Guest guest Posted October 14, 2001 Report Share Posted October 14, 2001 Even before followup on outcome, we need to find a way to share results, diagnoses and treatments with each other in this profession. I find most practitioner's and students charts difficult to read, and not thorough in reporting diagnosis and treatment plans, not to say followup. There is little communication between practitioners on case histories. I haven't a clue on what most of my peers are doing. As a new practitioner... I am certainly doing my best to develop good habits! One of the first things I ask a patient, that returns, is how did you feel after the last treatment? With the patient that I am treating for Xue & Qi Yu in the sacral/UB area... with Acupuncture only she was getting a 3 hour relief post tx. Now with herbs... an unmodified Du Huo Ji Sheng Tang, in Granule form, she is waking up without pain! This is a first for her... for sometime. Now we are able to go further with it... because now she stated that the pain came later in the day, when she received a phone call that "stressed" her out. Sometimes when I do not hear back from a patient, I do a follow up, courtesy call. Primarily because I really want to know what is working. Recently, I treated a patient with damp heat manifesting as shingles. Pain changed with tx. and I prescribed him Long Dan Xie Gan Tang... unmodified, granule form. During follow-up call the pt. said he absolutely could not drink the tea. I stressed the importance of the herbs and how beneficial I thought they would be for him! Anywise... have not heard back. What do others do? Do you give them pill form to insure compliance?!? Teresa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 , <alonmarcus@w...> wrote: The discustion sould be clinically based and not theoretical as is always done in this group > Alon I agree with Alon that the discussion should be clinically rooted, not merely theoretical speculation. However, any bias in this group towards speculation over empirical pragmatism is neither mine nor the mission of the group. Personally, I am a pragmatist, not a theorist or philosopher. I use theory only to the extent that it explains what has been empirically observed and can thus provide guidance and shortcuts in the clinical process. Theory has no inherent value. The map is not the terrain. So I am the one who raised the issue of raw foods and minimizing the consumption of grains on this list, hardly dyed in the wool TCM positions. And I will support anyone who also raises " heretical " points of view. I think this list includes those who are on both ends of the spectrum and if anyone feels inhibited from presenting an unpopular viewpoint, I apologize. Feel free to dicuss chinese herbology from any perspective you please. Someone said the other day using herbs from a pharmacological point of view is not chinese medicine. Well, I strongly disagree. According to Paul Unschuld, the scholarly form of CM from which TCM is descended was never practiced by any but a miniscule % of the population in China throughout her history. First of all, most people could not read before the communist revolution, so that precluded practice that was dependent upon being literate. So professional chinese medicine may have embraced bian zheng lun zhi, but the vast majority of the populace practiced empirical pragmatic forms of the medicine. While I believe to ignore the usefulness of theory and bian zheng lun zhi often results in poor results, it is incorrect to say that methods other than bian zheng are not CM. CM is whatever has been practiced in China. Arguably, the case could be made that bian zheng style is not truly representative. So in modern times, pharmacological data has been integrated into TCM and this is merely another development in CM. If you don't like it, don't bother with it. But it is mainstream in China and I doubt its going away just because some of us find it offensive. This conflict seems no different than the conflicts between those who only use five phases or chronoacupuncture vs. those who do TCM, etc. Let a hundred flowers bloom and those that have vitlaity will survive and the rest will wither. That's evolution. whatever has the most adaptive value in the real world will prevail and no words can stop that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 Prof. >Feel free to dicuss chinese herbology from any perspective you please. Thank you! Jean ===== -------------------------------- < ¨C¤Ñ³£ ©_¼¯ > www..tw Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 bian zheng lun zhi often results in poor results, it is incorrect to say that methods other than bian zheng are not CM >>>That is very true and also covers another incorrect statement that there were no specialist in TCM. Many dr were known to treat special aspects like bone dr etc. There are many family traditions that are known for their special formulas for special diseases. They were probably more common then well educated dr Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 On Saturday, October 20, 2001, at 01:39 PM, wrote: > -Someone said the other day using herbs from a pharmacological point of > view is not chinese medicine. Well, I strongly disagree. When did this come up? What I read was that using Chinese medicinals biomedically as 'antibiotic-like' substances or 'immune-enhancing' agents was not TCM. Also, that the clinical use of such agents in contraction of anthrax (the example given) was theoretical, in that it had never been done clinically. This is essentially very different that understanding Chinese medicinals pharmacologically. I am presently working on a software project that attempts to do this on a very large scale. I'll report to the group once this is well underway. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 On Saturday, October 20, 2001, at 01:39 PM, wrote: > , <alonmarcus@w...