Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 All, I have some pent-up posts in me following the synergies of thoughts stirred up by the conference, so please bear with me while I bend your 'ears' awhile. It seems to me that what is most needed to improve our system(s) of teaching Chinese herbal medicine in the West is not an especial revamping of herbal teaching, though that can of course always be improved, but a revamping of the way we teach basic theory. Back to basics, always back to basics. As the conference went on, I thought more and more how appropriate it was that the conference began with Sharon Weizenbaum's presentation on "Yin and yang in right relationship," as she termed it. She spoke of how yang needs to underpin yin in the body, just as fire under a cauldron of water is the right relationship to create steam. However, in the body, the lower body is yin and the upper body yang. We are not talking about reversing the body's natural relationships, but about yang within yin and yin within yang. Sharon drew a basic taiji symbol on the board, but what she left out was the two little opposite-colored dots that are always there in the ancient symbol. This is why I say our basic theory teaching is not wrong or too simple but only needs to go one step further to give students its basic subtlety. One small step for a teacher, one giant leap for studentkind. IMO, it is a shame that we had to go to what may be the most advanced CM conference ever held in America to hear the sort of thing Sharon was presenting. It's really basic theory and should be part of every student's first-year training. In my experience, I have to spend a lot of time un-teaching students the notions they get from their beginning textbooks, again, not that they're wrong but that they're not quite subtle or sophisticated enough for real life. And why should we settle for preparing students for anything short of real life? When I first read Bob Flaws' presentation on how it is that women in their 40s commonly present with kd yang xu hot flashes, I was jazzed, thinking that here was another piece of the puzzle that was missing. I see this sort of diagnostic picture all the time in clinic. Most of the time when I present this idea to students, they look at me as if I'm the enemy. Here we go again, they think, one person told us one thing and another is telling us something different. Actually I'm not telling them anything different, anything they shouldn't already be able to understand given their training, but they don't get it, don't want to get it, don't want to hear it, makes their heads hurt. I persevere with what I see as this level of sophistication in diagnostic training, but it's like watering the sidewalk. In clinic students fall back to their comfort zone, which is the ideas they got in the first semester, which just aren't quite good enough for diagnosing and treating real people. It's not a problem with the paradigm but with the teaching of it. It all goes back to yin and yang, but sophisticated yin and yang, not simplistic yin and yang. Solutions: 1) So we need to rewrite the textbooks. I vote for Sharon Weizenbaum to write the beginning Western CM textbook. Though the guys who've written the ones we're using are obviously excellent clinicians with sophisticated diagnostic understanding, their books haven't gotten that across, or at least I don't see it. Secondly, in the basic theory courses we need to take each of the concepts presented and immediately apply them to real patients, not theoretical patients, but real patients. Yes, start with simple cases, but real ones. And students need to start writing case presentations and theory papers from the get-go, and they need to be held to a college-level writing standard, not a junior-high standard. 2) I believe it is going to have to be the NCCAOM's responsibility to designate the translational criteria and terminology we must all agree to use and abide by. Somebody has to take the bull by the horns to cut down this "Tower of Babel," and they, or CCAOM, or somebody, has to act, and quickly, and we must all shut up and go along, like it or not. I have had my problems with "Wiseman-ese," as I call it, but after Craig Mitchell's presentation on the Ban Xia Xie Xin Tang clinical picture as being "fullness without repletion," I never appreciated having the word "repletion" in our vocabulary so much. As far as I'm concerned, we can use Wiseman's terminology and I'll go along with it. If we teach it to the students from the beginning, they won't have much of a problem with it, either. They just resist having to change horses mid-stream, or having to ride two or more different horses at the same time, and I don't blame them. I don't like it either. Even if as a field we just agreed on the terms for pulse diagnosis, we might revolutionize the medicine. Maybe someday when CM is taught through universities, Chinese medical language proficiency will be part of the pre-med training, and we can teach CM in Chinese! Don't laugh: in the old days medical doctors-to-be all had to study Latin and Greek. Of course that was in the days when all educated people studied Latin and Greek, but it is some kind of precedent. 3) A lot more time in raw herb clinic. We learn more from treating patients than from anything else, especially when it comes to raw herbs. 150 or 210 clinical hours is woefully inadequate, to me. More like 660 hours, or maybe 10,000. 4) Our schools need to spend a lot more time and effort preparing students for the business world, including support networks for graduates. This is not China. The only reason there are still chiropractors is because their schools pound business into their heads. Even so, a lot of chiropractors don't make it, but I bet most do. I don't know the exact figures about how many CM graduates are still practicing five years after graduation, but it is probably no more than 50% or so. Did you know that only about 20% of massage school graduates are still practicing two years after graduation? Do the schools tell students these things? Well, I do, but I'm rare, I think. Our mission as educators is not primarily to prepare our students to pass a national or state board test, but to prepare them to pass the test(s), succeed in practice, satisfactorily help the great majority of their patients, and help grow and nurture the profession so it is still around in another 2,500 years. Otherwise we are not doing our jobs. 5) A final herbal course on the Shang Han Lun and Wen Bing: at least a full semester, not a full 30 minutes. 