liver depression fire versus liver fire

[Guest guest]

How is liver depression fire different from liver fire. what is the

dividing line, if any? Liver fire is described in all texts as largely

being due to depression of liver qi leading to fire. However liver

depression fire is not discussed in basic texts, yet comes up frequently in

internal medicine texts. When liver qi depression begins to transform to

fire, the addition of mu dan pi and zhi zi is often sufficient as in jia

wei xiao yao san, but also mu xiang shun qi wan in sionneau for abdominal

distension. but when liver depression is fully transformed and the

complaint is now called liver/GB replete heat or liver fire, the indicated

formulas are those like long dan xie gan tang and dang gui lu hui wan.

 

Do people generally recognize liver depression fire as subacute or even

chronic, with full liver fire being only acute and short lived. Of course,

it is important to not confuse this with ascendant liver yang. While

liver qi depression and liver fire can figure into liver yang rising, this

latter pattern requires a vacuity of yin-blood to be diagnosed. Is this

correct ? On the other hand, liver wind, which can be the cause of many

dizziness disorders and spasmodic complaints, could be due to liver

depression fire. correct?

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre minds " --

Albert Einstein

 

 

 

[Guest guest]

When liver qi depression begins to transform to

fire, the addition of mu dan pi and zhi zi is often sufficient as in jia

wei xiao yao san, but also mu xiang shun qi wan in sionneau for abdominal

distension. but when liver depression is fully transformed and the

complaint is now called liver/GB replete heat or liver fire, the indicated

formulas are those like long dan xie gan tang and dang gui lu hui wan.

>>>>Todd

We have here not only the langue of the pathomech but also what is the

presenting end symptoms. In jia wei xio yao, you are still dealing with

harmonizing between liver spleen while in long dan you do not have to have any

spleen or middle qi symptoms or signs. Liver wind can be diagnosed whenever

there are wind symptoms and congested/constrained liver (usually with fire) or

with yang rising which is a deficient syndrome

alon

 

 

[Guest guest]

These are the exact terms discussed in the first pages of the Chase translation.

Take

a look when you get to work and let us know how and if it answers your

questions.

doug

 

 

, wrote:

> How is liver depression fire different from liver fire. what is the

> dividing line, if any? Liver fire is described in all texts as largely

> being due to depression of liver qi leading to fire. However liver

> depression fire is not discussed in basic texts, yet comes up frequently in

> internal medicine texts. When liver qi depression begins to transform to

> fire, the addition of mu dan pi and zhi zi is often sufficient as in jia

> wei xiao yao san, but also mu xiang shun qi wan in sionneau for abdominal

> distension. but when liver depression is fully transformed and the

> complaint is now called liver/GB replete heat or liver fire, the indicated

> formulas are those like long dan xie gan tang and dang gui lu hui wan.

>

> Do people generally recognize liver depression fire as subacute or even

> chronic, with full liver fire being only acute and short lived. Of course,

> it is important to not confuse this with ascendant liver yang. While

> liver qi depression and liver fire can figure into liver yang rising, this

> latter pattern requires a vacuity of yin-blood to be diagnosed. Is this

> correct ? On the other hand, liver wind, which can be the cause of many

> dizziness disorders and spasmodic complaints, could be due to liver

> depression fire. correct?

>

>

> Chinese Herbs

>

> voice:

> fax:

>

> " Great spirits have always found violent opposition from mediocre minds " --

> Albert Einstein

>

>

>

[Guest guest]

 

 

Hate to say this, but I think the problem you pose is largely terminological. In

other words, it is only a problem in English, not in

Chinese.

 

The full and correct Chinese term for the pattern of liver fire is ascendant

liver fire flaring (gan huo shang yan). The term for liver

depression is either liver depression transforming heat (gan yu hua re) or liver

depression/depressive heat (gan yu, yu re). Fire (huo) is

quantitatively more extreme than heat (re). Because liver fire is shang yan

(ascendant and flaring or flaming), it's symptoms manifest

primarily in the region of the head: headache (as in trigeminal neuralgia), red,

painful eyes, a bitter taste in the mouth, a red facial

complexion. Liver depression/depressive heat's symptoms are not as intense and

are not necessarily located in the head (shang,

upper, above). They include a bitter taste in the mouth, irritability, rib-side

pain, epigastric burning pain, hot, painful nipples, profuse,

bright red-colored menstruation, a shortened menstrual cycle or lengthened

menstrual period, red tongue with yellow fur, and a

bowstring, rapid pulse.

