Chosen (Buffy, Season 7, Episode 22)

The final televised Buffy episode offers a very clear Channel Divergence to treat, one which accesses the last of the Extraordinary Vessels, the one concerned with passing on a lineage, with making choices, with encircling a person’s body into a solitary figure — but one which also brings all that to the surface, changing the form of one’s life through manifesting one’s choices.  Willow opens this channel with magic (and it often seems like magic for an acupuncturist to be able to treat multiple people simultaneously, as most clinicians can attest.)  This post, then, is for Willow.

The Channel Divergence I propose treating in this episode is the Kidney CD.  It’s intimate link with the Dai Mai and other Extraordinary Vessels points to its capacity to access not only to the ‘Prisoners of the Dungeon’ (the Turok-han vampires beneath the seal), but also the physiology which will be passed into the Slayer Lineage.

The episode opens with Caleb coming back to life and Buffy slicing him in two, ‘up the middle’, starting with his ‘external kidneys’.  Buffy quotes the openign lines of the Buffy series, and comes to the realisation that it doesn’t have to be that way:  “one in every generation…  She alone…”

Angel and Buffy then have a discussion about having souls, or specifically, about Spike’s ensoulment.  Buffy admits that Spike is in her heart.  Buffy then returns home.  Alone.

Buffy presents her plan to the Scoobies, a plan which will ensure she is not alone.  It is also a plan which entails Willow going beyond the darkest place she had ever been.  Later in the episode, we will see Willow come out the other side, having gone through that darkness, to a place of light.  The Potentials, too, will have to make a choice.  They go to the Hellmouth, and collectively feed their blood to the seal, opening it.  The non-potentials — Dawn, Xander, Anya, Giles, Principal Wood — stay above ground.  Dawn delivers a potent line to Buffy before she enters the Hellmouth:  “Anything you say will sound like good-bye”.  Dawn then walks away.

Descending into the depths while Willow casts her spell, they wait for their transformation into Slayers.  Willow’s spell succeeds.  A great battle ensues, culminating in Spike’s redemption and the collapse of the Hellmouth.  (The collapse of the Hellmouth incidentally disrupts the Scoobies’ plans for what to do after the battle.)

The final lines of the episode contain food for thought in reference to the KD CD:  “We changed the world.”  “We’ll have to find them [the new Slayers].”  And perhaps most importantly, when using the Channel Divergences of Acupuncture for self-transformation, Buffy says:  “Make your choice:  are you ready to be strong?”

How exactly does this episode relate to the Kidney Channel Divergence?  After all, it is usually used for deficient yin conditions from overwork (“lao taxation”) and adrenal exhaustion (a condition in which too much yin has been transformed into wei qi).  Those familiar with the ‘kidney return’ protocol will note that it uses selected points on the KD CD.  Symptoms include empty fire, which is a loss of jing giving way to heat.  The trajectory of the Kidney CD will illustrate my argument more fully:

The channel diverges from the primary Kidney meridian at KD-10, near the knee.  A he-sea or he-uniting point, this point homes to the Kidney organs.  A little known effect of the point is its usefulness in treating mental disorders.

From KD-10, the channel moves laterally to link up with the confluent point of the BL-KD Channel Divergence at BL-40.  BL-40 is the end of a third trajectory on the Bladder Meridian, originating at Du-4, moving outwards towards the lower inner bladder line (to encompass the shu points of the LI and SI) and down towards the knee.  This is one reason why BL-40 is particularly effective in treating low back pain:  it connects directly with the low back.  In combination with Du-26, the entire spine, including the marrow it houses, is affected.  (As a side note, Du-26 also treats mental disorders.)

From Bl-40, the channel follows the BL divergence pathway, passing through BL36 on its way to Du 4.  BL-36 and DU-4 both relate to the ability to stand upright, or as Buffy phrases it: “Can stand up, will stand up.”

From the Du Mai, which some readers may recall is the Extraordinary Vessel of individuation and going-out into the world to meet one’s destiny (Du-4 is called ‘Gate of Destiny’), the Kidney divergent channel then homes to the Dai Mai via BL-23 and BL-52, the shu points of the Kidneys and Will, respectively.  Physiologically, the movement to the Dai Mai allows the channel divergence to move pathogens to the last of the EVs:  wei qi using yuan qi to store or create latency.  The kidney uses fear or cold to repress pathogen, especially fear of dying, thus limiting potential of yuan qi.  It is the ‘dungeon’, reserved for prisoners who couldn’t be killed (due to status, position, lineage, family relations, etc).  Yet the next point in the channel, BL-52, is the gate of will, where one overcomes fear and cold and can make one’s choices.  In a way, this is also the point of a ‘will-within-the-will’, a situation in which a person is acting for one set of articulated reasons, but is actually responding to a much larger, more extensive set of choices about his or her life.  “Make your choice.”

Following the Dai Mai, the KD Channel Divergences goes to GB26, SP15, ST25, KD16, and CV8.  If the Kidneys are a dungeon, the Dai Mai is a closet, into which pour all the unresolved emotional and physiological work entrusted to a particular lineage to work out.  The Dai Mai is the means to transmit a factor to one’s future lineage to work out.  Physiologically, it helps let go of things person is not conscious of (wei qi is not conscious), often by invoking the qualities of the Gallbladder to help let go of fearful, repressed emotions, the baggage we have difficulty letting go of.  It sets the prisoners of the Kidney free.  “Anything you say will sound like goodbye.”  In patients with a KD CD pathology, the Dai Mai reflex area of the hara is often full or filling.

The KD Channel Divergence pathway then follows the primary KD Channel trajectory on the abdomen, which is actually the Chong Mai trajectory.  The KD CD thus accesses the ‘Gate of Destiny’, brings that individuation through the elements of life which need to be resolved, and transmits them within the person to the EV which contains the blueprint of one’s lineage.  It allows all that hidden fear and baggage to meet the emotions for resolution.  The Chong Mai, as both the sea of blood and sea of the 12 channels, is intimately concerned with the full range of human emotion.  “How does it feel, B?”  This is also where the pathophysiology can move from consuming jing to consuming blood in an effort to keep a pathogen latent.  From consuming the attention of one’s life, to sucking up emotional energy, certain pathologies move more deeply into the body.

From the Chong Mai and KD primary channel points, the KD CD moves to CV23 and the Root of the Tongue, having passed through the Heart.  CV-23 is a Yin Wei Mai point, and concerns both continuity — in the case of the Potentials, their continuity with the Slayer lineage, which is their destiny, and all the history and mystery inherent in that lineage — and integrity: how the person remains who they really are in the face of challenges presented by life.

From CV-23, the KD CD then moves along the Jawline.  How does a person integrate experiences into her life?  The jawline is where one can see how a person chews on, savours, and assimilates experiences.  It is also a final place for deposit a pathology:  the teeth hold latent pathogens.   (If the tooth is removed, pathogenic process may still continue, and move to affect the throat.  Gua sha ST5 area, SCM, if this portion of the CD is diseased.)  “I want you… to get out of my face.” (Or “a nice, wholesome, my person has a pierced tongue sort of way”)

From the jaw line, the Channel Divergence moves backwards to BL-10, which connects yin to the head via marrow at lower border of skull.  “It’s bloody brilliant.”  BL-10 is also a Window to the Sky point, and as such draws things up from where they’ve lain buried to the light of the heavens, much as Spike brought light from the ‘trinket’ to the Turok-han.  “Spike”

Treatment would be three-time needling, shallow-deep-shallow, as we want to bring up the slayer-essence latent in each potential.  However, instead of doing a strictly ascending, or even a looping technique (in which one begins with KD-10 on one side, moving to BL-10 and then down the other side, to exit at KD-1 or BL-67), I will take a tip from Spike, and bring the light of a WTS point to a Doorway to the Earth point, and then move in an ascending direction.  Thus, I will begin on the left side with BL-10 and move downwards towards KD-10; then I will move to the right side and begin with KD-10, moving upwards to the nape of the neck.  The idea is to bring the idea to the depths of the person, and draw out what is needed to make that realisation an actual reality.

From here, follow treatments with either the Dai Mai or Chong Mai will help ground the person in her or his new identity.  KD CD treatments combine very well with Dai Mai and Chong Mai treatments, as can be seen from the trajectory of the KD CD.

In terms of Herbal Medicine, many formulas can be used to augment jing.  As for envoys, several herbs go to the Dai Mai and other EVs, but Wu Zei Gu goes to the Dai Mai exclusively (and not to other EVs); to bring the formula outwards to the TaiYang level, Hua Jiao goes to the middle to disperse cold (but homes to the KD channel), and Gao Ben raises qi to the vertex.  Both herbs would be good additions to a martial arts training formula like Jin Feng Jiu, which increases jing and quiets restlessness.  Jin Feng Jiu is composed of equal portions Sheng Di, Shu Di, Dang Gui, Mai Dong, Di Gu Pi, and Yin Yang Hua, with one-half a portion of Sha Ren.  Grind or use whole to make wine, steeping the ingredients for two or three months first.  (Guard the body from losing jing while taking this formula; this is especially important for men.)

