California Acupuncture Board Decreases Herb Portion of Exam

[Guest guest]

Kokko said:

So, in my perfect world, I would have a series of tests....

didactic, case-studies, essay, oral and practical,

with the state boards allowing for deficits in one aspect and

strengths in another as a passing score.

For instance, didactic (40%), case-studies (20%), essay (10%),

oral (10%), practical (20%)

 

Stephen:

that certainly sounds like a more comprehensive way of testing

knowledge

for the practical, would you have students do an intake and

treatment in front of a panel of supervisors?

 

Z'ev said:

These are different skills, and our educational model largely

neglects the critical, pattern recognition skills that are

necessary to practice Chinese medicine

 

Stephen:

true, many students will answer case study questions with 5

patterns to address 5 symptoms instead of choosing a single

pattern that can explain all 5 symptoms. how do you help students

to think globally to improve at pattern discrimination?

 

Stephen Woodley LAc

 

--

http://www.fastmail.fm - The way an email service should be

 

 

 

 

[Guest guest]

What I'd like to see is an extra two years option for herbal pharmacology.

 

 

 

 

-

" " <johnkokko

 

Monday, July 27, 2009 8:54 AM

Re: Re: California Acupuncture Board Decreases Herb Portion

of Exam

 

 

> Eric,

> I think that this idea from yout last post:

> " Rather, I'd like to add an honors track, basically just have one of the

> two

> sections be more advanced and only occupied by interested students. "

> is right on. This seems to get to the major issue.. which is that there

> is

> a huge gap between students in the same class.

> Not everyone is a blank slate, bringing their own life experiences to the

> table.

> Even by the time they're 16, there are AP classes.

>

> Another idea is having independent study available for the " progressed

> students " ,

> in order to reserve resources for the school.

>

> K

>

[Guest guest]

Here is a little snippet of an email that was sent out by Bob Damone, the Dean

at the Pacific College of Oriental Medicine in San Diego. It looks like they

are taking a good stance on this issue to me:

 

Eric Brand

 

Begin quote:

 

" My personal belief is that this reflects the relative lack of comfort with

herbal medicine (as compared to acupuncture) by the 14% of all licensed

acupuncturists in California who responded to the survey, and should not be

misinterpreted as a means of determining what is best for clinical treatment

of patients or for Chinese medical curriculum.

 

Although these changes may change how we advise our students to study for

the California Acupuncture Board exam, they will NOT AFFECT our herbal

curriculum. PCOM will maintain or increase its commitment to Chinese herbal

medicine. In fact, we are discussing ways to actively increase our usage of

herbal medicine in the college clinic.

 

If you would like to read the occupational analysis, please go to the link

below:

 

http://www.acupuncture.ca.gov/students/oareport2008.pdf "

[Guest guest]

--- On Mon, 7/27/09, <zrosenbe wrote:

 

It is one thing to memorize patterns, it is another thing to

 

figure out the pattern for yourself through a process of critical

 

thinking. These are different skills, and our educational model

 

largely neglects the critical, pattern recognition skills that are

 

necessary to practice Chinese medicine.

 I wonder, how can bring new students up to the level of say, a Z'ev, or a Bob

Flaws? Or of any dozens of practitioners who post here, and probably dozens who

gently observe?The 'core drive' to find and unlock the logic of this system is a

very personal story, especially in this new world. We learn what works just as

when we are feeling pulses as a class, then report what we feel and what we

interpret before our peers. Very humble, very appropriate. Then, the teacher

(the one with the most success) gives their interpretation. What I am saying is,

this is different than teaching welding or electrical wiring. Welding and

electrical wiring have their subtle nuances too, for what kind of rod at what

temperature for what metals; what amperage calculations and spikes etc. This

medicine hopefully, happily goes right into the human's life; and herbal

modifications, point selections and action there, are subtle beyond subtle. How

to teach that drive. Recently

I've found myself at a point where I can't hear the music clearly as I thought

I used to. One pulse or patient's word, or a paragraph from the classics send my

mind into a tsunami of images, memories, instincts.Reviewing it,  I know it is

because I haven't penetrated or understood even the basics. We can teach a bit

but the drive and need can't be taught, only encouraged. This stuff is profound

and perplexing, we have great schools and teachers. In time all the knotty stuff

will mix with world med and the best way will emerge. Thanks

 

 

 

 

 

 

 

[Guest guest]

thanks, Eric for the link.

