Artwork for podcast Qiological Podcast
060 Treating Inflammation With Chinese Medicine • Will Maclean
Episode 6027th November 2018 • Qiological Podcast • Michael Max
00:00:00 01:05:57

Shownotes

Inflammation is a popular topic in the worlds of both alternative and conventional medicine. It’s a pathologic process that is the result of certain disease processes and the generator of others. It is also something that can be treated very well with East Asian medicine.

In this episode we explore how the fundamentals of the Liver/Spleen relationship, the Heart/Kidney axis and digestion in general all can contribute to treating lingering heat in the body.

We also take a look at lingering pathogens, and discuss how herbs with opposite effects are useful in treating these kinds of conditions as they help to reestablish dynamic equilibrium to the body.

Listen in for a conversation on the power of harmonization in the treatment inflammatory conditions.

 

Head on over to the show notes page for more information about this episode and for links to the resources discussed in the interview. 

Transcripts

Will Maclean:

The three things that we can do something about, uh, what I

Will Maclean:

call the primary pathological triad.

Will Maclean:

That's number one.

Will Maclean:

And that's probably the most important.

Will Maclean:

The second is a lingering pathogen of some sort, because once you've got

Will Maclean:

a lingering pathogen in the system, you've got this constant conflict

Will Maclean:

between the junkie and the pathogen.

Will Maclean:

And the third one is this disconnection between the heart kidney axis, which

Will Maclean:

is the Thermo regulation system of the body, the water fire balance.

Michael Max:

I'm Michael max.

Michael Max:

And this is qiological the podcast for practitioners and students of

Michael Max:

acupuncture in east Asian medicine.

Michael Max:

If you're new here, welcome.

Michael Max:

And if you're a regular listener, I've got a great conversation

Michael Max:

with will McClean coming up today.

Michael Max:

By the way, if you're familiar with Will's writing, Eastland press has a

Michael Max:

new edition of the clinical handbook of internal medicine coming out, and

Michael Max:

you can snag it with a discount for another week or two pop on over to the

Michael Max:

podcasts page on the website and click on the Eastland press icon for details.

Michael Max:

If you listened to the podcast here for any length of time, you'll know

Michael Max:

that I've got an interest in marketing.

Michael Max:

Actually, what I have is an interest in how people connect

Michael Max:

with each other, make me.

Michael Max:

And create sense in their world, which is partly what attracted me to the

Michael Max:

practice of medicine in the first place.

Michael Max:

I've also got this interest in what I like to think of as first principles,

Michael Max:

the stuff that underlies any process or manifestation, kind of like us east

Michael Max:

Asian medicine practitioners think of yin and yang, where the resonant

Michael Max:

manifestation of the five phases.

Michael Max:

First principles are not like scripts, hacks or shortcuts, which I suspect

Michael Max:

are of limited value as those focus on results rather than on process.

Michael Max:

First principles in the area of marketing are the building blocks of how we

Michael Max:

make meaning and how we communicate with those that we wish to serve.

Michael Max:

You have probably heard me talk about Seth Goden, uncle Seth, as I like to think

Michael Max:

of him, he's a smart and funny uncle.

Michael Max:

I wish I had had as a kid.

Michael Max:

I recently read his latest book.

Michael Max:

This is marketing, and I want to tell you about.

Michael Max:

It's not a book about marketing, reading.

Michael Max:

This book could change how you interact with your spouse, dial down

Michael Max:

your activity to those idiots over there and open your sense of inquiry

Michael Max:

into situations that seem confusing.

Michael Max:

And without a lick, a logical sense, if all you learned from

Michael Max:

reading this book is it's for them.

Michael Max:

It's not for you.

Michael Max:

Then this book would have been worth your time.

Michael Max:

I think this has been one of those reoccurring lessons that's come

Michael Max:

around for me as a businessperson.

Michael Max:

It's come around again and again, for a long time, I thought I could

Michael Max:

help everybody with acupuncture.

Michael Max:

What I've come to discover is I can't understanding it's for them.

Michael Max:

It's not for you.

Michael Max:

Not only lets me take myself off the hook.

Michael Max:

It lets the people who may not be ready to use our.

Michael Max:

It lets them off the hook too.

Michael Max:

It's not a failure on anyone's part.

Michael Max:

And it saves a lot of waste of time and emotion.

Michael Max:

And beyond the arena of marketing our practices, I found that

Michael Max:

pausing for a moment to remember it's not for me, it's for them.

Michael Max:

This helps me to better understand aspects of life and culture.

Michael Max:

That don't make any sense to me.

Michael Max:

Like I dunno, stadium sports, small dogs, sneaky tofu, or a Kia soul cars.

Michael Max:

I think it just comes down to honest differences, differences that separate

Michael Max:

us into dissimilar crowds, but consider this wherever there's an outside.

Michael Max:

There's also an inside and I'm reminded by uncle Seth's work that we can

Michael Max:

focus and be generous with the inside, with those who we wish to serve.

Michael Max:

And we do it best, not when we try to exclude others, but recognize

Michael Max:

that there are those who just aren't interested and not waste our valuable

Michael Max:

time or energy, trying to change them.

Michael Max:

It's not for them.

Michael Max:

Keep your attention on those who our work is for and help them with

Michael Max:

the changes that they want to make.

Michael Max:

1 0 1 last thing about marketing.

Michael Max:

I'm still looking for someone who genuinely loves doing health fairs

Michael Max:

and it shows in your paycheck too.

Michael Max:

I'd love to have a conversation with you here on the podcast.

Michael Max:

Again, it's an area that's completely out of my introvert's area of interest,

Michael Max:

but I'd like to better understand how these situations can be helpful for some

Michael Max:

people ping me if this is your balance.

Michael Max:

Hey everybody.

Michael Max:

Welcome back to chia logical.

Michael Max:

My guest today is will McLean will is a long time 30 year

Michael Max:

practitioner down in Australia.

Michael Max:

He's currently on sabbatical where he's doing some work on one of his books.

Michael Max:

He is trained both in Australia and did some time in Honjo China.

Michael Max:

In addition to teaching internationally, he is the co-author of a veritable

Michael Max:

library of books on Chinese medicine, including the three volume series

Michael Max:

titled clinical handbook of internal medicine, which by the way, we will

Michael Max:

be talking about later in the show.

Michael Max:

We'll welcome to GLI.

Will Maclean:

Thanks, Michael pleasure to be here.

Michael Max:

I'm really excited to be talking to you.

Michael Max:

You know, I'm excited to talk to everybody that's on my show.

Michael Max:

Imagine that I'm the one who invites them.

Michael Max:

I think so, too.

Michael Max:

So you've done a lot of books.

Michael Max:

You've done a lot of writing.

Michael Max:

You know, we were talking earlier before we, uh, turned on the tape.

Michael Max:

A book is a lot of work and you've got more than a few.

Michael Max:

And anyone that hasn't done a book probably doesn't know that the

Michael Max:

incredible effort that goes into it.

Michael Max:

I'm a little curious, indeed.

Michael Max:

Yeah.

Michael Max:

What has incited you, whatever got you started with writing

Michael Max:

books in the first place?

Michael Max:

Well,

Will Maclean:

it was really practical because I was teaching

Will Maclean:

that one of the colleges in Sydney, not too long after I graduated.

Will Maclean:

In fact, I think I started teaching at about 19 91 92, something

Will Maclean:

like that in those days, there just wasn't very much material.

Will Maclean:

I was teaching a course on internal medicine amongst other things, but

Will Maclean:

the source materials that I learnt when I was at school were pretty poor.

Will Maclean:

That didn't really reflect the clinical reality that always

Will Maclean:

starting to observe in practice.

Will Maclean:

So I started to compile course notes, you know, things that I

Will Maclean:

thought were a bit more realistic.

Will Maclean:

I had some good source materials that I've picked up in China when I

Will Maclean:

was there or Chinese was improving.

Will Maclean:

So I started slowly to compile a series of lectures on internal medicine.

Will Maclean:

So

Michael Max:

it was really your class

Michael Max:

notes

Will Maclean:

in a sense.

Will Maclean:

Yeah, basically that's how it started.

Will Maclean:

The first volume was certainly compiled from class notes.

Will Maclean:

And then of course over time, as I got more and more experienced in

Will Maclean:

practice, those course notes became modified by what I was seeing.

Will Maclean:

There was often quite a, an interesting divergence between the original

Will Maclean:

Chinese materials and what the reality of a Western clinical practice

Michael Max:

was.

Michael Max:

I think this is something that we all go through.

Michael Max:

I know, I certainly know that I did where we learned this theory.

