經方學

There is a section in Comparing Formula Presentations: Five Steps to Differential Diagnosis in the Treatment of Cold Damage on formulas, presentation, and illness. Unlike the way Huang writes, the author of this book writes in a condensed, specific fashion and is very clear about where within the six warp the illness is located. The more I read it, the more there appears to be spaces to read between the lines. There are areas compact in meaning, but with pointers to other presentations which when combined together gives a three-dimensional texture to the illness and context in which it is found. Obviously, it is easier to formulate a more effective treatment when the one has a clear idea of what is being treated and the terrain in which it is found.

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Let’s take a look at how the entry of a very simple little formula, Zingiberis Rhizoma and Aconiti Radix Decoction (gän jiäng fù zî täng), is written and use it to tease apart its associated presentation and illness, along with a read between a few of the lines.

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Formula: Zingiberis Rhizoma and Aconiti Radix Decoction (gän jiäng zhì fù zî täng) is Frigid Extremities Decoction (sì nì täng) with the Glycyrrhizae Radix (gän câo) removed, however the dosage [of each ingredient] is relatively larger. Note: unprepared Aconiti Radix lateralis (fù zî) is called for.

Presentation: Internal Yin/ Tai Yin Level

Irritability and restlessness with general disquiet. Non-acute Frigid Extremities Decoction (sì nì täng) presentation with relatively severe cold due to deficiency.

Disease:

No vomiting- this condition has no relation to a shao yang presentation.

No thirst- this condition has no relation to a yang ming presentation.

Deep and minute pulse with no significant heat in the body, the body feels cold with reversal cold of the hands and feet- Tai Yin Level

There are no exterior presentations; the irritability is not related to an unresolved exterior presentation. During the day the patient is irritable and unable to sleep, however in the night they calm down.** — This is extreme yin cold irritability, not the deficiency irritability with insomnia that is treated by Gardenia and Prepared Soybean Decoction (zhï zî chî täng).

** Line 61 of the Shang Han Lun:

For irritability and restlessness with inability to sleep during the day, but calm and quiet at night without vomiting or thirst, no exterior presentation, a sinking, faint pulse, and no great fever [in a patient] who has had sweating induced after purging, Ginger and Aconite Accessory Root Decoction Pill (gän jiäng fù zî täng) masters it

Zingiberis Rhizoma (gän jiäng) and Aconiti Radix lateralis (fù zî) warm the middle and eliminate cold. Zingiberis Rhizoma (gän jiäng) leans toward treating cold fluids rebelling upwards; Aconiti Radix lateralis (fù zî) more toward treating tenesmus due to cold fluids. Together these herbs warm above and below, it is an important prescription that warms the middle and eliminates cold.

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Between the lines:

First looking at the formula, Frigid Extremities Decoction (sì nì täng) is made of three herbs, two that warm the interior and one that harmonizes. Not only is the harmonizer removed, but unprocessed Aconiti Radix lateralis ( fù zî) is called for as well. From this alone we know we are dealing with an internal presentation of severe cold.

Turning to the presentation, all the charts in this book specify which of the six warps are addressed by the formula. More interesting in my mind is that it also differentiates between external and internal yang, and external and internal yin. I see this as a way of helping us to further understand the character of the illness. In the case of Zingiberis Rhizoma and Aconiti Radix Decoction (gän jiäng fù zî täng) we are dealing with a problem at the inner yin aspect of the tai yin warp. What kind of illness is this? Judging from the herbs being used to treat it, it would appear it is an issue having to do with a profound depletion of the yang leading to severe internal cold.

For the sake of comparison let’s take a look at True Warrior Decoction (zhën wû täng). This formula treats illnesses that straddle the exterior yin aspect of the shao yin and interior yin aspect of the tai yin warps. Judging by the herbs that comprise this formula there are going to be issues of cold, pain and fluid metabolism. As there is an aspect of this illness presentation that touches on the shao yin, we can infer that there likely will be issues that relate to the kidney or heart. Indeed, issues of water metabolism are a key True Warrior Decoction (zhën wû täng) issue.

When prescribing herbs and going through the mental gymnastics required to find the right medicinals, it is useful to be able to rule out entire formula families, thereby being able to concentrate our attention on the realm of potentially beneficial herbs. Using the lack of symptoms is helpful here. In this case “no vomiting” and “no thirst” means we can disregard the shao yang and yang ming levels as the disease has no relation or connection those warps. There is something very elegant and clinically useful here, as it gives us a kind of shorthand for understanding a patient’s condition.

