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Hongkong CM doctors wants hospital access to SARS patients

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April 14, 2003

 

Dear Listmembers,

 

As I was searching on-line for articles in the Chinese language press on the origins of the SARS epidemic, I came across this open letter from the 'HKBU Society ' and the " Concerned Public TCM Medical Treatment Service Group' published in the April 8,2003 issue of the Takung Pao on-line edition ( http://www.takungpao.com/inc/print) . In the interest of providing a well rounded understanding of the the unfolding worldwide epidemic which originated from Hongkong and Southern China as welll to amplify their muffled point of view, I have translated the letter in to English and send them to our rs and other institutions which might be interested in their plight.

 

Here in the State of Victoria , Australia, there are over 500 registered Chinese medicine practitioners. As a practitioner of Chinese medicine in this state for the past 20 years, I have treated isolated cases of patients in some of the public hospitals for various conditions. And this can be arranged if the patient or the family members looking after the patient decides to have Chinese medicine treatments. However, in case of participation by Chinese medicine practitioners in the treatment of contagious diseases in hospital setting, this issue is still unclear.

 

Regards,

 

Rey Tiquia

President

Alliance of Associations of Australia

Victoria, Australia

Tel:(03) 94991362

 

 

It is a Pity to Abandon the Use of

 

In This SARS Outbreak

 

In recent times , the news about the SARS epiidemic is becoming shocking every passing day. Residents of Amoy Gardens are now being quarantined. There is now the talk that the port city of Hongkong is becoming an 'epidemic port'. Undoubtedly, this 'atypical' pneumonia is fast becoming an infamous 'typical' popular anxeity.

 

At present, the number of people being iinfected is increasing. Western medicine uses ribavirn in conjunction with steroids as its main therpeutic tool. Although it has been used to some success, however, it does not seem to work with some patients. At the same time it has many side-effects. Under this situation, on the otherhand, we have not heard the government considering to invite Chinese medicine practitioners to participate in the prevention and treatment of SARS patients(in the hospital). After pondering a hundred times, this is really perplexing. At present, therre are 8,000 qualified Chinese medicine practitioners in Hongkong (of this number more than 5,000 are Chinese mediciine practitoners while 2,000 are registered Chinese medicine practitoners. They are all ready to serve the community. There are also three universities which run full-time courses on Chinese medicine. Among there ranks are well-known TCM experts.

 

Recently, many of these TCM experts have come out and publiscized their analysis and study of the current epidemic. They think it can be categorized as 'Spring warm epidemic' chun wen with in the TCM discipline of 'Warm Febrile diseases' or Wen Bing . These infectious disease have the characterisitcs of 'inner fever brought about by external factors' wai gan nei re . This condition known as 'Spring warm epidemic' has been discussed around in the past within TCM circles for several centuries. On the otherhand, the pathomechanism bing ji known as 'inner fever brought about by external factors' has been recorded historically since the time of the Eastern Han Dynasty. Hence, there are plenty of historical experiences accumulated in this regard. In fact, it is possible, that these concepts and methodologies can play a role in this current SARS epidemic.

 

In the neighbouring city Guangzhou, a similar epidemic outbreak . Hospitals in this city has used the method of Chinese medicine in coordination with pei he Western medicine in the treatment of hospitalized SARS patients. The results were not bad. Especially with regards SARS patients with lung disease complications, and where the use of pharmaceuticals are forbidden, in these cases Chinese medicine was put into good use.

 

Here in Hongkong , we have enough Chinese medicine resources (both trained personell and medicinal herbal resources ) . Hospitals and beds are already there. And these are not inferior to those in Guangzhou. These are excellent conditions for providing Chinese mediical treatment and services to SARS patients. Unfortunately, at this point in time, we have not heard any signs that the government is considering inviting Chinese doctors to participate in the treatment of SARS patients.

This leads to the inability of traditional Chinese medical practitioners of the same generation to enter the hospital wards as medical support personell yi hu zhe de shen fen and thus rid the patients of their illness and sufferings. Aside from Western medicine, city residents are left with no other choices. This is indeed a pity.

