Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Sharon, It is the cold pathogen itself that is causing the bleeding. After that you can tell any further story you want that explains why this might happen, but that only confuses the issue. Meaning, it may make some sense in your mind to say the cold is creating heat or creating stasis and that is " really " what is causing the bleeding (because 'we know that is what causes bleeding'). But this circular logic only inhibits things, and one can therefore miss the cure. The cure is to eliminate the cold, period! This is actually classic SHL thinking. One major premise of the book is how to eliminate the pathogen from the body. It mentions nothing of zang-fu or complex theory, just how do we get it out. For example, once you start to say that the cold is causing stasis, one will say, there must be stasis (to treat). Or if one thinks the cold is causing heat (that is causing the bleeding), there must be heat (to treat). Otherwise what is the point of thinking that there is heat or stasis? Therefore our treatment would be (at least to some degree) clear heat (or move stasis) especially since bleeding is usually acute. But once again my argument (for the cause of bleeding) rests solely on the treatment and not the story in one's mind (as with my nocturia example). Cold as a cause for bleeding is supported in the SHL case literature and this is precisely why a formula like gui zhi jia fu zi tang can treat bleeding. Commentary specifically states, " Cold can cause bleeding. " This is also precisely why being fixed in a box will confine oneself to only see options that one believes are correct. I find that the " stories " get people into trouble very easy. So you may be right that (in your theory) bleeding is always caused by 4 major things, but IMO this confuses the issue for treatment / treatment principles. Treatment principles should, in theory, follow the dx. This is why I always say, you can tell any story you want, but always look at the treatment, this is where the truth lies. How confusing would it be to tell a student that heat is really causing the bleeding but the treatment is really gui zhi jia fu zi tang. hhhmmm. zen cohen?? I am with Alon, I don't buy empty theory. (For Alon and others) To sum up: this idea of cold causing bleeding is not my idea, just something that I read in SHL commentary and case studies. This seems to be a good example of how studying the classics opens one up to wider possibilities than just basic TCM thoughts. Alon, may have been versed with this idea already, for he seems to have studied widely, especially SHL. But maybe, Alon, you have integrated much more classical understanding that you think? I find many ideas I come across are in modern books, commentaries on past books, but just aren't on the TCM radar. BTW: This type of thinking / treatment has been successfully applied to ulcerative colitis (or Crohn's) cases (with bleeding). Meaning the fundamental strategy is to dispel cold and warm. As far as I know this is not a typical treatment for rectal bleeding found in TCM nor a theoretical (4 causes of bleeding) one. Have others seen this? Regards, - _____ On Behalf Of sharon weizenbaum Sunday, May 13, 2007 6:14 AM cold causing bleeding (Jason)I disagree. It misses cold. But I clearly understand your scaffolding thinking. That is why " they " lump Sp, Kid with qi xu, and Empty and full heat with heat. Etc etc.. But cold is not there. (Sharon) Could you explain cold causing bleeding. The only way I can understand this is that cold can cause blood stasis which can cause bleeding - this would still be under blood stasis or cold could depress the Qi and cause heat to build up which would cause bleeding - this would still be under heat. How would cold by itself cause bleeding? In the 4 causes I teach, we always stress that one must find the cause of the heat or blood stasis. These causes can be quite varied so that Blood stasis as a cause for bleeding does not imply one methodology or formula - same with heat. Sharon Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz <sweiz%40rcn.com> www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Hi Jason, I get what you are saying but...... So a patient is definately cold and they are bleeding. How do you explain how the cold is causing the bleeding? What is the pathological mechanism that causes the blood to leave the vessels? Part of the FDM is to base our diagnosis on what we know for sure - in this case cold - and then explain the non-definitive symptom - in this case bleeding - based on what we know for sure. We explain this based on our knowledge of physiological and pathological mechanisms. Now cold is an interesting one in terms of blood stasis - I find, clinically blood stasis from cold is generally treated without using and herbs to vitalize the blood. Other types of blood such as Qi stasis congealed blood, Qi deficiency congealed blood, Blood deficiency congealed blood etc - all require blood vitalizing herbs in treatment. To a large extent in my clinical experience, when there is cold - it is sufficient to warm the channels, or uterus or stomach or what ever the location and the stasis, by itself, disperses. This is why, when a woman comes to me with dysmenorrhea and it is from cold - I think " good news! " because simply warming the uterus will eliminate even very chronic, debilitating pain. So, I wonder if this is not the issue here - that the bleeding is actually from cold causing blood stasis but that blood vitalizing