Language

[Guest guest]

, Rory Kerr <rorykerr@w...>

wrote:

 

> - " only research " can prove what?

 

design a study to see if one style is more effective than another, just as Will

suggested for studying the efficacy of those who read chinese versus those

who don't. otherwise, all we have is anecdote.

 

While everyone likes to say how the commuists molded TCM to fit their

marxist dialectic, there is a good case to be made that this modern era had

the LEAST cultural constraint of any era in chinese history. In the past,

doctrine was unverifiable; at least the moderns applied science to test their

ideas. Thus, it is hardly that TCM is better than anything else; it is merely

that

it is the only style that has had any significant experimentation (except for

allopathic style use of herbs). It is the only style one can really make any

claims for at all based upon science. Meager as it may be, it is far more

significant than the study of any other style. It may be the worst of the

group,

but we can only know that by comparative research. I assumed, my mistake,

that all would understand that I was referring to research of a type not yet

done - comparative, not the existing body of research.

 

[Guest guest]

, " <

@h...> " <@h...> wrote:

 

I am currentl=

> y doing a detailed study of SHL style prescribing, and not just a classical =

> approach, but with modern case studies... One sees formulas given over

and o=

> ver that one could Never have gotten to using modern TCM style

 

you may not have gotten to the same formulas, but you may have gottenthe

same clinical resuls with a TCM method. Just because a case study written

by an SHL style practitioner claims that only by using this method could he

solve the case carries about as much weight with me as japanese style

acupuncturists who claim only their method could solve what TCM cannot.

The bias is so overwhelming as to put the entire subject in dispute. I have no

doubt this method works equally well, but to say it works better than TCM in

any given case is merely the bias of the doc who wrote the case and there is

no amount of such cases that could convince me otherwise. As I said, only

research can sort out whether one style ever or always has superiority. My

teacher and her father did NOT find the SHL to be an important source of their

clinical inspiration. Clearly others do. No one would argue that different

theories lead one down different roads, but if they all get to the same place,

it

would seem we are back at personal predilection again.

 

[Guest guest]

While everyone likes to say how the commuists molded TCM to fit their marxist dialectic, there is a good case to be made that this modern era had the LEAST cultural constraint of any era in chinese history

 

>>>>And Chinese history is full of "book burning". I totally agree with you that we are talking about biased approaches that besides lip service have not been thoroughly proven or compared to any extent.TCM is certainly the dominate style at this point and most likely to be researched.

Alon

[Guest guest]

Let us not loose the PAST by adopting a western model of throwing out what = is not prevailing/ in the present- This has been a huge stregth of CM in the= past... anyway.,..>>>Lets not romanticize as i said before there has been plenty of book burring in old China as well

Alon

[Guest guest]

>

> you may not have gotten to the same formulas, but you may have gottenthe

> same clinical resuls with a TCM method. Just because a case study written

> by an SHL style practitioner claims that only by using this method could he

> solve the case carries about as much weight with me as japanese style

> acupuncturists who claim only their method could solve what TCM cannot.

 

I do not think this is the point. a) The case studies are not making such

claims... b) Many times the case study says, this and this and this has been

tried with no luck, so we then tried this SHL approach. It isn't saying it is

the only way... it gives one another option when standard TCM doesn't work... or

even another option that suits a given case better than a standard TCM way.

 

Although some may exclusively use SHL style and get the same results as modern

TCM, I am advocating mixing the two methods, just opening up the options...

 

 

 

 

> The bias is so overwhelming as to put the entire subject in dispute. I have

no

> doubt this method works equally well, but to say it works better than TCM in

> any given case is merely the bias of the doc who wrote the case and there is

> no amount of such cases that could convince me otherwise.

 

AS for me... I do not make such claims...

 

As I said, only

> research can sort out whether one style ever or always has superiority. My

> teacher and her father did NOT find the SHL to be an important source of their

> clinical inspiration.

 

I can only imagine that one who finds no use or inspiration of something like

the SHL hasn't adequately studied it (maybe I am wrong), but one should easily,

with proper study, be able to extract different ways to view a given problem,

widening one's options. If one prefers this style or not is a personal issue.

If one only likes 1 style that is there perogative, BUt.. It is like saying that

person A has never found any use or inspiration for studying modern-western

orthopedics, preferring to use standard TCM style treatments. While person A

might not like the western-ortho stuff, it is hard to argue that if personA put

in the time to learn it that it could only ENHANCE their results and

understanding of what is going on. MAybe it would

only be used in a small % of cases that didn't respond, but it is hard to argue

that it doesn't have a potential. I think that is my point. -

Also,

As I remember, a concept taught early on in TCM school was that some patients

will need a wenbing TX, some a SHL TX, some a TCM tx or whatever. IF one

doesn't fully understand a given approach then that is one less option,

correct????

 

 

Clearly others do. No one would argue that different

> theories lead one down different roads, but if they all get to the same place,

it

> would seem we are back at personal predilection again.

 

I argue that they don't always lead down the same road. But most of the time

they may...

 

-

 

PSPSPSPS - does this silly have a spell-check???

[Guest guest]

, "

<@h...> " <@h...> wrote:

> As I remember, a concept taught early on in TCM school was that

some patients will need a wenbing TX, some a SHL TX, some a TCM tx

or whatever. If one doesn't fully understand a given approach then

that is one less option, correct????

 

 

Jason:

 

I think you are correct and hit on an essential point. The

practitioner shouldn't be the one deciding if the treatment should

be done in SHL, WB, Zang/fu, or another style---the patient should.

Let me make an analogy. There is a " controversy " in pulse diagnosis

whether the right proximal position should be considered SJ, Kidney

yang, SI, or lower abdomen.

 

The correct answer is all of the above. The correct question does

not ask which it is, it asks " when " does the right proximal indicate

any one of those in particular. All these concepts were developed

because practitioners (whose writing was later included or mentioned

in the classics) had patients who manifested all those diverse

patterns. It is the practitioner's responsibility to recognize which

pattern (sometimes several at the same time) the patient is

manifesting. If the practitioner's skill is limited to only knowing

basic Li Shi-zhen---or worse, TCM style (all wiry/all damp)---the

patient's chances for recovery are that more limited.

 

Understandably, if one isn't taught pulses in school---or SHL, or

WB, or Suwen---they have no choice but to try and force their

limited model on each patient.

 

 

Jim Ramholz

[Guest guest]

, " <

@h...> " <@h...> wrote:

 

>

> I can only imagine that one who finds no use or inspiration of something like

the SHL hasn't adequately studied it (maybe I am wrong),

 

todd: that is pretty bold statement. Li Wei memorized the SHL and JGYL

when she was ten years old and was required to continue these studies

throughout her childhood.

 

Jason: While person A might not like the western-ortho stuff, it is hard to

argue that if personA put in the time to learn it that it could only ENHANCE

their results and understanding of what is going on. MAybe it would

: be that as it may, she studied this material and found no inspiration in

it. sure it is possible if she studied more or harder or with more of an open

mind, the result would have been different (as I said, other of my teachers

felt

different and I am influenced by all of them). But in my 15 years in this

field,

she remains the most clinically efficacious herbalist I have ecer known. I am

sure everyone has someone like this and in some cases, they were pure

TCMers and others more arcane. But options do not necessarily make for

better success. If that were true, then the most diverse education would be

the best and we know it is not. To be perfectly clear, it is not the SHL had no

value to my teacher, it was that she felt the insights relevant to her practice

were incorporated in later works like zhu dan xi. She was a scientist and a

pragmatist, so like me, her incentive to learn more or utilize the classics in

day

to day practice centered on clinical utility and that alone. To say she was

uninspired by the SHL merely means she had no clinical need for this book

on a day to day basis, nothing more, nothing less. More power to all of you

who find daily inspiration in this book. It does not detract from your

experience that there are those of us who do not.

 

[Guest guest]

Thanks, Jason.

