Earth/metal applications

amyjenner: April 26, 2019, 2:44pm
I’m confused about when earth and metal are applicable. If someone happens to be obese or super thin, are these
points considered relative to their moving to appropriate weight or is it that balancing the constitution can be
helpful no matter the main complaint? I guess I’m not totally clear on when, having identified one of these
earth/metal body types, I would give an earth/metal treatment? Am I treating the body type or am I treating all
other complaints via the body type?

KristinWisgirda: April 24, 2019, 1:44pm
The damp/dry dynamics of Earth and Metal can impact a wide variety of complaints. Taking one of the intro
classes on offer will help you begin to understand how to consider these in diagnosis and treatment.

michaelmax: April 24, 2019, 2:25pm
Hi @amyjenner, So generally speaking the Earth/Metal types are notable by their physical body with the yang
ming side of the tending to be thin and the tai yin side tending to be overweight.
Again, this is not a hard and fast rule, but a rule of thumb that generally pans out.
Basically we are looking at issues of fluid metabolism and movement. Dry is associated with thin, wet is associated
with fat. Neither dry nor wet are considered to be “good or bad” but rather we are looking at the dynamic of what is
happening in the relationship between taiyin fluid and yangming dryness.
So in an attempt to answer your question. Yes, if someone is overweight or very thin, then it’s not a bad idea to
start with looking which channel is most excess, and then tonifying its counterbalancing channel.
amyjenner:
Am I treating the body type or am I treating all other complaints via the body type?
As is often the case in clinic…sometimes body type, sometimes complaint.
Sometimes working the constitution is all you need to do, other times there is a branch issue that needs to be
cleared for the system to find balance.26/01/2024, 12:23Earth/metal applications – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/earth-metal-applications/149/print2/5
Indeed at the beginning this can be confusing. Keep re-reading Toby’s article. It makes more sense over time. Keep
hanging out here and asking questions, that is what we are here for.
And as @KristinWisgirda suggested, a class really will help you to get this stuff dialed in.
Thanks for showing up and engaging the material!

ngmatthews: October 4, 2021, 5:15pm
Your question pertains to root and branch. In this system our treatment of root will treat branch because every
treatment affects all 12 channels. I think it is pretty easy to spot a Metal/Earth type. In fact, if the person is neither
skinny nor fat, neither dry nor wet, I will only then look to the other patterns. In other words, this group of
channels is so easy to discern, that I look to them first. Just remember that we use St to balance Lung relative
excess, and LI to balance relative Sp excess. I tend to most often see Lung types in my practice, with Sp excess
types next most common. Not sure why that is. St excess types are the rarest. Since Toby recommends that we
don’t repeat a treatment more than a couple of times, you can certainly then go to your next best guesses, which
would then be in the other channels. By rotating treatment approaches, over a few visits, we can accomplish a lot.

KristinWisgirda: April 24, 2019, 8:58pm
michaelmax:
Basically we are looking at issues of fluid metabolism and movement. Dry is associated with thin, wet is
associated with fat.
Most of the discussion so far has referenced body types, but it is really helpful to consider Earth/Metal whenever
the fluids are involved in pathology. For instance, I’ve seen Toby supplement double dry LI in a fit normal sized
patient with significant knee swelling. The swelling was the grossest presentation so drying the damp was the
treatment priority. I’ve supplemented double damp Spleen in an overweight patient with dry mouth with good
results.
I now inspect fluid dynamics more closely in all of my patient regardless of whether they are fat or thin.

michaelmax: April 24, 2019, 10:36pm
KristinWisgirda:
Most of the discussion so far has referenced body types, but it is really helpful to consider Earth/Metal
whenever the fluids are involved in pathology. For instance, I’ve seen Toby supplement double dry LI in a fit
normal sized patient with significant knee swelling.26/01/2024, 12:23Earth/metal applications – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/earth-metal-applications/149/print3/5
Good point @KristinWisgirda, while we often will focus primarily on the body for Metal/Earth types and in fact
this can be an easy entry into the system as it often is the case. Still, as you point out here, that is not always the
case.
That being said, until you are able to identify these constitutional aspects, it will be hard to use the nuanced
approached that you discuss here with Toby treating the deeply internally damp knee of the the patient whose body
type is NOT Spleen excess, but their problem is related to an excess of taiyin fluid.
This is what makes practicing medicine so much fun… and at an times infuriating.

amyjenner: April 25, 2019, 12:10am
Thanks all. That was very helpful.

KristinWisgirda: April 25, 2019, 11:45am
michaelmax:
That being said, until you are able to identify these constitutional aspects, it will be hard to use the nuanced
approached that you discuss here
Sa’am appears so simple but applying it to clinical reality is so much more complicated. Even though I attended the
Seattle class, I am going to Tucson in hope of really deepening my understanding of the basics. I’ve messed up
enough cases and been confused enough times, I want to have more resources so I can Sa’am responsibly!

Tobydaly1: April 25, 2019, 3:13pm
Look forward to seeing you there Kristin!

amyjenner: May 1, 2019, 12:02am
I’m wondering what happens when a long time damp in and out, obese SP xs person ages, and the skin dries out.
Do they become LU xs? I have a number of women in my practice that are going into menopause who have been
obese with moist skin their whole lives but are now saying it is getting dry. Their financial situations aren’t getting
better…26/01/2024, 12:23Earth/metal applications – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/earth-metal-applications/149/print4/5

michaelmax: May 2, 2019, 1:53am
@amyjenner this is a good question. I suspect as these women age they are becoming more deficient in both
blood and yin. And they are still in the taiyin conformation as both LU and SP are taiyin.
As to financial situation, do keep in mind that LU types do not necessarily mean they have $$$ in the bank. Look
to see if they are “resourced” which can mean they have money, but it can also mean they support or resources
from other places. And of course +LU does not equal “has money.” But it is something worth investigating as part
of the picture.

mtewksbury: May 2, 2019, 11:03pm
I have had similar thoughts, Kristen.
Sa’am is deceptively minimal. But the more that I work with it, the deeper and more nuanced the system becomes.
I will be in Tuscon as well. This will be my 1st class and I can’t wait to get more of a foundation to work from.
See you there!
Marintha

michaelmax: May 4, 2019, 7:56pm
mtewksbury:
Sa’am is deceptively minimal. But the more that I work with it, the deeper and more nuanced the system
becomes.
I’ve had the same experience @mtewksbury, it seems simple on the surface. Like you could use it in a community
acupuncture setting in a formulaic way. But as you spend a little more time with the method it opens up an whole
new vista of perception and nuance. Sometimes i feel like Neo shortly after taking the red pill.

Tobydaly1: May 4, 2019, 7:37pm
Michael, I did give you the choice of which pill to take
michaelmax #15May 4, 2019, 7:57pm26/01/2024, 12:23Earth/metal applications – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/earth-metal-applications/149/print5/5
Nah… you were way more crafty than that.