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FUNDAMENTAL   DISHARMONIES

Deficiency Qi

     Qi disharmonies are broken down into four basic categories in Oriental Medicine.  These are Deficient Qi, Collapsed Qi (aka, Sinking Qi Syndrome), Stagnant Qi, and Rebellious Qi (Qi Perversion Syndrome).  Qi Deficiency is insufficient to sustain any of the five Qi functions.   Qi is thought to be deficient within the human body when the five fundamental Qi functions of transporting transforming, holding, rising, and warming, and protecting are in disharmony.  Further Qi Deficiency is associated with deficiency of any of the types of Qi such as Deficient Protective Qi (Humeral Immune Response) one may develop signs and symptoms such as low resistance to the common cold.  Frequent colds and spontaneous sweating are indicative of Deficient Protective Qi.                  

     Qi Deficiency can affect the entire system.  The signs and symptoms associated with general Qi Deficiency are a lack in desire for action/movement or lethargy, Dizziness, blurring of vision, spontaneous sweating worse on exertion or movement; thus the lethargy.  The Tongue Diagnosis reveals a pale tongue with deficiency pulse.   Finally, Qi Deficiency is used to describe that state of a Deficient Qi Organ or Deficiency of specific Organ Qi.   Since the kidney is the Ruler of water, Kidney Qi Deficiency might be accompanied with incontinence or spermmatorhea.  Qi like everything has a Yin and Yang aspect.  Later when you learn to Diagnose through combined Western/Oriental Medicine, Deficiency and Excess are important distinguishing categories of the Eight Principal System.  Qi       

    

Stagnant Qi

      When the normal flow of Qi is disturbed, slowed or stopped the situation was described as Stagnant Qi.  If Qi is Stagnant, it can disturb the harmony of the Organs.   Since the Lungs rule Qi, then when Qi becomes stagnant within the Lungs, than signs and symptoms are associated with Coughing and dyspnea.  If Qi is Stagnant in the Liver, abdominal distention and distention of the rib cage occurs as the Liver stores blood.  If there is a disturbance in flow the Liver overengourges.  When Stagnation occurs, this generally refers to accumulation of blood in one of the organs discussed or due to obstruction of blood circulation or extravagated blood, which has not been dispersed or expelled from an organ. 

      Generalized signs and symptoms are Pain, ecchymosis or petehial hemorrhages, and masses or tumors.  Etiological events included abrasion and contusions, hemorrhage, pathogenic invasion of the blood, or even deficiency Qi. 

 

Rebellious Qi

      When this Qi goes the wrong direction compared with that described as normal, it is known as Rebellious Qi.  The most common example is Stomach Qi.  Stomach Qi descends.  Thus if Stomach Qi is rebellious or perverted, the signs and symptoms would be vomiting, nausea, hiccups and belching.  This is usually the result of phlegm in the stomach or food poisoning, invasion of the stomach by exogenous pathogenic factors.  Rebellious Lung Qi is associated with coughing and asthmatic breathing.  Perversion of Qi relative to the Liver causes headache, vertigo, dizziness, hemoptysis, hematemesis, and in the worse case coma.  Liver in Oriental Medicine is associated often with stress due to anger or aggression.

 

Blood Disharmony

      Blood Disharmony has been distinguished by two main categories.  That of Deficient Blood and Congealed (a.k.a. Blood Stagnation).  Whenever an Organ, the tissues or even the entire body is Deficient in blood, the tissues are not nourished.  If the disharmony affects the entire body then signs and symptoms were Pallor-pale complexion especially the face and lips, dizziness, blurred vision, palpitations, insomnia, numbness of the hands and feet, and cold.   The Tongue examination again reveals pale nature and the pulse is thready.   

      When there is isolated Blood deficiency of an internal organ than Organ Qi is affected.  Remember the Heart Rules the blood.  Therefore, if there is Deficient Heart Qi, the patient might demonstrate tacycardia or again, palpitations.         

      Conversely, if the Blood is congealed, it is not flowing smoothly and obstruction to flow occurs.  The signs and symptoms associated with Congealed Blood are usually swelling of the organs (usually the Liver), deep, stabbing pains accompanied by cysts, tumors and Amennorhea (Clinically noted over 2,000 years!). Two important clinical aspects of blood are related to heat in the blood and blood loss.  

 

BLOOD HEAT

      The symptoms of blood heat are generally skin diseases with red eruptions, dry mouth absent desire to quench the thirst, a perception of warmth in the body, Mental anxiety, or mania in severe cases, possible hemorrhagic syndromes, profuse menstrual flow in woman and bleeding.  The signs are a Deep Red tongue and discovery of a Rapid pulse.   The etiology of Blood Heat or heat in the blood results from either internal heat in the blood system or from invasion of the blood by exogenous pathogenic heat (factors). 

