Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 I have 2 questions that I can't seem to find a satisfactory answer in books. 1) At what point does enduring internal dampness either turbid-dampness or damp-heat become " insubstantial " phlegm. It is much more common to see patterns that deal with the dampness aspect however, at some point and in an older patient, you would have phlegm.?. At what point should the diagnosis/treatment principles be refined ? 2)When treating phlegm, what are we really doing when we " vaporize " it? thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 Just curious, where is the term vaporize from? Do you know the Chinese? -Jason _____ On Behalf Of Sharon Sherman Tuesday, January 08, 2008 12:43 PM Phlegm vs Dampness I have 2 questions that I can't seem to find a satisfactory answer in books. 1) At what point does enduring internal dampness either turbid-dampness or damp-heat become " insubstantial " phlegm. It is much more common to see patterns that deal with the dampness aspect however, at some point and in an older patient, you would have phlegm.?. At what point should the diagnosis/treatment principles be refined ? 2)When treating phlegm, what are we really doing when we " vaporize " it? thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 As to the first part, as I understand it, " insubstantial " phlegm is simply that which can be coughed up or otherwise excreted. " Substantial " might just be known as " seen " phlegm. Phlegm is a disorder of the fluids, often but not always coming simply from damp. The Clavey book on Fluid Pathology covers all of this beautifully. Doug , " Sharon Sherman " <empirical_point wrote: > > I have 2 questions that I can't seem to find a satisfactory answer in > books. > 1) At what point does enduring internal dampness either > turbid-dampness or damp-heat become " insubstantial " phlegm. It is much > more common to see patterns that deal with the dampness aspect > however, at some point and in an older patient, you would have > phlegm.?. At what point should the diagnosis/treatment principles be > refined ? > > 2)When treating phlegm, what are we really doing when we " vaporize " it? > thanks > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 In Maciocia's new edition Foundations of book he differentiaties dampness from phlegm: Also, HB Kim's Handbook of Oriental Medicine 3rd ed. is an effective resource text: *dampness:* of both internal and external origins (etiologies) stemming from SP dysfunction; When the SP is diseased, transportation and transformation are obstructed and instead of moving upwards, gu qi byproducts (post-heaven) move downwards to the lower jiao; notice the following patterns: SP damp-heat/ damp-cold LV/GB damp-heat, LI damp-heat, UB damp-heat with s/s of heaviness etc (without dizziness) *phlegm:* of internal etiology only stemming from ST dysfunction (ST is the origin of fluids) ST is in charge of rotting and ripening (R & R). When diseased, instead of substances moving downwards, they pathologically move upwards to the upper jiao; notice the following patterns: Lung phlegm accumulation; Lung phlegm-heat Heart phlegm misting orificies; Heart phlegm-fire In phlegm, you may also see mental disorders with s/s of oppression of the chest, nausea, heaviness, head muzziness, plus dizziness *Phlegm patterns:* Substantial = visible: Lung phlegm (can be expelled) Non substantial = invisible, except for stones and swellings Skin : lumps under the skin, nerve ganglia, lymph nodes, thyroid swellings Channels: numbness HT: mental illness, mental confusion, depression, anxiety GB/KD: GB or KD/UB stones Joints: bone deformities in chronic rheumatoid arthritis * Types of Phlegm: *Wind-phlegm Phlegm-heat Cold-phlegm Damp-phlegm Qi-phlegm Phlegm-fluids (Tan Yin) *Tan Yin:* Phlegm-fluid (ST and Intestines) Key Sx: gurgling sounds Suspended fluids (Hypochondrium) Key Sx: cough, ribcage pain Flooding fluids (Limbs) Key Sx: Pain, deep heaviness, puffy swelling Propping Fluids (Above diaphragm) Key Sx: cough, panting, inability to lie flat For manifestations of these patterns, consult Maciocia's book or HB Kim's book (pgs 76-77) *Water accumulation:* This is a separate entity that is more closely related to dampness; It is derived from external : (wind-water attacking Lungs): facial and hand edema use : Lung 7, LI 4, LI 6, UB 39, UB 22, Du 26 or internal : (KD/SP yang def): yin edema : below the waist edema use : KD 3, KD 7 (moxa), Du 4, Ren 4, 6 etc... There are other pathologies also... ascites, pulmonary edema etc. The general pulse is rolling (slippery) and string-taut (wiry) The general tongue qualities are: dampness and phlegm : thicker, greasier to curdy tongue coating water accumulation: moist or slippery tongue coating, possibly enlarged also (this is like " Tongue edema " ) Physiologically, the three jiaos have transformation and transportation of " body fluids " (Jin/ye): fog, froth, drainage ditch Nguyen Van Nghi says that San Jiao is better translated as: " triple metabolism " instead of " triple burner " . San Jiao is more akin to water than fire; It controls water irrigation and the movement of yuan qi from the dantian/ mingmen to the organs to the channels. The peritoneum may be the " visible " membrane that represents the san jiao, as it connects the three jiaos and the major viscera up through the diaphragm. *Channels digression: *Both the SP and KD channels end at the tongue: SP primary spreads across the bottom of the tongue KD branch ends at the root of the tongue SP channel pathology: pain and stiffness of tongue KD channel pathology: dryness of tongue HT luo goes to the tongue also: HT 5 (luo pt) for aphasia Sudden hoarseness of voice: wind-heat or ST luo pathology Extraordinary channels that go to Throat: Ren, Chong, Yin-wei Hope this helps. . (Coordinator/ Instructor for TCM Review) www.tcmreview.com .. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 Actually " substantial " phlegm is what is pathologically manufactured as productive sputum. I agree the Fluid Physiology book is comprehensive but still does not really bridge the gap. Even in my very " beginners mind " , when I look at the Pi Wei Lun translation the question remains. In enduring disease mechanisms at what point when you have T/T pathophysiology will the depressive damp-heat move beyond to " be " phlegm and as such how do you intellectually/clinically think about it and when is it time to move into other treatment strategies? The symptomatology in books for insubstantial phlegm many times overlap. However, the classes of herbs are different --- In , " " wrote: > > As to the first part, as I understand it, " insubstantial " phlegm is > simply that which can be coughed up or otherwise excreted. > " Substantial " might just be known as " seen " phlegm. Phlegm is a > disorder of the fluids, often but not always coming simply from damp. > The Clavey book on Fluid Pathology covers all of this beautifully. > Doug > > > , " Sharon Sherman " > <empirical_point@> wrote: > > > > I have 2 questions that I can't seem to find a satisfactory answer in > > books. > > 1) At what point does enduring internal dampness either > > turbid-dampness or damp-heat become " insubstantial " phlegm. It is much > > more common to see patterns that deal with the dampness aspect > > however, at some point and in an older patient, you would have > > phlegm.?. At what point should the diagnosis/treatment principles be > > refined ? > > > > 2)When treating phlegm, what are we really doing when we " vaporize " it? > > thanks > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 I'm sorry but HB Kim has produced a study guide that is largely if not wholely a copying of other people's texts. I do not allow it as a resource in papers in my classes. HB is a wonderful guy, a former student, and I have to admire his ambitions and teaching abilities. However, until his sources are fully attributed (and many are) I have my doubts. Doug , " " <johnkokko wrote: > > In Maciocia's new edition Foundations of book > he differentiaties dampness from phlegm: > Also, HB Kim's Handbook of Oriental Medicine 3rd ed. is an effective > resource text: > > *dampness:* > of both internal and external origins (etiologies) > stemming from SP dysfunction; > When the SP is diseased, transportation and transformation are obstructed > and > instead of moving upwards, > gu qi byproducts (post-heaven) move downwards to the lower jiao; > notice the following patterns: > SP damp-heat/ damp-cold > LV/GB damp-heat, LI damp-heat, UB damp-heat > with s/s of heaviness etc (without dizziness) > > *phlegm:* > of internal etiology only > stemming from ST dysfunction (ST is the origin of fluids) > ST is in charge of rotting and ripening (R & R). > When diseased, instead of substances moving downwards, > they pathologically move upwards to the upper jiao; > notice the following patterns: > Lung phlegm