Western Medicine

Colorectal cancer affects the colon or the rectum. The colon is the major part of the large intestine. It consists of four parts, the ascending, transverse, descending and sigmoid colon.

After food is digested in the stomach and small intestine the digested material passes though the colon. The main function of the colon is to absorb water and some mineral salts from the digested material. The digested material enters the colon as a liquid. As the material passes through the colon water and mineral salts are absorbed back into the blood stream. By the time the digested material reaches the rectum it is no longer in a liquid-like form but in the form of feces. The rectum is a short muscular tube that connects the colon to the anus. Its function is to hold feces until they are expelled through the anus.
In the United States colorectal cancer is the third most commonly diagnosed cancer and third leading cause of cancer related deaths in both men and women. Among them, 90% of all cases are diagnosed after the age of 50. The occurrence of colorectal cancer is the same for both men and women up to the age of 50. After the age of 50 the incidence of colorectal cancer is higher in men than in women. The incidence of colorectal cancer throughout the world varies greatly. The incidence of colorectal cancer is highest among industrialized countries of Europe and North America.

Chinese Medicine

Colorectal cancer is a Western medical term and is not specifically discussed in classical TCM texts. However, the main symptoms and signs of the disease are recorded in the following conditions:

	Intestinal mass 'chang ji': refers to movable abdominal mass accompanied by pain or distention.
	Bloody stools 'chang pi': refers to projectile bleeding from the rectum during defecation. This is due to the attack of wind evils in the stomach, leading to prolonged accumulation ofdampness evils in the large intestine. It affects the distributing areas of Shao Yin meridians finally.
	Abdominal mass 'zheng ji': the mass seen over the abdomen. When it is always palpable and immovable, accompanied by localized pain is named as "zheng", and that with intermittent occurrence, movable and accompanied by wandering pain is named as "ji".
	Organ intoxication 'zang du': refers to a dark reddish bloody discharge due to prolonged organ damage. This causes inflammation of the lining of the large intestine due to accumulation of toxic material in the organs.
	Hematochezia 'bian xue': passage of bloody stools; due to heat evilsdamaging the vessels and lettingblood escape into the surrounding tissues. It also present when there is accumulation of virulent dampness evil in the large intestine, deficiency of spleenyang and stomach yang, or accumulation of wind evil at the yinfen level (the deeper level of the body).
	Diarrhea 'xia li': Excessive and frequent evacuation of watery feces, usually indicating gastrointestinal distress or related disorder.
	Rectal carcinoma blocking the anus 'suo gang zhi': a carcinoma causing narrowing of the rectum and anus, resulting in the discharge of slender feces and foul fluid, and accompanied by tenesmus (painful, ineffectual straining to empty the bowel).

All these TCM conditions present similar symptoms to colorectal cancer. The TCM physicians usually consider all of the above conditions during consultation.

TCM image of the large intestines

Western Medicine

Prevention and early detection are very important factors in controlling and curing colorectal cancer. Several factors have been identified which play a role in the risk and development of colorectal cancer. They include; age, colorectal polyps, diet, family history, genetics (heredity), and inflamatory bowel disease.
Age
Colorectal cancer occurs most frequently after the age of 50. The average age at diagnosis is 60-65. The risk of colorectal cancer increases after the age of 40 and up to the eight or ninth decade of life.
Colorectal Polyps

Polyps in the colon

The presence of colorectal polyps can increase the risk for colorectal cancer. Polyps are benign growths in the colon and rectum but they can become cancerous over time. Approximately 30% of people in their 50's develop polyps; the occurrence of polyps increases to about 50% in people in their 70's. Not all polyps will become cancerous only about 5% of all polyps will become cancerous. It can take 5-10 years for a polyp to become cancerous.
Diet
The incidence of colorectal cancer is highest in countries where meat is a major part of the diet and fruits, vegetables and fiber are a small part of the diet. The Western diet is high in animal fats and low in fiber. Diets in underdeveloped countries tend to be rich in fibers from fruits, vegetables and grains, and low in fat. Studies have shown that meat and fat consumption increase the risk of colorectal cancer. It is thought that dietary fats produce cancer-causing substances when they are digested.
Family History and Genetics
Having a first-degree relative (parent, sibling, or child) has been shown to increase one's risk of colorectal cancer 2-4 fold. There are other genetic conditions that are associated with an increased risk for colorectal cancer. They include familial adenomatous polyposis (FAP) and Garner's Syndrome which are inherited conditions. Patients with these conditions develop hundreds of polyps in their colon and rectum. The polyps can become cancerous and persons affected with these conditions have nearly a 100% risk of developing colorectal cancer if left untreated.
Inflammatory Bowel Disease
Ulcerative colitis is a condition associated with an increased incidence of colorectal cancer. Patients who have ulcerative colitis have a 30-fold increase in risk. The duration of disease appears to be linked with the increased risk for colorectal cancer. Patients have a 3% increase in risk of developing colorectal cancer after 10 years of active disease and the risk increases to over 30% with 30 years of active disease.

