Touched (Buffy, Season 7, Episode 20)

How sexuality impacts one’s approach to an apocalypse is explored in this episode, augmented by an excellent soundtrack.   Faith and Wood let out their physical tension; Xander and Anya find comfort in the familiarity of one another’s bodies; Willow and Kennedy finally go ‘all the way’; and Buffy and Spike achieve an intimacy which does not rely on sexual activity, but on simple holding and being held by another person.

Sexual encounters aside, the actual plot involves Faith leading the potentials into a trap:  They discover a bomb in the vineyard moments before it explodes.  Diagnostically, the episode references sweat and scent several times.  Wood refers to how when the First appeared to him, it took the form and image of his mother, right down to her perfume.  Spike tracks Buffy by her scent (despite not breathing; but then, we saw him  waterboarded by a Torakhan earlier in the season, a form of torture which should not have affected a non-breathing creature).

Overall, this episode provides a good opportunity to revisit some Channel Divergence physiologies as they link up with other channel systems.  The diagnostic entry point will be a re-examination of the five odours as they pertain to the CDs and point to other channel systems.  Then I will examine sexual form and function from several channel perspectives.

To review, the five odours and their five-phase correlates among the Primary Channels are generally listed as:

Rancid, like oil that has been too long exposed to air, is associated with the Wood phase of the Liver and Gallbladder.

Scorched, appropriately associated with the Fire phase of Heart and Small Intestine.

Fragrant, Sweet, corresponding to the flavour of earth and grains (when chewed for a long time), is associated with the Earth phase, and the Spleen and Stomach organs.  (The Pancreas are associated with the Spleen in this system.)

Rotten, Rank, or Fishy, like the breath of one who has tuberculosis or a Lung abscess, is associated with the metal phase, and with the Lungs and Large Intestine.

Putrid, Rotting, Decay, the scent of winter’s kill before it freezes, or the smell of wood left underwater and ice for a season, is associated with the water phase, and with the Kidney and Bladder organs.

The Channel Divergences link the yin and yang primary channels of a particular phase of qi (wood, fire, earth, metal, water), and in this way a diagnostic correspondence between patient odour and channel to be treated could be formed.  However, let’s complicate the picture in two different ways.  The first way is to link the CDs with other channel systems by phase.  The second way is to look at the interaction of CD fluids, channel systems, and organ-tissue relationships.

To begin with the first set, but with an eye to the second:

The BL-KD CD is associated with jing, and draws heavily on the Extraordinary Vessel system.

The GB-LV CD is associated with xue-blood, and relates in particular to the mu points and Luo Vessels.

The ST-SP CD is associated with jin-fluids, and intersects with the Heart through its own trajectory, through the Chong Mai’s relationship with blood, and through its ability to nourish the upper sensory portals, including the tongue.

The SI-HT CD is associated with both sweat and ye-thick fluid, which nourishes the Sinew Vessels.

The TW-PC CD is associated with ying qi, and moves heat out to jing-well points through nodes to terminations.  Sinew Vessels begin at the jing-well points.

The LI-LU CD is associated with wei qi,  and begins the cycle of primary meridians.

Bringing the five-phase odour correspondences into the above chart, several resonances between odour and channel systems occur:

Decaying, putrid odours point towards jing and the EVs.  (Note that decay can be associated with the teeth as the SI meridian deposits pathogens there to maintain latency.)

Rancid odours indicate the luo vessels, and emotion left too long un-aired out and unresolved.

Fragrant odours point to the heart and sense of perception.

Scorched odours, that ‘burnt out’ smell, indicate the marrow and sinews may benefit from treatment first.

Rotten, fishy odours suggest that the primary meridian cycle may be most effective in treating the pathophysiology currently underway in the person.

