My Full Recovery By TCM + TCM issues Q&A

[Hip]

TCM, on the other hand, doesnt group the symptoms into one overrriding "label/name" because it believes in part that alot of people with generally similar symptoms doesnt mean simplistically that everyone will be having the same illness and same treatment will cure all.

Neither does modern scientific medicine group similar symptoms under one disease name. In the case of ME/CFS, if you look at this list of diseases that can have similar symptoms to those of ME/CFS, you see that there are dozens of disparate illnesses on that list.

No decent doctor would jump to the conclusion that a patient has ME/CFS just on the basis of their symptoms; they first need to ensure the patients does not have some completely different disease that happens to exhibit similar symptoms to ME/CFS.

This is known in TCM as the principle of "Similar symptoms but Different Illness Origins, and Different Symptoms but Similar Underlying Illness Origins".

In scientific medicine, dealing with "similar symptoms but different illness origins" is termed "performing a differential diagnosis".

 

[Jenny]

Well there's a small world!


So from Giovanni Manioca's book: in the 1990s you were "immobile in bed" from ME/CFS, but were able to go back to work after two years of treatment taking the following herbal formulas:

Bu Zhong Yi Qi Tang (ginseng and astragalus combination), and
Minor Chai Hu, by which I am guessing Giovanni means: Xiao Chai Hu Tang (minor bupleurum decoction).

The ingredients of both these two formulas are given in this post.


And from your thread: you relapsed back into ME/CFS in 2004 after a minor skiing accident, but you later again attained remission from ME/CFS in 2012, after six months of fortnightly acupuncture, and taking twice daily a Chinese herbal formula given to you by the TCM partitioner Dr Dan Jiang in London. You say you don't know the name of this Chinese herbal formula prescribed by Dr Dan Jiang because it is written in Chinese.


One question I have: when you relapsed back into ME/CFS after the minor skiing accident, did you try taking the original herbal formulas that Giovanni Manioca gave you?

No that wasn't possible. The herbs that Giovanni prescribed were subtly changed each time I saw him and I had no record of the various combinations. And it probably wouldn't have been a good idea because when I relapsed in 2004 I had severe pain - an additional symptom which I hadn't had previously - and while in the 1990s I had been cold all the time, in 2004 I was often hot and sweating. So I would have needed a different prescription. Sadly Giovanni had moved to the US, so I couldn't go back to him.

(Just for the record, it's Giovanni Maciocia, not Manioca.)

 

[Hip]

So I would have needed a different prescription.

You are suggesting that your development of new symptom of being hot and sweating would suddenly stop Giovanni Maciocia's original herbal prescription working? I know that in ME/CFS, sometimes supplements or drugs that were helping patients at one point stop working at a later stage; but in general, if something was helping in the past, it is often going to continue to help.

You may even be on Giovanni's original herbal prescription right now (since you don't know what herbs are being given to you by your new herbalist). By the way, if you take a picture of the Chinese name of your current herbal formula, and upload it in a post on this thread, I should be able to get its English name, using online translation.

The herbs that Giovanni prescribed were subtly changed each time I saw him and I had no record of the various combinations.

That's not what Giovanni says in his book: he says he treated you with:

Bu Zhong Yi Qi Tang
Chinese name: 补中益气汤

Xiao Chai Hu Tang
Chinese name: 小柴胡汤

No mention of subtle changes in this herbal formulation (at least in the text from the book that @wintersky quoted). So I assume he does not consider those changes important.

Just for the record, it's Giovanni Maciocia, not Manioca.

Thanks, I corrected the error.




May I ask, what gave the your conviction to keep taking the Chinese herbs prescribed by Giovanni that eventually led to your significant remission from ME/CFS? Since it took 2 years before you obtained this remission, what kept you going? Or were there early encouraging signs of health improvements within the first few weeks or months taking these herbs?

I would find it hard to keep up the commitment to taking herbs if after a month or two there were no health improvements, especially if there were no guarantees of a positive outcome.

 

[invisiblejungle]

I have the second copy of Maciocia's book, published in 2008. I've extracted the chapter on CFS for those who are interested:

https://www.dropbox.com/s/qmm2a6wqlyfzivr/MECFS-ChineseMedicineMaciocia.pdf?dl=0

I've also uploaded the chapter on CFS from the book The Treatment of Modern Western Diseases With Chinese Medicine (2005) by Bob Flaws and Philippe Sionneau:

https://www.dropbox.com/s/btn8gzv788lc1ni/MECFS-ChineseMedicineBobFlaws.pdf?dl=0

 

[wintersky]

Hi All,

Hope you all had a good day/night.

Neither does modern scientific medicine group similar symptoms under one disease name. In the case of ME/CFS, if you look at this list of diseases that can have similar symptoms to those of ME/CFS, you see that there are dozens of disparate illnesses on that list.

No decent doctor would jump to the conclusion that a patient has ME/CFS just on the basis of their symptoms; they first need to ensure the patients does not have some completely different disease that happens to exhibit similar symptoms to ME/CFS.

