TCM is Dead, Long Live TCM

[Guest guest]

Well at the end of three weeks on the hospital ward, I've come to

the conclusion that TCM in mainstream hospitals is long gone. The

majority of doctors favour WM over TCM. An allopathic diagnosis is

given first along with the medication. TCM is used more so to

control the side effects seen when large doses of WM are used and

they are regularly. Although, this gives out the question " how can a

correct TCM diagnosis be given when the WM medication has changed

the T and P so much " ?

 

The director of the rheumatology ward said to me that if you want to

see real TCM, you'll have to go to the countryside and see it there.

I may post the positive aspects of what I've seen to the group but

in reality it's all pro WM. When there is an interesting piece of

TCM treatment it's usually ends up being secret formula. TCM

classical theory is usually either ignored or twisted to fit a bio-

medical model.

 

Of course you can still find TCM in the street clinics, but this is

somewhat strange aswell. I've been to one place and observed the

doctor treat just one aspect of a patient's complaint, probably the

most notable by the patient. No herbs were given for root treatment

but rather just the twig of the branch.

 

There's still that air of acupuncture and Tuina being a lesser form

of treatment to internal medicine aswell. Something I found strange.

We were taught in the UK to combine both theories and treatments,

but here in China I suggested acupuncture theory in relation to a

headache and got a definite 'no, no'. It seems the Confucius system

still exists in medicine, with WM ranking top, followed by internal

medicine, acupuncture, Tuina and GuaSha.

 

All negative, nah. It's just a case of picking out the bits you feel

are right and leaving the rest. I guess that goes for most things so

why should TCM be any different. There's still much to learn, but

you'll just need to go and find it for yourself. I'm sure China will

go back to its roots eventually, once they have finished climbing

along the branch of WM. They'll probably end up having to import a

lot of knowledge from abroad. We'll see.

 

Attilio

[Guest guest]

On 12/03/2004, at 1:29 PM, wrote:

 

> Well at the end of three weeks on the hospital ward, I've come to

> the conclusion that TCM in mainstream hospitals is long gone. The

> majority of doctors favour WM over TCM. An allopathic diagnosis is

> given first along with the medication. TCM is used more so to

> control the side effects seen when large doses of WM are used and

> they are regularly. Although, this gives out the question " how can a

> correct TCM diagnosis be given when the WM medication has changed

> the T and P so much " ?

>

>

 

Hi Atillio,

 

I know exactly where you are coming from with these your latest

comments and observations. My 1 year clinical internship in Nanjing

circa 2002 was almost identical to your current one.

 

For the first few weeks it all seems new and overwhelming; then I

reached the stage you have now.........the realisation that I am not

really learning what I thought i would be. ie. the western understand

of what constitutes TCM.

 

The term TCM in the west seems to have a different connotation

generally to what is considered TCM in china. You and I were immersed

in " the real TCM " in china; the reality is that it does rely heavily on

biomedicine now.

 

My greatest challenge was overcoming my disappointment in what I was

exposed to and learning in regards to clinical practice for use in the

west. I simply can not prescribe western drugs as I am not a registered

biomedical doctor. This made it frustrating to say the least when

trying to learn herbal treatment protocols and even chinese medical

differential diagnosis in my clinical experiences.

 

My stint in internal medicine was primarily spent seeing patients with

diabetes and hypertension. All of which were primarily treated with

WMeds with a rather standard herbal formula added almost as an

afterthought to deal with side-effects of these meds and some branch

symptoms that the WMeds didn't address.

 

I don't wish to sound arrogant or condescending; but I often felt that

my TCM diagnosis ability and knowledge of standard TCM principles far

outclassed many of the doctors in the hospital. Often a doctor only

ever used (knew?) 2 or 3 different pulses and tongue patterns for weeks

on end. When asked about specific etiology and pathology of a case in

terms of TCM they often had no real explanation for it, especially in

terms of how it related to the herbs they prescribed. " Why do you use

this herb? It lowers BP.... " I got the overwhelming impression that in

was more a general herbal protocol for a specific western disease or

symptom rather than based on proper pattern differentiation.

 

All negative? Well, no. I did come across a VERY small minority of

doctors with deep traditional knowledge and willingness to share.

Interestingly, these are the doctors most desperately sought after by

the patients themselves (the demand for the " old " TCM far outstrips

supply in china). Sadly, the vast majority rushed through patients in 5

or 6 minutes with a WM prescription and a standard herbal formula.

 

Perhaps this is a symptom of the healthcare structure in china where

there is no chance to do a thorough TCM pattern diagnosis due to time

limits and patients numbers. I feel for these doctors due to their low

pay and need to prescribe western meds to live (under the table

payments is part of the reason for the use of so many western drugs).

 

Bottom line? I feel that what we may consider in the west as TCM is

dead china as far as professional training is concerned.

 

I for one think this is tragic; but I must console myself with the fact

that the tradition does survive and it is up to me to investigate it

for myself through study and self-directed learning until I find a true

teacher.

 

I am increasingly getting the impression that the traditions of chinese

medicine will live longer and be more utilised clinically in the west.

Fact is; they already are. I feel that western practitioner of TCM

actually try to use TCM prinicples to guide treatment in clinic; this

is simply NOT so in modern china. I know many list members who have not

actually trained in china will find this statement impossible to

believe; but from my and others experience......it is simply a fact.

