Guest guest Posted September 29, 2003 Report Share Posted September 29, 2003 All, Regarding the " Examples " thread I started: 1. The thread was a response to requests for specifics regarding Dr. Unschuld's question as to whether we were going to continue to confirm the current inaccurate understandings (in this case that physician-modified formulas have been a constant one-right-way). In that regard, notions that customized formulas are superior, " work for me, " are used in China, can be successfully taught, and so forth are not really to the point. The issue is whether or not we are going to absorb better information into our self- definition or whether we are going to defend a status quo based on an earlier less-informed understanding. 2. While it is natural that clinicians on a practitioner discussion list would assess this issue based on what they do in clinic, or teach, or see as more effective in their own experience, the issue is much broader. Are going to create a standard of the notion that physician-modification is superior and cement it into place through curriculum and licensure? Will we permit a more competitive intellectual environment? In other words, are we to ignore the heterogenaity of CM in favor of a single approach that is based on an inaccurate portrayal of history? 3. People have a right to choose for themselves based on their own assessments. They cannot do this if they don't have the information and if the alternatives have been ruled-out. Bob bob Paradigm Publications www.paradigm-pubs.com P.O. Box 1037 Robert L. Felt 202 Bendix Drive 505 758 7758 Taos, New Mexico 87571 --- [This E-mail scanned for viruses by Declude Virus] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2003 Report Share Posted September 29, 2003 However, I am not sure that this is what is creating the misrepresentation of Chinese medicine in this country. I think it also has to do with the american fantasy of China (both historical and present) and that we act to exploit that fantasy in our marketing and promotion of CM. >>>I totally agree Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2003 Report Share Posted September 29, 2003 Ken - While I didn't say it, this is indeed important - as I always tell my students, it is essential to know about a source before citing it. And, unfortunately, the weight of time and sales that Kaptchuk, Bensky, Korngold & beinfeld, etc have to their books makes it hard to argue that they are sources that still need to be placed in the context of who the authors are and how they are trained. (and you know I agree about the translation/terminology issue so I don't need to belabor that here). >I've talked with several of the folks >whom you mention in your post, Marnae, >and am now arranging for an informal >get together in San Diego in November >during the PCOM symposium. > >Will you be there? > >I want to take the opportunity of having >many folks together in the same place >at the same time to talk all of this >over and figure out what to do. Not sure yet if I will be in SD. Definitely can't make it for the whole symposium but thinking about going for Unschuld's two days. Even if I am not there, I would like to be a part of this discussion - any chance of an East Coast get together? Marnae >Ken > > > > >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 September 30, 2003 Report Share Posted September 30, 2003 Dear Colleagues, As for any proposal that physicians restrict themselves to using pre-ordained, unmodified herbal formulas from the 'tradition', I'd like to point out that this begs many questions, one of which is, at what point in oriental medical history should this limitation have been applied? Quite clearly, had it been applied at the outset, there would be no subsequent tradition to draw upon. Anyone who suggests that physicians should not modify prescriptions as a principle to be applied to others, rather than as a personal working method, should explain how they know that an absolute and final knowledge of medical treatments and conditions has been achieved, and divulge to others what that absolute knowledge is, and the sacred texts that consecrate that knowledge for eternity. Wainwright - Robert L. Felt Monday, September 29, 2003 8:11 PM Examples All, Regarding the " Examples " thread I started: 1. The thread was a response to requests for specifics regarding Dr. Unschuld's question as to whether we were going to continue to confirm the current inaccurate understandings (in this case that physician-modified formulas have been a constant one-right-way). In that regard, notions that customized formulas are superior, " work for me, " are used in China, can be successfully taught, and so forth are not really to the point. The issue is whether or not we are going to absorb better information into our self- definition or whether we are going to defend a status quo based on an earlier less-informed understanding. 2. While it is natural that clinicians on a practitioner discussion list would assess this issue based on what they do in clinic, or teach, or see as more effective in their own experience, the issue is much broader. Are going to create a standard of the notion that physician-modification is superior and cement it into place through curriculum and licensure? Will we permit a more competitive intellectual environment? In other words, are we to ignore the heterogenaity of CM in favor of a single approach that is based on an inaccurate portrayal of history? 