Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 Clavey translates from the nei jing: " Autumn exposure to damp will lead to cough if it rebels upward, but to withering of the tendons otherwise. " The last phrase caught my attention because it suggests a connection between lurking pathogen theory and atrophy syndrome (wei zheng). As we know, many have tried to link lurking pathogen theory with HIV and hepatitis C and herpes simplex, the viral STD's that can enter the blood directly and seemingly go latent for years. This idea is analogous to the theories of lurking pathogen, however the sexual route of transmission is not described as such nor is the direct entry of pathogen into the blood (into the blood level, yes, but that is not quite the same thing, IMO). Sexual excesses were thought to contribute to the pathogen being able to lodge, brew and eventually flare, but no infection was perceived to have occurred through that route. I have suggested elsewhere that this perception was incorrect and many chronic diseases may indeed have been due to slow infections transmitted sexually than loss of jing, per se. Since a lurking pathogen could lodge in a healthy person with no initial acute sx, how would one ever know? When it came out acutely, you could perhaps then show that that something was going on that had lurked for years, but you could not really say what role sex played (STD, jing loss or both). There is certainly no doubt that STDs have existed for all of hx and the chinese had no conception of this. On the other hand, lurking pathogen theory has not cured a single case of HIV. But perhaps it can keep the disease at bay. Question: can you treat a lurking pathogen with cold, draining herbs while it lurks or only after it surfaces? Liu Guohui gives a case of spleen yang xu with dampheat lurking. But before the DH flared in this case, all you would see is spleen yang xu. If you treated the spleen yang xu at this stage, then you would keep the pathogen lurking. Liu says a flareup is good because then you give treatment. Otherwise you are stuck. However, he also says the whole theory has always been very controversial amongst CM scholars. Some might say that strengthening the spleen yang to contain the pathogen is the best approach. But what if the pathogen brews and does damage while it lurks. real catch-22. But if you need a flareup to clear the pathogen, that raises some interesting thoughts. It makes one think of things like healing crises induced through cleansing methods applied in vacuous patients. Think about it. The spleen yang xu patient comes into the Naturopath's office and says they often get sick with colds, fever, cough, sore throat, etc. When you see them they are not acute, but with spleen qi and yang xu. You decide the patient must have some toxins that need to be cleared so they don't keep flaring up whenever the patient is stressed or weakened in some way. So you fast and purge the patient. This does clear quite a bit of excess from the yangming channels, but also weakens the qi. This allows the lurking pathogen to flare and the " cleansed " patient has a so-called " healing crisis " . At this stage, there may be even further use of detoxifying herbs. this would not be out of character in TCM as Liu and others write that lurking heat is mainly treated by draining, not by releasing the exterior. Naturopaths have often been criticized for purging in acute attacks, but as Liu pointed out at CHA in 2003, this is the naive thinking of those have not deeply studied warm disease. So this tried and true naturopathic approach may have found a home in lurking pathogen theory. I particularly think of the well known class of western herbs traditionally called alteratives. they were used over a period of time to " cleanse the blood " . they were used in all manner of serious chronic illness and they would all pretty much be classified as heat clearing and draining in TCM. This may explain the immense success of Naturopathy in treating Chronic illness in vacuous patients using methods that are seemingly contraindicated by TCM. Naturopaths also would follow such protocols with their own system of supplementation through diet, vitamins, protomorphogens, etc. While there was a period where Naturopathy was overrun by vegan hippies who lost sight of the balanced approach and went way too far on cleansing, the actual elders of the profession advocated the judicious use of meat, esp. organ meats, and organ extracts to rebuild vitality. Adrenal exhaustion is similar to kidney xu, for example. Just another reminder that chronic illness is complex and merely supplementing apparent vacuity in patients with frequent recurrent flareups may not be the ideal approach. This is really similar in vein to Craig Mitchell's presentation at CHA, where he suggested many chronic illnesses may be relieved quickly and often permanently at times using SHL formulas to open and move. Now while it is difficult to find records of lurking disease caused by STD in china, Chip Chace has shown there are quite a few cases that begin with a respiratory complaint. It is thought by many mainstream researchers that diseases like ALS, Myasthenia Gravis, MS, are all initiated by common viruses that begin as URIs. A more radical theory would involve mycoplasma, which I only mention as it also starts often a lung infection. Steve Clavey says such a contraction could to " withering of the