Next, the organ-tissue correspondences as they are associated with CD fluids:

LV is associated with blood and sinews (possibly meaning ‘nerves’); GB governs the bones.  In the CD channel system, the SI-HT CD relates to the sinews.  This comes about in part because SI-9, on the SI-HT CD trajectory, moves blood into the sinews.  The form of the sinews is felt through the movement of ye-thick fluid, the fluid of the SI CD.  The function of the sinews is brought about through blood, the fluid of the GB-LV CD.  The blood relationship of the Liver is more closely linked to the Luo Vessel system here.

HT rules over the mai, the vessels.  This includes the arteries as well as the jing-luo mai, the qi mai, and the bao mai. In other words, the Heart rules over the primary meridian cycle, the luo mai system of collaterals, the extraordinary vessels, and the enveloping vessel.  Absent are the CDs (but all the CDs go to the Heart) and the Sinew Channels (but the Sinew Channels are associated with the SI-HT CD).

SP is associated with the flesh; ST is associated with blood.  Because the luo vessels are about how events have not been ‘digested’  or assimilated by the person in question, the ST-SP CD and the Luo Vessels have a relationship.  Looking at the relation between LV and ST in this respect may be useful, for treatment patterns.  The Yin Wei Mai, a major intersection on the ST-SP CD could bear a certain relationship to the flesh, as the inner aspect of the body’s substance, linking everything together.

LU is associated with the skin, which is the domain of wei qi and the sinew vessels; LI is associated with jin-fluids, which provide the source of wei qi.  The LU, LI, SJ-PC CD and SI-HT CD all overlap with the beginnings of the sinew vessels.  In fact, however, the SI-HT CD is more associated with the end or binding points of the sinew vessels, while the SJ-PC CD is associated with their beginnings.  The LU-LI system is associated with wei qi, which is also the domain of the sinew vessels.  However, because the LU-LI CD is also associated with the Primary Channels, the LU-LI system goes ‘deeper’ into the body than the sinew channels themselves would.

KD are associated with bones, but the GB ‘masters’ the bones; the BL is associated with jing.  This correspondence fits in nicely with the BL-KD CD association with the EVs.  However, the SI-HT CD deposits pathogens in the jing-associated teeth.  The SI is further associated with the thick fluids which nourish jing-associated marrow.  However, the BL-SI and KD-HT channels link up through their TaiYang and ShaoYin associations.

When the topic turns to sexual function, several aspects come to the fore.  First, LV-5, the LV luo point, which is also on the LV CD trajectory, influences libido.  (The BL-KD CD and its relationship to the lineage-linked jing is clearly implicated in sexual functioning.)  Second, the relationship between wei qi and jing shares an analagous relationship to ejaculation:  wei qi is the yang qi which propels jing outside the body.   In this regard, two other CDs come into play, the SJ-PC channel divergence which conveys yang qi (and links the Heart and Kidneys, essential for climax — the moment when Heart Fire is discharged downwards towards the Kidneys) and the LI-LU CD which deals with wei qi.  Third, the SI-HT CD comes into play when sensation is involved; this includes pathophysiologies like vulvadinia and perhaps also hydroceles.   The ST-SP CD comes into play with openness and making sense of the person one is relating to (or not relating to) in sexual intercourse.

Perhaps in a future post, I will take each of the couples as a case study to illustrate the interplay of each channel system.  For now, however, the post is long enough!

As always, these posts are meant for entertainment and educational purposes, and are not meant to diagnose, treat, or cure any particular conditions.  If you or a loved one have recently begun to smell different and you are concerned about what this may mean, please see a qualified practitioner.  Happy Slayage!

Villains (Buffy, Season 6, Episode 20)

Events really begin to pick up pace as the Scoobies try to come back together:  Xander tries to save Buffy (Willow removes the bullet from Buffy once she’s in hospital), Buffy and Xander try to disuade Willow from going after Warren; Buffy tries to get Spike to help (but he’s left Sunnydale); and Anya tries to stop Willow when she goes to the magic shop to gain power.  Dawn is left alone to find Tara’s body.  The two poetically together as the ones who don’t quite fit in with the others, reminiscent of an early episode in Season 5, but tragically different.  At one point, Xander says he’s had blood on hands all day.

