was essential oil now is medical ethics

[Guest guest]

Trevor,

 

Interesting post, thanks for joining in. Because I think it is best to

address your comments in context please see below.

 

> Thomas wrote,

> " Are we to think the final word has been laid down about

> how to use herbs from China and how to use them to modify formulas? If so,

the

> medicine is dead. Is that what we should believe? "

 

>trevor wrote:

> This is an interesting thought you have, as many believe in Chinese

medicine that it is not about trying to figure out endless extra ways that

formulas may be modified and in some way " out smart " the ancients.

 

thomas:

I am not sure where you got the idea that I am trying to " 'out smart' the

ancients. " Furthermore, I am a little miffed by such a suggestion. Chinese

medicine has always been an evolving medicine. My point in the statement

above was to point out that the ideas about how to use plants is always

evolving (see your own past statement about your teacher's use of herbs to

treat skin diseases) and the addition of plants from China has always been a

part of the tradition (there are a large number of " standard " medicinals

that are not native within the borders of China (cinnamon, myrrh, American

Ginseng, to name just a few).

 

>trevor wrote:

>Many believe that it is more about becoming efficient at diagnosis so that

one knows how to " properly fit the key " , ie use the endless supply of herbs

and formula that is available to us already. If the correct diagnosis and

application of an herbal formula, that has been used for centuries in the

same fashion, still works to alleviate and even cure certain suffering, then

how can that be seen as a " dead " medicine?

 

thomas:

First, to answer your question, I don't see it as a dead medicine and while

I take a different path than you and your teacher, we all seem to be adding

new therapies to our treatments in one form or another. While I don't

disagree with your statements entirely I think this is part of my point,

thank you. Becoming efficient in diagnosis is absolutely the most important

part of clinical Chinese medicine, without it the rest is essentially

useless. However, if you think the people we are treating and their ecology

is the same as it was in ancient China I would have to disagree. We are

exposed to more and more things that simply didn't exist in ancient times,

and I am not just talking about the obvious pollution issues we all face,

but also the lifestyle and foods that we eat, the stresses that we face and

the " evolution " of the way we think about, well, everything. Also, to use

the word " endless " is a bit of a stretch since the plants found in Chinese

medicine only represent, and I am guessing now, about 17% of the worlds

medicinal plants. As for the formulas, well I think we all know there are a

lot and I recently received a copy of a book that one of my friend's father

help put together of " secret " formulas from Sichuan with a whole group of

" formulas " that look more like duiyao than what most of us would think of as

standard formulas. Many of these formulas use herbs that are not part of

what most of us would consider the standard materia medica, rather they are

made up of herbs that grow regionally and those doctors use. How is that any

different? Do you think these doctors tell there patients, " Well, these

herbs are not part of the standard Chinese materia medica, but my teacher

told me it worked. It is, therefore, experimental and I need you to sign

this consent form. " ?

>

> To me there is nothing wrong with incorporating western herbs into your

chinese herbal recipes, even if it is purely based on empirical usage.

 

What does " even if it is purely based on empirical usage " mean? Is that not

the crux of all of our medicine? Empiricism is the basis of science in its

purest form. Empirical knowledge is what the vast majority of medicine and

learning is about. This is the evolution of all " sciences, " which I would

most definitely define Chinese medicine as part of. Four definitions of

science from a medical dictionary at dictionary.com (# 4 sure sounds like

what you said your teacher does) and is btw what we all do is all of our

lives.

1. The observation, identification, description, experimental

investigation, and theoretical explanation of phenomena.

2. Such activities restricted to explaining a limitied class of natural

phenomena.

3. Such activities applied to an object of inquiry or study.

4. Knowledge, especially that gained through experience.

 

Do you think that if any of the past great doctors of Chinese medicine were

given any number of Western herbs and, perhaps, a little bit (or a lot) of

information on how to use them that they would not work to incorporate them

into their practice (this is assuming they would have continued access to

them)? All you need to do is look at the past and present state of Chinese

medicine to see that it is happening right in front of us. I was recently at

the medicinal botanical garden in Xi'an and to my surprise the most common

plant in the garden, having at least 5 different areas of planting, was

echinacea (an American medicinal plant that you can find in my book). This

plant, along with many other Western herbs can be found in every medicinal

plant garden I have been to in China. The one here in Beijing has at least

three species from my book (echinacea, California poppy, St. John's wort).

These are not just specimens, they are looking at them as medicines, trying

to learn how to incorporate them into Chinese medicine. And, in fact, some

of them have found their way in to the corpus of Chinese medicine while for

the others, it is only a matter of time.

 

<trevor wrote:

>I believe, as Bob mentioned, that it is just about communicating properly

to your patients what you are doing. Is it something you made up? Is it

something you learned from a teacher? Or read in a book? I always try to

explain the actions of the herbal formula I give my patients. I tell them

where I learned such styles of treatment, and whether it is " new " theory or

if it is " traditional " .

 

Bob also invoked Nazi Germany when thrashing the use of " non-standard "

treatments within Chinese medicine. I think we are all aware of the

" universal ethics " he mentioned, and that is a good start, but the field of

ethics has changed over time and I don't think that invoking the Nazi's is

anything more than overstating or in some way trying to suggest there is a

parallel. If you haven't, I would suggest that you look at

UNESCO<http://portal.unesco.org/shs/en/ev.php-URL_ID=1883 & URL_DO=DO_TOPIC & URL_SE\

CTION=201.html>'s

website for the latest " Declaration. " Likewise, I think we should all read

traditional Chinese medical ethics (Sun Si-miao is a good place to start) as

well as the many other great thinkers out there that have written on the

subject.

 

While I agree that appropriate communication with my patients is critical, I

do not explain every little thing to them. This is not because I am trying

to hide anything from them (I freely tell them I use Western and native

plants in my practice), but I believe that the power of the mind is

incredibly strong when it comes to healing. So, while I may tell them that I

am using a Western herb I may frame it as being fresh, local, organic,

clean, etc. rather than to suggest that it is " experimental " (which I don't

believe) and I don't, as a matter of practice, tell them where I learned it,

as I don't think most patients really care if I learned it from this teacher

or that teacher or this book or that book. With very few exceptions, I don't

make anything up, everything I do is based on either direct teaching or

literature, or in the very rare exception that I see something clinically

that I have not heard or read from an outside source. If I figure something

out that is a new use or application, I tell my patients such, more to

inspire them on the path toward health than to warn them that the therapy is

" experimental. " Let's face it, herbs are pretty gentle and unless you are a

complete idiot or simply careless the chance of really hurting someone is

pretty slim. I can say with all honestly that the worse (unexpected) thing

that has ever happened to a patient of mine is a case of the shits. Frankly,

in the end I think it was a good thing for this person.

 

> I even do this with acupuncture. For example, I tell all my IVF patients

when they come in for acupuncture that what I am offering them is new and

based on modern research studies. That the point combination showed good

benefit according to the study, but they are not necessarily traditional in

any sense, as we didn't have IVF 2000 years ago!

>

> When I use Mazin's creams for psoriasis (which work amazingly well), I

tell them that they are the product of 25 years of experience using

traditional Chinese herbal preparations

> combined with the best knowledge in modern western cream manufacturing.

>

> Communication is key.

>

> T

 

All I can say to this is that I guess you are more " ethical " than I. That

being said I don't believe I am doing anything unethical, and there are a

lot of other people out there that are doing similar things that I do, and

some that I would consider further from the " center " or " standard " of

Chinese medicine, and I would be willing to bet they don't explain all that

they are doing for any number of reasons, that includes people working here

in China. That being said, I am glad there are folks like yourself that are

as conservative as you seem to be and I am very happy that you brought your

respectful perspective into the conversation. To quote you, " Communication

is the key " and I would only like to add one word to that and say,

" conscious communication is the key! " OK I added a exclamation point too,

sue me :-)

 

Respectfully yours,

Thomas

 

--

 

Beijing, China

Author of " Western Herbs According to Traditional : A

Practitioners Guide "

Check out my blog: sourcepointherbs.blogspot.com

 

 

 

[Guest guest]

Hi Thomas,

 

Just to clarify, I was only trying to point out that your statement about

Chinese medicine being dead unless it is constantly learning how to use and

modify formulas with new-to-Chinese-medicine herbs discredits the work of many

great modern Doctors whom rely only on the Classics to achieve good clinical

outcomes. Arnaud would be one of them. He claims to achieve excellent results,

with many complaints from people living in our " modern " world and all its

changed ecology, using formulas modified with herbs only as Zhang Zhong Jing

would have used- 2000 years ago. I have others teachers that do and claim the

same..... so is the medicine they practice dead?