In scientific medicine, dealing with "similar symptoms but different illness origins" is termed "performing a differential diagnosis".

Hi, Hip. Personally, I doubt that no medical tradition, be it Western or not, would survive by having a hair-tight exact list of symptoms under one category. There has to be a margin for differing illness symptoms under the same umbrella. Yes, i do also know that there is a principle of elimination being used to reject other illness possibilities via symptoms. I have had gone through quite some of those "rejection tests" myself on the Western side personally long ago. TCM also has a process of elimination for actual clinical diagnosis (and i believe other medical traditions do too).

The correct contextual meaning over what i said above that you should take away here is "relatively" speaking, TCM's illness symptoms range are strikingly much more "wider" for any given classification. The latter is what strikes alot of new beginners to TCM and it is possible that 2 different TCM doctors can come up with entirely different view of illness origins and hence, treatment method and focus.

@winterskyI am curious since you seem to be very familiar with TCM...........(.sorry if you have already covered this question) in your opinion if a person has a mixture of deficiency and excess..............which one do you treat first............or do you treat both simultaneously?

Hi, Tammy. I must say that i have very little knowledge of TCM frankly as i am not formally trained. However, given that you have Giovanni's book, you should, i believe notice him saying in the book that for mixture and excess conditions, the medical practitioner has to determine what is the predominant issue and secondary issue and severity of each. Both are usually treated simultaneously in actual clinical practice but there is a focus depending on the individual severity. For one, so far for the little that ive read of Giovanni's book, most of Giovanni's beliefs in his book reflects usual TCM beliefs and practice. I say most, because i have not read the entire book, but only small parts so far. In reality, in chronic cases where there is severe pain/serious symptoms that the individual has great difficulty enduring, there is equal focus naturally on treating both "deficiency" and "excess"(inclusive of secondary factors that cause pain).

Giovanni gives lots of clinical cases in his books and states reasons for his personal judgement via symptoms and symptom severity and personal analysis of the predominance of either "deficiency" or "excess" in specific clinical instances he says there. I'll give a personal instance for you to understand. I have a young family member with Arthritis symptoms (search for one of my previous post in this thread for more info). Symptoms include severe multi-days upper back extreme pain and muscle stiffness so bad she was almost immobile. Yes, her lower body had no symptoms but the situation was such that every step she walked caused immense upper body pain and stiffness. She limped badly to take every single step and was semi-immobile lying in bed most of the time for many days. She had to stop work during this few days naturally. The underlying predominant issue for her was very predominant and severe deficiency from my tongue analysis, but here the pain and muscle stiffness causing mobility problems was extreme, so we focused on "excess" (wind factors and blood stasis causing the problem here).

I gave her a decoction with a high dosage of blood-circulating + blood stasis dispelling herbs (and hence pain reduction too) such as Cinammon and Tumeric which eased the upper body and immobility symptoms tremendously within a day and she managed to resume work within the next day of decoction consumption. (caution: most blood circulating herbs etc have very harsh properties such as creating strong "internal heat" and cannot be consumed in the long run). The formula focus on "excess" was used for about a week and there was only minor symptoms of stiffness and numbness for which then the formula focused much more on tonifying "deficiency" with less focus on "excess" and has been so ever since then.

Personally, i find that Giovanni's book here is, relatively so reader-friendly for the average layman/non-TCM reader.

Wintersky

 

[wintersky]

Hi Jenny,

Good to know that you have at least found some kind of partial relief. It is indeed a small world, as Hip says.

That's not what Giovanni says in his book: he says he treated you with:

Bu Zhong Yi Qi Tang
Chinese name: 补中益气汤

Xiao Chai Hu Tang
Chinese name: 小柴胡汤

No mention of subtle changes in this herbal formulation (at least in the text from the book that @wintersky quoted).

Hi Hip, i know this is a long thread abut I believe i have said somewhere before in this forum that in usual clinical TCM practice, there are always minor continuous adjustments of the main formula on a constant (usually weekly) basis or so, according to the patient's individual various specific conditions such as for instance feeling internally "too cold or warm". Continuous minor adjustments to the formula (individual herb dosage, ratio, inclusion or deletion of herbs) are being made whenever one visits any TCM doctor. This is commonly known also by alot of people who visit TCM doctors. Giovanni doesnt mention minor continuous adjustments, because it is well understood by alot of TCM readers with rudimentary knowledge.

For instance, "Bu Zhong Yi Qi Tang"/Ginseng and Astragalus combination has 6 herbs out of 8 total, that are very "warm" in TCM thermal property, while the 2 remaining ones (Sheng Ma and Chai Hu) are only "slightly cold". In TCM terms, this formula is very "warm" and only suits people who are "neutral" or "cold". People with "warm" constitution might take it, but very cautiously with continuous adjustments of herbal dosage, ratio and inclusion of additional herbs to balance the "overall warm formula nature". For people of current "cold" or "neutral" thermal constitution, taking a "warm" formula can, over a period of time, cause them to become "warm" and in turn exhibit warm" symptoms.

