Research Showing Differences Between Chinese & Germans

October 18, 2005

On Oct 18, 2005, at 2:16 PM, wrote:

> It also raises the issue of genetic differences being a prominent

> factor in presentation.

> Some of the attributes you describe also do not change very much

> during treatment. And I

> am not just talking about my patients, but also my frequent

> observation of hundreds of

> other patients who were treated by other supposedly expert px in

> school clinics in 3

> different schools over a 19 year period. Patients who have

> toothmarked tongues typically

> will always have toothmarked tongues. Same with wiry pulses. These

> parameters may

> lessen a bit during treatment and exacerbate with certain behaviors,

> but they never

> disappear. This observation is one more piece of evidence that

> chinese herbology has

> most of its effects on symptoms, not underlying pathology.

--

I have to disagree with your conclusion here, by which I mean that your

conclusion is presented as a problem with TCM, whereas my view is that

of course, treating symptoms is relatively simple, treating

constitutional tendencies is not simple, and may well be impossible in

many cases, and in any event is more than a matter of just prescribing

herbs. Most people have constitutional tendencies, what we call

pre-heaven constitution, and these are reflected in often unchanging

signs such as you mention. In my view, these tendencies generally

should not be described as pathology (unless the person has a

congenital disease). They may become pathological (ie a disease) if a

causative agent or behavior etc enters the picture. It is equally

possible, if the person is sufficiently aware, to live in a way that

balances their tendencies, and therefore prevents the conversion to

pathology. Herbal medicine can be included in the methods used to

prevent conversion, but should be secondary to avoiding the causes of

disease, which are well described in TCM.

> The value of pattern differentiation is not that it leads to cure of

> organic illnesses, but that if done properly, allows the treatment of

> a wide range of presentations without causing iatrogenesis. The

> primary longterm benefits of TCM are not the rectification of

> mysterious patterns of imbalance, but rather something much more

> mundane.

--

Again I have to respectfully disagree. I believe it is a well

established tenet of Chinese medicine that for long term, or

constitutional disorders, advising the patient how to live their life

is the primary approach, before treatment with herbs, or acupuncture or

anything else. In other words, patient awareness is the main benefit.

Of course, I agree that avoiding iatrogenesis is also a great benefit.

> Many chinese formulas used for longterm use contain herbs that

> promote digestion and relaxation (such as ginger, jujube and

> licorice). Arguably most of the benefit of chinese herbs beyond

> symptoms relief is due to improved nutrition and sleep as a result.

--

Of course, poor nutrition is counted as a cause of disease in Chinese

medicine, as is insufficient sleep. The manner of your comments seems

to discount it's importance.

Rory

October 18, 2005

On Oct 18, 2005, at 5:31 PM, wrote:

> I'm hoping for some considered opinions of how to

> " mainstream " more difficult material into the student and practitioner

> population (i.e. books).

--

Surely that is what Bob and Robert are devoting themselves to, and for

that matter Todd is also with CHA. Do you think books are a better

solution? I don't think that gets to the source of the problem. Those

who want to learn more have access to the information and avail

themselves of it. Those who are not so motivated have just as much

access, but don't avail themselves of it. It's up to the individual to

choose what sort of practitioner they are.

Rory

October 18, 2005

On Oct 18, 2005, at 5:09 PM, wrote:

> People in the U.S. who have a combination of junk food diets,

> environmental

> toxic exposure, and heavy-metal toxicity always have the most complex

> patterns.

> >>>>>

> Roger the environment in Chinese cities is much more toxic than US.

--

I'll second that. I was in Beijing in the early '90s. It was March, and

the Olympic Committee visited town. The government decided that no coal

fires should be allowed during the visit, which was only a day I think.

The change in the air was dramatic, and wonderful.

Rory

October 18, 2005

Again I have to respectfully disagree. I believe it is a well

established tenet of Chinese medicine that for long term, or

constitutional disorders, advising the patient how to live their life

is the primary approach, before treatment with herbs, or acupuncture or

anything else. In other words, patient awareness is the main benefit.

>>>>>

Rory the usual advice however often does not lead to change in outcome in

chronic diseases. The change of a mindset which is the internal cause is a

slippery slope which is hard to respond to as one cannot prove a negative.

Oakland, CA 94609

October 19, 2005

If one limits TCM Tx to herbal formulas, then I would definitely agree that

this does not often permanently change constitutional factors and is most

likely to result in only symptom palliation. However, if one uses this

information as the basis for correction of dietary imbalances and educates

clients on environmental factors that may aggravate their condition,

including resolving any heavy metal toxicity that may be present, I've

observed that it **is** possible to achieve significant shifts in health.

