Help me understand my treatment : Tonify Spleen and transform phlegm

[Guest guest]

this is what my ac told me, so if she needs to tonify spleen and

transform phlegm, then does that mean i have over deficient or excess

spleen " qi " ? does that also mean i have phlegm...and to transform it

into what?

 

my main problem is fertility which is supposed to be related to kidney

and auto-immune hyper-active immune system which is related to lungs

but she didnt mention i have problems with those and instead, to

tonify spleen and transform phlegm...

 

marilyn

[Guest guest]

Chinese Traditional Medicine , " emailme_marilyn "

<emailme_marilyn wrote:

>

> this is what my ac told me, so if she needs to tonify spleen and

> transform phlegm, then does that mean i have over deficient or

excess

> spleen " qi " ? does that also mean i have phlegm...and to transform it

> into what?

>

> my main problem is fertility which is supposed to be related to

kidney

> and auto-immune hyper-active immune system which is related to lungs

> but she didnt mention i have problems with those and instead, to

> tonify spleen and transform phlegm...

>

> marilyn

>

 

Here is an article that goes deeply (and intelligently)into the issues

raised in the question above and several other questions recently

asked. If one can understand these issues it will be a step forward in

understanding many common but difficult to resolve problems.

Marilyn - human body is not as simplistic as many think - so many

sytems are involved in pathology that it is not possible to second

guess diagnosis and therapy - this article clearly explains why.

 

This article can be read at www.bluepoppy.com. Bob Flaws is a world

treasure and has done an immense service to TCM and the English

speaking TCM community. He is a internationaly recognised scholar as

well as one of the greatest TCM clinicians - in my opinion he is one

of the world's greatest Gyneocologists and Obstetricians.

Unfortuantely - from what I have heard - he does not accept new

patients. He is an unbelievably busy person - He is a perfect example

of a true physician combining the mind of a scholar and master

clinician with sense of public service - his free contributions to the

public and to other clinicians is widely praised. He has written many

books a few of which will become classics.

 

This is heavy going for those who do not understand TCM terminology

but it is worthwhile reading just to get a sense of how a master of

TCM thinks and looks at these issues we have been discussing.

 

Here is the link and the article - note especially the comments about

phlegm and its relationship to many pathological states. Remember

phlegm is produced in the Spleen and stored in the Lungs.

 

http://www.bluepoppy.com/press/download/articles/autoimmune.cfm

 

ALLERGIES, AUTOIMMUNE DISEASES & YIN FIRE

 

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

 

INTRODUCTION

If one looks at the pattern discrimination of various allergies and

autoimmune diseases in modern Chinese medical texts, one will see

several patterns listed under each disease category. Then, under each

pattern, there are generalized signs and symptoms, tongue signs, and

pulse signs. Under that come the treatment principles for that

particular pattern. And finally, there is a suggested Chinese

medicinal formula based on the treatment principles. Therefore, such

textbooks make it seem that the clinician's job is to determine which

of the listed patterns their patient exhibits and then give them the

treatment described under that pattern.

 

The problem with this very clear-cut methodology is that patients with

allergies and autoimmune diseases rarely exhibit a single pattern.

Rather, real-life patients with these kinds of chronic diseases

typically exhibit three, four, five, or six patterns simultaneously.

This means that no single formula under any one pattern is going to be

categorically correct.

 

For instance, many Chinese medical beginners' textbooks give the

patterns under allergic rhinitis as wind cold external invasion

pattern, lung qi vacuity pattern, spleen qi vacuity pattern, kidney

yang vacuity pattern, and phlegm dampness pattern. However, first of

all, we must distinguish between the acute allergic episode and the

underlying bodily constitution or terrain, what Chinese doctors refer

to as the " habitual bodily " condition. During an acute allergic

rhinitis attack, the attack itself is provoked by an unseen airborne

pathogen, i.e., wind, and the signs and symptoms most typically

involve clear, white or " cold " phlegm. Therefore, the acute episode is

described as a wind cold external invasion pattern. But this does not

account for why one person has been invaded when another exposed to

the same external evils has not.

 

If one is invaded by external evils, it means that the person's

defensive qi has not been strong enough to secure the exterior and

densely pack the interstices. The defensive qi is manufactured by the

spleen qi and sent up to the upper burner for distribution to the

exterior by the lungs. Hence, we can say that everyone suffering from

allergic rhinitis has a de facto defensive qi vacuity. In clinical

terms, this means a lung-spleen qi vacuity. All the medicinals used to

supplement the defensive qi primarily supplement the lung qi by

fortifying the spleen and boosting the qi. Therefore, it is not that

some allergic rhinitis sufferers have a lung qi vacuity, while others

exhibit a spleen qi vacuity.

