So, What Is Wrong With The NHS?


Brexit aside, the NHS is probably the subject most likely to divide opinions in Britain these days. You can hear it referred to as “the best healthcare system in the world” and also as “outdated, inefficient and not fit for purpose”. You can hear stories about inadequate service, neglect, huge waiting lists, waste and chaos alongside stories of great care and professionalism. There is no doubt the NHS is a very integral part of the British existence, so much so that I think it also became part of the British identity. It has definitely got a special status. No politician in his/her right mind would touch it with a barge pole. Any policy makers daring to suggest that maybe the traditional way the NHS runs needs a change is seriously risking a fierce backlash that may put their future careers at risk. It all becomes very emotional. I, however, am not a politician or a policy maker so I am completely relaxed about saying what I think on the matter. I have also seen how Health Service can be delivered, in a different way to the NHS, in other countries.

Before I start it is important to make 2 points very clear!

Firstly, is the fact that I have no personal interest or bias regarding the matter. If anything, my own business is benefitting greatly from the failings of the NHS. My only interest is my despair at watching this great institution crumbling under its own enormous weight, unable to supply the high level Health Service the citizens of this great country deserve!

Secondly, none of the criticism in this post is directed towards the NHS staff. The great majority of the NHS staff, particularly the Doctors and Nurses, are very professional and hard-working people. The failings of the NHS are not their fault. If anything, they are another victim of the problems. Having to work in an under-staffed, under-financed and often chaotic organization can’t be fun. They deserve more just as the patients do.

 Those “Drs and Nurses” are often used by people who are resisting change in the NHS: “How dare you criticize our wonderful Doctors and Nurses who work so hard to save people’s lives.” Well, I don’t. Actually, I never heard anyone do so. This hysterical tone is very common everytime the issue comes up for discussion. Another common, and no less hysterical argument, is that any suggested change is somehow an attempt to privatise the NHS by the back door. An interesting thing happened last night. As if to help me demonstrate my point I got an email from Mr Stephen Fry urging me to sign a petition calling for the Government not to allow any American companies to apply for any contract relating to the NHS. I am a big fan of Stephen Fry (anyone who watches The Black Adder Goes Forth or listens to the Harry Potter audio knows the man’s a genius!). I know he had some problems with his health, I assume he has been treated by the NHS and now wants to do something to help. That is great but is it helpful? For a start, why single out the US? What difference does it make from which country is the company? It sounds to me very much like discrimination. Secondly, who is to say that UK companies will necessarily do a better job than a company from abroad? You may not be aware of it but in today’s Global way of doing things, foreign companies are running a few of our operations in the UK, just as UK companies do in other places around the world. So long as those companies comply with UK rules and regulations and supply a service at the level required by the UK Government then it doesn’t really matter where they originate from! In any case, my point is that this is nothing to do with privatizing the NHS. Indeed, many private companies are already taking part in running different parts of the NHS at this present time. I think the greatest fear that people have is that treatment may not be available (free) when they need it.

At the moment, anyone in the UK can be treated for free on the NHS regardless of their age or their medical condition. This principle should be preserved. People are looking at private insurance companies, like BUPA, PPP etc, and worry that the future of the NHS will look like them. The panic is understandable. These companies are a rip-off. They charge high fees that will be unaffordable for most people and, worse, these fees grow exponentially if your health deteriorates. It is understandable why people panic when they hear the words private and medicine used in the same sentence. The good news is there is a third way. Great Health service is possible without the need for poor and poorly people having to pay a lot of money for it. I will explain how this third way works later but first, what is actually wrong with the NHS at the moment?

Where do we start? Well, to simplify I’ll focus on two points: availability and organization.

The problem with availability, or the lack of it, is probably emanating from the lack of resources, there are simply not enough doctors, nurses and medical facilities for the size of the population it serves. As a result we often need to wait two to three weeks before being seen by our own family doctors, or many months before seeing a specialist. I have to let you in on something, citizens of this Great country: this situation would be completely unacceptable in any other country. I was about to write “in any other developed country” but thinking about it-no, any other country. More than that, it would sound ridiculous to them. If someone is suffering why do they need to wait for weeks or months to get help? Yet somehow it has become acceptable in this country.

As to organization, the NHS is massive, one of the biggest organisations in the world. I keep on hearing stories regarding the insufficiencies of its practices. Nothing demonstrates this point better than the failure to implement a computer programme for the NHS. Amazing as it sounds, NHS hospitals and other institutions don’t have an electronic way of communication between them eg patients, patients’ notes, tests and so on. More than that, even within many hospitals there is no one computer system to connect all the different wards and departments. This is causing an enormous waste of time and money, not to mention problems with a good level of medical service. For example, imagine a consultant facing a patient who has been in different wards in the hospital before. He needs to have all the information about him, there and then, on his computer screen. Because of this problem that is often impossible. The lack of a single unifying NHS computer system is just one example of inefficiency. Unfortunately, I have to say indifference towards inefficiency is a typical phenomenon in the public services.

People are probable expecting me to talk about the ongoing refusal of the NHS to use any complementary medicine. Whilst I am sure that incorporating therapies like Chiropractor, Acupuncture or Herbal medicine in the NHS will help a lot in both improving the service and saving money, I also think this problem is dwarfed by the problems of lack of availability and organization. Actually, it has just given me an idea for my next blog: should the NHS use Complementary Medicine? But now back to our issue: what is the problem with the NHS? I was talking about lack of availability which is mainly resulting from a chronic lack of adequate funding plus organisational problems and inefficiencies which contribute to the lack of funding problem as well as reducing the level of service.

So, what is the solution? Well, the tragedy is that the solution is very simple. There is no need to reinvent the wheel or come with some super- sophisticated plan. All you need is the political will to change and then just look across the Channel to Europe. Many countries in Europe have health services that are operated and funded in a different way to the NHS. The levels of service are enviable and it doesn’t cost much. My own experience is with the system operating in Israel. I know many countries in Europe have the same, or very similar, systems.

So, how it works? A number of private companies are the Health providers. A person can choose which one he goes with. This creates healthy competition between them regarding both the level of services and the prices. The prices are means-tested and also supervised and limited by the State. The monthly contribution only depends on your level of income (like a kind of Health income tax) and you will never be asked to pay more just because you use the service more (which is the case with private health insurance companies). So this Health Service is always available for everybody at anytime as long as they pay their fees. These fees, by the way, needn’t be high and are worth every penny. The Health Service you’ll get will be superb, a world apart from the current deficiencies of the NHS. An added bonus is much more money for social services, education and other public services. Some people may object to paying for Health Service. Well my answer is: we really don’t have much choice. The system of funding the Health Service from general taxation is clearly not fit for purpose and is having a disastrous effect on other services. Most people said in a survey they’ll be happy to pay if they know they’ll get a better service. It doesn’t have to be expensive: if everyone pays (it has to be compulsory) then the individual fee is quite small. And the bottom line is: we can see it is working beautifully in other countries so why not in the UK?

Best Health for all,

Dr Ilan Shahor




The Great British Med Off V.

Stress, anxiety, mood disorders and sleep.

Hi everyone! Today I am going to discuss a group of conditions that is close to my heart. Generally, we can refer to them as conditions of the mind. They include stress, anxiety, mood disorders (depression, irritability, bipolar disease etc) and insomnia (sleep problems). So why are these close to my heart? I think for two main reasons. Firstly is the lack of understanding of these conditions by modern medicine. The brain is by far the most complex organ in our body. Our understanding of its working is extremely limited. This fact hasn’t stopped modern medicine from producing a long line of medicine aimed at affecting our brain. Secondly, people who suffer from these conditions often feel ashamed of their situation. They have no physical ailment as such to show for their difficulties and yet the suffering inflicted by conditions of the mind can often be worse and more debilitating than the physical ailments.

Before I start talking about the specific conditions, there is one general principle that is of major importance. In my opinion there is always a reason, a cause, for these symptoms. If someone is suffering from depression or anger or mood swings or any other mental/emotional condition it is always a result of something that happened, or is happening, in the patient’s life. This may not be obvious, sometimes it is hidden or repressed or happened a very long time ago, but there is always something. This may sound obvious, however, I am afraid to say that there is very little consideration for it when it comes to treatments available in both Chinese and Western medicine.  Both disciplines look at the current symptoms and ask how can we help with these? There is not much consideration for what brought them on, for the underlying cause. In my opinion, until the underlying cause has been addressed the treatment won’t be complete. It may give some help with the symptoms but in most cases it will be only temporary relief. How can we address the cause? I will explain later but for now let’s start the comparison.

As usual I will try and simplify things. For that I’ll divide the subject into two: mood and anxiety disorders, and  sleeping problems (insomnia). The Western medicine (WM) treatment for anxiety is with antidepressants. If this doesn’t work then they may be supplemented with a tranquiliser or antipsychotic or both. These medicines have some success in reducing anxiety-however, the tranquilisers are highly addictive and the antipsychotics tend to have side effects. The antidepressants are usually safe but their effect on anxiety is limited. Chinese medicine treatment with Acupuncture and Chinese herbs will aim at the underlying condition. From a Chinese medicine point of view anxiety is often the result of physical, mental and emotional factors. A careful diagnosis has to take place for effective treatment. For example, a common cause of anxiety is when too much stress and pent up emotions affect the liver. The liver regulates the emotions and therefore, when under pressure, our ability to cope with stress reduces dramatically. Chinese medicine treatment of anxiety is not as powerful as the western medicine tranquilisers, but in mild to moderate cases tends to be a more effective, safer and longer lasting solution. 