I've frequently seen people with toothmarked (scalloped) tongues that

permanently change with shifts in diet. Herbal formulas alone will often

not work, as proper Middle Burner function is dependent on giving up a lot

of the crap that most Americans eat. Even the timing of meals can have a

major impact on Middle Burner and sleep patterns.

For example, a typical work day in the life of an urban middle class worker:

Rush to work with no breakfast except coffee. Then more coffee and donuts

in early morning, perhaps nibbling on candy and junk food throughout the

day. A business lunch eaten in overstressed and frantic conditions. Then

work late and eat gut-bursting quantities of restaurant food (mostly

microwaved at that) high in hydrogenated and poor quality oils (canola,

etc.) at 9pm or even later, leading to nights of indigestion, restless

sleep, and flatulence. I know plenty of urban acupuncturists who follow

this timing pattern to accommodate their clients. Every time I visit a

city, I have to deal with this nonsense, so that I dread such trips. No

amount of Chinese herbal formulas can ever undo the damage this does. Rural

folk generally have saner patterns of living.

Roger

> " " <

>Re: Research Showing Differences Between Chinese & Germans

>

>It also raises the issue of genetic differences being a prominent factor

>in presentation.

>Some of the attributes you describe also do not change very much during

>treatment. And I

>am not just talking about my patients, but also my frequent observation of

>hundreds of

>other patients who were treated by other supposedly expert px in school

>clinics in 3

>different schools over a 19 year period. Patients who have toothmarked

>tongues typically

>will always have toothmarked tongues. Same with wiry pulses. These

>parameters may

>lessen a bit during treatment and exacerbate with certain behaviors, but

>they never

>disappear. This observation is one more piece of evidence that chinese

>herbology has

>most of its effects on symptoms, not underlying pathology. The value of

>pattern

>differentiation is not that it leads to cure of organic illnesses, but

>that if done properly,

>allows the treatment of a wide range of presentations without causing

>iatrogenesis. The

>primary longterm benefits of TCM are not the rectification of mysterious

>patterns of

>imbalance, but rather something much more mundane. Many chinese formulas

>used for

>longterm use contain herbs that promote digestion and relaxation (such as

>ginger, jujube

>and licorice). Arguably most of the benefit of chinese herbs beyond

>symptoms relief is

>due to improved nutrition and sleep as a result.

>

>Todd

>

---Roger Wicke, PhD, TCM Clinical Herbalist

contact: www.rmhiherbal.org/contact/

Rocky Mountain Herbal Institute, Hot Springs, Montana USA

Clinical herbology training programs - www.rmhiherbal.org

October 19, 2005

On Oct 19, 2005, at 12:09 AM, Rory Kerr wrote:

> Again I have to respectfully disagree. I believe it is a well

> established tenet of Chinese medicine that for long term, or

> constitutional disorders, advising the patient how to live their life

> is the primary approach, before treatment with herbs, or acupuncture

> or

> anything else. In other words, patient awareness is the main benefit.

On Oct 19, 2005, at 1:01 AM, wrote:

> Rory the usual advice however often does not lead to change in

> outcome in chronic diseases. The change of a mindset which is the

> internal cause is a slippery slope which is hard to respond to as one

> cannot prove a negative.

--

Sorry Alon, I don't get your response:

What are you relying on to make this assertion (does not change

outcome)?

How are you defining outcome?

What is the usual advice you refer to?

Rory

October 19, 2005

" I don't think that [i.e., books] gets to the source of the problem.

Those who want to learn more have access to the information and avail

themselves of it. Those who are not so motivated have just as much

access, but don't avail themselves of it. It's up to the individual to

choose what sort of practitioner they are. "

Rory,

Good point. You can lead a horse to water, but you can't make them

drink. It's not as if the information is not available. It is and has

been for years. However, it's not just a matter of students choosing

what kind of practitioners they will be. It is also a matter of the

schools chosing certain books (or no books) rather than others.

Unfortunately, at too many schools it is a question of the blind

leading the blind. Also uinfortunately (and more difficult to talk

about), there is an issue of racism. On the one hand, too many

administrators think that every Chinese must be a good/better Chinese

doctor, while too many Chinese think that only they really know and

understand Chinese medicine.

Bob

October 19, 2005

industrialization

>>>>

Roger

I believe they have been using coal extensively for quite a while.

Lots of stuff in that

Oakland, CA 94609

October 19, 2005

Ah, this is what I get for trying to be " PC " first thing in the morning

: ) And I came across a little chidey, forgive me for that (my own

poor word choices at work!). I'm sure I can't enlighten anyone about

anything, especially someone as educated as yourself.

