Patterns & WM lab tests

[Guest guest]

I have been thinking more and more about the issue of lab tests and

other WM diagnostic examinations and CM pattern discrimination. As I

believe I have said before on this list, there is a growing body of

literature in China on the relationship between lab tests and other

Western diagnostic examinations and CM patterns. I also believe I have

said that, to date, based on my own reading of the literature, no such

test appears as yet to be considered definitive and standard for the

establishment of a particular CM pattern. Conversely, it is possible

to establish a WM disease diagnosis on a single Western lab test, for

instance, diabetes and fasting blood glucose, hypertension and a

sphymometer (sp?) reading, hyper- or hypo thyroidism and TSH, or

dyslipidemia and a blood fats panel. While numerous authors have

published studies showing a statistical relationship between WM tests

and certain Chinese patterns of certain WM diseases, that relationship

is not one to one.

 

I think everyone on this list would agree that signs and symptoms

(even psychiatric signs and symptoms) have a physiological basis. So

it only seems reasonable that we should be able to establish pattern

discriminations by measuring physiological changes in the body. After

all, patterns are nothing other than patterns of such signs and

symptoms. However, I think where some Chinese researchers have or are

going wrong is looking for/at a single parameter, hoping that there

will be a one-for-one relationship between some reading of that

parameter and a CM pattern. This seems to mistake the very nature of a

pattern as opposed to a disease.

 

As we well know, two patients with a single WM disease may present

very different CM patterns. All patients with that disease will/must

display the core pathognomonic or defining signs and symptoms of that

disease. However, when we look at the whole person, we see that they

also present a host of accompanying symptoms. In the CM literature,

these are referred to as either " accompanying symptoms " or

" generalized symptoms. " As a for instance, a patient with migraine has

to have a certain type of paroxysmal head pain to qualify for this WM

disease diagnosis. Nevertheless, individual patients may have either

diarrhea or constipation, may have either profuse phlegm or scanty

fluids, may have either a red or pale white facial complexion, etc.,

etc., and it is often these accompanying or generalized signs and

symptoms which differentiate the patient's pattern as opposed to their

pathognomonic S & S.

 

What I am getting at here is that, in all probability, we can and will

be able to determine CM patterns via WM lab tests and other diagnostic

examinations. However, instead of this being accomplished by a single

test or examination, it will be established by a " pattern " of tests

and examinations. In other words, I believe it will be by a

corroboration or " triangluation " of S & S that such patterns will be

identified just as we already do with our four examinations (si zhen).

Because there are so many testable variables in human physiology, it

is going to be difficult to determine just what panel of tests should

be used to determine which patterns in which diseases. But, although

this maybe complex and time-consuming, I do believe it is doable.

 

Let's take a for instance. Diabetes is diagnosed in WM by FBG, PPBG,

and/or OGTT. If we now add blood lipids, blood pressure, and urine

analysis and look at these as complex patterns, my guess is that we

could work out a CM pattern discrimination. Maybe I don't have exactly

the right combination of tests. Maybe I should have included

ophthalmogic examination or neurological examination or the

measurement of some neurotransmitter instead of one or more of the

tests I have suggested. For instance, irritability is major symptom of

most CM liver patterns, and there probably is a testable

neurotransmitter or comparative panel of neurotransmitters that are

associated with for this symptom. Since I'm not a WM expert, I don't

know what the tests should be, but I feel fairly confident that A),

since there is only a single body, patterns can and will be identified

by WM tests and B) this will eventually be accomplished by patterns of

such tests and not a single test in any given situation.

 

Any feedback on these opinions would be appreciated.

 

Bob

[Guest guest]

In other words, I believe it will be by a corroboration or "triangluation" of S & S that such patterns will be identified just as we already do with our four examinations (si zhen). Because there are so many testable variables in human physiology, it is going to be difficult to determine just what panel of tests should be used to determine which patterns in which diseases. But, although this maybe complex and time-consuming, I do believe it is doable.>>>That's why we have computers these days. A pattern may emerge. We need to get the data in so that we can see

Alon

[Guest guest]

For instance, irritability is major symptom of most CM liver patterns, and there probably is a testable neurotransmitter or comparative panel of neurotransmitters that are associated with for this symptom.

>>>Not yet, but possibly dopamine dominance would come up would be interesting

Alon

[Guest guest]

Bob,

 

One of the reasons that I focus so intently

on the subject of language, nomenclature,

translation standards, etc. (concerns that

I recognize we have in common) is that as

Chinese medicine continues to become more

widely studied and practiced there is bound

to be increasing demand on the part of

doctors and the citizenry that they purport

to represent to know " how it works. "

 

Regardless of whether or not anyone will

ever be able to respond to such demands to

the satisfaction of a substantial fraction

of those posing such questions, questions

will continue to emerge. And the broad public

discussion, fueled as it is by such broad

misunderstanding and no-understanding of

Chinese medical terms has already taken on

some farily ominous tones.

