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As everyone knows, much of western medicine is based upon consensus

rather than experimental evidence. this includes the use of

hemodialysis and drug treatment of malignant hypertension to control

stroke. these approaches have not been studied according to the

standards requested of us to apply within our own field. Interestingly,

the reasons are the same as why the chinese do so-called " poor "

research. It is considered unethical to do such studies when there is

universal agreement amongst practitioners about their efficacy.

However, a movement is growing to challenge certain clinical myths and

replace them with evidence based medicine. for a look at this approach

amongst our western med peers, check out this link

 

http://www.cyberounds.com/conferences/nephrology/

 

--

 

Chinese Herbal Medicine

 

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Ummmm...not sure why you use the example of hemodialysis. I must say that,

as a dialysis patient myself, I have seen quite a bit of western medical

research on various aspects of dialysis, including outcome research on

benefits of shorter vs. longer running time, effectiveness of different

types of synthetic kidneys, and the use of formaldehyde vs. citric acid as a

dialysate. At least with regard to hemodialysis, I'd say the medicine is

based on research. Perhaps one area where consensus comes up is that the

runs in Europe are far longer than the US, probably because of health care

costs. People live longer when dialysis treatments last longer, which is

why many western European countries' nephrologists require longer run times.

(American docs seem less anxious about run times).

 

Jeff

 

 

>Todd <

>

>cha

> consensus vs. evidence

>Wed, 17 Jan 2001 16:04:43 -0800

>

>As everyone knows, much of western medicine is based upon consensus

>rather than experimental evidence. this includes the use of

>hemodialysis and drug treatment of malignant hypertension to control

>stroke. these approaches have not been studied according to the

>standards requested of us to apply within our own field. Interestingly,

>the reasons are the same as why the chinese do so-called " poor "

>research. It is considered unethical to do such studies when there is

>universal agreement amongst practitioners about their efficacy.

>However, a movement is growing to challenge certain clinical myths and

>replace them with evidence based medicine. for a look at this approach

>amongst our western med peers, check out this link

>

>http://www.cyberounds.com/conferences/nephrology/

>

>--

>

>Director

>Chinese Herbal Medicine

>

>

>

 

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, " Jeff Gould " <jeffgould@h...>

wrote:

> Ummmm...not sure why you use the example of hemodialysis.

 

All I can say is check out the link. It is not my personal opinion,

but that of the research analysts. What has never been studied is

comparison of a control group versus an experimental group, for ethical

reasons. Outcomes research does not use a control. But if its good

enough for them,it should be good enough for us, too.

 

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Outcomes research does not use a control. But if its good enough for them,it should be good enough for us, too

>>>Out come research is acceptable if done correctly and if objectives are used

alon

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At 2:29 AM +0000 1/18/01, Jeff Gould wrote:

>Perhaps one area where consensus comes up is that the

>runs in Europe are far longer than the US, probably because of health care

>costs. People live longer when dialysis treatments last longer, which is

>why many western European countries' nephrologists require longer run times.

> (American docs seem less anxious about run times).

---

 

The conclusion I draw from your statement here is that US doctors

care less about their patient's lives than do European doctors. Is

that what you are suggesting?

 

Rory

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>At 2:29 AM +0000 1/18/01, Jeff Gould wrote:

> >Perhaps one area where consensus comes up is that the

> >runs in Europe are far longer than the US, probably because of health

>care

> >costs. People live longer when dialysis treatments last longer, which is

> >why many western European countries' nephrologists require longer run

>times.

> > (American docs seem less anxious about run times).

>---

>

>The conclusion I draw from your statement here is that US doctors

>care less about their patient's lives than do European doctors. Is

>that what you are suggesting?

>

>Rory

 

I don't know that I'd go that far, but...here's my take. If you are going

to have a chronic degenerative disease in the US, end stage renal disease is

the way to go. Three months after you are on hemodialysis, you become

eligible for medicare, regardless of your age. Medicare pays for 80% of all

your medical expenses (not just those direclty related to dialysis). Of

course, each dialysis run costs around $250-300, I cannot remember, and it

does also depend upon what medications you also require. Depending upon the

state in which you live, you may also be eligible to purchase supplemental

insurance for the remaining 20%, which is most often a state's Blue Cross

program. That will pay the rest, minus a $100 once a year deductable.

