Too deficient to tonify

[Guest guest]

I wonder if anyone has any further information on this kind of state, apart

from he brief passage in Bensky, which I know Victoria has quoted before? I

am thinking speifically of the 'signs of deficiency fire appear with

tonification' version, I think that is what I might be dealing with in part.

 

Also Bensky has got me thinking about the combination of dampness and yin

deficiency, and the difficulty of treating one without exacerbating the

other, damaging yin. Any insights on that subject??

 

Thanks

 

Jackie

[Guest guest]

On Friday, July 18, 2003, at 07:04 AM, jackie wrote:

 

> Also Bensky has got me thinking about the combination of dampness and

> yin

> deficiency, and the difficulty of treating one without exacerbating the

> other, damaging yin. Any insights on that subject??

 

Liu Wei Di Huang wan contains some herbs to nourish yin as well as a

couple herbs that can drain damp. It can be used for a case in which

there is dampness and yin deficiency.

 

Of course, you might want to keep an eye on the patient carefully, to

make sure that the dosages are working out.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

> Liu Wei Di Huang wan contains some herbs to nourish yin as well as a

> couple herbs that can drain damp. It can be used for a case in which

> there is dampness and yin deficiency.

 

But it the context of possible 'too deficient to tonify' - it does not seem

to fit the bill. I have been looking for reasons for adverse reactions (that

I think would be classified as a heat reaction) to yin tonics in cases of

yin deficiency.

 

After such a reaction to a few very mild yin tonic herbs, I tried a modified

Liu Wei formula which contained more cold heat clearers, but the reaction

was the same if not more so.

 

Then in scouring Bensky's 'Formulas and Strategies' I ran across a section

on clearing deficiency heat pp100. There were a few things that ran bells

like:

 

" Because the yin and fluids are depleted, the body is unable to generate

sweat..........the fact that the patient does not lose his appetite

indicates the problem is not at the qi level, and the digestive system is

relatively unaffected. Nevertheless, injury to the yin and blood causes a

general loss of nourishment and thus emaciation'.

 

I wonder if, starting from a place of low spleen qi and dampness, if you add

heat from deficiency, that it's fluid stagnating effect could create a

relative lack of fluids (though a lack of fluid flow really)? Then,

increasing heat could further damage yin, leading to more deficiency heat -

a vicious circle? I wonder if this could possibly create a situation where

there is accumulation of fat (because of the damp) together with loss of

muscle (from the excess heat/deficiency) in late spring/ summer?

 

On pp102, in the Analysis of 'Cool the Bones powder' Qing Gu san, he says:

 

'.... although yin must be nourished to ensure any lasting benefit, the

primary focus should be on clearing heat from deficiency. The substances

that perform this function are different from the bitter, cold substances

that clear heat excess, since the latter would injure the yin. The

distinction of this formula is it utilises most of the major substances that

specifically clear heat from deficiency............Yin Chai Hu reduces the

fever from deficiency without any of the draining tendancies that could

further injure the yin. " In addition the deputies in the formula 'vent heat

externally'.

 

It's very difficult to sort out the chicken from the egg, but it seems to me

from Bensky's comments, maybe Lui Wei is balanced to prevent there being any

stagnation of fluids caused whilst yin is tonified, rather than for treating

a very hot, stagnant/deficient pattern?

 

I notice Da Bu Yin wan on pp 267 is aimed more at holding down rising

yang/fire too - just don't fancy boiling up pigs marrow for a horse!<g>

 

Does this make sense?

 

Jackie

[Guest guest]

On Saturday, July 19, 2003, at 07:05 AM, jackie wrote:

 

> It's very difficult to sort out the chicken from the egg, but it seems

> to me

> from Bensky's comments, maybe Lui Wei is balanced to prevent there

> being any

> stagnation of fluids caused whilst yin is tonified, rather than for

> treating

> a very hot, stagnant/deficient pattern?

