integrative possibilities

[Guest guest]

If you accept the premises

 

1. certain diseases may be incurable despite any use of herbs, diet

and other natural measures, due to factors rooted in prenatal essence

 

2. however all syndromes that arise as a result may be controlled

noniatrogenically through some means

 

3. thus a patient may have to accept the lifelong use of medicinals in

some cases (usually in all cases after a certain age, which will vary

according to prenatal essence)

 

4. if one will be dependent on medicinals anyway, then it makes no

difference whether one uses drugs, herbs or both, as long as the

syndromes are resolved noniatrogenically

 

5. this makes the trend in china of using combined drug herb therapy a

likely trend in the US and europe as well. However, in the current

state of affairs, only MDs can manage such cases in most countries.

 

There already has been a reaction to this trend amongst Chinese

traditionalists in the PRC.

 

http://english.people.com.cn/200503/09/eng20050309_176223.html

 

But I think it is still pretty clear which way the wind is blowing.

The idea of using laws to prevent excessive modernization of chinese

medicine is ridiculous and obviously dead in the water with all the

potential profits involved. It is also an outrageous interference with

free speech and free enterprise. Traditionalists will need to prove

their worth either by having hordes of adoring patients and/or

scientific research to back them up.

 

Meanwhile in other arenas, modernization will definitely continue. It

doesn't really concern me if others in the field believe there is a

more predominant role for in America for some other approach to TCM

than what I have outlined above. Because I not only think this is the

most likely, but also the most desirable state of affairs. A holistic

healthcare system attends to the parts and the whole. WM is far more

powerful at affecting the parts. Its only problem is that it often

damages the whole in the process. While we we probably never get to

know, it is very possible that drugs like vioxx could be used safely in

small doses when combined with chinese herbs. Just as research shows

liver disease in patients taking oral hypoglycemics can be completely

reversed in this way.

 

I have not found American doctors willing just yet to consider these

things, but research from China done properly in the next decade will

change things. And you can expect this research to be done if the

chinese want to try something like patenting a proprietary mixture of

herbs with a drug. this would spur research as the companies would be

rewarded with control over profits just as if they had made a new drug.

This will allow the recycling of old drugs in combination with herbs

all double blind tested in asia as the next generation of

pharmaceuticals. This trend is actually old (which is why many current

asian patent meds already have drugs in them; it is not adulteration,

but purposeful as reported by Subhuti at the Pacific symposium a few

years back.

 

I do believe the evidence coming from both TCM and European natural

medicine journals supports the use of isolates and whole substances for

the most effective treatment of illness. Isolates may range from

things like sam-e to vitamins to drugs. There is no doubt in my mind

that one can help a great many people with TCM alone, but I think the

combined approach yields better results and can be done with complete

safety. There will always be a niche for some who want to practice

this way, but the masses will never be interested. If we want to reach

out to the public at large and mainstream medicine as well, I think

this is the best path to that end.

 

Paul Unschuld has apparently been giving strong encouragement to his

followers and students to explore styles of chinese medicine other than

the prevailing american model. This has prompted many to look

backwards in time to lost or forgotten traditions, which is one

possible response. But I would submit that the style of practice I

have proposed is also an unexplored avenue in the west, though quite

developed at this point in the PRC. Thus, at PU's prompting, I propose

that this path be one licensed practitioners consider in our

strategizing for the future. One can always be an herbalist, even

without a license.

 

But only a licensed group could ever lobby for the legal right to

prescribe remedies that contained drugs. Otherwise, as research from

Asia trickles in, MDs will begin to prescribe the new drug/herb

" patents " with great success despite making no use of pattern

differentiation. We can expect this as considerable allopathic style

research on TCM from China shows greater safety and efficacy than the

use of western drugs researched the same way. In addition, as I have

suggested in recent years, there is now evidence in PRC journals that

chinese syndromes may have a very high correlation with gene

expression, which will allow even MDs to do some degree of pattern

differentiation if they choose. And if evidence shows greater efficacy

by doing this, then HMOs will mandate it being done.