 

What this has to do with issues of language,

nomenclature, literature and communication

between Chinese medical personnel and Western

doctors and researchers is no doubt already

obvious to you personally. And many of the

primary concerns have been spelled out in posts

on this topic over the past couple of years.

 

One of the insights that I've discovered to

be of some interest in all of this is that

there exists a potential " common language "

in which Chinese medical concepts and Western

medical concepts might be closely correlated

allowing for the comparison of diagnostic

information and the development of mutually

coherent patterns of disease. By mutually

coherent here I mean patterns that conform

to the standards of Chinese medical diagnosis

and that make sense to a doctor or researcher

trained in Western medical sciences and arts.

 

This could have an enormous impact on issues

such as those you've discussed below and

the questions related to the interactions

of Chinese and Western medicinals, to name

just a couple of obvious areas.

 

I recently submitted a paper that I've

co-written with Prof. Zhu Jian Ping

to a number of people at the Santa Fe

Institute, where the subject of study is

complexity theory. In the context of

your discussion of patterns and WM lab

tests, I want to pass on just a few

thoughts from John Holland, one of the

pioneers of complexity theory and a

number of related ideas and disciplines.

 

Here he is responding to the overall notion

that a synthesis of traditional Chinese

medicine and complexity theory could be

potentially productive.

 

" Your use of ideas from " complexity studies " to underline an

understanding of the whole patient, rather than treating the patient

as an example of a disease, seems to me a good way of arriving at a

more patient-centered medicine.

[...]

" One sees the targeted medicines as something like local

interventions in a tropical rainforest, with complicated feedback

cascades that may completely overwhelm the anticipated

effects. The long-term goal, then, would be to relate the

terminologies of Chinese and Western medicine to the implied dynamics

(which is presumably common). "

 

I believe you have arrived at a rather similar

perspective at the end of your post, and the

point that I want to make here is that before

we can accomplish a meaningful relationship

bewteen the terminologies of the two subjects

and then proceed to correlate the conflated

list [it would be a fairly long list, to be sure]

to the implied dynamics, we have to have a

well established cohort of people who have

a strong foundation of understanding of the

terminology of Chinese medicine.

 

Currently the development of an adequate

cohort is impeded by a number of factors.

One is the still wide spread attitude

that Chinese medicine has no nomenclature.

Another is the subsequent neglect of its

very real nomenclature in the curricula

and examination standards currently in

place.

 

If you're interested in following up on

the complexity angle, the bulk of the June

issue of CAOM, which is just now going

into production, will be devoted to three

separate articles that examine the possibilities

of a developing interface between complexity

and Chinese medicine.

 

In short, it seems to me that the insights

of modern science have brought us close

to full circle with respect to the possession

of awareness and wisdom about the nature of

natural systems and their complex interactions

such as we find in ancient Chinese philosophy

and medicine.

 

Which reminds me, are you ever going to reply

to my question about where you place the limits

on philosophy?

 

The Complex Orientalist

[Guest guest]

Hmmm. I think that while there are probably more productive and mutually

beneficial ways for Chinese medicine to combine with modern Western

medicine, I don't think that lab tests, even patterns of lab tests, will

ever be able to do what practitioners of CM are trained to do. I am

thinking primarily of the cultivation of intuitive skills that are meant to

interpret subtle signs that may not be readable via lab testing. Certainly

there are physiological correlates of such patterns on some level, but the

relationship between organ systems and such really doesn't get read through

the blood, urine, or even in the neurotransmitters. Not, at least, in any

test or combo of tests that I've ever heard of.

 

Sonya

 

 

 

 

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[Guest guest]

, " pemachophel2001 "

<pemachophel2001> wrote:

but I feel fairly confident that A),

> since there is only a single body, patterns can and will be identified

> by WM tests and B) this will eventually be accomplished by patterns of

> such tests and not a single test in any given situation.

 

Bob

 

I couldn't have said it better. You have hit the nail right on the

head. More later, if I have some time for this.

 

[Guest guest]

Ken,

 

I did not mention complexity theory in my post because I don't really

know much about it. However, from the little I do know about it, it

does seem to be applicable to this situation.

 

BTW, how to to CAOM?

 

As for the philosophy question, it's not the kind of question I feel

any interest (or meaningful ability) in pursuing. For me, it's way too

abstract and way too complex.

 

Bob

 

, " dragon90405 " <yulong@m...> wrote:

> Bob,

>

> One of the reasons that I focus so intently

> on the subject of language, nomenclature,

> translation standards, etc. (concerns that

> I recognize we have in common) is that as

> Chinese medicine continues to become more

> widely studied and practiced there is bound

> to be increasing demand on the part of

> doctors and the citizenry that they purport

> to represent to know " how it works. "

>

> Regardless of whether or not anyone will

> ever be able to respond to such demands to

> the satisfaction of a substantial fraction

> of those posing such questions, questions

> will continue to emerge. And the broad public

> discussion, fueled as it is by such broad

> misunderstanding and no-understanding of

> Chinese medical terms has already taken on

> some farily ominous tones.

