Purality and Synthesis

[Guest guest]

Dear All:

I must confess a sense of vindication after reading portions of in Contemporary China – Plurality and Synthesis. In it, Volker Scheid confirms many of my assertions regarding influences on the development and practice of Chinese medicine.

The synthesis of biomedical thinking and Chinese medical thinking was important to two of my early teachers, Jiang Fujiang and Wang Jinling. Dr. Wang encouraged the selection of specific herbs based on biomedical research then adding it to formulas that were selected based on pattern discrimination. Dr. Jiang encouraged the use of classical formulas of the Shang Han Za Bing Lun and Wen Bing for modern biomedical conditions. Although there is tremendous plurality throughout the literature of Chinese medicine, there are forces attempting to standardize it. These forces are complex, involving sociological and political agenda as well as motives to preserve traditional practices. And - all this in the face of a newly emerging zeitgeist that embraces biomedical sciences as the gold standard. I believe there are other motives for standardization related to the training of large numbers of people. Standardization has marginalized the personal and secret transmissions elucidated by Hsu in the Transmission of Chinese medicine. To be fair, the nature of secret and personal transmission is marginalizing of it's own accord. Study of the classics is necessary and informs modern day practitioners of Chinese medicine who freely move in and out of classical perspectives and strict biomedical approaches or, they use sophisticated blends depending on the needs of the patient. For English speaking practitioners, there are now two complete editions of the Nei Jing, two Shang Han Lun, two Nan Jing, and two variations on Wen Bing. These are not ideal translations, but an individual can study and compare, extracting useful clinical strategies in the process. As an aside, I do not think it is necessary for practitioners to wait until they can fluently read Chinese prior to studying these texts, on the contrary, the study should be encouraged following the examples of Dr. Zhu in Plurality and Synthesis.

 

Equally important to familiarity with authoritative source literature is the experience of the practitioner. Scheid cites the frustration of young physicians who cannot practice herbal medicine because the patients seek the old Chinese doctors for herbs and they seek western medicine from the younger doctors. They all have the similar course work and access to literature. Experience does seem to make a difference.

And – the existence of Chinese medicine in other cultures is being transformed by its presence in those cultures and is returning home to roost in China. An example of this would be the conversation about the ying qi cycles (entry-exit systems) that are a common treatment focus among European colleagues in the schools of Van Nghi, Mann, and Worsely. Yet….we find little discussion about the practical use of the entry exit systems coming from China with no clinical strategies based on these methods. It is entirely possible that Chinese practitioners may embrace these methods – I have seen it. In addition they suggest that it is a new perspective to them.

 

Will Morris

[Guest guest]



I must confess a sense of vindication after reading portions of in Contemporary China – Plurality and Synthesis. In it, Volker Scheid confirms many of my assertions regarding influences on the development and practice of Chinese medicine. >>>>Although I have not had a chance to read it as of now. From the postings I have read I have to say that I feel the same

Alon

[Guest guest]

Yes - I have been waiting for them. I also anticipate it will make a big difference.

Emperor's is very fortunate to have on faculty Jerome Jiang who has a Ph.D. in philosophy and Chinese medical classics. I think this will give him better fuel to teach with. He has been using Herny Lu's text which is coming out in a new addition and is available at prepublication discount.

 

Will

I would point out, however, that Paul Unschuld's upcoming Nei Jing volumes (I was privileged to have a sneak preview from Paul last year with Andy Ellis and Chip Chace in attendence) will leap bounds beyond the present Nei Jing translations available. They will also transform the profession.

[Guest guest]

Yes Todd - I am exquisitely sensitive to the vagaries of secret transmissions. In addition, I think it is also important to consider the shortcomings of standardization. The decisions are not always that of consensus. Social, political and personal agenda of those in power often drive such decisions. My position on this is to question the veracity of the material no matter what the source. (my yin water constitution may be becoming transparent about now - please don't ask about conspiracy theories;-)

Will

.. We need to carefully evaluate all such transmissions, as I know Will does.

The value of standardization is mainly in that it provides a consensus of agreement, laying the foundations of both practice and research. It is the beginning, not the end.