 

Can depressive heat evolve into ascendant liver fire flaming? Yes, but these are

still two different patterns. As for liver depression

transforming heat being in Chinese language pattern identification textbooks, it

most certainly is. It is only given short shrift in English

language textbooks.

 

Bob

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

As for liver depression

> transforming heat being in Chinese language pattern identification

textbooks, it most certainly is. It is only given short shrift in English

> language textbooks.

 

 

that is really the issue. that this fairly common pattern is ignored in

american

books or confused with liver fire flaring. while this may be clear in chinese,

I

must say that the same precision you espouse is not present in some sections

of sionneau's work from BP. I assumed I would find the word flaring or

ascendant more common to describe the replete pattern.

 

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

>

>

> Hate to say this, but I think the problem you pose is largely terminological.

In other words, it is only a problem in English, not in

> Chinese.

 

Bob

 

I cannot read much chinese, though I do know the characters for liver, qi, fire,

yang and heat. I thus rely on wiseman in this matter.

 

there is no entry in the PD for liver depression transforming heat (gan yu hua

re) or liver depression/depressive heat (gan yu, yu re), so I will have to rely

on you for these. I certainly cannot say what appears most commonly on the

literature, but Wiseman clearly delineates liver fire from liver fire flaring in

name, then makes little distinction in meaning. He always uses the word huo

for these depressed liver patterns except in his discussion of heat depression.

though this pattern seems most similar in name and pathomechanisms to the

ones you mention, the symptoms seem more severe and decidedly different. I

do not question the veracity of your statements (I literally cannot), but would

merely submit that the evidence I can accumulate, albeit meager, does not

appear as black and white as you portray it (see below).

 

Wiseman defines the following:

 

liver depression transforming into fire (gan yu hua huo) - see depressed wood

transforming into fire

 

depressed fire (yu huo) - any pattern arising when yang becomes depressed

(h/a, red eyes, red urine)

 

depressed wood transforming into fire (yu mu hua huo) - depressed liver qi

causing fire signs such as red eyes, red face, h/a, dizziness, vomiting,

etc.....

 

heat depression (re yu) - a condition that arises when any persistent

depression transforms into heat (clouded head, dizzy vision, thirst, yellow or

red urine). Qi depression is the cause of all other depressions and the liver

qi

depression the root.

 

liver fire (gan huo) - A fire pattern from excess of the seven affects, liver

yang

transforming fire... red face, red eyes, dizziness, bitter taste, impatience,

whenthe upper body sx are pronounced, it is called

 

liver fire flaming upward (gan huo shang yan), which is attributed to liver qi

depression transforming into fire, which is basically the same with more

severe upper body sx.

 

 

 

>

> The full and correct Chinese term for the pattern of liver fire is ascendant

liver fire flaring (gan huo shang yan). The term for liver

> depression is either liver depression transforming heat (gan yu hua re) or

liver depression/depressive heat (gan yu, yu re). Fire (huo) is

> quantitatively more extreme than heat (re). Because liver fire is shang yan

(ascendant and flaring or flaming), it's symptoms manifest

> primarily in the region of the head: headache (as in trigeminal neuralgia),

red, painful eyes, a bitter taste in the mouth, a red facial

> complexion. Liver depression/depressive heat's symptoms are not as intense

and are not necessarily located in the head (shang,

> upper, above). They include a bitter taste in the mouth, irritability,

rib-side

pain, epigastric burning pain, hot, painful nipples, profuse,

> bright red-colored menstruation, a shortened menstrual cycle or lengthened

menstrual period, red tongue with yellow fur, and a

> bowstring, rapid pulse.

>

> Can depressive heat evolve into ascendant liver fire flaming? Yes, but these

are still two different patterns. As for liver depression

> transforming heat being in Chinese language pattern identification textbooks,

it most certainly is. It is only given short shrift in English

> language textbooks.

>

> Bob

[Guest guest]

while this may be clear in chinese, I

> must say that the same precision you espouse is not present in some sections

> of sionneau's work from BP. I assumed I would find the word flaring or

> ascendant more common to describe the replete pattern.

 

 

 

Agreed. Philippe was not as careful as he should've been in terms of

terminology, but you have to remember that he was going from

Chinese to French to English. We knew that this was not perfect, but no one else

was attempting to do what he wanted to. So we

went with him even though he was not our first choice. We always prefer working

with native English speakers who read Chinese.

Unfortunately, there just aren't enough of these to do the work that needs to be

done. But your point is well taken and heard on this

end.

 

If you can tell me which pattern names in which books are less than clear, we

can fix them next time we print this series. In fact, we

are planning to print the entire series in a re-edited version in only one or

two volumes. We just have to sell out of the present editions.

 

Bob

[Guest guest]

 

 

Never read these entries in the PD. I can only tell you what I see most commonly

when reading Chinese journal articles and the

Chinese books I happen to buy. Although I think the PD is generally excellent,

it is no substitute for having access to the general

body of literature. Any single source is going to be incomplete and will embody

various biases, both accidental and intentional. Again,

it is my experience that the more Chinese you can and do read, the clearer these

kinds of issues become.

 

Bob

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

 

> We have here not only the langue of the pathomech but also what is the

presenting end symptoms. In jia wei xio yao, you are still dealing with

harmonizing between liver spleen while in long dan you do not have to have

any spleen or middle qi symptoms or signs. Liver wind can be diagnosed

whenever there are wind symptoms and congested/constrained liver (usually

with fire) or with yang rising which is a deficient syndrome

 

I actually agree with Alon here. The representative formulas and their

indications often clarify what discrepancies in terminology may obscure. Bob

has made this point with regard to the patterns of liver qi vacuity and

gallbladder heart qi vacuity, patterns he has argued in the past are easily

explainable with reference to other pathomechanisms. In other words, if the

different terms and/or labels do not lead to different treatment strategies, the

distinctions are not that meaningful to me. It is my understanding from

talking to others who read chinese (both anglo and native), that different

authors use terms with differing levels of precision. And the waters become

much murkier the farther one traverses through the past. That precision is

not the distinguishing attribute of the chinese language.

 

Keep in mind that I do personally study chinese, but not for the precision Bob

speaks of. It was not Bob's citing of the phrases he most commonly

encountered in the literature that informed me of what I wanted to know. It

was, as usual, the english language definitions he provided. so no matter how

much chinese I can read, it will always come back to a dictionary for me. some

people strive for looking at the characters and not having a single english

thought pass through one's mind. I would offer that very few adults can reach

that levelof fluency in a foreign language using a completely foreign script.

so

I set the bar at recognition and conceptual understanding in english. Perhaps I

will feel different as time goes on. that would be really cool. I never

thought I

would be able to recognize raw herbs or even remember chinese characters.

 

let's look at a few passages from Sionneau volume 1:

 

pg. 1 head distension. disease cause and pattern one is listed as liver fire,

not

liver fire flaring. the passages goes onto say " when liver fire flares upward "

 

pg. 23 headache. pattern five is exuberant liver fire. exuberant means

vigorous. it does not appear to have a connotation of rising, per se.

 

in both cases above,despite the varying terminology, the same base rx is

chosen - long dan xie gan tang

 

this rx is also indicated on pg. 73 for head heat. on that page, the passage

reads if liver depression turns into heat, fire may flare upward.

 

so heat and fire are used here together

 

Interesting aside on page 144, where liver depression without any heat is

listed as the cause of facial tic. the explanation says that depressed liver qi

may burst out and counterflow. This sounds a lot like yang rising. However

yang rising is supposed to involve yin vacuity. I gave this explanation to my

advanced formulation class, several of whom pointed out that liver qi

depression was no where listed as a cause of counterflow liver qi (i.e. yang

rising). In fact, basic texts do not associate liver depression with wind

unless

heat transformation first occurs (see fundamentals by Ellis) The selected

formula in this section is chai hu shu gan wan plus gou teng. not black and

white.

