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    Post-Treatment Care Guide

    Acupuncture and cupping are common techniques used in Traditional Chinese Medicine (TCM) to address a wide range of health conditions. It is vital to take proper care of yourself after undergoing acupuncture/cupping/scraping treatment. 

    To optimise the benefits of your acupuncture or cupping session and minimise potential side effects, follow these essential aftercare guidelines:

    1. Rest and Unwind:

    After your session, prioritize relaxation and avoid strenuous activities, exercise, or heavy lifting for at least 24 hours. Intense activities may interfere with the therapeutic effects of the treatment.

    2. Hydration is Key:

    Stay well hydrated by drinking plenty of warm water post-session. This aids in flushing out toxins and rehydrating your muscles and tissues.

    3. Keep Warm:

    Cover treated areas or dress warmly to support your body's healing process. When necessary, consider warm compresses for pain relief, and avoid drafts, exposure to direct wind, or cold temperatures. Cupping opens pores and channels, making the body susceptible to external elements like wind and cold. 

    4. Mind Your Diet:

    Refrain from dairy, processed meats, sugary foods, alcoholic beverages, and caffeine for at least 24 hours post-treatment, as they may hinder the healing process.

    5. Monitor Symptoms:

    Be aware of the benefits, side effects, and overall experience. Your feedback is valuable for both you and your practitioner.

    6. Self-Care Practices:

    Incorporate self-care activities such as meditation, gentle stretching, and deep breathing exercises into your daily routine to sustain the advantages of your session.

    7. No Swimming for the Day:

    Avoid swimming for the remainder of the day to prevent dampness and getting chilled, which can counteract the benefits of the session.

    8. Steer Clear of Hot Therapies:

    Avoid hot showers, saunas, and hot tubs after treatment, as they may exacerbate inflammation or bruising.

    9. Sun Protection:

    Refrain from direct sun exposure for 24 hours post-treatment, as your skin may be more sensitive and prone to sunburn.

    10. Avoid Driving if Lightheaded:

    If you feel lightheaded or giddy, refrain from driving. Rest until you feel better or let someone else take the wheel.

    As with any medical treatment, acupuncture and cupping may have some potential side effects. Here are some possible side effects to be aware of:

    • Soreness or Bruising: Mild soreness or bruising at the treatment site, which should subside within a few days. 

    (Note: The cupping marks are the results of stagnation which can include dead blood cells, old lymph fluid, and toxins that the body has not been able to eliminate via its circulatory system. )

    • Dizziness or Light-Headedness: Some may experience dizziness or light-headedness during or after treatment. It is a temporary sensation due to changes in blood pressure or circulation.

    • Fatigue and Drowsiness: Normal response as treatments stimulate the nervous system and promote relaxation.

    • Minor Bleeding: Acupuncture needles may cause minor bleeding, especially on acupoints on the head/face as many capillaries lie below the skin of the face. Cupping may cause skin irritation or even blisters.

    • Emotional Release:  Treatments like acupuncture and cupping can sometimes trigger an emotional release like emotional, tearful, or overwhelmed. This is a normal response to the stimulation of certain points in the body and can be an important aspect of the healing process.

    We encourage you to embrace these aftercare guidelines for a holistic and effective recovery. If you experience any concerns, reach out to our physicians for support. Your well-being is our priority.

    Bridging East & West: Holistic Diabetes Management

    In the first installment of our “Bridging East & West” series, we’re diving into how to manage diabetes from both Eastern and Western medicine perspectives. It’s not just about treatments but finding a balance that gives you a full picture of how to manage diabetes.

    Article reviewed by:
    Dr. Chuah Hui En – Western Family physician at One Wellness Medical @ Sengkang Grand Mall
    Physician Kean Chan – TCM Physician at Eu Yan Sang Premier TCM Centre @ Woodleigh Mall and Eu Yan Sang TCM Clinic @ Sembawang

    Subscribe to our Instagram or Facebook to get health tips on how Traditional Chinese Medicine (TCM) and Western medicine work together to promote holistic well-being.

    The rising incidence of diabetes mellitus is an issue of global concern. What exactly is diabetes, and how is it different in Western medicine versus TCM?

    Understanding Diabetes in Western Medicine:

    Diabetes is a chronic metabolic disorder due to poor insulin production or insulin resistance, leading to high blood sugar levels.

    Diabetes can cause complications in your body, such as nerve damage (neuropathy), eye disease (retinopathy), and reduced kidney function (nephropathy) and you may not know of the damage until you develop symptoms or screen for these complications.[1] 

    Types

    Description

    Type 1 Diabetes

    • An autoimmune condition whereby the body's immune system attacks and destroys the beta cells of the pancreas, making it unable to produce insulin.

    • Not caused by diet or lifestyle.

    • Typically develops in children or early adulthood but can occur at any age.

    Type 2 Diabetes

    • Most common form.

    • Occurs when the body's cells do not respond well or are resistant to the body's own insulin.

    • Often associated with overweight and excessive body fat.

    • Develops in older adults, with increased risk above 40 years.

    How does TCM view Diabetes?

    Traditional Chinese Medicine (TCM) does not use the term “diabetes.” Instead, a group of symptoms characterised by excessive thirst, hunger, frequent urination, gradual weight loss, or sweet-tasting urine is referred to as “Xiao Ke” (消渴).

    Diabetes falls within the scope of “Xiao Ke” (消渴) in TCM.

    TCM identifies 3 primary factors contributing to "Xiao Ke" (消渴):

    • Congenital deficiencies (先天禀赋不足) lead to weak organ systems.

    • Dietary imbalances (饮食不节), especially overeating and a preference for specific foods, with obesity being a significant trigger.

    • Emotional disturbances (情志失调) cause damage to vital fluids (郁火伤津), with prolonged emotional imbalances as a contributing factor to the development and worsening of diabetes.

    Treatment of Diabetes

    Western Medical Approach:

    Insulin:

    • Stomach enzymes disrupt insulin activity, so insulin needs to be injected or pumped into the blood.

    Other Medications:

    • Individualised selection based on patients’ conditions, response to medications, and blood sugar control.

    • To stimulate pancreatic insulin production.

    • Prevent the liver from producing and releasing glucose into the blood.

    • Inhibit carbohydrate breakdown to slow absorption.

    • Increase tissue sensitivity to insulin.

    • Prevent kidneys from reabsorbing sugar into the blood.

    Traditional Chinese Medical Approach:

    Focuses on restoring the balance between ‘Yin’ and ‘Yang’ of the body:

    • TCM diagnosis considers the progression of the disease, tailoring treatment based on specific patterns observed.

    • Focuses on cleansing heat, moistening dryness, generating fluids and replenishing ‘Yin’.

    • Multiple organs including the lungs, spleen (stomach), and kidneys, are implicated.

    • Acupuncture is used to regulate the flow of ‘Qi’ along the lungs, spleen and kidney meridians, helps our organs maintain balance, and reduces dependence on external insulin.

    TCM focuses on cleansing heat, moistening dryness, generating fluids and replenishing ‘Yin’.

    Chinese herbs can complement insulin treatment to reduce blood glucose, here are some herbal medications for common symptoms:

    Abnormally Thirsty

    • Honeysuckle flower (金银花)

    • Ophiopogon root (麦门冬)

    Large Appetite yet Loses Weight

    • Gypsum (石膏)

    • Anemarrhena rhizome (知母)

    • Chinese foxglove root (生地黃)

    Excessive Urination

    • Processed Chinese foxglove root (熟地黄)

    • Cornelian cherries (山茱萸)

    • Chinese magnolia berries (五味子)

    Lifestyle Tips for Diabetic Patients:

    • Regular exercise and a healthy diet are important.

    • Closely monitor blood glucose and carbohydrate intake.

    • Avoid sugar, oil, caffeine and alcohol.

    • Diabetics heal poorly from wounds. Avoid injuries and keep limbs clean to prevent infection.

    • Maintain emotional balance to minimise disrupting the flow of Qi.

    TCM Health Report

    Early Detection Saves Lives

    Get an analysis of your dominant body constitution and lifestyle tips to help improve it. Available in both English and Chinese at all general and One Wellness Medical clinics.

    Diabetes is a ‘silent’ disease in its early stages, individuals may feel completely healthy until complications arise. Detect and address potential health concerns early on to stay ahead in your wellness journey.

    One Wellness Medical GP x Eu Yan Sang TCM

    Explore our holistic diabetes management at Eu Yan Sang One Wellness Medical clinics. Equipped with both TCM and Western family medicine services under one roof – let our integrated expertise provide you with personalized solutions for diabetes management.

    Source: [1]  https://www.healthhub.sg/programmes/diabetes-hub/types-of-diabetes

    6 Signs of Sub Health

    A person who has mild symptoms such as a dry mouth or a runny nose can still be unhealthy from a TCM perspective, even without suffering from the usual illnesses like fever or flu. Find out what it means to have sub-health and know some warning signs.

    “Sub-health is imbalance in the body that has not developed into an illness yet,” explains Physician Lin Jiayi, who is based at the Eu Yan Sang TCM Clinic at Serangoon Nex.

    “A person who has sub-health can just feel uncomfortable. If she goes to a hospital to do a check-up, she would not be diagnosed with a disease.” This is because Western medicine tends to identify illness by the presence of specific pathogens.

    However, TCM evaluates health by observing the overall state of the body. While sub-health usually does not cause major discomfort, it indicates an imbalance in the body that might lead to more serious conditions or illness. That is why TCM physicians advise that one should monitor one’s health for symptoms of sub-health.

    What causes sub-health?

    Imbalance in the organ systems is the most common cause of sub-health.

    In TCM, one’s well-being is dependent on the harmonious relationships between five major organs— the Heart, Liver, Spleen, Lungs and Kidneys. In TCM, each organ is a system of functions that is not limited to the functions of the anatomical organs. For example, the Heart is thought to influence the Blood as well as the emotions. The organs also have interdependent relationships with each other: the Heart supports the Spleen, while the Spleen is restricted by the Liver.

    Sub-health can be the result of issues in a specific organ or, more typically, issues that affect more than one organ. “When it comes to sub-health, normally more than one organ is causing the problem,” Physician Lin notes.

    Common Signs of Sub-health

    Signs of sub-health can be easy to overlook. Be aware of these common symptoms.

    Sign 1: Insomnia

    Possible cause: A common cause of sleeping difficulties is Heart fire — too much Yang or too little Yin in the Heart system. This leads to an excess of heat that disturbs the mind and body. According to Physician Lin, Heart fire often occurs together with Liver fire because the two organs have a close functional relationship.

    Sign 2: Irritability

    Possible cause: The feeling of being irritated or stressed might be caused by stagnation of Liver Qi, meaning the flow of Qi through the Liver has been impeded. This prevents the Liver from effectively carrying out its functions, which include the regulation of emotions.

    Sign 3: Runny nose in the morning

    Possible cause: A runny nose or sneezing in the morning may indicate a deficiency in Lung Qi. Other symptoms of deficient Lung Qi include shortness of breath, being susceptible to flu and sweating easily.

    Sign 4: Constipation

    Possible cause: Deficiency in the Spleen can cause difficulty with bowel movements. Spleen deficiency may also lead to other digestive issues such as bloating and gastric pain. “Many people have deficient Spleen Qi because of their lifestyle,” reveals Physician Lin. “They consume too much junk food and cold drinks, and eat at irregular intervals.”

    Sign 5: Frequent urination

    Possible cause: A need to pee more frequently, especially at night, might be caused by a deficiency in the Kidney system. Another sign of Kidney deficiency is lower back pain.

    Sign 6: Hair loss

    Possible cause: Hair loss is often caused by a deficiency in the Kidney and Liver systems. These organs govern the Blood and nourishment of the body, and are closely linked.

    Simple remedies for sub-health

    To restore a person’s balance, a physician may recommend treatments or diet and lifestyle changes that target specific organs. Here are some possible remedies:

    • For conditions caused by Heart fire: Drink cooling teas such as Chrysanthemum and Lophatherum Herb (Danzhuye, 淡竹叶). It also helps to go to bed earlier.

    • For conditions caused by Kidney and Liver deficiency: Take Fleeceflower Root (Heshouwu, 何首乌) which works on the Liver, Kidneys, and Blood.

    • For conditions caused by weak Spleen: Avoid cold food, cooling food, and raw food.

    • Do not overeat and have meals at regular intervals.

    From the Traditional Chinese Medicine (TCM) perspective, your body constitution can be broadly categorized into 10 types. In this one-to-one personal session with the physician, you can find out about your current dominant body constitution. Getting to know one’s body constitution is the first important step towards taking control of your own health. Eu Yan Sang TCM Health Constitution Report includes lifestyle-changing tips and simple recipes that can benefit your particular body. Let the physician be your personal guide to nurse yourself back to optimal wellness.

    Eu Yan Sang TCM Health (Body Constitution) Report

    At just $48*, Eu Yan Sang’s Comprehensive TCM Health Report includes:

    • One-to-one detailed consultation with Eu Yan Sang’s qualified TCM Physicians

    • Diagnosis of your dominant body constitution

    • 13-pager comprehensive report in both English and Mandarin

    • TCM-based lifestyle recommendations to regain balance

    *Additional consultation charge applies at our TCM Centre and Premier TCM Centre, prevailing GST applies.

    How To Boost Energy If You Always Feel Tired

    According to Jeffrey Ong, a physician with Eu Yan Sang, a well-known name in Asia when it comes to TCM products and services, fatigue can arise from a weak body constitution, overworking one’s body, and an unbalanced diet. A weak body constitution can arise from inborn factors or illness. Lifestyle and work are also major factors as too much can lead to physical and mental exhaustion. An unbalanced diet can harm our digestive tracts. All these can lead to deficiency of yin, yang, qi, and blood in various organs, causing us to be unwell and experience fatigue.

    Causes Of Fatigue

    • weak body constitution

    • overwork

    • unbalanced diet

    These three factors can lead to deficiency of yin, yang, qi, and blood in various organs

    TCM Principles

    Some principles of TCM are in tune with conventional medical practices. “When it comes to dealing with fatigue, one of the most important factors is sufficient rest,” says Physician Ong. “Sleep is known to be the best natural remedy, revitalising one’s energy and boosting the immune system. Engaging in some mild aerobic exercises and leisure activities can help to relax one’s body and mind as well. Also, keep to a balanced diet and avoid cold drinks, fried and oily food.”

    In TCM theory, there are five major internal organs. “When one suffers from fatigue,” says Physician Ong, “any one of the five may be affected.” In general, however, “fatigue is associated with a weakness in the spleen and kidney.” He goes on to explain that, in TCM, the spleen is largely responsible for nutrition and metabolism while the kidney is in charge of innate essence and growth. “Fatigue is often correlated to these two organs,” he advises. TCM can strengthen these weakened organs via herbal remedies or acupuncture.

