The Art of Palpating the Abdomen for the Purpose of Prescribing Chinese herbal formulas
This is a guest post from recent National College of Natural Medicine (NCNM) graduate, Kumiko Shirai. She is a fine herbalist already and obviously has an expertise in the (almost) lost art of abdominal diagnosis. I have seen this work in action and can attest to its amazing effectiveness! Please enjoy the article. There are more guest articles to come! -Eric
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Japanese abdominal diagnosis, known as fukushin 腹診 is an art form of medical practice that is virtually lost in modern practice of Chinese medicine. There are two major schools and types of abdominal diagnosis, Nanjing and Shanghan Lun schools, which separates into the Japanese schools of acupuncture and the schools of herbalism respectively. There are many modern books written on acupuncture style of abdominal diagnosis, which is also referred to as hara diagnosis, however books written on herbal prescription style of fukushin are difficult to find.
In the studies of Japanese style of herbal prescriptions, kampo, 漢方 which is mostly based on Han Dynasty formulas from the classical texts of the Shanghan Lun and the Jingui Yaolue, one can find many abdominal patterns and findings for almost every formula. It appears, though it is not certain, that Zhang Zhongjing used abdominal palpation as part of his diagnostic tools. And there are many Japanese scholars who have elaborated and perfected their practices of fukushin for the purpose of herbal prescriptions based on Zhang Zhongjing’s classical texts.
The concept and significance of the abdomen are different in Japan from what exists in Western cultures. It was not too long ago that Japanese people commonly said, “I am going to go see a doctor to get my abdomen examined.” In Japanese culture, the abdomen or hara is central. Alternatively, the nervous system and mind seem to be central in Western cultures. But, when we think about it, the Japanese idea makes a lot of sense. The abdomen is physically a central part of the body, containing many of the vital organs. Japanese people also believe that hara is the seat of the soul, where self-consciousness is anchored. On the other hand, from pathological sense, the abdomen is where people hold emotional stress, affecting their digestive problems as well as other physical discomforts. For this reason, in Japanese medicine, the hara becomes a pivotal part of the body during the examination, diagnosis, and treatment.
In fukushin, abdominal patterns are named after herbal formulas such as “Xiao Chaihu Tang pattern” or “sho” in Japanese, which already gives a diagnosis and a treatment plan. On the other hand, in the Nanjing school of abdominal diagnosis, abdominal patterns are named after theoretical diagnostic concepts such as “Liver qi overacting on Spleen”. The difference between Nanjing style of theoretical approach versus Shanghang Lun style of clinical approach is interesting in that it shifted the clinical practice of kampo in Japanese medical history. One of the most influential Japanese scholars, Todo Yoshimasu (1702-1773), emphasized mastering clinical skills rather than understanding theories. He claimed that “proof is always more convincing than logic,” accentuating the importance of the practice of palpation, and to treat what is obvious by carefully examining the abdomen. For this reason, Todo inspired many practitioners to practice palpation during the examination. However, Japanese scholars did not ignore fundamental theories of Chinese medicine completely, and fukushin is still very much based on theory as well.
In order to give an herbal formula based on abdominal diagnosis, one must understand the architecture of the formulas first. There are eight therapeutic methods in the study of herbal prescriptions, however, it is important to break up each method into further smaller groups, understanding the function of the pivotal herb or herbs in each formula. The key herb in a formula may not always be the emperor of the formula, though often times it is. For example, in the purging method, there can be different causes for accumulation in the middle burner hence requiring different approaches and treatment plans. While Dahuang (in Da Chengqi Tang) treats fullness caused by middle burner accumulation due to qi stagnation causing heat, Mangxiao (in Tiaowei Chengqi Tang) treats accumulation of the middle burner due to dryness of the intestines, and Taoren and Mudanpi (in Dahuang Mudanpi Tang) treat fullness by breaking up blood stasis, hence moving both qi and blood. As a consequence, these three formulas, which share a common category of method, will have different abdominal patterns and imply different treatment plans.
