clinical question for experienced practitioners

[Guest guest]

On 12/31/06, sharon weizenbaum <sweiz wrote:

>

> My question - is there anything about the fact that they are 50 and

> around the age of menopause that effects your treatment? In other

> words, if you took the fact that they are in the age arena of

> menopause completely out of the picture and then treated what you

> see, would your treatment be different than if this information was

> in the picture?

>

 

 

 

 

 

 

 

 

I still treat what I see, regardless of age. If the indications suggest

deficiency I'll supplement. If there is more excess, I'll drain. If there is

both excess and deficiency, I'll do my best to address both as is

appropriate to the presentation.

 

Age may inform my assessment of etiology in some instances and that can come

in handy for purposes of lifestyle modifications or explaining the cause to

a patient, but when it comes to acupuncture or herbal therapies, I still

treat what I see and that doesn't include the age (as an assumption of

anything in particular.)

 

Remember, the seventh jing cycle is the new sixth.

 

--

 

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

I guess I should say, no it doesn't make a difference but in truth I can't take

age out of the

equation. If they were younger I may be more likely take in other causes as the

probable

issue (such as blood deficiency). Call me a hack but all these symptoms have

different

protocols that I would use. For example I wouldn't go directly to Kidney Yin Xu

with

excessive bleeding and insomnia although I might with hot flashes and insomnia.

I don't

automatically associate all symptoms at 50 with " menopause " or Kidney Yin Xu

just as a

younger woman or man with the same symptoms obviously isn't going through

" menopause " .

 

doug

 

 

, sharon weizenbaum <sweiz wrote:

>

> So, here's my question for practitioners after all this talk about

> menopause.

>

> When a patient comes in saying that they have issues relating to

> menopause, we are trained to treat what we see. What we see varies

> depending on the patient. One might have hot flashes with no sweat.

> One might have night sweats without much heat. Another might have

> excessive bleeding and insomnia. Another might have low libido and

> vaginal dryness......All of these patients are about 50 and all are

> relating their symptoms to menopausal changes to themselves. So, you

> do your differential diagnosis and come up with a variety of patterns

> - one includes kidney yin vacuity, another kidney yang vacuity and a

> couple don't show any kidney signs but are more related to Qi

> depression - let's say.

>

> My question - is there anything about the fact that they are 50 and

> around the age of menopause that effects your treatment? In other

> words, if you took the fact that they are in the age arena of

> menopause completely out of the picture and then treated what you

> see, would your treatment be different than if this information was

> in the picture?

>

> Thanks!

>

> Sharon

>

>

> Sharon Weizenbaum

> 86 Henry Street

> Amherst, MA 01002

> 413-549-4021

> sweiz

> www.whitepinehealingarts.com

>

>

>

>

>

[Guest guest]

if you took the fact that they are in the age arena of

menopause completely out of the picture and then treated what you

see, would your treatment be different than if this information was

in the picture?

_____________________

 

Hi Sharon,

 

Assuming the objective is root treatment my answer is no, my treatment

would remain the same.

 

Joe

[Guest guest]

Sharon (and group),

 

 

 

This question gets to the heart of one of Volker's points and one of the

issues with CM. Meaning, do we treat the pattern that we see? Or do we treat

the disease that they present with? Or do we treat both? Well the obvious

answer (to me) is that we (almost always) should treat both. IMHO, one

cannot just treat what they see in regard to just the PATTERN (zang-fu)

without regard to the disease at hand (or visa versa). But the reality is

that one sees approaches on both ends of the spectrum, meaning there are

those who treat the pattern without understanding the disease, and others

who just treat the disease without regard to the pattern(s).

 

 

 

But the question that Volker is asking is what is this disease label of

menopause? Is it a disease? Is Chinese medicine's understanding of it based

on historical record or a modern, medically-influenced understanding? Is

there any validity to claiming that a woman's decline is due to kidney yin

deficiency? Clearly there is a push for this latter approach. His point is

that this understanding is only a modern concept, and it is dishonest to say

otherwise. It is not traditional CM, but TCM from the 60's.

 

 

 

Bob asked how our success is in treating Menopause. Most answered " great! "

Well I am with Volker, I have had problems, and many times it was because I

was getting caught up with the idea that the Kidneys must be in decline

(honoring the disease mechanism). This is not just a mistake on my part, but

clearly one that comes from a modern understating of the " disease " process

at hand. For example, one can consult the textbooks and this idea (menopause

having a kidney xu component) is present. Furthermore, one can read modern

case studies (menopause) in which the diagnosis (and treatment) contains

kidney yin deficiency with zero kidney signs, obviously purely based on the

understanding of what " Menopause " means. Therefore some in China also

believe this concept to be true in the clinic. As we know many doctor's

training is fully integrated with Western biological understandings. I think

Volker does a good job in tracing the history of how the menopause disease

heading came about and how it may not be a part of the Chinese medical

tradition, as many like to think. As an experiment I asked multiple students

what their understanding of menopause is, and all said that it related to

kidney decline (specifically kidney yin). Now the real question is does

this approach pan out in the clinic? Not can (any) CM treat the symptoms of

menopause successfully.

 

 

 

Furthermore, to just say we should treat what we see, is a double edged

sword. Of course it is true, but also leads to sloppy diagnostic approaches.

Meaning, it is real easy to see whatever one wants. It is also real easy to

disregard the disease process and just treat the pattern. But the question

is, do we consider this modern term, " menopause " as a disease, like lets say

hepatitis, or, lets say, cough? It really opens up a whole can of worms. In

regard to this menopause discussion we must look at what Volker is examining

to answer these questions. Meaning, what is this disease heading about and

is there research (or history) to suggest what many of the Chinese are

purporting, that is, equating menopause to: a) a disease in and of itself,

and b) kidney yin deficiency? Bob has a menopause book with case studies.

At a quick glance, no matter what the presentation, it seems that one always

(in addition to other patterns) nourishes yin (kidneys) even when there are

no yin xu signs. Therefore this does suggest that many modern doctors DO

equate menopause (or woman at the age of 50 with symptoms) to yin xu

(kidneys). It does suggest that this approach works for these doctors. Or it

may suggest that Volker's point is made, meaning it is now ingrained into

the mainstream thought (for better or worse). For clarity sake, CM is a

large world, and I am not suggesting that everyone thinks or practices in

this way. One can clearly find examples where one treats menopause

successfully w/o kidney yin supplementation.

 

 

 

Either way, it is obvious to me that there is a active AGENDA by the many

Chinese to update this medicine and some would say, sell this medicine to

the west. I agree with Volker that in this process Chinese medicine has

been simplified and modernized to a point where the standard party line may

just be inaccurate. Therefore, I don't disagree with his use of

colonization. It is stripping itself of its real strength and settling for a

biomedical approach that many times just is not effective or representative

what many CM doctors are actually doing in the clinic. For the record, I

have seen this simplified version fail in the clinic. One may chalk it up to

the wrong dx, and that is what it is, but more importantly it is IMO due to

misleading assumptions about a given disease, like menopause = kid yin xu.

 

 

 

Finally, a recent example of this colonization is a current book I purchased

on R.A. - it is one of the Shanghai (English and Chinese) texts (2004). This

book is part of series that is designed for " educating " westerners, much

like CAM. I found the translation to be much better than the attempts of

the past. But the material is laughable. It starts off with a biomedical

explanation of RA and then jumps into a few common patterns and treatments.

Very little for explanation and understanding of the pathomechanisms,

understanding herb choices and modifications, as well as individualizing for

the patient etc., etc. It offers no interesting way to think about things.

It is a .. COOKBOOK. and a bad one at that. This seems to be typical of most

of these modern books geared toward westerners.

