[00:00:03] Speaker A: Hi, everyone, and welcome to the Nervous Herbalist, a podcast for Chinese medicine practitioners who like herbs and want to learn more about their function, their history, and treatment strategies to use in the clinic. Let's get into it.
Hello, everybody, and welcome to the Nervous Herbalist. My name is Travis Kern, and I.
[00:00:23] Speaker B: Am here with Travis Cunningham.
[00:00:25] Speaker A: And we have a special show for you guys. Today. We are interviewing our friend and colleague, Kimiko Shirai.
Kimiko is a licensed acupuncturist and herbalist specializing in fukushin diagnosis and herbal medicine. She has a practice here in Portland, Oregon, and also teaches at a local Chinese medicine school as well as internationally. And she maintains her practice really focused on using fukushin diagnostic methods to address complex issues, internal conditions, and particularly with an emphasis in women's health. So we wanted to get her on to talk a little bit about her background and fukushin and how all of that connects particularly with women's health and other complex conditions. So, Kimiko, welcome.
[00:01:10] Speaker C: Thank you for having me.
[00:01:12] Speaker A: So we want to just start the conversation with a little bit of background, which is to say, how'd you get into this? What's the story?
[00:01:20] Speaker C: It's been a long journey. So I moved to the States when I was a teenager to study English, and my parents moved here with me, and I.
I studied English, and after that I studied Chinese medicine because my mom has always been a Tai chi master in Japan as well. And I grew up with healing, with foods at home.
My parents weren't a huge fan of taking drugs, so that was my first introduction to natural medicine.
[00:01:58] Speaker A: So it came through the lens of your. Of your mom?
[00:02:02] Speaker C: Yes.
[00:02:02] Speaker A: Yeah.
[00:02:03] Speaker C: But at that time, I knew nothing about Chinese medicine.
[00:02:06] Speaker A: Gotcha.
Is that. How did she get into Tai chi? Is that just a family thing too, or what?
[00:02:11] Speaker C: That was also a family thing. She met somebody, and then she went to China to study with somebody, and then she just fell in love with Tai chi and started that. Wow.
[00:02:20] Speaker A: So you had a sense of a kind of alternative, so to speak, different way of healing and stuff, even from being a kid?
[00:02:27] Speaker C: Yes.
[00:02:27] Speaker A: Was that.
Is that common in Japan? Like, were there other. Other families like yours who were using, you know, what we now think of as East Asian medicine? Or was it just.
[00:02:37] Speaker C: It was not common at that time.
[00:02:39] Speaker A: Yeah. So you guys were the weirdos.
[00:02:40] Speaker C: We were the weirdos, sure. My especially my mother.
Total weirdo.
Yeah.
[00:02:47] Speaker A: So then you make it to the States to study English. When was that?
[00:02:51] Speaker C: I was 14.
[00:02:52] Speaker A: Oh, wow. Okay. And then how. From that point to Chinese medicine, what's the leap there.
[00:02:59] Speaker C: Yeah. First I went to normal college just to get the bachelor's degree. I knew I wanted to go into medicine, so I did pre med, and that was okay. Just basic science, nothing special. And then my friend was actually going to school here at UNM studying Chinese medicine. So I was curious about that, and I wanted to study a little bit more about Chinese philosophy. So I switched my major during the bachelor's degree to liberal arts, focusing Chinese philosophy. So that was my first introduction to Chinese theory and philosophy, and that led me to Chinese medicine.
[00:03:40] Speaker A: Okay, wow. And so Nunm, that's the National University of Natural Medicine. Yes, of course, at that time it was ncnm, right?
[00:03:48] Speaker C: It was.
[00:03:48] Speaker A: That's right. Still just a college, now a university.
So you studied Chinese philosophy in undergrad, and so is that ultimately what your degree was?
[00:03:57] Speaker C: In the end, it was still Bachelor of Science, but my focus was in Chinese studies.
[00:04:02] Speaker A: Interesting. Okay, and then was it a straight run from there to studying Chinese medicine?
[00:04:08] Speaker C: Yes, it was.
[00:04:09] Speaker A: Okay, so you get into Nunm NCNM at the time and start really getting deep into the medicine. And then of course, now the way that you practice is slightly different, I imagine, than how you were trained in school. Or was there like a clear connection between the two there?
[00:04:26] Speaker C: I would say there's a clear connection between the two. I, at the time, I knew nothing about classical Chinese medicine versus traditional Chinese medicine.
It was the only school that I knew of, and I went because I had a friend that went there.
So I was, in a way, I was very lucky to be introduced to classical Chinese medicine from the beginning because that's all I knew.
And I am happy that I graduated from there having that knowledge and.
[00:04:53] Speaker B: But yeah, how would you define the difference between the two? As far as the education goes?
[00:05:00] Speaker C: You know, overall it's the same, but I think the way it was delivered is very different because when I think about classical Chinese medicine, they really emphasize on practice of qigong, tai chi, self cultivation, and modernizing the Chinese medicine because it is not pure black and white.
So when you're trying to standardize, like the NCCOM exams for board exam, for example.
[00:05:34] Speaker B: Yeah, right, the dreaded board exams.
[00:05:37] Speaker C: Yes. And we all have to learn how to take the exams, but that's not necessarily how things appear in a clinic in real life. Oh, yeah, right.
[00:05:46] Speaker A: So isn't that the truth? Yeah.
[00:05:47] Speaker C: So that was a hard thing, graduating from Nunm is that they taught me amazing clinical skills to think outside of this black and white linear way of thinking.
But then when I Graduated from school. I had to relearn everything to prepare for the board exam, to pass the board exam. Otherwise, I won't be able to use it.
[00:06:10] Speaker A: Right.
[00:06:11] Speaker C: So that was the only struggle and a shift to be able to pass the board exams and think more linearly to pass the board exams.
[00:06:21] Speaker B: Yep.
[00:06:21] Speaker A: Yeah. We had a. There's a thinker, a philosopher that Travis and I really like, a guy named Liu Ming, who was one of the founding deans at five branches down in California. And he ran a daoist institute in Berkeley called the Daoyuan Circle. And a lot of his lectures are recorded. He died in 2014, but a lot of his stuff's recorded, so you can listen to a lot of his discussion. And he has this constant refrain around how Chinese medicine school is a functional hoop that people have to jump through in order to be able to become a licensed acupuncturist. So his thought is. The way he would phrase it is you go to Chinese medicine school so that you can become a licensed acupuncturist, and then once you're a licensed acupuncturist, you can learn how to do Chinese medicine.
[00:07:06] Speaker C: Right. That's always the truth. Right.
True learning starts after you graduate.
[00:07:12] Speaker A: Yeah, exactly. Right. Because otherwise it's confined. I mean, even here, with our residency program, we delay doing the advanced clinical training that Travis Cunningham teaches because our residents are taking their boards. We don't want to confuse them, because we say, well, actually, you can use this formula for this and make this modification like that. And if we do that too soon, then they'll be disadvantaged in the board exam, which is pretty crazy.
[00:07:39] Speaker B: But it sounds like you did get some direction from school.
[00:07:44] Speaker C: I did.
[00:07:44] Speaker B: Yeah. Your training did start in school. So. So what. What was the training in school that was impactful for you?
[00:07:52] Speaker C: I do think that I. The herbal program was so solid, and I developed this love for Chinese medicine because of the herbal program. And I think that's also lacking in terms of.
Because the national board exam does not require people to take the herbal board exam. Many practitioners opt not to take them, but they're still licensed and able to practice acupuncture and herbal medicine without having to take in the board exam for the herbal medicine. And I think that's a.
I hope they would change because there are a lot of practitioners that are prescribing formulas in a patent form, and they think that's.
That's the best way to do it. But there's a lot more to that, and I feel that. I feel that there's power in herbal medicine and that's a huge part of it. So if you want to use the full scope of practice of Chinese medicine, I feel that we should be able to prescribe formulas and be able to modify and change dosages.
[00:09:01] Speaker A: Yeah, this is an interesting question. I know that the Oregon State association is actually part of their advocacy work right now is looking at changing the licensing structure to actually reflect people who have specific herbal certifications from the nccom. It's a pretty big lift because it's kind of obscure, right? Like, they have to go to the legislature and be like, we think that this distinction is really important and let me explain to you why. But of course, the people we're trying to convince, I mean, to them it's no, you know, they don't understand why it would matter.
But one of the things that comes up all the time, maybe you experience this too in your practice. Someone will call here and they live in, I don't know, Idaho, Iowa, something, and they'll be like, hey, do you guys do telemedicine? And we don't really do it much anymore because we find it hard to be agile with getting herbs to people. So what we try to do is say, oh, let's get someone in your area that can actually see you.
But then we have a really hard time figuring out who actually does this, does herbs.
[00:10:00] Speaker C: Yeah, absolutely.
[00:10:02] Speaker A: Look at everyone's website. It's all the same. You know, everyone does herbs if you look at people's websites, you know, but it's really hard. And so I've actually landed on three questions that I tell those folks to call people and ask. Right? And the first is in your practice. So talking to the provider in your practice, do you specialize in the use of herbal medicine? It's the first question. And the second one is, you know, roughly what percentage of your patients take herbs?
And then the third question is, are most of the herbs you prescribe custom written?
And if the person answers yes to all three of those questions, you're probably in a good spot.
[00:10:38] Speaker C: Right.
[00:10:39] Speaker A: You know, and if they don't know the answer or they're wishy washy about the answer, then you also have information, right? Because anyone, I mean, a percentage is a hard thing. But even still, like anyone who does herbs, like the three of us do herbs, can say yes to all of those, right? Like, yes, we have a specialization. Yes, most people take them and I don't know, like 90 plus percent of my people take herbs.
[00:11:00] Speaker B: Yeah, right.
[00:11:02] Speaker A: In which case you probably found the right person, you know. So.
So t you had some questions for Kimiko around the particular angle that both of you guys kind of share now this fukushin perspective.
So Kimiko, tell us a little bit about that. So you go through, there's your regular training at ncnm. How do you make the leap to this next more specialized thing?
[00:11:26] Speaker C: Yeah, so this was actually my thesis topic.
[00:11:28] Speaker A: Oh, cool.
[00:11:29] Speaker C: Yeah, so it was pretty fascinating. At the last year of Nunm, during my training, we had to pick a topic and I chose a topic that kind of circles me back to my root. And my entire family, my relatives in Japan made fun of me because they, you know, here I am going to the study abroad to the United States as a teenager and going to college, going to grad school and they're expecting me to become probably a surgeon or something, right?
[00:12:05] Speaker A: Yeah, of course.
[00:12:06] Speaker C: And then at the very last year of the medical training, I say I want to come back and write all the books on Fukushima in Japan. Because there was at that time there was nothing written and translated in English.
So I had to gather all the books in Japan in Japanese.
So I did that.
[00:12:27] Speaker A: What time period was that?
[00:12:28] Speaker C: This was in 2007.
[00:12:30] Speaker A: Okay, got it.
[00:12:31] Speaker C: And then my family's thought, you go through all this trouble to go to the States and you come back to Japan to study fukushin. So for them, like fukushin is like a. You mean like things that they used to do, like Asian time, You know, we used at my parents age, this was something that did as a child to go to the doctor to get the abdomen palpated. That was a normal practice.
So for them, why would you come back to Japan and study fukushin?
So but I had to gather all those books in Japanese because that was a variable. That was the only thing that was available. And I tried to translate and make sense out of it as much as possible to see if there was any pattern.
Because at that time there was nothing published in English that had more systematized explanation of this herb means this abdominal patterns.
So I tried to look at all these books and then I also went back to Shan Han Lin and Jing Gui Yadui and try to find the pattern. Is there a pattern to this or is it just completely random?
Right. And of course, clearly there was a pattern.
[00:13:46] Speaker B: Sure, yeah.
[00:13:46] Speaker C: So that's how I wrote my thesis on is like, okay, there's clearly a pattern for abdominal findings that matches a certain herbal methods. And there's a formula that goes with this herbal methods.
[00:13:59] Speaker A: Right.
[00:14:00] Speaker B: And with Herbal method. You mean like this finding on the abdomen points to go type formulas? Is that kind of what you're saying?
[00:14:08] Speaker C: Exactly.
[00:14:09] Speaker B: Just to give people an example.
[00:14:10] Speaker A: Okay, okay. I'm fascinated by just the work of translation like that.
[00:14:13] Speaker C: You know, that was the worst part of it, because I am not a translator. I can understand for myself, but I am a terrible translator.
And remember that also, I had already been away from home for so long that it was hard for me to go back to Japanese literature and read them. And those. Some of those textbooks that I found were so old that it was written in the very old style of Japanese language that my parents couldn't even understand.
But I could, because I had a little bit of training in classical text.
[00:14:48] Speaker B: Wow.
[00:14:49] Speaker C: So that was a plus.
[00:14:51] Speaker B: Interesting.
[00:14:52] Speaker A: Yeah, because I. My undergraduate training is in linguistics, and so anytime we get to the subject of translation, I'm always like, ooh, like structured translation. And I love the idea of it. And it's something that I think a lot of people don't understand who. Who don't speak multiple languages. But just because you speak Japanese fluently and you speak English fluently doesn't mean you can take a textbook like a highbrow, intellectual piece of Japanese writing, particularly one that's written in an old style, and then saying like, okay, now see if you can make this work in the clinic.
That's a really big lift. And the people who translate that is a whole skill entirely on its own, just being able to make sense of how all these pieces go together. So that is such an ambitious project, Kumiko. That's wild.
[00:15:40] Speaker B: It was.
[00:15:40] Speaker C: And at that time, there was actually no curriculum at our school that taught Japanese medicine or Korean medicine was just purely Chinese medicine. And I was really curious about my own culture and my roots, and what could I do to make a change and kind of go back to my ancestors and my roots and taking advantage of knowing Japanese.
[00:16:04] Speaker A: Yeah, for sure.
So you complete this thesis project and derive these relationships between abdominal diagnosis and formula patterns, and then how does it grow from there?
[00:16:18] Speaker C: So during that thesis project, I also found a teacher, Nigel Dalles, who is in New York, and he's a shiatsu practitioner who trained in Japan, but also a Kanpo practitioner. And he's the one that taught me fukushin.
So during that thesis time, I travel wherever he went to give a workshop and learn from him. And then. And even when in his classes, it wasn't a systematized way of teaching. In terms of this formula is this abdomen. This formula is this abdomen. But There was no pattern to it. And so it was.
It was great in terms of he categorizing the respiratory formulas and cardiovascular formulas, gynecology formulas. But in the clinic, when we palpating the abdomen and doing the intake for the patients, what we gather as an information in terms of palpating the abdomen. Oh, there's a hardness here. Oh, there's a pulsations in the abdomen. What does that mean?
So we have to do it kind of backwards thinking.
So I developed kind of program and teaching in a way that practitioners can utilize the information right away so they find the abdominal findings and then they can look back and say, okay, this meant this herbal method. That meant this finding means gluja method. But there's also underlying blood dryness that's presented in them. Abdominal patterns. What formulas has Guizhu method, but has blood nourishing herbs.
[00:17:56] Speaker A: Right, Right.
So it's an organized structure where each finding on the abdomen narrows down the formula choice until finally you land at the right one. Yes. Yeah, you mentioned that Nigel Dawes was a kanpo practitioner.
Tell us a little bit about that. Just in general. I know some people know the term, but maybe don't know what it means.
[00:18:16] Speaker C: Yeah. So kampo literally means Ham dynasty method, and it's loosely means Chinese herbal medicine that's practiced in Japan. So in a way, sometimes people refer that as Japanese herbal medicine, but it still is something that comes from China and especially the during the Han dynasty era. And it is the history of kanpo is also interested in Japan, because during the 18th century, there was a modernization of medicine in Japan, where a lot of drugs and vaccination were introduced.
So there was a decline of practice of kanpo during the 18th century.
And between that and then all the way to about 20th century, there was not a lot of Kanpo practitioners or practice of Kanpo.
[00:19:15] Speaker A: Sure.
[00:19:16] Speaker C: But during the 20th century, all the MDs were finding the side effects of the drugs.
So they started to incorporate kanpo in the hospitals, actually to treat those and counter those side effects of the drugs.
[00:19:31] Speaker B: Interesting.
[00:19:32] Speaker A: So people were taking both of them.
[00:19:34] Speaker C: They were taking the pharmacy, both of them. And they still do so in Japanese hospital setting.
First of all, In Japan, only MDs and pharmacists can prescribe Kampo the herbal medicine, not the acupuncturist.
[00:19:48] Speaker B: Right.
[00:19:49] Speaker A: Wow, that's interesting. So there isn't a class of non MD herbalists in Japan.
[00:19:57] Speaker C: All MDs are technically trained very little in Kampo.
So patients can come and say, I want to wait to take drugs. I Want to try with the Kampo first.
Right. So then they have a options to do that. Or they can take both at the same time.
[00:20:17] Speaker A: Got it.
[00:20:18] Speaker C: But it's only prescribed by MDs and pharmacists.
[00:20:21] Speaker B: Yeah. And there were. Correct me if I'm wrong, but there are certain people like Otsuka Sensei, right. Who really decided I want to do campo like that is the thing. Even with an MD training, kind of going all in on that method, Is that right?
[00:20:38] Speaker C: Yes, absolutely.
[00:20:41] Speaker A: So once you've done your training with Nigel Dawes and you've really started to take on this Fukushin project and organize it in a functional way, it's still, of course, something you're using in the clinic today.
[00:20:56] Speaker C: Yes.
[00:20:56] Speaker A: And something you're still teaching people today.
[00:20:58] Speaker C: Yes.
[00:20:59] Speaker A: Why?
Why this?
[00:21:00] Speaker C: Oh, it's so useful.
[00:21:02] Speaker B: So useful.
[00:21:03] Speaker A: So useful. Tell us how, Kumiko.
[00:21:05] Speaker C: Oh, it is so use useful. Because I don't know about you all, but pulse is so difficult. Right? This is something that I tell students all the time. If you had five practitioners in the room and one patient, they all take the pulse. All five practitioners are probably going to call that pulse quality differently in that one person. Whereas abdomen. We all going to agree on our findings.
And it's very. There's no. It's not mysterious like the pulses.
There's not a lot of room for interpretation.
You find what you feel and we all going to agree. And it's easy to master. It's not something that's subtle. It's not something you have to be super sensitive. Your hands don't have to be cultivated in a way that you had to do your qigong every day. It's not like that. So it's very easy to approach and it's one of the easiest diagnostic method and tools that we can use, but somehow not taught in most of our Chinese medicine curriculum. Right. Like we learn face, tongue, pulse, not abdomen. We don't really palpate the abdomen.
[00:22:18] Speaker A: I. I mean, I didn't know anything about it until Travis started doing training with it.
[00:22:23] Speaker C: Right.
[00:22:24] Speaker A: And so like you mentioned the pulse. I. I actually don't really use the pulse at all.
[00:22:28] Speaker C: Holy. Just so.
[00:22:29] Speaker A: Just, you know, sorry, everyone who's like horrified by that notion. But like, in fact, someone, one of the residents the other day was like, oh, what do you think about my pulse? I was like, oh, I have no idea. And they're like, what do you mean? I was like, I can. I can tell you if it's excess or deficient, that is it surface or deep, that's it. That's all I got. Subtlety on the pulse quality. I don't have it. And it's because of exactly what you said. I found it very hard to learn in school.
