Case histories

[Guest guest]

Dear Ken,

 

I would be honored to teach in the states ! Preferably, I would love to

combine teaching with research. Whats on offer Ken ?

 

Regards,

 

Rey Tiquia

[Guest guest]

Rey,

 

Get in touch with me off the list when

you have a few moments and I'll bring

you up to speed.

 

Ken

[Guest guest]

Hi All, & Ken & Attilio

 

Ken wrote:

> I'm working on a project that includes development of a case

> history format. I'd be very grateful for any input that any of you

> might have to make as to criteria for designing such a format. My

> aim is to see a standard form in widespread use that will allow us

> to gather and summarize outcomes. And we need some sort of

> standard format for reporting data in order to do this. So, any

> thoughts on this topic are much appreciated. Ken

 

Great idea and badly needed.

 

Though I have no template, there are probably several " out there " .

IMO, the most useful template should contain at least the following

data fields:

 

1. Client contact details: Name, address, phone, fax, email

 

2. Other personal (fixed) client data: gender, age, birthdate and

place of birth, previous dwelling places, occupation, reproductive

history, sexual preference(s) (hetero-, bi- or homo- sexual)

..

2a. Date of presentation and weather/climatic factors in the

previous few weeks.

 

2b. " In what way do YOU think that I can help you? "

 

3. Presenting S & Ss

4. Past S & Ss

5. Exaggerating factors

6. Ameliorating factors

7. Constitutional / emotional data

8. Likes and dislikes (in food, tastes, colours, seasons, etc)

 

9. Tests, conventional Dxs, therapies / medications used/being

used up to presentation

 

10. Discussion of past and present stresses, worries, traumas.

 

11. Nature of dreams, especially recurrent dreams.

 

12. Client's own ideas about the cause(s) & trigger(s) of the

current and past problems.

 

13. " In what way do YOU think that YOU can help yourself? "

 

14. System-specific (prompt-checklist) queries re all major organ-

systems:

nervous, resp, cardiovascular, digestive, reproductive/genital,

urinary, blood, hormonal, musculoskeletal, skin, teeth, hair, nails,

etc,

 

overlapping with the

 

Twelve Jing/Zangfu (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB,

LV),

 

Eight Mai (Extraordinary Vessels), etc

 

14. Findings on the Four Examinations [Looking, Listening,

Palpation/Pulses, Smelling], etc.

 

I throw these thoughts out as skeletons to be discussed and built

upon, as I have not time to flesh them in just now.

 

If Ken and others can synthesise a systematic and thorough

template from such and other sources, it would be most useful as

a " Front-End " menu from which to gather a very complete history.

 

That template could be stored as a digital form to record the

relevant aspects of the case.

 

When completed and verified, those data could be input into

databases that have the key S & Ss for the TCM Syndromes to

reach a short-list of the most likely Syndrome(s).

 

In turn, these could be input to databases with extensive details of

individual herbs & formulas to suggest the " most perfect match " for

the presented case.

 

PS: I had scribbled this before I saw more details from Attilio's

suggestions

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

[Guest guest]

Dear Ken,

 

In my group EPCEL (Education for Prostate Cancer Electronic Link) I

encourage use of the following format when relating case histories.

It is important for patients and their healers to be able to track

objective and measurable indices of disease and of health. The PC

(prostate cancer) history is then potentially a piece of scientific

data that may eventually be incorporated into a study showing the

relationship between PSA decline (decreasing disease) and androgen

recovery (increasing health). Many (if not all men) diagnosed with

prostate cancer have a low androgen level and this has been

attributed to prostate cancer growth. The theory is not generally

held in conventional medical circles but there is nevertheless strong

evidence to support the argument from within the WM paradigm. Of

course TCM treats the symptoms of prostatic disease as a deficiency

state, and attempts to increase Ki Qi and Jing with preparations

containing Yin Yang Hua for example, or preparations like Jin Kiu

Shen Qi Wan.

