Reverting yīn (jué yīn) disease pattern

Any pattern of reverting yīn (jué yīn) disease.

The reverting yīn (jué yīn) includes the liver and the pericardium, the liver being the more important. Reverting yīn (jué yīn) disease arises when disease in the yáng channels has been treated inappropriately or when lesser yīn (shào yīn) disease persists. It can also arise when externally contracted evil directly strikes the reverting yīn (jué yīn) owing to habitual liver channel vacuity and poor resistance to disease.

The reverting yīn (jué yīn) is the end of the yīn channels and beginning of the yáng (hence the name reverting yīn (jué yīn)). It is therefore classified as yáng within yīn. When a disease reaches the reverting yīn (jué yīn), it is in its final stage. Because right qì is exhausted, there is discontinuity between yīn and yáng.

For this reason, reverting yīn (jué yīn) disease is mainly characterized by a cold-heat complex, by alternating reversal cold of the limbs and heat effusion, and by vomiting.

The cold-heat complex takes the form of upper-body heat and lower-body cold. The main upper-body heat signs are thirst with large intake of fluid, qì surging up into the heart, heat vexation in the heart, hunger without desire to eat. The lower body cold signs are no desire for food and vomiting when the patient forces himself to eat. If worms are present in the stomach, there is vomiting of roundworms.

Alternating reversal cold of the limbs and heat effusion occurs in many patients with reverting yīn (jué yīn) disease. It arises when the fight between yáng qì and the exuberant yīn cold becomes acute and yīn and yáng are locked in confrontation (阴阳对峙 yīn yáng duì zhì). When yáng qì rallies, there is heat effusion, when yīn cold is exuberant, there is reversal cold of the limbs. The alternation between the two is traditionally described as overcoming and retaliation of reversal and heat overcoming and retaliation of reversal and heat (厥热胜复 jué rè shèng fù). If yáng returns after the yīn cold has reached its extreme, the patient may recover. If yīn cold is extremely exuberant, yáng qì may become critically weak, threatening the patient’s life.

Main name: Reverting yīn (jué yīn) disease pattern (厥阴病证 jué yīn bìng zhèng)

Description: Dispersion-thirst (severe thirst), qì surging up into the heart with pain and heat in the heart region; hunger without desire to eat; alternating reversal cold of the limbs and heat effusion; vomiting of roundworm after eating.

Pathogenesis: Reverting yīn (jué yīn) disease develops from transmission from other channels, especially the lesser yáng (shào yáng).

Analysis of signs

• Liver channel fire rising and liver qì running cross-counterflow: Qì surging up into the heart, pain and heat in the heart region, and hunger without desire to eat.
• Heat scorching liquid: Dispersion-thirst (meaning severe thirst with large fluid intake).
• Lower body cold damaging center yáng: Hunger with no desire to eat and vomiting after eating, sometimes with roundworm in the vomitus.
• Yīn and yáng locked in confrontation: Alternating reversal cold of the limbs and heat effusion, described as overcoming and retaliation of reversal and heat (厥热胜复 jué rè shèng fù), often appears in reverting yīn (jué yīn) disease.

Treatment

Medicinal therapy: Clear the upper body and warm the lower body using gān jiāng huáng qín huáng lián rén shēn tāng (干姜黄芩黄连人参汤 Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction) or má huáng shēng má tāng (麻黄生麻汤 Ephedra and Cimicifuga Decoction). For roundworm, use wū méi wán (乌梅丸 Mume Pill).

Acumoxatherapy: Needle BL‑18 (gān shù) and LR‑14 (qī mén) to move liver qì. Moxa CV‑12 (zhōng wǎn) and ST‑36 (zú sān lǐ) to downbear stomach qì. Moxa CV‑6 (qì hǎi) to move qì and blood in the lower burner. Worms, ST‑4 (dì cāng). Qì surging up into the heart, LR‑3 (tài chōng) and PC‑6 (nèi guān). Interior heat and exterior cold: LI‑11 (qū chí), LI‑4 (hé gǔ), TB‑2 (yè mén), ST‑36 (zú sān lǐ), and GB‑41 (zú lín qì).