Initially, Xander, Buffy, and Willow chase a decoy:  a Warren Robot.  That robot ends up with a deviated eye, before being dispensed with.  Ultimately, Willow disappears on Xander and Buffy, finds Warren, and chases him through the local forest.  After briefly and mildly torturing him, Willow flays him alive, thus rendering us unable to treat him using the sinew vessels…

The Jia Yi Jing mentions a sinew vessel treatment for deviated eye:  foot yang ming with hand tai yang.  If the deviation is due to heat, the sinew will be slack and there will be inability of the penis to produce an erection.  If the robot was made for Andrew, who hinted he was in love with Warren in the previous episode, heat symptoms are unlikely to be present.  Arched back rigidity is a feature of both cold and yang tension in the sinew, and needling with a red-hot needle is indicated.  Yin pathology features a forward bending posture with an inability to stretch out, as in the case of acute appendicitis.  Therefore, to treat the robot, use hot-needle, or in this case, perhaps electro-acupuncture, at tender areas along the ST and SI meridians, particularly as they meet on the face and at the extremities.  In a human subject, the goal is to warm wei qi enough to expel the wind-cold causing the deviation of the eye, which is often accompanied by deviation of the mouth.

The real treatment which needs to be done, however, is to resolve Willow’s pain over the loss of Tara, or rather, the horrid twist of fate that stole Willow’s hopes just as they were tender in the bud.  That pain is a stagnation of qi, blood, and body fluids, and Willow’s rampage can be seen as an effort to get all those humours flowing strongly again.  In a sense, what we see in her transformation is the yin stagnation of all humours suddenly transforming into a very powerful and outward directed yang magic.  Since the humours have already begun their transformation, the appropriate strategy would be to drain the yang, or otherwise hasten the complete transformation of yin into yang, so that the body can then be regulated once again.  In the meantime, a decoction of dan shen, mo yao, ru xiang, and dang gui (15g each) may be effective at relieving pain and opening the collateral vessels.  In Willow’s case, I would add strong exterior releasing herbs:  Ma Huang is the strongest of these; Jing Jie is useful for its blood moving properties and thus would blend with the formula easily; Ge Gen or Fang Feng help move fluids upwards and outwards.

The other herbal treatment I would suggest is for Warren.  The Chinese pharmacopeia contains several herbs specifically indicated to regenerate or restore flesh.  The top two most well known herbs for regenerating flesh are Huang Qi and Ru Xiang.  Huang Qi is often combined with Rou Gui and Dang Gui for this purpose, while Ru Xiang is either applied topically with Xue Jie (Dragon’s Blood, a resin), or internally with Mo Yao and She Xiang.  Zi Hua Di Ding is also an appropriate addition, as it’s penetrating action is most effective at resolving clove sores; however, given Warren’s total lack of flesh, this would be more appropriate once tissue was actually in place.  The formula used for Willow, thus would also be a good formula for Warren, with the addition of Huang Qi and She Xiang, if consumed internally.  Externally, powders of various tree resins — myrrh, frankincense, pine tar, and dragon’s blood — are appropriate.

The internal formula, because it also invigorates the collaterals, may be an effective one to use for people who have ‘thin skin’, both in the emotional sense, and in cases of sarcopenia.  In the latter case, Rou Gui, Jin Yin Hua, and Lian Qiao may be good herbs to add, as a preventive against developing fire toxins.  Fire toxins in the case of sacropenia will quickly lead to the development of clove sores and cellulitis.  The combination of Huang Qi and Jin Yin Hua, meanwhile, mildly generates blood.

As always, these posts are for entertainment and educational purposes only.  If you or a loved one have had their flesh flayed by a dark witch or warlock, please see a qualified practitioner to restore your skin to its usual thickness.

Happy Slayage!

Huang qi, ru xiang and zi hua di ding.

