Fundamentals of TCM 12/12/04
Note:10%-15% of people don’t respond to acupuncture at all. Pretty hard-core alcoholics tend to not respond to acupuncture at all, especially after extended periods.
Position of the heart in the body:
It rules or governs the blood and
blood vessels.
It is the residence of the spirit
(Shen)
Exterior body tissue is the complexion
Sweat is the fluid associated with
the heart
Interior/Exterior relationship with
small intestine
Free coursing (movement) of the qi
Associated with the health of
fingernails & toenails
Is it a thick or thin coating?
ring is the kidney (kidney yin).
Middle is spleen & stomach pulse
Cause of disease and pathogens
Final will cover today plus three
more organs (liver, heart, and kidney)
Heart
Position of the heart in the body:
It’s in the upper jiao.
It’s located deep inside the body to protect it from the pathogens. It is considered the “deepest” organ.
It rules or governs the blood and blood vessels.
The heart doesn’t pump the blood as in western medicine. Rather, it is responsible for directing the pulses of the body. This would be akin to the director of a symphony. The heart does not provide the “power” to the pulses, only the rhythm for the rest of the body to follow. Like the emperor, the heart would not do the actual work of circulation; instead it acts as a coordinating center for the motion reflected in the other pulses.
When the heart is working properly, the blood flows smoothly and nourishes the entire body.
Aspects of the heart:
The heart Qi – regulates the flow of
blood
In a well-balanced heart, the pulse will be even and regular. The pulse will be moderate and forceful if the heart qi is good.
Without enough heart qi, the blood will stagnate. Patients with stagnate blood may look bluish and their hands and feet may feel cold.
The Heart Blood – nourishes
This will affect the heart qi. With out sufficient amounts of heart blood. There will be palpitations, irregular heartbeats.
Since the heart is everybody’s emperor, deficient heart blood will cause the circulation of everybody to be bad. There will be a dull complexion over the entire body. There will be a spiritual fatigue or emotional exhaustion - much deeper than a physical tiredness. There may be a pathological sweat.
A pathological sweat is a copious or profuse perspiration that doesn’t serve the purpose of cooling the body. For example, the sweaty palms that comes with stage fright. Remember the five-phase association of the heart with sweat as the body fluid.)
Sovereign
The heart is the emperor, the boss. It is the governor of the 5 zang-viscus organs and 6 fu-bowels. (Ignore the pericardium).
It is the residence of the spirit (Shen)
The shen (spirit) is said to reside within the heart. The shen is much like the brain of western medicine. The aspects of the shen housed in the heart are:
Sleep
Thinking
Emotions
Consciousness/Alertness
Memory (mental activity)
When the heart is healthy, the mind is quite, we are at peace, we are calm, we sleep well, and we are alert and responsive to the environment. There can be restlessness, agitation, palpitation, susceptibility to fright, insomnia, and wild dreams when the heart is not well.
Emotions are a part of this as well. There are more yin emotions (love towards your cats) vs. yang emotions (thrill of roller coasters at Great America).
Heart yang emotion: refers to
enthusiastic and expansive emotions
Heart yin emotion: the more passive,
calm emotions (centered or grounded emotions).
The heart yin and yang emotions have to be balanced. You can’t have just enthusiasm. You have to be grounded as well.
The heart yang is a strong heartbeat. The heart yin refers to a nice regular moderate heartbeat. Again you need a balance. If they are balanced, the heart beats regularly with the proper amount of force. Yang is the gas; yin is the clutch and/or the break.
(see: Nourishing Destiny,
Jarrett)
(see: Heart Math –
Western scientists determined that the heart has its awareness that is 15 feet
away. Everyone is interacting at the heart level. The heart has it’s own seat
of consciousness even in western medicine.)
Five phase association
Related to fire.
Fire gives light and life to the world. The heart provides life and light to the whole body.
The western SAD disorder is a result of too little light.
Controls speech (tongue)
The tongue is the shoot or the sprout of the heart. Certain problems like stuttering or the inability to speak (aphasia) are rooted in the heart. Also associated with the heart are the nonsensical babbling or inappropriate speech like improperly uninhibited statements or more drastically Turret’s syndrome.