In closing, I want to emphasize that examining a person’s center is not only theoretically appropriate but also clinically helpful in the process of assessment, diagnosis and finally planning a treatment. Hence, Chinese medicine practitioners, are encouraged to cherish the art form of practicing this medicine by observing and touching each patient and interpreting such information as holographic representation of the body.
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Tags: abdominal diagnosis, asian medicine, clinic, Diagnosis, formulas, japanese medicine, patterns, schools, shang-han-lun, study, TheoryRelated posts
How the Chinese organ clock yields a more nuanced view of the Heart
Here I will present a basic overview of TCM information concerning the Heart and then add a layer of information gleaned from the Organ clock (a more CCM way of looking at things). I want to do this to demonstrate how the Classical approach yields a more nuanced view than the straight organ-based TCM approach does, including a small aspect of the clinical relevance of this approach. Disclaimer : I’m still a student. :)
The Heart is a central organ system. From the perspective of governmental metaphor, the Heart is most easily compared to the Ruler of feudal society. What does the ruler do? It’s tempting to simply say that he rules and leave it at that. However, most rulers through history have acted less as hands-on managers of their empires and acted more as figureheads - acting as moral compasses, inspiring and motivating the people when needed, acting as interpreters of Divine law and generally providing a center point around which the wheel of government turned. The Heart is said to provide a similar function for the human body. To look at this and say that the Heart is “most important” would be erroneous. The Emperor without his ministers, without the workers, without the land - is nothing. It is an interdependent system. But, still, the Emperor is crucial and a lot of attention should be paid to those things that are crucial. We’ll do so now.
In TCM, the Heart is said to have many functions/associations:
- The Heart contains the Shen, which rules the other “spirits” of the Zang organs
- Shen, as I have explained briefly elsewhere, can be translated as “Spirit” but it contains more meaning than the normal English concept of Spirit. Many contemporary commentators talk about Shen simply as consciousness, but I feel it is more than that.
- The Heart governs the Blood Vessels
- The Heart acts as Ruler of the other organ systems
- The Heart, as related to the brain and consciousness, is in charge of many mental processes (one can see this as similar to the Heart’s function via its relationship to Shen - the fire of consciousness)
- The Heart propels the Blood
- The Heart governs speech
- There are other attributes, but these are the main ones mentioned in a variety of texts.
In truth, despite all of these things, most Heart related pathologies diagnosed in TCM have to do with mental function or, sometimes, heart organ abnormalities (such as blood stasis in the Heart yielding angina). In clinic, I mostly see Heart Qi/Blood deficiency (with palpitations and poor memory) and some version of the confusingly named “Heart Fire” resulting in insomnia, anxiety and some type of vexation. Rarely do I see doctors diagnosing a problem with the heart when there are circulation problems (blood vessels) or speech problems. Further, I think that there should be more attention paid to the fact that, as EMPEROR of the other organ systems, the Heart may be a great place to look when a seemingly unrelated pathology is difficult to cure with the methods we would normally utilize. While I will not focus much on blood vessel or speech problems in this article - I would like to do so in the future.
For now, to help us understand the Heart a little more deeply, I offer a brief exposition of some of the basic symbols associated with the Heart on the Chinese medicine organ clock. I will then describe some ways we can use this understanding to expand on the basic information we learn from TCM literature.
What do we learn about the Heart organ system from the organ clock?
Temporal nature : 11-1pm (High Noon) and the Summer Solstice
At first glance, the pairing of the Heart with high noon makes intuitive sense. This is the time we associate with the zenith of the sun, the burning off of morning fogs, the time when all things are apparent, illuminated, complete. But look again at the symbol for the taiji and superimpose this over the organ clock. Remember these symbol fields are multi-layered and 
while some aren’t meant to be compared one-to-one, the flow of Yin and Yang through the organ clock (and through the days on Earth) is a crucial piece of information in our understanding of organ systems.
