modalities

[Guest guest]

, Eti Domb <etidomblac>

wrote:

 

>

> The combination of chinese medicine with other modalities usually leads

to a less than thourough study and practice of both, a " generic " use of

the modality without a deep enough study of either.

 

 

the same could be said of combining the study of acupuncture with

herbology or massage with either. these have all been separate practices

in china, yet we combine them into an eclectic TCM in america. do you

practice only one of these or do you dilute your study of all? do you

only practice tui na? you can't have your cake and eat it, too. like it

or not, the modern eclectic TCM includes aspects of western medicine and

modern style use of supplements like vitamins. You can pick and choose

which eclectic modalities you believe are " acceptable " , but how do you

know you are right besides some faith that you are correct? The fact that

acupuncture and chinese herbology arose in the same culture does not alter

the fact that they are distinctly different fields of study and always

have been. there is not the slightest bit of evidence that practicing

some mythical form of pure TCM gets better results than more eclectic

styles.

 

I favor teaching narrowly because it is quite clear to me that students

need to master a core set of ideas to lay a solid foundation for however

they plan to use TCM. I do not favor practicing in any particular way as

long as you have studied what you practice. There is at least as strong a

tradition in the last 50 years of combining western medicine and herbology

as there is in combining herbs and acupuncture. Which is more

" traditional " ? Neither. The point is there is no right way to practice.

And dilution of one's studies is meaningless unless it translates to lack

of clinical efficacy. chinese physicians of antiquity were eclectic by

definition, incorporating whatever was of value into their system. the

only reason they did not have western science in ancient times as part of

TCM is because it did not exist yet.

 

I consider myself a materia medica specialist and my study of materia

medica includes the study of substances from dozens of traditions. Most

world materia medica is chosen based upon empiricial ideas, not theory of

any kind. Others like ayurveda have very similar frameworks to to TCM and

essentially overlap (see yoga of herbs for more on this) Thus, utilizing

homeopathy or eclectic herbalism is merely a matter of incorporating the

materia medica into the TCM framework. This is actually not that

difficult because the remedies are described with pulse, tongue and the

answers to the " ten questions " . Since I am professionally trained in the

practice of TCM, I rely on TCM diagnostic methods. I also am also trained

in naturopathic medicine and have worked many years side by side with

naturopaths, so I have learned how to integrate such methods in my scope

of practice to maximize my results. I have devoted my time to the study

of materia medica over the past 20 years and have devoted little or no

time to acupuncture, massage and other external modalities. Whatever you

may think, my own actual two decades of experience using herbs and other

natural substances, plus my observation of others practicing eclectic

styles of medicine completely contradicts your assertion. I would assert

that incorporating foreign remedies into TCM is less intellectually

challenging than reconciling various schools of thought within acupuncture.

 

With all due respect, I cannot let your comments go unaddressed. I wonder

upon what basis you make this claim. Perhaps you could share the clinical

experiences you have had that prove your case. I have already mentioned

my use of supplements to treat intestinal dysbiosis, which I do not think

can be effectively treated with chinese herbs alone. I explained earlier

that the american diet, even the most wholesome version, is lacking in

vital non nutritive substances like soluble fiber, mucilage, enzymes, as

well as nutrients like EFA's, vitamins and minerals. In my experience the

failure to study western med and naturopathy to shore up TCM's weaknesses

leads to poor results. I know you and Z'ev and Bob will argue that my

results with pure TCM would be better if I focused on this. But no one

with extensive clinical experience has gone as far as to say I would get

better clinical results with this pure method. In fact, Bob Flaws said

otherwise and tried to make the case that we have an obligation to the

tradition to be pure, not because it is more effective, but to preserve it.

Well if you feel this way, too, more power to ya. But be clear, this

has nothing to do with clinical efficacy and fault me if you will, but

that is ALL I care about when I practice (as I said, teaching is a

different story). Would you be willing to give up acupuncture and massage

to see if pure herbology was effective by itself? I didn't think so.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

You can pick and choose which eclectic modalities you believe are "acceptable", but how do you know you are right besides some faith that you are correct? The fact that acupuncture and chinese herbology arose in the same culture does not alter the fact that they are distinctly different fields of study and always have been. there is not the slightest bit of evidence that practicing some mythical form of pure TCM gets better results than more eclectic styles. >>>At the same time the fact of historical use, while does give us comfort, does not translate to effectiveness as history and modern practice and research often shows. I also find the study of other traditions to enhance my understanding of TCM because it puts in on the alert and prevents me from being blindly trusting. Of course the same goes of my understanding of other traditions and short comings of them

Alon

[Guest guest]

 

Since my name came up in the discussion, I guess I should respond.

