latent heat

[Guest guest]

Here is Chip Chace's piece on latent heat

 

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Chinese Herbal Medicine

 

[Guest guest]

Todd how do you treat the recurrent colds due to latent heat (which herbs). This sounds interesting to me as I often see patients with recurrent "colds flus" that respond very poorly to 8 principles and zong fu.

thanks

alon

[Guest guest]

, <alonmarcus@w...> wrote:

how do you treat the recurrent colds due to latent heat (which herbs).

This sounds interesting to me as I often see patients with recurrent " colds

flus " that respond very poorly to 8 principles and zong fu.

> thanks

> alon

 

the strategy is to clear internal heat concurrent with relieving the

surface. Normally, herbs that drain internal heat may be

contraindicated in the acute onset of wind as they tend to move qi

downwards, rather than expel upwards. However, Chip has already

mentioned da qinglong tang as satisfying this tx principle. I don't

care for ma huang rx, feeling that their emphasis on the surface is too

strong for most of my patients. I use variations of xiao chai hu tang,

chai hu gui zhi tang, chai ge jie tang and chai hu zhi jie tang. I

always include huang qin and often huang bai and zhi zi. I may use

these formulae right at onset if patient complains of a cold, but has

little or no true surface conformation (usually absence of fever,

chills and body aches with only mild sore throat, often lateral,

perhaps one sided with lymphatic swelling). I also use these formulae

for true wind-cold invasions that do not resolve after a few days and

heat symptoms begin to arise. xiao chai hu is for stronger patients

with no surface component. Chai hu gui zhi is for weaker patients with

some surface sx. chai ge jie is for sinus congestion, neck pain. Chai

hu zhi jie is for chest pain.

 

I believe I have rarely seen acute wind-heat in the form of common cold

right at the onset in adults. Wind cold is much more common, I think.

for this reason, I think yin qiao san is overused, even abused. Heiner

Fruehauf feels that yin qiao requires significant fever or pronounced

sore throat,otherwise it actually saps wei qi, which is a warming yang

aspect of the body. I have had my best results with yin qiao in things

like tonsillitis and strep. Many common cold patients take this and

may get symptomatic relief, but complain of being chilly. those with

qi xu will become more susceptible to common cold if they take this too

frequently. finally, the patent gan mao ling from plum flower/mayway

has a reputation for wind cold amongst students, however an ingredient

analysis clearly reveals this rx to be heat clearing, not spicy warm

surface relieving. while the formulae I use are based on SHL ideas

about shaoyang pathology and my understanding of latent heat is

imprecise, I follow my teachers from chengdu and kanpo style in this

area. I find it to be successful.

 

[Guest guest]

Perhaps we shouldn't supressively treat all colds and flus, just gently

enhance their process towards expression.

 

Chinese medicine has both the principles of " warm the cold and cool the

hot " and " fight fire with fire " . I've often found that enhancing fever

with warm diaphoretics works to accelerate the body's own defense

mechanisms, kills off the pathogens and ultimately allows true cooling.

It often works better than trying to supress heat with cooling

medicinals.

 

If I'm understanding the mechanism of latent heat correctly, it would be

found in the conditons where the body needs to clean itself out and

disease is the mechanism for cleaning. In western naturopathic terms

the body needs to clean out accumulations of intracellular debris through

disease, which if supressed, will become a deeper or more serious

disease.

 

I'd be suprised if there isn't a description of this in the classics

somewhere since it is found in many healing traditions. Any idea where?

Can someone help me reframe this in terms?

 

Karen Vaughan

CreationsGarden

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[Guest guest]

while the formulae I use are based on SHL ideas about shaoyang pathology and my understanding of latent heat is imprecise, I follow my teachers from chengdu and kanpo style in this area. I find it to be successful.

>>>That is my training as well but I have a significant population in which this approach does not seem (to me) to clearly reduce the number of days patients feel ill. They usually tell me they feel more comfortable and feel the herbs are very helpful, but looking at the total days they feel sick I never know if they really are getting well faster. If they develop a significant cough I find it even more difficult to know how much true help they are getting. (interestingly at the AAOM meeting Dr Sam Leong also a SHL dr stated that coughs are difficult to treat)

I usually consider wind cold if the first symptoms are bodyaches, increased frequency of urination and runny nose. Wind heat if the first symptoms are more sore throat, no change in frinquency of urination and if patient feel worm. I usually can not get clear information as to change in thirst or color or urine (was very different in china). In my experience the pulses usually show more of the patient preexisting situation than the viral infection, although a change in rate is quit frequent.

