A Comparative Evaluation of Diagnostic Systems used in Herbal medicine

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A Comparative Evaluation of Diagnostic Systems used in Herbal

Medicine

Dr. Tierra L.AC., O.M.D.

Western Diagnosis

A. Origins and means

Diagnosis in scientific medicine (derived from the word " discern " in Greek)

is based on patient's history and physical examination and on laboratory testing. Case

history taking is a tradition dating back to the time of Hippocrates and a good physician

is skilled at how and when to ask the right questions. I have concurred with Weil

when he states, " More than one skillful physician has said that if one asks the

right questions, the patient will make the diagnosis for you in his or her own

words. " Physical examination is also an ancient art which has changed dramatically

since the advent of instruments in the 19th century. Laboratory testing is a radical

contemporary innovation that is rapidly becoming the mainstay of contemporary Western

medical scientific diagnoses and along with expensive technological diagnostic procedures

threatens to replace the traditional art of case taking and direct observation and

physical examination.

While previous diagnostic methods used by Western physicians were similar to the

Four Diagnosis of Traditional Chinese Medicine, the use of diagnostic instruments dates

back to 1819, with the introduction of the stethoscope by the French physician, Rene

Laennec (1781-1826). An explosion of diagnostic technology occurred in the late 1800s with

the mushrooming appearance of four types of procedures and inventions:

Instruments for, or means of visualizing gross anatomical structures, including the

opthalmoscope, laryngoscope, and X-ray;

Medical use of the microscope to correlate specific diseases with specific germs and

tissue changes;

Devices for measuring body function in momanometer, and electrocardiogram;

Chemical tests of body fluids and tissues.

In 1954 the Yale-New Haven Hospital performed forty-eight thousand laboratory

procedures; in 1959, ninety-eight thousand; and in 1964, two hundred thousand, while the

patient census increased only slightly in the same period. In the US as a whole, about 2

billion laboratory diagnostic tests were done in 1971, 3 billion in 1974, and 4.5 billion

in 1976 (Stanley Reiser, Medicine and the reign of Technology (Cambridge, Eng.:

Cambridge University Press, 1978), 159).

The increasing reliance on expensive diagnostic procedures and testing is sometimes

called

by some critics " defensive medicine,' because its intent seems more to protect the

doctor than to help the patient. With the increase of malpractice suits by dissatisfied

patients, doctors have been forced to resort to such extensive and expensive high tech

diagnostic procedures in attempt to protect themselves.

Nevertheless, the best diagnosticians remain highly trained observers who have learned to

rely on intuition based on subtle observations. Weil describes " an old

clinician in Boston who could " guess " the blood pressure of patients in the

hospital by watching them lying in their beds. His guesses were usually right to within a

few points. "

Urinalysis, X-rays, and standard blood tests may clinch an intuited diagnosis or provide

useful clues to prompt one and generally do not cause much discomfort or damage.

" Newer tests, " according to Weil, " are directly productive of

illness --- iatrogenic illness, that is, doctor-caused (from iatros, the doctor of ancient

Greece). " Some of the procedures that may injure or even kill significant percentages

of patients include, sampling pieces of liver, lung, and kidney, infecting

radio-paque dyes

into arteries, exposing patients to great numbers of diagnostic X-rays, injecting powerful

drugs for diagnosis.

Criticism by the AMA leveled at the few possible mishaps which have occurred in

chiropractic and traditional medicine must be compared to the large numbers of mistakes

which have been caused by medical doctors not in the course of treatment but simply as part

of contemporary diagnostic procedures. These may include such methods as

pneumoencephalography (injecting air into the ventricles of the brain for diagnostic

X-rays), angiography (putting catheters and dyes into major arteries), and many other

techniques counted as standard procedure in every Western allopathic hospital today.

B. Level of Reliability

A nationwide, 32 hospital study compared 1800 clinical diagnoses made on living

patients to anatomical diagnoses made at autopsy. They found the error rate was nearly 20

percent. About half of those mistakes probably led to death. (Washington University in St.

Louis Feature Service, September 1985)

With an 800 billion dollar a year U.S. medical bill, much of which is simply involved with

the process of diagnosis, we see how such extreme reliance on high tech diagnostic

procedures, not treatment contributes the largest percentage of that bill.

One is reminded of a statement by the German philosopher, Immanuel Kant,

" Physicians think they are doing something for you if they label it as a

disease. "

Applied and Behavioral Kinesiology

Good-Bad Methods

1. Applied kinesiology --- Dr. Goodheart saw a relationship between each large

muscle of the body to a body organ. He posited the idea that weakness in a muscle usually

meant that there was a problem at the energy level in the associated organ. He found that

by treating the muscle in a variety of ways and making it strong, he was able to improve

the functioning of the organ.

One of the methods used Dr. Goodheart to strengthen a muscle was through nutrition. Thus

is a particular nutritional supplement was given to a patient and the muscle tested

strong, it was the right supplement; if it tested weak, it was not. Other methods of

treatment could be similarly evaluated such as physical manipulations.

Basically this was a good bad method based upon the subjectively evaluation by the

practitioner as to whether a particular muscle felt stronger or weaker when influenced by

a particular substance, event or stimuli.

One of Dr. Goodheart's students was Dr. Diamond, M.D. who was an Australian

psychiatrist who relocated himself in the United States. After studying Dr. Goodheart's

methods, Dr. Diamond, seeing tremendous psychological value in the concepts of Applied

Kinesiology and developed his own more psychological approach which he called Behavior

Kinesiology (BK).

Behavioral psychology, according to Dr. diamond is based on the physiological feedback

loop of the Thymus gland. While previously, before the 1950's, little was understood about

the thymus since then with the increasing recognition, largely with the dawn of AIDS, of

the immune system, the thymus has risen in importance as the special area of the body

where bone marrow generated lymphocytes, are transformed by thymus hormones into

generations of lymphocytes called T-cells.

While B cells are antibodies originating in the bone marrow and secreted by plasma cells

to protect the body against external invasions of bacteria and viruses, T-cells are

B-cells which have been transformed in the thymus by a secretion called thymosin or

thymopoietin, into cytotoxic T-cells. The job of T-cells is to destroy cells which have

become cancerous or infected by viruses.

Understood in the light of BK, the thymus gland creates T-cells specifically to

" distinguish self from non-self, friend from foe, and to destroy foreign cells. "

These T-cells perform a vital immunocological surveillance that is directly concerned with

the body's ability to resist infections and cancer.

In all mammalian species there is a tendency for thymus activity to diminish with age with

a correspond risk of deadly diseases such as cancer.

The thymus gland, itself, is very stress sensitive. Within a day after undergoing a severe

physical or emotional stress, millions of lymphocytes are destroyed and the thymus shrinks

to half its size.

It is specifically this internal ability of the body to recognize viruses, bacteria,

diseases and cancerous cells as " friend or foe " that is at the heart of

Diamond's Behavioral Kinesiology. He hypothesizes that if certain cells created by the

thymus, can recognize foreign or non-foreign substances as useful or not, than the mind of

the individual must also be capable of such a recognition. In many instances, this

recognition is at the subconscious " energetic " level so that the therapist using

BK must find a way to access this " inner knowing. " This is done by first

establishing a normal resistance of a muscle group, usually, because of convenience, the

middle part of the deltoid and then comparing this muscular strength or resistance while

pointing to, thinking about or otherwise allowing the influence of a specific bodily area,

food, supplement, herb or other substance.

The basic purpose of BK is to test the positive, " good-bad " effects of a

substance or experience first on the thymus gland as the primary center of the

immune

system. In fact, according to Dr. Diamond, the method can be used to diagnose the

condition of specific organs or functions in the body as well as determine the effect of

specific substances and experiences on any or all other areas of the body.

The value of this diagnostic system, if indeed it can be regarded as such, is that it

generates information from the " inner " subconscious knowing of the patient. The

therapist only becomes a facilitator of this process. This approach, in itself, has

considerable therapeutic benefit whether in fact, the information indeed originates within

the patient or from various subjective or objective evaluations of the practitioner.

Using such a system, begins by indirectly centering and empowering the patient to an

understanding that he or she is responsible for his or her own well being. That there are

specific foods, supplements or herbs one can take that will prove to be uniquely

relatively beneficial or harmful. The therapist serves as a facilitator to help the patient

access this obvious fact.

The method is especially beneficial if the therapy one uses is largely dependent on the

patient's cooperation in affecting certain psychological and life style changes. It

metaphorically informs the patient through suggestion that if he or she, thinks, acts or

eats differently for instance, he or she can expect first an immediate positive response

by demonstrating a stronger muscular response through BK, secondarily a stronger and more

positive response in terms of all other physiological muscles and organs as well as all

mental process.

The negative aspect of this approach is first that it confines itself to an implied

" good-bad " methodology. Secondly that results while taking off from pseudo

objective scientific theories based on, for instance, the immediate response of the thymus

gland to the mere thought of a " good or bad " substance or experience, has little

control over the influence of other experiences that may be simultaneously influencing or

might I say, distracting, the patient while being tested.

