From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: Chinese Sentinel Article #2
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6649
Organization: unspecified
Date: Wed, 16 Dec 92 20:33:13 PST

The following article was printed in the San Francisco Sentinel on 
Thursday, December 10, 1992. It is being posted with the permission of 
the author, Charles R. Caulfield.
************************************************************************
                  Chinese Medicine & HIV Disease
                   Part II: Clinical  Practice
                     by Charles R.  Caulfield

      Chinese herbs and acupuncture are used as a either a primary or 
adjunctive medical treatment by well over a thousand HIV infected 
individuals in San Francisco. This, part two in a series on Traditional 
Chinese Medicine and HIV, will discuss the services provided by the 
three largest Community Clinics specializing in HIV treatment, as well 
as access to services and avenues of financial assistance for those who 
might feel they could benefit from it.

      We visited the three largest HIV Treatment Clinics in San 
Francisco: The American College of Traditional Chinese Medicine, Quan 
Yin Healing Arts Center, and the Immune Enhancement Project. While these 
three organizations are in general agreement on their theories of 
Chinese diagnosis and philosophy, each has a distinctly different 
approach to the delivery of treatment. The Sentinel interviewed the 
Clinical Directors of all three clinics, and found that despite their 
varied styles of practice each was staffed with people committed to 
their work , and very professional in their approaches to it.

      Our first visit was to the American College of Traditional Chinese 
Medicine (ACTCM), and their general medicine clinic located at 450 
Connecticut. As of July 1992 the college has been the recipient of a 
Ryan White CARE grant to provide free comprehensive Chinese medicine to 
50 HIV positive individuals in San Francisco. Its CARE funding  has 
recently been renewed, allowing them to provide free services to a 
substantial number of people through June of 1994.

     The Clinic is the teaching facility for the College and is a 
general medicine practice, treating HIV and other illnesses as well.  It 
places special emphasis on the art of Chinese Diagnosis of illness 
through a system of measurements unrelated to Western Medicine. 
Diagnostic skill is considered by the ACTCM faculty to be critical to 
effective treatment.

     The College's Clinic, which is directed by Howard Moffet, a 
licensed acupuncturist and American College alumnus, treats 
approximately 90 HIV clients regularly, 50 of whom receive free services 
through CARE funding. Treatment consists of acupuncture and raw herb 
formulas which are cooked and drunk as a tea. The clinic has a sliding 
scale ranging between $16 and $35 per visit depending on income. The 
clinic accepts Medi-CAL as full payment for acupuncture, and some health 
insurance companies  will reimburse clients for acupuncture, or 
"needling" as it is familiarly used. No insurance companies pay for the 
herbs, but resources exist in the community to subsidize Chinese Medical 
treatment. Sources of financial assistance are listed below. The Ryan 
White funded component provides lab work monitoring, weekly needling and 
raw herbal combinations to be prepared at home. Nutritional counseling 
is available and a nurse practitioner monitors the clients health from a 
western perspective. 

     Although the free CARE Program is full at the present time, they 
are accepting names to be put on their waiting list. Individuals on the 
waiting list will be taken on a first come first serve basis. ACTCM has 
minority referral sources including memoranda of understanding as  with 
EACH, Gay Asian Pacific Alliance and the Filipino Task force on AIDS. It 
is required of Ryan White providers that they specifically target 
underserved populations. To make an appointment or request information, 
the clinic can be reached at (415) 282-9603. 

        The Immune Enhancement Project,  located at 3450 16th Street at 
Sharon has an entirely different approach to herbal medicine. It uses 
herbal formulations in tablet form. Miichael Young, L.Ac., is the 
clinical director.  He has 4 years of clinical experience in TCM and 
HIV. The clinic treats HIV exclusively through the use of acupuncture 
and herbal combinations developed at the Institute for Traditional 
Medicine, (ITM) in Portland, Oregon , by Subhuti Dharmananda, PhD.  ITM 
conducts extensive clinical research into the effectiveness of it's 
herbal compounds, and provides discounted treatment  in exchange for 
participation in research.

        Dharmananda's formulas are based on traditional Chinese 
formulas, but  adjusted to conform with modern research 's findings. In 
1988, U.C. Davis conduced laboratory tests which demonstrated that 
certain common herbs had activity in vitro against several viruses, 
including HIV.  Other University research has demonstrated that several 
herbs have properties which can modify the immune response. Their base 
formula , Composition A, was strongly affected by this research, and the 
herbs are combined utilizing this data. This is not a traditional 
approach to herbalism,  but the clarity of the rationale is evident.