 

Further details on the WM approach available if you contact me

directly; however for the purpose of this thread here is the format I

like to use:

 

The first line of your PC history should look like this

(abbreviations defined below):-

 

DoB | Date Dx | bPSA | Stage & Grade | Primary & secondary treatments

 

Subsequent lines of your history should look like this:

 

Date | PSA | Testosterone | Condition & comments: adjuvants,

supplements and lifestyle changes

 

[ The separator '|' (or any other unique symbol) is a place marker

and used to enable loading into a spreadsheet so please keep it in

the line even if data is missing. For example you may want to make a

comment like this

 

02/01/2003 | | | Uploaded new Welcome Message to Epcel

 

Note there is no PSA or Testosterone date but the | | | is still

there !! ]

 

 

Definitions:

 

DoB - date of birth

Date Dx - Date of diagnosis

bPSA - first PSA reading

Stage - Using the TNM system see

http://www.prostateinfo.com/patient/treatment/tnm.asp

Grade - Gleason numbers see

http://www.prostateinfo.com/patient/tests/gleason.asp

Primary - First and main treatment received (e.g. surgery, hormone

block,)

Secondary - Supporting treatment (e.g. salvage radiation, hormone

block)

Adjuvant - Support medication such as bisphosphonates and calcitriol,

NAHT

Supplements - Vitamins and herbals (e.g. ginko), TCM formulae

Lifestyle - Changes in daily diet and exercise routines.

 

Rx - Prescribe

RT - Radiotherapy

RP - Radical Prostatectomy surgery

NAHT / NHT - neoadjuvant hormone therapy

 

 

 

Chinese Medicine , " kenrose2008 "

<kenrose2008> wrote:

> All,

>

> I'm working on a project that includes

> development of a case history format. I'd

> be very grateful for any input that any

> of you might have to make as to criteria

> for designing such a format.

>

> My aim is to see a standard form in widespread

> use that will allow us to gather and

> summarize outcomes. And we need some sort

> of standard format for reporting data

> in order to do this.

>

> So, any thoughts on this topic are

> much appreciated.

>

> Ken

[Guest guest]

Chinese Medicine , " sammy " wrote:

Of course TCM treats the symptoms of prostatic disease as a

deficiency state, and attempts to increase Ki Qi and Jing with

preparations containing Yin Yang Hua for example, or preparations

like Jin Kiu Shen Qi Wan. >>>

 

 

Sammy:

 

While some symptoms of prostatic cancer are due to deficiency (xu),

the cancerous growth itself is strongly excessive or replete (shi).

Do you ever address it, or leave that aspect to WM?

 

 

Jim Ramholz

[Guest guest]

Dear Jim,

 

Thank you for making your point. In answer to your question:

 

Although it is not generally known there is a model of prostate cancer which

asserts that cancerous growth is due to a deficiency of androgen

(testosterone and DHT to be precise). In brief, prostate cancer (PC)

responds in a biphasic fashion to androgen. The term 'biphasic' could be

represented graphically by a bell-sheaped (inverted-U) curve: A small amount

of androgen will trigger PC, whereas a larger amount will cause the PC to

undergo apoptosis. Hence within the deficiency condition there is something

really excessive going on.

 

Since most basic science courses teach only linear responses in biological

systems it is difficult for many people (including most western doctors and

scientists) to understand that " less means 'more' and more means 'less' " .

However I am sure most people reading this on the TCM list will have no

difficulty ;-) Having said that there may be differences in interpreting at

what stage more is less and so on. That is an area I'd dearly love to

investigate (with your help dare I add) and that indeed is why I have a

group trying to deal with this novel view of PC - novel from the point of

view of most men diagnosed with the disease in the West. So far I have

managed to reach a handful of men who are managing to maintain a relatively

high androgen level and keep their disease in remission - to the

astonishment of most doctors!

 

If you go to my home page you will see a 50 year old report detailing how

daily testosterone injections helped terminal cases of PC recover when all

else had failed. In those days they really did castrate PC patients and

remove their hypothalamus.

 

Anyhow, I'd like to see how we can translate the rather crude manouvre of

testosterone injection into a TCM procedure - one which supports the natural

production of androgens (and Jing generally). Here is my home page (I am

sure Atti will approve as he monitors EPCEL already) :-

 

epcel/

 

Hope that interests some of you and thanks for bringing up your point Jim.

BTW If you actually to the group you'll be automatically sent a

bunch of info on the ideas I have been trying to express. I am sure there is

a 'middle way' here between TCM and WM & I'd like to be part of bringing out

(learning more about) that knowledge.