accumulation; Lung phlegm-heat > Heart phlegm misting orificies; Heart phlegm-fire > In phlegm, you may also see mental disorders > with s/s of oppression of the chest, nausea, heaviness, head muzziness, plus > dizziness > > *Phlegm patterns:* > Substantial = visible: Lung phlegm (can be expelled) > Non substantial = invisible, except for stones and swellings > Skin : lumps under the skin, nerve ganglia, lymph nodes, thyroid swellings > Channels: numbness > HT: mental illness, mental confusion, depression, anxiety > GB/KD: GB or KD/UB stones > Joints: bone deformities in chronic rheumatoid arthritis > * > Types of Phlegm: > *Wind-phlegm > Phlegm-heat > Cold-phlegm > Damp-phlegm > Qi-phlegm > Phlegm-fluids (Tan Yin) > > *Tan Yin:* > Phlegm-fluid (ST and Intestines) Key Sx: gurgling sounds > Suspended fluids (Hypochondrium) Key Sx: cough, ribcage pain > Flooding fluids (Limbs) Key Sx: Pain, deep heaviness, puffy swelling > Propping Fluids (Above diaphragm) Key Sx: cough, panting, inability to lie > flat > > For manifestations of these patterns, consult Maciocia's book > or HB Kim's book (pgs 76-77) > > *Water accumulation:* > This is a separate entity that is more closely related to dampness; > It is derived from external : > (wind-water attacking Lungs): facial and hand edema > use : Lung 7, LI 4, LI 6, UB 39, UB 22, Du 26 > or internal : > (KD/SP yang def): yin edema : below the waist edema > use : KD 3, KD 7 (moxa), Du 4, Ren 4, 6 etc... > There are other pathologies also... ascites, pulmonary edema etc. > > The general pulse is rolling (slippery) and string-taut (wiry) > The general tongue qualities are: > dampness and phlegm : thicker, greasier to curdy tongue coating > water accumulation: moist or slippery tongue coating, possibly enlarged > also > (this is like " Tongue edema " ) > > Physiologically, the three jiaos have transformation and transportation of > " body fluids " (Jin/ye): fog, froth, drainage ditch > Nguyen Van Nghi says that San Jiao is better translated as: > " triple metabolism " instead of " triple burner " . > San Jiao is more akin to water than fire; > It controls water irrigation and the movement of yuan qi from the dantian/ > mingmen > to the organs to the channels. > The peritoneum may be the " visible " membrane that represents the san jiao, > as it connects the three jiaos and the major viscera up through the > diaphragm. > > *Channels digression: > *Both the SP and KD channels end at the tongue: > SP primary spreads across the bottom of the tongue > KD branch ends at the root of the tongue > SP channel pathology: pain and stiffness of tongue > KD channel pathology: dryness of tongue > HT luo goes to the tongue also: HT 5 (luo pt) for aphasia > > Sudden hoarseness of voice: wind-heat or ST luo pathology > > Extraordinary channels that go to Throat: Ren, Chong, Yin-wei > > Hope this helps. > > . > (Coordinator/ Instructor for TCM Review) > www.tcmreview.com > > . > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 OK, obviously you've done your work here beyond what the first post suggested. As to when clinically, when things become phlegm, I have one criteria which is the speed and activity of the symptoms and at which the symptoms come and go. In regards to damp, a muzzy head may be damp but with dizziness (activity) you have phlegm. Similarily, with mental issues, depression may be damp but when combined with outbreaks of anger (for example) then more phlegm. Same for stomach issues. General heaviness- damp- combined with nausea when confronted with smells then phlegm. A more difficult issue for me is the problem of when to " transform " the phlegm and when to use later on " scouring " herbs. In other words from Ban Xia to Tian Zhu Huang ________________ Once again, Subhuti has a good paper on this: http://www.itmonline.org/arts/bamboo.htm He (Jiao Shude) points out that tianzhuhuang is often used in formulas in place of zhuli because of its lack of availability in the West, and that tianzhuhuang and zhuli " both clear heat and phlegm from the heart, but the former tends to be drying, whereas the latter has a lubricating disinhibiting nature. " One might, therefore, use tianzhuhuang along with a lubricating herb such as ophiopogon or fritillaria to avoid the drying effect. Tianzhuhuang, he indicates, " has a special ability to clear heat and phlegm from the heart channel, open the orifices, and arouse the spirit, sweep phlegm, and stabilize fright. " Jiao compares bamboo