This is the time of the birth of the Yin. Which brings us to another temporal aspect of the Heart - it is situated at the time of the Summer solstice. The solstice is the time of the greatest day length - so again, it is all flourishing and awake and alive. However, the hidden principle is the one of the birth of the dark - for the zenith of a thing always brings about its immediate descent into expiration. What goes up must come down.
What does this tell us about the Heart? That while it is a very Yang organ, as the Emperor should be, but it also contains a deep Yin principle within it. Our professor, Heiner Fruehauf, often relates the Heart to the feminine principle - which makes sense given this information. In that way, it may be more accurate for us to think of the Heart as the Empress - or some amalgam of the Emperor and Empress. Here is perfect control, high intelligence, beauty, grace, compassion, mercy and power. It is an intensely active principle - Yang - but with this huge strength of the Yin.
Why do I say that the strength of Yin is large when it is, in reality, just the beginning of the growth of Yin? Because the entire momentum of Yin’s growth starts at this point - it somehow contains the whole force of the future splendor of Yin’s fullness. It is strong in the sense that is young, vital, and on the ascent.
I think this Yin principle is very important. At the height of summer, at the height of noon, this is when we may have the tendency to go all upward and outward - but it is crucially important that we go within, nourish our deep spiritual nature. Some cultural customs bear this out - such as the tradition of the midday siesta and the many spiritual activities that go on around the summer solstice. I think that, in some ways, the failure to do this can be seen in American capitalist culture. The principle of constant up, out, grow, flourish is often not balanced with careful reflection, willingness to “stand down,” controlled descent and respect for the more passive aspects of the universe. This failure has penetrated the consciousness of many American people and others affected by this philosophy and may have something to do with much of the pathology we see today. More about this later.
Earthly Branch Wu : combined with the symbolism of the Horse in the Chinese zodiac
The Earthly branch Wu 午, reinforces what we’ve already discussed about the Summer Solstice - given that it is the Earthly branch associated with that part of the year. It is a picture of either a battering ram or a mortar and pestle, and thus we see again the idea of death or destruction in this life affirming and light giving symbol of the Heart. Wu 午 is also associated with the number five insofar that it is pronounced the same as 五, Wu - “five.”
This brings us to consideration of the association of the number five and the Heart. We should note that we’re talking about the fifth month when we talk about the Heart. The number five is extremely important in Chinese cosmology - witness the deep symbolism of the five elements and a whole variety of other symbolism assocaited with five. There’s just so much that I could say in this realm (and actually did, but then deleted to save your poor eyes) but I will have to stop here for the sake of article length.
The Earthly Branch Wu 午 is related to the Horse in the Chinese Zodiac. Remember, the Earthly Branches were associated with an animal to help them be easier to understand by the common people. The Horse is a particularly fascinating symbol for the Heart, which I could talk for a long time about. But consider just a few simple items. The horse is tireless, constantly galloping away, carrying great loads, even fighting in battle - just as our physical Heart must
persist throughout our lifetimes. The horse seems to share a Shen level connection with the human being - a really close rider and horse seem to read one another’s minds, few verbal commands are needed when the relationship is strong. The horse is one of the most beloved animals in all cultures, people sometimes take better care of their horses than they do their children!
I am certain there is more to understand about the horse - I would love to hear what people come up with in the comments to this post - please post below!
As always, there are many more symbols that we can pull from the organ clock to help us understand the Heart more deeply - but let’s work with what we have so far.
How does this help us understand the Heart more completely?
There’s a lot one could say about these symbols. The most important take-home message I have received is the crucial nature of respecting the Yin nature of the Heart. However, I don’t think you should start dousing your anxiety ridden patients with cooling herbs! On the contrary, they probably need Fu Zi. Which actually brings me to an important relationship and my overall point. You’ll excuse me if I diverge a bit into conjecture and philosophical exploration? Thanks.
