essence and early onset illness

[Guest guest]

Something I read the other day caught my attention. The idea that

essence vacuity is a key factor in many chronic illnesses, especially

degenerative diseases that come on at a premature age. Or people who

have just been sickly all their lives with one ailment after another.

Now in order to accept this hypothesis, we must also accept the

position that no general kidney signs need be present in order to

diagnose essence vacuity. What is the standard thought on this matter?

And by standard I mean the widely represented in modern and ancient

mainstream texts? I was taught that disorders related to maturation

and development involved essence, but many such patients would not

necessarily present as having problems like impotence, low back pain,

etc. I think the latter kidney signs are more typical of those who

exhibit essence vacuity caused by classical kidney depleting activities

as opposed to inborn essence vacuity.

 

We have a chinese professor At PCOM, a classical scholar, who gets

quite a rap for his emphasis on essence vacuity in his diagnoses.

However, as he rightly points out, it is not that all patients have

essence vacuity, just a pretty large %, particularly the self-selected

sickly, multi-complaint, stress, fatigue, allergy types who dominate

the offices of a GP acupuncturist. I think its important to entertain

this hypothesis. However, before I go further, I have to consider how

blood stasis and the prevalence of that factor in aging figures into

this equation. My clinical experience and reading of modern research

and texts like Yan De xin's suggest blood stasis is a key factor in

aging and the associated degenerative diseases. However blood stasis

causes at least some of its damage by impairing the circulation of

essence to organs and tissues. But this refers to the diseases of

aging, not to the premature onset of chronic weakness, pain,

neurological and GI sx. Inborn essence vacuity could explain why

certain organs are chronically weak and the patient can never be cured.

So how does one treat such a patient?

 

In order to answer this, I think it is useful to consider the

relationship between essences, genes and hormones. Many of the

functions associated with essence and the signs of its decline are

identical to processes associated with the ebb and flow of various

hormones in modern physiology, esp. growth, DHEA and gonadal. In

addition, many important herbs that affect kidney function have their

primary effect on hormonal activity. Some are actually hormonal, such

as zi he che. Essence has long been associated with genetics for

obvious reasons - but remember, it is one's genes that contain the code

that creates the body structures and its ability to produce hormones.

If one received a defective inheritance or just comes from a defective

line, then one might have less ability to produce certain vital

substances. Tissue and organ function would thus be less than optimal

and health would always be poor. This is a far cry from a gross birth

defect. But it is arguably a lower grade type of essence vacuity.

 

Now such inborn weaknesses probably cannot be cured in that they are

genetically rooted. Unlike a person who is qi vacuous due to lifestyle

and can be restored to full health through proper lifestyle. If such a

person is still young, they will not need to take herbs on an ongoing

basis after they are better. But a person who has just always been

weak may need to take supplements for essence every day in order to

correct a vacuity that can never be completely rectified. In other

words, the body is genetically incapable of optimal physiology with

just diet and exercise. Ongoing use of supplements is indicated,

perhaps from a very young age. It is no surprise that this would be

true. We are able to care for and keep alive many members of society

who would never survive unbridled nature (amongst whom I include myself

and many other " healers " ). Medicine and culture have allowed the

physically weak to thrive and many such individuals have made great

contributions, perhaps due to not being constantly distracted by

hormone driven physical pursuits.

 

Another reason this idea is intriguing is it dovetails nicely with

certain trends in both life extension and naturopathy. In these

fields, the cause of many chronic dz and indeed aging itself is thought

to be hormone related. Interestingly, the prevailing idea is that

certain types of activities, such as poor diet and lack of exercise,

are what lead to hormonal decline. that the steep declines many

experience are not natural and necessary, but due to an accumulation

of the effects of sluggish circulation, poor nutrition and accumulation

of waste (which could be read as blood stasis, blood vacuity and damp

heat). Eating a certain way and exercising can actually slow, halt or

reverse these declines in those who do not have inborn errors of

metabolism. However, for those who cannot rectify their health through

these means, then supplements may indeed be necessary. Naturopaths and

MD's practicing life extension or specializing in endocrinology will

often use tailor made compounds of natural hormones. While hormone

therapy has a deservedly bad rap, there is evidence that proper

combinations of small amounts of natural hormones are not only safe

but, in those for whom they are indicated by blood work, lead to

dramatic improvements in health with neither short or longterm side

effects. If we can't accept this, then we must also dismiss the use of

zi he che, lu rong, various animal gonads, etc.