 

I have no problem with using any modality to treat patients, as long as

it is well studied and thought through. My argument in the past has

been when students/practitioners who were not fully absorbing of their

Chinese medical training diverge into eclectic superficial practices

after a weekend somewhere. I think this was Eti's point as well. I

still see a lot of this, practitioners who were not adequately trained

at pulse reading and pattern diagnosis mixing it up with

multi-marketing supplement or combination homeopathic lines to

compensate for their lack of proficiency in Chinese medicine. This not

to say this is solely the fault of the practitioner, often it is the

fault of inadequate training. Many people are trying to do their best

without adequate tools. How many programs in Chinese medicine give

adequate time to pulse diagnosis at this point, for example?

 

My concern is that our field not become like much of the chiropractic

profession, which has a percentage of practitioners who rely on the

sale of supplements and auxiliary techniques learned too quickly in

short seminars. It is a far cry from a well-trained naturopath who has

a systematic cohesion to his or her use of herbs, supplements and

techniques. One approach is a watering down, the other a focusing.

 

The ideal to me is to apply Chinese medical principles to the use of

these substances (supplements, Western herbs and the like), as part of

an overall health program including diet, exercise, meditation and

emotional work. This is certainly the method that Michael Broffman

uses. Over the years he has developed application of sophisticated

Chinese medical theory to eclectic methods of treatment.

 

In summary, it is the logical method of pattern diagnosis and

application of Chinese medical theory that makes our medicine what it

is. The use of Chinese herbal medicine and acupuncture, although

separate disciplines, do share the application of Chinese medical

theory for generations. Part of our job is to apply Chinese medical

theory to the full scope of medical practices 'out there' today.

 

The use of needles and herbs by other health professionals, or

sometimes even in zhong xi yi jie he/combined Western/Chinese medicine

is often based on biomedical principles, not yin-yang theory or pattern

diagnosis. Using the technology of Chinese medicine without the

theory, it is debatable if we can still call this Chinese medicine.

Using other medical technologies via the theory of Chinese medicine, in

my mind is more Chinese medicine than the other way around. It is the

philosophy of Chinese medicine, if you will, that needs to be retained,

not the technology.

 

You mentioned homeopathic remedies being classified by Chinese

medicine. While I enthusiastically encourage the application of

Chinese medical theory to 'Western' herbs, and give PCOM students

research projects in this. With homeopathic remedies, this is more

difficult because of the preparation methods of trituration and

succussion, which change the nature of the original substance.

Homeopathic medicine, at least the classical method of single remedies,

is based on a very specific mode of diagnosis and practice that doesn't

translate as easily to Chinese criteria. I know individuals such as

Digby Berkeley in South Africa and Vega Rozenberg (no relation) in

Flagstaff have done some work in incorporating five phase theory to

homeopathy, this is in its early stages.

 

 

 

 

On Wednesday, December 25, 2002, at 09:28 AM, wrote:

 

> I know you and Z'ev and Bob will argue that my results with pure TCM

> would be better if I focused on this. But no one with extensive

> clinical experience has gone as far as to say I would get better

> clinical results with this pure method. In fact, Bob Flaws said

> otherwise and tried to make the case that we have an obligation to the

> tradition to be pure, not because it is more effective, but to

> preserve it. Well if you feel this way, too, more power to ya. But

> be clear, this has nothing to do with clinical efficacy and fault me

> if you will, but that is ALL I care about when I practice (as I said,

> teaching is a different story). Would you be willing to give up

> acupuncture and massage to see if pure herbology was effective by

> itself? I didn't think so.

[Guest guest]

The use of needles and herbs by other health professionals, or sometimes even in zhong xi yi jie he/combined Western/Chinese medicine is often based on biomedical principles, not yin-yang theory or pattern diagnosis.

