AW: RE: biomedical and CM diagnosis

[Guest guest]

Very well said... but as we all know, one and the same disease can be the

consequence of a variety of different patterns and as Bob already pointed

out, one and the same pattern can lead to a variety of different diseases -

so what would you expect from books. Due to the complexity of nature they

all have to be restricted in one way or another.

And when it comes down to therapy, of course there should be plenty of ways

dealing with pathological patterns - having a variety of around 600

pharmacological substances - at least that´s what is available in my

country - I suppose you have even more...

Furthermore with more complex pathological patterns you will often end up in

a situation where you might not treat everything at once, but use some form

of timing in which you go forward solving one " knot " after the next... and

somewhere along the way you might even find that new pathological patterns

show up during therapy, that at the beginning were kind of covered by other

pathological layers...

So as a conclusion I think, successful therapy always needs to be completely

individual, at least if it deals with more complex pathological patterns.

 

Peter Powalka MD

 

-----Ursprüngliche Nachricht-----

Von: []

Gesendet: Freitag, 16. Februar 2001 05:49

An:

Betreff: 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.