Dr. Diamond cites how one will test negative to white sugar, coffee, loud rock music, a

disturbing color, picture, odor or any other experience. How can the therapist be sure

that the BK results are confined to the particular stimulus being tested.

The only answer, is that while intending to base one's results on the " inner

knowing " of the patient, the therapist, in fact is bringing to bear a lifetime's

worth of personal experience and prejudices which will have a decisive influence on the

ultimate results. First, we must bear in mind that it it not so easy to objectively

determine the relative strength or weakness of a muscle. There are, as Dr. Diamond readily

admits, many influences that will influence a patient's response. some of these are from

the patient such as:

The will or determination of the patient to offer or not significant muscular resistance

is capable of being influenced by various factors. One is the well known tendency of

patients to want to please their therapist or otherwise make him or her right, " which

the patient unconsciously sees to be for his or her own benefit. This is greatly aided by

various indirect non-verbal cues from the therapist who may have a particular preconceived

opinion or prejudice such as " alcohol and white sugar is not good for you, "

The personal determination of the therapist to motivate the patient to make those

changes that he or she knows or senses would be in the best interests of the patient. This

can be an unconscious evaluation on the part of the therapist testing the strength of the

muscle or a secret conscious determination based upon the therapist believing that he or

she knows what is best for the patient. In any case, such considerations would certainly

compromise any shred of objectivity on the part of the therapist.

Simple muscle fatigue from continues and repeated pressure will influence the relative

strength of a muscle, espcially if the determination is within a relatively small degree.

Kinesiology has become a very popular diagnostic modality by many wholistic therapists

including chiropractors, some osteopaths, occasional maverick wholistic medical doctors,

herbalists, nutritionists, naturopaths and acupuncturists. For some it serves as an

obvious trick to motivate and empower the patient to make those changes that the therapist

already has determined will be good for the patient. For others it offers an efficient

right brain exercise that is a welcome relief from the labyrinthine theoretical

considerations unique to the discipline of each therapeutic modality. There are many

problems. First, it does not allow for much involvement with the patient in terms of

mind-body relationships. The second problem is that the therapist is too easily inclined

to abandon his or her system of knowledge and skill be it chiropractic, herbal,

acupuncture, etc, in favor of an overly simplistic and dubious diagnostic system which

does not allow for a differential analysis of the whole person. Third, the system is all

too often easily abused as a con-artists game to get patients to purchase a variety of

high priced supplements.

By confining oneself to a good-bad feedback mechanism, Kinesiology is a sorry substitute

for the depth of understanding based on principles of Traditional Chinese Medicine,

Ayurveda or even comprehensive Western diagnostic systems is sorely lacking in

kinesiology. The danger then is to prescribe diet and supplements based on an overly

simplistic understanding of differences of constitution and disease manifestations between

people. Using a good-bad determination, offers little recognition for the possibility that

is equally a part of wholistic medicine and traditional medicine that particular symptoms

or disease patterns is often a manifestation of the best and therefore most healthy

response to an unhealthy stimuli or condition. the job of the therapist from this

point of

view is to attempt first to understand the unique expression of the patient without any

preconceived good-bad prejudicial considerations and help the body complete the process it

is in the process of manifesting. This is most obvious in the case of a rash or measles,

which in traditional herbal systems is best treated by taking herbs that help them ripen

and complete their cycle of expression.

Given the fact of all the complex variables described above, it is impossible to apply the

rigorous double-blind testing that medical modern science requires, one would have to say

that kinesiology as a diagnostic tool would fall more under the classification of

shamanistic rather than clinical. As with any of these systems, the value of diagnostic

evidence from muscle testing is absolutely dependent on the skills and " other "

knowledge that the therapist possesses rather than confirmable diagnostic data.

Recently, some acupuncturists, inspired by a Japanese therapist, use a system called

" O " ring testing. This is done by testing the muscular resistance of the thumb

and index finger when firmly locked together to form an O.

Too many therapists have succeeded in convincing patients that kinesiology is a valid and

reliable diagnostic tool. As a result, many of these find themselves rejecting truly

rational treatment and remedies that may actually be of value for their unique condition

because a therapist claimed it did not muscle test positively. Worse yet, is when friends

and untrained individuals set themselves up as experts in musce testing and evaluating

various supplements.

This kind of sham approach to diagnosis and treatment reflects negatively on the validity

and high standards of practice of the various conventional and alternative healing

modalities and exposes all of alternative medical practice to justly unfavorable

criticism. As such, it is up to those who disagree with such superficial and invalid

diagnostic approaches to speak out against it and help educate the consumer about the

dangers and differences in approach.

Too many times I have had patients report to me of a chiropractor or some other therapist

who gets such phenomenal results through muscle testing. I have personally wondered about

these reports and have taken steps to personally evaluate some of these by presenting

myself as a patient to a few.

One was highly touted in his results and called himself a neuro-chiropractor. The

" neuro " part referred to his approach being based on the muscles and joints of

the body receiving clear commands from the " thalamus part of the brain " and

therefore effecting a body-mind balance that would ultimately treat all or most diseases.

As with other, wholistic diagnostic systems, a good deal of the success of patients

treated based on kinesiology is the broader an more general value of the more wholesome

foods, supplements, physio-therapies that accompany it. Just as it is impossible to limit

the effects of a vitamin such as vitamin C or an herb such as ginseng to a particular part

of the body, it is also impossible to isolate the effects of a particular acupuncture point

or spinal manipulation. This is not offered so much as a criticism of kinesiology as a

diagnostic system but more to place it into perspective.

It is my personal opinion, however, that it is very dangerous for a practitioner to

abandon the diagnostic discipline of his own particular therapeutic modality

solely on the

basis of kinesiological diagnosis.

Iridology

According to the admittedly questionable legend of the origin of iridology as told by

Bernard Jensen, it all began as follows: during the mid 1800's a ten year old boy destined

to become Dr. Ignatz von Peczely of Egervar, Hungary, was playing with his pet owl.

Accidentally one of the owl's legs was broken. The young boy remembered noticing a curious

dark stripe form in the lower region of the iris of the bird which he later realized

corresponded to the area of the leg. Eventually the black stripe became a tiny black spot

which gradually filled in with white lines and shading. This youthful incident made a

lasting impression on the boy so that when he later grew into a successful doctor working

in hospital surgical wards at the college hospital he had the opportunity to observe the

irises of patients after accidents and operation. From this he was able to develop the

first iridology chart outlining corresponding areas of the iris of the eye with all parts

of the body.

Doctor von Peczely published his first book called " Discovery in the Realm of

Nature and Art of Healing " in 1866. The work was first promoted in Germany by August

Zoeppritz. Later, Dr. Emil Schlegel of Tuebingen published a book on the results of von

Peczely's establishing the Germans ongoing interest and evolution of iridology or the

method of diagnosing the body by study of the iris of the eye.

A Swedish homeopath, Nils Liljequist, further improved the methods of iris

diagnosis and

introduced it to America. A two volume set based on a translation of his writings was

called " Diagnosis from the Eye. "

Dr. Henry Lane, a native of Austria, moved to this country and taught iridology to

Dr. Henry Lindlahr of Chicago. Dr. Lindlahr practiced iridology and wrote about his

experiences in his many books. Dr. Lindlahr was famous for emphasizing the importance of

the " law of Cure " based on retracing prior acute symptoms which he believed were

the beginning of all chronic conditions.

One of the greatest iridologists of recent times is Johannes Thiel of Germany. A

detailed and outstanding textbook was by Dr. J. Haskell Kritzer. The late Dr.

and Dr. Bernard Jensen both have been popular exponents of this system which

in turn has been adopted by thousands of their followers and students.

As a student and protege of the beloved Dr. , I began my career as an herbalist

using iridology as the sole diagnostic method. The reasons why and the fact that after

three years I abandoned it in favor of traditional Chinese and Ayurvedic diagnostic

systems, is based upon certain deficiencies I personally felt and experienced with

iridology.

I say this despite the fact that many of my respected herbal colleagues still strongly

rely on iridology as their primary system of diagnosis and obviously must be getting, as I

did, some positive results in their prescribed herbal and dietary treatments based on iris

diagnosis. What ultimately persuaded me to give up the practice and teaching of iris

diagnosis was its inaccuracy and the tendency to provide the same kind of limited

un-wholistic good-bad negative information to the majority of patients. In this I was

reminded of how I felt when I personally attended Dr. 's readings and heard him

say essentially the same thing to every patient and subsequently prescribe the same diet

and at least one of his formulas for each major organ in the body. Dr. also

got very good results, but I feel certain that, despite his statement to the contrary, his

results had little to do with his iris diagnosis and everything to do with the generally

beneficial nature of his dietary regime for the majority of patients he was seeing at the

time and the broadly beneficial effects of his herbal formulas. .

