“Nightmares” (Buffy, Season 1)

Dreams are a wish of the heart, the Master says in this episode.  Nightmares, it would seem, are fears of real life.  Ordinarily a nightmare brings these fears to a place in which we can confront them and resolve them before they occur in real life.  This being Sunnydale, however, preparation has a way of making itself into reality.  In this particular episode, a boy lies in a trauma-induced coma, and his nightmare spills over to bring the nightmares of all the other residents of Sunnydale to life.

In Chinese medicine, dreams and nightmares can result from several pathogenic processes. The images found in dreams can even be used to identify zang-fu dysfunctions.  Mostly, they point to some sort of fire problem:  heat in the blood, heat in the liver, fire harassing the heart.

One element not discussed in TCM are nightmares resulting from, or while, one is in a coma. Coma itself is discussed under the topic “wind-stroke.”  While one could, through overlaying the two patterns of nightmare and wind-stroke, arrive at a diagnosis for this episode’s entertainment, I would add one other element:  the boy was afraid to confront his nemesis.  This could point to a Heart-Gallbladder emptiness pattern.  Typically, that pattern can be resolved through a variation of Wen Dan Tang, using an increased dosage of Sheng Jiang and sometimes adding Suan Zao Ren.  However, in this instance, the more immediate action to be taken is to awaken the boy from his coma.  Substances which open the orifices are called for.

The formula Zhi Bao Dan can be used in this situation.  According to Bensky’s commentary, it is indicated for “impaired consciousness to the point of coma,” and is “usually associated with summerheat-stroke… when heat sinks into the Pericardium and turbid phlegm veils the orifices of the Heart”  In the episode it is revealed that the boy had been playing baseball — thus a propensity to summer-heat — before he was assaulted by his coach — which would have injured the Pericardium’s qi.  Thus the mechanism which this formula treats was perfectly set up.  I would also argue that the fear the boy is expressing is due more to this injury to the Pericardium (and its role in protecting the Heart) than to any deficiency of the Gallbladder or Kidneys.

Acupuncture treatment in this situation would call for the use of jing-well points to revive consciousness; points to clear phlegm from the Heart’s orifices and expel summerheat are also recommended.  PC-9 and PC-6 come to mind.  HT-8 could be used as well.  CV-4 and SI-3 could help activate the Small Intestine’s energy to help release summerheat toxicity.  Since I do not like using more than three channels in a primary meridian treatment, this treatment suffices.  In lieu of the SI points, one could also try TH or GB points, since these pathology of the PC can easily develop into pathology of the channels following it.  TH and GB also have the additional benefit of being ShaoYang channels, which can effectively treat summerheat-damp conditions.  TH-5 and TH-15 can be used to open the outer gate of conscious awareness and to dispel phlegm.  (Most points around the gleno-humeral joint can treat phlegm.)

As always, this post is for theoretical purposes only, and is not meant to diagnose, treat, or cure any particular individual.  If you feel you can benefit from treatments of this nature, please see a qualified practitioner.


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