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I was reviewing shao yang disorders and noticed Bensky listed a white

tongue coat under xiao chai hu tang?

The shang hun lun mentions many heat signs, with of course no tongue

presentation. Any comments on why

this tongue coat is not at least slightly yellow?

 

-

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Cara Frank

[herbbabe]

Saturday, March 10, 2001

5:14 AM

To:

 

Re:

shao yang

 

It reflects dampness

and spleen deficiency- the ban xia and ren shen. shao yang is half and

half- the white reflects that.

 

Cara,

 

I don't know if I can necessarily agree with this. I am unsure where this sp qi xu/

dampness comes from. I have not

seen it mentioned in any texts.

Can one equate zheng qi xu with spleen qi xu (ren shen) or plegm and

turbidly (bensky) with dampness (ban xia)? If there was a spleen qi xu with

dampness wouldn't there be other signs?

And other herbs added?

Interestingly, the shang hun lun mentions sheng jiang and ban xia

together to regulate the spleen and stomach, downbear counterflow, and

check retching. If we take this a

step further and notice that with vexation in the chest without retching ren

shen and ban xia are removed.

Commentary mentions that ban xia is removed because there is no retching

counterflow. This makes one

possibly think that ban xia is there for more of its descending properties. ??

 

I also do not see how a white tongue coat

reflects half and half??? I always thought that a white tongue coat especially

mentioned here as thin, is normal.

This is why I bring up the question...? can you elaborate on this…

 

 

 

But it isn't

necessary to get hung up on the tongue coating: the symptom picture is

the clincher.

 

 

But of

course… and as listed in the shang hun lun commentary the essential features of

shao yang disease are bitter taste in the mouth, dry throat, and dizzy vision. (With these this is sufficient for dx). And again interestingly, all three of

these symptoms are stemming from heat.

 

-Jason

 

 

 

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Jason,

The white tongue coating reflects the combined influences of heat and cold. It could easily be slightly yellow for shao chai hu tang. Either way, the tongue coating is not going to make the diagnosis (could this be why Zhang Ji left it out?). The only tongue coating that tends to be pathopneumonic for a shao yang condition is unevenly distributed side to side (Maciocia).

Will

 

In a message dated 3/10/01 5:16:17 AM Pacific Standard Time, herbbabe writes:

 

 

 

I was reviewing shao yang disorders and noticed Bensky listed a white tongue coat under xiao chai hu tang? The shang hun lun mentions many heat signs, with of course no tongue presentation. Any comments on why this tongue coat is not at least slightly yellow?

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In a message dated 3/10/01 6:42:51 AM Pacific Standard Time,

WMorris116 writes:

 

<< The only tongue coating that tends to be pathopneumonic for a

shao yang condition is unevenly distributed side to side (Maciocia).

>>

Will, what does " pathopneumonic " mean? Are you referring somehow to the lung?

If so, how does that pertain to Jason's question?

 

Julie

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Sorry....mispelled it: pathognomonic = characteristic of a disease condition.

 

Will

 

In a message dated 3/10/01 9:05:39 AM Pacific Standard Time, juliej8 writes:

 

 

Will, what does "pathopneumonic" mean? Are you referring somehow to the lung?

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on 3/9/01 11:48 AM, at wrote:

 

I was reviewing shao yang disorders and noticed Bensky listed a white tongue coat under xiao chai hu tang? The shang hun lun mentions many heat signs, with of course no tongue presentation. Any comments on why this tongue coat is not at least slightly yellow?

 

 

 

-

 

It reflects dampness and spleen deficiency- the ban xia and ren shen. shao yang is half and half- the white reflects that. But it isn't necessary to get hung up on the tongue coating: the symptom picture is the clincher.

Cara

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" not at least slightly yellow? "

 

Dear Jason,

I instinctly felt you were right and looked it up in another book,

which is kind of standard over here:

Porkert,Manfred ,Klassische Chinesische Rezeptur.

He writes:

" tongue coating thin and white or white with a touch of yellow " !

(mit einem Stich in's Gelbe)

There it is!

 

" half and half "

I think with the word ambivalent you get it better. The white coating

seems paradox to the heat signs, well that's why you recognize it is

Shao Yang disorder: because of it's ambivalent nature.

 

" sp qi xu vs. zheng qi xu "

I agree with Jason here. It is not dampness and sp xu.

It is the regulating idea which stands behind the use of chai hu on

the one side and ren shen, ban xia and gan cao on the other.

