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, " " <

zrosenberg@e...> wrote:

 

>

> Liver qi xu: pale lusterless complexion, pale lips, poor muscle strength,

> tendency to frighten easily, tinnitus and deafness. .

 

Zev

 

What is the source of these s/s?

 

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on 1/3/01 10:39 PM, at wrote:

 

> , " " <

> zrosenberg@e...> wrote:

>

>>

>> Liver qi xu: pale lusterless complexion, pale lips, poor muscle strength,

>> tendency to frighten easily, tinnitus and deafness. .

>

> Zev

>

> What is the source of these s/s?

>

 

>

>

>

Primarily the Practical Dictionary.

 

Z'ev

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, " " <

zrosenberg@e...> wrote:

 

> > Zev

> >

> > What is the source of these s/s?

> >

>

> >

> >

> >

> Primarily the Practical Dictionary.

>

> Z'ev

 

thanks. I checked the source. It is not a well defined discete

pattern. there are no tongue and pulse signs given and unlike many

entries in the PD, there are no therapeutic recommendations. The

pattern seems to be covered by liver blood xu, general qi xu and GB qi

xu. The formula suggestion of nuan gan jian does not seem to address

the sx complex.

 

However, sionneau lists the lv/gb vacuity as a pattern for

susceptibility to fright. He lists ht/gb vacuity as a pattern for

susceptibility to fear. In both cases, we see pale tongue with thin

fur and fine or weak pulse. Lv/gb qi vacuity is treated with modified

si junzi tang plus yuan zhi,bai shao and suan zao ren, thus it matches

the patterns of qi xu plus lv/ht blood xu.

 

the formula for ht/gb qi xu is also similar. Shi wei wen dan tang is a

wen dan tang variation but also can be understood as a modified liu

junzi tang, again with suan zao ren, yuan zhi,but also sheng di and wu

wei zi. thus qi xu plus ht blood xu is addressed by this rx,as well.

However,it also clears phlegm from the heart and regulates qi. I'd be

interested in the page cites from li dong yuan and zhudanxi, so I can

pursue this further.

 

However,at first glance, there doesn't seem to be anything about the qi

xu symptoms in this syndrome that lead me to distinguish this pattern

from general qi xu with liver blood xu. The pattern also seems to be

somewhat covered by bugantang, which addresses those patterns. Since

the liver does not produce qi, it would seem that liver qi vacuity

would often be subsumed to other patterns that reflect the root source

of the lack of qi, such as kd or sp or lu qi xu. However, sionneau

quotes without citation that braveness arises from the sufficiency of

lv/gb qi, while the lack thereof results in fear. but the lack thereof

seems to be rooted in other qi producing organs, not the liver itself.

this seems relected in the indicated formulas. the exception is that

sudden fright may damage the lv/gb directly (according to sionneau).

 

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on 1/4/01 9:48 AM, at wrote:

 

>

> thanks. I checked the source. It is not a well defined discete

> pattern. there are no tongue and pulse signs given and unlike many

> entries in the PD, there are no therapeutic recommendations. The

> pattern seems to be covered by liver blood xu, general qi xu and GB qi

> xu. The formula suggestion of nuan gan jian does not seem to address

> the sx complex.

 

Nuan gan jian treats primarily liver yang and blood vacuity. . . .from what

I can see, liver qi vacuity overlaps with liver blood and yang vacuity, as

qi vacuity indicates a lack of functional ability, to regulate and move qi

through the liver viscera and channel, and to transform blood. This leads

to a cold, stagnant liver, and a loss of functional qualities.

 

In another source, Qin Bo-wei says the following: " the liver may be in a

state of qi vacuity and lack strength... .with symptoms of a vacuity

detriment of liver qi (and yang) such as sluggishness, depression,

gallbladder fright, headache, numbness and lack of warmth in the four

extremities. "

>

> However, sionneau lists the lv/gb vacuity as a pattern for

> susceptibility to fright. He lists ht/gb vacuity as a pattern for

> susceptibility to fear. In both cases, we see pale tongue with thin

> fur and fine or weak pulse. Lv/gb qi vacuity is treated with modified

> si junzi tang plus yuan zhi,bai shao and suan zao ren, thus it matches

> the patterns of qi xu plus lv/ht blood xu.

