Introduction
According to the Constitution of the World Health Organization (WHO), “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” [1] While this statement is at the top of the Constitution of the WHO, the principle is not widely practiced in Western countries, particularly in the United States. Healthcare in Western countries, including the United States, is dominated by allopathic medicine. Although allopathic medicine can be incredibly effective and employs the most cutting-edge medical technologies, it is still primarily reactive in nature. There are two primary reasons for this reality: (1) patients are not proactive in managing their health and (2) the diagnostic criteria utilized in allopathic medicine are too limited. The purpose of this article is to address these two reasons and illustrate the preventive power of Eastern medicine.
Reactive vs. Proactive Healthcare
Hippocrates, widely considered to be the “Father of Medicine,” was a major proponent of preventive medicine. “The Hippocratic philosophy on health care provision focused on the holistic health care model” that emphasized the promotion of health through lifestyle changes, including physical activity and dietary habits. [2] However, at some point in time, this changed. The current healthcare mindset in the West is predominantly reactive, where patients are not proactive in managing their health; once healthcare providers are involved, diseases have already progressed to a point where patients present with serious symptoms.
The United States’ Health Disadvantage
According to the Institute of Medicine and National Research Council, the United States “fares worse in nine health domains” when compared with peer countries: adverse birth outcomes, injuries and homicides, adolescent pregnancy and sexually transmitted infections, HIV and AIDS, drug-related mortality, obesity and diabetes, heart disease, chronic lung disease, and disability (e.g., arthritis). [3] Americans who reach age 50 “generally arrive at this age in poorer health than their counterparts in other high-income countries, and as older adults they face greater morbidity and mortality from chronic diseases that arise from risk factors (e.g., smoking, obesity, diabetes) that are often established earlier in life.” [3] While several of the health domains, such as obesity and heart disease, can be addressed by reducing risk factors through healthy lifestyles, unhealthy behaviors are only one part of the problem: “Individual behaviors may contribute to the overall disadvantage, but studies show that even Americans with healthy behaviors, for example, those who are not obese or do not smoke, appear to have higher disease rates than their peers in other countries.” [3]
A Shift in Our Healthcare Mindset
Another important factor is that Americans, as well as people from other Western countries, do not seek medical intervention until serious symptoms arise. There needs to be a paradigm shift in the healthcare mindset, from reactive to proactive, of both patients and providers in order for there to be any significant positive change in our health disadvantage. Not only do we, as a society, need to promote healthier lifestyles, but we also must encourage people to seek regular medical assessment. This, however, leads me to the second issue – the limitations of allopathic medical diagnostic criteria.
Currently, allopathic diagnosis is centered around the identification of disease based on physical examination, laboratory findings, and imaging studies. While these methods are extremely powerful for diagnosing and monitoring diseases, they do very little to prevent them. Patients are considered to be in good health so long as they do not present with any significant symptoms and their vital signs and laboratory findings are within the normal ranges. However, once a condition has progressed to the point where it can be detected by these tests, prevention is already out of the picture. Let us compare this approach to that of Eastern medicine.
The Advantage of Eastern Medicine Diagnosis
Eastern medicine is based on a system of balance. When a system is balanced, it is considered to be in a state of health; when a system is unbalanced, it is considered to be in a state of disorder. In traditional Chinese medicine (TCM), diseases and disorders are categorized according to the Eight Principles and the Internal Organs*. The Eight Principles consist of four pairs of opposing categories: Yin/Yang, excess/deficiency, hot/cold, and interior/exterior. The Internal Organs consist of five Yin Organs – Lung, Spleen, Heart, Kidney, and Liver – and six Yang Organs – Large Intestine, Stomach, Small Intestine, Bladder, Triple Burner (三焦, San Jiao), and Gall Bladder. Patients are assessed using the diagnostic methods of inquiring, inspection, auscultation, olfaction, and palpation. Based on the patterns of symptoms observed, TCM practitioners determine the nature of the disorder and which Internal Organs and/or meridians are affected. In many cases, these patterns may not register as abnormal in a physical exam or laboratory findings. As a result, an allopathic physician may consider a patient to be healthy, whereas a TCM practitioner may find the same patient to be in a state of disorder. Let us examine this disparity with a case study.
