Fire Heat Pathology | Treating Infection and Inflammation

Song – Jin –Yuan Dynasties, 960-1368 AD

Establishment of specialties such as pediatrics and gynecology

Establishment of special topics or approach to diseases

Centered around Fire-Heat Pathology

Dry Climate and tough weather

Intake of Beef, lamb, wheat, alcohol.

Tough terrain, tough people.

Even with wind-cold, frequently transforms into heat or dryness.

During Song Dynasty – Tai Ping Hui Min He Ji Ju Fang 太平惠民和剂局方 – mostly warming and tonifying, cannot be used well in heat conditions.

At Song Dynasty, emphasis was on formulas and less on the understanding of pathogenesis.

Dr. Liu, Wan Su, based on the foundations from Neijing and spent 35 years perfecting the Fire-Heat theories.

1.Frequency of Fire-Heat Pathology 火热广泛

2.“Six Qi can all transform to Fire” Doctrine 六气皆能化火

3.Extreme of Five Emotions create Heat 五志过极皆为热

4.Treatment of Fire-Heat Pathology 火热病的治法

5.Yang Qi Stagnancy 阳气怫郁

6.Wu Yun Liu Qi Pathology 五运六气病机

7.Kang Hai Cheng Zhi Discussion 亢害承制论

8.Elaboration of Za Bing 杂病的发挥

Originates from chapter 74 of Neijing Suwen Essentials of Disease and Therapy

Neijing 19 Etiologies (Neijing Bing Ji Shi Jiu Tiao 内经病机十九条)

Huang Di inquired, “Can you please describe the pathology for each organ system and its connection with the atmospheric influences?”

Qi Bo responded,” Symptoms of tremors and shaking of the limbs, dizziness, and vertigo are usually caused by wind and associated with liver. Many conditions of contraction and spasms are usually due to cold and associated with the kidneys.”………

Fainting and seizure, lockjaw and shivers, acute vomiting, manic and restlessness, edema and pain are due to fire. (5)

Abdominal distension and swelling, borborygmus and tympani, vomiting of foul matter and acid regurgitation and acute dysentery with bloody stools, body torsion and turbid secretions are usually due to heat (4)

5 belongs to zang, 1 wind, 1 damp, 1 cold, 1 upper, 1 lower

Eventually expanded to 56 types of Fire-Heat Etiology occupying 80% of all etilogies.

Asthma, vomiting, acid regurgitation, acute diarrhea, body torsion, turbid urination, ascites with tympani, rash, hives, open sores, tumor, nodules, fainting, swelling, nasal congestion, epistaxis, hematemesis, bloody stools, fever and chill, shivers, fright, confusion, sadness, manic, restlessness, throat pain, tinnitus, hearing loss, blurry vision, sneezing, acute disorders, delirium, etc.

Wind, damp, dryness, and cold can all transform to fire.

Wind originates from heat, heat is ben 本 and wind is biao 标, wind cannot exists without heat.

In general pathology, wind tends to combine with heat.

Damp disease does not occur on its own.

It is due to fire-heat stagnancy causing body fluid to stagnant creating water-damp

Most clinical manifestations are swelling.

Most swelling is due to damp-heat combination creating sluggish urination.

The herbs should be pungent bitter and cold

Dryness consumes yin fluid and frequently transforms to fire-heat.

Body fluid deficiency, blood deficiency, yin deficiency can all cause hyperactivity of yang creating internal heat.

Winter is cold and contracting and stagnant in nature. There is actually more dryness than Summer months.

Nourish yin to cool heat

Liu, Wan Su is recognized of his work in exogenous fire-heat discussions, but

He has also did some work in understandings of internal heat through the “extreme of five emotions creat heat”.

Five emotional imbalances can cause heat and heat can cause five emotional imbalances.

Biao Zheng

Pungent cooling or sweet cold

Ma Huang and Gui Zhi are not suitable

Frequently use Gan Cao甘草, Hua Shi 滑石, Cong Bai 葱白, Dou Chi 豆豉.

Biao Zheng with Nei Re, use Fang Feng Tong Sheng San 防风通圣散, Shuang Jie San 双解散.

Or use Tian Shui San 天水散 + Liang Ge San 凉膈散

Li Zheng

Purgation of Fire-Heat

Three Scenarios

◦Biao Zheng gone, Nei Re with abdominal distention, restlessness, pulse deep excess.

