Superior and Extraordinary Physicians

[Guest guest]

I remember that recently there was a discussion of what it means to be an

extraordinary physician. I couldn't find the thread, but this weekend I read an

article that discusses a classical view of what it means to be a superior

physician. I follow this blog through RSS, and it recently been more active with

some interesting posts and comments.

http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

 

I find that most people, when they read that the superior physician treats what

is not yet ill, they immediately talk about how patients only come to see them

when they are sick. The above posts tackles this well and with nice quotes from

the classics. Hope you enjoy...

[Guest guest]

Nice blog. His book is excellent as well. . .

 

 

On Jun 15, 2009, at 12:17 AM, d_munez wrote:

 

>

>

> I remember that recently there was a discussion of what it means to

> be an extraordinary physician. I couldn't find the thread, but this

> weekend I read an article that discusses a classical view of what it

> means to be a superior physician. I follow this blog through RSS,

> and it recently been more active with some interesting posts and

> comments.

> http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

>

> I find that most people, when they read that the superior physician

> treats what is not yet ill, they immediately talk about how patients

> only come to see them when they are sick. The above posts tackles

> this well and with nice quotes from the classics. Hope you enjoy...

>

>

>

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

In order to become a superior physician who treats illnesses before they

manifest...

what tools should we cultivate?

 

K

 

 

On Mon, Jun 15, 2009 at 11:01 AM, <zrosenbewrote:

 

>

>

> Nice blog. His book is excellent as well. . .

>

>

>

> On Jun 15, 2009, at 12:17 AM, d_munez wrote:

>

> >

> >

> > I remember that recently there was a discussion of what it means to

> > be an extraordinary physician. I couldn't find the thread, but this

> > weekend I read an article that discusses a classical view of what it

> > means to be a superior physician. I follow this blog through RSS,

> > and it recently been more active with some interesting posts and

> > comments.

> > http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

> >

> > I find that most people, when they read that the superior physician

> > treats what is not yet ill, they immediately talk about how patients

> > only come to see them when they are sick. The above posts tackles

> > this well and with nice quotes from the classics. Hope you enjoy...

> >

> >

> >

>

>

> Chair, Department of Herbal Medicine

> Pacific College of Oriental Medicine

> San Diego, Ca. 92122

>

>

[Guest guest]

If you read the blog, you'll see that 'treating illnesses before they

manifest " is interpreted as treating according to five phase cycles,

rather than directly attacking symptoms. In other words, as it says

in the Jin Gui Yao Lue, 'for diseases of the liver, treat the

spleen'. Another interpretation of this saying is that through astute

diagnosis, the physician determines which visceral systems are in

disharmony and treats them before they manifest full-blown disease.

 

 

On Jun 15, 2009, at 1:07 PM, wrote:

 

>

>

> In order to become a superior physician who treats illnesses before

> they

> manifest...

> what tools should we cultivate?

>

> K

>

> On Mon, Jun 15, 2009 at 11:01 AM,

> <zrosenbewrote:

>

> >

> >

> > Nice blog. His book is excellent as well. . .

> >

> >

> >

> > On Jun 15, 2009, at 12:17 AM, d_munez wrote:

> >

> > >

> > >

> > > I remember that recently there was a discussion of what it means

> to

> > > be an extraordinary physician. I couldn't find the thread, but

> this

> > > weekend I read an article that discusses a classical view of

> what it

> > > means to be a superior physician. I follow this blog through RSS,

> > > and it recently been more active with some interesting posts and

> > > comments.

> > > http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

> > >

> > > I find that most people, when they read that the superior

> physician

> > > treats what is not yet ill, they immediately talk about how

> patients

> > > only come to see them when they are sick. The above posts tackles

> > > this well and with nice quotes from the classics. Hope you

> enjoy...

> > >

> > >

> > >

> >

> >

> > Chair, Department of Herbal Medicine

> > Pacific College of Oriental Medicine

> > San Diego, Ca. 92122

> >

> >

[Guest guest]

Z'ev: " Another interpretation of this saying is that through astute

diagnosis, the physician determines which visceral systems are in

disharmony and treats them before they manifest full-blown disease "

 

Daniel: Which is a great thing to contemplate - how many times do you get a new

patient in for some minor complaint, they say 'everything else is fine, I am as

healthy as a horse' - and then you look at their tongue (dark red, thick yellow

coat, red spots, red tip, dark sublingual veins - just an example, but a common

one) and you take their pulse (overall rapid, very weak and deep proximal

pulses, full and overflowing middle pulses, 'spinning bean' distal pulses -

again, just an example, but not uncommon) - and you wonder, what should I say to

this person?