3. People have a right to choose for themselves based on their own assessments. They cannot do this if they don't have the information and if the alternatives have been ruled-out. Bob bob Paradigm Publications www.paradigm-pubs.com P.O. Box 1037 Robert L. Felt 202 Bendix Drive 505 758 7758 Taos, New Mexico 87571 --- [This E-mail scanned for viruses by Declude Virus] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 2003 Report Share Posted September 30, 2003 At 1:11 PM -0600 9/29/03, Robert L. Felt wrote: >Are going to create a standard of the notion that >physician-modification is superior and cement it into place through >curriculum and licensure? Will we permit a more competitive >intellectual environment? In other words, are we to >ignore the heterogenaity of CM in favor of a single approach that is based >on an inaccurate portrayal of history? -- Bob, Who is not permitting, or who is prohibiting, a more competitive intellectual environment? Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 2003 Report Share Posted September 30, 2003 At 1:21 PM +0000 9/29/03, kenrose2008 wrote: >After all, if you tell someone what they have to >study, what they have to do to get a license >to practice, what they can do in their practice, >how they can get paid by third party payers, >along with all the other things that the laws >and regulations exist to define and regulate, >then you have, indeed, defined and regulated >the subject, the study, the practice, etc. to >a very great extent. > >No? -- Not exactly, no. For example, ACAOM requires that history of acupuncture and OM is taught, and that it should include different traditions in both within and outside China. So, students should be aware early in their education that the umbrella of Chinese medicine is broad, and that what they are learning in their classes may fall only within a partial definition of it's scope. There are schools that offer training in systems that don't come under the TCM umbrella, for example TAI, yet graduates of such programs get licensed. Once licensed they are free to practice according to their training. In California they are compelled to study herbs for the licensing exams, but so far as acupuncture is concerned, and in most states, I believe they are ready to go. At least three schools I'm aware of, and I'm sure there are several more, offer serious study in Japanese acupuncture styles. Those trained in these systems have no problem adopting these styles in practice if they wish, and there is ready availability of further education, both in terms of books, journals and classes. So no, I don't think the subject or practice of Chinese medicine is restricted to a limited definition by the licensing regulations. In fact, the regulations I'm aware of are careful not to place restrictions on styles of practice; so much so that some feel free to interpret them to include practices that are clearly not Chinese medicine and never were, such as homeopathy. You seem to be of the opinion that there is a problem with our regulations, and there may well be. Can you say how you'd like to see them changed? Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 2003 Report Share Posted September 30, 2003 so much so that some feel free to interpret them to include practices that are clearly not Chinese medicine and never were, such as homeopathy. >>>>>That is why i like to think of any practice that has its basis in creating " balance " as complementary or in my mind identical to CM. To me if one seeks to create balance between Yin and Yang via ventral and dorsal channels or restore balance via assessment of joint functions and restore balanced flexion extension function (for example via osteopathic techniques) is basically the same. The language is a little different, reflects modern anatomy etc, but still similar in " principles " . Homeopathy however goes by different principles, but does has historical integrated use by OM practitioners in the west Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 2, 2003 Report Share Posted October 2, 2003 , " kenrose2008 " <kenrose2008> wrote: > Wainwright, > > , " Wainwright Churchill " > <WChurchill@b...> wrote: > > Dear Colleagues, > > > > As for any proposal that physicians restrict themselves to using > pre-ordained, unmodified > > herbal formulas from the 'tradition', > > I didn't see anybody make this proposal > or anything remotely like such a proposal. > Maybe I missed it. > > That someone points out that there is > a certain misperception related to particular > historical facts and sequences does not > suggest anything in and of itself other > than that we should pay attention to > the historical record if we aim to > legitimize what it is we think and do > based upon claims that it represents > some sort of historical tradition. > > Ken Ken and others, I am sure I have missed some major idea, but I have no idea what you or PU is getting at. What is the point that he is making, can you be clear? Can you give some examples? `Individual RX's are clearly part of the herbal tradition, and quite an important part. From SHL to modern china. I.e. I have never met a Chinese herbalist that doesn't individualize. Every classical herb text I have talks about modifications. All classical or pre-modern case studies that I have read all are individualized formulas. Where is the big discrepancy that you see that we (modern) TCM's are portraying that you feel are historically incorrect? Can you spell it out for me... I do have about 40 more msg.'s to catch up on, but I have to say I haven't read anything that really makes much sense yet, or seems clinically or socially useful. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2005 Report Share Posted July 18, 2005 I think people may want to reread or read this post by Bob Felt from 2 years ago. Bob is much more eloquent and well versed than I. I repost this to illustrate the point about who was actually doing what in China and when. Remember, the actual empirical evidence on chinese herbs suggest there is no advantage to any style over another. And that a reliable disease oriented prescription right off the rack will be superior to a mediocre tailor job any day of the week. I know most people on this list prescribe prepared medicinals. Speak up. I assume your patients are getting well. Even Z'ev and Bob flaws are both advocates of prepared meds these days. Same with Jake Fratkin, of course, and also Will Maclean. For the majority of my patients a BP prepared med will suffice and I hate to admit it, but even if I choose based upon western disease indications, the patterns match my close enough 90% of the time. > Robert L. Felt <bob > September 25, 2003 8:14:48 PM PDT > > Examples > > > One of the things the [unschuld] seminar participants had a very, > very hard time > accepting (and some refused to accept) was Paul's description of one > important 11th century event. It was an imperial edict that > created state > pharmacies to standardize price and quality. However, what it also > did was > take the drug trade away from physicians (who were vernacularly > known as > " Mr. Drug Seller " ). Physicians responded with a literature that > had been > rare until that point (as was materia medica or formulary based on > systematic correspondence). That literature marks the beginning of > the > assertion that the physician-individualized formula is superior to the > formulas of the literate tradition. > > Thus, from between the SHL in the first century, and the herb > literature of > the Sung-Jin-Yuan era, herbalism was rooted in disease-based > prescription > not unlike biomedical prescription today. After that period, to > the modern > period, the historic evidence is that condition-based (prepared > formula) > prescription was the norm and literate physician individualized > prescription was a practice for the elites. If you have looked at > Paul's > " Medicine in China: Historical Artifacts and Images, " you have seen > his > collection of medicine bottles, medicine ads and their claims. > > Now, consider what has been rejected by the field because we have > been sold the > idea that the standard for the field must be individualized > prescription. > For example, I remember distinictly that Kampo was outright > rejected by > the staff of NESA as an appropriate subject to teach in the early > '80's > because it was inferior to " What they do in China! " Despite the > fact that it > was a working model in a delivery system quite like ours, had a socio- > economic presence that could be measured, and a acessible thereapeutic > track record, it was dismissed as inferior. > > In the same sense, Chinese prepared formulas, (erroneously > believed to be > far more limited in scope than they are because people believe " patent > medicine " means what it meant in the West), are essentially the > bulk of what > people do in practice, but the least part of what they are trained > to use. > > This could be elaborated, consider for example that the entire > profession of > traditional pharmacist has been ignored, again because of the > picture of > history based on myth. This could be extended. Remember how the > insertion depths of the early English literature generated such a > bruhaha > about how Japanese Acupuncture must do nothing at all? Even though > literature surveys have shown that deep insertion depths are no > norm, that > " de qi " has often referred to a practitioner-sensed stimulas, not a > patient > response, you can still find people who insist that " What they do > in China " > proves that anything else is so much dross. > > A fair definion of " " -- in my opinion -- would > include the > understanding that whatever the proposed clinical superiority of > individualized prescription, it is a difficult and expensive system > to maintain > that has been long and widely supplemented by both traditional and > modern markets for prepared medicines that could be more effectively > trained with fewer resources, and more effectively delivered to the > paying > population. > > Consider how often we read on these lists about non-compliance with > decocted formulas and practice with foreign and domestic prepared > products that are understood primarily through commercial literature. > Was it fair to not give people the choice rather than make a > standard of an > elite medicine that the Chinese think takes until your 60's to master, > requires access to, or investment in a significantly costly > pharmacy, which is > typically maintained by a type of professional we don't have, and a > knowledge base we don't teach? > > I think that what Paul has been getting at, not just " in the > Woods, " is that we > have institutionalized so much about Chinese medicine that has no > substance in the subject's history, that we are failing to > understand how and > how not to apply it in our own societies. > > Bob > > > > bob Paradigm Publications > www.paradigm-pubs.com P.O. Box 1037 > Robert L. Felt 202 Bendix > Drive > 505 758 7758 Taos, New > Mexico 87571 Quote Link to comment Share on other sites More sharing options...
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