treatment of cancer patients

[Guest guest]

Frances, Bob, and All,

 

> Yes, this line of thinking makes total sense. It seems a good

direction

> for a movement in our profession. Related to it are the issues

recently

> brought up about our continuing education and ceu's. So much work

to be

> done. We definitely can't depend on the schools.

> Frances

>

> pemachophel2001 wrote:

>

> > However,

> > at BPE, we hear all the time from students and practitioners who

are

> > attempting to treat really scary diseases with basically no

training

> > and no access to good information on those diseases. I keep

wondering

> > why we think we can try to treat anything even if it exceeds our

scope

> >

> > of education.

 

I think this is a very important line of

development, but before I could agree that

it makes total sense I would suggest that

our brief on educational reform include

the issues related to foundations and education

in the fundamentals of the subject which

are similarly weak at present.

 

In the tai4 ji2 classic attributed to

Zhang San Feng, it states:

 

" If the timing and position are not correct,

the body becomes disordered,

and the defect must be sought

in the legs and waist. "

 

I believe the analogy between tai4 ji2

and Chinese medicine is valid and

valuable. What we do with our hands

in both disciplines depends upon the

strength of our foundations, our

flexibility, and our clarity of mind.

 

If we want well trained specialist

hands, we must reform the educational

system so that it adequately treats

the root and the center.

 

Ken

[Guest guest]

Ken,

 

I agree that real educational reform within our profession should, in

the best of all worlds, start with the fundamentals. However, so far,

we've seen little interest on the part of the schools to implement

such fundamental reform.

 

So perhaps the way to get reform going is to work backwards, not to

start at the beginning if, realistically, that is not possible. What

if we started with something that makes sense to a number of people --

stating what our graduates are actually qualified through their

training to treat. Mightn't this allow us to gradually and

incrementally work our way backwards to the real problems?

 

I think it would be hard to argue against such a basic endeavor as

creating such a list for students and the public AND maintain any kind

of academic or medical ethical credibility. However, once such a list

was created, wouldn't students want to push that envelope. " How come

we can't treat this or that? Oh, you mean that we would need to know

X, Y, Z? So how come you're not teaching us X, Y, Z? "

 

For instance, one of the things that students may need to learn in

order to treat cancer and other such serious, complicated diseases

might be a reading knowledge of Chinese, since there's plenty of

literature in Chinese and not very much in English.

 

On the other hand, thinking realistically about such a list of

conditions, I can't see the schools actually doing this. In fact, I do

think the schools would argue against such a list, although they may

not be willing to argue in public. I'm surprised that no one ventured

any responses to my original query about the financial and/or

political downsides of such a list.

 

Bob

 

, " dragon90405 " <yulong@m...> wrote:

> Frances, Bob, and All,

>

> > Yes, this line of thinking makes total sense. It seems a good

> direction

> > for a movement in our profession. Related to it are the issues

> recently

> > brought up about our continuing education and ceu's. So much work

> to be

> > done. We definitely can't depend on the schools.

> > Frances

> >

> > pemachophel2001 wrote:

> >

> > > However,

> > > at BPE, we hear all the time from students and practitioners who

> are

> > > attempting to treat really scary diseases with basically no

> training

> > > and no access to good information on those diseases. I keep

> wondering

> > > why we think we can try to treat anything even if it exceeds our

> scope

> > >

> > > of education.

>

> I think this is a very important line of

> development, but before I could agree that

> it makes total sense I would suggest that

> our brief on educational reform include

> the issues related to foundations and education

> in the fundamentals of the subject which

> are similarly weak at present.

>

> In the tai4 ji2 classic attributed to

> Zhang San Feng, it states:

>

> " If the timing and position are not correct,

> the body becomes disordered,

> and the defect must be sought

> in the legs and waist. "

>

> I believe the analogy between tai4 ji2

> and Chinese medicine is valid and

> valuable. What we do with our hands

> in both disciplines depends upon the

> strength of our foundations, our

> flexibility, and our clarity of mind.

>

> If we want well trained specialist

> hands, we must reform the educational

> system so that it adequately treats

> the root and the center.

