acupuncture of liver 3 may secure a normal balance in the energy flow as well as in bodily and spiritual functions.

    The spleen meridian like the stomach meridian is concerned with food digestion. It also controls muscles. It houses our ability to think, to study, to focus on a subject and remember. Excessive mental stress in our competitive society may have led to constant brooding and memory fault, abdominal distension and weak limbs. Needling spleen 3 or spleen 6 may provide the necessary strength for remedying the bodily, mental and spiritual trouble.

    Chinese holism thus involves whole making which is health. It relies on the holistic health-making tendency in the universe.

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yin and yang

    Everything in the universe is affected by, and is part of, Yin and Yang, composed of two opposing and still complementary principles.
    I found this concept very difficult and had to learn that either Yin or Yang pre-dominates. But I also had to realise that such predominance does not last and can be reversed.

    Yin has a cooling and Yang a heating effect, Yin is the 'water' nature of our body and Yang is the 'fire' nature, heating and activating the stored Qi into movement. Yang is energy and is non-substantial. Yin is matter and is substantial.

    An important clinical application follows. Patients can be divided in those who feel too hot and those who feel too cold, which means that either Yin or Yang predominates. An excessive energy or a deficient energy of Yin or Yang is corrected by special manipulation of the acupuncture needle.

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T'ai Chi

For several years I have followed the demonstrations of a T'ai Chi video which runs for fifty minutes and which explains the underlying principles. It promotes balance and vitality. Qi is encouraged to flow freely throughout the body as the result of certain stretching and breathing movements.

The result is "physical fitness, mental alertness and spiritual awakening". The video explains that it accepts the Chinese principle which considers stagnation to be an important cause for disease. It can be avoided if one performs T'ai Chi regularly which encourages self-development. It is achieved by passing through the stages which lead to the full T'ai Chi. I have benefited from T'ai Chi and I have introduced this video to some of my patients who have found it very helpful.

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‘Shiatsu is a therapy which works on all the different energetic levels of the physical, emotional and spiritual aspects of our personality. It evolved from thousands of years of Oriental medical history and specifically from the traditional Japanese medical approach.'

‘Shiatsu literally means “finger pressure”. The actual treatment, approach and philosophy are similar to those of Chinese acupuncture. Like acupuncture, shiatsu uses the meridians, but without the use of needles. Describing shiatsu as 'finger pressure' is somewhat misleading, as the therapist will use his thumbs, hands, elbows knees and sometimes his feet during treatment.'

‘Shiatsu works on the energy Qi which flows to all the pathways, known as meridians. The pressure and stretching techniques encourage self-healing, balance, ease and relaxation.’

(Text from Ray Ridolfi and Susanne Franzen, Shiatsu for Women, Thorsons, 1996.)

In 1997 I joined the Foundation Course, arranged by the British School of Shiatsu. The students were expected to practise on each other, instructed by the teacher. I then applied this knowledge to the treatment of my patients. Students are also encouraged to apply the treatment to their own bodily, mental and spiritual personalities.

I learnt to distinguish areas that feel empty, as they are lacking in energy, thus requiring tonification, and others that have an excess of Qi which requires softening. A balance has to be achieved.

I learnt that the sympathetic and parasympathetic systems are responsible for these phenomena. I also learnt that touch can be relaxing, stimulating and even painful. My fellow students complained that my touch was too heavy. I had the touch of a doctor who uses palpation to make a firm diagnosis. I was astonished when I and the patient (or fellow student) would still feel the Qi tingling in our hands after they had been lifted from the skin.

Western medicine is scientific-objective. The doctor and the patient are not personally related. In Shiatsu such objectivity is not the aim. The therapist is guided by his or her intuition and discovers how the patient responds - both are subjects and partners, although objective signs of health and illness are recorded.

Patients can be instructed not only to treat themselves, but also members of their families. For instance, a woman was able to stop her little boy's nausea and vomiting when she was shown how to apply pressure on pericardium 6 - the pressure having worked on the child's mind, stomach and liver Qi.

