Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 on 2/14/01 2:29 PM, alonmarcus at alonmarcus wrote: What I am saying is that CM and Biomedicine have a > totally different orientation and understanding of health and disease. > Although one may use theoretical overlaps by looking at symptoms and signs, > as I point out in my own books they should be viewed w/ great caution. > Because the biomedical model is based on a pathological model (when > possible) w/ a specific " lesion " that then has a particular prognosis etc. > to just plug in overlapping symptoms and theorize an outcome is not valid. > To me clinical studies is the bringing that is needed to make any such > process valid. The Chinese Medical Psychiatry book does this, however, at > least in 1985 when I was in China I witnessed (first hand) to complete > fabrication of studies and case histories published in professional > journals. I agree totally with Alon. I want to clarify, first, that I am not referring directly to " Chinese Medical Psychiatry " as a textbook. . . .I think Bob Flaws did an excellent job, and I plan to use it as a classroom text next semester in one of my classes. I am concerned about how integration of Chinese and Western medicines are happening in terms of overlapping models. As Alon points out, biomedical models are based largely on specific lesions and their prognosis. Chinese medical models are based on constellations of symptom patterns, on qualities rather than quantities. With essence/spirit disorders (Chinese) and emotional/psychological conditions (Western), there would seem to be more room to overlap than with specific morphological conditions. However, in any case, a practitioner of Chinese medicine needs to follow the thread through completely with pattern diagnosis, and then can cross-reference biomedical disease categories more effectively. However, in many studies and textbooks, the information is mixed together in a way that I, at least, find confusing. I also think this tendency has been confusing for students as well, and has often led to a less than ideal grasp of Chinese medical theory. These are on-going concerns, and as our profession evolves, I assume these issues will be clarified and/or resolved. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 With essence/spirit disorders (Chinese) andemotional/psychological conditions (Western), there would seem to be moreroom to overlap than with specific morphological conditions >>>That is very true since the western model for these are syndromes for the most part.There is no understanding as to a lesion or i.e. a disease Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2001 Report Share Posted February 15, 2001 , " " <zrosenberg@e...> wrote: > > I am concerned about how integration of Chinese and Western medicines are > happening in terms of overlapping models. As Alon points out, biomedical > models are based largely on specific lesions and their prognosis. Chinese > medical models are based on constellations of symptom patterns, on qualities > rather than quantities. While I pretty much disagree with you guys completely on this matter, I think the point is particularly off base when it comes to psychiatry as western medicine makes psychiatric diagnoses according to s/s complexes, not identifiable lesions. While there are theories about the physiological causes of psych disease, no lesion isa used to diagnose for schizophrenia, depression, ADHD, bipolar, etc. thus the correlation is even more valid in psychiatry than in other fields. But even in other specialties, I think it is an equally valid approach. for example, if one is treating parkinson's from a TCM perspective, then you would start by looking at case histories about treating tremors. this is no different than what the int. med authors did when they differentiated the western disease of parkinsons. the error is if one mistakes this process for a TCM analysis of the lesion of parkinsons, which it is not. It is an analysis of the s/s. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2001 Report Share Posted February 15, 2001 Well said... Especially since western biomedicine has an incredible diagnostic system that can utilized to really differentiate various aspects of the 'disease', enhancing TCM views...Although, I see the current resistance to this type of thought stemming from people using these texts/ methodologies as cookbooks. For example, picking a disease (western or eastern), flipping through a book and finding the pattern that fits best. I personally find this type of dx. oversimplified and brainless. One loses the ability to think, and relies on fitting people into a box, de-personalizing the treatment. Why is that you can look at 4 books/ authors of the same disease and find different patterns for each? And even within the same pattern different point and herbal px...? It seems that many moderns books are set-up in a way to encourage this cook-book style, although I do not know a better way... comments? - Robert Flaws [bob] Friday, February 16, 2001 7:32 AM FW: RE: Re: biomedical and CM diagnosis > [Original Message] > Robert Flaws <bobflaws > > 2/15/2001 8:42:49 AM > RE: Re: biomedical and CM diagnosis > > Alon, Z'ev, et al., > > When it comes to the realtionship between Chinese and Western medicines, I think it is important not to mix apples and oranges or, the case of some recent exchanges, patterns and diseases. Chinese medicine has used disease diagnosis as part of its prescriptive methodology for at least 2,500 years. In contemporary professional Chinese medicine, treatment is primarily predicated on pattern discrimination, and it is treatment based on pattern discrimination which makes it the safe and effective holistic medicine it is. However, such pattern discrimination is always preceded by a disease diagnosis. That disease diagnosis can be either a traditional Chinese disease category, such as wasting thirst, strangury, mounting, or yang wilting, or it can be a modern Western disease diagnosis. As I and most Chinese doctors see it, there is absolutely no problem with this, no contradiction, and no confusion. Patterns and diseases are not the same. As concepts, they each operate in our prescriptive methodology on their own levels and within their own spheres of influence. When we break a modern Western medical disease down into several Chinese patterns, what we are saying is that, based on real-life clinical experience, these are the Chinese medical patterns one sees most often in patients with these Western disease diagnoses. Having said that, we then go on to primarily treat the pattern. " Yi bing, tong zhi; tong bing, yi zhi. " > > However, while we could just identify a patient's pattern and treat it and forget about their disease diagnosis, whether traditional Chinese or modern Western, if we did so, we would be forgetting that different diseases have different natural histories (meaning courses, duration, prognosis, etc.). We would be forgetting the accumulated experience of clinicians regarding everything which makes one disease distinct from another. Two patient may present exactly the same patterns, for instance liver depression qi stagnation with phlegm nodulation and blood stasis. However, one patient may have fibrocystic breast disease, while the other patient may breast cancer. Obviously, the course and prognoses of these two patients are going to be quite different and one may choose to use certain medicinals in the treatment of one which are not so necessary and appropriate in the other. Further, by identifying the patient's disease diagnosis, we narrow down the probable range of presenting patterns. Instead of having to confirm or deny the possibility of any of hundreds of Chinese medical patterns, we can focus our attention on those several patterns which past experience has shown are the most likely. > > If one understands the difference between diseases and patterns as well as their different uses in Chinese medicine's prescriptive methdology, there is no particular danger of blurring the two systems of Western and Chinese medicine. Even though Chinese medicine does not posit an ontological dichotomy between psyche and soma, we can most definitely and quite helpfully distinguish those patterns which most commonly present in patients with a Western medical diagnosis of conversion disorder (one of the subsets of somatoform disorders). I see nothing confusing or ironic about this, even though Chinese medicine posits no dichotomy between psyche and soma. Here we are specifically talking about steps in a prescriptive methodology. Where the danger of blurring these two systems exists is saying that a kidney yin vacuity is the same as an adrenal insufficiency or that endometrisosis is the same as blood stasis. However, that is most definitely not what I or most Chinese doctors are saying when we present pattern discrimination breakdowns for modern Western diseases. In fact, presenting such multi-pattern discriminations works directly against such niave and oversimplistic attempts to reduce one system to another. > > In most contemporary Chinese medical texts (at least Chinese language ones), there is a clear-cut step-by-step progression from signs and symptoms gathered by the four examinations to a Western disease diagnosis, thence to a traditional Chinese diagnosis (or diagnoses, since most Western disease entities are made up of two or more Chinese disease entities), and then to a pattern discrimination. From the pattern discrimination we go to a statement of treatment principles which then lead us to a formulation of either acupuncture (or tuina) points or Chinese formula with its specific medicinals. This step-by-step process promotes greater and greater clarity at each step of its way. And I think it is necessary that, when we talk about the relationship of Western and Chinese medicines, where they converge and where they diverge, that we be as careful and as clear as our prescriptive methodology teaches us to be. As I and most contemporary Chinese doctors see it, there is a place in our prescriptive methdology where we can and even should take into account a patient's Western medical diseases