©Jeffrey C. Yuen MAS Seminar Edited to include disc & track numbers, overhead notes, subtopics, and questions D = Disc, T = Track, O = overhead page
CHINESE MEDICINE & ENDOCRINOLOGY
D1 T1 I. INTRODUCTION …a Western medical specialty with multi-disciplinary implications (similar to Chinese medicine with its emphasis on the inter- connectedness) D1 T2 / OØ Jin-Ye D1 T3 Role of hormones in transformation A. MULTI-DISCIPLINARY IMPLICATIONS 1. Effects on Gastroenterology & Metabolism …e.g., diabetes mellitus, thyroiditis 2. Effects on Gynecology & Obstetrics …e.g., fertility, menstruation, gestational issues 3. Effects on Pediatrics & Geriatrics …e.g., growth patterns, menopause/andropause 4. Effects on Immunity & Auto-Immunity …e.g., T-cell activity in HIV/AIDS 5. Effects on Neurology & Psychiatry …e.g., cortisols levels during stress …nervous system communicates through the nerve (some chemical) impulses – tend to be short & rapid …more related to the wei qi (jin -thin fluids) …glandular system communicates through chemical signals of the hormones – tend to be long-lasting & slow (more related to ye -thick fluids) D1 T4 B. CORRELATIONS TO CHINESE MEDICINE 1. Relationship to the Ye -Thick Fluids of the Jin-Ye / Body Fluids
…considered substantial and interrelated to qi and blood D1 T5 …as yin – functions to moisten and nourish the body; also can insulate warmth (e.g., KI yang) or pathogenic heat (e.g., damp-heat; latent heat)
…consider the philosophical implications of yin – nourishment, containment, completion, etc. D1 T6 …jin -thin fluids as more associated with the exocrine fluids (tears, saliva, sweat, nasal mucous, and spittle) –
1 associated with wei qi (e.g., thyroid and adrenal glands) & the ye -thick fluids with the endocrine secretions D1 T7 …Chp. 30, Ling Shu : When food has entered the Middle Jiao and the qi overflows (surplus), then its moistening nutrients will pour into the gu -bones and allow the bones to bend and straighten. That which benefits and supplements the nao -brain and sui - marrow is known as the ye -thick fluids. D1 T8 2. Role of the Curious Bowels ( Qi Zi Heng Fu ) …outlined in Chp. 11, Su Wen : The nao -brain, sui - marrow, gu -bone, mai -vessels, dan -gall bladder*, and bao -uterus all store yin but are shaped like the yang fu -bowels. They store jing -essence but do not excrete and are extraordinary fu-bowels. …*suggest that GB is responsible for the separation of the pure and turbid fluids entering the curious bowels (while the ST/SI are responsible for the separation of the pure-turbid of fluids entering Zang Fu) …perhaps responsible for transmission of information to stimulate the secretions of the glands (and the Zang-Fu – e.g., “stimulating hormones” (SH) Clarification: D1 T9 / O1 Fen-separation D1 T10 Curious organs D1 T11 Marrow and body's experiences …Jing -Essence decline with aging and the problems encountered during geriatrics are often hormonal D2 T1 Curious organs and Survival D2 T2 3. Concept of Gao-Huang …can infer gao -fatty tissue and huang -membrane or area between the Heart & Ge -Diaphragm* …* bing ru gao huang – the notion that conditions can’t be treated if located in this area …intimate relationship to BL-43 Gao Huang Shu which treated zheng gu -steaming bone and the five lao -taxations according to Hua T’o (combined with ST-36 Zu San Li (SSM added Ren 4 Guan Yuan to this treatment) …gao as yin and huang as yang
