Shao Yang syndrome

[Guest guest]

Friends -

 

Yesterday I had an opportunity to inquire about Shao Yang patterns with one of the more respected experts on the subject in the Beijing TCM University circles - Yang Tiande. According to Dr. Yang, if there is fever, then it must be alternating chills and fever. However, this is not the most significant symptom/sign for him - he uses the wiry pulse (that is after a floating pulse due to an attack of the exterior by Wind or Cold). Dr. Yang's position is that Zhang Ji was expert in pulse diagnosis and it was a critical piece of his method.

 

Will Morris

[Guest guest]

No - but the Paradigm Press version has clear pulse indicators. Shang Han Za Bing Lun has accounts of pulse patterns within each differential. My experience confirms Dr Yang's opinion. In my opinion, the textual elucidations and modern day studies have no basis without personal clinical verification.

 

Will

 

In a message dated 12/6/01 12:10:49 AM Pacific Standard Time, jramholz writes:

 

 

The pulse descriptions in the SHL are rather sparse. Did Yang Tiande every say why he thought Zhang Ji was an expert at pulses?

[Guest guest]

Will:

 

This is what I thought in an earlier posting.

 

The pulse descriptions in the SHL are rather sparse. Did Yang Tiande

every say why he thought Zhang Ji was an expert at pulses?

 

Jim Ramholz

 

 

 

 

 

 

, WMorris116@A... wrote:

> Friends -

>

> Yesterday I had an opportunity to inquire about Shao Yang patterns

with one

> of the more respected experts on the subject in the Beijing TCM

University

> circles - Yang Tiande. According to Dr. Yang, if there is fever,

then it must

> be alternating chills and fever. However, this is not the most

significant

> symptom/sign for him - he uses the wiry pulse (that is after a

floating pulse

> due to an attack of the exterior by Wind or Cold). Dr. Yang's

position is

> that Zhang Ji was expert in pulse diagnosis and it was a critical

piece of

> his method.

>

> Will Morris

[Guest guest]

I would also question Dr. Z.Z.J.'s expertise in pulse... For example

there is much commentary written on how many of the pulses are actually

just references to pattern identification, not anything to do with the

actual feeling of the pulse. Like a sort of code. Since we will never

know the truth on that one, we can look at usages, and if taken for face

value, one still sees a very limited, and most superficial, use of

pulses... if it was a critical piece in the method, why was not more

detail given?

 

Speaking of wiry, what do you think about Hammer's description of taut,

tense, tight, and wiry? Also, his ideas / commentary on the historical/

modern differences in the tight pulse are interesting eh? Especially

when applying in to excess w-c attack?

 

 

-

 

>

> jramholz [jramholz]

> Thursday, December 06, 2001 12:07 AM

>

> Re: Shao Yang syndrome

>

> Will:

>

> This is what I thought in an earlier posting.

>

> The pulse descriptions in the SHL are rather sparse. Did Yang Tiande

> every say why he thought Zhang Ji was an expert at pulses?

>

> Jim Ramholz

, WMorris116@A... wrote:

> > Friends -

> >

> > Yesterday I had an opportunity to inquire about Shao Yang patterns

> with one

> > of the more respected experts on the subject in the Beijing TCM

> University

> > circles - Yang Tiande. According to Dr. Yang, if there is fever,

> then it must

> > be alternating chills and fever. However, this is not the most

> significant

> > symptom/sign for him - he uses the wiry pulse (that is after a

> floating pulse

> > due to an attack of the exterior by Wind or Cold). Dr. Yang's

> position is

> > that Zhang Ji was expert in pulse diagnosis and it was a critical

> piece of

> > his method.

> >

> > Will Morris

>

>

>

[Guest guest]

In a message dated 12/6/01 8:17:08 AM Pacific Standard Time, alonmarcus writes:

 

 

 

Will what if the patient has a tendency or chronic wiry pulse anyway?