[Guest guest]

I enjoyed your post, Will. I also was inspired by Professor Zhu's cases

in the Scheid text.

 

I would point out, however, that Paul Unschuld's upcoming Nei Jing

volumes (I was privileged to have a sneak preview from Paul last year

with Andy Ellis and Chip Chace in attendence) will leap bounds

beyond the present Nei Jing translations available. They will also

transform the profession.

 

 

On Saturday, July 13, 2002, at 09:27 AM, WMorris116 wrote:

 

> Study of the classics is necessary and informs modern day practitioners

> of Chinese medicine who freely move in and out of classical

> perspectives and strict biomedical approaches or, they use

> sophisticated blends depending on the needs of the patient. For English

> speaking practitioners, there are now two complete editions of the Nei

> Jing, two Shang Han Lun, two Nan Jing, and two variations on Wen Bing.

> These are not ideal translations, but an individual can study and

> compare, extracting useful clinical strategies in the process. As an

> aside, I do not think it is necessary for practitioners to wait until

> they can fluently read Chinese prior to studying these texts, on the

> contrary, the study should be encouraged following the examples of Dr.

> Zhu in Plurality and Synthesis.

>

[Guest guest]

, WMorris116@A... wrote:

 

>

> Although there is tremendous plurality throughout the literature

of Chinese

> medicine, there are forces attempting to standardize it.

Standardization has marginalized the personal and

> secret transmissions elucidated by Hsu in the Transmission

of Chinese

> medicine. To be fair, the nature of secret and personal

transmission is

> marginalizing of it's own accord.

 

 

As Unschuld has pointed out, the plurality of CM is not a

reflection of clinical efficacy. the mere existence of secret family

styles does not mean they are actually effective. We need to

carefully evaluate all such transmissions, as I know Will does.

The value of standardization is mainly in that it provides a

consensus of agreement, laying the foundations of both practice

and research. It is the beginning, not the end.

 

[Guest guest]

In , " " <zrosenbe@s...> wrote:

> I would point out, however, that Paul Unschuld's upcoming Nei Jing

> volumes will leap bounds beyond the present Nei Jing translations

available. They will also transform the profession.

 

 

Z'ev:

 

Interesting. How so?

 

 

Jim Ramholz

[Guest guest]

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

> The value of standardization is mainly in that it provides a

> consensus of agreement, laying the foundations of both practice

> and research.

:

 

Where do you see research going in the next 5-10 years?

 

 

Jim Ramholz

[Guest guest]

, WMorris116@A... wrote:

<<< I must confess a sense of vindication after reading portions of

in Contemporary China †" Plurality and Synthesis.

In it, Volker Scheid confirms many of my assertions regarding

influences on the development and practice of Chinese medicine. >>>

 

 

I don't think your vindication is necessary---as long as you can

demonstrate the clinical effectiveness of your ideas. As long as

your patients " get it, " it's not as important that your colleagues

do. But ultimately, of course, it should be verifiable and

reproducible---unless you wish to keep it a secret transmission.

 

 

<<< The synthesis of biomedical thinking and Chinese medical

thinking was important to two of my early teachers, Jiang Fujiang

and Wang Jinling. Dr. Wang encouraged the selection of specific

herbs based on biomedical research then adding it to formulas that

were selected based on pattern discrimination. Dr. Jiang encouraged

the use of classical formulas of the Shang Han Za Bing Lun and Wen

Bing for modern biomedical conditions. >>>

 

 

I find your remark interesting because my own teacher, Jiang Jing,

talked more in biomedical terms rather than in those of CM.

Consequently, the way our system speaks of pulse diagnosis is in a

combination of 5-Phases and biomedical terminology (viewed from a

dynamical system perspective). When I took the NCCA exam in 1985, I

had to study " the offical " TCM.

 

 

<<< Although there is tremendous plurality throughout the literature

of Chinese medicine, there are forces attempting to standardize it.

These forces are complex, involving sociological and political

agenda as well as motives to preserve traditional practices. And -

all this in the face of a newly emerging zeitgeist that embraces

biomedical sciences as the gold standard. I believe there are other

motives for standardization related to the training of large numbers

of people. Standardization has marginalized the personal and secret

transmissions elucidated by Hsu in the Transmission of Chinese

medicine. To be fair, the nature of secret and personal transmission

is marginalizing of it's own accord. >>>

 

 

While I can agree with you that there are many motives, I can

appreciate the necessity of some standardization for basic education

and graduation requirements. But I would also agree with you that

not only has standardization marginalized secret transmissions, but

their accessibility and difficulty in being learned stops them from

gaining popularity equal to their effectiveness. Jiang Jing had

several hundred students over the years but only I and a few others

persevered and ever got anywhere with it.

 

 

<<< Study of the classics is necessary and informs modern day

practitioners of Chinese medicine who freely move in and out of

classical perspectives and strict biomedical approaches or, they use

sophisticated blends depending on the needs of the patient. For

English speaking practitioners, there are now two complete editions

of the Nei Jing, two Shang Han Lun, two Nan Jing, and two variations

on Wen Bing. These are not ideal translations, but an individual can

study and compare, extracting useful clinical strategies in the

process. As an aside, I do not think it is necessary for

practitioners to wait until they can fluently read Chinese prior to

studying these texts, on the contrary, the study should be

encouraged following the examples of Dr. Zhu in Plurality and

Synthesis. >>>

 

 

Agreed. But as important as the classics are said to be,

surprisingly little commentary is written and few practitioners

pursue reading the published literature. It would be interesting to

find out how well books and journals actually sell, to see how far

our profession has matured.

 

 

<<< . . . the conversation about the ying qi cycles (entry-exit

systems) that are a common treatment focus among European colleagues

in the schools of Van Nghi, Mann, and Worsely. >>>

 

Weren't you working on an article about this? Is it finished?

 

 

Jim Ramholz

[Guest guest]

I suppose a distinction needs to be made between my patients and my students. Students are allowed to explore my material in the way they are comfortable. They usually select me because of my interests and background. They have to determine for themselves if what I am teaching has any lasting clinical value for them. Certainly they observe the immediate clinical impact of the work. In addition to this they are required to render standard diagnosis and treatments especuially in the herbal area.

 

Will

 

 

> I don't think your vindication is necessary---as long as you can > demonstrate the clinical effectiveness of your ideas. As long as > your patients "get it," it's not as important that your colleagues > do.

But it is important that his (Will's) students get it and not just on his word alone. When one teaches in an intern clinic, it is not enough that the patients get it.

[Guest guest]

, " jramholz " <jramholz>

wrote:

 

:

>

> Where do you see research going in the next 5-10 years?

>

 

 

In my opinion, it has to go towards validation of our conceptual

framework, either by lab test correlations with patterns, interrater

reliability studies and clinical studies that use pattern

diferentiation (like the planned OCOM endometriosis study).

Within the context of so-called " normal " science (as Kuhn calls

it), the paradigm will be stretched to its limit. It is at this point

that we will begin to see research on CM expand into areas like

information science, complexity theory, etc. but these new

paradigms have not yet replaced the old paradigm precisely

because the old paradigm has not quite outlived its usefulness

yet. We must first demonstrate the limits of normal science as

applied to medicine. If we can prove certain things within the

context of normal science, as I have proposed, inevitably

consideration has to be given to those things that cannot be

proven thusly. this would be the control of our own knowledge

Ken refers to.

 

the two scenarios where we lose control of our knowledge are

 

1. all research is done western style and disease oriented and

all CM concepts are ignored. this is Sean's concern.

 

2. we stubbornly resist research using models of normal

science, claiming that no useful data about about CM can be

generated this way.

 

I think as long as significant number of the profession believe #2

is correct that #1 will actually be a likely scenario. Unless we

have dozens of studies like the OCOM one and the Benssousan

IBS study, plus others of the types I indicated, we will see Z'ev's

worst fear come true. Which is the cooptation of CM by WM. I

think proper research is one of the vital foundations for the

continued existence of CM as an independant art. And proper

research will only be done by those who are well-educated and

have access to chinese source material.