We often talk about the relationship of the Heart and Kidney - fire and water. They are obviously related via their Liuqi designation of Shaoyin, or lesser Yin. We learn that the Shaoyin fire of the Heart must descend through the Earth to reach the Shaoyin water of the Kidney. In doing so, the cold Kidney water, the depth of our wisdom and lineage, is animated by the pure fire of Spirit and consciousness. Wisdom without use of that wisdom is nothing but a lifeless puddle. Likewise, the pure Kidney water must be steamed up to cool and contain the sometimes over-exuberant Heart Shen. Consciousness without wisdom quickly becomes tyranny and zealotry.
This is one way that I understand the importance of using Fu Zi even in the case of patients who appear to have lots of flaring Heat - such as patients with intense insomnia and anxiety. So many TCM physicians would balk at serving Fu Zi to such a patient. To provide one example of a powerful use of this principle, let’s go to that little book known as the Shang Han Lun.
下之後．復發汗．晝日煩躁不得眠．夜而安靜．不
嘔不渴．無表證．脈沈微者．乾薑附子湯主之
Xià zhīhòu．fù fāhàn．zhòurì fánzào bùdé mián．yè ér ānjìng．bù
ǒu bù kě. wú biǎozhèng．mài chén wēi, shēn wú dà rè zhě,gān jiāng fùzǐ tāng zhǔ zhī.
When precipitation has been used, yet sweating is then promoted so that the person in the daytime is vexed, agitated and sleepless, but by night time becomes peaceful and retching, thirst, exterios signs and great generalized heat are all absent, and the pulse is sunken adn faint, then Gan Jiang Fu Zi Tang governs (Mitchell/Ye/Wiseman version).
While I would like to think that most doctors would see patient with this picture - particularly the faint pulse - and realize that an intensely warming formula can be indicated, I think that most would still shun such strength and instead use something milder, more cooling, and most likely less effective.
One more point and then I’ll close this article. I believe that this fire-water relationship and the general Yin nature of the Heart leads us to realize the wisdom of having a well-developed spirituality. Only by combining the deep wisdom of contemplation (dwelling in the water) with the animating ecstacy of consciousness (dwelling in the fire) can we have balance. Advising our patients to nourish themselves in this way - of course without necessarily promoting a particular practice or tradition - may go a long way to helping them achieve greater health.
Tags: balance, clinic, earthly branches, fire, heiner fruehauf, horse, insomnia, law, organ system, Organ systems, organ-clock, shang-han-lun, spirituality, symbolism, taiji, traditional-chinese-medicine, waterRelated posts
Deepest Health Chinese Medicine Podcast : Episode 6 - Schools of Chinese medicine and learning
Sorry to get this podcast out so late, folks. There’s been a heat wave in Oregon, and I’ve just been worthless for work. Things are still moving and changing here at Deepesthealth and you can keep looking forward to more great content. :)
This week’s podcast is a fairly quick one where I talk more about my clinical experience. The topic of this one concerns the different schools of Chinese medicine and how students should look at the possibility of “choosing” between them. It’s also the first podcast with the new equipment, tell me what you think in the comments!
Look forward to more great content next week - as well as a post coming out tomorrow that started out small and then grew into a monster!
My best to everyone - Eric
Tags: clinic, Learning, Podcast, schools, shang-han-lun, students, wen bing
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Experiments in Chinese herbalism : on the dangers of Yin Qiao-itis
What follows is a guest post by my friend and comrade in Shang Han Lun love, G. Michael Reynolds over at the Lifegiving Sword. I think it demonstrates a couple of things.
- That experimenting with herbs can - obviously - bring mixed results. :)
- That there’s real peril in standardized systems of medicine. I believe, in general, they tend to make lazy practitioners. I mean, seriously, do you see Yin Qiao in that tongue?
- The power of Classical formula principles.
