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Hi,

 

I am new, and I am also a new student to TCM. I am in

my second trimester, and I am finding it a little

frustrating.

 

I am an older student, therefore, I do alot of

reading, in the case of TCM and being new, this can

almost be dangerous, ya know! There is a saying, a

little bit of knowledge can be dangerious " . Many

things float around in your head, and need a slot.

 

Last night, I had a bad experience. I have an

instructor that took me to task because I would not

accept that " distention " was only a disorder of Qi.

 

I have looked it up in several books and distention is

also used also for Dampness and Phlem.

 

I guess the question is, should I accept distention

only as a disorder of Qi, and forget what I read?

 

Thanks

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Holly,

 

I think this is a simple matter of misunderstanding based on language or

translation. Of course, " distension " in the sense of a tight, drumlike

abdomen generally refers to qi stagnation. But in a larger picture,

distension in the sense of fullness, discomfort, accumulation, bloatedness,

etc. can be due to middle jiao dampness and phlegm. This is why, when I

teach, I used lots of different terms. I stress to my students that patients

will not come in complaining of " distension " ; they will say they feel

" sick " , or " full " or even " toxic " . It is up to you to determine whether this

is from gas, qi stagnation, water retention, dampness, or just that the

person feels " fat " . So your teacher missed an opportunity to explore with

you the various meanings and causes of " distension. "

 

 

Julie Chambers

 

 

-

" holly mead " <flwfree

 

Thursday, February 10, 2005 7:55 AM

New to TCM

 

 

>

>

> Hi,

>

> I am new, and I am also a new student to TCM. I am in

> my second trimester, and I am finding it a little

> frustrating.

>

> I am an older student, therefore, I do alot of

> reading, in the case of TCM and being new, this can

> almost be dangerous, ya know! There is a saying, a

> little bit of knowledge can be dangerious " . Many

> things float around in your head, and need a slot.

>

> Last night, I had a bad experience. I have an

> instructor that took me to task because I would not

> accept that " distention " was only a disorder of Qi.

>

> I have looked it up in several books and distention is

> also used also for Dampness and Phlem.

>

> I guess the question is, should I accept distention

> only as a disorder of Qi, and forget what I read?

>

> Thanks

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, holly mead <flwfree> wrote:

>

I would not

> accept that " distention " was only a disorder of Qi.

>

> I have looked it up in several books and distention is

> also used also for Dampness and Phlem.

>

> I guess the question is, should I accept distention

> only as a disorder of Qi, and forget what I read?

 

 

Holly

 

Excellent question. You most certainly should not forget what you read. But

you must

read critically and also look to verify the things you are told in books. If

you cannot find

the textbook citation to either support or defend the teacher's point of view,

politely ask

him or her where you can read more on this matter. If you have read that

dampness and

phlegm also lead to distention in some of your required texts, the instructor

should be

able to explain the discrepancy. I suspect this may come down to translation

terminology.

If one author is translating one term as distension and a second author another,

then you

may be both right. the only way to have this discussion is if we get our terms

straight.

Now this is hardly your fault. It is the fault of a profession that stubbornly

resists the

obvious and thus makes education a far more arduous task than it need be.

 

So the first question is what sources support each point of view? What does

Wiseman say?

Maciocia? Kapchuk? Only the first uses a standard translation terminology that

may be

easily investigated with regards to the original chinese character. thyerein

lies the crux of

the problem. Do you know if the instructor who " took you to task " made a point

of

identifying his or her sources. Or if they were speaking from their personal

reading in

chinese, what standard do they use for translation or at least what is the pin

yin for the

word in question? These are all reasonable questions if asked with all due

respect.

 

I can tell you that on page 31 of Wiseman's Introduction to English Terminology

of TCM, it

says, " signs of dampness encumbering the spleen include ... abdominal

distention " . There

are in fact dozens of refrences in this book to distention associated with

numerous other

pathogens. But in each case that pathogen is probably obstructing the qi and

that is

perhaps the most proximate pathomechanism of the distention. But that really is

somewhat semantic. It is certainly true qi stagnation is differentiated by

distending pains,

but I am not sure the converse is also true, that is distention is always an

indication of qi

stagnation and nothing else. The definition in the first edition of FCM refers

only to visible

expansion of the skin and does not limit it to any pathomechanism. From a

clinical

perspective, IMO, all pathogenic accumulation always causes qi stagnation if not

caused by

it. So this becomes somewhat moot in practice. I am sure some of language

experts can

clarify further.

 

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, JulieJ8 <Juliej8@b...> wrote:

So your teacher missed an opportunity to explore with

> you the various meanings and causes of " distension. "

>

 

 

while there are various causes of distention, if we are talking about the term

zhang4 which

Wiseman translates as distention, there appears to be only one fairly precise

meaning.

 

the state of being stretched out or inflated. refer to both objective swelling

and subjective

sensation.

