The case below teaches us both that quality and quantity matter. We may be very correct in our diagnosis and formula choice yet get it wrong in terms of the dosages of the individual herbs. Often practitioners are afraid of the action of an herb and so radically reduce its recommended dosage in a formula. Yet, this shift in dose can completely change or eliminate the effectiveness of the formula. How can we be safe when we are cutting ourselves off from the healing power of a formula? Having a patients illness continue is also far from being safe. If we are afraid of an herb and so change the basic structure of a formula by using way less than Zhong Jing advised, we can get very poor results. Below is an illustrative case I found: Continue reading
Eight Cases of Periodically Arising Illnesses
In all of the cases below the patients had symptoms that arise in a very periodic manner. In some of the cases, the patient was treated improperly because the focus of the treatment was on the symptoms rather than the periodicity of the symptoms. Continue reading
This post will be an update about what is happening at White Pine Institute as well as in my own life here in Western Massachusettes.
First me: I am beginning a new phase of life at age 60 that involves starting a small homestead/farm. I am calling it Ancient Ponies Farm, after my two Dales Ponies, Japser and Spencer, who will be gracing this farm with their presence soon. I’ll be having horses, chickens and hopefully bees. Maybe goats eventually. Collective gardens are being planned now. There are already 15 fruit trees; pear, apple, peach and there will be nut trees and berry bushes. The vegetable and herb (yes, Chinese herbs too!) gardens will be planned and the beds built this summer to be planted next spring.
View of South Pasture
This year I’ll harvest only fruit and garlic. There are 13 acres to play with, including 1000 feet of frontage on a perenial brook, a five-stall horse barn and my new home. If you’d like to keep up with what is happening on the homestead I am keeping a blog here. And I hope many of you can visit as well.
As for White Pine Institute, the schedule for the next Graduate Mentorship Program is now up on our current site. We are now working on a brand new website and a robust LMS (learning managment system) that will streamline the users experience in the next program. This LMS system is called Canvas. You will be informed when the new site is up and ready and at that point, registration for the 2018 program will open.
Bertha – Ready to Work
Well, that’s all for now! My new tractor, Bertha and I are signing off!
Gui Zhi Gan Cao Tang
This is the final post in the short series on Gui Zhi Tang. I hope you have enjoyed this series and that it has had some enlightening moments for you. I’ve certainly enjoyed putting it together. In this post, there are case studies and discussions about Gui Zhi Gan Cao Tang, another precious teeny tiny formula.
A key sign, according to Zhang Zhong Jing, to indicate the use of Gui Zhi Gan Cao Tang is the desire to put one’s hands on the chest, over one’s heart. I have found that many people do this but we’d never know unless we asked. If you have a patient with palpitations, anxiety, insomnia, fearfulness, night mares, dizziness or shortness of breath, ask them if they have a desire to put their hands on their chests. With an eye for this, you may notice patients that put their hands on their chests during your time with them. I’ve had patients tell me that they always fall asleep with their hands on their chests or that they love for their partner to place their hands on their chest. Sometimes the patient is not even aware that they keep their hand there until we ask. At any rate, this desire for a hand or pressure is a chest deficiency sign. Gui Zhi Gan Cao Tang warms and nourishes the heart Yang. As a teeny tiny formula it is found in many other formulas including Zhi Gan Cao Tang, Wen Jing Tang, Ling Gui Zao Gan Tang and of course Gui Zhi Tang. Continue reading
Hopefully you’ve had a chance to read the previous posts about Gui Zhi Tang and about Shao Yao Gan Cao Tang. Below I have included more discussion on Shao Yao Gan Cao Tang. The work of Liu Han-Tang I translated from his text A Record of Clinical Experience using Classical Formulas. After that I included some quotes from a newly translated text called A Walk Along the River: Transmitting a Medical Lineage through Case Records and Discussions by Yu Guo-Jun, translated by Andrew Ellis, Craig Mitchell and Michael FitzGerald and published through Eastland Press. I cannot recommend this text more enthusiastically. It will not only teach you with many subtle and awesomely cool insights, it will also inspire you and help you feel connected to this medicine we love to study. I think it’s on sale through the end of May too. 20% off! I think the passages I’ve quoted below will give you a taste of his work.
