personal vs. consensual

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

 

>

> More importantly, how might we foster the implementation of this

classification

system here in North America?

>

 

 

 

sort of what's on my mind. set aside the issue of secret systems and consider

merely

the consensual academic vs. the widely practiced personal (I'll consider

idiosyncratic

personal systems below or later). I noticed Bob included Deke Kendall and Mark

Seem amongst the " personalists " . Both of these gentlemen incorporate

considerable

amounts of WM info into their systems. Then we have the Worsley style, which

appears to be more of a personalistic system as well at this point. Same with

Jim's

korean pulse system. Now these personal styles generally have pretty precise

standards of diagnosis compared to the american version of consensual academic.

One could argue that many of the popular styles of japanese acupuncture

practiced in

the US are personal styles developed in the 20th century. The students of some

of

these teachers seem to have high interrater reliability, much moreso than I see

in so-

called eclectic TCM university training. Whether their methodologies are more

effective because they agree on diagnosis more often as a group is an open

question.

My personal experience is that when TCM is practiced according to consistent

standards, it works more often than when applied in a more idiosyncratic way. I

think

when comparing the efficacy of TCM vs. whatever else, often the observations are

between those adhering closely to a system like toyohari vs. an eclectic new age

melange that has somehow been labeled TCM by detractors.

 

this brings me to the issue of personal idiosyncratic styles with no current

following.

Well, Mark Seem started that way. So where do you draw the line. But more to

the

point. In an educational setting, what do you teach? We hear about the need to

study

the classics personally or with the guidance of an experienced teacher. But

this

inherently personalizes the medicine. If one works on one's own in this matter,

then

one is bound to err. If one works with a teacher, then the value is directly

proportional to the knowledge and experience of the teacher. But it is still

personal,

not consensual academic. So I agree strongly that foundational knowledge should

be

consensual academic. Any attempt to replace this consensual foundation with

something secret or personal is somewhat misguided. Then instead of working

with

the ideas of a professional international community, we bow to personality,

charisma

and loyalty. While the traditional master-disciple model is more akin to the

personal

style, I would personally wince at the thought of such bias being the core of my

education; others no doubt would revel in such. Having said that, my personal

teachers have biased me, but not always for the better. :-)

 

Heiner Fruehauf told me something wise one day. He was often asked at his

tender

of 34 at the time why he did not write a book. He said for a book to offer

anything

new, it had to inlude one's lifetime of experience. He said americans like to

whip

things out the moment they hear about something new. German scholars ponder for

a few decades. so what would it take before one could begin to accept the

personalized teachings of a first generation american Lac over the consensual

standards of the PRC. My criteria would center first around the issue of the

person's

actual access to chinese sources. I have no interest in following the personal

style of

someone who doesn't even have access to chinese medical literature. And their

access could not be cursory. they would have to be fairly fluent and widely

read

(BTW, these are my criteria; I can envision others for other reasons).

Preferably, the

personal system would have some history or research or following. Unless my

current approach is failing, I cannot ethically use nonstandard methods with no

solid

foundations or base of support. What constitutes such foundations is determined

case by case for me.

 

Are there any american teachers who are qualified to do this? Very few, I would

say.

Now there are those out there who are teaching systems of holistic healthcare

that

draw on chinese ideas as they are expressed in the american literature. But do

we call

that CM when the ideas are used without deep study of the source material. Mark

Seem calls what he does a new american acupuncture or osteopathic acupuncture.

I

think he makes it clear that what he is doing is NOT CM. Deke Kendall who has

read

the classics, says he has a better take on them. He is doing CM as he conceives

it;

same with Jeffrey Yuen, Michael Broffman, Master Ni. I personally practice a

style

influenced by naturopathy, but this is not what I teach in my core classes as I

do not

have personal source access to create a new version of CM for my students. And

the

core material of TCM is one of the foundations of my practice, as well. However

over

my lifetime, I will have had quite a few students who follow me and perhaps will

have

something to say on the matter when I'm much older.

 

[Guest guest]

 

 

The melange of diverse materials that are currently taught under the rubric of

TCM at most North American schools is the result of

schools hiring anyone they can to teach regardless of their training and style

of practice. There aren't enough qualified teachers of

standard professional (i.e., academic) CM to staff all the current schools. I

also imagine that many potential Western teachers would

question an abridgement of personal freedom if they were told they had to give a

certain lecture a certain way. In China, my

experience is that undergraduate lectures have been written or at least approved

by committee.

