pneumonia/neurological disorder connection?

[Guest guest]

I will try this again.

I am treating a patient who just came to me for Spasmodic dysphonia (loss of voice) - in western terms a neurological condition. In TCM, I find Qi, Yang, & yin insufficiencies. Other than this she is in very good health.I have another patient with neurological problems - atrophying celebellum. Again yang, qi & yin insuffciencies.

My observation and question to those more experienced: Both of these people had severe, hospitalizing pneumonia before (within a year) developing these neurological conditons. Should this be taking into my diagnosis/treatment strategy in some way that could help?

Mayn thanks for any insight you might provide.

Ruth Elder

 

 

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[Guest guest]

Dear Ruth,

 

you wrote:

> I will try this again. I am treating a patient who just came to me

> for Spasmodic dysphonia (loss of voice) - in western terms a

> neurological condition. In TCM, I find Qi, Yang, & yin

> insufficiencies. Other than this she is in very good health.

 

You are not providing sufficient info on your patient in order to get

a response, ie. tongue, pulse, etc. You might want to share with the

list why you find Qi, Yang, & yin vacuity on this patient.

 

> I have another patient with neurological problems - atrophying

> celebellum. Again yang, qi & yin insuffciencies.

 

> My observation and question to those more experienced: Both of

> these people had severe, hospitalizing pneumonia before (within a

> year) developing these neurological conditons. Should this be

> taking into my diagnosis/treatment strategy in some way that could

> help?

 

Maybe, and maybe not. Treatment is more effective when you take each

patient on their own merit. On what they present while on your office.

 

 

Fernando

[Guest guest]

Ruth

 

It seems as likely that a severe feverish condition damaged the

yin rapidly and set off the exacerbation. I think we should be

careful not to make equations between the TCM concept of latent

heat and the mere fact that a patient had a deep lung infection.

On the other hand, use of bitter cold substances (like using

antibiotics in a pneumonia patient who does not have full heat)

is one way heat gets trapped when it should have been

dispersed with spicy cool herbs. However, it would be

surprising if using exteriorizing herbs helped at this stage.

 

I personally have found my shallow understanding of latent heat

to be of more harm than good in clinical practice. Much of the

application of this concept to modern diseases is very

controversial and noted experts on the subject such as Chip

Chace say the idea has been misused often by those without

access to chinese source material. Nevertheless, it is in cases

that begin with obvious respiratory diseases in which latent heat

is most common, according to Chace (PCOM Symposium

2001). I would try contacting Chip directly about this. If not,

can fill in some blanks.

 

[Guest guest]

, " Ruth Elder, R.Ac. "

I'm wondering if any of one more experienced practitioners have seen

this and if treatment should take this into account? Is there latent

heat in the lungs? What symptoms would I look for? What herbs

would I use?

 

 

 

 

Ruth:

 

Can you describe the pulses clearly?

 

Examine the Right Proximal and the Left Middle Positions of the

pulses closely closely, as they will show activity in the cerebrum.

If there is degeneration you may find a Choppy movement if there is

blood stasis. If there is latent heat you may see some Sandy quality

indicating chronic heat drying out the yin. In conditions like

Parkinson's, you see a Choppy movement carrying some vibration or

Sandy quality in the Left Middle Fu (GB) as well as the Right

Proximal Fu (SJ). See my latest posting in the Advance Pulse

Diagnosis forum for more details about this Sandy quality. Shaoyang

energy reflects the energy of the nervous system, and we always find

pulses describing the neurological degeneration (MS, ALS,

Parkinson's) in the GB pulses since it creates a network that

traverses the head back and forth.

 

From an energetic perspective, the excessive perverse heat from the

lung may have followed the channels upward, against the controlling

cycle of 5-Phases. There has recently been some speculation in

Western literature that conditions like MS may have originated due

to infections in infancy before the immune system matured.

 

 

Jim Ramholz

[Guest guest]

Dear Ruth,

There is no doubt in my mind that the severe pneumonias may have

had something to do with both conditions, specifically the debilitation

that often accompanies such deep disorders and the concurrent massive

use of strong medications. Also, pneumonia may also mask other

infections that may eventually affect the nervous system.

 

However, this is all ballpark stuff.

 

As the other responders have noted, we need a much more careful

pattern diagnosis, pulse and tongue, and all the related symptoms, so

that we can work with this case.