I am interested in an email that you wrote a while ago on this matter were you stated that many of your patients probably have latent heat as they often have internal symptoms first, ( I see this all the time as well)

alon

[Guest guest]

, Karen S Vaughan <

creationsgarden@j...> wrote:

> Perhaps we shouldn't supressively treat all colds and flus, just gently

> enhance their process towards expression.

 

which is why I often perceive colds as wind cold and use warming herbs

for the surface component. I think the use of windheat herbs that

lower fever is often suppressive in common cold. However I do not

think this applies to hi fevers and raging heat due to clear infection.

In fact, wen bing theory, which is the source of the concept of latent

heat, also poses the idea similar to western med, of epidemic toxin,

which can attack anyone even those in perfect health, i.e. with no

internal accumulation to exteriorize. so in some cases,it may be

exteriorizing latent heat. In others, it may be true external

invasion. Neither idea is exclusively right. the idea that all

disease is part of the healing process is alien to TCM. Sometimes,but

not always. Naturopathy likes things black and white. TCM is better

with the gray.

>

> Chinese medicine has both the principles of " warm the cold and cool the

> hot " and " fight fire with fire " .

 

fighting fire with fire (or toxin with toxin, I think is actually the

expression) is rarely used in TCM, often for things like snake poison.

It is not a general priciple of tx, but an exception to the rule.

 

I've often found that enhancing fever

> with warm diaphoretics works to accelerate the body's own defense

> mechanisms, kills off the pathogens and ultimately allows true cooling.

 

I agree that this is true in low fever in wind cold, but not high fever

in wind heat. In fact, naturopathy often treats high fever with

purgatives and enemas, which is similar to tx of yangming pathology in

SHL. And warm diaphoresis will not touch the underlying heat pathogen,

just the branch sx as they exteriorize. continual warm diaphoresis

that ignores the internal heat may actually worsen the latent heat.

 

 

> If I'm understanding the mechanism of latent heat correctly, it would be

> found in the conditons where the body needs to clean itself out and

> disease is the mechanism for cleaning. In western naturopathic terms

> the body needs to clean out accumulations of intracellular debris through

> disease, which if supressed, will become a deeper or more serious

> disease.

 

while latent heat may be exteriorized by the zheng qi, I have much

better success resolving the syndrome permanently by clearing heat by

draining rather than sweating.

>

 

[Guest guest]

I agree with Karen that fevers should be expressed. And if managed

correctly, then latent heat does not develop. Something I notice often,

is a post febrile syndrome of relative Yin def. Shortly after a fever,

people feel a burst of " energy " and then typically they overdo it,

only to get exhausted. My observation is that this phenomena is caused

by Yin def. from the fever itself. Zhi Zi dou chi tang works like a

charm to clear out that empty heat. This really works well at preventing

latent heat before it starts.

 

Cara Frank

[Guest guest]

I can't say I fully understand anything, but it seems to me from my reading

and the posts that there is not much difference between internal heat

(either yin xu or shi) and latent heat--> they seem to be treated pretty

much the same? and manifest the same (heat coming from the internal going

towards the surface, not surface going in) maybe the only difference lies in

the way we perceive the etiology? which seems purely theoretical? (i.e.

catching the cold in the winter, pathogen going internal and expressing

itself in the spring) or whatever..? ...thoughts?

 

-

 

>

> CAra Frank [herbbabe]

> Sunday, November 19, 2000 7:09 AM

>

> Re: latent heat

>

>

> I agree with Karen that fevers should be expressed. And if managed

> correctly, then latent heat does not develop. Something I notice often,

> is a post febrile syndrome of relative Yin def. Shortly after a fever,

> people feel a burst of " energy " and then typically they overdo it,

> only to get exhausted. My observation is that this phenomena is caused

> by Yin def. from the fever itself. Zhi Zi dou chi tang works like a

> charm to clear out that empty heat. This really works well at preventing

> latent heat before it starts.

