misconceptions persist?

[Guest guest]

, Marnae Ergil <marnae@p...>

wrote:

 

> >

> >In any given outbreak of rhinovirus, 50% of those who contract the virus

> >never exhibit signs and symptoms of disease. I believe that all

> >who do exhibit disease do have some predisposing factor that has allowed

> >them to be invaded and become diseased by external evils.

>

> Could it not just be that that day they " let their defenses down " , got

> tired, were outside too long or whatever? Does there really have to be a

> vacuity? If so then is it appropriate to use MHT or would GZT be better?

>

>

 

 

 

that's what I was thinking.

 

todd

[Guest guest]

As a PCOM student I don't ever remember being taught to use Yu Ping Feng San

for all conditions. We are taught to take into consideration pattern

identification/treatment principle/ methods/formula. Formulas and modifications

should

conform to treatment methods and synergy of combinations. This is reinforced

in Jiao Shu De's book " ten lectures on use of medicinals " I feel his

introductions is one of the best guidelines for the use of herbs I have read. He

feels

principles/methods/formulas and medicinals are inseparably connected.It is

easy to theoretically argue any CM concept but what does clinical experience

over

decades tell us? It tells me that i don't have the volume of clinical

experience, yet, to debate fully what the masters have discovered. It takes in

depth

knowledge and humility to gain creative license, something that takes years.

When it come to Yu Ping Feng San specifically, Subhuti Daharmanandahe

quotes from " The Advanced textbook of TCM and Pharmacology " that Yu Ping Feng

San and Gui Zhi Tang are both indicated for exterior weakness

syndromes...similar but different. He comments that YPFS is more suited to those

suffering from

damp syndromes ie children while adults may easily suffer from damage to yin,

weakness of blood, etc. Long-term use of YPFS in its original form can

therefor damage not tonify. So persons suffering from dryness should expand the

formula to include principle elements of Sheng Mai San to tonify qi and yin. For

tonification, he also recommends another option, Bu Zhong Yi Qi Tang.

Again, another opinion. However in my mind... pattern

identification/treatment principle/method/formula/medicinals.

 

Full article of Yu Ping feng San I found at

www.itmonline.org/arts/jadescreen.htm

 

KenHoffman

 

 

 

[Guest guest]

> > Could it not just be that that day they " let their defenses down " , got

> > tired, were outside too long or whatever? Does there really have to be a

> > vacuity? If so then is it appropriate to use MHT or would GZT be better?

 

> that's what I was thinking.

>

> todd

 

Marnae &

 

If we're going to think like Chinese doctors, then we have to be consistent. If

one is tired, then there is vacuity, even if that vacuity is

only transient. Fatigue is, ipso facto, a symptom of qi vacuity. Another

possibility, every day we all experience a transient

relative defensive qi vacuity in the exterior when the defensive qi retreats

into the interior around sundown.

 

What does " letting one's guard down " mean to you in terms of Chinese medicine?

It seems a curious lapse of CM ideation.

 

Bob

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

Fatigue is, ipso facto, a symptom of qi vacuity. Another possibility, every day

we all

experience a transient

> relative defensive qi vacuity in the exterior when the defensive qi retreats

into the

interior around sundown.

>

> What does " letting one's guard down " mean to you in terms of Chinese medicine?

It

seems a curious lapse of CM ideation.

 

 

Bob

 

good points all, none of which I can dispute. I will ask if all agree that

" Fatigue is,

ipso facto, a symptom of qi vacuity " . I have read this from you, but seen other

thoughts as well. Is this a matter of differing opinion or clear right and

wrong?

 

[Guest guest]

, wrote:

 

Or is this a condition based treatment that works

> regardless of pattern?

 

 

I asked this question in my original post on the subject of YPFS. Of course,

the

answer would have to be no, but perhaps a qualified one. Do what appear to be

condition based treatments often work due to the elegance of the rx? According

to

Tom's rationale, YPFS works in most people because it addresses mechanism that

are

largely at play in most of those who are susceptible and balances clearing and

supplementing. The same could be said of the widespread use of xiao chai hu

tang

in Japan for hepatitis and why it seems so effective without regard for careful

pattern

dx.

