Integrative med/ was Chinese language ...

December 19, 2001

, " pemachophel2001 " <

pemachophel2001> wrote:

Bob,

> However, the multi-modal treatments described in those books were very

> expensive because of the large number of medicines and supplements

> prescribed.

good point.

Since honing my specifically Chinese medical skills (in

> great part to gaining access to the literature through learning to

> read Chinese), I get even better results, faster, with less expense to

> the patients and all without leaving the scope of my licensed and

> advertised profession.

Do you think there is any role for the use of supplements from a

western perspective or that chinese medicinals and supplements

prescribed according to TCM principles fulfill all the patient's needs.

Keep in mind that unlike CO, CA scope does allow us to prescribe these

other supplements. So does a multivitamin make sense because most

people do not derive adequate vitamins from food? Or glucosamine

sulfate (GS) because it directly rebuilds joint tissue? Would you ever

use such things? Would you only use them from a TCM perspective? For

example, perhaps GS has yin tonic effect. Or are there substances

within the TCM pharmacopeia you would use instead. For instance, high

collagen foods like beef tendon contain chondroitin and GS. If such

foods were indicated, then they might fill this role. Some of these

western isolates have the distinct advantage of ease of use, though.

GS, enzymes and vitamins all are quite potent at much lower dosages

than chinese medicinals. So would you ever advise using these in the

context of TCM? Perhaps enzymes promote spleen T & T.

December 19, 2001

of these western isolates have the distinct advantage of ease of use, though. GS, enzymes and vitamins all are quite potent at much lower dosages than Chinese medicinals. So would you ever advise using these in the context of TCM? Perhaps enzymes promote spleen T & T.>>>>>If this is a general question for all of us, I would use anything that is safe, effective and reasonable in cost. I myself do not like to makeup TCM functions to other medicinal, although I do for some musculoskeletal functions, because it is always speculative. Just like when I use TCM herbals I like to put on my TCM hat on. If I use modern pharmaceutical herbalogy I think in that mode.

Alon

-

1

Wednesday, December 19, 2001 6:19 PM

Re: Integrative med/ was Chinese language ...

, "pemachophel2001" <pemachophel2001> wrote: Bob,> However, the multi-modal treatments described in those books were very > expensive because of the large number of medicines and supplements > prescribed. good point.Since honing my specifically Chinese medical skills (in > great part to gaining access to the literature through learning to > read Chinese), I get even better results, faster, with less expense to > the patients and all without leaving the scope of my licensed and > advertised profession.Do you think there is any role for the use of supplements from a western perspective or that chinese medicinals and supplements prescribed according to TCM principles fulfill all the patient's needs. Keep in mind that unlike CO, CA scope does allow us to prescribe these other supplements. So does a multivitamin make sense because most people do not derive adequate vitamins from food? Or glucosamine sulfate (GS) because it directly rebuilds joint tissue? Would you ever use such things? Would you only use them from a TCM perspective? For example, perhaps GS has yin tonic effect. Or are there substances within the TCM pharmacopeia you would use instead. For instance, high collagen foods like beef tendon contain chondroitin and GS. If such foods were indicated, then they might fill this role. Some of these western isolates have the distinct advantage of ease of use, though. GS, enzymes and vitamins all are quite potent at much lower dosages than chinese medicinals. So would you ever advise using these in the context of TCM? Perhaps enzymes promote spleen T & T.ToddChinese 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.

December 20, 2001

Yes, I might recommend so-called nutritional supplements. As I think

you know, I have, at least for my own devices, tried to work out CM

descriptions of all the main supplements, and I take supplements

myself. I have no problem with incorporating any medicinal into the CM

pharmacopeia if we can work out a good CM description of it. After

all, American ginseng came to China from North America within the last

three hundred years. So a medicine does not have to come from

China in order to be a " Chinese medicinal (zhong yao). " In

addition, when one administers Shen Qu, one is administering digestive

enzymes. Or when one administers Mu Li or long Gu, one is

administering calcium. I personally do not care a whit where a

medicinal comes from. The issue for me is whether or not I can

understand it in terms of CM theory and then prescribe that medicinal

based on the patient's pattern discrimination. However, that's not

really what I was doing in Cervical Dysplasia & Prostate Cancer. It

was what I was attempting in Scatalogy, but I did not do it very well

because, at that time, I knew far less Chinese medicine.

What I'm not supportive of is members of our profession prescribing

supplements based solely on Western biomedical concepts and

principles. It is not uncommon for Chinese research protocols to be

two winged, where one wing is identified as the CM Tx wing and the

other wind is identified as the WM Tx wing. In not a few instances,

nutritional supplements comprise the treatment in the WM Tx wing. So,

without a CM medicinal description and without CM treatment based on

pattern discrimination, CM doctors in the PRC appear to identify such

supplements as " Western medicine. "

Bob

, " 1 " <@i...> wrote:

> , " pemachophel2001 " <

> pemachophel2001> wrote:

>

> Bob,

>

> > However, the multi-modal treatments described in those books were

very

> > expensive because of the large number of medicines and supplements

> > prescribed.

>

> good point.

>

> Since honing my specifically Chinese medical skills (in

> > great part to gaining access to the literature through learning to

> > read Chinese), I get even better results, faster, with less

expense to

> > the patients and all without leaving the scope of my licensed and

> > advertised profession.

>

> Do you think there is any role for the use of supplements from a

> western perspective or that chinese medicinals and supplements

> prescribed according to TCM principles fulfill all the patient's

needs.

> Keep in mind that unlike CO, CA scope does allow us to prescribe

these

> other supplements. So does a multivitamin make sense because most

> people do not derive adequate vitamins from food? Or glucosamine

> sulfate (GS) because it directly rebuilds joint tissue? Would you

ever

> use such things? Would you only use them from a TCM perspective?

For

> example, perhaps GS has yin tonic effect. Or are there substances

> within the TCM pharmacopeia you would use instead. For instance,

high

> collagen foods like beef tendon contain chondroitin and GS. If such

> foods were indicated, then they might fill this role. Some of these

> western isolates have the distinct advantage of ease of use, though.

> GS, enzymes and vitamins all are quite potent at much lower dosages

> than chinese medicinals. So would you ever advise using these in

the

> context of TCM? Perhaps enzymes promote spleen T & T.

>

December 20, 2001

Alon,

Good point. Any one individual's description of a new Chinese

medicinal is only speculative. If you look in the Zhong Yao Da Ci Dian

(The Great Dictionary of Chinese Medicinals), you will see that the

descriptions of individual medicinals has been a process of debate and

eventual consensus for those meds where we have a " standard "

description today. Along the same lines, it is common to see that one

or another aspect of a Western herb's CM description may be missing if

that med has only recently (say the last 150 years!) been imported to

China. For instance, certain " Western " herbs and foods lack channel

entry descriptions. Over time, with more experience and discussion, I

would imagine that some of these lacunae will be filled in.

What I'm getting at here is that any single person's description, be

it mine, Michael Tierra's, Peter Holmes', or others', is only a

provisional description until we as a profession come to some sort of

consensus. That being said, every Chinese medicinal description

that we regard as standard today began with a single practitioner's

speculation. " The journey of a thousand li... "

Why not let the journey begin?

Bob

, " Alon Marcus " <alonmarcus@w...> wrote:

> of these

> western isolates have the distinct advantage of ease of use, though.

> GS, enzymes and vitamins all are quite potent at much lower dosages

> than Chinese medicinals. So would you ever advise using these in

the

> context of TCM? Perhaps enzymes promote spleen T & T.

>

> >>>>>If this is a general question for all of us, I would use

anything that is safe, effective and reasonable in cost. I myself do

not like to makeup TCM functions to other medicinal, although I do for

some musculoskeletal functions, because it is always speculative. Just

like when I use TCM herbals I like to put on my TCM hat on. If I use

modern pharmaceutical herbalogy I think in that mode.

> Alon

> -

> 1

>

> Wednesday, December 19, 2001 6:19 PM

> Re: Integrative med/ was Chinese

language ...

>

> , " pemachophel2001 " <

> pemachophel2001> wrote:

>

> Bob,

>

> > However, the multi-modal treatments described in those books

were very

> > expensive because of the large number of medicines and

supplements

> > prescribed.

>

> good point.

>

> Since honing my specifically Chinese medical skills (in

> > great part to gaining access to the literature through learning

to

> > read Chinese), I get even better results, faster, with less

expense to

> > the patients and all without leaving the scope of my licensed

and

> > advertised profession.

