經方學

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There is a great saying in Chinese 一步一步來; 
keep putting one foot in front of the other.

It is good advice for any endeavor, but especially apropos for those projects that span years, or for journeys where the destination can barely be imagined, let alone seen, from the point of departure.

Five years ago The Ten Key Formula Families made its way into my hands. Two years ago I received Dr Huang’s permission to translate it into English. This past week my final proofing was completed, and it is now in the hands of my publisher, Eastland Press.

Look for it in the first quarter of 2009. It should be available soon after we have celebrated the year of Ox here in China.

滑 hua

It means slippery.
Like ice is slippery.
Or like summer oil coated roads in Seattle, when they get their first misting of a fall rain.

In Chinese medicine we use 滑 to describe a kind of pulse that has a certain feeling of phlegmy force. But, it is also used to describe a coating on the tongue.

Describing the slippery coating on the tongue (tongue not in cheek) is a rather slippery issue.

As with most everything in Chinese medicine (and language for that matter) it depends on context. The slippery tongue coat can be a slightly greasy, slightly glossy, almost shellacked like coating. Like the one often seen in the presentation for ban xia formulas. But, the tongue coating in dried ginger formulas is also often described as slippery, but here it is actually a bit more of a slimy coat.

Consulting the Chinese dictionary tells us that slippery also can mean glossy, as in shiny.

It would be convienant if there was always a one to one corraspondence between words, between languages, a gold standard  firm and unchanging rule. But, language is, well, more slippery than that.

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Whether you call it epigastic focal distention, glomus, an indistinct  feeling of discomfort in the chest, or any of the other various ways that we try to translate 痞 in English, this term seems to have a slippery and elusive meaning.

Often doctors in China will say this is a feeling on the part of the patient, while Japanese practitioners with their habit of abdominal palpation will say it is a feeling the hands of the practitioner can discern.

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In the Ban Xia Xie Xin Tang chapter of The Ten Major Formula Families, Doctor Huang has this to say:

Epigastric focal distention is a subjective feeling on the part of the patient where there is a feeling of discomfort or pain in the upper abdominal region; epigastric focal distention with firmness includes the afore mentioned subjective feelings on the part of the patient, plus a palpable feeling of firmness on the part of the practitioner.

I suspect that 痞 (pi) is one of those terms, that much like phlegm itself, that can be slippery and the cause of all kinds of distortion. There are terms in Chinese medicine which are more like puzzles, than answers. While I would not suggest that Doctor Huang has the definative answer to this particular question, his point of view does give us some guidelines to pay attention to in our own clinical practice. From that we can form our own ideas about what constitutes 痞, and how to treat it.