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Herbal Explorations

Adventures in Shanghai

By JK DeLapp

I just got back from a 22-day stay in the legendary city of Shanghai. What an experience! I would like to put together a collection of thoughts from my trip for you. If nothing else, it should be a fun read.

The first Monday in Shanghai marked the commencement of my ten days of work in three different hospitals. I spent most of my time working in two locations with the same group of doctors in Long Hua Hospital. My remaining two days, I worked with the great uncle of a family friend, an 84-year-old well-known herbalist at Zhong Yi Yi Hua (Chinese Medicine Hospital) near the West Nanjing Road stop off Line 2.

On my first day, the cabbie actually took me to the wrong hospital, which meant I was dreadfully late. In a city that speaks hardly any English, combined with my poor conversational Chinese, I walked right in and spent quite some time being lost. When I finally got to "where" I was supposed to be, it turned out, there was no Zhao Yi Shi (Doctor Zhao—my first contact there) that worked there.

"But hey, while you´re here, come with me."

As luck would have it, I was in the ER. They took me straight into a room and there, on the bed, was an Englishman. He just had a stroke, and nobody could communicate with him. Commically, he was an English teacher in Shanghai, married to a Chinese woman (who speaks English), and after almost eight years in the country…spoke no Chinese!

Me: "What meds are you on? And where are the tools?"

Englishman: "Meds—I have no idea. It´s all in Chinese. And tools? What tools? This is a Western ER!"

He was probably thinking,"Oh, great! The only Westerner to walk into the ER in China and he´s a Zhong Yi Yi (Chinese Medicine Doctor)!"

I stayed talking with the guy for a bit as I wondered how I got here. I did what work I could on him with just my hands and got some movement to return in his right leg and arm, but his right hand was still a bit shoddy. The Chinese in the ER clapped with amazement. I then made the suggestion that he see an acupuncturist and get on some herbs as quickly as possible. He looked a bit surprised about the suggestion, but swore he would get his wife to take him as soon as they were able to get ahold of her. I hope the bloke took my suggestion; it could really minimize his long term damage.

I did what work I could on him with just my hands and got some movement to return in his right leg and arm, but his right hand was still a bit shoddy. The Chinese in the ER clapped with amazement. I then made the suggestion that he see an acupuncturist and get on some herbs as quickly as possible. He looked a bit surprised about the suggestion, but promised he would get his wife to take him as soon as they were able to get a hold of her. I hope he followed through because it could really minimize his long term damage.

After getting off to a great start, I hopped a cab over to the correct hospital, only to find that they were out to lunch for the next hour and a half. I eventually connected with them for what would be a total of eight days of fun. Things were very different in Shanghai. There were no guide tubes for needles. They e-stim the heck out of everything. And there was only one head doctor (Zhao Yi Shi) and his six assistants—all graduates that will spend 3-5 years with him before being relocated to head positions in some other hospital somewhere in the country. Zhao Yi Shi did all the needling, and his assistants did all the e-stim and cupping. I saw a lot of cupping, including bleeding cupping. People who came in with fevers or back pain literally bled for it, which seemed to give them a lot of relief.

The main complaints with this batch of doctors seemed rather limited. I´ve seen much more variety of complicated cases back at home in the US. In Shanghai, there were a lot of "weight loss," in which already skinny people came in asking to be thinner. Most of them Zhao Yi Shi laughed at and sent away, but the more persistant ones got their treatments. There were also a lot of Wind Stroke patients. The weather was quite cold and windy in the city so Wind Stroke was a common complaint in the area. Quite fascinating. Oddly, they did not do any bone setting of the neck or upper back, which can often drastically improve a patient´s condition in the snap of a finger. Or a neck

In China, they generally split a shift—morning and afternoon—with about an hour break in between for the doctors to eat lunch. The batch I was working with would swap between two hospitals. So, some days they were in one place all day, and other days, they went back and forth.

Thursday are "Gao Fang" days, an interesting Shanghainese herbal practice that is practiced during the Winter. (Actually practiced all year long, but emphasized in the Winter). It was really a fascinating thing to observe. The doctor took pulses, asked a few questions, and then wrote a formula that could be as few as 20 herbs and as many as 50+.

The Gao Fang Formula, most traditionally prescribed on Dong Zhi (Winter Solstice) emphasizes Tonifying Yang while Nurturing Yin. The formula is prepared by the hospital, and takes 3-4 days to make. Roughly 5-8 kilograms of herbs are placed into large ceramic pots and covered with water, then brought to a boil. The water is then poured off into an even larger ceramic pot, and the process is repeated 3 more times. Herbs like Ren Shen, Lu Jiao Jiao, E Jiao, and Gui Ban Jiao are ground to a powder and added at the end to this final liquid. Over the next 3-4 days, this huge batch of tang is slowly simmered down to about a gallon of very thick gel. This prepared Gao Fang is taken morning and evening for the entirety of Winter. A Shanghainese Tradition "to keep a woman´s skin and hair soft and shiny, to keep men strong for their women, to keep the back strong and warm, and to keep both the loins and mind fertile."

I was told that Gao Fang could cost a person anywhere from 1,000 Yuan (roughly $170) up to a Million yuan ($170,000)! The price was dependent on both the quality and the rarity of the herbs used. And people were happy to pay it!

When it was all said and done, I helped prescribe nearly 1,000 Gao Fang Formulas to child and elderly alike. Once my Chinese friends found out that I was Zhong Yi Yi, every single one of them asked me to write a formula for them. I did so gladly.

During my time at Zhong Yi Yi Hua (Chinese Medicine Hospital) with Yuan Yi Shi, I saw a different picture. Yuan Yi Shi is an 84-year-old jovial, constantly smiling man, who is the great uncle of a friend of my Dad´s back in the States. He did not practice acupuncture, and solely prescribed herbs. He was a rather well-known heart doctor, so the cases I saw there were more complicated. All sorts of heart problems, along with stones—both Kidney and Gallbladder—are his forté. The occasional Xiao Ke (Wasting and Thirsting—i.e. diabetes) patient wandered in.

He worked alone, and had a single assistant that would transcribe his written formulas into the computer. His formulas averaged 18-25 herbs, and were usually taken for 10-14 days. He also prescribed Gao Fang, and was happy to see that I was familiar with the practice. Although no English was spoken by either him or his patients, my familiarity with Chinese Medical language gave us plenty to chat about. You would be surprised by just how much Chinese you probably already know. Of the two days I spent with him, we saw rougly 125 patients each day. It was quite amazing! And we never felt rushed.

The rest of my time in Shanghai consisted of eating, dancing, and sightseeing of wonderful places, like the Yu Yuan Gardens and Jing´an Temple.