Chinese Medicine

Click here to see the causes of colorectal cancer from a TCM perspective.
According to TCM, formation of cancer is generally due to the depletion of disease preventing factors and yin-yang disharmony of the body, which can result in different types of pathological phenomena, such as qi stagnation, blood stasis, phlegm condensation, toxic heat accumulation, and dampness collection. These morbid conditions interact with each other and cancer may form when they further interact with

external pathogenic factors.
The usual causative factors are as follows:
Improper Diet
TCM takes food very seriously and regards the middle burner (body region where the spleen and stomach are located) as the area for digestion. The digestive organs are vulnerable to inappropriate and unbalanced dietary habits, for example, excessive eating, greasy diet, over consumption of alcohol, and unclean foods. When the transportation and transformation processes are affected, undigested foods remain too long in the region and brew into dampness and heat evils. These evils accumulate and infuse downward into the large intestine, causing qi stagnation, and blood stasis in the intestines. The dampness, heat, stasis, and toxic materials all blend together and may cause cancer over time.

Emotional Problems
Extreme emotional conditions like pensiveness and anxiety leads to under-functioning of the liver and affects the movement of qi (vital energy) mainly, causing the formation of internal pathogenic factors such as dampness and phlegm. When these evils further stagnate, they transform into toxic heat evils, which then infuse downward and invade the intestines. This gives rise to qi stagnation and blood stasis in the intestines. Cancer may occur after a long period if the condition persists.

Uncontrolled Chronic Dysentery or Diarrhea
Persistent diarrhea leads to depletion of qi (vital energy) in the body which affects the spleen. In TCM, when the spleen cannot perform its transportation and transformation functions to send the pure nutrient essence upward to the heart and lungs where it is transformed into qi and blood for body nourishment, qi (vital energy) movement becomes abnormal and results in a morbid state. Impure substances or retention of phlegm and static fluid then build up. When this condition lasts for long periods, the internal equilibrium is disturbed, and cancer can easily form.

Western Medicine

Unfortunately the symptoms of colorectal cancer can sometimes be non-specific and varied. A delay in seeking medical attention can occur because the symptoms are often times vague and ignored.

The symptoms of colorectal cancer include:

	Changes in bowel function (constipation, diarrhea or both)
	Blood in the stool or rectal bleeding
	Narrowing of the stools (ribbon-like stools)
	Increase in abdominal gas or discomfort, bloating, fullness or cramping
	Unexplained weightloss
	Fatigue

These symptoms can be caused by other medical conditions. People often times will not seek medical attention for rectal bleeding or blood in the stool because they think the bleeding is caused by hemorrhoids. However, anyone experiencing any of these symptoms should seek medical attention to determine the cause of the symptoms and to rule out colorectal cancer. Early detection and diagnosis is very important in the prevention, cure and successful treatment of colorectal cancer.

Chinese Medicine

In TCM, colorectal cancer has a similar clinical presentation to Western medicine; however physicians also focus on changing symptoms, the individual's constitution, and the order in which symptoms appear. TCM practitioners first carry out a comprehensive consultation to gather an accurate picture of the internal disharmonies before implementing treatment. See article on "What to Expect from a TCM Doctor's Examination". The usual disharmony patterns caused by colorectal cancer are as follows:
1. Downward migration of damp-heat
Individuals present with abdominal cramps, diarrhea with mucous and bloody stools and tenesmus (painful, ineffectual straining to empty the bowel). There is a burning sensation in the anus and a palpable abdominal mass. Other associated symptoms include fever, aversion to cold, thirst, mouth dryness and general weakness.

TCM illustration showing different kinds of abdominal distention.