Sure, let's call it semantics, assuming that you don't mean that (as

most people do) as a dismissal; I know that as a translator, you care

about the specificity of words. But below you again use " race " and

" ethnicity " interchangeably, and I just don't think that they are. I

wasn't clear enough before: what I meant was that I didn't think that

" race " was a scientifically meaningful word; obviously it's still

meaningful otherwise, rather too much so. I think this may be one of

those areas though where Medicine is caught between Science and

Sociology. It just bugs me to see " race " used as a shorthand in medical

circumstances (e.g. given as a risk factor, used to " explain " things)

when it is really a proxy indicator for other things that may or may not

be genetic. Honestly I'm not the person who can resolve the issue I

brought up, I just wanted to bring it up, because I just dislike race

being reified in scientific contexts. I'm the sort of person who spends

too little time reading medical research and too much time at dinner

parties with leftist anthropology grad students! Talk about cultural

differences...

I was not taking issue with the point of your post, in fact I was

agreeing with it. Your posts are always thoughtful and well-written and

I appreciate them greatly. (I was thinking back to the discussion about

green chiles and musing about humans in the context of " terroir " )...And

you do bring up another good point below: I too was imagining that the

Germans studied were " ethnically " German, but who knows? Maybe some of

them were of Turkish or Congolese descent. Whatever that means.

Respectfully,

Nora

P.S. When I say " think " above, I really mean " think " ; I don't know, and

am also open to being enlightened.

Eric Brand wrote:

>All I said was: " The study showed that there is a

>difference between which pathologies show up between the races, which

>makes perfect sense and is also consistent with parallel observations

>in Western medicine. "

>

>I was simply referring to races because the article was constrasting

>ethnically Chinese people in China vs. Germans. While Germany and

>China both have substantial ethnic diversity, it seems that this

>article was comparing Han Chinese with Germans (who, unlike the

>Chinese cohort, did not appear to be specified as to their ethnicity).

> In Tianjin province were the study was taking place, the population

>is nearly exclusively Han. Racial differences in drug metabolism and

>such are widely researched in Western medicine, so I assumed (possibly

>incorrectly?) that the research concerned ethnicity.

>

>At any rate, I'm sorry if I was inadvertantly un-PC. If I was, it was

>entirely unintentional. To the contrary, I was taking issue with the

>fact that others were suggesting that certain ethnic groups or

>cultures were somehow more prone to " knotty " diseases than others.

>Knotty diseases have been recognized for a long time, and all people

>are equally subject to them.

>

>I like all people from every place and every ethnic group, and would

>love to see all of their knotty diseases resolved, so I assure you

>that I have no ill-intentions with my wording! Please enlighten me as

>to the current rules, I like to be PC.

>

>Maybe it is a semantics issue? You are saying that I should be saying

>populations or ethnic groups instead because race is a defunct

>category. Is the word " race " substantially different than " ethnic

>group " ? Merriam-Websters describes race as:

>

>2 a : a family, tribe, people, or nation belonging to the same stock b

>: a class or kind of people unified by community of interests, habits,

>or characteristics <the English race>

>

>Best,

>Eric

>

October 19, 2005

, Nora <nora@h...> wrote:

>

> Ah, this is what I get for trying to be " PC " first thing in the morning

> : ) And I came across a little chidey, forgive me for that (my own

> poor word choices at work!). I'm sure I can't enlighten anyone about

> anything, especially someone as educated as yourself.

Hardly. If I was sufficiently educated, I wouldn't be inadvertantly

offending people who go to frequent dinner parties with leftist

anthropology grad students. The only people who are really

well-educated think that they don't know enough, and they want their

education to be continually expanding. But I have a desire to be

better educated, so I want to know exactly what the difference is

between race and ethnicity so that I don't offend any leftist

anthropologists in the future.

Racism is a problem (which, as Bob pointed out, is an

all-too-prominent phenomenon within the our community). But the word

race itself is totally neutral until otherwise contaminated by racism.

You can see through to the meaning without getting caught up on the

words. I would much rather hear a sensible person talking about race

than a racist talking about ethnicity.

Another closely parallel word is " drug. " Drug is a completely neutral

word that has been worked into people's minds in such a convoluted way

that the word is now virtually too contaminated to use. We use the

word medicinal instead of drug not for accuracy, but because it is

more fashionable and in synch with our cultural prejudice. This is

Chinese Herbal Medicine. It would feel different if it was called

the Chinese Drug Academy. However, the word " herb, " in the context of

casual spoken Chinese medicine, generally means drug or medicinal,

since only a portion of the things we use are actually " herbs. " Herb

is not a very accurate word at all. Historians, pharmacologists, and

scholars in other university disciplines refer to the things we use as

traditional drugs or crude drugs, which is exactly what they are.

