Dose of herbs prescribed to Westerner in Beijing

[Guest guest]

I spent 3 months following TCM doctors in gynecology, dermatology and

opthalmology at hospitals affiliated with Zhejiang TCM University. Formulas

there were 150-250gms per bag... 1 bag per day. More common were formulas in

the 200-250gm range.

 

Sean

 

, " Marian Blum, L.Ac., DNBAO "

<chinesemed wrote:

>

> A client of mine just returned from Beijing with a loose herb formula from an

herbalist with a storefront there. Each bag weighs 180 grams. Instructions were

to boil herbs twice and drink resultant tea during one day. 14 bags for 14 days.

She doesn't have an acute or severe disease. I was surprised how high the dosage

is.

>

> Marian

>

 

Sean Michael Hall, L.Ac.

East Bay Acupuncture & Natural Medicine

2346 Stuart St.

Berkeley, CA 94705

http://www.ebacupuncture.com

[Guest guest]

Eric,

 

 

 

We all appreciate your perspective, but I have to say I feel that whenever

you join the conversation the tone starts to turn a bit sour because you

seem to categorically misinterpret people's points of view, twisting their

words and making it sound like they are extremists. Let me spell it out so

you can consider in the future to maybe pick your words differently.

 

 

 

1) Twice now you have alluded that (I) or other have said that we

believe that " All doctors writing heavy formulas have this malicious intent "

- No one is saying ALL. This was clarified in the last message. It is clear

that some do, and no one knows the true number. The is the only point, it

exists.

 

 

 

2) I am NOT " Categorically dismissing whole schools of thought [which]

leads to more limited and extreme perspectives. " - I personally have studied

large formula writing (as well many other schools of prescribing, although

Fire God - ) and choose to not do this (most of the time). This is NOT a

categorically dismissal for everyone just a choice for myself, there is a

huge difference. For example no one said Mazin or Trevor should not use

Large formulas. I have already stated there are plenty of people using giant

formulas and I am by no means dismissing the 1000s of doctors that do this

and get results, although we should question them (see bleow). There is a

difference. I just find it personally unnecessary most of the time.

 

 

 

But I personally must question modern approaches, as Volker does. You (and

others) may be completely satisfied with the progression of TCM in China.

Many doctors, actually a large number, are not happy with the lack of rigor,

the lack of classical study, lack of traditional understanding, shotty

research, and emphasis on Western disease and Western pharmacological

prescribing, that is pervasive in Modern TCM schools and hospitals. This has

influenced the formulas, like it or not.

 

 

 

3) No one is saying that EVERY large formula is written without good

" formula composition. " Actually all formulas have composition. IT is really

a matter of what one's slant is. Sometimes the formula is purely on the

pathomechanism, other times it is a compilation of all the most common

pathomechanisms for a given Western disease. These tend to be larger and

what I term as less focused. Of course it all depends on who writes it. Some

are good and some are bad, just like small formulas. However there is

general trend in China, that seems to a bit less focused with larger

formulas (this is my opinion as well as others).

 

 

 

Of course one can add 90 grams of minerals to a formula with ease and get

the dosage up very fast. I have seen this prescribed in Beijing to a 7 year

old kid, actually the total formula weighed in at 200+g a day for enuresis

(did not work though). We know this happens, but that does not mean it is

good or the best alternative. I personally find that although sometimes it

may be necessary, the majority of the time (large majority) such large

dosages are not needed.

 

 

 

Yes that is my personal slant, because I have seen such an approach be

effective without hammering people. I have also seen it not effective. But I

really am talking about the majority of the time, not a black and white

statement - everything must be small. Consequently, as previously stated I

will use large dosages of formulas when needed, I just don't start there

like many. My choice.

 

 

 

4) I also must clarify that my stance is not motivated by any personal

agenda, sales, or lecture material etc. Yes, I am writing a book discussing

this approach, which I do find fascinating, but honestly I could care less

if you or anyone buys it. I do it for my own learning, not money or fame. I

do not like lectures and I do not sell products or own a company in line

with what I am writing about. I am really just a clinician and that is what

I like. My stance is merely something I am interested in and have found to

be effective and hence safer for the treatment of disease compared to the

large modern formulas coming out of China. Hence I share a mere one

perspective that differs much from modern China.

 

 

 

So as Sean just has stated, as well as Eric, myself and probably the

majority of people on the list, have seen it is common to see 200+g formulas

in China. Something has changed recently. This is not common in the past

(traditional), at least for my reading. Eric states that pu ji xiao du yin

as an example of proof that historical formulas are large. This formula is

for an extreme situation, and used often in modern clinic, and actually

proves my point perfect, thanks for bringing it up. It only totals at

88grams a day! And that is my point. It is still small compared to the

modern 150-250g modern formulas.

 

 

 

What book am I reading? Just check out F & S or any Chinese one. Of course

there are some large formulas, but the general trend is not large. Again you

portray my statement as me saying that modern formula books have NO large

formulas, that again is not my point and a misrepresentation of my words. I

am not making a black and white statement, I am talking about the overall

trend. This is easy to see.

 

 

 

IF one looks through historical texts the large formulas will still be under

100-150g day, most under 100g. ON AVERAGE. Many smaller. This is not 200g a

day that is typical by many in China at the present time.

 

 

 

So of course some cases need large dosages and small, no one EVER said

otherwise. But the question is how big. If one doctor can get a result with

75g and another with 200g you can pick your method. Just because 1000s of

doctors are writing large formulas does not make it correct, the best, or

even safe.

 

 

 

Finally thanks for the recommendation on case study books, I do have the

Jiao-Shude one. Although I still consider him a modern physician, talking a

lot about Western disease. For example his famous RA formulas are mammoth. I

have used them in the past. He actually was in the next generation after Qin

BoWei. Qin Bo-Wei was much more classically minded. However, I was hoping

for a more traditional non-western slanted physician that uses 200g+ a day

routinely using straight CM diagnosis.

 

 

 

Just for the record I have probably over 50 case study books. Most of them

are non-modern. Most of them are famous clinicians either of people that

have recommended them to me or just my shear fame such as Ye Tian-Shi. I

would say I would be hard pressed to find 1 of them that on average uses

large formulas as we speak about above. If my point was so easy to discount,

then we should see oodles of books to the contrary, no?

 

 

 

Thanks for the dialogue now off to SuZhou to visit Ye Tian-Shi's residence,

 

 

 

-

 

 

 

 

 

 

On Behalf Of Eric Brand

Thursday, April 16, 2009 12:46 AM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

 

<%40> , " "

wrote:

Just to clarify I don't think anyone is saying that

> the majority of doctors base their prescriptions on financial inceptive.

> This is just one factor, that must not be overlooked, when e.g. a laowai

> goes to China and leaves with a huge formula.

 

For sure, foreigners in China should be constantly on guard against being

overcharged. While this type of thing does happen with regularity to locals

and foreigners alike, we cannot say that all doctors writing heavy formulas

have this malicious intent. It may simply be that the patient needed a

formula with minerals like long gu and mu li in it, which could easily add

60g to the formula from two ingredients alone. Since the thread started from

a Beijing experience, it is also worth noting that Beijing dose trends are

often on the high side (admittedly, since Beijing has roughly the population

of Australia there is a wide variety of everything there, so any

simplification is a bit imperfect).

 

However you may have missed some emails, the

> original statement was that 180g a day (what some consider large) was the

> average dose from a traditional perspective.

 

180g/day isn't " average, " it is on the high side, without a doubt. But it is

not atypical, that's my point. Just because someone prescribes 180g doesn't

mean that they don't understand good formula composition, are less

traditionally oriented, etc. It may be that the case was complex or severe.