I admit I don't get how they got these conclusions. The numbers look as if herbs

should be equal to acupuncture yet we end up with this 11% solution.... the mean

critical task index is often in the mid teens.

I also wonder if this was just so microanalyzed they missed the forest for the

trees. For example, if I give acupuncture 100% of the time to my acupuncture

patients, yet only give herbs 50% of the time (or every other week), because: 1)

the acupuncture is sufficient 2)they still have herbs left over from last week

3) they can't afford herbs.... does that mean that the CAB test should emphasize

herbs by half? I think not, dear colleagues!

Doug

 

 

 

, " Eric Brand " <smilinglotus

wrote:

 

> If you would like to read the occupational analysis, please go to the link

 

> http://www.acupuncture.ca.gov/students/oareport2008.pdf "

>

[Guest guest]

, " "

wrote:

>

> thanks, Eric for the link.

> I admit I don't get how they got these conclusions. The numbers look as if

herbs should be equal to acupuncture yet we end up with this 11% solution....

the mean critical task index is often in the mid teens.

> I also wonder if this was just so microanalyzed they missed the forest for the

trees. For example, if I give acupuncture 100% of the time to my acupuncture

patients, yet only give herbs 50% of the time (or every other week), because: 1)

the acupuncture is sufficient 2)they still have herbs left over from last week

3) they can't afford herbs.... does that mean that the CAB test should emphasize

herbs by half? I think not, dear colleagues!

 

I'm with you, Doug. The legal (and presumably scientific) validity of the study

was apparently justified by a mathematical technique. But perhaps it was

calculated using a mathematical equation that doesn't have proven validity when

evaluating a task of this nature.

 

If you have two jobs, threading beads and sewing buttons, but you have to sew

buttons three times more than you have to thread beads, it makes sense to

prioritize competence in the skill set of sewing buttons. But as Doug pointed

out, there are many confounding variables that affect the frequency of herbal

medicine use compared to acupuncture, such as compliance, added cost, potency,

and duration of the previous prescription.

 

Given that our title is a " licensed acupuncturist, " it makes sense that more

people would come to us for acupuncture than for herbal medicine. Furthermore,

we could easily treat the same patient three times a week with acupuncture while

they take an herbal prescription that only needed to be considered and prepared

once that week. Even if we use acupuncture in three times as many visits as we

use herbs, it doesn't make herbs less important in any way. One is just

comparing disparate treatments that have different indications, efficacy, and

time lines, so the frequency of administration is not really a valid indicator

of importance. In fact, respondents rated their importance as basically equal.

 

It is generally considered to be more difficult to achieve a basic level of

competence and safety with herbal medicine than it is with acupuncture.

Inappropriate treatment with herbal medicine is also generally considered to be

more dangerous than inappropriate treatment with acupuncture. The same equation

that one uses to evaluate the importance of sewing buttons vs. threading beads

cannot be used here.

 

Imagine if you had two jobs: killing chickens and killing pigs. Pigs are

bigger, so killing one pig may give you meat for a whole week, while killing one

chicken gives you meat for only one day. For your job, you may need to kill

chickens 7 times more frequently than you need to kill pigs, but should the test

of competency for your job be 7 times heavier in the art of killing chickens

rather than pigs? Granted, you have to kill a chicken more frequently, but

killing a pig takes much more skill and is much more dangerous. (Sorry about

the gross metaphor.) It is a good decision to have lower competency

requirements for the skill that is more difficult and more dangerous?