>

> What this has to do with issues of language,

> nomenclature, literature and communication

> between Chinese medical personnel and Western

> doctors and researchers is no doubt already

> obvious to you personally. And many of the

> primary concerns have been spelled out in posts

> on this topic over the past couple of years.

>

> One of the insights that I've discovered to

> be of some interest in all of this is that

> there exists a potential " common language "

> in which Chinese medical concepts and Western

> medical concepts might be closely correlated

> allowing for the comparison of diagnostic

> information and the development of mutually

> coherent patterns of disease. By mutually

> coherent here I mean patterns that conform

> to the standards of Chinese medical diagnosis

> and that make sense to a doctor or researcher

> trained in Western medical sciences and arts.

>

> This could have an enormous impact on issues

> such as those you've discussed below and

> the questions related to the interactions

> of Chinese and Western medicinals, to name

> just a couple of obvious areas.

>

> I recently submitted a paper that I've

> co-written with Prof. Zhu Jian Ping

> to a number of people at the Santa Fe

> Institute, where the subject of study is

> complexity theory. In the context of

> your discussion of patterns and WM lab

> tests, I want to pass on just a few

> thoughts from John Holland, one of the

> pioneers of complexity theory and a

> number of related ideas and disciplines.

>

> Here he is responding to the overall notion

> that a synthesis of traditional Chinese

> medicine and complexity theory could be

> potentially productive.

>

> " Your use of ideas from " complexity studies " to underline an

> understanding of the whole patient, rather than treating the patient

> as an example of a disease, seems to me a good way of arriving at a

> more patient-centered medicine.

> [...]

> " One sees the targeted medicines as something like local

> interventions in a tropical rainforest, with complicated feedback

> cascades that may completely overwhelm the anticipated

> effects. The long-term goal, then, would be to relate the

> terminologies of Chinese and Western medicine to the implied

dynamics

> (which is presumably common). "

>

> I believe you have arrived at a rather similar

> perspective at the end of your post, and the

> point that I want to make here is that before

> we can accomplish a meaningful relationship

> bewteen the terminologies of the two subjects

> and then proceed to correlate the conflated

> list [it would be a fairly long list, to be sure]

> to the implied dynamics, we have to have a

> well established cohort of people who have

> a strong foundation of understanding of the

> terminology of Chinese medicine.

>

> Currently the development of an adequate

> cohort is impeded by a number of factors.

> One is the still wide spread attitude

> that Chinese medicine has no nomenclature.

> Another is the subsequent neglect of its

> very real nomenclature in the curricula

> and examination standards currently in

> place.

>

> If you're interested in following up on

> the complexity angle, the bulk of the June

> issue of CAOM, which is just now going

> into production, will be devoted to three

> separate articles that examine the possibilities

> of a developing interface between complexity

> and Chinese medicine.

>

> In short, it seems to me that the insights

> of modern science have brought us close

> to full circle with respect to the possession

> of awareness and wisdom about the nature of

> natural systems and their complex interactions

> such as we find in ancient Chinese philosophy

> and medicine.

>

> Which reminds me, are you ever going to reply

> to my question about where you place the limits

> on philosophy?

>

> The Complex Orientalist

[Guest guest]

Currently the development of an adequatecohort is impeded by a number of factors.One is the still wide spread attitudethat Chinese medicine has no nomenclature.Another is the subsequent neglect of itsvery real nomenclature in the curriculaand examination standards currently inplace.>>>>>First you probably need to show that you can get a group of similarly trained practitioners to agree on diagnosis. This will always be the most difficult issue here. If you could get large groups of patients that have a definite CM diagnosis (in a reliable fashion) then you could plug in biomedical perimeters, tests, etc and see what comes out.

Alon

 

[Guest guest]

---

 

Since I'm not a WM expert, I don't

> know what the tests should be, but I feel fairly confident that A),

> since there is only a single body, patterns can and will be

identified

> by WM tests and B) this will eventually be accomplished by patterns

of

> such tests and not a single test in any given situation.

>

> Any feedback on these opinions would be appreciated.

>

> Bob

 

Bob,

Two thoughts on this which I think support your position:

The distinction between necessary and sufficient conditions provides

a hurdle and then a whopping jump for any attenpt to correlate a

single test to a CM pattern. Eg, if every case of kidney yang vacuity

has lowered levels of a chemical " p " then it is a necessary condition

of diagnosing that pattern. However,it is a whole other, massive,

step, in nature, to the position that every case of lowered p =

kidney yang vacuity, ie that it is a sufficient condition.

 

Secondly there is a feel of a category mistake lurking. CM patterns

describe a situation at an, albeit simplified, human level, with all

that implies interms of comlexity and interaction,that is their

advantage; from this view it is as unlikely to be able to correlate

a single test with a CM pattern as ascribe criminal behaviour to a

simple chemical analysis.

 

One possibility for how this might go is that at best sets of tests

overlap to some extent CM patterns so that no tests are necessary or

sufficient, there could always be excluding factors, but if enough

are present then they indicate a probability of a CM pattern. Which

is where we are now with gross signs and symptoms.

