comparison of chinese and western medicine

[Guest guest]

Hello everybody

I have a question from TCM practitioners in the group:

Do you think Chinese medicine is more efficient in treating diseases compared to

conventional Western medicine?If so, what kind of diseases?

The two systems are very different regarding their point of view of disease and

health and the methods of treatments, but how do you compare the outcome of

treatment in the two systems?

Regards

Saba Hoda MD

[Guest guest]

On Sat, Mar 6, 2010 at 5:55 AM, sabahoda <sahomd wrote:

 

>

>

> Hello everybody

> I have a question from TCM practitioners in the group:

> Do you think Chinese medicine is more efficient in treating diseases

> compared to conventional Western medicine?If so, what kind of diseases?

>

I think we'd have to look firstly at risk/benefits. Drugs work really well

for some problems, but they also bring up risks that the weaker herbs don't

have.

 

Generally, it is the chronic diseases that we see the greatest benefit as CM

is practiced currently. I have an instructor from Beijing who swore up and

down that there was a place for herbal injections and acupuncture in the ER.

There's a pretty wide variety of applications.

 

I had a injection of Rx. Bupleurum (chai hu) while I was in China after

contracting a flu. The fever and body aches were gone an hour after the

shot, though the " common cold " portion took another week to go away. Still,

I was quite impressed.

 

In the UK it seems that herbal medicine is quite popularly used in the area

of dermatology.

 

In the US, we see a lot of gynecology and infertility applications getting

rave reviews.

 

I myself am all about poop. And there are many digestive complaints that

respond well.

 

When in China, where there is a hepatitis C epidemic, every hospital had a

department devoted to the liver which often included the (Chinese medicine)

herbalist.

 

So we treat pretty much everything, though I would look to Western medicine

in order to keep someone alive when they can't breath or the heart stops or

something along those lines. Once they're stabilized, that's when I'd start

in with the Chinese medicine.

 

Ultimately, using both together is the best way, in my opinion. Though it is

difficult outside of Asia where it lacks cultural legitimacy.

 

> The two systems are very different regarding their point of view of

> disease and health and the methods of treatments, but how do you compare the

> outcome of treatment in the two systems?

>

Most of Chinese medicine's observations are at the gross anatomy level

(naked eyes, ears, etc.) we don't think about altering the form or function

of a given cell, chemical, enzyme. Rather we see a lump or mark or color or

smell or pattern of symptoms and try and make that normal.

 

We're both looking at the same body, but our levels of magnification are

different, and so assessing Chinese medicine with lab tests may satisfy our

science-focused modern culture, it doesn't always do a good job of assessing

quality of life, or specific symptoms. That's where we have to use

qualitative research instruments rather than the quantitative.

 

There was some research done in 1991 that asked some questions regarding

Chinese medicine of (Western) medical students in China. They have the

benefit of living in both cultures, the Chinese medicine-friendly culture as

well as modern scientific culture.

 

*Is CM useful for treating patients?*

 

- Yes: 98%

- No: 1%

- Not sure: 1%

 

*Does CM produce longer lasting and more complete results than Western

medicine?*

 

- Yes: 37%

- No: 24%

- Not sure: 39%

 

*Should CM only be used for minor illness, nothing serious?

*

 

- Yes: 15%

- No: 67%

- Not sure: 18%

 

*Is CM dangerous, preventing people from getting proper treatment?*

 

- Yes: 5%

- No: 80%

- Not sure: 15%

 

Source: Harmsworth, Lewith, Soc Sci Med. 2001 Jan;52(1):149-53

 

-al.

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao

 

 

 

[Guest guest]

Chinese Traditional Medicine , " sabahoda " <sahomd wrote:

> Do you think Chinese medicine is more efficient in treating diseases compared

to conventional Western medicine?If so, what kind of diseases?

 

I think there's very simple and clear difference between Western and Chinese

medicine. Let me share my thoughts with you. And please correct me if I'm wrong.

It's only my hypothesis.

 

First, let's define what disease is: Disease is a condition when the body is not

able withstand a strain.

 

(Here the 'strain' can be everything like, mechanical, emotional strain, viral

infection, faulty DNA replication, unhealthy diet, wet climate, accumulation of

dampness, our own stomach acid, anything)

 

Now here's the difference. I know it's an oversimplification but you'll get the

idea:

 

1. Western medicine tries to fix the problem by itself (even when it would be

the body's task to fix a particular problem)

2. Chinese medicine tries to wake up the body's own healing processes without

addressing the problem directly.

