Clinical Tip of the Day no. 3

A red tip of the tongue is very common. The tip corresponds to the Heart and the Shen and a redness of the tip always indicates emotional stress affecting the Heart: the redder the tip, the more intense the stress. Why is the tip affected and why does it become red? The Heart is affected by all emotions as it houses the Shen that feels them. When we feel angry, anger affects the Liver automatically, but it is the Shen of the Heart that “feels” the anger. Thus, a red tip of the tongue may be caused by any of the emotions, e.g. anger, sadness, grief, worry, fear, etc.

Why does the tip become red? The first effect of emotional stress is some Qi stagnation: when Qi stagnates, it frequently gives rise to Heat and hence the redness of the tip. If, besides being red, the tip is also swollen and has red points, it indicates that the emotional stress is even greater.

My favourite points - no. 2

LU-3 Tianfu (3 cun below axillary fold)
Window of Heaven point. These points regulate the ascending and descending of Qi from the body to and from the head: they do so in the crucial neck area. Therefore, they can both subdue rebellious Qi and promote the ascending of clear Qi to the head.

On a psychic level, LU-3 action in regulating the ascending and descending of Qi to and from the head has a mental-emotional effect. For example, insomnia is due to Qi ascending too much to the head (or not descending from it) while somnolence and forgetfulness are due to clear Qi not ascending to the head. The “Explanation of the Acupuncture Points” (1642) says that LU-3 can make Qi rise to treat forgetfulness, sadness and weeping due to Qi not rising to head. Forgetfulness is an important indication for this point: this is forgetfulness due to clear Qi not rising to the head. According to the “Explanation of the Acupuncture Points”, this point treats forgetfulness by stimulating the ascending of Qi of both Lungs and Heart.

The mention of weeping in this ancient text is interesting. It means that this point treats afflictions of the Lungs from sadness and grief leading to weeping.

Finally, “talking to ghosts” features heavily in this point's indications. Generally speaking, when ancient books mention such symptoms as talking or seeing ghosts among the indications of a point, it means that the point is indicated for relatively serious mental-emotional problems and, in particular, when the Mind is obstructed. Obstruction of the Mind can potentially cause serious mental problems such as manic-depression or psychosis. Again, this point can open the Mind's orifices, i.e. de-obstruct the Mind by regulating the ascending and descending of Qi to and from the head: it opens the Mind's orifices by promoting the descending of turbid Qi from the head and the ascending of clear Qi to the head (which, as we have seen above, is a general function of the Window of Heaven points).

My favourite points

Du-24 Shenting (Spirit Courtyard)
Du-24 is a very important and powerful point to calm the Mind. It is frequently combined with G.B.-13 Benshen for severe anxiety and fears.

An important feature of this point which makes it particularly useful is that it can both calm and lift the Mind: therefore it is used not only for anxiety and insomnia but also for depression and sadness. It is also used in psychiatric practice for schizophrenia and manic behaviour.

The name of this point refers to its strong influence on the Mind and Spirit. The courtyard was traditionally considered to be a very important part of the traditional Chinese house as it was the one that gave the first impression to visitors; it is the entrance. Thus, this point could be said to be the "entrance" to the Mind and Spirit and its being a courtyard, highlights its importance. Being the "entrance", it controls our relationships with others.

I call this point the "arena of Shen and Hun": this point regulates the movement of the Hun. When the movement of the Hun is excessive, the person is slightly manic; when deficient, the person is depressed. This point regulates the movement of the Hun and the control of the Shen over the Hun.

The point combines very well with Ren-15 Jiuwei to calm the Shen and lift mood in both anxiety and depression.

Clinical tip of the day no. 2 - Heart crack

The Heart crack on the tongue is relatively common. This crack is in the midline extending from near the root to near the tip; it therefore extends nearly the whole length of the tongue. The Heart crack indicates the constitutional tendency to mental-emotional problems: the deeper the crack, the stronger this tendency. If the Heart crack is accompanied by a change in the tongue-body colour and a red tip, it then indicates actual mental-emotional problems.

The two tongues presented here both have a Heart crack. The worst is the one on the bottom because the crack is deeper.

The view of tobacco in Chinese medicine

- Tobacco was introduced in China in 1575.

- The Zhen Nan Ben Cao (Ming) concludes that tobacco is pungent in taste, hot and toxic without any medicinal effect.

- The Ben Cao Cong Xin says “People nowadays inhale smoke down to the throat: this damages Blood and the voice.”

- Emperor Chong Zhen (Ming) enacts laws against smoking.

- Qu Ci Shan (Qing) says: “Tobacco is pungent and drying, it burns Jing (Kidneys) and the Fluids, damages the throat, the Stomach and the Lungs…it enters the Heart orifice causing mental confusion as if one were drunk. It makes the tongue coating dark-yellow or black, food and drink have no taste, the medical texts have no treatment for this.”

- Zhao Xue Min (Qing) thought that smoking damages the Lungs, exhausts Blood, injures Shen and shortens life.

The above statements are interesting as they show that, according to Chinese medicine, tobacco is drying, it dries up Fluids and the Jing (Essence). So, Western medicine focusses on the effects of tobacco on the lungs while Chinese medicine considers it to deplete Kidney-Jing as well. This would explain the toxicity of tobacco in pregnancy.

Clinical Tip of the Day

When treating the elderly, we should not over-emphasize Kidney deficiency.

Yes, most elderly people (though not all) will suffer from some form of Kidney deficiency but the most serious diseases of the elderly are caused by Phlegm, Blood stasis and internal Wind. These three pathogenic factors play a role in the pathology of stroke, coronary heart disease, cancer, high cholesterol, diabetes, hypertension, Parkinson's disease and Alzheimer's.

It follows therefore, that in treating the elderly, we should pay attention to resolving Phlegm, invigorating Blood and extinguishing Wind. These pathologies are also reflected in the pulse of the elderly that is frequently hard, Wiry and Slippery.