[00:22:54] Speaker B: Oh, it's impossible to learn in school.
[00:22:55] Speaker A: Yeah. And I just. I don't, like, like, there was so much to learn in school that I was like, I don't want to put my intellectual energy into this thing that feels so subjective and squishy. And like you said, five people give me five different reads on the same wrist.
And I think maybe, like, maybe if schools were different. Right? Like, maybe if you followed one supervisor for two, three years, like in a.
[00:23:20] Speaker C: Mentorship form or something.
[00:23:21] Speaker A: Exactly. So that that person puts their hand on, they say, this is wiry. And then you. That person's always going to call the same pulse wiry. So you can basically calibrate yourself to that person and then see how they use this thing that we have decided is wiry in the clinic. And then it all fits together. Right. But five different providers telling me five different pulses, using them all in different ways. I was like, this is madness. I can't do it. And so in my practice, before I started leeching off of Travis's learning with the abdomen, I just used tongues and what I. And questioning.
And as we all know, questioning the patient is useful, but has its limitations in terms of, like, well, which formula here? Because you tried your best to get as much information out of the patient as you could, but, like, it just didn't give you enough. And there's still too many formulas on the table to pick.
And when Travis started showing me the abdominal stuff, I was like, why didn't we learn this in school?
[00:24:20] Speaker B: Right?
[00:24:20] Speaker A: I mean, seriously, like, exactly how you categorize that, Kimiko. Like, it's relatively easy to learn. It's relatively objective. I mean, I suppose there's some qualities, like the sort of dry abdomen qualities maybe we might find some subtlety in. But, like, mostly we're all just going to agree. Yeah. And it's so clearly linked to a formula choice.
[00:24:39] Speaker B: Yeah.
[00:24:40] Speaker A: And that just blew me away. Like, I was like, seriously, we should be teaching this everywhere.
[00:24:44] Speaker C: Yes.
[00:24:45] Speaker B: Yeah, yeah, absolutely. I remember. So for those of you guys who don't know my. My history in this, I did a little bit of training in fukushin, and then I actually emailed Kimiko. One of our first interactions was over email, and I was like, kimiko, I'm trying to figure out this fukushin stuff. I don't know what's going on what do these qualities mean?
Do you like, would you mind engaging in a dialogue with me about this? And she was super gracious and very generous with her time and explanation. It was a long. It was a long email chain.
Yeah, but that's, you know, this is a little bit how I work. I'm curious and I, I want to. I want to understand things in clinic.
And, and if you don't, like, if you just toe in the water with a lot of these systems, you. They're not going to make much sense. You kind of have to go a little deeper. And like you were saying, figuring out formula methods with the abdomen is huge. If you just try to read the Inaba's text. Right. And you get to see the pictures, which is great. Now, there is a translation in English, but I don't think it's for all 12 volumes.
[00:25:55] Speaker C: I think they're still working on.
[00:25:57] Speaker B: Yeah, right. I think they have the first four, and the translation of the first four is great.
But if you read that translation, you'll see Inaba talking about how badly he's made mistakes. Right. Like, oh, the patient came in and I gave this formula, and then I did this formula, and six months later, the patient wasn't better. And I went to my teacher and my teacher scolded me and said, you do not understand the ways of the ancients.
And it's just like, holy crap. You know, I love that about that.
[00:26:30] Speaker A: Book though, because a lot of people, shall we call them case study or example books?
[00:26:34] Speaker B: Yeah.
[00:26:35] Speaker A: Only focus on success.
And you always think to yourself like, well, I mean, I'm glad he took two bags and felt great. But then you're like, but how many other patients did this work on?
[00:26:45] Speaker C: We can learn so much from our mistakes too.
[00:26:47] Speaker B: Yes, 100%.
[00:27:19] Speaker A: Travis and I talk about abdomens a lot on the show, but we've not really sort of organized it in this framework of fukushin as a method. So maybe for the listeners. Kimiko, can you give us just like a very brief walkthrough of like, okay, patient's in. You've done your questioning. It's time for abdomen. What does the.
[00:27:34] Speaker B: Actually, it would be cool to know what order you do your intake.
[00:27:39] Speaker A: Yeah, Maybe just start from the top, then walk us through it.
[00:27:42] Speaker C: So first of all, some practitioners have multiple rooms at once. Right. And I have tried that. I'm still trying that a little bit here and there, but most of my patients I spend with is 50 to 60 full minutes because I take all that time doing the intake, taking the so first I take do the intake and I take their pulse. I look at the tongue and I have them lay on the massage table and I palpate the abdomen.
And then by then that's already.
It's probably like 20 minutes total.
And then I have a pretty clear idea of what points to do and what formulas I'm thinking about.
So. And then I once I palpate the abdomen, then I put the needles in, I let them rest, and then I write down the formula.
[00:28:35] Speaker A: Got it. So when you approach the abdomen, give our listeners a sense of like general fukushin walkthrough. What's it look like?
[00:28:43] Speaker C: It's pretty quick. So I know that I think it actually takes even much less time than the pulse. Some people take pulse for five to 10 minutes. Right. The way I do the fukushin sequence, it takes less than two minutes.
But I do usually start with the abdominal massage, which all my patients love.
It's something that they expect. They know that I popped their bellies all the time. So when I skip it because like they were just here a few days ago or last week.
Some patients that I've known for years, I don't necessarily need to pop it their belly every single week.
But if I skip it, they will say, why is my belly rub.
I train my patients so well that they know that this is something that they should expect.
[00:29:29] Speaker A: Yeah, that's great. I love it. So when you do the abdomen, you walk through it, it's skin and skin. Like you're touching their actual skin.
[00:29:37] Speaker C: Yes, definitely. Skin on skin.
[00:29:39] Speaker A: Okay. And then this sort of kata the work through. How do you flow through it? What's the first part?
[00:29:45] Speaker C: Yeah. So first you visualize, you watch the abdomen, right? See if there's any scars. Is there any redness?
Does it look bloated?
And then you start palpating and massaging the belly to relax the abdomen. And then I start usually at the epigastric area and then subcostal.
And then I percuss over the stomach to listen.
And then I go right into the rectus abdominis muscle to feel the ropiness of the rectus.
And then I feel full pulsations all along the rami around the umbilicus.
And then I focus into the lower abdomen, feeling full fullness, emptiness hardness, bow tie. And then lastly I do the very deep palpation, which is really going looking for the blood stasis.
[00:30:36] Speaker A: Got it. Okay.
[00:30:37] Speaker C: And then end with the massage as well.
[00:30:39] Speaker A: So they get the massage on the front and the back end.
[00:30:41] Speaker C: Yes.
[00:30:42] Speaker A: Nice no.
[00:30:42] Speaker B: No wonder they demand it.
[00:30:44] Speaker A: They get two. What happened? I need my belly fixed.
So in that case, this is something that Travis and I talk about a lot. I mean, even just procedurally, mechanically, as you move through it, it sounds to me like you're kind of looking at surface level stuff to deeper stuff on some level, right? So we're like at the top layer of the body or at a QI level or something, and then we're moving deeper into the blood segments of the body.
[00:31:08] Speaker C: Yes, absolutely. Yeah, yeah.
[00:31:11] Speaker A: Why do it in that order?
[00:31:13] Speaker C: Well, because we have to treat what's on the surface first. What is excess or what is blocking first before we start to nourishing or building things up.
[00:31:23] Speaker A: This is something that we talk about a lot, actually.
[00:31:25] Speaker B: Oh, my God, it's so important. Oh, so, so important.
[00:31:28] Speaker A: We were joking the other day. That patient, or actually, no, it was one of our residents, was like, had a situation and they're like, I'm not sure, is it Xiaochai Hutong? I could probably go this way, but probably Shao Chai. I was like, just start with Xiao Cautang. Like, it's fine. You know, basically everybody needs a little harmonizing these days, you know, And I was joking that I feel like Xiao Caihutang has become. You know how some practitioners just use Xiao San all the time? Like, just like, oh, you're stressed, Shaya San.
I feel like that's sort of what's happened with me in Xiao Caiutang. I'm like, pretty much I have to start there always. You know, it's like everyone's got this disharmonious, stagnant quality.
And I think this is, again, another thing. You know, we talked about not learning the abdomens in school, but I also think one of the missing components in really understanding how to apply an herbal formula is not. I don't think I, at least speaking for myself, really understood the idea that you many times cannot just go straight to the thing that seems to be the core problem.
You know, it's like. Cause you do this diagnosis and you're like, oh, this is a blood stasis problem. And you're like, well, then I just need to move the blood. Move the blood, obviously. Why waste time?
Except it doesn't really work like that. Like, if you give that person the blood stasis formula, I mean, worst case scenario, nothing at all happens, right? And you're just like, this didn't work. But also they just send bloating or side effects, a loose stool, and. And they don't feel better. And you're going, did I get the formula wrong? Did I get the dosing wrong? And it's like, well, no, I mean, that's the formula for that stasis. But there was a pile of stuff on top of that problem that you haven't cleared.
And it's funny because now at this stage in clinical practice, having been doing this for a little while, that seems really obvious. But I remember as a student, it wasn't.
And I see it in our residents when they ask us questions about formulas, they're like straight to the root problem, you know, And I'm like, no, no, we gotta. But see all this subcostal tenderness? We can't deal with this yet.
[00:33:24] Speaker B: Yeah. You know, I have. I have a little bit of a theory about this. Well, I'm going to just say this and then you guys can feel free to disagree. But I think as you were saying, Kimiko, about the way that you learn in school, the diagnostic methods, right. You get pulse diagnosis, which is different from every person that you go to clinic with.
And then you get.
Most people don't get abdominal diagnosis at all. Some people are maybe lucky. But then everyone gets tongue diagnosis.