 

So they're targeting the two opposite ends of the scene. Western science targets

the strain which injures the body. Chinese science targets the body which is not

able to defend itself.

 

Both approaches can be good or bad. Generally we should you Western methods:

 

- when it's not expected for the body to heal by itself

- when there's no time wait for the body to heal by itself (like emergencies)

- when the benefits of accelerating the healing by Western methods are greater

then the risks arising from the fact that we ignore the body's own healing

mechanisms

- when the Western method is the only alternative available

 

And we should use Chinese medicine (or any other method that wakes up the body's

own healing mechanisms) whenever it's available.

 

Tamas

[Guest guest]

I agree with Tamas.

 

I also want to add some things.

 

Western medicine seam to have a huge gap between a healthy person and when it

regards a person as sick. This means that a person feeling not at ease, can go

to a hospital and they find nothing wrong. this can go on for several years

until Western medicine actually can find something in tests.

 

TCM philosophy is more like preventive. You should take care of the problem

before it becomes a problem. That is, treat whatever symptom, root and branch of

the discomfort as soon as possible.

 

This kind if philosophy must be better then the Western kind of thinking which

is more like wait until you can measure it and then cut it out or kill it with

medicine.

 

An anecdote for a good TCM doctor living in a village is, that if no one is sick

he is doing a good work. While if someone is allowed to get sick the doctor made

a lousy job.

 

I also think there is a problem in West with everything have to be Good/Bad,

better/worse, good/evil.

 

I do not think that Western is better or CM is better. It all depends on the

person that is ill, the illness and the circumstances around it.

 

/Peter

 

Chinese Traditional Medicine , " Tamas " <knz wrote:

>

> Chinese Traditional Medicine , " sabahoda " <sahomd@> wrote:

> > Do you think Chinese medicine is more efficient in treating diseases

compared to conventional Western medicine?If so, what kind of diseases?

>

> I think there's very simple and clear difference between Western and Chinese

medicine. Let me share my thoughts with you. And please correct me if I'm wrong.

It's only my hypothesis.

>

> First, let's define what disease is: Disease is a condition when the body is

not able withstand a strain.

>

> (Here the 'strain' can be everything like, mechanical, emotional strain, viral

infection, faulty DNA replication, unhealthy diet, wet climate, accumulation of

dampness, our own stomach acid, anything)

>

> Now here's the difference. I know it's an oversimplification but you'll get

the idea:

>

> 1. Western medicine tries to fix the problem by itself (even when it would be

the body's task to fix a particular problem)

> 2. Chinese medicine tries to wake up the body's own healing processes without

addressing the problem directly.

>

> So they're targeting the two opposite ends of the scene. Western science

targets the strain which injures the body. Chinese science targets the body

which is not able to defend itself.

>

> Both approaches can be good or bad. Generally we should you Western methods:

>

> - when it's not expected for the body to heal by itself

> - when there's no time wait for the body to heal by itself (like emergencies)

> - when the benefits of accelerating the healing by Western methods are greater

then the risks arising from the fact that we ignore the body's own healing

mechanisms

> - when the Western method is the only alternative available

>

> And we should use Chinese medicine (or any other method that wakes up the

body's own healing mechanisms) whenever it's available.

>

> Tamas

>

[Guest guest]

On Tue, Mar 9, 2010 at 5:54 AM, pejo_mstd <pejo_mstd wrote:

 

>

>

> Western medicine seam to have a huge gap between a healthy person and when

> it regards a person as sick. This means that a person feeling not at ease,

> can go to a hospital and they find nothing wrong. this can go on for several

> years until Western medicine actually can find something in tests.

>

Right. I call these patients " subclinical presentations " meaning that the

(patient perceived) symptoms are there, but the (objectively measurable)

signs are not. In the US, drug companies can market directly to consumers

via TV or print ads. This gives rise to more people asking for a given drug

than physicians feel comfortable giving to their patients.

 

It is in these cases when the signs are not there, that I would think herbs

can fit in to patient management.

 

>

> TCM philosophy is more like preventive. You should take care of the problem

> before it becomes a problem. That is, treat whatever symptom, root and

> branch of the discomfort as soon as possible.