 

Bob

[Guest guest]

Bob,

You probably have a better idea than me, or almost anyone else,

about who is teaching what at the various schools from your traveling

around, teaching seminars. I've often wondered, with great concern,

about who is teaching and what they are teaching at all these schools

in such places as Florida and the Midwest.

At PCOM, the OM and Herbal departments have gradually evolved to a

standard CM curriculum. I don't personally see having such a

curriculum as a hindrance to creativity, because academic Chinese

medicine is actually quite creative. It just requires a basis of

terminology, pattern differentiation, and prescriptions, and there is

enough literature and clinical data to make it very interesting.

In any true discipline, one has to base one's lectures on a body of

knowledge that already exists, and then add one's personal experience

and point of view based on that knowledge. Without it, one usually

ends making it up as one goes along.

 

 

 

 

On Dec 23, 2003, at 1:47 PM, Bob Flaws wrote:

 

>

>

> The melange of diverse materials that are currently taught under the

> rubric of TCM at most North American schools is the result of

> schools hiring anyone they can to teach regardless of their training

> and style of practice. There aren't enough qualified teachers of

> standard professional (i.e., academic) CM to staff all the current

> schools. I also imagine that many potential Western teachers would

> question an abridgement of personal freedom if they were told they had

> to give a certain lecture a certain way. In China, my

> experience is that undergraduate lectures have been written or at

> least approved by committee.

>

> Bob

>

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

I also imagine that many potential Western teachers would

> question an abridgement of personal freedom if they were told they had to give

a

certain lecture a certain way.

 

Indeed. I wonder if the concept of academic freedom typically applies in med

school

the way it does in liberal arts. I seriously doubt that in pathology 101 at

harvard, the

professor can teach anything they want. There are ways to allow considerable

freedom, but circumscribe it within certain parameters. Freedom without

structure is

worthless and unconstructive, even destructive IMO.

 

[Guest guest]

, " " <zrosenbe@s...>

wrote:

At PCOM, the OM and Herbal departments have gradually evolved to a

> standard CM curriculum. I don't personally see having such a

> curriculum as a hindrance to creativity, because academic Chinese

> medicine is actually quite creative.

 

We do have a standard curriculum on paper in a general way. But specific issues

such

as the diagnostic parameters for a particular pattern are not addressed, nor are

the

validity and consensus on various conceptual ideas. An example of the latter

might

be teaching that pathogens like dampness can substitute for normal physiological

substances like heart blood. There are areas of disagreement that can be

debated

and there are ideas which are almost unanimously dismissed by literate chinese

doctors. How can we have a solid core without sorting these issues out -

misconceptions, if you may. Bob Damone has suggested that PCOM and and all

schools convene committees to rectify the names, so to speak. These committees

should be led by senior chinese doctors working with americans who can read

chinese and are familiar with the diverse styles practiced in the US. The

chinese docs

should reflect a variety of biases - purist, integrative, biomedical, etc.

Likewise the

americans. Until such a thing happens across several colleges and the results

are

collated, we really have an illusory standard. And if it isn't obvious by now,

such

standards will necessitate a standard terminology. If a technical term doesn't

mean

basically the same thing to everyone who reads it, what kind of standard is

that? We

could call it the chaos standard. And to some that would no doubt be appealing.

:-)

 

[Guest guest]

That would be a later step, I think. There are a few hurdles to

overcome in the meantime. I am not suggesting that the job is finished

at PCOM or anywhere else, but that we need to build some ground-level

consensus as a beginning. At this point, there are still politically

and personally sensitive issues to address, among them acceptance of a

terminological standard. I think everyone should have input here, as

in translation, one needs native language speakers in both Chinese and

English.

 

The Chinese literature is much more comprehensive, so we could

certainly use those texts as the basis for pattern differentiation,

prescriptions, etc. as standard references, but we would still need to

use the English language literature as part of that standard reference

base.

 

There are some interesting Chinese texts out there. I have a pair of

texts, one of yin xu patterns, one of yang xu patterns, that is very

comprehensive, and I think would be fairly decipherable with Wenlin for

those whose Chinese skills are not up to snuff. It would also be

doable to translate them into English without too much difficulty, I

believe.

