DxD Session held on 31 August 2018.
Physician Lee Jin Shun is a registered TCM physician in Singapore. All TCM physicians are meticulously selected by our internal Medical Board and licensed by the TCM Practitioners Board, a regulatory body under the charge of the Ministry of Health.
Traditional Chinese Medicine (TCM) has been steadily gaining popularity in Singapore. There's a growing number of people seeking TCM treatments like herbal medication, acupuncture, and cupping to treat health problems.
Physician Lee answered questions from readers on:
- TCM treatments in Singapore
- What can be treated with TCM
- TCM treatment options in Singapore
- Cost of TCM treatments in Singapore
Thank you for your interest in seeking TCM to manage your insomnia.
I always tell my insomniac patient that everyone is born with the innate ability to fall asleep, so sleep should happen naturally, just like breathing! Sometimes, what we need is just a little helping hand to tune us back.
In fact, there are many possible reasons such as allergies, indigestion, pain, stress and anxiety which can lead to poor quality of sleep. Mental stress and fatigue makes up majority of the cases I see in practice.
According to TCM, insomnia arises due to imbalances in yin and yang, which is analogous to the circadian rhythm. The sympathetic nervous system a.ka excitatory component (Yang) prepares us for fight and flight in the day, while the parasympathetic nervous system a.k.a relaxing portion helps us to unwind at night.
'Qi' has a philosophical root from Taoism, and is believed to be the vital energy behind all occurrences in the universe and living entity.
As you can see from the table shown below,'Qi' and its movement plays a pivotal role for these processes to happen. In the absence of the energy source, there will be no structural or chemical changes and everything will be stagnant.
Rain formation (Universe)
Qi (energy source)
Intestinal contraction, enzymes
↑Evaporation - Upwards into sky
↑Absorption – inwards into blood
Condensation – forms cloud
Anabolism – promotes growth
↓Precipitation – falls as rain
↓Excretion – downwards as waste
'Qi' originates from two sources:
1. Innate or inherited from our parents before birth as Essence (精)
2. Acquired after birth from our diet, air and water. We are given the innate ability to digest food through enzymatic breakdown and intestinal contraction, but we will need continuous (acquired) supplementation from our diet and oxygen to replenish this innate ability. The two sources are therefore, said to be interdependent.
Body type is a mode of classification founded on TCM principles and observations which categorizes an individual’s constitution based on his/her predominant physical and psychological characteristics.
Hence, this explains someone's temperament and susceptibility to certain medical conditions. An individual often exhibits a principal body type with a combination of the others.
You were told that you have a yin and cold body type, in other words – Yang deficient (low in Yang energy). This means that you often experience cold extremities and are sensitive to cold weather and environments. You prefer warm places, hot food, and tend to be introverted. Typically, a Yang deficient person, is susceptible to water retention and excessive weight gain.
This is a question I get very often. Pulse taking is crucial, but does not necessarily provide adequate information to make a diagnosis.
A physician collects medical history, signs, and symptoms through the four diagnostic methods. He/she then analyzes the information, and derives a syndrome. This analysis lays down the foundation for a treatment methodology and plan.
The four diagnostic methods are:
- Inspection (望): tongue color, coating, gait, facial expression, wound assessment etc.
- Olfactory and Auscultation (闻): cough and lung sounds, abnormal odors, vocals etc.
- Inquiry (问): inquire further with specific questions to confirm physician’s diagnosis.
- Palpation (切): pulse taking, physical examination such as abdomen, joints etc.
Hi Wei Jie,
We were taught the various organ systems and their functions during our TCM Diagnostics module. Some examples are the spleen governs the digestive system, the lung oversees immunity, and the heart is in charge of the mind.
The basis of TCM diagnosis is what we called syndromes classification (辨证型), which are sets of signs and symptoms grouped together.
Hi Ming Lie,
Toxicity refers to undesirable and harmful effects produced by an herb that is unintended for its therapeutic effect. Toxicity may occur from overdose or when a drug has a narrow therapeutic index; the difference in its effective dose and toxic dose is very narrow.
Apricot seeds contain a compound which is converted to cyanide in the body, which inhibits the brain’s respiratory centre, explaining its ability to relieve cough and asthma.
It is also used to relieve constipation because of its oily content. However, overdosing or consuming it over a long period of time may potentiate cyanide poisoning.