* Note that the Internal Organs in TCM differ from the conventional understanding of internal organs; the Internal Organs each represent a complex of functions and physiological processes. For example, the Kidneys in TCM may include the functions of the kidneys, adrenal glands, and other organs, as well as a multitude of physiological processes that are involved in water regulation, genetics, bone health, etc. In this article, I will differentiate the TCM Internal Organs from conventional organs by capitalizing the TCM Internal Organs.
Case Study
A 37-year-old male construction worker presented with acute low back pain and chronic fatigue. In addition to the primary symptoms of low back pain and fatigue, this patient reported loose stools, poor appetite, weakness, and heaviness in the limbs. His face was slightly pale; his voice was weak; his demeanor was lethargic; his radial pulse was thin and weak, particularly on the right side; his tongue was pale and slightly scalloped. This patient had also consulted his primary care physician, who conducted a physical exam and ordered bloodwork, including a complete blood count (CBC), a complete metabolic panel, and a broad thyroid panel. The physical exam revealed no significant findings, and all vital signs and laboratory results were within normal ranges. The patient was prescribed a non-steroidal anti-inflammatory drug (NSAID) and advised to rest his back, take some time off work, and increase consumption of dietary fiber. Conversely, TCM assessment of this patient revealed the underlying patterns of blood stasis causing the low back pain and Spleen-Qi deficiency causing the fatigue. Therefore, the primary treatment principles were to remove blood stasis and to tonify Spleen-Qi. He was treated with a combination of acupuncture, manual therapy, cupping, postural exercises, herbal medicine, and lifestyle modifications (including dietary therapy). (You can find an in-depth explanation of the treatment methods applied in this case in our article “What is Qi? – A Scientifically-Minded Acupuncturist’s Perspective”).
Post-treatment evaluation of this patient revealed an 80% reduction in the acute back pain after the first treatment and 100% reduction after four treatments. He also reported a 30% improvement in energy levels after the first treatment and 90% improvement after ten treatments. After ten treatments, the patient returned monthly for reassessment and maintenance treatments. He experienced no resurgence in back pain and maintained a 90-95% improvement of fatigue symptoms, depending on his level of compliance with lifestyle modifications. However, this patient may have been able to avoid these patterns entirely if he had been assessed before symptoms developed. If he had come in to the clinic for a routine TCM evaluation, we likely would have identified and addressed the blood stasis that was accumulating in his Bladder meridian (Figure 1), the tension in his Superficial Back Line [4] (Figure 2), and the lifestyle and dietary habits that led to his Qi deficiency, thereby preempting his pain and fatigue.
Figure 1. Superficial Back Line.[4] Figure 2. Bladder meridian. [5]
Our Mission
As Eastern medicine practitioners, we neither have the ability nor the interest to replace our counterparts who practice allopathic medicine. Instead, we want to work synergistically with allopathic physicians to improve the quality of life of our patients and our community as a whole. Our mission at Rise is to provide our patients with a holistic and effective approach to healing, as well as the knowledge to proactively prevent illness and injury. We work tirelessly to ensure that our patients receive the care, tools, and knowledge to restore balance to their lives. We take pride in going above and beyond for those who choose us as their healthcare providers. We are committed to serving our community with integrity, professionalism, respect, compassion, and love. In doing so, we hope to improve the overall health and well-being of our entire community by promoting healthy lifestyle choices. To this end, we regularly host free seminars and workshops on topics ranging from nutrition to therapeutic meditative exercises. If you are interested in attending these events, subscribe to our mailing list at the bottom of this page and/or follow us on social media.
References
[1] World Health Organization. (1948, April 7). Constitution of the World Health Organization. World Health Organization. Retrieved October 21, 2021, from https://www.who.int/about/governance/constitution.
[2] Kleisiaris CF, Sfakianakis C, Papathanasiou IV. Health care practices in ancient Greece: The Hippocratic ideal. J Med Ethics Hist Med. 2014;7:6. Published 2014 Mar 15.
[3] Institute of Medicine and National Research Council. 2013. U.S. Health in International Perspective: Shorter Lives, Poorer Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/13497.
[4] Myers, Thomas W. (2011). Anatomy Trains. London: Urban & Fischer.
[5] Deadman, Peter, Mazin Al-Khafaji, and Kevin Baker. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications, 2009. Print.
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