Chai Hu Family Formulas - Chai Hu Tang and Si Ni San

[00:00:02] 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. Well, welcome back to another episode of the nervous herbalist, everyone. My name is Travis Kern, and as usual, I am here with my friend. [00:00:26] Speaker B: And colleague, Travis Cunningham. [00:00:28] Speaker A: And we are here to talk to you today about some exciting herbs that maybe you've been thinking about, seeing, hearing, or maybe you're using yourself. Today we're talking about Chihu family formulas. Chihu is perhaps, or maybe that whole family of formulas is perhaps one of the most commonly prescribed family of formulas in the famous iterations of Xiao Chihu Tang, Shiao San, Sin Shai Shugan, Sandhya. Lot of formulas that involve the use of chihu. Today, we wanted to take an opportunity to sort of divide the family into two broad groups. Now, of course, this is not a definitive dive into Chihu being one of the most famous and widely used herbs. It can obviously be cut any which way and can be talked about in a lot of different ways. But today, we want to help make a distinction in two large case use cases, particularly because here in Portland, spring is emerging. We're on the other side of equinox. And so we start to see a lot of chihu being used in various ways. And sometimes we see Chihu used in ways that maybe are less effective than they could be. And so we wanted to take some time to sort of divide that out. So to kind of begin the conversation, we want to take Chihu family formulas. And when I say Chihu family, I mean formulas that contain chihu as a major herb. If you take a look at some famous texts that do family work, like Huang Huang's ten key formula families, you can see the way that he divides up Chihu and the way he organizes that family himself. But for our purposes today, we want to talk about a single division between Chi Hu Tang formulas and formulas that come from Chi Hu Tang and Sineson, and the kinds of formulas that are iterative from Sineson. And what we mean by that is you learn about a formula, an individual formula, and depending on where you go to school and who talked to you about it or where you studied, some teachers will point out that a lot of the formulas that we deal with are manifestations of other formulas modified and changed consistently enough to become their own kind of formula. Right? So we end up naming Shiao San Shiao San, though, we need to recognize that in the end, it's an extension of Sinisan. So the conceptual model that begins thinking about how Shiao San works and what we do with it begins with the same kind of thinking that involves when to use Sinisan and how to use it. And this is true all over the place. I mean, we see iterations of Liu Bei di Huang Wan. We see iterations of other major formulas that become other famous formulas later on, and sometimes we forget that they began as something else. So to start today, we want to break it down. Let's start in the Chihu tang family of Chihu formulas. And t why don't you kind of lay out Chihu Tong as a formula and a family and sort of what some of the key factors are there, right. [00:03:34] Speaker B: So when I think of the chi Hu Tang formulas, I think of a very basic pattern that we see all the time in the clinic that has to do with an inability for the body to mobilize qi through the hollow spaces of the body. [00:03:55] Speaker A: When you say hollow spaces, what do you mean? [00:03:57] Speaker B: The hollow spaces could be pretty much anywhere that isn't a solid organ. It could be, you know, we hear about this, this idea of pivot areas, right, when we talk about xiaoyang disease. And so the original lines of xiaoyang disease, we have strange taste in the mouth or bitter taste in the mouth, soreness or dryness in the throat and dizzy vision. So we have, within those lines, we have something happening in the mouth and the throat, something happening in the eyes. We later see symptoms of dizziness and potential ringing in the ears. We have temperature fluctuations, and we have rib side pain. So if we just think about the throat, the eyes, the ears, these are all considered pivot areas. The diaphragm is also considered a pivot area. The armpits, the groin are other pivoting areas. [00:04:57] Speaker A: Even the rib side, right? Between back and front. [00:04:59] Speaker B: Exactly. Yeah, back in front. And so the way that I think about this is that when we have the circulation of Qi that's impeded. It's going to be impeded everywhere. But the places that it's going to show up are the places where the qi has a harder time moving anyway, right. Which are going to be places like, if we take, if we take the forearm, for example, and you look at the circulation of chi and blood through the musculature of the forearm, going up, up, up and out. And then you get to the wrist, you see that? Like, when we get to a joint, we have a bunch of stuff in the way in a joint, and that stuff is going to make the chi and blood harder to move through that area naturally. So if there's stagnation that's occurring throughout the whole body, it's going to show itself, particularly in the joint space as opposed to the forearm space. If we're using this metaphor, it's also. [00:05:58] Speaker A: Worth noting that sort of physically, a lot of your major acupuncture points are found at joints, at elbow, at wrist, at shoulder. Right. Various points in the neck, along the spinal vertebra. Articulations is where a lot of the classical emphasis was put on moving things, changing things. [00:06:17] Speaker B: Right, yeah, exactly. A chai Hu Tang pattern to take place. There basically has to be some kind of. For some reason, the qi of the body is stagnating. Right. The qi stagnates, and then there's a lot of different ways to explain why the next thing happens the way that it happens. I've literally had three different teachers tell me different, explain this dynamic in different ways. But basically, when the cheese stagnates, heat builds. So whether you choose to explain that by the qi is more like yang, and therefore, when it stagnates, Yang accumulates, and then you have heat. That's one explanation. I've also heard people say that when the qi stagnates, the body puts heat into the area to mobilize it. That's another. That's more of like a Shen hammer. That's the way that they think of qi stagnation. Shen Hammer pulse diagnosis. And then another way to think of it is actually that when the qi is moving smoothly, it's actually more related to keeping everything smooth and cool. So when it stops moving smoothly, you see heat accumulate because the qi is no longer presently moving through the area. And the heat that's accumulating is actually the heat that's already there but is no longer being tempered by the clean movement of chi. [00:07:45] Speaker A: Sure. It's interesting that the middle one is so divergent from the first and the third. Yeah, because, like, the first and the third, I mean, that's, you know, iterations of what I've heard over the years, too. It's just sort of like, you know, chi is a yang thing. [00:08:00] Speaker B: Yes. [00:08:00] Speaker A: And it will therefore naturally carry yang aspects like movement and heat and force. Right. And if it gets stuck in an eddy, right. In that flow, then all of that yang stuff pools there, too. I think it's also worth noting that thinking about the movement of qi, like you said in that third example, as a sort of. Almost like an evaporative cooling method. Right. Like, the chi moves through the body, and it carries the heat and moves, it disperses, it pushes it up through the skin layer, out from the surface, pushes it down into the bowel or out through the urine. That when Qi moves, it keeps things evenly regulated. And, you know, that's the beautiful thing about chinese medicine theory. Like, the specifics of it in this case, I don't know, matter so much. Right. Like, when qi stagnates, stuff doesn't move properly, and then all kinds of accumulative effects occur. And in this case, heat is almost always an effect from qi stagnation. And I should also say blood stagnation and other types of staging. Right. Lead to heat accumulation. [00:09:02] Speaker B: Right? Yeah. So we have the qi stagnation is taking place, and for whatever reason, heat is accumulating. And in the chai hutong pattern, heat is accumulating somewhere in the hollow spaces. The hollow spaces could be anywhere in the body. But particularly what we're going to see is a version of heat accumulation that then flares up and exhausts itself. Flares up and exhausts itself. So all of the symptoms that we see described around Xiao chai, Hu Tang and Xiaoyang disorder have to do with kind of a coming and going, a pivoting this way and a pivoting that way. And the way that we see that, as articulated in the pathophysiology, is the qi is stagnating. It's heating up, and then the heat flares. And because the heat is accumulate, the heat is flaring. Because it's a. It's. The phrase is like, it's not a true source of heat. It's heat from constraint, as our herbal teacher used to say. It exhausts itself at some point, and then it swings the other way. So there's this kind of accumulation, a flaring of the ministerial fire. The fire that's not of the emperor, but the minister, somewhere outside of the heart. It's not the heart. Right. It's flaring, and then it's causing symptoms, which could be a huge variety of things, but the principal ones we're seeing are going to be bitter taste in the mouth or strange taste in the mouth is how I learned to question it out for a patient. Some kind of soreness or dryness, some feeling in the throat, dizziness. Right. Dizzy, vision. [00:10:55] Speaker A: Well, and all those symptoms, the key factor here that you just described is that they come and go. [00:10:59] Speaker B: They come and go. [00:11:00] Speaker A: They change. This is the key thing. [00:11:02] Speaker B: Right. [00:11:02] Speaker A: Because, you know, having a strange taste in the mouth and a dry mouth in and of itself doesn't necessarily indicate a xiaoyang disorder, right. But that these symptoms or other symptoms of. Of any variety come and go because of this flaring and retracting mechanism. So, like, if you have this ball of constraint, at some point, the constraint overcomes its boundaries and it flares outward. [00:11:26] Speaker B: Right. [00:11:26] Speaker A: Just like a solar flare out of the sun. Or, you know, where I grew up in Louisiana, they have all of these petroleum factories, right. And when they collect too much of a certain type of flammable gas, they have to burn some of it off. [00:11:38] Speaker B: Right. [00:11:39] Speaker A: And literally call it a flare. And so you drive past the factory, and there'll just be, like, a flame, like, shooting out of the top of it. And it's exactly that idea. And then once it's burned off, then it's shut and it goes away. Right. So if you were observing in any of these metaphors, right. If you were observing this refinery from far away, you'd see flame for a while, and then it would be gone. [00:11:58] Speaker B: Right. [00:11:58] Speaker A: In an undetermined amount of time in