 

Of course, at present hospitals in Honkong have no such system of Chinese medicine cooridinating with Western medical system. However, it all returns to this point, it will be better to sigh with regret with the government on the one hand shouting aloud about its support for Chinese medicine, and on the otherhand kicking Chinese medicine out of the this campaign against SARS epidemic. We can just sigh in regret that in our hospital only Western medicine is allowed in while other (traditions of health care) are left out. Actually, if only the two sides can have the heart to allow Chinese medicine into the hospitals, it will not be hard to device a realistic system . Now it has been confirmed that SARS patients are being being forced to be hospitalized to receive Western medical treatments. However, there are SARS patients who do not respond to this treatment and are still receiving such treatments. There is no alternative tradition of healthcare to turn to . We still have to see whether this is good or bad for the patients.

 

Bacteria and viruses (especially viruses) do mutate. This is a fact. After mutation, the drug used to annihilate the mutated virus loses it's efficacy. Then a new drug has to be researched and designed to deal with it. Then there will be another viral mutation. Again another new drug has to be explored. This is a never ending 'chasing war '. The one that is left behind is none other than medical science. This time, the the pathogen responsible for the SARS epidemic is a mutated corona virus. There is no absolutely effective drug to deal with it. At this point, Western medicine seems to be in a very passive position. If and when Western medicine has found a new effective drug, the epidemic might then be over. However, no one can guarantee that in the future there will be no new viral mutation and a similar epidemic can happen. At this this time whether there will be a new drug to deal with this situation, no one knows. However, one thing is clear, there will always be patients who will suffer from the torture of diseases. Soceity will again witness a new chaos. And talking about the holistic perspective, the concept of tailoring treatment in accordance with the diagnosed clinical pattern bian zheng lun zhi is the basic feature of the theoretical system of Chinese medicine. From this macro perspective, the patient's clinical pattern zheng hou is seen as the basis of treatment. The pathomechanism bing ji is summed-up . And with a different pathomechanism a correspondingly different treatment plan is executed. This concept is not influenced by the micro perspective of bacteria, viruses and other microorganisms. In this regard, Chinese medicine can coordinate with Western medicine and thus give the former a good role to play.

 

The people of the city must be given an alternative choice !

 

With the proviso of putting the stess upon the health of the people of the city and giving them another choice, the government and hospials in Hongkong must open their doors.A plan must be drafted and implemented to allow patients in hospitals receive Chinese medicine treatment. This is due to the fact that everyone thinks about the health of the people of Hongkong. This is not just talking about this current epidemic. In the long term, Chinese medicine services must be included among the services they provide. Keeping Chinese medicine outside is not an enligthened policy. The time for action has come. We should not contemplate about this step until the next epidemic occurs . Hence, we hope that the Hongkong Government and hospitals quickly take an enlightened step forward. We also hope that SARS patients recover quickly and for the current SARS epidemic to be a thing of the past.

 

 

HKBU Society

 

Concerned Public TCM Medical Treatment Service Group

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This is interesting, considering my earlier discussion with Rory that

the SARS epidemic would possibly be a spring warmth epidemic with a

latent evil.

 

 

At 10:54 PM -0800 4/2/03, wrote:

(SARS certainly seems to fit the wen bing category of shi bing/seasonal

disease, perhaps a spring-warmth disease with latent heat effecting the

qi and possibly ying aspects. As you mention, Rory, we need more info,

including pulses, tongue descriptions, more detailed symptoms from a CM

perspective.)

 

 

On Sunday, April 13, 2003, at 05:51 PM, rey tiquia wrote:

 

>   Recently, many of these TCM experts have come out and publiscized

> their analysis and study of the current epidemic. They  think it can

> be categorized as 'Spring warm epidemic' chun wen  with in the TCM

> discipline of  'Warm Febrile diseases' or Wen Bing . These infectious

> disease have the characterisitcs of 'inner fever brought about by

> external factors' wai gan nei re . This condition known as 'Spring

> warm epidemic' has been discussed around in the past within  TCM

> circles for several centuries. On the otherhand,  the pathomechanism

>  bing ji  known as 'inner fever brought about by external factors' has

> been recorded historically since the time of the Eastern Han Dynasty.

> Hence, there are plenty of historical experiences accumulated in this

> regard. In fact, it is possible, that these concepts and methodologies

> can play a role in this current SARS epidemic.

