A Covid-19 Acupuncture case study

Mrs. Deer(her spirit animal, not her real name)

Patient: Female , 59 years old, 190 lbs, resides in New York

Severe pneumonia, COVID-19 Positive, had X-Rays showing GGO and severe phlegm build up
in lungs upon first hospitalization,

Mrs. Deer started feeling sick March 14, 2020, exhibited, low grade fever, exhaustion and
somnolence. She began to have a dry cough 6 days later. On March 20, 2020 she began to
have trouble breathing. By March 22, 2020 she was hospitalized due to breathing
complications. While in the hospital she had lung XRays and a COVID-19 test. The XRays
revealed GGO (ground glass opacity) in her lungs. The image was so remarkable that without a
COVID-19 test back yet her doctor diagnosed her with COVID-19. She had a fever the entire
time she was in the hospital. She was treated with Hydroxychloroquine and Azythromycin and
albuterol sulfate inhaler. Nebulizers were not used due to aerosolization. Mrs. Deer had severe
adverse reactions to the Hydroxychloroquine/Azythromycin combo. The medication resulted in
her lose of bowel control, wide spread urticaria and caused to experience strong delusions.
She remained in the hospital until March 26, 2020 when she was released after her fever
reduced and breathing stabilized. Her doctors requested that she do as much as possible not
to return to the hospital due to her medical history as they were worried she would not survive
the ventilation process. Within one week her condition began to decline sharply again and by
April 4, 2020 with her breathing severely compromised her family was worried about her
survival. Taking into consideration the percentage of deaths of patients in NY when put on
ventilation for COVID-19 and her medical history her family decided to try other means of
treatment.

Medical History:

Mrs. Deer was a marathon runner who had exercise induced asthma. 10 years ago she went
for a routine colonoscopy. She had an asthma attack while under anesthesia and aspirated
scarring her lungs. She has been on prednisone and albuterol inhalers for varying times over
the last decade due to the respiratory issues that started due to that event. She regularly uses
a nebulizer. She has gained 80 lbs over the past 10 years due to being on prednisone for long
durations of time during the past decade. Since the aspiration she has become more inclined
to catch colds and have mild respiratory disorders turn more severe lung ailments. She had
her gallbladder removed in July 2017. Her gallbladder had adhered to the surrounding tissues
and structures was filled with stones. At the time her doctors suspected the gallstones were
due to the heavy use of steroid therapy such as prednisone.

Mrs. Deer also has skin allergies pollen allergies. She is allergic to pollen, bees and she says
most trees and plants. She has carried an epi-pen which she has had to use before and takes
Zyrtec. Due to this she refuses herbal medicine. There for the treatment was entirely
acupuncture based.

Has a history of high blood pressure during ‘white coat’ encounters. She was put on Losartan
an Angiotensin II blocker

Day 1

Mrs Deer was breathless and speaking sparingly and quickly. At times she was gasping for air.
She was sitting on her couch hunched over and not moving much. She had severe and
sometimes stabbing upper mid back pain that wrapped around the sides to the front and into
the chest. This pain was exacerbated by cough and gasping and would sometimes leave her to
cry out if she was coughing or wheezing. Heightened sense of taste, skin swollen, and painful
when touched.

Her right pulses were overall wiry and rapid

Rt Cun: Weak, irregular and slightly choppy

Rt Guan: Thin

Rt Chi: Tight and Wiry

Left Pulses were very wiry and full and forceful

Lt Cun forceful wiry

Lt Guan forceful wiry

Lt Chi tight forcefully wiry

The full wiry quality of the left pulses are a sign of a severe case of phlegm mixed with perverse
heat that have accumulated in the chest. It also is a sign of the back pain she is experiencing in
the back and around the diaphragm. The weak and choppy pulse in the right cun position is a
sign of severe damage to the fluids of the lung and damage to Ying Qi including blood. The
thinness of the Rt Cun is a sign of deficiency of the Stomach and Spleen and which cannot
transform the dampness which transformed to phlegm in the chest. Tightness in the Chi
position of the Rt Chi is a sign of back pain.

