NEW lurking pathogen article & Case study

[Guest guest]

Dear group,

 

 

 

 

There is no doubt that lurking pathogens are an intriguing yet

confusing topic. Chip Chace has just finished an article/ Case study

that explores an important perspective surrounding some key issues.

AS I have recently mentioned, just because a pathogen 'lurks' or lays

dormant in the body, does not necessary guarantee the LP title, nor

guarantees that the LP treatment ideas will be successful...

Biomedical latent viruses, botox theories, or others, possibly only

cloud the issue of what the Chinese really meant by LP... With our

biomedical understanding of the body, much more focus is now on the

'pathogen', instead of the propensity of the situation. AS I have

said, almost anything can been labeled LP from a biomedical

understanding, underscoring the importance to `think Chinese' if we

really want to get any use from such wenbing-ideas as LP scenarios…

what does LP mean? Well… Chip's discussion is intriguing and starts to

close in on a real life clinical understanding of what a LP is & how

we define it, rooted in what I would call a very Chinese way of

thinking. Chip gives a very thought provoking yet clinical based

perspective. The case study itself is also quite interesting... IT

is a must read...Enjoy

 

 

 

 

http://www.siom.com/resources/texts/articles/c-chace/chace.html

 

 

 

 

-

[Guest guest]

, " " wrote:

> There is no doubt that lurking pathogens are an intriguing yet

> confusing topic. Chip Chace has just finished an article/ Case

study that explores an important perspective surrounding some key

issues. >>>

 

 

 

Jason:

 

Your website is shaping up nicely. It's bound to become a major

resource. And Chip continues to be one of the most cogent and

articulate authors in our field. I always look forward to his work.

 

>>> Biomedical latent viruses, botox theories, or others, possibly

only cloud the issue of what the Chinese really meant by LP... With

our biomedical understanding of the body, much more focus is now on

the pathogen', instead of the propensity of the situation. >>>

 

Definitions of terms always change due to the pressures of history

and new clinical findings. Chip " resolves " the issue by simply

limiting the definition of latent pathogens to its premodern concept-

--a practical and understandable decision--in order to insure and

promote a coherent and logically consistant view of CM.

 

Yet, while Chip has talked us out of it for the moment, we're still

left with the problem of how to define contemporary medical problems

in terms of CM. Can we choose to ignore virus, bacteria, prions;

exposure to heavy metals, organic polutants, pharmaceuticals;

diseases caused by problems of DNA (cancer, cystic fibrosis, etc.)

simply because they do not easily fit into prescientific terms? If

we're not going to ignore these new problems, we're left with only

talking about treating their symptom patterns, and cannot not

consider the real root of a disorder---unless CM can find some way

to adapt its terminology to contemporary history.

 

Recourse to the authority of ancient texts may not solve this

problem. Perhaps we've reached the epistemological limit of how CM

sees the world. And, therefore, the limit of what type of disorders

it can effectively treat.

 

 

Jim Ramholz

[Guest guest]

Some thoughts on Jim's take on Charles Chances article on lurking pathogens (by the way, I reccomend that anyone interested read his original article at Chinese Medicine)

 

Jim mentions the following:

Yet, while Chip has talked us out of it for the moment, we're still left with the problem of how to define contemporary medical problems in terms of CM. Can we choose to ignore virus, bacteria, prions; exposure to heavy metals, organic polutants, pharmaceuticals; diseases caused by problems of DNA (cancer, cystic fibrosis, etc.) simply because they do not easily fit into prescientific terms? If we're not going to ignore these new problems, we're left with only talking about treating their symptom patterns, and cannot not consider the real root of a disorder---unless CM can find some way to adapt its terminology to contemporary history.

 

Recourse to the authority of ancient texts may not solve this problem. Perhaps we've reached the epistemological limit of how CM sees the world. And, therefore, the limit of what type of disorders it can effectively treat. While accepting the fact that Chinese medicine, like all forms of healing, has limitations on what it can treat, I do believe that CM has not reached a limit of how it sees the world vis-a-vis modern biomedical understanding of disease. The crux of the difficulty is a lack of a common language through which biomedicine can appreciate and integrate what classical Chinese medicine is talking about.

 

It seems to me at this point that we may be forgetting that Chinese medicine can quite adequately respond to these biomedical terms and conditions through a careful focus on symptom patterns. We are not left with "only" treating symptom patterns but are instead blessed with being able to use differentiation of symptoms as a guide for treatment. Charles pointed out that the "lurking pathogen" concept may be best utilized as a principle for guiding treatment and thus as a theoretical framework for understanding changes in symptom presentation during an evolving course of treatment. Western medicine often considers these changing symptoms to be irrelevant to diagnosis.