When the tip of the tongue gets red or has a different shape to it, it indicates heart issues:
The tip of the tongue is red if
someone is stressed.
A sharp/pointed tip means some problem
with the heart organ/shen/stress.
If you are catching a cold, the upper
jiao portion of the tongue will be red. If you are getting a “wind heat” cold
the entire tip and back into the lung portion of the tongue will be reddish.
A little notch in the tongue can also
indicate stress. Some people will get a whole line that goes all the way back.
A “heart line”. It can also indicate a heart problem or heart disease.
It’s difficult to treat
men with depression, cause they may not even realize it, they displace it with
drinking, they can be irritable, anything but actually being depressed.
Paul Pitchford Healing
With Whole Foods; this will be required or recommended down the line. The
book talks about yin foods, etc…
Different types of mouth ulcers can be
treated using the heart channel.
Hua To 141AD
- invented surgery in Chinese medicine. Devised anesthesia.
Exterior body tissue is the complexion
Facial expressions and complexion can indicate the state of their spirit (shen).
If the heart is working properly the complexion will be “rosy”.
People showing the condition of their shen… people who are depressed or have mental problems can look catatonic or dull. Their whole face shows that lack of mental clarity, we say their shen is disturbed. Their faces may also be red as well.
Sweat is the fluid associated with the heart
Think of pathological sweat (sweaty palms).
People with heart attacks sweat profusely on the face. They are pale in the face, blue around the lips, and sweat (oily beads) dripping off of their face. A heart attack is “heart yang qi deficiency”. A lot of time women don’t feel the heart attack with left arm pain. They may feel congestion. The symptoms will not necessarily be the same as in men.
Pathological Element Heat
The heart is the most sensitive to heat.
Worry about sunstroke on a hot summer day.
Working in the coronary unit you’ll smell a scorched or burned smell.
Body Opening – auditory canal
Think of the Vegas nerve on just the other side of the auditory canal.
Western medicine has discovered that using an implant in the Vegas nerve can be used to treat depression.
Emotion
Joy is associated with the heart. Don’t have too much joy (excitement) it can hurt the heart.
Not enough excitement can also hurt the heart.
Inappropriate laughter or hysteria - This can be caused by overwhelming emotional stress. (A disturbed shen…)
Other Organ Relationships
Interior/Exterior relationship with small intestine
Channels connect them.
They are related by pathology.
Example:
Someone has excessive heart fire.
It moves into the small intestine.
The small intestine is the Tai Yang
channel (greater yang channel) as is the bladder. The small intestine is the arm tai yang. The bladder is the leg
tai yang. The tai yang is introduced as one of the 6 levels of disease.
This means the heat can move from the
small intestine to the bladder. It’s can act like a bladder infection. Urine
will be dark, it can burn, there can be pain in the bladder or lower abdomen,
and the amount of urine can be relatively small.
Heart – Small Intestine
It separates the clear from the impure. It separates the stuff that is not usable. The small intestine separates the liquids from the solids.
The small intestine channel is used to separate clear from blurry vision; to clarify the hearing.
Certain aspects of the small intestine revive people from fatigue and shock.
Heart – Spleen
Heart is the mother of the spleen. The connection between the two is blood and qi formation (gu qi).
The spleen keeps the blood within the blood vessels.
The heart governs the blood. The heart makes sure the spleen is acting correctly on the blood. The governor doesn’t do the actual work; it just oversees the organs doing the work.
Emotional stresses can imbalance change/upset digestion.
The starches get turned into serotonin in stress eaters.
The Spleen makes the blood and the heart blood is so important for the proper functioning of the heart. If the spleen is week you can have hemorrhaging which causes a deficiency in the heart blood.
Heart – Kidneys
The basic interaction of fire and water is key to the yin-yang and 5-phase theories.
There are deep acupuncture channels between the upper jiao (heart) and lower jiao (kidney). The heart connects to the lower jiao via the kidneys and the kidneys connect to the upper jiao through the heart.
