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experience --for what its worth

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I treated a student for a severe dermatitis. I used a variation of xiao

feng san. 1 pack containing chan tui gave good relief. so I deleted the

chan tui and added some herbs to try and moisten the dryness and heal the

cracking (he shou wu and mai men dong). 3 packs. the condition worsened

dramatically. At the patient's request I added back the chan tui, which I

don't even like to use. 3 packs. complete relief. I am surprised that

one herb seemingly made so much difference.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

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, <@i...> wrote:

I am surprised that one herb seemingly made so much difference.>>

 

 

 

What a thing for an herbalist to say! This is an example of the

necessity of looking at an herb's actions from the taste and channel

induction too. In an earlier post, you said that you didn't think it

important and now you find a case where it is.

 

Because it is sweet and cold and courses the lung and liver

channels, Chan tui helps stop the liver from sending wind/heat

externally (a common condition for skin problems).

 

 

Jim Ramholz

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, <@i...> wrote:

> I treated a student for a severe dermatitis. I used a variation of

xiao

> feng san. 1 pack containing chan tui gave good relief. so I

deleted the

> chan tui and added some herbs to try and moisten the dryness and

heal the

> cracking (he shou wu and mai men dong). 3 packs. the condition

worsened

> dramatically. At the patient's request I added back the chan tui,

which I

> don't even like to use. 3 packs. complete relief. I am surprised

that

> one herb seemingly made so much difference.

 

 

I think that this happens a lot with skin disease, (prehaps its just

that its most obvious here). I find that which herb from a category

works best is largely an empirical matter, although of course one can

justify it afterwards! Also i find that dispelling, clearing and

draining is usually the right approach even when the skin looks like

it needs moistening and nourishing.

Simon

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, <@i...> wrote:

added some herbs to try and moisten the dryness and heal the

> cracking (he shou wu and mai men dong). 3 packs. the condition

worsened

> dramatically.

 

Hi Todd.

 

This is a quote from an article written by Mazin Al-Khafaji:

" A common and understandable mistake that is frequently made..

is the desire to use blood and yin nourishing ingredients for the dry

phase of this disease. This should be resisted... The dryness is the

product of obstruction by dampness and fire-toxin, and using tonic

medicines will compound the problem by as it were 'adding oil to the

fire'. "

 

This article is about pompholyx eczema but i think this logic can

be applied to other skin conditions where tonify blood and yin leads

to a worsening of the condtion.

 

The article can be found in this link:

http://www.jcm.co.uk/SampleArticles/pompholyx.pdf

 

Levin Dan

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, " Danny Levin " <lvds@n...> wrote:

 

>

> This is a quote from an article written by Mazin Al-Khafaji:

> " A common and understandable mistake that is frequently made..

> is the desire to use blood and yin nourishing ingredients for the dry

> phase of this disease. This should be resisted... The dryness is the

> product of obstruction by dampness and fire-toxin, and using tonic

> medicines will compound the problem by as it were 'adding oil to the

> fire'. "

 

I think this is what happened. admittedly, I treat very few skin diseases. It

was

a relatively acute dermatitis, not a chronic eczema, so I don't think Jim's

explanation about chan tui was valid in my case. In fact, because the patient

is old and has a quite peeled tongue, I mistook there to be an internal

component when in hindsight that does not appear to be the case. It was

completely exterior. In my own defense regarding channel entering as a

clinical tool, I believe I have publicly retracted my earlier comments since I

have had numerous opportunities to see the folly of my ways since that time.

In fact, temp, taste and channel now form a key part of my teaching method,

which is a deviation from my teachers.

 

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I think this is what happened. admittedly, I treat very few skin diseases.

>>>Todd I think this happens in others diseases all the time as well. The temptation to notify too early or at all is too great and done too often when not appropriate

Alon

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

> I think this is what happened. admittedly, I treat very few skin diseases.

> >>>Todd I think this happens in others diseases all the time as well. The

temptation to notify too early or at all is too great and done too often when

not

appropriate

 

 

I am usally more careful about this. the patient seemed on the mend after one

pack and he was quite yin xu. I did continue with xiao feng san, just minus the

chan tui, plus 2 moistening herbs in low dose. the formula still had a heavy

emphasis on dispelling wind, stopping itching, cooling blood. given that the

patient was yin xu, which may have predisposed him to the blood heat, it all

seemed logical. the best learning is from cases where an error is made,

corrected and then success. I wish more people on this list and in english

journals would record their errors and rectifications. this is apparently

common practice in chinese case studies, as exemplified by chip chace's

fleshing out the bones. In the USA, case presentations by senior docs tend to

be self congratulatory. Everybody is apparently successful all the time. I

don't

buy it.