Michael Max:

We learned some stuff we get through school, and it's actually really

Michael Max:

curious when someone walks in and actually fits what we studied

Michael Max:

in school, because most people

Will Maclean:

don't that's right.

Will Maclean:

It's very, it's, it's an, a unique situation you think, oh, wow.

Will Maclean:

Maybe there is something in this after all, you know,

Michael Max:

I often think I'm clearly missing something here.

Michael Max:

Cause this just fits the book.

Will Maclean:

Yes.

Will Maclean:

But that particular in compatibility just became more and more

Will Maclean:

clear over a period of time.

Will Maclean:

But anyway, that's where the book started from.

Will Maclean:

That was where the first volume started from.

Michael Max:

It's sort of your journey with understanding clinical practice.

Will Maclean:

Originally, it was all going to go into one book,

Will Maclean:

but you know, internal medicine is really a huge and complicated field.

Will Maclean:

So the first book only covered four of the organ systems.

Will Maclean:

That's all we could actually physically print basically,

Michael Max:

unless you put wheels

Will Maclean:

on the thing.

Will Maclean:

Yeah, that's right.

Will Maclean:

It was a little cam to a thousand pages or something.

Will Maclean:

And I think in those days, the physical limit was around about a thousand

Will Maclean:

pages for the paper type that we had.

Will Maclean:

So my dream of having an all in one got thrown out pretty early.

Will Maclean:

So we went for a second volume thinking that that would be the end.

Will Maclean:

And then of course it just keeps on going.

Will Maclean:

It grew like topsy essentially.

Will Maclean:

And in fact with the new edition has grown again

Michael Max:

earlier, we were talking about inflammation.

Michael Max:

Inflammation is a big thing these days it's in, you know, it's in the news a lot.

Michael Max:

I really like to hear your thoughts about inflammation, how it looks in

Michael Max:

Chinese medicine, what we do with it.

Michael Max:

What are you thinking about this

Will Maclean:

stuff?

Will Maclean:

Inflammation particularly chronic inflammation has been one of my

Will Maclean:

major clinical and research interests for the last probably 10 years.

Will Maclean:

Just because it appears to be so phenomenally common.

Will Maclean:

This is not just from a general medical point of view, but from

Will Maclean:

a Chinese medical point of view.

Will Maclean:

So many of my patients present with what we would describe as some type

Will Maclean:

of heat complex, which is giving rise to at least a portion of their problem

Will Maclean:

and a whole bunch of their symptoms.

Will Maclean:

And what, let me go back a little bit.

Will Maclean:

I've worked in a number of different practices.

Will Maclean:

And one particular practice that I worked in was a general medical

Will Maclean:

practice with GPS and osteopaths and a whole bunch of other people.

Will Maclean:

And we used to cross refer a great deal between each other.

Will Maclean:

And I would end up getting a lot of patients with auto immune diseases

Will Maclean:

referred to me because the treatment, as you know, for autoimmunity, at

Will Maclean:

least this was probably 20 years ago.

Will Maclean:

Wasn't especially good.

Will Maclean:

You know, it was steroids, methotrexate, immunosuppressants, And patients that

Will Maclean:

often end up feeling worse than they did initially with all other drugs.

Will Maclean:

And they weren't really well controlled and so on and so forth.

Will Maclean:

So I was exposed to a lot of patients with so-called auto immune diseases.

Will Maclean:

And one of the things that they generally had in common from a Chinese medicine

Will Maclean:

point of view was this persistent peat.

Will Maclean:

They had some degree of heat somewhere, whether it was in their warm, swollen,

Will Maclean:

painful joints or in the skin problems that they had, which were sort of

Will Maclean:

red and raised and whatever it might be, your ulcerations of the oral

Will Maclean:

cavity, uh, you know, the whole bunch of different examples of that, but

Will Maclean:

take was the consistent finding.

Will Maclean:

And as you do as a practitioner, you think, okay, well, what do I do here?

Will Maclean:

I have to clear away, Hey, we can clear why, Hey, that's not a problem.

Will Maclean:

There's lots of ways to do that.

Will Maclean:

And patients will often get somewhat better, but it always seemed to come from.

Will Maclean:

You know that stop the treatment that go away.

Will Maclean:

They come back a few months later and everything had returned in

Will Maclean:

much the same sort of fashion.

Will Maclean:

So the problem seemed to me that it wasn't just getting rid of heat.

Will Maclean:

What the hell is the heat doing?

Will Maclean:

Where is it coming from in the first place?

Will Maclean:

That was the initial thing that got me started on that.

Will Maclean:

I had one particular patient, a lady with an auto immune disease called disease.

Will Maclean:

Also known as Silkroad disease.

Will Maclean:

You're familiar with that.

Michael Max:

I'm not familiar with that one.

Michael Max:

Tell us about

Will Maclean:

it.

Will Maclean:

Very unpleasant disease runs.

Will Maclean:

There's a strong genetic component to it.

Will Maclean:

It runs, you know, banned from China across to Turkey, and it was first

Will Maclean:

described by a Turkish physician.

Will Maclean:

Anyway, it's characterized by very unpleasant ulceration of the oral

Will Maclean:

cavity, the genitals and the eyes, as well as joint pains and fevers and

Will Maclean:

all the rest of this sort of stuff.

Will Maclean:

Now with this lady, you know, we were clearing hay clearing heat to

Will Maclean:

deal with those symptoms as much as possible, nothing was happening,

Will Maclean:

nothing was really doing anything.

Will Maclean:

And I ramped up the treatment quite considerably.

Will Maclean:

We started using much more hardcore medications.

Will Maclean:

In fact, I ended up using a thing called Lagos.

Will Maclean:

Are you familiar with that?

Will Maclean:

It's a strict regime, will 40.

Will Maclean:

And it's actually used from a Western medical point of view.

Will Maclean:

It's an immunosuppressant, it's a vine.

Will Maclean:

And it's used fairly extensively in China for auto immune problems.

Will Maclean:

Isn't it a bit toxic?

Will Maclean:

Yes, it is.

Will Maclean:

You've got to monitor liver function while your populations are taking it.

Will Maclean:

She was dedicated to treatment and she gave this a go, nothing

Will Maclean:

we weren't getting anywhere.

Will Maclean:

And I really liked this patient.

Will Maclean:

You know, sometimes you really have a special empathy with certain, you

Will Maclean:

know, you try to have empathy with all your patients, of course, but

Will Maclean:

this lady had some small kids and I really liked her a lot and she was

Will Maclean:

dedicated to her treatment as well.

Will Maclean:

So we went back to original materials to try and find some answer.

Will Maclean:

And as it turned.

Will Maclean:

This particular disease was described in the jingle jingle, a LOA.

Will Maclean:

It's a thing called hidden Fox who were, who were being

Michael Max:

hidden from disease.

Will Maclean:

Anyway, the solution given by John, John gin to this

Will Maclean:

was a harmonizing prescription, I think, or gunshot she has in tongue.

Will Maclean:

And you think, okay, well, what's going on there?

Will Maclean:

She's full of hate.

Will Maclean:

She's burning up.

Will Maclean:

You know, she's got inflamed joint, she's got all these ulceration.

Will Maclean:

She's hot all the time gunshot.

Will Maclean:

She is, she in tongue is not really a heat clearing formula.

Will Maclean:

What's the rationale, very harmonizing.

Will Maclean:

And of course, John does not give any rationale for its use,

Will Maclean:

but I thought, look, we'll give it a go and see what happens.

Will Maclean:

I'm running out of ideas.

Will Maclean:

So we tried it and it made a difference, not a huge one, but it made a difference.

Will Maclean:

What

Michael Max:

were the initial things that shifted.

Michael Max:

Well, she

Will Maclean:

felt better in general, that sort of overall

Will Maclean:

sense of wellbeing improved.

Will Maclean:

She wasn't feeling so terribly distressed.

Will Maclean:

Her oral ulcerations improved somewhat her joints while still fairly

Will Maclean:

uncomfortable were also slightly better.

Will Maclean:

She had one knee, which was really a problem, um, and her wrists were problems.

Will Maclean:

So it was terrible for her to pick up her children.

Will Maclean:

And that improves slightly to now these weren't dramatic by any means, but there

Will Maclean:

was a qualitative shift that we hadn't been able to achieve doing anything else.

Will Maclean:

And that really got me thinking about what was the rational

Will Maclean:

what's behind this thinking?

Will Maclean:

Anyway, that started the process.

Will Maclean:

I mean, basically when you've got this sort of hate, you have to

Will Maclean:

discover the source of the hate.

