Treating the Heart and the Mind - A glimpse of TCM
I am neither a cardiologist nor a shrink by training, but I have been minding everybody else's business and I have treated heart and mood problems for decades. I first got involved in this field when I spent time learning the pulse diagnosis, a special diagnostic tool in TCM which is 2000+ years old. I was astonished to find out that many, estimated to be 60% or greater, of my patients have weak heart pulse. From there I further studied this subject and got involved more and more.
Once I asked a cardiologist friend of mine : How many percent of your patients feel good after all the currently available interventions (stents, balloons, by-pass etc.), maximal medical therapy and cardiac rehabilitation. The answer stuns me : 50%. This is just one doctor's experience, reflecting the type of patients he takes care of. The number indicated there is room for clinical improvement even in the 21st century when modern medicine seems to be so advanced.
So, where is the heart pulse? Put your right index finger lightly on patient's left distal radial artery between the styloid process and the scaphoid bone (wrist), an experienced practitioner can get valuable information from the strength, amplitude, depth, shape, width and other finger feelings of the pulse, as opposed to the western practitioners focusing only on the rate and regularity of the pulse. Needless to say, there is great limitation on how much one can tell from just the pulse compared to modern technology used to assess the heart function, such as stress test, stress-Thallium, CT angiogram, echocardiogram, coronary catheterization and heart electrophysiology study. Nevertheless, it is a simple tool which helps :
- Differential diagnosis in puzzling cases. For instance, somebody with exercise intolerance or substernal and stomach area discomfort, is it the heart, lung or stomach?
- To make preclinical/subclinical diagnosis and to embark on preventive medicine. Given how prevalent cardiovascular disease is in western society (still the number one killer), I believe many do have preclinical coronary artery disease and heart failure. The challenge is how to make early diagnosis before the first clinical event which is usually a catastrophe.
- To guide the use of Chinese herbs as vasodilators and blood movers/invigorators, to improve systemic and coronary blood flow. The brain and the heart get more oxygen and nutrients and they work better. In case of emotional disorders, there is interesting difference between western and Chinese approach. Western medicine has in recent years discovered different neurotransmitters in the brain responsible for certain function. One example of the neurotransmitter is serotonin which is dubbed the happy hormone. People who feel depressed get SSRI (Selective Serotonin Reuptake Inhibitors) to boost the serotonin level at the neuronal synaptic sites. The Chinese medicine practitioners do not know anything about the neurotransmitters and they simply treat the whole body. From the perspective of pulse diagnosis, I just treat the abnormal pulse patterns I suppress the pulse when it is too strong, soften it when too tense, slow down when too fast, and vice versa.
- Is it the heart or the mind, or both?
Through pulse diagnosis, I can only tell if there a weak heart. A heart that does not pump enough blood out also does not perfuse its own muscle fibers well through coronary arteries. I won't be able to tell if there is valvular problem or coronary artery disease or congestive heart failure with certainty. Most patients would agree that their head is empty, i'e., lack of mental focus and concentration, poor memory, poor executive decision capability, insomnia, if their left cun pulse in thin, weak, deep. With herbal formulas such as Tian Wang Bu Tang, Yang Xin Tang, Ren Shen Yang Rong Tang, single herbal combination such as Dan Shen plus Shi Chang Pu plus Yuang Zhi. If all 6 pulse positions ware weak there is generalized weakness and that person needs strong tonic formulas such as She Quan Da Bu Tang, Bu Zhong Yi Qi Tang or Bu Zhong Yi Qi Tang plus Liu Wei Di Huang Wan.
There are closed to 300 diagnoses in the 5th edition of Diagnostic and Statistical Manual of Mental Disorders which is regarded as the bible of psychiatry. Pulse diagnosis can not possibly differentiate all the diagnoses, however, through the overall pulse form, shape, amplitude, strength, length etc. of all six finger positions with particular emphasis on the left cun position, a clear clinical picture often emerges, and a simple treatment plan can be established.
In this era of integration, I am definitely an advocate of putting all the good practices together, such as psychotherapy, cognitive behavior therapy, group support, medications when indicated, and Chinese medicine. Patients with mental disorders may improve quickly with less western medications and hence fewer side effects.
Sept 23, Saturday
10:30 am-12:00 pm
Treating the Heart and the Mind - a glimps of TCM
Dr. Peter Sheng
8280 Montgomery Road, Ste 100
Cincinnati, Oh. 45236
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