ROUND TABLE DISCUSSIO SERIES 1.
0 Therefore resulting in a human who health,
(FIRST)
TITLE: TRADITIONAL AND
COMPLEMENTARY MEDICINE
PRACTICES
SPEAKER 1: 1) Mohd Adzhar Abd Latif
2) Nornizam Ngadeni
DATE: 6 APRIL 2017
VENUE: DEWAN AL-AMIR, LEVEL 8,
UNIVERSITI ISLAM MALAYSIA
PRESENTATION:
The first speaker, Mohd Adzhar Abd
Latif, Yang Dipertua of GAPERA started the
session with an overview of the GAPERA.
He stated that GAPERA is an organization
appointed by the Ministry of Health in
Traditional and Complementary Medicine
Division to represent modalities of traditional
Malay medicine practices in Malaysia. He
emphasized that traditional Malay medicine
is not a sort of cut and paste practices, but it
has fundamentally rooted since the period of
Prophet Adam A.S. Before the discussion
proceed, Dr. Mohd Hatta ask a doubt
involving the challenges faced by Traditional
Malay Medicine Practice. Mohd Adzhar Abd
Latif said there are few challenges faces by
the Traditional Malays Medicine Practice and
the first single is the arrangement of the
management structure of GAPERA and the
second challenges is among the practitioners,
they tested to compete among each other to
prove who is the best among them. The
elaboration of the topic further continued by
Tuan Nor Nizam Ngadeni. The philosophy
and principle of traditional Malay medicine is
to preserve one’s health from spiritual and
physical illness by means of balancing mind,
nafs and four elements of human body.
physical and personality (sahsiah) for the
purpose of worshipping Allah. The source of
references in traditional Malay medicine was
from Quran, sunnan sittah, tasawwuf,
manuscripts and Qanun fil al tib by
Avicenna.
Traditional Malay medicine is a
complete, unique and stand alone, which
covers spiritual, physical, social, economy,
personality (sahsiah), nature, life of this
world (Dunya) and the hereafter (aakhirah).
According to traditional Malay medicine the
human torso is constituted of four elements;
earth, fire, water and wind elements
alongside with the temperaments (message);
blistering, stale, dry and wet. An imbalance
of these elements in human body will
manifest disease as in line with the traditional
Chinese medicine principle of yin and yang.
Nevertheless, the soul (Ruh) is the biggest
face in traditional Malay medicine because
human consists of Ruh and physical body
(jasad). Thus, if only focused on treating the
jasad without giving attention to Ruh, it is
seen treating a stiff.
Traditional Malay medicine began
during 12th century based on the manuscript,
artifact findings and research by scholars.
Historically, the cognition of this traditional
medicine came from animistic beliefs
whereby the Malays believed in Ruh or
spirits residing in certain objects. Before the
arrival and spread of Islam in the 15th
century, the animistic practices were
assimilated with Hindu and Buddha rituals as
a component of traditional healing. The broad
spread of Islamification by the Arabs
merchants is said to cleanse the practices
from rituals that shirk and opposites to the
Islamic sharia. However, the practices such
as acupuncture, Ayurveda, homeopathy,
herbal therapy, chiropractic, ancient
Egyptian, Greek and Rome medicine and the
modern medical science knowledge were
among the value added that work up the
uniqueness of traditional Malay medicine.
Single of the assimilation of Islamic practices
with Malay traditional medicine can be
discovered from the use of camphor and
agarwood based on the Quran, The Man, 76:
5. Besides, agarwood have long been
employed by the Arabs and prophet
Muhammad S.A.W as perfumes and in the
suffism, it is employed to appease the spirit’s
disturbances. Whereas camphor is used to
handle asthma, sinusitis, appease the spirit’s
disturbances and as a perfume. Several
historical manuscripts were the grounds of
the existence of traditional Malay medicine,
which covers Ruh elements and one of the
manuscript is Bustanus as Salatin wrote by
Nuruddin ar-Raniri in 1636. This manuscript
describes in details the Malay Medicine
particularly human anatomy that causes an
element of Ruh and just in its discourse.
Tuan Nornizam shared that there was
an argument with Traditional and
Complementary Medicine Division as the
panels want GAPERA to exclude Ruh
elements in traditional Malay medicine.
Nevertheless, with an explanation the Ruh
element still can be integrated in traditional
Malay medicine and GAPERA was asked to
get a practitioner competency module. Tuan
Nornizam also addressed that at this time
traditional Malay medicine was underrated as
such, it was practiced at so called ‘low-class’
places eg. Night market, street walk and
villages. Attempts to prevent traditional
Malay medicine from being tainted with
shirk and khurafat elements is by making
usage of Malay definition in article 160 of the
Constitution of Malaysia. The article defines
“Malay” as” the person professes the faith of
Islam…….”. Therefore, any patterns that did
not comply to Islamic sharia is prohibited to
be classed as a traditional Malay medicine.