herbs are not necessary so the blood stasis is not stated. You may say that blood stasis is an " added idea " but I have two questions: 1. what passage in the SHL are you referring to or could you give a case example in which there is bleeding from cold. 2. as above: What is the pathological mechanism that causes the blood to leave the vessels? Or is this just not important for you? Thanks, Sharon Sharon, It is the cold pathogen itself that is causing the bleeding. After that you can tell any further story you want that explains why this might happen, but that only confuses the issue. Meaning, it may make some sense in your mind to say the cold is creating heat or creating stasis and that is " really " what is causing the bleeding (because 'we know that is what causes bleeding'). But this circular logic only inhibits things, and one can therefore miss the cure. The cure is to eliminate the cold, period! This is actually classic SHL thinking. One major premise of the book is how to eliminate the pathogen from the body. It mentions nothing of zang-fu or complex theory, just how do we get it out. For example, once you start to say that the cold is causing stasis, one will say, there must be stasis (to treat). Or if one thinks the cold is causing heat (that is causing the bleeding), there must be heat (to treat). Otherwise what is the point of thinking that there is heat or stasis? Therefore our treatment would be (at least to some degree) clear heat (or move stasis) especially since bleeding is usually acute. But once again my argument (for the cause of bleeding) rests solely on the treatment and not the story in one's mind (as with my nocturia example). Cold as a cause for bleeding is supported in the SHL case literature and this is precisely why a formula like gui zhi jia fu zi tang can treat bleeding. Commentary specifically states, " Cold can cause bleeding. " This is also precisely why being fixed in a box will confine oneself to only see options that one believes are correct. I find that the " stories " get people into trouble very easy. So you may be right that (in your theory) bleeding is always caused by 4 major things, but IMO this confuses the issue for treatment / treatment principles. Treatment principles should, in theory, follow the dx. This is why I always say, you can tell any story you want, but always look at the treatment, this is where the truth lies. How confusing would it be to tell a student that heat is really causing the bleeding but the treatment is really gui zhi jia fu zi tang. hhhmmm. zen cohen?? I am with Alon, I don't buy empty theory. (For Alon and others) To sum up: this idea of cold causing bleeding is not my idea, just something that I read in SHL commentary and case studies. This seems to be a good example of how studying the classics opens one up to wider possibilities than just basic TCM thoughts. Alon, may have been versed with this idea already, for he seems to have studied widely, especially SHL. But maybe, Alon, you have integrated much more classical understanding that you think? I find many ideas I come across are in modern books, commentaries on past books, but just aren't on the TCM radar. BTW: This type of thinking / treatment has been successfully applied to ulcerative colitis (or Crohn's) cases (with bleeding). Meaning the fundamental strategy is to dispel cold and warm. As far as I know this is not a typical treatment for rectal bleeding found in TCM nor a theoretical (4 causes of bleeding) one. Have others seen this? Regards, - Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 S, But correct me if I'm wrong. If you dx blood stasis from cold with bleeding. There is almost always at least 1 blood mover in the prescription. IS that correct? -Jason _____ On Behalf Of sharon weizenbaum Sunday, May 13, 2007 8:56 AM Re: cold causing bleeding (SHL) Hi Jason, I get what you are saying but...... So a patient is definately cold and they are bleeding. How do you explain how the cold is causing the bleeding? What is the pathological mechanism that causes the blood to leave the vessels? Part of the FDM is to base our diagnosis on what we know for sure - in this case cold - and then explain the non-definitive symptom - in this case bleeding - based on what we know for sure. We explain this based on our knowledge of physiological and pathological mechanisms. Now cold is an interesting one in terms of blood stasis - I find, clinically blood stasis from cold is generally treated without using and herbs to vitalize the blood. Other types of blood such as Qi stasis congealed blood, Qi deficiency congealed blood, Blood deficiency congealed blood etc - all require blood vitalizing herbs in treatment. To a large extent in my clinical experience, when there is cold - it is sufficient to warm the channels, or uterus or stomach or what ever the location and the stasis, by itself, disperses. This is why, when a woman comes to me with dysmenorrhea and it is from cold - I think " good news! " because simply warming the uterus will eliminate even very chronic, debilitating pain. So, I wonder if this is not the issue here - that the bleeding is actually from cold causing blood stasis but that blood vitalizing herbs are not necessary so the blood stasis is not stated. You may say that blood stasis is an " added idea " but I have two questions: 1. what passage in the SHL are you referring to or could you give a case example in which there is bleeding from cold. 2. as above: What is the pathological mechanism that causes the blood to leave the