research methodology and experimental design

[Guest guest]

Funny,

I don't see this as a 'tongue lashing' at all, and I see no implication that

Trevor is being specifically addressed in his stance vis a vis the classics. I

think Steve is making the point that one can study the concepts of the classical

medicine via one's teacher or by working with specific texts, especially when it

comes to channel theory. .

 

But we'll have to wait from Trevor himself to see how he feels about this. .

 

Z'ev

On Feb 26, 2010, at 3:53 PM, wrote:

 

> Steven, this is one of a number of tongue lashings you have been dealing

> out, and quite frankly they are both unnecessary and unprofessional. It

> sounds to me like a teenager who is adamitely trying to defend a stance. To

> suggest, as you do, that Trevor hasn't learned to think about as well as

> embody and contemplate the Classics while learning to actually read them is

> preposterous and insulting to him and, frankly, to me. To answer your last

> question in this diatribe, it is all of the above! You need scholarship

> along with embodiment and contemplation, plain and simple.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

On Feb 26, 2010, at 6:34 PM, wrote:

 

> Steve et al,

>

> I think it is important to face some truths. If you don't read the

> original

> Chinese then people who do, are not likely to take what you say very

> seriously.

>

I think that this is an extraordinary pity.

 

I am put in mind of my post on December 26th concerning the notion of

interdisciplinary modes of rigor, and the need for all of us in the

profession to recognize that there are many pathways of knowledge--

and that their greatest contribution is to each other when they are

shared. The scholars must listen to the clinicians, as much as the

clinicians must listen to scholars-- as we also listen to the growers

of herbs who learn of their nature by cultivation, and the qi gong

practitioners who know the herbs vibrationally by smell and taste and

feel. We all must be humbly rigorous in allowing our " knowledge " to

be honed by those who have proven rigor by other ways of knowing than

our own.

 

If those who read the original Chinese texts will not listen seriously

to the clinicians and qi gong masters and others who have gifts of

insight to bring to our practice by other means than scholarship, we

are impoverishing ourselves tremendously!

 

Thomas, I have great respect for you and your work-- can you really

mean this, that no other pathway of knowledge within our field has

merit? I am not speaking of accepting anything as authoritative

without scrutiny, but will you not even consider the insights of those

who look to your scholarly talents for collaboration, confirmation,

and mutual enrichment?

 

Thea Elijah

 

 

[Guest guest]

It's only when I started teaching the Fundamentals class did I really start

digging into Chinese. I don't say I read but I am forever looking up words for

meaning. Some times meaning comes from translation, some comes from sociology,

some comes from history. Last year hearing Elizabeth Rochat saying rather

off-hand that " oh, we can't analyze this word because we are only analyzing the

English, we have to look at the Chinese " , that got me going.

 

Doug

 

,

wrote:

>

> Steve et al,

>

> I think it is important to face some truths. If you don't read the original

> Chinese then people who do, are not likely to take what you say very

> seriously. As someone who has spent the last few years working on my Chinese

> and can get through most of the basic texts without too much difficulty, I

> find reading most of the Classic texts quite challenging. After nearly 20

> years of studying Chinese medicine, most of it through translations, I am

> now beginning to see why people like Bob have been saying for years, " If you

> really want to understand Chinese medicine, learn to read Chinese " it is

> really that simple, there are very few translations that are going to get

> you anywhere near what you get when you actually read the original Chinese,

> sorry but that is the plain truth. The Mitchel, Wiseman, Feng translation of

> the Shang Han Lun is the only translation of a Classic that comes to mind as

> one of these exceptions.

>

> To be honest, I find what you say interesting, but knowing that you can't

> read the original makes it difficult for me to take it too seriously. I am

> sure you have worked very hard and perhaps have some good insight, but the

> reason I started to seriously study Chinese language was exactly because

> after teaching for a few years I came to the realization that anything

> outside of my clinical experience was nothing more than what the students

> could read in English and if I could read the original I would gain both a

> vastly larger corpus of information, and likely a heck of a lot of insight.

> Both have borne out to be true. And, I think if you ask anyone on this list

> who has gone through a similar process I feel confident they would say their

> experience is the same (or nearly so :-).

>

> This is not to say that one can not practice Chinese medicine without

> Chinese language skill, but to be a scholar and, in my opinion, a teacher,

> you MUST be able to read the original, this is, IMHO, basic academic rigor.

> I feel pretty confidant that if you went to any university and asked about

> becoming a scholar in any tradition they would ALL say you MUST learn the

> language of origin in order to pursue this endeavor.

>

> Although Bob is no longer with us on this forum, I will take this

> opportunity to thank him for all he has contributed to this field. He has

> been quite a lightning rod over the years, but all-in-all he has contributed

> at least as much as anyone else has to the furthering of Chinese medicine in

> the West. May you find true happiness!

>

> In Good Health,

> Thomas

>

>

> cell:

> Beijing, China

> Author of " Western Herbs According to Traditional : A

> Practitioners Guide "

>

>

>

>

[Guest guest]

Thanks for your feedback Thomas, though I'm not sure I'm the one that has

been giving tongue lashings, been de-legitimized by ad hominem arguments,

and now apparently demonized by taking statements out of context. I can see

that you believe I've been stubborn; indeed, I'm still waiting for any

substantive responses to the merits of the ideas I've presented on this list

-- most recently, my sharing of clinically valuable material the Imperial

Academy chose to suppress a thousand years ago for political reasons.

Apparently, a group of present day scholars choose to continue codifying

that suppression of free speech and thought a thousand years later. I can

only wonder why?

 

It appears we're at an impasse, if as you say " I (Thomas) find what you say

interesting, but knowing that you can't read the original makes it difficult

for me to take it too seriously. " Is that an enlightening standard for

pursuing deeper understanding? Seems a little odd to me that none of the

scholars on this list seem to have anything to say about my ideas, except

for claiming that they're illegitimate because I can't read Chinese as well

as they can.

 

Thank you, Z'ev, for supporting my attempts to have a voice. Funny thing is,

I respect scholarship, though I'm also mindful of the first chapter of Dao

De Jing (or if you follow the Mawangdui version, chapter 45) -- " The Dao

that can be spoken (written) is not the eternal Dao. " I haven't disrespected

actual scholarship in this thread; I've merely pointed out the inaccuracy of

broad and frankly vague claims that didn't agree with widely accepted

historical scholarship, such as the claim that there has been a consensus of

Chinese medicine theory/practice that developed during its history.

 

While the Imperial Academy may have tried to dominate Chinese medicine at

various times, every era saw new ideas and doctrines arise. Also, among its

departments there have always been competing theories, such as Waike,

Digestion, and Gynecology -- each with their own theories, some of which

differed from each other. Since the recording of Neijing launched the

written history of CM (that still exists) as a profoundly heterogenious pair

of texts, there has simply never been a " homogenous professional doctrine "

of Chinese medicine. The modern clinical doctrine, codified under the

influence of the Chinese government with its peculiar philosophical

perspectives is likely as close to homogeneous as at any time during the

history of CM, and Volker Scheid argued convincingly that even modern CM is

quite heterogeneous.

 

Steve

 

 

 

[Guest guest]

Steven,

can you talk about the suppression by the Imperial Academy....

I'm not sure I've heard about this... is this the neo-confucian suppression

of daoism?

Were texts re-written or burned?

 

Thanks,

K

[Guest guest]

John,

 

I was specifically referring to the suppression of the five systems of

channels in favor of the dominance of the " primary " channels as extensions

to the zangfu. Unlike your reference to Lingshu chapter 8 in the other

thread, the modern use of the zangfu as the cornerstone of CM theory has

grown increasingly physical over the centuries. The shift of modernization

that I'm referring to here has progressively developed since early in the

Song Dynasty, when it was canonized by the erection of the Bronze Man in the

capital city of the time (I believe Xian, though I'm not sure), which has

led to a progressive shift away from ( " applied philosophical " ) consideration

of the five systems of channels as the foundation of individual life toward

empirical studies of individual point functions.

