Yin Fire Scenarios (Li Dong-Yuan; Li Gao)

For us a picture of your tongue would be helpful or at least a verbal description - particularly as the pulse is widely subjective - most notably when someone is taking their own pulse.

–Done.

About the pulses: in addition to noting my own pulse changes throughout each day and week, a practitioner I see in town confirms these. He actually frowned in confusion once he felt the liver, because for the last year or so it’s always been taught and excessive. Within the past seven days it has been quite weak. In fact, it’s the weakest of all six pulses. It’s almost as if the liver and spleen have switched places. However, within the past two days in particular the liver and spleen are both on the weak end; they’re only registered on deep palpation. It’s no coincidence that within these same last two days that I’ve had considerable pain in my abdomen that I haven’t felt in more than a year now. I also had a soft stool today–not expected whatsoever. I’ll be on the lookout for see-sawing constipation-diarrhea. Today, I had an episode of extreme fatigue accompanied by dizziness, vertigo, and slight heat rush. I imagine this is liver yang, but could I exhibit concomitant liver yang rising via stagnation and liver yin deficiency? Perhaps the signs are all suggesting that by overusing pungent, bitter, and cold medicinals I’ve only added insult to injury for stagnation.

All that said, I would stick to extremely basic formulas with very precise actions if I were to use herbs at all. For example, trying to “clear heat” and then “tonify the spleen” at the same time (even though that is loosely what Li Dong Yuan seemed to indicate) will often further confuse the systems in the body. With these types of conditions and with sensitive systems you need very basic and very clear instructions to be provided to the body. Assaulting your body with complex formulas rarely clears these kinds of conditions up over the long term.

–Although I’d love to hanker down on a simple formula, I’m however quite reluctant to follow this ideology because it hasn’t worked for me in the near-past. It made things worse, actually. I had taken a week or two of Ban Xia Xie Xin Tang and had resolved some issues but they had quickly returned in full swing. Then early in January of this year I began Xiao Yao San with added Dang Shen for severe spleen deficiency. This tang aims to free the liver and supplement the spleen–respectfully. It does not account for internal heat brewing, especially runaway ministerial fire as in the yin fire scenario. In my case it was clear that the sweetness (especially of Zhi Gan Cao) only fueled the flames of my lower burner causing severe bloating, indigestion, and gas. My anger was twofold and outbursts much more frequent. Depression hit hard. “Do not supplement until evils have been eliminated…unless the righteous qi has been damaged” rings Bob in my head. To the best of my knowledge ministerial fire always consumes the righteous qi. This ties in with one of my fundamental questions: how can I differentiate between a plausible present damp-cold issue (as the result of too much fire-squelching) and any evils (pathogens; Gu) which may have resisted my gunfire barrage? Nothing tells me that I have any issues with the exterior and that everything is interior, so I must be certain that it is indeed damp-cold–right? (Flaws suggests that qi-rectifiers and exterior-resolvers are closely-related–so it is farfetched to speculate that all of this out-thrusting may be the cause of a deplete liver pulse?). I can however be certain that despite supplementing the spleen I may not be proportionally freeing the qi mechanism at the same time, simply pouring damp earth onto the lower burner (which is why I have the belly and body of a starving child in a developing nation; emaciated with a ballooned abdomen). So, how can I upbear the clear without further engendering dampness?

Most of these layered conditions are a process and they can be difficult to resolve completely and yin fire is a indication of how complex and layered these conditions.

–I would agree with you that an yin fire scenario is complex, but I disagree that the layers metaphor can adequately describe these modern, knotty diseases (quoting Bob Flaws): “In complex, multi-pattern presentations, you cannot “peel the layers of an onion”… [because] there are no layers.” According to Li yin fire disease mechanisms are mutually engendering （相生）. Li also stresses that if there are symptoms of hot and cold, dampness and dryness, vacuity and repletion at the same time then this implies either (A) concomitant blood, yin, and/or fluid vacuities; (B) heat disturbing the lungs or heart; and © kidney yang vacuity exist simultaneous with (1) spleen vacuity; (2) inhibition of qi (read: stagnation); and (3) either depressive or damp heat–in this order of impact. Therefore (quoting Flaws again): “…one must write complex formulas which treat all the disease mechanisms at the same time, not one after the other.” I truly appreciate your input and clinical experience, but personally I cannot ignore the realization that what you suggest and these texts suggest are worlds apart, adding to my sense of uncertainty.