My own misgivings about iridology became especially apparent when giving a seminar at

Esalen and I was casually socializing and sitting with several of my students on the

living room floor of Pfeiffer house one evening when they all requested that I read their

irises. I must have read from twelve to fifteen sets of irises over the course of an hour.

It was at that time that I was confronted with questions about the accuracy and ethics of

a system that authoritatively told somebody based on a single piece of rather inconclusive

evidence, that they were essentially sick or nearly sick. I heard myself reciting the

standard litany of iridology, " nerve rings here, prolapsed colon there, heart

lesions, etc. " -- even to the point of suggesting cancerous or

pre-cancerous

conditions any or all of which may or may not have actually existed!

One positive outcome for them was that they became motivated, hopefully, to a better

lifestyle and dietary regime. For me and hopefully for them, that they had the experience

of purchasing several of Dr. 's excellent formulas which I just happened to be

selling and might experience the many health benefits from following a relatively balanced

herbal program.

As I became more deeply interested in traditional Chinese herbal and Ayurvedic

differential diagnosis, I found iridology to be of little or no value compared to the more

comprehensive value of these Asian diagnostic systems. My last consideration for the value

of iridology was the hope that I could monitor a patient's progress by observing the

fabled " fine white healing lines slowly filling in the dark lesions, " which I

never saw or the eyes change to a lighter color, which I did observe and was supposed to

represent a cleansing or detoxification. The problem was that matching the lighter eye

shade that developed after a patient went on a cleansing, vegetarian, mostly fruit and raw

food diet for a few months, from the perspective of Chinese differential diagnosis and

based on other signs and indications, represented blood deficiency or anemia.

Nevertheless, despite the fact that I was no longer using iridology but relying solely on

traditional diagnostic systems of Traditional Chinese Medicine (i.e. acupuncture and

Chinese herbalism) I was undaunted to try to satisfy at least for myself the value and

truth, if any of iridology. A younger colleague fully equipped with the most up to date

specialized iridology equipment introduced himself and stated that he wanted to give

iridology readings at my clinic and at the same time monitor the course of my patients

over a period of six months.

Given the fact that for most of us as well my patients six months is quite a long period,

there was ample opportunity for many of these to go through a variety of health related

changes. Some people became well and got sick again with either the same or perhaps a

different set of symptoms, others suffered injuries or operations. They all had their

irises repeatedly photographed and studied by my colleague and myself. Where was Peczely's

owl or the markings he claimed to observe in patients of the 19th century Hungarian

hospital ward? Were were the fine white healing lines that were supposed to knit together

the small dark lacunae corresponding to the healing of operations and injuries of

different parts of the body?

Our conclusion after six months: my colleague, trying to hold on to the fast disappearing

shred of belief in the validity of iridology sheepishly and somewhat guiltily sold his

camera to another would be iridology enthusiast. I buried my official iridology magnifying

head band in a box in a dark, hopefully soon forgotten area of my office closet, where I

must confess it still remains after over 15 years, unopened.

Since that time and only last year I spoke with another herbalist, colleague, Debra Nuzzi,

who worked as the editor of many of Dr. Bernard Jensen's books, including his " The

Science and Practice of Iridology. " She continues to hold Dr. Jensen in high esteem

both as a teacher and dedicated healer. Nevertheless in assembling the various photographs

for his book, she told me how she confronted Dr. Jensen with the fact that in the many

photographs she was editing to include in the book there were never any fine white lines

filling in dark areas that would exemplify healing and recovery. It seemed that, like my

colleague with the camera and myself, attempts to discover positive signs of healing

solely from iridology was for Dr. Jensen more of a longed for hope than a reality.

As with kinesiology, I would not question the value of these " good-bad " systems

when used by an experienced and skilled practitioner. The problem is when an inexperienced

practitioner naively decides that he need not study or practice any other diagnostic

system. That he or she can know everything solely from pushing a patients arm up or down

or looking with a magnifying glass in this or her eyes. As we shall see, even in

Traditional Chinese or Ayurvedic medicine few experienced practitioners would trust

themselves to rely solely on such highly respected systems as pulse or tongue diagnosis.

Rather these methods are part of a broader, more holistic differential system which

evaluates different diagnostic indications, comparing them against each other and arriving

at a differential hypothesis for which to begin treatment.

Radionics and Psionic Medicine

Radionics is a diagnostic method and treatment that is done at the distance from the

patient. Psionic medicine is a simpler version of radionics that is primarily based on the

use of a device such as the pendulum. Both these methods are based on a similar unified

theory concept. This concept was developed and exemplified through the teachings of a

distinguished physician, ce, Mac Donagh and Rudolf Steiner and it essentially

affirms the interconnection of all life and phenomena as understood in various Asian

spiritual philosophies such as Yoga and Buddhism. The concept of radionics and psionic

medicine along with more recent techniques such as crystal healing is based on the idea

that by clearing one aspect or part of the the self or universe through the force of

directed will and intention, another person or part of the universe will also be cleared.

Thus absent diagnosis and treatment of disease can be accomplished by simply stilling the

mind to a certain rate of vibration (usually called " alpha " which is

approximately seven brain cycles per second) and focusing inward one can determine and

affect the condition of another individual irregardless of their location in the world or

universe.

Since many highly skilled and effective herbalists use a psionic methods called

" dowsing " with the use of a pendulum it is appropriate to consider this approach

as a prototype for a wide variety of so-called psychic or shamanistic diagnostic methods.

I must preface my discussion by saying that I have absolute belief and first hand

experience of the spiritual unified field concept as well as the potential and power of a

absent diagnosis and treatment. I feel that such methods can be abused and misused and

readily admit of in-genuine charlatry and should be regarded, especially, it it the only

understanding one has of healing and health, with suspicion.

Radionic machines, including a wide variety of high priced electro-diagnostic machines are

being widely manufactured and sold and used by very competent natural

practitioners ranging

from herbalists, acupuncturists to radical medical doctors. I believe that such mercenary

sale and use of these pseudo-scientific devices are unnecessary since the energy that is

supposed to operate them is essentially mental. They may have some definite

" shamanistic " value as they constitute a material bridge between the physical

and mental worlds.

It is unfortunate and confusing at best, to substitute or mistake such methods for

appropriate understanding and study of herbal diagnosis and healing. I have seen master

herbalists such as the late Norma Myers of Vancouver B.C. adroitly and expertly use a

window shade string to determine specific foods, herbs and amounts to include in an herbal

formula for her patients. I have confidence in her ability to do this because she had a

consummate knowledge of herbs and healing and would often use a pendulum to check between

a number of possibilities that she already considered might be effective for a condition.

Since there is a big area for the influence of hypnotic suggestion and placebo effect in

such methodology, it is not always clear, nor, however, do either the therapist or patient

cares why something may be effective so long as it is. The problem is that it may be

un-duplicatable in the hands of another, unless one considers the implications of the use

of Bach Flower Essences as a manifestation of this same psychosomatic phenomena.

The general un-reliableness of such an approach, plus its highly subjective nature and

tendency to be influenced by various external influences should rule such methods of

treatment as not inherent to the practice of herbal medicine but useful as an adjunctive

tool for diagnosis and treatment.

Spiritual medicine as a part of holistic healing has always been a part of traditional

herbalism in all cultures. We see this in the tendency to combine shamanistic practices

and rituals in Traditional Chinese herbalism as influenced by the Taoists as well as the

use of omens and talismans that is a part of Ayurvedic medicine. further, herbs and

diseases have been classified in many traditional cultures according to astrological signs

and condition. This is seen in the writings of the famous sixteenth century herbal

physician, Culpepper whose controversial statement as a closing state of his

famous Complete Herbal is " To such as study astrology (who are the only men I know

that are fit to study physic, physic, without astrology, being like a lamp without

oil. "

The world's most renowned medical astrologist, Ingrid Naiman, achieves phenomenal results

in combining astrological-spiritual guidance together with traditional herbal medicine for

the treatment of cancer. I am honored and proud of the fact that she has chosen to use my

herbal Planetary formulas, River of Life and The Complete Pau 'd Arco Combination along

with escharotic salves based on traditional Eclectic formulas to achieve her outstanding

results.

The HERBAL TAROT developed by artist-herbalist Cantin and myself associates a

single herb with each of the 78 cards of the Tarot. The major arcana has a single herb

assigned to each card that most represents the energies and qualities while each of the

four minor arcana or suites corresponds to the four elements, the pentacles for the earth

elements using herbs that are good for digestion and assimilation; the swords for the air

element using herbs that are useful for treating the respiratory and nervous systems; the

cups for the water element assign herbs that are good for the genito-urinary tract and

finally the wands for the fire element that combine herbs that both cool and stimulate

circulation.

The traditional symbology of the cards are preserved to allow for the subconscious mind to

associate images that correspond to various stages and states of one's conscious

evolution. A particular spread can serve the same purpose as a Navajo sand painting to

help the patient get in touch with different psycho-physiological aspects relating to

their healing. The herbs indicated can be used as talismans, essences or as " plant

allies " that if not specifically indicated for the patient, can help guide both the

patient and healer to an herbal combination that would be useful for their particular

condition.