 

If certain levels of circulating hormones are necessary for optimal

health and the body is unable to produce them endogenously, then they

must be supplemented. No amount of acupuncture or good diet will help

the body produce something it cannot encode for. In addition, we must

determine this inborn vacuity by extensive history taking since classic

kidney signs may be absent. then we must be careful when administering

the herbs as such patients may have major problems with liver, spleen,

phlegm damp, etc., making tonics hard to digest. In this latter

situation, the nei jing advises to use acumoxa to help digestion so one

can take tonics. Do people feel confident in identifying inborn

essence vacuity that may be subtle? Experience in treating illnesses

this way? Our esteemed professor here at PCOM puts a lot of emphasis

on the presentation of a tender tongue as a key determinant. I would

have to agree that in many lifelong sickly patients, tenderness of the

tongue is quite common. It is also common to see very small tongues

with scanty coats in such cases, even if other s/s would make one

suspect a more spleeny tongue. I am reminded in such cases that

prognosis is always better when s/s line neatly. A yin xu tongue in

patient who exhibits primarily damp and spleen symptoms is a typical

example. This could be the progression of undiagnosed diabetes or just

syndrome X (insulin resistance syndrome). Whenever one sees a small,

tender or otherwise yin xu tongue in a young person, under 35-40, I

think that should set off an alarm. Again, the key to proper use of

such herbs in combining to aid assimilation. I think many may have had

bad experiences using rich tonics because the unmodified classical

formulas like you gui wan are just not constructed properly for most

american patients, IMO.

 

 

 

 

Chinese Herbs

 

 

FAX:

 

 

[Guest guest]

kidney signs need be present in order to

diagnose essence vacuity.

>>>Todd I do not know if your post arises from reviewing my work, but i have

learned that essence deficiency, especially if not post-natal, does not have to

show such K symptoms and signs. As far as hormonal work and clinical utility i

have to agree, but i would not use the term natural hormones but bio-identical

hormones. All hormones are natural.

Alon

 

 

[Guest guest]

, " Alon Marcus "

<alonmarcus@w...> wrote:

> kidney signs need be present in order to

> diagnose essence vacuity.

> >>>Todd I do not know if your post arises from reviewing my work,

but i have learned that essence deficiency, especially if not

post-natal, does not have to show such K symptoms and signs.

 

hhhmm.. Could we elaborate on this? First, I.e. I think there is

spleen essence, liver essence, yin-blood essence etc… But how can one

dx kidney essence without kidney signs?

Maturation and developmental issues are known as kid essence xu signs.

Correct? Length of illness i.e. chronic 30 year problem DOES not,

IMO, allow one to blindly dx kidney essence or kidney problems for

that matter as many people do. Also is there a Chinese source that

discusses this? Also the teacher at PCOM, as far as my memory serves

me, would almost always say essence vacuity. BUT his rx's would many

times not have KID essence herbs. I have always been puzzled by his

equating tenderness with essence vacuity. Was he using essence in a

more general sense (i.e. spleen essence) instead of kidney essence?

Maybe Todd or others could aquire some more information from him, but

in the meantime

Could you (pl.) supply examples of how you believe you can dx kid

essence vacuity without kidney s/s? . I am just wondering what s/s

one bases such an idea on?

 

-

 

 

As far as hormonal work and clinical utility i have to agree, but i

would not use the term natural hormones but bio-identical hormones.

All hormones are natural.

> Alon

>

>

[Guest guest]

most developmental disorders never show any k s/s, they are by definition k

essence related. Scoliosis for example has been often related to k essence by my

TCM teachers, even though you do not see any k s/s.

Alon

 

 

[Guest guest]

, " Alon Marcus " <alonmarcus@w...>

wrote:

 

> >>>Todd I do not know if your post arises from reviewing my work, but i have

learned

that essence deficiency, especially if not post-natal, does not have to show

such K

symptoms and signs. As far as hormonal work and clinical utility i have to

agree, but i

would not use the term natural hormones but bio-identical hormones. All hormones

are

natural.

 

 

Really, then we must define natural. They are not all naturally occurring. oral

estrogen has

been biochemically altered to allow it to be orally absorbed. I call that

semi-synthetic.

same diff, I guess. It was your book that I read this in, but not the first

time I 'd heard it.

