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Deepest Health Podcast 15 – Does where Chinese herbs are grown really matter?

Eric Grey — Sun, 09 Oct 2011 03:20:10 +0000

Another aspect to the more advanced Chinese herb learning method that I teach is diving into the huge amount of information concerning where herbs grow up. Using the metaphor of the growth and development of a human being, it is undeniable that where we grow up influences the people we end up becoming. The same is true of Chinese herbs!

Topics covered

1. Why I love the herb method I teach

2. Why location matters when it comes to Chinese herbs

3. Small application of the herb learning method with one of your friends and mine, Chenpi – aurantium – citrus peel

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Deepest Health Podcast 14 -Interview with Dr. Arnaud Versluys (Part 3 of 3)

Eric Grey — Sun, 09 Oct 2011 03:18:44 +0000

Topics covered

1. What to do when you cannot secure the herbs you need (for instance, Mahuang and Xixin)

2. What about growing our own herbs locally and using them in Chinese herbal formulas?

If you are interested, please check out parts I and II of this interview.

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Deepest Health Podcast 13 – Interview with Mark Silver

Eric Grey — Sun, 09 Oct 2011 03:17:13 +0000

When I contacted Mark Silver, founder of the Heart of Business and Portland local, I was hoping to entice him to come and speak to students at NCNM. I succeeded in that, with the additional bonus that he was kind enough to offer to do a podcast interview with me for Deepest Health! After a few fits and starts, we managed to make our schedules line up nicely and we sat down for a chat on an early spring morning.

Topics covered

1. Should healthcare practitioners worry about the recession?

2. How you can get more patients without constantly explaining what we do

3. What Chinese medicine practitioners should watch out for when starting their own businesses

4. Technology & business : are they antithetical to holistic medicine?

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Deepest Health Podcast 12 – Interview with Dr. Arnaud Versluys (Part 2 of 3)

Eric Grey — Sun, 09 Oct 2011 03:15:29 +0000

Topics covered

1. How one uses the Shang han lun in contemporary clinical practice, particularly concerning complex diseases typically seen in modern times

2. The importance of specializing in a particular style of Chinese medicine

3. Some advice to those of us seeking Chinese medicine knowledge

I think you’ll really enjoy the information AND the audio quality – I think I finally got it right. Check it out at the bottom of this article!

Note : Dr. Versluys uses a few names that may be unfamiliar to listeners – I want to clarify these things for you. Li Dong Yuan is the author of The Treatise on the Spleen and Stomach: (Pi wei lun). Zhang Zhong Jing is the author of the Shang Han Lun and the Jin gui yao lue (originally united as the Shang Han Za Bing Lun).

If you are interested, please check out Part I and Part III of this interview

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Deepest Health Podcast 11 – Interview with Dr. Arnaud Versluys (Part 1 of 3)

Eric Grey — Sun, 09 Oct 2011 03:13:47 +0000

This is the first section of a three part interview with Dr. Arnaud Versluys of the Institute of Classics in East Asian Medicine. Arnaud has been part of my education and inspiration in Chinese medicine since the beginning. As well as leading & teaching at ICEAM, he practices his craft in NW Portland, OR.

Topics covered

1. The relationship of the Classical texts to the practice of medicine

2. The importance of careful study

3. Food for thought regarding the various schools of Chinese medicine

Note: Please pardon the relatively low volume of this podcast – we had some technological problems. If you are interested, please check out Part II and Part III of this interview.