2. Excessive accumulation of poisonous pathogens
The main presentations are poor appetite, feverish sensation accompanied with chest oppression, thirst, abdominal distention and cramping and severe diarrhea with mucous stools (which are dark purple in color).
3. Interior retention of blood stasis
Individuals present with an abdominal mass accompanied by fixed and persistent pain, abdominal distention, straining when defecating, diarrhea with pus and blood, a grayish complexion and a skinny appearance.
4. Deficiency in qi (vital energy) and blood
Individuals present with a pale complexion, light-colored lips and nails, general weakness, shortness of breath, bland taste in the mouth, poor appetite, full sensation in the epigastric region, tenesmus (painful, ineffectual straining to empty the bowel) or anal prolapse in severe cases, malnutrition and a skinny appearance.
5. Yang deficiency in spleen and kidney
Individuals present with a pale complexion, general malaise, apathy, aversion to cold temperatures, limb coldness and poor appetite. There can also be abdominal pain and distention, diarrhea in the morning and weakness and soreness in the lumbar (lower back) and knee regions.
6. Yin deficiency in liver and kidney
Individuals have a skinny appearance, dizziness, ringing in the ears, hot sensation in the chest, palms and soles, insomnia with nightmares, lumbar soreness, leg weakness and constipation with or without abdominal pain.

Western Medicine

The diagnosis of colorectal cancer can be made through a variety of diagnostic tests. Early detection is very important for colorectal cancer. If colorectal cancer is found early, the chances for curing the cancer are greatly improved. Precancerous polyps can be detected and removed before they become cancerous. When colorectal cancer is detected early the prognosis is very good; approximately 90% will survive 5 years after diagnosis. When the cancer is detected at a later stage, meaning the cancer has spread to other organs near the colon or rectum, or to the blood system it is estimated that only 60% will survive 5 years after diagnosis. If the cancer has already spread to other organs such as the liver, lungs or bone, only 8% will be expected to live 5 years after diagnosis. Unfortunately in the United States only approximately 37% of all cases of colorectal cancer are diagnosed before the cancer has spread to other organs. This emphasizes the need for early detection and screening for colorectal cancer.

Colorectal cancer can be detected by the following tests, digital rectal exam, ultrasound or CT scans, barium enema studies, and colonoscopy or flexible sigmoidscopy. Blood tests such as, liver function tests and carcinoembryonic antigen assay test (CEA), are helpful in diagnosing colorectal cancer.
Digital rectal exam
A digital rectal exam is an exam in which the doctor will insert a gloved finger into the rectum to feel for any abnormal areas. This can detect the presence of polyps or cancerous growths.
Ultrasound or CT studies
Ultrasound or CT studies can be useful to detect the presence of cancer outside the colon or rectum.
Barium enema with air contrast studies

Barium enema with air contrast studies can show the presence of colon polyps or tumors. This technique is not very useful in detecting rectal polyps or tumors. Patients undergoing barium enema with air contrast studies have barium sulfate, a substance that is detected by x-ray, instilled into their colon. The colon is then filled with air and x-rays are taken.
Colonoscopy or flexible sigmoidoscopy
Flexible sigmoidoscopy and coloscopy use similar techniques. A slender, flexible, hollow, lighted fiberoptic tube is inserted through the anus and into the colon where the doctor can view the colon and rectum. If a polyp or cancerous growth is seen it can be removed or a piece of it can be removed for biopsy. The flexible sigmoidoscopy differs from a colonoscopy in the amount of colon that can be viewed. The flexible sigmoidoscope can only view about half of the colon. The colonoscope is longer and can view the entire length of the colon. In the United States about one-third of colorectal cancers are not within the reach of the flexible sigmoidoscope.
Carcinoembryonic Antigen assay (CEA)
The carcinoembryonic antigen assay test is blood test that is usually done after colorectal cancer is diagnosed. Elevated levels of CEA in the blood can occur in the presence of colon and rectal tumors, however other non-cancerous conditions can result in an elevated blood level. Because of this, the test is not useful in the screening of colorectal cancers.

Chinese Medicine

Diagnosis in TCM places importance on determining the circumstances and manifestations of a disease through inquiry and observation of symptoms. Diagnosis is based on the four traditional examination techniques:
Questioning: The TCM practitioner will establish the medical history of both the patient and his family.
Observation: Examination of the physical features of the body, such as the face, tongue, hair, nails, sputum (mucus that is coughed up), and location of pain, all offer clues to the problem. The tongue is a particularly useful indicator of the functioning of the internal organs.
Listening and Smelling: The odor of sputum and breath and listening to chest sounds offer additional clues to the patient's health.
Touching: Feeling the pulse is a cornerstone of TCM diagnosis and gives the practitioner much information about any bodily imbalance.
TCM practitioners will usually begin with a full investigation of the patient and categorize symptoms under special syndrome groups known as "disharmony patterns." Certain disharmony patterns are present at different stages of a disorder. See article on "Principles of Diagnosis" In addition to manifestations of colorectal cancer as mentioned previously, practitioners also use pulse and tongue examination to obtain a diagnosis.
1. Downward migration of damp-heat
The major diagnostic presentations are abdominal cramps, diarrhea with mucous and bloody stools, tenesmus (painful, ineffectual straining to empty the bowel and bladder), and a burning sensation in the anus. On examination, the tongue is red, and covered by yellow and greasy fur. The pulse is rolling and rapid.

