Guest guest Posted March 3, 2002 Report Share Posted March 3, 2002 An additional comment: The council of schools and colleges has required the inclusion of drug-herb interactions in the cirriculum. While I personally think it is a good idea, what I perceive is the attitude of the council is that there is, somehow, a body of knowledge out there that is ready to be taught, data to be accessed, studies and research to rely on. There simply is not. We have to be careful to not make assumptions that will be used against our profession in the long run. I have been beta-testing software to help determine POTENTIAL drug-herb interactions, and have some observations from clinical experience . We need to gather clinical experience from TCM practitioners, both here and in China, and this is a long-term project. I have also seen this attitude when I have taught seminars that approach this subject. Students and practitioners have expected ready-made, pre-existing definitive data, and it doesn't really exist from what I have seen , limited as my exposure is(except with such subjects as chemotherapy and steroidal drugs) in the Chinese journals. Perhaps Bob Flaws has come across other useful material in the Chinese journals, it would be interesting to hear from you on this, Bob. There have been a couple of individuals who have speculated on drug-herb interactions, and I have put across proposals of possible interactions in the recent past (such as immunosuppressive medications with herbs). But they are theoretical, or observed clinically by a few individuals. These observations are not yet reliable. On Sunday, March 3, 2002, at 06:03 PM, Alon Marcus wrote: > We have rectified that (at PCOM). As of next semester, each herb course > will have the equivalent of 4-5 hours of discussion on herb toxicity, > drug/herb interactions, herb pharmacology, etc. > >>>Unfortunately so little real clinical information is known. > Alon > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2002 Report Share Posted March 4, 2002 Z'ev - Your point is entirely valid. I would like to add a conceptual adjustment. The Council of Colleges (CCAOM) is similar to a trade union for schools. They have no authority to require schools to do anything. The accreditation commission (ACAOM) has the authority to make requirements. They are doing so on the recommendation of CCAOM. I served on the curriculum committee of CCAOM who provided input on program of study changes to ACAOM. The two major topic areas were the herb and biomedical programs; these two knowledge domains feed each other when it comes to drug herb interactions. Schools can no longer afford to avoid sound biomedical training as a commitment to the acupuncturist as artist. There is an awareness of the lack of substantive information regarding drug-herb interactions. We also saw the need for this topic to be present in the core curriculum of each and every school. The issue is so hot and emergent, the profession and the schools can no longer keep their heads in the sand on this. Will An additional comment: The council of schools and colleges has required the inclusion of drug-herb interactions in the cirriculum. While I personally think it is a good idea, what I perceive is the attitude of the council is that there is, somehow, a body of knowledge out there that is ready to be taught, data to be accessed, studies and research to rely on. There simply is not. We have to be careful to not make assumptions that will be used against our profession in the long run. I have been beta-testing software to help determine POTENTIAL drug-herb interactions, and have some observations from clinical experience . We need to gather clinical experience from TCM practitioners, both here and in China, and this is a long-term project. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2002 Report Share Posted March 4, 2002 There have been a couple of individuals who have speculated on drug-herb interactions >>>>That is correct mostly speculation. What we need is to teach the science of pharmacology so that we can be part of the community that discuses and hopefully studies this Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2002 Report Share Posted March 5, 2002 Z'ev, I completely agree that there is, as yet, no large and reliable body of knowledge on Chinese medicinal-Western medicinal interactions. In fact, from my reading of approximately 15% of the CM journals from the PRC annually, this does not seem to be of much interest to the authors who publish in those journals. While there is a steadily growing literature on treating the side effects of Western meds with Chinese medicinals, I hardly ever come across articles on adverse WM-CM interactions. In fact, I can't think of a single such article I have read in the past year. I think one of the reasons for this is that, in standard professional Chinese medicine, we don't use singles; we are essentially always using polypharmacy formulas. I think this changes the whole question or, at least, makes the question of specific Chinese medicinal-Western medicine reactions less cogent. Basically, my impression is that we are playing a game whose rules have been set by WM. The concern over herb-drug intereactions was initially raised and is continuously fanned by the WM establishment. In trying to prove our legitimacy to this power structure, we have assumed that this is a real concern that needs to be addressed. We have bought into this concern without, necessarily, examining its fundamental suppositions. In China, the integration of these two medicines is quite far along. More and more studies are being published comparing the integrated Chinese-Western medicine treatment of this or that to the WM treatment alone. It seems to me that less and less studies are comparing pure CM to pure WM. So the question is, if herb-drug interactions are really such an important clinical topic, how come the people in the PRC do not seem very interested in this issue? If it truly were an important clinical issue in the modern practice of CM, shouldn't the people who are doing the most integrated CM-WM be interested in it? So, on the one hand I think Z'ev is absolutely correct in saying that teaching classes on this subject matter are way premature. On the other, I question whether this really is an important subject for concern in the first place. Bob , " " <zrosenbe@s...