Pathomechanisms and pattern identification

[Guest guest]

Question:

 

What is the relationship between the theory of

pathomechanisms of the zang4 fu3 (bing4 ji1)

and pattern identification (bian4 zheng4)?

 

How are these two theories understood?

 

How are they taught in the schools?

 

What books or other materials are used that

cover the question I raised above?

 

Thanks for any help you can give on this.

 

Ken

[Guest guest]

, yulong@m... wrote:

> Question:

>

> What is the relationship between the theory of

> pathomechanisms of the zang4 fu3 (bing4 ji1)

> and pattern identification (bian4 zheng4)?

 

>

> How are these two theories understood?

 

I understand pathomechanisms to be the explanations of how a pattern of

disharmony (syndrome) arises. the bing ji are based upon an

understanding of normal organ function and how that function may go

awry. For example if spleen function of transformation and

transportation fails, a number of patterns may ensue, including

dampness, phlegm accumulation and food accumulation. While patterns

are known by their signs and symptoms, it is often vital to identify

their underlying etiologies for several reasons. It plays a role in

confirming that the s/s complex makes sense. For instance if s/s of

phlegm are somewhat vague and inconclusive, the absence of the

corrollary bing ji may allow one to rule out the pattern as likely.

Bing ji also allow one to create complex diagnoses by understanding the

interrelationship between seeminly disparate patterns. for example,

spleen qi xu may lead to kidney yin xu because the spleen plays a role

in producing postnatal essence. Failure to understand these

relationships leads people to make simplistic diagnoses and miss the

mutually engendering pathomechanisms at play in most complex diseases.

 

>

> How are they taught in the schools?

 

pathomechanisms are often glossed over in the foundational stage sof

education. At PCOM, several professors put considerable emphasis on

understanding these factors later on (Zev Rosenberg, Bob Damone, Greg

Bantick, Lynda Harvey, to name a few). I emphasize them in

understanding the patterns herbs treat in my introductory materia

medica classes. Students had apparently had little exposure to this

concept in their intro theory class and many really struggled with this

in my class. In my advanced clinical herbology class, I found

upperclass students had had little of this info at all and were very

resistant to the importance thereof and often missed this info on

exams. One exasperated student told me she had been an A student for

three years and had no idea what I was asking her to explain to me.

 

>

> What books or other materials are used that

> cover the question I raised above?

 

Blue Poppy books on internal medicine specialties put considerable

emphasis on bing ji and the relationship to bian zheng. So does

wiseman/ellis fundamentals, another reason this book should be a

required text from day one.

 

[Guest guest]

---

<<

> How are they taught in the schools?

 

pathomechanisms are often glossed over in the

foundational stage sof

education. At PCOM, several professors put

considerable emphasis on

understanding these factors later on (Zev Rosenberg,

Bob Damone, Greg

Bantick, Lynda Harvey, to name a few). I emphasize

them in

understanding the patterns herbs treat in my

introductory materia

medica classes. Students had apparently had little

exposure to this

concept in their intro theory class and many really

struggled with this

in my class.>>

 

My method of teaching these to first year students is

constant reinforcement, not terribly intellectual but

it works, I think. Every time I present a phlegm

pattern, I go over it again... what are some of the

pathomechanisms involved? Failure of the Spleen to

transform ingested fluids, failure of the Lung to

depurate, pathogenic heat giving rise to phlegm...

blah blah blah. Fundamentals fundamentals

fundamentals. After a while they don't even need to

have me review them, they know I'm going to ask and

they just start reciting. The first three foundation

classes I teach are the most important, and if I do my

job right I know that later classes will be much

easier. Differential Dx won't be a bunch of s/s that

" make no sense " .

 

<<

> What books or other materials are used that

> cover the question I raised above?

 

Blue Poppy books on internal medicine specialties put

considerable

emphasis on bing ji and the relationship to bian

zheng. So does

wiseman/ellis fundamentals, another reason this book

should be a

required text from day one.>>

 

We require Fundamentals at Midwest, though some of my

fellow instructors rely more on Maciocia. The

students frankly don't like Fundamentals and don't

read the book even though I write the exams based on

it. All the more reason for me to drive the basic

stuff home in class.

 

A basic difference between the two is that

Fundamentals uses the pathomechanisms themselves to

differentiate certain bian zheng -- for example,

Wind-Cold fettering the Lung is a sub-set of

Non-Diffusion of Lung Qi, Damp-Phlegm in the Lung is a

sub-set of Impaired Depurative Downbearing, Spleen Qi

Vacuity is a sub-set of Splenic Transformation

Failure. So if the student wants to look up these

patterns in the Fundamentals, they need to look under

the pathomechanism first to find the pattern.

Maciocia's book does not organize these patterns in

this way. So the reading of Fundamentals reinforces

the pathomechanism in a way that other basic texts do

not. The problem is that more advanced classes

utilize texts which categorize under bian zheng or

disease entity, so there is little continuity for this

concept of organizing by pathomechanism later on.

