Tunnel Vision: Another Lesson from a Mismanaged Case

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By Jason Blalack

Case records documenting mismanaged illnesses often demonstrate an error reflecting a conceptual bias on the part of the attending physician.

Such errors may appear either transparent or opaque to the reader, depending on one’s knowledge and conceptual orientation. Case records such as these can free us from the shackles of our own biases and preconceptions regarding the practice of medicine. We discussed a number of such records in previous issues of the Journal (Spring and Autumn 2011).

What follows is a classic case record from the 1600s. It was written at a time prior to the most significant developments in warm disease theory, when cold damage theory was the still the dominant model for treating externally contracted disease. As such, this case may well have been published as a challenge to the prevailing thinking of its time. Although the erroneous administration of a warming strategy figures prominently in this case, we do not wish to suggest that any particular approach is superior to another. The case record literature contains an equal number of cases illustrating the incorrect use of cooling methods.

Perhaps, more importantly, the following case illustrates a flexible and innovative approach that is quite characteristic of master physicians of the Ming and Qing dynasties (1368-1912). Yu Chang (style name Jiayan , 1585-1664), the original author of this case, was himself a significant and influential commentator on the Discourse on Cold Damage (Shang han lun ) and Essential Prescriptions from the Golden Cabinet (Jin gui yao lue both 2nd Century). Here we see him both encompassing and expanding the bounds of those conceptual frameworks, and for this reason it has appeared again and again in medical texts over the centuries. We believe that its message remains relevant today.

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About Jason Blalack

Jason Blalack is a globally recognized leader in the field of Chinese medicine and has practiced for over 15 years in Boulder, Colorado. He specializes in difficult to treat conditions utilizing Chinese herbalism, acupuncture, and functional medicine.… Read more »


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