 

the patient may not say this, but it should be fairly easy to determine by both

looking and

defining what you mean as above.

 

OTOH, man3/fullness in wiseman terms refers only to the subjective sensation of

expansion or pressure, which may or may not be associated with distention.

 

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Thanks for your reply, and I guess I was sending out a

message for all of those that study and teach Chinese

Medicine.....and asking an important question, a

thought that has been crossing my mind of late.....

made a statement once in class that he did not

appreciate the " New Age " type of style of Chinese

Medicine, and I must tell you that being new, that is

how it comes across.

 

I was in my clinic the other day, and I was told that

most of the patients had Blood Stasis, and I asked,

well how do we know that? And the answer was that

under the tongue, if it is purple, and it goes up 3/4

of the way, the patient requires treatment. Hmmmm

 

Of course I checked my own tongue, and sure enough I

was told I had Blood Stasis and needed treatment. I

said, treatment for WHAT exactly, I do not have pain,

nor discomfort etc. Then I was told that I needed

digestive enzymes.....okay.....I asked what having

Blood Stasis ment to me since I had no illness that

was aware of, and I was told I needed to be treated.

Right.....

 

So then I go to my OM2 instructor and I said.....I

thought Blood Stasis had " pain " because that is what

you are teaching me, STAGNATION IS PAIN, and I told

him that I had Blood Statsis and no pain, his answer

was, " pain is relative " .

 

It seems to me that we as students are being left out

of the good stuff, so I have taken Todd's advise and I

am doing my own reading and my own studying. But how

many people are buying this McDonald's, fast food way

of teaching? As a future practitioner, will we truely

be qualified to practice , because I

feel that we are learning something that is an

offshoot of the real thing. I hope I am wrong, but I

am getting some pretty flakey answers on just about

everything I ask, so I am going to stop asking.

 

Holly

 

 

 

 

--- JulieJ8 <Juliej8 wrote:

 

>

> Holly,

>

> I think this is a simple matter of misunderstanding

> based on language or

> translation. Of course, " distension " in the sense of

> a tight, drumlike

> abdomen generally refers to qi stagnation. But in a

> larger picture,

> distension in the sense of fullness, discomfort,

> accumulation, bloatedness,

> etc. can be due to middle jiao dampness and phlegm.

> This is why, when I

> teach, I used lots of different terms. I stress to

> my students that patients

> will not come in complaining of " distension " ; they

> will say they feel

> " sick " , or " full " or even " toxic " . It is up to you

> to determine whether this

> is from gas, qi stagnation, water retention,

> dampness, or just that the

> person feels " fat " . So your teacher missed an

> opportunity to explore with

> you the various meanings and causes of " distension. "

>

>

> Julie Chambers

>

>

> -

> " holly mead " <flwfree

>

> Thursday, February 10, 2005 7:55 AM

> New to TCM

>

>

> >

> >

> > Hi,

> >

> > I am new, and I am also a new student to TCM. I am

> in

> > my second trimester, and I am finding it a little

> > frustrating.

> >

> > I am an older student, therefore, I do alot of

> > reading, in the case of TCM and being new, this

> can

> > almost be dangerous, ya know! There is a saying, a

> > little bit of knowledge can be dangerious " . Many

> > things float around in your head, and need a slot.

> >

> > Last night, I had a bad experience. I have an

> > instructor that took me to task because I would

> not

> > accept that " distention " was only a disorder of

> Qi.

> >

> > I have looked it up in several books and

> distention is

> > also used also for Dampness and Phlem.

> >

> > I guess the question is, should I accept

> distention

> > only as a disorder of Qi, and forget what I read?

> >

> > Thanks

>

>

>

>

>

>

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, holly mead <flwfree>

wrote:

>

 

>

> So then I go to my OM2 instructor and I said.....I

> thought Blood Stasis had " pain " because that is what

> you are teaching me, STAGNATION IS PAIN, and I told

> him that I had Blood Statsis and no pain, his answer

> was, " pain is relative " .

 

 

I am sure the teacher in questions reads this list and he is

certainly a reliable source who likes critical discussion. I would

offer some other possibilities. Blood stasis in the network vessels

(as opposed to the main or extraordianry vessels) is also indicated

by distended sublingual veins. Blood stasis in the network vessels

does not necessarily manifest as pain at all. The network vessels and

their deterioration with age are a major topic of TCM geriatrics.

Blood stasis in the network vessels has been associated with

atherosclerosis, diabetes, liver diseases, autoimmunity, depression

and cancer. Since atherosclerosis starts in most Americans around age

11, it is not unrealistic that evidence shows in the tongue by early

adulthood depending on diet and activity. In addition, the distended

sublinguals may appear in those who symptoms are solely related to

emotional manifestations of qi stagnation and blood stasis, such as

depression, anxiety or insomnia. I am just offering general thoughts

here as I have no familiarity with your case.