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Deepest Health Podcast 10 – End of term clinical reflections

Eric Grey — Sun, 09 Oct 2011 03:12:23 +0000

Topics covered

1. My reflections as I come to the end of my first term/quarter in clinic at NCNM

2. The importance of memorization

3. The weirdness of caring for patients

4. Using all our gifts

Note: The book about Davinci that I reference in the podcast is an easy, inspiring read How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day (affiliate link)

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Deepest Health Podcast 9 – Interview with Dr. Heiner Fruehauf, Part II

Eric Grey — Sun, 09 Oct 2011 03:10:46 +0000

Topics covered

1. How a classical understanding can transform our understanding of medicine

2. The real importance of legendary figures in Chinese medicine history

3. What the classical approach lends to a contemporary Chinese medicine context & the importance of lineage

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Deepest Health Podcast 8 – Interview with Dr. Heiner Fruehauf

Eric Grey — Sun, 09 Oct 2011 03:05:24 +0000

This is the first of a two part interview series with Dr. Heiner Fruehauf. Heiner is a founding professor of the school of Classical Chinese Medicine at National College of Natural Medicine in Portland, OR, owner of Classical Pearls, purveyor of truly great Chinese herbal products and primary contributor to Classicalchinesemedicine.org.

Topics covered

1. What is Classical Chinese medicine?

2. Different models of learning and teaching Chinese medicine – the importance of transmission

3. Upper, middle and lower level physicians in Chinese medicine

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Deepest Health Podcast 7 – Clinical confidence and memorization

Eric Grey — Sun, 09 Oct 2011 03:03:49 +0000

Topics covered

1. What it means to have confidence in clinic

2. Shy I believe memorization is so important for Chinese medicine practitioners

3. Best practices for memorization

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Deepest Health Podcast 6 – Schools of Chinese medicine and learning

Eric Grey — Sun, 09 Oct 2011 03:02:17 +0000

Topic covered

1. Different schools of Chinese medicine and how students should look at the possibility of “choosing” between them (it’s a big topic, and the only one in this podcast)

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Deepest Health Podcast 5 – Interview with Brandt Stickley

Eric Grey — Sun, 09 Oct 2011 03:00:16 +0000

I am honored to offer this interview of Brandt Stickley talking about his practice and teaching of Chinese medicine. This was early in the podcast’s history, and the first interview, so the sound quality is a little dubious. Dr. Stickley apologizes for his very high volume.

Topics covered

1. Contemporary Pulse Diagnosis

2. Working with and learning from the incomparable Dr. Leon Hammer

3. Dr. Stickley’s basic understanding of Classical Chinese Medicine

4. Entering the mystery, the importance of the senses, and other exciting stuff

Links of note:

Dragon Rises.org : site containing articles, links and information about seminars pertaining to Contemporary Pulse Diagnosis
Dragon Rises College of Oriental Medicine

Dr. Leon Hammer’s two most well-known books are Dragon Rises, Red Bird Flies and Chinese Pulse Diagnosis: A Contemporary Approach (Revised Edition) (both affiliate links)

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Deepest Health Podcast 4 – Cancer, pulse taking & trust

Eric Grey — Sun, 09 Oct 2011 02:54:17 +0000

Topics covered

1. What can Chinese medicine do for cancer?

2. Difficulties in pulse diagnosis

3. Confidence in prescribing herbal formulas

Note: The natural medicine business blog I mention in the podcast no longer exists.

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Deepest Health Podcast 3 – The Power of Self Cultivation

Eric Grey — Sun, 09 Oct 2011 02:49:19 +0000

Topics covered

1. The power of self-cultivation for Chinese medicine practitioners

2. Caring for patients from the moment they arrive until the moment they leave

Note : You can find most of the links discussed in the post in the recommendations vault.

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Deepest Health Podcast 2 – Visualizing my way to Chinese medicine success

Eric Grey — Sun, 09 Oct 2011 02:43:42 +0000

Topics Covered

1. My clinical experience thus far: difficulties and excitement

2. How I use visualization as a way to learn to be more effective and efficient in clinic

3. A few questions I have about clinical practice

Note: The new blog (about natural medicine and business) mentioned is now defunct, its content mostly absorbed into Deepest Health.

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Deepest Health Podcast 1 – Lessons learned in Chinese medicine clinic

Eric Grey — Sun, 09 Oct 2011 02:31:35 +0000

This first try into podcasting had its bumps and bruises as I got used to the process of podcasting, including the technology. As the episodes wear on, you can notice an increase in sound quality and my comfort with the process.

