Paradigms of evidence

[Guest guest]

On Thursday, July 24, 2003, at 07:27 PM, wrote:

 

> , " "

> <zrosenbe@s...> wrote:

>> Right on, Emmanuel. You put your thoughts into words elegantly,

> and I

>> emphatically agree. If we are going to do studies on CM, we must

> use

>> the criteria of CM to design them, i.e. patterns and

> pathomechanisms

>> not molecular science.

>>

>>

>>

>>

> Z,

>

> Do you not think that you can do both at once? I.e. if one does a

> study on AIDS patients with patterns and pathomechanism... this

> incorporates to ideas, a specific pathogen (virus) and then the CM

> pattern. This seems to one of the trends in china. I think

> forgetting about the western disease in many cases would lead to

> serious detriment...

 

I think you can do both at once, but the mechanisms are different. One

is process-oriented, the other molecularly oriented. Criteria,

diagnoses, and studies must be differentiated accordingly.

 

I don't think Emmanuel is suggesting forgetting about the biomedical

disease identification. That would be foolish. . . it is just a

different way of organizing clinical data for the purpose of treatment.

 

> Sometimes it is nice to have the patient feel better, (as this is

> extremely important, but not that hard with acupuncture), but to

> create serious organic change seems to be paramount in many modern

> diseases, cancer, hep, aids, etc... noting the biological markers for

> these diseases, most of the time can determine the stage the patient

> is in... Is this not valuable? For health? For acceptance in our

> western medical society, that we all are involved in?

 

There is no doubt that this is all valuable and important. And, in

many cases, I think WM does a good job at it, although sometimes not

with therapeutic interventions. I don't have a problem with that, I

have a problem with CM trying to do something that WM does more

efficiently, and ending up being second-rate at it. CM will target

the patient in a different way, and this is truly 'complimentary'.

 

 

>

[Guest guest]

But doesn't diabetes include peripheral neuropathies, impotence, loss

of eyesight, etc. as part of the disease? The glucose levels are just

the most dramatic and visible part of the disease.

 

I think the issue here is that when there is morphological damage

(tissues, cells) that is irreversible, that one needs specific

pharmacological drugs to use as 'replacement therapies', otherwise the

function of those cells, tissues and organs 'dies'. The dosages need

to be precise, as when using insulin or thyroxin in thyroid disease. I

don't think Chinese medicine can do that very well. Chinese medicine

can maintain the equilibrium of the rest of the body and mind, lessen

side effects of medications, and perhaps reduce the drug dependency.

 

If one is in early stages of diseases such as diabetes, however, it may

well be possible to reverse the condition just with Chinese medicine.

There are a number of scenarios like this, and every case has to be

taken on its merit, stage, and specific etiology when treating specific

diseases.

 

It sounds like you had a fascinating meeting with your Chinese Dr.

friend.

 

 

On Thursday, July 24, 2003, at 07:52 PM, wrote:

 

>> I think this is a good point, in certain situations we can't treat/

> (cure) the 'disease' , but can just treat the symptoms, and this is a

> huge strength we have... but if we did that for every disease than we

> are second rate, clean-up docs... maybe this is our destiny.

[Guest guest]

Hi Jason,

 

I thank you for your warm consideration of my post. I realize that it was provocative, and people are indeed kindly responding to the issues I pointed at. My time is a bit short so let me briefly state that I am not against anything you've suggested here. Wrestling with the real world pressures of life provides much instruction. I don't mean to foist this discussion off on Ken, Marne, Rey or one of the many translators, but what is hypertension in the paradigm of CM? It's so very hard to see many years down the road what the results will be from very small actions taken today. Yehuda posed a good question, and you provided a real world answer. In my original post I said I was not credentialed correctly to offer the solution in specifics regarding the CM paradigm. You, Jason, and Rey, Z'ev and so many others will be the ones to determine if you are framing an experiment within your paradigm and finding evidence and results within your paradigm. How does the current incarnation of the Western scientific method fit into the paradigm of CM protocols and treatment? Does it? Can it?

 

I've got to go, but I really like what you've presented here as a statement regarding your willingness to wrestle with these ideas.