 

 

 

One may say, hey this is just a starting point, one still has to treat what

they see. I say that is BS. This book is supposed to be a specialty book,

specific for one disease, yet it gives a TCM explanation suited for 2nd year

students. It is IMO purposely dumbed for the sale to " Westerners " . I have

heard many say that Chinese just can't believe we can handle the " real "

medicine. I do think that many believe this, but as Sharon pointed out,

students will learn if you can teach them.

 

 

 

But the real issue here comes down to efficacy. If, as Volker has suggested,

the authors that started writing that menopause = kid yin xu, a) do not

treat this way, b) have not actually tested this theory, then we MUST

question where it comes from. Does this approach work NOW? Anecdotal cases

from acu + herb (+ who knows whatever else) style treatments give no

evidence that this approach works or doesn't. We should just be critical of

what we are being fed, and not just take everything hook line and sinker.

Thanks Volker! It is very tricky subject and I don't have any real answers,

but I am not about to just sign up for this over-simplified version of CM as

I unfortunately :-) already know better.

 

 

 

My 2 cents,

 

 

 

-

 

 

 

_____

 

 

On Behalf Of

Sunday, December 31, 2006 12:05 PM

 

Re: clinical question for experienced practitioners

 

 

 

I guess I should say, no it doesn't make a difference but in truth I can't

take age out of the

equation. If they were younger I may be more likely take in other causes as

the probable

issue (such as blood deficiency). Call me a hack but all these symptoms have

different

protocols that I would use. For example I wouldn't go directly to Kidney Yin

Xu with

excessive bleeding and insomnia although I might with hot flashes and

insomnia. I don't

automatically associate all symptoms at 50 with " menopause " or Kidney Yin Xu

just as a

younger woman or man with the same symptoms obviously isn't going through

" menopause " .

 

doug

 

@ <%40>

, sharon weizenbaum <sweiz wrote:

>

> So, here's my question for practitioners after all this talk about

> menopause.

>

> When a patient comes in saying that they have issues relating to

> menopause, we are trained to treat what we see. What we see varies

> depending on the patient. One might have hot flashes with no sweat.

> One might have night sweats without much heat. Another might have

> excessive bleeding and insomnia. Another might have low libido and

> vaginal dryness......All of these patients are about 50 and all are

> relating their symptoms to menopausal changes to themselves. So, you

> do your differential diagnosis and come up with a variety of patterns

> - one includes kidney yin vacuity, another kidney yang vacuity and a

> couple don't show any kidney signs but are more related to Qi

> depression - let's say.

>

> My question - is there anything about the fact that they are 50 and

> around the age of menopause that effects your treatment? In other

> words, if you took the fact that they are in the age arena of

> menopause completely out of the picture and then treated what you

> see, would your treatment be different than if this information was

> in the picture?

>

> Thanks!

>

> Sharon

>

>

> Sharon Weizenbaum

> 86 Henry Street

> Amherst, MA 01002

> 413-549-4021

> sweiz

> www.whitepinehealingarts.com

>

>

>

>

>

[Guest guest]

So, here's my question for practitioners after all this talk about

menopause.

 

When a patient comes in saying that they have issues relating to

menopause, we are trained to treat what we see. What we see varies

depending on the patient. One might have hot flashes with no sweat.

One might have night sweats without much heat. Another might have

excessive bleeding and insomnia. Another might have low libido and

vaginal dryness......All of these patients are about 50 and all are

relating their symptoms to menopausal changes to themselves. So, you

do your differential diagnosis and come up with a variety of patterns

- one includes kidney yin vacuity, another kidney yang vacuity and a

couple don't show any kidney signs but are more related to Qi

depression - let's say.

 

My question - is there anything about the fact that they are 50 and

around the age of menopause that effects your treatment? In other

words, if you took the fact that they are in the age arena of

menopause completely out of the picture and then treated what you

see, would your treatment be different than if this information was

in the picture?

 

Thanks!

 

Sharon

 

 

Sharon Weizenbaum

86 Henry Street

Amherst, MA 01002

413-549-4021

sweiz

www.whitepinehealingarts.com

 

 

 

 

 

[Guest guest]

But the real issue here comes down to efficacy. If, as Volker has suggested,

the authors that started writing that menopause = kid yin xu, a) do not

treat this way, b) have not actually tested this theory, then we MUST

question where it comes from. Does this approach work NOW? Anecdotal cases

from acu + herb (+ who knows whatever else) style treatments give no

evidence that this approach works or doesn't. We should just be critical of

what we are being fed, and not just take everything hook line and sinker.

Thanks Volker! It is very tricky subject and I don't have any real answers,

but I am not about to just sign up for this over-simplified version of CM as

I unfortunately :-) already know better.

>>>>>>

Jason

This is what i have called practicing from theory for years now (patients bodies

never read text books). TCM pattern dx has been just that in many fields, not

just menopause. It always amazes to me that practitioner ignore what is in front

of them in favor of theory and beliefs.

 

 

 

 

Oakland, CA 94609

 

 

-

Sunday, December 31, 2006 4:17 PM

RE: Re: clinical question for experienced practitioners

 

 

Sharon (and group),

 

This question gets to the heart of one of Volker's points and one of the

issues with CM. Meaning, do we treat the pattern that we see? Or do we treat

the disease that they present with? Or do we treat both? Well the obvious

answer (to me) is that we (almost always) should treat both. IMHO, one

cannot just treat what they see in regard to just the PATTERN (zang-fu)

without regard to the disease at hand (or visa versa). But the reality is

that one sees approaches on both ends of the spectrum, meaning there are

those who treat the pattern without understanding the disease, and others

who just treat the disease without regard to the pattern(s).

 

But the question that Volker is asking is what is this disease label of

menopause? Is it a disease? Is Chinese medicine's understanding of it based

on historical record or a modern, medically-influenced understanding? Is

there any validity to claiming that a woman's decline is due to kidney yin

deficiency? Clearly there is a push for this latter approach. His point is

that this understanding is only a modern concept, and it is dishonest to say

otherwise. It is not traditional CM, but TCM from the 60's.

 

Bob asked how our success is in treating Menopause. Most answered " great! "

Well I am with Volker, I have had problems, and many times it was because I

was getting caught up with the idea that the Kidneys must be in decline

(honoring the disease mechanism). This is not just a mistake on my part, but

clearly one that comes from a modern understating of the " disease " process

at hand. For example, one can consult the textbooks and this idea (menopause

having a kidney xu component) is present. Furthermore, one can read modern

case studies (menopause) in which the diagnosis (and treatment) contains

kidney yin deficiency with zero kidney signs, obviously purely based on the

understanding of what " Menopause " means. Therefore some in China also

believe this concept to be true in the clinic. As we know many doctor's

training is fully integrated with Western biological understandings. I think

Volker does a good job in tracing the history of how the menopause disease

heading came about and how it may not be a part of the Chinese medical

tradition, as many like to think. As an experiment I asked multiple students

what their understanding of menopause is, and all said that it related to

kidney decline (specifically kidney yin). Now the real question is does

this approach pan out in the clinic? Not can (any) CM treat the symptoms of

menopause successfully.

 

Furthermore, to just say we should treat what we see, is a double edged

sword. Of course it is true, but also leads to sloppy diagnostic approaches.

Meaning, it is real easy to see whatever one wants. It is also real easy to

disregard the disease process and just treat the pattern. But the question

is, do we consider this modern term, " menopause " as a disease, like lets say

hepatitis, or, lets say, cough? It really opens up a whole can of worms. In

regard to this menopause discussion we must look at what Volker is examining

to answer these questions. Meaning, what is this disease heading about and

is there research (or history) to suggest what many of the Chinese are

purporting, that is, equating menopause to: a) a disease in and of itself,

and b) kidney yin deficiency? Bob has a menopause book with case studies.

At a quick glance, no matter what the presentation, it seems that one always

(in addition to other patterns) nourishes yin (kidneys) even when there are

no yin xu signs. Therefore this does suggest that many modern doctors DO

equate menopause (or woman at the age of 50 with symptoms) to yin xu

(kidneys). It does suggest that this approach works for these doctors. Or it

may suggest that Volker's point is made, meaning it is now ingrained into

the mainstream thought (for better or worse). For clarity sake, CM is a

large world, and I am not suggesting that everyone thinks or practices in

this way. One can clearly find examples where one treats menopause

successfully w/o kidney yin supplementation.

 

Either way, it is obvious to me that there is a active AGENDA by the many

Chinese to update this medicine and some would say, sell this medicine to

the west. I agree with Volker that in this process Chinese medicine has

been simplified and modernized to a point where the standard party line may

just be inaccurate. Therefore, I don't disagree with his use of

colonization. It is stripping itself of its real strength and settling for a

biomedical approach that many times just is not effective or representative

what many CM doctors are actually doing in the clinic. For the record, I

have seen this simplified version fail in the clinic. One may chalk it up to

the wrong dx, and that is what it is, but more importantly it is IMO due to

misleading assumptions about a given disease, like menopause = kid yin xu.

 

Finally, a recent example of this colonization is a current book I purchased

on R.A. - it is one of the Shanghai (English and Chinese) texts (2004). This

book is part of series that is designed for " educating " westerners, much

like CAM. I found the translation to be much better than the attempts of

the past. But the material is laughable. It starts off with a biomedical

explanation of RA and then jumps into a few common patterns and treatments.

Very little for explanation and understanding of the pathomechanisms,

understanding herb choices and modifications, as well as individualizing for

the patient etc., etc. It offers no interesting way to think about things.

It is a .. COOKBOOK. and a bad one at that. This seems to be typical of most

of these modern books geared toward westerners.

 

One may say, hey this is just a starting point, one still has to treat what

they see. I say that is BS. This book is supposed to be a specialty book,

specific for one disease, yet it gives a TCM explanation suited for 2nd year

students. It is IMO purposely dumbed for the sale to " Westerners " . I have

heard many say that Chinese just can't believe we can handle the " real "

medicine. I do think that many believe this, but as Sharon pointed out,

students will learn if you can teach them.

 

But the real issue here comes down to efficacy. If, as Volker has suggested,

the authors that started writing that menopause = kid yin xu, a) do not

treat this way, b) have not actually tested this theory, then we MUST

question where it comes from. Does this approach work NOW? Anecdotal cases

from acu + herb (+ who knows whatever else) style treatments give no

evidence that this approach works or doesn't. We should just be critical of

what we are being fed, and not just take everything hook line and sinker.

Thanks Volker! It is very tricky subject and I don't have any real answers,

but I am not about to just sign up for this over-simplified version of CM as

I unfortunately :-) already know better.

 

My 2 cents,

 

-

 

_____

 

On Behalf Of

Sunday, December 31, 2006 12:05 PM

Re: clinical question for experienced practitioners

 

I guess I should say, no it doesn't make a difference but in truth I can't

take age out of the

equation. If they were younger I may be more likely take in other causes as

the probable

issue (such as blood deficiency). Call me a hack but all these symptoms have

different

protocols that I would use. For example I wouldn't go directly to Kidney Yin

Xu with

excessive bleeding and insomnia although I might with hot flashes and

insomnia. I don't

automatically associate all symptoms at 50 with " menopause " or Kidney Yin Xu

just as a

younger woman or man with the same symptoms obviously isn't going through

" menopause " .

 

doug

 

@ <%40>

, sharon weizenbaum <sweiz wrote:

>

> So, here's my question for practitioners after all this talk about

> menopause.

>

> When a patient comes in saying that they have issues relating to

> menopause, we are trained to treat what we see. What we see varies

> depending on the patient. One might have hot flashes with no sweat.

> One might have night sweats without much heat. Another might have

> excessive bleeding and insomnia. Another might have low libido and

> vaginal dryness......All of these patients are about 50 and all are

> relating their symptoms to menopausal changes to themselves. So, you

> do your differential diagnosis and come up with a variety of patterns

> - one includes kidney yin vacuity, another kidney yang vacuity and a

> couple don't show any kidney signs but are more related to Qi

> depression - let's say.

>

> My question - is there anything about the fact that they are 50 and

> around the age of menopause that effects your treatment? In other

> words, if you took the fact that they are in the age arena of

> menopause completely out of the picture and then treated what you

> see, would your treatment be different than if this information was

> in the picture?

>

> Thanks!

>

> Sharon

>

>

> Sharon Weizenbaum

> 86 Henry Street

> Amherst, MA 01002

> 413-549-4021

> sweiz

> www.whitepinehealingarts.com

>

>

>

>

>

[Guest guest]

Theory and clinical reality are two sides of the same coin, and

always have been in Chinese medicine. There is faulty theory and

sophisticated and flexible theory. There is astute clinical vision,

and simplistic clinical vision.

 

 

On Dec 31, 2006, at 4:38 PM, wrote:

 

> This is what i have called practicing from theory for years now

> (patients bodies never read text books). TCM pattern dx has been

> just that in many fields, not just menopause. It always amazes to

> me that practitioner ignore what is in front of them in favor of

> theory and beliefs.

 

 

 

 

[Guest guest]

Thank you Sharon, as usual for bringing the discussion " gracefully " back to TCM

and pattern diagnosis...that is what I always appreciate about your posts! To

keep us focused on our own medicine.

 

Linda

-

sharon weizenbaum<sweiz

To:

< > ;

Chinese Medicine <Chinese Medicine\

@>

Sunday, December 31, 2006 8:28 AM

clinical question for experienced practitioners

 

 

So, here's my question for practitioners after all this talk about

menopause.

 

When a patient comes in saying that they have issues relating to

menopause, we are trained to treat what we see. What we see varies

depending on the patient. One might have hot flashes with no sweat.

One might have night sweats without much heat. Another might have

excessive bleeding and insomnia. Another might have low libido and

vaginal dryness.....All of these patients are about 50 and all are

relating their symptoms to menopausal changes to themselves. So, you

do your differential diagnosis and come up with a variety of patterns

- one includes kidney yin vacuity, another kidney yang vacuity and a

couple don't show any kidney signs but are more related to Qi

depression - let's say.

 

My question - is there anything about the fact that they are 50 and

around the age of menopause that effects your treatment? In other

words, if you took the fact that they are in the age arena of

menopause completely out of the picture and then treated what you

see, would your treatment be different than if this information was

in the picture?

 

Thanks!

 

Sharon

 

Sharon Weizenbaum

86 Henry Street

Amherst, MA 01002

413-549-4021

sweiz<sweiz

www.whitepinehealingarts.com

 

[Guest guest]

I agree with Z'ev, and our job is to figure out what is good theory and junk

theory. I think Alon's point is valid but again one cannot just throw out

all theory and JUST read the bodies, well you can, but that starts to get

into a different realm. I like to have an balance of both. An optimal

scenario is when we read the bodies and then allow " trusted " theory to

inform us on the bigger picture filling in the gaps of pathomechanisms and

disease influences on the body. But what if the theory (i.e. menopause) is

just flawed like Volker suggests? Then we have a problem. I am not saying it

is, but his point is heard. It is though, an invented modern disease, with

no history beyond 1960. Does anyone have case studies prior to 1960 in

treating menopause like conditions with the backdrop of kidney yin xu?