 

 

That would be the nervous system or Liver Depression Qi Stagnation (I hate to use the word Qi given recent discourse ;-) It either doesn't count - or they could require Xiao Chai Hu Tang with additional confirmation. This would be for a progression from a floating pulse to a moderate depth with wiriness.

Also - the frequency of alternating chills and fever could be spread out over days.

 

Will

[Guest guest]

Will what if the patient has a tendency or chronic wiry pulse anyway?

Alon

 

-

WMorris116

Wednesday, December 05, 2001 10:47 PM

Re: Shao Yang syndrome

Friends - Yesterday I had an opportunity to inquire about Shao Yang patterns with one of the more respected experts on the subject in the Beijing TCM University circles - Yang Tiande. According to Dr. Yang, if there is fever, then it must be alternating chills and fever. However, this is not the most significant symptom/sign for him - he uses the wiry pulse (that is after a floating pulse due to an attack of the exterior by Wind or Cold). Dr. Yang's position is that Zhang Ji was expert in pulse diagnosis and it was a critical piece of his method. Will Morris 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.

[Guest guest]

Also - the frequency of alternating chills and fever could be spread out over days. >>>This is interesting. If one has a chills and then a fever in a few days then it can be considered alternating fever chills?

Alon

 

-

WMorris116

Thursday, December 06, 2001 10:22 AM

Re: Re: Shao Yang syndrome

In a message dated 12/6/01 8:17:08 AM Pacific Standard Time, alonmarcus writes:

Will what if the patient has a tendency or chronic wiry pulse anyway? That would be the nervous system or Liver Depression Qi Stagnation (I hate to use the word Qi given recent discourse ;-) It either doesn't count - or they could require Xiao Chai Hu Tang with additional confirmation. This would be for a progression from a floating pulse to a moderate depth with wiriness. Also - the frequency of alternating chills and fever could be spread out over days. Will 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.

[Guest guest]

In a message dated 12/6/01 9:15:39 AM Pacific Standard Time, alonmarcus writes:

 

 

This is interesting. If one has a chills and then a fever in a few days then it can be considered alternating fever chills?

 

yes...very interesting...will

[Guest guest]

<<I would also question Dr. Z.Z.J.'s expertise in pulse... >>

 

With all due respect, I will follow the Dr's Yang and their opinions on this.

<<For example there is much commentary written on how many of the pulses are actually just references to pattern identification, not anything to do with the

actual feeling of the pulse. Like a sort of code. >>

 

Can you rephrase this? Please include reference passages.

 

<<Since we will never know the truth on that one, we can look at usages, and if taken for face value, one still sees a very limited, and most superficial, use of

pulses... if it was a critical piece in the method, why was not more

detail given?>>

 

Critical components are often simple and powerful. Further details could well obfuscate an eloquent and deeply meaningful message.

<<Speaking of wiry, what do you think about Hammer's description of taut,

tense, tight, and wiry? >>

 

They are very convenient for record keeping. However, it can be confusing for the uninitiated. One must also consider whether the use of a mainstream term such as tight or wiry for idiosyncratic purposes is what one wishes to do. I have moved in and out of the use of these terms in this fashion over the years. If I am not concerned with communicating with colleagues it is a more efficient method of recording a finely differentiated progression of Chinese pathophysiology.

 

 

Also, his ideas / commentary on the historical/modern differences in the tight pulse are interesting eh?

 

Yes - that's why I spent 8 years with him. Anything specific? I often disagreed with the man -- yet I have deep love and respect for him.

 

Will

[Guest guest]

In a message dated 12/7/01 7:31:38 AM Pacific Standard Time, pemachophel2001 writes:

 

 

I haven't read the whole string, so I may have missed the relevant cite, but what is your source for this assertion?

 

 

Bob - I've been reading too many documents the last few weeks and I don't recall. As soon as I find it, I'll post.

Will

[Guest guest]

Will,

 

I haven't read the whole string, so I may have missed the relevant

cite, but what is your source for this assertion?

 

Bob

 

 

, WMorris116@A... wrote:

> In a message dated 12/6/01 9:15:39 AM Pacific Standard Time,

> alonmarcus@w... writes:

>

>

> > This is interesting. If one has a chills and then a fever in a few

days then

> > it can be considered alternating fever chills?

>

> yes...very interesting...will

[Guest guest]

Will,

 

Thanks. I regard it as highly dubious, but I'd like to judge the

credibility of the source before weighing in on this.

 

Bob

 

 

, WMorris116@A... wrote:

> In a message dated 12/7/01 7:31:38 AM Pacific Standard Time,

> pemachophel2001 writes:

>

>

> > I haven't read the whole string, so I may have missed the relevant

> > cite, but what is your source for this assertion?

> >

>

> Bob - I've been reading too many documents the last few weeks and I

don't

> recall. As soon as I find it, I'll post.

>

> Will

[Guest guest]

In a message dated 12/7/01 11:41:14 AM Pacific Standard Time, pemachophel2001 writes:

 

 

Thanks. I regard it as highly dubious, but I'd like to judge the credibility of the source before weighing in on this.

 

 

 

Bob - I still do not have the source but spent the evening with a friend from Chengdu Suwen Su, taking the opportunity to inquire about the issue. Dr. Su said "of course, this is a malarial pattern that would be classified under Shao Yang stage". Dr. Su's specialty is dermatology and he has 20 years experience. I will seek out the commentary of a specialist in SHL with 40+ years of experience.

 

Will

[Guest guest]

In a message dated 12/10/01 7:03:48 AM Pacific Standard Time, rorykerr writes:

 

 

I'm not sure what Alon and Will are trying to describe here, but it seems to be a period of chills, followed by a period of neither chills nor fever, followed by a period of fever. If this is the case, then it doesn't sound like malaria, which has a sequence of fever and chills, or alternating chills and fever, over a short period of time, (a few hours), followed by one or more days of no fever and chills. The cycle repeats at regular intervals. The fever and chills are not separated by days.

 

Also, a distinction should be made between a malarial pattern at the shaoyang stage, and a shaoyang stage shang han pattern as described in the SHL. They aren't the same thing.

 

 

You are correct Rory. That was a highlight of Suwen Su's opinion as he pontificated on the correlations. SHL does not specify time frame for chill-fever alternation. I have seen three cases wherein a larger time frame was involved (days) and the use of Xiao Chai Hu Tang was successful. In my opinion, extending the concept out over several days is not much of a stretch.

A bigger stretch is the previous conversation about chills and fever being mandated to render a Shao Yang diagnosis. The text states only one key symptom from the category is necessary. The claim 'since the text is missing portions, Zhang Ji really intended Chills alternating with fever to be a critical component of the diagnosis' doesn't hold up logically for me.

 

Students miss the diagnosis time and time again because of hanging onto the notion of alternating chills and fever as a necessary component of the diagnosis. As Dr. Yang and three other Chinese faculty I have surveyed recently replied 'it is only true in the context of fever.' If there is fever - it must be alternating chills and fever.

 

A wiry pulse is a critical portion of the diagnosis. If there is a bitter taste in the mouth and dizziness, yet the pulse is deep and thready - there is potential trouble if Xiao Chai Hu Tang is prescribed under conditions that may be a Shao Yin condition. I believe type of circumstance is why Yang Tiande considers the pulse the most important feature of a Shao Yang syndrome. A condition wherein pulse is not as critical might be a Yang Ming Jing pattern where a high fever is the most critical diagnostic component. Here the pulse will probably flood (arrive with force and depart without force) but it may not be "big."

 

Will

[Guest guest]

At 10:31 AM -0600 12/6/01, Alon Marcus wrote:

>Also - the frequency of alternating chills and fever could be spread

>out over days.

> >>>This is interesting. If one has a chills and then a fever in a

>few days then it can be considered alternating fever chills?

------------

 

At 3:07 AM -0500 12/10/01, WMorris116 wrote:

>>In a message dated 12/7/01 11:41:14 AM Pacific Standard Time,

>>pemachophel2001 writes:

>>

>>Thanks. I regard it as highly dubious, but I'd like to judge the

>>credibility of the source before weighing in on this.