 

So perhaps we need to really ramp up any activity associated with

creating a legal class of asian remedies that L.Ac. can prescribe

regardless of their status otherwise. This will create a regulatory

framework for later adding drug/herb products into the list of approved

remedies. This might necessitate being able to do western diagnosis in

order to make it all fly. All this makes a strong case for using the

second tier doctorate (the current DAOM) mainly as a Integrative

medicine training ground, not a mix of IM, research, language, classics

and teacher training, for example. Set the stage for a viable request

to expand scope of practice into the realm of western medicine,

basically something something like a PA or LNP program, where the

primary clinical focus still remained advanced pattern diagnosis and

treatment based thereupon. If one understands the role of a drug as an

ingredient in a formula with clear TCM functions, then the use of the

combined drug/herb products is still Chinese medicine, IMO.

 

As I said, I think this is one path, perhaps the most viable one, for

those who want to be the primary providers of professional CM in

america. While there are many who scoff at the use of drugs or the use

of prepared products, for me it comes down to the product. Chinese

product development will likely result in very convenient delivery

forms further skewing where the masses will get their medicinal

strength herbs. In fact, if we pursue the route of pure classical CM,

then we may find ourselves forever competing with health food stores,

the internet and chinese herbs shops for our patients. If a licensed

practitioner has nothing more to offer than a chinese herb shop owner

with a family lineage, why pay the big bucks for what is often

perceived as the lesser service. But a doctor who could prescribe

convenient, safe, powerful and effective remedies in forms patients

would comply with. Now that would be a breakthrough.

 

Hyperglycemia and hypertension are the two main pathophysiologies that

I usually think of when on this topic. Heart disease and diabetes are

the 2 of the most controllable forms of death in the US, IMO. While

having a genetic component, lifestyle can yield varying degrees of

mitigation. But what about the majority, who, for whatever reasons,

cannot use lifestyle to control these things. Either they are

undisciplined or despite their best efforts, they still remain unwell.

Some combination of drugs in most cases can correct the specific

pathophysiology, though leaving the cause unaddressed. Plus the drugs

may be dangerous or unpleasant. If this huge population of patients

cannot control their lifestyle and cannot have their syndromes resolved

with Chinese herbs alone, but will take unpleasant drugs to guard their

life, why not seize this opportunity to give them the best of both

worlds.

 

It is very possible that the genetic roots of these ailments will be

unraveled as time goes on. Until then, TCM can play a vital role in

helping people cope with illness as they age, giving them care that

does not hurt them, yet offers adequate protection against stroke and

heart attacks. Then they just might live long enough to enjoy the

revolution in western medicine that some say will never come. I would

certainly discourage my students from ever allowing their patients to

suffer for reasons of philosophy alone. Provide the patient the full

range of options truthfully with all risks and rewards disclosed and

then let them decide what course to pursue.

 

 

 

Chinese Herbs

 

 

 

 

 

 

[Guest guest]

This is not the point of the article as I read it. While I agree that

legally protecting Chinese medicine is a hopeless venture, I think some

attention needs to be taken to the fact that too small a percentage of

students and practitioners in the system seem to be really interested

in Chinese medicine per se; Western medicine is 'where the action is',

the money and prestige. I think the point of the article is that

Chinese medicine needs to be revived and stimulated from within as well

as without, that the foundations need to be strengthened and developed.

 

 

On Apr 6, 2005, at 10:47 AM, wrote:

 

> There already has been a reaction to this trend amongst Chinese

> traditionalists in the PRC.

>

> http://english.people.com.cn/200503/09/eng20050309_176223.html

>

> But I think it is still pretty clear which way the wind is blowing.

> The idea of using laws to prevent excessive modernization of chinese

> medicine is ridiculous and obviously dead in the water with all the

> potential profits involved. It is also an outrageous interference with

> free speech and free enterprise. Traditionalists will need to prove

> their worth either by having hordes of adoring patients and/or

> scientific research to back them up.