    Before the fatigue strikes, Physician Ong lets on that there should be some warning signs. Which signs you get depends on your particular body constitution. And your particular body constitution needs to be carefully assessed before a course of treatment can be prescribed, including herbal remedy, acupuncture, tui na, and cupping,” says Physician Ong. Combinations of treatments are sometimes used to increase effectiveness.

    If you have anaemia, diabetes, or other diseases, the course of treatment “will be based on the overall diagnosis of the patient’s entire body condition, not specific to certain diseases.” Still, Physician Ong advises patients to notify all their physicians of everything that they are currently taking to prevent herb-drug interaction.

    If you are already on a conventional course of treatment for fatigue, Physician Ong assures, “There are many patients who are taking Western medications and using TCM at the same time to complement the treatments.”

    Herb Remedies

    Here are some TCM herbs that can help to fight fatigue:

    • American Ginseng: good for people who work long hours and lack rest

    • Lingzhi: enhances immunity by boosting the function of white blood cells

    • Chinese Wolfberry: full of beta-carotene, an antioxidant, this herb is effective against tired eyes

    • Wild Chinese Yam: for people experiencing low energy coupled with digestive problems

    Supplements

    Besides taking TCM herb, a boost in certain vitamins and minerals could increase energy levels:

    • Vitamin B12: helps increase energy levels and lift concentration and mood[1]

    • Vitamin B9 (Folic Acid, Folate): insufficient amount of this vitamin could lead to confusion, depression, lethargy, and slow reaction time[2]

    • Vitamin D: a lack of this vitamin, which aids metabolism, could lead to low energy, poor-quality sleep, and mood swings[3]

    • Magnesium: vital for adrenal glands, the poor functioning of which can lead to fatigue[4]

    Stimulating Acupoints

    So you’ve heard of acupuncture. But you don’t always need an expert to insert needles at the appropriate points. There are certain easy-to-reach acupoints that you can massage about 20–30 times a day to keep yourself stimulated and energised:

    • He Gu: located on the dorsum of the hand, between the first and second metacarpal bones, in the middle of the second metacarpal bone on the radial side, it boosts qi and strengthens the immune system

    • Bai Hui: located at the intersection of the line connecting the apexes of the two auricles and the median line of the head, it helps improve mental functions, calms nerves, and promotes flow of qi

    Case Studies

    Physician Ong relates two cases in which he helped tired-out patients using a mix of treatments from the TCM medicine chest.

    One was a student burning the midnight oil for a big exam who snacked to stay awake. She soon lost her appetite, turned pale, and her stools became loose. “I diagnosed her condition as a deficiency in spleen qi, and prescribed herbal medication to tonify her spleen and boost the qi of her body,” he reveals. After a week, her condition improved. “She felt much more energised during the day and could perform better in school.”

    Another case involved a young working mum. She often felt stressed and frustrated, and had insomnia, dry throat, heart palpitations, and night sweats, which led to all-day lethargy. The lack of energy affected her work; she also had terrible mood swings at work and at home. “I diagnosed her condition as a deficiency in heart yin, manifested in signs of heatiness and restlessness,” says Physician Ong. “I prescribed herbal medication to nourish the yin and clear excess heat in her body; I also performed acupuncture on her to calm her nerves.” After a few more visits, her condition gradually improved and she was able to concentrate better at work.

    Now that you know how TCM approaches the treatment of fatigue, you should find out what diseases could be putting you through the wringer.

    References:
    [1] http://www.cheatsheet.com/health-fitness/5-natural-supplements-that-can-help-fight-chronic-fatigue.html/?a=viewall
    [2] http://www.myprotein.com/thezone/nutrition/always-tired-best-supplements-beat-extreme-fatigue/
    [3] http://www.cheatsheet.com/health-fitness/5-natural-supplements-that-can-help-fight-chronic-fatigue.html/?a=viewall
    [4] http://www.cheatsheet.com/health-fitness/5-natural-supplements-that-can-help-fight-chronic-fatigue.html/?a=viewall

    Boosting Your Child’s Immunity with TCM

    Parents often despair – with good reason – that their school-going children not only catch whatever’s going around, but pass it on quite indiscriminately to siblings and playmates.

    As was the case with Ms Winifred Ling, whose two-year-old daughter, Olivia, got sick “almost every month” for a year after she started going to nursery.

    “She mostly had colds,” Ms Ling, a psychologist practicing in Singapore, recalls. “She would have a runny nose, lots of phlegm, and would be coughing quite a lot. Sometimes, when she had a hacking cough, she would end up vomiting.” “We would take her to see a paediatrician and she would be alright for a while after taking the prescribed medication, but then she would catch the next virus going around.”

    Eventually, Ms Ling took her daughter to see a Traditional Chinese medicine (TCM) practitioner who focused as much on resolving Olivia’s symptoms as on boosting her immune system. Olivia was managed with herbs and paediatric tui na, a form of massage therapy that promotes the smooth flow of qi (a person’s vital force) in the body. Together, the treatments not only eliminated the pathogens that caused Olivia’s illness but also strengthened her overall constitution.

    “She is five now, and we have continued our regular TCM visits and treatments as they help keep her healthy,” Ms Ling says.

    Smoothing out the energy flow

    Olivia’s case is not uncommon among children, whose immune systems are still developing and are susceptible to environmental allergens and diseases.

    TCM practitioners believe that children have relatively weaker lung, kidney and spleen systems, which can compromise their overall immunity.

    “A weak lung system increases the likelihood of respiratory illnesses, while a weak spleen system makes one prone to digestive illnesses,” says Eu Yan Sang physician Quek Yiyan. “That’s why children often catch colds and have stomach upsets.”

    In TCM, healthy qi defends against external pathogens. When the flow of qi in organs is not optimal, their delicate yin-yang balance is disturbed. In managing children, TCM practitioners therefore focus on strengthening or restoring the flow of qi, particularly around these vulnerable systems. The objective is to keep the body in a balanced yin-yang state, says Physician Quek.

    Like running water in a stream, Qi cannot afford to be stagnant, “If an organ is colonised by bacteria, such an invasion can be imagined as a brackish pond,” she says. “The organ then has to be ‘cleansed’ and the proper flow of qi re-established.”

    Re-establishing the flow of Qi can be done using different therapies, including herbal medication, paediatric tui na, or by making adjustments to diet or lifestyle.

    A natural way

    Herbs are an important cornerstone of TCM treatment and have a variety of effects, such as warming, cooling and strengthening (increasing qi). Although the types of herbs prescribed to children are similar to those prescribed to adults, the dosage and specific formulas depend on the child’s condition, age and weight. This is why a trained and licensed TCM practitioner should always be consulted, Physician Quek says.

    Paediatric tui na is also an effective treatment for young children. A trained paediatric physician uses specialized massage techniques to stimulate acupoints that are specific to children, enhancing the flow of qi throughout their body.

    Other TCM treatments like acupuncture and cupping are generally not recommended before adolescence. However, a physician may decide on them on a case-by-case basis.

    TCM treatments offer a safe and reliable alternative with few side effects, an important consideration for parents keen to ensure the health of their children. Should a child fall sick, TCM also focuses on solving the root cause of the illness, not just the symptoms.

    Better habits for stronger immunity

    TCM practitioners generally advocate a holistic – and sustainable – approach to building a strong immune system. Besides prescribing herbal medication, tui na, and acupuncture for older children, physicians are likely to also advise on an appropriate diet and lifestyle.

    Cold drinks and too much fried, sweet or spicy food should be avoided as they create “dampness” in the body, Physician Quek says. “Excessive amounts of these foods weaken the digestive function of the spleen and stomach, which in turn allows dampness to accumulate,” she explains. Accumulated dampness can, over time, cause blockages and illness. Regular mealtimes should also be observed, as this helps with proper digestion.

    Herbs that help increase Qi can be added to soups or stir-fries. These include Poria (Fuling, 茯苓), White Atractylodes (Baizhu, 白术), Euryale seeds (Qianshi, 芡实), Coix barley (Yiyiren, 薏苡仁), Astragalus root (Huangqi, 黄芪) and Chinese yam (Huaishan, 淮山). Chinese yam, in particular, can be consumed daily as a food supplement as it helps improve digestion, Physician Quek says.

    Herbs with strengthening properties should not be given to a child who is already ill as “these herbs could strengthen the invading pathogen instead, and make expelling it more difficult”, she cautions.

    Qi Strengthening Soup

    Ingredients:

    • Astragalus root (Huangqi, 黄芪) 10g

    • White Atractylodes (Baizhu, 白术) 10g

    • Licorice root (Gancao, 甘草) 5g

    • Pork ribs 500g

    • Water 1L

    Quantities can be varied to individual liking


    Preparation:

    1. Rinse the herbs and blanch the pork ribs.

    2. Place all ingredients into 1L of boiling water.

    3. Simmer over low heat for three to four hours.

    4. Serve.

    Good lifestyle habits should also be practiced. These include getting adequate sleep, having moderate exposure to cold weather to “build up the child’s resistance to external pathogens”, and catching some sun to “help boost yang qi, which is important for a child’s development”.

    This holistic approach to strengthening immunity is something Ms Ling appreciates – although it took some effort on her part as well.

    “When we first started TCM, my daughter had trouble taking the herbs, but now it’s no longer an issue,” she says. “And happily, she doesn’t fall sick so frequently anymore.”

    Better Diabetes Management with TCM

    For five months, Richard*, who had a 20-year history of diabetes, experienced numbing, burning, and tingling sensations in his lower limbs. By the time the sixty-four-year-old sought help from a Traditional Chinese Medicine (TCM) practitioner, his lower calves were hyper-pigmented, his tongue was dark red with a thick coating, and his pulse was tense and “slippery”.

    With herbal medications, however, his symptoms improved noticeably. He continues to take the prescribed herbs and returns to his TCM physician for fortnightly reviews.

    Traditional Chinese Medicine has a long and successful history of managing diabetes and its complications. References to xiao-ke, a disease characterised by persistent thirst and hunger, copious urination and weight loss, can be found as early as the 1st century BCE, in the medical text Huang Di Nei Jing (The Yellow Emperor’s Inner Classic). Translated literally as “wasting thirst”, it was believed to be the result of consuming too much fatty, sweet, or rich food.

    Today, TCM practitioners see poor diet as just one of four major contributing factors to the root cause of diabetes, believed to be a depletion of yin energy – a cool, dark and earthy energy – combined with excessive asthenic fire in the body.

    Beyond greasy, sweet and spicy food, and alcohol, all of which exhaust the spleen and result in the production of damp heat, three other factors commonly cause yin depletion and excessive fire in the body:

    • an unstable emotional life, which disrupts the flow of energy in the body and causes qi stagnation, leading to an excess of internal fire;

    • imbalances and disruptions in energy that are present at birth;

    • excessive sexual intercourse, which depletes kidney essence, impairing its ability to provide yin to the whole body.

    Symptom-led treatment

    Unlike conventional medicine, TCM is not concerned with blood glucose levels but instead, the actual symptoms displayed by the individual patient. These symptoms can be distilled into three main categories: upper, middle, and lower wasting.

    Upper wasting is primarily characterised by excessive thirst. Other typical symptoms may include a dry mouth, irritability, a red tongue with a thin yellow coating, and rapid pulse. A TCM practitioner may diagnose someone with these symptoms as having Lung Heat with Depletion of Jin syndrome – a rise in internal heat, primarily in the lungs, due to a deficiency in yin jin (body fluids). This can be managed with a concoction made with Coptis Chinesis (Huang Lian), Ophiopogon Japonicas (Mai Dong), and Radix Rehmannia (Sheng Di Huang).

    The most apparent symptom of Middle wasting is excessive hunger. Patients will also likely suffer from bad breath, weight loss, frequent oral ulcers, excessive thirst and urine output, constipation with dry stools, a red tongue with yellow coating, and a strong rapid pulse. Also known as Stomach Fire syndrome, it is commonly managed with a remedy known as Jade Maiden Decoction, made with Gypsum Fibrosum (Shi Gao), Rhizoma Anemarrhenae (Zhi Mu), and Gardenia Jasminoides (Zhi Zi).

    Finally, lower wasting can be recognised by excessive turbid urination, often accompanied by lower lumbar pain and weakness in the knees, fatigue, dizziness, tinnitus (ringing in the ears), dry lips, dry and itchy skin, a red tongue with little or no coating, and a thin and rapid pulse. These symptoms point to a deficiency of yin in the kidney syndrome, which is commonly managed with Six-flavour Rehmannia Pills, made with Schisandra (Wu Wei Zi), Chinese Yam (Shan Yao), and Wolfberries or Goji berries (Gou Qi Zi).

    Broadly speaking, “the main goal in TCM treatment of diabetes is to invigorate the spleen (pancreas) and revitalise the kidneys,” explains Eu Yan Sang Senior Physician Tang Yue.

    Using TCM to better outcomes

    Particularly over the last decade, scientific studies have backed the use of TCM to complement or augment conventional medicine in the treatment of diabetes, and to mitigate the risks associated with certain medications.

    In a study conducted in 2013, 800 patients were managed with either the ‘Xiaoke Pill’, a compound of Chinese herbs combined with glibenclamide, or glibenclamide alone. Glibenclamide, an antidiabetic drug commonly used to manage type-2 diabetes, is associated with drug-induced hypoglycemia. At the end of 48 weeks, those taking the Xiaoke Pill showed a significantly reduced risk of hypoglycemia and similar improvements in glycemic control compared to those who took glibenclamide. The controlled, double-blind trial was conducted in China and edited by US-based Pennington Biomedical Research Center.

    It is important to remember however, that when TCM is used in conjunction with western medication, it should always be done with the knowledge and advice of both a qualified TCM practitioner and a western medical professional.

    Eat your way to better health

    As important as herbal medication is, it is only part of the solution.

    “Even with medication, diet control is just as important,” says Senior Physician Tang. He advises patients to avoid foods high in sugar, such as candy, chocolate, pastries, and sweetened drinks, and to reduce their intake of starch and fat.

    Instead, they should fill up on foods with a low glycaemic index (GI), which can help reduce spikes in their blood glucose levels. These foods include oats, wholemeal bread, brown rice, lentils, soy and walnuts. Other beneficial foods, like black fungus, Chinese yam, barley, American ginseng and wolfberries can be consumed in soups.

    Lifestyle changes must also be made, which means adopting a diet that is low in fat, sugar and salt, and making time for aerobic exercise. This makes the body more receptive to insulin, says Senior Physician Tang.