"Warm" symptoms can to name afew, include fever, cough, sore throat, sweating, feeling too "hot" to sleep at night. In TCM, getting an individual with "warm" thermal property currently, to take a strongly "warm" formula and without further balance and continuous adjustment especially, is a major violation of TCM principle and can lead to dangerous additional illness symptoms.

For the record, it is commonly only mentioned as Ginseng in the Ginseng and Astragalus Formula, but what is not being said here is that only people with sufficient TCM background will understand that the herb really mentioned here is not American Ginseng/Xi Yang Shen, but Korean (Gao Li Sheng) or China Ginseng (Ren Shen) which has been treated differently by steaming and sun-drying repeatedly which gives it a very "warm" property. The different Ginseng treatment and Ginseng Sub-species for Korea/China Ginseng gives vastly enhanced properties (especially efficacy). The Ginseng Quality called for here is not basic soup grade quality that is commonly consumed in Asia restaurants/eateries but must at least be of moderate price range. Really wild Ginseng would be ideal here as efficacy is even better, but for a formula that is consumed on a regular basis, 100% wild ginseng is too exorbitant for most people, so moderate to high quality cultivated ginseng is used.

Wintersky

 

[Hip]

Continuous minor adjustments to the formula (individual herb dosage, ratio, inclusion or deletion of herbs) are being made whenever one visits any TCM doctor.

Yes, but is there any evidence that these minor adjustments are of any healing importance? They might just be for comfort purposes. For example, I may take an aspirin if I have a cold or fever, but that aspirin does not help me get rid of the cold; it just reduces my fever symptoms, and makes me feel better. It has no healing action with respect to the cold. The same may be true of these minor formula adjustments in TCM.

@Jenny suggests the minor formula adjustments are of critical importance; but is there any evidence for this? What do TCM practitioners say about this issue?

And while we are on this subject, are there any published studies that show the TCM concepts of dampness, dryness, heat, cold and wind have practical healing utility? For example, are there any studies in which look at the outcomes of treating patients with TCM by taking these dampness etc concepts into account, versus ignoring them? Some practices can be handed down for thousands of years; but that does not necessarily mean there is any truth behind them.

 

[wintersky]

Hey Hip,

@Jenny suggests the minor formula adjustments are of critical importance; but is there any evidence for this? What do TCM practitioners say about this issue?

.. Yes, but is there any evidence that these minor adjustments are of any healing importance?

Statistically, testing a secondary order effect here (minor formula adjustments) would require a big sample size to reach sufficiently adequate asymptotic convergence. If your idea of evidence relates to a specific numerical number, you have to search yourself online as i do not know if it exists.

With regards to minor adjustments and their healing importance, TCM's theoretical/structural outlook is that they can have up to a major influence. In TCM's framework, there are multiple ways this happens:

1. Basic Western Science says that heat applied to objects like gases for instance, causes expansion and constant movement while Water particles contracts and slow down at low temperatures and even stop altogether ie. freeze at sufficient temperatures. In TCM, if a thermally "cold" person takes a "cold" formula, one possible consequence might be congealing of blood. When blood congeals and slows down, very few nutrients might be absorbed by the bloodstream from the stomach's digestion of food, due to the slow blood flow.

The opposite scenario of a "warm" person taking a "warm" herbal formula can also be seen in the analogy of over-operating machinery beyond limits with too much energy input, causing overheating and machinery breakdown. basic science says that high energies causes heat in an environment. In the human case, blood and energy flows too fast and the person might feel very "warm" symptoms such as a fever which as everyone knows, can cause irreversible brain damage if temperatures are high enough. Excessive "warmth" also causes moisture issues as water dries up and water is needed to cool down the machinery or body. Take the case of an actual car which needs sufficient water to prevent an overheated engine which might break down or stop operating to cool down.

Hence, for instance, taking a "warm" formula for a "warm" person without adjustment and inadvertently causing "warm" symptoms such as a fever means that one needs to stop taking the formula currently or else face a potentially life-threatening situation.

2. Human conditions arent static and change over time. Over a few days while taking a formula, an individual might get acute illness symptoms from environment such as a flu after being near a person with flu. TCM view is that most tonification of blood or energy cannot be taken while there is rapidly developing acute conditions as it might "tonify" the acute pathogen as well. In such cases, this acute pathogen will be very difficult to eradicate later over time if it is allowed to grow even more rapidly, for instance. If tonification has to be forcibly used in dangerous scenarios where the patient is very weak/immediately life-threatening, there are herbs added to eliminate the acute pathogen concurrently. It does not make sense to not do any minor adjustments here if by tonification, one set of illness symptoms is reduced, while another new symptom set increases.

3. There are also alot of other varied conditions that can happen here that prevents absorption and healing efficacy. For instance, too much "cold" herbs can lead to possible diarrohea after some time. With diarrohea, most current dietary intake is lost. Here, in TCM, herbs with astringent effect such as Schisandra are taken to stop fluid loss. In the opposite case of too much heat, the brain might partially malfunction with heat from fever or the body has profuse sweating heat and clearing herbs items like Gypsum Fibrosum or moisturizing herbs like Radix Ophiopogonis are taken together. There are very specific multiple criteria for the usage of the above herbs mentioned as each of them has different organ effects and effect levels etc etc.