 

THE CENTRAL ROLE OF THE SPLEEN IN ALLERGIC & AUTOIMMUNE DISEASES

The spleen is in charge of moving and transforming water liquids. If

the spleen is vacuous and weak, then it may fail to move and transform

water within the body. If this gathers and accumulates, water may

transform into dampness. If this dampness endures, it may congeal into

phlegm. Thus it is said, " The spleen is the root of phlegm

engenderment, while the lungs are [only] the place where phlegm is

stored. " Therefore, everyone with allergic rhinitis does have phlegm

dampness, not just lung-spleen qi vacuity.

 

The spleen is the latter heaven or postnatal root, while the kidneys

are the former heaven or prenatal root. The postnatal and prenatal

support and assist one another. When we are young, our kidneys and

spleen are both immature, meaning vacuous and weak. Our spleen matures

first at around six or seven years of age. It is because the spleen

matures and now engenders a superabundance of qi and blood postnatally

that acquired essence can bolster the kidneys and hence the kidneys

can mature and become exuberant at adolescence. Likewise, it is the

spleen which first become weak due to aging, and then only secondarily

do the kidneys become vacuous and weak after that. Therefore, in

clinical practice, one rarely encounters a pure kidney yang vacuity.

In almost all cases, what one actually sees is a spleen qi-kidney yang

vacuity. Since the lungs, spleen, and kidneys are the three viscera

which transform and engender the qi and which move and transform water

in the body, when one of these malfunctions, typically at least one

other does as well. Therefore, what one really sees as the underlying

terrain of allergic rhinitis sufferers is either a lung-spleen qi

vacuity with phlegm dampness or a lung-spleen qi vacuity and kidney

yang vacuity with phlegm dampness. Then invasion of external wind cold

evils is superimposed on this habitual bodily constitution.

 

In addition, because the clear qi is not being upborne and dampness

and phlegm are hindering and obstructing the free flow of qi, most

allergic rhinitis patients also exhibit signs and symptoms of liver

depression qi stagnation even though no Chinese textbook lists this as

one of the patterns of this disease. Yet I have never seen an allergic

rhinitis patient who did not have at least some signs and symptoms of

liver depression. If nasal obstruction has endured for a long time,

cold evils may have transformed into heat. Because qi moves the blood

and if the qi stops, the blood stops, enduring nasal congestion may

also have resulted in blood stasis. So besides, lung-spleen qi

vacuity, phlegm dampness, and liver depression with possible kidney

yang vacuity, there may also be transformative heat, damp heat, and/or

blood stasis. And as soon as our patients exhibit a combination of

spleen vacuity, liver depression, and some kind of evil heat, we have

crossed into the territory of yin fire.

 

YIN FIRE & ALLERGIES AND AUTOIMMUNE DISEASES

In fact, most sufferers of allergies, including atopic dermatitis,

allergic asthma, and so-called food allergies, including allergic

colitis, exhibit yin fire patterns with spleen qi vacuity, liver

depression, and some kind of heat, usually depressive and/or damp

heat. Likewise, most autoimmune sufferers also exhibit the same or

similar combination of core patterns. Remember, autoimmune diseases

are simply an allergy against onself. Such autoimmune diseases include

rheumatoid arthritis (RA), dermatomyositis/polymyositis, systemic

lupus erythmatosus (SLE), multiple sclerosis (MS), scleroderma,

myasthenia gravis, Sjögren's syndrome, Crohn's disease, Hashimoto's

thyroiditis (a type of hypothyroidism), and endometriosis (due to

autoimmune ovaritis). Most patients with autoimmune diseases do not

exhibit a single textbook pattern but rather a cluster of patterns

perhaps best described by Li Dong-yuan's yin fire theory. Further,

most patients with chronic fatigue immune deficiency syndrome (CFIDS)

and fibromyalgia also exhibit yin fire patterns. In other words, most

patients with these conditions exhibit some combination of spleen qi

vacuity, liver depression, and evil heat plus some other patterns as

well.

 

Take for instance rheumatoid arthritis. The overwhelming majority of

patients with rheumatoid arthritis complain of fatigue. Fatigue is the

single most obvious and important symptom of a qi vacuity, and the

spleen is the latter heaven root of qi engenderment and

transformation. Therefore, most patients with rheumatoid arthritis

have a spleen qi vacuity. Now, anyone who is chronically ill is going

to have liver depression qi stagnation even if that liver depression

did not originally cause their disease. After all, if one is diseased,

one ipso facto cannot fulfill all one's desires. Either one cannot do

what one wants, eat what one wants, look as one wants, or cannot get

away from one's pain as one wants. Such unfulfilled desires are the

main cause of liver depression. Therefore, everyone who is chronically

ill does have liver depression.

