Guest guest Posted March 21, 2002 Report Share Posted March 21, 2002 I received this: I have a question about yourinterpretation of Stephen Clavey's work. You wrote that he clearly statesthat pathological substances can't be turned into physiological substances.I remember thinking the same thing! Really,Clavey just says that pathological substances can't perform physiologicalfunctions. They can indeed be returned to physiological functions though. Since the time I began thinking about this, many years ago now, I haveworked clinically with the concept regularly. For example, yesterday I sawa patient who had suffered from extreme watery diarrhea for over a year anda half. Her tongue was swollen, cracked with a peeling coat. I gave herherbs precisely to help her absorb pathological damp so it could becomephysiological yin. So I sent stephen this: StephenSomeone sent me this. What are your actual thoughts? Thanks. I teach some of this material and I want to be accurate.And he replied: Hi My main point was that pathological substances cannot perform physiological functions I do not remember reading anywhere in the Chinese literature about pathological substances being transformed back into physiologically useful substances; most of the time where the sequela of 'transformation' is discussed it is in regard to expulsion from the body. Probably for this reason, I do not myself think this way in clinic; that is to say I do not try to change pathological substances back into physiological ones. The example given by your questioner is not perhaps as clear as could be, since treating the watery diarrhea will naturally reduce the loss of fluids and replenish the yin which was damaged by the water loss in the first place. I would be interested in what herbs absorb the dampness to replenish the yin. There is of course the phrase Yi1 zhe3, Yi4 ye3 'Medicine is in the idea', or 'healing is in the concept' which means (as you know, most likely) that one has an understanding of what is happening with the patient, and can design a strategy for restoring balance. People work in different ways on the broad canvas of TCM (and the even broader canvas of 'Oriental Medicine'!), and so just because I haven't seen this idea in my readings doesn't mean it won't work (or even that it is not present in some place in Chinese -- I haven't read everything by a long shot!). Just haven't seen it. I tend to keep trying out the concepts I do find in Chinese because a) there are LOTS of things to try, many of which we in the West are not sufficiently familiar with yet (eg a good description of the concept of 'ascending descending entering and exiting': Sheng Jiang Chu Ru); b) I think someone should become as familiar as possible with what has been done already, while others are innovating; so I guess I can do my bit in this area, since I read Chinese and all; and c) its fun. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2002 Report Share Posted March 21, 2002 A few comments. I think this discussion rides on top of a more basic set of questions concerning the mechanisms by which environmental influences enter the organ systems of the body and interact. When you give a salty flavored herb, for example, with the idea that this flavor affects the kidney, what is happening? Or when does the spring breeze become an environmental pathogen, i.e., an evil? If I understand the questions raised, they are focused on whether or not the body can somehow " reabsorb " something that has been pathological or pathogenic and have that something become involved in normal physiology? Is that a correct restatement of the question? [...] I presume Steven isn't on the list, but here are my thoughts in response to what he said to you. > > My main point was that pathological substances cannot perform > physiological functions This seems to make perfect sense and to be more or less a simple restatement of the distinction that is implied by the two terms. > > > > I do not remember reading anywhere in the Chinese literature about > pathological substances being transformed back into physiologically > useful substances; most of the time where the sequela of > 'transformation' is discussed it is in regard to expulsion from the > body. Here is where I think we should consider the meanings of the relevant terms. For instance, what is xie2? As I read the character, and as I wrote about it in Parabola a few years back, I don't see that it is primarily a term that describes substances, rather dynamics of relationships. What is simply moving in the environment today, can be an evil tomorrow. And what is an evil for you is not necessarily an evil for me. This all follows from the very basic assumption of different patient, different place, different time: different treatment. Accordingly, I don't think there is any categorical imperative in medical theory that suggests that the pathological substances in the body cannot be processed physiologically as the body is restored to homeostasis, or in Chinese terms, relative harmony of yin1 and yang2. Almost nothing remains in the body permanently. Virtually everything just flows through. We're just tubes. Of course the ancient Chinese view was expressed differently, but functionally, I believe that the same conclusion can be reached based upon this understanding. Probably for this reason, I do not myself think this way in > clinic; that is to say I do not try to change pathological substances > back into physiological ones. This also makes good sense. Why would one want to do this? The focus of treatment should be to restore the operational balance of yin1 and yang2 in the whole body and in the affected parts and systems, no? The fate of the " pathological substance " is that it will end up like almost everything else in the body, being eventually excreted during the course of healing and normal physiology. > > The example given by your questioner is not perhaps as clear as could > be, since treating the watery diarrhea will naturally reduce the loss of > fluids and replenish the yin which was damaged by the water loss in the > first place. I would be interested in what herbs absorb the dampness to > replenish the yin. Well, I think immediately of di4 yu2. It dries up oozing, promotes the regrowth and regeneration of flesh. I was talking to a fellow who deals in herbs here in Berkeley the other day and he pointed out to me that Benksy does not list any toxicity issues and cites only one rat study in which no toxic effects but increased levels of lipids in liver cells were noted. However, most pharamcists in China with whom I've spoken about this herb (which is used for things like hemorrhoids, uterine bleeding, and superating sores, etc. quite commonly in China, though I think it is not so widely used in the States) will caution against its overuse. It contains tanin, and according to these Chinese pharmacists can be toxic to the liver. It is used in burns, but when the burns cover a large percentage of the body, I understand from these pharmacists that its use is limited owing to this potentially toxic effect. I also think of san1 qi1, which helps the body to dry and absorb fluids and is a typical ingredient in formulas given, for example to post-partum mothers in China to help restore the yin1 that is damaged during birth. As I understand it the PLA soldiers all have a bit of it in their packs for dealing with wounds and sores. So its effectiveness is quite well known in China for dealing with these issues related to accumulation of blood and other fluids and stopping them and restoring the healthy condition of the yin1. It can stop bleeding for example without causing congealed blood. In other words, it helps the body absorb the fluid while nourishing and restoring the yin1. At least that's what I've always heard about it. I use it principally in formulas for external application where its effects are quite remarkable. > > There is of course the phrase Yi1 zhe3, Yi4 ye3 'Medicine is in the > idea', or 'healing is in the concept' which means (as you know, most > likely) that one has an understanding of what is happening with the > patient, and can design a strategy for restoring balance. Excellent point. And one that further speaks to the importance of having a good firm grasp of the meanings of the terminology and the associated references in the literature. I'll just point out that there are additional interpretations of this phrase. People work in > different ways on the broad canvas of TCM (and the even broader canvas > of 'Oriental Medicine'!), and so just because I haven't seen this idea > in my readings doesn't mean it won't work (or even that it is not > present in some place in Chinese -- I haven't read everything by a long > shot!). Just haven't seen it. A'int that the truth! > > I tend to keep trying out the concepts I do find in Chinese because a) > there are LOTS of things to try, many of which we in the West are not > sufficiently familiar with yet (eg a good description of the concept of > 'ascending descending entering and exiting': Sheng Jiang Chu Ru); Yeah. And I would just underscore LOTS. b) I > think someone should become as familiar as possible with what has been > done already, while others are innovating; so I guess I can do my bit in > this area, since I read Chinese and all; and c) its fun. More fun than a barrel of monkeys. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2002 Report Share Posted March 21, 2002 , " dragon90405 " <yulong@m...> wrote: > > If I understand the questions raised, > they are focused on whether or not the > body can somehow " reabsorb " something > that has been pathological or pathogenic > and have that something become involved > in normal physiology? > > Is that a correct restatement of the > question? yes > > Here is where I think we should consider the > meanings of the relevant terms. For instance, > what is xie2? As I read the character, and > as I wrote about it in Parabola a few years > back, I don't see that it is primarily a > term that describes substances, rather > dynamics of relationships. What is simply moving in > the environment today, can be an evil tomorrow. that is true for exterior evils, but it doesn't make sense for interior evils. While dampness and wind exist in the normal " healthy " environment, they don't exist in the healthy human being. So any presence of dampness in the interior is pathological, even if dampness is a normal part of the extrnal environment. > Accordingly, I don't think there