Guest guest Posted May 11, 2004 Report Share Posted May 11, 2004 The main organization of TCM treatment manuals seems to have always centered around disease or symptoms (bian bing), then subcategorized by patterns (bian zheng). This is evident in books ranging from nei jing ling shu to jin gui yao lue to dan xi xin fa to modern nei ke texts. Formulas are often indicated in internal medicine texts for a much broader range of chief complaints that are listed in formula texts. For example, if you look at Philippe Sionneau's 7 volume treatment of disease in TCM series, you would find bu zhong yi qi tang indicated as the base formula used in treating dozens of complaints that would not be found in a database that was limited to the data found in a formula text (like Bensky). For example, sionneau lists liu jun zi tang for remission stage wheezing due to spleen qi xu with phlegm, which makes perfect sense. However, Bensky does not indicate this formula for wheezing. Concerns have been raised in some quarters that books organized like sionneau's lend themselves to abuse. Because it is so easy to find any chief complaint imaginable in the series, there may be a tendency to ignore multiple patterns or complaints when using the texts. In Sionneau's defense, he does explicitly state that his intent in his books is NOT to encourage the correlation of any disease with a single pattern. But rather that the patterns listed in each chapter represent a network of mutually engendering possibilities. In order to properly treat a disease, one must actually consider that a number of different pathomechanisms are at play and that one's final formula will take all of these into consideration. I find internal medicine texts to be quite useful in that they tend to organize information on one page that could otherwise be found in several different sources (basic texts, materia medica and formularies). If students can avoid the tendency to treat diseases and do multipattern diagnosis, these books can be useful ways of accessing data. They are thus quite useful when relying on the printed word. However, would well designed computer databases obviate the need for such an independent organization of data. I hadn't really considered that before. I think the popularity of the internal medicine genre of literature in the past 800 years is probably because these books were the first attempts to " search and sort the database " . But they have always been tempting crutches after they become gospel. Once upon a time zhu dan xi brought his knowledge of materia medica, formulas and theory together into essays on the treatment of specific diseases, as so many others have also done. But in coming up with their successful strategies, didn't these doctors basically " search " their own brains for prior information about pathomechanisms, herb functions and classical prescriptions to develop their formulas. A modern database that has boolean search capabilities should allow one to access all the theory, herb and formula data that correlate to a precise set of parameters. If your herb and formula database was sufficiently broad enough, couldn't one access the information necessary to treat any symptom or chief complaint listed in a formula or herb texts without having to resort to a separate disease database. The question is whether internal medicine texts still offer something unique and valuable above and beyond a " sort and search " of patterns, herbs and formulas. Well, they provide detailed information on the pathomechanisms of symptoms , but this could also easily be digitized. They may record the valuable experiences of an individual. A random sort and search gives you rational choices, but only experience verifies if those choices are valid. We might combine any number of herbs as the primary strategy for treating phlegm, but instead we combine ban xia and chen pi. OTOH, perhaps we hold these experiences too sacrosanct. Qin bo wei says to respect the idea, not the formula itself. In chinese culture, great new ideas had to pass a test of literacy and cultural correctness. They were not subjected to any clinical testing. for example, for centuries, the prevailing theory about aging involved an extrapolation of zhu dan xi's ideas on yin xu. Now this premise has been challenged by yan de xin, who not only grounds his ideas in the classics, but for which modern research seems to offer strong confirmation. Clearly, it would be remiss to ignore past experience as it has been collected in int. med. texts. But it would also be remiss to not avail ourselves of the technology that will allow us to explore unexplored possibilities and novel ideas merely by having more powerful ways of sifting through existing data. I have long argued that there is more TCM data and essays already available in English than most folks would ever read in a lifetime. We have often heard the argument on this list that since 99% of chinese medical literature is untranslated, if you can't read medical chinese pretty well, you don't have access to what you need to practice effectively. However, no one is really saying that we need access to more herbs or more formulas in our pharmacies. The missing genres are largely case studies and internal medicine literature. But much of that " missing " int. med. data may actually be already available between existing materia med and formula texts. It just has not been sorted for convenient use. As for case studies, they are indeed useful, but educational theory shows that working through cases is infinitely more educational than just reading them. Clever software design can actually turn cases into exercises that reinforce basic knowledge and improve prescription writing. Chinese Herbs FAX: Quote Link to comment Share on other sites More sharing options...
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