Regulating between earth and wood certainly, but not eliminating

dampness or tonifying the spleen as such. ban xia then of course is

also there because of it's descending function, to stop nausea and

enhance the appetite.

In ChengDu I was told that renshen also stands there to block the way

for the pathogenic factor not to get deeper (into the Yin), by

reinforcing the zheng qi.

 

Yours Patrick

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, " Patrick Rudolph " <patim.rudolph@g...>

wrote:

 

>

> " sp qi xu vs. zheng qi xu "

> I agree with Jason here. It is not dampness and sp xu.

> It is the regulating idea which stands behind the use of chai hu on

> the one side and ren shen, ban xia and gan cao on the other.

> Regulating between earth and wood certainly, but not eliminating

> dampness or tonifying the spleen as such. ban xia then of course is

> also there because of it's descending function, to stop nausea and

> enhance the appetite.

> In ChengDu I was told that renshen also stands there to block the way

> for the pathogenic factor not to get deeper (into the Yin), by

> reinforcing the zheng qi.

>

 

 

My SHL teachers also hearked from chengdu and I also understood the

nature of renshen as to prevent shaoyang from going to taiyin.

However, one can also use a fomula based upon an analysis of its

ingredients, not merely its classical indications. In that case, ban

xia and sheng jiang definitely address dampness and phlegm, whilst ren

shen and gancao address qi xu. I certainly may use this rx as a

template to address spleen qi with damp/phlegm and liver qi constraint

with heat. However, I usually modify the formula to address these

patterns. And such patients often present with a yellow tongue coat in

my practice. If no heat signs are present, then huang qin would not be

indicated, but this may include heat effusion in the absence of yellow

tongue coat. ther lack of yellow tongue coat in some cases suggests to

me that the heat is more superficial and has not yet affected the

internal organs in which case I expect it to show up on the tongue.

This includes when the lungs are directly affected. I find this rx to

be excellent for some cases of lingering phlegm heat with yellow tongue

coat, especially when heat effusion alternates will feeling cold. This

pattern may include cough or sinusitis. BTW, Bensky's colleague, Shou

Chun Ma was a professor at Chengdu himself.

 

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Cara,

 

 

 

I don't know if I can necessarily agree with this. I am unsure where this sp qi xu/ dampness comes from. I have not seen it mentioned in any texts. Can one equate zheng qi xu with spleen qi xu (ren shen) or plegm and turbidly (bensky) with dampness (ban xia)? If there was a spleen qi xu with dampness wouldn't there be other signs? And other herbs added?

 

My feeling is that the SP xu came first. clinically this the the usual scenario- def SP qi- def Wei qi- any manner of EPF's, and moving through the body according to 6 stages, 4 levels or wind variations ( depending on your filter)

 

Interestingly, the shang hun lun mentions sheng jiang and ban xia together to regulate the spleen and stomach, downbear counterflow, and check retching. If we take this a step further and notice that with vexation in the chest without retching ren shen and ban xia are removed. Commentary mentions that ban xia is removed because there is no retching counterflow. This makes one possibly think that ban xia is there for more of its descending properties. ??

 

 

Nausea/vomiting. may not be a symptom, bitter taste is rarely reported. What you may read in the classics, while valuable as a learning tool, may have little bearing on what your patients report. Shao yang may be reported as : I never feel like I'm the right temperature. ( think shao yang or think ying- Wei) I have never felt well since the flu always feel like I'm fighting something. ( same - but for different reasons. if it's shao yang then the P hasn't effectively thrown it off- it still half in-half out. if it's Wei then move to a gui zhi tang strategy. or cinnamon/bupluerum combo.). If there is not a sticky tongue coating, then go ahead and remove the ban xia. the formula can be drying without it. but don't rely on sx of nausea. People rarely experience it.

 

I also do not see how a white tongue coat reflects half and half??? I always thought that a white tongue coat especially mentioned here as thin, is normal. This is why I bring up the question...? can you elaborate on thisŠ

 

Most likely the tongue body is red, reddish, maybe scarlet to reflect heat. the white tongue coating reflects that there is also a damp pathogen that doesn't involve heat. that's what I meant. that two temperatures are coexisting. Also , you should remember that liver pathology is not always reflected in the tongue. You might also see: a coating on only one side, or yellow on one, white on the other side. The tongue proper could be red on only one edge ( usually the left- extremly common sx). But, heck, it could be normal, and if it is, but the sx are there, you still have a shao yang disharmony.

 

is that any clearer?

Cara

 

 

 

 

 

 

 

But it isn't necessary to get hung up on the tongue coating: the symptom picture is the clincher.

