xing and zheng

[Guest guest]

, " James Ramholz " <

jramholz> wrote:

 

>

> If we look at the Fang Yaozhong system of pattern differentiation

> (bian zheng) in Sheid's book, it includes a fairly comprehensive and

> detailed approach in seven step: (1) determine the location of the

> illness in the visceral system or channel; (2) determine the nature

> of the illness in terms of yin/yang, qi, blood, etc; (3) determine

> the location and character of the liiness process; (4) give priority

> in terms of 5-phases types of overcoming (what I have earlier

> discussed as the Revenge Cycle); (5) align therapeutic strategies

> with previous processes; (6) seek the root; (7) develop treatment

> ahead of the dynamics of the disorder. Conspicuous among the methods

> he utilizes is five-phases---another subject besides pulses that is

> hardly discussed in most TCM schools.

 

Good stuff. I think it is interesting that Fang's system was NOT suppressed by

the communists. It was there for anyone to learn and use. I am sure it held

favor in certain circles. Beijing is apparently much more western in its

orientation than shanghai or chengdu. So apparently these ideas were

actively discussed in chinese TCM schools, even during the height of

standardization.

 

I would like to discuss what it actually means in practical terms to " develop

treatment ahead of the dynamics of the disorder " . Since Scheid does not give

an example of this. This of course harks back tot he SHL where ZZJ suggests

the same.

 

an obvious transmission is the liver overcoming the spleen via the control

cycle (wood over earth). If the liver is constrained, it may overcome the

spleen, even if the spleen is not weak. If the spleen has not yet been invaded,

but one wants to prevent that future possibility, how does one go about this

clinically. Do you think that Fang means one should supplement the spleen

prior to the development of spleen signs (and by this I mean there are not

even pulse signs of spleen weakness yet). Or does it mean one must address

the liver now before there is trouble later by emphasizing dispersing herbs?

Does anyone have examples from the medical literature that explciitly

illustrate this process. Does the mere inclusion of zhi gan cao in a liver

formula serve the purpose of protecting tranverse invasion of earth by wood?

 

[Guest guest]

At 06:56 PM 4/26/2003 -0500, you wrote:

>>Why

don't the translators stop re-translating much of the same materials and

do some of these different approaches. Cant you guys get together and

divide some of the work

Alon

It's not really that simple. Who is to say that one particular

author or series editor is the final word on a particular topic. As

you can see from looking at Gynecology for example, there are many books

(even a few published by the same company BP) and yet they all contain

different information. And, just as in western medicine there are

often many, many texts on a similar topic, this is also true in China and

in relation to Chinese medicine. I find it quite valuable to be

able to read around in a topic rather than to be limited to one text that

one individual has chosen to translate. And actually, there is not a lot

of duplication that goes on, although the content of some texts may

overlap other texts, we still have next to nothing about most areas where

there may be many books in Chinese.

Also, translation can be a very very tedious task so it always helps to

have something that you are particularly interested in or inspired by to

keep you going. As yet, there are not enough of " us guys "

doing translation to even begin to say that we don't need more of

anything. Bensky and Mitchell are a good example - Craig has

completed a translation of the SHL. Does that mean that Bensky

should not do his? I don't think so. Yes, there

may be enough basic point location texts (although CAM is so bad that I

never use it anymore if I can help it), but other than that, there is

still too much to be translated to say that any particular area should

not be addressed anymore because it is " done. "

Marnae

 

 

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[Guest guest]

On page 341 of Deng's Practical Dx in CM he discusses the concept of bian

bing and bian zheng. Identification of patterns really began with

the SHL, but although the identification of patterns is essential, this

does not mean that disease does not exist in CM. For example, zhong

feng (wind-stroke) is a disease name, not a pattern, so, indeed, it is

our job, to figure out the presenting pattern. Wiseman's dictionary

says: " a specific disease enttity may be characterized by different

patterns that reflect different pathomechanisms or variations in the

disease that are determined by the patient's individual state of health.