 

The crux of the difference between CM and Western medicine in my mind is that the TCM approach is to consider the presence of symptoms as synonymous with the presence of a treatable condition while the biomedical approach is to consider a symptom as an indicator of a possible condition that may or may not actually be a mandate for treatment. Western medicine will then conduct tests based on possible causes of presenting symptoms and then proceed to diagnosis and treatment principle based on those tests. As asserted by Current Medical Diagnosis and Treatment, “Diagnostic tests are used to help establish or exclude the presence of disease in symptomatic patients.” If testing or imaging cannot determine a clear diagnosis, then treatment with modern biomedicine is problematic. Given

the frequency of visits that do not result in clear-cut diagnoses, this leaves quite a few patients in biomedical clinics without recourse to treatment.

 

 

As practitioners of Chinese medicine, as long as we carfully differentiate symptoms and signs, we will be able to provide some relief for any condition that comes our way. This, to me, is the fundamental "take home message" of the Shang Han Lun.

most respectfully,

JDRJason Robertson, L.Ac. Ju Er Hu Tong 19 Hao Yuan 223 Shi Beijing, Peoples Republic of China

home-86-010-8405-0531cell- 86-010-13520155800

 

SBC DSL - Now only $29.95 per month!

[Guest guest]

> Your website is shaping up nicely. It's bound to become a major

> resource.

 

Thanx...

 

And Chip continues to be one of the most cogent and

> articulate authors in our field. I always look forward to his work.

 

I too...

 

>

> >>> Biomedical latent viruses, botox theories, or others, possibly

> only cloud the issue of what the Chinese really meant by LP... With

> our biomedical understanding of the body, much more focus is now on

> the pathogen', instead of the propensity of the situation. >>>

>

> Definitions of terms always change due to the pressures of history

> and new clinical findings. Chip " resolves " the issue by simply

> limiting the definition of latent pathogens to its premodern

concept-

> --a practical and understandable decision--in order to insure and

> promote a coherent and logically consistant view of CM.

>

> Yet, while Chip has talked us out of it for the moment, we're still

> left with the problem of how to define contemporary medical

problems

> in terms of CM. Can we choose to ignore virus, bacteria, prions;

> exposure to heavy metals, organic polutants, pharmaceuticals;

> diseases caused by problems of DNA (cancer, cystic fibrosis, etc.)

> simply because they do not easily fit into prescientific terms?

 

I do not think anyone is saying to ignore this information... At

least in my mind it seems that the integration is done many times by

people who don't fully understand Chinese medicine... they take a

concept from western medicine Latent virus and automatically assume

that it is the same thing as a latent pathogen from CM... it sure

sounds like the same thing even when one reads basic descriptions,

i.e. hides in the body and comes out at a later time... But that, as

we have discussed, is not the whole story. I do not have a definite

answer on how to integrate the above western ideas. But I have two

ideas 1) the obvious, how it presents; there is nothing wrong with

this. 2) Modern research in CHina (and hopefully in the states soon)-

we need something more to expand the theory of CM other than just

saying , " oh it sounds like this concept in the wenbing era called

latent pathogen' therefore it must be the same'... Furthermore, the

nature of CM seems to be best fitted at seeing the whole presentation

(or symptoms) vs. a specific virus.. WM has a much better handle (and

the tools) to go after specific pathogens... CM at the moment does

not... If one notes i.e. Flaws's western disease book one sees an

integration that makes sense to me. Using western disease names

(therefore western dx) and mixing it with CM Dx... this does not

ignore the virus therefore the western disease, and at the same time

allows for the pattern based style of CM to integrate with it.

So I ask, if we allow for the change of terms, ie. Latent pathogens

to include modern latent pathogen criteria, where does this get us

from a CM perspective. The treatments (i.e. wenbing) are not set up

for this type of situation. So we have a very broad term that does

not at all help us from a CM perspective in treating the condition.

 

 

If

> we're not going to ignore these new problems, we're left with only

> talking about treating their symptom patterns, and cannot not

> consider the real root of a disorder

 

I don't see why by treating the patterns is necessary missing the

root... Western medicine might say the X virus is the root, but CM

says lv qi is the root... who is right?? IMO< neither and both..

again if going after a specific virus is the key, WM's tools are much

more efficient anyway... we should not forget that we have 1000's of

virus's in us right now, why do some come out and some do not, and

why at some times and not others; this is crux of the issue, and CM

seems to answer these more relevant questions.

