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AI the Emerging Challenge for Our Profession

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Chinese medicine practitioners need to embrace ancient diagnostic methods to stay relevant in the face of AI advancements.

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Dr Karen Bilton

October, 2024

Over 30 years of practice and 20+ years of teaching pulse diagnosis in English speaking countries, and in China, I am seeing young practitioners face new pressures. Learning skills in an apprentice style that was once the base of the medicine has virtually disappeared in favour of Western style university learning. And following graduation from these institutions, there are little or no opportunities available to work as interns under experienced doctors. More often than not they are left to find their own way.

 

Our newer practitioners have become the casualties of the Westernisation of Chinese medicine. Turned out from for-profit schools with their degrees they find themselves in the bind of reality where they must see patients to pay rent, and have little resources, financial or energetic, to gain more knowledge that is critical for their survival as practitioners. Skills learnt in school clinic become their mode of practice. They record symptoms reported by their patients (which are often physical), look at the tongue, feel pulse for a minute or two, maybe quickly palpate a body area, they then provide treatment – acupuncture, herbs, hoping they will achieve the desired results.

 

While it may pay the bills this month, there are problems with this approach that jeopardise its implementation as a long-term plan. Aside from the fact that patients are often poor historians, this process simply organises and categorises what the patient has reported (or known knowledge) and requires little skill or inspiration on the part of the practitioner. This is the role of a technician not a physician, and more importantly this is the domain of AI. That is, this approach derives an output by organising bites of known information from the data base of that patient. Doing no more than any current AI app to come up with a point and herb formula.

 

In this rapidly evolving era of technology, we should be asking ourselves how will AI effect, or even threaten our position as acupuncturists and Chinese medicine practitioners. Will AI be telling us what points and formulas to use based on the input of signs and symptoms? In fact, this situation is probably here right now.

 

If we continue down this path, we stand to lose even more of our skills. So how do we remain relevant the relentless advancement of technology? I do not believe technology can adequately assess the complexity of a living being – our body, mind and spirit. However, to remain relevant and have greater than AI success with our treatment we need to offer something different to our clients, and that is a humanistic approach.

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We are more than the reductionist view of biology concerned with the cellular structure of the tissues in our anatomical organs. We are manifestations of different forms of energy that are in a constant state of flux to maintain homeostasis in response to the changing energy within as well as that of our environment. Our existence is based on interchange and transformation. As with all organisms in nature, once this movement ceases, life stops with it. Whether we like to admit it or not, we are part of this cosmos, connected to and bound by the same rules, and will return to the powers that created us.

 

To behold with humility the complexity of life, and the spectacle of a single cell developing into the intricacy of an entire person, or to the ecosystem of the earth and the universe, we need some way of describing phenomena. And this is available to us by way of the theories on which our medicine is based. We need to get back to our roots and the ancient skills that have survived thousands of years to consider our being as energy transformations manifesting as body, mind and spirit.

 

Let us for a moment ponder the following quotes from Suwen 8 and Dragon Rises, Red Bird Flies (Hammer, 2005)

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Our Water phase

  • SW 8 The Kidneys are responsible for the arousing of power, skill and ability stems from there.

  • DRRBF Water is directly related to our ancestorial cosmic energy. It gifts us the intuitive intelligence that we are endowed with as children of the universe and connects us to our ancestors and fellow man. (Hammer, 2005)
     

Our Wood phase

  • SW 8 The liver is the official functioning as general. Planning and deliberation originate in it. The gallbladder is the official functioning as rectifier. Decisions and judgments originate in it.

  • DRRBF Wood is responsible for the assertion and direction of being. Our motivation and when to advance and retreat in the face of life’s perplexing problems. (Hammer, 2005)
     

Our Fire phase

  • SW 8 The heart is the official functioning as ruler. Spirit brilliance originates in it.

  • DRRBF Fire Coordinates the passion, love and communication of being. It gifts us the divine inspiration of human creativity (or that which is not yet known), love and conscious intellect. (Hammer, 2005)
     

Our Earth phase

  • SW 8 The spleen and the stomach are the officials responsible for grain storage. The five flavours originate from them.

  • DRRBF Earth provides the capacity for bonding and resilience of boundaries. It provides us with metabolism and sustenance in this world – physically, mentally and spiritually. (Hammer, 2005)
     

Our Metal phase

  • SW8 The lung is the official functioning as chancellor and mentor. Order and moderation originate in it.

  • DRRBF Metal offers us transformation and order in the chaos, and the individuation and of our being. (Hammer, 2005)

 

How can we assess these characteristics and how they manifest in physiology? The patient cannot report this, so how do we access this information? By incorporating the diagnostic methods so eloquently and meticulously laid out in the Neijing Suwen. Observing the person their complexion, body morphology, how they speak, their odour. Inspecting the eyes and face, palpating the pulse, abdomen and skin. This knowledge has survived in the linage methods that have travelled to us across millennia. The timeless perpetuity of this ancient information, like the formulas of the Shanghan zabing lun, are a treasure of mankind that have become living cosmic entities in their own rite.

