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DR. STEMMLER’S MONTHLY TEACHING ROUNDS

SEPTEMBER, 1998

What’s New in Medicine-East and West

(Copyright Stemmler, 1998)

East

Thirty four cases of chronic aplastic anemia ( a disease where the bone marrow is suppressed and does not produce red cells, white cells and platelets, which form blood in our bodies), were treated with prepared Rehmannia (a Chinese herb) in addition to the drug stanozosol (an anabolic steroid) for a course of 3 weeks, and compared to a control group, which was treated with the drug alone. Treatment effectiveness was 85.8% in the group using the herb/drug combination, versus only 58.8% in the group using only the drug.

(From:Yuan Aping, Liu Chao, Huang Xia, et al, The Second Affiliated Hospital of Henan Medical University, Zhengzhou. Chinese Journal of Integrated Traditional and Western Medicine, Vol. 18, No.6, June 1998)

COMMENTS: Aplastic anemia is a very serious disease with a high mortality rate and rather ineffective treatment. It is often a side effect of medications, most commonly due to drugs such as chloramphenicol, phenylbutazone, sulphas and gold compounds, the latter which are frequently used in rheumatoid arthritis. Many of the cancer therapies suppress the bone marrow, but virtually any of the many drugs on the market can potentially have such an effect. Often the disease just presents without any cause being found, and there is definitely an increased incidence of this condition in the Orient.

Western treatment consists of transfusions and control of infections (patients with this disease are extremely susceptible to infections) in mild to moderate cases, and high doses of steroids, cyclosporin, androgens and bone marrow transplants in severe cases.

Yet, even with all these efforts, the mortality rate in severe cases can still exceed 50%.

Prepared Rehmannia root or Shu-di-huang is mainly classified in the category of "herbs for nourishing blood", although it also has other properties, such as regulating menstrual disorders and treating diabetes. It grows in Northern China, and has long, oval leaves and reddish orange flowers with a bit of purple. Yet, only the root of the plant is used for medicinal purposes. And, depending in what form it is used, its therapeutic properties change. This is true for most Chinese herbs. To enhance the herb’s blood-tonifying properties, the root is steamed until cooked, then dried, and steamed and dried again several times, which is what is called "the cooked or prepared Rehmannia root", in contrast to using the fresh root or the dried root, both with altogether different therapeutic properties. Prepared Rehmannia is incompatible with certain herbs, as well as with garlic, onion, iron and any metal utensils or preparations. Now you can see how important it is to have the right herb prescribed, the right part of the herb, the right preparation of the herb, and being cautioned against herbs, chemicals or minerals which may inactivate the effectiveness of the herb!

We will be seeing with increasing frequency how Chinese medical therapeutics can enhance many of our Western treatments, especially those which are ineffective or just moderately effective.

 

West

Oh John, please don’t!

Oh John, please…

Oh John…

Oh…!

A double-blind, randomized study was conducted on 1998 women (not to be confused with the current year), at 21 centers worldwide. Centers included 4 in China ( Beijing, Nanjing, Shanghai and Tianjin). Of course, with its massive population, China contributed with 25% of the patient sample: 500 women enrolled. The study’s purpose was to compare 2 regimens of "the morning after pill".

Traditionally, a hormonal regimen known as Yuzpe had been used, where women were given a high dose (estrogen-progesterone) contraceptive pill in two doses, 12 hours apart. The downside was its moderate effectiveness and a high incidence of side effects (nausea and vomiting). In this multicenter study, the Yuzpe regimen was compared to the administration of only its progesterone portion, at a higher dose: levonorgestrel 0.75mg given in two doses 12 hours apart. The good news: not only was the single hormone more effective in preventing pregnancies (85% versus 57%), but it also had significantly fewer side effects. (23% versus 50% for nausea and 5% versus 18% for vomiting). (From the Task Force on Postovulatory Methods of Fertility Regulation: WHO, Randomized Controlled Trial of Levonorgestrel versus the Yuzpe Regimen of Combined Oral Contraceptives for Emergency Contraception. The Lancet, Vol.352, August 8, 1998)

COMMENTS: Of course, I hope that most of you are contraceptive conscious, but "accidents" happen; after all we are just human, and many of us have been "swept away" by a candlelight dinner, Rachmaninoff’s No. 2 playing in the background, and champagne on ice. So, should you or any women in your family ever face such a situation, you may want to ask your doctor for a prescription for 2 doses of levonorgestrel 0.75mg taken 12 hours apart. Prevention is better for your health than an abortion or an unwanted child.