Will Maclean:

That's the only way to really move forward with treatment.

Will Maclean:

Where is that heat coming from and why is it being continually

Will Maclean:

created over and over again?

Will Maclean:

The more you clear it, fine, you get rid of it, but it comes back, right?

Will Maclean:

Something is smoldering.

Will Maclean:

Something is smoldering.

Will Maclean:

Something is continually producing these hate.

Will Maclean:

So that was the starting point for thinking a bit more

Will Maclean:

deeply about the problem.

Will Maclean:

And then over the years with a lot more research and a lot more clinical

Will Maclean:

experience, I came to the conclusion that there are three major sources

Will Maclean:

of this persistent heat in the body.

Will Maclean:

And this seems to be reasonable to model.

Will Maclean:

So I'm not claiming that it's the answer by any means, but it's certainly

Will Maclean:

been a very helpful guiding principle in my practice over the years.

Will Maclean:

And the three sources of heat, uh, without going into too much technical detail, this

Michael Max:

is a shelf for practitioners.

Michael Max:

We can go as deep and geeky as you want to go.

Will Maclean:

Let me go back.

Will Maclean:

There are actually six sources of persistent hate, but three that we

Will Maclean:

can do something practical about.

Will Maclean:

You know, we can actually intervene with in our practice, the three that

Will Maclean:

we can't really do a whole lot about.

Will Maclean:

There's a constitutional component.

Will Maclean:

Patients who have a liver fire or a heart fire type constitution, they

Will Maclean:

seem to be prone to developing heat type pathology as they get older.

Will Maclean:

And there's not a whole lot.

Will Maclean:

You can really do about that in my experience.

Will Maclean:

Diet is also extremely important and you know, you just put too much fuel in like

Will Maclean:

a compost tape, which gets hot basically.

Will Maclean:

And my experience has manipulating people's diet is one of the

Will Maclean:

hardest things to do in practice.

Will Maclean:

I'm

Michael Max:

a real failure at getting people to change their diets.

Michael Max:

It's

Will Maclean:

very, very difficult.

Will Maclean:

The three things that we can do something about, uh, what I call

Will Maclean:

the primary pathological trial.

Will Maclean:

That's number one and that's probably the most important.

Will Maclean:

The second is a lingering pathogen of some sort as once you've got a lingering

Will Maclean:

pathogen in the system, you've got this constant conflict between the junkie and

Will Maclean:

the pathogen, which creates its own source of hate, which creates the fire of battle.

Will Maclean:

If you like the conflict of battle.

Will Maclean:

And the third one is this disconnection between the heart kidney axis, which

Will Maclean:

is the Thermo regulation system of the body, the water fire balance.

Will Maclean:

All right.

Will Maclean:

So if that heart kidney axis is out of whack for some reason, then either

Will Maclean:

there's not enough water to control the fire, or the fire just gets out of

Will Maclean:

control on its own of its own accord.

Will Maclean:

And then you get this persistent level of heat and they all have their own

Will Maclean:

signatures, clinical signatures, which you can identify fairly clearly in a

Will Maclean:

practice, but they all end up causing rather similar looking clinical profile.

Will Maclean:

No, they all generate hate.

Will Maclean:

They all generate ongoing heat.

Will Maclean:

And unless you deal with the underlying reason, if you don't get rid of the

Will Maclean:

lingering pathogen, that's there, or you don't balance out the tryout in

Will Maclean:

some way, or try and reestablish the connection between the heart and kidney.

Will Maclean:

Basically, all you're doing is putting a bandaid on the hate

Will Maclean:

and it will keep on coming back,

Michael Max:

which is what Western medicine does

Will Maclean:

basically.

Will Maclean:

Exactly.

Will Maclean:

In fact, most treatments do seem to just put a bandaid on it.

Will Maclean:

And that's certainly what I was doing by just clearing huddle at the time.

Will Maclean:

It wasn't really doing the job.

Will Maclean:

I'm

Michael Max:

not familiar with this primary triad that you're

Michael Max:

speaking about, or maybe I am, but I don't know it by that name.

Michael Max:

What are, what is the primary triad?

Will Maclean:

Basically, it's a very simple concept.

Will Maclean:

It's essentially the relationship between the liver and spleen.

Will Maclean:

One of the major primary axes of the body and how that relationship

Will Maclean:

when broken down starts.

Will Maclean:

Some type of hate.

Will Maclean:

And I tell you, the triad is dysfunction, the liver dysfunction of the spleen

Will Maclean:

and the generation of heat, which those three points of the triangle.

Will Maclean:

And the interesting thing about that is that once the triad of pathology

Will Maclean:

is established, you know, once the liver and spleen are out of balance

Will Maclean:

and the hate's been created, it tends to be self perpetuating and

Will Maclean:

you can deal with one point on the triad, like clearing away the hate.

Will Maclean:

But unless you deal with all three at once, the whole thing just keeps on going.

Will Maclean:

It rolls around and reestablishes itself.

Will Maclean:

This was one of my seminal insights.

Will Maclean:

So I think as far as my own practice is concerned, you know, you would see

Will Maclean:

patients with this mix of pathology, some sort of liver, pathology, cheese

Will Maclean:

stagnation, some sort of Splendas function, deficiency, or damp or

Will Maclean:

phlegm or something along those lines.

Will Maclean:

And some type of.

Will Maclean:

And focused on strengthening the spleen perhaps, or regulating the

Will Maclean:

liver or clearing away heat and the patient would get a bit better,

Will Maclean:

but then it would come back again.

Will Maclean:

That was a consistent finding in my practice.

Will Maclean:

You know, you really never got satisfactory long-term clinical outcomes

Will Maclean:

and it wasn't until I put this together in my own head, there's nothing new.

Will Maclean:

Of course.

Will Maclean:

I mean, this has been described in the literature, but I got the hang of it

Will Maclean:

that I started to see the rationale for the concept of harmonization and

Will Maclean:

how that then fits back into what we were talking about before John John

Will Maclean:

Jennings insight in using gunshot shish in tongue to treat hidden Fox disease,

Will Maclean:

which is characterized by masses of hate.

Michael Max:

And this is a situation here with delivering spleen and balance where

Michael Max:

harmonization would be really helpful.

Will Maclean:

Absolutely harmonization is the strategy.

Will Maclean:

And of course the primary pathological triad is so common because the modern

Will Maclean:

lifestyle is essentially tuned to.

Will Maclean:

Sedentary life, you know, increasingly sedentary habits, which Microsoft

Will Maclean:

display crummy diet, which also mucks up the spleen, certain medications,

Will Maclean:

which muck up the spleen, financial, global, emotional family stresses of

Will Maclean:

various sorts, which impact on the liver additives and preservatives in foods,

Will Maclean:

medications also, which muck up the liver.

Will Maclean:

You know, the endless looking at screens, which damages liver, blood people staying

Will Maclean:

up late at night, which mucks up the liver by because the liver is of course

Will Maclean:

involved in regulating all of the various cycles, the day of night cycle, the

Will Maclean:

menstrual cycle and so on and so forth.

Will Maclean:

So there's many ways to impede delivering the spleen, largely lifestyle based.

Will Maclean:

And once that relationship's out of whack, then it's so easy to generate heat

Will Maclean:

because you've got chronic T stagnation.

Will Maclean:

You often generate some degree of stagnant hate when this plane's out of

Will Maclean:

whack, it generates damp and the hate that's there can then generate, can

Will Maclean:

interact with the heat and you've got.

Will Maclean:

Hate will eventually damage in.

Will Maclean:

So you end up with the inefficiency plus the heat.

Will Maclean:

So it becomes quite a complicated scenario, but I have found

Will Maclean:

that the primary pathological triad is at the base of so much

Will Maclean:

pathology in my clinical practice.

Will Maclean:

Now I can only speak for my practice.

Will Maclean:

You know, everyone's practice is different.

Will Maclean:

I have attracted over the years, a certain type of patient.

Will Maclean:

So I've got a certain clinical bias.

Will Maclean:

Of course it may well be different than other people's practices, but the

Will Maclean:

understanding of the primary pathological triad and of course, lingering pathogens

Will Maclean:

and the heart kidney axis issue really revolutionized the way that I

Will Maclean:

swore chronic inflammatory problems.

Will Maclean:

And I saw a lot of them.

Will Maclean:

It makes a lot of sense.

Michael Max:

I want to get into some of these other ones here in just a month.

Michael Max:

And I can see how the guns, how station Tom would really fit in there.

Michael Max:

And to me, this, I got a big smile on my face because I've done a

Michael Max:

fair amount of study with Dr.

