Case study: Raise Yang? (nasal congestion / epilepsy)

[Guest guest]

I am treating a patient with herbs and have had very good success

treating chronic nasal congestion with a modified Wen Fei Tang and

Shen Ling Bai Zhu San . He presents with LU, SP qi xu, dampness, some

blood yu locally and liver qi yu with some heat.

 

He would like to switch over to a long term formula. Some of the

herbs in the formula raise qi and yang and help other herbs do the

same so address the nose. This pt has a hx of epilepsy that is

infrequent.

 

Sheng Ma, Chai Hu, Huang Qi.

 

My two part question is:

 

Sheng Ma and Chai Hu raise qi but they are classified as cooling?

Wouldn't warm herbs be more likely to raise yang? Please refresh me

on this - raising clear yang and temp not necessarily like signs.

 

How concerned should I be keeping these herbs in his formula? How

much raising of yang with these herbs at a medium dose (6g sheng ma,

chai hu, 12 g huang qi) long term will provoke liver wind. Since I am

nourishing a good deal does this offset the potential issue.

 

Any ideas are welcome.

 

Other info for case study

 

 

T: pale, toothmarked, tenders sides (KD xu), red dots tip, slight

brownish coating, thick in back

 

P: lung xu, heart agitated and raised, slippery SP, xu Liver, KD

pulses xu.

 

Overall extreme tiredness (3/10). Pt is a cardiologist AND a research

scientist so very intellectually (over) active with a few kids to

boot. Slightly overweight.

 

I've looked these herbs up in Bensky but my questions remained.

 

Thanks ahead

 

Mitch

[Guest guest]

Interesting questions, Mitch. You might look at it, if you have questions about

it, you

probably shouldn't use it. Are you mainly concerned about the epilepsy? I'm not

sure what

Wen Fei Tang is. I assume it is for lung heat...

Can we assume that you want to use the raising three herbs as in Bu zhong Yi qi

tang. Do

you want to use these to address the tiredness? In that case, it seems like he

has too much

damp to do so. Stick to the tonifying Spleen and drying herbs such as Bai or

Cang Zhu

(with a thick coat). I'm not sure you need to raise the other herbs to the nose

using these

three. Xi Xin, Xin yi Hua, Cang er zi, bai zhi will all find their way up there.

Chuan Xiong

may be more suitable. Bo he will clear the nose and also move liver qi.

I'm curious as to the formula you've been using so far and how it will differ.

hope this helps,

doug

 

, " mitchellmustinharris "

<mitchellmustinharris wrote:

>

> I am treating a patient with herbs and have had very good success

> treating chronic nasal congestion with a modified Wen Fei Tang and

> Shen Ling Bai Zhu San . He presents with LU, SP qi xu, dampness, some

> blood yu locally and liver qi yu with some heat.

>

> He would like to switch over to a long term formula. Some of the

> herbs in the formula raise qi and yang and help other herbs do the

> same so address the nose. This pt has a hx of epilepsy that is

> infrequent.

>

> Sheng Ma, Chai Hu, Huang Qi.

>

> My two part question is:

>

> Sheng Ma and Chai Hu raise qi but they are classified as cooling?

> Wouldn't warm herbs be more likely to raise yang? Please refresh me

> on this - raising clear yang and temp not necessarily like signs.

>

> How concerned should I be keeping these herbs in his formula? How

> much raising of yang with these herbs at a medium dose (6g sheng ma,

> chai hu, 12 g huang qi) long term will provoke liver wind. Since I am

> nourishing a good deal does this offset the potential issue.

>

> Any ideas are welcome.

>

> Other info for case study

>

>

> T: pale, toothmarked, tenders sides (KD xu), red dots tip, slight

> brownish coating, thick in back

>

> P: lung xu, heart agitated and raised, slippery SP, xu Liver, KD

> pulses xu.

>

> Overall extreme tiredness (3/10). Pt is a cardiologist AND a research

> scientist so very intellectually (over) active with a few kids to

> boot. Slightly overweight.

>

> I've looked these herbs up in Bensky but my questions remained.