 

In gratitude,

Emmanuel Segmen

 

 

-

 

Friday, July 25, 2003 6:38 AM

Re: Paradigms of evidence

, yehuda l frischman <@j...> wrote:> Hi Emanuel,> > I was just thinking: how, from a TCM perspective, can you do double blind> studies to compare the results, unless your are dealing with patients> that have the same tongue and pulse readings and the same differential> diagnosis? Otherwise, even if the patients had precisely the same> diagnosis, how could you possibly compare results because the treatment> protocols would be completely different. It would be like comparing , yehuda l frischman <@j...> wrote:> Hi Emanuel,> > I was just thinking: how, from a TCM perspective, can you do double blind> studies to compare the results, unless your are dealing with patients> that have the same tongue and pulse readings and the same differential> diagnosis? Otherwise, even if the patients had precisely the same> diagnosis, how could you possibly compare results because the treatment> protocols would be completely different. It would be like comparing> apples and oranges (even though both are fruit, and both are cool, sweet> and sour, they nonetheless are quite different). > > I think that I remember Ted Kapchuk making the point that each system> is its own science with its own laws, but that the methods and> properties of one can't be applied to another.> > Besides, can you ever imagine reading in JAMA an article entitled:> "Results of double-blind study of Liver-fire derived hypertension of 200> patients in the 30 to 40 age group, treated with acupuncture?" Maybe> someday, but far in the future. > >Well this is somewhat going on now... there is a compromise, for better or worse.. I.e. they find 500 people with hypertension, weed out the ones that are NOT liver-fire. then they set up a criteria, if they have liver fire with X syndrome add Y herb, if they have Z syndrome add Y+YY herb.. etc.. Or they do the study with 3 patterns , liver fire, liv/kid yin xu, and sp qi xu. all with different base formulas, and then modification based on symptoms... this is quite reasonable IMO, and they still can (if they choose to) adhere to normal western- research-rigor, to what degree is another question… Emmanuel, are you against this? Of course in real practice as also with WM, the whole human being is considered, fine… but if Chinese herbs work for hypertension, we should be able to see it with such studies… look at the IBS research…. Furthermore, most people in the country aren't even writing individual Rx for each patient. They are using patents, pills, extracts or whatever. SO such a study is actually more detailed and more CM than most practitioners are even practicing in this country…-> apples and oranges (even though both are fruit, and both are cool, sweet> and sour, they nonetheless are quite different). > > I think that I remember Ted Kapchuk making the point that each system> is its own science with its own laws, but that the methods and> properties of one can't be applied to another.> > Besides, can you ever imagine reading in JAMA an article entitled:> "Results of double-blind study of Liver-fire derived hypertension of 200> patients in the 30 to 40 age group, treated with acupuncture?" Maybe> someday, but far in the future. > >Well this is somewhat goning on now... there is a comprimise, for better or worse.. I.e. they find 500 people with hypertension, weed out the ones that are NOT liver-fire. then they set up a criteria, if they have liver fire with X syndrome add Y herb, if they have Z syndrome add Y+YY herb.. etc.. Or they do the study with 3 patterns , liver fire, liv/kid yin xu, and sp qi xu. all with different base formulas, and then modification based on symtpoms... this is quite resonable in IMO....-Jason

[Guest guest]

Ken,

 

I think it's pretty clear to me that you provided the precise answer to my question here and need not have apologized in your subsequent post. I did pass the ball to you for this answer that I could not have so eloquently expressed. I would have modestly proposed the paradigm of winning a judo match by the rules of the NFL or the World Boxing Association. Wherein the NFL and the WBA get things accomplished so much more quickly and efficaciously ... much like WM. Thank you for your way over the top efforts to make things perfectly clear while at the same time offering unparalleled opportunities to ponder numerous and exquisite wardrobe changes. I am in your debt for your heroic flight of imagination.

 

In gratitude,

Emmanuel

 

-

kenrose2008

Friday, July 25, 2003 5:52 PM

Re: Paradigms of evidence

Emannuel, I don't mean to foist this discussion off on Ken, Marne, Rey or one of the many translators, but what is hypertension in the paradigm of CM? Let's put it into another frame of reference.What is the aria of the Queen of the Nightin the second act of Die Zauberflote inthe paradigm of The Peony Pavillion?I don't know if you or anyone will find thiseven remotely responsive. But when I triedto answer more directly, I ran into aproblem that I have been trying to getwell defined for more than a decade now.This problem relates to the developmentof a method for the transmission ofthe gist of a set of ancient Chineseideas in terms that will be found notonly meaningful but alive by modernnon-Chinese readers and students.And having failed to do so up until thismoment, of course, I could go no further.So I had to use a manuver defined byRichard Hofstadter as joots (jump out ofthe system) in order to try and find aframe of reference in which your questionand the answers...and further questionsthat it develops might be most useful.I know you're busy now, and in fact Iam about to disappear into a travelingmode which could last for the nextfew months. So I don't know that we'llbe able to beat this horse to death.But if you compare the Queen of the Night'sarias from the first and second actsof the Magic Flute, and if you ask yourselfhow to translate that development into Beijing Operaor the ecstacy of a whirling dervishwell then you'll be on the path ofdiscovering what hypertension is inChinese medicine......maybe.KenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

wrote: Without confirmatory evidence THAT IS ACCEPTABLE TO WM/conventional scientists, CAM practitioners - whatever their modalities and clinical expertise - will remain OUTSIDERS on the fringes of mainstream medicine.

