We know from the texture of our lives that the Chinese yin/yang theory of opposites attracting and mutually transforming into one another is one of the ways that life grows, unfolds, and transforms. It is somehow comforting to know that moments of despair will in time tranform, and that present frustrations can be the inspiration to questions that lead us to wider view of the world.

But, on a less grand scale, opposites as they are currently constellated can give us deeper insight and understanding into the present situation. Anyone who has studied even a little of the six warp of the Shang Han Lun will easily recognize the da huang presentation of excessive heat that burns the tongue coating into a dry yellow-black, turns the stool into a dry compacted mass, and causes thirst as a rescue signal to replace the fluids that are pouring out as sweat.

Ever stop to think about what is the opposite of this kind of presentation?

It is the presentation for gan jiang! Check it out:

• Vomiting of saliva or phlegm fluid. Clear, thin and odorless stool and urine.

• Abdominal distention and pain, nausea and vomiting, or coughing.

• The mouth is moist and there is a lack of thirst, aversion to cold with a desire for warmth, listless and dispirited.

• Pale or pale red tongue, with a greasy coating; the coating is usually white and greasy, grey-black and greasy, or white and glossy. (This is the ginger tongue)

Notice here that both the da huang and gan jiang presentation include signs of abdominal distention and pain. As is so often the case with Chinese medicine, we can not even begin to consider what herbs to use from a single symptom, the entire gestalt must be considered.

While these two herbs lives pages and pages away from each other in the materia medica, in practice patients with signs of the cinnamon twig and astragulas presentations are often puzzlingly similar.

Both have signs of spontaneous sweating, both have moist skin, and an aversion to wind will dog both types. Likewise, there often are complaints about the limbs with both constitutions.

How to tell them apart?

First, look to the abdomen. Those with a gui zhi constitution will tend to have flat, tight abdomens, while the huang qi clan has a soft belly that can be deeply palpated without discomfort. Both can have pale tongues, but the gui zhi tongue tends to be red and pale, or dark red; while the huang qi tongue is pale or dull and pale, it also tends to be flabby.

Both of these types sweat easily, but sometimes the sweat of the astragalus body type will have a yellowish color. They both dislike wind and are quite effected it. If you ask a patient if they are sensitive to drafts, and they don’t really understand the question, they likely are NOT one of these body types.

While both might complain of limb discomfort, the character of that discomfort is quite different. The cinnamon twig people tend to have joint pain, while our astragalus friends have more of a sensation of heaviness or numbness.

When faced with similarities in constitutional type, it helps to know the key aspects that lead you to see the distinctive differences!

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We learn about in our Chinese medicine textbooks, a certain kind of insubstantial mix of phlegm and qi that collects in the throat... 咽喉異物感Plum Pit Qi.

It is a pretty little diagnosis. Sounds very….Asian…Sounds very beautiful, and somehow exotic, but I have yet to have have a patient Western, or Asian, walk into my clinic and say “I have plum pit qi.”

Dr Huang talks about this particular condition as a subjective feeling on the part on the patient where there is some kind of odd sensation involving the throat. It could be that there is a feeling that something is stuck in the throat, something that can neither be swallowed or coughed out. It could be a bit of phlegm, or an irritation or tickle that constantly has someone clearing their throat.

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Or, it could be some kind of issue that causes problems with speaking, or leaves people with a feeling of chest stuffiness, that the breathing is somehow off, or the words that one seeks to speak come out not quite right, or that somehow something is causing the functions that run through the throat to not quite work so smoothly.

This kind of presentation could have its roots in either an emotional issue, or some physiological process that has gone astray. It really does not matter the origin, what matters is the patient has arrived at this juncture in their state of health, and there are formulas that treat it, and treat it well.

As practitioners, it is our job to figure this stuff out, to take what our patients say, express, or leave out, and see if matches what we know about the particular uses of an herb or formula. Ban xia hou po tang, is the formula that is famous for treating “plum pit qi.” But, if we can begin to see under the iceberg of “an odd feeling in the throat”, we can begin to see a whole constellation of patterns and situations where this formula may be of benefit.

And it helps if you understand something about Ban Xia Constitution, which was talked about here.

Jade Windscreen is for building the immune systems in those who easily get colds.

I’m one of those people.I’ve easily gotten colds my entire life.I wish it were not so.I remember reading about Jade Windscreen and thinking my troubles were over. But, after taking it for a week or so, I woke one winter night in a panic thinking the house was on fire.It was not, but I had this odd smell of burning paper in my nose. Which followed me around for a few days until I stopped the Jade Windscreen.Let’s look at this from the point of view of constitution. The main herb in Jade Windscreen is Huang Qi. And the body type associated with Huang Qi tends to be a bit on the heavy side, and what in the usual Chinese medicine lingo we would say is damp, with a bit of a fluid metabolism problem. The Bai Zhu in that formulas also is one of the main herbs that Zhang Zhong-Jing used to correct water metabolism problems. The Fang Feng? While it does release the exterior, it also can be a bit drying as it promotes the expulsion of water via the sweat.For a guy like me that tends toward dryness it is little wonder this stuff kindled an internal fire!

Consider that different body types have affinities for different herbs, and need to be regulated in different ways.

Someone who does not tend toward dampness, likely will have trouble with drying formulas like Jade Windscreen. Perhaps you have noticed in your clinical work that some textbook seemingly easy to apply formulas are terrifically ineffective.Huang suggests if you have a Cinnamon Twig person who frequently gets colds in front of you, see how they do on Gui Zhi Tang. Likewise, if they are a Bupleurum type consider Xiao Chai Hu Tang. There may also be opportunities to combine Jade Windscreen with these more constitutional formulas as well. As always, by the presentation, chose the herbs!

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.

I am beginning to understand this.That there are constitutional types who respond well to particular herbs.

As Dr Huang outlines in The Ten Major Formula Families there are a number of different families of which we tend to be a part. Those of the Ban Xia family are a most interesting part of the family tree.Ban xia types, unlike my original concept of a person phlegmy and dull with fatigue, according to Huang these people are lively, vivacious and extremely emotional. They have big, expressive eyes that spark like those of a movie star. Their presence is felt when they enter a room. They tend to be rather photogenic too.And they are sensitive. Very sensitive. Often, they are artists. They make good actors, performers and speakers. They are that kinds of people that are very involved with their own emotions. These are the people that have odd symptoms for which no amount of blood work, CAT scans or X-rays will show a cause. They often experience problems with the throat, and easily get worked up into insomnia.There are some kinds of phlegm that are not substantial. For these people the ban xia based formulas are a tremendous benefit.

You can find it here.

In addition to the nice little quiz format of the study guide, she has collected quite a few of the articles in English that touch on Huang Huang’s work. Some good reading there.

Who knows why some computers just will not talk to each other. A few of you who are going on the Nanjing trip have had trouble with certain .pdf files going through the email.

Here they are:

Chinese Visa Application Form

Simple Guide to Studying Medicine in China