Essential Oils

September 9, 2009

Thanks Brian. Yes, what I was talking about in my post was the doctrine of

informed consent. This is a key element of the so-called Four Universal

Principles of Bioethics adopted after the Nazi " medical experiment " of WWII. If

I remember correctly, informed consent is a corollary of the principle of

independence -- that patients have a right to decide for themselves what

treatment they will receive. However, to exercise that right, they need all the

relevant information to weigh their options. This should be a part of every

class on medical ethics. IMO, any such class lacking a discussion of the four

above-mentioned principles is severely lacking and ill-informed.

September 9, 2009

" Where is the line drawn on prescription modification if we are strictly

following EBM guidelines? "

Common sense, albeit the least common of all human senses.

As the Grand Lama in Lost Horizons said: " Moderation in all things, including

moderation. "

No need to throw the baby out with the bathwater.

September 9, 2009

Bob,

I like it. Thanks.

It seems to me that EBM relative to AOM needs further discussion. The faculty at

AOMA landed upon " evidence and experience based medicine " as a way to make EBM

educational objectives relevant for our program.

EBM is used to determine policy. Who is the decider? By that I mean, who decides

what quality evidence is? Where are the resources placed? And who benefits?

Will

, " pemachophel2001 " <bob wrote:

>

> " Where is the line drawn on prescription modification if we are strictly

following EBM guidelines? "

>

> Common sense, albeit the least common of all human senses.

>

> As the Grand Lama in Lost Horizons said: " Moderation in all things, including

moderation. "

>

> No need to throw the baby out with the bathwater.

>

September 10, 2009

Will,

That is an interesting story about the addition of Kava in to Chai Hu Mu Li Long

Gu Tang in Taiwan. I will look for that information. Eric, have you seen

anything around this. Kava is one of the herbs in the first volume of my book,

so any information around how it is used in Taiwan would be very interesting and

I would like to include it in the second volume as an addendum.

Bob, Brian, et al,

While I do not disagree with you that informed consent is an extremely important

ethical matter, and I am not categorically opposed to telling my patients that I

use Western herbs in my practice, I disagree that it is experimental. If this

was true then everything that we do is experimental. Can you be absolutely sure

that you have made the correct diagnosis and have prescribed the right formula

with perfect modifications?

When I use Western herbs in practice it is either as a simple/combination that

is given separately as a tincture (sometime this is a combination of Western and

Chinese herbs) or they are combined into a larger formula, based on a standard

formula. Can you be sure that every combination of herbs you give has been given

before and therefore you know any and all the possible outcomes? Are the human

ecosystems of your patients the same as the patients of Yuan Dynasty China?

The herbs I use have a long history of use. Most of them have abundant

literature, often dating back well over a 1000 years. They are primarily used as

modifications to address certain symptoms or symptom patterns. Over my years

working in Michael Tierra's clinic, as well as with a number of other

practitioners in Santa Cruz who use some Western herbs, along with studying with

some very good Western herbal teachers such as Christopher Hobbs (who is also an

L.Ac.) and David Hoffmann, combined with a fever for reading everything I can

possibly find about these herbs (both historical and modern) lead me to feel

very comfortable using these herbs in my practice. I feel like I know them as

well as (or even better than) I know the " Chinese " herbs found in the Bensky et

al. MM. Finally, the manuscript was read by a number of my colleagues who

commented on and in some cases influenced the final product.

So, I don't really consider the use of these herbs as experimental per se. What

is experimental is the way I describe the herbs, the jargon of Chinese medicine.

However, when you read the book, you will see me state very clearly that I

consider this the next step, not the final word. In fact, this is true in

Chinese medicine. Are we to think the the final word has been laid down about

how to use herbs from China and how to use them to modify formulas? If so, the

medicine is dead. Is that what we should believe?

Also, when you read the book you see that, just like in a Chinese materia

medica, an herb is described by its function and then by its indications. The

function is, I will admit, somewhat experimental. However, the indications are

not! These are the indications that can be found throughout the literature for

these plants. The construction of the language of Chinese medicine, the jargon

if you will, is used to teach, understand, and apply the system of Chinese

medicine. This is, of course, extremely important. But, if you read several

Chinese materia medicas you will see that there is not complete agreement about

most herbs. So, to suggest that Chinese medicine and all its theories and

therapies are absolutely agreed upon is, well, simply not true.

Finally, again, if anyone has any specific comments or questions about what I

have written feel free to contact me, either publicly or privately and I will do

my best to address the comments or answer the questions.

In Good Health,

Thomas

September 10, 2009

Thomas you wrote,

" Are we to think the final word has been laid down about

how to use herbs from China and how to use them to modify formulas? If so, the

medicine is dead. Is that what we should believe? "

This is an interesting thought you have, as many believe in Chinese medicine

that it is not about trying to figure out endless extra ways that formulas may

be modified and in some way " out smart " the ancients. Many believe that it is

more about becoming efficient at diagnosis so that one knows how to " properly

fit the key " , ie use the endless supply of herbs and formula that is available

to us already. If the correct diagnosis and application of an herbal formula,

that has been used for centuries in the same fashion, still works to alleviate

and even cure certain suffering, then how can that be seen as a " dead " medicine?

To me there is nothing wrong with incorporating western herbs into your chinese

herbal recipes, even if it is purely based on empirical usage. I believe, as Bob

mentioned, that it is just about communicating properly to your patients what

you are doing. Is it something you made up? Is it something you learned from a

teacher? Or read in a book?

I always try to explain the actions of the herbal formula I give my patients. I

tell them where I learned such styles of treatment, and whether it is " new "

theory or if it is " traditional " .

I even do this with acupuncture. For example, I tell all my IVF patients when

they come in for acupuncture that what I am offering them is new and based on

modern research studies. That the point combination showed good benefit

according to the study, but they are not necessarily traditional in any sense,

as we didn't have IVF 2000 years ago!

When I use Mazin's creams for psoriasis (which work amazingly well), I tell them

that they are the product of 25 years of experience using traditional Chinese

herbal preparations

combined with the best knowledge in modern western cream manufacturing.

Communication is key.

T

, " "

wrote:

>

> Will,

>

> That is an interesting story about the addition of Kava in to Chai Hu Mu Li

Long Gu Tang in Taiwan. I will look for that information. Eric, have you seen

anything around this. Kava is one of the herbs in the first volume of my book,

so any information around how it is used in Taiwan would be very interesting and

I would like to include it in the second volume as an addendum.

>

> Bob, Brian, et al,

>

> While I do not disagree with you that informed consent is an extremely

important ethical matter, and I am not categorically opposed to telling my

patients that I use Western herbs in my practice, I disagree that it is

experimental. If this was true then everything that we do is experimental. Can

you be absolutely sure that you have made the correct diagnosis and have

prescribed the right formula with perfect modifications?

>

> When I use Western herbs in practice it is either as a simple/combination that

is given separately as a tincture (sometime this is a combination of Western and

Chinese herbs) or they are combined into a larger formula, based on a standard

formula. Can you be sure that every combination of herbs you give has been given

before and therefore you know any and all the possible outcomes? Are the human

ecosystems of your patients the same as the patients of Yuan Dynasty China?

>

> The herbs I use have a long history of use. Most of them have abundant