Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 Dear list members, I am gathering data on this recent flu epidemic, since it has been so pervasive and severe this year. I know many of you have recently treated cases. So, I am asking my colleagues: 1) what you've seen in symptoms, signs and stages 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) 3) your diagnoses 4) treatment 5) prescriptions 6) success 7) relationship to seasonal qi and weather changes Look forward to hearing from you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 I can add something to this conversation, but before I go any further, do you think it best to write directly to you and then you can synthesize the information and post it, or shall we all post our observations directly to the list? -al. On Dec 10, 2003, at 11:02 AM, wrote: > Dear list members, > I am gathering data on this recent flu epidemic, since it has been > so pervasive and severe this year. I know many of you have recently > treated cases. So, I am asking my colleagues: > 1) what you've seen in symptoms, signs and stages > 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) > 3) your diagnoses > 4) treatment > 5) prescriptions > 6) success > 7) relationship to seasonal qi and weather changes > > Look forward to hearing from you. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 please do on list Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 I'd actually appreciate both. I could compile if you send to me, but I'd like the whole list to benefit from individual posts as well. Thanks, Al. Z'ev On Dec 10, 2003, at 11:25 AM, Al Stone wrote: > I can add something to this conversation, but before I go any further, > do you think it best to write directly to you and then you can > synthesize the information and post it, or shall we all post our > observations directly to the list? > > -al. > > On Dec 10, 2003, at 11:02 AM, wrote: > >> Dear list members, >> I am gathering data on this recent flu epidemic, since it has >> been >> so pervasive and severe this year. I know many of you have recently >> treated cases. So, I am asking my colleagues: >> 1) what you've seen in symptoms, signs and stages >> 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) >> 3) your diagnoses >> 4) treatment >> 5) prescriptions >> 6) success >> 7) relationship to seasonal qi and weather changes >> >> Look forward to hearing from you. >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 On Dec 10, 2003, at 11:02 AM, wrote: > Dear list members, > I am gathering data on this recent flu epidemic, Okay, I have two patients with whom I can start to identify the unique personality of this virus' symptoms, but therapeutically, I didn't have a chance to do too much... PATIENT #1 > 1) what you've seen in symptoms, signs and stages Day 1: fever (sensations of heat) in the head. Some redness on the cheeks. Slight sore throat. Fullness of the head and slight headache. Tongue and pulse was unremarkable (generally thin and weak in this particular patient and they remained so at this point) Day 2: higher fever, dizziness, fatigue, nausea, severe vomiting of food stuffs, then gastric juices, yellow in color. On the one patient I observed at this stage, she also had a headache surrounding one eye. She has a history of Shao Yang headaches and I wasn't sure if one was occurring simultaneously or if the fever was causing heat to rise up into the yang ming channel of one side only. Her migraines also generate vomiting frequently, so the severe vomiting may too have been just a stroke of bad luck where she had a migraine and a wind-heat condition at the same time. Sore throat appeared to be less of a problem at this point. Tongue was unremarkable. Pulse was stronger than usual, slightly rapid as well. Day 3: fever broke, left with copious clear nasal discharge. At this point, more of your typical wind-cold issue. Also, dry cough which I presume was due to the heat damaging the Lung yin. Day 4, 5, 6, 7, nasal discharge slowly diminishes, no other symptoms. No wait, there was a nosebleed that first night after the fever broke. We decided that this was a side-effect of the " day-quil " she was taking. There was also insomnia, again a potential side-effect of " day-quil " though I wonder about that, since the last dose she took was in the afternoon, and she remained awake, blowing her nose, till 4 am. It is possible that the excessive nose-blowing caused the nose bleed, but it wasn't just a little bit, it was a lot of blood. I don't think that this would be considered blood level heat from a four stages perspective. She does have a tendency toward Spleen Qi deficiency, but bruising isn't her main thing. > 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) Day 1 & 2: wind-heat attack Day 3: wind-cold with Lung Yin deficiency Day 4 through 7: wind-cold slowly receding > 3) your diagnoses See above > 4) treatment Day 1: Yin Qiao San with Chuan Xiong Cha Tiao San, cupping on upper back. These were done late in the day, after the pathogen had grown all day. I would have liked to get to it earlier, but didn't have a chance. Day 2: Small amount of baked apple to protect stomach, advil, plus downward stroking Qi therapy on the back. This was pretty much all I could do for this patient at this point as the headache, nausea was very significant and I knew that until I addressed