DM

[Guest guest]

, " <@h...> "

<@h...> wrote:

Bob Flaws, obviously , in the last year or two has put out 450 pages on

this one disease. IS this information useless?

 

Hardly, but it also has not changed my approach to treating diabetes. The

basic ideas of focusing on spleen xu, dampheat and yin xu with

complications of blood stasis has always been effective for me. I noticed

long ago that the strict thirsting and wasting approach to DM was flawed

since most DM patients did not present this way at first. Bob's book is a

great text and no doubt contains different strategies than I use. the

fact that he has gathered all this together in one place with citations,

etc. is truly wonderful. I suppose I would have been better off having

access to this material in chinese from day one. It would have been

easier, perhaps.

 

I always learn new and interesting stuff when I read translated material.

I read very thought provoking translation on tong xie yao fang the other

day that gave me new insights into bai shao (channel guiding herb for the

spleen!!) and fang feng (raises yang qi and disperse liver constraint).

But while fascinating, it is not information I would ever have gone

digging for and I do not think it changes my use of tong xie yao fang. On

the other hand, I will probably try fang feng in other scenarios for liver

constraint. But mostly out of curiosity. I do not believe my past

effectiveness has been hindered by NOT using fang feng this way. I mean I

use the same ten formulas and 100 herbs over and over again.

 

I guess I feel that after so many years of either treating or supervising

dozens of cases every week that I am pretty clear about what works in the

cases I normally see. Being a pragmatist, no new information would change

the way I treat patients unless I have been unsuccessful in the past. for

example, I would entertain novel ideas about treating tinnitus, but even

those who read chinese all the time tell me they have extreme difficulty

with this condition. My point is that many experienced practitioners do

not feel any need to learn chinese NOW. Time, experience and the steady

trickle of good translations has filled that void effectively. On the

other hand, for those with minimal clinical experience, the gains of being

able to access information quickly in texts rather than over many years of

trial and error is probably immense. Of course, on the third hand, you

might be better off spending your time apprenticing with a live master

than reading some dead folks books. Whatever I have gotten from books,

which is quite a lot, is always trumped in clinic by the words of

respected teachers I can still hear whispering in my ears.

 

When I was in acupuncture school, I studied kung fu for several years. My

teacher had been training since early youth, He basically had no regular

childhood, just martial arts. He knew dozens and dozens of esoteric forms,

all of which he had mastered (mantis, monkey, dragon, tiger, snake and

many more styles). He was a formidable fighter and no untrained person

could ever stand a chance against him in a streetfight. In fact, I saw

him take out a group of 5 men twice his size while bouncing in a bar one

night. There were actually three of us who hung out together. the third

guy was a former black beret special forces in the army. He had nowhere

near the depth and nuance of training of my teacher. But his martial

techniques were so effective that he always defeated my teacher when

sparring. He knew from experience what worked and he used a few

strategies over and over again. No amount of training on the part of his

opponent could overcome this simple effectiveness. He never had the

slightest inclination to learn any of the animal forms because he had

never lost a sparring match against a traditional martial artist EVER. He

had ass kicked by marines a few times though. Has anyone ever seen that

little brazilian guy who win every one of those no holds barred world

fighting competitions. He has basically one move. The point is that

after a time, more knowledge does NOT necessarily mean more effectiveness.

It is what you do with the knowledge you have. Of course, there are

limits to this argument. If you only know one herb, you can't practice

medicine. But once upon a time, zhang zhong jing wrote the SHL based upon

his study of about ten books PLUS his experience. Would he have done a

better job if he had access to all 10,000 volumes available in 1900. Hard

to say. :-)

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

At 12:06 PM -0800 2/13/03, wrote:

> , "

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

> Bob Flaws, obviously , in the last year or two has put out 450

>pages on this one disease. IS this information useless?

>

>Hardly, but it also has not changed my approach to treating

>diabetes. The basic ideas of focusing on spleen xu, dampheat and

>yin xu with complications of blood stasis has always been effective

>for me. I noticed long ago that the strict thirsting and wasting

>approach to DM was flawed since most DM patients did not present

>this way at first. Bob's book is a great text and no doubt contains

>different strategies than I use. the fact that he has gathered all

>this together in one place with citations, etc. is truly wonderful.

>I suppose I would have been better off having access to this

>material in chinese from day one. It would have been easier,

>perhaps.

