Once a terrible plague wiped out thousands of people. A pious queen, concerned that this plague would spread also to her neighboring realm, summoned her priests and asked how she could save her people. After conferring, the priests said that this was a visitation from the lord Shiv, who had to be supplicated through prayer. Thus appeased, Shiv appeared and agreed to let his disciple Nandi, protect the country. When the Plague entered this land, Nandi came down on him with all his might. A truce was made, the terms being that the Plague would stay only for one day in the capital and claim only one victim. But the next day, one hundred people were dead. Enraged, Nandi searched out the Plague and thundered that this scoundrel had broken his promise, The Plague mocked that he had not. "I did take only one person. The other ninety-nine had a simple fever and a little swelling of the glands. They mistook these for signs of my approach and died of fear. I had nothing to do with it."-- An Indian Folk-tale

In 1992, the first women's only Traditional Chinese Medicine (TCM) HIV clinic, was established at the Iris Center, in San Francisco. If you are an HIV positive woman, with or without symptoms, it is wise to consider a therapy that can not only treat some of your symptoms in relatively non-toxic ways but which can also keep your physical and emotional immunity, strong and healthy.

In the Chinese system, when we speak of immunity, we include not only the ability to fight infection but also the internal ability of the body to remain strong. This internal strength comes from the body's ability to digest and assimilate food. Some of this stamina, we are born with and some of this we acquire through good nutrition and life-style.

When an HIV positive woman comes to a practitioner of TCM, she is also diagnosed according to the Chinese system of diagnosis. This system uses her presenting symptoms and signs to make a pattern diagnosis that describes her particular imbalance in the body. Once these symptoms have been controlled, treatments continue in order to correct the imbalances in the body's energies that led to these conditions in the first place.

These imbalances may have come about because of emotional or environmental pressures. The emphasis continues to be on restoring one's internal resources and energy so that further illness doesn't recur.

For example, two women come in with heavy menstrual bleeding. "A" has dark blood, fibroids, a regular cycle and arthritis. "B" has pale blood, sever PMS, ovulation cramps and psoriasis. After examining the differing tongues an pulses of both these women, a diagnosis of blood stasis may be given to the first one and a diagnosis of blood deficiency may be given to the second one. Treatment, which will include acupuncture, herbs and nutrition, will use different acupuncture points and herbs for the two HIV positive women.

Gynecological exams are very important. They are routinely recommended. If the fibroids are very large, then surgery may be the better option.

TCM has a strong preventive component. The concept of Qi is at the core of this. Qi cannot be grasped or isolated. But this non-stuff is also the essential stuff of our fax-machines and TV sets. In our bodies, it is the animating life-force. A persons Qi is strong if the skin is not wrinkled, hands and feet are not cold and if there is no pallor. We all have reserves of Qi and prevention means mobilizing these reserves so that disease can be resisted or the progression of existing disease can be slowed. Acupuncture has diverse therapeutic benefits that affect peripheral micro-circulation, gastro-intestinal peristalsis, blood pressure, secretion of hydrochloric acid, the production of red and white blood cells and the inhibition of pain. Additionally, the stimulation of ear points can decrease cravings and withdrawal reactions in the treatment of alcohol, drug, tobacco and food addictions. For those who dislike needles, similar benefits can be had by the use of herbal medicine and nutrition.

Women are more likely to get disorders such as low Red Blood Cells and low platelets coming from malnutrition, lupus, pregnancy or TB. Other immune-compromised symptoms are spontaneous sweats, fatigue, depression and digestive problems. In addition, women may have recurring yeast infections, discharges that are not yeast or bacterial, genital warts and herpes out-breaks with every menstrual cycle. With menopause, irregularities in the cycle, greater irritability and hot flashes can affect most women. Pregnant women may have lower back pain, heart-burn, nausea/vomiting and insomnia. Finally, there may be the side-effects from anti-virals -- skin rashes, neuropathy, anemia and stomach upsets.

TCM, i.e. Acupuncture and herbs, can raise blood counts in many cases. As a result, symptoms that occur with the menstrual cycle, gradually start recurring less frequently. Menopausal hot flashes can be confused with the spontaneous sweats of HIV. But both are very amenable to treatments with herbs and acupuncture. Some of the discomforts of pregnancy can be very easily be treated by Ear Acupuncture and/or Moxibustion (herbal heating of Acupuncture points).

D4T, 3TC, DDI and AZT are not without their toxicities. It is important to open our minds to see what other methods may be available if these drugs cannot be handled by someone -- methods that might replace them or that might mitigate their side--effects. Since most drugs are inadequately tested on women, monitoring their effects by regular lab test and observations of the tongue and pulse changes, is greatly emphasized.

The TCM approach is very encompassing. If a woman walks in one morning with oral sores or vaginal yeast, instead of just treating this with herbs and/or acupuncture, or in combination with anti-fungals, all of which will help in symptom alleviation, a practitioner of TCM will also ask some questions about what the person may have eaten or done in the past day or days. In many cases, there will be an over-indulgence in white sugar or some other inappropriate food or stress prior to an exhibition of these symptoms. At this point, the woman is encouraged to see the link between her choices and the manifestation of certain imbalances. This, over time, provides some sense of control.

This perspective also goes a long way in reducing the fear the panic that an HIV+ person can feel every time time some symptom pops up. A realization like this and the applications of it can help a person see that every symptom manifestation is not an irreversible progression of the disease. Fear lowers immunity. Once someone can step back and see the significant role that she plays in the management of her condition, then the dance really begins to change.

The importance of nutrition cannot be emphasized enough. Many cases of diarrhea respond to simple changes in diet -- eating white rice and yogurt, eliminating milk and high fiber foods. Avoiding sugar, alcohol and breads with yeast can dramatically reduce systemic and local yeast infections.

Since effective treatments for the flu are available, herbal therapies for this are encouraged as much as possible as too frequent a use of antibiotics can make the body resistance to them and more prone to yeast infections.

TCM has long recognized the several strains of viruses that can cause a flu. (In our terminology, these are identified as "wind", "heat", "cold", or "damp"). That is why the indiscriminate use of Golden Seal (e.g. with beginning flu symptoms) is not always correct and if used incorrectly, can actually worsen some scenarios in which Cinnamon may be the appropriate choice. The self-prescription of herbs is discouraged. So is the self prescription or over-use of vitamins which are not without their toxicities. The holistic approach that we advocate stresses exercise and here at Iris Center we offer Yoga, not only for stress reduction, but for the management of certain symptoms like asthma.

Our experience in these past few years has led us to concur with Jeff Baggish, MD, who in his book "How the Immune System Works", (Ziff-Davis Press, 1995) states that is possible to have a functional, immune system with zero T-cells if one has a normal amount of neutrophils, white blood cells, and natural killer cells.

TCM may not always raise T-cells, but its ability to raise the many other components of immunity is very sound. Though we regularly monitor blood-work, we have found that it is more important to look at the over-all picture -- Liver function, total CBC for example, rather than frown with concern every time the T-cells fluctuate.

Also, by using an approach that nurtures immunity from many different directions, we are hoping to create an expanded understanding of the idea of "cure". It may be inadequate to look for one agent or gun that kills the virus, simply because there is no one virus or one strain of it. The hope may lie in looking for factors that keep people healthy, with a lessened recurrence of symptoms and in a relatively positive state of consciousness. Once these symptoms have been controlled, treatments continue to correct the imbalances in the body's energies that led to these conditions in the first place. These imbalances may have come about because of emotional or environmental pressures. The emphasis continues to be on restoring ones internal resources.