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Fw: Paradigms of evidence

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, " Alon Marcus "

<alonmarcus@w...> wrote:

> 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.

 

Actually I do see a difference. I have never heard of anyone

excluding a CM pattern b/c of not having a specific sign like

floating pulse. Furthermore, I have never heard of CM being able to

dx with one sign or symptom exclusively (at least in mainstream CM) -

It is always about relationships... This is significantly different

than diagnosing hypothyroid no matter what the presentation is… and

WM may also look at physical signs, but very rarely will physical

signs override the lab tests (if ever) – I think only in situation

where there is not yet a lab test does WM base dx on s/s (i.e.

Fibromyalgia) – But in this case we have a dx that is almost

completely meaningless…

 

>> 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.

 

To a certain extent. The good MD's are more refined. But MD's (all

the time) order massive amounts of tests and just see what comes back…

 

 

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I would agree with your sentiments, Todd.

 

 

On Sunday, August 3, 2003, at 09:12 AM, wrote:

 

> , " 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.

>

.

>

>

>

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I think both of you are correct. I think Todd is making specific

points to measure differences between CM and WM, and as you point out,

those differences are not so clear cut. . . .except in treatment

modalities. The end result of pattern differentiation is a

multi-ingredient herbal prescription or combination of acupuncture

points, whereas the end result of most WM diagnostics is a single drug.

 

It is interesting to me that the Shang Han Lun spends a great deal of

time discussing transmuted patterns and side effects of wrong

treatment, such as precipitation (purgation). Today, lazy or poor

treatment by a CM practitioner usually has few side effects, just no

effect at all on the condition. Whereas lazy or poor WM treatment

often leads to toxic reactions. I often see this 'one size fits all'

mentality in Chinese medicine practitioners with such things as zhong

gan ling and yin qiao san. While it rarely damages patients, it is

more of a nostrum mentality than actual treatment of the particular

condition.

 

 

On Sunday, August 3, 2003, at 10:33 AM, Alon Marcus 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. 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

>

<image.tiff>

>

>

> Chinese 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.

>

>

>

>

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Furthermore, I have never heard of CM being able to dx with one sign or symptom exclusively (at least in mainstream CM) - It is always about relationships... This is significantly different than diagnosing hypothyroid no matter what the presentation is… and WM may also look at physical signs, but very rarely will physical signs override the lab tests (if ever) – I think only in situation where there is not yet a lab test does WM base dx on s/s (i.e. Fibromyalgia) – But in this case we have a dx that is almost completely meaningless…>>>>>>>Not true. Surgery for example is done all the time based on pattern diagnosis and physical signs even when lab tests are negative or oven suggest the contrarily. Drugs are given empirically on the bases of personal physician experience all the time. For example, appendixes are taken out all the time in patient with normal CBCs. The list is very long. If you get a lab that suggests a pathology you often need to conceder is it primary or not. There are many levels of detective work (i.e. patterns) that a good internists needs to do based on physical signs and symptoms.

 

Because CM does not have true objective signs that is we do not have overwhelming signs determining diseases. We still see many CM practitioner put overwhelming weight on a certain signs such as pulse diagnosis. There is much oversimplification done when comparing CM and WM in both directions.

Alon

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, " Alon Marcus "

<alonmarcus@w...> wrote:

 

> >>>>>>>Not true. Surgery for example is done all the time based on

pattern diagnosis and physical signs even when lab tests are negative

or oven suggest the contrarily. Drugs are given empirically on the

bases of personal physician experience all the time.

 

I guess my above was unclear, I was realy just referring to

diagnosis.. Sure treatments are given all the time for reasons that

are unclear, but you have to admit that a great majority (prob 95%+)

of western diseases are defined by some value or defined lesion. IT

seems there are only a handful of diseases otherwise, like 'sydromes'

that do not. I can't think of one disease that I have seen in the

last 3 months that doesn't have a specific test or cause that defines

it.

 

 

>ALON> For example, appendixes are taken out all the time in patient

with normal CBCs. The list is very long. If you get a lab that

suggests a pathology you often need to conceder is it primary or not.

 

Considering something as primiary or not still does not change the

fact that the patient has it, is that correct? It seems that in the

majority of diseases, if you get the value you get the disease...

That is why I see people all the time that have 5+ diseases... these

are not patterns from WM, but different values that have shown up...

 

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I was realy just referring to diagnosis..

>>>>>No what i am saying is that while for example a high CBC is needed for an epi many patients will have normal CBCs and surgery called for just on clinical bases. This is true on many conditions.

Alon

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It seems that in the majority of diseases, if you get the value you get the disease... That is why I see people all the time that have 5+ diseases... these are not patterns from WM, but different values that have shown up

>>>>A disease is a pattern is WM. Sometimes diseases are known to effect different systems and than you have a primary and secondary diseases/patterns.

Now to think that CM finds A pattern for all the diseases a patient might have is not correct. We often see differing patterns depending on what is considered the "disease" name. Sometimes we cab create a nice theoretical thread and thus define one as primary and others as secondary and tertiary. Now some like to call this multiple patterns, others say it is multiple pattern related to different symptoms or diseases.

Alon

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Emmanuel wrote:

It's my opinion that we have a profoundly powerful technology and a remarkably weak system of checks and balances on it.

 

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

 

Alon,

 

I'm not sure that CM can help Western science out of it's own ditch so to speak except by inspiration. If balance and synchronicity are your first guiding principles, then perhaps you will not "intrude" upon the genome of others, as my genetic engineering cousin would say. CM did not get itself into the unmitigated mess Western science and it's technologies have accomplished. Powerful tools can make powerful messes. As computer science friends might say, it takes a computer to make a really big mistake. So I'm suggesting that we get "inspired". I'm suggesting we could use a little guidance. At least in my teaching I find myself getting inspired to look at new things based on some guidance on things I'm attempting to learn about in CM. This isn't an answer, but rather a more directed line of questioning.

 

Emmanuel Segmen

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