The kidney yang qi (kidney energy) is the root of all energy in the body. Kidney yang provides the power/energy for the heart. Kidney yang is the power for the heart to control the pulses. Kidney yang has a lot to do with animation in the body.
The fire at the Ming Men Huo provides the physical heat for all of the organs and comes from the kidney.
Kidney yin is the water within water that controls the fire. The kidney yin provides moderation for the fire. It gives calmness to the spirit. It keeps the heart fire under control.
The heart heat is the animation/awareness/figurative heat. The kidney heat is the physical heat.
Pericardium
In Chinese, the pericardium is called the Xin Bao (heart wrapping). The pericardium is the first line of defense for the heart. Evil pathogens have to make it through the pericardium to get to the heart. It protects the heart from intense heat (fevers) and from phlegm, keeping it from reaching the heart.
The PC is the ambassador and from that happiness is derived. It’s the pimp for the heart. It’s involved with the link up between the sexes.
Different kinds of emotional shen disturbances are treated using the pericardium channels.
It the pericardium channel that’s used to treat motion sickness (PC – 6 Neigua). This is also good for people who have shen disturbances (one that has nothing to do with the heart and one that does.)
Heart Channel
It starts deep from the heart and goes down to the diaphragm. A branch goes up to the face and tongue. Another branch heads out and you can needle it at heart number 1 in the armpit (that’s where you sweat…). That branch heads down the medial aspect of the arm and wrist and ends on the little finger.
The heart channel is near the lung channel. The heart channel is also connected to the kidney as well.
Liver
This is the general of the body. It is in charge of the overall planning of the body.
Free coursing (movement) of the qi
The liver is in charge of the free coursing of blood and qi in the body. Here, free coursing does not refer to just the proper amount but the actual distribution and the organization of the qi. Free coursing of qi means that the liver is there to circulate, loosen, relax, disperse, or to make Qi flow smooth and free. It’s “softens” the qi. For example: the liver makes sure the stomach qi and spleen qi are interacting correctly. It is the power behind the throne (Note the sheng cycle, the liver is the mom of the heart). This free coursing aspect is the most important function of the liver.
Whenever we are talking about problems that are affected by the liver we are almost always talking about the smooth flow of qi. Clinically there is a lot of stagnant liver qi in the US.
The tree/wood grows/moves easily up and out. This is the direction for the liver qi to move – upwards and outwards in all directions. If the liver qi isn’t moving correctly, the qi in the other organs won’t be right either.
Some examples:
The “liver qi attacks the stomach”.
The liver qi isn’t moving properly so the stomach qi won’t flow properly.
Stomach qi up – throw up – spleen qi down – diarrhea.
The “Ko” cycle means the liver qi has
a lot to do with the spleen or stomach qi.
The liver can cause counter flow lung
qi or coughing in the lungs. The liver is along the insulting cycle for the
lungs.
The flow of qi is very important in
digestion. Especially in the middle jiao.
The liver qi is also important in the
gall bladder. The flow of liver qi instructs the gall bladder to release its
bile at the right time. (The reason for gallstones – bile being stored up and
cooked down instead of being properly released.) (Cancer in Chinese medicine is
considered stagnation…). Western medicine says gallstone show up in females,
fat, forty, and fair (the Chinese would add frustrated).
The biggest reason that liver qi gets
stagnant in the first place is anger/frustration/dissatisfaction. When the
liver qi gets stuck, it becomes like a compost pile and starts generating its
own heat.
Lateral costal areas – hyperchondrium
– patients may feel a pain in the ribs when they have liver problems. This
feeling can be on one side, the other, or both. The liver channel runs
bilaterally.
If the liver qi is stuck, you can feel
like there’s a lump in your throat. This lump in the throat is the “plumb pit”
glomus as it is called in Chinese or glomus hysterica in western medicine.
There’s a liver channel running deep through there. Western medicine can’t
explain it, but they do say to “have a good cry”. Chinese medicine can treat
the problem with a liver acupuncture point. Liver 3 is a common point to use to
move liver qi. (All the yang channels meet at the top of the head…)
In women stuck liver qi can cause PMS.