 

While latent heat is a possibility, it sounds more like a deep cold

damage developed after the pneumonia to me.

 

Again, I can only speculate based on the information you gave us.

But I hope it is helpful anyway.

 

It is nice to hear from you again, Ruth.

 

All the best,

 

 

On Sunday, September 29, 2002, at 06:15 AM, Ruth Elder, R.Ac. wrote:

 

> I will try this again. 

>

> I am treating a patient who just came to me for Spasmodic dysphonia

> (loss of voice) - in western terms a neurological condition.  In TCM,

> I find Qi, Yang, & yin insufficiencies.  Other than this she is in

> very good health.

>

> I have another patient with neurological problems - atrophying

> celebellum.  Again yang, qi & yin insuffciencies.

>

> My observation and question to those more experienced:  Both of these

> people had severe, hospitalizing pneumonia before (within a year)

> developing these neurological conditons.  Should this be taking into

> my diagnosis/treatment strategy in some way that could help?

>

> Mayn thanks for any insight you might provide.

>

> Ruth Elder

>

>

>

>

 

>

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>

> Join the worldís largest e-mail service with MSN Hotmail. Click Here

>

> 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]

, " " <@i...> wrote:

Much of the application of this concept to modern diseases is very

> controversial and noted experts on the subject such as Chip

> Chace say the idea has been misused often by those without

> access to chinese source material.

 

 

:

 

Wiseman's dictionary defines latent (fu) as " persistant but not

visible or active. " And latent qi (fu qi) as " Any evil qi that

remains latent in the body and that causes disease after some time. "

This definition is wide enough to include virus, bacteria, etc.,

that are present but which cause no immediate symptomology.

 

What is the controversy?

 

 

Jim Ramholz

[Guest guest]

Todd and Jim -

In my experience, "Any evil qi that remains latent in the body and that causes disease after some time" is closer to clinical reality than the emerging aversion to this diagnosis. I spoke with Tiande Yang on the subject and he concurred with Wang Shuhe on this subject. Paraphrased: "A yang pulse in a yin section or a yin pulse in a yang section are signs of latent processes."

And let's not forget to discuss the real clinical possibility of latent cold. However, this does require the acumen to correctly identify a 'tight' or jin pulse. Wiseman's description fails to identify the distinctions. Hammer has seen fit to use the English term for other purposes entirely, generating tremendous confusion. As result, he has lost the virtues of the tight (jin) pulse for clinical purposes. Rory is one of the few people I know who understands it.

will

 

Wiseman's dictionary defines latent (fu) as "persistant but not visible or active." And latent qi (fu qi) as "Any evil qi that remains latent in the body and that causes disease after some time." This definition is wide enough to include virus, bacteria, etc., that are present but which cause no immediate symptomology.

What is the controversy?

[Guest guest]

Rory is one of the few people I know who understands it. (jin or tight) pulse.

 

I should say that Jim probably does - I have never discussed it with him.

Will

[Guest guest]

The 'latent qi school' (not a formal school, so the quotation marks),

is a collection of authors from the late Qing dynasty to the present

era. This theory is the latest development in the Chinese medical

tradition, so it is new, ongoing, and open to discussion and debate. I

think it reflects changing developments in chronic disease as a result

of new epidemics, STD's, viral disorders, and drug suppression. The

Chinese material is very interesting, and I've just begun working on a

little of it that Chip Chace sent me. Clincially, whatever is in

English is not enough or sufficiently reliable to use clinically, but

theoretically, I think the concept is very useful. There is some

discussion of the topic in Guohui Liu[s " Warm Diseases: A Clinical

Guide " , and I agree with him that it is potentially a very useful

concept for the types of suppressed diseases that we see in modern

practice.

 

 

On Monday, September 30, 2002, at 12:49 AM, James Ramholz wrote:

 

:

>

> Wiseman's dictionary defines latent (fu) as " persistant but not

> visible or active. " And latent qi (fu qi) as " Any evil qi that

> remains latent in the body and that causes disease after some time. "

> This definition is wide enough to include virus, bacteria, etc.,

> that are present but which cause no immediate symptomology.

>

> What is the controversy?

>

>

> Jim Ramholz

[Guest guest]

Will, Z'ev:

 

The discussion so far has only mentioned and implied that physical

processes (virus, cold, etc.) are apt and not uncommon conditions to

be considered latent. Much Western literature is devoted to

speculating about the latent causes of diseases in this way.