Michael Max:

Wong Wong and one of his favorites for ulcers that go anywhere along

Michael Max:

the mucosal membranes from the mouth to the anus, to the vagina,

Michael Max:

uh, God's house, ShaoYin tongue.

Michael Max:

And as we're having this conversation, it's great.

Michael Max:

I'm getting another point of view and going, oh, I can really see the,

Michael Max:

the beautiful harmonization, you know, it's a fairly gentle formula.

Michael Max:

And when we see the situations with lots of heat and inflammation and

Michael Max:

big sores, and you're like, this is going to take care of that.

Michael Max:

What it's extraordinary, it really makes us think about patho mechanism.

Will Maclean:

Absolutely.

Will Maclean:

And you know, this is the interesting thing I think about for me about

Will Maclean:

China's medicine is the detective component of it, you know, the puzzle

Will Maclean:

solving, but to solve puzzles, you need to have a lot of material.

Will Maclean:

You need to have a lot of background material in your head

Will Maclean:

that you can draw upon a lot of different models to draw upon.

Will Maclean:

You

Michael Max:

know, we were talking about this earlier, before we

Michael Max:

got on the line about you've been in practice 30 ish years.

Michael Max:

I'm coming up.

Michael Max:

I'm in my 20th year.

Michael Max:

And I was saying how I was reading something recently, fairly basic stuff.

Michael Max:

I don't know how many nth time I've been reading it, but it comes through.

Michael Max:

And I just it's like, wow, I really get it.

Michael Max:

And I'm thinking, why did it take this long to get out?

Michael Max:

You know?

Michael Max:

And it's, I think you're really putting your finger on something here.

Michael Max:

There's this iterative process.

Michael Max:

We have to see something again and again and again, in a variety of contexts,

Will Maclean:

China's medicine is very much a holistic.

Will Maclean:

Well, I should say, holographic is what I meant to say.

Will Maclean:

System whereby each piece of information doesn't really mean anything on its own.

Will Maclean:

It only means something in relationship to many other pieces of information.

Will Maclean:

And as you gather experience and your ex your information base expands, then each

Will Maclean:

individual piece of information starts to take on a different meaning within the

Will Maclean:

context of your expanding knowledge base.

Will Maclean:

So many things you won't get until you've been, you've seen hundreds or thousands

Will Maclean:

of patients with a particular sort of problem, because you just don't have

Will Maclean:

that background knowledge to draw upon.

Will Maclean:

And it's like the pulse.

Will Maclean:

It really can't get the pulse.

Will Maclean:

I don't think until you have matched pulse states with thousands of patients,

Will Maclean:

it's that physical memory of something tied to an observation and doing

Will Maclean:

that over and over and over again is when you start to think, oh yeah.

Will Maclean:

Now I can see where that pulse is coming from and what that actually

Will Maclean:

means because I've seen it over and over and over and over and over again.

Will Maclean:

Staying

Michael Max:

with this primary triad for a moment, we talked

Michael Max:

about the God's house station.

Michael Max:

Taiyang what are some of your other strategies, thoughts, or formulas, or even

Michael Max:

acupuncture for working on this particular

Will Maclean:

piece?

Will Maclean:

From a herbal point of view, the strategies are almost always drawn.

Will Maclean:

Well, they're always drawn from the harmonizing group of formulas, but that's

Will Maclean:

a really broad category of formulas.

Will Maclean:

And the intent of a harmonizing formula is to deal with all three

Will Maclean:

points of the triad at the same time.

Will Maclean:

Now in practice, what you see is that patients will tend to skew towards

Will Maclean:

one corner of the triangle, depending on where they are in their life.

Will Maclean:

It's a dynamic process.

Will Maclean:

So from treatment to treatment, it can change.

Will Maclean:

And that's what you want.

Will Maclean:

You want it to do.

Will Maclean:

You want it to change from time to time, so you can track where they're

Will Maclean:

at depending on their life, their diet, their emotional world, their

Will Maclean:

work habits, and so on and so forth.

Will Maclean:

They might swing between having more heat or more component of chicken

Will Maclean:

strident or more Splain issues.

Will Maclean:

So the, all of those harmonizing prescriptions, uh, aimed at dealing

Will Maclean:

with different combinations, if you like of the three pathologies.

Will Maclean:

Now, another thing that, uh, informed me in this particular area was the

Will Maclean:

understanding of shout shy, who Taiyang.

Will Maclean:

Now everyone knows certainly one of the most interesting

Will Maclean:

prescriptions in the materia Medica, and one of the most widely used.

Will Maclean:

In fact, my understanding is that in Japan shy, your tongue is the number

Will Maclean:

one formula manufactured in granules.

Will Maclean:

I've heard that as well.

Will Maclean:

And it used to, before I understood the process, it confused me.

Will Maclean:

I couldn't work out what was going on because my understanding of

Will Maclean:

shaoyang tongue was that it's for shaoyang syndrome, shaoyang syndrome

Will Maclean:

being a post-infectious states.

Will Maclean:

A week or so after someone's had some upper respiratory tract problem

Will Maclean:

or whatever, it might be the lapse into a shower chair, your tongue

Will Maclean:

confirmation, which was fine, but it didn't explain why so many

Will Maclean:

people were using shout show tongue.

Will Maclean:

And it wasn't until I started to look at this in the context of

Will Maclean:

the primary pathological trial, that it all started to make sense.

Will Maclean:

And as it turns out, when you look at the triad, if you imagine a triangle with

Will Maclean:

a liver pathology, splint, pathology, and hate, and we've got a whole bunch

Will Maclean:

of harmonizing formulas, which are aimed to deal with this particular mix

Will Maclean:

of pathology, it turns out that shout show tongue does a bit of each of those.

Will Maclean:

It regulates deliver.

Will Maclean:

It's got chai hu in it.

Will Maclean:

So it regulates liver Chi it's strengthens and protects the spleen.

Will Maclean:

It has wrenching Gunshow it clears hate it has one chin.

Will Maclean:

So it does a bit of each of these necessary balancing steps

Will Maclean:

without doing too much of any.

Will Maclean:

So when you map formulas, according to their therapeutic bias, Ciao.

Will Maclean:

Ciao.

Will Maclean:

Taiyang essentially maps pretty much right in the middle.

Will Maclean:

So it's the most well-balanced of all of the harmonizing prescriptions

Will Maclean:

when it comes to tuning up the primary pathological trial.

Will Maclean:

And as it turns out, primary pathological tried is such an incredibly common mix

Will Maclean:

of pathology in the clinic that you could actually go into clinic and just give

Will Maclean:

everyone shout, shout your tongue and your strike rate would probably be pretty good

Will Maclean:

even without knowing what you're doing, because most people feel a bit better.

Will Maclean:

It's like,

Michael Max:

it's a broad spectrum.

Michael Max:

Harmonizer.

Will Maclean:

Exactly.

Will Maclean:

That's exactly right.

Will Maclean:

If you've got a bit more heat in the system, you'd want to go

Will Maclean:

somewhere else, Goa shaoyang or or something along those lines.

Will Maclean:

I'm not familiar with that one.

Will Maclean:

Uh, that's one of the most interesting formulas it's used for drum distension

Will Maclean:

drum distension is a type of societies

Michael Max:

and what's the name of

Will Maclean:

it again?

Will Maclean:

yeah, it's traditionally considered to be.

Will Maclean:

Sort of a, it's a purgative formula, which clears away fluid from the abdomen.

Will Maclean:

But it, in fact is a harmonizing formula.

Will Maclean:

The definition of harmonizing prescriptions is that they're often

Will Maclean:

quite complicated recruitment.

Will Maclean:

They combine herbs with opposing actions.

Will Maclean:

So they'll have very cold and very hot herbs together.

Will Maclean:

For example, should gal and foodstuff or gangs, young and

Will Maclean:

chin, you know, that sort of thing.

Will Maclean:

They'll combine herbs with opposing natures, bitter

Will Maclean:

sweet and so on and so forth.

Michael Max:

Yeah.

Michael Max:

Well we see that one a lot in a . Oh yes.

Michael Max:

I love that.

Michael Max:

I go through that stuff like crazy around here.

Will Maclean:

Absolutely.

Will Maclean:

That's been a mainstay of my practice over the years, too, and

Will Maclean:

exactly for that very same reason.

Will Maclean:

It balances the primary pathological triad.

Will Maclean:

That's the way that I look at it.

Will Maclean:

All right.

Will Maclean:

It's got guns young.

Will Maclean:

It's got one chin, those opposing Herb's they drive dynamic movement within the.

Will Maclean:

You got the hot herbs, which elevate, she lift up splint.

