R: Liu Wei Di Huang Wan & Pregnancy

January 19, 2009

Dear Hugo, I'm sorry, but I do not agree (completely) with you: according to

the ancient theory you are completely right, but now, at the present time,

we have to consider western Laws, too. Since Liu Wei is made with Mu Dan Pi

AND Shu Di Huang, the most important tonifier of Blood and Yin, the recipe

is useful in moving blood (and tonify it), too. Since the foetus is a

Tan/phlegm and a blood clot, all of the herbs that could move phlegm and

blood would be avoided. I think that could be better give the usual " drugs "

as Iron, Folic acid (not more than 400 micrograms per day, because an amount

over this quote could give bresat cancer), that tonify Blood, without make

it circulating (safer and sure, without any law's problem, in case of any

difficulty as spontaneous abortion or similar); then, after delivery, it

seems very important tonify Yin and Blood, as before pregnancy, up to

prepare the future mother, just stopping treatment as she knows she's

pregnant. Without any kind of controversy, of course.

_____

Da: Chinese Medicine

Chinese Medicine Per conto di Hugo

Ramiro

Inviato: lunedì 19 gennaio 2009 4.16

A: Chinese Medicine

Oggetto: Re: Liu Wei Di Huang Wan & Pregnancy

Hi Chris:

What a CM doctor does in every instance is justify his or her prescription.

If the signs, symptoms and history point toward a certain formula, then it

is justifiable to apply it. Once the signs and symptoms change, which

changes the trajectory of the history as well, then it is no longer

justifiable to apply the initial prescription, and the doctor must move

forward to the next indicated prescription. Following change is the modus

operandi of .

Mu Dan Pi is acrid, bitter and mildly cool. Mu Dan Pi clears heat and cools

the blood, clears the fire of yin deficiency, clears

blood stasis and dissolves clots, drains pus and reduces swelling due to

blood stasis.

Mu Dan Pi is contraindicated in cold disorder, pregnancy, excessive

menstruation.

Let's say, Chris, that your wife tends toward some deficiency heat, which

she should if Liu Wei has been prescribed for her. Guess what deficiency

heat untreated means for the baby? Insufficient jing provided by the mother

during gestation - that leads to all sorts of things, from restless fetus,

to difficult labour, to a child who tends to deficiency heat early in life

and so on. And guess what would solve these problems? Liu Wei Di Huang (with

Mu Dan Pi). We could say that it is risky for this patient to _not_ take Liu

Wei Di Huang (with Mu Dan Pi).

That said, if your wife does not present with the appropriate S & S, then she

should not be taking Liu Wei Di Huang. If possible, you can look for a more

experienced practitioner to care for her.

To finish up, if your wife has a very mild deficiency heat syndrome, you may

want to switch her to high quality Liu Wei pills, and a low dosage might be

warranted as well. However, you would be justified in prescribing medicine

for deficiency heat so long as she presents with that, pregnant or not.

Always match the syndrome and follow closely. It's like push hands.

Hope that helps,

Hugo

________________________________

Hugo Ramiro

http://middlemedici <http://middlemedicine.wordpress.com> ne.wordpress.com

http://www.chinesem <http://www.chinesemedicaltherapies.org>

edicaltherapies.org

________________________________

chriskjezp <chriskresser@ <chriskresser%40gmail.com> gmail.com>

Traditional_ <Chinese Medicine%40>

Chinese_Medicine

Sunday, 18 January, 2009 20:46:00

Liu Wei Di Huang Wan & Pregnancy

Hi,

This is my first post here in a long while. I'm a student at AIMC

Berkeley just starting my clinical internship.

My wife has been taking Liu Wei Di Huang Wan for yin xu and is doing

very well on it. However, we've decided to start a family and I'm

wondering if it's safe for her to continue taking it.

In the Bensky formulas book Liu Wei Di Huang Wan is not

contraindicated during pregnancy. However, one of the individual

ingredients - Mu Dan Pi - is contraindicated during pregnancy.

We want to be cautious, of course, and if there's even a chance that

this formula could cause problems I'd like to find a better one for

her that wouldn't interfere with pregnancy. I'd welcome your ideas on

that as well.

With appreciation,

Chris

__._,_..___

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January 19, 2009

I think that an important thing to remember are that formulas are

synergistic and not just a combination of herbs...

the whole is greater than the sum of its parts.