Topics covered

1. Focus and intention: getting out of one’s own way

2. How it was needling “real” people for the first time

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The concept of constitution in Chinese herbal medicine

Eric Grey — Wed, 11 Nov 2009 20:00:41 +0000

Established readers : this is one of many reposted articles you will see in the coming months. It is part of the redesign process. I hope you agree that all of these articles are worth another look!

I have to admit to some weirdness around the concept of “constitution.” This is absolutely unfounded, I have no clinical or theoretical information to back up my feeling. I think I’ve just seen this concept be misused. Once you get an idea in your head that a patient is a “Chaihu person,” or a “Bladder CF,” or a “Shaoyang patient,” it seems to be a little difficult to think outside that box. It offends my desire to meet the patient where they are without preconceptions.

Now, don’t get me wrong, I realize that this is part of what WE DO in Chinese medicine in particular and natural medicine in general. We look at the gestalt of the patient, and we make a helpful generalization about their condition and the treatment that is likely to rectify it. We look into past and future and consider how the patient came to be where they are and where they might be going, and treat them based on all of this information. I have no problem with that. But, I find myself a little worried when I persistently think about a person as, say, a “Chaihu” person, even before they come in – and use that lens to view whatever it is they might be presenting with in the current moment.

Before you click on the comment button prematurely – know that this is an attitude that is changing for me. The more patients I see, the more I see really weird cases. These cases involve patients who present with a certain picture that so strongly speaks to a particular treatment strategy but for whom that treatment strategy does not work. Searching for a remedy usually guides me in a very unexpected direction. In retrospect, looking through the patient’s case, I usually see a certain pattern emerge.

Here’s an example from my time in the student clinic.

A patient presenting with very serious symptoms (serious blood stasis, ongoing memory loss, digestive chaos, emotional instability and more) also had a *very* excess pulse – pounding, tight and wiry at all depths with some choppiness throughout. A dong (flicking bean) pulse was found on both sides between the first and second positions. A lot of stasis in the tongue. The supervising doctor and I discussed the case for a while, trying to seek out the best formula. For the next six or eight weeks, we used some variation of Taohe Chengqi Tang + Zhishi Xiebai Guizhi Tang with some incorporation of Guizhi Fuling Wan. We wanted to treat the most excess, the most “outward” of the symptom picture first.

As the treatment progressed, however, it… uh, didn’t. The patient’s symptoms didn’t lessen much, the pulse picture didn’t change. We decided to work from another direction. Following the recommendation from one of my mentors, I used a modification of Shenqi Wan with some additional blood movement incorporated. The patient found almost immediate improvement and continued to improve for the next several months. Later acute episodes found us changing our formula strategy a bit, but Fuzi has always been involved and when the Fuzi is removed, the patient worsens.

Now part of this is just my clinical immaturity and maybe my inability to see signs that, for a more experienced practitioner, would seem obvious. I’m sure there are several of you in the audience shaking your heads sagely – ah yes, of course, Fuzi. But, one could easily see something about “constitution” in this case. I’ve had similar experiences otherwise. It’s not always obvious in the pulse, it’s not always clear in the history, but when you go with it – improvement is found on all levels.

There doesn’t seem to be something that binds these cases together in every case. For instance, I am in no way convinced that if a different person with a similar presentation as above were to come to the clinic that I would be able to resolve their situation in the same way. But, I may be able to look at this person and – over time – learn some basic characteristics that help me to identify patients who might need this approach… this is, to me, constitution.

I’ve been reading the Classicalformulas.com blog over the last couple of months. I’ve also read through the book the blog is affiliated with, Ten Key Formula Families in Chinese Medicine. I enjoyed reading it. One thing I couldn’t quite get into was the classification of people based on their body type. While I, of course, pay attention to body type – I don’t think I’ve gone as far as thinking that a person fell into a certain class of formulas because of that body type. I’d love to hear from anyone who has used, or currently uses, this type of classification. Have you found it works all the time? 90% of the time? Something else?

