Please allow us to introduce Dr Su Shan-Yu, expert in women’s health, lecturer in TCM Gynecology and Obstetrics at China Medical University and researcher in the field of post-pregnancy care. Dr Su is an old friend of Herbprime’s and we were delighted that she had time to sit down with Anthony O Connor (@Anthoneedles ) and speak about Chinese medicine’s unique view of women’s health and how we can support it.

Dr Su is also one of the lecturers on the UK Taiwan Academy of Traditional Medicine (@UKTATM ) Diploma in Chinese Herbal Medicine course. She is an excellent teacher and clinician, in very high demand by students at CMU, so we are very happy to have her on board.

Do you have any questions about women’s health for Dr Su or Anthony? Please leave them in the comments!

“What herbs are good for anxiety?”

I was asked this question by someone a few weeks ago. I gave an honest answer.

“It depends on the diagnosis.”

“Right sure, but what herbs?”

I wasn’t being evasive; one of the tenets of Chinese medicine is “Same illness, different treatments / different illnesses, same treatment.” When working with a condition we take into account the entirety of the patient’s presentation. Because of this, for certain patients in certain circumstances almost any herb can be utilised as at least part of the overall treatment. Our herbal formulas can include Yin Nourishing or Damp Draining herbs, Yang Tonifying or Heat Clearing. Our treatment approaches can involve calming, or moving, or nourishing, or clearing.

So the question becomes: given this level of complexity and personalisation, how can you prescribe effectively? This is where our training in the diagnostic and prescriptive protocols of Chinese medicine comes into play, but rather than explaining those topics in depth I looked for an analogy in the landscape around me, and I think I found one. Anyone that’s worked on or been around farmland will know what it’s like to transform a field from something wild into something that can be utilised; for crops or grazing or building on. Inspired by the sustainable farming methods so common in this part of Clare I saw some parallels in how I work as well. I hope you find it interesting.

Endometriosis (?)

Chinese medicine has a lot to say about period pain. Practitioners take into consideration cycle length, regularity, ovulation symptoms, pre-menstrual symptoms, whether these abate with the bleed or continue into it, even the quality of menstrual blood. Compared to this Western medicine has little to say about period pain until it starts to manifest in a way that can be measured with the tools of Western medicine. Then it’s given names like endometriosis or PCOS or others.

This is not to say that these conditions don’t exist or to undermine the experiences of anyone living with them, but this can lead to a very scary binary treatment approach of ‘Just take a painkiller / the pill and stop complaining’ to ‘You need major surgery’, with nothing in between.

In my clinic I’m noticing more women, especially younger women, have a much better connection with their cycles these days. They know approximately where they are on their cycle and how they tend to feel and what signs and symptoms they tend to experience around that particular time. With this naturally comes a curiosity as to what may be behind symptoms they’re feeling, and sometimes a real worry when it comes to issues like period pain. When the only labels you have for this pain are frightening ones like endometriosis, and when the only mainstream treatments for this label are so invasive, this can naturally cause concern.

This video is more about general period pain than endometriosis specifically, which I will talk about in a future post. But before I made a video about that I wanted to widen the conversation about period pain to a broader scope than just these Western diagnoses. Chinese medicine views this condition as a spectrum with endometriosis on the far end. We have different tools for dealing with different manifestations and like all our treatments, these are based on the person and how they are presenting individually.

“When should I see a practitioner?”

I’ve brought in a special guest to help me with this video. Last week Katie asked me a few questions about the right time to contact a therapist, ie when in acute need or when feeling better. But she also had other questions, relating to how practitioners manage a patient load and their own mental and physical health. I’m familiar with the first question as I hear it quite commonly, but the others revealed a way that patients might be thinking that had never occurred to me before. Katie kindly agreed to appear on camera to help me discuss these questions in todays quick video.

This is a tricky topic to address but one I see apparent every time I open Instagram, and in many recent conversations with friends and patients. I hope what I say may be of some use.

Given that I’m currently trapped inside by oddly-potent snowfall it seems an appropriate time to speak about the ‘Zuo Zi Yue’ or ‘Sitting Month’.

Chinese medicine views the time immediately after giving birth as extremely important for the mother. Great care and support is given to guiding her through the four weeks following labour. During this time the mother strictly rests and nurses while other family members take over all household chores. She also takes a series of Chinese herbal medicine formulas to both aid faster recovery from labour and to try to get ahead of any common postpartum issues.

The difference between this practice and what I see in my clinic is stark. The lack of support for mums postpartum is absolutely shocking, and in my experience can lead to issues that can carry forward for years. All of these things were of course exacerbated by lockdown, and the insane and very dodgy practices carried out by many hospitals.

But today I just want to speak about what can be done to support mothers. The day after International Women’s Day I’d like to offer an example of one practice which is woman-focused, honours the mother’s among us and pays them back for what they give during pregnancy and labour.

‘What herbs are good for my immune system?’

This is a common question, and one that doesn’t have a clear answer in Chinese medicine. Firstly, what people mean by ‘immune system’ isn’t always clear, and secondly it varies depending on presentation and circumstances.

If there is a bug going around that you want to resist we normally prescribe formulas that are a mix of herbs that benefit the Interior (your overall health) while Releasing the Exterior, expelling any pathogens that may find their way to you.

However, if you are in the early stages of fighting a sniffle, then the focus shifts purely towards Expelling the Pathogen with acrid, dispersing herbs. While this is an effective strategy it’s not appropriate to use long-term, as over time these herbs can deplete the patient, given their focus on fighting and Expelling Pathogens.

Finally, if the person is looking to support their immune system because they’re experiencing repeated issues of the respiratory system (e.g. recurrent chest or sinus infections), the focus then shifts towards regulating the Lung organ. Of course, we never treat in isolation in Chinese medicine, so regulating the Lung will usually involve regulating other internal organs as well.