>

> Do you think there is any role for the use of supplements from a

> western perspective or that chinese medicinals and supplements

> prescribed according to TCM principles fulfill all the patient's

needs.

> Keep in mind that unlike CO, CA scope does allow us to prescribe

these

> other supplements. So does a multivitamin make sense because most

> people do not derive adequate vitamins from food? Or glucosamine

> sulfate (GS) because it directly rebuilds joint tissue? Would you

ever

> use such things? Would you only use them from a TCM perspective?

For

> example, perhaps GS has yin tonic effect. Or are there substances

> within the TCM pharmacopeia you would use instead. For instance,

high

> collagen foods like beef tendon contain chondroitin and GS. If

such

> foods were indicated, then they might fill this role. Some of

these

> western isolates have the distinct advantage of ease of use,

though.

> GS, enzymes and vitamins all are quite potent at much lower

dosages

> than chinese medicinals. So would you ever advise using these in

the

> context of TCM? Perhaps enzymes promote spleen T & T.

>

> Todd

>

December 20, 2001

So, without a CM medicinal description and without CM treatment based on pattern discrimination, CM doctors in the PRC appear to identify such supplements as "Western medicine."

>>>>Bob-- How do you come up with credible functions? I have seen W meds described in CM by looking at their side effect profiles. That is so false. First as one can see from a quick look, only a certain amount of individuals develop certain side effects. Each may have totally conflicting effects. So if we take CM approach than medicines do not have general effects but only individual effects.

Also, as I asked in past, if we looks at MAOIs for example, do they strengthen Jing (because they can lengthen animal life, and improve brain function in animal studies) or do they burn Yin because most are metabolized to amphetamine like compounds, and often have amphetamine like sideeffects?

I totally disagree I think if one is to use WM meds or such one needs to think within that system. Just like if one is to use TCM one should, most of the time, do differential diagnosis in TCM. At time similarities can be used to overlap usage and understanding.But basically they are both completely different

Alon

-

pemachophel2001

Thursday, December 20, 2001 10:00 AM

Re: Integrative med/ was Chinese language ...

Yes, I might recommend so-called nutritional supplements. As I think you know, I have, at least for my own devices, tried to work out CM descriptions of all the main supplements, and I take supplements myself. I have no problem with incorporating any medicinal into the CM pharmacopeia if we can work out a good CM description of it. After all, American ginseng came to China from North America within the last three hundred years. So a medicine does not have to come from China in order to be a "Chinese medicinal (zhong yao)." In addition, when one administers Shen Qu, one is administering digestive enzymes. Or when one administers Mu Li or long Gu, one is administering calcium. I personally do not care a whit where a medicinal comes from. The issue for me is whether or not I can understand it in terms of CM theory and then prescribe that medicinal based on the patient's pattern discrimination. However, that's not really what I was doing in Cervical Dysplasia & Prostate Cancer. It was what I was attempting in Scatalogy, but I did not do it very well because, at that time, I knew far less Chinese medicine.What I'm not supportive of is members of our profession prescribing supplements based solely on Western biomedical concepts and principles. It is not uncommon for Chinese research protocols to be two winged, where one wing is identified as the CM Tx wing and the other wind is identified as the WM Tx wing. In not a few instances, nutritional supplements comprise the treatment in the WM Tx wing. So, without a CM medicinal description and without CM treatment based on pattern discrimination, CM doctors in the PRC appear to identify such supplements as "Western medicine."Bob, "1" <@i...> wrote:> , "pemachophel2001" <> pemachophel2001> wrote:> > Bob,> > > > However, the multi-modal treatments described in those books were very > > expensive because of the large number of medicines and supplements > > prescribed. > > > good point.> > Since honing my specifically Chinese medical skills (in > > great part to gaining access to the literature through learning to > > read Chinese), I get even better results, faster, with less expense to > > the patients and all without leaving the scope of my licensed and > > advertised profession.> > Do you think there is any role for the use of supplements from a > western perspective or that chinese medicinals and supplements > prescribed according to TCM principles fulfill all the patient's needs. > Keep in mind that unlike CO, CA scope does allow us to prescribe these > other supplements. So does a multivitamin make sense because most > people do not derive adequate vitamins from food? Or glucosamine > sulfate (GS) because it directly rebuilds joint tissue? Would you ever > use such things? Would you only use them from a TCM perspective? For > example, perhaps GS has yin tonic effect. Or are there substances > within the TCM pharmacopeia you would use instead. For instance, high > collagen foods like beef tendon contain chondroitin and GS. If such > foods were indicated, then they might fill this role. Some of these > western isolates have the distinct advantage of ease of use, though. > GS, enzymes and vitamins all are quite potent at much lower dosages > than chinese medicinals. So would you ever advise using these in the > context of TCM? Perhaps enzymes promote spleen T & T.> 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.

December 20, 2001

"The journey of a thousand li..."Why not let the journey begin

>>>No problem but we need to discuss the process of thought

Alon

-

pemachophel2001

Thursday, December 20, 2001 10:40 AM

Re: Integrative med/ was Chinese language ...

Alon,Good point. Any one individual's description of a new Chinese medicinal is only speculative. If you look in the Zhong Yao Da Ci Dian (The Great Dictionary of Chinese Medicinals), you will see that the descriptions of individual medicinals has been a process of debate and eventual consensus for those meds where we have a "standard" description today. Along the same lines, it is common to see that one or another aspect of a Western herb's CM description may be missing if that med has only recently (say the last 150 years!) been imported to China. For instance, certain "Western" herbs and foods lack channel entry descriptions. Over time, with more experience and discussion, I would imagine that some of these lacunae will be filled in.What I'm getting at here is that any single person's description, be it mine, Michael Tierra's, Peter Holmes', or others', is only a provisional description until we as a profession come to some sort of consensus. That being said, every Chinese medicinal description that we regard as standard today began with a single practitioner's speculation. "The journey of a thousand li..."Why not let the journey begin?Bob , "Alon Marcus" <alonmarcus@w...> wrote:> of these > western isolates have the distinct advantage of ease of use, though. > GS, enzymes and vitamins all are quite potent at much lower dosages > than Chinese medicinals. So would you ever advise using these in the > context of TCM? Perhaps enzymes promote spleen T & T.> > >>>>>If this is a general question for all of us, I would use anything that is safe, effective and reasonable in cost. I myself do not like to makeup TCM functions to other medicinal, although I do for some musculoskeletal functions, because it is always speculative. Just like when I use TCM herbals I like to put on my TCM hat on. If I use modern pharmaceutical herbalogy I think in that mode. > Alon> - > 1 > > Wednesday, December 19, 2001 6:19 PM> Re: Integrative med/ was Chinese language ...> > > , "pemachophel2001" <> pemachophel2001> wrote:> > Bob,> > > > However, the multi-modal treatments described in those books were very > > expensive because of the large number of medicines and supplements > > prescribed. > > > good point.> > Since honing my specifically Chinese medical skills (in > > great part to gaining access to the literature through learning to > > read Chinese), I get even better results, faster, with less expense to > > the patients and all without leaving the scope of my licensed and > > advertised profession.> > Do you think there is any role for the use of supplements from a > western perspective or that chinese medicinals and supplements > prescribed according to TCM principles fulfill all the patient's needs. > Keep in mind that unlike CO, CA scope does allow us to prescribe these > other supplements. So does a multivitamin make sense because most > people do not derive adequate vitamins from food? Or glucosamine > sulfate (GS) because it directly rebuilds joint tissue? Would you ever > use such things? Would you only use them from a TCM perspective? For > example, perhaps GS has yin tonic effect. Or are there substances > within the TCM pharmacopeia you would use instead. For instance, high > collagen foods like beef tendon contain chondroitin and GS. If such > foods were indicated, then they might fill this role. Some of these > western isolates have the distinct advantage of ease of use, though. > GS, enzymes and vitamins all are quite potent at much lower dosages > than chinese medicinals. So would you ever advise using these in the > context of TCM? Perhaps enzymes promote spleen T & T.> > Todd> > > >

December 20, 2001

, " pemachophel2001 " <

pemachophel2001> wrote:

>

> What I'm not supportive of is members of our profession prescribing

> supplements based solely on Western biomedical concepts and

> principles.