In the case of other mood disorders, I think, both WM and CM have more effective treatments than in the case of anxiety (although the general principles for how treatment is carried out is similar). Antidepressants are usually effective in treating the symptoms of mood disorders. If one suffers from low mood, depression, anger or mood swings then antidepressants will often be effective in moderating those emotions and are therefore considered to be an effective treatment.

 Indeed, if these symptoms are stopping you from being able to function normally and the drugs make you functional again then that must be considered a success. However, there are a few problems here: firstly, most users of antidepressants report a general damping down of their emotions. They will often say they don’t feel depressed any more but neither do they feel real happiness or real excitement so although they feel better than they were they want to be able to feel emotions again! ; secondly, the usual problem with WM drugs: they don’t treat the cause, the reason for the mood problems. The symptoms are therefore likely to come back when the medicine has been discontinued. This point, which is true for many WM medications, is particularly important in the case of anxiety and mood disorders. One in every 5 people in the UK has been prescribed antidepressants over the last year! Over 4 million people are long term users. In the US one in 6 people are long term users of antidepressants. These figures are shocking. The fact that so many people need mood modifying drugs to stay functional primarily raises questions regarding the way we live our lives in these modern times-but this is a subject for another post. In the context of this post, these figures clearly indicate that modern medicine is failing in curing these conditions and is instead producing a generation of people who are dependent on these drugs. A great situation for the pharmaceutical industry but not particularly good for the sufferers.

So, what are the CM solutions for these mood related conditions? On the one hand CM has a much deeper understanding of these conditions. The treatment therefore is working on a deeper level and results, when positive, tend to be long term. On the other hand, in my experience CM, whilst often very effective in treating mild to moderate conditions, often tends to struggle with severe forms of depression and anxiety. It is not completely failing with severe cases and can sometimes still work, but much less than is the case with mild to moderate manifestations. Another problem with CM treatment of these conditions is that, like WM, it doesn’t deal enough with the emotional circumstances of the patients: are they in a stressful situation? Are thinking patterns and conditioning affecting how they feel? Is there an emotional trauma or traumas in their past?. With a lot of sufferers until we have cleared these conditions then we won’t be able to truly help them since the emotional problem which is emanating as a result of these conditions will keep on coming back. In these conditions, in my opinion, the patient will greatly benefit from counselling. I am referring here to patient and proper counselling, one that persistently explores the deep seated reason for the mood disorder or the anxiety. It can be hard for the patient and it may take time but in the hands of  good counsellor or psychologist the results will be very good and long-standing. The counselling technique that is used in the NHS called CBT (cognitive behavioural therapy) can be helpful but is limited. It gives you tools to help you deal with your symptoms but, just like antidepressants, it’s not (in most cases) treating the root of the problem.

 So, to sum up: for mood disorders and anxiety, WM medications should be preferably avoided unless the symptoms are severe and no other solution is working. In cases where you feel you need these medications, it is recommended to use them as a temporary solution until deeper and more permanent change can be achieved.

 CM offers more gentle, deeper and non-addictive treatment and therefore will be preferable as a first choice. However, in some more severe cases it may not be effective and WM medicines will be needed. Both forms of treatment are recommended to be supplemented by counselling.

Sleep problems or insomnia is a lot easier to compare. The verdict here is, I think, fairly straightforward. WM has a few different drugs that will make you sleep. The majority of them are tranquilisers but there are a few exceptions. Some will work well but often the patient will still feel sleepy it is time to wake up in the morning and start the day. Another problem with those meds is the usual one: not treating the cause will lead to dependency. Often, as well, one tends to get used to the pills and will need something stronger..and so on.

The CM approach to insomnia is very different. In CM we don’t look to tranquilise the patient or to knock him out. Instead we are looking for the reason, the cause of the insomnia, and will aim to mend it to allow our sleep mechanism to work properly again. There are clearly different patterns of sleep difficulties. Some can’t go off to sleep easily, some will wake up very early in the morning, some will have a very light sleep and will keep on waking up. Other factors are vivid dreams, night heat or night sweats, palpitations etc. Different sleep patterns arise from different reasons and therefore will be treated differently. Different Acupuncture points and/or different herbs will be used to treat different causes of insomnia. With this individual approach of looking at the root of the problem, the treatment of insomnia with Chinese medicines and Acupuncture is very successful. Most importantly there is no dependency-when the patient sleeps well he’ll be able to keep on doing so without the treatment.

So, to sum up. Insomnia: CM has the clear edge. WM should be used only in the most resistant cases.

That’s it for this post. Next time I am going to take a break from The Great comparison series of blogs and turn my attention to sorting out the NHS. 

Good health everyone.

Dr Ilan Shahor


Lungs and Airways Conditions, Allergies and Hayfever

Hello everybody. It’s nice to be back again writing about Health issues rather than Politics – although I have to admit it was fun to write my last one! Fun may be an exaggeration. Let’s say it sometimes feels good to get things off your chest!

Today we are going to discuss lungs and airways conditions, allergies and hayfever. These are not accidentally put together. In Chinese Medicine terms these are very much related. Hayfever is a type of allergic reaction and most allergies, in Chinese medicine, are a result of the lungs Immune system dysfunction.

We’ll start from the most common airways conditions: colds, flus and chest infections. I put these together as they are all Acute infection type conditions. Colds and flus are caused by a virus whilst chest infections can be caused by a virus or bacteria. The Western medicine approach to these upper respiratory tract infections (URTI) is mainly to help with the symptoms until the infection will clear by itself. The reason for this approach is that we still haven’t got an effective medicine for viruses. The medicines that are available to reduce the symptoms are varied but, generally speaking, are based on chemicals which aim to reduce the body’s natural immune reaction to the virus e.g. paracetamol or aspirin. This may sound counter intuitive but the principle here is that a lot of the symptoms we feel, such as a high temperature for example, are as a result of our immune system trying to fight the invader. Stop this reaction and you stop the symptoms! These medications tend to be quite effective in reducing the symptoms and help us to continue to function but is this necessarily a good thing for our long term health? The answer, in my opinion, is most probably not! I can’t see how stopping our immune system from doing its job is a healthy approach. I understand that sometimes in life we need a fast relief but I will recommend to use it as sparingly as possible. I feel there will be long term consequences to our immune system’s ability to deal with invaders if we use it on a regular basis. This advice is particularly important for parents who tend to feed Calpol (Children’s paracetamol) to their kids on a very regular basis. In the case of chest infection, as a result of a bacteria rather than a virus, the Western medicine treatment with antibiotics will be often very effective. However, in my opinion antibiotics for chest infections should be used only in the difficult and stubborn cases since it is clear that regular use of antibiotics has a weakening effect on our digestive and immune systems.

The approach of Chinese medicine to URTI is very different We are not looking at the type of bug which has invaded the body, instead we are looking at the reaction of the body to this invasion and then treat it accordingly. An experienced TCM Practitioner will be able to identify one of many patterns of Acute URTI and will then be able to choose the right combination of Herbs and /or Acupuncture points to remedy this pattern and restore normality. In some cases (particularly with children and the elderly) herbs to support and strengthen the immune system will be added. The treatment of URTI with TCM is, in most cases, highly effective. The old belief that a cold will clear within a week without treatment and within seven days with treatment is not applicable in the case of Chinese medicine. In most cases we can shorten the duration and help with the symptoms without damaging the immune system in the process. So, in the case of Acute URTI (colds, flus and chest infections) there is a clear advantage to Chinese medicine with one exception being the most severe and stubborn bacterial chest infection that may end up needing antibiotics!

The second most common lung condition is Asthma. Asthma is a condition characterized by shortness of breath, wheezing and coughing caused by the narrowing of the airways. This narrowing is a result of a contraction of the airways or a secretion of phlegm in the airways or both. The reason for the contraction and the phlegm is largely unknown. In some cases there is a clear link to Allergic reaction but in the majority of cases the cause remains a mystery (at least according to modern medicine knowledge). Asthma is very common and, alarmingly, is getting more and more common over the last 30 years. The reason for this increase is again mainly unknown although air pollution, stress and bad nutrition are the usual suspects. Asthma can affect all ages and in severe cases can be lethal.

The treatment of asthma from a Western medicine point of view is aimed initially at reducing the symptoms by reversing the contraction of the airways and the main medicine used for this is the famous Ventolin inhaler. Ventolin is very popular due to its fast effect: short of breath? take a puff and feel better almost immediately. However, medical studies have shown that long term use of Ventolin increases morbidity and mortality (the severity of the condition and the death rate!). The other type of inhaler is more for prevention of attacks and contains steroids. Steroids are a very effective anti inflammatory and asthma is no exception. Steroid based inhalers are fairly effective in prevention of asthma attacks. The problem is, as usual in the case of steroid use, the side effects. Since the use here is targeted and local (not passing through the digestive system) it was hoped therefore that it wouldn’t spread through the body. However, studies into the effects of a long-term use of steroid based inhalers showed risks that are very similar to those caused by the use of oral steroids e.g. diabetes, high blood pressure and osteoporosis.