* * *

So this completes my series of posts on Buffy the Vampire Slayer and Chinese Medicine.  I originally began this exercise simply because I needed a way to keep my diagnostic skills up between my graduation from acupuncture school and being allowed to practice.  I also wanted a forum for presenting some of the more obscure, ‘superstitious’ aspects from the history of Chinese Medicine out into the world.

I hope you’ve enjoyed reading these posts as much as I’ve enjoyed composing them.  As always, the posts have been meant for educational purposes only.  If you or another person feel you could benefit from the perspective of Chinese Medicine, please see a qualified practitioner.

Finally, all medicine, but Chinese medicine in particular serves a single purpose:  to relieve unnecessary suffering so that individuals can return and live out their lives.  The final line of the series puts this nicely:

“You’re not the one and only chosen one now.  you’ve just got to live as a person.”

Happy Slayage.

Jason Scott Johnson
2013, September 29.
Michaelmas Day.

 

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Help (Buffy, Season 7, Episode 4)

Welcome to Buffy’s first week of actually interacting with the students! In this episode, we are treated to a variety of student problems, from the real and serious (a student whose older brother has joined the Marines during the US-led invasion of Iraq in 2002) to the surreptitious (a student who says he thinks he’s gay proposes that Buffy go on a date with him to disprove his feelings) and the amusing (Dawn sees her counsellor to complain how Dawn’s older sister steals her clothing). The principle focus, however, is on Cassie, a beautiful girl who writes poetry, creates art, speaks eloquently, and has a sincere presence. She also ‘knows’ things, and something she knows is that she will die the following Friday. The rest of the episode sees Buffy and the Scoobies trying to untangle the mystery of how she’ll die.

(Willow uses the term ‘pre-cog’ to describe Cassie, a reflection of high school and college abbreviation of terms like ‘pre-cal’ for pre-calculus, or here, ‘pre-cognitive’. However, I like to think of the term as being analogous to Pink Floyd’s ‘Brick in the Wall’ — a ‘cog in the machine’. Cassie is ‘pre-cog’ in that she hasn’t been molded to fit the machinery of society yet.)

Unfortunately, although Buffy manages to disrupt a demon-summoning group of students, and even catches a crossbow bold before it strikes Cassie, Cassie still dies. It turns out a heart condition ran in her family. The final scene shows the Scoobies on the couch, mourning the death of this beautiful girl. Buffy asks the question, ‘What do you do when you can’t help?’

That will be the topic of today’s post. How does Chinese medicine know when it cannot help, and what does the practitioner — or patient — do then?

First, I want to stress that this post is not about how Chinese medical practitioners know when to refer their patients to biomedical or other medicine practitioners for treatment.  Rather, the focus is just within the scope of the Chinese medical tradition’s diagnostic and prognostic paradigm.

In some medical traditions, learning how to identify what diseases and conditions can be treated and which are terminal is the first lesson a medical student studies.  The quintessence trantras of Tibetan Medicine, for example, put it as the second lesson, after a cosmological introduction to the medical tradition.  (‘The whole world is a garden of medicine if prepared properly’, is the short version of that cosmology.)  Chinese medicine, though, has its references to death as a prognosis scattered throughout its medical texts.  In general, however, the the patient’s pulse, hara, and shen tell the practitioner whether the patient will live or die.

The most commonly understood pulse pattern indicative of death is a separation of yin and yang.  This happens in terminally ill patients as they approach their final days.  However, Cassie would not have had such a pulse; rather, in her case, the Heart or Pericardium pulses would have felt different.  In Contemporary Chinese Pulse Diagnosis, an area on the wrist just to the side of the HT pulse is related to diagnosing the quality of the heart valves.  The practitioner in this case, could make note of it, send the patient for biomedical measurements, and then work as part of a team to address the underlying issue.

With hara diagnosis, even if a patient has stopped breathing or is turning blue, if a stirring near the umbilicus can still be felt, there is hope the patient will live.  The ‘moving qi’ between the kidneys is still active, and can still deliver the necessary qi to the organs and spirits of the patient.  If this moving qi is absent, the prognosis leans towards death.

The shen, or affect, is also a means for assessing whether a disease can be treated.  If the shen and qi does not correspond to the patient’s bodily form, the Jia Yi Jing states, the prognosis is death.

So what happens if the patient is going to die and medicine can not cure them?  Is there nothing medicine can offer besides pain-killers?  (As a side note, Chinese Medicine avoids the use of opiates as pain-killers, and instead relies on qi moving medicinals like Yan Hu Suo, Wu Ling Zhi, and San Qi, none of which impair mental functioning.)

In Cassie’s case, she is resigned to dying early; but this does not mean she gave up on living, nor did she try to rush her life experiences before their proper time.  In a moving monologue, Cassie tells Buffy that Cassie would like to fall in love, go backpacking, see the Mona Lisa… but she knows it will not happen.  She knows she must live her life as it comes to her, and right then, she was in high school, dividing her time between her parent’s houses.  She was cultivating the life she had then.  Her self-cultivation took the form of introspective poetry, expressive artwork, and an online gallery in which to feature it.  She cultivated a world that would outlive her.

As I’ve mentioned earlier in these posts, the highest calling of Chinese Medicine is on the cultivation of destiny.  If a technique allows a person to continue completing their relationship obligations to family, to themselves, and to the world; if it helps them honour or hone their talents, even when life is ebbing away, Medicine still has a place.  For many, that place is called hospice care.  Acupuncture has a place here.  Points used to comfort the dying include BL-62, CV-17, Yin Tang, and Du-23.  PC-6, HT-5, and LU-7 are also useful to open the heart and free the tongue, to work through grief into acceptance.  ST-25 (Heavenly Pivot) and various Kidney points are also commonly used to move the metal-qi of death into the stillness of water.

In the past, most people died through the metal meridian:  Lung conditions and Large Intestine (dysentery, cholera) conditions were rampant.  Now, people die through other meridians, often HT and PC for men; PC and LV for women.  Following five-phase and six-channel theory, expression through Tai Yang and out into the world (and proper closing off of some outer-worldy factors), or a movement to experience joy would be recommended for PC and LV cases (as, for example in various gynecological cancers).  A gathering to earth and society is the energetic movement to aim for in cardiac cases.  This was how Cassie herself achieved the serenity — a sad serenity, to be sure — that she did.  She focused on friends, even when she knew some, like Dawn, had initially become friends with her just to keep an eye out or get more information.

It is the role of the practitioner to know and understand when each of these movements is the next step on the patient’s path, and to arrange for support in guiding the patient there as necessary.

As always, these posts are for educational and entertainment purposes only.  If you or a loved one feel that Chinese Medicine may provide a means to helping make peace with life and death, please see a qualified practitioner.

Normal Again (Buffy, Season 6, Episode 17)

This episode begins by picking up with some fall-out from the previous episode.  Xander appears at Buffy and Willow’s door, and Xander makes a speech to his friends that perhaps anyone ever left by a man might want to hear.   The, of course, the plot thickens.  Buffy is stuck by a demon whose venom causes her to shift in an out of consciousness.  Or rather, she shifts between two different conscious states, each with its own plotline: Buffy-the-Slayer in the Buffyverse and Buffy-Institutionalised-in-Los-Angeles in a real-life setting.  Willow makes a diagnosis after giving Buffy an antidote (which unbeknownst to Willow, Buffy poured out beside her bed):  ‘Buffy, you’re brain is cooking’.

The question, of course, is whom should we treat?  Who is the ‘real’ Buffy?  The institutionalised Buffy or the Slayer Buffy?  And how do the sinew vessels interact with psychology?

Let’s start with herbal medicine treatments, first. Willow seems to think that Alkanet root and Nettle leaf would make an effective remedy.  Alkanet is typically used for making dye, although Culpepper notes it can be made into an ointment and used to treat inflammations and St Anthony’s fire.  St Anthony’s fire can refer to several different modern diseases, but in Britain, it tended to refer to inflamed skin conditions which Chinese medicine might characterise as fire toxins in the blood.  Nettles are well known in European herbalism for their blood purifying properties.  It can be made into an ointment with myrrh, and is said to open the pipes of the lungs to expel phlegm.  Culpepper notes that both Alkanet and Nettles are good antidotes for stinging creatures.  This may be the reason for Willow’s choice of these two herbs in particular.  (For the curious, see http://complete-herbal.com/culpepper/nettles.htm and http://botanical.com/botanical/mgmh/a/alkan024.html for more information. )

I personally would favour Wang Qing Ren’s formula, Decoction to Wake from the Nightmare of Insanity, Dian Kuang Meng Xing Tang. Its ingredients include:

Tao Ren (Semen Persicae) 24g
Gan Cao (Radix Glycyrrhizae Uralensis) 15g
Su Zi (Fructus Perillae Frutescentis) 12g
Chi Shao (Radix Paeoniae Rubrae) 9g
Chai Hu (Radix Bupleuri) 9g
Da Fu Pi (Pericarpium Arecae Catechu) 9g
Chen Pi (Pericarpium Citri Reticulatae) 9g
Mu Tong (Caulis Mutong) 9g
Sang Bai Pi (Cortex Mori Albae Radicis) 9g
Ban Xia (Rhizoma Pinelliae Ternatae) 6g
Xiang Fu (Rhizoma Cyperi Rotundi) 6g
Qing Pi (Pericarpium Citri Reticulatae Viride) 6g

Wang Qing Ren’s formulas are noted for treating blood stagnation, and this is one of at least two formulas for treating blood stagnation in the head, particularly when that blood stagnation obstructs the orifices.  (The other formula is Tong Qiao Huo Xue Wan.)  In this respect, both Willow and I agree that some agent has caused an obstruction in the orifices, leading to heat.  Willow suggests phlegm, and this formula also drains phlegm.  However, this formula has a very strong effect on blood stagnation due to the high dosage of Tao Ren — it ‘purges’ or ‘breaks’ blood stagnation to open the orifices and clear heat.  It also contains qi moving herbs to transform phlegm.