So, we can't nullify a formula just because one herb moves blood and another

drains dampness.

As Arnaud Versluys states, herbalism is different from formulaism.

Shu di and shan yao and shan zhu yu are sticky and can hold things in

place.. that's why we have the other 3 herbs to give a counterpoint. Of

course, some classicists don't really think we should be giving Liu wei to

adults, since it was made as a pediatric formula for kids. In any case,

I've never heard of Liu wei being contraindicated during pregnancy... Anyone

else?

Now, Liu wei might not be the best formula, not because of Mu dan pi, but

because of Fu ling and Ze xie draining out potential essence from the

mother, which is not quanitatively harmful, but qualitatively so. Liu wei

is a Song dynasty modification of Zhang Zhong Jing's formula.. Jin gui shen

qi wan. What happens when you take out the two herbs which kick-start the

metabolism.. gui zhi and fu zi?

You get kind of a sticky mess. There's no yang to interact with the yin.

We should let our conscience and understanding of the classics drive us, not

fear. Hopefully, bio-medicine can enhance our understanding, not hinder

it. We have to have faith in our own medicine and be able to speak it

fluently with articulation and not trepidation and that requires for us to

work a lot harder. Hope I don't sound pedantic... I'm kicking my own butt

out of respect of the masters.

If your wife's in second trimester and her yin deficiency sx are dry

mouth/throat and feeling hotter during the afternoon....

consider da zao (red) and lo han guo tea. It works. Best thing is to not

interfere with nature, unless you have to.

For acupuncture ... KD 9, once a trimester and moxa ST 36 a few times a

week.

K.

On Mon, Jan 19, 2009 at 6:53 AM, <

saudelligabriele wrote:

> Dear Hugo, I'm sorry, but I do not agree (completely) with you:

> according to

> the ancient theory you are completely right, but now, at the present time,

> we have to consider western Laws, too. Since Liu Wei is made with Mu Dan Pi

> AND Shu Di Huang, the most important tonifier of Blood and Yin, the recipe

> is useful in moving blood (and tonify it), too. Since the foetus is a

> Tan/phlegm and a blood clot, all of the herbs that could move phlegm and

> blood would be avoided. I think that could be better give the usual " drugs "

> as Iron, Folic acid (not more than 400 micrograms per day, because an

> amount

> over this quote could give bresat cancer), that tonify Blood, without make

> it circulating (safer and sure, without any law's problem, in case of any

> difficulty as spontaneous abortion or similar); then, after delivery, it

> seems very important tonify Yin and Blood, as before pregnancy, up to

> prepare the future mother, just stopping treatment as she knows she's

> pregnant. Without any kind of controversy, of course.

>

> _____

>

--

www.tcmreview.com

The Four Reliances:

Do not rely upon the individual, but rely upon the teaching.

As far as teachings go, do not rely upon the words alone, but rely upon the

meaning that underlies them.

Regarding the meaning, do not rely upon the provisional meaning alone, but

rely upon the definitive meaning.

And regarding the definitive meaning, do not rely upon ordinary

consciousness, but rely upon wisdom awareness.

January 19, 2009

Thanks, everyone for your replies. Just wanted to clarify a few things:

- My wife isn't currently pregnant. We are just beginning to try to

get pregnant.

- About three weeks ago my wife started having tidal fever, night

sweats, insomnia and thirst. This followed a four-month treatment

protocol for candida that involved various antifungal herbs and

supplements. I imagine that protocol damaged her yin considerably,

which led to the symptoms above.

- My wife worked with an herbalist during the protocol above. I

presented her case to an instructor at my school with 30+ years of

experience, and he prescribed Liu Wei Di Huang Wan + Fu Xiao Mai + Wu

Wei Zi for her.

I suppose my question is this: is there another formula that would

address the deficient heat symptoms and nourish the yin without

possibly endangering a fetus? I appreciate that yin deficiency with

heat isn't conducive to getting pregnant or a healthy pregnancy, and

that's why I'm interested in treating her for that. On the other

hand, I'd like to be cautious and not use medicinals that might cause

harm.

Thanks again for your support.

Chris

January 19, 2009

Gabrielle,

I must strongly disagree with your conclusions. Blood stasis and

phlegm accumulation are pathological products the result of pattern

disharmonies, not of a natural process such as pregnancy! Do you have

any source for your conclusions in Chinese medicine?

