Guest guest Posted October 29, 2000 Report Share Posted October 29, 2000 I am curious... if a patient comes in with a set of symptoms (i.e. abdominal distention with constipation/ fullness) and then one prescribes lets say, hou po, da huang, & zhi shi? is this TCM? Or someone who had acute arthritis - has an acute attack (li jie) with paralysis of the extremities and pain in joints and is given fu zi, huang qi, ma huang, bai shao, zhi gan cao?? Or what about fan shi for cardiac beriberi? IS this TCM? - > > > Sunday, October 29, 2000 8:19 PM > > Re: PC-SPES > > > , <alonmarcus@w...> wrote: > The formulas did not make any sense at all. From what I saw they never > matched the tongue, they never made sense for the chief complain. No > body has any ide what he's doing. He had a great reputation. The > doctors I studied with said they tried, but could not, make any sense > after analyzing hundreds of formulas. > > Is this CM? > > alon > > If he looked at the pulse and tongue, he must have been doing some form > of bian zheng, even if you couldn't follow his logic. otherwise, why > bother? did he give the same rx to all patients with the same disease? > If not, he must have been making differential assessment of patients. > It may not be TCM, but its still bianzheng and I think that is what > Zev was referring to. > > > > > > 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. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2000 Report Share Posted October 29, 2000 on 10/29/00 10:00 PM, at wrote: > I am curious... if a patient comes in with a set of symptoms (i.e. abdominal > distention with constipation/ fullness) and then one prescribes lets say, > hou po, da huang, & zhi shi? is this TCM? This is pattern diagnosis, no? liu jing bian zheng/six channel pattern diagnosis. We would apply the Shang Han Lun criteria of yang ming bowel repletion, and then you could use those medicinals.. . . .although what you are describing is quite simplified. You would be more accurate if you felt for a sunken tense pulse, were more precise as to the abdominal diagnosis, and saw a yellow tongue coat. > Or someone who had acute arthritis - has an acute attack (li jie) with > paralysis of the extremities and pain in joints and is given fu zi, huang > qi, ma huang, bai shao, zhi gan cao?? This is more problematic. . . .without a more complete diagnosis, you run a risk in using such medicinals as fu zi. . .. if there are signs of repletion heat. > IS this TCM? If so, incomplete TCM. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2000 Report Share Posted October 30, 2000 Let me back track a bit...1) all 3 example are from a classic text - jin gui2) Zhang zhong jing does not give a pattern dx in the text for many syndromes (including the one's commented on)-3) Zhang zhong jing often only lists symptoms that describe the syndrome, and as in the examples below, he gives no tongue or pulse. Later commentators are the ones who label these syndromes according to patterns.4) Modern commentators differentiate them even further.5) Was Dr. Zhang practicing TCM when he didn't pattern differentiate and only gave herbs to address certain symptoms without naming a pattern?6) Is TCM only pattern dx? and if so, did TCM exist before pattern dx evolved?7)> Or someone who had acute arthritis - has an acute attack (li jie) with> paralysis of the extremities and pain in joints and is given fu zi, huang> qi, ma huang, bai shao, zhi gan cao??This is more problematic. . . .without a more complete diagnosis, you run arisk in using such medicinals as fu zi. . .. if there are signs of repletionheat.> IS this TCM?If so, incomplete TCM. I am curious, if Dr. Zhang only wrote what was above, is this incomplete TCM ? 8) This says to me that TCM is fluid changing evolving system. Just as Li Dong Yuan felt the need to look at medicine differently than Dr. Zhang, today we should be open to the next step.Example:Bai he syndrome :1) only symptoms are listed (i.e. wanting to eat, but reluctant to swallow food and unwilling to speak, or lies in bed yet cannot lie quietly due restlessness, want to walk about, but soon becomes tired, and a few others)2) rx given: bai he and the juice from sheng di3) no patterns are given by Dr. Zhang4) modern-day practitioners differentiate into 7 or so zang-fu patterns.->>> on 10/29/00 10:00 PM, at wrote:>> > I am curious... if a patient comes in with a set of symptoms> (i.e. abdominal> > distention with constipation/ fullness) and then one prescribes> lets say,> > hou po, da huang, & zhi shi? is this TCM?>> This is pattern diagnosis, no? liu jing bian zheng/six channel pattern> diagnosis. We would apply the Shang Han Lun criteria of yang ming bowel> repletion, and then you could use those medicinals.. . .> .although what you> are describing is quite simplified. You would be more accurate> if you felt> for a sunken tense pulse, were more precise as to the abdominal diagnosis,> and saw a yellow tongue coat.