the future, flame again. And then it would be gone. [00:12:03] Speaker B: Right. [00:12:03] Speaker A: So in this case, it's the same thing, right. This constraint is tight and bundled. It blasts outward, manifests in whatever symptoms it happens to people, the classic ones, like you mentioned. And then those symptoms fade or become something else. Right. They're shifting back and forth, back and forth, back and forth. [00:12:18] Speaker B: Right. [00:12:18] Speaker A: And that's the key element here. [00:12:20] Speaker B: Right. [00:12:21] Speaker A: The alternation is the thing that indicates the mechanism, the pathomechanism that you're describing. [00:12:27] Speaker B: Right. And similar to the chi not moving well in certain spaces that tend to be more stuck or I harder to move through spaces. Anyways, we're going to see patterns like this play out during times when the chi has a harder time moving in nature. So in transition is when we tend to see more difficulty with qi movement. Right. If there is difficulty, we're gonna see it there especially, which is perhaps why. [00:12:59] Speaker A: We notice this pattern often in the transitional times of the year. [00:13:04] Speaker B: Exactly. [00:13:04] Speaker A: Spring and fall. [00:13:05] Speaker B: Exactly. [00:13:06] Speaker A: Right. Spring and fall, when we're pivoting between the extremes of winter and summer. [00:13:10] Speaker B: Right? [00:13:10] Speaker A: Yeah. So how does Chaihutang now, I'm saying chai Hu Tang. But of course, practically speaking, almost everyone's heard of Shao Chaihutang. You've probably taken Shao chai Tong. You've probably seen someone taking Shao chai Tang. [00:13:24] Speaker B: Yeah. [00:13:24] Speaker A: Not a lot of people have experience with dachia Yutang. [00:13:29] Speaker B: Right? Da cha Yutang is the other formula. [00:13:31] Speaker A: You've got the big chai Yutang dachutang and little Xiao Cao Tang. So maybe help us understand how this pair of formulas, if we think of them as a pair, work on this xiaoyang pivot. And then what's the difference? Why do we see so much more xiao chao Tang than Da in the world we see? [00:13:54] Speaker B: Well, it might be different in different places in the world. Right. We see our patterns here. But. So dachai Hu Tang is a key difference from xiao chai Hu Tang. Because in Dachai Yutong, you also have a Yang Ming aspect to things. So there's a dryness in the middle that's taking place, causing usually the symptom of constipation. So the ministerial fire, again, we have Qi stagnation, the flaring of fire. And the way that the fire is flaring in this case is gonna be to zap the flu of Yang Ming, which is going to cause the symptom of constipation. [00:14:34] Speaker A: And specifically, like, dry, dry constipation. Not just a reduction in frequency, but the stool itself is harder and drier. [00:14:41] Speaker B: Yes, absolutely. [00:14:43] Speaker A: Which accounts for why there's dahuang in that formula. [00:14:45] Speaker B: Yep, yep. Yeah, exactly. Dahlong and Dershi. And. But what's interesting about that formula is that you have an increased dosage of Xiangjiang. Right. And then you also have the removal of gonzao. Right. And you would think, like, why would you remove Gansao from Dachai Hu Tang? Right. But Gansao will see in the Sinnisan structure here in a minute that Gansau is used specifically to moderate wooden from controlling earth. And in this case, we actually want to strengthen the function. We want to warm and pungently disperse earth as well. So we want both the ability for descending to take place in a dachai Hu Tang pattern. But we don't want to cool off the middle jow too much. We actually want to warm the middle zhao, which is why there's more of an emphasis on the Xiangjiang and the. And removal of Gansao. [00:15:52] Speaker A: Right. Because in this case, we want to activate. We want to leverage, basically wood's ability to force Earth. [00:16:00] Speaker B: Correct. [00:16:01] Speaker A: Because the real thing that we're dealing here is this constraint pattern. [00:16:04] Speaker B: Correct. [00:16:06] Speaker A: And the flaring in this case for dachai yutang, the flaring has parched yang Ming fluids. And so now we can see in stomach and enlarged intestine than a dryness, a hardness that we're trying to purge. [00:16:20] Speaker B: Right. [00:16:21] Speaker A: Yeah. So, okay, obviously then key factors for dacha Hu Tang are this hard, dry stool. [00:16:27] Speaker B: Yeah. [00:16:27] Speaker A: Right. But if this flaring that you've described manifests in other ways. Of course, xiao cha Yu Tang is the big lifter there. [00:16:36] Speaker B: Right. [00:16:37] Speaker A: But of course, I think maybe a lot of people think of sha chaotang as a cold and flu formula because we see that a lot, because, of course, it can be. But what are maybe some of the other kinds of symptomology that aren't cold and flu, where shuttle time would be relevant? [00:16:50] Speaker B: So a good one coming up for us right now, seasonally is seasonal allergies. It's a massively useful formula for seasonal allergies because again, one way to view seasonal allergies is an inability for the body to pivot from one season to another, though there can be root causes to that, to the reason somebody's having allergies, the acute thing that often needs to be addressed is the body needs to help transition from one space to another. And the way that works physiologically is with the movement of Qi and the movement of body fluids. [00:17:28] Speaker A: It's an important distinction too. Like you said, a lot of people who have allergies writ large, you'll meet patients and they'll be like, you know, they'll, they'll self describe like, oh, I'm super allergic. I take lots of claritin. I'm allergic to everything. [00:17:41] Speaker B: Yeah. [00:17:42] Speaker A: Food, things in the air. [00:17:43] Speaker B: Yeah. [00:17:44] Speaker A: You know, other people's emotions. Just like super allergic. [00:17:47] Speaker B: Right. [00:17:48] Speaker A: This thing that people will describe, and of course, if that's the case, if you have someone who's just like, in their own experience are sort of, sort of hyper allergic, there's without doubt a deeper constitutional issue that's creating that circumstance sense. But in the short run, usage. Right. Right now in March or April or May, hay fever, pollen, all of those classic allergic symptoms, xiao chai Yotang is very likely to be something that you can employ with great success if for no other reason, just at the most basic level, that their allergies, these kinds of allergies are seasonal, which means, by definition, they come and go. [00:18:26] Speaker B: They come and go, exactly. [00:18:28] Speaker A: And they occur at the pivot point in the year. If you're running a checkbox, like a checklist for things that count as xiaoyang, even at the most macro level, that the illness presentation comes and goes and that it happens at the pivot points of the year are big check marks for the use of xiao chaotang. [00:18:47] Speaker B: Absolutely. [00:18:48] Speaker A: Now, that doesn't necessarily mean. Right, though, that Xiao Chaiotang is also going to get at the core reason that they have problem pivoting. [00:18:55] Speaker B: Right. [00:18:56] Speaker A: Right. In fact, xiao chai Yutang facilitates the. Yeah, but it doesn't necessarily address why they're having a problem pivoting. [00:19:03] Speaker B: Yeah, absolutely. [00:19:04] Speaker A: Yeah. I think that's an important distinction because some people might hear like, oh, Shao Shai Tang for allergies, it's like, well, yes, I mean, classically chinese medicine. Right? Yes and no. [00:19:13] Speaker B: Right, right, sure. [00:19:14] Speaker A: Yes, absolutely. It deals with the symptoms of allergies. We prescribe it for that all the time. But once you get the symptoms under control, a much deeper dive into any host of formulas that could be used to deal with the underlying problem. [00:19:26] Speaker B: Absolutely. [00:19:27] Speaker A: Which could be anything from, you know, middle jaw deficiency, damp accumulation, fluid metabolism to kidney yang deficiency and predominant cold. I mean, it could be a lot of things. [00:19:37] Speaker B: Yeah, right. [00:19:38] Speaker A: For sure. Okay, so we've got this idea of xiaoyang. We've got this idea of pivot. We know that constipation is a key indicator for dachai Hu Tang. When trying to deal with this xiaom presentation on the Xiao chai tongue side, what are the key? You know, give us maybe the top three or four indicators that say to you, oh yeah, xiao chaotang. [00:20:03] Speaker B: So a lot of the way that I like to start off treatments, like if I had one single formula that I would use that if I could only use one formula for every person that came through the clinic for a whole host of variety of problems, if I could only pick one formula, it would be xiao chai Hu Tang. And a lot of the way that I'll use it will be to modify it or to add another formula into it, but I will still use it. So it's an amazingly useful formula. And the key symptoms that you would be looking for would be the key symptoms from the lines we already mentioned, those something going on in the throat, something, some strange taste in the mouth, dizziness or the predilection for dizziness. But if you have those, and if the person has like two or three, that's pretty good indication that you can use it. If they don't have those, though, you can still use it, but you want things to be justified a little more specifically. So you would want to see a tendency toward wiriness, and the pulse, for example, is a pretty good indication. You want to see constraint. If you do abdominal palpation, you could see tenderness underneath the rib side is a really good indication for the need for a chaihu tong structure. Alternating temperature patterns. So anything where the temperature gets hot and then it gets cold, or the person has a hard time regulating. [00:21:44] Speaker A: Hot. [00:21:45] Speaker B: Flashes can be addressed a lot of the time with a chihu tong structure. But not even hot flashes, like you can have acute onset cold and flu. Right. Where there's some kind of temperature change between hot and cold, a person can chronically just not feel very comfortable. Like, their body can't regulate temperature wise very well, so they find themselves often putting on clothes and then taking off clothes. Or you can see it at different times during the day. A lot of the time when people are trying to go to bed, they won't be able to regulate their temperature. I go under the covers and then I'm too hot, and then I pull off the covers, and then I'm too cold. So there's temperature differences that are a key symptom. You also typically have some kind of vexation. So vexation is a word that we take from the classics, which means something like irritability, something like, I don't know, just constraint or stress or. [00:22:42] Speaker A: Don't you love the fact that, like, vexation couldn't possibly be a less useful model? Which is why is the patient experiencing vexation? [00:22:51] Speaker B: Yeah. [00:22:52] Speaker A: Like