       IEP also receives Federal Care funds to provide herbs and 
acupuncture at no cost for 60 clients. Their contract provides weekly 
acupuncture and includes herbal preparations developed by Dharmananda 
which are taken as tablets.

      In  order to reach underserved cultural populations they have 
referral networking agreements with American Indian AIDS Institute, the 
Black Coalition on AIDS, and the Latino AIDS Project.

Client satisfaction questionnaires if IEPs clients have been fairly 
positive. Unfortunately, they are not able at this time to accept Medi-
CAL significantly limiting access. The Immune Enhancement Project can be 
reached for information, or an application for the CARE funded Program, 
by calling (415) 252-8711. The staff is supervised by Young, a licensed 
acupuncturist who has been involved in Chinese treatment of HIV for over 
four years.

      Quan Yin Healing Arts Center at 1748 Market Street has seen over 
500 unduplicated clients during the last year.. Their Clinical Director 
is Dr. Misha Cohen, who is one the most influential practitioners of TCM 
today. Cohen had input into ITM's basic formula, Composition A when 
those two groups worked collaboratively. Since then, she has developed 
her own basic herbal tablet formula for HIV. Cohen has likely seen more 
HIV clients than most in clinicians in Chinese Medicine  and has been 
specializing in HIV and gynecology since 1984. Quan Yin uses very 
specific protocols for treating various HIV-related syndromes, developed 
based on the successes and failures Quan Yin has achieved with thousands 
of patients seen in their clinic during the last 8 years. She has 
addressed physicians academically at Conferences in China. In a 1989 
profile of Cohen in Image  Magazine, she was  referred to as "arguably, 
San Francisco's leading practitioner of Chinese Medicine." Quan Yin 
provides a holistic combination of services, including psychotherapy, 
massage, yoga  and the services of a Western MD,  Dr. Nancy Harris, who 
with Cohen train the staff in both Western and Asian rationales of 
medical treatment.  Quan Yin has trained practitioners form around the 
world in the use of their methods in a two day education  seminar . The 
Quan Yin HIV Certification Program trains clinicians in Chines and 
western considerations in treatment. All of Quan Yin's practitioners are 
graduates of the Certification Program adhere to her protocols  drawn 
from her extensive clinical experience. Quan Yin also offers diseases 
other than HIV, such as chronic hepatitis and Chronic Fatigue Syndrome. 
Cohen recently presented data on her observations at the recent Zurich 
AIDS Conference. She is currently the Vice-President of the California 
Acupuncture Association. Cohen, in  an interview stated that she 
believes that Quan Yin's multidimensional nature was it's strongest 
point in HIV disease. Quan Yin and San Francisco General Hospital are 
currently enrolling individuals for a study of the effects of Chinese 
Herbs.

     Quan Yin operates on a sliding scale, based on income. The do 
accept Medi-CAL for acupuncture, lab work and visits with Nancy Harris, 
MD. They offer program packages by selling bulk quantities of herbs at a 
reduced rate. They are staffed by bilingual clinical as well as office 
staff.

      Chinese Medicine, like anything else, is not for everybody, but 
many people rely on it and swear by the results. It is known to be non-
toxic, and even though the herbs are not insurance reimbursable, they 
usually cost no more than  $12.00 per week to use. For enrollment in the 
federally funded programs, one should call and get on their waiting 
lists. It could be a while before being seen. Financial assistance 
through other agencies is available to people with HIV illness. The AIDS 
Emergency Fund, who give grants to assist with the cost of treatment, 
can be contacted by calling (415) 441-6407.  Information regarding The 
John Ribinsky Acupuncture Fund, which subsidizes acupuncture treatment 
for PWAs, can be obtained at the clinics themselves.

     It is the intent of this article to advise people as to the current 
accessibility of a clinical option which, although largely a West-Coast 
phenomenon, has a large and regular following. To gain a broader base of 
understanding the reader is referred to two excellent reference 
materials, which describe the philosophy and practice of Chinese 
Medicine: Between Heaven and Earth: A Guide to Chinese Medicine, by 
Beinfield and Korngold, 1991, Ballantine, NY, and The Web that Has No 
Weaver, by  Ted Kaptchuk, 1983, Congdon and Weed, NY. 
Newsgroups: sci.med.aids