the immediate concern of these two symptoms, nothing else would help. Ultimately, the downward stroking on the back with gobs of intent to lower the stomach Qi helped and she was able to keep the advil down and sleep. The next morning, she was through the worst. Day 3: day-quil > 5) prescriptions see above > 6) success Hmmm. good question. I think that if there was any success it was the use of Yu Ping Feng San and copious Vitamin C that prevented anybody else in the family from getting infected. As for the primary patient, she sprung back after day two. > 7) relationship to seasonal qi and weather changes none noted. PATIENT #2 > 1) what you've seen in symptoms, signs and stages I can only talk about the past for this patient, as I didn't see her till today, and by today, things were pretty much back to normal, however her history included a more mild, but otherwise similar condition as PATIENT #1. It should also be noted that PATIENT #2 had a flu shot. Day 1: Symptoms on Monday included a slight fever, mostly noticable as heat in the head. Achyness in the Tai Yang region of the shoulders and neck, fatigue; and later on in the day, nausea and vomiting. Vomitis included food stuffs early on, giving way to gastric juices which were yellow. Patient began drinking more water and that made the vomitis more watery. Day 2: nausea and vomiting, sensations of heat in the head Day 3: nausea through the morning, then it went away. This is the day that I saw this patient. Her tongue was red and dry. I presume this is due to the heat damaging the Yin. She reports that she was thirsty all day too. Her chief complaint today is insomnia that has been around for the past month and due to stress. She also reported that she was premenstrual and that her main symptom of that is moodiness. Her pulse was inconsistent, which is one of those forms of choppy in which the strength is strong then weak. It took me a long time to really get her pulse. It wasn't weak, but difficult to really get a bead on, like the right side was hidden very close to the tendon and the left side was choppy as I mentioned above. I gave her Suan Zao Ren Tang for the stress induced insomnia, Xiao Yao Wan for the PMS, and I added some Huang Bai (with the Zhi Mu in Suan Zao Ren Tang) to clear out the deficiency heat. (all of these things mixed into one capsule). Acutherapy included An Mian, UB 17, 18, 19, 20, and 21 to regulate and move the Blood of the Liver and the Spleen, and Spleen 6 to generate more Blood, Qi and Yin. -- Pain is inevitable, suffering is optional. -Adlai Stevenson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2003 Report Share Posted December 10, 2003 , " " < zrosenbe@s...> wrote: > I'd actually appreciate both. I could compile if you send to me, but > I'd like the whole list to benefit from individual posts as well. > Thanks, Al. I agree Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2003 Report Share Posted December 11, 2003 Day 2: higher fever, dizziness, fatigue, nausea, severe vomiting of food stuffs, then gastric juices, yellow in color. >>>I have seen two families where the nausea and vomiting were seen right at onset with high fever, headaches, and body aches. I have treated these with combination of Yin Qiao and modified Hou Xiang Zheng Qi San (thinking the severe N/V is retain summer heat). All did well in terms of symptoms relief. They all felt normal within 4 days. I have no idea how long it would have taken otherwise Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2003 Report Share Posted December 11, 2003 I would have leaned toward the Huo Xiang Zheng Qi San too, but for the lack of a thick tongue coating and the pronounced fever. Can you 'splain the " retained summer heat " ? Are you saying that the pathogenic factor got in during the week before Halloween when we had all that hot dry fire weather? I've always thought of summer heat as being the most literal of external pathogenic factors meaning that you need exposure to really hot weather to get summer heat. It has been decidedly fall/winter-like since Halloween in the LA area. -al. On Dec 11, 2003, at 8:07 AM, Alon Marcus wrote: > Day 2: higher fever, dizziness, fatigue, nausea, severe vomiting of > food stuffs, then gastric juices, yellow in color. >>>> I have seen two families where the nausea and vomiting were seen >>>> right at onset with high fever, headaches, and body aches. I have >>>> treated these with combination of Yin Qiao and modified Hou Xiang >>>> Zheng Qi San (thinking the severe N/V is retain summer heat). All >>>> did well in terms of symptoms relief. They all felt normal within 4 >>>> days. I have no idea how long it would have taken otherwise > Alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2003 Report Share Posted December 11, 2003 Can you 'splain the " retained summer heat " ? Are you saying that the pathogenic factor got in during the week before Halloween when we had all that hot dry fire weather? I've always thought of summer heat as being the most literal of external pathogenic factors meaning that you need exposure to really hot weather to get summer heat. It has been decidedly fall/winter-like since Halloween in the LA area. -al. >>>>>I think this is a liberal adaptation. As fever in the winter is some times thought of as lurking pathogens (explaining the Heat) and since my patients had high