what? [00:22:52] Speaker B: Yeah, exactly. [00:22:53] Speaker A: Like, this is one of those things. Like, I understand, you know, my. My undergraduate backgrounds in linguistics and language, right? So, like, I understand the translator's desire to be accurate and specific in representing what the Chinese, the classical Chinese means in English. But like, really? Yeah, vexation. [00:23:12] Speaker B: Right. [00:23:13] Speaker A: I mean, I guess you got to use a lot of other words is the trouble, right? Because vexation is a complex sort of emotional presentation that could look like a lot of things. So if you're out there and you, like, hear stuff like vexation or like other kind of clumsy, in my opinion. Clumsy translations of classical phrases, like, you know, instead of excess and deficiency, you'll hear the repletion and what's the. What's the other word? It's replete. Gosh, I can't even remember now. See, this is how much I purged it from my mind. But it's the other one. It's like when people were doing, like, translations in the sort of wade Giles days, like before pinyin, you'd see these other uses of words, right? And you're just like, replete. Like the. It's a repletion pattern. And you're like, no one uses the word repletion. Does it make any sense? Like, excessive deficiency is a much better translation, even if, like, in a pure translate meaning point of view, it's not quite as accurate. [00:24:15] Speaker B: Right. [00:24:15] Speaker A: Vacuity. That's how dumb is that word, right? Vacuity. [00:24:19] Speaker B: Yeah. [00:24:20] Speaker A: Like, ugh. Come on. Right. So even if deficiency is less technically accurate than the word vacuity, there's an important need to make your own terminology for your own thinking, practical, right. And look, if you're out there and you're like, I love repletion and vacuity, I'm sorry to have insulted your sense of, like, decorum and aesthetic, but I don't think that, generally speaking, is a very accessible term. Right. And that there is value in finding terminology that's accessible. [00:24:51] Speaker B: Right. [00:24:51] Speaker A: So if you have, you know, if you're out there thinking vexation, like, don't worry, there are a lot of different ways to think about the word vexation, but relative to this conversation, it is an important differentiating factor. Like, when you're looking at the list of. Of things to confirm your suspicion absolutely. That this is a xiaoyang issue, you've got this vexation category where you can place any number of emotional sort of presentations that will qualify. [00:25:17] Speaker B: Right? Yep. Yeah, absolutely. So, like, just to go on a little bit, insomnia, anxiety, any kind of, like, so many different presentations for women's health, you know, those kinds of issues, there's so many things that oftentimes require using a harmonizing formula, the chief of which is xiao chai Hu Tang, before we get into anything else. So if somebody has kidney yang deficiency, very clearly kidney yang deficient pattern for me, and I feel their pulse and by their symptoms, I can tell on top of that pattern, there's a constraint pattern. I'm going to treat the constraint pattern before I treat the kidney deficiency pattern. [00:26:07] Speaker A: Yeah. [00:26:08] Speaker B: Right. [00:26:09] Speaker A: Because otherwise, the likelihood that you'll be able to successfully get to the kidney pattern. [00:26:14] Speaker B: Yeah. [00:26:14] Speaker A: With constraints sitting on top of it. Like, how is the pattern of your herb going to reorient the deep seated pattern of this bigger problem? Exactly. Young problem. If there's constraint at the. The upper layer. [00:26:27] Speaker B: Exactly. [00:26:28] Speaker A: There's just no way to do it. [00:26:29] Speaker B: And if we add fire to the system and there's already fire flaring, we run the risk of flaring the fire more. [00:26:38] Speaker A: Yeah. [00:26:39] Speaker B: Rather than clearing and smoothing everything out first. And then when everything's calm and died down, that's when we add more resources to the physiology. [00:26:48] Speaker A: Absolutely. [00:26:49] Speaker B: Yeah. [00:26:49] Speaker A: I mean, this is like trying to deal with digestive problems by, like, just going, going at the root issue when people can't digest anything. [00:26:55] Speaker B: Right. [00:26:55] Speaker A: Right. It's like, no, that's not going to work. You can't get there. There's too much stuff in the way. Okay. So we have a sense now of chihu Tong formulas. Right. Da and Xiao chai Hu Tang and their key importance in this very, very commonly seen clinical presentation of Xiaoyang syndrome, which we think of as problems with the pivot, right? Yep. Constraint problems that prevent the smooth transition from one state to another state, right? Yep. And that the, if there is a key indicator for Xiaoyoung syndrome, it's alternation. [00:27:31] Speaker B: Yeah. [00:27:32] Speaker A: In its alternation, in whatever regard. Right. If you have things that come and go, you need to be looking at Xiaong problems as a way to confirm your diagnosis. So let's compare. So let's, let's transition over then to the other large family inside of Chihu. Maybe we'll call it a subfamily. So we have Chaihu family, and then we've got some subfamilies here. We got the chaihu tong subfamily, and now we're looking at Sinisan subfamily. Sinisan, of course, translation translated into English often as frigid extremities powder. [00:28:06] Speaker B: Yeah. [00:28:08] Speaker A: As the name would suggest for people who have cold hands and feet. [00:28:11] Speaker B: Right. [00:28:12] Speaker A: And, you know, remarkably cold hands and feet as a symptom are a great place to be. Like, oh, I should probably look at sines. It turns out that the kind of constraint that causes cold hands and feet is often addressed by sines. So we've just been talking about constraint in the context of a xiaoyang syndrome. Now we're talking about constraint in a different context, still qi constraint. Yeah, but it looks different here. It's not xiaoyangi. What's the difference? How do we understand that? Now we're in a different realm of constraint. [00:28:47] Speaker B: Yeah. So the basic difference, the way that I like to think of it, is externalization versus internalization constraint. So a chai Hu Tang pattern would be an externalization of constraint where you have fire flaring up and out, causing some kind of problem. With sinison, the constraint happens in the interior. So you don't have, like, upward rushing symptoms, really, with a sinison pattern, you have the qi that's getting constrained. And the way that I usually think of it is in the abdomen. Like, there's literally a Qi constraint that's taking place in the abdomen that qi is not moving out well enough to get to the periphery fully. So we don't. [00:29:34] Speaker A: Which gives us the classic cold hands and feet. [00:29:36] Speaker B: Correct. Yeah, cold hands and feet. But it's this kind of cold hands and feet. You'll find people will say, if you have a singing tongue pattern. Right. With futzi ganjang jargon sao. This pattern to differentiate from sinisan the hands in sinisan will not be as cold as they will be in a sini tang or a dangwe sini tangin formula pattern. So usually what they'll say is the hands, the fingers are cold in a sini san pattern, whereas the hands are cold in a sini tongue pattern. And the cold reaches all the way up to the wrists and beyond with a dangwe sini tang pattern. In truth, my, in my own clinical experience, the problem is you can have patterns layered on top of each other. [00:30:25] Speaker A: Yeah. [00:30:26] Speaker B: So, like, you can have a sini san pattern and underneath have deficiency cold at the same time. And then the hands are going to be, like, way colder. But you can still use the sini san, you know, you probably should use start sinisan. Feels like good is another good starting formula. I like to think of sinison as a swiss army knife because you can put sinison in and then you can plug and play different herbs, different formulas. You can add, subtract. You can do all these kinds of beautiful things with the formula to address a ton of different conditions. And I think it is worth noting that sinison in and of itself is a combination of formulas. So we already have insinisan xiao Yao gansaotong, which is our key formula for spasmodic cramping. Right. And people have spasmodic cramping in a whole number of conditions. But it's the key formula for, the first thing that I think of it for anyway is painful menstruation that has a cramping nature that it feels like that's tight and it cramps and then it kind of, it goes back and forth. It feels like there's something squeezing, like that kind of pain. It's absolutely the most effective formula to try shayo gansatong. Shiao Gansatong, which could be seen inside of a sinison. Right? [00:32:00] Speaker A: Without a doubt. [00:32:01] Speaker B: Yeah. [00:32:01] Speaker A: One of the reasons that, you know, it's interesting to think about how, like, where do we draw the line between stacked formulas, right. Because Shiao Gansatong is one of the smaller chinese medicine formulas. Right. I mean, it's just, it's just the two herbs in. [00:32:14] Speaker B: Right. [00:32:15] Speaker A: Right. What is it, twice or three times? Baixiao to Gansao? [00:32:20] Speaker B: You know, I don't know what the original dosage is. I know people play around with it. [00:32:25] Speaker A: It's just more than. [00:32:26] Speaker B: Yeah, yeah. [00:32:27] Speaker A: They shouldn't be equal. Right. Like the shiao should be greater than the gansao. But, you know, a lot of times we joke, you and I joke a lot too. We're like, you know, this is a new formula, and it'll be like, ee futsa. What was that? [00:32:40] Speaker B: Baijung san. [00:32:41] Speaker A: Baijiang san. E fuutsu. Baijiang san. What's in that? Oh, it's eiren Futza Baijiang san. It's like, is that really a name for a formula? I mean, it'd be like saying, like, it's not a hamburger. It's like a beef lettuce tomato bun sandwich. [00:32:56] Speaker B: Right, right. [00:32:56] Speaker A: Like, that's like, what? What are you talking about? But in this case, Shiao Gansao Tang is like, mechanically is a really important component of what's happening inside of Sinisan. Even though we're thinking about Sinisan as a chaihu family formula, because it certainly is, it integrates this even more, a tinier sort of module within itself. So also, I just want to note for the listeners too, you've heard us say Sini san and Sinny Tang. Despite the similarity in the name, Sinny Tangin is not a chai family formula. [00:33:32] Speaker B: Right, right. [00:33:33] Speaker A: Travis mentioned the ingredients there a second ago. [00:33:35] Speaker B: Yeah. Futza ganjiang zhirgan sao. [00:33:38] Speaker A: Exactly. Not a chai family formula, but relevant for devastated yang cold. That's in the system. Very important. Which, by the way, is often a secondary or maybe even a tertiary effect of chronic Qi stagnation that's not managed. Right. Like, you can find that presentation, but I just wanted to point that out. So we're talking about