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Is there any dispute in the TCM literature that liver yang rising

always involve yin/blood vacuity and thus cannot be solely caused by

liver depression unless the depression has transformed to heat and

damaged the yin?

 

That pure liver excess s/s identify patterns of depression heat or fire

rising, not ascendant yang. Thus tian ma gou teng yin is not

appropriate for patterns rooted in liver qi depression with no vacuity

of yin or blood.

 

 

 

 

Chinese Herbs

 

 

 

 

(619) 668-6964

 

 

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, wrote:

> Is there any dispute in the TCM literature that liver yang rising

> always involve yin/blood vacuity and thus cannot be solely caused by

> liver depression unless the depression has transformed to heat and

> damaged the yin?

 

 

 

Yes, I think there is. In issue #7, 2004 of Jiang Su Zhong Yi Yao

(Jiangsu & Medicinals) in an article on the Chinese

medical patterns of hypertension and and modern Western analyses

appearing on pages 56-58 of that issue, Hu Rong lists the following

patterns of hypertension:

 

1. Ascendant liver yang hyperactivity

2. Liver fire hyperactivity & exuberance

3. Yin vacuity/yang hyperactivity

4. Yin & yang dual vacuity

5. Plus the complications of blood stasis and phlegm dampness

 

This would suggest that Hu in any case believes there is a pattern of

ascendant liver yang hyperacrivity without accompanying yin vacuity. I

say this because he/she lists yang hyperactivity with yin vacuity as a

separate pattern. Unfortunately, he/she does not give the symptoms of

this pattern. Instead, he/she describes all the Western biological

markers associated with this pattern. Since this is an article on the

relationship of CM patterns to Western biological markers, there is no

discussion of the CM treatment of these patterns.

 

Bob

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, " Bob Flaws " <pemachophel2001>

wrote:

 

> Yes, I think there is. In issue #7, 2004 of Jiang Su Zhong Yi Yao

> (Jiangsu & Medicinals) in an article on the Chinese

> medical patterns of hypertension and and modern Western analyses

> appearing on pages 56-58 of that issue, Hu Rong lists the following

> patterns of hypertension:

>

> 1. Ascendant liver yang hyperactivity

> 2. Liver fire hyperactivity & exuberance

> 3. Yin vacuity/yang hyperactivity

 

 

Bob

 

What are the formulas for each pattern?

 

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At 2:49 PM +0000 9/30/04, Bob Flaws wrote:

>As I said in my post, there were no formulas given. That was not what

>the article was about. :-)

--

 

However, there seems to be agreement between several texts that:

 

Ascendant liver yang hyperactivity: tian ma gou teng yin

Liver fire hyperactivity & exuberance: long dan xie gan tang

Yin vacuity/yang hyperactivity: qi ju di huang wan

 

In my experience it's useful to think of a wider range of patterns

and formulas to treat people with hypertension than is generally

given in our Chinese source textbooks and articles.

 

Rory

--

 

 

 

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At 3:08 PM -0500 9/30/04, Alon Marcus wrote:

>What are the most common you conceder

--

Alon,

 

My approach (not unique I'm sure) generally is to set aside the fact

of hypertension until I've decided the disease and pattern diagnosis

in CM, then choose formulas that I would use on that basis, and only

then look at adjustments for hypertension based on research. Often

there are multiple patterns in patients with well established

hypertension, and the situation is complicated as well as helped by

medications.

 

Of the formulas usually recommended for HTN, I almost never end up

with long dan xie gan tang, occasionally with tian ma gou teng yin,

more often with tian wang bu xin dan, shen qi wan and its

derivatives, chai hu jia long gu mu li tang, xue fu zhu yu tang, ban

xia bai zhu tian ma tang.

 

Back in the mid-1980s I developed a list based on the Japanese

material on the subject published in the OHAI Journal. The Japanese

have a lot of experience with hypertension, so even though they don't

quite speak TCM, I figured that it was probably useful information.