For any members of the general public currently reading, please don’t become too alarmed by this story. In all systems of medicine, there are ok practitioners, good practitioners, great practitioners and a few folks who shouldn’t but somehow DO make it into the practitioner pool. The difference between Chinese and allopathic medicine in this regard is that Chinese medicine is highly unlikely to kill people even when practiced badly, while allopathic medicine is somewhat less blessed.
This is one reason I am so passionate about the style of Chinese medicine that I am learning. In my experience the kinds of mistreatment problems described below are far less likely to happen within Classical styles. Enjoy this fun read.
Eric
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From Michael: “This story involves a whole host of mistakes, the first and second of those made by me personally, the rest made by three different supervisors in the school clinic. The 3 doctors who led me down the wrong path will remain nameless, however I will point out that the doc who set things to rights is none other than our own Abdallah Stickley. Make what you will of it!”
So here’s the story. On a Sunday evening, I get suddenly sick right before bed. I mean instantaneously sick. My ear started kind of hurting, throat bothering me a little, was sort of dizzy, a slightly productive cough appeared, and some urethral pain (which i have sporadically anyway, but it changed quality a little and intensified). I went to bed determined to do something about it in the morning.
In the morning all the symptoms were the same, but with a little added intensity and a headache that would only appear at pinpoint locations on the GB channel (like GB-2, GB-14, GB-20) and only on one side. Also some retching, mostly due to the cough. I checked my pulse as best I could (always dodgy when you’re sick) and it seemed to me like it could have been considered (in TCM pulse parlance) rapid, slippery, and a bit tight, but also a bit deep at the same time. A mid level pulse, not coming up to the Qi level. So, determined to handle this via SHL style medicine, i wrote the following formula:
Chai Hu
Huang Qin
Gan Jiang
Ban Xia
Bai Shao
Zhi Gan Cao
Fu Ling
Wu Wei Zi
At this point I made a fateful mistake which this whole story turns on. I probably could have booted the whole thing out of my system had I added Gui Zhi. However, I panicked and did not put my full faith in the method I was using. Instead of thinking “quick onset, minor ear and throat irritation=Taiyang, Urethra and bladder pain=Water inhibition=Shaoyang,” I thought “TCM says ear pain is treated with Long Dan Cao. It also treats Liver channel issues like urethral pain. The throat part is covered by the Shaoyang part of this formula” and instead added Long Dan Cao. This formula was made with Teacher #1’s blessing.
That evening I woke up with the same symptoms more or less (adding in sneezing), except now I was getting some dark urine, a tiny bit of dark phlegm, and my pulse was now showing superficial, rapid, and slippery over all. I really panicked at this point, as I begin to think that I did the whole thing wrong. I started to think that the pathogen had time to turn into a heat condition, that despite evidence to the contrary, SHL formulas cannot treat Heat conditions, Wen Bing is right, TCM is right, and a whole other host of lunatic thoughts brought on by someone with Phlegm-Fire problems getting hit by a phlegm producing illness and waking up in the middle of the night….
In my panic I made my second mistake. I took a big hit of Yin Qiao Pian. It will not surprise you to know that within an hour I found myself on the couch thinking “wow…im FREEZING now…” In the morning, I took another YQP dose but half that of the previous one and trotted off to school, feeling worse. I decided that I’d swallow my pride and find a clinic supervisor to look me over and tell me what they thought, because clearly I had blown my own diagnosis and treatment. So, Teacher #2 gave me a looking over and suggested that I stick with the YQP, as it sounded like a heat condition due to the rapid pulse (which was now back down to the Blood depth again) and the dark urine in the morning coupled with the small amount of yellow phlegm. I complied and finished off my YQP that night.
