What TCM Never Had to Deal With
You probably started getting a sense of it when you were in school. The professors would talk about diabetes as "wasting-and-thirsting disease" and you had a thought that you didn't know anyone who was wasting away in any way, shape or form. Or you saw patients in your student clinic tell you they reacted to gluten and you realized this did not come up in any textbooks you owned. Or they told you they had Crohn's disease, or lupus or any myriad of other illnesses, and while we could certainly come up with a differential diagnosis for these, it might have started niggling at the back of your mind that those classic texts rarely, if ever, saw these issues. Why do you think that is?
It's possible that people don't fully appreciate how much more pressure we put our systems under in this modern age. I'm not talking about chemicals, or lack of exercise, or staring at computer screens, although all that is valid. I'm talking about the exponential increase of major areas of illness that our Chinese forefathers in medicine did not see often, if ever.
One they definitely never saw was the decimation of our gut bacteria by antibiotics. People don't fully understand this issue because they mistakenly think those antibiotics are helping their sinus infection, ear infection or bronchitis. So they take them willy-nilly and think that taking a pro-biotic will then replace any of the ones they might have lost from the antibiotic. I cannot say strongly enough how incorrect that is. This is one of the hottest fields in research right now, with one of the understanding being that diversity is key. Research is showing that greater diversity allows a person to resist stress and disease and that people with an altered gut microbiome have more inflammation and more disease — asthma, allergies, autoimmune disease, inflammatory bowel disease, obesity, diabetes, mental health issues and cancers. How fast does it take to change or damage your gut bacteria? A 7-day course can wipe out strains that, two years later, haven't recovered, and it's questionable at that point if they ever will.
It's now being considered that, while antibiotics have no doubt saved many lives, they have also been a nuclear bomb to our gut bacteria, with the corresponding damage. We've had antibiotics for about 80 years and we've permanently and forever changed human history and health in using them. We will never get that diversity back. You cannot ingest probiotics and think that'll do it or do fecal enemas or even culture your own bacteria in a dish and reintroduce it back into your gut — your system will simply not allow it. By the time you set your gut bacteria at the age of about two, that's it. Done. And how many times does the average person give their child an antibiotic before that age? And then after that age? Or while Mom is pregnant? Or before pregnancy?
TCM never had to deal with wiping out our gut bacteria with antibiotics or damaging them with modern American processed foods (available, of course, not just in America). Did you know you can alter your microbiota by eating poorly? And by "poorly," I mean eating sugar, processed flours, poor quality and highly processed fats and not eating fermented foods. The Chinese did things correctly to support their guts without even knowing it. And now modern culture has wrought a time bomb that is ticking away as we health care practitioners and researchers try to figure out what we did, how much damage there is and if it's possible to fix it.
You might think I'm being dramatic, and while time will tell, it's very possible that this is the root of many of the issues of modern medicine. Take autoimmune diseases for a moment. While occasional autoimmune diseases definitely existed in traditional Chinese medicine (Type 1 diabetes is now considered autoimmune), they did not see what we now see in modern culture: according to the Mayo Clinic, lupus has tripled in the last forty years. Multiple sclerosis has tripled in Finland and has nearly identical numbers in Scotland, England, the Netherlands, Denmark and Sweden, where the number of people with MS has been rising at nearly three percent a year. Multiple sclerosis rates in Norway have risen 30 percent since 1963, echoing trends in Germany, Italy and Greece, where MS rates have doubled over the past thirty to forty years. Between 2001 and 2009, Type 1 diabetes rates have risen 23% in the U.S. We can't even call it juvenile diabetes anymore, as it strikes adults as well. Researchers say this cannot be attributed to better diagnosing or improved testing, but that this is an environmental problem. And an environmental problem the traditional Chinese didn't have to deal with — the use of chemicals, ingesting drugs that damage the gut, the intake of sugar, altered gut bacteria, an environment that is "too clean" with our zealousness for a bacteria-free environment and GMO's. While we can deal with the symptoms of these diseases with our ability to differentially diagnose, the underlying problem is understandably unrecognized in TCM.
Type 2 diabetes is also a disease the traditional Chinese rarely saw. Like I mentioned earlier, Type 1 as a "wasting and thirsting" disease was mentioned in the literature and we certainly learned how to recognize that. But Type 2 diabetes — sure, we'd discuss Dampness and Spleen Qi deficiency and people being overweight, but the epidemic we have now boggles the mind. The Chinese didn't see anything close to this degree and if it was clear what the root cause was (one source being an abundance of carbohydrate intake) they certainly wouldn't have been recommending congee for that weak Spleen.
While there's no question that our intake of fructose, sugars, sweeteners and refined flours have brought about a huge amount of this epidemic, there's also a lot of evidence that we've caused it in other ways. Like I mentioned before, eating a standard American diet of high processed carbs and high fat (and not the good ones) can cause the dysbiosis, an imbalance of the gut bacteria. Did you know that the gut microbiota contributes to glucose management and proper weight? And that if you don't have the right gut bacteria you'll gain weight regardless of how you eat? They've done human studies and saw that the gut bacteria of people with diabetes varied quite a bit from people without diabetes. What about this one — people who got gastric bypass saw a change in their gut bacteria that allowed them to keep the weight off? In fact, in mouse studies, they transferred bacteria from the mice that had gastric bypass to overweight mice, and those mice also lost weight. I mention this because we are often very quick to condemn overweight people based simply on what they eat, but if you've inherited the wrong ratio of bacteria from your parents or your environment as a child, you'll gain weight even if you're eating well below your calculated metabolic amount of calories.
When one looks back in time, one begins to realize that our modern diseases are not the same as what one reads in traditional literature — this is not the bubonic plague, or tuberculosis or small pox. These are a bit more insidious — diseases that show an inherent weakness at the core of our humanness, ones that affect the more deficient of our population and have a hidden root, leaving us to treat the branches. It is because of this that I didn't stop my education with Chinese medicine, but have expanded to include some modern understandings so that I can better treat these patients. I hope that we, as people committed to healing, are willing to expand our education to do the same.