When we write about them, we refer to them as " medicinals " because

people get in a tizzy one way or the other if one uses the loaded word

drug. Drug has so much baggage on it that the word is hardly worth

using- but why should you let a bunch of racists or freaks against

drugs (from either camp) ruin a perfectly good word?

Today I was substitute-teaching a class of Taiwanese medical students

(WM) at a local university. The class was on medical English and one

of the girls corrected herself after using the word " drug " ; she

switched to " medicine " (she was talking about a steriod cream). I

asked her what she thought the difference was. She thought that if it

was taken internally, it was called a drug, but if it was applied

topically, it was called a medicine. Actually, there is no

difference. They are both drugs. But I told her that doctors use the

word with a different nuance than the general public does, and many

" alternative health care " types use the word drug with a different

nuance still.

The difficulty for her was that in Chinese, there is only one word for

drug/medicine/medicinal animal-mineral-plant. The word is yao4. We

study Chinese yao4, Chinese medicinal substances. Western doctors

study Western yao4, drugs. Chinese kids at a dance club eat yao4,

drugs. The division and the moral judgement isn't inherent within the

word yao4 in Chinese, so it is difficult for Chinese people to learn

how to divide it when they learn English. But since there is such a

strong difference in potential interpretation, we use the word

medicinal when we translate the word yao4 in Chinese medicine. It is

the most neutral word, even though my spell-checker doesn't have it

built into the dictionary.

> Sure, let's call it semantics, assuming that you don't mean that (as

> most people do) as a dismissal;

not at all. I mean it simply a chance for me to receive a lesson in

semantics.

I know that as a translator, you care

> about the specificity of words.

I am not particularly obsessed with the specificity of words. There

are too many other aspects of communication going on to get hung up

exclusively on the words. But when it comes to Chinese medicine or

any other body of complex technical information, I am comforted when

professionals can at least all relate to a certain standard of

accurate parlance. Western doctors speak about the same things at the

same level of detail and accuracy no matter what language they are

using. I think that TCM people in the West should speak about things

with the level of detail and accuracy that is used in Chinese, that's all.

Respectfully,

Eric

October 19, 2005

Roger

I thought you may want to read this. This email is from an MD friend that works

very close with Doctors Data

As re; your question cilantro and chlorella binds up some of the heavy metals in

the stool but does not get into the blood/interstitial space. I suspect the

modified citrus pectin or for that matter nsy good fiber source will contribute

similarly to helping lower heavy metal burden. DMPS DMSA , CaEDTA really are the

only agents that work at binding and increasing excretin of heavy metal. Even

Selenium works by basically sequestering mercury in a unreative form but does

nothing to actually lower the overall heavy metal load/amount. By the way

Doctor's Data can't make Rx recc but they see all the test results and they note

that DMPS orally works best to lower mercury etc and does as good a job as IV

route if not better.

Oakland, CA 94609

October 19, 2005

>

> On Behalf Of

> Tuesday, October 18, 2005 3:31 PM

>

> Re: Research Showing Differences Between Chinese & Germans

>

> Again I apologize for unfortunately using knotty in my previous post,

> collapsing Heiko's response into the mix. I appreciate both Roger and

> Bob's efforts into the righting the situation. I've been taking the

> Blue Poppy courses the last few days and they are really good. But it

> is interesting that both Roger and Bob offer their own curriculum

> through (on-line) classes. My concern is that for the most part the

> books we are offered the same solutions for zang-fu issues that may or

> may not be relevant for the Western clinician.

I do not interpret the findings of this Bob's study the support this. I do

not believe that 'the books we are offered' are not applicable in the

Western Clinic. IMO, all that this study is saying is that different

groups, albeit, based on race, region or whatever will present, generally

speaking, with different tendencies.

In a sense this information does not help us in the clinic, unless

one's practice is based on playing the odds with generalizations. It merely

informs us people are different, one still must go through all the same

diagnostic steps (pulse / tongue et al) and come up with one's own

diagnosis. (as Bob pointed out).

I personally have never understood why people even mention

generalizations or things like 45% of Cancer patients have XYZ.... Hoe does

this help? If anything when we see stats like, '70% of XYZ patients will be

pattern ABC' this only seems to put us more quickly in a box that

potentially might not be true. I say use your BASIC tcm skills and think

critically and you will be fine. You should place people into patterns based

on there presentation, not a stat, a racial or regional tendency. Granted

such things are interesting to look at. I.e. the way regions affect people

as a whole can be extremely valuable, but I have a hard time believing that

we don't have the tools (from our books) to deal with the VAST majority of

western patients. I also agree with Eric (et al), that Western's are not

any more prone to knotty diseases than i.e. Chinese, and somehow TCM just

doesn't work as well in the West.