Wasn't sure if you wanted me to spill thebeans. alon's book is great. More

details to come

after publication.

 

[Guest guest]

, " Alon Marcus "

<alonmarcus@w...> wrote:

> most developmental disorders never show any k s/s, they are by

definition k essence related. Scoliosis for example has been often

related to k essence by my TCM teachers, even though you do not see

any k s/s.

> Alon

>

>

[Guest guest]

, " " <@h...>

wrote:

 

> Could you (pl.) supply examples of how you believe you can dx kid

> essence vacuity without kidney s/s? . I am just wondering what s/s

> one bases such an idea on?

 

 

I am the one asking for citations, not offering them. I read some things and

have heard

things that require more support, though logical on their face. I was asking

from help

from those who read chinese out there. You worked with the professor in

question for

years. I never have. Did you never ask him where he got these ideas from? I

assumed his

fomulas often address the branch and thus do not treat essence directly, at

least at first.

If you are no going to treat essence vacuity, why dx it. did he give lifestyle

advice based

upon this? did he just mean it was genetic and thus never curable, so

palliation was all

that was possible?

 

but,for example is congenical mental retardation always essence vacuity in part?

if so,

many of these folks have no porblems with low back pain or sexual dysfunction or

urination. And what do you mean by spleen essence vacuity? I know all organs

use

essence, but I never heard of treating spleen essence as distinct from essence

in general.

Could YOU elaborate? Personally I have never been a strong a strong proponent

of any

kidney school. I hope others will entertain this idea and not be stifled by

your dismissal of

it.

 

[Guest guest]

, " " <@h...>

wrote:

 

>

> Alon,

>

> I think my point was that those developmental s/s are kidney signs,

> period. I am more curious about non-developmental, more chronic

> situations.... I think everyone agrees about the childhood stuff.

 

 

I guess we are having semantic issues here. Any failure to develop properly

could be a

kidney sign then. Perhaps this idea has been construed too narrowly. I think

the inability

to produce adequate levels of testosterone could be considered a development

jing issue.

It could lead to lifelong problems in many areas, but not present with goss

kidney

pathology. Is this essence vacuity? Or just constitutional weakness? What is

such a

weakness, but a defective inheritance, i.e. essence vacuity of some sort?

 

[Guest guest]

, " "

wrote:

> , " "

<@h...>

> wrote:

>

> > Could you (pl.) supply examples of how you believe you can dx kid

> > essence vacuity without kidney s/s? . I am just wondering what s/s

> > one bases such an idea on?

>

>

> I am the one asking for citations, not offering them. I read some

things and have heard

> things that require more support, though logical on their face. I

was asking from help

> from those who read chinese out there. You worked with the

professor in question for

> years. I never have. Did you never ask him where he got these

ideas from? I assumed his

> fomulas often address the branch and thus do not treat essence

directly, at least at first.

> If you are no going to treat essence vacuity, why dx it. did he

give lifestyle advice based

> upon this? did he just mean it was genetic and thus never curable,

so palliation was all

> that was possible?

>

> but,for example is congenical mental retardation always essence

vacuity in part? if so,

> many of these folks have no porblems with low back pain or sexual

dysfunction or

> urination. And what do you mean by spleen essence vacuity? I know

all organs use

> essence, but I never heard of treating spleen essence as distinct

from essence in general.

> Could YOU elaborate? Personally I have never been a strong a strong

proponent of any

> kidney school. I hope others will entertain this idea and not be

stifled by your dismissal of

> it.

 

 

 

Don't get me wrong, I am not at all dismissing it. I am asking the

same questions that you outline above. IF I came off as dismissive I

apologize. I am just asking for some examples of what you speak of,

from anyone, or citations (also)...

 

-Jason

[Guest guest]

I think my point was that those developmental s/s are kidney signs,

period. I am more curious about non-developmental, more chronic

situations....

>>>Agreed, in chronic situation from what i have read most of the time the

etiology is usually said to be related to behavior depleting essence such as sex

leading to disease, and then most often there is association with other k s/s. A

big difference however is that k s/s are often associated with either cold or

heat symptoms (ie yang def and yin def) while when speaking of K-essence one

does not need to see heat or cold s/s.

