Positive Health Online

Introduction

Ancient societies venerated age and experience, giving respect to the elderly and allowing them to contribute their experience to society as a whole. Out of sight, out of mind does not relate to children anymore, but to the elderly. In today's youth-obsessed society, the elderly are pushed into the background and not seen as relevant. Treatment of the aged has become reduced to prescribing medication to keep many of our elderly docile and out of sight in nursing homes.

As many societies consider the thin spread of health resources and budgets in the management of a rapidly ageing population, antidepressants, mood enhancing medication, even anti-psychotic medication is not only widely used but is licensed for use with the elderly. Such drugs join the many other medication categories regularly doled out to frail bodies.

Anyone who has had first hand experience of how we manage our ageing relatives will know that overmedication does nothing to enhance the quality of life; it merely keeps the subjects quiet.

As their physical and mental resources lessen, these once vital people become anxious, afraid and grieve at their loss of control and function. They want to express how they feel and this should be acknowledged and managed within a holistic treatment strategy. Depression and lassitude in the ageing need not immediately be labelled as pathological, as this often triggers an even stronger medication chain, further impacting on their quality of life.

One of the primary reasons why more and more people of all ages, from all walks of life, are actively seeking complementary healthcare treatments and are willing to pay personally for them is a resistance to over medication. The World Health Organisation states that US$2300 million is spent each year on complementary therapies in England.[1] This is a direct resistance to over-use of strong and expensive medications. We cannot continue to accept over-medication as an ageing norm. We just end up with a suppression of emotions in a pharmaceutical haze.

The TCM Approach to Longevity and the Treatment of the Elderly

In Traditional Chinese Medicine (TCM) one of the most important texts is the Yellow Emperor`s Classic of Internal Medicine which says: "There is Yang energy in the human body like there is sun in the sky....and the bodily health of a man depends on the clear and floating Yang energy."[2]

Traditional Chinese Medicine has long concentrated on the idea of holistic treatment. This has been an accepted form of treatment over millennia, and long before it became fashionable to hold a holistic view.

It is only recently that the historical archives in China containing invaluable information have become available for study. Previously, they had been closely guarded by succeeding dynasties and latterly by zealous ministry officials. During the period of the Qing Dynasty, approximately one hundred and fifty years ago, China's Dowager Empress Cixi, originally a concubine from Manchuria, became the force behind the imperial throne. She needed all her energy, vitality and a clear head to survive the intrigues of court throughout her long life.

The physicians and pharmacists from the imperial court spent much time doing her bidding and during the Qing dynasty, wrote many herbal prescriptions for the Dowager Empress, or 'The Old Buddha', as she was known.

Thankfully these were faithfully documented by her attendants and remain in the archives. Many of these prescriptions have survived and are in use today. Their ingredients show a clear strategy of holistic treatment for regeneration and longevity.

These treatment strategies acknowledged the mental, emotional and physical condition of the patient and prescribed herbs and treatments accordingly.

The Three Treasures

The Tao, the Path or the Way, and The Taoist philosophy of one source or whole, is principal in protecting life's Three Treasures, by nourishing them and not deliberately diminishing them. This is a philosophy that we could learn from and use today and is one that is talked about by modern health gurus in many disciplines.

The Three Treasures, which we refer to in Traditional Chinese Medicine are Essence, Energy and Spirit, or as they are referred to in the practice of Traditional Chinese Medicine, Jing, Qi and Shen.[3] All three are irreversibly connected, interrelate and do or die together. You really cannot have an effective TCM treatment without treating all three aspects of a person. To borrow a religious concept, they are three in one, a trinity.

The Traditional Chinese Medical Assessment

Visiting a TCM practitioner can be an enlightening and hopefully a satisfying experience.

There will of course be a standard form filling procedure regarding medical history, lifestyle, diet and many questions regarding the presenting complaint. There is also a wider practical, more comprehensive form of assessment. Looking, listening, observing, palpating (examining using touch), even smelling are all vital aspects of the TCM assessment. That is not to say that your TCM therapist will be wandering around you touching and sniffing – far from it, but it is quite startling what information can be obtained from observation alone.

This includes observing demeanour, vitality, facial expressions and contours, mood, listening to the voice, the breathing, observing the tongue, feeling pulses, and palpating channels or meridians, when relevant. The information gathered will allow the practitioner to establish a root and branch treatment strategy, taking all 'three treasures' into consideration.

The practitioner is looking to determine the cause of complaint that has resulted from an imbalance in the body system. Because the human body is such a complex entity, it is often necessary to tonify vitality and function in one area while reducing it in another.

