Daniel: December 5, 2019, 12:19am
So now with the development of Sa’Am well underway in my clinic, I am embarking on a process I have been
through before . . . .It’s a very long slow, humbling process . . . the synthesis and integration of multiple styles in
clinic – and the challenge of on the one hand, working with the accumulated expertise one has in a clinical style
with which they have a long history and on the other hand, being the humble kindergartner they are with the new
style. A few years ago, I went through such a process with the Kiiko palpatory style and the Ren Ying Cun Kou
pulse taking I had learned in Ed Neal’s Nei Jing classes. I eventually wrote an article in the Journal of Chinese
Medicine about the full process of integration / synthesis as I experienced and understood it and I also did an online
webinar on the process… . . . . .
Here is the article I published . . .
Here is a slide from a webinar I presented . . . .
16/01/2024, 11:56The Process of Clinical Synthesis – Qiological Community
https://forum.qiological.com/t/the-process-of-clinical-synthesis/770/print2/4
Now I find myself administering Sa’Am treatments and at the same time performing full body Kiiko style
palpatory inquiries. I am beginning to find some very interesting things. I expect the next two to three years will
have me accumulate an interesting picture . I stress this is VERY early stages and the process as I experienced and
understand it is what I call ‘very delicate’, iterative, and observationally complex.
Michael – perhaps we could do a webinar on this topic on Qiological . . .
Daniel: December 5, 2019, 11:36am
One thing I am finding is that often (of course not always, but certainly often enough to have already emerged as
significantly notable) a counterbalance channel pair we would identify through Sa’Am diagnosis ALSO shows up
strongly in palpation! It’s very interesting. So, just two examples from earlier this week. 1. A woman whose main
complaints are anxiety and being hot all the time – so hot (she works in a grocery store) – she often goes into the
walk in cooler at work just to cool off. Full Sa’Am assessment identified the Bladder-Heart pair as central to the
case. And interestingly, through full body palpation on front and back, Palpable reactivities were strongest on the
Bladder and Heart channels and points. 2. A woman whose main complaint is Rhinitis – a chronic stuffed nose –
breathes through her mouth so much, she has developed dental health issues . . but there is really no loose phlegm –
she never has to blow her nose – its that kind of deep dry rhinitis. Sa’Am diagnosis identified the Lung-Stomach
pair as very central to her case (among others). And interestingly, on palpation, Lung channel and Stomach channel
points were the most reactive.
And . . . of course, there are cases where Sa’Am and Kiiko-palpatory do not match up at all . . . . and I am left
wondering what that means (presumably, it reveals two distinct ‘dimensions’ within the channel system of the
patient’s situation – perhaps over time, the relationship between these two dimensions will emerge in some way or
ways). As I always say to patients who ask me when recounting their symptoms, “Does that make sense?” . . . .
“Everything makes sense. We just have to make sense of it!”
There appears to me at this very early stage to be a Palpation – Sa’Am Observation synthesis waiting there to be
fleshed out through the kind of delicate process I experienced before . . . time will, of course, tell. The ‘delicate’16/01/2024, 11:56The Process of Clinical Synthesis – Qiological Community
https://forum.qiological.com/t/the-process-of-clinical-synthesis/770/print3/4
nature of the process is that it all sits on a need to not force anything, be highly and consistently observant (often of
nuances), to be critically minded, and to merge the ‘activity’ of engagement with the ‘surrender’ of allowing
emergence.
rappeports: December 5, 2019, 1:01am
Thx Daniel. Also, Volker Scheid will be speaking about this same idea in terms of herb practice at the Shen Nong
Society conference this year. He calls this synthesis Meta-practice.
Daniel #4December 5, 2019, 1:35am
Interesting! I like that phrase a LOT because it is a ‘meta practice’ experience for sure. If you ever become aware
of an article or available powerpoint from his talk, please let me know.
rappeports: December 5, 2019, 2:51am
You can live stream the conference and his class the next day. www.shennongsociety.org
michaelmax: December 6, 2019, 4:38am
Daniel:
Michael – perhaps we could do a webinar on this topic on Qiological . . .
I’d love to! Let’s do it. As we grow in our work we of course bring on, and at time shed ideas and methods. Finding
a way to craft all we’ve experienced into a coherent practice… I suspect this is a big part of our “work” in
becoming skilled practitioners.
michaelmax: December 6, 2019, 4:43am
Daniel:
One thing I am finding is that often (of course not always, but certainly often enough to have already emerged
as significantly notable) a counterbalance channel pair we would identify through Sa’Am diagnosis ALSO16/01/2024, 11:56The Process of Clinical Synthesis – Qiological Community
https://forum.qiological.com/t/the-process-of-clinical-synthesis/770/print4/4
shows up strongly in palpation!
A question for me about working with any method is “can I triangulate what I already know/use in a way that
always me to bring what I’ve learned, and at the same hold it loosely enough so the new methods can gain a
foothold in my experience. And then what kind of gestalt might emerge?”
Thanks for your observations here that connect what you know, with what we are learning.
KristinWisgirda: December 6, 2019, 1:15pm
Daniel:
a counterbalance channel pair we would identify through Sa’Am diagnosis ALSO shows up strongly in
palpation!
Sometimes channel, sometimes quality.
Palpating channels almost always provides clarifying information when the picture isn’t clear to me. Observing the
channels is helpful too. It is worth having a patient take their shirt off for a quick look at the torso to see where the
moles, birthmarks and scars from surgeries and major accidents they haven’t mentioned.
Daniel: December 7, 2019, 2:45pm
Yes! in my experience, marks, moles and scars almost always have relevance to the emerging picture and the case.
. . . . in the context of BOTH ‘sometimes quality and sometimes channel’