Daniel: December 31, 2019, 3:47pm
A patient I have been seeing for a couple of months who has responded exceptionally well to Sa’Am treatments for
a number of very longstanding issues – including psoriasis on her scalp, anxiety around a number of issues, upper
back rash, sleep – so much so her husband recently noted with joy that he had his ‘wife back’ . . . . came in after ten
days with a bad chest cold that was lingering . . . she basically had chest congestion – you could hear it when she
spoke and when she breathed. So I just adopted a kind of acute-first aid Sa’Am posture and figured she needed
‘drying out on the inside’ and I gave her a Stomach supplementation treatment. . . . after some time, I could hear
outside in the main office through the treatment room door, her cough had become drier quite dramatically but had
actually worsened in terms of frequency and intensity of coughing – by then, it was ‘too late’ to switch it up so I
just continued but I felt bad that perhaps I had worsened the situation. She came in ten days later – still with the
cough – this time it actually sounded even moister, more phlegmy and in full assessment of the presentation, I
somehow decided to do another Stomach supplementation treatment (don’t ask!) . . . by this time, I stayed with her
– sure enough, within minutes, she developed an intense barky very dry cough . . . I immediately took the needles
out and replaced the treatment with a Lung supplementation (by the way – interestingly – on palpation, BOTH Lung
and Stomach channels were hyper-aesthetic) . . . within minutes, the cough stopped and she sunk into a relaxed
state. For the next twenty minutes, not a single cough . . . . morals of the story . . . (1) pay attention . . . (2) don’t
assume phlegmy cough needs ‘drying out’ . . . on the contrary . . . as we know, the Lungs like moisture . . . .
KristinWisgirda: December 31, 2019, 4:04pm
There is nothing better than experience to help us learn. Symptoms in real time are the best teachers.
Cough is another one of those symptoms where any channel is potentially game.
Wheezing without any phlegm is tricky too.
George_Mandler: January 2, 2020, 2:19pm
Good case Daniel. What did Dr Yu Gou-Jun say “famous doctors don’t treat cough”.?
In your case it is phlegm in the lungs – but so often it is from post nasal drip. I think post nasal can sometime fall
exterior and sometime interior.
Your case along with Kristin’s personal experience with LI+ post really demonstrates the dynamic nuances we
need to key in for the LI/SP LU/ST balancing.
erin: January 18, 2023, 11:35pm
29/01/2024, 11:31Cough / Congestion – Dry or Damp – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/cough-congestion-dry-or-damp/810/print2/3
I was just going to post about this very topic so thought I would add my ideas and questions here. I am a bit
confused with dry vs damp in a situation like this. When there is phlegm in the lungs – it is tempting to assume
damp but I feel like dryness can also cause phlegm. (or a lack of physiological fluids) It seems like we really need
to nuance it – thick phlegm vs watery, easy to expectorate vs difficult, better with fluids…
And then if there are other symptoms like sore throat, headache, etc, how much weight to we give the other
symptoms?
I have seen a lot of CC’s lately, as well as people who want to “boost their immune system”. I know that we always
treat what is there, but is there a way to strengthen someone who doesn’t present with a lot of other symptoms?
(other than their whole family has a cold)
I find the psoriasis to be interesting as well – patches of dryness on the exterior. Should we always moisten the
exterior? I am wondering how we can nuance this further? What questions can we ask to tease out the right
treatment approach. (itch, redness, b/w, w/w …) And what do these answers tell us for sure?
Daniel: January 19, 2023, 3:04am
I have found the inside/outside damp/dry parsing to be one of the most challenging in this system. I have certainly
had ‘phlegm in lung’ cases where internal drying is the right thing and other cases where internal moistening is the
right thing. These are almost always cases that really require looking at the whole case in a very meta way . . . and
also being ‘creative’ in each case as to what is ‘internal’ versus ‘external’ . . . I have had several cases where it was
clear that considering the entire GI tract from mouth to anus as ‘External’ was the right perspective. The one piece
that seems to me based on my experience to be most reliable in this moist/dry internal/external parsing for me is
body morphology and flesh distribution in the belly versus in the legs and arms. When I am all confused by phlegm
and where it is located, dry eyes, sweat, etc etc . . . I step way back and look at them and ask myself . . . . ‘am I
looking at a LI excess body? A ST Excess body? A Lu Excess body?’ . . . and the answer to that question very very
often (not always but very often) points me in the right direction.
George_Mandler: January 22, 2023, 3:21pm
Hi Erin – thank you for reviving the thread.
I concur with Daniel’s right on response and also experience the dry/wet dynamic to be a tricky one. It is easy
when body morphology presents clearly. Overweight with dry skin, nice thenar then ST+ supplementation is a
confident choice. Or the thin moist skin to supplement LU+.
But these mixed cases, which are most,can be confusing.
erin:
When there is phlegm in the lungs – it is tempting to assume damp but I feel like dryness can also cause
phlegm. (or a lack of physiological fluids) It seems like we really need to nuance it – thick phlegm vs watery,29/01/2024, 11:31Cough / Congestion – Dry or Damp – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/cough-congestion-dry-or-damp/810/print3/3
easy to expectorate vs difficult, better with fluids…
If there is a mixture of both ST/LU I would look somewhere else to see if there is a bigger delta between channels.
If not take a step back to take your patient ‘in’. As an example perhaps if someone had more energy, stronger I
would consider ST+ in this case vs someone that is weaker and perhaphs has trouble getting a breath in, then I
would consider LU+ supplementation.
erin:
And then if there are other symptoms like sore throat,
If acute sore throat like “I am getting sick” supplementing BL+ works very cool.
If sore throat from say post nasal then same process as above.
erin:
I find the psoriasis to be interesting as well – patches of dryness on the exterior. Should we always moisten the
exterior? I am wondering how we can nuance this further?
For say psoriasis on a thin person don’t forget other moistening – such as supplement BL+ and see if it fits. You
could also consider a SP+ supplementation if not red but dry scaly. As Daniels said look at it all. Take a step back
and consider all the channels and see if you land on one.
I have an overweight Sjogren’s patient with normal skin, her thenars are not strong one way or the other, resources
are OK. She seems to have good response with both ST+ for glomus issues and LU+ for dry mouth. I see this that
both channels are low and need to be brought up.
erin:
I have seen a lot of CC’s lately, as well as people who want to “boost their immune system”
There are lots of funny terms out there. If someone has allergies or autoimmune disease their immune system is
working too much. It has PTSD. I always correct my patients to say “we want to regulate their immune system”.
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