 

Simon

[Guest guest]

Bob,

 

> I did not mention complexity theory in my post because I don't

really

> know much about it. However, from the little I do know about it, it

> does seem to be applicable to this situation.

 

SFI, which is to some extent the home of

complexity theory, has only been in

existence since the mid-1980's. But

during nearly two decades of development

the ideas have become considerable,

particularly with respect to what now

appears to a growing number of people

to be their potential for serving as

the scientific side of a bridge between

the systems of knowledge that we tend

to embrace with terms like " Chinese

medicine " and " science " .

 

>

> BTW, how to to CAOM?

 

Here's the link to the journal's website.

http://www.harcourt-international.com/journals/caom/

There you'll find a link for subscriptions.

>

> As for the philosophy question, it's not the kind of question I

feel

> any interest (or meaningful ability) in pursuing. For me, it's way

too

> abstract and way too complex.

 

Noted. For me it remains a central

concern, particularly in developing

ways for communicating subtle and

difficult Chinese concepts in language

that modern people can understand and

employ effectively.

 

From the perspective of standards of

discourse (which we have been discussing

in the interval since you dismissed

my position regarding the need for a

firm footing in philosophical meanings

and matters as a prerequisite to the

successful study of Chinese medicine

as being " guo fen " or in English

" over the limit " ) I suggest that you

may wish to reconsider since it now

appears that you have no basis for

having made that statement. This is

not so much a matter of concern over

who's watching us talk in this forum

as it is a matter of engendering a

culture of mutual respect for one another's

ideas. I certainly don't expect that

you or anyone else will necessarily

agree with my opinions about this or

anything in particular or anything

at all, for that matter.

 

But if one of us is going to dismiss

another's opinion, I think he or she

should be prepared to at least explain

their basis for doing so.

 

I'm not objecting to the disagreement.

I'm not objecting to style or emotion

or anything else. I rather enjoy the

occasional rough and tumble. Lon offhandedly

suggested that I may be a conspirator

in the camp of " physicians, Marxists,

and pharmaceutical industries " the

other day on the other list; and I

got a kick out of that.

 

I find the expression of other people's

points of view truly illuminating.

 

I also suspect that aside from currently

demuring on the subject, you do hold some

opinion or position that for whatever

reasons you have decided to keep to yourself.

 

That's okay with me, as well. But we can't

both talk about it and not talk about it

the same time. If you see my point.

 

My position, as I've stated here and in

the past, is that without an adequate

exploration of the philosophical underpinnings

of Chinese medical terms and theories, one

is in danger of becoming lost in a landscape

of words and symbols that have significations

pointing to places one does not even recognize

as being in existence.

 

I don't think it is now or ever was over any

limit. I think it's a core, central concern.

And I base this not on my own revelation

but on a reading of classical sources, such

as Sun Si Miao, whom I have quoted at some

length on this point in the past.

 

Best,

 

Ken

[Guest guest]

Sonya,

 

> Hmmm. I think that while there are probably more productive and

mutually

> beneficial ways for Chinese medicine to combine with modern Western

> medicine, I don't think that lab tests, even patterns of lab tests,

will

> ever be able to do what practitioners of CM are trained to do.

 

I agree. But along the lines I brought

up the other day, I think that lab tests

provide an opportunity for exchange of

data between the two " systems " . Knowledge

and certainty are different. Certainty

is based upon what is established clearly.

Knowledge is bit less fixed and, to be useful

must be bound to what is established. Sometimes

this confirms what is established. Sometimes

certainties are shaken free.

 

I think the issue then becomes how do

we accomplish the correlation...binding

if you will...of the kind of knowledge

that is produced in lab tests and the

kind that is engendered in the interaction

between doctor and patient according to

traditional Chinese theories and practices?

 

It is from this point of view that the

correlation of Chinese medical thought

and complexity theory appears to have

so much potential. So many of the basic

terms and concepts have meanings which

are 1) similar; and 2) clearly derived

from looking at the world as an aggregation

of complex systems, layers, operations,

etc.

 

I am

> thinking primarily of the cultivation of intuitive skills that are

meant to

> interpret subtle signs that may not be readable via lab testing.

 

Yet I think both approaches aim at the

same target, i.e. what is going on in

the internal organs of the body. Of

course, one of the great diagnostic

advantages of Chinese medicine is the

theory of zang4 xiang4 that enables

doctors to see the internal workings

of the body by interpretation of

external appearances. This basic theory

drives the cultivation of perceptive

and intuitive skills. Such skills can

even be employed in the reading and

interpretation of lab reports.

 

Certainly

> there are physiological correlates of such patterns on some level,

but the

> relationship between organ systems and such really doesn't get read

through

> the blood, urine, or even in the neurotransmitters. Not, at least,

in any

> test or combo of tests that I've ever heard of.

>

 

But wouldn't it be interesting to

compare two sets of data and see if

correlations emerged?