This isn’t to say that Chinese medicine doesn’t treat the ‘immune system’, but rather that its approach is more subtle, time-dependent, circumstances-dependent and presentation-dependent. These three presentations are not mutually-exclusive either; the versatility of our formula construction allows us to mix, match and modify as needed for our patient, even taking things like the change of seasons into account.

People may be surprised to learn that many of the most important Chinese texts (particularly Chinese herbal medicine texts) deal extensively with epidemic and infectious febrile illnesses.

There’s a lot of those going around at the moment and while treating them I’ve found myself drawn towards a particular family of herbal formulas; those from the Shang Han Lun, a herbal medicine text from 200AD. The efficacy of these formulas when prescribed to patients separated by 8,000 km and 1,800 years astonishes me. The personal story behind the text, and the man who wrote it, Zhang Ji, is something I also find quite moving.

Today I took the opportunity to discuss the title of the text, what ‘cold damage’ is with relation to infectious illness and explain a little bit about how we approach treating infectious illnesses beyond an ‘anti-viral’, ‘anti-bacterial’ or ‘boosting the immune system’ approach.

Merry Christmas everyone.

Today, as an exciting sequel to my video on CHM and infectious illness, I present my experience being on the receiving end of a Wind - Damp - Cold pathology 😅.

Chinese medicine has multiple systems for categorising infectious illness, most of which are very different from the virus / bacterium-based categorisations of Western medicine. Though myself and Katie almost certainly picked up the same initial infection it manifested and progressed very differently for both of us. Not only did this require different herbal formulas for each of us, it actually necessitated using wholly different systems of diagnosis to arrive at these prescriptions.

A broad categorisation would be that I manifested with a Wind Damp Cold pattern and Katie with a Wind Damp Heat pattern. However these are extremely broad categorisations, to narrow things down to a formula required more specificity.

My illness fit neatly into the ‘Taiyang’ categorisation from the ShangHanLun (‘Treatise on Cold Damage’, herbal text from 200CE approx.) and I was able to draw from that.

Katie’s manifestation better matched the ‘Qi’ categorisation from the Wen Bing school (‘Warm Pathogens, herbal text from 1700CE approx.) and I was able to draw from this for her prescription.

Chinese medicine treats the disease as it manifests, and ideally gets ahead of pathogenesis before it happens. Particularly in the case of infectious illnesses they can change by the hour. Having a good understanding of the principles of how the body fights infection, as well as a large ‘toolkit’ of formulas and modifications to draw on, as well as familiarity with key signs and symptoms to guide your formula choice is important for effective treatment.

An interesting exercise in illness that has hopefully led to an interesting video and absolutely was not worth the sub-par meal we suffered through while getting ill

In Western medicine illnesses are often only identified when there is a measurable physiological change to the body; an increased white blood cell count, a growth of new tissue, a deficiency of iron etc. But illnesses often start long before this, with subjective feelings of discomfort or unease that are far more difficulty to quantify.

In one school of Chinese medicine practice we use a model called the ‘Four Levels’ of an illness. They are 1) Wei [Defensive Qi] 2) Qi [Nutritive Qi] 3) Xue [Blood] and 4) Yin.

The first two Levels of this system are ‘Qi’ levels. In this context Qi means alterations to the normal functioning of the body that are incorporeal_, i.e. they haven’t affected the structures of the body yet. The last two Levels deal with physical substances, Blood and Yin. These changes _are corporeal and measurable.

Chinese medicine is often said to treat illnesses before they begin. What we actually do is endeavour to treat them while they’re still at the Wei / Qi stage. How do you diagnose something that hasn’t manifested physically yet? We use our same tools of questioning, palpation, tongue and pulse diagnosis. We pay attention not just to symptoms but also ‘signs’, which are quirks of a person’s presentation that aren’t necessarily debilitating or bothersome but do give us good information about their overall health. Things like a preference for hot or cold drinks, what time they tend to fall asleep and wake up, their subjective body temperature and so on. This all helps us gather information about a person and build a ‘pattern diagnosis’ which allows us to begin treatment.

Trad session at the (now sadly closed) Daly’s Bar in Ennistymon.

I live alone. By January 2021 we were almost a year into lockdown, I wasn't working and I was starting to lose my mind a little. I wasn't in the worst circumstances, in fact I had little to complain about. But I definitely went to a strange place in my head to get through those days. I think we define ourselves a little through others' view of us, and in the absence of any other human contact I decided to film myself to see exactly how I was coping. I don't know if the result is good or bad. In fact I think that anyone that gets through these days by whatever means can call that an absolute victory.

This is a film about one day in lockdown, but since every day is the same this is also a film about life in lockdown.

A short (almost) film, suitable for people who like polychords, black and white seascapes and (potentially) Murakami

Is herbal medicine safe? Why are so many people afraid of it even when the WHO lists it as an approved treatment? I dig into these and other issues in this episode of Chinese Medicine Explained.

What animal products do Chinese medical practitioners use? What purpose do they serve in the medicine? What regulations are in place to protect endangered species? What exactly are the uses of rhino horn in Chinese medicine?

Recent news stories have focused on 'COVID Tongue' as a possible newly discovered symptom of COVID19. In this video I cover the usage of tongue diagnosis in Chinese medicine and how it might be relevant to the current pandemic.

Does acupuncture hurt? How are the needles inserted? Can I move while the needles are in? I answer these questions and more in this episode of Chinese Medicine Explained.

Referenced acupoints

YangLingQuan - GB34

ShenTing - GV24

What is Qi? What is its function in the body and in treatment? In the first episode of Chinese Medicine Explained I cover some common misconceptions about Qi and how it's actually used in Chinese Medicine.