 

 

---unless CM can find some way

> to adapt its terminology to contemporary history.

 

I don't truly understand this... it has adapted many western ideas

and terms... but unsure what you mean.

 

>

> Recourse to the authority of ancient texts may not solve this

> problem. Perhaps we've reached the epistemological limit of how CM

> sees the world.

 

Well... ancient texts of course do not have all the answers, and that

is why modern china is constantly expanding the medicine... But there

are many things to learn from them... and I think this is more

important for the westerner than the Chinese. How many on the list

can say that they can truly think in a SHL mindset. I said last

night to a friend that I have met only very few western's that could

think SHL (BEnsky comes to mind) , but I have met many Chinese practs

that could. what does this mean? well if you have mastered the past

it gives you a firm foundation for integration, and future

development... but if you can't even do the basics of CM (not just

TCM), then I feel one has no say is saying that CM is limited for X

or Y type situation.

 

And, therefore, the limit of what type of disorders

> it can effectively treat.

 

Example, Ok lets look at herpes or AIDS, how does knowing the details

of the virus help us treat it from a CM perspective? Much more

important is the presentation which is nothing different than what

has been occurring for 1000+ years. If we want to inhibit the virus

I think WM is much better at this. Can you elaborate a little more on

what you are thinking, or am I just missing your point with above

ramblings.

 

-

 

Chinese Medicine/

[Guest guest]

, " " wrote:

At least in my mind it seems that the integration is done many times

by people who don't fully understand Chinese medicine... they take a

concept from western medicine Latent virus and automatically assume

that it is the same thing as a latent pathogen from CM... it sure

sounds like the same thing even when one reads basic descriptions,

i.e. hides in the body and comes out at a later time... We need

something more to expand the theory of CM other than just

saying, " oh it sounds like this concept in the wenbing era called

latent pathogen' therefore it must be the same'... >>>

 

 

While there is a strong overlap in discussions about latent

pathogens and viruses, I don't think there is any real " integration "

until an effective theory and clinical application are demonstrated.

This is one issue that Chace, I believe, makes clear and can easily

be agreed to by all.

 

But, like you, I'm interested in raising this question. In part

because the details of the Dong Han pulse diagnosis system already

reflect many ideas from Western medicine; but also because this type

of discussion is part and parcel of the inevitable historical

development of CM in America. On the surface, at least, these ideas

seem to fit together; although what we're saying may or may not be

thought of as germaine to CM in the long run. We may need several

hundred years to make that judgment. But it is evidence of a fusing

of Chinese and Western medicial sensibilities. We should try to

answer this question before the MDs do, and irrevocably change CM

beyond repair.

 

In a few years, we may be able to say " latent pathogens " just like

we say " atom. " For centuries atoms were once considered to be

indivisible objects; now we know they are composed of a wide variety

of particles which, in themselves, are not indivisible. While we

understand the earlier definition being totally different than the

contemporary one, we can easily distinguish one from the other in

their context and application. After all, the Chinese didn't always

define terms the same way. For instance, I thought it funny that the

Mai Jing discusses the right proximal pulse position as another

reference to kidney/bladder. Then, in the last chapter, it mentions

a 'new fangled theory' saying that some practitioners think it might

refer to the SJ. Those crazy kids!

 

 

>>> If one notes i.e. Flaws's western disease book one sees an

integration that makes sense to me. >>>

 

I think it's a good beginning for TCM---especially for herbalists---

because it reduces all sorts of complicated disorders to simple

patterns and aplies many of the same familiar formulas.

Psychologically, it gives us a sense of participation, authority,

and control when discussing Western-styled disorders. But I think

there is a richer vein to mine for some of those problems in other

Chinese theories like 5-Elements and pulse diagnosis---which, IMO,

are usually conspicuously absent in most TCM diagnosis. Probably

because there are not immediate herbal applications as in the SHL

and WB.

 

 

>>> So I ask, if we allow for the change of terms, ie. Latent

pathogens to include modern latent pathogen criteria, where does

this get us from a CM perspective. The treatments (i.e. Wenbing) are

not set up for this type of situation. So we have a very broad term

that does not at all help us from a CM perspective in treating the

condition. >>>

 

They're " hidden " and they're " pathogens " ; so, what are we going to

do? Maybe the problem is in the limitation of the theory or the way

it is applied. The Wenbing theory was developed in response to new

pathological conditions in China. Perhaps we can adapt or develop it

in response to our silent epidemic of DNA mutations, pollution,

stress, and latent viruses and bacteria. We don't necessarily need

to wait for symptoms and signs to appear before we respond. These

disorders have latent periods of sometimes years.

