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The Four Levels theory explains how to treat you when what are called 'Warm' diseases, such as from bacteria and viruses, penetrate your health defences.
(Some pages on this site are a bit more demanding of the reader than others. This is one of them! That may be because this is where different strands in Chinese medicine come together, so to understand it you need familiarity with other parts of the system.)
What are 'Warm' diseases? Basically, they are caused by infectious agents such as bacteria and viruses that usually enter via your nose or mouth. But they could also enter via skin wounds and your eyes, or any other bodily orifice.
What sort of bacteria and viruses? These include:
This is easier said than done! Obviously, if you can, don't get ill. Basically this comes down to hygiene.
This important topic is covered here.
The Chinese doctor who conceived the idea of the Four Levels, Ye Tian Shi, was familiar with the identification of patterns of disease according to the Six Stages. The Six Stages was, up to then, the main system for classifying and treating diseases.
The problem was that the Six Stages, first written about in 220AD, had deficiencies. It applied to diseases that were thought to be 'caught' by transmission through the skin, like Cold - not the common cold, caused by a virus - but what happens when you get so cold you get sick.
You may not think that Cold on its own can cause a disease, but I assure you it can.
Indeed, it happened to me! I've put what happened to me on a page on the penetration of Wind-Cold.
As we know now, contagious diseases enter mostly via the mouth, nose and throat. But it took us many centuries to realise this.
The Chinese were ahead of us. They couldn't of course see the bacteria, let alone the viruses, because they lacked our modern microscopes, so they called them 'invisible worms'.
Some of the syndromes described in the Four Levels are identical with syndromes described in the Six Stages. That shows that the body has a range of strategies for dealing with invasive diseases, and some of them are appropriate for both 'cold' and for 'warm' diseases.
Ye Tian Shi worked out the Four Levels where your body places its defences when an infectious disease (when characterised by Wind-Heat, which they called a 'Warm' disease) gains entry. Each of the Four Levels show how serious a disease is and what to do about it.
These theories are used to this day in Chinese medicine. For example his Four levels theory apparently helped Chinese doctors classify the SARS epidemic a few years ago.
What did YeTian Shi intend by the term 'Warm Disease'?
Thank God for modern medicine! It saves lives all the time, especially in emergencies.
But one of its main weapons, antibiotics, is becoming unreliable.
Antibiotics no longer work effectively because the bugs are getting ahead: like the weeds in my garden (see the picture - left!) which grow faster than I can pluck them out.
Doctors are now urged to restrict antibiotic use in 'less important' diseases so that they can be relied on in more serious situations.
Otherwise the bugs will adapt even faster and eventually no antibiotics will work. Given that no new antibiotics have been discovered for many years, this is a problem. Indeed, some diseases are already becoming un-treatable with antibiotics. (Actually, several new ways of impeding the bugs have been found, but tests on humans won't start for another two years ie 2017, and if successful the drugs won't become available until some time after that.)
There are other, promising lines of modern medical research and attack, but eventually the bugs will always adapt to them, so the more we can get our bodies to cope without drugs, the more likely that when we really need one of modern medicine's weapons, it will work.
The Four Levels theory helps us to understand what is happening when, from the same bacteria or virus, one person gets one set of symptoms but his friend gets another, and what to do about it.
More even than the acupuncture points suggested at each level, the herbal prescriptions Ye Tian Shi suggested, along with enhancements to them over the following centuries, show how Chinese medicine sees a possible way through these potentially major problems.
I have never been called to treat someone at the third and fourth of these four levels (the Ying and Blood levels). I don't work in a Western medicine hospital which is where you would end up with symptoms of the severity these syndromes describe.
In Third world countries, you could easily have these symptoms, in which case you would need urgent medical care.
The Chinese experience is that, with the right tools to hand, these four levels conditions can sometimes be saved. By 'tools' I mean the herbs and the acupuncture etc..
It may be that with the decline in effectiveness of antibiotics, the Chinese understanding of these conditions may provide another way for Western medicine, with its huge resources, to treat these disease syndromes.
Although Western medicine would be urgently trying to identify the appropriate antibiotic for the pathogen in question, Chinese medicine would use quite another approach to prescribe.
For instance in the Pericardium Heat syndrome of the Ying-Nutritive level, the suggested recipe is Qing Ying Tang. The action of this is not specifically to kill the pathogen (remember that 300 years ago they had no means to identify the pathogen), but to relieve the Fire, drain the heat, calm and steady the mind, and nourish Yin.
Of course, the formula is adapted to the situation. Two patients with the same Pericardium Heat syndrome might have subtly different recipes according to their needs.
One of the strengths of Chinese medicine is the importance it places not just on clearing - in this case - the Heat - but on nourishing the Yin, which the Heat is damaging.
You could say that the herbs encourage the body to improve its nutrition, to get more out of what is eaten and to steady it: unlike many modern Western medications which just attack the perceived pathogen without helping the body cope with the damage it has done.
By the way, Qing Ying Tang in its original formulation requires the use of rhinoceros horn. Fortunately there are nowadays better alternatives to this ingredient. This is yet another reason for condemning the needless slaughter of endangered species such as the rhino.
If you live in the Edinburgh area of Scotland, where the author of this site (and of the books described below) works, click on Edinburgh Acupuncturist.
If you live elsewhere, click on BAcC.
Please note! The Kindle editions are less easy to read! Although the paper editions cost more, they are much easier to read and to refer back and forth to the contents and index.
Here are some of the books Jonathan has written:
Still only one comment, though personally I think this is my best book so far.
Published 1986 and, amazingly, still selling. Was apparently used back then by at least one acupuncture college to help students understand Chinese medicine!
No comments yet: just published. (Despite the lurid cover, it explains the five main types of phlegm and what works best for each type. I hope it's easy to read and will be much more useful than all the websites on the subject.)
3000 years of Chinese being stressed, and at last, here's a book showing how all that experience can help you!
By the author of this website, it explains in simple English how to use stress to improve and enhance your life.
NB You can also order 'Qi Stagnation - Signs of Stress' from your bookseller.
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