Guest guest Posted July 18, 2004 Report Share Posted July 18, 2004 Dear teachers, friends and colleagues, I posted last Thursday, but as it never appeared, I am repeating it. Last week, when discussing a patient with my mentor, Zhang Ji, I was introduced to a new term, spleen wind, which Dr. Zhang said was mentioned in some of the classics. The patient presented with tell tale signs of wind: tremor, jaw shaking, muscle spasms, but interestingly, pulse was not at all wiry. Rather, right pulses were weak and slippery and left pulses were thready and rapid. I should mention some additional facts about this patient: 63 year old female, very good appetite, very healthy diet, thin appearance, blood sugar levels good, thyroid levels normal, long standing kidney and heart yin xu which is improving. Dr. Zhang differentiated between liver wind and spleen wind as follows: liver wind is much more exhuberant manifesting with tremor and spasms anywhere, whereas spleen wind specifically results from spleen xu and yin xu and is manifested as smaller more rhythmic spasms in or around the chin, mouth, and lips. Both patterns of wind commonly present with phlegm as well. Any comments? Yehuda Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2004 Report Share Posted July 18, 2004 , Yehuda L Frischman <@j...> wrote: > Dear teachers, friends and colleagues, > > I posted last Thursday, but as it never appeared, I am repeating it. > > Last week, when discussing a patient with my mentor, Zhang Ji, I was > introduced to a new term, spleen wind, which Dr. Zhang said was mentioned > in some of the classics. The patient presented with tell tale signs of > wind: tremor, jaw shaking, muscle spasms, but interestingly, pulse was > not at all wiry. Rather, right pulses were weak and slippery and left > pulses were thready and rapid. I should mention some additional facts > about this patient: 63 year old female, very good appetite, very healthy > diet, thin appearance, blood sugar levels good, thyroid levels normal, > long standing kidney and heart yin xu which is improving. Dr. Zhang > differentiated between liver wind and spleen wind as follows: liver wind > is much more exhuberant manifesting with tremor and spasms anywhere, > whereas spleen wind specifically results from spleen xu and yin xu and is Of course yin xu / blood xu can cause wind (which could be related to the spleen) but instead of story telling can I ask what herbs he / she recommened for spleen wind... -JAson > manifested as smaller more rhythmic spasms in or around the chin, mouth, > and lips. Both patterns of wind commonly present with phlegm as well. > > Any comments? > > Yehuda Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2004 Report Share Posted July 18, 2004 Dear Jason, As the herbs reveal, this is a complicated patient presenting with spleen xu causing spleen wind, and kidney/heart yin xu. In addition to the vacuity heat she also manifests replete heat. And the combination of spleen xu, heart heat and wind has engendered phlegm. This is a patient who has taken herbs for 4 years, and over the past 6 month (particularly the past 2 months) has responded extremely well to herbs and her prescription has been modified weekly reflecting her changes. Essentially each prescription consists of 18 herbs. Here is the current prescription: Di long9, Jiang can 9, dan nanxing 9, shi chang pu 9, yuan zhi 9, fu shen 9, sheng di huang 30, bai shao yao 30, tian ma 9, gou teng 30, huang qi 15, xi yang shen 6; pre-cooked: gui ban 15, bie jia 15, mu li 15; as powder: quan xie & wu gong 3 each; and finally raw da huang a total of 5 grams daily. BTW, this patient's replete heat symptoms have been dramatically resolved (as has her constipation) since she has taken the raw da huang. (She originally was taking 7g daily 3 month ago, and we have been gradually cutting back as less produces diarrrhea. Yehuda .... Dr. Zhang differentiated between liver wind and spleen wind as follows: > liver > wind > > is much more exhuberant manifesting with tremor and spasms > anywhere, > > whereas spleen wind specifically results from spleen xu and yin xu > and is > > Of course yin xu / blood xu can cause wind (which could be related > to > the spleen) but instead of story telling can I ask what herbs he / > she > recommened for spleen wind... > > -JAson > > > > manifested as smaller more rhythmic spasms in or around the