 

I've stayed out of this discussion so far, I wanted to see what others

had to say. But I agree 100% with Jason's post.

 

While I've got a long way to go (lifetimes perhaps) in grasping even

the basic classical literature, it is there where I find my inspiration

to teach, practice and daily roll up my sleeves to get to work.

Medicine for me is an art as well as a science, a philosophy as well as

a profession, and, yes, a way of thinking. I get valuable data and

insights into the clinical process from modern case studies and

literature, but a lot of it is relatively dry and uninspiring (to me).

The occasional gem of an insight from a text like Nan Jing or SHL can

keep me going for months.

 

 

On Saturday, December 7, 2002, at 06:42 AM,

< wrote:

 

> I think the point with classical studies like the SHL is =

> this: It is not about the formulas, it about a different way of

> thinking abo=

> ut the disease process

[Guest guest]

 

 

But options do not necessarily make for

> better success. If that were true, then the most diverse

education would be

> the best and we know it is not. To be perfectly clear, it is not

the SHL had no

> value to my teacher, it was that she felt the insights relevant to

her practice

> were incorporated in later works like zhu dan xi.

 

How could anyone even consider making such

a comparison unless they had studied the

book? This feeling you ascribe to her is

one that is only available to someone who

has the earlier education in place to serve

as the foil for later learning and experience.

 

If it is denied to people in their earlier

training, they either get it later or they

never do.

 

Ken

[Guest guest]

As I've said before, I don't see any reason to discount anything in

Chinese medical literature, ancient or modern or in between. We will

each resonate with different aspects of the literature. Chinese

medicine has root and branch, and together it makes the tree. Why

ignore the roots for the branch, or visa versa? It makes no sense to

me.

 

While Qin Bo-wei, one of the architects of modern TCM, had one point of

view, other physicians such as Xu Da-chun (in Forgotten Traditions of

Ancient ) stated that " students reading the Mai Jing

must consult the Nei Jing, Nan Jing, and the doctrines of Zhang

Zhong-jing (SHL, JGYL) As a result, they will acquire a firm

perspective in their bosom. " This was the classical way to study

Chinese medicine. I see no reason not to continue in this way. We may

not be 'there' yet in the West, but I see it as a worthy goal for the

future.

 

 

On Friday, December 6, 2002, at 10:56 PM,

< wrote:

 

> my own teacher who learned CM as a young girl from her father's family

> tradition did not put much stock in the study of SHL, feeling that

> insights from

> that book visa ve prescription writing had been incorporated into

> later texts

> she preferred, such as dan xi xin fa and wen bing xue. As qin bo wei

> writes,

> " dan xi established prescriptions modeled upon the prescriptions of

> zhongjing

> and used medicinals in a manner that was modeled on that of li

> [dongyuan] "

> We also know that the wen bing theorists were strongly influenced in

> their

> prescriptionology by the SHL. Arguably, these two trends had a strong

> influence on the style of practice of modern TCM. SHL forms the

> roots, but my

> teacher felt one could practice as well or better using the fruits of

> the

> development of these roots over the centuries than by accessing the

> roots

> themselves. A modernist position perhaps, but not unheard of in

> chinese

> history.

[Guest guest]

I agree. A flexible approach to clinical practice should be based on

knowing different pulse maps and methods of pattern differentiation,

not just zang-fu.

 

 

On Saturday, December 7, 2002, at 05:18 PM, James Ramholz

<jramholz wrote:

 

> Jason:

>

> I think you are correct and hit on an essential point. The

> practitioner shouldn't be the one deciding if the treatment should

> be done in SHL, WB, Zang/fu, or another style---the patient should.

> Let me make an analogy. There is a " controversy " in pulse diagnosis

> whether the right proximal position should be considered SJ, Kidney

> yang, SI, or lower abdomen.