diagnosis, just as they are also other places in this process where we should definitely not allow the Western disease diagnosis to affect our Chinese medical logic. > > Bob > > > [Original Message] > > <zrosenberg > > > > 2/14/2001 5:38:12 PM > > Re: biomedical and CM diagnosis > > > > on 2/14/01 2:29 PM, alonmarcus at alonmarcus wrote: > > > > What I am saying is that CM and Biomedicine have a > > > totally different orientation and understanding of health and disease. > > > Although one may use theoretical overlaps by looking at symptoms and signs, > > > as I point out in my own books they should be viewed w/ great caution. > > > Because the biomedical model is based on a pathological model (when > > > possible) w/ a specific " lesion " that then has a particular prognosis etc. > > > to just plug in overlapping symptoms and theorize an outcome is not valid. > > > To me clinical studies is the bringing that is needed to make any such > > > process valid. The Chinese Medical Psychiatry book does this, however, at > > > least in 1985 when I was in China I witnessed (first hand) to complete > > > fabrication of studies and case histories published in professional > > > journals. > > > > > > I agree totally with Alon. I want to clarify, first, that I am not > > referring directly to " Chinese Medical Psychiatry " as a textbook. . . .I > > think Bob Flaws did an excellent job, and I plan to use it as a classroom > > text next semester in one of my classes. > > > > I am concerned about how integration of Chinese and Western medicines are > > happening in terms of overlapping models. As Alon points out, biomedical > > models are based largely on specific lesions and their prognosis. Chinese > > medical models are based on constellations of symptom patterns, on qualities > > rather than quantities. With essence/spirit disorders (Chinese) and > > emotional/psychological conditions (Western), there would seem to be more > > room to overlap than with specific morphological conditions. However, in > > any case, a practitioner of Chinese medicine needs to follow the thread > > through completely with pattern diagnosis, and then can cross-reference > > biomedical disease categories more effectively. However, in many studies > > and textbooks, the information is mixed together in a way that I, at least, > > find confusing. I also think this tendency has been confusing for students > > as well, and has often led to a less than ideal grasp of Chinese medical > > theory. > > > > These are on-going concerns, and as our profession evolves, I assume these > > issues will be clarified and/or resolved. > > > > > > > > > > > > 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. > > > > > > > > > > Bob Flaws > Blue Poppy Enterprises, Inc. " Medical Style of A New Generation " > bobflaws > 5441 Western Ave., #2 > Boulder, CO 80301 USA > Tel. 303-447-8372 > Fax 303-245-8362 Bob Flaws Blue Poppy Enterprises, Inc. " Medical Style of A New Generation " bobflaws 5441 Western Ave., #2 Boulder, CO 80301 USA Tel. 303-447-8372 Fax 303-245-8362 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 February 15, 2001 Report Share Posted February 15, 2001 on 2/15/01 8:21 PM, at wrote: > , " " <zrosenberg@e...> > wrote: > >> >> I am concerned about how integration of Chinese and Western medicines are >> happening in terms of overlapping models. As Alon points out, biomedical >> models are based largely on specific lesions and their prognosis. Chinese >> medical models are based on constellations of symptom patterns, on qualities >> rather than quantities. > > While I pretty much disagree with you guys completely on this matter, I > think the point is particularly off base when it comes to psychiatry as > western medicine makes psychiatric diagnoses according to s/s > complexes, not identifiable lesions. While there are theories about > the physiological causes of psych disease, no lesion isa used to > diagnose for schizophrenia, depression, ADHD, bipolar, etc. thus the > correlation is even more valid in psychiatry than in other fields. I think I said the same thing in my original post, if you read it again more carefully. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2001 Report Share Posted February 15, 2001 , " " <zrosenberg@e...> wrote: > on 2/15/01 8:21 PM, @i... at @i... wrote: > western medicine makes psychiatric diagnoses according to s/s > > complexes, not identifiable lesions. While there are theories about > > the physiological causes of psych disease, no lesion isa used to > > diagnose for schizophrenia, depression, ADHD, bipolar, etc. thus the > > correlation is even more valid in psychiatry than in other fields. > > I think I said the same thing in my original post, if you read it > again more carefully. > so you did. my error. sorry. I still think the process is also valid for physical ailments with lesions, though. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 > [Original Message] > Robert Flaws <bobflaws > > 2/15/2001 8:42:49 AM > RE: Re: biomedical and CM diagnosis > > Alon, Z'ev, et al., > > When it comes to the realtionship between Chinese and Western medicines, I think it is important not to mix apples and oranges or, the case of some recent exchanges, patterns and diseases. Chinese medicine has used disease diagnosis as part of its prescriptive methodology for at least 2,500 years. In contemporary professional Chinese medicine, treatment is primarily predicated on pattern discrimination, and it is treatment based on pattern discrimination which makes it the safe and effective holistic medicine it is. However, such pattern discrimination is always preceded by a disease diagnosis. That disease diagnosis can be either a traditional Chinese disease category, such as wasting thirst, strangury, mounting, or yang wilting, or it can be a modern Western disease diagnosis. As I and most Chinese doctors see it, there is absolutely no problem with this, no contradiction, and no confusion. Patterns and diseases are not the same. As concepts, they each operate in our prescriptive methodology on their own levels and within their own spheres of influence. When we break a modern Western medical disease down into several Chinese patterns, what we are saying is that, based on real-life clinical experience, these are the Chinese medical patterns one sees most often in patients with these Western disease diagnoses. Having said that, we then go on to primarily treat the pattern. " Yi bing, tong zhi; tong bing, yi zhi. " > > However, while we could just identify a patient's pattern and treat it and forget about their disease diagnosis, whether traditional Chinese or modern Western, if we did so, we would be forgetting that different diseases have different natural histories (meaning courses, duration, prognosis, etc.). We would be forgetting the accumulated experience of clinicians regarding everything which makes one disease distinct from another. Two patient may present exactly the same patterns, for instance liver depression qi stagnation with phlegm nodulation and blood stasis. However, one patient may have fibrocystic breast disease, while the other patient may breast cancer. Obviously, the course and prognoses of these two patients are going to be quite different and one may choose to use certain medicinals in the treatment of one which are not so necessary and appropriate in the other. Further, by identifying the patient's disease diagnosis, we narrow down the probable range of presenting patterns. Instead of having to confirm or deny the possibility of any of hundreds of Chinese medical patterns, we can focus our attention on those several patterns which past experience has shown are the most likely. > > If one understands the difference between diseases and patterns as well as their different uses in Chinese medicine's prescriptive methdology, there is no particular danger of blurring the two systems of Western and Chinese medicine. Even though Chinese medicine does not posit an ontological dichotomy between psyche and soma, we can most definitely and quite helpfully distinguish those patterns which most commonly present in patients with a Western medical diagnosis of conversion disorder (one of the subsets of somatoform disorders). I see nothing confusing or ironic about this, even though Chinese medicine posits no dichotomy between psyche and soma. Here we are specifically talking about steps in a prescriptive methodology. Where the danger of blurring these two systems exists is saying that a kidney yin vacuity is the same as an adrenal insufficiency or that endometrisosis is the same as blood stasis. However, that is most definitely not what I or most Chinese doctors are saying when we present pattern discrimination breakdowns for modern Western diseases. In fact, presenting such multi-pattern discriminations works directly against such niave and oversimplistic attempts to reduce one system to another. > > In most contemporary Chinese medical texts (at least Chinese language ones), there is a clear-cut step-by-step progression from signs and symptoms gathered by the four examinations to a Western disease diagnosis, thence to a traditional Chinese diagnosis (or diagnoses, since most Western disease entities are made up of two or more Chinese disease entities), and then to a pattern discrimination. From the pattern discrimination we go to a statement of treatment principles which then lead us to a formulation of either acupuncture (or tuina) points or Chinese formula with its specific medicinals. This step-by-step process promotes greater and greater clarity at each step of its way. And I think it is necessary that, when we talk about the relationship of Western and Chinese medicines, where they converge and where they diverge, that we be as careful and as clear as our prescriptive methodology teaches us to be. As I and most contemporary Chinese doctors see it, there is a place in our prescriptive methdology where we can and even should take into account a patient's Western medical diseases diagnosis, just as they are also other places in this process where we should definitely not allow the Western disease diagnosis to affect our Chinese medical logic. > > Bob > > > [Original