 

In signing off I would like to say that your impressions of the role of

acupuncture and tuina in china are also very similar to mine. But I

have been told consistently that these modalities have always played

this minor role in TCM in china................the west was exposed and

embraced acupuncture first and out of context with clinical reality.

 

Best Wishes to all,

 

Steve

 

Dr. Steven J Slater

Practitioner and Acupuncturist

Mobile: 0418 343 545

chinese_medicine

[Guest guest]

Hi Attilio,

 

Fot the past 50 years the flame of acupuncture, which was nearly snuffed out

by the chinese revolution has been rekidled in the west. I don't think I

exagerate when I state, that we are more likely to find a master of

acupuncture in the western world than in china.

 

I'll go further, I think that the true understanding of the power of

acupuncture is as likely to be found in the West, because we have had 2 to

3 generations of western people grappling with understanding 'acupuncture'

in all of its ramifications and adding the emotional and psychological

understanding that paradoxically the west is so good at.

 

salvador

_

 

Attilio wrote:

>Well at the end of three weeks on the hospital ward, I've come to

>the conclusion that TCM in mainstream hospitals is long gone. The

>majority of doctors favour WM over TCM. An allopathic diagnosis is

>given first along with the medication. TCM is used more so to

>control the side effects seen when large doses of WM are used and

>they are regularly. Although, this gives out the question " how can a

>correct TCM diagnosis be given when the WM medication has changed

>the T and P so much " ?<<<<<<<<<<

 

_______________

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[Guest guest]

Hi Steven and Salvador,

 

Yes, I agree with your comments to a large extent. A few inquisitive

doctors asked how things were in the UK with regards to the old ways

of TCM. I got the impression that some doctors do believe in the old

ways, the I Ching for example, aswell as astrology. They see it and

believe it but can't speak of it. It's regarded as suspicious and

therefore untrue, because it cannot be seen. When I said that you

can't see Damp, they say it's just not allowed. Apparently in the

south of China it's a little more relaxed and their able to use

astrology to determine illness, coz the government cannot reach that

far.

 

I do believe that there are still some good TCM practitioners in

China who have their whole heart dedicated to TCM. Although I feel

that certain restrictions or perceptions limit their scope. I'm not

saying I'm better than them, of course they are more gifted than

myself, but some may be unwillinging to except anything other than

what they have. An example can be seen in a selection of patients

that are stressed, overworked or with emotional difficulties. To the

doctors these factors are completely ignored in a large part. This

is frustrating to say the least.

 

From the bigger picture, it all makes sense. I think that the two

big worlds of East and West are running towards each other, and are

clashing, smashing as we speak. The miss-mash that comes out of this

is the world we're trying to make sense of today. This often

involves moving pieces around, changing perceptions, re-ordering

thinking and so on.

 

I do believe that TCM has moved to the West for a very good reason

and that is to further develop itself. Just because none of the

classics were written in the West and we don't all speak fluent

Mandarin, that doesn't mean we can't inject a new and vibrant way of

thinking into TCM. For example, I find that Westerners are more

likely to accept the emotional imbalance often seen in our patients

and the side effects of pharmacological drugs. These things will

eventually come to our Chinese cousins but until then it's our way

to proceed and we shouldn't stop.

 

Talking of drug companies, I heard that one popped into the hospital

today and gave a super-slick presentation on a new drug. Equipped

with the latest Sony laptop and accompanying projector, claims of

near perfect recovery rates against not a mention of side effects

cares a lot of clout in China. In any country the naïve are sold and

the wise stay quiet, so who's to knock them, not me.

 

So it's all swings and roundabouts. Probably in 10 years China will

be giving the West a run for their money in the WM world and will

look upon TCM as an advantage. Although, WM in the West may well be

looking to TCM aswell. Whatever the way, I think TCM has a

guaranteed positive outcome, so long as the patients keep on getting

better and tell their friends.

 

Attilio

 

" salvador march " <salvador_march@h...> wrote:

> Hi Attilio,

>

> Fot the past 50 years the flame of acupuncture, which was nearly

snuffed out

> by the chinese revolution has been rekidled in the west. I don't

think I

> exagerate when I state, that we are more likely to find a master

of

> acupuncture in the western world than in china.

>

> I'll go further, I think that the true understanding of the power

of

> acupuncture is as likely to be found in the West, because we

have had 2 to

> 3 generations of western people grappling with

understanding 'acupuncture'

> in all of its ramifications and adding the emotional and

psychological

> understanding that paradoxically the west is so good at.

>

> salvador

> _

>

> Attilio wrote:

> >Well at the end of three weeks on the hospital ward, I've come to

> >the conclusion that TCM in mainstream hospitals is long gone. The

> >majority of doctors favour WM over TCM. An allopathic diagnosis is

> >given first along with the medication. TCM is used more so to

> >control the side effects seen when large doses of WM are used and

> >they are regularly. Although, this gives out the question " how

can a

> >correct TCM diagnosis be given when the WM medication has changed

> >the T and P so much " ?<<<<<<<<<<

>

> _______________

> Express yourself with cool new emoticons

http://www.msn.co.uk/specials/myemo