 

Ken

[Guest guest]

Ken,

 

I think the issue then becomes how do

>we accomplish the correlation...binding

>if you will...of the kind of knowledge

>that is produced in lab tests and the

>kind that is engendered in the interaction

>between doctor and patient according to

>traditional Chinese theories and practices?

 

I think the kinds of information that we are dealing with here is

complementary, like Henri Bergson's intuition and intellect.

Correlation, combination, or integration must evolve I think with a spirit

of respect for the integrity of each way of knowing. That said, I think the

binding might be better balanced in a dialogue form first, as opposed to the

immediate assumption that translation is possible. I think that's been the

main hindrance to true communication, especially in Western science

dominated China. And this is why really I recoil from the thoughts of CM dx

from lab tests: it's skipping the conversation and going right to the

conclusion-- (I encourage anyone to challenge me on this line of thought...)

 

This basic theory

>drives the cultivation of perceptive

>and intuitive skills. Such skills can

>even be employed in the reading and

>interpretation of lab reports.

 

True, and they are! The difference is that in Chinese medicine, our whole

training is in the development of intuition. In Western med, the doctors

use it to some degree, but are taught that reason is better. I think the

formal application of intuitive lab testing would be grand. However, like

the yinometer/yangometer idea, I think that there's only so far we can go

with direct correlations. The MS unmyelinated fibers and yin xu thing that

was mentioned the other day on this list comes to mind, but could we say

just looking at the lab test that for sure there is yin xu? Wouldn't we

still have to see the tongue and feel the pulse, look at the face, and ask

the questions, etc....

 

>But wouldn't it be interesting to

>compare two sets of data and see if

>correlations emerged?

 

Yes, it would. But I wouldn't treat anyone based on them. Probably ever.

 

Sonya

 

 

 

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[Guest guest]

, " Sonya Pritzker " <spritzker15@h...> wrote:

 

> I think the kinds of information that we are dealing with here is

> complementary, like Henri Bergson's intuition and intellect.

> Correlation, combination, or integration must evolve I think with a

spirit

> of respect for the integrity of each way of knowing.

 

Sonya,

 

I particularly appreciate your reference to Bergson. I have

considered Bergson's premise, with which I wholeheartedly agree, to be

a reminder (among other things) why it is futile to " explain " one

discipline (say TCM) with another (laboratary analysis). I would not

even suggest that modern science could describe the entire richness of

CM, nor would I believe that chinese medical concepts can reveal the

same data as modern testing. These two methodologies disclose

different data.

 

However, I also believe, as has been elucidated by Ken Wilber (also a

fan of Bergson, BTW), that every phenomena has multiple correlates.

There are systemic and organismic aspects to every event in human life

just as there are biochemical ones. Assume TCM is a systemic,

organismic model of the body (as Needham argues). This does not

preclude there being discrete biochemical changes being associated

with these functional changes. In fact, I think they are two sides of

the same coin. So I do not think one can ever " explain " the other, but

I do think there are correlates that ocur together in time and space.

And those correlates may include a symptom complex and certain as yet

undetermined lab tests.

 

One of your criticisms of this premise was that you were unaware of

any lab tests that could be used to correlate a TCM dx. But I think

my position and that of Bob's and perhaps Ken's, is that the work

still needs to be done to elucidate all of this. It is a given to me

that there are physiological correlates for all medical phenomena

described by TCM. So we just need to find what they are. There is

preliminary work in China along these lines, as reported by Subhuti

Dharmananda.

 

In addition, in my own practice I have found some coincidences, let's

call them for now, between TCM dx and certain lab tests such as food

allergy, comprehensive stool culture, DHEA, testosterone and other

hormones. I suspect a wide battery of tests would reveal a range of

subclinical biochemical abnormalities that could be used as the basis

to develop patterns of tests as Bob suggested.

 

 

The difference is that in Chinese medicine, our whole

> training is in the development of intuition. In Western med, the

doctors

> use it to some degree, but are taught that reason is better.

 

see, I don't think I really agree with this, that CM is foremost about

intuition and WM is about reason. I think the CM I learned is all

about reason and logic and this has been the dominant mode of thinking

in CM for the past millenium. I also do not consider intuition to

exist separate from reason (so perhaps I differ from Bergson on this

account). I think true intuition occurs when one has moved beyond

simple logic to something more all encompassing or visionary, but

still including reason. I do not see reason and intellect as two

sides of the same coin.

 

 

could we say

> just looking at the lab test that for sure there is yin xu?

Wouldn't we

> still have to see the tongue and feel the pulse, look at the face,

and ask

> the questions, etc....

 

and therein lies the question. Who would be more accurate? The

" average " pulse taker or the " average " lab tech. There's only one way

to find out. Not that my main interest is in replacing traditional

diagnsotics, but if the most skilled diagnosticians are rare, it is

distinctly possible that lab testing will more accurate than the those

with lesser skills. This has certainly turned out to be the case in

western medicine. A great cardiologist can diagnose a wide range of

diseases with a stethoscope. The average doc can't tell you much

without a battery of tests. Ideals are nice, but realistically there

is no way everyone in our field is going to be a master. I certainly

don't see any harm in learning whatever we may to enhance the

diagnostic process. Lab tests could never replace the four exams

because if you didn't do the four exams, you wouldn't know what lab

test to order in the first place.

