Treatment of modern mestern diseases with Chinese medicine

PRAISE FOR

THE TREATMENT OF MODERN WESTERN MEDICAL

DISEASES WITH CHINESE MEDICINE SECOND EDITION

This book represents another major step in the development of a more comprehensive view of East Asian medicine.

The authors help students and practitioners begin to think their way around frequently seen clinical scenarios that

are not covered in other English language sources.

—Greg Bantick, B.Ac., MTOM,

Senior Lecturer, Pacific College of Oriental Medicine

These two unanimously recognized and appreciated specialists in their field have managed to combine the nosology

of modern Western medicine with the subtle, multidimensional modes of thousands-year-old traditional Chinese

medicine. This powerful textbook is a rich, invaluable, and totally accessible source of diagnostic and therapeutic teach￾ings, even for experts of Chinese medicine.

—Patrick Basmadjian, M.D. & acupuncturist (Belgium)

Written by two of the West’s most prolific teachers, writers, researchers, and clinicians of Chinese medicine and writ￾ten specifically for Western practitioners of Chinese medicine, this book is the first comprehensive clinical

resource of its kind. Its detailed Chinese medical discussions of more than 60 diseases, including concise Chinese med￾ical disease mechanisms and detailed medicinal in acupuncture treatment protocols, as well as an Introduction that will

improve every practitioner’s clinical skills in treating the complicated Western diseases we see in real-life practice are sure

to make this superb work the most valuable textbook and clinical manual on the shelves of every Western practitioner

of Chinese medicine.

—Simon Becker, Dipl. Ac. & C.H.,

Author of A Handbook of Chinese Hematology

This book skillfully combines a clear and complete approach to each disease by both Western and Chinese medicine.

Physiopathology, clinical aspects, and therapeutics are described thoroughly and precisely in both systems. It is a

bridge that will enable MD’s to understand the Chinese medical point of view and Chinese medical practitioners to gain

clear access to the Western medical approach. A brilliant synthesis!

—Florence Bouvelot-Brézillon, M.D. & acupuncturist (France)

I

t must be said with great verve: There is no other book like this one in the cross-cultural bibliography of East-West

healing. It is destined to quench the yearning of many seasoned practitioners that uncomfortably straddle both heal￾ing realms. It is like finally having a bilingual encyclopedic clinical dictionary that adroitly renders obeisance to both lan￾guages. Bravo!!

—Robert J. Casanas, M.A., M.D.,

Board-certified Internist, Assistant Clinical Professor, School of Medicine, University of California

This excellent text provides a sophisticated response to one of the more pressing concerns facing practitioners of

Traditional Chinese Medicine today: how to integrate contemporary clinical experience with ancient therapeutic

wisdom. The authors systematically analyze a comprehensive range of modern diseases and syndromes from both a

Western and Chinese medical perspective using intelligent and well-researched interpretations of etiology, pathophysi-

ology, and diagnosis, including classical and contemporary reference materials. The result is a serious clinical manual of

internal medicine which focuses on modern, recalcitrant disease and the relevance of Traditional Chinese Medicine in

both understanding and treating it. This is a text that any practitioner, faced with their more challenging cases, from

chronic fatigue syndrome to irritable bowel syndrome to multiple sclerosis, will be excited about. It will enhance not

only their therapeutic endeavors, but also their ability to integrate Western and Eastern interpretations of disease. As

such, any committed practitioner of TCM will want it in their library immediately.

—Nigel Dawes, M.A., L.Ac.,

Dean, Graduate School of Oriental Medicine

New York College of Wholistic Medicine, New York, USA

The Treatment of Modern Western Medical Diseases with Chinese Medicine represents a major contribution to the pro￾fessional literature of TCM. Bob Flaws and Philippe Sionneau have crafted a brilliant text based on scholarly review

of the contemporary medical literature and their own clinical insights and wisdom. This volume provides a wealth of

clinically relevant information which will be of immediate use to both students and professional practitioners of TCM.

