© Leon I. Hammer, M.D.

LESSON NINE

Contemporary Oriental
Medicine Foundation
1000 NE 16th Ave.,
Building F, Gainesville,
FL 32601, USA

Dr. Leon Hammer, M.D.

Continuing the series of clinical insights
Sharing the wisdom of over sixty years as a physician, and over forty years as a practitioner of Chinese medicine

Lesson Nine begins a discussion of a concept unique to Contemporary Oriental Medicine: Dr.
Shen’s Systems model. Over the course of Lessons Nine and Ten, we will discuss each of the
four Systems - Nervous, Circulatory, Digestive, and Organ - and learn how they differ from
traditional Chinese medical understanding. While examining the etiology of each, Dr. Hammer
will also investigate the pathologies that might lead a practitioner to
suspect a System dysfunction. Unlike Organ disease, which tends to
be more specific in its effects, pathologies that fall within the Systems
“The task of the modern
model can be recognized by the fact that they have more of a educator is not to cut down
widespread impact on health and disease. Because the Systems jungles but to irrigate
themselves have very broad physiological functions, their disorders deserts.” 

have an equally broad effect on the entire organism. Dr. Hammer - C.S. Lewis
believes it vital that the Systems be understood and considered, as
knowledge of their presence is critical to successful and accurate
diagnosis.

Lesson Nine 1
 © Leon I. Hammer, M.D.

Systems
During his long career, Dr. Shen treated hundreds of thousands of patients. He discovered, as
I’m sure many practitioners have, that some of these people had conditions that did not fit within
existing pathological models. Before consulting Dr. Shen, these patients had usually visited
many Western medical doctors, where, despite exhaustive tests, they had been left without any
practically useful biomedical diagnosis. Despite his considerable diagnostic skills, Dr. Shen
could find none of the familiar signs - those he associated with disease in the traditional Chinese
medical system - either in Face Reading, or in his examinations of the pulse, tongue, face and
hand color, and eye, etc. The symptoms these patients presented were somewhat vague,
shifting, and inconsistent. He could discern no disharmony in any zang-fu organ or channel, and
he found no disturbance in Qi, Blood, or body fluid. There was no pathology familiar to Chinese
medicine.

Dr. Shen discovered that, in some patients, it was the functional systems in their entirety, and not
just a specific organ that were disrupted. He distinguished what he called traditional ‘true
disease’ - a disease easily diagnosed by Western medicine or TCM - from ‘false’ or ‘System’
disease: an illness more easily understood through his variation of Chinese medicine. He
gradually conceived a model for this theory consisting of four major systems, and for this he
drew upon the layering of energy from superficial to deep, as described by Chang Chung Ching
in the Shang Han Lun.

Dr. Shen perceived four Systems:




The ‘Nervous System’

The ‘Circulatory System’

The ‘Digestive System’

The ‘Organ System’

In previous Lessons I have briefly mentioned some of these, such as the ‘Circulatory’ and
‘Nervous’ Systems. Here, I shall present a brief overview of each of the four Systems, including
their normal physiology, and how their pathologies may manifest in signs and symptoms.

Each section ends with a herbal formula used for treating the relevant ‘System’ condition. As
always, please be aware that any treatment prescription requires a full examination and
diagnosis of each patient, and can only be made in the full knowledge of each patient as an
individual.

The ‘Nervous System’

Dr. Shen associated the ‘Nervous System’ with the lightest and quickest energy. This would
therefore be identified with Tai Yang and especially the Bladder channel, the outer course of
which is accessed for the treatment of psychological disorders. Nervous system messages are
by far the most rapidly conducted, when compared to those of the endocrine or circulatory
systems.

Lesson Nine 2
© Leon I. Hammer, M.D.

The closest equivalent to this System in TCM is one of the singular organs, the Sea of Marrow,
which is engendered and maintained by Kidney Essence, and refers to the substance of the
bone marrow, the brain, and the spinal cord.

Dr. Shen identified two broad dysfunctions of the ‘Nervous System’; he termed them ‘Nervous
System Tense’ and ‘Nervous System Weak’.

‘Nervous System Tense’

Those patients affected by a ‘Nervous System Tense’
condition could be described as being in a state of
functional hyper-vigilance. They are hyper-aware of
everything around them, and hypersensitive; their minds
seize upon the things they perceive and go over and over
them, often into the night, when it can affect their sleep.
These people are in a state of survival, but they can also
be strong, controlled and effective, as befits those who
are genetically “determined” to survive.

First Impressions of the pulse (both wrists, all six Principal

positions palpated at the same time) reveal the pulse to be very Tense overall, with a very Thin
and Tight quality at the Qi Depth.

