Ying level – Heat in the Pericardium

Jonathan Clogstoun-Willmott

April 17, 2023

With Ying level Heat in the Pericardium, the disease process has now penetrated past the Wei and Qi levels (the initial immune response levels) into what is called the Ying or Nutritive level: this is a deeper Yin level. Here the disease attacks how your body nourishes itself, and with this Heat in the Pericardium it begins to get closer to your Heart. Consequently there are symptoms showing that the Mind is affected, but also, being at such a deep level, yin issues are involved.

(Confused by yin and yang? In theory this takes 5 minutes to understand … for some people … but it may take you longer than that to read our introductory page on it!)

Main symptoms for Ying Level Heat in the Pericardium

Fever, especially at night, the yin time of day, making restful sleep much more difficult.
Insomnia
The mind is affected, leading to forgetfulness, problems speaking and understanding, confusion and incoherence.
Irritability
Delirium
Restless
Heat, the body feels hot, from attack in the centre, but the extremities feel cold as there’s no spare qi to circulate Blood that far out
Despite Heat, there is usually no thirst (thirst occurs at the Qi level, much less so at this Ying level)
Rashes are macular
Tongue is red, dry and bare – no coating
Pulse is thin and rapid

What this means – its pathology

Night-time should be a quieter time, appropriate for rest. But with the disease getting closer to the essential centre energies, yin is disrupted, and so is sleep.

The centre means the Heart, and the area round it, which govern the Mind, the Shen . With Heat in the Pericardium the Heart – hence the Mind – is unsettled and incoherent, leading to delirium.

Heat should circulate but here it’s trapped in the centre, causing damage and, unable to reach the extremities, you get cold hands and feet.

The tongue’s body lacks a coating, a sign of extreme yin deficiency, and its redness displays Heat.

This can seem like a strong set of symptoms, an excess, but it’s not. Instead, it comes from weakness in the face of adversity. This is confirmed by the pulse, which is not full or overflowing but thin and fast.

Aims of treatment for Ying level Heat in the Pericardium

Treatment aims to

clear Heat from this Ying level and the Pericardium: then to
steady and reestablish consciousness and
promote the formation of fluids and their circulation

Of course, these are interconnected, because the consciousness is disarranged because of the Heat in the pericardium.

Likewise, fluids (ie yin), if healthy and circulating properly automatically cool the Heat (yang). This is just like an internal combustion engine where, even if the car is driven through hot desert, enough coolant working as designed keeps the engine performing smoothly and not over-heating.

But if the coolant runs dry, the engine will over-heat and seize up, and the driverwill panic!

Acupuncture treatment for Ying level Pericardium Heat

Points on the Pericardium level for clearing or regulating heat include P 9, P8, P3. Because the Mind is often affected here, points on the Heart channel would also be used such as H9; also general points for Heat, such as L.I.11 and perhaps Sp 10 (to cool Blood). Points at the very tips of the fingers also help clear the excess nature of the condition (shixuan points). Other points might include Du14. To nourish Yin, think of K3, K6, K10.

Herbal treatment for Ying level Pericardium Heat

Qing ying tang is appropriate here. Note: in the original, classic formulation, this includes rhinoceros horn for which we would now substitute other ‘herbs’: perhaps bai wei or bai xian pi.

What can YOU do to assist treatment?

As the patient’s disease-process proceeds deeper, what the average helper can do grows more limited. However, warming hands and feet may help Blood flow, and encouraging the patient to drink increases yin resources.

Avoid what are called hot foods and choose from cold foods. (The patient’s digestion will work better if both fluids and food are eaten lukewarm.)

For someone hovering around delirium, company often helps.

What happens if you suppress symptoms of this level?

Well, firstly, this is a serious state of affairs and in some cases it precedes death. So preventing further deterioration is of utmost importance!

However, unless you can clear the Heat, it will go somewhere else, probably deeper and therefore to one of the syndromes at the Blood level such as ‘Heat Victorious agitating the Blood‘. That’s even more serious.

Usually, western medicine would look for the causes of internal inflammation and might prescribe drugs to calm and quell it: steroids, and probably antibiotics. It’s a case of yang at the centre or yin, disrupting energy flow. Drugs to ‘calm’ the mind might calm delirious outbursts but I doubt they would restore proper consciousness.

Such medicine might preserve life but at a low level of existence: void of spirit and very little energy.