 

the section on constipation in volume 6 on page 274 lists the pattern of liver-

gallbladder replete fire. the pathomechanism is described as being due to

liver deprssion transforming into depressive heat or fire. While there are

some upper body symptoms to this pattern, it is a constipation pattern, thus

the locus of the fire remains in the lower. there is no mention of flaring at

all.

the rx is dang gui lu hui tang

 

I assume philippe is actually translating or compiling information from chinese

sources in consultation with his associate Lu Gang. I do not assume he is just

being careless with terminology. However I do accept the possibility that I am

misreading all this.

 

In the chapter on hemafecia on pg. 299, the pattern of liver fire invading the

stomach, the same depressed liver heat or fire pathomechanism is given,

however this time it moves transversely into the stomach, again not flaring

upwards. The indicated formula is dan zhi xiao yao san. Now the interesting

thing is that I am never confused about how to treat these variously labeled

permutations. Is there heat? How strong. Strong enough to use long dan xgt?

of just jia wei xys. Is yang rising, yin vacuous, wind blowing? treat these as

they manifest. It seems to me that giving too much precision to terminology

could lead to the wrong treatment in some cases. Why not use long dan xie

gan tang for the liver fire hemafecia or jia wei xiao yao san for a liver fire

headache. I think a moment's thought shows why jwxys is better for a upper

GI problem and LDXGT for head sx. But that has nothing to do with pattern

labeling. I know Bob does not put any more stock in TCM concepts than as

convenient maps, so I am not suggesting otherwise, just sussing out the actual

nuances at play. Looking at the terms used in wiseman and sionneau, I am

still unclear as to the precise distinct meanings of these various terms, if

indeed there is one.

 

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

 

> Agreed. Philippe was not as careful as he should've been in terms of

terminology, but you have to remember that he was going from

> Chinese to French to English.

 

Are you sure that philippe was not actually reading various different term

choices in the chinese literature and translating accordingly. Why would

Philippe translate gan huo shang yan as foie feu instead of foie feu ondoie in

the first place. Why would he sometimes use feu and sometimes ardeur when

speaking of liver depression. Was he careless or was this faithful to the

original. I would want to make sure the latter was the case before arbitrarily

standardizing this information. If vagaries are common, I would want the

american literature to reflect this just as I would want the precision when that

is the case. If it is as precise as you say, then this bears directly on our

discussion of standards. If the chinese is actually vague, perhaps we should be

more precise in our standards.

 

[Guest guest]

pg. 1 head distension. disease cause and pattern one is listed as liver fire,

not

liver fire flaring. the passages goes onto say " when liver fire flares upward "

 

pg. 23 headache. pattern five is exuberant liver fire. exuberant means

vigorous. it does not appear to have a connotation of rising, per se.

 

in both cases above,despite the varying terminology, the same base rx is

chosen - long dan xie gan tang

 

this rx is also indicated on pg. 73 for head heat. on that page, the passage

reads if liver depression turns into heat, fire may flare upward.

>>>>>Todd this as always been by point. From i have seen in over 20 years of

dealing with these issues there is a huge gulf between the language writers and

practitioners use and what they do in real life patients. To me the second is

all i care about and that is why i look at the prescription and not the " words. "

I still believe (from my experience) that most of this obsession with terms is

because of the need to compensate for the fact that CM relies on subjective

symptoms and signs and the need for people to get a sense of control. It is not

about " real " demonstrable depth and accuracy. In print one can make lots of

distinctions that can not be done on real patients. Formulas have their

indications and when understood things become a LITTLE clearer.

When you read case histories from china I am always amazed at how much license

the writers use to ignore some of their own presentation of symptoms and signs

to make their interpretations fit-in. Again at times looking at the Rx is

helpful to sort the " bull " often dressed as explanation of how the author sees

the case but again which more often than not ignores much of their own

information. There is almost never a discussion of why not take this other

information a discuss in real patient terms these were seen one way and not

another.