Again, unless one were an Edgar Cayce, I would caution against the inexperienced relying

solely on such purely psychic or intuitive methods. Usually it doesn't work if one's ego

is involved and at times, it is very difficult to remove one's ego sufficiently to achieve

reliable results with such methods.

Western Medical Herbalism

Western medical herbalism, unlike traditional Asian systems, such

as Traditional Chinese

Medicine, Ayurvedic and Unani or Tibb herbal medicine, seems to lack a universally

accepted traditional or school of herbal medicine. Since the time of Henry VIII, with the

signing of the herbalist charter, herbal medicine has been protected in the UK and

throughout the Commonwealth (including Australia and New Zealand) against the type of

repression that has occurred in other countries, especially in the US.

There are no laws restricting the practice of herbal medicine in the UK by anyone but

there is the National Institute of Medical Herbalists who have a four year curriculum with

highly trained and qualified graduates who practice professionally. The herbalism

expounded by graduates of the NIMH is a combination of humoural theory as represented in

the Teachings of Hippocrates and the Roman Galen, the lineage of medical herbalists that

have been a part of the rich herbal heritage of Great Britain, the significant influence

of North American ian herbal medicine as transported from America to the U.K. by

Dr. Coffin and last but not least, orthodox scientific medicine.

Two of the leading exponents of British Medical Herbalism in North America are

Hoffman and McQuade. One of the most interesting and important books specifically

outlining the system, besides Hoffman's writings is Herbal Medication by A.W. Priest

and L.R. Priest.

In terms of diagnosis, according to Fulder, " Modern Western herbalists use

much the same terminology and concepts as current orthodoxy (referring to Western medical

science), but they are interested in detecting and restoring normal function rather than

acting to stop a pathology. The symptom is seen as a sign, if read correctly, point to the

seat of disorder. For example an infection may point in the first place to 'stagnation' of

the affected tissues. Healthy tissues, like running water, cannot suffer colonization by

bacteria; such an invasion can only occur in the histological equivalent of the brackish

pond. Treatment of infections then demands that the tissue be 'cleansed' and brought back

into the vital circulation. Antiobiotics would only be necessary in this scheme if the

colonization was so excessive that there was real doubt as to the host's ability to

overcome it from vital resources, and then appropriate only if underlying stagnation were

treated as well. Using antibiotics alone is seen as being as productive as pouring

disinfectant into a brackish puddle and pronouncing it 'clean'.

The same concern with underlying causes marks the herbal practitioner's approach to other

conditions. A spasmodic condition like asthma or colitis speaks first of an irritant

factor combined with a tendency to over-react. AN inflammatory condition like skin disease

or arthritis speaks of a healthy but insufficient attempt to eliminate toxic

accumulations. Similarly, in dealing with migraine or the autoimmune conditions a primary

aim is to search for the source of toxicity, perhaps in defective digestive or liver

function or in inadequate elimination. "

Medical herbal diagnosis uses the standard methods of Western medical science to determine

where the primary and secondary physiological imbalances occur that may be the underlying

cause for a particular disease manifestation. There is a special emphasis on case history,

taking into account current stresses, dietary habits and lifestyle as well as

evaluating

the main physiological functions of the body: digestive, respiratory, genito-urinary,

cardio-vascular, nervous and emotional. This is done together with relative clinical

assessments: general physical examination, blood pressure, pulse, microscopic assessment

of urine, blood and stool.

There are two predominant influences prevalent within the practice of Western Medical

Herbalism as represented in NIMH. These include " physiomedicalism " and other

systems based on Western physiology such as " holistic herbalism " of

Hoffman.

Physiomedicalism

Physiomedicalism originated from the teachings of (1769-1843) and who

himself was strongly influenced by Native American healing practices, the use of their

herbs but more important the use of the vapor bath which was derived from the

physio-spiritual teachings of the Native American 'sweat Lodge', that combined the

psycho-active principle of prayer with physical therapies.

's system, at one time in 19th century North America claimed up to three

million adherents, later matured in the work of Wooster Beach (the founder of Eclectic

Medicine), W.H. Cook, T.J. Lyle and J.M. Thurston. The essential emphasis of 's

system was based on the essential vitality of the organism and its ability to eliminate

toxic waste from the organs and tissues or the body. In this, there is considerable

similarity with the concept of " chi " in Traditional Chinese Medicine or

" prana " in Ayurveda. The major difference with Chinese herbal medicine is in the

emphasis on detoxification whereas Chinese herbal medicine has tonification or the

principle of to " first tonify the deficiencies, " as its founding maxime.

Ayurveda emphasizes a balance of both elimination and detoxification. Japanese-Chinese

herbal medicine, called " kanpo " again sees even the process of tonification as a

way not only of building up the deficiencies but to tonify or strengthen the bodies'

eliminative power.

According to Herbal Medication, physiomedical diagnosis, while borrowing the terms of

Western pathology, aims at a deeper understanding or functional organic states. Symptoms

are evaluated in terms of their being manifested as:

Symptoms: the subjective and objective superficial evidence of systemic disturbance.

Functional disorders: variations from the normal standard of performance or balance function in any organ or system, reflecting imbalance of autonomic function.

The true disease state involving organic changes in cells and tissues.

The limit of treatment is restoration to a state of relative functional equilibrium and

optimum trophic state, subject to the tendencies and predispositions of the physiological

and temperamental typology. "

Peculiar to the diagnostic system of physiomedicalism as expounded by Priest and Priest

and others who representative of the the National Institute of Medical Herbalists, is an

assessment of underlying vitality necessary for effective herbal treatment. The vital

state may be:

Positive: the symptoms represent positive eliminative or reconstructive action--the

healing crisis of Naturopathy.

Tolerant: relative equilibrium and compensation is established and the encumbrance

tolerated in various tissues.

Negative: the symptoms represent a forced reaction to a progressive encroachment of

obstructive conditions and pathological deterioration, but ineffectually in ultimate

result, leading to low-grade chronic symptoms--- the disease crisis of Naturopathy. "

Disease is seen as a necessary compensation to an imbalanced condition. Before

disturbing the particular adaptation the body has made to, for instance, an imbalanced

diet, lack of sleep, various physical and emotional stresses, one needs to evaluate the

inherent strength or weaknesses the body has to make the necessary changes. A positive

crisis assumes that the body has sufficient vital energy to overcome the disease as in a

simple cold or flu for instance. All that is needed is proper management, to get out of

the body's way through rest and fasting or simple diet. A negative disease crisis requires

stronger support of relative vital functions in order to prevent chronic soquelae from

becoming established.

In terms of the Eliminative functions which especially include the colon and kidneys,

evaluations are made as to the bodies' ability to adequately eliminate waste materials on

three levels:

Intra=cellular: the interplay of electrolyte functions and the diffusion of chemical

ions across the cell membrane.

Organismic: the processes of intermediate metabolism.

Special organs of excretion: specific functions to eliminate unusable end products and

chemical wastes. "

The synthetic metabolic process of anabolism or the eliminative process of catabolism

results in some chemical by-product that requires elimination. If for any reason, proper

elimination cannot be achieved, the chemical by-product is stored in the tissues of the

body and gradually obstructs other vital metabolic processes that lead to chronic

degenerative disease.

It is for these kinds of conditions that alteratives are indicated to promote elimination

of various tissue wastes. These include herbs broadly classed as blood purifiers by

Western herbalists or 'heat clearing herbs' in Chinese herbal medicine. also included are

diuretics to eliminate fluid wastes, purgatives to eliminate solid wastes and cholagogues

to promote the discharge of bile and general blood purification through the liver.

Following the principles of ian theory as the basis for physiomedical practice,

the patient is evaluated in terms of the need for thermotaxis and hydration using the

so-called vapor bath, to remove toxic encombrances from the tissues of the body. In this,

the American (1769-1843), strongly influenced by Native American healing

practices, may have been imitating the universal practice of the " sweat lodge "

that integrated sweating and prayer to purify body, mind and spirit.

The underlying cause of disease according to and subsequent physio-medical

practices is chronic sub-thermal conditions that impeded or slowed the eliminative

processes of the body. From this, the use of warming stimulants such as cayenne and ginger

and the vapor bath became, as it still is today in the legacy of the late Dr.

, the primary therapy of ian physiomedical herbalism.

The second characteristic is the use of the lobelia emetic for helping to clean mucus from

stomach and lungs. This practice has much in common with similar emetic therapies

recommended in Ayurvedic medicine that also uses vomiting as a technique for clearing deep

seated mucus called " kapha " and in its more degenerative form " ama "

from the tissues of the body.