--

 

It could also be that if you were a specialist treating 40 or more

diabetics a day, at all depths of disease, in a Chinese hospital you

would need an increased therapeutic arsenal. I suspect much of the

published material comes from such a background.

 

Rory

--

[Guest guest]

, Rory Kerr <rorykerr@w...>

wrote:

 

> It could also be that if you were a specialist treating 40 or more

> diabetics a day, at all depths of disease, in a Chinese hospital you

> would need an increased therapeutic arsenal. I suspect much of the

> published material comes from such a background.

 

 

you may be right. I see about 50% musculo, 35% psychosomatic (meaning

undiagnosed complexes of physical and mental s/s; this is NOT meant

derogatorily), 5% misc and 10% chronic internal illness, with less than .5% of

any one chronic disease (such as DM). for a few years my practice was all

autoimmune and hep C, but the patient volume was pretty low and I made

money other ways. So for a general practice, which is what most of us do, I

think things are adequate. But a GP doesn't need the same advanced

knowledge as a specialist and we should all keep that in mind.

 

[Guest guest]

, Rory Kerr <rorykerr@w...>

wrote:

 

>

> It could also be that if you were a specialist treating 40 or more

> diabetics a day, at all depths of disease, in a Chinese hospital you

> would need an increased therapeutic arsenal.

 

Rory and Jason, et. al.

 

I was just thumbing through BP's DM book reading about the

pathomechanism of polyuria. On second thought, I would say that Rory is

right that if I treated all stages of diabetes in large numbers of patients and

I

was the main case manager, then I would definitely find the english language

material inadequate. So not having this book in the past would have probably

tied my hands in that scenario. Unfortunately, that is not my scenario. I

somewhat reluctantly adopted the role of general practitioner after being

unable to earn enough money trying to specialize. I now find great

satisfaction writing formulas for my mostly gyn and musculoskeletal patients.

 

I still get to treat more serious complaints like fibroids and RA under this

rubric, but things like hep C and lupus are still quite rare. So while you guys

are no doubt right with regard to the further expansion of CM into the

mainstream treatment of chronic illness, I still think we are well prepared to

be

GP's using just the current GOOD english language literature. And arguably,

with each new book from BP and paradigm, we become more capable of

treating these serious illnesses with access to only the english literature.

for

example, the issue on DM is now moot with the publication of this very

comprehnsive book (thank-you Bob!!).

 

However I need to make another observation, which is that the growth of

interest in acupuncture and the increasing patient load nationwide does NOT

reflect a change in patient demographics. Most of the growth is the areas of

musculoskeletal and psychosomatic complaints. We seem to be establishing

an important niche in this area where western med often only can offer

dangerous drugs or disfiguring surgery. But I think interest amongst patients

and medical doctors for us to treat heart disease, DM, etc. is still quite low.

As

we try and make inroads into this area, it thus becomes vital that those who

will hold our mantle be able to access chinese source material, i.e. our

DAOMs. Otherwise I fear we will make a bad showing when asked to

demonstrate our skills in this arena. I think logic suggests this is vital and

unlike our experience as GP's, I do not think we have enough collective

clinical experience to claim we can successfully treat more serious illnesses

at our current level of training. In other words, there is really no evidence

to

contradict this logical inference. So when I say a longtime practitioner can

rely on experience plus english language sources, the statement should

really be amended to say for GP and pain management. Of course, there are

many general exceptions to this rule, but most are because the practitioner

has taken on advanced studies.

 

[Guest guest]

In other words, there is really no evidence to contradict this logical inference. So when I say a longtime practitioner can rely on experience plus english language sources, the statement should really be amended to say for GP and pain management. Of course, there are many general exceptions to this rule, but most are because the practitioner has taken on advanced studies.>>>Todd many of us have been treating all the conditions you sighted for many years. As for effectiveness, possibly increased information would help. As i have said in the past, many times it is the application of the information that is more difficult. Lastly one needs to evaluate the results one sees in China treating these conditions.

Alon

[Guest guest]

 

 

I agree with you 100%... I think my initial rant was initiated becuase here in

Boulder the populus looks towards CM before western medcine in many situations

(even serious conditions).. But you are right the mainstream America is prob not

reflective in this bubble-population... Anyway...