6) As for herbal training in particular, there is a wonderful article at http://www.rmhiherbal.org/a/f.ahr2.educ.html by Roger Wicke, PhD and C. S. Cheung, M.D. called "Modest proposals for improving traditional Chinese herbology education." It is actually anything but modest, IMO. In summary: "The aspiring TCM herbalist who prefers a quality education rather than merely a collection of gold-embossed papers should seek out his or her own plan of action, choosing knowledgeable instructors in each field rather than committing oneself to confinement in any single education institution for several years. The following subjects are recommended in the order listed, with some variation depending upon one's goals and intended specialization. * Pre-TCM studies: human anatomy and physiology. * Core curriculum: TCM health assessment, materia medica, herbal formulation, comparative pathology (TCM and Western biomedical), environmental health issues. * Supervised clinical practice and independent practice with guidance from an experienced TCM herbalist; learning counseling techniques and communication skills, if one is rusty in that area. * Practical information necessary for functioning as an herbalist in modern society: small business skills, basic law and understanding of constitutional rights, political and ethical issues. * Ancillary fields of study, of which some knowledge is desirable, and in which one may choose to specialize: history and philosophy of TCM, Chinese language and TCM literature, phytochemistry and pharmacognosy, plant taxonomy; scientific research design, including multivariate statistics; sub-specialties of TCM, including women's problems, pediatrics, athletic training support, internal disorders, epidemiology, etc." There is much more of substance touched on in the article. I highly recommend it. If you have read this far, thank you for your time and consideration. Joseph Garner Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 Par, I really do not mean to belittle the textbooks. They are a serviceable introduction to the subject. They just don't go quite far enough in thoroughly elaborating the basics of yin, yang and their relationship to clinical reality for Westerners, in my opinion. The cultural references are just that, references from Chinese culture and history and their way of thinking and make sense in context. I agree that more Chinese cultural/historical background might help Western students decipher things better. I imagine when people steeped in Chinese tradition were first introduced to Western ways, they probably thought we were all weird. Apparently they did, because they called us barbarians. I also imagine it would be difficult to write a textbook for a pre-modern Chinese person about modern medicine that would adequately explain all the scientific sophistication underpinning the medical paradigm. In terms of Chinese medicine, Western society is out of the loop, so we are "pre-modern" to CM in that sense. Joseph Garner >>>Yeah! I remember sitting down with Chinese Acupuncture and Moxabustion the day after I went to school to buy my books and thinking, "holy crap, you've got to be kidding!" Unfortunately they weren't... It would also be nice to compile some encyclopedia style articles about various pertinent aspects of Chinese culture that often help to give places to put all of these new ideas we learn in school. Green dragons and white tigers abound, metaphors about irrigation and imperial court life run rife. PS, what in heck is a straightened [sp?] spleen? Is it like little spleen in korean theory? Par Scott<<< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 In a message dated 6/17/03 4:27:02 PM, acugrpaz writes: 2) I believe it is going to have to be the NCCAOM's responsibility to designate the translational criteria and terminology we must all agree to use and abide by. Somebody has to take the bull by the horns to cut down this "Tower of Babel," and they, or CCAOM, or somebody, has to act, and quickly, and we must all shut up and go along, like it or not. ACtually, this sort of thing would be better covered by the many times still-birthed "OM teachers association", which I would hope would be more strongly supported by those who stand the gain the most, but somehow always seem to fear the most, the CCAOM. It is not within NCCAOM's purview to do anything of this sort. It is their mission to be followers, not leaders. It is the AAOM and the CHA mission to be leaders of such things, as our profession matures. David Molony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 The term is pi yue, or straitened spleen. It occurs in the Shang Han Lun section on mai zi ren wan/Hemp Seed Pill. It describes a Chinese disease pattern where stomach heat penetrates the spleen, disturbing the spleen's function of separating clear and turbid. As a result, there is dry constipation concurrent with frequent, sometimes copious clear urination. On Tuesday, June 17, 2003, at 06:44 PM, Par Scott wrote: > what in heck is a straightened [sp?] spleen? Is it like little spleen > in korean theory? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 Yeah! I remember sitting down with Chinese Acupuncture and Moxabustion the day after I went to school to buy my books and thinking, "holy crap, you've got to be kidding!" Unfortunately they weren't... It would also be nice to compile some encyclopedia style articles about various pertinent aspects of Chinese culture that often help to give places to put all of these new ideas we learn in school. Green dragons and white tigers abound, metaphors about irrigation and imperial court life run rife. PS, what in heck is a straightened [sp?] spleen? Is it like little spleen in korean theory? Par Scott - acugrpaz Cc: cniemiec ; k8s ; KellyHedberg ; JoaJames Tuesday, June 17, 2003 1:20 PM Teaching All,I have some pent-up posts in me following the synergies of thoughts stirred up by the conference, so please bear with me while I bend your 'ears' awhile.It seems to me that what is most needed to improve our system(s) of teaching Chinese herbal medicine in the West is not an especial revamping of herbal teaching, though that can of course always be improved, but a revamping of the way we teach basic theory. Back to basics, always back to basics.As the conference went on, I thought more and more how appropriate it was that the conference began with Sharon Weizenbaum's presentation on "Yin and yang in right relationship," as she termed it. She spoke of how yang needs to underpin yin in the body, just as fire under a cauldron of water is the right relationship to create steam. However, in the body, the lower body is yin and the upper body yang. We are not talking about reversing the body's natural relationships, but about yang within yin and yin within yang. Sharon drew a basic taiji symbol on the board, but what she left out was the two little opposite-colored dots that are always there in the ancient symbol. This is