Beginners Guide to Shang Han Lun, level 2

So, about eight months ago I gave beginners tips for the Shang Han Lun. Now I think it’s time we moved up to the next stage. Here are some tips for the practitioner who is really ready to start using the Shang Han Lun to treat.

1. Understand very clearly Interior and Exterior. The three Yang conformations are the Exterior, the three Yin conformations are the interior. The imaginary border between the two is between Shaoyang and Taiyin. If the defenses are sufficiently weakened and the invading pathogen strong enough, it will pass into the interior at Taiyin. The reason this is important: while the pathogen is still in the exterior it is relatively easily flushed out. Once it passes into the interior it begins doing damage to the Spleen and Lung, which has immediate effects on the Qi and Blood production systems, further weakens the immunity, and also creates the opportunity for lurking pathogens. In other words, it’s a ticket to chronic disease. Do not let this happen.

2.The Yang must be protected. Shang Han Za Bing medicine is predicated on the idea that the Yang is the thing that must be protected first and foremost. (I will quickly mention that the historically correct model of Yin/Yang does NOT have them as equals, but rather with Yang in the leading position. More on this another time.) In order to kick out the invader, the patient must have Yang sufficient to the task. Where does this Yang come from? The Organs, aka the Yin conformations. Your job is to protect the Organs (therefore protecting the systemic Yang) while out-thrusting the pathogen. Protect the Taiyin like its a city under siege.

3. Memorize and understand the Magic Five.So whats the primary method of protecting the Taiyin? The Magic Five: Ren Shen, Ban Xia, Sheng Jiang, Zhi Gan Cao, Da Zao. When you see combinations of these herbs in a SHL formula, you know that they are there to fortify Taiyin in some way, whether by protecting against cold herbs like Chai Hu and Huang Qin or more simply boosting the Yang via the Spleen. Cold damages the Spleens ability to operate and slows down Qi and Blood production, which weakens the nutritive and defense capabilities of the whole body. Therefore, it can’t be allowed to touch the Taiyin in any form, whether pathogenic or herbal. (This is why cold TCM formulas like Yin Qiao San are such a disaster).

4. Xiao Chai Hu Tang is the key. In my opinion, a working understanding of Xiao Chai Hu Tang will unlock the whole book for you and enable you to start “reading the directions” in a sense. The reason is this: Zhang Jie states that only one symptom is required to be present in order to prescribe XCHT. The unspoken proviso here is that you must be able to see the process of Shaoyang obstruction behind that symptom. What this does is set the table for being able to prescribe the formula for conditions of internal cause that carry the same pathomechanism. Whether the headache from obstruction of the Gall Bladder channels descending function is caused by an exterior pathogen moving inward or by the internal cause of unchecked anger and frustration, the treatment is the same if the mechanism is the same.

5. Be precise with ingredient choices and amounts. A frequent problem that I run into with experienced practitioners is that they try to “mellow out” SHL formulas like XCHT by doing things like quartering the amount of Chai Hu, adding Dang Gui, decreasing Sheng Jiang in situations where Gan Jiang is called for, etc. In a word, don’t do it. The ingredients are specific and necessary and amounts are in particular ratios for a reason. The change of a ratio between two herbs will change what the formulas do, and in the very specific world of SHL medicine that’s usually the difference between a formula that cures and a formula that doesn’t work. Also make doubly sure that you are applying the correct modifications as illustrated in the commentary. Again, this is the difference between success and failure.

I suggest visiting the forum at www.arnaudversluys.com and having a look around. This is the best place to get SHL questions answered.