> wrote: > An additional comment: > The council of schools and colleges has required the inclusion of > drug-herb interactions in the cirriculum. While I personally think it > is a good idea, what I perceive is the attitude of the council is that > there is, somehow, a body of knowledge out there that is ready to be > taught, data to be accessed, studies and research to rely on. There > simply is not. We have to be careful to not make assumptions that will > be used against our profession in the long run. I have been > beta-testing software to help determine POTENTIAL drug-herb > interactions, and have some observations from clinical experience . We > need to gather clinical experience from TCM practitioners, both here and > in China, and this is a long-term project. > > I have also seen this attitude when I have taught seminars that approach > this subject. Students and practitioners have expected ready-made, > pre-existing definitive data, and it doesn't really exist from what I > have seen , limited as my exposure is(except with such subjects as > chemotherapy and steroidal drugs) in the Chinese journals. Perhaps Bob > Flaws has come across other useful material in the Chinese journals, it > would be interesting to hear from you on this, Bob. There have been a > couple of individuals who have speculated on drug-herb interactions, and > I have put across proposals of possible interactions in the recent past > (such as immunosuppressive medications with herbs). But they are > theoretical, or observed clinically by a few individuals. These > observations are not yet reliable. > > > > > > > On Sunday, March 3, 2002, at 06:03 PM, Alon Marcus wrote: > > > We have rectified that (at PCOM). As of next semester, each herb course > > will have the equivalent of 4-5 hours of discussion on herb toxicity, > > drug/herb interactions, herb pharmacology, etc. > > >>>Unfortunately so little real clinical information is known. > > Alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2002 Report Share Posted March 5, 2002 I believe we have a moral obligation to pursue the topic to the best of our ability. In addition, it may not come from Chinese sources. Will So, on the one hand I think Z'ev is absolutely correct in saying that teaching classes on this subject matter are way premature. On the other, I question whether this really is an important subject for concern in the first place. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2002 Report Share Posted March 5, 2002 Z'ev: With the integration of Western meds and Chinese herbs in China, wouldn't there be a wealth of experience to draw on from those Asian hospitals and practitioners? Jim Ramholz , " " <zrosenbe@s...> wrote: > An additional comment: > The council of schools and colleges has required the inclusion of > drug-herb interactions in the cirriculum. While I personally think it > is a good idea, what I perceive is the attitude of the council is that > there is, somehow, a body of knowledge out there that is ready to be > taught, data to be accessed, studies and research to rely on. There > simply is not. We have to be careful to not make assumptions that will > be used against our profession in the long run. I have been > beta-testing software to help determine POTENTIAL drug-herb > interactions, and have some observations from clinical experience . We > need to gather clinical experience from TCM practitioners, both here and > in China, and this is a long-term project. > > I have also seen this attitude when I have taught seminars that approach > this subject. Students and practitioners have expected ready- made, > pre-existing definitive data, and it doesn't really exist from what I > have seen , limited as my exposure is(except with such subjects as > chemotherapy and steroidal drugs) in the Chinese journals. Perhaps Bob > Flaws has come across other useful material in the Chinese journals, it > would be interesting to hear from you on this, Bob. There have been a > couple of individuals who have speculated on drug-herb interactions, and > I have put across proposals of possible interactions in the recent past > (such as immunosuppressive medications with herbs). But they are > theoretical, or observed clinically by a few individuals. These > observations are not yet reliable. > > > > > > > On Sunday, March 3, 2002, at 06:03 PM, Alon Marcus wrote: > > > We have rectified that (at PCOM). As of next semester, each herb course > > will have the equivalent of 4-5 hours of discussion on herb toxicity, > > drug/herb interactions, herb pharmacology, etc. > > >>>Unfortunately so little real clinical information is known. > > Alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2002 Report Share Posted March 5, 2002 Not in the specific area being discussed, i.e., drug-herb interactions. On Tuesday, March 5, 2002, at 09:50 PM, jramholz wrote: > Z'ev: > > With the integration of Western meds and Chinese herbs in China, > wouldn't there be a wealth of experience to draw on from those Asian > hospitals and practitioners? > > Jim Ramholz > > > > > , " " <zrosenbe@s...