Fw: Paradigms of evidence

[Guest guest]

And again, Attilio. I hope you will forgive this intrusion on TCM.

 

Emmanuel Segmen

- Emmanuel Segmen

Thursday, July 24, 2003 10:12 PM

Re: Paradigms of evidence

 

Dear Esteemed Colleagues,

 

I hope you'll take up this discussion where I left it with Alon. I kind of hope you all figure out what a research paradigm is, and what a dominant paradigm is. I hope you see that proving something in paradigm #1 about paradigm #2 makes paradigm #2 a lesser part of paradigm #1. If this is not quite getting across to you, take a moment review my post to Alon. If you're still not there, try reading Thomas Kuhn's Structures of Scientific Revolution. Consider that really winning any argument is proving the other guy right. If you can prove the other guy is right, then your reality contains his reality.

 

I'm not skittish at all of people ganging up on me regarding this point. I'll take the heat. But like a really good medical student or practitioner, please comment or ask a question after you've researched it a bit. Okie dokie? This is about the real future of CM. Michael McGuffin warned us at AHPA meetings that the FDA was going to come up with a standard practice model for CM. It's on their agenda and may take several years to put together. Check with him about it. If some academic or professional network puts together a written paradigm, the FDA may adopt it in part or in whole. If you make the CM paradigm based on Western science principles, my sons will not have what I have in 2003 regarding CM treatment in the U.S. Small actions taken over time have profoundly big consequences. Watch your back.

 

Emmanuel SegmenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Attilio, I'm continuing the thread backwards in time - from two days ago.

 

Emmanuel Segmen

- Emmanuel Segmen

Thursday, July 24, 2003 9:37 PM

Re: Paradigms of evidence

 

Emmanuel wrote: Thus, I would reject double blind studies with CM treatment principles regarding WM disease states since CM is not working with molecular mechanisms in the patient nor in the treatment model

 

Alon wrote: >>>Why then we see treatment of western diseases with Chinese medicine all over the literature? I totally reject your statement above. What we need is to have studies that allow CM all the freedom it needs within it own paradigm but at the same time, if it can not change the course of biomedical defined disease than CM will have no future. If I cant see blood glucose drop I do not care how you frame the treatment of diabetes in CM

 

Hi Alon. I kind of thought this would get your attention. ;-) I've really wanted to discuss this with you since we've been agreeing about stuff of late.

 

No, I would not want to limit your knowledge of WM or CM nor your practice of each nor your chance to integrate the two. In fact you and I have come to a number of agreements regarding this point. I like that you have some very clear knowledge about what's real in WM and Western science. You've made some profoundly insightful points in the past that caught my attention. I think I acknowledged that regarding you post today, right? It gave me a chance to segue into how paradigms communicate and how they don't communicate.

 

It's great that you have your knowledge and your practice. Beware of being true to your own statement from earlier today. Figure out what is "evidence" within a given paradigm. I most heartily agree with you that WM has an enormous amount of "bad science" because people want to practice clinically as they always have and were trained to do and refuse to accept epidemiological studies. You made an excellent point about that today.

 

However, if you prove with double blind studies that certain herbs formulated together cure or successfully treat a WM disease state, you've said nothing about CM and everything about WM. Hey, it works, right? Your technique for proof would be the Western scientific paradigm and your proof itself would be about a WM disease state. Thus, you would be practicing WM and introducing a CM herbal formula into it. That seems to be a fairly common practice among practitioners on list. They are not practicing CM. They are practicing WM using CM tools. No flies on you if you get the results that you are seeking. Think about which paradigm you are contributing to if you present your study. WM practitioners may nod their heads and agree, by golly he did it. I used to win many of my judo matches with standard college wrestling techniques. Hey, I won. Right? Did I advance with regard to judo? No. I just proved that people who practice judo at the student level are vulnerable to college wrestling techniques. My judo master still swept the floor with me as easily as before. I think it's clear to you that you are doing WM with CM tools. I don't think you mind as long as you are serving your patients. I don't think your patients mind as long as they are getting well. It's all good, right?

 

If, however, you want to advance one paradigm or the other, you need to find evidence based tests within the context of that paradigm. Read my post again. I definitely reject double blind studies with CM treatment principles regarding WM disease states as advancing anything in particular. Some pharmacologist or biochemist will come along and characterize the molecules that she or he can find in the herbal formula and make a WM drug. So statins are really CM based on Merck's research at UCLA, right? Wrong. It's WM research. Yes, it works. Yes, CM thought of it first ... way first ... like centuries first. But the whole nature of what Merck did was not CM, it was WM. So the results are WM.