[Guest guest]

Daniel,

I consider it my obligation to tell them everything I find. In

fact, I would say that I am a subversive, in that my goal is to help

people upgrade their health, so new patients with a little issue can

be opened up to caring for their health in a more comprehensive

manner. .

 

I see the type of patient you mention all the time. . .

 

 

On Jun 15, 2009, at 2:04 PM, Daniel Schulman wrote:

 

>

>

> Z'ev: " Another interpretation of this saying is that through astute

> diagnosis, the physician determines which visceral systems are in

> disharmony and treats them before they manifest full-blown disease "

>

> Daniel: Which is a great thing to contemplate - how many times do

> you get a new patient in for some minor complaint, they say

> 'everything else is fine, I am as healthy as a horse' - and then you

> look at their tongue (dark red, thick yellow coat, red spots, red

> tip, dark sublingual veins - just an example, but a common one) and

> you take their pulse (overall rapid, very weak and deep proximal

> pulses, full and overflowing middle pulses, 'spinning bean' distal

> pulses - again, just an example, but not uncommon) - and you wonder,

> what should I say to this person?

>

>

>

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Hi All:

 

--Daniel-

'spinning bean' distal pulses - again, just an example, but not uncommon) - and

you wonder, what should I say to this person?

---

 

  You say, " nobody's perfect. by the way, have you ever felt [insert indicated

signs and symptoms here]. "

 

 Hugo

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies.org

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Hi All:

 

--Z'ev-

I consider it my obligation to tell them everything I find

---

 

 I agree. These are our Findings.

 

 Hugo 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies.org

 

 

 

 

 

[Guest guest]

Hugo - the interesting thing I find is that 90% of the time I do ask that (I run

through the entire list of symptoms likely to accompany such signs - menstrual,

digestive, sleep, etc etc etc) and what is so interesting is that most often,

the patient will say no to all the questions which can mean one of two things

(at least) - either they are not being truthful in their replies (overtly or

perhaps subconsciously?) OR the pulse and tongue signs are manifesting prior to

any symptomology.

 

Chinese Medicine , Hugo Ramiro <subincor

wrote:

>

> Hi All:

>

> --Daniel-

> 'spinning bean' distal pulses - again, just an example, but not uncommon) -

and you wonder, what should I say to this person?

> ---

>

>   You say, " nobody's perfect. by the way, have you ever felt [insert

indicated signs and symptoms here]. "

>

>  Hugo

> ________________________________

> Hugo Ramiro

> http://middlemedicine.wordpress.com

> http://www.chinesemedicaltherapies.org

>

>

>

 

[Guest guest]

 Hi Daniel, I know that you must ask that. My comment was more of the

tongue-in-cheek kind.

 

 I wanted to reply because the topic can be a delicate one for some people, as I

discovered (again) just today, as a matter of fact. " Too much perception " can be

perceived as imagination, or worse, as a personal ability to be judgemental and

to jump to conclusions.

 Dangerous territory unless a patient knows you well or you have good rapport

with them.

 

 I would welcome thoughts on this topic.

 

 Hugo

 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies.org

 

 

 

 

 

________________________________

Daniel Schulman <daniel.schulman

Chinese Medicine

Monday, 15 June, 2009 21:15:42

Re: Superior and Extraordinary Physicians

 

 

 

 

 

Hugo - the interesting thing I find is that 90% of the time I do ask that (I run

through the entire list of symptoms likely to accompany such signs - menstrual,

digestive, sleep, etc etc etc) and what is so interesting is that most often,

the patient will say no to all the questions which can mean one of two things

(at least) - either they are not being truthful in their replies (overtly or

perhaps subconsciously? ) OR the pulse and tongue signs are manifesting prior to

any symptomology.

 

Traditional_ Chinese_Medicine , Hugo Ramiro <subincor@..

..> wrote:

>

> Hi All:

>

> --Daniel-

> 'spinning bean' distal pulses - again, just an example, but not uncommon) -

and you wonder, what should I say to this person?

