Out of My Mind (Buffy, Season 5, Episode 4)


In this episode we learn about the seriousness of Joyce’s medical condition, as she collapses and is taken to the hospital for treatment.  We also see Spike’s quest to get the chip removed from his brain.  Riley’s doubt about being good enough for Buffy, and the legacy of his time in the Initiative, continue to develop.  Finally, this is the episode which ends with Spike’s nightmare about kissing Buffy.

In case you think this episode is pretty tame from the Chinese medical point of view (despite the brain surgery on Spike and Riley’s heart attack), I would disagree.  What a plethora of pathologies this episode presents!  Everything from nosebleed, syncope, tachycardia and “hyper-adrenal overload”, not to mention brain surgery with local anesthetic, and the rather rarely presented erotic dream.

Where shall we begin?

A simple remedy for nosebleed used in Chinese medicine is a fresh Perilla leaf — Zi Su Ye, also known as Shiso in Japanese — rolled up and inserted into nostril.  Quick and effective.  If anyone has ideas for acupuncture remedies for nosebleed, let me know.

Syncope, we treated in the first episode of this season with Dracula.  Syncope is a similar phenomena to absence seizures, from a TCM perspective.  So I would refer you to Season 5, Episode 1’s post.

Neurosurgery can be performed using acupuncture anesthesia.  In fact, it is this accomplishment which contributed to stimulating interest in acupuncture among the United States’ medical establishment.  The points are usually stimulated with electricity or a beam from a 2.8–6 mW helium-neon laser apparatus (Model CW-12, Chengdu Thermometer Factory) delivered and focused to a red spot on the selected skin point of the patient. In the absence of laser or electro-stimulation, strong de qi sensation from conventional acupuncture suffices.

For those interested in more in-depth reporting on acupuncture anesthesia, I would recommend:  http://jama.ama-assn.org/content/229/10/1317.full.pdf+html (page1320); and http://onlinelibrary.wiley.com/doi/10.1002/lsm.1900040311/abstract

The tachycardia and hyper-adrenal overload bit is more complex.  Usually, rapid heartbeat, assessed by a ‘hastened’ quality to the pulse more than through sheer numerical beats per minute, indicates heat in the system.  In Riley’s case, extreme heat would be present.  Hyper-adrenal overload could be translated into an ungrounded yang qi, perhaps floating kidney fire run amok.  However, the presentation Riley presents is great strength and stamina — thus, something is feeding the Liver’s sinews with plenty of blood and qi.  However, Riley’s presentation is clearly unsustainable, and therefore pathological.  He does not have the yin capability of reigning in the out-of-control hormones circulating through his body.  While hormones of various sorts are considered ye-thick fluids, and thus under the control of the Small Intestine — yin fluid controlled by a yang organ — something in the relation of the shaoyin-taiyang dynamic seems to be amiss.  In particular, I would focus on the Heart-Small Intestine connexion, even more than the Kidney-Heart (shaoyin) or the Triple Heater-Pericardium relationship.  How should this issue be treated?

The treatment goals are to clear fire from the small intestine and build yin fluids to anchor yang.  In particular, we want to assure that Heart yin can withstand the yang energy in the Fire element system of the body.  (Both the Heart and the Small Intestine are fire phase organs.)  Therefore, I would use something which builds Heart yin, such as Suan Zao Ren Tang, with a larger quantity of heat clearing herbs which go to the Small Intestine, like Qu Mai (dianthus amurensis — garden variety Chinese pinks) and Mu Tong (caulis akebia).  I would also add some Zhi Zi, which is very cold in nature, but with a focus on the Triple Heater, in an effort to draw off some heat from the Pericardium.  The Pericardium has the function of clearing heat from the Heart.  If this modified formula does not work (it should induce copious urination), I might consider switching my diagnosis to a Four Levels school of thought, and diagnose heat in the Blood level (moving to the Jing level).  I would give a pill traditionally containing Rhinoceros horn, but which now uses Water Buffalo horn instead (in at least a 10-fold increase in dosage).

In terms of acupuncture, I would regulate the PC meridian at PC-6, aiming to address the blood level first.  I would not treat the yang meridians first, although according to the Ling Shu, pathology enters there initially.  Next, I would bleed the luo point of the Small Intestine, SI-7, to release heat from that channel’s blood level.  If necessary, I might also needle SI-2, the ying-point on the channel, to treat fire conditions and address the fluid component of the channel.   Bloodletting TH-5 would be considered if necessary — that is, if cooling the SI channel enough so that the Pericardium could address the heat was not successful.  Success would be assessed by a decrease in pulse rate.  Note, I would not treat the Heart meridian in this more Japanese style of thinking with the meridians.  Cooling the SI meridian should help balance its relationship with the HT, while the PC-TH should begin to address the pathology of excess heat in the body.  I would follow up with treatment of KD yin and jing in an effort to secure whatever excess heat may still be in the body.  Riley might do well to refrain from losing any jing (i.e. ejaculating) until the heat is entirely cleared from his system.

Since interpersonal relationships and Chinese medicine is part of my clinical interests, I will also mention the question at the end of the last post.  In the previous post, I wondered about how to address the problem of ‘the one for you’ not loving you  back — here we see the response of ‘the one’:   if communication, opening up to someone and becoming vulnerable enough to let you know the ‘one’ more than any other person has already is not good enough, then no treatment will be effective.

As always, these posts are for entertainment and educational purposes only.  If you or a loved one is experiencing tachycardia or symptoms of mania, please see a qualified physician and ensure communication between your biomedical and complementary medicine practitioners. 


Happy Slayage!

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