1. COLIN Chan Introduction of Herbal Medicine…

2. A) TCM Practice in Singapore

3. Legislation and Registrations Regulation of TCM Practice 1.The Traditional Chinese Medicine Practitioners Act was passed on 14 Nov 2000. 2.The registration of TCM Acupuncturist started in 2001. 3.The registration of TCM physicians in 2002. 4.With effect from 1 January 2004, those who wish to practice the prescribed practice of TCM are required to be registered with the TCM Practitioners Board and possess valid practicing certificates. Complimentary medicine including Traditional Chinese Medicine (TCM). MOH, Singapore. Copy right: : Colin Chan

4. Types of Registrations Full Registration. Conditional registration. Proceed to the application of practicing certificate. Copy right: : Colin Chan

5. The term “Traditional Chinese General Medicine” Means: 1.Acupuncture. 2.Diagnosis, treatment, prevention or alleviation of any disease or any symptom of a disease or the prescription of any herbal medicine. 3.The regulation of the functional states of the human body, on the basis of traditional Chinese Medicine. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Copy right: : Colin Chan

6. The term “Herbal Medicine” Means: 1.Any material or product known or claimed to have therapeutic or other heath benefits which contains either raw or processed ingredients of plant, inorganic or animal origin. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Copy right: : Colin Chan

7. Standard of good TCM practice … Must include: 1.Good history taking and appropriate TCM clinical examination. 2.No remote initial consultations. 3.Only use appropriate and accepted methods of TCM treatment. 4.Not to offer treatment packages in a form of “guarantee of a cure”. 5.Referrals. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Copy right: : Colin Chan

8. The Medical Records … Must include: 1.Particulars of patient. (Name, IC, Gender, Age, Add, Contact) 2.Drug allergies and medical history. 3.Main complaint. 4.Other observations. 5.Diagnosis. 6.Treatment. 7.Prescription. 8.Instructions to patient. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006 Copy right: : Colin Chan

9. Must include:  Name and signature of TCM physician.  Name and address of place of practice.  Name and address of patient.  Date of prescription.  Name and dosage of herbal medicine.  Total amount to be supplied.  Route of administration.  Preparation method. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Prescription… Copy right: : Colin Chan

10. TCM is the study of… TCM theories TCM diagnostic doctrines, principal of treatment and treatment methods Herbal medicine and TCM prescriptions Acupuncture Ailments of different disciplines Diet Therapy/Tuina/History/Case studies etc. Copy right: : Colin Chan

11. B) Before the application of Herbal Medicine…

12. TCM diagnostic doctrines 4 analytical methods. (collect information) 8 parameters. (categorize conditions) Diagnosis based on Qi, blood and body fluid. Diagnosis based on 6 meridians. Diagnosis based on organs/viseras. Diagnosis based on pathogens etc. Copy right: : Colin Chan

13. Observation (tongue). 望 Auscultation/Olfaction. 闻 Interrogation (Asking). 问 Palpation (pulse). 切 TCM Analytical methods Copy right: : Colin Chan

14. Observation of the tongue … Tip – Heart/Lung (1 st ) Center – Spleen/Stomach (3 rd ) Root – Kidney (4 th ) Margin – Liver/Gall Bladder (2 nd ) Body and Coating color, shape, texture, movement, nature Copy right: : Colin Chan

15. Example … Normal Copy right: : Colin Chan

16. Palpation 切 Pulse (Very common, usually radial pulse). Chest. Abdomen. TCM diagnostic method Copy right: : Colin Chan

17. Analysis of the pulse … Include: Speed. Strength. Shape and dynamics. Flow and regularity etc. Front: Cun 寸 Middle: Guan 关 Rear: Chi 尺 Copy right: : Colin Chan

18. Example … Some examples: Floating. Deep (sink). Late (delayed). Rapid. Smooth. Un-smooth. Bounding. Soft and floating. Full. Thin and small. Abrupt and irregular. Slow and irregular etc. Copy right: : Colin Chan

19. Great clinical significance in TCM… 1.When disease occurs, qi and blood vary leading to pulse change. 2.Pulse examination can establish… the health status of the patient, the characteristics of causative factors, the progression and changes of ailments. The pulse … Copy right: : Colin Chan

20. Applications of the 8 parameters … Exterior / Interior (depth). Cold / Hot (characteristics). Deficiency / Excess (aggressiveness). Yin / Yang (Over-all status). It often combines, interact, inter-change in clinical settings. Copy right: : Colin Chan