> ---

>

>   You say, " nobody's perfect. by the way, have you ever felt [insert

indicated signs and symptoms here]. "

>

>  Hugo

> ____________ _________ _________ __

> Hugo Ramiro

> http://middlemedici ne.wordpress. com

> http://www.chinesem edicaltherapies. org

>

>

>

 

[Guest guest]

I think one thing it says is that most people are not in touch with

their bodies, until their fire alarms go off. .. this is one of the

great things about acupuncture, yoga, qi gong and body therapies, is

that they help put people back in touch with their bodies again. .

 

 

 

On Jun 15, 2009, at 6:15 PM, Daniel Schulman wrote:

 

>

>

> Hugo - the interesting thing I find is that 90% of the time I do ask

> that (I run through the entire list of symptoms likely to accompany

> such signs - menstrual, digestive, sleep, etc etc etc) and what is

> so interesting is that most often, the patient will say no to all

> the questions which can mean one of two things (at least) - either

> they are not being truthful in their replies (overtly or perhaps

> subconsciously?) OR the pulse and tongue signs are manifesting prior

> to any symptomology.

>

> Chinese Medicine , Hugo Ramiro

> <subincor wrote:

> >

> > Hi All:

> >

> > --Daniel-

> > 'spinning bean' distal pulses - again, just an example, but not

> uncommon) - and you wonder, what should I say to this person?

> > ---

> >

> > You say, " nobody's perfect. by the way, have you ever felt

> [insert indicated signs and symptoms here]. "

> >

> > Hugo

> > ________________________________

> > Hugo Ramiro

> > http://middlemedicine.wordpress.com

> > http://www.chinesemedicaltherapies.org

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Daniel,

 

It is also possible that the patient is not paying attention to the issues you

mention.  I see this quite often - and commonly a few weeks after the initial

conversation, they will say, " You know, I was paying attention to such-and-such,

and I noticed that it is exactly as you described.  How did you know? "

 

Many of my patients have become accustomed to ignoring their body's messages to

them, and in working with me, there is an opportunity to change this.

 

Andrea Beth

 

 

Traditional Oriental Medicine

Happy Hours in the CALM Center

635 S. 10th St.

Cottonwood, AZ  86326

(928) 274-1373

 

 

--- On Mon, 6/15/09, Daniel Schulman <daniel.schulman wrote:

 

Daniel Schulman <daniel.schulman

Re: Superior and Extraordinary Physicians

Chinese Medicine

Monday, June 15, 2009, 6:15 PM

 

Hugo - the interesting thing I find is that 90% of the time I do ask that (I run

through the entire list of symptoms likely to accompany such signs - menstrual,

digestive, sleep, etc etc etc) and what is so interesting is that most often,

the patient will say no to all the questions which can mean one of two things

(at least) - either they are not being truthful in their replies (overtly or

perhaps subconsciously?) OR the pulse and tongue signs are manifesting prior to

any symptomology.

 

Chinese Medicine , Hugo Ramiro <subincor

wrote:

>

> Hi All:

>

> --Daniel-

> 'spinning bean' distal pulses - again, just an example, but not uncommon) -

and you wonder, what should I say to this person?

> ---

>

>   You say, " nobody's perfect. by the way, have you ever felt [insert

indicated signs and symptoms here]. "

>

>  Hugo

> ________________________________

> Hugo Ramiro

> http://middlemedicine.wordpress.com

> http://www.chinesemedicaltherapies.org

>

>

> 

>

>

>

>

>       

>

>

[Guest guest]

Superior physicians

1) get to the root and treat the branches as well

2) treat the whole and not just the parts

3) can diagnosis by looking, as well as asking, smelling, listening and

palpating

4) can give a prognosis if that is possible

5) are unselfish in their actions

6) are humble in their relationships

7) follow the classics

8) heal themselves and learn from their patients

 

anything else?

 

K

 

 

 

On Tue, Jun 16, 2009 at 8:19 AM, <wrote:

 

>

>

> Daniel,

>

> It is also possible that the patient is not paying attention to the issues

> you mention. I see this quite often - and commonly a few weeks after the

> initial conversation, they will say, " You know, I was paying attention to

> such-and-such, and I noticed that it is exactly as you described. How did

> you know? "

>

> Many of my patients have become accustomed to ignoring their body's

> messages to them, and in working with me, there is an opportunity to change

> this.