      If the blood heat affects the Heart, symptoms such as mental illness (manic-depression), mouth ulcers and anxiety.  If the blood heat affects the Liver, the symptoms are dermatological conditions characterized by itching, redness and of course heat (one of most common form of benign skin disorders in O.M.).  If the blood affects the Uterus and Penetrating Vessel, there will be excessive blood loss during the menses.  

      The first chapter of the Miraculous Pivot “Fine needles are applied to clear obstructions in meridians and collateral’s and to regulate Qi and Blood.”  In Precious Supplementary prescriptions indicates that if blood heat is due to obstructions in meridians and collateral’s, which regulate Qi and Blood, then, “Needling may promote smooth circulation of Qi and Blood”.  Through continuing research at the Neff Clinic, we will be continually researching the scientific efficacy of Acupuncture.

 

BLOOD LOSS

      The two main cause of blood loss in oriental medicine are deficient Qi or blood heat.  The symptoms are blood loss to the surrounding tissues in either case.  Minor causes include Stasis of Blood with insufficiency of the holding vessels and Yin Deficiency.  These are manifested as Hematemesis, hemoptysis, melaena, Epistaxix, menorrhagia, metrorrhagia, and haematuria. Disharmony Reproduction and development were associated with Jing.  Thus, Disharmonies of Jing affect sexual dysfunction, inability to reproduce, improper maturation and premature aging.  Disharmony.   Shen was described as life’s vitality, human thought, consciousness and awareness.  Thus if there is a Shen Disharmony human thought may be disturbed.  They eyes may be cloudy, insomnia, forgetfulness and in the worse case incoherent speech.  With extreme Shen disharmony may lead to unconsciousness or violent madness.

 

JING DISHARMONY 

     Reproduction and development were associated with Jing.  Thus, Disharmonies of Jing cause sexual dysfunction, inability to reproduce, improper maturation and premature aging.

  

SHEN DISHARMONY

Shen was described as life’s vitality, human thought, consciousness and awareness.  Thus if there is a Shen Disharmony human thought may be disturbed and the eyes may be cloudy with insomnia, forgetfulness and in the worse case incoherent speech.  With extreme Shen disharmony the condition may lead to unconsciousness or violent madness.

 

FLUID DISHARMONY

      Disharmony of fluids would of course be related to dryness of the skin, eyes, lips and scalp.  This type of disharmony has a generalized category of Yin and Water disharmonies.  Disharmony between the Stomach, Kidneys, Lungs and Large Intestine occur due to fluid deficiencies.

 

Stomach dysfunction due to Fluid Disharmony

      Deficiency of Stomach Qi especially Stomach Yin yield body fluid deficiency.  The signs and symptoms generally include the dry tongue with horizontal cracks and a dry mouth absent the desire to drink or only a desire to drink in “small sips”:    

 

Kidney dysfunction due to Fluid Disharmony

      Deficiency of Kidney Yin yields a body fluid deficiency and dryness.  The  signs and symptoms generally include scanty urination, a dry mouth at night and a dry throat.   

 

Lungs dysfunction due to Fluid Disharmony

      The signs and symptoms associated with Lung Disharmony are dry skin   and dry cough.               

 

Large Intestine dysfunction due to Fluid Disharmony               

     The signs and symptoms associated with Large Intestine Disharmony are dry stools.  The Large Intestine is related to the Stomach as both are Yang and    as such are known as within the same classification of “Bright Yang” a deficiency of fluids from the Stomach are then easily attributed to or are consistent with subsequent fluid deficiency of the Large Intestine.

  

EDEMA

      Deficiency of the Spleen, Lungs or Kidneys or a combination result in Edema in Oriental Medicine.   Remember the Spleen is entrusted with transformation and transportation.  The Kidneys govern Water and the Lungs send the purified fluids to the skin and muscles in Oriental Medicine.  Thus is there is a Disharmony between any combinations of these organs or singularly, the Body Fluids are not transformed properly, and with improper fluid transport, they overflow out of their holding structures (treat Channels and with Herb’s), and settle in the interstitial space; and space under the skin. 

      Lung Qi deficiency is associated with edema in the upper part of the body, such as the face and hands.  The initial etiology has been associated with invasion of exterior Wind-Cold interfering with the lung functions of dispersing and descending Body Fluids.             

      Spleen Qi deficiency is associated with edema accumulating within the middle part of the body, such as ascites (abdominal edema).    