why I say our basic theory teaching is not wrong or too simple but only needs to go one step further to give students its basic subtlety. One small step for a teacher, one giant leap for studentkind.IMO, it is a shame that we had to go to what may be the most advanced CM conference ever held in America to hear the sort of thing Sharon was presenting. It's really basic theory and should be part of every student's first-year training. In my experience, I have to spend a lot of time un-teaching students the notions they get from their beginning textbooks, again, not that they're wrong but that they're not quite subtle or sophisticated enough for real life. And why should we settle for preparing students for anything short of real life? When I first read Bob Flaws' presentation on how it is that women in their 40s commonly present with kd yang xu hot flashes, I was jazzed, thinking that here was another piece of the puzzle that was missing. I see this sort of diagnostic picture all the time in clinic. Most of the time when I present this idea to students, they look at me as if I'm the enemy. Here we go again, they think, one person told us one thing and another is telling us something different. Actually I'm not telling them anything different, anything they shouldn't already be able to understand given their training, but they don't get it, don't want to get it, don't want to hear it, makes their heads hurt. I persevere with what I see as this level of sophistication in diagnostic training, but it's like watering the sidewalk. In clinic students fall back to their comfort zone, which is the ideas they got in the first semester, which just aren't quite good enough for diagnosing and treating real people. It's not a problem with the paradigm but with the teaching of it. It all goes back to yin and yang, but sophisticated yin and yang, not simplistic yin and yang.Solutions:1) So we need to rewrite the textbooks. I vote for Sharon Weizenbaum to write the beginning Western CM textbook. Though the guys who've written the ones we're using are obviously excellent clinicians with sophisticated diagnostic understanding, their books haven't gotten that across, or at least I don't see it.Secondly, in the basic theory courses we need to take each of the concepts presented and immediately apply them to real patients, not theoretical patients, but real patients. Yes, start with simple cases, but real ones. And students need to start writing case presentations and theory papers from the get-go, and they need to be held to a college-level writing standard, not a junior-high standard.2) I believe it is going to have to be the NCCAOM's responsibility to designate the translational criteria and terminology we must all agree to use and abide by. Somebody has to take the bull by the horns to cut down this "Tower of Babel," and they, or CCAOM, or somebody, has to act, and quickly, and we must all shut up and go along, like it or not. I have had my problems with "Wiseman-ese," as I call it, but after Craig Mitchell's presentation on the Ban Xia Xie Xin Tang clinical picture as being "fullness without repletion," I never appreciated having the word "repletion" in our vocabulary so much. As far as I'm concerned, we can use Wiseman's terminology and I'll go along with it. If we teach it to the students from the beginning, they won't have much of a problem with it, either. They just resist having to change horses mid-stream, or having to ride two or more different horses at the same time, and I don't blame them. I don't like it either. Even if as a field we just agreed on the terms for pulse diagnosis, we might revolutionize the medicine.Maybe someday when CM is taught through universities, Chinese medical language proficiency will be part of the pre-med training, and we can teach CM in Chinese! Don't laugh: in the old days medical doctors-to-be all had to study Latin and Greek. Of course that was in the days when all educated people studied Latin and Greek, but it is some kind of precedent.3) A lot more time in raw herb clinic. We learn more from treating patients than from anything else, especially when it comes to raw herbs. 150 or 210 clinical hours is woefully inadequate, to me. More like 660 hours, or maybe 10,000.4) Our schools need to spend a lot more time and effort preparing students for the business world, including support networks for graduates. This is not China. The only reason there are still chiropractors is because their schools pound business into their heads. Even so, a lot of chiropractors don't make it, but I bet most do. I don't know the exact figures about how many CM graduates are still practicing five years after graduation, but it is probably no more than 50% or so. Did you know that only about 20% of massage school graduates are still practicing two years after graduation? Do the schools tell students these things? Well, I do, but I'm rare, I think. Our mission as educators is not primarily to prepare our students to pass a national or state board test, but to prepare them to pass the test(s), succeed in practice, satisfactorily help the great majority of their patients, and help grow and nurture the profession so it is still around in another 2,500 years. Otherwise we are not doing our jobs.5) A final herbal course on the Shang Han Lun and Wen Bing: at least a full semester, not a full 30 minutes.6) As for herbal training in particular, there is a wonderful article at http://www.rmhiherbal.org/a/f.ahr2.educ.html by Roger Wicke, PhD and C. S. Cheung, M.D. called "Modest proposals for improving traditional Chinese herbology education." It is actually anything but modest, IMO. In summary:"The aspiring TCM herbalist who prefers a quality education rather than merely a collection of gold-embossed papers should seek out his or her own plan of action, choosing knowledgeable instructors in each field rather than committing oneself to confinement in any single education institution for several years. The following subjects are recommended in the order listed, with some variation depending upon one's goals and intended specialization. * Pre-TCM studies: human anatomy and physiology. * Core curriculum: TCM health assessment, materia medica, herbal formulation, comparative pathology (TCM and Western biomedical), environmental health issues. * Supervised clinical practice and independent practice with guidance from an experienced TCM herbalist; learning counseling techniques and communication skills, if one is rusty in that area. * Practical information necessary for functioning as an herbalist in modern society: small business skills, basic law and understanding of constitutional rights, political and ethical issues. * Ancillary fields of study, of which some knowledge is desirable, and