 

When I worked in the clinic with Bob Damone at PCOM, we would often talk

about how satisfying it is to have a small, concise, eloquent formula

because it satisfies our sense of aesthetics. But he mentioned that

sometimes when he tried to trim down he felt like he lost his edge on some

of the cases, and concluded that he had to prioritize his patient's results

over his own sense of aesthetics. Certainly Bob favors a traditional

approach, and he isn't building big formulas so that he can charge more or

so that he can throw in a bunch of half-baked pharmacological ideas.

 

Some cases simply need small doses and minimal complexity, others need more

power and complexity. One cannot judge a practitioner by formula size alone,

especially if you are just looking at a single case.

 

A

> book here or there only shows exceptions, but the mass volumes of texts

> speaks loudly. Of course there might have been a great physician who

slipped

> through the cracks, but let us look at the big picture.

 

The big picture and the massive collective experience of Chinese medicine

quite plainly shows us that both large and small formulas are in common use.

Doctors that prescribe 100-200g/day formulas are not rare exceptions by any

stretch of the imagination. Categorically dismissing whole schools of

thought leads to more limited and extreme perspectives.

 

Chinese medicine is beautiful because it is balanced and flexible.

Categorical statements generally show up when someone is trying to sell

their own personal angle or lecture material, if anything this is the thread

in CM that is most associated with selling an overpriced " prescription. "

Your attempts to dismiss the large dose approaches of hundreds of thousands

of doctors reeks of this type of zeal, like a new convert who got out of a

seminar and now only does one approach that is somehow more real and

authentic than all the rest. I respect that you have great teachers that use

small doses and I'm sure that you are learning a lot with them, but no

matter how good one's teachers are, we must study widely and not be bound to

the same limitations that any one given teacher has. The consensus of the

historical texts and the real-life doctors clearly shows that diverse,

balanced, and flexible approaches are the main thing that CM revolves

around.

 

> Consequently, are we then to believe that there is really all these

gigantic

> formulas out there that missed our modern textbooks and are more effective

> than what we read about.

 

Most well-educated doctors have the same respect for Fang Feng Tong Sheng

San as they have for Gui Zhi Tang, even though one formula is massive and

the other is tiny. How about pu ji xiao du yin? I don't know what modern

textbooks you are reading, but all the main ones I have certainly have big

formulas along with small ones.

 

Can someone point out a famous clinician (or a

> few) in CM history that has a case study book that demonstrates 200+g

> formulas a day as the average treatment style.

 

Jiao Shu-De comes to mind. He is a very famous clinician, on par with

someone like Qin Bo-Wei. His prescriptions are often quite large, and his

book is universally well-regarded in the Chinese clinical community.

 

Eric Brand

 

My blog: http://bluepoppy.com/blog/blogs/index.php

 

 

 

 

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[Guest guest]

A teacher of mine said that

complicated people need complicated formulas

simple people need simple formulas.

 

Complicated practitioners often reflect that in offering many ingredients in

their recipes,

while simple people usually stick to less spices in their soup.

 

Complicated and Complex are different birds.

 

I've also noticed that people who use " heavy " needles, often give higher

doses as well vice versa.

ie... Japanese needling and small kampo formulas vs strong de qi needling

and 200gm rxs.

 

We express our natures outwardly and want others to be like us.

You see this in the way we talk, write, walk, drive, cook food and cook

herbs

Wasn't it the Germans who perfected expressionistic art?

 

Are there geographically cultural distinctions which create dosage

variations?

For instance, Fu zi grows plentifully in Sichuan, so it makes sense that

they dose high (high supply)

whereas in the North, it might have been harder to get large quantities of

the herb (travel issues),

so even though Fu zi makes sense in cold Manchuria,

it's used in higher doses in the places where it grows best

(so the considerations are more materially based than philosophically

driven)

 

If there's a famine or shortage of produce and vegetation, I'd probably dose

small and try to be as efficient

as possible with what I have.... Maybe these considerations created

traditions, which are narratives we hold

and carry down through generations, even after horses are replaced with

cargo carriers.

 

K

[Guest guest]

The dosage argument is a little silly. I don't think anyone would argue that 24g

of chi hu is a small dose and yet that is what ZZJ uses in SHL quite often. I

think its more about focus and clarity of formulation. As far as the case Jason

i was wandering why for example guizhi jia ge gen or other ge gen formula was

not used as dryness was a significant issue. Perhaps because the pulse was not

slippery but it was also not a guizhi pulse. Also the lack of sweating would

suggest a mahuang based formula.

Alon

 

 

[Guest guest]

Hi Alon and all

 

It is interesting to see this case

It comes from a book from China, so we don't have the benefit of the treating

physician for feedback

 

I agree Alon, if nothing else, it looks like Gui Zhi Ma Huang Ge Ban Tang which

is famous for itchy skin and would seem to fit the bill better with the no sweat

statement...

but if it resolved the issue...

 

I can't remember the explanation offered...something about the fact that it was

a 9 years old child...

 

 

Stephen Woodley LAc

[Guest guest]

--- Greg wrote:

 

>

> Furthermore, Chinese medicine always has to consider the time, location, and

individual in treatment. Fire God School originated in Chengdu, Sichuan, which

is one of the dampest, cloudiest, least sunny areas of China, and where the

people are constitutionally quite tough, and where some people actually take

fuzi as food. I've never tried to dose fuzi anywhere near as high as these guys,

so I can't say from experience, but I imagine if you take this method to say,

where Jason lives, Boulder, Co, where it is super dry, super sunny, and people

have never taken a Chinese herb in their life, let alone fuzi, and they have

wimpier constitutions than the average Sichuan nongmin(farmer), the results may

be less than desirable.

>

> Same with the Jiangnan region of China (Jiangsu, Shanghai, Zhejiang), where

the Menghe docs are from, and where the " Shanghai School " Daniel mentioned is

from. The people here are not as tough as in Sichuan, the climate is damp in

summer, but winter is actually quite dry, they don't eat spicy food, and

certainly don't take fuzi as a food. Because of this, some docs here developed a

more " gentle " style, and they get good results with it here. Maybe if they tried

this method in Chegdu the results would be dissapointing.

>

 

Hi Greg,

 

FWIW, Lu Chong-Han specifically addressed this issue of how Sichuan's

climate/diet has influenced the use of fuzi, ginger etc- he went to great

efforts in his book " Fu Yang Jiang Ji " to give examples of using his formulas

effectively all over China.

 

Dr. Lu is the third generation representative of the fire-spirit school, and

when he was young he studied in Nan Jing (Jiang Su). In his book he describes

the skepticism that his treatment style was met with changing to acceptance when

the local doctors and professors saw the results.

 

This is not to disagree with your basic point, but the great number of

successful cases presented in the book challenges the idea that the fire-spirit

school's formulas are only/more effective in Sichuan.

 

Regards, Henry

 

Chinese names (on the off chance that it displays correctly )

 

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[Guest guest]

Henry et al,

 

 

 

 

 

I just picked up the book that Greg previously mentioned on the fire-spirit

school, it is an interesting read for sure. I am wondering if you or others have

actually studied with any of these guys. If so, are they using these type of

formulas on most people or just a select few. I would like to hear more of the

day to day clinical outcomes of such an approach. I could see how it could be

effective on a select few, but treating the mass majority of problems with this

method is quite simply mind-boggling.

 

 

 

In the past I sat clinic with a guy who used a similar approach (lots of fuzi,

ganjiang etc. in patients that had apparent heat signs). He did not claim to be

practicing any fire-spirit school, actually he usually just said it was all

based on NeiJing . He of course said that the heat signs that we saw were all

really from cold, which of course makes sense. However, when patients came back

he really jacked a few. Their heat signs were significantly worse as well as

additional ones appeared, and the chief complaint was not better.