>

> The correct answer is all of the above. The correct question does

> not ask which it is, it asks " when " does the right proximal indicate

> any one of those in particular. All these concepts were developed

> because practitioners (whose writing was later included or mentioned

> in the classics) had patients who manifested all those diverse

> patterns. It is the practitioner's responsibility to recognize which

> pattern (sometimes several at the same time) the patient is

> manifesting. If the practitioner's skill is limited to only knowing

> basic Li Shi-zhen---or worse, TCM style (all wiry/all damp)---the

> patient's chances for recovery are that more limited.

>

> Understandably, if one isn't taught pulses in school---or SHL, or

> WB, or Suwen---they have no choice but to try and force their

> limited model on each patient

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

But, similar to Felix

> Mann, I have come to the conclusion that, while acupuncture practice

> MAY be described from a Chinese medical point of view, that is not a

> sine qua non for its effectiveness.

 

I for one would ike to hear more of your thoughts on this subject. You have

made this statement or allusion several times in recent years on this forum

and elsewhere. in order to contextualize it for this forum, perhaps you could

explain why you think TCM theory is relevant to the effectiveness of

herbology, but not acupuncture. especially since TCM theory was originally

applied to acupuncture and was only applied widely to herbal practice in the

past 800 years.

 

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

 

Now, since I only use a single modality, I get very clear and

> immediate feedback about the effectiveness of my application of that

> modality. Until then, all I could really say was that the combination

> of therapies I employed seemed to get satisfactory results.

 

: sorry if I mistook this to mean what has been my experience, which is

that multiple modalities practiced competently get results similar to single

modalities practiced expertly. I, of course, cannot compare this within my own

practice, but I can assess my results in comparison to others around me who

have access to chinese literature. to be honest, I know of no one who

generates the bulk of their income from private practice who uses only one

modality, except for some herb shop chinese herbalists. But all L.Ac. I know,

even chinese, practice at least acupuncture in america. I have not observed

that knowing chinese or being chinese leads to any greater efficacy in

practice when I see other's results. And being in a school clinic, I get to

witness the progress of many patients being treated by many different

practitioners. In fact, I find that many americans practicing eclectically

often

get better results than many chinese I know who tend to practice only TCM

(herbs and acupuncture). Also, working with naturopaths for many years, I

see no greater success with TCM in general than I do with naturopathy.

 

I recently saw a massive clinical survey, the details of which I cannot reveal

at

this point. But it was a random survey of 1200 charts out of 5000. However ,

suffice it to say that 75% of patients in this practice are either

musculoskeletal

(mostly injury and OA) or psychosomatic (fatigue, depression, insomnia).

Actually, very few patients use TCM for gynecology or GI and no serious

illness made up more than .5% of cases. In fact, all serious chronic internal

illnesses together made up less than 10% of cases. Since acupuncture alone

is quite effective for pain complaints and most psychosomatic disorders are

self limited, it is unsurprising that what you say below is also true (and one

last word below):

 

This is a very complex problem because, if one does acupuncture along

> with herbal medicine, one can typically get a good effect via the

> acupuncture often in spite of misprescription of the herbs.

Therefore, what I often see is people getting mettzo-mettzo (Chinese:

> ma-ma hu-hu) or even satisfactory results with combined acupuncture

> and Chinese herbs even when the Chinese herbs appear to be wide of the

> mark.

To make this matter even more complex, typically all herbs in a

> given formula which, as a formula is incorrect, are not individually

> incorrect. Since we never know how many meds in an Rx have actually

> achieved the intended result, just getting some of the meds correct

> seems to work in a number of cases.

 

> It was only after I stopped doing routine acupuncture and also gave up

> any and all non-Chinese treatment modalities (such as orthomoleculars,

> enzymes, etc.) that my pattern discrimination and prescribing of

> Chinese medicinals really became good.

