Welcome to Acu in Practice! This week we continue our “refresher” on the 6 Stages Model of Traditional Chinese Medicine. This diagnosis and treatment model can be especially useful for infectious and chronic inflammatory disease. In short, the model theorizes that disease begins on the most external level of the body where the immune system (Wei Qi) combats it and either wins by expelling the pathogen or allows the pathogen deeper into the next levels. The deeper the pathogen or disease is allowed to go, the more difficult it is to diagnose and treat. We are now refreshing on the 4th Stage, which is the first of the Yin Levels. The Yin layers of the body are associated with deeper or organ level disease.

The Tai Yin level is the outermost of the Yin levels and is associated with the Spleen and the Lung. The most common pattern associated with disease at this level is Spleen Yang deficiency, often occurring due to unresolved Wind-Cold-Damp penetrating through all 3 of the Yang layer. Tai Yin disease may also occur from a constitutional predisposition to Spleen deficiency. The common symptoms seen are spontaneous diarrhea with little to no thirst increase, but with abdominal pain, reduced appetite and inability to keep food and water down. The pulses will be deficient. Clinical examples include chronic gastritis, gastric ulcers (especially equine), chronic diarrhea, IBD, fading kitten and puppy syndromes, and hypoadrenocorticism.

Acupuncture points and herbal formulas will vary based on the individual patient and signs, but some examples include:

Acu Points:
BL 20 – nourish the Spleen
SP 6 – nourishes Spleen, enhance transportation and transformation, nourishes Qi and Blood, removes Damp.
BL 21` – harmonizes the Stomach and middle jiao
ST 36 – removes Damp, strengthens the middle Jiao, nourishes Qi and Blood
CV 12 – moves Qi in the Middle Jiao, treats abdominal pain
*If Cold signs are apparent, consider moxa on these points.

Herbal Formulas:
The classical formula recommended is Li Zhong Tang (Center Rectifying Decoction) to warm the middle jiao, dispel cold, tonify Qi and Strengthen Spleen and Stomach.
Modifications/additions can be made to include the following:
For abdominal pain, in a pattern that began as Tai Yang and was deepened with the use of moistening herbs – Cinnamon Twig Decoction plus Peony.
With extreme excess abdominal pain – Cinnamon Twig Decoction plus Rhubarb.

This post was created by Nell Ostermeier, DVM, CVA (IVAS) and is intended for informational use, not to replace medical advice. You can learn more about the author and additional cases at: www.peopleandpet.com

A special thanks and reference to: THE SIX STAGE: A WAY TO UNDERSTAND TODAY’S CHRONIC DISEASES Cynthia J. Lankenau, DVM, RH (AHG), CVA, GDVCHM, ACCHVM presented at IVAS Congress 2018.