Donley: May 13, 2019, 11:48pm
Hi everyone,
I have a patient started me wondering if there were a Sa’am organ type that fits with a person who never stops
talking. My patient is a 72-year-old male. Overweight (but not extreme). Tall. Spleen-Yellow face. All pulses, all
positions deficient. Two hearing aids and two knee replacements. Nice guy, but he never stopped talking during the
1.5-hour initial intake. With all the talking it was quite a task to actually do the 10,000 questions. His voice is
neither loud nor soft. He is not socially awkward, and he is intelligent. He just never stops! He would go from story
to story (on the topic of all that ails him at least) without a break. While I was checking his pulses and moved to
check his Sunko pulse he was still talking. After a couple of seconds, he did say, “do I need to be quiet?” I smiled
and said that that would be helpful, he said, “okay”, but then started up again!
He made the appointment for pain from a hernia operation about three months ago, but he said the day of the
appointment that the pain was not bothering him on that day, so he wanted to address his sciatica pain. I ended up
tonifying Si to utilize its moving aspect (and that could address the residual pain from the operation for which he
had made the appointment 5 days earlier). I placed them on the right side in the follow order: +Si 3, +Gb 41, -Ub
66, -Si 2. After I finished with Si 2 he did take a breath and quietly began reflecting on his late wife. I thought that
was a good change as it was the slowest and quietest he has spoken the whole time. I told him I would let him rest
for a few minutes, but that I would be at my desk going over his paperwork (I currently have only one room.) At
that point, he started talking again full speed, and never stopped the whole 20 minutes with needles in.
Again, he was nice, not being inappropriate (other than the talking), but boy did he wear me out! Would this talking
lead to the Lv characteristic of contemplation even though there was nothing “inner” about it, and he wasn’t really
“contemplating”?
KristinWisgirda: May 14, 2019, 1:25pm
Curious about which channel his sciatica involved- UB maybe?
Talkativeness is diagnostic for Heart excess. He doesn’t sound aggressive with his talking, so no obvious GB
excess.
If you think he can tolerate some ice cold water, tonify UB next time.
Donley: May 14, 2019, 1:47pm
Good thoughts @KristinWisgirda,
The sciatica pain was projecting down the Ub. The Ht excess may fit nicely, and yes, there is no aggression
involved that I can ascertain. I was thinking of tonifying the Kd to address some Yin Xu symptoms. I thought of Ub26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
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for a second but dismissed it because I only noticed false heat signs. If Ub will work with false heat as well, I think
that is a good path to take.
KristinWisgirda: May 14, 2019, 2:42pm
From your description, his talking is the grossest sign. +++ for a heart excess diagnosis. UB channel pain added to
that puts tonifying UB at the top of the list. If there aren’t any grosser signs or symptoms in his presentation and as
long as he isn’t really cold, I would UB+.
Please let us know what happens.
michaelmax: May 15, 2019, 4:15am
KristinWisgirda:
Talkativeness is diagnostic for Heart excess. He doesn’t sound aggressive with his talking, so no obvious GB
excess.
Thanks for that reminder @KristinWisgirda about talking and the Heart. And helpful to hear from @Donley that
the sciatic pain went down the back of the leg.
Curious to hear how the next treatment goes.
Gosh this stuff is fun
Donley: May 15, 2019, 4:48am
Thank you @KristinWisgirda for your insights. I will see him again next week, and post an update. And, I agree
@michaelmax, this stuff IS fun!26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
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sweiz: May 18, 2019, 10:49am
Hi Donley,
This case kept rolling around in my mind. I agree with Michael and Kristin that heart excess sounds like the way to
go. For a second-tier thought, I was considering having liver for SJ excess in your pocket.
The talking may also be a response to feeling over-exposed.
KristinWisgirda: May 20, 2019, 1:33pm
Donley:
After a couple of seconds, he did say, “do I need to be quiet?” I smiled and said that that would be helpful, he
said, “okay”, but then started up again!
The polite San Jiao excess type would never talk this much and then disregard the practitioner’s suggestion that
quiet would be helpful.
How much of a narcissist is this guy? It sounds like he primarily was talking about himself. Even though SI+ didn’t
help, K excess might be a secondary pathology to consider. Is he symmetrical and have a hearty constitution?
Was there an obsessive ruminative quality to his chatter? Possible Spleen excess. If internal/external damp is strong
enough, it might be be brew into enough heat that could cause the hyperactive talk. You said he was overweight
somewhat. How is his skin and sweat level?
Donley: May 22, 2019, 12:16am
KristinWisgirda:
How much of a narcissist is this guy? It sounds like he primarily was talking about himself.
He may be a bit self-centered, but not overly so I think, this was his first appointment with me so the conversation
was about him.
I’m thinking Kd deficient (both knees replaced and hearing aids in both ears, wakes 3-4 times at night to urinate).
This is info. I didn’t share at the beginning of this post as I was just asking about over-talking, but I like where the
conversation has gone! He is symmetrical looks good.
KristinWisgirda:
Was there an obsessive ruminative quality to his chatter?26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
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No rumination. He was all over the place. It was almost like I was listening in on his stream of thought.
KristinWisgirda:
You said he was overweight somewhat. How is his skin and sweat level?
skin is not too dry or oily. If I had to choose I would say on the dryer side thought. Sweat level he says is a non-
issue.
The more I communicate with him the more I am seeing the Ht excess presentation. He revealed to me after I sent
my follow-up email that he does indeed have anxiety and feels palpitations from time to time (during the interview
he denied both of these, but I think he wasn’t really hearing me when I asked because he was thinking of what he
was going to say next!)
Donley: May 22, 2019, 12:32am
I also wanted to share that the universe drove home the sciatica pain going down the Ub channel maybe should be
treated via the channel (very elementary, I know – makes me feel silly to have missed it the first time).
I flew back home this weekend and of course had a few blister packs of 5 needles (almost perfect amount for
Sa’am). A relative who had never had acupuncture before was talking about her hip pain that she had had for the
past 3 months. She had been to a chiro 3 different times for it (the most recent was two days before I saw her) and
the adjustments had no effect. I offered to give a treatment and she was game. The sciatica pain was (you guessed
it) going down the Ub channel (mostly), and she is a talker! As Toby says, “My Acupuncture finger was itching”.
I tonified Ub on opposite side. Five minutes in I asked her about the pain. Her look of surprise was pretty nice to
see! After the treatment she stood and had no pain. Gave her a follow-up treatment the next morning (she woke up
stiff) and the stiffness went away. I texted this afternoon (3 days later and a 5 hour car ride later) and she still has
no pain or stiffness.
It was rewarding to have such positive and visually verifiable (pretty significant limp gone) results with four
needles and twenty minutes, and in front of my family no less (some of which are not too sure about my path).
KristinWisgirda: May 22, 2019, 2:40pm
Donley:
I’m thinking Kd deficient (both knees replaced and hearing aids in both ears, wakes 3-4 times at night to
urinate)
Looking at these symptoms through the Sa’am lens, I don’t jump to Kidney. Weak knees is actually a Stomach
excess sign, especially (but not only) related to money loss. That he had both knees replaced in the past means that26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
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there was a Stomach excess at some point, though I wouldn’t treat it now unless that was a problem area and fit the
treatment priority of the moment.
Rule out other possible causes of nocturia before jumping to supplement Kidney. Is his prostate enlarged? Is he
urinating completely each time?
Donley:
He is symmetrical
Symmetry is a sign of good Kidney resources.
Kidney + can still be considered if he really needs to be consolidated at some point. Toby says that he often toggles
between SI+ and K+ for older people as appropriate.
The sweat question was another way to find out how wet/dry his surface is. Sounds like he is drier outside + being
overweight, you might note Lung excess as a tendency that would benefit for St+ at some point.
Overall it sounds like UB+ is the strategy to consider next time if he continues that level of excess talking and it
fits his chief complaint.
Donley: May 22, 2019, 2:46pm
Thank you for sharing your knowledge so willingly @KristinWisgirda. It is very helpful!
KristinWisgirda: May 22, 2019, 2:52pm
I just came back from the Tucson class. I had attended the Seattle class already but reviewing the material and
catching more nuances made round 2 so worth it. It exceeded my expectations. Being exposed to more cases in the
class and the extra clinic day also helped me better understand Sa’am clinical reasoning. I highly recommend
taking a class when you get a chance.
You really have to let go of other diagnostic systems and see through Sa’am eyes to get the best results with this
system.
Donley: May 22, 2019, 3:09pm
I will attend a live class as soon as I am able. Like you, I would also like to eventually take multiple classes. I’m
also excitedly awaiting the book Toby and Michael are working on!
1 Like26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
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rappeports: May 26, 2019, 12:55pm
another reason for talking so much is loneliness after losing his wife- maybe broken heart is heart excess in this
system?
lauramcgraw: May 28, 2019, 4:36pm
Yay! I was in Seattle class also and am headed to join class and clinic in St. Louis.
Looking forward to round 2:)
Donley: May 30, 2019, 2:28am
UPDATE
Hello everyone,
I saw this patient again this afternoon. Was still talkative.
Some of his complaints:
1.) A “feeling in the chest” sometimes. Not painful, not “scary”, “just kind of a feeling”.
Last week he had a heart monitor for three days, and he tried to elicit the feeling by
drinking a lot of coffee and moving around a lot, but the feeling never came while
wearing the monitor.
2.) When trying to fall asleep his right leg (same side as the intermittent sciatica pain)
will “jerk” and have a “feeling”. Again it doesn’t hurt. But it annoys him and makes
him “angry”. Then he is awake for a while until it happens again when he starts to
doze off.
Because of the “feeling” in the chest. and the “jerking” and “feeling” in the leg (UB & GB channels) I thought the
UB+ would be a good fit still. After the needles were in (left side) he was completely quite with his eyes closed for
10 minutes! However, after those 10 minutes he started talking again (even trying to tell me silly jokes) *shrugs
shoulders
KristinWisgirda: May 30, 2019, 4:57pm
Donley:
he was completely quite with his eyes closed for 10 minutes!26/01/2024, 12:09Which Characteristic Never Stops Talking? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/which-characteristic-never-stops-talking/219/print7/7
Sounds like progress for this gentleman! Just reading that gave me a big sense of relief. Thanks for the update.