>>

>Bob - I still do not have the source but spent the evening with a

>friend from Chengdu Suwen Su, taking the opportunity to inquire

>about the issue. Dr. Su said " of course, this is a malarial pattern

>that would be classified under Shao Yang stage " . Dr. Su's specialty

>is dermatology and he has 20 years experience. I will seek out the

>commentary of a specialist in SHL with 40+ years of experience.

 

---------

 

I'm not sure what Alon and Will are trying to describe here, but it

seems to be a period of chills, followed by a period of neither

chills nor fever, followed by a period of fever. If this is the case,

then it doesn't sound like malaria, which has a sequence of fever

and chills, or alternating chills and fever, over a short period of

time, (a few hours), followed by one or more days of no fever and

chills. The cycle repeats at regular intervals. The fever and chills

are not separated by days.

 

Also, a distinction should be made between a malarial pattern at the

shaoyang stage, and a shaoyang stage shang han pattern as described

in the SHL. They aren't the same thing.

 

Rory

 

--

[Guest guest]

 

WMorris116

[WMorris116]

I have seen three cases wherein a larger time frame was

involved (days) and the use of Xiao Chai Hu Tang was successful

 

[JASON]

Just because XCHT works for a given

situation a) doesn’t mean that the rx

is even what got the person ‘better’, b) does not allow one to use

some circular logic and believe that the ‘situation’ was then a

shaoyang… XCHT does NOT equal shaoyang. Let us not forget there is much more to

understanding the essence of shaoyang, and there are many formulas one may prescribe

in such a pattern/ shaoyang.

 

 

-Jason

[Guest guest]

These are the opinions of Yang Meiqiang. He maintains that SHL has 1900 year history of use and can be used from a biomedical-scientific point of view. Dr Yang had a conversion 30 years ago when children were dying of a combined pneumonia and small pox epidemic. Biomedical approaches were failing and in his position as hospital chief, he allowed the SHL specialist to see a case. This went successfully as a Shao Yin diagnosis. So they went to the SHL specialist's teacher the three men devised a treatment plan for delivery to the other hospitals in the region. Dr Yang has followed SHL and his two dedicated SHL specialist teachers for the last 30 years now.

Shao Yang Cellular immunity is weak and so is the pathogen. Low toxicity causes a lower fever. Aversion to cold is only slight. This is because the endopyrogens are low so the fever is low. Depending on which aspect there will be more aversion to fever or more aversion to cold. It is more common than Tai Yang especially in children and elderly. It is the first choice and can cover many disorders. Though the toxins weak, it is still a toxin which will cause disorder of the vegetative nervous system the Sympathetic Main symptoms are nervous system or digestive such as bitter mouth, dry throat, dizziness, or headache. These are due to slight toxins attacking the body. If there are no toxins but emotional disorders, the same symptoms may be present. Depression thus applies to Shao Yang disease. This is why it is the most commonly prescribed formula. Xiang Huo premiere fire – due to emotional disorders. The sympathetic stimulation that takes place in the Tai Yang Stage lingers and affects gut function. Dr Yang studied this and showed that there is a reduction of gastrin, cholecystokinin, and enterase under the influence of the sympathetic dominant state caused by a presence of pathogens in the system.

 

This concurs with my experience and what I have taught on this subject for the last 9 years. Often, my first indication that the Shao Yang may be penetrated is loss of appetite. It is easy enough to rule out the other patterns, they are much more severe.

 

To be redundant: give me a patient with wind cold or wind heat attack. Let the pulse be no longer floating but wiry, and let there be a loss of appetite - bingo. I will begin to add XCHT to the external relieving formula in proportion to the distribution of symptoms.

 

Will

If cold or fever are not very severe give Xiao Chai Hu Tang.