The Chinese medicine view of asthma is a bit different to the Western medicine one. Most importantly we don’t see it as one condition. I often use asthma as an example when I try to explain the difference between TCM and WM thinking. If you take a step back and look at it carefully you can see clearly that asthma can manifest in a different way in different people. The main symptom can be shortness of breath in some cases or cough in others. The cough can be phlegmy in some and completely dry in others. The phlegm can be thick or loose or watery, white or yellow or green. Triggers differ largely-some are triggered by stress, some by exercise, some by the weather (humidity or dryness), some react to allergent, and so on. In Chinese medicine each one of these will be considered to be a different condition and will therefore be treated differently. For example, a dry type asthma will be treated with herbs and acupuncture points that aim to help the airways and lungs produce the moisture needed for normal function. The phlegmy and wet asthma, however, will be treated with herbs and acupuncture points that will do just the opposite this time, helping the airways and lungs to dry up and get rid of the phlegm. There are of course a few other considerations when choosing the treatment in each case, most importantly-as ever in TCM-treating the underlying cause as well as the symptoms. The point is the treatment is tailored for each individual case! This approach combined with a deep understanding of the asthma symptoms and causes leads to a very high success rate in the treatment of Chronic Asthma with TCM.

So, to sum up asthma. In the case of acute attacks WM has the upper hand in its ability to bring fast relief. In the case of the treatment of Chronic Asthma TCM is much more effective.

The next lung condition is COPD (chronic obstructive pulmonary disease). COPD is very common and it actually includes a few conditions, most commonly emphysema and chronic bronchitis. Here the comparison is easy since WM doesn’t offer any effective treatment for these conditions, except oxygen support in the very late stages. Chinese medicine however has more to offer. These conditions are chronic in nature and often cannot be reversed, but with a good course of Acupuncture and Chinese herbs the symptoms can be reduced and the deterioration in the lung function slowed down.

Next is Bronchiectasis. This condition is characterized by a formation of air pockets in the lungs. These pockets tend to fill up with phlegm resulting in chronic cough and deterioration in the normal lung function. The WM treatment is limited to breathing physiotherapy. It is important since it is helping the patient to release some of the phlegm which is stuck in the lung. However, the effect on the patient’s symptoms is fairly limited. From my experience the effect of Chinese medicine on this condition is much more substantial. Treatment with herbs and acupuncture points which clear phlegm and strengthen the lungs result in significant and long-lasting improvement in most cases! CM will have a similar effect in most cases of chronic cough.

Next for Allergies. To simplify and shorten things I’ll try and consider all types of Allergies in one section. This will include skin allergies, airways related allergies and Hayfever. Generally speaking, allergic reactions occur when our Immune systems hyperreact to a stimulant. In other words, instead of having the normal measured and effective Immune response as a normal response to what the body identifies as an unwanted invader, the Immune system will overreact and will activate mechanisms in the body which are inappropriate for this situation and will therefore cause problems (symptoms).We are all familiar with hayfever, allergies to cats or other animals, dust mite allergies etc. These are all different materials or organisms which will commonly trigger an inadequate Immune reaction in susceptible individuals.

The Western medicine treatment for allergies is mainly with Antihistamines. Antihistamines are, generally speaking, quite effective in reducing the symptoms of allergic reaction. The problem here is that they don’t treat the root of the problems but are purely for the symptoms. They are fairly safe medications but can cause drowsiness. The Chinese medicine approach to allergies is a) treat the symptoms and b) calm and regulate the Immune system (stop it from over-reacting). As a result of this approach the improvement is long lasting and often even permanent.

 To sum up, lungs, airways conditions and allergies are a good demonstration of the difference between WM and CM approaches. If you need a quick relief of your symptoms then WM is probably more effective. However, if you are a bit more patient,  care about your health and are interested in long term relief or a cure then CM is your preferred option.

Best of health everyone,

Dr Ilan Shahor.

Traditional Chinese Herbal Medicine and Brexit

As promised, we are taking a break from the Great Med Off series. I’ll be back covering Western and Chinese medicines next time, but today I am going to discuss the issue which is on almost everyone’s mind-Brexit. For the love of God, WHY??? Nobody wants to hear yet another opinion! Also, of course, I can get myself into trouble with some of my patients. Emotions are very high, yet the sequence of events which helped me make up my mind regarding the Brexit question is interesting and is TCM related and that is why I am going to share it with you.
In the early days after David Cameron announced that there was going to be a referendum. I thought that I would vote for remain. To be perfectly honest, like most people, I knew very little about the EU. It was more of an intuition. It has always made sense for me that people should cooperate, share and help each other so why not be in a union with our friends in Europe? Indeed, why not? Well, something has happened during the run up to the referendum which has started me thinking properly. Before I tell you about it I have to give you a bit of background. The struggle of Herbalists against the mainstream medical institution’s attempt at stopping them from practising is hundreds of years old.  Mainstream medicine always viewed the Herbalist community (out of ignorance of course) as a bunch of charlatans. In the old days Herbalists were considered as witches and often ended up in jail or even burned on the stake. Luckily the methods of persecution have changed but not the principle. Mainstream medical science (these days strongly supported by the pharmaceutical industry) relentlessly tries to stop Herbal medicine practice.

Since I started practicing Chinese medicine 24 years ago there have been 3 orchestrated attempts by the Authorities to pass laws regarding the manufacturing, the prescribing, and the use of Herbal medicine. These laws, often camouflaged as public safety concerns, were very clearly designed to devastate the herbal medicine industry and the Herbal medicine practice. The first of those came in the late 90’s-a set of new rules and regulations regarding the manufacturing, the selling and the prescribing of herbal medicines brought in front of Parliament by the Medical Control Agency (MCA). The centre point of this new legislation was that herbal products would no longer be regarded as food supplements.  Instead they would be treated as medicines! The implications of that were huge! It meant that each herbal medicine would have to go through the same testing that new medicines do in order to be approved for use!  This would have completely destroyed the Herbal practice since no herbs would ever be available again. The herbal medicines companies are all very small with a large amount of products (hundreds). Unlike the pharmaceutical companies which are very big companies with a very small amount of products. To test a new product takes years and costs many millions, but it is still worth it for the pharmaceutical companies. They will get their money back on the investment. For the Herbal companies it is of course a complete impossibility! So, faced with the prospect of annihilation, the Herbalist community fought back. Herbalists and their patients wrote to their local MPs, signed petitions, and even went on a demonstration in front of the Houses of Parliament. To everyone’s surprise the Campaign worked. The MPs had a good look at the Bill, realized the problems, and rejected it. The MCA was told to go back to the drawing board and to come back with a more balanced and sensible Bill. This was Democracy in motion!
About 3 years later the MCA came back to Parliament with a new Bill. There were few little changes from the original one. Firstly, the MCA changed its name to the MHRA (Medicines and Healthcare Products Regulatory Agency). Secondly, they kept it secret and the Herbalists heard of it only about 2 weeks before the vote in Parliament so we had very little time to campaign. Other than these there were very little changes of substance, just cosmetic ones. Again we fought a fast and successful campaign. Common sense and Democracy prevailed again!
The third time the Herbalist community had to face this sort of threat was around 2008. This time we had a real problem. This time the herbs directive came from the EU. There was simply nothing we could do about it. The EU Herbal medicine directive, although not as devastating as the original MCA one, is still a very bad piece of work. It is supposed to offer public protection from rogue medicines and yet it is doing just the opposite. For example: those “take-away” style  Chinese herbal places which sprout up around the town centres are having no problems practicing with the new regulation-and that is despite the many court cases brought against them for using banned Herbs and Pharmaceuticals. At the same time, genuine Herbalists run into trouble and have to seriously find a way to bend the rules just to be able to keep on practicing. Many useful, effective, much loved and 100% safe products had to be stopped. They just disappeared never to come back. A few Herbal companies had to close down. But probably worst of all, courses for Herbalists are now impossible to find. Chinese medicine courses are simply not on offer anymore. It is simply too hard and complicated to practice TCM in the UK in light of the EU Herbs directive. It came into full effect in 2014.
I think what happened is that I heard about yet another of my Herbs suppliers closing down in the run up to the Referendum and that made me start thinking.  The main problem is not with the directive itself (although bad enough) it is with the process. Some bright spark in an office in Brussels set out a directive. There was no consultation, there was not understanding of the situation, problems or needs of the Herbal medicine reality in the UK. We had no chance to have any influence on the process and could not even protest after. I didn’t vote him in and I can’t vote him out. No accountability whatsoever, no consultation, no democracy.
 It’s not just the Herbs directive, this flawed process happens in many other areas of our lives controlled by the EU. If you value democracy then this is very very wrong!  This lightbulb moment made me look a bit more closely at the effects of the EU projects on our lives.
Not far from my Leicester Clinic a big construction project was unfolding. Humberstone Road was having a very welcome facelift. At the end of the street a sign declared: this project is supported by money from the European Union! The initial response to this information is ”Great! We are getting money from the EU to make Leicester look better!” Then I thought again. What is actually happening here? We pay our hard earned tax money to the UK Government. They then pass it to the EU. The EU use it to pay for fancy offices and generous salaries for its workers and then, whatever is left, they send back to the UK for Projects. Which Projects get the left-over money? That is decided by EU Bureaucrats who probably don’t know much about the UK, about its culture, its ways, and its needs. Sorry my dear Remainer friend but this just makes absolutely no sense to me.
The more I looked at it the more convinced I became. The way the EU operates at the moment and, maybe more importantly, the direction it is moving toward is simply not good and is going to end up in tears. I am aware of course that there are some good sides to the Project. As I mentioned earlier I am always for cooperation and support but there is absolutely no need for the obsessive control over Member countries’ rules and internal affairs which is coming from Brussels!!! As demonstrated by the case of the Herbal medicine directive: it doesn’t work and it will gradually cause more unrest in other EU countries!
Please understand that my support for leaving the EU is nothing to do with a hope of getting my herbs back. I know unfortunately this is not going to happen, not in my working lifetime anyway. It is purely about bringing back sovereignty and democracy.
And, one last thing I would like to say to my “Remain” friends: many people born in the UK  who have probably never experienced life anywhere else often don’t appreciate how great this country is. Of course it is not perfect and it has problems the same as everywhere but, nevertheless, it is a great place with great strength, great tradition and great people! It will have no problems with coping, flourishing and fulfilling its potential outside the EU.
And on this positive note we’ll end today’s post. I hope I haven’t upset anyone. Next time, hopefully we’ll be back to proper TCM and Human Health matters!