One major area of interest to your practitioner is the state of your tongue, as it is said that the tongue never lies, and that is quite true of a TCM tongue reading. Your state of energy, you're internal excess or deficiencies, your moods, even your anger and frustration will be displayed on your tongue.[4]

A decision will be made as to whether the condition is a deficient or excess one, or should the strategy be to tonify and nourish or reduce and dredge, or maybe both. In many cases it can be both as most of us are complex beings and can often present with an excess condition, over an underlying deficiency. A TCM therapist will then treat all three treasures in a Root and branch treatment strategy.

Biological Not Chronological Age

Our biological age, rather than our chronological age should be given prime consideration. How many people do you know whose looks and energy defy their known age? This is not only the genetic luck of the draw, but is also a triumph of nurture over nature. We can add to our Jing, and or essence, our Qi or vitality, by the way we live, exercise, what we eat and how we treat our ailments. This is also supported by current research at Tufts University in the US by Harvard graduates and endocrinologists Rosenberg and Evans.[5] They have defined a biological age measurement system called biomarkers. Biomarkers describe and measure critical biological functions that influence vitality and measure your biological age, regardless of what your birth certificate says. Their research has shown that should one or more functions become compromised they can be restored.

It is not necessary to accept that natural ageing means natural reduction of energy and capacity. We can stay and look younger for longer. Although this is exciting research, and biomarkers are a vital measurement system, the concept of restoration and regeneration of biological function and capacity through tonification of Jing or essence and Qi or vitality is not new to the TCM therapist.

We have never thought: "If you don't use it, you lose it." With TCM treatments, we can tonify and nourish the yang, or strength of the body, when lifestyle or illness has diminished it. That is one of the critical biomarkers. We can increase the basic metabolic rate, another biomarker, by tonifying spleen and kidney energy. We can help the body to regulate its internal heat, another biomarker.

While current research such as Evans and Rosenberg's concentrates on the biological functions and critical measurements, it ignores the emotions and the spirit or Shen - something that the Empress Cixi's physicians took into account. Close examination of her physician's treatment strategies and herbal prescriptions show that her Jing and Qi were being tonified, and her internal heat was successfully cleared. Additionally her spirit was being calmed and her moods and concentration were considered within the herbal prescription.

The imperial records actually give details of some of her favourite herbal remedies two of which are outlined below. Because she had many remedies in court, all these remedies were checked and then tested and tasted by her physicians before she consumed them.

'Modified Old Buddha'

This vital energy building and yin and yang reinforcing syrup was intended to strengthen the Empress or Old Buddha's vital energy. It tonified her spleen Qi and warmed the kidneys or the 'Gate of Vitality' as they are known in TCM. The syrup was a decoction of yin and yang tonic and balancing herbs to preserve her vital energy.

Herbs were added to treat Qi stagnation/blockage or her moods, and soothe her emotions so her Qi flowed smoothly. The herbs were decocted (boiled down to extract their vitality), tasted, added to honey to make syrup and given to her daily.[6]

In addition to taking this syrup and an additional prescription, Earthly Immortal and Golden Marrow Pill, for 100 days, records show that her vital energy was invigorated and her skin was lustrous.[6]

Eight Treasures Cake

These formulae of four Qi or vital energy tonics and four Xue or blood tonics were ground into a powder and made into small cakes of 30 grams each. This was a palatable way to take herbs regularly and one the empress preferred. This formula, known as Ba Zhen Wan, or 'Women's Precious Pills', is used today by women across the world to strengthen their Qi or vital energy and nourish the blood.[6]

Ginseng for Protection Against Disease

The Empress ordered that one gram of ginseng be prepared for her each day. This was a commonly used method of disease prevention at the time, which is still used today as I found out on a recent trip to China. I was offered a pot of Eight Treasure Tea, to which my hostess added a slice of ginseng. Like the Empress, she chewed the ginseng when the tea had finished boosting her immune system and strengthening her body's yang or vitality.

Ginseng was recorded as having the functions of nourishing organ functions, calming the mind, easing fright and promoting intelligence. Effects noted by Dr Jelleff Carr, a US scientist who has studied the effects of Ginseng in depth.[7] In Chinese Herbal Medicine, Ginseng is often the principal herb used to tonify Qi or vital energy.

Treatment of Vascular Dementia with TCM

Research has shown that the TCM approach can have a positive effect on vascular dementia. A recent study on 30 patients with varying degrees of vascular dementia, carried out by doctors Zhuang, Li, Zheng and Yang at the 1st Affiliated Hospital of Guangzhou University, shows this is the case.[8] After two months of combined treatment (acupuncture, moxibustion and Chinese herbs) there were significant differences in the clinical symptoms between pre and post treatment.