chin, > mouth, > > and lips. Both patterns of wind commonly present with phlegm as > well. > > > > Any comments? > > > > Yehuda > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2004 Report Share Posted July 21, 2004 I rearranged the herbs in the rx below to make a point. how does the dx of spleen wind lead us to a different rx than using standard patterns. I am always wary of drawing on a concept just because it is mentioned in the classics. My question would be how come this concept has remained undeveloped for 2000 years. Perhaps because it is redundant and yields no clinical insights. Spleen vacuity causes blood xu, yin xu and phlegm. Blood and yin xu lead to wind, which is compounded by phlegm This rx merely addresses these patterns and no new fancy term is necessary or even helpful. Unless one is saying that spleen qi xu directly causes wind to arise, this concept of spleen wind is meaningless. If this is the claim, please explain the pathomechanism of wind due to spleen xu without including blood xu as the true proximate cause. Why? because wind due to blood xu is almost always rooted in spleen qi xu. Unless spleen xu can directly explain wind without including other substances or organs in the explanation, this is just erudition without purpose. Blood xu wind is already considered a mild form of wind. I think it behoove all of us to focus on consensus approaches to TCM and not be seduced by new (or old undeveloped) ideas or additional data. The basic patterns of TCM in modern texts cover all possible aberrations of physiology, IMO. The reason certain patterns are left out of modern texts is that they yield no clinical strategy that would not have been chosen using standard methods. I doubt the founders of TCM accidentally left something important out of the picture (p.s. since mysticism was never part of TCM,it was not left out by the communists; the confucians bagged it long ago). , Yehuda L Frischman <@j...> wrote: Note that ten of the following herbs have some effect on wind calming. The dosages are also quite high. This formula would calm wind even if the spleen was left unaddressed. transform phelgm: dan nanxing 9, shi chang pu 9, calm spirit: yuan zhi 9, fu shen9, extinguish wind: > Di long9, Jiang can 9, tian ma 9, gou teng 30, mu li 15; quan xie & wu gong 3 each; supplement yin and ext. wind. bai shao yao 30 pre-cooked: gui ban 15, bie jia 15, sheng di huang 30, da huang 5 grams daily. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2004 Report Share Posted July 21, 2004 I hope to address your post in about 2 weeks, as I will be unavailable until then. Thanks for your understanding, Yehuda On Wed, 21 Jul 2004 23:26:20 -0000 " .geo " < writes: > I rearranged the herbs in the rx below to make a point. how does the > > dx of spleen wind lead us to a different rx than using standard > patterns. I am always wary of drawing on a concept just because it > is mentioned in the classics. My question would be how come this > concept has remained undeveloped for 2000 years. Perhaps because it > is redundant and yields no clinical insights. Spleen vacuity causes > > blood xu, yin xu and phlegm. Blood and yin xu lead to wind, which > is > compounded by phlegm This rx merely addresses these patterns and no > > new fancy term is necessary or even helpful. Unless one is saying > that spleen qi xu directly causes wind to arise, this concept of > spleen wind is meaningless. If this is the claim, please explain > the > pathomechanism of wind due to spleen xu without including blood xu > as > the true proximate cause. Why? because wind due to blood xu is > almost always rooted in spleen qi xu. Unless spleen xu can directly > > explain wind without including other substances or organs in the > explanation, this is just erudition without purpose. Blood xu wind > is already considered a mild form of wind. I think it behoove all > of > us to focus on consensus approaches to TCM and not be seduced by new > > (or old undeveloped) ideas or additional data. The basic patterns > of > TCM in modern texts cover all possible aberrations of physiology, > IMO. The reason certain patterns are left out of modern texts is > that they yield no clinical strategy that would not have been chosen > > using standard methods. I doubt the founders of TCM accidentally > left > something important out of the picture (p.s. since mysticism was > never part of TCM,it was not left out by the communists; the > confucians bagged it long ago). > > > > > , Yehuda L Frischman > <@j...