      Finally, a Kidney-Yang deficiency will cause edema to accumulate in the lower part of the body, such as the legs and ankles.  In Oriental Medicine, this is thought often to be a result of the kidneys being overused to filter complex proteins due to body disharmony especially Congestive Heart Failure.       

 

PHLEGM

      A dysfunction of the Spleen in transforming and transporting fluids (absence of lymphatic drainage).  Phlegm enigmatic is thought to be an etiological factor as well as pathology.  When the Phlegm is retained over a long period of time it, in itself becomes a cause of disease.        

      As the Phlegm accumulates it the Lungs and Kidneys, as they are involved in the regulation of fluids, further indicate the Internal Disharmony.  When the Lungs fail to disperse and descend fluids, the Kidney fails to transform and excrete fluids, which results in further accumulation of Phlegm (Angiotensin II).   

      When attempting to diagnosis phlegm, look to the essential signs.  These are a slipper or sticky tongue coating and a Slippery or Wiry Pulse.

      Phlegm classification is divided into Substantial Phlegm, such as the sputum that collects in the Lungs and is spat during bronchitis or other lung Diseases and Non-substantial, which is retained subcutaneous, or in the channels.  In Oriental Medicine, it is thought to form Gall Stones (Cholilithiasis) or Kidney stones.  It is also thought to settle in the joints as arthritic bone deformation and is thought (Blood and Phlegm Pathogenic Factors) to affect any internal Organ, the Skin and the channels.  The etiological forms follow:

 

Qi Phlegm

      A non-substantial type which manifests with a feeling of swelling in the throat (absent actual swelling), a difficulty in swallowing and a feeling of stuffiness of the chest and diaphragm.

      This Stagnant Throat Qi is thought to be due to emotional disharmonies affecting and causing stagnation of Liver Qi.  This disorder is known as “Plum-Stone syndrome” in Chinese Medicine and flair has and abates relative to mood swings.

 

Fluid Phlegm

      This form of Phlegm is known as “Yin” in Chinese Medicine.  This is translated as “fluids” or “watery”.  Fluid Phlegm is divided into four subcategorize.        

 Fluid Phlegm in the Stomach and Intestines.           

      1.  The symptoms are abdominal fullness and distention, vomiting of watery fluids, a dry tongue and mount absent the urgency to drink, stomach sound    likened to splashing within the stomach, loose stools, fullness of the chest and weight loss.   The signs are a Swollen tongue with a sticky coating and a Deep-         Slippery pulse (see definitions of pulse types O.M.).        

 

Fluid Phlegm above the diaphragm.                       

      2.  The symptoms are cough, asthma, edema, and dizziness.  The signs are        a Sticky thick white tongue coating, a Wiry pulse and inspection of the sputum          sample reveals an abundance of white.  Exposure to cold aggravates or exacerbates      the symptoms.      

 

Fluid-Phlegm in the hypochondria.               

     3.  The symptoms are hypochondriac pain (flank pain), which is worse on coughing and breathing, a feeling of distention of the hypochodrium, and shortness of breath.  The signs are a Sticky tongue coating with a Deep-Wiry pulse.       

 

Fluid-Phlegm in the extremities.          

     4.  The symptoms are a feeling of heaviness of the body, a pain in the muscles, no sweating, no desire to drink, and a cough.  The signs are a sticky-        white tongue coating; a Wiry or Tight pulse and the sputum sample looks again as if there is an abundance of white.  However, this sputum is associated with a       cough and is not exacerbated by cold.

 

PATHOGENIC PATTERN RECOGNITION 

     Wind, Cold, Dampness, Summer-Heat, Dryness, Fire, Phlegm and Congealed Blood/Blood Stagnation are the various forms associated with Pathogenic factors, which invade the body.  In Oriental Medicine, pattern recognition of disharmony is considered more important than its etiology.  These will be discussed relative to classification, pattern recognition and placement in differential diagnosis in Oriental Medicine save Phlegm and Congealed Blood, which has already been discussed.  

 

WIND

      Wind can affect a patient both externally and internally.  The nature of Winds affect on the body is injury to the Blood and Yin.  Wind is often the vehicle, which brings heat or cold against and into the body.  Thus, Wind is Yang in nature.     

     Symptoms of Interior Wind include paralysis (Wind-stroke).  External Wind causes facial paralysis (Bells Palsy) or simply neck stiffness.  In Chinese Medicine there is a saying “Sudden rigidity is due to Wind”.  The clinical manifestations of Wind follow:  Rapid Onset, rapid changes in symptoms and signs, traveling pains, tremors, convulsions, and of course stiffness and/or paralysis.  It is thought to affect the top part of the body, the Lungs first, the skin accompanied by itching.  Paralysis, tremors, and convulsions are exclusive Interior Wind.  Facial paralysis (Bell’s palsy) again, is caused by exterior Wind.      