>

Bob

How do you feel about those who are fully trained in western holistic

medicine like naturopathy prescribing supplements from a biomedical

perspective? Is it inherently iatrogenic or does it have potential

value?

December 20, 2001

Alon,

I will be giving a talk on just this topic on Jan. 9 in Boulder which

will be audio- and videotaped and turned into a Distance Learning

program. That program should be available about 6 weeks later.

However, to precis that discussion, I think you have to look at: 1)

all the intended effects as those effects are reframed in Chinese

medical terms, 2) all the adverse reactions (again reframed into

Chinese medical terms), and 3) any effects associated with

combinations with any other substances that we already know about in

CM (also reframed into Chinese medical terms. What I mean by reframed,

if a med causes PVCs, that info would need to be reframed into heart

palpitations (xin ji). Since we know what are the disease mechanisms

of heart palpitations, now we have something we can work with.

With the above three groups of information, I believe you should next

look for the single Chinese medical mechanism which would account for

all of these pieces of information. I refer to this process as

triangulation. If your Chinese medical theory is good, you should be

able to come up with a single mechanism which can account for all a

medicinal's intended and adverse effects as well as all its effects

in combination. The more information one has that can be reframed into

terms gatherable by the four examinations and, therefore, can be

processed according to the logic of CM, the more likely one will be

able to arrive at a reasonable provisional description.

I agree that only certain patients will have certain side effects from

a particular Western med (or any substance for that matter). However,

that does not obviate the issue. In fact, if one comes up with a

reasonable Chinese medical description based on the agreement of all

these streams of information, then one should be able to predict (on

the basis of pattern discrimination) who is most likely to have which

side effects. Further, it is categorically methdologically incorrect

when attempting to describe a new medicinal in CM terms to allow

Western pharmacodynamics to color that description. I believe the key

to coming up with a good CM description is weeding out information

that is unknowable via the four examinations. Basically, one aproaches

the problem just as if one were doing a pattern discrimination on a

patient.

Obviously, the initial description is only a working hypothesis. After

creating such a hypothesis, one needs to see if it is supported by

clinical experience. For instance, if we say chlomid, the fertility

drug, is an interior-warming medicinal, according to Chinese medical

theory, would that account for it stimulating ovulation in some women

and causing yin vacuity amenorrhea and infertility in other women?

Since ovulation in Chinese gynecology is associated with a

cyclic hyperactivity of ministerial fire, warming the interior makes

sense in terms of CM theory. However, since heat may damage and

consume yin, in women with a " habitual bodily yin vacuity, " interior

warming may damage yin, giving rise instead to a pathological fire

effulgence. Since ovulation can only occur if and when yin " reaches

its extreme " cyclically (out of which yang grows), consumption and

damage of yin might cause anovulation in some women with, in some

cases, irreversilbe infertility. In my clinical experience, this

side effect of chlomid is most likely to occur in thin, ectomorphic

women with underdeveloped secondary sexual characteristics. Reframe

that into CM and you get " habitual bodily yin vacuity. "

Therefore, we both would agree that any hypothesis must be borne out

by actual clinical experience with real-life patients. If the

description doesn't fit all the data, then a new hypothesis needs to

be developed which would account for all the data.

Also, in closing, let me suggest that it is important that the

combination of functions of a new CM medicinal be analogous (although

not necessarily identical) to one or more already described Chinese

medicinal. It's my opinion that one should be very careful if one

comes up with a combination of functions which no other Chinese

medicinal also has. While this is not logically impossible, it

definitely makes me nervous. Take for example Peter Holmes' original

CM description of comfrey as a yin supplement. If you look at all the

yin supplements in B & G (Bensky & Gamble), I don't think you will

find any that have all the functions Peter ascribes to comfrey.

However, if you look at Rhizoma Bletillae Striatae (Bai Ji), I think

you find all the moistening, bleeding-stopping, and vulnerary

functions and indications Peter describes.

As an extension of this point, I think it is most important to come up

with the overall categorization of a new CM medicinal. If one can come

up with the basic category (such as qi-rectifier, exterior-resolver,

blood-quickener), than I think you know a lot about that medicinal,

how it works in the body, and what its adverse reactions might be in a

particular patient.

Bob

, " Alon Marcus " <alonmarcus@w...> wrote:

> So,

> without a CM medicinal description and without CM treatment based on

> pattern discrimination, CM doctors in the PRC appear to identify

such

> supplements as " Western medicine. "

>

> >>>>Bob-- How do you come up with credible functions? I have seen W

meds described in CM by looking at their side effect profiles. That is

so false. First as one can see from a quick look, only a certain

amount of individuals develop certain side effects. Each may have

totally conflicting effects. So if we take CM approach than medicines

do not have general effects but only individual effects.

> Also, as I asked in past, if we looks at MAOIs for example, do they

strengthen Jing (because they can lengthen animal life, and improve

brain function in animal studies) or do they burn Yin because most are

metabolized to amphetamine like compounds, and often have amphetamine

like sideeffects?

> I totally disagree I think if one is to use WM meds or such one

needs to think within that system. Just like if one is to use TCM one

should, most of the time, do differential diagnosis in TCM. At time

similarities can be used to overlap usage and understanding.But

basically they are both completely different

> Alon

>

> -

> pemachophel2001

>

> Thursday, December 20, 2001 10:00 AM

> Re: Integrative med/ was Chinese

language ...

>

> Yes, I might recommend so-called nutritional supplements. As I

think

> you know, I have, at least for my own devices, tried to work out

CM

> descriptions of all the main supplements, and I take supplements

> myself. I have no problem with incorporating any medicinal into

the CM

> pharmacopeia if we can work out a good CM description of it. After

> all, American ginseng came to China from North America within the

last

> three hundred years. So a medicine does not have to come from

> China in order to be a " Chinese medicinal (zhong yao). " In

> addition, when one administers Shen Qu, one is administering

digestive

> enzymes. Or when one administers Mu Li or long Gu, one is

> administering calcium. I personally do not care a whit where a

> medicinal comes from. The issue for me is whether or not I can

> understand it in terms of CM theory and then prescribe that

medicinal

> based on the patient's pattern discrimination. However, that's not

> really what I was doing in Cervical Dysplasia & Prostate Cancer.

It

> was what I was attempting in Scatalogy, but I did not do it very

well

> because, at that time, I knew far less Chinese medicine.

>

> What I'm not supportive of is members of our profession

prescribing

> supplements based solely on Western biomedical concepts and

> principles. It is not uncommon for Chinese research protocols to

be

> two winged, where one wing is identified as the CM Tx wing and the

> other wind is identified as the WM Tx wing. In not a few

instances,

> nutritional supplements comprise the treatment in the WM Tx wing.

So,

> without a CM medicinal description and without CM treatment based

on

> pattern discrimination, CM doctors in the PRC appear to identify

such

> supplements as " Western medicine. "

>

> Bob

>

> , " 1 " <@i...> wrote:

> > , " pemachophel2001 " <

> > pemachophel2001> wrote:

> >

> > Bob,

> >

> > > However, the multi-modal treatments described in those books

were

> very

> > > expensive because of the large number of medicines and

supplements

> > > prescribed.

> >

> > good point.

> >

> > Since honing my specifically Chinese medical skills (in

> > > great part to gaining access to the literature through

learning to

> > > read Chinese), I get even better results, faster, with less

> expense to

> > > the patients and all without leaving the scope of my licensed

and

> > > advertised profession.

> >

> > Do you think there is any role for the use of supplements from a

> > western perspective or that chinese medicinals and supplements

> > prescribed according to TCM principles fulfill all the patient's

> needs.

> > Keep in mind that unlike CO, CA scope does allow us to prescribe

> these

> > other supplements. So does a multivitamin make sense because

most

> > people do not derive adequate vitamins from food? Or

glucosamine

> > sulfate (GS) because it directly rebuilds joint tissue? Would

you

> ever

> > use such things? Would you only use them from a TCM

perspective?

> For

> > example, perhaps GS has yin tonic effect. Or are there

substances

> > within the TCM pharmacopeia you would use instead. For

instance,

> high

> > collagen foods like beef tendon contain chondroitin and GS. If

such

> > foods were indicated, then they might fill this role. Some of

these

> > western isolates have the distinct advantage of ease of use,

though.

>

> > GS, enzymes and vitamins all are quite potent at much lower

dosages

> > than chinese medicinals. So would you ever advise using these

in

> the

> > context of TCM? Perhaps enzymes promote spleen T & T.