 

 

 

Either way, I think addressing Sharon's question is important. Do we

consider some underlying thread, due to the mechanism of the disease or age

of patient - if so can our assumption be based on a biomedical explanation

(i.e. hormones) like Volker suggests?

 

 

 

In the meantime here are some quotes.

 

 

 

from John Chen, PhD:

 

 

 

" According to traditional Chinese medicine, the fundamental changes that

occur during menopause can be attributed to kidney deficiency. Since the

kidney is the organ responsible for growth, maturation and aging, the

deficiency of kidney yin is directly related to signs, symptoms and

complications of menopause. "

 

 

 

From an article translated by Bob Flaws article: , " In discussing the above

statistics, Ye says that kidney vacuity is the single most important factor

in the cause of menopausal syndrome. "

 

 

 

So I would say that in general people believe the kidney xu (yin) is the

predominant factor in menopause. This translates to many as treating this

even if s/s are not seen or not predominant. Case studies do support this.

Websites support this. But most people agree that we need to treat what we

see, case studies definitely support this. Thoughts?

 

 

 

-

 

 

 

_____

 

 

On Behalf Of

Sunday, December 31, 2006 6:31 PM

 

Re: Re: clinical question for experienced practitioners

 

 

 

Theory and clinical reality are two sides of the same coin, and

always have been in Chinese medicine. There is faulty theory and

sophisticated and flexible theory. There is astute clinical vision,

and simplistic clinical vision.

 

 

On Dec 31, 2006, at 4:38 PM, wrote:

 

> This is what i have called practicing from theory for years now

> (patients bodies never read text books). TCM pattern dx has been

> just that in many fields, not just menopause. It always amazes to

> me that practitioner ignore what is in front of them in favor of

> theory and beliefs.

 

 

 

 

..

 

 

<http://geo./serv?s=97359714/grpId=201013/grpspId=1705060815/msgId=

38338/stime=1167615062/nc1=3836825/nc2=3848643/nc3=3848530>

 

 

 

 

 

[Guest guest]

Jason,

 

 

One thought I have to share, on the issue of just reading the

body. I remember something Paul Unschuld said at his seminar here in

San Diego three years ago. He said that the body is silent, and that

all medicine is interpretive. In other words, different cultures

develop theories to explain the phenomena that are observed in the

body. In Ancient China, it was waterways, irrigation ditches,

storehouses, transportation routes, the organization of the

government. Modern biomedicine is no different. We have the

illusion in our culture that modern medicine is free of bias or

perspective, but that is clearly not the case. Even the most

empirical physician is practicing on a set of assumptions and

interpreting what is happening with their patients before deciding to

treat.

 

The issue with menopause is more complex, and all I can say for

now is that a broad perspective is helpful, with as much input from

different sources, before making a clinical decision.

 

 

On Jan 1, 2007, at 11:02 AM, wrote:

 

>

>

> I agree with Z'ev, and our job is to figure out what is good theory

> and junk

> theory. I think Alon's point is valid but again one cannot just

> throw out

> all theory and JUST read the bodies, well you can, but that starts

> to get

> into a different realm. I like to have an balance of both. An optimal

> scenario is when we read the bodies and then allow " trusted " theory to

> inform us on the bigger picture filling in the gaps of

> pathomechanisms and

> disease influences on the body. But what if the theory (i.e.

> menopause) is

> just flawed like Volker suggests? Then we have a problem. I am not

> saying it

> is, but his point is heard. It is though, an invented modern

> disease, with

> no history beyond 1960. Does anyone have case studies prior to 1960 in

> treating menopause like conditions with the backdrop of kidney yin xu?

>

> Either way, I think addressing Sharon's question is important. Do we

> consider some underlying thread, due to the mechanism of the

> disease or age

> of patient - if so can our assumption be based on a biomedical

> explanation

> (i.e. hormones) like Volker suggests?

>

> In the meantime here are some quotes.

>

> from John Chen, PhD:

>

> " According to traditional Chinese medicine, the fundamental changes

> that

> occur during menopause can be attributed to kidney deficiency.

> Since the

> kidney is the organ responsible for growth, maturation and aging, the

> deficiency of kidney yin is directly related to signs, symptoms and

> complications of menopause. "

>

> From an article translated by Bob Flaws article: , " In discussing

> the above

> statistics, Ye says that kidney vacuity is the single most

> important factor

> in the cause of menopausal syndrome. "

>

> So I would say that in general people believe the kidney xu (yin)

> is the

> predominant factor in menopause. This translates to many as

> treating this

> even if s/s are not seen or not predominant. Case studies do

> support this.

> Websites support this. But most people agree that we need to treat

> what we

> see, case studies definitely support this. Thoughts?

>

> -

>

> _____

>

>

> On Behalf Of Z'ev

> Rosenberg

> Sunday, December 31, 2006 6:31 PM

>

> Re: Re: clinical question for experienced practitioners

>

> Theory and clinical reality are two sides of the same coin, and

> always have been in Chinese medicine. There is faulty theory and

> sophisticated and flexible theory. There is astute clinical vision,

> and simplistic clinical vision.

>

>

> On Dec 31, 2006, at 4:38 PM, wrote:

>

> > This is what i have called practicing from theory for years now

> > (patients bodies never read text books). TCM pattern dx has been

> > just that in many fields, not just menopause. It always amazes to

> > me that practitioner ignore what is in front of them in favor of

> > theory and beliefs.

>

> .

>

> <http://geo./serv?s=97359714/grpId=201013/

> grpspId=1705060815/msgId=

> 38338/stime=1167615062/nc1=3836825/nc2=3848643/nc3=3848530>

>

>

>

[Guest guest]

Jason,

Have you found that internal medicine books that are not translated into English

are that

much more sophisticated? I wonder if its a matter of selling a simplified CM to

us or is just

a reflection of TCM in China. I think you understand the question.

I also know that there is a multiplicity of thought in China, and yes, there are

many, many

brilliant practitioners in China who are matching and surpassing our tentative

probings

step-by-step at a high level.

 

Conversly we hear that China would like to institute the same type of hospital

oriented

TCM in the West. This strategy would provide a lot of jobs for Chinese

practitioners

comfortable in the hospital system and books like these might lay the path not

just for

Western but for Chinese practitioners here. In the same way that allowed TCM to

" integrate " with WM in China.

 

The word colonization means that the Chinese actually believe themselves that CM

is less

important than WM. Knowing different and selling us this Westernized version is

better

called fraud. :-)

 

Doug

 

 

>

>

> Finally, a recent example of this colonization is a current book I purchased

> on R.A. - it is one of the Shanghai (English and Chinese) texts (2004). This

> book is part of series that is designed for " educating " westerners, much

> like CAM. I found the translation to be much better than the attempts of

> the past. But the material is laughable. It starts off with a biomedical

> explanation of RA and then jumps into a few common patterns and treatments.

> Very little for explanation and understanding of the pathomechanisms,

> understanding herb choices and modifications, as well as individualizing for

> the patient etc., etc. It offers no interesting way to think about things.

> It is a .. COOKBOOK. and a bad one at that. This seems to be typical of most

> of these modern books geared toward westerners.

>

>

>

> One may say, hey this is just a starting point, one still has to treat what

> they see. I say that is BS. This book is supposed to be a specialty book,

> specific for one disease, yet it gives a TCM explanation suited for 2nd year

> students. It is IMO purposely dumbed for the sale to " Westerners " . I have

> heard many say that Chinese just can't believe we can handle the " real "

> medicine. I do think that many believe this, but as Sharon pointed out,

> students will learn if you can teach them.

