Book Review Graphic Treating AIDS with Chinese Medicine
by Mary Kay Ryan and Arthur D. Shattuck

$29.95; Pacific View Press, 1994;
360+ pages
ISBN 0-915649-00-4.

Reviewed by Karin Hilsdale, Ph.D., L.Ac.


This excellent, comprehensive and ground-breaking book offers TCM practitioners a number of perspectives in dealing with the critical HIV/AIDS epidemic.

The foundational perspective is one of public health. The authors base their findings on over seven years' experience in developing and operating HIV/AIDS clinics in the Chicago area, utilizing TCM modalities in consultation with researchers and clinicians elsewhere. They have shared candidly the complexities of these public health ventures as a guid to others, including useful information in an appendix on financial, legal and practical issues that need to be coinsidered.

However, the core information that will bring most practitioners back to this book again and again is the thorough consideration of symptoms according to TCM differentiation of syndromes, with point and herb prescriptions in most cases. Although these comprehensive listings are certainly no substitute for the face-to-face classroom trainings in HIV/AIDS for TCM practitioners that have been developed in recent years (such as the English-language instruction at Quan Yin Center for the Healing Arts in San Francisco and the Chinese language classes through the Oriental Healing Arts Institute, "OHAI," in Southern California), they can serve as a basis for comparing one's own reading of clinical indicators against the sum of the authors' extensive clinical experience. They are clear about the problems of being able to know with certainty which processes observed clinically may be related to disease and which may be due to drug side effects. They skillfully present TCM modalities as complementary to Western treatment.

In addition to being clinically useful, the book offers much to readers of a theoretical bent. At the outset, the authors review basic TCM concepts, including useful comparisons with Western medical models. They then go on to present their own TCM model of AIDS. While recognizing others' thinking in this regard (that of Misha Cohen and the OHAI publications emphasizing deficiencies, and of Bob Flaws' characterization of the disease as warm, of the hidden qi variety leading to damp heat toxins), they end up moving away from Shang Han Lun (six stages) thinking to a position closer to the Wen Bing heat induced disorders school of thought.

They summarize,

    "Our own view based on our observations leads us to believe that AIDS begins as a low-level Yin and Blood Deficiency, with the invasion beginning deeply at the level of the Kidney and working its way out, undermining systems above it as it progressed."

The lack of pertinent commentary on the issue of latency within the cold disease model is important to them:

    "Although AIDS may look somewhat Cold at late stages, it is initially a situation of increasing low-level Heat. Even later, when Cold symptoms may occur, they do so mixed with Heat symptoms... (It) is a contagious disease which displays deep symptomatology at its outset, has a Warm rather than Cold nature, and has a latency period of variable duration during which importanl clinical events are taking place."

Moreover, they emphasize the pervasive clinical issues of dryness which they have observed, in contrast to Flaws' consideration of damp heat.

The book is attractively designed and user-friendly. The authors provide descriptions of symptoms common to almost all AIDS patients, those which develop as the disease progresses, those which occur in some patients but not in others, and correspondences to TCM nomenclature.

They discuss working with different types of asymptomatic HIV+ patients as well as the clinically difficult progressed cases of AIDS, never failing to honor the needs of the whole patient in terms of emotional and cognitive reactions. Useful charts compare contents of commonly prescribed patent herbal formulas, such as Composition A, Enhance and Resist. An appendix rates efficacy of treatment in a long list of syndromes such as anxiety, thrush, and wasting syndrome. An index guides practitioners to specific diseases, disorders, herbs, symptoms and treatments.

One chapter addressed issues of "special populations," given that the authors' primary experience has been with gay male patients. The information on treating female patients and intravenous drug users may be familiar to those of us active in this treatment area; however, the material addressing the specialized problems involved in treating hemophiliacs with herbs and acupuncture will likely be novel to most readers.

Ryan and Shattuck conclude with a chapter on specific recommendations from TCM nutrition for a full variety of commonly-experienced conditions in HIV/AIDS, and another on non-TCM complementary therapies such as nutritional supplements and Western herbs. Their advice to guide patients through the confusing maze of claims and lifestyle demands with caution and simplicity seems correct --that patients should be encouraged to seek qualified practitioners in nutrition, Western herbs or homeopathics, and "limit the scope of their remedies, both for ease of management and to prevent life from being reduced to medicine."

This flavor of seeing the person behind the disease -- of concern about the imbalance that patients can develop in the pursuit of healing, of understanding the financial disasters involved in these illnesses - permeates the narrative sections of the book. "Success" of treatment is clearly measured in qualitative terms for patients' lives, as well as in hoped-for increases in longevity.

Ryan and Shattuck conclude with the challenge for our profession to be able to move our research and clinical efforts into the public health arenas where treatment and education are so desperately needed. "Successful" TCM treatment of these illnesses in either private office or public clinic, given the lack of substantive progress in Western medical research for "the cure," can only enhance our profession in these difficult times.


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