And because the tongue is much more readily agreed upon by everyone else, that's the one that people use.
And I think this has a deleterious effect on diagnosis because it overly materializes what people think the diagnosis is. So people can see water metabolism problems on the tongue easier. Right. They can see blood stasis on the tongue easier. But qi problems are harder to see.
Right. The superficial and external contraction, very difficult to see on the tongue. Sometimes the tongue doesn't change. Hardly at all.
[00:34:41] Speaker A: No.
[00:34:41] Speaker B: Right. Now, some of that stuff you can see on the abdomen, which is why the abdomen is great. But I don't know if this is your experience, but there are certain patterns that are also very difficult to see with fukushin that are kind of superficial external contraction. Is that your experience too?
[00:34:58] Speaker C: Yeah, absolutely.
[00:34:59] Speaker B: Yeah.
But it's interesting because the tongue diagnosis is what people tend to feel confident with because there's more universality and agreement when we go to clinic and school.
But then that's also how people start to conceptualize the reality of Chinese medical diagnosis as students.
So then they sort of overly prioritize the material aspects and under prioritize the functional aspects.
Over prioritize yin type treatment and under prioritize treating. Treating the yang. Right. Or treating the surface or the function.
Yeah. So this is my. This is one of my conspiracy theories. I think about this all the time. Because when we get residents here who are training and I hear about their thought process with diagnosis, it's almost always overly materialized. They miss something superficial, they miss something that's functional.
[00:35:54] Speaker A: Yeah.
[00:35:54] Speaker B: And then they give a treatment and then it's. It's not so effective. And they're like, why? Right, right, yeah.
[00:36:00] Speaker C: That's what I mean by like first removing the obstruction.
[00:36:05] Speaker B: Yes.
[00:36:06] Speaker C: So that's. Once we move obstruction or move excess, then the body should know how to restore itself.
[00:36:15] Speaker B: Right.
[00:36:16] Speaker C: Or let the body restoring some and seeing what's still underlying.
[00:36:20] Speaker B: Yeah.
[00:36:21] Speaker C: Right. So then there's a lot of things comes up after you correct your bowel movements once you open the epigastric area.
Right. And then the things really come up.
[00:36:31] Speaker B: Right.
[00:36:32] Speaker C: And then, you know, you still need to treat that.
[00:36:34] Speaker B: Right. Yep.
When is the. Is the fukushin not as effective? Let's talk about that because I think that would be interesting for people to know.
[00:36:44] Speaker C: Right. When is it not effective is like you said, when person is having the external contraction. So in a tie in state, there's not much to be found in the belly, but in the pulse and in the symptoms.
[00:36:59] Speaker B: Right, right. Yep. That's my experience too.
[00:37:03] Speaker A: I mean, this highlights the position, I think, of abdominal diagnosis where like, if tongue is most material and pulse is the most functional.
[00:37:13] Speaker B: Functional.
[00:37:14] Speaker A: Immaterial.
[00:37:14] Speaker B: Immaterial.
[00:37:15] Speaker A: Then of course the abdomen is in between.
[00:37:17] Speaker B: Yes.
[00:37:17] Speaker A: Yeah.
[00:37:18] Speaker C: It kind of is you in this.
[00:37:20] Speaker A: Oh. And I think it's one of the reasons too, that it's easier to learn because it's more material. Material stuff's easier to learn. Right. You can see it.
[00:37:26] Speaker B: Right.
[00:37:27] Speaker A: We can touch it and be like, see, it's hard.
[00:37:28] Speaker B: Yeah.
[00:37:29] Speaker A: Poke it. Immaterial things, harder to learn require more calibration, more specific attunement.
And it's the stuff that I think is also the stuff that's really hard for western sciences to understand. Because western science is material science.
[00:37:43] Speaker B: Exactly.
[00:37:43] Speaker A: And so it's like this pulse thing. What are you talking about? It's crazy, you know, But I think it's interesting that you guys point out where the failure is or the limitation, I guess not really failure. It's just a limitation of the model. Because if something is happening right now, I mean, we all know how quickly external contraction changes to the point, in fact, that like most of the time, by the time someone comes in here, they're not in a tai young state anymore because it just. It already happened.
[00:38:07] Speaker B: Not exclusively.
[00:38:08] Speaker A: Yeah, yeah. I feel like the only people who really benefit from my. My top level Herbal stuff is myself, my wife, and our immediate friends who now know to call me and be like, hey, I think this. And I'm like, great, here's this formula for you. But the patients, you know, it takes three, four days for them to get in to see you, if they come at all. Which is another thing we've been training our people more and more about. It's like, look, man, if you got a cold, get in here.
In fact, just this week, this is, of course, the time of year for it. We're recording this in fall in Portland. That's what people are getting sick.
And so people have recurring appointments, newer patients to us, people we haven't gone through this ritual with already. And so they'll be sick and they'll call to cancel the appointment. You know, oh, I'm sick. I don't want to get you guys sick. And literally I say, I can't. This is the phrase I use all the time. I'm like, hey, if you feel like you can get here safely, put a mask on, come in. We deal in sick people.
That's actually what we do. So it's totally fine for you to come in sick. It's so funny, right. Because could you imagine someone like, canceling their MD Dr. Appointment because they were sick? You know, be like, you go to the doctor when you're sick, you know?
[00:39:12] Speaker B: Right.
[00:39:12] Speaker A: But people imagine us, I think, in that. Because some people do ask for cancels. Right. Like Cairos and massage therapists and stuff like that.
[00:39:18] Speaker B: And a lot of people in our field, if we're being clear.
[00:39:20] Speaker A: Yeah.
[00:39:21] Speaker B: A lot of people in our field want their patients to cancel if they're sick.
[00:39:24] Speaker A: Yeah. Well. And if you don't have herbs in your back pocket, there's not. I mean, I'm sure you can do something, obviously, with acupuncture, but it's not going to be quite the same as if you have herbs that are in the mixture. So. Yeah. It's interesting to think about abdominal diagnosis in this middle space, really, between tongues and.
[00:39:40] Speaker B: Yeah.
[00:39:41] Speaker A: And pulse. I also think it's interesting the.
The idea that people overly relying on tongues drives them to a more material diagnosis, you know?
[00:39:49] Speaker B: Yeah. It's just something I've noticed, and I don't know if it's true. It's just something that I put together.
[00:39:55] Speaker C: Oh, yeah.
[00:39:55] Speaker A: You know, it feels true.
[00:39:56] Speaker B: Yeah.
[00:39:57] Speaker A: I mean, for whatever that's worth it. It feels.
[00:39:59] Speaker B: Feels true.
[00:40:00] Speaker A: Well, and also because, like, tongues are like. What I always think is interesting about a tongue, right. Is like, you look at Someone's tongue. And I think if you're good at tongues, you can see what is this person's chronic nature. Right. Their constitutional basis. Right. You look at a tongue and be like, we got a water metabolism problem. We got a damp accumulation thing. We've got a spleen deficiency.
Easy to see on a tongue. But that doesn't necessarily mean that we need to then tonify the spleen as the first move. Sure. It's like, actually, probably not. There's probably so many things that need to happen before that. But what I like about it is, like, once the abdomen starts to clear and once the, you know, I guess you guys would have better thing with the pulse. But I feel the pulse and I go, well, it doesn't feel crazy to me. So that's about as far as I get with it.
[00:40:46] Speaker B: It's less crazy this time.
[00:40:47] Speaker A: Less crazy this time. And the abdomen starts to clear.
And then I'm wondering like, well, what else? Like, what's next? Now I can look at tongue, right? And be like, oh, see, tongue is still showing us this core problem. Because it can take. I mean, in my experience with tongue, I mean, it can take months for a tongue to shift because it's so material, so body.
[00:41:07] Speaker B: Right. It's one of the reasons I think people who exclusively do acupuncture don't use the tongue as much. I only know of one acupuncturist who looks at the tongue before and after treatment and who thinks that they can see a difference.
[00:41:20] Speaker C: Oh, wow.
[00:41:21] Speaker B: Yeah, that's Shimomura Sensei, high level acupuncturist.
[00:41:25] Speaker A: I was gonna say, they probably can see a difference.
[00:41:28] Speaker B: I mean, you can see a difference. If you take a picture of the tongue before and after you treat somebody, you can see a difference. But it's. I mean, I can't claim.
[00:41:37] Speaker A: No, that's another.
[00:41:39] Speaker B: Anything like that.
[00:41:40] Speaker A: That's another level of skill, you know, so.
So after you work through someone, you've got this idea, Kimiko, of a formula in mind, because the abdomen has helped to clarify that.
I'm interested in how you talk to patients about taking herbs. This is something we talk to the listening audience here a lot and our residents a lot.
And the reason I'm asking is because, you know, when a lot of people come to us in the residency or other practitioners we know who don't use a lot of herbs, they're interested in it, but they. This is what they'll often say. I, I love herbs. I wish I. I want to write more herbs, but patients Just aren't really interested in taking it. That's what they'll say to me. Right. And I always think, like, all of our patients take herbs. Are we. You know, and I don't. But I don't think that's because we just lucked out and got the ones who are already interested in it. I think it's about how we pitch it.
[00:42:29] Speaker C: It is about educating them. Yeah, yeah. And so I do tell them that it is the most beneficial to do. It kind of comes in a package. Right. And unlike in China, we are not seeing patients daily with acupuncture treatments in order to get them better. If they're coming on daily basis, maybe they don't need herbs. But most of the time, we don't see them for a whole week, two weeks.
So I said during that time that I don't see you. If you are continuing taking herbs, it's going to keep that efficacy of the Chinese medicine as a whole and you will get better quicker.
[00:43:06] Speaker A: Yeah. It's like it's doing the work that you would be doing if they came in every day.