>

> Ken

[Guest guest]

Bob,

 

> I agree that real educational reform within our profession should,

in

> the best of all worlds, start with the fundamentals. However, so

far,

> we've seen little interest on the part of the schools to implement

> such fundamental reform.

 

I place the burden on individuals, starting

with myself. I see education as an ongoing

process, only a small portion of which is

conducted during one's enrollment in school.

>

> So perhaps the way to get reform going is to work backwards, not to

> start at the beginning if, realistically, that is not possible.

What

> if we started with something that makes sense to a number of

people --

> stating what our graduates are actually qualified through their

> training to treat. Mightn't this allow us to gradually and

> incrementally work our way backwards to the real problems?

 

Certainly. I'm not arguing against the

general proposal you make, only pointing

out that if an individual wants a high

level of skill, he or she must work to

develop their foundations.

 

 

>

> I think it would be hard to argue against such a basic endeavor as

> creating such a list for students and the public AND maintain any

kind

> of academic or medical ethical credibility. However, once such a

list

> was created, wouldn't students want to push that envelope. " How

come

> we can't treat this or that? Oh, you mean that we would need to

know

> X, Y, Z? So how come you're not teaching us X, Y, Z? "

 

Makes sense.

>

> For instance, one of the things that students may need to learn in

> order to treat cancer and other such serious, complicated diseases

> might be a reading knowledge of Chinese, since there's plenty of

> literature in Chinese and not very much in English.

 

Makes more sense.

>

> On the other hand, thinking realistically about such a list of

> conditions, I can't see the schools actually doing this. In fact, I

do

> think the schools would argue against such a list, although they

may

> not be willing to argue in public. I'm surprised that no one

ventured

> any responses to my original query about the financial and/or

> political downsides of such a list.

 

I, too, am curious to know people's

perceptions on this score.

 

Ken

[Guest guest]

, " pemachophel2001 "

<pemachophel2001> wrote:

> Ken,

 

 

>What if we started with something that makes sense to a number of

people -- stating what our graduates are actually qualified through

their training to treat.

 

How would these qualifications be stated or phrased? Would the list

state that graduates of XYZ College are qualified to treat biomedical

conditions or would the list present Chinese medical patterns and

disease categories? Or both?

 

>I think it would be hard to argue against such a basic endeavor as

creating such a list for students and the public AND maintain any

kind of academic or medical ethical credibility.

 

Who maintains the list? How is it disseminated to the public? When

is it updated? How do CEUs figure into it and how much paperwork

would be generated by practitioners trying to " upgrade " their

qualifications? Who will pay for it?

 

>For instance, one of the things that students may need to learn in

order to treat cancer and other such serious, complicated diseases....

 

By existing legal restrictions, I would not be permitted to " treat

cancer. " Publishing such a list would only stir the stew on this

subject and potentially reinforce the legal vice already placed on our

profession.

 

>I'm surprised that no one ventured any responses to my original

query about the financial and/or political downsides of such a list.

 

I was also surprised and have been waiting for others to respond

to your proposal. As a student, I realize my opinion may not be your

first objective, yet I feel compelled to tell you the idea has made

me uneasy since I first read your post. Your intentions are positive

and you seem to have the best interest of the profession in mind.

However, a list like this has potential for misuse. As I contemplate

my future as a practitioner, I am constantly confronted with

limitations imposed by existing medical legalities and mindsets; this

list initially feels like a new cop added to the beat.

 

Please don't misunderstand - I am in favor of improving education

and enhancing our exposure to specialities. PCOM has been amping up

the curriculum steadily since I first enrolled and the academic rigor

increases with each trimester. Much emphasis has been placed on

case-based learning which encompasses both Chinese medical and

biomedical perspectives, including knowing when to refer patients out

when their condition may exceed our scope of practice or abilities.

 

What I feel is lacking most in our profession are willing mentors.

As the student population grows exponentially, the availability of

mentors should expand as well. However, our classes are merely

larger and the ideal teacher-student relationship has waned. I have

been fortunate to have multiple clinic shifts with the same teacher

and have been able to cultivate, or at least iniate, what could be a

mentor for my continued growth as a future practitioner. The general

mood in the college, however, supports the idea of tasting as much

variety as possible before moving on - a superficial exposure to

everything rather than deep cultivation of a few things. At the same

time, I have written papers for classes only to have them never

returned, or returned with minimal comment. I have taken numerous

" essay " examinations only to have them graded by someone other than

the professor - so the teacher may never really know how well

his or her knowlege is being transmitted and assimilated. In other

words, the curriculum is hardy, the opportunities to learn are

growing, but I'm not sure the school is actually AWARE of what I, as

an individual, will be qualified to practice.

