Ying level Heat in the Ying or Nutritive level

Jonathan Clogstoun-Willmott

April 17, 2023

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.

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.