2. Excessive accumulation of poisonous pathogens
The major diagnostic presentations are poor appetite, fever with dysphoria (an emotional state characterized by anxiety, depression, or unease), thirst, abdominal distention and cramping, diarrhea with mucous feces (which are copious and dark purple in color). On examination, the tongue is red, and covered by yellow or dried yellow colored fur. The pulse is surging and rapid.

3. Interior retention of blood stasis
The major diagnostic presentations are fixed and persistent abdominal pain and grayish complexion. On examination, the tongue is dark and purple in color, and covered with brusied spots. The pulse is hesitant or taut or knotted and intermittent.

4. Deficiency in qi (vital energy) and blood
The major diagnostic presentations are pale complexion, light-colored lips and nails, general weakness and shortness of breath. On examination, the tongue is pale with a thin and white coating; the pulse is deep and thready.

5. Yang deficiency in spleen and kidney
The major diagnostic presentations are pale complexion, aversion to cold temperatures, limb coldness and diarrhea in the morning. On examination, the tongue is bulky and the pulse is deep, thready, and weak.

6. Yin deficiency in liver and kidney
The major diagnostic presentations are constipation, wasting of body tissue, dizziness, ringing in the ears, and a feverish sensation in the chest, palms, and soles.
On examination, the tongue is dark red and covered by scanty fur. The pulse is thready and taut, or rapid and thready.

Western Medicine

Surgery is considered the primary treatment for both colon and rectal cancers. Chemotherapy and radiation therapy are often used to treat colon and rectal cancers. The stage or extent of spread of the cancer will influence the treatment options for a patient with colorectal cancer.

Surgery

For both colon and rectal cancer, surgery is performed to remove all cancerous tissues while trying to retain as much function of the colon and rectum as possible. During surgery the surgeon will remove the part of the colon or rectum which contained the cancerous tissue and a small amount of normal healthy tissue surrounding the cancerous tissue. Lymph nodes near the cancerous tissue are often times removed as well. These lymph nodes will be analyzed to determine if any cancer had spread to them. The healthy parts of the colon or rectum will be reconnected. If the surgeon can not reconnect the healthy portions of the colon or rectum, a colostomy will be created. A colostomy is an opening in the abdomen that allows feces to pass through. A bag is placed over the opening to collect the feces. Sometimes patient may have a temporary colostomy, in which a colostomy is created to allow the healthy tissue to heal, after which time the patient's colon or rectum is reconnected and the colostomy is removed. After the colostomy is removed the patient passes feces through their anus. Surgery can be curative for early-stage colorectal cancer.

A colostomy is an opening in the abdomen that allows feces to pass through.

Chemotherapy

Depending on the extent or stage of the cancer at the time of initial diagnosis, chemotherapy may be given before or after surgery. When chemotherapy is given after surgery to kill any remaining cancer cells or to prevent the spread of cancer cell it is referred as adjuvant therapy. There are several chemotherapy drugs that are used for colorectal cancer. Some are given as adjuvant therapy while others are used if the cancer returns or spreads to other organs. Chemotherapy for colorectal cancers can be given through the veins into the blood or be taken by mouth.

Unfortunately, when chemotherapy is given through the veins into the blood or taken by mouth, healthy cells as well as cancer cells are affected. Most side effects of chemotherapy are a result of the healthy cells being affected by the chemotherapy. Common side effects of chemotherapy medications that are used to treat colorectal cancer include, mouth sores, diarrhea, and low blood counts.

If the cancer has spread to the liver, chemotherapy medications can be injected into one of the blood vessels going directly to the liver. This type of chemotherapy can decrease the occurrence of side effects that one would experience if the same medication was given into a vein. However this type of chemotherapy administration will not treat cancer that has spread to organs other than the liver.
Radiation therapy

Radiation therapy is not routinely used for the adjuvant treatment of colon cancer. However, it is used for rectal cancer. Radiation therapy may be given before or after surgery to patients with rectal cancer depending on the extent or spread of the cancer at the time of diagnosis. The goal of radiation therapy is to use high-energy rays to damage cancer cells and to stop them from growing. The radiation therapy only affects the tissue and cells that are exposed to the high energy rays. Side effects of radiation therapy include diarrhea, low blood counts, skin irritation, and fatigue.