>

> This kind if philosophy must be better then the Western kind of thinking

> which is more like wait until you can measure it and then cut it out or kill

> it with medicine.

>

This is important. TCM signs can appear long before any symptoms manifest. I

have a great example of this.

 

In 1998, I treated a guy for tennis elbow, (lateral epicondilitis.) He was

one of my first patients, and I was taught to think beyond a particular

symptom (elbow pain) to address the underlying issue that gave rise to it.

In his case, what I saw led me to give him a formula that used Long Dan Xie

Gan Tang (Gentiana Clear the Liver Decoction) as its base. I remember him

getting impatient with all of my questions that seemed to him to be

unrelated. I took that cue and focused on his elbow pain. He took the herbs

for a few weeks and I didn't see him again. (For the record, impatience can

be a Liver symptom.)

 

Six years later, I was teaching a class on scalp acupuncture and supervising

interns in a teaching clinic. One of my scalp acupuncture students was also

one of my clinic interns. She had a friend who'd had a stroke a few months

prior. They rolled him in to the clinic and we gave him some acupuncture

treatments.

 

It was the guy with the tennis elbow. He'd had a stroke and was now in a

wheelchair. We looked at his tongue, took his pulse, asked some questions

and gave him scalp acupuncture. I also wrote him an herb formula. I did not

consult his file from my own practice as it wasn't even in the same

building. However, I thought it would be interesting to see how the two

formulas compared.

 

When I tracked down his file I noted that about 80% of the herbs (and 100%

of the base formula) were identical. His internal condition had not changed

much, it still pointed toward Long Dan Xie Gan Tang. I thought that was kind

of amazing.

 

But what really blew me away was realizing that Long Dan Xie Gan Tang could

prevent strokes, at least in theory. Liver Yang rising (the disharmony

treated by this formula) can often present as what Western medicine would

call high blood pressure, even with high cholesterol and/or bleeding of

micro-capillaries. Of course, not everybody who is in danger of having a

stroke would benefit from this formula, only those with a specific

presentation (tongue appearance, pulse qualities, etc.) but I still had to

wonder what would have happened (or NOT happened) if he'd taken the herbs

more seriously.

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao

 

 

 

[Guest guest]

Hi everybody

I agree with all the problems and pitfalls of Western medicine. I think that the

biomedical paradigm, although many times useful, is far from complete.I strongly

believe that this paradigm needs corrections in many respects.

I also understand the philosophical basis of CM.The fascinating,holistic,

vitalistic way of looking at human body. The question is,in the real world, how

effective CM treatments are? You know that personal experiences with the

therapies are not enough to show the efficacy of a therapeutic regimen. Why

controlled studies in this field are so limited and give so many contradictory

results?

 

Saba Hoda MD

[Guest guest]

Hi Saba ...

 

Western protocols differ fundamentally in their reliance on Newtonian laws or

theories. Acupuncture is based on an entirely different and time proven paradigm

of energetics which in many instances cannot be 'measured' or 'quantified' using

what Western science regards as their 'objective' criteria - having no

application in the quantum realm. Western medicine has had a spurious history,

at least in the US.

 

Here's an excerpt from  How Scientific is Modern Medicine? By Dana Ullman...

 

" The entire Medical Society of New York was kicked out of the AMA in 1881 simply

because this state's medical organization admitted into its membership any

medical doctors who utilized homeopathic medicines, no matter what their

academic credentials were.

 

Modern medicine uses the double-blind and placebo-controlled trial as the gold

standard by which effectiveness of a treatment is determined. On the surface,

this scientific method is very reasonable. However, serious problems in these

studies are widely acknowledged by academics but remain unknown to the general

public. Fundamental questions about the meaning of the word " efficacy " are

rarely, if ever, raised.

 

For instance, just because a drug treatment seems to eliminate a speci- fic

symptom doesn't necessarily mean that it is " effective. " In fact, getting rid of

a specific symptom can be the bad news. Aspirin may lower your fever, but

physiologists recognize that fever is an important defense of the body in its

efforts to fight infection. Painkilling drugs may eliminate the acute pain in

the short term, but because these drugs do not influence the underlying cause of

the discomfort, they do not really heal the person, and worse, they can lead to

physical and psychological dependency, addiction, tolerance, and increased heart

disease. Sleep-inducing drugs may lead you to fall asleep, but they do not lead

to refreshed sleep, and these drugs ultimately tend to aggravate the cycle of

insomnia and fatigue. Uncertainty remains for the long-term safety and efficacy

of many modern drugs for common ailments, despite the high hopes and sincere

expectations from the

medical community and the rest of us for greater certainty.

