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Mr. ,

 

I've read many of your responses to the issues/ topics at hand and agree

almost wholeheartedly with your views. For whatever it is worth...thought

you should know. I have been a practitioner of TCM and a Sifu of Choy Li

Fut/Tai Chi for over 30 years out of Seattle. I spent my time reviewing the

formula by Dr. Pei & the case as a whole and grew from it. Interesting

use of Mu li :)

Take care,

David Akrish

-

" " <

Saturday, January 10, 2004 8:58 AM

Re: Fatigue: peculiar case study

, " "

wrote:

> , " "

<@h...>

> wrote:

>

> it is bad practice to second guess case studies, you will miss

> > the point. More important is to try to learn from what is

written and

> > get the lesson that is being presented.

>

>

>

> I think you have to do both. You have to look at the case itself,

but much like one

> would critique a research study by asking questions about followup

issues, I think

> that question is also valid here.

>

I think you are right to a certain extent.. It is always nice to ask

further questions, but to a certain extent it is moot, because one

can never know the unknown. It is real easy to say, well (in that

case study) they had fatigue and obviously they would have a better

formula if they supplemented qi, but then you never learn anything.

You are stuck in your own box. It is really hard to criticize a

case study when you are not there. IMO, they are there for the

lesson. Except it and open the mind. It has actually taken me a

long time to get that point, and I still struggle with it. Although

many of the case studies, some of the best, have multiple visits,

and mistakes are obvious and present to demonstrate the aspects of

the lesson. These are easier to criticize, but again I think if one

fixates on looking to variables that are not mentioned then one can

easily miss the idea. What if. What happened then. etc etc. I find

pointless.

-

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.

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, " David and Teah Akrish "

<yes@h...> wrote:

> Mr. ,

>

> I've read many of your responses to the issues/ topics at hand and

agree

> almost wholeheartedly with your views. For whatever it is

worth...thought

> you should know. I have been a practitioner of TCM and a Sifu of

Choy Li

> Fut/Tai Chi for over 30 years out of Seattle. I spent my time

reviewing the

> formula by Dr. Pei & the case as a whole and grew from it.

Interesting

> use of Mu li :)

>

What exactly is mu li being used for? I posted the case study

because i was having trouble understanding the possible asymmetry

between the diagnosis and treatment strategy, and was wondering how

others interpreted it.

I would of thought in case such as this, that the emphasis would

have been on percolating water and assisting qi transformation.

Instead the Doctor chose too nourish yin fluids, clear heat and

disinhibit urination.

How many people would have chosen a similar treatment strategy in

the light of a pale, swollen tongue, deep weak pulse, whole body

edema, inhibited urination and utter lethargy. The Doctors diagnosis

amounted to something described as Qi exhaustion in principle.

still perplexed,

matthew

> Take care,

>

> David Akrish

> -

> " " <@h...>

>

> Saturday, January 10, 2004 8:58 AM

> Re: Fatigue: peculiar case study

>

>

> , " "

> wrote:

> > , " "

> <@h...>

> > wrote:

> >

> > it is bad practice to second guess case studies, you will miss

> > > the point. More important is to try to learn from what is

> written and

> > > get the lesson that is being presented.

> >

> >

> >

> > I think you have to do both. You have to look at the case itself,

> but much like one

> > would critique a research study by asking questions about followup

> issues, I think

> > that question is also valid here.

> >

>

>

> I think you are right to a certain extent.. It is always nice to ask

> further questions, but to a certain extent it is moot, because one

> can never know the unknown. It is real easy to say, well (in that

> case study) they had fatigue and obviously they would have a better

> formula if they supplemented qi, but then you never learn anything.

> You are stuck in your own box. It is really hard to criticize a

> case study when you are not there. IMO, they are there for the

> lesson. Except it and open the mind. It has actually taken me a

> long time to get that point, and I still struggle with it. Although

> many of the case studies, some of the best, have multiple visits,

> and mistakes are obvious and present to demonstrate the aspects of

> the lesson. These are easier to criticize, but again I think if one

> fixates on looking to variables that are not mentioned then one can

> easily miss the idea. What if. What happened then. etc etc. I find

> pointless.

>

> -

>

>

>

> 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.

>

>

>

>

>

>

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Share on other sites

Hi Matthew,

 

Your question is exactly why this was such a great case...at least to me.

When I was training as a paramedic my head instructor warned us of the

limitations of 'cookbook medicine'.

Yin draws in and down. Mu li, energetically, moves downward and draws H20

(water follows salt). The use of this herb was the personal lesson I took home

from this case. Tu fu ling draws/pulls/directs water. As I meditated on the

initial formula it made more and more sense. Plus---the Dr.'s personal

interaction with the pt. had to have a profound effect on his use/guiding force

to this initial formula. This is how I am able to 'fill in the blanks' when

knowing case studies can only give so much information. This case definitely

fringes on higher thinking coupled by simplicity and true knowledge of what you

see, and what you know...all IMO! To me this is what separates TCM from the

rest. That being individuality. Would I have used this formula...HMMMM!