And while we are on this subject, are there any published studies that show the TCM concepts of dampness, dryness, heat, cold and wind have practical healing utility? For example, are there any studies in which look at the outcomes of treating patients with TCM by taking these dampness etc concepts into account, versus ignoring them? Some practices can be handed down for thousands of years; but that does not necessarily mean there is any truth behind them.

In the first place, in medical testing, designing a test of a generalized concept directly itself is extremely tough. For instance, for "dampness", imagine the difficulty of gauging via tongue analysis, thick tongue coating characteristic and the swollen tongue characteristic. There is also a technology issue involved here in objective, accurate measurement and putting them down into numbers.

Testing a concept via precise formula effect is what is more practical and being commonly done. Personally, i have not intentionally spent time to search for articles on what you mentioned specifically. You would have to go dig it out on your own. That being said, i have encountered by chance for instance, some "blood stasis" studies. The blood stasis overview link below might be a good start-point to link to other clinical studies. There were 52 clinical studies done on blood stasis as said.

http://www.hindawi.com/journals/ecam/2015/316872/

Yes it is true that practices handed down for ages does not necessarily mean there is any truth. Given extensive clinical usage of herbs in Asia's significantly big population for thousands of years, personally, i recall having read somewhere revisions to specific herbal knowledge of effects and actions in modern times, but for a very small number of herbs. For the concepts of pathogenic factors (cold, wind etc), the ideas expressed here still stand the same as long ago. The revisions that i know of are on better combined treatment via multiple herbs than before. Im not a scholar of such a complicated subject on thousands of years of Eastern Medical History so take my words with a big grain of salt and do the actual research yourself or find an actual scholar.

Wintersky

 

[brenda]

Some practices can be handed down for thousands of years; but that does not necessarily mean there is any truth behind them.

In trying to understand TCM, from what I have read myself, of this system and of macrobiotics, we must forget the western understanding of medicine. For example, the idea of a doctor to us is someone we go to when we are sick for a remedy. In TCM, a doctor is a person who maintains ones health and if he does not achieve that, then he is sacked. Of course we in the west go looking for help when we are sick as we do not understand the concept of maintaining health while we have it in general. Of course athletes etc do understand this.

So the practises which were successful were handed down through many generations, through observation and the dedication of the practitioners. The proof of the pudding has been in the eating. I am sure that it is necessary to try a few practitioners before we find the one that can help us in complicated conditions like this one. I wonder if there are any pointers please to help in our search?

I have used accupuncture on two occasions and found them extremely helpful and am considering trying it again. My only worry is finding a practitioner who is not suitable for me and having my condition worsening because of my sensitivities to everything including Chinese herbs.

 

[Jenny]

You are suggesting that your development of new symptom of being hot and sweating would suddenly stop Giovanni Maciocia's original herbal prescription working? I know that in ME/CFS, sometimes supplements or drugs that were helping patients at one point stop working at a later stage; but in general, if something was helping in the past, it is often going to continue to help.

You may even be on Giovanni's original herbal prescription right now (since you don't know what herbs are being given to you by your new herbalist). By the way, if you take a picture of the Chinese name of your current herbal formula, and upload it in a post on this thread, I should be able to get its English name, using online translation.





That's not what Giovanni says in his book: he says he treated you with:

Bu Zhong Yi Qi Tang
Chinese name: 补中益气汤

Xiao Chai Hu Tang
Chinese name: 小柴胡汤

No mention of subtle changes in this herbal formulation (at least in the text from the book that @wintersky quoted). So I assume he does not consider those changes important.





Thanks, I corrected the error.




May I ask, what gave the your conviction to keep taking the Chinese herbs prescribed by Giovanni that eventually led to your significant remission from ME/CFS? Since it took 2 years before you obtained this remission, what kept you going? Or were there early encouraging signs of health improvements within the first few weeks or months taking these herbs?

I would find it hard to keep up the commitment to taking herbs if after a month or two there were no health improvements, especially if there were no guarantees of a positive outcome.

Hi Hip

I think wintersky has explained how adjustments in formulations are made. It involves both changes in the types of herbs in the mix and changes in the amounts of each within one prescription. I don't have any details of my current herbs I'm afraid, and again these change a lot. Sometimes the focus is on 'dampness', at other times it's on 'chi', and sometimes 'heat'.

Also, the herbs are just part of the treatment. I had and still have regular long acupuncture sessions, sometimes with moxa.

It took a few months to see improvements with Giovanni - I was still having bad spells, but they gradually became less frequent and less severe. I think that with ME one needs to try things for longer than just a few months anyway. Also I felt that Giovanni really understood what I was going through, within the paradigm of TCM. He seemed an extremely skilled practitioner. He could tell what symptoms I was having at any one time just by looking at my tongue and feeling my pulses, without me saying a word. So it was my confidence in him that motivated me to continue.