The next line describes a “sinking and minute pulse with no significant heat in the body, the body feels cold with reversal cold of the hands and feet” and then classifies this as a tai yin level condition. There are numerous conditions that could show with a sinking and minute pulse. Here it is the reversal cold of the hands and feet along with signs of internal cold that tips it into the tai yin level.

In discussing irritability and restlessness the author is using the vocabulary of context and presentation via the process of comparison. These symptoms can arise from a number of different etiologies. He is very clear that “there are no exterior presentations, so the irritability can not being coming from an unresolved exterior” more interesting is that “during the day the patient is irritable and unable to sleep, however in the night they calm down.” We often think of irritability being due to a condition of excess. Untold doses of Rambling Powder (xiäo yao sän), Frigid Extremities Powder (sì nì sân) and Bupleurum Powder to Dredge the Liver (chái hú shü gän sân) are prescribed for patients with irritability, however in this case not only has the exterior been ruled out, but we also know the illness has no connection with the shao yang warp either. The key here is that the patient is irritable in the day, but calms down at night. But, this is not the calm of contentment and wellbeing; it is they appear of calm due to severe depletion of the yang. During the daytime the patient’s depleted yang receives some assistance from the yang qi of the day. It gives them enough “oomph” to contend with the overwhelming yin cold of their condition, but they are seriously depleted and thus irritable and fussy. At night when the yin qi is ascendant they sink back into quiet and calm. This is a false condition of quiet, as the patient’s yang qi is extremely weak. Really they are more in a stuporous state than one of true calm.

The author goes further here and says that this irritability is one that is due to extreme yin and cold and is not a case of deficiency irritability that would be treated by Gardenia and Prepared Soybean Decoction (zhï zî chî täng). Again, we are seeing how comparison between presentations helps to clarify our clinical gaze. The author assumes the reader has the ability to decode a Gardenia and Prepared Soybean Decoction (zhï zî chî täng) presentation and know what that means. For those of us that think only in zang/fu terms we can be quickly be lead astray. This is not the heat of floating yang due to yin deficiency. It is a yang ming level heat in the stomach and chest that is without constipation. It is heat, but as it is only heat and not accompanied by constipation; it is therefore not considered to be excess.

So, what does the irritability of an extreme yin cold condition look like, other than an inability to sleep during the day? I suspect these patients have a fragility about them. One thing for sure, it will no doubt be a type of irritability that will respond favorably to Aconiti Radix lateralis preparata (zhì fù zî), which is interesting as that is not exactly the first herb most would consider in the treatment of irritability.

Finally there is an explanation about how the dried ginger and aconite treat cold fluids that are rebelling upward, or being forced downward. The tai yin warp is associated with the digestion, and these two herbs target the middle and warm it. Once again the author is emphasizing the involvement of the tai yin warp for this formula’s presentation.

This all may seem like a hall of mirrors, and it is if you don’t have a compass by which to steer. But like any system, the six warp, once you learn to make sense of the landscape, can bring a startling clarity to your clinical work.

If you are regular reader of classicformulas.com then you have a pretty good idea of the value that Dr. Huang places on constitution, formula presentation, illness and the interaction between them. If you have worked with these methods yourself in the clinic, it is likely that it has at times sharpened your clinical eye and helped to craft a formula that powerfully changed a patient’s condition. It is equally likely that there have been times when a patient’s constitution seemed to morph between types, and a single formula presentation was impossible to nail down. Our patients continuously challenge us to push wider the doors of our perception and clinical understanding.

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As mentioned in a previous post, this time in Naning Huang introduced us to another set of filters that can help us to get a glimpse of our patient’s constitutional disposition.

In addition to looking for the herbal family into which they fall, we can also look through the lenses of: deficiency and excess, heat and cold, stagnation of qi or of the blood, and the presence of phlegm or dampness.

When looking through the lens of formula family or herbal presentation does not give us the focus we need to confidently write a prescription, engaging these other eight parameters gives us another corner from which to view the problem.