 

[Guest guest]

, " dragon90405 " <yulong@m...> wrote:

> But wouldn't it be interesting to

> compare two sets of data and see if

> correlations emerged?

 

 

 

Ken:

 

There are already a number of correlations of WM to CM when using

pulse diagnosis. My artcle, " Organs and Their Associated Pulses in

the Dong Han System, " in the Files section, mentions a number of

them. No doubt the Shen/Hammer people have others. To paraphrase

your argument, we haven't exhausted our own information sources yet.

 

A problem not yet pointed out in the thread is that WM tests are not

always that reliable in measuring and defining a problem. For

example, I have seen many women whose thyroid test shows them in the

normal range, yet they still have hypothyroid symptoms and their

pulses also indicate hypothyroid [see article for pulse markers].

 

But in general, you may still want to use some tests as motivation

for examination in CM. If hypoglycemia is diagnosed by WM, it may be

thought of as spleen yang xu; if diabetes, then both spleen yang and

yin xu, since both the control (yang) and production (yin) of

insulin is a problem.

 

 

Jim Ramholz

[Guest guest]

 

 

 

 

 

Sonya,

 

Our training as practitioners of is not based solely on the development of intuition, that is just one part of the mandalic whole. We are trained in a very precise diagnostic system based on a vast knowledge base. Intuition is important, but a good practitioner uses his didactic skills to assess and evaluate the patient and reach a diagnosis, a treatment principle and protocol. We have a beautiful oppurtunity in our medicine to Tai Chi our way from reason to intuition, finding a delicate balance between them.

 

>True, and they are! The difference is that in Chinese medicine, our whole

>training is in the development of intuition. In Western med, the doctors

>use it to some degree, but are taught that reason is better. I think the

 

 

>formal application of intuitive lab testing would be grand. However, like

>the yinometer/yangometer idea, I think that there's only so far we can go >with direct correlations. The MS unmyelinated fibers and yin xu thing that >was mentioned the other day on this list comes to mind, but could we say >just looking at the lab test that for sure there is yin xu? Wouldn't we >still have to see the tongue and feel the pulse, look at the face, and ask >the questions, etc.... > > >But wouldn't it be interesting to > >compare two sets of data and see if > >correlations emerged? > >Yes, it would. But I wouldn't treat anyone based on them. Probably ever. >

Iwouldn't either. But would I use the lab test as a diagnostic tool to see what I am dealing with? Sure. Then, a further differential diagb=nosis would be called for. But what does intuition have to do with that?? I find diagnosis very reason oriented.

Eti

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[Guest guest]

, " eti domb " <etidomb@h...> wrote:

> We have a beautiful oppurtunity in our medicine to Tai Chi our way

>from reason to intuition, finding a delicate balance between them.

 

What do you mean by the above?

 

Fernando

[Guest guest]

, " eti domb " <etidomb@h...> wrote:

> But what does intuition have to do with that?? I find diagnosis

>very reason oriented.

 

Eti, I agree. However, I think that at some point most practitioners

begin to work with a balance of insight, observation, intuition,

inductive and deductive thinking, in their efforts to understand to

some degree the complexities presented by their patients. A

combination of the above, provides us with the *reason* to diagnose.

This, I think, is what makes our medicine such a beautiful art form.

 

Fernando

[Guest guest]

Eti,

 

, " eti domb " <etidomb@h...> wrote:

>

But what does intuition have to do with that?? I find diagnosis very

reason oriented.

 

I just wanted to slip in a comment here.

This remark suggests to me that you observe

a categorical distinction between " reason "

and " intuition " that I think has been

called into question by contemporary

research in neuro-science and which is

seen to be unsupportable from the point

of view of traditional Chinese knowledge.

 

I'm thinking of the work of Antonio Damasio,

that has been mentioned on this list in

the past, namely his two books, Descartes

Error and The Feeling of What Happens, in

which he narrates his work in the construction

of neural maps and functional imaginging data

that suggests that the parts of the brain and cognitive

capacities that underlie, embody, and enable

both inuititve and rational thought processes

are closely interrelated and inseparable.

That is to say that patients with certain

patterns of pathology, lesions in parts

of the brain known to be associated with

rational thought processes, have the predictable

attentuation of those rational capacities but

also exhibit corresponding emotional/intuitive

deficiencies. I've summed it up here in a way

that is vastly over simplified and suggest that

you or anyone interested take a look at these

books.

 

To my understanding of it, one of the

great strengths of traditional Chinese

diagnostics is that it trains both the

rational and intutive capacities of

practitioners and provides a theoretical

context in which the doctor can reason

with his or her intuitions. This is what

I meant when I said above that the view

expressed in your remark is not supported

by traditional Chinese epsitemology.

