Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 Doug, Jason, The way I see this issue is basically cognitive. In other words, the Chinese medical physician needs to have both a local and global view in one's mind concurrently. We have to have the big picture, along with the details at the same time. The problem in Western CM education is using linear thinking (A, B, or C, 'exam thinking') as opposed to seeing the diagnostic information as a field, a synthesis of symptoms that create a richer and deeper field as more information is gathered by the physician. As one gains in clinical experience, the CM physician is able to make clear connections that will reveal a larger pattern. Another issue is what we can call foreground and background symptoms. In computer science, there are new approaches to databases that see information as fields of data, and specific pieces of data/information as points of light within a galaxy of information 'stars'. As different symptoms are accentuated or diminished over time, patterns shift, overlap, or transmute into new patterns. The Shang Han Lun uses this approach. For example, a gui zhi tang pattern with wheezing adds hou po and xing ren, with stiff neck and shoulder adds ge gen, with weakened heart yang from sweating subtracts bai shao, creating new formulas and patterns. The sophistication inherent in Chinese medical diagnostics, pattern differentiation and treatment strategies is not only 'ancient', but 'post-modern' as well. It remains to be seen if more than a few individuals will find some way to 'crack the code' of Chinese medicine in such a fashion that is true to its roots, but finds interfaces with systems theory and other cybernetic systems. ---- wrote: > David, this is the big issue in terms of education. As students we get > tested that with this symptom, one has this syndrome. Too often and > for four years students are being trained to mark A, B, C or all the > above. Then it is an eye-opener to see that dryness might not Always > be Yin Xu. Once you start seeing about pathomechanisms and the > movement of qi and disease (through time) it is easier identify an > appropriate pattern. > > To a degree, I agree one can justify (with enough work), " any symptom > and a pattern " and I've heard some doozies. To keep it from being > simple Willy-nilly (or MSU as we say here) as Jason suggests, then a > greater study into pathomechanisms will take you away from the one to > one correspondence as is often learned in school. > > Doug > > > > > If you are resourceful enough and consult enough texts or > > > practitioners, you can pretty much find a match b/w any symptom and a > > > pattern. Because of the inter-relatedness of CM physiology and > > > patterns, there always seems a way to make connections. This is what I > > > believe is the hardest for students and new practitioners. > > > > > > Al's cases are prime examples: bound constipation narrowed down to yin > > > or blood vacuity (what about the LU not descending, or the SP not > > > making fluids), or the three sign of cold/hands feet, stress, and ?, > > > narrowed to down to LV constraint. > > > > > > CM diagnosis is so subjective and I think many just fall into > > > comfortable ways of doing it through time. But as a 2 year old > > > practitioner, who is still very interested in the medicine and > > > improving clinical results, this is my biggest issue. > > > > > > Any words of wisdom? > > > Dave Vitello > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 Dear Doug, Al, Alon, Jason, Dave and All, I haven't participated much because of work load. But I am following. This conversation about patterns seems significant. Z’ev, well put. I agree with you that, “pattern differentiation and treatment strategies is not only ancient, but post-modern.†I am not certain if there is a code to “crack,†however. It seems to me that Chinese medicine and its roots, is similar to theory and other cybernetic systems. As for pattern discernment, I think you are on to something with respect to cybernetic theory. One problem that I often see in the application of viscera and bowel theory is the tendency to throw symptoms out if they do not fit the dominant theme. This reduction one’s awareness to a single pattern in order to create a diagnosis poses distinct problems. It inevitably leaves something out of the inquiry, something considered noise. It is an attempt to create control. This very noise, however, can be the source of new learning, as it opens new avenues of inquiry, creating not just more questions, but different kinds of questions. The ability to tolerate paradox, ambiguity, and complexity in the data is necessary, as it generates insight. My preference is to parse each and every sign and symptom into a set of TCM terms, then to assign similar pieces of data into groups. These groups are then built into a flow chart so I can see who is doing what to whom. Once this is in place, I can easily identify where I might topple this ‘house of cards.’ This approach allows me to use the convention of a single or dual diagnosis in the viscera-bowel model and yet design a treatment which is connected to the whole. Warmly, Will , <zrosenbe wrote: > > Doug, Jason, > The way I see this issue is basically cognitive. In other words, the Chinese medical physician needs to have both a local and global view in one's mind concurrently. We have to have the big picture, along with the details at the same time. The problem in Western CM education is using linear thinking (A, B, or C, 'exam thinking') as opposed to seeing the diagnostic information as a field, a synthesis of symptoms that create a richer and deeper field as more information is gathered by the physician. As one gains in clinical experience, the CM physician is able to make clear connections that will reveal a larger pattern. > > Another issue is what we can call foreground and background symptoms. In computer science, there are new approaches to databases that see information as fields of data, and specific pieces of data/information as points of light within a galaxy of information 'stars'. As different symptoms are accentuated or diminished over time, patterns shift, overlap, or transmute into new patterns. The Shang Han Lun uses this approach. For example, a gui zhi tang pattern with wheezing adds hou po and xing ren, with stiff neck and shoulder adds ge gen, with weakened heart yang from sweating subtracts bai shao, creating new formulas and patterns. > > The sophistication inherent in Chinese medical diagnostics, pattern differentiation and treatment strategies is not only 'ancient', but 'post-modern' as well. It remains to be seen if more than a few individuals will find some way to 'crack the code' of Chinese medicine in such a fashion that is true to its roots, but finds interfaces with systems theory and other cybernetic systems. > > > ---- wrote: > > David, this is the big issue in terms of education. As students we get > > tested that with this symptom, one has this syndrome. Too often and > > for four years students are being trained to mark A, B, C or all the > > above. Then it is an eye-opener to see that dryness might not Always > > be Yin Xu. Once you start seeing about pathomechanisms and the > > movement of qi and disease (through time) it is easier identify an > > appropriate pattern. > > > > To a degree, I agree one can justify (with enough work), " any symptom > > and a pattern " and I've heard some doozies. To keep it from being > > simple Willy-nilly (or MSU as we say here) as Jason suggests, then a > > greater study into pathomechanisms will take you away from the one to > > one correspondence as is often learned in school. > > > > Doug > > > > > > > > If you are resourceful enough and consult enough texts or > > > > practitioners, you can pretty much find a match b/w any symptom and a > > > > pattern. Because of the inter-relatedness of CM physiology and > > > > patterns, there always seems a way to make connections. This is what I > > > > believe is the hardest for students and new practitioners. > > > > > > > > Al's cases are prime examples: bound constipation narrowed down to yin > > > > or blood vacuity (what about the LU not descending, or the SP not > > > > making fluids), or the three sign of cold/hands feet, stress, and ?, > > > > narrowed to down to LV constraint. > > > > > > > > CM diagnosis is so subjective and I think many just fall into > > > > comfortable ways of doing it through time. But as a 2 year old > > > > practitioner, who is still very interested in the medicine and > > > > improving clinical results, this is my biggest issue. > > > > > > > > Any words of wisdom? > > > > Dave Vitello > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 Beginning students often make the mistake of matching single symptoms to patterns that simply do not make sense in context. As a first approximation, TCM pattern assessment can be boiled down to an almost algebraic set-matching algorithm. I describe this in the following article: http://www.rmhiherbal.org/review/2002-2.html Computer-aided instruction in TCM clinical analysis and decision- making skills In a nutshell: " the user's task is to determine whether the information is adequate to make an assessment and, if so, to specify the syndrome correctly from among a group of similar or closely related syndromes. " Of course there is a lot more to it than that; etiology comes into play, and that is where the tendency of patterns to transform into other patterns is taken into account. Then there are rules of formula strategy (clear Excess before tonifying Deficiency, etc.) Many students miss the boat at step one, thinking that TCM pattern assessment is totally arbitrary. Perhaps that is because there is a lot of sloppy thinking by students and even a lot of teachers and practitioners. ---Roger Wicke PhD Rocky Mountain Herbal Institute website: http://www.rmhiherbal.org/ email: http://www.rmhiherbal.org/contact/ On 2008.Aug.20, at 11:46, wrote: > 1f. Re: Pattern Identification > Posted by: " zrosenbe " zrosenbe > zrosenberg2001 > Tue Aug 19, 2008 11:54 pm ((PDT)) > > Doug, Jason, > The way I see this issue is basically cognitive. In other > words, the Chinese medical physician needs to have both a local and > global view in one's mind concurrently. We have to have the big > picture, along with the details at the same time. The problem in > Western CM education is using linear thinking (A, B, or C, 'exam > thinking') as opposed to seeing the diagnostic information as a > field, a synthesis of symptoms that create a richer and deeper > field as more information is gathered by the physician. As one > gains in clinical experience, the CM physician is able to make > clear connections that will reveal a larger pattern. > > Another issue is what we can call foreground and background > symptoms. In computer science, there are new approaches to > databases that see information as fields of data, and specific > pieces of data/information as points of light within a galaxy of > information 'stars'. As different symptoms are accentuated or > diminished over time, patterns shift, overlap, or transmute into > new patterns. The Shang Han Lun uses this approach. For example, > a gui zhi tang pattern with wheezing adds hou po and xing ren, with > stiff neck and shoulder adds ge gen, with weakened heart yang from > sweating subtracts bai shao, creating new formulas and patterns. > > The sophistication inherent in Chinese medical diagnostics, > pattern differentiation and treatment strategies is not only > 'ancient', but 'post-modern' as well. It remains to be seen if > more than a few individuals will find some way to 'crack the code' > of Chinese medicine in such a fashion that is true to its roots, > but finds interfaces with systems theory and other cybernetic systems. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 " don't know much about cybernetics " as the song goes but I will make a case for a retro devils argument. Will's analogy of the house of cards is interesting. I've always described diagnosis as being a set of dominoes with the diagnosis on the face pointed away from you. What I like about CM is the bi-phasic aspect. It all comes down to Yin or Yang. Therefore ask the right question and half the dominoes can be knocked down. (Although a question can also make you pull up a few dominoes to be knocked down later.) At the end of this process the last domino standing will be the diagnosis. It's a way of describing the process that cuts through the possibilities, the chaos if you will. I don't know if a Yin Yang perspective clashes or complements " post-modernity " , cybernetic and chaos theory talk but I have a feeling we'll be back to discussing Yin into Yang before long if we pursue other systems. On the side- Scheid mentions that it was Qin Bowei who first began making those cool flow charts that Jeremy Ross and all of us have since utilized. Doug , " Will Morris " <wmorris33 wrote: > > Dear Doug, Al, Alon, Jason, Dave and All, > > I haven't participated much because of work load. But I am following. > This conversation about patterns seems significant. > > Z’ev, well put. I agree with you that, “pattern differentiation and > treatment strategies is not only ancient, but post-modern.†I am not > certain if there is a code to “crack,†however. It seems to me that > Chinese medicine and its roots, is similar to theory and other > cybernetic systems. > > As for pattern discernment, I think you are on to something with > respect to cybernetic theory. One problem that I often see in the > application of viscera and bowel theory is the tendency to throw > symptoms out if they do not fit the dominant theme. This reduction > one’s awareness to a single pattern in order to create a diagnosis > poses distinct problems. It inevitably leaves something out of the > inquiry, something considered noise. It is an attempt to create > control. This very noise, however, can be the source of new learning, > as it opens new avenues of inquiry, creating not just more questions, > but different kinds of questions. The ability to tolerate paradox, > ambiguity, and complexity in the data is necessary, as it generates > insight. > > My preference is to parse each and every sign and symptom into a set > of TCM terms, then to assign similar pieces of data into groups. These > groups are then built into a flow chart so I can see who is doing what > to whom. Once this is in place, I can easily identify where I might > topple this ‘house of cards.’ This approach allows me to use the > convention of a single or dual diagnosis in the viscera-bowel model > and yet design a treatment which is connected to the whole. > > Warmly, > > Will > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 Please, what " cool flow charts " are? Thanks, E > On the side- Scheid mentions that it was Qin Bowei who first began > making those cool flow charts that Jeremy Ross and all of us have > since utilized. > > Doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 No big deal... you've seen them everywhere if you have done any studying. A visual representation of the text. Just a box with a symptom pointing to another box which points to another etc... I just remember Ross's Zang Fu book as the first one I had seen. Clavey in Fluid Physiology has a few comprehensive ones. Giovanni now in his books? , " zvedita " <zvedita wrote: > > Please, what " cool flow charts " are? > > Thanks, > E > > > On the side- Scheid mentions that it was Qin Bowei who first began > > making those cool flow charts that Jeremy Ross and all of us have > > since utilized. > > > > Doug > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2008 Report Share Posted August 20, 2008 All, I just noticed that Lorne Brown posted a few more interviews with Dr Huang Huang on the CMT website- http://chinesemedicinetools.com/. There is one where he is talking about character typing based on Shang Han Lun formulas or herbs for a specific disease. Interesting approach. I thought it was a fitting contribution to this conversation :-) Trevor , " " wrote: > > No big deal... you've seen them everywhere if you have done any > studying. A visual representation of the text. Just a box with a > symptom pointing to another box which points to another etc... I just > remember Ross's Zang Fu book as the first one I had seen. Clavey in > Fluid Physiology has a few comprehensive ones. Giovanni now in his books? > , " zvedita " <zvedita@> wrote: > > > > Please, what " cool flow charts " are? > > > > Thanks, > > E > > > > > On the side- Scheid mentions that it was Qin Bowei who first began > > > making those cool flow charts that Jeremy Ross and all of us have > > > since utilized. > > > > > > Doug > > > Quote Link to comment Share on other sites More sharing options...
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