The formula has been the subject of several studies for the treatment of mental illnesses such as schizophrenia.   For those interested in how Chinese Medicine treats mental illness, check out this article by Heiner Freuhof:  http://sinimed.co.il/documents/info2/pdf/treatment%20of%20mental%20disease%20by%20heiner%20fruehauf-JCM.pdf

Regardless, giving this formula to both or either Buffy will resolve the dilemma of which Buffy, which universe, is ‘real’.

In terms of acupuncture, for a sinew treatment, I would select the Arm Tai Yang (SI).  This channel is indicated when the eyes have been closed a long time before being able to see, according to the Jia Yi Jing (Scroll 2, Chapter 6).  The channel begins at the little finger and travels up the arm to the scapula, levator scapula muscle, and on either side of the ear, ending at the outer canthus of the eye.  Treatment should particularly focus on opening Du14 and the Window to the Sky points on the neck, before proceeding to palpate the channel for sore points.  These points should then be treated with either a hot-needle or with thread moxa.

That treatment may not touch Willow’s diagnosis, however.  Her diagnosis of a brain being ‘cooked’ reminds me of brain fever, a sensation which used to be experienced by people dying of AIDS in the 1980s and early 1990s.  That condition could be seen as wei qi consuming marrow or invading the jing level.  For that, the Channel Divergences are most appropriate.  However, both the Arm Tai Yang and the Foot Shao Yang sinew vessels meet at the outer canthus.  Since the Foot Shao Yang sinew vessel connects to the Gallbladder primary channel, I might consider needling GB13 (Ben Shen), GB11 (Tou Qiao Yin), GB19 (Nao Kong), GB 39 (Shu for Marrow) in order to draw out the wei qi from the jing, and then direct that qi outwards along the sinew vessels by needling with stone needles at the sore points, before closing with threat moxa at SI1.

Another place of intersection for the both the GB and SI meridians is at SI-17, formerly located on the GB channel.  SI-17 functions as the Window to the Sky point for the Gallbladder channel, and thus has a particular influence over the marrow, brain, and shen (due to the SI-HT-shen connexion).  Cupping that point, perhaps with some bloodletting, may be effective at bringing wei qi to the surface in cases where a person’s shen is disoriented and harassed by heat and blood stagnation affecting the orifices.

The physiology of the above treatments rely on the role wei qi plays in ‘automatic’ perception.  It’s role in the brain is to bring external information inwards, but without conscious integration; that integration and storage is the role of the marrow, which is the union of jing and shen, experiences and character (the ‘real’ meeting the ‘ideal’ which creates a person’s ‘destiny’ in life).   When wei qi usurps the role of the clear yang of shen, a loss of lucidity ensues.  When shen cannot link with jing because wei qi has taken that place, the union of wei qi and jing causes brain fever.  This heat stagnates and consumes the very yin marrow.  Invigorating blood and clearing heat are therefore called for.

 

A third option would be the Tai Yang connexion of SI and BL channels.  While the SI sinew vessel ends at the outer canthus, the BL primary channel emerges at BL-1, which is where wei qi exits the body after its interior passage at night.  This leads us to consider the Extraordinary Vessel treatment appropriate for Buffy:  A Yin Qiao- Yang Qiao combination.  The Qiao Mai deal with how people consciously see things.  The Yin Qiao is inward looking:  How does Buffy see, or want to see, herself?  The Yang Qiao is how Buffy sees the world.  The two need to be connected and harmonised.  Therefore, needle KD-6, begin with the Yin Qiao, then BL-1, and close with BL-62.  BL-62 is called ‘Shen Mai’, the ‘extending vessel’, and is known for its ability to clear the shen-spirit.  (The character for ‘shen’ in the point name is different from the character ‘shen’ meaning ‘spirit’ or ‘habitus’.)  This treatment would need to be carried out over the course of 3 or more months, and while it may help ease Buffy’s cooking brain, is more geared to reorienting her to the world and her destiny in both worlds, the inner and the outer.

As always, these posts are for entertainment and educational purposes only.  If you or a loved one wish to explore Asian medical treatments for mental illness, brain fever, and integrating the interior life with external demands, please see a qualified practitioner.

Happy Slayage!

No Place Like Home (Buffy, Season 5, Episode 5)

In this  episode we discover that Dawn is not really Buffy’s sister.  While that does not make Dawn ‘unreal’ — she is certainly real, and sought after — it will add a layer of complexity to future treatments involving Dawn.  We also watch Buffy find a glowing orb and have her first encounter with Glory, the exiled goddess who just wants to go home. Meanwhile, Buffy’s mother continues to have headaches — this time, Joyce comments, the initial headache brought along some friends.

What Joyce seems to be describing is a cluster headache, more common among men (it is nicknamed the ‘male migraine’), although we know the cause is due to her brain tumour(s).  Just as biomedicine has a few types of headaches — cluster and migraines among them — so also in Chinese medicine is a headache ever just ‘a headache.’  Most Chinese medical practitioners are not going to tell a patient to ‘take two and call me in the morning’ if they phone in with a headache, precisely because even mild headaches in Chinese medicine fall into one of several categories.  Instead of ‘take two’, a few questions will be asked, typically beginning with ‘where is the headache located’.  This may be followed by, ‘what sort of pain is it?’  Finally, a few questions about associated symptoms may be discussed:  ‘Are you feeling cold?  Do you have tight neck and shoulders?  Sore throat?  Did you wake up groggy?  Are you nauseous?  Is your urine bubbly?’

The various types of Chinese Headaches are well known by practitioners of Chinese Herbal Medicine, because certain herbs are prescribed depending on the location of the pain.  Studies into the receptor proteins for the active compounds of these herbs, and the particular tissues in which those proteins are located, may give some clue to the biomedical genesis of various types of headaches.  Of course, then the public would need to be educated to describe their headaches by location, pain, and associated symptoms.

Headaches defined more by location of the pain include TaiYang, YangMing, ShaoYang, jueyin, and Du Mai.  These are regions of the head through which the associated channels pass.  Note:  the associated herbs are never given alone, but only in combination with other herbs to alleviate associated symptoms.

TaiYang headaches are felt around the occiput and back of the head, as the TaiYang channel passes from the thoracolumbar aponeurosis upwards along the erector spinae muscles, over the cranial aponeurosis and to the top of the orbital ridge.  To treat a TaiYang headache, use Qiang Huo

Yang Ming headaches are your typical sinus headaches:  cheekbones, above the eyebrows, perhaps part of the jaw.  They cluster around the Stomach meridian, which travels from the toes up the leg, the rectus abdominis, SCM, and encircles the jaw and travels upwards along the sides of the nose to the inner canthus of the eye.  For Yang Ming headaches, use Bai Zhi

ShaoYang headaches are the headaches experienced at the temples, on the side of the head.  These are the most common types of headaches seen without symptoms associated with colds or sinus infections.  For these cases, use Chai Hu.

JueYin headaches are orbital headaches — around the eyes, between the eyebrows.  The herb which used to be used was Xi Xin; it must always be combined with ginger to reduce its toxicity.  It must not be given to patients with compromised kidney function (kidneys in the biomedical sense of the term).  ONLY THE ROOTS AND RHIZOME OF XI XIN SHOULD BE USED.  The aerial portions are high in aristolochic acid.  For more information, see this paper:  http://www.ncbi.nlm.nih.gov/pubmed/18693102

A headache at the top of the head only is a Du Mai headache.  The Du Mai, or Governing Vessel, passes along the spine from the tip of the coccyx to the middle of the upper lip.  For such a headache, use Du Huo.  Qiang Huo and Du Huo are often combined because of the geographic overlap in types of headaches they treat.

Often, headaches are associated with the common cold.  The common cold is also divided into several types in Chinese Medicine, characterised by whether the accompanying symptoms are ‘cold’ or ‘hot’ in nature.  Being relatively superficial in nature, rather than an internal issue with the body’s overall physiology, these diseases are classified as ‘external wind’ — wind being the element of change which disrupts the body’s external defences.  (Think of sleeping in a cold draft and waking up with a stiff neck.)  Jing Jie is a good herb for any external wind invasion.