Also, the implementation of the recent Act
775 (Traditional and Complementary
Medicine Act 2016) exemplifies a significant
attempt to regulate the traditional and
complementary medicine services in
Malaysia and to provide for matters
connected therewith. He closed the first
session by stressing that the Malays should
understand the principle of traditional Malay
medicine, applying in daily life and the
practitioner should further does research to
produce scientific evidence.
Among the challenges faced by the
traditional Malay medicine practitioners
were because of traditional Malay medicine
itself is not structured and not well centered,
the practitioners are preferred to work alone
as they learned from different teachers and
competitiveness pertaining to the experiences
as well as commercial values. Tuan
Nornizam stated that any rituals that involved
animistic spirituals or jin are not considered
as traditional Malay medicine because it is
not obliged to Islamic sharia. Mohd Adzhar
Latif added that GAPERA also in the midst
of cleansing the traditional Malay medicine
modalities from any shirk and khurafat
rituals. At this moment, traditional Malay
medicine modalities are covers cupping,
Malay traditional massage, confinement care
and a bit of spirituality aspects.
ROUND TABLE DISCUSSIO SERIES 1.0
(FIRST)
TITLE: TRADITIONAL AND
COMPLEMENTARY MEDICINE
PRACTICES
SPEAKER 2: Mr. Anthony Wong Wei Bing
DATE: 6 APRIL 2017
VENUE: DEWAN AL-AMIR, LEVEL 8,
UNIVERSITI ISLAM MALAYSIA
PRESENTATION:
The second speaker, Mr. Anthony
Wong Wei Bing is a Programme Director
Chinese Medicine Division of International
Medical University (IMU). He also from
Federation of Chinese Physicians and
Medicine Dealers Associations of Malaysia
(FCPMDAM). The second session was
started with the introduction of Traditional
Chinese Medicine (TCM) origins. He stated
that TCM originated in ancient China, which
is a coherent and independent organization of
thought and practice that has been acquired
over thousands of years. Settled in the
philosophy, logic, sensibility, and habits of
Chinese culture. It views the human body as
an integrated whole. Inseparable from the rest
of nature, the body is defined as in opposition
to nature and yet unified with it. In this
system, maintaining human health is
considered achievable via a delicate balance
between two opposing, but inseparable,
principle elements called “Yin” and “Yang”.
These included by providing the necessary
health treatment, diet, lifestyle, emotional
condition and exercise maintain a healthy
state. TCM suggests that wellness can be
accomplished by maintaining Yin and Yang
in a balanced state in the human body and that
an internal imbalance between the two
elements is responsible for a state of disease.
TCM considers that “Qi” is the life
force or energy that influences health and
when it related to the human body, Qi was
used to explain different substances. Keeping
a balance between Yin and Yang is
considered to be the foundation for the
healthy flow of Qi. Thus, any disruption in
the Yin and Yang system would disrupt the
flow of Qi, thereby becoming the basis for a
state of disease or nuisance. In TCM, they
take the body as machine, where if there any
problem occurred, the only thing they can
manage is to mend it for example by surgery.
They also consider body as garden which
means everything in our physical structure is
related to one another. Because of that, when
one piece of the body having a problem, they
will await how it touches on its surrounding
connection to maintain it back to balance
state. TCM treatment is tailored to the person
and not necessarily the disease. TCM
encompasses many different exercises,
including acupuncture, moxibustion, Chinese
herbal medicine; Tuina (Chinese therapeutic
massage), dietetic therapy, and tai chi and Qi
gong to treat or prevent health problems.
TCM is practiced through the
treatment by differentiation of syndrome or
pattern recognition. Differentiation means a
comprehensive analysis, while syndromes
refer to symptoms and signs. Differentiation
of syndromes implies that the patient's
symptoms and signs collected by the four
diagnostic methods are examined and
summarized so as to identify the etiology,
nature and localization of a disease, and the
relation between vital Qi and pathogens,
thereby determining what syndrome the
disease belongs to. The other words, from the
symptoms experienced by patients, the
practitioner tries to categorize them into
different syndrome and then analyzes and
diagnose into the pattern. After that, the
treatment plan and principle will come out of
from the pattern for the patient. TCM treating
same diseases with different methods
because of different syndrome and can
treating different diseases with the same
methods of treatment principle thus
demonstrates the uniqueness of TCM.
Basic Theory of TCM consists of Yin
and Yang Theory, Five Elements Theory,
Visceral/Organ Manifestation Theory, Vital
Substance - Qi, Blood, Body Fluid, Essence
and Spirit, Meridian Theory, Etiology and
Pathogenesis, Pathological Mechanism and
Principles of Treatment and Prevention.