 

East

Occipital (base of the skull) neuralgia (commonly known as a headache) is a condition that frequently occurs in the young and people between the ages of thirty and fifty. The stabbing or electric shocklike throbbing pain may occur every few seconds and often radiates to the top of the head. 565 patients (272 males and 293 females) were treated at a center in China during the period between January 1985 and October 1994. Many of these patients had been previously tried on medications and nerve blocks. A particular set of points primarily along the Gallbladder meridian and associated meridians, as well as local tender points were used, following classical Chinese medical theory. The curative rate was 95.1%, with 53.2% of those being cured after only one treatment.(From Ge Ji-kui and Ge Shu-han, Acupuncture Treatment of Occipital Neuralgia. Shenyang Hospital of the Air Force, Liaoning Province. International Journal of Clinical Acupuncture, Vol.9, No.1, 1998)

COMMENTS: Headaches as well as many types of neuralgias usually respond well to acupuncture. It is important, though, to make an accurate diagnosis within the Chinese theoretical framework, in order to have good therapeutic results. Depending on the general physical-mental-spiritual health of the patient, complete resolution of various types of headaches can occur between one and 20 treatments or more. How long the patient has suffered from headaches or with what frequency they occur is not as important as the patient’s general balance. I have seen patients completely resolve their headaches of 20 to 30 years in one to three or four sessions, without recurrence over several years follow up. Others, with a more recent onset of headaches and less frequent attacks may require much longer. That is why it is necessary to address the patient as a whole, and the symptom headache as only a manifestation of a far more complex underlying dysfunction. Treating the symptom headache with analgesics, muscle relaxants, sedatives and antidepressants is like putting a lid on a pot about to overcook: sooner or later it will be a real big mess.

 

West

Vitamin E- The primary food sources for vitamin E are vegetable and seed oils. Vitamin E in food, which is mostly gamma-tocopherol, acts as an antioxidant, a function that may protect against cancer and cardiovascular disease. Yet, vitamin E in supplements is mostly alpha-tocopherol which in vivo ( in living systems outside the laboratory) may actually block the antioxidant activity of the gamma- tocopherol consumed in foods, and may therefore even have a prooxidant effect. High doses of vitamin E may also interfere with vitamin K metabolism and platelet function, both of which are vital factors in our body’s capacity to control bleeding.(From The Medical Letter on Drugs and Therapeutics, Vol. 40 (Issue 1032), July 31, 1998)

COMMENTS: Time to go back into the kitchen and prepare fresh, healthy, wholesome foods from "scratch". In general, I do not recommend bottled vitamins, unless the person is truly vitamin deficient, chronically ill or unable to eat a consistently balanced diet. I realize that most of you are too busy and often too tired to shop for fresh produce and then start cooking after a long and stressful day. On the other hand, I listen to patients complain about fatigue, headaches, depression, panic disorders, upset stomachs, and "just not feeling well", and inevitably, I will obtain a dietary history and hear a horror story from a nutritional perspective. People put themselves (or allow others to influence them so) on the most bizarre and restricted regimens in order "to feel better". And all they achieve by such an extremist intervention is to deprive the body of what it wants, which is often what the body really needs. You are what you eat. Eat a variety of foods, and as straight from Nature as possible. Wholism is a concept that not only applies to us, but is actually found all throughout our Universe. Say, for example that, you decide to have a chicken-vegetable sandwich and a fruit salad for lunch, Yum! You can get a lot of vitamin E in your selection, but in a wholesome form: your whole grain bread has E, but also has B1, Niacin, pantothenic acid, Phosphorus, Magnesium, and Molybdenum! Your E actually has an "entourage"of accompanying vitamins, it enters your body in its natural form and can be recognized by your cells as such. The same will happen with the dark leafy vegetables, asparagus and cucumbers and chicken on your sandwich, and the bananas, apples (with skin!) and nuts in your fruit salad! What a different experience for the body than encountering a dark, gelatinous substance containing "E", most of its structure which is foreign to the body!

Next time you think E, think vegetable and seed oils, dark, leafy vegetables, legumes, nuts, soy products, eggs, meat, chicken and fish, parsley, cucumbers, apples and bananas, and nuts. BON APPETIT!

Christina Stemmler, MD


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