Guest guest Posted August 22, 2000 Report Share Posted August 22, 2000 I was in San Diego last week observing a clinic shift at PCOM. During a discussion of long dan xie gan tang and what constituted overuse of this formula, I mentioned the famous dictum that it will injur the spleen if overused. And that recurring dampheat that seemed to call for repeated uses of this formula suggest a deeper pathology that is at the root (perhaps yin xu, yin fire, depressed fire). And that while this rx would definitely relieve branch sx each time, it might be at the expense of the root (since bitter herbs can both injur the spleen and dry the yin). The other supervisor felt that the prohibition against long dan xie gan tang was overstated. In Bensky, we are warned against long term large dosage use, but what that means is vague. Is two weeks long term? one month? I think in low to moderate doses this formula is indeed safe for a few weeks. It is the recurrent need that always concerns me. The conversation then segued into what my colleague felt was a clinical overemphasis on spleen/stomach pathology. Now those of you who have taken my classes or read some of my recent articles know that I lay my emphasis on the qi dynamic in general, rather than spleen/stomach in particular. Numerous factors disrupt the qi dynamic, including spleen xu, dampheat, gu toxins, liver depression, blood stasis and phlegm. However, having said that, in my practice, I think it is clear that american diet, worrying, lack of exercise lead to clear spleen pathology in almost all of my chronically ill patients. This doesn't have to be the case. I could envision a scenario where dampheat from causes other than diet leads to yin xu in a patient who eats well, exercises and has a healthy spleen. But in Portland, with damp weather, endless milky lattes and incredulous stares if you dare say, "hold the mayonnaise", that is the exception. Well, you don't have to spend more than a few hours in San Diego to realize things are a bit different. The weather is conducive for year round exercise, even if just walking. The climate would be forgiving to the spleen in another way, as well. Raw salads are well tolerated in the warm weather. So I wonder if my college was speaking from his experience, which may be quite different form mine. We saw this disparity based on climate when treating AIDS patients in Portland. After a year, myself, Heiner Fruehauf, subhuti dharmananda, Edie Vickers, several chinese doctors all agreed that damp, phlegm and yang xu prevailed, with liver qi depression being most prevalent in early stages. This was despite the fact that most early reports from California emphasized yin xu and dryness. Robert Kaneko, clinic director at OCOM suggested to me at the time that this was a climatic influence at work. ITM seemed to prefer the theory of AIDS as a shang han disorder, but I continue to think the disparity was climatic in nature. -- Chinese Herbal Medicine (503) 771-9599 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2000 Report Share Posted August 22, 2000 on 8/22/00 11:04 AM, Todd at wrote: I was in San Diego last week observing a clinic shift at PCOM. During a discussion of long dan xie gan tang and what constituted overuse of this formula, I mentioned the famous dictum that it will injur the spleen if overused. And that recurring dampheat that seemed to call for repeated uses of this formula suggest a deeper pathology that is at the root (perhaps yin xu, yin fire, depressed fire). And that while this rx would definitely relieve branch sx each time, it might be at the expense of the root (since bitter herbs can both injur the spleen and dry the yin). The other supervisor felt that the prohibition against long dan xie gan tang was overstated. In Bensky, we are warned against long term large dosage use, but what that means is vague. Is two weeks long term? one month? I think in low to moderate doses this formula is indeed safe for a few weeks. It is the recurrent need that always concerns me. The conversation then segued into what my colleague felt was a clinical overemphasis on spleen/stomach pathology. Now those of you who have taken my classes or read some of my recent articles know that I lay my emphasis on the qi dynamic in general, rather than spleen/stomach in particular. Numerous factors disrupt the qi dynamic, including spleen xu, dampheat, gu toxins, liver depression, blood stasis and phlegm. However, having said that, in my practice, I think it is clear that american diet, worrying, lack of exercise lead to clear spleen pathology in almost all of my chronically ill patients. This doesn't have to be the case. I could envision a scenario where dampheat from causes other than diet leads to yin xu in a patient who eats well, exercises and has a healthy spleen. But in Portland, with damp weather, endless milky lattes and incredulous stares if you dare say, " hold the mayonnaise " , that is the exception. Well, you don't have to spend more than a few hours in San Diego to realize things are a bit different. The weather is conducive for year