 

There were also changes in texts, including herbal texts, which the Song

Imperial government was able to enforce through " flooding the market " with

works produced with the relatively new technology of mechanical printing.

One example of this shift was literally uncovered by Donald Harper, who also

did the translation of medical texts found among the Mawangdui findings,

which included a wonderful introduction of about 120 pages largely about

Neijing. Harper found a pre-Song version of Su Simiao's *Qian Jin Yao

Fang*in Dunhuang, and notes a drastic revision wherein the post-Song

version,

which has been the only one available since that period, resulted from

systematic cleansing of material that might be considered " spiritual " --

that is, relating to the intention of the practitioner.

 

Harper's translations of the respective passages from the Tang and Song

versions follow ( " Three Medieval Wu Zang Lun Textsin Manuscript from

Dunhuang and Turfan, " 2004, Univ. of Chicago):

 

Tang: The method for pounding medicine: burn incense, and sprinkle and sweep

to make (the area) clean and pure. Let there not be random talking. Youths

should be made to pound it, striving to make it very fine. Let the number

for the pestle reach a thousand or myriad; the more (pounding the better.

After completing the combining and blending, set (the medicine) on a table

before [buddhist and Daoist icons for inspiring the intention of healing]…

Entreat with your whole heart, and seek the root heart in praying for your

wish. Then there is divine aid, and the living vapor of the eight directions

fills the four limbs.

 

Song (and later editions): …the more (pounding) the better.

 

Yet, I am primarily a clinician, so I haven't done my own (primary) search

and translations. I rely on responsible Sinologists and members of our

profession who have developed their language skills sufficiently to do

translations. I appreciate their many wonderful contributions to our

profession, and do my own analyses based on my studies of Chinese history

and thought, and my perception of problematic issues within the " standard "

doctrine of modern TCM (as the twentieth century re-organization of Chinese

medicinal doctrine was exported to us in the west, dubbing it " traditional "

for propaganda reasons, to fulfill a perceived thirst among westerners in

classical Chinese thought).

 

My study of Chinese " thought " over thirty years leads me to conclude that

the " standard " clinical doctrine, based on classifying the manifestations of

distress into symptom-sign complexes, and then applying treatment strategies

to " balance " them is just not the whole picture. I've concluded that the

subtle and incisive minds that wrote and studied such texts as Neijing (and

frankly Dao De Jing) over the centuries must have come up with more

sophisticated ideas about how to work with the dynamic and responsive nature

of the embodied spirit as it adapts to various challenges to its vitality.

 

For instance, what does modern TCM teach us to do with patients that shows

only symptoms and signs of deficiency, yet they can't tolerate tonics -- if

we don't have western medical diagnoses? I recently posted links to two

essays on this topic, which for the convenience of any interested readers

I'll include again -- " Is this Excess or

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Deficiency-or\

-Excess.pdf> "

and " The Myth of

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Myth-of-Defic\

iency.pdf>. "

In addition to good translations, might adding such perceptions and thoughts

to the discussion of Chinese medicine also enhance its practice?

 

Steve

 

 

 

On Fri, Feb 26, 2010 at 8:35 PM, <johnkokko wrote:

 

>

>

> Steven,

> can you talk about the suppression by the Imperial Academy....

> I'm not sure I've heard about this... is this the neo-confucian suppression

> of daoism?

> Were texts re-written or burned?

>

> Thanks,

> K

>

>

>

 

 

 

[Guest guest]

Steve,

 

I know you mean well in regards to your ideas, but I have t say that I just read

your two essays, and I had a hard time understanding your point. I find that you

tend to jump around a lot in your writing, making it hard for me, the reader, to

get a clear grasp of your intention.

 

In the first one, " Is this Deficiency or Excess? " , I understand that you are

attempting to share your prospectives on acupuncture channel theory, but the

rest is unclear. DId you decide later that Gui Pi Tang was the wrong treatment

for your patient? Did she continue to take it, stop taking it? It is not clear

in the manner that you have presented it.

 

I mean if it was about, " looking past her apparent deficiencies " , how is this

different than standard TCM? This is exactly how I was taught in my training. I

was never taught to try and just fit symptoms or diseases into a nice box, so

that you confirm ones theory of diagnosis. One has to have a firm grasp on the

multitude of ways that a symptom can arise from, be flexible and open minded, so

one can adapt ones theory and thinking as the clinical picture changes.

 

Modern TCM is truly a collection of many schools of thought, of which many of us

have been exposed to and taught. We should be able to draw upon these different

schools, so as to use the most appropriate one when the times dictates, and know

how to switch to a different one when results are not optimal. I like what Jason

pointed out in the commentary to a classical case study, " Qin's (Bo Wei) point

is that doctors that are schooled in a well-rounded Chinese medicine approach

will have access to all of these approaches, and should be able to

systematically figure out which one is best. "

 

Perhaps you can clarify your point? Are you putting down CM? Are you saying your

thinking is better? How is your approach to problem solving any different than

normal CM?

 

Trevor

 

 

, Steven Alpern <stevenalpern

wrote:

>

> John,

>

> I was specifically referring to the suppression of the five systems of

> channels in favor of the dominance of the " primary " channels as extensions

> to the zangfu. Unlike your reference to Lingshu chapter 8 in the other

> thread, the modern use of the zangfu as the cornerstone of CM theory has

> grown increasingly physical over the centuries. The shift of modernization

> that I'm referring to here has progressively developed since early in the

> Song Dynasty, when it was canonized by the erection of the Bronze Man in the

> capital city of the time (I believe Xian, though I'm not sure), which has

> led to a progressive shift away from ( " applied philosophical " ) consideration

> of the five systems of channels as the foundation of individual life toward

> empirical studies of individual point functions.

>

> There were also changes in texts, including herbal texts, which the Song

> Imperial government was able to enforce through " flooding the market " with

> works produced with the relatively new technology of mechanical printing.

> One example of this shift was literally uncovered by Donald Harper, who also

> did the translation of medical texts found among the Mawangdui findings,

> which included a wonderful introduction of about 120 pages largely about

> Neijing. Harper found a pre-Song version of Su Simiao's *Qian Jin Yao

> Fang*in Dunhuang, and notes a drastic revision wherein the post-Song

> version,

> which has been the only one available since that period, resulted from

> systematic cleansing of material that might be considered " spiritual " --

> that is, relating to the intention of the practitioner.

>

> Harper's translations of the respective passages from the Tang and Song

> versions follow ( " Three Medieval Wu Zang Lun Textsin Manuscript from

> Dunhuang and Turfan, " 2004, Univ. of Chicago):

>

> Tang: The method for pounding medicine: burn incense, and sprinkle and sweep

> to make (the area) clean and pure. Let there not be random talking. Youths

> should be made to pound it, striving to make it very fine. Let the number

> for the pestle reach a thousand or myriad; the more (pounding the better.

> After completing the combining and blending, set (the medicine) on a table

> before [buddhist and Daoist icons for inspiring the intention of healing]…

> Entreat with your whole heart, and seek the root heart in praying for your

> wish. Then there is divine aid, and the living vapor of the eight directions

> fills the four limbs.

>

> Song (and later editions): …the more (pounding) the better.

>

> Yet, I am primarily a clinician, so I haven't done my own (primary) search

> and translations. I rely on responsible Sinologists and members of our

> profession who have developed their language skills sufficiently to do

> translations. I appreciate their many wonderful contributions to our

> profession, and do my own analyses based on my studies of Chinese history

> and thought, and my perception of problematic issues within the " standard "

> doctrine of modern TCM (as the twentieth century re-organization of Chinese

> medicinal doctrine was exported to us in the west, dubbing it " traditional "

> for propaganda reasons, to fulfill a perceived thirst among westerners in

> classical Chinese thought).

