The cultural climate of contemporary healthcare is changing rapidly. As the North American public increasingly discovers the validity and efficacy of traditional Chinese medicine (TCM), both patients and practitioners here are catching glimpses of the potential for a comprehensive cooperation between the previously separate worlds of allopathic (that is, ¡¥Western¡¦ or ¡¥modern¡¦) medicine and traditional Chinese medicine. This partnership has begun not only here but is also in progress in many of the nations in which modern and ancient medicines co-exist. There are notable examples of forward-looking hospitals and medical centers that are welcoming the assistance of TCM practitioners, and of TCM medical schools placing additional emphasis on the importance of training graduates who possess a broad understanding of both medical worlds, and being able to welcome and effectively communicate with partners within the allopathic model.
There are layers of action and potential throughout both worlds, but some are less ¡¥integrated¡¦ than others. An acupuncturist need not know surgical techniques in order to appropriately address the presenting problems of a patient who desires assistance in recovering from surgery. A surgeon need not know how to do acupuncture in order to recommend that the surgical patient pursue a course of acupuncture to assist in resolving post-surgical pain and swelling. The partnership across this line is assisted by, but not ultimately completely dependent upon, communication between the two professionals.
However, when the TCM practitioner specializing in internal medicine, endocrinology, or gynecology turns to prescribing herbal medicines while the internist, endocrinologist, or gynecologist turns to prescribing pharmaceuticals, the potential for enhancing, exaggerating, undermining, or complicating the other¡¦s efforts becomes much more apparent and potentially serious. When it comes to co-treating with medicines meant to be ingested, the need for communication becomes much clearer, and more urgent. The reasonable nexus of these two very different worlds would seem to be at the point of diagnosis, but even here it seems there could be a confounding welter of confusing terminology and approaches for both parties, creating a gulf between sincere professionals on either side.
While a neurologist would view and treat a headache patient from one angle, a TCM doctor would consider the same patient in light of a whole series of both similar and very different criteria. Neither is ¡¥right¡¦ or ¡¥wrong¡¦ for having a different approach than the other, and both have valuable healing services to offer. Although it is prohibitively expensive in terms of both time and life energy for all M.D.s to learn TCM and all practitioners of Chinese medicine to earn medical degrees, there can and must increasingly be a shared vocabulary of understanding accessible to both medical traditions. This common ground can enhance the ability of both TCM and allopathic doctors to cooperate in providing the highest quality care to their patients while observing the utmost care to safeguard all patients from untoward reactions, interactions or complications resulting from co-treatment.
The following pages are certainly aimed primarily at TCM practitioners who are functioning either in independent or group practices, in complimentary care group practices or centers, or in hospitals incorporating both medical traditions. However, those nurses, M.D.s, chiropractors, naturopaths, nutritionists and others who find themselves practicing alongside or in cooperation with TCM professionals will find the material in this text to be of help as they consider the purposes and actions of herbal medicines previously veiled by the mysteries of unfamiliarity, unique terminology and distinctive diagnostic strategies.
There is no disputing the superiority of combining individual skill, excellent training, and extensive experience in selecting precisely the right combination of herbs for the particular patient and precise condition, tailoring treatments to fit the surrounding climate, circumstances, unique patient constitution, and previous patient responses to individual herbs or combinations. However, there is also a long-respected broader territory of reliable treatment using pre-processed combinations of herbs for very effective application to a specific range of action and symptomology. This middle ground, appropriately catalogued, documented and explained, can be very useful to the practitioner.
An M.D. debating whether a particular pharmaceutical product is appropriate for a patient who is already taking an herbal formula need not return to TCM school to learn the individual characteristics of 5,000 herbal substances and the myriad applications of each substance and of combinations thereof if appropriate information is available to her or him regarding the constituents and pharmaceutical actions of the herbal formula that the patient is taking.
Similarly, a doctor of TCM need not obtain a degree in pharmacology in an allopathic medical school in order to gain precise and adequate information as to the potential for enhanced or conflicting actions of the herbal medicines under consideration for a patient who has already begun taking pharmaceutical products to address symptoms. Having a clear and extensive resource for understanding the nature and TCM-context actions of commonly used pharmaceuticals is a key asset for this practitioner.
We have selected the Evergreen herbal formulas as the exemplars in this Clinical Manual because these formulas represent the most recent and innovative approach of TCM to address modern illnesses. For these new formulas, though their effectiveness has been documented by much clinical and laboratory research, there is not currently sufficient English-language explanation to ensure understanding and proper usage among practitioners. In other words, it is necessary to make sure contemporary practitioners understand how these newest formulas work so they can make correct diagnoses and treat accordingly.
We choose to keep a simple focus in this volume. Thus, neither classical formulas, nor formulas from multiple sources are covered in order to avoid repetition or unnecessary complication of the discussion. There is abundant documentation that exists for classical formulas from centuries of clinical application. There is no need to revisit those classics here, as we already know what they do and how they work. Naturally, a practitioner taking careful note of the details of this volume will find that he or she can take general principles or specific information for use in considering other formulas, which is a positive by-product, though not the central focus of this text.
The Lotus Institute of Integrative Medicine intends for this Clinical Manual to provide not only a helpful resource for TCM practitioners and others, but also to form a bridge of communication precisely at the point of convergence of traditional Chinese medicine and other medical traditions. The thorough documentation and extensive discussion available for the products from Evergreen Herbs offer a broad and useful base from which to begin. It is our hope that the indexes, guidelines, and supplementary material will make this volume even more accessible and helpful; we welcome your feedback and suggestions for future editions.
Sincere regards and best wishes for your endeavors in providing superlative healthcare,
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