2 …suggest that the turbid of jin protects the external anatomy (i.e., wei qi ) and the turbid of ye protects the internal anatomy (i.e., Zang-Fu ) by its “membrane” – which mobilizes PFs to the bone, marrow, etc. Three Major Focal Points for Endocrinology: D2 T3 / O2 Throat D2 T4 GB Relationship D2 T5 / O3 Gao Huang 4. Its Western Medical Functions to Chinese Concepts …birth/lactation, growth, development, reproduction (Kidneys ) …electrolyte and water balance ( San Jiao ) …often more associated with the “cooling” mechanism to reduce elevated levels – i.e., negative feedback mechanism (San Jiao ) …nutrient absorption & metabolism ( Spleen & Stomach ) …involves all nutrients – carbohydrates, protein, and fat – e.g., metabolic allergies can be due to its glandular regulators – protein toxemia can lead to hypertension, epilepsy …stress from endogenous & exogenous factors (Lung & Liver ) …its release directly into the blood ( Heart ) for chemical signaling and/or lymph ( Spleen & Lung ) as ductless glands …effect over target organs to maintain homeostasis (San Jiao )
[See p. 4: II. MODEL OF THE JIN-YE]
D2 T8 C. IMPORTANCE OF SYNERGY & ANTAGONISM 1. No Glandular Condition is a Singular Condition …consider the synergy/antagonism of the glands …e.g., inactivity of the ovaries (e.g., gestation/ menopause) can result in enlarged thyroid -- compensatory hypertrophy …synergetic complex includes pituitary-adrenal-thyroid- gonads counterbalanced other the other glands – pineal-pancreas-parathyroid-thymus
3 D2 T6 II. MODEL OF THE JIN-YE A. INFLUENCE OF THE IMPERIAL MEDICAL ACADEMY (Based on the Teachings of Chen Zi-Ming & later Xue Ji (1488-1558 CE) EARTH (Spleen/Stomach)
FIRE (Heart) METAL (Lungs)
WOOD (Liver) WATER (Kidneys)
WATER (Kidneys) WOOD (Liver)
METAL (Lungs) FIRE (Heart)
D2 T7 Right Side of the Model : …Production of the Jin-Ye /Body Fluids (Stomach) and its Ascension to the Lungs for Misting & then its Descension to the Kidneys to Support Pre- Natal Jing -Essence …the relationship of the Middle Jiao to the Upper & Lower Jiao – collectively as San Jiao and its regulation of Jin-Ye and Shui Dao / Waterways …the descension of Lung qi to be grasped by the Kidneys …Acquired Essence (Post-Natal) supporting Pre-Natal Essence …Development of the foundational formula: Four Gentlemen Decoction/ Si Jun Zi Tang: Ginseng/ Ren Shen (3-9g), White Atractylodes/ Bai Zhu (6-9g), Hoelen/ Fu Ling (6-9g), Honey-Fried Licorice/ Zhi Gan Cao (3-6g) …Transformation to Xue /Blood from Acquired Post-Natal Essence from the Kidneys to Liver with Liver Blood generating Heart Qi
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D2 T8 Synergy and Antagonism [See p. 3: C. IMPORTANCE OF SYNERGY & ANTAGONISM] Left Side of the Model : D2 T9 …Production of Blood (Earth) and its Movement (Fire) to Storage (Wood) For Fertility (Water and Metal) or its Release (Metal) as Menstruation …Spleen as the Foundation – the Root of Post-Natal Qi …in relations to blood reflected by SP-21 Da Bao , HT-1 Ji Quan , and LR-13 Zhang Men (emphasized by Wang Qing-Ren )
4 …Relationship to the Zong -Ancestral Vessels – Chong Mai (Earth), Du Mai (Fire), Dai Mai (Wood), Ren Mai (Water & Metal) D3 T1 …development of the foundational formula: Four Substance Decoction/ Si Wu Tang : Angelica Sinensis/ Dang Gui (9-12g), Ligusticium Wallichi/ Chuan Xiong (3-6g), White Paeonia/ Bai Shao (9-15g), Processed Reh- mannia/ Shu Di Huang (9-12g) D3 T2 Menstrual model D3 T3 Lunar-solar cycle …note the importance of the Lungs in GYN as blood requires qi and subsequently is considered secondary to qi …Xue Ji also emphasize that Liver Fire results in yu -blood stasis with yu-depression resulting in anger and jie -clumping of qi …menstruation waxes and wanes like the moon ( yue jing ) and follows the cycles of yin (7x4=28 days) …strategy for endocrine issues (e.g., xiao-ke /wasting & thirsting, zheng-gu / steaming bone syndrome) often involves combining both sides of the model (e.g., Liu Wei Di Huang Wan /Six Ingredients Rehmannia Pills) D3 T4 / O4 Physiology D3 T5 / O5 Physiology cont.