 

 

> Example, OK, lets look at herpes or AIDS, how does knowing the

details of the virus help us treat it from a CM perspective? >>>

 

In the previous forum discussion of Anthrax, there was confusion and

argument over how to treat it and whether Wenbing theory applied.

Instead of waiting and diagnosing the symptoms after they appeared,

a better plan would be to treat the Anthrax as a hidden pathogen,

immediately after exposure and before symptoms developed, with a

formula headed by proven antibacterial action. This seems to have

been done in the case of the SARS epidemic---although many often

used those kinds of formulas even without a known exposure to the

pathogen. Instead of waiting for the body's overt response,

calculate (a Dong Han idea) in CM terms what the nature of the virus

is and what effect it will have. This can be done as a problem of

Guest/Host energies, which is covered in the Suwen.

 

Another example: when there have been discussions of AIDS, I have

always heard it diagnosed by others as being spleen or kidney xu

(correct me if I'm wrong). While spleen and kidney xu are an issue,

they are a byproduct of the real problem, the activity of the virus.

From the Dong Han perspective, a virus is a shaoyang type of fire.

The nature of the virus is more like a hidden heat. We can see that

development in the pulses at the blood depth, especially in the

spleen and liver positions (in the exchange along the sheng cycle in

5-Elements); often even during development prior to symptoms or when

the viral load is negligable. So even in spleen and kidney xu there

is still a defining dynamics of repletion. Knowing the dynamics of

the virus alerts us to the types of CM findings we may expect to see.

 

It's not that CM does not have anything to say about these kinds of

problems. IMO, it's just that the solutions are found in less

popular and more complex theories than the SHL and WB. Perhaps their

time of use has come round again?

 

 

Jim Ramholz

[Guest guest]

, " James Ramholz " <jramholz>

wrote:

 

>

> It's not that CM does not have anything to say about these kinds of

> problems. IMO, it's just that the solutions are found in less

> popular and more complex theories than the SHL and WB. Perhaps their

> time of use has come round again?

>

 

 

In private discussions with Guohui Liu, he has made it clear to me that he

thinks lurking heat theory is a good place to begin to describe pathogens like

viruses such as HIV. However he qualifies that by saying the existing

application of that theory cannot account for many of the features of latent

viruses (which are actually not latent since they do damage the body without

symptoms for many years). And further, the therapies described in wen bing

texts are not effective in the treatment of AIDS. So while the idea may be a

spring board, all the clinical work is yet to be done. The best thing we could

do right now would be a meta-analysis of a huge number of case histories of

all types of latent viruses and see if we can actually identify any patterns.

 

[Guest guest]

, " " <@i...>

wrote:

> , " James Ramholz "

<jramholz>

> wrote:

>

> >

> > It's not that CM does not have anything to say about these kinds

of

> > problems. IMO, it's just that the solutions are found in less

> > popular and more complex theories than the SHL and WB. Perhaps

their

> > time of use has come round again?

> >

>

>

> In private discussions with Guohui Liu, he has made it clear to me

that he

> thinks lurking heat theory is a good place to begin to describe

pathogens like

> viruses such as HIV.

 

Yes.. I have seen lurking pathogens concept in Chinese 'textbooks'

used to describe AIDS, but when one looks at the tx's they are just

basic zang-fu, so where is the value? I feel the modern textbooks

are greatly influenced by western ideas. (for better or worse)

 

However he qualifies that by saying the existing

> application of that theory cannot account for many of the features

of latent

> viruses (which are actually not latent since they do damage the

body without

> symptoms for many years). And further, the therapies described in

wen bing

> texts are not effective in the treatment of AIDS.

 

My point exactly...

 

So while the idea may be a

> spring board, all the clinical work is yet to be done. The best

thing we could

> do right now would be a meta-analysis of a huge number of case

histories of

> all types of latent viruses and see if we can actually identify any

patterns.

 

 

Chip & I (him more than me) have translated many wenbing case studies

on latent pathogens, I think this is where to start. They will be

slowly added to the website (Chinese Medicine) ...IMO, The

unfortunate thing is that the wenbing era used a term that is so

closely related to the way we view many diseases today.. I think

using the term, as said before, confuses the issue... a separation of

terms needs to occur... meaning, a clear distinction between wenbing

LP and modern LP's... as jim said, many (modern) pathogens

are " lurking " - so why not call it LP...? I have although, seen

little commonality in the clinic between the two. So one may view

HIV as a lurking pathogen, but if the treatments (wb) don't work,

then what? How do we make this a springboard? What about WB LP

theory helps us treat these diseases? Finally, a common LP txP is to

evict the pathogen out through the layers, can HIV ever be evicted

(at least with herbs?) how do the treatment principles of eviction

relate to the progression of disease?