Hi Phil,

 

I'm glad to have inspired in some small way along with the others your energetic post today. Your comment above is precisely the idea I wish to dispute, so I'm heartened that you've managed to state it so well.

 

Those whom we now call Western medicine doctors were fringe element outsiders until the early 1900s. Their method of overcoming homeopaths and all other comers had little to do with double blind studies. They astounded their audience with successful surgeries. They pulled out their little trick called antiseptic technique. Dr. Brodman probed the human brain for centers of function and so on. They also made profoundly astute political moves while the audience was awed by their surgeries. They took over the professional body called the AMA and turned it into a powerful politcal action committee. They then transformed the medical school curriculums and their credentialing, and then establised the FDA. The rest, as they say, is history.

 

The allopaths did not ever present anything acceptable to the homeopaths or other conventional practitioners of their time. I recommend CM practitioners figure out that their actions must in fact proceed along a much more monied and political vein if they want a more central part the stage. Paradigms become dominant because of economic and political interests. It also helps if the paradigm works and creates a bit of a stir in the audience. Also read Kuhn. One of the most important things Kuhn notes is that we scientists do research only on things that we already know about. All of the research chiefs at UC Berkeley, UC San Francisco, Stanford or San Francisco State University would scold the hell out of the graduate students if the graduate students even slightly imagined anything for which there were no established materials and methods.

 

Double blind studies done perfectly on behalf of CM will convince no one in Western medicine of anything. It might scare them, but it won't win them over because it's not in their economic nor political interest. It might convince a few insurance company administrators or congressmen, and therein will lie the path to success at the center stage. More likely research studies will do no such thing. I'm recalling a 1999 Journal of the American Medical Association article proclaiming that in 1998 Americans spent 40% of their health related dollars on alternative medical treatment and over the counter alternative remedies. In 1999 the New England Journal of Medicine unleased a torrent of editorials lashing chiropratic medicine and CM. I believe WM will respond badly to any success that CM has. I also believe that CM will have success as more practitioners are trained in CM and Americans spend their money on CM rather than on WM for treatments that CM does well.

 

Just my scattered thoughts at the end of a rather challenging week.

 

Thanks for your thoughts, Phil.

 

Emmanuel Segmen

[Guest guest]

Peripheral neuropathies, etc. are not an inherent and inevitable aspect of

diabetes, but an outcome of chronic uncontrolled hyperglycemias--i.e., of

uncontrolled diabetes. A person may have diabetes (e.g., that their pancreas

is not producing enough or any insulin, dysfunctional beta cells, etc.) but

if they effectively control their blood sugar levels (e.g., with insulin

injections,diet, drugs & c), they will not inevitably develop the

complications of uncontrolled diabetes--i.e., peripheral neuropathies, etc.

NWhite

-

" " <

 

Friday, July 25, 2003 10:18 AM

Re: Paradigms of evidence

 

 

> , " "

> <zrosenbe@s...> wrote:

> > But doesn't diabetes include peripheral neuropathies, impotence,

> loss

> > of eyesight, etc. as part of the disease? The glucose levels are

> just

> > the most dramatic and visible part of the disease.

>

> But, if one has per neuropathy, impotence, loss of eyesite etc w/o a

> glucose issue then is it diabetes..? I think the hallmark of WM Dx

> is based on a definite lesion or pathogen oriented approach. There

> are exceptions like fibromylagia... I consider the above s/s

> secondary to the disease, but not necessary... this is where CM and

> WM different correct? In CM s/s make the disease...

>

> -

>

>

>

> Chinese Herbal Medicine, a voluntary organization of licensed healthcare

practitioners, matriculated students and postgraduate academics specializing

in Chinese Herbal Medicine, provides a variety of professional services,

including board approved online continuing education.

>

>

>

>

[Guest guest]

Dear Doug, Jim Ramholz and

 

Thank you for your recent responses. thank you for letting me know of your long history of support for CM tradition and classicism. I've only been posting to CHA since earlier this year and haven't read the long archives of your writing. My initial post was in response to your and Bob Flaw's counterpoint response to Z'ev's statement in support of classicism. I'm heartened to know that you, as I, believe that any research conducted on behalf of CM must apply CM principles and seek evidence from within the paradigm of CM. I'm even further heartened by the fact that you keep up this CHA site which is becoming quite an institution. Well done!