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Synchronistically I picked up a book (well, about a dozen actually) from a tiny, but well stocked medical bookstore off Han Zhong Road. One of the participants of this seminar has a theory that if a book has a picture of the author, and that author looks really nerdy, then it is probably a good book. The fellow with the heavy glasses on the cover of Comparing Formula Presentations: Five Steps to Differential Diagnosis in the Treatment of Cold Damage. (方證相對：傷寒辯證論治五步) fit the bill. Partly it was the nerdy guy on the cover, partly it was the plethora of case studies, some from the northern master of the Shang Han Lun, Liu Duzhou (劉度舟) and others from masters of the “Fire God” current (火神派) such as Fan Zhonglin (範中林). All were written with a clear-cut five step process that showed how they targeted at which level(s) the illness was lodged. Thought provoking case studies that weave through warp and woof of level, constitution and presentation; it went into the “buy” pile.

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It is unseasonably cold in Nanjing at this time, and reading in the comfort of a heated hotel room at the end of the day is all the recreation I want. Browsing the first few pages I was met with a familiar sight. A table of illness parameters that included the eight that Huang has been talking about.

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Now, anyone even slightly familiar with the study of modern Chinese medicine will certainly have been exposed to these eight parameters. It is part of the basic filter set through which we peculate the confusions and difficulties of our patients. However, we also run the logistics of yin, yang zang and fu, phase transformations and perhaps a few odd perspectives learned from teachers who paid attention to their clinical experience. Somehow, getting back to the basics of what is easily observed, what is concrete and without abstraction, has helped me to re-ground my clinical observation skills.

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Basics, like a black dress and simple string of pearls, never go out of style.

Every now and then I like to pull something off my Chinese shelf and give it a read. Sometimes I just open to a page and start reading, sometimes I browse the table of contents for some inspiration on a challenging clinical case. Today, it was the former motivation and as I was feeling a bit homesick for Taiwan, I figured a bit of a re-read of some of Dr. Jiang’s stuff would be the antidote. It is good to be reminded of the basics; like how to treat the Liver.

Doc Jiang had a bunch of books in print and a few more that were always in the process of being written. At the age of 98 he was as active and sharp as anyone in their 60’s, and he always had some kind of writing project going. Here are a few pages of his outline for treating the Liver.

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METHODS FOR TREATING LIVER PRESENTATIONS

Method: Dredging the Liver and regulating qi. When Liver qi stagnates on its own in the Liver channel, with primary symptoms of focal distention and fullness in the chest and abdomen along with stabbing pain in the hypochondria. The formula to use is Aucklandia to Smooth the Qi Decoction (mù xiäng shùn qì täng).

Method: Soften the Liver and nourish the Blood. Used for blood deficiency where the Liver has lost its softness due to lack of nourishment. The key symptoms seen are throat dryness, and lack of moisture on the tongue with a thin and weak pulse. The formulas to use are Linking Decoction (yï guàn jiän) or a modified version of Four-Substance Decoction (sì wù täng).

Method: Warm and Open the Liver Channel. Used for Bulging Qi disorders (疝氣 shàn qì). Symptoms seen include cold pain in the lower abdomen and weighted pain. The formula to use is Conduct the Qi Decoction (dâo qì täng).

Method: Dredge the Liver and Disperse Stagnation. Used for Liver qi stagnation that does not reach its destination, the qi mechanism is kinked up, with symptoms of pain in both costal margins being seen. The formulas to use are a modified version of Rambling Powder (xiäo yao sän) or Bupleurum Powder to Dredge the Liver (chái hú shü gän sân).

Method: Tonify the Liver and Nourish Blood. Used for Liver deficiency with dry blood. Symptoms seen include tightness under the hypochondriac which manifests when excessively hungry, and is exacerbated when fatigued. The formula to use is Hua’s Decoction to Tonify the Liver (huá shì bû gän täng).

Method: Calm the muscles and quiet rebellion. Used for rebellious Liver qi rising upward with symptoms hiccup from counterflow, high-pitched voice along with a sense of urgency to the speech. The formula to use is Inula and Haematite Decoction (xuán fù dài zhê täng).

Method: Clear and drain Liver fire. Used for excessive heat in the Liver channel. Symptoms seen include hypochondriac pain, bitter taste in the mouth, and a distended feeling in the ears with a loss of hearing. The formulas to employ are Gentiana Decoction to Drain the Liver (lóng dân xiè gän täng) or Tangkuei, Gentian, and Aloe Pill (däng guï lóng huì wán).

Method: Dredge the Liver and harmonize the collaterals. Used for stagnated and depressed Liver qi with disharmony in the channels and collaterals. Symptoms seen include hypochondriac pain and swellings in the body. The formulas to use are Inula Decoction (xuán fù huä täng) or Calm the Liver and Dredge the Collaterals Pill (píng gän shü luò wán).

