A big thank you to all participants of our Introduction to Traditional Chinese Medicine Theory (Fundamentals) webinar on 23 July 2022, Saturday! During the session, the fundamentals of TCM Theory was shared and there was an overwhelming response during the Q&A session; fret not as Physician Niklas from ZhongJing TCM has answered them below!
Thank you to Physician Niklas as well for the time in going through and providing the answers.
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U Live Team :)
Q&A with Physician Niklas
What are physicians looking for when they check the tongue?
By looking at the tongue, TCM physicians can infer the condition of the body, and together with the symptoms presented by the patient and history taking through asking, along with pulse taking, we can then make a diagnosis of the disease/body condition.
e.g., for heat, the tongue is red, while for cold the tongue is pale, or pale red.
If there is dampness, the coating on the tongue would be thick and white, and if there is heat, the coating would also appear yellow.
This is also the reason why physicians may suggest not cleaning the tongue before a consultation if the patient has a habit to do so in the morning.
How does acupuncture help the body?
Qi and blood flows in the body through pathways called meridians, and on these meridians are acupoints, where concentrations of Qi and blood are believed to congregate as focal points.
Through the use of acupuncture needles, or through acupressure techniques, the practitioner can then attempt to regulate and smoothen the flow of Qi and blood, or stimulate certain acupoints believed to help with certain functions (e.g. ST36 Zu San Li to regulate stomach function).
What are the possible causes for swollen feet if the blood test indicates no issues with the kidney?
Swollen feet may be due to poor blood circulation, or poor organ function resulting in a retention of water and dampness in the body, presenting as swollen feet.
It may be good to see a doctor for a follow-up, and highlight this situation to him/her.
TCM medicine in the form of powder – how different is it from the original form? Any processed?
TCM herbs are raw and unprocessed, so the bioavailability of active compounds is at the highest. Some TCM physicians would recommend this for certain conditions in order to increase the efficacy of the treatment. However, there is some hassle to decoct the herbs and prepare (soak for 30 mins, boil for 20 mins, pour out the first decoction and put aside, boil once more for 20-30 mins, pour out the second decoction and mix with the first before separating into 2-3 servings to be consumed per day).
In the powder form, different manufacturers would use different methods to decoct the herbs for processing into the powder, the most common is aqueous extract which is boiling and then condensing the decoction before turning it into a powder. In order to stabilise the powder, additives may be used such as starch to prevent it from coagulating.
For the over-the-counter TCM cough medicines, there are Heaty/Cold types. How do you identify the type of cough one is having?
Heaty cough: coughing with yellow phlegm, phlegm can be sticky, sometimes with sore throat, loud, usually aggravated with hot or spicy foods.
Cold cough: coughing with white phlegm, phlegm can be thin or fluid, or even scanty, throat is usually uncomfortable or itchy (note: not pain), coughing can be with wheezing or breathlessness, usually aggravated when exposed to wind or cold, and cold, fresh foods.
What is 支气管敏感 and how to deal with it?
支气管敏感 would be roughly translated into a hypersensitive bronchus.
In TCM, this is regarded as a lung deficiency condition, meaning that the lung is weak. You can rectify this through the use of medicine in order to minimise the relapse of symptoms, but you would still need to start to strengthen the lungs through moderate cardiovascular training.
If my skin always feels itchy, is it most likely due to wind? What simple remedies can help to ease the symptom?
Yes, if skin is itchy, it is most likely due to wind, although heat can also cause this issue.
It would be better to see a TCM physician regarding this as addressing itchy skin can be quite complicated due to age.
Also, if you do observe any lesions on the affected area, it would be recommended to have a consult with a Western doctor first before TCM treatment, in order to rule out any possible contagious skin conditions (e.g. ringworm, chicken pox etc.).
What are the recommended food and activities to help
strengthen our spleen?
One of the easily available foods that can be used to
strengthen the spleen would be Chinese Yam, which can be cooked into a soup
with red dates and some cuts of meat.
In TCM, the spleen is associated with the muscles of the
body, so theoretically, training the muscles and building it up can strengthen
(However, physical training or strength/resistance training
can be quite a touchy issue. Hehehe… For the ladies, don’t worry you can’t get
too bulky due to your genetics and hormones. Only guys can get bulky due to the
Personally, that was how I had addressed my digestive issues. I realised that my digestive issues went away as I slowly put on muscle mass due to my judo and weights training (56kg to 69kg).
What can be diagnosed when a TCM physician takes/checks the pulse?
For me, I would use the pulse in conjunction with the symptoms presented and history taking, in order to make a diagnosis.
However I do know of some senior physicians in Singapore and in China that can gues the condition based on just the pulse.
How does one become a certified TCM practitioner?
You have to complete formal education in TCM studies, and
pass the registration exam.
Singapore College of TCM offers this to the public (Full time studies 5 years, part time studies 7 years), while NTU offers this in conjunction with Beijing University of Chinese Medicine as a 5-year programme, entering from polytechnic or A levels.
After you complete the programme, you then have to sit and pass the Singapore TCM Registration Exam (STRE), which happens once a year. If you fail, you then have to retry next year, at the point of failure (e.g. if you fail at the last paper, then you retake at the last paper the next year). You can only attempt the Exam four times.
Is it better to use fan or aircon?
It is definitely better to use the fan than the aircon.
In Singapore, because the weather is already so warm, we are also tending towards taking cold drinks or foods in a bid to cool off. Also, our indoors is also airconditioned, sometimes to alarming temperatures.
So, if we are constantly in a cold environment, and taking cold foods, our bodies would be in a Cold state (Yin-Cold state, or Yang Deficiency state), which can then manifest as symptoms.