 

 

 

Of course we might just say his skill was not that good, but it is hard to

believe that one doesn’t see side-effects often. Or should I say, the

potential for side-effects with such an approach seems high, without the proper

skill. I would love to hear more about someone who has had the privilege to see

this style work in person (sorry if I missed an email that may have discussed

this.) This is a fascinating topic, and hope that someone could put together

their clinical observations in a email, article, or even book.

 

 

 

-

 

 

 

 

On Behalf Of henry_buchtel

Monday, April 20, 2009 10:40 AM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

--- Greg wrote:

 

>

> Furthermore, Chinese medicine always has to consider the time, location, and

individual in treatment. Fire God School originated in Chengdu, Sichuan, which

is one of the dampest, cloudiest, least sunny areas of China, and where the

people are constitutionally quite tough, and where some people actually take

fuzi as food. I've never tried to dose fuzi anywhere near as high as these guys,

so I can't say from experience, but I imagine if you take this method to say,

where Jason lives, Boulder, Co, where it is super dry, super sunny, and people

have never taken a Chinese herb in their life, let alone fuzi, and they have

wimpier constitutions than the average Sichuan nongmin(farmer), the results may

be less than desirable.

>

> Same with the Jiangnan region of China (Jiangsu, Shanghai, Zhejiang), where

the Menghe docs are from, and where the " Shanghai School " Daniel mentioned is

from. The people here are not as tough as in Sichuan, the climate is damp in

summer, but winter is actually quite dry, they don't eat spicy food, and

certainly don't take fuzi as a food. Because of this, some docs here developed a

more " gentle " style, and they get good results with it here. Maybe if they tried

this method in Chegdu the results would be dissapointing.

>

 

Hi Greg,

 

FWIW, Lu Chong-Han specifically addressed this issue of how Sichuan's

climate/diet has influenced the use of fuzi, ginger etc- he went to great

efforts in his book " Fu Yang Jiang Ji " to give examples of using his formulas

effectively all over China.

 

Dr. Lu is the third generation representative of the fire-spirit school, and

when he was young he studied in Nan Jing (Jiang Su). In his book he describes

the skepticism that his treatment style was met with changing to acceptance when

the local doctors and professors saw the results.

 

This is not to disagree with your basic point, but the great number of

successful cases presented in the book challenges the idea that the fire-spirit

school's formulas are only/more effective in Sichuan.

 

Regards, Henry

 

Chinese names (on the off chance that it displays correctly )

 

 

 

 

 

 

 

 

[Guest guest]

Heiner Fruehauf has a bunch of material on the fire spirit school,

including articles and videos, at his website

http://classicalchinesemedicine.org

 

Interesting stuff indeed.. . . .

 

 

On Apr 20, 2009, at 7:16 AM, wrote:

 

>

>

> Henry et al,

>

> I just picked up the book that Greg previously mentioned on the fire-

> spirit school, it is an interesting read for sure. I am wondering if

> you or others have actually studied with any of these guys. If so,

> are they using these type of formulas on most people or just a

> select few. I would like to hear more of the day to day clinical

> outcomes of such an approach. I could see how it could be effective

> on a select few, but treating the mass majority of problems with

> this method is quite simply mind-boggling.

>

> In the past I sat clinic with a guy who used a similar approach

> (lots of fuzi, ganjiang etc. in patients that had apparent heat

> signs). He did not claim to be practicing any fire-spirit school,

> actually he usually just said it was all based on NeiJing . He of

> course said that the heat signs that we saw were all really from

> cold, which of course makes sense. However, when patients came back

> he really jacked a few. Their heat signs were significantly worse as

> well as additional ones appeared, and the chief complaint was not

> better.

>

> Of course we might just say his skill was not that good, but it is

> hard to believe that one doesn’t see side-effects often. Or should I

> say, the potential for side-effects with such an approach seems

> high, without the proper skill. I would love to hear more about

> someone who has had the privilege to see this style work in person

> (sorry if I missed an email that may have discussed this.) This is a

> fascinating topic, and hope that someone could put together their

> clinical observations in a email, article, or even book.

>

> -

>

>

[

> ] On Behalf Of henry_buchtel

> Monday, April 20, 2009 10:40 AM

>

> Re: Dose of herbs prescribed to Westerner in Beijing

>

> --- Greg wrote:

>

> >

> > Furthermore, Chinese medicine always has to consider the time,

> location, and individual in treatment. Fire God School originated in

> Chengdu, Sichuan, which is one of the dampest, cloudiest, least

> sunny areas of China, and where the people are constitutionally

> quite tough, and where some people actually take fuzi as food. I've

> never tried to dose fuzi anywhere near as high as these guys, so I

> can't say from experience, but I imagine if you take this method to

> say, where Jason lives, Boulder, Co, where it is super dry, super

> sunny, and people have never taken a Chinese herb in their life, let

> alone fuzi, and they have wimpier constitutions than the average

> Sichuan nongmin(farmer), the results may be less than desirable.

> >

> > Same with the Jiangnan region of China (Jiangsu, Shanghai,

> Zhejiang), where the Menghe docs are from, and where the " Shanghai

> School " Daniel mentioned is from. The people here are not as tough

> as in Sichuan, the climate is damp in summer, but winter is actually

> quite dry, they don't eat spicy food, and certainly don't take fuzi

> as a food. Because of this, some docs here developed a more " gentle "

> style, and they get good results with it here. Maybe if they tried

> this method in Chegdu the results would be dissapointing.

> >

>

> Hi Greg,

>

> FWIW, Lu Chong-Han specifically addressed this issue of how

> Sichuan's climate/diet has influenced the use of fuzi, ginger etc-

> he went to great efforts in his book " Fu Yang Jiang Ji " to give

> examples of using his formulas effectively all over China.

>

> Dr. Lu is the third generation representative of the fire-spirit

> school, and when he was young he studied in Nan Jing (Jiang Su). In

> his book he describes the skepticism that his treatment style was

> met with changing to acceptance when the local doctors and

> professors saw the results.

>

> This is not to disagree with your basic point, but the great number

> of successful cases presented in the book challenges the idea that

> the fire-spirit school's formulas are only/more effective in Sichuan.

>

> Regards, Henry

>

> Chinese names (on the off chance that it displays correctly )

>

>

[Guest guest]

wrote:

 

>

> I just picked up the book that Greg previously mentioned on the fire-spirit

school, it is an interesting read for sure. I am wondering if you or others have

actually studied with any of these guys. If so, are they using these type of

formulas on most people or just a select few. I would like to hear more of the

day to day clinical outcomes of such an approach. I could see how it could be

effective on a select few, but treating the mass majority of problems with this

method is quite simply mind-boggling.

>

>

 

Hi Jason,

 

I've never studied with or met any of the people in question, I've just read

their books and heard/read other people's opinions about them. I do have one

friend (a doc in GZ) who is a disciple of Li Ke in Shaanxi (not officially a

member of the fire spirit school, but his formulas resemble theirs). I'll ask

him to give us some 1st person perspective.

 

For more mind-bogglingosity ->

 

" In the last year I treated 2,745 patients (...) and prescribed a total of

20,076 formulas. (...) 99.7% of the formulas included [some form of] ginger.

(...) 98.8% of the formulas included [some form of] gui zhi. (...) 96.8% of them

included [some form of] fuzi. " (Lu Chong-Han, " Fu Yang Jiang Ji " )

 

Regards, Henry

[Guest guest]

In addition to the fire-god school, there are many other doctors with strong

biases in any given direction. In fact, doctors with strong biases have often

been pinnacle figures in the development of Chinese medicine. For example, all

of the four great masters of the Jin-Yuan dynasty had relatively extreme

opinions. Each left us with important formulas that fill a special niche in the

modern Chinese medical arsenal. Similarly, broader developments such as warm

disease and cold damage theories were created by practitioners with an inherent

bias. The validity of this bias was proven by formulas that were effective when

employed, and the repeated successful resolution of cases by means of these

formulas is what made these theories survive over generations.

