Chinese LANGUAGE - once again...

[Guest guest]

ALon and Others,

 

 

(further commetns on CHiense languange)...

 

 

I am a practionter... I study CHinese everyday...

 

 

 

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

wrote:

> 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]

ALon and Others,

 

(Sorry about the previous post)

 

(Further comments on Chinese language)...

 

 

I am a practitioner... I study Chinese everyday... And I think it is extrem=

ely valuable to my practice.

My current position on the study of Chinese language (for students and prac=

titioners) is as follows...

 

- What I see as a huge, underestimated resource of Chinese language, is th=

e access to different modes of thinking... English translations (modern) mos=

tly include a basic TCM (almost cookbook)thought process... And as we all kn=

ow, this method, as valuable as it is, is limited. ALon (and others) consta=

ntly notice the limitations of TCM, therefore forge new grounds to fill the =

void, therefore incorporating many western ideas. This is great and needed!=

but, there is another side that cannot be ignored, that I can truthfully sa=

y exists. It leads to a more ROUNDED Chinese medicine education that I feel=

can only be obtained (in the current time period) by reading Chinese. [The=

refore important in the educational process] It gives the practitioner optio=

ns that are not available with the standard TCM model. One day, yes, much m=

ore will be translated, but at present moment it IS NOT! Yes we have a FEW c=

lassics and other modern texts, but this is just a start. If one complains t=

hat TCM doesn't have the answer, one option is to look to the past, (as well=

the west)…

People ask, do we have enough training to fill the public's needs as a prim=

ary care physician – or `effective practitioner'. I currently believe the a=

nswer is NO! if the answer were yes, I ask then, why is Alon and others cons=

tantly mentioning the limitations of TCM and reaching towards Western medici=

ne to fulfill their patients' needs. {and granted this problem may also exi=

st in modern-China-TCM} If our TCM training was adequate then this would not=

be necessary. I believe it is not adequate, there needs to be more. Wester=

n medicine integration is part of this… but my current (Chinese) endeavors a=

re starting to uncover many different non-zang-fu modes of thinking that giv=

es many more options to modern day problems that are not mentioned in Englis=

h. I stress- it comes down to a different way of thinking that is not made =

clear (to my knowledge) in the English language. And yes, many of these are=

not tested in a modern research environment and should be, but I think we c=

an all agree that many modern TCM ideas have come about through political in=

fluences, alienating many past concepts, to theoretically create a superior =

system. But this does not always happen… This all may also be likened to Tod=

d's thoughts on `WE CAN LEARN FROM naturopathic medicine' … We can also le=

arn from `CHINESE MEDICINE'… and this take reading skills. If the knowledge=

is so readily available in the English language, than why is there such a d=

ifferent mentality and methodology between the average Chinese practitioner =

and Western practitioner?? I Believe 100% there is something more there, a=

nd I think (personally) - finally - I am starting to see the some light at t=

he end of the tunnel of my Chinese studies. One can then argue, what serves=

the modern practitioner more… and one can argue what serves the student mor=

e… but let us remember we are Chinese medicine practitioners, and I think it=

is an ignorant view to harp on the limitations of TCM without having access=

to the language – and looking only to non-Chinese solutions. Although, I a=

cknowledge, it is perfectly legitimate to embrace a complementary solution o=

f western/ alternative western medicine as a adjunct to one's seemingly (or =

real) deficiencies in one's TCM training. If the latter is true, IMO, I thin=

k one should realize this is personal decision and not the only solution.

Let us not judge TCM as what is only translated and let us not judge TCM a=

s what is currently in China. Let us search for GEMS of the past while inte=

grating modern discoveries. An integrated approach, by definition, is not g=

oing to have as good of understanding (of TCM) as a strictly TCM approach. =

This may be better or worse it is hard to say. But let us be clear.. to stu=

dents and for schools. If a school offers a CM program make it that and inc=

lude the language.. IT a school offers an integrated approach , make it so… =

and be clear… Maybe one wants to dabble a little in this (TCM) and little in=

that (western) little is that (naturopathic medicine) – and this might be =

the best… Or maybe nailing just one- CM – can cover many more bases that ev=

er imagined. I know for a fact, that what I thought was brick wall for a tho=

ught process in TCM, was only opened by an enlightened passage from the past=

.. enough babble..

 

-

 

 

, " Alon Marcus " <alonmarcus@w...> =

wrote:

> 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 w=

hat is the best course of study for students in TCM schools that are plannin=

g 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 lev=

el doctorate program, what should be the additional hours consisting off? Wh=

at 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 pr=

obably 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 mic=

hell/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 a=

n increasing body of good translations, including publication in English fro=

m china? How much western med is necessary to become a safe primary care pro=

vider? Can one use biomedical training to increase one's TCM skills and is b=

iomedical training necessary to advance TCM practice? My opinions are well k=

nown. 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, whi=

ch 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 me=

dical 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 on=

ly 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 st=

udent can see many of the diseases they only read about. Finally I think thi=

s conversation should be dominated by practitioners understanding their need=

s rather than educators, publishes, writers and schools of TCM with their ow=

n agendas.

> Alon

[Guest guest]

 

Let us not judge TCM as what is only translated and let us not judge TCM a= s what is currently in China

 

>>>This is were I have a little trouble with the entire argument. First, why is the chinese system (TCM)choose what it does? Why so many modern Chinese CM practitioners choose TCM as their main mode apparata even though they have excess to all the materials? TCM is the dominate style not only in China. And lastly lets not ignore first hand experiences in CM in china, japan, Korea etc.

 

starting to uncover many different non-zang-fu modes of thinking that giv= es many more options to modern day problems that are not mentioned in Englis= h. I stress- it comes down to a different way of thinking that is not made = clear (to my knowledge) in the English language. And yes, many of these are= not tested in a modern research environment and should be, but I think we c= an all agree that many modern TCM ideas have come about through political in= fluences, alienating many past concepts, to theoretically create a superior = system.

 

>>>This may or not be promising. Why don't you start translating this stuff? Also, are you saying that the problem is that it is not translated or that one can not understand it in translation?

Alon

[Guest guest]

Let us not judge TCM as what is only translated and let us not judge TCM a= s what is currently in China

>>>PS. Jason like i said in the past in the hospital I worked in there where a few practitioners that used other than TCM methods. One was probably the most popular in the outpatient department (seeing some 100 patient in one morning), although i do not think anybody on this list would think his approach had any finesse to it. He used HUGE formulas of 20-60 herbs each, usually 40 or so. From what we know as herb functions you could never make any sense of the formulas, they were all over the place. He would only ask 1 or 2 questions about main complaint and many times barley look at tongue or take pulse.Unfortunately I was not allowed to follow his outcomes so i have no comments. Another Dr had a much greater influence on me and he practices a family style that used mild formulations. Although I find this approach often better tolerated, and therefore better compliance, I cant say it is superior to TCM. By far the majority of practitioner used what can be characterized as TCM with their own emphasis. Some liked modern pharmacology and some used other information that came from a particular text or style. but using TCM you could still follow the rational behind treatments. So at least in the ONE hospital i have experience in (and i know that is only one in thousands) there was a varaity of approaches used. There was freedom for each practitioner to use what ever they wanted to use and still both old and new practitioners used what can be characterized as TCM.

Alon

[Guest guest]

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

 

>

> >>>This is were I have a little trouble with the entire argument. First, why

is the chinese system (TCM)choose what it does?

 

This is a complicated question, and I think much of the reasons for

systemization are very important, but much has been excluded, for better or

worse.

 

>>>Why so many modern Chinese CM practitioners choose TCM as their main mode

apparata even though they have excess to all the materials?

 

(jason) I think this is clear... This is what is taught in the schools... very

simple... but.. (see below)

 

(alon) TCM is the dominate style not only in China. And lastly lets not ignore

first hand experiences in CM in china, japan, Korea etc.

 

(jason) Again, no argument this is the prevailing paradigm... I am, though, kind

of unclear what you are getting at, But there are others paradigms (many

others)... BUT, In my experience, CHinese (educated) dr.'s (and some educated

westerners) write much more thought provoking formulas, far beyond the basic

zang-fu TCM style... where do the get the ideas? from their broad

reading/education. But I think that this is the exception not the rule. The

one's with the access use what the learn. The one's just trained in the schools

here (or there) use what they learned. Simple....

