anecdotes and citations

[Guest guest]

I founded CHA to satisfy some personal needs. One is my belief that

only consensus results in knowledge of value. Anecdotes play a role in

developing this consensus. Anecdotes are the starting point of all

knowledge, whether ultimately verified through experiment or the

consensus of a community of experts. While I argue the immense need

for controlled experiments in our field, I do not mean to diminish the

value of anecdotal experience (note that both words share the same

root). However, for an anecdote to be of value without a controlled

experiment, I insist on certain criteria. Probably all ideas in CM

began with personal anecdotes. But they only acquired value if they

stood the test of time. An idea is only valid knowledge after many

others have applied it. The long hx of CM in china provides one the

ability to explore what was adopted as effficacious and what was thrown

by the way side. While discarded ideas may have value in a new era and

culture (Unschuld makes this point in his interview in AT this month),

the application of said ideas by a single person is meaningless. If

the idea is not to be tested in a controlled fashion, then there is

only one other test of validity, IMO. The consensus of one's peers.

However, that consensus cannot just be granted based upon title or past

contributions. Each new idea must be debated and thoroughly vetted in

order to insure we are not just experimenting on our patients

willy-nilly. That would be highly unethical. The vetting of new (or

discarded old) ideas will necessarily demand information about what

sources led down this road. Typically new ideas must be grounded in a

study of classical texts, if the proof is to be based on anecdotal

consensus. Just pulling something out of your butt does not cut it

with me. So where did the idea come from? How does it make sense in

the context of existing consensus?

 

One of the purposes of CHA was create a shortcut to developing

consensus on new and old ideas and even standard TCM doctrine. By

having a large diverse group, one person could check to see if their

experience was shared or not. For example, I have discovered that most

on this list do not favor the style of dosing I advocate. I can

justify my position with respect to many source texts, modern research,

etc. Yet many will insist that microdoses work the same as decoction

or that microdoses are more spiritually active, thus better for subtle

disharmonies on the mental level. After five years, so many people

have made this claim that I do not dismiss it anymore. In fact, while

I used to tell students that patents are essentially worthless, I now

tell them that they may be useful in certain circumstances. Not only

has the consensus shaped my position, but so have the intellectual

arguments explaining this phenomena that have been posed by Mssrs.

Flaws and Maclean, the former hardly a patent advocate by any stretch.

However I still patiently await objective proof of even a single case

of serious structural changes in the body that was impacted by patents

alone as the main therapy. I mean reversal of fibroids or

endometriosis, remission of AI disease, halting of the progression of

hep c cirrhosis, etc. Thus CHA can play a valuable role in creating

new consensus, at least in my mind. Unfortunately, I have found too

many on this list who want isolated anecdotes to stand by themselves as

valuable teachers and then get upset when they are challenged. While

every experience is a teacher of sorts, I find it careless to value

personal knowledge over collective knowledge. Even spiritual pursuits

must take place in a commnuity of the likeminded in order to be

verified. In the zen monastery, you do not decide when you have

achieved, the master does and he does this based upon a long evolved

community consensus of the criteria.

 

 

 

Chinese Herbs

 

 

FAX:

 

 

[Guest guest]

I agree with what you say, but I think a missing piece of the puzzle of

the Western practice of CM is an in-depth examination of the case

history literature, to see how Chinese medical treatment evolved over

time in the treatment of specific patterns and diseases. This is a

difficult undertaking, because, of different cultural descriptions of

disease over time, but one I hope medical anthropologists will help us

with in the future.

 

Then we could put our own clinical experience into the perspective of a

time line stretching back hundreds, if not thousands, of years.

 

 

On Aug 8, 2004, at 12:41 PM, wrote:

 

> I founded CHA to satisfy some personal needs. One is my belief that

> only consensus results in knowledge of value. Anecdotes play a role in

> developing this consensus. Anecdotes are the starting point of all

> knowledge, whether ultimately verified through experiment or the

> consensus of a community of experts.

[Guest guest]

, " " <zrosenbe@s...>

wrote:

> I agree with what you say, but I think a missing piece of the puzzle of

> the Western practice of CM is an in-depth examination of the case

> history literature, to see how Chinese medical treatment evolved over

> time in the treatment of specific patterns and diseases.

