Sionneau on decoctions

[Guest guest]

Acupuncture Today, September 2002, has an interview with Philippe

Sionneau, in which he states:

 

" In order to promote the practice of Chinese medicine, it would be

much better to have a handful of well-trained, effective

practitioners than thousands of superficially-trained, mediocre ones. "

 

" All the good practitioners I've seen, without exception, prescribe

decoctions...I'm convinced there is no other option. I prescribe

customized raw herb formulas in my own practice. This is the

traditional way of practicing this art. The practitioner exerts his

skill in his modifications of the formula. Standard formula rarely,

if ever, fit the complexity of the patients we see in practice. Low

dosage pills were meant for self-medication; they don't belong in

professional practice...Being pioneers does not give us the right to

act as we please... "

 

 

Rory

--

[Guest guest]

Dear Rory,

 

Thank you. I saw that as well and was thrilled to read it. I quoted it to my

herbs students on the first night of class 2 weeks ago!

 

Julie

 

> " All the good practitioners I've seen, without exception, prescribe

> decoctions...I'm convinced there is no other option. I prescribe

> customized raw herb formulas in my own practice. This is the

> traditional way of practicing this art. The practitioner exerts his

> skill in his modifications of the formula. Standard formula rarely,

> if ever, fit the complexity of the patients we see in practice. Low

> dosage pills were meant for self-medication; they don't belong in

> professional practice...Being pioneers does not give us the right to

> act as we please... "

>

>

> Rory

[Guest guest]

, Julie Chambers <info@j...>

wrote:

I quoted it to my

> herbs students on the first night of class 2 weeks ago!

>

> Julie

 

 

me, too.

 

>

> > " All the good practitioners I've seen, without exception,

prescribe

> > decoctions.

[Guest guest]

Thank you. I saw that as well and was thrilled to read it. I quoted it to myherbs students on the first night of class 2 weeks ago!>>>Does that mean that almost all the Taiwanese herbalist are not good?

Alon

[Guest guest]

Alon,

 

If you are asking me what Philippe meant, I don't know. I guess you'd have to ask Philippe if he meant that. I quoted the part about decoctions being the way to prescribe herbs!

 

Julie

>>>Does that mean that almost all the Taiwanese herbalist are not good?

 

Alon

[Guest guest]

, " ALON MARCUS " <

alonmarcus@w...> wrote:

>

> >>>Does that mean that almost all the Taiwanese herbalist

are not good?

> Alon

 

I believe he also includes powdered extracts as a form of

decoction, if that is what you are talking about (this is based on

private communication). The main issue is adequate dosage

and individualization of formulas. Taiwanese herbalists genrally

modify their powder base formulas, but they do only prescribe

about 10 grams per day. On the other hand, it is my

understanding that these lower dose formulas work slower than

the chinese formulas. while they are much, much stronger than

patents, they do not equal the decoctions prescribed in chinese

studies. I find americans need a very strong short term effect to

get them to take the powders or decotions long term. While the

moderate doses work over time, I get poor compliance unless

symptoms change in the first week.

 

[Guest guest]

"In order to promote the practice of Chinese medicine, it would be much better to have a handful of well-trained, effective practitioners than thousands of superficially-trained, mediocre ones."Does no one else find this a bit offensive? Quite an elitist view, and disappointing to see it published in a professional paper. Maybe he should consider writing for Quackbusters.

 

Sean Doherty

[Guest guest]

If you are asking me what Philippe meant, I don't know. I guess you'd have to ask Philippe if he meant that. I quoted the part about decoctions being the way to prescribe herbs!

>>>I know, I am just reacting the "only way"statement. This attitude just reminds me of the many "old masters"in china I followed each of which was saying the opposite than the other

Alon

[Guest guest]

I believe he also includes powdered extracts as a form of decoction, if that is what you are talking about (this is based on private communication).

\>>>Then I agree. But, to say pills do not belong in a professional shelf is ludicrous. Why then the hospital I worked at had its own manufacturing facilities and many Dr did prescribe pills. Some time only pills some time with an herbal tea.

Alon

[Guest guest]

Does no one else find this a bit offensive? Quite an elitist view, and disappointing to see it published in a professional paper. Maybe he should consider writing for Quackbusters.

 

>>>>And i would mind seeing his practice audited

Alon

[Guest guest]

Or the Japanese? (By the way, I 'believe' in decoctions, but I don't

think it is the only way to get herbs to patients effectively).

 

 

 

On Monday, September 16, 2002, at 05:21 PM, ALON MARCUS wrote:

 

> Thank you. I saw that as well and was thrilled to read it. I quoted it

> to my

> herbs students on the first night of class 2 weeks ago!

>

> >>>Does that mean that almost all the Taiwanese herbalist are not good?

> 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.