> .............................>

> -

>

>

[Guest guest]

Obviously one cannot discard theory in CM, it is a theory based medicine.

However, it is an empirical medicine and therefor one must question ones'

assumptions at every turn. These ideas of predetermined syndromes, especially

has they pertain to western diseases and as found in TCM, are purely theoretical

and almost never useful. To practice CM one must follow the clues very flexibly.

 

 

 

 

Oakland, CA 94609

 

 

-

Monday, January 01, 2007 11:02 AM

RE: Re: clinical question for experienced practitioners

 

 

 

 

I agree with Z'ev, and our job is to figure out what is good theory and junk

theory. I think Alon's point is valid but again one cannot just throw out

all theory and JUST read the bodies, well you can, but that starts to get

into a different realm. I like to have an balance of both. An optimal

scenario is when we read the bodies and then allow " trusted " theory to

inform us on the bigger picture filling in the gaps of pathomechanisms and

disease influences on the body. But what if the theory (i.e. menopause) is

just flawed like Volker suggests? Then we have a problem. I am not saying it

is, but his point is heard. It is though, an invented modern disease, with

no history beyond 1960. Does anyone have case studies prior to 1960 in

treating menopause like conditions with the backdrop of kidney yin xu?

 

Either way, I think addressing Sharon's question is important. Do we

consider some underlying thread, due to the mechanism of the disease or age

of patient - if so can our assumption be based on a biomedical explanation

(i.e. hormones) like Volker suggests?

 

In the meantime here are some quotes.

 

from John Chen, PhD:

 

" According to traditional Chinese medicine, the fundamental changes that

occur during menopause can be attributed to kidney deficiency. Since the

kidney is the organ responsible for growth, maturation and aging, the

deficiency of kidney yin is directly related to signs, symptoms and

complications of menopause. "

 

From an article translated by Bob Flaws article: , " In discussing the above

statistics, Ye says that kidney vacuity is the single most important factor

in the cause of menopausal syndrome. "

 

So I would say that in general people believe the kidney xu (yin) is the

predominant factor in menopause. This translates to many as treating this

even if s/s are not seen or not predominant. Case studies do support this.

Websites support this. But most people agree that we need to treat what we

see, case studies definitely support this. Thoughts?

 

-

 

_____

 

On Behalf Of

Sunday, December 31, 2006 6:31 PM

Re: Re: clinical question for experienced practitioners

 

Theory and clinical reality are two sides of the same coin, and

always have been in Chinese medicine. There is faulty theory and

sophisticated and flexible theory. There is astute clinical vision,

and simplistic clinical vision.

 

On Dec 31, 2006, at 4:38 PM, wrote:

 

> This is what i have called practicing from theory for years now

> (patients bodies never read text books). TCM pattern dx has been

> just that in many fields, not just menopause. It always amazes to

> me that practitioner ignore what is in front of them in favor of

> theory and beliefs.

 

.

 

<http://geo./serv?s=97359714/grpId=201013/grpspId=1705060815/msgId=

38338/stime=1167615062/nc1=3836825/nc2=3848643/nc3=3848530>

 

 

[Guest guest]

Having practiced for a while in two distinctly different locations,

Boulder, Colorado and rural western Montana, my experiences of

dealing with many illnesses, not just menopause, is that the range of

TCM pattern manifestations in the two locations are quite different.

In rural western Montana, the cases of menopause I've seen fall more

into the Kidney-Liver Yin Deficiency patterns that one might expect

from reading TCM textbooks. In Boulder, however, the range was

considerably wider and I saw more cases of menopause with hot flashes

that did not seem to fall clearly into Kidney Yin Deficiency. Liver

Qi Stagnation was much more prevalent. This does not mean to me that

TCM pattern recognition algorithm is faulty, it just means that the

patterns that resulted when I lived in Boulder differed from what TCM

scholars claimed is the norm. If there is one thing that I interpret

differently, knowing that a woman is of menopausal age, is that I

attach a lower probability to hot flashes being associated with

Kidney Yin Deficiency and will look at other symptoms more carefully

to decide which patterns are predominant.

 

I also agree with Z'ev in that there is simplistic TCM theory and

more complex theory. Too many practitioners seem willing to throw out

TCM theory completely, when they may not be applying it accurately or

correctly. One of my pet peeves is that, like in reproducing a

scientific experiment, it is difficult to prove a negative, and one

can easily " reproduce " someone else's protocol in a slapdash and

sloppy manner just to " prove " that it does not work. These types of

" proofs " are found in all sorts of scientific literature, and this

type of research is crap. On the other hand, if someone has made

their best effort to reproduce a protocol and clearly understands it,

and yet cannot make it work, that person's results have more

credibility. Most practitioners, including even faculty at many TCM

colleges **cannot** do basic TCM pattern assessment, according to the

rules defined by TCM scholars and their definitions of the syndromes.

A computer can do better than these people. Only people who can

demonstrate that they can do complex pattern analysis **by the

rules** are qualified, in my opinion, to judge in what circumstances

TCM pattern recognition protocol is inadequate. That might be less

than 10% of the profession.

 

I've asked myself many times why the rural population of western

montana differs from that of Boulder, Colorado, and I have several

ideas - one is that the percentage of vegetarians is much lower. In

Boulder, I saw a lot of vegetarians who consumed significant amounts

of soy products. There is a huge amount of information out now on the

hazards of unfermented soy products (soy milk, tofu, soy protein

additives to processed foods of all types, etc.); I've seen soy

products create very severe Liver Qi and Blood Stagnation in people,

especially women. I had a few cases in which the hot flashes during

menopause were clearly related to consumption of soy, and symptoms

resolved over 70% by simply stopping all soy - the other 30% was

resolved with herbs.

 

What I find so outrageous is the health food stores hyping soy

isoflavones as being beneficial for menopause and hormone regulation.

In my observation, soy is nothing but a disaster. Could this be the

major reason why women, especially in urban areas are displaying

atypical menopause, at least according to the TCM traditionalists?

 

See for more info:

http://www.ratical.org/ratville/soydangers.html

Soy Alert -- Tragedy and Hype: The Third International Soy Symposium

by Sally Fallon & Mary Enig, PhD

 

 

---Roger Wicke PhD

Rocky Mountain Herbal Institute

website: http://www.rmhiherbal.org/

email: http://www.rmhiherbal.org/contact/

[Guest guest]

This question gets to the heart of one of Volker's points and one of the

issues with CM. Meaning, do we treat the pattern that we see? Or do

we treat

the disease that they present with? Or do we treat both? Well the

obvious

answer (to me) is that we (almost always) should treat both. IMHO, one

cannot just treat what they see in regard to just the PATTERN (zang-fu)

without regard to the disease at hand (or visa versa). But the

reality is

that one sees approaches on both ends of the spectrum, meaning there are

those who treat the pattern without understanding the disease, and

others

who just treat the disease without regard to the pattern(s).

 

 

Thank you for such an in depth reply Jason and everyone. I agree

with you that one does best to treat the disease and the pattern

together. So, then the question is, what is the disease? Is it

menopause or is it insomnia, restless legs, vaginal dryness etc. I

think Volker was pointing out that menopause as a disease is an

invention from the West. It's an invention Chinese medicine

adopted. Does it help us as practice to have this new invention?

It is, without a doubt, true that the symptoms can arise and cluster

around a certain period of time in women's lives. I suppose this is

what constitutes a syndrome - menopausal syndrome. This only tells

us that a variety of symptoms cluster at a certain time but it does

not make the time itself a disease. In fact, the Nei Jing is quite

clear that the decline is natural - so, by itself it cannot be a

pathology.