 

The joint pain of rheumatoid arthritis is categorized as bi or

impediment in Chinese medicine. Either it can be wind cold damp

impediment or wind damp heat impediment. One or the other of these is

typically superimposed on a basis of spleen qi vacuity and liver

depression. In rheumatoid arthritis in the West, wind damp heat

impediment is very common. If the spleen qi is vacuous and weak, then

the spleen may not be engendering and transforming blood sufficiently.

Therefore, there may be a concomitant liver blood-kidney yin vacuity.

Or kidney yin vacuity may be due to enduring heat damaging and

consuming yin fluids. It is also possible that enduring disease or

aging may result in spleen qi vacuity evolving into kidney yang

vacuity, in which case there is still spleen qi vacuity but now there

are also some signs and symptoms of kidney yang vacuity as well. If

the qi is vacuous and the liver is depressed, the qi may not have

either the power or the free flow to move blood and water liquids. In

that case, there may be the complications of blood stasis and/or

phlegm nodulation.

 

RA, dermatomyositis, polymyositis, Crohn's arthritis, fibromylagia,

and SLE are all types of impediment conditions due to complicated yin

fire scenarios. MS is a wilting condition (wei zheng) due to the same

basic disease mechanisms minus the impediment patterns. Most

autoimmune sufferers have a history of one or more allergies. They

often have histories of antibiotic use, which has damaged the spleen.

In China today, a popular topic for Chinese medical journal articles

is post-antibiotic spleen qi vacuity or intestinal dysbiosis due to

spleen qi vacuity in turn due to antibiotics. In such cases, the

spleen qi has been damaged and this results in dampness, while

dampness transforms into damp heat. We have discussed some of the most

important causes of spleen qi vacuity in a previous essay. In the

West, these have to include faulty diet, too much thinking, too much

worry and anxiety, not enough exercise, and too much work, and usually

there are some or all of these in significant amounts in allergy and

autoimmune patients.

 

WOMEN & AUTOIMMUNE DISEASES

In particular, more women than men suffer from autoimmune diseases and

the incidence of such autoimmune diseases increases in the mid-30s and

through the 40s and 50s. This is no accident and also has to do with

the same set of disease mechanisms we have been discussing under the

title yin fire. Women lose blood every month. Therefore, they are more

prone to spleen vacuity than men, since it is the spleen, which

carries the brunt of blood production. Even if a woman does not lose

too much blood each month, the fact that during the second half of her

menstrual cycle two things happen which account for the cyclic

worsening of both spleen qi vacuity and liver depression. If a woman

is marginally blood vacuous, when the blood is sent down to accumulate

in her uterus during the premenstruum, there may not be enough left

over to emolliate and harmonize her liver. Thus her liver becomes

depressed and her qi becomes stagnant. Since this also means that the

liver is replete, a replete liver may invade the spleen, making it

vacuous and weak. All this helps explain why women are more at risk

for autoimmune diseases than men. It also explains PMS and why PMS

worsens in the mid-30s and 40s.

 

The Nei Jing says that the spleen becomes weak due to aging in the mid-

30s in women. Thus it is common for the incidence of autoimmune

diseases, read yin fire scenarios, to increase after 35 or so. By the

40s, spleen qi vacuity is beginning to affect kidney yang. The yang of

the kidneys is also necessary for the liver to do its job of coursing

and discharge. Liver function is not just dependent on blood for its

nourishment. It also requires kidney yang to " warm and steam " the

liver. If kidney yang becomes weak due to aging as a consequence of

the spleen qi no longer bolstering and assisting it the way it once

had, then this will also aggravate any tendency towards liver

depression qi stagnation.

 

HOW TO TREAT ALLERGIES & AUTO-IMMUNE DISEASES VIS Á VIS YIN FIRE

Thus round and round it goes. But it is Li Dong-yuan's theory of yin

fire, which helps one cut through this cycle of one disease mechanism

engendering another. When one suffers from an allergic or autoimmune

disease, during times of relative remission, one needs to treat all

the disease mechanisms associated with the " habitual bodily " or

underlying condition all at one go. Then, during acute exacerbations,

one needs to treat the underlying " habitual bodily " condition plus any

other patterns superimposed upon that basis.

 

In other words, during acute allergic rhinitis episodes, one usually

needs to supplement the lung and spleen qi (really the same thing),

possibly also supplement kidney yang, rectify the qi and downbear

counterflow, transform phlegm and eliminate dampness, and dispel wind

and disinhibit the portals (of the nose), while securing the exterior.

If damp phlegm has transformed into damp heat and phlegm, then one

might also have to clear heat.