> wrote: > The discustion sould be clinically based and not theoretical as is > always done in this group > > Alon > > I agree with Alon that the discussion should be clinically rooted, not > merely theoretical speculation. However, any bias in this group > towards speculation over empirical pragmatism is neither mine nor the > mission of the group. Personally, I am a pragmatist, not a theorist or > philosopher. I use theory only to the extent that it explains what has > been empirically observed and can thus provide guidance and shortcuts > in the clinical process. Theory has no inherent value. The map is not > the terrain. Chinese medicine is not an either/or proposition. Theory has always developed in response to clinical need,and in turn, informed clinical work. Warm disease theory developed in response to new conditions and punishing epidemics, for example. There needs to be scholars to research, propose, and deliver theory for the medicine to stand on. No world medicine has survived without a body of literature to draw on. As Ken Rose has pointed out, the Chinese medicine we have today is the result of a literary canon, that requires study, reflection and commentary. Clinical practice is where medicine is practiced, the study hall is where it is elaborated. I don't understand this artificial us vs. them scenario between clinicians and scholars. I don't see this bifurcation in the Chinese medical tradition. > > > So in modern times, pharmacological data has been > integrated into TCM and this is merely another development in CM. If > you don't like it, don't bother with it. But it is mainstream in China > and I doubt its going away just because some of us find it offensive. New developments do not have to be accepted without criticism. We don't have to just throw up our hands, on one end, or ignore it, on the other. They should be critiqued, tried out, not just adapting a 'politically correct' stance. I personally am very cautious about endorsing massive antibiotic campaigns even in a serious disease such as anthrax. I worry as much about destruction of the human immune system from overuse of antibiotics as I do about the disease. It is worth our while to investigate the use of herbal medicine in epidemics, as has been done in China. We shouldn't dismiss the possibility outright, we are limiting ourselves unnecessarily. The new Warm Disease text published by Eastland Press has some interesting tidbits about recent applications of warm disease prescriptions in epidemics. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Theory in Chinese medicine has always been intimately connected with the observations and thought processes of physicians applying yin/yang to clinical situations.. The elaborate wen bing literature and theory developed out of clinical necessity and examination of data. Theory and clinical application develop from an interaction with each other, not in isolation. On Sunday, October 21, 2001, at 11:40 AM, <alonmarcus wrote: > Chinese medicine is not an either/or proposition. Theory has always > developed in response to clinical need,and in turn, informed clinical > work. > >>>The question arises when one applies theory to an untested > situation. While an approach may sound correct in real life patients it > may do nothing. That is were the truth lies > Alon > > > > 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 October 21, 2001 Report Share Posted October 21, 2001 Dear Colleagues.... One of my early teachers Jinling Wang promoted a balanced use of classical theory and current clinical research. His style was to select a formula on the basis of pattern discrimination and then add herbs on the basis of specific action established by modern research methods. It has worked for me. The SHL breakdown of anthrax could be used in a similar fashion. Use the appropriate antibiotic and treat with herbs according to the SHL stages as they present. This is how Maiqing Yang would approach the issue. Will Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Theory has no inherent value. Is this a theory? > > Someone said the other day using herbs from a pharmacological point of > view is not chinese medicine. Well, I strongly disagree. As I recall the discussion of the other day it concerned the trend away from Chinese medical theory as the guiding principles for the study, research, and clinical application of Chinese medicinal ingredients and formulas. I believe if you examine your remark above and my understanding you can see how differently two people can construe the same conversation. This is an interesting phenomenon in and of itself, but it suggests to me that theory may indeed have a value that we ought to recognize as inherent. It forms the basis for the mode of thinking, the way in which information is gathered, compiled, analyzed, understood and put into pragmatic application. Those who proceed directly to the endpoint of clinical application without adequate time spent in the theoretical therefore can find themselves with no adequate guide. According to > Paul Unschuld, the scholarly form of CM from which TCM is descended was > never practiced by any but a miniscule % of the population in China > throughout her history. First of all, most people could not read > before the communist revolution, so that precluded practice that was > dependent upon being literate. How do you explain the extensive collections of books then? Why would illiterates have so many books? You and I know each other, and I certainly know that it is not your intention to say so but your argument begins to sound like you are suggesting that knowledge that can and has been refined and transmitted for centuries is useless. So professional chinese medicine may > have embraced bian zheng lun zhi, but the vast majority of the populace > practiced empirical pragmatic forms of the medicine. Case in point. What you're saying is that the unfortunate scarcity of well educated and skillful medical personnel supports a view