>>Zev i just wander if one uses needle to balance the autonomic nervous system is that not Yin Yang?

Alon

[Guest guest]

It depends on how that is thought through. In other words, not random

needling, but setting up specific protocols with specific criteria on

how to do so. I don't know of anyone who has done that particularly,

perhaps you do?

 

 

On Wednesday, December 25, 2002, at 04:27 PM, Alon Marcus wrote:

 

> The use of needles and herbs by other health professionals, or

> sometimes even in zhong xi yi jie he/combined Western/Chinese medicine

> is often based on biomedical principles, not yin-yang theory or pattern

> diagnosis. 

> >>Zev i just wander if one uses needle to balance the autonomic

> nervous system is that not Yin Yang?

> Alon

[Guest guest]

> On Wednesday, December 25, 2002, at 04:27 PM, Alon Marcus wrote:

> > >>Zev i just wonder if one uses needle to balance the autonomic

> > nervous system is that not Yin Yang?

> > Alon

 

 

Alon:

 

In fact, this is the way we prefer to talk about the interpretion of

the pulses in our pulse system. My teacher used few of the TCM terms

and always discussed problems from a mixed CM and biomedical

approach. Pulse diagnosis and a general systems approach to

biomedicine overlap in many useful ways. It is a way of viewing

problems stereoscopically, as it were.

 

There are a variety of examples. In particular cases of increased

heartrate, we can find a wiry movement at the endocrine depth going

from the adrenals to the heart (Dong Han system), so we can actually

see the sympathetic nervous system responding in CM terms. A

wiriness at the 2nd of 5-depths (Nan Jing) in the Middle Right

position indicates that nervous tension is inhibiting digestion

(another sympathetic response). Or, a wiry movement in the lungs

during an asthma attack indicates overstimulation of the

parasympathetic response.

 

While we can reveal these symptoms in questioning a patient and

match them to a WM parameter, it is actually easier to read them in

the pulses. Often, the patient will overlook or not recall

specifics. The pulses show the condition clearly and objectively;

even when symptoms may not be overtly present.

 

In fact, restricting yourself to only one way of looking at things,

even under the flag of being a purist, is [iMO] naievte; each seems

to help fill in the incompleteness and limitations of the other. The

best example I can think of is cancer. TCM, when limited to 8-

Principles and Zang/fu criteria, has no direct sense of the

essential character of the cellular activity involved in cancer---

its abnormal growth and possible metastasis---and only looks at the

larger, overt symptoms. But when we look at cancer from the 5-Phase

pulse picture, we can often identify that abnormal growth and

metastasis. Aside from the Dong Han system, Jin Wei and the

Shen/Hammer system come closest to ientifying that cancer movement.

 

 

 

Jim Ramholz

[Guest guest]

It depends on how that is thought through. In other words, not random needling, but setting up specific protocols with specific criteria on how to do so. I don't know of anyone who has done that particularly, perhaps you do?>>>Yes with as much consistency (perhaps more) as K-7 "tonifying"ther kidneys

Alon

[Guest guest]

In fact, Bob Flaws said > otherwise and tried to make the case that we

have an obligation to the > tradition to be pure, not because it is

more effective, but to preserve it.

 

 

 

Please be careful not to conflate various of my remarks.

 

1) For the record, I believe I get MUCH better clinical results since

I've devoted myself solely to Chinese herbal medicine (which, for me,

does include Chinese dietary therapy), including better results with

intestinal dysbiosis. It is my experience that going deeply into a

single art is what leads to true mastery. I agree with you that such

specialization could and perhaps even should include specialization in

Chinese medicinals at the expense of acupuncture and/or tuina and

vice versa.

 

2) I believe that I do have an obligation to the art as well as to my

patients, although I am not sure that I necessarily feel that ALL

practitioners have such an obligation. I think that's a subject open

to debate.

 

3) I do believe that one can be a good eclectic clinician. However,

that being said, it is my experience that eclecticism more commonly

leads to superficiality than great clinical effectiveness. I have yet

to meet anyone I would call a great doctor who is an eclectic.

However, I have met a number of people I would say are great doctors

who have specialized just in Chinese herbal medicine.

 

Bob