 

Here's how I see it, having consulted the Bensky text:

 

Liu Wei Di Huang Wan:

clears def. heat = nourishes yin

 

Da Bu Yin Wan

clears def. heat > nourishes yin

 

Qing Gu San

clears def. heat only.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

> Here's how I see it, having consulted the Bensky text:

>

> Liu Wei Di Huang Wan:

> clears def. heat = nourishes yin

>

> Da Bu Yin Wan

> clears def. heat > nourishes yin

>

> Qing Gu San

> clears def. heat only.

 

For sure but only Liu Wei encourages urination, drains dampness too, doesn't

it?

 

It seems to be a question of emphasis - I don't know if draining could cause

a problem in cases of more severe or maybe chronic deficiency fire? But I

can see why the fire might have to be given more prominence on occasions.

 

And I don't understand why certain herbs are more specific for clearing heat

from deficiency, but their action must be different for them to be

classified so mustn't it?

 

Jackie

[Guest guest]

> Then in scouring Bensky's 'Formulas and Strategies' I ran across a

section

> on clearing deficiency heat pp100. There were a few things that ran

bells

> like:

>

> " Because the yin and fluids are depleted, the body is unable to

generate

> sweat..........the fact that the patient does not lose his appetite

> indicates the problem is not at the qi level, and the digestive

system is

> relatively unaffected. Nevertheless, injury to the yin and blood

causes a

> general loss of nourishment and thus emaciation'.

 

When the term " level " is used in TCM, the author usually is talking

about the four levels of Virulent Heat Evils or Warm Diseases. The

Virulent Heat model was developed when China began to get hit with

epidemics which overwhelmed the strongest Protective Qi. It was

recognized that the old Six Stages of Cold-Induced Evils was

inadequte in predicting the course of and providing effective

treatment for these new epidemics.

 

The four levels are Protective (Wei), Qi, Nutritive (Ying), and Blood

(Xue). These are further subdivided. For example, Wei-stage Wind

Heat and Wei-stage Wet Heat.

 

As far as Qi Deficiency (as opposed to the Qi-level of a Virulent

Heat Evil), the usual manifestation is loss of appetite. BUT, you'll

run across some cases where the opposite will occur. Instead of loss

of appetite, the individual will have a voracious appetite.

Sometimes, this paradox is related to Stomach Yin Deficiency or Heat

in the Stomach, but not always.

 

I also want to point out that a person can be overweight and still

be " emaciated " . The person is Fluid and Blood Deficient, and this

causes the skin to look wrinkled. This is not a case of the skin

being loose and wrinkled because fat has been lost in a hurry but

because the person lacks needed Fluid and Blood.

>

> I wonder if, starting from a place of low spleen qi and dampness,

if you add

> heat from deficiency, that it's fluid stagnating effect could

create a

> relative lack of fluids (though a lack of fluid flow really)? Then,

> increasing heat could further damage yin, leading to more

deficiency heat -

> a vicious circle? I wonder if this could possibly create a

situation where

> there is accumulation of fat (because of the damp) together with

loss of

> muscle (from the excess heat/deficiency) in late spring/ summer?

 

TCM recognizes that any extreme can change into its opposite. Noon

is the most Yang time of the day, and thereafter Yang starts to wane

and Yin starts to wax until midnight which is the most Yin time of

the day. After midnight Yin starts to wane and Yang to increase.

 

You'll also see things changing into their opposites in health

matters. You've touched on some of them. Dampness damages the

Spleen, thus creating more Dampness because one of the functions of

Spleen Qi is to " transform and transport " Fluids. One of the

symptoms of Qi Deficiency is spontaneous sweating. This can only go

on so long before the person starts to develop Dryness problems. The

clinical picture will be one of mixed Dampness and Dryness. This is

going to be more difficult to treat than either Dampness or Dryness

alone because when you treat one, you often aggravate the other. Dry

the Dampness, and Dryness becomes worse. Moisten the Dryness, and

the Dampness can become worse.