Dr Ilan Shahor

Acupuncture Leicester Blog Post

The Great British Med Off!

Digestive System Disorder 2

In today’s post I am going to conclude the discussion we started in the last one: the treatment of digestive system conditions using Western Medicine (WM) versus Chinese Medicine (CM). Meds and operations versus Acupuncture and Chinese herbs, which one is more effective? I hope you’re not starting to get a bit bored with the matter. The reality is that different conditions will react differently to WM and CM and therefore need to be discussed separately. I think this comparison is important, although I’ll consider having a little break from it in the next post, and find something maybe more exciting to talk about before coming back to complete the mission!
So, back to our subject. We are going to carry on down the GI tract with Diverticulitis, Anal conditions and IBS. Diverticulosis is a very common diagnosis given to people with GI symptoms. The pathology here is the formation of pockets in the wall of the large colon. The problem I have with this diagnosis is that studies have shown that 70% of the over sixties will have diverticulosis in their large colon. Of course, most of these won’t have any GI symptoms. I have seen many patients over the years who had general GI symptoms like abdominal pain, bloating, diarrhea, constipation etc. These were diagnosed as diverticulosis just because that’s what came up in the scan. In most of these cases, in my opinion, the diverticulosis was obviously present but wasn’t the reason for the symptoms. In these cases the condition should have been diagnosed as IBS! They were treated as IBS and they got better. However, in some cases, the symptoms are as a result of the diverticulosis and in these cases the typical symptoms are localised abdominal pain or discomfort, usually after food and often in one specific location (where the pocket is). These cases are a bit more difficult to treat as there is a structural change in the colon which disturbs the normal function. The WM approach is to improve the smooth movement of digested material by creating a better bulk. This is done with bulking agents which are basically fibre rich powder like Fybogel. The idea is that better formed stools will be less likely to get stuck in the pockets. It tends to work reasonably well. The CM approach is to improve the general function of the large colon and to clean away any toxic stuff which is actually stuck in the pockets. This approach is often successful in alleviating the symptoms.
To sum up: the majority of the diverticulosis sufferers will be treated better with Acupuncture and Chinese herbs due to the fact that most of their symptoms are caused by IBS and not diverticulosis. For the few experiencing diverticulosis symptoms the CM and WM treatments are of about equal effectiveness. In some rare cases the diverticulosis pocket will get infected and this condition (called diverticulitis) is considered to be a medical emergency requiring hospitalisation and, often, an operation.
Next, Anal conditions, namely piles and anal fissures. These two are fairly common. The treatment with WM is initially with creams to soothe the symptoms in conjunction with meds to maintain bowel movement, but, if the condition persists then the next step is an operation to remove the fissure or a procedure to remove the piles. The Chinese medicine understanding of these conditions is that they are caused by blood stagnation and heat in the lower end of the digestive tract. The treatment aims at remedying that in conjunction with keeping the bowel movement regular and soft. The results are usually good and long-lasting. Piles and anal fissures, then, are treated more efficiently with Acupuncture and Chinese herbs than with the WM cream. However, in difficult cases we may have to resort to an operation or a procedure.

I’ve left the best to last. The most common of digestive system conditions is IBS (Irritable Bowel Syndrome). IBS refers to a situation where the patient experiences a symptom, or a mix of symptoms, like abdominal pain, swelling of the stomach, diarrhoea, constipation or both without having any pathological findings in medical tests.
From the definition you can understand why WM is struggling to get its head around this condition. If there are not pathological findings then what the hell is wrong here? What causes these symptoms? I was present once in a lecture given at a TCM convention regarding IBS. The lecturer was a Doctor from a world-leading centre for the study of IBS. The subject was “IBS , the WM view”. It went more or less like this: fifteen years ago we thought that IBS was caused by this, then we discovered we were wrong and it is actually caused by that, but then we found out that we were wrong again and ,actually, it was caused by that and so it went until now we are almost sure it is caused by this and that. Forgive me for not boring you with the details of this and that theories. I am not sure I can remember them anyway. I am not being disrespectful to the Lecturer. He was obviously a very intelligent man who was trying his best and besides, he did agree to come and give a presentation to a TCM convention- a thing that most WM doctors probably decline to do. It wasn’t his fault. It is the wrong assumption that IBS is one condition with one cause. It’s the WM model that a disease has a cause, certain pathological changes and a pattern of symptoms and this simply doesn’t work in the case of IBS. It follows that the treatment on offer is poor; doctors will try different medicines like Omeprazole or Mebeverine with very limited success in relieving the symptoms. Chinese medicine, however, understands IBS very well, a lack of pathological findings makes no difference to a good TCM practitioner. IBS is a functional condition. A lack of function of the digestive system is bread and butter in TCM. No two IBS sufferers will be the same. Each individual case should be initially assessed to understand the causes of the condition and the symptom patterns as well as the patient constitution. When this has been achieved the treatment will be very effective. Generally speaking, the common patterns that cause disruption of the digestive system functions are as follows:
• Weakness of the digestive system
• Too much fluid in the gut
• Problems with the movements and the energy flow in the digest tract
These can be combined and intertwined. They can be caused by stress and worry or by eating the wrong food or by overworking etc. This is a significant simplification. I don’t want to bore you with all the details. I just hope it will help you to understand that Chinese medicine has a very thorough understanding of IBS and therefore the treatment with Acupuncture and Chinese herbal medicine is very often successful.

To sum up our comparison, in this post we looked at Digestive tract conditions and which sort of treatment would be most effective: Diverticulosis -TCM, Anal fissures and Piles-TCM but some difficult cases will need WM, IBS -Acupuncture and Chinese herbs any day.

Good Health,
Dr Ilan Shahor

Acupuncture Leicester - Digestive System

Digestive System Conditions (Part One)


In today’s post we are going to have a close look at the treatment of digestive system conditions from the point of view of Western Medicine (WM) and Chinese Medicine (CM- and including Acupuncture and Chinese herbal medicine). This particular area may demonstrate more vividly the difference between the two approaches. Whilst WM tends to concentrate on the biological and chemical changes occurring in the disease process, CM is more concerned with the functional changes and what has led to them. The same applies to the approach regarding the treatment: WM focusing on trying to reverse, stop, or at least slow down these chemical and biological pathological changes, whilst CM focuses more on restoring the impaired functions of the organs by treating the underlying cause as well as the symptoms themselves. I will try and demonstrate that with an example: the different approach is particularly apparent with the most common G.I. condition i.e. Irritable Bowel Syndrome (IBS). It has no known chemical or biological changes associated with it. It is purely a functional problem and therefore a complete mystery to WM. For CM, however, it is the complete opposite. Since the symptoms are abundant we have a lot to work with to analyse, understand and treat the condition. On the other hand, in the case of IBD (Inflammatory Bowel Disease) like Crohn’s Disease the Doctors can see clear inflammatory changes and Autoimmune involvement and they therefore have more to offer in the way of treatment than in the case of IBS.

I am going to discuss in a bit more detail the most common of GI conditions: IBS, IBD, chronic constipation, diarrhoea, diverticulitis and stomach related conditions.

Let’s start from the beginning. The GI tract starts with the mouth. The most common mouth complaints are mouth ulcers/sores and inflamed gums. In both these conditions the treatment with WM is limited to soothing and pain reduction. CM, however, understands that both are a result of excess heat mainly in the stomach. The treatment, therefore, with Acupuncture and Chinese herbs, is aimed at reducing the stomach heat. The results are excellent and, since we treated the source, also longstanding.

Next is the Oesophagus. Primary oesophagus problems are fairly rare. Oesophagus problems are more commonly a result of stomach acid damaging the oesophageal lining, producing pain known as heartburn. We’ll discuss it with stomach acid problems.