that theory is valueless. That just doesn't make sense to me. I don't think the point is: can and will people not rely on whateve they must in an attempt to deal with disease. Of course they will. But isn't it just as true that they will always cleave to the more capable and well educated doctor whenever such appears? Aren't these two behaviors expressions of the same urge? While I believe > to ignore the usefulness of theory and bian zheng lun zhi often results > in poor results, How does this jibe with your remark above? it is incorrect to say that methods other than bian > zheng are not CM. CM is whatever has been practiced in China. I think this could almost be taken as conclusive proof that we exist in an environment in this field that is so debased that we do not even have a mutually understandable and agreeable definition of the term that describes the whole field. Your suggested definition may or may not be adequte. Part of what has been practiced over the centuries in China has been a traditional methodology for the ongoing reevaluation of the subject, which always leads to parts of it being allowed to fall into disuse and disappear. Such evaluations tend to be carried out on the basis of, you will forgive the term, theory. > Arguably, the case could be made that bian zheng style is not truly > representative. So in modern times, pharmacological data has been > integrated into TCM and this is merely another development in CM. If > you don't like it, don't bother with it. But it is mainstream in China > and I doubt its going away just because some of us find it offensive. But in China there is a relatively vivid establishment of traditional understanding and methodology against which this phenomon unfolds. Therefore there are opportunities for differing views to be compared and contrasted and evaluated on a number of different bases. > This conflict seems no different than the conflicts between those who > only use five phases or chronoacupuncture vs. those who do TCM, etc. Like Z'ev, I'm not entirely sure what you mean by " the conflict. " Personally, I don't have a conflict between theory and practice. Perhaps you can clarify exactly what this conflict is. > > Let a hundred flowers bloom and those that have vitlaity will survive > and the rest will wither. That's evolution. whatever has the most > adaptive value in the real world will prevail and no words can stop > that. But words can and indeed do guide us towards understanding. If you read the words of one of China's greatest physicians, Sun Si Miao, he suggested that the prerequisites to the study of medicine include extensive indoctrination in the theoy. According to this approach, those who lack such training are not qualified to study the subject let alone practice clinically. By the way, the application of such an approach does not include the banishment of the unqualified but rather suggests that they be made more qualified. And in so doing we are brought to the manifestation of the inherent value of theory: it guides us in improving our lot in life. But this is all just a theory. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Chinese medicine is not an either/or proposition. Theory has always developed in response to clinical need,and in turn, informed clinical work. >>>The question arises when one applies theory to an untested situation. While an approach may sound correct in real life patients it may do nothing. That is were the truth lies Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 But words can and indeed do guide ustowards understanding. If you read the wordsof one of China's greatest physicians, Sun SiMiao, he suggested that the prerequisites to the study of medicine include extensiveindoctrination in the theoy. According to thisapproach, those who lack such trainingare not qualified to study the subjectlet alone practice clinically.>>>>>It is the interaction of the guide to practice or theory and the result one gets with one patient that constitute what I like to call clinically valid statements. Now it true that what ever path one chooses in treatment comes out of some kind of guiding path and there for knowledge of theory, it is still a leap making conclusions on outcome between these to places. This point of interaction is in my opinion were the discussion should be emphasized, and it is not. A simple example is, in the year or so I have been in this discussion group we covered many case histories and many people put in their 2 cents but not one of these cases was followed up on. Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 , yulong@m... wrote: theory may indeed have a value > that we ought to recognize as inherent. > > It forms the basis for the mode of thinking, > the way in which information is gathered, > compiled, analyzed, understood and put > into pragmatic application. Those who > proceed directly to the endpoint of clinical > application without adequate time spent > in the theoretical therefore can find themselves > with no adequate guide. I don't disagree with you at all. In fact, anyone who has actually worked with me in clinic knows that I never make any clinical decisions w/o the application of theory. My point that theory has no inherent value means that while an herb may have an intrinsic activity (i.e. that it relieves pain or stops sweating), any number of theories can be used to apply it successfully, holistically and noniatrogenically. So these theories are all merely maps of the terrain, concepts or guides that have no importance beyond their utility. the herb itself has inherent value. So if one is trained in ayurveda, TCM, unani, native american healing and naturopathy, one has numerous theories to guide him. But the only thing of value is the clinical utility. So all I meant is that theory abstracted from practice is meaningless. And theory that is not actually grounded in clinical experience is potentially harmful. An example is