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>Message: 23

> Sun, 17 Mar 2002 11:28:11 -0800

> <

>another intermediary question

 

>Is yang xu ALWAYS a further complication of qi xu?....

>The question arose when one of my students said he was

>taught that qi xu ALWAYS precedes yang xu.

 

 

 

I was surprised to read that a student had insisted on this absolute

truth. My impression from the assortment of professors and textbooks

I've been exposed to is that absolutes are rare and unreliable.

Luckily, this same student asked me the same question today and we

had a chance to sort through it a little better. After our

conversation, I think the confusion is rooted in a poorly phrased

inquiry.

 

Based on your post and the student's confusion, I see two distinct

questions:

 

1] Is it possible to have one without the other?

-- a question of co-existence and degrees

 

2] Is it possible to have one without first having had the other?

-- a question of progression and stages

 

In other words, can you have Yang Xu without having s/s of Qi Xu in

the pattern? This seems improbable to me, mostly because many Yang

Xu s/s present as exaggerated Qi Xu s/s. Several textbooks skirt the

issue by using the dual term of " Yang Qi " which encompasses both.

For the sake of analogy, this question is like asking whether you can

be ravenous without being hungry. While the crazed ravenous feeling

predominates, hunger is an element of the sensation.

 

The second question is a little different in that it asks whether Qi

Xu NECESSARILY preceded the manifestation of Yang Xu. My brief

encounters with teachers like Bob Damone, Z'ev, and Min Fan lead me

to believe Qi Xu is not a prerequisite for Yang Xu. Overdosing your

patient on Shi Gao can directly max out the Yang, for example. In

this case, it's like asking whether a person is ALWAYS hungry before

they become ravenous. Someone in the acute stage of a blood sugar

crash could tell you it's very possible to go directly to a ravenous

state without feeling the milder sensation of hunger first.

 

As for the separate question regarding Kidney Qi Xu v. Kidney Yang

Xu, the books aren't very explicit. ZANG FU SYNDROMES, for example,

lists " Kidney Qi not Consolidated " as a sub-category of Kidney Yang

Xu. The Qi Xu pattern actually reflects the state of UB function not

being supported by Kidney Yang. Other sources, such as Deng's

PRACTICAL DIAGNOSIS, use the convenient Kidney Yang Qi phrase which

covers all the bases.

 

I'm pressed for time, so these are my superficial musings on the

subject.

 

I'm also hungry, which explains my choice of analogy :)

 

--Laurie Burton

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Laurie,

 

According to my understanding, yang (as in heart, spleen, or kidney

yang) is only a lot of qi in one place, enough qi to manifest both

warmth (wen) AND function (yong). So I would also say that yang

vacuity always includes qi vacuity.

 

However, that does not mean that if you have a yang vacuity, you

always need to include qi supplements, althgough this is commonly the

case, as in Shen Qi Wan, Kidney Qi Pills. A look through the

yang-supplementing category of formulas in B & B shows that almost all

do, in fact, include one or meds which supplements the qi and not

necessarily yang. Similarly, looking at the interior warming formulas,

the overwhelming majority contain at least one qi-supplementing med.

Or check out A Handbook of TCM Patterns & Their Treatments. The heart

yang vacuity pattern includes Ren Shen, as does the spleen yang

vacuity Rx, as does the lung-kidney yang vacuity Rx, and the large

intestine vacuity Rx contains Bai Zhu, Fu Ling, Gan Cao, and Da Zao.

 

Nor does it mean that the damage to the qi cannot be so great as to

directly manifest a pattern of yang vacuity without passing through

some intermediary qi vacuity pattern stage.

 

At least, this is my experience and understanding.

 

Bob

 

, " burtonperez " <tgperez@e...> wrote:

> >Message: 23

> > Sun, 17 Mar 2002 11:28:11 -0800

> > <@i...>

> >another intermediary question

>

> >Is yang xu ALWAYS a further complication of qi xu?....

> >The question arose when one of my students said he was

> >taught that qi xu ALWAYS precedes yang xu.

>

>

>

> I was surprised to read that a student had insisted on this absolute

> truth. My impression from the assortment of professors and

textbooks

> I've been exposed to is that absolutes are rare and unreliable.

> Luckily, this same student asked me the same question today and we

> had a chance to sort through it a little better. After our

> conversation, I think the confusion is rooted in a poorly phrased

> inquiry.

>

> Based on your post and the student's confusion, I see two distinct

> questions:

>

> 1] Is it possible to have one without the other?