At the same time i have seen Dr in China (and i guess that means a " Chinese

source) that treat many degenerative disease as Essence related with K and

essence herbs. I am particularly thinking of one of my teachers that was heavily

into the K " school. "

alon

 

 

[Guest guest]

Lets not forget that longevity and strength at old age is related to " strong

Essence " all over the classics. It is not far then to think of breakdown of Form

as relating to essence. There are also places were, for example, moxa daily at

St-36 is said to support essence and therefore longevity, resistance to disease

as well as strength of old age, all inverse to degenerative diseases.

Alon

 

 

[Guest guest]

, " Alon Marcus "

<alonmarcus@w...> wrote:

> Lets not forget that longevity and strength at old age is related to

" strong Essence " all over the classics. It is not far then to think of

breakdown of Form as relating to essence. There are also places were,

for example, moxa daily at St-36 is said to support essence and

therefore longevity, resistance to disease as well as strength of old

age, all inverse to degenerative diseases.

> Alon

>

>

[Guest guest]

One idea is that essence xu (is a general term) and may be different

from kid essence vacuity. OR am I half-baked???

 

>>>>>While i am certainly not qualified to quote every usage of the word Jing in

the classics, from the translation i have read, and i am will to bat, that the

usage of essence in the classics is not always clearly differentiated, between

relating to K-essence or essence in general, etc. With post natal Qi and the

Correct or righteous-Qi certainly there are many areas were different essences

come into play such as food-essence for example. The bigger question is the

clinical utility of these ideas, something that we cannot answered at this

point, unfortunately. For example can we treat scoliosis using essence promoting

acupuncture and herbs?

Alon

 

 

[Guest guest]

Todd:

This is a great post--I agree completely.

Misha

, wrote:

> Something I read the other day caught my attention. The idea that

> essence vacuity is a key factor in many chronic illnesses, especially

> degenerative diseases that come on at a premature age. Or people who

> have just been sickly all their lives with one ailment after another.

> Now in order to accept this hypothesis, we must also accept the

> position that no general kidney signs need be present in order to

> diagnose essence vacuity. What is the standard thought on this matter?

> And by standard I mean the widely represented in modern and ancient

> mainstream texts? I was taught that disorders related to maturation

> and development involved essence, but many such patients would not

> necessarily present as having problems like impotence, low back pain,

> etc. I think the latter kidney signs are more typical of those who

> exhibit essence vacuity caused by classical kidney depleting activities

> as opposed to inborn essence vacuity.

>

> We have a chinese professor At PCOM, a classical scholar, who gets

> quite a rap for his emphasis on essence vacuity in his diagnoses.

> However, as he rightly points out, it is not that all patients have

> essence vacuity, just a pretty large %, particularly the self-selected

> sickly, multi-complaint, stress, fatigue, allergy types who dominate

> the offices of a GP acupuncturist. I think its important to entertain

> this hypothesis. However, before I go further, I have to consider how

> blood stasis and the prevalence of that factor in aging figures into

> this equation. My clinical experience and reading of modern research

> and texts like Yan De xin's suggest blood stasis is a key factor in

> aging and the associated degenerative diseases. However blood stasis

> causes at least some of its damage by impairing the circulation of

> essence to organs and tissues. But this refers to the diseases of

> aging, not to the premature onset of chronic weakness, pain,

> neurological and GI sx. Inborn essence vacuity could explain why

> certain organs are chronically weak and the patient can never be cured.

> So how does one treat such a patient?

>

> In order to answer this, I think it is useful to consider the

> relationship between essences, genes and hormones. Many of the

> functions associated with essence and the signs of its decline are

> identical to processes associated with the ebb and flow of various

> hormones in modern physiology, esp. growth, DHEA and gonadal. In

> addition, many important herbs that affect kidney function have their

> primary effect on hormonal activity. Some are actually hormonal, such

> as zi he che. Essence has long been associated with genetics for

> obvious reasons - but remember, it is one's genes that contain the code

> that creates the body structures and its ability to produce hormones.

> If one received a defective inheritance or just comes from a defective

> line, then one might have less ability to produce certain vital

> substances. Tissue and organ function would thus be less than optimal

> and health would always be poor. This is a far cry from a gross birth

> defect. But it is arguably a lower grade type of essence vacuity.

