EYS TCM Clinic

TCM – A Complementary Approach

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.”

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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.

1 Author unknown. (2017). Acne. Retrieved from American Academy of Dermatology website:
2 Author unknown. (2017). How to recognise all the different signs of acne. Retrieved from Acne.com website:
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:
4 Author unknown. (2016). Skin health: Mirror to our internal health. Retrieved from Eu Yan Sang website:

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


  • 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


  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.”

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