leaves with bamboo shavings as follows: Danzhuye clears upper burner heat and vexation, cools the heart, and disinhibits water; zhuru clears center burner heat and vexation, harmonizes the stomach, and checks vomiting. _____________ As to what we are doing when we " vaporize " phlegm I rather unintellectually look at it as " making it go away. " Doug , " Sharon Sherman " <empirical_point wrote: > > Actually " substantial " phlegm is what is pathologically manufactured as productive > sputum. I agree the Fluid Physiology book is comprehensive but still does not really bridge > the gap. Even in my very " beginners mind " , when I look at the Pi Wei Lun translation the > question remains. In enduring disease mechanisms at what point when you have T/T > pathophysiology will the depressive damp-heat move beyond to " be " phlegm and as such > how do you intellectually/clinically think about it and when is it time to move into other > treatment strategies? The symptomatology in books for insubstantial phlegm many times > overlap. However, the classes of herbs are different > > --- In > , " " <taiqi@> wrote: > > > > As to the first part, as I understand it, " insubstantial " phlegm is > > simply that which can be coughed up or otherwise excreted. > > " Substantial " might just be known as " seen " phlegm. Phlegm is a > > disorder of the fluids, often but not always coming simply from damp. > > The Clavey book on Fluid Pathology covers all of this beautifully. > > Doug > > > > > > , " Sharon Sherman " > > <empirical_point@> wrote: > > > > > > I have 2 questions that I can't seem to find a satisfactory answer in > > > books. > > > 1) At what point does enduring internal dampness either > > > turbid-dampness or damp-heat become " insubstantial " phlegm. It is much > > > more common to see patterns that deal with the dampness aspect > > > however, at some point and in an older patient, you would have > > > phlegm.?. At what point should the diagnosis/treatment principles be > > > refined ? > > > > > > 2)When treating phlegm, what are we really doing when we " vaporize " it? > > > thanks > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 Doug, Thank you very much for the informative and thoughtful reply Regards Sharon , " " wrote: > > OK, obviously you've done your work here beyond what the first post > suggested. As to when clinically, when things become phlegm, I have > one criteria which is the speed and activity of the symptoms and at > which the symptoms come and go. In regards to damp, a muzzy head may > be damp but with dizziness (activity) you have phlegm. Similarily, > with mental issues, depression may be damp but when combined with > outbreaks of anger (for example) then more phlegm. Same for stomach > issues. General heaviness- damp- combined with nausea when confronted > with smells then phlegm. > > A more difficult issue for me is the problem of when to " transform " > the phlegm and when to use later on " scouring " herbs. In other words > from Ban Xia to Tian Zhu Huang > ________________ > Once again, Subhuti has a good paper on this: > http://www.itmonline.org/arts/bamboo.htm > He (Jiao Shude) points out that tianzhuhuang is often used in formulas > in place of zhuli because of its lack of availability in the West, and > that tianzhuhuang and zhuli " both clear heat and phlegm from the > heart, but the former tends to be drying, whereas the latter has a > lubricating disinhibiting nature. " One might, therefore, use > tianzhuhuang along with a lubricating herb such as ophiopogon or > fritillaria to avoid the drying effect. Tianzhuhuang, he indicates, > " has a special ability to clear heat and phlegm from the heart > channel, open the orifices, and arouse the spirit, sweep phlegm, and > stabilize fright. " Jiao compares bamboo leaves with bamboo shavings as > follows: Danzhuye clears upper burner heat and vexation, cools the > heart, and disinhibits water; zhuru clears center burner heat and > vexation, harmonizes the stomach, and checks vomiting. > > _____________ > > As to what we are doing when we " vaporize " phlegm I rather > unintellectually look at it as " making it go away. " > > Doug > > > > , " Sharon Sherman " > <empirical_point@> wrote: > > > > Actually " substantial " phlegm is what is pathologically manufactured > as productive > > sputum. I agree the Fluid Physiology book is comprehensive but still > does not really bridge > > the gap. Even in my very " beginners mind " , when