Guest guest Report post Posted February 16, 2003 Zang-fu pattern diagnosis can explain skin diseases, but they are very stubborn and difficult to alleviate. Especially so when they are repressed by repetitive drug treatments, or when they are life-long conditions. Skin disease is a vast topic, there are many types, I haven't read the Chinese literature on it (the English language literature is scarce), and I don't intend to specialize in it. This doesn't mean I won't attempt to treat some cases, I'll usually screen and see if the patient is appropriate for me to treat. On Sunday, February 16, 2003, at 03:52 PM, James Ramholz <jramholz wrote: > , " " wrote: >> Skin diseases I find to be one of the most difficult specialties > in Chinese medicine. I also refer out if I don't get reasonable > results. >>> > > > Z'ev: > > What is it about skin diseases that Zang/fu diagnosis doesn't > explain? > > > Jim Ramholz > > > Chinese Herbal Medicine, a voluntary organization of licensed > healthcare practitioners, matriculated students and postgraduate > academics specializing in Chinese Herbal Medicine, provides a variety > of professional services, including board approved online continuing > education. > > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 16, 2003 Space is limited, but I'll share one case now, one I think you remember. This is a 50 year old woman who was born with one kidney and an incomplete digestive tract, which took several surgeries to correct. She was put in a foster home as a teenager and abused there, leaving her with chronic anxiety. Having one kidney led to compromised kidney function. She has chronic eczema that comes and goes. She is diabetic. She has high blood pressure. Because of all the surgeries on her digestive tract, she finds it difficult to know when she is satisfied, therefore sometimes goes through binges of overeating. She occasionally has severe diarrhea, and severe fatigue. I started treating her seven years ago, at a time when she couldn't handle the various medications. She was unable to get out of bed, and was just beginning dialysis, and decided she'd rather die than do so. Chinese medical treatment has succeeded in keeping her off of dialysis for this time with no further degeneration of kidney function according to tests. Her blood pressure has been stable as well. If she watches her diet, her blood sugar stays within range. I treat her with acupuncture and moxabustion twice a week (unusual in my practice), and she has taken several prescriptions over the years, ranging from zhen wu tang to yu ye tang. She is able to maintain a reasonable life thanks to Chinese medicine. Pulses have also varied, from scattered to choppy to soggy over these seven years, occasionally a very wiry visceral liver pulse. Tongue is cracked, dark, occasional white coating. Basic pattern diagnosis is dual kidney and spleen qi vacuity, liver qi depression, Occasionally phlegm-damp accumulation in lungs, liver yang rising. Acupuncture protocols tend to include: modifications of Wang Leting protocols (see Golden Needle Wang Le Ting from Blue Poppy Press), back huato points, points on the yang ming channel foot and hand, abdominal mu points, quite a bit of moxa on back shu points (shen shu, Bl. 23). Moxa on yong quan Kd. 1 has been very helpful. A typical yang ming protocol will include LI 5/St41 with St 36 or 37 with moxa, St 25, LI 10. I needle unilaterally except for abdominals and sometimes back shu pts. On Saturday, February 15, 2003, at 07:16 PM, wrote: > This is the kind of stuff I personally would like to hear...(maybe > other > don't care) but.. I would like to hear some of these primary care > cases that > you rocked on... and also what primary care cases you didn't fair that > well, > which maybe has given you more wisdom to only approach such cases from > a > complementary approach. .. SInce our hospitals aren't integrated, there > seems to be little discussion, unless someone could point me to > something I > have overlooked... Thanx Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 I find it somewhat ironic that you fagree that TCM is not proven effective for many conditions, but then got defensive about your many years of clinical experience treating such illnesses successfully without needing access to chinese source material. You can't possibly be saying that you are effective at treating conditions like diabetes based soley upon trial and error over the years, while your chinese counterparts are ineffective at treating this condition even with immense resources at their disposal.>>>No I was saying that i have seen many such patients. Success needs to be defined. Patients often feel better but objective signs do not change. So like I have been saying all along there is shades of gray and we need to be more truthful at what we can expect. Also when I was in china patients mostly made the decisions of what they wanted i.e. tcm o wm. But not always, for example i remember several patients that wanted to leave the hospital to a wm hospital for surgical disease but were not allowed because my teacher wanted to prove something. One almost died Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 I think this is a mistaken idea that downplays the importance the chinese have always placed on disease diagnosis as well as pattern diagnosis. xiao ke is an ancient disease that has unique qualities that cannot be explained by merely lower, middle or upper yin xu. >>>When i talk about CM i am referring to modern TCM. Disease diagnosis is always the start point and then pattern diagnosis is always applied. Pattern diagnosis is always depnended on physical signs Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 Skin diseases I find to be one of the most difficult specialties in Chinese medicine. >>>Really depends on condition. Eczema, contact dermatitis,urticaria, some acne often respond quite well. Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 Zang-fu pattern diagnosis can explain skin diseases >>>In the clinic Zang-fu is not commonly used when treating skin diseases, at least not as i learned it or the hospital i worked in alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 , " ALON MARCUS " <alonmarcus@w...> wrote: > >>>When i talk about CM i am referring to modern TCM. Disease diagnosis is always the start point and then pattern diagnosis is always applied. Pattern diagnosis is always depnended on physical signs Really? It seems to me that it should be the other way around. I assume you mean modern TCM as it is practiced in China. To me, Pattern diagnosis is the starting point. Otherwise my observation of the pt's pattern is tinted by the disease diagnosis. Often the WM diagnosis is wrong for example in fibromyalgia. Fernando Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 To me, Pattern diagnosis is the starting point. Otherwise my observation of the pt's pattern is tinted by the disease diagnosis. Often the WM diagnosis is wrong for example in fibromyalgia.>>>Disease diagnosis is CM disease not wm disease alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 It seems we have a number of choices in diagnosis. 1) pattern diagnosis 2) channel-connceting vessel diagnosis (acupuncture/moxabustion) 3) Chinese disease diagnosis 4) WM disease diagnosis. Pattern diagnosis is the central motif of Chinese medicine, but there are times when we need to start with a disease diagnosis as well. In my own practice, with new patients I always feel the pulse first, and then ask questions based on the pulse so that I am not biased by their biomedical disease diagnosis, if they have one. It all really depends on the situation and the patient. On Monday, February 17, 2003, at 09:58 AM, fernando b. <fbernall wrote: > > Really? It seems to me that it should be the other way around. I > assume you mean modern TCM as it is practiced in China. To me, > Pattern diagnosis is the starting point. Otherwise my observation of > the pt's pattern is tinted by the disease diagnosis. Often the WM > diagnosis is wrong for example in fibromyalgia. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 wrote: > 3) Chinese disease diagnosis What's that mean? Like Xiao Ke, Lin syndrome? That sort of thing? -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 Yes. On Monday, February 17, 2003, at 11:14 AM, Al Stone wrote: > wrote: > >> 3) Chinese disease diagnosis > > What's that mean? Like Xiao Ke, Lin syndrome? That sort of thing? Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 , " " <zrosenbe@s...> wrote: > In my own practice, with new patients I always feel the pulse first, and then ask questions based on the pulse so that I am not biased by their biomedical disease diagnosis, if they have one. Z'ev: Do you distinguish patterns in the pulse that belong to the disease process (Western or Chinese) from the patient's response to it? Then treat the diesase pattern/process? I find doing it this way requires few herbal formulas tailored to the individual, and allows a more general approach. The more individualized work can be done with acupuncture. This leads me back to the thread about relating CM to WM. To quote a website on complexity: " One reason that nonlinear science holds such promise for knowledge development is that other theories have not adequately explained the following: Why is the natural history of an illness not the same in " like " cases? Why can we not make reliable predictions about the future even when we have accurate information about the past? How is it that crisis can be a positive experience? How do we understand wholeness? Why is seemingly random or chaotic functioning in many natural systems healthy and optimal functioning? " Although TCM reduces many disease processes to a few simple patterns or combinations of patterns, I think it is an interesting example of nonlinearity in that 'small changes can have great effects'. So herbal formulas, even while not treating a disorder directly, can have remarkable effect. More than finding a one-to-one association between a Western test and CM theory, this is a way to bridge both cultures. At least, it will be easier once WM considers nonlinearity in their daily practice. Jim Ramholz Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 The only reason one starts with CM disease diagnosis is that it is the disease that makes the difference if one is to use one formula for yin def or another etc. Disease diagnosis should not influence pattern diagnosis at all Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 I agree. The information from the biomedical diagnosis may enrich the pattern diagnosis, but we need the pattern differentiation to develop treatment criteria for the patient. On Monday, February 17, 2003, at 12:40 PM, ALON MARCUS wrote: > The only reason one starts with CM disease diagnosis is that it is the > disease that makes the difference if one is to use one formula for yin > def or another etc. Disease diagnosis should not influence pattern > diagnosis at all > Alon > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 17, 2003 Alon, I've given this a little more thought and I think you're right. Fernando , " ALON MARCUS " <> >>> Disease diagnosis is always the start point and then pattern diagnosis is always applied. Pattern diagnosis is always depnended on physical signs Quote Share this post Link to post Share on other sites