sini san, which is a chihu family formula. Sinitang. A different formula, though. Very important. All right, so within Sinisan, we've got xiao gansao tang. [00:34:12] Speaker B: Yeah. [00:34:13] Speaker A: So that's Baixiao and Gansao. [00:34:15] Speaker B: Right. [00:34:15] Speaker A: Which you mentioned has this softening effect. [00:34:17] Speaker B: Right. [00:34:17] Speaker A: This loosening, spasmodic stuff. You mentioned the menstrual cramps. A lot of spasmatic cramping is really well affected by shiao gansao tang. Right. Because you have an interesting interplay of flavors. Why don't we, since we're talking about it inside a sinisan, why don't you talk a little bit about the flavor aspect of shiao gansao tongue and how it actually softens musculature. [00:34:39] Speaker B: So we have in shaoyao a sour flavor and in Gan Sao, a sweet flavor. So we're combining sweet and sour. Sweet and sour is our magic combination from the naejing to transform yin. So if we want to build yin in any way, shape, or form, we're going to use sweet and sour if we want to build yang. Right. The magic combination is sweet and pungent or sweet and acrid. So those are kind of the two, like two flavor combinations from the Nijing that are important to remember. [00:35:14] Speaker A: So it's like sweet and sour chicken versus general sauce chicken. That's what you're talking about. [00:35:19] Speaker B: Exactly. Sweet and sour versus huang Di would be very proud that we're. [00:35:25] Speaker A: Absolutely. Actually, you can really just understand your chinese medicine through a panda express menu is really what you got. Sorry, I just. Hearing the phrase sweet and sour in the context of, like, a chinese thing, I just immediately just had to jump into the. That's it. [00:35:42] Speaker B: And, you know, I've had. Somebody told me a story who's a teacher at PCoM. One of his students usually takes xiaoya Gan Sao tong around her menses. Cause she tends to have menstrual cramping. And the xiao Yao gansa Tong works very well for her. But one time she was studying and busy and didn't have. Just forgot about it. Right. Didn't have the herbs. And there it comes. It's coming on, and it's starting to get pretty intense. And she actually took, I think it was. She had lemons in her house. So she squeezed some lemon juice, and she had, like, some candies, some little, like, tiny candies. I don't know what they were, but she drank this lemon juice with the candies, and her cramping got better. [00:36:36] Speaker A: Really? [00:36:37] Speaker B: So just with this. Yeah. Like, with this idea of flavor and nature being an alchemical combination, like, information that we're giving to the body, actually, when we give an herbal formula, we're telling the body to do something, do this right. Really changes kind of our point of view on what's inside of the herbs, what are the chemical constituents. It's actually the flavors that are telling the body how to articulate a point of physiology. And I just thought that was kind of cool. [00:37:12] Speaker A: It's incredibly cool. [00:37:13] Speaker B: Yeah. [00:37:14] Speaker A: I mean, it's a. Although, I guess I'll say, too, like, if anybody's ever brewed up Baixiao on its own, it's not like, lemons. [00:37:21] Speaker B: No, no, no. [00:37:23] Speaker A: Sour in Baixao is, frankly, challenging to detect. [00:37:27] Speaker B: It's mild. Yeah, it's pretty mild. [00:37:29] Speaker A: You grew up a bunch of baixao. In fact, in some ways, I actually think it's easier. This is going to sound weird to folks, but for those of you who don't know this yet, I have a really strong nose. Like, I can differentiate things by sour. And so I think it's actually easier to smell the sour. [00:37:44] Speaker B: Yes, I do too. [00:37:45] Speaker A: Like a bai shao. Like, you just put yourself 100%, a freshly open bag of baixao. You can smell the sour better than it is to taste it. I mean, it's there, but you got to really train that palate to taste it. Not like lemon juice. But that's an interesting mechanic. I mean, this idea that the flavor carries the messaging. Right. It's interesting. You know, we spend so much time in the modern world understanding pharmakinetics, right. Pharmaceutical mechanisms and the interaction between chemicals and the body. Because, you know, that's how biomedicine wants to think about the world, right? That everything is amazing mechanical interaction. And what's interesting is that even in that context, there's a lot of use. For example, the word messenger, like a chemical messenger, like, oh, this chemical carries this signal to this transmitter, which then facilitates this product. [00:38:39] Speaker B: Right, right. [00:38:40] Speaker A: And while chinese medicine and herbs don't at all, I think, work in that way, in terms of synapses and chemistry, and I, this sort of thing, the flavor and the combination of flavors in a finished formula are a composite messenger. [00:38:57] Speaker B: Yes. [00:38:58] Speaker A: A communicator carrying a message into the body that says things should be laid out like this. [00:39:04] Speaker B: Yes. [00:39:04] Speaker A: Right. And the way that I think about that often is in terms of pattern. [00:39:08] Speaker B: Right. [00:39:08] Speaker A: Because we always think of, like, you know, we're trained to Bianca. Right. To, like, do the pattern differentiation. What's the pattern? What's the pattern? And in that line of thinking, then, an herbal formula, a composite herbal formula with all of its various single herbs and all of its various dosage, creates a complex web, a pattern that we then overlay on top of the patient's current physiology, what does it look like? And by making that pattern in our herbs robust and targeted and aligned appropriately with the sort of illness pattern that the patient has, we can tug that illness pattern toward the pattern of our formula and align them. [00:39:52] Speaker B: Yes. [00:39:53] Speaker A: And when those two things fall into alignment, the patient feels better. The herbal formula continues to direct the body in a particular direction, and now things are working like they ought to. Right. And so if that's messenger, if that's a pattern, if that's an image, like whatever the sort of, sort of cognitive, intellectual space you need to occupy in order to understand what's happening, that is the mechanism. We are redirecting the function, the physiology of a human body or really a living body. Because I use herbs on my pets, for example, in many ways, it's actually much easier to use herbs on dogs. We can talk about that later. But anyway, I think it's important to think about it that way. [00:40:37] Speaker B: Yes. [00:40:38] Speaker A: If you spend too much time trying to figure out what the active component of chihu is, for example, it will not make you a better herbalist. No, I'm going to say that definitively. [00:40:51] Speaker B: Definitely not. [00:40:52] Speaker A: It won't. Knowing that there are 423 identifiable compounds in Chihu, and these four are at the highest concentration. So if we took out an extract, you know, what's chihu in English? It's so the. What are we going to call its active ingredient? Like blue parensis. Right. So, like, we'll just name blueprints. Yeah, the blueprints are very high in the chaise. We're going to go ahead and make a concentrated extract of blueprints. If you take this one capsule, you'll get more blueprints than you could consume if you ate 300 pounds of chihuahu. Right. Y'all, that's not gonna help. That's not helpful. Like, stop it with the concentrated supplements. Stop it with the herb extracts. There's no artistry in that. There's no elegance to that design. Right? Like, oh, sawpaw metal is good for men's health. Let me just take some sawpaw metal. What? [00:41:49] Speaker B: Why? [00:41:50] Speaker A: What about it is good for men's health? What's the problem being corrected? What is the pattern of saw palmetto that needs to be overlaid on top of your pattern in order to facilitate change? There is none of that sophistication in that kind of sort of, I don't know, what do you call it? Like, nutraceutical, biopharmaceutical, organaceutical, whatever. Insert whatever trendy word you want to talk about, which means taking chemicals out of plants. Right. And trying to make them work. It's more complicated than that. It's not just a chemical. So I just. I want to put that out into everyone's thinking that part of the reason that we do this show actually is to not just talk about the way that herbs work, but to help all of you who are interested in using more herbs develop strategies to improve the way you think about these things. Because it's not a vending machine, right? It's not a plug and play. Like, oh, they've got alternating symptomology. So chow chai Yu tang, for sure. I mean, like, yeah, that's probably a great place to start, but there's more to it than that, right? [00:42:54] Speaker B: Yeah, absolutely. [00:42:55] Speaker A: And having a sense of what that more is is really important, so. [00:42:59] Speaker B: Right again. [00:43:00] Speaker A: So on the flavor issue then. So we've got, like you said, we've got the sour, we've got the sweet softens the tissues. [00:43:05] Speaker B: Right? [00:43:06] Speaker A: Right. [00:43:06] Speaker B: And sweet is according to the naging, again, from a five phase point of view, if we want to look at it from that perspective, sour is the flavor that does well, it tonifies metal, but it also reduces wood directly. Right. Sweet tonifies Earth. So in this case, because of what we're looking at, we're looking at, when we see Xiao Yao Gan sa Tong mentioned in the Shanghaiden, we see it mentioned under a chapter where it talks about hypertonicity in the legs, some kind of cramping that's taking place in the legs. Now, in reality, you can see cramping taking place anywhere in the body. If a muscle is cramping or if it's spasming, it has wind. Right. So a muscle. Right. We learn, like the tissue layers, according to the, the five phases, muscles are associated with earth. If we have wind inside of earth, we have wood overacting onto earth. So the basic formula, the most basic formula to treat wood overacting on earth is xiaoya gansatong because we have a sweet flavor which tonifies earth, moderates earth, or tonifies earth. And we have sweet flavor, also moderates wood, believe it or not. So there's both a tonification of earth and a moderation of wood. And there's a line that says if the, if wood suffers from excess, eat sweet swiftly to comet is what the naging says. So it actually says to use the sweet version to sweet flavor first. If there's, if there's a problem with, with excess water. And then the sour is going to help increase that effect at controlling, making sure wood doesn't get out of hand. And so that's the basic combination of the sweet and the sour. We're working on restraining wood and solidifying earth. [00:45:15] Speaker A: Yeah. So that is now, you know, the reason we took the time to talk about that is because, of course, those two herbs are inside of Sinisan. Sinisan. The other two herbs, of course, being chaihu and Jershar. [00:45:28] Speaker