 

Despite this strong bias (or perhaps because of it), each of these schools of

thought has created enduring formulas that form the foundation of knowledge that

all practitioners use. Most practitioners today choose a relatively balanced

blend of theory that is inspired by all of these different influences, and

employ principles from different schools of thought depending on which one best

fits the case in front of them.

 

This is the way that most of us practice. One could even argue that it seems

correct in a common-sense sort of way, since the one constant in Chinese

medicine is the idea of balance between extremes. Chinese medicine has

collected a vast amount of experience and diverse viewpoints over the past two

thousand years; in fact, this is one of its unique features. One can draw from

many theories to explain and treat a case, this is a beautiful thing when done

well. By contrast, limiting most cases to one particular treatment approach

will feel a bit forced or unnatural in some patient scenarios.

 

Yet we do see that some doctors persistently advocate a particular method of

treatment. For some it is kidney supplementation. For others it is warming, as

in the fire-god school. Others invariably fear heat and use cooling and

yin-enriching therapies, shying away from hot medicinals. For some it is based

on climate, for some it is straight Shang Han Lun. Still others use integrative

medicine formulas right out a textbook. Obviously, anyone who says that one way

is the best for every case will have a lot of dissenting opinions.

 

However, having one relatively extreme opinion is arguably good for recognition

and innovation. If the four great masters of the Jin-Yuan dynasty all had a

common sense, middle-ground approach, we never would have had innovative

formulas like bu zhong yi qi tang (center-supplementing qi-boosting decoction).

Most of us probably utilize Li Dong-Yuan's theories on the spleen and stomach

every day, but only a small minority of modern practitioners base all of their

patient's treatments around the spleen and stomach. Yet the four great masters

were masters precisely because they thought outside the box and developed new

strategies and formulas that survived hundreds of years of testing and scrutiny.

 

If such doctors weren't extremists in a way, we never would have heard of them.

There is a buzz about fire-god practitioners because they do something that most

other doctors wouldn't do. Similarly, there are a few very famous doctors in

Beijing that base everything around blood-moving. These guys prescribe hefty

doses of e zhu and san leng to every patient that walks in the door. Maybe some

of these schools of thought will make lasting innovations that are recognized

for hundreds of years, while others will be isolated fads that don't stand the

test of time. Regardless, they will stand out. There will be buzz, people will

talk about them.

 

Further, we see that various people in different camps generate quite a buzz and

achieve excellent marketing just by endorsing an extreme viewpoint that has

market appeal. Confidence and extreme viewpoints are memorable and distinctive.

Many may think that the balanced old sage that just uses common-sense,

straightforward Chinese medicine is ultimately the best doctor at the end of the

day. But certainly he won't have the buzz and the fame factor that the doctor

who routinely uses 100g of fu zi will enjoy. After all, who wants to go to a

seminar where the person offers the same common sense that you could get from

your grandma for free?

 

Eric Brand

[Guest guest]

, " Eric Brand " <smilinglotus

wrote:

> Many may think that the balanced old sage that just uses common-sense,

straightforward Chinese medicine is ultimately the best doctor at the end of the

day. But certainly he won't have the buzz and the fame factor that the doctor

who routinely uses 100g of fu zi will enjoy. After all, who wants to go to a

seminar where the person offers the same common sense that you could get from

your grandma for free?

 

 

Just because I am using the example of fu zi, please understand that I am not in

any way disparaging the fire-god school of thought. In fact, I think it is

quite interesting. Aconite was recognized as one of the most important

medicinal herbs in virtually every region that had the plant growing. Despite

its extreme toxicity, people all over the world recognized its value and sought

to harness its medicinal properties. In Chinese history, the amount of effort

that went into learning how to process fu zi and wu tou is amazing. The

monograph on fu zi in any Chinese materia medica is always the longest in the

book.

 

Similarly, rou gui is an incredibly important substance worldwide, as well as

within Chinese medicine. And overall, the general concept of favoring warming

therapies has very deep roots within historical Chinese medicine.

 

It should also be noted that the fire-god school often uses very long decoction

times, which greatly reduces the toxicity of (already processed) fu zi.

 

Eric Brand

[Guest guest]

Hi Henry,

 

> Hi Greg,

>

> FWIW, Lu Chong-Han specifically addressed this issue of how Sichuan's

climate/diet has influenced the use of fuzi, ginger etc- he went to great

efforts in his book " Fu Yang Jiang Ji " to give examples of using his formulas

effectively all over China.

>

 

Lu is mentioned in the book I have, as is Li Ke (who was mentioned by someone

else a few posts ago. I also have a Li Ke book, and while he does sometimes do

similar things as the fire-god guys, he is just in general a kind of large dose

practitioner, dosing heavy both the hot and cold herbs, and reportedly saving a

lot of lives).

 

 

> Dr. Lu is the third generation representative of the fire-spirit school, and

when he was young he studied in Nan Jing (Jiang Su). In his book he describes

the skepticism that his treatment style was met with changing to acceptance when

the local doctors and professors saw the results.

 

Interesting. I'll have to look for his book.

 

>

> This is not to disagree with your basic point, but the great number of

successful cases presented in the book challenges the idea that the fire-spirit

school's formulas are only/more effective in Sichuan.

 

I have no doubt that one can get this to work in other regions and with other

types of people, but I still tend to think it is probably better suited for some

regions/people than others. Places that have predominance of yin-qi either in

the form of cold or damp/high humidity or lack of sunshine are probably better

suited than hot, sunny, and dry places, although I'm sure one can find cases

here and there that would respond well no matter what the climate. Ultimately,

flexibility and rational approach are the key, I think.

 

In any case, now I'm really aching to go study with one of these guys.... :-)

 

Best wishes,

 

Greg

[Guest guest]

Eric, thanks for that well-written post. I admit to being a sucker for anything

that appears contrary to standardized practice yet is effective . I get really

happy when I see stuff like in Lu Chong-Han's book like-

 

" When I use herbs in the clinic, my usage may not be the same as in the

textbooks, so I received criticism. (laughter) I wasn't supposed to use them in

that way because it wasn't in the textbooks. Additionally, at that time, I had

to supervise interns, which brought about a lot of trouble. What kind of

trouble? The interns based their pattern determination, method choosing and herb

usage on what the textbooks taught. However, what I said to them in the clinic

was different; there was quite a discrepency between my usage and that in the

textbooks, so the students were quite perplexed. (...) [the students] thought

that after 5 years of formal education, studying the basic theory, diagnostics,

herbs, formulas and clinical courses, that herbs should be used " this way " .

However, Professor Lu used the herbs in a different way... and the method that

they used did not produce good results, while Prof. Lu's method got very good

results. " (p.11,12, " Fu Yang Jiang Ji " Lu Chong-Han)

 

I'd like to take issue with one thing you said-

 

Eric Brand wrote:

>

 

Most practitioners today choose a relatively balanced blend of theory that is

inspired by all of these different influences, and employ principles from

different schools of thought depending on which one best fits the case in front

of them.

>

> This is the way that most of us practice. One could even argue that it seems

correct in a common-sense sort of way, since the one constant in Chinese

medicine is the idea of balance between extremes. Chinese medicine has

collected a vast amount of experience and diverse viewpoints over the past two

thousand years; in fact, this is one of its unique features. One can draw from

many theories to explain and treat a case, this is a beautiful thing when done

well. By contrast, limiting most cases to one particular treatment approach

will feel a bit forced or unnatural in some patient scenarios.

>

 

I don't disagree that the majority of TCM practitioners (in China) make use of a

wide variety of theories and treatment methods, but I would argue that this is a

characteristic of what is called the " School school " :^) (xue2 yuan4 pai4),

meaning doctors who graduated from the formal higher education system in China.

