Guest guest Posted December 8, 2000 Report Share Posted December 8, 2000 If you have access to it and are interested, check out the December 6, 2000 issue of the Journal of the American Medical Association. It includes the following article on clinical investigation: " Electroacupuncture for Control of Myeloablative Chemotherapy-Induced Emesis, A Randomized Controlled Trial, " by Shen, Wenger, Glaspy, Hays, Albert, Choi, and Shekelle (4 of who are MDs, 2 PhDs, and 1 OMD). Conclusions: In this study of patients with breast cancer receiving high-dose chemotherapy, adjunct electroacupuncture was more effective in controlling emesis than minimal needling (sham acupuncture) or antiemetic phamacotherapy alone, although the observed effect had limited duration. In the electro-acupuncture treatment, they stimulated PC 6/nei guan and ST 36/zu san li. In the sham treatment, they stimulated LU 7/lie que and GB 34/yang ling quan. The good stuff: postive results, reputable journal, peer reviewed. The bad stuff: still more MDs doing our work for us. ______________________________\ _____ Get more from the Web. FREE MSN Explorer download : http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2000 Report Share Posted December 8, 2000 Jeff, Thanks for bringing this up. > The bad stuff: still more MDs doing our work for us. Why is this bad? It seems to me that the subject belongs to those who take responsibility for it. I don't know if there are any MDs on this list, but I don't think it's accurate, fair, or particularly productive to characterize a category of human beings as " bad " in the way that you have done. Nor do I think the " us " vs. " them " approach is really very sensible. If it's true that: >The good stuff: postive results, reputable journal, peer reviewed. Then how can it be bad that those whose journal it is are engaged in " our " work? The work will get done...by whomever does it...based on demand that comes, in the final analysis, from the marketplace of consumers of medical services. What would be bad is if we don't get busy and raise the level of standards in Chinese medical education, training practice, research, and scholarship. As you note, if we don't do it, someone else will. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Why is this bad?It seems to me that the subject belongs to those whotake responsibility for it. >>>Correct alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Ken Rose wrote: > > The bad stuff: still more MDs doing our work for us. > > Why is this bad? Its bad becaue MD's are inherently bad people. Sorry, that was really stupid. You're right that we can't judge a researcher by his or her credentials, but the trend for MD's doing TCM research is that they do not engage in syndrome differentiation. That's why the IBS formula that was researched in Australia a few years ago was really a formula that contained three formulas. One for damp-heat one for Qi stagnation and a third which I can't remember, probably Spleen Qi deficiency. What is going on right now in my neck of the woods is a few of us are getting together to see if we can at least find some agreeement in syndrome differentiation. The three patients that we three saw yesterday varied widely in their diagnosis, though there was some overlap. It was a little bit disturbing to see so much differentiation differentiation. By the way, to get an article published in the JAMA, does one have to be a member of the AMA? Anybody know? -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 That's why the IBS formula that wasresearched in Australia a few years ago was really a formula thatcontained three formulas. One for damp-heat one for Qi stagnation and athird which I can't remember, probably Spleen Qi deficiency.>>>>this sounds allot like the discussions here about the so called complicated western patient that requires multiple treatment principles does it not? alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 The three patients that we three saw yesterdayvaried widely in their diagnosis, though there was some overlap. It wasa little bit disturbing to see so much differentiation differentiation.>>>Welcome to reality. Like I said in our study no two out of 9 practitioners agreed on any one of 29 patients. alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 > > You're right that we can't judge a researcher by his or her credentials, > but the trend for MD's doing TCM research is that they do not engage in > syndrome differentiation. I dont' know if this is true or not, but assuming that this is the case, why? Why could it possibly be that MDs (or anyone else for that matter) would not employ these basic theoretical tools? Your anecdote testifies to one likely cause: an utter lack of agreement not to mention shared understanding on the part of professionals in the field. Anyone looking for such causes should look to the effects of a discipline constructed on inadequate foundations. > > What is going on right now in my neck of the woods is a few of us are > getting together to see if we can at least find some agreeement in > syndrome differentiation. The three patients that we three saw yesterday > varied widely in their diagnosis, though there was some overlap. It was > a little bit disturbing to see so much differentiation differentiation. I read this as a manifestation of what we lovingly call " the terminology issue " or words to that effect. I am constantly reminded of the passage from Lao Zi that states: To