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A Chinese Herbology Viewpoint of Protease Inhibitors for AIDS
Joseph Garner, Dipl. Ac., CH
(NCCA)
Editor:
I found Stephen Byrnes' letter
of reply to David Sanford's article on protease inhibitors interesting,
though a bit over the top. I agree with Dr. Byrnes that Mr.
Sanford's article sounded like an ad for PI's. However, this
does not warrant Dr. Byrnes' assertion that those who benefit
from PI's are most likely only doing so because of the placebo
effect. This is the same argument so often used against integrative
and alternative medicines by members of the medical establishment,
and it is just as demeaning and nonsensical when done by one
of "us" as by one of "them."
I agree wholeheartedly that
the monolithic pharmaceutical-based medical establishment tends
to follow the party line in lockstep regardless of common sense,
especially in the case of AIDS. I agree that the presentation
of protease inhibitors and other drugs as miracle cures or great
steps forward in the fight against AIDS is more than premature.
What needs to be understood by all concerned is the full mechanism
by which medicinals work.
The point of view of mainstream
medicine is non-holistic. Side effects are inevitable, because
medicines are aimed at pieces and parts of the body/mind/life
in question, not all of it, and the medicines are toxic to boot.
The principle of borrowing from Peter to pay Paul is an everyday
thing in the mainstream and is not questioned. Holistic medicine,
on the other hand, is supposed to work toward the betterment
of the whole person. When properly prescribed, medicinals are
not supposed to have side effects because their whole web of
effects is supposed to be understood in light of the whole pattern
of illness of the person being treated.
What this means is that the
energetic part of the equation must be addressed. This element
is lacking – totally missing in mainstream medicine and
often sorely lacking in so-called holistic medicine. Understanding
the energetics of medicinals, whether drugs, herbs, foods or
what-have-you, allows the medical system to understand who will
benefit and who will not. Currently, the pharmaceutical industry
is planning to use genetics to determine who will gain benefits
from what drugs and who will not. This is probably a step in
the right direction, but still the energetic piece ofthe puzzle
will be missing.
I practice one of the energetic
modalities – Chinese medicine. Ayurvedic, Tibetan and Galenic
medicine (and perhaps others) also treat according to energetic
models. In all these medicines, producing side effects means
the practitioner has missed part or all of the diagnosis. A
"typical" AIDS patient, if there is one, presents,
from a Chinese medicine point of view, with a combination of
Kidney Yin Deficiency leading to Deficiency Fire along with
Spleen (and perhaps Kidney) Qi or Yang Deficiency, Liver Depression
Qi Stagnation, Depressive Heat, Damp Heat Toxin, perhaps Ministerial
Fire and a plethora of variations on this theme. When properly
diagnosed according to our system of pattern diagnosis, proper
treatment principles lead us to a correct, customized herbal
formula and/or acupuncture and/or Qi Gong, etc. treatment. Patients
improve because we are hitting them where they live, not smacking
them glancing blows.
Natural medicines work best
when patients are not so far down the road of chronic illness.
Many of those who are moderately ill or less can be brought
to a state of health. Usually with natural medicines, those
who are terribly ill die. The power of modern medicines seems
to be the hope for most AIDS victims who are in the final stages.
But these medicinals need to be formulated with an eye toward
understanding their energetic effects, so that specific formulas
can be customized for specific patients or at least specific
types of the illness. Only then can side effects be avoided
or minimized and only then can the medical community understand
on whom to use what treatments.
Protease inhibitors work for
some and not others because of the energetic as well as chemical
effects of the drugs. By energetic effects I mean the effects
medicinals have on the subtle energies of the body, the body
as viewed as a series of energy vortices rather than merely
a chemical machine.
Medicinals in Chinese medicine
are typed according to temperature (also called nature), direction,
taste, channels entered into, category of strongest action,
indications and other elements. Temperature means the inherent
effect the medicinal has on the body after ingestion. Black
tea for example, whether drunk hot, cold or tepid, once ingested,
has the energetic effect of cooling the body. Direction means
whether the substance causes energy in the body to rise toward
the head or sink toward the feet, and also float towards the
body's surface or sink deeper toward the core. Taste means whether
sweet, sour, salty, bitter, pungent, bland or a combination.
Different tastes have different actions. In brief, sweet tonifies,
sour astringes, salty softens hardness, bitter clears heat,
pungent disperses and bland acts as diuretic. Medicinals enter
into one or more of the acupuncture channels (meridians) to
do their work. Substances are classified according to their
most prominent effect on the body, which differs somewhat according
to the classifier. Actions mean such things as dispersing the
surface, clearing heat, draining dampness and so on. Indications
mean specific patterns of illness treated with the medicinal.
Viral infections are seen as
a form of heat or fire in Chinese medicine, so antivirals are
known to be cold by nature, as are antibiotics. Vitamin C, goldenseal
and echinacea are also cold by nature. This is why vitamin C
irritates the stomach at high doses. Coldness leads to strong
fixed-location pain. Coldness in the stomach produces knotting
pain. Cold also interferes with the ability of the stomach to
maintain body temperature and thus digest properly. Protease
inhibitors appear to share this unfortunate side effect mechanism,
though with devastating effects compared to vitamin C's relatively
innocuous ones.
