Question Details
Shao Yang Disharmony
by sophiek - August 14, 2023
Hi Steve,

I'm wondering if you could clarify some things about Shao yang Disharmony as a TCVM pattern.

Is it correct that Blood deficiency and Damp are underlying patterns that then can eventually lead to Shao Yang Disharmony? Can it also occur alone, without a predisposing factor/pattern?

With my patients I am often finding Shao yang Disharmony, as it's the later stages of chronic disease by the time they get to me, so I don't seem to be seeing as many patients with just Blood Deficiency or just Damp etc. I am wondering if I am over interpreting / over diagnosing this.. but if those patterns often lead to SYD, would it make sense to almost always pair a XCHT based formula with a second formula to address the underlying pattern? ie 'open the gate' to allow the underlying pattern to be resolved - Is it the first step in unpeeling the layers that is often needed to get a response?

I feel like I find a toned, thin, deep pulse in many of my patients, which I have interpreted as Blood Deficiency with Stagnation (not sure if this is correct!) - which again I feel like I would reach for a XCHT based formula with a Blood tonic.

Thanks for your help, any extra info would be great!
by naturevet
August 18, 2023
Hi Sophie,

Dampness and Phlegm accumulation (in the Middle Burner) was historically considered to be an underying cause of Shao Yang disharmony. Hence the inclusion of Ban Xia in Minor Bupleurum.

In small animal practice, I find it is Blood or Yin deficiency that precedes some cases. Shao Yang disharmony is essentially a problem with uneven Yang movement. If it is stuck in one place, it can both damage Yin and be more readily exposed as present in Yin deficient patients.

Think of an animal with Yang trapped internally in the Yang Ming. The concentration of energy in the Stomach damages its Yin. As that Yin declines, it is less balancing of Yang. Thus, any time Yang enters the Yang Ming, Stomach symptoms begin to materialize, because Yang is staying there just a bit too long.

How consistent an association is this? I find most skin dogs have Blood and Yin deficiency, calling for Si Wu Tang. Many Shao Yang dogs with GI issues need Yi Guan Jian. But a disc dog with no hind limb movement needs Chai Hu Gui Zhi Tang first, and only later shows any benefit from Du Huo Ji Sheng Tang. So it depends on the situation whether or not I will pair a Blood/Yin tonic with XCHT at the outset. My default bias is to start with XCHT and see if the tonic is needed (because deficiency symptoms are manifesting). The exception to this is the pairing of Si Wu Tang with XCHT, which is almost invariably needed in Shao Yang skin problems in dogs..

Hopefully this helps!?

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