> >

>

December 20, 2001

I have no problem with those professionals who are dually trained and

licensed to prescribe according to both systems. However, I am against

people who are not specifically trained in the prescription of

nutritional supplements prescribing them even though that is within

their legal scope of practice.

Nevertheless, even nutritional supplements have their potential side

effects and, therefore, in certain cases at certain doses, a

nutritional supplement might be iatrogenic. In my experience,

prescribing these based on a CM understanding can help identify who

might experience such side effects and what to do about them if they

do. I don't feel there is naything inherently or intrinsically

itatrogenic about nutritional supplements. All medicinals are tools,

and, as tools, they may be used rightly or wrongly, wisely or

unwisely. In my experience, CM pattern discrimination is one of the

world's wisest systems of medicinal prescription.

Bob

, " 1 " <@i...> wrote:

> , " pemachophel2001 " <

> pemachophel2001> wrote:

>

> >

> > What I'm not supportive of is members of our profession

prescribing

> > supplements based solely on Western biomedical concepts and

> > principles.

> >

>

> Bob

>

> How do you feel about those who are fully trained in western

holistic

> medicine like naturopathy prescribing supplements from a biomedical

> perspective? Is it inherently iatrogenic or does it have potential

> value?

>

December 20, 2001

Interesting, I would like though if you can take a drugs and we can look at it. By the way I will try to ask my wife to look at records of women taking clomed and see if we can come up with more data to support your observations

Alon

-

pemachophel2001

Thursday, December 20, 2001 4:57 PM

Re: Integrative med/ was Chinese language ...

Alon,I will be giving a talk on just this topic on Jan. 9 in Boulder which will be audio- and videotaped and turned into a Distance Learning program. That program should be available about 6 weeks later. However, to precis that discussion, I think you have to look at: 1) all the intended effects as those effects are reframed in Chinese medical terms, 2) all the adverse reactions (again reframed into Chinese medical terms), and 3) any effects associated with combinations with any other substances that we already know about in CM (also reframed into Chinese medical terms. What I mean by reframed, if a med causes PVCs, that info would need to be reframed into heart palpitations (xin ji). Since we know what are the disease mechanisms of heart palpitations, now we have something we can work with. With the above three groups of information, I believe you should next look for the single Chinese medical mechanism which would account for all of these pieces of information. I refer to this process as triangulation. If your Chinese medical theory is good, you should be able to come up with a single mechanism which can account for all a medicinal's intended and adverse effects as well as all its effects in combination. The more information one has that can be reframed into terms gatherable by the four examinations and, therefore, can be processed according to the logic of CM, the more likely one will be able to arrive at a reasonable provisional description. I agree that only certain patients will have certain side effects from a particular Western med (or any substance for that matter). However, that does not obviate the issue. In fact, if one comes up with a reasonable Chinese medical description based on the agreement of all these streams of information, then one should be able to predict (on the basis of pattern discrimination) who is most likely to have which side effects. Further, it is categorically methdologically incorrect when attempting to describe a new medicinal in CM terms to allow Western pharmacodynamics to color that description. I believe the key to coming up with a good CM description is weeding out information that is unknowable via the four examinations. Basically, one aproaches the problem just as if one were doing a pattern discrimination on a patient.Obviously, the initial description is only a working hypothesis. After creating such a hypothesis, one needs to see if it is supported by clinical experience. For instance, if we say chlomid, the fertility drug, is an interior-warming medicinal, according to Chinese medical theory, would that account for it stimulating ovulation in some women and causing yin vacuity amenorrhea and infertility in other women? Since ovulation in Chinese gynecology is associated with a cyclic hyperactivity of ministerial fire, warming the interior makes sense in terms of CM theory. However, since heat may damage and consume yin, in women with a "habitual bodily yin vacuity," interior warming may damage yin, giving rise instead to a pathological fire effulgence. Since ovulation can only occur if and when yin "reaches its extreme" cyclically (out of which yang grows), consumption and damage of yin might cause anovulation in some women with, in some cases, irreversilbe infertility. In my clinical experience, this side effect of chlomid is most likely to occur in thin, ectomorphic women with underdeveloped secondary sexual characteristics. Reframe that into CM and you get "habitual bodily yin vacuity."Therefore, we both would agree that any hypothesis must be borne out by actual clinical experience with real-life patients. If the description doesn't fit all the data, then a new hypothesis needs to be developed which would account for all the data.Also, in closing, let me suggest that it is important that the combination of functions of a new CM medicinal be analogous (although not necessarily identical) to one or more already described Chinese medicinal. It's my opinion that one should be very careful if one comes up with a combination of functions which no other Chinese medicinal also has. While this is not logically impossible, it definitely makes me nervous. Take for example Peter Holmes' original CM description of comfrey as a yin supplement. If you look at all the yin supplements in B & G (Bensky & Gamble), I don't think you will find any that have all the functions Peter ascribes to comfrey. However, if you look at Rhizoma Bletillae Striatae (Bai Ji), I think you find all the moistening, bleeding-stopping, and vulnerary functions and indications Peter describes. As an extension of this point, I think it is most important to come up with the overall categorization of a new CM medicinal. If one can come up with the basic category (such as qi-rectifier, exterior-resolver, blood-quickener), than I think you know a lot about that medicinal, how it works in the body, and what its adverse reactions might be in a particular patient.Bob , "Alon Marcus" <alonmarcus@w...> wrote:> So, > without a CM medicinal description and without CM treatment based on > pattern discrimination, CM doctors in the PRC appear to identify such > supplements as "Western medicine."> > >>>>Bob-- How do you come up with credible functions? I have seen W meds described in CM by looking at their side effect profiles. That is so false. First as one can see from a quick look, only a certain amount of individuals develop certain side effects. Each may have totally conflicting effects. So if we take CM approach than medicines do not have general effects but only individual effects.> Also, as I asked in past, if we looks at MAOIs for example, do they strengthen Jing (because they can lengthen animal life, and improve brain function in animal studies) or do they burn Yin because most are metabolized to amphetamine like compounds, and often have amphetamine like sideeffects?> I totally disagree I think if one is to use WM meds or such one needs to think within that system. Just like if one is to use TCM one should, most of the time, do differential diagnosis in TCM. At time similarities can be used to overlap usage and understanding.But basically they are both completely different> Alon> > - > pemachophel2001 > > Thursday, December 20, 2001 10:00 AM> Re: Integrative med/ was Chinese language ...> > > > > Yes, I might recommend so-called nutritional supplements. As I think > you know, I have, at least for my own devices, tried to work out CM > descriptions of all the main supplements, and I take supplements > myself. I have no problem with incorporating any medicinal into the CM > pharmacopeia if we can work out a good CM description of it. After > all, American ginseng came to China from North America within the last > three hundred years. So a medicine does not have to come from > China in order to be a "Chinese medicinal (zhong yao)." In > addition, when one administers Shen Qu, one is administering digestive > enzymes. Or when one administers Mu Li or long Gu, one is > administering calcium. I personally do not care a whit where a > medicinal comes from. The issue for me is whether or not I can > understand it in terms of CM theory and then prescribe that medicinal > based on the patient's pattern discrimination. However, that's not > really what I was doing in Cervical Dysplasia & Prostate Cancer. It > was what I was attempting in Scatalogy, but I did not do it very well > because, at that time, I knew far less Chinese medicine.> > What I'm not supportive of is members of our profession prescribing > supplements based solely on Western biomedical concepts and > principles. It is not uncommon for Chinese research protocols to be > two winged, where one wing is identified as the CM Tx wing and the > other wind is identified as the WM Tx wing. In not a few instances, > nutritional supplements comprise the treatment in the WM Tx wing. So, > without a CM medicinal description and without CM treatment based on > pattern discrimination, CM doctors in the PRC appear to identify such > supplements as "Western medicine."> > Bob> > , "1" <@i...> wrote:> > , "pemachophel2001" <> > pemachophel2001> wrote:> > > > Bob,> > > > > > > However, the multi-modal treatments described in those books were > very > > > expensive because of the large number of medicines and supplements > > > prescribed. > > > > > > good point.> > > > Since honing my specifically Chinese medical skills (in > > > great part to gaining access to the literature through learning to > > > read Chinese), I get even better results, faster, with less > expense to > > > the patients and all without leaving the scope of my licensed and > > > advertised profession.> > > > Do you think there is any role for the use of supplements from a > > western perspective or that chinese medicinals and supplements > > prescribed according to TCM principles fulfill all the patient's > needs. > > Keep in mind that unlike CO, CA scope does allow us to prescribe > these > > other supplements. So does a multivitamin make sense because most > > people do not derive adequate vitamins from food? Or glucosamine > > sulfate (GS) because it directly rebuilds joint tissue? Would you > ever > > use such things? Would you only use them from a TCM perspective? > For > > example, perhaps GS has yin tonic effect. Or are there substances > > within the TCM pharmacopeia you would use instead. For instance, > high > > collagen foods like beef tendon contain chondroitin and GS. If such > > foods were indicated, then they might fill this role. Some of these > > western isolates have the distinct advantage of ease of use, though. > > > GS, enzymes and vitamins all are quite potent at much lower dosages > > than chinese medicinals. So would you ever advise using these in > the > > context of TCM? Perhaps enzymes promote spleen T & T.> > > > > >

December 20, 2001

- In my experience, prescribing these based on a CM understanding can help identify who might experience such side effects and what to do about them if they do.