 

As a student, I anticipate that I'll be qualified to treat Qi and

Blood vacuity and stagnation, Yin and Yang imbalances, Phlegm and

body fluid pathologies, and patterns such as Spleen Qi Xu with

dampness. This pattern alone relates to a broad range of diseases and

chief complaints - how would a list quantify this accurately? What

would it lead my potential patients to expect? And, in the end, would

it really prevent unethical or less capable practitioners from

" treating " cancer?

 

You've provoked a feast of questions. I hope the debate will

continue.

 

Laurie Burton

[Guest guest]

Laurie,

Many of us may be willing to mentor new grads, but due

to the enormous numbers of students being graduated each year, the pressures

of merely maintaining our practices demands most of our energies.

And I still thank you for expressing your concerns here.

Frances

 

What I feel is lacking most in our profession are willing

mentors.

As the student population grows exponentially, the

availability of

mentors should expand as well.

 

burtonperez wrote:

,

"pemachophel2001"

<pemachophel2001> wrote:

> Ken,

 

>What if we started with something that makes sense

to a number of

people -- stating what our graduates are actually

qualified through

their training to treat.

How would these qualifications be stated or phrased?

Would the list

state that graduates of XYZ College are qualified

to treat biomedical

conditions or would the list present Chinese medical

patterns and

disease categories? Or both?

>I think it would be hard to argue against such a

basic endeavor as

creating such a list for students and the public

AND maintain any

kind of academic or medical ethical credibility.

Who maintains the list? How is it disseminated

to the public? When

is it updated? How do CEUs figure into it and

how much paperwork

would be generated by practitioners trying to "upgrade"

their

qualifications? Who will pay for it?

>For instance, one of the things that students may

need to learn in

order to treat cancer and other such serious, complicated

diseases....

By existing legal restrictions, I would not be permitted

to "treat

cancer." Publishing such a list would only

stir the stew on this

subject and potentially reinforce the legal vice

already placed on our

profession.

>I'm surprised that no one ventured any responses

to my original

query about the financial and/or political downsides

of such a list.

I was also surprised and have been waiting for others

to respond

to your proposal. As a student, I realize my

opinion may not be your

first objective, yet I feel compelled to tell you

the idea has made

me uneasy since I first read your post. Your

intentions are positive

and you seem to have the best interest of the profession

in mind.

However, a list like this has potential for misuse.

As I contemplate

my future as a practitioner, I am constantly confronted

with

limitations imposed by existing medical legalities

and mindsets; this

list initially feels like a new cop added to the

beat.

Please don't misunderstand - I am in favor of improving

education

and enhancing our exposure to specialities.

PCOM has been amping up

the curriculum steadily since I first enrolled and

the academic rigor

increases with each trimester. Much emphasis

has been placed on

case-based learning which encompasses both Chinese

medical and

biomedical perspectives, including knowing when to

refer patients out

when their condition may exceed our scope of practice

or abilities.

What I feel is lacking most in our profession are

willing mentors.

As the student population grows exponentially, the

availability of

mentors should expand as well. However, our

classes are merely

larger and the ideal teacher-student relationship

has waned. I have

been fortunate to have multiple clinic shifts with

the same teacher

and have been able to cultivate, or at least iniate,

what could be a

mentor for my continued growth as a future practitioner.

The general

mood in the college, however, supports the idea of

tasting as much

variety as possible before moving on - a superficial

exposure to

everything rather than deep cultivation of a few

things. At the same

time, I have written papers for classes only to have

them never

returned, or returned with minimal comment.

I have taken numerous

"essay" examinations only to have them graded by

someone other than

the professor - so the teacher may never really know

how well

his or her knowlege is being transmitted and assimilated.

In other

words, the curriculum is hardy, the opportunities

to learn are

growing, but I'm not sure the school is actually

AWARE of what I, as

an individual, will be qualified to practice.

