Lurking Pathogens 13

Xuè level patterns

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Xuè level patterns

The Xuè (Blood) level is the deepest of the four levels, associated with the lower burner in three burners theory. Pathogens which fall from the Yíng to the Xuè level offer less opportunity for resolution. They are, by this point, more problematic to effectively vent. Since the Large Intestine is located physically in the lower burner, there is still the possibility of expulsion by purging. The imperative in the Xuè level is to cool the Blood and nourish Yīn, since it is the zone encompassing the Liver and Kidneys. Heat dessicating the Blood can lead to stasis, so cold Blood-quickening stasis-resolving agents may also be used.

Treatment with acupuncture will focus more on supplementing Blood and Yīn and clearing heat, hopefully preventing collapse of Yīn or Yáng. Patients with advanced levels of dysfunction seldom appear in ambulatory acupuncture clinics. In the case of Lurking Pathogens (LP), typically the pathogen will lodge in the Qì or Yíng levels indefinitely, gradually weakening the Yīn and Blood, obstructing the Qì and creating stasis. Thus, LP Xuè level patterns may appear clinically much like the later stages of any other degenerative process. Once secondary pathogenesis of Blood stasis and phlegm has occurred, the original LP becomes one of numerous pathogenic factors to address, and thus it may be difficult to establish LP as an etiology at all.

Manifestations may appear more toward the Liver or toward the Kidney, with severe deficiency heat signs, interior wind, sleep disruption and so forth. The approach to treatment is similar to more standard chronic Yīn-Blood deficiency cases.

Liver Shō

The Liver shō is a sequelae of the Pericardium shō, with emphasis on the manifestations of interior wind (spasm, tremor) and further signs of Blood stasis or heat, especially in the lower burner. As noted, the main principle is to supplement Blood, however measures should still be taken to cool or quicken the Blood, according to the manifestations of the particular case.

Points aimed at nourishing Liver and Kidney are Water points (salty and moistening) LR-8 (qū quán) and KD-10 (yīn gǔ), and Earth/Source points (sweet and nourishing) LR-3 (tai chong) and KD-3 (tai xi). LR-1 (dà dūn) is useful to retain fluid and Blood in the sinews to treat spasm. Points to cool and quicken Blood can be Fire points such as LR-2 (xíng jiān) and KD-2 (rán gǔ). KD-5 (shuǐ quán) also can function to move Blood. KD-9 (zhú bīn) can be used to settle fright in cases of emotional imbalance. KD-1 (yǒng quán) can be treated to anchor the Yáng.

Points: Root treatment: LR-8 (qū quán), LR-3 (tai chong), KD-10 (yīn gǔ), KD-3 (tai xi); LR-1 (dà dūn), LR-2 (xíng jiān), KD-1 (yǒng quán), KD-2 (rán gǔ), KD-5 (shuǐ quán), KD-9 (zhú bīn) depending on clinical manifestations

Kidney [Yīn] Shō

Kidney [Yīn] shō  represents a pattern of significant damage to Yīn and essence from the depressed heat of the LP. Manifestations may include signs of Yīn deficiency fire: night sweats, hot hands and feet, systemic dryness, insomnia, thready rapid pulse or rapid unrooted empty pulse, dessicated deep red tongue with no coating. Typically the abdomen will show emptiness in the subumbilical region.

The treatment strategy here is to gather the Yīn of the body to prevent Yīn collapse, and to clear deficiency fire. Using the Extraordinary Vessels of Ren and Yinqiao Mai master points LU-7 (liè quē) and KD-6 (zhào hǎi) to this purpose is indicated, as well as use of Water points KD-10 (yīn gǔ) and LU-5 (chǐ zé). KD-2 (rán gǔ) may be used to drain deficiency fire.

Points: Root treatment: KD-6 (zhào hǎi), KD-10 (yīn gǔ), LU-5 (chǐ zé), LU-7 (liè quē); KD-2 (rán gǔ)

Note: this newsletter is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.

References

Ellis, A., Wiseman, N., Boss, K., & Cleaver, J. (2004). Fundamentals of Chinese acupuncture (Revised ed). Paradigm Publications.

Liu, G. (2005). Warm pathogen diseases: A clinical guide. Eastland Press.

Maclean, W., Lyttleton, J., Bayley, M., & Taylor, K. (2018). Clinical handbook of internal medicine: The treatment of disease with traditional Chinese medicine. Eastland Press.

Wen, J. M., & Seifert, G. (2000). Warm Disease Theory: Wen Bing Xue. Paradigm Publications.

Young, G. (2022). Pearls of Chinese Medicine Wen Bing Seminar Series, Class 1. Presented online October 8, 2022.