 

Cheers,

 

Sammy.

writing from home

 

 

 

 

 

James Ramholz [jramholz]

28 December 2003 21:55

Chinese Medicine

Re: Case histories

 

 

Chinese Medicine , " sammy " wrote:

Of course TCM treats the symptoms of prostatic disease as a

deficiency state, and attempts to increase Ki Qi and Jing with

preparations containing Yin Yang Hua for example, or preparations

like Jin Kiu Shen Qi Wan. >>>

 

 

Sammy:

 

While some symptoms of prostatic cancer are due to deficiency (xu),

the cancerous growth itself is strongly excessive or replete (shi).

Do you ever address it, or leave that aspect to WM?

 

 

Jim Ramholz

 

 

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[Guest guest]

Sammy, and All,

 

I found your post thought provoking.

I hope my remarks below are helpful.

 

At the end you said,

 

I am sure there is

> a 'middle way' here between TCM and WM & I'd like to be part of

bringing out

> (learning more about) that knowledge.

 

 

If you take a look at that post I put

up a few hours ago with the quote from

the Ames/Hall Dao De Jing, you can follow

what I'm about to say as an example of

precisely the kind of onerous implications

of the way terms are rendered in Chinese

medicine and the impact of the equivocation,

here more linguistic than cultural.

 

You have taken a Chinese term, xu1, which

is commonly and very poorly rendered into

English as " deficiency " and equated it with

a deficiency of a particular substance in

the body, as it is identified by Western medical

science.

 

Jim's comment, I believe, got you going in

this very questionable direction, as it

implies that there is some constant theoretical

value to cancer that can be linked to the

two terms xu1 and shi2, which by the way simply do not

mean deficiency and excess.

 

These are two very clear examples of the way

in which the non-familiar is zapped into

familiarity by the translator's pen.

 

Students of Chinese medicine should be made

to understand how non-familiar these two

terms are as a prerequisite to gaining

any understanding of what they mean. And

the crime of forcing non-equivalent equivalencies

such as deficient and excess down students'

throats only exacerbates the whole sad

situations.

 

Xu1 and shi2 have no constant abstract theoretical

value. They are diagnostic terms in Chinese

medicine that relate to individual situations.

Everyone has xu1 and shi2. The taiji classics

contain some deep insights into xu1 and shi2

including one passage that reads:

 

each place in the body has the same xu1 and shi2.

 

So it is not meaningful to try and associate

constant values of xu1 and shi2 to supposedly

correlative markers used to identify organic

activity according to Western medical assay.

 

In patient X, who may well be characterized

by xu1 patterns, marker Y may indicate a

deficiency of some particular substance of

activity.

 

Yet patient Z, who may well be characterized

by shi2 patterns may also show this same

pattern of deficiency according to the

identical marker in the Western clinical

assessment.

 

There are just a handful of possibilities

given these few variables. Any might obtain

from diagnosis according to the two approaches

of Western and Chinese medicine, and this

doesn't begin to take into account the variety

of interprative approaches one might encounter

from one practitioner of Chinese medicine to

another.

 

So what is being correlated?

 

Confusion, unfortunately.

 

I wholeheartedly agree with and endorse the

purpose you state above. And I think more

than ever that if we aim as a group to

move forward out of the confusions that

we have thus far created and sustained,

one early, in fact immediate step that

we need to take is to recognize the actual

condition of things.

 

While debate continues to rage about the

meanings of the most basic terms, and where

people are admitted to this debate and

granted widespread credence who more or less lack

the qualifications to take part, it will

likely remain difficult for this awareness

to spread throughout the community.

 

People will continue to be confused and

misled by what they will see as noise

and fury signifying nothing.

 

But everyone can perform a kind of self-test

to determine where you are as an individual

when it comes to this sort of confusion.

 

Ask yourself what each of the terms listed

below means, and if you have any questions,

just recognize that you don't know.

 

According to the Dao De Jing, that is

the way to go about knowing. And if you

want to know Chinese medicine, this approach

to knowledge was, if not well known at least

readily available to be known by the authors

of the texts on which Chinese medicine at

least claims to be based.

 

It's not a bad idea, in other words, to

know what knowledge meant to the ancient

Chinese doctors and scholars who recorded

the knowledge that you think you are using in

your clinic today.

