a few more thoughts on NM

[Guest guest]

I wrote this essay in early 1994 and last revised it in 1999. I do not

necessarily agree with everything I wrote at that time,but it looked

pretty good at a glance.

 

A brief essay on the TCM view of the Naturopathic healing Crisis

 

There is an apparent discrepancy between the naturopathic admonition

to not suppress natural healing responses ( fever, discharges, cough)

and the dictum in chinese medicine that discharges be stopped and heat

cleared. However, upon further investigation, the correct practice of

chinese medicine (CM) is revealed to be in harmony with classical

naturopathic medicine (NM). I shall examine the treatment of fever,

colds, chronic discharges and diarrhea, to illustrate my points. I

shall also take a look at the healing crisis.

Fever is an important mechanism for restoring health. Modern science

has shown that increased activity of the immune system is caused by the

elevation of body temperature. Naturopaths have long respected the

power and importance of fever in restoring health. Not only is fever

viewed as curative in acute infection, but also in the recovery phase

of a chronic disease that has been treated naturopathically.

Hippocratic, Galenic, and Tibb Unani medicine (an arabic offshoot of

greek medicine, still practiced widely today), all used the fever as

their ally. Modern naturopathy expressly states that suppressing the

fever allows toxins to remain lodged in the body, promoting chronic

inflammation and disease.

CM treats fever differently, depending on whether it is acute or

chronic. Acute fevers can occur with patterns of Cold or Heat (TCM

medical terms will be capitalized). Thus, while Heat is always cooled

in CM, fever is not always cooled. In a Wind Cold invasion, the patient

experiences mild fever, generally no sweating (unless they are

deficient to begin with), body aches, nasal congestion, scratchy

throat. These symptoms are typical of the common cold. The method of

treatment called for is warm, pungent exterior resolving. These herbs

induce diaphoresis, temporarily increase body temperature, eventually

leading to reduced teperature and normalization. This promotion of

natural warmth of the body is used in most external invasions.

Even in Wind-Heat, diaphoretic herbs are used. The cooling formulas

used to treat Wind-Heat were actually designed to treat rather severe,

feverish disorders. These epidemic diseases arose in the 17th century

in China, and the old warming method for treating these fevers was

ineffective. Many people died before the introduction of the formulas

for warm diseases. However, these formulas, like yin qiao san, were not

designed for the common cold, and should be reserved for serious

situations. Heiner Fruehauf, Ph.D., chair of the CCM at NCNM has

likened them to antibiotics. It should also be noted that the herbs

used to treat surface symptoms (forsythia, lonicera, isatis) are not

the same as those used to treat internally generated Heat (coptis,

scute, phellodendron, moutan, scrophularia). The latter group is not

indicated in surface conditions. Because these formulas are

diaphoretic, I do not believe they are suppressive. They appear to

stimulate the immune system to attack toxins more effectively.

Occasionally, herbs like gypsum may be used to suppress a very high

fever. These situations, as in the use of bai hu tang, are life

threatening instances of dehydration.

When Heat is generated internally, fever may result, but the patient

may only feel warm, with no measurable increase in temperature. Fever

of this type is generally chronic, often tidal. The position of TCM is

that such fever often wastes the precious fluids and essences of the

body. Or, it is due to a depletion of yin essence from excessive stress

and labor, etc. In the latter case, the humoral factors that regulate

body temperature seem to be lacking, used up due to age or lifestyle.

Internal fever can be either Excess or Deficient. Cases due to excess

usually have Damp-Heat accumulation, due to diet. They rarely have a

measurable fever. They may feel warm, because their bodies are trying

to burn off the toxins in their guts. Because the pathogen originated

internally, it is flushed out through the internal avenues, not forced

through the skin. The herbs used to treat such patients essentially

promote the body’s ability to detoxify the liver and

digestive/eliminative system (as they are described in NM). Deficient

patients may have measurable fever, however, generations of chinese

physicians have discovered that if such patients are given

diaphoretics, they may worsen. This is because diaphoretics deplete

already tapped out bodily essences (in order to produce sweat). Some

such patients are not suffering from toxicity, but rather exhaustion.

Fever is their disease, not a healing reponse. It is not a response to

irritation, but an inability to maintain homeostasis in the face of

normal stress and aging.

What about when fever arises in the course of curative therapy? This

is expected in NM, but not in CM. Fever is the natural response of the

strong and healthy, in presence of toxins or external pathogenic

factors. NM relies on the observation that chronically ill patients,

when treated with diet and hydrotherapy, possibly with some gentle

stimulation of the “vital force” (homeopathy, acupuncture, eclectic

herbalism), often return to health via a fever and/or discharge

(discussed more below). Perhaps this is because this is the most

natural method of healing. When the body fails to eliminate toxins and

diseases through internal catabolism, the excretory organs and the

process of fever are the alternate routes.

Let’s entertain the possibility that chinese medicine does not cause

the healing crisis, not because it is suppressive, but because of its

elegance. Chinese medicine strengthens the “silent” mechanisms of

healing. Thus, if Damp-Heat is normally cleared by the liver’s detox

function, the ill patient does not necessarily need to find another

route of elimination, but one could also strengthen the liver’s

function with appropriate herbs. In both cases, the characteristic

tongue coat disappears during the course of therapy, indicating

success, not suppression. As Robert Svoboda, an eminent authority on

Ayurveda has pointed out, the healing crisis is not necessary to cure,

and is actually undesirable in many patients (Ayurvedic Healing).

Svoboda, recognizing that Ayurveda bears a superficial similarity to

NM, points out that the traditional Indian use of light diet and

cleansing teachniques (panchakarma) is done in a special way.

Specifically, herbs are used orally, topically, and rectally, to gently

soften the toxin accumulation (called ama in Ayurveda). This is done

prior to the actual cleansing. The result is that the toxins never

flood the bloodstream. They are eliminated without a crisis.

NM recommends the free flow of all discharges. Thus, diarrhea,

leucorrhea, polyuria, etc. can all be conceived as the body’s attempt

to relieve itself of toxins. Again, CM concurs with this in acute

disease, wherein purgation is used for dysentary and diuresis for UTI.

However, chronic examples of these symptoms are not generally

considered to involve toxins. If they do, it is in concert with weak

organ function. The leakage of these chronic discharges is considered

detrimental in CM. The loss of fluids is thought to deplete vital

essences. Thus, chronic diarrhea, sweating, etc. is always stopped, as

a matter of first recourse. Without Essence, the patient will die, no

matter how free of toxins he is. Toxins (Damp-Heat, etc.) can be

cleared later in such cases, but not via the organ that has been

weakened by chronic discharge. As stated above, discharge of any kind

is not expected in the course of treatment of a chronic disease with

CM. Again, the reasoning is similar. Because the toxins are eliminated

and the weaknesses restored, silently, there is no need for a discharge

crisis. Inspection of the tongue reveals that health has been

normalized, with no suppressed toxins.

 

 

 

Chinese Herbs

 

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