      Penetration of the body is thought to occur with Exterior wind by interference with the circulation of Defensive Qi of the skin and Blood vessels as well as the interspaces.  Since Defensive Qi warms muscles and the skin, the patient exposed to Exterior Wind experiences, chills, shivers and demonstrates an aversion to cold.  Aversion to cold will be demonstrable, as the patient will not leave the home.  Thus, aversion to cold is an “essential symptoms” in diagnosing Exterior Cold in Oriental Medicine.  The symptoms of sneezing and coughing are due to the Disharmony of the Lungs relative to the muscles and skin and thus Lung Dispersing and descending function is absent.  This in turn results in absence of Lung Fluid dispersion resulting in a runny nose accompanied by a white discharge, which is profuse in nature and often a fever.     

      Wind attacks the superficial bladder and Intestine Greater yang channels by blockage of Defensive Qi circulation.  Signs and symptoms associated with this channel Wind attack are pain and stiffness of the neck and back.  As mentioned earlier, wind attacks the superior aspects of the body with a sensation of itchy throat.           

      When Wind combines with cold, the signs are absence of sweating as the cold contracts the pores.  The pulse is tight.  When the Wind predominates or is significant relative to the cold.

      Normal body resistance is likened to a tendency to demonstrate Excess patterns, in Oriental Medicine.  This is the body’s Defensive Qi (sympathetic system under hypothalamic unconscious systems regulation), which constricts skin pores subsequently resulting in no sweating.  This pattern is known as Exterior-Excess.

      If a person’s resistance is poor or less than desirable with a tendency to Deficiency patterns, then the pores are open with sight sweating.  Today’s Oriental Medical Practitioner also realizes that this is a description of an individual who has poor cardiovascular and cardiopulmonary conditioning.  This patient description is called Exterior-Deficiency pattern.  The pulse associated with this condition is known as a Floating Pulse.  The ancients described this a Defensive Qi rushing to the Exterior, with the more palpable (superficial) pulse.  Further as discussed previously, Exterior Wind can cause facial paralysis presenting deviated math and eyebrows.  Because the ancients and you will be able to treat this condition with the acupuncture channels, they believed the Exterior Wind invaded the facial channels.  Following this concept the Exterior Wind could also invade the body channels particularly the Yang channels resulting in joint stiffness and pain know as Painful Obstruction Syndrome in Oriental Medicine.  Finally observation ay note the person affected by a period of windy weather ([particularly easterly wind) causing a neck ache and chronic headaches.  When Wind combines with other pathogenic factors, the conditions have been divided into sub-symptoms groupings of Wind-Cold, Wind-Heat, Wind-Damp, Wind-Water and Internal Wind.

 

WIND-COLD

     The signs and symptoms associated with Wind-Cold are o course Aversion to cold, shivering, sneezing, cough, running nose with white-watery mucus, no fever or slight fever, severe occipital stiffness and ache, no sweating, no thirst, Floating-Tight pulse, Tongue body color unchanged, thin-white coating.

 

WIND-HEAT

     Injury from Wind-Heat contains Chinese medicine observations of reactions to Heated Wind.  Heat signs are thirst, yellow mucus, more fever, a rapid pulse and a slightly Red Tongue body on the tip or sides.  During the acute stages, aversion to cold was described due to a disharmony with the circulation of Defensive Qi in the soft tissues.  Because the Defensive Qi warms the tissues, this constricted or rebound phenomena of the vessels into constriction of warm blood flow to the body; the patient demonstrates an initial aversion to cold.

     Differentials are red tongue body and/or tips and sides.  This is purported to be due to the outer aspects of the tongue reflecting the External nature of the pathogen as opposed to an internal cause, which would have more circulation damage and subsequent red central tongue area.  Pathogenic factors were again hot and cold with differentials which can be summarized in the following tables.Text Box:  

 

PATHOLOGY   HOT                        COLD

Differential          Thirst            No Thirst

                          Yellow Tongue coating    White Tongue Coat

The above chart differentiates Simple Hot pathogenic factors from Cold.  Below is a comparison of progressive signs and symptom associates with Disharmonies due to Cold or Heat.

Text Box:  

 

COLD DISHARMONY     HEAT DISHARMONY

 Aversion to cold in the      Constant thirsting  for cold absence  of thirst or           drinks,  febrile with  reddening drinking little in the way  complexion,  scanty urination hot fluids, Pallor, copious  of a deep-yellow                clear urine.                          