Also, many prescriptions designed for pregnancy, such as jiao ai

tang and gui zhi fu ling wan, have 'contraindicated medicinals' in

them, such as chuan xiong and tao ren. It all depends on context and

pattern. The combination of medicinals in formulas on one hand,

neutralizes side effects, and the proper diagnosis based on pattern

differentiation prevents mishaps. While biomedicine can provide

helpful insights to our practice, there is no evidence whatsoever that

giving liu wei di huang wan during pregnancy would be contraindicated

as long it was based on a correct diagnosis of the patient.

On Jan 19, 2009, at 6:53 AM, wrote:

> Dear Hugo, I'm sorry, but I do not agree (completely) with you:

> according to

> the ancient theory you are completely right, but now, at the present

> time,

> we have to consider western Laws, too. Since Liu Wei is made with Mu

> Dan Pi

> AND Shu Di Huang, the most important tonifier of Blood and Yin, the

> recipe

> is useful in moving blood (and tonify it), too. Since the foetus is a

> Tan/phlegm and a blood clot, all of the herbs that could move phlegm

> and

> blood would be avoided. I think that could be better give the usual

> " drugs "

> as Iron, Folic acid (not more than 400 micrograms per day, because

> an amount

> over this quote could give bresat cancer), that tonify Blood,

> without make

> it circulating (safer and sure, without any law's problem, in case

> of any

> difficulty as spontaneous abortion or similar); then, after

> delivery, it

> seems very important tonify Yin and Blood, as before pregnancy, up to

> prepare the future mother, just stopping treatment as she knows she's

> pregnant. Without any kind of controversy, of course.

>

> _____

>

> Da: Chinese Medicine

> Chinese Medicine Per conto di

> Hugo

> Ramiro

> Inviato: lunedì 19 gennaio 2009 4.16

> A: Chinese Medicine

> Oggetto: Re: Liu Wei Di Huang Wan & Pregnancy

>

> Hi Chris:

>

> What a CM doctor does in every instance is justify his or her

> prescription.

> If the signs, symptoms and history point toward a certain formula,

> then it

> is justifiable to apply it. Once the signs and symptoms change, which

> changes the trajectory of the history as well, then it is no longer

> justifiable to apply the initial prescription, and the doctor must

> move

> forward to the next indicated prescription. Following change is the

> modus

> operandi of .

>

> Mu Dan Pi is acrid, bitter and mildly cool. Mu Dan Pi clears heat

> and cools

> the blood, clears the fire of yin deficiency, clears

> blood stasis and dissolves clots, drains pus and reduces swelling

> due to

> blood stasis.

>

> Mu Dan Pi is contraindicated in cold disorder, pregnancy, excessive

> menstruation.

>

> Let's say, Chris, that your wife tends toward some deficiency heat,

> which

> she should if Liu Wei has been prescribed for her. Guess what

> deficiency

> heat untreated means for the baby? Insufficient jing provided by the

> mother

> during gestation - that leads to all sorts of things, from restless

> fetus,

> to difficult labour, to a child who tends to deficiency heat early

> in life

> and so on. And guess what would solve these problems? Liu Wei Di

> Huang (with

> Mu Dan Pi). We could say that it is risky for this patient to _not_

> take Liu

> Wei Di Huang (with Mu Dan Pi).

>

> That said, if your wife does not present with the appropriate S & S,

> then she

> should not be taking Liu Wei Di Huang. If possible, you can look for

> a more

> experienced practitioner to care for her.

>

> To finish up, if your wife has a very mild deficiency heat syndrome,

> you may

> want to switch her to high quality Liu Wei pills, and a low dosage

> might be

> warranted as well. However, you would be justified in prescribing

> medicine

> for deficiency heat so long as she presents with that, pregnant or

> not.

>

> Always match the syndrome and follow closely. It's like push hands.

>

> Hope that helps,

> Hugo

>

> ________________________________

> Hugo Ramiro

> http://middlemedici <http://middlemedicine.wordpress.com>

> ne.wordpress.com

> http://www.chinesem <http://www.chinesemedicaltherapies.org>

> edicaltherapies.org

>

> ________________________________

> chriskjezp <chriskresser@ <chriskresser%40gmail.com>

> gmail.com>

> Traditional_ <Chinese Medicine%40

> >

> Chinese_Medicine

> Sunday, 18 January, 2009 20:46:00

> Liu Wei Di Huang Wan & Pregnancy

>

> Hi,

>

> This is my first post here in a long while. I'm a student at AIMC

> Berkeley just starting my clinical internship.