Spiral (Buffy, Season 5, Episode 20)

Buffy and the Scoobies flee from Glory into the desert, pursued by the Knights of Byzantium (whose clerics mysteriously speak Latin rather than Greek; clearly, they were an order founded in the wake of 1204’s Fourth Crusade).  The knights surround the Scoobies in an abandoned gas/ petrol station.  Willow protects the area with a wall spell, but because Giles was wounded, Buffy calls Ben to address Giles’ injuries, allowing Glory to capture Dawn, destroy Willow’s barrier, and slaughter the Knights without a second thought (they would have killed her Key, after all; Glory was merely protecting Dawn).  When the Scoobies emerge, Buffy witnesses the carnage left by Glorificus, and collapses, catatonic.

A few interesting moral questions are raised in this episode.  Is this the first episode in which Buffy kills a human?  We don’t actually see the knight she axes in the chest die, of course — he could very well have turned into another Faith, ‘almost but not quite’.  Another moral question occurs when Ben saves Giles’ life; was Giles aware of that in the final episode of this season, when he ensures that Glory never return through Ben’s body?  Again, Ben could stop everything by taking a single human life:  but in contrast to everyone else, he knows that life is either his, or Dawn’s.  It is interesting that he does not choose to end his own life, although he clearly seems to believe he will one day be successful at containing Glory.  (Besides, that would end the Season a bit abruptly, a factor I’m sure Ben took into consideration when he decided to preserve his own life.)

What luo vessel pathology has shown up in the midst of all the excitement?  At the end of the episode, Buffy collapses entirely.  All her joints go slack.  This is the sign of the Great Luo of the  Spleen.  The opening point for this ‘extra’ luo vessel was located previously at GB 22 or 23, but today is acknowledged to be at SP 21.

Ordinarily, the Great Luo treats cases of unbearable pain, and I think I’ve mentioned it in a previous post dealing with suicide (as suicide occurs when pain outweighs a person’s resources to cope).  The relationship of unbearable pain (in repletion) and slackness of all the joints (when the Great Luo of the Spleen is in depletion) is clearly shown here, when Buffy’s limbs give out under her because of the shock and pain she feels at all the men who have died as a result of her actions, all the death and loss she brings into the world.  Is the Great Luo replete or depleted in this case?  I would suggest it became more and more replete, and then yang repletion changed to yin depletion.  Therefore, the treatment is to bleed the vessel and any spider veins which may have shown up along the serratus anterior muscles, followed by moxa.  Lots of moxa, I would think, until Buffy revives.  I might consider using moxa at SP 21, and then GB 22 and end at HT 1.

What herbs can be used to guide a formula to the Great Luo of the Spleen?  Goat horn (Gu Yang Jiao) is said by the Divine Farmer to treat ‘clear-eye blindness’, while Tao Hong Jing writes that it ‘cures bound qi in the hundreds of joints’.  It also treats heart vexation.  Together, these symptoms describe the sort of pain one feels when seeing reality clearly, so clearly that all one’s joints slacken.  It is used singly, one of the few herbs in the Chinese Materia Medica to be used without other medicinals.

If we are looking for a formula, we could ask what herbs go to the flanks, to both GB and SP?  What is the relation between SP-21, GB-22/23, and HT-1 from a herbal perspective?  Together, these three form a series of blood points.  Is it possible to move blood from one point to the other using herbs, rather than needles, harness SP yang to nourish the GB, or treat the GB so that the HT is nourished and SP replenished at the appropriate site?  This seems to be a case where the mansion of blood is an appropriate anatomical concept to use;  Xue Fu Zhu Yu Tang would make an appropriate base formula, and its actions do go to the flanks.  Another possibility is the formula Gu Zhen Tang, which restores yang qi to revive the Spleen.  When yang qi is exuberant, it will generate yin blood.  It consists of Ren Shen, Zhi Fu Zi, Fu Ling, and Bai Zhu (all at 7.5g), augmented by Shan Yao, Mi Zhi Huang Qi, Rou Gui, and Gan Cao (at 6g).