    “In Mandarin we say 管住嘴、迈开腿 (Guǎn zhù zuǐ mài kāi tuǐ), or watch what you eat and exercise since neglect of both is the most common cause of type-2 diabetes. Focus on maintaining a healthy Body Mass Index of between 18 and 23, and try and get active for at least 150 minutes a week. It will help you control your blood glucose levels and find your way to better health,” she says.

    *Not his real name

    Cholesterol and TCM

    Many people have misconceptions about cholesterol, thinking it is detrimental to the body however this is not exactly true. Cholesterol can be either a friend or an enemy, depending on their levels in blood stream. Cholesterol is an essential substance for the body’s normal physiological functions such as precursors for cellular membrane, certain hormones and vitamin D.

    Hypercholesterolaemia, or commonly known as high cholesterol occurs when the total cholesterol (TC) exceeds 240mg/dL, or when low-density lipoprotein cholesterol (LDL-C) exceeds 130mg/dL. Cholesterol plaques build up in the arteries, a condition called atherosclerosis which may partially or totally obstructs blood flow to organs such as the brain, heart, kidneys and extremities. A small portion of the plaque may break off, or the formation of blood clot on the plaque’s surfaces may result in a heart attack or stroke.

    Cholesterol is classified into LDL-C and high-density lipoprotein cholesterol (HDL-C). LDL-C is harmful to the body – it attaches to the arterial walls and hardens the arteries (reduced flexibility). In contrast, HDL-C helps to carry cholesterol to the liver for removal and storage which therefore prevents formation of cholesterol plaques.

    TCM Cause

    Li Guang Jun, a registered TCM physician physician with Eu Yan Sang TCM Clinic at Serangoon and Simei shares the following causes:

    • Yin deficiency with the production of asthenic Fire: Chronic mental stress or excessive emotional activities may cause Liver Qi stagnation and the production of Liver Fire when exhaust the Yin. The depletion of the Liver Yin may then complicate the Kidney.

    • Heat-phlegm syndrome: Alcoholism or a diet high in calories (fats and sugars) can damage the Spleen and Stomach, resulting in build up for phlegm-dampness and toxins.

    • Phlegm-Blood stasis syndrome: the formation of heat-phlegm (unwanted wastes) obstructs normal blood flow, causing stagnation of Blood. When heat, phlegm and Blood stasis mix with one another, they can result in the yin exhaustion of the Liver and Kidney with obstruction to proper circulation.

     
    Symptoms

    People with slightly elevated blood cholesterol often do not experience any symptoms However, the absence of symptoms does not indicate normal level of blood cholesterol. Therefore, regular medical check up is important in detecting the condition. Other symptoms may include giddiness, fatigue, weakness, insomnia, forgetfulness, chest discomfort and fast heart rate. High cholesterol is often seen in overweight or obese individuals. The chronic elevation of blood cholesterol without medical treatment can result in coronary heart disease, peripheral arterial disease which exhibit as chest pain (angina), heart attack, stroke and intermittent claudication (limping due to obstruction in arteries)

    TCM categorises high cholesterol into various syndromes, namely Phlegm obstruction type, Excessive Dampness with Kidney deficiency type, Stagnation of Qi with Blood Stasis type, Yin deficiency of the Liver and Kidney type, Yang deficiency of the Spleen and Kidney type and lastly simple type based on individual’s clinical presentation, tongue, pulse. A treatment plan is then formulated based on the different syndromes and according to individual’s physique.

    Susceptible group of people

    Family history of high cholesterol, individuals who are overweight or obese, middle aged and above, post-menopausal women, heavy smoker and drinker, people with sedentary lifestyle, people with medical conditions such as diabetes, high blood pressure, fatty liver. Irregular lifestyle, people who are easily tensed, agitated and under chronic mental stress.

    Cholesterol-lowering herbs

    There are various herbs or food that exhibit cholesterol lowering properties. Some examples are hawthorn (shan zha), red sage (dan shen), oriental water-plantain (ze xie), tuber fleeceflower (he shou wu), cassia seeds (jue ming zi), solomon’s seal (huang jing), kudzu root (ge gen), cattail pollen (pu huang), lotus leaves (he ye), gynostemma tea (jiao gu lan) and lastly ginkgo leaves (yin xing ye). They may be boiled or simmered with hot water and consume as tea. However, it is advisable to consult a physician as individual’s physique and symptoms may differ or when your condition persists or does not improve.

    Food Remedy

    Hawthorn congee

    Ingredients: Hawthorn fruit 30-45g (or fresh product 60g), white rice 100g, sugar

    Properties: Strengthen Spleen, Stomach and lower cholesterol. Suitable for individuals with high cholesterol, high blood pressure, coronary heart disease and those who experience indigestion (especially for those who consume plenty meat)

    Method: Boil hawthorn to obtain concentrated juice, cook rice with juice till desired consistency and sweeten as desired. Consume warm, once daily for 10 days.

    Caution: Not to be taken cold or on an empty stomach.

    Chrysanthemum and Cassia seed congee

    Ingredients: chrysanthemum 10g, cassia seeds 10-15g, white rice 50g, rock sugar

    Properties: Clear Liver and brighten eyes, lower blood pressure and soothe bowels

    Method: Place cassia seeds in clay-pot and roast till fragrant. When cooled, boil with chrysanthemum, filter and drain. Cook rice with filtrate till desired consistency, sweeten with rock sugar. Consume once daily, 5-7 days as a course of treatment.

    Fight The Flu With TCM

    In TCM, flu is perceived as an invasion of a body by external pathogenic factors (邪气), brought about by seasonal changes. The battle between pathogenic factors and the body’s immunity, also known as Vital Qi (正气) results in the exhibition of symptoms like runny nose, cough, dry throat and fever.

    The six external pathogenic factors are the wind, cold, summer heat, damp, dryness and fire heat. They arise from abnormal changes in the weather or climate, and can occur in combinations. The two most common ones are the wind-cold flu (风寒感冒) and the wind-heat flu (风热感冒).

    Wind-cold flu

    • Occurs more frequently during cold weathers or environments.

    • Running nose with clear mucus, severe aversion to cold, chills, fever, little or no sweating, cough with clear phlegm etc.

     

    Treatments are aimed at expelling out the heat and cooling the body. Examples of herbs which are used include Fructus Forsythiae (lian qiao, 连翘) and Flos Lonicera (honeysuckle flower, 金银花).

    Self-help home remedies

    Note: As discussed above, treatments vary a lot when dealing with different types of flu patterns in TCM, so it is important to have a correct diagnosis of your own condition before proceeding with any remedies.

    1) Ginger Tea

    • For patients suffering from the wind-cold flu pattern

    • Ingredients：10g Ginger, 10 to 15g Brown Sugar

    • Preparation: Slice the ginger and simmer in boiling water with the lid closed for 5 to 10 minutes. Add in brown sugar after. Drink while it is hot.

    2) Chrysanthemum Flowers Tea

    • For patients suffering from wind-heat flu pattern

    • Ingredients: 6g Chrysanthemum flowers, 6g Mulberry leaves, 3g Wolfberry fruit

    • Preparation: Simmer the flowers and leaves in hot water for 5 to 10 minutes. Add in the wolfberry fruits. Drink when cooled.

    As the saying goes, prevention is better than cure. With a stronger body resistance, one will be less susceptible to falling sick. It is vital to strengthen one’s body immune system, especially during the season of haze or influenza. Here are some tips!

    1. Always stay hydrated. A minimum of 8 cups or 1.9 litres of water is recommended.

    2. Exercise regularly. Simple jogging or swimming 3 to 4 times a week can help to ensure good blood circulation and a smooth flow of Qi in your body.

    3. Have adequate sleep. Have at least 7 hours of uninterrupted sleep every night to recharge our body.

    4. Have a balanced diet. Avoid spicy, fried and oily foods to prevent one from getting heaty. Avoid cold drinks. According to TCM, cold drinks and food can hurt our digestive system.

    5. Ensure adequate intake of fibre foods high in fibre and constantly replenish fluids to ensure smooth bowel movement.

    6. Herbs like wild American ginseng and cordyceps are known to help boost the body’s vital Qi and improve the respiratory (lung) functions. Having a luohan fruit tea regularly can also help to clear the lung heat and replenish the body’s yin.

    NOTE: In TCM, there is rarely a one-size-fit-all solution, even for people with the same condition their prescriptions are likely to be different due to different root cause and body constitution. For a more detailed diagnosis and treatment, one should consult a registered TCM physician. It is also advisable to consult a TCM physician for any herbal consumption or acupressure massage if one is pregnant.

    How TCM Works

    TCM treats the mind, body and spirit as a single entity. This holistic approach is derived from fundamental beliefs in the Chinese culture, which emphasise the inseparable nature of Man with the Universe, as well as the need for balance and harmony.

    When a person’s vital life force, known as Qi (气, pronounced “chi”), flows smoothly through the body, it establishes a balance between his spiritual, emotional, mental and physical realms. Similarly, the person needs to function in harmony with his environment, which includes acclimatising himself to the climate and the changes in his daily lifestyle.

    If that flow and balance is upset, disease and illness will arise.

    TCM employs a system of diagnosis, therapy and medication to restore that balance by boosting the body’s immune system in an attempt to fight off pathogens.

    A TCM treatment usually includes a combination of medicinal herbs, nutritional therapies, physical treatments such as acupuncture, moxibustion, cupping, massage or Tuina, and therapeutic exercises such as taichi and related breathing techniques.

    Drug-free Pain Management

    The most common types of pain that TCM Physician Chen Tong Mei sees are those that occur in the neck, shoulders, knees and wrists. She is a graduate of one of Beijing’s top universities specialising in acupuncture and bone-related injuries. She also has a Master’s in TCM from the Guangzhou University of Chinese Medicine, and now practises at the Woodlands branch of Eu Yan Sang TCM Clinic, where this interview took place.

    “These are problematic areas because of people’s bad posture when standing, sitting or carrying heavy objects,” she reveals “Nowadays, people are addicted to playing games on their mobile devices, which can cause their necks to stiffen. The youngest patient I have is about eight years old. Even when I was giving him treatment, he couldn’t stop playing with his video games!”

    How Pain Arises

    According to Physician Chen, there are two reasons that explain the causes of pain: pain caused by obstruction, and pain caused by weak qi, blood, liver or kidney. No matter the cause, it is possible for us to experience swelling, piercing, damp, stretching, cold or warm pains.

    Physician Chen believes that pain can affect every area and organ of the body. “TCM is best at managing pains caused by the nerves through acupuncture, scraping, tuina, star needles, and cupping,” she insists. “The effects of these treatments are very positive. However, other conditions, such as inflammations and bone spurs, are probably better left to Western medicine.”

    TCM is best at managing pains caused by the nerves through acupuncture, scraping, tuina, star needles, and cupping.

    Treatment Options

    As mentioned earlier, there are several ways that TCM manages pain, such as cupping, acupuncture, tuina, star needling, or intranasal light therapy.

    As Physician Chen points out, the benefits of acupuncture is far-reaching and can aid many ailments. “For less severe pains, the patients can go for scraping treatments. For deeper pains, cupping is the more recommended treatment,” she advises.

    Physician Chen adds that pain caused by treatments can be alleviated by intranasal light therapy. “On top of that, we use star needles on the affected area. Even though it may draw blood, it is part of the treatment.”

    Lifestyle Adjustment

    Physician Chen emphasises that while receiving TCM treatment for pain, the patient should remain physically active. That’s because exercising is the only way to loosen the muscles around the affected area, which decreases the risk of the pain recurring.

    “Basically, pain is usually caused by low blood flow to the affected area. This causes the nerves to become unstable. That’s why, during treatment, physicians will prescribe medication to patients to encourage blood flow, relax veins and soothes nerves, Physician Chen reveals.

    Another tip to control pain is to consume food items that eases pain naturally.

    Ginger/ Indian Curry / Chili Padi

    These contain turmeric, which can ease the pain patients are experiencing. Menstruating women should drink ginger tea with brown sugar to ease menstrual pains.

    Omega 3

    Research shows that Omega-3 in deep-sea fishes is great against inflammations, rheumatism, arthritis and migraines.

    Coffee

    Coffee disrupts the function of pain receptors, thus allowing you to feel less pain. However, this is only useful for individuals who do not drink coffee often.

    Berries/Cherries

    Strawberries, cherries and blackberries rival the effects of medications such as aspirin, and can improve your immune system and soothe inflammation.

    This is an extract of an article by Lisa-Ann Lee that first appeared in NATURA Issue 4. Find NATURA at Eu Yan Sang retail outlets, newsstands and major bookstores in Singapore.

    From 1 Mar 2024 till 31 May 2024, new patients can enjoy a physician consultation & pain relief acupuncture treatment at S$68* nett.

    *Terms and conditions apply

    Of Birds & Bees
    The Ticking Clock

    Singapore’s Total Fertility Rate stands at an abysmal 1.2—way below what the population needs to replace itself. Some of that is the result of people choosing not to marry; some from couples having very few children—either by choice or because having children has proved difficult.

    Dr Christopher Chen of the Christopher Chen Centre for Reproductive Medicine, comments, “If, despite regular intercourse every two to three days, pregnancy does not occur after six months to one year, then the couple may have fertility problems. The problems could be due to either the man or the woman, or combined.”

    Age is a huge factor in fertility.

    With couples marrying increasingly later and putting off having children— often to complete higher education and establish careers and finances— age-related fertility issues have become more common. “A woman’s fertility declines after the age of 25 initially slightly, but becomes quite precipitous after the age of 40. By the time she reaches 45, her prospect is very poor,” reveals Dr Chen. “Age also influences a man’s fertility. After the age of 50, there is a progressive decline in the man’s fertility and sexual performance.”

    Adds Dr Ann Tan of the Women and Fetal Centre, “With increasing opportunities for more women to be educated and develop their careers, fertility has taken a back seat. In many women’s minds, it is something that can be summoned at will when they need it.”

    That points to a host of lifestyle and societal factors that impact fertility. Education and career success sometimes take priority over having children. And, as Dr Tan points out, people often take their fertility for granted. A fast pace of life, stressful jobs and lack of work-life balance also take their toll.

    As Dr Chen puts it, “Modern living has clearly had an impact on the fertility both of men and women, especially in a fast-moving, demanding and stressful environment such as Singapore, where many people work long hours and travel for business. The lack of opportunity for a couple to have intercourse amid their busy schedules has an impact on fertility and on general health.”

    He continues, “Undoubtedly, mental, physical and emotional stresses have been found to impact fertility. In the man, it affects his sperm quality and count. In the woman, it can affect her ovulation. She may not ovulate over several periods of her cycles; she may produce poor quality eggs on account of these factors.”

    Let’s Talk About Sex

    Ultimately, for a couple to conceive a child, they need to have sex.

    That’s stating the obvious, but it’s shocking how little sex many couples have. A range of factors contribute to this, of which lifestyle and stress are two large ones.

