Yu jin regulates the qi within the blood. chuan lian zi, in comparison, only enters the qi level. Although this is not a blood stasis pattern per se, the use of yu jin prevents the stagnation from going to a deeper level. chuan lian zi does not have this ability. Or, quite simply, it points that there is some blood level involvement, for it is said, (in relation to constraint patterns), “In the beginning the disease is in the qi aspect, if it endures it enters the blood aspect.”

If I’m not mistaken, Ye Tian-Shi only uses chuan lian zi for constraint patterns when there is clear pain. Consequently, if it was added to the above cases, I would assume that there is a more severe presentation that is not mentioned, such as strong pain.

** Steve, nice observation in regard the SHL symptoms. Lets keep this in mind as we look at more cases.

From what I understand of my studies of the Shanghan Lun, baizhu is often removed if there are signs and symptoms like “pounding above the umbilicus,” vomiting, and abdominal fullness. Since I would assume Ye to be well versed in SHL, he probably removed baizhu for that reason in both of these cases.

Again, while I sort of get why yujin would be added to a case of Liver constraint engendering heat, I wonder what clinical signs and symptoms make him choose this medicinal over something like chuan lian zi?

-Steve