tendons " , the common presentation of all these illnesses. In these cases, the presentation of a lurking warm disease seems to fit quite well some of the traditional passages. I was wondering if anyone (Jason?) has seen examples of cases where wei zheng was attributed to a lurking pathogen? I know that a number of texts discuss it beginning as dampheat and treated with san miao wan. But it is not clearly described as lurking in those texts. By the time we see most such patients, they often have pronounced atrophy. But I wonder if displaced emphasis is put on supplementing even at this stage, emphasizing formulas like hu qian wan. This of course all dovetails into my recent discussion of veterinary medicine. If illness is induced by a lurking pathogen, then even chronic illness bears draining in most cases. I would offer that the nature of our pet's lives creates the perfect conditions for a lurking pathogen to brew. On one hand, if they go outside, they can become easily exposed to all manner of microbes plus climatic factors. OTOH, they are often allowed out just for intervals and actually spend most of their coddled and enjoying all the comforts of modern life (regular, nutritious food, controlled climate). Thus their qi stays strong throughout their lives despite having a pathogen brew. At a certain point, when they are elderly or stressed, the pathogen will flare. If you predominantly supplement at this point, then the pathogen will be suppressed and brew to cause further damage. Now I am not necessarily right about my supposition, but I think this should make clear to any serious student of veterinary TCM that there is much to consider in making a TCM diagnosis. To think that 2 days or even 200 hours is enough is just crazy. As anyone who made an attempt to study warm diseases knows, 10 YEARS is more like it. Chinese Herbs FAX: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 > >Now while it is difficult to find records of lurking disease caused by >STD in china, Chip Chace has shown there are quite a few cases that >begin with a respiratory complaint. It is thought by many mainstream >researchers that diseases like ALS, Myasthenia Gravis, MS, are all >initiated by common viruses that begin as URIs. A more radical theory >would involve mycoplasma, which I only mention as it also starts often >a lung infection. Steve Clavey says such a contraction could to > " withering of the tendons " , the common presentation of all these >illnesses. In these cases, the presentation of a lurking warm disease >seems to fit quite well some of the traditional passages. I was >wondering if anyone (Jason?) has seen examples of cases where wei zheng >was attributed to a lurking pathogen? I know that a number of texts >discuss it beginning as dampheat and treated with san miao wan. But it >is not clearly described as lurking in those texts. By the time we see >most such patients, they often have pronounced atrophy. But I wonder >if displaced emphasis is put on supplementing even at this stage, >emphasizing formulas like hu qian wan. [Jason] I have not come across any (Chinese) LP case studies that are wei zheng... But that does not say much... I think that the more I think about LP the less clear I get, I hope someday this reverses. For example, my big thing is to ask what about the treatment, and see how this relates to LPs. As I have mentioned previously, I think many many diseases can not be thought of as LPs (generally speaking)- just from the standpoint of a pathogen lingering. But most of the time this does us little good when it comes to Tx. I.e. in the wen bing xue, if I remember correctly, AIDS is attributed to a LP, yet the treatments do not resemble anything more than basic zang-fu, and of course as you point out do not cure anything... Furthermore, I think that many LP cases do have an important component of venting to the surface in the formulas, they are not all about draining... Where does GHL say that it is mostly about draining? But a couple things that I have wondered about for some time are 1) what do we do when there is no flare-up... 2) and what about flare-ups that occur and we apply a LP tx and it does not get rid of the pathogen (i.e. herpes)... I will see GHL this weekend and I plan to discuss some LP stuff with him, I will let you know if something interesting comes about... - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 > > >Unless there is an alternative to just waiting for a latent pathogen to >appear, I think we >consider inducing its appearance as a reasonable therapeutic option. If we >are pretty sure >the patient has such a pathogen, but is also vacuous, then our hands are >tied. Their >vacuity will worsen while we avoid tonfication, knowing this will further >suppress the >pathogen. but neither can we drain. While we wait, the pathogen will just >brew and do >more damage. Could it be that the most ethical thing to do is induce a > " healing crisis " and >follow rapidly with aggressive treatment for a lurking pathogen if and when >it surfaces? I >believe I have worked on a number of cases where either homeopathy or some > " cleansing " >regimen initiated by the patient or another px seeme to have revealed a >pattern that was >otherwise hidden. And these revealed patterns can then be treated with >Chinese herbs to >quickly resolve the crisis. I am just proposing an idea for discussion >here and trying to >draw on both actual chinese sources as well as cross-cultural empirical >observations of >seemingly similar phenomena. I know some would consider it anathema to >introduce >naturopathic style cleansing into TCM, but we must be open to new ideas. >The trick is see >if they make sense in terms of existing precedent or not. New ideas in CM >should be >rooted in classical theory and be a logical derivation thereof. > >Todd [Jason] No it is not anathema, I think this is a reasonable position and worth considering, but the question is, in these diseases can we really eliminate the deep lying pathogen, or are we just creating a crisis and then cleaning it up, and just waiting for the next attack... - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 , " " <@c...