In my reading and from hearing professors' stories, it seems that most people

who learned in a particular tradition or from one of their relatives tend to

stick to one treatment method. When it works it works, if it doesn't work the

patient goes somewhere else.

 

This is not to belittle either approach, but I have the impression that this

'best of' approach is a characteristic of modern CM, and not something that has

been particularily representative of CM in the past. Of course I'd be happy to

hear opinions to the contrary!

 

Regards, Henry

[Guest guest]

Eric,

 

 

 

I think you hit the nail on the head here. Who wants to pay for a seminar

where they learn 'just' CM. People want bells and whistles. However, as I

think you may agree, these core concepts are probably what most of us need

in the West. From my observation, our foundation on essential concepts is

weak. Instead of strengthening the core, which in the end will probably

treat 95% of people, we run towards anything wild, extreme, or innovative.

For better or worse, right?

 

 

 

I always liked the idea of not mistaking the obscure for profound. I

actually prefer core straight forward ideas in CM. Quite simply because they

usually are the most tested clinically. I find no shortage of material to

deepen one's skills without feeling the need to innovate or try extreme

treatments. However, maybe when I am 75 I may have 1 new idea for the

medicine, but most likely I will just follow in the footsteps of people much

smarter than me.

 

 

 

For those who know Min Fan from PCOM (is he still there?), he used to always

say, " I am much better doctor than Zhang Zhong-Jing. " The first time I heard

this I thought this guy is a bit arrogant , but really his point is very

sound. He (as well as us) have all of CM that followed ZZJ at our disposal

to study and to draw from to write prescriptions. Min, BTW, had some very

nice formulas.

 

 

 

There is something to be said for both innovations and followers. I just

wish that people in the West would have a bit more clinical experience and

theoretical and classic study before innovating and spouting out 'the way'.

Even the greatest innovators of CM studied extensively the texts and methods

before them, this is something we kind of like to skip in the West. For

example, warm disease (wen bing) doctors new Shang Han inside and out, it is

not like these ideas came out of the ether.

 

 

 

-

 

 

 

 

On Behalf Of Eric Brand

Monday, April 20, 2009 11:09 PM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

In addition to the fire-god school, there are many other doctors with strong

biases in any given direction. In fact, doctors with strong biases have

often been pinnacle figures in the development of Chinese medicine. For

example, all of the four great masters of the Jin-Yuan dynasty had

relatively extreme opinions. Each left us with important formulas that fill

a special niche in the modern Chinese medical arsenal. Similarly, broader

developments such as warm disease and cold damage theories were created by

practitioners with an inherent bias. The validity of this bias was proven by

formulas that were effective when employed, and the repeated successful

resolution of cases by means of these formulas is what made these theories

survive over generations.

 

Despite this strong bias (or perhaps because of it), each of these schools

of thought has created enduring formulas that form the foundation of

knowledge that all practitioners use. Most practitioners today choose a

relatively balanced blend of theory that is inspired by all of these

different influences, and employ principles from different schools of

thought depending on which one best fits the case in front of them.

 

This is the way that most of us practice. One could even argue that it seems

correct in a common-sense sort of way, since the one constant in Chinese

medicine is the idea of balance between extremes. Chinese medicine has

collected a vast amount of experience and diverse viewpoints over the past

two thousand years; in fact, this is one of its unique features. One can

draw from many theories to explain and treat a case, this is a beautiful

thing when done well. By contrast, limiting most cases to one particular

treatment approach will feel a bit forced or unnatural in some patient

scenarios.

 

Yet we do see that some doctors persistently advocate a particular method of

treatment. For some it is kidney supplementation. For others it is warming,

as in the fire-god school. Others invariably fear heat and use cooling and

yin-enriching therapies, shying away from hot medicinals. For some it is

based on climate, for some it is straight Shang Han Lun. Still others use

integrative medicine formulas right out a textbook. Obviously, anyone who

says that one way is the best for every case will have a lot of dissenting

opinions.

 

However, having one relatively extreme opinion is arguably good for

recognition and innovation. If the four great masters of the Jin-Yuan

dynasty all had a common sense, middle-ground approach, we never would have

had innovative formulas like bu zhong yi qi tang (center-supplementing

qi-boosting decoction). Most of us probably utilize Li Dong-Yuan's theories

on the spleen and stomach every day, but only a small minority of modern

practitioners base all of their patient's treatments around the spleen and

stomach. Yet the four great masters were masters precisely because they

thought outside the box and developed new strategies and formulas that

survived hundreds of years of testing and scrutiny.

 

If such doctors weren't extremists in a way, we never would have heard of

them. There is a buzz about fire-god practitioners because they do something

that most other doctors wouldn't do. Similarly, there are a few very famous

doctors in Beijing that base everything around blood-moving. These guys

prescribe hefty doses of e zhu and san leng to every patient that walks in

the door. Maybe some of these schools of thought will make lasting

innovations that are recognized for hundreds of years, while others will be

isolated fads that don't stand the test of time. Regardless, they will stand

out. There will be buzz, people will talk about them.

 

Further, we see that various people in different camps generate quite a buzz

and achieve excellent marketing just by endorsing an extreme viewpoint that

has market appeal. Confidence and extreme viewpoints are memorable and

distinctive. Many may think that the balanced old sage that just uses

common-sense, straightforward Chinese medicine is ultimately the best doctor

at the end of the day. But certainly he won't have the buzz and the fame

factor that the doctor who routinely uses 100g of fu zi will enjoy. After

all, who wants to go to a seminar where the person offers the same common

sense that you could get from your grandma for free?

 

Eric Brand

 

 

 

 

 

 

[Guest guest]

Henry,

 

 

 

I think you may be generally correct that there were many doctors just

practicing what they know. But can you name any of their names?

 

 

 

Meaning, it seems that the most famous clinicians/ doctors in history seem

to be ones that could practice multiple styles and put it all together.

Although as Eric has pointed out, many of these doctors will have theories

or specifics strategies / schools that they developed, however, this does

not mean that they did not have common sense and where just blazing a new

trail, or just practicing a single style that they became famous for.

 

 

 

For example, Liu He-Jian studied Neijing, Nanjing, and five periods and six

qi4 (wu yun liu qi) extensively for 40-50 years and only then wrote Nineteen

pathomechanisms (Bing Ji Shi jiu Tiao.) Consequently he was labeled as

starting the fire-heat school / Cold school (treatment) (»ðÈÈÅÉ, º®Á¹ÅÉ).

However he was known as a very effective clinician, and was not simple or

one track minded. For example, he ¡°did not think all disease was heat and

fire and was flexible in clinic.¡±

 

 

 

Even someone like Zhu Dan-Xi, who studied Liu He-Jian, Zhang Zi-he, Zhang

Yuan-Su, and Li Dong-Yuan, and followed many doctors because of his wealth,

was quite flexible in the clinic despite being known as the founder of yin

nourishing school.

 

 

 

But I think your point is that the higher educated and studied doctors were

the ones that practiced more widely. I would agree and it seems that this is

what made them famous and able to further develop theories in CM. No one

really remembers grandma¡¯s uncles who could cure any neck pain with one

needle, but nothing else.

 

 

 

Most of the greats have similar stories, Ye Tian-Shi studied since the age

of 14, and traveled around and studied with 17 famous doctors of his time.

His style is a bit of everything synthesized. Of course his wen bing cases

got later complied into the ¡®text¡¯ wen bing tiao bian.

 

 

 

This wide-ranging study is also why the meng-he tradition became so famous.

They were eclectics who had a large repertoire of strategies. They just

happen to use small formulas, with smaller dosages, as did Ye Tian-Shi.

 

 

 

Qin Bo-Wei, called ¡®The grandfather of TCM¡¯, was one of the first to

formally put together ¡°a best¡± of approach of study for the masses.