-

And I agree with Roger

> that often this drives the new practitioner into less than standard

> herbal solutions (if not into less than standard acupuncture

> techniques). I'm hoping for some considered opinions of how to

> " mainstream " more difficult material into the student and practitioner

> population (i.e. books).

> doug

>

> , rw2@r... wrote:

> >

> > An afterthought after I sent my previous reply:

> >

> > I've heard a lot of American TCM students express dismay at their

> lack of

> > results in applying what they have been taught is standard TCM pattern

> > analysis to cases. When this fails, they desert the TCM model and flail

> > about, finally reverting to the simplistic paradigm of choosing

> herbs and

> > formulas for western biomedical diseases. (This is not likely to

> work that

> > well either in my experience.) Instead what they should be doing is

> > learning their TCM theory and **complex** pattern assessment skills,

> which

> > very few ever bother attempting to learn. A major part of successfully

> > applying complex pattern assessment skills includes understanding how

> > modern dietary and environmental factors interact with the TCM pattern

> > manifestions. This is also missing from most TCM training programs. We

> > heavily emphasize the latter in our own curriculum.

> >

> > It's my suspicion that as China industrializes and imports more junk

> food

> > from abroad, that they will begin to see similar complexity of

> patterns in

> > Chinese people.

> > People in the U.S. who have a combination of junk food diets,

> environmental

> > toxic exposure, and heavy-metal toxicity always have the most complex

> > patterns of all. One way I make it easier on myself is to have such a

> > client clean up his or her diet before I even give herbs. Often,

> over 50%

> > of the symptoms and patterns resolve with this step alone, then the

> > remaining 50% can be more readily analyzed (pattern assessment).

> >

> > If one examines the history of western herbalism in the U.S. one

> sees the

> > same trend toward more complex illnesses with industrialization, and

> former

> > simple remedies do not work as well for these conditions.

> >

> > As industrialization on a massive scale began in countries like

> Germany and

> > England, it is not suprising that the extremes will be most dramatic

> there.

> > The science of epigenetics is revealing that environmental chemical

> > exposures, even if they do not necessarily cause genetic mutations, may

> > nevertheless cause transmission of health problems to at least several

> > generations, ***even if these latter generations are never exposed

> to the

> > original offending chemical toxins***. (One mechanism is by DNA

> > methylation.) This observation suggests that environmental toxins

> leave a

> > cumulative burden on successive generations and is a much more serious

> > problem that even most environmentalists acknowledge.

> >

> > I also agree with Bob conclusion that we cannot simply mimic what the

> > Chinese herbalists do. The patterns are more complex here and require

> > students be trained much more thoroughly in complex pattern recognition

> > skills. That's why we insist that all of our students, including

> ones who

> > have already completed a TCM college program, complete our TCM

> assessment

> > skills review, including use of special software that tests certain

> skills

> > in complex pattern recognition. Simplistic multiple-choice-type exam or

> > review questions ***DO NOT*** test these skills.

> >

> > Several years ago I wrote an article on this problem, as it was

> frustrating

> > to deal with colleagues and students who did not take this

> complexity issue

> > seriously and blithely pretended that we could simple mimic the Chinese

> > model and everything would work out OK:

> >

> > http://www.rmhiherbal.org/review/2002-2.html

> > Computer-aided instruction in TCM clinical analysis and

> > decision-making skills

> >

> > Bob, is it possible that the translated article (Research Showing

> > Differences Between Chinese & Germans) could be permanently posted

> on some

> > webpage? I would like to be able to refer students and others to it. I

> > believe it is an important article that all TCM students should be aware

> > of.

> >

> > ---Roger Wicke, PhD, TCM Clinical Herbalist

> > contact: www.rmhiherbal.org/contact/

> > Rocky Mountain Herbal Institute, Hot Springs, Montana USA

> > Clinical herbology training programs - www.rmhiherbal.org

> >

>

Chinese Herbal Medicine offers various professional services, including

> board approved continuing education classes, an annual conference and a

> free discussion forum in Chinese Herbal Medicine.

>

October 19, 2005

>

> On Behalf Of

> Tuesday, October 18, 2005 3:16 PM

>

> Re: Re: Research Showing Differences Between Chinese &

> Germans

>

> I've heard a lot of American TCM students express dismay at their lack of

> results in applying what they have been taught is standard TCM pattern

> analysis to cases.

> >>>>

> Roger

> The problem however is also true for PRC if one understand disease

> processes and critically evaluates what one sees in PRC.Lets not shift to

> romantic posturing

Yes.. But is this a lack of skill or lack of TCM? I guess that is somewhat

the magic question...

-

>

> Oakland, CA 94609

>

October 19, 2005

Yes.. But is this a lack of skill or lack of TCM? I guess that is somewhat

the magic question...