know through not knowing is best. Not to know through knowing is disease. We suffer from this disease. Fortunately there is a medicine that we can all take to combat it. But this medicine can only be prepared by individuals in the sanctity of their own hearts and minds. It is the elixir of understanding. The formula is given in various sources, notably The Great Learning, which advises us to seek " precise verbal definitions " to even our most inarticulate thoughts. The processes of the Chinese language are inextricably interlaced with the theories of Chinese medicine. It is, as Nigel Wiseman has pointed out " the neglected key. " Whether " we " are doctors, acupuncturists, teachers, researchers, or whatever, we should recognize the trouble and danger that lies ahead on the path leading to door after door which is held fast by the lock into which this key can be fitted. No key = no entrance. You cannot break these doors by force. They must be understood to open. The only real question facing any of us is " Can we do it? " My teachers in China refer to Chinese medicine as a vast ocean. We have likened the study to riding a dragon. But whatever the metaphor, the issue is: " Does it move you? " > By the way, to get an article published in the JAMA, does one have to be > a member of the AMA? Anybody know? JAMA author instructions can be found at: http://jama.ama-assn.org/info/auinst.html#Authorship Anyone interested in submitting articles and papers for publication in the Journal of Clinical Acupuncture and Oriental Medicine can email me directly. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 > alonmarcus wrote: > >>>Welcome to reality. Like I said in our study no two out of 9 > practitioners agreed on any one of 29 patients. We talked about this a bit yesterday. There was me, leaning toward the TCM as taught in Beijing. Another whom I suspect operates more from within the John Shen school of thought. (Will? Is that right?) And a third whom I saw doing more palpation techniques which I believe reflects some of Jeffrey Yuen's techniques. These are three very different paradigms all using the four pillars to come up with a diagnosis. I think that it we were to agree on parameters, we used the word " calibration " we'd have more consistent results. One thing that messed things up was the lack of a chief complaint. Given one CC, there are a finite potential causes for that CC. With those causes agreed upon (or maybe not) we can at least all focus on one complaint's causal syndrome. I think that this way of doing this will assist in us agreeing more often on diagnosis. -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 I think that it we were to agree on parameters, we used the word"calibration" we'd have more consistent results. >>>To some extent, but, because physical assessment is at the heart of CM it is very difficult to have reproducible agreement alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 > alonmarcus wrote: > this sounds allot like the discussions here about the so called > complicated western patient that requires multiple treatment > principles does it not? According to the Lancet: _______ 116 patients with IBS were assessed by the Rome diagnostic criteria for the disorder and then randomly allocated one of three treatments: a standard preparation of Chinese herbs; an individually tailored Chinese herbal-medicine formulation; or a placebo. All three preparations were in identical capsules taken three times a day. The trial was double-blinded and each patient had regular consultations with both a Chinese herbal-medicine practitioner and a gastroenterologist. _________ Unfortunately, I don't have the research in front of me, but as I recall, the group that got the formula which covered three bases and the group that got the formula that covered only *their* syndrome improved equally, but the group with the individualized formulas had a lower incidence of IBS symptom recurrences. In other words, their IBS didn't come back, whereas the group with the pre-made formula had a higher rate of symptoms returning. That's really good news, I forgot about this in my earlier posts. It adds credibility to the whole syndrome differentiation issue. I'll bet, given a finite number of causes for constipation, diarrhea, and/or abdominal pain, we would see more agreement between practitioners in regards to their syndromes. And of course, we'd have to factor in different terms used for identical things. Wood overacts on Earth, Liver attacks Spleen, Liver/Spleen Disharmony, Qi Stagnation and Deficiency... (as well as the elusive Liver Qi Deficiency...) They're all feet touching different corners of the same base. -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Alon Marcus wrote: > >>>Welcome to reality. Like I said in our study no two out of 9 practitioners > agreed on any one of 29 patients. > alon > ----------------------- Hi Alon, Where can I find your study? Rory Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Alon Marcus wrote: > I think that it we were to agree on parameters, we used the word > " calibration " we'd have more consistent results. > >>>To some extent, but, because physical assessment is at the heart of CM it is > very difficult to have reproducible agreement > alon > --------------- While I agree with your point, we should note that this is also true of biomedicine, so the standard we are looking at here is far from 100% reproduceable agreement. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Unfortunately, I don't have the research in front of me, but as Irecall, the group that got the formula which covered three bases and thegroup that got the formula that covered only *their* syndrome improvedequally, but the group with the individualized formulas had a lowerincidence of IBS symptom recurrences. In other words, their IBS didn'tcome back, whereas the group with the pre-made formula had a higher rateof symptoms returning.>>>>Actually the group that got the formula had better symptomatic relief but did not last as long as the individual formulas. No body was talking about a cure. That is a big word Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 While I agree with your point, we should note that this is also true of biomedicine, so the standard we are looking at here is far from 100% reproducible agreement.>>>Absolutely. You cant even get two MD's to agree on a neurological exam alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 Ken Rose wrote: > > > > > You're right that we can't judge a researcher by his or her credentials, > > but the trend for MD's doing TCM research is that they do not engage in > > syndrome differentiation. > > I dont' know if this is true or not, but assuming that this is the case, > why? Um. Because they don't know OM? Is this a trick question? : ) -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 It does, but not for the reasons that the "IBS formula" was thrown together, I think. It is one think to diagnose concurrent patterns (that must be related to each other, as in Dong-yuan prescriptions which have damage to the qi transformation as their root), another to throw three TCM patterns together that may be observed in a disease and come up with a formula to cover all three.>>>>>>Do you know the authors?or how they came up with the formula or this is another knee-jerk reaction alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 on 12/9/00 9:41 AM, alonmarcus at alonmarcus wrote: That's why the IBS formula that was researched in Australia a few years ago was really a formula that contained three formulas. One for damp-heat one for Qi stagnation and a third which I can't remember, probably Spleen Qi deficiency. >>>>this sounds allot like the discussions here about the so called complicated western patient that requires multiple treatment principles does it not? alon It does, but not for the reasons that the " IBS formula " was thrown together, I think. It is one think to diagnose concurrent patterns (that must be related to each other, as in Dong-yuan prescriptions which have damage to the qi transformation as their root), another to throw three TCM patterns together that may be observed in a disease and come up with a formula to cover all three. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 on 12/9/00 6:28 PM, alonmarcus at alonmarcus wrote: It does, but not for the reasons that the " IBS formula " was thrown together, I think. It is one think to diagnose concurrent patterns (that must be related to each other, as in Dong-yuan prescriptions which have damage to the qi transformation as their root), another to throw three TCM patterns together that may be observed in a disease and come up with a formula to cover all three. >>>>>>Do you know the authors?or how they came up with the formula or this is another knee-jerk reaction alon I am not going to respond to your insult. Figure it out for yourself. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2000 Report Share Posted December 10, 2000 I am not going to respond to your insult. Figure it out for yourself.>>>This is not intended as an insult, but a question. There are many formulas circulating that combine three Rx's for example blue poppy cold formula combines 3 Rx's. In the IBS study the formula gave better symptomatic affect than the individualized prescriptions although it was shorter lived. The fact that the authors were MD's, if they were, does not mean they do not understand TCM well. One of their stated goals was to compare individual therapy to a fixed formula. alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2000 Report Share Posted December 10, 2000 another to throw three TCM patterns together that may be observed in a disease and come up with a formula to cover all three.>>>>to follow this thinking then one can not make a patent formulas that is complex. alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2000 Report Share Posted December 10, 2000 Al, > > Um. Because they don't know OM? Is this a trick question? : ) Absolutely. Knowing is the trick. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2000 Report Share Posted December 11, 2000 Ken Rose wrote: > > Al, > > > > Um. Because they don't know OM? Is this a trick question? : ) > > Absolutely. Knowing is the trick. Funny story: A few years ago, I was in charge of creating the Emperor's College course catalog. I had a bunch of black and white photos that I'd taken with sort of a zen spirit in the composition. Beneath the imges I decided to add some cool quotes about education from the Taoist books I had laying around. So, I started throwing in these little sayings which all basically said the same thing. If you want to know something, don't learn about it. Don't go to school. Don't get an education. All these, in a TCM school's course catalog. I'm still kind of chuckling about that. -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
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