However, his style, does not remotely resemble what I see as modern TCM

hospital practice. Actually there was a huge political controversy that

happened that led our medicine down a different road in the 50s, than what

Dr. Qin was envisioning. Hence the medicine for better or worse transmuted

and as most say became simplified. But that is another story¡­

 

 

 

Of course as technology and texts have became more and more available, the

possibility of integrating various styles has become easier. Although, in

general it is a very difficult and arduous process that I image is best

accomplished by only the most dedicated CM clinicians/ scholars, especially

in the past. I image it was much more difficult for doctors in the past to

learn different styles, hence they got stuck with what they learned. However

people like Ye Tian-Shi who made it a point

 

to study with many many people gained a much broader perspective.

Consequently I do not think the ¡°best of¡± approach is necessarily only

modern. It is something that has been going on for some time, maybe just

from a fewer doctors than it is possible in today¡¯s time due to Dr.

Ding-Gan-Ren¡¯s / Dr. Qin¡¯s systematization as well as modern technology.

 

 

 

So quite possibly, as you state, this ¡°best of¡± approach is not

representative of the ¡°masses¡± of doctors that practiced in the past.

Actually I do not know how one could find out. But I do think that the

medicine that we have documented from these many great doctors seems to

represent the cream of the crop and mostly has an eclectic trend to it-

even when a given doctor is know for a specific school (pai).

 

 

 

I think an counter- argument is that this literary vein might not be

representative of the ¡®true medicine.¡¯ But I actually believe that it is

the cream of the crop of what happened in the past. What do you think?

 

 

 

For example, Ye Tian-Shi, in most scholars opinions that I have read, say he

actually wrote nothing at all, because he was too busy as a clinician. All

his recorded cases studies and ¡°wen re lun¡± were written down by his

students. So the argument that only famous books / doctors were famous

because they were just sitting in an ivory tower writing is not always the

case.

 

 

 

Comments?

 

 

 

-

 

=-------

 

 

I don't disagree that the majority of TCM practitioners (in China) make use

of a wide variety of theories and treatment methods, but I would argue that

this is a characteristic of what is called the " School school " :^) (xue2

yuan4 pai4), meaning doctors who graduated from the formal higher education

system in China. In my reading and from hearing professors' stories, it

seems that most people who learned in a particular tradition or from one of

their relatives tend to stick to one treatment method. When it works it

works, if it doesn't work the patient goes somewhere else.

 

This is not to belittle either approach, but I have the impression that this

'best of' approach is a characteristic of modern CM, and not something that

has been particularily representative of CM in the past. Of course I'd be

happy to hear opinions to the contrary!

 

Regards, Henry

 

 

 

 

 

 

 

 

[Guest guest]

Such important schools as the cold damage current and the warm disease

current were hardly 'ivory tower' schools. . they were intelligent

responses to epidemic diseases ravaging large numbers of people. It

seems sometimes in our field that some folks seem to think that real,

'practical' medicine is very empirical, technique-oriented, and if it

has a sophisticated, 'intellectual' theory behind it, that it cannot

be useful in clinic.

 

 

On Apr 21, 2009, at 7:29 PM, wrote:

 

> For example, Ye Tian-Shi, in most scholars opinions that I have

> read, say he

> actually wrote nothing at all, because he was too busy as a

> clinician. All

> his recorded cases studies and “wen re lun” were written down by his

> students. So the argument that only famous books / doctors were famous

> because they were just sitting in an ivory tower writing is not

> always the

> case.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

> I don't disagree that the majority of TCM practitioners (in China) make use of

a wide variety of theories and treatment methods, but I would argue that this is

a characteristic of what is called the " School school " :^) (xue2 yuan4 pai4),

meaning doctors who graduated from the formal higher education system in China.

In my reading and from hearing professors' stories, it seems that most people

who learned in a particular tradition or from one of their relatives tend to

stick to one treatment method. When it works it works, if it doesn't work the

patient goes somewhere else.

 

I completely agree. My first teacher outside of school, the boss at the

pharmacy DXD in San Diego, was a classic example of a lineage-trained master of

his own style. When it worked, it was amazing, and he had a big following. But

as I learned more, I realized that he had holes in his knowledge and theoretical

understanding that limited his ability to treat some portion of the patients.

These patients then went to other doctors until they found someone who could

help (or not). Of course, despite the limitations of his formal education, he

still changed the lives of thousands of people, and he saved several lives in

diphtheria outbreaks in Vietnam when he was a young doctor. He is a treasure

house of knowledge and I owe a lot to him- I even dedicated my first book to

him. But even though he passed on his whole lineage of recipes to me over the

years, I would never stop my studies there. Believe me, I have a lot of respect

for outside-the-box thinking, just like you do.

 

My main point is not that the " box " is correct, or doctors that think inside of

standard TCM theory are better in any way. Forever, the thing that expanded and

defined the shape of the " box " has been the influence of people that thought

outside the box. Without people thinking of new theories like wen bing or

spleen-stomach theories, we would have a much smaller box to work from today.

 

To me, the key point is that these people thinking outside the box should expand

the community, they should enrich the theories and practice of Chinese medicine.

All too often, we see people using such theories to polarize the community,

claim superiority, and suggest inferiority of other approaches. I'm certainly

not saying anyone here is doing this, but we can clearly see many many examples

of these people on the lecture circuit. In my view, this can be a destructive

influence on our field as well as a productive influence.

 

In Chinese society, these numerous theories co-exist in harmony. Each

theoretical school has devotees contrasted with lots of people who take

everything with a grain of salt. In the West, the discussion gets more

polarized, more us vs. them. Often it seems to be akin to marketing and

profiteering off of people that haven't had exposure to a diverse CM education.

 

CHA tends to be a remarkably mature discussion group. People raise points that

seek to truly expand our collective knowledge, to add new perspectives without

detracting from other perspectives. But in the outer field beyond CHA, we see

these acronyms and special, expensive schools and workshops that do indeed tend

to create division within the profession. CM has always been diverse, but it

has rarely been dogmatic.

 

Eric Brand

 

website: http://www.legendaryherbs.com

blog: http://bluepoppy.com/blog/blogs/index.php

[Guest guest]

Sorry if this posts twice.

 

By Henry:

> I don't disagree that the majority of TCM practitioners (in China) make use of

a wide variety of theories and treatment methods, but I would argue that this is

a characteristic of what is called the " School school " :^) (xue2 yuan4 pai4),

meaning doctors who graduated from the formal higher education system in China.

In my reading and from hearing professors' stories, it seems that most people

who learned in a particular tradition or from one of their relatives tend to

stick to one treatment method. When it works it works, if it doesn't work the

patient goes somewhere else.

 

By Eric:

I completely agree. My first teacher outside of school, the boss at the

pharmacy DXD in San Diego, was a classic example of a lineage-trained master of

his own style. When it worked, it was amazing, and he had a big following. But

as I learned more, I realized that he had holes in his knowledge and theoretical

understanding that limited his ability to treat some portion of the patients.

These patients then went to other doctors until they found someone who could

help (or not). Of course, despite the limitations of his formal education, he

still changed the lives of thousands of people, and he saved several lives in

diphtheria outbreaks in Vietnam when he was a young doctor. He is a treasure

house of knowledge and I owe a lot to him- I even dedicated my first book to

him. But even though he passed on his whole lineage of recipes to me over the

years, I would never stop my studies there. Believe me, I have a lot of respect

for outside-the-box thinking, just like you do.

 

My main point is not that the " box " is correct, or doctors that think inside of

standard TCM theory are better in any way. Forever, the thing that expanded and

defined the shape of the " box " has been the influence of people that thought

outside the box. Without people thinking of new theories like wen bing or

spleen-stomach theories, we would have a much smaller box to work from today.