This text is destined to become a standard reference in the practice of TCM in the West.

—Steve Erickson, Dipl. Ac. & C.H.,

Assistant Professor, Northwestern Health Sciences University

While this may not be the first book to describe the Chinese pattern discrimination and treatment of modern

Western diseases, this one is the most helpful in that it addresses the complexity of the mixed patterns we tend to

see in our patients with ever increasing frequency these days. Rather than simple patterns with one root cause, we tend

to see even the most apparently simple conditions complicated by layers of chronic illness which must be considered and

appropriately dealt with in order for full and lasting function and balance to be restored. All in all, this is a very practi￾cal text.

—Gary Klepper, D.C., Certified Chiropractic Acupuncturist

Every book published by Blue Poppy Press is exceptional in its material, and now The Treatment of Modern Western

Medical Diseases with Chinese Medicine joins its predecessors as one of the most knowledgeable and informative

resources for medical practitioners. It is refreshing to have both the Chinese and Western medical approaches to disease

readily available under one cover and to have the current medical literature from both ends of the spectrum at one’s fin￾gertips. Thank you again, Blue Poppy Press, for your innovative, thorough, and unparalleled approach.

—Lynn Kuchinski, M.I.M., L.Ac., Dipl. Ac. & C.H.,

Author of Controlling Diabetes Naturally with Chinese Medicine

I

n order for Chinese medicine, and in particular, Traditional Chinese Medicine (TCM), to become more integrated

into medical practice in the West, there is a need to bridge the many conceptual and practical differences between

Western medicine and Chinese medicine. In his latest work, The Treatment of Modern Western Medical Diseases with

Chinese Medicine, Bob Flaws, along with Philippe Sionneau, have produced a text that is, I believe, a major step in the

integration of these two medicines. Written in a clear style and very well organized and produced, this book will provide

practitioners with much valuable information both for understanding these two medicines as well as for using Chinese

medicine in caring for Western patients who have Western medical diagnoses. Western medical practitioners with an

interest in professional level Chinese medicine will find a great abundance of information to further their understand￾ing. Practitioners of Chinese medicine in Western countries have within this text a multitude of invaluable clinical

insights and, perhaps more importantly, an excellent source for an overall approach to utilizing Chinese medicine/TCM

in approaching patients who have been diagnosed and treated with Western medicine. As a Western-trained physician

practicing Chinese medicine, I applaud the publication of this text and heartily recommend it to any practitioner desir￾ing a more harmonious fusion of Chinese and Western medical practice.

—Charles May, M.D., DOM

Acupuncture and Chinese Herbology Diplomate, American Boards of Family Practice & Emergency

Medicine, former instructor and board member, American Academy of Medical Acupuncture

This volume will serve not only as a valuable reference for all experienced practitioners but, more importantly, its

detailed analytical approach will serve to teach and inspire less accomplished practitioners to begin to manage com￾plex Western diseases.

—John Pan, M.D., Clinical Professor & Director,

Center for Integrative Medicine, George Washington University Medical Center

Hyperthyroidism, essential hypertension, and fibromyalgia are Western medical terms, while qi goiter, wasting thirst,

and seasonal epidemics are traditional Chinese medical terms, and all have their own reality. This work represents

a magnificent bridge between these different medicines which is solidly constructed on clear, precise, profound, and

impeccable exposition of these different terms. This is an indispensable book for all those who hope to encounter har￾mony on the path of medicine.

—José A. Roquet, M.D.,

President of the Scientific Association of Medical Acupuncturists of Barcelona (Spain)

Thomson-Shore

Green Press Initiative

Stamp Centered Here

THE TREATMENT OF

MODERN WESTERN MEDICAL DISEASES

WITH CHINESE MEDICINE

SECOND EDITION

THE TREATMENT OF

MODERN WESTERN MEDICAL DISEASES

WITH CHINESE MEDICINE

SECOND EDITION

A TEXTBOOK

&

CLINICAL MANUAL

BY

BOB FLAWS & PHILIPPE SIONNEAU

Published by:

BLUE POPPY PRESS

A Division of Blue Poppy Enterprises, Inc.