fever and chills (which i find to be more often due to heat model that cold model) i combined the two formula. I had to explain as well as use herbs for the sudden onset of N/V with otherwise a typical flu. Non of the patients which i know well has any history of dampness or weak spleen. It seemed to work well for the symptoms they all felt less N/V, body pain and headaches fairly quickly. It still took 4 days or so for them to feel normal however. If others have other suggestions i would love to hear Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2003 Report Share Posted December 12, 2003 I think you are on to something with summer heat. I just spoke to someone who seemed to go through the whole course of this virus-flu with fever at 104 for 3 days and he finally lost consciousness for about a minute and was told at the emergency room he had dehydration. He was drinking lots of fluids but must have not had enough electrolytes. For what that's worth. ellie schafer Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2003 Report Share Posted December 12, 2003 I think this is a great idea, Z'ev. I am wondering what folks are doing herbally for themselves and their patients as well, as preventive measures? Other than Jade Windscreen, are there any herbal formulas you all are recommending to protect against contracting the flu? <zrosenbe wrote: Dear list members, I am gathering data on this recent flu epidemic, since it has been so pervasive and severe this year. I know many of you have recently treated cases. So, I am asking my colleagues: 1) what you've seen in symptoms, signs and stages 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) 3) your diagnoses 4) treatment 5) prescriptions 6) success 7) relationship to seasonal qi and weather changes Look forward to hearing from you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2003 Report Share Posted December 12, 2003 I agree, on list. I'd like to benefit from what everyone is seeing and doing. So far, my patients have had minor colds (wind-cold). Andrea Beth <zrosenbe wrote: I'd actually appreciate both. I could compile if you send to me, but I'd like the whole list to benefit from individual posts as well. Thanks, Al. Z'ev On Dec 10, 2003, at 11:25 AM, Al Stone wrote: > I can add something to this conversation, but before I go any further, > do you think it best to write directly to you and then you can > synthesize the information and post it, or shall we all post our > observations directly to the list? > > -al. > > On Dec 10, 2003, at 11:02 AM, wrote: > >> Dear list members, >> I am gathering data on this recent flu epidemic, since it has >> been >> so pervasive and severe this year. I know many of you have recently >> treated cases. So, I am asking my colleagues: >> 1) what you've seen in symptoms, signs and stages >> 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) >> 3) your diagnoses >> 4) treatment >> 5) prescriptions >> 6) success >> 7) relationship to seasonal qi and weather changes >> >> Look forward to hearing from you. >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2003 Report Share Posted December 13, 2003 Hi Andrea, We are finding that simply balancing different patterns [along with Jade Screen, Yin Chao San, Sang Ju Yin for acute cases...] has been very effective, for most of our clients warding off the " flu " bug. We had a couple people with a 104.+ temps. responding well to standard Wind Heat Formulas augmented. I followed up with a lung Yin formula in one case due to his chronic underlying xu pattern. Each case lasted approx. 4-6days. We, personally, haven't been 'invaded' by any means which can be possibly attributed to Internal Martial Arts and taking seasonal formulas Take care, David and Teah Akrish Heaven and Earth CMHC White Snake Choy Li Fut & Tai Chi 2100 E. Union Street Seattle, WA 98122 206-320-1041 - " " < Friday, December 12, 2003 12:21 PM Re: flu epidemic > I think this is a great idea, Z'ev. I am wondering what folks are doing herbally for themselves and their patients as well, as preventive measures? Other than Jade Windscreen, are there any herbal formulas you all are recommending to protect against contracting the flu? > > > > <zrosenbe wrote: > Dear list members, > I am gathering data on this recent flu epidemic, since it has been > so pervasive and severe this year. I know many of you have recently > treated cases. So, I am asking my colleagues: > 1) what you've seen in symptoms, signs and stages > 2) pattern differentiation (zang-fu, jing-luo, 4 aspect, six channel) > 3) your diagnoses > 4) treatment > 5) prescriptions > 6) success > 7) relationship to seasonal qi and weather changes > > Look forward to hearing from you. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2003 Report Share Posted December 16, 2003 Had an interesting talk with Yang, Tian-de today about this flu virus going around. In his opinion, being generally a Shang Han Lun/Spleen Stomach guy, he sees the flu as follows: Tai Yin Heat (Lung heat) causing the fever, headache, sore throat. But he believes that there is some pre-existent food stagnation, toxicity, or dampness in the middle Jiao that causes all the vomiting. The excess is aggravated by the heat that comes into the body through the Lungs. This gives rise to the excessive vomiting. I asked for a specific mechanism on the Lung heat causing vomiting and he only offered the Tai Yin to Yang Ming connection. His treatment strategy calls for purgation, believe it or not. What he suggests for those with damp or toxicity in the Stomach is Da Chai Hu Tang with the addition of Jin Yin Hua, Lian Qiao, Jing Jie, and Fang Feng The Da Chai Hu Tang is traditionally for a concurrent Yang Ming and Shao Yang syndromes. The addition of the four herbs for wind and heat extends its benefit into the Lung heat issue. For those leaning more toward the food stagnation pre-existing condition, he suggests adding Ban Xia, Fu Ling, Shan Zha and Mai Ya. I didn't ask him what he would add it to, but I presume Yin Qiao San. One interesting note, that came out during our talk today. As he was describing the differences between Xiao Qing Long Tang and Da Qing Long Tang, and later between Xiao Chai Hu Tang and Da Chai Hu Tang, I asked him if the formulas that begin with " Xiao " are for deficiency and those that begin with " Da " are for excess. He didn't agree with that statement, per se, but did agree that the " Da " formulas are generally stronger (and more often for excess) than the " Xiao " formulas which are generally weaker (and hence more appropriate for those deficiency types.) Just a little FYI if it didn't occur to you before this point. : ) -al. -- Pain is inevitable, suffering is optional. -Adlai Stevenson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2003 Report Share Posted December 16, 2003 , Al Stone wrote: > Had an interesting talk with Yang, Tian-de today about this flu virus going around. In his opinion, being generally a Shang Han Lun/Spleen Stomach guy, he sees the flu as follows: Tai Yin Heat (Lung heat) causing the fever, headache, sore throat.>>> Al, Z'ev: I would agree with Yang Tian-de in part. The energy is not unexpectedly Tai yin, as predicted by the 2004 calendar. In the pulses we always see deep phlegm/damp accumulating, engendering heat. I first started to see flu patients as soon as the season became Cold Dew. When fighting the condition, we can see the movement quicken in the lung position. It's not due to food stagnation or his other speculations, it's due to the accumulation during the year: the dominance of it being a damp (Ram) year (read Unschuld's appendix to his Suwen book for details). The energy alternates between the SHL Taiyin and Yangming levels when there is intermittent heat and fever. I think I predicted the Taiyin quality last Spring or so from the calendar. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2003 Report Share Posted December 16, 2003 , jramholz@m... wrote: > , Al Stone wrote: > > Had an interesting talk with Yang, Tian-de today about this flu > virus going around. In his opinion, being generally a Shang Han > Lun/Spleen Stomach guy, he sees the flu as follows: Tai Yin Heat > (Lung heat) causing the fever, headache, sore throat.>>> > > > Al, Z'ev: > > I would agree with Yang Tian-de in part. The energy is not > unexpectedly Tai yin, as predicted by the 2004 calendar.>>> Oops. Should read " 2003 calendar " . Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 Hi All, Interesting. The patients I have seen with flu are not having vomiting, except for one episode following extremely hard coughing. I've seen patterns that start out as wind-cold, and transform over a couple of days into internal heat, with fevers up to 102. Neither of the cases I saw included sore throat, but lots of nasal and chest mucus, mostly clear and occasionally yellow or green, but not very thick. I agree that food stagnation and spicy foods are part of the heat picture. Neither of these patients wanted to take herbs, so none were prescribed. Al Stone <alstone wrote: Had an interesting talk with Yang, Tian-de today about this flu virus going around. In his opinion, being generally a Shang Han Lun/Spleen Stomach guy, he sees the flu as follows: Tai Yin Heat (Lung heat) causing the fever, headache, sore throat. But he believes that there is some pre-existent food stagnation, toxicity, or dampness in the middle Jiao that causes all the vomiting. The excess is aggravated by the heat that comes into the body through the Lungs. This gives rise to the excessive vomiting. I asked for a specific mechanism on the Lung heat causing vomiting and he only offered the Tai Yin to Yang Ming connection. His treatment strategy calls for purgation, believe it or not. What he suggests for those with damp or toxicity in the Stomach is Da Chai Hu Tang with the addition of Jin Yin Hua, Lian Qiao, Jing Jie, and Fang Feng The Da Chai Hu Tang is traditionally for a concurrent Yang Ming and Shao Yang syndromes. The addition of the four herbs for wind and heat extends its benefit into the Lung heat issue. For those leaning more toward the food stagnation pre-existing condition, he suggests adding Ban Xia, Fu Ling, Shan Zha and Mai Ya. I didn't ask him what he would add it to, but I presume Yin Qiao San. One interesting note, that came out during our talk today. As he was describing the differences between Xiao Qing Long Tang and Da Qing Long Tang, and later between Xiao Chai Hu Tang and Da Chai Hu Tang, I asked him if the formulas that begin with " Xiao " are for deficiency and those that begin with " Da " are for excess. He didn't agree with that statement, per se, but did agree that the " Da " formulas are generally stronger (and more