>>> > Or someone who had acute arthritis - has an acute attack (li jie) with> > paralysis of the extremities and pain in joints and is given fu> zi, huang> > qi, ma huang, bai shao, zhi gan cao??>> This is more problematic. . . .without a more complete diagnosis,> you run a> risk in using such medicinals as fu zi. . .. if there are signs> of repletion> heat.>>> > IS this TCM?>> If so, incomplete TCM.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2000 Report Share Posted October 30, 2000 on 10/30/00 2:04 PM, at wrote: Let me back track a bit... 1) all 3 example are from a classic text - jin gui 2) Zhang zhong jing does not give a pattern dx in the text for many syndromes (including the one's commented on)- 3) Zhang zhong jing often only lists symptoms that describe the syndrome, and as in the examples below, he gives no tongue or pulse. Later commentators are the ones who label these syndromes according to patterns. 4) Modern commentators differentiate them even further. 5) Was Dr. Zhang practicing TCM when he didn't pattern differentiate and only gave herbs to address certain symptoms without naming a pattern? 6) Is TCM only pattern dx? and if so, did TCM exist before pattern dx evolved? 7) > Or someone who had acute arthritis - has an acute attack (li jie) with > paralysis of the extremities and pain in joints and is given fu zi, huang > qi, ma huang, bai shao, zhi gan cao?? This is more problematic. . . .without a more complete diagnosis, you run a risk in using such medicinals as fu zi. . .. if there are signs of repletion heat. > IS this TCM? If so, incomplete TCM. I am curious, if Dr. Zhang only wrote what was above, is this incomplete TCM ? 8) This says to me that TCM is fluid changing evolving system. Just as Li Dong Yuan felt the need to look at medicine differently than Dr. Zhang, today we should be open to the next step. Jason, any system is as good as the principles it is based on. If the principles are correct, they can be applied in an infinite variety of ways. Different ways of expressing medicine will come. . . .it will take, however, mastery of the system itself. TO write a symphony, you need to master the art of playing piano, and learn the great masters' works. We need to master the classical system of diagnosis, treatment and prescriptions.. . .unless you want to play avant-garde jazz! As far as what is said in the Golden Cabinet, I am not going to comment further until: 1) I have the time to read it in the original Chinese (very slow, in my case) or 2) There is a decent, reliable translation to refer to. Otherwise, distortions and errors are sure to cloud one's understanding. I don't know if I trust what the English version you are using actually says what it says. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 on 10/30/00 2:04 PM, at wrote: Let me back track a bit... 1) all 3 example are from a classic text - jin gui 2) Zhang zhong jing does not give a pattern dx in the text for many syndromes (including the one's commented on)- 3) Zhang zhong jing often only lists symptoms that describe the syndrome, and as in the examples below, he gives no tongue or pulse. Later commentators are the ones who label these syndromes according to patterns. 4) Modern commentators differentiate them even further. 5) Was Dr. Zhang practicing TCM when he didn't pattern differentiate and only gave herbs to address certain symptoms without naming a pattern? 6) Is TCM only pattern dx? and if so, did TCM exist before pattern dx evolved? 7) > Or someone who had acute arthritis - has an acute attack (li jie) with > paralysis of the extremities and pain in joints and is given fu zi, huang > qi, ma huang, bai shao, zhi gan cao?? This is more problematic. . . .without a more complete diagnosis, you run a risk in using such medicinals as fu zi. . .. if there are signs of repletion heat. > IS this TCM? If so, incomplete TCM. I am curious, if Dr. Zhang only wrote what was above, is this incomplete TCM ? 8) This says to me that TCM is fluid changing evolving system. Just as Li Dong Yuan felt the need to look at medicine differently than Dr. Zhang, today we should be open to the next step. Example: Bai he syndrome : 1) only symptoms are listed (i.e. wanting to eat, but reluctant to swallow food and unwilling to speak, or lies in bed yet cannot lie quietly due restlessness, want to walk about, but soon becomes tired, and a few others) 2) rx given: bai he and the juice from sheng di 3) no patterns are given by Dr. Zhang 4) modern-day practitioners differentiate into 7 or so zang-fu patterns. - Jason, I already made some points in the last post that, for some reason, didn't click with you. I don't know what else to say. I don't want to comment too much on the Jin Gui material, because the only translations available (OHAI and New World Press) are not trustworthy. In the past, I have found problems commenting