>

> Andrea Beth

>

>

> Traditional Oriental Medicine

> Happy Hours in the CALM Center

> 635 S. 10th St.

> Cottonwood, AZ 86326

> (928) 274-1373

>

>

> --- On Mon, 6/15/09, Daniel Schulman

<daniel.schulman<daniel.schulman%40>>

> wrote:

>

> Daniel Schulman <daniel.schulman<daniel.schulman%40>

> >

> Re: Superior and Extraordinary Physicians

> To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> Monday, June 15, 2009, 6:15 PM

>

> Hugo - the interesting thing I find is that 90% of the time I do ask that

> (I run through the entire list of symptoms likely to accompany such signs -

> menstrual, digestive, sleep, etc etc etc) and what is so interesting is that

> most often, the patient will say no to all the questions which can mean one

> of two things (at least) - either they are not being truthful in their

> replies (overtly or perhaps subconsciously?) OR the pulse and tongue signs

> are manifesting prior to any symptomology.

>

> --- In

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>,

> Hugo Ramiro <subincor wrote:

> >

> > Hi All:

> >

> > --Daniel-

> > 'spinning bean' distal pulses - again, just an example, but not uncommon)

> - and you wonder, what should I say to this person?

> > ---

> >

> > You say, " nobody's perfect. by the way, have you ever felt [insert

> indicated signs and symptoms here]. "

> >

> > Hugo

> > ________________________________

> > Hugo Ramiro

> > http://middlemedicine.wordpress.com

> > http://www.chinesemedicaltherapies.org

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Chinese Medicine , " Daniel Schulman "

<daniel.schulman wrote:

>

> Z'ev: " Another interpretation of this saying is that through astute

> diagnosis, the physician determines which visceral systems are in

> disharmony and treats them before they manifest full-blown disease "

 

And yet another is that even if the disease is full blown liver disease, for

example, filling the spleen qi is a way of stopping the disease. The idea seems

to be that if we go after the evil lodged in the liver directly, then it will

just move. There is no way to attack it directly and expect it to resolve, per

the five phases. If we fill up where it is going, then it has no where to go.

 

The Jin Gui Yao Lue section of the article is interesting in that, in the end,

the goal is to supplement the liver indirectly through the spleen to dislodge

the evil qi. This goes against what modern textbooks say, which is to directly

reduce/drain the affected zang. If we are to believe the JGYL, this would only

make things worse. Other classical texts I have read seem to have a similar

view-if evil is present, there has to be a place for it to reside. The only way

to get rid of it is to fill the respective vacuity and it will naturally go

away. No attacking, no direct supplementation of the affected zang, but a very

crafty and refined treatment.

Re: http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

[Guest guest]

all we need to do is be like bian que's brothers....

 

 

 

 

Chinese Medicine , <johnkokko

wrote:

>

> In order to become a superior physician who treats illnesses before they

> manifest...

> what tools should we cultivate?

>

> K

>

>

> On Mon, Jun 15, 2009 at 11:01 AM, <zrosenbewrote:

>

> >

> >

> > Nice blog. His book is excellent as well. . .

> >

> >

> >

> > On Jun 15, 2009, at 12:17 AM, d_munez wrote:

> >

> > >

> > >

> > > I remember that recently there was a discussion of what it means to

> > > be an extraordinary physician. I couldn't find the thread, but this

> > > weekend I read an article that discusses a classical view of what it

> > > means to be a superior physician. I follow this blog through RSS,

> > > and it recently been more active with some interesting posts and

> > > comments.

> > > http://windstonepress.com/2009/06/13/superior-and-inferior-physicians/

> > >

> > > I find that most people, when they read that the superior physician

> > > treats what is not yet ill, they immediately talk about how patients

> > > only come to see them when they are sick. The above posts tackles

> > > this well and with nice quotes from the classics. Hope you enjoy...

> > >

> > >

> > >

> >

> >

> > Chair, Department of Herbal Medicine

> > Pacific College of Oriental Medicine

> > San Diego, Ca. 92122

> >

> >

[Guest guest]

In the new Tang dynasty history annals, when Sun Simiao was asked how the great

doctors cure illnesses, this was his reply: (be aware, the terminology

translation by Nathan Sivin from 1968 is a bit hard to follow, before a lot of

the tcm terms were standardized...)

