I am not sure which forum to place this in, so I’ll post it here.

Following case:

74 year male. Recently relocated to US from Japan to live with daughter. Stroke three years ago. Speech slightly impaired, trouble walking and 80% loss of use of left hand, with weak left leg. 

Complains of dizzyness, loss of balance, cold, constipation. Large dark macula on right leg and arm. Wrenching contraction on left side of neck primarily on ST, GB and SJ channels. Patient feels very cold with aversion to outdoors. Pulse deep and rapid. Tongue: deviated, thick yellow greasy coat. 

Patient was placed on Chai Hu Long Gu Mu Li San in Japan.

After first acupuncture/moxa treatment patient felt warm and pulse was not full, bounding, but without force. Pain and tightening was 60% less. BM normal.

After second treatment, pain was reduced another 80%, however pulling continued and patient felt more cold. Dark macules about 80% gone on arms, about 45% less on legs. Pulses were again deep. BM normal -- large evacuation, well formed.

I would like to do herbs with them and I was thinking about a Chuan Wu Tang type formula, but would like help with a SHL, JG approach. Please advise.

Thanks

David

In the clinic, after resolving constipation I am getting people with sluggish (every other day) bowel movements. I am assuming that the pattern is moving from Yang Ming excess closing to an excess Jue Yin closing pattern. Would this indicate a Ma Zi Ren Wan (YM+JY) formula or something more strongly Jue Yin related?

I suppose implied in the question is does the "pumping" action of the Jue Yin PC include a direct action on the LI and peristalsis?  

Thanks in advance.

David 

In the contex of the six confirmations, what is the meaning of transformation?

What is the meaning of, to transform from the middle or to transform from the root?

"Yang ming & Jue Yin do not transform from the root or manifestation, but from their middle."

Huangdi Neijing Suwen Chapter 74.

Jue Yin middle or Zhong Chi is Shao Yang Fire. This I can understand. That Liver & Pericardium manifest as Gall Bladder & Tripple Heater.

But Yang Ming middle or Zhong Chi is Tai Yin Dampness. 

How is Yang Ming fever or constipation the manifestation of damp?

 Phil Baxter. Byron Bay Australia

Arnaud,

More questions about SHL patterns...

1.  Gui zhi jia ge gen tang and Ge gen tang.. are these both deficient closing formulas?

2.  Gan cao xie xin tang... do you add Ren shen or leave it out?  How come it's not in the SHL (Song dynasty version), but in the Jin gui yao lue?

3.  For Yang ming + Shao yin and Yang ming + Jue yin conformations, you said there is no direct transformation from the Yang ming into those... it goes into Tai yin first or through Shao yang into the other conformations.. is that correct?  If so, then the combinational pattern formulas: Da huang fu zi tang, Fu zi xie xin tang (YM + Shao yin) and Ma zi ren wan (YM + JY).. how do those fit in?  

4.  Zhu ling tang (lines 223, 224) are placed under Yang Ming in the Mitchell/Ye/Wiseman version.  Why do they categorize it under Yang ming and you put in in the Shao yin heat transformation pattern?   Is it also a Yang Ming conformation formula?

5.  Is Yin chen hao tang a Yang ming channel or bowel pattern?  Yin chen, Zhi zi, Da huang 

Thanks for the clarification. 

Arnaud,

I have many questions.  Thanks in advance for answering them.

1.  How come Ma huang jia zhu tang and Bai hu jia gui zhi tang were not placed in the Shang han lun and instead were edited into the Jin gui yao lue?

2.  Also, Gui zhi jia da huang tang is categorized in Mitchell/Ye/Wiseman in the Tai yin abdominal pain category..
I can see why it is a Tai yang/ Yang ming formula w/ Da huang, but why did they put it in the Tai yin category?

3.  Where would the Qing long tang formulas be categorized in the Tai yang conformations...  Da qing long tang = TY + YM?
Xiao qing long tang = TY + Xi xin (Shao yin) or Gan jiang (Tai yin) ?

4.  What about the Zhi zi heat formulas (which conformation description)

5.  Which conformation does long gu and mu li belong with, as in Gui zhi gan cao long gu mu li tang?

6.  There are chest bind and storehouse bind patterns, why are these related with Tai yang?

7.  Is Xiao jian zhong tang a combinational Tai yang with Tai yin pattern?
8.  Is Da xian xiong wan/tang a combinational Tai yang with Yang ming pattern?  Why are these in the Tai yang layer?
9.  Xiao xian xiong tang has huang lian, ban xia and gua lou in it...  Which pattern does this fit into?  Why Tai yang?

Thanks,

Kokko