Fwd: What Mismanaged Cases Teach Us About the Practice of Chinese Medicine

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http://216.92.231.121/Herbology/error_of_our_ways.htm

 

This is an article for intermediate and advanced students and professionals.

 

Levels of skill, training, and appitute differ among TCM healers just like

they differ among Western MDs and DOs.

 

The difference is that mismanged cases make up a large part of the modern

TCM literature. This is not because there are more mismanaged cases in TCM

than in Western medicine, but because the Chinese have a different attitude

towards mismanaged TCM cases than Western medicine has toward mismanaged

Western cases.

 

The Chinese recognize that we learn nothing from a billion cases that fit a

model. Nor do we increase knowledge and understanding all that much from

sucessful cases. It's the cases that don't fit the model that force an

expansion of the model, and it's the unsucessful cases that sharpen our

understanding and skills.

 

TCM healers are not satisfied with a certain percentage of patients

responding to treatment. The TCM goal is 100%. TCM healers tend not to be

big on attributing unsucessful cases to " it's psychological " , or to the will

of God, or to " it's just the way things are. " TCM healers tend to want to

know why something did not work in a particular case and what will work in

that particular case and why. Because of this attitude, TCM healers tend to

get sharper and more effective in their analysis and treatment skills as

time goes on.

 

Although the article doesn't use the wording I'm using here, TCM is very

aware of the fact that if a problem goes untreated long enough, it can

evolve into its opposite and manifest opposite symptoms from what it usually

does. An example of opposite symptoms is given early in the article when

the author talks about a rapid pulse sometimes being a symptom of Cold.

Most of the cases by far that you see where the person has a rapid pulse

will be due to Heat. Heat tends to speed things up. The pulse, motion, and

speech of people with Heat problems will tend to be rapid, and the vast

majority of cases where rapid pulse is a sign will be Heat cases. But, in a

very few cases, Cold will manifest as a rapid pulse. This article will give

readers some pointers on recognizing when this happens. (Note: The pulse

may also be rapid in some cases of Blood and Fluid Deficiency even though

Heat is not a factor in these cases. A slow pulse (and movements and

speech) almost always means Cold, but an exception is that well-conditioned

atheletes will have slower than normal heartrates.)

 

Heat can change into Cold and vice versa, Dampness can trigger Dryness, etc.

 

The first case study in this article is " Balancing the Liver & Extinguishing

Wind and actually aggravating Wind " . This is a very interesting case study

because it illustrates not taking the client's age into account and

forgetting a fairly well-known principle in TCM. Elderly patients do tend

to be Qi and Blood Deficient, and " in treating wind first treat the blood,

and in circulating the blood, the wind will be extinguished of its own

accord. " In other words, Blood Deficiency is a common cause of Internal

Wind. I know it's a fairly well-known concept in TCM because I first read

about it in Chinese Herbal Cures by Henry C. Lu, and this is a very general

introductory book.

 

This case also illustrates the importance of treating all major Roots when

concocting a formula or herbal regime. The treatment just for Qi imbalance

and Phlegm was not successful until the Blood problem was recognized and the

appropriate herbs added for that.

 

The second case " Treatment of abdominal distension via the spleen is

ineffective, but diffusing the lungs yields instant results " illustrates the

importance of etiology and taking a thorough history. It also illustrates

how even though all the symptoms may be in one organ system, the condition

actually orignates in another system, and that Root system is going to have

to be addressed before the problems can be resolved. In this particular

case abominal distention and other problems that can be associated with

Spleen imbalance actually had a Root in Lung damage due to a bout of flu a

few years before. The damage to and imbalance in the Lungs never was

properly treated, and the Lung imbalance impacted on the Spleen. Until the

primary Root, the Lungs, was addressed, the treatment of the Spleen was

ineffective. The Lungs had to be treated. Also note that the Lungs are Yin

Metal, and the Large Intestine is Yang Metal.

 

The third case is " External cold binds the exterior. " This case gives more

info on how a rapid pulse can occasionally be a sign of Cold instead of Heat

as is the case most of the time.

 

The fourth case, " Yang Vacuity & interior cold " illustrates how Cold

sometimes can generate Heat. It also gives more information on the

exceptions to a rapid pulse meaning Heat. ( " Vacuity " is another way of

saying " Deficiency " or " Emptiness " .)

 

Victoria

 

 

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