Integrating Eastern and Western Systems

[Guest guest]

ÿþ

[Guest guest]

Alon:

 

Can you offer some input into the limitations you found in TCM and

how integrating Western ideas about the musculoskeletal system filled

in details, or how you reframed Western ideas in TCM?

 

Jim Ramholz

[Guest guest]

Can you offer some input into the limitations you found in TCM and

 

>>>>The first weakness of TCM is the inability of diagnosing the exact nature and LOCATION of most diseases. I think people do not realize how much modern medicine they are using in their thinking. When I was in China I had a long talk with a western and CM trained Dr about the way TCM education was set up (he was very involved in that process). He told me that very early they realized, that CM only trained practitioners, too often misdiagnosed patients and that it led to many millions of deaths. And that was the reason they integrated modern medicine in the training. It is very romantic to say how CM Dr can diagnose using pulse and tongue but when they looked at real numbers it was freighting. It is modern medicine that allows you triage patients to what is appropriately treated with TCM or modern medicine not TCM diagnosis and that is done every day in China.

Secondly from what I have seen in China, as well as by observing my teaches here is the US and Japan and from my own experience, OM is mostly affective with functional disorders. And that is great because modern medicine often does not have much to offer. The hospital I worked in has been evaluating claims from all over china in the treatment of several diseases including primary hypertension, secondary hypertension, diabetes, hemorrhoids, hyperthyroidism, many infections, renal disorders, asthma, for the last 30 yr. Practitioners from all over China, that claimed they were able to cure these had to come and spend one yr treating patients, and their treatments evaluated.

In general what they found is the more objective finding for a disease exist (in other words the greater the pathology and the farther the condition is from a functional disorder) the poorer the results. For example, they concluded that TCM is not effective in treating Diabetes (that is lowering blood sugar) if only TCM principals are used. TCM is however helpful in decreasing some on the complications of diabetes as well as complaints like thirst, urination etc. TCM is not effective in treating primary hypertension if diastolic pressure is above 100 (remember using only TCM methods). It also ineffective in most secondary hypertension (they evaluated mostly do to renal and pulmonary diseases). Except for some acute mild nephritis TCM is not usually affective in treating most renal disorders. TCM does not have an affective radical treatment for hemorrhoids, (they even tested a semi-surgical procedure that involved injecting a thermojenic herbal formula into the hemorrhoid). These are studies done on thousands of patients and interestingly they were never published for political reasons. Most serous infection are not responsive. Apparently other hospital were doing the same thing for many other diseases.

 

and how integrating Western ideas about the musculoskeletal system filled in details, or how you reframed Western ideas in TCM?

>>>>>I have seen western ides integrated in the treatment of acute abdomen (as you can read in my blue poppy book), as well as many other books on the combing of TCM and biomedicine. For example, although I know many of you think reading the pulse should be as informative, in seeing acute abdominal pain patients and evaluating them with modern methods and principals of peritonitis, one can use the purging method in a patient that seems extremely weak and depleted from TCM point of view. I have seen several patients such as that being able to avoid surgery. These were patients that even my purging teacher would have not treated with purging before he understood the mechanism of illness from a biomedical perspective. However, most patient with acute abdomens that is considered surgical need surgery. I have seen the use on IGG and IGE titers used to evaluate herbal formulas in asthmatics which often led to a different formula then was thought to be appropriate. Although in general from what I have seen severely asthmatic patients (that is, history of more than one intubation and steroid dependent) can not be adequately controlled with TCM.

 

My personal practice is mostly pain and I am able to use non CM evaluation methods in deciding what channels and points to use every day. There is no way to evaluate the location of a primary lesion responsible for somatic pain in CM. The concepts of referred pain and tenderness are not well understood in CM, and unfortunately most chronic musculoskeletal pain is referred. Tests such as selective tension and other functional test are extremely helpful and improved my outcomes 10 fold. This is a topic that demands a week long retreat to discuss and if enough people that are interested in this subject are interested it would be great to do.

alon

[Guest guest]

Alon wrote: "Tests such as selective tension and other functional test are extremely helpful and improved my outcomes 10 fold."

 

Alon, what is selective tension and other functional tests? Very interesting email. Thanks.

 

Stephen

 

alonmarcus [alonmarcus]Thursday, November 02, 2000 11:56 AM Subject: Re: Integrating Eastern and Western SystemsChinese 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]

Alon, what is selective tension and other functional tests? Very interesting email. Thanks

>>Selective tension is a system that allows one to test specific tissue such as shoulder internal rotators by resisted internal rotation of the shoulder etc.

alon

[Guest guest]

on 11/2/00 10:55 AM, alonmarcus at alonmarcus wrote:

 

When I was in China I had a long talk with a western and CM trained Dr about the way TCM education was set up (he was very involved in that process). He told me that very early they realized, that CM only trained practitioners, too often misdiagnosed patients and that it led to many millions of deaths. And that was the reason they integrated modern medicine in the training. It is very romantic to say how CM Dr can diagnose using pulse and tongue but when they looked at real numbers it was freighting. It is modern medicine that allows you triage patients to what is appropriately treated with TCM or modern medicine not TCM diagnosis and that is done every day in China.