> > wrote: > > An additional comment: > > The council of schools and colleges has required the inclusion of > > drug-herb interactions in the cirriculum. While I personally > think it > > is a good idea, what I perceive is the attitude of the council is > that > > there is, somehow, a body of knowledge out there that is ready to > be > > taught, data to be accessed, studies and research to rely on. > There > > simply is not. We have to be careful to not make assumptions that > will > > be used against our profession in the long run. I have been > > beta-testing software to help determine POTENTIAL drug-herb > > interactions, and have some observations from clinical > experience . We > > need to gather clinical experience from TCM practitioners, both > here and > > in China, and this is a long-term project. > > > > I have also seen this attitude when I have taught seminars that > approach > > this subject. Students and practitioners have expected ready- > made, > > pre-existing definitive data, and it doesn't really exist from > what I > > have seen , limited as my exposure is(except with such subjects as > > chemotherapy and steroidal drugs) in the Chinese journals. > Perhaps Bob > > Flaws has come across other useful material in the Chinese > journals, it > > would be interesting to hear from you on this, Bob. There have > been a > > couple of individuals who have speculated on drug-herb > interactions, and > > I have put across proposals of possible interactions in the recent > past > > (such as immunosuppressive medications with herbs). But they are > > theoretical, or observed clinically by a few individuals. These > > observations are not yet reliable. > > > > > > > > > > > > > > On Sunday, March 3, 2002, at 06:03 PM, Alon Marcus wrote: > > > > > We have rectified that (at PCOM). As of next semester, each herb > course > > > will have the equivalent of 4-5 hours of discussion on herb > toxicity, > > > drug/herb interactions, herb pharmacology, etc. > > > >>>Unfortunately so little real clinical information is known. > > > Alon > > > > > > > > Chinese Herbal Medicine, a voluntary organization of licensed > healthcare practitioners, matriculated students and postgraduate > academics specializing in Chinese Herbal Medicine, provides a variety > of professional services, including board approved online continuing > education. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 6, 2002 Report Share Posted March 6, 2002 Will, Until or unless we somehow deal with the issue of CM polypharmacy prescription (which is the norm in standard professional CM), I think looking at individual Chinese herb-Western med reactions is misleading,possibly misrepresentative, and likely to be a big waste of time, money, and resources. It is also likely to result in mistaken governmental restriction of our practice based on such misleading, misrepresentative research or theoretical assumptions. (By theoretical assumptions, I mean the kind of theoretical possibilities that John Chen primarily talks about in his materials on herb-drug interactions.) Here's a for instance: In B & G, it says, under contraindications, that Gan Cao is contraindicated in case of dampness, nausea, and vomiting, which is true if used as a single. However, Gan Cao is a standard ingredient in a number of polypharmacy formulas used to treat dampness, nausea, and vomiting (e.g., Xiao Chai Hu Tang, Ban Xia Xie Xin Tang, Si Jun Zi Tang, and Er Chen Tang). Similarly, research might suggest that a particular Chinese med is incompatible with a particular Western med when used as a single. However, the situation may be completely different when that Chinese med is part of a correctly prescribed polypharmacy Rx based on the individual's pattern. I think this is why the Chinese do not seem to be very interested in this area of potential research. Bottom line in terms of what I am suggesting is that maybe we should consider fundamentally reframing the discussion. I think we are currently operating based on certain, largely unexamined concerns which have been presented to us from the outside. It is our choice whether we buy into those concerns and play that game or we try to reframe those concerns and change the whole discussion. Granted, reframing the discussion is always the more time-consuming, more difficult task, since people generally don't change their minds, at least not based on logic. However, in my experience, the difficulty of a project is seldom the best criterion for whether or not to pursue a particular course of action. Bob , WMorris116@A... wrote: > I believe we have a moral obligation to pursue the topic to the best of our > ability. In addition, it may not come from Chinese sources. > > Will > > > > > So, on the one hand I think Z'ev is absolutely correct in saying that > > teaching classes on this subject matter are way premature. On the > > other, I question whether this really is an important subject for > > concern in the first place. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 6, 2002 Report Share Posted March 6, 2002 With the integration of Western meds and Chinese herbs in China, wouldn't there be a wealth of experience to draw on from those Asian hospitals and practitioners?>>>>That assumes close monitoring Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 6, 2002 Report Share Posted March 6, 2002 Bottom line in terms of what I am suggesting is that maybe we should consider fundamentally reframing the discussion. I think we are currently operating based on certain, largely unexamined concerns which have been presented to us from the outside. >>>Your correct alon Quote Link to comment Share on other sites More sharing options...
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