RE: Shang Han formula? - whoops

[Guest guest]

After reading Jason's post - and then re-reading mine...

 

well, I am not sure how to blush on an e-mail

 

Stephen

I have seen 1000s of formulas written in the basic style...

 

there is no alternative than to eat crow and apologize

 

I have seen 100s of formulas written in the basic style...

 

I seem to have gotten over-enthusiastic with the zero key?

hiccup? stuck key?

 

I just blew it....sorry about that.

 

Stephen Woodley LAc

www.shanghanlunseminars.com

 

--

http://www.fastmail.fm - IMAP accessible web-mail

 

 

 

 

[Guest guest]

Stephen, Ze'v, Jason and all,

I agree; unless you follow a doctor outside of school for a few years, who

sees a lot of patients,

it IS difficult to see a lot of prescriptions.

 

In TCM college in the U.S., we might see 4-6 patients / day, three times/

week, for 2 years.

That would be somewhere in the 1000+ patient visits range

and usually only half of those are written prescriptions, while the other

half might be pills,

so we might see around 500 total while in school.

 

I was lucky enough to work at an herb company and see 5-10 prescriptions /

day, 3 x/ week for 7 years.

That would be somewhere in the 4000+ range total,

but the major limitation is that you're only processing someone's order and

you're not with the patient directly.

So, you can ask some questions to the practitioner, but really you're in the

dark trying to figure out what they're trying to do.

After a while, you see patterns in practitioners formulations and a

modification here and there,

which could be very interesting or totally mundane

and once in a while, someone who might be really famous in the TCM world

could drop a faxed formula in

and then a few herb nerds would pass a formula around to try to figure out

what's going on...

(of course everything was always confidential)

 

What you find most is that # 1... the one's who at least try to make a

custom formula know more about herbs

than those who just buy pills (this might seem really obvious).

# 2.. those who are really awesome probably just buy tons of bulk herbs or

concentrated powders and then make the

formulations in their own pharmacy, not sending them to the herb company as

the middle man to do their work for them.

(that is why I think that the best thing would be to follow a doctor who

really knows what they're doing and is willing for you to at least be able

to take the patient's pulse, while you fill the patient's formula)

# 3... people are changing their styles all of the time, there are very few

masters out there in the herb world and people tend to be very secretive

about their formulas, especially if it's a family style or they're unwilling

to teach, because the tradition is to just observe and work as a moxa slave

or herb filler boy (which was just fine with me too).

 

So, yes... we need more case studies published by the masters out there, no

matter what style they use. I have a few hundred case studies typed up by

people who studied under our same root teacher, since he did a few clinical

rounds over the years of a week each, where the students would bring in

their most difficult patients and the teacher would see around 30 patients/

day (just herbal prescriptions). That's a few hundred case studies, which

are immensely helpful. I think that this is a great model for others out

there to preserve the clinical knowledge of their root teachers. Hopefully,

when everything is polished, the root teachers would be willing to publish

this information to share with everyone else and then maybe concurrently,

commentaries could be written about these formulas and the methodology that

went into them as well.

 

I'm really glad that PMPH is going in that direction..

http://www.pmph.com/en/product.aspx?ColumnId=14

 

There are many family styles which may sadly die with time, because the

transmission is not shared correctly, just as traditional cultural knowledge

and languages are becoming extinct faster than ever with the progress of

modernization. It's up to us to preserve this human legacy...

 

K

 

 

 

 

 

 

On Mon, Mar 22, 2010 at 7:01 PM, stephen woodley <learntcmwrote:

 

>

>

> After reading Jason's post - and then re-reading mine...

>

> well, I am not sure how to blush on an e-mail

>

> Stephen

> I have seen 1000s of formulas written in the basic style...

>

> there is no alternative than to eat crow and apologize

>

> I have seen 100s of formulas written in the basic style...

>

> I seem to have gotten over-enthusiastic with the zero key?

> hiccup? stuck key?

>

> I just blew it....sorry about that.

>

> Stephen Woodley LAc

> www.shanghanlunseminars.com

>

> --

> http://www.fastmail.fm - IMAP accessible web-mail

>

>

[Guest guest]

In my case, I'd like to acknowledge Yo-san University where for a couple of

years I was filling prescriptions for the private clinic for the teachers there

(as well as their formulas for the student's patients). Dr's. Zhang, Wen, a

couple of Li's and Biao all put up with my questions, (as well as had to write

in pinyin!). My boss, Yuhong Chen went on to become a great herbalist and

supervisor at Yosan and Emperors (I was able to repay her, perhaps.)