 

In the past when I've forwarded this kind

of appeal, a certain percentage of folks

get bent out of shape over who the heck I

think I am and how can I say things like

this? But that really isn't where it's at.

 

Just ask yourself, What is:

 

qi

yin yang

wu xing

xu shi

jing luo

zang fu

 

And that's enough. If you know what those

terms mean, great. If you don't, that's great,

too.

 

But listen carefully to your answers.

Explain what these things mean to people

who have never heard of them, and then

see how clearly you have let someone

else understand them.

 

Well, there you go provoking my thoughts

again, Sammy.

 

Thanks,

 

Ken

[Guest guest]

Hi Rey,

 

Great stuff, as usual!

 

Phil

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Rey wrote: I think this is a very good project, Ken, and I think that

Atillo started with a very good format . I have looked into this issue

of case history writing in TCM when I was doing my Masters of

Science in l995 (when I was enrolled in the subject 'Diseases and

Society') and wrote a paper entitled " Remaking Traditional Chinese

medicine As contemporary Australian Medical Practice " One of the

my motives in writing the paper was the incrasing phenomenon of

scientization of TCM practice including the writing of it's clinical

case histories which is referred to in Chinese as 'Yi An' I am

presenting below an expanded version of the Yi An as written in my

paper.

 

THE MEDICAL CASE RECORDS A TECHNOLOGY THROUGH

WHICH EVALUATION PROCEEDS

 

" The medical case records is the basis upon which the TCM

practitoner makes his diagnosis and tratment of the patient. It is a

record of convergence between TCM theory and practice. It is a

record of TCM practice. It is a record of the process of

" differentiating clinical patterns and tailoring treatment. " (bian

zheng lun zhi). It is also the concrete manifestation of " choosing

individual remedies for the formulae on the basis of the established

therapuetic method and principle (li fa fang yao). " ( A General

Introduction to the schematization and use of the Medical Case

Records " Journal of TCM , I have to get the complete name of the

journal, volume and date of issue. "

 

I GENERAL INFORMATION (The patient's name, sex, age, place

of birth, place of origin (ji guan); residential address; date of

consultation. In case of infants or minors, include the names and

address of parents or guardian.

 

II Inquiry Wen Zhen

 

1. MAIN COMPLAINT : The main symptom or sign including

location , nature , extent and time they appear. They must be

summative using one or two words to accurately describe them .

 

EXAMPLE : " Recurrent colicky upper abdominal pain,

accompanied by vomitting for three times. "

 

2. HISTORY OR CURRENT CONDITION : This refers to the whole

historical developmental process of current condition. This can

include: time of onset of codition; what brought it about; where the

symptoms occurred; nature and severity of symptom; changes in

symptomss; accompanying conditions; treatment undergone and

present state of illness.

 

3. CURRENT SYMPTOM This aspect requires detailed record

including the " Ten Questions "

 

a. CHILLS AND FEVERS : Averssion to cold; aversion to wind'

fever, fever in afternoon; high fever; slight fever; severe fever at night;

fever at night and feeling of coldness during the daytime.

 

b. SWEAT Spontaneous sweating; nightsweats; severe sweating;

localized sweating.

 

c. DIZZINESS severity; accompanying symptoms.

 

d. PAIN location; time; nature (descriptive)

 

e. CHEST chest congestion; chest pain; palpitations

 

f. ABDOMEN abdominal pain;(location , nature, alleviated by cold

or heat; alleviated by pressure or not); abdominal distention

(extent); abdominal lump (size, location, texture, tenderness).

 

g. APPETITE: Too much appetite and always hungry (xiao gu

sheng ji); hungry but no appetite to eat; no appetite to eat; inability

to take in food; absence of ability to taste food; acid taste in

mouth; sweet taste in the mouth; salty taste in the mouth.

 

h. FAECES AND URINE constipated. diarrhoeia, abnormal

sensation when defecating; Urine ( quantity, frequency, urgency in

urinating; interrupted urination ; uirination at night; incontinence .

 

i. SLEEP insomnia, sleepiness

 

j. MENSTRUATION, VAGINAL DISCHARGE, PREGNANCY AND

MOTHERHOOD

 

1) age at initial period----duration of period---menopausal age

 

2)Menses colour; quantity (nummer of tampons used) texture

 

3) Vaginal Discharge (Dai) colour, quantity, texture and smell

 

4)Pregnancy: number of pregnancies, number of childbirths.

