GI SX

[Guest guest]

I think you stated this very clearly. However, what do you mean by the GI

sx

below? Example?

doug

(BTW: And do you think " liver qi " is one of those " straight from Chinese " terms

we

can change?)

 

> Interestingly in liver depression, GI sx are most pronounced and one uses

> formulas like wen dan tang which includes no liver depression herbs at all.

>

> Can anyone add clarity to this?

>

> I think that is beyond dispute. But if xiao yao is indiated in liver

constraint

> before OR after the spleen has been invaded, then where does chai hu shu gan

> wan fit in this scheme. Why would one use chai hu shu gan wan for liver

> depression alone if xiao yao is actually indicated. Perhaps qin bo wei has a

> clue. chau hu shu gan wan seems to fulfill his therapy in liver qi, not liver

> depression. Liver qi implies the liver is excess in its coursing and needs

> rectification, while liver depression means the liver is vacuous in its

coursing.

> So chai hu shu gan wan is indicated for liver invading the ST where coursing

is

> already excessive, while xiao yao san is for depression that may also involve

> spleen involvement now or later.

>

> Qin says liver depression may evolve into liver qi (which may also occur by

> itself), but liver qi cannot be restored back to depression. So in liver qi,

the

> invasion of the middle has already occurrred, while in xiao yao, it can go

either

> way. While many of us already use chai hu shu gan wan and xiao yao in this

> way, this does raise some questions about the placement of chai hu shu gan

> wan with liver depression in the absence of spleen vacuity. While this is

> correct, it may obscure the nature of the actual pattern, in which invasion

has

> already occurred. Or is it actually correct to use CHSGW in a pure depressive

> binding condition.

>

> Because CHSGW contains chai hu, it relieves depression, but the other herbs

> are mainly there to rectify stagnation from excessive coursing (wood

> overrestrains earth) that has resulted secondarily from the depression. BTW,

> qin clearly states that xiao yao san is a qi and blood supplementing formula

> that treats both a lack of coursing (wood fails to restrain earth) and lack of

> spleen qi. If liver depression causes liver qi, then one my use CHSGW,

> however if liver qi (over coursing or invading) arises directly from mental

> irritation, then one does not use chai hu rx at all, but focuses on the

middle.

> Interestingly in liver depression, GI sx are most pronounced and one uses

> formulas like wen dan tang which includes no liver depression herbs at all.

>

> Can anyone add clarity to this?

>

 

[Guest guest]

, " " wrote:

> I think you stated this very clearly. However, what do you mean by

the GI sx

> below? Example?

 

I miswrote, the qin does not say GI sx are not more evident than core liver

symptoms, just that the clinical strategy emphasizes the stomach

 

> doug

> (BTW: And do you think " liver qi " is one of those " straight from Chinese "

terms we

> can change?)

 

I am sure chip translated Qin's use of gan qi. However I have no idea how

widespread this idea is. It seems to be liver qi invading or counterflowing in

each case.

 

> > Interestingly in liver depression, GI sx are most pronounced and one uses

> > formulas like wen dan tang which includes no liver depression herbs at all.

 

chip writes on page 52 (translator's comment), referring to liver depression or

would not restraining earth,

" clinically, ... the emphasis is on the earth phase and there is a predominance

of symptoms involving stagnation within the stomach. these symptoms

include chest oppression, nausea, slow digestion and abdominal distension.

therapeutically, earth is oftenharmonized with with damp-transforming and

spleen regulating medicinals. when this is accomplished, the liver becomes

regulated without further intervention. Examples of this approach include jie

gan qian and wen dan tang. "

 

Everyone knows the latter rx does not have any liver depression herbs, per se.

the former rx is actually very simliar to ban xia hou po tang plus er chen tang

with bai shao. It thus does not course the liver significantly.

 

digression: bai shao, according to qin, does not course the liver. it

constrains it,

thus nourishing and softening to relieve constraint. It is thus ideal to

inhibit

overcoursing in liver qi or prevent secondary invasion subsequent to liver

depression

 

digression: this is a great example of the usefulness of classic texts and their

clinical relevance. despite the characterization of the members of this group

as

having no interest in such material, I believe it is rather the case that we

seek

information from the classics to serve practice. that practice can pivot from

the modern TCM methodology into the classics as necessary, that classical

mastery study need not precede clinical practice. This, as Scheid points out,

was chosen as the most pragmatic way to teach CM and deliver healthcare

based upon those ideas in the modern era. While opposed by many, then and

now, it has become a fait accompli internationally. It will be up to future

historians to discover why.

 

But arguably, it is nothing new. While there have always been a literati-

physician class, I believe one of Unshuld's other recurring themes was that the

largest group of healers in China were always of a more pragmatic bent (read

his books or take it up at the unschuld forum). Perhaps TCM is a decent

compromise between the classical scholars and the ubiquitous pragmatists.

One that lays a solid foundation of effective clinical practice and jumping off

point for exploring the classics and modern science. So it is not only

desirable,

but necessary, that as we explore this idea of developing some consensus on

TCM diagnostic standards, we refer to classic texts to support our positions as

necessary.

 

I am no classical scholar myself, but qin quotes liberally from a variety of

" classics " , thus he opens himself up to dispute on this account. Anyone game?

that's part of the issue with classical study. how many of us can grasp it

without modern commentary anyway. I found the same thing to be true of

my studies of western philosophy or eastern religion. I couldn't just pick up

the bhagavadgita. When I did, I invariably got it all wrong. Guided

interpretation, which is in part what TCM accomplishes, is not only necessary

but desirable for all advanced learning. Draw a map, then explore the actual

terrain. The problem is when people stop at the map. I think people in this

group may not explore the terran as I always would, but I think its quite clear

that no one here has pinned themselves to the map. Oh yeah, get multiple

commentaries before starting to conjecture on one's own.

 

digression: it is interesting that qin mentions xiao yao san as almost an

afterthought for liver depression. He says an alternative approach to the one

described above using wen dan tang uses chai hu as in xiao yao. Alternative,

not standard.