 

 

" In nature there are the four seasons and the five elements. Winter cold and

summer heat subsist in turn. Harmony gives rise to rai, anger to winds,

condensation to snow, expansion to the rainbow; these are the unvarying measures

in nature. In man there are four limbs and five viscera. For each period of

consciousness there is a period of sleep. Expiration and inspiration alternate.

Flowing gives rise to circulation, manifestation to outward appearance, issuing

forth to sound; these are the unvarying measutes in man. The function of the

Masculine is shape, and that of the Feminine is essence, in this respect nature

and man are identical.

 

When there is a disorder, if it is a steaming the result is fever; if a

stoppage, the result is chills' if a knotting, the result is tumourous

swellings; if a sinking in, the result is abscesses. Unrestrained motion causes

panting, exhaustion causes destruction. Disease manifests on the countenance,

and moves across the surface of the body.

 

This is also true of heaven and earth. The inequalities of the planetary

motions and the sweeping over of comets are nature's symptoms of disorders. The

coming of cold and heat out of their seasons are its steamings and stoppages.

The extrusion of boulders and the upthrust of land: these are its tumors. The

collapse of hills and the sinking of land; these its abscesses. Raging storms

are its panting; the drying up of streams is its dessication. The great

physician directs the forces with his medicinal substances, and relieves

symptoms with his needles and prescriptions. The sage supports the work of

government with his knowledge of human affairs. Thus the ills of the body are

curable, and natural calamities can be averted. "

 

 

As you can see, there are much vaster levels of this medicine. Humanity lives

between heaven and earth, and all factors influence our experience.

 

 

 

 

 

Chinese Medicine , <johnkokko

wrote:

>

> Superior physicians

> 1) get to the root and treat the branches as well

> 2) treat the whole and not just the parts

> 3) can diagnosis by looking, as well as asking, smelling, listening and

> palpating

> 4) can give a prognosis if that is possible

> 5) are unselfish in their actions

> 6) are humble in their relationships

> 7) follow the classics

> 8) heal themselves and learn from their patients

>

> anything else?

>

> K

>

>

>

> On Tue, Jun 16, 2009 at 8:19 AM, <wrote:

>

> >

> >

> > Daniel,

> >

> > It is also possible that the patient is not paying attention to the issues

> > you mention. I see this quite often - and commonly a few weeks after the

> > initial conversation, they will say, " You know, I was paying attention to

> > such-and-such, and I noticed that it is exactly as you described. How did

> > you know? "

> >

> > Many of my patients have become accustomed to ignoring their body's

> > messages to them, and in working with me, there is an opportunity to change

> > this.

> >

> > Andrea Beth

> >

> >

> > Traditional Oriental Medicine

> > Happy Hours in the CALM Center

> > 635 S. 10th St.

> > Cottonwood, AZ 86326

> > (928) 274-1373

> >

> >

> > --- On Mon, 6/15/09, Daniel Schulman

<daniel.schulman<daniel.schulman%40>>

> > wrote:

> >

> > Daniel Schulman <daniel.schulman<daniel.schulman%40>

> > >

> > Re: Superior and Extraordinary Physicians

> > To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> > Monday, June 15, 2009, 6:15 PM

> >

> > Hugo - the interesting thing I find is that 90% of the time I do ask that

> > (I run through the entire list of symptoms likely to accompany such signs -

> > menstrual, digestive, sleep, etc etc etc) and what is so interesting is that

> > most often, the patient will say no to all the questions which can mean one

> > of two things (at least) - either they are not being truthful in their

> > replies (overtly or perhaps subconsciously?) OR the pulse and tongue signs

> > are manifesting prior to any symptomology.

> >

> > --- In

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>,

> > Hugo Ramiro <subincor@> wrote:

> > >

> > > Hi All:

> > >

> > > --Daniel-

> > > 'spinning bean' distal pulses - again, just an example, but not uncommon)

> > - and you wonder, what should I say to this person?

> > > ---

> > >

> > > You say, " nobody's perfect. by the way, have you ever felt [insert

> > indicated signs and symptoms here]. "

> > >

> > > Hugo

> > > ________________________________

> > > Hugo Ramiro

> > > http://middlemedicine.wordpress.com

> > > http://www.chinesemedicaltherapies.org

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >