Newbie Questions

mariayung: December 10, 2020, 9:42pm
Hi There,
I am a newbie to Sa’am and been practicing only the supplementing techniques for the last 3 months. It is very
powerful both good and bad. Makes me excited and scared to use it. I have a few questions that came up with
practice. My apologies if some are redundant.
1.) Is Sa’am OK to use during pregnancy (I know SI+ is contraindicated)?
2.) Seems like once I shoved on a channel, it may have corrected the initial problem, but the shove may have been
too strong and created new imbalances. Is there a way to moderate the intensity of the shove?
3.) Is it OK to supplement another channel if the first choice after 10-15 minutes didn’t seem to do much?
4.) If a patient responded well after doing first choice of treatment but still has some residual issues, is it best to do
the treatment again, move on to the pair channel, or to move on to choice #2?
5.) It has been challenging for me to do the jing well points and have generally avoided it. How do other
practitioners approach this with their patients besides just sucking it up and just doing it?
6.) Can someone share what concave and convex illnesses are?
Thank you so much!!!

mariayung #1December 10, 2020, 9:42pm
Hi There,
I am a newbie to Sa’am and been practicing only the supplementing techniques for the last 3 months. It is very
powerful both good and bad. Makes me excited and scared to use it. I have a few questions that came up with
practice. My apologies if some are redundant.
1.) Is Sa’am OK to use during pregnancy (I know SI+ is contraindicated)?
2.) Seems like once I shoved on a channel, it may have corrected the initial problem, but the shove may have been
too strong and created new imbalances. Is there a way to moderate the intensity of the shove?
3.) Is it OK to supplement another channel if the first choice after 10-15 minutes didn’t seem to do much?
4.) If a patient responded well after doing first choice of treatment but still has some residual issues, is it best to do
the treatment again, move on to the pair channel, or to move on to choice #2?
5.) It has been challenging for me to do the jing well points and have generally avoided it. How do other
practitioners approach this with their patients besides just sucking it up and just doing it?
6.) Can someone share what concave and convex illnesses are?
Thank you so much!!!
2 Likes
George_Mandler #2December 11, 2020, 12:13am
Hi Maria
I replied to your other question first and now I see you are new at this.
Almost all your questions (or maybe all) can be answered by pouring over the posts in this wonderful forum. It is
like an encyclopedia for an oral tradition. (OK that is a stretch). For instance you can search “Jing well” and find a
discussion on it. Or “concave” etc. That will help you more than someone just answering the questions.
I would also go over your notes from the intro class and listen to the podcasts and watch all the great Qiological
crowdcasts that have been posted by Michael and Toby over the past 1.5 years. I still go over it again and again and
see something in a different light.That is pretty much a continuous education requirement for doing Sa’am.
2 Likes
KristinWisgirda #3December 11, 2020, 10:08am
Hi Maria,
Welcome to the forum!18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print2/7
mariayung:
I am a newbie to Sa’am and been practicing only the supplementing techniques for the last 3 months. It is very
powerful both good and bad. Makes me excited and scared to use it.
Excited and scared is the right combo of responses to practicing Saam. Keeping with one sided supplementing is
the best way to learn Saam and use it safely because it provides invaluable clarity, especially if you are new to
Saam.
Ditto to everything George says. I’ll save you some time by answering some questions that will be harder to come
by using the search function.
mariayung:
Is there a way to moderate the intensity of the shove?
No. The 4 point treatments are all in. Since response to treatments can be quite dramatic, it is really important to
evaluate your patients with fresh eyes at each treatment. I ask my patients lots of questions at each treatment to get
as much info as possible about their experience.
There are some advanced techniques that moderate the intensity but you have to learn the basic 12 treatments first
to get ready to understand how to use them.
mariayung:
Is it OK to supplement another channel if the first choice after 10-15 minutes didn’t seem to do much?
15 minutes is really close to full treatment time. At that point I would let them ride out the full 20 minutes. If the
patient isn’t settling and symptoms haven’t changed in the first 10 minutes, you can remove the needles and try
another channel. If the second treatment doesn’t create positive change and there are no adverse reactions, it is best
to let that treatment go to completion. Toby says that he rarely will move to a third channel but he is way more