[Guest guest]

In a message dated 12/11/01 11:11:05 AM Pacific Standard Time, alonmarcus writes:

 

 

Will were can i get more of Dr Yang writings

 

Alon - these are some of my notes and I am already at the upper limit of disseminatable (under contract) information.

 

Will

[Guest guest]



Will were can i get more of Dr Yang writings

Alon

 

-

WMorris116

Cc: WilliamLZuby

Tuesday, December 11, 2001 9:58 AM

Re: Re: Shao Yang syndrome

These are the opinions of Yang Meiqiang. He maintains that SHL has 1900 year history of use and can be used from a biomedical-scientific point of view. Dr Yang had a conversion 30 years ago when children were dying of a combined pneumonia and small pox epidemic. Biomedical approaches were failing and in his position as hospital chief, he allowed the SHL specialist to see a case. This went successfully as a Shao Yin diagnosis. So they went to the SHL specialist's teacher the three men devised a treatment plan for delivery to the other hospitals in the region. Dr Yang has followed SHL and his two dedicated SHL specialist teachers for the last 30 years now. Shao Yang Cellular immunity is weak and so is the pathogen. Low toxicity causes a lower fever. Aversion to cold is only slight. This is because the endopyrogens are low so the fever is low. Depending on which aspect there will be more aversion to fever or more aversion to cold. It is more common than Tai Yang especially in children and elderly. It is the first choice and can cover many disorders. Though the toxins weak, it is still a toxin which will cause disorder of the vegetative nervous system the Sympathetic Main symptoms are nervous system or digestive such as bitter mouth, dry throat, dizziness, or headache. These are due to slight toxins attacking the body. If there are no toxins but emotional disorders, the same symptoms may be present. Depression thus applies to Shao Yang disease. This is why it is the most commonly prescribed formula. Xiang Huo premiere fire – due to emotional disorders. The sympathetic stimulation that takes place in the Tai Yang Stage lingers and affects gut function. Dr Yang studied this and showed that there is a reduction of gastrin, cholecystokinin, and enterase under the influence of the sympathetic dominant state caused by a presence of pathogens in the system. This concurs with my experience and what I have taught on this subject for the last 9 years. Often, my first indication that the Shao Yang may be penetrated is loss of appetite. It is easy enough to rule out the other patterns, they are much more severe. To be redundant: give me a patient with wind cold or wind heat attack. Let the pulse be no longer floating but wiry, and let there be a loss of appetite - bingo. I will begin to add XCHT to the external relieving formula in proportion to the distribution of symptoms. Will If cold or fever are not very severe give Xiao Chai Hu Tang. 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.

[Guest guest]

In a message dated 12/11/01 2:26:46 PM Pacific Standard Time, zrosenbe writes:

 

 

 

This is very interesting. Has Dr. Yang published any articles in the Chinese journals you could guide me to?

 

No

[Guest guest]

Fernando,

 

 

 

how would you modify xcht if the above patient has also been diagnosed with Hepatitis C (and hopefully told you about it) and is under interferon therapy?

 

 

Remove Chai Hu and add Qing Hao. I would also consider using Bu Zhong Yi Qi Tang, Ling Zhi, Wu Wei Zi, Han Lian Cao, and Nu Zhen Zi.

 

Should you remove Chai Hu, would the formula be just as effective?

 

Also, is it still unethical/illegal to ask a patient if he/she has been diagnosed with hepatitis?

 

 

I would think you are ethically bound to make the inquiry. What state do you live in? Ethics are a complex inquiry and are closely linked to legal structure.

 

Will

[Guest guest]

This is very interesting. Has Dr. Yang published any articles in the

Chinese journals you could guide me to?

 

 

On Tuesday, December 11, 2001, at 07:58 AM, WMorris116 wrote:

 

> These are the opinions of Yang Meiqiang. He maintains that SHL has 1900

> year history of use and can be used from a biomedical-scientific point

> of view. Dr Yang had a conversion 30 years ago when children were dying

> of a combined pneumonia and small pox epidemic. Biomedical approaches

> were failing and in his position as hospital chief, he allowed the SHL

> specialist to see a case. This went successfully as a Shao Yin

> diagnosis. So they went to the SHL specialist's teacher the three men

> devised a treatment plan for delivery to the other hospitals in the

> region. Dr Yang has followed SHL and his two dedicated SHL specialist

> teachers for the last 30 years now.