Wind-cold invasions are the typical cold which begins with slight aches, slight runny nose, no change in tongue coating.  Gui Zhi Tang or Ma Huang Tang are commonly prescribed for these conditions, depending on the constitution of the individual.  A strong, hardy person is given Ma Huang Tang, a less robust person who tends to exhaust easily is given Gui Zhi Tang.   For tight neck and shoulders, use add Ge Gen (Kudzu root).  For headaches caused by a clenched jaw, add some Tian Hua Fen.  A simple herbal formula for TMJ that I use is Shao Yao Gan Cao Tang, with 3 – 5 g Tian Hua Fen (Gua Lou Gen) added as an ‘envoy’ or carrier herb.

Wind-heat headaches see the tongue coat become slightly yellow, the patient feels hot (although objective temperature may not be raised), and the throat is a little sore.  Light, floating herbs work well here.  Ju Hua (Chrysanthemum flower), Bai Ho (Chinese Mint), and Jin Yin Hua (Honeysuckle) all work well.  If the headache foreshadows a cold, adding some Da Qing Ye or Ban Lan Gen is not a bad idea.  Ge Gen can also be used in cases of wind-heat.

Wind-damp invasions lead to a sense of a heavy head, difficulty concentrating, thick white or slimy tongue coating, and bubbles in the urine (although bubbly urine is also indicative of internal dampness).  Fang Feng is used in this case; for internal dampness causing grogginess, Bai Zhu and Fu Ling are often useful, perhaps with some Bi Xie added to maintain physiological fluids while draining out pathological ones.  See ‘nobose’ below.

Finally, other symptoms reflect fluid physiology in the body:

A sharp pain is indicative of blood stagnation – Chuan Xiong is the best herb here.  Chuan Xiong is, in fact, useful to use in nearly all types of headaches.  Because it moves blood, it also helps expel external wind.  Its properties can be modulated to treat either wind heat or wind cold conditions, depending on the other herbs with which it is combined.

Nobose (fluid counterflow) is a pathology known in Kanpo, Japanese herbal medicine.  Reversal of the ordinary flow of fluids in the body, particularly when the fluids have become cold due to a lack of yang transformation can result in migraines.  The Japanese might prescribe Wu Zhu Yu Tang to treat migraines, rather than a Liver Qi moving herb.  For some schools of Kanpo, the key aspect of migraines is the extreme pain which is a symptom of cold damage.  The treatment principle is to warm the fluids, which will restore their natural flow in the body.

Qi stagnation causes dull pain.  Most often qi stagnation type headaches are assigned to the Liver, although what ‘Liver Qi Stagnation’ actually means is rarely described in detail in the classroom.   One function of the Liver in the body is to harmonise wei qi and ying qi.  When the Liver is weak, the relationship between external wei qi and internal ying qi is disrupted, leaving the body vulnerable to external wind invasions.  Gui Zhi Tang, because it contains the herb pairs gui zhi-bai shao and da zao-sheng jiang, harmonises wei qi and ying qi.  As such, it is a representative formula for proper Liver physiology.  A closer look at the flavour components as defined by fragments of the Tang Ye Jing Fang support that idea.  (I have written about this earlier, but if you want an elaboration, please ask for one in the comments section.)

Acupuncture treatments for headache also vary by type of headache.  LI-4, He Gu, is the most common point used to treat headaches, but TW3, between the middle and fourth fingers, can also be used.  SI-3, which opens the Du Mai, is another single point which is useful.  Many hand points, in fact, are useful for treating headaches; but so are a few points on the feet:  LV-3, ST-44, GB-41.

In Joyce’s case, knowing what else is going on, I would use either GB points exclusively, or I would use SI-3, points along the Du Mai, GB-13, and GB-41.  (The Gallbladder meridian runs along the side of the head, but is also associated with the brain itself; the Du Mai penetrates the brain.)  A more innovative approach would be to needle LV-1 (to activate the entire channel), DU-20 (the end point of one branch of the Liver Channel, at the top of the head), and LV-6, the xi-cleft point of the LV.  Xi-cleft points are recommended to treat pain.  LV-6 is particularly useful for pain experienced when recovering from hepatitis.  It clears heat and re-establishes proper circulation between qi and blood.  In Joyce’s case, it should ease both sharp and dull pain.

As always, these posts are for educational and entertainment purposes only.  If you feel Chinese Medicine may benefit you in helping ease your (physical) headaches, please see a qualified practitioner.

Happy Slayage!

Real Me (Buffy, Season 5, Episode 2)

In this episode three characters feel out of place.  Dawn is the central focus, and she is explicitly told by a crazy person on the street that she does not ‘belong’ ‘here’.  Tara, an outsider by virtue of the fact she was not in the first three seasons, spends some time with Dawn, sharing her own sense of not being part of the group either.  Finally, Harmony has a crisis of confidence (that is the only way to put it, really) and attempts to form her own little vampire coven with the explicit aim of killing her former high school classmate, the Slayer.

I’ve already addressed how to become more comfortable with oneself (Halloween, Season 2) using acupuncture and herbal medicine , so here I’m going to nuance the diagnosis and see how acupuncture might be used for self-confidence (Harmony, Dawn).  In terms of herbal medicine, I will look specifically at herbs  for finding one’s inner core — something Harmony eventually finds in the Angel series, after attending a life-coaching seminar for vampires.  Clearly, one can develop oneself through many modalities.

To gain insight into the physiology of having a core identity, I will look at the herbal tradition first.  According to the Divine Farmer (Shen Nong Ben Cao), the following eleven herbs help supplement or nourish the centre, often understood to mean the spleen.  However, ‘the centre’ (‘zhong‘) can have a broader meaning as well, including the gathering qi of the chest, the heart, and the stabilising pivot around which all other physiology moves.

The herbs include:  Ling zhi (but only ci, red, and therefore associated with the Heart);  Shan Yao (commonly used today to tonify qi, nourish the yin and Kidneys, and to bind the jing; the property of consolidating one’s essence is particularly important in anchoring one’s sense of self, or more specifically one’s sense of will to move through the world);  Ba Ji Tian (said by Shen Nong to warm the Liver, that is, to move it out of a state of contraction and into the world; Ba Ji Tian also tonifies the Kidneys, fortifies the yang, strengthens sinews and bones, and disperses cold-damp);  Bai Hao (more commonly known as moxa, one of the most yang plants); Di Fu Zi (which clears heat, eliminates dampness, promotes urination, and stops itchiness — implying that it can eliminate external wind or boost wei qi); Mai Men Dong (particularly noted to treat a damaged centre, nourish yin and Stomach; moisten Lungs, generate fluid, clear Heart); Sha Shen (clear LU heat, moisten LU yin, nourish ST, generate fluid);  Zi Cao (used to cool blood, invigorate blood, vent rashes);  Xuan Fu Hua (descend rebellious qi, expel phlegm, stop vomiting);  Du Zhong (said to supplement the centre ‘because it can make yin abundant’; more commonly used today to tonify Liver and Kidneys, strengthen sinews and bones, and calm the fetus);  Nu Zhen Zi (perhaps the most important of the eleven, it will nourish and tonify Liver and Kidney yin, and enhance visual acuity).

One formula which contains several of these herbs is from the Tang Dynasty Qian Jin Yao Fangby Sun Si-Miao, namely, Wu Bi Shu Yu Wan, or Wu Bi Shan Yao Wan.  This formula warms the yang and nourishes essence, while also nourishing the yin.  The twelve ingredients include only three from our list, but substitutions can be made for two additional herbs.  I would suggest substituting Chi Shi Zhi with Ci Ling Zhi, relying on the similarity in colour (perfectly reasonable Tang dynasty logic).  Nu Zhen Zi can be used as a substitute for Niu Xi or Tu Si Zi, while Mai Men Dong can replace the Sheng Di Huang if heat is not present.  Overall, this is a much larger formula than I am accustomed to prescribing.

If I were to reduce the formula to three or four herbs, I would go with Du Zhong, Shan Yao, Nu Zhen Zi, and Sha Shen.  Such a formula is heavy on the Kidney tonification, but also addresses wind (i.e. physiology and personhood confronting environmental change) and fluid balance.  If the Liver or Ming Men needed warming, I would add the Bai Ji Tian.  Looking ahead at how the pathology or treatment may progress, Gan Mai Da Zao Tang tonifies the ying qi; while Gui Zhi Tang will harmonise any resulting imbalance between the wei qi and ying qi.

The statement about how Du Zhong supplements the centre is important for understanding the physiology of ‘the centre’:  The centre relies on yin, yet a yin which can move outwards into the world.  Philosophically, yin is the solid, slow moving, thick, and gathering substance of the body.  Gathering is the movement  of the earth phase in particular, though one could also think of the movement as a pooling, in the sense of water pooling before it springs out of the earth.  This movement is different from the inward moving metal.  Though one could make an argument that that inward movement is also yin in nature, in comparison to outward moving medicinals which are yang, the eleven herbs seem to relate more to the moment when stillness has been reach and is ready to erupt, yin about to become yang.