The theory sounds nice to describe what is happening, but if the

tx's don't work, why don't we go elsewhere, instead of trying to

redefine a specific CM term?

Just some thoughts.

-

[Guest guest]

, " " wrote:

> Chip & I (him more than me) have translated many wenbing case

studies on latent pathogens, I think this is where to start.>>>

 

 

Can you give an example of any case studies that successfully

treated what we suspect was a virus or bacterial outbreak?

 

 

>>> IMO, The unfortunate thing is that the wenbing era used a term

that is so closely related to the way we view many diseases today..

I think using the term, as said before, confuses the issue... a

separation of terms needs to occur... meaning, a clear distinction

between wenbing LP and modern LP's... as jim said, many (modern)

pathogens are " lurking " - so why not call it LP...? >>>

 

This is just an example of the natural development of the language---

which is inevitable. It is our job to refine it. Like the example I

gave of " atom " , our definition and theory needs to be updated to

reflect contemporary phenomena; or simply admit our limitations.

 

Perhaps first we need to consider where we are successful in dealing

with viruses and bacteria. Certainly many Chinese formulas speed up

and resolve these types of infections. Most notably the various cold

and flu viruses (at least up to SARS) and some infections. These may

be latent for up to several weeks before symptoms actually appear.

We can often see signs in the pulse before symptoms appear.

 

One thing that makes a latent pathogen treatable is that it does not

disarm or attack the immune system itself.

 

 

>>> . . . but if the treatments (wb) don't work, then what? >>>

 

Then either the theory or the treatments, or both, must be

rethought. CM is not a closed system.

 

 

 

> . . . but if the Tx's don't work, why don't we go elsewhere,

instead of trying to redefine a specific CM term? >>>

 

This is another valid option. Where do you propose we go instead?

[Guest guest]

As one of the first people (in the West if not in China) to use the

concept of hidden or deep-lying warm evils (fu wen xie) for the

description of chronic viral diseases, I think this avenue of approach

is largely a dead-end in terms of effective treatment.

 

Bob

 

, " "

<@h...> wrote:

> , " "

<@i...>

> wrote:

> > , " James Ramholz "

> <jramholz>

> > wrote:

> >

> > >

> > > It's not that CM does not have anything to say about these kinds

> of

> > > problems. IMO, it's just that the solutions are found in less

> > > popular and more complex theories than the SHL and WB. Perhaps

> their

> > > time of use has come round again?

> > >

> >

> >

> > In private discussions with Guohui Liu, he has made it clear to me

> that he

> > thinks lurking heat theory is a good place to begin to describe

> pathogens like

> > viruses such as HIV.

>

> Yes.. I have seen lurking pathogens concept in Chinese 'textbooks'

> used to describe AIDS, but when one looks at the tx's they are just

> basic zang-fu, so where is the value? I feel the modern textbooks

> are greatly influenced by western ideas. (for better or worse)

>

> However he qualifies that by saying the existing

> > application of that theory cannot account for many of the features

> of latent

> > viruses (which are actually not latent since they do damage the

> body without

> > symptoms for many years). And further, the therapies described in

> wen bing

> > texts are not effective in the treatment of AIDS.

>

> My point exactly...

>

> So while the idea may be a

> > spring board, all the clinical work is yet to be done. The best

> thing we could

> > do right now would be a meta-analysis of a huge number of case

> histories of

> > all types of latent viruses and see if we can actually identify

any

> patterns.

>

>

> Chip & I (him more than me) have translated many wenbing case

studies

> on latent pathogens, I think this is where to start. They will be

> slowly added to the website (Chinese Medicine) ...IMO, The

> unfortunate thing is that the wenbing era used a term that is so

> closely related to the way we view many diseases today.. I think

> using the term, as said before, confuses the issue... a separation

of

> terms needs to occur... meaning, a clear distinction between wenbing

> LP and modern LP's... as jim said, many (modern) pathogens

> are " lurking " - so why not call it LP...? I have although, seen

> little commonality in the clinic between the two. So one may view

> HIV as a lurking pathogen, but if the treatments (wb) don't work,

> then what? How do we make this a springboard? What about WB LP

> theory helps us treat these diseases? Finally, a common LP txP is to

> evict the pathogen out through the layers, can HIV ever be evicted

> (at least with herbs?) how do the treatment principles of eviction

> relate to the progression of disease?