 

BTW, reading Wiseman's essays in the current Clinical

Acupuncture & OM was good for me, to reinforce the

value of using a standardized translation. I'm

currently trying to condition myself to lose the

pernicious habit of using words like deficiency and

tonification... ;0)

 

The students love Giovanni, though. In the advanced

Internal Medicine class the other day, a student was

doing a presentation on beng1 lou4/uterine bleeding

and listed GM's recommended herbs to stop bleeding

under their various categories. One of the categories

was " calm Blood " . I asked her if she knew what GM

meant by " calm " , as we hadn't learned that term --calm

as in ping2? maybe he meant he2? Since the category

included Sheng Di Huang and Mu Dan Pi, I assumed it

was " cool Blood " , though the list included Bai Shao,

for which I never learned cooling Blood as a function.

So I still don't know what she meant.

 

Another book which I've found helpful specifically in

teaching Phlegm pathomechanisms is " Fluid Physiology

and Pathology in TCM " by Steven Clavey; though it

doesn't use the Wiseman terminology, it is

well-referenced and not difficult to match technical

terms with the Fundamentals.

 

 

 

=====

Robert Hayden, L.Ac.

http://jabinet.net

 

 

 

Get email at your own domain with Mail.

http://personal.mail./

[Guest guest]

Does anyone include or interpret Western medical information (e.g.,

translate Western info into 5-Phases) in their diagnosis? Just curious.

 

Jim Ramholz

 

 

 

, r hayden <kampo36> wrote:

>

> ---

> <<

> > How are they taught in the schools?

>

> pathomechanisms are often glossed over in the

> foundational stage sof

> education. At PCOM, several professors put

> considerable emphasis on

> understanding these factors later on (Zev Rosenberg,

> Bob Damone, Greg

> Bantick, Lynda Harvey, to name a few). I emphasize

> them in

> understanding the patterns herbs treat in my

> introductory materia

> medica classes. Students had apparently had little

> exposure to this

> concept in their intro theory class and many really

> struggled with this

> in my class.>>

>

> My method of teaching these to first year students is

> constant reinforcement, not terribly intellectual but

> it works, I think. Every time I present a phlegm

> pattern, I go over it again... what are some of the

> pathomechanisms involved? Failure of the Spleen to

> transform ingested fluids, failure of the Lung to

> depurate, pathogenic heat giving rise to phlegm...

> blah blah blah. Fundamentals fundamentals

> fundamentals. After a while they don't even need to

> have me review them, they know I'm going to ask and

> they just start reciting. The first three foundation

> classes I teach are the most important, and if I do my

> job right I know that later classes will be much

> easier. Differential Dx won't be a bunch of s/s that

> " make no sense " .

>

> <<

> > What books or other materials are used that

> > cover the question I raised above?

>

> Blue Poppy books on internal medicine specialties put

> considerable

> emphasis on bing ji and the relationship to bian

> zheng. So does

> wiseman/ellis fundamentals, another reason this book

> should be a

> required text from day one.>>

>

> We require Fundamentals at Midwest, though some of my

> fellow instructors rely more on Maciocia. The

> students frankly don't like Fundamentals and don't

> read the book even though I write the exams based on

> it. All the more reason for me to drive the basic

> stuff home in class.

>

> A basic difference between the two is that

> Fundamentals uses the pathomechanisms themselves to

> differentiate certain bian zheng -- for example,

> Wind-Cold fettering the Lung is a sub-set of

> Non-Diffusion of Lung Qi, Damp-Phlegm in the Lung is a

> sub-set of Impaired Depurative Downbearing, Spleen Qi

> Vacuity is a sub-set of Splenic Transformation

> Failure. So if the student wants to look up these

> patterns in the Fundamentals, they need to look under

> the pathomechanism first to find the pattern.

> Maciocia's book does not organize these patterns in

> this way. So the reading of Fundamentals reinforces

> the pathomechanism in a way that other basic texts do

> not. The problem is that more advanced classes

> utilize texts which categorize under bian zheng or

> disease entity, so there is little continuity for this

> concept of organizing by pathomechanism later on.

>

> BTW, reading Wiseman's essays in the current Clinical

> Acupuncture & OM was good for me, to reinforce the

> value of using a standardized translation. I'm

> currently trying to condition myself to lose the

> pernicious habit of using words like deficiency and

> tonification... ;0)

>

> The students love Giovanni, though. In the advanced

> Internal Medicine class the other day, a student was

> doing a presentation on beng1 lou4/uterine bleeding

> and listed GM's recommended herbs to stop bleeding

> under their various categories. One of the categories

> was " calm Blood " . I asked her if she knew what GM

> meant by " calm " , as we hadn't learned that term --calm

> as in ping2? maybe he meant he2? Since the category

> included Sheng Di Huang and Mu Dan Pi, I assumed it

> was " cool Blood " , though the list included Bai Shao,

> for which I never learned cooling Blood as a function.

> So I still don't know what she meant.