>>>I have been trying to do this with many meds used in pain. and have not been able to predict which would do what, especially effecacy. It would be great if one for example could pick an anti-depresent based on TCM. Since it is realy an imperical process. i know some think they can, such as Dr Ziger, but I have not been able to replicate. The only side-effects that are very predictable are

1. N/ in patients that have strong history of Nausia, however there is no diffrence for example between Qi congestion, Sp def, Damp. Depends more on medication. For example, short acting effexor will do it for about 100% of people.

2. Difficulty with erections if one is already has difficult with erections, althogh I have seen several patients with K def s/s do better with SSRI's. Knowing the cause ie, blood stasis such as diabetis, or K def does make it easyer to see which will get what. I guess you can say that patient with H/Anxity s/s are often helped by SSRI's.

3. Constipation from most opiets, regardless of consitution, it is dose related much more than TCM diagnosis.

4. Constipation is worsen in patients that tend to be dry especially with old tricyclics, (not as much with trazadone) but again I have seen quite a veriation

5.Cell stabilizers often increase fatigue in those that are weak in general but again I have not been able to find a TCM pattern

These are just of the cuff but I have tried to do this. I would appriciate if others have diffrent experience

Alon

pemachophel2001

Thursday, December 20, 2001 5:11 PM

Re: Integrative med/ was Chinese language ...

I have no problem with those professionals who are dually trained and licensed to prescribe according to both systems. However, I am against people who are not specifically trained in the prescription of nutritional supplements prescribing them even though that is within their legal scope of practice. Nevertheless, even nutritional supplements have their potential side effects and, therefore, in certain cases at certain doses, a nutritional supplement might be iatrogenic. In my experience, prescribing these based on a CM understanding can help identify who might experience such side effects and what to do about them if they do. I don't feel there is naything inherently or intrinsically itatrogenic about nutritional supplements. All medicinals are tools, and, as tools, they may be used rightly or wrongly, wisely or unwisely. In my experience, CM pattern discrimination is one of the world's wisest systems of medicinal prescription.Bob , "1" <@i...> wrote:> , "pemachophel2001" <> pemachophel2001> wrote:> > > > > What I'm not supportive of is members of our profession prescribing > > supplements based solely on Western biomedical concepts and > > principles. > > > > Bob> > How do you feel about those who are fully trained in western holistic > medicine like naturopathy prescribing supplements from a biomedical > perspective? Is it inherently iatrogenic or does it have potential > value?> 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.

December 21, 2001

Alon,

I have done that numerous times in print. In my class on Jan. 9, I

will be doing this for Altace, one of the ACE inhibitors.

Bob

, " Alon Marcus " <alonmarcus@w...> wrote:

> Interesting, I would like though if you can take a drugs and we can

look at it. By the way I will try to ask my wife to look at records of

women taking clomed and see if we can come up with more data to

support your observations

> Alon

> -

> pemachophel2001

>

> Thursday, December 20, 2001 4:57 PM

> Re: Integrative med/ was Chinese

language ...

>

> Alon,

>

> I will be giving a talk on just this topic on Jan. 9 in Boulder

which

> will be audio- and videotaped and turned into a Distance Learning

> program. That program should be available about 6 weeks later.

>

> However, to precis that discussion, I think you have to look at:

1)

> all the intended effects as those effects are reframed in Chinese

> medical terms, 2) all the adverse reactions (again reframed into

> Chinese medical terms), and 3) any effects associated with

> combinations with any other substances that we already know about

in

> CM (also reframed into Chinese medical terms. What I mean by

reframed,

> if a med causes PVCs, that info would need to be reframed into

heart

> palpitations (xin ji). Since we know what are the disease

mechanisms

> of heart palpitations, now we have something we can work with.

>

> With the above three groups of information, I believe you should

for

> all of these pieces of information. I refer to this process as

> triangulation. If your Chinese medical theory is good, you should

be

> able to come up with a single mechanism which can account for all

a

> medicinal's intended and adverse effects as well as all its

effects

> in combination. The more information one has that can be reframed

into

> terms gatherable by the four examinations and, therefore, can be

> processed according to the logic of CM, the more likely one will

be

> able to arrive at a reasonable provisional description.

>

> I agree that only certain patients will have certain side effects

from

> a particular Western med (or any substance for that matter).

However,

> that does not obviate the issue. In fact, if one comes up with a

> reasonable Chinese medical description based on the agreement of

all

> these streams of information, then one should be able to predict

(on

> the basis of pattern discrimination) who is most likely to have

which

> side effects. Further, it is categorically methdologically

incorrect

> when attempting to describe a new medicinal in CM terms to allow

> Western pharmacodynamics to color that description. I believe the

key

> to coming up with a good CM description is weeding out information

> that is unknowable via the four examinations. Basically, one

aproaches

> the problem just as if one were doing a pattern discrimination on

a

> patient.

>

> Obviously, the initial description is only a working hypothesis.

After

> creating such a hypothesis, one needs to see if it is supported by

> clinical experience. For instance, if we say chlomid, the

fertility

> drug, is an interior-warming medicinal, according to Chinese

medical

> theory, would that account for it stimulating ovulation in some

women

> and causing yin vacuity amenorrhea and infertility in other women?

> Since ovulation in Chinese gynecology is associated with a

> cyclic hyperactivity of ministerial fire, warming the interior

makes

> sense in terms of CM theory. However, since heat may damage and

> consume yin, in women with a " habitual bodily yin vacuity, "

interior

> warming may damage yin, giving rise instead to a pathological fire

> effulgence. Since ovulation can only occur if and when yin

" reaches

> its extreme " cyclically (out of which yang grows), consumption and

> damage of yin might cause anovulation in some women with, in some

> cases, irreversilbe infertility. In my clinical experience, this

> side effect of chlomid is most likely to occur in thin,

ectomorphic

> women with underdeveloped secondary sexual characteristics.

Reframe

> that into CM and you get " habitual bodily yin vacuity. "

>

> Therefore, we both would agree that any hypothesis must be borne

out

> by actual clinical experience with real-life patients. If the

> description doesn't fit all the data, then a new hypothesis needs

to

> be developed which would account for all the data.

>

> Also, in closing, let me suggest that it is important that the

> combination of functions of a new CM medicinal be analogous

(although

> not necessarily identical) to one or more already described

Chinese

> medicinal. It's my opinion that one should be very careful if one

> comes up with a combination of functions which no other Chinese

> medicinal also has. While this is not logically impossible, it

> definitely makes me nervous. Take for example Peter Holmes'

original

> CM description of comfrey as a yin supplement. If you look at all

the

> yin supplements in B & G (Bensky & Gamble), I don't think you will

> find any that have all the functions Peter ascribes to comfrey.

> However, if you look at Rhizoma Bletillae Striatae (Bai Ji), I

think

> you find all the moistening, bleeding-stopping, and vulnerary

> functions and indications Peter describes.

>

> As an extension of this point, I think it is most important to

come up

> with the overall categorization of a new CM medicinal. If one can

come

> up with the basic category (such as qi-rectifier,

exterior-resolver,

> blood-quickener), than I think you know a lot about that

medicinal,

> how it works in the body, and what its adverse reactions might be

in a

> particular patient.