II. JIN-YE/BODY FLUIDS & ITS CORRELATION TO XUE- D3 T6 / O6 BLOOD A. SPLEEN & STOMACH …Chp. 81, Ling Shu : Ying -nourishing qi emerges from the Middle Jiao and secretes jin-ye to flow into the tissues and to seep into the sun mai .* If the jin-ye are harmonious, they can become blood through the transformation of the Lungs and Heart. The blood will then flow into the luo mai and with fullness, then flow into the jing mai to support yin and yang. …*debates relating to sun mai /grandchild vessels D3 T7 / O7 Distinct Meridians D3 T8 …Spleen manages both blood and the jin-ye to travel together within the vessels to moisten and nourish …blood stagnation can also obstruct the moistening effect of the jin-ye and if the jin-ye is damaged by heat, the vessels then become empty and deficient ( jin ku xue zao / jin withered blood dryness) D3 T9 B. HEART & KIDNEYS COMMUNICATION …Heart controls sweating and Kidneys controls diuresis –
5 weakness in both will affect the ye with deficiency in HT and KI yin resulting in the loss of control of the jin with sweating, palpitations, tinnitus, dizziness, hot flushes, scanty dark urine, steaming bone, and dry throat …this lack of communication can be from constitutional weak- ness, long-term illness, excessive worry, or severe blood loss D3 T10 / O8 C. LIVER & BRAIN …Liver (Wood) as extension of Kidneys (Water) with its blood support jing -essence below and sui -marrow above (the nao -brain); bone deep and sinew surface …Liver as the emissary of San Jiao (KI & HT) …neural control centers in the brain controlling the endo- crine glands with its main center at the hypothalamus (master switchboard) and the pituitary gland/hypophysis suspended below …the notion that Liver controls the smooth flow of qi – regulating, coordinating, and communicating mechanism
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Questions: D4 T1 / O9 Q: ST most yang organ? D4 T2, 3 / O9 Q: Swelling of LU cancer and pathogenesis? D4 T4 / O10 Q: Night shift and diabetes?
D4 T5 D. CORRELATIONS WITH DAOIST MICROCOSMIC ORBIT 1. Qiao-Portals as Major Reflex Points for the Glands …Ren 1/ Hui Yin & Gonads …Du 4/ Ming Men & Adrenals …Du-9/ Zhi Yang & Parathyroids …Du-16/ Feng Fu & Hypothalamus
6 D4 T8 / D5 T1 …3 Dan Tien /Elixir Fields – the basis of qigong and alchemical practices …correlation to San Jiao
Questions: D4 T9 Q: Pumping? D4 T10 Q: Insomnia during full moon? D4 T11 / O12 Q: Hair loss during menopause? D5 T1 / O11 Q: Clarify 3 pts on microcosmic orbit
END Day 1
Day 2 [Note: For following tracks, please refer to Overheads for Day 2]
Questions: D5 T2 / O1 Q: Review glands and points? D5 T3 Ren-5 as mu point of TH D5 T4 Review glands and points cont. D5 T5 Q: Breathing for diabetes? D5 T6 Q: Autoimmunity curable? D5 T7 Q: Locate BL-43? D5 T8 Q: Pharmaceutical impact on pulses? D5 T9 Q: Edema in ankles? D5 T10 Q: CPAP machine effect on lungs? D5 T11 / O2 Q: Small fetus?