>>>>

That is always the question in a system that historically views perfection as a

possibility as well as attributes it to allusive sages

Oakland, CA 94609

October 19, 2005

What are you relying on to make this assertion (does not change

outcome)?

How are you defining outcome?

What is the usual advice you refer to?

>>>>>>>>>>>>

Rory

The majority of my patients are highly educated and follow a healthy life style.

So if i look at their patterns and give advice from CM perspective usually the

changes in diet and exercise are not major. Many have been doing work on

themselves for many years and have not been exposed to major toxic environment

except for the artist i see. As Todd stated, i rarely see substantial changes in

tongues or real cures of nonfunctional internal medical problems. That is not to

say that i see none, i have. The % however is small, and as far as tongues more

often involves the fur than body (except for color), and that is true for all

the other practitioners i have followed in the last 25 years in US, PRC, and

Japan. So when i talk about outcome here i speak of objective signs and disease

pathology.

Oakland, CA 94609

October 19, 2005

Well I don't know where to go with this. I'm just looking for a way to

discuss the issues and problems of making better books (and I think

this means going beyond the basics). I don't think it's only an

English language issue as my Chinese colleagues have many of the same

issues with the majority of the Chinese language publications. You,

Bob, Eric and Roger are actually doing the work. I'm am looking for

some insight, although not only from you all, about what is needed and

how to get there.

anyway, sorry if I didn't articulate it well.

doug

P.s. the german study was only a ploy to get to these issues, the

racial implications, I think are moot and we should move on from them.

, " "

<@c...> wrote:

>

> >

> > On Behalf Of

> > Tuesday, October 18, 2005 3:31 PM

> >

> > Re: Research Showing Differences Between Chinese &

Germans

> >

> > Again I apologize for unfortunately using knotty in my previous post,

> > collapsing Heiko's response into the mix. I appreciate both Roger and

> > Bob's efforts into the righting the situation. I've been taking the

> > Blue Poppy courses the last few days and they are really good. But it

> > is interesting that both Roger and Bob offer their own curriculum

> > through (on-line) classes. My concern is that for the most part the

> > books we are offered the same solutions for zang-fu issues that may or

> > may not be relevant for the Western clinician.

>

> I do not interpret the findings of this Bob's study the support

this. I do

> not believe that 'the books we are offered' are not applicable in the

> Western Clinic. IMO, all that this study is saying is that different

> groups, albeit, based on race, region or whatever will present,

generally

> speaking, with different tendencies.

> In a sense this information does not help us in the clinic, unless

> one's practice is based on playing the odds with generalizations.

It merely

> informs us people are different, one still must go through all the same

> diagnostic steps (pulse / tongue et al) and come up with one's own

> diagnosis. (as Bob pointed out).

> I personally have never understood why people even mention

> generalizations or things like 45% of Cancer patients have XYZ....

Hoe does

> this help? If anything when we see stats like, '70% of XYZ patients

will be

> pattern ABC' this only seems to put us more quickly in a box that

> potentially might not be true. I say use your BASIC tcm skills and

think

> critically and you will be fine. You should place people into

patterns based

> on there presentation, not a stat, a racial or regional tendency.

Granted

> such things are interesting to look at. I.e. the way regions affect

people

> as a whole can be extremely valuable, but I have a hard time

believing that

> we don't have the tools (from our books) to deal with the VAST

majority of

> western patients. I also agree with Eric (et al), that Western's

are not

> any more prone to knotty diseases than i.e. Chinese, and somehow TCM

just

> doesn't work as well in the West.

>

> -

>

> And I agree with Roger

> > that often this drives the new practitioner into less than standard

> > herbal solutions (if not into less than standard acupuncture

> > techniques). I'm hoping for some considered opinions of how to

> > " mainstream " more difficult material into the student and practitioner

> > population (i.e. books).

> > doug

> >

> > , rw2@r... wrote:

> > >

> > > An afterthought after I sent my previous reply:

> > >

> > > I've heard a lot of American TCM students express dismay at their

> > lack of

> > > results in applying what they have been taught is standard TCM

pattern

> > > analysis to cases. When this fails, they desert the TCM model

and flail

> > > about, finally reverting to the simplistic paradigm of choosing

> > herbs and

> > > formulas for western biomedical diseases. (This is not likely to

> > work that

> > > well either in my experience.) Instead what they should be doing is

> > > learning their TCM theory and **complex** pattern assessment skills,

> > which

> > > very few ever bother attempting to learn. A major part of

successfully

> > > applying complex pattern assessment skills includes

understanding how

> > > modern dietary and environmental factors interact with the TCM

pattern

> > > manifestions. This is also missing from most TCM training

programs. We

> > > heavily emphasize the latter in our own curriculum.

