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boaz
Posted on Tuesday, February 10, 2004 - 22:40:   

Hi Shmuel,
One of the most seen complaints ( especialy in Israel) is tension and anxiety. I am having difficulty with this complaint. What I see most often is a liv(stag.)/ht(fire) disharmony with a defeciancy in the background , or extreme excess, usually fire.
When I try and treat these cases it is like opening the pandora box, you don't know whats gonna come out.(Especially when liv depressed Qi is involved).
I've treated migraines where during treatment severe tiredness appeared, or palpitations, mood swings etc. Usually once these symptoms arrive I try to treat them, but then I feel I am on a thin rope between tonifying and calming. Calming the patient is not that easy. Most patients I feel relay on their inner tension to get them through the day instead of their correct Qi.
Another problem , is that once I calm these tense patients, the tension reappears the next day or week, since it is deep situated in their life, work, family, philosophy, religion, etc.
Can we change all that ? Or just giving relief is the best we can do ? How can we predict what "garbage" will apear once we calm them - open stagnate energies.

boaz
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Shmuel Halevi
Posted on Wednesday, February 11, 2004 - 13:51:   


quote:

One of the most seen complaints ( especialy in Israel) is tension and anxiety. I am having difficulty with this complaint. What I see most often is a liv(stag.)/ht(fire) disharmony with a defeciancy in the background , or extreme excess, usually fire.



In the contrary. Anxiety syndrome and depression usually respond extremely well to acupuncture, you only need to devise your basic strategy and technique in order to deal with these disorders. The clinical success rate for these disorder are without comparison higher than those of modern medicine.
There are also other patterns, as rife as the one that you mention. For instance With K Yin Xu or Sp Qi Xu and even Liv Yang Xu (yes, Yang).

quote:

Another problem , is that once I calm these tense patients, the tension reappears the next day or week, since it is deep situated in their life, work, family, philosophy, religion, etc.
Can we change all that ? Or just giving relief is the best we can do ? How can we predict what "garbage" will apear once we calm them - open stagnate energies.



We, in TCM, usually treat psychological problems through their physical manifestations, as you well know. In many instances, especially when the disorder is new, there is a quick cure or amelioration. People who are anxious, frightened or apprehensive usually feel dizziness, palpitations, chest oppression, insomnia, dry mouth or many other symptoms. Treating the problem on the physical level, usually ameliorates these symptoms very quickly. When this happens and the patient starts feeling better in this sense, they regain their confidence and optimism and their trust in the Ch.dr. This is already a half cure. Now, if you involve other modalities, such as breathing excercise, dietary changes, herbs etc., you involve their participation in the recovery process and this enhances their chances two-fold. In any event, you are not a psychologist and you need not invove yourself with the "garbage" they have collected. If you see that they are full of this kind of stuff, don't hesitate to involve a psycho-therapist in the process. There is no shame in this. If their physical condition will get better, a fact which is almost guaranteed, the task of the psychologist will be much easier.
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boaz
Posted on Thursday, February 12, 2004 - 08:18:   

what is liv yang xu, I never hear this ?
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boaz
Posted on Thursday, February 12, 2004 - 14:04:   

What I was asking to be clearer, - when I treat patients with liv. dep.heat for example, similar to weekend headache, when tension they relay on so much is released there are sudden symptoms that apear. Usually I feel this is because the releasing of Qi. Should the dispersing method continue? is this part of the healing process, or should I address avery outcome seperatly, or is my diagnosis mistaken and and this is an adverse reaction ?
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Shmuel Halevi
Posted on Friday, February 13, 2004 - 14:02:   

Liv Yang Xu is, evidently, less seen in practice than the opposite condition of liver Yang exuberance. Here is a quote from an essay concerning this pattern:

quote:

Liver qi and yang deficiency
Theoretically, yin and yang exist in every single entity. Every zang and fu exhibits both yin and yang aspects and may exhibit either excess or deficiency states. Deficiency
can manifest within any of the four vital aspects: yin, yang, qi or blood, however within the context of a specific zangfu medical custom may focus more on one aspect than others.
In Chinese medicine, Liver qi stagnation has become the leading pattern of Liver pathology. This does not mean that its seemingly opposite condition, Liver qi and yang defi-ciency,
cannot simultaneously exist. In fact, it can.
Starting with the early medical classics, Chinese medicine recognised the existence of this pattern. 2,000 years ago, in The Yellow Emperor’s Classic of Medicine (Huangdi neijing),
it was stated right in the first chapter “when a man is at the age of seven by eight (56 years old), his Liver qi becomes weak, and his tendons are not able to move.”3 The classic
then further explained: “When a man is around the age of fifty, his Liver qi begins to decline. The physical Liver becomes thinner. Bile secretion is reduced and vision de-creases.”
4 In the chapter on dream analysis, moreover, the
classic advises: “With Liver qi deficiency one will dream of trees and grasses or of sleeping under a tree.”5 In another place, the text warns that “Liver qi deficiency will cause a person to become frightened.”6 Following these theories set out in the Yellow Emperor’s Classic, many scholar physicians of different eras discussed
Liver qi and yang deficiency. Chao Yuanfang (570–632), for instance, summarised the clinical signs and symptoms of Liver qi and yang deficiency in his influential compendium,
General Treatise on the Causes and Symptoms of Diseases (Zhubing yuanhou lun): “If the Liver qi is deficient, one may suffer from blurred vision, contraction of the tendons, tightness under the ribcage, shortness of breath, ridged and thin nails, green complexion, and a tendency to be sad and scared.” 7 Furthermore, he described the sensation of Liver qi deficiency as the feeling of “a refugee being chased
around.”8 To remedy this situation, he concludes, the Liver qi must be tonified.9
The Ming Dynasty’s most famous medical scholar, Zhang Jingyue (1563–1640), also associated tendon problems with Liver yang deficiency. He proposed that if “one has spasms, convulsion, pain, or numbness, this is due to Liver yang
deficiency failing to nourish the tendons.”10
Later, the Liver disease expert Wang Xugao (1798–1862) developed thirteen specific treatments for Liver disease. These included protocols for tonifying Liver qi and warm-ing Liver yang.11
It was in almost contemporary times that this problem was adequately summarised by one of the last masters of classical Chinese medicine. Zhang Xichun (1860–1933), in his influential book Chinese at Heart But Western Where
Appropriate: Essays Investigating an Integrated Form of Medicine (Yixue zhongzhong canxi lu), revealed anecdotes about his own clinical experience. “Since I started my practice, I have encountered many cases with Liver qi deficiency and subsequent failure of Liver qi to drain and
course. To rectify these problems, I have used many herbs to tonify the Liver yin and blood but with little effect. I decided to add Huang Qi (Radix Astragali) in large doses to tonify Liver qi, and the therapeutic results were immedi-ately
observed. The opinion that the Liver has no qi defi-ciency is not true.”


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Shmuel Halevi
Posted on Friday, February 13, 2004 - 14:13:   


quote:

What I was asking to be clearer, - when I treat patients with liv. dep.heat for example, similar to weekend headache, when tension they relay on so much is released there are sudden symptoms that apear. Usually I feel this is because the releasing of Qi. Should the dispersing method continue? is this part of the healing process, or should I address avery outcome seperatly, or is my diagnosis mistaken and and this is an adverse reaction ?



All these options are possible. It takes time and experience to tell which is which. Follow your instincts and try to understand by reading the pulse what changes occur. If you see that the pulse gets better but your patient seems to have new symptoms, it is usually O.K. and it means that the symptoms nay be the outcome of the changes that your patient undergo. But, if you have new symptoms and the pulse doesn't change for the better or even gets worse, this usually means that you are mistaken in your approach. In principle, good treatment usually alleviates the symptoms. If there is worsening, this should be only during the next 24 hrs. After that it should get better. Make sure you see your patient often enough so that you can keep a monitor on his developing condition.

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