5441 Western Ave., Suite 2

Boulder, CO 80301

www.bluepoppy.com

First Edition, October 2001

Second Edition, October 2005

ISBN 1-891845-20-9

COPYRIGHT © BLUE POPPY PRESS, 2001. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, transcribed in any form or by any means, electronic, mechanical,

photocopy, recording, or any other means, or translated into any language without the prior written permission of the publisher.

DISCLAIMER: The information in this book is given in good faith. However, the author and the publishers cannot be held responsi￾ble for any error or omission. The publishers will not accept liabilities for any injuries or damages caused to the reader that may result

from the reader’s acting upon or using the content contained in this book. The publishers make this information available to English lan￾guage readers for research and scholarly purposes only.

The publishers do not advocate nor endorse self-medication by laypersons. Chinese medicine is a professional medicine.

Laypersons interested in availing themselves of the treatments described in this book should seek out a

qualified professional practitioner of Chinese medicine.

Cover & Page design: Eric J. Brearton

COMP Designation: Original work

10 9 8 7 6 5 4 3 2

Printed at Thomson-Shore, Dexter, MI on Recycled Paper and Soy Inks

Library of Congress Cataloging-in-Publication Data

Flaws, Bob, 1946-

The treatment of modern Western diseases with Chinese medicine: a textbook &

clinical manual: including indications for referral to Western medical services / by Bob Flaws & Philippe Sionneau.

p. ; cm.

Includes bibliographal references and index.

ISBN 1-891845-20-9

1. Medicine, Chinese. I. Sionneau, Philippe. II. Title.

[DNLM: 1. Medicine, Chinese Traditional. WB 50.1 F591t 2001]

R601. .F583 2001

610’.951–dc21

2001035418

WHAT THIS BOOK IS

This book is a textbook and clinical manual on the treatment

of modern Western medical diseases with Chinese medicine.

By modern Western medical diseases, we mean the disease

categories of modern Western medicine excluding gynecolo￾gy and pediatrics. By Chinese medicine, we mean standard

contemporary professional Chinese medicine as taught at the

two dozen or so provincial Chinese medical colleges in the

People’s Republic of China. The two main therapeutic

modalities used in the practice of this style of Chinese med￾icine are acupuncture-moxibustion and the internal admin￾istration of multi-ingredient Chinese medicinal formulas,

and treatment plans for each disease discussed herein are

given for each of these two main modalities.

Since the middle of the 20th century at least, Chinese doc￾tors in China have been working out the most commonly

seen Chinese medical patterns of modern Western diseases.

This book follows in that tradition. We have taken this

approach because this book is meant primarily for use by

Western practitioners, and Western medicine’s diagnostic

nosology is the dominant one in this milieu. Most Western

patients come to Western practitioners of acupuncture and

Chinese medicine with a pre-established Western medical

diagnosis. This is what they are seeking treatment for and

this is what they feel most comfortable talking about. It is the

lingua franca of the Western health care marketplace. It is our

experience that, rightly or wrongly, even most Western

Chinese medical practitioners themselves mainly think in

terms of Western disease diagnoses. Thus the need for text￾books such as this.

HOW THIS BOOK WAS CREATED

In creating this book, we based its materials on two main

sources: 1) the contemporary Chinese language Chinese med￾ical literature and 2) our own clinical experience as Western

practitioners treating Western patients. As far as we know, this

is the first time that the treatment based on pattern discrimi￾nation of some of these diseases, such as fibromyalgia syn￾drome, interstitial cystitis, celiac disease, and Lyme disease,

has been discussed in the Chinese medical literature. Under

each disease, we have included short introductory sections on

its Western medical etiology, pathophysiology, diagnosis, and

treatment. However, these short sections are in no way meant

to replace more complete Western medical discussions of

these conditions. We are also not suggesting that Western

Chinese medical practitioners can or should make such

Western medical disease diagnoses, nor that every practition￾er can or should treat every case of every disease presented

herein. Some of the conditions contained in this book or

some of the stages of some of these diseases go beyond the

clinical skills of most Western Chinese medical practitioners.