>

> Bob

>

> , " Alon Marcus " <alonmarcus@w...>

wrote:

> > So,

> > without a CM medicinal description and without CM treatment

based on

> > pattern discrimination, CM doctors in the PRC appear to identify

> such

> > supplements as " Western medicine. "

> >

> > >>>>Bob-- How do you come up with credible functions? I have

seen W

> meds described in CM by looking at their side effect profiles.

That is

> so false. First as one can see from a quick look, only a certain

> amount of individuals develop certain side effects. Each may have

> totally conflicting effects. So if we take CM approach than

medicines

> do not have general effects but only individual effects.

> > Also, as I asked in past, if we looks at MAOIs for example, do

they

> strengthen Jing (because they can lengthen animal life, and

improve

> brain function in animal studies) or do they burn Yin because most

are

> metabolized to amphetamine like compounds, and often have

amphetamine

> like sideeffects?

> > I totally disagree I think if one is to use WM meds or such one

> needs to think within that system. Just like if one is to use TCM

one

> should, most of the time, do differential diagnosis in TCM. At

time

> similarities can be used to overlap usage and understanding.But

> basically they are both completely different

> > Alon

> >

> > -

> > pemachophel2001

> >

> > Thursday, December 20, 2001 10:00 AM

> > Re: Integrative med/ was Chinese

> language ...

> >

> > Yes, I might recommend so-called nutritional supplements. As I

> think

> > you know, I have, at least for my own devices, tried to work

out

> CM

> > descriptions of all the main supplements, and I take

supplements

> > myself. I have no problem with incorporating any medicinal

into

> the CM

> > pharmacopeia if we can work out a good CM description of it.

After

> > all, American ginseng came to China from North America within

the

> last

> > three hundred years. So a medicine does not have to come from

> > China in order to be a " Chinese medicinal (zhong yao). " In

> > addition, when one administers Shen Qu, one is administering

> digestive

> > enzymes. Or when one administers Mu Li or long Gu, one is

> > administering calcium. I personally do not care a whit where a

> > medicinal comes from. The issue for me is whether or not I can

> > understand it in terms of CM theory and then prescribe that

> medicinal

> > based on the patient's pattern discrimination. However, that's

not

> > really what I was doing in Cervical Dysplasia & Prostate

Cancer.

> It

> > was what I was attempting in Scatalogy, but I did not do it

very

> well

> > because, at that time, I knew far less Chinese medicine.

> >

> > What I'm not supportive of is members of our profession

> prescribing

> > supplements based solely on Western biomedical concepts and

> > principles. It is not uncommon for Chinese research protocols

to

> be

> > two winged, where one wing is identified as the CM Tx wing and

the

> > other wind is identified as the WM Tx wing. In not a few

> instances,

> > nutritional supplements comprise the treatment in the WM Tx

wing.

> So,

> > without a CM medicinal description and without CM treatment

based

> on

> > pattern discrimination, CM doctors in the PRC appear to

identify

> such

> > supplements as " Western medicine. "

> >

> > Bob

> >

> > , " 1 " <@i...> wrote:

> > > , " pemachophel2001 " <

> > > pemachophel2001> wrote:

> > >

> > > Bob,

> > >

> > > > However, the multi-modal treatments described in those

books

> were

> > very

> > > > expensive because of the large number of medicines and

> supplements

> > > > prescribed.

> > >

> > > good point.

> > >

> > > Since honing my specifically Chinese medical skills (in

> > > > great part to gaining access to the literature through

> learning to

> > > > read Chinese), I get even better results, faster, with

less

> > expense to

> > > > the patients and all without leaving the scope of my

licensed

> and

> > > > advertised profession.

> > >

> > > Do you think there is any role for the use of supplements

from a

> > > western perspective or that chinese medicinals and

supplements

> > > prescribed according to TCM principles fulfill all the

patient's

> > needs.

> > > Keep in mind that unlike CO, CA scope does allow us to

prescribe

> > these

> > > other supplements. So does a multivitamin make sense

because

> most

> > > people do not derive adequate vitamins from food? Or

> glucosamine

> > > sulfate (GS) because it directly rebuilds joint tissue?

Would

> you

> > ever

> > > use such things? Would you only use them from a TCM

> perspective?

> > For

> > > example, perhaps GS has yin tonic effect. Or are there

> substances

> > > within the TCM pharmacopeia you would use instead. For

> instance,

> > high

> > > collagen foods like beef tendon contain chondroitin and GS.

If

> such

> > > foods were indicated, then they might fill this role. Some

of

> these

> > > western isolates have the distinct advantage of ease of use,

> though.

> >

> > > GS, enzymes and vitamins all are quite potent at much lower

> dosages

> > > than chinese medicinals. So would you ever advise using

these

> in

> > the

> > > context of TCM? Perhaps enzymes promote spleen T & T.

> > >

> >

December 21, 2001

Alon,

Opiates are already described in the CM literature, and I have

published a translation of this material. I believe it was in an issue

of our online CM journal. So it was freely available at the time. That

description clearly explains why opiates cause constipation.

Bob

, " Alon Marcus " <alonmarcus@w...> wrote:

>

> - In my experience,

> prescribing these based on a CM understanding can help identify

who

> might experience such side effects and what to do about them if

they

> do.

> >>>I have been trying to do this with many meds used in pain. and

have not been able to predict which would do what, especially

effecacy. It would be great if one for example could pick an

anti-depresent based on TCM. Since it is realy an imperical process. i

know some think they can, such as Dr Ziger, but I have not been able

to replicate. The only side-effects that are very predictable are

> 1. N/ in patients that have strong history of Nausia, however

there is no diffrence for example between Qi congestion, Sp def, Damp.

Depends more on medication. For example, short acting effexor will do

it for about 100% of people.

> 2. Difficulty with erections if one is already has difficult with

erections, althogh I have seen several patients with K def s/s do

better with SSRI's. Knowing the cause ie, blood stasis such as

diabetis, or K def does make it easyer to see which will get what. I

guess you can say that patient with H/Anxity s/s are often helped by

SSRI's.

> 3. Constipation from most opiets, regardless of consitution, it is

dose related much more than TCM diagnosis.

> 4. Constipation is worsen in patients that tend to be dry

especially with old tricyclics, (not as much with trazadone) but again

I have seen quite a veriation

> 5.Cell stabilizers often increase fatigue in those that are weak

in general but again I have not been able to find a TCM pattern

> These are just of the cuff but I have tried to do this. I would

appriciate if others have diffrent experience

> Alon

> pemachophel2001

>

> Thursday, December 20, 2001 5:11 PM

> Re: Integrative med/ was Chinese

language ...

>

> I have no problem with those professionals who are dually trained

and

> licensed to prescribe according to both systems. However, I am

against

> people who are not specifically trained in the prescription of

> nutritional supplements prescribing them even though that is

within

> their legal scope of practice.

>

> Nevertheless, even nutritional supplements have their potential

side

> effects and, therefore, in certain cases at certain doses, a

> nutritional supplement might be iatrogenic. In my experience,

> prescribing these based on a CM understanding can help identify

who

> might experience such side effects and what to do about them if

they

> do. I don't feel there is naything inherently or intrinsically

> itatrogenic about nutritional supplements. All medicinals are

tools,

> and, as tools, they may be used rightly or wrongly, wisely or

> unwisely. In my experience, CM pattern discrimination is one of

the

> world's wisest systems of medicinal prescription.

>

> Bob

>

> , " 1 " <@i...> wrote:

> > , " pemachophel2001 " <

> > pemachophel2001> wrote:

> >

> > >

> > > What I'm not supportive of is members of our profession

> prescribing

> > > supplements based solely on Western biomedical concepts and

> > > principles.

> > >

> >

> > Bob

> >

> > How do you feel about those who are fully trained in western

> holistic

> > medicine like naturopathy prescribing supplements from a

biomedical

> > perspective? Is it inherently iatrogenic or does it have

potential

> > value?

> >

>

December 21, 2001

Bob I wanted to do this here so that we can have a discussion

Alon

-

pemachophel2001

Friday, December 21, 2001 8:04 AM

Re: Integrative med/ was Chinese language ...