 

Finally, even assuming that acupuncture and medicinal therapy are completely

comparable in every way except their frequency, how valid are statistics from

the state of California when it comes to assessing the relative importance of

medicinals vs. acupuncture in the field of Chinese medicine? For the sake of

argument, let's say that 3 patients in California receive acupuncture for every

1 person who receives herbs. Assuming they receive the same number of visits

per month from both groups, it would appear that a Chinese medical practitioner

needs to use acupuncture three times more, making it a more critical job skill

that justifies an overwhelming emphasis on the test. But if you step back from

California and look at the number of millions of patients that receive Chinese

medicine worldwide, there are easily 10 times more people being prescribed herbs

than acupuncture. So a global competence test would require 10 times more

questions on herbs than acupuncture, while a California competence test would

require 3 times more questions on acupuncture than herbs.

 

This model was chosen as the most " legally defensible " approach. I have to

wonder if anyone thought about asking a scientist in addition to a lawyer when

they designed the study.

 

Eric Brand

[Guest guest]

Jason,

This is exactly my own experience and opinion about decoctions.

 

To add one thing, the practitioner his or herself also needs to be willing to

take decoctions themselves. If not, the patient will immediately sense this

hypocrisy.

[Guest guest]

" I think if at this point in time, if acupuncture/moxa and herbal

medicine were offered as separate tracks, one or the other, an

overwhelming majority of applicants would choose acupuncture, because

of familiarity and economic potential, along with the pervading fear

of drug-herb interactions. "

 

I find this very, very interesting.

[Guest guest]

" It is one thing to memorize patterns, it is another thing to

figure out the pattern for yourself through a process of critical

thinking. "

 

Bingo! You hit the nail squarely on the head. Bravo!

[Guest guest]

My wife just began a 16 person cohort medical school program at UCB/UCSF that is

entirely case based and watching the curriculum unfold is very impressive.

Students are given layers of a case over three session, the first begins with a

symptom in a region of the body. Students then are assigned a learning objective

related to various structures or functions in that region and do a presentation

for the group. Needless to say these are very well trained students who have the

skills that Kokko recently mentioned T.C.M. students not necessarily being

required to have.

 

 

 

What I see happening is students immediately being required to access a broad

range of literature, and it isn't a scavenger hunt, these resources are made

explicitly available to them. There is also some testing to make sure they are

up to speed on required material, but there aren't systematic lectures.

 

 

 

Some of the Int. Medicine classes at the school I taught at have only weekly

case hx. requirements and no exams. While this certainly creates stress for

students, it doesn't seem to create the same kind of anxiety that test taking

does and clearly develops a type of critical thinking that test taking doesn't.

I also employed similar teaching/testing methods in a Dietetics class which I

will write about later in reference to some of the texts that have been

mentioned and questioned.

 

Ben

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

" It is one thing to memorize patterns, it is another thing to

figure out the pattern for yourself through a process of critical

thinking. "

 

Bingo! You hit the nail squarely on the head. Bravo!

 

 

 

 

 

 

 

 

 

_______________

NEW mobile Hotmail. Optimized for YOUR phone.

http://windowslive.com/Mobile?ocid=TXT_TAGLM_WL_CS_MB_new_hotmail_072009

 

 

[Guest guest]

Stephen,

 

In the case of a school we are familiar with, over-emphasis on review and

cumulative classes was a result of a couple of instances of people failing to

pass the board exam. Although I believe these classes are important, when they

are done to excess they cause an increase in rote memorization and a decrease in

understanding.

 

- Bill

 

 

 

> I do see a problem with students spending a huge portion of their

> time studying for cumulative exams and exam preparation classes

>

> Stephen:

> isn't this a response to poor passing rates? I wonder if the DAOM

> programs move the schools to consider the MSTCM as license prep

> and DAOM as advanced training?

> Perhaps students become reliant on exam prep classes and books

> and feel that they don't need to " get it " during school... " I'll

> just get through school and focus on exam prep... "

> what do you think?

>

> Stephen Woodley LAc

>

> --

>

[Guest guest]

Ben,

I think the solution to the boxed TCM plate-lunch

is starting or re-designing schools to develop programs that deepen

students' understanding

from the very beginning, just as your wife is fortunate enough to be in a

'real' learning

environment. I always wanted to attend a school more like Hogwort's or St

John's

in Annapolis and Santa Fe, where students are expected to read a book a week

and then come together and do critical close-reading amongst peers,

presenting projects

and writing essays without taking tests.