 

Doug and Jim, yes CM is here with WM, but I don't really see them either in conflict or in coordination each other. They are different paradigms and different options for the developing practioner as well as for the patient. WM is well established, and the protocols of research and product development are in place to protect and serve all parties: doctors, patients and of course the industry: HMOs and pharm manufacturers. CM does not need to enter this constellation to have its place on the American stage, but rather it must develop its own constellation. If it chooses to enter the WM constellation, it will of course cease to be CM.

 

A more hopeful development will be for more practitioners to graduate and serve a broader spectrum of American patients. As more American patients tend to engage the services of CM practitioners, the CM community will grow up into the established political and economic institutions of America and will cause those institutions to also grow. But the constellation will look a bit different from the one with WM at its center. It will include insurance, professional groups, educational institutions, research and so on. CM will share the stage with WM as it does now and develop its own defined role.

 

Thus, I support Z'ev's classicism in all things regarding CM. This is the root from which to grow a modern American constellation of healthcare delivery and patient care. It will look different from the WM constellation ... and that's completely okay and as it should be. It will also look different from China's integrated practice because America is a profoundly different place than China. CM may look different in every country in which it flourishes due to differences in culture, economics and politics. I do not anticipate WM and CM integration in America unless Mao reincarnates and invents the Microsoft of HMOs. I suppose this could happen in America ... right, Jim?

 

Emmanuel Segmen

[Guest guest]

Jim, Your points are well taken here. As you say, some of CM's modalities are being recruited by the constellation with WM at it's center. The constellation with CM at it's center will, I believe, carry on independently. I believe that your fortunes will lie in the fortunes of the latter development as you yourself note. I also believe (call me an optimist) that the constellation with CM at its center will flourish in America and will recruit around it all of the intricacies of intitutions that are uniquely American.

 

Emmanuel Segmen

 

, "Emmanuel Segmen" wrote:I do not anticipate WM and CM integration in America unless Mao reincarnates and invents the Microsoft of HMOs. I suppose this could happen in America ... right, Jim? >>>Emmanuel:Actually, the Medical acupuncturists have been integrating CM into Western institutions; including emergency rooms. They even have a study on this subject. Their bottle neck is just waiting for insurance companies to accept it more. So, no one is waiting for us to lead the way because we have the longest training.Understandably, classical herbalism probably won't be a regular part of this picture of integration; while patent companies like Health Concerns and Golden Flower may flourish in this new market.On the other hand, those of us who are "real" acupuncturists and herbalists can "integrate" into Western culture only to the extent that we claim a percentage of the healthcare pie in private practice, work in Western institutions, or work with WM specialists. It seems unlikely that someone will invest in a CM outpatient center or hospital here soon.Jim RamholzChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Hey Chad,

 

Thank you. You post is by far the best commentary on paradigms.

 

I got to meet Bucky Fuller a couple of times long ago and hear him lecture. Near the end of his life his normal manner of speaking was like the poem below. Seemed like he was on a mission and always going for the maximum trajectory for his life. His wife would guide him around. When he'd gotten through the assigned period of time for his lectures, his wife would come up on stage and grab his arm in mid-sentence. He would smilingly nod to the audience and smilingly be guided off stage in the lovingly business-like grip of his beloved (or his Beloved.)

 

Thanks for posting directly from the master himself. I love it.

 

Emmanuel Segmen

 

-

chadwick_m

Saturday, July 26, 2003 8:54 PM

Re: Paradigms of evidence

While looking for Kuhn's book, Emmanuel, in the local library, I came upon this instead. Enjoy.-Chad"God is twoingGod is threeingGod is multiplyingBy dividingThe second law of thermodynamics—Entropy—is also as we have learnedThe law of increase of the Random ElementI.e., every system looses energy—but Synergy meansBehavior of whole systemsUnpredicted byThe behavior of any separate part.EN—ergy behaves entropicallySYN—ergy behaves syntropically.God is entropyAnd God is syntropy,God is synergy.God is energy.And God is always A verb—The verbing ofIntegrity."-- Bucky FullerChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Jim, Your points are well taken here. As you say, some of CM's modalities are being recruited by the constellation with WM at it's center. The constellation with CM at it's center will, I believe, carry on independently. I believe that your fortunes will lie in the fortunes of the latter development as you yourself note. I also believe (call me an optimist) that the constellation with CM at its center will flourish in America and will recruit around it all of the intricacies of intitutions that are uniquely American.

