Daniel: August 30, 2019, 6:09pm
So, this morning I had a guy in – he installs industrial ventilation systems (like standing on ladders with his arms up
in very difficult spaces all day every day for 30 years now) and he is here for really bad right sided Yang Ming
shoulder pain and restriction (has also had Acromioclavicular joint surgery on the right AND surgery between the
anatomical snuffbox (LI 5) and thenar eminence on the right (talk about trauma to the Hand Yang Ming and Tai
Yin!!). Anyway . . . asking him various questions . . . .we get to the subject of weather and seasons . . . “I hate the
winter”, “I hate white”, “I hate the snow”, “I just HATE winter”. Now most of us would just assume he clearly has
a strong aversion to the cold (and maybe the damp), write that down and move on!! BUT NO! Its not about the
cold. He likes the cold. Its about how winter really LIMITS and CONSTRAINS him because of all the extra
clothing, shovelling to get the car out, can’t go in the woods easily – he HATES winter because it is limiting!! This
guy has three small businesses, is go go go go go all the time, hunts for all his meat, never stops. He’s all Large
Intestine – EVEN his issue with Winter – it’s NOT an aversion to cold – it is a Large Intestine Issue. The parsing we
have to do! (I supplemented Spleen on the Left and he fell into a DEEP state of relaxation)
adambroder: August 30, 2019, 7:44pm
What is it about LI and constraint that led you to make that connection? I would think more SI personally, since Tai
Yang is the most outward expanding of the 6 conformations, if we’re just focusing on this one idea.
Daniel #3August 31, 2019, 12:20am
As I understand Sa’am, the Spleen – Large Intestine counterbalance pair is exemplified by the laziness/bored –
industrious/never bored axis. This guy is entirely the industrious, never bored extreme. He has a full time job
installing industrial ventilation systems, he has a family bee-honey business, they have a family maple syrup
business in the Spring, they run rental properties, he hunts for all the meat his family eats and raise all their
vegetables, etc etc etc. This is Large Intestine in spades. What he hates about winter is that – where we live (LOTS
OF SNOW), his industriousness is constrained and limited by all the work it takes to be mobile in winter . . . the
clothes, coats, boots, shoveling snow, clearing snow to walk, to drive, the inaccessibility of much of the land due to
deep snow, frequent storms that shut down the whole place and make everyone home-bound for a day or two – he
experiences winter as a severe limitation on his daily industriousness. And it’s truly such a stellar example of being
very careful with reported symptoms like “I hate winter” and being sure to plumb a little deeper into the dynamic at
play.
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michaelmax: August 31, 2019, 6:52pm
Spot on @Daniel! There is some real nuance here, multiple levels we could tune into.
I also suspect that your years of practice has already shown you that the first idea that “fits the theory” might be too
much of a simplification to be helpful. I suspect we’ve all had those experiences of “well, they said they don’t like
the cold” when in fact it was WINTER and the constraints that he did not like.
The five phases can be misapplied very easily, but when used with skill and discernment… oh boy… does a fuller
picture open up.
Thanks for your astute discernment here and sharing this with us.
KristinWisgirda: September 4, 2019, 4:09pm
Thanks for presenting this case Daniel. It got me musing on the motivations for working so hard with such
diversified projects: St excess lack of resources or LI excess industriousness.
The LI excess has a hard time accessing and accepting the sweet, warm comfort of Spleen. They seem to be never
satisfied.
St excess perceives a lack of resources. I know many people who fret about money even though they have plenty.
Or folks who compulsively bulk shop to ease their anxiety about not enough.
Certainly patients can present with both.
Tobydaly1: September 5, 2019, 8:23pm
“Is not dread of thirst when your well is full, the thirst that is unquenchable?”
Khalil Gibran
KristinWisgirda: September 5, 2019, 8:26pm
Is that internal or external dryness?
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It’s more of a diagonal inner/outer thing
Daniel: September 6, 2019, 11:44am
That’s a great substantial reminder Kristin to never let up in this business – in the business of the inquiry.
