A Historical Investigation of Constraint

With Guest: Eric Karchmer

Episode Qi055

Liver qi constraint might be one of the most common diagnosis in the modern Chinese medicine clinic. But the role of the Liver has changed over time, and at one point it was even considered to be part of the neurological system.

In this episode we take a nuanced look at that wide and slippery constellation of symptoms that falls under the general rubric of “stress.”

Listen in for a conversation about Chinese medicine from a historical, anthropological and clinical perspective. And be prepared to be surprised!
In this conversation we discuss:
  • A brief history of constraint
  • In the early part of the 20thcentury the Liver was associated with the nervous system
  • Neurasthenia and Liver Qi Constraint
  • Zhu Dan Xi had a particular view of constraint as exemplified the formula Yue Ju Wan, 越鞠丸Escape Restraint Pill
  • The beginnings of Western medicine coming into China in the Republican Era was the catalyst for many changes in thinking and practice
  • Xiao Yao San, 逍遙散 Rambling Powder started off as a gynecological formula, not a prescription for emotional discomfort
  • Chinese medicine used to be used for acute conditions
  • How all this study and background influences Eric’s practice
  • TCM is not the enemy, it gives us a starting point with language and perception
"Be cautious about using overusing Yin Qiao San for common colds and upper respiratory tract infections. Many of the great scholars of the Republican era doctors argued that Cold, not Heat, was often the cause of many contagious conditions. When cooling herbs are used inappropriately, they can drive the condition deeper into the body. In my experience, warm, pungent herbs are an essential element to treating many upper respiratory conditions, even when signs of heat are present."
Eric Karchmer
I am a practitioner of Chinese medicine and a scholar of medical anthropology, researching the contemporary practice of Chinese medicine in China. I feel lucky to have these two fields of specialization that relate to each other in such interesting ways. From 1995 – 2000, I was a medical student at the Beijing University of Chinese Medicine, where I earned a Bachelor’s of Medicine. This training was the foundation for my future clinical practice but it was also an incredibly rich ethnographic experience that has informed all of my academic research and writing.

I have also had two very formative research opportunities after my graduation from Beijing University of Chinese Medicine that have shaped me both as a researcher and scholar. In 2008-2009, I was funded by the American Council of Learned Societies to collect oral histories from senior doctors of Chinese medicine that had learned and practiced Chinese medicine during the Republican period (1911-1949). This project exposed me to the richness of medical practice in China in the early 20th century. I was fortunate to be able to continue my research into this period of Chinese history with a second grant from the Wellcome Trust to support a collaborative research project on the history of medicine in East Asia. This project allowed me to explore the fascinating clinical writings from this period.

I do not claim to have a particular clinical style. Instead, I have, for better or worse, incorporated different techniques from the many wonderful teachers I have encountered during my studies. Perhaps most important to my clinical practice, however, is my library. I have acquired a very good collection of Chinese medicine texts over the years that I always consult whenever I encounter a new problem in my clinic. I believe I have grown the most as a practitioner through this kind of clinically focused reading.
Links and Resources


Visit Eric's website at Appalachian University's Department of Anthropology

Eric is a co-founder and responsible for the herbal formulations at Dao Labs

The Excitations and Suppressions of the Times: Locating the Emotions in the Liver in Modern Chinese Medicine is the article we reference in this discussion. It's a delicious and mind opening read.

There other authors were also involved in this writing project. If you liked the one above, you'll certainly these others by Volker Scheid, Keiko Daidoji, and Soyoung Shu



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I’ve heard it said that for something to be heard — it takes someone to speak and another to listen.

Michael Max

Acupuncturist, Podcast Host
About me
I've always been more drawn to questions than answers. And the practice of medicine seems to more lively when infused with a sense of curiosity and inquiry. It's been delight and honor to be able to discuss our medicine with so many thoughtful and skilled practitioners.