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  • Writer's pictureRichard Lai

#69: Treating Damp Heat in the Large Intestine | Key Acupuncture Points Explained

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So in this episode we go over Damp Heat in the Large Intestine !

Damp heat in the large intestine is viewed through the lens of the Eight Principles in Traditional Chinese Medicine (TCM) is characterized as a **full interior pattern**, comprising dampness and heat invading and impairing the large intestine. This impairment manifests in the following ways:

Clinical Manifestations

  1. Abdominal pain and fullness: This pain is not alleviated by a bowel movement, indicating Qi stagnation caused by dampness obstructing the large intestine’s function.

  2. Diarrhea: Dampness and heat affect the large intestine’s ability to reabsorb fluids, resulting in liquid stools.

  3. Mucus and blood in the stool: Mucus denotes dampness, characterized by heaviness, stickiness, and dirtiness, while blood signifies heat.

  4. Fever not relieved by sweating: Unlike exterior patterns, this fever indicates internal dampness.

  5. Thirst without desire to drink: Heat causes thirst, but the dampness makes one feel full, reducing the desire to drink.

  6. Offensive odor in stools, burning anus, scanty dark urination, and a general feeling of heat: These symptoms point towards the presence of heat in the body.

Functions of the Large Intestine in TCM

The large intestine has two primary functions:

- **Passage and Conduction**: Propelling feces toward the rectum for excretion.

- **Transforming Stools and Reabsorbing Fluids**: Receiving food and drink from the small intestine and transforming it into stool while reabsorbing certain fluids to send back to the spleen and lungs for body fluid formation.

Dampness obstructing these functions leads to Qi stagnation and the typical manifestations of damp heat described earlier.

Acupuncture Points to Treat Damp Heat

In this episode I highlight three acupuncture points effective in treating damp heat in the large intestine. These points align with the treatment principles for this pattern: clearing heat, resolving dampness, and stopping diarrhea.

#### Large Intestine 11 (LI 11)

- **Function**: Clears heat and treats intestinal issues due to its He-Sea point nature on the large intestine channel.

- **Location**: Halfway between Lung 5 and the lateral epicondyle of the humerus, found at the lateral end of the crease formed when the elbow is bent.

#### Stomach 37 (ST 37)

- **Function**: Lower He-Sea point of the large intestine, it treats both damp heat and diarrhea due to its principal action.

- **Location**: 3 cun inferior to Stomach 36.

#### Spleen 9 (SP 9)

- **Function**: He-Sea point of the spleen, it resolves dampness by regulating the spleen, opening water passages, and benefiting the lower jiao.

- **Location**: On the medial side of the lower leg in a depression on the medial condyle, on the same level as Gallbladder 34.

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Transcript of Episode

Dr. Richard Lai DPT LAc [00:00:00]:

Hey Everyone. Welcome back to study acupuncture with me. My name is Richard. I'm a doctor of physical therapy, and I'm an acupuncturist. And what do I do? I make acupuncture study content for busy acupuncturists and acupuncture students just like yourself. And in this episode, I'm gonna go over 3 acupuncture points that can help you to treat damp heat in the large intestine. And we're gonna get into all of that and more after we hear a quick word from our sponsor.

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Dr. Richard Lai DPT LAc [00:01:20]:

And we're back. So in this episode, we're going to talk about 3 acupuncture points that you can use as part of your point prescription for treating damp heat in the large intestine. Now, the first thing we should establish is what is damp heat in the large intestine? So whenever you look at a pattern, you should look at it from an 8 principles perspective. So for damp heat in the large intestine, this is a full pattern. It's a full interior pattern. In this pattern, dampness and heat since it's damp heat has invaded, has gone into the large intestine. So there's 2 pathogenic factors and they are impairing the function of the large intestine. And that impairment is what's going to cause very specific manifestations.

Dr. Richard Lai DPT LAc [00:02:04]:

So here on the screen we have a list of the clinical manifestations that are related to damp heat in the large intestine. And of course for my podcast listeners, I will read them to you because you can't see them. And so here on the screen, we have key manifestations like, for example, number 1, abdominal pain. We also have diarrhea and we have mucusblood in the stool. So those three key manifestations are abdominal pain, mucus and blood in the stool, and diarrhea. So these are the key manifestations that let you know that you're dealing with damp heat in the large intestine. Now the question is why? Why are these manifestations showing up for this pattern? And it's a great question because it lets us know the mechanism of the pattern. So first, let's talk about abdominal pain, abdominal fullness, which the abdominal pain it actually also says here that it's not relieved by a bowel movement and that's actually a key complaint from your patient The pain and the fullness we have is happening because of dampness.