In Chinese medicine, the problems with PMS flow along the liver channels, the
irritability (liver emotion), breast tenderness (liver channel runs beneath the
breasts), abdomen, etc… You can and should treat PMS before it shows up. You
can prevent it from happening before it happens. Get the liver qi moving
smoothly before it becomes a problem.
Jaundice, white of eye turn yellow,
bad taste in mouth, belching) all go together.
Stores blood
Blood is the treasure that is stored by the liver. The liver determines the amount of blood in the body. It makes sure that the blood is moved to the muscles during physical activity allowing the blood to nourish the muscles while they are working. If you lie down and sleep, liver qi will cause the blood to move back to the liver while you rest.
This is very important in women. Many gynecological problems have their roots in liver qi. If the liver has enough blood, the period will be normal. If the liver has deficient blood, the menstrual cycle will be delayed or skipped altogether.
If the liver blood gets too hot, it
can lead to excessive menstrual bleeding. (You would use a point to cool the
liver to treat this.)
If the liver qi is stagnant, it makes
the blood stagnant, and can cause painful periods. The menstrual blood will
have big dark clots. (Here, you would treat the stagnation of the liver to get
the qi moving in the liver.)
Ability to recover energy
The liver’s job of regulating blood volume throughout the body has an important influence on a person’s level of energy. It will make sure the right tissues are being nourished at the right time. The blood will return to the liver when the body is at rest.
People who get easily tired aren’t get the blood to the right places at the right time. Stagnation of liver qi is a part of Chronic Fatigue Syndrome.
We can protect the body by making sure that the skin has the blood necessary to protect the body.
Residence of the Hun
The “hun” is the ethereal soul. The Hun is yang as compared to the corporeal soul (po). The hun carries the soul to the next level of existence. It’s the part of you that “goes on”. (See the gray-white book).
It is said to influence the capacity to plan the life.
The ethereal soul is said to influence the capacity
of planning our life and find sense of direction in life. And lack of direction life and mental
confusion could be compared to the wandering of the ethereal soul own in space
and time. Thus, if the liver is
flourishing, the ethereal soul is firmly rooted in hopeless to plan our life
with wisdom in vision. If liver blood
in his week, the ethereal soul is not rooted in cannot give us a sense of
direction in life. If liver blood or
liver Yin is very weak, at times the ethereal soul may even leave the body
temporarily at night during sleep or just before going to sleep. Those who suffer from severe deficiency of
yen may experience a sensation as if they were floating in a few moments just
before falling to sleep: this is said to be due to the floating of the ethereal
soul not rooted in blood and yin
The ethereal soul it's also related to resoluteness
and a vague feeling of fear at night before falling asleep is also said to be
due to a lack of routing of the ethereal soul.
If you have plenty of liver blood, we can plan our life with wisdom because the soul is well rooted. The lack of nourishment and a rooted housing for the ethereal soul can cause fear as you go to sleep at night. The liver controls planning (the general). If you have a liver disharmony, you may have an inability to plan your life; you feel like you lack a sense of direction.
Five Phase association
Liver Opens to the eyes
The liver is associated with eyes and vision. We need the blood from the liver to nourish the eyes so that we can see clearly. Some examples of liver eye association include:
People who see the floaters have
insufficient liver blood to nourish the eyes. The Chinese call this flowering
vision.
If the eye prescription is changing
quickly, this can be caused by insufficient flow of blood to the eyes.
Dry eyes can also be caused by liver
blood deficiency in the eyes.
Cataracts can be treated if they
aren’t too bad.
When the liver gets hot, the eyes
become bloodshot.
Controls the sinews
The liver blood moistens the sinews. They aren’t the same as muscles. The sinews are that which allow movement. The state of the sinews affects our capacity for movement and physical activity. The sinews capacity for contraction and relaxation depends on the nourishment and moistening of the blood from the liver. Different types of muscle cramps can be poorly nourished sinews. Poorly nourished sinews can cause withered limbs.