vessels? Or is this just not important for you? Thanks, Sharon Sharon, It is the cold pathogen itself that is causing the bleeding. After that you can tell any further story you want that explains why this might happen, but that only confuses the issue. Meaning, it may make some sense in your mind to say the cold is creating heat or creating stasis and that is " really " what is causing the bleeding (because 'we know that is what causes bleeding'). But this circular logic only inhibits things, and one can therefore miss the cure. The cure is to eliminate the cold, period! This is actually classic SHL thinking. One major premise of the book is how to eliminate the pathogen from the body. It mentions nothing of zang-fu or complex theory, just how do we get it out. For example, once you start to say that the cold is causing stasis, one will say, there must be stasis (to treat). Or if one thinks the cold is causing heat (that is causing the bleeding), there must be heat (to treat). Otherwise what is the point of thinking that there is heat or stasis? Therefore our treatment would be (at least to some degree) clear heat (or move stasis) especially since bleeding is usually acute. But once again my argument (for the cause of bleeding) rests solely on the treatment and not the story in one's mind (as with my nocturia example). Cold as a cause for bleeding is supported in the SHL case literature and this is precisely why a formula like gui zhi jia fu zi tang can treat bleeding. Commentary specifically states, " Cold can cause bleeding. " This is also precisely why being fixed in a box will confine oneself to only see options that one believes are correct. I find that the " stories " get people into trouble very easy. So you may be right that (in your theory) bleeding is always caused by 4 major things, but IMO this confuses the issue for treatment / treatment principles. Treatment principles should, in theory, follow the dx. This is why I always say, you can tell any story you want, but always look at the treatment, this is where the truth lies. How confusing would it be to tell a student that heat is really causing the bleeding but the treatment is really gui zhi jia fu zi tang. hhhmmm. zen cohen?? I am with Alon, I don't buy empty theory. (For Alon and others) To sum up: this idea of cold causing bleeding is not my idea, just something that I read in SHL commentary and case studies. This seems to be a good example of how studying the classics opens one up to wider possibilities than just basic TCM thoughts. Alon, may have been versed with this idea already, for he seems to have studied widely, especially SHL. But maybe, Alon, you have integrated much more classical understanding that you think? I find many ideas I come across are in modern books, commentaries on past books, but just aren't on the TCM radar. BTW: This type of thinking / treatment has been successfully applied to ulcerative colitis (or Crohn's) cases (with bleeding). Meaning the fundamental strategy is to dispel cold and warm. As far as I know this is not a typical treatment for rectal bleeding found in TCM nor a theoretical (4 causes of bleeding) one. Have others seen this? Regards, - Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz <sweiz%40rcn.com> www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Jason I definitely integrates SHL thinking within my Rxs, i just cant do the pure thing and really want to hear more how you guys are doing it with US patients. - Sunday, May 13, 2007 6:28 AM RE: cold causing bleeding (SHL) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Doug (and group), I hope that our exchange was not too much for the group. But if we should stop please jump in (maybe below is a kind hint?) anyway, I'm glad to hear about your experience in the clinic Doug. NeiJing style practice is another influence that can produce some very out of the ordinary treatments. Recently while studying in ShangHai I observed a doctor that used, various chronological and other systems all based on the NeiJing. I am still processing the formulas to try to make sense of them. They are so far from what I would have picked I would have to spend much more time with him to really get some of his choices. He was just operating on a completely different system many of the times, but many times he would use basic TCM. I would like to hear about other's experience with doctors who use in NeiJing style treatments. Regards, _____ On Behalf Of Sunday, May 13, 2007 4:06 PM Re: cold causing bleeding (SHL) What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Please don't stop! I'm encouraging you guys. This is one of the best conversations I've seen in or out of CHA. (Just remind us what FDM and the others mean) doug , " " wrote: > > Doug (and group), > > > > I hope that our exchange was not too much for the group. But if we should > stop please jump in (maybe below is a kind hint?) anyway, I'm glad to hear > about your experience in the clinic Doug. NeiJing style practice is another > influence that can produce some very out of the ordinary treatments. > Recently while studying in ShangHai I observed a doctor that used, various > chronological and other systems all based on the NeiJing. I am still > processing the formulas to try to make sense of them. They are so far from > what I would have picked I would have to spend much more time with him to > really get some of his choices. He was just operating on a completely > different system many of the times, but many times he would use basic TCM. I > would