When I relapsed in 2004, by then he had moved to the US, but I contacted him to ask for his recommendations for practitioners in London. I saw three over the next few years, but had no improvement. I've struck lucky with my current one, though it did take over 6 months to see any improvements.

As I've said before, I'm still sceptical of TCM, and of course it's not possible to attribute my improvement to this treatment. I do think the skill of the practitioner is absolutely crucial. Both Giovanni and my current TCM doctor had extensive training in China - I wouldn't bother going to someone who hadn't had years of training and experience.

 

[Valentijn]

I have the second copy of Maciocia's book, published in 2008. I've extracted the chapter on CFS for those who are interested:

https://www.dropbox.com/s/qmm2a6wqlyfzivr/MECFS-ChineseMedicineMaciocia.pdf?dl=0

Excellent! I'm seeing a big problem here already, in the section explaining the Western medical perspective:

In the fourth model, there is an interaction among external insult (virus), depression and fatigue in a closed circle without being able to identify what is primary (Fig. 41.5). This last model is close to the Chinese medicine view of body and mind.

It should be obvious that 1) depression is not a symptom of ME, and most patients do not have it, and 2) the use of "fatigue" evidences a complete lack of comprehension of the disease. The book also favors Western definitions and descriptions which are not in use by anyone, based on the work of authors I've never heard of.

The author also states:

Modern Chinese medicine books do not have chapters on Chronic Fatigue Syndrome: therefore, the theory of Chronic Fatigue Syndrome presented below is the result of my experience in treating many patients suffering from Chronic Fatigue Syndrome over several years.

So he is not operating from methods developed over thousands of years, but rather is operating based on his own subjective perceptions. This is a problematic approach, as it especially subject to unconscious bias.

And how CFS supposedly becomes CFS after an infection:

What causes the formation of a residual pathogenic factor? Why are some invasions of Wind expelled without any further consequence and some are not? In my opinion, there are five main causes that favour the formation of a residual pathogenic factor:
• Weak constitution
• Exposure to cold, dampness or wind too soon after an invasion of external Wind
• Irregular diet
• Not taking care during an acute illness
• Antibiotics (they neutralize bacteria but they donot resolve Dampness or Phlegm. On the contrary,
they promote Dampness or Phlegm by weakening Stomach-Qi).

So why doesn't everyone end up with ME when they're eating crap, not resting during illness, and going out into the cold after being ill? It's the American lifestyle in a nutshell right there. And conversely, why didn't those of us who eventually developed ME instead develop it earlier when exhibiting exactly the same behavior during previous viral infections?

The metaphor of a burglar is used to describe the activity of a pathogen. Supposedly the burglar breaks in, and everything is fine once we get him out. But if he's killed then his body (the bacteria) somehow continues to be a "residual pathogenic factor". Chinese herbs are touted as being superior in that they supposedly help the immune system to do its job instead of killing the bacteria and leaving its polluting corpse behind.

This is quite a bizarre claim. How does the author think that the immune system gets rid of bacterial infections? By scaring them into running out of a bodily orifice? The immune system kills bacteria, just as antibiotics do. And supporting the immune system isn't going to work very well if the immune system is doing the wrong things in the first place.

And the author's view of CFS, plainly stated:

I personally consider the essential manifestations of true Chronic Fatigue Syndrome to be in four main groups:
1. A pronounced muscle fatigue and ache
2. Poor memory and concentration
3. Exhaustion
4. A persisting, intermittent, general flu-like feeling.

No mention of PEM. I guess there's not an element or herb for that?

Case Study #1 doesn't sound at all like ME to me:

After the meningitis she felt extremely tired and experienced a feeling of heaviness and ache of the limbs. She also felt hot and thirsty. On interrogation, she said she experienced a sticky taste in her mouth and had an excessive vaginal discharge. She also had some abdominal pain and her stools were always loose. Her memory and concentration were poor and she sweated at night sometimes.

Case Study #2 could very well be OI, not ME:

A 53-year-old woman complained of exhaustion, muscle fatigue and ache, a quivering of the muscles, poor memory and concentration, a feeling of muzziness and heaviness of the head and headaches. All these symptoms started after a viral infection 3 years previously. . . .

Cast Study #3 can also explained entirely by OI:

A 33-year-old man had suffered from exhaustion for the previous 4 years. He felt especially tired after eating, he sweated at night and his limbs felt heavy, tired and achy. He also experienced dull headaches when tired. . . .

Case Study #4 hasn't even been sick long enough to be diagnosed with ME/CFS. Post-Viral Fatigue Syndrome is quite likely:

A 28-year-old woman complained of total lack of energy, aches and fatigue of the muscles for the past 3 months. . . .

Case Study #5 somehow has had CFS for 2 years, but only had consistent viral symptoms for the past two months. So it sounds like two years of chronic fatigue followed by two months of post-viral fatigue syndrome:

A 31-year-old man had suffered from Chronic Fatigue Syndrome ever since he caught a viral infection 2 years previously. He had had another viral infection 2 months before he came for treatment, from which he had not recovered and experienced severe muscle fatigue and ache. . . .