 

Again, we don't see pure liver qi vacuity, but mixed patterns. This script

looks like bu gan tang, and makes perfect sense.

 

I would also consider huang qi, which recent Chinese studies indicates

benefits to the liver in high dosages. To quote the article ( " The Use of

Rx. Astragali in Liver Depression/Huang Jian-ge " ): " An etiology of liver

depression may be a qi vacuity which lacks the strength to course and drain;

it is not always repletion pattern. Liver qi vacuity deteriment was

recognized early on. For instance, the chapter " Treatise on true heaven of

the ancients in the Simple Questions/shang gu tian zhen lun states 'seven or

eight times out of ten the liver qi is depleted and the sinew cannot move'.

>

> the formula for ht/gb qi xu is also similar. Shi wei wen dan tang is a

> wen dan tang variation but also can be understood as a modified liu

> junzi tang, again with suan zao ren, yuan zhi,but also sheng di and wu

> wei zi. thus qi xu plus ht blood xu is addressed by this rx,as well.

> However,it also clears phlegm from the heart and regulates qi. I'd be

> interested in the page cites from li dong yuan and zhudanxi, so I can

> pursue this further.

>

 

I am waiting for Will Morris to respond on this.

 

> However,at first glance, there doesn't seem to be anything about the qi

> xu symptoms in this syndrome that lead me to distinguish this pattern

> from general qi xu with liver blood xu. The pattern also seems to be

> somewhat covered by bugantang, which addresses those patterns. Since

> the liver does not produce qi, it would seem that liver qi vacuity

> would often be subsumed to other patterns that reflect the root source

> of the lack of qi, such as kd or sp or lu qi xu. However, sionneau

> quotes without citation that braveness arises from the sufficiency of

> lv/gb qi, while the lack thereof results in fear. but the lack thereof

> seems to be rooted in other qi producing organs, not the liver itself.

> this seems relected in the indicated formulas. the exception is that

> sudden fright may damage the lv/gb directly (according to sionneau).

 

 

Your points are well taken. I hope my quotations help clarify the scenario

a bit more as well.

 

 

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At 5:48 PM +0000 1/4/01, wrote:

>However,at first glance, there doesn't seem to be anything about the qi

>xu symptoms in this syndrome that lead me to distinguish this pattern

>from general qi xu with liver blood xu. The pattern also seems to be

>somewhat covered by bugantang, which addresses those patterns. Since

>the liver does not produce qi, it would seem that liver qi vacuity

>would often be subsumed to other patterns that reflect the root source

>of the lack of qi, such as kd or sp or lu qi xu.

--

 

I agree. Although Qin Bowei discusses liver qi and deficiency of

liver qi, he does not discuss this as a treatable syndrome. In his

discussion of liver, he gives an extensive breakdown of liver

syndromes, and he has no listing for liver qi xu. It seems from the

Anthology that he does not define a qi xu syndrome for the liver

until it manifests as a specific dysfunction, in which case it has a

more specific name such as liver depression or reversal. From this I

think it is fair enough to speak of liver qi vacuity as a background

for syndromes, but not as a syndrome itself. Perhaps Chip Chace can

chime in on this, as he may have access to other materials that he

has yet to translate for us (hint).

 

Rory

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, Rory Kerr <rorykerr@w...> wrote:

 

> >xu symptoms in this syndrome that lead me to distinguish this It seems from

the

> Anthology that he does not define a qi xu syndrome for the liver

> until it manifests as a specific dysfunction, in which case it has a

> more specific name such as liver depression or reversal. From this I

> think it is fair enough to speak of liver qi vacuity as a background

> for syndromes, but not as a syndrome itself.

>

> Rory

 

Good Point. I don't have the anthology handy where I am. I should

have read your post first. Tomorrow I'm going to take a look at Li

dong yuan and zhu dan xi.

 

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on 1/4/01 10:51 PM, at wrote:

 

 

>> Anthology that he does not define a qi xu syndrome for the liver

>> until it manifests as a specific dysfunction, in which case it has a

>> more specific name such as liver depression or reversal. From this I

>> think it is fair enough to speak of liver qi vacuity as a background

>> for syndromes, but not as a syndrome itself.