 

Pale tongue with thin moist  Red tongue with             white coating.                          yellow (heat) and                                                  dry thick coating.

                                     

WIND-DAMP

      Earlier we discussed the ancients belief that because the channel treatment worked, the Wind now combined with a heavy dampness (high humidity) can affect the (intermittent claudication) and neighboring tissues.  Wind-Damp adds definitive symptoms including skin rashes and itching due to the affects of the Wind-Damp on the skin.  The signs and symptoms can be summarized as Wind-Damp, skin rashes, uticaria, purities (itching skin), fever, aversion to cold, sweating, aching tissues, joint swelling, a feeling of lethargy or heaviness.  When the pulse is taken, a Floating-Slippery pulse (see Pulse Diagnosis) is found.

 

WIND-WATER

      Remember the Lungs were attributed with the functions of dispersing and lower or des\ending fluids combined with “fresh air”.  Wind-Damp is thought to invade the lung and obstructing the thoracic organs Heart/Lungs, resulting in edema.  Because the result of the pathogenic factor was Lung Disharmony, the condition is more prominent on the face.  In TOM, this is likened to problems of the Upper Burner.

      In today’s modern OM, the hypothalamus was reacting to the change and responded with the appropriate upper respiratory tract response about the air passages in the face (mouth, nasal pharynx).  In any event, facial edema occurring in the beginning is the acute stage of illness known as Acute Nephritis.  Acute Nephritis is discussed in the differential diagnosis section of this book.  Any conditions like this would be immediately referred to a multidiscipline Medical Physician. 

 

INTERNAL WIND

      Internal Wind relates primarily to three conditions or groupings of symptoms such as Deficiency of Liver-Blood, Liver-Yang and a multidisciplinary approach handling Extreme Heat with immediate referral.  In general, Internal Wind symptoms are divided into very responsive conditions such s tremors, tics, severe dizziness, vertigo and numbness.  However, Internal Wind is also associated with convulsions, deviation of the mouth, unconsciousness, opisthotonos and hemiplegia. 

1.     Liver Yang (causing Liver-Wind/Internal Wind) is associated with headaches, irritability, and vertigo and in some cases severe dizziness. 

2.     Liver-Blood deficiency (causing Liver-Wind) causes a Liver-Wind to occur within the blood vessels because blood volume is low.  When the Blood Volume was low it was known as Liver-Blood Deficiency).  The signs and symptoms are tics, slight tremors (in Chinese called “chicken feet Wind” as the tremors look like the jerky movements of chicken feet when they scurry around), numbness, dizziness and blurred vision. 

3.     Extreme-Heat (causing Liver-Wind) I clinically the later stages of febrile diseases.  In OM, the Heat entered the Blood and generated wind in the space available from low blood volume.  The symptoms are high fever, delirium, coma and opisthotono.  Because Meningitis is Wind in the Liver and Pericardium, your study of the examination section is deemed mandatory unless you are a Medical Physician or Practicing Modern Oriental Medical Practitioner. 

COLD

      Cold in Oriental medicine is very akin to Western medicine.  As cold constricts the blood vessels tissues harden, contract and metabolism is slowed.  Ischemic pain due to overexertion is the most common medical example, which occurs daily.

     Why?  In 1980 I published the answer which follows:  Today we know that during overexertion, when a muscle contracts, large molecules of the resting organ break down into many small molecules, which pass into the tissue spaces.  These metabolites can remain in considerable concentrations in the tissue spaces for long periods and slowly diffuse into the blood.  As the metabolites remaining in the tissue spaces are osmotically active, they attract fluid from the blood and retain it.  Normally this facilitates a gradual diffusion of metabolites into the blood, owing to a difference of concentration.  Thu during strenuous exercise or overexertion, metabolites impure relative to the blood cannot be removed quickly enough.  Further, when a muscle contracts, it compresses the vessel init if it develops more than 19% of its maximal tension.  When it develops more than 76% of its maximal tension, blood flow is completely stopped.  Additionally, tissue pressure exceeds pressure within smaller, thin-walled vessels an even with arteries, thus causing temporary occlusion.  In OM, this is known as Pain Obstruction Syndrome.  Further, the metabolites tend to accumulate during exertion and increase with each additional contraction.  In other words, local blood flow spurts and ceases with cyclic contraction and relaxation and these spurts of blood are not equal to the normal circulation, thus allowing toxic metabolites to accumulate.  Hence, even during muscular activity, the weight of the muscle increase by 20% due to the increased amount of retained fluid and metabolites.  This swelling of the muscle causes muscle stiffness, which follows extreme exertion. 