 

The bottom line to scientific research is that a scientist can set up a study

that shows the guise of efficacy. In other words, a drug may be effective for a

very limited period of time and afterwards cause various serious symptoms. For

example, a very popular anti-anxiety drug called Xanax was shown to reduce panic

attacks during a two-month experiment, but once the person tries to reduce or

stop the medication, panic attacks can increase 300-400 percent ( Consumer

Reports , 1993).Would as many patients take this drug if they knew this fact,

and based on what standard can anyone honestly say that this drug is

" effective " ?'

 

 

" Dismantle your perceptions. Lose your mind. Abandon your ego. Come to your

senses.You cannot do all the good the world needs,thus the world needs all the

good you can do. " Dr.Twyla Hoodah, D.O.M.,

A.P. SpiritcareAcupuncture.org                        Â\

 Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â     

 

--- On Tue, 3/9/10, sabahoda <sahomd wrote:

 

sabahoda <sahomd

[Chinese Traditional Medicine] Re: comparison of chinese and western medicine

Chinese Traditional Medicine

Tuesday, March 9, 2010, 3:21 PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hi everybody

 

I agree with all the problems and pitfalls of Western medicine. I think that the

biomedical paradigm, although many times useful, is far from complete.I strongly

believe that this paradigm needs corrections in many respects.

 

I also understand the philosophical basis of CM.The fascinating, holistic,

vitalistic way of looking at human body. The question is,in the real world, how

effective CM treatments are? You know that personal experiences with the

therapies are not enough to show the efficacy of a therapeutic regimen. Why

controlled studies in this field are so limited and give so many contradictory

results?

 

 

 

Saba Hoda MD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Chinese Traditional Medicine , " sabahoda " <sahomd wrote:

>

>

> Hi everybody

>

>Why controlled studies in this field are so limited and give so many

contradictory results?

>

> Saba Hoda MD

>

 

Hello there

 

I'd like to bring up a few other inherent ideas that add to the complexity of

designing a " gold " standard tests or controlled studies.

 

One of the main issues seems to be that TCM ends up being more of an art form

and can vary from practitioner to practitioner. For example, if you have one

person go to 10 different TCM docs you'll likely end up with at least several

different interpretations and even more variation in what treatment they choose.

That is much less true of western medicine, and because of that it's easier to

identify and isolate one variable, which is what the scientific process is all

about. Western medicine, in a lot of cases, ends up being more this for that,

which also makes it easier to study.

 

Several people have used this analogy, including Al and others here. TCM ends

up being more like chefs (equivalent of a TCM doc), and you can use different

cooking methods, different spices, different ingredients, different tools,

different sizes and end up with a dish that has the taste you are looking for.

That's part of the art of cooking, and why there are so many recipes out there

that are all for the same thing. So judging which recipe tastes better, becomes

very subjective. Given many different sets of judges in a cooking competition,

you're likely to end up with different rankings each time (you'd also find this

subjectiveness in any art form competition, like figure skating in the

Olympics). It's much less subjective when you take a basket ball game for

example, the team with the most points at the end wins. Or back to the Olympics

example if you took any timed event, such as bobsleding, it's purely objective,

and the winner is clear.

 

Another thing that seems to be an issue is studies usually try to lump people

together in a group according to western diagnosis (ie athsma or high blood

pressure or diabetes), which is going to fundamentally alter conclusions and

give inconsistent widely varying results. Most TCM practitioners realize that

western diagnoses really don't play a part in a TCM diagnosis except to possibly

confirm a general pattern. It would be just as misplaced to try to study

western medicine from TCM diagnosis criteria.

 

Here is asthma for example, one western condition, and 3 TCM presentations, from

heat, from cold and from deficiency (of which they mention three types, Lung,

Spleen, and Kidney))

http://www.acupuncture.com/conditions/asthma.htm

 

Here is an example of a study that used western diagnosis and methods that found

this 3 herb combo (ASHMI)was effective for asthma and didn't have the side

effects that prednisone has.

http://www.acupuncture.com/newsletters/m_aug07/chinese_herbal_asthma.htm

 

I've seen/heard of some studies that take and make a standard before hand and

educate the practitioners as to what they want called what in the study (for

example what color is a pink or a purple tongue and what counts as a thick or

thin coating). In these types of studies they tend to get more consistent

diagnoses by standardizing some of the subjective stuff.