 

[Guest guest]

At 5:15 PM +0000 1/6/04, wrote:

>good points all, none of which I can dispute. I will ask if all

>agree that " Fatigue is, ipso facto, a symptom of qi vacuity " . I

>have read this from you, but seen other thoughts as well. Is this a

>matter of differing opinion or clear right and wrong?

--

 

I agree with Bob, also with his comment about maintaining CM

ideation. I would qualify his statement by saying that there may be

many reasons for qi vacuity, and qi vacuity may not be the main issue

to be addressed. Marnae raised the case of someone experiencing

transient tiredness due to say, inadequate sleep, or overwork that

day. Whether or not that person catches a cold will depend on

environmental factors relative to their qi. If not, a good night's

sleep will probably resolve the feelings of fatigue. If this person

who feels fatigue does catch a cold, then we can conclude that the

person's defenses were down, ie they had some measure of qi vacuity

that allowed a pathogen to take hold. IMO, it does not make sense to

conclude that the person has qi vacuity in the latter example but not

in the former.

 

The pattern they exhibit may a repletion, eg either wind strike or

cold damage, but this does not imply that there is not some measure

of qi vacuity that contributed to the situation. IMO, it simply means

that right now we have to use the appropriate strategy to treat the

cold as it is presenting. Once the surface is cleared, by either

harmonizing ying and wei or opening the interstices and promoting

sweating, if there are other issues to address, then do so. Marnae

also raised the question of whether to use ma huang tang or gui zhi

tang in a patient who was tired before for the reasons mentioned.

IMO, this choice should be made entirely on the presentation, and not

on the presence or absence of fatigue the day before. Of course the

instructions for both gui zhi tang and ma huang tang should include

going to bed wrapped warmly, so the issue of needed rest may well be

taken care of during the course of treatment.

 

Of course, people who catch colds may not necessarily experience

previous fatigue, and may be in good health. In that case I wouldn't

conclude that there was any measure of qi vacuity, only that the

pathogen was strong, or that the quantity of exposure was

overwhelming.

 

Rory

 

 

--

 

 

 

[Guest guest]

If we're going to think like Chinese doctors, then we have to be consistent. If

one is tired, then there is vacuity, even if that vacuity is

only transient.

>>>Bob I have to disagree with this statement. For example, pathogenic dampness

from exterior causes can block clear qi and lead to fatigue or what is described

in Chinese as cumbersome heaviness, both mental and physical. Many patients with

pathogenic factors complain of fatigue that respond to formulas that clear and

respond poorly to formulas that supplement. At the same time there are plenty of

references in the literature that state that whenever there is an excess of

pathogens righteous is deficient. Here again there is the question of theory vs.

practice. One can find supporting statements to justify just about any position.

Since CM is really a daily experiment when one's theory is tested on each

patient by his or hers response to treatment, only real cases can be discussed.

And since a trend can only be seen when large numbers of patients are analyzed

(and hopefully against another treatment), again only good clinical studies can

resolve these questions.

Alon

 

 

 

[Guest guest]

, Rory Kerr <rory.kerr@w...> wrote:

 

> --

>

> I agree with Bob, also with his comment about maintaining CM

> ideation. I would qualify his statement by saying that there may be

> many reasons for qi vacuity, and qi vacuity may not be the main issue

> to be addressed.

 

Ironically, perhaps the misconceptions are mine. but again, what about the

relatively healthy person with slight depressive heat and phlegm that don't

manifest

as any chronic sysmptoms that bother the patient. Is this person benfited by

taking

YPFS?

 

[Guest guest]

A related question I have would then be whether gui pi wan is the " student "

formula

that would benefit all students. good for overthinking injuring the spleen, poor

sleep,

anxiety, poor memory, etc. is it sufficiently elegant to serve this purpose for

all. I

find it to be a cloying formula. while good for some students, I have treated

others

with xiao yao san and huang lian wen dan tang with shi chang pu with good

results as

well for these sx.