 

(Z'ev) Hmm. . . . .this sounds very poliically motivated to me, Alon. It sounds like your physician friend had an agenda. TCM killed millions? And how did that happen, after many centuries of saving lives and serving as one of the greatest systems of medicine in the world? You are going to have to qualify that statement for me. Western medicine, at least in the West, has a track record of iatrogenesis and misdiagnosis as well. . . .that is the back of the huge edifice of modern medicine.

 

It would be much more germane to say that both forms of medicine are great sophisticated systems, and leave it at that, each with its strengths and shortcomings. But in mainland China, the integration of biomedicine has often led to the weakening of the subject material of TCM, especially the diagnosis. Look at the journals. Many of the articles rely on treatment of disease by biomedical diagnosis and testing, with nary a mention of a pulse or tongue. Then herbs or acupuncture points are dredged up. The technology of TCM has survived, but what about the theory and diagnosis?

 

For more on this largely politically motivated integration, read Manfred Porkert's " The Debasing of " and Heiner Fruehauf's series of articles on the history of TCM in the California Journal of Oriental Medicine.

 

 

 

Here is a quote from the Porkert text:

 

" By far the most fundamental and deadly threat to Chinese medicine comes form the political and hence didactic and methodological stance taken toward what is still called Chinese medicine (zhongyi) in China proper. This attitude originally was conditioned by the, at first sight, so impressive feats of WM and Western doctors in China in the late 19th and early 20th century. It was abetted by the professional ignorance of decision-making politicians who did not have the least idea, not an inkling of what produced these effects and these impressions, and in what consisted the methodological and practical difference between Western and Chinese medicine.

 

" So what we see in China today (are institutions) teaching an eclectic, that is indiscrimiate mixture of Chinese and Western empirical medicine. . ..with an external smattering of Western terminology to suggest some kind of trendy scientific aspirations. And these institutions are totally dependent upon the existence and input of Western medicine. "

 

" Feeling the pulse " , if it is still undertaken for ritual purposes, is not based upon any kind of stringent and consistent instructions. "

 

 

[Guest guest]

..this sounds very poliically motivated to me, Alon. It sounds like your physician friend had an agenda. TCM killed millions? And how did that happen, after many centuries of saving lives and serving as one of the greatest systems of medicine in the world? You are going to have to qualify that statement for me. Western medicine, at least in the West, has a track record of iatrogenesis and misdiagnosis as well. . . .that is the back of the huge edifice of modern medicine.>>>>>acute abdomens, infections, severe asthma, hart failure, renal failure etc. You do not realize to what extent we use modern thinking and thus practice much safer medicine. He was talking about the many only traditionally trained. He was a very strong supporter of TCM. I think you might be ignoring some public health data they used to in coming up with the TCM schooling programs. TCM does not do well with many sever diseases that require modern intervention, but many of these old timers were not knowledgeable and were treating these with TCM . according to him because of this data most old timers were forced back to school. This is not a contest Zev I am just repeating conversations I had.

 

alon

[Guest guest]

For more on this largely politically motivated integration, read Manfred Porkert's "The Debasing of " and Heiner Fruehauf's series of articles on the history of TCM in the California Journal of Oriental Medicine.>>>>>>>>>I am not sure how much experience Porket has treating seriously and acutely ill patients the type that end up in the ER in the west and now in China.

alon

[Guest guest]

on 11/3/00 5:42 PM, alonmarcus at alonmarcus wrote:

 

For more on this largely politically motivated integration, read Manfred Porkert's " The Debasing of " and Heiner Fruehauf's series of articles on the history of TCM in the California Journal of Oriental Medicine.

>>>>>>>>>I am not sure how much experience Porket has treating seriously and acutely ill patients the type that end up in the ER in the west and now in China.

alon

 

 

 

Why should this be a problem? His perspective is still valuable.

 

 

[Guest guest]

Why should this be a problem? His perspective is still valuable.

>>>>That is the basic difference in our thinking. While it is ok to look at OM from a historical perspective, for me only the bottom line, that is clinical success that I care about. From what I have seen in China much of their decisions are clinically based (although I agree there is much political stuff going on as well). When I asked about systems such as I change and others, they strongly stated that the reason they do not use this type of info is for clinical reasons not political.

alon

[Guest guest]

on 11/5/00 10:06 AM, alonmarcus at alonmarcus wrote:

 

Why should this be a problem? His perspective is still valuable.

>>>>That is the basic difference in our thinking. While it is ok to look at OM from a historical perspective, for me only the bottom line, that is clinical success that I care about. From what I have seen in China much of their decisions are clinically based (although I agree there is much political stuff going on as well). When I asked about systems such as I change and others, they strongly stated that the reason they do not use this type of info is for clinical reasons not political.

alon

 

OK, I take your word for it. Thank you for the clarification, Alon.

 

Kol B'Kavod,