Nowhere have I read a formal
Chinese medicine explanation of the energetics of protease inhibitors,
so I will attempt a preliminary one of my own. Obviously PI's
are cold by nature, probably bitter in taste, probably descending,
enter the spleen, kidney, urinary bladder and perhaps liver,
heart and large intestine channels, clear heat and kill viruses.
Their intensely cold nature causes abdominal pain and interferes
greatly with the functioning of the Chinese concept of the spleen,
which is seen as the primary digestive organ. The spleen also
holds blood securely in the blood vessels. Interference with
this activity leads to the PI side effect of increased bleeding
in hemophiliacs and may be the mechanism interfering with the
effectiveness of birth control pills. The Chinese see blood
as the woman's contribution to pregnancy; birth control pills
inhibit the smooth flow of blood; and PI's cause blood to flow
recklessly outside normal channels, perhaps skirting the avenues
patrolled by the birth control pills.
Blood sugar levels become problematic
in many people on PI's. The pancreas’ functions are subsumed
under the Chinese idea of the spleen. Diabetes is generally
seen as a problem of the spleen and kidneys (and sometimes lungs)
in Chinese medicine. impairnent of the spleen is often responsible
for diarrhea, another side effect of PI's. Impairment of kidney
or liver function can also lead to diarrhea in Chinese medicine.
Fatigue is a PI side effect usually produced by spleen dysfunction,
also possibly kidney dysfunction. Severe or long-lasting headaches
may be produced by lack of blood rising to nourish the channels
and vessels of the head due to poor blood production by the
spleen (also the kidneys).
Spleen dysfunction almost always
produces dampness due to lack of transformation and transportation
of fluids. This normally percolates downwards to the kidneys
and/or bladder. In the kidneys, the Ming Men or gate of life,
the pilot light of the body, when swamped by dampness, continues
to burn, though lower, but its warming action turns the dampness
to damp heat. This not only produces damp heat bladder symptoms
such as frequent, urgent, painful or burning urination and pain
in the low back, the ministerial fire of the Ming Men may break
upwards and lead to heat symptoms in the upper body, usually
in the stomach channel, such as mouth ulcers (the stomach channel
traverses the gums), nausea or vomiting and numbness or tingling
around the mouth. This numbness may also apply to the hands
and toes. The toes are also traversed by the stomach channel
and the fingers by the stomach's companion large intestine channel.
Also, a weakened spleen cannot provide sufficient blood to fill
the blood vessels, leading to internal wind, which manifests
as numbness and tingling. Nausea and vomiting may also be due
simply to spleen weakness (with possible complicity from the
liver). All these are PI side effects.
PI's may cause rashes or dry,
itchy skin, even hives. This can be from internal wind and possibly
damp heat dispersing into the surface of the body. Intensely
cold medicinals taken regularly tend to cool the body's core,
driving heat to the surface, known as true cold, false heat.
All this can interfere with the body's external protective mechanisms,
which can lead to easy sunburning, another PI side effect. Taste
changes can manifest with PI's, and the spleen governs the ability
to taste by its function of opening into the mouth. PI's can
apparently also produce heart disease symptoms, though I do
not know specifics. Both spleen and kidney dysfunction can lead
to heart dysfunction, especially over the course of chronic
illness. In the case of AIDS patients, their deep-seated and
complicated patterns of illness predispose them to strong side
effects as their previously unbalanced energies are wrenched
further out of line by super-toxic medicinals.
Also, PI's interact poorly with
anti-convulsants such as phenytoin, carbamazepine and phenobarbitol.
From a Chinese medicine perspective, anti-convulsants calm internal
wind. Since PI's can produce internal wind (see above), it is
no wonder these two classes of drugs disturb each other's function.
Those AIDS victims whose spleens
are strongest and whose heat symptoms are most prominent should
benefit the most from PI's. Conversely, those whose spleens
are weakest (read "fatigued" here) will suffer the
most from side effects. These individuals will manifest patterns
of weakness or vacuity. Those with relatively strong spleens
will manifest patterns of excess due to a battle between a relatively
strong immune system and a virulent opponent. Weak spleens cannot
tolerate cold medicinals (or energetically cold foods) at all.
Just as we in Chinese medicine
have been able to determine the energetics of myriad herbs,
foods, vitamins, amino acids and a wide assortment of drugs,
including Valium, Prozac and many others, we can figure out
protease inhibitors as well as the reverse transcription inhibitors
and new AIDS drugs (these other drugs, though differently acting
chemically, no doubt have at least somewhat similar energetic
actions to PI's). And when we do figure them out in more depth,
we will know how to make use of them. Of course, people like
me won't be legally able to use them, and those who can probably
will not listen to advice from someone like me.
But at least we'll understand
the side effects and who can best tolerate the drugs. Maybe
someday East and West really will meet and patients will at
last be fully served.
Joseph Garner, Dipl. Ac., CH
(NCCA)
The Valley Clinic
10565 N. Tatum Blvd., Suite B-115
Paradise Valley, Arizona 85253 USA
602-381-0800
Fax 602-381-0054
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