> -- a question of co-existence and degrees

>

> 2] Is it possible to have one without first having had the other?

> -- a question of progression and stages

>

> In other words, can you have Yang Xu without having s/s of Qi Xu in

> the pattern? This seems improbable to me, mostly because many Yang

> Xu s/s present as exaggerated Qi Xu s/s. Several textbooks skirt

the

> issue by using the dual term of " Yang Qi " which encompasses both.

> For the sake of analogy, this question is like asking whether you

can

> be ravenous without being hungry. While the crazed ravenous feeling

> predominates, hunger is an element of the sensation.

>

> The second question is a little different in that it asks whether Qi

> Xu NECESSARILY preceded the manifestation of Yang Xu. My brief

> encounters with teachers like Bob Damone, Z'ev, and Min Fan lead me

> to believe Qi Xu is not a prerequisite for Yang Xu. Overdosing your

> patient on Shi Gao can directly max out the Yang, for example. In

> this case, it's like asking whether a person is ALWAYS hungry before

> they become ravenous. Someone in the acute stage of a blood sugar

> crash could tell you it's very possible to go directly to a ravenous

> state without feeling the milder sensation of hunger first.

>

> As for the separate question regarding Kidney Qi Xu v. Kidney Yang

> Xu, the books aren't very explicit. ZANG FU SYNDROMES, for example,

> lists " Kidney Qi not Consolidated " as a sub-category of Kidney Yang

> Xu. The Qi Xu pattern actually reflects the state of UB function not

> being supported by Kidney Yang. Other sources, such as Deng's

> PRACTICAL DIAGNOSIS, use the convenient Kidney Yang Qi phrase which

> covers all the bases.

>

> I'm pressed for time, so these are my superficial musings on the

> subject.

>

> I'm also hungry, which explains my choice of analogy :)

>

> --Laurie Burton

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Bob,

 

I concede at the outset that the ultimate arbiter

of the importance of what I'm about to say is its

clinical efficacy, rather its impact on clinical

results, for certainly we need to be concerned about

things that not only raise clinical effectiveness

but also those that might lower it.

 

I will happily continue the discussion with

you all the way to the direct, immediate and

enduring impact on clinical interactions of

every point involved as we proceed, but I don't

see a way to jump directly to such conclusions and

first need to mark out the path by which I

see that we can get there.

 

This really just continues the thread about

how much philosophy is enough, and I recognize

that you have already expressed your distaste

for that thread. Again, I just don't see how

to proceed without mentioning this factor though.

 

I think your understanding of yang2 reflects

your belief that you don¡¯t need to understand

anything about the philosophical roots of the

word in order to use it in the clinic.

>

> According to my understanding, yang (as in heart, spleen, or kidney

> yang) is only a lot of qi in one place, enough qi to manifest both

> warmth (wen) AND function (yong).

 

I think this definition of yang2 as a description

Of symptoms errs on the side of reduction of

the integral meaning beyond recognition. This

clearly lies in the realm of the definitions involved

and the particular definitions that I see being

omitted here in your understanding are precisely

the definitions that come from philosophical

sources. Yang2, for example, is always and

especially when it is used to characterize

symptoms, the potential of transforming to

yin1, along with all of its other inseparable

links to its ubiquitous complement, yin1.

The inclusion of yin1 in the understanding of yang2

has to be ever present, and it is the philosophical

roots of these terms that bind them in this manner.

Once they are separated or used, as you have

used yang2 here out of this philosophical

context the terms lose critical components of

their meanings and take on meanings that stray

from their original sense.

 

The great doctors that I have observed do not

see yang2 as just a bunch of qi4 in one place.

They see the patient as a dynamic series of

transformations and always bear in mind

that what they are looking at is the flux

of yin1 and yang2. They know that conditions

constantly change from a fundamental philosophical

precept related to yin1 yang2 and change.

They employ their theoretical tools to ascertain

the nature of those changes and determine how

they can best be influenced to return to more harmonious

patterns. All of this, such doctors have told me,

stems from their understanding of yin1 and yang2

as they emerge from Chinese philosophy.

 

If yang2 as a symptom is and means

there's just a lot of qi4 in one place,

how does yin1 figure in this understanding?

 

It seems to me that the only way to proceed

is for me to ask you to give your definitions

completely so that I can be sure that I know

what you're talking about before discussing

it further.