>

> Shao Yang

>

> Cellular immunity is weak and so is the pathogen. Low toxicity causes a

> lower fever. Aversion to cold is only slight. This is because the

> endopyrogens are low so the fever is low. Depending on which aspect

> there will be more aversion to fever or more aversion to cold. It is

> more common than Tai Yang especially in children and elderly. It is the

> first choice and can cover many disorders. Though the toxins weak, it

> is still a toxin which will cause disorder of the vegetative nervous

> system the Sympathetic

>

> Main symptoms are nervous system or digestive such as bitter mouth, dry

> throat, dizziness, or headache. These are due to slight toxins

> attacking the body. If there are no toxins but emotional disorders, the

> same symptoms may be present. Depression thus applies to Shao Yang

> disease. This is why it is the most commonly prescribed formula. Xiang

> Huo premiere fire – due to emotional disorders.

>

> The sympathetic stimulation that takes place in the Tai Yang Stage

> lingers and affects gut function. Dr Yang studied this and showed that

> there is a reduction of gastrin, cholecystokinin, and enterase under

> the influence of the sympathetic dominant state caused by a presence of

> pathogens in the system.

>

> This concurs with my experience and what I have taught on this subject

> for the last 9 years. Often, my first indication that the Shao Yang may

> be penetrated is loss of appetite. It is easy enough to rule out the

> other patterns, they are much more severe.

>

> To be redundant: give me a patient with wind cold or wind heat attack.

> Let the pulse be no longer floating but wiry, and let there be a loss

> of appetite - bingo. I will begin to add XCHT to the external relieving

> formula in proportion to the distribution of symptoms.

>

> Will  

>

> If cold or fever are not very severe give Xiao Chai Hu Tang.

 

>

>

> 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.

>

>

>

>

[Guest guest]

>>>This is very interesting. Has Dr. Yang published any articles in the

Chinese journals you could guide me to?<<<

 

For what its worth, here's a little bit that I have on Dr. Yang:

http://www.acupuncture.com/Referrals/Yang.shtml

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

[Guest guest]

> -

> WMorris116@A...

 

> To be redundant: give me a patient with wind cold or wind heat

attack. Let the pulse be no longer floating but wiry, and let there be

a loss of appetite - bingo. I will begin to add XCHT to the external

relieving formula in proportion to the distribution of symptoms.

>

> Will

>

> If cold or fever are not very severe give Xiao Chai Hu Tang.

>

 

Will,

 

how would you modify xcht if the above patient has also been

diagnosed with Hepatitis C (and hopefully told you about it) and is

under interferon therapy?

 

Should you remove Chai Hu, would the formula be just as effective?

 

Also, is it still unethical/illegal to ask a patient if he/she has

been diagnosed with hepatitis?

 

fernando

[Guest guest]

Also, is it still unethical/illegal to ask a patient if he/she has been diagnosed with hepatitis?>>>It has never been illegal or unethical. With aids their used to be an issue of charting. But asking never

Alon

 

-

fbernall

Tuesday, December 11, 2001 6:49 PM

Re: Shao Yang syndrome

> - > WMorris116@A... > To be redundant: give me a patient with wind cold or wind heat attack. Let the pulse be no longer floating but wiry, and let there be a loss of appetite - bingo. I will begin to add XCHT to the external relieving formula in proportion to the distribution of symptoms. > > Will > > If cold or fever are not very severe give Xiao Chai Hu Tang. > Will,how would you modify xcht if the above patient has also been diagnosed with Hepatitis C (and hopefully told you about it) and is under interferon therapy?Should you remove Chai Hu, would the formula be just as effective?Also, is it still unethical/illegal to ask a patient if he/she has been diagnosed with hepatitis?fernandoChinese 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.