like to hear about other's experience with doctors who use in NeiJing > style treatments. > > > > Regards, > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Jason Can you describe the chronological and other systems he used thanks - Sunday, May 13, 2007 3:34 PM RE: Re: cold causing bleeding (SHL) Doug (and group), I hope that our exchange was not too much for the group. But if we should stop please jump in (maybe below is a kind hint?) anyway, I'm glad to hear about your experience in the clinic Doug. NeiJing style practice is another influence that can produce some very out of the ordinary treatments. Recently while studying in ShangHai I observed a doctor that used, various chronological and other systems all based on the NeiJing. I am still processing the formulas to try to make sense of them. They are so far from what I would have picked I would have to spend much more time with him to really get some of his choices. He was just operating on a completely different system many of the times, but many times he would use basic TCM. I would like to hear about other's experience with doctors who use in NeiJing style treatments. Regards, _____ On Behalf Of Sunday, May 13, 2007 4:06 PM Re: cold causing bleeding (SHL) What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Doug when you come across these maxims and how he uses them can you share on the list? - Sunday, May 13, 2007 3:06 PM Re: cold causing bleeding (SHL) What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Alon, I am not really sure exactly of the details. Basically with one system, he would prescribe different medicinals based on the year and month etc. I really could not follow many of his ideas. I actually only spent 1 day with this doctor, and since he was so far out of the norm for me, I kind of dismissed much of it. But to be fair, he merely had a system I just don't really understand. He also spoke in non standard terms, making it even harder to follow. Hence one reason I always harp on plurality in dx and tx and of course terminology and the need to allow for multiple systems. -Jason _____ On Behalf Of Alon Marcus Sunday, May 13, 2007 5:10 PM Re: Re: cold causing bleeding (SHL) Jason Can you describe the chronological and other systems he used thanks - @ <%40> Sunday, May 13, 2007 3:34 PM RE: Re: cold causing bleeding (SHL) Doug (and group), I hope that our exchange was not too much for the group. But if we should stop please jump in (maybe below is a kind hint?) anyway, I'm glad to hear about your experience in the clinic Doug. NeiJing style practice is another influence that can produce some very out of the ordinary treatments. Recently while studying in ShangHai I observed a doctor that used, various chronological and other systems all based on the NeiJing. I am still processing the formulas to try to make sense of them. They are so far from what I would have picked I would have to spend much more time with him to really get some of his choices. He was just operating on a completely different system many of the times, but many times he would use basic TCM. I would like to hear about other's experience with doctors who use in NeiJing style treatments. Regards, _____ @ <%40> [@ <%40> ] On Behalf Of Sunday, May 13, 2007 4:06 PM @ <%40> Re: cold causing bleeding (SHL) What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Jason I had the same problem trying to make sense of some of the family styles i saw in china - Sunday, May 13, 2007 4:43 PM RE: Re: cold causing bleeding (SHL) Alon, I am not really sure exactly of the details. Basically with one system, he would prescribe different medicinals based on the year and month etc. I really could not follow many of his ideas. I actually only spent 1 day with this doctor, and since he was so far out of the norm for me, I kind of dismissed much of it. But to be fair, he merely had a system I just don't really understand. He also spoke in non standard terms, making it even harder to follow. Hence one reason I always harp on plurality in dx and tx and of course terminology and the need to allow for multiple systems. -Jason _____ On Behalf Of Alon Marcus Sunday, May 13, 2007 5:10 PM Re: Re: cold causing bleeding (SHL) Jason Can you describe the chronological and other systems he used thanks - @ <%40> Sunday, May 13, 2007 3:34 PM RE: Re: cold causing bleeding (SHL) Doug (and group), I hope that our exchange was not too much for the group. But if we should stop please jump in (maybe below is a kind hint?) anyway, I'm glad to hear about your experience in the clinic Doug. NeiJing style practice is another influence that can produce some very out of the ordinary treatments. Recently while studying in ShangHai I observed a doctor that used, various chronological and other systems all based on the NeiJing. I am still processing the formulas to try to make sense of them. They are so far from what I would have picked I would have to spend much more time with him to really get some of his choices. He was just operating on a completely different system many of the times, but many times he would use basic TCM. I would like to hear about other's experience with doctors who use in NeiJing style treatments. Regards, _____ @ <%40> [@ <%40> ] On Behalf Of Sunday, May 13, 2007 4:06 PM @ <%40> Re: cold causing bleeding (SHL) What a great exchange of ideas between Jason and Sharon! I hesitate to break it up in any way, however I'd like to make a few points. I've just finished teaching a case review class where I force (!) the students to write formulas to the cases that are presented. Later we get the " answer " i.e. what the supervisor wrote for that case. I've found that the least important part of the class actually. With a number of formulas on the board, I try to analyze each of the students formulas and describe the mechanism that would make it work. (And why it wouldn't or how it could be tweaked.) I know the students enjoy this, or at least challenged by it. They aren't allowed to collaborate on their formulas. But I have to make it clear, that although the case can be approached a number of ways that it is NOT a matter of " anything goes " . This is an important point to make to them. If you go for the UB/K or treat the Liver Qi you must know why you are doing it and what YOUR rationale is. Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) I love going through formulas that have a diagnosis and see what other supervisors have written. I still do that from time to time at Emperors where we have an " out-basket " of formulas. I suggest that students do the same. As long as there is a diagnosis at the top, without it of course, it's worthless. Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2007 Report Share Posted May 13, 2007 Doug, I find this extremely interesting. Could you go into detail on how your lao zhongyi colleague bases his diagnoses in the Nei Jing? Thanks, On May 13, 2007, at 3:06 PM, wrote: > Working side by side with an old school doctor, I find his most > startling departures from > pattern diagnosis is not Western integration of course, but the use > of old maxims from the > Nei Jing. The degree to which he uses them as justification or as > true diagnosis is what > keeps me on my toes. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2007 Report Share Posted May 14, 2007 On May 13, 2007, at 7:24 PM, wrote: > (Doug)I've just finished teaching a case review class where I force > (!) the students to write > formulas to the cases that are presented. Later we get the " answer " > i.e. what the supervisor > wrote for that case. I've found that the least important part of > the class actually. > With a number of formulas on the board, I try to analyze each of > the students formulas > and describe the mechanism that would make it work. (And why it > wouldn't or how it could > be tweaked.) (Sharon) Hi Doug, So my question is, do you just have the students give formulas or do you have them diagnose the patient first? (Doug) Working side by side with an old school doctor, I find his most startling departures from pattern diagnosis is not Western integration of course, but the use of old maxims from the Nei Jing. The degree to which he uses them as justification or as true diagnosis is what keeps me on my toes. (Sharon) I suppose the skill is knowing when to pull out which maxim. It sounds like a wonderful opportunity to work beside this Doctor. (Doug)Yes, at first there where a lot of " they have fatigue therefore there is Spleen Qi Xu " type responses. Students are used to giving these rote answers because their grades depend on it. I would say that both Sharon and Jason are describing the alternative without using the words: Qi mechanism. This is what really needs to be taught from the beginning. (Why did it take me 8 years out of school to be introduced to the concept?) (Sharon) I strongly believe that the curriculums at most of the schools regarding the basics are inside out and misleading. It is in part driven by the exam but the exam is also driven by the curriculum which is driven by........long topic. I also strongly believe and have been working on a methodology/way of teaching that grounds students in clear " fundamental diagnostic methodology " that paves the way for and isn't at odds with clinical reality or future deepening into new areas. I agree that it shouldn't be that " these concepts " inadvertently get introduced 8 years after being out of school. Sharon Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2007 Report Share Posted May 14, 2007 > > (Sharon) Hi Doug, So my question is, do you just have the students > give formulas or do you have them diagnose the patient first? > We do a number of diagnosis possibilities first or sometimes I'll just give it to them and have them work from that. Often times I don't know what the " answer " is, that is, what the supervisor in the school clinic has diagnosed or prescribed. It keeps me on my toes, for sure! When I finally see how the case was managed and if I " disagree " I try to show their approach as I see it. When the students have their formulas (or points) written on the board, I'll go over how that may or may not work or what can be tweaked. It is here that the students often see how a simple Yin Xu diagnosis, for example, can have a number of permutations and facets. I try to make it open and the danger is, of course, that they think that " anything will work " . I try to dis-abuse them of that. In this process the students can and do look at books but they are not allowed to colaborate. That is a challenge for them that they need. > > (Sharon) I suppose the skill is knowing when to pull out which > maxim. It sounds like a wonderful opportunity to work beside this > Doctor. Al Stone really studied with him for a year. One example is reminding me that left side complaints are liver related. I found that useful with a patient with a choking sensation (on the left). It's simple stuff but it works. doug Quote Link to comment Share on other sites More sharing options...
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