However, I too use the aircon, so in order to address this, I make sure I try to take warm drinks as much as possible, dress adequately in cooler areas (e.g. sleeves and long trousers). I would also turn on the aircon in the evening and just turn it off before I go to bed.
How do I treat frozen shoulder with TCM?
Frozen shoulder is due to the muscles and ligaments stiffening, usually due to a history of injury, or chronic overuse of the upper limbs.
After makan, I still feel hungry and gas in stomach. Is this due to an issue with my zang organs?
Yes, this is due to Zang organ, usually due to poor spleen function. That’s why your body is unable to register the amount of food (feeling of hunger), and does not digest well (gas in stomach).
How true is it that massage can clear toxic or wind/guasha can help to clear heat from the body?
Massage can help promote Qi and blood circulation, and can also help drain some level of edema. In a sense, this is a form of clearing “toxin” by increasing the circulation so that the organs can do their job.
Guasha is a common treatment modality used to cause some bruising just beneath the skin, which would result in the trademark appearance of the skin.
How to relieve constipation through TCM?
There are many causes for constipation, so it is not easy to advise on this. It can be due to the body being too heaty, or too cold, or it is weak. It may be better to approach your TCM physician so that they may ascertain your body constitution and address the situation
How would TCM diagnose kidney problems? Western medicine uses GFR.
Like I mentioned in my talk, it is not right to use TCM theories onto Western medical theories.
The way how TCM diagnoses kidney issues is very much different from that of Western. TCM goes by symptoms, while Western would use symptoms with lab test results.
What does ba guan do in TCM treatment?
Ba Guan causes bruising (subdermal bleeding), like in Gua Sha.
What are the TCM treatments for eczema?
It is not easy to discuss treatment for eczema, as it is a very complicated issue. Eczema is due to an extremely hyperactive immune system, that is responding to allergens.
In my opinion, eczema can be managed, but not treated. TCM can manage the symptoms and we can minimise the use of steroids and other medicines.
In our hot weather we tend to drink cold/ice water, is this harmful to the body?
Yes, it is harmful. Refer to Question 11 please!
Too much cold/iced water will harm the Yang in the body, starting with the spleen and stomach. If our spleen and stomach is harmed, our digestion is the first to be affected. This would then cause our nutrient absorption to be affected.
Furthermore, TCM theories would suggest that the body is like a small furnace, always requiring a small fire inside to warm the body. If this fire is doused, then our physiological processes would be affected in the long run.
(Note that this may not be able to be determined via Western investigative procedures).
How about green phlegm?
Green phlegm is a sign of intense heat in the body.
It can also be due to food colouring, so do consider if you had any green food stuff before coughing out the phlegm!
Any difference in pill form or powder form?
Pills are basically compressed powder, with a layer to form the “shell” of it (similar for capsules)
They are essentially the same, and it is easier to consume than dissolving powder (no need to taste funky tasting stuff!)
How to improve nutrition absorption from the food we eat?
You can refer to Question 8 as well. From TCM theories, to improve absorption we need to strengthen the spleen and stomach.
Also, the usual commonplace advice applies, such as chewing more, eating smaller meals (70% full), but at more regular intervals. Also take note to have a balanced meal.
How to cure acid reflux?
Acid reflux can be due to many factors, such as heat in the stomach, or the stomach being cold, among others. It may be best to check in with a TCM physician in order to regulate the body.
For starters, do have your meals more regularly, and ensure that you have enough carbohydrates as well. If you are not able to have food on time, it would be advisable to keep some biscuits, or hot malt drinks on standby in order to tide through.
Are there natural TCM cures/remedies for gastric? (heard gastric is virtually incurable…)
This would be similar to Question 23. You may also refer to Question 8.
Gastric pain is a spasm of the stomach due to being too empty for too long. This is a sign of the spleen being harmed, that’s why it is showing up as pain.
Clinical Interests: TCM Internal Medicine (Respiratory diseases, sleep disorders, sub-health), TCM Tuina, Pain management
Physician Niklas has been a registered TCM Practitioner in Singapore since 2016. He has obtained his Double Degree in Biomedical Science and Traditional Chinese Medicine at NTU and BUCM in the same year.
Physician Niklas’s journey into TCM started when he joined his school’s Judo club. With the physical demands of the sport, he often turned to acupuncture sessions and TCM Tuina in order to continue his training. Tapping on his personal experiences in sports injuries, Physician Niklas understands the importance of proper management of injuries.
As such, Physician’s Niklas clinical interests lie in pain management, via acupuncture and TCM Tuina. Other interests include internal conditions, such as common respiratory diseases and sleep disorders. He also aims to advocate “Self-preservation and self-assistance, with perseverance”, combining good physical and mental health, that comes with determination.
Physician Niklas is also a lecturer with the Singapore College of Chinese Medicine (SCTCM).
About ZhongJing TCM
Zhongjing Traditional Chinese Medicine (Zhongjing TCM) was established in 2014 under the name of TCM Homecare and Nanyang Zhongjing Institution. A decision was made to rebrand and combine the strengths of both services. Therefore, in 2019, TCM Homecare was renamed Zhongjing TCM. The rebranding aims to collectively provide services of medical services and institution under the umbrella of Zhongjing TCM.
Zhongjing TCM prides itself in sharing TCM knowledge through lifelong learning with their very own Zhongjing TCM Institution. Zhongjing TCM is also committed to catering to individual needs encompassing personalized TCM modalities and herbs. Their state-of-the-art equipment, quality of herbs and products undergo the strictest quality checks so that you can enjoy with a piece of mind.
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