Will Maclean:

She improve the spleen and its ability to move things upwards.

Will Maclean:

You've got the bitter cold of the one group, the Hong Chin's one lens Hong

Will Maclean:

buyers, which caused to move downward.

Will Maclean:

So automatically you're setting up this sort of dynamo of movement, this physical

Will Maclean:

driving physical movement of cheap.

Will Maclean:

I

Michael Max:

sometimes think of it as like really turning a heavy flywheel.

Michael Max:

These are the herbs that give it some toric, really give it

Michael Max:

some energy to set it in motion.

Will Maclean:

Yes, indeed.

Will Maclean:

Well, that's how all of these harmonizing formulas actually really work in my

Will Maclean:

that's the way that I think about them.

Will Maclean:

Anyway, they drive physical processes rather than just thinking about

Will Maclean:

them, firing the spleen or regulating the liver or clearing away heat.

Will Maclean:

They stimulate movement.

Will Maclean:

And in fact, I think most of the really interesting formulas in the materia

Will Maclean:

Medica do much the same sort of thing.

Will Maclean:

They work like acupuncture.

Will Maclean:

They draw.

Will Maclean:

The movement of G essentially they're really dynamic.

Will Maclean:

Yeah.

Will Maclean:

Sri Fuji.

Will Maclean:

Your tongue does the same thing.

Will Maclean:

It's not a harmonizing formula, but you know, the combination

Will Maclean:

of Geogen and new sheet together near, she pulls things down.

Will Maclean:

Geogen lifts them up.

Will Maclean:

You've got the pivot, the dynamo,

Michael Max:

tonify the blood a bit and you move the blood and you move

Michael Max:

the cheese with, with that formula.

Michael Max:

It's another one, kind of a big, heavy hitter.

Michael Max:

When you think about it, it's moving

Will Maclean:

everything.

Will Maclean:

I couldn't imagine a practice without that one.

Will Maclean:

That's been another mainstay of my practice over the years.

Will Maclean:

I'm curious

Michael Max:

about the heart kidney connection.

Michael Max:

Is this, is this something that you would say is more emotionally based

Will Maclean:

very often?

Will Maclean:

Yes.

Michael Max:

Tell us a bit about what you see with that one in which formulas

Michael Max:

helped set that particular mechanism.

Michael Max:

Correct.

Michael Max:

Again,

Will Maclean:

to go backwards a little bit, the heart kidney axis and the liver

Will Maclean:

spleen access to the two main axes of the.

Will Maclean:

Now the liver spleen accesses for generating the daily cheek

Will Maclean:

we require for daily activities, physiology, normal physiology.

Will Maclean:

Whereas the heart kidney axis is your, your deeper axis.

Will Maclean:

It's the relationship between your template, your DJing, and how you

Will Maclean:

perceive the world through the shin and how normal your perception is.

Will Maclean:

Essentially the liver spleen access is easily mucked up.

Will Maclean:

You know, most people have experienced that, you know, you get upset and

Will Maclean:

you get a knot in your stomach.

Will Maclean:

That's the liver's plan disharmony, but the heart kidney access is being

Will Maclean:

so critical to our ability to form memories and our ability to see the

Will Maclean:

world clearly and therefore reproduce, which is ultimately what it's all

Will Maclean:

about from an evolutionary point of view is a very robust access.

Will Maclean:

Very hard to break, very hard to disrupt, but it gradually becomes weakened.

Will Maclean:

As you get older, as your yin is consumed by living hard, kidney

Will Maclean:

axis does become more fragile.

Will Maclean:

And is easier to disrupt.

Will Maclean:

However, in younger people who are robust, it takes a great deal of emotional trauma

Will Maclean:

to really make a significant impact on it.

Will Maclean:

And this is where it gets interesting in clinic because there's a whole group

Will Maclean:

of disorders, which occur when someone has had a major psychological trauma.

Will Maclean:

Now this can be a major car accident or some type of severe emotional shock.

Will Maclean:

The heart kidney axis is disrupted by severe emotional trauma.

Will Maclean:

So what we observe is the development of certain types of pathology,

Will Maclean:

which reflected disruption of heart, kidney access, generally

Will Maclean:

six to nine months after.

Will Maclean:

A big shock someone's spouse dies, or they were in a car accident and

Will Maclean:

they thought they were gonna die.

Will Maclean:

Whatever it might be in Australia some years ago, we had some very big bushfires

Will Maclean:

in Melbourne called the king lake fires.

Will Maclean:

And, you know, a lot of people were killed and we saw some patients after

Will Maclean:

that who had terrible problems with their heart kidney access because of

Will Maclean:

the terrible trauma of that experience.

Will Maclean:

So

Michael Max:

PTSD would fall into this category as well, then.

Will Maclean:

Yes, PTSD certainly can, but there's a very specific set of

Will Maclean:

physical symptoms that emerge out of this.

Will Maclean:

And very often they overlap with endocrine problems in Western medical sense.

Will Maclean:

So for example, dysfunction of the thyroid is quite a common experience.

Will Maclean:

So hyperthyroid problems, you know, be one example of

Will Maclean:

disconnection between the heart and.

Will Maclean:

The kidney water is not containing hot fire anymore.

Will Maclean:

So we ended up with this sort of flaring of heart fire, which manifests

Will Maclean:

in all the heat, the tachycardia, the insomnia tremors, the shin disturbances,

Will Maclean:

and so on and so forth, which are characteristic of the body's ability

Will Maclean:

to regulate its internal temperature.

Will Maclean:

People get really hot and can't cool down and they get cold and can't warm up.

Will Maclean:

So they have dysfunctional thermoregulation.

Michael Max:

Would you also see this to some degree with hypothyroid people,

Michael Max:

but in this case, it's more that the heart fire has been extinguished.

Michael Max:

And so you've got more kidney water the

Will Maclean:

other way as well when the hot kidney axis gets disrupted.

Will Maclean:

And this is discussed in the Shanghai Luna as well.

Will Maclean:

I think it's a Shanghai.

Will Maclean:

When you get disruption to the heart kidney axis, it can go one

Will Maclean:

of two ways into what's called heat transformation or cold transformation.

Will Maclean:

The transformation is more common in.

Will Maclean:

But the culture transformation is certainly there as well.

Will Maclean:

And they ultimately look to all intents and purposes like heart

Will Maclean:

and kidney inefficiency or heart and kidney yang deficiency.

Will Maclean:

So yes, called transformation is common in women.

Will Maclean:

It seems to be much more common than it is the heat transformation.

Will Maclean:

And in men it's slightly more common than it's a call to transformation.

Will Maclean:

I'm

Michael Max:

thinking about so many women I've seen in my practice who have

Michael Max:

thyroid issues and primarily hypo thyroid.

Michael Max:

Maybe they're just a little hypo thyroid.

Michael Max:

It's a little off, and I hadn't put this together until we're having

Michael Max:

this conversation right now, but I'm wondering if there's, as women have

Michael Max:

often experienced trauma that there's some hidden trauma there that's

Michael Max:

depressing that heart fire that's in increasing that kidney water.

Michael Max:

And, and there, there goes to the heart kidney axis.

Will Maclean:

What actually often happens, it seems is that the initial response

Will Maclean:

to some sort of traumatic experience, if that's what's causing it, it's not always.

Will Maclean:

You have to remember that as you get older, the heart kidney

Will Maclean:

axis becomes more fragile would after 40 half year Yin's gone.

Will Maclean:

So the access is really robust in your twenties and thirties, but as you hit

Will Maclean:

your forties, fifties, and sixties, the access becomes naturally more fragile.

Will Maclean:

So it takes less and less of a trauma to actually start to disrupt it even

Will Maclean:

without any sort of traumatic experience the access ultimately becomes disrupted.

Will Maclean:

Anyway, you know, one of the manifestations of a poor relationship

Will Maclean:

between the heart and kidney is the inability to form short term

Will Maclean:

memories because the heart kidney access is critical in the ability

Will Maclean:

to form memory in the first place.

Will Maclean:

You know, it's the relationship between the spleen part and the kidneys, the

Will Maclean:

spleen being the perception of being the, the focus of attention on something to be.

Will Maclean:

The ShaoYin the perception of course, and the storage and the kidney.

Will Maclean:

But if that process isn't working very well, then people can't

Will Maclean:

form those short-term memories.

Will Maclean:

And of course, that's incredibly common as you get older and older, that's

Will Maclean:

just a natural part of that disruption.

Will Maclean:

Hi, this is Dr.

Will Maclean:

Sky sturgeon with may way or so the basic question is how do I know how many T pills

Will Maclean:

to prescribe the answer is it depends.