For reasons of constitution, this pulse appears in ethnic groups whose survival through the
centuries has required extraordinary vigilance. However, a similar quality can be found today in
almost anyone who lives in a large city. This means that there are two types of Nervous System
Tense. One is constitutional, the other a result of Lifestyle or trauma: choices a person has
made, or situations inflicted upon him. Making the distinction between these two etiologies is
important, since individuals whose tension is related to current Lifestyle can manage their
conditions with Chinese medicine - herbs, needles, tui na - and may need to alter their life
situations as part of a successful treatment.

The principal symptom of ‘Nervous System Tense’ is an ongoing tension that may, or may not,
be related to any particular life stress. The tension can be in the family, and may have persisted
over many generations. Accompanying symptoms depend on the vulnerability of other organ
systems: they may be affected by the Excess Heat that will have developed during the process
of innately managing this condition, and especially by the stasis, which can be a consequence of
this condition when it persists over a long period of time.

When it is constitutional in origin, the overall ‘Tense pulse with a Thin and Tight quality at the Qi
Depth”, tends to be Slower, and the eyebrow hairs also tend to be so thick that individual hairs
are difficult to distinguish. In this situation, the condition is not affected by improvements in
Lifestyle. However, when the ‘Nervous System Tense’ condition is not constitutional and is due
to Lifestyle, the pulse is the same as just described, but is often more Rapid. The condition in
such a case will have begun through a change in life circumstances, such as a move to a more
dangerous neighbourhood.

Lesson Nine 3
 © Leon I. Hammer, M.D.

The closest, though very inadequate, approximation for this condition in TCM is Liver Qi
Stagnation, in which a person is repressing frustration, rage, and fear. ‘Containment’ is a
necessity in civilized society, and requires the harmonious energy of all five phases. The energy
of the Liver and its associated musculo-tendon-ligament and peripheral nervous structures must
be coordinated with a respondent, creative, spirited, controlled Heart. These go together with
the energizing Lungs and the nourishing Spleen, and all are supported by a healthy Kidney
Essence. The entire ensemble is coordinated by an efficient Triple Burner, defended by an alert
Pericardium Yin, and projected effectively as manifest behaviour by a healthy Pericardium Yang.

‘Nervous System Tense’

Chuan xiong Rz. Chuanxiong 5g

Yu jin Rx. Curcumae 6g
Lu lu tong Fr. Liquidambaris 12g
Jing jie Hb. Schizonepetae 2g
Bai shao Rx. Paeoniae Alba 6g
Yin chai hu Rx. Stellariae 3g
Xiang fu Rz. Cyperi Rotundi 2g
Yan hu suo Rz. Corydalis 10g
Huang qin Rx. Scutellariae Baicalensis 2g



‘Nervous System Weak’
A rough Chinese medicine equivalent to ‘Nervous System Weak’ would be deficiencies of Kidney
Qi, Kidney Yang, and Kidney Essence, appearing all together, usually from a shock in utero,
significant prematurity, or a major birth trauma. ‘Nervous System Weak’ represents a physical
and mental instability, and a vulnerability to illness. It is often found in those with a lifelong
history of neurasthenia, a psycho-pathological condition with symptoms of fatigue, anxiety,
headache, neuralgia and depressed mood. These patients tend to be highly vulnerable,
unstable, and easily disturbed or stressed; they are often subject to constantly fluctuating
allergies, and have symptoms that are always changing. Their social adjustment is precarious,
and they are often victims, rejected in childhood encounters and throughout later life.

If you find the pulse to have very deficient Proximal (chi) positions and the patient is under the
age of fifty, you could consider the possibility of ‘Nervous System Weak’. With such pulse
findings, the probability of a ‘Nervous System Weak’ condition gets greater the younger the
person: the same signs of weakness on the pulse of a thirty-year-old makes the presence of
‘Nervous System Weak’ even more likely than in someone twenty years older. This is because
this condition usually begins very early in life, or is constitutional in origin. Whereas an older
person may have very gradually acquired, through several decades of life, a weakness in the
Proximal positions, a young person with the same pulse finding, is more likely to have either
been born with that weakness, and/or been through traumatic experiences capable of creating

Lesson Nine 4
 © Leon I. Hammer, M.D.

that level of depletion. Dr. Shen would point to such a pulse in a young person and say, “How
can be: brand new.”

This condition manifests as weakness in the Proximal (Kidney) positions of the pulse because,
as I mentioned earlier, the ‘Nervous System’ is the substance of the brain and spinal cord:
manifestations of Kidney Essence. The simultaneous occurrence of both ‘Nervous System
Tense’ and ‘Nervous System Weak’ has been observed in people who have a family history of
‘NS Tense’, and who have had an unfortunate in utero experience of ‘NS Weak’.