>

> My study of Chinese " thought " over thirty years leads me to conclude that

> the " standard " clinical doctrine, based on classifying the manifestations of

> distress into symptom-sign complexes, and then applying treatment strategies

> to " balance " them is just not the whole picture. I've concluded that the

> subtle and incisive minds that wrote and studied such texts as Neijing (and

> frankly Dao De Jing) over the centuries must have come up with more

> sophisticated ideas about how to work with the dynamic and responsive nature

> of the embodied spirit as it adapts to various challenges to its vitality.

>

> For instance, what does modern TCM teach us to do with patients that shows

> only symptoms and signs of deficiency, yet they can't tolerate tonics -- if

> we don't have western medical diagnoses? I recently posted links to two

> essays on this topic, which for the convenience of any interested readers

> I'll include again -- " Is this Excess or

>

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Deficiency-or\

-Excess.pdf> "

> and " The Myth of

>

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Myth-of-Defic\

iency.pdf>. "

> In addition to good translations, might adding such perceptions and thoughts

> to the discussion of Chinese medicine also enhance its practice?

>

> Steve

>

>

>

> On Fri, Feb 26, 2010 at 8:35 PM, <johnkokko wrote:

>

> >

> >

> > Steven,

> > can you talk about the suppression by the Imperial Academy....

> > I'm not sure I've heard about this... is this the neo-confucian suppression

> > of daoism?

> > Were texts re-written or burned?

> >

> > Thanks,

> > K

> >

> >

> >

>

>

>

[Guest guest]

I have to dig my heals in here. I hope to convey this graciously as I am

currently feeling a lot of stagnation regarding this topic. Reading Chinese,

speaking Chinese, writing books and the like are noble efforts, but they are not

the actual practice of our medicine. They are not areas where the rubber meets

the road so to speak.

 

I know for a fact that people are publishing, regurgitating, teaching and

learning to read classics, that simply have very little if and practical skills

in the last 8 years. They speak as if they are the leaders and truly educated in

our field, yet they only know it through books, Chinese or otherwise. I would

much rather hear from a busy practitioner than a inexperienced scholar. I would

much rather meditate, than read about meditating. I would much rather help

people than conceptualize about it. Granted both are needed, but what really

matters

 

Scholastic study is intended to improve our medicine, not inhibit it and surely

not take precedent over the treatment room. I urge those of you who have not had

the clinical experience to back up your books, and claims to greatness of being

a 20 year old practitioner, to be honest with yourself and us.

 

, Steven Alpern <stevenalpern

wrote:

>

> John,

>

> I was specifically referring to the suppression of the five systems of

> channels in favor of the dominance of the " primary " channels as extensions

> to the zangfu. Unlike your reference to Lingshu chapter 8 in the other

> thread, the modern use of the zangfu as the cornerstone of CM theory has

> grown increasingly physical over the centuries. The shift of modernization

> that I'm referring to here has progressively developed since early in the

> Song Dynasty, when it was canonized by the erection of the Bronze Man in the

> capital city of the time (I believe Xian, though I'm not sure), which has

> led to a progressive shift away from ( " applied philosophical " ) consideration

> of the five systems of channels as the foundation of individual life toward

> empirical studies of individual point functions.

>

> There were also changes in texts, including herbal texts, which the Song

> Imperial government was able to enforce through " flooding the market " with

> works produced with the relatively new technology of mechanical printing.

> One example of this shift was literally uncovered by Donald Harper, who also

> did the translation of medical texts found among the Mawangdui findings,

> which included a wonderful introduction of about 120 pages largely about

> Neijing. Harper found a pre-Song version of Su Simiao's *Qian Jin Yao

> Fang*in Dunhuang, and notes a drastic revision wherein the post-Song

> version,

> which has been the only one available since that period, resulted from

> systematic cleansing of material that might be considered " spiritual " --

> that is, relating to the intention of the practitioner.

>

> Harper's translations of the respective passages from the Tang and Song

> versions follow ( " Three Medieval Wu Zang Lun Textsin Manuscript from

> Dunhuang and Turfan, " 2004, Univ. of Chicago):

>

> Tang: The method for pounding medicine: burn incense, and sprinkle and sweep

> to make (the area) clean and pure. Let there not be random talking. Youths

> should be made to pound it, striving to make it very fine. Let the number

> for the pestle reach a thousand or myriad; the more (pounding the better.

> After completing the combining and blending, set (the medicine) on a table

> before [buddhist and Daoist icons for inspiring the intention of

healing] & #65533;

> Entreat with your whole heart, and seek the root heart in praying for your

> wish. Then there is divine aid, and the living vapor of the eight directions

> fills the four limbs.

>

> Song (and later editions): & #65533;the more (pounding) the better.

>

> Yet, I am primarily a clinician, so I haven't done my own (primary) search

> and translations. I rely on responsible Sinologists and members of our

> profession who have developed their language skills sufficiently to do

> translations. I appreciate their many wonderful contributions to our

> profession, and do my own analyses based on my studies of Chinese history

> and thought, and my perception of problematic issues within the " standard "

> doctrine of modern TCM (as the twentieth century re-organization of Chinese

> medicinal doctrine was exported to us in the west, dubbing it " traditional "

> for propaganda reasons, to fulfill a perceived thirst among westerners in

> classical Chinese thought).

>

> My study of Chinese " thought " over thirty years leads me to conclude that

> the " standard " clinical doctrine, based on classifying the manifestations of

> distress into symptom-sign complexes, and then applying treatment strategies

> to " balance " them is just not the whole picture. I've concluded that the

> subtle and incisive minds that wrote and studied such texts as Neijing (and

> frankly Dao De Jing) over the centuries must have come up with more

> sophisticated ideas about how to work with the dynamic and responsive nature

> of the embodied spirit as it adapts to various challenges to its vitality.

>

> For instance, what does modern TCM teach us to do with patients that shows

> only symptoms and signs of deficiency, yet they can't tolerate tonics -- if

> we don't have western medical diagnoses? I recently posted links to two

> essays on this topic, which for the convenience of any interested readers

> I'll include again -- " Is this Excess or

>

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Deficiency-or\

-Excess.pdf> "

> and " The Myth of

>

Deficiency<http://www.ccmforhealing.com/wp-content/uploads/2009/08/Myth-of-Defic\

iency.pdf>. "

> In addition to good translations, might adding such perceptions and thoughts

> to the discussion of Chinese medicine also enhance its practice?

>

> Steve

>

>

>

> On Fri, Feb 26, 2010 at 8:35 PM, <johnkokko wrote:

>

> >

> >

> > Steven,

> > can you talk about the suppression by the Imperial Academy....

> > I'm not sure I've heard about this... is this the neo-confucian suppression

> > of daoism?

> > Were texts re-written or burned?

> >

> > Thanks,

> > K

> >

> >

> >

>

>

>

[Guest guest]

DM?,

 

 

 

I have a couple thoughts.

 

 

 

I completely agree that books written by scholars with no clinical

experience can be problematic. However, I am not sure which books and

writings you are referring to. Can you elaborate?

 

 

 

I primarily am a clinician and always look at things through this lens.

Theory is only theory and I always ask how does this apply clinically?

Consequently, my focus on writing, and even reading Chinese, has been

completely on the clinical side. And I am with you, I would much rather hear

from a busy practitioner than an inexperienced scholar. But honestly, for me

to be interested in an author, they must have both aspects. This is

precisely why like to read people like Ye Tian-Shi. He not only is regarded

as probably the most famous clinician in Chinese history, his mastery of

Chinese medicine theory and previous bodies of work was extremely high. I do

not see such a clear divide between scholars and physicians. Honestly, there

are plenty of Chinese physicians throughout history that have both aspects

well under control.