Arthritis is considered a bone disorder.
Tendonitis – over use has caused the qi to become unbalanced and pain ensues. Qi becomes stagnant, so blood doesn’t get it so there are problems with the sinews (tendons).
Alcohol causes heat in the liver that can cook down fluids that can cause stiffness.
Associated with the health of fingernails & toenails
The nails are considered a continuation of the sinews. You can see the health of your sinews by looking at your nails.
Brittle nails – not getting enough blood.
Emotion – Anger
Liver qi is in charge of emotions flowing smoothly as well. Feeling frustrated and depressed can be caused by stagnant liver qi. (The liver qi isn’t moving the emotions properly.) Conversely, bad emotions can keep the liver qi from moving freely. While stagnant qi can cause anger or frustration, the smooth flow can give a person a great creative drive and resoluteness.
Pathogen: Wind
Internal wind is associated with the liver. In Chinese medicine, the wind is associated with tremors or shaking. Too much heat can cause these kinds of tremors when they scorch the liver.
Angry people on a windy day, their necks hurt.
Imbalances causing liver wind can include:
High fever causing convulsions.
An imbalance with liver yin deficiency
causing liver yang to be in excess can cause convulsions, and high blood
pressure, or migraine headaches. This condition can be the cause for a stroke.
A liver blood deficiency. If there’s
not enough blood in the vessels, they can be empty and internal liver wind can
result.
Other organ interactions
Liver – heart
The heart moves the blood and the liver stores it. If the blood doesn’t have enough blood, the heart doesn’t have anything to govern.
Liver – Spleen
Digestion won’t happen if the liver over controls the spleen. This in turn will leave the liver without anything to store.
If you have excessive liver heat this can affect the heart and the spleen.
Excessive liver heat will cause the spleen to have diarrhea and the stomach to cause hiccups.
(Tinnitis: low sounds can be
deficiency, high roaring noises can be excess. Loud digestive noises mean
excess; quite digestive noises mean deficiency.)
Liver – Heart
Excessive liver heat can bleed into the heart and start to cause emotional problems.
Liver – Kidney
The kidneys are a deep storage area for the body. Liver and kidney are connected in many ways in the body. The classic says the liver and kidney are of the same source. They can both become deficient very easily. We usually don’t say liver-yin deficiency; we usually say kidney liver yin deficiency.
Liver – Gall bladder
The gall bladder is a curious or extraordinary organ. There are six curious organs. They are neither yin nor yang. The gall bladder has both yin and yang aspects. It doesn’t deal with food and waste products like the other fu-bowel organs. It is filled with a refined, pure substance – bile. The gall bladder also doesn’t open to the outside. It does not receive food and transport waste like the other fu-bowel organs.
It stores and excretes bile at the
proper time. The gall bladder needs the liver qi to release the bile at the
proper time.
The gall bladder also controls the
sinews. The liver blood nourishes the sinews. The gall bladder controls the
sinews. The gall bladder controls the movement of the sinews. Aches and pains
on the sides of the body are along the gall bladder channel. Sciatica along the
side of the legs is considered gall bladder sciatica. The pain shifts and moves
like the wind.
Gall bladder controls judgment. It
gives you the “courage” to act. The
gall bladder is associated with the heart. It gives you the courage to have
emotions.
The gall bladder also affects the mind
and sleep as well. It determines the quality of sleep and the length that you
sleep. Gall bladder qi deficiency can cause this getting up early. The gall
bladder’s time is from 11pm – 1am and the liver is 1am to 3am. (Wu zi – the
internal clock)
Tongue Diagnosis
Bearing of tongue
The bearing of the tongue is the overall presentation of the tongue. Sometimes the tongue is very stiff and the patient will move it very slowly. This could be an indication of Heat entering the pericardium. The heat is on its way to the heart (meningitis – very high fever, delirious). A stiff tongue could also be phlegm at the portals of the heart. This can cause the tongue to be difficult to move. Phlegm clogging the portals of the heart can cause mental problems as well – hearing sounds or imagining things. They could be confounded by phlegm.