Dr. Richard Lai DPT LAc [00:03:08]:

That dampness is obstructing the large intestine. That dampness is messing with the chi mechanism, which is known as the natural chi direction of the large intestine. The natural chi direction of the large intestine is downward, and this makes sense when you look at the functions of the large intestine. And there's 2 functions of the large intestine. The first function of the large intestine is that it controls passage and conduction. The second function of the large intestine is that it transforms stools and it reabsorbs fluid So in terms of the first function, in terms of passage and conduction what happens is that the large intestine is moving or conducting or propelling feces towards our rectum, so that way it can be excreted out of our body And then, in terms of the second function which is transforming stools, reabsorbing fluids, what the large intestine does is that it receives food and drink from the small intestine. The large intestine is going to take this food and drink, and it's gonna transform it into stool. Now it's also gonna take the fluid, and on one hand, the large intestine is going to allow some of that fluid to be excreted out with the feces.

Dr. Richard Lai DPT LAc [00:04:22]:

On the other hand, the large intestine is going to reabsorb some of that fluid. So that way this reabsorbed fluid can be sent back to our spleen. It can be sent back to our lungs. That way it can form body fluids in our body. And so with these two functions, the large intestine propels feces towards our rectum, and this is helped by the natural chi direction of the large intestine, which is down. While this is happening, the large intestine is also reabsorbing some fluid for body fluid formation, but it's also allowing some fluid to be excreted out the feces. And so now when a pathogenic factor like dampness or heat is in the large intestine, this is gonna impair the function of the large intestine. It's gonna impair also the natural chi direction of the large intestine.

Dr. Richard Lai DPT LAc [00:05:06]:

So that can cause chi to stagnate. It can also cause chi to move in its opposite direction, which is why here we have the abdominal pain and the abdominal fullness. It's because there's the disruption of the natural chi direction of the large intestine. Alright. Next on this list of manifestations of damp heat in the large intestine, we have diarrhea. Now this has to do with the second function of the large intestine, which is that the large intestine reabsorbs fluids. So again, in this pattern, dampness and heat has affected the large intestine, and it's impairing this function of reabsorbing fluids. And so what happens then is that there's gonna be some excess fluid that gets excreted out with the feces, and that's gonna make the feces very liquid.

Dr. Richard Lai DPT LAc [00:05:52]:

We call that diarrhea. Now we also have here mucus. We have also blood in the stool. Now when you see the word mucus, this is a sign that there's dampness involved. With dampness, when we see dampness, we think of 3 main things. We think dampness is heaviness. We think dampness is stickiness, and we think dampness is dirtiness. So if you need a refresher actually on all things dampness, please go on over to episode 45 of study acupuncture with me.

Dr. Richard Lai DPT LAc [00:06:23]:

I'll link that episode in the description of this episode. Now that episode again is on dampness in traditional Chinese medicine. So if you need a refresher, go over to that episode. So again, just to recap, what is dampness? Dampness is 3 things. Dampness is heaviness, stickiness and dirtiness. Heaviness is a feeling of heaviness in the body. That heaviness could be in the arms and legs. It could be in the body itself.

Dr. Richard Lai DPT LAc [00:06:46]:

It could be in the head. So these are all signs of dampness in the body. Dampness is also stickiness. So you might see a sticky tongue coating. You might see sticky taste in the mouth. So that's dampness, meaning stickiness. Dampness is also dirtiness, and dirtiness is actually when there's discharge from the body or even the urine sometimes will be described as cloudy, so that's indicative of dampness. It could also be described as turbid urine.

Dr. Richard Lai DPT LAc [00:07:13]:

That's pretty much similar to cloudy. If the patient also has vaginal discharges or if their skin is oozing, these could also be indicative of dampness as well. And so here in this episode, we're talking about damp heat in the large intestine. And what tells you that it's dampness is the mucus in the stool, the heaviness in the body and the limbs, and if you look at the pulse, it says slippery. That's also a sign of dampness, and then there's a sticky tongue coating as well. Now there's also here, it says, a fever that isn't relieved by sweating, and then it says thirst without desire to drink. Now these both are also manifestations that are indicative of dampness. Now if dampness is severe enough, the patient can actually present with a fever.