 

Sounds good for the patient, right? Well it is. But for the companies

providing the dialysis, the fee set for payments by medicare/HCFA are from

(I think, but cannot remember the exact date) 1982 or 83? So as a result,

while medical costs have skyrocketed, and while there is a good profit to be

had by running a dialysis clinic, it has not risen along with most of

medical costs. So there are certain things that might benefit patients,

such as longer runs in certain cases, which are not provided, because the

longer runs would result in zero profit for the company by requiring

additional pay for dialysis techs. As it is, most companies have

dramatically decreased the number of nurses on duty and replaced them with

techs who have far less training. (I would say that I have received

exceptional health care since the first day I was put on a machine, which'll

be two years in July).

 

Does this mean American doctors care less? No, but I don't think anyone who

works to promote health care, whether physicians or us, should do so for

free. The people running the dialysis clinics (which in many cases are

owned by physicians) shouldn't have to pay for the longer runs out of

reasonable profits or their own pockets. Don't know if this answers the

question or not.

 

Jeff

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, " Jeff Gould " <jeffgould@h...>

>

> I don't know that I'd go that far, but...here's my take. If you are going

> to have a chronic degenerative disease in the US, end stage renal disease is

> the way to go.

 

this is a general statement, not directed at all to Jeff's specific

case. It may not apply to him.

 

My herb teachr, Li Wei, was medical doctor in china during the 80's.

she was chief of renal pathology at Anhui Provincial Hospital. at that

time, access to dialysis was very limited in china (it may still be,

I'm not sure). without dialysis, her hands were tied with many of her

pateints,as western medicine still has little else to offer in this

regard. It was becasue of this that she begun to fall back on her

traditional training in TCM. Her father was a " famous old doctor " and

she had learned TCM from age 10, started seeing patients at age 14.

she found that in many cases of chronic renal failure, chinese herbal

medicine was effective at halting the disease and even restoring kidney

function. While I am not sure at what stage these patients were, I do

know that she used modern lab tests to evaluate kidney function. she

did not just rely on tongue and pulse. She treated patients according

to TCM bianzheng, but almost always added dong chong xia cao to the

formulas. I saw a number of dialysis patients have normal urination

restored here in the states. I did not do longterm followup, though.

I would not recommend substituting herbs for dialysis and many docs

will not allow their pateints to take herbs becasue of unknown effects

on kidney function. this has been exacerbated by the careless posturing

on the aristolochic acid issue by some american px, as well. We just

can't be trusted to protect public safety in this area. However, if

you have the opportunity, the key, as usual, is dosage. Li wei always

said the failure of therapy in such cases almost invariably involves

too LOW dosage of herbs. Dong chong xia cao is expensive and only high

quality will work, not the crap from grocery stores. But formulas

should use the upper end of dose range as listed in Bensky and the

entire rx should be about 100 grams per day. If you have tried low

dose herb protocols for renal failure without success, you haven't

really tried at all yet.

 

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Does this mean American doctors care less? No, but I don't think anyone who works to promote health care, whether physicians or us, should do so for free. The people running the dialysis clinics (which in many cases are owned by physicians) shouldn't have to pay for the longer runs out of reasonable profits or their own pockets. Don't know if this answers the question or not.

>>>>This is true across the board of American care these days

Alon

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I never treat dialysis patients, because of concern on either flushing out

of the benefits of herbal substances, or concentration of certain salts and

solids in the body from the process.

 

I do have a few late stage kidney disease patients who are doing well. One

was just starting dialysis six years ago when she came in, and she decided

to stop on her own. I have treated her twice a week during this time (this

is what is required to keep her system up), and she is doing well with

acupuncture and a lot of moxabustion. She also takes herbs for the kidneys

and spleen as well. She was born with one kidney, which took a lot of

burden, and an unusually incomplete digestive system which required 17

surgeries to construct. CM definitely has a good track record here.