Take care,

David

-

" facteau8 " <facteau8

Saturday, January 10, 2004 3:57 PM

Re: Your views/parrallel thoughts

> , " David and Teah Akrish "

> <yes@h...> wrote:

> > Mr. ,

> >

> > I've read many of your responses to the issues/ topics at hand and

> agree

> > almost wholeheartedly with your views. For whatever it is

> worth...thought

> > you should know. I have been a practitioner of TCM and a Sifu of

> Choy Li

> > Fut/Tai Chi for over 30 years out of Seattle. I spent my time

> reviewing the

> > formula by Dr. Pei & the case as a whole and grew from it.

> Interesting

> > use of Mu li :)

> >

>

> What exactly is mu li being used for? I posted the case study

> because i was having trouble understanding the possible asymmetry

> between the diagnosis and treatment strategy, and was wondering how

> others interpreted it.

> I would of thought in case such as this, that the emphasis would

> have been on percolating water and assisting qi transformation.

> Instead the Doctor chose too nourish yin fluids, clear heat and

> disinhibit urination.

> How many people would have chosen a similar treatment strategy in

> the light of a pale, swollen tongue, deep weak pulse, whole body

> edema, inhibited urination and utter lethargy. The Doctors diagnosis

> amounted to something described as Qi exhaustion in principle.

> still perplexed,

> matthew

> Take care,

> >

> > David Akrish

> > -

> > " " <@h...>

> >

> > Saturday, January 10, 2004 8:58 AM

> > Re: Fatigue: peculiar case study

> >

> >

> > , " "

> > wrote:

> > > , " "

> > <@h...>

> > > wrote:

> > >

> > > it is bad practice to second guess case studies, you will miss

> > > > the point. More important is to try to learn from what is

> > written and

> > > > get the lesson that is being presented.

> > >

> > >

> > >

> > > I think you have to do both. You have to look at the case itself,

> > but much like one

> > > would critique a research study by asking questions about followup

> > issues, I think

> > > that question is also valid here.

> > >

> >

> >

> > I think you are right to a certain extent.. It is always nice to ask

> > further questions, but to a certain extent it is moot, because one

> > can never know the unknown. It is real easy to say, well (in that

> > case study) they had fatigue and obviously they would have a better

> > formula if they supplemented qi, but then you never learn anything.

> > You are stuck in your own box. It is really hard to criticize a

> > case study when you are not there. IMO, they are there for the

> > lesson. Except it and open the mind. It has actually taken me a

> > long time to get that point, and I still struggle with it. Although

> > many of the case studies, some of the best, have multiple visits,

> > and mistakes are obvious and present to demonstrate the aspects of

> > the lesson. These are easier to criticize, but again I think if one

> > fixates on looking to variables that are not mentioned then one can

> > easily miss the idea. What if. What happened then. etc etc. I find

> > pointless.

> >

> > -

> >

> >

> >

> > 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.

> >

> >

> >

> >

> >

> >

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Share on other sites

, " David and Teah Akrish "

<yes@h...> wrote:

> Hi Matthew,

>

> Your question is exactly why this was such a great case...at

least to me. When I was training as a paramedic my head instructor

warned us of the limitations of 'cookbook medicine'.

>

> Yin draws in and down. Mu li, energetically, moves downward and

draws H20 (water follows salt). The use of this herb was the

personal lesson I took home from this case. Tu fu ling

draws/pulls/directs water. As I meditated on the initial formula it

made more and more sense. Plus---the Dr.'s personal interaction with

the pt. had to have a profound effect on his use/guiding force to

this initial formula. This is how I am able to 'fill in the blanks'

when knowing case studies can only give so much information. This

case definitely fringes on higher thinking coupled by simplicity and

true knowledge of what you see, and what you know...all IMO! To me

this is what separates TCM from the rest. That being individuality.

Would I have used this formula...HMMMM!

>

I wonder why the doctor chose to use Sheng di as the chief herb at

50g? It was a life and death case of qi exhaustion with a total

inability to transform water and prognosis was considered poor. The

pulse was Faint, the tongue pale and swollen and the young boy was

totally listless. In a case of full body swollen edema, I wouldn't

of thought to nourish yin, clear heat and generate fluids as a

treatment neccesity, particularly with a pale swollen tongue and drum

distension of the abdomen.

The use of ba ji tian after the initial few doses of the formula,

was i imagine added to augment yang in order to transform yin. Many

traditional herbal formulas that treat edema seem to focus on

supplementing qi and transforming dampness or warming yang and

disinhibiting the urination.

What role is sheng di playing???

Maybe nourishing yin and generating fluids to such a degree

(50g) with the addition of the mu li to downbear and also nourish yin

at 30g could be likened to the a Great rain storm flooding the river

and breaking open the dam. this of course being that the tu fu ling

cracks it first.

pondering on,

matt

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