So, here is a bow to Liu Han-Tang, a bow to Yu Guo-Jun and a bow to Shao Yao Gan Cao Tang. Continue reading
The last post was introducing the two teeny tiny formulas within Gui Zhi Tang: Shao Yao Gan Cao Tang and Gui Zhi Gan Cao Tang as sort of a Yin Yang pair. Now it’s time to go into these two formulas more deeply. In this post I am sharing some brief discussion and 9 case studies by various doctors about Shao Yao Gan Cao Tang. There is quite a range of illnesses that can treated with this formula. It is an incredibly useful formula that I, again, use every clinic day. Once you really understand this formula, you will also use it all the time with great success. In my own experience I’ve used it for spastic cough, constipation, intersticial cystitis, TMJ, restless leg syndrome and abdominal pain, among many other applications. It is teeny tiny so you can see these components in many other formulas such as Xiao Jian Zhong Tang, Si Ni San or Wen Jing Tang. Oh so many formulas! I love that the Tang Ye Jing‘s version of Xiao Chai Hu Tang, which is called Yang Dan Tang, is Xiao Chai Hu Tang plus Shao Yao, making this a formula that includes Shao Yao Gan Cao Tang. Since the Tang Ye Jing is the pre-cursor of the Shang Han Lun, I see this as hearty encouragement to consider integrating Xiao Chai Hu Tang with Shao Yao Gan Cao Tang by adding Shao Yao to it.
I hope you enjoy these cases as much as I have. Continue reading
Any formula that contains two herbs or less is a teeny tiny formula in my book. (Not that I’ve written my book yet!) Within Gui Zhi Tang there are two teeny tiny formulas. The beauty of knowing these teeny tiny formulas is that they shed immense light on the function of a larger formula that contains them. Gui Zhi Tang itself is a small formula with just five ingredients. It is interesting that such a small formula can still house two more formulas inside it.
In this post I’ll discuss which formulas are in Gui Zhi Tang and give a general discussion of what they are doing in there. This post is the first in a series. The next post will offer discussion and case studies about the first formula and the post after that will focus on the other formula. Wow, at the end of these posts you are going to really know Gui Zhi Tang inside and out. The teeny tiny formulas are also suprisingly useful in the clinic by themselves.
Below are discussions by myself and then by two Chinese doctors about these formulas. Both of them emphasize the fact that Gui Zhi Tang not only harmonizes the Ying and Wei but also harmonizes Qi and blood and Yin and Yang. It is through the action of these two teeny tiny formulas that Gui Zhi Tang’s action goes beyond harmonizing the Ying and Wei. Continue reading
Gui Zhi Tang
Hurrah for Gui Zhi Tang!
Gui Zhi Tang for ALL!
Ke Yun Bo called Gui Zhi Tang the “Formula for the Masses.” I use this formula every day I am in the clinic. In terms of illnesses, the reach of Gui Zhi Tang is extremely broad, extending well beyond the so-called wind cold. I use it for digestive, menstrual, skin, respiratory and emotional disorders. Below I have shared a LONG post that goes deeply into an expansive view of this most excellent and brilliant formula, illustrated through case studies and discussions. I translated most of these cases from Liu Du-Zhou’s Collected Case Studies from Renowned Physicians, with a few extra cases added from Feng Shi-Lun, Fu Yan-Ling and Cao Ying-Fu. If you take the time to read all of these 28 cases and the discussions, you will come away really understanding the wide range application of this formula.
Formula Explanation: By Liu Du-Zhu
This formula is used for a pattern in which there is lack of harmony between the Ying and Wei, The Qi and blood, the Yin and Yang and the Exterior and Interior. The principle symptoms are sweating, aversion to wind and cold and a weak pulse. Gui Zhi Tang is used to regulate and harmonize the Ying and Wei and Yin and Yang. It opens through to connect the exterior with the interior and the upper with the lower. The special characteristics of it are:
- It regulates and harmonizes the Ying and Wei by both generating and stopping sweat. Because, in the Gui Zhi Tang pattern, the “Ying is weak and the Wei is strong,” the Wei Qi is not in a harmonious relationship with the flourishing Qi (Ying).” The Ying Yin is weak on the interior and it is of no use to the Wei Yang. This is the so named “lack of harmony.” Because there is a loss of the functions to warm the muscle layer, fill the skin, fertilize the straie of the flesh and govern the opening and closing, there are the constant symptoms of a moderate and weak pulse, sweating and aversion to cold. Gui Zhi Tang has the special ability to regulate and harmonize the Ying and Wei. In the formula there is Gui Zhi, which is pungent and warm. It opens through the Yang and benefits the Wei. Shao Yao is sour and cold. It boosts the Yin and contains the Ying. When the Gui is combined with the sourness of Shao, it is not overly scattering. When Shao is combined with the pungent quality of Gui, the Yin does not congeal. Sheng Jiang is pungent and scattering. It assists the Gui to move to the exterior. Da Zao is sweet and moderate. It assists the Ying to move toward the interior. Gan Cao is sweet and balanced. For the Wei it is warm and for the Ying it is nourishing. It is a regulating and harmonizing herb. This formula uses sour and pungent together. Cold and warm are unified. Force is tempered with mercy. This is the meaning of inducing sweat while containing it. There is the function of regulating the Wei within the function of harmonizing the Ying. When the Yin and Wei are harmonized as one, the muscles and pores are resolved and disinhibited. The external evil follows the sweat and is resolved. The sweat going out creates harmony and so it stops. The Tang Ye Ben Cao explained it like this: “ The Gui Zhi method induces sweat. It does so by regulating the Ying Qi, which causes the Wei Qi to spontaneously harmonize. The wind Qi is not contained and so it is resolved with the sweat. Inevitably Gui Zhi is able to open the pores to induce a sweat. When there is abundant sweating, use Gui Zhi in order to regulate and harmonize the Ying and Wei. The evil will leave with the sweat and the sweating will stop. In this way, Gui Zhi is able to stop sweat.”
- Gui Zhi Tang is also able to regulate and harmonize Yin and Yang and resolve the exterior while treating the interior. The Lei Jing points out: “Entering the body is none other than the exterior and interior. The exterior and interior is no more than Yin and Yang. Yin and Yang are Ying and Wei and Ying and Wei are actually Qi and blood.” Regardless of whether it is an exterior pattern or an interior pattern, it all is a result of unregulated Yin and Yang. The treatment is inevitably to “carefully observe the regulation of Yin and Yang so they can be balanced again.” Gui Zhi Tang regulates and harmonizes the Ying and Wei. The foundation of this is the regulation and attention to Yin and Yang. Gui Zhi Tang contains Gui Zhi Gan Cao Tang. In this formula, pungent and sweet transform the Yang. It also contains Shao Yao Gan Cao Tang in which sour and sweet transform the Yin. When Yin and Yang are harmonized, the exterior and interior are also harmonized. Therefore Gui Zhi Tang not only treats contraction of and exterior evil, it also treats miscellaneous illnesses. It is as Xu Ling-Tai said: “This soup treats the exterior pattern by resolving the muscles and harmonizing the Ying and Wei. It treats the interior pattern by transforming Qi and regulating Yin and Yang.”