>

> Now such inborn weaknesses probably cannot be cured in that they are

> genetically rooted. Unlike a person who is qi vacuous due to lifestyle

> and can be restored to full health through proper lifestyle. If such a

> person is still young, they will not need to take herbs on an ongoing

> basis after they are better. But a person who has just always been

> weak may need to take supplements for essence every day in order to

> correct a vacuity that can never be completely rectified. In other

> words, the body is genetically incapable of optimal physiology with

> just diet and exercise. Ongoing use of supplements is indicated,

> perhaps from a very young age. It is no surprise that this would be

> true. We are able to care for and keep alive many members of society

> who would never survive unbridled nature (amongst whom I include myself

> and many other " healers " ). Medicine and culture have allowed the

> physically weak to thrive and many such individuals have made great

> contributions, perhaps due to not being constantly distracted by

> hormone driven physical pursuits.

>

> Another reason this idea is intriguing is it dovetails nicely with

> certain trends in both life extension and naturopathy. In these

> fields, the cause of many chronic dz and indeed aging itself is thought

> to be hormone related. Interestingly, the prevailing idea is that

> certain types of activities, such as poor diet and lack of exercise,

> are what lead to hormonal decline. that the steep declines many

> experience are not natural and necessary, but due to an accumulation

> of the effects of sluggish circulation, poor nutrition and accumulation

> of waste (which could be read as blood stasis, blood vacuity and damp

> heat). Eating a certain way and exercising can actually slow, halt or

> reverse these declines in those who do not have inborn errors of

> metabolism. However, for those who cannot rectify their health through

> these means, then supplements may indeed be necessary. Naturopaths and

> MD's practicing life extension or specializing in endocrinology will

> often use tailor made compounds of natural hormones. While hormone

> therapy has a deservedly bad rap, there is evidence that proper

> combinations of small amounts of natural hormones are not only safe

> but, in those for whom they are indicated by blood work, lead to

> dramatic improvements in health with neither short or longterm side

> effects. If we can't accept this, then we must also dismiss the use of

> zi he che, lu rong, various animal gonads, etc.

>

> If certain levels of circulating hormones are necessary for optimal

> health and the body is unable to produce them endogenously, then they

> must be supplemented. No amount of acupuncture or good diet will help

> the body produce something it cannot encode for. In addition, we must

> determine this inborn vacuity by extensive history taking since classic

> kidney signs may be absent. then we must be careful when administering

> the herbs as such patients may have major problems with liver, spleen,

> phlegm damp, etc., making tonics hard to digest. In this latter

> situation, the nei jing advises to use acumoxa to help digestion so one

> can take tonics. Do people feel confident in identifying inborn

> essence vacuity that may be subtle? Experience in treating illnesses

> this way? Our esteemed professor here at PCOM puts a lot of emphasis

> on the presentation of a tender tongue as a key determinant. I would

> have to agree that in many lifelong sickly patients, tenderness of the

> tongue is quite common. It is also common to see very small tongues

> with scanty coats in such cases, even if other s/s would make one

> suspect a more spleeny tongue. I am reminded in such cases that

> prognosis is always better when s/s line neatly. A yin xu tongue in

> patient who exhibits primarily damp and spleen symptoms is a typical

> example. This could be the progression of undiagnosed diabetes or just

> syndrome X (insulin resistance syndrome). Whenever one sees a small,

> tender or otherwise yin xu tongue in a young person, under 35-40, I

> think that should set off an alarm. Again, the key to proper use of

> such herbs in combining to aid assimilation. I think many may have had

> bad experiences using rich tonics because the unmodified classical

> formulas like you gui wan are just not constructed properly for most

> american patients, IMO.

>

>

>

>

> Chinese Herbs

>

>

> FAX:

>

>

[Guest guest]

Hi all

 

I wish I could (and one day, hopefull will) read the literature in

the original Chinese. For now, I must accept other's translations

and hence interpretations.

 

Macicioa's The Foundations of has a basic

discussion of essence and I'd like to quote and comment on some of

this.