[00:43:10] Speaker C: Exactly.
[00:43:11] Speaker A: Because they're taking it every day.
[00:43:12] Speaker B: Yeah.
[00:43:13] Speaker A: Right. They're going forward. Yeah. That. That confirms my suspicion. Like, it's about the pitch. Like you just have to convince people. Well, not even convince them. You just lay it out. Because that's the other thing. Because the word convince suggests there's, like, persuasion, but it's not a persuasion game. It's like, this is what I do. This is how I can help you get better. Right, right. That's it. That's the. That's the whole story in the end, you know?
So we have an idea, I think, of how fukushin works in general and how you use it in your practice. I know we were interested, too, in, like, how this plays out, particularly in the realm of women's health, which is a place that we don't have a lot of experience in. So maybe tell us a little bit about your interest there and sort of how that. How that works in your practice.
[00:44:12] Speaker C: You know, it's funny how this started, because I was never necessarily specializing in women's health, but somehow at school, people assumed that that's what I was specializing, because all the patients that are coming to see me at the school were coming with gynecological problems.
[00:44:31] Speaker A: Interesting.
[00:44:31] Speaker B: It shows you, I think.
[00:44:32] Speaker C: Yes, yes, yes.
So, so. And then I loved it. And then. So it's. It's great. But Fukushim is so useful in terms of gynecological health and women's health in general is because once when we're talking about the pulse, for example, Right.
When we are seeing the difference and changes in, in the blood, the quality of the blood, it takes a long time to actually manifest and see that change in the pulse.
And then also that quality is quite difficult in terms of it could be expiry, it could be choppy, it could be very faint, it could be very thin, it could be all over the place.
And then to get to that post, the change to that, it's pretty already advanced in terms of the blood pathology.
But we can catch that so much earlier in Fukushim by palpating the abdomen, you can detect the health of the blood much, much quicker, much earlier. And we can see the change. And then abdominal patterns actually may not change for a long time. So let's say somebody has a blood stasis, you find blood stasis in that Fukushim, you give formulas.
The abdominal patterns may not change for months, but their symptoms will get better much quicker.
Right. So some things, some patterns takes a longer time to dissolve in abdominal patterns like epigastric congestion or subcostal tightness, that's easier and to treat.
Whereas blood stasis in the abdomen, that might not go away for months or years.
[00:46:12] Speaker A: Right, Right.
[00:46:12] Speaker C: But they will start to feel better, their menstruation will get better. But also I love using the Fukushin for men's health because they don't menstruate. We cannot ask questions revolving around menstruation.
So they have no ways to really detect their blood, detect their blood health.
[00:46:33] Speaker A: Right.
[00:46:33] Speaker C: As women do.
[00:46:34] Speaker B: Really good point.
[00:46:35] Speaker C: Right. So like in the male body patients, I palpate the abdomen, I still, of course they have blood. So of course there's going to be a blood stasis too. And that I think that is a huge prevention for even like a bigger like cardiovascular health.
[00:46:53] Speaker A: Yep, that's a really interesting idea because that's true. Because when I question out menstruation for female bodied patients and someone's reporting, you know, very dark blood with clots and painful cramping and things and I'm saying like, oh, there's clearly a stagnant blood pattern here, there's no equivalent methodology that would just like because even if the person wasn't in here for menstrual problems, just as the normal questioning I'm seeing like, oh, there's very clearly a blood stasis issue going on because they're actually in here for shoulder pain. And it turns out that this is related. But we don't have an equivalent in the male questioning. And so being able to pull it from the abdomen is a real advantage.
I'm interested in something you said there, too, about the timeline for resolution in the abdomen. So one of the things that we've been spending a lot of time on in the show lately is not just identifying the initial formula that you might give someone for a condition, but then how the whole case changes as you sort of peel the layers off. And the question that we get asked from listeners and from the residents is, well, how do you know when it's time to change? Or how do you know when it's time to stop the formula, like, when it's successfully completed? And so you mentioned here that person's symptoms getting better, they're feeling better. That's obviously an indicator for stuff's going the right direction. But the abdomen's still showing same congestion, so they're not done. So you're having them continue until the abdomen clears?
[00:48:17] Speaker C: Yes.
[00:48:17] Speaker B: Yeah.
[00:48:18] Speaker C: Yes.
[00:48:18] Speaker B: Yep. That's. That's what I've found as well. The objective findings have to change.
[00:48:23] Speaker C: Yes.
[00:48:24] Speaker B: Yeah, yeah.
[00:48:25] Speaker A: Because otherwise it's like feeling better halfway through your antibiotics.
[00:48:28] Speaker B: Right.
[00:48:29] Speaker A: And then stop.
Right.
[00:48:30] Speaker C: It's like, nope, day five, and they give up. Yeah, yeah.
[00:48:33] Speaker A: No, you got to keep taking them all the way through.
[00:48:36] Speaker B: Yeah.
[00:48:36] Speaker A: Okay. And so for conditions then, that are more material in nature, like blood conditions, it's been your experience, too, that it can take a while for that to move.
[00:48:45] Speaker B: How do you assess the health of the blood in the abdomen? How would you say that that's done?
[00:48:50] Speaker C: Yeah. So first. First thing, when you touch the abdomen, how's the skin? Right.
So there's this certain moisture that you want to have in the skin and tone in the skin.
People who have dry blood or stagnant blood, they have dry skin. And sometimes in the worst case, it will be scaly skin. Like, we all learn about scaly skin with blastases. Right. So that's the most kind of severe version of that. But even if they have. For example, I have a patient who is way past menopause, and so we. I can't ask any questions about menstruation, but her chief complaint is constipation.
And then I tried a lot of things, but one thing that has always been consistent is her skin is so scaly and dry.
So I know that her constipation is really coming from the dryness of the blood.
So then your prescription methods change completely. You don't really think about all these purgatives or unblocking the bowels, but you really think about moistening the blood.
[00:50:00] Speaker A: Yeah. So a different approach. Like probably not a lot of heavy matzo renwan formulas. A shift instead to something more blood centric.
[00:50:08] Speaker B: Right. But then again, you also have Da huang Zhe tong wan in the deficiency taxation chapter, which is, you know, you're like, what? It's like Dahuang and bugs and stuff. Why is it deficiency taxation? But these things can co.
[00:50:21] Speaker A: Occur.
[00:50:22] Speaker C: Yes, it can.
Especially when it's chronic too.
[00:50:24] Speaker B: Especially when it's chronic. Yep. Yeah.
[00:50:27] Speaker A: I wish we could get our hands on those bugs.
[00:50:29] Speaker B: I know.
[00:50:30] Speaker A: It's really so hard to get the. It's the song.
[00:50:32] Speaker C: Yeah.
[00:50:32] Speaker A: It's hard to find the horse flies.
[00:50:34] Speaker B: Yeah.
[00:50:34] Speaker A: Which is crazy because like, surely we could get someone to grow some horse flies.
[00:50:38] Speaker C: Yeah, I think so. Yeah.
[00:50:40] Speaker A: The problem is always the same problem with herbs. Bulk herbs, though. It's just that there's no actual market for it.
[00:50:44] Speaker B: Yeah.
[00:50:45] Speaker A: Like I actually. Because in the US for example, you. You cannot find easily guiban. Or what's the other one? The.
[00:50:53] Speaker B: The top shell, Bijia.
[00:50:55] Speaker A: Yeah.
So we had.
I can't remember the formula now. It's one of the wands we were trying to make Dabuyun Wan. We were gonna make Dabuyin wan. And I wanted to make real wands. So I had to go find some guyban. And I was buying it from China just direct through Alibaba. And this was years ago before COVID And one of our shipments got flagged by U.S. department Wildlife and Fisheries because they were actually sending us some endangered turtles. Right.
But they were growing them on a farm. But it doesn't change the fact that they were endangered. Right. Or not endangered. They're on the protected list.
So I was like, okay, we can't get this guiban anymore. But I was like, wait a minute. I'm from Louisiana. People in Louisiana eat turtles. They capture them. There's a whole market.
[00:51:40] Speaker B: Turtle soup.
[00:51:41] Speaker A: Turtle soup. Turtle meat. You can buy it in the grocery store. Right. And so I thought, well, I wonder if I just figure out if someone in Louisiana is capturing the same rough species of turtle. Right. So anyway, it took me about half a year. I found someone really nice people in rural Louisiana. They are farmers and trappers. And so I convinced these folks to keep the. Because for them, the shell's just waste.
[00:52:03] Speaker B: Yeah.
[00:52:03] Speaker A: Because they. It's just the meat that they sell. So of course I wanted the.
The bottom shell, dorsal one, and the. What's the other side? I don't Know, I don't know, whatever the medical.
[00:52:14] Speaker B: Do my. Run my.
[00:52:15] Speaker A: The bottom shell. The one on the bottom. The opposite of the dorsal shell. Anyway, I wanted the one on the bottom. So I talked to them about it, and they were great. They would dry them out. They sliced them into pieces. They gave me a price that was expensive but not wild compared to, like, other animal products. I think it was like $40 a pound or something.
And I right now have, like, I don't know, like 15 pounds of Guiban.
[00:52:38] Speaker B: Here, because we still have some. Because we don't use it that often.
[00:52:41] Speaker A: We don't use it that much. And Dabu Yinhuan we use it for, but there's just not that much more. And other people don't really use it.
And ultimately we couldn't move as much of it as they could generate for us. I mean, they are trapping turtles constantly. So, like, we could have Guiban without end just from this one little farm, this one little source in Louisiana. But in the end, we just had to stop buying it. And just. I told him. I was like, hey, I'm sorry. I just. I have a surplus. I can't move it. You know, I even sent a sample to Spring Wind, to Andy Ellis at Spring Wind, and I was like, hey, I got a source. Domestic source, Guibon. You want to keep it on? You know, and they just had a lot going on. They'd never been able to make it happen.