 

 

 

Consequently, this leads into the next important point, one must choose

their sources wisely. In the West we have a handful of really incredible

clinicians, such as Dan Bensky, that have also devoted a good chunk of their

time and energy to produce high quality texts for us to read. Therefore,

just dismissing works because they are scholarly is foolish. However, there

is no question in my mind that I would rather read an author who has put the

time in and has actually studied Chinese medicine's past theories instead of

just riffing off basic Chinese medicine concepts. But that is just me...

 

 

 

 

 

Finally, writing, teaching, speaking, and reading is just a transmission of

information through language. Language, is unfortunately, inherently flawed.

It can never completely communicate the idea, and similarly why computer can

never really master Chinese medicine. However, language is the best vehicle

we have been discussing ideas over time and space. Anyone that disagrees, I

ask why are they even on this forum? Consequently, if someone wants to

understand what someone was saying 2000 years ago, they must have some

mastery of language from that time and beyond.

 

 

 

 

 

-Jason

 

 

 

 

On Behalf Of dmvitello01

Saturday, February 27, 2010 11:44 AM

 

Re: Research methodology and experimental design

 

 

 

 

 

I have to dig my heals in here. I hope to convey this graciously as I am

currently feeling a lot of stagnation regarding this topic. Reading Chinese,

speaking Chinese, writing books and the like are noble efforts, but they are

not the actual practice of our medicine. They are not areas where the rubber

meets the road so to speak.

 

I know for a fact that people are publishing, regurgitating, teaching and

learning to read classics, that simply have very little if and practical

skills in the last 8 years. They speak as if they are the leaders and truly

educated in our field, yet they only know it through books, Chinese or

otherwise. I would much rather hear from a busy practitioner than a

inexperienced scholar. I would much rather meditate, than read about

meditating. I would much rather help people than conceptualize about it.

Granted both are needed, but what really matters

 

Scholastic study is intended to improve our medicine, not inhibit it and

surely not take precedent over the treatment room. I urge those of you who

have not had the clinical experience to back up your books, and claims to

greatness of being a 20 year old practitioner, to be honest with yourself

and us.

 

 

 

 

 

 

 

[Guest guest]

Thea,

 

> > I think it is important to face some truths. If you don't read the

> > original

> > Chinese then people who do, are not likely to take what you say very

> > seriously.

> >

> I think that this is an extraordinary pity.

 

It may be a pity, but it is the truth, whether this is my opinion or not is

beside the point. I am not saying that those who practice and talk about, write

about, teach about their practice are wrong, but when they start taking a

decidedly scholarly approach to the medicine, that's when it starts to get

sticky.

 

> Thomas, I have great respect for you and your work-- can you really

> mean this, that no other pathway of knowledge within our field has

> merit?

 

I did not say that " no other pathway of knowledge within our field has merit, " I

said that if you take a scholarly pathway without being able to read the

original, those who can read the original are not likely to take you seriously.

I also clearly stated that I didn't believe the practicing the medicine without

reading Chinese was wrong or impossible.

 

I am not speaking of accepting anything as authoritative

> without scrutiny, but will you not even consider the insights of those

> who look to your scholarly talents for collaboration, confirmation,

> and mutual enrichment?

 

I did not and would not say such a thing. I have looked at most of what is

available in the English language, and studied the vast majority of it. But as I

gain access to the Chinese, I realize that most of it pales in comparison. There

was a comment, I believe it was from Steve, or perhaps Lonny, which said that

understanding the cultural context around the medicine is, perhaps, more

important than understanding the Chinese language. Perhaps this is true, but I

would argue that both are equally important, because you can not really

understand the language, especially the old written works without understanding

the cultural context. I have made a similar argument to this effect before, but

it was shot down by some of the list members.

 

I wrote my book with almost no Chinese language skills, the insights I shared

were based on my clinical experience with the plants. I think it is good work,

but then again I was not trying to interpret classical Chinese texts and would

not feel comfortable doing so without have a firm grip on the language and the

cultural context....but that is just me.

 

I will see one of my teachers today. He is 82 and so was trained

pre-university/Communist era. I will ask him about the big versus small " s "

argument and try to report back on what he thinks.

 

Peace,

Thomas

P.S. Z'ev, thanks for supporting Steven, I have looked at some of his work and

it does look interesting. My point is that if you have the Chinese commentary to

read, why would one read that of someone who can't read the original. That said,

I will take you comments to heart and look more closely at it.

[Guest guest]

Wow, it's getting a little hot in here. (DM, I hope you won't get too

entangled in that qi/blood stagnation. If you think I deserve to have a

voice in our profession, just go to my website -- check out my seminar

offerings, sign-up for the newsletter, read some essays.) Can we agree that

we are all caring (indeed passionate) people who are trying to improve our

profession, so we can help more patients more effectively? We're just

struggling a little with how best to do that.

 

I sincerely thank all of you that have read my comments here, and have

checked out some of my essays. I am certainly not trying to attack or

belittle Chinese medicine (as Trevor asked); indeed, I'm trying to uncover

deeper layers of its beauty in helping us understand the subtle dynamics of

individuals in health and disease. Thank you, Thomas, for checking out my

writings and not rejecting them out of hand. I hope that the limitations of

this messenger will not impede others from considering my message, which is

intended to help other practitioners refine their clinical skills.

 

Trevor wrote: " I mean if it was about, " looking past her apparent

deficiencies " , how is this different than standard TCM? This is exactly how

I was taught in my training. I was never taught to try and just fit symptoms

or diseases into a nice box, so that you confirm ones theory of diagnosis.

One has to have a firm grasp on the multitude of ways that a symptom can

arise from, be flexible and open minded, so one can adapt ones theory and

thinking as the clinical picture changes. "

 

Steve: Thank you for trying to read that essay. That was one of my early

efforts to articulate some challenging ideas. It discussed the case of a

woman that appeared to have a deficiency, which was actually an excess. On

the simplest level, perhaps one might say I was suggesting a new diagnostic

category -- Sanjiao excess. Indeed, I've now seen many dozens of patients

that seem to have various combinations of lung, spleen, and kidney

deficiencies who have actually been expressing sanjiao excess. I never heard

of such a thing in acupuncture school, but that was 25 years ago.

 

In a deeper sense, I was discussing the idea that symptoms and signs are not

always what they appear. The embodied spirit is dynamic and responsive, so

classifying its expression of distress in symptom-sign complexes only begins

the process of incisive diagnosis. If you learned to have " a firm grasp on

the multitude of ways that a symptom can arise from, be flexible and open

minded, so one can adapt ones theory and thinking as the clinical picture

changes, " then I salute your teachers. They did a fine job of refining the

basic clinical theory of modern CM. I've not heard of systematic discussion

of such response patterns in modern TCM.

 

Z'ev has correctly mentioned to me in private discussion that there is

precedent for that idea in SHL, relative to the transformation of pathology

due to incorrect treatment. I agree with him, and indeed I'd say we agree

that often " no treatment " is " incorrect treatment " through allowing

pathogenic factors to remain within the individual to progress and transform

on their own. So, when we see patients, I believe we are challenged to go

beyond the classification of symptoms and signs into syndromes to discern

the specific individual dynamics of the individual's struggle to maintain

life.

 

Steve

 

 

 

[Guest guest]

I think Thomas has hit the nail on the head. Please keep us posted on your

discussions with your teacher.

 

 

 

-Jason

 

 

 

 

On Behalf Of

Saturday, February 27, 2010 7:37 PM

 

Re: Research methodology and experimental design

 

 

 

 

 

Thea,

 

> > I think it is important to face some truths. If you don't read the

> > original

> > Chinese then people who do, are not likely to take what you say very

> > seriously.

> >

> I think that this is an extraordinary pity.