 

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I did continue with xiao feng san, just minus the chan tui, plus 2 moistening herbs in low dose. the formula still had a heavy emphasis on dispelling wind, stopping itching, cooling blood.

>>>To me this question is also important in orthopedics as this to some extent is an external medicine as well. For example, what should be the balance of information used from Organ diagnosis with tongue and pulse being very central.I have found it necessary to use information obtained from the tissues that are being treated to be more important many times. Any thoughts or input.

 

Alon

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Message: 7

Thu, 28 Nov 2002 12:53:14 -0600

" Alon Marcus " <alonmarcus

Re: Re: experience --for what its worth

 

I did continue with xiao feng san, just minus the

chan tui, plus 2 moistening herbs in low dose. the formula still had a

heavy

emphasis on dispelling wind, stopping itching, cooling blood.

>>>To me this question is also important in orthopedics as this to some

extent is an external medicine as well. For example, what should be the

balance of information used from Organ diagnosis with tongue and pulse

being very central.I have found it necessary to use information obtained

 

from the tissues that are being treated to be more important many times.

 

Any thoughts or input.

 

Alon

 

Yes, I also do a lot of work in orthopedics and find that " information

from the tissues " is often the most important Dx finding directing me as

to how and what to treat.

 

Mark Fradkin

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, Mark Fradkin <mfrad@b...> wrote:

 

> Yes, I also do a lot of work in orthopedics and find that " information

> from the tissues " is often the most important Dx finding directing me as

> to how and what to treat.

>

> Mark Fradkin

 

 

:-) I don't understand your terminology. what do you mean by information

from the tissues (I do little ortho treatment myself).

 

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I don't understand your terminology. what do you mean by information from the tissues (I do little ortho treatment myself).>>>For example when treating a joint, if the end-feel at the joint is soggy, ie the joint comes to a stop and if pressure is continues it give a little means there is fluid in the joint. I find it then necessary to use this information preempting signs of pulse or tongue when writing a formula often (not always). There are many other such examples. My point was that in skin disease it is well known that one often ignores organ, tongue and pulse symptom signs and writes a formula base on the appearance of the skin.

Alon

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

> , Mark Fradkin <mfrad@b...> wrote:

>

> > Yes, I also do a lot of work in orthopedics and find that

" information

> > from the tissues " is often the most important Dx finding directing

me as

> > to how and what to treat.

> >

> > Mark Fradkin

>

>

> :-) I don't understand your terminology. what do you mean by

information

> from the tissues (I do little ortho treatment myself).

>

 

 

When I evaluate a patient who has chronic pain related to a soft

tissue

injury and/or long term biomechanical imbalances, the PE(physical

exam)

of the joints and soft tissues involved directs my immediate Tx

strategy. What I call " tissue quality " is the critical piece of

" objective " information that I use to determine if Qi stagnation or

Blood Stasis prevails in the tissues and to what degree. Many years

of

doing palpation and hands on therapy everyday has given me a developed

sense of just how healthy tissues are compared to normal. I define

normal soft tissue as healthy if it is supple. I define supple as

tissue that is strong, flexible(full ROM) and not tender upon

palpation. Unhealthy soft tissue shows a wide range of qualities such

as- hard, tight, spasm, tender, knotty, etc. all of which can be

associated with some degree of chronicity and dysfunction.

 

As Alon said earlier this is external medicine; therefore, that is how

I

 

justify using the findings from the exterior to direct my initial Tx

strategy. As a support to the orthopedic Tx I also like to use herbal

Rx to work on the systemic patterns that I find. In some cases,

though

not most, my primary " orthopedic Tx " will be a herbal Rx.

 

I hope this answers your question. Or maybe it raises many more?

 

Mark Fradkin

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, " fradkin724 " <mfrad@b...> wrote:

 

> I hope this answers your question. Or maybe it raises many more?