>

> My wife has been taking Liu Wei Di Huang Wan for yin xu and is doing

> very well on it. However, we've decided to start a family and I'm

> wondering if it's safe for her to continue taking it.

>

> In the Bensky formulas book Liu Wei Di Huang Wan is not

> contraindicated during pregnancy. However, one of the individual

> ingredients - Mu Dan Pi - is contraindicated during pregnancy.

>

> We want to be cautious, of course, and if there's even a chance that

> this formula could cause problems I'd like to find a better one for

> her that wouldn't interfere with pregnancy. I'd welcome your ideas on

> that as well.

>

> With appreciation,

> Chris

>

> __._,_..___

> Messages in this topic (1) Reply (via web post) | Start a new topic

> Subscribe to the free online journal for TCM at Times

> http://www.chinesem <http://www.chinesemedicinetimes.com>

> edicinetimes.com

>

> Help build the world's largest online encyclopedia for Chinese

> medicine and

> acupuncture, click, http://www.chinesem

> <http://www.chinesemedicinetimes.com/wiki/CMTpedia>

> edicinetimes.com/wiki/CMTpedia

>

> http://groups.

> <>

> and adjust

> accordingly.

>

> Messages are the property of the author. Any duplication outside the

> group

> requires prior permission from the author.

>

> Please consider the environment and only print this message if

> absolutely

> necessary.

> MARKETPLACE

>

> ________________________________

> From kitchen basics to easy recipes - join the Group from Kraft Foods

>

> Change settings via the Web ( ID required)

> Change settings via email: Switch delivery to Daily Digest | Switch

> format

> to Traditional

> Visit Your Group | Terms of Use | Un

> Recent Activity

> * 3

> New MembersVisit Your Group

> Need traffic?

> Drive customers

> With search ads

> on

> Sitebuilder

> Build a web site

> quickly & easily

> with Sitebuilder.

>

> Going Green Zone

> Find Green groups.

> Find Green resources.

> .

>

January 19, 2009

Hi Gabriele!

In Canada I don't believe there are relevant laws. I don't know about Italy;

can you tell us?

I also find the risk of breast cancer with an overdosage of folic acid quite

serious and worrisome, don't you? How can we be sure of that sort of thing? What

if in another 10 years the risk is higher and different than we thought? For

example, now there's a definite link to colon cancer as well. And that's not

all:

" an emerging body of evidence suggests that folic acid supplementation may

enhance

the development and progression of already existing, undiagnosed premalignant

and malignant lesions. "

(Am J Clin Nutr 2004;80:1123â€“ 8.)

From " Herb Toxities and Drug Interactions " :

MuDanPi

AH: Not to be used during pregnancy. This ingredient is commonly used in China

during pregnancy to treat heat in the blood and/or blood stasis.

Therefore, I must stick, strictly, to a proper classical assessment, wherever

it may take us, and the matching treatment, wherever that may take us.

One-to-one correspondence is not Chinese medicine (i.e. Mu Dan Pi is never used

in pregnancy). Chinese medicine is about following the presenting pattern and

matching it - all in order to achieve that harmonious dynamic balance that is

known to create the strongest human bodies.

I still don't understand, Gabrielle, how you can counsel against using MuDanPi

during pregnancy *when it is indicated*. MuDanPi, in the appropriate formula, in

a pregnant woman who has blood stasis and blood heat, may be exactly what

prevents a miscarriage, or it may be exactly what allows a fetus to avoid

developmental harm. How do you justify arbitrarily removing segments of

Classical Medical theory and treatment from your practice? I don't understand

how you can remove all herbs that clear heat, move the blood and resolve phlegm

from your practice. What if an expectant mother presents with phlegm

accumulation, blood stasis and blood heat? Should we give them iron and folic

acid?

Thanks, and I am looking forward to your answer, I think we have had a

misunderstanding!

Hugo

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies.org

________________________________

<saudelligabriele

Chinese Medicine

Monday, 19 January, 2009 9:53:37