 

I'm happy to keep it to just three terms:

 

yin1 yang2 qi4

 

In fact we can just keep it to qi4, as I would

welcome the opportunity to respond to your

conclusion about our new book that it has no

bearing on clinical realities or the enhancing of

a reader's clinical competence by pursuing this

discussion, as I believe I can demonstrate otherwise,

at least give a strong suggestion that there is a

likelihood that individuals can, by understanding

what qi4 and yin1 and yang2 mean in the broadest possible

context of their original philosophical meanings,

enhance their grasp of what they are doing

in the clinic. I think it follows naturally that

people who understand what they're doing more

deeply can be anticipated to produce routinely

better results, regardless of their field of

endeavor.

 

I want to repeat that the book was not written with

a specific objective related to the enhancement of

readers' clinical competence. But as I thought about,

I realized that what you were saying was really not

so much about the book, of which you seemed to approve,

as it was about the point in contention here, i.e. that what's

in the book does have relevance to the education of doctors.

 

So, let's continue. The point appears to be

still very much unresolved. And if I'm wrong

and it all is irrelevant, I need to know.

 

Yang2 is not only a lot of qi4 in one place.

 

Your utter omission of the philosophical

perspective here has reduced a medical principle

beyond recognition, and I suggest potential clinical

function. I won't go into it any further until you

express your willingness to pursue the discussion .

 

We can get to what difference does it make,

but we have to go step by step. Of course, you

don't have to go along with me on this at all.

But I hope you will.

 

Ken

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, " dragon90405 " <yulong@m...> wrote:

>

>

> I think this definition of yang2 as a description

> Of symptoms errs on the side of reduction of

> the integral meaning beyond recognition.

 

 

Sometimes a cigar

is just a cigar.

 

 

 

Bob's answer is very useful, especially his examination of herbs prescribed to

treat the clinical diagnosis of various Yang Xu patterns. His perspective makes

the idea tangible and immediate, practical qualities for someone who must think

quickly within the limited time afforded clinical treatments.

 

This practicality in no way negates the value of your life's work; it

complements it. Your scholarship is valuable to all of us, perhaps in ways that

cannot be accurately measured. Bob's ability to hone in on one facet of complex

diagnosis is also valuable. One need not cancel the other out.

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> >

> > I think this definition of yang2 as a description

> > Of symptoms errs on the side of reduction of

> > the integral meaning beyond recognition.

>

>

> Sometimes a cigar

> is just a cigar.

 

But yang2 is never without yin1,

even in a cigar.

>

>

>

> Bob's answer is very useful, especially his examination of herbs

prescribed to treat the clinical diagnosis of various Yang Xu

patterns. His perspective makes the idea tangible and immediate,

practical qualities for someone who must think quickly within the

limited time afforded clinical treatments.

 

I didn't say that Bob's answer wasn't

useful. I commented on it because I

see in it an illustrative example of

the point that I've been trying to make.

I've never suggested that Bob's approach

to clinical medicine is not useful. I don't

assert that my approach should replace

his. I believe that he has a successful long

term practice, which indicates to me

that he knows what he's doing and his

voluminous publication on the subject

certainly testifies to the usefulness

of much of what he has to say.

 

I tend to say more or less precisely

what I mean, and had I meant to say that

Bob's answer was not useful, I would have

said that.

 

 

> This practicality in no way negates the value of your life's work;

it complements it.

 

I couldn't agree with you more, which is

precisely why I'm taking the time to

juxtapose them for all to see, hopefully

as clearly as possible.

 

Your scholarship is valuable to all of us, perhaps in ways that

cannot be accurately measured.

 

I'm glad you find it valuable, regardless of

whether or not all do. I'm always most

concerned with communication. And one

concern, which I did express about what

Bob had to say about A Brief History of Qi

was that it suggested to me that that work

has no particular value to those engaged in

studying and trying to understand the

medicine. I, of course, agree with you

or I wouldn't have been so bold as to

publish a book and promote it to a community

for whom it had no value.

 

Bob's ability to hone in on one facet of complex diagnosis is also

valuable. One need not cancel the other out.

 

The value of this discussion is that

it continue, not that it end. I am

in no slightest way interested in

canceling anything out. The finding

of fault does not equal the urge to

eradicate. I once again invoke the

proverbial wisdom of Wm. Blake:

 

Opposition is true friendship.

 

Even if it gets heated up from time

to time, perhaps especially when it

gets heated up. It means we're on to

something that matters, and

I think we can all learn a great deal

by finding out why it matters so much.

 

Ken

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