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A few basic Saam questions

I have a few holes in my understanding of basic Sa’am theory. Please help!

  1. When you tonify a channel, are you pulling from its pair? Often, we’re diagnosing an excess of a particular channel and then tonifying its pair, as in the case of tonifying SJ for abundant LR shielding or tonifying LI for copious SP dampness. Are we simply adding to the relatively deficient channel, or are we also pulling from the relatively excess channel?

  2. If the answer to Question #1 is that we are indeed pulling from the relatively excess channel: If BOTH channels are overall deficient (or excess, for that matter), how does toggling between the two channel help matters? Wouldn’t they just keep see-sawing back and forth, with the total amount of vitality in the paired network remaining the same?

  3. When we tonify a channel, are we strengthening that channel’s influence over physiological terrain or pathological factors, or both? For instance, in a case of dry tissues leading to accumulation of phlegm, is the recommendation to deal with the phlegm (by tonifying LI or SI) or the dryness (by tonifying, say, SP)?

  4. Assuming the answer to Question #3 is that Saam addresses both physiological terrain and pathological factors: Is there an order of operations? In the case of dryness leading to phlegm, which do you start with? Lubricating the tissues or drying the phlegm? It seems that making the right choice here is critical, because lubricating could worsen phlegm and drying could worsen underlying dryness. Does “addressing the grossest presentation” apply here? If the phlegm is on the mild side, you tonify SP, and if it’s on the extreme side you tonify LI? Or branch and root—dealing with the branch first before addressing the root? Or tonifying the root first so that it stops produces the branch?

“Clinic is hard,” for sure, but I’m wondering whether Saam’s theoretical framework makes things easier by answering these questions for us.

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Hi Ryan,

Revisiting the basics is always a fruitful practice.

No. Toby makes it very clear that you are not diminishing the super powers of one channel when you supplement the counterbalancer. This is why supplementing is so much safer than draining in Saam. You aren’t diminishing the person in the least only adding.
My personal take is that supplementing is the process of making the body better able to receive and utilize the channel qualities.

Questions 3+4: By supplementing you are improving function which will make the body better able to address pathogens.

For sure! The relationship of dryness and phlegm has been discussed many times throughout the forum because treating when both exist together requires careful investigation of each patient’s presentation. Reading case studies will coexisting damp and dry will help. Entering “cough” and “phlegm” on the forum search bar will lead you to such discussions.

The (often) clear treatment results Saam practice provides cut through the confusing pictures patients present. I know that Saam has made me a closer observer and a better student of the dynamics of damp/dry, hot/cold, interior/exterior, and yin/yang.

Clinical is hard and so very interesting! Let us know what you find.

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Question about the toggling:

If the patient responded well to the treatment but still has some residual symptoms, how will doing the pair channel affect the follow up treatment? Will it negate the initial response and make things worse again? Is it better to do the same treatment again (given that it is under 2 consecutive times)?

I am sorry as I am not following your question. If the patient responded well to the treatment why would you choose the paired channel? Unless you are certain that both channels are deficient and definitely need supplementation you can do that, but I have not experienced using the toggling in this way. If it worked I would do the same channel again or perhaps if you have a #1b choice do that channel and then the next treatment go back to the first channel that worked.

If it is not the right treatment it most certainly can and likely will.
You don’t want to haphazardly treat with Sa’am - make sure you have confidence in your diagnosis.

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