>

> Cara Frank

>

>

>

> Chinese Herbal Medicine, a voluntary organization of licensed

> healthcare practitioners, matriculated students and postgraduate

> academics specializing in Chinese Herbal Medicine, provides a

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>

[Guest guest]

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[Guest guest]

I wish some of the more experienced practitioners, that have spent more time in China, share their experiences in the clinics and hospitals. What have they seen treated successfully and predictably and what were the criteria for success etc. What systems have they observed mostly modern TCM, SHL or others.

My opinions on TCM were mostly formed between 1984-1990 after finishing my schooling and spending time in the municipal hospital in Guangzhou. I must admit that in the last 10 years after about 8 years of deep study of CM I exerted most of my energy on other subjects.

alon

[Guest guest]

, <@o...>

wrote:

> I can't say I fully understand anything, but it seems to me from my reading

> and the posts that there is not much difference between internal heat

> (either yin xu or shi) and latent heat--> they seem to be treated pretty

> much the same? and manifest the same (heat coming from the internal going

> towards the surface, not surface going in) maybe the only difference lies in

> the way we perceive the etiology?

 

It becomes clinically relevant when considering how to treat what

appears to be an acute external invasion. Rather than just relieving

the exterior, it may be necessary to clear internal heat, as well.

Conversely, latent heat may need to be at least partially dispersed

from the surface, while pure internal heat that arose internally needs

to be drained via stool and urine. finally, xu heat needs neither

draining or dispersing but supplementation of yin essence and calming

of yang fire. Several different tx principles come into play here and

choosing the wrong one will be iatrogenic.

 

[Guest guest]

>

> It becomes clinically relevant when considering how to treat what

> appears to be an acute external invasion. Rather than just relieving

> the exterior, it may be necessary to clear internal heat, as well.

> Conversely, latent heat may need to be at least partially dispersed

> from the surface, while pure internal heat that arose internally needs

> to be drained via stool and urine.

 

How would the symptomological differences manifest between heat arising from

purely internal means and latent heat? I'm having problems seeing the

difference? If there is no difference (of s/s) then arguing about the

pathogenesis seems moot. (?)

 

 

finally, xu heat needs neither

> draining or dispersing but supplementation of yin essence and calming

> of yang fire. Several different tx principles come into play here and

> choosing the wrong one will be iatrogenic.

>

 

>

 

 

 

If one looks at jia jian wei rui tang Bensky says it treats

" externally-contracted wind-heat in a patient with underlying yin

deficiency. " The herbs are not draining of the stool and urine but

releasing through the ext. IS this a yin xu rx or latent heat?

The s/s are " fever and slight chills, little or no sweating, headache, dry

throat, cough, sputum which is difficult to expectorate, thirst,

irritability, a dark-red tongue, and a rapid pulse. "

I think Gary seifert quoted how this rx is used for latent heat (but chronic

yin xu)? [Which I believe is the same thing?]

 

Also qin hao bie jia tang treats injury to yin from a febrile disease, and

it vents the heat.. is this yin xu with heat? or latent heat?

 

Basic Latent Heat:

 

1) Blackwell lists for spring-heat (latent heat) at qi level, " high fever,

restlessness, bitter taste in the mouth, dry mouth, scanty yellowy urine,

maybe nausea and vomiting, tongue = red, pulse = wiry, slippery, rapid. "

2) From the latest wen bing book " scorching heat, vexation, thirst, scant

yellow urine, red tongue, and yellow tongue moss. "

3a) Maciocia states for basic latent heat a person feels " suddenly very

tired with weary limbs, slightly thirsty, hot and irritable. He or she

would not sleep well and the urine would be dark... " pulse = find and

slightly rapid, tongue = red.

 

Latent heat with an external invasion:

 

3b) Maciocia, above s/s plus shivering, fever, occipital headache, aches and

sneezing. Pulse = find and rapid, tongue = red.

 

 

I am still having a difficult time understanding the difference between the

yin xu (w/ heat) and an external attack, and latent heat with an external

attack. The s/s look the same...(?) or differentiating latent heat (no

external attack) and yin xu with heat (no ext. attack)...

 

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