RE: yin fire & (multiple patterns)

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Wednesday, July 18, 2001 10:39 AM

 

Re: yin fire & dx.

 

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

sometimes it the combination of the herbs that you must look at like

bai shao and gui zhi in gui zhi tang. You cant just say you see here is a

spicy herbs and a blood tonic so we have two treatment principle

 

 

I totally disagree. the formulas can be used to address patterns in

combination or as a function of the individual herbs.

 

 

(Jason) That later part I would like to understand better, especially in

context of traditional approaches to writing formulas. Firstly, I am having

problems understanding that some of these simple formulas (mentioned

previously) are treating multiple (4-5) patterns.. Maybe I am

misunderstanding on a purely semantical level, but with my limited

experience I would like to put forth a proposition (or two):

Firstly I agree with alon. Does seeing a herb (i.e. ban xia) in a rx mean

the rx is transforming phlegm? I say no... Just because one sees i.e. ma

huang in a formula does not mean that you are releasing the exterior

(especially coupled with shi gao). One must look at the other herbs in a

formula and understand that there is synergy that is created by combining

them that treats a given tx principle for a pattern. What is the pattern?

(I say the diagnosis). I find that naming off the actions of a formula (as

todd mentioned a few msg.'s ago) is different than the pattern(s) being

treated. One can ask if a patient comes in with a blood stasis problem

(with underlying xue xu) (or xue xu with xue yu) would one give si wu tang?

It contains chuan xiong and dang gui... I would not. I would something like

tao hong si wu tang - this moves blood. So... I would not say that si wu

tang invigorates the blood. Of course severity is an issue, but just from a

theoretical perspective trying to understand the chinese method of dx --> tx

principles --> formula - I see that this is important -- for at least me to

understand.

I propose that many times these herbs that could be used for other things in

context with herbs in a given formula are sometimes not. Noting how the

Chinese assign various titles to placement of the herbs (i.e. chief, deputy,

assistant etc...) elaborates on this concept. Herbs many times are just

there to support the Chief herb, not really acting truly on its own.. I feel

this is holistic and the way Chinese formulas have been understood in the

past. For example, a moving herb is commonly added to a rx to keep things

from becoming too cloying, so yes one might say the formulas' action might

be moving, but it is not treating a stagnation pattern. Todd suggests: 6

gentlemen regulates qi (ala chen pi?) - > I feel if the patient came in with

a diagnosis of spleen qi deficiency (w/ damp) and qi stagnation, the formula

would not be 6 gentlemen. The chen pi is to transform damp /plegm in this

situation - following the dx associated with this rx. -- with other herbs

it could be used to address a qi stagnation pattern. Therefore I have a

hard time saying that 6 gentlemen regulates qi. Am I wrong to think in this

way?

So I propose that our Chinese forefathers still thought in relatively simple

patterns (1-2) and still do, but include other supporting herbs that may

look like the formula is doing a tremendous amount of things, but in regard

to the actual patient is still focusing on 1 or 2 areas. This is also

evidenced by every Eastern case study manual I own and almost every book.

Also the argument that Americans are complex and need complex formulas , I

am unsure, I am contemplating this. But if xia yao san or any of these

basic formulas mentioned previously are actually treating 4-5 patterns then

this would suggest that the Chinese were also complex since the beginning of

formula writing.. But again I propose that it is not the patient that is any

more or less complex but the practiontioners thinking.

As an exercise one could take many of the larger formulas (12+ ingredients)

and name off 8+ supposed different patterns that it treats -- looking at

herbs individually. I personally find this a Cartesian approach that seems

somewhat un-Chinese. This is not to say that it is not valid or even less

effective -- my argument seems to center around the original thinking behind

patterns and formulas/diagnosis of historical formulas and cases -- and then

of course how that relates to present day.

Finally does any of this actually matter... I have seen Todd's formulas and

have always thought highly of them; being well-balanced and effective. If

one says they are treating 1-2 patterns or 4-5 patterns and comes up with

the same formula does it matter? I think it only matters when you're not at

a very sophisticated level (i.e. students) -- it seems that many students

that take on multiple pattern philosophy forget about Synergy and how herbs

work together, picking one herbs for this, one herb that, one for that etc..

That is my feeling why diagnosis is kept simple and clear in the books --

which forms a solid foundation for the treatment principle.

Question: case studies that I have read take this simple approach; they are

the majority of the time real cases. Are they dumbed down for educational

purposes (1-2 patterns) or is the practitioner actually thinking on this

level? This is my question- trying to understand thought patterns of great

physicians of the past/present.

Question2: Why then do Chinese Dr.'s (as Todd noted from the PCOM files)

keep the dx. to 1-2 patterns if they are actually treating 4-5 patterns.. Or

are they not, and are we just interpreting something from their formulas?

If they are they must obviously be making a priority and then other

'patterns' are supporting the main focus correct? Again a semantical word

game?

this is why gui

zhi tang has been modified slightly to address far more than the

original taiyang syndrome, including heart disease and digestive

complaints.

 

(Jason) Yes but modified is the key.. i.e. in gui zhi jia shao yao tang,

doubling the bai shao sinks the gui zhi down into the abdomen to treat a

more digestive complaint and not release the exterior.. It now is a

different rx and different actions and treating a different pattern. Just

because one sees gui zhi does not mean that bai shao and gui zhi are

harmonizing the ying and wei.. or even releasing the exterior for that

matter. The chief ingredient changes hands. Changing the focus.. So,

changing the dosage changes the synergy of the herbs in the formula. Bai

shao significantly changes the way (where) gui zhi's actions are taking

place. If one just looks at things individually one could easily

misunderstand and prescribe the wrong rx.

Same for xiao chai hu tang.

 

(Jason) I am unsure how looking at the mods of these rx's demonstrates

prescribing according to the " functions of individual herbs " .

 

 

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