Method: Regulate the Liver and Spleen. Used for Liver and Spleen qi stagnation with symptoms of hypochondriac pain and upper abdominal fullness. The formula to employ is a modification of Rambling Powder (xiäo yao sän).

Method: Bank the Earth and drain the Liver. Used for when the Liver takes advantage of the Spleen, resulting in symptoms of abdominal pain. The formula to use is Important Formula for Painful Diarrhea (tòng xiè yào fäng).

Method: Drain the Liver and harmonize the Stomach. Used for when the Liver takes advantage of the Stomach, resulting in the Stomach losing harmony and its ability to descend, resulting in symptoms of abdominal pain and vomiting of sour fluids. Use the formula Two-Aged [Herb] Decoction (èr chén täng) combined with Left Metal Pill (zuô jïn wán).

Method: Dredging the Liver with bitter, acrid and sour. For use in treating Liver qi rushing upward to the Heart; resulting in pain in the chest, upper abdominal and hypochondriac regions. The formula to use is Melia Toosendan Powder (jïn líng zî sân).

Method: Restrain the Liver and drain the Lung. Used in the treatment of Liver qi rushing upward into the Lung, resulting in the Lung qi not being able to descend. There are symptoms of hypochondriac pain along with coughing and wheezing. Use a combination of formulas that restrain the Liver and drain the Lung.

Method: Regulate the Liver and pacify the Blood. Used for vigorous Liver wood where the wood fire trespasses on metal. Symptoms of hypochondria pain and coughing of blood are seen. Use a modification of Rambling Powder (xiäo yao sän).

Method: Nourish the Liver, clear heat and pacify the spirit. Used for unsettled Liver and Gallbladder where there are symptoms of fitful sleep. The formula to employ is Sour Jujube Decoction (suän zâo rén täng).

Method: Clear and pacify the Liver and Gallbladder. Used to treat deficiency wind of the Liver and Gallbladder, with symptoms of insomnia with fright. The formula to use is Mother-of-Pearl Pill (zhën zhü mû wán).

Method: Moisten yin to descend fire. Used for Liver and Kidney yin deficiency with a lack of movement due to qi stagnation. Symptoms of hypochondriac pain, chest and abdominal distention, and a tongue lacking moisture are seen. The formula to use is Linking Decoction (yï guàn jiän).

Eastland Press just released an herb index to The 10 Key Formula Families in Chinese Medicine as a PDF.

For those of you that would like a copy you can either go to Eastland’s site and get a copy, or simply click HERE to download a copy.

I am considering adding a discussion forum to the site. If anyone has a comment or suggestions about that, please leave a comment.

Another great interview is coming soon coming your way. Stay tuned!

It has been a long journey and I am delighted to share the news that The 10 Key Formula Families in Chinese Medicine is now available. You will be able to find it at the usual outlets, and of course from Eastland Press. To help celebrate the occasion Eastland Press is offering a discount on the book from now, until the end of August.

From Huang’s forward to the Chinese edition:

While there are no less than dozens of formula categories in Chinese medicine, large and small, in this book we will discuss ten key families. While becoming familiar with theses formula categories and their constituent herbs, will not enable the reader to have complete mastery over all aspects of Chinese medicine. It will however, allow practitioners to grasp the rules in general for using Chinese herbal formulas, to understand the basic principles of Chinese medicine’s differentiation of patterns as a basis for treatment, and to handle these with ease in the clinic. Thus, laying down a firm foundation for the further study of Chinese medicine.

It is deceiving how much time and effort is required to dig the English out of one thin, little book on Chinese medicine; nor is it a solitary endevor. The assitance of my editor, Dan Bensky; the ongoing conversations both in person and by email with Dr. Huang; the patients that have visited Yong Kang clinic over the past few years and various collegues who have proofed the material and offered up their insights and suggestions, all of them share the responsibily for this book making its way into English. All have played a role in helping me to bring Dr. Huang’s words and ideas to the Western reader. I owe a deep debt of gratitude to all who have helped bring this project to fruition.

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Andy Ellis is one of the significant contributors to our field. He is the co-author of The Fundamentals of Chinese Acupuncture, Fundamentals of Chinese Medicine, and Grasping the Wind. Author of Notes from South Mountain, and part of the team that has given us the latest edition of Eastland Press’s Formulas and Strategies. He is the founder of Springwind Herb Company; not only does he find time to teach and practice, but he manages to mix it up on a basketball court several times a week as well.