As always, these posts are for informational and entertainment purposes only.  If you feel you could benefit from the practice of Chinese Medicine, please see a qualified practitioner.

Happy Slayage!

The Yoko Factor (Buffy Season 4, Episode 20)

Willow makes a sort of throw-away statement in this episode about her hope that she and Buffy will become ‘little old ladies forgetting to take their pills.’

While I could turn this into a post about patient non-compliance (and wouldn’t it be great if we had a treatment for patient non-compliance?), I will instead treat the topic of herb-drug interactions from a Chinese pharmacological point of view.  In other words, Western pharmaceuticals from an Eastern physiological perspective.  Much of this material will be derived from a seminar Jeffrey Yuen gave on the same topic in 2010.

To narrow down this particular post’s presentation of herb-drug interactions, I will focus only on the four aspects of pharmacokinetics:  absorption, metabolism, distribution, and elimination of drugs.

1. Absorption: Most herbs and pharmaceuticals are brought into the body through digestion, although some are also inhaled (insufflation).  Therefore, to assess the qualities of a drug or herbal treatment, we look at the status of the SP and ST at the start of treatment and assess how they change during the course of treatment.  Likewise, we may look at the LU and LI — both organ and channel — changes as a result of inhaled drugs.  Channel changes that would be looked for include nodules, tightness, or flaccidity.

If a patient’s tongue is red, particularly without a coat, the mucosal lining of the stomach may be compromised.  The result is an increased rate an quantity of absorption. Astringent herbs decrease intestinal motility, increasing potential absorption time, while those which move qi (especially the wei qi of the Lungs) decreases potential absorption time.  These drugs can also induce latency of a TCM-defined pathogen.  H2 antagonists inhibit wei qi, which is responsible for peristalsis.

Minerals, including calcium, mu li, and long gu, alter the acidity of the stomach, and thus should be taken 2 to 3 hours after any pharmaceuticals which reduce stomach acidity.  This will allow the normal acidity of the stomach to interact with the herbal medications.

Nourishing ST yin will likely decrease absorption of herbs and drugs, as ST yin can be thought of as including the muscosal lining of the gut; likewise with LU yin and the lining of the Lungs.

2.  Metabolism

The Liver is primarily responsible for metabolising drugs.  Drugs which increase Liver metabolism (e.g. anticonvulsants, Rifadin, long-term NSAIDS, and some sleep medications/ phenobarbitols) will mean that herbal dosage will need to be increased, in order for the herbal components to remain in the system long enough to have an effect.

The opposite case, of decreased Liver metabolism, means a decreased dosage of drugs so as not to overwhelm the patient.  Liver metabolism can slow with alcohol, sulfur dioxide (avoid those bright orange apricots), antifungals, and some antibiotics (e.g. Erythromycin) and Tagamet.

Drugs which treat neurological diseases affect Liver metabolism (via their effect on wind symptoms); in such cases do not nourish LV blood, but regulate the Liver instead.  Drugs which treat infectious diseases and which inhibit LV metabolism may give rise to damp-heat.  Be aware that this damp-heat may lead to fire-toxicity (see elimination, below).

3.  Distribution

This is the part that many scientists don’t fully understand about either herbs or drugs.  Drugs which are constantly monitored tend to be prone to improper distribution.  These drugs also happen to most often affect the blood tissue itself — e.g. Coumadin and other blood thinners.  Other drugs become active only once released from the blood protein.  Because of the relation between blood and breast milk, both herbal medicines and drugs can be released and passed onto infants through the mother’s milk.

Herbs which invigorate the blood may be change the distribution of drugs throughout the body.  Herbs which increase breastmilk may also change the distribution of drugs in nursing mothers.

Anti-hyperlipidemia drugs tend to cause blood stagnation and wind-phlegm; conversely, those herbs which eliminate wind-phlegm may interact with such drugs.  NSAIDS tend to affect the blood and give rise to blood heat and wind.