This is a fascinating topic, in general, and one that I know has a lot of traction out there. So, even if you haven’t read the book above, I’d like to hear your thoughts. What do you think about constitution? Where is the classical support for this method? What have you been learning in your classes and seminars about constitution?

Phenomenology and Classical Chinese medicine : brief conclusions, opening doors

Eric Grey — Thu, 13 Aug 2009 07:12:00 +0000

Here are the last few paragraphs of my thesis in Chinese medicine for my MSOM degree at National College of Natural Medicine. As you can probably tell, I did not go as far with any of my research topics as I would have liked. I saw it mainly as a way to learn what resources existed, and sketch a general outline of where I would like to go with my investigations. I have to be frank, I haven’t yet taken the time to explore these topics much more deeply – I’ve been trying to rejuvenate myself from the rigors of school while also opening the clinic and writing more on this blog. However, I have all of the resources amassed and lots of brainstorms and outlines ready to be further explored. I’ll definitely share my ongoing investigations with Deepest Health readers.

—

Read Part I of the final chapter of my thesis

Read Part II of the final chapter of my thesis

—

First, the system must demonstrate a basic level of effectiveness. This could include evidence in the contemporary Western sense of controlled laboratory or clinical research, but could also include a mature history of effectiveness, such as Chinese medicine has in its extensive written record. Obviously, it could also include currently undeveloped research methodologies such as I discussed in Whole Systems Research. It will almost certainly also include so far undiscovered methods of obtaining knowledge.

Second, it must demonstrate its inclusion of a mature system of practitioner education and basic regulation of ongoing practitioner behavior. This simply means that an included system of medicine should show that it is making active attempts to behave ethically and to ensure that its practitioners obtain the highest level of education that is possible. External governmental controls could also be developed that both respect the integrity of the community of practitioners while providing the public with a sense of safety.

Third, a system of medicine should be open to discussion and evaluation by other systems. These interactions should be governed by an understanding that such interaction is for the benefit of all involved, not intended to discredit or eliminate one system in favor of another. Practitioners of each system should seek to become steeped in the foundational material of the other system before they seek to criticize it, as this will make for a more productive and scholarly interaction. My thoughts on this point resonate with the early philosophical work of Alasdair MacIntyre as developed in his book, After Virtue, published in 1981.

Finally, a system of medicine should not be integrated into the larger health care system until it demonstrates its safety for general use. As I’ve already mentioned, one of the biggest concerns about alternative medicine is whether it is safe. This is to be understood, since the primary guiding principle of all medical practice is to “first, do no harm.” Whether by laboratory testing, historical record or some other acceptable method, the system should indicate that its diagnostics and therapies meet a minimum standard of safety. Further, as stated before, the profession should be internally or externally regulated in an adequate way to ensure that practitioners are making safety a primary focus of daily practice.

Of course, there is a viable system of medicine that meets all of these criteria – Chinese medicine.

Chinese medicine not only meets the criteria above, but is also an ideal vehicle for avoiding the kind of objectification of patients that I am arguing against. In Chinese medicine, one always considers the more physical, measurable characteristics of a person as well as the less measurable, subtler features of his mental and social situation. In fact, such a separation of features of the person’s experience is simply not done. Every single identified sign or symptom is taken into the diagnostic framework and interpreted. This includes the more precise information as might be included on a laboratory report. But it also, and more commonly, includes the patient’s vague and self-defined complaints (“fuzzy headed,” “stuck,” and so on). Further, it relies on the complex and embodied senses of the practitioner to accurately observe and interpret the symbolic information inherent in face color and quality, pulse rate and quality, nail bed color and quality and so on. While this may seem a hopeless mess of factors that cannot possibly result in effective diagnosis, much less treatment, such is not the case. Diagnosis does happen, and so does healing. Chinese medicine, through its use of symbol, of metaphor, and its integration of the various subtle meanings and meetings within a human life both in diagnosis and in treatment – has a unique and time tested way to bring the interpretive meeting back into medicine.