Let us continue our journey down the digestive system. After the oesophagus is the stomach. The stomach function is to receive the food we eat, start the digestive process and gradually move it downwards to the duodenum. Stomach problems can generally be divided into acid related problems and stomach dysfunction problems. Acid problems are usually due to the stomach fluid being too acidic or due to the protective layer of the stomach walls being very weak or damaged. Another common problem occurs when the sphincter between the stomach and the oesophagus is malfunctioning allowing stomach acid to travel upwards causing heartburn. The symptoms of hyperacidity problems are usually a burning type of pain around the stomach area, sometimes radiating to the back; sometimes after

food but can also come before food (hunger pain). The symptoms of a malfunctioning stomach are more common after food and include bloating, fullness, extending or swollen stomach and pain. Other possible symptoms are low appetite, nausea and sickness. These two types of stomach problems can sometimes be combined. The WM treatment for stomach acid related problems is with antacid medications. There are different levels of those: from alkaline buffers like Gaviscon or Rennies which simply reduce the level of acidity of the stomach fluids, to drugs like Omeprazole which completely stop the production of acid. From the point of view of fast symptom relief these medicines are, in most cases, remarkably effective. When Omeprazole came on the scene about 25 years ago (I was a young doctor then, working in a hospital) doctors were reluctant to prescribe it. The worry was about the impact of no acid production on the stomach. The rationale was that the acid production must be there for a reason and that if it was eliminated it may cause some long term problems. At the time, Omeprazole was prescribed for the most severe acid related problems which had not responded to other treatment. However, over the years, the doctors became more and more relaxed about prescribing it. It is now one of the most commonly used medicines and these days it is used for almost any stomach niggle.  Recent studies into the long term effects of taking Omeprazole have found out, not surprisingly I have to say, that depriving the stomach of its natural way of working in an acidic environment has its price: from a problem in vitamin absorption which can lead to Osteoporosis and other problems and to increase cases of Oesophageal cancer. Yet again’ we find out that attempts to interfere with the natural working of the body have a long term negative consequence. So, treatment of acid problems with WM: good on the symptoms but worries about the long term use of the drugs. It is probably worth mentioning that WM almost eliminated the problems of stomach and duodenal ulcers. This very painful condition which used to be fairly common when I was a young doctor has almost disappeared now since the discovery that it is caused by a bacteria. Adding a course of antibiotics to the antacids made the treatment of these conditions very effective.

The Chinese medicine treatment of stomach over-acidity is aimed at reducing the hyper acidity state and at improving the stomach function. This treatment is often successful. It has no side effects and tends to last for the long term. However, in the case where Heartburn symptoms are a result of a Hiatus Hernia then CM can be less effective since we are talking about a structural problem. I still recommend to try and treat any stomach acid problems with Chinese herbs and Acupuncture first, but in some cases we’ll have to resort to acid blockers or, in some bad cases, to an operation to repair the Hiatus Hernia. 

The other type of stomach problems can generally be described as indigestion. It often includes symptoms like bloating, swelling of the stomach and epigastric pain. In some cases low appetite and/or sickness are present as well. WM will place these symptoms under the IBS diagnosis. The only WM treatment available for this condition is Mebeverine. It works on the nerve system. Although its mechanism of work is unknown it is thought to relax the digestive system muscles. Its effectiveness is controversial as a few studies failed to show anything above a placebo effect.

Chinese medicine treatment for these types of stomach complaints is highly effective. According to Chinese medicine these symptoms can arise due to one of three reasons:

 a) a weakness of the stomach 

b) accumulation of thick fluids in the digestive system (called dampness in CM)

c) stress, distorting the normal workings of the stomach

Combinations of two or three of those is not uncommon. The treatment of these with Acupuncture and Chinese herbs is very efficient. The aim is to restore the function of the stomach and therefore, when it’s done, we can stop the treatment without the risk of the symptoms returning.

I am going to skip Pancreal and Duodenum conditions which are fairly uncommon. We’ll briefly go through Gallbladder as I have a few more important conditions to cover in today’s post. So, the main problems with the Gallbladder are Gallbladder stones and Gallbladder infection (Cholecystitis). Cholecystitis is treated with antibiotics which are fairly effective for the Acute phase. The problem is, however, that the infection can turn into chronic inflammation of the Gallbladder wall. The treatment offered here is usually an operation to remove the Gallbladder. CM can treat Chronic Cholecystitis effectively without the need for an operation. Gallbladder stones are a much more common condition. They are more common in woman, over forty years old and overweight. CM is very effective in clearing gallbladder stones as long as they are 1cm or less in size. Bigger than this and we will struggle to dissolve them.

Next we are going to examine the treatment of IBD (Inflammatory Bowel Diseases). There are two conditions included in this category: Ulcerative Colitis (UC) and Crohn’s Disease (CD). Both are chronic inflammation in the digestive system but are different in some aspects, most importantly in their location. Whilst U.C. is limited to the large intestine, CD can accrue in any part of the GI tract. This difference has an implication re the treatment. Both conditions are probably Autoimmune in nature. 

The Western medicine treatment of both is generally with Immunosuppressant drugs. These medications suppress the activity of the Immune system and , by doing that, stop the Immune system from attacking the GI tract. Immunosuppressant drugs can be successful in reducing the inflammation and therefore the symptoms, and yet these are strong medications which are likely to have long term serious side effects like an increase in the likelihood of cancer (through repressing the normal work of our immune system). Another problem is that these meds are for life’ as often the case, they do not treat the root of the problem and therefore have to be taken continuously. In cases where the meds are not working, or have stopped working, the Doctors will resort to an operation to remove the affected segment of the GI. In the case of UC this will be a cure. Removal of the large colon means that the disease can’t come back. It will however leave the patient with chronic diarrhoea in a good case, or a colostomy bag in a bad one. When it comes to CD the situation is more complicated. Removal of the diseased area will only provide a temporary relief from the symptoms. The disease will flare up again in a different part of the Digestive tract. One of the things that shocks me most, is the willingness of the Doctors in this country to operate on a CD patient to remove the inflamed section. It is a temporary solution and will almost certainly eventually bring them to an early grave since there is only so much of the Digestive tract you can take out before it becomes incompatible with life. Sometimes there is no choice and an operation is needed but it should only be done as a last choice!

Chinese medicine treatment of IBD is quite effective although in some cases it needs to be given together with WM treatment, at least at the beginning of the treatment and until clear improvement has been achieved. These conditions are chronic and severe and therefore the treatment may take time. Acupuncture and Chinese herbs are needed and it is strongly recommended to go to an experienced Practitioner. If you can find the Practitioner and commit to possibly long term treatment then it is worth going for CM treatment for Crohn’s and/or UC. It will make you healthier and it may save your life. The few difficult cases that don’t react to CM treatment can be then treated with WM.

We are going to go down in the severity of the conditions and talk about chronic diarrhoea and chronic constipation . These can be very upsetting but, unlike IBD, there is no inflammation involved and they are extremely unlikely to kill you. I thought it important to discuss these fairly common conditions because, as amazing as it sounds, WM does not have the first idea as to what causes these two conditions and therefore the treatment offered is very poor! In CM however these conditions are the bread and butter of Digestive System malfunction. CM recognises a few clear patterns of diarrhoea and constipation. For example, constipation can be caused by dryness in the gut: the stools will be very dry and hard to pass. It can also be caused by Qi deficiency (lack of energy in the gut to move the stool forward). The stools in this case will be very thin. Constipation can also be caused by GI stagnation (problems with the smooth flow of energy in the colon); in this case the stools will be like small pebbles (rabbit droppings). Understanding the different patterns and the underlying causes allows Acupuncture and Chinese herbs to provide effective and longstanding treatment.

We are left with Diverticulitis, anal conditions and IBS and this post is already too long so I will discuss these in the next one! 

To summarise the Great WM /CM GI comparison so far: which is more effective?

Mouth conditions-CM all day

Stomach and Oesophageal related problems-WM for symptoms, CM for long-term help

Indigestion and other stomach malfunctions-definitely CM

Gallbladder conditions-Cholecystitis: WM for acute, CM for chronic

Gallbladder stones-CM for stones 1cm and smaller, WM for larger stones

IBD (Crohn’s Disease and Ulcerative Colitis)- CM except the difficult ones; often a combination of CM and WM will yield the best results

Next time IBS, Diverticulitis and anal conditions.

Looking forward for that!

Contact us today for any further information

Ilan Shahor Acupuncture

Dr Ilan Shahor


The Great Med Off 2: Musculoskeletal related pain conditions

In today’s post we are carrying on where we left off last time: trying to compare Chinese Medicine (CM) and Western Medicine (WM), from the point of view of effectiveness of treatment. In this post I am going to discuss a very common group of ailments- musculoskeletal related pain. Musculoskeletal conditions are probably the type of conditions most frequently seen in my Clinic. They are generally very common and are often poorly understood and treated by GPs. Musculoskeletal conditions include any pain that originates from the bones, muscles, ligaments, tendons and joints. Common manifestations are lower/middle/upper back pain, sciatica, neck pain, hip, knee, shoulder and other joints pain. Although there are a lot of different conditions in this category, the general treatment principles for the various Musculoskeletal conditions are pretty much the same (in both Western and in Chinese medicine). We’ll start with Western Medicine.

Generally speaking musculoskeletal related pain is, in my opinion, very poorly understood and treated by WM Doctors. However, in some situations, WM is superior to CM. I’ll try and explain. The WM treatment offered to people in these conditions is the usual sliding scale approach. Let’s take lower back pain as our example. A patient who presents at the GP with this complaint will usually be prescribed a course of painkillers or the so-called anti inflammatory drugs, which are painkillers with a different name. If these don’t achieve the desired results then the next step will be a course of Physiotherapy. Next will be the steroid injection and, if this fails, an operation will usually be offered. This is generally the flowchart with some small variations according to the individual circumstances. Let’s look at it stage by stage.