the application of herbs based upon their entering channel attributions to attempt to treat diseases for which the herb has not been used. does an herb treat eye pain just becasue it enters the liver channel? Or because we have a record of it being used to treat eye pain. If we know it treats eye paoin and it has been attributed to the liver, then we know under what circumstances to apply the herb (eye disease due to liver disharmony). But to use an herb with no recorded use for eye pain JUST because it enters the liver channel is the elevation of theory over empiricism. I see this kind of thing all the time. First of all, most people could not read > > before the communist revolution, so that precluded practice > that was > > dependent upon being literate. > > How do you explain the extensive collections > of books then? Why would illiterates have > so many books? I assume it was those who could read who owned the books. Are you disputing that the bulk of precommunist china was illiterate? > > You and I know each other, and I certainly > know that it is not your intention to say so > but your argument begins to sound like > you are suggesting that knowledge that > can and has been refined and transmitted > for centuries is useless. Not at all and I am not sure where you inferred that from. I merely am making the point that the majority of medicine practiced during chinese history was not the scholarly literate medicine and that body of empirical practice also has clinical value. this does not mean that the scholarly tradition has no value. In fact, being an educated elitist, I put more stock in practice blended with theory. But I do not dismiss the work of the illiterate healers, either. > > > > So professional chinese medicine may > > have embraced bian zheng lun zhi, but the vast majority of the > populace > > practiced empirical pragmatic forms of the medicine. > > Case in point. What you're saying is that the > unfortunate scarcity of well educated and > skillful medical personnel supports a > view that theory is valueless. That just > doesn't make sense to me. I can't help but think that you either misunderstood my use of the term inherent or that I used the word incorrectly. Hopefully, that has been clarified above. > > I don't think the point is: can and will people > not rely on whateve they must in an attempt > to deal with disease. Of course they will. > But isn't it just as true that they will always > cleave to the more capable and well educated > doctor whenever such appears? not necessarily. For example, in Africa, many people prefer working with uneducated shamans rather than with well educated modern physicians. Arguably,this has been a poor choice, given that by understanding certain concepts regarding germs, much suffering could have been avoided. > > While I believe > > to ignore the usefulness of theory and bian zheng lun zhi often > results > > in poor results, > > How does this jibe with your remark above? hopefully, you know the answer to this one after what I have said above. > > > Arguably, the case could be made that bian zheng style is not > truly > > representative. So in modern times, pharmacological data > has been > > integrated into TCM and this is merely another development in > CM. If > > you don't like it, don't bother with it. But it is mainstream in > China > > and I doubt its going away just because some of us find it > offensive. > > But in China there is a relatively vivid establishment > of traditional understanding and methodology > against which this phenomon unfolds. Therefore > there are opportunities for differing views to > be compared and contrasted and evaluated > on a number of different bases. yes, of course. > > > > This conflict seems no different than the conflicts between > those who > > only use five phases or chronoacupuncture vs. those who do > TCM, etc. > Personally, I don't have a conflict > between theory and practice. You don't. I don't, believe it or not. but one of the speakers at the symposium this fall does. His entire presentation is based upon the idea that chinese medical theory is bogus and one can only practice effectively from a pharmacological perspective. Others have argued that symptoms relief based upon treating ah shi points is all that is necessary. I disagree with both of these positions, BTW. However, I have also experienced the other extreme, as described above, where theory is used in the absence of any clinical foundation. I think it is careless to try novel methods on patients based purely upon theory if there are clinically proven methods that work. then there are things like NAET, which on one hand bothers me in its arrogance and bastardization of tradition, but also intrigues me in the plethora of reports of dramatic healing from both pt. and px of this method. In fact and I can't believe I am saying this, but NAET is a perfect example of the point I am making. NAET flies in the face of TCM theory, yet it appears to be of clinical value. Thus, it is the utility that again impresses me. But you cannot tell me there is no conflict between the proponents of NAET (a largely empirical method based upon muscle testing) and those who advocate classical study. So while I will continue to practice as I always have, which is to use TCM theory to guide my practice, I will not dismiss other approaches merely because they do not conform to certain theoretical principles. the proof is in the pudding. I use TCM because it is clinically grounded and I have seen it work over and over again. But if I started my studies today, would I be so adamant? I am not so sure. > > But words can and indeed do guide us > towards understanding. If you read the words > of one of China's greatest physicians, Sun Si > Miao, he suggested that the prerequisites > to the study of medicine include extensive > indoctrination in the theoy. According to this > approach, those who lack such training > are not