Case Study #6 again is of insufficient duration and completely inapplicable symptoms:

A 59-year-old woman suffered from exhaustion, weakness and aching of the muscles, weight gain and craving for sweets. All her symptoms had started 5 months previously, soon after returning from Thailand.

Case Study #7 again sounds pretty different from ME:

Case history A 22-year-old man had been suffering from Chronic Fatigue Syndrome since the age of 8 . . . . He came for a consultation when he was 21. At that time, his main symptoms were as follows. • Muscle ache • Extreme fatigue • “Brain fog” • Dizziness • Blurred vision • Insomnia, irritability • Poor memory and concentration • Mouth ulcers • Abdominal fullness and pain • Thirst, dry lips

Case Study #8 ... no idea, but it's not ME:

A 47-year-old woman had been feeling extremely exhausted for the previous 10 years. She had had acupuncture for a long time but this did not help her consistently. Her other symptoms included: a feeling of heaviness, a feeling of heat, hot feet in bed at night, thirst, slight ache in the muscles, insomnia and scanty-dark urine.

Case Study #9. This is getting ridiculous:

An 11-year-old girl had come down with a sore throat and tonsillitis 2 months before she came for treatment.

Case Study #10. Duration too short, post-viral fatigue syndrome at most:

A 13-year-old girl had had an influenza-like viral infection 4 months previously. This persisted and was not treated for 1 month, after which she was given antibiotics.

Case Study #11. It might actually be ME! I've changed the paragraphing so it makes slightly more sense:

A 40-year-old woman had been suffering from what had been diagnosed as Chronic Fatigue Syndrome for the previous 6 years. All her symptoms started after contracting influenza during her second pregnancy. During this acute infection she felt completely exhausted and could hardly walk.

She never recovered after this infection and continued to feel exhausted, shivery and experiencing a general flu-like feeling. Her muscles ached and felt very quickly fatigued after the slightest exercise. Her head felt muzzy and her short-term memory was poor.

Four years after the initial infection she contracted a new one that severely aggravated her symptoms. She had a pain in the spine and occiput, a numbness of her face, headaches, sore eyes, breathlessness, palpitations, a weakness of the right arm, diarrhea, and weak legs. She felt shivery and sweated.

This condition lasted for 5 months during which time she was in bed most of the time. At the time of her consultation these symptoms had disappeared but she still felt exhausted and shivery and had a flu-like feeling most of the time. The ache in the muscles had subsided while the fatigue remained.

Case Study #12. Sounds like a mood disorder + OI, perhaps:

A 59-year-old woman had been diagnosed as having had Chronic Fatigue Syndrome for the previous 4 years. She could not say exactly how it started. Her main symptoms when she came for treatment were: feeling “flat”, constipation, “racing feeling” with palpitations, ache and fatigue of muscles after the slightest exertion, exhaustion, “lacking energy and incentive”, passing water three times a night, backache, dizziness, tinnitus, feeling cold, breathlessness with palpitations, cold hands, flu-like feeling like a “burning coldness”, prone to catching colds after a shower or washing hair.

It sounds like approximately 1 out of every 12 of the "CFS" patients he sees actually have something resembling ME/CFS. So he's probably not a good source for theories about ME/CFS diagnosis, pathology, or treatment.

My general impression of TCM from the book is that there is a lot of philosophy or mysticism involved, and little science. Much as with homeopathy and similar treatments, I think that's just fine for people who desire that sort of treatment. And as with homeopathy, I get a little annoyed when baseless scientific claims are made or implied.

It's one thing to say that Chinese Medicine doesn't operate in the same framework as Western Medicine, but there is no Chinese Science versus Western Science. There's just science, and I'm not seeing any of it here. The Chinese Medicines explanation fall quite flat when they try to venture into scientific explanations and justifications, and it's probably much more honest and less provocative to simply understand and describe those unscientific mechanisms as beliefs or philosophies.

 

[Helen]

It's one thing to say that Chinese Medicine doesn't in the same framework as Western Medicine, but there is no Chinese Science versus Western Science. There's just science, and I'm not seeing any of it here. The Chinese Medicine explanation fall quite flat when they try to venture into scientific explanations and justifications, and it's probably much more honest and less provocative to simply understand and describe those unscientific mechanisms as beliefs or philosophies.

This year´s Nobel Prize in medicine goes to a Chinese researcher, shared with two others, who studied Artemisian in TMC as medicine for malaria....
http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/press.pdf

http://www.nature.com/nm/journal/v17/n10/full/nm.2471.html

 

[Valentijn]

This year´s Nobel Prize in medicine goes to a Chinese researcher, shared with two others, who studied Artemisian in TMC as medicine for malaria....
http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/press.pdf

I'm not denying that herbs (Chinese or otherwise) can be effective. But Traditional Chinese Medicine is not employing the scientific methodologies necessary to show effectiveness. And the manner in which those TCM therapies are being phrased and explained also have no scientific basis.