A stiff tongue can be caused by an internal liver wind. This could also manifest as a trembling tongue (or the patient could just be nervous.)
If the tongue is deviated, they may have had a stroke or impending stroke.
Body of tongue
Color
If the color is pale or cold looking it shows there is not a lot of heat. It could be that the qi is not caring the blood up to the tongue to color it properly.
A plump, pale tongue (maybe the tooth marks show) and it pale, the qi is deficient.
A blood deficiency pale tongue, the tongue will be pale and dry looking. It will look more like a towel or cat’s tongue. In addition, they also might night sleep well at night.
If the tongue is red, (red show’s heat)
A purple tongue will show stagnation of blood in the body. A purple spot on a particular spot on the tongue will show where the stagnation is.
Pepto Bismol pink – blood deficiency with heat.
Burgundy – heat, but purplish cast means stagnation as well.
Pale orange tongue with purple spots – shoulder pain with tendon problems. The spots were along the sides mostly. The orange color was deficient blood. The purple spots in the liver area made us think about liver stagnation. (The liver spots were there because of anger in this case.)
Cracked tongue shows a heat problem - like a mud puddle. However, some people are born with cracks in their tongue. It doesn’t necessarily mean something pathological.
A thorny tongue - like a strawberry seed tongue. Usually the tongue is red as well. This means excess heat. The taste buds swell up like thorns. This is usually when there is excess heat in the interior of the body. The more heat, the more the taste buds will protrude.
The whole body of the tongue can look like a crimson color. The darker or deeper the red the more heat there is. A crimson tongue would be a fairly intense heat.
A small dry and dark red tongue might also have a cracked to peeled off coating of tee tongue (an extreme “mirror” tongue)
Coat of tongue
Like the frosting on the cake.
The coat can be think or thin. A thin coat if you can see the body of the tongue through the coat. (maybe indistinctly) With a thick coat, you can not see the body of the tongue through the coat.
A thin coat means a more superficial problem with the body.
A thick tongue coat means an accumulation or stagnation. It could mean that there’s too much dampness or phlegm in the body.
Stagnation in the stomach – a thick coat. Food stagnation.
A thick coat can also mean that a person is getting sicker. If the coat is getting thinner and thinner the patient is getting better (generally).
A sticky (slimy) tongue coat – this is a sign of dampness. It almost looks like a person put their tongue in Crisco. Damp or phlegm.
Also a granular coat – This looks like a coarse substance on the tongue. Almost like cottage cheese or tofu on the tongue. It looks like it could be scrubbed off easily; this is often towards the back of the tongue. It looks more turbid or dirty. It tends to be more yellow, but it doesn’t have to be. It can also be yellow-brown, almost yellow black, or even a nice creamy white. It is caused by a turbid or dirty dampness.
Color of coat
Wind cold/common cold – a thin white cold – it could look like a normal tongue.
A yellow coat shows heat. – it shows the heat has gone into the body. The deeper the yellow coating the more severe the heat is.
A dry scorched yellow coating usually indicates they’ve had heat for an extended period of time.
Pulse
Don’t necessarily count the pulse rate.
Is it a big strong pulse or is it a deficient pulse?
A wiry pulse will come up and “sting” your fingers.
On Left
To find the pulse, place the middle finger the “bump” on the wrist and curve it around toward the inside of the arm. This will align the rest of the fingers.
Index is the heart
Middle is the liver
Ring is the kidney (kidney yin).
Weak kidney and pain in back go hand in hand.
On right
Index is lung
If you have a cold or are fighting one, it will float. It will float toward the surface and even float up towards the thumb.
Middle is spleen & stomach pulse
Ring is kidney yang
Next Sunday
Kidney
Cause of disease and pathogens
Review
Final
You need to get a 70% on all tests. If you don’t get this you can take a make up test. You call Gigi to schedule a make up test. (It’ll cost $25 – sometime you can get off the hook if there is a reasonable excuse you can get off.). If you don’t get at least a 70 on the second time you are required to take tutoring and then you get a third chance.