pathogenesis

[Guest guest]

Dear Friends, colleagues, and teachers,

 

I believe that one of the unique hallmarks of our medicine is the importance

of determining pathogenesis, and that for chronic illness, it is, IMHO, even

more of a priority than diagnosis. (I am explicitly referring here to Western

Biomedical diagnosis, and am not referring to the process of pattern

identification and differential diagnosis which give us essential information

as to the current status of the patient's functioning and interconnectness.)

For the fact is that illness never occurs in a vacuum, and by working with our

patients to determine from whence illness originated, we are able to, G-d

willing, unmask and render benign the monster that may have been slowly,

insidiously destroying our patient's health. Again, I want to emphasize, that

signs and symptoms, and differential diagnosis all provide important clues,

but IMVHO, the key is what we do with those clues, some of which may appear to

be unrelated. It is our ability to view the larger

panaramic picture, that will determine the degree of our success as agents of

healing. Just as when one's brakes begin to squeak, he knows that an important

aspect of his car needs to be addressed, so too, if they stop squeaking, it

would be foolish for him to think that the problem with his brakes had

spontaneously resolved itself. With that lengthy introduction, I would like to

posit that there are 3 basic pathogenic causes to chronic illness: inflammation,

vacuity, and damage to spleen and stomach. Please forgive me is this sounds

like dumbing down reductionism, but as a clinician, my first concerns are how I

can determine why my patient is suffering, from when was there a change to the

worse, and what event or life-change occurred then to engender that change.

Even though the four manifestations of inflammation: redness, heat, swelling

and pain are not identified as a unified pattern in Chinese medicine and are

rather identified as stasis or stagnation,

IMHO, inflammation preceeds, coexists with, and is far more pervasive than

just stasis. Though one might ask " what about cold stagnation, where

inflammation clearly is not a consideration? " I would contend that there the

root of the cold pathogen would be its damage to the Spleen and Stomach, and by

invigorating the digestive tract, by drying dampness, by warming the spleen,

cold stagnation will be resolved.

 

'Just thinking out loud.

 

I welcome your thoughts and criticisms

 

 

Sincerely,

 

 

 

 

 

 

 

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