Acute Coronary Syndrome is a medical emergency and should be attended promptly by a hospital medical team. However, you may consider TCM treatment once the condition stabilizes, and we can explore the possibility of preventing the deterioration or slowing the progression of ACS.
ACS may be managed under ‘chest pain’ (胸痹) in TCM and a consultation is necessary to assess your body constitution and the primary cause to it.
TCM is also effective in disease prevention especially when one starts to show early signs of certain diseases.
Why is it possible for TCM physicians use totally different prescriptions to treat the same condition?
Hi Kheng Siong,
There are numerous reasons that can cause insomnia. For example, a blocked airway due to allergies, heartburn from indigestion, painful medical conditions such as arthritis, premenopausal symptoms, or psychological disorders such as depression and anxiety.
So we come back to the concept of syndromes classification (辨证型), in which insomnia is divided into five syndromes. The physician you consulted most probably diagnosed each of you under a different syndrome, hence, two completely different prescriptions.
It depends on what medical condition you are seeking treatment for.
Acupuncture, which is recognized by the World Health Organization (WHO) is advantageous towards painful conditions such as sprain, muscle strain, arthritic disorders.
Some patients experience immediate relief after a single treatment. Herbal prescription, however, requires more time to take effect as the dose builds up in the bloodstream.
In general, acute conditions such as common cold, back sprain see faster and better results, while chronic conditions such as osteoarthritis, diabetes and high blood pressure etc require a longer course of treatment.
Hi Jing Ni,
Natural does not always equate to safety. We have heard of poisonous plants and fruits in the nature which can have detrimental effects when consumed.
However, the herbs that a physician prescribes has been used over thousand of years and proven to be safe.
In addition, Chinese proprietary medicines (CPMs) are regulated by the Health Sciences Authority of Singapore (HSA) and manufacturers of medicinal herbs are obliged to ensure they comply with local regulations, free of heavy metals and adulteration with substances under the Poisons Act and/or active synthetic substances.
Patients are advised to take them separately to prevent potential drug-drug interactions. It occurs when a compound affects the activity of a drug when both are taken together.
If one increases the effect of another, an overdose may occur or the side effects profile may be intensified. Similarly, if the efficacy of a drug is reduced, it will not elicit a therapeutic response and can be dangerous in some instances (e.g. diabetes).
Truth to be told, diabetes cannot be found in ancient TCM literatures.
However, a condition called “Xiao Ke” (Wasting-Thirst) was mentioned in the Yellow Emperor’s Classic of Internal Medicine written in Han Dynasty (黄帝内经), which has records of the following symptoms: frequent thirst, excessive hunger, sweet-tasting urine, and weight loss. Doesn’t it sound exactly like the diabetes that we know?
Therefore, diabetes may be treated under “Xiao Ke” which arises due to a deficiency in body fluids with production of dry heat.
Thank you for giving me the opportunity to address this issue. Traditional Chinese Medicine is broadly classified into two types:
- Medicinal materials (from plants, animals, or minerals in their natural states, or in processed forms that have undergone simple processing, such as trimming or desiccation.
- Chinese proprietary medicine (CPM) (finished form such as capsule, tablets and granules).
Currently, only CPMs are subject to pre-market approval and licensing for their import and sale in Singapore. The next time you purchase a CPM product, you should look out for the following label:
This question brings me back to my undergraduate days. My journey with TCM started with a double degree in Biomedical Sciences and Traditional Chinese Medicine that is jointly conferred by the Nanyang Technological University and Beijing University of Chinese Medicine.
Just like any medical student, I had to go through 5 years of study and clinical rotation.
In addition, I also had to fulfill 400 hours of post-graduate clinical internship before I was allowed to sit for the Singapore TCM Physicians Registration Examination (STRE). This exam is organized annually by the Traditional Chinese Medicine Practitioners Board (TCMPB), a statutory board under the purview of Ministry of Health (MOH).
Candidates who passed the examination will be issued a registration certificate. Thereafter, a person is said to be registered and licensed by the TCMPB, and is allowed to practice.
Hi Siew Ping,
When you're looking for a TCM physician in Singapore, there are a few things that you should take note of.
Firstly, you should find out if the physician is registered with the TCM Practitioners Board (TCMPB), a statutory board under the charge of Ministry of Health (MOH). If you are at his/her clinic, you should ask to see the physician’s registration certificate. Most of the times, the certificate will be hanging on the clinic's wall.
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