qualified to study the subject > let alone practice clinically. that is the bias of one who probably had little or no experience with other professional methodologies, like ayurveda or modern pharmacology. I agree to the extent that practicing based upon symptomatic empiricism alone is often dangerous in chronic internal diseases. But TCM is no better than other holistic professional methodologies, which was one of my points. the other point is whether only the ancient literate tradition can be legitimately labeled CM (Alon mentions the illiterate bonesetters; there were also apparently those who practiced effective eye medicne or ear medicine, etc., all w/o the benefit of bian zheng lun zhi). I have also practiced with enough naturopathic physicians over the years to know that herbs can be applied quite holistically and noniatrogenically from a purely pharmacological perspective. As Alon has pointed out on a number of occasions, modern physiology and pharmacology are indeed quite holistic at the basic science level. Modern medicine is often shortsighted and reductionistic in its application of its own science, but this same data can be applied holistically (as it is in so-called functional medicine). So any theory that explains the phenomena and makes it clinically useful is of value to me, but no theory has value beyond that. It does not provide some fixed, eternal universal principle. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 , <alonmarcus@w...> wrote: > Chinese medicine is not an either/or proposition. Theory has always developed in response to clinical need,and in turn, informed clinical work. > >>>The question arises when one applies theory to an untested situation. While an approach may sound correct in real life patients it may do nothing. That is were the truth lies > Alon and that was my point. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 , <alonmarcus@w...> wrote: > A simple example is, in the year or so I have been in this discussion group we covered many case histories and many people put in their 2 cents but not one of these cases was followed up on. > Alon I also would be very interested to hear what people actually did with their cases after receiving advice and how the cases turned out. Otherwise, the discussion is just so much flaunting of knowledge with no clinical grounding. Did your pt. get better from SHL methodology, yin fire theory, NAET, folk medicine, homeopathy or a pharmacological method? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 On Sunday, October 21, 2001, at 01:13 PM, wrote: \ > In Africa, many people prefer working > with uneducated shamans rather than with well educated modern > physicians. Arguably,this has been a poor choice, given that by > understanding certain concepts regarding germs, much suffering could > have been avoided. Of course, uneducated by Western standards. There is actually, in true shamanism, a rigorous training using the apprenticeship model. Even though not a literate medicine, but an oral one, there is a lineage of transmission of the medicine. This is why many people continue to consult the shamans. Also, many people are attracted to this medicine because of its inherent spiritual content, i.e. that becoming reconciled with the forces of heaven and earth is what brings health and healing. Modern medicine doesn't provide that. Obviously, there are a range of disorders that shamans can treat that biomedicine cannot and visa versa, and places where their interaction brings great benefit for patients. We see that here in America where Navajo healers work together with Western physicians. > > > > However, I > have also experienced the other extreme, as described above, where > theory is used in the absence of any clinical foundation. I think it > is careless to try novel methods on patients based purely upon theory > if there are clinically proven methods that work. Can you give me an example of when 'theory is used in the absence of any clinical foundation'? This certainly isn't the model of pattern differentiation in the TCM literature. > > > > > > But words can and indeed do guide us > > towards understanding. If you read the words > > of one of China's greatest physicians, Sun Si > > Miao, he suggested that the prerequisites > > to the study of medicine include extensive > > indoctrination in the theoy. According to this > > approach, those who lack such training > > are not qualified to study the subject > > let alone practice clinically. > > that is the bias of one who probably had little or no experience with > other professional methodologies, like ayurveda or modern pharmacology. Actually, Sun Si Miao's work (Qian Jin Yao Fang) is influenced by Indian/Buddhist medical texts and shamanistic ideas. He's a lot more eclectic than you might think in his sources. Nonetheless, he still demands deep study in order to become a physician. > > I agree to the extent that practicing based upon symptomatic empiricism > alone is often dangerous in chronic internal diseases. But TCM is no > better than other holistic professional methodologies, which was one of > my points. What are your examples of 'holistic professional methodologies' that you are saying are as valid as TCM? Certainly one can make a number of arguments here. TCM is not just another alternative medical approach. > the other point is whether only the ancient literate > tradition can be legitimately labeled CM (Alon mentions the illiterate > bonesetters; there were also apparently those who practiced effective > eye medicne or ear medicine, etc., all w/o the benefit of bian zheng > lun zhi). Medicine as culture has many levels of practice. In biomedicine, you have researchers (Ph. D.'s), general practitioners, surgeons, nurses, physicians assistants, physical therapists. While Chinese medicine was not an organized institutionalized system to the degree of modern biomedicine, empiricism was applied to relatively local