experienced than we are. The more treatments you do in a session the less clarity you are going to have about
treatment responses. Each set of needles also places a demand on the patient’s qi. Too many different treatments in
a session means the patient is getting shoved in too many directions.
Once you have exhausted the search function, feel free to ask follow up questions.
2 Likes
George_Mandler #4December 11, 2020, 3:00pm
Thanks Kristin much better than my reply…I’d add…
KristinWisgirda:18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print3/7
Once you have exhausted the search function, feel free to ask follow up questions
Or if you find a thread confusing and cannot answer the question yourself post it to that thread. It may be better for
organization than starting a new thread. I think revisiting the old threads can also help us see how our thinking
about an archetype/treatment etc may have changed.
This is a learning evolving process for us all. Clinic is fun.
2 Likes
mariayung #5December 11, 2020, 4:31pm
Sa’am demands respect after learning the hard way I am eager to dive deeper.
Thank you both and all the other folks who take the time to share your experiences and wisdom. Much gratitude.
1 Like
michaelmax #6December 12, 2020, 1:19am
mariayung:
Sa’am demands respect after learning the hard way
HI @mariayung I don’t think any of us have missed the opportunity to learn how powerful this system is due to a
fuzzy diagnosis, or simply misunderstanding a situation. And yes, those experiences will keep you on your toes,
and help to sharpen to focus and attention.
I had an herbal teach who said “you can say you know an herb or formula when you’ve used it and it worked and
you’ve used it and it didn’t and you know why.
This is why is it so important in the beginning to only use one side and one channel. Then if you get a bad
reaction,… you learn something. If you get a good reaction… you learn something. and If nothing much happens…
you’ve also learned something.
In time like learning a language and building a vocabulary, you’ll gain a kind of fluency.
Keep at it!!!
KristinWisgirda #7December 12, 2020, 12:34pm
mariayung:
Sa’am demands respect after learning the hard way 18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print4/7
We have all been there and done that.
2 Likes
mariayung #8January 2, 2021, 11:58pm
Seems like once I shoved on a channel, it may have corrected the initial problem, but the effects of the treatments
keeps on going and create new and unexpected imbalances. Seems like the direction of the initial treatment
continues on indefinitely. Have you found that to be the case? Thank you!
KristinWisgirda #9January 3, 2021, 3:44pm
mariayung:
it may have corrected the initial problem, but the effects of the treatments keeps on going and create new and
unexpected imbalances.
Framing it thus makes it sound like impulse of the treatment keeps pushing the patient in a particular direction
indefinitely. The continuous push aspect doesn’t sound quite right to me. The patient is changed after the treatment.
More often you get lots of positive side effects beyond the chief complaint.
If the initial treatment corrected the initial problem but seems to have created side effects, a couple of scenarios
come to mind.
Maybe there wasn’t such a discrepancy between the initial channel treated and its counterbalancer. This might be a
case for toggling the channel pair, if it is relevant to the side effect. This isn’t common but has happened a few
times in my practice.
Maybe the side effect symptom wasn’t really related to the treatment and instead was some other force came into
the patient’s realm to set him or her off balance.
Maybe the side effect symptom was there all along but it wasn’t barking as loudly as the initial chief complaint so
the patient wasn’t so aware of it.
Feel free to give examples from your practice.
1 Like
mariayung #10January 8, 2021, 5:03pm
Thank you for your reply. You are most kind to share your experience with us.
It seems to me that the continuous direction push is happening based on a few observations now but I am not able
to cite specific examples right now. I will be on the look out for the next scenario to share.18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print5/7
mariayung #11February 13, 2021, 9:59pm
Hi Kristin,
OK. I finally have an example of this continuous directional push notion. It is on myself:) I toggle between ST+
and LU+. When I do ST+, I feel that the downward pull continues. I will get more saggy in my appearance,
wrinkles and my jowls (OK, so I am maturing :)) would look more prominent a while after I do the ST+ treatment.
I can see it on my face. So I do LU+. I feel good for awhile and it does amazing things for my external appearance.
I look more youthful and uplifted. But a few days out, I started noticing a lot of chest oppression. At first, I thought