 

But I think we should also include emotions and other psychological

processes, since many of them exist unresolved (sometimes for years)

and only later contribute to problems. For example, one of the

interesting things I always like to point out during my first pulse

seminar is a movement at the adapted depth, deep in the right wrist,

between Middle and Proximal positions that indicates the affect of

the care giver when there was a lack of nurturing. This pulse

pattern exists years later---having become a part of their

psychological make up---to undermine spleen qi function.

 

While the literature is always interesting to consider, if we limit

ourselves and our definitions to what the Qing dynasty observed, too

many things may be left out. We need to adapt old theories to new

information; not use them as the final arbiter of authority.

Clinically, I don't see any reson not to use " latent " now as an

adjective for a number of things.

 

 

Jim Ramholz

[Guest guest]

As result, he has lost the virtues of the tight (jin) pulse for clinical purposes. Rory is one of the few people I know who understands it. >>>Will and Rory can you guys give your 2 cents on the issue of tight-tense, wiry etc. Do you concur the ideas of increasing Qi stagnation, heat, yin def

Alon

[Guest guest]

As a collection of authors, these people represent a later development in the notion of latent processes that have been recorded in the Nei Jing, Nan Jign, and Mai Jing. For me these earlier sources capture the essence - especially when it comes to diagnosis. The Qing dynast authors bring forth herbal treatment ideas, but the original sources hold the keys to the acupuncture methods of management in my estimation.

 

Will

 

 

The 'latent qi school' (not a formal school, so the quotation marks),

is a collection of authors from the late Qing dynasty to the present era.

[Guest guest]

Alon -

I concur with Hammer on the processes of qi stagnation - heat generated as a result of the bodies attempt to overcome qi stagnation - the heat beginning to burn off yin - and resulting yin xu. What I don't agree with is the decision to use the term tight to describe the pulse quality that represents heat burning off yin. This is yin burned from the intima of the vessels and is a sensation of a slightly thin and hard quality.

The key to the jin (tight) pulse is that it vibrates side to side. This is a sensation that feels as if it is tracking radial-ulnar while the finger is resting at the top of the wave cresting. One example: a student identified this sensation in the left guan (liver) position. Upon inquiry, the patient reported recent unsuccessful hernia surgery. However, the respiratory system is the most common repository of 'deep cold' as Dr Shen used to describe it - this is the same as latent cold. Dr. Shen found this commonly with allergies.

 

This pulse (jin-tight) is vastly different from what Hammer calls 'tight' with completely different clinical significance. Hammer did describe, and I don't know if it is in his book, a quality called 'unstable.' This pulse hits the finger in a different location each time. This is a very serious finding with such qi deficiency, that the pulse can't hold it's placement. He never entertained the real of the pulse tracking in a line radial-ulnar as in the jin pulse - at least not with me. This may have changed in the last few years.

 

Will

 

 

 

tight-tense, wiry etc. Do you concur the ideas of increasing Qi stagnation, heat, yin def

[Guest guest]

, WMorris116@A... wrote:

> I concur with Hammer on the processes of qi stagnation - heat

generated as a result of the bodies attempt to overcome qi

stagnation - the heat beginning to burn off yin - and resulting yin

xu. What I don't agree with is the decision to use the term tight to

describe the pulse quality that represents heat burning off yin.

 

 

Will:

 

We term the Tight (jin) pulse Urgent, and see it as an extreme case

of String or Wiry pulse; so we do not always look at it separately

from our perspective. As you mentioned, it's distinguishing physical

character is the back-and-forth vibration. It is mainly related to

cold perverse energy. The essential energetic characteristic of the

Tight or Urgent pulse is the absorption and release of qi caused by

the contracting nature of cold energy. It is a condition of extreme

tension and feels as if the yin/yang connection will break very

soon; so it is also a condition close to failure. But, when found,

it does not necessarily mean that this activity is about to stop;

rather it is about to be transformed to another condition. In the 5-

phase theory there is no complete stop; rather there is a

transformation or change into something else.

 

You can, for example, see this type of pulse in kidney failure. And

when it does occur, it indicates that the kidney is about to

completely fail. When, on the other hand, you see the Sandy pulse in

kidney failure, kidney function is in decline and only partial

functioning; but in case of the Tight or Urgent pulse, it is about

to stop. If you find an Urgent pulse in the stomach, it means that

the stomach function is closing down and is blocked; often the

patient is not able to breath due to the strength of the

contractions.

