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Founder’s Note : This is part of a series of articles about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi / Shanyao

Huangqin / Huanglian (you are here)

As before, we will begin with the Wood Phase and work our way around the cycle until we come to Water. We will kick off the Water herbs with Huangqin 黄芩, also known as Scutellaria baicalensis or skullcap root:

味苦皆屬水，地黃為之主，黃芩為木，黃連為火，白術為土，竹葉為水。

All bitter belongs to water, for it is governed by Dihuang, and Huangqin is wood, Huanglian is fire, Baizhu is earth, and Zhuye is water.

Huanglian 黃連 (Coptis root) is the Fire of Water.

Just as Huangqin carries the activity of Water into the realm of Wood, Huanglian is able to transfer the activity of Water into the realm of Fire. Water controls Fire in the Controlling Cycle of the Five Phases, which is very much in keeping with the heat clearing, fire draining action ofHuanglian. Among the most bitter substances in the materia medica, Huanglian has famously been described as being “more bitter than widow’s tears.” Its pronounced bitter flavor is so great that when it is added to decoctions with other herbs, even just a few grams of Huanglian can be enough to dominate the flavor of an entire formula.

Along with its yellow siblings, Huangqin and Huangbai, Huanglian clears heat, drains toxicity, and drains dampness. Huangqin’s action is ascribed to the upper burner, Huanglian to the middle burner, and Huangbai to the lower burner. In particular, Huanglian is often said to have an affinity to both the Stomach and the Large Intestines.

However, the fact that Huanglian is classified in the Tang Ye Jing as the Fire of Water implies that its action is not only confined to the middle burner.

This is supported by the Shen Nong Ben Cao Jing, which describes the action of Huanglian in this way:

黃連 味苦，寒。主熱氣，目痛，眥傷，泣出，明目，腸澼，腹痛，下痢，婦人陰中腫痛。久服令人不忘，一名王連。

Huanglian’s flavor is bitter [and its nature] is cold. It governs heat qi, eye pain, damage to the canthii, tears pouring out, brightening the eyes, intestinal afflux, abdominal pain, diarrhea, swelling and pain within the female genitalia. Protracted taking improves the memory; another name is Wanglian [literally, “King (Huang) Lian”, or perhaps, “King of succession / carrying on”].

Huanglian’s ability to improve memory suggests it has an effect not only on the digestive organ networks, but also on consciousness, through its ability to drain fire. In particular, this implies that Huanglian has an affinity to the Heart, which belongs to Imperial Fire and is the seat of consciousness.

There are sound theoretical reasons why an herb that has the ability to clear heat in the Stomach (and the intestines, part of the Yangming “Stomach Family” 胃家 weijia) would also affect the Heart. Although it is now classified as a Fire organ, it has been noted by Heiner Fruehauf and other scholars that initially the Heart was classified as an Earth organ, like the Stomach. This was no doubt due to the central role played by the Heart as the Emperor organ. When considering the circadian rhythm of yingqi through the channels and organs, the Foot Yangming Stomach and the Hand Jueyin Pericardium are clock opposites.

These cosmological connections are in turn describing close physiological connections.

In Chinese Medicine, when there is excessive heat in the Stomach, this can rise to harass the Heart, resulting in vexation, insomnia and other psycho-emotional symptoms as well as physical symptoms such as bleeding. From a biomedical perspective as well the adjacent structures of the anatomical heart and stomach can make it clinically challenging to differentiate between acid reflux and a heart attack.

Understanding these rich symbolic connections between the Stomach and the Heart can in turn help us to understand how Zhang Zhongjing uses Huanglian in his formulas. It is used in formulas that primarily treat damp heat in the Small Intestine (which from a Zang Fu perspective also belongs to Fire), such as Gegen Huanqin Huanglian Tang 葛根黃苓黃連湯. However, Huanglian also features heavily in formulas that treat symptoms such as “vexation in the heart with insomnia” (心中煩,不得臥), as in Huanglian Ejiao Tang 黃連阿膠湯. In fact, Huanglian is used in its greatest dose in Huanglian Ejiao Tang, which clearly emphasizes its ability to drain fire from the Heart.

In other cases, as in the Xie Xin Tang 瀉心湯 formulas, Huanglian is used to treat both digestive symptoms as well as vexation, indicating that heat is harassing the Heart.

In the Xie Xin Tang formulas, the key patho-dynamic is the stagnation of qi in the epigastrium, resulting in blockage and fullness in the epigastrium. This particular kind of stagnation is known as a glomus or pi 痞 disrupts the normal qi dynamic of the digestive symptom, resulting in heat in the Stomach and cold in the Spleen. The heat in the Stomach can in turn harass the Heart, resulting in symptoms of vexation, as in the symptom picture of Gancao Xie Xin Tang 甘草瀉心湯 described in Line 158 of the Shang Han Lun. In the Xie Xin formulas, the character xin 心 which normally indicates the Heart organ can be seen as a kind of shorthand for the region below the Heart, the xin xia 心下 or epigastrium. This usage again reflects the close relationship between the Stomach and the Heart, and the ability of Huanglian to treat both organ networks.

In all of these formulas, it should be noted that Huanglian is paired with fellow Water class herb Huangqin, which as we have discussed previously brings Water to Wood by cooling Ministerial Fire in the Gallbladder. Together this combination is able to strongly drain fire and resolve stagnation in the epigastrium. This synergy can be understood also in terms of the close association between Wood and Fire in the generating cycle, and also the relationship of Wood and Fire in respectively controlling and generating Earth.

Hopefully this examination of formula uses shows how the classification of Huanglian as the Fire of Water symbolically represents the full range of function of Huanglian. The close association between the Heart and the Stomach is implicated in many conditions we commonly encounter in the clinic, such as insomnia.

Watch for the next in the series, the popular herb Baizhu, Atractylodes rhizome! Stay updated on our newsletter, or watch all the action on Instagram.

The post Exploring the Tang Ye jing – Huanglian 黃連 – Fire of Water appeared first on Chinese Medicine Central.

2019-03-15 04:33:22 / 1月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

When I took over the acupuncture business and practice management courses at NUNM, it was two seminars situated near the end of the 4-5 year curriculum. The timing makes some sense, right? Students are primed to begin thinking about their careers, and have more information about the profession, so they can take better advantage of that teaching and experience in the courses.

When I was given an opportunity to completely reconfigure that whole part of the acupuncture curriculum, I jumped at the chance.

I decided to turn two courses into four, and made them into a weekly class format instead of seminar style, with the first course starting in the Fall of the first year. As this curriculum became the norm, I’d often be one of the first teachers that students were exposed to at the school (for better and for worse, no doubt)!

I made these changes for several reasons.

1. It’s a lot to learn in just two short terms, and I feared people weren’t really absorbing much. Students’ heads are swimming with information, and many of them are a bit (!) burned out.
2. Breaking up the material a bit more allowed me to focus on particular aspects of running an acupuncture practice during each term. This made for more focused teaching and learning in a program that’s already filled with so much diversity and task switching.
3. Most importantly, perhaps, I believe that students should start contemplating their position in the profession, the career they are entering and what they’d like to do upon graduation as soon as possible.

In fact, I’d love if people were able to take the first course in the series BEFORE they begin contemplating acupuncture as a profession.

The first course available to the public now, so if you’re in this boat or are in the first couple of years of your acupuncture education – go read the details and jump on board if it suits your fancy.

Every year, at the beginning of the business course, students complain that they feel they’re not ready for this, that they have NO IDEA WHAT THEY WANT TO DO WHEN THEY GROW UP, and that they feel the time could be better spent on theory or some other aspect of their education. By the end of the course, few are trying to make the same claims.

What can you learn about acupuncture business so early in your education, or even before you start school?

Lots. You can get to know the profession systematically, for one. How can you even start to think about your career, and determine whether it’s for you, without having an idea of what it’s all about, and what your options are? The vast majority of my students come to acupuncture education with almost NO knowledge of the profession.

When I taught the students only at the end of their education, you might be surprised (and saddened) at how many suddenly realized that the profession wasn’t for them, even if they loved the theories and idea of the medicine. Wouldn’t it have been better for them to know before they spent all that money and time? Maybe not for the schools, yeah, but for those students?

Definitely better to know early on.

Beyond orientation in the realities of acupuncture business and practice, there’s a lot more to teach to brand new students!

In the first course, we dig into the meaning of what it is to be an acupuncture professional. Is there a uniform? What do you “have to believe?” How does licensure work, anyway? Are there unique ethics for Chinese medicine practitioners? How can you be yourself and still be a respectful member of such an old and venerated tradition?

These things are important, and getting young acupuncture professionals to consider them makes for a better integration into the profession.

We also get into productivity and organization.

I think that one of the most important lessons we, as a profession, have to learn is how important it is to stay organized and to use our time wisely. Talking about work-life balance has NO meaning if you’re hopelessly disorganized and don’t show up for your appointments on time.

So many students arrive in medical school with high school or college organizational skills, and those tend to shatter into a million pieces in a rigorous program. Further, school skills are helpful in the real world, but you need to be prepared for the type and volume of information that can come at you during a busy clinical practice.

I like to teach task and project management using the Getting Things Done philosophy, but also try to make room for all kinds of productivity methodology. I also find it increasingly important to define what productivity is, and the limitations on a hyper-focus on perfection in this realm. It’s a big topic, and we barely touch on it, but most find it to be valuable.

Finally, I actually get them to start visioning their future acupuncture practice.

I even ask them (horror of horrors) to start considering what patient populations they might like to serve. It’s fascinating to see how much these ideas evolve over the four+ years of schooling, and the students get ample opportunity to revise their concepts year after year. This is another benefit of a multi-course approach, over a long period of time. They grow, they learn, and they apply that to the frameworks they built in the first year. It’s one of my favorite parts of teaching these courses.

Again, students can have a lot of resistance to defining who they want to treat when they don’t even know what treatment means. I feel for them, but again, find that encountering and frequently reviewing ideas about professional future serve as a powerful antidote to the pressure and anxiety that can build as graduation looms closer.

As I transition to more online, world-wide teaching of acupuncturists, I want to replicate the best of this approach

With the first three of the four courses already ready for registration, I’m now turning towards figuring out who these courses will resonate with most. It’s true that most people searching for acupuncture business training are practitioners in their first few years of practice, or folks who have run up against the limitations of their own knowledge as they grow their clinics. Anyone who fits those drop-description:encodeds could definitely benefit from these teachings, and I’m looking forward to refining these courses to suit people a little farther along the path.

But, in the end, my primary passion will always be teaching acupuncture students. I am particularly seeking those who go to acupuncture schools that don’t have much in the way of practical business training. It confuses me how little attention most schools pay to this important part of the curriculum, but at least now there’s a readily available choice.

When did you start studying acupuncture business?

I’m interested to hear others’ experiences of learning this part of acupuncture professional life. Did you get training every step of the way, or only near the end? Do you feel you were adequately prepared for what it takes to be successful as an acupuncturist? Add your comments below!

The post The best time to learn about acupuncture business is NOW appeared first on Chinese Medicine Central.

2019-02-09 00:00:18 / 2月前 / Eric Grey from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi / Shanyao / Huangqin (you are here)

Now that we’ve completed our tour of the herbs of the Metal Class, our ongoing exploration of the Tang Ye Jing moves on to the herbs of the Water Class.

As before, we will begin with the Wood Phase and work our way around the cycle until we come to Water. We will kick off the Water herbs with Huangqin 黄芩, also known as Scutellaria baicalensis or skullcap root:

味苦皆屬水，地黃為之主，黃芩為木，黃連為火，白術為土，竹葉為水。

All bitter belongs to water, for it is governed by Dihuang, and Huangqin is wood, Huanglian is fire, Baizhu is earth, and Zhuye is water.

We’ve seen through examining the action of the herbs of the Metal Class how the Tang Ye Jing’s classification system describes their function.

Generally speaking, we can say that the grouping of an herb with two phases means that it mediates between the two – so that we can understand Huangqin as bringing Water into the realm of Wood.

Now if we knew nothing about the actions and indications of Huangqin, we might assume that this means Huangqin’s action is to tonify Wood, because we know that through the generating cycle Water nourishes Wood. However, Huangqin is not typically understood as a tonic in either contemporary Chinese Herbal Medicine, or in Classical sources.

Here’s what the Shennong Bencao jing has to say about Huangqin:

味苦平。主治諸熱黃疸，腸澼洩利，逐水，下血閉，惡瘡疽蝕，火瘍。一名腐腸。生川谷。

Huangqin tastes bitter and neutral. It governs all hot yellowing disorders, intestinal afflux, diarrhea and dysentery, expelling water, descending blood obstruction, [treating] malign sores, subcutaneous ulcers, erosions [of the flesh], and firey sores. Another name for it is Fuchang (Putrid Intestines). It grows in rivers and valleys.

Based on this passage, Huangqin is an herb that powerfully clears heat by virtue of its bitter flavor. And indeed that is how Huang Qin is used by Zhang Zhongjing. It’s a very commonly encountered herb in the Shang Han Lun and Jin Gui Yao Lue, where it is often paired with Chai Hu to harmonize disease in the Shaoyang, as in Xiao Chaihu Tang (小柴胡湯) and its variations. And from seeing its application as a Shaoyang herb, we will be able to understand why it is classified as the Wood of Water.

It may be helpful to briefly review Six Conformations (六經 Liu Jing) theory here.

Shaoyang’s function is described as pivoting (樞 shu), it governs the Ministerial Fire (相火 xiang huo), and it encompasses both the San Jiao, which from a Five Phase perspective belongs to Fire, and the Gallbladder, which belongs to Wood. From this lens, Shaoyang pathology can be understood as arising from the dysfunction of Ministerial Fire – the cardinal signs of a Shaoyang pattern are described as “a bitter taste in the mouth, dry throat, dizzy vision” (口苦，咽乾，目眩) in the Shang Han Lun.

From a Six Conformations perspective, this symptom complex can all be attributed to the flaring of Ministerial Fire.

However, from a Five Phases perspective, we might describe this same pathology in in terms of Wood and Fire – dysfunction of the generating cycle, wherein Wood feeds too quickly into the Fire phase, causing flaring of Fire and the various heat signs seen in Shaoyang syndrome. In either case, the remedy for an excess of Fire is Water.

Enter Huangqin!

Huangqin’s bitter flavor brings the cooling activity of Water to Wood by descending, controling, and clearing congested Ministerial Fire in the Gallbladder. It works synergystically with Chaihu for this purpose. Chaihu moves, courses, and releases Gallbladder qi while Huangqin drains fire; together they harmonize the Shaoyang.

Chaihu and Huangqin are paired together so commonly in the Shang Han Lun and Jin Gui that is sometimes difficult to seperate their actions, however the action of Huangqin alone is illustrated in a lesser known formula called Huangqin Tang (黃芩湯).

Huangqin Tang is discussed in Line 172 of the Shang Han Lun:

太陽與少陽合病，自下利者，與黃芩湯

When in taiyang and shaoyang combination disease there is spontaneous diarrhea, it is suitable to give Huangqin Tang.

“Spontaneous diarrhea” is very much in keeping with the indications of Huangqin listed in the Shen Nong Ben Cao Jing (as well as the colorful alternative name of Fuchang, “Putrid Intestines!”). It is also interesting to consider the etiology of the kind of diarrhea described in this passage, as well as the composition of the formula. Huangqin Tang consists of the ingredients Huangqin, the Wood of Water, and also Shaoyao, the Earth of Metal, as well as Dazao, the Fire of Earth and Gancao. the Wood of Earth.

There is some debate among different commentators about how to understand the pathophysiology behind diarrhea in a Taiyang and Shaoyang combination disease, but one interpretation is that heat in the Gallbladder is being transferred to the Small Intestine. Like other Shaoyang patterns, this a problem of obstructed and stagnant Ministerial Fire, however this particular pattern is playing out within the fu organs.

And as with a more general Shaoyang pattern, the Huangqin Tang pattern involves Wood and Fire, and is addressed by using Huangqin to bring the activity of Water into the realm of Wood by draining Gallbladder heat.

And earlier this series we’ve explored how Shaoyao, as the Metal of Earth, can help to control Wood while the combination of Shaoyao and Gancao together can relax and soothe urgency. While we’ve yet to analyze the role of Dazao, understanding the functions of the herbs we have already covered should help to understand the actions of both Huangqin Tang and Huangqin as a single herb.

Based on this analysis, Huangqin ‘s function of draning heat from the Gallbladder can be understood in terms of bringing Water into Wood.

This is in keeping with the direction of Water, which the Neijing associates with the season of Winter and the concept of going into storage (cang 藏). The direction of Fire, in contrast, is to move upward and outward; it is assoicated with the activity of Summer, which is growth (zhang 長) and expansion.

These are in effect opposing actions, and the dynamic balance between Fire and Water is the basis for normal physiology in the microcosm of the body and the orderly movements of the seasons in the macrocosm of the cosmos.

In between Fire and Water is the phase of Wood.

We know from Five Phase theory that the Child of any given phase can drain its Parent, and we can apply this metaphor to the concept of Wood and Ministerial Fire – if Fire rages out of control, it will eventually consume Wood. Bringing a healthy dose of Water in the right way does not douse the Fire, but causes it to descend, become consolidated, and stored in a way that it can do its appropriate work of warming and moving without destroying the base upon which it feeds.

Huangqin is now hopefully a bit clearer to you as far as clinical use, and we’ve started to understand how the Tangye jing approaches herbs of the water class. Keep an eye out for the next in the series, everyone’s favorite herb, Huanglian. Feel free to comment on this post if you have questions – or maybe join us on Facebook?

The post Exploring the Tang Ye jing – Huangqin 黄芩 – Wood of Water appeared first on Chinese Medicine Central.

2019-02-07 06:38:45 / 2月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi / Shanyao (you’re here)

We’ll continue working in the metal class of herbs…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shanyao] is water.

Finally, we come to the end of the cycle of Metal and examine Shanyao, the Water of Metal.

Shanyao (山藥) or Shu Yu (薯蕷), also known as Dioscorea, is a Chinese Yam The Shennong Bencao jing describes it this way:

署豫　味甘小溫。主治傷中，補虛羸，除寒熱邪氣，補中益氣力，長肌肉。久服耳目聰明，輕身不饑延年。一名山芋。生山谷

Shu Yu tastes sweet and slightly warm. It governs damage to the center, supplementing deficiency emaciation, eliminating cold and hot pernicious qi, supplementing the middle, increasing qi and strength, and growing the tendons and flesh. Prolonged taking sharpens and brightens the ears and eyes, lightens the body, eliminates hunger and extends life. Another name for it is Shan Yu (“Mountain Tuber”). It grows in Mountains and Valleys.

Those of you familiar with Zhang Zhongjing’s formulas are already aware that this herb is not a common ingredient in the Shang Han Lun or Jin Gui Yao Lue.

It appears in the famous formula Shen Qi Wan (腎氣丸), Shen Qi Wan’s lesser known cousin formula, Gualou Qu Mai Wan (栝蔞瞿麥丸), and a tonic formula that bears its name, Shu Yu Wan (薯蕷丸).The fact that all of these formulas are wan indicate that they are to be taken for a long time, and have the primary function of tonifying deficiency, which is very much in keeping with the functions described in the Shen Nong Ben Cao Jing.

Shen Qi Wan and Shu Yu Wan both are listed in the Jin Gui Yao Lue’s Chapter on Vacuity Taxation. Shen Qi Wan is indicated for a pattern of “vacuity taxation with lumbar pain, urgent cramping in the lesser abdomen and unsmooth urination” (虛勞腰痛，少腹拘急，小便不利者，八味腎氣丸主之), while Shu Yu Wan is indicated for “vacuity taxation with every insufficiency [and] the hundred diseases of wind qi.” (虛勞諸不足，風氣百疾，薯蕷丸主之). Gualou Qumai wan is listed in the Chapter on urinary disorders, where it described as treating a pattern of unsmooth urination with thirst, attributed to pathological accumulation of water (小便不利者，有水氣，其人若渴 ).

The diseases listed here all involve some kind of deficiency, and two of them specifically mention impaired fluid metabolism, which has direct relevance to Shanyao’s label as the Water of Metal.

In the case of Shanyao, its Sour Flavor brings the action of Metal, which is to gather and astringe, to the phase of Water. What this means is in practice is that it has a gathering, astringing, or securing effect on the Kidneys. This makes sense, given that in both Shen Qi Wan and Shu Yu Wan, it is paired with Dihuang, the Water of Water.

As the horary herb of Water, Dihuang is able to replenish its own phase (in the same way that we saw Wuweizi, as the Metal of Metal, replenishes the Lungs).

Shanyao supports this activity by its Sour flavor and gathering action.

It is able to gather and astringe fluids and both post and pre-natal essence to tonify deficiency. This relationship can hopefully illuminate more broadly the way in which Metal can generate Water.

And the herbal pairing of Shanyao with Dihuang occurs not only Shen Qi Wan, but in the many post-classical formulas dervied from it, such as Liu Wei Dihuang Wan (六味地黄丸) and its many variations, as well as You Gui Wan (右歸丸) and Zuo Gui Wan (左歸丸).

Shen Qi Wan can be understood as the combination of three herbs that support the Yin (Dihuang, Shanyao, Shanzhuyu) with three herbs that drain pathological fluid (Fulingg, Zexie, Mudanpi) and two herbs that support the Yang  (Guizhi and Fuzi).

The later formulas essentially take one or more of these functions as primary.

For example, Liu Wei Dihuang Wan removes the Yang tonics and its variations such as Zhi Bai Dihuang Wan may add additional herbs to clear heat or supplment Yin. And You Gui Wan takes Shen Qi Wan but removes the draining herbs, and adds additional Yang tonics such as Tu Su Zi and Lu Jiao Jiao. All of these formulas, however, contain both Shanyao and Dihuang, because they are all seeking to supplement the Kidney, and Shanyao’s ability to tonify Water when combined with Dihuang is unsurpassed.

In the case of Gualou Qu Mai, while there is deficiency, it is primarily of the Kidney’s ability to transform and steam fluids. Water collects below, leading to unsmooth urination but does not rise to

moisten the upper burner, leading thirst. In this case, Fuzi (Water of Wood) is used to stimulate the Kidney to transform fluids in the lower burner, while Shanyao (Metal of Water) helps to gather fluids in the upper burner, when paired with the fluid generating and thirst quenching Gualougen / Tianhuafen.

This ability of Shanyao to gather, contain, and astringe is an important property that is used in many post-classical formulas as well, such as Wan Dai Tang (完帶湯), which is often used to treat vaginal discharge, or Shen Ling Bai Zhu San (參苓白術散), whose formula pattern often presents with watery loose stools. Shan Yao is a key ingredient in both of these formulas.

This herb has somewhat less to discuss than the others, due to its low use in ZZJ’s formulas, but it is still quite interesting and hopefully will expand your use of the formulas where it is used.

We’ll now take the series to the next element in the cycle – the water herbs.

If you’re not already subscribed to the newsletter, that’s the best way to be informed of future content including the future posts in this series. Also know that the Shennong method course, suitable for beginners in Chinese herbalism, is available for registration here on the site. Thank you for your ongoing support!

The post Exploring the Tang Ye jing – Shanyao 山藥 – Water of Metal appeared first on Chinese Medicine Central.

2019-01-23 13:10:34 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

I’m currently in the process of polishing and releasing a series of four courses intended to help students, new practitioners and other interested people to run a vibrant acupuncture practice that supports them in creating a good life.

The first course is already ready for registration, and is priced so students and practitioners of all stripes can afford it.

There are other courses out there, other teachers. Why am I doing this?

Surveying the scene, there are some great folks putting information out there for acupuncturists who may not have much business acumen. And let’s be honest – that’s a lot of us! Most of us started out in this profession because we love helping people, and we are intrigued by the medicine itself. Many students aren’t even fully aware they’ll likely be full time entrepreneurs upon graduation!

(Yes, yes, there are increasing numbers of jobs available – but an average acupuncture student cannot rely on that being the case. Nor that the job they get will be one worth keeping)

The anxiety acupuncturists have usually comes down to finding, and keeping, patients.

That makes sense. Patients are the lifeblood of any acupuncture practice. Most folks see “marketing” as the primary way to get patients – where that term usually refers to the kind of active, often creative, efforts to get the word out over digital and analog channels. Websites, for example. Brochures, business cards, speaking engagements, social media. That sort of thing.

It makes sense, then, that much of the educational material to help acupuncturists focuses on marketing as such.

But, in my experience, for many – it’s just not enough.

Why? It’s likely not the quality of the materials themselves. I’ve been very impressed with what’s come on the scene in the last 3-4 years. It’s likely not that the people consuming the materials aren’t good enough, or fail to implement the strategies they learn. Acupuncturists, in my experience, are an intelligent, hard working and quick learning bunch. So, why?

The answer isn’t simple, and I’m sorry about that. It starts with the relative complexity of acupuncture practice.

Our medicine is complex, right? We learn all the normal stuff – anatomy, physiology, both biomedical and classical, points, herbs, formulas. Depending on where you go to school, you also learn Chinese culture, classical Chinese reading comprehension, cosmology and symbolism, translation, mental health principles, how to run a Chinese herbal medicinary… need I go on? And that’s before we start talking about the professional realm.

Running a medical practice is, naturally, equally complex!

I’ll not list off all the various areas you have to at least know the basics about here, but there’s quite a bit to know. While you don’t need to know everything in perfect clarity, and depending on your situation some things may be taken care of for you, it’s still a bewildering array of factors that go into running and practicing in a Chinese medicine clinic. And, hey, you should also maintain some semblance of balance in your life as well, right? That’s a lot.

Unfortunately, the formal education in these topics is woefully lacking in acupuncture educational programs. There are some that make an attempt, and plenty of us pick things up from our teachers as we go along. But there’s not much effort to systematically put the type of focus on running an acupuncture practice that students so desperately need.

If any one of these factors is seriously deficient you’re going to suffer. And all the marketing in the world isn’t going to help you if you can’t keep your paperwork straight, or are still struggling to understand yourself as a medical professional, or can’t figure out how to get malpractice insurance. It’s just not going to help enough to make a difference.

So – what can we as acupuncturists do? I think an answer can be found in the theories behind Chinese medicine as a system.

I’m not one to try to force every aspect of human existence into the five phases or what have you, but in this case, I think it’s useful. One of the greatest things about our Chinese medical theories is the simple explanatory power they have in so many situations. It’s a mistake to rely on this uncritically, or too much, but when we’re seeking to parse through a bewildering array of factors – CM theory excels.

If we think about the major systems in a typical business, marketing being one, as an interrelating group of forces we must balance – things start to get clearer. Say we look at marketing as a wood principle in acupuncture practice. What happens if you have a patient that comes in and they’re constantly going, going, going, pushing, pushing, pushing like that wee plant in the early spring breaking the ground on its way up? What happens when wood gets out of balance in this way?

The specifics here don’t really matter.

The point is, when we put so much of our energy in one place without reference to the co-equal aspects of the business behind it, symptoms of imbalance will be the result. Whether those imbalances come inside of ourselves (stress, anxiety, lost productivity) or outside (low patient numbers, or the wrong patients) the result is the same. Our acupuncture practice isn’t as fulfilling as it could be.

I want to provide a systematic approach for improving your acupuncture practice

My courses are an attempt to provide a complete basic training in all the major areas necessary to run a great acupuncture practice. It’s not as sexy as trying to give you that one big marketing strategy that might make you a millionaire.(Narrator: It won’t)

But, this approach – learning all I can about all aspects of business and balancing my activity between them – has guided me to a stable, growing, two location practice that is about to do some pretty interesting things in the world. It’s allowed me to achieve my lifelong dream of a beautiful home with a view on the Oregon Coast. It’s kept me from working annoying second jobs.

This approach has, in short, guided me in the creation of a truly successful acupuncture practice.

I’ve been teaching these courses for 7 years, live, at NUNM – and the consistent feedback is that this material helps. Is it the right approach for everyone? Of course not. But it works well for me, and has worked well for hundreds of students so far.

Like our medicine, I believe business is best practiced when rooted in holism

Holism as a principle guides us to considering each piece of a whole, and noting how the resultant whole is actually much more than its parts. Holism as a principle asks us not to privilege one bit over another, but to see the interrelationship of these factors as primary. I’m asking you to consider what impact such thinking could have on your current or future acupuncture practice.

Are you willing to give it a try?

Join the newsletter or follow CMC on social if you’d like to hear more details about the courses.