> wrote: I think that many LP cases do have an important component of venting to the > surface in the formulas, they are not all about draining... Where does GHL > say that it is mostly about draining? he says that cases lodged in the ying or xue should be drained. Sometimes he refers to moving pathigens to the qi from the ying so they may be expelled, but he never once refers to moving pathogen from the ying or xue out through the wei But a couple things that I have > wondered about for some time are 1) what do we do when there is no > flare-up... see my other thoughts on this 2) and what about flare-ups that occur and we apply a LP tx and > it does not get rid of the pathogen (i.e. herpes)... do you mean the pathogen recurs in TCM terms or we just can't get rid of the virus in western terms. Because someone could be infected, but never have outbreaks. Are they then cured or suppressed? How can you tell? Chip wrote in an article that often latent heat takes many flareups and treatments to be completely cured and perhaps never can. He also thinks of it more as a syndrome than a " thing " , per se. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 , " " <@c...> wrote: > > > >Todd > [Jason] > No it is not anathema, I think this is a reasonable position and worth > considering, but the question is, in these diseases can we really eliminate > the deep lying pathogen, or are we just creating a crisis and then cleaning > it up, and just waiting for the next attack... So, first, is the deep lying pathogen synonymous with a microorganism or just an overlapping idea? I think the exterior pathogenic attack is actually a state of affairs in physiology that usually, if not always, involves microorganisms (either as cause or scavenger). However the theory describes a state of imbalance caused by a battle between good and evil. It is not all about the microbe. And even the excess is not all about the microbe either. However, the seasonality of infectious disease is a well known phenomena. So when addressing a deep-lying pathogen, the long term strategy is not to just attack an evil, but to change the conditions in which it resides. Some such conditions can be cleared, it seems. People who felt poorly for years after a cold treated with antibiotics, for example. But not herpes as you mention. I have seen herpes go into long term remission, but surface gain as soon as conditions permit. But perhaps herpes is better understood as a dampheat pathogen which may linger and require very prolonged treatment and fastidious lifestyle. Many herpes patients may not be up to the task. I will post some more thoughts about dampheat and lurking pathogens later. for now, just consider whether dampheat alone lurks or just lingers and what is the difference? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 > > >Sunday, September 12, 2004 4:18 PM > >Re: lurking pathogens > > , " " <@c...> >wrote: > >I think that many LP cases do have an important component of venting to the >> surface in the formulas, they are not all about draining... Where does >GHL >> say that it is mostly about draining? > >he says that cases lodged in the ying or xue should be drained. Sometimes >he refers to >moving pathigens to the qi from the ying so they may be expelled, but he >never once >refers to moving pathogen from the ying or xue out through the wei [Jason] I agree with this, but when asked in person he did say that this part of it, and said LP theory is not clear... [Also, Chip is a big proponent of venting through the exterior] Also case studies do demonstrate this idea.. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 During all this discussion of lurking pathogens, I stumbled onto the following article: http://www.newswithviews.com/Howenstine/james16.htm THE OVERLOOKED RELATIONSHIP BETWEEN INFECTIOUS DISEASES AND MENTAL SYMPTOMS As a beginning practitioner 20 years ago, I tended to assume that microbial infections tended to correspond with some type of Heat, usually Excess Heat, but I now know better. From reading medical literature and piecing it together with the description of symptoms and signs, it is clear that microbes can induce or accompany (I'll grant that its not always clear which comes first, the microbe or the " milieu interior " ) pathogenic states that fall into a wide range of TCM categories. For example, in the above article the physician author discusses the observation that people with hypothyroid condition often do not manifest fever when infected by a microbe that would ordinarily cause it. This is reminiscent of Deficiency of Yang conditions, or ShaoYin Deficiency Cold syndromes in which symptoms of exhaustion and debility, diarrhea, increase in severity from a preexisting Deficiency of Yang on invasion by an " Evil " . Also of interest are the antimicrobial effects of many herbs, including tonics, warm-interior herbs (i.e., cloves), and others, not just the bitter-cold herbs. I've had a number of cases over the years that seemed to be classic TCM Deficiencies of various types, which responded better once I targetted specific herbs because of the likely microbial infections that might be present. For example, severe Spleen Yang Deficiency with loose watery diarrhea might involve a number of intestinal infections. True Man's Decoction to Nourish the Organs [Zhen- Ren/ Yang~ Zang\ Tang-] contains Cinnamomi Cassiae, Cx [rou\ gui-] - Potent in vitro inhibitory effects against many Gram-positive bacteria and pathogenic fungi. Terminaliae Chebulae, Fr [he- zi~] - Strong in vitro inhibitory effects against numerous strains of Shigella, Pseudomonas aeruginosa, Salmonella typhi, and Corynebacterium diptheriae. Likewise, a lot of Yin Deficiency conditions, with or without Deficiency Fire, may also be associated with infections. For example, note that Rx Ophiopogonis has antimicrobial action vs. E. coli. Many urinary tract infections are caused by E. coli, and if associated with Kidney Yin Deficiency, this would be an obvious herb to choose. Because of this, I'm compiling as much information as I can on the specific antimicrobial actions of herbs in the materia medica. The medical information and the TCM perspectives are mutually compatible if one recognizes that to " attack a pathogen " sometimes means giving an herb that happens to be classified as a tonic, if both the pattern indications match ***and*** the anti-microbial actions match. ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org > " " < >Re: lurking pathogens > >So, first, is the deep lying pathogen synonymous with a microorganism or just an >overlapping idea? I think the exterior pathogenic attack is actually a state of affairs in >physiology that usually, if not always, involves microorganisms (either as cause or >scavenger). However the theory describes a state of imbalance caused by a battle between >good and evil. It is not all about the microbe. And even the excess is not all about the >microbe either. However, the seasonality of infectious disease is a well known >phenomena. > >So when addressing a deep-lying pathogen, the long term strategy is not to just attack an >evil, but to change the conditions in which it resides. Some such conditions can be >cleared, it seems. People who felt poorly for years after a cold treated with antibiotics, for >example. But not herpes as you mention. I have seen herpes go into long term >remission, but surface gain as soon as conditions permit. But perhaps herpes is better >understood as a dampheat pathogen which may linger and require very prolonged >treatment and fastidious lifestyle. Many herpes patients may not be up to the task. I will >post some more thoughts about dampheat and lurking pathogens later. for now, just >consider whether dampheat alone lurks or just lingers and what is the difference? ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Roger, This is very interesting to me in the framework of the Shang Han Lun's treatment strategies. The strategies of three yin diseases are markedly different from those of three yang diseases. We see many warm to hot medicinals such as fu zi and chuan jiao being used. It would seem that one of the SHL strategies is to eliminate disease evils with hot acrid medicinals when the yang qi is feeble. Roger, what data do you have on any anti-microbial effects of fu zi? On Sep 13, 2004, at 8:34 AM, rw2 wrote: > Also of interest are the antimicrobial effects of many herbs, > including tonics, warm-interior herbs (i.e., cloves), and others, not > just the bitter-cold herbs. I've had a number of cases over the years > that seemed to be classic TCM Deficiencies of various types, which > responded better once I targetted specific herbs because of the likely > microbial infections that might be present. For example, severe Spleen > Yang Deficiency with loose watery diarrhea might involve a number of > intestinal infections. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > >rw2 [rw2] >Monday, September 13, 2004 9:35 AM > > Re: lurking pathogens > > >During all this discussion of lurking pathogens, I stumbled onto the >following article: > http://www.newswithviews.com/Howenstine/james16.htm > THE OVERLOOKED RELATIONSHIP BETWEEN INFECTIOUS DISEASES AND MENTAL >SYMPTOMS > >As a beginning practitioner 20 years ago, I tended to assume that microbial >infections tended to correspond with some type of Heat, usually Excess Heat, >but I now know better. >From reading medical literature and piecing it together with the >description of symptoms and signs, it is clear that microbes can induce or >accompany (I'll grant that its not always clear which comes first, the >microbe or the " milieu interior " ) pathogenic states that fall into a wide >range of TCM categories. For example, in the above article the physician >author discusses the observation that people with hypothyroid condition >often do not manifest fever when infected by a microbe that would >ordinarily cause it. This is reminiscent of Deficiency of Yang conditions, >or ShaoYin Deficiency Cold syndromes in which symptoms of exhaustion and >debility, diarrhea, increase in severity from a preexisting Deficiency of >Yang on invasion by an " Evil " . [Jason] I think though on needs to be careful with such generalizations... as GHL's case, that Todd mentions, demonstrates that one can manifest heat signs from an external attack and even have a lurking pathogen (of i.e. d-h) overlayed with a constitutional yang xu. Such rules, IMO, only limit what one sees in the clinic. One can clearly have yang xu and get invaded and present with heat. -Jason Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 I don't want to speak for Roger, but I am sure he understands this. This will depend on the complexity of the pattern or patterns, such as a shao yin yang xu pattern wind-cold attack with heat effusion (ma huang xi xin fu zi tang). There will be interior and exterior cold, and the heat effusion is the only sign of external attack, as the pulse is deep and thready. On Sep 13, 2004, at 11:39 AM, wrote: > I think though on needs to be careful with such generalizations... as > GHL's > case, that Todd mentions, demonstrates that one can manifest heat > signs from > an external attack and even have a lurking pathogen (of i.e. d-h) > overlayed > with a constitutional yang xu. Such rules, IMO, only limit what one > sees in > the clinic. One can clearly have yang xu and get invaded and present > with > heat. > > -Jason > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > >rw2 [rw2] >Monday, September 13, 2004 9:35 AM > > Re: lurking pathogens > > >During all this discussion of lurking pathogens, I stumbled onto the >following article: > http://www.newswithviews.com/Howenstine/james16.htm > THE OVERLOOKED RELATIONSHIP BETWEEN INFECTIOUS DISEASES AND MENTAL >SYMPTOMS > >As a beginning practitioner 20 years ago, I tended to assume that microbial >infections tended to correspond with some type of Heat, usually Excess Heat, >but I now know better. >From reading medical literature and piecing it together with the >description of symptoms and signs, it is clear that microbes can induce or >accompany (I'll grant that its not always clear which comes first, the >microbe or the " milieu interior " ) pathogenic states that fall into a wide >range of TCM categories. For example, in the above article the physician >author discusses the observation that people with hypothyroid condition >often do not manifest fever when infected by a microbe that would >ordinarily cause it. This is reminiscent of Deficiency of Yang conditions, >or ShaoYin Deficiency Cold syndromes in which symptoms of exhaustion and >debility, diarrhea, increase in severity from a preexisting Deficiency of >Yang on invasion by an " Evil " . > >Also of interest are the antimicrobial effects of many herbs, including >tonics, warm-interior herbs (i.e., cloves), and others, not just the >bitter-cold herbs. I've had a number of cases over the years that seemed to >be classic TCM Deficiencies of various types, which responded better once I >targetted specific herbs because of the likely microbial infections that >might be present. For example, severe Spleen Yang Deficiency with loose >watery diarrhea might involve a number of intestinal infections. >True Man's Decoction to Nourish the Organs [Zhen- Ren/ Yang~ Zang\ Tang-] >contains > Cinnamomi Cassiae, Cx [rou\ gui-] - Potent in vitro inhibitory >effects against >many Gram-positive bacteria and pathogenic fungi. > Terminaliae Chebulae, Fr [he- zi~] - Strong in vitro inhibitory >effects against >numerous strains of Shigella, Pseudomonas aeruginosa, Salmonella typhi, and >Corynebacterium diptheriae. > >Likewise, a lot of Yin Deficiency conditions, with or without Deficiency >Fire, may also be associated with infections. For example, note that Rx >Ophiopogonis has antimicrobial action vs. E. coli. Many urinary tract >infections are caused by E. coli, and if associated with Kidney Yin >Deficiency, this would be an obvious herb to choose. > >Because of this, I'm compiling as much information as I can on the specific >antimicrobial actions of herbs in the materia medica. The medical >information and the TCM perspectives are mutually compatible if one >recognizes that to " attack a pathogen " sometimes means giving an herb that >happens to be classified as a tonic, if both the pattern indications match >***and*** the anti-microbial actions match. [Jason] I would assume though that one would need to know which microbe that person has, and this is a major problem for TCM clinics, especially acute problems on the fly... I think it would be a little premature to include such herbs without having a 1 to 1 correlation - unless they are normally used for such a disease (of course). Furthermore, I do not think there is any guarantee that what has been proven to be effective in *vitro* would even get to the target area in VIVO... I think it is a leap of faith to think that MMD can kill e-coli in the bladder... Have you read some studies? Furthermore, What strand of e coli was MMD tested on? Any / all of them? I certainly need more information & data than many of these controversial in vitro studies - which I am very skeptical of. I think that is why Bensky took out all of that stuff in his new book... Finally I don't think this is anything new, for didn't China go through this big microbial phase in the 70's and 80's. And although this type of thinking has clear use on some levels, it is my impression that China has backed off from their once over-zealous pro-microb war ( this is from the