The most common formulas used by well known practitioners in Japan

seemed to be da chai hu tang, chai hu jia long gu mu li tang, and

huang lian jie du tang. These hardly get mentioned in Chinese sources

I've seen. Now we have F & S which lists 15 formulae, and several

texts with chapters on hypertension. Of those I've looked at the best

seems to be Flaws & Sionneau's Treatment of Modern Western Diseases

which recommends about 12 formula for different patterns with

adaptations.

 

Rory

--

 

 

 

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At 12:26 AM -0500 10/1/04, Alon Marcus wrote:

>Have you treated many cases? if yes what severity and what types of

>results have you been getting

--

 

Not many cases of treating HTN on its own, and its not a focus of my

practice. Usually its treating the patient for some other problem,

and while doing that they are happy to include the HTN. As to

success, it seems highly variable. The cases that seem most

successful are those that come in at an early stage before they are

medicated. Long term medicated cases are hard to budge significantly,

IMO. With the latter I think small gains are the best you can expect.

I haven't followed recent Japanese studies to see what their success

rates are. Have you?

 

Rory

--

 

 

 

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> In my experience it's useful to think of a wider range of patterns

> and formulas to treat people with hypertension than is generally

> given in our Chinese source textbooks and articles.

>

> Rory

 

Absolutely! The Chinese have made a fundamental conceptual mistake vis

a vis the pattern discrimination and treatment of EH. They start by

equating EH with headache and dizziness, and then they posit the

patterns and formulas for headache and dizziness. However, most EH

sufferers are asymptomatic and do not have headache and dizziness.

Therefore, the patterns for those symptoms are irrelevant. This

highlights one of the downsides of a culture which values consensus

and tradition too highly. This error has become the party line. It's

not that it's totally wrong. It just isn't totally right. No wonder CM

isn't particularly good fro treating EH; it's typically not treating

the patients presenting patterns.

 

Bob

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With the latter I think small gains are the best you can expect.

I haven't followed recent Japanese studies to see what their success

rates are. Have you?

>>>>>No i have not, and i find the same thing although more having to do with

severity than if they are or were medicated. I just dont think TCM is very

effective for essential HBP. I have seen hundreds of cases in China.

Alon

 

 

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At 10:24 AM -0700 10/1/04, alon marcus wrote:

>I have seen hundreds of cases in China.

--

 

Did the doctors you observed follow standard patterns/formulas, or

were they more flexible?

 

Rory

--

 

 

 

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At 3:13 PM +0000 10/1/04, Bob Flaws wrote:

>No wonder CM

>isn't particularly good fro treating EH; it's typically not treating

>the patients presenting patterns.

--

 

My impression is that herbs deal more effectively with well

established vacuity patterns, and with phlegm and blood stasis,

whereas acupuncture can have immediate effects on the autonomic

nervous system which regulates blood pressure. As in the case that reported, I've seen blood pressure reduce dramatically with

acupuncture in cases where the blood pressure rise was recent and

stress related, even if there is a genetic tendency in such cases. In

China most cases do not receive acupuncture treatment, so basing what

we do here upon Chinese or Japanese herbal studies or theoretical

ideas may not be giving us the information we need to get to an

effective combined therapy.

 

Rory

--

 

 

 

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--- Rory Kerr <rorykerr wrote:

 

 

 

At 2:49 PM +0000 9/30/04, Bob Flaws wrote:

>As I said in my post, there were no formulas given.

That was not what

>the article was about. :-)

--

 

However, there seems to be agreement between several

texts that:

 

Ascendant liver yang hyperactivity: tian ma gou teng

yin

Liver fire hyperactivity & exuberance: long dan xie

gan tang

Yin vacuity/yang hyperactivity: qi ju di huang wan

 

wiseman says that Ascendant liver yang hyperactivity,

by definition is a pattern of Yin vacuity/yang

hyperactivity. Where does he get this? I assume it

is the standard definition given in most medical

dictionaries. IMO, qi ju di huang wan has little or

no short term effect on yang hyperactviity.

 

 

 

 

 

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