- Gui Zhi Tang regulates the spleen and stomach. It attends to and protects the root of the post heaven. Within the formula there is Gui, Jiang, Zao and Cao, which are all food ingredients. They fortify the spleen and open the stomach effectively. The spleen and stomach are the root of the post heaven. They are the source of generation and transformation. By regulating the spleen and stomach, Gui Zhi Tang achieves the goal of regulating Ying and Wei as well as the Yin and Yang. It is really as Zhang Xu-Gu said: “This formula establishes a method that begins in the spleen and stomach and goes to the Rong Wei, making a circuit around the whole body to blend the exterior and interior, regulate Yin and Yang and harmonize Qi and blood. This is why it is not only for exterior contraction. It is also a method that can also treat interior damage.”
Professor Liu Du-Zhou pointed out that the Shang Han Lun has two prerequisites: The first is to “harmonize Yin and Yang” and the second is to “protect the stomach Qi to preserve the fluids.” These to prerequisites are both contained in Gui Zhi Tang.
One can see that Zhang Zhong-Jing placed this formula at the head of the formulas for the masses. It is worthy of Ke Yun-Bo’s appellation that this is the “Chief formula for the masses.”
The use of this formula in the clinic is very broad. It is not only used for Zhong Feng, Shang Han and miscellaneous illnesses. It can be used for any problem in which there is lack of harmony of the Ying and Wei and Yin and Yang where there is sweating, aversion to wind and cold and a weak pulse. When using it, keep in mind the following points:
- Keep the dosage ratio of Gui Zhi and Bai Shao the same. Changing the amounts of either of them, changes the treatment parameters.
- If you are using Gui Zhi Tang to induce a sweat, you must give hot gruel in order to nourish the source of the sweat and to prevent damage.
- When inducing sweat, you do not want it to pour out. A very slight sweat is good.
- It is contraindicated to use Gui Zhi Tang when there is an exterior excess pattern or a hot disease.
28 Cases and Discussion
I’m really excited to let everyone know that my colleague and friend, Ben Walker, is organizing the ICEAM Shang Han Lun series to take place in Boston, starting in June. I highly recommend this series. All of the instructors for the program are excellent.
From: Ben Walker
Dr. Arnaud Versluys and the Institute of Classics in East Asian Medicine will be launching their flagship East Coast branch in Boston, beginning June 3-4 2017. The complete Diplomate in Canonical Chinese Medicine training spans 17 weekends over the course of 2 years. It is a unique combination of in-depth instruction on the theoretical aspects of Han Dynasty herbal medicine, and hands-on transmission of a classical pulse system in a clinical setting. At the core of Dr. Versluys’s scholarship is the view of the Shanghan Zabing Lun as the condensation and application of Neijing theory, Bencao Jing herbs and Tangye Jing formulas. This work is given immediacy and clinical relevance through its synthesis with Tian family pulse diagnosis, a system of profound clarity and practicality. In addition, there are practical sections on Fukushin abdominal diagnosis, and on creating acupuncture treatments that dovetail with classical herbal formulas. The training is open both to licensed practitioners and to current Master’s students. Each weekend is approved for 16 NCCAOM CEU’s. Package deals for the first 8 weekends are currently available on the ICEAM website
Dr. Versluys is one of the few Westerners to have received his full medical training in China. He spent a total of twelve years at the Chinese medical universities of Wuhan, Beijing and Chengdu, where he pursued his Bachelor, Master and Doctorate degrees in Chinese medicine.
In 1999, Dr. Versluys met Dr. Zeng Rongxiu 曾榮修, under whom he trained in traditional Shanghan Lun discipleship for 13 years. Dr. Zeng was the last living disciple of the great Shanghan pulse master Tian Heming 田鶴鳴. During his long career as an internal medicine doctor in Chengdu, he synthesized a highly effective system of constitutional approaches to chronic illness. He was known for his unrelenting enthusiasm for clinical precision and the healing power of classical herbal formulas. Dr. Zeng passed the leadership of his lineage, his personal writings, and all Tian lineage materials to his main disciple, Dr. Versluys, and the Institute of Classics in East Asian Medicine, where his legacy is now secured for posterity.