Challenge for Modern Medicine: Incurable Diseases and Ancient Chinese Medicine

1. Challenge for Modern Medicine: Incurable Diseases and Ancient Chinese Medicine Edward S Yang University of Hong Kong Columbia University 2018

2. Drugs for common coldPower of science & side effects • B.B.P. capsule: stop running nose, a toxicant; nausea,drowsiness, constrict blood vessels in the body • Ambroxol: dissolve mucus and relax coughing; breaks up phlegm in diseases.Nausea, vomiting, diarrhea, gastrointestinal side effects, skin rash and itching • Lysozyme: Fleming discovered anti-bacteria enzyme: lysozyme (1923) and penicillin (1928) (first natural antibiotic drug in 1940) that won him the Nobel prize in 1945. Lysozyme was not synthesized until 2007. • Cetirizine: forsneezing, itchy, runny and blocked nose, red and watery eyes; drowsiness, excessive tiredness, dry mouth, stomach pain, diarrhea, vomiting • Dexitromethorphan (optional): cough suppressant, signals in the brain that trigger cough reflex, a drug of morphine class with sedative properties:nausea. drowsiness, diarrhea/constipation • Paracetamol (optional): relieve pain and fever;nausea, stomach pain, and loss of appetite, jaundice • HK Life Expectancy: M/F 67.8/75.3 (1971) and 81.7/87.7 (2017)

3. Contents • Common incurable diseases • Western & Chinese medicine • Acoustic shear wave (ASW) induced Ca2+ waves in cultured cells/mice • Measure Qi (ASW) via vibrating needle • ALS: Herbal medicinefor patients/mice • Program for incurable diseases • Conclusion/future plans

4. Common Incurable DiseasesThe rubber meets the road • Amyotrophic Lateral Sclerosis: 0.22M (2015) • Cirrhosis: 2.8M, 1.3M death (2015) • Lupus: 5M (2018) • Parkinson’s: 6.2M (2015) • Schizophrenia: 23.6M (2013) • Alzheimer’s: 29.8M (2015) • Cancers: 90M (2015) HK$ 5M/patient/yr • Lymph-edema: 200M (2017) • Depression: 300M (2018) • Ageing: 7.6B (2018)

5. Western Medicine • Surgery, antibiotics, chemical drugs revolutionized medicine • Genetic/molecular promise of cures • Annihilation tactic & surgery • High toxicity, side effects, high costs • Mutation, adaptation and migration • Clinical statistics as gold standard

6. Chinese Medicine • Unschuld: Huang DiNei Jing medicine Is New Medicine –Laws of Nature • It includes Shang Han Lun • 2,000 yrs of human clinical trials • Low cost, low toxicity, less side-effects with self-repair, homeostasis • Better for chronic diseases & pains • No sciencefor Qi, Meridian • Shang Han Lunupdating • Complementary between West and Chinese

7. Qi in Huang Di Nei JingUnschuld translations (2011, 2016) • “Qi is from inhale and exhale” respiration • “Qi changes internally to move and emerge” motions in diverse forms • “Qi is believed to exist in all possible aggregate states, from air, vapour, liquid and solid matter” • Hypothesis:Qi is an acoustic shear wave packet, the wave itself and all materials it carries including O2- gas, lymphatic fluid and Ca2+in solid state

8. Confocal Fluorescence MicroscopyCultured endothelial and fibroblast cells8 runs x 3 points statistics

9. Ca2+ oscillation and memory

10. 140 120 100 110 sec 70 sec 160 sec 130 sec 150 sec 80 sec 110 130 60 50 90 70 Latency (s) Peak (DF/F0) 80 230 220 210 200 190 180 170 160 150 140 130 120 110 100 90 80 70 60 50 47.52 1.55 1.50 1.45 1.4 1.35 1.3 1.25 1.20 1.15 1.10 1.05 1.00 100 sec 120 sec 50 sec 60 sec 90 sec 140 sec 150 160 10 .

11. Qi - In Vivo monitoring of Ca2+ Single-photon laser fluorescence Needle at ST36 left-leg, image 1cm below

12. Single- and two-photon fluorescence microscopy 12

13. Two-photon fluorescence showing Ca2+ migration in mouse in vivo (Qi) under acupuncture driven by a 400 Hz piezoelecric driver 13

14. In vivo time dependent Ca2+ waves (Qi) and migration in mouse muscle fibers (meridians<100 microns) - #006 on the initiation of calcium wave and its formation 14

15. Acupuncture in Human Qi and meridians have never been measured • We observe all body needles vibrate • Convert time to frequency spectrum via FFT • Define ASW wave packet asQi • Qi includes ASW wave packet, Ca2+ ,fluid, gas and other materials • Muscle fibers waveguide asMeridian

16. Confluence of Longitudinal (Jing) and Collateral (Luo) Meridians with Acu-points

17. Electric driver needles at acu-point 2/3 (neck & back)

18. Frequency spectrum of driving signal at acu-point 2/3

19. Resonance of distant (~50cm) needlesat acu- (4) and sham(4a) points respectively (elbow)

20. Resonance of distant (~80cm) needle at acu point 5 on hand

21. 10 Hz Resonance at needle 4/4a (left elbow) and 5 (hand)

22. Spectra comparison • Electricity Group • Control Group 0.2 0.2 0.8

23. Statistical test • We form the 2-by-2 contingency table as: • Null hypothesis: the positive rate in the “electricity group” is the same as the “control group”, which means there is no non-random association between frequencies detected and electrical acupuncture. • Alternative hypothesis: the positive rate in the “electricity group” is higher than that of the “control group”. • By using one-tail “Fisher’s exact test”, we calculate the p-value from the contingency table: p-value = 0.0035 • Null hypothesis is rejected using 1% significant level. 23

24. Future Plan I • Clinical resonance amplification • Frequency tuning in electro-acupuncture • Clinical Foot GB, ST and Hand LI meridians • MRE Meridian mapping • Array drivers to enhance efficacy

25. Amyotrophic Lateral Sclerosis (ALS)most challenging for Herbal Medicine • FDA approved drug Riluzole: 3-mos life extension but no healing • Life expectancy: 6 - 30 months • Stephen Hawking rare exception • Few patients, simple trial, unambiguous • 5-10% genetic (SOD1), 90-95% sporadic. Doubts in animal model

26. Shang Han Lun & Liu Shao-wuHerbal formulas update and revision • Zhang Zhong-Jing (250 AD): 1stprescriptive herbal medicine, 112 recipes • Liu Shaowu (1907-2004): tested 112 formulas with 70,000 patients in 1972-74. • Extra 29 formulas for neural, heart, liver, lung colon, muscle, lymphatic, mental diseases. • 協調整體 and 突出局部 for effective therapy (Orthodox TCM): defensive vs. offensive • Grandson Dr. Liu led ALS team since 1988. • Former student Dr. Li is a current leader

27. Jiefuling Recipe

28. Herbal Medicine: Amyotrophic Lateral Sclerosis (ALS) Statistics

29. 88 ALS Patients with Limb-Onsettreated with Jifuling and Anshen Tang

30. 121 ALS Patients with Bulbar Onsettreated with Jifuling and Yuanqi Tang

31. 19 ALS Patients taken Riluzolebefore receiving Jifuling treatment

32. 14 ALS Patients taken Riluzole with Jifuling concurrently

33. Results - Survival

34. Results -Weight

35. Conclusion - ALS ALS patients: effective with Jiefuling, better with Riluzole Mice trial SOD1: some help in weight, no gain in survival rate (UMass Med/Harvard MGH March/June 2018). Low toxicity verified Option 1: Herbal Human Trial for Jiefuling and Riluzole Option 2: Repeat dose at +25% and 7-days schedule for animal trial

36. Turning Incurable to CurableIn principle possible • Chineseherbal is primary defensive: Strengthen, harmonize, regulate, repair all cells and molecules. Whole bodysystem homeostasis. Weak offense. • Westernmedicine is mostly offensive:isolate, localize and attack to eliminate, annihilate good/bad cells. No defense • Acupuncture: defense and offense

37. Future Plan IIConceptual Innovative Designs • Herbal Incurable Disease Clinic • MBBS physicians- PhD Program (MB-PhD) 協調整體-突出局部Clinical Trials 1.ALS: herbal & riluzole (UMass/MGH joint) 2. Parkinson’s: herbal, scalp acupuncture 3. Lymph-edema: all herbals 4. Common cold: pills minus side-effects • Herbal Medicine Mental Disorder Centre • Applied herbal cancer medicine • Ageing: Age + 10 with herbal supplements