As a student, I anticipate that I'll be qualified

to treat Qi and

Blood vacuity and stagnation, Yin and Yang imbalances,

Phlegm and

body fluid pathologies, and patterns such as Spleen

Qi Xu with

dampness. This pattern alone relates to a broad

range of diseases and

chief complaints - how would a list quantify this

accurately? What

would it lead my potential patients to expect?

And, in the end, would

it really prevent unethical or less capable practitioners

from

"treating" cancer?

You've provoked a feast of questions. I hope

the debate will

continue.

Laurie Burton

 

 

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.

 

 

[Guest guest]

Laurie,

 

> How would these qualifications be stated or phrased?

 

I think it might be very good if colleges voluntarily provided their

students a list of the diseases that they had been taught to treat

while a student.

 

> Who maintains the list?

 

I would see this as a voluntary list provided to graduating students

for informational/educational purposes only. It would be a cautionary

list, a sort of parting wake-up call or reality-check. When I

graduated from the acupuncture training I initially did at the

Shanghai College of CM, I was given just such a list. However, it had

no regulatory power; it was purely ethical/educational. Similarly, I

was given a list of diseases I should feel free to treat by my very

fist acupuncture teacher, (Eric) Tao Xi-yu.

 

I was fully expecting someone to bring up some of the difficulties and

objections you have raised. I'm not looking to create another layer of

regulations enforced by some outside entity. However, it is my

experience that, if a profession does not set its own guidelines

(which are reasonable to the larger community), outside entities

eventually will.

 

How is it disseminated to the public?

 

I'm not sure it should be. I don't think it needs to be.

 

What I do think needs to happen and which I do not see happening is at

least a discussion in the schools of what a new graduate's scope of

practice should be based on the education they have received. I think

Z'ev and others have stated some of the problems they also see of

people thinking they should attempt to treat everything even though

they were not trained to treat certain things. I believe it was Z'ev

or Todd who gave the very good example of obstetrics in the case of a

practitioner who has not specifically studied and been trained in

obstetrics. I get such questions on an almost daily basis and I often

have to shake my head wondering why the person thinks they should be

attempting to treat something they known nothing about.

 

> What I feel is lacking most in our profession are willing mentors.

> As the student population grows exponentially, the availability of

> mentors should expand as well.

 

A number of years ago, Miki Shima told me of a mentoring program that

was initiated by some CA acupuncture assoc. As Miki described it, the

mentor helped the younger practitioner both clinically and

professionally/businesswise. If you think that is a good idea and the

program no longer exists, why not start it up again? " Better to light

one candle... "

 

However, our classes are merely

> larger and the ideal teacher-student relationship has waned. I have

> been fortunate to have multiple clinic shifts with the same teacher

> and have been able to cultivate, or at least iniate, what could be a

> mentor for my continued growth as a future practitioner. The general

> mood in the college, however, supports the idea of tasting as much

> variety as possible before moving on - a superficial exposure to

> everything rather than deep cultivation of a few things.

 

So who at the college have you complained to? In what forums have you

tried to discuss this issue? Have you posted an article on this on the

student Website or in the student newsletter? What about starting a

" Let's Go Deeper Club. "

 

At the

same

> time, I have written papers for classes only to have them never

> returned, or returned with minimal comment. I have taken numerous

> " essay " examinations only to have them graded by someone other than

> the professor - so the teacher may never really know how well

> his or her knowlege is being transmitted and assimilated. In other

> words, the curriculum is hardy, the opportunities to learn are

> growing, but I'm not sure the school is actually AWARE of what I, as

> an individual, will be qualified to practice.

 

Sorry to hear about your experiences. However, my own criticisms of

the schools and how they are operated are legion and legendary. Enough

said, at least by me.

 

> As a student, I anticipate that I'll be qualified to treat Qi and

> Blood vacuity and stagnation, Yin and Yang imbalances, Phlegm and

> body fluid pathologies, and patterns such as Spleen Qi Xu with

> dampness. This pattern alone relates to a broad range of diseases

and

> chief complaints - how would a list quantify this accurately? What

> would it lead my potential patients to expect? And, in the end,

would

> it really prevent unethical or less capable practitioners from

> " treating " cancer?