 

[Guest guest]

, " Alon Marcus " <alonmarcus@w...>

wrote:

 

> >> Many patients with pathogenic factors complain of fatigue that respond to

formulas that clear and respond poorly to formulas that supplement.

 

my experience squares with Alon's. especially those with liver depression

leading to

emotional depression and a sense of fatigue.

 

[Guest guest]

would qualify his statement by saying that there may be

many reasons for qi vacuity, and qi vacuity may not be the main issue

to be addressed. Marnae raised the case of someone experiencing

transient tiredness due to say, inadequate sleep, or overwork that

day. Whether or not that person catches a cold will depend on

environmental factors relative to their qi.

>>>>How about patients with Yin that feel fatigue in the morning and improved in

afternoon after activity, so typical of yin pathogens?

Alon

 

 

[Guest guest]

my experience squares with Alon's. especially those with liver depression

leading to

emotional depression and a sense of fatigue.

 

>>>Also often in dampness and dampheat, as well as bloodstasis and food

stagnation

Alon

 

 

[Guest guest]

Clear right and wrong. While some Chinese authors posit a phlegm damp

encumbrance pattern, when they go on to treatment, it is

clear from an analysis of the meds that it is an underlying spleen vacuity

causing phlegm dampness. So the fatigue is not directly a

result of the phlegm dmapness, but is pathognomonic of qi vacuity. This is also

what I was taught at the Shanghai College of CM.

 

Bob

[Guest guest]

Along these lines, the MHT pattern is described in Chinese as an " exterior

repletion " (biao shi) in terms of the eight principles. That's

all that's being said. Neither more nor less. It is also describing the

constellation of signs and symptoms after the person has gotten

sick. It in no way describes the person's condition before they got ill. Pattern

and disease cause are not one and the same thing in

standard professional Chinese medicine, unless on is talking specifically about

" disease cause pattern discrimination. "

 

Bob

[Guest guest]

Excellent question. He or she probably would be ok and maybe even benefit from

taking YPFS. However, this is not the standard

correct answer to their clinical conundrum. They should take Xiao Chai Hu Tang

preventively. Why? The defenisive qi issues from the

middle burner and is a by-product of the function of the spleen. At least that

is the standard contemporary point of view in the PRC.

In this case, this patient's liver depression causing the depressive heat is

inextricably involved with their spleen vacuity. " When the

liver is depressed, first replete the spleen, " and, " Liver disease is spleen

disease. " In addition, their spleen vacuity/defensive qi vacuity

is also inextricably and bidirectionally involved with the phlegm. " The spleen

is the root of phlegm engenderment, " but, " The

Spleen is averse to dampness. " Further, their phlegm is inextricably associated

with their liver depression bidirectionally. " Qi

stagnation and phlegm turbidity are mutually engendering. " XCHT deals

categorically with all of these things. If one wants, one could

add some Radix Astragali Membranacei (Huang Qi) to that Rx in order to increase

it's ability to strengthen this particular patient's

defensive qi even more. Remember, the defensive qi is part of the righteous qi,

and the righteous qi is produced abundantly when the

viscera and bowels function correctly in a balanced and harmonious way.

 

Bob

[Guest guest]

, " " wrote:

> A related question I have would then be whether gui pi wan is the " student "

formula

> that would benefit all students. good for overthinking injuring the spleen,

poor sleep,

> anxiety, poor memory, etc. is it sufficiently elegant to serve this purpose

for all. I

> find it to be a cloying formula. while good for some students, I have treated

others

> with xiao yao san and huang lian wen dan tang with shi chang pu with good

results as

> well for these sx.

 

No, it's not. This is because, previously we were talking about the production

of the defensive qi. Now you have switched to talking

about a set of symptoms. While there is only one avenue for the production of

the defensive qi, there are multipe disease mechanisms

causing the symptoms you list, some involving repletion and some vacuity. As you

have noted, differetn students with various

combinations of the above symptoms have benefited from different formulas,

presumably because they manifest different overall

patterns.

 

Bob

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

> > > Could it not just be that that day they " let their defenses

down " , got

> > > tired, were outside too long or whatever? Does there really

have to be a

> > > vacuity? If so then is it appropriate to use MHT or would GZT

be better?