 

On the other hand, I believe that the work you are doing to widen the usage of

medicinal plants within is very important. For example, Tian Ma

has already been shown to be quite depleted in the wild and it is this form that

outshines any cultivated form in effect. Tian Ma is a very classical, efficient,

and good herb, but if it is not around to use anymore then what can we use to

substitute it? The work you are doing will help us with other options as the

demand for certain plants outgrows the supply. The use of local, organic, and

fresh herbs may be a good solution.

 

The whole of the 90's for me was spent homesteading, growing, and wildcrafting

the wild medicinal and edible plants of the pacific northwest to the rockies. I

became quite familiar with many " local " plants and love them. As I have

mentioned in past conversations with Michael Tierra, my goal has always been to

be able to incorporate this love of my backyard into the asian healing tradition

that I have now become accustomed. To do this demands some " experimentation " , as

I or no-one else knows exactly how these two systems really go together. To add

some Oregon grape root into my Chinese herbal recipe for a damp heat type eczema

may be really beneficial, or it may not. I wont know until I try and to try is

an experiment outside of the training I was given that has worked.

 

I will mention that I feel I am " experimenting " even when I will use a herb,

listed in Bensky, that I have no previous experience with and/or no previous

exposure to via teachers.

 

You mentioned that in all your clinical practice the worst side effect you saw

was the shits. Well what about the lack of a positive resolution of the problem

you are treating? What about the patients we see that come into our offices

after seeing some other practitioner, be it a Naturapathic, alliopathic, or

Chinese medical Doctor, for say 9 months and they claim that no change occurred?

Is it ethical to apply a treatment for so long, waste a patients money and time,

without seeing any change or good outcome. Mixing formulas that we have no

previous experience in seeing effective change with may be just like this.

 

Now perhaps you get really good results in your clinic using the systems that

you are designing and that is really awesome! I haven't seen your book yet, but

I hope that you are documenting and sharing your case studies so that all can

learn. This for me was the jump I made from being just a college student,

studying what herbs do from a text book, to being a clinician who tries to learn

from others exactly how they used that herb in a clinically effective way. Cause

in the end, it is the results the patient experiences that are everything :-)

 

Trevor

 

 

 

 

 

,

wrote:

>

> Trevor,

>

> Interesting post, thanks for joining in. Because I think it is best to

> address your comments in context please see below.

>

> > Thomas wrote,

> > " Are we to think the final word has been laid down about

> > how to use herbs from China and how to use them to modify formulas? If so,

> the

> > medicine is dead. Is that what we should believe? "

>

> >trevor wrote:

> > This is an interesting thought you have, as many believe in Chinese

> medicine that it is not about trying to figure out endless extra ways that

> formulas may be modified and in some way " out smart " the ancients.

>

> thomas:

> I am not sure where you got the idea that I am trying to " 'out smart' the

> ancients. " Furthermore, I am a little miffed by such a suggestion. Chinese

> medicine has always been an evolving medicine. My point in the statement

> above was to point out that the ideas about how to use plants is always

> evolving (see your own past statement about your teacher's use of herbs to

> treat skin diseases) and the addition of plants from China has always been a

> part of the tradition (there are a large number of " standard " medicinals

> that are not native within the borders of China (cinnamon, myrrh, American

> Ginseng, to name just a few).

>

> >trevor wrote:

> >Many believe that it is more about becoming efficient at diagnosis so that

> one knows how to " properly fit the key " , ie use the endless supply of herbs

> and formula that is available to us already. If the correct diagnosis and

> application of an herbal formula, that has been used for centuries in the

> same fashion, still works to alleviate and even cure certain suffering, then

> how can that be seen as a " dead " medicine?

