My intentions were not to arrogantly question the original author’s expertise. I was simply posing a question that came to me intuitively. I am still learning and am trying to see where my thoughts are in relation to those that are much more skilled than I am. The idea was posed with the intent of learning and not proving anything. However, I do see where you are coming from and appreciate your suggestions as well.

However we can think through your theory and evaluate that. First, I do not understand why you consider this a triple burner issue and want to address the Kidney yang through supplementing Kidney Yin and Jing. From the case itself it says that this is a wood and earth pattern, therefore it makes sense to address it from this perspective as Fei does. I see no reason to look beyond that.

I would like to discuss the idea that ‘there are many angles to approach a given situation.’ I am actually not inclined to think this way and do believe there is a “best approach.” Actually, Qin Bo-Wei discusses this and points out that doctors may actually consider different symptoms as starting points for their diagnostic process, however if one’s methodology is sound then everyone in the end should come up with the same diagnosis.

Of course, if you compare diagnostic results from a strict cold damage practitioner, a strict warm disease and another Earth School practitioner then most likely they all will have different approaches. However, it is my opinion that there is one superior approach; however it is impossible to know which one. However Qin’s point is that doctors that are schooled in a well-rounded Chinese medicine approach will have access to all of these approaches, and should be able to systematically figure out which one is best. Hence 10 doctors should come up with the same answer. Formulas will of course vary much more than diagnosis and treatment principles.

Too often in the West we hear that if you get 10 practitioners in the room you will get 10 diagnostic answers and all of them can be correct. Because we favor creativity over core theoretical knowledge and rigor we often see all sorts of diagnostic and pathodynamic ideas emerge when explaining cases. Hence everyone can be right and we get 10 correct answers. I think this is incorrect and only further perpetuates a lack of rigor that we often see here in the West.

I agree with Qin Bo-Wei, there’s a correct way of thinking when approaching diagnosis. Anyone should be able to follow this process and come up with the same diagnosis. We do not need to be overly creative and make up our own theoretical constructs, but follow what others have done in the past.

I would love to hear other peoples’ opinion on this topic…

Great case. My guess is that the second 又 is used to emphasize the (negative) enduring depression. Is this the one you mean?

Eran

Mazin replied on the use of Yi Mu Cao for IBS, for which he claims it was a clinical finding of his own. He remembers having a patient who suffered with IBS (both urinary and bowel), who also had irregular menstruation. The formula he used was basically modified Tong Xie Yao Fang with urine activating herbs like Ze Xie, Qu Mai, and with Yi Mu Cao 12g. The patient returned with a slight decrease in IBS symptoms, but no change in the menstrual signs. His favorite herb combo for menstrual irregularity is Xiang Fu with Yi Mu Cao, but he was out of stock of Xiang Fu, so decided to double the dose of Yi Mu Cao to 24 grams. When The patient return, her menstruation was more regular and her IBS symptoms had calmed down.

Mazin has then tried this higher dose of Yi Mu Cao on many patients over the years and has found it to be a very useful herb for IBS. I guess Yi Mu Cao is classically known to be good for urinary symptoms, but not so much for the Bowels. Years later, Mazin found a research study in Chinese where Yi Mu Cao in higher dose ranges helped 97% of patients suffering with watery diahrea.

Anyways, it seems Yi Mu Cao could be viewed as a useful herb to calm IBS, either bladder or Bowel or both, particularly when there is Qi stagnation symptoms. I think this could be understood via its ability to help regulate the menses, and thus affect the Qi mechanism. It also seems to have direct dampness draining abilities.

Best
Trevor