But so something like the horse flies, like the Zuchong, it's the same, right? Like, there are people who grow worms for bait, people who grow mealworms for, like, I buy them for my chickens. You can buy a bag of dried mealworms to, like, give to the chickens. There are people who grow bugs as part of their business, but there's no business for black horse flies.
[00:53:40] Speaker B: Right, right, right.
[00:53:41] Speaker A: I mean, we do. We have use for it, but, like, we're tiny, you know, I need, what, two pounds a year of black horse flies, you know, like, that's just not going to be worth it.
[00:53:50] Speaker B: It takes a lot black horse flies to get to £2. Things are light.
[00:53:53] Speaker A: Yeah, exactly. So I always. It's so frustrating because there's. There's these cool formulas and cool compositions. I mean, this is our perpetual conversation with not being able to get Ma Huang, for example.
[00:54:03] Speaker C: Right.
[00:54:04] Speaker A: Super tedious. Actually, we didn't tell you about that. We've been using brigham tea, the domestic ephedra, and substitute for Mahuang at like 150%. So, like, half again as much when dose it seems to work okay. I mean, it's interesting. Yeah, it's not. It's not the fullness of Mahuang, but it's pretty close approximation so far.
So at least for the more surface y stuff like, I don't know yet about if you know, for arthritic conditions and stuff at work there. But anyway, it's an interesting observation. And it's the same genus, just a different species, the domestic.
[00:55:06] Speaker B: I want to ask you about some particular formulas that you might have some expertise in.
[00:55:11] Speaker C: Okay.
[00:55:12] Speaker B: So when we were getting into clinical practice, the most influential teacher for our herbal medicine was Greg Livingston, who taught us at OCOM and then came to practice here. And, you know, Greg still comes by every now and then. Like, we like seeing him. But Greg really was very influential in our interest in using a certain set of formulas because he would literally use them all, all the time. You know, xiao cai, hutong, wulingsan, dongwei, xiaoya san, sinisan guizhu, fuling wan. Like if. If you could learn how to use those five and they're. They have shared herbs, right?
[00:55:55] Speaker A: Sure.
[00:55:55] Speaker B: So you can use them together.
Man, you could treat a whole lot of stuff with just those herbs.
I want to ask you about dongwei shaya san. So what would point you to a dongwei shaoya san type of picture from the perspective of fukushin and the other symptoms that would kind of ping on your radar for that formula?
[00:56:16] Speaker C: Yeah, yeah, It's a fascinating formula. I think of that formula as one that harmonize the blood and the water.
Right. And then so you have three sets of herbs that work on the blood and three sets of herbs that work on the water metabolism.
And in the abdomen, there is going to be some dryness of the blood.
So there could be pulsations in the abdomen. Pulsations, especially around the umbilicus.
There could be a blood stasis or what we call oketsu positive, like around the zugong area, there's going to be tenderness or pain or there's a knot.
Right.
[00:56:55] Speaker B: And is that around? For those people who don't know that, that's around the umbilicus, like to the side and a little bit below kind of.
[00:57:04] Speaker C: Yeah. It's basically a midpoint between the umbilicus and asis.
[00:57:08] Speaker A: Right.
[00:57:10] Speaker C: Some people call it like around the. Roughly around the Spleen 14, which is also has a fascinating name where it has a fujie. So it's like an abdomen knot. So it's literally at the point where the oketsu will be. There's that Knot sensation.
So there's that. And then also some kind of water metabolism in the abdomen too. So that again, that could be manifested as pulsations in the abdomen. Or it could be you can hear the water sounds or you see the water retentions in the body.
And then it's mentioned in the Jingui chapter. Right. For the pregnancy chapter. So I have had patients or I've had students ask questions about how can we use this, or is it safe to use this? Because it has quite a bit of Chong Shuang as well, which moves the blood, which is not safe during pregnancy.
So I've had students ask me about that. But it is mentioned in pregnancy chapter. It is safe because Bai Shao is so high. It's the highest dose of Bai Shao that we see.
So I said, as long as Bai Shao is higher than the Trang Shan, it is safe.
But I use it outside of pregnancy, of course, for a lot of things like PMS even because during that, the luteal phase, during the PMS time, a lot of women have this retention of water problem. So they feel bloated, they feel fat, and they feel flabby. The pants don't fit right. So it's like this, like they're retaining. It's not that they're getting fat. They're just retaining more water during that luteal phase.
So I think it's really useful during that phase too.
And also even premenopausal or even menopausal time, when also women will say, I can't seem to lose weight no matter what I eat, no matter how much I exercise, I'm even eating better. But I have all this weight gain, especially around the torso.
And then you pop in and you're just like, there's no stagnation in terms of excess. It's not that their bowels are blocked.
[00:59:20] Speaker B: Sure.
[00:59:21] Speaker C: And it's not that they're just simply just getting fat. It's just really, they're just retaining more water in the tissues.
[00:59:26] Speaker B: Yeah.
[00:59:27] Speaker C: So I think, I think of using like Dangu Xiaoya sound for that too.
[00:59:31] Speaker B: Makes sense.
[00:59:32] Speaker C: Yeah. So it's definitely not just pregnancy. There's a lot of things you can use Dangoo Shaya San for.
[00:59:38] Speaker A: I'm interested really to. To hear the, you know, the natural question from the students. Right. That's like, wait, this formula has some herbs in it that are quote unquote, contraindicated in pregnancy.
But that, of course, in the composition of Dang Wei Xiao San, the effect, the blood moving effect is mitigated by the xiaoya that's in there. Right. This came up the other day. A resident was asking us about, just in general, how do we deal with patients on blood thinners patients, pregnant patient has had history of breast cancer.
In fact, we had another clinician call to see what we knew about which herbs were estrogenic, was the way that rephrased which words are estrogenic. Because they had a patient who had history of breast cancer and now they're having really, really intense menopausal symptoms. In fact, they've been going on for a super long time. This patient apparently has hot flash every 25 minutes for the last decade.
And none of the Western interventions were available because of the history of breast cancer. And so any of the hormonal regulatory tools they were like, we're not going to use.
So the practitioner was like, well, which of the herbs are estrogenic? And I was like, nobody knows that.
And they were like, what do you mean? I was like, well, it's just the research is not really existent and if it is, it's super thin. And so, like, you know, the truth is, is that, like, if from my point of view, if the pattern calls for it and you use the formula in appropriate relationship to the pattern and the diagnostic. Diagnostic tools that you have, I think you can use it.
[01:01:09] Speaker C: Absolutely, I agree.
[01:01:10] Speaker A: And they were like, but what if there's an estrogen component? I was like, I don't know that there's any way to know that, you know, because. And even if there were, I'm not sure that looking at it through such a narrow lens, because this comes up, like, even, even the fact, like dongwei, if you just Google Donggui or maybe actually Dong Kuai or whatever it is that they call it in English, you know, and you just read the. Whatever comes up, the WebMD equivalent, like, it'll tell you contraindicated in pregnancy.
[01:01:38] Speaker C: Right?
[01:01:38] Speaker A: Abortifacient, you know, and you're like, dongwe, contraindicated in pregnancy. Like, it's like in every pregnancy formula ever.
[01:01:46] Speaker B: Right?
[01:01:46] Speaker A: You know?
[01:01:47] Speaker B: Yeah.
[01:01:47] Speaker A: And. But again, it's just like you have just a really limited window. And so people see that and they're like, oh, this is dangerous. But it fails to understand that in composition, with the right pattern, it's okay.
[01:02:00] Speaker C: And I think that's the idea of looking things materialistically too, right? In a Western world.
[01:02:04] Speaker B: Yes.
[01:02:05] Speaker C: They look at the one component or one chemical component in that herb, not as a formulation of the herbs. Together there are six herbs in that formula.
[01:02:15] Speaker A: And with the dose, like you mentioned, the dosing, the bishop high dose changes the way the whole thing works. It's not just the ingredients themselves, but their relative constituents.
[01:02:25] Speaker C: And then the bioshock dosage is high in that because it's protecting the fluid retention into the blood because you need that all that water content in the blood volume during pregnancy.
So you can even use it for during like preeclampsia. Right. When they have this risk of retention of the water or high blood pressure during pregnancy. But then you don't want to use diuretic like a ruling sound for people who are pregnant because they actually need all that fluids.
[01:02:56] Speaker A: Right.
[01:02:56] Speaker C: To be reabsorbed into the bloodstream.
Yeah. So I kind of think about like a dango Shaoya san as that's what I mean by harmonizes the relationship between the blood and water.
It reabsorbs that water content into the bloodstream which mother needs. You don't want to use like directly like a wooling sound that will flush it out.
[01:03:18] Speaker A: Right? Yeah.
[01:03:19] Speaker B: And there's some. Some I've heard some people argue again for the inclusion of Chuan Cheng with the exclusion of gui zhi during pregnancy at certain phases. Right. Because the Guizhu is going to heat up the blood more, whereas the Quanzhong isn't going to be as warm, but it's going to have a similar pungent kind of dispersal of the blood.
So in Dangui Shaoya san, you don't have Guizhi in Wulingsan you do.
[01:03:43] Speaker C: Right?
[01:03:44] Speaker B: Right. So that's kind of. That's an interesting thought there.
How do you like to. Do you like to modify Dangui Sha ya san when you write it? Is it a formula you typically give unmodified? How do you use it?
[01:03:55] Speaker C: Usually I usually give it unmodified. So that's another thing that maybe we should talk about a little bit about is modifications of the formulas.
So interestingly, we were talking about the Kanpo, the way Kanpo is practiced in Japan.
The way it's practiced in Japan, there's no room for modifications in Japan. So it's regulated by insurance company and it's funded by insurance company. And this is. In a way it's great because there's a lot of money for research. So that's why there's a lot of research in Kampo in Japan. Because it's. Pharmaceutical companies own it.