    “Couples need to look realistically at improving their lifestyle to give them opportunities to relax and to have intercourse, especially during the woman’s fertile period,” suggests Dr Chen. “Modifying their work environment and changing jobs can be considered. Ultimately, couples need to make time to be together and to have more frequent intercourse. The best time for a couple to conceive is between Day 11 and Day 16 of a 28- to 30-day menstrual cycle.”

    And what about the stress that trying to conceive a baby can in itself bring to a couple? “Making a baby should not be perceived as a chore,” advises Dr Chen. “Couples who take it easy in conceiving are more successful than those who try hard. Sex should not be regimented; it should be enjoyed. The couple should create a conducive environment for lovemaking and not just aimed at baby-making. The couple should combine the pleasure of sex and the pleasure of conception.”

    The TCM Perspective

    In traditional Chinese medicine (TCM) principles, the most important organs that govern the regulation of blood and qi and their related activities are the liver, spleen and kidneys. The spleen is the main ‘factory’ that produces blood and qi, while the liver is responsible for maintaining a smooth and even flow of these two important essences. According to Senior Physician Zhong Xi Ming from the Eu Yan Sang Premier TCM Centre, when it comes to fertility, “the kidneys play a big role in successful conception and normal reproduction.”

    How does TCM manage this problem? The first method is via herbal prescriptions, which aims to nourish and balance the body, especially the reproductive system, liver, kidneys and spleen. Acupuncture can regulate the function of the relevant organs to strengthen and invigorate the whole body. Diet and exercise may also come into play.

    The overarching principle of TCM when it comes to fertility is to “cultivate the soil before planting the seed,” as Senior Physician Zhong puts it. “We manage holistically, taking into account your physical, emotional and spiritual aspect.” This means TCM does not only focus on managing a particular fertility-related problem. “We also want to improve all systems of your body and mind,” she reveals. “If you are sleeping well, are full of vitality, have proper digestion and healthy sense of self, then all systems will work more efficiently, including your reproductive system.”

    Acupuncture and Reproductive Health

    Acupuncture treatment regulates the flow of qi and blood, tonifying where there is deficiency, draining where there is excess, and promoting free flow where there is stagnation. Researchers from New York’s Weill Cornell Medical Center reviewed existing studies and found that acupuncture helps…

    1. Reduce stress hormones that interfere with ovulation

    2. Normalise hormones that regulate ovulation so an egg is released

    3. Increase blood flow to the uterus, improving the chances of a fertilised egg getting implanted

    4. Improve ovulation cycles in women with polycystic ovary syndrome (PCOS), which makes getting pregnant difficult

    5. Improve pregnancy rates in women undergoing in vitro fertilisation (IVF)

    If you want to avoid taking fertility drugs, are not eligible for IVF, or want to improve the success rate of IVF, consider acupuncture and herbal medicine.

    Basic TCM Concepts
    What is Traditional Chinese Medicine?

    Traditional Chinese Medicine, or TCM, is one of the world’s oldest forms of medicine, with a history of more than 2,500 years. It is the essence of Chinese history, philosophy and medical knowledge. It is still the main form of medicine to many Chinese today.

    With more research being done, and greater worldwide interest in natural products, TCM is increasingly recognised as a viable form of alternative medicine in other parts of the world.

    One important perspective of TCM concerns the balance of the body (形，Xing) and mind (神，Shen). A healthy body forms a firm foundation for a healthy mind, which includes one’s thoughts, emotions and psychological state.

    In short, TCM does not manage the illness alone, but the person with the illness. This medical approach is built upon the concepts of Zang Xiang, Yin Yang and the Five Elements.

    Zang Xiang 藏相

    Zang Xiang literally means the external manifestations of the health condition or status of our internal organs.

    Zang Xiang forms the basic principle of most TCM diagnoses. By examining the symptoms displayed at superficial level, the root causes of the illnesses in the body can be nailed down; the principle of treatment can be derived and administered accordingly.

    Zang refers to the interior location of the Zang-fu（脏腑）organs; while Xiang refers to their external appearance or symptoms.

    Zang-fu covers the five Zang organs (the Heart, Liver, Spleen, Lungs and Kidneys) and six Fu organs (the Gall bladder, Stomach, Bladder, Large Intestines, Small Intestines and Triple Energizer).

    Triple Energizer (三焦，San Jiao) refers to the upper (region above diaphragm), middle (region in between diaphragm and belly button) and lower (region below belly button) parts of the body, and its most important function is to govern water metabolism.

    Yin Yang 阴阳

    Everything in the universe exists as two opposing yet interdependent forces – Yin and Yang. They are two opposites of a whole which cannot exist without each other. Yin literally represents the “shady or dormant” aspect (e.g. water, dark, cold, night, passive, female) while Yang refers to the “sunny or active” aspect (e.g. fire, bright, hot, day, active, male).

    In TCM, the Yin Yang concept is applied to understand the complex interconnections and constant changes in the human body. TCM views the human body as an integrated whole, where all organs and systems are interconnected and interdependent of each other. Generally, when Yin and Yang are in balance, our body is healthy; but if one force dominates the other, pain and illness will arise. TCM uses the Yin Yang concept to diagnose patterns of disharmony and determine treatments to restore balance.

    Five Elements 五行

    The Five Elements consist of wood, fire, earth, metal and water. Each represents different properties, functions or appearances under which all things in the universe can be classified. This concept is used to describe interactions and relationships between all natural phenomena.

    The Five Elements interact with one another in two cycles, mainly the enhancing and destructive cycle. In the enhancing cycle, each elemental phase is assisting one another by boosting their ability to transform, whereas the destructive cycle exerts its effect by keeping each elemental phase under control to ensure balance and harmony.

    In TCM, balance between generation and control is important for health maintenance.

    Keep An Eye On The Ball – And Your Health – This World Cup
    Health hazards of staying up late

    World Cup season is upon us! Are you one of those hardcore fans who would loath to miss a single match? Staying up late is all well and good if you don’t do it too often.

    Ask yourself the following questions — Are you becoming more forgetful recently? Are you experiencing delayed reactions? Do you face difficulties with making good judgments? If you answered yes to any of these questions, you might be suffering from increased lethargy, irritability, and an inability to concentrate due to a lack of rest.

    You may ask, “What’s the big deal?”

    A lack of sleep is actually a bigger deal than you’d think. Studies have shown that a lack of sleep can lead to an increased risk of heart attack, high blood pressure, and stroke.

    To add to that, uncontrollable snacking and an increased intake of alcohol while catching the World Cup with your friends can take a toll on your cardiovascular system. Snacks such as peanuts and potato chips have high salt content and can lead to an increase in blood pressure, while alcohol contributes to an increase in blood pressure and heart rate.

    Staying up late also interferes with the production of melatonin, a hormone that acts as a strong oxidant and prevents the loss of collagen in our skin. This can lead to obvious eye bags, and poor skin elasticity, resulting in wrinkled, saggy, and dull skin.

    Health hazards of staying up late, according to TCM

    From the perspective of TCM, pulling all-nighters not only affects your concentration and memory, you also face a higher risk of falling sick. Sleep deprivation potentially depletes your Yin fluids which is crucial to the nourishment of the body — with Yin in deficiency, Yang will be in excess.

    This results in increased heatiness, which subsequently leads to symptoms such as excessive thirst, dryness or bitterness in the mouth, ulcers, and throat irritation. A lack of Yin can also lead to a lacklustre complexion.

    Pay attention to how your body reacts to external factors, and what’s going on inside you. Treat these signs seriously and take action accordingly.

    Tips to stay healthy
    1. Be disciplined and set your own curfews

    According to proponents of TCM, the optimal time for a deep sleep is between 11pm and 3am. Staying up past 11pm would prevent the regeneration of liver Yin and blood. This would lead to excessive ‘heat’ building up in the liver, which is characterized by:

    • dizziness

    • distending sensation in the head

    • a headache on the temples

    • ringing in the ears or sudden deafness

    • red, swollen or painful eyes

    • bitter or dry taste in the mouth

    • red or flushed face

    • irascibility, fits of anger

    • insomnia

    • strong or vivid dreams

    • dark or scanty urine; and

    • constipation

    2. Next best alternative to alcohol

    While it is common for World Cup fans to crack open a can of ice-cold beer while watching the match, we’d like to recommend healthier alternatives to keep your blood pressure and heart rate down. Try brewing a Chrysanthemum & Peppermint Tea, or preparing a bowl of Snow Pear Soup White Fungus Lily Bulb instead. These two beverages have additional benefits — the former contains Chrysanthemum that clears heat while Peppermint clears the mind and improves thinking during the day; the latter can effectively moisten the lungs and increase Yin. A mixture of lily bulbs and lotus seeds can also calm the mind, promoting better sleep. Here are some easy recipes you can try:

    a. Snow Pear Soup with White Fungus, Lily Bulb 百合银耳雪梨汤

    Ingredients:

    • Dried lily bulbs: 50g

    • White fungus: 1 head

    • Snow pear: 1

    • Lotus seeds: 50g

    • Rock sugar: 50g – 80g

    • Water: 1.5 litre

    Quantities can be varied to individual liking

    Preparation:

    a. Soak the white fungus and dried lily bulbs in water overnight.
    b. Cut the snow pear and soaked white fungus into smaller pieces.
    c. Add water to a pot and place lily bulbs, white fungus, and lotus seeds into the pot.
    d. After boiling, use low fire to cook for one hour.
    e. Add in the cut pieces of snow pear and rock sugar.
    f. Continue cooking until the pear and white fungus becomes soft.

    b. Chrysanthemum & Peppermint Tea 菊花薄荷茶

    Ingredients:

    • Chrysanthemum flower: 4-5 pieces

    • Peppermint leaves: 5-10 pieces

    Preparation:

    a. Place both ingredients into a cup

    b. Add hot water and cover for 5 to 10 minutes.

    3. Relieve tensions with Acupressure Point Massage

    While your eyes are glued to that TV screen, the long hours of physical inactivity can take a serious toll on your back. It can result in stiffness of the back, tension in your neck and shoulders, and even severe headaches. These conditions could even worsen if your team is playing poorly, or if the game goes down to the wire — anxiety is a great trigger for muscle tension and old pain patterns.

    If you find yourself in this situation, instead of popping a pill, try Acupressure point massage. Sit back and apply pressure to specific pressure points to unblock the meridians and let the “qi” flow through your body. With these 6 simple Acupressure point massages, you can now relieve those tensions that have been hindering your World Cup experience:

    a. San Yin Jiao (SP6) – SP6 is located 4 finger widths above the inner ankle, behind the tibia. Massaging this point can tonify Yin of the spleen, liver and kidney systems.

    b. Tai Chong (LV3) – LV3 is found on the foot about two finger widths above the area where the skin of the big toe and second toe join. Massaging this point helps to calm the liver and reduces excessive liver Yang.
    c. Zu San Li (ST36) – ST36 is located 4 finger widths below the knee, and 1 finger width outside the shin bone. Massaging this point can tonify the spleen and increase immunity.
    d. Baihui (DU20), Taiyang (EX3), Fengchi (GB20) – These points are found on the head. Massaging them specifically can increase blood circulation to the head and increase alertness during the day. Baihui (DU20) is located on the intersection between the midline of the head and the line joining the apex of the ears.
    e. Taiyang (EX3) – EX3 is found at the temples of the head, in a depression about 1 thumb width posterior to the midpoint between the outer end of the eyebrow and the outer canthus of the eye.
    f. Fengchi (GB20) – GB20 is located at the depression between 2 major muscles (sternocleidomastoid muscle and the trapezius) at the back of the neck, at the base of the skull.

    4. Choose Healthier Snacks and Drinks

    If sleeping late has become inevitable during this season, you may want to counteract these potential health conditions by drinking more water during the day and incorporate more leafy vegetables and a variety of fruits into your diet. It is best to avoid eating fried and oily food for the time being as these foods are known to cause the body to become excessively heaty.

    Sleepy? We know what comes to your mind first is probably a cup of joe or a can of Red Bull. Although stimulants such as caffeine may help keep you awake during the day, it can also affect your sleep cycle if it is taken too late in the evening. As such, you may want to consider taking some American ginseng tea instead, which can nourish Yin and invigorate Qi to boost your mental alertness and immunity. A win-win situation!

    As you partake in the soccer fever, do not let that take a toll on your health. Keep yourself hydrated, well-rested and keep to a nutritional diet to help you stay in top form, all day and night!

    Facing The Facts: Tackling Skin Issues

    For both men and women, the body’s largest organ plays the role of protective barrier and mirror to the internal state of health. The skin is not only the first line of defense against sunlight, chemicals, infections and cuts, but also reflects how well internals systems and organs are functioning.

    But differences in biology, genetics and lifestyle mean that each gender’s skin protects and reacts differently1 to internal and external factors. In Traditional Chinese medicine (TCM) terms, these differences are explained by yin and yang.

    The opposing yet interdependent forces of yin, a cool, quiet nourishing force, and yang, a warm, active and invigorating force, must be in balance for perfect health – and skin. Women, however, are prone to be deficient in yin, particularly when menstruating, pregnant, in labour and breastfeeding. These activities deplete the blood, which is yin in nature, says Eu Yan Sang physician Anita Pee.

    “Young working mums often juggle multiple roles at work and at home, leaving little time for rest and for the body to replenish its blood and essence (yin) stores,” she adds. “A woman’s yin also naturally decreases with age.”

    Besides yin deficiency, other issues can show up on the skin, she says, including qi stagnation from emotion stress and blood stasis that results from this stagnation. Men, too, have their share of skin issues, says Ms Pee. “Men are more likely to consume foods that are high in sugar and fat content, and drink alcohol, which exacerbate the accumulation of heat and dampness in the body, making them more susceptible to skin problems related to excessive heat (yang),” she explains.

    Facing up to men’s skin issues

    As far as skin is concerned, men have several factors working in their favour.

    For one, they have thicker skin – 25 percent thicker to be precise, thanks to testosterone, commonly known as the “male hormone”. Men also have tougher skin and higher collagen density than women, one explanation for why women appear to age faster.

    They are also paying more attention to their skin. Where vanity was once considered a woman’s domain, men are now more open to using skincare products to prevent or manage skin issues, and are more willing to spend money on maintaining their appearance.

    However, some skin issues remain difficult to dodge. One of the more common ones men face after hitting puberty is stubborn acne. Some 80 percent of teenage boys suffer from acne, as compared to 70 percent of teenage girls she sees, says Eu Yan Sang physician Anita Pee.

    Acne in men is typically caused by an accumulation of heat and dampness in the stomach and spleen, possibly exacerbated by the consumption of spicy and oily food, she says.

