Menopausal syndrome: Volker's article

December 25, 2006

Some of Volker's arguments re the introduction of menopausal syndrome

as a disease category into CM in the 1960s hold water. However, his

dismissal of the historical record in terms of equating the tian gui

with kidney water is so simplistic and cursory as to make me wonder if

there isn't a larger agenda here. Really authoritative CM

practitioners back as far as the Ming have equated the tian gui with

kidney water and this is the accepted standard interpretation in China

today. So possiting that yin vacuity is the precipitating disease

mechanism of menopause is not simply a modern, erroneous idea.

Bob Flaws

I understood was Mr. Scheid was saying differently than you did Bob.

I read that he was making the point that whether Tian Gui is

associated with Kidney Yin or not, 7 x 7 years should not be seen as

a deficiency of Tian Gui or Kidneys unless such signs and symptoms

are present. I have seen and been influenced by the idea that one

should always treat the Kidneys when the symptoms are related to

menopause in many books and articles and, like Volker, have had to

learn to think for myself.

For me, the main culprit for confusion in diagnosis is a culprit that

was also born of the modern period Volker writes about. It is the

organization of the modern texts. Most modern books are organized in

a most unhelpful way that is misnamed " pattern differentiation " . A

symptom or disease is named and then 4-7 possible " patterns " are

listed. This is the modern phenomena that has most obstructed the

ability of practitioners to diagnose properly. It is very rare that

one is able to " find " one's patient in these repetitive lists. They

rarely accurately reflect the clinical reality. They encourage the

practitioner to try to find their patient's pattern in the list and

thereby discourage the practitioner to develop their own diagnosis.

Most of my students find themselves frustrated by these texts and

rarely helped. Diagnosis is not taught in the schools, including the

Chinese schools. What is taught in the schools here, with the

exception of SIOM, is the party line, a packaged deal that we all

bought. The fact that we don't know how to diagnose and the fact

that the schools don't teach it has nothing to do with our mediocrity

or inferiority - we just do the best with what we have and we are

working constantly to improve and deepen.

Since the Nei Jing, there has always been the recognition that there

are different levels of insight and expertise among doctors.

(Inferior, medium, and superior are the traditional ways of describing

these levels). And I think we can say that, in reality, most

practitioners fall into the inferior and medium (i.e., mediocre)

categories in the same way that the majority of practitioners of any

art will fall into those two categories. That's just the way bell

curves operate. However, that is due to these practitioners' own

innate intelligence and natures and acquired habits and proclivities

rather than anything that has to do fundamentally with the medicine

itself.

I very much disagree with these comments and find them judgmental and

potentially arrogant (unless you put yourself with the rest of us

mediocre or inferior practitioners). Having taught students for

years, I have found the majority of them to be intelligent,

dedicated, wise, enthusiastic and frustrated with what they have been

given. Perhaps it is the teacher or the curriculum, not the student,

who is inferior when the students are unable to learn. Then again,

perhaps what the Nei Jing is referring to is that all three levels

are within each of us.

I found Volker's article to be a breath of fresh air as he

articulated what I have been thinking for years - what has been given

to us is incomplete at best and is organized to confuse, not to

teach. I have been watching Heiner's videos (http://

associates.classicalchinesemedicine.org) and am again relieved to

find that indeed there is a medicine there behind the facade of what

has been given to us. This is also why I appreciate books like Fluid

Physiology and Pathology and Pathomechanisms of the Heart. They are

designed to teach a give a broad sense of an area of our medicine.

In his article Volker said that he had to learn to think for

himself. My question is what does that mean? How do we learn to

diagnose and treat if what has been given leads us in the wrong

direction? This is our work in my opinion - to excavate, clarify,

consider, study, listen and learn. Something starts to develop and

we get better.

Sharon

Sharon Weizenbaum

86 Henry Street

Amherst, MA 01002

413-549-4021

sweiz

www.whitepinehealingarts.com

December 25, 2006

Bob writes

" Since the Nei Jing, there has always been the recognition that there