Dr. Richard Lai DPT LAc [00:07:56]:

And because it's dampness, this fever isn't gonna be relieved by sweating it out. It's only going to be relieved by resolving the dampness, and that's a huge clue for us as to the root of why the fever is there. Because usually when we see a fever, we think an exterior pattern, like, for example, wind cold has invaded the body, meaning it's invaded the exterior surface of the body, which is the toli, the area between the skin and the muscles. When that happens, our body responds by having a fever because the wei qi is being impaired, so that's why we have a fever. It's also why we feel a little cold, because the wei qi has a function to warm the body, and that pathogenic factor that's present is interfering with the function of the wei qi. So we had a fever and we also get a feeling of cold. And so what we do is we release the exterior so that way we can kick that pathogenic factor out. One way to do that is by sweating it out.

Dr. Richard Lai DPT LAc [00:08:52]:

You sweat it out, you relieve the fever. But here, it says a fever that's not relieved by sweating it out. So that means the root isn't an exterior pattern. That means that it must be something else. Here it's dampness. So that's why it's only gonna be relieved by resolving dampness. And then with the thirst without desire to drink, this points to damp heat. Now the heat is causing the thirst, but because there's dampness, dampness we know it makes you full, makes you heavy.

Dr. Richard Lai DPT LAc [00:09:22]:

The dampness is what's making you not want to drink. And so you're thirsty because of the heat, but you're also full because of the dampness, so you don't really want to drink. So that's why it says thirst without desire to drink. Alright. Now on this list of manifestations, we also have an offensive odor in the stools. We have burning anus, and we have scanty dark urination. We also have a feeling of heat. These are all heat signs.

Dr. Richard Lai DPT LAc [00:09:47]:

Offensive odor. That's a sign of heat in the body. Burning, that's also a sign of heat in the body. Dark, burned, urination, that's also a sign of heat in the body, and of course a feeling of heat that's indicative of heat as well. So when we're evaluating our patients and we're finding these manifestations or when you're taking the board exam and you're seeing these manifestations 1 by 1. Now, when you're looking at the question, what you do is you identify the manifestations and you relate them to a pattern or syndrome. So for example, alright, you see mucus, and you say, alright, that's dampness. We see offensive odor.

Dr. Richard Lai DPT LAc [00:10:25]:

Alright. Well, that's heat. We also see other dampness signs. Okay. We see heaviness. We see stickiness. We see a slippery pulse. So that means there must be dampness in this question.

Dr. Richard Lai DPT LAc [00:10:35]:

We also see thirst, though. So thirst, we see dark urination. We also see a red tongue body. So so there must be heat here. So when you put all that together, you get dampness, you get heat, you put it together, you get damp heat. And then you can confirm that when you look at the tongue and pulse, which here we see that the tongue presents as a red tongue body with a sticky yellow tongue coating. So a red tongue body, that's indicative of heat. A sticky tongue coating, that's indicative of dampness.

Dr. Richard Lai DPT LAc [00:11:06]:

And then yellow, that's a pathological color, which is a sign for heat. And so if you put all that together, you again get damp heat. Alright. So that brings us to the 3 acupuncture points that you can use in a point prescription to treat damp heat in the large intestine. And these 3 acupuncture points, I chose because they are in line with the treatment principle for this pattern. And the treatment principle, we need to know, we need to learn for the exam. So the treatment principle for large intestine damp heat is three things. Number 1, it's to clear heat.

Dr. Richard Lai DPT LAc [00:11:41]:

Number 2, it's to resolve dampness. And then number 3, it's to stop the diarrhea, because diarrhea can affect our body negatively. It can actually exacerbate things in our body because of the loss of fluids that's associated with it. Now to treat damp heat in the large intestine, you can use a combination of any of the points on the screen Now the 3 that I find especially useful are Large Intestine 11, Stomach 37 and Spleen 9 Now large intestine 11, I use this one because it can clear heat Large intestine 11 is the hsi point of the large intestine channel and we know that the HSE points of the 5 shoe points are really great for treating intestinal issues. Now if you've been following me for a while, since the very beginning of study acupuncture with me, you might remember one of my first episodes where I talked about the mnemonic of the shoe points, which the mnemonic for the shoe points are my friends are all idiots. Now the 5th word is idiots. The 5th word is associated with the 5th point which is the hesi point. Now idiot starts with the letter I.