How does one claim that " TCM has let them down " and another use ONLY CM and

get incredible results- not needing naturopathic or whatever. Well, it is

probably impossible to prove, but my guess is that the more rounded and read

(especially Chinese literature) have a much better probability of ending up as

the latter. Finally I have worked with a few Chinese TCM docs, that just simply

have information (even within modern style) that is just not in English.

Again, this is not putting down people (alon or others) who incorporate other

modalities. I just think that whatever side of the fence one is on, we should

realize they both have viable solutions. I personally have not seen any hint

that CM or TCM has these massive limitations that is driving me to pursue other

modalities. I am finding answers in the Chinese literature (modern and past)...

This is just my choice. I like CM.

 

 

>

> >>>This may or not be promising. Why don't you start translating this stuff?

 

I am, I translate/ read everyday... Slowly, but I do it... And I am learning

from it, expanding my thought processes... Enabling me to see other options...

 

>>> Also, are you saying that the problem is that it is not translated or that

one can not understand it in translation?

 

I think you know my stance on this... IF one has good translations than there is

no problem... But there are too many books that haven't been touched upon. What

I will do, For example, is do a search in actual books and electronic media

(which is pretty massive in Chinese) on a topic like yin fire, and read/

translate multiple author's views on such a topic. It is very enlightening, and

pretty much none of it is in English. I do not know if I ever will publicly

release anything, but I am planning to write a few articles on such topics to

help clarify some mistakes that I feel have been made.

It is just a matter of initiative, if one is a westerner or Asian. Let us

remember, There are plenty of lazy Asian's who never read beyond the basic TCM

school material...

Finally I think TCM is for the masses, a gross over-simplification for a

great number of people. To make it appealing, it must be easy, and have

answers. But life and medicine is not cut and dry. When one dives deeper into

the void one sees contradictions and one can make a choice, write them off and

only rely on a consesus view or one can learn the flexibility of our existence

and learn how to juggle many seemily contradictory paradigms. This latter

stance is not going to be tolerated by many, therefore I think that is one

reason that TCM is the way it is. But that is yet another option.

 

-JAson

[Guest guest]

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

wrote:

 

> >>>PS. Jason like i said in the past in the hospital I worked in there where a

few practitioners that used other than TCM methods. One was probably the most

popular in the outpatient department (seeing some 100 patient in one morning),

although i do not think anybody on this list would think his approach had any

finesse to it. He used HUGE formulas of 20-60 herbs each, usually 40 or so. From

what we know as herb functions you could never make any sense of the formulas,

they were all over the place. He would only ask 1 or 2 questions about main

complaint and many times barley look at tongue or take pulse.Unfortunately I was

not allowed to follow his outcomes so i have no comments. Another Dr had a much

greater influence on me and he practices a family style that used mild

formulations. Although I find this approach often better tolerated, and

therefore better compliance, I cant say it is superior to TCM. By far the

majority of practitioner used what can be characterized as TCM with their own

emphasis. Some liked modern pharmacology and some used other information that

came from a particular text or style. but using TCM you could still follow the

rational behind treatments. So at least in the ONE hospital i have experience in

(and i know that is only one in thousands) there was a varaity of approaches

used. There was freedom for each practitioner to use what ever they wanted to

use and still both old and new practitioners used what can be characterized as

TCM.

 

[jason] I think this is excatly the point, there are many styles, even in the

hospitals. But in the west we do not have this option. Most are not educated

enough to even attempt something like a SHL approach. One may have a class in

school about the SHL, but there is no way that one could start using such an

approach without seeing it in action or reading many case studies. there is

much pharmacological uses of herbs that I know I have never seen in English that

are supposedly used in a given way in China...again it just comes down to pure

access of information...

also I do know that in many hospitals a standard TCM approach is the status

quo. but once one goes out into the streets one can find an immense amount of

diversity. I still, though, am unsure of what to do with all these supposedly

lineage styles

 

-jason

[Guest guest]

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

wrote:

> Let us not judge TCM as what is only translated and let us not judge TCM a=

> s what is currently in China

> >>>PS. Jason like i said in the past in the hospital I worked in there where a

few practitioners that used other than TCM methods. One was probably the most

popular in the outpatient department (seeing some 100 patient in one morning),

although i do not think anybody on this list would think his approach had any

finesse to it. He used HUGE formulas of 20-60 herbs each, usually 40 or so. From

what we know as herb functions you could never make any sense of the formulas,

they were all over the place. He would only ask 1 or 2 questions about main

complaint and many times barley look at tongue or take pulse.Unfortunately I was

not allowed to follow his outcomes so i have no comments. Another Dr had a much

greater influence on me and he practices a family style that used mild

formulations. Although I find this approach often better tolerated, and

therefore better compliance, I cant say it is superior to TCM.