Doug

 

 

, <johnkokko wrote:

>

> Stephen, Ze'v, Jason and all,

> I agree; unless you follow a doctor outside of school for a few years, who

> sees a lot of patients,

> it IS difficult to see a lot of prescriptions.

>

> In TCM college in the U.S., we might see 4-6 patients / day, three times/

> week, for 2 years.

> That would be somewhere in the 1000+ patient visits range

> and usually only half of those are written prescriptions, while the other

> half might be pills,

> so we might see around 500 total while in school.

>

> I w

> K

>

>

>

>

>

[Guest guest]

John I agree it is very hard to figure it out with our current educational

system! However most students don't see anywhere near 1000 patients during

school, and many schools do not even do herbs for a good half of the clinic

shifts (meaning acupuncture only). Many times the same patient is seen over

and over and the formula is not changed. Also, since pain is a big reason

people come in, the number of formulas for these patients is minimal.

Consequently, the number of actual written formulas in most schools is

almost nil. I would be surprised if a student graduated and wrote more than

25-50 formulas. I'm curious what the current requirement is for a number of

patients seen to graduate?

 

 

 

One must really find a mentor after one graduates to really understand

clinical Chinese herbalism. For example, in one morning in China, one can

see 50-60 formulas written by a single doctor. Second best thing is of

course studying case records, as we have been talking about. The majority of

the time, one can study many more famous doctors in books than they can

actual people. Obviously though the former is best. However, one can learn

quite a bit from case records. Here is a quick little essay that I wrote for

understanding case records. This is essentially my observations while

studying Ye Tian-Shi's cases which are probably obvious for most people.

However some people may find some benefit.

 

 

 

Chinese Medicine/case-studies/understanding-case-records-pt

-1/

 

 

 

One reason many practitioners and students are stuck with stock formulas is

that they have no mentor to watch and learn from. Furthermore, there are no

real classes in learning to write your own prescriptions. Although I will

never argue with someone's choice to stick to formulas and the standard

modifications, I do believe that this is only an entry point.

 

 

 

What are other's thoughts?

 

 

 

-

 

 

 

 

 

 

On Behalf Of

Tuesday, March 23, 2010 10:01 AM

 

Re: Shang Han formula? - whoops

 

 

 

 

 

Stephen, Ze'v, Jason and all,

I agree; unless you follow a doctor outside of school for a few years, who

sees a lot of patients,

it IS difficult to see a lot of prescriptions.

 

In TCM college in the U.S., we might see 4-6 patients / day, three times/

week, for 2 years.

That would be somewhere in the 1000+ patient visits range

and usually only half of those are written prescriptions, while the other

half might be pills,

so we might see around 500 total while in school.

 

I was lucky enough to work at an herb company and see 5-10 prescriptions /

day, 3 x/ week for 7 years.

That would be somewhere in the 4000+ range total,

but the major limitation is that you're only processing someone's order and

you're not with the patient directly.

So, you can ask some questions to the practitioner, but really you're in the

dark trying to figure out what they're trying to do.

After a while, you see patterns in practitioners formulations and a

modification here and there,

which could be very interesting or totally mundane

and once in a while, someone who might be really famous in the TCM world

could drop a faxed formula in

and then a few herb nerds would pass a formula around to try to figure out

what's going on...

(of course everything was always confidential)

 

What you find most is that # 1... the one's who at least try to make a

custom formula know more about herbs

than those who just buy pills (this might seem really obvious).

# 2.. those who are really awesome probably just buy tons of bulk herbs or

concentrated powders and then make the

formulations in their own pharmacy, not sending them to the herb company as

the middle man to do their work for them.

(that is why I think that the best thing would be to follow a doctor who

really knows what they're doing and is willing for you to at least be able

to take the patient's pulse, while you fill the patient's formula)

# 3... people are changing their styles all of the time, there are very few

masters out there in the herb world and people tend to be very secretive

about their formulas, especially if it's a family style or they're unwilling

to teach, because the tradition is to just observe and work as a moxa slave

or herb filler boy (which was just fine with me too).

 

So, yes... we need more case studies published by the masters out there, no

matter what style they use. I have a few hundred case studies typed up by

people who studied under our same root teacher, since he did a few clinical

rounds over the years of a week each, where the students would bring in

their most difficult patients and the teacher would see around 30 patients/

day (just herbal prescriptions). That's a few hundred case studies, which

are immensely helpful. I think that this is a great model for others out

there to preserve the clinical knowledge of their root teachers. Hopefully,

when everything is polished, the root teachers would be willing to publish

this information to share with everyone else and then maybe concurrently,

commentaries could be written about these formulas and the methodology that

went into them as well.

