Oct 24 2009
Why differentiate constitution?
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I will be taking a group to Nanjing next month to study with Dr. Huang. To prepare and brush up my Chinese I’m going over his lecture notes. They are a treasure trove of clinical common sense and revelation. They also help to illuminate why the Gui Zhi Fu Ling Wan I gave to patient with blood stagnation in the lower burner had such an unexpectedly bad reaction. Right disease, wrong constitution.
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Here is a little snippet from his notes on the importance of differentiating constitution:
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There is a correlation between treatment efficacy and differences in constitution. The same herbs that are used to treat the same illness in those with differing constitutions will have differing therapeutic effects. Moreover, some prescriptions will merely be useless, while others will cause severe and harmful reactions. Xu Lingtai refers to this phenomenon as “differing kinds of people with the same disease” (病同人異 bìng töng rén yì). To insure the effective use and safety of medicinals the Jing Fang current places special emphasis on the differences between people, by paying attention to and taking into consideration the differences between constitutional types.
It is never as simple as Formula A= Illness B. We must also consider the terrain of our patients.
One response so far
This article reminds me of a concept that Jeremy Ross taught when he brought out his book on combining western herbs and chinese medicine. He had a demonstration where he had the class taste a particular herb and ask if it was cold or hot. Some said cold, some said hot. I don’t remember his references in classical medicine, but he said that it wasn’t new that a particular herb would be hot for some and cold for others, depending on their constitution and/or what they needed.