 

I think my point is that I am not saying that TCM is worse or better than

anything else (this may be what you are also saying), it is about having

different options to a situation that may not respond to the typical Tx. Just

like Todd's example, with naturopathic medicine. Some situations will be better

handled with a SHL approach. Just like Alon likes other modern approaches, this

is an option for him... All seem valid... I currently believe that there are

many more answers untranlated in the Chinese literature... IT just seems to be

what one likes, and then one must have the wisdom to know where the limitations

lie within such a system...

 

-JAson

[Guest guest]

BUT, In my experience, CHinese (educated) dr.'s (and some educated westerners) write much more thought provoking formulas, far beyond the basic zang-fu TCM style... where do the get the ideas? from their broad reading/education. But I think that this is the exception not the rule. The one's with the access use what the learn. The one's just trained in the schools here (or there) use what they learned. Simple.... >>>Are you saying that these do not follow TCM basic principles?

Alon

[Guest guest]

How does one claim that "TCM has let them down" and another use ONLY CM and get incredible results- not needing naturopathic or whatever.

>>>This is easy to answer. I take my experience with Miriam Lee for example. When looking at results of treatments many of the other students were always impress without doing any follow-up. So that while things looked great in the short term often not on long-term follow up, which I did in privet. I think much of the statements of GREAT RESULTS are weak, made by people that still have very poor understanding of disease processes, natural course of diseases, and poor criteria of success.

Alon

[Guest guest]

Well, it is probably impossible to prove, but my guess is that the more rounded and read (especially Chinese literature) have a much better probability of ending up as the latter.

>>Again here the best example is follow-up in China

A;pn

[Guest guest]

I am, I translate/ read everyday... Slowly, but I do it... And I am learning from it, expanding my thought processes... Enabling me to see other options...>>How about publishing it or sharing on list

alon

[Guest guest]

I think this is excatly the point, there are many styles, even in the hospitals. But in the west we do not have this option.

>>I do not know how it is these days but in my day at school we did apprenticeships with many dr and thus styles.

Alon

[Guest guest]

There is a reason why such individuals as Nathan Sivin, a professor of

history of Chinese science and medicine at the University of

Pennsylvania, says that medicine is not a science. There is always the

art of medicine, and because of the complexity of human beings, results

are always going to be like a house of mirrors reflecting in different

directions.

 

To quote (from a seminar by Dr. Sivin in China):

 

" Anyone practising or studying Chinese medicine in China is used to

defending the idea that it is a science. The notion that biomedicine

itself is not a science left the participants, with the exception of a

few perennially skeptical graduate students, stymied. I argued that for

most historians and many physicians, medicine is an art of caring for

suffering people that extensively uses knowledge from biology,

chemistry, physics, etc., and that a physician who approached a patient

like a biological scientist approaching an experimental animal could

not provide good care. My point did not have much impact. Tossing away

the ideal of Science is too dangerous, even for the sake of discussion. "

 

How are we to judge if short-term or long-term results are what to be

desired? For a person with a long-term serious disease, a few days of

relief will be like heaven, even if the illness returns. Of course,

short-term relief, as Alon points out, can be illusory in the overall

scheme of things, but medicine is so vast that some practitioners and

even schools are for the short-term, others excel at the long-term.

And, I agree, a superior level of knowledge is necessary to manage

long-term cases.

 

I always emphasize the long-term, because I treat largely complex cases

of long-standing. In cases like this, one needs to learn about the

long view, and how to work with time to heal patients. For this, I

find the teachings of the Nan Jing to be superb. I always try to

remind myself that the best-kept secret Chinese medicine is its deep

understanding of time and timing.

