by Malia Kirby

So...this all started out as what was supposed to be a "quick" rant on tradition in our field, which then promptly turned into a monster of a post.  If you missed Part One, CLICK HERE to read it now.

Citation Needed

This one’s a doozy, and there are three different areas that need to be addressed: spreading misinformation, using appropriate citations and  references, and falsified credentials.

Spreading Misinformation

Honestly, I don’t think this is intentional and when it does happen, I think it’s understandable on how and why it occurs, even if it is unfortunate.  In fact, let’s take a quick poll: raise your hand if you’ve ever had an instructor tell you that wind cold changes into wind heat.  I know I’ve had more than one teacher make such claims, as well as a number of colleagues.  I’ve even had colleagues “prove” that’s the case, citing Liu Wan-su, but that’s based on an assumption similar to claiming that two times three equals five.  It’s reading something quickly and not thinking it through or understanding what’s right in front of you.

...

Let’s take a look at Liu Wan-su’s actual opinion: The six qi all transform into heat over time.  So, if cold turns into heat over time, this means that wind cold turns into wind heat over time, right?  Wrong!  If you think about it, you’ll see we’ve gone off course.  What does cold do by its very nature? Cold slows things down.  Cold contracts and congeals.  Cold stagnates and, without treatment, obstructs the free flow of qi and blood.  What happens when you have untreated stagnation or obstruction?  Friction and pressure build up, creating heat.  There’s where the heat is coming from, resulting from the natural effects of cold, and is NOT the equivalent of a wind heat pathogen, and the treatments are considerably different.  That’s one of the reasons why Xiao Chai Hu Tang, a formula originally written to treat wind cold moved into the shao yang, is also regularly used as a harmonizing formula.  Plus, let’s not forget that the collection of tai yang bing formulas also include a number of additional prescriptions to use when wind cold has been treated improperly.  At first, I figured those might have been a bit high-strung of Zhang Zhong-jing…until I spent an entire cold & flu season prescribing them to patients who had originally been given Yin Qiao by another practitioner in the health collective I was with at the time.

Here’s another example: raise your hand if you’ve been taught that eating raw vegetables causes spleen yang xu.  I’m included in that one, too.  Now raise your hand if you eat raw vegetables regularly and don’t have spleen yang xu.  Yup, me too.

Where did this one come from?  Microbiology.  Here in the United States, one may safely eat raw fruits and vegetables.  Over in China, however, that’s not the case.  You see, the Chinese have fertilized their fields for centuries using “night soil (1),” aka human fecal matter collected during the nighttime hours.  What’s one of the most commonly transmitted infections from fecal matter in food?  If you also said E. coli, you get a gold star and a standing ovation.  And, what might the symptoms of an E.coli infection be?  Abdominal cramping, bloating, and pain, nausea, loss of appetite, and watery diarrhea.  Fever does not necessarily need to be present and the stools aren’t foul smelling, at least as far as stool smells go, but it’s still dookie.  Might those symptoms sound familiar?  It certainly sounds like a spleen yang xu pattern to me.

Now, am I coming down on all of our instructors for continuing to teach and spread misconceptions?  Absolutely not!  It's not their fault for teaching their students exactly as they were taught by their own instructors.  You can't teach what you don't know and we all assume that we wouldn't be taught a piece of information if it wasn't true.  In the case of the E. coli example, there's certainly a nugget of truth there, it just isn't the WHOLE truth as that's pretty context dependent to fully understand what's going on.  In the first example, well, that's just one little piece in a very strong case supporting a continuation of study post-graduation.  Crack open the old texts and take a look around, but don't stop there!  In order to understand within context, it helps to learn about the culture and--I know this is beating a dead horse here at the Pop--but learning the language doesn't hurt, either, and not just to translate from journal articles and ancient texts.  Knowing the language helps you to wrap your head around the neurolinguistics of a completely foreign culture.  Chinese may have an information density similar to English, but what that information focuses on isn't even remotely close to what we're used to.  It's an entirely different way of thinking and perceiving the world around you.  For more on this, CLICK HERE, HERE, and for even more...HERE.

Check Your References

Social media has become quite the interesting phenomenon in our field.  A few weeks ago, I noticed that one of the threads in a group was beginning to reach gargantuan proportions and—as most online debates go—had ventured out of the realms of heated argument and into energetic mud-slinging.  What I found most interesting about the whole shebang, however, wasn’t really even the debate, but the citations that were given to support each person’s viewpoint.

The majority of people involved in the debate were citing required texts from the classroom.  If the posts had been transformed into Mad Libs, it would have been something along the lines of, “(Derogatory name), look it up.  Go pick up your (beginning textbook) by (author name) and look on (page number). (Condescending insult).”  While I could easily rant on how rudely each person was treating everyone else in the thread or the fact that those threads weren’t private and could have been read by potential patients, which isn’t exactly the best public face you’d want to share for your practice (that’s a post for another day), but that on a whim, I decided to start checking up on each citation.  Being a jerk to your fellow colleagues is bad enough as it is (punishable by daily scarring moxa on Du 1 for a decade), but if you’re being a jerk and can’t back up your statements, you receive an additional five years of daily freehand needle technique practice on Ren 1 by brand-spanking new students in my book.  Sure enough, each citation given was written in each textbook given…but those were all citations referring to other texts.  “Why not give the referenced authors’ citations?” I wondered, as I started looking those up in the library…and I found my answer.