round exercise, even if just walking. The climate would be forgiving to the spleen in another way, as well. Raw salads are well tolerated in the warm weather. So I wonder if my college was speaking from his experience, which may be quite different form mine. We saw this disparity based on climate when treating AIDS patients in Portland. After a year, myself, Heiner Fruehauf, subhuti dharmananda, Edie Vickers, several chinese doctors all agreed that damp, phlegm and yang xu prevailed, with liver qi depression being most prevalent in early stages. This was despite the fact that most early reports from California emphasized yin xu and dryness. Robert Kaneko, clinic director at OCOM suggested to me at the time that this was a climatic influence at work. ITM seemed to prefer the theory of AIDS as a shang han disorder, but I continue to think the disparity was climatic in nature. From observing students, I think that nearly all of them have spleen damage from poor diet and overthinking. We cannot overemphasize spleen issues in this culture. But, yes, there is more tolerance for colder yin foods in this climate. However, long dan xie gan tang, in my opinion, is overused. Like in every clinical situation, over and over again, the pattern has to be correct to choose the prescription, otherwise undesirable effects and even transmuted patterns are possible. I agree with the other supervisor that the Bensky text that what is a long-term usage or dosage is not clear. . . ..another reason why clincial Chinese records and access to source texts for prescriptions is important. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2000 Report Share Posted August 22, 2000 Dear I think, the long dan xie gan tang need to be taken for 2 week to three week, then change another formula depend on the patient's body need on your diagnosis You have happy day. Nhung Ta > > I was in San Diego last week observing a clinic shift at PCOM. During > a discussion of long dan xie gan tang and what constituted overuse of > this formula, I mentioned the famous dictum that it will injur the > spleen if overused. And that recurring dampheat that seemed to call > for repeated uses of this formula suggest a deeper pathology that is > at the root (perhaps yin xu, yin fire, depressed fire). And that > while this rx would definitely relieve branch sx each time, it might > be at the expense of the root (since bitter herbs can both injur the > spleen and dry the yin). The other supervisor felt that the > prohibition against long dan xie gan tang was overstated. In Bensky, > we are warned against long term large dosage use, but what that means > is vague. Is two weeks long term? one month? I think in low to > moderate doses this formula is indeed safe for a few weeks. It is the > recurrent need that always concerns me. > > The conversation then segued into what my colleague felt was a > clinical overemphasis on spleen/stomach pathology. Now those of you > who have taken my classes or read some of my recent articles know that > I lay my emphasis on the qi dynamic in general, rather than > spleen/stomach in particular. Numerous factors disrupt the qi > dynamic, including spleen xu, dampheat, gu toxins, liver depression, > blood stasis and phlegm. However, having said that, in my practice, I > think it is clear that american diet, worrying, lack of exercise lead > to clear spleen pathology in almost all of my chronically ill > patients. This doesn't have to be the case. I could envision a > scenario where dampheat from causes other than diet leads to yin xu in > a patient who eats well, exercises and has a healthy spleen. But in > Portland, with damp weather, endless milky lattes and incredulous > stares if you dare say, " hold the mayonnaise " , that is the exception. > > Well, you don't have to spend more than a few hours in San Diego to > realize things are a bit different. The weather is conducive for year > round exercise, even if just walking. The climate would be forgiving > to the spleen in another way, as well. Raw salads are well tolerated > in the warm weather. So I wonder if my college was speaking from his > experience, which may be quite different form mine. We saw this > disparity based on climate when treating AIDS patients in Portland. > After a year, myself, Heiner Fruehauf, subhuti dharmananda, Edie > Vickers, several chinese doctors all agreed that damp, phlegm and yang > xu prevailed, with liver qi depression being most prevalent in early > stages. This was despite the fact that most early reports from > California emphasized yin xu and dryness. Robert Kaneko, clinic > director at OCOM suggested to me at the time that this was a climatic > influence at work. ITM seemed to prefer the theory of AIDS as a shang > han disorder, but I continue to think the disparity was climatic in > nature. > > > -- > > Director > Chinese Herbal Medicine > > (503) 771-9599 > > ---- > > ---- > 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. > > Quote Link to comment Share on other sites More sharing options...
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