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Dear Zev,

 

I think you are right . I still have some materials in the Chinese

language downloaded from HK newspapers . One is an article

written about a CM practitioner in HK who actually advocating

the use of certain foods like nashi pear in dealing with the'dry

'environmental parameters of the Spring Warm SARS epidemic .

I am translating it now and will send it to the list once finished.

 

Regards,

 

Rey Tiquia

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At 6:04 PM -0700 4/13/03, wrote:

>This is interesting, considering my earlier discussion with Rory

>that the SARS epidemic would possibly be a spring warmth epidemic

>with a latent evil.

--

 

Z'ev, I'm more than willing to be convinced by you, but so far my

re-reading of the patterns of Spring-Warmth hasn't brought me round.

Can you be more specific as to why you think this is a good fit?

 

Rory

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At 1:15 AM +0000 4/14/03, rey tiquia wrote:

I still have some materials in the

Chinese

language downloaded from HK

newspapers

--

 

Rey, thank you so much for all this translation you are doing

for us. It's very interesting and very much appreciated.

 

Rory

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April 15,2003

 

Dear Rory,

 

Thank you for your feedback and nice comments. I am doing

this translation work partly because of the frustration one gets

from reading the papers and medical journals about the

coverage of this epidemic which makes invisible efforts made by

the local people in combatting the disease and on the otherhand

makes so visible the narrow micro efforts to track down the

micropathogen supposedly responsible for the disease. In

addition, I can see through this SARS epidemic the coming to life

and further development (theorectically and in the realm of

'doing' ) of traditional medical practices which is impacting on

what we are doing in far and distant corners of our many

localized world.

 

Regards,

 

Rey Tiquia

 

 

, Rory Kerr <

rorykerr@w...> wrote:

> At 1:15 AM +0000 4/14/03, rey tiquia wrote:

> >I still have some materials in the Chinese

> >language downloaded from HK newspapers

> --

>

> Rey, thank you so much for all this translation you are doing for

us.

> It's very interesting and very much appreciated.

>

> Rory

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Jim,

 

Not sure what " good " means in your question.

 

The person who sent me the link is an

acupuncturist from upstate New York

who was recently in Beijing where

she and I were talking about the

SARS situation.

 

So far as where the material comes from, the

source is clearly identified in the text

itself. The writer is a graduate of the Harvard

School of Public Health, if I remember correctly.

 

He addresses several issues that I

have been wondering about. And I

was just curious to see what others

would make of his somewhat enthusiastic

theory about the nature of the current

epidemic.

 

Remember, just because you're paranoid

doesn't mean they're not after you.

 

Ken

 

, " James Ramholz "

<jramholz> wrote:

> , " dragon90405 " wrote:

> > All,

> >

> > A friend in New York just sent me this link.

> >

> > http://www.fromthewilderness.com/free/ww3/040603_sars_scam.html

>

>

>

> Ken:

>

> Is this conspiracy theory stuff from a " good " friend?

>

>

> Jim Ramholz

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, " dragon90405 " wrote:

> Not sure what " good " means in your question.

 

Someone who provides generally reliable information.

 

 

> He addresses several issues that I

> have been wondering about. >>>

 

Which issues? Please explain.

 

 

Jim Ramholz

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Well, gee, there's now a whole website devoted to SARS, surprise, surprise.

With several links, some to articles questioning the science around the

discovery and analysis of it(including commentary by Frank Plummer, who

directs one of the WHO labs in Canada), as well as reporting on the

condition's movement " on the ground " (as we now say).

 

The name of the website may suggest it is set up to defend the travel

industry, a perhaps worthy purpose, or self-serving, but at least they're

upfront about it.

 

ann brameier

 

> All,

>

> A friend in New York just sent me this

> link.

>

> http://www.fromthewilderness.com/free/ww3/040603_sars_scam.html

>

> Ken

>

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oops, sorry, forgot to include the website(was in a hurry). Here 'tis:

http://www.sarstravel.com/

 

ann

 

> Well, gee, there's now a whole website devoted to SARS, surprise,

surprise.

> With several links, some to articles questioning the science around the

> discovery and analysis of it(including commentary by Frank Plummer, who

> directs one of the WHO labs in Canada), as well as reporting on the

> condition's movement " on the ground " (as we now say).

>

> The name of the website may suggest it is set up to defend the travel

> industry, a perhaps worthy purpose, or self-serving, but at least they're

> upfront about it.