Day 1 Tongue Coat Pre Treatment

Thick sticky yellow coat, much of the coat was dry,

Coat covers from mid lung area back through the
red of the tongue. Tongue body particularly beneath
the coat was red, crack in the center line beneath
the coat showing the compromised actions of the
Stomach and Spleen

Upon examining patients back it, a large lump of what seems to be tightened muscle exists
along the Du channel from BL-13 to BL-17

Diagnosis: Phlegm heat toxins obstructing the Lungs and the Du Channel creating rebellious Qi

Treatment principle: Transform and clear phlegm heat, open the chest, tonify the kidneys to
anchor lung qi, open Du Mai and clear obstruction

Treatment : KI-3, LU-6, LU-7, LU-9, LI-11, LI-4, SJ-5, PC-6, BL-12, SP-9, ST-36, ST-40, LU-5,
CV-17, Local needling around the ridge of the lump along the spine

- KI-3/Lu-6 as a pair anchors Qi and benefits the Lung, arrests wheezing by disseminating and
descending Lung Qi, alleviate stagnation

- Lu-7/Lu-9 - transforms phlegm, subdues rebellious Qi, calms cough, arrests wheezing by
promotes the descending of lung qi

- LI-11/LI-4 clears heat and regulates Wei Qi and sweating

- SJ-5/PC-6 is a combination used to release the front and back, relax the diaphragm and
help regulate heart rate, the combo has been used to regulate and stop Atrial fibrillations

- BL-12 directed downwards to BL-13 to descend Lung Qi

- SP-9/ST-36 fortifying the Stomach and Spleen to resolve dampness

- ST-40 - transform phlegm and damp, clear phlegm from lungs and alleviate cough and
wheezing

- Lu-5 clear heat and descend rebellious Lung Qi

-
Needling along lump was to disperse stagnation and release the back

Laser Acupuncture:

The Avant LZ30 class 3 laser was used for all laser treatments. Using lymphatic setting on
SCM bilateral from sternum to jawline, one minute per section applied directly to skin.
Acupuncture pointer used to treat the following points: SP-6, KD-3, UB13, UB-23, LI-11.

At the end of the treatment after much reduction and clearing of heat Moxa was done to
strengthen Qi from being so weak

Moxa was done to back - along the ridge found along the spine, upper back along Bladder shu
points and along the back around BL-23.

Tongue at end of Day 1 treatment

Her tongue coat began to break up by the end of the treatment

with the phlegm coat moving forward on the tongue and the color
around the edges changing from yellow to white and sides of the
coat becoming frothy. The breaking up of the coat and moving
forward on the tongue represents the break up of the phlegm and
movement upward by the lungs, the yellow to white representing
the clearing of heat from the chest and the frothiness and fluid
entering the coat is a sign that the congealed phlegm heat in the
chest is now softening and becoming pliable and more fluid as it
is broken down.

There was a day between Day 1 and Day 2 of treatment. The following is a picture of the
patient’s tongue between the two days of treatment

Thick coat reducing, yellow color consistently clearing,

color of tongue body is becoming darker red. The coat
reducing is a sign of phlegm being transformed and
broken up, the yellow to white is a sign of clearing of
heat in the phlegm however the reddening of the tongue
is a sign that the heat internally is becoming fire

Day 2 treatment

After first treatment

Mrs Deer started expectorating bits of brown and green phlegm after first treatment

She feels 20% of her cough had become productive

Breathing much better than first treatment however still having difficulty breathing and
wheezing a bit

Chest has opened after first treatment but most of the pain moves around side and back

The night after she was treated, Mrs Deer ate a full meal for the first time in nearly 4 weeks
since the ordeal started.

Skin pain reduced quite a bit since last

She is sitting up more and not as slumped over as the first day

Craving ice water

Pulse:

Right Pulse : much thinner than day one but still wiry, rapid

Rt Cun: wiry slightly rapid

Rt Guan : wiry, softened a bit compared to last treatment

Rt Chi : thin wiry

Left Pulse:

Lt Cun Wiry Rapid

Lt Guan: Tight, slightly rapid

LT Chi: Weak

The rapidity of the pulse is a sign of severe heat. The wiriness of the pulse is a sign of phlegm
heat obstruction. The reduction in fullness compared to day 1 is a sign of a decline in perverse
heat. The strengthening of the pulse over all on the right cun is a sign of an increase in lung qi
and the kidneys despite being weak now grasping the Qi.