While our paths often cross in Taipei, this time we had to catch up on online.

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How did you manage to find your way to Taiwan in the 80’s, and what was your motivation at the time?

I first went to Taiwan in 1983 to further my studies in acupuncture. I had studied with Dr. So at the New England School of Acupuncture for a year or so and then Dr. So got ill. I wanted to learn the real thing and since China was not accessible at that time I opted for Taiwan. At that time I had no intention to study herbs but when I got to Taiwan I realized that Chinese medicine there was largely herbal. There were, and still are, herb shops in every neighborhood.

You have spent time both in Taiwan and Mainland China. How would you say the medicine traditions differ between these two places?

It is hard to characterize an entire population. There are many traditions in Taiwan and many in Mainland China. In herbal practice there has been a great influence by Japan in Taiwan. The most obvious one being the use of concentrated granules. Like the Japanese, Taiwanese doctors emphasize formulas from the Discussion of Cold Damage (傷寒論 Shang Han Lun) and the Restoration of Health from the Myriad Diseases (萬病回春 Wan Bing Hui Chun). In modern mainland China the Restoration of Health from the Myriad Diseases is largely ignored. The Cultural Revolution, which had a large influence on China also influenced the medicine. Much of the spiritual nature was removed and a more dialectical approach was substituted for primarily political reasons. That is not to say that there were not many wonderful schools of thought that survived this purging but it was definitely an influence and can be seen in the modern writings.

Both Taiwan and China seem to feel a need to have their medicine be taken seriously by the West. They have taken slightly different approaches to gaining this approval. That is a long topic perhaps for another discussion.

Dr. Shi was a real influence for you. What about your time with him informs the way you approach medicine today?

Dr. Shi was the kind of doctor that I had hoped I would find in China. His unending patience and kind manner set an example that my better self recognized immediately. His approach to the medicine was not dogmatic and he felt truly that he was the fortunate recipient of a tradition that dated back to the early Han. Anyone who spent time with him gleaned immediately that he felt privileged to be able to help others with the information and tradition that had been handed down to him. I can only hope to emulate his manner and the unending study he engaged in order to help his patients.

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Andy’s book about Dr. Shi, not only is part of his contribution to us in the West, but also passes along some of the essence of Dr. Shi’s experience, learning and teaching. You can download THIS pdf file that contains a few pages from the book; it gives  a glimpse into the mind of Dr. Shi. Andy is making the book available at a 10% discount to the readers of classicformulas.com.

Click HERE to go directly to the Springwind site, at the checkout page simply enter classicformulas in the coupon space. This book not only gives great clinical tips, it also gives you a taste of how a gentleman/doctor thinks and works. We don’t have many books like this.

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It may not be a trip to China, but it is an opportunity
to engage the mind of a true doctor of the art!

I am ever reliant on the knowledge, guide and good will of others. This book Extraordinary Views of Abdominal Patterns (腹證奇覽 fù zhèng qí lân) originally caught my attention when friend asked me to pick up a few copies for him on one of my trips to Taiwan. I snagged a copy for myself at the time, and like The 10 Key Formula Families have been reading it over a period of time. The more I read, the more interesting it becomes.

As this book also focuses on the classic formulas, it is not surprising that there are tie-ins to some of the clinical considerations that Dr. Huang tends to stress. More interesting, this book gives clear and concise abdominal presentations that help the practitioner to focus their clinical perception through the use of their hands and consider the objective physical presentation of the patient’s abdomen.

I asked Nigel Dawes, one of the foremost western practitioners of Japanese Kampo, about this book. He had this to say:

The book you are referring to, 腹證奇覽 Fuku Shoh Ki Ran  (Extraordinary Views of Abdominal Patterns, is one of the most famous Edo Period (1600 – 1862) Japanese texts on Fukushin (abdominal diagnosis) it was written around 1800 by 稻葉克文禮  Inaba Katsubunrei who was born around 1805.

It seems the book had a great influence in spreading the importance of Fukushin in the practice of Kanpo.  Little is known about Inaba and a positive date of birth or hometown is not even known.

He was said to be an orphan and had minimal education, but he decided nonetheless to become a doctor. So he looked for a way to train without being able to read/write. He met a doctor, who was an expert in Fukushin. This doctor was not a direct student of Todo Yoshimasu, (perhaps the most celebrated of the Kanpo doctors of the Edo period in Japan), but was an admirer of his.

