經方學

One of the really interesting things about use of the “jing fang” is that the change of a single herb, or even the amount of an herb used, can have a significant impact on the function of the formula.

A friend of mine who has shelves full of books concerning the Shang Han Lun once mentioned over tea and cookies that because the classic formulas are not made of many herbs, it is easy to understand how a small change can have significant results. Thus, studying and using the prescriptions from the Shang Han Lun and Jin Gui Yao Lue are a great way to both save your patients money, as these prescriptions tend not to be expensive, and for you as the practitioner to hone your skill in understanding how the change of a single herb can have profound clinical effects.

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As Dr. Huang says, this is part of the “beautiful attraction of the Classic Formulas.”

It is rare that I find really amazing books about Chinese medicine. The vast majority of mind opening books in my collection have been recommended to me by someone else. I am ever in the debt of others who also walk this path. Recently, over a plate of dumplings, Gabriel Fuentes and I were discussing medicine in Taiwan. Taiwan is a goofy place as it is possible to be a well skilled doctor and not have a license. For that matter, it is possible to study for years and years abroad with deeply skilled doctors, but if you don’t have the pedigree of a Taiwanese diploma; no license for you. However, if you have the “stuff” to be a doctor, you open a clinic anyway. If you have the ability to help people; they will come to you.  I just love Taiwan!

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Over those dumplings I found out about this guy, Dr. Zhang,  who is rumored to be good with the pulse, and spot-on with herbs. A bunch of both students and licensed doctors ride up into the mountains outside of Taichung to study with him, and they have written down the methods and clinical reasoning of this guy.

The great thing about knowing how to read Chinese is that you get access to material as far away from English as Taipei is from Tennessee.

One of the collections of notes concerns dui yao, the pairing of herbs. While these herbal couplets are useful when thinking about any formulation, the changes they make to a “jing fang” formula are even more pronounced. Here is a taste of Dr. Zhang Guo-Yang’s work. I hope you find it helpful in your clinical practice!

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.

When I studied Chinese in Taiwan, I always recorded my classes into a little MP3 player. I found that usually I needed to listen to the recording about three times before I really heard and understood everything the teacher said.

All of Huang’s lectures in October were recorded for the same reason. There is always something that slips by in the moment of an intrusive car horn honk, or slamming hotel door, or moment of mental stutter as Chinese and English words play ping-pong with meaning across a frayed synapse.

So, the other day I caught this on the way to work

Huang: Cinnamon is the Chinese 阿斯匹林. It acts like aspirin to invigorate the blood, improve circulation and keep the heart healthy.

Simple. Effective.
And one of the few Chinese herbs that actually is tasty.

Six months of planning. Uncountable hours of preparation. Like cultivating a soil that will bring forth a burst of brilliance and flower, this has been my life this past year.The first international Classic Formula class in Nanjing with Dr Huang has wound its course. Nourishing as a long cooked soup, where flavors slip and blend into a more complex creation, the knowledge and skill of Huang, combined with the experience and inquiry of the practitioners who travel from a world away created two weeks of rich exchange that will be a benefit drunk by our patients. While it was my intentions and effort that built the frame, and strung the weft. And my ability to shuttle between languages helped to weave the tapestry that was to unfold, however as the vehicle I didn’t so often get to see or experience the collage of thread and connection that are the tapestry itself.This trip, however, has not been for me. It has been for the practitioners that entrusted their time and effort to this endeavor. It has been for Dr. Huang, to give him a chance to teach a western group of doctors. And it has been for the pursuit of taking the seeds of an ancient medicine that offers solutions to modern problems, and planting them in a foreign and ready soil..The success of this class lies not with one person. The ever dependable Andrea Elliott, with her excellent Chinese language, and more importantly cultural skills, and our master of arrangements Tracy Wang were responsible to hiding the complexity of structure that supported us in our two weeks with Dr. Huang.They get the credit for making this event run smoothly, in a country where things rarely run smoothly.….And then, there were the practitioners who came from America and Italy. Seasoned and thoughtful doctors who brought their thirst for knowledge and desire to be of service to their patients. They were the water and sunlight that gave Dr Huang the opportunity to share this ideas and experience in ways that will no doubt help all of us to serve our communities, and to further the development of Classic Formulas in our own lands!

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!