They (Western European, Japanese, and Chinese researchers) received a Nobel Prize for showing the efficacy of the herb in a scientific context. Not for explaining that the herb has been credited with curing Latent Heat or whatever for the past 4,000 years. They engaged in the scientific research and testing of a hypothesis, and discovered why the traditional remedy was only inconsistently working. And then they found a way to make it work consistently.

The Giovanni book exhibits no such interest in science.

 

[Helen]

I totally agree @Valentijn. I just couldn´t resist posting about how ancient TMC might well contain treatments that could be very useful in modern medicine when investigated by valid scientific methods. I hope there will be more substances that will be proved beneficial to humans. In my opinion Eastern medicine too often is dismissed due to quite another terminology. I learnt from a TMC doctor some of their thinking and pretty much is similar to Western medicine but expressed quite differently.

 

[msf]

I believe that Chinese medicine is like kung fu - it works well in some situations, but the explanation for why it works isn´t the correct one.

 

[msf]

I was quite interested in trying Huang Qin because it inactivates Nf-KB, but the chinese medicine doctor I asked about it wanted to give me something else for one of the traditional reasons. I would love to find a chinese medicine doctor who knows about the pharmacology of the herbs.

 

[wintersky]

Valentijn,

You are too new to TCM and there are alot of erroneous misinterpretations on your part, which is understandable and happens all the time with English TCM books. Giovanni's books are very user-friendly for the non-TCM person, but i would say that it is naive to think that one can read a TCM medical text totally correctly as intended without a certain amount of pre-requisite TCM knowledge. it is also obvious that you do not take the effort to read through the entire thread before asking very detailed questions for which the answers can be directly/indirectly found within.

Giovanni also tries his best to present a comprehensible English understanding of TCM to Western readers, but as with every translation of such a complex system, there are way too many things that are unexplained for the sake of simplicity. Another difficulty here in correct language and concept translation is that there usually is a loss when translating Chinese words which have many nuances to Western words.

It should be obvious that 1) depression is not a symptom of ME, and most patients do not have it, and 2) the use of "fatigue" evidences a complete lack of comprehension of the disease. The book also favors Western definitions and descriptions which are not in use by anyone, based on the work of authors I've never heard of.

For starters, the "depression" here does not refer to the Western Concept of Depression. It refers actually more to "Shen"/Spirit. The word "depression" mentioned here refers to the overall mental health of a person.

So he is not operating from methods developed over thousands of years, but rather is operating based on his own subjective perceptions. This is a problematic approach, as it especially subject to unconscious bias.

He is summarizing his personal Clinical Experience and is frank about this. While it is his subjective perceptions, it can trigger new possible approaches by other researchers to pave the way for better disease understanding. If you feel that there's no worth in his subjective personal experiences totally, you have the personal subjective option to not read it too.

So why doesn't everyone end up with ME when they're eating crap, not resting during illness, and going out into the cold after being ill? It's the American lifestyle in a nutshell right there. And conversely, why didn't those of us who eventually developed ME instead develop it earlier when exhibiting exactly the same behavior during previous viral infections?

Even for 2 people with 100% same diet and same 100% physical life experience, there is also the "Congenital Jing" issue whereby parents via their genes and characteristics pass different varying health constitutions to us. Just as some people are born perfectly healthy, there are also others born with genetic defects. Besides, even if it's a hectic lifestyle, everyone still has a slightly varied lifestyle, different environmental conditions (tropical weather for me here) and different psychological thoughts.

And conversely, why didn't those of us who eventually developed ME instead develop it earlier when exhibiting exactly the same behavior during previous viral infections?

Im no god here. But my personal viewpoint is that of bacterial mutation over time.

The metaphor of a burglar is used to describe the activity of a pathogen. Supposedly the burglar breaks in, and everything is fine once we get him out. But if he's killed then his body (the bacteria) somehow continues to be a "residual pathogenic factor". Chinese herbs are touted as being superior in that they supposedly help the immune system to do its job instead of killing the bacteria and leaving its polluting corpse behind.

This is quite a bizarre claim. How does the author think that the immune system gets rid of bacterial infections? By scaring them into running out of a bodily orifice? The immune system kills bacteria, just as antibiotics do. And supporting the immune system isn't going to work very well if the immune system is doing the wrong things in the first place.

If you read Giovanni's section correctly, what he said there was that TCM and it's herbs boost up the immune system gradually over a long period without side-effects instead of directly killing bacteria with side-effects like Antibiotics does, which ive quoted 4 scientific studies expressing the side-effects in post #36:

http://forums.phoenixrising.me/inde...y-tcm-tcm-issues-q-a.40176/page-2#post-647326

In the first place, if you think hard enough...... one possibility is the immune system might be over-reacting to defend the body because of a certain "deficiency" condition.... In the "deficiency" condition, the human body or immune system might over self-adjust antibodies levels on its own when dangerous pathogens are detected..... Hence, when the underlying "deficiency" is corrected, the immune system over-adjustments might reduce.