 

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Holly,

Before we condemn the diagnostic significance of sublingual veins, it

behooves us to check out this further. My first hearing of this is from

seminars with Kiiko Matsumoto. I have a great deal of respect for her

clinical experience. I too have noticed predominance of this sign usually

confirmed with pressure pain in lower left abdominal pain and indicating

blood stagnation. Not all stasis is connected to pain. Blood stasis is

found frequently in the elderly. We should not condemn what we do not

understand, ask questions. This symptom is clinically relevant. It is

unfortunate that your teachers did not share background info with you.

Mike W. Bowser, L Ac

 

 

On 2/10/05 11:50 PM, " holly mead " <flwfree wrote:

 

>

> Thanks for your reply, and I guess I was sending out a

> message for all of those that study and teach Chinese

> Medicine.....and asking an important question, a

> thought that has been crossing my mind of late.....

>

made a statement once in class that he did not

> appreciate the " New Age " type of style of Chinese

> Medicine, and I must tell you that being new, that is

> how it comes across.

>

> I was in my clinic the other day, and I was told that

> most of the patients had Blood Stasis, and I asked,

> well how do we know that? And the answer was that

> under the tongue, if it is purple, and it goes up 3/4

> of the way, the patient requires treatment. Hmmmm

>

> Of course I checked my own tongue, and sure enough I

> was told I had Blood Stasis and needed treatment. I

> said, treatment for WHAT exactly, I do not have pain,

> nor discomfort etc. Then I was told that I needed

> digestive enzymes.....okay.....I asked what having

> Blood Stasis ment to me since I had no illness that

> was aware of, and I was told I needed to be treated.

> Right.....

>

> So then I go to my OM2 instructor and I said.....I

> thought Blood Stasis had " pain " because that is what

> you are teaching me, STAGNATION IS PAIN, and I told

> him that I had Blood Statsis and no pain, his answer

> was, " pain is relative " .

>

> It seems to me that we as students are being left out

> of the good stuff, so I have taken Todd's advise and I

> am doing my own reading and my own studying. But how

> many people are buying this McDonald's, fast food way

> of teaching? As a future practitioner, will we truely

> be qualified to practice , because I

> feel that we are learning something that is an

> offshoot of the real thing. I hope I am wrong, but I

> am getting some pretty flakey answers on just about

> everything I ask, so I am going to stop asking.

>

> Holly

>

>

>

>

> --- JulieJ8 <Juliej8 wrote:

>

>> >

>> > Holly,

>> >

>> > I think this is a simple matter of misunderstanding

>> > based on language or

>> > translation. Of course, " distension " in the sense of

>> > a tight, drumlike

>> > abdomen generally refers to qi stagnation. But in a

>> > larger picture,

>> > distension in the sense of fullness, discomfort,

>> > accumulation, bloatedness,

>> > etc. can be due to middle jiao dampness and phlegm.

>> > This is why, when I

>> > teach, I used lots of different terms. I stress to

>> > my students that patients

>> > will not come in complaining of " distension " ; they

>> > will say they feel

>> > " sick " , or " full " or even " toxic " . It is up to you

>> > to determine whether this

>> > is from gas, qi stagnation, water retention,

>> > dampness, or just that the

>> > person feels " fat " . So your teacher missed an

>> > opportunity to explore with

>> > you the various meanings and causes of " distension. "

>> >

>> >

>> > Julie Chambers

>> >

>> >

>> > -

>> > " holly mead " <flwfree

>> >

>> > Thursday, February 10, 2005 7:55 AM

>> > New to TCM

>> >

>> >

>>> > >

>>> > >

>>> > > Hi,

>>> > >

>>> > > I am new, and I am also a new student to TCM. I am

>> > in

>>> > > my second trimester, and I am finding it a little

>>> > > frustrating.

>>> > >

>>> > > I am an older student, therefore, I do alot of

>>> > > reading, in the case of TCM and being new, this

>> > can

>>> > > almost be dangerous, ya know! There is a saying, a

>>> > > little bit of knowledge can be dangerious " . Many

>>> > > things float around in your head, and need a slot.

>>> > >

>>> > > Last night, I had a bad experience. I have an

>>> > > instructor that took me to task because I would

>> > not

>>> > > accept that " distention " was only a disorder of

>> > Qi.

>>> > >

>>> > > I have looked it up in several books and

>> > distention is

>>> > > also used also for Dampness and Phlem.

>>> > >

>>> > > I guess the question is, should I accept

>> > distention

>>> > > only as a disorder of Qi, and forget what I read?

>>> > >

>>> > > Thanks

>> >

>> >

>> >

>> >

>> >

>> Chinese Herbal Medicine offers various professional services, including board

> approved continuing education classes, an annual conference and a free

> discussion forum in Chinese Herbal Medicine.

>

>

>

>

>

>

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