◦Deep heat toxin creating dry throat, asthma, abdominal pains, pulse deep thready.

◦Damp heat.

Da Cheng Qi Tang大承气汤 or San Yi Cheng Qi Tang 三一承气汤

Huang Lian Jie Du San 黄连解毒散

Small dose of Huang Lien Jie Du San 黄连解毒散 or Liang Ge San 凉膈散

Liu, Wan Su’s focus is not only on Fire-Heat pathology, but also the patency flow of Qi.

The great Dao has no shape or form. Without Qi, no life can exists; transformation of Qi gives birth of all lives; changes of Qi creates changes in lives; abundance of Qi strengthen the organism; deficiency of Qi weakens the organism; normal Qi promotes harmonious lives; deranged Qi creates diseases; termination of Qi causes the death of life.

If Yang Qi is stagnant, Fire-Heat develops creating many different pathologies.

Xuan, Qing, Tong 宣清通三法

Disperse, Cleanse, Open methodologies

Pungent, Bitter, Cold Herbs

◦Xuan – to clear biao, not sweating, to clear stagnancy – pungent cool herbs

◦Qing – to clear stagnant heat – bitter cold herbs

◦Tong – mainly purging – pungent, bitter, cold herbs

Even though human beings can master their environment and creates a micro-climate for herself, climate, weather, and environmental changes are still very influential in causing or triggering diseases and imbalances.

Five Cycles – five elemental or five zang influences

Wu Yun Liu Qi inter-supporting and inter-controlling.

To ensure seeking for balance in constant imbalance.

Huang Di Su Wen Xuan Ming Lun Fang

◦Also known as Xuan Ming Lun Fang

黄帝素问宣明论方

1172 AD

15 chapters, 348 formularies

Fang Feng Tong Sheng San 防风通圣散

Di Huang Yin Zi 地黄饮子

Gui Ling Gan Lu Yin 桂苓甘露饮

66% combination of warming and cooling herbs

21% warming, 13% cooling

Tonify Kidney Benefit Essence, Nourish Heart Open Orifice

Stroke, Loss of Speech, especially Kidney Yin and Kidney Yang Deficiency types

Locomotor Ataxia – syphilis of the spinal cord characterized by degeneration of sensory neurons and stabbing pains in the trunk and legs and unsteady gait and incontinence and impotence

Meniere’s Syndrome, Hyperthyroidism, Neurasthenia, Chronic Nephritis, Infertility

生地 Sheng Di 3 liang

巴戟天 Ba Ji Tian 1 liang

山茱萸 Shan Zhu Yu 1 liang

肉蓯蓉 Rou Cong Rong 1 liang

石斛 Shi Hu 1 liang

炮附子 Fu Zi 1 liang

茯苓 Fu Ling 1 liang

石菖蒲 Shi Chang Pu 1 liang

遠志 Yuan Zhi 1 liang

肉桂 Rou Gui 1 liang

麥冬 Mai Dong 1 liang

五味子 Wu Wei Zi .5 liang

生薑 Sheng Jiang

大棗 Da Zao

薄荷 Bo He

Established foundations for

◦Pathogen Attacking Doctrine

◦Dan Xi Doctrine

◦Warmth Disease Doctrine

An adaptive mechanism, fever is the body’s reaction to pathogens; it attempts to raise core body temperature to levels which will denature, debilitate, or kill the pathogen. Most fevers are caused by infections and almost all infectious diseases can cause fever. When a patient has or is suspected of having a fever, that person’s body temperature is measured using a thermometer. If successful in ridding the body of an invasive pathogen, fever is an important protective immune mechanism and should generally not be suppressed. However, there are instances when fever escalates to temperatures where the body is at risk of destroying its own cells and must be brought under control with suppressive medication.

An infection is the detrimental colonization of a host organism by a foreign species. An infection is, in effect, a war in which the infecting organism seeks to utilize the host’s resources in order to multiply at the expense of the host. The infecting organism, or pathogen, interferes with the normal functioning and perhaps the survival of the host. Colloquially, a pathogen is usually considered a microscopic organism though the definition is broader, including bacteria, parasites, fungi, viruses, prions, and viroids. The branch of medicine that focuses on infections and pathogens is infectious diseases

Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. Inflammation is characterized by the following quintet: redness (rubor), heat (calor), swelling (tumor), pain (dolor) and dysfunction of the organs involved (functio laesa).