Ying level Heat in the Ying or Nutritive level

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With Heat in your Ying or Nutritive level, the disease process has penetrated past the Wei and Qi levels (the initial and secondary immune response levels) into what is called this Nutritive level.


Main symptoms of Heat in the Ying or Nutritive level

  • Night fever, or fever mainly at night
  • Dry mouth, but no desire to drink
  • Insomnia
  • Delirium
  • Mental restlessness
  • Speech inarticulate or aphasia (a bit like someone’s inability to speak coherently after a stroke)
  • Macular rash
  • Tongue: red, without coating
  • Pulse: fast and thin


What is the pathology behind heat in the ying or nutritive level?

Taken on their own, you might not think these symptoms of Heat in the Nutritive level were serious. But as a development from the wei and qi levels, as a hot disease penetrates, they point to a weakened immune system backed into a corner with few ways out.

With its nutritive level under attack your body’s ability to feed itself, to nourish itself, is under attack. What should be restful, yin-type, activities are disturbed.

  • Sleep at night is difficult because of fever.
  • Your body needs fluids but can’t accept them.
  • Your mind is restless as it cannot settle, nor can it say what it needs.
  • The macular rash means blood escapes under the skin and can’t be cleared up.


A red tongue points to Heat: its lack of coating shows the Stomach has lost the fluids it needs to digest food and to protect itself, so it cannot absorb nutrition.

Your pulse lacks force (thin or fine) and its speed again points to Heat.

So here, the yin qualities of the body have been hurt by the Heat. (That means a yang force, the Heat, has overcome your yin resources, your fluids and ability to manufacture more fluids.)

Aims of treatment

  • Clear Heat
  • Re-establish the body’s ability to moisten and nourish itself

Acupuncture for heat in ying or nutritive level

Points to clear this kind of heat are at the distal ends of the most affected acupuncture channels, for example those of the Pericardium and Heart. They might be bled: sore but often very effective.

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

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.



Bag of Chinese herbs

What can YOU do to assist treatment?

As the patient’s disease-process proceeds deeper, what the average helper can do grows more limited.

  • 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?

Remember, that your symptoms show your body’s best attempt at dealing with the invasive force.

If you are able to suppress them, you’ll get its next best attempt. Read more under suppression.

That tends to be at a deeper level, associated with less energy overall.

It might reduce the night fever, but probably there would be no improvement in how refreshed the patient was by sleep.

The mind would probably become even less coherent.

The pulse would probably remain fine, but less fast, showing less energy overall.

Most likely, suppression here would hasten descending the invading Heat down to the next level, the Blood level, a still more serious situation…


Refresh your memory of the four levels:


If the invading pathogen overcomes defences at this Ying or Nutritive level it proceeds to the deepest level, your Blood level:

… where it leads to one of the following:


How did your disease process get here?

It probably came from the Qi level where it overcame one of the following defences:


Another response at this ying level:

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