Research for CM

October 9, 2003

Alon, Emmanuel, Phil, Rory and Z'ev, et al

The research issue needs to be thought through very carefully. Some

points:

1) With respect to Rory's comment:

>>>The first step in this direction would have to be to

include an academic track in clinical research methods from day one

in the curriculum, so that the students are involved and evolving in

research throughout their training. Research involvement for all

three to four years of a training , and publishable group product,

should then be a requirement for graduation. >>>

Do we wish to instill a research culture in CM training? I feel that

Rory's suggestion would do just that - it would make science the basis

of the intellectual approach towards CM. This is exactly one of the

issues Unschuld was warning us about, as he entreated us to keep CM

separate from scientific culture. Indeed, several of Unshuld's

comments are relevant here - if we are researching CM, which style do

we test?

One has to contrast this with other possible emphases in training -

for example, one could try to instill a culture of historical/literary

research, to teach the sort of isses Ken often discusses. That would

put the emphasis in training on the CM tradition itself, rather than

lead us away from it and towards a scientific outlook, which in time

would probably embrace more and more biomedical concepts at the

expense of CM theory. I would suggest that whatever we do in the way

of clinical research, historical, anthropogical, epistemological and

intercultural research are also very important, and probably at least

equally important as clinical research.

2) With respect to Z'ev's comment

> From my space, I would only be supportive of research that is similar

> to the outcome-based studies in China on herbal and point

> prescriptions, for treating pattern-based conditions within specific

> disease categories. I am not talking about mining the Chinese materia

> medica for new drugs.

Despite the fact that this research probably wouldn't be that weighty

from a scientific point of view, it could still be useful and

productive. In the UK, I've known several obstetricians who were very

interested in the study about turning breeches using moxa which was

published in JAMA, and who even sent my wife and me patients for this

treatment.

Which leads me to two further suggestions:

3) We need to try to evolve research strategies that are explicitly

paradigm-sensitive

4) It would be very useful if colleges and other CM organisations and

practitioners got together and co-ordinated their efforts to both

develop paradigm-sensitive research strategies, and also to liaise

systematically to ensure that their research was compatible so that it

was directly amenable to meta-level analysis, and also efficient at

meeting a well thought out overall strategy for research. This is a

bit like co-ordinating telescopes in different locations in

astronomical research.

5) A further idea - try to liaise with respectable PRC institutions

and discuss with them the type of research we require, simultaneously

ensuring that any research they conduct is carried out in a rigorous

and honest manner.

In short, despite the many possible problems with research, if the CM

profession in the West can develop a well thought out,

paradigm-sensitive, collective strategy for research, that is

carefully co-ordinated, I think we can do much much more in the way of

producing useful work than if we work in an isolated and

unco-ordinated manner. It's one of the ways of counteracting shortage

of funding, and in fact, it could enable us to receive much more funding.

This co-ordinated research effort could not only involve the US and

PRC, but also other countries, such as the UK, Germany, Australia, etc.

If we did get this together, I really think that something valuable

could ensue.

Best wishes,

Wainwright

October 9, 2003

At 9:05 PM +0000 10/9/03, wainwrightchurchill wrote:

>Do we wish to instill a research culture in CM training? I feel that

>Rory's suggestion would do just that - it would make science the basis

>of the intellectual approach towards CM. This is exactly one of the

>issues Unschuld was warning us about, as he entreated us to keep CM

>separate from scientific culture. Indeed, several of Unshuld's

>comments are relevant here - if we are researching CM, which style do

>we test?

--

I'm not sure what Unschuld is referring to, but perhaps it is

bio-medical research, which would indeed change our culture. However,

I think we have to be careful to distinguish what research might mean

to us. We must also consider the long term consequences of not being

the prime movers with respect to research in our own field. I agree

that some focus on research in our education would be a change, and

would change the educational culture to some extent. I don't agree

that it need be a polluting influence, or an overwhelming influence.

One of the advantages of doing it ourselves is that we get to define

the parameters. We know what happens when we leave it to others.

As to which style we should study, that could be left up to the

individual researchers, or institutions, doing the research.

>One has to contrast this with other possible emphases in training -

>for example, one could try to instill a culture of historical/literary

>research, to teach the sort of isses Ken often discusses. That would

>put the emphasis in training on the CM tradition itself, rather than

>lead us away from it and towards a scientific outlook, which in time

>would probably embrace more and more biomedical concepts at the

>expense of CM theory. I would suggest that whatever we do in the way

>of clinical research, historical, anthropogical, epistemological and

>intercultural research are also very important, and probably at least

>equally important as clinical research.

--

I agree that these other research fields are of importance, but they

can be left to others, or those of us with the background and

interest. What makes clinical studies our special interest is that we

are trained as clinicians, so we have the qualifications to judge the

clinical standards of a study, which outsiders do not, and often do

not care about.

Rory

--

October 10, 2003

Rory,

One of the issues that concerns me is the pressure on us to

biomedicalise. As Unschuld has alluded to, we need to be concerned

about how we culturally apprehend truth. As I'm sure you'll agree,

approaches that are within the Chinese tradition are not second nature

to us by virtue of acculturation. By the time one gets around to

studying acupuncture, one will have been indoctrinated with 12 years

of school education, at least three to four years of university, etc.,

of training to approach reality with a scientific worldview. This is

taken for granted, probably as much so as during medieval times, the

Christian theological worldview formed the basis of people's sense of

reality. CM is based on a very different attitude to the modern

scientific. CM becomes much more accessible if one has experience of

meditation, tai qi, etc., disciplines that slowly develop perceptions

and ways of being that are alien to our culture.

An important element of training in CM should be, in my opinion, to

cultivate oneself in what, for convenience, I'll call a meditative

basis. However, it is also important to have the conceptual tools to

assist the intellect in this totality (interestingly, the word

'intelligence' originally denoted the totality of a person's

faculties, including the spiritual, gradually being degraded to what

one might call 'cleverness' (Heidegger)). Therefore, exposure to

matters that pertain to intercultural issues are important in CM

training.

All this has to be considered in the context of very powerful pressure

to conform to standard scientific procedure. This is like a strong

ocean current in which one is navigating, and if one doesn't perceive

the current, and compensate for it, one is likely to end up somewhere

else.

Within our culture, research is very important, and I agree with you

that it's important for us to not ignore this, since if we do, we'll

find that our field is being defined by biomedicine. I think it is

desirable for us to conduct research, and we're the only people who

can ensure that such research is paradigm-sensitive. Even then, I

expect that we'll have problems, but at least we'll have the bulwark

of (hopefully) good quality work that is consonant with our own

medical bases.

Wainwright

-

" Rory Kerr " <rory.kerr

Friday, October 10, 2003 2:39 AM

Re: Research for CM

> At 9:05 PM +0000 10/9/03, wainwrightchurchill wrote:

> >Do we wish to instill a research culture in CM training? I feel that

> >Rory's suggestion would do just that - it would make science the basis

> >of the intellectual approach towards CM. This is exactly one of the

> >issues Unschuld was warning us about, as he entreated us to keep CM

> >separate from scientific culture. Indeed, several of Unshuld's

> >comments are relevant here - if we are researching CM, which style do

> >we test?

> --

> I'm not sure what Unschuld is referring to, but perhaps it is

> bio-medical research, which would indeed change our culture. However,

> I think we have to be careful to distinguish what research might mean

> to us. We must also consider the long term consequences of not being

> the prime movers with respect to research in our own field. I agree

> that some focus on research in our education would be a change, and

> would change the educational culture to some extent. I don't agree

> that it need be a polluting influence, or an overwhelming influence.

> One of the advantages of doing it ourselves is that we get to define

> the parameters. We know what happens when we leave it to others.

>

> As to which style we should study, that could be left up to the

> individual researchers, or institutions, doing the research.

>

> >One has to contrast this with other possible emphases in training -

> >for example, one could try to instill a culture of historical/literary

> >research, to teach the sort of isses Ken often discusses. That would

> >put the emphasis in training on the CM tradition itself, rather than

> >lead us away from it and towards a scientific outlook, which in time

> >would probably embrace more and more biomedical concepts at the

> >expense of CM theory. I would suggest that whatever we do in the way

> >of clinical research, historical, anthropogical, epistemological and

> >intercultural research are also very important, and probably at least

> >equally important as clinical research.

> --

> I agree that these other research fields are of importance, but they

> can be left to others, or those of us with the background and

> interest. What makes clinical studies our special interest is that we

> are trained as clinicians, so we have the qualifications to judge the

> clinical standards of a study, which outsiders do not, and often do

> not care about.

>

> Rory

October 10, 2003

Wainwright and All,.

I strongly support both your views here, Wainwright, as well as Unschulds. I've

weighed on this many times in this past year. As a Western scientist I can

assure you that no matter what you put into the Western science evaluation

machine, you always get out Western science. If you are keen to throw away CM

paradigm and all 3,000 years of CM empiricism along with it's intuitive side,

then double blind studies is the way to go. Death of CM guaranteed ... at least

in this land and in this culture. I would be sad to see that. CM may find a

way to live on in Chinese culture. My hope is that American culture can be

flexible enough to make the accommodation for CM ... but I could be wrong to

hope for such a thing. I'll hand on to my optimism for now.

Emmanuel Segmen

-

wainwrightchurchill

Thursday, October 09, 2003 2:05 PM