 

Here's the real take home lesson, Alon, that I'm trying to comment on. When Merck did this research, did WM communicate with CM at all? The answer is no. Not at all. Can you, Alon, nevertheless use this information and get positive results in treating your patients? Yes. I just suggest to you to keep a wary eye that this sort of thing does not advance CM. Unless I'm mistaken, you are credentialed as an L.Ac. That is the correct credential in this country for practicing CM. You can embrace WM all you want, but I suspect your fortune lies with the advancement of CM. Are you following my drift here, Alon? This is actually more than just a philosophical issue. It's an issue of identity and credibility. Please read Thomas Kuhn's book. It's thin, it's in English, it costs $9.60, and you've got one of the quickest minds around. I also sense you are nobody's fool. Am I right? So figure out what is the dominant paradigm. Figure out the paradigm of your credential. Where is your future and your fortune? Is it time to become a PA or an MSN? Is it time to embrace CM and figure out how to do evidence based studies from the perspective of CM? Or if you don't do the research, is it time to figure out when research supports CM? How does this differ from research that takes the tools of CM to prove a point in WM? Hey, I'm a Western scientist. I'm just calling out in a friendly way across the Gulf of CM/Western science to say that I've got plenty of friends in Western science here in the U.S. of A. I'd really kind of like to see CM flourish as well. So I'm hoping since you've got some training in CM that you'll consider helping it flourish. I keep seeing CM people bow to paradigm proofs of Western science.

 

Anyway, please read Thomas Kuhn and get back to me on this. I have a sense we might make some headway in our discussion of this point. It's not about your freedom to practice what you want today. It may be about your freedom to do so in 10 years. It's mainly about your future credibility and the credibility of CM as it grows up in the U.S.

 

Emmanuel Segmen

[Guest guest]

Dear Alon,

 

I've carefully read your current posts. I'm noting another area of agreement between us though we occupy sometimes opposite sides of the same coin. It is nevertheless, the same coin. One of us is the yin while the other is the yang ... or some equivalent therein.

 

You write: I therefore believe that the incorporation of some of the scientific method is NEEDED to advance CM beyond its limitations.

 

This is actually not different from my contention that CM will cause Western scientific research to make important advances ... if WM is willing to be guided.

 

Your comment and my comment are actually representative of the same interaction. One is the left handed chirality ... the other is the right handed chirality.

 

All of your other comments I shall let stand as the appropriate counterpoint to my remarks. Thank you for the interaction.

 

In gratitude,

Emmanuel Segmen

 

 

 

[Guest guest]

You write: I therefore believe that the incorporation of some of the scientific method is NEEDED to advance CM beyond its limitations.

 

This is actually not different from my contention that CM will cause Western scientific research to make important advances ... if WM is willing to be guided.

 

Your comment and my comment are actually representative of the same interaction. One is the left handed chirality ... the other is the right handed chirality.

 

All of your other comments I shall let stand as the appropriate counterpoint to my remarks. Thank you for the interaction.

>>>>>

I agree. There is much to learn from both methods

Alon

[Guest guest]

, Emmanuel wrote:

> I therefore believe that the incorporation of some of the

scientific method is NEEDED to advance CM beyond its limitations.>>>

 

 

Emmanuel:

 

I think your comment will become an increasingly important point. A

number of aspects pertaining to treatment with CM must change in

light of WM. Where SHL gave rise to WB; now WB will have to give

rise to something new. CM will have to adapt to seriously be

considered more than palliative in some areas. It's probably one of

those historical inevitabilities.

 

 

Jim Ramholz

[Guest guest]

Jim,

 

It's probably one of

> those historical inevitabilities.

>

>

> Jim Ramholz

 

The judgments of history are really only

well suited to an historical perspective.

We cannot really be archaeologists of what

we ate at breakfast.

 

Trying to judge what we do today in light

of its historical implications is an inherently

dangerous thing to do. It may be that western

science proves necessary to the acculturation

of Chinese medicine to areas outside of China...

 

....or something entirely counter intuitive

may take place. Generally speaking, I'd

say most of what we predict never comes to

pass and this begins with tomorrow's weather

and certainly extends to the future of complicated

phenomena like Chinese medicine.