 

To me, the key point is that these people thinking outside the box should expand

the community, they should enrich the theories and practice of Chinese medicine.

All too often, we see people using such theories to polarize the community,

claim superiority, and suggest inferiority of other approaches. I'm certainly

not saying anyone here is doing this, but we can clearly see many many examples

of these people on the lecture circuit. In my view, this can be a destructive

influence on our field as well as a productive influence.

 

In Chinese society, these numerous theories co-exist in harmony. Each

theoretical school has devotees contrasted with lots of people who take

everything with a grain of salt. In the West, the discussion gets more

polarized, more us vs. them. Often it seems to be akin to marketing and

profiteering off of people that haven't had exposure to a diverse CM education.

 

CHA tends to be a remarkably mature discussion group. People raise points that

seek to truly expand our collective knowledge, to add new perspectives without

detracting from other perspectives. But in the outer field beyond CHA, we see

these acronyms and special, expensive schools and workshops that do indeed tend

to create division within the profession. CM has always been diverse, but it

has rarely been dogmatic.

 

Eric Brand

[Guest guest]

It seems here on CHA that we are very excited about the Shang Han Lun and " the

Classics " . Obviously I have my own new interest in Classics and much of this is

because I have gone to enough lectures where the " same old TCM " was presented.

I'm not looking for something new, I'm just seeing what is lacking. I've been

practicing for 13 years now and it seems that something is missing- its natural

to want to go back to the source. Especially since I'm teaching a Fundamentals

class now and the way of presenting this material from others seems somehow

lacking.

 

My question for those of you who frequent China, is this going on in China as

well? Is there a dissatisfaction with TCM that is more a maturing of the

medicine or is this regional? Is our interest because of Sharon getting

interested in this and hooking Huang Huang up here? Are we interested in Arnaud

Versluys because we have an interest in Shang Han Lun or was Arnaud Versluys

studying SHL because that is the trend in China?

 

Doug

 

Sorry, Jason, I missed what this " best of " remark refers to... can you explain a

little... Is this a reference to the generalities of TCM?

[Guest guest]

This seems to be a very nice web site for huoshenpai.

http://www.huoshen.org/?page_id=41

Gabe Fuentes

--- On Mon, 4/20/09, <zrosenbe wrote:

 

 

<zrosenbe

Re: Dose of herbs prescribed to Westerner in Beijing

 

Monday, April 20, 2009, 9:26 AM

 

 

Heiner Fruehauf has a bunch of material on the fire spirit school, 

including articles and videos, at his website

http://classicalchinesemedicine.org

 

Interesting stuff indeed.. . . .

 

 

On Apr 20, 2009, at 7:16 AM, wrote:

 

>

>

> Henry et al,

>

> I just picked up the book that Greg previously mentioned on the fire-

> spirit school, it is an interesting read for sure. I am wondering if 

> you or others have actually studied with any of these guys. If so, 

> are they using these type of formulas on most people or just a 

> select few. I would like to hear more of the day to day clinical 

> outcomes of such an approach. I could see how it could be effective 

> on a select few, but treating the mass majority of problems with 

> this method is quite simply mind-boggling.

>

> In the past I sat clinic with a guy who used a similar approach 

> (lots of fuzi, ganjiang etc. in patients that had apparent heat 

> signs). He did not claim to be practicing any fire-spirit school, 

> actually he usually just said it was all based on NeiJing . He of 

> course said that the heat signs that we saw were all really from 

> cold, which of course makes sense. However, when patients came back 

> he really jacked a few. Their heat signs were significantly worse as 

> well as additional ones appeared, and the chief complaint was not 

> better.

>

> Of course we might just say his skill was not that good, but it is 

> hard to believe that one doesn’t see side-effects often. Or should I 

> say, the potential for side-effects with such an approach seems 

> high, without the proper skill. I would love to hear more about 

> someone who has had the privilege to see this style work in person 

> (sorry if I missed an email that may have discussed this.) This is a 

> fascinating topic, and hope that someone could put together their 

> clinical observations in a email, article, or even book.

>

> -

>

>

[

> ] On Behalf Of henry_buchtel

> Monday, April 20, 2009 10:40 AM

>

> Re: Dose of herbs prescribed to Westerner in Beijing

>

> --- Greg wrote:

>

> >

> > Furthermore, Chinese medicine always has to consider the time, 

> location, and individual in treatment. Fire God School originated in 

> Chengdu, Sichuan, which is one of the dampest, cloudiest, least 

> sunny areas of China, and where the people are constitutionally 

> quite tough, and where some people actually take fuzi as food. I've 

> never tried to dose fuzi anywhere near as high as these guys, so I 

> can't say from experience, but I imagine if you take this method to 

> say, where Jason lives, Boulder, Co, where it is super dry, super 

> sunny, and people have never taken a Chinese herb in their life, let 

> alone fuzi, and they have wimpier constitutions than the average 

> Sichuan nongmin(farmer), the results may be less than desirable.

> >

> > Same with the Jiangnan region of China (Jiangsu, Shanghai, 

> Zhejiang), where the Menghe docs are from, and where the " Shanghai 

> School " Daniel mentioned is from. The people here are not as tough 

> as in Sichuan, the climate is damp in summer, but winter is actually 

> quite dry, they don't eat spicy food, and certainly don't take fuzi 

> as a food. Because of this, some docs here developed a more " gentle "  

> style, and they get good results with it here. Maybe if they tried 

> this method in Chegdu the results would be dissapointing.

> >

>

> Hi Greg,

>

> FWIW, Lu Chong-Han specifically addressed this issue of how 

> Sichuan's climate/diet has influenced the use of fuzi, ginger etc- 

> he went to great efforts in his book " Fu Yang Jiang Ji " to give 

> examples of using his formulas effectively all over China.

>

> Dr. Lu is the third generation representative of the fire-spirit 

> school, and when he was young he studied in Nan Jing (Jiang Su). In 

> his book he describes the skepticism that his treatment style was 

> met with changing to acceptance when the local doctors and 

> professors saw the results.

>

> This is not to disagree with your basic point, but the great number 

> of successful cases presented in the book challenges the idea that 

> the fire-spirit school's formulas are only/more effective in Sichuan.

>

> Regards, Henry

>

> Chinese names (on the off chance that it displays correctly )

>

>

[Guest guest]

Z'ev,

 

I 100% agree, and did not mean to imply otherwise. It just seems that in the

past when people bring up scholars and famous doctors they seem to dismiss

them because they were just in the ivory tower. Obviously not! Consequently,

they will say the true medicine is the one that is not documented, hence

oral... Never really understood this argument...

 

-Jason

 

 

 

On Behalf Of

Tuesday, April 21, 2009 10:30 PM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

Such important schools as the cold damage current and the warm disease

current were hardly 'ivory tower' schools. . they were intelligent

responses to epidemic diseases ravaging large numbers of people. It

seems sometimes in our field that some folks seem to think that real,

'practical' medicine is very empirical, technique-oriented, and if it

has a sophisticated, 'intellectual' theory behind it, that it cannot

be useful in clinic.

 

 

On Apr 21, 2009, at 7:29 PM, wrote:

 

> For example, Ye Tian-Shi, in most scholars opinions that I have

> read, say he

> actually wrote nothing at all, because he was too busy as a

> clinician. All

> his recorded cases studies and " wen re lun " were written down by his

> students. So the argument that only famous books / doctors were famous

> because they were just sitting in an ivory tower writing is not

> always the

> case.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

I certainly knew you agree with me, but felt the point needed to be

made. .

 

 

On Apr 22, 2009, at 4:19 AM, wrote:

 

> Z'ev,

>

> I 100% agree, and did not mean to imply otherwise. It just seems

> that in the

> past when people bring up scholars and famous doctors they seem to

> dismiss

> them because they were just in the ivory tower. Obviously not!