>

> > that's what I was thinking.

> >

> > todd

>

> Marnae &

>

> If we're going to think like Chinese doctors, then we have to be

consistent. If one is tired, then there is vacuity, even if that

vacuity is

> only transient. Fatigue is, ipso facto, a symptom of qi vacuity.

 

I do not agree with this statement, and many others do not also

(Chinese and western)... Fatigue can be from stagnation, yin xu,

external attack etc etc. In these situations one does not give qi

supplementors to alleviate the fatigue.

 

-

[Guest guest]

, " "

wrote:

> A related question I have would then be whether gui pi wan is

the " student " formula

> that would benefit all students. good for overthinking injuring

the spleen, poor sleep,

> anxiety, poor memory, etc. is it sufficiently elegant to serve

this purpose for all. I

> find it to be a cloying formula. while good for some students, I

have treated others

> with xiao yao san and huang lian wen dan tang with shi chang pu

with good results as

> well for these sx.

>

 

 

 

 

I agree 100%... these statements, even though running rampant

through the schools, and probably even exist in China, are gross

over-simplifications. I think these statements go unchecked because

the majority of students that actually believe in this type of

thinking end up buying the teapills and pop a few every once in

while and bingo they may feel better (placebo, or not) and more

importantly, at the dose they use, there is little chance of side-

effects. But guipiwan, IMO, does not fit many people in my patient

population. I have only prescribed it once in the last 6 months.

I think there are tons of these statements, like yinqiao for any

kind of external attack, or shenghuatang for every post-partumer

(past CHA topics). These are silly, and even though they might come

out of a Chinese mouth (usually a questionable herbalist) they are

just for the general populous, and not individualized- and can be

harmful. They can be a problem if the person really is need of help

or dose is therapeutic.

I.e. can you give siwutang to every woman after menses. NO! , but

the majority of woman that don't have real problems can take this

and probably get benefit. But if the case is complex and the woman

has serious menstrual issues, there is good reason to question this

generalization and make sure supplementing blood is enough or even

necessary.

-

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

> Excellent question. He or she probably would be ok and maybe even

benefit from taking YPFS. However, this is not the standard

> correct answer to their clinical conundrum. They should take Xiao

Chai Hu Tang preventively. Why? The defenisive qi issues from the

> middle burner and is a by-product of the function of the spleen.

At least that is the standard contemporary point of view in the PRC.

 

I can't seem to find the original post that this msg is responding

to so forgive me if it is out of context… I am just going to make

some general comments that I disagree with…

I am still unsure what source this standard is coming from, but, it

is my understanding that, wei qi is a product of the Lungs, spleen

and kidneys, and some say also from liver qi. China is still a huge

country with millions of practs with different views about many

things…

 

 

> In this case, this patient's liver depression causing the

depressive heat is inextricably involved with their spleen

vacuity. " When the

> liver is depressed, first replete the spleen, " and, " Liver disease

is spleen disease. "

 

Yes these are Chinese quotes, but there are plenty of quotes to

support anything… They do not make up some universal truth or

statement of fact, IMO… For example there are plenty of times that

one moves liver qi and does not include spleen tonics… You have to

always look at the herbs and TX P. Therefore Liver disease does not

always constitute spleen disease in the clinic.

 

In addition, their spleen vacuity/defensive qi vacuity

> is also inextricably and bidirectionally involved with the

phlegm. " The spleen is the root of phlegm engenderment, " but, " The

> Spleen is averse to dampness. "

 

Again I think the former is true and not. There are times when

there is phlegm in the lungs and the spleen is not involved. Do you

agree?

 

-

[Guest guest]

> I do not agree with this statement, and many others do not also

> (Chinese and western)... Fatigue can be from stagnation, yin xu,

> external attack etc etc. In these situations one does not give qi

> supplementors to alleviate the fatigue.

 

Jason,

 

1. Please quote a Chinese source that says stagnation can cause fatigue.

 

2. Yin xu always includes an element of qi xu as does yang xu. See the opening

chapters of the Xue Zheng Lun's discussion of the

relationship between qi and yin fluids. I know Chip has a copy.