Message] > > <zrosenberg > > > > 2/14/2001 5:38:12 PM > > Re: biomedical and CM diagnosis > > > > on 2/14/01 2:29 PM, alonmarcus at alonmarcus wrote: > > > > What I am saying is that CM and Biomedicine have a > > > totally different orientation and understanding of health and disease. > > > Although one may use theoretical overlaps by looking at symptoms and signs, > > > as I point out in my own books they should be viewed w/ great caution. > > > Because the biomedical model is based on a pathological model (when > > > possible) w/ a specific " lesion " that then has a particular prognosis etc. > > > to just plug in overlapping symptoms and theorize an outcome is not valid. > > > To me clinical studies is the bringing that is needed to make any such > > > process valid. The Chinese Medical Psychiatry book does this, however, at > > > least in 1985 when I was in China I witnessed (first hand) to complete > > > fabrication of studies and case histories published in professional > > > journals. > > > > > > I agree totally with Alon. I want to clarify, first, that I am not > > referring directly to " Chinese Medical Psychiatry " as a textbook. . . .I > > think Bob Flaws did an excellent job, and I plan to use it as a classroom > > text next semester in one of my classes. > > > > I am concerned about how integration of Chinese and Western medicines are > > happening in terms of overlapping models. As Alon points out, biomedical > > models are based largely on specific lesions and their prognosis. Chinese > > medical models are based on constellations of symptom patterns, on qualities > > rather than quantities. With essence/spirit disorders (Chinese) and > > emotional/psychological conditions (Western), there would seem to be more > > room to overlap than with specific morphological conditions. However, in > > any case, a practitioner of Chinese medicine needs to follow the thread > > through completely with pattern diagnosis, and then can cross-reference > > biomedical disease categories more effectively. However, in many studies > > and textbooks, the information is mixed together in a way that I, at least, > > find confusing. I also think this tendency has been confusing for students > > as well, and has often led to a less than ideal grasp of Chinese medical > > theory. > > > > These are on-going concerns, and as our profession evolves, I assume these > > issues will be clarified and/or resolved. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Jason, Your points are well taken. I have several things I'd like to say in response. 1) Because different textbooks give different patterns for the same diseases as well as different treatments for the same patterns of a single disease (based on their individual author's experiences and inclinations), it is extremely important to read or reference a number of such books, not just one. Since we generally don't have much depth in the English language literature, this underscores the necessity of reading Chinese. 2) As an extension of this, having looked at several such textbooks, the practitioner must still (as I think you already know and agree) craft an individualized treatment for each individual patient. The benefit of referencing several such books is that, while one may not choose to use any of the protocols contained in any of those references, they still do give a general idea of what other, presumably more experienced practitioners consider the basic parameters for treatment. In other words, they may not give a recipe, but they do give models. 3) The Chinese medical literature is made up of a number of identifiable genres, each of which has its own place and purpose in the overall scheme of things. Textbooks and clinical manuals such as we are talking about which give several patterns under each disease are one such specific genre within the Chinese medical literature. As such, they are meant as teaching and didactic conventions. They are meant to provide neophytes with a basic overview and some sense of general guidelines. However, they are also meant to be supplemented by other genres within the literature and, more importantly, by one's personal clinical mentors. Other genres of CM literature which go beyond such basic, beginning level information and approaches include case histories, clinical audits and other outcomes studies, so-called medical essays, and the classics, i.e., the premodern literature. Unfortunately, unless one can read Chinese, most Western students and practitioners do not have access to much in the way of this other, more advanced, more nuanced, and more realistic CM literature. Again the importance of reading at least modern medical Chinese! If one understands that books such as these are only meant as the first rung in a ladder of graduated CM medical genres, then they are fine for what they are. It's just that, as you point out, by themselves they are not sufficient to the exigencies of real-life clinical practice. Bob > [Original Message] > > > 2/16/2001 9:42:31 AM > RE: RE: Re: biomedical and CM diagnosis > > Well said... Especially since western