> wrote: > > Note that ten of the following herbs have some effect on wind > calming. The dosages are also quite high. This formula would calm > wind even if the spleen was left unaddressed. > > transform phelgm: > > dan nanxing 9, > shi chang pu 9, > > calm spirit: > > yuan zhi 9, > fu shen9, > > extinguish wind: > > > Di long9, > Jiang can 9, > tian ma 9, > gou teng 30, > mu li 15; > quan xie & wu gong 3 each; > > supplement yin and ext. wind. > > bai shao yao 30 > pre-cooked: gui ban 15, > bie jia 15, > sheng di huang 30, > > > da huang 5 grams daily. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2005 Report Share Posted March 25, 2005 I happened upon the formula GU ZHEN TANG in the old Bensky (pg 239), dating back some 400 years ago to the " zheng Zhi ZHun Sheng " , as one of the variations of SI JUN ZI TANG. In his description of the indications for the formula he mentions the same " Spleen Wind " which you discounted as a meaningless term last year. Here he gives clarification of it being truly a unique term, clearly different from liver wind, and seems to express it to be a pathogenic sequela of Spleen Yang deficiency Tai Yin channel disorder: " For chronic Spleen wind from exhaustion of the true or yang qi. Manifestations include a lethargic and blunted affect or frank somnambulance (I don't know what he means by that-yf), a pasty white complexion, profuse sweating, rhythmic spasms of the hands an feet (this must be the wind part!-yf) clear liquid diarrhea, a pale tongue with a thin white coating, and a submerged, faint pulse. This condition most often occurs as a sequelae to a prolonged bout of vomiting and diarrhea. " FYI Does anyone know if this condition is discussed and elaborated upon elsewhere? Yehuda On Wed, 21 Jul 2004 23:26:20 -0000 " .geo " < writes: > I rearranged the herbs in the rx below to make a point. how does the > > dx of spleen wind lead us to a different rx than using standard > patterns. I am always wary of drawing on a concept just because it > is mentioned in the classics. My question would be how come this > concept has remained undeveloped for 2000 years. Perhaps because it > is redundant and yields no clinical insights. Spleen vacuity causes > > blood xu, yin xu and phlegm. Blood and yin xu lead to wind, which > is > compounded by phlegm This rx merely addresses these patterns and no > > new fancy term is necessary or even helpful. Unless one is saying > that spleen qi xu directly causes wind to arise, this concept of > spleen wind is meaningless. If this is the claim, please explain > the > pathomechanism of wind due to spleen xu without including blood xu > as > the true proximate cause. Why? because wind due to blood xu is > almost always rooted in spleen qi xu. Unless spleen xu can directly > > explain wind without including other substances or organs in the > explanation, this is just erudition without purpose. Blood xu wind > is already considered a mild form of wind. I think it behoove all > of > us to focus on consensus approaches to TCM and not be seduced by new > > (or old undeveloped) ideas or additional data. The basic patterns > of > TCM in modern texts cover all possible aberrations of physiology, > IMO. The reason certain patterns are left out of modern texts is > that they yield no clinical strategy that would not have been chosen > > using standard methods. I doubt the founders of TCM accidentally > left > something important out of the picture (p.s. since mysticism was > never part of TCM,it was not left out by the communists; the > confucians bagged it long ago). > > > > > , Yehuda L Frischman > <@j...> wrote: > > Note that ten of the following herbs have some effect on wind > calming. The dosages are also quite high. This formula would calm > wind even if the spleen was left unaddressed. > > transform phelgm: > > dan nanxing 9, > shi chang pu 9, > > calm spirit: > > yuan zhi 9, > fu shen9, > > extinguish wind: > > > Di long9, > Jiang can 9, > tian ma 9, > gou teng 30, > mu li 15; > quan xie & wu gong 3 each; > > supplement yin and ext. wind. > > bai shao yao 30 > pre-cooked: gui ban 15, > bie jia 15, > sheng di huang 30, > > > da huang 5 grams daily. > > > > Quote Link to comment Share on other sites More sharing options...
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