bi syndrome

[Guest guest]

I am curious how much instruction students and px received in the

herbal treatment of bi syndrome. We have a popular elective at PCOM,

but the subject is otherwise not well covered. Our OM classes cover bi

syndrome pattern differentiation, acupuncture selection and standard

textbook formulas. However the actual complexity of prescribing for bi

syndrome patients is left unaddressed (except in the elective I

mention). Also, how much instruction in external applications? I

received none and little is taught at PCOM. This would seem to be an

oversight that ignores an important fact. 60% of OM patients

nationwide come for neuromuscular problems, many of which are either

due to or complicated by painful obstruction. Due to necessity, I have

made an extensive study of this subject in english and find herbal

treatment to be very helpful in many cases. But not du huo ji sheng

tang for everyone.

 

Now this lack of training in this area raises a question for me. The

herbal community is very focused on internal medicine complaints rather

than musculoskeletal disorders. This dominates our discussion here,

workshop topics and educational agendas. Yet only 25% of patients

nationwide visit acupuncturists for internal disorders. And while many

of these patients have internal diseases, OM is not yet widely used for

these conditions. No more than 3% come for any single class of

internal disorders (respiratory in this case). I am currently reading

a translation of a chinese bi syndrome text by some french guy and the

emphasis in this text is decidedly upon herbology. It seems

counterproductive to devote so much time to the study of rarely treated

conditions and give short shrift to that seen most frequently. Since

any herbal specialty is an avenue to deep study of herbology in

general, why is there not more emphasis on pain treatment with herbs?

One would still have to understand formula construction and

modification. How to address complex conditions of hot, cold, vacuity,

repletion, etc. But one would have the added benefit of strong

familiarity with strategies focused specifically on pain treatment.

 

As everyone knows, I am a vocal advocate for integrating chinese

herbology into the mainstream care of a wide range of internal

disorders. That has been the driving force that led me to TCM and has

kept me here for so long. Most of you also know I consider myself

primarily a pragmatist and it is the utilitarian nature of CM that

mainly interests me. But how pragmatic is it to focus master's level

education on internal medicine rather than pain management. The survey

results of acupuncture usage I have been quoting recently were somewhat

of a wakeup call to me. If our services are mainly used for

neuromuscular problems (which includes autoimmune diseases in most

cases), perhaps our master's programs should really focus on making us

true specialists in this area. Now that we have accredited doc

programs, perhaps those are the place to specialize in various forms of

internal medicine. The dividing line between L.Ac. and DAOM may turn

out to be in who gets to treat internal complaints on a wide scale. I

already have inklings that the PCOM DAOM, with its emphasis on

integrative med, with MD's on the doc clinical staff, is creating a

context that is much more appealing to MD's vis a vis the use of CM for

chronic illness other than pain.

 

Neuromuscular complaints are hard enough to treat as it is. The

difficulty of any specialty is why WM and CM in china create

specialists, not generalists, for serious illnesses. It seems the

public has already decided what our specialty is. The title of L.Ac.

kind of pidgeonholes us as well. Primarily acus, thus primarily pain.

Well, why not go with the flow. If these are our patients, this what

we should be best at. Now I know SOME of you have practices of mostly

internal med patients or have great success getting your

musculoskeletal patients to commit to longterm treatment for

concomitant internal complaints, I think this is not the norm. Most

patients do not have the discipline or time or money to make these

commitments. We have a lot of education to do and perhaps only DAOM

status will pave the way after all (did I just write that??!!). In the

meantime, let's get best at what we do most. Fact is, whatever a few

very established folks on this list are doing, most current students

and new px and mostly doing neuromusc work. Am I right? I used to

bemoan this state of affairs till I realized that writing formulas for

bi syndrome and injury was just as fun as writing them for anything

else. When I was in private practice in OR, I limited my practice to

10 hours per week and only took internal med cases. But now at PCOM, I

treat or supervise 50 cases per week and luck of the draw makes most of

them neuromusc. If your sole income is to be from practice, don't fail

to deeply study pain management from both east and west.

 

 

 

Chinese Herbs

 

 

FAX:

 

 

[Guest guest]

, wrote:

> I am curious how much instruction students and px received in the

> herbal treatment of bi syndrome. We have a popular elective at PCOM,

> but the subject is otherwise not well covered. Our OM classes cover bi

> syndrome pattern differentiation, acupuncture selection and standard

> textbook formulas. However the actual complexity of prescribing for

 

I agree that PCOM lacks in it's covering of bi syndrome and of the use

of external applications, something that I have been very interest in

for years and will continue to persue on my own.

 

As to your question as to why this has happened: I firmly believe

that if Giovanni had written a bi syndrome and / or external

application book back in the 1990's that the subject matter would be

firmly placed, not only in PCOM cirriculum, but on a national level as

well. How sad is that?

 

Brian C. Allen