Alon

 

 

[Guest guest]

Alon, Very well put.... This is why we need teachers! And it is no accident

that my

favorite books are the Jiao Shu-de and the Qin BoWei. Both of which are largely

lectures given to their students. And to this I would add the Bob Damones CHA

CEU

class. At some point I'm sure I'll take one of Flaws' on-line courses and get me

some

of that proprietary knowledge!

doug

 

 

> >>>>>Todd this as always been by point. ....... I still believe (from my

experience)

that most of this obsession with terms is because of the need to compensate for

the

fact that CM relies on subjective symptoms and signs and the need for people to

get

a sense of control.................

.. There is almost never a discussion of why not take this other information a

discuss

in real patient terms these were seen one way and not another.

> Alon

>

>

[Guest guest]

And to this I would add the Bob Damones CHA CEU

class.

>>>>I should take it. I got a copy of his lecture at last pcom which was

disappointing to me because it was quite basic (the tape did however miss some

of the end of the lecture so i cant say what he said then)

Alon

 

 

[Guest guest]

, " " wrote:

It seems to me that giving too much precision to terminology

> could lead to the wrong treatment in some cases. >>>

 

 

:

 

You have reframed the position I have expressed about translation!

 

But it's not a matter of " too much precision " . The real issue is

that there is more novelty and variety in our patients, than in our

dictionaries. The typical diagnosis found in modern TCM journals and

texts is highly simplified (IMO from, at least, the point of view of

the pulses), and this can dovetail with the Western sensibility to

reduce things to their basic elements rather than see things in

context and as relationships.

 

Let's use the dictionaries when they match the patient; but be open

to new expressions in CM.

 

Even after 20 years of studying pulses with my teacher, my patients

still show me new things that he didn't.

 

 

 

Jim Ramholz

[Guest guest]

> I assume philippe is actually translating or compiling information from

chinese

> sources in consultation with his associate Lu Gang. I do not assume he is

just

> being careless with terminology.

 

As Philippe's editor on this project, I can say that he was definitely getting

his materials from Chinese sources. However, the Chinese

sources sometimes use abbreviations or idiosyncratic pattern names for who knows

what reasons. Because Philippe was a

young and relatively inexperienced practitioner and translator (by his own

description) when he compiled this material, he often stuck

to the Chinese original when further clarification or standardization would've

been useful for Western readers. Further, not all Chinese

authors are careful about the words they use. Sometimes they too make mistakes.

 

Six or seven years down the line from when Philippe and I started the Treatment

of Disease in TCM project, I too have many problems

with some of tyhe terminology and especially the pattern names. I hope to

rectify all this when we go into a second printing. I think we

can make it much clearer and more transparent.

 

I also agree with both Alon and you that looking at the formula recommended or

used is often the clearest indication of what the

author was trying to get across.

 

Bob

[Guest guest]

> Are you sure that philippe was not actually reading various different term

> choices in the chinese literature and translating accordingly. Why would

> Philippe translate gan huo shang yan as foie feu instead of foie feu ondoie in

> the first place. Why would he sometimes use feu and sometimes ardeur when

> speaking of liver depression. Was he careless or was this faithful to the

> original.

 

I would say that Philippe was faithful to the Chinese original " to a fault, "

although I know that, on several occasions, Philippe was

willing to change fire to heat based on my questioning of exactly the kinds of

things you have been asking about. In general, it is my

experience as and working with beginning translators that one is hesitant to

change a single syllable of the Chinese. However, in

creating a compilation such as this (which is actually classified as an original

work), it is also my experience that it is better to adopt

some internal standards. For instance, we are going to reissue my menstrual

diseases, vaginal diseases, and Path 1 & 2 as a single

book on CM gynecology. When we do, I'll be standardizing many of the terms taken

from a variety of sources so that the reader can

be clearer how they relate from disease to disease and pattern to pattern.

Likewise, as I've said for Treatment of Disease.

 

Bob

[Guest guest]

" The real issue is that there is more novelty and variety in our patients, than

in our

dictionaries. "

 

Sure, " The dao that can be daoed is not the dao, " etc., etc. However, that does

not obviate the need for coprofessionals to share

information, and that requires a common lingo with commonly held definitions.

While language cannot adequately capture reality, it's

still the main tool we use to communicate on forums such as this. (We all know

that 75% or more of all LIVE communication is

nonverbal.) Therefore, its incumbent that we use language as accurately and

transparently as possible, especially in written

communication.