Will Maclean:

May we standard dose is 24 pills per day, but you should

Will Maclean:

rely on your clinical judgment.

Will Maclean:

If 24 pills seems like too many, realize that 24 pills is about equal to nine

Will Maclean:

to 12 grams of a raw herb formula.

Will Maclean:

Also, you may want to adjust the dosage up or down depending on your patient's

Will Maclean:

weight, because the standard dose is forty one hundred and twenty five pounds.

Will Maclean:

Other factors to consider are the severity of the condition, whether the condition

Will Maclean:

is acute or chronic excess, or deficiency, your patient's age, constitution, the

Will Maclean:

presence of other health issues and other factors based on your clinical

Will Maclean:

assessment, for more information, check out, determining the right dosage for your

Will Maclean:

patient on may way.com by Laura strokes.

Michael Max:

So when you're thinking chronic inflammation and it's the

Michael Max:

heart kidney access, what are some of the kinds of issues that show up?

Michael Max:

And then what are some of the formulations that you found helpful?

Will Maclean:

Well, in terms of inflammation, it's almost always, of

Will Maclean:

course the, uh, heat transformation, the in damage component of it.

Will Maclean:

So not enough kidney water, heart fire starts to flare, but of course, one

Will Maclean:

of the things that happens with heat is that it it's a very young pathogen,

Will Maclean:

so it tends to dissipate over time.

Will Maclean:

So even though if someone had quite a significant degree of heat, initially

Will Maclean:

that will naturally wane as time goes by.

Will Maclean:

So the more chronic the pathology becomes, the more muted the

Will Maclean:

heat component becomes as well.

Will Maclean:

When there is this participant heat, as a result of the heart

Will Maclean:

kidney access, there's a number of ways you can address the problem.

Will Maclean:

But my favorite is the standard formulation.

Will Maclean:

It's ten one Bush, and Don is one of another, one of the standout formulas.

Will Maclean:

Oh

Michael Max:

man.

Michael Max:

You know, I order that stuff in by the wheelbarrow load.

Michael Max:

That is one of my, that is an amazing

Will Maclean:

prescription.

Will Maclean:

It is.

Will Maclean:

It's a remarkable prescription and it's for exactly this

Will Maclean:

heart kidney disconnection or a weakening of the heart, kidney ax.

Will Maclean:

A very, very common problem.

Will Maclean:

Of course, as you will know, yes.

Will Maclean:

As I said, it doesn't have to be traumatic as you get older at wakens naturally.

Will Maclean:

So a small upset can often be enough to tip the balance, but in a younger person,

Will Maclean:

in their twenties, you would expect to find some more significant trauma.

Will Maclean:

Unless of course, they were born with some diminishment of

Will Maclean:

their gene in the first place.

Will Maclean:

So if they didn't have the full compliment to start off within the

Will Maclean:

heart, kidney axis is by definition going to be somewhat weaker to start off.

Will Maclean:

As far as production of inflammation is concerned, that's actually quite

Will Maclean:

a minor one that causes a particular type of problem, which as I said, often

Will Maclean:

manifest as thyroid problems or pancreatic problems or reproductive problems,

Will Maclean:

but mostly thyroid and pancreatic.

Will Maclean:

So diabetes type two diabetes will often be along those lines as well.

Will Maclean:

But most commonly thyroid, but of those three causes of inflammation that we

Will Maclean:

can influence the primary pathological trial is by far the commonest.

Will Maclean:

And as it turns out, unfortunately, the most difficult to deal with because,

Will Maclean:

you know, the patient has to participate pretty substantially in the process.

Will Maclean:

Whereas in the case of a lingering pathogen, they often don't have to,

Will Maclean:

if you get rid of the pathogen, the problem often will resolve the patient.

Will Maclean:

Doesn't have to do anything.

Will Maclean:

So that's quite an quite a different sort of situation.

Will Maclean:

So

Michael Max:

lingering pathogen tends to be less of a lifestyle issue.

Michael Max:

Very

Will Maclean:

often it does.

Will Maclean:

It depends on exactly the pathogen and where it's located,

Will Maclean:

but certain sorts of other new.

Will Maclean:

And in fact, the most common pathogens are quite easy to deal with.

Will Maclean:

And if you can dislodge the pathogen from where it's hidden in the body,

Will Maclean:

then homeostasis takes place and the body just looks after itself

Will Maclean:

without the patient having to do exercise or change their diet.

Michael Max:

Well, these lingering pathogens be like from

Michael Max:

injuries or would they be from having had a bad, cold or a flu?

Michael Max:

Where do these tend to come from?

Will Maclean:

Well, the most common is, is a poorly managed infection.

Will Maclean:

So a wind heat or a wind cold or something along those lines of lung hate pathology.

Will Maclean:

It can be anything.

Will Maclean:

It doesn't matter.

Will Maclean:

That was badly managed.

Will Maclean:

He's a very common cause of a lingering pathogen.

Will Maclean:

And you can think about, you know, it's fairly obvious when you think about it.

Will Maclean:

You know, if you've got a wind heat pathology, for example,

Will Maclean:

from a Chinese medicine point of view, what are you trying to do?

Will Maclean:

You're trying to open the paws up and push the pathogen off the surface

Will Maclean:

and away get rid of it that way.

Will Maclean:

So you're venting it from the body to the outside.

Will Maclean:

The way the treatment goes now is that people will often resort to antibiotics,

Will Maclean:

for example, or bitter cold herbs.

Will Maclean:

And they have the opposite effect of what we're trying to achieve.

Will Maclean:

Bitter cold substances of which antibiotics are one type, you

Will Maclean:

know, bitter, cold, uh, substances.

Will Maclean:

They shut pause.

Will Maclean:

The coldness closes, pause and pulls things into the body.

Will Maclean:

You know, we use that when we using one chin or dark one to purge out through

Will Maclean:

the bell, but that's exactly the opposite of what we're trying to achieve when

Will Maclean:

we're using a venting prescription, like in Charleston, for example.

Will Maclean:

So a great way to get a lingering pathogen.

Will Maclean:

One of the most common is to.

Will Maclean:

I have a bad treatment.

Will Maclean:

You know, our poorly managed acute infection will frequently go on

Will Maclean:

to cause a lingering pathogen.

Will Maclean:

There are many other ways as well, people who go to the gym when they've

Will Maclean:

got something, trying to sweat it out.

Will Maclean:

For example, they've got a finite resource of cheese to overcome the

Will Maclean:

pathogens, but if they're burning up in activity, there's much less

Will Maclean:

lift for the immune system to use.

Will Maclean:

And that's another way that pathogens can occur.

Will Maclean:

It's not always the result of an infection.

Will Maclean:

It can be related to medications.

Will Maclean:

Certain medications act like a pathogen on the body.

Will Maclean:

Essentially what a lingering pathogen is from this perspective is a

Will Maclean:

persistent and abnormal immune response.

Will Maclean:

The immune system is set up to work and then it doesn't switch off properly.

Will Maclean:

And so that's signaled by a small group of persistent symptoms,

Will Maclean:

which are fairly easy to identify.

Will Maclean:

But basically, regardless of what the etiology is, the immune system,

Will Maclean:

rather than going back to its normal resting phase is to continually doing

Will Maclean:

something which it shouldn't be doing.

Will Maclean:

And this manifests with various sorts of heat.

Michael Max:

How do you like to treat these particular lingering pathogens?

Michael Max:

You vent

Will Maclean:

them.

Will Maclean:

You have to get them out

Michael Max:

with a more harmonizing.

Michael Max:

So you go more.

Will Maclean:

Yeah.

Will Maclean:

Venting is the way to eliminate a pattern.

Will Maclean:

It depends on where the pathogen is.

Will Maclean:

This is quite a large topic, as you can imagine.

Will Maclean:

And

Michael Max:

it's disgusting.

Michael Max:

The Shanghai wound quite a bit as well, where sometimes you'll,

Michael Max:

you'll want to get it out.

Michael Max:

Sometimes you'll want to take it in.

Michael Max:

And you know, like through the stool, uh, it depends on which, uh, the, the

Michael Max:

judging the six levels it's lodged in.

Will Maclean:

Yes.

Will Maclean:

And that certainly is a great starting point, but I found it rather

Will Maclean:

confusing when I was confronted with patients who clearly had some

Will Maclean:

sort of post-infectious process.

Will Maclean:

And that's what.