 

Also, as in western medicine, there is very rarely a textbook case where the

individual only has this one condition and no comorbidities. So you have to

design a study that isolates these as much as possible in the over all picture.

Bottom line is creating a study for TCM stuff is very in depth, and there are

many subjective aspects to it that would need to be isolated to produce a good

study.

 

That and research studies are basically an empirical tool, and shine when

testing empirical qualities. They have a much harder time assessing subjective

or more artistic qualities.

[Guest guest]

Hello again

Thank you for all the elaborate answers

 

There are many pitfalls with the RCT so popular in mainstream science.That shows

that we can never take the result of those trials as absolute facts, but what

other method do we have to judge so many varied claims about efficacy of a

treatment. In the field of medicine quackery is by no means rare. So there

should be a " standard " for accepting or rejecting a treatment. If not RCT , then

what?

We should remember that patients are sometimes in such a desperate situation

that they may trust whoever who claims to cure them.But we, as medical

community,whether conventional or alternative, should help them find the right

way. Suppose that one of your friends asks you about an herbal formula, or a

massage therapy, or a hands-on energy therapy for a specific disease? How will

you answer him/her?

 

Besides, by putting CM in the field of art, we are deprived of predictability of

a treatment. When a patient comes to you, how often are you sure about the

outcome of your treatment?

 

Regards

Saba Hoda MD

[Guest guest]

Hello everybody,

I have followed this discussion with interest and I am impressed by the

eloquence and excellent thought processes that I have seen. With reference to

our learned colleague Saba Hoda, I agree that RCT are necessary, but in response

to his question  regarding a response to a friend presenting with a specific

disease, in the first instance  I am replying as a Traditional

practitioner and acupuncturist.

 

It has been quite correctly mentioned in a previous email, that a Western

diagnosis can represent many TCM diagnoses and it is for this very reason that a

patient may receive a varied response from a number of TCM doctors, however my

answer to the question would be based on my personal experience of treating

that problem previously, if I felt that I had a point prescription/ or herbal

formula  that could work,  I would offer to treat them, but always after he

had first spoken with his GP and found out whether he/she could treat the

disease successfully.

 

A particular example is Irritable Bowel Syndrome, possibly idiopathic, and

generally unsuccessfully treated by Western Medicine, in my experience. I

have on the other hand have successfully treated many people presenting with

what we in TCM could diagnose as Liver invading the Spleen, and these patients

have without  exception been diagnosed as sufferers of IBS.

 

In conclusion, WM and alternative medicine can and should co-exist for the

benefit of all. If a patient needs surgical intervention, then WM is the master,

however if a patient wants holistic medicine then so be it.

 

Let us embrace our medical differences and not spend our lives trying to

discredit one another, after all the patient is the one who loses the most.

 

Regards

 

Andrew Colombini BSc. (Hons) TCM MBAcC

 

 

[Guest guest]

Hi all,

 

Just to add a few points to the question of why there is no RCT of Chinese

herbal medicine.

 

There is plenty of research, and I mean thousands and thousands of studies.

However they are often not in the English language, but in Chinese. Also,

many of them (can't give you a percentage, but it is significant) are

somewhat bogus. Of course, biomedical research can be tweaked to produce

better numbers too. However many researchers don't take Chinese research too

seriously, and for good reason.

 

Still, many Chinese peer-reviewed journals are indexed by PubMed, I'm

assuming that these have been vetted to insure that the content is better

than some of the research that has come out of China in the past.

 

As for finding decent research in Asian herbal medicine, I think that the

Japanese are quite up to speed with the quality and legitimacy of their

medical research. And they've done a lot of work on Chinese herbal formulas,

which they call " Kampo medicine " .

 

Free full-text articles:

http://www.ncbi.nlm.nih.gov/pmc?term=kampo%20medicine

Abstracts: http://www.ncbi.nlm.nih.gov/pubmed?term=kampo%20medicine

 

Next, polypharmacy (formulas with multiple herbs) is quite difficult to

research well. Herbal medicines are not (yet?) standardized to a potency. I

understand that most herbs have a chemical signature used in the

identification stage of the extraction process, but that doesn't always (or

ever?) actually speak of potency, especially when you consider how a given

herb can have widely divergent actions, probably due to more than one

constituent ingredient being active for a given action.