The next morning, I felt worse (keep in mind that I’d already felt bad enough to leave school after an hour or two on both Monday and Tuesday). While in the truck, I got the Missus to take a picture of my tongue, which I present here:
(It may be hard to tell since this is a photo, but that coat-outside of the back area-is definitely a WHITE coat)
I went to school again, toughed it out for my half day class, arranged to be absent from my clinic shift the following day, came home, crashed. The next day, I was still worsening. By the end of the day, I broke down and went back to the clinic hoping to find another supervisor to evaluate. I managed to catch one on her way out the door and Teacher #3 gave me 10 minutes worth of diagnosis and prescription. She wrote a formula which I dont have in front of me, but which I think goes something like this:
Huang Qin
Long Dan Cao
Yu Xing Cao
Xing Ren
Gui Zhi
Wu Wei Zi
Ban Xia
Bai Shao
(It actually had 13 herbs, but these are the only ones i can remember. I’ll get the full list off my chart tomorrow. Basically its a cold, cold formula.)
So I filled this one, took it, next morning woke up feeling like I was going to suffocate. i had to cough for about 5 minutes solid to establish normal breathing. Not happy. However, continued to take the formula. Over the course of the next few days (Fri-Mon) I got marginal improvement at best but still felt horrendous. On Tuesday, I had class followed by clinic. By Clinic time I felt like I was going to die, so I threw myself on the mercy of Dr. Stickley, who did the diagnostics and Rx’ed the following formula:
Chai Hu
Huang Qin
Gan Jiang
Bai Shao
Ban Xia
Fu Ling
Wu Wei Zi
Gan Cao (we were out of Zhi gan Cao in the pharmacy)
Jie Geng
I took a dose in the clinic and then went home afterwards and went to bed.
Next morning, 75% improvement.
So there you have it. I still haven’t finished kicking this thing but I’ve only been on the sensible formula for a day. I’m thinking it may need a little Gui Zhi at some point if it doesnt resolve itself.
G. Michael Reynolds
Tags: chinese-herbs, errors, guest-post, shang-han-lunRelated posts
The six conformations: an exploratory post
The topic of the Six Conformations is huge. So huge, it’s been a bit intimidating to write about. But, it’s something that we hear a lot about in our Classical Chinese Medicine studies here at NCNM in Portland. So, as most times, see this as the beginning of a long exploration. If you’re here without much knowledge of the Six Conformations I hope that this, and related posts, will help broaden your understanding. If you’re here with lots of knowledge of the Six Conformations, I hope you will share your wisdom with us in the comments.
The Six Conformation system is another on par with the Five Elemental Phases. It is a way to sort the macrocosm and microcosm into manageable chunks that have meaningful relationships with one another. It’s worth mentioning that the Shang Han Lun is based on Six Conformation differentiation. In heaven, they refer to weather patterns - or atmospheric Qi. In the human being, they refer to systems in the body. This is important. When people hear about the Six Conformations, they often think about the channels only - so when I say Taiyin, folks automatically think, “Spleen and Lung channels.” This is erroneous thinking, even though many influential books translate Liu Jing as “Six Channels.” Just as the Five Elemental Phases don’t refer only to organs or layers of the body, but include those; the Six Conformations don’t refer only to channels or even their paired organs, but include those.
Let’s get the nitty gritty details out of the way. What are the Six Conformations?
- Taiyang - 太陽 - Great Yang - associated with the Bladder and Small Intestine organ systems
- Yangming - 陽明 - Yang Brightness - associated with Large Intestine and Stomach organ systems
- Shaoyang - 少陽 - Lesser Yang - associated with the Gallbladder and Triple Burner organ systems
- Taiyin - 太陰 - Great Yin - associated with the Lung and Spleen organ systems
- Shaoyin - 少陰 - Lesser Yin - associated with the Heart and Kidney organ systems
- Jueyin - 厥陰 - Reverting Yin - associated with the Pericardium and Liver organ systems
There’s a lot of layers of information associated with each of these categories. I couldn’t hope to look at all of it in one blog post. Let’s look at the most basic layers.
Climactic factors (for better or for worse)
The Six Conformations are related to Six climactic factors/Qi (Liu Qi). These should be in balance in nature, but when they are out of balance we know them as the Six Evils.
