Research and Criteria

November 22, 2003

, " Rey wrote:

> In my Master's thesis, I have argued that instead of the present

state of using laboratory replications to evaluate TCM practice, I

propose that evaluation assumes life within the locale of the TCM

microworld. The evaluation of TCM practice and it's therapuetics

must make visible entities like clinical pattern (zheng hou),

formulae, materia medica (yao), Qi, flavours, Channel associations

gui jing) etc. >>>

Rey:

Can you go into more detail about how these concepts can be

evaluated so that they can be understood and accepted by people

outside our profession?

At the outset it seems difficult since Westerns already think that

there is no such thing as qi or channels outside of Chinese

metaphysics.

Jim Ramholz

November 22, 2003

Rey,

This is beautiful and clearly stated. It gives an outline for research that

retains the ontology of what is a human in the scope of CM practice. Nice going

.... more than that ... excellent job thus far.

Emmanuel Segmen

-

Saturday, November 22, 2003 6:56 PM

Research and Criteria

Reading Rey's comments on another forum, I asked him if I could post

his comments on the CHA list. Here they are.

(Rey) Having articulated and documented the practice and 'doing' of

Chinese

medicine , the logical step is to work out a system of evaluating the

efficacy of it's treatment protocols. Up to this point in time, no

evauation system has been devised and developed out of TCM's own

practice .

This is a core issue that needs to be resolved in the contemporary

practice

of Chinese medicine both in China , Taiwan and in the West . This is

even

given urgency by the recent resurfacing of comments of 'quackery of

TCM' as

it relates to the " effectiveness of anything in TCM " .

I have always argued against the use of the value, standard and

theory

of science in evaluating TCM therapuetics. This scientific evaluation

of

TCM which reduces this body of knowledge into shrinking 'bits' of

laboratory data is becoming a worrying trend in TCM research ,

especially

in Mainland China. A survey of a hundred published clinical trials

conducted

in China on the evaluation of the efficacy of Chinese medicinal herbs

published in five Chinese language TCM journals covering a period of

10

years (l986-1996) confirmed this trend.

In my Master's thesis, I have argued that instead of the present

state

of using laboratory replications to evaluate TCM practice, I propose

that

evaluation assumes life within the locale of the TCM microworld. The

evaluation of TCM practice and it's therapuetics must make visible

entities

like clinical pattern (zheng hou), formulae, materia medica (yao) , Qi,

flavours, Channel associations gui jing) etc .

As one contemporary veteran TCM practitioner in China staaed in l981:

" Changes which occur on the patient's condition after the

administration of the therapeutic remedy is the clear mirror

which tests the efficacy of the practitioner's formula set on

the basis of a therapeutic method. Hence, with regards

the results of the therapy, , they should be timely

evaluated and

verified... there should be follow-up visits , all round

investigations as well as detailed records kept. " ( " The Path

Taken by Veteran Well-Known TCM Practtioners " Ming Lao

zhong Yi

zhi Lu p. p243-244)

November 22, 2003

Jim,

I would recommend that Rey not get distracted from his goal. If quantum physics

people needed to convince everyone early on that their work was important, they

might not have gotten it done. Also Rey's work may engender genuine interest.

I'm a Western scientist, and I'm interested.

You recall that Todd mentioned to me that statistical research is important

because, well, we have jet planes and computers to communicate with. His point

was well taken, and I heartily agree with his point. A common American

expression is, " If we can put a man on the moon, then we ought to be able to

...... " Fill in the blank. The fact is that our science is rather powerful,

awesomely powerful with regard to manipulating the inanimate world. But ....

we don't have the sophistication and finesse to treat a living organism with the

common cold. We are living in a time of guns and steel. These are not the

tools we need nor the theoretical science we need to address living things.

Chinese medicine and its theory to me as a scientist has a certain finesse. My

colds and flus get resolved within a day, often within hours if I treat myself

quickly and directly with acupuncture and herbal formulas. I genuinely want as

a Western scientist to be " informed " by CM in its own language. Not in my

language. Does that make any sense to you? Do you sense the intrigue I feel?

Do you also sense the frustration I feel with regard to Western science's lack

of finesse in these area? I feel I've done some good science in the area of

molecular biological mechanisms in human chromosomal DNA. I've also had

enormous pleasure in teaching both fundamental as well as somewhat sophisticated

ideas in anatomy and physiology. Western science has stood by me in some areas,

but fallen down in a great many other areas. So CM holds some promise for

expanding my own sense of my scientific paradigm. No, I have little interest in

watering down CM theory to some artificial common denominator of common

language. I don't want to go to some idea which is an illegitimate child of CM.

Rather I want to be informed by the source itself. So do you see that Western

science studies that look at inanimate objects applied to living organism bores

me? Done that. Thank you. Now what Rey is suggesting is really interesting.

Anyway, you perhaps get my drift here.

Respectfully,

Emmanuel Segmen

-

James Ramholz

Saturday, November 22, 2003 8:09 PM

Re: Research and Criteria

, " Rey wrote:

> In my Master's thesis, I have argued that instead of the present state of

using laboratory replications to evaluate TCM practice, I propose that

evaluation assumes life within the locale of the TCM microworld. The evaluation

of TCM practice and it's therapuetics must make visible entities like clinical

pattern (zheng hou), formulae, materia medica (yao), Qi, flavours, Channel

associations gui jing) etc. >>>

Rey:

Can you go into more detail about how these concepts can be evaluated so that

they can be understood and accepted by people outside our profession?

At the outset it seems difficult since Westerns already think that there is no

such thing as qi or channels outside of Chinese metaphysics.

Jim Ramholz

November 22, 2003

, " Emmanuel Segmen " wrote:

My colds and flus get resolved within a day, often within hours if I

treat myself quickly and directly with acupuncture and herbal

formulas. I genuinely want as a Western scientist to be " informed "

by CM in its own language. >>>

Emmanuel:

Sorry to rock the boat. Who is the real audience for this message?

Are we just preaching to the choir? How does it make sense to a

Western scientist,the American public, or anyone outside of our

profession when she or he doesn't understand 'CM's own language'? If

this is the case, then a great deal of education and translating

need to be done first. Otherwise

But . . . saying that your colds and flu get resolved more

quickly, " often within hours " , is the type of language a Western

scientist can understand. This is the kind of study that I expect

can be understood.

Jim Ramholz

November 23, 2003

I have always argued against the use of the value, standard and

theory

of science in evaluating TCM therapuetics. This scientific evaluation

of

TCM which reduces this body of knowledge into shrinking 'bits' of

laboratory data is becoming a worrying trend in TCM research ,

especially

in Mainland China.

>>>What do you suggest

alon

November 23, 2003

, " Alon Marcus " wrote:

> Rey: I have always argued against the use of the value, standard

and theory of science in evaluating TCM therapuetics. This

scientific evaluation of TCM which reduces this body of knowledge

into shrinking 'bits' of laboratory data is becoming a worrying

trend in TCM research, especially in Mainland China.

> Alon: What do you suggest? >>>

My question, too.

Jim Ramholz

November 23, 2003

Changes which occur on the patient's condition after the

administration of the therapeutic remedy is the clear mirror

which tests the efficacy of the practitioner's formula set on

the basis of a therapeutic method. Hence, with regards

the results of the therapy, , they should be timely

evaluated and

verified... there should be follow-up visits , all round

investigations as well as detailed records kept. " ( " The Path

Taken by Veteran Well-Known TCM Practtioners " Ming Lao

zhong Yi

>>>>Again the question is how do you record such changes? how do you account for

changes that are natural to the course of the disorder treated? how do you

account for factors outside the therapeutic input? how do you measure the power

of groups outside each patient? and most impotently what constitute the recorded

evidence, i.e. how is it measured. Can biomedical test be used to evaluate

results? is glucose levels important if one treats sweet urine disorders? etc

alon

November 23, 2003

I would recommend that Rey not get distracted from his goal. If quantum physics

people needed to convince everyone early on that their work was important, they

might not have gotten it done. Also Rey's work may engender genuine interest.

I'm a Western scientist, and I'm interested.

You recall that Todd mentioned to me that statistical research is important

because, well, we have jet planes and computers to communicate with. His point

was well taken, and I heartily agree with his point.

>>>Do not blame Todd for my mischief's

Alon

November 23, 2003

we don't have the sophistication and finesse to treat a living organism with the

common cold.

>>>This is a red herring as we can treat a common cold, ie make symptomatic

effects with biomedical drugs, nutrition etc., we can reduce time of infection,

and the common cold is not so simple as the name makes it sound.

Alon

November 23, 2003

My colds and flus get resolved within a day, often within hours if I treat

myself quickly and directly with acupuncture and herbal formulas.

>>>Emmanuel nice for you, but i know that this is not the common experience when

looked at scientifically. I have seen many thousands of patients treated for

colds and flues by my self as well as many other dr in three continents using

TCM. I love it when people say a cold goes away within the same day if they

treat it soon. Unless it is a large group with controls you have no idea if you

truly are getting a cold. Everyone feels at times as though he/she is getting a

cold only to feel better by the end of the day or next morning. Again this is

were logics must play a role and personal feelings must be ignored as evidence

Alon

November 23, 2003

Alon,

As Dr. Zhang always says: " No maybe, no could be, no probably " , when it

comes to diagnosis. He (and I) firmly believe that lack of success

clinically is much more often than not, due to incorrect differential

diagnosis, and not listening and prioritizing the body's sometimes subtle

signs. I can't tell you how many times I have had to bite the bullet and

shut myself up, listening to patients who were misdiagnosed, and didn't

get better. I think that that is the major reason for lack of results.

Clinically, we are looking for results and a model for scientific

verification that a treatment worked would only be valid for that

patient, before and after. Because everyone is different and no one is a

clone, any study would by definition by flawed and would be comparing

apples and oranges.

Yehuda

On Sun, 23 Nov 2003 10:35:23 -0600 " Alon Marcus " <alonmarcus

writes:

> My colds and flus get resolved within a day, often within hours if I

> treat myself quickly and directly with acupuncture and herbal

> formulas.

> >>>Emmanuel nice for you, but i know that this is not the common

> experience when looked at scientifically. I have seen many thousands

> of patients treated for colds and flues by my self as well as many

> other dr in three continents using TCM. I love it when people say a

> cold goes away within the same day if they treat it soon. Unless it

> is a large group with controls you have no idea if you truly are

> getting a cold. Everyone feels at times as though he/she is getting

> a cold only to feel better by the end of the day or next morning.

> Again this is were logics must play a role and personal feelings

> must be ignored as evidence

> Alon

>

November 23, 2003

, yehuda l frischman wrote:

> He (and I) firmly believe that lack of success clinically is much

more often than not, due to incorrect differential diagnosis, and

not listening and prioritizing the body's sometimes subtle signs. >>>

And I.

> Clinically, we are looking for results and a model for scientific

> verification that a treatment worked would only be valid for that

> patient, before and after. Because everyone is different and no

one is a clone, any study would by definition by flawed and would be

comparing apples and oranges. >>>

But, if the CM Tx is a success, shouldn't the WM signs change too---

cancer markers, coughing, fever, etc.? If we are in America, don't

we need to somehow persuade WM on its own terms; or show how they

things they value can be found in CM?

Jim Ramholz

November 23, 2003