 

5)Child: normal period of gestation; premature; difficult labour;

history of infectious diseases; smallpox; measles, immunizatoion

Individual characteristics: prome to convulsions, diarrhoeia; asthma

History of previous illnesses: treatment and prognosis

 

III. Inspection (Wang Zhen)

 

A. WHOLE BODY INSPECTION

1. Spirit (Shen) normal, tired, dispirited, overactive, irritable

 

2. Consciousness: Clear, blurry, sleepu, uncounsious

 

3. Demeanor: natural and normal, suffering, frightened, worried,

withdrawn , dull or happy

 

4. Facial Colour: flushed, ruddy, red on both cheeks; bluish;

purpple

 

5. Body Consittution: overweight ; thin

 

6. Decorum : moves naturally, oncomfortable with body

movements; paralyzed; half-body paralisis; shaking or tremors

 

B. REGIONAL INSPECTION head; face, eyes, nose, ears, mouth,

lips, throat, neck. chest and abdomen, back and lower back, upper

extremeties, lower extremeties, skin, front yin (genitalia), back yin

(anal opening)

 

C. INSPECTING SECREATIONS saliva, vomit, faeces, urine, child

index finger,

 

D. INSPECTING THE TONGUE

1. Colour : pink, red, purple, bluish

2. Appearance: Flabby, thin, fissures, teethmarks

3 Texture: stiff, soft, shaking, veers to one side; contracted,

wagging

 

IV Listening and Smelling (Wen Zhen)

 

A. LISTENING TO THE SOUND

1. Voice: high pitch; low pitch; hoarse; voieless; screaming;

moaning

 

2. Talk : talks a lot; talks little; delirium; talks to oneself;

murmuring in unconcious state

 

3. Breathing: wheeze; loud and hoarse; slight and faint breathing;

inhaling more or exhaling less or vice-versa.

 

4. Cough: loud and big cough; hoarse cough; coughs like

barking dog; chiken sounding cough.

 

5. Vomit: high pitch and low pitch

 

6. Hiccups: high pitch and faint

 

B. FOUL SMELL

1. Mouth Qi acidic foul smell; fermented foul smell; very foul smell;

foul spirit smell; foul smell similar to decaying fruit

 

2. Sweat Qi Urine smell

 

3. Secreations : (including pus, phleg, vaginal discharge,

urine and faeces)

 

4. Sick Person Room Qi : corpse smell; bloody smell, urine smell;

smell of decaying fruits; rotten smell

 

V Palpations (Qie Zhen)

 

A. Feeling the Pulse (mai zhen)

 

1. PULSE LOCATION

A. Superficial with soggy (ru) lethery (ge) hollow (kong) and

scattered (san)

 

B. Deep : with hidden(fu); frail (ruo) confined (lao)

 

C. Right Cun ---Guan--- Chi d. Left Cun---Guan--- Chi

 

2. PULSE RATE Slow (chi), moderate(huan), rapid(shuo), galloping

(ji)

 

3. PULSE SHAPE Thready(xi), minute (wei), long (chang), short

(duan),

 

4. PULSE STRENGTH empty (xu); full (shi)

 

5. PULSE MOMENTUM (mai shi) flooding (hong), taut (xuan);

slippery (hua) moving (dong), choppy (se)

 

6. PULSE RHYTHM (Mai Lu) hurried (cu) knotted (jie) , intermittent

(dai)

 

PALPATION Qie

 

1. Skin:cool, hot, moist, dry. sweling, depressions

 

2. Hand and Foot: cold, hot, fever on palm. fever on back of hand ,

moist , dry

 

3. Chest

 

4. Abdomen: cool, hot, soft, hard, distended, lumps, tenderness

 

5. Acupuncture Points : knots, sensitivity, tenderness

 

VI . Differentiation Clinical Patterns BIAN ZHENG

 

A. Eight Principal Patterns

 

B. Patterns of Acupunncute Channels: Taiyang; Shaoyang;

Yangming; Taiyin; Shaoyin; Jueyin

 

C. Patterns of Internal Organ Dishrnony Heart--liver--spleen--lung--

kidneys

 