>

> Thanks ahead

>

> Mitch

>

[Guest guest]

Here is the indications for Wen Fei Tang. Learned it from Bob Damone.

 

Lung Qi Vacuity Cold treating Nasal congestion:

Enduring disease and bodily weakness, loss of nourishment following

disease, vacuity detriment to the lung viscus, lung qi insufficiency

and defensive yang vacuity and weakness may all lead to easy invasion

of evil toxin (common cold, allergy are examples). The causes are

both vacuity and ineffective clearing and depurating of lung qi -

this allows evil toxin to become stagnated,

retained, and bound within the nasal orifice. Evil toxin congeals and

gathers within the nasal tissue and

damages and erodes the flesh of and membranes; this lease to Deep

Source Nasal Congestion

 

Formula:

 

Wen Fei Tang: huang qi, ding xiang, cong

bai, qiang huo, ma huang (can be substituted with platycodon, sinapis,

or magnolia bark) sheng ma, fang feng, ge gen, gan cao.

 

Thanks for your comments Doug. I had thought of some of the herbs you

mentioned especially Bo He. The epilepsy seems to be more from a

phlegm origin with all the spleen xu and damp signs - blocking the

channels creating wind, so the Liver heat may not be such a concern

afterall. I was thinking of Shi Chang Pu and some phlegm heat herbs to

handle that aspect.

 

The reason Liver has been on my mind is that the formula worked very

well until some major emotional stress came his way. Then he took

some big steps backwards. So I am trying to find the balance bewteen

how much Liver is truly associated in his root versus a branch context.

 

again any ideas are welcome.

 

the raise yang and temp questions for sheng ma and chai hu is sort of

a side bar but still interests me.

 

Mitch

 

, " "

wrote:

>

> Interesting questions, Mitch. You might look at it, if you have

questions about it, you

> probably shouldn't use it. Are you mainly concerned about the

epilepsy? I'm not sure what

> Wen Fei Tang is. I assume it is for lung heat...

> Can we assume that you want to use the raising three herbs as in Bu

zhong Yi qi tang. Do

> you want to use these to address the tiredness? In that case, it

seems like he has too much

> damp to do so. Stick to the tonifying Spleen and drying herbs such

as Bai or Cang Zhu

> (with a thick coat). I'm not sure you need to raise the other herbs

to the nose using these

> three. Xi Xin, Xin yi Hua, Cang er zi, bai zhi will all find their

way up there. Chuan Xiong

> may be more suitable. Bo he will clear the nose and also move liver qi.

> I'm curious as to the formula you've been using so far and how it

will differ.

> hope this helps,

> doug

>

[Guest guest]

On 8/20/07, mitchellmustinharris <mitchellmustinharris wrote:

>

>

> Sheng Ma and Chai Hu raise qi but they are classified as cooling?

> Wouldn't warm herbs be more likely to raise yang? Please refresh me

> on this - raising clear yang and temp not necessarily like signs.

>

 

 

 

 

 

 

Raising clear yang means " raising its location in altitude " , as opposed to

" raising its quantity " . Directionality is one aspect of these herbs, as is

their thermal natures. The two aren't especially dependent on each other to

my understanding.

 

Sheng ma and chai hu both have cool natures, but lift all the same. Probably

not a bad thing considering the red dots in the anterior portion of the

tongue.

 

> How concerned should I be keeping these herbs in his formula? How

> much raising of yang with these herbs at a medium dose (6g sheng ma,

> chai hu, 12 g huang qi) long term will provoke liver wind. Since I am

> nourishing a good deal does this offset the potential issue.

>

 

 

 

 

 

 

I have a few patients with clear-yang-not-rising signs and symptoms, plus

some Liver wind symptoms in the head. I'm with you on this. I wouldn't say

that I have a definitive answer for you, but what I've done is treat both in

a formula and nobody's gotten worse yet (first, do no harm). So I use the

lifting herbs from Bu Zhong Yi Qi Tang, plus either tian ma and gou teng, or

shi jue ming to extinguish the wind and/or pathological liver heat/qi/wind

that is rising.

 

--

, DAOM

Pain is inevitable, suffering is optional.