 

In order to pull something like this off, students would have to write an

entrance essay

and show that they have a previous GPA that trusts that they will pass any

test,

without having to drill them with multiple choice questions for the next

four years.

This would reflect our status as graduate level colleges and not just trade

schools.

It would truly be a revolution and would cultivate excellent practitioners

for the following generations.

Of course, at the end of their training, they can take a review class and

probably have the highest

pass rates of any school in the country.

 

K

 

 

 

On Tue, Jul 28, 2009 at 8:48 AM, ben zappin <btz23 wrote:

 

>

>

>

> My wife just began a 16 person cohort medical school program at UCB/UCSF

> that is entirely case based and watching the curriculum unfold is very

> impressive. Students are given layers of a case over three session, the

> first begins with a symptom in a region of the body. Students then are

> assigned a learning objective related to various structures or functions in

> that region and do a presentation for the group. Needless to say these are

> very well trained students who have the skills that Kokko recently mentioned

> T.C.M. students not necessarily being required to have.

>

> What I see happening is students immediately being required to access a

> broad range of literature, and it isn't a scavenger hunt, these resources

> are made explicitly available to them. There is also some testing to make

> sure they are up to speed on required material, but there aren't systematic

> lectures.

>

> Some of the Int. Medicine classes at the school I taught at have only

> weekly case hx. requirements and no exams. While this certainly creates

> stress for students, it doesn't seem to create the same kind of anxiety that

> test taking does and clearly develops a type of critical thinking that test

> taking doesn't. I also employed similar teaching/testing methods in a

> Dietetics class which I will write about later in reference to some of the

> texts that have been mentioned and questioned.

>

> Ben

>

>

> " It is one thing to memorize patterns, it is another thing to

> figure out the pattern for yourself through a process of critical

> thinking. "

>

> Bingo! You hit the nail squarely on the head. Bravo!

>

> ________

> NEW mobile Hotmail. Optimized for YOUR phone.

> http://windowslive.com/Mobile?ocid=TXT_TAGLM_WL_CS_MB_new_hotmail_072009

>

>

[Guest guest]

Bill,

So, would these classes be better if they were more cooridinated

with the primary teacher?

Perhaps these classes would serve better if a TA reviewed your

lecture, answered questions and quizzed students to make sure

they " got " what you are teaching?

 

With the risk of belaboring the point:

a problem I see is that undergrad students often " navigate "

through 4 years of courses one semester at a time.

Most students are trying to get through the current semester and

then they can check another course off the list and finally

obtain a BS or BA

 

CM school needs to be far more integrated as each course should

build on the next and from the last.

Do I understand your concern that these review courses aren't

reviewing, but rather are competing for students' time and

attention?

 

Stephen Woodley LAc

 

--

http://www.fastmail.fm - The professional email service

 

 

 

 

[Guest guest]

John,

I've often dreamed of designing or attending a program where one

would study the classical Chinese medical texts while concurrently

studying classical Chinese language. My model was always the St.

John's College in Santa Fe and its summer program in the Chinese

classics. Never could take the time off to do it, it is still a dream

of mine to attend. .

 

 

On Jul 28, 2009, at 10:58 AM, wrote:

 

> Ben,

> I think the solution to the boxed TCM plate-lunch

> is starting or re-designing schools to develop programs that deepen

> students' understanding

> from the very beginning, just as your wife is fortunate enough to be

> in a

> 'real' learning

> environment. I always wanted to attend a school more like Hogwort's

> or St

> John's

> in Annapolis and Santa Fe, where students are expected to read a

> book a week

> and then come together and do critical close-reading amongst peers,

> presenting projects

> and writing essays without taking tests.

>

> In order to pull something like this off, students would have to

> write an

> entrance essay

> and show that they have a previous GPA that trusts that they will

> pass any

> test,

> without having to drill them with multiple choice questions for the

> next

> four years.