Alon,I have done that numerous times in print. In my class on Jan. 9, I will be doing this for Altace, one of the ACE inhibitors.Bob, "Alon Marcus" <alonmarcus@w...> wrote:> Interesting, I would like though if you can take a drugs and we can look at it. By the way I will try to ask my wife to look at records of women taking clomed and see if we can come up with more data to support your observations> Alon> - > pemachophel2001 > > Thursday, December 20, 2001 4:57 PM> Re: Integrative med/ was Chinese language ...> > > Alon,> > I will be giving a talk on just this topic on Jan. 9 in Boulder which > will be audio- and videotaped and turned into a Distance Learning > program. That program should be available about 6 weeks later. > > However, to precis that discussion, I think you have to look at: 1) > all the intended effects as those effects are reframed in Chinese > medical terms, 2) all the adverse reactions (again reframed into > Chinese medical terms), and 3) any effects associated with > combinations with any other substances that we already know about in > CM (also reframed into Chinese medical terms. What I mean by reframed, > if a med causes PVCs, that info would need to be reframed into heart > palpitations (xin ji). Since we know what are the disease mechanisms > of heart palpitations, now we have something we can work with. > > With the above three groups of information, I believe you should next > look for the single Chinese medical mechanism which would account for > all of these pieces of information. I refer to this process as > triangulation. If your Chinese medical theory is good, you should be > able to come up with a single mechanism which can account for all a > medicinal's intended and adverse effects as well as all its effects > in combination. The more information one has that can be reframed into > terms gatherable by the four examinations and, therefore, can be > processed according to the logic of CM, the more likely one will be > able to arrive at a reasonable provisional description. > > I agree that only certain patients will have certain side effects from > a particular Western med (or any substance for that matter). However, > that does not obviate the issue. In fact, if one comes up with a > reasonable Chinese medical description based on the agreement of all > these streams of information, then one should be able to predict (on > the basis of pattern discrimination) who is most likely to have which > side effects. Further, it is categorically methdologically incorrect > when attempting to describe a new medicinal in CM terms to allow > Western pharmacodynamics to color that description. I believe the key > to coming up with a good CM description is weeding out information > that is unknowable via the four examinations. Basically, one aproaches > the problem just as if one were doing a pattern discrimination on a > patient.> > Obviously, the initial description is only a working hypothesis. After > creating such a hypothesis, one needs to see if it is supported by > clinical experience. For instance, if we say chlomid, the fertility > drug, is an interior-warming medicinal, according to Chinese medical > theory, would that account for it stimulating ovulation in some women > and causing yin vacuity amenorrhea and infertility in other women? > Since ovulation in Chinese gynecology is associated with a > cyclic hyperactivity of ministerial fire, warming the interior makes > sense in terms of CM theory. However, since heat may damage and > consume yin, in women with a "habitual bodily yin vacuity," interior > warming may damage yin, giving rise instead to a pathological fire > effulgence. Since ovulation can only occur if and when yin "reaches > its extreme" cyclically (out of which yang grows), consumption and > damage of yin might cause anovulation in some women with, in some > cases, irreversilbe infertility. In my clinical experience, this > side effect of chlomid is most likely to occur in thin, ectomorphic > women with underdeveloped secondary sexual characteristics. Reframe > that into CM and you get "habitual bodily yin vacuity."> > Therefore, we both would agree that any hypothesis must be borne out > by actual clinical experience with real-life patients. If the > description doesn't fit all the data, then a new hypothesis needs to > be developed which would account for all the data.> > Also, in closing, let me suggest that it is important that the > combination of functions of a new CM medicinal be analogous (although > not necessarily identical) to one or more already described Chinese > medicinal. It's my opinion that one should be very careful if one > comes up with a combination of functions which no other Chinese > medicinal also has. While this is not logically impossible, it > definitely makes me nervous. Take for example Peter Holmes' original > CM description of comfrey as a yin supplement. If you look at all the > yin supplements in B & G (Bensky & Gamble), I don't think you will > find any that have all the functions Peter ascribes to comfrey. > However, if you look at Rhizoma Bletillae Striatae (Bai Ji), I think > you find all the moistening, bleeding-stopping, and vulnerary > functions and indications Peter describes. > > As an extension of this point, I think it is most important to come up > with the overall categorization of a new CM medicinal. If one can come > up with the basic category (such as qi-rectifier, exterior-resolver, > blood-quickener), than I think you know a lot about that medicinal, > how it works in the body, and what its adverse reactions might be in a > particular patient.> > Bob > > , "Alon Marcus" <alonmarcus@w...> wrote:> > So, > > without a CM medicinal description and without CM treatment based on > > pattern discrimination, CM doctors in the PRC appear to identify > such > > supplements as "Western medicine."> > > > >>>>Bob-- How do you come up with credible functions? I have seen W > meds described in CM by looking at their side effect profiles. That is > so false. First as one can see from a quick look, only a certain > amount of individuals develop certain side effects. Each may have > totally conflicting effects. So if we take CM approach than medicines > do not have general effects but only individual effects.> > Also, as I asked in past, if we looks at MAOIs for example, do they > strengthen Jing (because they can lengthen animal life, and improve > brain function in animal studies) or do they burn Yin because most are > metabolized to amphetamine like compounds, and often have amphetamine > like sideeffects?> > I totally disagree I think if one is to use WM meds or such one > needs to think within that system. Just like if one is to use TCM one > should, most of the time, do differential diagnosis in TCM. At time > similarities can be used to overlap usage and understanding.But > basically they are both completely different> > Alon> > > > - > > pemachophel2001 > > > > Thursday, December 20, 2001 10:00 AM> > Re: Integrative med/ was Chinese > language ...> > > > > > > > > > Yes, I might recommend so-called nutritional supplements. As I > think > > you know, I have, at least for my own devices, tried to work out > CM > > descriptions of all the main supplements, and I take supplements > > myself. I have no problem with incorporating any medicinal into > the CM > > pharmacopeia if we can work out a good CM description of it. After > > all, American ginseng came to China from North America within the > last > > three hundred years. So a medicine does not have to come from > > China in order to be a "Chinese medicinal (zhong yao)." In > > addition, when one administers Shen Qu, one is administering > digestive > > enzymes. Or when one administers Mu Li or long Gu, one is > > administering calcium. I personally do not care a whit where a > > medicinal comes from. The issue for me is whether or not I can > > understand it in terms of CM theory and then prescribe that > medicinal > > based on the patient's pattern discrimination. However, that's not > > really what I was doing in Cervical Dysplasia & Prostate Cancer. > It > > was what I was attempting in Scatalogy, but I did not do it very > well > > because, at that time, I knew far less Chinese medicine.> > > > What I'm not supportive of is members of our profession > prescribing > > supplements based solely on Western biomedical concepts and > > principles. It is not uncommon for Chinese research protocols to > be > > two winged, where one wing is identified as the CM Tx wing and the > > other wind is identified as the WM Tx wing. In not a few > instances, > > nutritional supplements comprise the treatment in the WM Tx wing. > So, > > without a CM medicinal description and without CM treatment based > on > > pattern discrimination, CM doctors in the PRC appear to identify > such > > supplements as "Western medicine."> > > > Bob> > > > , "1" <@i...> wrote:> > > , "pemachophel2001" <> > > pemachophel2001> wrote:> > > > > > Bob,> > > > > > > > > > However, the multi-modal treatments described in those books > were > > very > > > > expensive because of the large number of medicines and > supplements > > > > prescribed. > > > > > > > > > good point.> > > > > > Since honing my specifically Chinese medical skills (in > > > > great part to gaining access to the literature through > learning to > > > > read Chinese), I get even better results, faster, with less > > expense to > > > > the patients and all without leaving the scope of my licensed > and > > > > advertised profession.> > > > > > Do you think there is any role for the use of supplements from a > > > western perspective or that chinese medicinals and supplements > > > prescribed according to TCM principles fulfill all the patient's > > needs. > > > Keep in mind that unlike CO, CA scope does allow us to prescribe > > these > > > other supplements. So does a multivitamin make sense because > most > > > people do not derive adequate vitamins from food? Or > glucosamine > > > sulfate (GS) because it directly rebuilds joint tissue? Would > you > > ever > > > use such things? Would you only use them from a TCM > perspective? > > For > > > example, perhaps GS has yin tonic effect. Or are there > substances > > > within the TCM pharmacopeia you would use instead. For > instance, > > high > > > collagen foods like beef tendon contain chondroitin and GS. If > such > > > foods were indicated, then they might fill this role. Some of > these > > > western isolates have the distinct advantage of ease of use, > though. > > > > > GS, enzymes and vitamins all are quite potent at much lower > dosages > > > than chinese medicinals. So would you ever advise using these > in > > the > > > context of TCM? Perhaps enzymes promote spleen T & T.> > > > > > > > > > >

December 22, 2001

For instance, if we say chlomid, the fertility drug, is an interior-warming medicinal, according to Chinese medical theory, would that account for it stimulating ovulation in some women and causing yin vacuity amenorrhea and infertility in other women? >>>>>

Bob, according to my wife chlomed does not cause amenorrhea or infertility at all. Can you show some evidence of this.