 

Most of the current CM research proposals received by NIH are

thinly veiled attempts to get funding for existing programs at

various institutions. Few either ask fundamental questions or

do well-designed clinical interventions. It is another example of

short-sighted vested interests ignorantly sabotaging the

profession.

 

[Guest guest]

, WMorris116@A... wrote:

 

I think it is also important to consider the

> shortcomings of standardization. The decisions are not always

that of

> consensus. Social, political and personal agenda of those in

power often

> drive such decisions.

 

Yes, but in the case of TCM herbal medicine, it is fairly easy to

trace the historical development of the style. There is nothing

unfamiliar in the works of zhu dan xi, for example. So TCM is

hardly pure contrivance. And standards have been in

development for a 1000 years. It seems unlikely to me that there

could have been a sound basis for promoting any other style as

the state medicine. No other style has the same degree of

historical or textual support as TCM. That does not diminish the

value of other styles, just makes them imposible to systematize,

which is vital for an education " system " . Hopefully, a properly

designed system also includes the tools for fairly evaluating

data from outside the system.

 

Now, the preminence of the TCM style may indeed be rooted in

the agenda of the powers in which it has developed. This is

always the case. But it also appears to have a life of its own.

Conspiracy requires a level of intelligence and cooperation on

such a grand scale that I do not think it exists. Personally, I

believe knowledge and culture are subject to the same laws of

evolution that rule the physical world. The mode of thinking that

is most adaptive for a particular era and culture prevails and

ultimately no amount of logic or force can change this.

 

[Guest guest]

, " jramholz " <jramholz>

wrote:

 

> I don't think your vindication is necessary---as long as you can

> demonstrate the clinical effectiveness of your ideas. As long

as

> your patients " get it, " it's not as important that your colleagues

> do.

 

But it is important that his (Will's) students get it and not just on

his word alone. When one teaches in an intern clinic, it is not

enough that the patients get it.

 

[Guest guest]

Z'ev -

 

Go to http://www.tcmcollege.com/yellowem/yellowemp.htm

 

Will

 

 

How can I get a copy of Henry Lu's new Nei Jing? I have had the old one for over 20 years.

[Guest guest]

Jim -

 

But ultimately, of course, it should be verifiable and reproducible---unless you wish to keep it a secret transmission.

 

 

I had a teacher who defined two types of secret transmission. One is 'clandestine' and is merely the act of witholding information for economic, personal or social reasons. The other is 'occult' or that which is hidden or not apparent. The latter requires certain cultivation and development on the part of the recipient. I personally abhor the former having been subjected to it throughout much of my professional life.

 

 

But I would also agree with you that not only has standardization marginalized secret transmissions, but their accessibility and difficulty in being learned stops them from gaining popularity equal to their effectiveness. Jiang Jing had several hundred students over the years but only I and a few others persevered and ever got anywhere with it.

 

 

I think idiosyncrasies of various lineages also interfere with the potential for mainstream expression. Part of the process of standarization mandates a common demoninator and this is clearly not the peak of the expression. Standardization requires those who make the decsions to determine what components can be grapsed by large groups of people.

 

 

 

<<< . . . the conversation about the ying qi cycles (entry-exit systems) that are a common treatment focus among European colleagues in the schools of Van Nghi, Mann, and Worsely. >>>

 

Weren't you working on an article about this? Is it finished?

 

 

I am still working on it for about six months from now. The next issue of Acupuncture Today has an interpretation of the use of chapter four of the Su Wen regarding pulse diagnosis.

 

Will

[Guest guest]

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

But it is important that his (Will's) students get it and not just

on his word alone. When one teaches in an intern clinic, it is not

enough that the patients get it.

 

:

 

I was thinking first of being in a private practice. It's important

that his students get it only because he teaches in a clinic and

because he chooses not to keep it a secret transmission. That's why

I added that it should be " verifiable and reproducible. "

 

I've chosen to do the same thing and have wrestled with how to

create that bridge between my system and practitioners who do TCM.