Another aspect to note about these herbs is the association with Kidneys and Spleen.  The spleen stores ying qi, the kidneys store essence.  These two yin substances may be implicated in the centre in ways which blood (stored in the Liver), sweat (the fluid of the Heart) and thick fluids (governed by the Small Intestine), and thin fluids (of the Large Intestine and Lung) are not.  What differentiates ying qi and jing from these other substances?  Simply put, together they give rise to the form of the body.  Jing qi is the template according to which ying qi will pattern itself in the formation of the limbs and channels of the body.  As that which forms the exterior body, jing and ying qi are the centre of human physiology.

In terms of acupuncture, I would note that the he-uniting points, where the qi of a channel plunges into the interior, are either water- or earth-associated points — earth associated on yang channels, because heavenly yang seeks earthly yin; water on yin channels, because yin must pool before it can spring upwards with wood-like yang movement.  I would therefore suggest using a he-united point treatment on our patients.  The he-points are said to treat organ-disorders as well as problems with qi counter-flow.

What channels shall we choose for the treatment?  I would suggest using LU-5 and SP-9, both on the taiyin channel.  Taiyin opens from the interior outwards towards the exterior.  It is responsible for bringing yin nourishment to the form of the external body.  It thus serves a function similar to what the eleven herbs noted above tend towards doing.

As always, these posts are for entertainment purposes only.  If you feel you could benefit from the traditions within East Asian medicine, please see a qualified practitioner.  Happy Slayage!

Buffy vs Dracula (Buffy, Season 5, Episode 1)

Dracula seems to have everyone in his thrall in this first episode of season five.  Xander fully succumbed to the Master’s powers, and even Buffy seems taken in by his foreign charm.

From an outside perspective, if one doesn’t believe in Dracula’s powers, it merely seems that everyone has suddenly developed mild epileptic seizures. Unlike grand mal seizures, characterised by violent shaking and unconsciousness, petit mal seizures seem quite benign and unremarkable: the person having one simply seems to have ‘zoned out’.  Because of this, such seizures are sometimes called ‘absence seizures.’  (Schoolchildren experiencing one of these seizures may be accused of daydreaming or not paying attention in school.)

What might I suggest to counteract this insidious power of Dracula over Buffy and the Scoobies?  Can acupuncture or herbal medicine offer any help?

The formula Chai Hu jia Long Gu Mu Li Tang has, in fact, been used to treat epilepsy in Japan, and several Kanpo practitioners have claimed cures after a round of treatment by this formula or the similar Xiao Chai Hu Tang jia Gui Zhi jia Shao Yao Tang (Otsuka 2010, trans. de Soriano and Dawes, p72).

Chai Hu jia Long Gu Mu Li Tang focuses on relieving constraint of yang qi through venting the yang channels exteriorly and draining heat internally.  The Long Gu and Mu Li also serve to sedate and refocus the mind, and being salting in nature, will soften any phlegm present.  When the external yang channels are blocked, the patient can neither rotate externally (shao yang), nor more forwards (tai yang), nor stop him or herself once moving (yang ming).  Clearly, Dracula’s powers are focused on closing off the yang channels and his ‘magic’ hold over people is really only at an external level.  The constraint of yang qi on the interior leads to heat, and if phlegm were already present in a person — as perhaps in Xander’s case — this phlegm may begin to harass the heart and mind, leading to erratic behaviour, giving the impression that Dracula controls the affected person.  However, a few doses of Chai Hu jia Long Gu Mu Li Tang should release someone from Dracula’s hold.

The second formula combination, Xiao Chai Hu Tang with Gui Zhi jia Shao Yao Tang is composed of chai hu (7), ban xia (5), sheng jiang (4+4), huang qin (3), da zao (3+4), ren shen (3), and gan cao (2+2), plus gui zhi (4)  and shao yao (6).  This combination also focuses on releasing constraint, although it focuses more on the shao yang and tai yin systems than on the other two yang channels.  It also focuses more on the middle warmer, rather than the upper warmer.  It can be used for delirious speech as well as the more usual alternating chills and fever (or alternating attention and inattention).  It would seem this combination would therefore be more appropriate for Xander than for Buffy.

As for acupuncture, how can the condition be approached?  If we translated from the herbal physiological diagnosis, we are confronted with a simple case of constraint of the exterior, possibly beginning to move interiorly in Xander’s case.  I might suggest a sinew vessel treatment for Buffy, and a primary treatment approach for Xander.  However, a simpler approach might be available for each.

If the issue is simply one of constrained yang qi, then it would stand to reason that choosing one or two points which affect several yang channels and which release the exterior should be sufficient treatment.  Du-14 is one such point:  all yang channels meet here, and it is used to treat exterior conditions, rigidity of the sense organs and clear the brain.  It therefore seems ideal.  If releasing heat from the interior is necessary, the point can be bled and cupped (‘wet’ cupping). Bleeding will draw the heat from the interior, and cupping will help release the exterior and the tendons of the neck, allowing clear yang to ascend and descend properly.  In cases of extreme external cold and internal heat, the point can be bled and cupped, and moxa can then be applied subsequently to warm the exterior.

If Du-14 alone seems insufficient, Bl-35 is known as the meeting point of yang.  Not much used today, it may nonetheless bring yang qi from the Du Mai to the Tai Yang channel.  The drawback to using Bl-35 in this instance is that the pathogenic influence, if not fully released through TaiYang, may become trapped midway between the interior and exterior, and a follow-up treatment will be necessary.  Again, the point could be bled (and this might prove useful in cases of hemorrhoids caused by wei qi trapped in the digestive organs and unable to return to the exterior upon awakening — as can happen with too much day time napping).

As always, although based on Eastern Medical physiology, these posts are for entertainment purposes only.  If you feel you could benefit from Chinese or Japanese herbal medicine and acupuncture, please see a qualified practitioner.

Happy Slayage!

Where the Wild Things Are (Buffy Season 4, Episode 18)

Make up sex seemed to be the theme of this episode, and Riley and Buffy are at the core of the supernatural problem to be overcome.  Their incessant need to be closer to one another began to generate some strange events at Riley’s place, first manifesting themselves right before a big party.  When the party gets underway, some of the women begin to cut their hair, a glass bottle used in playing ‘spin the bottle’ explodes, and a G-spot appears in a wall for the amusement and wonder of party-goers.  Eventually all this fecundity leads to faster-than-kudzu vine growth throughout the corridors of the place, and the Scooby gang must figure out how to rescue Riley and Buffy from the death-by-sexual-exhaustion that awaits them.

It turns out that the dorm where Riley lives used to be a foster home of sorts.  The lady who ran the home used to reward the children when they were ‘good’ and punish them when they were ‘dirty’.  Anya understands this to mean ‘not dirty-muddy’, and the lady confirms Anya’s suspicions:  the children were punished when the girls were vain about their hair, or the boys lustful after other girls.  The result is a house filled with powerful energies which never got released.

[As a completely separate digression, more for the theology portion of my blog, something the old woman who used to run the foster home made something click in my mind:   She said that if she had not punished the children, or rather, if they had continued in their paths, ‘they would be kept out of the kingdom.’   The implication is of a specific sort of heavenly kingdom in an afterlife.  What clicked for me was that in the medieval period, when Christian theologians wrote about the ‘kingdom’, very often (at least for the monastic writers), they were referring to the kingdom entered through contemplation and stillness.  In some ways, this is simply a Christian continuation of the philosophical ideal of the ancient world.  For the monastic writers, a focus on distractions of any sort — vanity or sex — led away from entering the fulness of that contemplation, and disrupted the stillness of body and mind that was sought.  With a loss of monasticism and mysticism after the sixteenth century in certain parts of Europe and the Americas, the result was a much more literal take on the ‘kingdom’.  Instead of being a direction for or place of repose in meditation, it became literalised as an otherworldly place in the future.  It became not simply something unattainable in this life (unlike the accessibility of contemplation), but the dungeon of a most beautiful castle (to allude to the writings of a sixteenth century Spanish mystic, Teresa of  Ávila).]

In one of the initial Angel episodes — the one which started these blog posts, in fact — I treated the idea of the three types of ghosts:  wandering hosts, hungry ghosts, and horny ghosts, any of which can take possession of a person, often after traveling somewhere, and use them to attempt to fill the ghost’s needs.  Therefore, I will not revisit those ideas here; instead, the diagnosis I will give for this episode is simply excess libido.  (‘Libido’ means sex drive.)

In case readers think no one wants a lowered libido, I would mention that I have actually had patients in the clinic present with this concern.  I will mention two briefly, below.  I will also include a link to a recovering sex addict:

http://www.bbc.co.uk/news/magazine-16469222

Martial artists often advise their students to refrain from ejaculation during particularly intense training months.  What is the reasoning behind this advice?