Chinese Medicine

Various TCM therapies can be used at any stage of the disease or in combination with Western treatment at any time. Individuals can benefit from its preventative effects, improve their quality of life or boost the immune system, relieve or eliminate adverse effects caused by chemotherapy, and even help in the palliative care of terminal cancer patients. The following methods are for general information only; a qualified physician should always be consulted for treatment options. Self-treatment is not recommended.

Physicians select the treatment method according to TCM differential diagnosis, the "disharmony patterns" made by analyzing the collected data. All these remedies are adjusted to suit specific individual conditions.

Downward migration of damp-heat
Therapeutic aim: to clear away heat in order to drain dampness. Commonly used prescriptions are huaihua diyu tang, qingchang yin, or baitouwengtang.

Sample prescription: baitouweng tang(白頭翁湯)

Excessive accumulation of poisonous pathogens
Therapeutic aim: to clear away heat to cool blood, remove stasis, and detoxify the body. Commonly used prescriptions are wuwei xiaodu yi and huanglian jiedu tang.

Sample prescription: huanglian jiedu tang (黃連解毒湯)

Interior retention of blood stasis
Therapeutic aim: to clear away heat to cool blood, remove stasis, and detoxify the body. Commonly used prescriptions are wuwei xiaodu yi and huanglian jiedu tang.

Sample prescription: xiefu zhuyu tang(血府逐瘀湯)

Deficiency in vital energy (qi) and blood
Therapeutic aim: to replenish qi and nourish the blood. Commonly used prescriptions are guipi tang and bazhen tang.

Sample prescription: guipi tang (歸脾湯)

Yang deficiency in spleen and kidney
Therapeutic aim: to warm and tonify the spleen and kidneys. Commonly used prescriptions are zhenling baishu sanand sishen wan.

Sample prescription: shenling baishu san (參苓白術散)

Yin deficiency in liver and kidney
Therapeutic aim: to nourish and tonify the liver and kidney. A commonly used prescription is zhibai dihuang wan.

Sample prescription: zhibai dihuang wan (知柏地黃丸)

Treatments other than the oral drugs include acupuncture, plasters, sauna, and massage. These methods are commonly applied to localized lesions according to the presentation of symptoms.

Acupuncture

To relieve pain and vomiting, selected acu-points are:
zu-san-li, tian-shu, he-gu, xia-ju-xu, nei-guan, and da-chang-shu.

Samples of acu-points that helps to relieve pain and vomiting.

Moxibustion
This is suitable for colorectal cancer patients who have complications such as ascites (free fluid accumulating in the abdominal cavity). Selected acu-points are:
tian-shu, zhong-wan, xia-wan, guan-yuan, shen-quel.
Recommended treatment is 2-3 times daily.

Topical application of drugs
This refers to local application of pounded fresh medicinal herbs or moisturized medicinal powder over the affected part. They are applicable for local infections, ulcers, swelling, pain and injuries. In this case, individuals can apply to relieve pain caused by cancer, e.g. toad paste.

Application of TCM plaster for topical use.

Enema
This refers to the introduction of a liquid into the bowel via the rectum, to be either expelled or retained. It is suitable for individuals with bloody stools. For example, a TCM decoction is prepared using the bark of Chinese Corktree (huang bai), root of Baikal Skullcap (huang qin), root of Redroot Growwell (zi cao), rhizome of Japanese Fleeceflower (hu zhang), common Picria herb (ku shen), and fruit of Japanese Apricot (wu mei).

TCM has many patent drugs or simple folk remedies for relief of symptoms. Physicians usually prescribe these to complement other treatments.

This method is beneficial for regulating the body and mind, strengthening the constitution, and relieving the adverse effects of radiotherapy or chemotherapy. Patients select relevant exercises in consultation with their physician. A desirable result can only be achieved by long-term and persistent practice.

For example:

• First prepare by adopting a half standing and half sitting posture; hold the arms tight at the side with the each hand in a fist; the two feet are a shoulder's width apart and the eyes are slightly closed.Slowly start to inhale, grab the ground with the toes, contract the groin area, and lift up the anus.Concentrate on making the breath (qi) sink down to the dantian (3 cm below the navel); let your mind control the qi circulating throughout the body; then exhale and relax. Say to yourself that qigong can cure cancer and let the hands and feet wave freely.
• Practice this every morning and night.