We’re just getting started.

The post Why taking an acupuncture practice marketing course may not help appeared first on Chinese Medicine Central.

2019-01-15 06:41:16 / 3月前 / Eric Grey from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi (you’re here)

We’ll continue working in the metal class of herbs…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Next in our exploration of the 25 Herbs of the Tang Ye Jing, Next, we consider Wu Wei Zi.

As the Metal of Metal, Wu Wei Zi is the quintessence of the sour flavor, and it is the perfect herb to illustrate why the Tang Ye Jing ascribes the action of sour to Metal. Let’s begin with the Shen Nong Ben Cao Jing’s entry for Wu Wei Zi:

五味子 味酸，溫。主益氣，欬逆，上氣，勞傷，羸瘦，補不足，強陰，益男子精。

Wu Wei Zi’s flavor is sour, [its temperature] is warm. It governs augmenting qi, cough reversal, surging qi, taxation damage, debilitating emaciation, tonifies insufficiency, strengthens yin, augments male essence. It grows in mountain and valleys.

This drop-description:encoded is in keeping with the statement in Su Wen Chapter 22 that when the Lungs desire to be gathered, urgently eat sour to gather them (肺欲收，急食酸以收之).

Wu Wei Zi is most frequently seen in the SHL not in a formula of its own, but as half of a two herb modification for the treatment of cough.

In Line 96, for example, when using Xiao Chai Hu Tang (小柴胡湯) to treat a Shaoyang pattern, we are told that if the condition presents with a cough, we are to remove Ren Shen, Da Zao, Sheng Jiang and add Gan Jiang and Wu Wei Zi. This same modification occurs in Line 316, which describes a Shaoyin pattern treated by Zhen Wu Tang (真武湯). The line states that when there is a cough, Gan Jiang and Wu Wei Zi as well as Xixin are added.

A quick side note – if the words Shaoyang and Shaoyin don’t make much sense to you, you might be interested in our online course looking into the Six Conformations. 

We can understand these modifications in light of the statement in Su Wen Chapter 38, that it is not only the Lung which causes cough, but potentially any of the Five Zang and Six Fu (五藏六府，皆令人欬，非獨肺也). These modifications show us how to elegantly treat both the branch (cough) as well as the root (the underlying imbalance).

This combination of two or three herbs of a particular action, offset with an herb with an opposite action, is one of the signatures of the formula found in the Tang Ye Jing.

It is also one of the signatures of Zhang Zhongjing’s formulas! We can also see the combination of acrid (Gan Jiang and Xixin) and sour (Wu Wei Zi) as promoting the physiology of the Lungs. We know from basic Chinese Medicine physiology that the Lungs are in charge of dissipating and disseminating qi, functions that are promoted by outward movement of the acrid flavor. The gathering movement of the sour flavor, meanwhile, promotes the Lung’s descending function as well mirroring the action of inhalation and drawing in air.

We can also understand this combination in light of Su Wen Chapter 22, which states that acrid purges the Lungs while sour tonifies them (用酸補之，辛寫之); thus this combination is simultaneously draining pathological excess while also protecting the qi of the Lungs. The three herb combination of Gan Jiang, Xixin, and Wu Wei Zi also features in the formula Xiao Qing Long Tang (小青龍湯), where it is used to restore normal function to the Lungs, and when combined with Ban Xia, to remove stagnant fluids from the upper burner.

There is a lot more to say on Wuweizi, but much of it only makes sense once we’ve explored the other herbs.

My hope is, after the whole series is done, to create an expanded version as an ebook that would add more information about specific formulas and deeper analysis that’s only possible when things are complete.

But, before that, on to our last herb in the metal class – Shanyao – next week!

The post Exploring the Tang Ye jing – Wuweizi 五味子 – Metal of Metal appeared first on Chinese Medicine Central.

2019-01-10 05:59:01 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi (you’re here)

We’ll continue working in the metal class of herbs…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Next in our exploration of the 25 Herbs of the Tang Ye Jing, Next, we consider Wu Wei Zi.

As the Metal of Metal, Wu Wei Zi is the quintessence of the sour flavor, and it is the perfect herb to illustrate why the Tang Ye Jing ascribes the action of sour to Metal. Let’s begin with the Shen Nong Ben Cao Jing’s entry for Wu Wei Zi:

五味子 味酸，溫。主益氣，欬逆，上氣，勞傷，羸瘦，補不足，強陰，益男子精。

Wu Wei Zi’s flavor is sour, [its temperature] is warm. It governs augmenting qi, cough reversal, surging qi, taxation damage, debilitating emaciation, tonifies insufficiency, strengthens yin, augments male essence. It grows in mountain and valleys.

This drop-description:encoded is in keeping with the statement in Su Wen Chapter 22 that when the Lungs desire to be gathered, urgently eat sour to gather them (肺欲收，急食酸以收之).

Wu Wei Zi is most frequently seen in the SHL not in a formula of its own, but as half of a two herb modification for the treatment of cough.

In Line 96, for example, when using Xiao Chai Hu Tang (小柴胡湯) to treat a Shaoyang pattern, we are told that if the condition presents with a cough, we are to remove Ren Shen, Da Zao, Sheng Jiang and add Gan Jiang and Wu Wei Zi. This same modification occurs in Line 316, which describes a Shaoyin pattern treated by Zhen Wu Tang (真武湯). The line states that when there is a cough, Gan Jiang and Wu Wei Zi as well as Xi Xin are added.

We can understand these modifications in light of the statement in Su Wen Chapter 38, that it is not only the Lung which causes cough, but potentially any of the Five Zang and Six Fu (五藏六府，皆令人欬，非獨肺也). These modifications show us how to elegantly treat both the branch (cough) as well as the root (the underlying imbalance).

This combination of two or three herbs of a particular action, offset with an herb with an opposite action, is one of the signatures of the formula found in the Tang Ye Jing.

It is also one of the signatures of Zhang Zhongjing’s formulas! We can also see the combination of acrid (Gan Jiang and Xi Xin) and sour (Wu Wei Zi) as promoting the physiology of the Lungs. We know from basic Chinese Medicine physiology that the Lungs are in charge of dissipating and disseminating qi, functions that are promoted by outward movement of the acrid flavor. The gathering movement of the sour flavor, meanwhile, promotes the Lung’s descending function as well mirroring the action of inhalation and drawing in air.

We can also understand this combination in light of Su Wen Chapter 22, which states that acrid purges the Lungs while sour tonifies them (用酸補之，辛寫之); thus this combination is simultaneously draining pathological excess while also protecting the qi of the Lungs. The three herb combination of Gan Jiang, Xi Xin, and Wu Wei Zi also features in the formula Xiao Qing Long Tang (小青龍湯), where it is used to restore normal function to the Lungs, and when combined with Ban Xia, to remove stagnant fluids from the upper burner.

There is a lot more to say on Wuweizi, but much of it only makes sense once we’ve explored the other herbs.

My hope is, after the whole series is done, to create an expanded version as an ebook that would add more information about specific formulas and deeper analysis that’s only possible when things are complete.

But, before that, on to our last herb in the metal class – Shanyao – next week!

The post Exploring the Tang Ye jing – Wuweizi 五味子 – Metal of Metal appeared first on Chinese Medicine Central.

2019-01-10 05:59:01 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi (you’re here)

We’ll continue working in the metal class of herbs…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Next in our exploration of the 25 Herbs of the Tang Ye Jing, Next, we consider Wu Wei Zi.

As the Metal of Metal, Wu Wei Zi is the quintessence of the sour flavor, and it is the perfect herb to illustrate why the Tang Ye Jing ascribes the action of sour to Metal. Let’s begin with the Shen Nong Ben Cao Jing’s entry for Wu Wei Zi:

五味子 味酸，溫。主益氣，欬逆，上氣，勞傷，羸瘦，補不足，強陰，益男子精。

Wu Wei Zi’s flavor is sour, [its temperature] is warm. It governs augmenting qi, cough reversal, surging qi, taxation damage, debilitating emaciation, tonifies insufficiency, strengthens yin, augments male essence. It grows in mountain and valleys.

This drop-description:encoded is in keeping with the statement in Su Wen Chapter 22 that when the Lungs desire to be gathered, urgently eat sour to gather them (肺欲收，急食酸以收之).

Wu Wei Zi is most frequently seen in the SHL not in a formula of its own, but as half of a two herb modification for the treatment of cough.

In Line 96, for example, when using Xiao Chai Hu Tang (小柴胡湯) to treat a Shaoyang pattern, we are told that if the condition presents with a cough, we are to remove Ren Shen, Da Zao, Sheng Jiang and add Gan Jiang and Wu Wei Zi. This same modification occurs in Line 316, which describes a Shaoyin pattern treated by Zhen Wu Tang (真武湯). The line states that when there is a cough, Gan Jiang and Wu Wei Zi as well as Xi Xin are added.

We can understand these modifications in light of the statement in Su Wen Chapter 38, that it is not only the Lung which causes cough, but potentially any of the Five Zang and Six Fu (五藏六府，皆令人欬，非獨肺也). These modifications show us how to elegantly treat both the branch (cough) as well as the root (the underlying imbalance).

This combination of two or three herbs of a particular action, offset with an herb with an opposite action, is one of the signatures of the formula found in the Tang Ye Jing.

It is also one of the signatures of Zhang Zhongjing’s formulas! We can also see the combination of acrid (Gan Jiang and Xi Xin) and sour (Wu Wei Zi) as promoting the physiology of the Lungs. We know from basic Chinese Medicine physiology that the Lungs are in charge of dissipating and disseminating qi, functions that are promoted by outward movement of the acrid flavor. The gathering movement of the sour flavor, meanwhile, promotes the Lung’s descending function as well mirroring the action of inhalation and drawing in air.

We can also understand this combination in light of Su Wen Chapter 22, which states that acrid purges the Lungs while sour tonifies them (用酸補之，辛寫之); thus this combination is simultaneously draining pathological excess while also protecting the qi of the Lungs. The three herb combination of Gan Jiang, Xi Xin, and Wu Wei Zi also features in the formula Xiao Qing Long Tang (小青龍湯), where it is used to restore normal function to the Lungs, and when combined with Ban Xia, to remove stagnant fluids from the upper burner.

There is a lot more to say on Wuweizi, but much of it only makes sense once we’ve explored the other herbs.

My hope is, after the whole series is done, to create an expanded version as an ebook that would add more information about specific formulas and deeper analysis that’s only possible when things are complete.

But, before that, on to our last herb in the metal class – Shanyao – next week!

The post Exploring the Tang Ye jing – Wuweizi 五味子 – Metal of Metal appeared first on Chinese Medicine Central.

2019-01-10 05:59:01 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

Part 1 / Part 2 / Part 3 / Part 4 (you’re here)

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Next in our exploration of the 25 Herbs of the Tang Ye Jing is Shaoyao (芍藥), the Earth of Metal.

Shaoyao is peony root (Radix Paeoniae), but in modern Chinese Herbalism there is no generic peony root as such – we differentiate between Baishao (白芍) or White Peony (Radix Paeoniae Alba) and Chishao (赤芍) or Red Peony (Radix Paeoniae Rubra). Both herbs in modern TCM theory are said to effect the Blood, with Baishao having a more nourishing quality and Chishao are more moving and cooling quality, respectively.

Classical Chinese herbal texts, including the Tang Ye Jing, Shen Nong Ben Cao Jing, and the Shang Han Za Bing Lun however do not differentiate between Baishao and Chishao, consistently referring instead to “Shaoyao”. There is often debate over whether a given formula should use Baishao or Chishao, and the decision on when to use one variety over another (or when and if to combine them in the same formula) is beyond the scope of this article.

With that in mind, let’s begin by looking at the Shen Nong Ben Cao Jing’s entry for Shaoyao:

芍藥 味苦、平。主邪氣腹痛，除血痹，破堅積、寒熱、疝瘕，止痛，利小便， 益氣。生川谷。

Shaoyao: Its flavor is bitter and [its temperature is] neutral. It governs pernicious qi abdominal pain, removing blood impediment, breaking hard accumulations, cold and heat, moundings and masses, stops pain, smooths urination, and boosts qi. It grows in rivers and valleys.

 

The predominant flavor is bitter and not sour, although having seen how this plays out in Zhishi and Dandouchi, we shouldn’t be thrown off by this apparent discrepancy. However, it’s also worth noting that in most post-classical and modern materia medicas, the flavor of both Baishao and Chishao are listed as having a sour as well as a bitter flavor. The clinical indications described here are likely to seem very dynamic (i.e. “breaking hard accumulations”, etc) if we are primarily thinking of Baishao as a blood tonic, as it is classified in modern TCM. However, these indications align very closely with the way Zhang Zhongjing uses Shaoyao.

“Pernicious qi abdominal pain” (邪氣腹痛) is probably the most immediately clinically useful sign for applying Shaoyao.

Herbalists who are trained in various Japanese lineages of abdominal diagnosis typically look for specific signs of a tight or spasming rectus abdominus, for example. And while there are much broader applications for Shaoyao, we consistently find a close association between Shaoyao and abdominal symptoms. Exploring this relationship will help us to understand how Shaoyao is used in classical Chinese herbalism, as well as what it means to say that Shaoyao is the Earth of Metal.

Shaoyao’s action can be understood as bringing the activity of Metal into the realm of Earth.

This is easy enough to relate to the condition of abdominal pain, since the abdomen belongs to the Earth, as it lies in the center and house the Spleen and Stomach, the Earth organs. Shaoyao acts to bring Metal into this dynamic, by gathering (the action ascribed to the Sour Flavor of Metal); specifically, by gathering nutritive fluid (which, insofar as it originates in the Middle Jiao, can be ascribed to Earth).

Gathering nutritive fluid provides the material substrate for Blood formation, which accounts for the Blood nourishing action ascribed to Shaoyao (and Baishao in particular). Shaoyao’s gathering action moistens, nourishes, and softens. Moreover, it is this ability to gather the nutritive fluids that also provides a counterbalance to the moving, circulating action of Guizhi, creating the most distinctive and versatile duiyao pairings in the work of Zhang Zhongjing, the Wood of Wood with the Earth of Metal.