on poorly translated texts. I have an original Chinese copy, but I don't have the time to sit and translate and decipher right now, there is too much on my plate. I know you have studied this text with J. Min Fan, perhaps you could ask him. I would say that many classics are written in a short-hand style, and were commented on over centuries to fill in details, or even more significantly, that THE AUTHOR ASSUMED YOU KNEW THE DETAILS. There is also a sense of oral tradition, of clinical development of ideas in the text, and, certainly, historical 'filling in' of information that is implied or not listed, because of the short-hand style. The passage above on li jie, for example, is translated in the New World Press jin gui as 'acute paralysis'. That is a complete distortion of the meaning of the term, and leads you to the false conclusion that Dr. Zhang is giving you free reign to use these medicinals in any acute paralytic situation. This is totally false perception, beginning with wrong translation, where the author is trying to find a biomedical equivalent and failing, and followed by wrong interpretation. If you read the Wiseman dictionary, li jie is defined as 'joint running wind', defined as " a disease with redness and swelling of joints, with transformation of wind/cold/damp into heat in patients sufffering from liver/kidney (yin) vacuity " . You are looking at a bian bing/disease differentiation, requiring a preexisting knowledge of bi zheng /impediment patterns (painful obstruction),appropriate medicinals, and the pattern differentiation required to understand it. Right away, you are back in the realm of bian zheng, and must know it to know what medicinals and prescriptions to use. If you biomedicalize li jie into acute paralysis, a great deal of essential information is lost, and, yes, you may be seduced into thinking that Chinese medicine is merely treating at a symptomatic level. I would strongly suggest that you avoid this translation, as it will lead to grievous errors. As far as using Li Dong-yuan as the impetus for updating the tradition, be my guest. I certainly don't put myself at his level, the more I study, the more I realize my shortcomings in my knowledge. I am not arrogant enough to think I can I guess the next step, that I can 'update' the tradition without deepening my knowledge of the medicine itself. Our grasp of Chinese medicine is still very tenuous, Jason, and I find that most of our debating is based on incomplete and often inaccurate understanding of the source material itself. The li jie detail above is just one example. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 As far as using Li Dong-yuan as the impetus for updating the tradition, be my guest. I certainly don't put myself at his level, the more I study, the more I realize my shortcomings in my knowledge. I am not arrogant enough to think I can I guess the next step, that I can 'update' the tradition without deepening my knowledge of the medicine itself. Our grasp of Chinese medicine is still very tenuous, Jason, and I find that most of our debating is based on incomplete and often inaccurate understanding of the source material itself. The li jie detail above is just one example. >>>> For me it is the following master practitioners, as I did in China, with a critical eye, and using this experience to deside if there is a need to update and improve. In my experience there is much to improve. You are right the more one's education the better one is capable. How ever, there is great danger in assuming that everything or most of what has been written is always correct. For example including your question of how modern drugs influence pulses and their application to pattern discrimination. Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 on 10/31/00 8:41 AM, alonmarcus at alonmarcus wrote: As far as using Li Dong-yuan as the impetus for updating the tradition, be my guest. I certainly don't put myself at his level, the more I study, the more I realize my shortcomings in my knowledge. I am not arrogant enough to think I can I guess the next step, that I can 'update' the tradition without deepening my knowledge of the medicine itself. Our grasp of Chinese medicine is still very tenuous, Jason, and I find that most of our debating is based on incomplete and often inaccurate understanding of the source material itself. The li jie detail above is just one example. >>>> For me it is the following master practitioners, as I did in China, with a critical eye, and using this experience to deside if there is a need to update and improve. In my experience there is much to improve. You are right the more one's education the better one is capable. How ever, there is great danger in assuming that everything or most of what has been written is always correct. For example including your question of how modern drugs influence pulses and their application to pattern