 

Emmanuel Segmen

 

, "Emmanuel Segmen" wrote:I do not anticipate WM and CM integration in America unless Mao reincarnates and invents the Microsoft of HMOs. I suppose this could happen in America ... right, Jim? >>>Emmanuel:Actually, the Medical acupuncturists have been integrating CM into Western institutions; including emergency rooms. They even have a study on this subject. Their bottle neck is just waiting for insurance companies to accept it more. So, no one is waiting for us to lead the way because we have the longest training.Understandably, classical herbalism probably won't be a regular part of this picture of integration; while patent companies like Health Concerns and Golden Flower may flourish in this new market.On the other hand, those of us who are "real" acupuncturists and herbalists can "integrate" into Western culture only to the extent that we claim a percentage of the healthcare pie in private practice, work in Western institutions, or work with WM specialists. It seems unlikely that someone will invest in a CM outpatient center or hospital here soon.Jim RamholzChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

<susegmen@i...> wrote:> Hey Chad,> > Thank you. You post is by far the best commentary on paradigms. Paradigm theory is part of philosophy of science which is a rigourous discipline. So, for instance, which of the twenty two ways in which Kuhn uses "paradigm" ( Hacking, Representing and Intervening 1983)is this the best commentary on? Or more generally, are you talking of the relativist interpretation of Kuhn or the moderate historical version?The danger for CM of paradigm theory is that it can present a feelgood philosophical quicksand whilst, I would suggest, that what is needed is an underpinning of terminological ,philosophical and scientific rigour.Simon

 

Agreed. Please proceed!

 

Emmanuel Segmen

[Guest guest]

The danger for CM of paradigm theory is that it can present a feelgood philosophical quicksand whilst, I would suggest, that what is needed is an underpinning of terminological ,philosophical and scientific rigour.Simon

 

Hi Simon,

 

I like your post and thought I should first elaborate. My concern with regard to much of the talk on this list is the notion that CM and WM can be somehow seamlessly integrated or that they can inform one another without regard to losses in translation. Some believe that Western science can ingest, digest and disgorge a sufficient number of numbers that we'll be able to actually calibrate CM tool, CM treatments and CM patient presentations. As a Western scientist, I truly see that such a scenario will in fact come to pass. However, WM and CM are so profoundly different in character and development, that I've called for a point of order on this issue. CM is the written tradition acrued over thousands of years from several and disparate oral traditions that even today are still alive to some small degree. I work with agronomist PhDs in each of numerous provinces: Jilin, Nei Mon, Shandong, Shaanxi, Gansu, Sichuan and Yunnan. They individually work to document the oral traditions of the growers in part to document the natural and sustainable growing methods and in part to assure revenue streams reaching these fairly remote peoples. My concern is that CM represents actually a rather vast cultural tradition and is not just the sciences of acupuncture and herbology learned at American TCM schools. Of course, acupuncture and herbology themselves are also more than what we might think of as a medical science in the West. My own Western science as it is currently practiced in biology and biochemistry has it's classical literature as recently as the 1960s and 70s especially if you think of molecular biology and genetics. I've been alive during it's entire development. I will also admit that my training in philosophy came in the late 1960s after which I practiced poetry, art and theater for 10 years. Then I had three other undergraduate majors in biochemistry, molecular biology and psychology before getting to graduate work. I have not studied more history of science since the 1970s than philosophy of science. So I studied classical Kuhn more or less when he published. It left an impression upon me.

 

Having said that, I look forward to the development of your ideas. A few here have read and studied the classical Kuhn of the 1960s and some like myself may have ventured forward in time as well. If no one else on list reads your commentary, at least I will thoroughly savor it. I agree like Ken Rose that a clear terminology is paramount regarding saving the root of Chinese medicine into the whirlwind of American culture and American science. As a genetic engineer and biochemist I can assure you that CM will be eaten up by Western science, digested and presented as numbers, molecules, HPLC topographies and eventually a few pharmaceutical products. We biochemists tend to blend entire animals and centrifuge them in order to find a single molecule. That's just our way. ;-)

 

So then, Simon, how shall we approach terminology rigorously? How are your Chinese translation capabilities? Mine are virtually nonexistent except for the ability to lose the requisite number of arguments with my wife. I'm working on it ... slowly. However, I will warn you regarding paradigm collision. I'm married to a Chinese woman who was a classics literature major in Chinese and a long time student of Buddhist practices. She's also an acupuncturist by an eight year apprenticeship but not licensed in the U.S. In contrast, I'm the son of Eastern European immigrants who became research scientists in America. My marriage to my wife is the paradigm collision in microcosm that WM versus CM is in macrocosm. I love my marriage for its "rigorousness" as you so wonderfully put it. I love working with Chinese herbs at Asia Natural and teaching physiology at Merritt College for the pure fascination with the magnificent collision of cultures. I live side by side with inspectors and scientists from the FDA, USDA and Fish and Wildlife. They like rigor, too. But to them my products are bark, twigs, leaves, roots and flowers. I give them a Latin binomial, and then they can finally go to work. It's quite hilarious.