it was due to my meditation practice and was not sinking the Qi enough. I did more Qi Gong to sink Qi but the
problem came back and is worst a week later. It just occurred to me that maybe it was the directional treatment of
uplifting Qi with LU+. I did ST+ and it felt better. This is what I mean when I question whether the directional
push keeps going because initially, the treatment seem like a good thing and I felt great but then as the days went
on, the direction of the treatment becomes too much.
cassiopeia #12February 22, 2021, 8:41pm
Hi Maria,
It sounds like you have both ST and LU excess signs to work with, so the safest thing is to move away from this
pair, and choose a different treatment.
For example, perhaps KD+ would help with your youthful appearance without chest oppression? Or P+ would help
with breathing without causing wrinkles?
This thread does bring up a longstanding question of mine:
how do you differentiate when a pair is too close so you need to look elsewhere, VS. a pair is close and needs
toggling? Does anyone have experience/wisdom on this topic?
1 Like
George_Mandler #13February 23, 2021, 5:18pm
cassiopeia:
how do you differentiate when a pair is too close so you need to look elsewhere, VS. a pair is close and needs
toggling? Does anyone have experience/wisdom on this topic?
There are no hard and fast rules for this as it is case dependent, don’t you think? In the first couple of treatments if
I think toggling is needed and I can find another channel that feels appropriate to supplement I go with that channel
If I do not see another channel whose supplementation would benefit the patient I choose one of the toggle
channels. (I am sure I have come across this situation but cannot pull one up at the moment).18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print6/7
If there are two channel that feel both excess I stay away from it and definitely find another channel in the
beginning.
The difference in that one case is channels are both excess vs channels that need supplementation.
(as an aside the pair I toggle the most is SI/KD).
As treatments progress I typically find the picture becomes clearer. When it doesn’t or the patient is not improving,
those are the challenging clinic moments.
1 Like
cassiopeia #14February 24, 2021, 11:35pm
George_Mandler:
If there are two channel that feel both excess I stay away from it and definitely find another channel in the
beginning.
George, that’s something I need to noodle on more. I have in general viewed it through the lens of channel excess
helping to point to paired channel to treat, as Toby taught. So I don’t have in my head a view of what channel xu
looks like, besides the excess of the paired channel. If you have it more clearly sorted out in your mind, I’d love to
hear it.
Right now I’m accepting that toggling is just one of those things that requires more experience to really grasp.
George_Mandler #15March 13, 2021, 5:36pm
cassiopeia:
I have in general viewed it through the lens of channel excess helping to point to paired channel to treat, as
Toby taught.
Yes we look at it as a relative excess in a paired system to choose a treatment channel, but we have seen where
someone can have both LR excess and SJ excess qualities. So you want to look elsewhere.
cassiopeia:
So I don’t have in my head a view of what channel xu looks like, besides the excess of the paired channel
There is definitely experience and the feel of the Sa’am treatment/rhythm. Both paired channel can certainly be
deficient, but one may show more excess than another at certain times.
So yes the tradition looks at it from relative excess, but to put in my understanding I see sometimes the channels as
both deficient. I have heard Toby explain this in clinic as well with the idea of toggling the channels.18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print7/7
I bring in our CM tools that are not part of this system (pulse, tongue, abdomen, channel palpation) but I need to
add those into my understanding of this beautiful tradition as I will never have the clairvoyance of Sunim Doam
(Toby’s teacher). I feel brining these other skills into clinic is useful in helping in making sense of treatment
strategies as long as the treatment principles stay within the gems Toby teaches us. From this we can understand
when both channels are deficient.
The easiest example is the my deficient looking females who gets menstrual cramps but continues spotting until
day 9 after flow stops on day 3. No varicosities, pretty, marginal medial heel, dry skin, sunken CV3 etc. I toggled
SI+/KD+ where I supplement SI+ before the period and then supplement KD+ on CD4 when spotting stops.
With that said is she SI excess? – the only box that is checked is no varicosities.
For KD excess the only box is a slight oketsu before period. So she is not really a strong excess for either, but she
has so many deficient signs from our CM perspective.
Does that help?

