Introduction
Inflammation and infection are two terms that are sometimes mistaken for each other. To distinguish them in Western Medicine, inflammation is part of the complex biological response of vascular tissues to harmful stimuli. Infection, on the other hand, is the invasion by and multiplication of microorganisms within the body. Another way to view this is that infection is the invasion of exogenous pathogens in an organism, whereas inflammation is the response of the organism to the pathogens.
In TCM, however, both inflammation and infection, regardless of the etiology (bacterial, viral, fungal, etc.), are considered as being “Fire.” The causative factors of “Fire” can be grouped into three categories:
- External factors
- Internal factors
- Factors that are neither internal nor external
External factors include the different external pathogenic factors: wind, cold, summer-heat, dampness, dryness, and fire. Internal factors include the 7 emotions. Factors that are neither internal nor external may include traumas and injuries, such as dog bites. All of these pathogenic factors can result in hot conditions, or “fire,” which can be further divided into inflammation and infection.
Inflammation
Inflammation translates to solid heat in patients. Solid heat refers to symptoms manifested when the patient experiences a very strong reaction to infection. Solid heat is also known as excess fire, and its etiological factors can be either biological, such as micro-organisms and animal bites, or non-biological, such as trauma, physical injuries, and chemical exposures, etc. Solid heat can be acute or chronic. The acute form of solid heat may include purulent inflammations. Tissue damage, vascular change, and tissue proliferation may also be seen with many cases of solid heat, as well as abscesses, cellulitis, and ulcers.
The pulse for solid heat is forceful and strong on all levels, and with such a pulse, the patient should not be tonified. It is always prudent to take the pulse before determining the method of treatment, because patients may at times manifest only signs and symptoms of solid heat, but they may have an underlying mixed condition, such as a combination of solid fire mixed with damp heat, or solid fire in the upper jiao and cold in the lower jiao.
Infection
Infection can manifest as deficient fire, yin deficiency, yang deficiency, or damp-heat. When the source of infection is bacterial or viral, the manifesting diagnosis is usually deficient fire, yin deficiency, or yang deficiency. When the source of infection is fungal, it usually manifests as damp-heat.
Infection that manifests with deficiency is caused by invasion of pathogenic micro-organisms in the body—bacterial infections (leading to furuncles, carbuncles, food poisoning, etc.), and viral infections (influenza, herpes simplex, shingles, etc.). In these cases, yin deficiency usually presents with more severe symptoms than yang deficiency.
Herbal pastes or pills should be used when treating long-term deficient conditions. In cases of yin deficiency, the blood pressure is low and the heart rate is fast. When examining the pulse, the yin deficient pulse will be thin, floating, and weak, and will disappear upon pressure. The right guan position, also known as the Spleen position, is the origin of energy, the earth; whereas, the left guan, the Liver position, is the assistant. If both the right and left guan are weak and empty, the body is truly deficient, and may indicate an autoimmune disorder. In this case, the patient should tonify the body through nutritional adjustments. In cases of yang deficiency, the pulse will be weak, but will have a jump at a slightly deeper level than a yin deficiency pulse. The blood pressure in yang deficient cases should be low, and the heart rate slow.
Infections that manifest as damp-heat usually are fungal in origin, including tinea, candidiasis, fungus, and yeast infections. The pulse in a patient manifesting with damp-heat is usually deep, scattered, and forceful upon pressure. Besides fungal infections, three other possibilities may also cause this type of pulse.
- Phlegm in the respiratory system
- Injuries: dead blood from previous traumatic injuries, or drinking very cold water immediately after exercising
- Polyps in the large intestine
If this type of pulse appears in the left chi position, it may translate to uterine polyps.
Detailed pulse diagnosis and herbal treatment for the various etiologies of inflammation and infection will be covered in part II of this article.
About the Author
Master Jimmy Wei-Yen Chang is a Doctor of Oriental Medicine trained in Taiwan and a licensed acupuncturist in California and New York. He has over 30 years of concentrated clinical experience, applying his expertise in differential diagnosis and herbal prescription. Master Chang is the author of the pulse diagnosis manual, Pulsynergy, and he currently pursues his specialties in private practice in Hacienda Heights, California. He is widely recognized for his skills in correlating definitive pulse diagnoses with herbal prescription.
To learn more about pulse diagnosis and herbs, click here [2] to view a complete list of courses by Jimmy Chang.