 

So, Simon, there are many here including me who will listen avidly to your crisp delivery regarding the terminology that provides the premise of a CM paradigm. Ken Rose has been harping on this very thing for quite some time and managed to publish two books on the subject. There are others on list who are translators who I believe would like to see CM presented as a clear pradigm in the English language. If I notice you enjoying and feeling good during your presentation, I promise not to tell any one. I will simply applaud you and cheer you on all the way.

 

In gratitude,

Emmanuel Segmen

 

[Guest guest]

In a message dated 7/27/2003 12:38:48 AM Pacific Daylight Time, dallasking writes:

 

 

Paradigm theory is part of philosophy of science which is a rigourous discipline. So, for instance, which of the twenty two ways in which Kuhn uses "paradigm" ( Hacking, Representing and Intervening 1983)is this the best commentary on? Or more generally, are you talking of

the relativist interpretation of Kuhn or the moderate historical version?

 

The danger for CM of paradigm theory is that it can present a feelgood philosophical quicksand whilst, I would suggest, that what is needed is an underpinning of terminological ,philosophical and scientific rigour.

 

Hi Simon and Emmanual,

 

I miss the good old Greek usage rather than modern adaptations. Kuhn apers to have understood the etymological roots of the word.

 

paradeigma

A paradeigma is a mythological example (cf. our word 'paradigm'), introduced by a speaker to increase the persuasiveness of his words (by pointing to occasions in legend where a well-known figure behaved the way the speaker would like his interlocutor to behave).

This use of the word is similar to how Chinese writers would gain credibility by referring the material to mythic figures such as the Shen Nun Ben Cao or the Huang Di Nei Jing.

 

But - alas the word is forever changed in meaning....

 

Will

[Guest guest]

try this for startershttp://www.emory.edu/EDUCATION/mfp/Kuhn.htmlTodd

 

Thanks

 

In the outline that you have referenced here, the following represents a significant position taken by Kuhn from which I argued in colloquiums in the late 1960s and early 1970s. Partly this is because I was in the midst personally of absorbing an oral lineage in meditation practices. As well I had been much the lineage student of Schopenhauer, Nietzsche, Husserl, Heidegger and Sartre with a strong focus on Husserl and Heidegger. I'm sure Simon must understand from his education why I was taking the positions that I was taking. It speaks to the British rejection of CM. Britain and America are the homes of logical positivism ... and America is its culture. The following part of the outline you've presented was important to me at the time of my studies and presentations. I thank you both, Simon and for your posts.

 

Emmanuel Segmen

 

Kuhn refutes this logical positivist view, arguing that

 

the logical positivist view makes any theory ever used by a significant group of competent scientists immune to attack. to save paradigms/theories in this way, their range of application must be restricted to those phenomena and to that precision of observation with which the experimental evidence in hand already deals. the rejection of a paradigm requires the rejection of its fundamental assumptions and of its rules for doing science—they are incompatible with those of the new paradigm. if the fundamental assumptions of old and new paradigm were not incompatible, novelty could always be explained within the framework of the old paradigm and crisis can always be avoided. revolution is not cumulation; revolution is transformation

[Guest guest]

 

, "" <zrosenbe@s...> wrote:> Right on, Emmanuel. You put your thoughts into words elegantly, and I emphatically agree. If we are going to do studies on CM, we must use the criteria of CM to design them, i.e. patterns and pathomechanisms not molecular science.> > >Z,Do you not think that you can do both at once? I.e. if one does a study on AIDS patients with patterns and pathomechanism... this incorporates to ideas, a specific pathogen (virus) and then the CM pattern. This seems to one of the trends in china. I think forgetting about the western disease in many cases would lead to serious detriment...Sometimes it is nice to have the patient feel better, (as this is extremely important, but not that hard with acupuncture), but to create serious organic change seems to be paramount in many modern diseases, cancer, hep, aids, etc... noting the biological markers for these diseases, most of the time can determine the stage the patient is in... Is this not valuable? For health? For acceptance in our western medical society, that we all are involved in?-JAson

Hi Jason,

 

Your suggestion is the most relevant part of the discussion. It's where the rubber hits the pavement. How can you do this without losing the root of CM? That is, as you bring about true organic change as you say from the perspective of WM using acupuncture and herbal decoctions, how will you document your accomplishment? With HPLC biochemical markers? That invites WM to render your work from the root of CM into molecules, blood work, and pharmaceutical products. I would care as a proponent of CM to not cut CM's head from its body. I would like to preserve the root which accomplished the "organic change". You accomplish your feat of organic change, not with molecular pharmaceutical products, but with acupuncture and herbal decoctions. I do not pretend to have a solution to this problem. I've raised this issue because I noted it in Z'ev's presentations among others, I observe the importance of retaining and even strengthening the root of CM into the future, and I don't have a clue as to how to solve the problem. How does one retain the root of CM, bring about true organic change from the WM perspective, and then not get co-opted?