Patients Tongue prior to treatment Day 2

Coat has lessened substantially, tongue body has become

more red. These are signs of the phlegm decreasing,
however the heat is increasing as a result of the phlegm and
damp clearing

Diagnosis: Phlegm heat toxins obstructing the Lungs

Treatment principle: Transform and clear phlegm heat, arrest wheezing, strengthen the kidneys
to anchor lung qi

Cupped patient’s back to help clear phlegm from lungs

Sliding Cupping upwards from BL-17

Cups also applied to BL-23 to anchor Lung Qi to Kidneys

Cups applied to SP21 Da Bao to open the chest and invigorate blood Qi

Treatment:

BL-13, BL-17, BL-18, BL-20, BL-21, BL-23, KI-3, Lu-6, SP-9, LI-11, LI-4

- BL-13/BL-17/BL-18 to open the chest, release the diaphragm and clear heat

- BL-20/21 to strengthen ability of the Spleen and Stomach to transform phlegm

- BL-23 tonify the kidneys to grasp Lung Qi

- KI-3/Lu-6 as a pair anchors Qi and benefits the Lung, arrests wheezing by disseminating and
descending Lung Qi, alleviate stagnation

- SP-9 to strengthen the spleen and resolve dampness

- LI-11/LI-4 pair clears heat and regulates Wei Qi and sweating

Laser Acupuncture

Lymphatic setting used on SCM bilateral from sternum jawline, one minute per section applied
directly to skin. Acupuncture pointer used to treat the following points: SP-6, SP-9, TH-5,
UB13, UB-23, LI-11. Each point treated bilaterally for one minute per point.

Patient’s tongue post treatment Day 2

The redness was less in the tongue body which is a sign

of clearing heat. The thick yellow coat started moving
upward on the tongue due to cupping. This is a sign of
the solidified phlegm breaking up and moving upward.

Day 3 treatment

The night after Day 2 treatment Mrs. Deer had a difficulty sleeping due to coughing. Post
cupping she began coughing more than she had in the prior four weeks she has been sick

Pain in the back is significantly less

She has strong feelings of heat in the body

She is breathing rapidly, at times trouble catching breath but significantly better

She is sitting up and walking around a bit

Craving Ice water

Pulse:

Right Pulses: Thin and Wiry

Rt Cun: Empty Thin and Wiry, at deeper level tight lacking force

Rt Guan: Empty Thin and Wiry, at deeper level tight lacking force

RT Chi: Very Thin, vessel is tight but pulse is rather faint

Left Pulse: Thin

LT Cun: Weak

LT Guan: Thin and Wiry

LT Chi: faint

Thin and wiry aspect of the pulse is a sign of damage to qi and blood causing deficiency due
to the phlegm and inflammatory heat. The emptiness is a sign of damaged Upright Qi and yin
by the pathogen resulting in an increase of heat. The weak Left Cun position is a sign of poor
sleep which reduces Heart Yang. The thin and wiry feeling at the left guan position is a sign of
phlegm heat and stagnation in the middle jiao. The reduction in force is a sign the phlegm is
continuing to be significantly cleared.

Patient’s tongue prior to treatment day 3

Tongue coat has greatly reduced but body of tongue has

increased showing an increase of heat/fire. This is a sign
that as the patient’s phlegm is clearing however she is
severely yin deficient with a full expression of heat.

Diagnosis: Phlegm heat in chest with underlying fire in Shao yang

Treatment Principle: Clear phlegm heat, Drain Shao Yang, Consolidate Lung Divergent to assist
in clearing phlegm heat

Treatment:

GB-44, GB-43, GB-25, KI-3, LU-6, LI-1, LI-18, ST-12, LU-1, GB-22, LU-3, LU-11

- GB-44/GB-43 are paired to disperse and clear damp and heat from Shao Yang and GB
Divergent (post needling this pair, the lung pulse gained a strength), open and benefit the
chest and costal region

- GB-25 as the Mu point of the Kidney’s on foot Shao Yang and the GB Divergent this point
anchors Lung Qi to Kidneys and assists the function of Kidney’s grasping qi to subdue
wheezing

