Guest guest Posted February 22, 2004 Report Share Posted February 22, 2004 In the west, are the following premises generally true? 1. most people got into acupuncture to do pain treatment 2. acupuncture is highly effective for pain relief and patients report high satisfaction 3. the vast majority of patients come for neuromuscular problems 4. neuromuscular specialists typically use other modalities in addition to or instead of CM (see caveat below) 5. neuromuscular specialists are primarily acupuncturists who rarely use raw herbs 6. modern chinese texts on bi syndrome actually emphasize herbal treatment 7. in comparison to pain treatment, the total experience of our profession using raw herbs to treat internal disorders in the west is so miniscule as to be almost meaningless vis a vis generalization and conclusion What are we to make of the fact the most successful application of CM in the west is an eclectic form of physical medicine? Is it reasonable to say that the various techniques applied in CM pain treatment are parts of tui na? Or is this something wholly other? And what untapped role can herbs play in this area? I have found herbs to make a dramatic difference in AI dz. and plantar fascitis, but to be somewhat insignificant in osteoarthritis, spasm and injury. In the latter cases, weekly acupuncture with assorted physiotherapies, exercise and posture re-education work whether internal herbs are used aggressively or not. However I have found external herbs to be a great help in these cases, especially when the patient seems to have plateaued. If the pain or parathesia is improved with warmth in the chronic phase, an aconite containing liniment can be remarkable. Perhaps I am getting the daoist thing all wrong here. But people like me have been beating our heads against the wall trying to mainstream CM internal medicine for 2 decades now. And yet so little interest amongst the public and medical docs for what we actually do. A recent evidence-based supplement conference at Scripps in san diego painted the picture nicely. PCOM was invited to participate, but the organizers had no interest in hearing about the use of TCM, but rather about which of our single herbs were most dangerous, most popular and most " proven effective " . Now I am all for evidence based medicine, but the MD crowd does not understand what we do and even more troubling, they have no interest. Ironically, I think the only solution is to do proper research like the OCOM study on endometriosis. If we do not grab this ball soon, CM internal medicine will likely be coopted by MD's as is it has in Japan. Fact is that allopathic CM works. If you write a formula that matches the patterns of 75% of the patients with a given disease, then the formula will work for a random 75% of patients. WM thinks this is an excellent result. And I doubt many CM px get better results than this doing individualized formulation. If this was not true, why would Bob Flaws suggest that his ultimate immortals formula is good for most perimenopausal women (and I agree) or why is so much successful research from china essentially allopathic. Now I would argue that an expert CM herbalist is necessary for those 25% of non-self-limited diseases that do not fit typical groups of patterns. But we MUST prove that if we are to have any role in 21st century healthcare. Otherwise, we will have research proving allopathic efficacy with CM and no proof at all that we could do it better in some or all cases. We may have to resign ourselves to the fact that, as in Japan, MD's will begin to widely use CM rx in an allopathic fashion and they will get results that make their patients happy most of the time. That will leave us to distinguish ourselves in some fashion. I have been able to make little headway in my attempt to mainstream CM internal medicine, in large part due to resistance from WITHIN the field. We don;t have the will to do the research we need to do and we don't have the clout to just bulldoze our way into the mainstream. Meanwhile, very few patients come for internal med and even fewer will comply with raw herbs. So rather than hanging out around back, trying to slip in every time someone leaves the door open for a split second, I have decided to walk in the front door. While the first 7 years of career was focused exclusively on internal disorders, the last 3.5 have been focused on neuromuscular (NM). Because of my role in the PCOM clinic, I have been involved in so much more patient care these 3.5 years than in the past 7 that I now have more experience treating neuromuscular conditions than internal ones. Now don't get me wrong, I bet I still get more internal med experience than most px. My level of internal med practice has stayed the same for 11 years, but luck of the draw has led my NM patients to go from 0/week - 30/week. One caveat. In hindsight, many of my internal med patients were basically NM patients also (migraine, menstrual, MS, RA, SLE, AIDs neuropathy, etc.). Treatment was focused on rectifying zang-fu, while I will be getting into direct physical therapies in my soon to open home practice. I am hardly abandoning internal med here. Just trying to help as many folks as possible using the most accepted form of CM. I hope to make some headway on intenal medicine with patients, insurers and docs by first getting my foot in the FRONT door. Hopefully my rep and position will help in this endeavor. In my career, I have sold ten times as many MD's on acupuncture for pain treatment as on herbs for internal med. And that is hardly where my passion has lain. It is just the path of least resistance. If one adopts the path of least resistance not as a conformist, but with an eye on changing from within, is that daoist or sellout? BTW, while I have resisted a home practice for years, many of the most successful established px in SD, including most of the senior PCOM faculty, operate home practices. And treating NM problems with herbs is fun and challenging. In fact, more challenging than herbology for me. Having my head in a book has always been my personal path of least resistance. So it will take some personal discipline for me to adapt to society's flow and not my own. But then am I here to help or to make a point? Chinese Herbs FAX: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2004 Report Share Posted February 22, 2004 , wrote: And treating NM problems with herbs > is fun and challenging. In fact, more challenging than herbology for > me. This should have read something like this: " treating NM problems with herbs and acupuncture is fun and challenging. In fact, way more challenging than solely using herbology for internal complaints. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 24, 2004 Report Share Posted February 24, 2004 , wrote: > > Fact is that allopathic CM works. If you write a formula that matches > the patterns of 75% of the patients with a given disease, then the > formula will work for a random 75% of patients. WM thinks this is an > excellent result. And I doubt many CM px get better results than this > doing individualized formulation. If this was not true, why would Bob > Flaws suggest that his ultimate immortals formula is good for most > perimenopausal women (and I agree) or why is so much successful > research from china essentially allopathic. I highly question this sweeping generalizational 'fact' .. Where is this 75% from?? I really do not think things are that easy, otherwise we would have already rocked the allopathic world... AS far as bob's motives, I do not think this is proof of anything… and can we say that because (possibly) 1 or 2 diseases respond this way that all will? I would like to hear more… - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 24, 2004 Report Share Posted February 24, 2004 then the > formula will work for a random 75% of patients. >>>>If this was true TCM would be the only medicine practiced in the world Alon Quote Link to comment Share on other sites More sharing options...
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