 

In my journey with Chinese medicine, I have been fortunate to experience and respect the humbling scope of these such methods in pulse diagnosis. I have learnt that the pulse is without a doubt the rendering of our Being. On it is recorded the characteristics of our ancestorial energy, our entry into this current life, all that has occurred since and what the future pathways may hold. It tells a story that bypasses consciousness and established narratives and communicates a persons’ true homeostatic needs. We are accessing information about the patient that is as yet unknown, and AI has no access to this cosmic intelligence in the way human wisdom and skill does. Empowered with this knowledge in the clinic we consider the entire energetic being of a person and we can treat with integrity.

 

This intelligence and skill are not necessarily enigmatic or difficult to learn. In the pulse diagnosis tradition in which I am trained, Dr Shen’s Systems Approach is a simplified way of looking at physiology that is in the very infancy of imbalance, before overt signs and symptoms arise. Each System is related to the six conformations and can be assessed by pulse characteristics that don’t need years of practice to differentiate. It allows the practitioner a good approximation of the state of a person’s energy transformation.

 

The integrity, substance and strength of the pulse right side is Dr Shen’s ‘Digestive System’. It represents Yangming and its Zhong qi Taiyin. The ability of Yangming to descend, its function to activate yin, and the capacity for yin to accept yang. It also indicates the ability of the Lungs to descend fluids, and the capability of yang activity to actuate yin or Spleen flesh.

 

The vigour of the left side pulse or ‘Organ System’ indicates the fundamental potential of yang that is stored in Shaoyin, Taiyin, Jueyin. The opening of which can be gauged by what Dr Shen called the ‘Nervous System’ Taiyang and its Zhong qi Shaoyin, assessed by the Depth to which the impulse rises. While the flow and movement of physiology, or pivot function, is represented by his ‘Circulatory System’ Shaoyang and its Zhong qi Jueyin. It can be assessed by the Rate and Rhythm of the pulse.

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Another simplistic way of looking at this pulse method is considering the three main Depths of the pulse. The Qi Depth is the most superficial of these. It not only tells us of the state of systemic qi but also how person a reaches out to, and engages the world. An impulse felt at the Qi Depth with normal buoyancy and resilience indicates that person is living life with vitality and able to adjust and roll with the punches that life throws. If Hard qualities are felt this tells us there is some inflexibility in the way people react or their responses to life’s stressors. Soft qualities may indicate that person is too accommodating while Vibrations tell us of worry and past trauma.

 

If the impulse rises above the Qi Depth it can indicate conditions of excess, heat, or the Tai yang conformation hyperreactive and engaged for protection, placing that person in a state of hypervigilance. If the impulse is first encountered below the Qi Depth it indicates qi deficiency, and the person is tired and perhaps not engaged in life with vigor.

 

The Blood Depth represents the state of systemic blood and the endurance and resources of the person. Palpated on the way down it gives us information about the quality of blood and tissue circulation, and palpated on the way up indicates how the blood flows through the vessels. The Organ Depth tells us the state of the yin organs, the constitution and the foundation of that person. And the essential issue of there being adequate yang to maintain normal physiology.

 

This information can be gathered in minutes and all it requires is our awareness of and connection to the cosmic intelligence gifted us as children of the universe. And AI has no access to this. Bottom line! To stay ahead of AI, we must get back to our roots. Learn the old methods and keep the knowledge alive for future generations.

 

My advice to practitioners starting out, study the Classics, learn pulse, become adept at body type recognition, palpate the abdomen, look at eyes. Find lineage traditions that connect with you, ones that are clear and which you have access for repeated practical reinforcement. This is how we can offer our patients something more than a Westernised approach to acupuncture and formulas, something more than AI. We offer them true Chinese medicine.

 

References

  1. Hammer L. Dragon Rises, Red Bird Flies: Revised Edition. Seattle: Eastland Press; 2010.

  2. Neijing Suwen: Unschuld P. and Tessenow H. translation. University of California Press: 2011.

  3. Hammer L. Chinese Pulse Diagnosis, A Contemporary Approach: Revised Edition. Seattle: Eastland Press; 2005.

  4. Hammer L, Bilton K. Handbook of Contemporary Chinese Pulse Diagnosis. Seattle: Eastland Press; 2012.

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Dr Karen Bilton, Ph.D.

Karen started her career in healthcare as a physiotherapist and has been practicing acupuncture and Chinese medicine for 30 years. She is licensed to practice in Australia and the USA having worked there for 15 years. 

 

Her career has been greatly influenced by long-term mentor Dr Leon Hammer, MD, renowned Chinese medicine practitioner, physician and child psychiatrist. During their 27 years together, she inherited the Menghe-Ding pulse method and the application of ontological psychology to the Chinese medical model defined by Dragon Rises, Red Bird Flies (Hammer, 2005). Karen also has studied Classical Chinese herbal medicine with Professor Heiner Fruehauf and Jing Fang prescription with Professor Huang Huang.

 

Karen completed doctoral studies evaluating the reliability of pulse diagnosis and is co-author of a Handbook of Contemporary Chinese Pulse Diagnosis. She has lectured at Pacific College of Oriental Medicine NY, the University of Technology, Sydney, and the University of Western Sydney. She has taught pulse diagnosis classes and presented at conferences in China, USA, Australia, and New Zealand and has published in peer review journals. 

 

Currently she is in clinical practice in Sydney, Australia, and continues her exploration of acupuncture, Chinese herbal medicine in relation to Daoist cosmology. She endeavors to share her knowledge teaching classes in pulse diagnosis and the psychology of Dragon Rises, Red Bird Flies. 

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