A few weeks ago,

I started noticing that many of my patients had sinking pulses. According to the Mai Jing/Pulse Classic and Nan Jing/Difficult Classic, this pulse is the normal pulse (石脉 shi mai/stonelike pulse) of wintertime, and it was appearing in late summer/early autumn! .

I told my patients and colleagues that I was concerned that we were going to have early winter weather (rain, wind and cooler temperatures), and that could mean unusual illnesses associated with yang ming (st/l.i.) and lungs. Sure enough, in the last two weeks various ‘flus and colds’ have appeared, with symptoms of vomiting, loss of appetite, diarrhea, cough, phlegm, sinus congestion, and have been hanging on longer than usual. I’ve seen a lot of combination shao yang/yang ming conditions, and have been focusing on various modifications of xiao chai hu tang/minor bupleurum decoction, such as da chai hu tang, or adding sang ju yin, or chai hu gui zhi tang, depending on which channels have been afflicted

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