B: Right. [00:45:28] Speaker A: So now, you know, we've got chaihu in the mix here. Jersey is in the mix. And those two herbs together have a different effect than, of course, the interaction between Baixao and Ganzao du. [00:45:43] Speaker B: Right. [00:45:43] Speaker A: So let's talk about kind of what those two herbs are like and then combine it all into one formula and understand, like, okay, how does the formula work together with all four? [00:45:52] Speaker B: So the other, the other mini formula before we get to that, the other mini formula inside of sinisan is jursher xiaoyao san, which is a formula that's in the jingue, which is surprisingly or no surprise, just tertiary. [00:46:06] Speaker A: And xiaoyao, imagine, imagine my shock and. [00:46:11] Speaker B: It'S in there for postpartum abdominal pain. And it says the patient has vexation flow, fullness and an inability to lie down. So describing some kind of cramping that's taking place in the abdomen. And there is likely, it doesn't say this, but there's often likely some minor constipation involved in this pattern. [00:46:33] Speaker A: So I would like to offer in this case too, since we talked about vexation before that, I think it's helpful to think about vexation as the patient is bothered. [00:46:43] Speaker B: Yes, like bothered. [00:46:45] Speaker A: They're just bothered. Right? Like it's, you know, because it's possible to have these kinds of symptoms. Because, you know, it's funny, anytime you read a classic text or even a modern one, you know, like a macio or a Bensky or whatever, the symptoms always sound so severe. [00:46:59] Speaker B: Right, right. [00:46:59] Speaker A: Like, oh, my God, could you imagine, like, you're dizzy and you're vomiting and abdominal pain. Like, it just sounds like the worst disease ever. [00:47:06] Speaker B: Yeah, yeah. Crazy nice. [00:47:07] Speaker A: But it is actually possible for patients to have all those symptoms in a way that actually doesn't bug them because it's not that serious. Right. And so vexation is a, again, it's a terrible word, but, like, if the patient is bothered, like, agitated, they're irritated, they're, they're anxious. Like, any of these words that say, like, these symptoms are happening and I'm not just, like, going to work anyway because, like, whatever's not that big a deal, right? No, vexation is now in play, and that's a key component to work in here. [00:47:36] Speaker B: Right. [00:47:36] Speaker A: And it doesn't, you know, it doesn't mean, of course, the patient could be ignoring their symptoms and maybe they should be bothered. And what about tolerance? Like, you don't need to parse that far, right? It's just, are they bugged about it or not? Right. [00:47:49] Speaker B: Are they bothered or are they hot and bothered? [00:47:51] Speaker A: Yeah, right. Exactly. Right. Like, what's, what's the deal? So I think that's a good way to think about vexation because you're gonna. Any person who studies herbs and does it through a classical approach is going to come across this translation all the time. [00:48:03] Speaker B: Yes. [00:48:04] Speaker A: Vexation. Vexation, vexation. [00:48:05] Speaker B: Yeah. No, well, good. That's a good point of clarification. So jersha, shaoya san is also in the formula, and xiaoya, we have the same. We already talked about that sour flavor. Xiaoyao is also considered bitter in some texts. So typically, I think of it easier to look at classical formulas and then assigned ascribe one flavor to them just for my own understanding. Like, how was this doctor using this particular herb in this case versus other cases? So that's, that's just the thing that I like to use to help me understand it. So in this case, I think shaoyao is also being used for its sour flavor, and dersher is being used for its bitter flavor. And bitter has a descending effect. Bitter does three things, according to the nijing. It reduces earth. It can do three things, I guess, is what I should say. It can reduce earth, it can descend metal, and it can tonify the water phase. So in this particular case, the way that I understand it is it's descending metal. Right. Kind of stuckness and cramping in the, in the intestines. Metal is what descends. Right. So you're using the bitter flavor to help articulate descent and. [00:49:31] Speaker A: Strong herb. [00:49:32] Speaker B: Yes. [00:49:33] Speaker A: One of the things that I always like to point out, too. So Jersey and Jirka are the same fruit, but jersey is a yemenite, a little green one. Tiny green one. If you've ever seen Jersey in a bulk pharmacy, really good. Jersey is really quite small. Like, kind of, kind of the size of like a large shooting marble in a lot of ways. And when you see it in the pharmacy, it's usually been chowed. So it's been cooked. Right. So these tiny little green oranges, also, if you've ever seen, like, a citrus tree, the fruit come out in tiny little round greenhouse circles. They're picked at that stage, and then they're split in half, and then they're chowed. Right. So they're dry fried until they're cooked. Now, even despite the fact that they've been really heavily toasted, if you open a bag of chercher, the smell is overwhelmingly citrus. [00:50:27] Speaker B: Yes. [00:50:28] Speaker A: Bright. [00:50:29] Speaker B: Yes. [00:50:29] Speaker A: Potent. [00:50:30] Speaker B: Yes. [00:50:30] Speaker A: It's like if you peeled even a fresh orange under your nose from the grocery store. The drisher is twice that kind of potency. The movement of drisher is apparent in its smell. [00:50:44] Speaker B: Absolutely. [00:50:44] Speaker A: And it's incredibly bitter. [00:50:48] Speaker B: Yeah, very bitter. [00:50:50] Speaker A: It's a raw baby fruit, so it is both acrid and bitter. And it's been chowed. Imagine if you had it just straight off the tree. It would be even more intense. [00:50:59] Speaker B: Oh, yeah. [00:51:00] Speaker A: Compared to jerke which is the fruit once it's been matured. So he actually brought the fruit to maturity. It's still a bitter orange, meaning not like a table orange. You would never find a jerka orantium in the grocery store. Cause it just doesn't taste good. So you're not gonna make fruit salad out of it. But even still, that more matured fruit, just by the nature of being further along in its life process, is not as forceful as sure is. [00:51:29] Speaker B: Right. [00:51:30] Speaker A: Still descending, still moving downward, all those kinds of things, but not with the same punch that you get out of tertiar. [00:51:37] Speaker B: Right. [00:51:38] Speaker A: So I like to point out to people, there's a lot of herbs that we use are all from the same plant, different parts of the plant, or different, different points in its life cycle. And I think it's helpful to think about that. Like, if you were going to modify a formula, for example, that had djerka in it or jersey in ithood, and why might you trade one out for the other? Is there a situation in which you might need to have a different effect? And so it's nice to know which things are connected to each other. [00:52:05] Speaker B: Right. [00:52:05] Speaker A: So you can kind of draw that extension. [00:52:07] Speaker B: Right? Yeah. [00:52:08] Speaker A: Okay. So we now have a sense of the two sub formulas that are inside of sinisan. So now let's talk about the whole composition. So now we've got chaihu in there. So we've got chihu, chic, baixao, chirgon cao. [00:52:21] Speaker B: Right. So chaihu is a fascinating herb in terms of its functions. It's very unique, and there's disagreement about it both in time and in practice. [00:52:39] Speaker A: As in, over time, people have said different things about it. [00:52:41] Speaker B: Over time, people have said different things about it. And one of the key things that is debated is flavor. So in the shenong bansao jing, chaihu is considered bitter and neutral. It's not considered pungent. When we learned it in school or cool, we. Or cool in school, we learned acrid and cool. Right. [00:53:02] Speaker A: And, and also, you'll hear us use acrid sometimes. Also pungent. [00:53:07] Speaker B: Pungent and acrid, we're using synonymously. [00:53:09] Speaker A: Same thing. Yes. Yeah. [00:53:11] Speaker B: So with Chihu's function, I've heard it explained in a number of ways. We have kind of three good, different formulas that people use chihu with commonly. So those and at different dosages. So the other thing that you see is that herbs functionality can differ depending on the dosage. Sometimes it can be different depending on how you dose it. In a xiao chihu tong structure, you're using chihu around 24 grams, or at least I do. That's the ratio dosage that I always use, 24 grams of chihu, which is a lot. That's a good, that's a good, strong dose of chihu. Now, when we're doing that, we're articulating a movement in the body. This is how I think of it. I think of Chihu as bitter. The way that I learned to think of the function of chihuahu is that because this is a weird, weird way to talk about it, but this is how it was explained to me. Chihu is bitter and it's neutral in temperature. Therefore, neutral is the least, the least yang nature. So this is one way that it was explained. So if you can follow bitter and neutral, neutral is the least yang flavor or, sorry, nature, and therefore the least because it's the least imposing. [00:54:41] Speaker A: Like it has no quality. [00:54:42] Speaker B: It has no quality, exactly. [00:54:44] Speaker A: Yeah. [00:54:44] Speaker B: So when something is neutral and it sometimes has an opposing effect to what would typically be thought of for that flavor, does that make sense? [00:54:56] Speaker A: So because it can't assert itself right. [00:54:59] Speaker B: Through nature, so bitter, we would typically think of, like, according to the Nijing, bitter drains, dries or makes firm. That's what the naging says about bitter. But for chihu, it's bitter and neutral, therefore it's bitter, but it's going to lift. And we think of chaihu as lifting. And then at some point, once it reaches kind of the surface, it kind of goes the other way and then descends. That's how I was taught to think of it. Now other people will say different things. I had one teacher who used to say, chihu is just lifting. That's what he would say. [00:55:39] Speaker A: And you can imagine that that lifting motion is where we get a lot of the acrid. [00:55:44] Speaker B: Yeah, exactly. [00:55:45] Speaker A: The acrid concept of its flavor. [00:55:48] Speaker B: And if we look at different formulas throughout history, Xiao chai Yutong being the first. Right. And then further along, we have xiaoyao sandhya, right, where we would use fewer grams of chaihu typically than we would in Xiao chai Hu Tang, like maybe half the dose, nine to twelve or something like that. And then in Bu Zhong Ichitang, we're gonna use even fewer, you know, one to six, maybe. [00:56:14] Speaker A: Yeah. [00:56:14] Speaker B: Right. And so the decrease in dosage of chihu is articulating the yin and yang component of chihu. Any kind of dosage is articulating yin and yang. Right. So if we dose something higher, we're emphasizing the yin