 

It's important to keep diseases (bing) and patterns (zheng) separate.

Two patients can present the same pattern, although they have

different disease diagnoses. One has a benign, self-limiting condition

and the other has a serious, life-threatening condition. In such

cases, it is extremely important to know about the differences in

natural history (i.e., the etiology, pathophysiology, epidemiology,

diagnosis, treatment, and prognosis) between these two diseases. For

instance, certain diseases respond to certain medicinals better than

others even for the same pattern.

 

Professional CM uses what is called " dual diagnosis " (liang zhen).

There is disease diagnosis (bian bing) and pattern discrimination

(bian zheng), and both elements are extremely important in the overall

care of the patient. (Bob Damone will be teaching a class for Blue

Poppy Institute which specifically addresses this relationship and

what knowing about the disease does for the CM practitioner.) Although

standard professional CM tends to emphasize pattern discrimination, to

forget about disease diagnosis and treatment predicated upon that

diagnosis is also a procedural mistake in professional CM. The two

diagnoses are like the two wings of a bird. It is the coordination

between those two wings what allow the bird to fly high in the sky.

 

I agree that treatment based on pattern discrimination gives us more

latitude than purely disease-based practitioners, and I'm really happy

that someone has brought that up. It needs to be kept in mind. It

allows us greater flexibilityt as practitioners, and Ken has recently

remarked that it is important that we use our disciplines flexibly. I

would hate for such a list as I originally proposed to become a rigid,

doctrinaire cudgel for beating people down. I'd be the first to say

that there are times when you must go beyond your initial training.

Otherwise you don't grow. However, there has to be some perspicacity

involved to temper unalloyed enthusiasm. Without such perspicacity,

there is foolhardiness.

 

Ah, Kong-zi's Zhong Yong, the Doctrine of the Mean.

 

> You've provoked a feast of questions. I hope the debate will

> continue.

 

Me too.

 

Bob

[Guest guest]

, " pemachophel2001 "

<pemachophel2001> wrote:

> Laurie,

 

> for informational/educational purposes only. It would be a

cautionary

> list, a sort of parting wake-up call or reality-check. When I

> graduated from the acupuncture training I initially did at the

> Shanghai College of CM, I was given just such a list. However, it

> had no regulatory power; it was purely ethical/educational. ...I'm

not looking to create another layer of

> regulations enforced by some outside entity.

 

Bob,

I appreciate your thoughtful response and am relieved by your further

clarifications.

 

By mentioning some of the missing feedback in my education, I hoped to

emphasize only that I'm uncertain whether the school fully knows what

its graduates are capable of, or not. Despite this, I believe more

than ample opportunity is provided for students to garner knowledge

and sponge up experience - and I've had several teachers who foster

such academic exchange. To be fair, the responsibility is not

exclusively that of the educators; students have to remain hungry,

diligent, and aware of their own boundaries.

 

Now that I have a better idea of your concept, the list you're

suggesting might be more useful midway through the program, rather

than as a graduation gift. It could serve as a promise and as an

ethical guideline simultaneously.

 

Laurie

[Guest guest]

Laurie,

 

Thanks for expressing your concerns. I see that

you and Bob have clarified several points, but

there are a couple I wanted to follow up on.

>

> What I feel is lacking most in our profession are willing mentors.

> As the student population grows exponentially, the availability of

> mentors should expand as well. However, our classes are merely

> larger and the ideal teacher-student relationship has waned. I

have

> been fortunate to have multiple clinic shifts with the same teacher

> and have been able to cultivate, or at least iniate, what could be

a

> mentor for my continued growth as a future practitioner. The

general

> mood in the college, however, supports the idea of tasting as much

> variety as possible before moving on - a superficial exposure to

> everything rather than deep cultivation of a few things. At the

same

> time, I have written papers for classes only to have them never

> returned, or returned with minimal comment. I have taken numerous

> " essay " examinations only to have them graded by someone other than

> the professor - so the teacher may never really know how well

> his or her knowlege is being transmitted and assimilated. In other

> words, the curriculum is hardy, the opportunities to learn are

> growing, but I'm not sure the school is actually AWARE of what I,

as

> an individual, will be qualified to practice.

 

This strikes me as extraordinarily insightful.

