Apr 23 2007
Sweatless gui zhi types?
I did not expect so many comments so quickly. If this continues I will have to look into setting up a discussion forum on this site as well.I love going to Chengdu for the ma-la hotpot, cheap foot massage, and teahouses. I also love to visit there because I get to hang out with Eran Pupkin, an Israeli friend who is about to begin a 5 year Masters program there. I’m jealous!A recent email of his had this:
Can you write more about the gui zhi type, and what happened if the person does not sweat at all, but have all the other symptoms, does he/she still consider a gui zhi type?
Oddly enough, this was the question that was at the top of my list to ask Dr. Huang when I met with his last week to discuss some questions I had about the book.He had this to say:This is tricky. First of all, you can not really rely on your patients for much useful information. Often they really don’t know what it is that you are looking for. Then, there are those that will try to tell you what they think you want to hear. Others, will exaggerate. Still others, just do not really pay much attention to their experience. So, if you ask them questions like “do you sweat easily”, they either misunderstand what you are asking about, or just plain don’t know.
What to do? Look for yourself at the skin, if it is coarse, dry, and looks kind of sandy, they are NOT a gui zhi type. If, however, they have skin that is fine, more white in color and is moist, then this is can be seen as an indication that they are a gui zhi kind of person.You as the doctor need to use your own eyes and hands to make sense of the person in front of you. Do not overly rely on what they have to say!
2 responses so far
Hello everybody,
Thank you Michael, for asking Dr. Huang about the sweating issue in gui zhi type people.
In my opinion, the more information I get from the patient, the better. If the questioning is done right, then the collected data could make a huge difference in my choice of differentiation, treatment strategy, and finding the right formula.
So, I do rely on my patients and trust them for giving me information, and in order to not mislead them, I have to ask the right questions.
About the skin issue, reality is more complex then textbooks, so the skin could be white in color, but not moist nor dry. Then if I will not trust or rely on my patients, I cannot really decide if there is excessive sweating or not. A problem…ah?
Another question is about the definition of Dr. Huang regarding the gui zhi type. Does Dr. Huang refer to gui zhi TANG type or gui zhi the herb?
Some people are gui zhi (herb) type, but not gui zhi tang (formula) type. Does Dr. Huang find difference in these two types?
Last, the Master’s degree program in Chengdu is 3 years, not 5. And you are more then welcome to visit me some more. The hotpot is on me!
Eran Pupkin
Eran
I don’t think Huang’s comments mean that we should not listen carefully to our patients. But, more that we should some clear ideas in our own minds about what we are looking for, and how to go about getting that information. My take on it, is that Huang is suggesting we use certain observable signs to indicate what might be happening for a patient.
For example, dry skin, that is more rough than smooth, would lead us to think that this person does not sweat much. A person with delicate skin that is moist, we might infer they have palpitations or other gui zhi kinds of signs.
As to the question of are some people gui zhi (herb), but not gui zhi tang (formula) types? My take on this is that if someone is a gui zhi (herb) type, they are going to benefit from a gui zhi family formula. It might be gui zhi tang, but depending on the symptoms and other problems, they might benefit from gui zhi fu zi tang, or gui zhi fu ling wan, there where were issues with cold, or blood stagnation.
Maybe you would like to come to Nanjing this fall and study with Huang for 2 weeks? I’m in the process of pulling a class together!