 

When an organ fails completely, only its own elemental pulse will be

beating in its position, indicating that communication with the

other organs has been cut. The comment in Li Shi-zhen that, for

example, a String or Wiry pulse in the liver is " normal " is a

misunderstanding. While it is the " typical " type of perverse energy

associated with the liver, it is not normal in the sense

of " healthy " or " desirable " .

 

 

Jim Ramholz

[Guest guest]

, WMorris116@A... wrote:

One example: a student identified this sensation in the left guan

(liver) position. Upon inquiry, the patient reported recent

unsuccessful hernia surgery.

 

 

Will:

 

Were you able to examine this patient yourself? I sometimes find

a " tug " or vibration in only one direction---not side-to-side---of a

Wiry or String pulse. It is not a general condition of a pulse

position but a localized feature in one sector or fraction of a

position along the String. This indicates not the urgency of the

Tight pulse but the uneven tension of connective tissue or muscular

tissue due to scarring after an operation; often causing pain.

 

 

Jim Ramholz

[Guest guest]

Jim -

 

I am surprised on this one. The Ling Shu describes a healthy expression of the pulse as the elemental pulse of the organ plus stomach qi. This is a direct contradiction to your schools thoughts on the subject. Can you comment?

 

Will

 

When an organ fails completely, only its own elemental pulse will be beating in its position, indicating that communication with the other organs has been cut. The comment in Li Shi-zhen that, for example, a String or Wiry pulse in the liver is "normal" is a misunderstanding. While it is the "typical" type of perverse energy associated with the liver, it is not normal in the sense of "healthy" or "desirable".

[Guest guest]

Jim -

 

What is Dr Jiang's rational for translating jin as 'urgent'? It seems to me the conventional transliterative 'tight' is closer to the sensation. But - the main reason I raise this question is that many practitioners from China are using the term 'urgent' to describe a forceful and rapid arrival.

 

These pulses tight and wiry are very similar they both have tension as a feature. However, the etiology is different and there must be a distinguishing features related to the pathogenesis.

For qi stagnation and wiry, the response of the nervous system and renin-angiotensin system causes the vessels to contract. This tends to be evenly distributed and somewhat smooth until the heat causes sufficient yin deficiency of the intima of the vessels and eventual sclerosing.

For cold and tight - the response of the nervous system and it's interactions with the vascular system is often sudden and uneven which leads to the description "twisted like a rope." However, this description is rarely present in healthy responsive vessels whereas the vibrating side to side is usually present.

 

The conditions related to the jin pulse can often be mild functional disorders such as chronic allergies, cold in the uterus, cold in the liver channel. It can also be involved in the serious end-stage disorders of kidney failure as you describe, however, my experience on that is more commensurate with Shang Han Lun. Cold can be involved in the more serious Shang Han Lun stages of Tai Yin - Shao Yin and Jue Yin, but Zhang does not describe the tight pulse for those patterns, they are usually of a deep and/or weak nature. The kidney failure of Shao Yin stage, has a pulse 'faint' or 'fine' in Wiseman's version.

Will

 

We term the Tight (jin) pulse Urgent, and see it as an extreme case of String or Wiry pulse; so we do not always look at it separately from our perspective. As you mentioned, it's distinguishing physical character is the back-and-forth vibration.

It is mainly related to cold perverse energy. The essential energetic characteristic of the Tight or Urgent pulse is the absorption and release of qi caused by the contracting nature of cold energy. It is a condition of extreme tension and feels as if the yin/yang connection will break very soon; so it is also a condition close to failure. But, when found, it does not necessarily mean that this activity is about to stop; rather it is about to be transformed to another condition. In the 5-

phase theory there is no complete stop; rather there is a transformation or change into something else.

[Guest guest]

Yes - it was evenly moving side to side. The diagnosis was cold in the liver channel.

 

Will

 

Were you able to examine this patient yourself? I sometimes find a "tug" or vibration in only one direction---not side-to-side---of a Wiry or String pulse. It is not a general condition of a pulse position but a localized feature in one sector or fraction of a position along the String. This indicates not the urgency of the Tight pulse but the uneven tension of connective tissue or muscular tissue due to scarring after an operation; often causing pain.