But at the same time there's no room for modifications because it's already prepackaged pre boiled and you don't make up your own Prescriptions.
So the way kanpo is practiced in Japan is interesting because if anything, if you feel the need to modify, they are more likely to combine formulas than adding one or two herbs to the formula.
So they will say you have a dango Shaoya San pattern, but then they might combine that with other formulas. Maybe they have a morning dose and they have an evening dose.
So that's how they do it. They consider formula as a kind of a packaged in a way that it has to fit the pattern in a certain way. If you have to modify by adding more than two herbs to the formula, your diagnosis is wrong. There's other formulas that probably better match the pattern.
[01:05:38] Speaker B: Makes sense.
[01:05:39] Speaker A: I love. It's an interesting headspace too, where it's like, oh, if you need to modify, you probably have the wrong formula.
[01:05:46] Speaker C: Think about other formulas.
[01:05:47] Speaker A: Yeah, well, and actually what's really fascinating too is when you know, with learning more about the complexity of formula, diagnosis and prescription. On the one hand you have all these very many formulas, but then of course, when you really start to peel them back, they are. I mean, it's a new formula, but in fact it's just a modification on a base conceptual formula. And so on some level, we joke about this all the time, like, what's the difference actually between a modification and a new formula? Especially when you have. When you have a formula that, you know, just has two herbs in it, you know, and it's like, oh, actually we combined this formula and this formula, but the formula we combined it with just has two herbs in it. So is that actually a formula and a new formula that came out of it? Or did you just add two herbs to the original? You know, and so on some level, it's a little bit semantic and a little bit funny about how they get combined.
I didn't realize that Campo was controlled in that kind of rigid way. I knew that people didn't modify it, but I guess I didn't really know why.
[01:06:45] Speaker B: So then for your practice, how does that translate to what you do?
[01:06:49] Speaker C: Yeah, so I do have a lot of pre blended formulas as a formula. Right. So I try to use those as much as possible, but when I do need modifications, I have them pick up herbs from other places to be added. I write my formulas too, but I do try to use the formula as a whole as much as possible because it's interesting to see what that can do to patients.
[01:07:19] Speaker B: Right.
[01:07:19] Speaker C: And what. And then you also know if your formula was off or not right away.
You know, it's just like. And then. But if you're modifying, making up your own formulas, you don't know, you don't have much of a directionality in terms of was that right on or what? What herbs in that formula worked?
[01:07:36] Speaker B: Right.
[01:07:36] Speaker C: You know, so.
[01:07:37] Speaker B: Yeah. And if you don't ever use formulas unmodified, you may never learn what they do.
[01:07:42] Speaker C: Right, right.
[01:07:43] Speaker B: Without modification.
[01:07:44] Speaker A: So, yeah, I think the best example for that we were. This was a while ago, but I remember in school learning about sore throat modifications for Xiaochai Hutong.
Yeah, exactly. So it's like you add in, like, what was it like? Mabo and.
[01:08:03] Speaker B: Yeah, Shuanshan, that's the other one. Up the gans out.
[01:08:06] Speaker A: Up the gans out. Right. And then so in my mind, in the first couple years we were here, you know, someone comes in, they have Xiaoyang presentation with sore throat. And so here's your Xiao Cao tong with, you know, Shuanshan was the one that got added in the most. You know, maybe some shogun. Some shogun if it was very painful.
[01:08:25] Speaker B: Right.
[01:08:25] Speaker A: You know, and now, of course, like, you don't need to do that. Just give them xiaochaiotong treats, sore throat.
[01:08:32] Speaker C: Right.
[01:08:32] Speaker A: And so all this time, you know, you're giving. I was giving this formula with these modifications and thinking like, oh, great, their sore throat went away because I modified it. But in fact, probably it would have gone away anyway because those modifications not actually necessary for this level of presentation. And you know, perhaps if someone was showing up with like strep throat and nodules and like, they're like, you know, ulcerations in the throat, like, okay, maybe then I need to add something. But just plain old cold and flu sore throat. Yeah. Xiaochai tongue's all you need. And your point, I think is well taken, right. That you just. You wouldn't know that if you're always modifying.
So just start with the basic formula as close you can.
And then one of the things I love that Travis has been doing with the residents is teaching them really constrained modifications. So, for example, like cough mod on Xiao Chaotang. This is a specific shift, but when we shifted, we always shifted the same way. So you're not just randomly grabbing cough herbs that you think might be helpful. But it's now, I mean, in some ways we call it a cough mod, but again, as I said, I'm not really sure how that's different from just giving it a new name. Like if you took Xiaocautang Kaufman with the Ganjiang and Wu Weizi and you just called it something else and be like, we give Xiaochaiutang when there's no cough and we give whatever this other thing is called when there is cough, but it's the same formula with the mod. Like that would be the same conceptual space, like it's a unit that you're placing in, not so much as randomly adding things and taking them out.
[01:09:56] Speaker C: Right. And I think it's nice for new practitioners to start their practice like that too, having already pre blended formulas like that and then see what they can do with that. There's so much you can do. We can just easily give new practitioners like 20 top formulas, most useful formulas and you can do so much with those. Right, right. Because they might not have funding to have a full medicine at the first year of practice. Right. So that's a really good way to start in terms of your first small business.
[01:10:27] Speaker B: Absolutely.
[01:10:28] Speaker A: Because it is expensive to get it set up. I want to play a little slight devil's advocate on that idea though, because I know that all of us are a little bit critical of the use of patent medicine, right. Which is say like a fixed formula, unmodified, etc.
How do you imagine, Kimiko, that like, where's the difference then between having a clinic of pre blended granules that are made, for example, and having a collection of patents that are those same formulas unmodified. What's the difference there in terms of effectiveness or choice or whatever?
[01:11:00] Speaker C: I think mostly just the pattern is just like you have to take so many of them, right? Because there's a lot.
[01:11:04] Speaker A: It's a dose question.
[01:11:06] Speaker C: Right. There's a lot of preservatives and there's binders and things like that. So I wonder, instead of just having those raw herbs with just, you know, cornstarch and then having them into pills, you have to take so many of those pills.
[01:11:22] Speaker B: So many?
[01:11:23] Speaker A: Yeah, so many.
[01:11:24] Speaker B: Like what?
[01:11:24] Speaker C: Like 20 pills or something.
[01:11:26] Speaker B: Oh my God, way more.
[01:11:28] Speaker A: We had a joke where like because we used to keep a couple of formula, like just the tea pills, you know, the little BB tea pills. And I had a bottle of Xiao Cautang tea pills and I basically took half the bottle as his dose. Like I just, I put it in my mouth like however many I could put in my mouth.
So I must have eaten like 40 of them.
[01:11:49] Speaker B: Yeah.
[01:11:49] Speaker A: You know what I mean? And maybe 50 of them. And even then it was just like yeah, I guess maybe.
[01:11:56] Speaker B: Right.
[01:11:57] Speaker A: It just didn't seem potent enough. Right. So like if, if you think like, oh well, I can buy this bottle of tea pills and they're quote Unquote, concentrated, whatever that means. And so I can. I only need to take four pills three times a day and I'm gonna get my results. I mean, if you can do that, like if you figured out how to do that as a practitioner, more power to you, Right? Like, if you get the clinical results with that dosing, that's great, that's very cheap for your patients. But in my experience, if, if you're dosing that way, you're probably not getting very good results or worse. Almost for me is we're underselling what herbs are in that experience. It's like you give someone something and you the practitioner, and frankly, neither the patient have any expectation it's really going to help.
[01:12:40] Speaker B: Right.
[01:12:40] Speaker A: It's like they're taking fish oil or something like, oh, yeah, I mean, maybe it'll help. It's like, no, man, we should be able to measure and see. That is helping. And if you have to eat 50t pills at a time to get the result, then it's definitely not cost effective anymore. Also, it's gross. Have you ever tried a terrible 50 BBs at a time? Oh my God, I wouldn't recommend it.
[01:13:00] Speaker B: Yeah.
Okay, one more formula. Wen jingchang.
[01:13:06] Speaker C: Oh, I love that formula.
[01:13:07] Speaker B: Yeah, Tell us about Wen Jingtong.
How do you. So firstly, like what diagnostically strikes you or makes you think of that formula both from the abdomen and from symptoms or what a patient's reporting.
[01:13:21] Speaker C: I think it's an interesting formula because I think in a jingling it mentions in a way that. Right. So when women cycle in the number of seven. Right. So by the seventh cycle, when they turn 49.
[01:13:36] Speaker B: Right.
[01:13:36] Speaker C: When that's when they transition from reproductive years to non productive years going through menopause.
So it's interesting that Jingui actually says a woman of about 50 years having these symptoms of dryness, like a thirst chapped lips. And you can really think about dryness of mucosal membranes. They could also have vaginal dryness and pain with intercourse.
So it's a very moistening to the blood.
But then also the line talks about how all these menopausal symptoms could be prevented if every menstruation was complete and full.
Like the line talks about how this is because at this one point during the labor there was some blood stasis left behind. And now the woman is 50 and they have this thirst and dry chapped lips and then they have this tidal fever.
So I think it's fascinating that the line itself already is teaching us how to prevent the symptoms that associated with the menopause. The menopause is not a disease. It's a normal transitional phase. But the symptoms associated like hot flashes, joint aches, bloating, all these things, it can be prevented if every single menstrual cycle is completed. Meaning that the blood is, the uterus is cleaned out every month and every labor is also. There's no blood ceases left behind.
So I think it's very interesting nine that kind of teaches us like we should be harmonizing chin blood every cycle. And then luckily woman bodies have ability to do that, you know, and men bodies have ability to do that too. And you through do that through stool. Right. Like you can expel blastasia through stool.