 

-JAson

 

 

, " <@i...> "

<@i...> wrote:

> , Rory Kerr <rorykerr@w...>

> wrote:

>

> >

> > It could also be that if you were a specialist treating 40 or more

> > diabetics a day, at all depths of disease, in a Chinese hospital you

> > would need an increased therapeutic arsenal.

>

> Rory and Jason, et. al.

>

> I was just thumbing through BP's DM book reading about the

> pathomechanism of polyuria. On second thought, I would say that Rory is

> right that if I treated all stages of diabetes in large numbers of patients

and I

> was the main case manager, then I would definitely find the english language

> material inadequate. So not having this book in the past would have probably

> tied my hands in that scenario. Unfortunately, that is not my scenario. I

> somewhat reluctantly adopted the role of general practitioner after being

> unable to earn enough money trying to specialize. I now find great

> satisfaction writing formulas for my mostly gyn and musculoskeletal patients.

>

> I still get to treat more serious complaints like fibroids and RA under this

> rubric, but things like hep C and lupus are still quite rare. So while you

guys

> are no doubt right with regard to the further expansion of CM into the

> mainstream treatment of chronic illness, I still think we are well prepared to

be

> GP's using just the current GOOD english language literature. And arguably,

> with each new book from BP and paradigm, we become more capable of

> treating these serious illnesses with access to only the english literature.

for

> example, the issue on DM is now moot with the publication of this very

> comprehnsive book (thank-you Bob!!).

>

> However I need to make another observation, which is that the growth of

> interest in acupuncture and the increasing patient load nationwide does NOT

> reflect a change in patient demographics. Most of the growth is the areas of

> musculoskeletal and psychosomatic complaints. We seem to be establishing

> an important niche in this area where western med often only can offer

> dangerous drugs or disfiguring surgery. But I think interest amongst patients

> and medical doctors for us to treat heart disease, DM, etc. is still quite

low. As

> we try and make inroads into this area, it thus becomes vital that those who

> will hold our mantle be able to access chinese source material, i.e. our

> DAOMs. Otherwise I fear we will make a bad showing when asked to

> demonstrate our skills in this arena. I think logic suggests this is vital

and

> unlike our experience as GP's, I do not think we have enough collective

> clinical experience to claim we can successfully treat more serious illnesses

> at our current level of training. In other words, there is really no evidence

to

> contradict this logical inference. So when I say a longtime practitioner can

> rely on experience plus english language sources, the statement should

> really be amended to say for GP and pain management. Of course, there are

> many general exceptions to this rule, but most are because the practitioner

> has taken on advanced studies.

>

 

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

 

> >>>Todd many of us have been treating all the conditions you sighted for

many years.

 

and so have I. but you have long ago stated that most of your practice is

musculoskeletal. I have met very few folks in our field who have truly

specialized clinical knowledge outside this area. while you may have treated

these conditions, are you really able to generalize about your success from

such a small sample.

 

[Guest guest]

, " <

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

>

>

> I agree with you 100%... I think my initial rant was initiated becuase here in

Boulder the populus looks towards CM before western medcine in many

situations (even serious conditions).

 

that's pretty cool and probably pretty rare outside san fran, santa fe, taos,

santa cruz and boulder. even in portland, arguably the most liberal

progressive city in the US, there was little interest in CM in chronic illness.

practicing in places like Portland and SD used to be an endless source of

frustration to me because of this. perhaps I do not market myself well, but I

know I did better than most portlanders in attracting such patients and still

fell

short of my goals. however, the act of prescribing is equally creative and

satisfying whatever one treats. I just had to let go of my hero complex and

content myself to be a GP. that's the hand I have been dealt. :-)

 

this may an argument for a multi-tiered profession, as advocated by the

alliance and NCCAOM and CCAOM, rather than the entry level one size fits

all DAOM advocated by AAOM and now tacitly, ACAOM. Perhaps we should

start to look at masters in AOM versus Doc in AOM like GP versus specialist

instead of outdated versus modern. Recognize that a lower level of training is

needed to be a GP. This would solve a lot of the conflict that is bound to

arise

when the first class of DAOMs graduates and proclaims the rest of us

obsolete. Less education should mean lower fees and thus a good first tier

for the healthcare system. One can then see the high priced specialists as

necessary. If the DAOM's instead put themselves out there as a newer and

better GP, I expect the infighting in the field to increase to a fever pitch as

old

timers rail against the DAOM's as inexperienced academic hacks to counter

the weight of the doctor title. it would be better perhaps if we set up an

amiable multi-tiered system in advance of this scenario. There is no evidence

that we need an entry level DAOM in order to insure good GP care, so my

current feeling is that this is a mistake that would fracture an already

fragmented profession even more.

