The beautiful balmy autumn weather was too good to last. In the middle of October, temperature in this northern-most part of China dropped to around freezing. We put on more clothes -- although the local students are made of strong stuff. They continued to wear just the thinnest jackets, and hardly anyone wore hats and gloves. Heating finally came on in the buildings, and with this, a new problem became readily apparent.

About 70% of China's power comes from coal, a dirty form of energy. Last winter, the level of fine particulate matter, or PM2.5, in Harbin air reportedly reached 1,000 micrograms per cubic meter, exceeding the level set by the World Health Organization by a factor of 40.

The smog shut down roads, schools and the airport. Visibility was reduced to less than 20m in some places. It is not that bad at the moment, but it was obvious starting last week that the air quality is severely compromised. The air is acrid and breathing is more difficult. We have started wearing face masks, although I don't know how much they help. I am concerned for my poor lungs, but I get to go home in a month or so. What if you lived here all the time and the haze hangs around six months of the year? 

It became apparent very quickly after arriving in Harbin that the local cuisine is all about one thing. Fried, preferably deep-fried. Actually, make that two things. Fried and salty. The perfect combination if you want to have high blood pressure.

Hypertension is the main reason why people have stroke. If you have been eating the typical Harbin cuisine all your life, you are bound to have an unhealthy blood pressure. Add to that the Harbin fondness for meat and alcohol (think of those cold winters that you have to get through), and it certainly explains why the hospitals have got very good at treating stroke patients with a combination of Western and Chinese medicine. Because there are so many of these patients!

What you need to do is have lots of fruit and vegetables and prepare them very simply. I like wandering around the local street markets to see what is in season. Unfortunately I live in student accommodation without a kitchen, so am reliant on the university dining halls and local restaurants for food. Eating healthily has been my biggest challenge so far during these past six weeks since starting my hospital placement.

One of our favourite treats now is to go hotpot (or steamboat) restaurants. You sit down on a table with a small stove in the middle. A big pot goes on that, filled with broth. You order plates of vegetables, mushrooms, tofu (and meat if you like), which are placed in the pot until they are cooked. You fish these out and eat them with a sauce that you create from a selection of sauces, herbs and other ingredients. It's a beautiful meal, with no sign of oil anywhere! 

After neurology, we moved on to the dermatology clinics of Dr Wang He Ping and Dr Wang Jun Zhi. Mostly we observed cases of eczema, psoriasis, uticaria (nettle rash), acne and shingles. With skin conditions, herbs reign supreme. The doctors prescribe herbs that patients drink, apply on skin, or wash their skin with. Because the study of herbs is done as a post-graduate course in the UK (unlike in China, where students learn herbs and acupuncture together), I find myself a bit lost in dermatology, although it is still very useful to review the Chinese medicine patterns for these skin conditions.

Take psoriasis. In Western medicine, the cause of psoriasis is unknown, although it is believed to be a hereditary skin condition, triggered by infection and mental factors. In Chinese medicine, one of the causes of psoriasis is pathogenic Wind which incubates in the body. This transforms into Heat, and Wind and Heat struggle in the skin, resulting in the scaly, itchy patches. A Chinese medicine practitioner might prescribe herbs to clear the Heat, resolve toxins, and expel Wind.   

However if there is a lot of Heat in the body that needs to be removed, the patient might have a blood cupping treatment, like the patient in the photo. Small punctures are made near an acupuncture point, then a glass cup which has been heated with fire is placed over the point. Because the heat creates a vacuum, the cup sticks to the skin and is left there for around 10 minutes, at which time the vacuum draws out blood. It might not be a pretty sight but it is a very effective way of removing Heat from the body.