 

 

On Sunday, December 22, 2002, at 06:55 PM, Alon Marcus wrote:

 

> How does one claim that " TCM has let them down " and another use ONLY

> CM and get incredible results- not needing naturopathic or whatever.

> >>>This is easy to answer. I take my experience with Miriam Lee for

> example. When looking at results of treatments many of the other

> students were always impress without doing any follow-up. So that

> while things looked great in the short term often not on long-term

> follow up, which I did in privet. I think much of the statements of

> GREAT RESULTS are weak, made by people that still have very poor

> understanding of disease processes, natural course of diseases, and

> poor criteria of success.

> 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]

> >>>Are you saying that these do not follow TCM basic principles?

> Alon

 

I don't really get this question...?? But the priciples are of course CM, yin

yang, hot cold etc... if these are basic priciples then of course they follow

the basic theories of CM, but we are talking about something that is beyond

'basic' priciples...

 

-JAson

[Guest guest]

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

wrote:

 

> >>>This is easy to answer. I take my experience with Miriam Lee for example.

When looking at results of treatments many of the other students were always

impress without doing any follow-up. So that while things looked great in the

short term often not on long-term follow up, which I did in privet. I think much

of the statements of GREAT RESULTS are weak, made by people that still have very

poor understanding of disease processes, natural course of diseases, and poor

criteria of success.

> Alon

 

Alon,

I don't know what to tell you... Maybe you had some bad experiences... I have

seen great results.. How do I define great results? well that is the magically

question... Quite simply it usually revolves around the patient having a certain

complaint, and most of the time has got no relief from western mainstream or

alternative medicine.. Now if a CM treatment is administered and the patient

comes back and says WOW that is the 1st time in 1 year that I have ever ______>

fill in the blank < - sometimes these results last and sometimes they don't, but

I talk to people all the time and they say stuff like " Hey nothing could help

me, and they wanted to do surgery, and CM saved me... " This is GREAT... Finally

I like to factor in such factors as state of mind of the patient... Even in a

worse case scenario and there is no hope for a cure if the patient can have a

better sense of self and feel at ease about their situation,,, THIS IS GREAT....

No medicine can CURE every disease, medicine is just about easing people's minds

than substatiating some cure on paper... But I believe that CM can do both (in

many cases)... THis is the beauty of it... And many times if one can calms

someone's spirit, the body can heal itself.. and that is also GREAT.... I think

your last statement is completely not fair. - But yes results should be

qualified more than they are, but in do time.. right now 'here in the trenches'

I see results that my CM collegues' patients get and I am am amazed with

them... Hey but mabey I just a poor criteria for success...??

 

-Jason

[Guest guest]

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

wrote:

> I think this is excatly the point, there are many styles, even in the

hospitals. But in the west we do not have this option.

> >>I do not know how it is these days but in my day at school we did

apprenticeships with many dr and thus styles.

> Alon

 

Alon,

 

This can only be taken to a certain point.. let's say you have a teacher at

your school that you want to learn something from... a) the chance of spending

any extended amount of time with that system is rare... b) Since schools are

focusing on TCM in the classes and majority of the clinic (and they should) one

would have to put aside the basic foundational approach to persue something

else. - i.e. the people who usually study japanese have a usaully sacrifice

there TCM somewhat to get the japanese stuff. c) I don't think that in the

western educational model students barely, for whatever reason, get the TCM

stuff down by the time they graduate, I think the learning curve is much slower

in the west than for a asian in china,.. once one get the basics then they can

move on... SO, the students cannot grasp additional material properly without a

solid foundation. d) MOST IMPORTATNT - IF a teacher is trying to teach you a

style and there is almost non-existant literature (no supplemetatry literature)

on the subject well that makes it even harder... again my point about reading

widely,- BECAUSE of all this the schools usually tone down all the more

ecentric styles (and they should) and focus usually on a TCM approach (this was

the way it was a PCOM). I studied with a lot of people in school (almost

everyone possible) and I did not see much variety. [ one exception was the 20-30

ingredient Rxs from prof Z, and they shut that style down, Todd is that

correct?] BUT there was a few dr.'s that were not in the clinic that I got Rx's

from and they were not basic TCM zang-fu - and many I am just starting to

understand now...

