Lily+Disease+(Bai+He+Bing)

In this disease the patient feels like eating but is unable to eat. They feel like lying down i.e., sleeping but cannot lie down. Hey feel like moving but cannot move. Their affect is restless, but they also tend to be taciturn and speak little. They may feel cold without being cold (i.e. chills), or they may feel hot without there being heat (i.e. fever). In addition there may be a bitter taste in the mouth, reddish urine and a faint, rapid pulse. As Zhang Zhong-jing says, it is as if the person were possessed even though their body is harmonious and normal
 * Lily Disease (Bai He Bing) **

Relevant Western Diseases: Psychoneurosis, anxiety disorder, phobia and obsessive and compulsive disorder, affective disorder, schizophrenia and pre-menopausal syndrome, chronic fatigue syndrome

Differential Diagnosis: Medical Disorders: Psychiatric Disorders: A. Somatoform Disorders B. Hypochondriasis C. Histrionic Personality Disorder D. Major depressive episode w/ somatization E. Psychotic disorders, including schizophrenia F. Generalized Anxiety Disorder (GAD) G. Factitious Disorder H. Malingering
 * 1) Early or mild forms of Parkinson’s Disease
 * 2) Early or mild forms of Parkinsonism
 * 3) Early or mild forms of Multiple Sclerosis
 * 4) Early or mild forms of other degenerative neurologic disorders

TCM Etiology & Pathogenesis: “Due to depression and binding of the seven affects or after great illness, there is a lack of nourishment of the heart spirit which thus becomes disquieted. Such malnourishment of the heart spirit may be due to various types of Yin vacuity and may be aggravated by liver depression, phlegm, and/or heat, the latter two of which may ascend and also harass the spirit, hence disquieting it all the more”1

“Generally heat, fire, dryness evil Qi, and chronic emotional disharmony or Zhang Fu disharmony are the commo etiological factors”2

Prognosis: This disease can be resolved after a short time of treatment, it can be made worse by incorrect or delayed treatment. Also it can be found in some severe Shen problem situations.

Diagnosis: Should have A, then refer others
 * 1) Irritable, depressed, fatigue and moody
 * 2) Dislikes talking, excess thinking and worry.
 * 3) Appetite, sleep and behavior are sometimes disturbed
 * 4) Feeling hot or cold alternately

TCM Pattern Differentiation: Yin Deficiency and Heat Burning Within Causing Shen Irritability 2 Irritable, depression, anxiety, moody all the time, dislikes talking and social interaction, low or no appetite, insomnia, excess thinking, worry, timidity and lassitude, indecisive and hesitant, low motivation, slight bitter taste in the mouth, yellowish colored urine, dry mouth [Bai He, Sheng Di Huang] Thirsty: + Shi Hu, Lu Gen, Tian ua Fen Fever: + Shi Gao, Zhi Mu Nausea: + Dai Zhe Shi, Zhu Ru Phlegm: + Dong Gua Ren, Tian Zhu Huang, Bei Mu Palpitations: + Fu Xiao Mai, Da Zao Night Sweats: + Huang Bai, Mu Li Heart-Lung Vacuity with Internal Heat 1 Desire but inability to eat, desire to lie down but inability to lie down, desire to move but inability to move, restless affect at the same time as taciturnity and speaking little, possible cold feeling without being cold (i.e. chills), or a possible hot feeling without there being heat (i.e. fever). In addition may be a bitter taste in the mouth, reddish urine [Bai He (15-60g.), Zhi Mu (10g.), Sheng Di (15g.), Gan Cao (6g.), Huai Xiao Mai (15-30g.), Da Zao (5 pieces)] Marked oral dryness: + Tian Hua Fen, Sha Shen Marked heat signs: + Hua Shi, Mu Li, Long Gu
 * Tongue:** reddish tongue, little or no coat
 * Pulse:** thready, rapid
 * Acupuncture Treatment:** HT-7, SP-6, KI-3, KI-6, BL-15, BL-23, BL-43, Yintang
 * Herbal Treatment:** Bai He Di Huang Tang Modification2
 * Modifications:**
 * Tongue:**
 * Pulse:** faint, rapid
 * Treatment Principles:** Enrich Yin and clear heat, quiet the spirit and stabilize the mind
 * Acupuncture Treatment:** BL-13, BL-15, HT-7, PC-6, KI-3, SP-6. Even technique for first four, Tonifying technique for last two
 * Herbal Treatment:** Bai He Da Zao Tang Jia Wei1
 * Modifications:**

Phlegm Heat Harassing Above 1 Essence spirit abstraction and restlessness, deranged speech, laughing and crying without constancy, desire but inability to eat, desire to move but inability to move, headache and distention, emotional rashness and impetuosity, chest and rib-side fullness and oppression, vexation and agitation, restless sleep, scanty sleep and easily being awakened, profuse dreams, easy fright, red facial complexion [Bai He (15-60g.), Zhi Mu (10g.), Sheng Di (15g.), Gua Lou (10g.), Xing Ren (10g.), Zhi Shi (6g.), Chen Pi (10g.), Ban Xia (10g.), Fu Ling (12g.), Dan Nan Xing (10g.), Huang Qin (10g.), Gan Cao (6g.)]
 * Tongue:** red tip, thin yellow slightly slimy coat
 * Pulse:** slippery, rapid
 * Treatment Principles:** Clear heat and eliminate phlegm, nourish Yin and quiet the spirit
 * Acupuncture Treatment:** Even technique: BL-15, HT-7, CV-17, CV-12, Drain: PC-7, ST-40, Tonify: SP-6.
 * Herbal Treatment:** Bai He Hua Tan Tang1