 

3. If fatigue occurs with an external attack, then it is due to qi xu. Fatigue

is not a standard symptom of wind cold or wind heat

external contraction. If you say it is, then please cite me a Chinese source

which says it. When there is fatigue, there is either a half

internal-half external pattern or an external repletion and internal vacuity. In

the first case, Xiao Chai Hu Tang is the standard Rx; in the

second, an external draining-internal supplementing Rx is chosen, again, often

XCHT.

 

Bob

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

 

>

> 3. If fatigue occurs with an external attack, then it is due to qi xu. Fatigue

is not a

standard symptom of wind cold or wind heat

 

In wiseman's PD, all references to fatigue say qi xu is underlying. However, we

need

to address the fact that so many anecdotes suggest fatigue has been relieved by

using excess clearing herbs. Perhaps what we are treating is not really

fatigue. But

also, does not circulating qi help restore mild vacuity. If according to yan de

xin,

stagnation causes vacuity, then perhaps in mild or early cases of fatigue,

moving qi

and transforming phlegm leads to quick restoration of the qi w/o direct

addressing.

This does not mean there was no vacuity, just that it did not need to be treated

directly. does that make sense?

 

As for fatigue during a cold, this sx is also relieved in relatively healthy

people by

clearing the pathogen w/o qi supplementing. So the same scenario may apply. We

assume the fatigue was due to the pathogen because treating the pathogen alone

restored the qi. I don't think it is that hard to accept that treating one

pattern may

affect another and one may get overall positive effect w/o addressing

everything. Its

all a matter of degree. If we are talking about CFS patients, then I think

vacuity is

pronounced enough to necessitate direct tx. Fatigue for a few months or mild

fatigue, perhaps not. does this explain experience and preserve theory.

 

I think the same thing applies to the YPFS issue. Perhaps underlying vacuity

is

necessary for wei qi instability (wiseman does not have an entry for wei qi

vacuity,

BTW, which underscores the importance of careful terminology in this discussion

as

Thomas has pointed out). But perhaps in some patients of young age and good

health, all that is necessary to prevent the arisal of vacuity is to keep the

body clear of

phlegm and the qi circulating. It really comes down to chicken and egg. Is it

not a

valid point of contention as to whether vacuity is the main cause of stagnation

or

vice-versa?

 

[Guest guest]

, " Bob Flaws "

<pemachophel2001> wrote:

> > I do not agree with this statement, and many others do not also

> > (Chinese and western)... Fatigue can be from stagnation, yin xu,

> > external attack etc etc. In these situations one does not give

qi

> > supplementors to alleviate the fatigue.

>

> Jason,

>

> 1. Please quote a Chinese source that says stagnation can cause

fatigue.

>

> 2. Yin xu always includes an element of qi xu as does yang xu. See

the opening chapters of the Xue Zheng Lun's discussion of the

> relationship between qi and yin fluids. I know Chip has a copy.

 

I do not doubt that what you say is in the book you say, but that

does not make it fact. This is an idea and I think it is wrong, and

there is much evidence to support this, IMO. I think more important

than statements like this is clinical reality. For examples, case

studies and pattern descriptions with treatments. For example, if

one sees treatments that address fatigue as a complaint (among

others) and do not include qi tonics, this says much. For example:

vertigo, dizziness, tinnitus headache fatigue etc. red tongue yellow

coating – TxP:subdue yang and search wind, level the liver and

transform stasis – shanyangjiao, shi jue ming, dan shen, xuan shen,

shan zhi, huangqin, gouteng, tianma,niuxi, yi mu cao, tongtiancao…

(No tonics)

 

Furthermore, there are plenty of yin xu Rx's that do not contain qi

xu tonics. Take dabu yin wan for example. If such Rxs exist and

they actually supplement yin and cure the condition then I have a

hard time believing that all yin xu patterns have an element of qi

xu.

 

What do you think of someone who has liver fire -> insomnia ->

fatigue.. DO you want to supplement, do they have qi xu.. I don't

see it that way.