[Guest guest]

Will,

 

Hammer does speak of the 'unstable pulse' quality on his book. He

states that " This sign indicates imminent extremely serious illness in

the particular yin organ associated with the position in which it is

found. At the left distal position, for example, coronary occlusion or

heart failure can be anticipated at any time " He adds that the

" ..sense under the finger at that position is of total chaos. This is

why some observers in the past have mistakenly attributed this

phenomenon to a true arrhythmia. However, a true arrhythmia appears

over the entire pulse at all positions "

 

Fernando

 

 

 

> This pulse (jin-tight) is vastly different from what Hammer calls

'tight'

> with completely different clinical significance. Hammer did

describe, and I

> don't know if it is in his book, a quality called 'unstable.' This

pulse hits

> the finger in a different location each time. This is a very serious

finding

> with such qi deficiency, that the pulse can't hold it's placement.

He never

> entertained the real of the pulse tracking in a line radial-ulnar as

in the

> jin pulse - at least not with me. This may have changed in the last

few years.

>

> Will

[Guest guest]

In the Nan Jing, this is called a 'visceral pulse'. It is a pulse with

an exaggerated quality, such as xian/wiry (associated with the liver),

without stomach qi. The stomach qi provides smoothness and suppleness.

Without it, to the degree that stomach qi is absent, the liver is in

the process of failing or has 'died'.

 

 

On Tuesday, October 1, 2002, at 02:30 AM, James Ramholz wrote:

 

> When an organ fails completely, only its own elemental pulse will be

> beating in its position, indicating that communication with the

> other organs has been cut. The comment in Li Shi-zhen that, for

> example, a String or Wiry pulse in the liver is " normal " is a

> misunderstanding. While it is the " typical " type of perverse energy

> associated with the liver, it is not normal in the sense

> of " healthy " or " desirable " .

[Guest guest]

Will:

What is Dr Jiang's rational for translating jin as 'urgent'? It

seems to me the conventional transliterative 'tight' is closer to

the sensation. But - the main reason I raise this question is that

many practitioners from China are using the term 'urgent' to

describe a forceful and rapid arrival. These pulses tight and wiry

are very similar they both have tension as a feature. However, the

etiology is different and there must be a distinguishing features

related to the pathogenesis.

 

Jim:

Keep in mind that our nomenclature and logic was arrived at in

relative isolation; as far as I know, his teacher and he are the

only developers of what is found in our system (and now there is

what I'm doing to it). So any influence from the Chinese---except

for the classics---isn't there, and we often learned what the

classics " meant to say " but was poorly articulated (poor editing no

doubt). I guess that he termed it urgent because of the the quality

of the sensation, the pulse seeming as if it were going to break.

Probably more from a sense that the condition was urgent and a value

judgment. In our system, when viewing sectors smaller than a single

position, the meaning may be independent of and shift from what is

generally understood as the quality applied to the whole position.

We hardly ever ascribe a quality to the overall pulse of a position

without then identifying (usually different) qualities to the

various parts of that position.

 

Undoubtedly, the sensation of tension is the general category that

puts them into the same group. Our etiology is worked out by seeing

what other qualities are associated in the pulse quality and how it

connects to other pulse positions and movements.

 

 

 

Will:

The conditions related to the jin pulse can often be mild functional

disorders such as chronic allergies, cold in the uterus, cold in the

liver channel. It can also be involved in the serious end-stage

disorders of kidney failure as you describe, however, my experience

on that is more commensurate with Shang Han Lun. Cold can be

involved in the more serious Shang Han Lun stages of Tai Yin - Shao

Yin and Jue Yin, but Zhang does not describe the tight pulse for

those patterns, they are usually of a deep and/or weak nature. The

kidney failure of Shao Yin stage, has a pulse 'faint' or 'fine' in

Wiseman's version.

 

 

Jim:

The vibration back and forth is the essential character of the

urgency and the sensation that yin and yang are about to be cut. In

milder functional disorders, we might see the vibratory quality as a

harmonic of another condition carried by the cold, tense movement.

It's hard to say without sitting down together.

 

There are several other ways to look at the failure of an organ. For

example, in the case of the kidney, the faintness and fineness

qualities would indicate that general kidney yang function is

declining; the Tight or Urgent pulse following another etiology.