 

I remember the Jane Lyttleton article in which she quoted the

authors of Feminine Forever who called menopause " estrogen deficiency

disease " , likening it to diabetes, the " insulin deficiency disease " .

This was written at the dawn of ERT by the folks who ended up making

billions on the hormone.

 

So far, it seems that all of you esteemed and experienced

practitioners have learned to treat what presents. To answer my own

question, it is what I do. It took me a while, like Jason, to let go

of the Kidney assumption. I've had to learn to let go of it in

relation to fertility as well.

 

If menopause is not a disease itself, why do symptoms arise at that

time? I have my own way of thinking of it....I imagine it as a river

flow that declines. Tendencies to pathology can be there before the

levels go down but don't show up until the decline. The decline

itself is not the problem and the goal is not to fill the river. If

someone is Yin depleted, this will become worse. If someone has

blockage, this may show up. If someone is Yang deficient, this may

appear.

 

It seems pretty standard for my students to determine Yin vacuity

when there are hot flashes and/ or night sweats. My results improved

vastly when I was able to see the patho-mechanisms at work when these

symptoms came from Qi or Yang Vacuity or Stasis.

 

Sharon

 

 

 

 

Sharon Weizenbaum

White Pine Healing Arts

86 Henry Street

Amherst, MA 01002

www.whitepinehealingarts.com

sweiz

413-549-4021

 

 

 

 

 

 

[Guest guest]

" According to traditional Chinese medicine, the fundamental changes that

occur during menopause can be attributed to kidney deficiency. Since the

kidney is the organ responsible for growth, maturation and aging, the

deficiency of kidney yin is directly related to signs, symptoms and

complications of menopause. "

 

From an article translated by Bob Flaws article: , " In discussing

the above

statistics, Ye says that kidney vacuity is the single most important

factor

in the cause of menopausal syndrome. "

 

So I would say that in general people believe the kidney xu (yin) is the

predominant factor in menopause. This translates to many as treating

this

even if s/s are not seen or not predominant. Case studies do support

this.

Websites support this. But most people agree that we need to treat

what we

see, case studies definitely support this. Thoughts?

 

 

 

Well, I just disagree. If I put together all of my successful cases

of treating symptoms arising in relation to menopause I would imagine

about 1/5 would have Kidney Yin vacuity as a primary disease factor.

I must say that many of the research articles just don't ring true to

me. Any thoughts on that?

 

Sharon

 

 

 

Sharon Weizenbaum

White Pine Healing Arts

86 Henry Street

Amherst, MA 01002

www.whitepinehealingarts.com

sweiz

413-549-4021

 

 

 

 

 

 

[Guest guest]

Finally, a recent example of this colonization is a current book I

purchased

on R.A. - it is one of the Shanghai (English and Chinese) texts

(2004). This

book is part of series that is designed for " educating " westerners, much

like CAM. I found the translation to be much better than the attempts of

the past. But the material is laughable. It starts off with a biomedical

explanation of RA and then jumps into a few common patterns and

treatments.

Very little for explanation and understanding of the pathomechanisms,

understanding herb choices and modifications, as well as

individualizing for

the patient etc., etc. It offers no interesting way to think about

things.

It is a .. COOKBOOK. and a bad one at that. This seems to be typical

of most

of these modern books geared toward westerners.

 

One may say, hey this is just a starting point, one still has to

treat what

they see. I say that is BS. This book is supposed to be a specialty

book,

specific for one disease, yet it gives a TCM explanation suited for

2nd year

students. It is IMO purposely dumbed for the sale to " Westerners " . I

have

heard many say that Chinese just can't believe we can handle the " real "

medicine. I do think that many believe this, but as Sharon pointed out,

students will learn if you can teach them.

 

 

 

Yes, this is just the type of book that confuses. I find it

especially insidious when it is a western disease that is being

" dumbed " down.

 

Andy Ellis recently taught a class here as part of the Graduate

Mentorship Program on Bi. He drew extensively from the unpublished

work of Jiao Shude. There was an implicit guiding question

throughout the whole lecture which was " How does Jiao Shude think and

how can we learn to think like him? " Dr. Jiao is a practitioner who

treated thousands of cases of Bi, including Bi with deformed joints.

He won awards for his approaches. I'm glad that material like this

is being translated and taught. Other texts like Chip's Qin Bowei

anthology and Liu Feng Wu's gynecology help us learn to think and

understand - imho.

 

as for the Chinese not believing that we can handle the " real "

medicine. I've heard that. Yet, I've also heard Chinese teachers

say that westerners have an enthusiasm and love for the medicine that

is largely lacking in their Chinese students.

 

Sharon

 

Sharon Weizenbaum

White Pine Healing Arts

86 Henry Street

Amherst, MA 01002

www.whitepinehealingarts.com

sweiz

413-549-4021

 

 

 

 

 

 

[Guest guest]

Sharon,

One of the problems is that a majority of the English-language

textbooks fail to teach the student how to diagnose and/or

differentiate patterns. One prominant exception is Jiao Shu-de. His

new book, " Case Histories On Pattern Differentiation " takes you step

by step through diagnostic and treatment protocols, creating

prescriptions, dosages, responses, modifications, successes and

failures. We need many more books like this.

 

The hormone replacement fad is just one of many medical fad

bandwagons that alternative medical practitioners have tried to jump

on and exploit. I remember when " herbal phen-fen " was in the health

food stores. . that is, until the original phen-fen was banned. I

remember seeing " herbaproz " in the stores as well, trying to mimic

prozac. When we try to use herbs to mimic drugs, such as st.

johnswort, black cohosh or gingko, the results are poor, and the

studies damning. We need to raise the level of practice in our own

field, and any associated field that relies on herbal medicine.

 

The fear of aging may be the root cause for many problems in the

marketing of medicine today. One of the most popular money-makers

for acupuncturists is 'facial rejuvenation'. Hormones, natural or

synthetic, pilates, plastic surgery and special diets abound in

American culture for the baby boomers. It is these medical fads and

trends that can only influence the practice of Chinese medicine as

well, so we should not be surprised that these kinds of questions

come up. Practitioners feel pressured by their patients, and

competition from M.D.'s and other health providers (think about how

many acupuncturists work in chiropractic offices) to give 'feel-good'

treatment and products.

 

It takes great courage to stick to the tools of our profession and

try to use them in the way they were designed to be used. It also

seems to take a continually searching mind to study hard enough to

uncover what is really going to be helpful in the CM literature as well.

 

 

 

 

On Jan 1, 2007, at 4:04 PM, sharon weizenbaum wrote:

 

> I remember the Jane Lyttleton article in which she quoted the

> authors of Feminine Forever who called menopause " estrogen deficiency

> disease " , likening it to diabetes, the " insulin deficiency disease " .

> This was written at the dawn of ERT by the folks who ended up making

> billions on the hormone.

>

> So far, it seems that all of you esteemed and experienced

> practitioners have learned to treat what presents. To answer my own

> question, it is what I do. It took me a while, like Jason, to let go

> of the Kidney assumption. I've had to learn to let go of it in

> relation to fertility as well.

 

 

 

 

[Guest guest]

It seems that we all got caught early on defaulting to kidney yin vacuity.

Like others too, I had to fail to manage one patients hot flashes to really

wake me up to more careful pattern discrimination.

 

Still- the overriding patterns are related to yin and yang/ fire and water.

Women feel hot/ sweaty/ dried out. But also without sexual heat, poor

memory, fatigue.

 

that said: I wish to reiterate my perspective on liu wei di huang wan.

when I was in china, I was taught that for premenopausal women ³treat the

kidneys². For post menopausal women ³ treat the spleen qi². It¹s interesting

to think about preserving the kidney qi in what is ,practically speaking,

the only way possible: through a postnatal vehicle- the spleen.