The clinical symptoms present to varying degrees in all 30 patients were headache, dizziness, hemi-paralysis, forced crying, laughing and other emotional disorders. Acupuncture was used on selected points on the patients every second day and moxibustion (heat) was used on selected acupoints, also every second day, so that the patients effectively had a treatment every day. The treatment lasted 30 minutes each day. Additionally, patients were given herbal formulae based on the diagnostic patterns of the disorder.

All the patients in this study were chosen according to accepted international clinical standards. They all had typical signs of local focus of the nervous system, confirmed by CT or MRI scans. Other types of induced dementia were ruled out for this study. The standards for evaluating the therapeutic effect of treatments were changes of patient's intelligence and self-managing ability in daily life as observed before and after treatment.

The results showed that of the 30 patients in the study, 12 had marked improvement, 15 had improvement and three had no improvements, giving an effective rate of 90%. The additional clinical symptoms of headache, dizziness, forced laughing and crying showed pronounced improvement with a 92.9% effect rate in emotional disorders.

Alice: A Case Study

While I was training to become an acupuncturist, part of my 'outreach' programme was to go into a nursing home and treat some of the residents. Alice (not her real name) in her early 80s was one of my 'ladies'. Although not able to get around much, Alice was on a cocktail of medication and shuffled from bed to chair. During the many discussions I had with her daughter and the monosyllabic responses from Alice herself, it emerged that Alice had been an active woman, always in control all her life. She had planned for her retirement and old age with meticulous care.

She lived alone and as she got older, availed herself of day care and family visits. When she became less able to manage, she refused to allow her daughter to arrange a live in carer, insisting with an iron will that she could manage. Following a fall, Alice went from hospital to the nursing home to recover, but in fact, she never returned home. Once she became mobile again she started to walk the corridors of the home continuously insisting she wanted to go home. For a busy, modern, understaffed nursing home, she was becoming 'troublesome'.

This caused great distress to her daughter as Alice was clearly not able to manage herself and afraid of letting a stranger into her house to look after her. There was no option but that she would continue to live in the nursing home as her daughter was not in a position to live with her.

The focus of her treatment and medication became sedation, as a still lucid resident who complained loudly and tried to order a taxi to take her home was not one the nursing staff was willing to cope with. Although her daughter was extremely unhappy at the over-medication of her mother, she was unable to complain with any effect as the home had a waiting list of people willing to take her place. Obviously neither criticizing the regime nor leaving was an option.

I worked on Alice with some acupuncture points, and some finger pressure on selected acupuncture points. I tonified her energy, worked on her Qi blockages and calmed her spirit. Over a period of 20 treatments, she became more responsive, and her eyes lost that dull look. She began to settle into her surroundings. We were able to have her medication changed and reduced from the heavy cocktail she had been prescribed initially to quiet her. Her appetite improved and she started to enjoy days out with her daughter.

Although she often talked of her home and her garden, she now realized she would live in the nursing home and seemed finally to accept the situation. While this was not the ideal solution for her, it was much better than existing in a zombie-like state due to over-medication.

Sadly I saw many people like Alice, being wheeled or shuffling into a modern, clean but soulless dayroom, to spend hours gazing at the television.

Conclusion

Chinese Medicine and other Complementary Therapies are relevant and useful for a holistic treatment for the chronically ill or the elderly. The treatments carried out during the Qing dynasty on an ageing Empress are as relevant today as they were then, perhaps even more so, considering the standard methods of treating the elderly through current popular, suppressive and costly medication.

References

1. WHO Press Release. WHO/38. May 16th, 2002.
2. Qi Wu Andrew et al. Yellow Emperor's Classic of Internal Medicine. China Science & Technology Press. p19. ISBN 7-5046-2231-1.1997
3. Reid Daniel. Guarding the Three Treasures. Simon & Schuster. London. p1. ISBN 0-671-71146-6. 1993.
4. Maciocia Giovanni. Tongue Diagnosis in Chinese Medicine (Revised Edition). Eastland Press. Seattle. 1995.
ISBN0-939616-04-1
5. Kenton Leslie. Age Power. Vermillion Press. London. p26. ISBN 009185746-5. 2002.
6. Professor Chen Keji. Imperial Medicaments. Foreign Languages Press. Beijing. p27. ISBN 7-119-01336-X. 1996.
7. Reid Daniel. The Tao of Health Sex and Longevity. Simon & Schuster. London. p241. 1989.
8. World Federation of Acupuncture Societies. World Journal of Acupuncture and Moxabustion. pp6-11. ISSN NO. 1003-5257. June, 1999.

Further Information

For a Registered Acupuncturist (UK) contact:
The British Council for Acupuncture, 63 Jeddo Road, London W12 9HO.
Tel: 020 8735 0400; www.acupuncture.org.uk
Ireland/N.Ireland:

Acupuncture Foundation:

Tel: 1850 577 405; acu@indigo.ie; www.acupuncturefoundation.org.