>

> Another book which I've found helpful specifically in

> teaching Phlegm pathomechanisms is " Fluid Physiology

> and Pathology in TCM " by Steven Clavey; though it

> doesn't use the Wiseman terminology, it is

> well-referenced and not difficult to match technical

> terms with the Fundamentals.

>

>

>

> =====

> Robert Hayden, L.Ac.

> http://jabinet.net

>

>

>

> Get email at your own domain with Mail.

> http://personal.mail./

[Guest guest]

In a message dated 4/16/01 10:46:33 AM Pacific Daylight Time, jramholz writes:

 

 

 

Does anyone include or interpret Western medical information (e.g., translate Western info into 5-Phases) in their diagnosis? Just curious.

 

 

Yes....Will

[Guest guest]

In a message dated 4/16/01 7:04:21 PM Pacific Daylight Time, WMorris116 writes:

 

 

Does anyone include or interpret Western medical information (e.g., translate Western info into 5-Phases) in their diagnosis? Just curious.

 

Just kidding ......To risk the obvious...and one of my teachers wished that we become masters of the obvious, I use lipids for wood, inflammatory components such as sed rate for fire, sugars for Earth, salts for Water, and....oddly enough, metals for metal.

 

Will

[Guest guest]

Will:

 

I enjoyed your previous note; you and I have a similar sense of humor.

We use a similar 5-Element rationale for incorporating Western med

info; often using the Front and Back of the pulse movement to

distinguish between the function and organic aspects of a disorder

(e.g., the difference between hypoglyemia and diabetes).

 

Has anyone developed these ideas in print? I haven't seen Clavey's

book, would it be in there?

 

Jim Ramholz

 

 

, WMorris116@A... wrote:

> In a message dated 4/16/01 7:04:21 PM Pacific Daylight Time,

> WMorris116@A... writes:

>

>

> > Does anyone include or interpret Western medical information (e.g.,

> > translate Western info into 5-Phases) in their diagnosis? Just

curious.

> >

>

> Just kidding ......To risk the obvious...and one of my teachers wished

that

> we become masters of the obvious, I use lipids for wood,

inflammatory

> components such as sed rate for fire, sugars for Earth, salts for

Water,

> and....oddly enough, metals for metal.

>

> Will

[Guest guest]

it's Kim McCabe: I haven't been able to change

the setting for the herb academy. If it's possible

can you change mine so that I can log in if I want to

without receiving everyone's responses. Or, if that's

not possible, please disconnect my membership until I

come back to china. sorry but i've been so busy and

i'm computer illiterate. thanks, kim

--- wrote:

> , yulong@m... wrote:

> > Question:

> >

> > What is the relationship between the theory of

> > pathomechanisms of the zang4 fu3 (bing4 ji1)

> > and pattern identification (bian4 zheng4)?

>

> >

> > How are these two theories understood?

>

> I understand pathomechanisms to be the explanations

> of how a pattern of

> disharmony (syndrome) arises. the bing ji are based

> upon an

> understanding of normal organ function and how that

> function may go

> awry. For example if spleen function of

> transformation and

> transportation fails, a number of patterns may

> ensue, including

> dampness, phlegm accumulation and food accumulation.

> While patterns

> are known by their signs and symptoms, it is often

> vital to identify

> their underlying etiologies for several reasons. It

> plays a role in

> confirming that the s/s complex makes sense. For

> instance if s/s of

> phlegm are somewhat vague and inconclusive, the

> absence of the

> corrollary bing ji may allow one to rule out the

> pattern as likely.

> Bing ji also allow one to create complex diagnoses

> by understanding the

> interrelationship between seeminly disparate

> patterns. for example,

> spleen qi xu may lead to kidney yin xu because the

> spleen plays a role

> in producing postnatal essence. Failure to

> understand these

> relationships leads people to make simplistic

> diagnoses and miss the

> mutually engendering pathomechanisms at play in most

> complex diseases.

>

> >

> > How are they taught in the schools?

>

> pathomechanisms are often glossed over in the

> foundational stage sof

> education. At PCOM, several professors put

> considerable emphasis on

> understanding these factors later on (Zev Rosenberg,

> Bob Damone, Greg

> Bantick, Lynda Harvey, to name a few). I emphasize

> them in

> understanding the patterns herbs treat in my

> introductory materia

> medica classes. Students had apparently had little

> exposure to this

> concept in their intro theory class and many really

> struggled with this

> in my class. In my advanced clinical herbology

> class, I found

> upperclass students had had little of this info at

> all and were very

> resistant to the importance thereof and often missed

> this info on

> exams. One exasperated student told me she had been

> an A student for

> three years and had no idea what I was asking her to

> explain to me.

>

> >

> > What books or other materials are used that

> > cover the question I raised above?

>

> Blue Poppy books on internal medicine specialties

> put considerable

> emphasis on bing ji and the relationship to bian

> zheng. So does

> wiseman/ellis fundamentals, another reason this book

> should be a

> required text from day one.

>

 

>

>

>

 

 

 

 

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