I say this because all too often we hear that CM does not treat

" diseases " but only patterns - Again, a semantic issue that can

be quite clinically important. Within diseases, patterns must be

identified in each presenting individual and these patterns are

identified by the s & s.

You are quite correct that in the '70's much of what was written in

English was indeed designed to look at s & s and ignored the

concept of the pattern, however, it seems to me that in the past 10

-1 5 years with the publication of numerous new texts and the increase in

translation of original material we have moved past this, although it is

one of the hardest concepts for students to grasp. I have taught in 3

schools over the past 6 years and see that the difference between

programs and the student's ability to become good practitioners lies

exactly here. When faculty can take the student past the

" cookbook " prescription of herbs and acupuncture you begin to

see the changes that are really interesting. The mediocre student

often does not ever reach this point and continues to treat based on the

what the books say rather than what presents in front of them, but the

good student " gets it " and is able to move on.

Isn't this sort of what was seen in Bensousson's Australian study of

IBS. During treatment, equal improvement was seen in patients

taking a standard formula and patient's taking individualized formula,

but, 7 weeks (I think) after treatment was completed, only those taking

individualized formula remained at earlier levels of improvment while

those taking standard formula had regressed.

 

At 12:03 PM 4/26/2003 -0700, you wrote:

Has anyone read Volker Scheid's

(various pages in chin. Med in contemp. china) where he talks about type

(xing) versus pattern (zheng). According to his professor Zhu,

typing tends to pidgeonhole the patient as either this or that. the

example he gives is for meniere's disease being either liver yang rising,

phlegm-turbidity, etc.. He considers those types if the goal of the

dr. is to match the patient to one of the s/s complexes. He says

this is prominent in some circles in modern china, but also has been

roundly criticized by many since its inception. typing is a

westernized approach designed to link discrete diagnoses to patients as

with western diseases. Zhu argues that practicing according to bian

zheng is actually a process of identifying the multiple pathomechanisms

that are involved in a case and crafting a formula that takes account of

all these facets. that does not necessarily mean treating every facet

simultaneously, but it does require their consideration.

 

Apparently many of the standard textbooks in the 70's were organized

around typing, even moreso were those designed for export. CAM is a

modern incarnation of this trend, I believe. So some have argued

that TCM is a bunch of contrived boxes. Others have argued that it

is a flexible set of guideposts. Apparently it is both and

neither. If one uses textbooks listings as types, it does seem

quite limiting. But if one uses the textbook listings as patterns, then

it becomes much more flexible. Unfortunately the omission of

pathomechanisms from many internal medicine textbooks printed in english

has led to a default application of TCM as a typing methodology. I

am sure many of you have had teachers who argued both adamantly for and

against typing (without calling it that - everyone uses the term patterns

regardless of what they are actually doing, it seems). those who

would say you can only choose one pattern per case and those who advocate

treating up to a dozen patterns at once.

I think much of the criticism leveled at the TCM style in some circles is

dues to the fact that many of the teachers educated by these textbooks in

modern china were taught to practice bian xing, not bian zheng. I

think some americans have gravitated to bian xing for its simplicity and

straightforwardness. Others have rejected it as heartless and cold

and sterile, with no room for creativity. I would have to say that

when reads books like zhu dan xi and li dong yuan, the discussion of

treatment does seem to center on descriptions fo pathomechanisms rather

than named patterns in many case, thus supporting the interpretation of

bian zheng offered by Professor Zhu above. so for those who have

rejected TCM, one should really read Scheid (and Farquhar) and you may

reconsider the supposed limitations of this style of practice.

 

 

Chinese Herbs

 

 

voice:

fax:

" Great spirits have always found violent opposition from mediocre minds " -- Albert Einstein

</blockquote></x-html>

 

Marnae C. Ergil, M.A, M.S., L.Ac.