 

I am not sure how you assess that. If I was unsatisfied with my results I would

change my approach. Once upon a time you were satisfied with a similar

approach and only circumstances forced you to change your style. You may

claim you are now better or more effective, but with all due respect, you

wouldn't take someone on their word alone, would you? And if you are

indeed correct, how do you reconcile so many chinese studies that showed

high success rates despite not using any pattern discrimination at all. You

make a good case that studying chinese and focusing on a single modality

has made you (and would probably make anyone) more effective at THAT

modality. I do not believe anything you have said is convincing at all this

makes you a more effective practitioner. You dismiss the effects of eclectic

practice as placebo and bedside manner, yet why couldn't it be argued that

cultivating your bedside manner is the most important thing one can do. I

would be willing to wager that the doc with the best bedside manner gets

better results than the guy who can recite every concept with authority (p.s. I

am not that guy)

 

[Guest guest]

In fact, I find that many americans practicing eclectically often get better results than many chinese I know who tend to practice only TCM (herbs and acupuncture). Also, working with naturopaths for many years, I see no greater success with TCM in general than I do with naturopathy.>>>>>As we never done a true clinical audit all this talk is totally anecdotal. I for one think that modalities can be senegistic and lead to better results. I know for a fact that at least for orthopedic problems outcome is better. Todd I would like to see you guys out in the school take 300 charts in random, take out self limiting and totally subjective cases and do an official follow-up on the patients. Can you give this as an assignment to a student?

Alon

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

>

>

> But what is the profession other than the abstract aggregate of all us

> individuals? The people who run and teach at the schools are, for the

> most part, also practitioners. So if we all do not take responsibility

> for the art, then, in reality, no one takes responsibility.

>

> Bob

 

I just don't think everyone in the field has to contribute in the same way to

the

profession as a whole. I will quote from something you gave me at

symposium 2 years ago from zhong shan's medical teachings,

 

" to save lives should be your sole aim, idea, purpose and concern "

 

for TCM scholars, this entails rigorous translation of chinese literature

perhaps. for the practitioner, it means doing whatever does the most good

and least harm. I am a better practitioner because of your writings over the

years. I am also better due to the writings of Michael Murray, ND and subhuti

dharmananda.

 

[Guest guest]

, " ALON MARCUS " <

alonmarcus@w...> wrote:

Todd I would like to see you guys out in the school take 300 charts in

random, take out self limiting and totally subjective cases and do an official

follow-up on the patients. Can you give this as an assignment to a student?

> Alon

 

that is doable, but I have no way to assign it in any class I teach. I think we

know what we would find, though. unless patients have attended to lifestyle

changes, they usally get sick again. the exception is pain due to injury.

 

todd

[Guest guest]

 

 

I agree that not everyone necessarily has to contribute in the same

way. However, I would still say that each practitioner has a

responsibility to the future as well as a debt to the past. Some may

feel and, therefore, act on that responsibility stronger than others.

I regard " my patients " to include those I personally see in real-life

as well as the patients of anyone who has been influenced by my

writings.

 

Bob

 

, " <@i...> "

<@i...> wrote:

> , " Bob Flaws " <

> pemachophel2001> wrote:

> >

> >

> > But what is the profession other than the abstract aggregate of

all us

> > individuals? The people who run and teach at the schools are, for

the

> > most part, also practitioners. So if we all do not take

responsibility

> > for the art, then, in reality, no one takes responsibility.

> >

> > Bob

>

> I just don't think everyone in the field has to contribute in the

same way to the

> profession as a whole. I will quote from something you gave me at

> symposium 2 years ago from zhong shan's medical teachings,

>

> " to save lives should be your sole aim, idea, purpose and concern "

>

> for TCM scholars, this entails rigorous translation of chinese

literature

> perhaps. for the practitioner, it means doing whatever does the

most good

> and least harm. I am a better practitioner because of your writings

over the

> years. I am also better due to the writings of Michael Murray, ND

and subhuti

> dharmananda.

>

 

[Guest guest]

that is doable, but I have no way to assign it in any class I teach. I think we know what we would find, though. unless patients have attended to lifestyle changes, they usally get sick again. the exception is pain due to injury

>>>This is what we are talking about however. All the rest is mental masturbation. Doing it will also give clues as to language

Alon

[Guest guest]

I regard "my patients" to include those I personally see in real-life as well as the patients of anyone who has been influenced by my writings.

>>Thats good since you need a practice

alon