February 2010
For me, this month marks the beginning of my London practice. I am now practising Chinese medicine including acupuncture in Chelsea. I am working from the Chelsea Natural Health Clinic on the Fulham Road. It?s a bit of return to my roots as I grew up in South West London and I'm very exited to be developing my practice in London. I will still be practising in Bath, my adopted home, as well.
January 2010
A bit of a rant this month I'm afraid. Listening to 'Any Questions?' on radio four last month there was a question about NHS funding for alternative therapies. And I was a little disappointed, but not entirely surprised, by some of the panellists' responses. I was particularly concerned that some of them:
- treated all possible alternative medicines as if they were all equally effective or ineffective;
- contended that there is no evidence base at all for any alternative medicines;
- but yet contended that all western medical drugs and procedures have a reliable evidence base.
However, fortunately a GP called in to raise just these points on 'Any Answers?' (the programme for public response to the original programme).
In particular one of the panellists, Ben Goldacre, who holds himself out as a scientist determined to shed light on 'bad science' seems to have fallen for the old trick that statisticians would refer to as 'mistaking absence of evidence for evidence of absence'. Essentially, a lack of scientific evidence for something does not mean that it does not exist; it may merely mean that the research has not been carried out.
Putting this into context: in the west at least, I think it is fair to say that funding for most medical research comes from the large pharmaceutical companies. Since there is no real benefit for them in funding research into treatments like acupuncture and herbal medicine, where the interventions cannot easily be replicated and mass-produced, they understandably have no real motivation for doing so. And as most people practising alternative medicine are sole practitioners with small businesses, there is little scope for them to carry out the necessary research themselves.
Going back to the 'Any Questions?' programme and media coverage of Chinese medicine in general, unfortunately, as the saying goes, the empty vessel makes the most noise; it is often those with least understanding and knowledge of a subject who put forward their opinions most loudly. It is so rare to hear someone say those wisest of words - 'I don't know'.
December 2009
The Tao Te Jing (the book at the heart of Taoism which has had a major influence on Chinese culture and in particular on Chinese medicine) is directed mainly at individuals but also concerns itself to a degree with principles of governance. Taking a simple example, it states 'If a country is governed wisely its inhabitants will be content...' And it was of this that I was reminded when some recently published research into homicide rates caught my eye a few days ago.
The research, carried out by a professor at Ohio State University, appeared to show a correlation over time between murder rates and peoples' views about the legitimacy of their government and how much they identify with their fellow citizens. Very simplistically, the more content people are with their government, the lower murder rate tends to be. The professor found this after analysing data from the past 400 years in the United States and Western Europe.
Previous theories concerning which factors may have the greatest influence on murder rates - from social causes such as poverty and unemployment to the effect of punitive, supposedly deterrent measures such as capital punishment - have all seemed to fall down when looked at over the long term.
To give a bit more detail, according to the author of the research the predisposition to murder is rooted in feelings and beliefs people have toward government and their fellow citizens. In the West, the individual is generally regarded as the core unit of society and we tend to try to find the causes for the ills of society at an individual level, by considering what makes individuals act in certain ways. But this research highlights that sometimes it can be useful to look at these things from a broader perspective.
Just to be clear, I'm in no way suggesting that countries like China which have developed from this different cultural base are currently better governed than Britain or the States. As it says elsewhere in the Tao Te Jing 'If a country is governed with tolerance the people are comfortable and honest. If a country is governed with repression, the people are depressed and crafty'.
October/November 2009
My attention over the past couple of months has been taken up in part with responding to a Department of Health consultation into whether practitioners of acupuncture, herbal medicine and traditional Chinese medicine should be subject to statutory regulation.
In this age where people complain of over-regulation, you may be surprised to learn that my own view - shared by many of those who practice herbal medicine in this country - is that statutory regulation is the best way forward. This is mainly because from April 2011, as a result of some changes to European law, unregulated practitioners will no longer be able to prescribe herbal medicines in the form of powders, granules, capsules and pills etc. which have been pre-prepared by third parties. So, unless practitioners have the facilities to prepare these kinds of medicines themselves - which as you can imagine is prohibitively expensive for most sole practitioners - they will only be able to give patients loose herbs to boil up and then only if they keep a fully stocked herbal pharmacy.
Until recently it seemed to be a question of 'when' not 'if' the profession would be regulated. But, whether because of financial concerns or otherwise, it now seems to gave slipped lower down the government's agenda and the Department of Health appears to be looking for reasons to justify not introducing regulation. The Chinese herbal medicine profession is currently lobbying hard to secure statutory regulation but it remains to be seen whether, in the current political climate with the focus on improving the economy and with an impending general election, we will succeed or this will be left by the wayside.
September 2009
Regular visitors to this website may have noticed two new additions this month. The first is my 'testimonials' page - an opportunity for me to share some comments and feedback from previous patients.
The second and more fundamental addition is the page giving details about my new low cost 'acupuncture only' service. This is a new service aimed specifically at conditions that can be treated in a straightforward way with acupuncture - for example back pain, joint pain and headaches - which usually require a more standard treatment meaning that the whole consultation process can be shorter, more streamlined and therefore less expensive.
So if you'd like to give feedback or want any further information about my new low cost service, get in touch.
August 2009
We've been hearing a lot recently about how the Met Office got their summer predictions wrong. Everyone's expectations were raised back in April that this would be a hot and dry summer, but we have so far been mainly disappointed.
When the Met Office recently revised their prediction, I was reminded of something I heard on the radio when the initial predictions were released. A natural forecaster who uses traditional methods for predicting the weather was being interviewed and, when asked what his predictions for the summer were, suggested it would actually be, at least in part, along the same lines as the previous few years. His standpoint was that it would be very unusual for it to be suddenly hot and dry for the whole summer after two years of extraordinarily wet weather. So while us optimists live in hope that we are still set for a scorcher later in August, so far the traditional methods have proved more accurate.