 

-JAson

[Guest guest]

, " "

<zrosenbe@s...> wrote:

In cases like this, one needs to learn about the long view, and how

to work with time to heal patients. For this, I find the teachings

of the Nan Jing to be superb. I always try to remind myself that the

best-kept secret Chinese medicine is its deep understanding of time

and timing.

 

 

Z'ev:

 

This idea seems to be omitted from general TCM. Can you expand on

this a little bit?

 

Jim

[Guest guest]

How are we to judge if short-term or long-term results are what to be desired? For a person with a long-term serious disease, a few days of relief will be like heaven, even if the illness returns. Of course, short-term relief, as Alon points out, can be illusory in the overall scheme of things, but medicine is so vast that some practitioners and even schools are for the short-term, others excel at the long-term. And, I agree, a superior level of knowledge is necessary to manage long-term cases.

 

>>>>Zev you are right and I must admit that I am strongly influenced by the ideas of mentors of mine that rejected palliative care especially in orthopedics. This is something i have internal struggles with

Alon

[Guest guest]

I don't really get this question...?? But the principles are of course CM, yin yang, hot cold etc... if these are basic principles then of course they follow the basic theories of CM, but we are talking about something that is beyond 'basic' principles...

>>>I am talking about those that are covered by most modern TCM text books. Are these totally different approaches?

Alon

[Guest guest]

I don't know what to tell you... Maybe you had some bad experiences... I have seen great results.. How do I define great results? well that is the magically question... Quite simply it usually revolves around the patient having a certain complaint, and most of the time has got no relief from western mainstream or alternative medicine.. Now if a CM treatment is administered and the patient comes back and says WOW that is the 1st time in 1 year that I have ever ______> fill in the blank < - sometimes these results last and sometimes they don't, but I talk to people all the time and they say stuff like "Hey nothing could help me, and they wanted to do surgery, and CM saved me..." This is GREAT... Finally I like to factor in such factors as state of mind of the patient...

 

>>>Jason clearly we all see these and had many such patients, otherwise we could not stay in practice. However, the question becomes of percentage and longevity of changes. Criteria of what we see? How much objective measurement is used? How often such changes are only patient reporting and how often it is a measurable objective? What diseases are we talking about? and many more such questions. The reason I like to state my experience with Miriam Lee is that she is one of the best acupuncturist (not an herbalist) I have studied with and which I spent over 2 years with and did many many folowups on her patients. That is where the big questions arose for me. On followup patients statements sounded very different than when we saw them in clinic, indluding many many many statements like nothing has never help except this. The perspective a patient gets 2 years later is often very different than during treatment. Now i am not saying every patient had disappointing results many were very satisfied and I still use treatments I have learned from Dr Lee every day. I know i sometimes sound extremely negative on CM, that is only in trying to make such points. It is a great medicine that has worked for me, for the most part, for 20 years. I would just like to get the conversation to a different level than the old almost magical thinking (feelings) about CM.

Alon

[Guest guest]

c) I don't think that in the western educational model students barely, for whatever reason, get the TCM stuff down by the time they graduate, I think the learning curve is much slower in the west than for a asian in china,.. once one get the basics then they can move on...

>>>Perhaps the conversation should include entrance requirements to school?

I guess these days students do not go outside school to get more internship experience. It was quite common in my day

Alon

[Guest guest]

Jim

>

>

> Z'ev:

>

> This idea seems to be omitted from general TCM. Can you expand on

> this a little bit?

>

>

 

I, too, am interested to get Z'ev's take on

this, but I just wanted to quickly note that

the opening chapters of the Nei Jing are

largely about time and timing, particularly

about the importance of harmonizing one's

own changes with the changes in the natural

environment. Yin1 yang2 theory develops

largely from this consideration of correct

timing.

 

Ken

[Guest guest]

An undeniable principle of classical Chinese medicine, so easy to

forget and hard to find today, is that human beings are a microcosm of

a great macrocosm. As Ken pointed out, the Nei Jing compares human

beings and their channels and viscera with stars, rivers, trees and

mountains. As it says in Ling Shu, ch. 71: " Heaven has sun and moon,

man has a pair of eyes. Heaven has wind and rain; man has joy and

anger. Heaven has the five notes; man has the five viscera (and so

on). " We can either see this as quaint superstition, or see it as a

statement of the underlying unity of human beings with creation that is

a core concept of Chinese medicine.