 

Under vacuity taxation/ detriment (which I assume csn relate

directly to the complaint of fatigue) it lists the 7 emotions,

external damage etc. as a cause… as a pattern we have blood stasis

and also there is yin xu (lung) pattern- and the Tx is

shashenmaimendongtang – (note: no qi supplementing)

 

Finally one of the #1 complaints in the US besides back pain is

fatigue… I see it all the time. These people many times do have qi

xu, but many times do not. Moving qi and blood many times cures

them (among other things that are not qi supplementing), as Todd

mentions.

 

 

>

> 3. If fatigue occurs with an external attack, then it is due to qi

xu. Fatigue is not a standard symptom of wind cold or wind heat

> external contraction.

 

Almost every patient that I see that is sick (flu cold) has fatigue-

AS my teachers always said, this is normal, and DO NOT supplement.

Meaning for such a pattern one most likely will be fatigued. Maybe

there is some terminology issue here, but when you give them an

externally releasing Rx and you release the pathogen, they no longer

have the fatigue, amazing.. It just seems like a no brainer. I do

not see the qi xu if you cure a problem without supplementing qi.

 

-Jason

[Guest guest]

On Jan 7, 2004, at 10:03 AM, wrote:

 

> In wiseman's PD, all references to fatigue say qi xu is underlying.

> However, we need

> to address the fact that so many anecdotes suggest fatigue has been

> relieved by

> using excess clearing herbs. Perhaps what we are treating is not

> really fatigue.

 

That was my thinking as well. Fatigue hasn't yet been well defined in

this forum.

 

According to the Clinical Handbook of Internal Medicine

(Maclean/Lyttleton) there are a few syndromes that are responsible for

somnolence (duo mei), which they define as a unique type of mental

fatigue that gives rise to the inability to stay alert during the day.

The common pathomechanism to all the syndromes listed is that the Clear

Yang is not able to rise to the head.

 

Syndromes include:

Dampness wrapping the Spleen

Phlegm obstruction

Blood stagnation

Spleen Qi deficiency

Spleen and Kidney Yang deficiency.

 

One issue that must arise too is our perceptions of ourselves and the

words that we use to describe them. Is being " burnt-out " fatigue?

 

I have a respected elder who says that most depression is dampness.

Upon further questioning I determined that the reason for this is the

apathy associated with depression. Apathy is dampness according to this

guy, which seems reasonable.

 

But apathy must also feel like fatigue to some, depending on how they

organize their bodily sensations, and this is a deeply cultural issue,

what we call our feelings.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

> I do not doubt that what you say is in the book you say, but that

> does not make it fact. This is an idea and I think it is wrong, and

> there is much evidence to support this, IMO. I think more important

> than statements like this is clinical reality. For examples, case

> studies and pattern descriptions with treatments. For example, if

> one sees treatments that address fatigue as a complaint (among

> others) and do not include qi tonics, this says much. For example:

> vertigo, dizziness, tinnitus headache fatigue etc. red tongue yellow

> coating – TxP:subdue yang and search wind, level the liver and

> transform stasis – shanyangjiao, shi jue ming, dan shen, xuan shen,

> shan zhi, huangqin, gouteng, tianma,niuxi, yi mu cao, tongtiancao…

 

Not all Chinese doctors are equal in knowledge, experience, and simple inte=

lligence. This is why it has been recongized for at

least 2000 years that Chinese doctors come in at least three grades: superi=

or, mediocre, and inferior. So a single case history from a

single Chinese doctor is meaningless. If you've read the body of my work, y=

ou will see that I have published numerous translations of

Chinese materials where the Chinese has made some terminological or procedu=

ral faux pas. The point of these published pieces is

exactly that one has to be careful when pointing to a single Chinese source=

.. Simply coming from China does not make it right, as

Alon has aptly pointed out on numerous occasions. When you go to China to s=

tudy and if you study with a number of different

teachers, you will see that some are simply better, more knowledgable, smar=

ter than others.

>

> Furthermore, there are plenty of yin xu Rx's that do not contain qi

> xu tonics. Take dabu yin wan for example. If such Rxs exist and

> they actually supplement yin and cure the condition then I have a

> hard time believing that all yin xu patterns have an element of qi

> xu.