Will Maclean:

The whole concept of the lingering pathogen came about essentially as a, as

Will Maclean:

a simplified way of trying to understand what's actually going on with these

Will Maclean:

pathological processes, the Shanghai loans, fantastic piece of work, but it

Will Maclean:

didn't clearly reflect what was going on in my clinical practice and without

Will Maclean:

going into a lot of technical stuff, cause it's a know it's a huge topic.

Will Maclean:

I teach this and it takes two days to get a start on the lingering pathogen concept.

Will Maclean:

But it's a really important one out, of course, it's really, at least

Will Maclean:

when I was training, it was, it was undervalued and skipped over somewhat.

Will Maclean:

And it took me years of trying to nut out what was going on with some

Will Maclean:

of my more difficult patients to work out that in fact, what they

Will Maclean:

ended up having was a lingering.

Will Maclean:

So since then, I've kind of put together a simplified model of how

Will Maclean:

this works, which again, reflects my own clinical experience.

Will Maclean:

Other peoples are going to be quite different because it's going to

Will Maclean:

vary depending on your geographical location, you know, the predominant

Will Maclean:

environment that you're in, of course.

Will Maclean:

Um, and I live in a temperate, you know, fairly mild climate and the lingering

Will Maclean:

pathogens tend to reflect that, but it might be different in Russia or, you

Will Maclean:

know, the tropics of central Africa.

Will Maclean:

This is

Michael Max:

one of the amazing things about Chinese medicine is we so have

Michael Max:

to take the context, not just of the person, but their lifestyle, where

Michael Max:

they live, all those other influences.

Michael Max:

It's uh, yeah, it makes it fun and incredibly annoying at

Michael Max:

times to try to get these things

Michael Max:

dialed.

Will Maclean:

Well, it does.

Will Maclean:

But having said that I've also taught this lingering pathogen business

Will Maclean:

in different places in, in the U S and in Norway and London, you know,

Will Maclean:

places with quite different climates.

Will Maclean:

And it has been the experience of the participants in the class to have a

Will Maclean:

great deal of recognition of what I was talking about in, in their own patients.

Will Maclean:

So there's a fair bit of overlap even with different climactic situations.

Will Maclean:

So

Michael Max:

when you're looking to do this venting of the pathogen,

Michael Max:

are you also at the same time giving some support to the normal cheek?

Michael Max:

So you've got something to work

Will Maclean:

with.

Will Maclean:

Absolutely.

Will Maclean:

You can.

Will Maclean:

And many of the formulas that are of the venting class do exactly that because you

Will Maclean:

have to not only encourage the pathogen to move from the inside to the outside,

Will Maclean:

which is the main strategy, you know, you've got to open the pause and give

Will Maclean:

it an exit point and then encourage it to move from where it's stuck, which is

Will Maclean:

most commonly the key level as it turns.

Will Maclean:

In my experience, which is lucky because it's actually quite easy to

Will Maclean:

vent a pathogen from the CI level.

Will Maclean:

What are some of the ways that you like to do that?

Will Maclean:

Again?

Will Maclean:

It depends on the type of pathogen and where it is within the

Will Maclean:

particular level, because there are different zones within each level.

Will Maclean:

So the chair level, for example, is essentially the zone between the

Will Maclean:

surface, the Taiyang the way level and the deeper internal organ systems,

Will Maclean:

the yang and the blood levels.

Will Maclean:

But within that, you've got different levels.

Will Maclean:

So if a pathogen is sitting up quite high within the chair level, and

Will Maclean:

as much closer to the surface, it tends to influence the lungs and the

Will Maclean:

TaiYin lungs and colon predominantly because they're close to the surface.

Will Maclean:

If the pathogen sits down before.

Will Maclean:

It tends to influence the spleen a bit more.

Will Maclean:

So you get a lot more gastrointestinal symptomatology.

Will Maclean:

So it depends on where the pathogen is and what type it is.

Will Maclean:

Dan Pete pathogens by nature tend to sink down deeper in, within the levels

Will Maclean:

because the nature of damp is to sync.

Will Maclean:

Whereas straight hate pathogens tend to sit up high because

Will Maclean:

he tends to rise upwards.

Will Maclean:

So if you're dealing with a straight heat pathogen in the chair level

Will Maclean:

actually turns out a very easy situation to deal with, even though they can

Will Maclean:

persist for months, if not years, the herbal solution is a thing called two.

Will Maclean:

Yeah, that's the one that I liked the best.

Will Maclean:

There are a number of ways to do it, but seems to be the

Will Maclean:

most reliable in my experience.

Will Maclean:

Juliet Shugar.

Will Maclean:

So

Michael Max:

there's JueYin, which is a wonderful peak clearing herbs,

Michael Max:

shrugging out very strongly heat clearing.

Michael Max:

What else is in that?

Will Maclean:

JueYin Shugar Taiyang it also has, let me just have

Will Maclean:

referred to my textbooks here.

Will Maclean:

I'll look it up and tell you exactly.

Will Maclean:

Ah,

Michael Max:

great.

Michael Max:

Yeah, I can.

Michael Max:

It's so funny.

Michael Max:

After years of practice, I will sometimes I just think of a formula

Michael Max:

by itself, but don't always think

Will Maclean:

about what's in it.

Will Maclean:

Yeah.

Will Maclean:

And this is one of those ones, cause you don't ever modify this.

Will Maclean:

It's never mucked around with.

Will Maclean:

Okay.

Will Maclean:

So it has done JueYin Chicago a bunch.

Will Maclean:

Yeah, my dong wrenchin so it's a modification of shall charge essentially.

Will Maclean:

And it only appears once you think it's in clause, 116 of

Will Maclean:

the shouts of the Shanghai lawn.

Will Maclean:

So it's, it's really under regarded in my experience, but I have

Will Maclean:

found it to be highly reliable for this particular problem.

Will Maclean:

It's only used for this particular problem, but I've found consistently if

Will Maclean:

someone has, what I diagnose ultimately is a heat pathogen in the chest.

Will Maclean:

And we give them Shugar tongue, then all being equal and without any other

Will Maclean:

complicating factors within a week or two, the problem is resolved very often.

Will Maclean:

It's quite dramatic in many cases because unless the pathogen is vented in some

Will Maclean:

way, it's got to get out and enlist.

Will Maclean:

It's gotten out.

Will Maclean:

The whole thing just keeps on kicking on.

Will Maclean:

And

Michael Max:

that brings us right back to the beginning of this conversation.

Michael Max:

You see these patients, they've got this ongoing thing.

Michael Max:

You can clear some heat.

Michael Max:

They're better for a while, but it comes back.

Michael Max:

And so this is, this is, this is what you gotta do.

Michael Max:

You gotta really get into that level.

Michael Max:

Your way of thinking about this is really helpful that we've got

Michael Max:

these three different places to look and begin to think about.

Michael Max:

Where do

Will Maclean:

I see.

Will Maclean:

Yeah, I've found it very useful, but again, let me just stress that

Will Maclean:

this is my experience and other people's is likely to be different.

Will Maclean:

There's probably other sources of this persistent hate, but ones

Will Maclean:

that, you know, maybe more common in, you know, somewhere else.

Will Maclean:

I don't know.

Will Maclean:

I'm

Michael Max:

sure that's the case.

Michael Max:

We all have our own particular clinical gaze.

Michael Max:

If you will, our way of interacting with things I find for myself, just in having

Michael Max:

this conversation with you, that having these three sort of buckets to think about

Michael Max:

it just opens up lots of possibilities.

Michael Max:

Are there other ways of looking at it?

Michael Max:

Are there other ways of going about it?

Michael Max:

Yes, of course.

Michael Max:

This just seems really doable.

Michael Max:

At least given the clinical experience that I've had

Will Maclean:

it simplifies.

Will Maclean:

The analysis of water is often quite complicated situations.

Will Maclean:

Cause very often patients who come in with this with one or more of

Will Maclean:

those problems, you know, they've had a problem for some time.

Will Maclean:

They've often been through the ringer, the medical ringer they've often medicated.

Will Maclean:

So when they present, there's a lot of different things going on.

Will Maclean:

So this is a way of, I've found this helpful as a way of clearing

Will Maclean:

away some of the complexity and getting, and focusing my attention.

Will Maclean:

If you like on the underlying important things that need to be

Will Maclean:

addressed rather than just looking at symptoms and attempting to do that.

Will Maclean:

Yeah.

Will Maclean:

That makes a lot of sense.

Will Maclean:

And it's made a big difference, you know, certainly it doesn't work in

Will Maclean:

every case by any means, but I would say that, um, it's much more satisfactory

Michael Max:

and unless you have some other comments about this, I'd like

Michael Max:

to turn to your book for a moment.

Michael Max:

Our friends at Eastland presser are bringing out.

