There are days where it seems times flows too quickly or to slowly. Some days feel as thought here are not enough hours, while other days seem to have too many. Humans and animals both have internal clocks, and likely you’ve heard the phase ‘biological clock’ which refers to the circadian rhythm of the body which informs the inner body to do specific tasks at certain times of the day.

Qi is constantly and endlessly flowing through the 12 main channels. It is present in each channel in its greatest amount for two hours each day.  So, according to the Nei Jing Su Wen, it completes its cycle through all 12 channels every 24 hours.  This is also known as the Ying Qi cycle. The Qi flows throughout the day, growing in amount in each channel in a specific order, following this circadian rhythm colloquially called the biological clock. Different symptoms in a patient occurring at a specific time can be used to assist with a TCVM diagnosis, such as waking each night restless between 1 am and 3 am which is the time of the Liver.

The flow of the Qi energy dominates each channel for two hours. It goes from wife to husband, husband to wife, starting at the Lung Channel at 3 am. From there it goes from the wife Lung (thoracic Yin) to the husband Large Intestine (thoracic Yang) before continuing to husband Stomach (pelvic Yang) to wife Spleen (pelvic Yin). This pattern continues throughout the day, and repeats every 24 hours.

Thypothetical Case 1

Species: Equine
Breed: Thoroughbred
Age: 5 years
Gender: Mare

Clinical Diagnosis (conventional): Recurrent Airway Disease

Conventional Indications:

This patient developed a chronic cough.  Initially, the cough was seasonal and worse in the Summer.  Recently, the cough is present from Spring until mid-winter. Additionally, the mare demonstrates some degree of exercise intolerance. There is minimal nasal discharge but it is sticky. Even at rest there is an increase in her respiratory rate. She now demonstrates a “Heave” line. The owner has been treating her by managing her environment to reduce molds, wetting her hair and has been managing her condition by utilizing oral prednisolone.

Traditional  Indications:

The patient demonstrates a chronic cough which is worse at night. The cough is dry. The mare has a good appetite. She still has trouble maintaining her weight.  Her stools occasionally can be somewhat dry. Her hair coat is slightly dull.  Her nares flare even at rest with inhalation. Her ears are 3 finger warm.  She demonstrates a “Heave line” along her ventral edge of her ribs.

Tongue: Pale-red and dry.

Pulse: Rapid, thready, weaker on the left.

TCVM Diagnosis: 

Lung Qi and Yin Deficiency

TCVM Assessment:

• Chronic cough- Most likely Deficiency
• Cough worse at night-Yin Deficiency
• Trouble maintaining weight-Qi Deficiency
• Dry stools- Yin or Blood Deficiency
• Dry hair coat-Yin Deficiency
• Warm ears-Heat
• Rapid pulse-Heat
• Thready pulse-Yin or Blood Deficiency
• Tongue: Pale, red, dry-Pale-Qi Deficiency, red indicates Heat, Dry suggests Yin or Blood Deficiency

Treatment Principles:

• Nourish Yin
• Tonify Qi
• Stop cough
• Resolve Phlegm

Acupoint Prescription:

LU-8, LU-9, SP-6, SP-9, BL-13, KID-3, CV-22, Ding-chuan

• LU-8- Jing-river, metal point for sore throat
• LU-9-Yuan source point. Nourishes Yin and Qi
• SP-6-tonifies Qi and Blood
• KID-3-Yuan source point for the Kidney, tonifies Qi and Yin. Can help with sore throat and strengthen inhalation.
• CV-22-used to stop cough
• Ding-chuan-used to stop cough

Chinese Herbal Prescription:

• Bu Fei San + Bai He Gu Jing Tang (Lily Formula)
• Use these formulas together
• Bu Fei San tonifies Lung Qi, dose 15g orally twice daily.
• Bai He Gu Jing Tang (Lily Formula) tonifies Yin and transforms Phlegm, dose 15 g orally twice daily.

Thypothetical Case 2

Species: Canine
Breed: Blue Heeler
Age: 6 years
Gender: N

Clinical Diagnosis (conventional): Behvavioral Issue-Insomnia/Restlessness

Conventional Indications:

The patient was recently rescued through a local shelter.  Shortly after coming into the home the owners noted that the pet would awaken every night at 1am, restless.  Offering water and allowing the pet to go outside to urinate and defecate did not alleviate the restlessness. It was also noted that the pet would occasionally vomit a small amount of billous fluid in the early am before breakfast.  While always happy to see the owners, he was beginning to behave in a more aggressive manner with visitors.

Traditional  Indications:

Bright, alert and responsive. The pet was in good flesh (BCS 5/9).  There was slight discomfort on palpation of the abdomen in the flank region. Stools were formed but had a very strong smell.  The patient also had a sour odor to his breath.

Tongue: Red, especially along the edges.

Pulse: Wiry and slightly fast.

TCVM Diagnosis: 

Liver Qi Stagnation

TCVM Assessment:

• Waking at 1am-this is the hour of the Liver
• Restlessness-Liver/Gallbladder Stagnation
• Vomiting bilous fluid-Liver overcontrolling Stomach
• Strong smell to stool-Heat
• Sour smell to breath-Liver Qi Stagnation
• Red tongue, especially along the edges-Liver Qi Stagnation
• Wiry pulse-Liver Qi Stagnation
• Fast pulse-Heat (from Stagnation)

Treatment Principles:

• Resolve Stagnation
• Help Stomach Qi descend
• Calm the Mind

Acupoint Prescription:

GV-20, BL-14, BL-18, BL-19, BL-21, PC-6, LIV-3, GB-34, An-shen *

*aquapuncture with vitamin B-12 3ml bilaterally

• GV-20-Calm the Mind
• BL-14-Back shu point for the Pericardium
• BL-18-Back shu point for the Liver
• BL-19-Back shu point for the Gallbladder
• BL-21-Back shu point for the Stomach
• PC-6-Master point for the cranial abdomen, calms the Mind, helps Stomach Qi descend
• LIV-3-Shu-stream point for the Liver, smooths the flow of Liver Qi, resolves Stagnation
• GB-34-Earth point on the GB channel, moves Liver Qi, helps Stomach Qi descend
• An-shen-Calms the Mind

Chinese Herbal Prescription:

• Shen Calmer concentrated (Jing Tang Herbal)
• Classical antecedent Tian Wan Bu Xin Wan
• Nourish Heart Yin, calm the Shen, soothe Liver Qi.
• Dose: 0.5g/20 lbs. by mouth twice daily.

Edited by Greg Todd, DVM, CVA. Hypotherical Case by Greg Todd, DVM, CVA