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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:

 

 

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, 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. "

 

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, 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…

 

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