 

First, the " essence is the " basis of Kidney Qi. Essence is fluid-

like and naturally belongs to Yin...In addition, it provides the

material basis for Kid-Yin to produce Kid Qi by the heating action

of Kid Yang. "

 

Essence is " the basis of constitutional strength...and resistance to

exterior pathogenic factors. Althought the Defensive Qi is mostly

responsible for protection from exterior pathogenic factors, it also

draws its strength and has its root in the Kid Essence...'Simple

Questions' chapter 4 says:'If the Essence is properly stored (i.e.

not dissipated), no exterior febrile diseases will be contracted in

the Spring...if the Essence is not stored in Winter, exterior

febrile diseazses will be contracted in the Spring.' "

 

" Essence, Qi and Mind also represent three different states of

condensation of Qi, the Essence being the coarsest and densest, Qi

being more rarefid and the Mind being the most subtle and

immaterial. According to chinese Medicine, Essence and Qi are the

essential foundation of the Mind. If Essence and Qi are healthy and

flourishing, the Mind will be happy and this will lead to a healthy

and happy life. If Essence and Qi are both depleted, then the Mind

necessarily will suffer. "

 

" The state of the Essence can to some degree be deduced from the

patient's past: a history of serious childhood diseases would

indicate a weak constitution. It can also be observed in the

pulse: ...scarttered or leather quality indicates poor and weakened

Essence. The tongue can show a weakened Essence if its root has " no

spirit " .

 

" Some Chinese language expressions also show how these concepts are

rooted in Chinese culture. 'Jing-Shen' (i.e. Essence-Mind)

means 'mind' or 'consciousness', showing the interaction of body and

mind. 'Jing-Shen' also means 'vigor, vitality, drive' all qualities

which are present when both the Essence and the Mind are healthy and

strong. 'Jing-shen-bing' means 'mental illness'. "

 

As to Alon's reference to scoliosis not being a Kidney sign, what

about the fact the Kidney rules the bones and development? I have

seen patients who, as Todd said, took scrupulous care of themselves

and don't present with classic Kidney signs but were infertile (a

possible xu Essence manifestation). If one maintains their post

heaven essence through scrupulous lifestyle, their qi will be

continually maintained and they may have few complaints. However, on

furthur questioning they may have been clingy children who had a lot

of " headaches " and needed a lot of attention from parents. Jeffrey

Yuen talked about Ren Mai dysfunction with relation to this

presentation and, of course, the Essence circulates and is stored in

the 8 extras.

 

So, I think we can become too focused on low back pain and urinary

dysfunction with respect to identifying problems with the Kidney and

and essence in particular. The Kidney is the " root " of the body and

can manifest its deficiency in many what look like mysterious ways.

Essence is the basis for Kidney Qi and consequently all the body's

various forms of qi. I like what somebody else in the group said

(Todd?) about what appears to be a " Spleeny " patient who presents

with what looks like a yin xu, small, thin coatless tongue. The

Essence is not being transformed into Kid Qi at such a rate that it

is able to support Spleen Qi and hence the symptoms of Spleen

disease. I think the Kidney's priority would be to protect and

support the Kidney functions and body parts so the Spleen suffers,

especially without scrupulous attention to lifestlye and diet which

in and of themselves support Spleen function, taking some of the

load off the Kidney having to contribute. Like Todd said, many of

these people discover early on that they must take special care

however it never occurs to them that they may be constitutionally

weak, just scrupulous. I think if one does a very in depth intake,

some potential Kidney symptom is lurking in the area we may

attribute to Liver, Heart, Spleen or Lung--all of which require

support from Essence to accomplish their activities well.

Infertility, bone problems (scoliosis), low immunity, late or early

menstrual onset or testicle development may be such " hiding "

symptoms. Also I have found that some especially large people (who

were very small in their childhood, late to develop and then had

huge growth spurt) may be in this class. I had a patient like this

who was born with " horseshoe " kidneys (not differentiated). At 60 he

complained of complete impotence which, in desperation, he received

Testosterone injections for (which worked!). I would have like to

treat him but he was " quite satisfied " with the injections and had

only come to me for a " cold " which wouldn't go away and was causing

him to be very weak. He was an enormous person who looked

quite " strapping " on first glance.

 

Regards, Shanna

[Guest guest]

On Jul 3, 2004, at 1:43 PM, wrote:

> Something I read the other day caught my attention.  The idea that

> essence vacuity is a key factor in many chronic illnesses, especially

> degenerative diseases that come on at a premature age.  Or people who

> have just been sickly all their lives with one ailment after another. 

> Now in order to accept this hypothesis, we must also accept the

> position that no general kidney signs need be present in order to

> diagnose essence vacuity.  What is the standard thought on this

> matter?

>   And by standard I mean the widely represented in modern and ancient

> mainstream texts

--

 

you've raised a very interesting issue for discussion. I have a

couple of citations, insight from one of my teachers, and some comments

of my own.