> > >

> > > It's my suspicion that as China industrializes and imports more junk

> > food

> > > from abroad, that they will begin to see similar complexity of

> > patterns in

> > > Chinese people.

> > > People in the U.S. who have a combination of junk food diets,

> > environmental

> > > toxic exposure, and heavy-metal toxicity always have the most

complex

> > > patterns of all. One way I make it easier on myself is to have

such a

> > > client clean up his or her diet before I even give herbs. Often,

> > over 50%

> > > of the symptoms and patterns resolve with this step alone, then the

> > > remaining 50% can be more readily analyzed (pattern assessment).

> > >

> > > If one examines the history of western herbalism in the U.S. one

> > sees the

> > > same trend toward more complex illnesses with industrialization, and

> > former

> > > simple remedies do not work as well for these conditions.

> > >

> > > As industrialization on a massive scale began in countries like

> > Germany and

> > > England, it is not suprising that the extremes will be most dramatic

> > there.

> > > The science of epigenetics is revealing that environmental chemical

> > > exposures, even if they do not necessarily cause genetic

mutations, may

> > > nevertheless cause transmission of health problems to at least

several

> > > generations, ***even if these latter generations are never exposed

> > to the

> > > original offending chemical toxins***. (One mechanism is by DNA

> > > methylation.) This observation suggests that environmental toxins

> > leave a

> > > cumulative burden on successive generations and is a much more

serious

> > > problem that even most environmentalists acknowledge.

> > >

> > > I also agree with Bob conclusion that we cannot simply mimic

what the

> > > Chinese herbalists do. The patterns are more complex here and

require

> > > students be trained much more thoroughly in complex pattern

recognition

> > > skills. That's why we insist that all of our students, including

> > ones who

> > > have already completed a TCM college program, complete our TCM

> > assessment

> > > skills review, including use of special software that tests certain

> > skills

> > > in complex pattern recognition. Simplistic multiple-choice-type

exam or

> > > review questions ***DO NOT*** test these skills.

> > >

> > > Several years ago I wrote an article on this problem, as it was

> > frustrating

> > > to deal with colleagues and students who did not take this

> > complexity issue

> > > seriously and blithely pretended that we could simple mimic the

Chinese

> > > model and everything would work out OK:

> > >

> > > http://www.rmhiherbal.org/review/2002-2.html

> > > Computer-aided instruction in TCM clinical analysis and

> > > decision-making skills

> > >

> > > Bob, is it possible that the translated article (Research Showing

> > > Differences Between Chinese & Germans) could be permanently posted

> > on some

> > > webpage? I would like to be able to refer students and others to

it. I

> > > believe it is an important article that all TCM students should

be aware

> > > of.

> > >

> > > ---Roger Wicke, PhD, TCM Clinical Herbalist

> > > contact: www.rmhiherbal.org/contact/

> > > Rocky Mountain Herbal Institute, Hot Springs, Montana USA

> > > Clinical herbology training programs - www.rmhiherbal.org

> > >

> >

> > Chinese Herbal Medicine offers various professional services,

including

> > board approved continuing education classes, an annual conference

and a

> > free discussion forum in Chinese Herbal Medicine.

> >

October 20, 2005

On Oct 20, 2005, at 12:41 AM, wrote:

> Well I don't know where to go with this. I'm just looking for a way to

> discuss the issues and problems of making better books (and I think

> this means going beyond the basics). I don't think it's only an

> English language issue as my Chinese colleagues have many of the same

> issues with the majority of the Chinese language publications. You,

> Bob, Eric and Roger are actually doing the work. I'm am looking for

> some insight, although not only from you all, about what is needed and

> how to get there

--

Doug,

I'm not quite clear what it is you'd like to see included in books

that now is not. In general, the english language books are getting

more sophisticated and useful, eg by starting to include more detailed

information about pathomechanisms, something of a black hole in out

literature and therefore knowledge as a profession. The Chinese tend to

be better trained in this area, and some non-Chinese who have become

familiar with it in following Chinese doctors.

My feeling is that for subjects such as observations about differences

between populations and how that changes treatment approaches, these

are very new material about which there is probably insufficient

consensus to justify a book. Of course, it is a very interesting issue,

and one we should be struggling with. For this I think journals are a

more suitable venue, preferably journals with an active letters column.

I think Bob Flaws has developed a publishing project that allows him to

offer some of what you (and I) are looking for. It allows him to devote

sufficient time to the project, and to generate some income for doing

so, thus making it sustainable.

These are just a few thoughts on a subject that, I agree with you,

needs to be addressed.

Rory

October 20, 2005

" P.s. the german study was only a ploy to get to these issues... "

I'm aghast that anyone would think that I would post material on a

forum such as this for ulterior motives.