 

It may be a pity, but it is the truth, whether this is my opinion or not is

beside the point. I am not saying that those who practice and talk about,

write about, teach about their practice are wrong, but when they start

taking a decidedly scholarly approach to the medicine, that's when it starts

to get sticky.

 

> Thomas, I have great respect for you and your work-- can you really

> mean this, that no other pathway of knowledge within our field has

> merit?

 

I did not say that " no other pathway of knowledge within our field has

merit, " I said that if you take a scholarly pathway without being able to

read the original, those who can read the original are not likely to take

you seriously. I also clearly stated that I didn't believe the practicing

the medicine without reading Chinese was wrong or impossible.

 

I am not speaking of accepting anything as authoritative

> without scrutiny, but will you not even consider the insights of those

> who look to your scholarly talents for collaboration, confirmation,

> and mutual enrichment?

 

I did not and would not say such a thing. I have looked at most of what is

available in the English language, and studied the vast majority of it. But

as I gain access to the Chinese, I realize that most of it pales in

comparison. There was a comment, I believe it was from Steve, or perhaps

Lonny, which said that understanding the cultural context around the

medicine is, perhaps, more important than understanding the Chinese

language. Perhaps this is true, but I would argue that both are equally

important, because you can not really understand the language, especially

the old written works without understanding the cultural context. I have

made a similar argument to this effect before, but it was shot down by some

of the list members.

 

I wrote my book with almost no Chinese language skills, the insights I

shared were based on my clinical experience with the plants. I think it is

good work, but then again I was not trying to interpret classical Chinese

texts and would not feel comfortable doing so without have a firm grip on

the language and the cultural context....but that is just me.

 

I will see one of my teachers today. He is 82 and so was trained

pre-university/Communist era. I will ask him about the big versus small " s "

argument and try to report back on what he thinks.

 

Peace,

Thomas

P

 

 

 

 

[Guest guest]

Steve,

 

I agree with you that many so called deficiencies, may in fact be excesses. This

is certainly true for one of the fields that I like to focus on, dermatology.

All too often I come across practitioners asking me why their patient is not

getting better, even though they feel as if they did a stellar job in their

differential diagnosis. From what I can see, deficiency is all too often over

diagnosed, and I believe this stems from a lack of true understanding of the

disorder they are trying to treat. Everybody thinks they are weaker then they

are, and because of this they find any way to put their patient (or themselves)

into the " deficiency " box.

 

I recently took on a patient, who is also a practitioner of ,

that had developed fairly aggressive psoriasis on her lower limbs in the last 2

years since giving birth. She attributed her skin condition to a state of blood

Xu, because of the association with the pregnancy. Her formula for herself was

loaded with every blood tonic possible, but even after several months of taking

her recipe her skin did not get better, and in fact was worsening. Hence why she

consulted with me.

 

When I looked her over I noticed a clear case of psoriasis due to Blood heat

with stasis and fire toxin. Within one month on a recipe to treat this, her

psoriasis receded significantly, no new lesions developed, her itch disappeared,

her energy improved, etc. The only tonic medicine in her formula was probably

Sheng Di Huang, which was obviously nurturing her blood as well as clearing heat

from it.

 

I really feel that developing an eye for the specific conditions that we treat,

helps to stop the guessing game of diagnosis. If we have developed a good

familiarity of certain conditions, we can approach them with confidence, and

have realistic expectations of changes. Knowing how to read a deficient state

from an excessive one, or how they may be contributing to each other, is

obviously very important, and I would say that my most respected teachers of

modern Chinese medicine were able to impart this onto me.

 

If this was merely about providing systematic relief, then please ask my wife's

opinion, as she was treated in this fashion over 8 years ago with herbal

medicine for very severe widespread atopic eczema (she had this for 22 years).

She has been clear ever since, her skin is stable, and she can eat foods that

used to put her into the hospital because of anaphylaxis. Her emotional state is

happy as well, as her self image had a huge lift. In western terms she was

basically cured, which was a miracle and being viewed as impossible from their

understanding of the human body.

 

So I obviously disagree with you in terms of CM only offering symptomatic

relief. Perhaps you could clarify what this means to you.

 

The whole line between excess and deficiency is not necessarily black and white.

I remember learning how Ku Shen, which is in the clear damp heat category of

herbs, can be used as a tonic. Ku Shen, from what I understand, is called

" Bitter Ginseng " , which signifies it's tonic properties. The ability to tonify

though is via clearing away excesses, so that the bodies right Qi is not

weighted down, and can now be strong (sorry for the terminology). Ku Shen is

used in many formulations for skin disease, asthma, heart disease, and even

sleep disorders.

 

So yes I agree with you that we should be on the look out for people who have

" appeared to have a deficiency, which was actually an excess " . This is a

definitely a part of the Chinese medicine as I have been taught.

 

Best,

Trevor

 

, Steven Alpern <stevenalpern

wrote:

>

> Wow, it's getting a little hot in here. (DM, I hope you won't get too

> entangled in that qi/blood stagnation. If you think I deserve to have a

> voice in our profession, just go to my website -- check out my seminar

> offerings, sign-up for the newsletter, read some essays.) Can we agree that

> we are all caring (indeed passionate) people who are trying to improve our

> profession, so we can help more patients more effectively? We're just

> struggling a little with how best to do that.

>

> I sincerely thank all of you that have read my comments here, and have

> checked out some of my essays. I am certainly not trying to attack or

> belittle Chinese medicine (as Trevor asked); indeed, I'm trying to uncover

> deeper layers of its beauty in helping us understand the subtle dynamics of

> individuals in health and disease. Thank you, Thomas, for checking out my

> writings and not rejecting them out of hand. I hope that the limitations of

> this messenger will not impede others from considering my message, which is

> intended to help other practitioners refine their clinical skills.

>

> Trevor wrote: " I mean if it was about, " looking past her apparent

> deficiencies " , how is this different than standard TCM? This is exactly how

> I was taught in my training. I was never taught to try and just fit symptoms

> or diseases into a nice box, so that you confirm ones theory of diagnosis.

> One has to have a firm grasp on the multitude of ways that a symptom can

> arise from, be flexible and open minded, so one can adapt ones theory and

> thinking as the clinical picture changes. "

>

> Steve: Thank you for trying to read that essay. That was one of my early

> efforts to articulate some challenging ideas. It discussed the case of a

> woman that appeared to have a deficiency, which was actually an excess. On

> the simplest level, perhaps one might say I was suggesting a new diagnostic

> category -- Sanjiao excess. Indeed, I've now seen many dozens of patients

> that seem to have various combinations of lung, spleen, and kidney

> deficiencies who have actually been expressing sanjiao excess. I never heard

> of such a thing in acupuncture school, but that was 25 years ago.

>

> In a deeper sense, I was discussing the idea that symptoms and signs are not

> always what they appear. The embodied spirit is dynamic and responsive, so

> classifying its expression of distress in symptom-sign complexes only begins

> the process of incisive diagnosis. If you learned to have " a firm grasp on

> the multitude of ways that a symptom can arise from, be flexible and open

> minded, so one can adapt ones theory and thinking as the clinical picture

> changes, " then I salute your teachers. They did a fine job of refining the

> basic clinical theory of modern CM. I've not heard of systematic discussion

> of such response patterns in modern TCM.

>

> Z'ev has correctly mentioned to me in private discussion that there is

> precedent for that idea in SHL, relative to the transformation of pathology

> due to incorrect treatment. I agree with him, and indeed I'd say we agree

> that often " no treatment " is " incorrect treatment " through allowing

> pathogenic factors to remain within the individual to progress and transform

> on their own. So, when we see patients, I believe we are challenged to go

> beyond the classification of symptoms and signs into syndromes to discern

> the specific individual dynamics of the individual's struggle to maintain

> life.