There is also (at least) a third type. I had a patient with a case

of chronic glomerular nephritis whose pulse was quite different. The

conditon was very slow and localized. The organ was slowly failing

because protein was getting stuck, inflaming, and scarring the

glomeruli; only 40% of the kidney remained functioning when he came

to me. At the organ depth of the left proximal position, the pulse

looked like it was collapsing in on itself---the proximal and distal

aspects of the pulse in the kidney position were both coming to the

center of the position---this is what I call an advanced form or

development of the Drumskin (ge) pulse. After the condition

stabilized and dialysis was avoided, (most importantly) his pulse

became more moderate, slightly soft. In terms of function, his

kidney was 90 years old; but the pulse was fairly unremarkable.

 

 

Jim Ramholz

[Guest guest]

In , " " <zrosenbe@s...> wrote:

> In the Nan Jing, this is called a 'visceral pulse'. It is a pulse

with an exaggerated quality, such as xian/wiry (associated with the

liver), without stomach qi. The stomach qi provides smoothness and

suppleness. Without it, to the degree that stomach qi is absent, the

liver is in the process of failing or has 'died'.

 

 

Z'ev:

 

Here I'm not only thinking of the missing smoothness and suppleness

from the earth (stomach qi), which is you are correct in pointing

out more common; but also the spreading quality that indicates its

connection to fire, the descending quality that indicates its

connection to metal, and the concentrating or building which

indicates its connection to water. The 5-Phases within each organ

itself. As the Wiry (xian) movement becomes tends to become more

tense, it may vibrate and become Urgent as it gets closer to this

type of organ failure.

 

Another, opposite pathway to organ (or body part) failure is

indicated by a development in the Drumskin (ge) movement---described

in my previous post. It usually indicates that the organ or body

part is failing due to a different etiology; usually some highly

localized (not systemic) blockage. For example, I saw this movement

in a case of impotence which was caused by pituitary dysfunction.

The patient checked out healthy in all the Western tests except

testosterone production. After a few treatments and some herbs, he

recovered. The only thing we could figure was that it occured

because he worked in dense electrical fields as an engineer that

had, somehow, interfered with the pituitary.

 

 

Jim Ramholz

[Guest guest]

Will

Thanks. Its interesting as what you describe my teacher in china used to call the bean pulse

Alon

[Guest guest]

, WMorris116@A... wrote:

> I am surprised on this one. The Ling Shu describes a healthy

expression of the pulse as the elemental pulse of the organ plus

stomach qi. This is a direct contradiction to your schools thoughts

on the subject. Can you comment?

 

 

Will:

 

From our perspective, the only healthy pulse is a sine wave. Like

the energy of the year, that dynamics includes or is composed of all

the elements (seasons). Any break from this symmetry is information

about how a particular organ is developing problems. So it's as if

we are always thinking in base-5.

 

The Ling Shu is only considering at the yin/yang (base-2) quality of

the pulse; emphasizing the functional (yang) aspect of the organ,

its own elemental quality, and the nurturing or supportive (yin)

aspect from the stomach connection. The Mai Jing, for example, seems

more 5-Phase orientated.

 

There is no contradiction, just a shift in perspective regarding the

assumptions you want to speak from. For example, whenever I read you

or someone from the Shen/Hammer tradition, I have to remind myself

of the tacit differences between our systems to try and clearly

follow along (not always successfully). I prefer using 5-Phases

because it is a dynamical system and we are primarily interested in

the communication between organs and their associated body parts.

Western medicine is also beginning to discusss body in terms of

dynamical systems and networks. We see the 8-Principle diagnosis as

background details---often the consequence and not the cause of a

disorder.

 

 

Jim Ramholz

[Guest guest]

While I don't doubt that this is true, and it seems to be derived from

Jiang Jing's holographic five phase model, do you have any textual

sources for the material I can look up and/or study?

 

Thanks,

 

 

On Tuesday, October 1, 2002, at 09:33 AM, James Ramholz wrote:

 

> Here I'm not only thinking of the missing smoothness and suppleness

> from the earth (stomach qi), which is you are correct in pointing

> out more common; but also the spreading quality that indicates its

> connection to fire, the descending quality that indicates its

> connection to metal, and the concentrating or building which

> indicates its connection to water. The 5-Phases within each organ

> itself. As the Wiry (xian) movement becomes tends to become more

> tense, it may vibrate and become Urgent as it gets closer to this

> type of organ failure.