>

> ann brameier

>

> > All,

> >

> > A friend in New York just sent me this

> > link.

> >

> > http://www.fromthewilderness.com/free/ww3/040603_sars_scam.html

> >

> > Ken

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Jim,

>

> Which issues? Please explain.

>

>

 

In the early days of the reporting about

SARS, one of the first thing that really

concerned me was the breakdown of the

separation between the couple dozen or

so labs that the CDC and WHO use for

analyses in such situations. They were

once all independent commercial operations

that competed with each other and therefore

constantly focused highly critical eyes

on one another's research.

 

Somehow, more or less at once when the

SARS epidemic broke out, there was a

utter dissolution of the competitive

nature of this network that resulted in

a worldwide cooperation and sharing of

data, analyses, interpretations, etc.

 

This is quite startling. It means that

it is far, far easier to manufacture

consensus concerning things about which

no consensus is actually justified.

 

The numbers also never added up to me,

and Horowitz addresses both of these

in the Great Global Scam article.

 

I've worked in mass media over a span

of more than twenty years, and I've

come to recognize the kind of distortion

that political/military interests exert

on the flow of information through

various media outlets. With the concentration

of owership of media in the States and

elsewhere, the control of the data/information/knowledge

that people access and believe has become

far more managable than ever.

 

Like others on this list, I'm also

very concerned that so many individuals

in the Chinese medical community, both

here in China and around the world,

seem to have swallowed hook, line, and

sinker, the notion that what we really

should do is view the Chinese materia

media and art of formulas as an extension

of Western pharmaceutical science, looking

in essence for magical herbal bullets

with which to shoot the predatory pathogens.

 

I had a long meeting with Dr. Fan yesterday,

the doctor that I mentioned last week.

 

We will probably not conduct the interview

with him on camera until next week at the

earliest. But he has agreed to write an

article on his views on SARS and the

application of Chinese medical theory to

its diagnosis and treatment. And I have

agreed to translate and publish it.

 

Anyhow, those are just some of my concerns.

 

Ken

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I couldn't agree more, Jim.

 

'Me-too-ism, look at us, we have anti-viral herbs' is not going to be

very helpful in the long run.

 

Instead, what we should be sharing is the traditional CM perspective on

infectious diseases, comparing, contrasting and complimenting the WM

approaches.

 

 

On Tuesday, April 15, 2003, at 05:23 PM, dragon90405 wrote:

 

 

 

>

> Like others on this list, I'm also

> very concerned that so many individuals

> in the Chinese medical community, both

> here in China and around the world,

> seem to have swallowed hook, line, and

> sinker, the notion that what we really

> should do is view the Chinese materia

> media and art of formulas as an extension

> of Western pharmaceutical science, looking

> in essence for magical herbal bullets

> with which to shoot the predatory pathogens.

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, " " wrote:

> I couldn't agree more, Jim. >>>

 

The statement wasn't mine; it was Ken's. But it is one that makes

sense to me as a CM practitioner. The attitude is, after all, simply

the Western perspective that everything means something real only in

WM terms. The problem with Western thinking is that it excludes

other competing types.

 

But I don't have any problem with saying that herbs have antiviral

properties, as long as that is a prelude to---as you nicely put it---

sharing the CM perspective. If saying that herbs have a antiviral

properties helps get us a serious first look, then we should make

every effort to try and capitalize on that attention with a

practical CM viewpoint, and convince people that Western science

fits into the Chinese perspective.

 

Unfortunately, right now we don't have that information to provide

any real perspective---and I find it troublesome and significant

that neither do the Chinese TCM practitioners!

 

My impression (please correct me if I'm wrong) is that TCM

practitioners do not seem to be part of the first line of defense to

be called during a national medical crisis---or even the second

line. Perhaps it is politics. If they are outside the loop in these

situations, then CM is being marginalized even in China! If they are

not included in their own country among the best minds to deal with

this medical crisis, what does that say about CM's (and our) future?

 

 

Jim Ramholz

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April 16,2003

Dear Jim,Zev, Ken,

 

The problem with Western thinking is that it excludes

> other competing types.

