Tidal heat

Heat effusion, sometimes only felt subjectively, occurring at regular intervals, usually in the afternoon or evening (postmeridian tidal heat). Tidal heat effusion may form part of both vacuity and repletion patterns.

Patterns

yáng brightness (yáng míng) bowel repletion (阳明腑实 yáng míng fǔ shí) can cause tidal heat at the stage of the disease when heat has abated somewhat but not fully. The yáng brightness (yáng míng) tidal heat is a specific form of postmeridian (p.m.) tidal heat that is called late afternoon tidal heat because it occurs at roughly 3–5 p.m. It differs from other tidal heat occurring in other patterns by being a heightening of an otherwise constant heat effusion. It is associated with streaming sweat on the hands and feet, hard fullness and pain in the abdomen, constipation (sometimes heat bind with circumfluence), vexation and agitation, parched yellow tongue fur, and a sunken replete pulse. In severe cases, there may be clouded spirit and delirious raving.

Medicinal therapy: Use Major Qì-Coordinating Decoction (大承气汤 dà chéng qì tāng), Minor Qì-Coordinating Decoction (小承气汤 xiǎo chéng qì tāng), or Stomach-Regulating Qì-Coordinating Decoction (调胃承气汤 tiáo wèi chéng qì tāng).

Acumoxatherapy: Base treatment mainly on ST, LI, and GV. Select ST-44 (Inner Court, 内庭 nèi tíng), LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), LI-6 (Veering Passageway, 偏历 piān lì), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), GV-14 (Great Hammer, 大椎 dà zhuī), and PC-5 (Intermediary Courier, 间使 jiān shǐ); needle with drainage.

Yīn vacuity blood depletion (阴虚血亏 yīn xū xuè kuī) causes postmeridian (p.m.) tidal heat, i.e., a tidal heat in the afternoon, evening, or night. This is accompanied by heat in the heart of the palms and soles, heart vexation, insomnia, heart palpitation, night sweating, emaciation and haggard appearance, a red tongue with scant fur, and a fine rapid pulse.

Medicinal therapy: Enrich yīn, nourish the blood, and clear heat. Use Bone-Clearing Powder (清骨散 qīng gǔ sǎn) plus Chinese angelica (Angelicae Sinensis Radix, 当归 dāng guī) and white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào).

Acumoxatherapy: Base treatment mainly on the three yīn channels of the foot, HT, and GV. Select KI-6 (Shining Sea, 照海 zhào hǎi), KI-2 (Blazing Valley, 然谷 rán gǔ), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), HT-8 (Lesser Mansion, 少府 shào fǔ), HT-7 (Spirit Gate, 神门 shén mén), LU-10 (Fish Border, 鱼际 yú jì), GV-14 (Great Hammer, 大椎 dà zhuī), and PC-5 (Intermediary Courier, 间使 jiān shǐ); needle with even supplementation and drainage.

Spleen-stomach qì vacuity (脾胃气虚 pí wèi qì xū) causes morning tidal heat that abates in the afternoon (or sometimes postmeridian tidal heat), accompanied by scantness of breath, laziness to speak, lassitude of spirit, limp limbs, spontaneous sweating, bright-white facial complexion, pale soft tongue, and a fine, vacuous, weak pulse.

Medicinal therapy: Eliminate heat with warmth and sweetness. Use Center-Supplementing Qì-Boosting Decoction (补中益气汤 bǔ zhōng yì qì tāng).

Acumoxatherapy: Base treatment mainly on back transport points, CV, and GV. Select BL-20 (Spleen Transport, 脾俞 pí shù), BL-21 (Stomach Transport, 胃俞 wèi shù), CV-6 (Sea of Qì, 气海 qì hǎi), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and GV-14 (Great Hammer, 大椎 dà zhuī); needle with supplementation.

Summerheat-heat damaging qì (暑热伤气 shǔ rè shāng qì) in children gives rise to a summer infixation with tidal heat in children. It may take the form of heat effusion in the morning that cools in the evening or heat effusion in the evening that cools in the morning. This is associated with thirst with intake of fluid, vexation and agitation, torpid intake, lassitude of spirit, slimy tongue fur, and fine rapid pulse.

Medicinal therapy: Clear summerheat and boost qì with Wáng’s Summerheat-Clearing Qì-Boosting Decoction (王氏清暑益气汤 wáng shì qīng shǔ yì qì tāng).

Acumoxatherapy: Base treatment mainly on PC, ST, LI, and GV. Select PC-6 (Inner Pass, 内关 nèi guān), LI-4 (Union Valley, 合谷 hé gǔ), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and GV-14 (Great Hammer, 大椎 dà zhuī); needle with drainage, and supplement CV-6 (Sea of Qì, 气海 qì hǎi), BL-20 (Spleen Transport, 脾俞 pí shù), and BL-21 (Stomach Transport, 胃俞 wèi shù).

Static blood (瘀血 yū xuè) lying depressed in the inner body causes postmeridian tidal heat with dry throat and mouth, washing the mouth with water but no desire to swallow it, concretion lump in the abdomen or a painful area on the body, a green-blue or purple tongue possibly bearing stasis macules, and a rough fine pulse. In severe cases, patients may have encrusted skin and dull black eyes.

Medicinal therapy: Quicken the blood, transform stasis, and clear heat. Use House of Blood Stasis-Expelling Decoction (血府逐瘀汤 xuè fǔ zhú yū tāng) plus rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng) and moutan (Moutan Cortex, 牡丹皮 mǔ dān pí).

Acumoxatherapy: Base treatment mainly on SP, LR, and KI. Select BL-17 (Diaphragm Transport, 膈俞 gé shù), SP-10 (Sea of Blood, 血海 xuè hǎi), LI-4 (Union Valley, 合谷 hé gǔ), LR-3 (Supreme Surge, 太冲 tài chōng), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), KI-6 (Shining Sea, 照海 zhào hǎi), KI-2 (Blazing Valley, 然谷 rán gǔ), and LR-2 (Moving Between, 行间 xíng jiān); needle with drainage.