Ying level

Syndrome of heat at the Ying level (the Nutritive level)... 

If the pathogenic heat is not eliminated at the Wei or Qi levels, it further invades the deeper level of the body, the Ying level, where the Nutritive substances of the body, such as the Yin, the blood and the essence are involved. In some severe cases, the pathogenic heat invades the Ying level directly, bypassing the first two levels. 

Dryness in the mouth but with no desire to drink is another sign of heat at the Ying level as the body starts to consume the Yin instead of trying to obtain fluid by drinking. 

Sheng Di Huang is sweet and cold. It primarily enters the Heart, Stomach and Kidney meridians. It can effectively clear heat, cool the blood and nourish the Yin. It matches the syndrome perfectly and is often used as chief in formulas that clear the heat at the Ying level. 

Dan Shen is cold and pungent, and enters the Heart meridian directly. It can cool the blood and reduce the heat in the blood. Its pungent nature disperses and dissolves the congealed blood and promotes blood circulation. It can also disperse constrained Qi in the chest. It is commonly used in combination with other chief herbs to reduce the heat at the Ying level and is a very effective herb to calm the mind and treat restlessness, irritability and a warm sensation in the chest caused by heat in the blood. 

Mai Men Dong is sweet and cold and Xuan Shen is salty and cold. These two herbs can nourish the Yin and clear the heat. They enhance the ability of the chief ingredients to clear the heat at the Ying level. 

These two herbs are cold in nature and can strongly clear the heat at the Qi level. In addition, they can disperse the constrained heat and Qi, thus clearing the heat effectively. In the formula to treat heat at the Ying level they are often used as assistants to vent heat from the Ying level to the Qi level, as their aromatic smell can disperse the heat and vent the heat, eventually eliminating it from the body. 

This formula is devised to clear heat at the Ying level, nourish the Yin and cool the blood. The manifestations are fever that is higher in the night, irritability, restlessness and thirst with no desire to drink. In severe cases, delirium, vague erythema and purpura may appear. Patients may have a red tongue without coating or with a dry, thin coating and a rapid, forceful or thready pulse. 

Five herbs serve as assistants. Dan Shen cools the blood and disperses the blood stagnation, which are the common accompanying pathological changes when there is heat at the Yin level. Dan Zhu Ye and Huang Lian can clear heat and calm the mind. Jin Yin Hua and Lian Qiao can vent the heat to the Qi level as they are aromatic herbs. They clear heat that has been vented from the Ying level in order to eliminate the heat from... 

Herbs that clear heat in the Ying level and herbs that vent heat to the Qi level are used together. 

When heat is at the Ying level, the main organs involved are the Heart and the Liver. In this formula, treatment is concentrated on cooling the Liver and calming the wind. 

These substances have already been discussed in Section 3, Syndrome of heat at the Ying level. They are also used when the heat is at the Xue level under the same principle. As the condition is more severe, the dosages of these ingredients should be larger and they should be applied promptly without hesitation. 

Dan Zhu Ye and Lian Qiao are assistants. They can clear the heat from the Qi level, and therefore can vent the heat from the Ying level to the Qi level. 

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