Stage one: painkillers/anti-inflammatory drugs. The case here is similar to the criminal overuse of antidepressants by GPs. The problem is the same: these medicines do not treat the problems that cause the pain, they only treat the pain itself. The problem here is that since the original condition hasn’t been resolved then the patient will become dependant on their painkillers. The longer the drugs are used the higher the risk of side effects. Possible side effects from the use of anti-inflammatory drugs and painkillers vary from digestive problems to stomach bleeds and kidney failure. Another problem is that after a while the body develops tolerance towards the medicine and its effect lessens. The patient will then need a bigger dose or even another type of medicine (often stronger). It is not unusual for people who struggle with chronic pain to be on two, three, or even four types of medicine to deal with the pain. Of course, the more medicines you take the greater the risk of side effects. I have to clarify here-I am not completely opposed to the use of pain medication. Just as in the case with antidepressants it has its place and should be used in some cases-mainly for short term help and when all else has failed. In any other cases we should surely try and treat the condition with safer and healthier methods and should always aspire to a long term relief whenever possible.

Stage two: If painkillers are found to not be enough then we move to a course of Physiotherapy. Physiotherapy, when it is being done properly, is an important part of effective treatment for musculoskeletal conditions. In the U.K. at the moment, unfortunately, the Physiotherapy available on the NHS is very limited.

Stage three: Steroid injections. A mix of steroids, painkillers and local anaesthetics is injected directly into the painful area. The results are mixed. While in some cases quite a quick reduction in pain can be achieved this tends to be only temporary. Within a few weeks to a few months the pain is often back. The injection can only be repeated two or three times as more than this can start to cause damage to the structure that has been injected.

Stage four: Operation. I am often amazed how quickly patients with musculoskeletal problems are offered an operation to solve the problem. Of course, in some cases an operation is needed. If the cartilage is torn or the joint is completely worn out then no amount of Acupuncture or Osteopathy can help. However, in many cases, operating on a musculoskeletal problem is like using a sledgehammer to kill a fly. Usually there is no need to apply an expensive and possibly dangerous procedure, with questionable success rate, when you can almost always cure the problem with a simple and safe method like Acupuncture.

I am aware that I am generalizing here…there are a lot of different causes of musculoskeletal pain…but the general principle still applies: why use heavy handed methods (painkillers, steroid injections, operation) with possible dangerous side effects when you can sort out the problem with Acupuncture. Acupuncture is extremely safe and very effective in treating most musculoskeletal pain conditions, particularly when the pain is arising from ligaments or tendons, strains or inflammation, arthritic joints and muscle problems. Another major advantage of Acupuncture is that in many cases we can achieve a long term relief and even a cure. Unlike the opinion prevalent among Doctors and Physiotherapists, Acupuncture is definitely not just pain relief. In most cases it can create a better condition for healing by improving blood circulation, relaxing the muscles and reducing inflammation.

So, when it comes to musculoskeletal pain conditions, who is the winner? Western Medicine has the stronger ability to reduce pain with powerful pain killers. It can also replace the whole joint when the old one is beyond repair. However, in the great majority of musculoskeletal pain conditions Acupuncture will be more effective, much safer, and will achieve long standing results without developing a dependency on the treatment. It’s also important to say that in some situations a combination of Western and Chinese medicine will achieve the best results.

In the next post I’ll be concentrating on Gastrointestinal conditions. I will discuss Inflammatory Bowel Diseases such as Crohn’s Disease and Ulcerative Colitis as well as IBS (Irritable Bowel Syndrome) and others. I am looking forward to this one as it is going to be a particularly interesting one. Now I just have to find the time to write it!

Best of health to everyone.

Dr Ilan Shahor

The Great British Med Off

In today’s post I will try and embark on the very complicated task of comparing Chinese medicine and Western medicine. Having qualified and practised in both disciplines I think I am in a good position to do so. The subject is vast, it’s multifaceted with different layers to it. It can easily fill a book or two. As usual, I am going to try and simplify matters. I will try and focus on the practical aspects: which discipline is likely to be more beneficial in which condition; what are the pros and cons etc. The next few posts will be dedicated to this comparison with a different group of conditions in each post.

However, before starting with all of this I would like to stress a very important point. In many cases it is not necessarily one type of therapy or the other which will reap the most benefit but a combination of both. In China, Chinese and Western medicine are working effortlessly in harmony side by side. Chinese medicine practitioners are also trained in Western medicine and vice versa. There is an understanding of the pros and cons, the strengths and weaknesses and, most importantly, the limitations of each discipline. A Western medicine practitioner, in China, won’t hesitate to refer a patient for a course of Chinese medicine treatment on occasions where they feel it will be beneficial. A TCM (traditional Chinese medicine) practitioner, on the other hand, will be able to identify the cases which require Western medical intervention.

Let me give you an example of how it works in practice. A stroke is a very common condition. It can have a devastating effect on the patient. In the West, from the people who survive a stroke, 33.3% will recover completely, 33.3% will partially recover, that means they will have some residual paralysis, and 33.3% will stay fully paralysed. Western medicine has no means to affect or improve this outcome. In China, however, the treatment for a stroke is a beautiful demonstration of the possible cooperation between TCM and Western medicine. A patient with a stroke will be rushed firstly into a Western medicine ward and will normally stay there for a few days only. After being assessed by the doctors as being in a stable condition, the patient will be transferred into a rehabilitation unit. On that unit most of the methods used for rehabilitation are TCM methods, namely: Acupuncture, Chinese herbal medicine and tuina (physiotherapy of Chinese medicine). The full recovery rates on these units is around 80%!! This demonstrates how Western and Chinese medicines can (and should) work beautifully together. Soon after the stroke, at the early stage, Western medicine is essential. In a small portion of patients emergency surgery will be needed. Chinese medicine can’t help those patients at that stage. In the later stage, however, the rehabilitation is the important factor and that is where Western medicine can’t help much but Chinese medicine can!

The question that naturally arises is why can’t it work like that in our health system? After all we all want as successful an outcome as possible for the patient. The answer is that, unfortunately, when it comes to openness towards and awareness of other treatment options we are miles behind the Chinese. Whilst TCM practitioners qualified in this country have a good knowledge and understanding of Western medicine basics and in particular of “red flag symptoms” (symptoms that may indicate a serious medical condition and therefore require a referral to a doctor), Western medicine practitioners haven’t got a clue about TCM and what it can do. There is still a complete ignorance regarding the issue and that is a great shame!

However, we can’t keep digressing from our main issue: the Great Med Off! I would like to start with the treatment of cancer. It is by far the most asked about condition in my Clinic. Can Chinese medicine cure cancer? The answer to this question is, unfortunately, in most cases, no. Chinese medicine is extremely good in fixing body systems that are malfunctioning but if there is a lump of cancerous growth in the body then it is just not strong enough. I have heard about cancer cases which have been cured or at least been improved with TCM treatment but these were all in China, in a very specialist clinic using very strong herbs (mainly animal products) which are not available to us in the UK. The bottom line is that, despite the obvious shortcomings of the Western medicine treatment for cancer (severe side effects), I still usually recommend to those who ask me to keep on with the Western medicine treatment, particularly in cases where there is a chance of a cure.

Chinese medicine, however, still has an important part to play in the treatment of cancer. On my last trip to China I saw a presentation of a big study of the treatment of cancer by a combination of TCM and Western medicine. In that study breast cancer patients were divided into two groups. One group had received the traditional Western medicine treatment of an operation and chemotherapy or radiotherapy. The other group received the same treatment and in addition they received TCM treatment that included acupuncture, Chinese herbal medicine and a form of exercise (QiGong or TaiChi). The results were: a) a dramatic reduction in the side effects from the Western medicine treatment and a significant increase in the quality of life in the combined Western and Chinese medicine therapy and, more surprisingly, b) a 30% increase in the survival rate in the combined treatment group! So again I would say combine if you can. The problem is that it is becoming harder and harder to combine Chinese medicine in the treatment of cancer in this country. In the past I used to treat people who were going through chemotherapy and radiotherapy with acupuncture and herbal medicines. Those treatments were very successful. The patients used to suffer much less from side effects and felt generally better. They used to go through the treatment with much less problems including less bone marrow suppression (which causes a fall in white blood cell count and often forces the doctor to stop or to reduce the chemotherapy!). It was common for my patients to report that the doctors asked them how they were staying so well. Recently, unfortunately, more and more treatment centres tell their patients not to take any other treatment during the chemotherapy. The reason given is that they don’t want anything to interfere with their treatment. This policy comes out of the ignorance of Western Medicine Doctors regarding Chinese medicine. The doctors are probably too busy to check out the available research. Again I think that it’s a great shame. So when it comes to cancer I will say definitely combine if you can but if I had to choose a winner then it is Western medicine due to its better ability to deal with tumours and an overall bigger chance of a cure.