 

Thank you for applying yourself to this question. I sense that some will view my concerns as appropriate and others will view my concerns as ill placed or possibly irrelevant.

 

Emmanuel Segmen

[Guest guest]

At the risk of too much levity, but picking up on Ken's use of roundabout

metaphors, here's a joke:

 

What did the balloon say on the slow wagon to China?

 

Answer:

 

Acupuncture or bust!

 

Pat

 

 

 

 

" James Ramholz "

<jramholz To:

 

om> cc:

Re: Paradigms of evidence

Office:

07/26/2003 07:11

PM

Please respond to

chineseherbacadem

y

 

 

 

 

, " Emmanuel Segmen " wrote:

I do not anticipate WM and CM integration in America unless Mao

reincarnates and invents the Microsoft of HMOs. I suppose this could

happen in America ... right, Jim? >>>

 

 

 

Emmanuel:

 

Actually, the Medical acupuncturists have been integrating CM into

Western institutions; including emergency rooms. They even have a

study on this subject. Their bottle neck is just waiting for

insurance companies to accept it more. So, no one is waiting for us

to lead the way because we have the longest training.

 

Understandably, classical herbalism probably won't be a regular part

of this picture of integration; while patent companies like Health

Concerns and Golden Flower may flourish in this new market.

 

On the other hand, those of us who are " real " acupuncturists and

herbalists can " integrate " into Western culture only to the extent

that we claim a percentage of the healthcare pie in private

practice, work in Western institutions, or work with WM specialists.

It seems unlikely that someone will invest in a CM outpatient center

or hospital here soon.

 

 

Jim Ramholz

 

 

 

 

 

 

 

 

 

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare

practitioners, matriculated students and postgraduate academics

specializing in Chinese Herbal Medicine, provides a variety of professional

services, including board approved online continuing education.

 

 

 

 

[Guest guest]

Double blind studies done perfectly on behalf of CM will convince no one in Western medicine of anything. It might scare them, but it won't win them over because it's not in their economic nor political interest.

>>>I disagree and it already changed to landscape compared to 20 years ago

alon

[Guest guest]

WM is well established, and the protocols of research and product development are in place to protect and serve all parties: doctors, patients and of course the industry: HMOs and pharm manufacturers

>>>WM is changing at a lighting speed, i would not say it is established

alon

[Guest guest]

Peripheral neuropathies, etc. are not an inherent and inevitable aspect ofdiabetes, but an outcome of chronic uncontrolled hyperglycemias--i.e., ofuncontrolled diabetes. A person may have diabetes (e.g., that their pancreasis not producing enough or any insulin, dysfunctional beta cells, etc.) butif they effectively control their blood sugar levels (e.g., with insulininjections,diet, drugs & c), they will not inevitably develop thecomplications of uncontrolled diabetes--i.e., peripheral neuropathies

>>>My point exactly

Alon

[Guest guest]

But doesn't diabetes include peripheral neuropathies, impotence, loss of eyesight, etc. as part of the disease? The glucose levels are just the most dramatic and visible part of the disease.

>>>If sugar is controlled you don't get these complications

Alon

[Guest guest]

Doesn't this suggest that these methods andrealities constitute some sort of uber-paradigmthat in crossing all the others, transcendsand thus encompasses them? I don't think thisis a descent into language or, horrors, logic.You seem to be asserting the existence of somesort of absolute reality here by which, somehow,all paradigms can be analyzed and evaluated,measured and found either adequate or inadequate.

>>>>>>>The absolute reality will be defined in each study. And can be changed from study to study as long as one does not allow for poor objectivity to rule.

If you believe in the lessons of history,then a forward extrapolation of historicaltrends suggests that it is far more likelythat the methods and realities of Chinesemedicine can and will embrace and subsumethose more recent methods and realitiesthat arose in the West as a consequence ofa whole complex series of events knownlovingly as the history of science.

>>>I think we are seeing this in China as we speak. The WM paradigm is seen all over TCM.

 

 

Certainly that point of view is easier to argueand accept than its opposite, which would hold,I guess that the less one knew about such thingsthe more reliable their clinical perceptions would be. And that really just seems a little far fetched.