in which one may choose to specialize: history and philosophy of TCM, Chinese language and TCM literature, phytochemistry and pharmacognosy, plant taxonomy; scientific research design, including multivariate statistics; sub-specialties of TCM, including women's problems, pediatrics, athletic training support, internal disorders, epidemiology, etc."There is much more of substance touched on in the article. I highly recommend it. If you have read this far, thank you for your time and consideration.Joseph Garner 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 Joseph All of your points are well-taken, but, I believe some schools - at least the one I work for are already doing it. We teach almost exactly what Sharon taught in our fundamental theory course (1st semester). I don't think we need to re-write thetextbooks - I think the teachers need to teach more than what is in the book. Books should not be the only source of knowledge for any class. They should be a basis and then the teacher should go further. We use only Wiseman's terminology and we require a semester of Chinese during the program so that students can understand the usefulness of learning Chinese and of using Wiseman's terminology Students begin writing in their Fundamental Theory course and continue until the end of the program. In clinic there is no separation of acu hours from herb hours - every student is in clinic for about 900 hours and all of that is both. A good practice management course is essential. Aren't most schools teaching SHL and WB now? We have a full semester on each. We have a course in History, Pharm/Tox and several of the other " ancillary " topics you mention, giving the student an introduction and an opportunity to make informed decisions. I think all schools should strive to reach these and more goals - but teachers need training. Just because someone is a great clinician, this does not make them a great teacher. Teaching is more than just standing up and reading what is in the book and I have seen some great clinicians who were really bad teachers - even in clinic. I have said this before - in trad. academia grad students learn to teach - that is a part of their job as graduate students - we are not teaching our students to teach, and I do not believe that our DAOM programs are going to do any better job at that than the current master's program does. IN addition to needing to train teachers, we need administrators (Dean's, President's etc) with a committment to education and an understanding of curriculum design. Too many school are opened either by people who think they are going make money off of it or who think that because they are good clinicians they will make good educators. Finally, the Accreditation Commission needs to get stronger and be more willing to put schools who have had the same problems for years on probation or even pull their accreditation - even if the school has been open for years and has been accredited and has a good reputation. If ACAOM is willing to stand behind its standards, then schools will live up to and beyond their standards. Marnae At 04:20 PM 6/17/2003 -0400, you wrote: All, I have some pent-up posts in me following the synergies of thoughts stirred up by the conference, so please bear with me while I bend your 'ears' awhile. It seems to me that what is most needed to improve our system(s) of teaching Chinese herbal medicine in the West is not an especial revamping of herbal teaching, though that can of course always be improved, but a revamping of the way we teach basic theory. Back to basics, always back to basics. As the conference went on, I thought more and more how appropriate it was that the conference began with Sharon Weizenbaum's presentation on " Yin and yang in right relationship, " as she termed it. She spoke of how yang needs to underpin yin in the body, just as fire under a cauldron of water is the right relationship to create steam. However, in the body, the lower body is yin and the upper body yang. We are not talking about reversing the body's natural relationships, but about yang within yin and yin within yang. Sharon drew a basic taiji symbol on the board, but what she left out was the two little opposite-colored dots that are always there in the ancient symbol. This is why I say our basic theory teaching is not wrong or too simple but only needs to go one step further to give students its basic subtlety. One small step for a teacher, one giant leap for studentkind. IMO, it is a shame that we had to go to what may be the most advanced CM conference ever held in America to hear the sort of thing Sharon was presenting. It's really basic theory and should be part of every student's first-year training. In my experience, I have to spend a lot of time un-teaching students the notions they get from their beginning textbooks, again, not that they're wrong but that they're not quite subtle or sophisticated enough for real life. And why should we settle for preparing students for anything short of real life? When I first read Bob Flaws' presentation on how it is that women in their 40s commonly present with kd yang xu hot flashes, I was jazzed, thinking that here was another piece of the puzzle that was missing. I see this sort of diagnostic picture all the time in clinic. Most of the time when I present this idea to students, they look at me as if I'm the enemy. Here we go again, they think, one person told us one thing and another is telling us something different. Actually I'm not telling them anything different, anything they shouldn't already be able to understand given their training, but they don't get it, don't want to get it, don't want to hear it, makes their heads hurt. I persevere with what I see as this level of sophistication in diagnostic training, but it's like watering the sidewalk. In clinic students fall back to their comfort zone, which is the ideas they got in the first semester, which just aren't quite good enough for diagnosing and treating real people. It's not a problem with the paradigm but with the teaching of it. It all goes back to yin and yang, but sophisticated yin and yang, not simplistic yin and yang. Solutions: 1) So we need to rewrite the textbooks. I vote for Sharon Weizenbaum to write the beginning Western CM textbook. Though the guys who've written the ones we're using are obviously excellent clinicians with sophisticated diagnostic understanding, their books haven't gotten that across, or at least I don't see it. Secondly, in the basic theory courses we need to take each of the concepts presented and immediately apply them to real patients, not theoretical patients, but real patients. Yes, start with simple cases, but real ones. And students need to start writing case presentations and theory papers from the get-go, and they need to be held to a college-level writing standard, not a junior-high standard. 