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.
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.
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.