>>

>> Rory

>

 

Clinically, where I have observed liver qi xu is in later stages of liver

cirrhosis, hepatitis C, multiple sclerosis, post-alcoholism or drug use or

other long-term diseases of wasting or liver damage, again, as you note,

combined with other patterns such as liver blood vacuity, liver depression

or other visceral patterns (sp qi xu, kd qi xu).

 

 

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At 6:51 AM +0000 1/5/01, wrote:

>Tomorrow I'm going to take a look at Li

>dong yuan and zhu dan xi.

---

 

These books are poorly indexed. I reviewed each book and was unable

to find anything relevant to this discussion, but I could easily have

missed it. Perhaps Will can put his finger on the reference.

 

Rory

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At 7:59 AM -0800 1/5/01, wrote:

>Clinically, where I have observed liver qi xu is in later stages of liver

>cirrhosis, hepatitis C, multiple sclerosis, post-alcoholism or drug use or

>other long-term diseases of wasting or liver damage, again, as you note,

>combined with other patterns such as liver blood vacuity, liver depression

>or other visceral patterns (sp qi xu, kd qi xu).

--

 

But how do you separate out liver qi xu? Undoubtedly you are right

that the liver qi is deficient, because it is implicit in some other

syndromes.

 

Rory

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Rory:

<<Are you saying that Li is recommending BXYQT for liver vacuity, or

any other liver pattern for that matter? When you say it works, what

do you mean?>>

 

No I am stating that BZYQT works for Liver Qi Xu patterns (primarily because of

the

Chai Hu content, it is at the Spleen end of the Liver-Spleen continuum, yet

maintains an

action on the Liver). If we are to express the possibility of the superior

physician,

prevention is required, I would suggest that waiting for a frank symptological

picture is

practicing a game of catchup. Large doses of Huang Qi are my primary strategy,

however,

Bu Zhong Yi Qi Tang works for the various patterns listed below when

appropriately

modified, and this is a distinctly different use than for conventional Spleen

patterns or

recovery from infections.

 

This Liver Qi Xu will necessarily affect the coursing and draining, storage and

releasing of

Blood, the state of the sinews, and the sociopolitical position as General (self

esteem,

planning, council to the Emperor).

 

Zev, I just can't go with Vacuity - it makes no sense - Xu is more eloquent for

me.

 

Will

 

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At 11:27 AM -0800 1/6/01, Will wrote:

>No I am stating that BZYQT works for Liver Qi Xu patterns (primarily

>because of the

>Chai Hu content, it is at the Spleen end of the Liver-Spleen

>continuum, yet maintains an

>action on the Liver).

--

OK, I understand what you're saying, but I'm not clear what the

criteria are for the liver pattern, and for the effectiveness of the

treatment. For instance, are you saying that the criteria for liver

qi xu is an empty left guan position alone, or are there other

confirming symptoms you need?

 

> If we are to express the possibility of the superior physician,

>prevention is required, I would suggest that waiting for a frank

>symptological picture is

>practicing a game of catchup.

--

I couldn't agree more.

 

Rory

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on 1/6/01 11:27 AM, Will at will wrote:

 

 

 

>

> Zev, I just can't go with Vacuity - it makes no sense - Xu is more eloquent

> for me.

>

> Will

 

 

Will, I cannot understand why no one in our profession has any trouble with

counterintuitive biomedical language. Even lay people seem to have little

problem with it. . .my patients, for example, are very versed in it. It is

quite arbitrary, based on obscure latin roots, but does the job. It is also

quite standardized. For example, thrombocytopenia. Why not just say,

'having fewer than the number of platelets per unit of volume of blood'?

If you look in the Practical Dictionary, you will see why vacuity makes

sense, and why it is a better term choice than deficiency (although I have

no problem with deficiency, per se). This has been discussed enough in the

literature that I don't need to add more here. As far as xu goes, Pinyin in

and of itself is a bridge between Chinese and English, but doesn't express

inate meaning without access to the original character. It gets quite

clumsy if you have sentences that are replete with technical terms. For

further extrapolation on the Pinyin issue, go to paradigm-pubs.com, go to

the reference section, pull down the Nigel Wiseman menu, and download " A

Reply to Buck and Maciocia " .

 

 

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