I had a feeling you may receive my reply in this way. I truly appreciate your input. I apologize if I stepped on your toes with the references to Bob. It’s just that I’ve versed myself in his materials when I started taking the herbs seriously. This was in January of this year. To be honest, I should give myself more credit and give you more back-story than what I’ve divulged here:

I was living in Taiwan from 2012 to 2013. During the transition from the first year to the next, I suffered a heart attack (I’m 27 years old). Long-story-short, symptoms kept piling on and worsening, I spent 7 straight months seeking standard medical attention to no avail when finally I received a diagnosis only after being hospitalized and poked and prodded for clues (2 weeks in the hospital). After receiving this news, my doc literally told me “I don’t think [Western] medicine can help you.” I packed up and returned to the US, not knowing much about the nature and “origins” of autoimmunity. I was overly confident that our health systems would be more versed–and therefore more capable–of curing me. Although I still believe a cure exists, I doubt it is easily and/or often achieved.

Since returning to the US, I made my first changes to the diet early 2014. In retrospect, these were basic at the time–primarily no gluten, corn, dairy, or soy. I followed the protocol laid forth by Susan Blum (M.D.) in her publication “The Immune System Recovery Plan.” I figured if she cured herself of Hashimoto’s (also what I have according to standardized diagnosis procedures) so can I. I’ve now come to realize that it doesn’t really matter what “type” of autoimmune disease you have because all of them are really just colors or shades of the same monster.

Any-who, I kept running into a wall on this diet. As time went by I revised it further, looking at other variables beyond the composition of what I ate; how it’s prepared, what proportions, etc. So this is how I’ve come to the current diet I’m on now reflective of my initial comment on this thread (the topic post).

I regularly test with Genova Diagnostechs on stool composition–metabolic and pathological panels mostly. Consistently throughout testing this last year it shows I have a NULL value of lactobacillis species. This concerns my [TCM] practitioner and myself the most, because we both understand that gut health is pivotal to the recovery of all other systems–and therefore total recovery. The results of these tests and the symptoms I’ve experienced up until now clearly coincide with antibiotic use; overly-adventurous eating (too much street food); extreme taxation; chronic drug, alcohol, and tobacco use; genetic predisposition (I consult with an expert in Methylation Genetics) via the 23 chromosome report; and other questionable life choices. Since returning to the US, the gut-related symptoms are primary with fatigue, inflammation (swelling and discomfort–including taxed breathing and hypochondria-related issues), and psychological distress (anxiety, bipolarism, depression) following suit, respectively. The severe cardiac distress (tachycardia, arrhythmia, mitral valve prolapse) don’t happen nearly as often or consistently as they had in Taiwan.

What do you think of my tongue? Anything remarkable?

Regarding your disposition on modernity: I would have to agree with you in general, however it’s a fine line to traverse between the foundation of TCM and everything we know from the classics and today’s modern TCM, which makes amendments. To be honest, the complex formula and Flaws is a far cry from the classics–and on-par with what you suggest. I guess I can only say that I’m apprehensive mostly because I greatly fear “dropping the ball” and ruining the last few months (and in bigger perspective these last 9 months) of progress. I also question whether or not any progress has been made, ironically. Chronic disease is difficult to gauge especially when I cannot objectively assess myself since it is my own body, sensations, mentality, and emotions. I keep a log but have since learned not to embellish in its tendency to embody OCD tendencies.

I would love a consult from Bob. However, I’m currently in Minneosta and without much mobility or capital–it’s a long process waiting for disability. Perhaps I can gain his attention long-enough to hear me out in asking for his two cents. Any advice? If I do get a hold of him I will absolutely contribute my findings here for further constructive discussion. I’d also like to see other comment on this thread for some variety–it never hurts.

If I don’t hear from you tomorrow, have a wonderful weekend and again thank you very much for your insight.

Cheers and namaste