Huntington Herbs & Acupuncture

(631) 549-6755

[Guest guest]

Ken,

You are absolutely correct that jing-luo theory has received short shrift

in the English language literature. I believe that this is largely

because acupuncture is not seen as being as effective or as

" sexy " as medicinal agents are and so many schools give very

cursory introductions to channel theory and then ignore it, never really

talking about divergent, luo, sinew etc. channels. This is really

too bad because it makes for mediocre acupuncturists! Are there any

Chinese texts that you would recommend for translation? This is

something that I would be interested in but have not had the time to

research lately.

Marnae

At 12:01 AM 4/27/2003 +0000, you wrote:

There are other major areas of

theory that

have been poorly represented in the English

language literature and therefore in the

current standards of instruction and examination

that are used to qualify practitioners.

Ironically, these include some of the

most basic concepts. I believe that jing luo

theory is rather poorly represented in

much of the current Chinese medical literature

available in English, whether it be translations

or derivative texts.

That's another hole I'm hoping to see

filled in the not-too-distant-future.

Ken

 

 

 

[Guest guest]

, Cara Frank

<herbbabe@e...> wrote:

> I'm wondering: among the list members that write their own

formulas: how many write herb formulas NOT based on a traditional

formula, but based on the actions of herbs/dui yao mechanisms?

Written from scratch? >>>

 

 

Cara:

 

Sometimes I wonder if it's even possible to come up with a random

collection of herbs when writing for a particular condition that

isn't based on a classical formula. I taught myself to read some

Chinese in order to see what herbal formulas are available. One book

on musculoskeletal disorders has over 5,000 formulas (yep, I counted

them during a slow afternoon).

 

Sometimes I go through it and other Chinese books just to see how

many different ways there are to use a particular herb, for example,

like san qi. In fact, just last night I found a simple and

interesting formula for cancer of the uterus composed only of yi yi

ren (500) and san qi (300)---interestingly the herb amounts are in

the Fibonacci ratio.

 

 

Jim Ramholz

[Guest guest]

Cara -

I think you are talking about bian bing (identification of disease) and

not bian zheng (identification of patterns). Bian zheng gives room

for creativity, but bian bing merely names the presenting problem.

Both are helpful and both are important concepts in CM, but it is bian

bing that allows us to individualize our treatment .

marnae

At 07:07 AM 4/27/2003 -0400, you wrote:

It's not only that it hampers

" creativity'. Bian Zheng can be confusing to

students if the patient presents w/ s and s that exist outside the

assigned

patterns. It can be an impediment to logical reasoning. If we take it to

be

the truth that all menieures is caused by Liv yang to phlegm fire,, but

our

patient presents differently, then the risk is that the practitioner

begins

to question his/her diagnostic skills. Bian zheng can fly in the face

of

common sense.

In the class that I am plannning for TAI- one ongoing branch will be

" Slow

Diagnisis " or " Deconstructed Diagnosis " or " how

do we know what we know? " .

I want to work with this very issue to empower students to trust

their

diagnostic skills- to avoid jumping to conclusions: to think clearly

and

independently. To discriminate patterns without freaking out. To go

to the

next logical step of choosing an appropriate formula- and then to add

and

subtract appropriately. Based on the patient- not the preassigned

patterns.

Bian Zheng should be seen as a jumping off point and nothing more.

Cara

>

> While bian xing can point pracitioners to the ballpark, I am one

of

> those who finds it to be 'cold and sterile, with no room for

> creativity'.

>

>

> On Saturday, April 26, 2003, at 12:03 PM, wrote:

>

>> Has anyone read Volker Scheid's (various pages in chin. Med

in

>> contemp. china) where he talks about type (xing) versus

pattern

>> (zheng). According to his professor Zhu, typing tends to

pidgeonhole

>> the patient as either this or that. the example he gives

is for

>> meniere's disease being either liver yang rising,

phlegm-turbidity,

>> etc.. He considers those types if the goal of the dr. is

to match the

>> patient to one of the s/s complexes. He says this is

prominent in

>> some circles in modern china, but also has been roundly

criticized by

>> many since its inception. typing is a westernized approach

designed

>> to link discrete diagnoses to patients as with western

diseases. Zhu

>> argues that practicing according to bian zheng is actually a

process

>> of identifying the multiple pathomechanisms that are involved in

a

>> case and crafting a formula that takes account of all these

facets.

