COLIN Chan Introduction of Herbal Medicine…. A) TCM Practice in Singapore.

COLIN Chan

Introduction of Herbal Medicine…

A) TCM Practice in Singapore

Legislation and Registrations

Regulation of TCM Practice

1. The Traditional Chinese Medicine Practitioners Act was passed on 14 Nov 2000.

2. The registration of TCM Acupuncturist started in 2001.

3. The registration of TCM physicians in 2002.

4. With effect from 1 January 2004, those who wish to practice the prescribed practice of TCM are required to be registered with the TCM Practitioners Board and possess valid practicing certificates. Complimentary medicine including Traditional

Chinese Medicine (TCM). MOH , Singapore.

Copy right: : Colin Chan Copy right: : Colin Chan

Types of Registrations

• Full Registration.

• Conditional registration.

Proceed to the application of practicing certificate.


The term “Traditional Chinese General Medicine”

Means:

1. Acupuncture.

2. Diagnosis, treatment, prevention or alleviation of any disease or any symptom of a disease or the prescription of any herbal medicine.

3. The regulation of the functional states of the human body, on the basis of traditional Chinese Medicine.

Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006.


The term “Herbal Medicine”

Means:

1. Any material or product known or claimed to have therapeutic or other heath benefits which contains either raw or processed ingredients of plant, inorganic or animal origin.



Standard of good TCM practice …

Must include:

1. Good history taking and appropriate TCM clinical examination.

2. No remote initial consultations.3. Only use appropriate and accepted

methods of TCM treatment.4. Not to offer treatment packages in a form of

“guarantee of a cure”.5. Referrals.



The Medical Records …

Must include:

1. Particulars of patient. (Name, IC, Gender, Age, Add, Contact)

2. Drug allergies and medical history.3. Main complaint.4. Other observations.5. Diagnosis.6. Treatment.7. Prescription.8. Instructions to patient.

Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006


Must include:

Name and signature of TCM physician. Name and address of place of practice. Name and address of patient. Date of prescription. Name and dosage of herbal medicine. Total amount to be supplied. Route of administration. Preparation method.


Prescription…


TCM is the study of…

• TCM theories

• TCM diagnostic doctrines, principal of treatment and treatment methods

• Herbal medicine and TCM prescriptions

• Acupuncture

• Ailments of different disciplines

• Diet Therapy/Tuina/History/Case studies etc.


B) Before the application of Herbal Medicine…

TCM diagnostic doctrines

• 4 analytical methods. (collect information)

• 8 parameters. (categorize conditions)

• Diagnosis based on Qi, blood and body fluid.

• Diagnosis based on 6 meridians.

• Diagnosis based on organs/viseras.

• Diagnosis based on pathogens etc.


• Observation (tongue). 望 • Auscultation/Olfaction. 闻• Interrogation (Asking). 问• Palpation (pulse). 切

TCM Analytical methods


Observation of the tongue …

Tip – Heart/Lung (1st)

Center – Spleen/Stomach (3rd)

Root – Kidney (4th)

Margin – Liver/Gall Bladder (2nd)

• Body and Coating

color, shape, texture, movement, nature


Example …

Normal


Palpation 切•Pulse (Very common, usually radial pulse).

•Chest.

•Abdomen.

TCM diagnostic method


Analysis of the pulse …Include:

Speed.Strength.Shape and dynamics.Flow and regularity etc.

Front: Cun 寸

Middle: Guan 关

Rear: Chi 尺


Example …Some examples:

• Floating.• Deep (sink).• Late (delayed).• Rapid.• Smooth.• Un-smooth. • Bounding.• Soft and floating.• Full.• Thin and small.• Abrupt and irregular.• Slow and irregular etc.


Great clinical significance in TCM…

1. When disease occurs, qi and blood vary leading to pulse change.

2. Pulse examination can establish… • the health status of the patient, • the characteristics of causative factors,• the progression and changes of ailments.

The pulse …


Applications of the 8 parameters …• Exterior / Interior (depth).

• Cold / Hot (characteristics).

• Deficiency / Excess (aggressiveness).

• Yin / Yang (Over-all status).

It often combines, interact, inter-change in clinical settings.


Take 5 …


• Principal: As a basic guideline to treatment.

