Doctor blends the best of East and West

The 88-year-old Shi Jizhao recently completed a Chinese-English bilingual book about her six decades' of clinical experience combining traditional Chinese medicine (TCM) and Western medicine.

Entitled "100 Cases TCM Differential Diagnosis of Syndromes," the book is going through the editing at the Beijing-based Science Press before it will arrive in bookstores later this year.

She gained a better understanding of TCM principles when integrating Western medicine techniques and hoped to interest the domestic medical circles, she said.

Sitting in her home in Beijing, the retired well-known TCM doctor from the Peking Union Medical College Hospital (PUMC) still keeps a clear mind despite being hard of hearing. Her medical wisdom does not seem to recede with the passage of time.

"The doctors can always see more if they offer their medical solutions from the two systems," said Shi.

Mixing

Shi graduated from the Shanghai Medical College in 1941. In the 1950s, Shi was already a chief physician at the PUMC. No different from most Western medicine practitioners nowadays, Shi also doubted TCM's reliability, she recalled, while holding a firm belief that Western medicine was the most scientific medical system in the world.

"At that time, we Western medicine doctors had no concept about TCM theory and sometimes even discriminated against it," recalled Shi.

One day after she got to know that she was selected to join the TCM study group in the hospital, she retained the feeling of resistance for quite a while.

Although their teacher was Shi Jinmo, one of the most famous TCM masters at that time, she was still in a low spirit at his classes.

"To be honest, I had learnt nothing during that training," said Shi.

Before her happiness on returning to her post at the internal medicine department had cooled down, she was sent out to Nanjing, capital of East China's Jiangsu Province, to receive a further two years' intensive training in TCM.

"I only took it as an assignment to revive Chinese medicine, of course, not out of my own will," said Shi.

In Nanjing TCM Hospital, she met many well-known veteran Chinese medicine figures. What upset her most was the ardent hope from the old generation. "They thought highly of us and wished us to pass on their TCM knowledge," said Shi.

Gradually, she noticed that most of the patients would wear a big smile when they took a second visit to these old masters.

"So I started to be convinced that TCM could not just treat the patients, but also cure their diseases effectively," said Shi.

Shi did not waste her training this time. And she gained both the theory and clinical experience from her old masters.

As soon as she went back to the PUMC, she received an assignment to establish the TCM department in the hospital.

"I nearly cried when I got the news," she said. "I felt I was too incompetent to do the job."

Thus with the feeling of uneasiness, she started her lifetime experiment of integrating TCM and Western medicine.

Combination

Shi was not alone. Two old and experienced TCM doctors joined her department.

She watched attentively how they made diagnoses from different clinical syndromes and prescribed appropriate herbal medicines.

However, she did not rely on TCM alone and was always seeking more scientific proof from the point of Western medicine.

"TCM is directed to the symptoms, not the diseases. Once the experienced doctors diagnose the symptoms such as cold, cough, and stomach ache, they can treat them well. However, they may not know what complicated cases they have actually cured," said Shi.

For each visiting patient, Shi would first arrange a routine pathology examination in the lab to make sure of the causes of their diseases. Then she would make use of TCM theories in diagnosing the conditions and prescribe herbal medicine.

TCM diagnostic methods require doctors to feel the pulse of the patients and look from patients' facial appearances, colours of the tongue, the urine, the stool, the skin, among others. These are important in what the academics call the TCM "differential diagnosis of syndromes."

Once, a patient had an attack of malignant malaria and was admitted to the hospital for treatment. But since the onset of the disease, the patient, a woman, started to pass pasty stools.

With intense treatment, the malaria test for the patient was negative. The doctor in charge considered there was no need for her to receive further treatment from the Western medicine perspective.

However, the patient, since her discharge from the hospital, had felt extremely weak and was prone to catch colds. She still had abnormal stools.

So she came to Shi's department for herbal treatment a week later. The microscopic examination showed nothing particular. Shi made a diarrhea diagnosis.

In TCM, the disease is considered to be a deficiency of Qi vital energy in the spleen and stomach, which should be invigorated.

So Shi wrote out two prescriptions of herbal medicine for her. After taking the medical concoction for two weeks, the patient's condition was markedly improved. A month later she came back looking very healthy with a rosy face.

Shi has established a complete medical record for each patient. "I have all their medical examination data, and it can help me understand what kind of diseases my herbal prescriptions have actually cured," said Shi.

Bodily functions

By keeping careful records, Shi has found that TCM differential diagnosis of syndromes was not all powerful. Sometimes, if the pathology was not made clear, the function of herbal prescriptions might be limited.

TCM could treat nettle rash patients well, but many of them had a relapse. It puzzled her for a while.

Finally, the lab findings revealed the culprit. In fact, a lot of the patients had liver diseases, which resulted in a lower immunity from the attack of nettle rash.

"Liver is an important organ of metabolic function. So it greatly affects the blood coagulation, immunology, and internal secretion. So there are a wide variety of clinical manifestations once the liver functions abnormally," explained Shi.

It was the knowledge of the liver from the Western medicine that had helped her resolve the TCM mystery, Shi said.

There were just several prescriptions Shi would commonly write out. "After certain combination and modification, they are effective in treating a wide variety of diseases," she said.

Especially for liver diseases, herbal medicine could generally achieve much more satisfactory effects than Western medicine, she summarized from her clinical experience.

Before Shi learnt TCM, she generally prescribed the most updated Western medicine for her patients suffering from liver diseases. It did not work well and so she could only advice them to have more rest.

One of Shi's colleagues in the hospital had been in the early stage of liver cirrhosis for years. He came to the TCM department with a final glimmer of hope that the herbal medicine might do him some good.

A month later, Shi encountered the doctor, who happily told her that his liver disease had fully cleared up.

What has kept Shi working on TCM is that it takes a holistic approach and the overall analysis of the illness, Shi said. The patient's condition might lead to only one prescription that could treat several diseases.

When a patient with liver disease came to her, he did not mention his thinitis at all. "However, years later, the recovered liver patient surprisingly told me that his thinitis had also disappeared," said Shi.

Unfair treatment

As one of the founders of the TCM department in the hospital, Shi had witnessed its rise and fall in the past 40 years.

During the early days, the TCM department, as a new rising force in the hospital, won great support from administration level. "At that time, there were the best herbal medicine in the hospital pharmacy," said Shi.

However, since the late 1960s, she has not felt that strong support again up till today. She said she has witnessed the status of her department going down.

As a doctor of integrating TCM and Western medicine, Shi seemed always to be excluded or even despised by both TCM doctors and Western medicine doctors.

"I felt so sad when I heard that the old TCM masters criticized that I had distorted the original face of TCM," said Shi.

However, in face of all these obstructions, Shi has not lost her heart.

"The TCM knowledge we have learnt all comes from the ancient medical classics and the old masters' experience. Though we could have developed TCM with the accumulation of personal experience, the process will be really slow and it will not keep up with the rapid development of Western medicine with the strong backing of modern science," said Shi.

Source: China Daily