> This would reflect our status as graduate level colleges and not

> just trade

> schools.

> It would truly be a revolution and would cultivate excellent

> practitioners

> for the following generations.

> Of course, at the end of their training, they can take a review

> class and

> probably have the highest

> pass rates of any school in the country.

>

> K

>

> On Tue, Jul 28, 2009 at 8:48 AM, ben zappin <btz23 wrote:

>

> >

> >

> >

> > My wife just began a 16 person cohort medical school program at

> UCB/UCSF

> > that is entirely case based and watching the curriculum unfold is

> very

> > impressive. Students are given layers of a case over three

> session, the

> > first begins with a symptom in a region of the body. Students then

> are

> > assigned a learning objective related to various structures or

> functions in

> > that region and do a presentation for the group. Needless to say

> these are

> > very well trained students who have the skills that Kokko recently

> mentioned

> > T.C.M. students not necessarily being required to have.

> >

> > What I see happening is students immediately being required to

> access a

> > broad range of literature, and it isn't a scavenger hunt, these

> resources

> > are made explicitly available to them. There is also some testing

> to make

> > sure they are up to speed on required material, but there aren't

> systematic

> > lectures.

> >

> > Some of the Int. Medicine classes at the school I taught at have

> only

> > weekly case hx. requirements and no exams. While this certainly

> creates

> > stress for students, it doesn't seem to create the same kind of

> anxiety that

> > test taking does and clearly develops a type of critical thinking

> that test

> > taking doesn't. I also employed similar teaching/testing methods

> in a

> > Dietetics class which I will write about later in reference to

> some of the

> > texts that have been mentioned and questioned.

> >

> > Ben

> >

> >

> > " It is one thing to memorize patterns, it is another thing to

> > figure out the pattern for yourself through a process of critical

> > thinking. "

> >

> > Bingo! You hit the nail squarely on the head. Bravo!

> >

> > ________

> > NEW mobile Hotmail. Optimized for YOUR phone.

> > http://windowslive.com/Mobile?ocid=TXT_TAGLM_WL_CS_MB_new_hotmail_072009

> >

> >

[Guest guest]

Yes exactly. They also stifle creativity, logic, and problem solving.

 

 

> Do I understand your concern that these review courses aren't

> reviewing, but rather are competing for students' time and

> attention?

>

> Stephen Woodley LAc

>

>

[Guest guest]

Bill,

I think it depends who's teaching the review classes.

How many of these review classes are your students taking?

One class a year? before comprehensive exams?

or are you talking about the one class they take before taking their Boards?

 

From my experience, review classes are 2 unit classes,

around 60 hours out of a 3000 hour curriculum.

That would be 1/ 50 of the total time in TCM school.

 

How do they stifle creativity, logic and problem solving?

 

If this is the case, whoever is teaching those review classes are not doing

their job.

50% of the CA boards are case-studies.

These case-studies depend on logic and problem solving.

They should be learning case-study analysis (logic and problem solving) in a

review class.

 

Unfortunately, these problem-solving skills should have been acquired long

before a review class.

They should have been fostered in grammar school, at home, at work, on the

streets

or at least in Case Management and Clinical training.

 

Going back to the conversation with Z'ev. The best way to foster these

virtues

is to make the entire curriculum more well-rounded...

where the student thinks for themselves and shares these ideas with their

peers and guides....

writing essays, presenting projects, practicing immediately what they learn

didactically.

The student should be able to know HOW to learn, not just WHAT to learn.

 

Last week, I took a Tibetan medicine class and got some good ideas for

teaching,

which is very rare from taking regular TCM CEU classes.

Some of the things that are often implemented in traditional Tibetan

education are like Jedi training,

in comparison to power-points or reading-out-of-the-book lectures.

 

For instance, training to memorize pulses of multiple people while being

blind-folded

and being able to identify herbs blind-folded. Memorizing colored tree

diagrams, which integrate both sides of the brain.