Admittedly, I was so ‘impressed’ I had critically broken through the strong default tendency to rush to ‘aversion to
cold’ upon hearing of the vehemence of his dislike of winter – that my critical faculties promptly got ‘lazy’ in
regards to the ensuing importance to parse out a possible Large Intestine – Stomach discernment. I’d have to plumb
deeper with him to make that distinction – as its not so clear. On the one hand, he does not strike me as the ‘fret
about money’, ‘bulk shopping’ kind of person. He does seem to tilt towards ‘industrious’ BUT on the other hand,
he did report they hunt and get several deer in the freezer every year so their ‘meat needs’ are taken care of . . and
he also reported accumulating enough resources to be able to retire soon. So yes, there is a motivation to
accumulate and put away resources. Interesting!!!
lauramcgraw: September 6, 2019, 4:21pm
Thanks for this case!
Storing away the bounty of the earth!!
KristinWisgirda: September 6, 2019, 7:32pm
The other explanation for those who are industrious is that they are Kidney excess. They can be extremely
productive because they are not as easily worn out- so why not!
So fun to think about the possibilities. I love these cases. Thanks!
Daniel: September 6, 2019, 9:32pm
Ha! We could probably find a reason for every channel in Excess to manifest as ‘industriousness’!! SanJiao Excess
. . . industriousness because they are obsessively compelled to organise and straighten up everything that is out of
place, perpetually! etc etc. As I often say about Chinese Medicine . . . .’ anything can be anything’!! Corollary:
Clinic is Hard!
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michaelmax: September 6, 2019, 9:37pm
Lately I’ve had this image/feeling that being in clinic is like being at large and NOISY party. You get snippets of
conversation over the din. Sometimes you can have a conversation, but you have to listen really hard. And then
someone else shouts and you hear that instead.
That’s what being in clinic is like.
It requires being able to pull the signal from noise and there’s lots of noise. Different “people” (channels) saying
different things, that sound similar, but they actually have very different story lines.
Please remind me why I did not go into something easier like trading oil futures, or building rocket ships.
lauramcgraw: September 7, 2019, 12:41am
Michael Max I thought you were already doing those things in your spare time!
michaelmax #15September 7, 2019, 1:38am
ha ha ha… funny. Oil futures sounds risky, but the rocket ships… not a bad idea.
Daniel: September 7, 2019, 1:14pm
Yes – as I like to say – and its tremendously humbling – when you enter the treatment room – there are 10,000 things
going on – and you may be able to sense 20 or 30 or 40 of them at best! Good luck with that!! BUT – that is
precisely why working at the more ‘integrative’ level of archetypes is so potentially powerful . . . . Chinese
Medical notions of Wood, Water, Fire, Tai Yin, Shao Yang, Damp, Dry, etc etc are highly embracing and ultimately
much more potentially informative than ‘wrist pain’ or ‘acid reflux’. If we can really get and observe ‘Wood’ or
‘Yang Ming’ in clinic – we are working at a much higher level of integration on the ‘ladder’ between the 10,000
things and the Dao and so we are able to attend to our patients in a profoundly more integrative way. If we
successfully identify and observe the dynamics and manifestations of Yang Ming or Metal and attend to them as
needed, we are doing SO MUCH more than addressing ‘wrist pain’! Of course, its tremendously challenging to
cultivate that capacity – but we are so lucky to practice a medicine that offers us such a powerful way to ‘organise
the noise in the party’.
Jeffrey: September 7, 2019, 4:14pm
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KristinWisgirda:
St excess perceives a lack of resources. I know many people who fret about money even though they have
plenty. Or folks who compulsively bulk shop to ease their anxiety about not enough.
Certainly patients can present with both.
This is a great distinction,very useful/helpful…STxs with “perception” of lack, (rather than a real lack), vs. LIxs
industriousness. Interesting how that quality can get confused. Sometimes these aha moments are the closest to
home. Also I like the bit about Kxs being enduring/ industrious. Thanks yall for scratching below the surface and
adding to the paradigm.
KristinWisgirda: September 7, 2019, 9:16pm
Jeffrey:
STxs with “perception” of lack, (rather than a real lack),
What a patient believes of themselves manifests in the channels.
Jeffrey: September 8, 2019, 12:45am
Even better! Thanks.