is any > categorical imperative in medical theory > that suggests that the pathological substances > in the body cannot be processed physiologically > as the body is restored to homeostasis, my question to Stephen Clavey and several others who read a lot of medical texts in chinese has centered around what it says in the medical literature. there may not be a categorical imperative aginst this phenomena, but there is also apparently an absence of this idea. In other words, it may be possible, but no one has mentioned it. Of the dozen or so people I queried, all said that any references they had seen to this topic stated that pathogenic evils were transformed into something that could be excreted from the body. Noone could remember seeing a description of damp evil being transformed into kidney yin, for example. As an aside, the image of an alchemist turning lead (a poison) into gold comes to mind...... The focus of treatment > should be to restore the operational balance > of yin1 and yang2 in the whole body and > in the affected parts and systems, no? > The fate of the " pathological substance " > is that it will end up like almost everything > else in the body, being eventually excreted > during the course of healing and normal > physiology. no, I think one has to directly engage the pathogenic evils on most occasions. It is not my experience that working merely from the perspective of yin yang balance is sufficient in complex cases. That should be a broad goal one tries to achieve in one's overall formulation, but there are also the details of accomplishing this goal and those details involve things like quickening blood and transforming dampness, i.e. direct engagement with the enemy. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2002 Report Share Posted March 21, 2002 > > If I understand the questions raised, > > they are focused on whether or not the > > body can somehow " reabsorb " something > > that has been pathological or pathogenic > > and have that something become involved > > in normal physiology? > > > > Is that a correct restatement of the > > question? > > yes OK. I still have a little suspicion that I don't get something about the gist of the question, or rather why it's being raised. Is there a particular issue or set of issues that need to be resolved? > > > > > that is true for exterior evils, but it doesn't make sense for interior > evils. While dampness and wind exist in the normal " healthy " > environment, they don't exist in the healthy human being. So any > presence of dampness in the interior is pathological, even if > dampness is a normal part of the extrnal environment. OK. Do you mean that there is no internal pathogenesis that results in accumulation of dampness? Of course internal and external are intimately interlinked, so it's perhaps not entirely possible to talk about this in terms that give the impression of them being mutually exclusive. After all, all of the water in the body comes from outside, and it returns to the outside. There is no water being manufacture in the body. And all of the liquid that travels around in the body is therefore external in origin. It's how the liquid is transformed and transported that determines whether or not dampness results...among other potential causes and influences, of course. > > > Accordingly, I don't think there is any > > categorical imperative in medical theory > > that suggests that the pathological substances > > in the body cannot be processed physiologically > > as the body is restored to homeostasis, > > my question to Stephen Clavey and several others who read a > lot of medical texts in chinese has centered around what it says > in the medical literature. there may not be a categorical > imperative aginst this phenomena, but there is also apparently > an absence of this idea. In other words, it may be possible, but > no one has mentioned it. This is where I being to suspect that I don't really track with the gist of the thread. So what? There are all kinds of things that aren't mentioned in the medical literature. What is it that you're trying to solve? I get the feeling that we're trying to determine whether or not ancient writers were possessed of modern sensibilities. I suspect not, for the most part. Of the dozen or so people I queried, all > said that any references they had seen to this topic stated that > pathogenic evils were transformed into something that could be > excreted from the body. By some methods other than physiology? All the medicinals do is influence the physiological structures and functions, no? Noone could remember seeing a > description of damp evil being transformed into kidney yin, for > example. I wouldn't anticipate finding such a statement in any medical classic because it just wouldn't make sense based on my understanding of the terms involved. Evil is a term that describes pathological processes. An evil is not a substance per se but a description of a complex of factors that have resulted in an illness or which have that potential. As an aside, the image of an alchemist turning lead (a > poison) into gold comes to mind...... An interesting image and one that has cognates in medical theory, particularly relating to the use of medicinals that can, in