Metal, Earth and Wood

One of the first things we learn about as practitioners is the ubiquity of the pattern of excessive Wood invading the Earth. Indeed, the opening passage of the Jin Gui Yao Lue uses the relationship of Wood and Earth as an example to discuss how disease is transmitted…

夫治未病者，见肝之病，知肝传脾

One who treats disease when it has not manifested sees the Liver is diseased, and knows it will pass from the Liver to the Spleen [and that] one must first fill the Spleen…

 

As a Metal herb, Shaoyao can drain excessive Wood, however it accomplishes this by gathering Yin fluid, which has a moistening, soothing effect.

This treatment strategy is especially effective in protecting the Earth against the activity of excessive Wood. Recall in the article on Zhishi, we discussed Zhishi Shaoyao San, a two herb combination indicated in the case of abdominal fullness with vexing pain (腹痛煩滿). Our understanding of this formula is deepened and completed when we consider the combination of Zhishi, the Wood of Metal, and Shaoyao, the Earth of Metal, with Zhishi more forcefully bringing a descending mandate while Shaoyao gathers, nourishes and softens.

Line 30 discusses the use of Shaoyao Gancao Tang. It states that when there is “..continued slight urgency and spasm of the lower legs, one should give a heavy dose of Shaoyao Gancao Tang and then the lower legs will be able to stretch.” (脛尚微拘急，重與芍藥甘草湯，爾乃脛伸). This line describes a disease of the sinews, which have become tense and malnourished due to a deficiency of yin fluids of the Liver.

The gathering, moistening and nourishing activity of Shaoyao is able to treat this, and it is further enhanced by the addition of Gancao, whose sweet flavor soothes urgency, in keeping with the principle of Su Wen Chapter 22, which states “”When the Liver suffers urgency, urgently eat sweet in order to relax it.” (肝苦急，急食甘以緩之).

Together Shaoyao and Gancao simultaneously nourish the sinews and relax the Liver by moistening and replenishing Yin fluids.

The formula Si Ni San (四逆散) can be understood as a combination of Shaoyao Gancao Tang and Zhishi Shaoyao San, with Chaihu added to more directly course and disperse stagnant Wood. Although Chaihu is typically considered to be the lead herb in this formula, the importance of Shaoyao as a Minister cannot be overstated.

Line 279 states:

本太陽病,醫反下之,因而腹滿時痛者,屬太陰也,桂枝加芍藥湯主之

When originally there was disease in the Taiyang, but the physician purges it, and consequently there is abdominal fullness with periodic pain, this belongs to the Taiyin. Guizhi Jia Shaoyao Tang governs it.

Guizhi Jia Shaoyao Tang consists of the same ingredients as Guizhi Tang, but the dosage of Shaoyao has been doubled, which directs the therapeutic action of the formula from the surface (the Taiyang) to the interior (the Taiyin, which also belongs to Earth). It treats abdominal pain by warming and opening the channels to relieve spasm.

If Yitang (飴餹) is added to Guizhi Jia Shaoyao Tang, it will greatly enhance the formula’s nourishing and fluid replenishing properties, and yield the formula Xiao Jian Zhong Tang (小建中湯), one of whose key indications is abdominal pain arising from qi and blood deficiency of the middle burner.

Line 100 states,

傷寒，陽脈澀，陰脈弦，法當腹中急痛者，先與小建中湯，不差者，與小柴胡湯主之

In cold damage, when the yang pulse is choppy and the the yin pulse is wiry, there is generally urgent pain in the abdomen, first give Xiao Jian Zhong Tang. If there is no cure, then give Xiao Chaihu Tang.

 

There is some debate over the pulse signs in this line should be interpreted, but general agreement that the symptoms of urgent, cramping pain in the abdomen can be understood in terms of Wood overacting on Earth. However, we must also differentiate whether this symptom is primarily one of deficiency (and thus is treated by Xiao Jian Zhong Tang), or primarily one of excess (and thus is treated with Xiao Chaihu Tang).

In both formulas, however, it should be noted that Zhang Zhongjing takes care to treat the Earth even as he treats Wood. In the case of Xiao Jian Zhong Tang this is more primary, but even Xiao Chaihu Tang, which can be understood primarily as coursing stagnant Wood, protects the Earth with Renshen, Shengjiang, Da Zao, and Zhi Gancao (herbs that we will examine in subsequent articles!).

Lastly, it should be noted that in Line 96, an important modification of Xiao Chaihu Tang is to replace Huangqin with Shaoyao when there is Xiao Chaihu Tang pattern with abdominal pain (若腹中痛者，去黃芩，加芍藥). Hopefully after this article, the pathomechanisms behind this substitution have become more clear.

Whew! What an important herb – we could go on about it all day. But, let’s put this one to rest and look forward to the next in the series – Wuweizi 五味子!

The post Exploring the Tang Ye Jing – Shaoyao 芍藥 – Earth of Metal appeared first on Chinese Medicine Central.

2019-01-04 09:02:36 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is part of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

Part 1 / Part 2 / Part 3 / Part 4 (you’re here)

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Next in our exploration of the 25 Herbs of the Tang Ye Jing is Shaoyao (芍藥), the Earth of Metal.

Shaoyao is peony root (Radix Paeoniae), but in modern Chinese Herbalism there is no generic peony root as such – we differentiate between Baishao (白芍) or White Peony (Radix Paeoniae Alba) and Chishao (赤芍) or Red Peony (Radix Paeoniae Rubra). Both herbs in modern TCM theory are said to effect the Blood, with Baishao having a more nourishing quality and Chishao are more moving and cooling quality, respectively.

Classical Chinese herbal texts, including the Tang Ye Jing, Shen Nong Ben Cao Jing, and the Shang Han Za Bing Lun however do not differentiate between Baishao and Chishao, consistently referring instead to “Shaoyao”. There is often debate over whether a given formula should use Baishao or Chishao, and the decision on when to use one variety over another (or when and if to combine them in the same formula) is beyond the scope of this article.

With that in mind, let’s begin by looking at the Shen Nong Ben Cao Jing’s entry for Shaoyao:

芍藥 味苦、平。主邪氣腹痛，除血痹，破堅積、寒熱、疝瘕，止痛，利小便， 益氣。生川谷。

Shaoyao: Its flavor is bitter and [its temperature is] neutral. It governs pernicious qi abdominal pain, removing blood impediment, breaking hard accumulations, cold and heat, moundings and masses, stops pain, smooths urination, and boosts qi. It grows in rivers and valleys.

 

The predominant flavor is bitter and not sour, although having seen how this plays out in Zhishi and Dandouchi, we shouldn’t be thrown off by this apparent discrepancy. However, it’s also worth noting that in most post-classical and modern materia medicas, the flavor of both Baishao and Chishao are listed as having a sour as well as a bitter flavor. The clinical indications described here are likely to seem very dynamic (i.e. “breaking hard accumulations”, etc) if we are primarily thinking of Baishao as a blood tonic, as it is classified in modern TCM. However, these indications align very closely with the way Zhang Zhongjing uses Shaoyao.

“Pernicious qi abdominal pain” (邪氣腹痛) is probably the most immediately clinically useful sign for applying Shaoyao.

Herbalists who are trained in various Japanese lineages of abdominal diagnosis typically look for specific signs of a tight or spasming rectus abdominus, for example. And while there are much broader applications for Shaoyao, we consistently find a close association between Shaoyao and abdominal symptoms. Exploring this relationship will help us to understand how Shaoyao is used in classical Chinese herbalism, as well as what it means to say that Shaoyao is the Earth of Metal.

Shaoyao’s action can be understood as bringing the activity of Metal into the realm of Earth.

This is easy enough to relate to the condition of abdominal pain, since the abdomen belongs to the Earth, as it lies in the center and house the Spleen and Stomach, the Earth organs. Shaoyao acts to bring Metal into this dynamic, by gathering (the action ascribed to the Sour Flavor of Metal); specifically, by gathering nutritive fluid (which, insofar as it originates in the Middle Jiao, can be ascribed to Earth).

Gathering nutritive fluid provides the material substrate for Blood formation, which accounts for the Blood nourishing action ascribed to Shaoyao (and Baishao in particular). Shaoyao’s gathering action moistens, nourishes, and softens. Moreover, it is this ability to gather the nutritive fluids that also provides a counterbalance to the moving, circulating action of Guizhi, creating the most distinctive and versatile duiyao pairings in the work of Zhang Zhongjing, the Wood of Wood with the Earth of Metal.

Metal, Earth and Wood

One of the first things we learn about as practitioners is the ubiquity of the pattern of excessive Wood invading the Earth. Indeed, the opening passage of the Jin Gui Yao Lue uses the relationship of Wood and Earth as an example to discuss how disease is transmitted…

夫治未病者，见肝之病，知肝传脾

One who treats disease when it has not manifested sees the Liver is diseased, and knows it will pass from the Liver to the Spleen [and that] one must first fill the Spleen…

 

As a Metal herb, Shaoyao can drain excessive Wood, however it accomplishes this by gathering Yin fluid, which has a moistening, soothing effect.

This treatment strategy is especially effective in protecting the Earth against the activity of excessive Wood. Recall in the article on Zhishi, we discussed Zhishi Shaoyao San, a two herb combination indicated in the case of abdominal fullness with vexing pain (腹痛煩滿). Our understanding of this formula is deepened and completed when we consider the combination of Zhishi, the Wood of Metal, and Shaoyao, the Earth of Metal, with Zhishi more forcefully bringing a descending mandate while Shaoyao gathers, nourishes and softens.

Line 30 discusses the use of Shaoyao Gancao Tang. It states that when there is “..continued slight urgency and spasm of the lower legs, one should give a heavy dose of Shaoyao Gancao Tang and then the lower legs will be able to stretch.” (脛尚微拘急，重與芍藥甘草湯，爾乃脛伸). This line describes a disease of the sinews, which have become tense and malnourished due to a deficiency of yin fluids of the Liver.

The gathering, moistening and nourishing activity of Shaoyao is able to treat this, and it is further enhanced by the addition of Gancao, whose sweet flavor soothes urgency, in keeping with the principle of Su Wen Chapter 22, which states “”When the Liver suffers urgency, urgently eat sweet in order to relax it.” (肝苦急，急食甘以緩之).

Together Shaoyao and Gancao simultaneously nourish the sinews and relax the Liver by moistening and replenishing Yin fluids.

The formula Si Ni San (四逆散) can be understood as a combination of Shaoyao Gancao Tang and Zhishi Shaoyao San, with Chaihu added to more directly course and disperse stagnant Wood. Although Chaihu is typically considered to be the lead herb in this formula, the importance of Shaoyao as a Minister cannot be overstated.

Line 279 states:

本太陽病,醫反下之,因而腹滿時痛者,屬太陰也,桂枝加芍藥湯主之

When originally there was disease in the Taiyang, but the physician purges it, and consequently there is abdominal fullness with periodic pain, this belongs to the Taiyin. Guizhi Jia Shaoyao Tang governs it.

Guizhi Jia Shaoyao Tang consists of the same ingredients as Guizhi Tang, but the dosage of Shaoyao has been doubled, which directs the therapeutic action of the formula from the surface (the Taiyang) to the interior (the Taiyin, which also belongs to Earth). It treats abdominal pain by warming and opening the channels to relieve spasm.

If Yitang (飴餹) is added to Guizhi Jia Shaoyao Tang, it will greatly enhance the formula’s nourishing and fluid replenishing properties, and yield the formula Xiao Jian Zhong Tang (小建中湯), one of whose key indications is abdominal pain arising from qi and blood deficiency of the middle burner.

Line 100 states,

傷寒，陽脈澀，陰脈弦，法當腹中急痛者，先與小建中湯，不差者，與小柴胡湯主之

In cold damage, when the yang pulse is choppy and the the yin pulse is wiry, there is generally urgent pain in the abdomen, first give Xiao Jian Zhong Tang. If there is no cure, then give Xiao Chaihu Tang.

 

There is some debate over the pulse signs in this line should be interpreted, but general agreement that the symptoms of urgent, cramping pain in the abdomen can be understood in terms of Wood overacting on Earth. However, we must also differentiate whether this symptom is primarily one of deficiency (and thus is treated by Xiao Jian Zhong Tang), or primarily one of excess (and thus is treated with Xiao Chaihu Tang).

In both formulas, however, it should be noted that Zhang Zhongjing takes care to treat the Earth even as he treats Wood. In the case of Xiao Jian Zhong Tang this is more primary, but even Xiao Chaihu Tang, which can be understood primarily as coursing stagnant Wood, protects the Earth with Renshen, Shengjiang, Da Zao, and Zhi Gancao (herbs that we will examine in subsequent articles!).

Lastly, it should be noted that in Line 96, an important modification of Xiao Chaihu Tang is to replace Huangqin with Shaoyao when there is Xiao Chaihu Tang pattern with abdominal pain (若腹中痛者，去黃芩，加芍藥). Hopefully after this article, the pathomechanisms behind this substitution have become more clear.

Whew! What an important herb – we could go on about it all day. But, let’s put this one to rest and look forward to the next in the series – Wuweizi 五味子!

The post Exploring the Tang Ye Jing – Shaoyao 芍藥 – Earth of Metal appeared first on Chinese Medicine Central.

2019-01-04 09:02:36 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the third of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

Part 1 / Part 2 / Part 3 (You’re here)

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Having explored Zhishi as the Wood of Metal, we now move on to the next phase in the cycle and come to Dandouchi (淡豆豉), the Fire of Metal.

Dandouchi is the fermented black soybean (Latin Name: Semen Sojae Preparata). Dandouchi is not the most commonly prescribed herb in classical herbalism (although it does feature prominently in several of Zhang Zhongjing’s formulas, which we will explore shortly). In fact, it is not even included in the Shen Nong Ben Cao Jing.

The first mention of Dandouchi in a Chinese materia medica is the Ming Yi Bie Lu (名醫別錄), an herbal text attributed to the Daoist alchemist Tao Hongjing. Recall that Tao is also the purported author of the Fu Xing Jue Wu Zang Yong Yao Fa Yao (輔行訣臟腑用藥法要), the previously lost manuscript that contains the only passages we have of the Tang Ye Jing.

Here is what the Ming Yi Bie Lu has to say about Dandouchi:

豉: 味苦，寒，無毒。主傷寒，頭痛，寒熱，瘴氣，惡毒，煩躁，滿悶，虛勞，喘吸，兩腳疼冷，又殺六畜胎子諸毒。

[Dan Dou] Chi: Its flavor is bitter, cold and nontoxic. It governs cold damage, headache, [alternating] cold and heat, malarial qi, evil toxins, vexation agitation, stifling fullness, taxation fatigue, panting on inhalation [and] cold pain of both feet; moreover, it kills all various toxins in the six domestic animals, fetuses and children.