 

I agree with Jim's above statement. As well as the fact that it is

all about politics. It is what is referred to in the past as

'scientism " , which It is very much alive in China today. For TCM

to be accepted as 'real' it has to be 'modern' and 'scientific'. The

Communist Party in China under Mao was spooked by this

scientistic persective. As a result, research and pedagogical

training in TCM is always pegged to the gold standard of science

i.e. positivistic science. This was how the Frankensteinian notion

of 'integrating TCM with biomedicine " or zhong xi yi jie he was

born.

 

I believe that TCM practitioners in China has to develope a

'real' and independent perspective of their own which free from

this scientistic perspective. And this needs time and efforts on

their part . And TCM practitioners in the West have to support

their quest for this independent perspective .

 

Since accessing on-line the views of TCM practitioners in

Hongkong vis-a-vis the SARS epidemic, I can see that some

individual and organizations over there are taking a perspective

quite different from the mainland scientistic perspective. In

addition, their TCM view of the epidemic is evidently more

sophisticated than the mainland apporach. For me this is very

exciting.

 

Regards,

 

Rey Tiquia

 

 

 

 

 

, " James

Ramholz " <jramholz> wrote:

> , " Z'ev

Rosenberg " wrote:

> > I couldn't agree more, Jim. >>>

>

> The statement wasn't mine; it was Ken's. But it is one that

makes

> sense to me as a CM practitioner. The attitude is, after all,

simply

> the Western perspective that everything means something real

only in

> WM terms. The problem with Western thinking is that it

excludes

> other competing types.

>

> But I don't have any problem with saying that herbs have

antiviral

> properties, as long as that is a prelude to---as you nicely put it--

-

> sharing the CM perspective. If saying that herbs have a antiviral

> properties helps get us a serious first look, then we should

make

> every effort to try and capitalize on that attention with a

> practical CM viewpoint, and convince people that Western

science

> fits into the Chinese perspective.

>

> Unfortunately, right now we don't have that information to

provide

> any real perspective---and I find it troublesome and significant

> that neither do the Chinese TCM practitioners!

>

> My impression (please correct me if I'm wrong) is that TCM

> practitioners do not seem to be part of the first line of defense

to

> be called during a national medical crisis---or even the second

> line. Perhaps it is politics. If they are outside the loop in these

> situations, then CM is being marginalized even in China! If they

are

> not included in their own country among the best minds to deal

with

> this medical crisis, what does that say about CM's (and our)

future?

>

>

> Jim Ramholz

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, " rey tiquia " wrote:

> Since accessing on-line the views of TCM practitioners in

> Hongkong vis-a-vis the SARS epidemic, I can see that some

> individual and organizations over there are taking a perspective

> quite different from the mainland scientistic perspective. In

> addition, their TCM view of the epidemic is evidently more

> sophisticated than the mainland apporach. For me this is very

> exciting. >>>

 

 

 

Rey:

 

Can you summarize some of those perspectives which are different

from the mainland?

 

Jim Ramholz

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, " James

Ramholz " <jramholz> wrote:

> , " rey tiquia "

wrote:

> > Since accessing on-line the views of TCM practitioners in

> > Hongkong vis-a-vis the SARS epidemic, I can see that some

> > individual and organizations over there are taking a

perspective

> > quite different from the mainland scientistic perspective. In

> > addition, their TCM view of the epidemic is evidently more

> > sophisticated than the mainland apporach. For me this is

very

> > exciting. >>>

>

>

>

> Rey:

>

> Can you summarize some of those perspectives which are

different

> from the mainland?

>

> Jim Ramholz

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April 16, 2003

 

Dear Jim,

 

I just lost two pharagraphs of my reply to your querry. Now I have

to redo the whole thing from memory,

 

> Can you summarize some of those perspectives which are

> different

> > from the mainland?

> >

 

This is a very good question.

 

One of the main feature of some of the HK TCM practitioners

perspective vis-a- vis SARS ( and what we in the West see as

microbial infections diseases) is the conceptual clarity with

which they view the disease from the Wen Bing philosophical

tradition and how clearcut the differentiation is made from the

biomedical microbiological perspective. At the early stages of

the SARS epidemic , they have seen the epidemic as 'Spring

Warm Febrile diseases ' or Chun Wen ; Wind-Heat ' or Feng Re

which are sub-categories under the broad classification under

Wen Bing. It is very different from the hodge-podge mainland

perspective which is always straining to see the Ming Dynasty

Wu You Xing's notion of 'pestilential Qi' or Li Qi as modernistic

virus, bacteria and microorganisms.