component of the herb, the flavor of the herb, and we're emphasizing a specific function that it has. So in Xiao chaihu Tong, we're trying to harmonize xiaoyang by lifting with the chaihu and then bringing it in. We're trying to articulate the full pivot. [00:56:50] Speaker A: Yeah, you're mimicking the pivot. [00:56:51] Speaker B: You're mimicking the pivot used here to. [00:56:53] Speaker A: Mimic the pivot to set that pattern. [00:56:55] Speaker B: Absolutely. [00:56:56] Speaker A: So that way the other herbs work in coordination with that and the body moves into the pivot, actually embraces it. [00:57:02] Speaker B: And keep in mind that we're also pairing it with Huang Qin, which is another bitter herb that's cold. That's going to have a much more clear descending function. So we're going to have a lifting and descending with Chihu, and we're going to have a descending of Huang chin with the Sinnisan structure, we have a more proper descent that's taking place from the dersher. So we have a more lifting quality of the chihu, but then we also have a descending quality, and then we really have a stronger descending quality of the chersher. [00:57:39] Speaker A: So if you're comparing Sinisan to Xiao Chaitan in this space, like what we're talking about here, Xiao Chai Tang, because of the way Huang Qin and Chaihu interact, we end up with this lifting, descending, lifting, descending. This thing that is the pivot. Right. Whereas because of the forceful nature of the jursher. [00:58:02] Speaker B: Right. [00:58:02] Speaker A: That we see in Sinistan and also because the dosage is different as well. [00:58:10] Speaker B: Definitely. [00:58:10] Speaker A: Right. So we have a smaller dose of chihu. [00:58:15] Speaker B: Yeah. [00:58:16] Speaker A: So that means we're not necessarily emphasizing the strength. [00:58:20] Speaker B: The strength. [00:58:21] Speaker A: Right. That explosive and then retreat quality of Chihu. It means that the force of the gershar is going to move things down. [00:58:29] Speaker B: Right. [00:58:30] Speaker A: And so Sinesan is going to. Well, and this is how I think about it. I think about it as a circulating formula. Right. In terms of, like, it's going to take things that are stuck and push them out to the extremities. And of course, this can sometimes be a little challenging for people to think about because if you think of that stuckness in the middle and we're going to say that the formula moves down. Right. You might think that that only counts to your legs. Right. To your feet. Right. But I want to help. I think there's some helpful way to think about it. One of the key components is that down. Yes. Is from your middle down to your lower jow to your feet. Right. But out to your extremities on your hands is also very much a down movement. True, I think. Right. I mean, we think of it laterally. [00:59:20] Speaker B: Sure. [00:59:21] Speaker A: Maybe your hands are above your head. Right. I think it's also worth pointing out that this is where, and I will admit freely that this is where it can get confusing for people who are. Who are new to thinking about it in this way. Right. Because you're like, wait, is it down or is it lateral? [00:59:36] Speaker B: Yeah, like, is it. [00:59:37] Speaker A: Is it out? Is it in? We're putting all this emphasis on bitter and this idea of downward force, but now we're talking about it going to your hands, but also your feet. I think there's a couple of important factors here. One, as you've already mentioned, in the Sinisan pattern, the cold feet is more significant than the cold hands. [00:59:56] Speaker B: Yeah. And I would say, too, that, like, chihu tong pattern, you're not. You're gonna have a flaring of fire somewhere. There's gonna be heat somewhere. In a Sinnison pattern, if there's heat, it's always only in the intestinal tract. Like, you can have a little bit of damp heat in a Sinnison pattern, whereas a chihu tongue pattern, the heat is gonna be in the periphery. It's going to be up in the face, it's going to be in the throat. It's going to be temperature changes. You can have nausea. Right. In a chaihu tongue pattern, you can't really have nausea in a Sinnison pattern. There's nothing to address that. [01:00:34] Speaker A: There'd be no reason to use sinesan if you had nausea. [01:00:37] Speaker B: Right? [01:00:37] Speaker A: Yeah, I guess. I mean, not so much in the comparison between Sinnisan and Sha chow tan, but just in sort of, like, understanding that when I take Sinisan, it can help the qi constraint and therefore make the chi move into your hands and your feet, even though it's moving downward, quote, unquote. Like, how am I supposed to think about that? Right. [01:00:58] Speaker B: Right. [01:00:59] Speaker A: I think it's also worth noting that citrus, all the citruses, including even Chen pee, which is a different ball of wax, but all the citruses have a kind of woody movement to them. [01:01:12] Speaker B: Yeah. [01:01:12] Speaker A: The way they smell, the way they act in the body. And when I say woody, I wish. I wish this wasn't just an audible and auditory medium, but, like, you know, fire moves up and out. It's got this fountain maneuver. Right. And like, water moves down and out. Right. Like, it's like the opposite. The fountain up and the drain down. [01:01:34] Speaker B: Yeah. [01:01:34] Speaker A: And then metal has this constraining quite this sort of boundaries that hold and create space and wood. Pushes against that in all directions. [01:01:45] Speaker B: Yes. [01:01:45] Speaker A: Right. So it's not just up or down, but it's. It's just this, like, little starburst. [01:01:49] Speaker B: Right. [01:01:49] Speaker A: Moves outward. So when I say that, like, citrus has a woody quality, that's what I mean. Like, even though Dersher's movement is down. [01:01:59] Speaker B: Yeah. [01:01:59] Speaker A: And what's significant about that is crap that's stuck in your middle. Right. At the diaphragm in the chest. Epigastric. The way to get that out of a patient is not out of their mouth. Right. Like, you're not. Like, if stuff is stuck in the middle, we're not going to try to encourage that to come out of their throat. [01:02:18] Speaker B: Right. [01:02:19] Speaker A: Belching or vomiting. I mean, okay, there could be extreme circumstances where purgation through vomiting is necessary, but we're not talking about that. We're talking about more conventional things. So if stuff is stuck in the middle, Qi is stuck. This sort of ephemeral, intensely important yang quality of all living things is stuck. Right. We have to disperse that. Chaihu and Jersey come along to do that dispersive quality. But the direction that that stuckness has to go is down. [01:02:48] Speaker B: Right. [01:02:48] Speaker A: And that is, I think, where we can make the distinction. So we use something like chihu. We use something like, both have these woody movements to them, this sort of starburst explosion. But it's still focused downward. [01:03:03] Speaker B: Yeah. And another point of distinction, like, we hear hands and feet cold. Right. With Sinnisan. But really, like, the blockage of the Qi isn't in the hands. [01:03:16] Speaker A: No, it's way before that. [01:03:17] Speaker B: It's in its interior. That's where the blockage is. So we're not trying to, like, we're not really trying to move Chi out to the extremity. We're trying to get it unstuck in. [01:03:29] Speaker A: The interior, and then it'll just go. [01:03:31] Speaker B: Where it needs to go. And then it'll just go where it needs to go. With Xiao chai Hu Tang, it's not necessarily like that, because you can have a stuckness in any of those hollow spaces. It can be anywhere around the body. Like, there's. There's case studies of doctors who used, um, chai Yu Guizhougan Zhang tang, for example, which is a version of Xiao Chaoyutong that's been modified for bone spurs in the spine, because the way that the thought was, well, the spur is articulating into one of the hollow spaces. So the way that we're going to treat that is by treating the. We're going to clear the hollow spaces. And that's crafty. Yeah. I mean, there's all kinds of stuff. [01:04:13] Speaker A: To think about that. [01:04:14] Speaker B: Yeah. [01:04:14] Speaker A: Yeah. Well, so this. The reason I wanted to point that out is because, like, the terms that we're using here, the flavors, the directions, the phases, you and I both find that really helpful ways to think about stuff. This stuff. I would argue that it is, in fact, one of the simpler ways to get your head out of the vending machine model of herbs and into understanding how your formula is really functioning. Right. But I will again admit that on its. At first, Blanche, it might seem a little overwhelming. Right. Sure. Thought they were talking about outward, but now they're talking about downward. And then there was this thing, and it was up, but now it's down and hot, and then there was wood, and wood had a direction, and, you know, it can seem like it's a little overwhelming, and I get that. What I'll say is, I think it's just important to continue to listen to talks like this one and talk by other people who work in this space. And again, not everyone. Like Travis said a second ago, the chihu in particular is a very debated herb. Like, exactly what its flavor is, exactly what its movement is. Theres a lot of very smart people, people with a lot of clinical experience and history and academic training, who might think about Chihu in an entirely different way. For better or for worse, we can't. No one is right. You're never going to come down to a position where it's like, this is empirically what Shihu does. We can only rely on our clinical experience and our clinical theory and apply those two things together in practice with patients and then see what it looks like on the ground. And there's going to be some variation, without doubt. But whether or not you think that shihu is acrid or you think that it's bitter, by the way, it's probably not sweet. So if you're coming up, if you're coming up with that, you might actually be wrong. I'm just gonna. Just gonna say you might be wrong on that. But my point being is that there is a space for reasonable people to disagree and still be able to use the herb and even understand the herb in a really effective way. Way. Yeah. I want to. I want to touch a little bit on the mechanism of chaihu, like, in terms of how it moves in the body. We've talked about this rise and then this fall, I want to talk about something that I think is particularly applicable to Chihu, but not just chihu which is that we talk about herbs that move things, right? Like, oh, eat this herb, move qi, move blood. [01:06:48] Speaker B: Right? [01:06:49] Speaker A: And I don't know that a lot of people have had the occasion or the opportunity to really think about what that means, right? Like, what does it mean to, like, so I eat chaihu and it moves some chi. [01:07:01] Speaker B: Yeah. [01:07:02] Speaker A: Right. How. How does it do that? And I don't mean biomechanically. Right. Sort of conceptually. Like, how does it do that? And I think in this case, it's helpful to consider, as