 

In the case of RA, during remission, one typically has to supplement

the spleen qi, possibly supplement liver blood and kidney yin,

possibly also supplement kidney yang, course the liver and rectify the

qi, possibly clear depressive, damp, or vacuity heat, possibly quicken

the blood and dispel stasis and/or transform phlegm and scatter

nodulation. During acute attacks, one must do all of this plus dispel

either wind, cold, dampness or wind, damp, heat, free the flow of

impediment, and stop pain. In SLE, there basically is always wind damp

heat impediment, and not wind cold dampness.

 

Likewise, in the case of MS, one usually has to supplement the same

viscera as in RA, course the liver and rectify the qi, and possibly

quicken the blood and dispel stasis. If there is damp heat, one must

also clear heat and eliminate dampness, even though this is not damp

heat impediment, per se. Usually in MS, there is also some element of

either blood vacuity or yin dryness somewhere in the body even if

there is spleen vacuity with dampness transforming into damp heat.

 

CONCLUSION

 

Because most allergy and autoimmune disease sufferers do not manifest

the single, simple, discreet patterns that are described in beginners'

textbooks, they require more complex formulas than the simple

classical formulas which for the bulk of commonly available

Chinese " patent medicines. " Because these are chronic conditions that

require long-term, protracted treatment, administering medicinals in

pill form makes such long-term treatment easier, and, hence patient

compliance is greater. Therefore, I believe many Western patients with

chronic allergic conditions and autoimmune diseases will benefit from

Blue Poppy Formulas based on Li Dong-yuan's yin fire theories. These

are the types of formulas which I prescribe to all my patients with

these sorts of diseases, and this is what I have seen work best in

Western patients with these " difficult to treat, knotty diseases. "

 

For More Information...

 

Check out Blue Poppy Seminars Allergies & Autoimmune Diseases Distance

Learning Program

[Guest guest]

I want to emphasize something from the article for the readers who

are new to TCM:

 

" THE CENTRAL ROLE OF THE SPLEEN IN ALLERGIC & AUTOIMMUNE DISEASES

The spleen is in charge of moving and transforming water liquids. If

the spleen is vacuous and weak, then it may fail to move and

transform

water within the body. If this gathers and accumulates, water may

transform into dampness. If this dampness endures, it may congeal

into

phlegm. "

 

One of the functions of the Spleen is to transport and transform

water in the body. If the Spleen is weak and the Spleen Qi

Deficient, this doesn't happen like it needs to, and Dampness

results. If that Dampness hangs around long enough, it congels into

Phlegm.

 

Please keep in mind that TCM Organs are not equivalent to anatomical

organs. They are collections of functions. Some of these functions

are recognized in Western anatomy and physiology - like the Kidneys

and kidneys and urination - but some are not. (Like the Kidneys

including many of the functions associated with the adrenal glands.)

 

Some of the functions of the Spleen includes functions of the

pancreas. In fact, some Western writers even refer to it as the

Spleen-Pancreas. But some of the functions of the Spleen aren't

functions of either the spleen or the pancreas. For example, the

Spleen (Qi) transforms and transports water. If it's Deficient, the

water is going to accumulate into Dampness because it's not being

properly moved. If that Dampness hangs around long enough, it will

congel into Phlegm.

 

One of the hardest steps for most Westerners who are learning about

TCM is to temporarily put aside what they know about anatomy and

physiology. TCM physiology is very different from anatomical

physiology. The more you read and the more familiar you become with

TCM, the easier it becomes to do this. One of the reason why names

of TCM Organs are capitalized is to aid people in making this

transition. As well as to alert them that it's the TCM Organ being

talked about and not the anatomical organ.

 

The term " Deficiency " refers to there being a problem because there

is not enough of something. In this case, the person doesn't have

enough Spleen Qi. The term " Excess " refers to there being a problem

because there is too much of something. In this case, Danpness and

Phlegm. Because the Spleen Qi is Deficient, an Excess of Dampness

and Phlegm have been created. It's fairly common for people to have

mixed Deficiency and Excess problems. (BTW, for the students on the

list, Blood Stasis and Qi Stagnation are classified as Excess

problems. Any Stagnation or Stasis is too much. Rebellious Qi also

is classified as an Excess problem. (Qi ascending when it should be

descending is " Rebellious Qi " .) Sinking Qi is classified as a

Deficiency problem. Another function of the Spleen is to control the

raising of Qi. Qi " sinks " (descends when it should be ascending)

when the Spleen and Spleen Qi are Deficient. This can result in

prolapsed stomah, uterus, bladder,kidney, or anus.)

 

The Spleen is most vulnerable to Dampness. This creates one of those

snowballing situations that TCM is so good at recognizing. The

increased Dampness further weakens the Spleen, and this in turn

weakens the Spleen further which results in even more Dampness, and

so on.

