physiology

[Guest guest]

My main interest is to understand how the body maintains health and

develops illness from a western physiological model. Corollary to that, I

wish to understand what natural substances I can use to manioulate body

chemistry to promote health and healing. My interest in chinese medicine

stems from the fact that it is the most developed of the ancient herbal

traditions in that it is literate and quite old. However I have no less

interest in the medicines of ayurveda, unani, greek/arabic, native

american, mayan, tibetan, european, eclectic, homeopathy, physiomedicalist,

etc. But none of them offered the type of formal study that interested

me. So I chose TCM, but mostly because its system of differential

diagnosis was clearly the most well developed.

 

But for me it has never been as much about chinese medicine as it has been

about understanding physiology better and gaining tools to manipulate it

safely and effectively. I appreciate chinese medicine for the insight it

has given me into both these things. So I suppose you could say that I

don't actually practice TCM. I practice natural medicine influenced

strongly by my training in TCM. I think our Acupuncture scope of practice

in california actually sanctions this style of practice (since we are

allowed to order lab tests, prescribe a full range of supplements, not

just chinese herbs, to restore health, and arguably, make western

diagnosis - which I don't currently do; all of which raises the point

about in which areas we really need more education for this evolving

profession, but I digress).

 

In this process of understanding physiology better, it is vital that I

have access to the most accurate translations. Otherwise my insights will

be based upon erroneous data. Kind of makes me like wang qing ren, the

blood stasis guy who did the lousy dissections. Oh yeah, he wrote some of

the most important formulas in modern TCM history (like xue fu zhu yu tang)

.. but I digress. ;-) Now the question arises as to whether this is " OK "

or not? As I said, it is in my scope of practice and supported by my

formal education and post graduate training. so it is OK on that account

in CA (but, beware, not everywhere). But is it OK that my main interest

is in deepening my knowledge of human physiology, not chinese medicine,

per se. I have been wrestling with this idea for some time now and have

just become able to articulate it. I have wondered why I cannot settle

down and learn chinese. I am not intellectually lazy, despite what some

might think. But investing my time in that does not interest me and I see

no return on my investment in terms of clinical efficacy now or anytime

soon. That is not to say that many people would not find this the best

path to enhanced knowledge and clinical efficacy. But my time is better

spent with my actual interests.

 

We have heard many times that TCM never establishes roots in a society

until its practitioners learn to read the mother tongue. However, TCM

never had to contend with an equally powerful indigenous medicine before,

so perhaps the old model does not completely apply. I believe scientific

medicine will prevail (as soon as it actually gets scientific) and that

insights will be drawn from TCM and many other ancient forms of healing in

creating a new science (of complexity, if you will). But the language of

the ancient han people is not going to suddenly replace scientific

parlance when it comes to medicine, ever. So it may be that the New

Medicine that includes the american practice of acupuncture will differ

from the historical trend. rather than essentially replacing the

indigenous medicine of the culture, as it always has in the past (korea,

japan, vietnam), TCM may rather be absorbed into an expanded scientific

framework (that embraces holism, systems, chaos, etc.). I really see that

as the most likely possibility (though perhaps 100 years away).

 

Why do I bother to ramble on about this. Because it hits right at the

heart of this debate about what we need to study in order to be effective

practitioners within the american acupuncture profession. We need to

recognize the essential value of preserving our roots and integrating them

into whatever comes next. But we also must cultivate whatever comes next.

I think that what comes next involves science as much as classics. I

know some of you find this idea abhorrent. But it is clear we do not need

to read chinese to be effective healthcare providers. And we may be

equally effective practicing a different way than pure TCM, such as mixing

western herbs, vitamins (in which I think one should be formally trained

to practice, BTW). We may need to learn to read chinese to understand

chinese as the chinese understood it. that may be nice, but is it

pragmatic for everyone? And is it what is really the best use of limited

resources in the profession? I know it will be argued that until we have

adequate translation or access to chinese sources, we will not be able to

articulate this into a new paradigm anyway. I agree, but not everyone

practicing in the new paradigm needs to know the language programmers use

to create the software. I can already read in the Practical Dictionary

comprehensive definitions of more terms and explanations of concepts than

some translators even think exists.