In sum, I believe that medicine is not the kind of activity that can, or should, be governed by single-minded adherence to the analytical sciences as they are currently practiced in most places in First world nations. Such devotion to technological medicine encourages a compartmentalized way of viewing the body and the human being’s place in the universe while also producing a distance between doctor and patient that is not conducive to healing. We need not abandon the analytical tradition or the fine tools brought to us by contemporary Western medical practice. But nor should we attempt to eradicate all systems of medicine that fail to meet our ideological standards concerning evidence. Condemning disciplines based on ideological notions of “pseudoscience” cannot be helpful for patients. A more inclusive approach respects the integrity of safe, integral and mature disciplines while acknowledging the need for the public to feel reasonably assured concerning their safety and effectiveness.

The Lingshu and becoming a superior Chinese medicine practitioner

Eric Grey — Tue, 16 Jun 2009 16:45:09 +0000

There is a very interesting discussion going on over at Richard Goodman’s blog – He explains…

“…Ling Shu Chapter 55

The superior physician treats that which is not yet ill. The inferior physician treats that which is already ill.

This is a fairly famous statement, which is often interpreted to be a call to preventative medicine. Modern physicians often complain that patients come in with specific complaints and it is impossible to treat what is not yet ill. I find this stance strange, as if we are to believe if someone has a disease which has already become manifest, the practitioner is prevented from treating what is not yet ill.

At any rate, the following quote from Nanjing has a completely different interpretation of the above passage:

Treating what is not yet ill means that when one sees illness in the liver (for example), this (can be) transmitted to the spleen. First fill (shi2) the spleen qi so that there is no way for it to accept the liver’s evil qi. This is what is called treating what is not yet ill.

As you can read, the writer of the Nan Jing felt that the meaning of treating what was not yet ill did not mean some psychic rendering of signs and symptoms, but a way of treating a person who comes with a specific complaint. ”

Talking with my friend and colleague Michael Givens, he stated his conviction that this Classical passage tells us succinctly how we must proceed as Classically trained physicians. I agree! When a patient comes in to see us, we must be doing a number of things simultaneously. We must see the present complaint as it is an express of physiology gone awry, and we must situate that within a matrix of time and space that helps us understand the root of the disease as well as its potential for adverse development.

While your chronic cough may be easy to ignore and seemingly innocuous, not to mention related only to the “Lung,” as Classically minded practitioners, we need to see under, around, beyond and between that.

This asks a lot of practitioners. We need to understand physiology in all of its manifestations, with all of the conceptual systems we have to understand them. This is particularly true of the six conformations, as they are the broadest, most comprehensive, and least misleading structures we have available. But, we must also know the five element model (and all of the interrelationships therein), the complexity of the channel system (from minute luo to cutaneous regions), and yes, we can also take into account the Zangfu information (particularly as contained in the Neijing and other Classical texts) and everything else we have learned. It is my preference to stick with the six conformations and five elements, and others may have other preferences.

We need to understand the manifold ways that physiology can be disturbed, and understand the diverse ways this can express in patients. We must understand how disease progresses through time, and what factors might upset the “normal” progression.

This is to say nothing of all we must know for treatment. This is to say nothing of the intense rectification of the self that must take place in order for our true healing power to come forth. It is to say nothing of a lot of things, but a lot about a little. And that little is critically important, so important that it was enshrined in the foundational texts of our medicine.

I don’t know if I will ever “be” a superior physician – it seems to me the kind of thing that one continually strives for, a moving target that helps to keep the thirst for excellence alive. But, I do know that the rest of my life will be devoted to attempting to understand the above, and attempting to let that understanding flow into my treatment, and to let my treatment be of service to my patients.

What about you? How do you understand the above line? Do you feel prepared to strive for the “rank” of superior physician? Discuss here in the comments or on Richard’s fine site.