>

> thomas:

> First, to answer your question, I don't see it as a dead medicine and while

> I take a different path than you and your teacher, we all seem to be adding

> new therapies to our treatments in one form or another. While I don't

> disagree with your statements entirely I think this is part of my point,

> thank you. Becoming efficient in diagnosis is absolutely the most important

> part of clinical Chinese medicine, without it the rest is essentially

> useless. However, if you think the people we are treating and their ecology

> is the same as it was in ancient China I would have to disagree. We are

> exposed to more and more things that simply didn't exist in ancient times,

> and I am not just talking about the obvious pollution issues we all face,

> but also the lifestyle and foods that we eat, the stresses that we face and

> the " evolution " of the way we think about, well, everything. Also, to use

> the word " endless " is a bit of a stretch since the plants found in Chinese

> medicine only represent, and I am guessing now, about 17% of the worlds

> medicinal plants. As for the formulas, well I think we all know there are a

> lot and I recently received a copy of a book that one of my friend's father

> help put together of " secret " formulas from Sichuan with a whole group of

> " formulas " that look more like duiyao than what most of us would think of as

> standard formulas. Many of these formulas use herbs that are not part of

> what most of us would consider the standard materia medica, rather they are

> made up of herbs that grow regionally and those doctors use. How is that any

> different? Do you think these doctors tell there patients, " Well, these

> herbs are not part of the standard Chinese materia medica, but my teacher

> told me it worked. It is, therefore, experimental and I need you to sign

> this consent form. " ?

> >

> > To me there is nothing wrong with incorporating western herbs into your

> chinese herbal recipes, even if it is purely based on empirical usage.

>

> What does " even if it is purely based on empirical usage " mean? Is that not

> the crux of all of our medicine? Empiricism is the basis of science in its

> purest form. Empirical knowledge is what the vast majority of medicine and

> learning is about. This is the evolution of all " sciences, " which I would

> most definitely define Chinese medicine as part of. Four definitions of

> science from a medical dictionary at dictionary.com (# 4 sure sounds like

> what you said your teacher does) and is btw what we all do is all of our

> lives.

> 1. The observation, identification, description, experimental

> investigation, and theoretical explanation of phenomena.

> 2. Such activities restricted to explaining a limitied class of natural

> phenomena.

> 3. Such activities applied to an object of inquiry or study.

> 4. Knowledge, especially that gained through experience.

>

> Do you think that if any of the past great doctors of Chinese medicine were

> given any number of Western herbs and, perhaps, a little bit (or a lot) of

> information on how to use them that they would not work to incorporate them

> into their practice (this is assuming they would have continued access to

> them)? All you need to do is look at the past and present state of Chinese

> medicine to see that it is happening right in front of us. I was recently at

> the medicinal botanical garden in Xi'an and to my surprise the most common

> plant in the garden, having at least 5 different areas of planting, was

> echinacea (an American medicinal plant that you can find in my book). This

> plant, along with many other Western herbs can be found in every medicinal

> plant garden I have been to in China. The one here in Beijing has at least

> three species from my book (echinacea, California poppy, St. John's wort).

> These are not just specimens, they are looking at them as medicines, trying

> to learn how to incorporate them into Chinese medicine. And, in fact, some

> of them have found their way in to the corpus of Chinese medicine while for

> the others, it is only a matter of time.

>

> <trevor wrote:

> >I believe, as Bob mentioned, that it is just about communicating properly

> to your patients what you are doing. Is it something you made up? Is it

> something you learned from a teacher? Or read in a book? I always try to

> explain the actions of the herbal formula I give my patients. I tell them

> where I learned such styles of treatment, and whether it is " new " theory or

> if it is " traditional " .

>

> Bob also invoked Nazi Germany when thrashing the use of " non-standard "

> treatments within Chinese medicine. I think we are all aware of the

> " universal ethics " he mentioned, and that is a good start, but the field of

> ethics has changed over time and I don't think that invoking the Nazi's is

> anything more than overstating or in some way trying to suggest there is a

> parallel. If you haven't, I would suggest that you look at

>

UNESCO<http://portal.unesco.org/shs/en/ev.php-URL_ID=1883 & URL_DO=DO_TOPIC & URL_SE\

CTION=201.html>'s

> website for the latest " Declaration. " Likewise, I think we should all read

> traditional Chinese medical ethics (Sun Si-miao is a good place to start) as

> well as the many other great thinkers out there that have written on the

> subject.