biomedicine has an incredible > diagnostic system that can utilized to really differentiate various aspects > of the 'disease', enhancing TCM views...Although, I see the current > resistance to this type of thought stemming from people using these texts/ > methodologies as cookbooks. For example, picking a disease (western or > eastern), flipping through a book and finding the pattern that fits best. I > personally find this type of dx. oversimplified and brainless. One loses > the ability to think, and relies on fitting people into a box, > de-personalizing the treatment. Why is that you can look at 4 books/ authors > of the same disease and find different patterns for each? And even within > the same pattern different point and herbal px...? It seems that many > moderns books are set-up in a way to encourage this cook-book style, > although I do not know a better way... comments? > > - > > > Robert Flaws [bob] > Friday, February 16, 2001 7:32 AM > > FW: RE: Re: biomedical and CM diagnosis > > > > > [Original Message] > > Robert Flaws <bobflaws > > > > 2/15/2001 8:42:49 AM > > RE: Re: biomedical and CM diagnosis > > > > Alon, Z'ev, et al., > > > > When it comes to the realtionship between Chinese and Western medicines, > I think it is important not to mix apples and oranges or, the case of some > recent exchanges, patterns and diseases. Chinese medicine has used disease > diagnosis as part of its prescriptive methodology for at least 2,500 years. > In contemporary professional Chinese medicine, treatment is primarily > predicated on pattern discrimination, and it is treatment based on pattern > discrimination which makes it the safe and effective holistic medicine it > is. However, such pattern discrimination is always preceded by a disease > diagnosis. That disease diagnosis can be either a traditional Chinese > disease category, such as wasting thirst, strangury, mounting, or yang > wilting, or it can be a modern Western disease diagnosis. As I and most > Chinese doctors see it, there is absolutely no problem with this, no > contradiction, and no confusion. Patterns and diseases are not the same. As > concepts, they each operate in our prescriptive methodology on their own > levels and within their own spheres of influence. When we break a modern > Western medical disease down into several Chinese patterns, what we are > saying is that, based on real-life clinical experience, these are the > Chinese medical patterns one sees most often in patients with these Western > disease diagnoses. Having said that, we then go on to primarily treat the > pattern. " Yi bing, tong zhi; tong bing, yi zhi. " > > > > However, while we could just identify a patient's pattern and treat it > and forget about their disease diagnosis, whether traditional Chinese or > modern Western, if we did so, we would be forgetting that different > diseases have different natural histories (meaning courses, duration, > prognosis, etc.). We would be forgetting the accumulated experience of > clinicians regarding everything which makes one disease distinct from > another. Two patient may present exactly the same patterns, for instance > liver depression qi stagnation with phlegm nodulation and blood stasis. > However, one patient may have fibrocystic breast disease, while the other > patient may breast cancer. Obviously, the course and prognoses of these two > patients are going to be quite different and one may choose to use certain > medicinals in the treatment of one which are not so necessary and > appropriate in the other. Further, by identifying the patient's disease > diagnosis, we narrow down the probable range of presenting patterns. > Instead of having to confirm or deny the possibility of any of hundreds of > Chinese medical patterns, we can focus our attention on those several > patterns which past experience has shown are the most likely. > > > > If one understands the difference between diseases and patterns as well > as their different uses in Chinese medicine's prescriptive methdology, > there is no particular danger of blurring the two systems of Western and > Chinese medicine. Even though Chinese medicine does not posit an > ontological dichotomy between psyche and soma, we can most definitely and > quite helpfully distinguish those patterns which most commonly present in > patients with a Western medical diagnosis of conversion disorder (one of > the subsets of somatoform disorders). I see nothing confusing or ironic > about this, even though Chinese medicine posits no dichotomy between psyche > and soma. Here we are specifically talking about steps in a prescriptive > methodology. Where the danger of blurring these two systems exists is > saying that a kidney yin vacuity is the same as an adrenal insufficiency or > that endometrisosis is the same as blood stasis. However, that is most > definitely not what I or most Chinese doctors are saying when we present > pattern discrimination breakdowns for modern Western diseases. In fact, > presenting such multi-pattern discriminations works directly against such > niave and oversimplistic attempts to reduce