- Taiyang - Cold : associated with water, contracting quality
- Yangming - Dryness : associated with metal, dessicating quality
- Shaoyang - Fire : associated with fire, flaring/ministerial in quality
- Taiyin - Damp : associated with earth, sticky and heavy in quality
- Shaoyin - Heat : associated with fire,
- Jueyin - Wind : associated with wood, wandering in quality
As I said above, people often think Six Conformations = Six Channels. Me, I have the opposite problem — I have it so embedded in my head that the Six Conformations = Six Channels = Six Qi (atmospheric and evil) that sometimes I become a bit confused by it. My understanding so far is simple — when we talk about the Six Conformations out of context (as we are now) the concept includes shades of all these meanings (Qi/climactic factors, Jing/channels, layers of the body, etc) and much more. When we are looking at a Conformation more specifically as in a disease, we can tease out what piece of information is most relevant for us at the time. I hope this is clear. It’s a hard thing to explain.
The order of the conformations and the layers of the body
The specific order I keep using as I list the conformations is not without reason. While there is some discussion about the placement of Yangming, most of my teachers seem to agree on this order.
Taiyang is the most outward of the conformations. It governs the most superficial layers of the body and is associated with the Weiqi or defensive force of the human being. Think of the premiere formulas associated with Taiyang - Gui Zhi Tang and Ma Huang Tang. Both strongly resolve the surface. Yangming is the next layer deep - both in some sense physically and also in terms of how external pathogens must progress in their quest to do harm. It is in the Yangming stage that we get great fevers, this is a storehouse of immense Qi and Blood force in the average person. Think how well this resonates with the Stomach and Large Intestine organ systems, both deep dealers in the most basic, primal functions of life. The last Yang conformation, and thus the last protector against a disease becoming deeply internalized, is Shaoyang. Shaoyang is said to “pivot” (a long discussion) between internal and external, and thus has a kind of oscillating quality.
Now we enter the interior of the body, going ever deeper. Taiyin is the first of the Yin conformations and in some way exemplifies a kind of “doing without doing” — the most active of the passive organ systems. Going a layer deeper we find Shaoyin, the north and south poles of the body - Heart and Kidney, the basic axis of the functioning of the human body. When external pathogens reach this deeply, serious disease is the result. Finally, Jueyin - the deepest, but also the possibility of rebirth into the Taiyang conformations in the classic cyclic manner of Chinese philosophical systems. Jueyin is deeply involved with blood, as can be seen clearly in its encompassing of both Liver and Pericardium.
Pairing of the organ systems : insight into pathology
The more I write about this, the more I find to write. For now, I’ll just mention one quick thing. The conformations can be paired in the following way:
- Taiyang - Shaoyin : BL/SI with KD/HT
- Yangming - Taiyin : ST/LI with SP/LU
- Shaoyang - Jueyin : GB/TB with LR/PC
Anyone can see the wisdom of these pairings - reuniting the five elementally associated organ pairs. We have been taught that these are pairings of mutual support. Taiyang is supported by Shaoyin, and Shaoyin feeds Taiyang. Thus, when you have a disease in one, the other is somehow involved. There are particular ways that we have learned to understand this system of differentiation. But a simple thing to consider is this — take one manifestation of Yangming disease, serious constipation. What happens if one over purges in Yangming disease and why? It’s easy enough to say that overpurging (using cold and bitter materials) will cause damage to the Spleen that can manifest itself in a variety of ways, including as diarrhea. Why is that?
One way to explain it is to consider that Taiyin is the support of Yangming, so that when you overtax Yangming it will draw energy from Taiyin, ultimately depleting it. Of course, there are people who would explain this in a much more nuanced way but when I’ve mentioned it to others they seem to understand. Hopefully it will be helpful to you.
I’ll talk more about how I’m learning about the six conformations in the future. I’ll be interested to read any comments - add your thoughts to the discussion!
Eric
Tags: classical-chinese-medicine, shang-han-lun, six conformations, Theory, Zhang Zhong Jing
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