articles etc that I have read bashing the banlangen for cold mentality... Any comments on this one? - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 I do not think there is any guarantee that what has been proven to be effective in *vitro* would even get to the target area in VIVO >>That is a major point which makes these clinical assumption totally ridiculous alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 On Sep 13, 2004, at 8:34 AM, rw2 wrote: > he medical information and the TCM perspectives are mutually > compatible if one recognizes that to " attack a pathogen " sometimes > means giving an herb that happens to be classified as a tonic, if both > the pattern indications match ***and*** the anti-microbial actions > match. The only problem I have with this approach is that I never know what kind of dosage or duration was used that allowed researchers to make this biomedical statement. Its kind of like seeing Rx. Rehmaniae (Shu Di Huang, Sheng Di Huang) listed as an ingredient in an Aveda skin cream. I don't know of any topical applications for this Yin/Blood tonic, but that doesn't mean that there aren't. My suspicion however is that the Aveda chemists read that Rehmannia (probably taken internally) can help to moisturize the skin, and so they add a dusting of it to their skin cream without any particular thought as to the minimum required dosage. In return, they get to market their products as having Ancient Chinese natural herbal ingredients. So, even though some heat-clearing herbs have anit-microbial actions, what is the typical minimum dosage for such actions? 100% of common TCM dosage? 50%? -- Pain is inevitable, suffering is optional. -Adlai Stevenson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 To answer a number of comments about incorporating an antimicrobial strategy: I am emphatically NOT suggesting that one ignore the standard TCM pattern-recognition paradigm. It is not a question of either/or, but *both*. I think that what gave the medicalized, anti-microbial approach a bad name is that it has been promoted by people who wish to " scientize " TCM. Even many Chinese TCM journals have made this mistake by exclusively focusing on the presumed microbe involved, and completely ignoring the TCM indications. The results of this latter approach are often poor and haphazard, and I am not recommending it. What I am suggesting is the following: That standard TCM pattern matching algorithms, along with common sense dietary recommendations, work in the vast majority of cases. But in a minority of cases with suspected infectious components, it may be useful to choose the herbs such that they satisfy **both** the TCM pattern indications and the anti-microbial actions. Someone brought up the issue of how does knowing the anti-microbial actions of an herb help if one cannot identify the pathogen. Good point. I don't get involved in microbiology lab stuff. But I do read medical articles and try to keep up with major developments in medicine. In talking with older, experienced physicians, it is clear to me that we all have pattern-recognition schemes that we use to recognize certain phenomena. Certain microbes leave behind specific patterns of symptoms and signs. Malaria is a classic example. Pseudomonas often has a characteristic fishy smell. The Valley Fever case I posted a few days ago is another typical example of how one sometimes has to piece together circumstantial evidence: occupational and environmental history plus known or suspected exposure to situations in which certain pathogens are known to lurk. For example, I know that if I go on a backpack trip in the Rockies and come down with diarrhea a few weeks later, that giardia would be high on the suspect list. So any formula should include herbs that not only match the patterns, but have specific anti-giardia action. If Bensky decided to take out the antimicrobial information in his new materia medica, I think this is unfortunate, as I felt the information was useful. Though the other physiological/pharmacological information was more difficult to interpret, and I feel that new students are better off ignoring the latter until they master the basics. Z'ev, I don't have any information on the antimicrobial action of fu zi - my impression is that of all the Interior-warming herbs, it does not have much antimicrobial action, but works more on the endocrine and cardiovascular system. Cloves and evodia, in contrast, have strong anti-microbial actions; that's why cloves is used as an oral antiseptic, as well as its ability to numb tooth and gum pain. And you'll find evodia in several of the Spleen-Yang Deficiency formulas - it has action vs. cholera and various intestinal parasites. Regarding Jason's comment about E. coli in the bladder, research on various remedies such as cranberry juice has shown that the mechanism of action is not to kill the E. coli, but to break the sticky bonds that the E. coli cell surface proteins make with the bladder and urethral mucosa and to make the mucosa more " slippery " . I have no data, but I would not be surprised to find that Ophiopoginis has a similar effect on E. coli urinary tract infections. It is interesting to note that many of the formulas for Dampness of Urinary Bladder, even some of those with considerable Heat, do not use a lot of bitter-cold antibiotic herbs, but use diuretic action " drain-Dampness " . If one uses strong anti-microbials on E. coli bladder infections, the bowel flora becomes disrupted (damages Spleen), and can ultimately make the problem worse. TCM theory and medical knowledge coincide in many areas, if one looks hard enough. ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org > " " <zrosenbe >Re: Re: lurking pathogens > >Roger, > This is very interesting to me in the framework of the Shang Han >Lun's treatment strategies. The strategies of three yin diseases are >markedly different from those of three yang diseases. We see many warm >to hot medicinals such as fu zi and chuan jiao being used. It would >seem that one of the SHL strategies is to eliminate disease evils with >hot acrid medicinals when the yang qi is feeble. > Roger, what data do you have on any anti-microbial effects of fu zi? > > >On Sep 13, 2004, at 8:34 AM, rw2 wrote: > >> Also of interest are the antimicrobial effects of many herbs, >> including tonics, warm-interior herbs (i.e., cloves), and others, not >> just the bitter-cold herbs. I've had a number of cases over the years >> that seemed to be classic TCM Deficiencies of various types, which >> responded better once I targetted specific herbs because of the likely >> microbial infections that might be present. For example, severe Spleen >> Yang Deficiency with loose watery diarrhea might involve a number of >> intestinal infections. > ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2004 Report Share Posted September 15, 2004 Hi Todd and everyone, I have just started reading this thread and will respond more when I have read the rest of the replys (assuming that happens...there's so many!). I am very interested in this topic. I have seen quite a bit of evidence in my own practice that it is almost always a good idea to do clearing treatments before you begin tonifying. I often do a Shaoyang treatment with St. 36 as a first treatment, and you'd be amazed how often symptoms clear right up. you gave some really good examples of healing disciplines that utilize this theory. Another good example is 5 Element Acupuncture. They almost always do an Aggressive Energy treatment (and sometimes a Dragon treatment) as their first treatment. I think that this method of treatment is even more important in the modern age with all the vaccines, antibiotics, and pollution. I do think that it is the humane thing to do, but I also warn my patients what might happen. Laura , " " wrote: > , wrote: > > At a certain > > point, when they are elderly or stressed, the pathogen will flare. If > > you predominantly supplement at this point, then the pathogen will be > > suppressed and brew to cause further damage. > > And the paradoxical nature of this situation is such that supplementing could lead to > temporary improvement in the patient's condition when the pathogen is again suppressed. > Since it would be the lurking pathogen that is the immediate cause of the most acute sx a > patient would experience (which would thus cause them to go to the doctor), the > perception would be the patient had been cured when the pathogen is suppressed again. > The repercussions would only be realized later after further brewing and resurfacing with a > vengeance takes place. > > I think we really need to consider how to handle this paradox. In between flareups, if we > tonify, then we aid deeper suppression. But we can't treat the pathogen directly while it > lurks, what are we to do? Liu wrestles a bit with this controversy and it is no doubt one of > the reasons many scholars dismissed this theory as difficult to use in practice. It is my > observation that many illnesses are casually attributed to lurking pathogens even when in > the remission phase, such as MS. But, again, if the pathogen has not flared, then it cannot > be drained. Should we consider whether there is value to the observations of 5 > generations of naturopaths regarding the induction of healing crises to " reveal the > pathogen " , so to speak. If no pathogen is revealed, no lasting harm is done. If it is, then > direct treatment prior to longterm balanced treatment might make a major difference in > some cases. > > I should also add that this approach is similar to Ayurveda, where phase one of chronic > illness treatment is always cleansing before supplementation. As Svoboda teaches in his > texts on the subject, ayurvedic methods induce a cleansing of toxins first by softening up > stored " gunk " . It is then expected that all nature of poison will enter the blood and cause > suffering, so this softening is immediately followed by blood cleansing with detoxifying > herbs. This is interesting because lurking heat in CM lurks in the nutritive or blood levels. > When it flares, herbs that clear blood or ying heat are often used. According to Svoboda, > Ayurveda does not induce the classical healing crisis of naturopathy because it is > anticipated and treated when the tongue changes before sx bother the patient. In both > some wen bing passages and in classical ayurveda, the tongue coat will change from > scanty or thin to thick. > > Homeopathy has a similar idea. It's called hering's law. It proposes that deep-lying > pathogens or patterns or miasms, etc. can wreak havoc on the body and when treated, > they reveal themselves by moving successively to more and more superficial levels. > Vaccines have always been a culprit to homeopaths and most drugs (and often herbs) are > viewed suspiciously as suppressive