>

> Steve

>

>

>

[Guest guest]

Yes, I also agree. Basic CM.

 

 

 

-Jason

 

 

 

 

On Behalf Of trevor_erikson

 

 

 

 

 

So yes I agree with you that we should be on the look out for people who

have " appeared to have a deficiency, which was actually an excess " . This is

a definitely a part of the Chinese medicine as I have been taught.

 

Best,

Trevor

 

 

 

 

 

 

 

[Guest guest]

Wonderful. So, we're all in agreement. Trevor, perhaps your patient (who is

also herself a practitioner) misread her own symptoms and signs. It happens.

Or, perhaps your interest in dermatology allowed you to recognize an excess,

where systemic signs of deficiency may have mislead many practitioners. That

has long been one of the key values of specialization in CM -- it allows one

to learn to better recognize how to differentiate symptoms for particular

disease categories. One of my key points for the past month has been that

there are many cases where patients would be categorized by the " standard

diagnostic categories of modern TCM " as deficiencies, where they actually

have excesses. Those symptoms-sign complexes aren't wrong, they're just

incomplete -- a beginning instead of an end. As I mentioned before, Trevor,

if you learned that well in your training, then I salute your teachers.

 

The five systems of channels is simply the conceptual framework provided in

the opening chapters of Lingshu that helps us recognize that scenario. Many

people appear to exhibit deficiencies, like the many people who need a

little coffee or tea to " get going, " yet in reality they have incipient

excesses. The presentation of many patients appear as deficiencies, because

their embodied spirits are devoting substantial resources (qi, blood,

fluids, etc.) to storing away the excesses (such as unresolved emotional

conflicts -- the internal causes of disease), so there is insufficient such

resources to conduct current activities. So, they appear to exhibit

deficiencies, yet they really have excesses.

 

Steve

 

On Sun, Feb 28, 2010 at 7:22 PM, <

> wrote:

 

>

>

> Yes, I also agree. Basic CM.

>

>

> -Jason

>

> <%40>

>

[ <%40>\

]

> On Behalf Of trevor_erikson

>

>

> So yes I agree with you that we should be on the look out for people who

> have " appeared to have a deficiency, which was actually an excess " . This is

> a definitely a part of the Chinese medicine as I have been taught.

>

> Best,

> Trevor

>

>

[Guest guest]

Steve,

I appreciate your point here, and I don't think that anyone on the list will

deny that there are many times where the patient is excess when " presenting " as

deficient. However what you are noticing is not a limitation of modern TCM but

more likely just poor diagnostic skills from the practitioner. Many people that

aren't thoroughly trained make such errors, hence this is a educational (or

experience) problem and definitely not a " modern TCM " problem.

I can assure you that TCM if practiced properly has plenty of tools to parse out

such discrepancies. So I just don't understand your concept of " standard

diagnostic categories of modern TCM " - TCM is a fluid flexible system geared to

the individual and not a box for someone to be put into. Such boxes or standard

categories are only meant as learning tools and not to be taken literally in the

clinic. Doing this is quite frankly a very low level of medicine. Unfortunately

many students are under the impression that this is how TCM is supposed to be

practiced.

 

-Jason

 

 

> ----

> Steven Alpern <stevenalpern

> disease categories. One of my key points for the past month has been that

> there are many cases where patients would be categorized by the " standard

> diagnostic categories of modern TCM " as deficiencies, where they actually

> have excesses. Those symptoms-sign complexes aren't wrong, they're just

> incomplete -- a beginning instead of an end. As I mentioned before,

[Guest guest]

Jason, Steve, et al.,

 

I had a rather short and surprising conversation with my teacher on Sunday

regarding big or small " s " spirit. He simply said he has no religious beliefs or

spiritual path and he doesn't believe that Chinese medicine, as a practice, has

a need for Spirit. He said that deep in the past, perhaps, some people had this,

but is was not necessarily part of the mainstream medicine. He said that anyone

can have a spiritual path and that was neither here nor there, he doesn't and

doesn't see it in the literature.

 

When I tried to press for more, he just brushed it aside and said, he had

nothing more to say, it is not something he understands or believes in and this

idea was never taught by his teachers.

 

But that is just one man's opinion. I would not call my teacher a scholar, I

would call him a clinician. He has been seeing patients for 64 years and has

never incorporated " Spirit " into his practice. You decide!

 

 

In Good Health,

Thomas

, " " wrote:

>

> I think Thomas has hit the nail on the head. Please keep us posted on your

> discussions with your teacher.

[Guest guest]

Hi Thomas

I've been asking some of the same questions around my school regarding this

topic, you should see the looks I get. I think this topic is only well

known amongst a few Guru like western teachers. There are a few Neijing

scholars coming to our school for some lectures this weekend, I'll put

forward some of these questions again. I hope I don't get laugh out of the

room.

Gabriel Fuentes

 

--- On Mon, 3/1/10, wrote:

 

 

 

Re: Research methodology and experimental design

 

Monday, March 1, 2010, 9:56 PM

 

 

 

 

 

 

Jason, Steve, et al.,

 

I had a rather short and surprising conversation with my teacher on Sunday

regarding big or small " s " spirit. He simply said he has no religious beliefs or

spiritual path and he doesn't believe that Chinese medicine, as a practice, has

a need for Spirit. He said that deep in the past, perhaps, some people had this,

but is was not necessarily part of the mainstream medicine. He said that anyone

can have a spiritual path and that was neither here nor there, he doesn't and

doesn't see it in the literature.

 

When I tried to press for more, he just brushed it aside and said, he had

nothing more to say, it is not something he understands or believes in and this

idea was never taught by his teachers.

 

But that is just one man's opinion. I would not call my teacher a scholar, I

would call him a clinician. He has been seeing patients for 64 years and has

never incorporated " Spirit " into his practice. You decide!

 

In Good Health,

Thomas

, " " <@.. .>

wrote:

>

> I think Thomas has hit the nail on the head. Please keep us posted on your

> discussions with your teacher.

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Gabriel,

 

All this talk about " shen " and " Shen " is basically a side-show. If you have

several Neijing scholars coming to your school this weekend, ask them about

the channel divergences or the evolution and transformation of pathogenic

factors in eventually becoming disease. Ask them something with clear and

interesting clinical implications. That will facilitate your embodying their

teachings, and perhaps to evaluate how well these scholars have embodied

their studies.

 

Steve

 

On Mon, Mar 1, 2010 at 10:02 PM, Gabriel Fuentes <fuentes120wrote:

 

>

>

> Hi Thomas

> I've been asking some of the same questions around my school regarding this

> topic, you should see the looks I get. I think this topic is only well

> known amongst a few Guru like western teachers. There are a few Neijing

> scholars coming to our school for some lectures this weekend, I'll put

> forward some of these questions again. I hope I don't get laugh out of the

> room.

> Gabriel Fuentes

>

> --- On Mon, 3/1/10,

<tag.plantgeek<tag.plantgeek%40gmail.com>>

> wrote:

>

> <tag.plantgeek <tag.plantgeek%40gmail.com>>

>

> Re: Research methodology and experimental design

> <%40>

> Monday, March 1, 2010, 9:56 PM

>

>

>

>

> Jason, Steve, et al.,

>

> I had a rather short and surprising conversation with my teacher on Sunday

> regarding big or small " s " spirit. He simply said he has no religious

> beliefs or spiritual path and he doesn't believe that Chinese medicine, as a

> practice, has a need for Spirit. He said that deep in the past, perhaps,

> some people had this, but is was not necessarily part of the mainstream

> medicine. He said that anyone can have a spiritual path and that was neither

> here nor there, he doesn't and doesn't see it in the literature.

>

> When I tried to press for more, he just brushed it aside and said, he had

> nothing more to say, it is not something he understands or believes in and

> this idea was never taught by his teachers.