In terms of Chinese medicine, we know that Jing is transformed into qi and by assimilating the qi of food to its template is also transformed to support blood.  However, the focus in the case of martial arts is really not on the usual aspects of Chinese medicine — the zangfu or three humours — so much as on the tissues of the body.  (This paradigm much more in evidence in Ayurvedic rasayana tonics).  Although we can derive relationships between the tissues and the internal organs — the Spleen controls the Flesh, the Kidneys are associated with Bone, the Liver with Tendons, for example — in a more direct path, we can say that jing nourishes the marrow (‘sui’ or, in Jeffrey Yuen’s tradition, ‘jing-shen’), which allow the bones to be supple and the tendons to be strong.  Jing thus supports the density of bone and the limberness of the joints.  Although practitioners debate whether jing can actually be nourished or ‘regained’, it is said the jing is formed (or released by ming men) after about 90 days or 3 months.  Because the Extraordinary Vessels are filled with jing, EV treatments are typically given for three months before results are seen.  In my clinical experience with an older woman with slight damage to jing, it took  four months, at which point some rather profound changes came about in her life and her outlook on life.  I might have advised continuing with that treatment for another few months, but clinical rotations changed, and I did not see her as a patient after five months of treating her.

To return to martial arts:  Not all students feel up to the task of withholding their essence, and so the masters have come across several formulae which seem to have beneficial effects.

Gui Zhi Long Gu Mu Li Tang is the usual formula used by martial artists when they are training but wishing to have an aid to retaining their jing.  Gui Zhi jia Long Gu Mu Li Tang is made by decocting equal amounts of Gui Zhi (‘cinnamon twig’), Bai Shao (‘white peony root’), Long Gu (‘dragon bone’), Mu Li (‘oyster shell’), and Sheng Jiang (‘fresh ginger-root’), with 12 pieces of Da Zao (‘red dates’) and two-thirds the amount of Gan Cao (‘licorice root’).

Gui Zhi and Bai Shao together regulate the qi of the interior (ying qi) and exterior (wei qi), ensuring that the interior is astringed, and the exterior is dispersed and properly moving.  Sheng Jiang and Da Zao serve a similar function, with Da Zao nourishing the heart and blood, and Sheng Jiang warming the qi.

The Divine Farmer indicates Long Gu for treating “heart and abdominal demonic influx, spiritual matters, old ghosts, cough and counterflow… in females leaking, concretions and conglomerations, hardness and binding, and in children heat qi and fright epilepsy.”

The Divine Farmer says Mu Li — with protracted taking — kills evil ghosts, fortifies the bone joints, and prolongs life.  “It eliminates tuggings and slackenings, mouse fistulas, and, in females, red and white vaginal discharge.”  It also treats cold damage.  Today, however, it is also used to clear heat and astringe, and for this reason is used to treat seminal emission.  “With Rehmannia as its envoy, it boosts and astringes the essence and stops frequent urination,” according to Wang Hao-gu.

In both cases, ghosts are referred to; but so is ‘leaking’ in females.  This is sometimes interpreted as leaking of essence, or the female equivalent of spermatorrhea.

As a whole, the formula treats (dreams of) sex with ghosts in women, and spermatorrhea (i.e. masturbation) in men, according to Zhang Zhong Jing, the physician under whose name this formula was passed to us.   Ted Kaptchuk has explained that ‘sex with ghosts’ can also mean having a ‘dream lover’ in the sense of Mariah Carey’s song:  ‘Dream lover, come rescue me.’  This is a formula for the sort of person who can never be satisfied with one person because her ideals can never be fulfilled by an actual person.

Interestingly, the obverse of excess libido can be a fear of intimacy.  Having ‘ghost lovers’, in the sense of being ephemeral, here one day and gone the next, is another way of articulating that phenomenon.  As the article on sex addiction noted, this is precisely the sort of psychological mechanism articulated by the writer of that column.

But what produces the libido?  In Byzantine or Galenic medicine, it was thought that semen built up and caused friction within the vessels of the testicles and spinal chord.  This friction generated heat within the body, which in tern was interpreted — as the English phrase still reflects — as being ‘hot and bothered’.  A similar logic can underlie the explanation of how slippery medicinals which usually nourish jing, can in fact be used to regulate the sexual appetite:  they lubricate the vessels, thus preventing the build up of heat from the friction of too much substance; yet they can also be seen to quell empty fire, when yin deficiency from loss of essence is the root.

For speculative purposes, I would also note that in Galenic medicine, semen was thought to be composed of little homunculi, little tiny fetuses (or as Giles expressed it, ‘tiny, tiny babies!’).  Extending that thought process, one might posit that herbs to calm the fetus and address ‘restless fetus disorder’ in Chinese Medicine might work in men to calm libido.

One patient I had was an elderly man (in his 80s) who came in complaining that after about a week or so, he gets very testosterone-y, and the only way to release it is through masturbation.  He was not satisfied with this solution, and sought herbal medicine to help.  I prescribed a very simple formula:  Wu Wei Zi Tang.  Composed of Wu Wei Zi only, in a rather small dose, it was designed to astringe and nourish (male’s) essence, as well as calm the shen.  He did not return to the clinic, so I do not know what his experience with this formula was; however, he had presented to other practitioners beforehand without lasting success.  My assumption is that he either gave up, it worked, or he went somewhere else.

Since the good physician also looks at the future injuries which accrue should a pathology continue, I would briefly refer the reader to a chapter in Hua Tuo’s treatise on the internal viscera.  In a section on bi (‘obstruction’) syndrome (often correlated with various types of arthritis today), the Tang dynasty physician Hua Tuo describes ‘bone bi’ as “due to injury of the kidneys by inordinate sexual desire.

I have seen this in the clinic.  One patient, a man in his 50s came in complaining of severe gout and kidney stones.  His history indicated that he never went a day without sex (either with or without someone, he specified) since his late teens, and often several times a day.  While he was quite impressed with the quality of his physical presentation at those times, overall, his case illustrated exactly the sort of  ‘bone bi’ that Hua Tuo alludes to.  I used a formula to dissolve bone spurs (in the hope it would also affect gout deposits and kidney stones) and augment the kidneys.  I also advised him to refrain for sex, or at least curtail his activities while on the formula.  Returning to the clinic, he indicated his ‘kidneys felt stronger’ or more ‘full’, and subsequent clinicians kept him on a variant of the same formula.

Hua Tuo continues the progress of the pathology: Dispersed internally, kidney qi is not able to shut and confine,” leading to leakage and chaos in the interior, specifically the centre and upper jiao.  This in turn leads to qi glomus of the triple warmer, which impacts the ability of food and water to be transformed into essential qi.

Interestingly, that glomus and blockage of proper assimilation of food qi can be correlated with the phenomena of certain foods being particularly prone to aggravate attacks of gout.

The inability of food to be properly transformed allows evil qi to invade ‘in a wanton way’, leading to four possible scenarios:

1. Evil qi surges to Heart and tongue giving rise to aphasia; or

2. Evil qi affects the SP and ST, causing them to be unable to replenish the flesh; or

3. Evil qi flows to low back and knees, leading to paraplegia; or

4.  Evil qi attacks the lateral limbs creating numbness or insensitivity in the limbs.

To address the inability of the Triple Warmer to aid in the assimilation of food, and to rectify the glomus qi in the chest and upper back, I would use Hua Tuo’s Asafoetida Free the Qi Pills:

Asafoetida, 2 liang; Chen Xiang, 1 liang; Gui Xin, 0.5 liang; Qian Niu Mo 1 – 2 liang.  Boil Asafoetida in wine down to a paste.  Add the other ingredients, powdered and form into pills the size of a plum.  Dosage:  one pill dissolved in wine.  (Note the original formula coats pills with zhu sha.)

Once the qi is rectified and the libido flows spontaneously rather than in a libertine fashion again, the essence should be replenished.  This can be accomplished with a medicinal wine designed to strengthen the tendons, also drawn from the Martial Arts tradition:

Jin Feng Jiu:

Sheng Di, Shu Di, Dang Gui, Mai Dong, Di Gu Pi, Yin Yang Huo, and half an amount of Sha Ren.  Grind or use whole to make wine.  Add to a fifth of 80 proof alcohol or less; steep for 60 – 90 days.  Like Wu Wei Zi alone, this formula increases jing and quiets restlessness.  It should go without saying that refraining from a loss of seminal essence while taking this formula is advised.

As always, this post is for educational and entertainment purposes only.  If you feel you could benefit from the application of Chinese medicine, please contact a qualified practitioner.

References:

Yang Shou-zhong (1993).  Master Hua’s Classic of the Central Viscera.  Blue Poppy Press.

Yang Shou-zhong (1998).  The Divine Farmer’s Materia Medica.  Blue Poppy Press.

Superstar (Buffy Season 4, Episode 17)

The Jonathan episode!  It is amazing how much difference a change of clothing, hairstyle, and habitus — the way one holds one’s body and moves it through space — makes.  Actors are consummate artists in this respect, able to shift from one habitus to another convincingly.  Body language reveals much about a person’s character.  Sarah certainly did it in the previous episode, when Faith had taken over Buffy’s body — Sarah adopted the mannerisms that Eliza used to portray Faith.  In so doing, she demonstrated the history Faith had lived through, how she felt about herself and the world.

