A toddler lies on her stomach. A doctor vigorously massages her legs while her mother talks to her. This department treats lower leg abnormalities. In paediatric out-patients, a nurse in starched cap tapes a patch containing herbs on a baby’s chest and then her feet for a chronic bronchial condition.
A few floors up, intern doctors gather to study MRIs in the surgical department, discussing treatment which may include surgery, post-operative acupuncture, herbal medicine and drugs.
This is the Guilin Hospital of Traditional Chinese Medicine, the headquarters of a complex that includes another hospital and two community health centres. Guilin is a small city in southern China, located on the Li River, with a population of around 1.34 million.
While it’s called a traditional hospital, it combines Traditional Chinese Medicine (TCM) and Western medicine. The general secretary of the hospital, Dr Roan Quan, shows me round; Dr Wang Guo Song, who specialises in diabetes, acts as translator. It’s a modern hospital which is being upgraded section-by-section as money becomes available. The 500-bed hospital has 31 departments and sees around 600 000 out-patients a year.
It’s much like any hospital you’d find in South Africa, until you take a closer look. In the same building as the state-of-the-art radiology section are acupuncture and massage. Side-by-side are two medicine stores, one with pharmaceutical drugs, another with Chinese patent medicines and a room packed ceiling to floor with herbs. In the quality control room, a cabinet displays some of the more commonly used herbs for quality control.
In China, herbal medicines account for 30 to 50 percent of total medicinal consumption, with over 6 000 herbs identified. In the pharmacopoeia of the People’s Republic of China (2005), which defines China’s herbal medicine standards, there are 1 146 monographs. Compare this to 380 in Germany and no official monographs in the US. TCM dates back more than 2 000 years, with herbal medicine and acupuncture developing along separate paths, and studied as separate disciplines.
In recent history, after the Chinese Communist Party came to power in 1949, many leaders were in favour of discarding TCM in favour of Western; others saw the value and usefulness of TCM, and a programme was embarked on to see how efficacious it was from a modern perspective.
Today the Chinese medical system is described as “walking on two legs” with its policy of developing both modern and traditional medicines. It has a substantial infrastructure of research, education and training in herbal medicine, with around 100 TCM research institutes and around 3 875 TCM designated hospitals.
It’s difficult for me to work out how decisions are made as to which medicine should be used when. At Guilin Hospital there are rooms for Chinese diagnosis, general examination and Western diagnosis. “The patients must be satisfied, they can choose,” says Wang.
The two systems come from such different philosophical backgrounds. The key to the way they work together is that TCM doctors have two years of Western medical training and medical doctors have two years of TCM training. At Guilin Hospital, 30 percent of doctors are Western-trained, the rest TCM-trained, a ratio set down by the government.
In the Department of Coronary Disease and Stroke, an elderly man is being treated after a severe stroke. There’s a wooden box on his stomach, with sweetly pungent smoke coming out. This is moxibustion, using Moxa (Chinese Mugwort, which burns slowly and evenly). Moxibustion is used to increase heat to an area in “cold” conditions. He is also being given electrical therapy, is getting oxygen, and has had a tracheotomy. At the same time a mechanical device slowly moves his right leg up and down. He will also have acupuncture and herbal medicine.
As in every hospital, the pharmacy is a busy place. Here, however, pharmacists rush around weighing out different herbs according to prescriptions, mixing and packaging them for patients to boil at home.
In the general medicine wing there’s a section for Women’s Diseases. Breast cancer is treated with TCM and chemotherapy, with good results, says Wang.
The 5th floor is Dr Wang’s section, Diabetes Mellitus and Kidney Disease. Diabetes is a growing problem here as people increasingly eat more refined foods. We’re told that the proliferation of KFCs in China means “Kids Fat Coming”.
Diabetes is treated with Chinese herbs, and at the foot clinic a herbal dressing is made up, according to different symptoms. They are also successfully using stem-cell therapy for low blood flow in the lower legs.
In a lecture room a blackboard is covered in English writing, surprisingly. Dr Wang explains that every Wednesday there are lectures on TCM and Western medicine to update the doctors’ knowledge. The room is also used for lifestyle education.
In the surgery section there’s a room for herbal steam baths for pain relief for those awaiting surgery; post-operatively, they are likely to receive acupuncture.
The newly built TCM centre also houses diagnostic equipment for X-rays, angiography, CT procedures and mammograms.
As we tour the next floors, things become more interesting to me as someone foreign to this kind of hospital. A doctor is doing “cupping” on a patient with a chronic cough: using a flame she creates suction in bamboo cups and places them all over the body. Babies are vigorously massaged using Tui Na (a “push and pluck” massage), and small children receive acupuncture. There’s a blood- letting room, which is not as bad as it sounds: as a way to treat some conditions, anything from a few drops to a few millilitres of blood is removed (using a needle or suction cup), a very effective treatment. Another therapy I hadn’t heard of is Guasha therapy, where the skin is scraped to raise a sha (rash) to promote qi (life energy) and blood circulation, as well as the removal of toxic heat, stagnant blood and lymph fluid.
TB, says Wang, had at one stage almost disappeared in China, but is returning. HIV, as with TB, is treated at special centres separate from hospitals. Anti-retrovirals are being used with Chinese herbs which are very good for immunity.
In Beijing, at the Xiyuan Hospital of the China Academy of Chinese Medical Sciences, we see a master acupuncturist at work. He’s now 80 years old, moving from bed to bed, inserting needles carefully. Intern doctors follow him, watching his technique. He works carefully, almost as if he is feeling for the right point, the right depth to push the needle in. He only sees about 40 patients in the morning: others see 100 a morning, their technique different and much faster. Acupuncture, perhaps better known in the West than the more extensively used herbal medicine, is also a developing science, and techniques change; today heat is used and electro-stimulation is added to the needles.
At the Qiqong Tui na department Dr Tu Ren Shun, a qualified medical doctor (and a fifth-generation Qiqong practitioner) treats difficult cases. A woman from Singapore tells us he’s the best around, which is why she’s come so far. She spent months in a wheelchair after a stroke, and after four sessions she’s walking. Dr Tu Ren , with EU funding and a team of talented doctors, is doing research on the benefits of Qigong.
The China visit has opened doors and been valuable to the South African delegation. Professor Zhang Yi, an acupuncturist in Cape Town who organised the tour, says he hopes to build relationships with Chinese hospitals and set up an exchange programme. “It was interesting for me to see how acupuncture was being used as a new way to lose weight, and how Chinese Tui Na was used for infant cerebral palsy,” he said.
What China has to offer the world in medicine is a model for integration of different systems. South Africa, where traditional medicine is far from being regulated or integrated, could learn a lot. - Weekend Argus