Goodbye Iowa (Buffy Season 4, Episode 14) Part 1/2


After Maggie Walsh’s death at the hands — or the Polgara spike — of Adam, the Initiative team members go off their usual medication routine.  The result is a set of behaviour changes involving hostility, itchy skin, sudden anger, confusion, and incoherent speech.  Towards the end of the episode, Adam reveals himself to the characters as the cause of Maggie’s death.  Adam seems to be a very articulate and straightforwardly announces what makes him tick:  “Who am I?”  he asks.  “I know what I am, but that does not explain who I am.”  With that announcement, and the sudden appearance of more Initiative men who take Riley away to a military hospital for treatment, Adam leaves the scene.

Drug withdrawal is the obvious diagnosis for this episode, but Adam’s question at the close is more interesting to me.  Therefore, I will split this post into two (as I did with the Ted posts), each with its own particular focus.

Symptoms similar to what the Initiative men were experiencing can be seen when withdrawing from several different types of drugs, including psychiatric medications.  Treatment protocols have been designed to help wean people off drugs, the NADA protocol being the most well known.

The NADA protocol for treating drug dependency makes use of ear acupuncture, a rather modern addition to the acupuncture tradition.  The ear is seen as a microcosm of the human body, inverted into a fetal pose.  The lobe of the ear contains points associated with the brain and head, while the feet and legs are towards the apex of the ear.  Internal organs are in the concha, near the opening of the auditory canal.

The NADA protocol uses five points:  Shen Men, Autonomic point, Liver, Kidney and Lung 2.  Shen men is used for anxiety; the Liver and Kidney associated points reflect their ability to detoxify the body according to the tradition of Western medicine.

The Lung point is an interesting one in that it bridges the Western function of being an organ of detoxification, and the Chinese association of the Lung — because of its link to the po-spirits (corporeal souls) — with addiction disorders.  As Riley stated of Maggie, “There must be something making her act this way.”  From a Classical Chinese viewpoint, that thing is a disordered po.  Proper qi gong technique, or herbs which restrain the qi (e.g. Huang Qi, Wu Wei Zi) are sometimes helpful in such cases.

Drug withdrawal symptoms on the other hand, vary by drug, and Chinese medicine theoretically takes each person’s withdrawal on a case-by-case basis.  In other words, knowing the specific drug isn’t the determining factor for subsequent treatment of its withdrawal symptoms.

In the case of Riley and his men, the mechanism in Chinese medicine involves a stirring of wind (and sometimes dampness) internally, and contraction of wind externally.  Given Riley’s other statements about decreased physical stamina, it would seem that the particular drugs he was on augmented qi and blood.

A Shaolin temple formula I have used with athletes, ‘Harvest the Training Powder’ does precisely that — the chief herb is Dang Gui, which nourishes the blood and invigorates qi. That formula includes Dang Gui as the chief herb, Chen Xiang, Ju Hong, and Hong Hua as deputies, Jiang Xiang, Zhi Qiao, and Tao Ren as assistants.  A similar formula, designed to be taken with rice wine before training includes Shan Yao as the chief, Sheng Di, Bai Zhu, and Huang Qi as the Deputies, Dang Gui, Chen Pi, Mu Xiang, Gua Lou Ren, and Gan Cao as assistants, and small amounts of Xiao Hui Xiang and Chen Xiang, though I would not call them envoys.  Both formulas work on moving the qi while at the same time moistening and nourishing the blood.

Riley has what in Kampo medicine would be recognised as a ‘blood’ body type (Forrest has more of a ‘qi’ body type — leaner and more wiry).  He would therefore have a particular susceptibility to blood empty and blood full disorders; Forrest would have a similar tendency to qi-type disorders.

It seems that in Riley’s case, a diminishment of blood has given rise to stirring of wind.  Herbally, we could treat this either by augmenting the blood and qi with the above-mentioned Shaolin formulas; or by dredging wind, nourishing and moving blood, and generally addressing the Liver.

A formula such as Si Wu Xiao Feng Yin would be useful in this case.  It moistens and invigorates the blood and expels wind-damp (which gives rise to the itchiness Riley was displaying).    Unsurprisingly, it contains a few herbs also used in the training formulae, though with a greater emphasis on moving blood to expel wind.  The ingredients are:  sheng di, dang gui, jing jie, fang feng, chi shao, chuan xiong, bai xian pi, chan tui, bo he, du huo, chai hu, and da zao.

In terms of acupuncture, however, a treatment approach which involves the Stomach may be more appropriate.  The Stomach deals with blood; its heat produces restlessness and irritability; and its associated arm channel, the Large Intestine channel, deals with wind-heat.  If, however, we thought wind-damp might be a culprit, then the ShaoYang channels might be a better place to begin.  In this latter case, we would be addressing the GB with its relationship to the marrow and Sea of Marrow (i.e. the brain and material basis of synthesising the spiritual aspects of the various zang-organs — will, intent, shen, hun, po), and the Triple Heater which has an intimate relationship to the Gate of Destiny (Ming Men).

How would we parse out the difference between the two?  Where is the point to treat the hundred insects crawling under the skin?  (SP-10 — also called Xue Hai or Sea of Blood — and GB-31 both work.)  Is a rash weepy? (Use Shao Yang.)  Is the patient alternating cold and hot, either physically or psychologically? (Again, Shao Yang.)  Do we approach this from a Primary Channel perspective — in which case Yang Ming and ShaoYang are very far apart, and the pathology would be seen as a result of diet — or a Six Channels perspective, in which case the two yang channels follow one another closely?  Finally, if we include  the Po-spirits, residents of the bones (controlled by the GB) and Lungs (paired with the LI via the luo point), then we have another set of points to draw from.

If I were to look at the Stomach channel and its pairs I could select ST-36, ST-37 (LI lower sea point); and either LI-6 (luo point) or SP-10.  From a ShaoYang treatment perspective, GB-31, GB-39, GB-8 all come to mind.  GB-8, the root of the soul is useful for helping people re-orient themselves, while GB-39 treats the marrow, that which exists within the bones — such as the po — while GB-31 is useful for itchiness in general.

As always, these posts are for entertainment purposes only.  If you feel that Chinese medicine could help benefit your exercise programme or help you or someone you love in their struggle with drug dependency, please see a qualified practitioner.  (I can provide recommendations for practitioners specialising in these approaches in Oxfordshire, Boston, and the San Francisco Bay Area.)

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