>

> But that is just one man's opinion. I would not call my teacher a scholar,

> I would call him a clinician. He has been seeing patients for 64 years and

> has never incorporated " Spirit " into his practice. You decide!

>

> In Good Health,

> Thomas

> , " " <@..

> .> wrote:

> >

> > I think Thomas has hit the nail on the head. Please keep us posted on

> your

> > discussions with your teacher.

>

>

[Guest guest]

Thomas

 

Do you get any sense that this might be a politically expedient

response from your teacher? I mean, given the long history of

" plausible deniability " for such matters in Chinese medicine, lest the

Emperor cut one's head off for deviating from the official party line?

 

These days one might not literally have one's head cut off, but

minority views in Chinese medicine, especially those concerning

spirit, tend to arouse a very fierce response. I could understand

anyone being unwilling to speak up about such things. I have heard

that this is especially so in China. But you would be a better

observer for that question than I.

 

 

Thea Elijah

 

On Mar 1, 2010, at 10:56 PM, wrote:

 

> Jason, Steve, et al.,

>

> I had a rather short and surprising conversation with my teacher on

> Sunday regarding big or small " s " spirit. He simply said he has no

> religious beliefs or spiritual path and he doesn't believe that

> Chinese medicine, as a practice, has a need for Spirit. He said that

> deep in the past, perhaps, some people had this, but is was not

> necessarily part of the mainstream medicine. He said that anyone can

> have a spiritual path and that was neither here nor there, he

> doesn't and doesn't see it in the literature.

>

> When I tried to press for more, he just brushed it aside and said,

> he had nothing more to say, it is not something he understands or

> believes in and this idea was never taught by his teachers.

>

> But that is just one man's opinion. I would not call my teacher a

> scholar, I would call him a clinician. He has been seeing patients

> for 64 years and has never incorporated " Spirit " into his practice.

> You decide!

>

> In Good Health,

> Thomas

> , " "

> wrote:

> >

> > I think Thomas has hit the nail on the head. Please keep us posted

> on your

> > discussions with your teacher.

>

>

>

 

 

 

 

[Guest guest]

Thomas,

 

 

 

Thanks for the report, and I bet your teacher can write a formula (or insert

a needle) better than anyone on the list.

 

 

 

-Jason

 

 

 

 

On Behalf Of

Monday, March 01, 2010 8:56 PM

 

Re: Research methodology and experimental design

 

 

 

 

 

Jason, Steve, et al.,

 

I had a rather short and surprising conversation with my teacher on Sunday

regarding big or small " s " spirit. He simply said he has no religious

beliefs or spiritual path and he doesn't believe that Chinese medicine, as a

practice, has a need for Spirit. He said that deep in the past, perhaps,

some people had this, but is was not necessarily part of the mainstream

medicine. He said that anyone can have a spiritual path and that was neither

here nor there, he doesn't and doesn't see it in the literature.

 

When I tried to press for more, he just brushed it aside and said, he had

nothing more to say, it is not something he understands or believes in and

this idea was never taught by his teachers.

 

But that is just one man's opinion. I would not call my teacher a scholar, I

would call him a clinician. He has been seeing patients for 64 years and has

never incorporated " Spirit " into his practice. You decide!

 

In Good Health,

Thomas

 

 

 

 

 

 

[Guest guest]

I bet your teacher can write a formula (or insert

a needle) better than anyone on the list.

 

Lonny: On what data is this conclusion based? Are you saying that clinical

experience is primary?

[Guest guest]

Jason,

 

This talk of " better " is tedious and distracting. Indeed, what does it even

mean? What is the mark of a " good " treatment? Is it the

balancing/ameliorization of symptoms and signs, or the mobilization of wei

qi?

 

I submit that I started really learning Chinese medicine, when I clearly

understood that it was the latter, yet my entire training and most of what

I've seen in writing about CM points to the former. I find this disturbing,

and believe that CM has SO MUCH more to offer than I was taught in

acupuncture school. Clearly, there have been (and are currently) very

inspired and inspiring physicians and teachers. However, I find the clinical

methodology of modern TCM, which focuses so much on classifying patients

into symptom-sign complexes, inadequate. Of course, the best practitioners

and teachers of either race (or frankly either linguistic group) can

penetrate through the limitations of that basic methodology, yet I believe

we need to honestly ask ourselves as a profession how often or widely is

that ideal realized? Might we also ask if there might be some other ideas

from the history of CM (like extensive use of the five systems of channels)

that we'd add to the modern doctrine to help us practice CM more incisively?

 

So, what happens when a practitioners successfully stimulates the

mobilization of wei qi in a patient? Sometimes, when the symptoms are the

direct result of the patient's struggle with blockage, they just get better.

However, when the patient's condition is the expression of a more entangled

situation with multiple layers of pathogenic factor and " coping response, "

mobilizing wei qi can easily stimulate a " healing event " -- where the

patient's embodied spirit actively confronts some stagnation it had

previously tolerated, and pushes it out. These " healing events " are

generally symptomatic, and can be quite unpleasant. Yet, I submit they are

the mark of " good " treatments, as they stimulate profound healing rather

than short-term amelioration of symptoms, which BTW is the standard

promulgated when we " take our lead " from western medicine. We can do better

than that, MUCH better.

 

I know nothing of Thomas' teacher, and have no doubt that there are many

Chinese (or other) practitioners with 64 years experience, who have attained

very high accomplishment. I hope he learns a lot, and comes back to share

with other members of the profession. Yet, there remains Jason's pesky issue

of " better. " And, I really don't know what it means. What IS the mark of a

" good " treatment and how do we learn to do it? I submit that for acupuncture

specifically there are a lot of contributing factors.

 

I had occasion to attend a weekend seminar several years ago taught by a

very eminent practitioner who had been brought to the U.S. from China to

teach this seminar. I was very excited by this opportunity, because the

focus of the seminar was chapter 10 of Lingshu, a topic that I'd already put

some effort into studying (even if only in English translation). I had every

hope that it would be a serious academic and clinical forum, because while

it was available as CEU, it was part of a core course in the doctoral

program of one of the schools. I was disappointed, and I certainly wasn't

the only one. There were at least a dozen people sitting in the back of the

room (where I was not), who were barely paying attention to the

presentation, which was quite dull, even for practitioners who had not

studied chapter 10 in any more detail that is included in widely available

textbooks of TCM. While he gave a lot of specific protocol information, it

was quite repetitive -- using a very small selection of points.

 

In addition to this presentation, he also talked specifically about needling

and did a few clinical demonstrations. While this part of the seminar was

somewhat more interesting than the lecture, it was far from inspiring. He

talked for a while about the many hours of work he did for many months when

he was learning to needle to " strenghten " the qi of his hands. While this

discussion was interesting, I find it a little " off point, " because its

based on an inaccurate assumption. The " strength " of one's qi is only one

factor (and I believe not the most important factor) in consistently doing

" good " treatments, which I'd say are ones that stimulate lasting changes in

the patient's qi -- which of course is not entirely within the control of

the practitioner. It's an interaction, not simply a matter of applying a

" good " treatment.

 

He shared three standards of effectiveness for acupuncture treatments, so of

which were extremely compelling and others were less so:

 

1. propagation of qi sensation -- while some " good " treatments (according

to the standard above) the patients feel the propagation of qi, some they do

not. Also, some treatments where the patient feels propagation are " good, "

some are not. Indeed, I was very unimpressed by his main demonstration of qi

propagation. He had a demonstration model lie supine with legs extended. He

lifted on by the heel, until the sinew was tensioned, then he needled U.B.

40 with a method that was somewhat similar to chiseling, but he made it more

complicated requiring a lot of practiced dexterity. Of course, the model

felt strong propagation down the posterior leg, and the doctor could lift

the heel slightly higher, but that was simply a sinew release, which was

basically assured by the physical positioning of the patient.