>>>Yes and No. Being invested in one paradigm sometimes does not allow one to see the trees from the forest. As we all know as CM practitioners when looking at much of biomedicine practices

But it very much is saying that we definethem as valid or invalid depending on howthey measure up to whatever methods andrealities you have in mind.

>>>>Will not argue this. The feel good everything is ok and true is not part of what i think is needed in medical sciences.

What are the objective methods and realitiesif not models of thought? Are they eternaltruths? Do they come from beyond languageand the other vagaries of human existence

>>>>Well as long as we can agree that the sky is blue i will leave this at that. If we cant than there is nothing to talk about

 

Alon

 

[Guest guest]

Bob,

 

I very much appreciate your post below regarding controlling blood glucose balance. Dr. Kang had similar findings over the years that he was Chief of TCM at the Shanghai Hospital #1. No glucophage for his current patients at his San Francisco clinic. Whether obese, underweight or of normal body habitus, Dr. Kang notes that the standard CM treatment even back in the 80s was quite effective for insulin resistance. Obesity is actually a better sign than underweight for those who are insulin resistant. Overweight means that the adipose and other body tissues can still "see" insulin even if the liver is insulin resistant. Underweight means that adipose and other body tissues can not "see" the insulin, so there is wide spread insulin resistance. The information you give below is vital for people to know, in my opinion. Obviously anyone who is making unwise food selections leading to a diet of refined carbohydrates with high glycemic indices must address this aspect of their health as well. Research has shown over the last decade that a diet high in refined carbohydrates is as correlated to diabetes type II as is obesity.

 

Thanks for your post on this topic.

 

A week or two ago I had posted quotes from the current U.S. Surgeon General and the Direct of the CDC in Atlanta. They both indicated that diet and lack of physical activity leading to obesity (or general insulin resistance) was the number one American health problem ... not emerging infectious diseases such as SARS. This correlation with what CM has been noting about American health can not be overlooked.

 

Emmanuel Segmen

 

-

Bob Flaws

Friday, July 25, 2003 7:55 AM

Re: Paradigms of evidence

Yesterday I translated an article that compared the use of a standard Chinese medicinal formula to glipizide (Glucotrol) for the treatment of 60 some type 2 diabetics who presented a pattern of either qi & yin dual vacuity or yin vacuity with heat exuberance. Not only did the Chinese formula work equally well for lowering the FBG, PPBG, and IR as the glipizide, the Chinese meds also lowered mean diastolic & systolic blood pressure, TC, TG, blood viscosity, and red blood cell agglutination. Seems to me that's a fine thing to know and disseminate.BobBut before the p starts shooting, we might > be able to regulate glucose levels enough to stabilize them... this > we should be able to do much better than WM... and if we had research > that says we can, then bam... I don't know what this `bam' is about, > but it sounds like a good thing...> > -Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

This raises a couple of knotty problems.First, as you recently noted yourself,all we need is for some outfit like the FDAto come up with the algorithms for the practiceof Chinese medicine and then where will westand?

>>>>>Problems of documented efficacy will probably start dogging us soon. We will to do a lot of explanation as to "this acupuncture protocol" vers "acupuncture" did not work and so on

 

Second, if these methods and realities ofyours already exist, why haven't they beenapplied to simply sort everything out andput everyone on notice as to what "objective"and true and valid and real and so on?>>>>>These circular arguments can go on forever

 

Do you actually have/know methods and realitiesthat will allow you to evaluate and therebyknow the objective truth about clinicaloutcomes?

>>>>Very simple, if you treat diabetes and the sugar stays high you failed...

 

Alon

[Guest guest]

How does it avoid the insurance tragedy?

 

In the long run maybe in a countries like USA practitioners soon will

develop there insurance company.

 

just a thought...

 

Marco

 

-

" " <zrosenbe

 

Tuesday, August 05, 2003 10:15 AM

Re: Re: Paradigms of evidence

 

 

> All the more support for the argument for cash practice.

[Guest guest]

All the more support for the argument for cash practice.

 

 

On Tuesday, August 5, 2003, at 07:24 AM, Laurie wrote:

 

> At the CSOMA conference this weekend, a panel discussion on legislative

> issues clarified the Ephedra situation: at some point during the

> battle

> it became irrelevant whether or not we retain the legal right to

> prescribe Ma Huang; insurance companies will not back the product or

> will charge exorbitant rates no one can afford, including our

> suppliers. Even if we retain the legal right, we may have already lost

> our consumer right. In a situation like this, is it productive to yell

> at the biomedical horse and its riders? Is it ok to stand in our

> stables, continuously refitting our boots and saddles? Or does our

> hope

> for enduring change rest in educating the crowd through which these

> horses ride, those consumers who might call out for different riders

> or,

> at least, better competition and a more populated track.