Herbal medicine plays a mainstream role in insurance-reimbursed, government regulated, medical care in China and Japan. An estimated eighty five percent of Western trained allopathic physicians in Japan and China, use Kampō (Japanese traditional medicine) and traditional Chinese medicine respectively in daily practice. The standard of medical care is the same in Japan and China as it is in the United States. At Long Hua Hospital, in Shanghai, China, doctors sit in humble offices no larger than ten by fifteen feet, prescribing pharmaceutical drugs and herbal medicine, often concurrently, to between sixty and eighty out-patients per day. In the in-patient departments, patients are hospitalized while doctors assess the treatment of complex medical conditions with Western pharmaceuticals and Chinese herbal medicine.
Chinese medicine has a long history of evolution and development. It is a complete system of medicine with a unique theoretical basis called syndrome or pattern differentiation. On the basis of theoretical study and clinical practice made by previous generations and with the adoption of modern scientific theory and technology Chinese medicine continues to develop and play a major role in healthcare today. This is clearly observable in Shanghai University of Traditional Chinese Medicine's teaching hospital.
A tiered treatment approach is apparent at the hospital. When the evidence base shows that Western pharmaceutical drugs are the most effective for a disease, these drugs are given as the primary treatment. If there are known pharmaceutical drug side effects, Chinese herbal medicine is used to mitigate them. In these cases, Western drugs are primary and Chinese herbal medicine clearly secondary. Where Western pharmaceutical drugs are not known to treat a condition very well, Chinese herbal medicine is given as the primary treatment, even if this is not Western evidence based. With this integration of Western pharmaceutical drugs and Chinese herbal medicine, the patient appears to be the primary beneficiary.
The “tradition” of a three millennia old herbal medicine has been inherited and “modernized” in the following ways. First, the therapeutic effects of Chinese herbal medicine are being applied in a linear Western fashion, with the support of modern pharmacological research. For example physicians use Tian Ma (Gastrodiae Rhizoma) to lower blood pressure or Shan Zha (Crataegi Fructus) to lower blood pressure and reduce cholesterol. By using herbs, patients require less Western pharmaceuticals to achieve targets. In this example, a Western pharmaceutical drug to lower blood pressure might be the primary treatment, and the herbal medicine an assistant, because they both work well and result in an improved treatment outcome.
Secondly, following a more “traditional” approach, pattern differentiation is applied to biomedical conditions. Where Western drugs have limited success, herbs and formulas are prescribed based on these patterns. It is generally thought that a disease includes the whole pathological course while a syndrome [or pattern] is just the summarization of the disease process at a certain stage of its development. As an example, Western pharmaceuticals don’t have successful treatment strategies for Hashimoto’s thyroiditis, thyroid nodules or viral infections. In these cases, herbal medicine is used as the primary treatment modality, based on pattern differentiation, even if this is not Western evidence based. And thirdly where pharmaceutical drugs are clearly the treatment of choice, in oncology for example, herbal medicine is used to mitigate what can be severe side effects.
It is an eye opening experience to observe the sheer number of patients that present to simple doctors’ offices during one morning session. It is inspiring to observe the skill and scope of the doctors, as they apply their diagnostic and prescriptive skills, seamlessly intertwining the respective strengths of Western and Chinese medicine.