The Tibetan four medical tantras were written as a way to be taught, not

just read,

so everything is organized, numerically and categorically....

much like the Jia Yi Jing by Huang Fu-Mi (which would be a great text book

for us in TCM)

 

I understand your frustrations, but I don't see how a 2 credit review class

can be blamed for these failures.

Can you explain?

 

K

 

 

 

 

On Tue, Jul 28, 2009 at 10:44 PM, bill_schoenbart <plantmed2wrote:

 

>

>

> Yes exactly. They also stifle creativity, logic, and problem solving.

>

> > Do I understand your concern that these review courses aren't

> > reviewing, but rather are competing for students' time and

> > attention?

> >

> > Stephen Woodley LAc

> >

> >

>

>

>

 

 

 

--

 

Turtle Island Integrative Health

 

 

TCM Review director

CA State Board Prep Courses

www.tcmreview.com

 

 

 

[Guest guest]

I think what is missing in the herb (and general) education is the student

having a sense of the end results. They go through 2 or more years of herbs,

semester by semester, quiz by quiz, exam by exam, with no goal in mind: writing

a formula for a patient. I'm not advocating jumping the gun, but I think giving

the parameters of the goal will help in the details as given in the individual

classes. Simple enough I think.

 

As to the review classes, I think the students know that they are a separate

animal... yet many say that the medicine, or at least their knowledge, only

comes together after studying everything together. I agree that they are not a

creative process. I only object when students do all their studying while in

classes out of the review books. The medicine isn't a set of bullet points and

charts.

Doug

 

 

 

 

, " bill_schoenbart " <plantmed2

wrote:

>

> Yes exactly. They also stifle creativity, logic, and problem solving.

>

>

> > Do I understand your concern that these review courses aren't

> > reviewing, but rather are competing for students' time and

> > attention?

> >

> > Stephen Woodley LAc

> >

> >

>

[Guest guest]

, " "

wrote:

I only object when students do all their studying while in classes out of the

review books. The medicine isn't a set of bullet points and charts.

 

Sorry, that was so good that I had to repost it for emphasis...

 

Eric Brand

[Guest guest]

My response to Steven was specific to a school where we both teach. I won't

mention names, because it is a good school with some typical flaws that need to

be worked out. In this case, the person doing the review classes gives them so

much work, they neglect their core classes. Often, they are " reviewing " material

that they haven't even studied yet. There is no coordination with other teachers

regarding the material they are tested on. The students spend way too much time

memorizing material for their review and cumulative classes. In some cases, they

even skip core classes and don't study for midterms in order to study for these

review classes. I think review classes are essential, but when they are overdone

they stifle creativity and logic.

 

- Bill Schoenbart

 

 

, <johnkokko wrote:

>

> Bill,

> I think it depends who's teaching the review classes.

> How many of these review classes are your students taking?

> One class a year? before comprehensive exams?

> or are you talking about the one class they take before taking their Boards?

>

> From my experience, review classes are 2 unit classes,

> around 60 hours out of a 3000 hour curriculum.

> That would be 1/ 50 of the total time in TCM school.

>

> How do they stifle creativity, logic and problem solving?

>

> If this is the case, whoever is teaching those review classes are not doing

> their job.

> 50% of the CA boards are case-studies.

> These case-studies depend on logic and problem solving.

> They should be learning case-study analysis (logic and problem solving) in a

> review class.

>

> Unfortunately, these problem-solving skills should have been acquired long

> before a review class.

> They should have been fostered in grammar school, at home, at work, on the

> streets

> or at least in Case Management and Clinical training.

>

> Going back to the conversation with Z'ev. The best way to foster these

> virtues

> is to make the entire curriculum more well-rounded...

> where the student thinks for themselves and shares these ideas with their

> peers and guides....

> writing essays, presenting projects, practicing immediately what they learn

> didactically.

> The student should be able to know HOW to learn, not just WHAT to learn.

>

> Last week, I took a Tibetan medicine class and got some good ideas for

> teaching,

> which is very rare from taking regular TCM CEU classes.

> Some of the things that are often implemented in traditional Tibetan

> education are like Jedi training,

> in comparison to power-points or reading-out-of-the-book lectures.