D5 T12 / O3 General Treatment Strategy: D5 T13 Do we have to use glandulars? D5 T14 Jin-ye and Divergent channels D6 T1 “” “” cont. D6 T2 / O4 Jin-ye and Primary channels D6 T3 Sensory Orifices D6 T4 Circadian Rhythm and Pineal Gland D6 T5 Change Perception
D6 T6 III. WORKING WITH FLUID PATHOLOGY IN CCM A. ZANG & THEIR INFLUENCE ON FLUIDS (Spleen, Lungs, Kidneys) 1. Spleen …transformative and transportative aspects on the food & drinks to become jin-ye (the steaming action of the Stomach and the absorbing action of the
7 Spleen*) …*argued by Zhao Xian-Ke in Yi Guan to be under the auspices of the Kidneys (e.g., KI-2 Ran Gu with a pathway to SP-8 Di Ji ) …also the relationship to the Stomach and Intestines …in the Jia Yu Jing , Large Intestine rules the jin and Small Intestine* rules the ye produced by the Stomach – regulate with lower he -sea points of the Stomach – ST-36 Zu San Li , ST-37 Shang Ju Xu , ST-39 Xia Ju Xu (also the shu -transport points for food & drinks and blood, Chp. 33, Ling Shu ) …*Small Intestine further separates the pure and turbid which when deficient will increase fluids to Large Intestine and decrease fluids to Urinary Bladder D6 T7 2. Lungs …fluids undergo qi transformation to further refine the qing-pure to enter the jing -channels to nourish and moisten (like a mist upon a river) …the duo -turbid is expelled as han -sweat and also descends to the Bladder to be li -disinhibited as urine …the qing-pure ascends to the Lungs* (via San Jiao & Kidney Yang) or transformed to yuan -source qi into the Kidneys …*Chp. 71, Ling Shu : Zong Qi gathers in the chest and exits through the throat and guan-link to the vessels of the Heart with the movement of the breath (i.e., qi moves blood) …when the Lungs are weakened by EPFs ( feng shui / wind-water), the movement of fluids is affected (ascension and descension) resulting in edema, borborygmus, and turbid urine D6 T8 …the Bladder as the “portal” for elimination of impure Fluids (from the Lungs, Small Intestine, Heart, San Jiao) as urine by the zheng hua /steaming-transform- ing of the Kidneys
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8 Questions: D6 T9 / O5 Q: Menopausal hot flashes w history of breast cancer? D6 T10 / O6 Q: Effect of GB removal? D6 T11 Q: Lack of GB, effect on brain-uterus-marrow? D6 T12 / O7 Q: More timid or shortened life expectancy? D6 T13 Q: More susceptible to brain memory disorders? D6 T14 Q: Cupping for BL-43? D7 T1 / O8 Q: Pulses and endocrine system? D7 T2 Glands and correlation D7 T3 Q: Associated points? D7 T4 Q: Increase of hormonal cancers?
[See p. 11: IV. COMMON ETIOLOGY OF HORMONAL IMBALANCES]
D7 T10 …according to the SHL tradition, water can build up in TaiYang (BL/SI) to manifest as heat (with wei-qi ) to create headache, fever, irritability, thirst but vomiting fluids, urinary difficulty, floating pulse
(shui ni zheng /water rebellion pattern) D7 T11 3. Kidneys …Kidney Jing -Essence produces yuan-source qi via the zheng -steaming/vaporizing action of Kidney Yang to move in San Jiao to allow for qi hua -transformation and to exert control over the irrigation/movement of the jin-ye /body fluids …provides the yang in the different stages of fluid meta- bolism and transformation; evaporates fluids back to the chest (Lungs and Heart) to moisten Lung Yin e.g., Kidney points on the chest and their relations to Chong Mai D7 T12 / O9 …collectively, the relationship of LU/SP/KI to fluid meta- bolism and its stagnation which results in phlegm stasis – consider that lymphatic congestion can result in endocrine issues and vice versa (e.g., the breast); the locations of some glands are also associated with lymph nodes (their treatment can affect each other)
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D7 T13 B. IMPORTANCE OF SAN JIAO 1. Dissemination of Yuan Qi …Chp. 66, Nan Jing : San Jiao is responsible for the
9 dissemination of yuan -source qi and conducts the qi in the 3 regions (i.e., zong -chest/ancestral, gu - grain, yuan -original qi) to the Zang-Fu …Jin Gui Yao Lue : San Jiao moves and gathers yuan-zhen /source-true