always, the yin yang aspect of what's going on here, right. If you want to move something, if you want to create qi, to move something, you're going to need some substantive fuel to convert into the ephemeral nature that is qi. Right. One of my favorite things that one of our teachers said, you know, in his lectures, one of his many funny lectures, is that I. Human beings are a million parts yin and one part yang, right? And everyone sort of thinks, because you see the taiji symbol and you just think like, oh, they're in equal proportion. Like, no way, man. We live in a material, substantive world. The vast majority of everything that you interact with is yin stuff, right? Because you need a lot of yin stuff in order to facilitate Yang. You just don't need that much yang. It's a very potent item. So if you want to introduce yang into the system through herbs, you're gonna have to convert some yin stuff into yang to facilitate that movement. Right. Exactly how that happens and what degree. Like, this is where you can get messy, right? Because you're like, well, if I took 10 grams of chihu, that gene generates five imaginary units of yang, and it used up 100 units of yin. Like, nah, man, you're getting way too empirical about this. Right? This is a conceptual idea, but it's a useful one, because we've all. I think you and I have certainly experienced. A lot of people have heard and some people listening may have experienced themselves, that Chihu family formulas and formulas that contain Chihu can sometimes act weird. Certain people's bodies. So, for example, Shaya san, which we haven't talked a lot about, but everyone's favorite. Are you dealing with stress? Take some chia san. And then the patient will take the chia san, and they'll feel, like, agitated and anxious, and you're like, wait a minute. That's not how that's supposed to work. It's supposed to do. Supposed to do the opposite. It's like, all of a sudden, they're anxious and they're having terrible poops, and we're supposed to do the opposite of that. What's going on? It could be. I mean, there are several reasons why that could happen, but it could also be that the action of Shao san, in particular, to convert some yin stuff into Yang stuff to move qi and circulate it, right. To relieve the constraint where the liver is overacting on the spleen, to do that mechanism of process that there actually wasn't a good stock of yin stuff in that patient's body. And the formula that you gave them converted a limited supply, maybe we'll call it a deficient supply of yin, into Yang to relieve the constraint. And instead, what you did was let loose a bunch of errant Yang in the body, and the same feelings of constraint that showed up as, say, anxiety and irritability are now just turned up. And so you're sitting there looking at it going like, oh, crap, like, I don't understand. This pattern on its face should be well served by a sinesan modification like Shia san, and it didn't work. Right, right. There are potential reasons for that, and a lot of them have to do with yin stuff. Right. So let's talk a little bit about that transition from Sini san into a formula like shiao san. I think a lot of people may not actually know that shayo san is a derivative formula from Sinisan. [01:10:52] Speaker B: From Sini san, as is chihu shu gon san. [01:10:54] Speaker A: As is chihu shugan san. Exactly. Which we've talked about before. So shiao san, in particular, we hear the famous phrase wood overacting earth. Right. Liver overworking, spleen, maybe less commonly heard, unless you're a person who studies classical stuff. Gallbladder over control. Stomach. [01:11:13] Speaker B: Stomach. [01:11:13] Speaker A: Right. [01:11:14] Speaker B: Well, what overacting on earth? We just take that idea and like this most common diagnosis in chinese medicine school, right? You go into the clinic, it's wood overacting on earth. That's what it is. [01:11:29] Speaker A: So common, we just shorten it to wood overacting. Yeah, whatever would overacting earth, man, whatever act. [01:11:36] Speaker B: But if you look at formulas, I mean, there are so many formulas. The treat wood overacting on earth. As we just discussed, xiao Yao, gansao tang treats wood overacting on earth. Sinisan treats wood overacting on earth. Guizhou Tang arguably treats wood overacting on earth. Xiao Jianzhong tang, a derivative of guizhou tang, treats wood overacting on earth. Xiao Yao San treats wood overacting on earth. There's so many formulas that treat wood overacting on earth. It's crazy. So to figure out how it can actually apply to a patient, to the patient in front of us, we have to know more than just wood overacting on earth. Wood overacting on earth actually doesn't tell us very much other than a basic, very broad dynamic that's taking place. [01:12:24] Speaker A: Right, yeah. [01:12:29] Speaker B: Transitioning from Sinisan into a formula like xiaoya San. And you're gonna know more about this than me, because you use Xiao San way more than I have. But my understanding of the pattern is that we're moving from, firstly, a six confirmation point of view into a Zanfu organ diagnostic model, where we're focusing more on liver Qi movement as opposed to xiaoyang constraint. Xiaoyang ministerial fire flaring. We're sort of not using that model to approach the pattern differentiation. We're using a different model. And to articulate the movement of liver Qi, we often combine herbs like chihu and dangwe together, or different things like this. So maybe you want to talk a little bit about that. [01:13:22] Speaker A: Yeah. I want to say first that Shia san is incredibly commonly produced or prescribed. Excuse me, sometimes to the point that I'm like, oh, my God, really? Chiao san again? Yeah. But also, I will say that a lot of people deal with a complex wood overacting pattern that is more specifically a liver qi overacting spleen pattern. Right. Which looks particularly like emotionally induced digestive disorder. [01:13:50] Speaker B: Right? [01:13:51] Speaker A: Now, the thing that's key about this, in my opinion, is that because a person is stressed or irritable in and of itself, does not necessarily mean shaya san is the formula to use. Right? [01:14:05] Speaker B: Yeah. [01:14:05] Speaker A: There's a lot of reasons why someone might be stressed or irritable, even if it's a liver chi constraint problem, which is the other way that you'll see this, right. If people don't mention would overacting, they'll be like, oh, she's just got a lot of liver Qi constraint. Like, okay, yeah, fine. But that still doesn't mean the Shia san is the thing to do. The thing about Shaya san for me is you need to have this, the weak spleen symptoms, right? [01:14:25] Speaker B: Yeah. [01:14:26] Speaker A: So if you have a person who's just irritable, right. But they don't have any digestive disorder that goes along with it, right? Which I will say is not that common. [01:14:36] Speaker B: Right. [01:14:37] Speaker A: A lot of people usually have both, right? But if you don't have. And here's the other thing. Not only are you having a weak spleen problem, but in my experience, in the clinic, it is a damp spleen with loose stool is the key indicators in my mind for Shia san, because you can be irritable with dry, hard constipation. And I don't think Shia sounds a good mix for that. But what is more often the case, at least what I see in my practice, is a person who probably constitutionally is a worrier. [01:15:10] Speaker B: Right. [01:15:10] Speaker A: And that's actually part of my differential. I'll ask people like, would you describe yourself as a worrier? [01:15:15] Speaker B: Yeah. [01:15:15] Speaker A: Right. Because it's a little hard to suss out a person's stress and anxiety, because, you know, like, a lot of people have stress, but they don't feel it. A lot of people are easily stressed about things that, that are relatively minor. Some people don't have any manifestations of stress, but they actually are ruminating in their mind, mind all the time. [01:15:33] Speaker B: Yeah. [01:15:33] Speaker A: So I really like the question, are you a worrier? [01:15:35] Speaker B: Yeah. [01:15:36] Speaker A: Because if you are a worrier, you will immediately say yes. [01:15:39] Speaker B: Yes. [01:15:40] Speaker A: If you're not really one, you'll be like, well, I mean, sometimes I already know, and it doesn't matter what you say. Yeah, I already know the answer, which is not really okay. Because people who worry know it and they'll say it immediately. Right. So if you have a worrier type presentation, usually also happens to go along with difficulty sleeping, because people will be ruminating a lot. Right. And then on top of that, when their worry goes up, they end up with, you know, what's commonly described as sort of butterflies in the stomach. It could be anything, sort of like indigestion, nausea, a little bit grumbling gas and bloating, belching, any of that kind of stuff. And then usually loose stool or I think it's also still possible to use Shia sandhorn, have some alternation in the stool. So it's loose and then it's constipated. It's loose and it's constipated. But as we have mentioned, that might also then mean xiao chai Tong might be a more appropriate thing to pull in there. But anyway, you've got this liver Qi constraint problem. You've got this worry, anxiety, emotional presentation, and you have a loose stool component. [01:16:46] Speaker B: Right. [01:16:47] Speaker A: Now, Shiao san makes sense. Why? Well, Shia sandhorn, as we mentioned, is a derivative of sinisan, but importantly, it has baiju and fuling in it. Right, right. And baiju and fuling. Baiju in particular is a great, great herb for wet, weak spleens. [01:17:04] Speaker B: Yes. [01:17:04] Speaker A: It's low grade drying, not in an overly intense way. And if you chow the baiju, right, which is often the way that it shows up in Shia san, chao baiju, you're not gonna be encouraging a very fast peristalsis. Right. By chowing the baiji, you're pulling some of that kind of bright essential oil out of the product. And so it just doesn't move the intestines quite as heavily. [01:17:25] Speaker B: Right. [01:17:26] Speaker A: And then you combine that with fouling, which, of course, promotes the spleen and drains dampness. So, like, the two of those things together are key components for the digestive aspect of liver cheese stagnation. If you don't have a digestive aspect, you need to be looking at another formula. [01:17:40] Speaker B: Right. [01:17:42] Speaker A: We all know that doesn't stop people from just slinging shout like, yeah, oh, no problem. And then, of course, let's not forget that, you know, Jia Wei, Shao san, which has Muudan P and Djerza added into the mix as well, is another really remarkable modification for this warrior type emotional pattern. A digestive outcome. Again, still often loose stool, but with heat signs. So maybe there's even some, like, burning or pain, a defecation, maybe when irritability strikes, there's redness in the face. Maybe there's some skin, skin presentation that can even look like some heat going on. A lot of the decision I'll make to use a jawe