And while this disappoints me on the one hand, it also interests me; sometimes traditional knowledge can trump the latest cutting edge science.
Enjoy the summer!
July 2009
Continuing on the theme of research into Chinese medicine, this month saw the publication of several interesting studies relating to Chinese medicine, and in particular my attention was drawn to a couple which concerned women's health issues.
The first found that that certain forms of acupuncture can help in polycystic ovarian syndrome (PCOS) by decreasing activity of the sympathetic nervous system (a branch of the autonomic nervous system). This decrease is important because the raised sympathetic nerve activity that occurs in PCOS is a causative factor in insulin resistance, raised blood insulin, obesity and cardiovascular disease. In the study acupuncture also helped regulate the menstrual cycles of the participants, as well as reducing their testosterone levels and waist circumference - high testosterone and a large waist circumference both being risk factors in cardiovascular diseases.
The other study was a systematic review of research into the use of Chinese herbal medicine for endometriosis. The authors found evidence to suggest that Chinese herbal medicine could reduce the symptoms of endometriosis at a level comparable to standard Western treatment. However significantly they also found that Chinese herbal medicine typically resulted in fewer side effects than conventional drug treatment.
So that's more welcome and encouraging news.
June 2009
Episodic or chronic tension headaches - to the layperson headaches which are either frequently recurring or ongoing and are often stress-related - can seriously affect someone's quality of life. I'm not sure whether Western medicine has a satisfactory answer to this problem, but reassuringly a recent paper has indicated that acupuncture may well be of benefit.
The Cochrane library (home to a large catalogue of medical meta-review papers) has just published a paper updating a review carried out in 2001. The authors of this update conclude that 'acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches'. Knowing the terminology that is usually employed in such reports, I take this to be a very positive endorsement of the powers of acupuncture in relation to such headaches. It is particularly significant that the studies concerned looked at acupuncture as a prophylactic, i.e. using acupuncture in the prevention of such headaches, rather than just as a means of treating a current headache.
As I have mentioned previously in these postings, I think that high quality research is essential in developing acceptance of acupuncture, particularly in the West. This recent meta-review update is another a step towards that goal.
May 2009
There was an interesting article in this week's New Scientist about what is termed 'nocebo' which they described as 'placebo's evil twin brother'. The nocebo effect describes the phenomenon where, if we believe something is harming us, we will be harmed.
An example cited was of a man diagnosed with severe liver cancer and given only months to live. A few months later he died as had been expected. His autopsy however revealed that, far from being advanced, the tumour was actually still quite small and would not ordinarily have killed him. The inference drawn from this was that it was his belief that he was dying that actually killed him.
The article gives many other examples of the nocebo effect, including situations where alerting people to the potential side effects of drugs has led to them experiencing those side effects, even where they were taking a placebo!
This nocebo concept raises many very interesting questions about how medical professionals should communicate and interact with their patients in order to minimise the nocebo effect.
We should be aware of the power our beliefs and expectations can have over our health, whether for better or worse. Really placebo and nocebo are two sides of the same coin; they both represent the same power which is named 'placebo' or 'nocebo' depending on how desirable or otherwise the outcome is to us.
April 2009
To gain recognition and acceptance in the West (where the western medicine paradigm is the prevailing one), Chinese herbal medicine needs to prove itself through well conducted laboratory research and clinical trials. This is still limited outside of China mainly because there is little funding for it. The majority of medical research in the West is funded by pharmaceutical companies, and as Chinese medicines cannot realistically be patented in the form they are used, there is understandably little in it for them.
However there is still good quality research being conducted. For example, a team of researchers recently carried out a review into the effects of Japanese herbal medicine on gastrointestinal (digestive system) problems. Japanese herbal medicine is derived from Chinese herbal medicine and most of the herbal formulas used in Japanese herbal medicine are based on traditional Chinese formulas.
The reviewers found that a herbal formula called rikkunshi-to (known as liu jun zi tang in Chinese medicine) was effective in reducing the discomfort associated with functional dyspepsia (non-ulcer digestive problems) and dai-kenchu-to (da jian zhong tang in Chinese medicine) was effective at relieving constipation and post-operative ileus (disruption to the normal propelling function of the bowel.
Although in this case the findings relate to some fairly broad categories of illness - constipation and functional dyspepsia - often research examines specific conditions e.g. in this case functional dyspepsia, constipation and post-operative ileus. This is generally because it is easier to study a very narrow condition where the cause is known i.e. post operative ileus. However, in my opinion these type of findings are still helpful, not only because they may have broader implications for similar problems; but also because they add to the growing body of evidence in favour of herbal medicine.
March 2009
Another piece of research caught my eye this month, not simply for itself but also because it reminded me of a connected piece of research from 2007. Both studies were related to garlic and its health benefits.
It has countless health benefits from helping protect the heart, to preventing the common cold. It truly is a wonder food. But the research I saw this month suggests that its main health giving properties may actually derive from an acid that is produced by the decomposition of allicin, the main active ingredient.
In my mind this ties in with the 2007 piece of research which suggested that, while most of the health benefits of garlic are tested used raw garlic, cooking can reduce the levels of the health promoting compounds. But crushing the garlic (ideally ten minutes before cooking) can protect against the detrimental effects of cooking. Crushing or chopping garlic releases an enzyme, alliinase, that catalyzes the formation of allicin which subsequently breaks down into the beneficial compounds.
So there we have it. Eat garlic - loads of it if possible - but crush it ten minutes before cooking. Bish bosh.
Click here for previous journal entries.