 

If chinese medicine is going to eventually replace western medicine, then

we all probably need to read chinese. But if chinese medicine's most

dramatic effect will be to influence the development of western medicine

and science, then there are a lot of roles for our profession to play,

from rigorous translation of classical and modern sources to pushing the

fringes of western science. If I can identify any weakness of the field,

it would be that we are ignoring both the past and the future. On one

hand, too many claims are made about chinese medicine that have no

foundation in textual sources. On the other hand, attempts at a

sophisticated integration with the cutting edge of western science are

completely lacking as well. Both are due to lack of education. So the

question is do we all need to read chinese to attain the goal I describe.

Or is it satisfactory for those who are focused on the creation of this

" new medicine " to be sure that they have their facts straight before they

draw conclusions about what the " TCM says about this or that " . I would

argue, as Will has, that having access to a team of scholars, translators

and native chinese clinicians serves this purpose well. Perhaps we are

fortunate that our jobs give us this luxury, but I chose to be in this

mileu for exactly this purpose. It serves me, my patient and the

profession better if I pursue my strengths and rely on others to shore up

weaknesses. As a reminder, that is the main reason I created this forum.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

have been wrestling with this idea for some time now and have just become able to articulate it. I have wondered why I cannot settle down and learn chinese. I am not intellectually lazy, despite what some might think. But investing my time in that does not interest me and I see no return on my investment in terms of clinical efficacy now or anytime soon. That is not to say that many people would not find this the best path to enhanced knowledge and clinical efficacy. But my time is better spent with my actual interests.We have heard many times that TCM never establishes roots in a society until its practitioners learn to read the mother tongue. However, TCM never had to contend with an equally powerful indigenous medicine before, so perhaps the old model does not completely apply. I believe scientific medicine will prevail (as soon as it actually gets scientific) and that insights will be drawn from TCM and many other ancient forms of healing in creating a new science (of complexity, if you will). But the language of the ancient han people is not going to suddenly replace scientific parlance when it comes to medicine, ever. So it may be that the New Medicine that includes the american practice of acupuncture will differ from the historical trend. rather than essentially replacing the indigenous medicine of the culture, as it always has in the past (korea, japan, vietnam), TCM may rather be absorbed into an expanded scientific framework (that embraces holism, systems, chaos, etc.). I really see that as the most likely possibility (though perhaps 100 years away).Why do I bother to ramble on about this. Because it hits right at the heart of this debate about what we need to study in order to be effective practitioners within the american acupuncture profession. We need to recognize the essential value of preserving our roots and integrating them into whatever comes next. But we also must cultivate whatever comes next. I think that what comes next involves science as much as classics. I know some of you find this idea abhorrent. But it is clear we do not need to read chinese to be effective healthcare providers. And we may be equally effective practicing a different way than pure TCM, such as mixing western herbs, vitamins (in which I think one should be formally trained to practice, BTW). We may need to learn to read chinese to understand chinese as the chinese understood it. that may be nice, but is it pragmatic for everyone? And is it what is really the best use of limited resources in the profession? I know it will be argued that until we have adequate translation or access to chinese sources, we will not be able to articulate this into a new paradigm anyway. I agree, but not everyone practicing in the new paradigm needs to know the language programmers use to create the software. I can already read in the Practical Dictionary comprehensive definitions of more terms and explanations of concepts than some translators even think exists.

>>>>Todd thank you for articulating all my thoughts and beliefs so clearly

Alon

[Guest guest]

At 12:53 PM -0800 12/20/02, ALON MARCUS wrote:

>But it is clear we do not need to read chinese to be effective

>healthcare providers.

--

 

If this debate is to move forward at all, we need to decide

what the question is, and argue around that issue. I see the issue as

this:

 

Should the education of TCM practitioners in college programs include

Chinese language study?