Dr. Richard Lai DPT LAc [00:12:49]:

So that's how you know that hesi points can treat intestinal issues and categorically the hesi points are where chi begins to go internal and so that's why it can treat intestinal issues like for example the abdominal issues that we see in damp heat in the large intestine So, Large Intestine 11 being the hussy point can treat all the abdominal issues that we see here. But not only that, large intestine 11 itself also has a specific function to clear heat, and this is because it is a yangming channel. The yangming channel is full of yangqi and blood, and so large intestine 11 can treat excesses of yang, which heat is a form of excess yang. Large intestine 11 is super easy to find. Large intestine 11 is located halfway between Lung 5 and the lateral epicondyle of our humerus, which very easily you can also just ask your patient to just bend their elbow, and you can find this point at the lateral end of the crease that's formed when they bend their elbow. Alright. Now point number 2 of this episode is stomach 37. Now stomach 37 is categorically the lower Hussey point of the large intestine.

Dr. Richard Lai DPT LAc [00:13:59]:

So categorically, it's a lower Hussey point, so that means it can treat intestinal issues as well. And so for this point, Stomach 37, it can especially treat damp heat and diarrhea. In fact, stomach 37 is one of the principal points for treating diarrhea. So it can treat diarrhea whether that diarrhea is from an excess cause or from a deficiency cause. So an excess cause like damp heat, or if it's a deficiency cause like spleen chi deficiency, you can use sum 37 to treat it. Now where is this point located? So this point is located 3 soon inferior to stomach 36. Stomach 36, we find all the time. We love stomach 36.

Dr. Richard Lai DPT LAc [00:14:39]:

Stomach 36 is 3 soon inferior from our femoral joint line, and that stomach 37 is just another 3 soon from there. And 3 soon is just the width of your patients and in terms of body measurements. Alright. Now the last point of this episode is another hussy point, which is spleen 9. So spleen 9 is the hussy point of the spleen. So it categorically can also treat intestinal or abdominal issues. But not only that, spleen 9 is especially useful in treating dampness. That's because the spleen is responsible for TNT, which is transforming and transporting.

Dr. Richard Lai DPT LAc [00:15:18]:

And if something though is affecting the function of TNT, transforming and transporting, then what happens is fluid can accumulate in the body, and that fluid accumulation can lead to dampness accumulation as well and so if there's dampness in the body, Spleen 9 can resolve that dampness because it regulates the spleen, it opens the water passages, it also benefits the lower jaw so it can treat dampness in the bottom Now how do you find spleen 9? Spleen 9 is on the medial side of your lower leg. On the medial side of your lower leg, you have a medial condyle. On that medial condyle, there's an angle that goes up and in. Now you can run your finger along that angle, and spleen 9 is going to drop into a depression there. So your finger is going to drop into a depression, that's where spleen 9 is. And you can check your placements to make sure you're on spleen 9 by making sure you're on the same level as gallbladder 34. That's because gallbladder 34 and spleen 9 are on the same level. Alright.

Dr. Richard Lai DPT LAc [00:16:15]:

And that actually brings us to the end of this episode. I hope that you got something of value out of this episode. And if you did, I just ask that you please share that wealth with a friend, whether you share it on social media, through your Instagram stories, or you link this episode directly to them by way of a DM. When we share knowledge in acupuncture, we share confidence in acupuncture. It's only going to make all of us better. And who wins when we're all better at our clinical skills? Our patients win because they get the best clinical care possible. And if this was your first time studying with me and you want to get into the habit of studying consistently and making progress through your studying, then I highly recommend that you download my free weekly plan. When I was in acupuncture school, I use this exact planner and it helped me make a plan and stick to it.

Dr. Richard Lai DPT LAc [00:17:01]:

So that way, on the one hand, I can be aware of my schedule for the week because, you know, as acupuncture students, we're very busy. A lot of us work full time. A lot of us are taking care of a family or other responsibilities that we have An acupuncture school is just something on top of all that. So we need to be aware of our busy life and we need to know our schedule so that we can find these pockets of opportunity for us to input study times into. Now what I would do is I would even pre plan what I was gonna study at that exact time, because this just helps you to remove any friction to studying. And you want to try to remove as much friction as possible. That way you could just go into your flow state and study right away. And because I pre planned exactly what I needed to do at exactly what time, All I needed to do was show up and just do the work.

Dr. Richard Lai DPT LAc [00:17:51]:

So you can download my free planner at my website at www. Studyaccu with Alright, everyone. Until next time. God bless and happy studying.

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