This is an interesting point your bring up, that sometimes treats that look like they should work, just don’t. Or, something odd is what does work. I look forward to getting more of this material into English, so we can look and see if there is some kind of constitutional aspect that might be playing a role here.

This case you mention, where you used the Bai Hu Tang, makes sense, especially if the person is a shi gao constitution. the kind of sweating you mention certainly makes me think they might be.

Just briefly — I have a patient who was suffering from severe “stomach duct pain” with no observable cause (no GB or pancreas involvement, and no signs of gastritis). She had been diagnosed as GB / ST disharmony d/t the symptoms and a thin wiry pulse. She was prescribed Xiao Chai Hu Tang and Si Ni San combined but with little effect. I initially tried using this same approach adding blood breaking and qi rectifying herbs, but with similiarly little effect – the sharp severe fixed pain continued to come back.

So I had to take a few steps back and look at her as a whole person. She’s strong / robust physically. When she has symptoms of illness, they tend to affect her digestion – diarrhea mainly – and she always has lots of belching. Indeed, her entire family loooooves to eat, and belch. In addition, she sweats profusely, but mostly along her Stomach channel on her legs. Her tongue is sl. red, with a thin yellow coat, and when she is in pain, her pulse slows and tightens considerably, to about 50 BPM.

The next episode of pain occured, and this time she had pronounced glomus and smelly diarrhea, again with a very slow pulse. This made it more clear. I prescribed Da Cheng Qi Tang – the glomus and diarrhea were gone within a day, but just below her ribcage was still very uncomfortable. I prescribed Bai Hu Tang for one week, and all symptoms disappeared, including the slow tight pulse. It’s been a few months, and the pain has not recurred.

I remember reading a line in the SHL equating a certain kind of slow pulse with a heat bind pattern. But mostly, I think of her as a yangming type of person.

My son is the same way – physically robust, loves food and eating, reacts strongly to food in general, has the tightened corners of the mouth that Dan Bensky describes in yangming types, and his problems respond to formulas that clear yangming excess.

david