 

Two other concepts that you will see a lot in regards to TCM are

external and internal. Dampness can arise in the environment and

affect ( " invade " ) the body, or it can originate in the body. An

example of the latter is that dairy foods and wheat are particularly

Damp-engendering. That's why people with Spleen weakness (or people

with colds) are advised to limit or eliminate dairy and wheat from

their diets for a while. You don't want more Dampness. Excessive

thinking and overdoing physically also can damage the Spleen and

weaken it, allowing Dampness to accumulate. " Excess thinking " means

pensiveness or obsessing about something. Brooding. Or, it can mean

studying too much. One's life needs to be balanced even when in

school or on a job that requires a lot of thinking.

 

Dampness in the environment can readily invade (affect) the body.

This includes things like living in a house that is too damp,

sitting on damp ground or other surfaces, wearing clothes that are

wet from rain or from the perspiration of exercise, living in areas

that are unusually foggy, wading in water, etc. Women are more

vulnerable to Dampness than men are. Especially after childbirth

and during their periods. (Giovanni Maciocia, The Foundations of

, p. 241.)

 

Dampness usually will " team up with " Heat or Cold. Thus, you will

see references to Damp Heat or Damp Cold. The treatments are

different for the two.

 

Phlegm readily " teams up with " other Perncious Evils (Heat, Cold,

Wind, Dampness, and Dryness). You may see references to Heat Phlegm,

Cold Phlegm, Damp Phlegm, Wind Phlegm, and Dry Phlegm. Treatment is

going to vary according to what type of Phlegm. For example, the

best way to treat Cold Phlegm is not with the herbs to get rid of

Phlegm but with herbs that will correct the Cold problem. The

Dampness is congeling into Phlegm because of the effects of Cold.

The students on the list will be covering this later in their

studies. The Spleen will still need to be strengthened.

 

A weak Spleen practically always is a part of Phlegm problems. There

is some disagreement about what it means that Phlegm always ends up

in the Lungs. Phlegm can be a problem in any part of the body. It's

just that it has a special affinity for the Lungs. For example,

certain deformed bone problems (spurs) in some types of arthritis

are Phlegm problems.

[Guest guest]

This article is very interesting in terms what I discussed with some

others today . . .

 

One of the TCM students has been suffering from allergies and began

working on it in the clinic. After a lecture on crossing points in

our very rudimentary acupuncture class, she spoke with the intern and

after using Spleen-Lung crossing point her allergies have been resolved.

 

I was speaking with my grandmother this morning who is nearly 80 and

she constantly tormented by allergies, sinus pressure and she also has

lupus. She has used acupuncture for other types of pain in the past,

but needles left little holes in her body that bled and didn't close

for several days, she finally admitted to me. That would be off

putting for anyone.

 

She is going back to her western doc to see if he thinks acupuncture

might be helpful to her. I hoping and praying she will go after

months of my nagging (in spite of myself).

 

Zenisis

 

 

 

Chinese Traditional Medicine , " Vinod Kumar " <vinod3x3 wrote:

>

> Chinese Traditional Medicine , " emailme_marilyn "

> <emailme_marilyn@> wrote:

> >

> > this is what my ac told me, so if she needs to tonify spleen and

> > transform phlegm, then does that mean i have over deficient or

> excess

> > spleen " qi " ? does that also mean i have phlegm...and to transform it

> > into what?

> >

> > my main problem is fertility which is supposed to be related to

> kidney

> > and auto-immune hyper-active immune system which is related to lungs

> > but she didnt mention i have problems with those and instead, to

> > tonify spleen and transform phlegm...

> >

> > marilyn

> >

>

> Here is an article that goes deeply (and intelligently)into the issues

> raised in the question above and several other questions recently

> asked. If one can understand these issues it will be a step forward in

> understanding many common but difficult to resolve problems.

> Marilyn - human body is not as simplistic as many think - so many

> sytems are involved in pathology that it is not possible to second

> guess diagnosis and therapy - this article clearly explains why.

>

> This article can be read at www.bluepoppy.com. Bob Flaws is a world

> treasure and has done an immense service to TCM and the English

> speaking TCM community. He is a internationaly recognised scholar as

> well as one of the greatest TCM clinicians - in my opinion he is one

> of the world's greatest Gyneocologists and Obstetricians.

> Unfortuantely - from what I have heard - he does not accept new

> patients. He is an unbelievably busy person - He is a perfect example

> of a true physician combining the mind of a scholar and master

> clinician with sense of public service - his free contributions to the

> public and to other clinicians is widely praised. He has written many

> books a few of which will become classics.

>

> This is heavy going for those who do not understand TCM terminology

> but it is worthwhile reading just to get a sense of how a master of

> TCM thinks and looks at these issues we have been discussing.

>

> Here is the link and the article - note especially the comments about

> phlegm and its relationship to many pathological states. Remember

> phlegm is produced in the Spleen and stored in the Lungs.