D. Patterns of Qi, Blood, Body Fluids Disharmonies Deficient---

Deficient----Deficient Qi Blood Body Fuids Excess

Excess Excess

 

E Eiological Patterns Exterior Afflications (Wai Gan) wind, cold,

summerheat, damp, dryness, fore Interior Trauma (Nei Shang)

Seven Emotions, others

 

F. Patterns of Exterior Heat Afflictions

1. Patterns of Six Divisions

2. Patterns of Four Stages- Triple Burner

 

(The above is a translation of a segment of Deng Tie Tao's book

Zhong Yi Zhen Duan Xue TCM Diagnostics , People's Health

Publishing House, (Beijing , l987) Warm Regards, Rey Tiquia Phd

Candidate Dept. of History and Philosophy of Science The

University of Melbourne Parkville Victoria Australia

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

[Guest guest]

-

Dear Phil,

 

Thanks for the feedback . I still have to get back to you about the

" injectables " which was interrupted by that 'hiccup' in the CHA

involving Emmanuel Segmen.

 

Warm regards,

 

Rey Tiquia

[Guest guest]

Ken,

 

You are provoking my thoughts too !

 

> In patient X, who may well be characterized ....

 

I'd prefer discussion of particular cases to illustrate generalities. You

can find them on EPCEL if you care to go there. At the moment the discussion

on EPCEL is taking place solely in terms of the WM paradigm, with my

'cutting edge' stuff interposed in order to get guys away from the century

old " castration is good for you " thinking.

 

I don't mind admitting I am a 'learner' when it comes to TCM and would not

presume to advise any of my EPCEL rs on TCM diagnosis, or how to go

about treating themselves with TCM. They do nevertheless treat themselves

with propriety formulae mostly, and I am eager to see how these formulae fit

into individual patterns of disharmony.

 

I am convinced there is a middle way between TCM and WM because there is one

world, one reality, and the convergence of our modelling of our perceptions

/ experiences is an inevitability of sharing and communication.

 

And

 

> Just ask yourself, What is:

 

qi

yin yang

wu xing

xu shi

jing luo

zang fu

 

Ken, I'd like someone to tell me how to just pronounce the words ;-)

 

BTW, I took a look at Falun Gong last night on:

http://www.falundafa.org/book/eng/dymf.htm and there were for the first time

some easy to read explanations and pronunciations in the footnotes. I did

however get a little worried about the 'supernormal' claims at the ende of

chapter 2. I think this rather extreme interpretation of the Tao can be

equivocated with the subjective relativism and 'anthropism' suggested by

string theory: however, as Susskind himself admits this (equivocation) is an

epiphenomenal quality of a physical real-world theory and not to be taken

seriously. I am not too happy with that 'supernormal' aspect of Falun Gong

for the same reason: namely that just theorising about something without a

sound grounding in empirical testing can get you into an awful lot of

trouble.

 

Any thoughts on Falun Gong -- maybe we (anyone who responds) should start a

separate thread if there is ?

 

Back to dealing with prostate cancer in the real word for me.

 

Cheers,

 

Sammy.

 

 

 

 

 

 

kenrose2008 [kenrose2008]

29 December 2003 01:10

Chinese Medicine

Re: Case histories

 

 

Sammy, and All,

 

I found your post thought provoking.

I hope my remarks below are helpful.

 

At the end you said,

 

I am sure there is

> a 'middle way' here between TCM and WM & I'd like to be part of

bringing out

> (learning more about) that knowledge.

 

 

If you take a look at that post I put

up a few hours ago with the quote from

the Ames/Hall Dao De Jing, you can follow

what I'm about to say as an example of

precisely the kind of onerous implications

of the way terms are rendered in Chinese

medicine and the impact of the equivocation,

here more linguistic than cultural.

 

You have taken a Chinese term, xu1, which

is commonly and very poorly rendered into

English as " deficiency " and equated it with

a deficiency of a particular substance in

the body, as it is identified by Western medical

science.

 

Jim's comment, I believe, got you going in

this very questionable direction, as it

implies that there is some constant theoretical

value to cancer that can be linked to the

two terms xu1 and shi2, which by the way simply do not

mean deficiency and excess.

 

These are two very clear examples of the way

in which the non-familiar is zapped into

familiarity by the translator's pen.