We can see from this that Tao’s understanding of Dandouchi makes it a tremendously useful herb.

However, just as we did with Zhishi, there is a seeming discrepancy here: the Tang Ye Jing classes Dandouchi with Metal, and therefore Sour, and yet the Ming Yi Bie Lu describes it as being bitter and cold. Modern materia medicas such as Bensky tend to agree with this classification, but also emphasize its acrid nature. And of course the Tang Ye Jing associates Fire with Salty, and none of the Materia Medica state that Dandouchi is salty. So how are we to understand this in terms of the Tang Ye Jing’s classification?

Fire of Metal

Let’s consider what it means for Dandouchi to be considered the Fire of Metal. We saw in our exploration of Zhishi as the Wood of Metal that Zhishi’s activity could be seen as carrying the action of Metal into the domain of Wood (specifically, through its activity of strongly descending the Gallbladder and breaking knotted qi).

In a similar fashion, then, we must understand Dandouchi’s action as involving the relationship between Metal and Fire. And we know that this involves the Controlling Cycle, as Fire Controls Metal.

Examining Zhang Zhongjing’s formulas with Dandouchi will help make this more concrete. Most of formulas that contain Dandouchi can be found in Clause 76 of the Shang Han Lun:

發汗後，水藥不得入口為逆，若更發汗，必吐下不止。發汗吐下後，虛煩不得眠；若劇者，必反覆顛倒，心中懊憹，梔子豉湯主之。若少氣者，梔子甘草豉湯主之。若嘔者 梔子生薑豉湯主之

After sweating is promoted, if water and medicine are unable to be ingested due to counterflow [but] again sweating is promoted, there will be incessant vomiting and diarrhea. After the promotion of sweating and the use of vomiting or purging [methods], there is empty vexation with inability to sleep; if the condition is severe, with tossing and turning and anguish in the heart, Zhizi Chi Tang governs it. If there is shortage of qi, Zhizi Gancao Chi Tang governs it. If there is nausea, Zhizi Shenjiang Chi Tang governs it.

There’s quite a bit to unpack in this clause, and extensive debate in the commentaries over what is meant precisely by many of the terms in this line, such as ’empty vexation’ (xu fan虛煩). The general consensus though is that describes a presentation of formless (1) stagnant heat in the chest. Improper usage of purgatives, vomiting, or excessive sweating pushes the pathogenic factor further into the body where it becomes trapped in the upper burner. The vexation and anguish described the line are all signs of heat.

Although the line mentions the Heart specifically, we can understand this as involving the chest cavity more generally.

Insofar as the chest cavity houses the Lungs, and is also implicated in Yangming disease we can say that it belongs to Metal. Nausea, vomiting, and shortage of qi (which in this context may simply mean shortage of breath) are also pathologies that all belong to the Metal organs of the Lung and Stomach. The same pathology described by Line 76 can also arise in Yangming disease; see Lines 221 and 228, which also describe a situation of formless heat in the chest, and for which Zhizi Chi Tang is also indicated.

To summarize then, the clinical situation described here then is one of heat (Fire) trapped in the chest (which belongs to Metal) – and a key herb to treat this pathology is Dandouchi, which opens and vents the Lung, allowing the heat an exit. Its cold nature helps to soothe vexation, and also resonate with the cool qi of Autumn that likewise belongs to Metal. Based on this analysis, we can say that the main action of Dandouchi is to protect Metal from being damaged by Fire by venting heat from the chest. It is classified as the Fire of Metal, because it functions to removes Fire from Metal.

Post Classical Formulas

Dandouchi features prominently in a number of post-classical formulas where it performs the same function as it does in Zhizi Chi Tang and its modifications. The most famous of these is the formula Yin Qiao San (銀翹散), which is indicated in the Wen Bing Tiao Bian (温病條辨) for Taiyin Wind Warmth (太陰風溫), a pattern that manifests with signs of heat damaging Metal, such as sore throat. It is also frequently added to the pediatric formula Xie Bai San (瀉白散), devised by the Song Dynasty physician Qian Yi to drain stagnant heat from the Lungs.

Although it is beyond the scope of this article series to delve deeply into these post-classical formulas, it is worth mentioning because their usage of Dandouchi follows the same principles as Zhang Zhongjing’s usage, which is ultimately derived from the Tang Ye Jing. This demonstrates the deep and wide ranging influence that this text has over all of Chinese Herbalism.

I will move on to consider the next herb, Shaoyao, in the sequence in the next article. It’ll be an action-packed exploration since Shaoyao is such a frequently used herb!

References

(1) “Formless” in the sense that the heat does not have substantial pathogenic factors like phlegm, or from an excess heat in the Stomach. Some commentators prefer the term “residual heat”.

The post Exploring the Tang Ye Jing – Dandouchi 淡豆豉 – Fire of Metal appeared first on Chinese Medicine Central.

2018-12-28 00:41:50 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the third of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

Part 1 / Part 2 / Part 3 (You’re here)

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Having explored Zhishi as the Wood of Metal, we now move on to the next phase in the cycle and come to Dandouchi (淡豆豉), the Fire of Metal.

Dandouchi is the fermented black soybean (Latin Name: Semen Sojae Preparata). Dandouchi is not the most commonly prescribed herb in classical herbalism (although it does feature prominently in several of Zhang Zhongjing’s formulas, which we will explore shortly). In fact, it is not even included in the Shen Nong Ben Cao Jing.

The first mention of Dandouchi in a Chinese materia medica is the Ming Yi Bie Lu (名醫別錄), an herbal text attributed to the Daoist alchemist Tao Hongjing. Recall that Tao is also the purported author of the Fu Xing Jue Wu Zang Yong Yao Fa Yao (輔行訣臟腑用藥法要), the previously lost manuscript that contains the only passages we have of the Tang Ye Jing.

Here is what the Ming Yi Bie Lu has to say about Dandouchi:

豉: 味苦，寒，無毒。主傷寒，頭痛，寒熱，瘴氣，惡毒，煩躁，滿悶，虛勞，喘吸，兩腳疼冷，又殺六畜胎子諸毒。

[Dan Dou] Chi: Its flavor is bitter, cold and nontoxic. It governs cold damage, headache, [alternating] cold and heat, malarial qi, evil toxins, vexation agitation, stifling fullness, taxation fatigue, panting on inhalation [and] cold pain of both feet; moreover, it kills all various toxins in the six domestic animals, fetuses and children.

We can see from this that Tao’s understanding of Dandouchi makes it a tremendously useful herb.

However, just as we did with Zhishi, there is a seeming discrepancy here: the Tang Ye Jing classes Dandouchi with Metal, and therefore Sour, and yet the Ming Yi Bie Lu describes it as being bitter and cold. Modern materia medicas such as Bensky tend to agree with this classification, but also emphasize its acrid nature. And of course the Tang Ye Jing associates Fire with Salty, and none of the Materia Medica state that Dandouchi is salty. So how are we to understand this in terms of the Tang Ye Jing’s classification?

Fire of Metal

Let’s consider what it means for Dandouchi to be considered the Fire of Metal. We saw in our exploration of Zhishi as the Wood of Metal that Zhishi’s activity could be seen as carrying the action of Metal into the domain of Wood (specifically, through its activity of strongly descending the Gallbladder and breaking knotted qi).

In a similar fashion, then, we must understand Dandouchi’s action as involving the relationship between Metal and Fire. And we know that this involves the Controlling Cycle, as Fire Controls Metal.

Examining Zhang Zhongjing’s formulas with Dandouchi will help make this more concrete. Most of formulas that contain Dandouchi can be found in Clause 76 of the Shang Han Lun:

發汗後，水藥不得入口為逆，若更發汗，必吐下不止。發汗吐下後，虛煩不得眠；若劇者，必反覆顛倒，心中懊憹，梔子豉湯主之。若少氣者，梔子甘草豉湯主之。若嘔者 梔子生薑豉湯主之

After sweating is promoted, if water and medicine are unable to be ingested due to counterflow [but] again sweating is promoted, there will be incessant vomiting and diarrhea. After the promotion of sweating and the use of vomiting or purging [methods], there is empty vexation with inability to sleep; if the condition is severe, with tossing and turning and anguish in the heart, Zhizi Chi Tang governs it. If there is shortage of qi, Zhizi Gancao Chi Tang governs it. If there is nausea, Zhizi Shenjiang Chi Tang governs it.

There’s quite a bit to unpack in this clause, and extensive debate in the commentaries over what is meant precisely by many of the terms in this line, such as ’empty vexation’ (xu fan虛煩). The general consensus though is that describes a presentation of formless (1) stagnant heat in the chest. Improper usage of purgatives, vomiting, or excessive sweating pushes the pathogenic factor further into the body where it becomes trapped in the upper burner. The vexation and anguish described the line are all signs of heat.

Although the line mentions the Heart specifically, we can understand this as involving the chest cavity more generally.

Insofar as the chest cavity houses the Lungs, and is also implicated in Yangming disease we can say that it belongs to Metal. Nausea, vomiting, and shortage of qi (which in this context may simply mean shortage of breath) are also pathologies that all belong to the Metal organs of the Lung and Stomach. The same pathology described by Line 76 can also arise in Yangming disease; see Lines 221 and 228, which also describe a situation of formless heat in the chest, and for which Zhizi Chi Tang is also indicated.

To summarize then, the clinical situation described here then is one of heat (Fire) trapped in the chest (which belongs to Metal) – and a key herb to treat this pathology is Dandouchi, which opens and vents the Lung, allowing the heat an exit. Its cold nature helps to soothe vexation, and also resonate with the cool qi of Autumn that likewise belongs to Metal. Based on this analysis, we can say that the main action of Dandouchi is to protect Metal from being damaged by Fire by venting heat from the chest. It is classified as the Fire of Metal, because it functions to removes Fire from Metal.

Post Classical Formulas

Dandouchi features prominently in a number of post-classical formulas where it performs the same function as it does in Zhizi Chi Tang and its modifications. The most famous of these is the formula Yin Qiao San (銀翹散), which is indicated in the Wen Bing Tiao Bian (温病條辨) for Taiyin Wind Warmth (太陰風溫), a pattern that manifests with signs of heat damaging Metal, such as sore throat. It is also frequently added to the pediatric formula Xie Bai San (瀉白散), devised by the Song Dynasty physician Qian Yi to drain stagnant heat from the Lungs.

Although it is beyond the scope of this article series to delve deeply into these post-classical formulas, it is worth mentioning because their usage of Dandouchi follows the same principles as Zhang Zhongjing’s usage, which is ultimately derived from the Tang Ye Jing. This demonstrates the deep and wide ranging influence that this text has over all of Chinese Herbalism.

I will move on to consider the next herb, Shaoyao, in the sequence in the next article. It’ll be an action-packed exploration since Shaoyao is such a frequently used herb!

References

(1) “Formless” in the sense that the heat does not have substantial pathogenic factors like phlegm, or from an excess heat in the Stomach. Some commentators prefer the term “residual heat”.

The post Exploring the Tang Ye Jing – Dandouchi 淡豆豉 – Fire of Metal appeared first on Chinese Medicine Central.

2018-12-28 00:41:50 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the second of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

Part 1 / Part 2 / Part 3 (You’re here)

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood,Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shan Yao] is water.

Having explored Zhishi as the Wood of Metal, we now move on to the next phase in the cycle and come to Dandouchi (淡豆豉), the Fire of Metal.

Dandouchi is the fermented black soybean (Latin Name: Semen Sojae Preparata). Dandouchi is not the most commonly prescribed herb in classical herbalism (although it does feature prominently in several of Zhang Zhongjing’s formulas, which we will explore shortly). In fact, it is not even included in the Shen Nong Ben Cao Jing.

The first mention of Dandouchi in a Chinese materia medica is the Ming Yi Bie Lu (名醫別錄), an herbal text attributed to the Daoist alchemist Tao Hongjing. Recall that Tao is also the purported author of the Fu Xing Jue Wu Zang Yong Yao Fa Yao (輔行訣臟腑用藥法要), the previously lost manuscript that contains the only passages we have of the Tang Ye Jing.

Here is what the Ming Yi Bie Lu has to say about Dandouchi:

豉: 味苦，寒，無毒。主傷寒，頭痛，寒熱，瘴氣，惡毒，煩躁，滿悶，虛勞，喘吸，兩腳疼冷，又殺六畜胎子諸毒。

[Dan Dou] Chi: Its flavor is bitter, cold and nontoxic. It governs cold damage, headache, [alternating] cold and heat, malarial qi, evil toxins, vexation agitation, stifling fullness, taxation fatigue, panting on inhalation [and] cold pain of both feet; moreover, it kills all various toxins in the six domestic animals, fetuses and children.

We can see from this that Tao’s understanding of Dandouchi makes it a tremendously useful herb.

However, just as we did with Zhishi, there is a seeming discrepancy here: the Tang Ye Jing classes Dandouchi with Metal, and therefore Sour, and yet the Ming Yi Bie Lu describes it as being bitter and cold. Modern materia medicas such as Bensky tend to agree with this classification, but also emphasize its acrid nature. And of course the Tang Ye Jing associates Fire with Salty, and none of the Materia Medica state that Dandouchi is salty. So how are we to understand this in terms of the Tang Ye Jing’s classification?

Fire of Metal

Let’s consider what it means for Dandouchi to be considered the Fire of Metal. We saw in our exploration of Zhishi as the Wood of Metal that Zhishi’s activity could be seen as carrying the action of Metal into the domain of Wood (specifically, through its activity of strongly descending the Gallbladder and breaking knotted qi).

In a similar fashion, then, we must understand Dandouchi’s action as involving the relationship between Metal and Fire. And we know that this involves the Controlling Cycle, as Fire Controls Metal.