4.  Elimination

The Liver and Kidneys are primary sites of metabolic elimination. Damage to the Kidneys not only slows elimination, but can lead to auto-intoxication, which in Chinese terms can be thought of as fire toxicity (and thus treated with Jin Yin Hua and Lian Qiao).  Anti-inflammatories and drugs such as methotrexate slow elmination.  Therefore, patients taking these drugs should not only be started on a low does of herbs, which is gradually increased, but also given greater time between taking the herbs.

Alkaline agents increase the elimination of acid; citrates alkalinise the system.  Therefore, in herbal formulae which use long gu or shells, be aware that they may have a synergistic effect with alkaline drugs.

Drugs which give rise to damp-heat in the LV (e.g. certain antibacterials), or which impact wei qi can give rise to LV stagnation or exhaustion.  The LV is responsible for smoothing the relationship between wei and ying qi; if it must work harder to move wei qi, the LV can easily become deficient.  Tonifying the LV qi through regulation is beneficial in these cases.  Analgesics, when used over a long period of time, can numb the Liver.

While on the topic of hormones and hormone medication, I should point out Buffy’s impromptu diagnosis of Riley having ‘testosterone poisoning.’  Now there’s an interesting diagnosis, and one we could plausibly see in the clinic if we ever have a patient on anabolic steroids (the sort used to improve athletic performance or appearance).

One class of drugs which hasn’t been mentioned are hormone regulators and replacements.  This would include certain contraceptives, steroids, and thyroid medications.  Generally, hormones can be considered functionally similar to ye-thick fluids.  A simple acupuncture formula to regulate hormones is KD2, SP8, and KD21 and ST25.  Alternately, one could use KD20, SP18, ST42, and CV12.

KD-2 is the most yang point on the KD-channel, and it has  branch which goes to SP8, earth pivot; ST25, celestial pivot and KD21, Dark Gate (doubly yin) round out the nourishing and enlivening actions of this point prescription.

ST42 nourishes the jin-fluids of the eyes, CV12 accesses the fluids of the ST, while SP18 celestial cleft and KD20 free the grain, both relate to ST fluids and movement.

Herbally, the best ye-fluid formula I’ve come across is Zeng Ye Tang, Generate the Fluids Decoction, composed of Xuan Shen, Mai Men Dong, and Sheng Di Huang (some use Shu Di Huang), modified accordingly.  Some modifications include Wu Wei Zi and Ren Shen for yang or hormone deficiency with difficulty consolidating fluids; Ge Gen and Sheng Ma to raise the fluids and generate jin-thin fluids; Sang Ye can likewise be added for its moistening and outward moving properties. Qu Mai and Mu Tong, of course, are a good choices for moving the ye-fluids into the SI meridian; the SI meridian is responsible for ye-fluids.  To guide the formula to the SI Channel Divergence, I would also add some Sang Bai Pi.

I have never tried using this formula with Gui Zhi, Bai Shao, and Gan Cao, which have the properties of freeing the collaterals and relaxing the muscles to increase fluid absorption, but I might not rule it out.  Certainly, in Riley’s case, he perhaps needed a little bit of sedation, so a bit of muscle relaxation and cooling off might be in order — definitely add some Ge Gen (relax the upper back) and Zhi Zi (to cool the blood and go to the TW; otherwise, for heat in the blood with some stagnation, I would use Mu Dan Pi).

Zeng Ye Tang is used in cases of ye-fluid deficiency.  In cases of excess, regulate fluids through the Triple Warmer mechanism and with qi moving medicinals.  Qi moving medicinals tend to be drying, so be sure to balance the drying action on the ye-fluids with jin-fluid preserving herbs (wu wei zi, shi gao, sang ye).

As always, these posts are for informational purposes only.  If you have questions about herb-drug interactions, please see a qualified herbal practitioner in concert with your prescribing physician(s).  Do make certain all prescribing physicians are aware of all pharmaceuticals you are taking, and do not haphazardly combine herbal supplementation (i.e. in doing so you create your own formula inadvertently) without consulting a qualified herbalist.