 

Students of Chinese medicine should be made

to understand how non-familiar these two

terms are as a prerequisite to gaining

any understanding of what they mean. And

the crime of forcing non-equivalent equivalencies

such as deficient and excess down students'

throats only exacerbates the whole sad

situations.

 

Xu1 and shi2 have no constant abstract theoretical

value. They are diagnostic terms in Chinese

medicine that relate to individual situations.

Everyone has xu1 and shi2. The taiji classics

contain some deep insights into xu1 and shi2

including one passage that reads:

 

each place in the body has the same xu1 and shi2.

 

So it is not meaningful to try and associate

constant values of xu1 and shi2 to supposedly

correlative markers used to identify organic

activity according to Western medical assay.

 

In patient X, who may well be characterized

by xu1 patterns, marker Y may indicate a

deficiency of some particular substance of

activity.

 

Yet patient Z, who may well be characterized

by shi2 patterns may also show this same

pattern of deficiency according to the

identical marker in the Western clinical

assessment.

 

There are just a handful of possibilities

given these few variables. Any might obtain

from diagnosis according to the two approaches

of Western and Chinese medicine, and this

doesn't begin to take into account the variety

of interprative approaches one might encounter

from one practitioner of Chinese medicine to

another.

 

So what is being correlated?

 

Confusion, unfortunately.

 

I wholeheartedly agree with and endorse the

purpose you state above. And I think more

than ever that if we aim as a group to

move forward out of the confusions that

we have thus far created and sustained,

one early, in fact immediate step that

we need to take is to recognize the actual

condition of things.

 

While debate continues to rage about the

meanings of the most basic terms, and where

people are admitted to this debate and

granted widespread credence who more or less lack

the qualifications to take part, it will

likely remain difficult for this awareness

to spread throughout the community.

 

People will continue to be confused and

misled by what they will see as noise

and fury signifying nothing.

 

But everyone can perform a kind of self-test

to determine where you are as an individual

when it comes to this sort of confusion.

 

Ask yourself what each of the terms listed

below means, and if you have any questions,

just recognize that you don't know.

 

According to the Dao De Jing, that is

the way to go about knowing. And if you

want to know Chinese medicine, this approach

to knowledge was, if not well known at least

readily available to be known by the authors

of the texts on which Chinese medicine at

least claims to be based.

 

It's not a bad idea, in other words, to

know what knowledge meant to the ancient

Chinese doctors and scholars who recorded

the knowledge that you think you are using in

your clinic today.

 

In the past when I've forwarded this kind

of appeal, a certain percentage of folks

get bent out of shape over who the heck I

think I am and how can I say things like

this? But that really isn't where it's at.

 

Just ask yourself, What is:

 

qi

yin yang

wu xing

xu shi

jing luo

zang fu

 

And that's enough. If you know what those

terms mean, great. If you don't, that's great,

too.

 

But listen carefully to your answers.

Explain what these things mean to people

who have never heard of them, and then

see how clearly you have let someone

else understand them.

 

Well, there you go provoking my thoughts

again, Sammy.

 

Thanks,

 

Ken

 

 

 

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[Guest guest]

Sammy,

>

> You are provoking my thoughts too !

 

Glad to return the favor.

 

Please let's make it clear that working

for the development of the capacity for

professionals who cope with such conditions

as prostate cancer in the real world to

communicate clearly and effectively among

themselves and with their respective publics

is part of dealing with those conditions.

 

Each of us has his or her own clinical as

well as personal scenes.

 

The discussion about language is all too

frequently pushed to the side as being

a separate issue from clinical reality.

But nothing is more central to clinical

realities in Chinese medicine than the

ability to communicate with the patient.

Of course not all such communication takes

place via language, but language affects,

effects, informs, and influences virtually

all such interactions.

 

And those who seek clinical efficacy are

well advised to pay attention to these

matters, both in terms of their own personal

sense of certainty, uncertainty, and understanding

and in terms of the development of a professional

approach to confronting and dealing with

challenges such as prostate cancer in the

real world.

 

While we continue to tolerate the degraded

handling of language, terminology, translation

and related matters in education and

training in the field, we continue to foster

the confusions that isolate and undermine

the work of clinicians everywhere.

 

Ken