I look at the Pi Wei > Lun translation the > > question remains. In enduring disease mechanisms at what point when > you have T/T > > pathophysiology will the depressive damp-heat move beyond to " be " > phlegm and as such > > how do you intellectually/clinically think about it and when is it > time to move into other > > treatment strategies? The symptomatology in books for insubstantial > phlegm many times > > overlap. However, the classes of herbs are different > > > > --- In > > , " " <taiqi@> wrote: > > > > > > As to the first part, as I understand it, " insubstantial " phlegm is > > > simply that which can be coughed up or otherwise excreted. > > > " Substantial " might just be known as " seen " phlegm. Phlegm is a > > > disorder of the fluids, often but not always coming simply from damp. > > > The Clavey book on Fluid Pathology covers all of this beautifully. > > > Doug > > > > > > > > > , " Sharon Sherman " > > > <empirical_point@> wrote: > > > > > > > > I have 2 questions that I can't seem to find a satisfactory > answer in > > > > books. > > > > 1) At what point does enduring internal dampness either > > > > turbid-dampness or damp-heat become " insubstantial " phlegm. It > is much > > > > more common to see patterns that deal with the dampness aspect > > > > however, at some point and in an older patient, you would have > > > > phlegm.?. At what point should the diagnosis/treatment principles be > > > > refined ? > > > > > > > > 2)When treating phlegm, what are we really doing when we > " vaporize " it? > > > > thanks > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 Doug - did you mean 'substantial' phlegm is that which can be coughed up? I seem to remember a rule of thumb that phlegm and dampness were similar - but phlegm affected the upper body and dampness affected the lower body. That might be a little simplistic, but may be useful. Geoff , " " wrote: > > As to the first part, as I understand it, " insubstantial " phlegm is > simply that which can be coughed up or otherwise excreted. > " Substantial " might just be known as " seen " phlegm. Phlegm is a > disorder of the fluids, often but not always coming simply from damp. > The Clavey book on Fluid Pathology covers all of this beautifully. > Doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 whoops, my mistake... you are right... substantial is that which can be coughed up. As to your second sentence it's kind of, really generally, kind of OK as a generalization. Dampness has a propensity to sink, phlegm - like fire - to rise, but I would use other criteria to differentiate them. doug , " G Hudson " <crudo20 wrote: > > Doug - did you mean 'substantial' phlegm is that which can be coughed > up? I seem to remember a rule of thumb that phlegm and dampness were > similar - but phlegm affected the upper body and dampness affected the > lower body. That might be a little simplistic, but may be useful. > > Geoff > > > > , " " > <taiqi@> wrote: > > > > As to the first part, as I understand it, " insubstantial " phlegm is > > simply that which can be coughed up or otherwise excreted. > > " Substantial " might just be known as " seen " phlegm. Phlegm is a > > disorder of the fluids, often but not always coming simply from damp. > > The Clavey book on Fluid Pathology covers all of this beautifully. > > Doug > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 Douglas, My belief is that a firm understanding of the basics brings mastery; it's the same with plumbing, cooking and zen. I did say " resource " and not " source " text, because it is derived from the texts that are important enough to be on the CA state board list. Actually, all of the organized material in his 3rd edition is " attributed " to the " Source " texts, which themselves are compilations of " other people's work. " The material that I listed in my previous email is derived from Maciocia's Foundations of Chinese medicine, but organized more succinctly in HB's book. Respectfully, K. On Jan 9, 2008 10:12 AM, wrote: > I'm sorry but HB Kim has produced a study guide that is largely if not > wholely a copying of other people's texts. I do not allow it as a > resource in papers in my classes. HB is a wonderful guy, a former > student, and I have to admire his ambitions and teaching abilities. > However, until his sources are fully attributed (and many are) I have > my doubts. > Doug > > --- In <%40>, > " " > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 10, 2008 