 

There is also the factor of Hot/ Cold not being the same throughout

the body. A common scenario in humans (don't know about horses since

they don't walk upright) is Heat in the Lungs and Heart and Cold

below the waist. (Heat rises.) Treat the Heat, and it can make the

Cold worse. Treat the Cold, and it can make the Heat worse.

 

There are guide herbs which will target specific merdians and Organs,

but I have had mixed success with these. But that probably is due to

there being a lot I still need to learn. I've gotten somewhat better

results with a combination of herbs and acupressure, using the herbs

to treat the Coldness and the acupressure to release Heat.

 

" Heat from deficiency can occur for many reasons. When it arises

during the final stage of a warm-febrile disease when the heat has

depleted the yin or settled into the deep, yin regions of the body,

it is characterized by fever at night which cools by morning.

Chronic injury to the Liver and Kidneys may present with similar

symptoms including tidal fever, steaming bone disorder, or a chronic,

unremitting low-grade fever.

 

" The formulas which are used in treating this type of disorder

consist of herbs that clear heat from deficiency and enrich the yin.

If the signs of deficiency are more pronounced than those of heat,

formulas that tonify the yin should be prescribed (see chapter 8). "

(Chinese Herbal Medicine Formulas & Strategies, DAn Bensky & Randall

Barolet, pp. 100-101.)

 

Yin Deficiency can arise or Yin can be damaged due to a variety of

causes. One of these is a Warm-febrile (fever) disease injuring the

Yin. Heat can damage Yin, which leads to more Heat from Yin

Deficiency. This Heat can transform into " Fire " . The formulas in

this section of Bensky and Barolet are particularly good for cases

where a feverish disease has led to Yin Deficiency. Or, particularly

good for cases where Yin Deficiency is manifesting primarily with

Heat.

 

One phrase you'll see a lot is " Yin Deficiency with Heat " .

Deficiency Heat (not enough Yin to cool the body properly) is not the

only possible manifestation of Yin Deficiency. Yin also calms and

moistens the body. Sometimes the aggitation (not enough Yin to calm)

will predominate. Sometimes the Dryness will predominate. When you

see the phrase " Yin Deficiency with Heat " it means that the

Deficiency Heat symptoms are particularly marked in the individual,

and that Heat needs to be cleared in addition to the Yin being

supplemented.

 

Not any old Heat-clearing formula or herb will do when it comes to

clearing Deficiency Heat. Some of these Heat-clearing herbs will

damage Yin! " Nor should bitter, cold herbs that clear heat be

prescribed, since they will cause further injury to the yin. " (p.

101) Bensky and Barolet also talk about the need for clearing Heat

when Yin Deficiency manifests as Heat: " Once heat has settled in the

body, it is unwise to nourish the yin alone since this will only

serve to trap the heat inside. " (p. 101) This is touching on the

problem of Damp Heat developing. (Yin moistens in addition to cooling

and calming. If Heat is present, that moistening can turn into Damp-

Heat.)

 

There may be some difficulties in analzying " Steaming Bone Disorder "

in animals since the main symptom relies on the individual being able

to report a feeling of heat deep inside though the body even though

the skin feels normal. This disorder frequently shows up in

connection with what is called diabetes in the West. The Bensky and

Barolet description of the herbs used in this formula does offer

insights into herbs to use when Heat needs to be cleared but you

don't want to do it via sweating because the individual is sweating

too much already because of Qi Deficiency, and further sweating will

damage the Qi further.

 

I've emphasized some of the things you've said as a way of helping

you sort out which came first and how to approach healing in this

particular individual.

 

Victoria

 

>

> On pp102, in the Analysis of 'Cool the Bones powder' Qing Gu san,

he says:

>

> '.... although yin must be nourished to ensure any lasting benefit,

the

> primary focus should be on clearing heat from deficiency. The

substances

> that perform this function are different from the bitter, cold

substances

> that clear heat excess, since the latter would injure the yin. The

> distinction of this formula is it utilises most of the major

substances that

> specifically clear heat from deficiency............Yin Chai Hu

reduces the

> fever from deficiency without any of the draining tendancies that

could

> further injure the yin. " In addition the deputies in the

formula 'vent heat

> externally'.