    For 28-year-old Rob*, acne on his back and face had persisted for two years before he visited a Eu Yan Sang clinic. The pustules were dark red and hard, and he also had pimples on his face that were small, red and oozing pus.

    “Men generally have more yang than women, and heat and fire tend to accumulate at the yang meridians on the back, giving rise to acne in that particular area,” explains Ms Pee.

    Acne problems like Rob’s are usually managed with herbs to dispel heat, reduce dampness and remove toxins. These could include Forsythia, which reduces oily secretions, and Dandelion, which has antibacterial properties and contains vitamins that promote skin healing. Coix seed can help strengthen the spleen and eliminate dampness while clearing heat and draining pus, while Red Peony Root clears heat and toxins in the blood, and promotes blood circulation.

    Rob saw positive results in a week, when new acne growth slowed. After a month, his complexion had become clearer.

    Besides acne, men are also more prone to skin conditions like tinea versicolour or ringworm, rhinophyma, and psoriasis.

    Tinea versicolour, a fungal infection that causes itchy, scaly spots to form on the skin, is also linked to damp-heat, says Ms Pee. This is typically managed topically with Rhubarb, which purges heat from the body, and dried Alum, which reduces dampness2.

    Rhinophyma, a form of rosacea (skin redness) that causes the nose to become red and bulbous, is frequently – and mistakenly – thought to be the result of excessive drinking. TCM practitioners believe that it is caused by heat in the lungs and stomach, and manage it with herbs like Loquat Leaf, Mulberry Root Bark and Coptis Rhizome, all of which help dispel this heat.

    Severe psoriasis, meanwhile, is characterised by thick, red patches covered with white scales. These form as a result of accelerated cell turnover3.

    In a 2017 study published in the American Journal of Clinical Dermatology, Swedish researchers from Umea University analysed data gathered from 5,438 psoriasis patients and found that women have a statistically lower rate of severe psoriasis than men across all age groups4.

    Psoriasis in men is usually caused by blood stasis or blood heat. Psoriasis caused by blood stasis manifests as dark, thick and hard scales on the skin. It can be managed with Tao Hong Si Wu Tang, a herbal formula that includes Peach Kernel, Safflower Flower, Chinese Angelica Root, Lovage Root, Red Peony Root and Rehmannia, and which promotes blood circulation. Psoriasis caused by blood heat, and which manifests as reddish and intensely itchy skin, can be managed with Rehmannia, Red Peony Root and Tree Peony Root Cortex, which clear heat in the blood.

    Besides herbs, acupuncture is also widely used to address skin issues (see box). The holistic approach advocated by TCM will usually also include dietary and lifestyle changes including getting adequate amounts of sleep, eating less oily and spicy food, avoiding prolonged exposure to UV rays, and implementing a good skincare routine.

    How acupuncture boosts skin health

    While acupuncture is more commonly used to relieve aches and pains, it can be beneficial for skin health.

    A 2010 study by researchers from Beijing Daxing Hospital found the therapy very effective in managing acne. The study involved 200 acne sufferers who were divided into two groups: an acupuncture treatment group and a drug therapy control group. The former underwent four sessions of acupuncture treatments, while the latter was prescribed antibiotics in the form of tetracycline and metronidazole tablets.

    After two months, some 94 percent of the patients in the acupuncture treatment group saw positive effects, with 34 stating that they had fully recovered and 43 more reporting that over 70 percent of their skin lesions had disappeared. By comparison, 82.5 percent of participants in the drug therapy control group experienced a beneficial outcome, with 16 reporting a full recovery, and 21 reporting that over 70 percent of their skin lesions had disappear5.

    Another study, published in 2014 in the Journal of Alternative and Complementary Medicine by researchers from the Beijing University of Chinese Medicine, found that acupuncture was also effective in managing melasma.

    The researchers evaluated data from six trials published before July 2013 where acupuncture was used to manage women with melasma.

    The affected areas decreased by over 90 percent in the 468 female participants who underwent acupuncture treatments6, leading researchers to conclude that acupuncture was more effective in managing melasma than Vitamin C and E tablets.

    TCM physicians believe that acupuncture helps dispel the heat and dampness that cause skin problems. They also believe that the insertion of acupuncture needles into the skin triggers the body’s self-repairing mechanisms – specifically, it boosts collagen and elastin production in the affected areas and causes skin to appear plumper7.

    Acupuncture can also lift and sculpt the jawline by tightening loose facial muscles, and reduce puffiness of the face by addressing internal issues like digestive problems and poor lymphatic drainage. The result: a healthier-looking complexion.

    References
    1 Howard, D. (2016). Is a man’s skin really different? Retrieved from International Dermal Institute website:
    http://www.dermalinstitute.com/us/library/17_article_Is_a_Man_s_Skin_Really_Different_.html
    2 Eu Yan Sang. (2016). Skin woes. Retrieved from Eu Yan Sang website:
    http://www.euyansang.com.sg/skin-woes/eysbeauty8.html
    3 Mayo clinic staff. (2017). Psoriasis: definition. Retrieved from Mayo Clinic website:
    http://www.mayoclinic.org/diseases-conditions/psoriasis/basics/definition/con-20030838
    4 Author unknown. (2017). Men more prone to severe psoriasis. Retrieved from Health24 website:
    http://www.health24.com/Medical/Skin/Fungal-skin/men-more-prone-to-severe-psoriasis-20170412
    5 Author unknown. (2017). Acupuncture acne treatment protocol found effective. Retrieved from Healthcare Medicine Institute website: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1712-acupuncture-acne-found
    6 Chai, Q. Fei, Y. Hong, Y. Cao, H. (2014). Acupuncture for melasma in women: A systematic review of randomized controlled trials. Retrieved from the Journal of Alternative and Contemporary Medicine website:
    http://online.liebertpub.com/doi/full/10.1089/acm.2014.5103.abstract
    7 Author unknown. (2016). How acupuncture can rejuvenate your skin. Retrieved from Eu Yan Sang website:
    http://www.euyansang.com.sg/how-acupuncture-can-rejuvenate-your-skin/eysbeauty4.html

    Teen Acne

    Nineteen-year-old polytechnic student Megan Koh first developed acne five years ago. “It was itchy and painful at times,” she recalls. When antibiotics from her dermatologist failed to clear her skin, her sister encouraged her to try TCM.

    When she first visited the TCM clinic, the acne on her cheeks and chin were red, swollen and pus-filled. The physician explained that she had developed them due to hormonal changes during puberty. He recommended acupuncture, which would strengthen her body, improve her energy and manage the issue from the inside out.

    In addition to acupuncture treatments, he prescribed oral medication in the form of pills, powder and a liquid mixture for both day and night, as well as creams to apply on the affected areas two to three times a day. He also recommended that she avoided fried and spicy food, cold drinks and ice cream.

    A month after beginning treatment, “my breakouts were not as frequent, the acne spots were smaller and some were not filled with pus,” she says.

    Getting to the root causes

    Acne affects up to 50 million Americans each year. Research shows that 85 per cent of those between the ages of 12 and 24 will experience some amount of acne during their teen years1.

    Acne occurs when the skin over-produces sebum, causing pores to get clogged. The build-up also causes surrounding hair follicles to swell, allowing the bacteria that live on the skin surface to enter the pores and infect the sebum.

    The condition appears in various forms, ranging from mild to severe. Whiteheads and blackheads appear as small blemishes on the skin. Papules are red and inflamed, while pustules are painful, pus-filled lesions. In severe cases, skin may develop large and inflamed nodules or cysts, which may leave permanent scarring2.

    In Traditional Chinese Medicine (TCM) terms, there are three underlying causes of acne. Firstly, consuming too much spicy, sweet or oily food can lead to heat and dampness accumulating in the stomach and spleen. This disrupts the normal flow of ‘qi’, a person’s life force. “The damp-heat moves upward and outward instead. It gets trapped at the skin surface and manifests as acne,” says Eu Yan Sang physician Anita Pee.

    Managing teen acne

    Once the cause of the teen’s acne has been determined, TCM physicians will usually draw up an individualized treatment plan, taking into consideration the underlying cause of the acne as well as the teen’s physical constitution and any lifestyle or dietary factors that may be exacerbating the problem, says Ms Pee.

    Chinese herbs have significant anti-acne properties, as a 2003 study by Korean researchers from the Skin Research Institute shows.

    The study compared Oriental herb extracts with erythromycin, an antibiotic, and retinoic acid, both of which are commonly used to manage acne. It found that an herb called Angelica dahurica and erythromycin had comparable effects, while another herb, rhizoma coptidis, was more effective than retinoic acid3.

    Other Chinese herbs that can help curb acne include:

    • 连翘 (forsythia) and 蒲公英(dandelion): Manages acne caused by excess heat within the body by clearing heat and toxins, reducing swelling and dissipating nodules. Forsythia reduces oily secretions, while dandelion has anti-bacterial properties and contains vitamins that promote skin healing.

    • 薏苡仁(coix seed): Manages acne caused by damp heat and more severe forms such as nodules and cysts. It strengthens the spleen, clears heat and drains pus.

    • 赤芍(red peony root): Manages acne caused by damp heat such as cystic acne. It clears heat, cools blood and dispels blood stasis.

    Other practical steps to manage acne include adopting a good skincare routine, consuming less fried, oily and sweet food, drinking at least eight glasses of water a day, having adequate sleep, managing stress well and exercising regularly.

    In most cases, patience is key: “It will usually take about 3 months to manage normal acne. Serious cases will take about 6 months,” says Ms Pee.

    How TCM diagnoses acne

    In TCM, the areas on the face or body covered with acne serves as an indicator of the state of the person’s organs and meridian points4.

    Lung heat manifests as acne on the forehead and nose. The person will show an aversion to heat and also experience chills because of his or her sensitivity to the wind. The tongue will appear red with a thin yellow coat.

    If acne appears on the chest, shoulders, back and around the mouth, the person has stomach heat, which indicates stomach or constipation problems. He or she is likely to be thirsty all the time and have foul breath, and may have a big appetite. The tongue appears red with a thick yellowish coat.

    Those with oily complexions and acne that is inflamed and pus-filled, meanwhile, may have damp heat. He or she experiences constant thirst with no desire to drink, and may be averse to heat. The tongue is red with a thick, yellow coating.

    Blood heat may be the cause of mild to moderate acne, usually on the nose, around the mouth, and between the brows. Besides experiencing symptoms such as a flushed red face, extreme sensitivity to heat, dry stools and darker-coloured urine, the tongue is usually red with spots.

    Toxic heat has similar symptoms to blood heat, but the acne in this case is more serious and pus-filled, and the skin around the inflamed lesions is usually red and painful. The tongue is red with a sticky yellow coating, and the teen may feel lethargic.

    Excessive heat and wind in the lungs can also lead to a breakout. In TCM, wind is believed to have a pathogenic, or disease-causing, ability. “When pathogenic wind attacks, the uppermost part of the body, mainly the lungs, is affected first,” she explains. “Combined with excess heat, the wind-heat trapped in the lungs manifests as acne on the skin surface, and is often itchy.”

    Finally, acne also develops when there is too much dampness in the body. A weak spleen impairs the body’s ability to process nutrients from food and water. This, in turn, disrupts the flow of qi, blood production and circulation. “Dampness and blood stagnation obstructs skin pores and causes the formation of deep-rooted and large acne,” she says.

    References
    1 Author unknown. (2017). Acne. Retrieved from American Academy of Dermatology website:
    https://www.aad.org/media/stats/conditions
    2 Author unknown. (2017). How to recognise all the different signs of acne. Retrieved from Acne.com website:
    https://www.acne.com/types-of-acne/acne-signs/
    3 Nam, C. Kim, S. Sim, Y. Chang, I. (2003). Anti-acne effects of Oriental herb extracts: A novel screening method to select anti-acne agents. Retrieved from US National Library of Medicine website:
    https://www.ncbi.nlm.nih.gov/pubmed/12637783
    4 Author unknown. (2016). Skin health: Mirror to our internal health. Retrieved from Eu Yan Sang website:
    http://www.euyansang.com.sg/skin-health%3A-mirror-to-our-internal-health/eysbeauty1.html

    Beauty: From The Inside Out

    When his father was diagnosed with terminal cancer in 2014, Benjamin Kwan was under mounting stress. Almost overnight, his skin became inflamed and itchy. “It was very uncomfortable and frustrating, and I lost sleep because of it,” the 28-year-old entrepreneur recalls.

    He tried several over-the-counter creams for his eczema before moving on to steroidal creams prescribed by a skin specialist. But the eczema persisted. Seeking alternatives, he turned to Traditional Chinese Medicine (TCM).

    He was prescribed a powder containing a mixture of herbs which he dissolved in water and drank twice a day. Within days, the itchiness had lessened and the rash began to subside. Two to three weeks later, it had mostly disappeared, except for the areas around his hips and knees. He continued taking the herbs and that, too, disappeared over the next three months.

    “I was so much happier and could sleep through the night again,” he says.

    Restoring balance

    TCM practitioners believe that good skin is an outward reflection of physical, emotional and mental health. “TCM views the body as an integrated whole, in that the health of the internal organs is reflected externally. The heart and liver are impacted by stress, and that manifests externally as acne on the forehead or the bridge of the nose,” explains Eu Yan Sang physician Lin Xiao Yan.

    In TCM terms, good health is defined as a body in balance. Yin and yang are two opposing yet interdependent forces that exist within the body. For perfect health, yin, a cool, quiet yet nourishing force, and yang, a warm, active and invigorating force, must be in balance. A person’s life force, or Qi (气, pronounced “chi”), flows through the body to sustain this balance, and thereby, a person’s health.

    When yin and yang are perfectly balanced, particularly in the heart, lungs and spleen, the complexion appears radiant and well nourished. Conversely, when one force dominates the other, and the organs are not operating in sync, issues will manifest.

    Excessive heat (yang) in the heart, resulting from emotional tension or consuming too much spicy food1, for example, can result in itchiness. A deficiency of yang energy in the heart, meanwhile, can make the complexion appear dull.2

    TCM believes that the lungs – one of the body’s five yin organs – control the skin and hair, promote the circulation of qi in the body, and nourish the skin with fluids. When the lungs are healthy, the skin is moist and supple; if they are dry and heaty, the skin becomes flaky and itchy and may experience a burning sensation due to a lack of nourishment.

    The spleen, meanwhile, removes dampness in the body. When there is a dysfunction of the spleen, the accumulation of excess dampness and heat can cause an increase in the production of sebum, leading to acne outbreaks, rashes or eczema.

    Addressing the source of problems

    A variety of therapies, including herbal medication, acupuncture and tui na, alone or in combination, can be used to address skin problems. The ultimate aim of treatment is to restore yin-yang balance to the heart, lungs or spleen, and a smooth flow of qi in the body.