discrimination. Alon I couldn't disagree with anything you've said here, Alon. My understanding has always been to adapt what one has learned to clinical reality. . ..all the authorities I've studied say this is the tao of Chinese medicine. How we actually 'update and improve' is the real question. . . .. and for that, we need to examine what it is our fellow practitioners are actually doing in clinic with this tradition. As far as pulses being influenced by modern drugs, I have always stated that this is my own clinical observation, not the gold standard. It is just at the time I wrote these articles, no one else had put forward anything else (except Bob Flaws). I have always solicited feedback on this topic, and would love to open this up to discussion on this forum. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 Jason, I already made some points in the last post that, for some reason, didn't click with you. I don't know what else to say. Unclear about this, especially since I never responded...? I don't want to comment too much on the Jin Gui material, because the only translations available (OHAI and New World Press) are not trustworthy. In the past, I have found problems commenting on poorly translated texts. What about the pi wei lun, we all have said how poor the translation is? I have an original Chinese copy, but I don't have the time to sit and translate and decipher right now, there is too much on my plate. I know you have studied this text with J. Min Fan, perhaps you could ask him. I would say that many classics are written in a short-hand style, and were commented on over centuries to fill in details, Yes I have talked with min fan about this issue (more later)... and yes much has been ADDED over the years creating new knowledge and understanding. Dr. Zhang did not know anywhere near what we know today. (paraphrased from min fan) or even more significantly, that THE AUTHOR ASSUMED YOU KNEW THE DETAILS. How do you know this? True or not, Dr. Zhang is dead, we cannot ask him... (paraphrased from min fan) this in only speculation... There is also a sense of oral tradition, of clinical development of ideas in the text, and, certainly, historical 'filling in' of information that is implied or not listed, because of the short-hand style. anything believed to be implied is again speculation... not written...I am unsure what this short-hand style means? The passage above on li jie, for example, is translated in the New World Press jin gui as 'acute paralysis'. If you look again it says "acute arthritis (lijie), with paralysis of the extremities and athralgia" That is a complete distortion of the meaning of the term, and leads you to the false conclusion that Dr. Zhang is giving you free reign to use these medicinals in any acute paralytic situation. This is totally false perception, beginning with wrong translation, if you haven't read the Chinese, how do you know it is an incorrect translation? I have translated it myself and asked min fan, we both see no problems with what is written in both books...FYI- OHAI says "wu tou tang treats arthritis so painful that the patient is unable to flex or extend the limbs" where the author is trying to find a biomedical equivalent and failing, and followed by wrong interpretation. If you read the Wiseman dictionary, li jie is defined as 'joint running wind', defined as "a disease with redness and swelling of joints, with transformation of wind/cold/damp into heat in patients sufffering from liver/kidney (yin) vacuity". 1) the pattern differentiation and etiology is Wiseman not Dr. Zhang, this is a latter addition. what Wiseman says in evolution from Dr.. Zhang... (which is fine, but recognize it for what it is) - This is not what Dr. Zhang said. period. jin gui only says what it says... a) this is different than today's understanding - obvious by the herbs chosen, versus what would be given today for li jie mentioned by Wiseman. Dr. Zhang is giving - ma huang, bai shao, fu zi, zhi gan cao, & huang qi - this is not addressing lv/kid yin xu - but pain due to to cold. We cannot rely on Wiseman's translation for everything! - b) could this be symptomatic relief? Or lack of understanding by Dr. Zhang? or just different approach than today? 