 

I agree and this is the correct use of anecdotes, IMO. I am quite disappointed

that book

publsihers continue to pump out materia medicas and formularies, when case

studies are

what we need. This is the main reason to learn to read chinese, IMO. But I was

thinking

earlier that I rarely find my hands tied by lack of such information in my day

to day

practice.

 

Z'ev

 

Correct me if I am wrong, but I believe you are just reaching a point where you

can access

such literature in chinese. How often have you failed or had no recourse with

your

patients because of your prior lack of access to chinese. Never, right?

Reading more may

give your more insight and nuance, but it remains to be seen if it gives you

more efficacy.

Over the years, several of us have repeatedly asked for examples of cases that

could not

have been treated without either studying the classics or reading old cases.

Craig Mitchell

and Dan Bensky have been presenting such cases according to the SHL, but both

make

clear that such cases are the exception, not the rule. While the highest level

of practice

demands such scholars who have insight into strange and difficult cases, most of

the time

standard methods wortk just fine. In those rare cases, one can always refer.

For me,

cases play an important role in education. But endlessly accessing cases for

clinical

practice is not something I think is necessary for most folks. This underscores

why I

believe that learning chinese is essential for the field, but not for every

practitioner.

.

[Guest guest]

,

wrote:

I used to tell students that patents are essentially worthless, I

now

> tell them that they may be useful in certain circumstances. >

However I still patiently await objective proof of even a single

case

> of serious structural changes in the body that was impacted by

patents

> alone as the main therapy. I mean reversal of fibroids or

> endometriosis, remission of AI disease, halting of the progression

of

> hep c cirrhosis, etc.

 

For the most part I agree with your position on dosing. I try to use

the most effective dose I can with my patients. However, sometimes

they won't let me.

Insert Anecdote here...a patient with severe dysmenorhea and

diagnosed with endometriosis came to me several months ago and would

not take any of the herbs I gave her. She would take them home and

then tell me at the next visit that she 'couldn't' take them. So

finally after a few weeks of this I said ok if you want to work with

me (she didn't want surgery) you have to at least try some pills.

She agreed and I called her a few days later to see if she was

actually taking them. Based on her presentation I gave her shao fu

zhu yu wan (plum flower) and jia wei xiao yao wan (Minshan). Both at

8 pills three times a day with four days off a month. She has been

faithfully taking these ever since. After several months her level

of pain is NO pain every other month(before and during her menses)

and about 25% of what it was on the other month. She hasn't had

another ultra sound yet but we are both encouraged. She is also less

tender with abdominal palpation. She comes in for acupuncture 2x's a

month and I always do microelectrostim from zigong to Spleen 8 as

well as other points so who knows, what has had more effect.

 

Jill Likkel

[Guest guest]

There is no doubt that my access to Chinese case history literature is

still slow and painstaking, and time is something I don't often have.

I think rather than specific scripts, herbs, or acupuncture points,

what I am looking for here is the modus operandi of the physician. In

other words, how the physician thought through the case, made the

diagnosis, and chose treatment. This is what was so fascinating about

Craig Mitchell's lecture on SHL diagnosis and treatment. It helped me

make new connections with my synapses, and broke old patterns in my

thinking. This is an exercise we need a lot more of in our field.

 

 

On Aug 8, 2004, at 5:07 PM, wrote:

 

> Correct me if I am wrong, but I believe you are just reaching a point

> where you can access

> such literature in chinese. How often have you failed or had no

> recourse with your

> patients because of your prior lack of access to chinese. Never,

> right? Reading more may

> give your more insight and nuance, but it remains to be seen if it

> gives you more efficacy.

> Over the years, several of us have repeatedly asked for examples of

> cases that could not

> have been treated without either studying the classics or reading old

> cases. Craig Mitchell

> and Dan Bensky have been presenting such cases according to the SHL,

> but both make

> clear that such cases are the exception, not the rule. While the

> highest level of practice

> demands such scholars who have insight into strange and difficult

> cases, most of the time

> standard methods wortk just fine. In those rare cases, one can always

> refer. For me,

> cases play an important role in education. But endlessly accessing

> cases for clinical

> practice is not something I think is necessary for most folks. This

> underscores why I

> believe that learning chinese is essential for the field, but not for

> every practitioner.