Next in our Great Med Off are skin conditions. I chose it to follow the cancer section probably due to my need to balance things up. After giving the advantage to Western medicine regarding cancer treatment, when it comes to skin conditions then Chinese medicine is a clear winner. Skin conditions like eczema, psoriasis and acne are common, usually chronic, and very poorly treated by Western medicine in my opinion. The Western medicine approach to treating these conditions is suffering from the usual problem: it only treats the symptoms. The first line of treatment is usually with creams, mainly creams containing steroids. On the one hand these are quite effective and will clear most types of skin lesions. The problems start when we stop using them. The condition is likely to come back. A long term use of steroid cream will damage the skin and is therefore not recommended. The use of steroid creams can therefore only be recommended in light and self limiting conditions and is usually not effective in the chronic condition. The second line of treatment is with steroid or other Immunosuppressant drugs. The dynamic there is similar to the use of cream. These medicines will often be very effective in clearing the skin condition. However, the condition will be almost certain to come back, at least as bad as it was before the treatment, when we stop the medicine. A long term use of these medicines will cause serious side effects such as kidney or liver failure, diabetes, atherosclerosis and others.
The only cases where I support the use of steroids or Immunosuppressant drugs in skin conditions are those where the condition is extremely severe and other treatments have failed.

The Chinese medicine approach for skin conditions is different. It has a good understanding of the reasons and causes of these diseases. Treatment with Acupuncture and Chinese herbs is directed towards the cause of the symptoms as well as the symptoms themselves. With chronic conditions the patient will have to be a little patient as the treatment may take a few months but the results are usually excellent and long-lasting. (For a more detailed explanation as to how Chinese medicine can understand and treat skin conditions please go to the conditions section in my website.)

In my next post I am going to discuss musculoskeletal conditions, digestive system problems and psychiatric conditions with the pros and cons of Western medicine and Chinese medicine regarding the treatment of these areas. Which one will come out on top? The answers are all in my next post.

Good health for everyone.

Dr Ilan Shahor

About Chinese Medicine Part 2: So how does it all work?

Today I will set about the complicated task of trying to explain the logic behind Chinese Medicine, or How It All Works. I use the word complicated, not because the logic itself is complicated, in fact it is all based on very simple and practical principles. However, to explain it to someone with no formal knowledge of TCM can be tricky. I remember the first time I was battling with TCM theories. It was during my TCM course with the Beijing University. We were all medical doctors and we all struggled. It was very hard for us to comprehend what the lecturers were saying. It was completely different from everything that we knew (and remember most doctors think they know most things there are to know about human health). The main problem was that we heard about Qi and Yin and Yang, heat, cold, dampness and what happens when these are out of balance. It sounds initially like a dry list of statements that didn’t make much sense,it was like reading out of telephone directory. How do you know? Where is the proof? What makes you think that all of this is actually true? We all felt a bit uncomfortable, with some of us probably questioning the wisdom of paying out good money for attending the course.

This heart-sinking feeling started to gradually change when we began to see patients. All of these seemingly dry and abstract theories (for modern doctors) started to come to life. We could actually see then that the Yin deficient patients were getting hot and dry mouthed at night for example, and that the patients with excess dampness felt heavy, bloated and sluggish. The Qi deficient ones were tired and their speech sounded like they were straining to get the words out of their mouths. The blood deficient ones were pale and a bit dizzy; the liver stagnation patients were emotional and impatient and so on. It all started to make sense. We started to realise that all of these TCM theories are based on careful and patient observations, and are based in reality. The warming up of our attitude towards the TCM theories further strengthened when we noticed the night heat and dryness had improved when the patient was treated for the Yin deficiency; the mood swings and irritability had disappeared when the liver stagnation had been attended to, and so on. Brilliant, I thought; as I keep on telling my patients-the proof is in the pudding. I have never looked back since.

In the beginning, however, it was all a bit difficult to understand so I will do as I always do and try and simplify TCM for you. So, where shall we start? I think that the two most important principles in maintaining health according to Chinese medicine are flow and balance. Flow refers to the flow of Qi (body energy), blood and body fluids. Balance refers to the balance between Yin and Yang, heat and cold, dryness and dampness and excess and deficiency. As long as free flow and balance are maintained in our bodies then all is good; we feel well and are not suffering from any ailments or symptoms. However, if the flow is blocked or disturbed, or if the balance fails to be maintained, then problems will start. These problems can be on the physical, emotional or mental levels. I will explain in more detail, starting from the flow. The most important flow is the flow of the Qi. Blockage of this flow will result in pain that is usually dull or throbbing in nature. A common example of pain from the stagnation of Qi is the abdominal pain suffered by some of the IBS (irritable bowel syndrome) sufferers. On some occasions the flow of Qi is not blocked but just disturbed. A very common example of that is when the liver Qi flow is disturbed usually following stress or worry. The resulting symptoms will be mainly emotional such as mood swings and irritability. The Qi is needed for all the body functions and therefore a disturbance in its flow can be followed by symptoms in different systems of the body. It will usually start to cause a problem in the weakest area in each individual. Problems with the flow of blood will also primarily manifest as pain. Pain from blood stasis will typically be sharp and stabbing in nature. Blood is most important in women and most gynaecological problems are related with blood circulation problems. Examples are endometriosis, PCOD (polycystic ovary disease), infertility and painful periods.

The flow of blood is also essential in the healing process of wounds and traumatic injuries. It is quite astonishing to see how quickly traumatic injuries are healed when treated with Acupuncture and herbs to improve blood flow.Another example is non-healing ulcers. These are typically occurring in diabetics and old people and are the result of poor blood circulation that prevents healing.These patients will have to go to the GP clinic two or three times a week to change the dressing on the wound/ulcer but there is not a prospect of it healing. However, if it is treated with Chinese herbs that improve blood flow then the wound/ulcer will heal within a few weeks!

The flow of body fluids is also very important-we are 70% water. Still, normally, we don’t feel that damp. However, if the normal flow of fluids around the body is disturbed then problems will start to manifest. These types of problems can manifest in different systems of the body. A few common examples are: digestion problems such as bloating and diarrhoea, oedema, skin conditions like eczema and psoriasis, joint problems like arthritis, thrush and others. So, maintaining the free flow of Qi, blood and body fluids is very important. As long as they flow then all is in working order.

Now, what about balance? We mentioned Yin and Yang, heat and cold, dryness and dampness and excess and deficiency.First Yin and Yang, this blog is too short, of course, to explain the Yin and Yang concept properly. It’s a bit tricky to understand and I have met a few practitioners who still struggle with it but I’ll try to explain. Yin and Yang are the two opposite aspects of any energy. They contrast but co-exist and are co-dependant. Everything in nature has a Yin and Yang aspect to it. The famous Yin and Yang symbol (see picture) symbolises this co-existence. It shows two separate powers creating the whole. The little dot represents the small amount of Yin within the Yang and vice versa. They are co-dependant and nourish each other. Yang is hot and fiery and rising upward and Yin is cool and watery and going downwards and so on. So what does it all mean to human health? In the human body the Yin and Yang have to be operating in perfect balance. Any change from this balance will start to manifest as physical symptoms e.g. if the Yin energy is weak then the person may feel hot, particularly at nights-night sweats are possible, dry mouth, or general dryness and sleeping difficulties. It’s like our coolant and moisturising fluids are missing. The Yin deficiency symptoms tend to be more prominent at night as night is normally the time when the Yin is predominant whilst the Yang is predominant during the daytime. The most common example of Yin deficiency is the menopausal age. At this age the woman experiencing a sudden drop in the Yin energy results in symptoms of night sweats, dryness and so on. These women, by the way, will respond wonderfully well to a course of treatment to strengthen their Yin energy. When the Yang energy is low, the patient will feel cold and tired. Low libido, sexual function and difficulties, and water retention are common as well. The deficiency of Yin or Yang can be general in the body but can also be limited to a specific organ e.g. asthma arising from lung Yin deficiency will typically manifest as wheezing with a dry cough and a dry throat whilst asthma arising from a lung Yang deficiency will more often manifest with wheezing with a cough with a large amount of phlegm obstructing the airways. The picture can be a bit more complicated when there is a mix of Yin and Yang deficiency but an experienced TCM practitioner should be able to make the right diagnosis and apply the right treatment!

The second type of balance that needs to be maintained in order to promote health is dampness and dryness. Our body needs to be in a perfect level of humidity throughout all the different tissues and organs. We are made of 70% water and yet we normally don’t feel watery. That is due to this perfect working balance of the fluids within us. What happens if this balance is disturbed? We start to struggle. This can happen in certain areas of the body (e.g. digestive system) or within certain systems (e.g. joints) or it can be general in our body. An added complication to these conditions is that when fluids start to accumulate in the body they often turn from clear healthy fluids to more thick heavy and sticky fluids, termed by TCM as damp. Damp is a major pathogen in TCM. It commonly arises as a side product of ineffective digestion and is found to gradually accumulate and spread in the body. It’s common in modern day due to rich and often unhealthy diet and eating habits, often combined with being under pressure and with a weakened digestive system. When it accumulates it can cause problems in different systems of the body e.g. abdominal pain, bloating and diarrhoea, arthritis and asthma. Heaviness and stiffness are common.
The opposite of dampness is dryness. In these situations the organs and tissues are suffering from a lack of moisture. This situation can arise from the presence of heat which dries the tissues, from problems in the body water distribution system or pathway or from lack of Yin ( remember, the energy that keeps us cool and moist). A common manifesto can be constipation with dry stools, dry skin conditions like eczema, and lung conditions like asthma.