Is this not a consequence of the role and status of

preparation to pass the licensing exam? The

brief on public education that was one of

the principle themes of the 2000 presidential

election included an indictment of schools

that " teach the test " . But it seems to me

that the whole educational system in California,

and to a greater or lesser extent the rest

of the country, is slanted towards teaching

the test.

 

I take it that the school is actually aware

of the likelihood of your passing the test.

I say this not to take a pot shot at the

school but to point out how easy the situation

is to remedy. All that has to happen is

for some people to change their minds and

shift the emphasis. The infrastructure is

all there. We're just one thought away.

 

Regarding the scarcity of mentors, can you

detail the ideal scene of having a mentor?

 

And if there are others who share this

concern, I'd like to learn more about

what people need and want in the way

of mentoring.

 

>

> As a student, I anticipate that I'll be qualified to treat Qi and

> Blood vacuity and stagnation, Yin and Yang imbalances, Phlegm and

> body fluid pathologies, and patterns such as Spleen Qi Xu with

> dampness. This pattern alone relates to a broad range of diseases

and

> chief complaints - how would a list quantify this accurately?

 

I think this is a darn good question.

How would you go about qualifying an

individual with respect to their capacity

to see and treat these things effectively?

 

I posed this same question to Bob Flaws

in the other thread: should the interaction

between a practitioner of Chinese medicine

and his or her patient resemble the conduct

of a conventional MD?

 

What

> would it lead my potential patients to expect? And, in the end,

would

> it really prevent unethical or less capable practitioners from

> " treating " cancer?

 

And how might it impact on the character

and efficacy of Chinese medical interventions?

 

 

>

> You've provoked a feast of questions. I hope the debate will

> continue.

 

Well, that's up to you now.

 

Ken

[Guest guest]

I believe this points out an important epistemological limitation of

CM, and raises [what I find to be] an interesting question. If two

patterns are the same but one is life-threatening and the other is

not, then are they really the same pattern? Obviously, something

more or different is going on in one. If this is the case, then we

are facing either our theory's limitation or the limitations of the

practitioner describing it.

 

The root of a problem may not be presenting any S/S to fix a

complete pattern. This is true of some cancers and the early stages

of anthrax, as well as other disorders. It would be folly for CM

alone to attempt to treat these conditions if there is a very

critical and limited timeframe. CM can neither diagnosis nor treat a

problem that occurs at the molecular level; it's below the threshold

of what we can know and what we can directly affect. In some other

diseases such as cystic fibrosis, for example, the root of the

problem is a misfolded protein in the cell membrane; the S/S are a

branch or product of a genetic mistake.

 

When I was talking about cancer earlier, I should have been more

clear and more specific by saying the cancer movement or the

doubling or knotting movement in the pulse. The cancer itself, the

pathological multiplication of cells, is unobservable and

untreatable by CM. And, as in WM, only when a mass grows to a

significant size will it's influence and consequences become

observable. Even the types of pulse movement which precede cancer

are not directly causative because of number of variables involved---

what Complexity Theory would call the butterfly effect or

sensitivity to initial conditions.

 

What I proposed earlier was not a protocol but a treatment strategy

incorporating 5-Phases and 6-Qi. It is an illustration of the way my

teacher has worked over the years, and I do now. I think it was

unfair to say that it was an unprofessional presentation when the

forum is casual and anecdotal; it was my 2 cents. The complete

protocol actually incorporates the patient's MD as their primary

physician. It is an integrative approach used with many cases. The

success is largely dependent on the WM end; but CM medicine can

certainly extends their time, decreases infection rates, decrease

side effects, etc. I had hoped that, because it was unfamiliar and

different from basic 8-Principles, if practitioners were interested

in that sort of approach they would ask about it---if not, not. And

political issues aside, I think a refusal to help " impossible " cases

reflects both a bankruptcy of theory as well as a bankruptcy of

compassion. As a profession we have a responsibility to extend

ourselves to help.

 

 

Jim Ramholz

 

 

 

 

 

 

 

It's important to keep diseases (bing) and patterns (zheng)

separate.