Overall, there are many common elements in the practice of physiomedical herbalism and

older traditional systems, especially Ayurveda. The biggest difference, as with most

Western medical herbal systems, is in the more subtle differential evaluation not only of

bodily and emotional symptoms but tongue, pulse, abdominal and palpation diagnosis as is

characteristic in Traditional Chinese, Ayurveda as well as the more highly developed art

of herbal tonification therapy used in these traditional Asian systems. It seems that in

Western medical herbal systems, while there is much regard for what is called " vital

force " there is little understanding of the herbs and preparations that can be used

directly to supplement these subtle energies as with the Chinese use of herbs like

ginseng, codonopsis, dang quai, astragalus to name a few and the various tonics used in

Ayurveda such as the purified mercury compound called " Sidh Makaradwaj " or

Chyavanprash.

Holistic Medical Herbalism

This system is another branch of British Medical Herbalism as presently expounded in

the writings of Hoffman and the teachings of McQuade. This approach is very

similar to the preceding except there is not such a strong influence of ian

herbalism with the use of strong stimulants such as cayenne, the vapor bath and the

lobelia emetic.

Holistic medical herbalism represents an attempt to prescribe relative simple herbs

according to the condition of the various biological organs and physiological functions of

the body. As with all the more evolved systems of herbal medicine, the actual Western

named disease, especially in more chronic conditions is treated indirectly using herbs

appropriate for various systems, especially the digestive-eliminative systems, the

circulatory system and the nervous systems.

The method of evaluating the state of health is through standard case history evaluation

of symptoms, clinical evaluations and Western microscopic tests. The term

" holistic " refers not only to the relationship of the body and mind but the

inner relationship of the various organs and physiological processes.

Herbs, diet and various physical exercises are recommended to remove any stagnations of

toxins in any of these systems. By so doing, the body is best able to strengthen and heal

itself.

In America, herbalist, , has evolved his own unique medical herbal system

based on a profound and intimate understanding of Western physiology and the actions of

specific herbs. 's diagnostic approach is generally based on observation of the the

patient and his or her symptoms.

Western Scientific Medicine

We need to mention Western scientific medicine, because some of the diagnostic

procedures of this approach are used by medical herbalists. The most significant

difference in the approach of orthodox Western medicine is its emphasis on symptom

suppression primarily through the use of surgery and drugs. With the rapid rise of medical

technology, there are increasingly refined and expensive diagnostic tests which can supply

a seemingly inexhaustible series of criteria to support one's thesis concerning a

patient's condition.

There is, so far, little regard for holistic interrelationships between the various

internal organs. Thus the underlying cause of disease is of little consequence and too

often the most shallow understanding of a particular condition, however couched it may be

in scientific medical jargon, is the result.

Treatments are prescribed according to the specific disease, often with little regard for

the nature and condition of the patient. The result is a plethora of adverse reactions to

treatment, rampant patient dissatisfaction and skyrocketing medical costs.

Back in 1874, one of the great eclectic physicians, M Scudder stated in his book

" Specific Diagnosis " , " It is yet the opinion, that " diagnosis "

has reference to the classification of disease according to the received nosology; that it

means naming the affection " bilious fever, " " typhoid fever, "

" pneumonia, " " nephritis, " etc. And so it does with the genius doctor,

at large, and their souls travail in diagnosis until a suitable name is delivered. And

then they consult their memories and books for recipes to throw at this name, which to

them seems almost an entity. "

Later, Scudder is even more vitriolic as he states, " Do you mean to say, " asks the

reader, " that the present system of nosology is useless? " Yes, so far as curing

the sick is concerned, that is just what I mean to say. Not only useless, but worthless--a

curse to physician and patient--- preventing the one from learning the healing art, and

the other from getting well.---- The first lesson in pathology we want to learn is, that

disease is wrong life. The first lesson in diagnosis is, that this wrong finds a distinct

and uniform expression in the outward manifestations of life, cognizable by our senses.

The first lesson in therapeutics is, that all remedies are uniform in their action; the

conditions being the same, the action is always the same. "

In his two volumes " Specific Diagnosis " and Specific Medication " Scudder

outlines a system of differential diagnosis, including pulse, tongue and other signs and

symptoms that is amazingly like that of Traditional Chinese and Ayurvedic medicine. Also

like these traditional systems of remedy classification, Scudder is opposed to isolating

and separating the classification from the specifically named disease. Like the

indications of traditional herbal systems, Scudder states that the " new diagnosis

means medicine, and must point out the cure for the particular case in hand. "

Whereas Western medicine has tended to advance towards increasing diagnostic technology,

traditional medicine aims at sharpening the sensory direct powers of observation,

listening, feeling and interrogation of the healer.

Specific Western diagnosis can be very misleading. The reason for this is always in the

subsequent treatment which usually aims at the most superficial suppresion of symptoms.

Usually what is best for suppressing symptoms is usually harmful to the overall

life force

of the individual. For instance, an anti-depressent sedative such as Haldol (haloperidol)

is the current drug of choice for dementia and Alzheimer patients. Its action is aimed

totally at suppressing aberrant behavior. Unfortunately it is well known to cause

irreversible damage to the brain and thus hastens the metal degeneration. Similarly,

various forms of corticosteroids are used for treating a variety of chronic inflammatory

diseases including diseases of the respiratory tract, skin as well as various rheumatic

and arthritic conditions.

The patient who takes corticosteroids today is generally quite aware of the inevitable

side effects from long term use. Nevertheless, this particular class of drugs is

remarkably effective in suppressing painful inflammatory conditions. Whereas the intention

of the Western medical doctor is to fully supplant the body's natural capacity to produce

anti-inflammatory hormones through the adrenals and endocrine system, the traditional

herbalist uses herbs that contain saponins which are used as organic building blocks or

hormone precursers by the body.

The use of antibiotics is well known to cause an indiscriminate destruction not only of

unfavorable bacteria but favorable ones as well. Since the favorable flora and fauna seem

to play an important immunocological function, the abuse of antibiotics has been attributed

as the underlying cause of many chronic immune dysfunctions that we se today. Just as

destroying a certain insect or animal in nature can upset the delicate balance that exists

there, so also the destruction of certain microorganisms in the body can cause an

imbalanced proliferation of others such as candida albicans. One of the questions that I

have not seen addressed, however, is what other substances besides antibiotics can

imbalance favorable microorganisms in the body. Taking the perspective that antibiotics

have a cold energy, and that these are known to exert marked antibiotic properties, we

might see some broad relationship whereby other cold natured substances such as a lack of

calories, protein, excess of vegetables, vitamins, especially vitamin c might cause a

similar imbalance.

The use of sulfisoksazole, a sulfonmide drug for urinary tract infections while having

the ability to overcome the infection, also has well documented injurious effects on the

kidneys. Since many who have problems with urinary tract infections would be understood in

TCM to have chronic kidney-adrenal deficiency, to cure an infection in the urinary tract

with a drug that further injures the kidneys seems in the long run counterproductive. The

problem is compounded by the fact that medical doctors are not usually aware of underlying

lifestyle causes that may be the root of the problem. Some of these are the abuse of what

is classified in traditional medicine as " heating " substances such as sugar and

other stresses. To remove the acute pattern of disease without addressing the underlying

cause seems to be very short sighted to say the least.

It is interesting to note that such conditions as high cholesterol and blood lipids may

correspond to traditional imbalances described in the ancient literature of Ayurveda.

There is a definite correlation between what is classified as " ama " in Ayurveda

with high blood lipids. Ama is described as a sticky substances that impairs circulation

and is accompanied with a wide variety of circulatory disorders. It is particularly

associated with aging and there certain herbal preparations that are traditionally used in

Ayurveda to help reduce Ama in the body. The primary preparation is called

" guggula " which is a preparation made from the resin of commiphora guggul.

Usually for excess ama it is combined with triphala which combines three myrobolic fruits

that together are revered as the most precious of all herbal formulas in

Ayurveda because

of their balanced detoxifying effects. In Chinese medicine a similar diagnosis, however at

a more extreme stage of imbalance is called " invisible phlegm masking the opening of

the heart " . This condition is usually associated with insane or impaired mental

function since the heart, in TCM governs the mind.

It would seem that the biggest problem in Western medicine is that there is little, if

any, correspondence between diagnosis and cure as Scudder so aptly noted. Western medicine

generally takes a symptomatic mechanical perspective to treatment while traditional herbal

medicine takes a nutritional approach based on attempting to discover what the body needs

to maintain better homeostasis. Drugs are used to mechanically inhibit certain adverse

so-called disease reactions, whereas herbs in the hands of a traditional practitioner are

used to empower vital organic processes so the body heals itself.

There is a problem, with Traditional Western herbalism being corrupted with the Western

medical model. There is a danger in using herbs such as mahuang in highly concentrated

extracts to boost energy. There is also a problem in over inflating through advertising

specific herbs for a specifically named pathological disease.

Because of their mild nature, herb work best when used holistically, in harmony with all

physiological functions and processes. With the exagerated emphasis on quality and

potency, the public is misinformed to believe that if an herb doesn't work in its whole

form, it must be taken in an concentrated extract before it will prove effective. While

the question on herb quality is of paramount importance to the producer of herb products,

the problem of selecting the correct herbal remedy is the primary problem of the

practitioner.