 

In no way shape or form do I mean to dismiss

the historian's art and its enormous applicability

to the study of Chinese medicine. To the contrary,

I believe such a study is imperative. But it

only pertains to the past and not to speculation

of what the future may look like when viewed from

an historical perspective.

 

The lessons of history are relatively clear,

when we simply look directly at them.

 

If we learn from them, we can hopefully do

just what you suggest we ought to be doing,

i.e., adapting the received database to

the contemporary conditions.

 

But note that the operant phrase is

" received database " . First we have

to adequately receive it. And in order

to do that we must, as a group, come to

terms with what it means to receive the

database of traditional Chinese medicine.

 

That's the whole point of what I've

been calling, not without an ironic

grin, a grassroots revolution in the

study of traditional Chinese medicine

in the West. If, indeed, as you suggest,

Western science has to be incorporated

and integrated into Chinese medicine,

then our primary responsibility as those

who bear the standards of the subject

in the West is to ensure that what there

is to integrate with is, itself integral

and congruent with the subject that has

preceeded it.

 

And if you turn out to be wrong in this

prediction, at least if we concentrate

on shoring up the foundations of the subject

we will have something that can have

a history when the future rolls around.

 

Ken

[Guest guest]

, " kenrose2008 " wrote:

It may be that western science proves necessary to the acculturation

of Chinese medicine to areas outside of China... >>>

 

 

That certainly seems to be the case outside China. But the influence

of science in China itself seems dominant if the SARS epidemic is

any example; as well as the scrambling by traditional practitioners

in China to adapt to the introduction of Western medical science (as

described by Volker Scheid).

 

While we can't be the archeologists of our breakfast, it is now way

past dinner.

 

 

Jim Ramholz

[Guest guest]

Jim,

 

 

> It may be that western science proves necessary to the

acculturation

> of Chinese medicine to areas outside of China... >>>

 

 

>

>

> That certainly seems to be the case outside China.

 

Yeah, well, that wasn't my point. And I

don't really appreciate your having taken

my remark out of context to make it appear

as if we are agreeing on this.

 

We're not. What I was saying is that your

attempt to prophesize is as questionable

as anybody else's. Moreover, the whole

attempt to justify one's position by

referring to future outcomes is a dangerous

road to travel. It leads to blindness.

 

But the influence

> of science in China itself seems dominant if the SARS epidemic is

> any example;

 

There is no question that the country was

caught up in a wave of sloganeering that

focused largely on " science " in direct

response to SARS.

 

But you should be aware that there are

many (I have no head count, but many

in China always means thousands, at least,

and probably tens of thousands in this

case) practitioners, students, patients,

and other enthusiasts who support traditional

Chinese medicine as an integral subject that

deserves respect and recognition as just that.

Nor does this suggest that such people

reject the appeal of modern science.

There are those types, I have met them.

But the point I'm making is that there

are all types here, and it is not proper

to try and lump such large numbers of

people and views into a single category.

 

Please let's avoid the unfortunate tendency

to talk about 1.3 billion people as if they

were all one.

 

as well as the scrambling by traditional practitioners

> in China to adapt to the introduction of Western medical science

(as

> described by Volker Scheid).

 

I am not familiar with the description to which

you refer, but once again your generality (even

if you want to attribute it to someone else)

is extremely dissatisfying to anyone who has

seen the scene here in China in any depth

whatsoever. It's just not so monolithic as

you make it out to be. And I have to imagine

that Volker does not represent it to be so

either. But like I say, I don't know on this

last point.

 

Look at Jason Robertson's recent posts.

Dr. Wang Ju Yi may be a leading example

of a trend in traditional Chinese medicine

on the mainland, but he is in no slightest

way unique. There are lots and lots of

doctors and students and patients here

who are very concerned about the integrity

of traditional medicine and are working

hard...and quite effectively to sustain

it.

 

Once again, what you are doing is engaging

in a distortion of data in order to support

your forgone conclusion, just as when you

snip a sentence from my post and make it

look like I was agreeing with you.

 

I am most certainly not.

 

I disagree strongly with what you are saying

and with the way in which you are going

about saying it.

 

This is a relatively easy point to " prove " .

 

Any time you want to, come to China.

I will personally escort you to so many

doctors, clinics, students, and even

government administrators who are

not only concerned but working extremely

diligently to preserve and maintain the

integrity of traditional Chinese medicine

here that your feet will ache.