cassiopeia: March 22, 2021, 2:07pm
Yes that certainly helps. Last week I had a super beautiful patient who’s taking longer than usual to get pregnant
(i.e. the last 2 pregnancies were conceived on the first try; this time she’s not pregnant after 2 tries). She is SO
symmetrical and so fertile that I previously wouldn’t have used KD+ on her, but thinking about your analysis of
deficiency made me palpate her low abdomen more carefully, and there was a big emptiness. Very helpful to have
another angle for viewing patients; thanks for explaining.
Hi Maria
I replied to your other question first and now I see you are new at this.
Almost all your questions (or maybe all) can be answered by pouring over the posts in this wonderful forum. It is
like an encyclopedia for an oral tradition. (OK that is a stretch). For instance you can search “Jing well” and find a
discussion on it. Or “concave” etc. That will help you more than someone just answering the questions.
I would also go over your notes from the intro class and listen to the podcasts and watch all the great Qiological
crowdcasts that have been posted by Michael and Toby over the past 1.5 years. I still go over it again and again and
see something in a different light.That is pretty much a continuous education requirement for doing Sa’am.

KristinWisgirda: December 11, 2020, 10:08am
Hi Maria,
Welcome to the forum!18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print2/7
mariayung:
I am a newbie to Sa’am and been practicing only the supplementing techniques for the last 3 months. It is very
powerful both good and bad. Makes me excited and scared to use it.
Excited and scared is the right combo of responses to practicing Saam. Keeping with one sided supplementing is
the best way to learn Saam and use it safely because it provides invaluable clarity, especially if you are new to
Saam.
Ditto to everything George says. I’ll save you some time by answering some questions that will be harder to come
by using the search function.
mariayung:
Is there a way to moderate the intensity of the shove?
No. The 4 point treatments are all in. Since response to treatments can be quite dramatic, it is really important to
evaluate your patients with fresh eyes at each treatment. I ask my patients lots of questions at each treatment to get
as much info as possible about their experience.
There are some advanced techniques that moderate the intensity but you have to learn the basic 12 treatments first
to get ready to understand how to use them.
mariayung:
Is it OK to supplement another channel if the first choice after 10-15 minutes didn’t seem to do much?
15 minutes is really close to full treatment time. At that point I would let them ride out the full 20 minutes. If the
patient isn’t settling and symptoms haven’t changed in the first 10 minutes, you can remove the needles and try
another channel. If the second treatment doesn’t create positive change and there are no adverse reactions, it is best
to let that treatment go to completion. Toby says that he rarely will move to a third channel but he is way more
experienced than we are. The more treatments you do in a session the less clarity you are going to have about
treatment responses. Each set of needles also places a demand on the patient’s qi. Too many different treatments in
a session means the patient is getting shoved in too many directions.
Once you have exhausted the search function, feel free to ask follow up questions.

George_Mandler: December 11, 2020, 3:00pm
Thanks Kristin much better than my reply…I’d add…
KristinWisgirda:18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print3/7
Once you have exhausted the search function, feel free to ask follow up questions
Or if you find a thread confusing and cannot answer the question yourself post it to that thread. It may be better for
organization than starting a new thread. I think revisiting the old threads can also help us see how our thinking
about an archetype/treatment etc may have changed.
This is a learning evolving process for us all. Clinic is fun.

mariayung: December 11, 2020, 4:31pm
Sa’am demands respect after learning the hard way I am eager to dive deeper.
Thank you both and all the other folks who take the time to share your experiences and wisdom. Much gratitude.

michaelmax: December 12, 2020, 1:19am
mariayung:
Sa’am demands respect after learning the hard way
HI @mariayung I don’t think any of us have missed the opportunity to learn how powerful this system is due to a
fuzzy diagnosis, or simply misunderstanding a situation. And yes, those experiences will keep you on your toes,
and help to sharpen to focus and attention.
I had an herbal teach who said “you can say you know an herb or formula when you’ve used it and it worked and
you’ve used it and it didn’t and you know why.
This is why is it so important in the beginning to only use one side and one channel. Then if you get a bad
reaction,… you learn something. If you get a good reaction… you learn something. and If nothing much happens…
you’ve also learned something.
In time like learning a language and building a vocabulary, you’ll gain a kind of fluency.
Keep at it!!!

KristinWisgirda: December 12, 2020, 12:34pm
mariayung:
Sa’am demands respect after learning the hard way 18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print4/7
We have all been there and done that.

mariayung: January 2, 2021, 11:58pm
Seems like once I shoved on a channel, it may have corrected the initial problem, but the effects of the treatments
keeps on going and create new and unexpected imbalances. Seems like the direction of the initial treatment
continues on indefinitely. Have you found that to be the case? Thank you!

KristinWisgirda: January 3, 2021, 3:44pm
mariayung:
it may have corrected the initial problem, but the effects of the treatments keeps on going and create new and
unexpected imbalances.
Framing it thus makes it sound like impulse of the treatment keeps pushing the patient in a particular direction
indefinitely. The continuous push aspect doesn’t sound quite right to me. The patient is changed after the treatment.
More often you get lots of positive side effects beyond the chief complaint.
If the initial treatment corrected the initial problem but seems to have created side effects, a couple of scenarios
come to mind.
Maybe there wasn’t such a discrepancy between the initial channel treated and its counterbalancer. This might be a
case for toggling the channel pair, if it is relevant to the side effect. This isn’t common but has happened a few
times in my practice.
Maybe the side effect symptom wasn’t really related to the treatment and instead was some other force came into
the patient’s realm to set him or her off balance.
Maybe the side effect symptom was there all along but it wasn’t barking as loudly as the initial chief complaint so
the patient wasn’t so aware of it.
Feel free to give examples from your practice.