10 the qiao -portals: GB-12 Wan Gu , GB-18 Cheng Ling , GB-3 Shang Guan , GB-21 Jian Jing , GB-28 Wei Dao , SJ-8 San Yang Luo , SJ-9 Si Du , SJ-17 Yi Feng , SJ-21 Er Men , SJ-22 Er He Liao …importance of GB if there’s sensory orifices involvement (as well as Small Intestine)
[See p. 12: V. BASIC TREATMENT RECOMMENDATIONS]
D7 T4 IV. COMMON ETIOLOGY OF HORMONAL IMBALANCES …glands are influenced by all aspects of san yin /three causes – (1) climatic/environmental/ecological (e.g., influence of sunlight and lunar aspect on pineal, gonad-menstruation); (2) emotional (e.g., adrenal & cortisol levels) and dietary (e.g., pancreas and thyroid with metabolic dysfunction); (3) constitutional/congenital (e.g., pituitary) D7 T5 A. WEAKNESS OF JING -ESSENCE …due to constitutional weakness, aging, excess hormone loss (e.g., childbirth, sex, etc.) …due to blockage by tumors D7 T6 B. EXHAUSTION OF BLOOD …due to overwork (physical, emotional, mental), lao - consumption, poor diet weakening the Spleen-Stomach D7 T7 Foods that build hormones D7 T8 …results in blood stasis (as compensation to blood deficiency) …strong emotional trauma or difficulty with the rites of passage e.g., cycles of 7 & 8) can precipitate endocrine disorders (i.e., xue -blood relationship to ye -thick fluids) – treat with PC channel D7 T9 C. FROM DU -POISONING (TOXEMIA) …most common cause of endocrine issues with auto-intoxi- cation occurring from excessive high protein foods with excess protein in the blood resulting in inflammation and elevated immunoglobulins or excessive consumption of gluten which can congest the lymphatics resulting in phlegm stasis …long-term exposure to EPF’s will hurt LU/HT, precipitated by wind will requires blood to expel the PF – yi guan …can also be due to radiation or nuclear exposure
[Back to p. 9: III. WORKING WITH FLUID PATHOLOGY IN CCM, Lungs … according to SHL]
11 D8 T3 V. BASIC TREATMENT RECOMMENDATIONS A. REGULATION OF THE STOMACH TO AFFECT JIN-YE 1. Trajectory of the Stomach – for hormonal deficiency* …*notion that Kidney jing -essence can only be deficient and all ye /hormonal issues involve deficiencies (even hyperactivities as a reflection of compensatory/anta- gonistic effects) – concept of sheng-hua /engender- transform D8 T4 …beginning with BL-1 Jing Men – meeting of ST/SI/ Qiao Mai …if heat, add ST-5 Da Ying ; if stagnation, add ST-9 Ren Ying
…BL as the outlet for fluid stasis – commonly seen in hormonal issues D8 T5 / O12 …combined with specific Lung, Spleen, and/or Kidney points – e.g., LU-1 Zhong Fu , SP-9 Yin Ling Quan , KI-15 Zhong Zhu D8 T6 2. Fluid Stasis as Dampness/Phlegm to reflect Deficiency rather than excess (teachings of Zhang Jing-Yue ) …phlegm/dampness due to yin -deficiency or yang - deficiency …phlegm is only the branch/manifestation of the ROOT (which is often a deficiency) …phlegm (as Water) is rooted in the Kidneys and its branch is the Spleen (as Earth) …when fluids descends to the Kidneys and is not properly transformed or eliminated, it can result in yi tan /flooding phlegm (often the result of Earth/Spleen being weak due to poor digestion) D8 T7 / O11 General Fluid/Hormonal Regulation : …invigorate Kidney yang to support Spleen – KI-2 Ran Gu with SP-8 Di Ji to regulate fluids at Ren 12 Zhong Wan with ST-42 Chong Yang D8 T8 Q: Essential oils? D8 T9 …can add KI-20 Fu Tong Gu to ascend Spleen to SP- 18 Tian Xi or KI-21 You Men to descend Stomach to ST-25 Tian Shu D8 T10 3. Factors for Hormonal Loss – Small Intestine …aging or natural hormonal loss, add SI-6 Yang Lao (SI controls the ye which also be conceived as acquired/
12 post-natal jing -essence) …e.g., consolidate exterior/ gu jin or gu biao with HT-6 Yin Xi and SI-3 Hou Xi or LI-4 He Gu with KI-7 Fu Liu …SI deals with bone loss, tooth decay – e.g., tonify SI-8 Xiao Hai , BL-11 Da Zhu , and GB-39 Jue Gu for osteoporosis, hyperactivity of parathyroid glands …SI goes to BL at BL-1 Jing Ming to support brain with post-natal essence …SI affects all the sensory portals (i.e., SI-18 Quan Liao ), especially the eyes and ears …SI-15 Jian Zhong Shu for sensory acuity – glaucoma, retinopathy, macular degeneration …SI-12 Bing Feng for deafness, auditory loss due to hyperadrenal (e.g., floating yang) …loss due to weak Spleen in banking the vessels – SP-8 Di Ji with BL-51 Huang Men or KI-16 Huang Shu , BL-43 Gao-Huang Shu