>

> http://www.bluepoppy.com/press/download/articles/autoimmune.cfm

>

> ALLERGIES, AUTOIMMUNE DISEASES & YIN FIRE

>

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

>

> INTRODUCTION

> If one looks at the pattern discrimination of various allergies and

> autoimmune diseases in modern Chinese medical texts, one will see

> several patterns listed under each disease category. Then, under each

> pattern, there are generalized signs and symptoms, tongue signs, and

> pulse signs. Under that come the treatment principles for that

> particular pattern. And finally, there is a suggested Chinese

> medicinal formula based on the treatment principles. Therefore, such

> textbooks make it seem that the clinician's job is to determine which

> of the listed patterns their patient exhibits and then give them the

> treatment described under that pattern.

>

> The problem with this very clear-cut methodology is that patients with

> allergies and autoimmune diseases rarely exhibit a single pattern.

> Rather, real-life patients with these kinds of chronic diseases

> typically exhibit three, four, five, or six patterns simultaneously.

> This means that no single formula under any one pattern is going to be

> categorically correct.

>

> For instance, many Chinese medical beginners' textbooks give the

> patterns under allergic rhinitis as wind cold external invasion

> pattern, lung qi vacuity pattern, spleen qi vacuity pattern, kidney

> yang vacuity pattern, and phlegm dampness pattern. However, first of

> all, we must distinguish between the acute allergic episode and the

> underlying bodily constitution or terrain, what Chinese doctors refer

> to as the " habitual bodily " condition. During an acute allergic

> rhinitis attack, the attack itself is provoked by an unseen airborne

> pathogen, i.e., wind, and the signs and symptoms most typically

> involve clear, white or " cold " phlegm. Therefore, the acute episode is

> described as a wind cold external invasion pattern. But this does not

> account for why one person has been invaded when another exposed to

> the same external evils has not.

>

> If one is invaded by external evils, it means that the person's

> defensive qi has not been strong enough to secure the exterior and

> densely pack the interstices. The defensive qi is manufactured by the

> spleen qi and sent up to the upper burner for distribution to the

> exterior by the lungs. Hence, we can say that everyone suffering from

> allergic rhinitis has a de facto defensive qi vacuity. In clinical

> terms, this means a lung-spleen qi vacuity. All the medicinals used to

> supplement the defensive qi primarily supplement the lung qi by

> fortifying the spleen and boosting the qi. Therefore, it is not that

> some allergic rhinitis sufferers have a lung qi vacuity, while others

> exhibit a spleen qi vacuity.

>

> THE CENTRAL ROLE OF THE SPLEEN IN ALLERGIC & AUTOIMMUNE DISEASES

> The spleen is in charge of moving and transforming water liquids. If

> the spleen is vacuous and weak, then it may fail to move and transform

> water within the body. If this gathers and accumulates, water may

> transform into dampness. If this dampness endures, it may congeal into

> phlegm. Thus it is said, " The spleen is the root of phlegm

> engenderment, while the lungs are [only] the place where phlegm is

> stored. " Therefore, everyone with allergic rhinitis does have phlegm

> dampness, not just lung-spleen qi vacuity.

>

> The spleen is the latter heaven or postnatal root, while the kidneys

> are the former heaven or prenatal root. The postnatal and prenatal

> support and assist one another. When we are young, our kidneys and

> spleen are both immature, meaning vacuous and weak. Our spleen matures

> first at around six or seven years of age. It is because the spleen

> matures and now engenders a superabundance of qi and blood postnatally

> that acquired essence can bolster the kidneys and hence the kidneys

> can mature and become exuberant at adolescence. Likewise, it is the

> spleen which first become weak due to aging, and then only secondarily

> do the kidneys become vacuous and weak after that. Therefore, in

> clinical practice, one rarely encounters a pure kidney yang vacuity.

> In almost all cases, what one actually sees is a spleen qi-kidney yang

> vacuity. Since the lungs, spleen, and kidneys are the three viscera

> which transform and engender the qi and which move and transform water

> in the body, when one of these malfunctions, typically at least one

> other does as well. Therefore, what one really sees as the underlying

> terrain of allergic rhinitis sufferers is either a lung-spleen qi

> vacuity with phlegm dampness or a lung-spleen qi vacuity and kidney

> yang vacuity with phlegm dampness. Then invasion of external wind cold

> evils is superimposed on this habitual bodily constitution.