 

Da Bu Yin Wan is a formula we all have to study in school, but look at the =

literature and you'll see it's not that commonly sed in its

pure form in clinical practice. As a building block, ok. As stand-alone, ra=

rely and, even then, questionably. Compared to Liu Wei Di

Huang Wan, it's use is minimal, and that's precisely because, among other d=

efinciency, it does not address qi vacuity. Liu Wei Di

Huang Wan is the famous Rx it is because it contains Shan Yao and Fu Ling, =

both of which supplement the qi, even if they are not

both categorized as qi supplements.

 

> What do you think of someone who has liver fire -> insomnia ->

> fatigue.. DO you want to supplement, do they have qi xu.. I don't

> see it that way.

 

The first thing is to put them to sleep. However, yes, if I were treating t=

hem and they said they were fatigued, I would supplement their

qi. One of the causes of insomnia is unconstructed and malnourished heart s=

pirit. Lack of sleep damages and consumes the qi as

does " vigorous fire " which " eats " qi. So yes, I probably would also use one=

or more supplements. Further, liver fire typically evolves

from depressive heat, and depressive heat is a species of yin fire. Li Dong=

-yuan says that fortification of the spleen helps downbear yin

fire. So, for that reason too I would likely add qi supplements. If handled=

correctly, they will not aggravate liver fire but can actually

hasten liver fire's recovering. But I have written about all of this at len=

gth also. In any case, for me, this is, at least in part, the

difference between a ming lao yi's practice and someone of lesser experienc=

e and/or intellect.

>

> Under vacuity taxation/ detriment (which I assume csn relate

> directly to the complaint of fatigue) it lists the 7 emotions,

> external damage etc. as a cause… as a pattern we have blood stasis

> and also there is yin xu (lung) pattern- and the Tx is

> shashenmaimendongtang – (note: no qi supplementing)

 

Seems to me that you need to learn that both Sha Shen and Mai Men Dong do s=

upplement the qi even though they are not

categorized as qi supplements. From my point of view, your understanding is=

not very sophisticated. Seems simplistic and

sophomoric. But, hey, that's just me speaking.

 

> Finally one of the #1 complaints in the US besides back pain is

> fatigue… I see it all the time. These people many times do have qi

> xu, but many times do not. Moving qi and blood many times cures

> them (among other things that are not qi supplementing), as Todd

> mentions.

 

Sorry, in my 26 plus years of studying and practicing CM, I have never seen=

a fatigued patient who did not have qi vacuity. Maybe you

haven't learned all the necessary signs and symptoms and the right ways to =

query. That all took me many years to. Sorry, no

shortcuts except studying with a very experienced, very educated teacher.

 

> > 3. If fatigue occurs with an external attack, then it is due to qi

> xu. Fatigue is not a standard symptom of wind cold or wind heat

> > external contraction.

>

Almost every patient that I see that is sick (flu cold) has fatigue-

 

Agreed. Me too!

 

> AS my teachers always said, this is normal, and DO NOT supplement.

> Meaning for such a pattern one most likely will be fatigued. Maybe

> there is some terminology issue here, but when you give them an

> externally releasing Rx and you release the pathogen, they no longer

> have the fatigue, amazing.. It just seems like a no brainer. I do

> not see the qi xu if you cure a problem without supplementing qi.

 

Sorry, Jason, your teacher is, IMO, simply wrong. It is typical of many mod=

ern Chinese doctors point of view. It is an example of the

overly simplistic thinking of many practitioners of modern CM. It's what a =

lot of Westerners criticize as on this forum on a regular

basis. However, you might want to look into the phenomenal success of OHCO'=

s Cold Snap and BPH's Cold Quell. Might give you

something more to think about. BTW, OHCO's formulator has been in practice =

longer than I have.

 

Bob

[Guest guest]

 

 

The question is not whether patient's symptoms can recuperate without specific

treatment. We all know they can and do. The

question is if addressing the qi makes the healing faster, better, more

complete. My expefrience says yes.

 

Please note, I only came to this conclusion after a number of years of arguing

for the more standard TCM party line on this.

 

Bob