TCM: Personal Observation

Comment by Chad J. Dupuis, L.Ac.

I&#39m not entirely certain of the reason for your post as you don&#39t really appear to have a question. But there are some strongly misleading and outright incorrect statements in your post that would first need to be cleared up. The others are largely explained by understanding the diagnostic framework within TCM (start by reading "What Does Acupuncture Treat?").

1) You say, "current unregulated market in the US"

I&#39m not certain where you live or who you saw, but acupuncture is heavily regulated in the US. All practitioners have medical licenses in their individual states (for the 95% that have practice laws on the books). All practitioners also have to have 3-4 years of post-graduate education and have passed national board exams from the NCCAOM with some states having additional tests before licensure).

2) You say, "that the results of acupuncture cannot be sustained" - perhaps this has been your experience but this is far too broad to carry much weight. There are volumes of TCM related studies (acupuncture, herbs, tuina, etc.) that not only lead to sustained results in a very broad range of conditions, but do it with less side effects than allopathic medicine in many cases. There are large numbers of these studies posted in our recent research section drawn from peer-reviewed medical journals from around the world.

3) The rest of your statements can really be discussed together - but I&#39ll call out one as an example of a deep misunderstanding of how Chinese Medicine diagnoses work - when you say "even though medically one has no blood deffeciency practitioner says according to Eastern medicine one is defficient" - this is actually quite correct - you can be blood deficient and not be anemic (I believe what you are alluding to). This misunderstanding arises from a deep difference between the western physiological concept of "blood" and the tcm concept of "blood" - explained briefly on our concept of blood page.

All the rest of your statements about practitioners not giving you the same exact diagnosis - is absolutely expected with a system as large and diverse as TCM. There are many sub systems - japanese, korean, five element, etc. and then multitudes of family and master level systems within the misnamed "tcm". They don&#39t have to agree necessarily to get results. They simply have to use their training to form their view of what is going on in your body and use their training based on that to form a treatment plan. Standardizing that like how it is taught in schools in the US is somewhat possible but only to a degree. Chinese Medicine is both an art form and a science and both need to be respected.

For other items in your list, such as "lack of standardization of the herbs", I&#39m not sure what you mean here (ingredients? or composition?). The composition of the formulas is well defined and entirely standardized for what are called "patent" formulas - like the ones in our store for example. For raw herbs (as teas, etc.) this again goes back into the art form of Chinese Medicine where it is actually beneficial to the patient to have the ability to customize herbal formulas for a particular patient and then continuining customizing as they go along their path of healing. Western medicine would love to have this ability built into it&#39s medicine instead of the one size fits all model that leads to so many side effects and/or poor therapeutic responses.

Now I don&#39t know what your personal experience has been and I&#39m sorry to hear that you didn&#39t get results from what sound like either unlicensed or very poor practitioners in the US. Not sure what makes you think they are the "top" in their profession (or even what qualifies you to say something like that with such a poor understanding of the basics of Chinese Medicine). Either way, I hope this information and the links I pointed you to serve to help you past these strong misconceptions of what the practice of Chinese Medicine is in the US and around the world.

Comment by Archived User

Thank you for responding. The subject of my post was "personal observation" not "professional observation". The reason for posting was to get other opinions. The website does not say that one can only post a question.

It is TCM practitioners that have told me that the same patent formula may differ based on the company. If it is an art then the same results cannot be duplicated hence the unpredictability. I did not rate the practitioners these are ratings provided by people who are more knowledgable in TCM. I did not get the sense that practitioners were required to have medical files on their patients a standard practice in "Western" medicine.

Thanks.

Comment by Archived User

In my years of training I&#39ve kept medical records on everyone I&#39ve treated either in the clinic or in their home. It is rare when I don&#39t. Most practitioners I have met do the same. So I&#39m surprised at your comment. I totally agree with the comments by Chad above so I&#39m not going to comment on the specifics already covered. We were taught in school which the average to completion was 5 years after their undergraduate work. I&#39m sure there are exceptions but the majority of people I meet keep records. The one good acupuncturist who didn&#39t and I filled out his paper work for him. I found that he knew the patient&#39s history and medical record better than I could ever fill out. He had that type of a mind. I don&#39t.