> Consequently,

> they will say the true medicine is the one that is not documented,

> hence

> oral... Never really understood this argument...

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Min hasn't taught at PCOM in the last few years, but continues to give

seminars. I personally take such statements with a grain of salt,

because there are no physicians in the modern era who have been able

to create such a systematic approach to internal medicine as Zhong

Zhong-Jing. Even though we have access to more information, the

ability to deeply penetrate the principles of Chinese medical theory

is still quite challenging. Physicians such as Qin Bo-wei and Jiao

Shu-de have done a great job of synthesizing and modifying gu fang for

modern diseases, but they haven't really developed new currents as the

Jin-Yuan physicians did. .

 

 

 

On Apr 21, 2009, at 5:58 PM, wrote:

 

> For those who know Min Fan from PCOM (is he still there?), he used

> to always

> say, " I am much better doctor than Zhang Zhong-Jing. " The first time

> I heard

> this I thought this guy is a bit arrogant , but really his point is

> very

> sound. He (as well as us) have all of CM that followed ZZJ at our

> disposal

> to study and to draw from to write prescriptions. Min, BTW, had some

> very

> nice formulas.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Douglas,

I've gotten to know Arnaud Versluys very well, and there is a

reason why folks such as myself and Alon Marcus have chosen to study

with him at the point of our careers, well past a quarter century.

Like you, I've felt the 'lack' in most TCM seminars/programs, because

I can basically figure out for myself protocols, points, herbs, etc.

by understanding pathomechanisms and underlying CM theory. Even

though I've studied material related to the Shang Han Lun for many

years, most of what Arnaud teaches is new to me and most other

practitioners I know.

 

Arnaud is actually unique in that he not only trained in the

college system in China, but apprenticed himself to a 'pure' SHL

teacher, Dr. Zeng Rongxiu. It may appear that a SHL approach to

herbal medicine is 'narrow', but there are actually several hundred

formulas (including the Jin Gui Yao Lue) , all related to each other

in a familial sense. It is a very in-depth, complex system that is

also very practical, especially if one includes the abdominal

palpation and pulse materials to confirm one's choice of prescription.

 

I appreciate Huang Huang as well, he is a great scholar and has

done in-depth study of such great historical physicians as Xu Da-chun,

who wrote his own clinically-based commentary on the Shang Han Lun.

What I don't understand is why he underestimates six channel theory in

his teachings, does he think that Western students don't 'get it', or

does he assume that we are already well-schooled in this theory?

 

We must always remember that the Shang Han Za Bing Lun is the

foundational text of Chinese herbal medicine, and the root of all

other currents in Chinese herbal medicine. By no means does this mean

that we should restrict ourself just to SHL/JG formulas, but having

this foundation has always been a requirement in studying internal

medicine, and we are no different.

 

 

 

 

On Apr 21, 2009, at 11:12 PM, wrote:

 

>

>

> It seems here on CHA that we are very excited about the Shang Han

> Lun and " the Classics " . Obviously I have my own new interest in

> Classics and much of this is because I have gone to enough lectures

> where the " same old TCM " was presented. I'm not looking for

> something new, I'm just seeing what is lacking. I've been practicing

> for 13 years now and it seems that something is missing- its natural

> to want to go back to the source. Especially since I'm teaching a

> Fundamentals class now and the way of presenting this material from

> others seems somehow lacking.

>

> My question for those of you who frequent China, is this going on in

> China as well? Is there a dissatisfaction with TCM that is more a

> maturing of the medicine or is this regional? Is our interest

> because of Sharon getting interested in this and hooking Huang Huang

> up here? Are we interested in Arnaud Versluys because we have an

> interest in Shang Han Lun or was Arnaud Versluys studying SHL

> because that is the trend in China?

>

> Doug

>

> Sorry, Jason, I missed what this " best of " remark refers to... can

> you explain a little... Is this a reference to the generalities of

> TCM?

>

>

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Z¡Çev¡¤

 

 

 

Two issues¡¥¡¥¡¥

 

 

 

1) I think we are confusing effective doctor versus innovations (or an

innovative doctor). Just because someone does not develop a new current in

Chinese medicine does not make them any less of effective doctor. Really

Min¡Çs point, I believe, is about being an effective clinician, and that

is

it. He is not comparing modern doctor¡Çs or his self¡Çs ability to

come up

with new ideas.

 

But we also should not forget, ZZJ was also really just a compiler of

formulas and strategies of that time period. It is suspected that around age

40 he became a government official and then accessed the massive libraries

of the time. Over the next 7-10 years he wrote SHL/JGYL. It was not ZZJ

himself that slaved 50+ years in the trenches developing theories and

formulas based on his treatment of disease. He just documented mostly what

was happening already, and I am sure added a bit. We don¡Çt even know how

effective of a doctor he was, I suspect not as good in comparison to later

famous physicians, and that is Min¡Çs point.

 

2) I personally find modern synthesizers such as Qin Bo-Wei to have a

much more solid grasp of internal medicine than e.g. ZZJ¡Çs work. This is

not only because they make use of the last 2000 years of development but

also are able to deeply understand things that ZZJ had not a clue about.

There is no question that if I had to pick between just the SHL/ JGYL or Qin

Bo-Wei¡Çs systematic approach into understanding internal medicine, I

would

hands down choose the later. Quite simple for example, QBW cherry picks the

best ideas from SHL / JGYL as well as other historical texts. I find ZZJ a

bit limited for internal medicine, but that is just me. However even Arnaud

says that ZZJ¡Çs approach will only cure 50% of disease, but that is

really

neither here nor there.

 

 

 

But we should not forget that actually most internal medicine usages of SHL

formulas came after ZZJ. Almost all the really cool SHL stuff (e.g. what

Huang Huang and Arnaud are teaching) are not in the SHL but come from people

expanding its usage and theory. Should we say this again, ¡ÈNot in the

SHL

itself¡É However, there are oodles of JGYL and SHL commentaries that are

extremely effective in the clinic but really have little to do with the way

that someone like ZZJ would have used the formulas. These people are

building on the basic foundation, stretching it as much as possible, seeing

what works clinically, and expanding the way we look at these texts. Many

times they are very different ideas. People like Dr. Qin for example have

taken many SHL formulas and reworked them for the modern era, and hence they

are now more effective. Most SHL experts, although respect the classic texts

really utilize these later developments.

 

 

 

If one were to try to use SHL / JGYL without commentary as a systematic

roadmap to deal with internal medicine then one will have to try very very

hard. It is like reading tea leaves. It is not easy, and there is a large

array of varying opinions, hence why we have 100s-1000s of books written on

the topic.

 

 

 

-

 

 

On Behalf Of

Wednesday, April 22, 2009 12:25 PM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

Min hasn't taught at PCOM in the last few years, but continues to give

seminars. I personally take such statements with a grain of salt,

because there are no physicians in the modern era who have been able

to create such a systematic approach to internal medicine as Zhong

Zhong-Jing. Even though we have access to more information, the

ability to deeply penetrate the principles of Chinese medical theory

is still quite challenging. Physicians such as Qin Bo-wei and Jiao

Shu-de have done a great job of synthesizing and modifying gu fang for

modern diseases, but they haven't really developed new currents as the

Jin-Yuan physicians did. .

 

 

On Apr 21, 2009, at 5:58 PM, wrote:

 

> For those who know Min Fan from PCOM (is he still there?), he used

> to always

> say, " I am much better doctor than Zhang Zhong-Jing. " The first time

> I heard

> this I thought this guy is a bit arrogant , but really his point is

> very

> sound. He (as well as us) have all of CM that followed ZZJ at our

> disposal

> to study and to draw from to write prescriptions. Min, BTW, had some

> very

> nice formulas.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122