>

> While I agree that appropriate communication with my patients is critical, I

> do not explain every little thing to them. This is not because I am trying

> to hide anything from them (I freely tell them I use Western and native

> plants in my practice), but I believe that the power of the mind is

> incredibly strong when it comes to healing. So, while I may tell them that I

> am using a Western herb I may frame it as being fresh, local, organic,

> clean, etc. rather than to suggest that it is " experimental " (which I don't

> believe) and I don't, as a matter of practice, tell them where I learned it,

> as I don't think most patients really care if I learned it from this teacher

> or that teacher or this book or that book. With very few exceptions, I don't

> make anything up, everything I do is based on either direct teaching or

> literature, or in the very rare exception that I see something clinically

> that I have not heard or read from an outside source. If I figure something

> out that is a new use or application, I tell my patients such, more to

> inspire them on the path toward health than to warn them that the therapy is

> " experimental. " Let's face it, herbs are pretty gentle and unless you are a

> complete idiot or simply careless the chance of really hurting someone is

> pretty slim. I can say with all honestly that the worse (unexpected) thing

> that has ever happened to a patient of mine is a case of the shits. Frankly,

> in the end I think it was a good thing for this person.

>

> > I even do this with acupuncture. For example, I tell all my IVF patients

> when they come in for acupuncture that what I am offering them is new and

> based on modern research studies. That the point combination showed good

> benefit according to the study, but they are not necessarily traditional in

> any sense, as we didn't have IVF 2000 years ago!

> >

> > When I use Mazin's creams for psoriasis (which work amazingly well), I

> tell them that they are the product of 25 years of experience using

> traditional Chinese herbal preparations

> > combined with the best knowledge in modern western cream manufacturing.

> >

> > Communication is key.

> >

> > T

>

> All I can say to this is that I guess you are more " ethical " than I. That

> being said I don't believe I am doing anything unethical, and there are a

> lot of other people out there that are doing similar things that I do, and

> some that I would consider further from the " center " or " standard " of

> Chinese medicine, and I would be willing to bet they don't explain all that

> they are doing for any number of reasons, that includes people working here

> in China. That being said, I am glad there are folks like yourself that are

> as conservative as you seem to be and I am very happy that you brought your

> respectful perspective into the conversation. To quote you, " Communication

> is the key " and I would only like to add one word to that and say,

> " conscious communication is the key! " OK I added a exclamation point too,

> sue me :-)

>

> Respectfully yours,

> Thomas

>

> --

>

> Beijing, China

> Author of " Western Herbs According to Traditional : A

> Practitioners Guide "

> Check out my blog: sourcepointherbs.blogspot.com

>

>

>

[Guest guest]

Thomas,

 

IMO, I hardly " invoked " the Nazis. I was just setting the historical context for

the creation of the " Four Universal Principles of Biomedical Ethics. " Based on

my experience as a teacher, I very much doubt if many members of our profession

have even heard of these, much less know when and why they were created.

 

BTW, China is probably the world's largest commercial producer of Echinacea.

However, to my knowledge, it's mostly exported.

[Guest guest]

Hi Trevor,

 

And to further clarify, I never said and I don't think I suggested that

people who practice classical Chinese medicine are practicing a dead

medicine. If I believed that I wouldn't bother to spend my time studying

with people here.

 

Thanks for the kudos. Really!

 

BTW: if you were to look in my book you would see that there are several

species of Mahonia used in Chinese medicine with nearly the same indications

known for the use of Oregon grape root (of which there are also several

species). This type of work is exactly where my deepest research interest

lies, looking at plants of the same species or within the same genus used in

different cultures.

 

I can easily grant you that there is a degree of experimentation in

everything a practitioner does, e.g. your statement about " experimenting "

with an herb you have a reference for but no prior experience. This is

especially true for ALL new practitioners (that goes for ALL medical

professions). (I am not suggesting you are a new practitioner.)