I am a computer scientist who pioneered the field of bio informatics at a time when it did not exist. We found the first Asthma gene. We had the same problems with diagnosis working with doctors who often found opposite strategies for the same disease. We found that to make any progress in finding genes that we had to pay attention to the pattern of the disease. Classic example was asthma and differentiating a swollen throat closing up from bronchial inflammation closing it off. Two different doctors describing the same "disease" with two separate mechanisms. That is what I love about Chinese Medicine because they deal with patterns of health.

I found in school a common phrase among the Chinese practical phrases ... one disease many treatments, one treatment many diseases. Many like me do not discuss the various Chinese diagnosis with the patient ... but I write them down each time and follow the wonderful world of boolean logic in this medicine for treatment.

Now, what I&#39m hearing from you is many practitioners, different diagnosis across them. Well, diagnosis is the hardest thing to get right in any medical community. Fortunately, if we help the body in any way it seems to get better. What I loved about clinic in school is that we had multiple people there zeroing in together on what was the problem. I miss that so I keep working in a wellness clinic where we can rub shoulders and check on each other.

Does it work? Do we get results? I would think that is your best question. By the way, I read many questions into your statement. Thank you for asking. We can always use more dialogue. My patients tell me it works. I don&#39t tell them. And I listen very carefully to what is working. And like the president of Pacific College of Oriental Medicine once said to me, always diagnose. It is the key to being able to see what treatment works and when. If you treat from your diagnosis then when things work, you begin to make the connection. It makes this medicine repeatable.

From my perspective then it makes sense Gui Zhr Fu Ling Wan across two different "diseases" because the health pattern being addressed may be the same. Herbs have actions and combine in unique ways according to how they are prepared and combined so the same formula can have a different preparation and result. One learns these in various texts like the Materia Medica and books on preparation, on classic formulas, and on herb combining. Today many herbalists treat viral and bacterial infections. Some treat parasites. Some treat colds, flu, and serious conditions. I know I have.

I was introduced to Chinese Medicine in 1973 in Chile when I came down with amoebic dysentery and found myself getting and weaker and weaker from medical treatment and nobody I talked to seemed to get over it. So I simply asked around for someone who had gotten better. I used the same Chinese herbalist and his use of a classic Chinese formula completely got rid of it in three months.

I think the biggest question for all of us to ask every day is ... is it working? The more I ask others who work in this field, the more I find for them and me that it is working.

Comment by Chad J. Dupuis, L.Ac.

It&#39s true you don&#39t have to post a "question", but you would have to have some reason to post it openly on a website. Your post wasn&#39t really framed in the sense that you wanted a response but was so filled with misinformation that it had to be responded to. I hope you better understand now some rudimentary aspects of Chinese Medicine.

With regards to the patent formulas, yes, between companies there are (( mild )) differences between the formulas. These are based on certain things - (1) availability of herbs - so if a particular herb is low in global stock substitutions will be made if possible otherwise the patent formula may simple be unavailable (i.e. not produced) for weeks/months until the herb is available - (2) cost of herbs - some ingredients can be expensive and herbalist can debate how important that particular herb is worth in the formula vs. a substitute or forgoing it completely - (3) country restrictions - some ingredients are not allowed in certain countries so they are substituted or left out - (4) animal cruelty - some ingredients from animals in particular are either not allowed in certain countries or viewed as too cruel to the animals so they are substituted or left out. Now in the hands of a good herbalist, these mild differences will not make much of a difference in the clinical outcome, nor in the clinical usage of the formula. It is important to remember that the formulas are guides and when you are working with raw herbs or combining patent remedies you are trying as much as possible to tailor the "formula/combination" to the patient as an individual which is one of many benefits of the dynamicness of Chinese Medicine.

With regards to medical records, I personally have never seen a practitioner not keep medical records. But it is true that they can be sparse and this is again because of the dynamic nature of Chinese Medicine where you are individualizing treatments on a per treatment basis and not replicating the same exact thing over and over as you would in general terms within western medicine.

Comment by Archived User

I appreciate the person who initiated this discussion. While it may not have been a question in the "technical sense" of the word, it raised issues that I have also wondered about at times, and I have found the ensuing responses to be informative. I think the issues raised also reflect the problem that, just as with practictioners of Western medicine, there are widely varying degrees of competence and accountability among practitioners in this field. I am impressed by the professionalism of Chad and the other practitioners who write here, but I have encountered other practitioners who are not so responsible.

Gary