>> that does not necessarily mean treating every facet

simultaneously,

>> but it does require their consideration.

 

 

 

[Guest guest]

Yes, they do learn to individualize all treatments (usually), but again,

this is a very difficult concept for many of our students. I think

in part this has to do with the type of student that is beginning to

enter the field. With more and more schools popping up (we

currently have 9 in NY State) and schools choosing not to maintain high

academic standards in favor of increasing bodies in seats, the caliber of

student has changed. The student body has also gotten increasingly

younger - students are coming right out of college (or immediately after

finishing their 60 undergrad units) and for many of them it is more about

having a career than it is about really understanding the medicine.

It is not hard, in most schools, to get by at the lowest common

denominator - after all, a " C " is passing and as long as you

pass, well... In most states, where the NCCAOM acup exam is the only

requirement in addition to school, it is pretty easy to get a shoddy

education, pass the exam and start practicing - or doing no fault.

Perhaps before we make entry level a doctorate, we need to look at our

standards for admission and start to think about being more selective

about our students - or use the doctorate to allow ourselves the luxury

of being selective and not letting everyone become a

" doctor " .

marnae

At 11:10 AM 4/27/2003 -0500, you wrote:

>>>>I

am confused. Don't people at the school learn to individualize all

treatments? I have always spoke against the theoretical forcing of

patterns especially on WM diseases. However when I was in school as early

as 1982 Dr Lai for example never used to use so called text book patterns

when seeing A patient. It was always a web that was weaved for any

individual patient. This was the case in China as well. Am I missing

something here? There was always discussion of developmental

pathomechanisims, although I often found them quite speculative, and

different Dr never agreed with each other. There was more agreement of

the current presenting pattern. When making a diagnosis the typing

symptoms were often attributed to a mechanism (often pejant holed) which

often bothered me as almost any symptom can be attributed to a variety of

mechanisms. The picking of symptoms to support a mechanism or another was

often quite arbitrary, again something that still bothers me quite often

when reading case histories, e.g., patient has back pain and cold feet

showing evidence of K yang def etc.

alon

 

[Guest guest]

, " " wrote:

If the spleen has not yet been invaded, but one wants to prevent

that future possibility, how does one go about this clinically. Do

you think that Fang means one should supplement the spleen prior to

the development of spleen signs (and by this I mean there are not

even pulse signs of spleen weakness yet). Or does it mean one must

address the liver now before there is trouble later by emphasizing

dispersing herbs? >>>

 

If there is no pulse signs that the spleen is weakening or liver is

invading, then the issue is moot---it's not happening. The priority

is to address the liver. But you can still add herbs that support

the spleen to the formula as a precaution---ginseng, astralagus,

atractylodes, licorice, etc. Especially when you can anticipate an

event coming that might change the balance and allow wood to invade--

-for example, spring is coming or the patient is expected to go

through a particularly stressful period of overworking soon.

 

 

> Does anyone have examples from the medical literature that

explciitly illustrate this process. >>>

 

As I've mentioned before, you can calculate 5-Phases Revenge (Scheid

translates it as Overcoming) Cycle using the material in Su Wen

chapters 66-74 to anticipate what type of energy will dominate the

cold/flu season in 2003. It qualifies as number 4 and can be used

for 7 in Yang's list.

 

 

Jim Ramholz

[Guest guest]

This is actually a good question and an area of great confusion. IF

you look through Wiseman, you will see that the term for both sign and

pattern is zheng. Scheid actually speaks to this (sort of) on page 209

where he quotes Zhang Wi yao who says " One [thus] can see that all

the way up to the Qing (dynasty), patterns, diseases, and symptoms and

signs within in CM werenot intrinsically different terminological

constructs. Even though different historical periods and different

authors may have endowed [these terms] with rigorous content, they

later...stood side by side and [no one definition] was generally

accepted. Thus prior to the 1950's " patterns " are not the

basic concept of CM theory and therefore one can also say that bian zheng

lun zhi (pattern identification and treatment determination) was not

[yet] established as a theoretical system. "

Looking again at the SHL, we see a description of symptoms that determine

an appropriate formula and the pattern then takes on the name of the

formula, not the signs = a pattern which then has a commonly used formula

that can be modified to the individual.