I would like to take a few examples from the current popular books and literature on

herbs to point out some of the misleading information that does not corroborate

traditional diagnostic systems with the herbal remedy.

St s Wort (Hypericum Perforatum)

A recent book Hobbs is quoted as stating " In Europe, St.

s Wort has a

long history of use, particularly as a folk remedy in the treatment of wounds, kidney and

lung ailments, and depression. "

Next the author goes on to describe a clinical study of 15 women suffering with depression

who were given a standardized extract (promoting his companies' product line), which

" led to significant improvement in symptoms of anxiety, depression, and feelings of

worthlessness " according to a German study. In addition, the extract greatly improved

sleep quality because it was effective in relieving both insomnia and hypersomnia

(excessive sleep).

The problem with this from a clinical perspective is that there are many causes of

depression and related insomnia. It most certainly has an emotional cause which is

different for each individual. There are many who tend to fall depressive slump for which,

I suppose St s Wort might be effective. The question is how long must it be taken

before such favorable results are noticed and assuming that the depression comes in

cycles, how can we distinguish the difference between a self limiting cycle and the effect

of St s Wort. Further, supposing that the cause of one individual's chronic depression

is traumatic memories of child abuse or lack of self esteem perhaps aggravated by a recent

separation, what is St. s Wort going to do about these causes for depression which

usually take time to resolve. It seems that in these circumstances we need to determine

whether published scientific research plays a significant " placebo " like role in

the popular use of St. s Wort for depression on the European continent.

Looking up Hypericum in Boericke's Materia Medica, a homeopathic materia medica that tends

to use a majority of low potency or mother tincture herbal remedies, we find that St

s Wort is specific for nerve injuries and symptoms associated with an injured nervous

system. Certainly an emotional shock with resultant depression would qualify as a possible

injury to the central nervous system. For that matter an injury to the spine or the coccyx

also qualifies as affecting the automatic nervous system. There is a big distinction

between depression caused by recent shock or injury as opposed to chronic depression

caused by more deep seated psychological problems. I personally know how complex and

difficult it is to treat chronic depressive individuals and it is extremely misleading to

not specify the specific type and causes of depression for which St s Wort might be

effective.

Taking one more example of the misrepresentation that results from trying to validate a

traditional herbal remedy solely from a superficial Western allopathic medical perspective,

the use of a standardized 24% extract of flavonoid glycosides of Ginkgo biloba is

described allopathically indicated for

:

Decreased blood supply to the brain

Senility, ringing in the ears, dizziness

Impotence

Varicose veins

Alzheimer's disease

The same author describes the leaves as being traditionally used to " benefit the

brain " . The overwhelming description of use for Ginkgo, especially the nuts, is for

the treatment of asthma and coughs. There is also a less frequent reference for the leaves

as being used to treat coughs and asthma. Other uses are as a digestive stimulant and

antiparasite remedy.

The fruit is classified in Traditional Chinese Materia Medicas as an astringent herb with

sweet, bitter, slightly toxic and neutral properties. It is used to expel phlegm from the

lungs, luekorrhea, spermatorrhea, frequent urination and urinary incontinence. No mention

in traditional medicine for the use of the leaves especially in a concentrated 24 to one

extract form to improve vascular circulation to the brain.

We can read voluminous information about the chemistry of 24% ginkgo leaves as well as its

effects of cells, neuronal cells, tissues, blood. We read of studies that seem to point to

the usefulness of gingko in the treatment of Alzheimer's disease. The pressing question

for the therapist is how can he or she determine whether the whole flesh and blood person

who sits before him or her in a clinical setting is the one for whom 25% Ginkgo extract is

indicated? For an herbalist to give allopathically for any conditions of the indicated key

use is hardly worthy of the high art and science of herbal medicine.

The indications are simply not specific enough to inform the practitioner of the

effectiveness of the remedy. To make our diagnosis and prescribing more accurate and

precise all we need to do is inquire about the cause of the above stated indications or in

a word fill in the important question of who with the well known indications for 24%

ginkgo extract should get the remedy. This requires a lot more thought and consideration

on the part of the practitioner.

Decreased blood supply to the brain could be caused by simple lack of blood or anemia for

which ginkgo has little benefit. Its primary benefit, if we are convinced by the

scientific studies, is to improve circulation of blood and nerve force not to directly

tonify or nourish it. Ginkgo is a circulatory stimulant so that it may be good for

circulatory problems related to all the above indications, making it a useful yang-moving

tonic but it is not good for patterns of deficiency chi, blood or yin-essence. In fact,

taken alone, it could further exhaust the body's reserves and deplete blood and yin, which

is a broad term that describes bodily fluids and substance.

From these few examples, we see that there are some very real problems in applying an

allopathic diagnostic model to the use of herbs. I personally hope, that herbalists will

take a more active role in condemning such dangerous and misleading herbal indications by

scientists and those who have made themselves spokespersons for the simplistic allopathic

style of herbal prescribing whose primary aim is to cell herbal products rather than make

them therapeutically useful agents.

Western Medical herbalists, however, have found good use for combining Western

diagnostic procedures with herbal medicine. They use such indexes as blood pressure,

microscopic lab tests, pulse, symptom evaluation and so forth to arrive at a differential

diagnosis of what organs and functions to treat that is appropriate to the individual

rather than the disease name.

Traditional Chinese Medical Diagnostic Models

TCM diagnosis is based on a differential system where several

parameters are examined

based on the four diagnosis, questioning, observation, palpation and listening and the

predominant concurring findings are taken as the basis for the diagnosis. This is called

'differential' diagnosis and strongly contrasts with the earlier simplistic iridology and

kinesiological " good-bad " systems and other overly simplistic diagnostic systems

that are based on one finding only. Western medical diagnosis is also based on a

differential system of evaluating several parameters before making a fully

authoritative

diagnosis. The problem is that Western medicine aims only at diagnosing the named

pathology while Traditional diagnostic systems such as Ayurveda and TCM aim at diagnosing

dynamic functional organic systems encompassed by the concepts of the ZangFu organ

syndromes.

Chinese physiology takes quite a different perspective from Western scientific physiology.

First, the Chinese describe only twelve functional organ systems of which the six

transformative solid yin organs are the most important. The remaining six yang hollow

organs are merely considered as vessels of transport and their function is usually

directly related to the function of the deeper Zang or yin organs.

The six Zang are heart, pericardium, spleen, lungs, kidney and liver. There are

corresponding diagnostic indications for each of these some of which are obvious from a

Western perspective such as palpitations and blood vessels are indicative of heart,

urinary problems are indicative of kidney-bladder imbalances and cough, nasal conditions

are indicative of lung imbalances. Other indications are not so obvious from a Western

perspective such as the relationship of the ears or head hair to the kidneys, insane or

aberrant mental behavior and the tip of the tongue to the heart, feelings of spaced out,

un-groundedness to the spleen. There are even assignments of physical postures and

movements that are used to direct the TCM physician to the troubled organ system such as

problems with stretching or walking being heart related, problems associated with sitting

being related to the spleen, problems with standing being associated with the kidneys and

so forth.

In fact, it might be said that the only limits to interpreting any given symptom or sign

is the knowledge and understanding of the physician.

Despite the sometimes colorfully obtuse language of TCM it is my belief that the major

difference between Western and classical Chinese medical physiology are semantic based

upon two very different perspectives of the body. To begin, traditional medicine is truly

holistic in that it unites all physical and mental symptoms in a common diagnostic system.

The mind and body are simply not separate according to Traditional medicine.

In TCM, various emotional states are aligned with each of the five elements and their

corresponding organs so that their is a corresponding emotion and mental state for each

element-organ. Similarly, Ayurveda outlines gunas or states of consciousness with each of

the three humours or tridosha, which is the basis of Ayurvedic diagnosis. They are

influenced by food, herbs and various lifestyle factors and are sattva, a state of

peaceful equilibrium, rajas, a state of outgoing, aggressive action and tamas, a state of

inertia or dullness. Obviously, such conscious states and their correspondences have a lot

to do with one's health.

Both traditional systems see health asa state of balance or homeostasis. TCM seeks to

achieve a balance of yin-passive and yang-active physiological function which equates to

the concept of shiva-shakti in Ayurveda. Ayurveda, nevertheless, emphasizes a balance in

terms of three using the tridosha or three humour system.

Both systems really accomplish Scudder's dictum that " diagnosis means cure "

since the specific diagnosis of each system is integrally linked with a classification of

foods, herbs, lifestyle, exercise that is intended to counterbalance any perceived

diagnostic imbalance.

The greatest difference with Western scientific diagnosis is again that the objective of

Western scientific diagnosis is to arrive at a specifically named pathology for which a

drug or surgery is usually prescribed whose intent is to somehow inhibit the expression of

the pathological condition. Traditional herbal medicine, aims at providing herbs and

special foods whose purpose is to stimulate innate biological functions that help the body

heal itself. the difference between these two systems is not really so black and white but

represents a more general tendency. With allopathic herbalism, the intention is to use

herbs to stop an itch, kill a virus, bacteria or yeast; with traditional herbalism herbs

may also be used 'allopathically' but there is always a dominance of treating the

underlying causes of imbalance.