> The theory sounds nice to describe what is happening, but if the

> tx's don't work, why don't we go elsewhere, instead of trying to

> redefine a specific CM term?

> Just some thoughts.

> -

[Guest guest]

, " " <@h...>

wrote:

 

>

> Yes.. I have seen lurking pathogens concept in Chinese 'textbooks'

> used to describe AIDS, but when one looks at the tx's they are just

> basic zang-fu, so where is the value?

 

there is no value unless the idea leads to novel treatments

 

 

>

> Chip & I (him more than me) have translated many wenbing case studies

> on latent pathogens, I think this is where to start.

 

no, I am talking about analysing AIDs cases and seeing if they conform to any

pattern of wen bing, not vice-versa. If not, is the idea of lurking pathogen

expandable in any meaningful way to account for this. The concept has been

expanded many times and there are apparently many conflicting ideas about

what it means even in the classical chinese wen bing lit.

 

How do we make this a springboard?

 

I think Liu was just being kind when he said this. he does not use this idea in

his practice or it would be included in his book.

 

 

> The theory sounds nice to describe what is happening, but if the

> tx's don't work, why don't we go elsewhere, instead of trying to

 

 

I agree with you.

 

[Guest guest]

Bob,

 

On a contrary note, as one of the first people to discuss pulse diagnosis

findings regarding latent or hidden pathogens, my experience clearly confirms

the clinical value of such thinking. This is a conversation which has yet to

bear out it's possible fruits and is rooted in the Nei Jing, Wen Bing and Mai

Jing.

 

Will

 

> As one of the first people (in the West if not in China) to use the

> concept of hidden or deep-lying warm evils (fu wen xie) for the

> description of chronic viral diseases, I think this avenue

> of approach

> is largely a dead-end in terms of effective treatment.

[Guest guest]

, WMorris116@A... wrote:

> On a contrary note, as one of the first people to discuss pulse

diagnosis findings regarding latent or hidden pathogens, my

experience clearly confirms the clinical value of such thinking.

This is a conversation which has yet to bear out it's possible

fruits and is rooted in the Nei Jing, Wen Bing, and Mai Jing. >>>

 

 

Will:

 

Likewise in the Dong Han pulse system you can often see and

differentiate bacterial and viral infections by the characteristic

qualities that they add to the pulse: a virus infection will show a

heat quality which will appear with a smaller and rounder texture; a

bacterial infection will appear smaller, sharper, and with a kind of

saw-toothed quality.

 

When not related to a general systemic infection, you will find

these qualities in the pulses associated with the localized and

specific types of tissue the infection is found in; so, for example,

you would need to use 5-depths method, decribed in the Nan Jing.

 

 

Jim Ramholz

[Guest guest]

, WMorris116@A... wrote:

> Bob,

>

> On a contrary note, as one of the first people to discuss pulse diagnosis

findings regarding latent or hidden pathogens, my experience clearly confirms

the clinical value of such thinking.

 

are you referring to disease like AIDS? what wen bing type treatment

strategies do you use to address this lurking heat and how do you evaluate

your results? thanks.

 

[Guest guest]

In a message dated 7/2/2003 9:52:42 PM Pacific Daylight Time, writes:

 

 

Are you referring to disease like AIDS? what wen bing type treatment strategies do you use to address this lurking heat and how do you evaluate your results? thanks.

- no as far as AIDS is concerned. For nine years the Red Cross sponsored herbal treatments for AIDS patients in my Berkshire practice. The major concern I had for them was when the pulse would globally lose root -- this almost always portended a serious downturn in status.

 

I am referring to patterns such as latent cold in respiratory conditions or chronic fatigue patterns, or latent heat in chronic fibromyalgia or chronic fatigue.

 

Will

[Guest guest]

In a message dated 7/3/2003 7:23:39 AM Pacific Daylight Time, pemachophel2001 writes:

 

 

That's interesting, but I would need to see data on inter-rater reliability and some sort of objective proof about the clinical utility. If you say this is valuable, then the burden is on you to supply the proof of that assertion.

 

Bob -

As you know, such studies have barely emerged for pulse diagnosis and do not exist for this type of finding. However, since you are first in asserting the lack of utility based on your personal experience, you also maintain a burden of proof in that regard. Or, if we sustain your logic, personal experience has no validity until subjected to inter-rater reliability or other studies; I consider this a reasonable position. The are of inter-rater reliability studies is something I am particularly intersted in and hope to generate more of.