 

So, researching formulas can be difficult, however the Chinese (and this

represents much more legitimate research) have looked at their herbs through

biomedical eyes for years and many many of their herbs constituent

ingredients are described in Western terms such as the

berberine<http://en.wikipedia.org/wiki/Berberine>in Huang Qin (Scute)

and Huang Lian (Coptis) having anti-biotic functions.

This list could fill a book. There is no question that herbs have

reproducible actions due to specifically identified active ingredients.

 

More below:

 

On Wed, Mar 10, 2010 at 7:05 AM, sabahoda <sahomd wrote:

 

>

>

> So there should be a " standard " for accepting or rejecting a treatment. If

> not RCT , then what?

>

Chinese medicine is said to be easy to learn, but difficult to practice. it

is also called an " experiential medicine " meaning that older practitioners

who have had a chance to try this stuff out tend to be better than the

newbies coming out of school. This is somewhat contrary to the Western model

that believes modern innovation and education is more important than

experience.

 

Asian (Confucian) culture also favors age, the assumption is that the older

you get, the wiser you get and as such the better a practitioner you become.

 

But we in the West have some herbal remedies that are widely accepted, but

not researched too. In the US we have a sort of cultural recognition of the

value of chicken soup in the treatment of the common cold or flu. This is

actually a folk remedy that goes back to a Jewish

rabbi<http://en.wikipedia.org/wiki/Maimonides>in the 12th century.

 

So, I decided to look up any RCTs that actually proved that chicken soup has

any particular medical benefits. What I found was more scanty than most

Chinese herb research. I found only four studies.

 

1. The first was a commentary about how nobody has researched it because

everybody knew it worked, having used it for hundreds of years.

2. The next was a study that showed movement of neutrophils in the lung

tissues, which is consistent with an immune response.

3. Finally, there were a few reports of adverse events, all of which were

due to " hypernatremia <http://en.wikipedia.org/wiki/Hypernatremia> " or

too much salt in the blood. This is kind of funny to me, because it suggests

that the problem wasn't the chicken soup as much as the cook who was

seasoning it with too much salt.

 

 

The point here is that chicken soup has not been deeply studied because the

culture already accepts its efficacy. Asian culture doesn't ask for these

RCTs, on herbal medicine, they don't need to.

 

But that's no excuse. The fact is, we outside of China do have to initially

take something of a leap-of-faith. I myself tend to be on the skeptical side

and don't adopt everything I hear just because it is Chinese, though if it

has withstood the test of time, that's worth some of my trust.

 

> We should remember that patients are sometimes in such a desperate

> situation that they may trust whoever who claims to cure them.But we, as

> medical community,whether conventional or alternative, should help them find

> the right way.

>

Absolutely, and we herbalists in the US often have a financial incentive to

sell herbs because very few just write a prescription and have the patient

go elsewhere for the herbs. So there is an economic conflict of interest

there.

 

But to answer your question, our ability to help patients find their way is

always going to be through our own eyes and what we consider legitimate

proof. What is legitimate to me will be different from you, and everybody

else. So, ultimately we have to refer based on our own personal

understandings. I can however direct you to an article that talks about

liability issues for MDs who refer to CAM practitioners. This is probably

more of an American issue as lawsuits are kind of common here among

professions that are perceived as having deep-pockets (meaning lots of money

for the taking.)

 

> Suppose that one of your friends asks you about an herbal formula, or a

> massage therapy, or a hands-on energy therapy for a specific disease? How

> will you answer him/her?

>

I have experience with all three of those items, and have in my own mind, an

idea of what each is good for. There are many CAM activities that I think

are 100% bogus too. Still, I think that much of what drug therapy achieves

is also placebo. The question then becomes, which is the most efficacious,

cost-effective, and safe placebo. I have no problem with placebo.

 

Anti-depressants promote themselves as achieving results for 25% more people

than placebos. However, that is skewing the numbers. When they state that,

it is because they're removing everybody who didn't respond to either

placebos or drugs. (Note that the numbers below are somewhat invented, but

the trend is correct.)

