yunnan bai yao

[Guest guest]

, " " <@h...>

wrote:

 

there is much more going on here then 1 idea about

> 1 herb (especially a western idea) - there is also a blood moving

> component.

 

To reiterate what Sharon said a few days back, YNBY stops bleeding WITHOUT

causing stasis. That is the traditional view. The modern research is

clearly mixed. I think it is careless to just cavelierly recommend this

before surgery and certainly no layperson or student should be doing that.

But Jason is right that there are many strategies that are considered

dangerous by some and safe in the hands of others. Perhaps we must

consider carefully whether we should be informing the public that a

practice used by a segment of the profession is inherently dangerous when

there is no evidence this is actually the case (sound as the logic may be)

.. It is one thing to debate what works and what doesn't amongst ourselves,

but this may be perceived by the public as patient endangerment by those

who would prescribe YNBY this way.

 

To me, my version of common sense dictates that I would not prescribe this

medicine before surgery. I doubt very much that any patient I see prior

to surgery is suffering from the pattern treated by YNBY anyway unless

they need surgery due to injuries. However, I would not give any meds

before surgery, so this may be moot for me. In fact, I also don't give

herbs to pregnant or nursing women, either. I am just very conservative

about these things. However I always tell my students that one can learn

how to treat OB problems safely if one does advanced training in this area.

And I certainly don't doubt the training and experience of others on

this list and those quoted who differ from me in this aspect of their

practice. So I have no choice but to heed their words and keep an open

mind.

 

One thing is for sure, I want decisons about such matters to be made by

community consensus and dialogue and from a perspective that considers

various inputs, including historical and scientific. I would also be most

interested in the modern chinese experience with this matter.

 

A perhaps analogous example occurred to me. There are styles of deep

needling acupuncture that have a high risk for injury. These methods also

do not suit my conservative nature. These methods are however safe and

effective in the hands of someone trained and skilled in their use. Like

the feats a great surgeon can accomplish. But in the hands of novices, I

have seen such methods be downright dangerous. Perhaps this is the middle

ground. Strategies of high risk should perhaps be reserved for those with

more experience and more likely success.

 

An analogous case occurred to me. I had a patient recently who had

presented with an episode of month long uterine bleeding, then cessation

of menses for 5 months. she was diagnosed with uterine fibroids. However

her presentation was classic yin vacuity (hot, malar flush, red dry tongue,

fast, thin pulse). However she also presented with distended sublingual

veins and palpable abdominal masses. She was mid/late 40's and she wanted

her period back. I told her it might not come back but we would get her

as healthy as possible. I prescribed zhi bai di huang wan with san qi and

pu huang, subbing sheng di for shu di. The intern was very concerned that

the patient would not get her period back while taking these herbs. I was

more concerned that she would bleed heavy if we used straight blood moving.

I believe she has had 4 or 5 normal periods at this point now.

 

finally I stumbled upon this from xu and wang, san qi " decreases blood

viscosity " , quoted from the Chinese Journal of Pharmacology and Toxicology,

a chinese language publication. still haven't changed my mind,though. :

-)

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein