Yin Fire - treating difficult conditions.

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Extracts from:

 

LI DONG-YUAN'S THEORY OF YIN FIRE & DIFFICULT TO TREAT, KNOTTY DISEASES

by Bob Flaws, Dipl. Ac. & C.H., FNAAOM

 

Full text at www.bluepoppy.com

 

 

.......Although we must explain these one after the other in a linear

fashion, the reader should understand that these five disease mechanisms are

all mutually interdependent. This means that any one of these mechanisms can

result in the creation of any of the others. Because of this, real-life

patients do not typically exhibit only one or another of these five, but

rather three, four, or all five at one time. However, Li begins his

explanation of yin fire with the spleen, and that is where we will also

begin.

 

If, due to over-thinking, anxiety and worry, under-exercise, over-taxation,

faulty diet, or erroneous medical treatment, the spleen qi is damaged and

become vacuous and weak, then the spleen will not be able to do its various

duties and functions. One function of the spleen is to control water liquids

in the body, moving and transforming these. If the spleen qi becomes vacuous

and weak and, thus, cannot move and transform water liquids, these may

gather and accumulate and transform into dampness. This dampness may then

hinder and obstruct the free flow of yang qi. Because yang qi is inherently

warm, it too becomes stagnant and depressed. The yang qi backs up and

transforms into depressive heat. If this depressive heat mutually binds with

accumulated dampness, this will give rise to damp heat. Although this damp

heat may be engendered in the middle burner, dampness, being turbid and

heavy, typically percolates downward to the lower burner. However, because

heat is yang, it tends to counterflow upward. If this heat counterflows

upward, it may damage yin fluids and the qi of the spleen, stomach, heart,

and/or lungs.

 

If, due to unfilled desires or anger damaging the liver, the liver loses its

command over coursing and discharge, the liver will become depressed and the

qi become stagnant. Once again, because the qi is inherently yang and,

therefore, warm, qi depression may transform into depressive heat. These

heat evils will also counterflow upward to accumulate in and damage the

spleen, stomach, heart, and/or lungs. Because liver depression is a

repletion and replete liver wood may counterflow horizontally to assail the

spleen, liver depression typically results in concomitant spleen qi vacuity.

 

If, for any of the above reasons, the spleen becomes vacuous and weak, it

may also not engender and transform blood adequately. This may then give

rise to blood vacuity. Blood and essence share a common source. This means

that the liver and kidneys share a common source. Great or enduring blood

vacuity may eventually reach the kidneys, resulting in kidney yin vacuity.

If yin become insufficient to control yang, then yang may become hyperactive

and also ascend. In addition, it is the blood which nourishes the liver. The

Nei Jing (Inner Classic) says that when the feet obtain blood, the feet can

walk. When the hands obtain blood, the hands can grasp. When the eyes obtain

blood, the eyes can see. And when the ears obtain blood, the ears can hear.

This means that the function of any tissue or organ in the body is dependent

on adequate nourishment by blood. If the spleen fails to engender and

transform adequate blood, then the liver may be deprived of its nourishment.

If the liver fails to obtain blood, then it cannot do its duty of coursing

and discharging the qi. ***Therefore, liver blood vacuity leads to or

aggravates liver depression qi stagnation. If this liver depression

transforms into heat or fire, it can then eventually evolve into liver yang

ascendant hyperactivity or vacuity heat................****

 

Although most Westerners know that lifegate fire is synonymous with kidney

yang or kidney fire, few also know that lifegate fire is larger than just

kidney yang. Lifegate fire is the root of all yang in the body. This means

that the yang qi of all the viscera and bowels join in and partake of the

ministerial fire. If the yang qi in any viscera or bowel becomes hot or

hyperactive for any reason, this may cause upward stirring of ministerial

fire. This is called xiang sheng or mutual engenderment in Chinese. The

reader should here remember the saying that, " The seven emotions when

extreme may all transform into fire. " According to yin fire theory, this

implies that any extreme emotion may also stir ministerial fire.

 

If the ministerial fire counterflows upward, several things may happen.

First, Li says that the ministerial fire and the spleen qi are mutual

enemies. In the Pi Wei Lun, Li says that the ministerial fire and spleen qi

cannot both exist in the same place. Therefore, if the ministerial fire

stirs upward, it may, and commonly does, damage the spleen qi. Second, if

ministerial fire stirs upward, it may lose its root in its lower source.

This means that upward stirring of ministerial, or lifegate, fire may leave

the lower burner vacuous and cold below, while heat accumulates above. And

third, if heat accumulates above, it will typically consume stomach yin, lie

deeply or hide in and damage the lungs, and/or cause restlessness of the

heart spirit.

 

Conversely, one way of preventing upward stirring of ministerial fire is to

keep the spleen fortified and strong. According to Li, if the spleen qi is

healthy and strong, then earth qi, i.e. dampness, will not pour downward to

damage the kidneys and stir the lifegate. Another way of preventing upward

stirring of ministerial fire is to keep the clear qi's upbearing and the

turbid qi's downbearing freely flowing, and this immediately implies

maintaining the liver's coursing and discharging of the qi. ......

 

All this means that yin fire scenarios are typically complicated by the

presence of external evils, deep-lying or hidden evils, or retained evils,

phlegm congelation or nodulation, food stagnation, etc. Yin fire scenarios,

therefore, are not just made up of the five basic patterns or mechanisms

listed above but usually involve at least some other externally invading or

internally engendered evil qi. The above explanations should also not be

taken as categorically complete. They merely serve to indicate some of the

main, most obvious complications of the five basic disease mechanisms

identified by Li Dong-yuan as the root of yin fire.

 

When it comes to treating yin fire, it is like Alexander the Great and the

Gordian Knot. When Alexander was in Anatolia (present-day Turkey), he was

presented with the Gordian Knot and told that whoever was able to untie this

knot would rule all of Asia. Many had tried, but all before Alexander had

failed. Whenever one pulled on one side of this knot, it tightened up

somewhere on the other side. Alexander pondered this problem for a bit, then

drew his sword, and cut the knot in two all in one stroke. Yin fire

scenarios must be managed in Chinese medicine with much the same technique.

If one looks at the majority of Li's formulas in his two greatest books, the

Pi Wei Lun and the Lan Shi Mi Cang (The Orchid Chamber Secret Treasury), one

can identify five basic principles Li used to treat multi-pattern yin fire

conditions (I am indebted to my good friend, Charles Chace, who first

identified these five principles in this way). These five principles are:

 

1. To fortify the spleen and boost the qi so that the clear can be upborne

and the turbid downborne. Medicinally, it is sweet, warm medicinals which

mostly do this.

 

2. To disinhibit the qi mechanism and promote the free flow of upbearing and

downbearing. Medi-cinally, this is primarily accomplished by acrid,

qi-rectifying, exterior-resolving medicinals.

 

3. Clear whatever kind of evil heat is present. Medicinally, this mainly

implies using at least some bitter, cold medicinals.

 

4. Identify whatever disease mechanisms are also at work and also use

ingredients which rebalance those mechanisms. Therefore, if there is blood

stasis, use blood-quickening medicinals. If there is phlegm, use

phlegm-transforming medicinals. If there is disquieted spirit, use

spirit-quieting medicinals, etc. In other words, do whatever else is

necessary.

 

5. Determine the relative strengths and priorities between the above four

principles and compose your treatment plan accordingly. This means that one

may not start as the basis of their treatment with a qi-supplementing

formula. If heat is the main thing, then the guiding formula will probably

come from the heat-clearing category. However, in that case, if there is

truly a yin fire scenario, the formula will need to be modified with at

least some spleen-supplementing and liver-rectifying medicinals. Likewise,

if the main condition is blood stasis but blood stasis occurs within a yin

fire pattern, then one may begin with a blood-quickening formula but then

modify that with the probable inclusion of spleen supplements,

heat-clearers, and liver-rectifiers.