What distinguishes the approach of herbal TCM from Western herbal medicine, with respect to cancer care? Welcome back again. In this lesson, we will be discussing the key concepts of TCM, Traditional Chinese Medicine, and its impact on oncology care, primarily the use of Chinese herbal medicine. Traditional Chinese herbal medicine is one of the world's most ancient and rich schools of medicine, and it's significantly differs from other traditional schools of medicine, in its structured, whole system approach to patient care. As an example, I'm holding the root of the ginseng plant, Ren Shen in Chinese. One of the most important Chinese herbs, which is considered in Western medicine, to be an adaptogen, in that it can stabilize physiological processes, and promote homeostasis. Though Chinese herbal products such as ginseng, Ren Shen, have been shown in clinical research to alleviate cancer related symptoms such as fatigue. From a TCM perspective, ginseng's properties go beyond its use in clinical practice for specific symptoms like fatigue. Although it is considered to be able to provide energy to stimulate the chi, the energy. The TCM herbal practitioner who is considering the use of Ren Shen, will take into account the herb's qualities, within a wider context of care. This contrasts greatly with the approach of Western medicine, which takes a simplistic cause-and-effect approach, to treating a patient with depleted energy, following chemotherapy. In such cases, the TCM herbalists will first assess the patient's concerns as they relate to symptoms, which are associated with cancer-related fatigue, using a philosophical yet practical, systematic approach, in which acupuncture herbs and other TCM modalities will be combined as part of a holistic therapeutic treatment program. The basic theoretical principle behind the TCM approach to healing, including that related to the use of herbal medicine, requires the practitioner, to first identify any disharmonious pattern of health and disease in the patient. Imbalances in the energy forces of the human body considered in Chinese medicine as microcosmos are viewed within the context of disharmony in nature or macrocosmos. Imbalances in the micro and macrocosmos may be viewed from a number of aspects. The most familiar pattern being the theory of yin and yang, where two gestures or qualities are in equilibrium. The yin aspect reflects a more shady or resting state. The yang, a most sunny, more dynamic state. The qualities of yin and yang, are not seen in TCM as two opposing entities, but rather as qualities, which nourish one another, with each part containing a piece of the other's qualities. In this sense, herbal medicine is related more to the inside of nature, in which the Earth nourishes the macrocosmos and herbal remedies, the depletion of yin, which typifies the patient reserves during chemotherapy. Other aspects of TCM such as acupuncture, are identified more as a yang intervention when compared to herbs, although both may nourish depleted vitality, energy, or chi, which usually persist during the 10 or so days following chemotherapy. In the case of a patient undergoing chemotherapy, who is suffering from fatigue, the TCM practitioner will include herbal medicinal products as part of the treatment, thereby nurturing the depleted soil of the inner organs. Acupuncture will be used as well, in order to stimulate movement and vitality. Another guiding principle in TCM, which addresses the dynamic between the micro and the macrocosmos, is the balance or imbalance of the five elements, which interact along a continuum of the following gestures: water, wood, fire, earth and metal. The five elements interact on a constant basis with each other. Water generates wood, and wood generates fire, and so on. The five elements also correspond with different aspects of the macro and microcosmos, such as the five colors, tastes, body organs, referred as zang-fu, emotional states, and many other aspects which will interact with each other. These complex and intricate web of interacting systems and their components, guides the TCM therapist when treating patients with herbal medicine, acupuncture, acupressure, massage, twinga, qigong, meditation and movement, and other modalities. So, hello everybody, we're going to have a chance now to taste from this delicious meal, that we've all prepared together. So, just a minute before hand, let's close our eyes and center into ourselves. Take in a deep breath, breathe in, breathe out, and connect to your bodies, feel your body internally, relax into your body, let all tension flow out down into the Earth. A little smile, the tip of your mouth smile inwardly, internally, into our internal organs, and they are going to receive this food, smile to our stomach, to our liver, to our spleen, smile into our hearts, and just relax, and let our body expand to the flavors, to the tastes, to the energy of the food. From the herbalist's perspective, the selection of the herbal compounds to be used is made by considering factors such as the specific qualities of the color, temperature, and taste of the herb, as they relate to the five elements and their ability to strengthen, stimulate, harmonize, or deplete the other elements. The TCM herbalists will be required to adapt and modify the herb's properties during their preparation process, which may include cooking, extracting, and so on. The work of the TCM herbalist is far from intuitive. As with any TCM therapy, the herbalist must first assess the patient's condition in order to identify the imbalance in yin-yang, the disharmony between the five elements and stagnation or deficiency or both of the zang-fu internal organs, among other factors. After taking an extensive history and examining the patient's pulse, tongue, eyes, and skin, in order to establish a diagnostic pattern, the practitioner can then focus the treatment on the diagnosed clinical pattern of disharmony. It is at this stage that the appropriate individual herb or multi-herb formula, can be prescribed together with acupuncture or other manual modalities and guidance on nutrition and physical activity. This will in turn enable the patient to return to a state of equilibrium and health. What is special about the miso soup is that it has actually the aspect of the yin and yang aspect, it has the yin aspect of the water of nutrition of all the elements that it has inside it, the roots the seaweed, the onions, the tofu, the carrots, and all the other elements that are inside it,. The yang aspect which actually energizes the body, energizes the organs to start working, to contract, to expand. So, it's really a very active sort of a dish, and it gives a lot of energy when you feel low in energy, we really recommend to take a dish of miso soup. For oncology patients, herbal medicine may be directed at a more than just the relief of symptoms, since the prescribed compounds, addresses the imbalance and disharmony, that has according to TCM, played a central role in the pathogenesis of the patient's suffering and improved quality of life and well-being. The ability of herbal medicine to heal, is most often seen by the conventional medical establishment as no more than alchemy, with combination of heap of molecules or active components leading to varied physiological effects. Traditional Chinese Medicine in contrast, sees herbal medicinal practice as a process of remodeling, in which an earthy substance is spiritually molded and transformed. This remodeling is applicable to both individual herbal ingredients as well as multi-herbal formulas and is the base for the design of the herbal treatment regimen. Herbal formulas may also contain non-herbal components, such as animal byproducts or minimal ingredients. The combination of different compounds in the TCM herbal formula, allows the herbalist to assess a number of treatment objectives simultaneously. Strengthening specific elements or internal organs, targeting the herbal formula activity to specific body part or activity, reducing the effect of toxic substances like chemotherapy, and interacting with the other components in a synergistic manner augmenting their intended effects without having to significantly increase their dose in the formula. The synergy between the many components of the herbal formula creates a situation in which the sum is greater than its parts, while at the same time utilizing a safer dose for each of the parts.