    In cases of eczema, herbal remedies have proven effective. In a 2009 study by researchers at Japan’s Yoshiteru Shimoide Clinic of Internal Medicine, 87 percent of the 274 long-term eczema patients treated with herbal remedies were symptom free after just four months, while a further 12 percent showed marked improvement.3 The research subjects were adults who had suffered from eczema for an average of 12 years, and had patches of chronically itchy, dry, inflamed skin over at least 10 percent of their bodies. The herbal remedies were selected and administered based on the symptoms of the individual patient.

    In a retrospective study4, conducted between August 2006 and May 2008 at Mount Sinai Hospital in New York, TCM therapies – including herbal medication and acupuncture – were also found to be effective on children. Dr. Julia Wisniewski, who headed the project, is quoted to have said that there was a need for alternative treatments for eczema as many patients with severe allergies continue to have flare-ups a decade after standard therapy with steroids and immune-suppressing agents.

    Besides eczema, TCM can be used to manage a range of other skin problems, from acne to more severe conditions such as psoriasis. Psoriasis, an autoimmune disease that results in itchy, scaly patches of skin, is often accompanied by psychological problems – including anxiety and depression – due to its highly visible symptoms.

    A 2004 clinical assessment conducted at Taiwan’s Chang Gung Memorial Hospital5 successfully used indigo naturalis to help reduce the appearance of the physical symptoms of psoriasis, leading to improved well-being. Almost three-quarters of the 42 patients enrolled in the trial reported a complete clearing of psoriasis in the attended areas after three months.

    The study is particularly important given the numbers – according to a 2016 report by the World Health Organization, at least 100 million individuals worldwide are affected by psoriasis.

    Acne sufferers, meanwhile, benefit most from acupuncture in combination with therapies such as herbal treatments and cupping, according to a 2013 study that evaluated 43 trials involving 3,453 patients.7

    The best approach, however, is preventive, says Ms Lin. Herbal treatments formulated for the individual, and taking into consideration his or her lifestyle and other factors, can help keep the body in balance, and the skin clear. Herbs such as lily bulb, for instance, nourish the lungs and calm the heart, preventing excessive heat from accumulating. Mulberry leaves alleviate dryness in the lungs, while barley removes heat and dampness in the spleen.

    Loke Y. L., a 32-year-old teacher in Singapore who consumed a herbal powder over the course of a year, found that it helped more than just her skin. “I used to fall ill frequently and would take more than a week to recover from the flu. But since taking TCM medicine, I seldom fall sick,” she says.

    Mitigating factors

    Internal imbalances are not the only causes of skin problems. The environment around us also plays a part. “Certain diseases are more prominent in certain types of weather, environments, or geographical locations,” Ms Lin says. “When the skin is exposed to excess heat and humidity, itchiness, rashes, and blisters can occur.” In these situations, herbal medications, as well as practical steps such as not bathing in hot water and keeping out of the sun, can help relieve symptoms. Lifestyle changes – sleeping by 11pm, a balanced diet and regular exercise – will also have a positive impact.

    The best herbs for great skin

    It is no wonder that TCM herbs like goji berries have made their way into the creams and serums produced by skincare brands around the world, and that TCM is generating brands of its own.

    Here are some beauty-boosting herbs:

    • Chinese wolfberries, also known as Goji berries: Nourishes yin and improves blood production. Packed with antioxidants and boosts collagen and elastin production8

    • Ginseng: Brightens the complexion and diminishes signs of aging9

    • Soy beans: Smoothens wrinkles10

    • Lingzhi and licorice: Anti-ageing and detoxifying properties11

    • Cordyceps: Revitalises the complexion and strengthens skin against environmental damage12

    • Green Tea: Packed with bioflavonoids and catechins, which promote elasticity, improve tone and restore skin at the cellular level13

    • Gingko biloba14: Contains antioxidants to diminish the effects of free radical damage on skin

    Physician Lin emphasizes, however, that getting to the root of the problem might make for more lasting effects, adding: “The best way to manage skin problems is to identify their underlying causes. In that way, we aim to reflect beauty from the inside out.”

    References
    1 Clogstoun-Willmott, J. (2016). Heart Fire: The kind of heat in your heart that you don’t want. Retrieved from Acupuncture Points Website: http://www.acupuncture-points.org/heart-fire.html
    2, 11 Eu Yan Sang. (2016). Tips for a healthy, rosy complexion. Retrieved from EuYanSang.com:
    http://www.euyansang.com.sg/tips-for-a-healthy-rosy-complexion/eysbeauty2.html
    3 Shimoide, Y. (2009). An End To Suffering From Atopic Dermatitis. The Journal of Allergy and Clinical Immunology, S41.
    4 Wisniewski, J., Nowak-Wegrzyn, A., Steenburgh-Thanik, E., Sampson, H., & Li, X. (2009). Efficacy and Safety of Traditional Chinese Medicine for Treatment of Atopic Dermatitis (AD). Journal of Allergy and Clinical Immunology, S37.
    5 Lin, Y.-K., Chang, C.-J., Chang, Y.-C., Wong, W.-R., Chang, S.-C., & Pang, J.-H. S. (2008). Clinical Assessment of Patients With Recalcitrant Psoriasis in a Randomized, Observer-Blind, Vehicle-Controlled Trial Using Indigo Naturalis. Arch Dermatol, 1457-1464.
    6 World Health Organisation. (2016). Global Report on Psoriasis. Geneva: PDF here
    7 Cao, H., Yang, G., Wang, Y., & Liu, J. (2013). Acupoint Stimulation for Acne: A Systematic Review of Randomized Controlled Trials. Medical Acupuncture, 25(3), 173–194. http://doi.org/10.1089/acu.2012.0906
    8, 9, 10, 12, 13, 14 Eu Yan Sang. (2016). 6 TCM herbs for the skin. Retrieved from EuYanSang.com:
    http://www.euyansang.com.sg/6-tcm-herbs-for-the-skin/eysbeauty5.html

    Mirror, Mirror: Tackling Skin Issues

    For both men and women, the body’s largest organ plays the role of protective barrier and mirror to the internal state of health. The skin is not only the first line of defense against sunlight, chemicals, infections and cuts, but also reflects how well internals systems and organs are functioning.

    But differences in biology, genetics and lifestyle mean that each gender’s skin protects and reacts differently1 to internal and external factors. In Traditional Chinese medicine (TCM) terms, these differences are explained by yin and yang.

    The opposing yet interdependent forces of yin, a cool, quiet nourishing force, and yang, a warm, active and invigorating force, must be in balance for perfect health – and skin. Women, however, are prone to be deficient in yin, particularly when menstruating, pregnant, in labour and breastfeeding. These activities deplete the blood, which is yin in nature, says Eu Yan Sang physician Anita Pee.

    “Young working mums often juggle multiple roles at work and at home, leaving little time for rest and for the body to replenish its blood and essence (yin) stores,” she adds. “A woman’s yin also naturally decreases with age.”

    Besides yin deficiency, other issues can show up on the skin, she says, including qi stagnation from emotion stress and blood stasis that results from this stagnation. Men, too, have their share of skin issues, says Ms Pee. “Men are more likely to consume foods that are high in sugar and fat content, and drink alcohol, which exacerbate the accumulation of heat and dampness in the body, making them more susceptible to skin problems related to excessive heat (yang),” she explains.

    Facing up to women’s skin issues

    Women’s skincare is big business which continues to grow as both young and old spend billions in the quest for flawless, youthful-looking skin.

    However, a yin deficiency – common during menstruation, pregnancy, labour and breastfeeding – will often show up in the skin as acne, pigmentation issues like melasma, or eczema, says Ms Pee.

    Unlike men, who experience breakouts on their back, women are more likely to experience acne breakouts on the chin.

    Before menstruation, yin deficiency in the kidneys can cause a build-up of internal heat which shows up on the chin, explains Ms Pee. Herbs such as the Glossy Privet fruit, which nourishes the kidneys, and Rehmannia root, which reduces heat, can help2.

    Melasma is another skin condition that can cause more than a spot of bother. “Yin deficiency in the liver and kidneys can result in inner heatiness, disrupting blood flow to the skin and causing dark spots on the face,” explains Ms Pee. Qi stagnation due to emotional stress can also lead to pigmentation characteristic of melisma.

    According to the American Academy of Dermatology3, 90 percent of those who develop melasma are women.

    Chinese herbs such as gotu kola4 can help lighten dark spots by clearing heat and dampness, and reducing toxins and swelling. When in powder form and mixed with water, the paste can be applied directly onto blemishes.

    Other commonly prescribed herbs include Chinese Wolfberries, Chinese Dodder Seeds and Siberian Solomon Seal Rhizome, which nourish the liver and kidneys. Salvia Root and Spatholobus Stem, meanwhile, help improve blood circulation.

    Eczema, or atopic dermatitis, can also cause much discomfort, since it causes the skin to become inflamed, itchy, flaky and dry. In more severe cases, sores, scabs, blisters and bleeding may occur.

    According to Ms Pee, this is caused by internal factors such as dampness, heat and wind in the body, and external factors like stress, diet and climate changes5.

    Both oral and topical herbal medications, which include herbs like Patchouli to boost spleen health and eliminate dampness, and Broom Cyprus Fruit, Dictamnus Root Bark and Sophora Root to reduce itching, as well as acupuncture (see box), can help.

    The hormone surge of oestrogen, progesterone, oxytocin and endorphins when pregnant6 can cause and even worsen the problem, as 30-year old housewife Adelene Low-Chng found out when she was pregnant with both her first and second children in 2012 and 2015.

    Her TCM physician gave her capsules containing herbs with anti-itch properties to take orally, and a lotion to apply topically. After two weeks the itch subsided and, after she delivered, the situation completely resolved.

    The appearance of wrinkles and saggy skin as women age can also be troubling. Exposure to sun and wind, and illness are among factors that can cause these signs of qi- and blood-deficiency to appear even earlier. Ms Pee suggests either acupuncture to promote blood circulation in the facial region and boost qi and blood, or herbs like Angelica root and Astragalus root.

    As with most ailments, preventing the problem is always preferable, says Ms Pee, adding: “It is important to use adequate sun protection, exercise regularly, have a balanced and nutritious diet with sufficient fluid intake, and get enough rest.”

    How acupuncture boosts skin health

    While acupuncture is more commonly used to relieve aches and pains, it can be beneficial for skin health.

    A 2010 study by researchers from Beijing Daxing Hospital found the therapy very effective in managing acne. The study involved 200 acne sufferers who were divided into two groups: an acupuncture treatment group and a drug therapy control group. The former underwent four sessions of acupuncture treatments, while the latter was prescribed antibiotics in the form of tetracycline and metronidazole tablets.

    After two months, some 94 percent of the patients in the acupuncture treatment group saw positive effects, with 34 stating that they had fully recovered and 43 more reporting that over 70 percent of their skin lesions had disappeared. By comparison, 82.5 percent of participants in the drug therapy control group experienced a beneficial outcome, with 16 reporting a full recovery, and 21 reporting that over 70 percent of their skin lesions had disappear7.

    Another study, published in 2014 in the Journal of Alternative and Complementary Medicine by researchers from the Beijing University of Chinese Medicine, found that acupuncture was also effective in managing melasma.

    The researchers evaluated data from six trials published before July 2013 where acupuncture was used to manage women with melasma.

    The affected areas decreased by over 90 percent in the 468 female participants who underwent acupuncture treatments8, leading researchers to conclude that acupuncture was more effective in managing melasma than Vitamin C and E tablets.

    TCM physicians believe that acupuncture helps dispel the heat and dampness that cause skin problems. They also believe that the insertion of acupuncture needles into the skin triggers the body’s self-repairing mechanisms – specifically, it boosts collagen and elastin production in the affected areas and causes skin to appear plumper9.

    Acupuncture can also lift and sculpt the jawline by tightening loose facial muscles, and reduce puffiness of the face by addressing internal issues like digestive problems and poor lymphatic drainage. The result: a healthier-looking complexion.

    References

    1 Howard, D. (2016). Is a man’s skin really different? Retrieved from International Dermal Institute website:
    https://www.dermalinstitute.com/article/is-a-mans-skin-really-different/
    2 Lim, L. B. (2016). Kidney, liver health linked to acne. Retrieved from The Straits Times website:
    http://www.straitstimes.com/singapore/kidney-liver-health-linked-to-acne
    3 Author unknown. (2017). Melasma: Who gets and causes. Retrieved from American Academy of Dermatology website:
    https://www.aad.org/public/diseases/color-problems/melasma#causes
    4 Author unknown. (2016). 5 herbal remedies for melasma. Retrieved from LifeMartini website:
    http://www.lifemartini.com/herbal-remedies-for-melasma/
    5 Eu Yan Sang. (2016). Skin health: Mirror to our internal health. Retrieved from Eu Yan Sang website:
    http://www.euyansang.com.sg/skin-health%3A-mirror-to-our-internal-health/eysbeauty1.html
    6 Harris, S. (2016). Eczema and women’s hormones. Retrieved from WebMD website:
    http://www.webmd.boots.com/skin-problems-and-treatments/eczema/features/eczema-womens-hormones
    7 Author unknown. (2017). Acupuncture acne treatment protocol found effective. Retrieved from Healthcare Medicine Institute website: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1712-acupuncture-acne-found
    8 Chai, Q. Fei, Y. Hong, Y. Cao, H. (2014). Acupuncture for melasma in women: A systematic review of randomized controlled trials. Retrieved from the Journal of Alternative and Contemporary Medicine website:
    http://online.liebertpub.com/doi/full/10.1089/acm.2014.5103.abstract
    9 Author unknown. (2016). How acupuncture can rejuvenate your skin. Retrieved from Eu Yan Sang website:
    http://www.euyansang.com.sg/how-acupuncture-can-rejuvenate-your-skin/eysbeauty4.html

    TCM Perspective: Indigestion

    In TCM, our digestive system transforms food into Qi and Blood, which are the most important substances necessary for life. Thus, maintaining good digestion is the basis for good health.

    Our digestive system includes the functions of the Stomach, Spleen, Large Intestine and Small Intestine.

    The Stomach is the main receiver of the food we consume. It is in charge of receiving and breaking down food and liquids for further absorption. If this function is disturbed, disharmonies such as loss of appetite, nausea and vomiting may occur.

    The Spleen is the key organ of digestion in TCM. It transforms the nutritive essence from food and liquids in the Stomach into Qi, Blood and body fluids. The Spleen is also responsible for water metabolism. When the Spleen is in disharmony, symptoms like abdominal distention, poor appetite, loose stools or edema may follow.

    The Small Intestine receives food from the Stomach to carry out the further absorption of essential nutrients needed by the body. Disharmony in the Small Intestine may give rise to urinary or bowel disorders.