At 01:52 PM 4/27/2003 -0500, you wrote:

based

on

zheng, not xing (or bing).

>>>Todd are you referring to xing as

in body? ie signs?

alon

 

[Guest guest]

, Marnae Ergil wrote:

>>[ Alon wrote] Why don't the translators stop re-translating much

of the same materials and do some of these different approaches.

Can't you guys get together and divide some of the work?

 

 

> [Marnae wrote] It's not really that simple. Who is to say that one

particular author or series editor is the final word on a particular

topic. >>>

 

 

Marnae makes an excellent point. And this issue is a good argument

for learning how to read at least some Chinese yourself.

 

 

Jim Ramholz

[Guest guest]

This is actually a paradox of Chinese medical education in the West.

On one hand, we basically advertise acupuncture as the 'main modality'

in the schools, profession and licensure, on the other hand, we don't

adequately cover channel theory in the schools (except for Japanese

acupuncture programs). However, the strong showing of such texts as

" The Channel Divergences " by Miki Shima and Chip Chace does bode well

for translating more jing-luo material. I know lots of people who are

excited by this book. I hope the sales match the excitement.

 

 

On Monday, April 28, 2003, at 10:24 AM, Marnae Ergil wrote:

 

> You are absolutely correct that jing-luo theory has received short

> shrift in the English language literature.  I believe that this is

> largely because acupuncture is not seen as being as effective or as

> " sexy " as medicinal agents are and so many schools give very cursory

> introductions to channel theory and then ignore it, never really

> talking about divergent, luo, sinew etc. channels.  This is really too

> bad because it makes for mediocre acupuncturists!  Are there any

> Chinese texts that you would recommend for translation?  This is

> something that I would be interested in but have not had the time to

> research lately.

>

> Marnae

[Guest guest]

Marnae,

I don't think that Todd or anyone else is disputing the importance

of disease differentiation in Chinese medicine. Clearly, Chinese

medicine also treats specific diseases. I think the issue is the

modern simplification of pattern differentiation into typing

differentiation/bian xing (which isn't in the Wiseman dictionary) that

was developed by Western physicians such as Chen Ziyin in the 1950's

(fenxing shi zhi/distinguishing types and applying treatment pg. 226 in

Volker's book).

 

 

On Monday, April 28, 2003, at 10:20 AM, Marnae Ergil wrote:

 

> Identification of patterns really began with the SHL, but although

> the identification of patterns is essential, this does not mean that

> disease does not exist in CM.  For example, zhong feng (wind-stroke)

> is a disease name, not a pattern, so, indeed, it is our job, to figure

> out the presenting pattern.  Wiseman's dictionary says: " a specific

> disease enttity may be characterized by different patterns that

> reflect different pathomechanisms or variations in the disease that

> are determined by the patient's individual state of health. I say this

> because all too often we hear that CM does not treat " diseases " but

> only patterns - Again, a semantic issue that can be quite clinically

> important. Within diseases, patterns must be identified in each

> presenting individual and these patterns are identified by the s & s.

[Guest guest]

Marnae,

While I agree with you that having several texts on a particular

subject has value, and often different information, several English

language books 'recycle' the same information over and over again. For

example, while there is a vast amount of material in Chinese on materia

medica unknown in English, there are three or four materia medicas that

have come out since Bensky that have essentially the same information

as the Bensky text. There has been little or no improvment on what was

originally done in the Bensky text, as far as the essential information

goes.

 

 

On Monday, April 28, 2003, at 10:06 AM, Marnae Ergil wrote:

 

> Yes, there may be enough basic point location texts (although CAM is

> so bad that I never use it anymore if I can help it), but other than

> that, there is still too much to be translated to say that any

> particular area should not be addressed anymore because it is " done. "

[Guest guest]

I hope (think) that Jiao is at least in part an exception.