complaints, such as bone or ear, which didn't require as much overview or differentiation. > I have also practiced with enough naturopathic physicians > over the years to know that herbs can be applied quite holistically and > noniatrogenically from a purely pharmacological perspective. You and I have also discussed the potential excesses of over prescribing herbal medicinals and supplements from such a perspective. > So any > theory that explains the phenomena and makes it clinically useful is of > value to me, but no theory has value beyond that. It does not provide > some fixed, eternal universal principle. > > On the contrary, I think the philosophical bases of Chinese medicine, Ayurveda and Tibetan medicine clearly are seeking a universal principle, the principle of change. They are the core of medicine itself. . . yin/yang, tridosha, the Buddhist theories of life, death and suffering. All medicine is informed by the world view of the culture it develops in. And, finally, medicine has always been studied with a reverence for the knowledge base on which it was built. One doesn't 'discard' theory. . . .one works with it in context. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Hi,Every one, > According to Paul Unschuld, the scholarly form of CM from which TCM is descended was never practiced by any but a miniscule % of the population in China throughout her history. >First of all, most people could not read before the communist revolution, so that precluded practice that was dependent upon being literate. How do you know most people can't not read jsut according to some one saying that before. We chinese have lots old sayings aall about reading: " studying is the most important things in the univeral " , " there is no body knowing your name duing ten years study,but,when you passing the imperial examination ,the famous will all over the world " Study is the only way that poor people's hope to jump out the poor,no matter how poor the family is,parents always save money for childred to study. how do you know that most people can read in Chin-dynasty? 2.Do not forget the power of oral trasnmit.India people use oral transmit skill to inherity India philosophy and poem.As well as chinese 3.Almost every intellectuals know TCM in the passing 1000s years.Like Lee, Shi-Jen in Min-dynasty Su,Shi4. as well as theose TCM doctor,they are all intellectuals or imperial examination........ We are the nation of scholarly familys. If :most people could not read ( after) the communist revolution.The answer is:maybe, becasue communist revolution really distory every thing...that was a huge tragedy of human being.... Jean ===== -------------------------------- < ¨C¤Ñ³£ ©_¼¯ > www..tw Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 On the contrary, I think the philosophical bases of Chinese medicine, Ayurveda and Tibetan medicine clearly are seeking a universal principle, Hi, > the principle of change. They are the core of medicine itself. . . yin/yang, tridosha, the Buddhist theories of life, death and suffering. All medicine is informed by the world view of the culture it develops in. And, finally, medicine has always been studied with a reverence for the knowledge base on which it was built. One doesn't 'discard' theory. . . .one works with it in context. I am totally agree with ! Jean ===== -------------------------------- < ¨C¤Ñ³£ ©_¼¯ > www..tw Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Hi,Will, > One of my early teachers Jinling Wang promoted a > balanced use of classical > theory and current clinical research. His style was > to select a formula on > the basis of pattern discrimination and then add > herbs on the basis of > specific action established by modern research > methods. It has worked for me. > > The SHL breakdown of anthrax could be used in a > similar fashion. Use the > appropriate antibiotic and treat with herbs > according to the SHL stages as > they present. This is how Maiqing Yang would > approach the issue. > > Will This is another good alternative approach,too. Jean ===== -------------------------------- < ¨C¤Ñ³£ ©_¼¯ > www..tw Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 Alon, > A simple example is, in the year or so I have been in this discussion group we covered many case histories and many people put in their 2 cents but not one of these cases was followed up on. Just curious to know why you think this is. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 21, 2001 Report Share Posted October 21, 2001 > > I don't disagree with you at all. Remarkable. And even more so since you go on to make statements that I understand to be in more or less complete disagreement with what I thought I said. I believe we have wandered into some sort of tyranny of words, as the more we talk about it, the stranger it all starts to seem. In fact, anyone who has actually > worked with me in clinic knows that I never make any clinical decisions > w/o the application of theory. My point that theory has no inherent > value means that while an herb may have an intrinsic activity (i.e. > that it relieves pain or stops sweating), any number of theories can be > used to apply it successfully, holistically and noniatrogenically. So > these theories are all merely maps of the terrain, You've used this phrase a couple of times now and I begin to wonder what you really mean. To a person lost in a terrain, an accurate map is not merely anything but survival. concepts or guides > that have no importance beyond their utility. This is a tautology since nothing has any importance beyond its utility...particularly if you are judging importance based upon utility! See what I mean? the herb itself has > inherent value. So if one is trained in ayurveda, TCM, unani, native > american healing and naturopathy, one has numerous theories to guide > him. But the only thing of value is the clinical utility. So all I > meant is that theory abstracted from practice