 

In your book, Ken, ( " A Brief History of Qi " ), you translated sections

from Guan Zi's " Si Shi/The Four Seasons " , explaining the necessity of

living harmoniously with time vis a vis seasonal changes and

transformations. And, of course, the sections in the Nei Jing on the

five movements and six qi (wu yun liu qi) in terms of calendrical

changes, and the Yi Jing's unfolding of patterns from yin and yang that

manifest over time.

 

It is good to have some familiarity with these philosophies and texts,

so that one becomes immersed in a different perception of time than the

one that dominates our culture. . .largely linear and progressive,

rather than cyclical. A good starting point is the section on five

movements and six qi in Paul Unschuld's " " , and much of

Blue Poppy's " A Study of Daoist Acupuncture and Moxabustion " .

 

Without this sense of time, it is difficult to understand how Chinese

medicine works.

 

In Western thought and medicine, time influences on life and medicine

have been documented in many texts, such as " The Body in Time " , " The

Clockwork Sparrow " , and " The Clocks that Time Us " . The science of

chronobiology has developed to understand circadian rhythms and how

they influence health, disease and medical treatment.

 

Systematic correspondence, especially as expressed in five phase

theory, compares the yin viscera to phenomena in nature, including

season, timing, behavior. Healing is largely seen as living in harmony

with time, as expressed through cosmic, seasonal, and natural rhythms.

 

I always tell PCOM students that if they want a deeper understanding of

medicine, they should go out to nature regularly and observe wave forms

in the ocean (very useful in understanding how to palpate the vessels),

observe natural rhythms of plants and animals, sunrise and sunset.

They should also bring this awareness into their clinical reality,

creating an environment where people can relax and 'tune in' to a more

natural rhythm.

 

Now, let us focus in on the practical aspects of time and medicine.

 

Every disease has an origin, a period of development, and ultimate

outcome. Without knowing this process, we are limited to 'treating

what we see'. We can expand what we see beyond just the present

moment. Each moment is a vortex between the past and future, and in

the moment, one needs to trace the origin of the disease as much as is

possible, and chart a course for the future to relieve it. For

example, today I saw a young woman in her 20's for the first time in

ten years. I felt her pulse before asking questions, and noted that

the liver pulse was full and slippery, so I asked if her menstrual

cycle was due (it was). Otherwise, the pulse was short and choppy. I

deduced blood stasis in the lower burner, preventing the normal flow of

blood and qi to the upper and lower parts of the body. The tongue was

very swollen and pale, showing spleen qi vacuity, On palpating her

abdomen, I found it ropy below the navel, especially in the vacinity of

zigongxue. I deduced that her menstrual cycle must be irregular by the

choppiness in the pulse and the abdominal tension, and she confirmed

that it had been so for the last year. Her problem had developed after

a c-section five years ago, but she had never noticed the abdominal

tension until recently, and then in the last year, her menses became

irregular.

 

So we see that a slow process of accumulation and stasis began after

the c-section, leading to the present blood stasis and spleen qi

vacuity pattern. There is also possible liver qi depression as well,

despite her youthful age.

 

In deciding on treatment, with acupuncture I worked on the chong and

ren channels, and gave a modified version of gui zhi fu ling wan for

treatment (with medicinals to supplement spleen and warm the kidneys).

 

Because the menstrual cycle is connected with lunar and seasonal

cycles, we can work in three month implementations, using herbal

medicine (possibly changing prescriptions during the cycle), and weekly

or bi-weekly acupuncture treatments. We work with time to bring the

cycle back into synchronicity, and improve the circulation of blood and

qi. Her diet was excellent, so I recommend warm castor oil compresses

on the abdomen to help soften the muscle tension and aid in restoring

the normal flow in the channels that run through the abdomen.

 

In tracking the course of an illness, we need to recognize 1) its

strength 2) duration 3) the relationship of evil qi to correct qi

(which is stronger, and by how much). We then choose therapeutic

strategies that over time will supplement correct qi or attack evil qi,

depending, again, on the strength of the disease when compared with the

strength of the body.