 

The thought occurred to me to include times when I did not get the results I

expected as being my worst unexpected side effect, thank you for bringing

that up. To answer your question, " Is it ethical to apply a treatment for so

long, waste a patients money and time, without seeing any change or good

outcome[?] " NO! I think it is quite unethical to proceed in a treatment with

a person for more than a few weeks, with rare exceptions, without seeing

some progress. And I have no problem telling someone I really don't know how

to help them. I am fully cognisant that I can not help everyone, and while I

wish that were not true I think it is something every practitioner must come

to terms with, or they are in for a bumpy ride.

 

The first book did not have any case studies in it, and that is a major

deficiency that will be rectified in the second volume. Actually, I am

inviting anyone who would like to contribute a case study that includes the

use of one or more Western herb(s) to be included in the second volume,

which I am working on now. Anyone who is interested please contact me

off-list. My work is not about me me me, it is about helping people, helping

people, helping people! I just happen to be foolish enough to spend my time

writing instead of sleeping or doing the other myriad things I probably

should be doing :-)

 

Thanks for the great discussion. I hope we can trek through the woods of the

Pacific Northwest someday and enjoy the glories of that wonderful land that

I, and apparently you adore.

 

In Good Health,

Thomas

 

Hi Thomas,

 

Just to clarify, I was only trying to point out that your statement about

Chinese medicine being dead unless it is constantly learning how to use and

modify formulas with new-to-Chinese-medicine herbs discredits the work of

many great modern Doctors whom rely only on the Classics to achieve good

clinical outcomes. Arnaud would be one of them. He claims to achieve

excellent results, with many complaints from people living in our " modern "

world and all its changed ecology, using formulas modified with herbs only

as Zhang Zhong Jing would have used- 2000 years ago. I have others teachers

that do and claim the same..... so is the medicine they practice dead?

 

On the other hand, I believe that the work you are doing to widen the usage

of medicinal plants within is very important. For example,

Tian Ma has already been shown to be quite depleted in the wild and it is

this form that outshines any cultivated form in effect. Tian Ma is a very

classical, efficient, and good herb, but if it is not around to use anymore

then what can we use to substitute it? The work you are doing will help us

with other options as the demand for certain plants outgrows the supply. The

use of local, organic, and fresh herbs may be a good solution.

 

The whole of the 90's for me was spent homesteading, growing, and

wildcrafting the wild medicinal and edible plants of the pacific northwest

to the rockies. I became quite familiar with many " local " plants and love

them. As I have mentioned in past conversations with Michael Tierra, my goal

has always been to be able to incorporate this love of my backyard into the

asian healing tradition that I have now become accustomed. To do this

demands some " experimentation " , as I or no-one else knows exactly how these

two systems really go together. To add some Oregon grape root into my

Chinese herbal recipe for a damp heat type eczema may be really beneficial,

or it may not. I wont know until I try and to try is an experiment outside

of the training I was given that has worked.

 

I will mention that I feel I am " experimenting " even when I will use a herb,

listed in Bensky, that I have no previous experience with and/or no previous

exposure to via teachers.

 

You mentioned that in all your clinical practice the worst side effect you

saw was the shits. Well what about the lack of a positive resolution of the

problem you are treating? What about the patients we see that come into our

offices after seeing some other practitioner, be it a Naturapathic,

alliopathic, or Chinese medical Doctor, for say 9 months and they claim that

no change occurred? Is it ethical to apply a treatment for so long, waste a

patients money and time, without seeing any change or good outcome. Mixing

formulas that we have no previous experience in seeing effective change with

may be just like this.

 

Now perhaps you get really good results in your clinic using the systems

that you are designing and that is really awesome! I haven't seen your book

yet, but I hope that you are documenting and sharing your case studies so

that all can learn. This for me was the jump I made from being just a

college student, studying what herbs do from a text book, to being a

clinician who tries to learn from others exactly how they used that herb in

a clinically effective way. Cause in the end, it is the results the patient

experiences that are everything :-)

 

Trevor