2) I believe it is going to have to be the NCCAOM's responsibility to designate the translational criteria and terminology we must all agree to use and abide by. Somebody has to take the bull by the horns to cut down this " Tower of Babel, " and they, or CCAOM, or somebody, has to act, and quickly, and we must all shut up and go along, like it or not. I have had my problems with " Wiseman-ese, " as I call it, but after Craig Mitchell's presentation on the Ban Xia Xie Xin Tang clinical picture as being " fullness without repletion, " I never appreciated having the word " repletion " in our vocabulary so much. As far as I'm concerned, we can use Wiseman's terminology and I'll go along with it. If we teach it to the students from the beginning, they won't have much of a problem with it, either. They just resist having to change horses mid-stream, or having to ride two or more different horses at the same time, and I don't blame them. I don't like it either. Even if as a field we just agreed on the terms for pulse diagnosis, we might revolutionize the medicine. Maybe someday when CM is taught through universities, Chinese medical language proficiency will be part of the pre-med training, and we can teach CM in Chinese! Don't laugh: in the old days medical doctors-to-be all had to study Latin and Greek. Of course that was in the days when all educated people studied Latin and Greek, but it is some kind of precedent. 3) A lot more time in raw herb clinic. We learn more from treating patients than from anything else, especially when it comes to raw herbs. 150 or 210 clinical hours is woefully inadequate, to me. More like 660 hours, or maybe 10,000. 4) Our schools need to spend a lot more time and effort preparing students for the business world, including support networks for graduates. This is not China. The only reason there are still chiropractors is because their schools pound business into their heads. Even so, a lot of chiropractors don't make it, but I bet most do. I don't know the exact figures about how many CM graduates are still practicing five years after graduation, but it is probably no more than 50% or so. Did you know that only about 20% of massage school graduates are still practicing two years after graduation? Do the schools tell students these things? Well, I do, but I'm rare, I think. Our mission as educators is not primarily to prepare our students to pass a national or state board test, but to prepare them to pass the test(s), succeed in practice, satisfactorily help the great majority of their patients, and help grow and nurture the profession so it is still around in another 2,500 years. Otherwise we are not doing our jobs. 5) A final herbal course on the Shang Han Lun and Wen Bing: at least a full semester, not a full 30 minutes. 6) As for herbal training in particular, there is a wonderful article at http://www.rmhiherbal.org/a/f.ahr2.educ.html by Roger Wicke, PhD and C. S. Cheung, M.D. called " Modest proposals for improving traditional Chinese herbology education. " It is actually anything but modest, IMO. In summary: " The aspiring TCM herbalist who prefers a quality education rather than merely a collection of gold-embossed papers should seek out his or her own plan of action, choosing knowledgeable instructors in each field rather than committing oneself to confinement in any single education institution for several years. The following subjects are recommended in the order listed, with some variation depending upon one's goals and intended specialization. * Pre-TCM studies: human anatomy and physiology. * Core curriculum: TCM health assessment, materia medica, herbal formulation, comparative pathology (TCM and Western biomedical), environmental health issues. * Supervised clinical practice and independent practice with guidance from an experienced TCM herbalist; learning counseling techniques and communication skills, if one is rusty in that area. * Practical information necessary for functioning as an herbalist in modern society: small business skills, basic law and understanding of constitutional rights, political and ethical issues. * Ancillary fields of study, of which some knowledge is desirable, and in which one may choose to specialize: history and philosophy of TCM, Chinese language and TCM literature, phytochemistry and pharmacognosy, plant taxonomy; scientific research design, including multivariate statistics; sub-specialties of TCM, including women's problems, pediatrics, athletic training support, internal disorders, epidemiology, etc. " There is much more of substance touched on in the article. I highly recommend it. If you have read this far, thank you for your time and consideration. Joseph Garner Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 We teach almost exactly what Sharon taught in our fundamental theory course (1st semester). I don't think we need to re-write thetextbooks >>>And did 20 years ago at ACTCM alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 17, 2003 Report Share Posted June 17, 2003 This semester at PCOM (herbal prescriptions classes) , I've taken on giving out and requiring terminology (with pinyin, chinese and english translation) for each category of herbal prescriptions. I teach that terminology and conceptual knowledge is the first link in a logical chain to patterns and prescriptions. On Tuesday, June 17, 2003, at 11:04 PM, Par Scott wrote: > In some ways this draws us back into the language debate, which I'm > sure nobody wants to get started again. The longer I spend grading > papers for this herb class the closer I am to buying everyone in the > class a Wiseman dictionary and forcing them to read it at katana > point. Basic terminology seems to be very muddled and we have a tool, > which admittedly is in need of some refinement, that can address the > problem. I agree we are obliged to use it. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2003 Report Share Posted June 18, 2003 Joseph, Why not criticize them? Sorry, I guess I don't mean to knock them entirely (except for CAM), but I found it very frustrating to find so little information available. For instance, many ideas about yin yang theory become clearer if you study ba gua trigrams. I suspect one could write something that would run four or five pages in a textbook that could present the basic theory of yin and yang interaction as expressed by trigrams which express the six basic interactions of heaven and earth, but you have to go a long way from any basic TCM text to find good information on this. The structure of Chinese medical thought is to some extent culturally contextual, especially in terminology, but it is also based on a variety of theories like yin/yang-ba gua, five element, etc. It seems like a cop out to say there is no way to introduce that information if it would greatly enhance the way students learn and understand. In a way these would reflect physics and chemistry in terms of western medicine, in that they reflect the roots of TCM physiology. If you really want to understand western medicine, it helps to have a very good handle on chemistry etc. In fact, they don't let you study it until you have gotten a basic grasp of it. If you really want to understand Chinese medicine, it would seem to obligate one to study these other systems to a slightly greater extent than learning the grain that represents water element. I don't think you could make a full course out of TCM herbal five phase/yin yang pharmacokinetics, but it could certainly be a very interesting couple of chapters in a basic textbook. There seems to be a gap between basic level texts and most of the rest of the literature. I was surprised there was no second level theory class when I was in school. Students in the acupuncture track were woefully unprepared to diagnose in terms of TCM, and herb students had to struggle, and frequently totally fail to understand what was going on in terms of single herbs and formulas (by the time internal medicine rolled around they either quit or got with the program). I have spent some time thinking about how to structure a TCM textbook; one could have sections in each chapter which present successive layers of theory: Basic explanations of terminology, basic ideas of pathology/physiology, explanations of treatment principles related to the physiology/pathology mentioned, more elaborate and interconnected physiological theory, points and herbs that relate to the functions mentioned with discussions of the qualities that make them function the way they do. Steven Clavey's excellent book on body fluids is something like what I'm thinking about, but you would sort of have to cram it sideways into Giovanni's fundamentals and clinical books. First year students read sections coded by color, second year read those to refresh the idea and then go deeper, herb students read as it pertains to herbs, etc. By creating depth in the book you remove what ends up being endless restatements of basic theory which seem to occupy about 50-75% of professional/non-basic level texts. Students could use the same book, and cover the same information at deeper levels each term. It would also insure that there was a theoretical continuity from basic to advanced information which is really lacking right now. This could be done as a series, with a point manual, materia medica and formulary which are keyed to the text and specialty skills texts could be added as produced. It is a frequently expressed opinion that the study of TCM is iterations of the same information which gathers more depth at each pass, why not write the book that way? Additionally, I haven't seen to many medical textbooks written by one person. While I'm not sure we could find a specialist in every aspect of every thing we'd have to cover, it makes sense to get people who have plumbed some depths to bring back what they consider the meat of what is there. I realize this whole idea is somewhat pie in the sky, but I think that it would work for the job. Best of all, we could get Churchill Livingstone to bind it so it would fall apart in a month! In some ways this draws us back into the language debate, which I'm sure nobody wants to get started again. The longer I spend grading papers for this herb class the closer I am to buying everyone in the class a Wiseman dictionary and forcing them to read it at katana point. Basic terminology seems to be very muddled and we have a tool, which admittedly is in need of some refinement, that can address the problem. I agree we are obliged to use it. Sorry if I sound like a cranky crank, my sciatica is acting up... grrr Peace in all seasons, Par - acugrpaz Tuesday, June 17, 2003 6:19 PM Re: Teaching Par,I really do not mean to belittle the textbooks. They are a serviceable introduction to the subject. They just don't go quite far enough in thoroughly elaborating the basics of yin, yang and their relationship to clinical reality for Westerners, in my opinion. The cultural references are just that, references from Chinese culture and history and their way of thinking and make sense in context. I agree that more Chinese cultural/historical background might help Western students decipher things better. I imagine when people steeped in Chinese tradition were first introduced to Western ways, they probably thought we were all weird. Apparently they did, because they called us barbarians. I also imagine it would be difficult to write a textbook for a pre-modern Chinese person about modern medicine that would adequately explain all the scientific sophistication underpinning the medical paradigm. In terms of Chinese medicine, Western society is out of the loop, so we are "pre-modern" to CM in that sense.Joseph Garner>>>Yeah!I remember sitting down with Chinese Acupuncture and Moxabustion the day after I went to school to buy my books and thinking, "holy crap, you've got to be kidding!" Unfortunately they weren't... It would also be nice to compile some encyclopedia style articles about various pertinent aspects of Chinese culture that often help to give places to put all of these new ideas we learn in school. Green dragons and white tigers abound, metaphors about irrigation and imperial court life run rife. PS, what in heck is a straightened [sp?] spleen? Is it like little spleen in korean theory? Par Scott<<< 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2003 Report Share Posted June 18, 2003 , acuman1@a... wrote: > ACtually, this sort of thing would be better covered by the many times > still-birthed " OM teachers association " , which I would hope would be more strongly > supported by those who stand the gain the most, but somehow always seem to fear > the most, the CCAOM. > It is not within NCCAOM's purview to do anything of this sort. It is their > mission to be followers, not leaders. It is the AAOM and the CHA mission to be > leaders of such things, as our profession matures. We had a teacher's meeting at CHA one afternoon during lunch. I learned some interesting things. the meeting was minuted and the minutes will be posted in a few days. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2003 Report Share Posted June 18, 2003 >>>Joseph All of your points are well-taken, but, I believe some schools - at least the one I work for are already doing it. ... Marnae<<< Marnae, First of all, thank you for your presentation at the conference on men's diseases. I believe it is an importanf field for American TCM to be more expert at. Secondly, I am glad to hear that your school, at least, is presenting TCM in a way that should have been done all along. Having been intimate with two schools and having interacted with students and teachers from all over, it seems to me that for the most part we all got the same basic education with the same basic assets and flaws. It behooves the field to emulate your school's manner of doing things, which will save students a lot of stumbling around in the dark and create a much higher standard. Bravo! Joseph Garner Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2003 Report Share Posted June 19, 2003 >>>...Again, however, in some ways the teacher is even more important than the text. It is a teacher's job to elucidate and expand upon what is in the book. When I teach Fundamental Theory, we spend time talking about what is in the book but then we go further, we look at the type of thing that Sharon talked about ("yin yang in right relationship"), we look at the ba gua, we look at history. It is a teacher's job to go further and offer his/her students more than is in the book - Certainly having a text to support this would be great, but because the text doesn't exist yet doesn't mean we shouldn't be doing it. Marnae<<< Marnae, I could not agree more. But. Considering that different teachers come from such different backgrounds in understanding and experience despite the relatively uniform TCM training, practically speaking, it seems to me from hard experience that without texts of a higher standard we cannot guarantee that all our classes will consistently reach that standard. For years I have expanded upon the textbooks to the best of my understanding. For years I have found myself often teaching something somewhat different than others teach. I do not wish to confuse or confound students. I do not wish to fight with or appear to contradict other teachers. I want something the practice as a whole can more-or-less agree on as a higher standard of textbooks. I do not wish to snuff out the differences in approach; I don't think we ever could even if we wanted to. I think the beginning of this should be focused on where the rubber hits the road--clinic. What Sharon spoke of as pathognomic signs/symptoms, i.e., if a patient has such-and-such sign or symptom, then they must have this and only this pattern: this we must as a paradigm agree upon, at least for the most part. Granted there aren't too many of these pathognomic signs/symptoms, but they are crucial to proper diagnosis. We must focus on holding our students and ourselves to knowing what we know from intakes and only knowing what we know, and figuring out the seemingly contradictory signs/symptoms from that, if possible. Not letting students get away with, "They have fatigue, so they must have spleen qi xu." So the first textbook may have to be a list and explanation of pathognomics. Sharon? perhaps this could be a subject for the next conference. Or perhaps we should just spend the whole conference studying the SHL/Wen Bing from different people's perspectives. Joseph Garner Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2003 Report Share Posted June 19, 2003 Par - I dont think that your book idea is a pipe dream. It is something that I and others have also been thinking about for a while. Almost none of the books that we have available are really textbooks - Maclean & Lyttleton come the closest - and, I agree that it should not be written by one person - chapters by individuals who can really talk about a particular topic. and, yes, as a series rather than one book - one book is too big and too much. However, an integrated textbook series would be great. Again, however, in some ways the teacher is even more important than the text. It is a teacher's job to elucidate and expand upon what is in the book. When I teach Fundamental Theory, we spend time talking about what is in the book but then we go further, we look at the type of thing that Sharon talked about ( " yin yang in right relationship " ), we look at the ba gua, we look at history. It is a teacher's job to go further and offer his/her students more than is in the book - Certainly having a text to support this would be great, but because the text doesn't exist yet doesn't mean we shouldn't be doing it. Marnae At 11:04 PM 6/17/2003 -0700, you wrote: Joseph, Why not criticize them? Sorry, I guess I don't mean to knock them entirely (except for CAM), but I found it very frustrating to find so little information available. For instance, many ideas about yin yang theory become clearer if you study ba gua trigrams. I suspect one could write something that would run four or five pages in a textbook that could present the basic theory of yin and yang interaction as expressed by trigrams which express the six basic interactions of heaven and earth, but you have to go a long way from any basic TCM text to find good information on this. The structure of Chinese medical thought is to some extent culturally contextual, especially in terminology, but it is also based on a variety of theories like yin/yang-ba gua, five element, etc. It seems like a cop out to say there is no way to introduce that information if it would greatly enhance the way students learn and understand. In a way these would reflect physics and chemistry in terms of western medicine, in that they reflect the roots of TCM physiology. If you really want to understand western medicine, it helps to have a very good handle on chemistry etc. In fact, they don't let you study it until you have gotten a basic grasp of it. If you really want to understand Chinese medicine, it would seem to obligate one to study these other systems to a slightly greater extent than learning the grain that represents water element. I don't think you could make a full course out of TCM herbal five phase/yin yang pharmacokinetics, but it could certainly be a very interesting couple of chapters in a basic textbook. There seems to be a gap between basic level texts and most of the rest of the literature. I was surprised there was no second level theory class when I was in school. Students in the acupuncture track were woefully unprepared to diagnose in terms of TCM, and herb students had to struggle, and frequently totally fail to understand what was going on in terms of single herbs and formulas (by the time internal medicine rolled around they either quit or got with the program). I have spent some time thinking about how to structure a TCM textbook; one could have sections in each chapter which present successive layers of theory: Basic explanations of terminology, basic ideas of pathology/physiology, explanations of treatment principles related to the physiology/pathology mentioned, more