Right. But it's, it's easy to detect that in women in terms of if woman is for example, having scanty period or having no period because of contraception, for example. Right. We know that that's causing quite a bit of blastasis.
[01:15:54] Speaker B: Yeah.
[01:15:54] Speaker C: And in come 50, they are going to have a lot of menopausal symptoms and they're going to be uncomfortable during that transitional state.
[01:16:02] Speaker B: Yeah, Yep.
[01:16:04] Speaker A: This is the kind of stuff that if human beings had longer lifespans, you could track for yourself better over time. Right. Like imagine if you could be a doctor working with, with women, female bodied patients for say 60, 70 years. Right. In which case you would literally be able to be like, see these patients, we manage their qi and blood cycle well and behold their menopausal process was minimal transition. We just had to help a little bit. And these other ones who we weren't able to do that for, for whatever reason, had much more intense menopausal symptoms. There's a problem with creating systems around this stuff, is that the timeline for observation and intervention is large because by the time someone comes to see you, for example, having really painful menopausal symptoms, well, the time has passed to correct it cyclically.
And then when you're treating people, younger people who are still menstruating and you are correcting it, the likelihood that you will still be seeing them as a practitioner when that person is 50 is low. So now there's no one to track it. Right. To say like, oh, see, it worked.
And so it lives in some level in sort of like a theoretical place, you know. But I, it's, it's very interesting to considering like you mentioned, how many people because of contraception are not menstruating at all. And what is the effect of that, you know, biomedically?
No effect.
[01:17:31] Speaker B: Right.
[01:17:31] Speaker A: You know, they're like, ah, it doesn't matter.
[01:17:32] Speaker B: Or like one of the doctors told one of my patients, oh, it's like plugging a hole in a leaking bucket. That's the reason that we're gonna do this Stasis.
[01:17:42] Speaker A: Yeah, yeah.
[01:17:43] Speaker C: That's obstruction, literally.
[01:17:45] Speaker A: That's what they said to them.
[01:17:46] Speaker B: That's what they said to them. Yeah.
[01:17:47] Speaker A: Come on, man, find it. Image. Like, that's not a. Oh, man. Plug a leaking bucket.
[01:17:52] Speaker B: That's like, there's a hole in the.
[01:17:54] Speaker A: Bucket and you gotta plug it up. Was that doctor a guy?
[01:17:57] Speaker B: No, it was actually.
It was a female doctor.
[01:18:00] Speaker A: Yeah. Wow. That's also kind of wild. I was like, that sounds like something a male gynecologist would say, like, plug the bucket, you know, But.
[01:18:06] Speaker B: Right, yeah.
[01:18:07] Speaker A: Jesus.
[01:18:08] Speaker B: What about abdominal findings for when you.
[01:18:11] Speaker C: Yeah, so it's. It's relatively similar to Dangri Shaya sign, a way that you still feel the blood stasis.
So you feel that the tenderness and a knotted kind of bound sensation like the zukon area and then pulsations around the umbilicus. There's not going to be so much of the water symptoms.
[01:18:31] Speaker B: Right, Yep.
[01:18:33] Speaker C: That will be the squashy. Yeah.
[01:18:35] Speaker B: Yep. That makes sense. Yeah. Do you find there's a difference in the level of dryness in the wenjingtong pattern versus Dango Shaoya san or not so much much.
[01:18:45] Speaker C: I don't know. Possibly.
[01:18:47] Speaker B: Yeah.
[01:18:48] Speaker C: One thing that is different for sure is the temperature, I think, because Wen Jin tan, like as the name suggests, it's like it's warming.
[01:18:57] Speaker B: Right.
[01:18:57] Speaker C: So it is this emphasis of the cold.
[01:19:01] Speaker A: Right.
[01:19:01] Speaker C: So they have had history of being cold or symptoms that are alleviated by the application of the warmth, like dysmenorrhea. That is better with the heat packs. Right, Right. And especially even like the people think about Wen Jin tan pattern. And why would you use that for menopause? Because it's warming formula.
Right. But then there are people who have had history of cold in general, but when they hit the menopause and get hot flashes, they get this sudden heat flushing. But then once that goes away, they also feel chill again.
[01:19:41] Speaker B: Yes.
[01:19:41] Speaker C: So you really have to look into this. Signs of. Is there actually sign of cold?
[01:19:46] Speaker B: Yeah, that makes a lot of sense. And a lot of the modern formula approach, maybe like an ar xiantong type of thing for that, that presentation.
But it's still like both yin and yang. It is nourishing. So it's. I think. Yeah, that makes a lot of sense.
[01:20:01] Speaker A: Yeah.
[01:20:01] Speaker C: There's wujiu in there, that's really warm. But at the same time, like my mendon is higher dose, right? Very high dose. And then there's ojiao, there's renshen. So there's nourishment of the fluids as well and blood.
[01:20:13] Speaker B: How do you like to dose your Wu Ju?
[01:20:16] Speaker C: I keep it between six and nine.
[01:20:18] Speaker B: Six and nine?
[01:20:19] Speaker C: Yeah. Okay.
[01:20:19] Speaker B: Yeah.
[01:20:20] Speaker A: Tasty.
[01:20:21] Speaker B: This is one of the things that I've noticed with different practitioners who use Wen Jingtang. A lot of people will say, I was Even looking at Dr. Huang Huang's book the other day, and he was introducing Wen Jingtong and he has that like Starting at like 2, you dose Wuzhu you, and then you can go up, you know. And Greg, I remember when we were learning from him, he would also start the dosage of the Wu Ju and everything else would be pretty standard, but the wuju you would be very low. And then he would slowly ratchet it up.
And I don't use Wencheng Tong as much now as I did when I started my practice because I use the more standard dose of Wujiu. And so I'm trying to compare, like, should I use the standard dose or should I go lower?
And I, I, I end up like, now I'm more like what you said, like, if, if it's the wrong formula, then I'll pick a different formula to address the issue.
[01:21:20] Speaker A: Right, yeah.
[01:21:21] Speaker B: So, so interesting. Six to nine. Yeah, that's, I'd say that's a little higher than what I've seen some other people do.
[01:21:28] Speaker A: Well, thanks for hanging out with us, Kimiko.
[01:21:30] Speaker B: Yeah, yeah, thanks for coming.
[01:21:32] Speaker A: So we talked a lot about your training and your background and how you use this stuff. But of course you are teaching people how to do fukushin and other things. Right.
And you've got some classes coming up in January?
[01:21:45] Speaker C: Yes, currently I'm teaching a class right now that's about to finish. And there's a new series that's starting in January next year and that will all be online.
And then we will also have like in person workshop in Portland.
[01:22:01] Speaker A: Very cool. Where should people go to get more information about that?
[01:22:05] Speaker C: They can directly email me or they can actually go to my website as well.
[01:22:10] Speaker A: Your website's kumikoshurai.com?
[01:22:12] Speaker C: Yes. And then under the lectures, there should be some links to the online courses as well.
[01:22:17] Speaker A: Perfect. We'll make sure to put that website into the show notes so people can find it. And then, and you know, we're recording this in fall 25. You'll be teaching these new round of classes in 26. But. But if people are catching this episode in the future, probably still just go to that website, right? That'll be the best way to connect with you around education and training.
[01:22:36] Speaker C: Yes.
[01:22:37] Speaker A: Awesome.
[01:22:38] Speaker B: I also, I just want to say one more thing about the Fukushin training side. We were comparing different diagnostic parameters before in terms of their relative material versus immaterial.
But the other way to compare them is the amount of time it takes to become for those methods to become useful. Right. And the pulse by far takes the longest. I don't think there's any argument about that. The tongue is maybe a little faster, but I actually think the abdomen, the Fukushin, is very fast. And if you are considering spending time to learn it, you can do a basic training course that's didactic. Come to a weekend or two and you can be pretty on top of fukushin. Like you can really use it quickly. And that's something I don't know that people are aware of.
[01:23:30] Speaker C: Right. And that's a consistent feedback that I got from my students is that every time we finish the weekend, right, all day Saturday, Sunday, at the end of the Sunday, they feel like, oh my gosh, I can use this in clinic tomorrow. I got this.
[01:23:46] Speaker B: And that's not the same with other things. So I just wanted to highlight that.
[01:23:51] Speaker C: I think it really does increase the confidence in practitioners skills too.
[01:23:56] Speaker A: That's what I. That's what I love about it. I mean, for myself and especially with our, with our residents just watching.
You know, this show is targeted toward people who like herbs, but also people are kind of new to herbs. And one of the things that we hear about, you know, people like there's so many formulas, there's so many choices. Like I, you know, I can whittle it down to a segment of things, but I just don't know how to pull the trigger on the final one. You know, the one that really needs to happen. And I think what I love the most about the Fukushin abdomen stuff is it really does just rapidly simplify what you need to choose.
And if you're new and you're just overwhelmed by how much there is, you do some training with Kimiko, come to a weekend, get calibrated on the abdomen, and then you can just start writing formulas because you will know this abdomen for this formula. It's just a direct thing. You don't have to intellectualize it too much. It's just what do you find? Treat that.
And it really does work.
[01:24:51] Speaker B: Yep.
[01:24:51] Speaker A: That's what I love about it.
Awesome. Well, thank you listeners, as always. If you guys have suggestions for our show, you can email
[email protected] thenervousherbalistmail.Com we'd love to hear some suggestions from you. And as always, please rate and review the show wherever you listen to us. That makes it easier for other people to find us. And so I'd like to thank you, Kimiko, again, for joining us.
[01:25:16] Speaker C: Thank you.
[01:25:17] Speaker A: And I am Travis Kern along with Travis Cunningham. And we'll catch you guys next time.
[01:25:21] Speaker B: See you next time.