"Standing posture" usually seen at the beginning of qi-gong practice.

Western Medicine

Because the prognosis for colorectal cancer is greatly improved with early diagnosis, prevention and proper screening for colorectal cancer is critical in reducing the number of people diagnosed with colorectal cancer and the number of deaths caused by the cancer. Identifying and proper screening of patients that are at an increased risk for colorectal cancer help prevent or detect colorectal cancer in an early stage. Taking steps to minimize ones risk for colorectal cancer is also important to prevent colorectal cancer. The American Cancer Society recommends the following guidelines for nutrition and physical activity to help lower the risk of colorectal cancer:

Eat a variety of healthful foods, with an emphasis on plant sources.
Adopt a physically active lifestyle.
Maintain a healthful weight throughout life.

If you drink alcoholic beverages, limit consumption.

The American Cancer Societyrecommends the following guidelines for nutrition and physical activity to help lower the risk of colorectal cancer:

1. Eat a variety of healthful foods, with an emphasis on plant sources.
   Adopt a physically active lifestyle.
   Maintain a healthful weight throughout life.
2. If you drink alcoholic beverages, limit consumption.
   

• Yearly fecal occult blood test plus flexible sigmoidoscopy every 5 years;

  Flexible sigmoidoscopy every 5 years;Yearly fecal occult blood test;Colonoscopy every 10 years;

• Barium enema with air contrast study every 5 years.

People with an increased risk for colorectal cancer should begin screening before the age of 50. The following are considered to have an increased risk for colorectal cancer.

• Having a first-degree relative (parent, sibling or child) with colorectal cancer before the age of 60 or two first-degree relatives at any age;Having a hereditary condition (familial adenomatous polyposis);Personal history of polyps or colorectal cancer;
• Personal history of inflammatory bowel disease.

Other factors have been linked to a reduction in risk for colorectal cancer, which include the use of anti-inflammatory drugs and aspirin, estrogen therapy, and calcium and folic acid supplements.

Chinese Medicine

TCM methods of prevention and management are similar to Western medicine, please see Western section for reference; nursing management is a characteristic of TCM. TCM physicians concentrate on the following:
Psychological consultation and reassurance
Both the physician and family members should try to relieve the patient's mental burden through language and behavior, so as to build up the patient's self-confidence to fight the cancer. Patients can also help by practicing qigong. Keeping good personal hygiene, eating a moderate diet, avoiding cigarettes and alcohol, and keeping stress to a minimum, are also important ways to prevent disease progression.

Food and dietary therapy
Patients should have multiple small meals everyday; the food should be light and easily digested, and cover all essential nutrients. The daily diet should include an increased intake of fiber and fruit. TCM functional food has a long history, and the use of tonics taken with food pre-date their use as medicine. Combined with food, tonics are absorbed better and are seen as an ideal way to keep bodily functions in check.

Porridge of Water Caltrop
Therapeutic benefits: used as a tonic to invigorate the stomach and nourish the intestines.

Ingredients:

10-20 pieces
water caltrop

Water caltrop

1 tablespoon
honey

about 1 cup
glutinous rice

(Job's tears, lotus seed or the seed of Golden Euryale (qian shi) can replace water caltrop with the same results.)
Method:
Peel off the skin of the water caltrop and cook in a pot with sufficient water; when it turns into a semi-paste, add the glutinous rice and further cook into porridge. Add one tablespoon of honey before serving.

Other functional foods like dried mushrooms, white and black fungus, and fresh mushrooms are also recommended. These foods enhance the immune system and improve the body's constitution.

Western Medicine

Written By:
Western Medicine:
Leanne M. Sakamoto, Pharm.D., is an Assistant Professor of Clinical Pharmacy at the University of Southern California School of Pharmacy, and Manager of the Ambulatory Pharmacy at the USC/Norris Comprehensive Cancer Center and Hospital in Los Angeles, California.

Chinese Medicine

Chinese Medicine:
Wang Li (王立)
Professor, Beijing University of Chinese Medicine

Editors:
Angela Collingwood MSN, Integrated Chinese Medicine Holdings Ltd.
Angelo Chung B Pharm, Integrated Chinese Medicine Holdings Ltd.
Jennifer Eagleton BA & MA (Asian Studies), Integrated Chinese Medicine Holdings Ltd.
Rose Tse, Integrated Chinese Medicine Holdings Ltd.