 

 

>

> While we can't be the archeologists of our breakfast, it is now

way

> past dinner.

 

I guess that depends on whose watch you're

looking at.

 

By comparison to the Chinese record,

the whole experience of the last couple

hundred years in the West is, well, just

a few ticks of the big hand.

 

Ken

[Guest guest]

, " kenrose2008 " wrote:

What I was saying is that your attempt to prophesize is as

questionable as anybody else's. Moreover, the whole attempt to

justify one's position by referring to future outcomes is a dangerous

road to travel. >>>

 

Perhaps, then, we should call it an expectation.

 

 

 

Jim Ramholz

[Guest guest]

Jim,

 

Point of order, and point of information. Those words attributed to me are ' words I believe. My comments are in counterpoint to that. I represent the view that Western science would do well to be guided CM. Not that CM would do well to be guided by Western science. That latter is inevitable. The former would be an act of enlightenment in my humble opinion. My perspective is like viewing a family situation. The great grandparents can not use the high tech equipment that all of the great grandchildren are playing with. Yet it would be an act of family functionality if the great grandchildren respected the ancestors enough to be guided by the long held traditions and mores of their elders while exploring their new technologies.

 

I am a Western scientist who views the entirety of his tradition as existing pretty much in a single lifetime. The bibliography of my 1992 thesis reached back in time to the most classic and original paper in my molecular biology paradigm. That paper was published in 1978. Prior to 1978, no one could have framed the question that I was working on. That's how fast Western science is growing and why I believe it desperately needs guidance. The very existence of Western science as we currently know it did not exist whatsoever when I was already 30 years old, and my first son was three years old. Will this current iteration of what we call Western science even exist for my son's son? Will you subject a 3,000 year old science to the rigors of this flash-in-the-pan only to find you have to fully revise your approach in 10 or 20 years?

 

In two decades on some future list wherein we speak in holographic virtual community conversations, we may look at this insistence on using 2003's Western science tools to look at and verify CM and sigh, "Wow, I'm glad we're past that now."

 

Emmanuel Segmen

 

 

-

James Ramholz

Thursday, July 31, 2003 11:15 PM

Re: Fw: Paradigms of evidence

, Emmanuel wrote:> I therefore believe that the incorporation of some of the scientific method is NEEDED to advance CM beyond its limitations.>>>Emmanuel:I think your comment will become an increasingly important point. A number of aspects pertaining to treatment with CM must change in light of WM. Where SHL gave rise to WB; now WB will have to give rise to something new. CM will have to adapt to seriously be considered more than palliative in some areas. It's probably one of those historical inevitabilities.Jim RamholzChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

James Ramholz

Friday, August 01, 2003 10:54 AM

Re: Fw: Paradigms of evidence

 

, "kenrose2008" wrote:It may be that western science proves necessary to the acculturation of Chinese medicine to areas outside of China... >>>

 

Jim,

 

Fairly major POINT OF ORDER here. I'm noting that you are posting to CHA that both Ken and I believe or have written such statements as the above. What's up with this? Why are you doing this? These are not our words. Please respond.

 

Emmanuel Segmen

[Guest guest]

, " Emmanuel Segmen " wrote:

I'm noting that you are posting to CHA that both Ken and I believe

or have written such statements as the above. >>>

 

 

Emmanuel:

 

My apologies if I lost track of this thread and misquoted either of

you.

 

People should reread your posts to get it correct.

 

 

Jim Ramholz

[Guest guest]

That's how fast Western science is growing and why I believe it desperately needs guidance. Why do you think it needs guidance? I would think new discoveries is all the guidance that is needed. Of course as long as the mind is open, and the system allows for all ideas to be looked at and tested

Alon

[Guest guest]

, " Emmanuel Segmen " <

susegmen@i...> wrote:

 

> In two decades on some future list wherein we speak in holographic

virtual community conversations, we may look at this insistence on using

2003's Western science tools to look at and verify CM and sigh, " Wow, I'm glad

we're past that now. "

 

paradigms only shift when the " normal science " of any era can no longer

entirely explain the phenomena it attempts to describe. While I believe this to

be the case already, that has hardly been proven. And only by proving that

western science can observe but not explain TCM related phenomena will the

paradigm shift. Right now there is hardly a preponderance of evidence to

suggest this tot he average scientist. So first we push the boundaries of

western science. But again, I do not envision there ever being a dominant

paradigm centered around yinyang and five phases as decscribed in the

chinese classics. I do think a careful exploration of those concepts could be a

transforming force on western science leading to a new hegelian synthesis that

incorporates the existing data and methodologies of both worldviews into a

new structure that includes but transcends the old ones. But I think the

language that will be used will be that of complexity theory, information and

systems sciences.