The third balance is the one between heat and cold. The temperature has to be right all over the body to sustain good function. As is the case with other elements, heat and cold can affect one area of the body or be generalised all over the body. Some of us are naturally colder and will be more susceptible to cold related problems, and vice versa with the naturally hotter people. In some cases we can have a mixed picture where in certain parts of the body there is too much heat and in others too much cold. This can make treatment a bit tricky and an accurate diagnosis is essential here. The most common symptom from excess cold is pain. It is commonly in joints (the ones that get worse on a cold day), in the digestive system or in the gynaecological system. Heat problems are very common these days. Generally speaking, a rich diet and stress are to blame for that as both tend to generate excess heat in the body. Excess heat is a common cause of most skin conditions, inflamed joint conditions like gout, most types of migraines and many others.

The balance between excess and deficiency is very important but is also a bit hard to explain. Generally speaking the practitioner has to decide, in any one case, are the symptoms a result of the patient lacking in something or having too much of something. In other words, what is causing the imbalance-too much (excess) or too little (deficiency)? For example, the patient is feeling too hot-is that a result of too much heat in the body or is it a result of a deficiency in the Yin energy which is the energy that keeps the body cool? The patient feels a lack of energy – is it a deficiency in his Qi energy or is it a result of dampness clogging his body and making him feel heavy and sluggish? Correct diagnosis is absolutely essential and getting it right is more than halfway towards successful treatment.

Alongside free flow and balance, there is one more critical aspect of Chinese Medicine, which I have not yet discussed with you: the function of the body organs.

One of the most amazing insights of TCM into the human body is the understanding of the subtle function of the organs. Try and tell a doctor that the heart is responsible for our sleep and our mental ability and he will think that you are tripping on something! The heart is just a muscly pump which pumps the blood around the body, he will say. A similar bemused reaction will follow the claim that the liver is in charge of our emotional functions and is of crucial importance in conditions like depression and anxiety. Modern medical science knows only about the physical and chemical functions of our organs but unfortunately has no idea about their subtle functions! Understanding the function of the different organs, particularly of the heart, kidneys, lungs, liver and spleen ( in TCM the concept of spleen includes the pancreas, the duodenum and the small intestine) is essential for successful diagnosis and treatment.

In reality, of course, humans are not simple and often symptoms will arise of a combination of two or more of these imbalances. For example, stress can disturb the flow of the liver Qi which will often affect the spleen; a weak spleen will cause inefficient digestion which will result in an accumulation of dampness. The dampness can clog the flow of Qi and so on. In my clinics I often see cases which are very complicated, many systems are involved and imbalances are intertwined.
The longer you leave the problem without treating it the more complex things tend to get. The reason for this is simple: when one area or system starts to malfunction it inevitably puts pressure on other areas or systems of the body; after all, they are all connected and intertwined in the great living work which is our human body. It is very important therefore for the TCM practitioner to have a deep understanding of the subtle workings of the body and of the different pathologies that may affect it. An accurate diagnosis is key to a successful treatment.

I hope this post makes TCM a bit more understandable. It is about a fully established and very effective form of medicine and it’s important to me that people understand more about it.

In my next post (or maybe few posts since it’s a big subject) I am going to compare Western and Eastern medicine in their philosophy, understanding and methods. That is, I am going to try and look at how they compare in treating different conditions.

Good health to all of you,

Dr Ilan Shahor

About Chinese Medicine. Part I. “So, what is it that you do?”

I have often been asked this question, as one does, on social occasions and so on. To be honest these moments are one of the very rare occasions when I wish I was still working as a Western Doctor. It would be so much easier to say “I am a Paediatrician” or “I am a Urologist”. People know what those are; there are no awkward moments, unlike when I say “I’m a Chinese Medicine Practitioner”. (Oh, that’s interesting, so you stick needles in people?) Yes, pretty much, I stick needles in people for a living. You can see why it somehow makes me feel a bit uncomfortable. Of course, Chinese medicine is much more than that: an established and extremely clever, beautifully constructed, multi faceted way of understanding everything about human health and sickness. It covers every aspect of health, physically, mentally and emotionally. It possesses a deep understanding of the processes of health and illness. It understands the factors that affect our health such as lifestyle, emotions, food, weather and so on. It is of course much too complicated to convey all of this in conversation over a dinner party. Usually, if I try, I soon have to stop as I can detect the puzzlement in the eyes of the person I’m chatting to.
“You need to write about it in your blog” my daughter told me. Yes, that makes more sense. I won’t have anyone’s confused look to stop me in my tracks, so I am going to give it a go. I will try to simplify things as much as possible, whilst still doing justice the important principles of T.C.M. (traditional Chinese medicine). Like everything in Chinese medicine it is all about keeping the balance.

The main parts of T.C.M. are Acupuncture, Chinese herbal medicine and Tuina, which is the physiotherapy of Chinese medicine. Other associated methods are exercise, like QiGong and Tai Chi, nutrition, and lifestyle advice. All are very important and are used in my clinic, individually or in combination, according to the needs of each individual case.

Trying to simplify things (again) I will mainly discuss Acupuncture and herbal medicine, focusing in this first post of the series on general principles. But first: how did it all begin?

This is one of the most commonly asked questions, and justifiably so. Who came up with this crazy idea of sticking needles into people to make them feel better? The disappointing answer to this question is that we don’t know. Acupuncture was practised well before written history began. There has been no evidence found to help solve the mystery. The most likely theory is the idea came about when someone was accidentally stabbed by a sharp object, and experienced the unexpected effect of some sort of symptom being relieved. From that point onward began a patient process of trial and error to identify all the acupuncture points on the human body. It became clear that most of these points are located on a network of lines on the human body. They realised these lines (termed meridians) are the main pathway of the body’s energy (termed the Qi). Now, as long as the Qi energy is strong and is free to flow along the Meridians, all is good, we feel well and in good health. However, if the Qi is weak or blocked we will develop problems. Now, what can cause the Qi to struggle? Before I attempt to answer this question I would like to pause for a moment. Starting to talk about Qi and Meridians usually makes some people (particularly people with a scientific background) switch off. I can understand that, after all I used to think just like that myself in my early academic life. I would like to point out all of this knowledge regarding TCM theory is based on knowledge accumulated through trial and error, and careful observations over hundreds of years. It is not just a strange idea someone thought up in the shower. It is based on simple facts that are tried and tested, and that is one of the main reasons it is so effective!

As well as Acupuncture, the same is true for Chinese herbal medicine. We often hear in the media that Chinese people believe that this herb is good for that, and so on. Actually, it has nothing to do with belief and it has everything to do with sound science. The basic assumption was that since humans are part of nature, made of the same materials and using the same energy as the rest of nature, then there must be materials in the natural world that can help us when we get ill. How this works is explained more in my next blog, but a summary is that everything in nature exists in perfect balance, and so it is in the human body. If for some reason this balance has been disrupted we will feel it as an illness or as a symptom. The assumption was that there must be materials out there in nature which can redress these imbalances that are making us ill. With this in mind a great search began.

The ancient Chinese doctors have tried absolutely everything in the natural world to see the effect on the human body: plants, minerals and animals. More than that, when they tried a plant they tried the different parts of the plant separately: the roots, the stalk, the bark, the leaves, the flowers, the fruit (immature then mature), the peel, the stones- and so on. Then each of these can be prepared in a different way to achieve different effects. For example, it can be taken raw or dried or fried or fried in honey/vinegar/wine and so on. The same goes for animals. Every animal and every different part of every animal has been tested to see its effect on the human body. From this you can start to comprehend the huge variety of material tested over the years: hundreds of thousands, probably millions of substances. Out of these the Chinese medicine materia medica has been established, in which over 5000 materials have been identified as having a medicinal property.

A very important fact about this process of creating the materia medica is that these materials have been always tested by ancient doctors themselves and usually on themselves. Famous ancient TCM practitioners used to try new materials on themselves and report the effects. They used to go through hundreds of different materials and it wasn’t surprising that some of them got ill and even died in the process. It sounds terrible, but due to the sacrifices of these brilliant ancient scientists we have this enormous body of knowledge, regarding the effect of these herbs on the human body, and their ability to heal diseases and ease symptoms. The fact those doctors tested the herbs on themselves made the information much more reliable. Modern medicines are tested on animals. Very commonly they show a good result when tested on rats or monkeys but when they are used in humans problems start to appear.

To sum up this point: the use of Acupuncture needles and herbal medicine to help people with their medical problems is often viewed, in the West and in particular by the scientific establishment, with great suspicion. It is often referred to as: an untested and unproven method of treatment. This description could not be further from the truth in regard to Chinese medicine. Actually, the truth, as is often the case, is the complete opposite. Chinese medicine has been tried, tested and proven much more thoroughly than any modern method of treatment has. It is based on careful and patient observations and an accumulation of experience over hundreds of years. That is the reason why, despite never having the scientific knowledge and technology available to modern medical science, TCM is still much safer and, in many cases, a much more effective method of treatment than modern medicines!

Now, as we put this important point to bed, we can move on to trying to explain how it all works, and what is the logic behind it.

In my next blog I will try and do just that. I will try and make sense of terms like Qi, balance, yin, yang, heat and dampness. Hopefully then TCM will start to make more sense.

Have a good week,