The concept of Yin-Yang is probably
the single most important and distinctive
theory of Chinese medicine. It is extremely
simple, yet very profound and represents
opposite but complementary qualities. It
poses two opposite forces as the underlying
cause of all changes. At the same time, it
emphasises the unity of these opposites. It is
the general terms for the opposing aspects of
objects or phenomena in nature. They may
represent two opposing objects or two
opposing aspects within a single object. In all
situations, they are interdependent. Yin does
not exist without Yang, nor does Yang exist
without Yin. In opposing each other, they
create unity. Five Elements indicates five
basic processes of Nature, a way of
describing the internal structure of a system,
and the process of change within a system
and between the system and its environment.
TCM Diagnostic Methods were elaborated as
the methods used to examine patients and
collect pathological data, mainly including
inspection, listening and olfaction, inquiry
and pulse-taking, known as the four
diagnostic methods. Inspection method
associated with analysis of patient’s mental
state, facial complexion, skin condition,
postures, sense organ, tongue and coating
condition. For the auscultation and olfaction,
it was related to listening and smelling
respectively. Interrogation (inquiry) was
regard to family history, chilliness and fever,
sweating, appetite, menstrual cycles, thirst
and drinking, frequency of urination and
bowels movement while palpation included
pulse taking, body palpation and meridian
palpation. The other TCM diagnostic
methods are eight principle pattern
identification diagnose (Yin and yang, cool
and hot, deficient and excessive condition,
exterior and interior condition), viscera
pattern identification diagnose, disease cause
pattern identification diagnose, Qi-blood
pattern identification diagnose, Jin-ye pattern
identification diagnose, six meridian pattern
identification diagnose, defensive qi, nutrient
and blood pattern identification diagnose and
meridian diagnose.
The practices of TCM involve
Chinese Materia Medica which use anything
possible from nature that later categorize into
its function. Chinese Materia Medica is a
general term referring to the herbal drugs,
animal drugs and mineral drugs, which
reflect the characteristics of Chinese history
and culture as well as the natural resources in
China. “ShenNong's Classic of Meteria
Medica”, is the first Chinese Pharmacopeia
can be dated back to Qin-Han dynasty period.
The classic has three volumes, which
recorded 365 types of medicine that in line
with the beliefs 1 day for 1 medicine in 1
year. Characteristics of Chinese
medicine/herb consist of: (a) the four natures
/ four properties (cold, cool, warm and hot);
(b) the five flavors (Sour, bitter, sweet,
pungent and salty); (c) the movement of the
medicine which are Lifting / Ascending,
Lowering / Descending, Floating and
Sinking; (d) the meridian tropism: refers to
the characteristic of the Chinese medicine
which will take effect to certain meridian and
the organ the meridian correspond to.
Chinese materia medica were processed prior
to use through the technique of altering the
nature properties of crude medicines by
processing using heat and combination with
various materials in a kind of alchemical
approach to preparation. Methods of
processing medicine involves discarding
impurity and use many of different ways to
removing or reducing the toxicity, drastic
properties and side effects of some Chinese
medicinal herbs and hence promoting
therapeutic effects. Taking away the
impurity, non-pharmaceutical parts and
unpleasant tastes thus making the medicinal
herbs clean and pure, and convenient for
patients to take.
Apart from herbs, Mr. Wong also
stated other famous treatment used in TCM.
They are acupuncture and Moxibustion.
Acupuncture is a system of treatment which
involves the insertion of fine sterilised
needles through the skin at specific points
known as acupoints, with the intention of
positively affecting a patient’s clinical
condition or health status, and is one of the
key components of TCM. Acupuncture
technique can be categorised into Filiform
needle, three-edged needle, plum blossom
needle, electro-acupuncture, scalp
acupuncture and ear/Auricular acupuncture.
Moxibustion is a method that treating &
preventing illness by using the heat from
burning moxa to stimulate the acupoints. The
functions including warming the meridians
and expelling cold, to circulate the flow of Qi
and blood and to reduce swelling and
disperse accumulated pathogens. Besides,
cupping also used in TCM similar to those in
traditional Malay medicine practice. Cupping
is applied to the skin to induce a local
congestion through the removal of air from
the cup. The functions are to warms and
improve Qi and blood circulation in the
meridians, to diminish swelling and pain and
to dispel cold and dampness. Application of
cupping can be divided into dry and wet
cupping. Tuina also used as a treatment in
TCM. Tuina is a form of hand manipulative
therapy where it is a hands-on body treatment
that uses Chinese Taoist and martial arts
principles in an effort to restore the Yin and
Yang balance in the body to archived health.
The other two more important things that
applied in TCM are Chinese dietary and
exercise therapy. They recommended their
patients to take the food that has the same
characteristic as medicine and suggest to
practice exercise that is not too strong, as so,
various kind of Qigong exercise is developed.
