RE: cold causing bleeding (SHL) 4 causes incomplete?

[Guest guest]

Sharon, et al,

 

 

 

The more I think about this bleeding example the more I think it illustrates

my point about people diagnosing differently as well as people trying to fit

things into their own system (and what this circular logic means). For

example it is the standard for us to believe that there are only four types

of bleeding. When a fifth type is suggested, we try to explain it and fit

it into one of the other four types. I find this phenomenon quite

interesting. What is happening here is there is a different diagnosis system

that conflicts with someone else's basic belief system. Not only is there a

completely strange formula choice, but the basic diagnosis and

pathomechanism does not conform to mainstream thought. What do we do with

that?

 

 

 

The FDM system relies on explaining things through their own specific

understanding of pathomechanisms and physiology. If that system only

acknowledges four types of bleeding then of course it must fit in with one

of those four (to a FDMer). In the situation that I presented it is like

fitting a square peg in a round hole, and doesn't realize the peg is square.

One will try to explain the cold causing bleeding by a mechanism that is

familiar to them, for example blood stasis (which was suggested), or even

heat. I can assure you that the SHL expert (whose case this is) does not see

it that way. On the contrary, he not only specifically states that this case

/ condition (chronic heavy nosebleeds) is one caused by " cold. " He goes on

to explain his pathomechanism for this occurring. Essentially there is a

cold damaging the yang (which becomes deficient, meaning that is unable to

retain its function over the blood.) Hence bleeding.

 

 

 

To hopefully nip any attempts to fit this into one of the four boxes I

state: There is no blood stasis symptoms or reflection in the treatment or

commentary. There is also no signs of heat nor in the treatment or

commentary. There are no signs of qi xu in the case, treatment, commentary;

and cold influencing the yang --> yang xu is not equivalent to qi xu. Since

there is no organ involvement (Spleen or kidney) we can rule those out. In

this case I can firmly say that trying to fit it into any of the above is

just incorrect and defeats the purpose of reading a case study and listening

to what the writer is trying to say. Furthermore, fitting it into one of the

four basic patterns would in no way come up with the treatment given. This

does not say that one may actually be able to treat this patient in another

manner. It is just impossible to say for sure what would or would not have

worked except for what did work!

 

 

 

One can say, that is BS (because it doesn't fit within the four bleeding

criteria), or we can somehow create a story on how it actually does.

Actually one could take any case out there and force it into any diagnostic

system they choose. Theory is fun like that, especially CM theory, which as

we know, can essentially explain anything (if we let it). But this I feel

defeats the purpose of reading such case studies. This expert sees things a

different way and he explains his thinking. You have the right to disagree,

but you also have the opportunity to view things a different way, his way.

His diagnosis is clearly different then the FDM system, specifically because

he says the bleeding and coming from cold (and makes no mention of the

four). He gives two bags of Gui Zhi Fu Zi Tang and cures the condition.

Therefore we can learn a different way of thinking, if we are open to it.

This is a different way to view not only this specific problem, but bleeding

in general. In his commentary he says specifically that

 

 

 

" nosebleeds most of the time belong to a heat pattern, but also it can

belong to a cold pattern. "

 

 

 

And this is the point, period. One can take it or leave it. IMO saying there

are only four types of bleeding is limiting and just incomplete.

 

 

 

So to answer Sharon's question, the pathomechanism is important to me. But

let us not forget that it is still a story that relies on the theory. That

theory might be slightly different for another person, as is the case here.

I do not believe CM or any medicine (or any one person, or one school of

thought) has any monopoly on some inherent truth in understanding and

describing the body. We have a strong theoretical medicine, but it is not

uniform. Throughout history people have had a myriad of differing points of

view, many contrary to each other. Herbs many times have differing

attributes throughout the centuries because (same) conditions treated with

that medicinal had different theoretical understandings/ pathomechanisms

attached to it to explain why it happened.

 

 

 

Take for example wen dan tang.

 

 

 

Regards,

 

 

 

-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