In TCM this is expressed in the concept of supporting the Righteous chi while eliminating

the evil chi. Bob flaws in his article published in American Herbalism, described the

difference in TCM when he says, " Bian bing means to differentiate various named

diseases and recognized pathological signs and symptoms. Bian zheng, on the other hand,

means to discriminate various professionally recognized patterns of disharmony. " Since

traditional diagnosis always leads to cure, there is the concept of " Tong bing yi

zhi, Yi bing tong zhi -- One disease, different treatments; Different diseases, same

treatment " .

The fundamental difference therefore between Western and traditional diagnostic systems is

the difference between " form and function. " Western medicine, being more

material is based on form whereas traditional medicine is more energetic and is based on

function.

Pulse Diagnosis

There are several similar diagnostic criteria used in traditional diagnostic systems

but one of the most characteristic and enigmatic to Western practitioners is that of the

pulse. Pulse diagnosis is of paramount importance in is the hallmark of a classical

physician. The pulse is a direct manifestation of the circulatory energy of the body and in

the hands of an expert physician, is best for describing the internal function of the body

mind complex. In Tibetan culture, they use a system of pulse diagnosis that is strongly

influenced by the Chinese, it is so ingrained amongst the people that upon first contact

with a physician, the patient automatically holds out his arms for a pulse reading. It is

expected that a qualified physician, without any further questioning, will be able to tell

the patient something that is relevant to their condition. Failing to do this, patients

would have no faith in the doctor's qualifications. Nevertheless, despite its high regard

in traditional cultures, in dialectical materialistic TCM, the pulse is taken as being of

secondary importance with interrogation being primary.

The reason, obviously, is the illusive nature and the profound experience required to

accurately and effectively read the traditional pulses. While a traditional student would

have confined himself to following the model of his experienced teacher, today, with the

advent of publishing and communication, the study of pulses is further complicated by the

different styles and ways that it is taken. This is true not only between cultural lines

but even within each tradition between different schools of practitioners.

One of the most interesting statements of a highly respected Taiwan trained practitioner in

the San Francisco Bay area, Broffman is that the classical five phase pulse

correspondences on the wrist are only the norm but that, in clinical practice, the pulse

must be assessed on an individual basis with the actual organ locations on the wrist being

idiosyncratic for each individual.

The idea that the meaning of the pulses in terms of their location may be different for

each individual makes such a rational understanding of pulse diagnostics by a linear

thought oriented Western student an almost insurmountable leap of faith.

Despite the fact that pulse diagnosis is such a distinctive aspect of TCM diagnosis, it is

generally considered to be only about 40% reliable as a sole diagnostic method by most TCM

practitioners. It is the experienced masters who are able to accurate physiological and

lifestyle analysis based on pulse reading. Then, of course, considering that observation

of the patient's complexion, voice, manner is also able to provide a great deal of

information about the patient that may be either consciously or not noted by the

practitioner.

Unlike other diagnostic criteria, the pulse is very reactive and reflects the most current

state of the individual. The practice of taking the pulse on the radial artery of the wrist

was first expounded in the " Nan Jing " or " Classic of Difficulties " .

Before that the pulse was taken at nine different arteries, three on the head, three on

the hands and three on the legs, each reflecting the condition of the upper, middle and

lower burners, respectively. The triple burner refers to the organs that are located

within the upper, middle and lower parts of the body.

An old common saying concerning the difficulty of learning pulse diagnosis is: " In

the mind quite certain, under the finger unsure " . The idea is to unite the knowledge

of pulse taking with the actual process of feeling.

Three fingers are placed on three different positions beginning at the base of the wrist

with the index finger representing the upper warmer including the heart and lungs, the

middle fingers over the thenar prominence indicating the liver-gall bladder on the left

and the spleen-stomach on the right, the ring finger higher just proximal to the thenar

prominence with the kidney-bladder on the left and the triple warmer-pericardium on the

right.

Ideally the pulses are studied in the early morning taking about 15 minutes to study each

wrist. The patients are should be horizontal at the level of the heart. The breath of the

practitioner should be equalized and the mind stilled.

This later indication has two functions. Traditionally, without a second hand on a watch,

the speed of the pulse could only be measured by counting the number of beats per normal

respiration of the physician. Less than four beats per complete respiration indicates a

slow pulse while more than five indicates a fast pulse.

Another reason for stilling the mind is that pulse diagnosis is a subtle intuitive art

requiring an empty, open and receptive mental state. The fact is that the best pulse

diagnosticians combine a balance of rational observation with intuitive thought processes.

One great ancient clinician states that " The essential when watching a patient is to

preserve the mind and turn the thoughts within, to quiet the breath and turn inward

one's gaze, to keep the heart attentive - showing a line of fine inquiry: then one can

reach the spiritual light, search through all obscurities, and decide upon the question of

life and death, without one single mistake in a thousand cases. "

Most individuals are able to discern six relatively easily verifiable qualities which form

the basis for pulse study. These form the basis of the eight principles which allows one

to evaluate overall yin-yang homeostasis and metabolic function.

Following are the six basic pulse qualities:

WEAK OR EMPTY PULSE= an empty pulse may feel rather big but soft. The pulse may be

rather big but empty on slightly stronger pressure. This type of pulse signifies deficient

chi. A weak pulse can also feel thin or thready which signifies deficient blood.

FULL PULSE= this pulse feels full, big, rather hard and long. If the pulse is ful and

rapid it represent excess heat, if it is full and slow it indicates excess cold.

SLOW=COLD (less than four beats per complete respiration of the practitioner or less

than 60 beats a minute)-- a slow and empty pulse indicates empty-cold from deficient yang,

a slow and full pulse indicates full-cold from excess yin.

FAST=HEAT (more than 5 beats per respiration of the practitioner or 80 or more beats per

minute) surface or floating=exterior or acute disease or in rarer cases, it will appear as

floating for internal deficient conditions such as anemia, cancer or yin-wasting diseases.

This pulse is felt with a light pressure of the fingers, just resting on the artery.

DEEP PULSE= This pulse requires a deeper pressure to discern. It must be felt with a

heavy pressure of the fingers close to the bone. A deep and weak pulse indicates

deficiency of chi and yang, a deep and full pulse indicates stagnation of chi or blood in

the interior, or internal cold or heat.

FLOATING OR SUPERFICIAL PULSE= This is opposite of the previous. the pulse is felt with

a light pressure of the fingers just resting on the artery. A floating pulse indicates a

surface condition or in chronic disease, an exhaustion of the internal (yin) organs. A

floating and fast pulse indicates surface heat while a floating, slow pulse indicates

surface cold. Most often a floating pulse indicates a superficial acute

condition such as a

cold, cough or flu. If the pulse feels floating and slow one would prescribe warming and

stimulating diaphoretics such as cayenne pepper or ginger for instance. If it is floating

and fast, one might give relaxing diaphoretics such as lemon balm or catnip to relieve the

external condition.

If the pulse feels weak and deficient, one would not use eliminative or strong heat

clearing but rather emphasize the use of tonics. If it feels strong and full, one would

prescribe some type of clearing or eliminative strategy. If it feels slow which signifies

cold, one would prescribe warming and stimulating herbs; if fast, cooling and sedating

remedies. If it is floating one would use some type of surface relieving diaphoretic

herbs. If it is floating at the superficial level but empty at the deep level, it

indicates yin deficiency and would require yin-nutritive tonics. If the pulse feel deep

one would treat internal organ conditions. If deep and weak, it is a deficiency of chi and

yang and would require tonics. If it is deep and full, it indicates stagnation of chi and

blood and one would use emmenagogue herbs and foods that would promote blood circulation

or carminative herbs that promote circulation of chi.

Ayurvedic Pulse Diagnosis

Ayurvedic medicine attempts to correlate the pulse to the tridosha or three humours.

The pulse closest to the wrist which is taken by the index finger of the physician

corresponds to the vata-air or nerve oriented humour, the middle position taken with the

middle finger corresponds to the pitta-fire or digestive and circulatory humour; the third

position taken with by the ring finger corresponds to the kapha-fluid or bodily substance

humour.

The individual qualities of the pulse are described in terms of several animals. A vata or

air predominant pulse is compared with the movement of a snake or leech. Usually this

pulse feels faster and indicates indigestion, nervous problems, fever, etc. In Chinese

medicine it might be classified as yin deficient.

A pitta or fire predominant pulse is described as resembling the jerky movement of a frog,

a sparrow or a crow. Since these are generally a jerky or jumpy movement, it can indicate

insomnia, diarrhea, vertigo, hypertension, heat of the skin, palms, soles and burning

eyes.

