PR1301 Tutorial 1

1. Generally, encouraged to go to Western doctor, before resorting to CAM. Why should we not
place CAM as our first priority?
- This is only general advice for the public. We still must make sure standard therapy is taken
into consideration, e.g. usual lifestyle modifications, dietary modifications, exercise, rest,
sleep, relaxation and food.
- There are exceptions, depending on the severity of the condition, traditional usage (has
been used for long, and is best form of treatment), individuals patients body, etc where
CAM is okay with being prioritised first. As long as the delay in trying CAM first does not
affect the outcome, it is okay to approach CAM first.
- CAM mostly used for minor conditions first, e.g. sore throat use andrographis. Conditions
where you can treat yourself
- But in the case of cancer, should well ahead go approach a Western doctor and not delay
the treatment process with CAM. In cases, where the delay will worsen the condition
- Not many CAM therapies are approved and considered safe. With exceptions of taichi

2. How to consume Panax ginseng?

- Panax ginseng can be cut into slices, steeped in hot water like tea, or boiled/double boiled
(become more concentrated) or the slices or roots can be boiled in soup. Also used in
combination with other herbs
- Panax ginseng very heaty

3. Tolerance to hawthorn (as a sedative) and thus reduce its cardiotonic effect?
- No reports on this result, tolerance to hawthorn is not known. Unlike other western
medicines
- Easier to develop tolerance to Western medicine than herbal medicine, but this is only in
general and for specific drugs

4. Many herbs have anti-cancer properties, e.g. fermented black garlic, neem, ginger, eurycoma,
ginseng etc. Which is the best for anti-cancer?
- None. They are not the usual anti-cancer herbs, even when they have demonstrated anti-
cancer effects. Not yet tested in clinical trials (tested in humans), not tested in laboratory
- Also depends on the type of cancer cells, the type of cancer. Some anti-cancer herbs can
cause other kinds of cancer to grow as well
- Well known anticancer herbs are Pacific yew and periwinkle -> tested on cancer cells, where
they inhibited the growth of cancer cells.
- How to know which herbal medicine is best for a certain property/disease and choose it
over other herbs? You can refer to official recommendations, traditional uses, scientific
studies, and clinical trials if available
Even though have anti-cancer effects, not well known for treating cancer!!
Check if the herb has any clinical trials/scientific studies
Saba snake grass: anti-cancer properties

5. Why cant we use ginseng for everything?

- Indeed an adaptogen, hence making it look suitable for everything
- But it is also considered heaty, and should be used appropriately, especially during an active
phase of disease. Want to make sure body is using its only ability to fight the disease, rather
than over stimulate the immune system, complicating things. In this case, P.ginseng may not
be recommended
- e.g. Echinacea. Do not overstimulate body, take a drug holiday!!
6. Meadowsweet; used as an antacid in the treatment of acid indigestion in the stomach. Is
stomach bleeding due to acid indigestion?
- No. Stomach bleeding is not due to acid indigestion. But it can be due to an ulcer.
- Acid indigestion is due to impaired ingestions, discomfort in the digestive trait, where acid
produced to digest food may sometimes cause discomfort

7. What is the difference between antioxidant and immune-stimulatory effects?

- Antioxidant: molecule that inhibits the oxidation of other molecules.
- Oxidation is a chemical reaction in our body required for bodily functions, but can also form
free radicals which can attack the healthy cells of the body, leading to damage, disease and
severe disorders
- Antioxidant effects oppose the effects of oxidation, and hence protect the cells from harmful
effects of free radicals
- Immunostimulatory: stimulates the immune system

8. Ephedrine
- CNS stimulant, make heart pump faster and blood pressure go up. Vasoconstrictor
- Uses:
o Acute bronchospasm (it relaxes bronchial smooth muscles)
o Nasal congestion (constrict blood vessels in nasal passage, reduces drainage of fluid
from blood vessels to nasal passage = reduces runny nose!!)
o Reversal of spinal or epidural anaesthesia-induced hypotension (CNS stimulant),
used as an injection. A painkilling procedure for childbirth. Increase blood pressure
during child birth as blood pressure will decrease

Effects of herbs more of geared towards TCM uses and not Western uses

Scope: Dr Lin (everything before recess week), Dr Koh (up to and including integrative medicine)
Closed book, MCQ, short questions in less than an hour
12 Oct 2017, Thursday, MD1, Tahir Foundation Building, Level 5, Analysis Teaching Lab (MD1-05-
01A)