Happy Slayage!


The Prom (Buffy, Season Three, Ep 20)

This is the episode in which Hell Hounds with a taste for the well-dressed are unleashed on Buffy’s senior prom classmates.  It is also the episode in which Joyce tells Angel that he must break up with Buffy, and do what she cannot.  While he does appear in time to have the last dance with Buffy, this is good-bye to the Buffy-Angel romance in Sunnydale.

Before the last dance, and before Joyce’s talk, if I recall correctly, was the dream-sequence scene which will be the focus of today’s diagnosis.  The context of the dream is the heart-rending decision which needs to be made between the two of them; the actual content of the dream sees Buffy explode into flames.

Clearly, the heart organ, being a fire-phase organ, is implicated.  However, I would like to suggest two other options.

First, dreams can have diagnostic significance in Chinese medicine, as elucidated by the Yellow Emperor in the Su Wen, and elaborated upon in the Jia Yi Jing (scroll 6, chapter 8).   Dreams of fire indicate an exuberance of both yin and yang; they are not anchored.  Dreams of smoke and fire, and hills indicate something going on with the Heart or Small Intestine, that is, with the fire-phase related organs.  (Technically, in the Jia Yi Jing, counterflow qi invading the small intestine would give rise to dreams of crowded streets and cities.)  In relation to the correspondence with fire-phase organs, I would extend the diagnostic possibilities to include the vessels (controlled by the Heart); the thick fluids and sweat (administered by the SI and HT); and also to the actual pathogen of fire itself.

Fire as a pathogen can affect the Heart, Stomach, Liver, Lungs, and Skin, and give rise to ‘fire toxins’.  Given the context of the dream, I would diagnose fire harassing the Heart.  Heart fire is often drained via the Small Intestine channel, or through the SI and Bladder.

Ying-spring points are recommended by the Nan Jing to treat fire conditions, so I would think of SI-2 being a good point to treat; to make the connexion to the Heart more explicit, I might add the luo point of the SI channel, SI-7 to the treatment.  I would not bloodlet the luo point, since I am using it in its capacity as a connecting point between the Heart and Small Intestine.  This gives a simple two point combination treatment to address the fire component.  However, it does not address the underlying factors, nor does it strengthen the most likely places the pathogen would move to after the Heart.

From the Heart, fire could move to the Lungs, which are very susceptible to dryness and heat.  After heartbreak, some people experience a period of dryness and numbness.  One could also argue this post-heartbreak experience is due to sadness and grief, which can weaken the Lung and make metal susceptible to illness.  In Buffy’s case, augmenting fluids, especially thin fluids in the case of the Lung, but also the water element more generally, would be recommended.

Taking a primary meridian perspective, rather than the previous three burners or physiological perpective, what follows the HT and SI channel in sequence is the Bladder and Kidney pair of channels.  Being water-phase related channels, one might think of tonifying them to build up fluids, extinguish fire, and arrest the progression of the pathogen.  A little bit of rest and darkness after a break up is often a good thing.  Points to think about would be KD-10, a water point on a water channel.  BL-40, which connects to Ming-Men, BL-23, may also be a good point to use.  In combination with the SI points mentioned above, it may be able to draw fire back to their source in the Kidneys, much like the herbal combination Huang Lian and Rou Gui.  I would not, in this case, use KD-2, since the KD are not experiencing a fire pathology as of yet, but I might consider tonfying KD-3 or BL-62.  Regardless, the treatment principle is to ensure that Kidney qi remains firm or stable.