A kapha or water predominant pulse is described as the movement of a swan, cock or

peacock. This is generally a slow pulse and indicates the presence of phlegm coughs, a

melancholic disposition, etc.

Western Pulse Diagnosis

Western medical diagnosis also recognizes various pulse indications that correlate with

disease factors. For instance:

A fast pulse indicates fever or inflammation

A slow pulse indicates inaction, weak digestion,

A small or weak pulse indicates general debility and possible anemia

There are literally dozens of other pulse indications that once were part of the

medical doctors training and are seldom used today in modern clinical practice except for

the speed.

Ayurvedic Medicine

Like Traditional Chinese Medicine, Ayurvedic Medicine, the ancient, traditional medical

system of India dating from around 2000 to 1500 BC, is based on an energetic model where

the native constitution of the patient, diseases, herbs, foods, remedies and treatments

are all classified as hot-cold, moist-dry, light-heavy, coarse-smooth, weak-strong, etc.

The entire system is based on what is called Tridosha or the Three Humours. In the sense

of Ayurveda, a 'dosha' means 'fault', a quality or substance that is controlled

neutralized by the elusive balance of each other.

Tridosha could be considered the distinctive and founding principle of Ayurveda and is

comparable in importance to Yin and Yang in TCM. It is interesting that as Ayurveda has a

dual system called " shiva-shakti " as part of its philosophy it is not strongly

emphasized as the Three Humours. In TCM, there is also a Three Humour diagnostic

classification, probably originating from India, while it is important to the system, it

is remains as only one approach to the classification of diseases and herbal treatments.

The early Greco-Roman humoural system expounded by Hippocrates to Galen, is probably more

closely based on the Ayurvedic model.

Ayurveda also has a Five Element model as a cornerstone of its theory. It is similar to

the TCM Five Elements and to the Greco-European Four Elements although there are

differences probably based on social, cultural and geographical characteristics unique to

each area and society. The Chinese Five Elements are Fire, Earth, Metal, Water and Wood;

the Ayurvedic Five Elements are Fire, Earth, Water, Air and Ether and the Greco-Roman is

Fire, Air, Water and Earth. The differences are even less if we consider that in both the

Chinese and Ayurvedic systems, Earth may not have been a distinctive element but was the

center for the outer four. We may also consider that the Chinese having Metal and Wood for

two of its elements is more an expression of its earth centered agrarian philosophy while

Air and Ether of Ayurveda perhaps is an expression of the more spiritually centered

philosophy so characteristic of ancient and modern India. In any case, the similarities of

the Humoural and Elemental systems of these three great cultures, strongly suggests that

there was a dynamic exchange of knowledge between all the great civilizations of the

ancient world and that the knowledge of India was probably a root for all of them.

In Ayurveda, diagnosis and treatment is centered around the understanding of Tridosha or

Three Humours which are: Vata or Air, Pitta or Fire and Kapha or Earth.

TRIDOSHA

Dosha

Quality

Physiological Action

Psychological Action

Vata

Subtle, Moving, Dry, Light, Cold, Rough, Quick

Motor and Sensory nerve functions, Respiration, Elimination

Movement, Creativity, Energy, Activation

Pitta

Hot, Light, Penetrating, Acidic, Clear

Digestion, Hunger, Metabolism, Thirst,

Vision, Desire, Joy, Memory, Extroverted

Kapha

Solid, Heavy, Oily, Immobile, Soft

Strength, Endurance, Growth, Regularity, Lubrication

Peace, Courage, Friendship, Generosity, Tolerance, Austerity

(Chart derived from Ayurveda: The Ancient Indian Healing Art by Gerson MD, Publ

Element Press)

Like TCM, the Ayurvedic doctor diagnosis by evaluation of symptoms and direct sensory

experience of touch (pulse and body palpation), listening (sound of voice and body

sounds), observation (the body and facial appearance and tongue) and smell (body odors). A

major difference between TCM and Ayurveda is that the latter places a greater emphasis on

constitution while TCM at least as it is currently practiced in China and the West is more

disease oriented. This difference offers the possibility of combining the two systems

effectively since at least in my opinion, Ayurveda is better at constitutional analysis

while TCM is better at disease diagnosis. In all cases the qualitative difference between

the two lies in their ability to produce the most reliable and effective

treatment result.

Ayurveda also expresses an important concept where " agni " or " life

fire " eventually vitiates tridosha leading to impaired digestion. This eventually

creates " Ama " which is an accumulation that begins in the GI tract and

eventually congests and blocks the " srotas " or channels (roughly equivalent to

the TCM meridians) involving the blood vessels, capillaries and lymph system. In

contemporary Western thought the is roughly equivalent to hypercholesterol and/or

hyperlipedemia which is considered an important predisposing condition leading to heart

failure and stroke, the leading causes of death.

Ama generally burdens the system and can impair various other systems that eventually

manifest as chronic diseases including gallstones, bronchitis, cancer, depression,

arthritis and so forth.

Like TCM, Ayurveda posits two general types of disease: exogenous, or diseases that

originate outside the body, and endogenous or diseases that are more chronic and originate

inside the body. While external climatic factors are the cause of exogenous diseases such

as fevers, colds and flus, Ama is the root of more endogenous diseases such as arthritis,

heart disease and cancer. When Ama accumulates in the digestive tract it can be observed

as a thicker than normal whitish coat on the tongue. In TCM, this is viewed as cold

stagnation which being an obstruction can eventually change to heat and a variety of

chronic inflammatory conditions. When it changes to heat, the coating will appear

yellowish.

Ama is viewed as the very death or " harbinger of misery, the cause of disease "

as described by Gerson. In contrast to TCM, which views various and particular

imbalances with no great overriding emphasis on one, Ama, in Ayurveda, becomes a general

cause for all chronic disease. The measures used to balance the doshas and eliminate Ama

in Ayurveda include lifestyle changes, dietary, herbal, physiotherapeutic and a system of

profound detoxification called " Panchkarmas " . " Panch " , meaning

" five " and " karmas " meaning " tasks " or " jobs "

relates to five methods that are systematically performed over a concentrated period of

time of say a month or more alternating 1. sweating, 2. oiling, 3. bleeding, 4. vomiting

and 5. enema.

This is mostly unique to Ayurvedic Medicine as most of these methods are not emphasized in

contemporary TCM practice although they do have some historical tradition of their use in

Chinese medicine. In any case, Panchkarma is another powerful adjunct therapy that can

easily be added to the practice of TCM or any other alternative healing practice with

great result.

Some important Ayurvedic herbal therapies is the use of Triphala which consists of three

myrobalans or fruits each having the property to regulate each of the respective

Tridoshas. Thus Amla (Emblic myrobalan) regulates fire or Pitta humour, Bibhitaki (Beleric

myrobalan) regulates water-earth or Kapha humous, Haritaki (Chebulic myrobalan) regulates

air or Vata humour. The overall effect is to clear the entire GI tract, regulate the

bowels and improve digestion and generally eliminate Ama from the GI tract. It is taken

for constipation or diarrhea and as a foundation for gently detoxifying the entire body

without causing and weakness or deficiencies. Guggul is another important Ayurvedic

preparation made from the purified resin of the guggul plant which is closely related to

myrrh. Guggul is specific for eliminating hypercholesterol and hyperlipidemia. It is

indicated for all circulatory and arthritic conditions.

Conclusion

As the West and various countries of the world adopt various traditional systems of

healing such as TCM and Ayurveda, as well as forming some diagnostic methods of their own,

we will see a tendency for these various traditions to be either corrupted or enriched,

depending upon one's point of view. In any case, the mutual influence between Western

scientific medicine and traditional medical systems such as TCM and Ayurveda is inevitable

and are being taught side by side in colleges in each of their respective countries. Just

as the more wholistic influence of traditional healing systems are a welcome perspective

to the practice of conventional Western medicine, so also should the influence of Western

scientific understanding be harmonious with the tenets of traditional medical systems.

Diagnosis will always be a challenge in every healing system. Because of this, intuition

will always be a vital part of practice of any good physician. Some Western approaches

such as kinesiology, radionics and in my opinion, iridology, focus more on the intuitive

side of diagnosis. As with any diagnostic method, the approach used is as good as the

practitioner. However, the concept of differential diagnosis, meaning to evaluate an

individual from different criteria should remain important as a check and balance to

lessen the possibility of error.

My approach is to evaluate all that is possible of the known and continue to extend

gradually to the stages of the more intuitive level of knowing. I think it is dangerous

for most practitioners to start from the intuitive or unknown to the known because at the

very least, a sound intuitive judgment must be dependent on a level of inner clarity that

may not always be present. In traditional systems such as pulse and tongue diagnosis there

are the verifiable pulses and tongue signs and there are the less verifiable indications

based on assigning individual organs or humours to areas within a half inch of each other

on the radial artery of the wrist or interpreting individual areas of the tongue as

belonging to specific organs of the body. Intuition is less obvious in modern

today's

technological Western medicine, however, the qualitative difference between one doctor and

the next may be the one with the best hunch.

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