If the key words of Chinese medicine are change and transformation — the harmonious movement of qi and blood in the person (giving a shen spontaneously in tune with its environment), the transformation of qi from one phase or type  into another — than this episode demonstrates exactly the result at which treatment in Classical Chinese medicine aims.  While acupuncture and herbal medicine will generally have an effect on the body regardless of a person’s belief in their efficacy, treatment proceeds much more quickly if the patient is also working on self-cultivation.  Medicine and self-cultivation go hand in hand, regardless of what sort of medicine one is using.  Both Riley and Jonathan demonstrate such synergistic work in this episode.

Obviously, in Jonathan’s case, his self-cultivation was a short-cut, and thus unstable and short lived.  He cast a spell which altered the history of Sunnydale (if not other places).  In the process, he not only begot a monster which embodied his darker aspects, he also came to some realisations about the process of healing.

Both Buffy and Riley ask for relationship advice from Jonathan.  What Jonathan tells Buffy then, she tells him again at the end.  Jonathan recognises the truth of that advice for himself as well.  Things take time.   It does not happen all at once.  But it is worth it, in the end, if one extends effort slowly, consistently, in small steps.  As the tattoo of one friend reads, “A little bit, every day, with devotion.”

Forgiveness is a form of healing.  For me, I often view forgiveness as a resolution of grief.  In terms of Chinese medicine, lack of forgiveness is a holding pattern, a type of stasis in a body which benefits more from movement.  With movement, change and transformation can occur, grief can be resolved, and though life may never be the same, it can flourish once again.  Indeed, from the point of view of Classical Chinese Medicine, it is best not to return to the state in which one found oneself before trauma, since some weakness in physiology allowed illness to take root.  The goal of medicine, then, is to move one through the pathology into a stronger, more stable and malleable place.  This takes time, attention, and effort.

Buffy and Riley allude to such a process when we learn that Riley has taken control of his own diet.  Although he was told the food he received from his superior officers was no longer spiked with drugs, he decided to take no chances, and has been making his own food (or getting it elsewhere).  Preparing one’s own food is a basic form of self-cultivation which supports the work done in the clinic.  Qi Gong is another example, and in previous episodes we’ve seen that Riley does push-ups upon arising, despite the fact that they are not ‘regulation’:  he does them for his own benefit.

The key insight of self-cultivation, that things take time, leads to the question of making a prognosis in Chinese medicine.  How is a prognosis made?  What factors influence a prognosis?  Prognosis of death or recovery was one of the fundamental aspects of ancient Chinese medicine, at least if the manuscript texts are to be believed:  they constantly state what is a positive sign, and what signs indicate death.

Prognosis in Chinese Medicine is dependent on location, time, and communication.  Location refers to where in the body the illness is located:  is it external (e.g. wind-cold manifesting as the common cold); in the channels or muscle layer; in the hollow organs (i.e. GI tract), the solid organs, or the extraordinary organs?  Does it affect the wei qi, ying qi, blood, or jing levels?  The more superficial the location, the better the prognosis.

Time refers to the amount of time the illness has been in the body.  The more acute the case, usually the better the prognosis, except in cases of hemorrhagic fevers, which are extreme heat penetrating to the depths of the blood-jueyin level.  In cases where the illness has been prolonged, this is often an indication of emptiness of some aspect of the body’s own defensive capabilities, and thus is a sign that healing will take longer, unless such emptiness is also addressed.  In this regard, the patient’s own resources also factor into prognosis.

Finally, communication refers to two aspects:  the patient-practitioner communication, in which the patient describes to the practitioner what is going on with the body and emotions contextually, and where the practitioner (in addition to paying attention to what the body is trying to communicate via its pulses, abdominal conformation, and channel changes) clearly articulates what can be done to help the treatment progress even outside the clinic (e.g. walks in the fresh air, regular bed times, avoiding greasy food, when to take herbal medicine, etc).

The second aspect of communication has to do with the body’s own internal communication.  This internal communication is often referred to as harmony between the wei and ying qi.  The two levels of qi are in communication with one another.  Yin and Yang are not separating but mutually transforming and supporting one another.  Change and transformation are allowed to happen because these different aspects of the body are communicating clearly with one another, and not getting muddled by the advance of a pathogen.  The body knows what resources should be drawn upon in order to effectively expel the invading pathogen, or to smoothly rectify pathophysiology.

An example of miscommunication in the bodily physiology is when the Large Intestine becomes yin or fluid deficient.  Since the fluid associated with the LI is the jin or thin fluids, and since the jin circulates with wei qi, the body will draw both jin and wei qi (defensive qi) inwards in an effort to make up the depletion of jin in the Large Intestine.  However, this qi is quite hot, very yang in nature, and the result is actually inflammation — and symptoms like IBS.  Herbally, we would want to use something which redresses this imblance and floats the qi outwards again, while nonetheless still moistening the intestines.  Sang Ye, Jie Geng, and Qu Mai (for the SI) all fit this description.  They either release the exterior or float outwards, and are associated with the Intestines, the Lungs, and usually also moisten dryness.  Combined with careful observation by the patient leading to behaviour modifications to prevent future mishaps, the use of herbal formulae or acupuncture can help rectify the current patho-physiology, and  allow healing can progress apace.

As always, this post is for entertainment and educational purposes only.  If you feel you could benefit from learning other ways to cultivate your life according to the principles of Chinese medicine, I would refer you to Claude Larre’s The Way of Heaven and The Secret Treatise of the Spiritual Orchid, both published by Monkey Press.  These books are commentaries on key aspects from the medical canon, rather than texts belonging specifically to Daoism, Confucianism, or any of the other hundred schools which flourished during the Han and pre-Han dynastic periods.  Happy Slayage!

Who Are You? (Buffy Season 4, Episode 16)

At the end of the previous episode, we saw Buffy and Faith fight, with Faith pulling out a magical device at the last moment and linking hands with Buffy.  In this episode, we learn that Buffy and Faith have switched bodies.  Faith now inhabits Buffy’s body, while Buffy is trapped within Faith’s.  Both come to understand the other a little bit more as a result.

Not before a little bit of havoc and revenge has been wreaked by Faith, though.  In particular, Faith decides to sleep with Riley.  Riley picks up that something is amiss, particularly afterwards, when he tells Buffy’s-body-inhabited-by-Faith that he loves her.  Faith-inhabiting-Buffy’s-body, not expecting any such talk after sex, jumps up and becomes very agitated.  ‘What just happened meant nothing’, she declares.

Given Faith’s own background, such behaviour is not unexpected.  After all, towards the end of the episode, Faith-in-Buffy’s-body gives Riley the brilliantly delivered line, “I can’t use you.”  In terms of acting technique, the ambiguity of that line was very psychologically perceptive of Faith’s character.  She cannot use Riley in a fight, because he is injured; but more broadly, she cannot exploit him, and he isn’t out to exploit her.

Leaving aside the philosophical-medical considerations emerging from the slow melding and changing of Faith’s personality to match her Buffy body, the overall pattern of Faith’s interaction with Riley made me think of dissociative disorder, particularly as it applies to sexual interactions.  Simply put, dissociation during sex is when one person simply ‘checks out’ and goes somewhere else mentally, avoiding the impact of what is actually going on.  Often this habit is developed as a result of sexual exploitation of some sort, though it need not be.  Nor does it necessarily need to be confined to the bedroom.  Sometimes people will check out of other difficult situations.

A colleague once asked for ideas of how to address these symptoms from a Chinese Medical standpoint.  This episode presents the perfect opportunity to explore those ideas further.

First, we could look at the situation as primarily one concerning consciousness and attention.  Consciousness is associated with the shen-spirit.  Attention can also be associated with the shen-spirit; but it can also be associated with the gathering power of the Spleen, and referred to as yi-intent.  The shen is anchored to the body by the jing, and emerges from the union of qi and blood.  If consciousness is departing, this is a form of a rupture between the yin aspects of the body — jing and blood — from their partnered yang aspects — shen and qi.  The treatment approach, therefore, would seek to anchor the shen in the jing, or the qi in the blood.

Typically, sticky herbs like shu di, e jiao, gui ban jiao or even lu jiao jiao (which is a bit more on the yang-tonifying side) could be used.  The stickiness reflects viscous jing.  Something yang and light in nature would reflect the shen; perhaps fragrant chen xiang would be a good choice.  I personally prefer the use of Lu Jiao Jiao in this instance, because it already reflects the presence of yang-shen within sticky-jing oriented substances.  Being the essence of an antler, which is the outward expression of life, and which requires great amounts of both qi and blood in the springtime, I feel it adequately captures much of what we are trying to accomplish.  (Sang Bai Pi would work similarly.)  However, Lu Jiao Jiao does not clarify consciousness.  In some ways, it doesn’t so much bring consciousness back to the jing as much as it causes the jing to express itself outwards consciously.  To augment this effect by engaging the spleen, I might add either Fu Shen — a very consciousness clearing herb, relieving people of the burden of potential (i.e. dampness unable to become physiological fluid) — or Gan Cao, which helps bring people back to centre.  Ren Shen also has this centring effect.

