What then is the ‘sub-health state’? Firstly, the definition describes those who do not have any organic physical diseases but are functionally unstable between health and illness; for instance, those who suffer from chronic fatigue syndrome and are mentally tired and anxious without showing any physical evidence of illness according to hospital diagnosis. The second group includes those who feel unwell physically and emotionally and live a low quality of life with negativity. And thirdly, those who suffer from minor ailments such as pains and aches, headaches, insomnia, stress or mild depression. Those who are very vulnerable to flu and infections belong to this category. The sub-health state also describes those who are allergic to different foods and environments as well as those who get emotionally upset and angered easily, or are in a constant worry or sorrow. Even over-indulgence in love, joy or excitement can bring the person into this sub-health state by lowering their levels of energy and tolerance. Hence we arrive at the Chinese medicine concept of harmony and balance. To maintain a relatively stable state of harmony and balance, the Chinese physician will use herbal medicine, acupuncture and soft tissue therapy to regulate the physical and psycho-emotional state of the patient. With a balanced lifestyle, the Chinese physician will seek to return a patient to a relatively healthy state or reverse the decline in health holistically. In this way, Chinese medicine as a medical system is ideally positioned to integrate with Western medicine which is more interventional in approach. The sub-health state now characterises the pattern of health and disease of the modern time. Economically and politically such a trend in health patterns is a warning to the world as we approach material abundance and consumer affluence.

Therefore, we can summarise that in Western medicine we classify disorders in terms of a set of symptoms belonging to a particular disease or organic dysfunctions according to our knowledge of anatomy and physiology, whereas in Chinese medicine we differentiate illnesses in terms of syndromes or patterns of diseases. Western medicine takes the view that the aetiology of a disease belongs to a specific physiological system such as the digestive system or the nervous system. Chinese medicine looks at a disease’s causes as imbalances or dysfunctions between the holistic relationship of organs and their interaction with functional or organic materials of the body such as Qi, blood and body fluid. The concepts of Yin and Yang balance, deficiency or excess and exogenous or endogenous causes are used to identify the body's current ‘reaction state’ and to determine the primary and secondary syndromes during a complex situation of interrelations and interactions within the body. Chinese medicine also classifies diseases according to the different Yin and Yang meridians. Together with syndromes and disease names, there are approximately 4,000* different classifications which can be found in many classic medical texts such as Shang Han Lun (伤寒论) and Jin Gui Yao Lue (金匮要略). Chinese medicine believes that syndromes develop along with the progress of time and that an illness can be reversed with treatment. So a syndrome may develop into different diseases, and a disease can develop into multiple syndromes. This is why we call the Chinese medical classification as being 'non-specific' in methodology. Whereas Western medicine adopts a definitive evidence methodology in disease classifications. According to the latest information there are over 8,000* diseases now identified within Western medicine. This is a fundamental difference between the two medical systems that causes a great deal of confusion when diseases and syndromes are being discussed in clinical case studies during my teaching courses with Western medical doctors. Medical education in China also confronts this difference constantly. This will remain one of the fundamental problems in integrating Chinese medicine with Western medicine. And indeed the synergy of syndromes and diseases will be at the very heart of a new medical system that is capable of dealing with the medical complexity of our modern world.

Research in 'comparative medicine' between the Eastern and Western approaches is deepening our understanding of medicine, theoretically as well as in practical clinical terms. How can we evolve an integration that is meaningful and works organically as a result of synergy rather than a piecemeal ‘try one, if it doesn’t work try another’ approach. In the West, when people have a serious health problem they obviously try Western medicine, drugs or surgery before turning to complementary medicine or Chinese medicine. Unfortunately Chinese medicine is used as a last resort which denies it the opportunity to help the patient sooner. At such a late stage in a patient's illness, the essence of Chinese medicine is not being used to the maximum. The clever patients in China are being looked after by the physician in their sub-health state. In ancient times, the superior physicians - as described by the Yellow Emperor’s Classic of Internal Medicine - are those who were paid to look after the people in health. They were forced to work for nothing if they failed in their job. Only inferior doctors treated patients in ill health. If you are among those who belong to the categories of sub-health syndromes then you should immediately seek the help of a Chinese physician who has the wisdom to regulate your syndrome and put you back into a relatively healthy state.