 

I want to put forth the idea that LWDHW nourishes the kidney yin, but with

absolutely no kidney tonics!

Shu di- nourishes the blood

Shan zhu yu- astringent. Prevents leakage. Doesn't actually tonify

Shan Yao- the spleen. And also an astringent, absorbent effect

Fu ling- the spleen again

Mu dan pi- here addresses latent heat- from the liver.

Ze xie- also clears empty heat, drains dampness.

 

Deconstructing LWDHW in this way has opened up how I think about menopausal

symptoms. It¹s allowed me to break out of a narrow box of kidney yin

vacuity. It has vastly increased my clinical accuracy- and I don¹t use it

all the time at all! I think we owe it to ourselves, as thoughtful

practitioners, to revisit all diagnostic theories and not allow ourselves to

get locked into what is handed us in the books.

 

Happy new year all

 

Cara O. Frank, R.Ac, Dipl Ac & Ch.H.

President China Herb Company of the Chinese Herb Program

Tai Sophia Institute of the Healing Arts

215-438-2977

Fax 215-849-3338

 

 

 

Thank you for such an in depth reply Jason and everyone. I agree

with you that one does best to treat the disease and the pattern

together. So, then the question is, what is the disease? Is it

menopause or is it insomnia, restless legs, vaginal dryness etc. I

think Volker was pointing out that menopause as a disease is an

invention from the West. It's an invention Chinese medicine

adopted. Does it help us as practice to have this new invention?

It is, without a doubt, true that the symptoms can arise and cluster

around a certain period of time in women's lives. I suppose this is

what constitutes a syndrome - menopausal syndrome. This only tells

us that a variety of symptoms cluster at a certain time but it does

not make the time itself a disease. In fact, the Nei Jing is quite

clear that the decline is natural - so, by itself it cannot be a

pathology.

 

I remember the Jane Lyttleton article in which she quoted the

authors of Feminine Forever who called menopause " estrogen deficiency

disease " , likening it to diabetes, the " insulin deficiency disease " .

This was written at the dawn of ERT by the folks who ended up making

billions on the hormone.

 

So far, it seems that all of you esteemed and experienced

practitioners have learned to treat what presents. To answer my own

question, it is what I do. It took me a while, like Jason, to let go

of the Kidney assumption. I've had to learn to let go of it in

relation to fertility as well.

 

If menopause is not a disease itself, why do symptoms arise at that

time? I have my own way of thinking of it....I imagine it as a river

flow that declines. Tendencies to pathology can be there before the

levels go down but don't show up until the decline. The decline

itself is not the problem and the goal is not to fill the river. If

someone is Yin depleted, this will become worse. If someone has

blockage, this may show up. If someone is Yang deficient, this may

appear.

 

It seems pretty standard for my students to determine Yin vacuity

when there are hot flashes and/ or night sweats. My results improved

vastly when I was able to see the patho-mechanisms at work when these

symptoms came from Qi or Yang Vacuity or Stasis.

 

Sharon

 

Sharon Weizenbaum

White Pine Healing Arts

86 Henry Street

Amherst, MA 01002

www.whitepinehealingarts.com

sweiz <sweiz%40rcn.com>

413-549-4021

 

 

[Guest guest]

Sharon,

 

 

 

I agree with your disagreement, that is precisely why I posted it. {I was

not supporting this kid yin idea, but showing that we read this stuff all

the time and it is so prevalent in the literature} But IMO and others like

yourself, Volker etc. it just doesn't ring true. I think the potential

political agenda being propagated must be looked at.

 

 

 

-Jason

 

 

 

_____

 

 

On Behalf Of sharon weizenbaum

Monday, January 01, 2007 5:11 PM

 

Re: clinical question for experienced practitioners

 

 

 

" According to traditional Chinese medicine, the fundamental changes that

occur during menopause can be attributed to kidney deficiency. Since the

kidney is the organ responsible for growth, maturation and aging, the

deficiency of kidney yin is directly related to signs, symptoms and

complications of menopause. "

 

From an article translated by Bob Flaws article: , " In discussing

the above

statistics, Ye says that kidney vacuity is the single most important

factor

in the cause of menopausal syndrome. "

 

So I would say that in general people believe the kidney xu (yin) is the

predominant factor in menopause. This translates to many as treating

this

even if s/s are not seen or not predominant. Case studies do support

this.

Websites support this. But most people agree that we need to treat

what we

see, case studies definitely support this. Thoughts?

 

 

 

Well, I just disagree. If I put together all of my successful cases

of treating symptoms arising in relation to menopause I would imagine

about 1/5 would have Kidney Yin vacuity as a primary disease factor.

I must say that many of the research articles just don't ring true to

me. Any thoughts on that?

 

Sharon

 

 

 

 

 

 

[Guest guest]

I must say that many of the research articles just don't ring true to

me. Any thoughts on that?

>>>>>

I believe that is the biggest problem we have to face. On the one hand we have

theoretical and poetic literature and on the other unbelievable research. I

think we as a profession will have to address this hopefully sooner than later

 

 

 

 

Oakland, CA 94609

 

 

-

sharon weizenbaum

Monday, January 01, 2007 4:11 PM

Re: clinical question for experienced practitioners

 

 

" According to traditional Chinese medicine, the fundamental changes that

occur during menopause can be attributed to kidney deficiency. Since the

kidney is the organ responsible for growth, maturation and aging, the

deficiency of kidney yin is directly related to signs, symptoms and

complications of menopause. "

 

From an article translated by Bob Flaws article: , " In discussing

the above

statistics, Ye says that kidney vacuity is the single most important

factor

in the cause of menopausal syndrome. "

 

So I would say that in general people believe the kidney xu (yin) is the

predominant factor in menopause. This translates to many as treating

this

even if s/s are not seen or not predominant. Case studies do support

this.

Websites support this. But most people agree that we need to treat

what we

see, case studies definitely support this. Thoughts?

 

 

Well, I just disagree. If I put together all of my successful cases

of treating symptoms arising in relation to menopause I would imagine

about 1/5 would have Kidney Yin vacuity as a primary disease factor.

I must say that many of the research articles just don't ring true to

me. Any thoughts on that?

 

Sharon

 

Sharon Weizenbaum

White Pine Healing Arts

86 Henry Street

Amherst, MA 01002

www.whitepinehealingarts.com

sweiz

413-549-4021

 

[Guest guest]

A few months ago I had the opportunity to study with Barabara Kirschbaum at one

of her

tongue DX courses. Her take on menopausal sundrome is that Kidney Yin Xu was a

theory

proposed by men and is not the major pathomechanism seen in her clinic. She has

over

twenty thousand slides of tongues from the past twenty something years of

practise,

presently sees over 90 patients a week, and in her opinion seeing a kidney yin

xu manifest

on a 50 year old womans toungue is rare. She says that excessive conditions, in

particular

liver depression Qi stagnation, phlegm and dampness, are the most common.

This to me makes the most sense and follows some of Bob's thinking that

menopause is

not a disease, menopausal syndrome is. The liver is responsible for the smooth

shift of

heart blood decending to the uterus during menstrual years to heart blood

nourishing the

spirit and other parts in menopause. A natural and normal physiologic event. If

the liver is

depressed then the shift doesn't happen smoothly, and problems manifest.

 

My two cents,

Trevor

, " " wrote:

>

> Sharon,

>

>

>

> I agree with your disagreement, that is precisely why I posted it. {I was

> not supporting this kid yin idea, but showing that we read this stuff all

> the time and it is so prevalent in the literature} But IMO and others like

> yourself, Volker etc. it just doesn't ring true. I think the potential

> political agenda being propagated must be looked at.