Marnae

At 11:03 AM 4/28/2003 -0700, you wrote:

Marnae,

While I agree with you that having several texts on a

particular

subject has value, and often different information, several English

language books 'recycle' the same information over and over again.

For

example, while there is a vast amount of material in Chinese on materia

 

medica unknown in English, there are three or four materia medicas that

 

have come out since Bensky that have essentially the same information

 

as the Bensky text. There has been little or no improvment on what

was

originally done in the Bensky text, as far as the essential information

 

goes.

 

On Monday, April 28, 2003, at 10:06 AM, Marnae Ergil wrote:

> Yes, there may be enough basic point location texts (although

CAM is

> so bad that I never use it anymore if I can help it), but other than

 

> that, there is still too much to be translated to say that any

> particular area should not be addressed anymore because it is

" done. "

 

 

[Guest guest]

Z'ev -

you are absolutely correct - ideally, new txts will add to the material

rather than re-hash it in its entirety. Unfortunately, I think that

for publishers of translations, sales also is a part of the equation, and

it would be quite a challenge for any book to try to match Bensky in

terms of sales, thus making the translation of another materia medica

that does not have some catch (like Jiao's clinical experience and the

fact that it will be a part of a series) a major problem. And, to

be honest, doing that kind of rote translation of hundreds of substances

in order to glean the few pearls that emerge from those that have not

been translated is a lot of work. Perhaps doing a compilation that

includes primarily substances that are not in Bensky or more information

about substances that are in Bensky might be an approach.

Marnae

At 11:03 AM 4/28/2003 -0700, you wrote:

Marnae,

While I agree with you that having several texts on a

particular

subject has value, and often different information, several English

language books 'recycle' the same information over and over again.

For

example, while there is a vast amount of material in Chinese on materia

 

medica unknown in English, there are three or four materia medicas that

 

have come out since Bensky that have essentially the same information

 

as the Bensky text. There has been little or no improvment on what

was

originally done in the Bensky text, as far as the essential information

 

goes.

 

On Monday, April 28, 2003, at 10:06 AM, Marnae Ergil wrote:

> Yes, there may be enough basic point location texts (although

CAM is

> so bad that I never use it anymore if I can help it), but other than

 

> that, there is still too much to be translated to say that any

> particular area should not be addressed anymore because it is

" done. "

 

 

[Guest guest]

I think that would be a great idea.

 

 

On Monday, April 28, 2003, at 11:17 AM, Marnae Ergil wrote:

 

> Perhaps doing a compilation that includes primarily substances that

> are not in Bensky or more information about substances that are in

> Bensky might be an approach.

[Guest guest]

I highly endorse the Jiao book. I wasn't thinking of the Jiao text as

a materia medica text in my discussion, I have always thought of it is

commentary by a great physician on the materia medica. What is great

about this book are the clinical pearls that Dr. Jiao provides, along

with dui yao and representative prescriptions. We plan to use this book

in several classes at PCOM. I know you had a role in the

translation, and you did a great job. I look forward to the next text

in the series.

 

 

 

On Monday, April 28, 2003, at 11:12 AM, Marnae Ergil wrote:

 

> I hope (think) that Jiao is at least in part an exception.

>

> Marnae

>

> At 11:03 AM 4/28/2003 -0700, you wrote:

>

> Marnae,

>     While I agree with you that having several texts on a particular

> subject has value, and often different information, several English

> language books 'recycle' the same information over and over again.  For

> example, while there is a vast amount of material in Chinese on materia

> medica unknown in English, there are three or four materia medicas that

> have come out since Bensky that have essentially the same information

> as the Bensky text.  There has been little or no improvment on what was

> originally done in the Bensky text, as far as the essential information

> goes.