 

There is, at least, the ideal of an

integrated mode of thinking in which

the doctor observes, listens, smells,

and feels the patient in order to gather

an overall impression of what is going on.

Clearly this involves both a kind of

direct, intutive knowledge as well as

a highly cultivated set of sensibilities

as to what the various impressions gathered

all mean.

 

Ken

[Guest guest]

Sonya,

 

> I think the issue then becomes how do

> >we accomplish the correlation...binding

> >if you will...of the kind of knowledge

> >that is produced in lab tests and the

> >kind that is engendered in the interaction

> >between doctor and patient according to

> >traditional Chinese theories and practices?

>

> I think the kinds of information that we are dealing with here is

> complementary, like Henri Bergson's intuition and intellect.

 

It's been twenty years since I read Bergson.

But I think I can track with this.

 

> Correlation, combination, or integration must evolve I think with a

spirit

> of respect for the integrity of each way of knowing.

 

Agreed. And this was one of the first things

that attracted me to the people at SFI. This

is one of the key experiential facts of complexity

studies. It's even reflected in the design of

the facility at SFI, which is one that is

at least meant to encourage interaction

between individuals on a direct common

footing that tends to retain the integrity

of each way of knowing.

 

That said, I think the

> binding might be better balanced in a dialogue form first, as

opposed to the

> immediate assumption that translation is possible. I think that's

been the

> main hindrance to true communication, especially in Western science

> dominated China. And this is why really I recoil from the thoughts

of CM dx

> from lab tests: it's skipping the conversation and going right to

the

> conclusion-- (I encourage anyone to challenge me on this line of

thought...)

 

OK. Since you asked...

 

I don't challenge the statements before

" And this is why... " I just don't see

that the recoil is actually supported by

them. In fact, all I'm suggesting is that

the subject of conventional diagnostic

tests might...I want to underline might

be a productive grounds on which to base

a dialog between the two points of view

that are both, after all, looking at the

same patient...or could be if someone wanted

to arrange a study that way.

 

Jim points out that some of this kind of

thing does in fact already exist. I'm

aware at various approaches. What I'm

saying is that we face, first and foremost

a communications challenge in that we've

got to be able to shuttle the data back

and forth between two conceptual sets,

two mind sets, if you will, and have it

remain alive and intact.

 

I utterly agree with you that dialog is

the way to do it, and that all such dialog

can only really be carried out in an atmosphere

of mutual respect.

>

> This basic theory

> >drives the cultivation of perceptive

> >and intuitive skills. Such skills can

> >even be employed in the reading and

> >interpretation of lab reports.

>

> True, and they are!

 

Yeah, well that was the point of my response

to Eti. What's true is that all human cognition,

which Western " scientists " once mistakenly

divided according to " rational " and " emotional "

or " intuitive " as if these were themselves

somehow organic categories reflecting neural

substrata that could be identified, as in

" this is the reason area of your brain "

and " this is the intuition area of your brain " ,

all such activity is closely interrelated

and the parts, when broken affect the

operation of the whole system in ways

that don't conform to the old prejudices.

 

And that's all those old notions of categorical

distinction between reason and emotion turn

out to be, I believe...just old prejudices.

 

The difference is that in Chinese medicine, our whole

> training is in the development of intuition.

 

As Eti pointed out, that's not our whole training.

We are trained to think rigorously using our

intuition as a guide and source of critical

inputs.

 

In Western med, the doctors

> use it to some degree,

 

The good ones to a great extent.

 

but are taught that reason is better.

 

I don't think it's outrageous to conceive

of an environment in which both points of

view can be mutually enlightening.

 

I think the

> formal application of intuitive lab testing would be grand.

However, like

> the yinometer/yangometer idea, I think that there's only so far we

can go

> with direct correlations.

 

I'm not assuming anything about the correlations

or lack thereof. Until the correlations could be

made, it's pointless to speculate as to what they

may or may not reveal.

 

The MS unmyelinated fibers and yin xu thing that

> was mentioned the other day on this list comes to mind, but could

we say

> just looking at the lab test that for sure there is yin xu?

 

This would seem to be a misunderstanding of

yin1 xu1. Certainly before any such correlations

could be made, we'd have to be a tad more certain

about what the terms on both ends of the correlation

actually mean.

 

Wouldn't we

> still have to see the tongue and feel the pulse, look at the face,

and ask

> the questions, etc....

 

How else would you have the data from the Chinese

medical perspective to correlate?

>

> >But wouldn't it be interesting to

> >compare two sets of data and see if

> >correlations emerged?

>

> Yes, it would. But I wouldn't treat anyone based on them.

Probably ever.

>

 

I should hope not. The point isn't to

supplement diagnostic skills as much

as it is to open channels of communication.

 

Ken

[Guest guest]

Absolutely. On so many levels our medicine presents with complex patterns and systems, as well as a wide array of diagnostic parameters upon which one can build. It makes for a very interesting time intellectually as well as intuitively.