Therefore, readers are warned to be circumspect about what

they choose to treat, neither exceeding their legal scope of

practice or the bounds of good judgement.

In general, Bob Flaws is responsible for most of the

Introduction as well as the Western medical introductions to

each disease, their Chinese medical disease categorization,

and their Chinese medical disease causes and mechanisms.

Signs and symptoms for each pattern under each disease and

their treatment principles were a joint effort by Bob Flaws

and Philippe Sionneau. In most cases, Bob Flaws is respon￾sible for the guiding formula under each pattern, Philippe

Sionneau is responsible for the formula’s analysis, and both

Bob and Philippe worked together on the additions and sub￾tractions. Philippe Sionneau is responsible for the majority

of the acupuncture protocols presented in this book, includ￾ing the basic formulas, formula analyses, and additions and

subtractions. The concluding Remarks section to each dis￾ease was likewise a joint effort on the part of Flaws and

Sionneau.

PREFACE

HOW THIS BOOK IS ARRANGED

The diseases in this book are arranged in alphabetical order

for ease of use by busy clinicians. However, a second Table of

Contents is provided arranging these same diseases under the

main subspecialties of internal medicine, such as cardiovas￾cular disorders, gastrointestinal disorders, respiratory disor￾ders, neurological disorders, musculoskeletal disorders, etc. A

bibliography of Chinese, English, and French language

sources is given at the back as well as both a general and a

separate formula index.

HOW THE DISEASES INCLUDED WERE CHOSEN

As the title of this book makes clear, all the diseases in it are

modern Western medical diagnoses. In chosing what to

include and what not to include, we constantly found our￾selves juggling what is commonly seen by Western practi￾tioners of Chinese medicine, what there is information on

in the Chinese language Chinese medical literature, and

what already exists in the English language Chinese medical

literature. Some of the diseases in this book are not so com￾monly seen in the West, such as idiopathic thrombocy￾topenic purpura and aplastic anemia, not to mention

Behçet’s syndrome. However, these diseases are routinely

included in Chinese language texts of this type. Although

Western practitioners may not need daily access to the infor￾mation on these diseases, when they do, this information

will be available to them. In addition, they also give evi￾dence of how Chinese medical practitioners think about

and treat such Western medical diseases. Therefore, they

serve as a model of a methodology as well as a clinical reper￾toire. If one understands how the Chinese medical materials

under these diseases was arrived at, then one should also be

able to do the same thing when faced with a Western med￾ical disease not currently included in this or other books on

Chinese medicine.

As the reader will see, some Western medical diseases which

are very common in the everyday clinical practice are not

included in this book. Mostly this is because good informa￾tion on their Chinese medical treatment already exists in

other English language sources and there were size con￾straints on how big a single volume such as this can be. For

instance, constipation is dealt with exhaustively in Philippe

Sionneau’s The Treatment of Disease in TCM, impotence is

dealt with in Anna Lin’s A Handbook of TCM Urology &

Male Sexual Dysfunction, colic, otitis media, and strep throat

are dealt with in Bob Flaws’s A Handbook of TCM Pediatrics,

depression and anxiety are dealt with in Bob Flaws and James

Lake’s Chinese Medical Psychiatry, and psoriasis and eczema

are dealt with in Liang Jian-hui’s A Handbook of TCM

Dermatology, all available from Blue Poppy Press.

TERMINOLOGICAL STANDARDS

As with other Blue Poppy Press books, the Chinese-English

translational terminology for all Chinese medical technical

terms used in this book is based on the work of Nigel

Wiseman as it has appeared in Glossary of Chinese Medical

Terms and Acupuncture Points (1990), English-Chinese

Chinese-English Dictionary of Chinese Medicine (1995), and,

more recently, Wiseman and Feng Ye’s A Practical Dictionary

of Chinese Medicine (1998). Readers wanting a definition of

any of the Chinese medical technical terms used in this book

should refer to the last title listed above. We believe it is the

single best Chinese medical dictionary existing in English at

the present time. Departures from Wiseman et al.’s suggest￾ed terminological standards are footnoted with explanations.