mariayung: January 8, 2021, 5:03pm
Thank you for your reply. You are most kind to share your experience with us.
It seems to me that the continuous direction push is happening based on a few observations now but I am not able
to cite specific examples right now. I will be on the look out for the next scenario to share.18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print5/7

mariayung: February 13, 2021, 9:59pm
Hi Kristin,
OK. I finally have an example of this continuous directional push notion. It is on myself:) I toggle between ST+
and LU+. When I do ST+, I feel that the downward pull continues. I will get more saggy in my appearance,
wrinkles and my jowls (OK, so I am maturing :)) would look more prominent a while after I do the ST+ treatment.
I can see it on my face. So I do LU+. I feel good for awhile and it does amazing things for my external appearance.
I look more youthful and uplifted. But a few days out, I started noticing a lot of chest oppression. At first, I thought
it was due to my meditation practice and was not sinking the Qi enough. I did more Qi Gong to sink Qi but the
problem came back and is worst a week later. It just occurred to me that maybe it was the directional treatment of
uplifting Qi with LU+. I did ST+ and it felt better. This is what I mean when I question whether the directional
push keeps going because initially, the treatment seem like a good thing and I felt great but then as the days went
on, the direction of the treatment becomes too much.

cassiopeia: February 22, 2021, 8:41pm
Hi Maria,
It sounds like you have both ST and LU excess signs to work with, so the safest thing is to move away from this
pair, and choose a different treatment.
For example, perhaps KD+ would help with your youthful appearance without chest oppression? Or P+ would help
with breathing without causing wrinkles?
This thread does bring up a longstanding question of mine:
how do you differentiate when a pair is too close so you need to look elsewhere, VS. a pair is close and needs
toggling? Does anyone have experience/wisdom on this topic?

George_Mandler: February 23, 2021, 5:18pm
cassiopeia:
how do you differentiate when a pair is too close so you need to look elsewhere, VS. a pair is close and needs
toggling? Does anyone have experience/wisdom on this topic?
There are no hard and fast rules for this as it is case dependent, don’t you think? In the first couple of treatments if
I think toggling is needed and I can find another channel that feels appropriate to supplement I go with that channel
If I do not see another channel whose supplementation would benefit the patient I choose one of the toggle
channels. (I am sure I have come across this situation but cannot pull one up at the moment).18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print6/7
If there are two channel that feel both excess I stay away from it and definitely find another channel in the
beginning.
The difference in that one case is channels are both excess vs channels that need supplementation.
(as an aside the pair I toggle the most is SI/KD).
As treatments progress I typically find the picture becomes clearer. When it doesn’t or the patient is not improving,
those are the challenging clinic moments.

cassiopeia: February 24, 2021, 11:35pm
George_Mandler:
If there are two channel that feel both excess I stay away from it and definitely find another channel in the
beginning.
George, that’s something I need to noodle on more. I have in general viewed it through the lens of channel excess
helping to point to paired channel to treat, as Toby taught. So I don’t have in my head a view of what channel xu
looks like, besides the excess of the paired channel. If you have it more clearly sorted out in your mind, I’d love to
hear it.
Right now I’m accepting that toggling is just one of those things that requires more experience to really grasp.

George_Mandler: March 13, 2021, 5:36pm
cassiopeia:
I have in general viewed it through the lens of channel excess helping to point to paired channel to treat, as
Toby taught.
Yes we look at it as a relative excess in a paired system to choose a treatment channel, but we have seen where
someone can have both LR excess and SJ excess qualities. So you want to look elsewhere.
cassiopeia:
So I don’t have in my head a view of what channel xu looks like, besides the excess of the paired channel
There is definitely experience and the feel of the Sa’am treatment/rhythm. Both paired channel can certainly be
deficient, but one may show more excess than another at certain times.
So yes the tradition looks at it from relative excess, but to put in my understanding I see sometimes the channels as
both deficient. I have heard Toby explain this in clinic as well with the idea of toggling the channels.18/01/2024, 10:42Newbie Questions – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/newbie-questions/1433/print7/7
I bring in our CM tools that are not part of this system (pulse, tongue, abdomen, channel palpation) but I need to
add those into my understanding of this beautiful tradition as I will never have the clairvoyance of Sunim Doam
(Toby’s teacher). I feel brining these other skills into clinic is useful in helping in making sense of treatment
strategies as long as the treatment principles stay within the gems Toby teaches us. From this we can understand
when both channels are deficient.
The easiest example is the my deficient looking females who gets menstrual cramps but continues spotting until
day 9 after flow stops on day 3. No varicosities, pretty, marginal medial heel, dry skin, sunken CV3 etc. I toggled
SI+/KD+ where I supplement SI+ before the period and then supplement KD+ on CD4 when spotting stops.
With that said is she SI excess? – the only box that is checked is no varicosities.
For KD excess the only box is a slight oketsu before period. So she is not really a strong excess for either, but she
has so many deficient signs from our CM perspective.
Does that help?