is meaningless. No it's not. It more or less has to be abstracted from practice in order to be studied and taught, and it more or less has to be integrated into practice in order to be meaningful and effective. Again, you seem to be wrestling with some sort of conflict here that continues to elude me. And > theory that is not actually grounded in clinical experience is > potentially harmful. An example is the application of herbs based upon > their entering channel attributions to attempt to treat diseases for > which the herb has not been used. does an herb treat eye pain just > becasue it enters the liver channel? Or because we have a record of it > being used to treat eye pain. If we know it treats eye paoin and it > has been attributed to the liver, then we know under what circumstances > to apply the herb (eye disease due to liver disharmony). But to use an > herb with no recorded use for eye pain JUST because it enters the liver > channel is the elevation of theory over empiricism. I see this kind of > thing all the time. I don't follow your example entirely, but what you seem to be getting at in this hypothetical example is a misuse of theory that I would tend to attribute to a lack of understanding of it. > > First of all, most people could not read > > > before the communist revolution, so that precluded practice > > that was > > > dependent upon being literate. > > > > How do you explain the extensive collections > > of books then? Why would illiterates have > > so many books? > > I assume it was those who could read who owned the books. Are you > disputing that the bulk of precommunist china was illiterate? I tried to indicate that this question is a red herring. The bulk of the population of pre- as well as post-communist China does not comprise physicians. There are somewhere in the neighborhood of a quarter to half a million doctors of TCM in China today. Compare that figure to the population total and you see what I mean. I suspect that today's statstics reflecting per capita density of doctors in China exceed those of bygone days. I don't have evidence to support this, just suspicion. Do I reject the assertion that the bulk of doctors in pre-communist China were illiterate? I think so. I'll have to give some more detailed thought. But I think that I would be comfortable assuming that the bulk of doctors of Chinese medicine down through the ages, at least if we begin to count in the Han dynasty, we probably educated folk. As I say this I recognize that there are numerous traditions of medicine in China and that many of these have long existed in the countryside beyond the reach of officaldom and systematized education. But I suspect that little of these traditions has actually reached American soil, and I do not think first of these kinds of transmissions when we discuss Chinese medicine in general. Perhaps this is a ripe area to explore for this tyranny of definitions that I feel we have wandered into. > > > > > You and I know each other, and I certainly > > know that it is not your intention to say so > > but your argument begins to sound like > > you are suggesting that knowledge that > > can and has been refined and transmitted > > for centuries is useless. > > Not at all and I am not sure where you inferred that from. I merely am > making the point that the majority of medicine practiced during chinese > history was not the scholarly literate medicine and that body of > empirical practice also has clinical value. this does not mean that > the scholarly tradition has no value. In fact, being an educated > elitist, I put more stock in practice blended with theory. But I do > not dismiss the work of the illiterate healers, either. Again, I sense the emergence of a conflict that I don't grasp the meaning of. > > > > > > > I can't help but think that you either misunderstood my use of the term > inherent or that I used the word incorrectly. Hopefully, that has been > clarified above. Well, frankly not entirely, as noted. > > > > > I don't think the point is: can and will people > > not rely on whateve they must in an attempt > > to deal with disease. Of course they will. > > But isn't it just as true that they will always > > cleave to the more capable and well educated > > doctor whenever such appears? > > not necessarily. For example, in Africa, many people prefer working > with uneducated shamans rather than with well educated modern > physicians. Arguably,this has been a poor choice, given that by > understanding certain concepts regarding germs, much suffering could > have been avoided. Huh? > > > > > But in China there is a relatively vivid establishment > > of traditional understanding and methodology > > against which this phenomon unfolds. Therefore > > there are opportunities for differing views to > > be compared and contrasted and evaluated > > on a number of different bases. > > yes, of course. Point being that it makes a substantial difference in terms of the status and importance afforded the study of theory. Please understand that what got me going was a statement: theory has no inherent value. It's simply the kind of remark that I find it hard to let blow by in the course of a discussion without inquiring what it really means. I'd be willing to accept that it was all just some sort of misunderstanding of terms, if it weren't for the fact that as noted above I think we may not be in agreement...even if I don't seem to be able to put my finger on it. Fortunately, I'll be in San Diego in a few days and look forward to being able to sit down and talk it out with you. > > > > But words can and indeed do guide us > > towards understanding. If you read the words > > of one of China's greatest physicians, Sun Si > > Miao, he suggested that the prerequisites > > to the study of medicine include extensive > > indoctrination in the theoy. According to this > > approach, those who lack such training > > are not qualified to study the