Question from the Q&A

George_Mandler: October 12, 2019, 12:33pm
At the recent Q&A (Thank you Michael & Toby!) at the 40’ mark Logan asked about a patient with knee pain.
The Cliff Notes of what Logan presented:
42yo female. Knee pain Tendency to run cold –
Treated HT+ and knee pain 80% better. But then patient got angry
Next treatment did Liver+ and anger improved
But then redness around mouth showed up
Logan states she now sees a yangming block as she found out patient had a lot of reflux.
Logan asked about what direction to go in.
Logan thought about supplementing ST+ – but her skin is not dry.
Logan treated LI+ but didn’t make a difference
Toby then suggested to Liver+ to balance out the heat.
But then Toby stated “she probably needed SJ+ instead of Heart+ – double fire of HT is too much – you went too
far with HT+ so use the Liver+ to cool it down” (paraphrasing)
WHOA! I am confused why SJ+ to start out?
I get that it is 2nd warmest channel, but the MC was knee pain and she was cold and it gave an 80% improvement.
I would never get to using SJ+ if this patient came to me. Also using Liver+ helped this patient with the anger that
the HT+ treatment brought up. Are we saying that she is deficient in both Liver and SJ?
A cold patient w/knee pain would bring me to a SJ+ treatment unless the pain was on Liver channel or they had
some clear Liver excess signs which I do not believe Logan’s patient had. I see that Toby may have been talking in
20/20 hindsight, but I am still confused by the suggestion of SJ+.
Can anyone shed light on my confusion about Toby saying that SJ+ would be better? Or if anyone has similar
cases, this is a new way of thinking about the SJ for me in terms of it just to warm someone.
Thank you.

Tobydaly1: October 12, 2019, 8:00pm
George_Mandler:
Toby then suggested to Liver+ to balance out the heat.
But then Toby stated “she probably needed SJ+ instead of Heart+ – double fire of HT is too much – you went25/01/2024, 11:40Question from the Q&A – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/question-from-the-q-a/677/print2/2
too far with HT+ so use the Liver+ to cool it down” (paraphrasing)
WHOA! I am confused why SJ+ to start out?
Hey George,
Hope everything is well with you.
Sorry for the confusion on how I presented recommendations on Logan’s case. I was speculating that because the
patient got angry s/p supplementing the Ht this could have been due to the Ht’s double fire nature being too hot for
her patient. I suggested that instead she might have supplemented SJ, which is just warm, as a more cautious way
to address the knee pain as her first treatment.
George_Mandler:
I get that it is 2nd warmest channel, but the MC was knee pain and she was cold and it gave an 80%
improvement. I would never get to using SJ+ if this patient came to me. Also using Liver+ helped this patient
with the anger that the HT+ treatment brought up. Are we saying that she is deficient in both Liver and SJ?
I’m speculating that the double fire of Ht “over heated” her system making her relatively Liver deficient.
George_Mandler:
A cold patient w/knee pain would bring me to a SJ+ treatment unless the pain was on Liver channel or they had
some clear Liver excess signs which I do not believe Logan’s patient had. I see that Toby may have been
talking in 20/20 hindsight, but I am still confused by the suggestion of SJ+.
Can anyone shed light on my confusion about Toby saying that SJ+ would be better? Or if anyone has similar
cases, this is a new way of thinking about the SJ for me in terms of it just to warm someone.
Yes this is based purely on 20/20 hindsight. I was using this apparent case of “overheating” to emphasize the need
for caution when supplementing Ht. Thanks so much for your questions. I realize I should have done this much
more overtly.

Jeffrey: October 12, 2019, 9:14pm
good question/good answer…thanks both for bringing this up and concluding. I think the new zoom Q&A with this
type of follow up is wonderful. thanks