>

> For instance, training to memorize pulses of multiple people while being

> blind-folded

> and being able to identify herbs blind-folded. Memorizing colored tree

> diagrams, which integrate both sides of the brain.

> The Tibetan four medical tantras were written as a way to be taught, not

> just read,

> so everything is organized, numerically and categorically....

> much like the Jia Yi Jing by Huang Fu-Mi (which would be a great text book

> for us in TCM)

>

> I understand your frustrations, but I don't see how a 2 credit review class

> can be blamed for these failures.

> Can you explain?

>

> K

>

>

>

>

> On Tue, Jul 28, 2009 at 10:44 PM, bill_schoenbart <plantmed2wrote:

>

> >

> >

> > Yes exactly. They also stifle creativity, logic, and problem solving.

> >

> > > Do I understand your concern that these review courses aren't

> > > reviewing, but rather are competing for students' time and

> > > attention?

> > >

> > > Stephen Woodley LAc

> > >

> > >

> >

> >

[Guest guest]

Doug and Bill,

Yes... like Stephen said, the entire curriculum should be developed to

reinforce

every other class that the student is taking. In other words, every class

should be

reviewing and reinforcing everything else. In the days when there was

apprenticeship

learning, practice was first and theory came second. These days, it's

reversed.

I think that's difficult for people to really wrap inside of themselves.

 

Review books should be review books, not source texts.

That is jumping the gun. Like getting a black belt by reading Bruce Lee's

Jeet Kune Do

and not sweating or getting any bruises at all or digging deep to find any

answers for ourselves.

One of the greatest feelings I get is when I get an insight into something

that I just took

for granted because I memorized it. Finding out WHY and HOW, not just WHAT.

Reading Bill's last post, I can see the problem with students going for the

goal

without enjoying the journey itself. The gold IS the rainbow itself, not at

the end of it.

 

K

[Guest guest]

Absolutely. We need to give some breathing room to the students and

professors, informal grand rounds, small groups studying together,

mentoring relationships. I like some of those Tibetan exercises. It

reminds me of the eccentric teacher Sung Baek, who used to train

people to feel pulses by having them tie a string around a patient's

wrists, tie them to the window sill, and then read them by palpating

the string . .

 

 

On Jul 29, 2009, at 5:29 AM, wrote:

 

> Going back to the conversation with Z'ev. The best way to foster these

> virtues

> is to make the entire curriculum more well-rounded...

> where the student thinks for themselves and shares these ideas with

> their

> peers and guides....

> writing essays, presenting projects, practicing immediately what

> they learn

> didactically.

> The student should be able to know HOW to learn, not just WHAT to

> learn.

>

> Last week, I took a Tibetan medicine class and got some good ideas for

> teaching,

> which is very rare from taking regular TCM CEU classes.

> Some of the things that are often implemented in traditional Tibetan

> education are like Jedi training,

> in comparison to power-points or reading-out-of-the-book lectures.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

K,

 

 

 

Sorry for the delay in responding to your question, I have been quite busy.

I don't think there is any quick and easy answer, and there are many more

unknowns than clear answers. However here are a few things that I have

seen/consider.

 

 

 

1) there are a percentage of patients that have gastrointestinal

problems from granulars. I have no way to predict ahead of time which ones

will have this issue. However it should be noted that if one does not

routinely go back and forth between bulk and granulars, it may be easy to

confuse such symptoms as a side effect of actual formula. For example, two

weeks ago, I switched a patient to granulars and she developed nausea. She

thought it was the formula (the formula had not changed.) I switched back to

bulk and the symptom was gone. I have seen a large range of gastrointestinal

problems from granulars.

 

2) External attacks seem to be treated best with bulk herbs. This is

something I don't even mess around with any more. I get such consistent good

results with external attacks with bulk herbs, and squirrely results with

granulars, I really talk my patients into bulk. I am pretty sure this is

because of the decreased acrid quality. Although granular companies say that

they ensure that volatile oils etc. are intact, a taste test, as well as

many clinical encounters leads me to believe otherwise. There is clearly a

element missing, some kind of 'pop', that one just doesn't get with

granulars.