>

>

>

> -Jason

>

>

[Guest guest]

Haven't been around for a while -- holidays and all. So I don't know

all of what's been said on this topic since I was last here.

Interesting that's it's still going. However, one thing I would like

to make clear. The Chinese have NOT made menopause into a disease. It

is a part of the natural life-cylce of the human female. It is either

" menopausal SYNDROME " or " peri-menopausal SYNDROME " which are the

disease categories in contemporary CM, same as in modern WM.

Menopausal syndrome refers to a recognized but individually variable

constellation of clinical symptoms occurring after menopause has

occurred and peri-menopausal syndrome refers to a recognized but

individually variable constellation clinical symptoms in the years

immediately prior to menopause. The adoption of these WM disease

categories are similar to the use of PMS and FBD in contemporary CM

gynecology.

 

:-)

 

Bob

 

P.S. The all-caps are the only way I know of emphasizing within posts

on this forum, but I'm not shouting here. Would that I could figure

out how to insert italics on this forum. Emphasis is only to make

myself clear.

[Guest guest]

" From an article translated by Bob Flaws article: 'In discussing

the above statistics, Ye says that kidney vacuity is the single most

important factor in the cause of menopausal syndrome.' "

 

For purposes of clarification, I do not necessarily agree with the

Chinese authors I translate. Sometimes and I and say so, sometimes I

don't and say so, and sometimes I simply present what the author(s)

has/have to say without comment.

 

Bob

[Guest guest]

" The word colonization means that the Chinese actually believe

themselves that CM is less important than WM. Knowing different and

selling us this Westernized version is better called fraud. "

 

Just like Americans, different Chinese think different things. Many

(in fact most non-practitioner) Chinese I have met believe WM IS

better than CM. This is evidenced by health care usage statistics in

the PRC. (The last statistics I remember seeing on this was that 75%

of the Chinese population only use WM and only 10% only use CM.)

However, within the ranks of CM practitioners, I doubt that this is

the majority opinion. From my experience, I would say that the

majority opinion is that WM and CM each have their strong and weak

points. That being said, some practitioners advocate the integration

of these two as being superior to either alone, while others believe

that CM medicine alone should be used in those areas it gets the best

results. I know many Chinese doctors who are passionate about CM,

either pure CM or integrated WM-CM. I personally doubt whether

conscious (i.e., deliberate) fraud plays a major part in the Chinese

attempts to popularize CM worldwide.

 

Bob

[Guest guest]

Bob, I agree completely about the multiplicity of ideas in China.

 

________

The following has nothing to do with TCM but is only a rant about

colonization... feel free

to skip...

 

Although this is a side line to an actual discussion of the medicine, I'm taking

off on this

idea of colonization because ultimately it seems a degrading and paternalistic

view of the

Chinese. Although we know that there is a strong influence of WM in CM, using

this word

suggests a lack of free agency on how the Chinese want to define their own

medicine.

Many would argue, although we may disagree with this extreme case, that CM has

always

been flexible in influences. However, we must see that although we may see it as

misguided the many voices make certain that it is not unconscious. The degree to

which it

reaches modern textbooks (aimed at the west or not) is a political process of

whose voice

is heard.

 

I wanted to make sure with the way that Jason's paragraph was structured that

people

understood that Scheid implies that the Chinese themselves were " colonized " not

they

were trying to colonize us. I think Jason understood this but I wanted to be

sure.

Colonization in the sense Fanon used it was a critique of his own people, a sort

of

equivilant of Malcolm X calling other blacks Uncle Toms. So here we have

anthropologists

- calling the Chinese having a colonized consciousness. And without

aknowledging, as you

have often said, this multiplicity of thought. As if the Chinese weren't

" authentic " enough.

Again, it implies that a psychological state of un-consciousness.

 

 

The point of all this is that I want to be precise about this word,

colonization, because it

could easily become the catchword that explains a entire vastly complex process.

 

 

 

 

Scheid in his article notes a PhD paper by Eric Karchmer as the source of the

colonial term

in reference to TCM. Mr. Karchmer himself went through the MD program at Beijing

TCM

University and then returned to write a PHD in anthropology.

 

From the Menopause article-

 

As we shall see,

answering these questions will reveal TCM to be a rather different practice than

the one we

commonly imagine it to be: not the alternative medical tradition familiar from

the stories

we tell ourselves and our patients but a medical practice whose very essence has

been

transformed in a process of colonisation and subjugation by biomedicine.

Scheid

 

 

And a web clip of an abstract given at a conference.

13

POSTCOLONIALISM, QI, AND THE PROPENSITIES OF THE BODY

Eric Karchmer

There is probably no other theoretical term in Chinese medicine that is more

widely known and more poorly understand than qi . Contemporary scholars seem

to be unable to decide whether it is a material substance of the body, a

functional

/ energetic representation of bodily processes, or both. I believe that these

equivocations about the nature of qi are an artifact of the colonial and

postcolonial power inequities that have shaped modern China. In the early 20th

century, European imperialism and the rise of the Chinese nation state

precipitated a crisis in the scientific legitimacy of Chinese medicine. As a

result,

Chinese medicine doctors have attempted to define their own practice in terms of

the epistemological categories of Western medicine. For example, many doctors

have argued that the Western medicine body is (relatively) material ¨C defined

by

the structures of modern anatomy, while the Chinese medicine body is

(relatively)

immaterial ¨C marked by ¡°functional¡± (or ¡°energetic¡±) transformations.

Contemporary definitions of qi straddle this binary opposition of substrate and

function (or matter and energy). I propose that we attempt to re-invigorate this

concept through the notion of ¡°propensity,¡± as developed in Francois

Jullien¡¯s

study of Chinese philosophy. If we imagine qi as a descriptive term for the

various propensities of the body (instead of energies or functionalities), we

can

not only move beyond the epistemological biases of Western medicine, but also

appreciate the power of this tool for the empirical study of the body.

 

 

Finally, a recent example of this colonization is a current book I purchased on

R.A. - it is

one of the Shanghai (English and Chinese) texts (2004). This book is part of

series that is

designed for " educating " westerners, much like CAM. I found the translation to

be much

better than the attempts of the past. But the material is laughable. It starts

off with a

biomedical explanation of RA and then jumps into a few common patterns and

treatments.

Very little for explanation and understanding of the pathomechanisms,

understanding

herb choices and modifications, as well as individualizing for the patient etc.,

etc. It offers

no interesting way to think about things. It is a .. COOKBOOK. and a bad one at

that. This

seems to be typical of most

of these modern books geared toward westerners.

Jason

 

, " Bob Flaws " <pemachophel2001

wrote:

>

> " The word colonization means that the Chinese actually believe

> themselves that CM is less important than WM. Knowing different and

> selling us this Westernized version is better called fraud. "

>

> Just like Americans, different Chinese think different things. Many

> (in fact most non-practitioner) Chinese I have met believe WM IS

> better than CM. This is evidenced by health care usage statistics in

> the PRC. (The last statistics I remember seeing on this was that 75%

> of the Chinese population only use WM and only 10% only use CM.)

> However, within the ranks of CM practitioners, I doubt that this is

> the majority opinion. From my experience, I would say that the

> majority opinion is that WM and CM each have their strong and weak

> points. That being said, some practitioners advocate the integration

> of these two as being superior to either alone, while others believe

> that CM medicine alone should be used in those areas it gets the best

> results. I know many Chinese doctors who are passionate about CM,

> either pure CM or integrated WM-CM. I personally doubt whether

> conscious (i.e., deliberate) fraud plays a major part in the Chinese

> attempts to popularize CM worldwide.

>

> Bob

>