For Andrew: I was having trouble with the chat last night and wasn't able to ask a couple of questions. 1) Chai Hu: in the first paragraph under primary uses it refers to treating liver depression - I don't remember discussing this pattern in class - would this be the same as liver qi stagnation? 2) Chai Hu is a shao yang formula - with shao yang diseases, do they always start out with an infectious disease? We talked about malaria and Lyme but are there other EPFs that can cause shao yang that are not infectious diseases? 3) I find that my asthma patients (cats usually) struggle much more with the exhalation and lower airway disease. So this doesn't really fit with kidneys not grasping the qi and therefore use of Bu Gu Zhi. Is there a pattern that would go along with wheezing on exhalation? Maybe this is more superficial and just related to lung and not kidney? Thank you Dana

Andrew said: 1. Liver-based depression is not specifically a TCM pattern. This is a differentiation of depression that David uses from an integrative herbal medicine perspective. You will have a class on that in the future- stay tuned. 2. Chai hu is one herb used in shao yang stage disorder. Xiao Chai Hu Tang is one example of a formula used in that stage. There are others. Shaoyang stage is from the Shang han lun (Theory of cold damage). In this theory there are six stages of how wind-cold enters the body and causes disease. It occurs with any disease where there is a wind-cold EPF that does not resolve in the initial days-week (called the Taiyang stage). The wind-cold is strong and the defenses are not sufficient, so the wind-cold sinks deeper into the body and Shaoyang stage symptoms arise. At this point the disease is chronic. Examples can be things like Lyme or chronic viral infections but we cannot limit it to western pathomechanism. Please read this article for more info: http://www.shen-nong.com/eng/exam/diagnosis_sixmeridians.html Syndrome differentiation according to the six meridians Based on the distribution of the three yang meridians and the three yin meridians, symptoms and signs of exogenous diseases are classified into six stages that correspond to one of these particular meridians. The three yang meridians are located on the exterior parts of the body and as a disease or evil progresses the disease's symptoms will progress along the more interior yin meridians. The more interior the disease has progressed the more severe the illness and damage to the organs. www.shen-nong.com 3. Correct, if exhalation is the issue we tend to think of lung patterns first. I may also consider liver patterns, for example in a case where there is a muscular or emotional component causing diaphragmatic constriction. If it is very chronic, and/or degenerative, and/or inhalation type we then add kidney to the diagnosis.