diagnostic spectrum

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On Jan 4, 2010, at 2:18 PM, trevor_erikson wrote:

 

> Once the disease is labeled and named, then the pattern can be

> determined (or disease factors as Sharon called it). So once we know

> for sure that we are dealing with Psoriasis and not a fungus, we

> then need to determine if this psoriasis is due to heat in the

> blood, cold stagnation, fire toxin, damp heat, blood stasis, blood/

> yin xu, etc. A trained eye can just look at the lesion and know what

> percentage of each may be present.

>

> Then, as Sharon pointed out, we need to look at the individual as a

> whole person. How is their digestion, sleep, urination, thirst

> levels, menstruation, etc.

>

> Sharon also pointed out that we need to define the location of the

> problem. I will mention that some disease names have their location

> already within it- ie. Head-ache, abdominal pain, etc. To me these

> can be seen as both a defined disease and also a symptom of

> something else. Regardless, if a patient comes in with a headache,

> we need to treat the headache and see it go away. There is a saying

> I have heard in Chinese that says " regardless of the type of

> headache, always use Chuan Xiong " . Again, by knowing the name of our

> disease, we can use certain herbs that are known to " empirically'

> treat that particular problem.

>

> To me it is impossible to treat a condition without first knowing

> the disease presenting. Every disease comes with well defined and

> understood habits that help in determining the pathomechanism and

> treatment. As far as I am aware, Psoriasis was labeled as a defined

> disease entity in Chinese medicine at least 2000 years ago- having

> Traditional names like Bai Bi (White dagger sore/ white crust) or

> Song Pi Xuan (Pine skin dermatosis), She Shi (Snake Lice), and Wan

> Xuan (stubburn dermatosis).

>

Looking at Sharon's schema and yours, I am reminded of a microscope

and its ability to resolve at different levels of magnification. It's

like a continuum of information spanning from the disease itself to

the person who has the disease-- and the levels of interrelationship

that weave the two together. Clearly it is important to look at this

whole continuum, and it is good to have a clear paradigm to guide this

intention. It does seem, however, that some practitioners have a

greater genius for focus on one end of the continuum-- e.g. Trevor

and his orientation towards understanding the disease first, and only

then looking at the whole person. Other practitioners have more of a

talent, training or inclination to look at the whole person first e.g.

constitutional-style treatment, and then secondarily (if at all)

looking at the disease factors etc, and then perhaps the disease

itself. Let me be very very clear that I am not saying that one way

is " right " or better than the other-- I am just noting that there is a

continuum here, and that while it would of course be ideal for every

practitioner to have exceptionally attention to all levels of the

continuum, I note that with rare exception (and from what her students

say about her, Sharon may be one of these rare exceptions),

practitioners tend to have " favorite " levels of the continuum where

they most like to focus. I like to focus on what I call Pattens of

Disharmony/Transformation of Virtue. What I mean by this term is the

middle ground of relationship between the client and the disease--

like the white stuff between the orange and the peel. (I can talk

more about it if anyone cares to know-- right now I am just using it

as an example of another option for primary focus, i.e. the middle

ground of relationship between the constitution and the disease,

rather than more on the constitution or more on the disease.)

 

Again, I am not claiming any bias to be better--- I am only claiming

bias to be inevitable in almost all cases, because we all have varying

temperamental styles which inform our focus and expertise as

practitioners. To recognize these differences without the competition

of better/worse or " the only way to do it " opens up wonderful

possibilities for collaborative discussion. For my part, I am utterly

fascinated to continue this conversation and find out more about other

people's diagnostic process (and, as mentioned in my other post today,

to learn more about how we teach diagnosis to students whose

temperament and cognitive styles may be different than our own).

 

I wish I could remember the specifics of the following story, but I

cannot: I was in discussion a difficult case with a colleague. The

colleague suggested that I take an a b c approach--- and I said " Yes,

that seems most direct, but I am going to take an x y z approach. " He

asked, " Why, if a b c is more direct? " I said, " Because I am not

very good at a b c, and I am very very good at x y z, so that even

though it is true that a b c is the more direct approach, the client

will get better faster if I do what I am very good at. "

 

I suspect that often we do what we do best even if it is not what the

client most needs. Hey it's worth a shot. Often it works, if we

really are very good at what we do. Other times, as Trevor puts it,

we miss the boat-- but if we are aware of the whole continuum of

focus, even if we are not a master of every aspect, we know to whom to

refer or look for advice.

 

 

-----I guess, as mentioned in my interdisciplinary rigor essay, I see

a lot of potential in not attempting to homogenize what it means to be

a good practitioner-- or a great practitioner. We have such different

inherent gifts. I've seen so many students who simply did not have

the left brain capacity to do the levels of differential analysis

required by good herbal prescription, but who knew how to be with

clients in such a healing way that the potentially very deep

homeostatic treatments of the 5 Element tradition utilized their right-

brain skills perfectly. I've seen more analytical students who were

simple not comfortable with the necessary rigors of quiet mind and

empty heart that the 5 Element practitioner must cultivate in order to

be successful-- they just did not want to go there-- and that's fine,

they don't have to; they can be brilliant practitioners in a more

analytical style of treatment.

 

Just musing.

 

 

Thea Elijah

 

 

 

On Jan 3, 2010, at 6:35 PM, swzoe2000 wrote:

 

> In other words, there is so much more than the " pattern " that we

> must take into account. To summarize:

> Disease factor

> Symptom

> Location

> Type of person

> Presentation

> Disease

>

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

>

> Cheers,

> Trevor

>

>