 

[Guest guest]

That's how fast Western science is growing and why I believe it desperately needs guidance. Why do you think it needs guidance? I would think new discoveries is all the guidance that is needed. Of course as long as the mind is open, and the system allows for all ideas to be looked at and tested

 

Alon

 

Alon,

 

Thanks for asking. I've not met anyone or any system that doesn't need guidance. It's my opinion that our technologies currently proceed largely without adult supervision. That's my opinion from my training in Western science. It's my opinion that we have a profoundly powerful technology and a remarkably weak system of checks and balances on it. I do not view our ethical maturity at this time to be a match for our technological might. This was noted over and over again in my graduate training in genetic engineering. The Asilomar conference in the 1970s was an attempt on the part of geneticists for scientific ethics to catch up with science's technological might. It's my opinion that we have not succeeded and that the mismatch between a body of ethics and our technological base is profound .... greatly out of balance. I personally believe Western science needs all the guidance it can get from the arts, philosophy, the ethics of current and historical cultures and so on. This is my view.

 

Emmanuel Segmen

[Guest guest]

, "Emmanuel Segmen" wrote:I'm noting that you are posting to CHA that both Ken and I believe or have written such statements as the above. >>>Emmanuel:My apologies if I lost track of this thread and misquoted either of you. People should reread your posts to get it correct.Jim Ramholz

 

Jim,

 

Apology accepted. Thank you. I sense that by now most people who read CHA regularly know our positions. Thus, it was shocking to me to see our positions represented in their counterpoint. Since I'm taking this time to accept your apology, I'll also extend my thanks for seeing what's it's like to represent the opposite opinion.

 

Thank you,

 

Emmanuel Segmen

 

[Guest guest]

>>>I think you right about this, but how CM help with this?

 

worldly phenomena

Marco

 

[Guest guest]

It's my opinion that we have a profoundly powerful technology and a remarkably weak system of checks and balances on it. >>>I think you right about this, but how CM help with this?

Alon

[Guest guest]

Emmanuel wrote: That's how fast Western science is growing and why I believe it desperately needs guidance. Alon wrote: Why do you think it needs guidance? I would think new discoveries is all the guidance that is needed. Of course as long as the mind is open, and the system allows for all ideas to be looked at and tested

 

 

Alon,

 

Thanks for asking. I've not met anyone or any system that doesn't need guidance. It's my opinion that our technologies currently proceed largely without adult supervision. That's my opinion from my training in Western science. It's my opinion that we have a profoundly powerful technology and a remarkably weak system of checks and balances on it. I do not view our ethical maturity at this time to be a match for our technological might. This was noted over and over again in my graduate training in genetic engineering. The Asilomar conference in the 1970s was an attempt on the part of geneticists for scientific ethics to catch up with science's technological might. It's my opinion that we have not succeeded and that the mismatch between a body of ethics and our technological base is profound .... greatly out of balance. I personally believe Western science needs all the guidance it can get from the arts, philosophy, the ethics of current and historical cultures and so on. This is my view.

 

Emmanuel Segmen

[Guest guest]

, " " <@i...>

wrote:

But again, I do not envision there ever being a dominant

> paradigm centered around yinyang and five phases as decscribed in

the

> chinese classics. I do think a careful exploration of those

concepts could be a

> transforming force on western science leading to a new hegelian

synthesis that

> incorporates the existing data and methodologies of both worldviews

into a

> new structure that includes but transcends the old ones. But I

think the

> language that will be used will be that of complexity theory,

information and

> systems sciences.

>

 

 

As always I have problems with the use of the paradigm paradigm, but

that aside how do you think any incorporation will occur which

doesn't cash out in terms of biochemical or physiological mechanism?

Even if the overarching theories are of complexity etc.

 

And what is the methodology of CM as distinct from scientific

methodology? Where I am coming from on this latter is that when I

practice clinically I see myself as pursuing a scientific methodology

of assessing initial data, allowing for variables,isolating key

factors, trialing different imputs and assesing outcomes.