Examining Zhang Zhongjing’s formulas with Dandouchi will help make this more concrete. Most of formulas that contain Dandouchi can be found in Clause 76 of the Shang Han Lun:

發汗後，水藥不得入口為逆，若更發汗，必吐下不止。發汗吐下後，虛煩不得眠；若劇者，必反覆顛倒，心中懊憹，梔子豉湯主之。若少氣者，梔子甘草豉湯主之。若嘔者 梔子生薑豉湯主之

After sweating is promoted, if water and medicine are unable to be ingested due to counterflow [but] again sweating is promoted, there will be incessant vomiting and diarrhea. After the promotion of sweating and the use of vomiting or purging [methods], there is empty vexation with inability to sleep; if the condition is severe, with tossing and turning and anguish in the heart, Zhizi Chi Tang governs it. If there is shortage of qi, Zhizi Gancao Chi Tang governs it. If there is nausea, Zhizi Shenjiang Chi Tang governs it.

There’s quite a bit to unpack in this clause, and extensive debate in the commentaries over what is meant precisely by many of the terms in this line, such as ’empty vexation’ (xu fan虛煩). The general consensus though is that describes a presentation of formless (1) stagnant heat in the chest. Improper usage of purgatives, vomiting, or excessive sweating pushes the pathogenic factor further into the body where it becomes trapped in the upper burner. The vexation and anguish described the line are all signs of heat.

Although the line mentions the Heart specifically, we can understand this as involving the chest cavity more generally.

Insofar as the chest cavity houses the Lungs, and is also implicated in Yangming disease we can say that it belongs to Metal. Nausea, vomiting, and shortage of qi (which in this context may simply mean shortage of breath) are also pathologies that all belong to the Metal organs of the Lung and Stomach. The same pathology described by Line 76 can also arise in Yangming disease; see Lines 221 and 228, which also describe a situation of formless heat in the chest, and for which Zhizi Chi Tang is also indicated.

To summarize then, the clinical situation described here then is one of heat (Fire) trapped in the chest (which belongs to Metal) – and a key herb to treat this pathology is Dandouchi, which opens and vents the Lung, allowing the heat an exit. Its cold nature helps to soothe vexation, and also resonate with the cool qi of Autumn that likewise belongs to Metal. Based on this analysis, we can say that the main action of Dandouchi is to protect Metal from being damaged by Fire by venting heat from the chest. It is classified as the Fire of Metal, because it functions to removes Fire from Metal.

Post Classical Formulas

Dandouchi features prominently in a number of post-classical formulas where it performs the same function as it does in Zhizi Chi Tang and its modifications. The most famous of these is the formula Yin Qiao San (銀翹散), which is indicated in the Wen Bing Tiao Bian (温病條辨) for Taiyin Wind Warmth (太陰風溫), a pattern that manifests with signs of heat damaging Metal, such as sore throat. It is also frequently added to the pediatric formula Xie Bai San (瀉白散), devised by the Song Dynasty physician Qian Yi to drain stagnant heat from the Lungs.

Although it is beyond the scope of this article series to delve deeply into these post-classical formulas, it is worth mentioning because their usage of Dandouchi follows the same principles as Zhang Zhongjing’s usage, which is ultimately derived from the Tang Ye Jing. This demonstrates the deep and wide ranging influence that this text has over all of Chinese Herbalism.

I will move on to consider the next herb, Shaoyao, in the sequence in the next article. It’ll be an action-packed exploration since Shaoyao is such a frequently used herb!

References

(1) “Formless” in the sense that the heat does not have substantial pathogenic factors like phlegm, or from an excess heat in the Stomach. Some commentators prefer the term “residual heat”.

The post Exploring the Tang Ye Jing – Dandouchi 淡豆豉 – Fire of Metal appeared first on Chinese Medicine Central.

2018-12-28 00:41:50 / 3月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the second of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

You can find the first article in the series here.

Let’s proceed beyond the introduction by jumping into an exploration of the 25 herbs referenced in the Tang Ye Jing (TYJ).

Because we conceived of this series in the late autumn, we decided to start with the metal class herbs. The text tells us…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

 All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood, Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shanyao] is water. 

Let’s start with the wood herb, since that’s the phase of initiation. Zhishi is the unripe fruit of the bitter orange (Fructus aurantii immaturus). It’s placement here as the Wood of Metal might seem a bit puzzling at first. After all, being that it’s bitter orange, it’s most well known for its bitter flavor. This probably leads you to wonder why a a bitter herb classified as belonging to the Metal Phase, when the TYJ has just told us that sour belongs to Metal.

Sometimes classical herbalists see a Chinese herb differently from more modern practitioners.

And this is especially important to keep in mind when studying Zhang Zhongjing’s formulas. In this case however, the ancient sources tend to agree in emphasizing Zhishi’s bitter properties. Consider its entry in the Shen Nong Ben Cao Jing (神農本草經):

枳實 味苦寒。主治大風在皮膚中如麻豆苦癢，除寒熱熱結，止利。長肌肉，利五臟，益氣輕身。生川澤。

Zhishi: Its flavor is bitter and cold. It governs treating great wind within the skin causing severe itching as if caused by hemp seeds, removes cold and heat hot knotting and stops diarrhea. It promotes growth of flesh and muscle, benefits the five zang, increases qi and lightens the body. It grows in rivers and marshes.

If Zhishi is bitter, why is it classed as a Sour herb in the TYJ?

Contemplating this question will help us better understand the clinical uses of Zhishi, as well how the TYJ classifies herbs.

Let’s consider the action of bitter: we know from the first entry in this series that according to the Neijing, bitter hardens or consolidates (堅). But bitter also drains downward. This downward movement also belongs to Metal, which descends as well as gathers. One of the main functions of the Lung, as the Metal zang, is the descent of qi and fluids. The descending action of Lung qi is also responsible for pushing out waste through its paired fu organ, the Large Intestine. In terms of the activity of the Six Conformations, Dry Metal belongs to Yangming, whose activity of closing (合) can also be understood as a kind of descent, and this conforms with the physiological function and direction of the “Stomach Family” (胃家) in taking in food and pushing it through the body via peristalsis.

From this perspective, Zhishi belongs to Metal because it descends.

What does it mean to say that it belongs also to Wood, that it is the “Wood of Metal”? One way of understanding this is that it mediates the relationship of Metal to Wood. In terms of the Five Phases, the Lung’s descent balances the ascent of the Wood zang, the Liver, which is in charge of ascending qi. We know that Metal Controls Wood via the Controlling Cycle. When Wood is excessive, it is checked by the descending mandate of Metal. Through its activity of descending, Zhishi can check the excessively upbearing activity of Wood by promoting the activity of Metal. When the Shen Nong Ben Cao Jing says that it treats knotting (結), we can understand this to be referring to the knotting of qi that occurs from constraint when Liver Wood is in excess.

Zhishi can cut through this by descending, in effect we might say this is helping Metal to control Wood.

If this seems abstract, let’s consider some famous formulas that employ Zhishi. Commonly, Zhishi is employed in formulas when there is considerable qi stagnation in the chest and abdomen, and more specifically, within those cavities of the chest and abdomen that belong to Yangming, and thus to Metal.

We can see this when it is paired with Baishao (the Earth of Metal) to form Zhishi Shaoyao San (枳實芍藥散). In the Jin Gui Yao Lue, this two herb formula was indicated for abdominal fullness and vexing pain in postpartum women (產後腹痛煩滿) and it is often used as a relatively gentle way to treat to constipation. Zhishi breaks through abdominal knotting and promotes the descending of the Yangming, promoting bowel movements, while Baishao soothes, softens and moistens.

From a Five Phase perspective, we can understand this as involving a disharmony between Wood and Metal, which is in turn affecting the Earth Phase.

In addition to Zhishi and Bai Shao, Si Ni San contains Zhi Gan Cao (thereby incorporating Shao Yao Gan Cao Tang, a formula we will explore when we look at Bai Shao Yao) as well as Chai Hu. Zhishi performs the same functions of descending through the Yangming spaces to move through stagnation, while Bai Shao soothes and nourishes Jueyin Wood, but Zhishi’s activity also synergizes with Chai Hu as well as Bai Shao. Chai Hu has an overall lifting action, which balances Zhishi’s descending action.

If we wanted to consider this in terms of the zang fu, we can understand Chai Hu as acting more on the Liver, while Zhishi acts on the Gallbladder.

Chaihu promotes the upbearing activity of the Liver, while Zhishi promotes the downbearing activity of the Gallbladder. Balancing the upbearing and downbearing activity of the Wood zang and fu in turn helps to balance the upbearing and downbearing of the central pivot of the Spleen and Stomach. Regulating ascending and descending in this fashion is one characteristic of the harmonizing method (和法) in Chinese herbalism.

Other formulas that demonstrate the descending activity of Zhishi are the Cheng Qi Tang (承氣湯) family of formulas, which emphasize Zhishi’s action on the Yangming organs well as Wen Dan Tang (溫膽湯), which emphasizes its ability to descend the Gallbladder.

Hopefully by now it’s clear why Zhishi is grouped with Metal, and also what it means to say that it is the Wood of Metal.

This analysis should hopefully also emphasize something about the classical perspective: there’s a kind of fluidity to certain categories. Things like the flavor of an herb, or even what organs that herb effects, are not entirely fixed or consistent. This can seem quite maddening if you are used to the more rigid categorizations of TCM, or if you’re just a Metal individual that likes things to be orderly and tidy. What’s important to pay attention to, however, is the qi dynamic. Zhishi belongs to Metal because it descends, and therefore, its action accords with the basic direction of Metal. By descending, it is able to carry the relationship of Metal to Wood.

This basic and essential dynamic helps us to understand literally all of Zhishi’s abilities, and its role in the dozens of classical formulas it occurs in.

We can conceptualize Zhishi as affecting the Gallbladder, or the various organs and tissues belonging to Yangming. We can remember that it treats various bindings and knottings of qi, and we can also consider its effect on substances like phlegm. All these ways of conceptualizing its action are useful in various contexts, but they are all derived from understanding the basic direction and dynamic of Zhishi. That directional dynamic is completely described by the statement that Zhishi is the Wood of Metal.

Grasping this principle and applying it in a fluid way enables us to use Zhishi clinically, and it also demonstrates the elegance and power of a classical approach to herbalism.

Look for my next article in a week, exploring the next herb of the metal class – Dandouchi, fermented soybean! Yum!

The post Exploring the Tang Ye Jing – Zhishi 枳實 – Wood of Metal appeared first on Chinese Medicine Central.

2018-12-21 06:43:25 / 4月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the second of a series of articles we’ll be releasing here about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. 

You can find the first article in the series here.

Let’s proceed beyond the introduction by jumping into an exploration of the 25 herbs referenced in the Tang Ye Jing (TYJ).

Because we conceived of this series in the late autumn, we decided to start with the metal class herbs. The text tells us…

味酸皆屬金，五味[子]為之主，枳實為木，豉為火，芍藥為土，薯蕷為水。

 All sour belongs to metal, for it is governed by Wuweizi, and Zhishi is wood, Chi is fire, Shaoyao is earth, and Shuyu [better known to modern practitioners as Shanyao] is water. 

Let’s start with the wood herb, since that’s the phase of initiation. Zhishi is the unripe fruit of the bitter orange (Fructus aurantii immaturus). It’s placement here as the Wood of Metal might seem a bit puzzling at first. After all, being that it’s bitter orange, it’s most well known for its bitter flavor. This probably leads you to wonder why a a bitter herb classified as belonging to the Metal Phase, when the TYJ has just told us that sour belongs to Metal.

Sometimes classical herbalists see a Chinese herb differently from more modern practitioners.

And this is especially important to keep in mind when studying Zhang Zhongjing’s formulas. In this case however, the ancient sources tend to agree in emphasizing Zhishi’s bitter properties. Consider its entry in the Shen Nong Ben Cao Jing (神農本草經):

枳實 味苦寒。主治大風在皮膚中如麻豆苦癢，除寒熱熱結，止利。長肌肉，利五臟，益氣輕身。生川澤。

Zhishi: Its flavor is bitter and cold. It governs treating great wind within the skin causing severe itching as if caused by hemp seeds, removes cold and heat hot knotting and stops diarrhea. It promotes growth of flesh and muscle, benefits the five zang, increases qi and lightens the body. It grows in rivers and marshes.

If Zhishi is bitter, why is it classed as a Sour herb in the TYJ?

Contemplating this question will help us better understand the clinical uses of Zhishi, as well how the TYJ classifies herbs.

Let’s consider the action of bitter: we know from the first entry in this series that according to the Neijing, bitter hardens or consolidates (堅). But bitter also drains downward. This downward movement also belongs to Metal, which descends as well as gathers. One of the main functions of the Lung, as the Metal zang, is the descent of qi and fluids. The descending action of Lung qi is also responsible for pushing out waste through its paired fu organ, the Large Intestine. In terms of the activity of the Six Conformations, Dry Metal belongs to Yangming, whose activity of closing (合) can also be understood as a kind of descent, and this conforms with the physiological function and direction of the “Stomach Family” (胃家) in taking in food and pushing it through the body via peristalsis.

From this perspective, Zhishi belongs to Metal because it descends.

What does it mean to say that it belongs also to Wood, that it is the “Wood of Metal”? One way of understanding this is that it mediates the relationship of Metal to Wood. In terms of the Five Phases, the Lung’s descent balances the ascent of the Wood zang, the Liver, which is in charge of ascending qi. We know that Metal Controls Wood via the Controlling Cycle. When Wood is excessive, it is checked by the descending mandate of Metal. Through its activity of descending, Zhishi can check the excessively upbearing activity of Wood by promoting the activity of Metal. When the Shen Nong Ben Cao Jing says that it treats knotting (結), we can understand this to be referring to the knotting of qi that occurs from constraint when Liver Wood is in excess.

Zhishi can cut through this by descending, in effect we might say this is helping Metal to control Wood.

If this seems abstract, let’s consider some famous formulas that employ Zhishi. Commonly, Zhishi is employed in formulas when there is considerable qi stagnation in the chest and abdomen, and more specifically, within those cavities of the chest and abdomen that belong to Yangming, and thus to Metal.

We can see this when it is paired with Baishao (the Earth of Metal) to form Zhishi Shaoyao San (枳實芍藥散). In the Jin Gui Yao Lue, this two herb formula was indicated for abdominal fullness and vexing pain in postpartum women (產後腹痛煩滿) and it is often used as a relatively gentle way to treat to constipation. Zhishi breaks through abdominal knotting and promotes the descending of the Yangming, promoting bowel movements, while Baishao soothes, softens and moistens.

From a Five Phase perspective, we can understand this as involving a disharmony between Wood and Metal, which is in turn affecting the Earth Phase.

In addition to Zhishi and Bai Shao, Si Ni San contains Zhi Gan Cao (thereby incorporating Shao Yao Gan Cao Tang, a formula we will explore when we look at Bai Shao Yao) as well as Chai Hu. Zhishi performs the same functions of descending through the Yangming spaces to move through stagnation, while Bai Shao soothes and nourishes Jueyin Wood, but Zhishi’s activity also synergizes with Chai Hu as well as Bai Shao. Chai Hu has an overall lifting action, which balances Zhishi’s descending action.

If we wanted to consider this in terms of the zang fu, we can understand Chai Hu as acting more on the Liver, while Zhishi acts on the Gallbladder.

Chaihu promotes the upbearing activity of the Liver, while Zhishi promotes the downbearing activity of the Gallbladder. Balancing the upbearing and downbearing activity of the Wood zang and fu in turn helps to balance the upbearing and downbearing of the central pivot of the Spleen and Stomach. Regulating ascending and descending in this fashion is one characteristic of the harmonizing method (和法) in Chinese herbalism.

Other formulas that demonstrate the descending activity of Zhishi are the Cheng Qi Tang (承氣湯) family of formulas, which emphasize Zhishi’s action on the Yangming organs well as Wen Dan Tang (溫膽湯), which emphasizes its ability to descend the Gallbladder.

Hopefully by now it’s clear why Zhishi is grouped with Metal, and also what it means to say that it is the Wood of Metal.

This analysis should hopefully also emphasize something about the classical perspective: there’s a kind of fluidity to certain categories. Things like the flavor of an herb, or even what organs that herb effects, are not entirely fixed or consistent. This can seem quite maddening if you are used to the more rigid categorizations of TCM, or if you’re just a Metal individual that likes things to be orderly and tidy. What’s important to pay attention to, however, is the qi dynamic. Zhishi belongs to Metal because it descends, and therefore, its action accords with the basic direction of Metal. By descending, it is able to carry the relationship of Metal to Wood.

This basic and essential dynamic helps us to understand literally all of Zhishi’s abilities, and its role in the dozens of classical formulas it occurs in.

We can conceptualize Zhishi as affecting the Gallbladder, or the various organs and tissues belonging to Yangming. We can remember that it treats various bindings and knottings of qi, and we can also consider its effect on substances like phlegm. All these ways of conceptualizing its action are useful in various contexts, but they are all derived from understanding the basic direction and dynamic of Zhishi. That directional dynamic is completely described by the statement that Zhishi is the Wood of Metal.

Grasping this principle and applying it in a fluid way enables us to use Zhishi clinically, and it also demonstrates the elegance and power of a classical approach to herbalism.

Look for my next article in a week, exploring the next herb of the metal class – Dandouchi, fermented soybean! Yum!

The post Exploring the Tang Ye Jing – Zhishi 枳實 – Wood of Metal appeared first on Chinese Medicine Central.

2018-12-21 06:43:25 / 4月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the first of a long series of articles we’ll be releasing here about the theory and herbs of the Tangye jing. The enthusiasm and scholarly integrity of the author – new regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. Thank you and welcome, Joshua!

What is the Tang Ye Jing?

The Decoction Classic or Tang Ye Jing (湯液經) is an ancient text in the historical canon of Chinese Medicine.

Building on the content of both the Shen Nong Ben Cao Jing (神農本草經) and the Huang Di Nei Jing (黃帝內經), it describes Chinese herbs and their interactions in terms of the Five Phases (五行) and the dynamics of the Five Flavors (五味). It is the first text we know of solely devoted to herbal formulas, and it had a seminal influence on Zhang Zhong Jing (張仲景), author of the Shang Han Za Bing Lun (傷寒雜病論).

To say that the Tang Ye Jing is a mysterious text would be an understatement.

Despite its status as a foundational text of Chinese Medicine, relatively little is known about it. Attributed to an author called Yin Yi (伊尹), there is no exact date for its composition, although it is referenced in many other classical medical texts, such as the preface to the Zhen Jiu Jia Yi Jing (針灸甲乙經). Although copies of the Tang Ye Jing were apparently available as early as the Eastern Han Dynasty (25 – 220 CE), it appears to have disappeared by the Song Dynasty (960 – 1279 CE), and it was believed to be lost for centuries.

In the 20th century however, another ancient text was discovered, the Fu Xing Jue Wu Zang Yong Yao Fa Yao (輔行訣臟腑用藥法要), a work attributed to the Daoist herbalist and Tao Hongjing (陶弘景, 456-536 CE). The Fu Xing Jue,whose full title could be translated as “Auxiliary Secrets For Treating the Zang Fu Using Herbal Medicine”, discusses the Tang Ye Jing extensively and also contains long passages that appear to be direct excerpts from the Tang Ye Jing.

Although some controversy over the authenticity of the Fu Xing Jue remains, for the most part scholars and practitioners and China have accepted it, and the portions of the Tang Ye Jing contained within it, as genuine.

Why Study the Tang Ye Jing?

While the history of the Tang Ye Jing remains somewhat murky, it is clear that it is heavily associated with Daoism and also that its impact on Zhang Zhong Jing was profound. Several of the most famous formulas of the Shang Han Lun and Jin Gui Yao Lue appear, often under different names and with slightly different ingredients, in the Tang Ye Jing.

This implies that Zhang Zhong Jing learned these formulas originally from the Tang Ye Jing, and adapted them to treat the conditions outlined in his text. And of Zhang Zhong Jing formulas which cannot be directly traced back to the Tang Ye Jing can still be usefully analyzed according to the Five Phase and Flavor dynamics laid out in there.

Because the works of Zhang Zhong Jing form the canonical basis of Chinese formula science, it’s not much of an exaggeration to say that the Tang Ye Jing is the wellspring of all Chinese Herbalism.

Therefore, if we want to gain a deeper understanding, either of Zhang Zhong Jing’s formulas specifically or Chinese Herbal Medicine more generally, it makes sense for us to thoroughly understand the Tang Ye Jing.

Moreover, because the Tang Ye Jing utilizes the Five Phases as its framework, it has the potential to be extremely useful for practitioners who may already use other systems based on the Five Phases, such as Saam Four Needle Acupuncture, Master Tung’s Acupuncture, Worsley Five Element Acupuncture, or the system of Chinese Medicine psychology in Dr. Leon Hammer’s Dragon Rises Red Bird Flies.

By studying the Tang Ye Jing, we can gain a better understanding of the Five Phases overall, and this can in turn deepen other Chinese Medicine practices that make use of the Five Phases as a model, and perhaps help to better integrate them with herbal medicine.

The Basic Structure of the Tang Ye Jing

The Tang Ye Jing’s materia medica consists of twenty five herbs, classified in sets of five according to Flavor and Phase identification. In terms of Flavor, Acrid herbs belong to Wood, Salty herbs to Fire, Sweet herbs to Earth, Sour to Metal and Bitter to Water. Nested within each of the five phases, this five fold pattern repeats itself, so that within the Wood phase we have five herbs that are in turn classified as the Wood of Wood, Fire of Wood, Earth of Wood, Metal of Wood, and Water of Wood.

This classification system is similar to the Five Shu Points of acupuncture, where we have at one level the Five Phase classification of a channel (i.e., the Hand Taiyin Lung Channel is Metal) and then all of the Five Phases represented in the Shu Points of the channel (i.e. LU11 shaohang is Wood of Metal, LU10 yuji is Fire of Metal, LU9 taiyuan is Earth of Metal, etc). From this basic structure, formulas are constructed that tonify or drain the corresponding organ associated each Phase. This is reminiscent of the way that Saam Four Needle Acupuncture and other styles have constructed protocols to tonify or drain channels and organs according to the Five Phases.

So far, so good, except for one detail that is probably nagging those of you who are familiar with the Nei Jing’s discussion of the flavor and nature of herbs in terms of the five phases.

The Tang Ye Jing’s association of flavors with particular phases probably seems different from the common order we are taught in Chinese Medicine school. Most of us learn that Wood is associated with Sour, Fire with Bitter, Sweet with Earth, Metal with Acrid, and Water with Salty.

Ultimately, this common set of association of Flavor with the Five Phases is rooted in the Nei Jing. We encounter it time and time again throughout the text, but it is specifically highlighted in Chapters 4, 5, 9, 10, 23, 67, and 70. With the exception of associating Sweet with Earth, the Tang Ye Jing otherwise seems to turn the standard correlative cosmology of Chinese Medicine on its head.

This provides us with an important opportunity to reflect on some of fundamental operating principles of Chinese Medicine.

Chinese Medicine does not deal in absolute truth or dogma; instead, it offers us different frameworks and models by which we can apprehend reality. In this case, it offers us a model by which we can approach both the materia medica as well as our patients. The same phenomena can be analyzed in terms of Yin and Yang, or in terms of Heaven, Earth and Humanity, or the the Four Levels, or the Five Phases, the Six Conformations, etc.

These are all just different perspectives that can be brought to bear on a given situation. And so the different arrangement in the Tang Ye Jing does not actually contradict the more standard arrangement. In fact, it can help us enrich our existing knowledge, so that we understand what it really means to say that “Sour goes to the Liver”, as well as understanding what the Tang Ye Jing means when it associates Sour with the Lung.

The key to all of this can be found within the Nei Jing.

A good place to begin our exploration of this topic is Chapter 22 of the Su Wen, entitled “Discussion of the Qi of the Five Zang Following the Seasons” (藏氣法時論). Uniquely, Chapter 22 lists the Five Phase Flavor associations we find in the Tang Ye Jing side by side with the more standard arrangement found in the other chapters of the Nei Jing.

It states that the Flavors assigned to the Five Phases by the Tang Ye Jing tonify their respective organs – so that Acrid tonifies the Liver, Salty tonifies the Heart, Sweet tonifies the Spleen, Sour tonifies the Lung, and Bitter tonifies the Kidney. In addition, it also says that the more standard arrangement of Flavor have a reducing or draining effect on their paired organs – so Sour drains the Liver, Sweet drains the Heart, Bitter drains the Spleen, Acrid drains the Lung, and Salty drains the Kidney.

For many of you, this will make more sense when we’re actually talking about herbs – so that’s where we’ll go in the next article in this series! Thanks for joining me – and don’t hesitate to chat with me over on Facebook about this post. I look forward to it!

Works Cited

• Foundations of Theory for Ancient Chinese Medicine by Liu Guohui
• “Introducing the Fuxing jue (Extraneous Secrets) and Tangye jing (Decoction Classic) Translation Project” by Heiner Fruehauf
• “Introduction on Fu Xing Jue: Passages from Tang Ye Jing” by Hui Zhang, Chengdu University of Traditional Chinese Medicine
• Huang Di Nei Jing Su Wen translated by Paul Unschuld

The post A brief introduction to the Tang Ye Jing 湯液經 – Part 1 appeared first on Chinese Medicine Central.

2018-12-13 02:00:24 / 4月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

Founder’s Note : This is the first of a long series of articles we’ll be releasing here about the theory and herbs of the Tangye jing. The enthusiasm and scholarly integrity of the author – new regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page. Thank you and welcome, Joshua!

What is the Tang Ye Jing?

The Decoction Classic or Tang Ye Jing (湯液經) is an ancient text in the historical canon of Chinese Medicine.

Building on the content of both the Shen Nong Ben Cao Jing (神農本草經) and the Huang Di Nei Jing (黃帝內經), it describes Chinese herbs and their interactions in terms of the Five Phases (五行) and the dynamics of the Five Flavors (五味). It is the first text we know of solely devoted to herbal formulas, and it had a seminal influence on Zhang Zhong Jing (張仲景), author of the Shang Han Za Bing Lun (傷寒雜病論).

To say that the Tang Ye Jing is a mysterious text would be an understatement.

Despite its status as a foundational text of Chinese Medicine, relatively little is known about it. Attributed to an author called Yin Yi (伊尹), there is no exact date for its composition, although it is referenced in many other classical medical texts, such as the preface to the Zhen Jiu Jia Yi Jing (針灸甲乙經). Although copies of the Tang Ye Jing were apparently available as early as the Eastern Han Dynasty (25 – 220 CE), it appears to have disappeared by the Song Dynasty (960 – 1279 CE), and it was believed to be lost for centuries.

In the 20th century however, another ancient text was discovered, the Fu Xing Jue Wu Zang Yong Yao Fa Yao (輔行訣臟腑用藥法要), a work attributed to the Daoist herbalist and Tao Hongjing (陶弘景, 456-536 CE). The Fu Xing Jue,whose full title could be translated as “Auxiliary Secrets For Treating the Zang Fu Using Herbal Medicine”, discusses the Tang Ye Jing extensively and also contains long passages that appear to be direct excerpts from the Tang Ye Jing.

Although some controversy over the authenticity of the Fu Xing Jue remains, for the most part scholars and practitioners and China have accepted it, and the portions of the Tang Ye Jing contained within it, as genuine.

Why Study the Tang Ye Jing?

While the history of the Tang Ye Jing remains somewhat murky, it is clear that it is heavily associated with Daoism and also that its impact on Zhang Zhong Jing was profound. Several of the most famous formulas of the Shang Han Lun and Jin Gui Yao Lue appear, often under different names and with slightly different ingredients, in the Tang Ye Jing.

This implies that Zhang Zhong Jing learned these formulas originally from the Tang Ye Jing, and adapted them to treat the conditions outlined in his text. And of Zhang Zhong Jing formulas which cannot be directly traced back to the Tang Ye Jing can still be usefully analyzed according to the Five Phase and Flavor dynamics laid out in there.

Because the works of Zhang Zhong Jing form the canonical basis of Chinese formula science, it’s not much of an exaggeration to say that the Tang Ye Jing is the wellspring of all Chinese Herbalism.

Therefore, if we want to gain a deeper understanding, either of Zhang Zhong Jing’s formulas specifically or Chinese Herbal Medicine more generally, it makes sense for us to thoroughly understand the Tang Ye Jing.

Moreover, because the Tang Ye Jing utilizes the Five Phases as its framework, it has the potential to be extremely useful for practitioners who may already use other systems based on the Five Phases, such as Saam Four Needle Acupuncture, Master Tung’s Acupuncture, Worsley Five Element Acupuncture, or the system of Chinese Medicine psychology in Dr. Leon Hammer’s Dragon Rises Red Bird Flies.