>

> In addition, because the clear qi is not being upborne and dampness

> and phlegm are hindering and obstructing the free flow of qi, most

> allergic rhinitis patients also exhibit signs and symptoms of liver

> depression qi stagnation even though no Chinese textbook lists this as

> one of the patterns of this disease. Yet I have never seen an allergic

> rhinitis patient who did not have at least some signs and symptoms of

> liver depression. If nasal obstruction has endured for a long time,

> cold evils may have transformed into heat. Because qi moves the blood

> and if the qi stops, the blood stops, enduring nasal congestion may

> also have resulted in blood stasis. So besides, lung-spleen qi

> vacuity, phlegm dampness, and liver depression with possible kidney

> yang vacuity, there may also be transformative heat, damp heat, and/or

> blood stasis. And as soon as our patients exhibit a combination of

> spleen vacuity, liver depression, and some kind of evil heat, we have

> crossed into the territory of yin fire.

>

> YIN FIRE & ALLERGIES AND AUTOIMMUNE DISEASES

> In fact, most sufferers of allergies, including atopic dermatitis,

> allergic asthma, and so-called food allergies, including allergic

> colitis, exhibit yin fire patterns with spleen qi vacuity, liver

> depression, and some kind of heat, usually depressive and/or damp

> heat. Likewise, most autoimmune sufferers also exhibit the same or

> similar combination of core patterns. Remember, autoimmune diseases

> are simply an allergy against onself. Such autoimmune diseases include

> rheumatoid arthritis (RA), dermatomyositis/polymyositis, systemic

> lupus erythmatosus (SLE), multiple sclerosis (MS), scleroderma,

> myasthenia gravis, Sjögren's syndrome, Crohn's disease, Hashimoto's

> thyroiditis (a type of hypothyroidism), and endometriosis (due to

> autoimmune ovaritis). Most patients with autoimmune diseases do not

> exhibit a single textbook pattern but rather a cluster of patterns

> perhaps best described by Li Dong-yuan's yin fire theory. Further,

> most patients with chronic fatigue immune deficiency syndrome (CFIDS)

> and fibromyalgia also exhibit yin fire patterns. In other words, most

> patients with these conditions exhibit some combination of spleen qi

> vacuity, liver depression, and evil heat plus some other patterns as

> well.

>

> Take for instance rheumatoid arthritis. The overwhelming majority of

> patients with rheumatoid arthritis complain of fatigue. Fatigue is the

> single most obvious and important symptom of a qi vacuity, and the

> spleen is the latter heaven root of qi engenderment and

> transformation. Therefore, most patients with rheumatoid arthritis

> have a spleen qi vacuity. Now, anyone who is chronically ill is going

> to have liver depression qi stagnation even if that liver depression

> did not originally cause their disease. After all, if one is diseased,

> one ipso facto cannot fulfill all one's desires. Either one cannot do

> what one wants, eat what one wants, look as one wants, or cannot get

> away from one's pain as one wants. Such unfulfilled desires are the

> main cause of liver depression. Therefore, everyone who is chronically

> ill does have liver depression.

>

> The joint pain of rheumatoid arthritis is categorized as bi or

> impediment in Chinese medicine. Either it can be wind cold damp

> impediment or wind damp heat impediment. One or the other of these is

> typically superimposed on a basis of spleen qi vacuity and liver

> depression. In rheumatoid arthritis in the West, wind damp heat

> impediment is very common. If the spleen qi is vacuous and weak, then

> the spleen may not be engendering and transforming blood sufficiently.

> Therefore, there may be a concomitant liver blood-kidney yin vacuity.

> Or kidney yin vacuity may be due to enduring heat damaging and

> consuming yin fluids. It is also possible that enduring disease or

> aging may result in spleen qi vacuity evolving into kidney yang

> vacuity, in which case there is still spleen qi vacuity but now there

> are also some signs and symptoms of kidney yang vacuity as well. If

> the qi is vacuous and the liver is depressed, the qi may not have

> either the power or the free flow to move blood and water liquids. In

> that case, there may be the complications of blood stasis and/or

> phlegm nodulation.

>

> RA, dermatomyositis, polymyositis, Crohn's arthritis, fibromylagia,

> and SLE are all types of impediment conditions due to complicated yin

> fire scenarios. MS is a wilting condition (wei zheng) due to the same

> basic disease mechanisms minus the impediment patterns. Most

> autoimmune sufferers have a history of one or more allergies. They

> often have histories of antibiotic use, which has damaged the spleen.

> In China today, a popular topic for Chinese medical journal articles

> is post-antibiotic spleen qi vacuity or intestinal dysbiosis due to

> spleen qi vacuity in turn due to antibiotics. In such cases, the

> spleen qi has been damaged and this results in dampness, while

> dampness transforms into damp heat. We have discussed some of the most

> important causes of spleen qi vacuity in a previous essay. In the

> West, these have to include faulty diet, too much thinking, too much

> worry and anxiety, not enough exercise, and too much work, and usually

> there are some or all of these in significant amounts in allergy and

> autoimmune patients.