and of themselves, be classified as toxins but which have a therapeutic value because of the way they influence the phsyiology. But such influences would not be described in Chinese medical terms as incorporation of either the medicinal or the evil it was administered to affect into the yin1 or yang2 of the body. It's a matter of the usage of the terms, I think, not the accounting for physiological behaviors. > > The focus of treatment > > should be to restore the operational balance > > of yin1 and yang2 in the whole body and > > in the affected parts and systems, no? > > The fate of the " pathological substance " > > is that it will end up like almost everything > > else in the body, being eventually excreted > > during the course of healing and normal > > physiology. > > no, I think one has to directly engage the pathogenic evils on > most occasions. It is not my experience that working merely > from the perspective of yin yang balance is sufficient in complex > cases. That should be a broad goal one tries to achieve in one's > overall formulation, but there are also the details of > accomplishing this goal and those details involve things like > quickening blood and transforming dampness, i.e. direct > engagement with the enemy. I don't see these as being in conflict or even different. The way to engage the enemy is to assess the yin1 yang2 balance of the given situation and apply the right influence at the right time. It all depends on circumstances. In disorders of the yin1, Su Wen advises that we treat the yang2. And in disorders of the yang2 treat the yin1. In Who Can Ride the Dragon we talk about the incorporation of this martial metaphor, which seems to echo to some extent writings from the Sun Zi tradition to describe the mitigation of xu1 and shi2. The broad goal does not change its basic character as the focus shifts from one order of magnitude of the body's organization to another or from the battle within the organism to the battle between the organism and environmental factors, and this extends from the medical to the martial arena. One of the great aspects of yin1 yang2 theory is its scalability. I tend to think of a good many theories as tools for doing just this, i.e. scaling yin1 yang2 theory to a virtually infinite range of images of the body's substances and functions. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2003 Report Share Posted May 20, 2003 Group, I made an an error in my qi dynamic article on the JCM CD-ROM, which was pointed out by Sharon Weizenbaum below. She is correct about what Clavey actually said. However in a clarification to me below, he also said that while not stated in his book, the statement I made that was erroneously attributed to him was also his understanding (i.e. that pathological substances can't be transformed into physiological substances). As a caveat, though, he also said he had not read everything and certainly would not rule out this idea. I am always curious about historical precedents for ideas, so I was wondering if anyone had anything to contribute to the evidence on either side of this debate. I am not a scholar myself. I like to think of myself as partly a reporter in this forum, putting forth my admittedly flawed understanding of ideas I have assimilated so they may be corrected or enhanced in the public dialog. Sharon Weizenbaum wrote: You wrote that he clearly states that pathological substances can't be turned into physiological substances. I remember thinking the same thing! I remember having a talk about it with Chip Chace out on a rock by a lake up in the rocky mountains. Really, Clavey just says that pathological substances can't perform physiological functions. this is true They can indeed be returned to physiological functions though. this is the point of debate. Since the time I began thinking about this, many years ago now, I have worked clinically with the concept regularly. For example, yesterday I saw a patient who had suffered from extreme watery diarrhea for over a year and a half. Her tongue was swollen, cracked with a peeling coat. I gave her herbs precisely to help her absorb pathological damp so it could become physiological yin. This has worked wonderfully for her. It's an invaluable concept. I can think of many more examples of this conversion from patho to physio. Regards, Sharon My main point was that pathological substances cannot perform physiological functions (gosh, how the proffession has matured! This idea now seems quite obvious, but when the book was written there were still questions like 'Well if she has dampness, HOW can she have yin deficiency!?' meaning that the students thought the dampness would tonify the yin). I do not remember reading anywhere in the Chinese literature about pathological substances being transformed back into physiologically useful substances; most of the time where the sequela of 'transformation' is discussed it is in regard to expulsion from the body. Probably for this reason, I do not myself think this way in clinic; that is to say I do not try to change pathological substances back into physiological ones. The example given by your questioner is not perhaps as clear as could be, since treating the watery diarrhea will naturally reduce the loss of