often for excess) than the " Xiao " formulas which are generally weaker (and hence more appropriate for those deficiency types.) Just a little FYI if it didn't occur to you before this point. : ) -al. -- Pain is inevitable, suffering is optional. -Adlai Stevenson Chinese Herbal Medicine offers various professional services, including board approved continuing education classes, an annual conference and a free discussion forum in Chinese Herbal Medicine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 Yes, it is interesting, none of the patients I've seen have had gastrointestinal symptoms, at least not until much later on. It seems to be an upper burner phenomena, largely in the sinuses, with the mucous you describe. Perhaps L.A. patients are having a different presentation? Interesting, it is so close to San Diego. I've heard of a few children having gastrointestinal symptoms here. I've been using a few different prescriptions, among them chai ge jie ji tang, qing bi tang, and jing fang bai du san/ren shen bai du san in earlier stages. On Dec 17, 2003, at 11:22 AM, wrote: > Hi All, > > Interesting. The patients I have seen with flu are not having > vomiting, except for one episode following extremely hard coughing. > I've seen patterns that start out as wind-cold, and transform over a > couple of days into internal heat, with fevers up to 102. Neither of > the cases I saw included sore throat, but lots of nasal and chest > mucus, mostly clear and occasionally yellow or green, but not very > thick. I agree that food stagnation and spicy foods are part of the > heat picture. Neither of these patients wanted to take herbs, so none > were prescribed. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 On Dec 17, 2003, at 11:22 AM, wrote: > I've seen patterns that start out as wind-cold, and transform over a > couple of days into internal heat, with fevers up to 102. Neither of > the cases I saw included sore throat, but lots of nasal and chest > mucus, mostly clear and occasionally yellow or green, but not very > thick. That's was kind of my question to Dr. Yang. Basically, my question was, everybody with the nausea and vomiting has the pre-existing middle Jiao issues? He said yes. So, here we have some people getting the flu virus (perhaps the same one, perhaps not, we really don't know) and they passed through it without the intense vomiting, likely because their middle Jiao's were okay to begin with. Would you agree with that, that they didn't have any Spleen/Stomach issues? -- Pain is inevitable, suffering is optional. -Adlai Stevenson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 Al, Actually, I disagree, but my case sampling (2) is too small to really draw a conclusion. One of my flu patients has a long history of middle and lower jiao damp heat, associated with Spleen Qi deficiency and lots of rich, sweet foods. The other patient does not have middle or lower jiao congestion. Yet, they exhibited identical symptoms and duration of illness with the flu, which did not include vomiting except for the one incident following extrremely harsh and prolonged coughing - this was, however, in the woman with the damp heat history. Al Stone <alstone wrote: On Dec 17, 2003, at 11:22 AM, wrote: > I've seen patterns that start out as wind-cold, and transform over a > couple of days into internal heat, with fevers up to 102. Neither of > the cases I saw included sore throat, but lots of nasal and chest > mucus, mostly clear and occasionally yellow or green, but not very > thick. That's was kind of my question to Dr. Yang. Basically, my question was, everybody with the nausea and vomiting has the pre-existing middle Jiao issues? He said yes. So, here we have some people getting the flu virus (perhaps the same one, perhaps not, we really don't know) and they passed through it without the intense vomiting, likely because their middle Jiao's were okay to begin with. Would you agree with that, that they didn't have any Spleen/Stomach issues? -- Pain is inevitable, suffering is optional. -Adlai Stevenson Chinese Herbal Medicine offers various professional services, including board approved continuing education classes, an annual conference and a free discussion forum in Chinese Herbal Medicine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2003 Report Share Posted December 17, 2003 , wrote: > Actually, I disagree, but my case sampling (2) is too small to really draw a conclusion. >>> Andrea: It's not a matter to be decided in any uniform way. The general tendency of the population is to have pulses showing dampness/phlegm in the lungs--in part due to the Earth character of the year (Ram) and as a consequence of heat during the summer creating the need for the lungs to produce mucus for protection. In the Fall, when the energy comes back inside, it's like two weather fronts colliding. Against that background, you have to compare the individual pattern of any particular patient---this is the interaction of Host and Guest energies. That's why there can be a wide variety of symptomatic reactions to the flu, plus the usual variations of the flu virus. Patient populations symptoms will vary according to local environments, too. You need to look at all these factors to be comprehensive. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
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