JUST TO SHARE (Lau Tai Onn): Traditional Chinese Medicine in Malaysia

The blogger’s note: Dr. JB Lim has recently shared with his chat group friends his past experience in the practice of Traditional Chinese Medicine (TCM) in Malaysia and other subjects.

Date posted: 18/07/2021 @ 9:07 pm

I was tasked to learn TCM at the Traditional Chinese Medical Institute in 2, Jalan Hang Jebat in Kuala Lumpur in the 1987 when I served as one of the members in the very high-powered Joint WHO-MOH-IMR Expert Technical Committee.

I went there officially after MOH wrote them a letter explaining my presence and my purpose there. I was there for 6 months after work from 7 to 11 pm every night learning from them as I needed to write out a report on their training, acceptability by the public, efficacy, safety the clinical procedures they use.

The report was needed for discussions on the legal, administrative, logistics aspects and problems of admitting them into government hospitals years later.

I was the only Chinese member in that Committee. That was why they needed to send me there. Fortunately the TCM doctors there can speak English very well and we could converse with each other easily.

Suddenly I found myself extremely "popular and very acceptable" to them and to members of other associations including their Federation dealing with medicinal herbs because they knew I was going to be the only and the key person that was going to make a difference to their practice.

The official report I submitted was over 250 pages (as good as a PhD thesis) with another summary of 30 pages for the MOH policy makers and Expert Technical Committee to consider and decide whether or not to accept and recognize them.

Even after having a short stint learning from them, initially their theory and practice was alien to my medical and scientific background, I am still far from being qualified as a TCM doctor.

I served in that Committee till I retired in 1994 and some others took over.

It was meetings after meetings non stop almost every week as we needed to look at so many issues, such as their training, qualifications, safety, clinical efficacy, administrative and legal aspects, its acceptance by the people (surprisingly the clinic was extremely crowded mainly by Chinese but also by lots of Malays and Indians).

I like to go there every night due to the fragrance and aroma of herbal medicines emanating in the air in their entire clinic.

It was so unlike the odourless synthetic drugs in a hospital pharmacy. Nothing nice to smell in an allopathic hospital pharmacy.

It was only about 6 years after I retired, the government on recommendation by WHO officially based on my report recognized TCM on par with conventional medicine to be incorporated into the mainstream National Health Care System.

Initially they incorporated TCM and other complementary medical systems in just 3 government hospitals as an experimental pilot project, but now they are available in over 20 government hospitals where the public can go for TCM treatment for certain cases through referrals.

Following their recognition at least 6 private universities here have now started to offer a 4 or 5 years structured course in TCM leading to an Honours Bachelor's degree. It is okay. They are legitimately qualified as they too have to learn the basic medical sciences like anatomy, physiology, biochemistry, pathology, pharmacology and an additional pharmacognosy too in their first two years before their clinical years just like in conventional allopathic medicine except they take different therapeutic approaches in their clinical years.

When i had clinic sessions with them, they impressed me very much with the way they handled acupuncture so aspectically using gloves, face mask and disposal sterilised needles or personal needles that needed to be passed through a flame to sterile them first.

It was very surgical they handled it and it was completely anesthesia (no pain) despite so many needles being inserted at specific locations without any local anesthetic.

When i was in the Committee, WHO Consultant who sat there told us in China TCM is a 5 year university course where students needed to learn at least 30% of conventional allopathic medicine, and students in conventional medicine needed to learn at least 30% of Traditional Chinese Medicine for them to integrate into their health care system which WHO told us was the world best.

In the final examination in China both types of medical students must answer 30% of the questions taken from each of the allopathic and TCM systems, and when they work together side by side in hospitals they refer to each other which system is best for certain cases.

They exchanged clinical notes during their training and they understood each other’s technical language as they needed to learn 30% of each syllabus.

I think they are also following this approach in selected Malaysian government hospitals currently and I was told the government has sent a lot of our doctors to China for training for integration.

A few private hospitals in Malaysia are now also offering TCM after the official recognition of TCM and all the Western complementary and alternative systems of medicine to be practised in this country.

But all must be registered by their respective Medical Councils like MMC for allopathic medicine.

Now the TCM physicians even have their own Chinese Medical Association i.e. MCMA, just like MMA after their recognition by an Act of Parliament in 2000.

I am happy for them though it was many years of hard work for me sitting in that very difficult but the highest powered Expert Technical Committee from 1987 till1994.

I have lots of very invaluable experiences learning a lot of new knowledge, working both as a nutritionist and as a senior medical researcher in other fields in such a glamourous institute as the IMR from 1969 till 1994, exactly 25 years, and now also exactly 25 years after retirement.

Date posted: 18/07/2021 @ 10:51 pm

(In response to a friend’s question whether TCM can do open heart surgery)

Yes they do in China.

They even performed open heart surgery using acupuncture since US President Nixon’s time when he visited China in the 1960s.

They use acupuncture instead of GA and heart-lung perfusion machines on fully conscious patients together with conventional surgeons operating.

However, the open heart surgery has its limitations as the patient needed to cooporate as they are fully conscious during the entire surgery by breathing on their own without endotracheal intubation requiring oxygen and anaesthestic.

For that the patients need two weeks training prior to surgery.

But the advantage is completely no pain, fully awake and know what's going on and absolutely no adverse sides effects of drugs and post surgical anaesthesia.

Some years ago, I read in the Star or NST a few operations here in this country were done using acupuncture instead of GA with the help of TCM doctors from China.

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Date: 18/07/2021 @ 11.45pm

These days nobody refers conventional allopathic medicine as "western medicine" anymore because there are a lot of other alternative systems of medicines like homoeopathic medicine, naturopathic medicine, hypnotherapy and even western botanical medicines that are originated from the west and belong to the west because the Westerners themselves now are very disgruntled with their own "western medicine" and looking into the east like China instead.