Chinese medicinals are identified first by pharmcological

Latin followed by the Pinyin romanization of their Chinese

names in parentheses. However, after identifying a medicinal

within a particular section in this dual manner, only Pinyin

is used when the same medicinal is discussed in subsequent

paragraphs. Similarly, Chinese medicinal formulas are also

identified dually throughout this text. We first give their

Chinese name in Pinyin romanization followed by our own

translation of that Chinese name in parentheses. In terms of

acupuncture points, these are identified first by their Chinese

name rendered in Pinyin followed by a channel-numeric

notation. These notations are based on the World Health

Organization’s suggested acupoint nomenclature system.

However, as in other Blue Poppy Press books, we have cho￾sen to abbreviate the channel names thus: Lu = lungs, LI =

large intestine, St = stomach, Sp = spleen, Ht = heart, SI =

small intestine, Bl = bladder, Ki = kidneys, Per = pericardi￾um, TB = triple burner, GB = gallbladder, Liv = liver, GV =

governing vessel, and CV = conception vessel.

WHAT THIS BOOK IS MEANT TO DO & WHERE

IT FITS IN THE CHINESE MEDICAL LITERATURE

As a textbook and clinical manual, this book is an example

of a particular genre within the Chinese medical literature.

In this genre, diseases are broken down into a number of dis￾crete patterns and then treatment protocols are given for

each pattern. While such a simplistic approach is not reflec￾tive of real-life clinical practice, it is a necessary step in one’s

Chinese medical education. Textbooks such as this are meant

as the first step in a process leading to a more mature and

complete understanding of clinical reality. They are not

meant as stand-alone bibles, and no such book can fulfill all

a clinician’s needs. After familiarizing oneself with the infor￾mation in a book such as this, the Chinese medical student

or practitioner is expected to go on to read various case his￾tories, research reports, and medical essays exemplifying and

elucidating how this material is actually used. More impor￾x THE TREATMENT OF MODERN WESTERN DISEASES WITH CHINESE MEDICINE

PREFACE xi

tantly, one’s clinical mentors are meant to demonstrate and

embody the real-life use of this information.

However, by and large, Western practitioners do not have

access to this supplementary literature, nor do most of us

have on-going mentoring relationships with “old Chinese

doctors” with 20-50 years clinical experience. Therefore, this

book is arranged somewhat differently from most Chinese

language examples of this genre. It is divided into two parts.

The first part is a general introduction to the theories and

principles that we believe are most important in treating the

types of complex diseases contained in this book. Most

Western patients with chronic diseases do not present a sin￾gle, neatly circumscribed pattern. Instead, they typically

present anywhere from a minimum of three simultaneous

patterns to 10 or more. While textbooks such as this must

present the discrete patterns under each disease, these pat￾terns do not appear in such a stark and simple manner.

Rather they combine in complicated multipattern presenta￾tions. This is why the kinds of diseases described in this book

are often referred to as “knotty,” meaning that they are com￾plicated knots of several disease mechanisms bound togeth￾er. When it comes to the Chinese medical treatment of such

knotty, multipattern conditions, there are certain Chinese

medical theories and principles which can help one under￾stand and untie such complicated webs. These include Liu

Wan-su’s theory of similar transformation, Li Dong-yuan’s

theory of yin fire, and Zhu Dan-xi’s theory of the six depres￾sions. Thus, unlike most such treatment manuals, the first

part of this book is devoted to an explanation of these

extremely useful theories.

The second part of this book is the treatment formulary sec￾tion. Like most textbooks of this genre, each disease or con￾dition is divided into a number of patterns with treatment

principles and protocols given for each pattern. This method

of presentation is a convention meant to demonstrate the

main disease mechanisms at work in each disease in as “high

relief” as possible. However, the reader is advised to always

keep in mind that this method of presentation is only a con￾vention. Although we have tried to include as many compli￾cated, multipart patterns under each condition as possible,

the patterns that appear in Chinese medical textbooks such

as this are only building blocks which must be combined and

modified in order to more accurately match each individual

patient. In Chinese medicine, patients are not squeezed into

patterns to make them fit. Rather, patterns are modified

around the patient to completely reflect each patient as they

actually are in any given moment of time. In an attempt to

underline this fact, the reader is reminded in the “Remarks”

section at the end of each disease that the real situation is

typically more complicated than any one pattern presented

above.

Readers unfamiliar with the Chinese medical literature and

the process of Chinese medical education may ask, “Why

create such a textbook if it is not congruent with clinical real￾ity?” The answer, or at least our answer, is that no words can

completely encompass reality. As Lao Zi said, “The dao that

can be spoken of is not the dao.” However, one can hint at

reality by approaching it from several directions until a fuller,

more complete picture is at least intimated. Presenting sim￾ple patterns under each disease is a necessary first step in

gaining clarity into the treatment of diseases by Chinese

medical pattern discrimination even though it is not the

definitive or last step. If one understands that textbooks such

as these only provide a sort of bare-bones map or ground￾work, then one can gratefully accept them for what they are

worth as part of a multipart process of maturation.

OUTCOMES STUDIES & CASE HISTORIES

Stastical outcomes studies and representative case histories

for most of the diseases covered in this text are available from

Blue Poppy Press. Blue Poppy Press currently publishes over

275 Research Reports on almost as many Western diseases,

with new Research Reports being added on a regular basis.

Each Blue Poppy Research Report contains abstracts of one

or more clinical audits or other outcomes studies published

in Chinese medical journals in the last 10 years. Many of

these reports also contain representative case histories as per

Chinese medical convention. In addition, Blue Poppy Press

publishes a quarterly on-line Chinese medical journal.

Typically, abstracts of 8-12 Chinese outcomes studies are

published in each issue of this on-line journal. Subscriptions

to this journal are free, and the journal can be accessed at:

www.bluepoppy.com.

We hope this book will be useful to many Western practi￾tioners of Chinese medicine. The authors take full responsi￾bility for any errors contained herein and ask our readers to

send us their corrections, amendments, and advice. We

would also like to thank Drs. John Pan and Robert J.

Casanas and Chinese medical practitioners Greg Bantick and

Simon Becker for their review of our working manuscript

and their many pieces of valuable advice which were includ￾ed in our finished product.

TABLE OF CONTENTS

(ALPHABETICAL)

Preface ……………………………………………………………………………ix

Introduction …………………………………………………………………………1

1. Acne Vulgaris …………………………………………………………………39

2. Allergic Rhinitis ………………………………………………………………47

3. Alzheimer’s Disease ……………………………………………………………53

4. Amyotrophic Lateral Sclerosis (ALS) …………………………………………59

5. Ankylosing Spondylitis (AS) …………………………………………………67

6. Aplastic Anemia (AA) …………………………………………………………73

7. Behçet’s Syndrome ……………………………………………………………79

8. Benign Prostatic Hypertrophy (BPH) …………………………………………87

9. Bronchial Asthma ……………………………………………………………95

10. Carpal Tunnel Syndrome (CTS)………………………………………………107

11. Celiac Disease ………………………………………………………………111

12. Cerebral Vascular Accident (CVA) ……………………………………………115

13. Cervical Spondylosis …………………………………………………………121

14. Cholecystitis/Cholelithiasis…………………………………………………129

15. Chronic Active Hepatitis (CAH) ……………………………………………137

16. Chronic Fatigue Immune Deficiency Syndrome (CFIDS) …………………147

17. Chronic Glomerulonephritis …………………………………………………153

18. Chronic Pancreatitis …………………………………………………………163

19. Chronic Prostatitis ……………………………………………………………169