 

[Guest guest]

Alon,

 

As i have said in the past, many times it is the application of the information

that is more difficult.

 

Can you explain this? I think that the increased information has to be coupled

with increase understnading in theory. One without the other only makes for

limited applications and therefore limited results. But I would like to here

excatly what you mean by this...

 

-Jason

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

 

> >>>Todd many of us have been treating all the conditions you sighted for

many years.>

 

> > >>>Todd many of us have been treating all the conditions you sighted for

>many years.

>

>and so have I. but you have long ago stated that most of your practice is

>musculoskeletal. I have met very few folks in our field who have truly

>specialized clinical knowledge outside this area. while you may have

>treated

>these conditions, are you really able to generalize about your success from

>such a small sample.

>

>Todd

>

 

And not to mention, unless I am missing something, alon as been pretty clear

that he uses CM and gets results, but also is not happy with the

predictability and therefore has searches for new approaches to treating

these diseases on his own, based on CM principles- forging new ground. So

alon may have been treating these for years, but I assume straight CM has

not been satisfactory for him, therefore I can only assume that a book like

this could have helped Alon years ago, possibly enabling him not to have to

re-invent the wheel. I always am puzzled when people forge new ground,

claiming CM is limited, but do not have access to adequate source

material... but if one's experience let's say in china shows something than

that may or may not be valid, depending on the hospital, quality of dr.;s

etc, but I am still curious if alon will mention the diseases he feel he

cannot treat with the basic CM out there, or what diseases he saw in CHina

that were not being treated adequately... I have mentioned tinnitus, and

alon has mentioned chrohns (?) , but what else..?? I am sure alon (or

others) must have more experiences you can share...

 

 

 

-JAson

 

 

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[Guest guest]

Recognize that a lower level of training is needed to be a GP.

<<<Being a GP is not lower level as one needs a very broad view.

Alon

[Guest guest]

Can you explain this? I think that the increased information has to be coupled with increase understanding in theory. One without the other only makes for limited applications and therefore limited results. But I would like to here exactly what you mean by this

<<<Understanding the theory is only the starting point. Since TCM is based on subjective data only ( I know some would disagree)it is the organization of this data that is the art of TCM and is the most difficult aspect of TCM. The saying I heard in china all the time is TCM is easy to learn but difficult to practice and West Med is hard to learn and easy to practice. This reflects the challenge of application. TCM is best learned under apprenticeship. Theoretical learning can take you only so far

Alon

[Guest guest]

but I am still curious if alon will mention the diseases he feel he cannot treat with the basic CM out there, or what diseases he saw in CHina that were not being treated adequately... I have mentioned tinnitus, and alon has mentioned chrohns (?) , but what else..?? I am sure alon (or others) must have more experiences you can share...>>>I can give you many. For example, asthma if the patient has had a history of more than one intubations TCM is often not adequate. While many asthmatic do very well I have seen very many patients in china that could not get off steroids. So its not just the condition but also the severity. Since we have been talking about diabetes. While TCM is said to do well with potential of complications, it is not sufficient in type 1 or patients that are insulin dependent. The list can go on. When I first got to the hospital in china I asked several Dr to make a list of diseases that they think TCM, biomed, and combined methods were most effective. The list for biomed only was quite long, as was TCM alone but tended to be poorly understood, self limiting and functional disease or diseases were no alternative existed. If i can find the lists I will post them. However i think i do not have them any longer.

Alon

[Guest guest]

, " Alon Marcus "

<alonmarcus@w...> wrote:

> Recognize that a lower level of training is

> needed to be a GP.

> <<<Being a GP is not lower level as one needs a very broad view.

 

 

Agreed. Also, a GP needs to know when to refer out within our field.

The problem is finding those to refer to. There are those who

specialize but due to the infancy of our profession and lack

experience are not much more effective than a GP. Internship and

Mentors for the specialists are needed.