>

>

> On Monday, April 28, 2003, at 10:06 AM, Marnae Ergil wrote:

>

> >  Yes, there may be enough basic point location texts (although CAM is

> > so bad that I never use it anymore if I can help it), but other than

> > that, there is still too much to be translated to say that any

> > particular area should not be addressed anymore because it is " done. "

>

>

>

[Guest guest]

, " James Ramholz " wrote:

In fact, just last night I found a simple and interesting formula

for cancer of the uterus composed only of yi yi ren (500) and san qi

(300)---interestingly the herb amounts are in the Fibonacci ratio.

>>>

 

 

Correction: this formula is for a uterine muscle tumor (zi gong ji

liu) and not necessarily for malignancy. Nonetheless, it is a simple

and elegant combination.

 

 

Jim Ramholz

[Guest guest]

The xing that Scheid refers to means " mould; model; type;

pattern " . It does not mean body, nor is it really a term that

means signs/symptoms. Rather it refers to the a type or a pattern -

again, bringing up the point that patterns and s/s were not really all

that differentiated until the modern era.

Marnae

 

At 04:37 PM 4/28/2003 +0000, you wrote:

--- In

, " Alon Marcus " <

alonmarcus@w...> wrote:

> based on

> zheng, not xing (or bing).

> >>>Todd are you referring to xing as in body? ie

signs?

> alon

I noted in the first post of this threads that scheid calls bian xing

differentiation

of types. you can look up types in his index to read the passages

about this

topic.

 

[Guest guest]

, " " wrote:

> If you'd like to see a study on five phases and acupuncture,

Stephen Birch has one published as an appendix to Yoshio

Manaka's " Chasing the Dragon's Tail. " >>>

 

 

Of particular interest to those who incorporate 5-Phases--or want to-

--is the last 100 pages of Paul Unschuld's new book, " Huang Di Nei

Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese

Medicial Text " (University of California Press, 2003). While not a

straight translation, he translates and discusses the history and

development of the theory of Five Periods and Six Qi (wu yun liu

qi), which was added to the Su Wen during the Tang era. Although it

is not a 'how to' explanation, it's the most extensive and detailed

study on the subject.

 

 

Jim Ramholz

[Guest guest]

, " " wrote:

> This is actually a paradox of Chinese medical education in the

West. On one hand, we basically advertise acupuncture as the 'main

modality' in the schools, profession and licensure, on the other

hand, we don't adequately cover channel theory in the schools

(except for Japanese acupuncture programs). However, the strong

showing of such texts as " The Channel Divergences " by Miki Shima and

Chip Chace does bode well for translating more jing-luo material. I

know lots of people who are excited by this book. I hope the sales

match the excitement. >>>

 

 

Z'ev:

 

Like you, I was excited about the Shima/Chace book---particularly

because the Dong Han (Korean) system of acupuncture extensively uses

divergent points and channels (but differently than the Shima

method). In fact, my teacher always used a sophisticated Korean

style of acupuncture as the primary treatment method for treating

everything, and herbs only as support. For a long time, the only

herbal formula my teacher gave out to patients was his teacher's

longevity prescription containing 33 herbs. Consequently, I follow

his example today but have expanded on the number of formulas

typically prescribed (about 20), even though I have a complete

pharmacy of concentrates.

 

Maybe schools and conference promoters could find those teachers and

practitioners which use these methods rather than the usual TCM

topics.

 

 

Jim Ramholz

[Guest guest]

Jim,

When I reflect on my practice, I almost always base my formulas on a

formula- because the formula embodies a concept. Or it's built on a dui yao

dynamic. For instance : bei mu gua lou san is built on the idea of phlegm

heat: the formula clears heat, resolves phlegm and moistens. The concept of

making the lungs cooler and wetter is the hallmark of the formula. Sort of

like guaifenisin; a mucolytic expectorant. But even if I don't use that

formula, I'm likely to include bei mu/gua lou in a phlegm heat formula

that' based on something else.

More than once in china a dr said: the formula is liu wei di huang wan and

proceeded to write a rx w/ ONLY Sheng di and then various other herbs. Sheng

di was the concept.