    The Large Intestine receives residual materials sent down from the Small Intestine, absorbs the remaining nutrients and essential fluids, then excretes the waste in the form of faeces. Dysfunction of the Large Intestine may result in abdominal pain, loose stools or constipation.

    The Bladder stores and excretes urine. Common urinary problems may be manifested as incontinence or difficulty in urination, with a burning or painful sensation.

    Digestive Disorder

    Lifestyle, stress and dietary factors can put a strain on our digestive system. TCM provides satisfactory relief for digestive disorders through herbal medication, acupuncture and other treatment methods.

    Here are some common digestive disorders and their related treatments from the TCM perspective:

    (A) Indigestion
    Indigestion is a condition caused by food stagnation. Overeating, eating too fast, or having a weak digestive system may also contribute to indigestion. Common symptoms of indigestion include fullness, bloating or aching in the upper, middle or lower abdomen, hiccups, a poor appetite, or breaking wind accompanied with strong and undesirable smells and bad breath.

    In TCM, the treatment principles work by nourishing the entire digestive system to improve our digestive functions, as well as inducing bowel movements to remove stagnant food.

    Common Chinese herbs used to relieve digestive problems are Hawthorn Berry (Shanzha, 山楂), Barley Sprout (Maiya, 麦芽), Rice Sprout (Guya, 谷芽), Chicken Gizzard Lining (Jineijin, 鸡内金), Unripe Bitter Orange (Zhishi, 枳实), Tangerine Peel (Chenpi, 陈皮) and Areca Seed (Binglang, 槟榔).

    Acupuncture, massage, herbal medicines and dietary changes can help to relieve digestive problems too.


    (B) Irritable Bowel Syndrome (IBS)
    IBS is a common gastrointestinal disorder which may manifest itself differently from person to person. Some of the common symptoms of IBS are abdominal bloating, cramping or pain, flatulence, diarrhoea and/or constipation. Common symptoms of indigestion include fullness, bloating or aching in the upper, middle or lower abdomen, hiccups, a poor appetite, or breaking wind accompanied with strong and undesirable smells and bad breath.

    IBS can result from eating too much greasy or spicy food, or from emotional factors such as depression, excessive anxiety and insomnia. These emotional factors may be triggered or aggravated by stress.

    For symptoms of IBS, TCM prescriptions use herbs such as White Atractylodes (Baizhu, 白术), Tangerine Peel (Chenpi, 陈皮), Poria (Fuling, 茯苓), Siler Root (Fangfeng, 防风), White Peony Root (Baishao, 白芍), Licorice Root (Gancao, 甘草), Chinese Yam (Huaishan, 淮山) and Dried Ginger (Ganjiang, 干姜).

    Acupuncture helps by alleviating the pain, regulating bowel movements and preventing abdominal pains or cramps associated with this condition. It also regulates the gastrointestinal functions, which may in turn manage the root of the problem.


    (C) Heartburn
    Heartburn is a condition where our Stomach acid rises up to the oesophagus. It is also known as acid reflux or acid regurgitation. The acid may cause a burning pain in the chest or throat, and leave a sour taste in the mouth. In TCM, heartburn is regarded as a manifestation of disharmonies in the Stomach and Liver’s functions. The basic treatment principle is to restore balance to optimise the functions of the Liver and Stomach.

    Common herbs used to relieve heartburn symptoms are Processed Pinellia (Zhibanxia, 制半夏), Chinese Dates (Dazao, 大枣), Licorice Root (Gancao, 甘草), White Poeny Root (Baishao, 白芍), White Atractylodes (Baizhu, 白术), Peppermint (Bohe, 薄荷), Hare’s Ear Root (Chaihu, 柴胡), Chinese Angelica (Danggui, 当归), Poria (Fuling, 茯苓) and Fresh Ginger (Shengjiang, 生姜).

    Ban Xia Xie Xin Wan (半夏瀉心丸) and Xiao Yao Wan (逍遥丸) are two classic formulae commonly used to reduce acid reflux and relieve heartburn symptoms.

    Beware These 6 Confinement Myths

    In TCM, a woman loses large amounts of Qi and blood during childbirth, putting her body in a “cold” phase. This is why Chinese culture recommends a month-long period of “confinement” for the new mother. These weeks of rest and a modified diet are intended to restore the mother’s balance and return her to full health.

    While certain confinement practices are common, it’s a bad idea to follow them blindly. Discover the truth behind the myths from a TCM perspective.

    1. Myth: Do not drink plain water
    This comes from the belief that drinking plain water causes water retention or will cool down the body too much.

    The truth: There is no harm in drinking plain water. In fact, because new mothers tend to sweat heavily because of hormonal changes, they have all the more reason to drink water and keep hydrated. However, new mothers should be encouraged to drink warm water instead of cold water.

    2. Myth: Consume alcohol
    Drinking alcoholic beverages or eating dishes cooked with alcohol is thought to boost blood circulation and warm up the body.

    The truth: It is correct that alcohol is used in TCM to expel cold and promote circulation. That said, new mothers should not regard alcohol as essential to their recovery. In fact, nursing mothers should avoid alcohol, since it can be passed on to their baby through breast milk.

    3. Myth: Do not shower or wash one’s hair
    Contact with water is thought to cause “wind” to enter the body and lead to headaches and rheumatism later in life. This taboo may have originated from northern China of the past. Since water quickly became freezing because of the cold weather, it was easy to catch a chill from bathing.

    The truth: It is perfectly fine to continue one’s bathing habits. Besides maintaining personal comfort, regular bathing helps prevent skin and wound infections. However, the mother should not bathe with cold water. She should also dry her body immediately after bathing to prevent exposure to cold air.

    4. Myth: Consume plenty of herbal supplements
    Since childbirth drains a woman of Qi, it is recommended that she stock up on specific herbal soups and dishes that boost energy and blood.

    The truth: Since every woman’s health profile is different, she may not benefit from the same remedies that help others. It is better to consult a qualified TCM physician for personalised advice and treatment.

    That said, one dietary recommendation can be generalised to all new mothers. In TCM, it is best to avoid cooling foods during confinement. Eating such foods carry a risk of harming one’s Spleen and Stomach and hampering recovery. Foods to avoid include bamboo shoots, bananas, crabs and oysters.

    5. Myth: Do not read or cry
    Childbirth is thought to weaken the Liver, which is linked to the eyes. Therefore, one should avoid putting stress on the eyes by reading or crying. Otherwise, one might experience eye problems later in life.

    The truth: There is no basis for the belief that reading or crying would lead to eye problems. However, TCM experts do hold that the large loss of blood during childbirth may weaken the eyes. This is because blood is related to the Liver, which is associated with the eyes. Regular consumption of Liver-protecting foods, such as Chinese Wolfberries, would help maintain eye health.

    6. Myth: Wear warm clothing and do not use fans and air-conditioning
    As with bathing, any exposure to cool air is said to cause “wind” to enter the body and lead to health problems later in life.

    The truth: The key here is moderation. The new mother should do what makes her comfortable. In a hot and humid climate, fans and air conditioners may even be essential for preventing heat rash. However, the new mother should not let the fan or air-conditioner blow directly on her.

    All About Cholesterol

    Dr Tan Hong Chang, Associate Consultant in the Department of Endocrinology, Singapore General Hospital, explains that the human body is a cholesterol factory as it needs cholesterol to function. “Cholesterol is used by the body to make cell membranes, hormones and vitamin D,” he explains. “It’s also part of the outer covering of nerves, and is a component of bile. As the body is able to make cholesterol in the liver and other organs, there is no minimum requirement for cholesterol intake.”

    Good cholesterol (HDL) helps transport cholesterol from the blood to the liver, before excretion in the bile. Bad cholesterol (LDL) is deposited in the blood vessels, forming plaques in the arteries. The relative level of HDL and LDL in your blood is dependent on genetics and diet. When we refer to high cholesterol levels, we predominantly refer to the bad cholesterol, ie high LDL-cholesterol. “High cholesterol increases cardiovascular risk because cholesterol can get deposited in the arterial wall, causing narrowing and hardening of the artery, which leads to atherosclerosis,” reminds Dr Tan. The total cholesterol-to-HDL ratio is an indication of the proportion of good and bad cholesterol, and is a better indicator of cardiovascular risk than total cholesterol.

    Dr Peter Eng, Consultant Endocrinologist at Peter Eng Endocrine Clinic in Mount Elizabeth Medical Centre, advises that our body needs to maintain a desirable cholesterol level of no more than 5.2mmol/L (200mg/dl). Total cholesterol levels above 6.2mmol/L (240mg/dl) or LDL-cholesterol levels above 4.1mmol/L (160mg/dl) are considered high for a person without other risks of heart disease. A person with other risk factors for heart disease—such as smoking, hypertension or diabetes—requires a lower target level.

    Risk Factors

    Li Guang Jun, a registered TCM physician with the Eu Yan Sang TCM Clinic at Seragoon Nex and Eastpoint Mall, comments, “In TCM, high cholesterol is thought to result from chronic mental stress or excessive emotional upheavals, which cause the liver qi to stagnate, producing “fire” that depletes yin in the liver. Consuming too much alcohol and a high-calorie diet can also damage the spleen and stomach, resulting in the build-up of toxins, phlegm and “dampness. Risk factors include a family history of high cholesterol, menopause, heavy smoking and drinking, obesity, and/or chronic conditions such as diabetes, high blood pressure and a fatty liver. Chronic mental stress is also a risk factor.”

    According to Physician Li, symptoms of high cholesterol include:

    • phlegm stagnation

    • qi stagnation

    • blood stasis

    • deficient yin in liver and kidney

    In TCM, a person’s inability to digest efficiently may affect how cholesterol is processed and stored in the body. Similarly, with blood and fluid circulation, slower fluid circulation will encourage more or larger deposits of cholesterol, while poor blood circulation is seen in many types of arthritic disorders as well as some types of cardiovascular diseases. Excretory system dysfunction is also a huge indicator, as “the relationship between the liver and bile production is critical to ensure cholesterol is eliminated efficiently when bile is released.”

    TCM – A Complementary Approach

    When Ms Rachel Chan was preparing her 5-year-old for an operation to refine an earlier procedure for his cleft palate, she reached for the best that medicine had to offer – from the East and the West.

    On her sister’s advice, Ms Chan sought the opinion of a Traditional Chinese Medicine (TCM) practitioner, who had qualifications in both the Biomedical Sciences and TCM. The practitioner concurred that the child had environmental allergies, and also found that “the qi of his endogenous lungs was weak and needed strengthening,” says the 34-year-old stay-at-home mum.

    The physician prescribed herbs – among them bamboo and mulberry leaves, and chrysanthemum and honeysuckle flowers – which Ms Chan brewed into a drink for her son to help fight bacteria and reduce inflammation. She also started him on tui na to help him cough up his phlegm more effectively. Two weeks later, the boy’s cough had improved, and she moved him on to a nourishing brew of wild American ginseng and dendrobium stem to prepare him for surgery. Ms Chan also made TCM a part of his post-operation recovery plan.

    Today, she continues to include TCM in managing her son’s general wellness. “When he falls sick, he recovers faster and stays well for longer,” she says.

    Similarly, stay-at-home mum Brenda Tan wanted a form of treatment that targeted the root of her then six-year-old daughter’s persistent and recurring eczema. She found a “non-steroidal” cure in TCM. Besides oral herbal medication, Ms Tan received herbs for her daughter’s bath and a topical cream for the affected areas. “I was also given a list of food items that my daughter was to avoid,” she adds.

    Treatment continued for about a year, and “the eczema never came back”.

    Total wellness

    Ms Chan and Ms Tan are among a growing number of parents exploring – and embracing – TCM as a complement to conventional Western medicine, says Eu Yan Sang physician Anita Pee.

    By 2015, TCM practitioners at Eu Yan Sang Integrative Health in Singapore were managing over 13,000 children aged 12 years and below a year. This age group, which formed 15 per cent of the Group’s patients, represented an increase of more than 40 per cent over 2011.

    Most parents are drawn by TCM’s holistic nature and its emphasis on total mind and body wellness, as well as the role it can play in preventing disease, boosting a child’s immunity, and enhancing growth and development, explains Ms Pee.

    “TCM is natural, with minimal side effects,” she says. “And it manages the root causes of diseases and conditions.”

    Because their bodies are inherently immature, children are susceptible to illnesses, particularly those that affect the lungs and the spleen. That is why for children, TCM’s focus is on shoring up immunity and vitality, or ‘qi’.

    “When using TCM to bolster the child’s immunity, we focus on building up the ‘qi’ in these organs through TCM herbs, paediatric tuina and by advising (caregivers) on the right diet for the child,” says Ms Pee.

    When considering TCM for their children, many parents also wonder where it might fit into a child’s existing wellness and medical regime.

    That was at the top of Ms Chan’s list of questions.

    “I was concerned that the TCM practitioner would ignore Western fundamentals of diagnosis and medicine… but I was reassured after I received practical advice from my physician, who also gives her young children TCM herbs,” she says. This included tips on diet and getting adequate sleep.

    Ms Tan was pleased to find that her TCM physician was fully bilingual in English and Chinese, as many practitioners are these days. She had been worried that a language barrier would affect her ability to understand and follow through with her daughter’s treatment plan.

    Not miniature adults

    What is important when incorporating TCM into a child’s health regime is to remember that children are not miniature adults. Children are less mature both physically and functionally, Ms Neo says. To ensure safety and efficacy, they should not be given herbal medication prescribed for an adult, even in smaller doses.

    The type of herbs prescribed and their dosage depend on the child’s condition, age and weight, she says, citing a case where two brothers, just a year apart and presenting similar symptoms, needed different herbs and dosages.

    She also cautions that TCM is not always the answer, for example, in cases when a child is experiencing acute symptoms, such as high fever, vomiting and convulsions. These should be managed at a hospital, as should conditions like suspected appendicitis and fractures.

    Parents must additionally be aware of the different TCM therapies, and the age at which they are appropriate.

    Generally speaking, the best age to start herbal treatments is six months, or after the child has begun eating solids, Ms Pee says. Herbs that can affect hormonal development are only prescribed after adolescence.

    Another common and effective TCM therapy for young children is paediatric tui na. This is very different from the adult version, and can benefit children as young as six months old. “This technique enhances a child’s energy flow by massaging various acupoints that are specific to children,” Ms Pee says.

    Treatments like acupuncture and cupping are generally not recommended before adolescence. There are, however, some exceptions. These are decided by trained physicians on a case-by-case basis, says Ms Pee.

    What is suitable and when

    TCM herbs, paediatric tui na
    Infants: From six months to 1 year old
    Toddlers: Between 1 and 3 years old.
    Preschoolers: Between 3 and 7 years old.