 

Quoting from the Su Wen, Wei Li & David Frierman (Clinical Nephrology

in , page 7):

 

Su Wen, Chapter 9, states:

The Kidney is the place of storage of the true yang and the root of

storage in the body. The Kidney stores the essence qi of the five

viscera and six bowels.

--

 

This suggests to me that all the organs have their own essence, and

that if the role of the kidneys is storage of essence, a weakness of

essence related to one of the other organs would not necessarily

involve any kidney symptoms, but that the symptoms would reflect

weakness of the organ in question. If it was essence related directly

to the kidneys then, of course, there would be kidney symptoms. Also,

if the kidneys function of storage is impaired, one might have symptoms

that generalized debility.

 

-------------------------------

Su Wen, Chapter 1, states:

Kidney qi is the former heaven qi of the human body, but it can only

bring its functions into play when it is nourished by the latter heaven

qi. The essence of the five viscera and six bowels is supplied from the

finest essence of water and grains. It is only after receiving and

storing the essence of food that the five viscera and six bowels can

provide essence for the kidney. The kidney is water. It receives and

stores the essence and qi from the five viscera and six bowls.

Therefore the kidney can only spread its essence and qi to the whole

body when the five viscera and six bowels are substantially filled with

essence.

--------------------------------

 

This suggests to me that if there is a weakness in transformation and

transportation (etc) that that the essence may become and remain

depleted. This could be because of essence weakness of the

spleen/stomach, making it a pre-heaven cause; or it may be due to

post-heaven causes such as malnutrition, or irregular diet causing

spleen/stomach weakness. In this case there will be more generalized,

perhaps variable, symptoms, and well as those related directly to

spleen/stomach.

 

BTW, I have not been able to confirm the above translations, but I

assume they are reliable based on their source. I would want to verify

the translation if making a more formal case. Its a place to start at

least.

 

On Jul 3, 2004, at 1:43 PM, wrote:

> We have a chinese professor At PCOM, a classical scholar, who gets

> quite a rap for his emphasis on essence vacuity in his diagnoses. 

> However, as he rightly points out, it is not that all patients have

> essence vacuity, just a pretty large %, particularly the self-selected

> sickly, multi-complaint, stress, fatigue, allergy types who dominate

> the offices of a GP acupuncturist.   I think its important to

> entertain

> this hypothesis.

--

 

I agree with you. One of the things that most impressed me when I

studied with John Shen was his careful distinction of pre & post heaven

causation, including that of essence, using various means including

pulse. Dr Shen always emphasized the importance of understanding the

cause of the patients disease in order to be effective. It heartens me

to know that there is a professor at PCOM that operates on this level,

and I'd encourage any PCOM students to learn what you can from her or

him.

 

Which brings up a comment made in another CHA thread:

 

On Jul 3, 2004, at 6:12 PM, bcataiji wrote:

> At PCOM, the

> emphasis is clearly on history.  The tongue and pulse may or may not

> confirm the history.  Precedence is rarely (I cannot think of an

> instance in my experience at PCOM) put on tongue and pulse over

> history.

--

 

This tells me that either the students are not understanding their

teachers, or that the teachers that Brian was exposed to at PCOM were

unable to integrate variable information into their understanding of

the patients. It is a monumental misunderstanding to suggest that

because the tongue or pulse doesn't seem to fit the history that they

should be ignored. The tongue and pulse often tell you what the

patient, for various reasons, does not. In the case where there is

essence vacuity, one will frequently find disparate, even paradoxical,

diagnostic information. If one is ignorant of the implications, one

will of course conclude that some of the information is irrelevant.

Operating on an inadequate understanding, the practitioner will also

likely have a difficult time treating the patient effectively in the

longer term.

 

Rory

 

 

[Guest guest]

On Jul 3, 2004, at 8:18 PM, Misha Cohen wrote:

 

> ,

> wrote:

>>

 

>> Our esteemed professor here at PCOM puts a lot of emphasis

>> on the presentation of a tender tongue as a key determinant. I would

>> have to agree that in many lifelong sickly patients, tenderness of the

>> tongue is quite common.

 

perhaps you can describe this " tender tongue " appearance a bit?

One of my supervisors in clinic showed it to me once and the only real

quality I could identify about it was that its edges looked like they

were water logged. Like when you take a long bath, and your fingertips

get all wrinkly. I saw these kinds of wrinkles on the lateral margins

of the tongue.