Another approach would be to relate the yang-oriented shen to qi, and look at how qi is anchored in the body.  We know that the ancestral qi gathers in the Lungs, and that the Kidneys grasp Lung qi.  Therefore, something which helps the Kidneys anchor the qi may prove useful.  In such a case, I would think of the formula Ren Shen Ge Jie Tang.  This formula is mildly yang-tonifying, and is often used in cases of asthma.  I have also heard of it used when couples are trying to conceive.  The concept there is that the Kidneys, or jing, will grasp a Ling-soul to enable conception to occur.

If the qi is weak, the po may rage out of control.  This gives rise to addictive disorders.  Someone who is both a sex addict and checks out during sex would likely need to have both jing and qi tonified.  The above formula, with the addition of one or two qi-tonifying or qi-circulating ingredients may be useful in such cases.  I would consider adding Shan Yao (to astringe essence) or Wu Wei Zi (to astringe LU qi and generate essence) with a herb like huang qi, which tonifies qi but also constrains the exterior.

A third way to look at the issue is to consider the path of the Liver channel, and the role that  LV channel blood and mai has in influencing the genitalia.  The Hun, stored in the LV and in Blood, follow the Shen, which are stored in the Mai-vessels.  This is the place of the Pericardium, as we noted in the previous post, but also of the Chong Mai, which disperses into the Chest.  In this case, I would use acupuncture and lead the shen from the chest down to the LV channel.  Perhaps I would combine a Ren Mai with a Chong Mai treatment, beginning with LU-7, followed by CV-17, CV-15, KD-15 (Uterus Gate), KD-13 (Qi Cave), and Closing with SP-4 — if I chose to use that particular trajectory of the Chong Mai.

The place of the pericardium is interesting to consider in this respect.  The Pericardium is likened to the Confucian ministers, whose responsiblity it is to ensure the Emperor be in the right place and perform the correct rituals at the proper time. If consciousness is not present when it should be, this can be seen as the fault of the ministers, in this case, the Heart Master Collateral, or PC meridian.  PC-6, a luo mai point having a relation to the blood, and called ‘inner gate’ to reflect its relationship to letting certain emotions in to consciousness and the heart, CV-17 (mu point of the PC), and CV-15 (mu point of the HT) are all useful points in this regard.  If a person is also emotionally stuck, I would add the he-uniting or he-sea point of the PC to the prescription, since he points are useful in cases of blood stagnation — and in cases of pathology due to previously poor intake (usually thought of as dietary) choices.

Note Buffy puts her hand to CV-17 after returning to her own body:  the Heart was finally back in its proper place, regulated through the Pericardium — in this case, PC-8, where the magical device was held.

Finally, someone who is facing challenges with intimacy, wandering from person to person — this issue is the flipside of the episode  ‘Where the Wild Things Are’ (Season 4, Episode 18), and will be treated then.

Until that time, please remember that these posts are for entertainment and educational use only.  If you feel you could benefit from Chinese Medical approaches to your life, please see a qualified practitioner.  If you are interested in bodily memory, by all means search using the terms ‘heart transplant’ and ‘bodily memory’.  Happy Slayage!

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

Towards the close of this episode, when Adam is revealed as the Big Bad of the season, Adam makes a statement which leads not so much to a diagnosis so much as to a treatment plan.  “I know what I am, but not who I am.”  Adam, of course, tried to go about discovering who he was by approaching the matter mechanistically:  the vivisection of humans and demons.  He is trying to probe the deeper and most intimate sources of how human life is expressed.  For the Classical Chinese physician, the channel system which governs this are the Qi Jing Ba Mai:  the Extraordinary Meridians of the Eight Vessels.

These Vessels are considered to be the repository not only of jing, the essence inherited from before birth, but also of those factors, particularly emotional ones, which the individual person, or his family lineage, has not been able to resolve.  They can thus be thought of as ‘karmic’ in the sense of a long-term expression of response to lived environments.  In this regard, the EVs are that system in the body which conveys, as a template, the genetic and epigenetic expression of post-natal qi.  Through the action of source qi, post-natal qi is assimilated to the pattern the jing provides, giving rise to flesh and form in the body.

The extraordinary vessels, filled with jing and shen as they are, deal with the existential issues Adam considers — who am I?  They are the deepest part of the body’s channel physiology and come into play in the unfolding of the jing (KD-6, BL-62) as it is transmuted by ming men fire (SJ-5, PC-6) into qi (LU-7, SP-4) and shen (GB-41, SI-3).

As described in previous posts, the EVs — like all the channel systems — can be thought of as a description of the movement of a person through existence.  Jeffrey Yuen discusses how the Ren, Du, and Chong form the basis of individuation and growth; the Wei Mai integrate the yin and yang functions of the body; the Qiao Mai reflect one’s view of the world and self; the Dai mai discharges and drains what needs to be let go, or retains what the person is unwilling or unable to address at particular times in his or her life.

Specifically, the Chong provides the central blueprint of a person’s life, the sea of blood, from whose union with qi shen arises.  The Ren Mai involves attachment, its formation and the solidity such reassurance gives to children as they grow.  It is the consolidated Sea of Yin which allows what is necessary for growth to be held adequately, without being torn by the dissipating nature of Yang.  The Du Mai is about unfolding into an upright posture, the individuation and going forth into the world, the dissipation or outward movement of the Sea of Yang.

For Adam, then, an EV treatment might be most appropriate to aid him in his quest for self-knowledge.  Adam’s EV functioning is unclear.  One could regulate the Yin Qiao Mai and couple it with the Chong Mai, with the intent to facilitate his ability to look inward at his blueprint; yet he seems to know his blueprint from the disc or CD he inserted into the Cyborg portion of his anatomy.  Looking inward at his blueprint does not seem to be the issue.

Another approach would consider that Adam has not lived; he has not engaged with the external world.  This is the province of Du Mai.  He does seem to have a bit of excess in the Yang Qiao Mai, trying to figure out the world, so perhaps the Yin needs to be regulated as well.  His question, at its most basic level, seems to be:  ‘What is my destiny in the world?’

Four points on the Du, Ren, and Qiao Mai open the body to its destiny.  These points happen to be where some people sense their ‘gut feeling’ the ‘core’ or ‘innermost’ part of their gut — the ‘will within the will’ as it were.   The points on the Ren Mai are located two and three thumb widths below the navel, CV-4 and CV-5.  On the low back, in the two intervertebral spaces between L2 and L4, where some people feel a tingling in their spine when something is ‘right’, the points GV-4 and GV-3 can be located.  Finally, the other points, which are rarely thought about in terms of feeling one’s way, are located at the inner canthi of the eyes — the portion of the eye near the tear ducts and nose.  Bl-1, a place at which clarity of vision — or its blurriness — manifests.  All the above points share as one of their several appellations the name, ‘Ming Men’, Gate of Destiny.

I would start first with the Qiao Mai, opening with BL-62, then needling BL-1.  Adam has been looking to excessively at the world, and needs to anchor within; so the next points would be CV-4 and CV-5.  These points are also the mu-points for the Small Intestine and Triple Warmer, referred to above as expressing jing and shen outwards (the SI being paired with the Heart and Vessels which govern and store the Shen).  One could opt to close with LU-7 at this point.  I might consider leading this consolidation back to the source, to GV-3 and GV-4, before ultimately closing with SI-3 (the control point on the Du Mai).

Needles should be inserted fairly deeply.  A vibrating technique should be used to obtain qi.  The needles should be retained for 40 minutes or so (although Adam’s jing is possibly quite motile, as an infant’s would be, and thus needle retention could be shorter in time).  Treatment should be once weekly, for three months.

Herbal treatment would lead the fire back to the source using Rou Gui and Huang Lian, while augmenting yin and jing with either E Jiao or Gui Ban.  In lieu of animal products (not really an issue for Adam, but in countries where animal products are restricted an issue for practitioners), one might try using Shu Di and Luo Shi Teng.  This latter herb usually treats the Luo Mai; but when the luo empty into the EVs, it may be helpful to see if the luo can be engaged through herbal treatment to reverse the flow.

The question of the state of Adam’s jing and ming men fire highlights a plot hole — we don’t really know how he came to life.  Does he have a base creature on which he was built?  Was this creature still alive when the operations were being performed?  Is he primarily an augmented human being?  Primarily a Demon?  Do demons have the same vasculature as humans?

Adam’s physiology raises particularly interesting questions from a Chinese perspective.  Does he have any extraordinary vessels?  Does he have a shen, which would have a curriculum to work out in this world?  Did he embody the unresolved pathologies contained in the luo vessels of a previous existence?  How would a Chinese Frankenstein’s monster be created?  How would the connexions of the various channels be treated?  Would a ‘translation’ of channels into fascial continuity provide a different take on how such a creature could be constructed?

I will leave such philosophical questions for the readers of this post to ponder.

As always, this post is for informational purposes only.  If you think Chinese Medicine can help you engage with your life’s work in greater depth or with greater clarity, please see a qualified practitioner.  Happy Slayage!

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