Qiological Community

The opposite people- esp with BL/HT axis

I am curious about what others experiences are with people who respond the direct opposite to HT+ or BL+. I have noticed that you can strengthen BL and people who feel cold start to feel warm or strengthen HT and cool someone down. I’ll give a few examples.

I had a patient who was female which I know adds weight to HT+ but she was running hot. Her face was red, her epigastric area was soft and warm and her pulse was a little rapid. Her chief complaint was headaches at the occiput. My first treatment for her was BL+. She settled on the table.

At her next appointment she said her headaches were mildly better but she was extra hot. Feeling super over heated. Because her headaches came down a smidge and with this overwhelming heat (with a red face and hot to touch) I thought I would try BL+ one more time. Mistake. She got a terrible headache after the treatment and felt ever hotter. I got her back in clinic and did HT+ opposite side. She felt cooler right away and is completely resolved her headaches. It made me wonder if I need to place an extra weight to her being female. It was so curious.

Today I had a gentleman who gets episodes of gout where it’s red hot and painful. He hasn’t had an episode in many months but came in to prevent any further episodes. His last episode of gout was right on his heel following the bladder line. He however talks about how cold he is and he has mild tension in his epigastrium. Remembering the last patient I decided to give more weight to him being male along with the red hot symptoms that come with flare ups and went for BL+. He settled really well. His observations- he felt more comfortably warm.
Curious. I am wondering if this happens often to others and I’m trying to dissect it a bit to see if I can understand it better.

Hi Shannon
I have had people react the opposite of what I would expect from the given treatment. It can be perplexing. But then I need to look into deeper the why and sometimes pin it back to my diagnosis or a lack of understanding of their presentation.

My experience is that temperature reporting can be so subjective and confusing. Although your first case she sounds hot with no cold anywhere not even her extremities?

I don’t believe there is anything in the foundational principles that says men are HT excess and women are BL excess. I have heard Toby say that in general he supplements more BL+ on men and HT+ more on women. But I don’t take their sex into account as for BL/HT it is usually clear which one is needed. i.e. Hypo vs Hyper

Yes I’d be supplementing BL+ with just that info for sure. I’d want to see her headache decrease significantly in the first 5-10 minutes (if she could feel it laying down).

I am starting to practice that I want to repeat a treatment then I need a clear reason why no other channel is as suitable. If it only came down a smidge I might be looking elsewhere especially given she was still so hot. What other signs did she have? Were her feet and legs even hot? Headache definitely on BL channel and not GB channel? Was the personality hyper too?

Wow. I don’t have an answer why that supplement HT+ cooled her down given she still had all the same heat signs above, so am just looking for other clues - what is her personality like? But obviously for some reason she did not need more Bladder energy as that was cranked given her response.

As far as why he felt warmer I could make something up that it helped his energy flow and so normalized his temperature. Did the warmer feeling persist to the next treatment, now that would be cool.
I have supplemented BL+ on a thin freezing cold, dry, hyper female with a rapid pulse who said her temperature felt good afterwards and was warmer that week. Go figure, has to be her physiology is more regulated, that was my only answer.
But these are definitely the exception. Your female headache case is more perplexing given all the HT excess signs she presents

As an aside I find it amazing how well BL+ can work for lateral heel plantar fasciitis, especially if other pieces fit. I haven’t used it for gout yet.


Hi Shannon,
I would totally pick UB+ for this woman as well, but since she obviously needed H+, I wonder if there is another piece of information that can be the more GROSS thing in the room to guide you?

For example, in your gouty man, even though he was cold, his gout - the main complaint - is red hot.
So in your hot headache lady, does she like to have ice or heat on her occiput for her headache? does she get more headaches in the summer or winter?

I had a patient who needed to cover up her whole body with heavy blankets during a headache (always occipital), BUT she needed an ice pack on her head. She responded well to UB+. If I only listened to her general complaint of cold, I would have picked H+.

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Thanks for responses!

I’ve done a few workshops with Toby. I am almost certain in at least one of them he pointed out that if the patient is a woman give more weight to BL XS and men give more weight to HT xs. Have I had this wrong? I seem to have it in my notes. Maybe I misheard something?

This woman is super interesting. She’s a minister and always doing things for others. Takes on/ shares in their losses. Has a friend who had a loss in pregnancy and it really affected her. That really gave me more weight to heart XS as well.

I rarely do the same channel 2 X in a row but I guess I felt that with all the heat/ red face and occipital pain it just seemed so obvious. She also was driving with her windows open in winter because she felt so hot. Well lesson learned.

About a year and a half ago she had a concussion and I often treated her with LIV + because she had to wear sunglasses indoors, light bothered her that much. It really helped.
I am considering next time I see her LiV+ again. At the moment she has very mild light sensitivity. I wonder if when I toned down the shao yin fire, the shao Yang fire got that much stronger.

Thinking this through her secondary complaint is exhaustion. In nov she got overwhelmed with exhaustion that she needed to start napping midday and can’t stay awake past 8pm. So right in front of me I see the hypo functioning aspect! I tried ST + as the second grossest thing in the room is that she is a heavy set woman with dry skin and very plump thenar eminence. It did nothing spectacular.

Again thanks for responding. Sometimes I feel like by just discussing a case on this platform I can see a few things more clearly.

I think there is general confusion around this and my response made it more confusing. I checked in with Toby and he replied:
“You’ve got this right,. gender is a consideration but a mild one. It is easily overlooked if you see other gross manifestations”

In my practice gender is the last thing I may consider if it consider it all with a HT/BL imbalance. I find many thin dry women benefit from BL+ supplementation, sometimes they are cold too. On the handouts with the principles Toby laid out from his teacher Do’am there is nothing about sex of the patient. So that is what I mean by it is not a foundational principle. We may factor in the sex of the patient with other S/S to help make a close clinical decision.
The way you wrote up your case it seemed you shied away from using BL because she was female as a first thought. The sex would be towards the end of the list in weight as she was hot. Am I making sense?

As an aside I often think of supplementing SI+ for concussions. Can that fit her - she has lots of love for others what about her self? Medial heels, varicosities?

Yes! This system is so amazingly cool how it works when we put all the pieces together. As an aside, if she had this hypo function the same time she had the heat I may be shying away from the BL/HT axis and looking elsewhere as those are two big clinical weight considerations.

Thank you for posting. It is so helpful for all of us!