Interestingly, what was being cited wasn’t actually in the classical text referenced, and after checking multiple translations, I began to wonder where the statement came from in the first place.  Were these poor editing errors?  Were these simply “Oops, I goofed,” moments on behalf of the authors?  That’s certainly possible and highly likely on both.  Mistakes are part of the human condition and are forgivable offenses.  None of us are omniscient gods (and thank heaven for that, because how boring would that be?) and expecting perfection at all times from an author, a teacher, or a publisher just isn’t realistic.  We all are, however, responsible for our own educational experiences and research.  If you can’t find any other reference backing up a claim, it’s probably suspect, similar to using Wikipedia as your sole reference in a research project.  Don’t just settle for one reference or one teacher to hang your proverbial hat on.

In the same thread mentioned above, those that weren’t citing texts were citing their teachers.  While that’s certainly ok, what I found surprising was the fact that, “because my teacher said so,” was expected to be a quality response that couldn’t be questioned.  No, it isn’t a quality response.  Be specific.  Name names, and be sure to be able to say whether what you’re citing was your teacher’s personal opinion and clinical experience, or if your teacher was pulling that from a particular source.  If it was from a source, be prepared to name the source.

I can hear you now, “Oh, I could never question my teacher because that’s so disrespectful.”  Well, that may have been true in the orally passed traditions and in the history of Asian cultures and I certainly understand that perspective, but this isn’t China, Japan, Taiwan, or any other Eastern culture.  That doesn’t really apply here.  Besides, it’s your education we’re talking about.  You’re paying them to teach you, but that isn’t a one-way street running from the instructor directly to you.  It’s an interchange, and if you don’t understand a concept fully and don’t bother to seek further clarification, you’re actively stunting your growth as a practitioner.  That’s your responsibility as a student.  Never be afraid to ask your teachers questions, even after you’ve moved on and have a practice of your own.  Those worth their salt enjoy sitting down to talk shop with their students who have gone on to enter the profession.

Credentials

Years ago, I belonged to a Meetup group of sorts where a number of people gathered together to discuss different types of natural medicines…until fall rolled around and one woman got up, claiming to be a licensed acupuncturist and started lecturing about something she was calling Traditional Chinese Medicine.  She started the discussion by stating that the season of Fall was the season of Wood, which corresponded to the Liver.  Due to the fact that the Liver was in charge of the season, she claimed that the best prevention against seasonal colds and flu was a weekly cold (refrigerated!) coffee enema until the season moved into winter.  After her lecture, I asked her where she received her training, which was, “the famous Dr. ________,” whom I hadn’t heard of before that moment.  After a spot of research, she wasn’t licensed through the state (Colorado has an online searchable database for licensed individuals) and her education turned out to be an online correspondence course from a gentleman well-loved in New Age spiritual circles, but unknown outside of that particular community.  I couldn’t find any proof that the man had ever studied TCM—no mention of study at any school or an apprenticeship, and certainly no national certifications or documentation in any state licensure database.  Needless to say, she was more than a little embarrassed to admit she wasn't a licensed practitioner and that she might have been better off researching her teacher’s credentials in TCM before handing him her hard-earned cash when confronted about her actual title.

This is one of the reasons why we have accredited schools, national certification, and state licensures.  Contrary to the popular complaint, it isn’t just to squeeze every last drop out of our already-empty pockets while we’re students, and it isn’t just to allow for the ability to receive governmental cheese in order to complete the program.  That’s just sour grapes.  We have these things—the ACAOM, the CCAOM, the NCCAOM, and every other “OM” acronym in association with our profession—because we belong to a profession.  In order to do what we do, regardless of the tradition, you actually have to sit down and learn an entire body of specialized knowledge.  You can’t just punt in our field and these organizations are the gatekeepers that help to set the bar for entry-level proficiency.  Do I like my student loan payments or my recertification fees?  No, I don't.  But, just like how I’m not entirely fond of paying taxes, I do like the benefits those dollars pay for: my taxes go to road maintenance, state parks, education, and social programming to help make where I live a better place, while my recert/relicensing/continuing ed fees go to making me a more well-rounded practitioner, distinguishing me as a cost-effective health care provider instead of some snake oil salesman hocking a questionable product that could potentially hurt someone.   Just as you wouldn’t go to your neighbor for neurosurgery (unless, of course, your neighbor happens to actually BE a neurosurgeon), it’s a sure bet that we wouldn’t be gaining respect in the medical world if we didn’t have them around, and that’s nothing to shake a stick at.

Long story short?  Check up on your educational providers.  If they aren’t approved providers through your state or through the NCCAOM, make sure to look into whether or not they’re qualified to provide you with an education.  If you’re looking to get into the profession, check to see if the schools you’re interested in are accredited.  If they’re not, don’t be shy, embarrassed, or worry that it’s poor form to ask why.  It isn’t!  That’s just good business sense.  If you’re going to drop the kind of cash you’ll drop on the current standards, you definitely want to make sure you’ll have the ability to join the profession and become a licensed practitioner, otherwise you may as well use the money for a house, a start for your kids’ college education, or a sabbatical overseas.  Don’t try to save time and money by taking an online crash course or any other program that doesn’t allow you to sit for the exams. The career you save could be your own.

1. Ling Bo, et al. “Use of Night Soil in Agriculture and Fish Farming.” World Health Forum. Vol 14. 1993.  Pgs 67-70