[net.med] Chinese Medicine

bob@textware.UUCP (Bob Felt) (09/05/85)

> I am offended by Walt
> Stolls religious awe of principles which were set down by the chinese
> several thousand years ago. I am equally offended by the "rational" 
> community invoking "Scientific Method" like some blind, dumb god and 

While it is true that the words and ideas which are used in Oriental
medicine are also used in Oriental religion, particularly [TD]aoism, these
ideas are differentiated in context and by the combinations of radicals
that form the characters.  It is also the case that Buddhist medicine is a
special branch of Oriental medicine which has incorporated the Buddhist
theological position.  These ideas surface in the context of medical-moral
thought (ie: abortion, or meat eating).  However, there is no question that
the characters used in the medical texts are a specific medical vocabularly
with very direct medical meanings.  The most common of these is [qi, ki,
chi].  This is the ``energy'' or life force most people talk about when
discussing Chinese medicine.  However, it is usually used in compound
concepts which express a specific function of the human body: wei qi
(defensive), ying qi (nutrative), rong qi (the meridian energy affected by
acupuncture).

The point of intersection between ``religion'' (Taoism can not be fairly
called a religion in our sense of religion) and ``medicine'' is also quite
clear.  Cosmological energies are thought to relate interdependantly with
human energies.  Think of three intersecting fields, each of which
represents a set of energetic qualities (ionic gradients, electrical
potentials, gravitational forces)...activity in one will be reflected in
the others.  We (man) can affect the cosmos to some extent, thus religious
behavior.  The cosmos affects us; thus, the medicine recognized that both
heaven (time and macro-enviroment such as weather) and earth (immediate
environment such as food and poisions) as medical variables.  Thus,
Oriental medicine has a vocabulary for the ``big three'' influences: heaven
- man - earth.  Allopathic medicine, our physiological medicine, is a
subset of the variable relative to man, internal and external
micro-environment.  The Chinese recognized this area and did surgical
anatomy, but did not develop the tools of celluar pathology.  Modern
Chinese and Japaneese physicians have added allopathic data to the theory.

The problem of using these ideas without the specific medical background of
the characters is that something which has the sense of observational data
in the medical texts dosen't generalize well.  This is clear in the sugar
debate.  ``Sugar causes diebetes'' can be said by an Oriental physician
only in specific cases.  ``Sugar is bad for you'' from an Oriental medical
perspective is something which may be legitimately said to someone
specific, recognizing that sugar may also be medicinal in other cases.
Grain sugars for example, are the frequent component of Oriental drugs
intended for the weak, malnourished, or hypoactive.

There is no diabetes in Oriental medicine (it is true however that Oriental
physicians use the terms...every one must speak to the western docs these
days).  There is ``thirsting and wasting'' disease.  If you take a roomfull
of diabetics (the western diagnosis) the corresponding eastern diagnosis
will not be one-to-one.  Further, Oriental medical theorists distinquished
medicines from foods by potency, not by quality.  Sugar is ``warm,
nutrative, humid, and enters the middle burner.'' The simplest terms in
which this can be fairly translated is not that it is bad, but that (1) its
ingestion will create metabolic warmth (temperature and activity), (2) it
is absorbed, not passed through, (3) there is fluid retained, and (4) this
activity will take place predominantly in the stomach, spleen and pancreas.
This is all the Chinese medical theorists meant, not ``good'' or ``bad,''
and there is little I see in the western idea of sugar metabolism or even
the ``empty calories'' idea which contradicts this view.

If you are deficient, cold and your fluid metabolism is alright and your
spleen-pancreas is not damaged, (all specific medical ideas) some sugar can
be used for your benefit.  Or, visa versa.  Chinese medicine is
heteropathic, things are ``good or bad'' only in relation to the condition
in which they are applied.  Thus, everyone is right (and wrong) from the
Oriental medical veiwpoint.  Sugar does cause diabetes, if used to excess
by those who are specifically deficient in regard to the function (in
Oriental medicine) of the spleen-pancreas complex of liquid transport,
purification and blood production.  On the other hand, sugar is not an
allopathic cause of diabetes in the sense that if sugar is there diabetes
is there.  For the allopaths, there are clear correspondences between the
``scientific'' (anatomical/physiological) description of diabetes and the
eastern (functional/energetic) description.  Basically, hyperactivity of a
weak function leads to hypoactivity.

In short, Oriental medicine is quite rational, that is, it is based on
repeated observations, by multiple observers over time.  Its theorists
tried to develop theoretical constructs which were predictive of health and
disease processes.  You can not make linear causal statements and be very
correct.  However, it also seems quite unfair to use the fairly new (and
often inadequate) physiological explanations of allopathic medicine as a
sine qua non.  Double blind is theoretically wonderful, but you don't need
to go as far as thallidomide to see that it does not have the
epidemological ``clout'' of long-term studies directed by the more general
predictive theories of Oriental medicine.  Take, for example, Vallium
(diezepam) which passed the expensive F.D.A. double blind protocols and is
the most prescribed drug in the U.S.  When people stop using it, the
withdrawl is difficult and there may be heart problems, some have been
fatal.