21. Take 5 … Copy right: : Colin Chan

22. Principal: As a basic guideline to treatment. Methods: 1.Internal treatment (herbal medicine, diet therapy). 2.External treatment (acupuncture, tuina, topical). Principal of treatment … Copy right: : Colin Chan

23. C) About TCM Herbal Medicine Copy right: : Colin Chan

24. TCM Treatments … The use of CMM:  Legally available in Singapore (GMP standard, HSA tested).  Reasonable quantities.  Name of medicine as used in CMM. PS: CMM: Chinese Herbal Medicine Materia Medica Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Copy right: : Colin Chan

25. Types of CMM… 1.Plant type. 2.Animal origin. 3.Insects group. 4.Marine source. 5.Mineral source. PS: CMM: Chinese Herbal Medicine Materia Medica. Copy right: : Colin Chan (root / stem / bark / twig / bud / petals / flower / leaves / fruit / seed,etc).

26. Treatment methods Mainly 11 ways (internal)…  Perspiration (Han)  Emetics (Tu)  Purging (Xia)  Harmonize (He)  Warm (Wen)  Clear (Qing)  Tonify (Bu)  Disperse (Xiao)  Sinus clearing (Kai Qiao)  Calming (Zheng Nai)  Astringent (Gu She) Copy right: : Colin Chan

27. Herbal Medicine The study of Herbal Medicine in…  Categories.  Properties and Characteristics.  Harvest and Storage and treatment of herbs.  Clinical usage (pairing, dosage, preparation and consumption etc).  Herbal Prescriptions. Copy right: : Colin Chan

28. Herbal Medicine and Prescriptions Categories…  Dispersing exogenous pathogens agents.  Purging agents.  Harmonizing agents.  Heat clearing agents.  Dampness dispersing agents.  Diuretic agents.  Anti-arthritic agents.  Warming agents.  Clearing sinuses agents. Copy right: : Colin Chan

29. Categories…  Calming agents.  Liver wind calming agents.  Qi regulating agents.  Heat clearing agents.  Blood regulating agents.  Digestive agents.  Cough and phlegm agents.  Tonic agents.  Astringent and anti worm agents. Herbal Medicine and Prescriptions Copy right: : Colin Chan

30. Properties and Tastes of Herbs The 4 properties are…  Cold  Cool  Hot  Warm  (Neutral) The 5 tastes are…  Acrid  Sweet  Sour  Bitter  Salty  (Bland) Copy right: : Colin Chan

31. Examples of herb…

32. Examples of herbs…

34. The Use of Herbal Prescriptions in Western clinical settings Commonly given as supplements…  Single drug (Herbal) prescription  Complex drug (Herbal) prescription

35. Single drug (Herbal) prescription Herbal Ma Huang  Property: Warm  Taste: Acrid  Channel: Lungs and Kidney Traditional usage:  Exogenous febrile disease of the wind-cold type Research: Active ingredient: ephedrine Modern usage: Cough mixtures Bronchodilators

36. Single drug (Herbal) prescription Herbal Gan Huang Cao (Penthori Chinenesis)  Property: Cold  Taste: Bitter  Channel: Liver, Gall Bladder and Kidney Traditionally usage:  Oedema, injuries, amenorrhea Research: Active ingredient: Quercetin and Gallic acid Modern usage: Jaundice Hepatitis, Fatty liver, Ca Liver

37. Complex drug (Herbal) prescription Capsule Artrex  Combination of 4 types of herbal medicine Withania Somnifera, Boswellia Serrata Curcuma Longa, Zingiber Officinale Research: Active ingredient: Contains immuno-boosters, analgesics agents, anti- arthritic agents, anti wind agents Modern usage: Osteo-arthritis

38. Withania Somnifera (Immuno- booster effect) Boswellia Serrata (Anti- inflam. effect)

39. Curcuma Longa (Analgesic effect) Zingiber Officinale (Anti-arthritic effect)

40. Modern development of Herbs Example: Chrysanthemum… 菊花 TCM: Slightly sweet, Bitter, Cold. Lung and Liver Channel. Clearing of heat agent. Modern: Anti bacterial and virus effects. Streptococcus, Staphylococcus, Pseudomonas TB Bacillus, Flu Virus, Skin Virus. Copy right: : Colin Chan

41. TCM physicians are not allowed to prescribe/dispense any western medicines. Ethical Code and Ethical Guidelines For TCM Practitioners, TCMPB Singapore January 2006. Copy right: : Colin Chan

42. Conclusion 1. Getting more common in western clinical usage. (as Supplements). 2. Not able to fulfill the full principle of treatment in TCM 3. Disadvantages noted. 4. Technical issues noted.

43. The End