By studying the Tang Ye Jing, we can gain a better understanding of the Five Phases overall, and this can in turn deepen other Chinese Medicine practices that make use of the Five Phases as a model, and perhaps help to better integrate them with herbal medicine.

The Basic Structure of the Tang Ye Jing

The Tang Ye Jing’s materia medica consists of twenty five herbs, classified in sets of five according to Flavor and Phase identification. In terms of Flavor, Acrid herbs belong to Wood, Salty herbs to Fire, Sweet herbs to Earth, Sour to Metal and Bitter to Water. Nested within each of the five phases, this five fold pattern repeats itself, so that within the Wood phase we have five herbs that are in turn classified as the Wood of Wood, Fire of Wood, Earth of Wood, Metal of Wood, and Water of Wood.

This classification system is similar to the Five Shu Points of acupuncture, where we have at one level the Five Phase classification of a channel (i.e., the Hand Taiyin Lung Channel is Metal) and then all of the Five Phases represented in the Shu Points of the channel (i.e. LU11 shaohang is Wood of Metal, LU10 yuji is Fire of Metal, LU9 taiyuan is Earth of Metal, etc). From this basic structure, formulas are constructed that tonify or drain the corresponding organ associated each Phase. This is reminiscent of the way that Saam Four Needle Acupuncture and other styles have constructed protocols to tonify or drain channels and organs according to the Five Phases.

So far, so good, except for one detail that is probably nagging those of you who are familiar with the Nei Jing’s discussion of the flavor and nature of herbs in terms of the five phases.

The Tang Ye Jing’s association of flavors with particular phases probably seems different from the common order we are taught in Chinese Medicine school. Most of us learn that Wood is associated with Sour, Fire with Bitter, Sweet with Earth, Metal with Acrid, and Water with Salty.

Ultimately, this common set of association of Flavor with the Five Phases is rooted in the Nei Jing. We encounter it time and time again throughout the text, but it is specifically highlighted in Chapters 4, 5, 9, 10, 23, 67, and 70. With the exception of associating Sweet with Earth, the Tang Ye Jing otherwise seems to turn the standard correlative cosmology of Chinese Medicine on its head.

This provides us with an important opportunity to reflect on some of fundamental operating principles of Chinese Medicine.

Chinese Medicine does not deal in absolute truth or dogma; instead, it offers us different frameworks and models by which we can apprehend reality. In this case, it offers us a model by which we can approach both the materia medica as well as our patients. The same phenomena can be analyzed in terms of Yin and Yang, or in terms of Heaven, Earth and Humanity, or the the Four Levels, or the Five Phases, the Six Conformations, etc.

These are all just different perspectives that can be brought to bear on a given situation. And so the different arrangement in the Tang Ye Jing does not actually contradict the more standard arrangement. In fact, it can help us enrich our existing knowledge, so that we understand what it really means to say that “Sour goes to the Liver”, as well as understanding what the Tang Ye Jing means when it associates Sour with the Lung.

The key to all of this can be found within the Nei Jing.

A good place to begin our exploration of this topic is Chapter 22 of the Su Wen, entitled “Discussion of the Qi of the Five Zang Following the Seasons” (藏氣法時論). Uniquely, Chapter 22 lists the Five Phase Flavor associations we find in the Tang Ye Jing side by side with the more standard arrangement found in the other chapters of the Nei Jing.

It states that the Flavors assigned to the Five Phases by the Tang Ye Jing tonify their respective organs – so that Acrid tonifies the Liver, Salty tonifies the Heart, Sweet tonifies the Spleen, Sour tonifies the Lung, and Bitter tonifies the Kidney. In addition, it also says that the more standard arrangement of Flavor have a reducing or draining effect on their paired organs – so Sour drains the Liver, Sweet drains the Heart, Bitter drains the Spleen, Acrid drains the Lung, and Salty drains the Kidney.

For many of you, this will make more sense when we’re actually talking about herbs – so that’s where we’ll go in the next article in this series! Thanks for joining me – and don’t hesitate to chat with me over on Facebook about this post. I look forward to it!

Works Cited

• Foundations of Theory for Ancient Chinese Medicine by Liu Guohui
• “Introducing the Fuxing jue (Extraneous Secrets) and Tangye jing (Decoction Classic) Translation Project” by Heiner Fruehauf
• “Introduction on Fu Xing Jue: Passages from Tang Ye Jing” by Hui Zhang, Chengdu University of Traditional Chinese Medicine
• Huang Di Nei Jing Su Wen translated by Paul Unschuld

The post A brief introduction to the Tang Ye Jing 湯液經 – Part 1 appeared first on Chinese Medicine Central.

2018-12-13 02:00:24 / 4月前 / Joshua Park, DSOM, LAc from 深回复(0)固定链接

As acupuncturists seeking to pay attention to acupuncture clinic marketing, things can quickly get overwhelming. After all, many of us will not have employment in the traditional sense, but instead be renters, independent contractors or active clinic owners on some level. We’ll be doing some amount of our financials, planning, evaluation, operations. We’ll be asked to know relevant legal and, in some cases, employment related information – some of which has little to do with the profession we signed up for.

And, oh yeah, there is the medical aspect, too. We should be excellent practitioners : diagnosing, researching cases, coordinating with other care providers, providing excellent hands-on treatment as well as suggesting dietary and other lifestyle alterations and – maybe – prescribing an herbal formula. No big deal. To say that many of us – particularly early in our careers – feel overwhelmed is an understatement. Finding work-life balance is key, and many of us can see we need more rest, more time with family, less time at work.

But we all perceive that the marketing piece is important…

After all, without patients, you don’t have a practice, you have an idea or an expensive hobby. The vast majority of acupuncturists don’t have much background in marketing – even though we know it’s important. Overwhelm on this point leads some of us to frantically try this and that marketing tactic at random – sometimes finding results – sometimes not. Others respond to the overwhelm by ignoring the problem entirely, and we all know how well the head-in-the-sand approach works long-term. Neither option is a great way to approach such an important part of our acupuncture practice life.

So, as a person who teaches and coaches acupuncture students and practitioners about professional life, I’ve wanted to do my part to give a little gift that will help reduce that overwhelm.

Over the next several articles, I’ll lay out a simple five element approach to putting a stable foundation under your acupuncture clinic marketing efforts. It’s an easy to understand model that won’t solve all your woes – but should help to get your feet under you so you can move forward with less anxiety and more confidence. While I don’t always love extending the metaphors of Chinese medicine to every little thing – in business I feel it supplies some depth & structure to what can be a challenging topic.

I want to wrap up this introductory article with a brief visit to each of the five elements and a hint of the lessons they have to teach us as we seek to craft inspiring & effective marketing for our acupuncture practices.

These will obviously be unpacked quite a bit more over the coming weeks – and note – these are my interpretations. The point is not whether some Song dynasty scholar would disagree with my assignment of a phase element to a particular business system – the point is to learn the information I’m structuring in that way. Look at what the finger is pointing towards, not at the finger – right?

Water reminds us of our deepest roots – our psychology, our values, our goals for our business, our unique ways of flourishing – and asks us to honor those at all points along the path of marketing our acupuncture practices. Water is also a call to attend to the holistic nature of acupuncture business (and all business – in my opinion) – all systems in a business impact all the rest. We cannot market in a vacuum – we must be completely aware of how our marketing practices impact our executive, operational, medical, financial, legal and personnel related business systems. This is complex, it’s true, but from that complexity comes marketing you can stand behind 100%.

Wood is strategy, planning – in connecting our marketing efforts to goals – concrete outcomes, and what we want for our world. This reduces the frantic, rushed sense some people get when they begin to work on marketing. All the tools, strategies, foreign concepts & words – it’s easy to see where overwhelm would come in. That energy needs focus, purpose. We need to have a plan. Wood gives direction to our frantic seeking – and allows us to truly see the best place for our efforts.

Moving on into full flourishing of fire – connection, our people, us, the Heart of things. Fire in marketing helps us to see that we reduce our field of choices considerably simply by attending to whom we want to reach – who do we serve? What sorts of information reaches them most easily? Would my clients respond to birthday cards? Would they come to in-house events? Where do they hangout online – or do they? These questions come from fire – and solving them is getting to the Heart of the marketing matter – people. Community.

Then to Earth – taking a pause, centering, reflecting and taking advantage of the information that we’ve already discussed to make wise decisions about which tools we’ll use, and how. How do we balance this activity against everything else we need to do in a way that helps us to continue to feel nourished? Earth is where we get to have fun picking things and setting them up, designing, experimenting, processing. And we get to do so guided by a plan, rooted in the fullness of our practices and ourselves – instead of feeling harried, pressed and disconnected from what nourishes us.

Finally, we complete this cycle of exploring the essentials of acupuncture clinic marketing by learning the lessons of metal. In metal we are reminded of the critical importance of analysis. It’s not enough to just do random techniques and hope for the best. We have to learn how to assess whether what we did made a difference to our bottom line. And as is reflected in all the phase elements in some way – we are doubly reminded of the importance of integrity in our marketing. This keeps the balance that the Lung, the Prime Minister, demands.

I’ll expand on each of these in turn – building out the model until it’s a complete schematic.

I’ll be interested to hear your feedback – feel free to provide in the comments, or you can join the CMC community with a Bulletin, Free Library & Forum subscription, and provide your feedback in a private, interactive setting.

The post Introduction To A Five Element Approach To Reducing Acupuncture Clinic Marketing Overwhelm appeared first on Chinese Medicine Central.

2018-05-12 10:28:27 / 11月前 / Eric Grey from 深回复(0)固定链接

As acupuncturists seeking to pay attention to acupuncture clinic marketing, things can quickly get overwhelming. After all, many of us will not have employment in the traditional sense, but instead be renters, independent contractors or active clinic owners on some level. We’ll be doing some amount of our financials, planning, evaluation, operations. We’ll be asked to know relevant legal and, in some cases, employment related information – some of which has little to do with the profession we signed up for.

And, oh yeah, there is the medical aspect, too. We should be excellent practitioners : diagnosing, researching cases, coordinating with other care providers, providing excellent hands-on treatment as well as suggesting dietary and other lifestyle alterations and – maybe – prescribing an herbal formula. No big deal. To say that many of us – particularly early in our careers – feel overwhelmed is an understatement. Finding work-life balance is key, and many of us can see we need more rest, more time with family, less time at work.

But we all perceive that the marketing piece is important…

After all, without patients, you don’t have a practice, you have an idea or an expensive hobby. The vast majority of acupuncturists don’t have much background in marketing – even though we know it’s important. Overwhelm on this point leads some of us to frantically try this and that marketing tactic at random – sometimes finding results – sometimes not. Others respond to the overwhelm by ignoring the problem entirely, and we all know how well the head-in-the-sand approach works long-term. Neither option is a great way to approach such an important part of our acupuncture practice life.

So, as a person who teaches and coaches acupuncture students and practitioners about professional life, I’ve wanted to do my part to give a little gift that will help reduce that overwhelm.

Over the next several articles, I’ll lay out a simple five element approach to putting a stable foundation under your acupuncture clinic marketing efforts. It’s an easy to understand model that won’t solve all your woes – but should help to get your feet under you so you can move forward with less anxiety and more confidence. While I don’t always love extending the metaphors of Chinese medicine to every little thing – in business I feel it supplies some depth & structure to what can be a challenging topic.

I want to wrap up this introductory article with a brief visit to each of the five elements and a hint of the lessons they have to teach us as we seek to craft inspiring & effective marketing for our acupuncture practices.

These will obviously be unpacked quite a bit more over the coming weeks – and note – these are my interpretations. The point is not whether some Song dynasty scholar would disagree with my assignment of a phase element to a particular business system – the point is to learn the information I’m structuring in that way. Look at what the finger is pointing towards, not at the finger – right?

Water reminds us of our deepest roots – our psychology, our values, our goals for our business, our unique ways of flourishing – and asks us to honor those at all points along the path of marketing our acupuncture practices. Water is also a call to attend to the holistic nature of acupuncture business (and all business – in my opinion) – all systems in a business impact all the rest. We cannot market in a vacuum – we must be completely aware of how our marketing practices impact our executive, operational, medical, financial, legal and personnel related business systems. This is complex, it’s true, but from that complexity comes marketing you can stand behind 100%.

Wood is strategy, planning – in connecting our marketing efforts to goals – concrete outcomes, and what we want for our world. This reduces the frantic, rushed sense some people get when they begin to work on marketing. All the tools, strategies, foreign concepts & words – it’s easy to see where overwhelm would come in. That energy needs focus, purpose. We need to have a plan. Wood gives direction to our frantic seeking – and allows us to truly see the best place for our efforts.

Moving on into full flourishing of fire – connection, our people, us, the Heart of things. Fire in marketing helps us to see that we reduce our field of choices considerably simply by attending to whom we want to reach – who do we serve? What sorts of information reaches them most easily? Would my clients respond to birthday cards? Would they come to in-house events? Where do they hangout online – or do they? These questions come from fire – and solving them is getting to the Heart of the marketing matter – people. Community.

Then to Earth – taking a pause, centering, reflecting and taking advantage of the information that we’ve already discussed to make wise decisions about which tools we’ll use, and how. How do we balance this activity against everything else we need to do in a way that helps us to continue to feel nourished? Earth is where we get to have fun picking things and setting them up, designing, experimenting, processing. And we get to do so guided by a plan, rooted in the fullness of our practices and ourselves – instead of feeling harried, pressed and disconnected from what nourishes us.

Finally, we complete this cycle of exploring the essentials of acupuncture clinic marketing by learning the lessons of metal. In metal we are reminded of the critical importance of analysis. It’s not enough to just do random techniques and hope for the best. We have to learn how to assess whether what we did made a difference to our bottom line. And as is reflected in all the phase elements in some way – we are doubly reminded of the importance of integrity in our marketing. This keeps the balance that the Lung, the Prime Minister, demands.

I’ll expand on each of these in turn – building out the model until it’s a complete schematic.

I’ll be interested to hear your feedback – feel free to provide in the comments, or you can join the CMC community with a Bulletin, Free Library & Forum subscription, and provide your feedback in a private, interactive setting.

The post Introduction To A Five Element Approach To Reducing Acupuncture Clinic Marketing Overwhelm appeared first on Chinese Medicine Central.

2018-05-12 10:28:27 / 11月前 / Eric Grey from 深回复(0)固定链接