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Modern TCM: Enter the clinic

The editor of Nature China reports on his first visit to a traditional Chinese medicine practitioner to find out how this ancient practice is dispensed in the twenty-first century — and to see if anything can be done to relieve his back pain.

The taxi rounded a corner and I wound down the window to let in some fresh air. Outside I could the see vibrant-coloured spittoons, hear the sharp clang of metal being worked and smell the scent of washed clothes hanging from ancient balconies. I had arrived in the old Yuexiu district of Guangzhou in south China. Although much of the district has taken on the modern sheen of corporate business, Yuexiu still contains enclaves of bygone times.

I was here to see if my persistent back problem could be helped. The past five years of office work and sitting at my desk had taken their toll. I had days when I woke up but could not get out of bed, and times when I tried to put on my socks but could not reach my feet.

I had never tried acupuncture before, so my TCM doctor, Xiuhua Chen, gave me a trial run by inserting a needle behind my ear.

Blood tests, X-rays and magnetic resonance imaging — everything at my Western-trained doctor's disposal had failed to identify the root of my pain. He assured me that I did not have arthritis, cancer or any inflammatory diseases, and that the problem was likely to be mechanical. All he could give me were painkillers — and antacids to quell any upset stomach that the painkillers caused.

Over the past few months my back pain had worsened. Walking or straightening my left knee would induce a tingling sensation at the back of my leg that radiated up to my hip and down to my toes. It got to the point where I started looking for alternative treatments to help me return to normal life. I researched medicine establishments online and asked around for recommendations, and found one place that sounded suitable, even though it was 170 km northwest of my home in Hong Kong.

The pharmacy at the Guangdong Provincial Hospital stores its Chinese herbs in traditional wooden cabinets.

The old and the new

The taxi stopped in front of Guangdong Provincial Hospital of Traditional Chinese Medicine. This was my first visit to a traditional Chinese medicine establishment. Even from the street, this hospital looked unlike other modern hospitals I been to before. Hanging on the wall near the entrance was a large LED display. Local people were standing below it, performing a series of slow movements and stretches in time with instructors on screen. They were doing baduanjin, a form of medical qigong, to strengthen their qi.

Women practising baduanjin in front of the Guangdong Provincial Hospital.

Guangdong Provincial Hospital actually provides integrative treatment, combining TCM and modern medicine. The hospital also claims to be the largest and busiest integrative hospital in southern China: more than 5.6 million patients visited in 2010 — around 15,000 patients each day.

Traditional approach

Once inside, my visit began on a familiar course to any visit to a medical facility. I filled in a registration form and received a smartcard to store my medical records. Then a nurse led me to my TCM doctor — Xiuhua Chen, who is also director of the Traditional Therapy Center. I told Chen of my medical history and described my symptoms. She asked me about my back problems as well as other questions related to how well I was sleeping and about my bowel movements. Then Chen took a good look at my tongue and felt my pulse.

But then the Asian approach to medicine became apparent. Chen concluded that the tingling sensation in my leg was caused by my back problem, and that I had xinhuo or 'heart fire' — a condition that causes restlessness, insomnia and oral ulcers (which I also suffered from). Chen offered me acupuncture to alleviate my pain, moxibustion and cupping to increase blood flow to my back, and bloodletting to clear the heart fire. She also reiterated what my other doctor had told me — that I might need to resort to surgery if my symptoms persisted.

The Traditional Therapy Centre at the Guangdong Provincial Hospital has a modern reception. As this was my first visit, I had to fill in a registration form. I was also given a smartcard to store my medical records.

Because I had never had acupuncture, I was unsure of what to expect — so Chen gave me a trial run. I sat down in a chair and she inserted a very thin, solid, stainless steel needle, about 3 cm long, into my head — just behind my right ear. When I stood up, I could feel that the tingling sensation had disappeared.

I was astonished: the needle insertion was fast and painless, and its effect instantaneous.

I was prescribed traditional herbs to treat my xinhuo (heart fire), which I was to take home and prepare into a type of tea. The herbs were vacuum packed and clearly labelled with information on the origin, net weight, and production and expiry dates.

The trial over, I followed Chen to a private room where I removed my clothes and lay down on my side on a treatment table. Chen inserted 2 needles into my head, 16 more into my back and 3 into my right ankle. This time, however, I could actually feel the needles enter my body. I told Chen where I felt the most pain and she adjusted the depth and location of the needles.

Chen then left the room and a nurse entered, pushing a trolley loaded with more needles, mugwort sticks, glass cups, and an alcohol burner. The nurse lit a mugwort stick and started circling it behind my back (which was still bristling with needles). Because I was facing away from the nurse, I could not see what she was doing, although I could smell the woody, spicy aroma of the burning mugwort, sense smoke against my back and feel heat through the needles. The moxibustion took around 15 minutes in total.

Treatment beds in the Traditional Therapy Centre set up for fumigation, which is a bit like aromatherapy. The machines blow herbal steam onto the body.

The nurse then pulled out all the needles, wiped my back with an alcohol solution, and started the cupping. By heating the air in the cup, each about 10 cm tall, and pressing it against my back, she created a vacuum that held it in place. I found the heat and the suction of the cups quite comforting, and a lot more pleasurable than acupuncture or moxibustion.

Herbs for home

“Finally it was time for the bloodletting and the nurse inserted more needles into the backs of my thighs.”

Finally, it was time for the bloodletting. The nurse inserted more acupuncture needles into the backs of my thighs and covered them with heated cups. Within 5 minutes, blood began to trickle from the base of each needle.

My treatment complete, the nurse led me to the TCM pharmacy to receive my medication. From the waiting area I could see the walls lined with traditional wooden cabinets where the herbs are stored. The herbs handed to me (to prepare at home — although they can do it for you on-site) were vacuum-packed, with the name, origin and manufacturing date clearly printed on the label. All in all, my bill came to 300 yuan (about US$50).

I walked happily away with my leg feeling much better. As I left the hospital, I saw the women still doing their baduanjin. I began to wonder if maybe I should start practicing baduanjin too.

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Cheung, F. Modern TCM: Enter the clinic. Nature 480, S94–S95 (2011). https://doi.org/10.1038/480S94a

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