 

The Shang Han Lun has the thread of time running through it. It traces

the course of disease from the exterior to the interior, from yang to

yin, and at each of six channel stages, the interaction of evil and

correct qi is diagnosed and treated accordingly through the eight

methods (vomiting, sweating, precipitation, supplementing, warming,

clearing, dispersing, harmonizing). It explains the transformation of

disease states over time, and how to develop treatment strategies at

each stage, with each change of pattern.

 

I'll be glad to continue if people want to ask questions, time

permitting.

 

 

 

 

 

On Monday, December 23, 2002, at 05:46 PM, dragon90405

<yulong wrote:

 

> Jim

>>

>>

>> Z'ev:

>>

>> This idea seems to be omitted from general TCM. Can you expand on

>> this a little bit?

>>

>>

>

> I, too, am interested to get Z'ev's take on

> this, but I just wanted to quickly note that

> the opening chapters of the Nei Jing are

> largely about time and timing, particularly

> about the importance of harmonizing one's

> own changes with the changes in the natural

> environment. Yin1 yang2 theory develops

> largely from this consideration of correct

> timing.

>

> Ken

>

>

>

>

>

[Guest guest]

, " "

<zrosenbe@s...> wrote:

A good starting point is the section on five movements and six qi in

Paul Unschuld's " " , and much of Blue Poppy's " A

Study of Daoist Acupuncture and Moxabustion " .

 

 

Z'ev:

 

I found the BP Taoist Acupuncture book disappointing since it only

repeated different timing methods without any explanation of what

actually makes a point " open " and why different systems show

different open points at the same time. Like much of Chinese medical

writing, it omits a great deal of details. Perhaps it's in the

wealth of untranslated material; but maybe not---otherwise the

authors, who have access to that material, probably would have

included those explanations.

 

The question of timing and time is interesting to me because I often

look at problems on a different time scale than most TCM diagnosis

which usually looks no further than some zang/fu xu or shi. For

example, I tend to look at the development of cold and flu symptoms

more often according to the annual 5-Phase cycle in the Suwen

instead of the Shan Han Lun (unless the patient had been well

balanced and the problem is superficial and acute); or psychological

and physical patterns in the pulse that show how a patient's history

not only sets the stage for seemingly simple problems years earlier,

but is still an essential part of the problem.

 

Unfortunately, few seem to share this interest or way of working. So

rendering a " diagnosis " when I'm doing clinical supervision is often

a conflict of sensibilities.

 

 

Jim Ramholz

[Guest guest]

I hope everyone is familiar with the very useful and free online acupuncture program at

www.acutempo.com

Created by Drs. Tureanu (Romanian MDs now in Canada and authors of an interesting acupuncture in gynaecology textbook), it includes open points for the day consulted. Although not as elaborate as the open points subprogram in Acuvision (which one must pay for, but which also displays the cosmology of the patient's date of birth and of the present day), its free availability is a wonderful gift.

Merry Christmas!

Neal White.

 

-

James Ramholz <jramholz

Tuesday, December 24, 2002 1:40 AM

Re: Chinese LANGUAGE - once again...

, "" <zrosenbe@s...> wrote:A good starting point is the section on five movements and six qi in Paul Unschuld's "", and much of Blue Poppy's "A Study of Daoist Acupuncture and Moxabustion".Z'ev:I found the BP Taoist Acupuncture book disappointing since it only repeated different timing methods without any explanation of what actually makes a point "open" and why different systems show different open points at the same time. Like much of Chinese medical writing, it omits a great deal of details. Perhaps it's in the wealth of untranslated material; but maybe not---otherwise the authors, who have access to that material, probably would have included those explanations.The question of timing and time is interesting to me because I often look at problems on a different time scale than most TCM diagnosis which usually looks no further than some zang/fu xu or shi. For example, I tend to look at the development of cold and flu symptoms more often according to the annual 5-Phase cycle in the Suwen instead of the Shan Han Lun (unless the patient had been well balanced and the problem is superficial and acute); or psychological and physical patterns in the pulse that show how a patient's history not only sets the stage for seemingly simple problems years earlier, but is still an essential part of the problem. Unfortunately, few seem to share this interest or way of working. So rendering a "diagnosis" when I'm doing clinical supervision is often a conflict of sensibilities.Jim RamholzChinese 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.