‘Nervous System Weak’

Chuan xiong Rz. Chuanxiong 4.5g
Yu jin Rx. Curcumae 4.5g
Jing jie Hb. Schizonepetae 3g
Bai shao Rx. Paeoniae Alba 6g
Xiang fu Rz. Cyperi Rotundi 4.5g
Yan hu suo Rz. Corydalis 9g
Bai zhu Rz. Atractylodis Macrocephalae 6g
Huang qi Rx. Astragali 9g
Shan yao Rx. Dioscoreae Oppositae 9g
Gan cao Rx. Glycyrrhizae 4.5g



Psychology
The integrity of the ‘Nervous System’ is the primary factor in the etiology of all psychological
disorders. If the ‘Nervous System’ is vulnerable, and the patient is subjected to stress (no matter
what the stress may be), there will inevitably be some kind of psychological disorder. In such
cases, the disorder may manifest with relative ease. If the ‘Nervous System’ is strong, any stress
is more likely to produce a physical illness, rather than one with psychological components.
These may develop, however, as an eventual reaction to the physical illness, should it last long
enough or be serious enough.

With sufficient stress, even someone with an extraordinarily healthy ‘Nervous System’ may
develop severe psychological problems. This becomes quite clear during war, when people who
are otherwise extremely stable emotionally break down, due to impossible physical and
emotional strain. In other words, everyone has his psychological breaking point, no matter how
healthy his ‘Nervous System’ may have been to begin with.

Lesson Nine 5
© Leon I. Hammer, M.D.

The ‘Circulatory System’

While all Systems are concerned with the movement of
Qi, the ’Circulatory System’ also involves the movement
of a heavier energy - Blood - throughout the channels.
Because of its involvement with the movement of
Blood, this system has an especially strong connection
with the Heart. As such, it is affected by the shock of
trauma, which will have a diminishing effect on the
circulation of Blood. As discussed in earlier Lessons,
both over-exercise for an extended period of time, and
the sudden cessation of heavy prolonged exercise,
cause a separation of yin and yang in the vessels; this
results in a form of ‘Blood out of control’, creating chaos in the Qi, or what I call ‘Qi Wild’.

Life experience is the basic etiology of ‘Circulatory System’ problems. There are two general
categories: one in which the Circulatory problem is secondary to an energy problem, and one in
which the Circulatory problem creates the energy problem. In the first scenario, a person has
either over-worked or over-exercised, creating a weak body condition and True Qi-deficiency.
This in turn affects circulation, because the Qi moves the blood. The pulse is generally Slow and
Feeble, though in the extremes it may be unbalanced, and one may not be able to get the rate at
all.

The second category, in which the Circulation has secondarily affected the energy, is caused by
some kind of relatively strong and sudden experience, such as an accident, emotional trauma, or
very severe weather conditions. In this situation, the pulse may at first be either very Fast or very
Slow. Later, it will usually be Slow, but Slow and Tight rather than Slow and Feeble. In general,
the pulse tends to be somewhat slower when Circulation has been affected by accident,
emotion, and weather, than when it is affected by body condition or energy.

Some of the more mild symptoms associated with problems of the ‘Circulatory System’ tend to
be fluctuating, and include cold hands and feet, migrating joint pain, and a propensity to anger.
In more severe cases, Circulatory issues will manifest as anxiety and depersonalization.

I have been unable to equate problems of the ‘Circulatory System’ with any conditions in TCM.
Bi syndromes due to Wind describe the ‘migrating’ aspect of symptoms, and Liver Qi Stagnation
describes an aspect of the ephemeral nature of the condition, but neither accounts for the
Heart-Circulation aspect.

Lesson Nine 6
 © Leon I. Hammer, M.D.

‘Circulatory System’

Qiang huo Rz. et Rx. Notopterygii 6g

Si gua luo Fasciculus Vascularis Luffae 6g
Dan shen Rx. Salviae Miltiorrhiziae 6g
Sang ji sheng Taxilli Herba 12g
Yuan zhi Rx. Polygalae 6g
Da zao Fr. Zizyphi Jujubae 10g
Dang gui Rx. Angelicae Sinensis 6g
Mu gua Fr. Chaenomelis 12g
Fang feng Rx. Saposhnikoviae 6g

In his idea of the Systems model, Dr. Shen has made a valuable statement about the existence
of Systems beyond the organ energies with which Chinese medicine is ordinarily concerned. His
insight into the effects of development, Lifestyle, organ states, and other factors on the ‘Nervous
System’ (or what we allude to roughly as ‘mind’ and ‘emotion’) is particularly significant.

In Lesson Ten…
Dr. Hammer will complete his presentation of the Systems model, describing the ‘Digestive’ and
‘Organ’ Systems. He also makes some very helpful comparisons between Dr. Shen’s ideology
and traditional Chinese medical thought, allowing for a deeper assimilation of this new
knowledge.

Lessons are freely circulated by the Contemporary Oriental Medicine Foundation.


Lesson content is produced by Dr. Leon Hammer, M.D. and Oliver Nash. Editing and design by Kira Nash

Lesson Nine 7