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RE: 5-10 patterns? Pi Wei Lun?

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Well said Ken.. Further comments.. (As a (life-long) student and a

'very-active observer')....

 

Bob wrote:

 

Once one has identified the various patterns a patient is presenting, one

next states the treatment principles that logically rememdy each of those

patterns. These principles should be stated in the order of severity or

predominance of each pattern. The standard words of these treatment

principles are the same words that are used for the chapter titles in our

materia medicas (at least in Chinese) and our formulas and prescriptions

(fang ji xue) books. Therefore, one simply picks appropriate medicinals for

each of the stated treatment principles. By appropriate, I mean meds which

do the required functions AND are empirically know to address the patient's

personal symptoms and complaints. Voila. Easy as pie.

 

Are you saying that you pick herbs for all 5-10 patterns that you see? My

current supervisor says the body gets confused when you try to do too much,

that is why she always picks the main problem (usually root) and treats this

and if done properly other problems disappear... Usually 1 simple Dx. Where

does this concept come from, treating 5-10 patterns... I have read Pi Wei

Lun, and personally I don't see this 5-10 pattern complex idea

demonstrated... can someone please give some specific examples on how this

is demonstrated in classics. Without specific examples of how you actually

use this in practice, which would be nice, I can only hypothesize on exactly

what one means by this. It seems that our modern differentiations, are based

on past doctors differentiations, and they do not always exactly lineup with

the patient. When this happens we seem to start grasping at extra symptoms

and adding extra patterns. I.e. we see SOB and palpitations istead of

exception that it is a by-product of the main pattern, we many times start

adding in Lung or Heart (upper burner) pattersn and then start to treat

this. My previous example of the sp qi xu, lv qi shi, xue xu, ht xue xu,

with kid xu, and dampness, was a by-product of this thinking... classics

still have all these issues but they focus in on the root (this is what I

have percieved so far...

 

As far as dampness only being related to aristocratics, I might have to

question this idea. In the PI Wei Lun , Li Dong-yuan mentions the

environment as creating many damp conditions.

Also are people saying damp diseases are most complex?

Why do people believe that Americans are more complex, what about Mexicans,

what about people with serious deficiencies getting life threatening

diseases/ plagues. Do Chinese belief this.?. Also why do people who have

very healthy diet and lifestyles come down with these supposed complex

patterns. How is that our modern society is complex and past Chinese are

not? Yet we are using those formulas to treat our modern society?

 

 

 

I also would like to question the worshipping of the Pi wei Lun in this

country (on the back of mine it says it is one of the most important books

and a history of Chinese medicine. " ) Is this true? It is my understanding

that a visible only one of 8 (possibly 10) books that a Li Dong-Yuan wrote.

And it is not even his main text it is a supplementary text. And supposedly

his theories (specifically yin fire) are highly controversial and are not

even included in mainstream Chinese theory. " One of my teachers says it is

just a fringe theory that is controversial and one can see how he just

renamed other classical theories. " (Professor from Nanjing) Is this true?

I do not know.

 

As For Easy...

Easy. This is very perplexing.. Especially here in the west... Everything

here is made easy right? Especially our TCM schools and I hear this

everyday, " why should I read anything extra, why should I memorize these

formulas, it will not help be a better practitioner " ... Woooo.. is it that

easy if we just believe in something it is easy to 'cure' people. TCM is a

very intellectually grueling process, My Chinese teachers constantly remind

of this..My Jin Gui teacher had to memorize all major classics, Jin Gui,

Shang Han Lun, Nei Jing etc... IS this pointless? Something has made this

man a great scholar, teacher, and practitioner. My current herb's teacher

has us memorize everything, period (pin yin , ingredients, dose, ci, source

text, fx, etc, etc,.. people whine and whine.. ) I asked how it was when she

went to school.. her reply was that it was medical school.. every class she

had was like that (memorizing everything)... It is grueling... But well

worth it, Mastery in anything IS NOT EASY and I would say anyone who is

selling this idea, be leery of (i.e. learn everything in a weekend)...

Religion?

 

Let us not forget that this is energy medicine and it is Magical... complex

or simple...

 

-Jason

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>Well said Ken.. Further comments.. (As a (life-long) student and a

>'very-active observer')....

>

>Bob wrote:

>

>Once one has identified the various patterns a patient is presenting, one

>next states the treatment principles that logically rememdy each of those

>patterns. These principles should be stated in the order of severity or

>predominance of each pattern. The standard words of these treatment

>principles are the same words that are used for the chapter titles in our

>materia medicas (at least in Chinese) and our formulas and prescriptions

>(fang ji xue) books. Therefore, one simply picks appropriate medicinals for

>each of the stated treatment principles. By appropriate, I mean meds which

>do the required functions AND are empirically know to address the patient's

>personal symptoms and complaints. Voila. Easy as pie.

>

>Are you saying that you pick herbs for all 5-10 patterns that you see? My

>current supervisor says the body gets confused when you try to do too much,

>that is why she always picks the main problem (usually root) and treats this

>and if done properly other problems disappear... Usually 1 simple Dx. Where

>does this concept come from, treating 5-10 patterns... I have read Pi Wei

>Lun, and personally I don't see this 5-10 pattern complex idea

>demonstrated... can someone please give some specific examples on how this

>is demonstrated in classics. Without specific examples of how you actually

>use this in practice, which would be nice, I can only hypothesize on exactly

>what one means by this.

 

Jason,

There are a few points here I'd like to make.

1) In five phase theory, we learn that when one phase or viscera is in

disharmony, it effects at least one or two other viscera, or all other

phases. For example, when the liver is replete, it will overact on the

spleen, causing spleen vacuity, and may 'insult' the lung/metal phase, also

causing vacuity, drain the mother phase (kidney/water). Illnesses do not

exist in isolation. . . .they always have an effect on the entire system,

so you have to treat the entire system. Otherwise, symptoms will reappear

in different form. This is called a bian zheng/transmuted pattern, where

you have complicated a formerly simple condition.

2) It is easy to SAY treat the root, hard in practice. . . .sometimes there

is a lot of branch symptomology. How do we know what the main problem is?

And if it is truly the root? Sometimes the root is not visible.

3) A typical female patient that I see may have a pattern such as sp qi xu

with damp, transforming to damp heat in the lower burner, which causes the

blood to stagnate. The damp heat weakens the kidney qi, interferes with

the free flow of liver qi, causing liver qi depression which further

weakens the spleen via the ke/control cycle.

 

What we are talking about is seeing health and disease as movement and

process, not a fixed, one-dimensional view. Both the Nan Jing in

acupuncture literature and Pi Wei Lun in internal medicine literature share

this view. And yes, Pi Wei Lun is one of several books by Li Dong-yuan.

But the others are not yet translated. . . ..so, this will do for now. For

me, with my background in macrobiotics and nutrition, and my observations

of damaged spleen in relatively affluent westerners (including Mexicans,

Jews, Blacks and everyone else I see), this teaching resonates with my

practice. Who knows what the 'teacher in Nanjing is thinking, and what his

reasons are? Is this a reason to dismiss such a vital teaching outright?

I, for one, am thankful for bu zhong yi qi tang. If it were the only

herbal prescription I had, I could still help most of my patients.

 

>

>As far as dampness only being related to aristocratics, I might have to

>question this idea. In the PI Wei Lun , Li Dong-yuan mentions the

>environment as creating many damp conditions.

>Also are people saying damp diseases are most complex?

>Why do people believe that Americans are more complex, what about Mexicans,

>what about people with serious deficiencies getting life threatening

>diseases/ plagues. Do Chinese belief this.?. Also why do people who have

>very healthy diet and lifestyles come down with these supposed complex

>patterns. How is that our modern society is complex and past Chinese are

>not? Yet we are using those formulas to treat our modern society?

 

Spleen/stomach damage, i.e. post-natal qi is damaged by consuming more than

what is necessary for life in health. There have been periods in Chinese

history that have had high consumption levels as a result of affluence, as

well. As far as people with 'healthy lifestyles and diets' coming down

with complex diseases, you will have to explain further.

>

>

>

>I also would like to question the worshipping of the Pi wei Lun in this

>country (on the back of mine it says it is one of the most important books

>and a history of Chinese medicine. " ) Is this true? It is my understanding

>that a visible only one of 8 (possibly 10) books that a Li Dong-Yuan wrote.

>And it is not even his main text it is a supplementary text. And supposedly

>his theories (specifically yin fire) are highly controversial and are not

>even included in mainstream Chinese theory. " One of my teachers says it is

>just a fringe theory that is controversial and one can see how he just

>renamed other classical theories. " (Professor from Nanjing) Is this true?

>I do not know.

 

I am unaware of anyone who worships the Pi Wei Lun. Perhaps inspired would

be a better term It inspires me, certainly. But so does the Nei Jing, Nan

Jing, Shang Han Lun, and lots of other texts. I only worship the G-d of

Israel.

>

>As For Easy...

>Easy. This is very perplexing.. Especially here in the west... Everything

>here is made easy right? Especially our TCM schools and I hear this

>everyday, " why should I read anything extra, why should I memorize these

>formulas, it will not help be a better practitioner " ... Woooo.. is it that

>easy if we just believe in something it is easy to 'cure' people.

 

Bob and Ken have been trading posts on this topic, and I'll sit this one

out and watch with bated breath from the sidelines. . . . .

 

TCM is a

>very intellectually grueling process, My Chinese teachers constantly remind

>of this..My Jin Gui teacher had to memorize all major classics, Jin Gui,

>Shang Han Lun, Nei Jing etc... IS this pointless? Something has made this

>man a great scholar, teacher, and practitioner. My current herb's teacher

>has us memorize everything, period (pin yin , ingredients, dose, ci, source

>text, fx, etc, etc,.. people whine and whine.. ) I asked how it was when she

>went to school.. her reply was that it was medical school.. every class she

>had was like that (memorizing everything)... It is grueling... But well

>worth it, Mastery in anything IS NOT EASY and I would say anyone who is

>selling this idea, be leery of (i.e. learn everything in a weekend)...

 

I agree with your Jin Gui teacher, that reciting the classics would be a

great way to teach Chinese medicine. . . .if you want, I'd be glad to do it

with you. It appeals to me, because this is how the Talmud is studied as

well. . . .reciting a section, then debating it.

 

Many great teachers of Chinese medicine will choose a section of a

classical text, and build a lecture on it. Luke described how his teacher,

Sun Baek, taught the Nei Jing this way. I'm all for it.

 

 

I am not so sure, however, that memorizing everything in every prescription

in a class is such a great idea. Unless the student learns the PRINCIPLES,

character and qualities of each prescription as well. Just quantitative

knowledge, without understanding, will fade from memory. A gallon of

gingko leaf tea won't bring it back.

 

 

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Jason,

 

Just a general comment on the cyclical modernization of

Chinese medicine that has occurred repeatedly in China

over the past many centuries...

 

Well, that's the first comment, i.e. that those who wish

to study and apply Chinese medicine are constantly faced

with the challenge of bringing ancient ideas into harmony

with contemporary conditions. That was the problem facing

the authors of the Nei Jing. That was the problem facing

Hua Tuo, Zhang Zhong Jing, and others from the Han

forward.

 

We face the same challenge today. We now have the

benefit of the accumulated best efforts of centuries' of

scholars. We also have the benefit of modern scientific

methods and rigors.

 

Are you familiar with The Structure of Scientific Revolutions

by Thomas Kuhn? In it he describes in general terms

the kinds of issues that we find ourselves face to face with.

 

Ken

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