Digest Number 1786

[Guest guest]

Hi Todd -

 

 

> One of my chinese colleagues is adamant that xiao yao san has no blood or

> > qi supplementing action. Our basic texts in english describe this rx as

> > being for liver depression with qi and blood vacuity. However my

> colleague

> > says this formula was designed to prevent transmission of the disease from

> > the liver to the spleen, such as zhang zhong jing mentions in the foreword

> > to the SHL or the admonition in the nei jing to build a well before you

> are

> > thirsty. So the questions are:

> >

> > what was the original intent?

> >

> > how is it commonly understood today?

>

 

One cannot deny the effect of single herbs in a formula unless they are

countered. Dang gui and bai zhu will have there way eventually, blood and qi

will

be supplemented.

 

Your colleague is correct the formula will fulfill the superior physician's

mandate and that is disease prevention. Here it is through preventing

transmission along the controlling cycle from wood to earth. The emphasis is

obviously

on wood. The wei qi flow at night is along the controlling cycle and bo he and

chai hu release the exterior in a formula that emphasizes the controlling

cycle. This may be a fruitful area for theoretical exploration.

 

Will

 

 

 

[Guest guest]

, WMorris116@A... wrote:

> Hi Todd -

>

 

>

> Your colleague is correct the formula will fulfill the superior physician's

> mandate and that is disease prevention. Here it is through preventing

> transmission along the controlling cycle from wood to earth. The emphasis is

obviously

> on wood.

 

I think that is beyond dispute. But if xiao yao is indiated in liver constraint

before OR after the spleen has been invaded, then where does chai hu shu gan

wan fit in this scheme. Why would one use chai hu shu gan wan for liver

depression alone if xiao yao is actually indicated. Perhaps qin bo wei has a

clue. chau hu shu gan wan seems to fulfill his therapy in liver qi, not liver

depression. Liver qi implies the liver is excess in its coursing and needs

rectification, while liver depression means the liver is vacuous in its

coursing.

So chai hu shu gan wan is indicated for liver invading the ST where coursing is

already excessive, while xiao yao san is for depression that may also involve

spleen involvement now or later.

 

Qin says liver depression may evolve into liver qi (which may also occur by

itself), but liver qi cannot be restored back to depression. So in liver qi,

the

invasion of the middle has already occurrred, while in xiao yao, it can go

either

way. While many of us already use chai hu shu gan wan and xiao yao in this

way, this does raise some questions about the placement of chai hu shu gan

wan with liver depression in the absence of spleen vacuity. While this is

correct, it may obscure the nature of the actual pattern, in which invasion has

already occurred. Or is it actually correct to use CHSGW in a pure depressive

binding condition.

 

Because CHSGW contains chai hu, it relieves depression, but the other herbs

are mainly there to rectify stagnation from excessive coursing (wood

overrestrains earth) that has resulted secondarily from the depression. BTW,

qin clearly states that xiao yao san is a qi and blood supplementing formula

that treats both a lack of coursing (wood fails to restrain earth) and lack of

spleen qi. If liver depression causes liver qi, then one my use CHSGW,

however if liver qi (over coursing or invading) arises directly from mental

irritation, then one does not use chai hu rx at all, but focuses on the middle.

Interestingly in liver depression, GI sx are most pronounced and one uses

formulas like wen dan tang which includes no liver depression herbs at all.

 

Can anyone add clarity to this?