>

>

>

>

[Guest guest]

Calm down, everyone! He was just expressing his OPINION, and he has a right to his OPINION.

I'll bet if any of us were interviewed about our views, we would say some very opinionated things about our practices, that might cause peoples' hair to bristle!

 

Julie

 

Does no one else find this a bit offensive? Quite an elitist view, and disappointing to see it published in a professional paper. Maybe he should consider writing for Quackbusters.

 

>>>>And i would mind seeing his practice audited

Alon

[Guest guest]

He includes not only Taiwan but China in his declaration, doesn't

he? Although I haven't used decoctions since the 80s, I do love

sweeping generalizations.

 

Sionneau would then be the one to ask about whether he creates

herbal formulas using classical ideas about taste, meridian

induction, or 5-Phases info. Can he respond or does anyone know?

 

 

Jim Ramholz

[Guest guest]

It would seem to me that, in the compromise that is medicine, there

are patients who will only ever take patents as well as others,

particularly those needing long term management, for whom patents are

entirely appropriate. So, for those of us who think that we need to

work toward a broader (more realistically confident?) view of Chinese

medicine, such opinions (what else could they be?)do need to be

challenged.

 

Simon K

 

, Julie Chambers <info@j...> wrote:

> Calm down, everyone! He was just expressing his OPINION, and he has

a right to his OPINION.

> I'll bet if any of us were interviewed about our views, we would

say some very opinionated things about our practices, that might

cause peoples' hair to bristle!

>

> Julie

>

> Does no one else find this a bit offensive? Quite an elitist

view, and disappointing to see it published in a professional paper.

Maybe he should consider writing for Quackbusters.

>

> >>>>And i would mind seeing his practice audited

> Alon

[Guest guest]

At 9:39 PM -0400 9/16/02, Nashua Natural Medicine

wrote:

" In order to promote the

practice of Chinese medicine, it would be

much better to have a handful of well-trained, effective

practitioners than thousands of superficially-trained, mediocre

ones. "

 

Does no one else find this a bit offensive?

Quite an elitist view, and disappointing to see it published in a

professional paper. Maybe he should consider writing for

Quackbusters.

 

Sean Doherty

--

 

Surely the objection you should raise to his comment is not

whether he is an elitist (which is ad hominem and beside the point),

but whether it is fair to say that we are turning out thousands of

mediocre practitioners; and whether it would be preferable to have

fewer but better-trained practitioners who got better results.

 

Rory

--

[Guest guest]

At 5:45 AM +0000 9/17/02, James Ramholz wrote:

>He includes not only Taiwan but China in his declaration, doesn't

>he? Although I haven't used decoctions since the 80s, I do love

>sweeping generalizations.

--

I believe he was speaking to an American audience, since the

interviewer was representing an American publication that is unlikely

to be read in the PRC and Taiwan.

 

>

>Sionneau would then be the one to ask about whether he creates

>herbal formulas using classical ideas about taste, meridian

>induction, or 5-Phases info. Can he respond or does anyone know?

--

He seems to be a serious student of the classics (I attended a

weekend seminar on acupuncture with him a while back which was

entirely sourced in the Han and pre-Han literature). He was trained

in China.

 

Rory

 

 

--

[Guest guest]

My name is Ta-Ya Lee. I was born and raised in Taiwan. Now I practice

western medicine as an adult nurse practitioner and acupuncture in Johns

Hopkins Community Physician group.

I have been observing all the discussion for past couple weeks.

I am a native speaker of Chinese and Taiwanese.

English is my second language. I received acupuncture training from

TAI in Columbia MD and had masters degree in nursing from Johns

Hopkins.

[Guest guest]

At 5:53 AM +0000 9/17/02, dallaskinguk wrote:

>It would seem to me that, in the compromise that is medicine, there

>are patients who will only ever take patents as well as others,

>particularly those needing long term management, for whom patents are

>entirely appropriate. So, for those of us who think that we need to

>work toward a broader (more realistically confident?) view of Chinese

>medicine, such opinions (what else could they be?)do need to be

>challenged

--

Yes, and that's why I posted his comments here. PS teaches quite a

bit in the USA, so his opinions are informed by that; and by his

knowledge of standards in China, where he was trained.

 

Regarding the use of patents, I think he is saying that he won't give

patents to patients if he thinks that he will get better results with

a decoction -- he refuses. I think he's referring to initial and

medium term treatment, not to long term care after the condition is

completely stabilized, but the interview did not get to that level of

detail.

 

He doesn't comment at all on the use of powders in the interview, but

I'm pretty sure he includes powders under the heading " decoctions " ,

since many formulae that are now given as a decoction were originally

written as powders. He says " all the good practitioners I've seen,

without exception, prescribe decoctions... " . He does not say what

else they do, or don't do.