According to Mr. Anthony Wong,
sexual matters were considered taboos in
Chinese culture and traditional Chinese
medicine believes that too much sexual
activities were not good for kidney. He also
emphasised that besides natural food, the
emotional aspect is crucial to avoid stress
thus attaining healthy aging.
ROUND TABLE DISCUSSIO SERIES 1.0
(FIRST)
TITLE: TRADITIONAL AND
COMPLEMENTARY MEDICINE
PRACTICES
SPEAKER 3: Dato’ Dr. Suriyakhatun
Osman
DATE: 6 APRIL 2017
VENUE: DEWAN AL-AMIR, LEVEL 8,
UNIVERSITI ISLAM MALAYSIA
PRESENTATION:
The last speaker, Dato’ Dr.
Suriyakhatun Osman, Secretary of the
Malaysian Homeopathic Medical Council
started the presentation with an overview of
homeopathy in Malaysia. It was introduced
as early as 1912 by Indian British soldiers.
Persatuan Homeopati Malaya was
established in 1961 and it was the first
homeopathy association in Malaya at that
time. In 2001, the Malaysian Homeopathic
Medical Council was formed and followed in
2004, Traditional and Complementary
Division in Ministry of Health was
established. The homeopathy 4 years taught
course for degree was introduced in CUCMS
in 2010. In Malaysia, homeopathic remedies
prepared after 60 dilutions were not need to
be registered and was classified under GRAS
(Generally Recognized as safe).
Basically, homeopathy is a system of
medicine based on the principle of “like cures
like” (in Latin words it was called similia
similibus curentur) or in other word a
substance that causes the symptoms of a
disease in healthy people would cure similar
symptoms in sick people. This doctrine was
created by Hahnemann, a German physician
who wanted to avoid the toxic effect of crude
doses of drugs. Therefore homeopathy
involved high dilutions as remedies to
produce a response. The principle was first
described in the Hindu writings over 3000
years ago, mentioned by Hippocrates, Galen
and Paracelcus until Hahnemann gave
homeopathy its name and expanded its
principle. The basis of treatment in
homeopathy were; homeopathy works with
the body’s response to illness and remedies
are prescribed according to the symptoms,
one remedy can be used to treat several
ailments and one ailment may need to be
treated with different remedies in different
person. Homeopaths were used materia
medica as a reference such as to know
symptoms produced by poisonings,
symptoms produced by provings and
symptoms relieved when remedy given for
other symptoms.
Dr. Suriyakhatun also shared an
interesting proving on monkey cup which it
helps to reduce her fear of driving in Kuala
Lumpur and makes his son (who actually a
peaceful person) to express anger after he
took monkey cup. Other properties that she
find out was monkey cup caused menstrual
cycle of ten women lasting longer than usual;
so it will be useful for women to perform hajj,
enhances sexual performances and ease the
menopausal symptoms. However the
findings was not enough to be in materia
medica. According to her, the reason that
makes homeopathy being looked down by
the doctors is because of the bad quality of
homeopaths in Malaysia wherein less than
10% were received full training in
homeopathy and medical sciences and there
were only 606 homeopaths that registered
with Malaysia Homeopathic Medical
Council. Due to this issue, several steps are
to be taken by Malaysia Homeopathic
Medical Council such as registration,
regulation, training and evaluation of current
practitioners and not giving license to the
practitioners from unrecognized institutions.
Furthermore, among the challenges faced by
Malaysian Homeopathic Medical Council are
the doubts in the effectiveness of
homeopathy, being labelled as a
pseudoscience, lack of credibility of
practitioners such as using un-earned titles
eg. professor, dato’, tan sri, sir and being a
con-men by selling homeopathic
concoctions. Dr. Suriyakhatun emphasised
that if homeopathy did not even works then
how come it has been officially recognized in
several countries such as India, Pakistan,
Russia, Cuba, countries in South America
and national health insurance covers
homeopathic treatment in Switzerland.
Besides up to the end of 2014, there have
been 198 peer reviewed papers with usable
data that reported randomised controlled trial
in homeopathy. She concluded the session by
stated that homeopathy worldwide is here to
stay, more research is on the way, one day
how homeopathic works will be uncovered, it
is in the realm of quantum physics and it is
based on laws already present in nature but as
yet not properly understood.
The answers highlighted that the
homeopathic pseudo-doctors were usually
among the older generation. However, the
younger generation of homeopaths will be
thoroughly screened using training syllabus
to ensure they are qualified as per mandated
by Traditional and Complementary Medicine
Division, Ministry of Health. Dr.
Suriyakhatun brought forward an example of
South Africa as the excellent country in
homeopathy field area as homeopaths there
need to completed 7 years training course for
a qualification purpose.