An American study reported abnormalities in cortisol levels in a group of 30 Chronic Fatigue Syndrome sufferers. They had a mild decrease in blood cortisol levels. Low levels of cortisol alter the immune function to allow exaggerated allergic reactions and the reactivation of dormant viral infections (= Latent Heat) such as Epstein–Barr virus.

-Giovanni Marciaco, pg 1144, The Practice Of Chinese Medicine

You are doing too much selective reading without reading patiently and this shows when you ask questions for which Giovanni has already offered an explanation by quoting a Scientific study within that chapter.

It sounds like approximately 1 out of every 12 of the "CFS" patients he sees actually have something resembling ME/CFS. So he's probably not a good source for theories about ME/CFS diagnosis, pathology, or treatment.

In the first place, there is no "exact" definition of CFS in TCM since everything is grouped according to an individual analysis of Pathogenic factors (wind, damp, cold etc). If his ME/CFS definition is too broad for you in your personal symptom interpretation of ME/CFS, then just read the few cases where he treats patients who have been diagnosed under Western Medical Outlook.

Now, afew things. Alot of the things you are asking here have already been answered or talked over in previous posts, or are available in the copy of Giovanni's CFS chapter which you quote from. I would appreciate if you take the effort to read the entire thread from start before you ask repetitive questions and create further self-confusion without deeper correct understanding. Thanks

Wintersky

 

[msf]

I actually speak Chinese (not bragging, took me much longer than it should have, and still not perfect), but I find it hard to believe that you have to speak Chinese to understand Chinese medicine properly - no one says you have to be able to speak English to understand Western medicine. The claim that you need to speak the language to understand the concepts reminds me of religion, not science.

 

[Valentijn]

For starters, the "depression" here does not refer to the Western Concept of Depression. It refers actually more to "Shen"/Spirit. The word "depression" mentioned here refers to the overall mental health of a person.

He was referring to a model used by a Western practitioner. In which case they meant depression when they said depression. Perhaps the author is roughly equating the Western concept of depression to a broader TCM concept. But the fact remains that he is endorsing a model where mental health is a very important part of the disease. Significant evidence exists to the contrary.

While it is his subjective perceptions, it can trigger new possible approaches by other researchers to pave the way for better disease understanding. If you feel that there's no worth in his subjective personal experiences totally, you have the personal subjective option to not read it too.

I was simply pointing out that his perceptions do not constitute a reputable source of information. That was not an insult - it's a fact of life, and it's the reason that there are scientific procedures that should be used to sidestep our unconscious human biases. And I most certainly am allowed to rationally critique the methods which he is using to reach his conclusions.

But my personal viewpoint is that of bacterial mutation over time.

This strikes me as another attempt at a pseudo-scientific explanation. I don't believe there is evidence of such a process causing a chronic illness to potentially start at a later time point. Can you provide an exact mechanism by which this could occur?

In the first place, there is no "exact" definition of CFS in TCM since everything is grouped according to an individual analysis of Pathogenic factors (wind, damp, cold etc). If his ME/CFS definition is too broad for you in your personal symptom interpretation of ME/CFS, then just read the few cases where he treats patients who have been diagnosed under Western Medical Outlook.

It's not "my" ME/CFS. It's ME/CFS. It has internationally accepted criteria which are used by most ME/CFS patients, researchers, and clinicians around the world. If he wants to cure more generic fatigue or dampness, then he should not purport to specifically be treating ME/CFS.

While ME/CFS may potentially be a subset of fatigue or dampness, it is a very distinct subset with distinct symptoms and distinct pathologies. He has made a big error by labeling his chapter as dealing with a specific Western illness, when he is really addressing something much, much broader, where fewer than 10% of the patients in that broad category actually have ME/CFS.

 

[wintersky]

Hi Msf,

Nowhere i did mention that one has to speak actually Chinese to understand Chinese Medicine properly. One issue i was saying was that there are alot of wrong translations of English TCM books in alot of cases by their authors. What i did not mention is that personally, i think it happens due to various reasons such as the inability to write lengthy and more precise definitions without exceeding publisher concerns about page count etc. I am also referring to the fact that some authors choose the easy way out in expression of concepts while translating or writing.

Giovanni also tries his best to present a comprehensible English understanding of TCM to Western readers, but as with every translation of such a complex system, there are way too many things that are unexplained for the sake of simplicity. Another difficulty here in correct language and concept translation is that there usually is a loss when translating Chinese words which have many nuances to Western words

I have no idea how you came up with the idea that i said that one must understand Chinese to understand Chinese Medicine. Dots. As you can see from my quote, i have only expressed that there are difficulties in translation is all, not Mission Impossible LOL! Personally i have no idea if Giovanni Marciaco as an Italian knows Chinese or not, but i have no doubt that he has a way more advanced understanding of Chinese Medicine than me, a Native Chinese speaker.

Hope the above clears up the miscommunication here. Good night all

Wintersky