In the meantime, my conversations are based on a discipline of lineal teachings, classical study and clinical application. The Mai Jing contains some of this discussion.

 

Will

[Guest guest]

Will,

 

That's interesting, but I would need to see data on inter-rater

reliability and some sort of objective proof about the clinical

utility. If you say this is valuable, then the burden is on you to

supply the proof of that assertion.

 

Bob

 

, WMorris116@A... wrote:

> Bob,

>

> On a contrary note, as one of the first people to discuss pulse

diagnosis findings regarding latent or hidden pathogens, my experience

clearly confirms the clinical value of such thinking. This is a

conversation which has yet to bear out it's possible fruits and is

rooted in the Nei Jing, Wen Bing and Mai Jing.

>

> Will

>

> > As one of the first people (in the West if not in China) to use

the

> > concept of hidden or deep-lying warm evils (fu wen xie) for the

> > description of chronic viral diseases, I think this avenue

> > of approach

> > is largely a dead-end in terms of effective treatment.

[Guest guest]

Will,

 

, WMorris116@A... wrote:

 

> I am referring to patterns such as latent cold in respiratory conditions or

> chronic fatigue patterns, or latent heat in chronic fibromyalgia or chronic

> fatigue.

 

There are some interesting formulas in Liu for heavy sensations, muddled

head and body pain, many due to some kind of dampheat. I have found

dampheat to be a common factor in many CFIDS and FMS patients. However I

have treated it as a zang fu disorder. I will have to look into whether a wen

bing etiology makes sense for some of my patients.

 

Did you see the case I posted last week on the woman with recurrent rhinitis

with no exterior symptoms and also a long history of chronic eczema (lurking

heat in the ying perhaps). I was hoping to get some direction visa ve lurking

heat in this case. Messages 18147 and 18166 contain the details.

 

[Guest guest]

, " " <@i...>

wrote:

> Will,

>Will,

 

> , WMorris116@A... wrote:

>

> > I am referring to patterns such as latent cold in respiratory conditions or

> > chronic fatigue patterns, or latent heat in chronic fibromyalgia or chronic

> > fatigue.

 

 

I was wondering what formulas you found useful for these presentations.

 

[Guest guest]

Will can you share some of your experience in treating AIDS, if you want please do it off list.

Thanks alon

[Guest guest]

, WMorris116@A... wrote:

> Bob,

>

> On a contrary note, as one of the first people to discuss pulse

diagnosis findings regarding latent or hidden pathogens, my

experience clearly confirms the clinical value of such thinking. This

is a conversation which has yet to bear out it's possible fruits and

is rooted in the Nei Jing, Wen Bing and Mai Jing.

>

 

 

I am unclear how the neijing & wenbing support your pulse ideas for

lurking pathogens. 1st the neijing only says about 2 sentences about

latent heat, and is almost clinically meaningless, and as far as

pulse and latent heat in the neijing goes, I have never seen any

mention, can you show me where?.. 2nd, everything I have read about

wenbing says how unreliable the pulse is for lurking pathogen

conditions. (But there is a lot of literature) – can you give some

citations.

 

But as far as burden of proof... It is not only Bob, but the Chinese

literature that supports that this leap is not very effective. The

burden ,IMO, is up to you to prove that it is effective.

 

-

[Guest guest]

The latent qi warm disease school is perhaps the most modern

development of traditional theory in China. I don't think it is a

complete approach at this point, and there have been many historical

interruptions, such as the introduction of biomedicine and its

antibiotics in the late 19th-early 20th century.

 

If clinical applications have failed so far, that doesn't necessarily

signal a dead end. I don't think we should write it off yet. While I

do not use this method clinically, I find it to be a good conceptual

tool in understanding some complex disease processes.

 

My conclusion for now: latent qi warm disease theory is not a dead end.

Let's continue to study and develop it.

 

 

On Friday, July 4, 2003, at 09:56 AM, wrote:

 

> But as far as burden of proof... It is not only Bob, but the Chinese

> literature that supports that this leap is not very effective. The

> burden ,IMO, is up to you to prove that it is effective.

>

> -

[Guest guest]

, " James Ramholz "

<jramholz> wrote:

> , " " wrote:

> > Chip & I (him more than me) have translated many wenbing case

> studies on latent pathogens, I think this is where to start.>>>

>

>

> Can you give an example of any case studies that successfully

> treated what we suspect was a virus or bacterial outbreak?