2) All these sources say basically the same thing.. I don't see the big translation issue...it seems clear to me. You can argue over this word or that, but the idea is simple and clear. But, I feel the debate is not based on the exact wording of the symptoms, but if Dr. Zhang names a pattern and if so what is it? am I wrong? In summary : A) only symptoms given. No pattern named. B) NO zang-fu is written. or other (Underlying) pattern -- only the name of the syndrome - li jie You are looking at a bian bing/disease differentiation, requiring a preexisting knowledge of bi zheng /impediment patterns (painful obstruction),appropriate medicinals, and the pattern differentiation required to understand it. This is only your belief... although it may be true... more on pattern differentiation later... Right away, you are back in the realm of bian zheng, and must know it to know what medicinals and prescriptions to use. If you biomedicalize li jie into acute paralysis, a great deal of essential information is lost, and, yes, you may be seduced into thinking that Chinese medicine is merely treating at a symptomatic level. There are plenty of instances were Chinese medicine only treats the symptoms.. no? I would strongly suggest that you avoid this translation, as it will lead to grievous errors. Actually I feel that with 2 translations and a teacher who goes through each section one by one, errors can be greatly eliminated. The section about acute arthritis is only 17 characters, it only takes but a few minutes to read through (and the last 5 characters refer to the formula)... As far as using Li Dong-yuan as the impetus for updating the tradition, be my guest. Actually this is just 1 example. More appropriate is the example of the dao, or yin or yang. Things are in constant change. I personally believe in the flow and evolution of thought, medicine, life etc... I certainly don't put myself at his level, the more I study, the more I realize my shortcomings in my knowledge. I am not arrogant enough to think I can I guess the next step, that I can 'update' the tradition without deepening my knowledge of the medicine itself. Our grasp of Chinese medicine is still very tenuous, Jason, and I find that most of our debating is based on incomplete and often inaccurate understanding of the source material itself. The li jie detail above is just one example. Then the question becomes, how can you (or others) put so much faith in other texts (i.e. pi wei lun, master hua's etc.) 1) they are fringe (or controversial) texts... 2) I find these translations much worse, especially since the characters are not even present. At least with the OHAI, I can reference characters. -again lets look at bai he bing (lily bulb disease), 1) we are not correlating a western disease 2) there are only symptoms given - and a formula to alleviate those symptoms 3) no pattern diagnosis is given until later commentary where various zang-fu differentiations are applied to it 4) when further differentiation is applied to it, interestingly enough, the formulas have also changed. - so... not only has our understanding of the disease changed and then further differentiated (zang-fu), new formulas have been applied to this -- this is evolution -- an understanding that what was originally written is not adequate to fit the case in front of us.. -so we must ask ourselves, if we don't use the original formulas, in the original preparations, with the original diagnosis what are we doing? To me it seems we are changing and evolving. And if you have your method of evolving, why can't someone else have theirs? the final question is... if Dr. Zhang was alive today would he write the book in the same way? Or would he use more detailed differentiation system...since we will never know, I look around at current writing and find a much different and more detailed system, this says to me that the medicine is the evolving... I personally want to flow with it... I get the impression from Z'ev's posts that he is trying to convince us that we shouldn't. (maybe I am misunderstanding him) - Z'ev says if I want to incorporate the western system into my medicine that I might "consider a career in Western medicine." ??? I am not afraid of growth, and it seems to me in China that they are not either (for example endometriosis, from my understanding, is now labeled a Chinese disease) are we saying that in America we practice a truer form of Chinese medicine than in China? are we saying that if we incorporate a Western medicine diagnostic system into CM that this is not CM? I don't think anyone is arguing that Dr. Zhang or past masters didn't differentiate, what I am with suggesting is that his differentiation system was different/more simplified/ and incomplete than our current system -- this would mean their is evolution. This is ALL I'm suggesting... a few thoughts... -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 We cannot rely on Wiseman's translation for everything! - >>>>Very interesting. Can you give more info Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 I am not afraid of growth, and it seems to me in China that they are not either (for example endometriosis, from my understanding, is now labeled a Chinese disease) are we saying that in America we practice a truer form of Chinese medicine than in China? are we saying that if we incorporate a Western medicine diagnostic system into CM that this is not CM? >>>My question exactly alon Quote Link to comment Share on other sites More sharing options...
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