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d. Zheng Xi - Syndrome Analysis, Symptoms Explanation

The original condition of Cystic Fibrosis is thought to be an inherited disorder of the exocrine glands, causing these glands to produce abnormally thick secretions of mucus and an increase of organic and enzymatic constituents of saliva, with accompanying overactivity of the auto immune system. Thickened secretions cause obstruction of airways, which lead to distal infections, which become chronic unless the obstruction is relieved. The glands most affected are those in the pancreas, respiratory system and the sweat glands. The earliest manifestation is meconium ileus, an obstruction of the small bowel. Thrust of western treatment is to manage the condition. There is no known cure and treatment is directed at prevention of respiratory infection, which is most frequently the cause of death.

In T.C.M. terms we see involvement from contributing factors. It is plausible the further diagnosis of Diabetes, Bronchiectasis, deep vein thrombosis and bowel obstruction stem from the continuing effects of his bodies battle with Cystic Fibrosis. It may be assumed the original pathology is caused by phlegm turbidity and water rheum (Tan Zhou Shui Yin), reacting to each other within the fluid mechanisms associated with the lungs and the Spleen. In this situation when the fluids (Jin Ye) are not functioning properly creates pernicious accumulation of phlegm and water (Tan Yin Xie Qi).

We understand the body to be holistic in nature with each organ system being related and interdependent. Therefore the chronic presence of pathogenic Tan Yin Xie Qi since birth has caused affect to her natural growth apart from the obvious assault upon the systems directly related to the spleen and lungs and is probably responsible for breakdown in the other three organ systems namely;

• Kidney Spleen depletion - Diabetes,

• Lung Heart - fear, difficult sleep, poor peripheral circulation i.e. deep vein leg thrombosis,

• Liver - emotional fluctuations (depression).

Thus we find effects within all of the five Yin organs (Wu Zang). The presenting clinical pathology will manifest numerous symptoms whenever his normal Qi (Zheng Qi - overall vitality) is depleted/overwhelmed by any prevailing pernicious influence (Xie Qi) in time, seasons, or place. I.E. social, seasonal or professional stresses, diet - which explains the broad range of symptoms he may present with and now exhibits. This explains the generally Xian pulse.

The patients Hua pulse; sticky wet white tongue coat, copious amounts of expectorated phlegm, constant cough and no energy indicates the centre warmer (Liver Spleen and Stomach) initially presents as centre warmer replete (Zhong Jiao Shi) and changes to Centre Qi insufficiency (Zhong Qi Bu Zu) thus the transportation and transformation (Yun Hua) function of the spleen Qi does not operate normally. This explains why his body easily develops collected water (Ting Shui) progressing to generating damp (Shi), damp gathering thickens becoming phlegm damp (Tan Shi), causing phlegm congestion and Qi stagnation, this is the source of the impaired depurative down bearing of the lung, hence explaining the cough (Ke Sou).

The spleen transformation and transportation (Yun Hua) function is inhibited by phlegm damp (Tan Shi). This means the upward movement of spleen Qi to lung is also inhibited, the character of the rising Qi is pervaded by a pernicious phlegm (Tan Yin) resulting in cough (Ke Sou), Bronchial constriction and blocking the function of lung Qi dissemination. And as the situation is prolonged and chronic, leads to weakening lung function (Fei Xu), as indicated by the blue sclera of the eyes and the Xu pulse on the lung position. Lung deficiency (Fei Xu) will affect the ability of the kidney to grasp the lung Qi (Na Qi function), eventually also weakening the Kidneys. This explains the Asthma type breathing (Xiao) and fatigue symptoms. These symptoms occur in people harbouring a lot of internal phlegm (Nei Tan) in the body and in the lungs or Bronchi, altogether explaining why he is short of breath, has a feeling of oppression of the chest and needs to cough up a lot of phlegm in order to relieve these symptoms.

The struggle between the bodies overall vitality, normal Qi (Zheng Qi) and chronic phlegm rheum (Fu Tan Yin) sluggish in the lungs causes heat to build up in the lungs and further thickens the phlegm thus explaining the ever-present thick yellow phlegm (chronic infection of the lungs) which can move to become clumped and further baked (Huo Tan), thus explaining the green phlegm. During times when his overall vitality is low (Zheng Qi Xu), and accompanied by an attack from an external or internal pathogens (Wai or Nei Xie Qi i.e. Wai Gan Feng Han or Re), seasonal factors, or when he does not eat properly or suffers emotional stresses or overworks, all exacerbates the chronic condition leading to Pneumonia, Bronchiectasis, bowel obstruction etc. and at these times causes him grievous concern for his own life. It is noted his yearly hospital visits fall either at the time of winter changing to spring or autumn changing to winter.

Note, to protect him in Sept. Oct. do not allow heat to build up in the centre Warmer (Zhong Jiao) i.e. reduce (Xie), the stomach and Bladder meridians.

To protect him in May and June, avoid dryness/heat gathering within the upper warmer (Shang Jiao) reduce (Xie), Per. and large intestine meridians.

The transformation and transportation (Pi Yun Hua) function does not only describe the upward movement of Qi to the lungs, but also the corresponding down bearing of the stomach Qi. The downward movement of turbid Qi, including substances, (Zhou Qi) through the stomach and intestines will also be poor, thus contributing to the build up of disharmony within both. The continuing struggle with the bodies normal Qi (Zheng Qi) causes fluctuation between diarrhoea and constipation, he also says bowel regulation is worse whenever he is on the stronger medications.

The three-left side Chen - deep, pulses indicate that the Yang Qi is hindered from spreading outward. The integrity of skeletal structure is likely to be the cause.

e. Zhi Ze - Treatment Principle

Down bear counter flow and transform the damp (Jiang Yi Hua Shi)

Diffuse the lung, stop the cough and calm the dyspnea (Xuan Fei Zhi Ke Ping Chuan, dyspnea).

Fortify the spleen, transform the phlegm and calm the dyspnea (Jian Pi Hua Tan Ping Chuan, dyspnea).

Clear heat, diffuse the lung and stop the cough (Qing Re Xuan Fei Zhi Ke).

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