But vindication is a personal emotional response, not an

intellectual one.

 

A system's effectiveness is its own vindcation. Many new ways of

working that were ridiculed by the mainstream later proved to be

important---in Western medicine, for example, the doctor simply

washing his hands (now I hear many of them do it).

 

Jim Ramholz

[Guest guest]

, WMorris116@A... wrote:

They have to determine for themselves if what I am teaching has any

lasting clinical value for them. Certainly they observe the

immediate clinical impact of the work.

 

 

Will:

 

I understand your point, but would say it differently. Students have

to find out whether they are capable of learning your system (not

all will be) and, therefore, able to reproduce the results of your

system. Especially because many of the skills involved are like

those of learning a musical instrument, not simply an intellectual

or academic exercise of opinion.

 

It is this variety of abilities of its practitioners that makes CM

(like most other things) a plurality; requiring, in turn, a process

of synthesis.

 

Jim Ramholz

[Guest guest]

We need to carefully evaluate all such transmissions, as I know Will does. The value of standardization is mainly in that it provides a consensus of agreement, laying the foundations of both practice and research. It is the beginning, not the end.>>>And that is the bottom line

Alon

[Guest guest]

The Nei Jing project involves several volumes, including several

commentaries, a survey of over a thousand journal articles, a glossary,

concordance, and direct translation. In other words, a thorough

discourse in English on the seminal classic of our profession, with

direct access to Chinese source material and explanation of terminology

as understood in different eras, such as the Ming dynasty.

 

The first volume will be released in spring 2003, and a web site devoted

to the project will be up in december 2002. No address as of yet.

 

 

On Saturday, July 13, 2002, at 10:22 PM, jramholz wrote:

 

> In , " " <zrosenbe@s...> wrote:

> > I would point out, however, that Paul Unschuld's upcoming Nei Jing

> > volumes will leap bounds beyond the present Nei Jing translations

> available. They will also transform the profession.

>

>

> Z'ev:

>

> Interesting. How so?

>

>

> Jim Ramholz

>

>

>

>

 

>

>

> 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]

How can I get a copy of Henry Lu's new Nei Jing? I have had the old one

for over 20 years.

 

 

On Saturday, July 13, 2002, at 10:41 PM, WMorris116 wrote:

 

> Yes - I have been waiting for them. I also anticipate it will make a

> big difference.

>

> Emperor's is very fortunate to have on faculty Jerome Jiang who has a

> Ph.D. in philosophy and Chinese medical classics. I think this will

> give him better fuel to teach with. He has been using Herny Lu's text

> which is coming out in a new addition and is available at

> prepublication discount.

>

> Will

>

> I would point out, however, that Paul Unschuld's upcoming Nei Jing

> volumes (I was privileged to have a  sneak preview from Paul last year

> with Andy Ellis and Chip Chace in attendence)  will leap bounds

> beyond the present Nei Jing translations available.  They will also

> transform the profession.

>

>

>

>

 

>

>

> 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]

Unschuld's Nei Jing project sounds very interesting. Ironically, I

had not seen any of the Dong Han ideas in print before I read some

of the commentaries and footnotes he included in the Nan Jing.

 

 

Jim Ramholz

 

 

 

 

 

In , " " <zrosenbe@s...> wrote:

> The Nei Jing project involves several volumes, including several

> commentaries, a survey of over a thousand journal articles, a

glossary, concordance, and direct translation. In other words, a

thorough discourse in English on the seminal classic of our

profession, with direct access to Chinese source material and

explanation of terminology as understood in different eras, such as

the Ming dynasty.

>

> The first volume will be released in spring 2003, and a web site

devoted to the project will be up in december 2002. No address as of

yet.

[Guest guest]

, WMorris116@A... wrote:

<<< I had a teacher who defined two types of secret transmission.

One is 'clandestine' and is merely the act of witholding information

for economic, personal, or social reasons. The other is 'occult' or

that which is hidden or not apparent. The latter requires certain

cultivation and development on the part of the recipient. I

personally abhor the former having been subjected to it throughout

much of my professional life. >>>

 

 

I can understand the necessity of the " clandestine " in some

circumstances. There is no obligation to give away years of

proprietary research and work.