 

I'm really glad that PMPH is going in that direction..

http://www.pmph.com/en/product.aspx?ColumnId=14

 

There are many family styles which may sadly die with time, because the

transmission is not shared correctly, just as traditional cultural knowledge

and languages are becoming extinct faster than ever with the progress of

modernization. It's up to us to preserve this human legacy...

 

K

 

 

 

 

 

 

[Guest guest]

Jason-

 

So you say:

" One reason many practitioners and students are stuck with stock

formulas is that they have no mentor to watch and learn from.

Furthermore, there are no real classes in learning to write your own

prescriptions. "

 

I agree with this statement, but only partially. I do agree that

students use basic formulas that they learn in school with only minor

modifications. I think, however, that they " should " use them, not

that they are " stuck " with them. I think that there are students who

actually try to write prescriptions like DGR or YTS or based on a

theoretical understanding of pathomechanisms, but these formulas

often fail in clinic because the students or newly minted

practitioners do not have the basic experience that these masters had

in the classics. This is actually more dangerous than just using

" stock formulas. "

 

Furthermore, the stock formulas can be quite flexible to use in

clinic when you learn, for instance, how ZZJ modified them. How many

people when they graduate know the " stock " modifications of xiao

chaihu tang, sini san, lizhong wan, or zhenwu tang and why they are

what they are? I would bet that not many. If they do not know the

" stock " modifications and how they work, then how can they know if

they need to use other modification?

 

In lieu of a mentor, which would greatly speed the process, students

need to work with the basic formulas and the standard modifications

to develop their own clinical experience to know whether they work or

not and for what types of cases. Only when they have developed

enough experience with them would they be able to know if they need

other modifications.

 

-Steve

 

Stephen Bonzak, L.Ac., Dipl. O.M.

http://www.health-traditions.com

sbonzak

773-470-6994

 

 

 

On Mar 23, 2010, at 3:04 PM, wrote:

 

> One reason many practitioners and students are stuck with stock

> formulas is

> that they have no mentor to watch and learn from. Furthermore,

> there are no

> real classes in learning to write your own prescriptions.

 

 

 

 

[Guest guest]

Stephan,

 

 

 

I agree 100% with your post, thanks for clarifying and expanding upon mine.

I in no way meant to suggest that students should jump straight into writing

formulas from scratch in some Ye Tian-Shi style. Clearly one needs to have

the basics down before this. My point was simply, when ready, it is quite

difficult to learn how to write individualized formulas with our current

educational system and lack of mentorship. I hope this changes in the

future...

 

 

 

-Jason

 

 

 

 

 

 

On Behalf Of Stephen Bonzak

Tuesday, March 23, 2010 6:29 PM

 

Re: Shang Han formula? - whoops

 

 

 

 

 

Jason-

 

So you say:

" One reason many practitioners and students are stuck with stock

formulas is that they have no mentor to watch and learn from.

Furthermore, there are no real classes in learning to write your own

prescriptions. "

 

I agree with this statement, but only partially. I do agree that

students use basic formulas that they learn in school with only minor

modifications. I think, however, that they " should " use them, not

that they are " stuck " with them. I think that there are students who

actually try to write prescriptions like DGR or YTS or based on a

theoretical understanding of pathomechanisms, but these formulas

often fail in clinic because the students or newly minted

practitioners do not have the basic experience that these masters had

in the classics. This is actually more dangerous than just using

" stock formulas. "

 

Furthermore, the stock formulas can be quite flexible to use in

clinic when you learn, for instance, how ZZJ modified them. How many

people when they graduate know the " stock " modifications of xiao

chaihu tang, sini san, lizhong wan, or zhenwu tang and why they are

what they are? I would bet that not many. If they do not know the

" stock " modifications and how they work, then how can they know if

they need to use other modification?

 

In lieu of a mentor, which would greatly speed the process, students

need to work with the basic formulas and the standard modifications

to develop their own clinical experience to know whether they work or

not and for what types of cases. Only when they have developed

enough experience with them would they be able to know if they need

other modifications.

 

-Steve

 

 

 

 

 

 

 

[Guest guest]

Jason,

I agree. However, at PCOM, we are working to focus in the future on all

aspects of formula writing, from different schools of thought. I am hoping to

produce a pamphlet or article on this issue in the near future. .

