the future of CM/was headaches

[Guest guest]

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

May be this will be based on modern pharmacological as well as some

kind of computer or laboratory patterns that will take into account

individual variation. Only the future will tale. But since this is a

clinical need it will come.

 

I am sure some people will object to my use of objective and subjective

in this post. for the purpose of this post, I will define objective as

quantitative and reproducible regardless of the skill of the operator

and subjective as qualitative and dependent upon the skill of the

operator. You can argue that this is not what these terms mean in your

mind, but it is how I have used them here.

 

There is preliminary work done in china correlating certain objective

lab parameters with TCM dx. The NIH OAM is also offering a grant to

study the validity of traditional diagnostics. I would be very

interested to do a large study of patients who had been been given TCM

dx according to agreed parameters and then doing extensive bloodwork,

MRI, etc. on these patients to find common objective signs. If there

are reliable objective correlations with TCM patterns, this would

confirm the vaidity of the traditional system. Western medical dx used

to be based upon subjective evaluations and only recently is based on

objective lab values. In many cases, the modern diagnostics proved the

validity of traditinal medial diagnosis. In other cases, subjective

diagnostics were found to be highly unreliable.

 

What it really came down was the skill of the diagnostician. a great

cardiologist used to be able correctly assess the heart with a

stethoscope alone. However, such physicians were always in the

minority, I would suspect. I believe the same is probably true in TCM.

It will turn out that the best diagnosticians are better than any

machine, but that machines are better than the average diagnostician.

If this is true, the only ethical course would be to shift emphasis to

relying on objective parameters to make TCM dx. Selection of formulas

and modification will still remain an art, but dx will become a

science. And the exceptional practitioner will still be able to catch

nuances of dx that no machine ever will.

 

I think this is analogous to the issue of using standardized hrbs in

practice. A skilled herbalist who regularly handles and uses herbs can

make organoleptic assessments of quality, but the average px who works

with patent meds and only handled raw herbs briefly during TCM school

is better off relying on objective standards. This is really not as

cynical as it may sound at first listen. By freeing ourselves from the

vagaries of our practice, we may be better able to do what is most

important, clinical practice. One will still need a full grasp of

traditional ideas in order to manipulate this objective information

successfully. for example, to merely identify that a patient has blood

stasis and spleen vacuity is essentially useless if one doesn't know

how these relate and how to address them.

 

Others will argue that the actual solution is to train students to more

reliably perform traditional diagnostics. I think this may be an ideal

that is not attainable no matter how hard we try. Anyway,it can't hurt

to test the hypothesis since NIH is offering the cash to do it. If it

turns out that traditional diagnostics is more reliable than scientific

diagnostics amongst the average (not the exceptional) practitioner,

that is fine with me. But I doubt this would be the result. I think

this whole line of thought is underscored by the fact that so many of

our colleagues already rely on methods other than TCM to make their dx,

methods of dubious value I might add (such as NAET, vegatesting,

bioresonance electroacupuncture dx, o-ring, AK, etc.).

 

 

[Guest guest]

Others will argue that the actual solution is to train students to more reliably perform traditional diagnostics

>>>>>There are several parts to this question. First is reliability, second is reproducibility and third is does having both being positive does one still get a specific result to a specific clinical disease (and here i will say biomedical diseases). I have no doubt that many CM patterns can and are recognized fairly consistently daily. The more practitioners have a unified training the more consistent the first two will be. The last is only going to be flushed out by much better outcome studies.Here again I will go back and say that as long as we have studies showing total effectiveness rate in the 90% we are looking at unreliable results, especially when we still see CURE rates in the 50%.

Alon

[Guest guest]

The NIH OAM is also offering a grant to study the validity of traditional diagnostics.

>>>What would they mean by this. Pattern diagnosis is not really a question that at this point correlates to anything we know about objective medicine.

Alon

[Guest guest]

I would be very interested to do a large study of patients who had been been given TCM dx according to agreed parameters and then doing extensive bloodwork, MRI, etc. on these patients to find common objective signs.

>>>That would be very interesting but I think a little ways from what we can do with biomedical evaluation at this point. Perhaps we will need to first develop some type of computer programs that could look at small measurable variables in Blood work.

Alon

[Guest guest]

In many cases, the modern diagnostics proved the validity of traditinal medial diagnosis. In other cases, subjective diagnostics were found to be highly unreliable. >>>

Its amazing how often it does not. I highly recommend reading and keeping up with Clinical evidence can be accessed at www.clinicalevidence.org

Alon

[Guest guest]

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

> The NIH OAM is also offering a grant to

> study the validity of traditional diagnostics.

> >>>What would they mean by this. Pattern diagnosis is not really a question

that at this point correlates to anything we know about objective medicine.

 

that's what we would need to prove.