• Methods:

1. Internal treatment (herbal medicine, diet therapy).

2. External treatment (acupuncture, tuina, topical).

Principal of treatment …


C) About TCM Herbal Medicine


TCM Treatments …

The use of CMM:

Legally available in Singapore (GMP standard, HSA tested).

Reasonable quantities. Name of medicine as used in CMM.

PS: CMM: Chinese Herbal Medicine Materia Medica



Types of CMM…

1. Plant type.

2. Animal origin.

3. Insects group.

4. Marine source.

5. Mineral source.

PS: CMM: Chinese Herbal Medicine Materia Medica.


(root / stem / bark / twig / bud / petals / flower / leaves / fruit / seed,etc) .

Treatment methods

Mainly 11 ways (internal)…

Perspiration (Han)

Emetics (Tu)

Purging (Xia)

Harmonize (He)

Warm (Wen)

Clear (Qing)

Tonify (Bu)

Disperse (Xiao)

Sinus clearing (Kai Qiao)

Calming (Zheng Nai)

Astringent (Gu She)


Herbal Medicine

The study of Herbal Medicine in…

Categories.

Properties and Characteristics.

Harvest and Storage and treatment of herbs.

Clinical usage (pairing, dosage, preparation and consumption etc).

Herbal Prescriptions.


Herbal Medicine and Prescriptions

Categories…

Dispersing exogenous pathogens agents.

Purging agents.

Harmonizing agents.

Heat clearing agents.

Dampness dispersing agents.

Diuretic agents.

Anti-arthritic agents.

Warming agents.

Clearing sinuses agents.


Categories…

Calming agents.

Liver wind calming agents.

Qi regulating agents.

Heat clearing agents.

Blood regulating agents.

Digestive agents.

Cough and phlegm agents.

Tonic agents.

Astringent and anti worm agents.

Herbal Medicine and Prescriptions


Properties and Tastes of Herbs

The 4 properties are…

Cold

Cool

Hot

Warm

(Neutral)

The 5 tastes are…

Acrid

Sweet

Sour

Bitter

Salty

(Bland)


Examples of herb…

Examples of herbs…

The Use of Herbal Prescriptions in Western clinical settings

Commonly given as supplements…

Single drug (Herbal) prescription

Complex drug (Herbal) prescription


Herbal Ma Huang

Property: Warm

Taste: Acrid

Channel: Lungs and Kidney

Traditional usage:

Exogenous febrile disease of the wind-cold type

Research:

• Active ingredient: ephedrine

Modern usage:

• Cough mixtures

• Bronchodilators


Herbal Gan Huang Cao (Penthori Chinenesis)

Property: Cold

Taste: Bitter

Channel: Liver , Gall Bladder and Kidney

Traditionally usage:

Oedema, injuries, amenorrhea

Research:

• Active ingredient: Quercetin and Gallic acid

Modern usage:

• Jaundice

• Hepatitis, Fatty liver, Ca Liver

Complex drug (Herbal) prescription

Capsule Artrex

Combination of 4 types of herbal medicine

Withania Somnifera, Boswellia Serrata

Curcuma Longa, Zingiber Officinale

Research:

• Active ingredient: Contains immuno-boosters, analgesics agents, anti- arthritic agents, anti wind agents

Modern usage:

• Osteo-arthritis

Withania Somnifera (Immuno-booster effect)

Boswellia Serrata (Anti-inflam. effect)

Curcuma Longa (Analgesic effect)

Zingiber Officinale (Anti-arthritic effect)

Modern development of Herbs

Example: Chrysanthemum…菊花

TCM: Slightly sweet, Bitter, Cold.

Lung and Liver Channel.

Clearing of heat agent.

Modern: Anti bacterial and virus effects.

Streptococcus, Staphylococcus, Pseudomonas

TB Bacillus, Flu Virus, Skin Virus.


TCM physicians are not allowed to prescribe/dispense any western medicines.



Conclusion

1. Getting more common in western clinical usage. (as Supplements).

2. Not able to fulfill the full principle of treatment in TCM

3. Disadvantages noted.

4. Technical issues noted.

The End

COLIN Chan Introduction of Herbal Medicine…. A) TCM Practice in Singapore.

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