Michael Max:

Tell us a bit about the book.

Michael Max:

It's a, it's a re printing, as I recall, it's a second edition, a second edition.

Michael Max:

Even better.

Michael Max:

Yeah,

Will Maclean:

it's a new edition.

Will Maclean:

So it's a fairly substantially expanded.

Will Maclean:

What I should say, is it the first volume of it?

Will Maclean:

There's three books in the original series.

Will Maclean:

The first one came out in 1997.

Will Maclean:

So it's like 20 years old now.

Will Maclean:

And I'd been in practice for 10 years by that stage.

Will Maclean:

And I was still pretty green, you know, after 10 years just

Will Maclean:

you're really pretty grain.

Will Maclean:

So the first volume was essentially derived from Chinese source materials.

Will Maclean:

You know, and as I mentioned before, it was this sort of a compilation of

Will Maclean:

lecture notes that I'd been compiling for a number of years for courses that I've

Will Maclean:

been giving it various schools, but it was after that, that it really, when you

Will Maclean:

start to get more and more experience, you start to see the disconnect between

Will Maclean:

the Chinese materials and what at least I was seeing in my practice.

Will Maclean:

There wasn't a lot of overlap.

Will Maclean:

So that first volume I don't think was particularly good in hindsight.

Will Maclean:

I mean, it was helpful by all means.

Will Maclean:

It was certainly a great starting place when you're looking at trying to get a

Will Maclean:

grips to with internal medicine pathology.

Will Maclean:

But my thinking on a lot of those problems has really changed a lot since then.

Will Maclean:

So the new edition basically has rewritten the first volume pretty substantially.

Will Maclean:

And the second one also with the hindsight of 30 years of clinical

Will Maclean:

practice and the addition of some collaborators as well, who have also

Will Maclean:

put their inputs into the new edition.

Will Maclean:

So it's not just mine and Jane Middleton's input anymore.

Will Maclean:

There are other people who have contributed fairly

Will Maclean:

substantially to the text.

Will Maclean:

Who else has helped out with this?

Will Maclean:

Well, my partner, Katherine, who's been in practice for about 20 years now.

Will Maclean:

She specializes in women and children's pathologies another longterm practitioner,

Will Maclean:

friend of mine called Mark Bailey.

Will Maclean:

These are the main contributors and their contribution is essential.

Will Maclean:

They've edited the text they've gone through and pointed out things that

Will Maclean:

they think don't necessarily gel with their experience enhance things

Will Maclean:

where they think this is particularly useful and so on and so forth.

Will Maclean:

Basically it, there are other people as well, who've contributed a little

Will Maclean:

bits and pieces here and there.

Will Maclean:

And ultimately what I would hope this would be my ultimate

Will Maclean:

dream is in a book like this.

Will Maclean:

And, you know, a big sort of compendium fucking encyclopedia really becomes the

Will Maclean:

collective work of the profession rather than, you know, the work of a few people.

Will Maclean:

Ideally the experience of many is compiled into a book that reflects

Will Maclean:

our clinical world in the west because it's not different to China.

Will Maclean:

It's not the same, you know, our diets, our lifestyles, our habits, our cultural

Will Maclean:

background is different and this produces different types of pathology.

Will Maclean:

There's no question about.

Michael Max:

Well, you know, I, I love that you've started with

Michael Max:

your experience early on teaching.

Michael Max:

You brought in things that you learned in China, you know what a great start

Michael Max:

that was 20 years ago with this book.

Michael Max:

And now you've got all kinds of other experience that's baked into this

Michael Max:

new edition, along, along with the experience of other practitioners,

Michael Max:

like you said, it's not just you, it's a community of Western practitioners

Michael Max:

in a sense, or a small community of Western practitioners that have taken

Michael Max:

this stuff, worked it distilled it.

Michael Max:

And now we're going to have the second edition.

Michael Max:

When does it come out?

Will Maclean:

Well, we're still working on it, but hopefully this year all going

Will Maclean:

well, you know, you have this, this, this ideal, and it, things have a way

Will Maclean:

of not really happening like that, but.

Will Maclean:

Four years down the track.

Will Maclean:

And I think it's going to have to happen this year.

Will Maclean:

We're on track for that.

Will Maclean:

I think at this point, like we were

Michael Max:

talking earlier it's it's that last rereads and dotting

Michael Max:

the I's and crossing the T's.

Michael Max:

And, but that's such a huge piece of the book.

Michael Max:

I mean, nobody, really?

Michael Max:

Anyone who reads a book, I think so often it's easy for us to think, oh

Michael Max:

yeah, someone just wrote this and you know, they run it through a spellchecker

Michael Max:

or whatever, but there's so much work that goes into the very end, unless

Michael Max:

you've done a book, you just don't know that last bit, that takes so

Will Maclean:

long.

Will Maclean:

Oh yeah.

Will Maclean:

And when you're dealing with a book that have thousands of pages, just physically

Will Maclean:

reading it and reading it closely is a huge and demanding task on its own.

Will Maclean:

I should just point out one other thing that's changed in this edition is that the

Will Maclean:

source materials from the first edition and the second from the first book,

Will Maclean:

the first volume and the second volume, the source materials that I use from

Will Maclean:

China have improved immensely as well.

Will Maclean:

There's a whole lot of new stuff.

Will Maclean:

That's come out in internal medicine in China recently that's really

Will Maclean:

significantly better than the original materials that I was using and a

Will Maclean:

much broader range of stuff too.

Will Maclean:

So there's all the bibliography of this new edition is huge.

Will Maclean:

A lot of really interesting stuff is happening in China as well.

Will Maclean:

But China's medicine now.

Will Maclean:

Well, are there any

Michael Max:

closing thoughts that you have that you would like to leave us

Michael Max:

with before we say goodbye here to.

Will Maclean:

Look, I've, I would say that over the course of my career, I've

Will Maclean:

noted a couple of things in particular.

Will Maclean:

We certainly we're getting a lot better at it in general.

Will Maclean:

And I think what that means is that we're getting much more familiar with

Will Maclean:

what our strengths and limitations are, you know, so we can focus on the things

Will Maclean:

that we do well, rather than trying to do everything and not doing so well.

Will Maclean:

You know, so as a professional, I think we're getting better

Will Maclean:

at identifying what we can do.

Will Maclean:

And that, that really works into integrating much better into

Will Maclean:

the health system in general.

Will Maclean:

You know, I've never liked the epithet that we go by, which is

Will Maclean:

the alternative medicine set and others, as far as I'm concerned,

Will Maclean:

there's only medicine and it either works or it doesn't in this country.

Will Maclean:

At least we're getting to the point where we're becoming more just

Will Maclean:

medicine and we do certain things.

Will Maclean:

Well, we don't do other things very well, but we're getting recognized for the

Will Maclean:

things that we do well, and we're doing more of it in, in a much more interesting

Will Maclean:

context within the hospital system.

Will Maclean:

From time to time, that's ramping up quite a bit now as it happened.

Will Maclean:

Yeah, happening

Michael Max:

in the states

Will Maclean:

as well.

Will Maclean:

That's one thing that I've noticed and that's really, I think, incredibly

Will Maclean:

positive, you know, if we can overcome the unrealistic expectations that a

Will Maclean:

lot of practitioners used to have, you know, and when I got out of school

Will Maclean:

and not in 87, I didn't know what I could do and what I couldn't do.

Will Maclean:

I'd been told that we could do anything that does leads to

Will Maclean:

masses of disappointments and pretty poor clinical outcomes.

Will Maclean:

When you try to do things, you can't really do very well

Michael Max:

knowing what you can do and what you can't is it's really important.

Michael Max:

It was a long

Will Maclean:

learning experience to find out where to focus our

Will Maclean:

talents and it made for a much more satisfactory clinical experience too.

Will Maclean:

When you get lot of good results consistently

Michael Max:

for everybody, the patient and the practitioner.

Will Maclean:

Absolutely.

Will Maclean:

And we've tried to, I think, incorporate some of that experience into the

Will Maclean:

clinical handbooks, to the new edition in particular, to help to guide people.

Will Maclean:

We'll realistically.

Michael Max:

Well, I look forward to reading it.

Michael Max:

It's one thing to read the stuff from China.

Michael Max:

And then it's another thing to read a Westerner's actual clinical

Michael Max:

experience will thank you so much.

Michael Max:

I really appreciate you being on qiological today.

Michael Max:

Maybe we'll do a part two sometime.

Michael Max:

Maybe I haven't been, maybe after the book comes out, we can sit

Michael Max:

down and dig into something there.

Will Maclean:

Absolutely.

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