    TCM herbs, regular tui na
    School-age children: 7 years old to pre-puberty.

    TCM herbs, regular tui na, acupuncture, cupping
    Adolescents/teenagers: Puberty to 18 years old for girls and 20 years old for boys.

    The right TCM partner

    With TCM being increasingly accepted as a viable form of treatment worldwide, authorities in several countries have taken steps to regulate practitioners in the TCM sector. This provides a starting point as to who you can trust with your child’s health, says Ms Pee.

    In Singapore, for instance, trained TCM practitioners are licensed by the Ministry of Health’s Traditional Chinese Medicine Practitioners Board. In Europe, there are regulations in several countries including Austria, where a TCM practitioner must also be a medical doctor, and Switzerland, where the practice of TCM is regulated by federal law1.

    This is reassuring for parents like Ms Chan and Ms Tan who have chosen to make TCM a part of their children’s wellness regime, even as they continue to consult with regular pediatricians.

    “My son still falls sick like any regular child and we still consult a pediatrician. But with TCM, the symptoms are a lot more manageable,” says Ms Chan.

    What is suitable and when

    Good lifestyle habits should also be practiced. These include getting adequate sleep, having moderate exposure to cold weather to “build up the child’s resistance to external pathogens”, and catching some sun to “help boost yang qi, which is important for a child’s development”.

    This holistic approach to strengthening immunity is something Ms Ling appreciates – although it took some effort on her part as well.

    “When we first started TCM, my daughter had trouble taking the herbs, but now it’s no longer an issue,” she says. “And happily, she doesn’t fall sick so frequently anymore.”

    It Takes Two

    The odds of getting pregnant seemed stacked against 37-year old Cathy Tan*.

    When she first consulted Dr Ann Tan at the Women & Fetal Centre in Singapore, the consultant obstetrician/gynaecologist found fibroids, ovarian cysts and polyps in her uterus. Surgery to remove them also removed her right ovary, decreasing her chances of getting pregnant.

    Cathy was also running out of time. Even with in vitro fertilization (IVF), the chances of conceiving was only between 20% and 30% past the 38-year mark.

    Recovering from surgery, she began researching complementary traditional Chinese medicine (TCM) therapies, and when she began IVF treatment in 2011, decided to try them alongside conventional treatment. “The Chinese herbs I would be taking could only be good for my body, so why not try it?” she rationalized

    Upon Dr Tan’s recommendation, she came under the care of Zhong Xi Ming, a senior physician with Eu Yan Sang in Singapore. The two worked hand in hand, combining the best of western fertility treatment with acupuncture and Chinese herbs to help Cathy become a mother.

    It took three cycles, but Cathy gave birth to her first child, a boy, the same year. Two years and two TCM/IVF cycles later, she became the mother of another son.

    Better together

    Increasingly, medical doctors and TCM physicians are working together to help couples become parents. And with good reason.

    A 2015 study by researchers from the Oregon College of Oriental Medicine, Oregon Health and Science University and the Northwest Center for Reproductive Sciences in Washington found that patients that complemented their IVF treatments with “whole-systems traditional Chinese medicine” had more live births (61.3%) than those who received only “usual” IVF care (48.2%). Whole-systems TCM includes acupuncture and Chinese herbal medicine as well as dietary and lifestyle recommendations.

    Even those who received just acupuncture alongside usual IVF care recorded a higher proportion of live births (50.8%), the study found. The study looked at the results of 1,231 fresh cycles.

    Another study led by cellular biologist Dr Shahar Lev-Ari, head of the integrative medicine unit of Tel Aviv University’s medical school in Israel found that TCM therapies gave a measurable boost to intrauterine insemination (IUI), with 65.5% of the test group conceiving, compared with 39.4% of the control group.

    “I am open to recommending my patients to avail themselves to TCM alongside Artificial Reproductive Technology (ART),” Dr Tan says. “I have had positive experiences with my patients’ use of TCM, and many couples do it quietly anyway, so I prefer to be upfront and ask them about it.”

    Physician Zhong recalls that when she first joined the Eu Yan Sang’s Reproductive Department more than a decade ago, she was unconvinced about the need for such a department, but people started streaming in.

    Both Dr Tan and Ms Zong consider Cathy their “miracle” patient.

    “It was a nice combination of work from Physician Zhong and myself to get the eggs out from someone who hardly produced any,” Dr Tan recalls. “And she wanted another and we both got stressed but she did it again!”

    Well-timed therapies

    Collaboration usually involves the two medical modalities taking precedence at different stages of the treatment plan, each referring patients to the other when necessary to ensure good quality eggs and sperm, successful implantation and a healthy, full-term pregnancy.

    TCM plays a particularly active role in the preparatory and pre-implantation stages.

    “Herbs and acupuncture can help to improve the womb lining, and enhance follicles so that the patient has a stable womb lining when the embryo is transferred to it,” says Physician Zhong. “Increasing the yang energy also helps to create a good uterine lining environment and increase the likelihood of successful embryo implantation. Factors such as a calm mind and a harmonious flow of qi and blood through the body also influence the blood circulation in the ovary and uterus, and have a positive effect on the success of IVF.”

    Acupuncture, in particular, has become popular with women undergoing fertility treatment, with several studies supporting its benefits as complementary treatment for IVF. In 2002, 160 IVF patients at a German fertility clinic participated in a study on acupuncture. Half of them received acupuncture 25 minutes before and after embryo transfer, while the other half received no complementary therapy. All 160 had good quality embryos transferred. Thirty-four of the 80 women who received acupuncture got pregnant compared to 21 of the 80 women in the control group.

    A journey requiring resilience

    Although ongoing studies and growing anecdotal evidence offer hope to couples struggling to conceive, the journey to a successful pregnancy and birth can be an emotional rollercoaster, requiring great resilience.

    “After my first failed IVF, I felt sad and thought that I was probably hopeless,” Cathy shares.

    Also, “the most successful treatment is one where both partners are equally in tune to reach the goal of having a baby,” Dr Tan advises. “It’s always very difficult and stressful when one partner wants it more than the other. They must realize that it’s not a blame game; try to make the best out of what you both are as a couple.”

    As always, work with a qualified TCM practitioner, and keep both your doctor and TCM practitioner informed of all treatments you are receiving.

    (*Name has been changed to protect the patient’s privacy)

    Studies cited/Sources:
    http://yourivfacupuncture.com/ya/wp-content/uploads/2010/04/Whole-systems-acupuncture-and-ivf-1.pdf
    http://www.israel21c.org/trouble-getting-pregnant-try-chinese-medicine/
    http://www.dailymail.co.uk/health/article-2084575/Traditional-Chinese-medicine-makes-fertility-treatments-effective.html
    http://yourivfacupuncture.com/what-is-the-process/research/medical-research-article-2/

    Covid-19 in TCM’s Point of View

    Over the past thousands of years of Chinese history, TCM has battled against hundreds of plagues that led to the accumulation of effective treatments and prevention methods to alleviate the symptoms experienced. Coronavirus disease (COVID-19) as we experience today, is also classified as a “plague”.

    Unlike a common flu that is caused by common pathogenic factors (e.g. wind, cold, heat, humidity, dryness and fire), plague is often associated with dampness and toxin pathogens. Currently, the clinical observations in China have shown that COVID-19 is commonly caused by the interactions of dampness, toxin, heat, and stasis, of which dampness being the most dominate pathogenic factor.

    For mild to moderate stages of COVID-19, the common symptoms observed are low fever, tiredness, dry cough, muscle ache, nausea or diarrhea. The common syndrome is “lung with dampness toxin retention” and hence the TCM treatment principle is to eliminate exterior pathogens, heat and dampness, detoxify and invigorate the spleen.

    Why do some people have it worst then? This is because COVID-19 is a disease that presents itself in different stages. For the critical stages, the toxin further attacks the lung and heart, at worst blocking the vital organ’s function and resulting in the collapse of yang qi in the body. This results in high fever, shortness of breath, unconsciousness, multiple functional failure and shock. The treatment principle at this critical stage aims to ventilate lung qi, remove heat to restore consciousness and to recuperate the yang qi.

    Here are some tips to help with your recovery from Covid-19.
    Do:
    consume smaller meal portions at the beginning and slowly increase portion as your appetite returns.
    Start off with food that are easy to digest, for example diluted porridge.

    Incorporate other nutritious food as you regain appetite, such as thicker porridge, fish meat and chicken soup.

    Tips: To remove excess dampness and strengthen your spleen, you can boil lotus leaves in water first and use this water to later cook your porridge. You can also add Chinese barley (薏苡仁), Chinese yam (山药), lotus seed (莲子), tangerine peel (陈皮) and Qian Shi (芡实) into your diet too.

    Don’t:
    over-consume cold and raw food such as fruits and salads, spicy and oily food as it will trap dampness and further burden your spleen and stomach.

    Sources: https://cmjournal.biomedcentral.com/articles/10.1186/s13020-020-00375-1

    Natural Rhythm of Yin & Yang in Our Body

    Sleep is an essential part of your life. It is not only a form of rest, but a physiological function that helps your body to recharge and perform at its best the next day.

    In TCM, sleep is part of the natural rhythm of Yin and Yang in the body. In the concept of Yin-Yang, Yin represents passive forces while Yang represents active forces. TCM classic The Spiritual Axis (Lingshu, 灵枢) uses the Yin-Yang concept to explain sleep in chapter 28. It is said that “when Yang is depleting and Yin is abundant, one’s eyes are closed. When Yin is depleting and Yang is predominant, one is awake.”

    Sleep is also believed to be regulated by the cycle of Protective Qi (Wei Qi) and Nutritive Qi (Ying Qi). Protective Qi flows along Yang meridians for 25 rounds during the daytime and circulates through the Yin meridians for another 25 rounds at night. The cycle in the day enables the body to be active and awake, while the cycle at night enables the body to rest and recharge.

    Sleep is a part of the Shen activities which function in the day and cease during the night to allow the Heart, Liver, Spleen, Lung and Kidney meridians to rest and recharge. You will be able to sleep well when the Shen is rooted and rested, but your sleep will be affected if the Shen is disturbed.

    Ideal Time to Sleep

     

    In TCM, Qi flows through 12 principal meridians within the body in a 24-hour cycle. When Qi flows through a specific principal meridian, it takes around 2 hours to vitalise and strengthen the organ system associated to that particular meridian before continuing to subsequent meridians.

    The ideal time to sleep in accordance to the meridian clock is by 11pm. If your sleep is disturbed at a certain hour repeatedly, it is an indication that the paired organ system may require your attention.

    TCM Diagnosis Methods

    In TCM, external symptoms are the manifestation of internal imbalances. Hence, a TCM physician assesses one’s state of health by analysing external symptoms displayed to seek evidence of internal problems. Unique diagnostic methods are used to collect and analyse clinical information.

    There are some diagnostic methods in TCM which are essential for determining the root causes of a health problem. A professionally trained TCM physician is usually able to differentiate the root causes of a problem by applying the following methods:

    • Observations (望): observe the entire body, which includes the tongue, complexion, body shape, posture, movement and vitality

    • Smelling and listening (闻): observe the smell of body odours, excretions and secretions; listen to the voice, tone, and sound of respiration or cough

    • Questioning (问): inquiring about the main concerns or complaints, the onset and duration of the problem, and relevant medical history and symptoms

    • Pulse analysing (切): feeling and evaluating the pulse by pressing on certain parts of the body such as the skin, muscles, acupoints, limbs, chest, abdomen and other areas

    Understanding Basic TCM Terms

    Traditional Chinese Medicine (TCM) is an ancient art of healing and an increasingly accepted practice around the world. Rooted in the ancient philosophy of Taoism, TCM dates back to more than 2,500 years ago.

    Here is a quick guide on the meanings behind commonly used TCM words.

    Five Elements

    The 5 elements are: wood, fire, earth, metal and water. Each has a specific characteristic as illustrated below:

    Qi

    A person’s vital life force, it is the source of energy flow in one’s body. If the qi is up and running, everything is in harmony. If the qi is weak or imbalance, illness and disease will occur.

    Meridian Systems

    The body has 12 principal meridian channels, and its primary focus is to carry and distribute qi, body fluids and blood to every part of the body. Meridians do not have anatomical structures. Along these 12 channels, lie acupoints. There are approximately 365 acupuncture points. Each point belongs to a particular meridian channel that connects to specific organs.

    Yin vs. Yang

    TCM considers the world as a single unit and its movement gives rise to yin and yang. The two opposing yet interdependent forces must maintain balance, and one cannot dominate the other. It is a concept used to diagnose patterns of disharmony and determine treatments to restore balance.

    The 5 Organs & their roles

    The Liver System

    Role: Regulates the qi movement throughout the body.

    Function: The Liver stores sufficient blood, boosts the digestive functions of the Spleen, nourishes the eyes from blood stored in the Liver and ensures proper movement of tendons preventing symptoms like spasms, numbness of limbs and difficulty bending or stretching.

    The Spleen System

    Role: Assists with digestion, and governs blood flow and fluid metabolism in the body.

    Function: Transform food into essence used for qi and blood transformation. Our spleen’s health is reflected in lips, mouth and movement of the limbs and muscles.

    The Lung System

    Role: Regulars qi movement necessary for blood circulation, fluid metabolism, the autonomic nervous system and the immune system.

    Function: Controls the circulation of qi and blood to moisten skin and body hair. When these functions are weakened, skin and hair become dull, rough and dry.

    The Heart System

    Role: Regulates the cardiovascular system while maintaining the nervous system’s functions. Qi from a health heart maintains an efficient blood flow in the blood vessels.

    Function: The heart stores the “spirit”, an individual’s vitality. This ensures optimum mental, cognitive and intellectual abilities.

    The Kidney System

    Role: Regulates the urinary system, and controls the reproductive and nervous systems.

    Function: The kidney stores ‘Jing’, an essential substance for bone growth, closely associated with life. Dental problems, hair loss, immature hair greying, hearing problems and urinary tract disorders are all signs of disharmony in the kidney system.

    Acupuncture

    It is a physical treatment that uses hair-thin needles at specific points on the body. Acupuncture helps to restore balance, clear blockage within the meridians and strengthens qi. It is commonly used in pain management, arthritis, depression, allergic rhinitis and other health issues.

    Cupping

    It is a physical treatment that uses glass or bamboo cups that are warmed to create a partial vacuum, so that a suction force can be created on the skin’s surface. Cupping helps to activate the lymphatic system promote blood circulation and aid deep tissue repair.

    Tuina

    It is a combination of massage, acupressure and other forms of body manipulation by applying pressure to acupoints, Meridians and groups of muscles or nerves to remove blockages that prevent the free flow or circulation of qi and blood.

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