Shia san versus a regular Shia san has a lot to do with the person's constitution. I'm looking at someone who is kind of ruddy and a little sweaty and a little bit, you know, kind of grease on the face and, like, they're short tempered and that, it's not worry now, it's irritating. Irritability. There's a clear heat component that rises up through the body. Now, adding those extra two heat clears and Mudan P and Djerza are great components to weave into that formula. Right? [01:18:46] Speaker B: Yeah. [01:18:47] Speaker A: So let's say we have all the irritability symptoms, or let's say the stress, emotional symptoms, the things that people call liver Qi stagnation. But we don't have any digestive problem. Right? Again, not all that common, but it does happen. Right. Well, now we're pulling back to Sinisan. Right? [01:19:03] Speaker B: Right. [01:19:03] Speaker A: At the core level and saying, like, well, perhaps all we need is Sinnisan, maybe a single herb increase in there. So Sinisan plus dongwe, which is almost a shia san, but not quite. Right. [01:19:16] Speaker B: Yeah. [01:19:16] Speaker A: Is now moving you along that way. [01:19:18] Speaker B: Certainly adjacent. Yeah. I think the Sinnisan, the basic Sinisan pattern can be really, it can be really useful to see or to use in the context of. We were mentioning men's health earlier. Let's take some saw palmetto for whatever. Sinison is like a golden formula for men's health, especially prostate issues, erectile dysfunction, problems with urination, any kind of uranogenital issue, it's wise to consider Sinison. It may not be, but it's a good one to consider. Sinisan is my favorite traveler's constipation formula. So I find that if you use something like Dachai hutong, it's a little too strong. Whereas if you use Sinisan, dad gets constipated on the road every time he travels. He'll come up with some Sinisan the first couple of days while he's traveling, and it's usually nothing knocks it right out. So there's a lot of really good ways to utilize the sinisense structure and also to pair in different formulas with it. Like if you add in Guager, like in the lines, it says if there could be palpitations, then you add in Guager. And you have absolutely xiaoya or you have guidance outong in there. [01:20:43] Speaker A: Absolutely. Yeah. And I mean, you can, and you can even pull in more containers, contemporary herbs like Danshan that we don't see a lot of mention for in classical texts. But Danshan is an amazing herb to deal with things that are affecting the heart and the blood. And it's not uncommon for people with prolonged constraint to have cardiovascular issues from an anatomical point of view. And then even just like heart chi constraint and that sort of tightness that comes in the upper jaw. Okay, well, so obviously, you know, these are just two subfamilies in the Chihu world. There are other types of families that could exist. And as we as anytime we spend time talking about herbs for any length of time, it's easy to see how obviously formulas get linked up with other formulas, components of formulas get pulled into formulas. And that's, of course, where it can start to seem intimidating to people. I think the goal of today, of course, is to just introduce these broad concepts and to start small. Right. So we're thinking of chihu as a group of formulas, subfamilies of Chihu Tang and Sinisan, where chaihu Tang is the world in which we deal with xiaang symptomology that we've clearly described as this alternation as a key factor along with some specific items from the classical texts, versus Sinisan, which is not an alternating symptom, not a pivot problem, but an internal constraint, like a tightness of the movement of qi, we often think about that in the middle of the body, and therefore the release of that allows qi to move in the directions that it needs to, which facilitates the warming of hands and feet. And then modifications to Sinnisan, or I guess iterations of Sinnisan, bring us to the real classic formula, chia san, which is highly effective for dealing with that internal constraint, but in my opinion, should be reserved for the secondary presence of digestive problems, specifically of the sort of weak, damp spleen variety. Right. Okay, one other question that I have. Do you ever use sinison? Do you ever imagine using sines on with people who don't have cold hands or feet, or do they always, oh. [01:22:55] Speaker B: Yeah, yeah, no, I'll use it. So I'll use sinison. Generally, there's something happening in the hands, like, some people. So heavier bodied people will tend to not have cold hands and feet, but will have sweaty hands and feet all the time. And I look at that as a similar, like, my interpretation is a similar, like, oh, the chi is stuck in the middle. It's not articulating outward, and it's not controlling, facilitating the clean movement of opening and closing on the periphery. So, like, that could be a sini swan, the Sinisan plus archentong or Sinnisan plus Pingweisan or something like that. [01:23:38] Speaker A: Sinister Ping Wei san is a great combo. Yeah, that's a whole talk about that. [01:23:42] Speaker B: Yeah, yeah. [01:23:44] Speaker A: Okay. So the reason I ask that is because I don't want people to think, like, because it's called frigid extraction extremities powder that I have to use it for frigid extremities. Also, by the way, you know, many of you out there are using granules. So of course, if you're using granules, that's the world that you're in. But if you have access to a bulk pharmacy and you can build cines on. As a sign. As a sign. [01:24:05] Speaker B: Oh, my God. Right? [01:24:06] Speaker A: So, like, you actually grind it up and you dose it. You know, like, the range is pretty, pretty variable in terms of, like, how much dose a person would take at a time, but I usually dose it at like 12 grams. Twelve or 16 grams of bulk san. Right. So it's ground into a relatively coarse powder. Put into, like, there's a couple ways you can do it. I think the most effective way to do it is put into a pot, say 16 grams, two tablespoons ish. Again, quick reminder, there is no concrete relationship between weight and volume. So when you hear me say 16 grams, maybe two tablespoons. Please do not assume that one tablespoon weighs 8 grams. [01:24:43] Speaker B: Right. [01:24:44] Speaker A: Right. Just empirically, that's probably not true. I'm giving you a rough estimation on how we do it here. So you put 16 grams into a pot with 12oz of water and bring it to a boil, drop it to a simmer and cook it for five minutes and strain it. Yeah, that's what I like the best. [01:24:58] Speaker B: Yeah. [01:24:59] Speaker A: If you can't boil it, boil some water like it's still boiling, pour it from the kettle into a mug with your herbs, and let that sucker steep for a good ten minutes. Right. And then strain it and drink it. Right. On the subject of drinking the dregs or not, by all means, feel free to drink the dregs. I think it's gross. Like, the powder that's in the bottom. Like, it's just gross. It's like, it's gritty and it's unpleasant. But, like, if you're like, I'm gonna get all those herbs, by all means. It's not entirely clear what the intention was with drinking the. The powder or not. From history and time. Did they drink the powder? Did they not drink the powder? I don't know. I don't know that anyone knows. Exactly. So, personal preference there, but I think if you boil for a couple minutes or strain or steep and strain, I think you're going to get the key effect. It's important, I think, to note that sinisan, as a formula moving qi constraint by its nature, works in a more yang space. [01:25:58] Speaker B: Yeah. [01:25:58] Speaker A: And therefore, sans, which are not long cooked, they're not deeply cooked. Extract the yang aspect, the more ephemeral aspect of an herb, the pattern that is created and woven from that kind of preparation is more yang in nature, and so it works. It's a nice synergy, whereas if you had some, like, intense, sticky yin formula, probably not gonna just, like, grind it into a powder and. And cook it for five minutes. Like, it's probably not going to be enough. Which is why we don't see a lot of yin tonifying sans sans. So if you're out there thinking, like, why is there San Juan Tang? Like, all the variations, like, there's a reason. It's not random. Right. But that said, most people in the modern clinic are using it in granules, so it's a bit of a moot point. But if you do have access to a bulk pharmacy or have an account with a pharmacy like root and branches pharmacy, in fact, rootandbranchpharmacy.com, you could order some San and give it a try and do a side by side, do a granule, do a bulk decoction, and do a San. And just experience that in your body. [01:27:04] Speaker B: And just to give you guys a little sneak peek of what you're likely to expect, all of our experiences with San in the past, when it's a san, when it's a pattern that needs a san, the san is the most potent. More than a tongue, more than a granule. It's the most potent, and it's the cheapest. It's the most cost effective way to take herbs, period. Way more cost effective than granules, even. [01:27:33] Speaker A: Absolutely. [01:27:33] Speaker B: And absolutely more effective. Like, unbelievably so. So anyway, just put that in your. [01:27:42] Speaker A: Calculator because, you know, it's true, like, granules are increasingly expensive, bulk herbs are incredibly expensive right now. San gives you a way to use less physical herb at a time, which is why it's cheaper. Right. But you're getting the advantage of super high quality potent herbs that were ground right at the point of use. Right. So that's really the, that's really the rub. All right, well, I think that, I think that takes us to the end of this, this little dive into Chahu family formulas. As always, you can reach [email protected] for information on creating an account and building chinese formulas for yourself. Those accounts are open to any licensed chinese medicine practitioner anywhere in the world and also to students of chinese medicine. So if you are in school and you would like to write an account with us so that you can write formulas and use yourself as a little bit of an experiment space, I think that's not a bad idea. And so you can make an account there. And of course, if you're looking for a clinical intervention, if you're a patient or you're interested in getting treatment with herbs, I would recommend finding a local practitioner in your area who emphasizes in herbs. It's always effective to have someone who can look at you and touch your body and do an abdominal exam if necessary. But if that's not available in your area, you can find us at root and branch. That's all spelled out, rootandbranchpdx.com, and you can even sign up for telemedicine there, and we can do some remote work. Right? So always best to find someone in your area first, if you can. But if you can't and you're looking for help, give us a, check us out online, rootandbranchpdx.com, and we will catch you guys next time. This is Travis Carr. [01:29:21] Speaker B: I'm Travis Cunningham, and we'll talk to you soon.