[Guest guest]

> Sometimes, this paradox is related to Stomach Yin Deficiency or Heat

> in the Stomach, but not always.

 

Yes I believe I have seen that too. My horse has a good appetite always, but

voracious in summer because of heat i think. Another metabolic horse I have

here, kd yin deficient I believe, has a voracious appetite in summer, and a

very poor one in winter.

 

> I also want to point out that a person can be overweight and still

> be " emaciated " . The person is Fluid and Blood Deficient, and this

> causes the skin to look wrinkled.

 

Several owners have seen that too in terms of 'poor turgor' - the skin once

pinched only sinks back slowly, as it would in dehydration. This does seem

to be more about blood - dehydration is not revealed on blood tests often.

This is a spring phenomenon in mine.

 

 

> There is also the factor of Hot/ Cold not being the same throughout

> the body. A common scenario in humans (don't know about horses since

> they don't walk upright) is Heat in the Lungs and Heart and Cold

> below the waist. (Heat rises.) Treat the Heat, and it can make the

> Cold worse. Treat the Cold, and it can make the Heat worse.

 

Yes, on two days when treating the liver heat in spring, I would suddenly

have a cold skinned horse in the morning. Exercise did not warm his skin up

either, but food did, immediately. But hot feet and Liver seems to be the

biggest problem they face.

 

 

> There may be some difficulties in analzying " Steaming Bone Disorder "

> in animals since the main symptom relies on the individual being able

> to report a feeling of heat deep inside though the body even though

> the skin feels normal. This disorder frequently shows up in

> connection with what is called diabetes in the West.

 

Interesting isn't it. Of course insulin resistance is the unifying factor

for most of these horses. I would not say 'This is what my horse has' but as

an investigation of there 'being a lot more heat deep inside than it would

appear' it seems to offer insight, maybe a way forward. Heat as I understand

it not only covers fever, but also inflammation and maybe hyperfunction,

excitory processes like overstimulation of the sympathetic nervous system?

IR and diabetes, they are discovering, are as much about circulatory and

cellular inflammation as it is about insulin and glucose homeostasis.

 

Jackie

[Guest guest]

-

victoria_dragon

Chinese Traditional Medicine

Sunday, July 20, 2003 7:04 AM

[Chinese Traditional Medicine] Re: Too deficient to tonify

 

<The four levels are Protective (Wei), Qi, Nutritive (Ying), and Blood (Xue).

These are further subdivided.>

 

Victoria,

I understand the above statement to reference four levels, but I only see that

you've identified Wei, Ying, and Xue (three levels). What is the fourth?

Jessica

 

 

 

[Guest guest]

> <The four levels are Protective (Wei), Qi, Nutritive (Ying), and

Blood (Xue). These are further subdivided.>

>

> Victoria,

> I understand the above statement to reference four levels, but I

only see that you've identified Wei, Ying, and Xue (three levels).

What is the fourth?

 

Qi is the second. Wei, Qi, Ying, and Xue.

 

Wei is the least serious, and Xue is the most serious. The Xue-stage

is divided into Xue-stage Excess Heat and Xue-stage Yin Damage.

 

Victoria

[Guest guest]

Thanks! I see where I misread it.

-

victoria_dragon

Chinese Traditional Medicine

Sunday, July 20, 2003 6:00 PM

Fw: [Chinese Traditional Medicine] Re: Too deficient to tonify

 

 

> <The four levels are Protective (Wei), Qi, Nutritive (Ying), and

Blood (Xue). These are further subdivided.>

>

> Victoria,

> I understand the above statement to reference four levels, but I

only see that you've identified Wei, Ying, and Xue (three levels).

What is the fourth?

 

Qi is the second. Wei, Qi, Ying, and Xue.

 

Wei is the least serious, and Xue is the most serious. The Xue-stage

is divided into Xue-stage Excess Heat and Xue-stage Yin Damage.

 

Victoria

 

 

 

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