 

Simon

[Guest guest]

, " Simon King " <dallasking@b...>

wrote:

 

>

> And what is the methodology of CM as distinct from scientific

> methodology?

 

while both sytems have reductionistic and holistic aspects, I think CM

emphasizes systems relationships and the current clinical practice of WM

emphasizes isolated biochemical markers. On the other hand, modern

physiology is already quite holistic, but this has not affected medicine much

yet, largely I would assume due to the pressure from the pharmaceutical

industry, who still appear to have a vested interest in the magic bullet

approach.

.

[Guest guest]

>>>I think you right about this, but how CM help with this?

 

worldly phenomena

>>>>How does that guide the lack of checks and balances of science?

Alon

[Guest guest]

holistic aspects, I think CM emphasizes systems relationships and the current clinical practice of WM emphasizes isolated biochemical markers.

 

>>>>This is often more of a slogan than anything else. If one diagnoses a low thyroid function, then one looks at s/s affecting almost every system in the body. So just because the diagnosis is very specific it relates to the entire system. This can be said for many so called non holistic WM aspects. If one has a brain tumor the clinician evaluates systems and signs of the whole body before considering the possibility of a brain tumor. When a clinician evaluates for liver-qi stagnation he does not do any more than a WM practitioner that evaluates for a liver disorder. The only thing that is different is the grouping of symptoms and signs, using a different set of signs to "determine" were and what the problem is.

If a patient comes to a "good" MD complaining of fatigue or depression. A good workup will include may "systems" signs, physical examinations, lab exams, psychological and spiritual inquiries.

The fact that many MDs do not do this is not different than many CM practitioner giving yin qiao to almost all cold and flues, something that is common both here and in china. Bad medicine is bad medicine. As long as we demonize one system and romanticize another we are just the Indian blind men feeling the elephant

 

Alon

[Guest guest]

, " Alon Marcus "

<alonmarcus@w...> wrote:

> holistic aspects, I think CM

> emphasizes systems relationships and the current clinical practice

of WM

> emphasizes isolated biochemical markers.

>

> >>>>This is often more of a slogan than anything else. If one

diagnoses a low thyroid function, then one looks at s/s affecting

almost every system in the body. So just because the diagnosis is

very specific it relates to the entire system.

 

I agree with most everything you say except 1 thing... How many

M.D.'s dx hypothyroid without having a specific marker? To them the

s/s do not matter, it is the marker. They may use the s/s to come

up with the idea to test the thyroid, but w/o the finding they will

not dx it. (I am not saying this is bad, but just indicative of the

system)... SO the thyroid may have an effect on many parts of the

body, but in reality the s/s do not matter what so ever, if the MD

sees it they dx it (the marker). I.e. I saw recently a patient dxed

w/ 'hypothyroid'. She has nothing but heat signs, overactivity etc

(nothing resembling hypot) although western science will still dx the

hypo... So it is the process of the Dx that differs so much, which

gives CM a distinct difference compared to WM.

 

-

[Guest guest]

I agree with most everything you say except 1 thing... How many M.D.'s dx hypothyroid without having a specific marker? To them the s/s do not matter, it is the marker. They may use the s/s to come up with the idea to test the thyroid, but w/o the finding they will not dx it.

>>>>How is this different than saying if you do not have a flowing pulse than you do not have a superficial syndrome or something like that. MW uses its own pattern diagnosis and it looks for both physical signs and lab data. I agree with you that the art of diagnosis is slowly getting lost in favor of laboratory diagnosis. At the same time, in order to know what lab to order the MD still must practice pattern/differential diagnosis.

 

'hypothyroid'. She has nothing but heat signs, overactivity etc (nothing resembling hypot....So it is the process of the Dx that differs so much, which gives CM a distinct difference compared to WM

 

>>>>Pattern diagnosis leads the MD to check the thyroid, this then lead to his diagnosis. The fact that the patient had a kind of false-heat or whatever you want to call it does not change anything within the process. The treatment with thyroid may still reduce these symptoms or they may be unrelated and further pattern diagnosis will be needed.

The nice thing in CM is that one does not need a western (therefore known) etiology to treat a patient. That to me is the biggest strength (and weakness) of CM. It is a weakness because the lack of "anatomical/ pathological" based diagnosis often does not allow one to truly have a good idea of prognosis.

 

Alon