 

What the argument should NOT be about is:

 

Should practitioners already degreed and licensed be obliged to study

Chinese language?

 

Your argument, which I find persuasive and do not dispute, addresses

the second question. As a degreed and licensed practitioner, your

personal time is better spent doing whatever attracts your interest.

Neither of you properly address the first question, because you

always personalize your argument to your own situation. Your personal

preferences should not be generalized to decide what is best for the

education of new TCM practitioners.

 

Rory

 

--

[Guest guest]

Neither of you properly address the first question, because you always personalize your argument to your own situation. Your personal preferences should not be generalized to decide what is best for the education of new TCM practitioners

 

>>>>I think he is an example of a practitioner's needs. The question is what is the best course of study for students in TCM schools that are planning to work in US. Since we are talking about a medical training of about 4000 hours. And now that the accreditation commission is backing up an entry level doctorate program, what should be the additional hours consisting off? What would be needed to make an effective practitioner that can function in a western environment? What are the missing skills? Is one better off reading 30 more English books or straggling in reading one in Chinese which would probably take the same amount of time. How long does it take one to be able to read the Nan-Jing or shang han? I think its much more efficient to read michell/wiseman and Unshuld. Can TCM ideas be learn in translation or one needs to see them in character? Is one better off spending several hundred hours in clinic or studying Chinese characters? What is the likelihood of having an increasing body of good translations, including publication in English from china? How much western med is necessary to become a safe primary care provider? Can one use biomedical training to increase one's TCM skills and is biomedical training necessary to advance TCM practice? My opinions are well known. I do think students have a limited amount of time and priorities must be made. I think that Chinese study is available via major universities, which are better equipped for this study, and if one is interested that is were it should be done. Once you know basic Chinese it is easy to apply it to medical Chinese especially if you are trained in TCM. I do believe that there is a basic difference in perceived need by those who spend more time reading and writing and practitioners seeing patients. I think practical biomedical training is a must to become a safe and effective practitioner and can make one a much better TCM physician as well. This type of integration is the only chance TCM has if it is to survive in the west. This type of integration is the only way we may see TCM training integrated into hospitals so that student can see many of the diseases they only read about. Finally I think this conversation should be dominated by practitioners understanding their needs rather than educators, publishes, writers and schools of TCM with their own agendas.

Alon

[Guest guest]

I concur with Alon and add the reasoning for it. If we look at the brevity of the study of Western Medicine and the study of Latin. While Latin used to be a requirement to study Western Medicine, it no longer is, although it is vital to know the meaning of many Latin terms as Medical Doctors. Similarly with chinese, I think it is useful to know and be familiar with some characters and medical terms, however, that will not be the only differentiating factor of an excellent and thorough pratitioner..... Thank you-- Sienahome

Rory Kerr <rorykerr wrote:

At 12:53 PM -0800 12/20/02, ALON MARCUS wrote:>But it is clear we do not need to read chinese to be effective >healthcare providers.-- If this debate is to move forward at all, we need to decide what the question is, and argue around that issue. I see the issue as this:Should the education of TCM practitioners in college programs include Chinese language study?What the argument should NOT be about is:Should practitioners already degreed and licensed be obliged to study Chinese language?Your argument, which I find persuasive and do not dispute, addresses the second question. As a degreed and licensed practitioner, your personal time is better spent doing whatever attracts your interest. Neither of you properly address the first question, because you always personalize your argument to your own situation. Your personal preferences should not be generalized to decide what is best for the education of new TCM practitioners.Rory-- 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]

, I think it is useful to know and be familiar with some characters and medical

terms, however, that will not be the only differentiating factor of an excellent

and thorough pratitioner..... Thank you-- Sienahome

 

 

I think one can be a thorough integrated practitioner without Chinese language,

but to consider oneself a thorough practitioner in just Chinese medicine without

access to the language/materials, IMO is a stretch... reading Giovanni, Bensky

and a few others will not make someone a thorough practitioner although one may

get excellent results...

also, what makes it useful to be just familiar with a few Chinese characters?

 

-- Jason