 

 

On Mar 23, 2010, at 7:09 PM, wrote:

 

> Stephan,

>

> I agree 100% with your post, thanks for clarifying and expanding upon mine.

> I in no way meant to suggest that students should jump straight into writing

> formulas from scratch in some Ye Tian-Shi style. Clearly one needs to have

> the basics down before this. My point was simply, when ready, it is quite

> difficult to learn how to write individualized formulas with our current

> educational system and lack of mentorship. I hope this changes in the

> future...

>

> -Jason

>

>

>

>

> On Behalf Of Stephen Bonzak

> Tuesday, March 23, 2010 6:29 PM

>

> Re: Shang Han formula? - whoops

>

> Jason-

>

> So you say:

> " One reason many practitioners and students are stuck with stock

> formulas is that they have no mentor to watch and learn from.

> Furthermore, there are no real classes in learning to write your own

> prescriptions. "

>

> I agree with this statement, but only partially. I do agree that

> students use basic formulas that they learn in school with only minor

> modifications. I think, however, that they " should " use them, not

> that they are " stuck " with them. I think that there are students who

> actually try to write prescriptions like DGR or YTS or based on a

> theoretical understanding of pathomechanisms, but these formulas

> often fail in clinic because the students or newly minted

> practitioners do not have the basic experience that these masters had

> in the classics. This is actually more dangerous than just using

> " stock formulas. "

>

> Furthermore, the stock formulas can be quite flexible to use in

> clinic when you learn, for instance, how ZZJ modified them. How many

> people when they graduate know the " stock " modifications of xiao

> chaihu tang, sini san, lizhong wan, or zhenwu tang and why they are

> what they are? I would bet that not many. If they do not know the

> " stock " modifications and how they work, then how can they know if

> they need to use other modification?

>

> In lieu of a mentor, which would greatly speed the process, students

> need to work with the basic formulas and the standard modifications

> to develop their own clinical experience to know whether they work or

> not and for what types of cases. Only when they have developed

> enough experience with them would they be able to know if they need

> other modifications.

>

> -Steve

>

>

[Guest guest]

Zev,

I would be really interested in this. This sounds like a terrific didactic

exercise.

 

Cara

 

On Mar 24, 2010, at 1:50 AM, wrote:

 

> Jason,

> I agree. However, at PCOM, we are working to focus in the future on all

aspects of formula writing, from different schools of thought. I am hoping to

produce a pamphlet or article on this issue in the near future. .

>

>

> On Mar 23, 2010, at 7:09 PM, wrote:

>

>>

>

[Guest guest]

Nice.. Keep us posted!

 

-Jason

 

 

 

 

On Behalf Of

Tuesday, March 23, 2010 11:50 PM

 

Re: Shang Han formula? - whoops

 

Jason,

I agree. However, at PCOM, we are working to focus in the future on all

aspects of formula writing, from different schools of thought. I am hoping

to produce a pamphlet or article on this issue in the near future. .

 

 

[Guest guest]

Jason, et al

I'm curious as to what anyone thinks about this site and the info on it?

http://www.acupuncture123.ca/E12%20TCM%20advanced%20class.html

Patrick

 

 

 

--- On Wed, 3/24/10, wrote:

 

 

RE: Shang Han formula? - whoops

 

Wednesday, March 24, 2010, 5:12 AM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nice.. Keep us posted!

 

 

 

-Jason

 

 

 

 

 

 

 

[] On Behalf Of

 

Tuesday, March 23, 2010 11:50 PM

 

 

 

Re: Shang Han formula? - whoops

 

 

 

Jason,

 

I agree. However, at PCOM, we are working to focus in the future on all

 

aspects of formula writing, from different schools of thought. I am hoping

 

to produce a pamphlet or article on this issue in the near future. .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Patrick,

 

 

 

I assume you are referring to the SHL / JGYL translations. I think there is

limited commentary, their translations are a little odd, e.g. Firexie, and their

English is not great, therefore their terminology is a little strange. But if it

works for you then it will get you in the ballpark. However if you like Shang

Han, I would just buy Mitchell, Ye, and Wiseman’s, which actually has

commentary.

 

 

 

-Jason

 

 

 

 

On Behalf Of Patrick Edgmon

Wednesday, March 24, 2010 6:41 PM

 

RE: Shang Han formula? - whoops

 

 

 

 

 

Jason, et al

I'm curious as to what anyone thinks about this site and the info on it?

http://www.acupuncture123.ca/E12%20TCM%20advanced%20class.html

Patrick