 

However, I've also heard of the tender tongue (Nen She or " young " )

looking like a skinless chicken breast while the opposite tongue (Lao

She or " old " ) has the striations of the a slab of beef. So, the tender

tongue is chicken, and the old tongue is beef.

 

Can you or your PCOM guy elaborate on the tender tongue's importance to

a Kidney Jing vacuity diagnosis? Is there a mechanism involved, and can

it be articulated?

 

Inquiring minds and tongues want to know!

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

A high rate of ejaculation appears to be linked to a reduced

 

risk of prostate cancer, according to data extracted from

 

the Health Professional Follow-up study which began

 

in 1992. This study of nearly 30,000 US men aged 46 to

 

81 years at the beginning of the study, took information

 

on numerous aspects of lifestyle, including ejaculation

 

frequency, with follow-up questionnaires every two

 

years. The men were asked to report the average number

 

of monthly ejaculations during their 20's and 40's and

 

during the year before the study began. The first find63

 

ing was that more frequent ejaculation was not linked

 

to increased risk of prostate cancer, and the second

 

was that men with the highest rate of ejaculation (21

 

or more per month during their 20s) appeared to be at

 

a reduced risk. The study does not appear to consider

 

whether ejaculating more reduces prostate cancer risk,

 

or whether it is being highly sexed that does it. (JAMA.

 

2004;291: 1578-86).

 

 

 

[Guest guest]

Hi All,

 

To throw another log on this fire, I have been wondering for years if Rh- babies

can be considered to have kidney essence deficiency, including the ones that

don't have obvious " failure to thrive " constitutions or mental retardation. I'm

sure " in my bones " that this is a jing issue, but I haven't been able to define

it in TCM terms. Anyone?

 

 

 

< wrote:

, " " <@h...>

wrote:

 

> Could you (pl.) supply examples of how you believe you can dx kid

> essence vacuity without kidney s/s? . I am just wondering what s/s

> one bases such an idea on?

 

 

I am the one asking for citations, not offering them. I read some things and

have heard

things that require more support, though logical on their face. I was asking

from help

from those who read chinese out there. You worked with the professor in

question for

years. I never have. Did you never ask him where he got these ideas from? I

assumed his

fomulas often address the branch and thus do not treat essence directly, at

least at first.

If you are no going to treat essence vacuity, why dx it. did he give lifestyle

advice based

upon this? did he just mean it was genetic and thus never curable, so

palliation was all

that was possible?

 

but,for example is congenical mental retardation always essence vacuity in part?

if so,

many of these folks have no porblems with low back pain or sexual dysfunction or

urination. And what do you mean by spleen essence vacuity? I know all organs

use

essence, but I never heard of treating spleen essence as distinct from essence

in general.

Could YOU elaborate? Personally I have never been a strong a strong proponent

of any

kidney school. I hope others will entertain this idea and not be stifled by

your dismissal of

it.

 

 

 

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.

 

 

 

 

 

 

[Guest guest]

Hi Al,

 

I remember this teacher describing the tender tongue as looking like a raw

chicken breast and also being somewhat shiny.

 

 

 

Al Stone <alstone wrote:

 

On Jul 3, 2004, at 8:18 PM, Misha Cohen wrote:

 

> ,

> wrote:

>>

 

>> Our esteemed professor here at PCOM puts a lot of emphasis

>> on the presentation of a tender tongue as a key determinant. I would

>> have to agree that in many lifelong sickly patients, tenderness of the

>> tongue is quite common.

 

perhaps you can describe this " tender tongue " appearance a bit?

One of my supervisors in clinic showed it to me once and the only real

quality I could identify about it was that its edges looked like they

were water logged. Like when you take a long bath, and your fingertips

get all wrinkly. I saw these kinds of wrinkles on the lateral margins

of the tongue.

 

However, I've also heard of the tender tongue (Nen She or " young " )

looking like a skinless chicken breast while the opposite tongue (Lao

She or " old " ) has the striations of the a slab of beef. So, the tender

tongue is chicken, and the old tongue is beef.

 

Can you or your PCOM guy elaborate on the tender tongue's importance to

a Kidney Jing vacuity diagnosis? Is there a mechanism involved, and can

it be articulated?

 

Inquiring minds and tongues want to know!

 

--

 

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.