 

Bob

[Guest guest]

, " Bob Flaws " wrote:

However, the Chinese sources sometimes use abbreviations or

idiosyncratic pattern names for who knows what reasons. Because

Philippe was a young and relatively inexperienced practitioner and

translator (by his own description) when he compiled this material,

he often stuck to the Chinese original when further clarification or

standardization would've been useful for Western readers. Further,

not all Chinese authors are careful about the words they use.

Sometimes they too make mistakes.>>>

 

 

 

All:

 

This is, again, the very problem I've been speaking about. And why

the original Chinese should always be included with the translation

to create an " Open Translation Standard " . It also would help

generate more interest in the Chinese language, and make the

original work more accessible to all students. If we don't, I'm

afraid the original literature will remain marginalized in this

profession---especially when the trend in our professional standards

are becoming increasingly like WM.

 

 

Jim Ramholz

[Guest guest]

you may want to dust off the red Jeremy Ross Zang Fu book. Almost 20 years

old now, you might find it terminology " challanged " but he does attempt to

delineate

these liver distinctions.

 

 

, " " wrote:

> let's look at a few passages from Sionneau volume 1:

>

> pg. 1 head distension. disease cause and pattern one is listed as liver fire,

not

> liver fire flaring. the passages goes onto say " when liver fire flares

upward "

>

> pg. 23 headache. pattern five is exuberant liver fire. exuberant means

> vigorous. it does not appear to have a connotation of rising, per se.

>

> in both cases above,despite the varying terminology, the same base rx is

> chosen - long dan xie gan tang

>

> this rx is also indicated on pg. 73 for head heat. on that page, the passage

> reads if liver depression turns into heat, fire may flare upward.

>

> so heat and fire are used here together

>

> Interesting aside on page 144, where liver depression without any heat is

> listed as the cause of facial tic. the explanation says that depressed liver

qi

> may burst out and counterflow. This sounds a lot like yang rising. However

> yang rising is supposed to involve yin vacuity. I gave this explanation to my

> advanced formulation class, several of whom pointed out that liver qi

> depression was no where listed as a cause of counterflow liver qi (i.e. yang

> rising). In fact, basic texts do not associate liver depression with wind

unless

> heat transformation first occurs (see fundamentals by Ellis) The selected

> formula in this section is chai hu shu gan wan plus gou teng. not black and

> white.

>

> the section on constipation in volume 6 on page 274 lists the pattern of

liver-

> gallbladder replete fire. the pathomechanism is described as being due to

> liver deprssion transforming into depressive heat or fire. While there are

> some upper body symptoms to this pattern, it is a constipation pattern, thus

> the locus of the fire remains in the lower. there is no mention of flaring at

all.

> the rx is dang gui lu hui tang

>

> I assume philippe is actually translating or compiling information from

chinese

> sources in consultation with his associate Lu Gang. I do not assume he is

just

> being careless with terminology. However I do accept the possibility that I

am

> misreading all this.

>

> In the chapter on hemafecia on pg. 299, the pattern of liver fire invading the

> stomach, the same depressed liver heat or fire pathomechanism is given,

> however this time it moves transversely into the stomach, again not flaring

> upwards. The indicated formula is dan zhi xiao yao san. Now the interesting

> thing is that I am never confused about how to treat these variously labeled

> permutations. Is there heat? How strong. Strong enough to use long dan xgt?

> of just jia wei xys. Is yang rising, yin vacuous, wind blowing? treat these

as

> they manifest. It seems to me that giving too much precision to terminology

> could lead to the wrong treatment in some cases. Why not use long dan xie

> gan tang for the liver fire hemafecia or jia wei xiao yao san for a liver fire

> headache. I think a moment's thought shows why jwxys is better for a upper

> GI problem and LDXGT for head sx. But that has nothing to do with pattern

> labeling. I know Bob does not put any more stock in TCM concepts than as

> convenient maps, so I am not suggesting otherwise, just sussing out the actual

> nuances at play. Looking at the terms used in wiseman and sionneau, I am

> still unclear as to the precise distinct meanings of these various terms, if

> indeed there is one.

>