New paradigm of research

[Guest guest]

Nov.14,2003

 

 

Hi Wainwright,

 

I really enjoy reading your philsophical insights.

 

I think you are right about Prof. Smallwood's enterprise on

biomedicalization. He is acting in accordance with his own professional

bias. It was very clear from the whole tone and content of his presentation.

And this is also very clear about his comments on 'evidence' or evidence

based- medicine which are the buzz words which comes out of the mouths of

every biomedical practitioner.

 

However, when it comes to TCM or CM we also have a very clear idea of

'evidence' i.e. clinical evidence. The Chinese word for evidence is zheng4

whose combined script meaning refers to speaking uprightly . Xie Guan

defines zheng 4 as Òdisease conditions within the body which are

discovered externallyÓ ti nei bing zhuang zhi faxian hu wai [ Xie Guan ,

Zhongguo yixue da cidian [Chinese Medical Dictionary ,Vol.4] ,Tong Xian

Da Zhong Publishing House,Beijing, l988 reprint of l921 edition China,

p.4487 ]. Zheng is also what we refer to as 'pattern' in 'pattern

differentiation. In contemporary times, the Chinese word zheng is

referred to as zheng hou which I translate into English as 'clinical

pattern'.

 

And in this whole process of pattern differentiation or bian zheng

lun zhi in chinese, we differentiate clinical signs and symptoms to

establish the pattern or the zheng hou. This is the bian zheng phase

of the TCM clinical encounter And on the basis of the clinical

pattern established , we prescribe the treatment which is a phase referred

to in Chinese as lun zhi.

 

In clinically evaluating the efficacy of therapy or therapies

administered to a specific patient, changes in the zheng hou or signs

and symptoms or the " disease conditions which are discovered extenally "

are also the most reliable indicators of clinical efficacy.

 

Herbs, acupuncture points, foods, or massage therapy are chosen

and administered on the basis of pattern differentiation . The clinical

efficacy of these therapies are also assessed on the basis of changes

in the clinical pattern i.e. changes in the symptoms.

 

This clinical evaluation is undertaken by employing the Four

examination techniques si zhen as an evaluation template. Instead

of using the Four Examination Techniques of observing, listening,

palpating and inquring to gather data for eventual diagnosis, the

Four Examination Techniques undergoes transformation into the

FOUR EVALUATION TECHNIQUES Si Ping and are used instead to observe,

palpate, listen/smell and interrogate symptoms to gather data to evaluate

the efficacy of therapies administred.

 

These clinial evaluation data generated are what I consider the

clinical evidence that validates the efficacy of TCM therapies.

 

Rey Tiquia

[Guest guest]

It was nice to hear from you again, Rey. I am an admirer of your work,

and look forward to seeing more.

 

 

On Nov 13, 2003, at 2:19 PM, Emmanuel Segmen wrote:

 

> Thanks, Rey.

>

> I figured you were the very guy to go to on this. I'm excited to hear

> of all your work. Congratulations! I know you're still in the midst

> of your work, but I feel like cheering as you sprint your way along

> the trails ... even blazing trails as you go. I look forward to

> savoring the words of your writing.

>

> In gratitude,

> Emmanuel Segmen

[Guest guest]

, " rey tiquia " wrote:

These clinial evaluation data generated are what I consider the

clinical evidence that validates the efficacy of TCM therapies. >>>

 

 

Rey:

 

Do you think these evaluation data are sufficient clinical evidence

in the eyes of the American public?

 

 

 

Jim Ramholz

[Guest guest]

Nov.14,2003

 

Dear Zev,

 

I have not left the list. I was following the threads all along. I

thought that after those hectic SARS moments early this year I

just wanted to have a break from the 'massive' translation work .

But I kept up with and enjoyed reading your harmony /reconciling

postings to the CHA. .

 

Regards,

 

Rey Tiquia

[Guest guest]

Dear Jim,

 

That is a very difficult question to answer. I think we have to wait

and see. But the more immediate question is : is it good enough

for us Chinese medicine practitoners in the West ?

 

Regards,

 

Rey Tiquia

 

 

 

 

 

, " James

Ramholz " <jramholz> wrote:

> , " rey tiquia "

wrote:

> These clinial evaluation data generated are what I consider the

> clinical evidence that validates the efficacy of TCM therapies. >

>>

>

>

> Rey:

>

> Do you think these evaluation data are sufficient clinical

evidence

> in the eyes of the American public?

>

>

>

> Jim Ramholz

[Guest guest]

, " rey tiquia " wrote:

> That is a very difficult question to answer. I think we have to

wait and see. But the more immediate question is : is it good enough

for us Chinese medicine practitoners in the West ? >>>

 

 

Rey:

 

Because I distinguishing the political implications from the purely

theoretical or historical, the way I look at it, we have 3 different

groups to persuade for different reasons:

 

1. ourselves.

2. The American public who are our patient base.

3. Other medical professions, politicians, insurance companies, and

other cultural gatekeepers.

 

Each wants or will accept a different type of proof or reassurance.

Whether or not Wiseman is a standard will not directly affect 2 and

3. How we do studies and use statistics will affect 2 and 3.

 

 

Jim Ramholz