 

So, the drug company will say:

Placebo helped: 75%

Drug helped: 100%

 

But in reality it was:

Placebo helped: 33%

Drug helped: 42%

Nothing helped: 58%

 

Both of these takes on the data are true, but one skews things by removing

those who didn't respond to either.

 

My point being that while it is GREAT to have RCT numbers to consider when

in practice (I sincerely wish I DID have these numbers to practice with)

they are nonetheless questionable. As the saying goes " statistics don't lie,

but statisticians do. "

 

>

> Besides, by putting CM in the field of art, we are deprived of

> predictability of a treatment. When a patient comes to you, how often are

> you sure about the outcome of your treatment?

>

Ah, the bane of my existence.

 

But with experience comes a certain recognition of body types, personality

types (which predicts compliance as much as pathology), patterns, etc. There

are some people whom I see and I provide a very positive prognosis because

of personal experience, others I tell them to try it for a few weeks and

we'll see if anything changes.

 

I am never sure that what I do will work, and this is an exceedingly

difficult issue to get past. As I mentioned above: Chinese medicine is easy

to learn, but difficult to practice. There's a corollary to that: Western

medicine is difficult to learn, but easy to practice.

 

You are correct that RCTs can help guide your clinical practice, and more

importantly, you can give your patients hard numbers (or at least have

access to them yourself) and we don't have that particular safety net in

Chinese medicine. I wish we did.

 

This is one reason that I'm taking Kampo medicine more seriously nowadays,

because they have more research to consider. It helps a lot.

 

-al.

 

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao

 

 

 

[Guest guest]

Chinese Traditional Medicine , Al Stone <al wrote:

> This is somewhat contrary to the Western model

> that believes modern innovation and education is more important than

> experience.

 

And this is a wrong and dangerous concept. I myself am a professional Software

Developer (I studied Chinese medicine on my spare time) and my experience and

skill level are counted before anything else, even though all I can screw up is

a web page, not somebody's health and body.

 

Even though the research on a drug is done, before prescribing this drug a

doctor has to diagnose the patient and also determine if there are any

contradictions to this drug, side effects, problems with the long term use etc.

Sure, there are tests but the doctor still has to order the right ones in a

timely manner and interpret the results of multiple and contradictory tests.

I've read somewhere that #3 cause of death is misdiagnosis/wrong prescriptions.

 

My Mom was an MD with 4 decades of experience before she retired, highly rated

among the patients. She's able to determine health problems/medical history of a

person by their appearance. I followed her recommendations when choosing

doctors. Unfortunately, I cannot do it anymore as I moved away. There is a big

difference between a doctor who quickly identifies the problem, orders very few

tests, and gives good recommendations before any tests and a doctor crapshooting

tests and pills for several months until the patient gets tired and goes away.

It's sad to see that the ART and intuition of medicine is being lost.

[Guest guest]

Couldn't agree more with Andrew on this.

 

The 'war' between alternative and complimentary medicines seems only to harm

patients and practitioners and in my view is always a symptom of dogma and

ignorance on both sides.

 

Great discussion though I am very interested in this and have enjoyed the

valuable resources that have been put out.

 

Paul

 

On 10 March 2010 16:30, Andrew Colombini <andycolombini wrote:

 

>

>

> Hello everybody,

> I have followed this discussion with interest and I am impressed by the

> eloquence and excellent thought processes that I have seen. With reference

> to our learned colleague Saba Hoda, I agree that RCT are necessary, but in

> response to his question regarding a response to a friend presenting with a

> specific disease, in the first instance I am replying as a Traditional

> practitioner and acupuncturist.

>

> It has been quite correctly mentioned in a previous email, that a Western

> diagnosis can represent many TCM diagnoses and it is for this very reason

> that a patient may receive a varied response from a number of TCM doctors,

> however my answer to the question would be based on my personal experience

> of treating that problem previously, if I felt that I had a point

> prescription/ or herbal formula that could work, I would offer to treat

> them, but always after he had first spoken with his GP and found out whether

> he/she could treat the disease successfully.

>

> A particular example is Irritable Bowel Syndrome, possibly idiopathic, and

> generally unsuccessfully treated by Western Medicine, in my experience. I

> have on the other hand have successfully treated many people presenting with

> what we in TCM could diagnose as Liver invading the Spleen, and these

> patients have without exception been diagnosed as sufferers of IBS.