The symptoms that are associated with the sub-health state are varied depending on individual syndromes. To give an indication on how to watch out for your own set of symptoms, I can only generalise some of the key patterns that are commonly seen. Liver syndromes tend to have a stagnating nature caused by energetic blockage as well as emotional trauma. The sufferer retains a lot of anger that explodes from time to time, or bottles up the emotions which are then expressed in outbursts and weeping. We call these people ‘liverish’. They may feel a fullness in the hypochondrium, may also suffer from eye problems, insomnia, or palpitations. This group of people may further develop digestive problems. They tend to have a red tongue with a taut and rapid pulse if they have heat within their syndrome. They might have a thin white coating on their tongue and a weak taut pulse if they have a tendency of developing stress, depression and digestive problems if the spleen is also affected. Premature ageing will begin if the syndrome is not being regulated by a physician who understands the intricacies of this complex condition.

In medical education we have Problem Based Learning (PBL), but in clinical medicine we are proposing Pattern Based Thinking (PBT) when we try to diagnose a patient according to syndromes. PBL looks at relationships in disorders. We have known the relationship between the functioning of the lungs and the skin as well as the musculoskeletal system; whenever there is a major external injury the patient will develop breathing problems. Chinese medicine observes that the skin and the lung has an external-internal relationship. The lung meridian is in a pair with the large intestine meridian. The lung is directly affected when external pathogens are invading the body such as heat, dryness, cold and wind which cause the lung to develop Yin deficiency. Coughing, phlegm (yellow phlegm is caused by heat invasion and clear phlegm is caused by cold invasion), asthmatic breathing and shortness of breath will be the resultant symptoms, and sometimes this leads to chronic bronchitis and fever. The person with Yin deficiency of the lung and stomach tends to have indigestion, IBS and normally has a red tongue with a weak and rapid pulse.

There are many groups of syndromes. We can go into further details when the physician is studying Chinese medicine with the aim of integrating this system of medical thinking with other systems of medicine. However in this E-Letter I will go into another group of syndromes which relates to kidneys and spleen, as this group is directly related to lifestyle and anti-ageing. The kidney is responsible for storing the 'inherited essence' derived from the parents, but at the same time it also needs to be replenished by the nourishment from our daily intake of food and liquid which the Chinese call ‘acquired essence’. The kidney is therefore the powerhouse that supplies the necessary Qi (energy) and essence for the functions of the whole body. The kidney is also responsible for the process of growth and sexual activities, the decline of which signify the ageing process. A premature decline of the kidney can be caused by bad lifestyle. The spleen is the organ responsible for transforming the food essence into a format that can be stored by the kidney. Hence ‘kidney Qi deficiency’ is directly related to the ‘spleen Qi deficiency’. Symptoms like back ache (such as osteoporosis), chronic fatigue, tinnitus, dizziness, impotence and women’s menstruation problems can all be caused by the deficiency of the kidney. This deficiency can be separately described as Yin or Yang, or both. Sometimes it also affects the liver and causes liver symptoms such as dryness in the eyes, irritability and involuntary muscle and tendon movements (tremors). When the heart is affected, the patients also develop insomnia. There are many types of tongue and pulse within Chinese medicine which are used to distinguish the subtleties of this complex web of syndromes.

You can now see the complicated and yet beautifully holistic patterns of identification, as used by Chinese medicine. They require years of intuitive clinical learning by the physician. You can see a comprehensive presentation of clinical patterns in Professor Deng Tie Tao’s book A Practical Diagnosis in Traditional Chinese Medicine (AM book no. BK2966) whose work is recognised as an authority in China. We are fortunate to have this selective translation in English. To maintain relative harmony within the person, including body, mind and emotion, a deep understanding of all the holistic relationships between different parts, functions and organs of the body and the internal and external causes of disease is fundamentally important. To maintain longevity or rejuvenate our vitality, Chinese medicine has a lot up its sleeve, accumulated in the past few thousand years. I can only give you an introduction to the wisdom of the Chinese physician, but with an unfortunate warning that many who are practicing in the West and indeed in the East are not up to scratch. So learn more yourself in order to discern a superior physician from a technical practitioner. Healing is different from repairing, a human being’s health cannot be fixed like a car or a computer.