 

 

 

 

 

But of courseŠ and as listed in the shang hun lun commentary the essential features of shao yang disease are bitter taste in the mouth, dry throat, and dizzy vision. (With these this is sufficient for dx). And again interestingly, all three of these symptoms are stemming from heat.

 

 

 

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  • 8 months later...

Bob,

 

I checked with Jin Hongyun who is a 'Bao Jian Yi' or doctor's doctor in

China. Her Master's degree is in cardiology and East-West medicine.

 

Dr. Jin stated " Of course! It can be a few days between chills and

fever. Some doctors write about the cycle being up to 30 days. " She also

affirmed the notion that chills and fever are not a critical component

of a Shao Yang diagnosis although they are one of the significant ones.

Dr. Jin also stated that for a single symptom of Shao Yang syndrome to

be a basis for rendering such diagnosis, the history is key.

 

All the Chinese faculty with whom I have raised the question about

longer cycles respond " of course!!! " .

 

Will

 

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Alon...this is not the type of history Dr. Jin is referring to. However, apparently the Japanese think it is true.

 

Will

 

n a message dated 12/11/01 10:03:57 AM Pacific Standard Time, alonmarcus writes:

 

 

Dr. Jin also stated that for a single symptom of Shao Yang syndrome to

be a basis for rendering such diagnosis, the history is key.

>>>>That would explain the large license the Japanese take with thin xiao chi wu in treating almost anything, since at one time all patients have had an exterior syndrome

Alon

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Dr. Jin also stated that for a single symptom of Shao Yang syndrome tobe a basis for rendering such diagnosis, the history is key.>>>>That would explain the large license the Japanese take with thin xiao chi wu in treating almost anything, since at one time all patients have had an exterior syndrome

Alon

 

-

Will

Monday, December 10, 2001 7:30 PM

Re: Shao Yang

Bob,I checked with Jin Hongyun who is a 'Bao Jian Yi' or doctor's doctor inChina. Her Master's degree is in cardiology and East-West medicine.Dr. Jin stated "Of course! It can be a few days between chills andfever. Some doctors write about the cycle being up to 30 days." She alsoaffirmed the notion that chills and fever are not a critical componentof a Shao Yang diagnosis although they are one of the significant ones.Dr. Jin also stated that for a single symptom of Shao Yang syndrome tobe a basis for rendering such diagnosis, the history is key.All the Chinese faculty with whom I have raised the question aboutlonger cycles respond "of course!!!".WillChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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Will,

 

Thanks for the clarification. Very interesting. I confess that I'm

somewhat surprised. I'm going to poke around in my library a bit to

see if I can find any written opinions about this. If so, I'll post

them here.

 

Bob

 

, Will <will@e...> wrote:

> Bob,

>

> I checked with Jin Hongyun who is a 'Bao Jian Yi' or doctor's doctor

in

> China. Her Master's degree is in cardiology and East-West medicine.

>

> Dr. Jin stated " Of course! It can be a few days between chills and

> fever. Some doctors write about the cycle being up to 30 days. " She

also

> affirmed the notion that chills and fever are not a critical

component

> of a Shao Yang diagnosis although they are one of the significant

ones.

> Dr. Jin also stated that for a single symptom of Shao Yang syndrome

to

> be a basis for rendering such diagnosis, the history is key.

>

> All the Chinese faculty with whom I have raised the question about

> longer cycles respond " of course!!! " .

>

> Will

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, WMorris116@A... wrote:

> Alon...this is not the type of history Dr. Jin is referring to. However,

> apparently the Japanese think it is true.

>

 

I am not sure the extensive japanese use of XCHT for internal

complaints has anything to do with fever or a shaoyang dx. It seems to

be more about having a " sho " of internal excess with heat and mild

vacuity, stagnation of qi, and fluids. Perhaps one of the kampo

experts on the list could comment.

 

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Like we heard it is often used for subcostal conformation in a weak patient. But i think also on other basis

Alon

 

-

1

Wednesday, December 12, 2001 3:20 PM

Re: Shao Yang

, WMorris116@A... wrote:> Alon...this is not the type of history Dr. Jin is referring to. However, > apparently the Japanese think it is true.> I am not sure the extensive japanese use of XCHT for internal complaints has anything to do with fever or a shaoyang dx. It seems to be more about having a "sho" of internal excess with heat and mild vacuity, stagnation of qi, and fluids. Perhaps one of the kampo experts on the list could comment.Todd Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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