 

Fernando

[Guest guest]

> Alon Marcus wrote:

 

> When I first got to the hospital in china I asked several

> Dr to make a list of diseases that they think TCM, biomed, and

> combined methods were most effective. The list for biomed only was

> quite long, as was TCM alone but tended to be poorly understood, self

> limiting and functional disease or diseases where no alternative

> existed.

 

Maybe this is a function of the terms used in your research. In

otherwords, what's the best treatment for a stroke? Why, blood thinners

like heperin of course!

 

What's the best treatment for wind-phlegm? Why, wind-phelgm formulas

such as Ban Xia Bai Zhu Tian Ma Tang, of course!

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

[Guest guest]

> " Alon Marcus " <alonmarcus

 

>

>Recognize that a lower level of training is

>needed to be a GP.

><<<Being a GP is not lower level as one needs a very broad view.

>Alon

 

I would argue that broadness of one's view is more dependent on the

theoretical system (i.e. CM vs. Western) more so than if one practices GM or

specializes.. Personally if I had DM I would rather go to a CM dr. who

specialized in DM than a GP who does a little musculoskeletal, GYN, gastro

etc... I think this is an important thing to explore and also marks a big

difference between the way CM can (and will) specialize vs. western

medicine.. It comes down to the theoretical framework...

 

-JAson

 

 

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[Guest guest]

While certainly specialization will deepen and broaden one's expertise,

the profession as a whole, as Todd pointed out, is not there yet. At

this point, for me specialization is internal medicine, chronic

disorders, and spirit-essence disorders. I do little in the way of

musculoskeletal disorders, never have done much. And, yes, much of

what I do is supportive or complimentary therapy to biomedical

treatment, but I do have some powerful primary care cases.

 

 

On Saturday, February 15, 2003, at 06:53 PM, wrote:

 

> I would argue that broadness of one's view is more dependent on the

> theoretical system (i.e. CM vs. Western) more so than if one practices

> GM or

> specializes.. Personally if I had DM I would rather go to a CM dr. who

> specialized in DM than a GP who does a little musculoskeletal, GYN,

> gastro

> etc... I think this is an important thing to explore and also marks a

> big

> difference between the way CM can (and will) specialize vs. western

> medicine.. It comes down to the theoretical framework...

>

> -JAson

[Guest guest]

>

> >>>I can give you many. For example, asthma if the patient has had a

>history of more than one intubations TCM is often not adequate. While many

>asthmatic do very well I have seen very many patients in china that could

>not get off steroids. So its not just the condition but also the severity.

>Since we have been talking about diabetes. While TCM is said to do well

>with potential of complications, it is not sufficient in type 1 or patients

>that are insulin dependent. The list can go on. When I first got to the

>hospital in china I asked several Dr to make a list of diseases that they

>think TCM, biomed, and combined methods were most effective. The list for

>biomed only was quite long, as was TCM alone but tended to be poorly

>understood, self limiting and functional disease or diseases were no

>alternative existed. If i can find the lists I will post them.

 

Again I think this is a very important topic, as alon, I think, will agree,

exploring what we think (and know) are the limitations of CM... THis is not

documented (at least in the states) very much... Like I mentioned

previously, IMO, western authors make more outrageous claims than chinese

text on the supposed efficacy of treatments (esp. acup,)... so if others

have some input chime in... I also think Todd's efforts to collect case

studies that have shown tangible evidence of disease reversal is

important... I am all about showing some substantial/ tangible results in

real diseases, and at the same time admitting where we fall short...

 

-Jason

 

 

 

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[Guest guest]

> " " <zrosenbe

 

>

>While certainly specialization will deepen and broaden one's expertise,

>the profession as a whole, as Todd pointed out, is not there yet.

 

Very much agreed...

 

At

>this point, for me specialization is internal medicine, chronic

>disorders, and spirit-essence disorders. I do little in the way of

>musculoskeletal disorders, never have done much. And, yes, much of

>what I do is supportive or complimentary therapy to biomedical

>treatment, but I do have some powerful primary care cases.

>

This is the kind of stuff I personally would like to hear...(maybe other

don't care) but.. I would like to hear some of these primary care cases that

you rocked on... and also what primary care cases you didn't fair that well,

which maybe has given you more wisdom to only approach such cases from a

complementary approach. .. SInce our hospitals aren't integrated, there

seems to be little discussion, unless someone could point me to something I

have overlooked... Thanx

 

-

 

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[Guest guest]

> > " " <zrosenbe@s...>

 

>

> At

> >this point, for me specialization is internal medicine, chronic

> >disorders, and spirit-essence disorders. I do little in the way of

> >musculoskeletal disorders, never have done much.