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D8 T11 B. REGULATION WITH SAN-JIAO (TOXEMIA) …consider San Jiao when there’s multiple involvement of the glands (e.g., bloodwork with irregularities in minerals, blood lipids, protein, and hormone levels) 1. “Negative Feedback Control” to monitor and maintain certain specific hormonal ranges …San Jiao represents a canal system and irrigation roadway for fluids provide by Stomach (e.g., ST-28 Shui Dao ) – regulate with SJ-9 Si Du , SJ-3 Zhong Zhu , SJ-6 Zhi Gou , SJ-2 Ye Men , SJ-1 Guan Chong D8 T12 2. Understand Compensation from other Hormones …certain conditions are due to compensation – e.g., conditions/diseases of menopause …notion of damp-heat with one as compensation for the other – e.g., xiao-ke /wasting and thirsting syndrome where there is dampness in Spleen or fire in Stomach with heat or damp responding to the other …heat can rise above with dampness to create goiters …damp can sink below with heat to create polycystic
13 ovaries, prostatitis …damp-heat can stay trapped in the center to create Diabetes D9 T1 …regulate with SJ-2 Ye Men , BL-39 Wei Yang along with ST-19 Bu Rong with points reflecting the respective heaters (e.g., Ren 17 Tan Zhong ; KI-16 Huang Shu *; Ren 7 Yin Jiao **) …*others attribute to Ren 9 Shui Ren , also relations to BL-43 Gao-Huang Shu ; **Ren 3 Zhong Ji …long-term damp-heat results in hot-phlegm with Lung
life, etc. 1. Circadian Rhythm – Four Gates of LU-1 Zhong Fu & LR-14 Qi Men ; enhance with Ren 12 Zhong Wan 2. Palpate the Microcosmic Qiao points for stagnation or flaccidity to determine which glandular reflex may be involved (can use Ren 4 Guan Yuan instead of Ren 1 Hui
Yin ) D9 T3 D. GALL BLADDER to AFFECT the NAO -BRAIN 1. Gall Bladder as the Link between the Zang-Fu and Qi Heng Zi Fu /Curious Bowels …regulation of GB to affect the Brain – pituitary and pineal glands as the “master glands” to regulate the other hormones …e.g., GB-13 Ben Shen and GB-19 Nao Kong with GB-39 Jue Gu 2. Working on a Neurological & Emotional/Stress Perspective (e.g., psychoneuroendocrinology) …open the portals to alter/awaken one’s consciousness …e.g., Window-to-Sky points – e.g., SI-17 Tian Rong or its ShaoYang pair with SJ-16 Tian You …combined with Du Mai points to affect the CNS, such as Du-17 Nao Hu or Du-24 Shen Ting D9 T4 3. Aspects of Memory …its retrieval under the domain of Gall Bladder and
14 Bladder as the channels that “exits” the Brain at Du-20 Bai Hui …Liver and its involvement in recognition, recall, and creativity of memory …influence of the Heart and its ability to express (e.g., verbalize) the memory – e.g., dyslexia …influence of the Spleen and the details of the memory …influence of the Lungs and false memory …influence of the Kidneys and the notion of “past- life” memory (e.g., serendipidity) …short-term memory loss is often associated with weakness in the Liver and Lungs (e.g., wandering hun ), while long-term memory loss is associated with weakness in Liver and Kidneys …GB serves as the yang outlet for the Liver and its storage of memory (and blood to impact the HT/SP) …BL serves as the yang outlet for Kidneys and its storage of ming -curriculum (and ye to impact the LU/SP/ST)
Questions: D9 T5 / O13 Q: Early onset puberty? D9 T6 / O14 Q: Most common food allergies effect on jing? D9 T7 / O15 Q: MS? D9 T8 Q: Patient position BL-43? D9 T9 Q: Moxa lower CV after BL-43? D9 T10 Q: Progesterone effect on peri-menopause? D9 T11 Q: Hashimoto? D9 T12 Q: Increase sex decrease cholesterol? D9 T13 Q: Change bone disorders? D9 T14 Q: Tx frequency w acupuncture only? D9 T15 Q: Tx for radiation exposure? D9 T16 Q: Post-menopause activity? D9 T17 Q: Premature menopause? D9 T18 Q: Transformation of qi and blood for men? D9 T19 Q: Alternative to BL-1? D9 T20 Q: Divergents to tx glandular issues? D9 T21 Q: Thymoma? D9 T22 Q: Human growth hormone therapy?
END Day 2
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