agent. Various pathogens such as syphilis and > gonorrhea have always played a large role in the homeopathic thought about chronic > illness. So they did see the direct link between chronic debilitating disorders being rooted > in slow or hidden STD type infections, a point not often emphasized about Hahneman's > and Kent's thought. In modern times, nosodes of a wide range of microorganisms are > used as root treatments. the idea of hering's law or the healing crisis has also taken a > modern face as the die off reaction accorded to both anti-candida and anti-mycoplasma > therapy. > > Unless there is an alternative to just waiting for a latent pathogen to appear, I think we > consider inducing its appearance as a reasonable therapeutic option. If we are pretty sure > the patient has such a pathogen, but is also vacuous, then our hands are tied. Their > vacuity will worsen while we avoid tonfication, knowing this will further suppress the > pathogen. but neither can we drain. While we wait, the pathogen will just brew and do > more damage. Could it be that the most ethical thing to do is induce a " healing crisis " and > follow rapidly with aggressive treatment for a lurking pathogen if and when it surfaces? I > believe I have worked on a number of cases where either homeopathy or some " cleansing " > regimen initiated by the patient or another px seeme to have revealed a pattern that was > otherwise hidden. And these revealed patterns can then be treated with Chinese herbs to > quickly resolve the crisis. I am just proposing an idea for discussion here and trying to > draw on both actual chinese sources as well as cross-cultural empirical observations of > seemingly similar phenomena. I know some would consider it anathema to introduce > naturopathic style cleansing into TCM, but we must be open to new ideas. The trick is see > if they make sense in terms of existing precedent or not. New ideas in CM should be > rooted in classical theory and be a logical derivation thereof. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2004 Report Share Posted September 15, 2004 , " heylaurag " <heylaurag@h...> wrote: > > you gave some really good examples of healing disciplines that > utilize this theory. Another good example is 5 Element Acupuncture. > They almost always do an Aggressive Energy treatment (and sometimes a > Dragon treatment) as their first treatment. OK Laura. I'll bite. tell us more. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2004 Report Share Posted September 16, 2004 Well I don't know a lot about it, but the theory is that you need to clear out the " aggressive energy " before you can do anything else. I've tried it on a few people with good results---but then I switch to TCM acupuncture because I don't know much about 5 Elements. A friend of mine is studying 5 Elements though, and he suggested that I integrate this into my practice as the first treatment every time--- haven't done that, but in time I might find it to be a good idea. Laura , " " wrote: > , " heylaurag " <heylaurag@h...> wrote: > > > > > you gave some really good examples of healing disciplines that > > utilize this theory. Another good example is 5 Element Acupuncture. > > They almost always do an Aggressive Energy treatment (and sometimes a > > Dragon treatment) as their first treatment. > > OK Laura. I'll bite. tell us more. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2004 Report Share Posted September 16, 2004 , " " <zrosenbe@s...> wrote: > Roger, > This is very interesting to me in the framework of the Shang Han > Lun's treatment strategies. The strategies of three yin diseases are > markedly different from those of three yang diseases. We see many warm > to hot medicinals such as fu zi and chuan jiao being used. It would > seem that one of the SHL strategies is to eliminate disease evils with > hot acrid medicinals when the yang qi is feeble. > Roger, what data do you have on any anti-microbial effects of fu zi I believe Fu zi is a potent antimicrobial. Heiner Fruehauf called the SHL the school of warming yang, that the primary action of those formulas is to move with heat. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2004 Report Share Posted September 17, 2004 >I believe Fu zi is a potent antimicrobial. Heiner Fruehauf called the SHL the school of >warming yang, that the primary action of those formulas is to move with heat. >Todd My favorite source reference on pharmacological effects is " Chinese Materia Medica: Chemistry, Pharmacology, and Applications " by You-Ping Zhu. If an herb has antimicrobial activity, it is usually discussed in detail. No anti-microbial effects were mentioned for fu zi. Likewise, Chen and Chen mention nothing either - primary effects are cardiovascular, antiinflammatory, analgesic, and effects on cellular metabolism (cAMP). It is possible that in Deficiency of Yang or Interior Cold cases, in which the individual is predisposed to Cold-Damp fungal infections and other Cold-type pathogens, that by warming the Interior and increasing metabolism, this would have an indirect effect by changing the milieu interior such that these pathogens would not find the changed environment to their liking. But that is different from a direct anti-microbial action. ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org Quote Link to comment Share on other sites More sharing options...
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