Comments on: Ye Tian-Shi – Constraint#4

By: Jason Blalack

Jason Blalack — Thu, 09 Jun 2011 15:36:42 +0000

1 .Yes you are right. This demonstrates how master physicians take the idea of a formula and tweak it for the individual presentation.

2. “horizontal movement of Qi” refers to Wood invading Earth. It is also referred to a horizontal counterflow pattern or wood not dredging earth (木不疏土 mu bu shu tu). The sentence following it helps understand it further, “This was a failure in free-coursing.” – This pathodynamic can easily lead to pain and alternating constipation and diarrhea. I am not sure that there is a lack of (or too much) descending of qi, to a degree that this must be directly addressed. But there is surely stagnation which has impaired the qi dynamic. The interesting issue is how does one restore it. Ye teaches us a interesting lesson.

By: Barry Levine

Barry Levine — Wed, 08 Jun 2011 21:01:47 +0000

The two formulae are an interesting comparison. It seems that Ye Tian Shi took the idea of Yi Guan Jian, but avoided the cloying hard-to-digest Sheng Di & Mai Men Dong.

BTW, what do you think he means by “horizontal movement of Qi”. I get that there’s stagnation, lack of descending (or too much, suddenly), but I don’t recall seeing this kind of description and wonder if there’s something specific meant here.

By: Jason Blalack

Jason Blalack — Wed, 08 Jun 2011 00:54:17 +0000

First thanks for your thoughts Barry. Here are some quick thoughts: 1. In regard to outcome etc. you may want to check out, Further thoughts on understanding Ye Tian-Shi’s case records. But I agree it would be nice to know this sort of thing. 2. There was not just diarrhea but "alternating constipation and sudden diarrhea", a typical sign we see in the clinic. However Ye looks at the underlying physiological disharmony / pathodynamic and treats this. Hence there is not much worry about moistening herbs creating diarrhea. These moistening herbs treat the underlying cause by softening the Liver, preventing the Liver from attacking the Spleen. When the Spleen is in balance then the bowels will regulate. You can compare this formula to Yi Guan Jian (Linking Decoction): sheng di huang (Rehmanniae Radix) gou qi zi (Lycii Fructus) sha shen (Glehniae/Adenophorae Radix) mai men dong (Ophiopogonis Radix) dang gui (Angelicae sinensis Radix) chuan lian zi (Toosendan Fructus)

By: Barry Levine

Barry Levine — Tue, 07 Jun 2011 21:28:08 +0000

What would be nice to know in a case like this is what the response was, how long the course of treatment and what the followup treatment was, since he states, “It is difficult for medicine to immediately work because the disease had endured for many years.”
Worth pointing out that Bai Zi Ren is a spirit calming herb, as well as being an oily seed that moistes the bowels. It seems that diarrhea was only occasional, as the laxative Tao Ren is also included, another oily seed. These are both herbs that can prompt loose stool in a patient with deficient Spleen Qi.

To me the first four herbs are a laxative formula with spirit calming and lower-warmer blood invigorating properties, as well liver-smoothing (Bai Shao, which relieves smooth muscle spasm/visceral pain.) I think the interesting part is the inclusion of Huang Lian and Chuan Lian Zi, especially the latter, which I have not used much at all, and will now consider more closely in similar cases.