 

But I can sympathesize with you, too. I hate being left out myself;

but sometimes it makes you stronger. Periodically my teacher would

mention a thing in passing without any real explanation (just like

much of the classics), and it would sometimes take me years to make

sense of it and develop it on my own. I discovered one way to

calculate earlier dates through the pulses years before he actually

showed me his way---because, as you said, it required a certain

cultivation and development on my part.

 

Jim Ramholz

[Guest guest]

Todd -

just to clarify -

 

Appropriate sequence and timing of information delivery to students is not what I refer to as secret. This secret cannot be known till the student has the capacity for realization, and it is not external agency making the decision. The Su Wen chapter four alludes to what I speak of here in the final paragraph of the China Science and Technology Press version.

I have see this often. The younger docs can be very secretive about there information. As they grow into the 'grandfather' phase of life, the information is given much more freely. Dr Shen was a good example of this. Another example is taking patents out of the bottle and repackaging, then selling at exorbitant prices. Both are based on survival.

the ethics you raise becomes the real question. I wish Unschuld would republish Medical Ethics in Imperial China, it would be great for more students to have access. We have professional codes of ethics and the Alliance and AAOM are working together on one for practitioners. Maybe we need one for teachers.

 

Will

 

To keep something clandestine for reasons merely of power for centuries would be considered wrong by modern medical ethics. this is quite different than not sharing knowledge because the student is not qualified, what Will calls secret.

[Guest guest]

, " jramholz " <jramholz>

wrote:

 

>

> I can understand the necessity of the " clandestine " in some

> circumstances. There is no obligation to give away years of

> proprietary research and work.

 

My gut goes with Will on this issue, but you make an interesting

point. None of us are teaching for free. Even if we write with litle

compensation, the return comes on the lecture circuit. Because

we freely share our ideas does not mean our motivations are

any more pure, perhaps. Good info has always been bought

and sold. thinks those drug companies or NIH researchers do

this out of the goodness of their hearts. On the other hand, there

is limit to propriety in medicine. Even drug companies lose their

patents over time. so there is also this recognition that once you

recoup a reasonable profit, the results of medical research

should be in the public domain. To keep something clandestine

for reasons merely of power for centuries would be considered

wrong by modern medical ethics. this is quite different than not

sharing knowledge because the student is not qualified, what

Will calls secret.

 

[Guest guest]

Volker Schied's new book, in Contemporary China,

deals with this issue very nicely. He shows how the development of CM

is always multifactorial and bidirectional. According to Schied, no

one entity drives the development of CM. I think his position is well

thought-out and well documented. If I were teaching a class in the

history of CM, this book would be on the required reading list.

 

Bob

 

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

> , WMorris116@A... wrote:

>

> I think it is also important to consider the

> > shortcomings of standardization. The decisions are not always

> that of

> > consensus. Social, political and personal agenda of those in

> power often

> > drive such decisions.

>

> Yes, but in the case of TCM herbal medicine, it is fairly easy to

> trace the historical development of the style. There is nothing

> unfamiliar in the works of zhu dan xi, for example. So TCM is

> hardly pure contrivance. And standards have been in

> development for a 1000 years. It seems unlikely to me that there

> could have been a sound basis for promoting any other style as

> the state medicine. No other style has the same degree of

> historical or textual support as TCM. That does not diminish the

> value of other styles, just makes them imposible to systematize,

> which is vital for an education " system " . Hopefully, a properly

> designed system also includes the tools for fairly evaluating

> data from outside the system.

>

> Now, the preminence of the TCM style may indeed be rooted in

> the agenda of the powers in which it has developed. This is

> always the case. But it also appears to have a life of its own.

> Conspiracy requires a level of intelligence and cooperation on

> such a grand scale that I do not think it exists. Personally, I

> believe knowledge and culture are subject to the same laws of

> evolution that rule the physical world. The mode of thinking that

> is most adaptive for a particular era and culture prevails and

> ultimately no amount of logic or force can change this.

>