 

Flowing from the above is the central role the HK TCM

practitioners' place on pattern diagnosis or bian zheng lun zhi in

looking at SARS. This shows that they know their practice and

how it differentiates from WM practice .They know who they are

are through what they are doing. They have liberated themselves

from the stranglehold of scientism. I am now translating a short

article from the Takung Pao which clarified at least for me the

distinction between common cold or gan mao; influenza (which

is a contemporary Chinese parlance for the disease), and shi

xing ganmao or the ancient name for influenza. In this article, a

practical distinction is made between the dialectical relationship

between Zheng Qi (which I translate as natural medicine or

natural body resistance) and Xie Qi ( heteropathy).

 

Regards,

 

Rey Tiquia

 

 

 

 

 

 

 

, " rey tiquia " <

rey@a...> wrote:

> , " James

> Ramholz " <jramholz> wrote:

> > , " rey tiquia "

> wrote:

> > > Since accessing on-line the views of TCM practitioners in

> > > Hongkong vis-a-vis the SARS epidemic, I can see that

some

> > > individual and organizations over there are taking a

> perspective

> > > quite different from the mainland scientistic perspective. In

> > > addition, their TCM view of the epidemic is evidently more

> > > sophisticated than the mainland apporach. For me this is

> very

> > > exciting. >>>

> >

> >

> >

> > Rey:

> >

> > Can you summarize some of those perspectives which are

> different

> > from the mainland?

> >

> > Jim Ramholz

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One of the main feature of some of the HK TCM practitioners perspective vis-a- vis SARS ( and what we in the West see as microbial infections diseases) is the conceptual clarity with which they view the disease from the Wen Bing philosophical tradition and how clearcut the differentiation is made from the biomedical microbiological perspective.

>>>>>I thought they stated that they were excluded from the clinical day to day treatment of SARS. Am I wrong?

Alon

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April 17,2003

 

Dear Alon,

 

I don't think they were excluded from the day-to-day clinical

trreatment of SARS especially those in the initial stages of the

diesease which can be attended to in out-patient clinic

conditions of private CM practititioners . They are instead not

being' invited ' by the HK Health authorities to treat SARS patients

in HK hospitals where the more severe cases involving

respiratory failures are being cared for.

 

Regards,

 

Rey Tiquia

 

 

 

, " ALON

MARCUS " <alonmarcus@w...> wrote:

> One of the main feature of some of the HK TCM practitioners

> perspective vis-a- vis SARS ( and what we in the West see as

> microbial infections diseases) is the conceptual clarity with

> which they view the disease from the Wen Bing philosophical

> tradition and how clearcut the differentiation is made from the

> biomedical microbiological perspective.

> >>>>>I thought they stated that they were excluded from the

clinical day to day treatment of SARS. Am I wrong?

> Alon

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They are instead not being' invited ' by the HK Health authorities to treat SARS patients in HK hospitals where the more severe cases involving respiratory failures are being cared for. >>>That is why i am wandering how they are coming up with their treatment theories

Alon

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At 1:15 PM +0000 4/16/03, rey tiquia wrote:

At the early stages of

the SARS epidemic , they have seen the epidemic as

'Spring

Warm Febrile diseases ' or Chun Wen ; Wind-Heat ' or Feng Re

which are sub-categories under the broad classification under

Wen Bing. It is very different from the hodge-podge mainland

perspective which is always straining to see the Ming

Dynasty

Wu You Xing's notion of 'pestilential Qi' or Li Qi as

modernistic

virus, bacteria and

microorganisms.

--

 

Rey,

 

According to my reading, (which is probably the same as

others on this list), Wu developed the theory of li qi in response to

epidemics for which the wen bing methods of the time (1600s AD) were

inadequate, and people were dying in droves. So, while current biases

in hospital based practice in China may show a preference for li qi

theory in the SARS epidemic, there is good historic justification for

this choice as well.

 

From what we've seen described, it seems to me that the

wind-warmth category fits better than the spring-warmth. However, it

may be better that these categories should be used flexibly, rather

than assuming that it has to be one or another.

 

Rory

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