 

Rory

--

[Guest guest]

Sean,

 

As Philippe's Blue Poppy editor, I have constantly had to tone down

his hortatory rhetoric. (AIN'T THAT IRONIC!) He's a very young man,

not to mention French. I agree, his phrasing was, at the very least,

impolitic. Give him time. IMO, his wine is not yet mature. Also,

please remember, he's writing in a foreign tongue. I doubt if he has

any idea how he actually sounds to Americans.

 

Bob

 

>

> Does no one else find this a bit offensive? Quite an elitist view,

and

> disappointing to see it published in a professional paper. Maybe he

should

> consider writing for Quackbusters.

>

> Sean Doherty

[Guest guest]

, Rory Kerr <rorykerr@w...> wrote:

> He seems to be a serious student of the classics (I attended a

> weekend seminar on acupuncture with him a while back which was

> entirely sourced in the Han and pre-Han literature). He was

trained in China.

 

 

Rory:

 

Judging from the few books of his I own, you have a more extensive

understanding of pulses. Did attending his seminar change the way

you work, or change your perspective on disorders and their

pathomechanisms?

 

 

Jim Ramholz

[Guest guest]

, " Bob Flaws " <pemachophel2001>

> As Philippe's Blue Poppy editor, I have constantly had to tone

down his hortatory rhetoric. (AIN'T THAT IRONIC!) He's a very young

man, not to mention French. I agree, his phrasing was, at the very

least, impolitic. Give him time. IMO, his wine is not yet mature.

Also, please remember, he's writing in a foreign tongue. I doubt if

he has any idea how he actually sounds to Americans.

 

 

Bob:

 

Perhaps you shouldn't tone him down. His books are excellent for TCM.

 

 

Jim Ramholz

[Guest guest]

wrote:

 

> I find americans need a very strong short term effect to

> get them to take the powders or decotions long term. While the

> moderate doses work over time, I get poor compliance unless

> symptoms change in the first week.

 

Definately.

 

Two points here:

 

1) Just as mater of patient management, I'll address some really

treatable complaint with herbs early on, even though its only a symptom.

That'll get the patient on-board for the longer term therapies. Just

have to knock out a symptom or two, and you'll have them as a patient

for much longer.

 

2) I've found in the past few months that people are becoming educated

somehow as to the slow, but more lasting benefits of herbs. I had a

lady report to me recently that she wants something that works slowly

because it was her experience that things that work quickly don't last.

 

She's not the only one, either, though I liked how she expressed it. I

still have my share of those seeking out miracle cures, but overall I've

seen a refreshing increase in patient patients lately.

 

Nice!

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

[Guest guest]

fewer but better-trained practitioners who got better results.

>>>That should be demonstrated

alon

[Guest guest]

At 5:27 PM +0000 9/17/02, James Ramholz wrote:

>Did attending his seminar change the way

>you work, or change your perspective on disorders and their

>pathomechanisms?

--

 

The seminar was on the mental-emotional indications of acupuncture

points in the classic literature. There was certainly useful

information presented, but no discussion of pathomechanisms that I

remember. I enjoyed it.

 

Rory

--

[Guest guest]

, " Nashua Natural Medicine " <

sean@n...> wrote:

 

>

> Does no one else find this a bit offensive? Quite an elitist

view,

 

what is elitist about it. perhaps you mean arrogant. SionneAu

reflects the dominant practice of TCM worldwide, which is the

use of decoctions or their equivalents (such as powders and

high potency extracts). He is dismissing the use of patent

medicines made from ground raw herbs and simple tinctures.

As long as one candeliver an effective dose, Mr. Sionneau would

be satisfied. the products I mentioned do not deliver a

pharmacologically active dose. perhaps they work on some

level other than pharmacology, but I will not personally address

that topic. Elite would refer what the few and privileged do.

Since worldwide in TCM, we are the few and privileged, I think

we can hardly call 300,000 TCM docs in china elitists

 

 

and

> disappointing to see it published in a professional paper.

 

 

Acupuncture today is a newspaper and his comments were

completely appropriate. He did not claim he has studeis to back

his point up. It is opinion and I must say, I mostly agree, though

it could have been delivered more diplomatically. If one reads

the intro to recent blue poppy books, you will see the same

position stated in the introductions regarding dosage and

decoctions.

 

Maybe he should

> consider writing for Quackbusters.

 

I am disappointed you feel that way. You seem to think Philippe

has exposed our profession as quacks while I think he has

sounded a much needed alarm. We will be quacks if we ignore

the evidence for too much longer, but right now I plead ignorance

and lack of source material and proper education. Finally, all my

chinese collaegues without exception feel the same way

Sionneau does about decoctions. they may have modified their

practices to accommodate america, but they haven't changed

their minds.