Bob

October 20, 2005

I'm just looking for a way to

discuss the issues and problems of making better books (and I think

this means going beyond the basics).

>>>>

What we really lack is true first hand information from truly experienced

practitioners seeing the type of patients we see on the medication used that we

see, etc.

Oakland, CA 94609

October 20, 2005

, Rory Kerr <rorykerr@o...>

wrote:

Of course, it is a very interesting issue,

> and one we should be struggling with. For this I think journals are a

> more suitable venue, preferably journals with an active letters column.

>

> I think Bob Flaws has developed a publishing project that allows him to

> offer some of what you (and I) are looking for. It allows him to devote

> sufficient time to the project, and to generate some income for doing

> so, thus making it sustainable.

Feng Ye told me that many Chinese studies have been done on the

pattern prevalence in different parts of China. Granted, the

information would likely be mostly variance based on weather and diet

as opposed to ethnicity, but it would still be interesting. As Rory

noted, these discussions are found in TCM journals rather than books.

I am too busy working on other things at the moment to add any new

projects, but perhaps some time in the future I can root through the

library, find and translate such a study, and send it to Blue Poppy.

Apparently the material exists for someone with the motivation to

browse a bunch of Chinese journals. Browsing the article titles in

journals is fun if you have free time and access to a stack of Chinese

journals. TCM journals often have English article titles and abstracts.

Eric

October 20, 2005

" Feng Ye told me that many Chinese studies have been done on the

pattern prevalence in different parts of China. "

Eric,

I've d to a dozen or more CM journals from the PRC for the

past dozen or more years and I've never seen any articles like this.

Each year I try to switch up some of the journals I to so

that I maintain a pretty good overview about what is being published.

BTW, if anyone wants to look though all of my collected Chinese

language journals, they can come to the Blue Poppy offices. We've been

talking recently about how we could make this collection usable to

more people.

Bob

October 20, 2005

The problem is that print textbooks, standard multiple choice quizzes,

flash-card study methods, and listening to lectures are inherently limited

means of teaching the complex pattern analysis skills that a number of

people on this (including myself) seem to think is necessary to improve

American TCM practioners' skills. Unless one gains considerable experience

with complex cases during one's internship, one is very unlikely to develop

these skills by reading books or listening to more lectures. That's why we

developed an extensive series of interactive games to address the problem.

In one hour, a game player can test himself on numerous random (but

clinically realistic) combinations and permutations of syptoms and signs

that would take weeks to encounter in clinic, receiving detailed feedback

on why there was or was not enough information to make an analysis. We've

been using this method for several years now, and the difference between

students who use this game software and those who have not are like day and

night.

For a detailed discussion of the limitations of conventional learning methods:

http://www.rmhiherbal.org/review/2002-2.html

Computer-aided instruction in TCM clinical analysis and

decision-making skills

---Roger Wicke, PhD, TCM Clinical Herbalist

contact: www.rmhiherbal.org/contact/

Rocky Mountain Herbal Institute, Hot Springs, Montana USA

Clinical herbology training programs - www.rmhiherbal.org

> " "

>Re: Research Showing Differences Between Chinese & Germans

>

>Well I don't know where to go with this. I'm just looking for a way to

>discuss the issues and problems of making better books (and I think

>this means going beyond the basics). I don't think it's only an

>English language issue as my Chinese colleagues have many of the same

>issues with the majority of the Chinese language publications. You,

>Bob, Eric and Roger are actually doing the work. I'm am looking for

>some insight, although not only from you all, about what is needed and

>how to get there.

>anyway, sorry if I didn't articulate it well.

>doug

>

>P.s. the german study was only a ploy to get to these issues, the

>racial implications, I think are moot and we should move on from them.

>

---Roger Wicke, PhD, TCM Clinical Herbalist

contact: www.rmhiherbal.org/contact/

Rocky Mountain Herbal Institute, Hot Springs, Montana USA

Clinical herbology training programs - www.rmhiherbal.org

October 20, 2005

Bob, I trying to say I was implicating my own motivations for bringing

up the German study not yours for posting it. I guess I should have

used the smiley face... :-)

I'm sorry you were aghast. (I sometimes get aghast but it usually goes

away with Xiang Lian Wan or Huo Xiong... :-) )

doug

, " Bob Flaws "

<pemachophel2001> wrote:

>

> " P.s. the german study was only a ploy to get to these issues... "

>

> I'm aghast that anyone would think that I would post material on a

> forum such as this for ulterior motives.

>

> Bob

>

October 20, 2005

On Oct 20, 2005, at 3:28 PM, Bob Flaws wrote:

> if anyone wants to look though all of my collected Chinese

> language journals,

--

Hmmm...I can see a tax deductible ski trip in my future...

Rory

October 20, 2005

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