Eti

 

 

 

 

 

 

 

>"fbernall"

> > > Re: Patterns & WM lab tests >Sat, 09 Mar 2002 19:59:45 -0000 > >, "eti domb" wrote: > > But what does intuition have to do with that?? I find diagnosis > >very reason oriented. > >Eti, I agree. However, I think that at some point most practitioners >begin to work with a balance of insight, observation, intuition, >inductive and deductive thinking, in their efforts to understand to >some degree the complexities presented by their patients. A >combination of the above, provides us with the *reason* to diagnose. >This, I think, is what makes our medicine such a beautiful art form. > >Fernando > Chat with friends online, try MSN Messenger: Click Here

[Guest guest]

I mean that reason and intuition are just like yin and Yang, one cannot be without the other. As Ken pointed out in his post, they are interwoven and related. I was stating (in a somewhat poetic language) that we integrate the two, dancing between them in a flowing meditation.

I hope that was clearer...

Eti

 

 

 

 

 

 

 

>"fbernall"

> > > Re: Patterns & WM lab tests >Sat, 09 Mar 2002 19:23:25 -0000 > >, "eti domb" wrote: > > We have a beautiful oppurtunity in our medicine to Tai Chi our way > >from reason to intuition, finding a delicate balance between them. > >What do you mean by the above? > >Fernando > Get your FREE download of MSN Explorer at http://explorer.msn.com.

[Guest guest]

Ken,

 

I should hope not. The point isn't to

>supplement diagnostic skills as much

>as it is to open channels of communication.

>

Great. I'm all for conversation. And as I just mentioned in my response

to Todd: I have often thought of how exciting it would be to look at the

physiological parallels to CM patterns, especially in neuro-biology. This

would obviously involve lab testing. I just wouldn't want the goal to be

looking at lab tests, or patterns of these, to come up with diagnoses in CM,

as it seems was the original suggestion...

 

Sonya

 

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[Guest guest]

KR wrote:

 

>This remark suggests to me that you observe

>a categorical distinction between " reason "

>and " intuition " that I think has been

>called into question by contemporary

>research in neuro-science and which is

>seen to be unsupportable from the point

>of view of traditional Chinese knowledge.

 

 

I think that Ken Wilber's perspective is a valuable one here, as Todd

mentioned earlier. His theory is that everything is multi-leveled, and that

structures such as intuition and reason are merely correlates in one big

integrated system. Each of us has concurrent " lines of self " that can and

do develop relatively independently of each other. His premise is that

overall development is non-linear because of these disparate lines of

growth.

 

I agree to the extent that certain areas tend to be emphasized more in

different cultures, families, and individuals. But I also think that there

is an interaction that occurs between the lines of self that ultimately

leads upwards-- emergence, complexity, etc.

 

What I think we are striving for is a way to separate structures like

intuition and reason, but still maintain the integrative perspective offered

by complexity and, to some extent, Chinese medicine.

 

And from that perspective, then yes, Eti, reason plays a huge role in

diagnosis. But so does intuition. My point was that in CM the training has

way more to do with balancing the two perspectives...

 

SP

 

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[Guest guest]

 

 

I love that you brought up Ken Wilber, one of my personal favorites. The

correlates in his system have inspired a lot of thought about the way that

Chinese medicine has evolved. I could launch into these, but I won't. All

I will say now is that yes, I agree that everything is multi-leveled.

Biochemistry is one aspect, as is intuition. Measurement can happen on many

levels, and comparison and correlation between such measurements is indeed

valuable.

 

Actually I couldn't support such exchange more, and as I spend 1/2 my time

reading Western texts on complexity, psychology, and neuro-biology, I should

probably have paid more heed to the value that I see in these ways of

looking at health and disease. In fact, I've often thought of how fruitful

it would be to compare the physiological correlates of TCM patterns with the

biochemistry of dysfunction, especially in terms of neurobiology.

 

I think that it may have come across that I didn't respect the need for

communication between the language of lab tests and that of CM. I was only

contesting the notion that a coherent CM dx could evolve from lab tests

alone. By all means, I would love to see more work done on the

physiological correlates of CM patterns. I would just hope it's in the

spirit of, as I mentioned, respect for each level. That's all I meant.

 

Also, I like that you challenged my distinction between reason and intuition

in Western/Eastern medicine. I really don't think either form of medicine

is all one or the other. I do think emphasis differs from one system to

another, and that traditionally Chinese medicine placed more importance upon

the integration of intuition and logic than did Western medicine. The last

100 years of TCM is a different story, though, with traditional roots

getting somewhat blurred.

 

Sonya

 

 

 

 

 

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[Guest guest]

How is intuition being defined in this dicussion? The usual

understanding of intuiting something is to understand it directly

without recourse to reasoning processes such as induction or

deduction. If this is what is meant, where does it apply to CM? Are

people really suggesting that the insights of CM are given to us

innately? If what is meant is that the rational processes of CM have

become so automatic that we may be no longer aware of them then, of

course, this is not intuition just subconcious reasoning which still

allows the possibility of post hoc communication and justification.

Alot less scary in the field of medicine I would suggest.

 

Simon

 

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