 

 

On Dec 23, 2003, at 5:30 PM, wrote:

 

> We do have a standard curriculum on paper in a general way. But

> specific issues such

> as the diagnostic parameters for a particular pattern are not

> addressed, nor are the

> validity and consensus on various conceptual ideas.

 

There are areas of disagreement that can be debated

and there are ideas which are almost unanimously dismissed by literate

chinese

doctors. How can we have a solid core without sorting these issues out

-

misconceptions, if you may.

 

 

 

[Guest guest]

, " " <zrosenbe@s...>

wrote:

 

>

> There are some interesting Chinese texts out there. I have a pair of

> texts, one of yin xu patterns, one of yang xu patterns, that is very

> comprehensive, and I think would be fairly decipherable with Wenlin for

> those whose Chinese skills are not up to snuff. It would also be

> doable to translate them into English without too much difficulty, I

> believe.

 

 

I am sure that the chinese have many books in potentially wenlin-compatible

electronic formats. No one seems to know how to access these, though. Where

are

they. I have asked a dozen times. If a book is printed, it exists in

electronic format

somewhere. Unless that format is completely obsolete, it should be able to be

easily

converted into unicode. This would be a project of immense value. All one

would

need is a comprehensive english table of contents to orient oneself. Who's in

china

right now? If such product, does not exist, why not try and work with a

publisher to

create one. If the books already exist, I can assure everyone this is not

rocket

science. A computer, unicode translation software and a CD burner and you have

a

business. If I could read enough chinese, I would do it myself.

 

[Guest guest]

, " " wrote:

> Indeed. I wonder if the concept of academic freedom typically

applies in med school the way it does in liberal arts. I seriously

doubt that in pathology 101 at harvard, the professor can teach

anything they want. There are ways to allow considerable freedom,

but circumscribe it within certain parameters. Freedom without

structure is worthless and unconstructive, even destructive IMO. >>>

 

:

 

I agree in part with your conclusion. I faced this issue a while

back at CSTCM, where I teach. I taught Point Theory II in order to

force me to review the basic material myself. Because we were going

through accreditation, a uniform syllabus for the class dictated the

process; which clashed with my free ranging teaching style.

 

But, even so, I could appreciate the need for the process in terms

of standardization and testing. The students may have missed out on

some clinically relevant material that I wanted to discuss, but I

think we reached a fair compromise.

 

 

Jim Ramholz

[Guest guest]

, " " wrote:

Bob Damone has suggested that PCOM and and all schools convene

committees to rectify the names, so to speak. These committees

> should be led by senior chinese doctors working with americans who

can read chinese and are familiar with the diverse styles practiced

in the US. The chinese docs should reflect a variety of biases -

purist, integrative, biomedical, etc. Likewise the americans. Until

such a thing happens across several colleges and the results are >

collated, we really have an illusory standard. >>>

 

:

 

I doubt that the logistics of getting these committees together will

be done. But it may be accomplished by a single author or group of

authors who writes a new textbook that evaluates all these

differenet methods. It should probably be a major seller.

 

 

Jim Ramholz

[Guest guest]

, " James Ramholz " <jramholz@m...>

wrote:

 

> I doubt that the logistics of getting these committees together will

> be done. But it may be accomplished by a single author or group of

> authors who writes a new textbook that evaluates all these

> differenet methods. It should probably be a major seller.

 

 

Actually we could pull it off at PCOM. I think the work of any single author

would be

essentially worthless in this regard as the very premise I submit demands a

group

dialog before publication. Otherwise we end up with another defacto standard

that

depends more on who publishes first, has money, political and/or academic

connections.

 

[Guest guest]

, " " wrote:

> Actually we could pull it off at PCOM. I think the work of any

single author would be essentially worthless in this regard as the

very premise I submit demands a group dialog before publication.

Otherwise we end up with another defacto standard that depends more

on who publishes first, has money, political and/or academic

> connections. >>>

 

 

:

 

Perhaps if PCOM does it and publishes their conclusions, other

schools will be motivated to use or copy your efforts.

 

 

Jim Ramholz

[Guest guest]

, " " <

zrosenbe@s...> wrote:

>I've often wondered, with great concern,

> about who is teaching and what they are teaching at all these schools

> in such places as Florida and the Midwest.

 

Well, Z'ev, as someone who has taught in both Florida and the Midwest, I can

say the students I taught in both regions learned TCM (unless I was specifically

teaching " Japanese acupuncture " ). In the school from which I graduated

(Midwest College), I was taught out of the Wiseman-Ellis Fundamentals, from

which I also later taught at the same school. For treatment strategy and

internal medicine, the text I used was Practical Therapeutics by Wu (a text

which was in use when I joined the faculty). When I was in school, these

classes were mostly taught by teachers from the PRC using their own

handouts. The herb texts used were of course Bensky et al.

 

So your " great concern " would seem to be somewhat groundless, at least

regarding Midwest's curriculum since 1993. Florida's programs are something I

cannot comment upon as my time in this particular state has been rather brief.

 

robert hayden

[Guest guest]

Thanks for the feedback. However, I was thinking more of some of the

smaller and newer schools in such places as the Carolinas, Texas, other

midwestern states, smaller cities in Florida, Arizona, etc. Midwest

Institute has been around for quite a long time, and has had time and

experience to develop a more experienced and developed faculty and

curriculum.

 

 

On Dec 25, 2003, at 7:03 AM, kampo36 wrote:

 

> , " " <

> zrosenbe@s...> wrote:

>> I've often wondered, with great concern,

>> about who is teaching and what they are teaching at all these schools

>> in such places as Florida and the Midwest.

>

> Well, Z'ev, as someone who has taught in both Florida and the Midwest,

> I can

> say the students I taught in both regions learned TCM (unless I was

> specifically

> teaching " Japanese acupuncture " ). In the school from which I graduated

> (Midwest College), I was taught out of the Wiseman-Ellis Fundamentals,

> from

> which I also later taught at the same school. For treatment strategy

> and

> internal medicine, the text I used was Practical Therapeutics by Wu (a

> text

> which was in use when I joined the faculty). When I was in school,

> these

> classes were mostly taught by teachers from the PRC using their own

> handouts. The herb texts used were of course Bensky et al.

>

> So your " great concern " would seem to be somewhat groundless, at least

> regarding Midwest's curriculum since 1993. Florida's programs are

> something I

> cannot comment upon as my time in this particular state has been

> rather brief.

>

> robert hayden

>

>

>

> Chinese Herbal Medicine offers various professional services,

> including board approved continuing education classes, an annual

> conference and a free discussion forum in Chinese Herbal Medicine.

>

>

>

>

>

[Guest guest]

, " kampo36 " <kampo36> wrote:

> , " " <

> zrosenbe@s...> wrote:

> >I've often wondered, with great concern,

> > about who is teaching and what they are teaching at all these schools

> > in such places as Florida and the Midwest.

>

> Well, Z'ev, as someone who has taught in both Florida and the Midwest, I can

> say the students I taught in both regions learned TCM (unless I was

specifically

> teaching " Japanese acupuncture " ).

 

> So your " great concern " would seem to be somewhat groundless, at least

> regarding Midwest's curriculum since 1993.

 

 

I am just as concenred about what gets taught in some california schools. there

is no

regional superiority in this field. PCOM chicago is in the midwest, BTW. I am

sure

there are good programs and good teachers and vice-versa everywhere. CA may cut

an edge with alt. med., but our px also tend to go off on new age tangents less

common elsewhere. Double-edged sword.

 

[Guest guest]

Seems to me that the obvious first thing to translate in terms of looking at

sources for establishing American standards for the teaching of CM is

the Chinese national standards that have already been published. Why reinvent

the wheel? Now it may be that, upon reading these standards,

we see that, for some reason, one or more of these Chinese standards are not

applicable or relevant in our patient population. But we don't and

won't know that until we can read those Chinese standards. My guess is that the

two books Z'ev has mentioned on yin and yang vacuities are

the work of one or a small group of authors. The Chinese national standards were

hammered out over a number of years by a large group of

senior practitioners from all over China. IMO, if we're going to have national

standards, that's the kind of " large group consensus " standards we

would need. For instance, every so often some Chinese author publishes an

article about the utility of a liver qi vacuity pattern. However, to date,

no group of municipal, provincial, or national Chinese doctors have accepted

this as a standard CM pattern (as, again IMO, well they should not).

 

Bob