Liver Depression-Yin Vacuity 1 Slightly red facial expression, quick bright eyes, desire to move but inability to move, great sighing, irritation and vexation, chest and rib-side fullness and oppression, possible acid regurgitation, insomnia, profuse dreams [Bai He (15-60g.), Sheng Di (12g.), Zhi Mu (10g.), Qing Pi (6g.), Chen Pi (6g.), Zhi Shi (6g.), Wa Leng Zi (15g.), Mu Xiang (9g.)]
 * Tongue:** red tongue, slightly yellow coat
 * Pulse:** slightly bowstring, fine, rapid
 * Treatment Principles:** Enrich Yin and resolve depression, soothe the liver and harmonize the stomach
 * Acupuncture Treatment:** Tonify: BL-15, HT-7, KI-3, SP-6, Drain: GV-20, Yintang, LR-14, CV-12
 * Herbal Treatment:** Bai He Li Yu Tang1

Spleen Depression-Lung Damage 1 Flushed red facial complexion, excessive thinking and worrying, fatigued limbs, aversion to stir, faint voice, quiet withdrawn affect, possibly melancholy, desire to eat but inability to eat, emission of coolness from the four limbs, numbness and tingling, paranoia, clouded head, torpid spirit, difficulty falling asleep at night, bitter taste in mouth, reddish urination [Bai He (15-60g.), Sheng Di (12g.), Zhi Mu (10g.), Gui Zhi (6g.), Cang Zhu (10g.), Chuan Lian Zi (10g.), Sha Ren (4.5g.), Dai Zhe Shi (12g.)]
 * Tongue:** red tongue
 * Pulse:** deep, fine
 * Treatment Principles:** Enrich Yin and supplement the lungs, fortify the spleen and resolve depression
 * Acupuncture Treatment:** Tonify: BL-15, BL-13, HT-7, ST-36, SP-6, Drain: LR-3, GV-20, Yintang
 * Herbal Treatment:** Bai He Li Pi Tang1

Loss of Regulation Between Yin and Yang 1 A sometimes red, sometimes white facial complexion, difficulty sleeping, profuse dreams, a desire to speak but inability to speak, a desire to stop speaking but inability to stop speaking, desire to lie down but inability to lie down, desire to sleep but inability to sleep, brooding and unhappiness, taciturnity, occasional heart vexation, occasional stretching and yawning, alternating sorrow and joy, seeming as if possessed [Bai He (15-60g.), Sheng Di (12g.), Zhi Mu (10g.), Rou Gui (10g.), Fu Zi (10g.), Long Gu (12g.), Mu Li (12g.)]
 * Tongue:** red tongue
 * Pulse:** fine, rapid, forceless
 * Treatment Principles:** Regulate an put in good order Yin and Yang
 * Acupuncture Treatment:** Tonify: BL-15, BL-23, GV-4, CV-4, SP-6, HT-7; Drain: GV-20, Yintang; add moxa: BL-23, GV-4
 * Herbal Treatment:** Bai He Gui Fu Long Mu Tang1

Lung-Kidney Yin Vacuity 1 Both cheeks slightly red, fatigue, lack of strength, tendency to sorrow and a desire to cry, occasionally appearing to shrink in fear, paranoia, vexatious 5-palm heat, steaming bones, tidal heat, easy fright, possible seminal emission and/or urinary incontinence, premature ejaculation, reddish urine [Bai He (15-60g.), Zhi Mu (10g.), Sheng Di (15g.), Di Gu Pi (10g.), He Shou Wu (10g.), Bie Jia (15g.)]
 * Tongue:** slightly red tongue
 * Pulse:** fine, rapid
 * Treatment Principles:** Enrich and supplement the ungs and kidneys, quiet the corporeal soul and stabilize the mind
 * Acupuncture Treatment:** Tonify: BL-13, BL-15, BL-23, KI-3, SP-6; Drain: GV-20, Yintang; bleed: GV-14
 * Herbal Treatment:** Bai He Ding Zhi Tang1

Non-Interaction Between the Heart and Kidney 1 Flushed red facial complexion, vexation and agitation, desire to sleep but inability to sleep, tossing and turning in bed restlessly, laughing and crying with no constancy, tendency to stretch, lots of yawning, difficulty falling asleep, nightmares, confused, disorderly dreams, counterflow chilling of the extremities, garrulousness, reddish urination [Bai He (15-60g.), Zhi Mu (10g.), Sheng Di (15g.), Huang Lian (3-6g.), Rou Gui (10g.), Long Gu (12g.), Mu Li (12g.), E Jiao (10g.)]
 * Tongue:** red tongue
 * Pulse:** fine, rapid
 * Treatment Principles:** Nourish the heart and enrich the kidneys, join and free the flow between the heart and kidneys
 * Acupuncture Treatment:** Tonify: BL-15, BL-23, GV-4, CV-4, SP-6, HT-7; Drain: GV-20, Yintang; add moxa to: BL-23, GV-4
 * Herbal Treatment:** Bai He Zi Shen Tang1