Shadow (Buffy, Season 5, Episode 8)

The story arc with Joyce continues in this episode when doctors discover a ‘shadow’ in her brain. Much of the episode takes place in the hospital, including a conversation between Riley and Buffy about her not opening up to him. Buffy commented that if she let go, she wouldn’t be able to stop — and other people were depending on her. Riley himself begins to lose control of his own feelings. He goes to the demon bar where he originally met Sandy, a female vampire. Riley allows her to bite him, on the neck, around ST-9. After some blood was taken, Riley seems to re-establish control over his feelings, and stakes her. Sandy therefore gives us the luo-channel to treat in this episode, namely, the Stomach channel.

The trajectory of the ST luo vessel begins at ST-40 (Feng Leng, ‘Bountiful Bulge’), whence one branch travels upwards towards the head and nape of the neck.  There it unites with the qi of the other channels before connecting with the throat below.  The exact meeting point is disputable:  it could meet at Du-14, the lower part of the nape of the neck, where all the yang channels meet; or it could be a bit higher, at Du-15.  If the channel then plunges downward to meet the throat, this could mean it moves to ST-12 — unless it began higher, in which case, St-9 is also a plausible option.

Pathologies of the channel include throat bi if the blood is in counterflow.  This can manifest concretely as an inability to express one’s emotions, feeling like one’s words are not being heard — very much the feeling Riley was having in the hospital with Buffy.  In case of repletion, the pathology follows the usual Yang-Ming exuberant pathology of mania-withdrawal.  Psychologically, this can be as mild as simply feeling that one’s emotions are out of control.  Depletion of the channel only affects the body from the luo-point inferiorly towards the foot, which loses its ability to function due lack of nourishment.  Withering of the lower leg may also accompany such a condition.

Depletion of the blood of the channel said to be full of qi and blood could plausibly occur as the sequelae to a blood-level warm disease, as in the case of bacterial meningitis.  The treatment would be to bloodlet ST-40 (and any broken blood-vessels along the lower limb), followed by moxa.  In Buffy’s case, ST-40 could be moxa’d in order to maintain her control.  In Riley’s case, blood was let along the trajectory of the channel, at the neck; lancing ST-40 seems to have been un-necessary.  It may be that in the case of counterflow, the treatment called for is to bloodlet further along the channel, without needing to bleed the actual luo point itself.  In this particular case, I’m theorising from a television show, rather than from my clinical experience — but I would be interested in hearing the experience of other clinicians.

The use of ST-40 as a luo point raises questions about the intrinsic physiology of ST-40.  The point is most well known for its ability to treat phlegm conditions of all types (which would include phlegm misting the Heart/ mind — carried, perhaps, via the luo-point’s blood as the Yang Ming meridian as full of qi and blood), though in clinical practice, it is most effective for treating phlegm resulting from Spleen qi overwhelmed by dampness.  This is because the luo points help regulate the yin-yang balance between paired channels.  In the case of the compromised Spleen, ST yang is directed towards the Spleen channel to help in its function of transforming yin-dampness.  In the case of mania, however, bleeding ST-40 serves to release heat from the blood, rather than dissolve phlegm from the Heart.

With regard to herbal medicine, Shi Hu is key for regulating Stomach blood.  Shi Hu combines well with Mai Men Dong, but it could plausibly be added to other blood-enriching formulas such as Si Wu Tang.  If using Si Wu Tang in this instance, I would replace Bai Shao with Shi Hu, to maintain the emphasis on ST, rather than LV, blood.  In cases of repletion, however, I would gravitate towards Bai Hu Tang, which goes to the Yang Ming channel and also impacts the blood; in fact, it was used to treat blood-level warm pathogens before that school developed as such.  (For more on the development of the warm disease school as an effort by the Southern Chinese to create an identity distinct from their Northern counterparts, see Hsu (ed.) 2001, Innovation in Chinese Medicine.)

As always, these posts are for educational and entertainment purposes.  If you feel you could benefit from the physiological approaches of Chinese medicine, please see a qualified practitioner.

Happy Slayage!


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