subject > > let alone practice clinically. > > that is the bias of one who probably had little or no experience with > other professional methodologies, like ayurveda or modern pharmacology. Well, as some one else pointed out, Sun Si Miao was really quite an elcectic himself. I'm starting to get the idea that the underlying conflict has to do with the confluence of Chinese medicine and other practices entirely. I've got no problem with an eclectic approach, which you seem to be favoring. But doesn't it just make sense that in studying any tradition, even if it is the intention of the student to fashion some sort of grand synthesis of many, that each be afforded the integrity of its own internal coherence? This is the inherent value of theory. > I agree to the extent that practicing based upon symptomatic empiricism > alone is often dangerous in chronic internal diseases. But TCM is no > better than other holistic professional methodologies, which was one of > my points. Not sure what the range of things you have in mind here is. the other point is whether only the ancient literate > tradition can be legitimately labeled CM (Alon mentions the illiterate > bonesetters; there were also apparently those who practiced effective > eye medicne or ear medicine, etc., all w/o the benefit of bian zheng > lun zhi). I have also practiced with enough naturopathic physicians > over the years to know that herbs can be applied quite holistically and > noniatrogenically from a purely pharmacological perspective. As Alon > has pointed out on a number of occasions, modern physiology and > pharmacology are indeed quite holistic at the basic science level. > Modern medicine is often shortsighted and reductionistic in its > application of its own science, but this same data can be applied > holistically (as it is in so-called functional medicine). So any > theory that explains the phenomena and makes it clinically useful is of > value to me, but no theory has value beyond that. It does not provide > some fixed, eternal universal principle. Where would you place yin1 yang2 theory in terms of its status as a theory and its relevance to clinical practice and results? Thanks, Todd. You know I appreciate the chance to kick these things around. 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Guest guest Posted October 22, 2001 Report Share Posted October 22, 2001 I think there is more attention paid to process than results. Also, there is a tendency to not follow-up on outcome in this profession. This is do to first and foremost lack of knowledge of pathology and normal course of diseases. Third I think culturally TCM de-emphasizes failure. Alon - yulong Sunday, October 21, 2001 6:44 PM Re: perspectives Alon,> A simple example is, in the year or so I have been in this discussion group we covered many case histories and many people put in their 2 cents but not one of these cases was followed up on.Just curious to know why you think this is.KenChinese 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 October 22, 2001 Report Share Posted October 22, 2001 On Monday, October 22, 2001, at 09:52 AM, ALON MARCUS wrote: > I think there is more attention paid to process than results. Also, > there is a tendency to not follow-up on outcome in this profession. > This is do to first and foremost lack of knowledge of pathology and > normal course of diseases. Third I think culturally TCM de-emphasizes > failure. > Alon > > Even before followup on outcome, we need to find a way to share > results, diagnoses and treatments with each other in this profession. > I find most practitioner's and students charts difficult to read, and > not thorough in reporting diagnosis and treatment plans, not to say > followup. There is little communication between practitioners on case > histories. I haven't a clue on what most of my peers are doing. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2001 Report Share Posted October 22, 2001 Sometimes when I do not hear back from a patient, I do a follow up, courtesy call. >>>You should routinely follow-up all your patients. Sometimes with some distance you get a different perspective as to outcome Alon - Teresa Hall Sunday, October 14, 2001 7:34 AM Re: Re: perspectives Even before follow-up on outcome, we need to find a way to share results, diagnoses and treatments with each other in this profession. I find most practitioner's and students charts difficult to read, and not thorough in reporting diagnosis and treatment plans, not to say follow-up. There is little communication between practitioners on case histories. I haven't a clue on what most of my peers are doing. As a new practitioner... I am certainly doing my best to develop good habits! One of the first things I ask a patient, that returns, is how did you feel after the last treatment? With the patient that I am treating for Xue & Qi Yu in the sacral/UB area... with Acupuncture only she was getting a 3 hour relief post tx. Now with herbs... an unmodified Du Huo Ji Sheng Tang, in Granule form, she is waking up without pain! This is a first for her... for sometime. Now we are able to go further with it... because now she stated that the pain came later in the day, when she received a phone call that "stressed" her out. Sometimes when I do not hear back from a patient, I do a follow up, courtesy call. Primarily because I really want to know what is working. Recently, I treated a patient with damp heat manifesting as shingles. Pain changed with tx. and I prescribed him Long Dan Xie Gan Tang... unmodified, granule form. During follow-up call the pt. said he absolutely could not drink the tea. I stressed the importance of the herbs and how beneficial I thought they would be for him! Anywise... have not heard back. What do others do? Do you give them pill form to insure compliance?!? TeresaChinese 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...
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