Pangs (Buffy Season 4, Episode 8)


Ah Thanksgiving.  It is actually Thanksgiving day as I write this, though here in England the British don’t seem to give thanks annually for the survival of their American colonies…

In this episode, Xander participates as a construction worker in a Groundbreaking ceremony for the new anthropology cultural centre.  (Once again, the anthropologists are a catalyst for trouble in Sunnydale.)

Xander breaks through the ground alright — and through the roof of what once was the old Sunnydale Mission.  In the process, he inhales the vengeance of a spirit warrior from the Chumash people indigenous to the area.  As a result, he comes down with all the diseases to which the Americans had never previously been exposed:  malaria, smallpox, syphilis.  (The syphilis question is somewhat open, however, given evidence from pre-Columbian Florida.)

Although Xander seems most concerned about the syphilis, which strangely does not seem to bother Anya, I already addressed that infection, together with Lyme’s disease, in a previous post.  Since smallpox is now extinct as an ongoing infectious disease, I’m left with malaria and ‘all other’ epidemic diseases Xander seems to have caught, residue from the epidemiological transition of the sixteenth through eighteenth centuries.

In addition to Xander’s problems, it seems Si Ni San may not have been the right formula to give Spike.  He’s looking even paler, covered in sweat, and actively shaking with chills.  His disease may have followed a progression from ShaoYin to JueYin — conveniently enough for our purposes, since Malarial Disorders tend to fall under the JueYin pattern in the Shang Han Lun .  (Such a progression assumes a linear movement from channel to channel in the Six Channel system, which is not always the case.  Each channel represents an aspect of physiology, and while they are all inter-related, those relationships are not necessarily in order.)

As a side note, did you get the ET reference(s) in this episode?  Spike running around, sick, trying to escape government operatives, bicycles to the rescue, someone lying sick at home from a disease caught from visiting foreigners…

Malaria, as defined today, is caused by protozoans in the blood and liver of human hosts.  Four types of malaria infect humans, of which P. Falciparum can be deadly.  All malarial types are transmitted by mosquitoes (of the Anopheles variety).  Malaria was formerly thought to be caught from the miasmic vapours  (mala aria) infesting swampland.  One early and effective medicine against malaria, quinine, was used by the British for their colonial administrators, and was derived from the bark of a Peruvian tree.  However, the World Wars interrupted trade in this medicinal, and new ones were sought.  Recently, those older standbys have ceased to be as effective as in previous years.

As the efficacy of older medicines for treating malaria has begun to wane, Chinese Herbal medicine has come to the attention of global health agencies.  At the centre of this attention is the herb Qing Hao, and more specifically, the chemical constituent Qing Hao Su (artemesinin).  Currently, that chemical appears to be the most effective means to treat malaria throughout the world.  However, although Qing Hao is now grown in various parts of Africa, only the initial cop seems to have enough of the chemical to make the herb useful in treating malaria; subsequent generations grown from local seed do not produce enough.  Work is underway to select varieties within Africa which continue to be high yielding producers.

Naturally, we would want to give Xander something with Qing Hao.  However, since he has numerous other diseases, we might want to look a little more closely at possible Chinese physiological processes underlying Xander’s amazing pathology.  Looking at the other formulas grouped with those which treat malaria, several are associated with the Gao Huang, or Membrane Source.

Therefore, let’s try Da Yuan Yin, for ‘foul turbidity entering the body via the nose and mouth to lodge in the membrane source’ — which is ‘closely associated with the Triple Burner and its dual function of circulating yang qi and body fluids’ according to Bensky’s Formulas and Strategies (p137).  The Gao Huang itself is said to be located above the diaphragm and below the heart.  This is the region associated with the Mansion of Blood in Wang Qing Ren’s physiological system.

The ingredients of Da Yuan Yin include:  cao guo, hou po, bing lang, huang qin, zhi mu, bai shao, gan cao.  3 g for all; half that for the cao guo and gan cao, decocted and taken warm in the afternoon.  Of the ingredients, the first three appear in most other decoctions used to treat illnesses in the membrane source.

Cao Guo treats dampness and accumulations, as well as malarial disorders of the cold type.  Bing Lang treats accumulations and stagnant qi, in addition to abdominal distention and malarial disorders.  Hou Po treats stagnant qi and abdominal distention, but is not specific for malarial disorders.  However, Hou Po is well known for its ability to dry dampness.

Judging from these three herbs, pathology of the membrane source would entail the accumulation of dampness, especially cold dampness, a distended abdomen, and an impaired qi mechanism.  These symptoms are reflective of Triple Warmer energetics — the Triple Warmer being one of two ShaoYang channels, whose pathologies manifest as alternating fever and chills — but are also localised to the abdomen.  As mentioned in a previous post, this area was listed by Wang Qing Ren as the place where Ming Men fire resided, hidden within the Mansion of Qi, which itself is closely interrelated with the Small Intestine.  Ming Men fire is associated with both the Kidneys and the process of transforming KD jing by means of the Triple Warmer mechanism.  The membrane source thus seems to be at the heart of this movement.  The location, however is quite different; therefore, I would propose looking at a different set of associations to tease out the energetics of this organ a little bit more.

The area of the membrane source happens to be the same region into which the Chong Mai is said to disperse (i.e. the chest).  Could the membrane source be related to this vessel?  Is the membrane source a mediating mechanism between qi (TW, KD) and blood (Chong, SI)?

A look at the acupuncture points associated with the Gao Huang might prove helpful.  KD16, located on both the KD channel and the Chong Mai, is the Shu point of the Huang.  Ellis, Wiseman, and Boss indicate that the Huang refers to an area below the Heart or around the Bladder.  CV-4, the mu point of the Small Intestine, and CV-6, the Sea of Qi, are also two points associated with the Huang (called by the name Shang Huang).  Thus, among the lower points associated with the Huang are one which treats the Small Intestine, one which engages the Sea of Qi, and two which relate to the Chong Mai (known as the Sea of Blood), as well as to the Kidneys.  I have been unable to locate any points on the chest which relate to the Huang.

On the back,  BL43 is the Gate of the Gao Huang, and it is indicated for moxabustion in cases where no other treatments are working.  I seem to recall Jeffrey Yuen saying that in the Tang dynasty this was one of the most popular points to use.  BL43 would correspond to the ‘spirit point’ associated with the PC (or specifically, with JueYin, which, as was mentioned at the outset, is associated with malarial disorders in the Shang Hang Lun).  However, the PC does not store any named spirits, not being a solid organ.  The PC and JueYin, however, are responsible for clarifying the blood.  Moxa on this point would indicate either that the function of JueYin is weak and in need of tonification, or that cold has invaded that area and is compromising its function (or both).  Again, we have an association with blood, and I would posit if an upper point were to be associated with the Huang on the Chest, it would be either PC-1 or CV-17.  I wonder if these are the points to which the Chong ultimately ‘scatters’?

Treating the membrane source thus seems to draw on the functions of how qi and blood relate to one another in forming the human body — and possibly also underlies the emergence of shen from the union of qi and blood.  If this process breaks down, the shen departs; thus the importance of using these points in diseases otherwise difficult to cure.

I may have to revisit this post to clarify the concepts under discussion, so any helpful comments about what areas need the most attention to make the logic clear would be helpful.

As always, this post is for entertainment purposes only.  If you feel that acupuncture or Chinese Herbal medicine may benefit you, please contact a qualified practitioner.  Happy Slayage!

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