one system to another. > > > > In most contemporary Chinese medical texts (at least Chinese language > ones), there is a clear-cut step-by-step progression from signs and > symptoms gathered by the four examinations to a Western disease diagnosis, > thence to a traditional Chinese diagnosis (or diagnoses, since most Western > disease entities are made up of two or more Chinese disease entities), and > then to a pattern discrimination. From the pattern discrimination we go to > a statement of treatment principles which then lead us to a formulation of > either acupuncture (or tuina) points or Chinese formula with its specific > medicinals. This step-by-step process promotes greater and greater clarity > at each step of its way. And I think it is necessary that, when we talk > about the relationship of Western and Chinese medicines, where they > converge and where they diverge, that we be as careful and as clear as our > prescriptive methodology teaches us to be. As I and most contemporary > Chinese doctors see it, there is a place in our prescriptive methdology > where we can and even should take into account a patient's Western medical > diseases diagnosis, just as they are also other places in this process > where we should definitely not allow the Western disease diagnosis to > affect our Chinese medical logic. > > > > Bob > > > > > [Original Message] > > > <zrosenberg > > > > > > 2/14/2001 5:38:12 PM > > > Re: biomedical and CM diagnosis > > > > > > on 2/14/01 2:29 PM, alonmarcus at alonmarcus wrote: > > > > > > What I am saying is that CM and Biomedicine have a > > > > totally different orientation and understanding of health and disease. > > > > Although one may use theoretical overlaps by looking at symptoms and > signs, > > > > as I point out in my own books they should be viewed w/ great caution. > > > > Because the biomedical model is based on a pathological model (when > > > > possible) w/ a specific " lesion " that then has a particular prognosis > etc. > > > > to just plug in overlapping symptoms and theorize an outcome is not > valid. > > > > To me clinical studies is the bringing that is needed to make any such > > > > process valid. The Chinese Medical Psychiatry book does this, > however, at > > > > least in 1985 when I was in China I witnessed (first hand) to complete > > > > fabrication of studies and case histories published in professional > > > > journals. > > > > > > > > > I agree totally with Alon. I want to clarify, first, that I am not > > > referring directly to " Chinese Medical Psychiatry " as a textbook. . . ..I > > > think Bob Flaws did an excellent job, and I plan to use it as a > classroom > > > text next semester in one of my classes. > > > > > > I am concerned about how integration of Chinese and Western medicines > are > > > happening in terms of overlapping models. As Alon points out, > biomedical > > > models are based largely on specific lesions and their prognosis. > Chinese > > > medical models are based on constellations of symptom patterns, on > qualities > > > rather than quantities. With essence/spirit disorders (Chinese) and > > > emotional/psychological conditions (Western), there would seem to be > more > > > room to overlap than with specific morphological conditions. However, > in > > > any case, a practitioner of Chinese medicine needs to follow the thread > > > through completely with pattern diagnosis, and then can cross-reference > > > biomedical disease categories more effectively. However, in many > studies > > > and textbooks, the information is mixed together in a way that I, at > least, > > > find confusing. I also think this tendency has been confusing for > students > > > as well, and has often led to a less than ideal grasp of Chinese medical > > > theory. > > > > > > These are on-going concerns, and as our profession evolves, I assume > these > > > issues will be clarified and/or resolved. > > > > > > > > > > > > > > > > > > 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. > > > > > > > > > > > > > > > > > Bob Flaws > > Blue Poppy Enterprises, Inc. " Medical Style of A New Generation " > > bobflaws > > 5441 Western Ave., #2 > > Boulder, CO 80301 USA > > Tel. 303-447-8372 > > Fax 303-245-8362 > > > Bob Flaws > Blue Poppy Enterprises, Inc. " Medical Style of A New Generation " > bobflaws > 5441 Western Ave., #2 > Boulder, CO 80301 USA > Tel. 303-447-8372 > Fax 303-245-8362 > > > > 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. > > > > > > 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. > > > Bob Flaws Blue Poppy Enterprises, Inc. " Medical Style of A New Generation " bobflaws 5441 Western Ave., #2 Boulder, CO 80301 USA Tel. 303-447-8372 Fax 303-245-8362 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2001 Report Share Posted February 17, 2001 So as a conclusion I think, successful therapy always needs to be completelyindividual, at least if it deals with more complex pathological patterns >>>that is always the bottom line ALon Quote Link to comment Share on other sites More sharing options...
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