elaborate and interconnected physiological theory, points and herbs that relate to the functions mentioned with discussions of the qualities that make them function the way they do. Steven Clavey's excellent book on body fluids is something like what I'm thinking about, but you would sort of have to cram it sideways into Giovanni's fundamentals and clinical books. First year students read sections coded by color, second year read those to refresh the idea and then go deeper, herb students read as it pertains to herbs, etc. By creating depth in the book you remove what ends up being endless restatements of basic theory which seem to occupy about 50-75% of professional/non-basic level texts. Students could use the same book, and cover the same information at deeper levels each term. It would also insure that there was a theoretical continuity from basic to advanced information which is really lacking right now. This could be done as a series, with a point manual, materia medica and formulary which are keyed to the text and specialty skills texts could be added as produced. It is a frequently expressed opinion that the study of TCM is iterations of the same information which gathers more depth at each pass, why not write the book that way? Additionally, I haven't seen to many medical textbooks written by one person. While I'm not sure we could find a specialist in every aspect of every thing we'd have to cover, it makes sense to get people who have plumbed some depths to bring back what they consider the meat of what is there. I realize this whole idea is somewhat pie in the sky, but I think that it would work for the job. Best of all, we could get Churchill Livingstone to bind it so it would fall apart in a month! In some ways this draws us back into the language debate, which I'm sure nobody wants to get started again. The longer I spend grading papers for this herb class the closer I am to buying everyone in the class a Wiseman dictionary and forcing them to read it at katana point. Basic terminology seems to be very muddled and we have a tool, which admittedly is in need of some refinement, that can address the problem. I agree we are obliged to use it. Sorry if I sound like a cranky crank, my sciatica is acting up... grrr Peace in all seasons, Par - acugrpaz Tuesday, June 17, 2003 6:19 PM Re: Teaching Par, I really do not mean to belittle the textbooks. They are a serviceable introduction to the subject. They just don't go quite far enough in thoroughly elaborating the basics of yin, yang and their relationship to clinical reality for Westerners, in my opinion. The cultural references are just that, references from Chinese culture and history and their way of thinking and make sense in context. I agree that more Chinese cultural/historical background might help Western students decipher things better. I imagine when people steeped in Chinese tradition were first introduced to Western ways, they probably thought we were all weird. Apparently they did, because they called us barbarians. I also imagine it would be difficult to write a textbook for a pre-modern Chinese person about modern medicine that would adequately explain all the scientific sophistication underpinning the medical paradigm. In terms of Chinese medicine, Western society is out of the loop, so we are " pre-modern " to CM in that sense. Joseph Garner >>>Yeah! I remember sitting down with Chinese Acupuncture and Moxabustion the day after I went to school to buy my books and thinking, " holy crap, you've got to be kidding! " Unfortunately they weren't... It would also be nice to compile some encyclopedia style articles about various pertinent aspects of Chinese culture that often help to give places to put all of these new ideas we learn in school. Green dragons and white tigers abound, metaphors about irrigation and imperial court life run rife. PS, what in heck is a straightened [sp?] spleen? Is it like little spleen in korean theory? Par Scott<<< 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2003 Report Share Posted June 19, 2003 At 3:17 PM -0400 6/19/03, acugrpaz wrote: Considering that different teachers come from such different backgrounds in understanding and experience despite the relatively uniform TCM training, practically speaking, it seems to me from hard experience that without texts of a higher standard we cannot guarantee that all our classes will consistently reach that standard. For years I have expanded upon the textbooks to the best of my understanding. For years I have found myself often teaching something somewhat different than others teach. I do not wish to confuse or confound students. I do not wish to fight with or appear to contradict other teachers. -- Joseph, Of course, in teaching beyond the textbook, you are bound to teach something different from other teachers. This problem will remain even if the textbooks are improved, and so will the problem of student confusion. The latter is part of being a student, and I see one part of my job as a teacher to expose and rectify the confusions. I think we have to accept that there will always be student confusion, and as Leon Hammer likes to say, our job is to not confuse the confusion. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2003 Report Share Posted June 20, 2003 >>>Joseph, Of course, in teaching beyond the textbook, you are bound to teach something different from other teachers. This problem will remain even if the textbooks are improved, and so will the problem of student confusion. The latter is part of being a student, and I see one part of my job as a teacher to expose and rectify the confusions. I think we have to accept that there will always be student confusion, and as Leon Hammer likes to say, our job is to not confuse the confusion. Rory<<< Rory, Naturally there will always be student confusion, and this is not necessarily a bad thing. What I wish to avoid, as much as possible, is teacher confusion, unnecessary confusion foisted on students whose heads are already swimming with a new paradigm they thought would be far easier to understand than it is. We will always need to expand on and inform what is in the textbooks, but better, clearer textbooks with more background in Chinese classics and culture, and, I think, a beginning section clearly delineating the differences, as much as they can be clearly delineated, between Eastern and Western thought paradigms, would go a long way to ease students into this new world. Throwing someone into the deep end of the pool may produce someone who knows how to survive in the water, but it does not necessarily produce a good swimmer. Joseph Garner Quote Link to comment Share on other sites More sharing options...
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