It is said that Inaba wrote Fuku Sho Ki Ran by having his students transcribe his dictations.

The content of this book is quite complimentary to that of The 10 Key Formula Families, watch for occasional excerpts here that will help you to add palpatory diagnosis to your clinical repertoire.

This October in Nanjing will be a unique opportunity to study constitution and the classic formulas of the Shang Han Lun and Jin Gui Yao Lue with Dr. Huang.

What you will gain from this special course:

• Learn the 10 basic constitutional types as outlined in The 10 Major Formula Families
• Understand the similarities and differences between the frequently used formulas families of the Shang Han Lun and Jing Gui Yao Lue.
• Observe and discuss clinical cases.
• Learn to use constitution diagnosis, and how to select appropriate prescriptions from within formula families.
• Become facile with the classic formulas.
• See Chinese medicine as it is practiced in China.
• Learn specific indications for particular formulas.

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When and where?
We will depart Seattle as a group on Oct 1st, begin classes on Oct 4th, and then leave China and return to the States on Oct 19th. Classes will be held in Nanjing in the conference room of our hotel, and clinic observation will be at the Nanjing TCM University, which is a 10 minute walk from the hotel.

What else?
There will be an optional day trip to Shanghai for a day of shopping, eating, and a trip to the top of the tallest building in China for a bird’s eye view of China’s biggest and most exciting city.
Of course, Nanjing itself is full of history, and colorful Chinese life to be explored.

China is a long way to go for just two weeks.
For those wishing to extend their stay in China, and explore the otherworldly natural beauty of Guilin, for an additional fee, we are offering an optional 5 days in Yangshuo. This lovely river town is at the very center of Guanxi province’s watercolor-like karst limestone mountains and meandering streams.

It all sounds great. How much for this adventure?
Price of $2,795 includes tuition, translation, accommodations, airfare from Seattle, ground transportation between Shanghai and Nanjing, and a Chinese visa.
Space is limited to 8 participants!
To reserve your place, a non-refundable US$300 deposit is required.

But wait, there’s more!
We are applying for NCCAOM PDA units.

Contact:
To be considered for this unique trip, email: michael@classicformulas.com
or call 206-788-5941.

It is not just that one can see more patients with a particular illness in a morning, than you might see in an entire year. Nor, is it that there is something about the busy as a bus station feel of a Chinese clinic, where patients jostle for position like horses at the starting gate.

It is not that it seems a bit odd that patients come in talking of body centered complaints like too much fire, stuffy chest feeling, or dizziness, instead of the oft heard Western psychological constructs of anxiety, depression or fatigue. And it is not that there are magic formulas that Chinese doctors use over on the Eastern side of the Western sea.

But, there is something.

A friend of mine that was recently studying for two weeks in Nanjing had this to say about her time there:

“While I’ve written all kinds of notes about formulas, herbs, tongues and their assorted coatings, what I notice is that I am just different in how I am with my patients, more directive, and without apology.”

There is something about as the Chinese say “opening your world eyes”, seeing how things are different precisely because your usual filters for how to see the world simply don’t work here. There is something about learning to navigate the Qi flow of traffic and crowds that force a completely different sense of movement and space. And then there are the ever present “why do they do it like this?” annoyances of life as it unreels in ways that bring us toe with toe with our assumptions, expectations and unspoken preferences.

Learning medicine in China comes peppered with fragrances and flavors we don’t have in the West. It can offer other views than those we have preciously cultivated. It is not always particularly pleasant, but it can be uniquely informative.
And vastly worthwhile.

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I have been fortunate in my time in Asia to have come across a number of doctors who have inspired and contributed to my journey of learning medicine. Doctor Huang has been particularly unique, as I’ve grown to know him through both his written words and the time we have spent together in his clinic, classes and discussing his book “shi da lei fang.” He is that rare combination of doctor, scholar, and teacher.

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This fall in early October we will hold in Nanjing the very first 2 week intensive for western practitioners. This course will be based on Dr. Huang’s understanding of constitutional types, formula families, and how it all comes together in the clinical setting. It will be an unusual opportunity to learn first hand how to use the classic formulas of the Shang Han Lun and Jin Gui Yao Lue to treat patients on both a constitutional and illness basis. Watch for more information here as we work out the details.

For more information, and to get on a mailing list so you can be immediately updated with the latest news on this event, send an email to: michael@classicformulas.com and prepare to deepen your own understanding of how these ancient formulas work in the modern world!