fluids and replenish the yin which was damaged by the water loss in the first place. I would be interested in what herbs absorb the dampness to replenish the yin. There is of course the phrase Yi1 zhe3, Yi4 ye3 'Medicine is in the idea', or 'healing is in the concept' which means (as you know, most likely) that one has an understanding of what is happening with the patient, and can design a strategy for restoring balance. People work in different ways on the broad canvas of TCM (and the even broader canvas of 'Oriental Medicine'!), and so just because I haven't seen this idea in my readings doesn't mean it won't work (or even that it is not present in some place in Chinese -- I haven't read everything by a long shot!). Just haven't seen it. I tend to keep trying out the concepts I do find in Chinese because a) there are LOTS of things to try, many of which we in the West are not sufficiently familiar with yet (eg a good description of the concept of 'ascending descending entering and exiting': Sheng Jiang Chu Ru); b) I think someone should become as familiar as possible with what has been done already, while others are innovating; so I guess I can do my bit in this area, since I read Chinese and all; and c) its fun. -- Chinese Herbs voice: (619) 668-6964 fax: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2003 Report Share Posted May 20, 2003 For example, yesterday I sawa patient who had suffered from extreme watery diarrhea for over a year anda half. Her tongue was swollen, cracked with a peeling coat. I gave herherbs precisely to help her absorb pathological damp so it could becomephysiological yin. This has worked wonderfully for her.. <<<How do you absorb pathological water as compared to other water? what herbs are these Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2003 Report Share Posted May 20, 2003 I have often wondered about this. My feeling is that the point at which substances are hua/transformed is the issue. If they are not transformed properly, they become xie/pathogenic. If they are transformed, they are zheng/correct. I don't think once pathogenic fluid is running through the intestine, it is going to be 'reabsorbed' or re-transformed while it is moving outwards. However, once the diarrhea is treated (by clearing heat, astringing, raising clear yang or some combination or other variation thereof), than there is no new pathogenic fluid developing anymore. For me, this is an issue of timing and semantics, not of physiological constituents. Phlegm, as another example, is relatively slow to develop, and stubborn phlegm may be deep-lying for some time. I hardly think that the actual phlegm is going to somehow recycle into good fluids, it needs to be hua/transformed, which I understand to mean that 1) the phlegm is broken down and eliminated 2) the disease pattern is alleviated so that ( for one example) the normal separation of clear and turbid by the spleen and stomach is restored, eliminating new production of phlegm. In the example given below, it doesn't seem to me that once you have the xie/diarrhea, which involves poor separation of clear and turbid, that the diarrhea is recycled into healthy fluids. It is already on its way out of the body. By changing the process and the pattern, the body stops the faulty separation of clear and turbid. I don't think it is a healthy idea to keep turbidity trapped in the body, and I don't know of any prescriptions other than possibly astringing ones that work in that way. For example, si shen wan/four miracle pill for wu gong xie/fifth watch diarrhea, caused by sp/kd yang vacuity cold. But this prescription, while astringing, addresses primarily warming the yang and aiding transformation of fluids. Is what is retained the pathogenic fluid? Or does it only become pathogenic if it is allowed to leave the body as diarrhea? If we look at another diarrhea prescription, such as ge gen huang qin huang lian tang, we see that the prescription repairs the qi transformation by using ge gen to raise clear yang along with huang lian and huang qin to clear heat. The diarrhea is arrested, but only by a combination of clearing heat or damp-heat and raising clear yang. This, to me, doesn't look like turning pathogenic fluids into healthy ones. Just some ideas. Sharon, how about some more detail on your approach including patterns and prescriptions? This sounds like it could be the beginning of an interesting discussion. I'm all ears. I'd also be interested to know if you have some Chinese sources that discuss these approaches. On Tuesday, May 20, 2003, at 11:05 AM, wrote: > > Since the time I began thinking about this, many years ago now, I have > worked clinically with the concept regularly. For example, yesterday > I saw > a patient who had suffered from extreme watery diarrhea for over a > year and > a half. Her tongue was swollen, cracked with a peeling coat. I gave > her > herbs precisely to help her absorb pathological damp so it could become > physiological yin. This has worked wonderfully for her. It's an > invaluable > concept. I can think of many more examples of this conversion from > patho to > physio. Quote Link to comment Share on other sites More sharing options...
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