>

> WOMEN & AUTOIMMUNE DISEASES

> In particular, more women than men suffer from autoimmune diseases and

> the incidence of such autoimmune diseases increases in the mid-30s and

> through the 40s and 50s. This is no accident and also has to do with

> the same set of disease mechanisms we have been discussing under the

> title yin fire. Women lose blood every month. Therefore, they are more

> prone to spleen vacuity than men, since it is the spleen, which

> carries the brunt of blood production. Even if a woman does not lose

> too much blood each month, the fact that during the second half of her

> menstrual cycle two things happen which account for the cyclic

> worsening of both spleen qi vacuity and liver depression. If a woman

> is marginally blood vacuous, when the blood is sent down to accumulate

> in her uterus during the premenstruum, there may not be enough left

> over to emolliate and harmonize her liver. Thus her liver becomes

> depressed and her qi becomes stagnant. Since this also means that the

> liver is replete, a replete liver may invade the spleen, making it

> vacuous and weak. All this helps explain why women are more at risk

> for autoimmune diseases than men. It also explains PMS and why PMS

> worsens in the mid-30s and 40s.

>

> The Nei Jing says that the spleen becomes weak due to aging in the mid-

> 30s in women. Thus it is common for the incidence of autoimmune

> diseases, read yin fire scenarios, to increase after 35 or so. By the

> 40s, spleen qi vacuity is beginning to affect kidney yang. The yang of

> the kidneys is also necessary for the liver to do its job of coursing

> and discharge. Liver function is not just dependent on blood for its

> nourishment. It also requires kidney yang to " warm and steam " the

> liver. If kidney yang becomes weak due to aging as a consequence of

> the spleen qi no longer bolstering and assisting it the way it once

> had, then this will also aggravate any tendency towards liver

> depression qi stagnation.

>

> HOW TO TREAT ALLERGIES & AUTO-IMMUNE DISEASES VIS Á VIS YIN FIRE

> Thus round and round it goes. But it is Li Dong-yuan's theory of yin

> fire, which helps one cut through this cycle of one disease mechanism

> engendering another. When one suffers from an allergic or autoimmune

> disease, during times of relative remission, one needs to treat all

> the disease mechanisms associated with the " habitual bodily " or

> underlying condition all at one go. Then, during acute exacerbations,

> one needs to treat the underlying " habitual bodily " condition plus any

> other patterns superimposed upon that basis.

>

> In other words, during acute allergic rhinitis episodes, one usually

> needs to supplement the lung and spleen qi (really the same thing),

> possibly also supplement kidney yang, rectify the qi and downbear

> counterflow, transform phlegm and eliminate dampness, and dispel wind

> and disinhibit the portals (of the nose), while securing the exterior.

> If damp phlegm has transformed into damp heat and phlegm, then one

> might also have to clear heat.

>

> In the case of RA, during remission, one typically has to supplement

> the spleen qi, possibly supplement liver blood and kidney yin,

> possibly also supplement kidney yang, course the liver and rectify the

> qi, possibly clear depressive, damp, or vacuity heat, possibly quicken

> the blood and dispel stasis and/or transform phlegm and scatter

> nodulation. During acute attacks, one must do all of this plus dispel

> either wind, cold, dampness or wind, damp, heat, free the flow of

> impediment, and stop pain. In SLE, there basically is always wind damp

> heat impediment, and not wind cold dampness.

>

> Likewise, in the case of MS, one usually has to supplement the same

> viscera as in RA, course the liver and rectify the qi, and possibly

> quicken the blood and dispel stasis. If there is damp heat, one must

> also clear heat and eliminate dampness, even though this is not damp

> heat impediment, per se. Usually in MS, there is also some element of

> either blood vacuity or yin dryness somewhere in the body even if

> there is spleen vacuity with dampness transforming into damp heat.

>

> CONCLUSION

>

> Because most allergy and autoimmune disease sufferers do not manifest

> the single, simple, discreet patterns that are described in beginners'

> textbooks, they require more complex formulas than the simple

> classical formulas which for the bulk of commonly available

> Chinese " patent medicines. " Because these are chronic conditions that

> require long-term, protracted treatment, administering medicinals in

> pill form makes such long-term treatment easier, and, hence patient

> compliance is greater. Therefore, I believe many Western patients with

> chronic allergic conditions and autoimmune diseases will benefit from

> Blue Poppy Formulas based on Li Dong-yuan's yin fire theories. These

> are the types of formulas which I prescribe to all my patients with

> these sorts of diseases, and this is what I have seen work best in

> Western patients with these " difficult to treat, knotty diseases. "

>

> For More Information...

>

> Check out Blue Poppy Seminars Allergies & Autoimmune Diseases Distance

> Learning Program

>