Report Share Posted January 10, 2008 Sorry, I just have a knee jerk reaction to this book. I wouldn't call it a book but an extremely large study sheet. With all due respect for the work that went into it, this is not the same of gleaning insights from other books and/or using your own experiences. I have seen students buying this and not buying Giovanni, CAM and the other required texts, because why bother when all the " facts " are compiled into one $80 resource. I didn't mean to lash out at you personally. I just cringe when I get papers " resourced " from HB and I try my best to discourage it being used academically. Doug , " " <johnkokko wrote: > > Douglas, > > My belief is that a firm understanding of the basics brings mastery; > it's the same with plumbing, cooking and zen. > > I did say " resource " and not " source " text, > because it is derived from the texts that are important enough to be > on the CA state board list. > > Actually, all of the organized material in his 3rd edition is " attributed " > to the > " Source " texts, which themselves are compilations of > " other people's work. " The material that I listed in my previous email > is derived from Maciocia's Foundations of Chinese medicine, > but organized more succinctly in HB's book. > > Respectfully, > K. > > > On Jan 9, 2008 10:12 AM, wrote: > > > I'm sorry but HB Kim has produced a study guide that is largely if not > > wholely a copying of other people's texts. I do not allow it as a > > resource in papers in my classes. HB is a wonderful guy, a former > > student, and I have to admire his ambitions and teaching abilities. > > However, until his sources are fully attributed (and many are) I have > > my doubts. > > Doug > > > > --- In <%40>, > > " " > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 10, 2008 Report Share Posted January 10, 2008 On Jan 8, 2008 11:42 AM, Sharon Sherman <empirical_point wrote: > 1) At what point does enduring internal dampness either > turbid-dampness or damp-heat become " insubstantial " phlegm. It is much > more common to see patterns that deal with the dampness aspect > however, at some point and in an older patient, you would have > phlegm.?. At what point should the diagnosis/treatment principles be > refined ? > An older patient can have an acute exterior invasion giving rise to the same herbal needs as a young patient with the same problem. Still, dampness+time=phlegm (my own mnemonic) but I don't know that this " time " is attached to the age of the patient, but rather the age of the pathology. We shouldn't be assessing patients on the basis of the number that they fill in for their age on one's intake form, but rather the age of their presentation. Look at republican presidential candidate John McCain. This guy's over 70 but I don't think that I could beat him in an arm wrestling contest. He's hearty! I think that your question regarding when damp becomes phlegm is a good one and can be answered by simply comparing the patient's presentation (signs, symptoms, etc.) to the indications of formulas or herbs. There are a few different flavors of phlegm and damp that are addressed with slightly different therapeutic strategies. The answer to your question is best described in the introduction to the various herb categories in the better herb books. The hard part is delineating a bold line between dampness and phlegm. However this is TCM. Bold lines aren't allowed. ha ha. Seriously, ban xia is found in Er Chen Tang for phlegm-damp; Ban Xia Bai Zhu Tian Ma tang for wind-phlegm; Ban Xia Hou Po tang for phelgm and qi stagnation in the throat ( " plum-pit " ); Ban Xia Xie Xin Tang for well, for everything that can attack the middle jiao; Bao He Wan for food stagnation; and Ping Wei San for dampness in the Stomach. So, go figure. Just phlegm alone comes in five flavors. phlegm-damp: ban xia wind-phlegm: tian nan xing dry-phlegm: chuan bei mu phlegm-cold: bai jie zi phlegm-heat: zhu ru phlegm-nodules: hai zao, kun bu Dampness comes in a few flavors too that all require unique treatment strategies that are generally evident when you look at how they're organized in the herb books that use the more modern schema of the 18 some-odd categories (beginning for instance with herbs that disperse cold, etc.). This is less evident in the books that categorize herbs by superior, middle, and inferior. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
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