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Lower-burner pattern
下焦病证 〔下焦病证〕 xià jiāo bìng zhèng
Any warm disease pattern chiefly characterized by severe damage to yīn taking the form of a (a) kidney channel pattern marked by generalized heat effusion, reddening of the cheeks, and heat in the palms and soles, or (b) a liver channel pattern characterized by wriggling of the extremities or tugging and slackening (convulsions). In either case, the tongue is crimson with little fur.
Description
- Foot lesser yīn (shào yīn) (shào yīn) kidney channel: Generalized heat effusion, reddening of the cheeks, heat in the hearts of the palms and soles more pronounced than in the back of the hands and dorsum of the foot, dry mouth and pharynx, heart vexation, insomnia, lassitude of spirit, and deafness. The tongue is crimson and dry with little fur. The pulse is vacuous and large or fine and rapid.
- Foot reverting yīn (jué yīn) (jué yīn) liver channel: Wriggling of the extremities or tugging and slackening (convulsions), lassitude of spirit, and
great thudding in the heart
(心中憺憺大动 xīn zhōng dàn dàn dà dòng, i.e., heart palpitation or fearful throbbing). The tongue is crimson. The pulse is vacuous or fine and rapid.
Pathogenesis: When evil heat passes from the center burner to the lower burner, it damages kidney yīn, giving rise to foot lesser (shào yīn) yīn kidney channel signs. When water fails to moisten wood, foot reverting yīn (jué yīn) liver channel signs of vacuity wind stirring internally appear. Depletion of kidney yīn means that kidney-water can no longer help heart-fire. So, there is yīn vacuity in the lower burner and repletion heat in the upper burner.
Analysis of signs
- Foot lesser yīn (shào yīn) (shào yīn) kidney channel: Generalized heat effusion, reddening of the cheeks, dry mouth and pharynx, and crimson tongue that is dry with little fur reflect the evil heat. The presence of heat in the hearts of the palms and soles, that is, heat more pronounced than in the back of the hands and dorsum of the foot indicate damage to kidney yīn. The heart vexation, insomnia, lassitude of spirit, and deafness. The pulse is vacuous and large or fine and rapid, which reflects both heat and yīn vacuity.
- Foot reverting yīn (jué yīn) (jué yīn) liver channel: The liver and its channel rely on the moistening action of the kidney. Persistent heat scorches the true yáng, giving rise to
depleted water and effulgent wood,
which deprives the sinews of nourishment and allows internal wind to arise. This results in wriggling of the extremities or tugging and slackening. Yáng vacuity is reflected in the lassitude of spirit, while the yáng exuberance is reflected in the
(心中憺憺大动 xīn zhōng dàn dàn dà dòng), which refers to fright palpitation or fearful throbbing. The crimson tongue reflects heat, while the vacuous fine rapid pulse also reflects the severe vacuity heat.great thudding in the heart
Treatment
Medicinal therapy: For lesser yīn (shào yīn) patterns, enrich kidney yīn using Pulse-Restorative Variant Decoction (加减复脉汤 jiā jiǎn fù mài tāng) or Triple-Armored Pulse-Restorative Decoction (三甲复脉汤 sān jiǎ fù mài tāng). For reverting yīn (jué yīn) channel patterns with vacuity wind, enrich yīn and extinguish wind using Major Wind-Stabilizing Pill dà dìng fēng zhū (大定风珠).
Acumoxatherapy: KI-9 (zhú bīn), KI-3 (tài xī), and LR-3 (tài chōng).
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