Two patients can present the same pattern, although they have

different disease diagnoses. One has a benign, self-limiting

condition

and the other has a serious, life-threatening condition. In such

cases, it is extremely important to know about the differences in

natural history (i.e., the etiology, pathophysiology, epidemiology,

diagnosis, treatment, and prognosis) between these two diseases. For

instance, certain diseases respond to certain medicinals better than

others even for the same pattern.

 

Professional CM uses what is called " dual diagnosis " (liang zhen).

There is disease diagnosis (bian bing) and pattern discrimination

(bian zheng), and both elements are extremely important in the

overall

care of the patient. (Bob Damone will be teaching a class for Blue

Poppy Institute which specifically addresses this relationship and

what knowing about the disease does for the CM practitioner.)

Although

standard professional CM tends to emphasize pattern discrimination,

to

forget about disease diagnosis and treatment predicated upon that

diagnosis is also a procedural mistake in professional CM. The two

diagnoses are like the two wings of a bird. It is the coordination

between those two wings what allow the bird to fly high in the sky.

 

I agree that treatment based on pattern discrimination gives us more

latitude than purely disease-based practitioners, and I'm really

happy

that someone has brought that up. It needs to be kept in mind. It

allows us greater flexibility as practitioners, and Ken has recently

remarked that it is important that we use our disciplines flexibly.

I

would hate for such a list as I originally proposed to become a

rigid,

doctrinaire cudgel for beating people down. I'd be the first to say

that there are times when you must go beyond your initial training.

Otherwise you don't grow. However, there has to be some perspicacity

involved to temper unalloyed enthusiasm. Without such perspicacity,

there is foolhardiness.

[Guest guest]

, " jramholz " <jramholz> wrote:

> I believe this points out an important epistemological limitation of

> CM, and raises [what I find to be] an interesting question. If two

> patterns are the same but one is life-threatening and the other is

> not, then are they really the same pattern? Obviously, something

> more or different is going on in one. If this is the case, then we

> are facing either our theory's limitation or the limitations of the

> practitioner describing it.

>

Jim,

 

I don't see this as any kind of limitation or problem with the system.

If one is clear A) what a pattern is and what the value of patterns

are in terms of guiding practice and B) what a disease is and what

the value of diseases are in terms of guiding practice, then there is

no particular problem. In my experience, it's only when you don't

approach the system on its own terms and don't accurately understand

the whole system as a system that problems such as you are raising

arise. As I said in my original response, when you coordinate bian

bing with bian zheng, the bird has two wings and flies clinically very

nicely.

 

Bob

>

>

>

>

>

> It's important to keep diseases (bing) and patterns (zheng)

> separate.

> Two patients can present the same pattern, although they have

> different disease diagnoses. One has a benign, self-limiting

> condition

> and the other has a serious, life-threatening condition. In such

> cases, it is extremely important to know about the differences in

> natural history (i.e., the etiology, pathophysiology, epidemiology,

> diagnosis, treatment, and prognosis) between these two diseases. For

> instance, certain diseases respond to certain medicinals better than

> others even for the same pattern.

>

> Professional CM uses what is called " dual diagnosis " (liang zhen).

> There is disease diagnosis (bian bing) and pattern discrimination

> (bian zheng), and both elements are extremely important in the

> overall

> care of the patient. (Bob Damone will be teaching a class for Blue

> Poppy Institute which specifically addresses this relationship and

> what knowing about the disease does for the CM practitioner.)

> Although

> standard professional CM tends to emphasize pattern discrimination,

> to

> forget about disease diagnosis and treatment predicated upon that

> diagnosis is also a procedural mistake in professional CM. The two

> diagnoses are like the two wings of a bird. It is the coordination

> between those two wings what allow the bird to fly high in the sky.

>

> I agree that treatment based on pattern discrimination gives us more

> latitude than purely disease-based practitioners, and I'm really

> happy

> that someone has brought that up. It needs to be kept in mind. It

> allows us greater flexibility as practitioners, and Ken has recently

> remarked that it is important that we use our disciplines flexibly.

> I

> would hate for such a list as I originally proposed to become a

> rigid,

> doctrinaire cudgel for beating people down. I'd be the first to say

> that there are times when you must go beyond your initial training.

> Otherwise you don't grow. However, there has to be some perspicacity

> involved to temper unalloyed enthusiasm. Without such perspicacity,

> there is foolhardiness.