>

> In conclusion, WM and alternative medicine can and should co-exist for the

> benefit of all. If a patient needs surgical intervention, then WM is the

> master, however if a patient wants holistic medicine then so be it.

>

> Let us embrace our medical differences and not spend our lives trying to

> discredit one another, after all the patient is the one who loses the most.

>

> Regards

>

> Andrew Colombini BSc. (Hons) TCM MBAcC

[Guest guest]

On Thu, Mar 11, 2010 at 8:47 AM, Paul Burdon <paul wrote:

 

>

>

> The 'war' between alternative and complimentary medicines seems only to

> harm

> patients and practitioners and in my view is always a symptom of dogma and

> ignorance on both sides.

>

Still, the desire to see studies is completely legitimate.

 

By the way, of all the things I've written over the past few days, the

comment about Western medicine favoring the new-and-improved is the most

opinion and least hard data of all my statements.

 

I think there is a natural tendency to want to see evidence for anything

new. I'm the exact same way with Chinese medicine. I hear new-and-improved

claims each and everyday coming from my industry too. Quantum this and nano

that...

 

But there are some unnecessarily closed minds too. I'm reminded of something

a patient once said to me. He wanted to see me for herbs for PTSD or post

traumatic stress disorder. It's been a few years, but as I recall, he'd been

in Iraq in 2004 or so. He was understandably shaken up by what he'd gone

through.

 

So, I began to interact with him to get a sense of how his PTSD presents, so

I could differentiate it based on TCM signs and symptoms. Do we begin by

calling this anxiety? fright? " qi wild " ? Insomnia?

 

At one point, however he mentioned that his psychiatrist did not support his

decision to approach his PTSD with Chinese medicine because there was no

PTSD in ancient China and thus there couldn't be any " traditional "

treatments for a " contemporary " disease.

 

That's an incredibly ignorant thing to say. Humanity has suffered from the

after-affects of emotional trauma since we were being stalked by lions in

Africa.

 

The idea that PTSD is something new really tweaked me. After all, the

Chinese DID invent gunpowder. Sheesh.

 

-al.

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao

 

 

 

[Guest guest]

That's the psychiatric mind set.

 

Behaviour is chunked into boxes and then the box is made into a

disoreder and then attempts are made to fix the disorder.

No sense of continuum.

 

It's mental! (no pun intended)

 

 

Paul

 

 

-

 

On 11 Mar 2010, at 17:27, Al Stone <al wrote:

 

> On Thu, Mar 11, 2010 at 8:47 AM, Paul Burdon

> <paul wrote:

>

> >

> >

> > The 'war' between alternative and complimentary medicines seems

> only to

> > harm

> > patients and practitioners and in my view is always a symptom of

> dogma and

> > ignorance on both sides.

> >

> Still, the desire to see studies is completely legitimate.

>

> By the way, of all the things I've written over the past few days, the

> comment about Western medicine favoring the new-and-improved is the

> most

> opinion and least hard data of all my statements.

>

> I think there is a natural tendency to want to see evidence for

> anything

> new. I'm the exact same way with Chinese medicine. I hear new-and-

> improved

> claims each and everyday coming from my industry too. Quantum this

> and nano

> that...

>

> But there are some unnecessarily closed minds too. I'm reminded of

> something

> a patient once said to me. He wanted to see me for herbs for PTSD or

> post

> traumatic stress disorder. It's been a few years, but as I recall,

> he'd been

> in Iraq in 2004 or so. He was understandably shaken up by what he'd

> gone

> through.

>

> So, I began to interact with him to get a sense of how his PTSD

> presents, so

> I could differentiate it based on TCM signs and symptoms. Do we

> begin by

> calling this anxiety? fright? " qi wild " ? Insomnia?

>

> At one point, however he mentioned that his psychiatrist did not

> support his

> decision to approach his PTSD with Chinese medicine because there

> was no

> PTSD in ancient China and thus there couldn't be any " traditional "

> treatments for a " contemporary " disease.

>

> That's an incredibly ignorant thing to say. Humanity has suffered

> from the

> after-affects of emotional trauma since we were being stalked by

> lions in

> Africa.

>

> The idea that PTSD is something new really tweaked me. After all, the

> Chinese DID invent gunpowder. Sheesh.

>

> -al.

>

> --

> , DAOM

> Pain is inevitable, suffering is optional.

> http://twitter.com/algancao

>

>