     It said, “Retention of Cold causes pain” (Zhai Ming Yi 1979 Clinical Chinese Medicine p 132).  Thus in these cases it is not cold causing pain but processes and soft tissue reactions to cold invasions due to disease.  Cold causes pain, stiffness, contraction of tendons and chilling to frost bite/gang green.  Cold can invade any part of the body and joint, but the most common places are the hands, arms, feet, knees, lower back and shoulders.

     In OM, three organs can be affected by Cold causing further disharmony.  These are the Uterus, Stomach and Intestines.  The Uterus demonstrates signs of acute dysmenorrhoea, the Stomach with symptoms of epigastric pain and vomiting and Intestinal cold resulting in abdominal pain and diarrhea.  Warmth makes this condition better including the pain.  Interestingly enough in the same referenced text, same page, it is said, “A disease characterized by thin, clear, watery and cool discharges is due to Cold”.  Other manifestations associated with cold are clear-white discharge form the nose, very pal urine, watery-loose stools and clear-watery vaginal discharges.

 

INTERNAL COLD

 

     Internal Cold is divided into Excess (Full) or Deficiency (Empty).  Yet, Internal Excess Cold after prolonged duration can become Deficiency Cold as the Spleen Yang is consumed.  Now, the Full Cold Pattern worsened into a Deficiency Internal Cold.  Remember Cold invades the channels (Painful Obstruction Syndrome) and can invade certain organs.  Excess and deficiency cold manifest similar symptoms, as they are both due to cold.  Differentials can be made on the following signs and symptoms.  Excess Internal Cold will be acute in onset with severe pain.  Tongue inspection reveals a thick-white coating.  The pulse is Full and tight.  Empty-Cold will present with a gradual onset of signs and symptoms, and the pain would not be mild to moderate.  The Tongue inspection reveals a thin-white coating and pale tongue body with the pulse recorded as weak or empty.

 

     Because this is Internal Cold, its site of origin is considered a disharmony within certain organs.  Yang deficiency of the Spleen, Lungs, Kidneys and Heart all Yin Organs, in itself is relative to consistency.

 

     Heart Yang deficiency specifically demonstrates symptoms of stuffiness and pain in the chest, with purple lips.  A Knotted pulse would be perceived.

 

     Lung Yang deficiency, as discussed earlier is linked with human resistance to disease and thus this patient reports greater preponderance toward the common cold.  Symptoms are sweating with a cough and oral white mucus or mild phlegm.

 

     Kidney Yang Deficiency patients generally demonstrate copious urination, cold feet and knees, impotence in men wit white leucorrhoea reported in women and posterior flank back pain.

      Spleen Yang Deficiency again is relative to diarrhea and a suppressed appetite are definitive symptoms.

      Although the pathogenic factor is no internal cod, all Cold pattern disharmonies share common symptoms, which should b assumed part of the definitive Organ Yang Deficiencies delineated above.  Again, Cold disharmony symptoms include old extremities leading to body chilliness, dull pain, no thirst but a desire t imbibe warm liquids.  The face is generally pale. The tongue demonstrates a thin white tongue coating.  Pulse examination reveals a Weak, Slow, Deep pulse.

 

SUMMER HEAT

     Summer heat is appropriately named as it is indicative of the season the symptoms predominately occur; Summer.  The signs and symptoms are sweating, headache, aversion to heat, scanty-dark urination, dry lips with thirst.  Examination reveals the pulse rapid while the Tongue is Red on the sides and especially the tip.

      Summer heat in western medicine is Sun Stroke with its associated mirage.  In OM when exposure to Summer Heat is considerable, severe clouding of the mind, slurred speech, delirium and unconsciousness are the symptoms.  The Poetic manifestation would be invasion of the Pericardium with heat.

 

DAMPNESS 

     Dampness, like liquids, blood and moisture are Yin factors.  Dampness is also a Yin Pathological factor, which tends to injure Yang aspects of health (see Yin Yang in the Eight Principals Chapter).  Dampness refers to a condition in which the etiology is considered acquired.  This may be through living in damp quarters, exposure to damp climate, wearing wet clothes, placing your head under water (pathogenic factor or infection through the ears; e.g. bacteria, virus, molds, spores, fungus, yeast, parasites) while swimming or hot tubing especially with children, several persons who may have an infection, and similar situational conditions.  Dampness like all the other pathogenic factors is divided into patterns and symptom classifications or groupings.  These types of Dampness are Heaviness, Dirtiness, and Stickiness.  Further Dampness is also divided into External and Internal the later of which will be discussed following the present review:

 

·        Heaviness/Dampness causes a feeling of heaviness of the extremities and/or the head.  Accompanying symptoms include a feeling of tiredness, a feeling of being dazed.  Since Dampness is heavy, it settles in the chest resulting in a feeling of fullness and stuffiness to the epigastrium and/or entire chest region.  In TOM, the poetic organ in which this is to occur is the Lower Burner.  As mentioned Dampness affects the head dulling the light of the mind and senses.