In this regard, Oriental medicine would say that ``the liver controls the
muscles and the liver creates the heart.'' This is not mystical at all,
they were just saying that you can not affect muscle conditions without
affecting the liver function and that a change in liver function will
affect the heart.  Since vallium is a muscle relaxant, a Chinese doctor
would say that it has ``entered the liver'' and achieved the muscle
relaxation by ``sedating the liver.'' Incidentally, Oriental
philosophy-medicine would say that the nervousness, tenseness and lack of
ease for which Vallium is typically prescribed are the results of an
hyperactive liver function.  While the drug does do what is intended, the
side-effect is that the liver's generative influence on the heart (it is
our most active muscle) is also sedated.  Thus, oriental prescriptions for
vallium indicated problems include substances or acupuncture points which
sedate the liver, or ``lower liver qi,'' and tonify the heart, etc.

> refusing to examine procedures which obviously work (like acupuncture)
> Too, there are enough acupunturists (and acupuncturees)
> around these days that there certainly seems to be a opportunity for an
> experimental study.

The problem here is in the problem statement, as with the Valium example.
First, the Chinese and Japanese object to the ``double blind'' protocol
when using patients.  Simply, they see it as unfair.  More importantly, the
double blind is essentially a drug protocol and acupuncture is not as
simply tested.  First, there is not one point selection protocol for one
disease (as in diabetes above), there is more correctly a set of treatment
strategies.  The treatment and diagnosis are inseperable.  Thus, for the
acupuncture tested to be fairly representative, the diagnosis must be
individually performed by someone who knows what they are doing.  This
brings in the placebo or ``faith healing'' argument against the results, or
leaves some amateur acupuncturist doing the work.  Two, the western
diagnosis which is usually the selection criterion for the test group may
not be related to a single treatment strategy.  Three, we are prejudiced in
favor of using MD's to do the acupuncture; in the Orient there is a
reasonable supply of MD-acupuncturists, here, there isn't and they have
been unwilling to test eastern diagnoses, or use the Oriental diagnostic
process as the selection criteria.

From: Gordon E. Banks

> Incidentally, you are quite mistaken about acupuncture.  It
> has been thoroughly investigated by scientific anesthesiologists,
> including theories as to why it works.
> This work occurred back in the early 70's, when physicians
> visited China and became interested in the methods of
> Chinese folk medicine, a traditional school that puts Walt's and
> Tom's primitive herbalism in the shade for erudition.

George Soulie De Morant wrote a rather comprehensive acupuncture text in
1939.  Although nominated for a nobel, which he didn't get, the information
which came from his 30 years of study never got to the U.S.  In France and
Germany however, there has been medical acupuncture (ie: acupuncture by
MD's) since Soulie De Morant.  There is a lot of published study.  Japan
too has done a great deal of work, including Dr. Yoshio Manaka's research
which relates the concepts of Chinese medicine to bio-electrical gradients
in the body.  There is a good deal done; however, the Chinese and Japanese
use what we disparagingly call ``anecdotal'' research (epidemilogical not
double blind) and our medical scholars tend to ignore it, even when it does
get translated.  This is silly, I'm reminded of a Japanese text of compound
drugs (herbs) where formulae with less than two hundred years of use are
labled ``experimental.''

There are massive differences between Oriental compound drugs (herbal
medicines) and herbology.  The first recorded book is the Shang Han Lun, AD
205, which describes the treatment of ``cold induced disease'' (colds, flu,
etc) including epidemic ``flus.'' The literature expands from there to
modern times.  The ``herbal'' name is a misnomer and quite misleading,
these are drugs which differ from western drugs in application.  The
Chinese theorized that there was no ``active ingredient,'' but a compound
of qualities which matched the ``sho'' of the disease with the ``sho'' of
the drug.  Again, heteropathy.  Again, there are some 1800 years of
practice on which to draw.  The heart of ``scientifc method'' is the
unprejudiced testing of a theory by observation.  It is this that we are
not getting from the general medical research community and is one of the
reasons (in my opinion) that the anti-medical arguments are so stronly
held.
--
Bob Felt
bbnccv!ewj01!textware!bob

wws@ukma.UUCP (Bill Stoll) (09/09/85)

Dear Bob,

I really appreciate your "note" on the net about Chinese Medicine.  I
have been shamed by my "colleagues", not my "peers", attitude when it
comes to the thousands of years of honest work, by caring, intelligent
healing professionals from another culture.

We have learned some things that they would have given their eye teeth
to know.  I'm sure they knew (and know) many things we should be so
wise as to want to give our eye teeth to know.  The incredible
arrogance the allopathic medical profession has evidenced has only
hurt our capacity to do what we have been charged to do: Heal the
Sick!.

One of the most powerful things I see happening is the combining of
the Eastern and Western ways.  Biofeedback has done much to break down
the nihilism of the sceptical western mind.  Now that electromagnetic
medicine is advancing in leaps and bounds western physicians are being
forced to consider "chi".  Psychoneuroimmunology is overwhelming the
narrow concepts of western orthodoxy that are no longer tenable.
Those professionals unable to make the leap to the new paradigm will
have to retire or become objects of pity.

cbosgd!ukma!wws(Walt Stoll)


-- 
Walt Stoll, MD, ABFP
Founder, & Medical Director
Holistic Medical Centre
1412 N. Broadway
Lexington, Kentucky  40505