>

>

 

Yes there are plenty, I am putting them together as we speak, for the

website... But the question is not, are the cases caused by some

virus or bacteria, but how are they presenting and how are they

treating them... Furthermore, if 10 cases are all assumed to be

viruses, this does not equate the inverse, that all lurking virus

are 'wenbing - lurking pathogens'...

-

[Guest guest]

>

> This is just an example of the natural development of the language--

-

> which is inevitable. It is our job to refine it. Like the example I

> gave of " atom " , our definition and theory needs to be updated to

> reflect contemporary phenomena; or simply admit our limitations.

> >>> IMO, The unfortunate thing is that the wenbing era used a term

> that is so closely related to the way we view many diseases today..

> I think using the term, as said before, confuses the issue... a

> separation of terms needs to occur... meaning, a clear distinction

> between wenbing LP and modern LP's... as jim said, many (modern)

> pathogens are " lurking " - so why not call it LP...? >>>

>

> This is just an example of the natural development of the language--

-

> which is inevitable. It is our job to refine it. Like the example I

> gave of " atom " , our definition and theory needs to be updated to

> reflect contemporary phenomena; or simply admit our limitations.

 

I agree, except for one thing... By changing the definition, we are

not making a more useful definition, we are doing the contrary. The

new definition gives us absolutely nothing as far as treatment goes.

IT is too broad. If all herpes (latent virus) = latent pathogen

someone needs to show me how this helps you treat this. I feel the

definition of atom now is more specific than previous, we have a

better understanding, it is more refined. To change the lurking

pathogen term to what you suggest, is almost going backwards. And

how is it our job to refine it? Is it our job to refine the `jin'

pulse? Maybe hammer has that authority, but do I? What if I said

that a tight pulse is any pulse that I feel is not vacuous. Not only

am I then confusing the issue (terminology), it leaves no valid

treatment parameters. And finally I am no pulse expert, so what gives

me the authority.

 

But the reality, imo, is this: latent viruses is such a broad

umbrella western disease causing factor, tell me, what is usefulness

in using that (latent virus) as a definition parameter? So lets play

the game: you feel a latent virus in the pulse, ok now what? What is

the next step… ?

 

-

 

ChineseMedicineDoc.com

[Guest guest]

I think you and Chip are absolutely correct on this. We should examine

each case with our conceptual tools and choose the appropriate method

of pattern differentiation, whether zang-fu, SHL, or Wen Bing. Michael

Broffman calls this 'eclectic' Chinese medicine. I would add, however,

that Michael is able to integrate information about viruses, stem

cells, and other biomedical phenomena into the Chinese medical

framework without compromising its integrity.

 

 

On Friday, July 4, 2003, at 10:06 AM, wrote:

 

> Yes there are plenty, I am putting them together as we speak, for the

> website... But the question is not, are the cases caused by some

> virus or bacteria, but how are they presenting and how are they

> treating them... Furthermore, if 10 cases are all assumed to be

> viruses, this does not equate the inverse, that all lurking virus

> are 'wenbing - lurking pathogens'...

> -

[Guest guest]

, " James Ramholz "

<jramholz> wrote:

 

 

> Perhaps first we need to consider where we are successful in

dealing

> with viruses and bacteria. Certainly many Chinese formulas speed up

> and resolve these types of infections. Most notably the various

cold

> and flu viruses (at least up to SARS) and some infections. These

may

> be latent for up to several weeks before symptoms actually appear.

> We can often see signs in the pulse before symptoms appear.

 

Ok.. this is interesting.. so we can build the body before a virus

comes out, what else?

 

But as far as LP in Chinese literature goes, I have never seen (again

doesn't mean much) a case study that treats a condition (lurking

pathogen) before it manifests. This is a totally different

ballgame. So do you often treat lurking pathogens before they

manifest? IF so how do you know it would have manifested..? Let's

take herpes again... You see someone and say, 'I think in 2 weeks you

will have an outbreak' so I will treat this... `or you will get a

cold in 1 week' I am just a little confused.. Obviously we treat

people all the time that are in remission stages for multiple kinds

of diseases, even people inbetween frequent bouts of colds, but I

don't see anything profound about this... can you elaborate?

 

-

 

ChineseMedicineDoc.com

 

 

 

>

> One thing that makes a latent pathogen treatable is that it does

not

> disarm or attack the immune system itself.

>

>

> >>> . . . but if the treatments (wb) don't work, then what? >>>

>

> Then either the theory or the treatments, or both, must be

> rethought. CM is not a closed system.

>

>

>

> > . . . but if the Tx's don't work, why don't we go elsewhere,

> instead of trying to redefine a specific CM term? >>>

>

> This is another valid option. Where do you propose we go instead?