Now we call normal hospital medicine as conventional or mainstream medicine.

All the other systems of medicine are either native or traditional medicine or western alternative medicine.

That was the term we used in our Technical Committee and is now also used by the government and MOH.

But now it is more suitable to use the term “complementary medicine” to mean they complement the deficiencies and weakness of each system rather than “alternative medicine” which is less used now because the word "alternative" means 'either this or that' , that would amount to accepting the weakness of either one.

So to complement each other’s strengths and weakness in health care is far better than single stand alone system.

Now in the west they have adopted an even better system by integrating the best therapeutic modality taken from each system and call it "integrative medicine".

I recently bought an awesome book on Integrative Medicine containing over 1,500 pages contributed by over 180 medical specialists and doctors around the world who have both MDs and PhDs combined in their qualifications to write forcefully.

It was an awesome book the way they described how medicine need to be integrated using the best of each system like in China where they combined TCM with drug based medicine.

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Date: 19/07 @12:01 am

Don't get me wrong.

Conventional medicine is still very good with emergency and critically ill patients that require intensive support with fast acting drugs and life support machines.

No other systems of medicine can beat that. I am with them and support them as I was involved in medical emergency myself.

But we fare very poorly with chronic conditions which is best managed by other medical systems that look at the whole picture more holistically as a person with a mind and soul and not some kind of biochemical machine that only needs to be treated by Big Pharma drugs to alter or divert the continuous chemical pathology.

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Date: 19/07/2021 @ 2:03am

I remember Dr Cavalli the Italian Psychiatrist who was sent from Italy as a Consultant to WHO, another WHO Consultant from Sweden and another WHO Regional Consultant from Manila sitting along with other Senior Directors from MOH in that Expert Technical Committee together with my boss and myself from IMR.

Dr Cavalli's office room was in IMR itself diagonally opposite mine but two rooms away. He was the person who encouraged me to do my PhD.

Directly opposite my room was our IMR clinic meant only for our IMR staff instead of them going to GH next door.

That was of course not the only technical committee I was privileged to sit in but was the most powerful one that was going to make that crucial decision whether or not to recognize TCM and other systems of medicine integrated into our mainstream health care system.

Years earlier besides research work which was more academic and scientific in nature, technical committees are far more powerful in that they are the decision and policy makers.

In the earlier years I also sat in other committees, one of which was I represented MOH in the SIRIM Technical Committees on standardization and quality control of food, biological and pharmaceutical products manufactured and imported by Malaysia.

I too served in the SIRIM Technical Committees on various products for about 10 or 12 years and I used to go to SIRIM HQ in Shah Alam every month, often bringing back samples to IMR for analysis and reporting back the results of the analysis to them at the next meeting a month later.

Those were the years I now fondly remember.

I made only part use of all my various types of university education in India, in the UK and at MIT.

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Date: 19/07/2021 @ 5:52 am

A few years past midway into the Expert Technical Committee, MOH and IMR held a two-day national conference on traditional medicine in one of the largest auditorium of the IMR.

It was completely packed with so many sitting on the steps on both sides and in the middle.

All were participants or observers representing the various systems of medicine in the country including specialist doctors representing the MMA, MMC and those from University Hospital, University of Malaya and some from the Faculty of Medicine, UKM and from KL General Hospital next door.

They all represented papers on their various systems of medicine.

I presented a paper on TCM on behalf of the Chinese Physicians Association of Malaysia as the conference was in English.

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Dr. JB Lim’s Economic Contribution in Clinical Research of Palm Oils

Date: 19/07/2021 @ 8:36 am

Another major contribution in medical research I was assigned by the Director of the IMR in the middle of doing my PhD was for me to lead a team of doctors and scientists mainly from the Haemotogical Division at IMR to carry out a clinical trial on the health benefits of our Malaysian Palm Oil against the very powerful lobbying by the American Soyabean Association against our palm oil.

We were losing hundreds of billions of Ringgits ever year in the sales of palm oil overseas against the extremely powerful American lobbying against our palm oil.

So i was assigned with a RM10 million project funded by the former Palm Oil Research Institute of Malaysia (PORIM) to tackle this massive problem.

It was a mountainous task for me against the very powerful Americans. It was a task much harder for me to tackle than doing my PhD.

It took us nearly 3 years to plan how to tackle this. I told my Director it was too difficult for me to fight against the powerful scientists in America.

So he assigned me initially with over 30 other specialist clinicians, scientists, pharmacologists among others from outside to assist me.

After countless technical meetings on the design of the study together with a bio-statistician that must be atom bomb proof, we then recruited in 2 dieticians from outside to join in.

Finally there were only 6 of us left after so much 'quarrelling' among the 30 researchers in the initial team because it was such a glamourous study against the Americans.

It was a very difficulty study filled with all sorts of technical problems, such as what happens if the student volunteers fell sick. Then we cannot treat them with drugs that may interfere with their blood chemistry. So we need to consult the pharmacologist which is the best way.

Finally my Director asked me should such an event arose I should use my training in natural medicine to treat them. So I needed to double up as a clinical researcher as well as a doctor in the clinical trail.

I have to carry a pager day in and day out in the event any of the volunteers fall sick. There was no mobile hand phones then, only pagers.

The study took us nearly a year to complete with lots of incentives given to the student volunteers.

Finally we made it by looking at the anti thrombogenicity of the blood and other haemotogical pathology that can cause heart disease that the Americans doctors claimed if they consume palm oil as a tropical oil.

The next step is to publish our findings. It has to be in a very influential medical journal and the paper has to be written in 'gold standard' for it to be accepted for publication. Every word we wrote in that paper must be atom bomb resistant.