mariamorris: August 30, 2019, 4:16am
I posted this in Sharon Weizenbaum’s GMP forum, but haven’t received any responses, so I thought maybe it was
more appropriate to post here.
A lot of my patients are new to me as I am building a practicing in the small town I moved to.
I have been doing straight SA’AM without herbs (Toby had suggested the first 3 SA’AM treatments without herbs
to assess easier the results of treatment) and I’ve seen some very dramatic results in both improvement and
worsening of symptoms.
My question is for those using both SA’AM and herbal formulas with patients. How do you assess if a patient’s
condition improves or worsens, what it is due to – the SA’AM or the formula? Knowing this would guide future
treatment with both herbs and SA’AM but it seems that one couldn’t really assess clearly as both can so
dramatically change the condition of a patient.
I’m hesitant to add herbal formulas until I can get a grasp of this.
Daniel: August 30, 2019, 11:28am
Perhaps part of the question to ask and look into is why you feel a need to do both? Do you feel there are things
you can’t touch with the acupuncture that you can touch with the herbs (and vice versa)? Is it clear in your mind –
this distinction? Do you feel clear and certain about the distinction? One possible strategy might be to just do the
acupuncture (with lifestyle advice) for at least a month and reserve herbs for the cases that seem to not be
progressing to the extent you’d like or expect (and perhaps even vice versa with some patients)?
George_Mandler: August 31, 2019, 6:48pm
I am writing fewer formulas since using Saam and I know others are as well. I use Saam first to see how much can
be resolved with my current needle skllls. I do not typically use herbs until I’ve done at least 2-3 Saam treatments.
That does let me know what is responding to acupuncture alone.
michaelmax: August 31, 2019, 6:54pm
like @George_Mandler, I’m using fewer herbs as well. Partly I don’t need to. And partly because I do want to see
what the Sa’am is doing, and if I Rx herbs, then it will be impossible to what is due to what. So in the interest of25/01/2024, 12:05SA’AM and herbal formulas – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-and-herbal-formulas/564/print2/4
simplicity (and because I’m a lazy acupuncturist) usually not herbs for the first few treatments.
lauramcgraw: August 31, 2019, 10:52pm
I agree with Michael and George on this one. I have been using less herbal Rx as well. I have been also waiting to
see what happens after 3 acupuncture treatments. Recently I had a case of a woman with diarrhea for over 10 years,
I wanted to use Shen ling bai zhu san but instead waited to see how she responded with Saam. After the first Saam
tx her diarrhea was cut in half and her tongue coating was almost back to normal( she had a thick white coating
with puffy tongue body and teeth marks). I just saw her for the 3rd tx of Saam and she has no diarrhea at all! So
didn’t need to use the Shen ling Bai Zhu san. Her tongue is still on the puffy side but no longer has a thick coating
and teeth marks are decreased.
I am now going to see how she does with a treatment in two weeks. Not sure if giving her the herbs would have
helped resolve things quicker, but I feel I may not have been able to tell which helped the most. This was very
clear, so fast with Saam!
George_Mandler: September 1, 2019, 12:09pm
lauramcgraw:
After the first Saam tx her diarrhea was cut in half and her tongue coating was almost back to normal( she had
a thick white coating with puffy tongue body and teeth marks).
Did you see her tongue coat change from start to end of treatment or the next time you saw her? There is a fellow
on this forum from St Louis who observes tongue change during treatment. I am blind to it and haven’t been able
to observe this phenomena. I am feeling inept.
I am curious about this great case too. SP+, LI+?
lauramcgraw: September 2, 2019, 2:47am
Yes I have heard about this fellow seeing tongues change during the treatment. I saw the change the next time I
saw her, it didn’t change much during the treatment. She was Spleen excess, so I suppl Lg. Int, such a huge
response I did it again and then again the third time. Waiting to see her in 2 weeks as she had no symptoms and felt
great. My second idea was to suppl. small intestine as she has some Kidney excess symptoms, and third idea was
supp. liver. Keep you posted!
1 Like25/01/2024, 12:05SA’AM and herbal formulas – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-and-herbal-formulas/564/print3/4
mariamorris: September 6, 2019, 10:08pm
Thanks for all your input.
@Daniel – I appreciate your questions. I haven’t been using herbs and when I think about that, it’s because I
haven’t needed to. There is one patient who is quite deficient who I think will need treatment over a longer period.
She doesn’t like needles, and I feel that she may be more comfortable with herbs, but yes, when I think about it, for
most patients, they haven’t needed the herbs in addition to SA’AM. I wonder though for very deficient patients, if
the adding herbs would help them more than just SA’AM.
@lauramcgraw @michaelmax @George_Mandler
It sounds like sometimes after the initial 3 treatments you do add herbs? I am now only either working solely with
herbs with some patients, or solely with SA’AM treatments. I don’t feel comfortable combining both because of
not knowing how to assess resultant changes. Could you share more on that?
I asked Sharon Weizenbaum my question in the GMP forum and found her response helpful. She wrote:
“I find that most often the patients themselves know what is causing the change. It is rare that they don’t. So, I ask
them what they think caused the good or bad change. I also just assess according to timing. Of course, if the change
is right after the needles go in, that’s pretty clear and this is quite common too. If a change is soon after they take
their herbs, or cumulative as they are taking it, this is pretty clear too. ”
Daniel: September 6, 2019, 11:07pm
In my 20 years of clinical experience, very very often, the peak response to a good acupuncture treatment is two
full days after the treatment (a very interesting phenomenon with some interesting implications). I’ve just observed
this so so many times.
Daniel: September 6, 2019, 11:08pm
The only ‘contraindication’ that I know of in the Nei Jing for acupuncture is when the patient is too weak, too
debilitated. In which case – a year or more of food therapy is recommended prior to considering acupuncture (as I
understand it).
michaelmax: September 7, 2019, 1:43am
Daniel:25/01/2024, 12:05SA’AM and herbal formulas – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-and-herbal-formulas/564/print4/4
In my 20 years of clinical experience, very very often, the peak response to a good acupuncture treatment is
two full days after the treatment (a very interesting phenomenon with some interesting implications). I’ve just
observed this so so many times.
This makes sense. And I have told patients for years that “it takes 3 days for a treatment to fully unfold itself into
your experience.”
I think this is because the acupuncture does not “do the work.” The patients do. Acupuncture points them in the
right direction. Then their physiology, mind, body, spirit, whatever you want to call it takes over and does the work.
As it should.
Having people depend on acupuncture is no better than having them be depend on a drug.
Jeffrey: September 10, 2019, 9:23pm
As many have said above, I too and writing significantly less formulas. Even though traditionally I would just as
well sit in my chair in my office, patient facing me in the hot seat on my left, draw out pulse dx, confirm in
auricular dx, write formula etc.
Now I am excited to be in the treatment room standing on both feet dealing with similar difficulties and elegance to
treat with 4 needles. And I am often shying away from writing those formulas to see what I can get done with Saam