 

·        Dirtiness/Dampness causes dirty discharges, such as cloudy urine samples, vaginal discharges or weeping dermatological conditions associated with Eczema.

 

·        Stickiness/Dampness causes chronic illness with recurring episodes.  Thus periods of remission with exacerbation.  The Tongue Inspection reveals a sticky tongue coating; sticky tastes and the pulse would be Slippery.

     When External Dampness is accompanied by heat, symptoms include fever, tongue coating of sticky and yellow with the pulse being Slippery and Rapid.  Epidemeologically, Damp-Heat is most frequent in summertime and just after the summer.  External Dampness injures the Spleen Yang and impairs transformation and transportation.  After the initial acute attack, more Dampness accumulates because of the lack of transformation and transportation of fluids.  At that point, Interior and Exterior Dampness appear clinically indistinguishable.  Finally, as noted before External Dampness can be treated by the channels for conditions, which cause the joints to ache and swell.  Generally the Shu-Stream/Delta Point’s assist in the treatment of a heavy feeling and achy, swollen joints.

 

INTERNAL DAMPNESS

 

     When the Spleen and/or Kidneys are in disharmony, the deficiency will lead to Internal Dampness.  The signs and symptoms are gradual onset of symptoms and may include fever.  The tongue will be sticky yet slim and the Pulse is Slippery and Fine, or Weak and Floating.

 

     As we have already discussed phlegm, it is best to realize that Dampness and Phlegm are similar as they both originate from a dysfunction of the Spleen’s TT functions (Transforming and Transporting).  The differences follow:

 

1.     Phlegm only originates from an interior dysfunction whereas Dampness can be either exterior or interior in origin.

2.     Phlegm is produced by a disharmony between the Lungs and Kidneys for Phlegm generation combined with the dysfunctional Spleen byproducts due to the failed Transforming and Transporting functions associated with the Poetic (OM defined) Spleen.

3.     Due to the heavy nature of dampness, it accumulates primarily in the lower body and extremities but can accumulate in the skull.  Phlegm primarily affects the middle and upper portions of the body.  For example, Phlegm may affect the thoracic region with a feeling of stuffiness in the lungs, and throat obstruction o mucus with often-excess sputum of a mucoid nature.

4.     Phlegm is said to “mist” the Mind causing psychological manifestations and ha been associated with mental retardation in children where Dampness has no such affect.

5.     Dampness in the head causes a feeling of heaviness where as Phlegm causes dizziness.

6.     Dampness can affect internal Poetic organs and the joints, while Phlegm causes lumps and subcutaneous swelling.

7.     Phlegm can originate from the condensing action of Fire (Hi Fever) on Body fluids.  Dampness arises from Spleen disharmony.

8.     Phlegm affects primarily the Yin Organs save the Stomach, while Dampness affect mostly the Yang organs save the Spleen.  Phlegm affects the Stomach and Dampness affects the Spleen.

9.     Of course, Phlegm would be consistent with heaviness while Dampness is consistent with sticky, dirty, flowing downwards and heaviness.

10. As you have already learned in this text Phlegm often associates with other pathogenic factors such s Wind, Cold, Damp, Dry, Fire and Qi.  These then are called Wind-Phlegm, Cold-Phlegm and so forth.  Dampness only associates with Heat or cold.

11. Phlegm has multiple forms such as thick and viscous to very dilute and watery known as Phlegm-fluids.  However, Dampness has only one form.

12. Relative to pulse diagnosis, both Phlegm and Dampness begin with the Slippery Pulse finding however, Phlegm also may have a wiry pulse whereas Dampness would be a weak-floating pulse.

13. Relative to tongue diagnosis, both have a sticky coating.  Phlegm can also demonstrate a dry and rough coating with prickles seen generally inside the central crack in the Stomach area of the tongue.  This indicates the presence of Phlegm-Fire in the Stomach.

14. Acupuncture points relative to Phlegm are treated on the Stomach Channel whereas the Spleen channel is treated to expel Dampness.  The main points to dispel Dampness are Yinlingquan Sp-9, Sanyinjiao Sp-6 and Taibai Sp-3.  Phlegm is treated at the point Fenglong St-40.