2. immediate symptom relief -- while immediate symptom relief is somewhat

interesting, as it may indicate a substantial opening of a blockage, it may

also indicate a scattering of the qi that had built up at a deeply

habituated blockage. The latter has little if any lasting impact, unless one

can treat every day, as the Chinese can easily in their hospitals, and

thereby " beat the blockage into submission. " We must recognize that

socio-economic system doesn't generally work that way. I believe we need to

work on ways to stimulate and facilitate profound healing in our patients,

when we can often treat at most 1-2 times per week.

3. change in physical lesions -- of course, this is VERY interesting,

though somewhat less so if it is accomplished through daily treatments over

many months. How are we to accomplish such opportunities in the U.S.? Yet,

even changing physical lesions need not require such treatment regimes. I've

had several patients with substantial physical lesions who had occasion to

have both before and after tests, whose results astounded (and even

horrified) their medical doctors. However, let me be clear, it is not me

that is doing the healing. It is their process. I simply simulate the

release of a patient's intrinsic capacity to heal -- his or her wei qi, and

that can't be standardized into protocols -- either acupuncture or herbal.

 

At the very least, I believe we should be careful in evaluating what is

" good " in Chinese medicine, and look deeply into the healing process of our

patients to stay on track.

 

Steve

 

 

On Tue, Mar 2, 2010 at 5:47 AM, <

> wrote:

 

>

>

> Thomas,

>

> Thanks for the report, and I bet your teacher can write a formula (or

> insert

> a needle) better than anyone on the list.

>

>

> -Jason

>

> <%40>

>

[ <%40>\

]

> On Behalf Of

> Monday, March 01, 2010 8:56 PM

>

> <%40>

> Re: Research methodology and experimental design

>

> Jason, Steve, et al.,

>

> I had a rather short and surprising conversation with my teacher on Sunday

> regarding big or small " s " spirit. He simply said he has no religious

> beliefs or spiritual path and he doesn't believe that Chinese medicine, as

> a

> practice, has a need for Spirit. He said that deep in the past, perhaps,

> some people had this, but is was not necessarily part of the mainstream

> medicine. He said that anyone can have a spiritual path and that was

> neither

> here nor there, he doesn't and doesn't see it in the literature.

>

> When I tried to press for more, he just brushed it aside and said, he had

> nothing more to say, it is not something he understands or believes in and

> this idea was never taught by his teachers.

>

> But that is just one man's opinion. I would not call my teacher a scholar,

> I

> would call him a clinician. He has been seeing patients for 64 years and

> has

> never incorporated " Spirit " into his practice. You decide!

>

> In Good Health,

> Thomas

>

>

[Guest guest]

Woah, hold on a minute guys. . .

 

I see a lot of room for bias in this discussion.

 

Let's remember that in socialist societies, there is no such thing at the

official level as a 'spirit'. The materialistic biases of modern

communist/socialist countries makes it more 'politically correct' to avoid

discussion of such a thing, except perhaps in an academic, safe milieu.

 

" Spirit " doesn't have to mean something metaphysical, beyond this world,

invisible, immortal.

 

Compassion, serving others, integrity, are part of the 'spiritual' nature of

humanity. It is not just a materialistic, automatic reflex conditioned by

evolution.

 

Yes, the opening chapters of the Su Wen provide a guidebook for living with the

seasons.

 

Or as Sun Si-miao said (and I checked several translations and the Chinese), " if

you do not read the Nei Jing you will not know the virtue of mercy, sorrow,

happiness, giving " .

 

I'm reading a little book called " Yojokun " by a Japanese neo-Confucian

physician, Kaibara Ekiken. It is all about how to live in harmony with nature,

season, family, environment, eat right, sleep right, manage emotions, etc. with

the goal of preservation and length of life.

 

" Yang Sheng " or nourishing life is about maintaining one's bodily and emotional

health, which in Confucian philosophy is the cornerstone of a healthy family and

society. The continuation of life through healthy children, descendants, who

will continue the life of one's family, culture and society.

 

Therefore, the physician in Chinese medicine is more than a technician relieving

symptoms, he/she is maintaining life, which is precious.

 

At its best, Chinese medicine can be a calling to service, for humanity, and if

one so believes, to G-d. . . .

 

 

On Mar 2, 2010, at 5:47 AM, wrote:

 

> Thomas,

>

> Thanks for the report, and I bet your teacher can write a formula (or insert

> a needle) better than anyone on the list.

>

> -Jason

>

>

> On Behalf Of

> Monday, March 01, 2010 8:56 PM

>

> Re: Research methodology and experimental design

>

> Jason, Steve, et al.,

>

> I had a rather short and surprising conversation with my teacher on Sunday

> regarding big or small " s " spirit. He simply said he has no religious

> beliefs or spiritual path and he doesn't believe that Chinese medicine, as a

> practice, has a need for Spirit. He said that deep in the past, perhaps,

> some people had this, but is was not necessarily part of the mainstream

> medicine. He said that anyone can have a spiritual path and that was neither

> here nor there, he doesn't and doesn't see it in the literature.

>

> When I tried to press for more, he just brushed it aside and said, he had

> nothing more to say, it is not something he understands or believes in and

> this idea was never taught by his teachers.

>

> But that is just one man's opinion. I would not call my teacher a scholar, I

> would call him a clinician. He has been seeing patients for 64 years and has

> never incorporated " Spirit " into his practice. You decide!

>

> In Good Health,

> Thomas

>

>

[Guest guest]

, Gabriel Fuentes <fuentes120

wrote:

> Hi Thomas

> I've been asking some of the same questions around my school regarding this

topic, you should see the looks I get. I think this topic is only well

known amongst a few Guru like western teachers. There are a few Neijing

scholars coming to our school for some lectures this weekend, I'll put

forward some of these questions again. I hope I don't get laugh out of the

room.

 

Gabe, I know you know this, but just be careful about how you ask so that you

don't embarrass yourself. Chinese doctors are impressed when Westerners ask

questions that demonstrate that we have diligently studied authentic Chinese

medicine, and they can get pessimistic when Western students ask fluffy

questions that make them wonder what on earth passes for CM in the West. When I

lived in Taiwan I heard no end of rants from doctors like Feng Ye who had no

patience for Western students because of their tendency to ask questions that

demonstrated a shallow understanding of Chinese medicine, especially when the

questions were trying to impose Western notions of spirituality onto Chinese

medicine. Westerners that go East looking to prove their preconceived notions

rather than being open to whatever reality they find can be a sore spot for many

doctors like Feng Ye. In the past, lots of Westerners went to Asia with very

minimal training, and their lack of informed questions gave us a really bad rap

as a group. I remember that Feng Ye was saying that his team eventually stopped

taking Western students because they were so sick of what he called the " Between

Heaven and Earth " level of education. Face is important in Chinese society, and

we all suffer the consequences of the bad impression that many Western students

make when they travel East. Besides, Chinese philosophy is already extremely

sophisticated, so there is no need to impose Western spirituality onto it.

 

If you ask a Neijing scholar a question that demonstrates insight into Chinese

culture, philosophy, medicine and history, they will be truly happy to share

their knowledge. If you ask them something that just makes them shake their

head in disbelief, we all suffer the consequences. As a community, we need to

ask questions that gain the respect of our Chinese teachers. Every time a

Western student asks a question that frustrates the teacher, we collectively

lose face and have to work that much harder to earn the respect of the Chinese

experts. In a field that has so much fascinating knowledge to learn, there is no

point in wasting time by asking an embarrassing question that will make the

doctor think you never made it past the Barnes and Noble understanding of CM.

 

I'm going to stay out of the fray on this discussion, but I'd like to thank

Jason, Trevor, Thomas, etc. for their excellent posts.

 

Eric