 

3) One of my main teachers in China says that many herb's subtle

functions (e.g. guiding properties or entering the collaterals) are lost

when one converts them to granulars. Hence some of the more tricky formulas

may not be as effective.

 

 

 

I don't know if this helps, but there are a few ideas to think about...

 

 

 

-

 

 

 

 

On Behalf Of

Monday, July 27, 2009 1:04 PM

 

 

 

 

Can you delve into why you feel that raw herbs are better for certain

patients?

which type of conditions especially...

 

Best,

K

 

 

 

 

 

 

 

 

 

[Guest guest]

Jason,

Yes...

some of the best herbalists say that bulk herbs are much better

and I wonder if it's because it's the " old way " or because

of the retention of the herbs' Shen, Qi and Jing.

 

It takes more work and it takes more space

and I applaud those who make that sacrifice.

 

When making granules, can something like Gou teng be cooked for less than 10

minutes?

If not, would this negate the herb's function?

 

When producing granules, is there a risk of over-cooking the herbs, sapping

it's Qi?

 

K

 

 

 

 

On Fri, Jul 31, 2009 at 5:37 PM, <

> wrote:

 

>

>

> K,

>

> Sorry for the delay in responding to your question, I have been quite busy.

> I don't think there is any quick and easy answer, and there are many more

> unknowns than clear answers. However here are a few things that I have

> seen/consider.

>

> 1) there are a percentage of patients that have gastrointestinal

> problems from granulars. I have no way to predict ahead of time which ones

> will have this issue. However it should be noted that if one does not

> routinely go back and forth between bulk and granulars, it may be easy to

> confuse such symptoms as a side effect of actual formula. For example, two

> weeks ago, I switched a patient to granulars and she developed nausea. She

> thought it was the formula (the formula had not changed.) I switched back

> to

> bulk and the symptom was gone. I have seen a large range of

> gastrointestinal

> problems from granulars.

>

> 2) External attacks seem to be treated best with bulk herbs. This is

> something I don't even mess around with any more. I get such consistent

> good

> results with external attacks with bulk herbs, and squirrely results with

> granulars, I really talk my patients into bulk. I am pretty sure this is

> because of the decreased acrid quality. Although granular companies say

> that

> they ensure that volatile oils etc. are intact, a taste test, as well as

> many clinical encounters leads me to believe otherwise. There is clearly a

> element missing, some kind of 'pop', that one just doesn't get with

> granulars.

>

> 3) One of my main teachers in China says that many herb's subtle

> functions (e.g. guiding properties or entering the collaterals) are lost

> when one converts them to granulars. Hence some of the more tricky formulas

> may not be as effective.

>

> I don't know if this helps, but there are a few ideas to think about...

>

> -

>

> <%40>

>

[ <%40>\

]

> On Behalf Of

> Monday, July 27, 2009 1:04 PM

>

>

> Can you delve into why you feel that raw herbs are better for certain

> patients?

> which type of conditions especially...

>

> Best,

> K

>

>

[Guest guest]

, <johnkokko wrote:

 

> When producing granules, is there a risk of over-cooking the herbs, sapping

> it's Qi?

 

Such items are generally produced without prolonged exposure to high

temperatures. Not all companies have technology that permits this, but most do

(the drying process can use high heat in addition to the decoction process, but

some technology minimizes this).

 

The use of a low-pressure (vacuum) environment allows one to reduce the boiling

point of the water, so companies typically can concentrate the decoction down

without prolonged exposure to high heat (i.e., the water can boil off and

evaporate at 60 C instead of 100 C).

 

Eric Brand

[Guest guest]

Jason,

 

Your client may be reacting to the excipient in granulars, many of which contain

various starches.? I have one who is quite gluten sensitive and can only use

granulars when the herb itself is the excipient.?

 

Generally I find that compliance is far better with granulars, and I've been

known to burn the herbs myself while decocting.

 

Karen Vaughan