In my practice the only true departure that I have is my cancer formulas,

which mostly don't resemble anything classical.

 

The example that you gave of yi yi ren and san Qi is at the heart of all

cancer rx's: phlegm and blood stasis.

 

Cara

 

5000? Wow!

 

 

> Cara:

>

> Sometimes I wonder if it's even possible to come up with a random

> collection of herbs when writing for a particular condition that

> isn't based on a classical formula. I taught myself to read some

> Chinese in order to see what herbal formulas are available. One book

> on musculoskeletal disorders has over 5,000 formulas (yep, I counted

> them during a slow afternoon).

>

> Sometimes I go through it and other Chinese books just to see how

> many different ways there are to use a particular herb, for example,

> like san qi. In fact, just last night I found a simple and

> interesting formula for cancer of the uterus composed only of yi yi

> ren (500) and san qi (300)---interestingly the herb amounts are in

> the Fibonacci ratio.

>

>

> Jim Ramholz

>

>

>

>

>

>

>

>

>

>

>

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]

Marnae- you are right. I only got 3 1/2 hours sleep last night- so I was loopy. Thanks for the correction. It occurred to me at some point in the car today.

 

Cara -

 

I think you are talking about bian bing (identification of disease) and not bian zheng (identification of patterns). Bian zheng gives room for creativity, but bian bing merely names the presenting problem. Both are helpful and both are important concepts in CM, but it is bian bing that allows us to individualize our treatment .

 

marnae

 

At 07:07 AM 4/27/2003 -0400, you wrote:

It's not only that it hampers " creativity'. Bian Zheng can be confusing to

students if the patient presents w/ s and s that exist outside the assigned

patterns. It can be an impediment to logical reasoning. If we take it to be

the truth that all menieures is caused by Liv yang to phlegm fire,, but our

patient presents differently, then the risk is that the practitioner begins

to question his/her diagnostic skills. Bian zheng can fly in the face of

common sense.

In the class that I am plannning for TAI- one ongoing branch will be " Slow

Diagnisis " or " Deconstructed Diagnosis " or " how do we know what we know? " .

I want to work with this very issue to empower students to trust their

diagnostic skills- to avoid jumping to conclusions: to think clearly and

independently. To discriminate patterns without freaking out. To go to the

next logical step of choosing an appropriate formula- and then to add and

subtract appropriately. Based on the patient- not the preassigned patterns.

Bian Zheng should be seen as a jumping off point and nothing more.

Cara

>

> While bian xing can point pracitioners to the ballpark, I am one of

> those who finds it to be 'cold and sterile, with no room for

> creativity'.

>

>

> On Saturday, April 26, 2003, at 12:03 PM, wrote:

>

>> Has anyone read Volker Scheid's (various pages in chin. Med in

>> contemp. china) where he talks about type (xing) versus pattern

>> (zheng). According to his professor Zhu, typing tends to pidgeonhole

>> the patient as either this or that. the example he gives is for

>> meniere's disease being either liver yang rising, phlegm-turbidity,

>> etc.. He considers those types if the goal of the dr. is to match the

>> patient to one of the s/s complexes. He says this is prominent in

>> some circles in modern china, but also has been roundly criticized by

>> many since its inception. typing is a westernized approach designed

>> to link discrete diagnoses to patients as with western diseases. Zhu

>> argues that practicing according to bian zheng is actually a process

>> of identifying the multiple pathomechanisms that are involved in a

>> case and crafting a formula that takes account of all these facets.

>> that does not necessarily mean treating every facet simultaneously,

>> but it does require their consideration.

 

 

 

 

[Guest guest]

Marnae:

you keep having weird attachments to your emails. They re like a pop up ad.

BTW- I was 20 when I enrolled in NESA. I hadn’t been to college at all.

Cara

[Guest guest]

, " James Ramholz " <

jramholz> wrote:

One book

> on musculoskeletal disorders has over 5,000 formulas (yep, I counted

> them during a slow afternoon).

 

I saw a tally somewhere of over 95,000 recorded distinct formulae