 

z'ev

 

I have always been impressed that you have cultivated this style of practice. I

think you persevered on one hand, but were also in the right place at the right

time. There are only a very small number of san diegans who will use TCM

as primary care for chronic illness and most of those are older counterculture

types -- a dying breed. those who were able to lay foundations with this small

group at a time when there were very few L.Ac. in san diego and hardly any

who did internal medicine are now able to reap the rewards of the seeds they

planted in the form of word of mouth. An old fashioned medical practice. but

there are definitely not enough such patients and word of mouth for the rest of

us. I do not know a single person in san diego who has duplicated your

success in this type of practice building, do you? All the other really big

succcesses in town are GPs or pain specialists. We have a tremendous

educational burden to convince the rest of the populace that we are more

than pain control. I have to add, sadly, that the old counterculture western

medicine haters in my practice are almost always the ones who fare worst

with their chronic illnesses (women who refulse lumpectomies and wake up

with metastasized cancer a year later are the latest demographic I am seeing

a lot of).

 

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

> Recognize that a lower level of training is

> needed to be a GP.

> <<<Being a GP is not lower level as one needs a very broad view.

> Alon

 

broad perhaps, but not deep. we have plenty of breadth in the english

literature, but not enough depth in many areas. so lets change lower to

deeper. in fairness, a specialist may not be able to recognize an ominous

sign outside his own specialty, but a GP might still need to refer to a

different

specialist for expert treatment. for example, I refer for stubborn skin

diseases

if my formulas do not work quickly.

 

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

The list for biomed only was quite long, as was TCM alone but tended to be

poorly understood, self limiting and functional disease or diseases were no

alternative existed.

replied:

this is an important point. it has often been touted that the chinese select

whether to use TCM or WM depending on which style if more effective for a

given disease. The corrollary evideence has been that for many poorly

understood diseases, people choose TCM. But this is no evidence that TCM

works, only evidence that WM does not for the given disease and that risk of

WM outweighs the possible benefit. People may actually be choosing TCM in

china the same way they do in the US. For self-medication for self-limited

complaints or as an option when WM is known to be ineffective. The

difference may be that do not use TCM as a last resort in these latter cases,

but these demographics prove nothing about efficacy.

 

Alon, I find it somewhat ironic that you fagree that TCM is not proven effective

for many conditions, but then got defensive about your many years of clinical

experience treating such illnesses successfully without needing access to

chinese source material. You can't possibly be saying that you are effective at

treating conditions like diabetes based soley upon trial and error over the

years, while your chinese counterparts are ineffective at treating this

condition

even with immense resources at their disposal.

 

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

Since CM is so dependent on skills such as interpreting physical signs

regardless on how much study one does on DM.

> Alon

 

I think this is a mistaken idea that downplays the importance the chinese have

always placed on disease diagnosis as well as pattern diagnosis. xiao ke is

an ancient disease that has unique qualities that cannot be explained by

merely lower, middle or upper yin xu.

 

todd

[Guest guest]

Skin diseases I find to be one of the most difficult specialties in

Chinese medicine. I also refer out if I don't get reasonable results.

However, most of the patients I've seen with skin disorders usually

have a combination disease pattern including other prominent symptoms

such as asthmatic breathing, blood sugar issues, joint pain which have

developed concurrently with the skin issues.

 

 

On Sunday, February 16, 2003, at 09:45 AM,

< wrote:

 

> broad perhaps, but not deep. we have plenty of breadth in the english

> literature, but not enough depth in many areas. so lets change lower

> to

> deeper. in fairness, a specialist may not be able to recognize an

> ominous

> sign outside his own specialty, but a GP might still need to refer to

> a different

> specialist for expert treatment. for example, I refer for stubborn

> skin diseases

> if my formulas do not work quickly.

[Guest guest]

, " " wrote:

> Skin diseases I find to be one of the most difficult specialties

in Chinese medicine. I also refer out if I don't get reasonable

results. >>>

 

 

Z'ev:

 

What is it about skin diseases that Zang/fu diagnosis doesn't

explain?

 

 

Jim Ramholz