 

 

 

 

 

on 1/23/01 9:12 AM, at wrote:

 

 

>

> My herb teachr, Li Wei, was medical doctor in china during the 80's.

> she was chief of renal pathology at Anhui Provincial Hospital. at that

> time, access to dialysis was very limited in china (it may still be,

> I'm not sure). without dialysis, her hands were tied with many of her

> pateints,as western medicine still has little else to offer in this

> regard. It was becasue of this that she begun to fall back on her

> traditional training in TCM. Her father was a " famous old doctor " and

> she had learned TCM from age 10, started seeing patients at age 14.

> she found that in many cases of chronic renal failure, chinese herbal

> medicine was effective at halting the disease and even restoring kidney

> function. While I am not sure at what stage these patients were, I do

> know that she used modern lab tests to evaluate kidney function. she

> did not just rely on tongue and pulse. She treated patients according

> to TCM bianzheng, but almost always added dong chong xia cao to the

> formulas. I saw a number of dialysis patients have normal urination

> restored here in the states. I did not do longterm followup, though.

> I would not recommend substituting herbs for dialysis and many docs

> will not allow their pateints to take herbs becasue of unknown effects

> on kidney function. this has been exacerbated by the careless posturing

> on the aristolochic acid issue by some american px, as well. We just

> can't be trusted to protect public safety in this area. However, if

> you have the opportunity, the key, as usual, is dosage. Li wei always

> said the failure of therapy in such cases almost invariably involves

> too LOW dosage of herbs. Dong chong xia cao is expensive and only high

> quality will work, not the crap from grocery stores. But formulas

> should use the upper end of dose range as listed in Bensky and the

> entire rx should be about 100 grams per day. If you have tried low

> dose herb protocols for renal failure without success, you haven't

> really tried at all yet.

>

 

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CM definitely has a good track record here.>>>>What type of diet is she on. Many patients can stay off dialysis if they are on a low protein diet. Monks on low protein diets with renal frailer often survive w/out dialysis.

Alon

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on 1/23/01 11:31 AM, alonmarcus at alonmarcus wrote:

 

CM definitely has a good track record here.

 

>>>>What type of diet is she on. Many patients can stay off dialysis if they are on a low protein diet. Monks on low protein diets with renal frailer often survive w/out dialysis.

 

Alon

 

Yes, she is on low protein diet. . .but occasionally has carbohydrate binges, largely connected with her multiple gut/stomach surgeries. . . it is hard for her to tell when she is satisfied.

 

 

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For some reason, this message didn't come through.>>>>>>I think this was about a book from blue poppy called treatment of disease by TCM or something like that. Its a great 7 book series that categorize disease by TCM disease names. The treatments are clear OM pattern w/out any of the common theoretical differentiations so common in many other books.

Alon

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By the way- on the thread of flushing things out: here's an interesting

case:

I have a patient w hep C. I've treated him for years w/ the usual suspects.

his enzymes have been normal for years and his viral load consistently

reducing. He got some pre-op testing for knee surgery, only to discover his

enzymes were very elevated. (750 and 980 I thank).

Long try short- it turns out that he had begun to drink distilled water-

which leached the herbs out. as soon as he discontinued the distilled water,

then enzymes began to go down again.

 

Cara

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on 1/23/01 4:08 PM, alonmarcus at alonmarcus wrote:

 

For some reason, this message didn't come through.

 

>>>>>>I think this was about a book from blue poppy called treatment of disease by TCM or something like that. Its a great 7 book series that categorize disease by TCM disease names. The treatments are clear OM pattern w/out any of the common theoretical differentiations so common in many other books.

Alon

 

This is one of the best series of books I've seen on TCM disease patterns. Really to the core stuff.

 

Z'ev

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Everyone,

 

This is a GREAT 7 volume set that Alon is referring to. I believe it is an essential reference text. Very usable.