With regard to herbs in general, Zhi Zi is a good heart fire herb, and treats a feeling of oppression in the chest, near the xiphoid process and the mu-point of the Heart.  In fact, one way to tell if zhi zhi should be added to a formula is to palpate that area; if tenderness is elicited, zhi zi could be added with good effect.  Buffy experienced chest oppression in this episode, reflective of her acute heartbreak.  (Regarding heartbreak, I might also think of the Pericardium, in its role as ‘Heart Protector’, and therefore add Dan Shen, and Xuan Fu Hua).  The resulting base formula is thus:  Dan Shen, to invigorate blood and supplement the PC and HT; Xuan Fu Hua, which descends, and treats the Lungs as well as the Heart; and Zhi Zi, to clear the fire.  Wu Wei Zi could be used to maintain the stability of Kidney qi and Lung qi both.

If the Lungs are thought to be in particular danger, I would also augment the three herbs with Huang Qin and Sha Shen.  Huang Qin is both tonifying for the Upper Warmer and it clears heat.  Sha Shen is moist and nourishes the Lungs; since HT fire can easily be transmitted to the LU, drying the fluids of the UW, Bei Sha Shen would be my chosen variety.

The other formula I might suggest would be Huang Lian E Jiao Tang, which treats kidneys, clears lungs, and descends fire.  The ingredients are huang lian, e jia, huang qin, bai shao, and ji zi huang (egg yolk).  This is a very tonifying formula, and if yin seems to be abundant (it has been so long since I’ve watched this episode, I cannot comment on the yin status of Angel and Buffy), then perhaps the simple but effective Jiao Tai Wan (ten parts huang lian to one part rou gui), as mentioned above, would suffice.

The second alternative I would suggest, and the one I would favour most, is to look at the Chong Mai.  The pathway of the Chong Mai follows that of the Kidney channel on the abdomen, and it disperses into the chest or heart (in men, it also continues and disperses onto the face, giving rise to facial hair).  As such, a different treatment strategy would be to stabilise the Chong Mai.  Treating the Chong Mai would serve the purpose of reigning in both yin and yang, as the initial dream diagnosis would require; but having its origin in the kidneys, stabilising the Chong would secure Kidney qi, as the previous treatment strategies mentioned.

Several herbs could serve this purpose, chief among them being Lu Rong.  Lu Rong tonifies the Du Mai, but also stabilises the Ren and Chong Mai.  Gui Ban seems to have its primary effect on the Ren Mai, and thus I would not consider it as a primary herb.  However, in the formula Gu Jing Wan, gui ban is used as the chief herb.  The formula clears heat and nourishes yin.  The formula typically treats continuous menstrual bleeding, or “gushing and trickling disorder”.  The ingredients, as provided by Zhu Dan-Xi, are prepared gui ban, dry fried bai shao, dry fried huang qin, dry fried huang bai, chun pi, and xiang fu.  In our current case, chun pi can be eliminated, since it focuses on astringing blood.  

The formula Shou Tai Wan, usually used to stablise the fetus in case of threatened miscarriage, relies less on animal ingredients, but its signs and symptoms have little to do with heat.  Nevertheless, for reference, the herbs in that formula are two parts tu si zi, and one part each of sang ji sheng, xu duan, and e jiao (this last being an animal product).  Interestingly, e jiao does clear the lungs, in addition to its role in stopping bleeding.

The point prescription I would use in this case would be:

Sp-4 to open the chong mai

KD-12, whose alternate name is ‘Yin Gate’

KD-14 is named after the stars which appear around prom time, between May 21 and June 4.  It treats accumulations of all sorts, though not fire.  Nonetheless, it might be interesting to consider this point. KD-15, Huang Shu relates to the area below the heart, and thus would be considered if KD-14 is not chosen.

KD-21, named ‘Dark Gate’, which in this particular instance I would relate to the mysterious process of love, heartbreak, life choices, and the unknown that comes with past loss and future potential.

PC-6 could be added to close the sequence, though I don’t consider this necessary.

As always, this post is meant for informational and entertainment purposes only.  If you feel you could benefit from Chinese medicine, please seek a qualified practitioner.  I am happy to provide references in MA, NY, FL, VT, CA, and in Oxfordshire, UK.