>

> Mark Fradkin

 

I follow you completely. Patients often ask me how I know where the " spot "

is? Same thing about experience palpating tissues. Are your palpatory

correlations rooted in any CM or japanese or other sources or personal

experience.

 

 

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Are your palpatory correlations rooted in any CM or japanese or other sources or personal experience.

>>>I integrate both OM ie Japanese and CM and Orthopaedic and osteopathic methods. They all have strengths and weaknesses. Put together I find my choices and scope of understanding increase. If I am giving herbs then I translate it to CM terms. If I palpate "channels" for example teaching from osteopathy have enhanced my ability to feel inert motions (circulation?) in channels and tissues. I am not always sure how to interpret them and still exploring.

Alon

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Dear Mark, Alon and Todd...

 

 

 

Interesting there is an article written by Dan Bensky http://www.siom.com/resources/texts/articles.html

 

 

"Listening to the Channels: Preliminary Reflections on the Adaptation of One Form of Osteopathic Palpation to Acupuncture" from North American Journal of Oriental Medicine (reprinted by permission)

 

You probably are aware of it.

However, I am wondering if any of you have written on the topic in question?

 

I am well aware that it is in the intrinsic of actual inter-connection and inter-communication between practitioner and patient, but ask since I am far from where you are...

 

Marco

 

 

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

> , " fradkin724 " <mfrad@b...> wrote:

>

> > I hope this answers your question. Or maybe it raises many

more?

> >

> > Mark Fradkin

>

> I follow you completely. Patients often ask me how I know where the

" spot "

> is? Same thing about experience palpating tissues. Are your

palpatory

> correlations rooted in any CM or japanese or other sources or

personal

> experience.

>

>

 

 

My palpatory correlations are a combination of my training in CM,

Neuromuscular Therapy, and experience.

 

Mark

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

> Are your palpatory

> correlations rooted in any CM or japanese or other sources or

personal

> experience.

>

> >>>I integrate both OM ie Japanese and CM and Orthopaedic and

osteopathic methods. They all have strengths and weaknesses. Put

together I find my choices and scope of understanding increase. If I

am giving herbs then I translate it to CM terms. If I palpate

" channels " for example teaching from osteopathy have enhanced my

ability to feel inert motions (circulation?) in channels and tissues.

I am not always sure how to interpret them and still exploring.

> Alon

 

Yes, this sounds similar to my experience and approach as well.

Although I have found the combination of CM and NMT to be very

effective most of the time some patient's " soft tissue terrain " is

difficult to interpret, as Alon has said. Much yet to explore and

develop!

 

Mark

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, " Marco " <bergh@i...> wrote:

 

> " Listening to the Channels: Preliminary Reflections on the Adaptation of

One Form of Osteopathic Palpation to Acupuncture " from North American

Journal of Oriental Medicine (reprinted by permission)

 

dan has always been big onthis stuff. eastland has published books on

visceral manipulation. he is a DO, after all. I have not read the article, but

I

like that he delineates it as an adaptation rather than pretending it is TCM.

 

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Dear

 

Thanks,

 

Do you + list recomend any book in particuliar?

 

Marco

 

 

 

 

-

 

Sunday, December 01, 2002 12:42 PM

Re: experience --for what its worth

, "Marco" <bergh@i...> wrote:> "Listening to the Channels: Preliminary Reflections on the Adaptation of One Form of Osteopathic Palpation to Acupuncture" from North American Journal of Oriental Medicine (reprinted by permission)dan has always been big onthis stuff. eastland has published books on visceral manipulation. he is a DO, after all. I have not read the article, but I like that he delineates it as an adaptation rather than pretending it is TCM.Todd

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Interesting there is an article written by Dan Bensky

>>>When palpating channels I find it necessary to actually hold two point on each channel bilaterally. Doing this I found flow (or movement I feel) to sometimes be in opposite directions in left and right channels. Some in proximal and other time distal direction

Alon

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dan has always been big onthis stuff. eastland has published books on visceral manipulation. he is a DO, after all. I have not read the article, but I like that he delineates it as an adaptation rather than pretending it is TCM.

>>It would be silly to pretend its TCM, However at the same time there are tremendous theoretical and basic principle parallels between osteopathy and OM. I heard a story that the founder of osteopathy rented his first office space from a Chinese store owner and one wanders if they did not talk to each other.

Alon

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