 

Mark Reese

 

-

alonmarcus

Tuesday, January 23, 2001 6:08 PM

Re: consensus vs. evidence

 

For some reason, this message didn't come through.>>>>>>I think this was about a book from blue poppy called treatment of disease by TCM or something like that. Its a great 7 book series that categorize disease by TCM disease names. The treatments are clear OM pattern w/out any of the common theoretical differentiations so common in many other books.

AlonChinese 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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Actually, Wei Li was my teacher also and I folllowed her for awhile. She

put me on dong chong xia cao for awhile. I purchased lab grown variety from

People's Herbs (I think that's the name). Pretty inexpensive compared to

raw. It was also 4:1 concentrate and probably the tastiest herb I ever had.

 

While I have no way of knowing, I believe that I was able to postpone

dialysis for a year or more. I only wish I had come across her sooner. She

ALWAYS gives people with decreasing kidney function (as measured by

creatinine clearance and BUY) this herb.

 

Of particular note, on several occasions, as my worsened, I would have

asthma-like attacks. I say asthma-like, because I had never really had

asthma before. It was the kidney xu kind, that is, harder to inhale than

exhale. When I started taking dong chong xia cao, it went away. This herb

is said to tonify both Lung and Kidney. I hadn't heard that asthma symptoms

are common with kidney failure, but for me, it was another interesting

illustration of just how TCM theory makes sense in the real world.

 

Jeff

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Mycoherb has a great water/alcohol extraction of cordyceps/dong chong xia

cao available at a very reasonable price. I've taken it and given patients

this herb for years. Highly recommended.

 

 

 

 

on 1/24/01 6:08 PM, Jeff Gould at jeffgould wrote:

 

> Actually, Wei Li was my teacher also and I folllowed her for awhile. She

> put me on dong chong xia cao for awhile. I purchased lab grown variety from

> People's Herbs (I think that's the name). Pretty inexpensive compared to

> raw. It was also 4:1 concentrate and probably the tastiest herb I ever had.

>

> While I have no way of knowing, I believe that I was able to postpone

> dialysis for a year or more. I only wish I had come across her sooner. She

> ALWAYS gives people with decreasing kidney function (as measured by

> creatinine clearance and BUY) this herb.

>

> Of particular note, on several occasions, as my worsened, I would have

> asthma-like attacks. I say asthma-like, because I had never really had

> asthma before. It was the kidney xu kind, that is, harder to inhale than

> exhale. When I started taking dong chong xia cao, it went away. This herb

> is said to tonify both Lung and Kidney. I hadn't heard that asthma symptoms

> are common with kidney failure, but for me, it was another interesting

> illustration of just how TCM theory makes sense in the real world.

>

> Jeff

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, " " <

zrosenberg@e...> wrote:

> on 1/23/01 4:08 PM, alonmarcus@w... at alonmarcus@w... wrote:

>

> For some reason, this message didn't come through.

>

> >>>>>>I think this was about a book from blue poppy called treatment of

disease

> by TCM or something like that. Its a great 7 book series that categorize

> disease by TCM disease names. The treatments are clear OM pattern w/out any

> of the common theoretical differentiations so common in many other books.

> Alon

>

> This is one of the best series of books I've seen on TCM disease patterns.

> Really to the core stuff.

>

> Z'ev

 

I couldn't live without these.

 

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, " Jeff Gould " <jeffgould@h...>

wrote:

> Actually, Wei Li was my teacher also and I folllowed her for awhile.

 

Jeff

 

I was supervising interns today and one asked me about a formula a

patient had brought from her old clinic. The header said OCOM and the

formula structure looked very familiar as did the handwriting. then at

the bottom I saw Dr. Li's initials and I got a big smile across my

face. Too bad she doesn't communicate so well, because she remains the

best herbalist I have ever worked with. Her objectively proved success

rate with chronic illness, as evidenced by lab testing, was so far

beyond anyone I ever worked with. Nice to think of her twice in one

day. Every time I dose an herb, I hear her words in my ear. " that's

too low; it will never work " or " my father never uses more than 6

grams of chuan xiong; too strong " .

 

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