Alon

-

pemachophel2001

Thursday, December 20, 2001 4:57 PM

Re: Integrative med/ was Chinese language ...

Alon,I will be giving a talk on just this topic on Jan. 9 in Boulder which will be audio- and videotaped and turned into a Distance Learning program. That program should be available about 6 weeks later. However, to precis that discussion, I think you have to look at: 1) all the intended effects as those effects are reframed in Chinese medical terms, 2) all the adverse reactions (again reframed into Chinese medical terms), and 3) any effects associated with combinations with any other substances that we already know about in CM (also reframed into Chinese medical terms. What I mean by reframed, if a med causes PVCs, that info would need to be reframed into heart palpitations (xin ji). Since we know what are the disease mechanisms of heart palpitations, now we have something we can work with. With the above three groups of information, I believe you should next look for the single Chinese medical mechanism which would account for all of these pieces of information. I refer to this process as triangulation. If your Chinese medical theory is good, you should be able to come up with a single mechanism which can account for all a medicinal's intended and adverse effects as well as all its effects in combination. The more information one has that can be reframed into terms gatherable by the four examinations and, therefore, can be processed according to the logic of CM, the more likely one will be able to arrive at a reasonable provisional description. I agree that only certain patients will have certain side effects from a particular Western med (or any substance for that matter). However, that does not obviate the issue. In fact, if one comes up with a reasonable Chinese medical description based on the agreement of all these streams of information, then one should be able to predict (on the basis of pattern discrimination) who is most likely to have which side effects. Further, it is categorically methdologically incorrect when attempting to describe a new medicinal in CM terms to allow Western pharmacodynamics to color that description. I believe the key to coming up with a good CM description is weeding out information that is unknowable via the four examinations. Basically, one aproaches the problem just as if one were doing a pattern discrimination on a patient.Obviously, the initial description is only a working hypothesis. After creating such a hypothesis, one needs to see if it is supported by clinical experience. For instance, if we say chlomid, the fertility drug, is an interior-warming medicinal, according to Chinese medical theory, would that account for it stimulating ovulation in some women and causing yin vacuity amenorrhea and infertility in other women? Since ovulation in Chinese gynecology is associated with a cyclic hyperactivity of ministerial fire, warming the interior makes sense in terms of CM theory. However, since heat may damage and consume yin, in women with a "habitual bodily yin vacuity," interior warming may damage yin, giving rise instead to a pathological fire effulgence. Since ovulation can only occur if and when yin "reaches its extreme" cyclically (out of which yang grows), consumption and damage of yin might cause anovulation in some women with, in some cases, irreversilbe infertility. In my clinical experience, this side effect of chlomid is most likely to occur in thin, ectomorphic women with underdeveloped secondary sexual characteristics. Reframe that into CM and you get "habitual bodily yin vacuity."Therefore, we both would agree that any hypothesis must be borne out by actual clinical experience with real-life patients. If the description doesn't fit all the data, then a new hypothesis needs to be developed which would account for all the data.Also, in closing, let me suggest that it is important that the combination of functions of a new CM medicinal be analogous (although not necessarily identical) to one or more already described Chinese medicinal. It's my opinion that one should be very careful if one comes up with a combination of functions which no other Chinese medicinal also has. While this is not logically impossible, it definitely makes me nervous. Take for example Peter Holmes' original CM description of comfrey as a yin supplement. If you look at all the yin supplements in B & G (Bensky & Gamble), I don't think you will find any that have all the functions Peter ascribes to comfrey. However, if you look at Rhizoma Bletillae Striatae (Bai Ji), I think you find all the moistening, bleeding-stopping, and vulnerary functions and indications Peter describes. As an extension of this point, I think it is most important to come up with the overall categorization of a new CM medicinal. If one can come up with the basic category (such as qi-rectifier, exterior-resolver, blood-quickener), than I think you know a lot about that medicinal, how it works in the body, and what its adverse reactions might be in a particular patient.Bob , "Alon Marcus" <alonmarcus@w...> wrote:> So, > without a CM medicinal description and without CM treatment based on > pattern discrimination, CM doctors in the PRC appear to identify such > supplements as "Western medicine."> > >>>>Bob-- How do you come up with credible functions? I have seen W meds described in CM by looking at their side effect profiles. That is so false. First as one can see from a quick look, only a certain amount of individuals develop certain side effects. Each may have totally conflicting effects. So if we take CM approach than medicines do not have general effects but only individual effects.> Also, as I asked in past, if we looks at MAOIs for example, do they strengthen Jing (because they can lengthen animal life, and improve brain function in animal studies) or do they burn Yin because most are metabolized to amphetamine like compounds, and often have amphetamine like sideeffects?> I totally disagree I think if one is to use WM meds or such one needs to think within that system. Just like if one is to use TCM one should, most of the time, do differential diagnosis in TCM. At time similarities can be used to overlap usage and understanding.But basically they are both completely different> Alon> > - > pemachophel2001 > > Thursday, December 20, 2001 10:00 AM> Re: Integrative med/ was Chinese language ...> > > > > Yes, I might recommend so-called nutritional supplements. As I think > you know, I have, at least for my own devices, tried to work out CM > descriptions of all the main supplements, and I take supplements > myself. I have no problem with incorporating any medicinal into the CM > pharmacopeia if we can work out a good CM description of it. After > all, American ginseng came to China from North America within the last > three hundred years. So a medicine does not have to come from > China in order to be a "Chinese medicinal (zhong yao)." In > addition, when one administers Shen Qu, one is administering digestive > enzymes. Or when one administers Mu Li or long Gu, one is > administering calcium. I personally do not care a whit where a > medicinal comes from. The issue for me is whether or not I can > understand it in terms of CM theory and then prescribe that medicinal > based on the patient's pattern discrimination. However, that's not > really what I was doing in Cervical Dysplasia & Prostate Cancer. It > was what I was attempting in Scatalogy, but I did not do it very well > because, at that time, I knew far less Chinese medicine.> > What I'm not supportive of is members of our profession prescribing > supplements based solely on Western biomedical concepts and > principles. It is not uncommon for Chinese research protocols to be > two winged, where one wing is identified as the CM Tx wing and the > other wind is identified as the WM Tx wing. In not a few instances, > nutritional supplements comprise the treatment in the WM Tx wing. So, > without a CM medicinal description and without CM treatment based on > pattern discrimination, CM doctors in the PRC appear to identify such > supplements as "Western medicine."> > Bob> > , "1" <@i...> wrote:> > , "pemachophel2001" <> > pemachophel2001> wrote:> > > > Bob,> > > > > > > However, the multi-modal treatments described in those books were > very > > > expensive because of the large number of medicines and supplements > > > prescribed. > > > > > > good point.> > > > Since honing my specifically Chinese medical skills (in > > > great part to gaining access to the literature through learning to > > > read Chinese), I get even better results, faster, with less > expense to > > > the patients and all without leaving the scope of my licensed and > > > advertised profession.> > > > Do you think there is any role for the use of supplements from a > > western perspective or that chinese medicinals and supplements > > prescribed according to TCM principles fulfill all the patient's > needs. > > Keep in mind that unlike CO, CA scope does allow us to prescribe > these > > other supplements. So does a multivitamin make sense because most > > people do not derive adequate vitamins from food? Or glucosamine > > sulfate (GS) because it directly rebuilds joint tissue? Would you > ever > > use such things? Would you only use them from a TCM perspective? > For > > example, perhaps GS has yin tonic effect. Or are there substances > > within the TCM pharmacopeia you would use instead. For instance, > high > > collagen foods like beef tendon contain chondroitin and GS. If such > > foods were indicated, then they might fill this role. Some of these > > western isolates have the distinct advantage of ease of use, though. > > > GS, enzymes and vitamins all are quite potent at much lower dosages > > than chinese medicinals. So would you ever advise using these in > the > > context of TCM? Perhaps enzymes promote spleen T & T.> > > > > >

Integrative med/ was Chinese language ...

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