 
Anti-ageing is always an interesting subject for all of us in the East and West. In my many years of research I have found that the Western approach of cell biology, the physiological, structural and cosmetic intervention to be limiting when compared to the fluidity of Chinese herbal medicine and its regulation of energy. The medical principle of promoting Jing (精) and Shen (神) in relation to promoting Qi and blood characterise Chinese medicine as a system that combines both the physical well-being as well as psycho-emotional well-being into its anti-ageing methodology. Chinese medicine recognises the relationship between the exterior appearance and interior health, and this is an important departure from the Western approach to anti-ageing. The unique relationship among Zang-Fu (脏腑) organs and their physiological link to Qi, blood and body fluid established by the meridian system as described by Chinese medicine, forms the basis of the principles for a clinical methodology in anti-ageing. Using herbal medicine, acupuncture and lifestyle medicine we can slow down the process of ageing. According to Chinese classical Materia Medica, Chinese herbs are classified in terms of nature, taste and meridian tropism besides the related pharmacological effects. Hot-natured herbs, for instance, are for warming cold syndromes whereas herbs of cold nature are for cooling hot syndromes. Their taste also affects different meridians; for example, bitter herbs affect the liver and sweet herbs affect the spleen. The principle of combining different herbs in a complex formulae is called Jun Shen Zuo Shi (君臣佐使) which is used by herbalists to tailor the herbal prescriptions for the individual patient with different syndromes. Chinese medicine is therefore a truly individualised medicine. Similarly, we select different acupuncture points on different meridians and combine them with specific disease points according to clinical experience in order to regulate the syndromes. Chinese syndrome acupuncture is therefore different from Western symptomatic medical acupuncture. When you see a Chinese physician, they will observe your tongue, pulse and vitality and will combine their analysis with your description of your current symptoms and your medical history. This process of analysis is called ‘Syndrome Differentiation’ (see Professor Deng’s book mentioned above). The logic of this process is based on the concepts of Yin and Yang synergy, balance and disharmony which belong to the methodology of thinking called ‘Dialectics’. This logical methodology is different from formal logic or mathematical logic of Western empirical sciences. The Chinese dialectical analysis is similar to the ‘Science of Logic’ proposed by Georg Wilhelm Friedrich Hegel and in many ways is expressed in philosophical terms similar to the scientific discoveries in Einstein’s Relativity Theory, the modern Standard Theory of physics as well as by Quantum Mechanics.

For the Chinese, the process of ageing is similar to the process of health and disease, and occurs at a micro energetic level because it is a change that is happening all the time within our body at sub-atomic particle levels. The causes of this change are both internal and external. The positive charge of protons, the negative charge of electrons and the neutral charge of neutrons at atomic level which make up the physical world are further influenced by their sub-atomic particles made of up-quarks and down-quarks. The quantum field at this minute space in which time becomes irrelevant is an inertia of enormous energy stabilised by a fine balance of positive and negative elements.

Chinese medicine philosophically infers that all things are changing and are created at this (atomic) level or beyond. This is summarised by the theory of Yin and Yang about the beginning of Dao (道) which came from ‘nothingness’ just like the Big Bang, which created our universe, came out of imbalances within a pre-Big Bang ‘void’ or ‘vacuum’. Western medicine - in its current Evidence Based mode - only investigates the human physiology at a cellular and molecular levels. The energies of particles are sensitive and yet stable but are subject to the momentum of the 'uncertainty principle' of quantum mechanics. Particles behave in a wave-like motion, which is in turn determined by a particle’s momentum and position. The wave nature of matter and the high speed movement of particles in motion, make our methods of measuring or quantifying matter accurately at a given time inaccurate. This ingenious discovery by a brilliant physicist Werner Heisenberg tells us that at a certain time we cannot be certain of the position of a particular particle, nor do we know the momentum of the forces involved in its creative possibilities. The quanta of energy of a particle with a certain frequency appear in wave functions which can be measured in zero value or non-zero value. The product of the uncertainties of the two quantities will always be relativistic or greater than the fundamental Planck’s Constant at quantum level. In lay person’s terms, the creative energies of matter are infinite, full of uncertainty and probabilities at the sub-atomic level of particles, quarks and bosons. The human body, as it ages in health or disease, is subject to these changes within the micro energetic levels of particles. This is what we know so far with new physics and perhaps we will progress to an even deeper level of understanding of the dynamics between the fundamental elements of matter in relation to the cosmos of universes. The dimension of consciousness as exhibited in the human mind or creatures of higher intelligence should also be considered as a part of the equation of existence besides physical matters. This brings us to the unimaginable complexity of advancing our knowledge of medicine in order to understand and cure diseases.

This may sound theological, but the possibility of instability at the quantum field level as described in the Planck’s Scale in which not only time is irrelevant but space is also illusional, is the very dynamic behind ‘universal change’ and the evolution of different forms of matter. Such changes also create new phenomena that affects our health and our ageing. Through the concept of Yin and Yang in the context of syndromes, Chinese medicine seeks to balance the macro patterns of the body in order to influence the micro energetics of the body at a particle level. Such a revelation is quite novel from an intellectual point of view. Obviously scientists will find this mystifying without further research and evidence. To get this, I am afraid we will have to wait for CERN - the Large Hadron Collider - to produce the evidence in experimental physics. Physics, unlike medicine, is now exploring the realm of science that is beyond the imagination of Evidence Based doctors. Perhaps it might give us some leads that will revolutionise medicine as we know it today.