15. Relative to Herb’s that Drain Dampness please review that later section of the book.  However, absent formulation, singular herbs such as Yi Yi Ren promotes urination, supports the spleen, transforms or reduce Phlegm to fluid and waste materials, which are disposed of through the elimination system as it clears heat, eliminates puss, has an affect on retardation o Neoplasms, Warts and in clinical studies inhibited the growth of certain forms of Cancer.  Lai Fu Zi transforms Phlegm, as well as Fu Ling, which is an excellent Herb to drain dampness, and Chen Pi, as it is a strong agent in the Drying of Dampness and Transforming of Phlegm down to fluids and waster materials as well as regulate Qi, and eliminates stagnation.

 

DRYNESS

     Obviously, Dryness is the degree of moisture or the absence of moisture.  Clinically, Dryness is associated with signs and symptoms experienced when living in a dry climate, home, room and so forth.  More importantly is the concept that this Dryness or drying process, would be damaging to fluids of the body.  Thus, Dryness damages Blood or Yin.  Dry sin, parched lips, dry throat, dry mouth, dry tongue, constipation to dry stools, inability to urinate or scanty urination are symptoms of dryness.

 

INTERNAL DRYNESS

      Stomach and/or Kidney deficiency are the most notorious causes for Internal Dryness.  Deficiency Yin or Deficiency Stomach and/or Kidney Yin are thought to be the mechanism.  Remember that with Circular Logic, just as the Chaos pranksters in everyone’s precalculus class demonstrating that 2+2=5, even though a mechanism is delineated for you in this text, when Yin grows, Yang accepts and so forth remaining in a harmonious flow.  Thus, Internal Dryness may not be a cause in some instances but rather the preceding event or sign.  The point is that if we understand the n’th degree of Einstein’s concepts, than it is Circular Logic, which allows Chaos theory.  However, as a sophisticate in the sciences, I have no problem interpreting real achievements into scientific mechanisms.  Until my readership grows and the cult (believe in non-scientific mechanisms to yield non-science), I must continue to teach Poetic Science.  However, just as you can walk up to the chalk board, cross out the derivative canceling the entrance into the theorem, one can make the better argument that there is order to the Universe whether it is unknown or remains unknown for a millennium.  Truth will bust through and explain reality.  Science allows Calculus to teach us that perfect math can yield imperfect math.  Thus, we as scientists must allow a moment of circular logic to enter into our way of contemplating.  However, with this allowance we are simply fulfilling scientific method and our experiential growth.   

     Finally, “Withering and cracking is due to Dryness”.  This saying, predating modern science has been around for thousands of years from a humble caregiver’s description of dry skin and a cracked tongue seen in this condition; Dryness.  Signs and symptoms of dryness today indicate a dry throat; mouth and a dry tongue perhaps with a mild peeling in its center or perhaps pink in color.

  

FIRE

      Profound heat is Fire in OM.  The etiology of Fire either is a profound internal organ disharmony or is derived from other pathogenic factors.  Once manifested however, it is a profound interior pathogenic factor.

     In oriental medicine Fire will move or burn and dry-out the tissues more than Heat. Heat does cause pain, thirst, Rapid pulse and a red Tongue but Fire damages the blood vessels and illustrates an internal drying and upward moving drying process resulting also in mouth ulcer.  Psychological manifestations such as anxiety, mental agitation, insomnia or mental illness are thought to be due to Mind Fire (perhaps Shen Fire).  Manifestations of Fire are determined by the Organ that is affected.  For example, if there is Stomach Fire the signs and symptoms are bleeding gums, gum ulcers, and haematemesis.

      Thus, Fire dries fluids, is injurious to the Blood and Yin, can deplete Qi, rise to the head and affect the mind.  In fact, there are many ancient phrases, which categorize effects of heat and fire.  For example, “Diseases manifesting with tympani sounds are due to Fire”.  This is in reference to the borborygmus sounds heard from the intestines or distended abdomen.  “Manic behavior is a manifestation of Fire”.  Here Fire was that which caused the Mind to be restless, agitated and in the worse case scenario, manic behavior.

      Excess fire is one of two classifications of Fire.  The symptoms associated with Excess fire are a red face and eyes, a dry mouth, a bitter taste, fever, constipation, scanty-dark urine, constant thirst, mental agitation, the Full-Rapid pulse, and a Red Tongue with yellow coating.  Vomiting of blood, hemorrhages, macules and dark purple spots under the tongue are signs of Fire entering the blood.

      Yin deficiency is the cause of Fire deficiency.  The symptoms of Fire deficiency are night sweats; a feeling of chest heat, palms and soles are warm, red cheeks, dry mouth, and afternoon fever.  The Tongue diagnosis discovers a Red and peeled tongue and the Pulse is Floating-Empty and Rapid.

 

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