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Clinical Problems
case study one case study two

This section is concerned with two patients who suffered from important problems that Western scientific medicine was not able to solve, but for which Chinese medicine provided an answer.

I used Chinese acupuncture, but in order to also use shiatsu I employed press needles. These consist of a material that adheres to the skin and has a small needle attached.

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case study one

    I have been this patient's doctor for over thirty years.

    She developed ulcerative colitis when she was in her early twenties. My treatment was only temporarily successful and, as there was a danger of malignant changes in the colon, she had the whole of her colon and rectum removed. She was fitted with a bag to receive the faeces from her ileum. Thus, her large intestine meridian could no more arrive at its pertaining organ.

    A few years ago she developed mild colicky pains that were related to gall stones. Although she was told that an operation might not lead to freedom from the pain, she had her gall bladder with the stones removed. Her gall bladder meridian is now also prevented from reaching its pertaining organ.

    The patient is used to her ileostomy, only occasionally is the discharge too liquid and she then uses some electrolyte replacement. But her gall bladder and liver meridians need attention.

    The colour of her tongue is normal, her pulse is wiry. She often complains of hypochondriac pain with distension and nausea, signs of liver-Qi stagnation. More important than her physical discomfort is her emotional and spiritual condition.

    I have used gall bladder 40 in her case. This point has a reputation of enabling a patient to deal with resentment and depression apart from relieving nausea and discomfort in the hypochondrium.

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case study two

    A woman aged 92.

    Her syndrome: General Yin deficiency, Heart Yin deficiency leading to insomnia, anxiety, occasional palpitations, agitation, constantly getting up from sitting position, restless walking about.

    In addition: Lung Yin deficiency was responsible for cough, noisy breathing, sticky sputum and Kidney Yin deficiency caused vertigo and poor memory. Bladder Yin deficiency explained her frequent desire to urinate, often every few minutes.
    Tongue slightly swollen. Full pulse.

    The patient was seen by a psycho-geriatrician who prescribed drugs to help her to sleep and to calm her.

    When her restlessness and anxiety became uncontrolled, further medication was not considered a possibility as it would make her lose her balance and fall down. Therefore, Chinese medicine had to be given to help her. I used press needles.

    My main acupoint for her was REN 15. This point nourishes all Yin organs and calms the mind.

    I was delighted when I found that she became quiet and went to sleep after the treatment for many hours. I combined REN 15 with REN 3. There was a good response; her frequency of urination was much reduced. My third point was Lung 8; the patient was encouraged to press the needle when her breathing became laboured.

    After a few days these beneficial results stopped. It is a common experience that new points have to be needled. I used liver 3 together with large intestine 4. The reason for choosing the liver meridian was this patient's spiritual grievance, her resentment that she was no longer able to be independent. She had to agree to being washed by a carer and to be helped to walk about. The liver point and its associated large intestine point proved very successful, restoring good sleep better appetite and even bringing back her creative ability to draw.

    These results were achieved by Chinese medicine, after Western medicine had failed to control her symptoms.

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I became interested in Chinese medicine because Western medicine had been unable to help me with a troublesome condition of my legs. I improved under Chinese medicine.

In T'ai Chi I was introduced to a form of physiology of Chinese medicine - a demonstration of the normal flow of energy which is the basis for health from a bodily, mental and spiritual point of view.

In shiatsu I learnt the importance of empathic understanding of the patient. Empathy is making an effort to feel another's emotions which may express spiritual suffering.

My preparation for the practice of Chinese medicine was completed when I adopted the use of acupuncture, using needles of different lengths apart from using press needles and using Chinese herbs.

Chinese medicine has been a revelation to me.

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Dr Ledermann would be happy to enter into correspondence with any reader.
He can be contacted at 121 Harley Street, London W1N 1DH.
Tel: 020 7935 8774 or at home on 020 7435 5133.

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