- KI-3/Lu-6 as a pair anchors Qi and benefits the Lung, arrests wheezing by disseminating and
descending Lung Qi, alleviate stagnation

- LI-1 clears heat and reduces swelling and oppression, this point is being used in conjunction
with LI/LU Divergent channel to clear heat internally along the Divergent channel

- LI-18/ST-12/LU-1/GB-22 are used together as the Large Intestine/Lung Divergent divergent

channel to stabilize and consolidate lung Qi and clear phlegm and heat

- LU-11/LU-10 paired to clear heat and transform phlegm particular from the inner pathway of
the Lung Divergent channels

- LU-3 clears lung heat, descends lung qi, cools heat in the Ying and blood and opens the
portals

LI/LU divergent was done DSD to consolidate the body’s resources to assist the body in
clearing phlegm and heat

Patient’s tongue post post Day 3 treatment

Day 4 treatment

The night of the 3rd treatment between 2-3 AM Mrs Deer awoke and began coughing up
substantial thick white sticky phlegm. This is a sign that the consolidation of lung Qi via the LI/
LU divergent treatment was able to invigorate the lungs and clear the phlegm in the chest.

Patient had been feeling heat in the extremities, particularly palms, also feeling heat in the
chest

Carrying on conversations without the sound of breathlessness,

Drinking ice water

Feeling some low and mid back pain

Pulse:

Right Pulse: Stronger than Day 3 and rapid

RT Cun: Rapid with more substance to this pulse

RT Guan: Rapid with substance

RT Guan: Rapid with substance

Left Pulse: Thinner than right side

LT Cun: Thin and empty

LT Guan: Wiry rapid but less forceful than day before

LT Chi: Thin less rapid

The increase in pulse strength particularly in the right cun position is a sign of the consolidation
of Lung Qi, particularly yang to push the phlegm out. Heat is coming to the surface.

Tongue pre treatment

Tongue red body, fairly coatless with small patches of coat of

froth

It is quite clear that the phlegm has substantially broken up over

night.

Diagnosis: Heat obstructing the Lungs

Treatment principle: Clear heat, Consolidate Lung Divergent to clear residual phlegm and heat

Treatment:

ST-36, Du-14, LI-11, LI-4, LI-18, ST-12, LU-1, GB-22, GB-21, BL-40

- ST-36/Du-14 bled to clear heat (ST-36 blood was dark due to blood stasis due to heat,
Du-14 blood more bright due to the heat rising to the surface)

- LI-11 paired with ST-36/Du-14 to clear heat - after these three used rapidity in the pulses of
the Stomach and Kidney feel that significantly less rapid

After the above groups of points the rapidity in the pulses reduced substantially

- BL-40 right side for back pain

- LI-18/ST-12/LU-1/GB-2 are used together as the Large Intestine/Lung Divergent divergent

channel to stabilize and consolidate lung Qi and clear phlegm and heat

These points will consolidate the Yang Qi of the Lung Divergent to arrest wheezing

- GB-21 is a point along the LI Divergent channel that helps to transform stasis in the chest
and clear heat, it releases the Jing well points and as such can assist in opening the exterior

LI/LU divergent was done DSD to consolidate the body’s resources to assist the body in
clearing heat

Tongue Post treatment

Tongue fairly coatless, less red, patchiness of froth and

phlegm reduced

Treatment day 5

Back pain alleviated from day before

Having Headache that feels like it is wrapping around her head

Having red/purple rashes on the skin - these started when she was given Hydroxychloroquine
in the hospital, they subsided a bit after but now have returned

Breathing considerably better, little breathlessness, no gasping, respiration far less rapid,
coughing reduced, still takes nebulizer as she has been for a since before her bout with COVID

When first released from the hospital she was talking the nebulizer every 2hours 45 minutes.
Since beginning the acupuncture the time between her nebulizer use is 4 hours

She has returned to working online teaching from home, after a few hours of teaching and she
feels slightly breathless

Feeling less hot, palms still feel quite warm

Mouth is quite dry

Craving Ice Water

Tongue pre treatment

Coatless and Red with cracks in the tongue body

Since the clearing of dampness and phlegm the

heat has become predominant. Qi and Yin
deficiency are apparent

Pulse:

Rt Pulses

Rt Cun: Slightly empty but stronger than previous days

Rt Guan: still a bit thin but stronger than previous days

Rt Chi: Thin

Lt Cun: Empty

Lt Guan:

Lt Chi

Diagnosis: Heat in the chest with yin deficiency

Treatment Principle: Clear heat, nourish yin, consolidate LI/LU divergent to assist in clearing
heat from the chest

Treatment:

ST-36, Du-14, LI-11, LI-4 KI-3, LU-6, SP-6, LI-18, ST-12, LU-1, GB-22, GB-21

- ST-36/Du-14 bled to clear heat (ST-36 blood was dark due to blood stasis due to heat,
Du-14 blood more bright due to the heat rising to the surface), after bleeding her headache
resolved

- LI-11/LI-4 paired with ST-36/Du-14 to clear heat - after these three used rapidity in the
pulses of the Stomach and Kidney feel that significantly less rapid

- KI-3/Lu-6 as a pair anchors Qi and benefits the Lung, arrests wheezing by disseminating and
descending Lung Qi, alleviate stagnation

- SP-6 tonifies Kidneys and nourishes Yin

LI/LU divergent was done DSD to consolidate the body’s resources to assist the body in
clearing heat

Moxa to Ren -6, upper bladder shu points, LU-9 - after needling and feeling the decline in heat
but deficiency in Mrs Deer’s pulses Moxa was done at the points listed to tonify Kidney and
Lung Qi - she immediately broke into sweats which she had not done since we began treating
her - afterwards she felt much better and had quite a bit of energy

Tongue post treatment

Treatment Day 5B (she received a second evening treatment to increase the dosage)

Palms no longer feel palpable warm, she is feeling far more comfortable body temperature

Tongue pre treatment

tongue body starting to lighten, not as red, sign of heat

clearing, cracks in tongue a sign she still has yin deficiency

Pulses : overall less rapid

Diagnosis: Heat in the chest with yin deficiency

Treatment principle: Clear heat, nourish yin, consolidate LI/LU divergent to assist in clearing
heat-

Treatment :

LI-11, LI-4, KI-2, SP-6, LI-18, REN-23, ST-12, LU-1, GB-22, GB-21

- LI-11/LI-4 clears heat and regulates Wei Qi and sweating

- SP-6/KI-2 used to clear deficient heat and nourish yin and tonify Kidneys

LI-18/ST-12/LU-1/GB-22

The use of the points LI-18/ST-12/LU-1/GB-22 are used together as the Large Intestine/Lung
Divergent divergent channel to stabilize and consolidate lung Qi and clear phlegm and heat

These points will consolidate the Yang Qi of the Lung Divergent to arrest wheezing

- GB-21 is a point along the LI Divergent channel that helps to transform stasis in the chest
and clear heat, it releases the Jing well points and as such can assist in opening the exterior

LI/LU divergent was done DSD to consolidate the body’s resources to assist the body in
clearing heat

Laser Treatment

Inflammation setting on SCM bilateral from sternum jawline, one minute per section applied
directly to skin. Acupuncture pointer used to treat the following points: Spleen channel from
SP-6 to SP-9, KD-3, UB13, UB-23, LI-11. Each point treated bilaterally for one minute per
point.

Tongue Post treatment

Tongue is red, but is not as red as prior days, the

picture was taken at night using a phone light so the
color is not under natural full spectrum light, the
cracks of the tongue appear to be closing a bit and up
close, in person, you can see a very slight layer of
white coat. This would appear to represent the slow
building of yin qi again

Day 6 Treatment

When arriving to see Mrs Deer she was walking around her house, had done her hair and was
folding blankets.

Today she was treated lying on her back, all previous days she was treated sitting down.

Her coughing has lessened and is not strong barking coughs like before

She still can become breathless with exercise and moving too much

Her appetite is not strong but her sense of taste and smell are very very acute so currently she
is not eating much. She reiterated she hadn’t really eaten much in the last 4 weeks.

Today she says she feels sufficiently cooler and does not feel any urge to drink ice water

Pulses:

Right Pulse: thin, slightly wiry, more substance than yesterday - no longer empty

RT Kidney pulse weak

Left Pulse:thin slightly wiry

LT Kidney Weak

The pulses show that there is still stagnation and deficiency but Mrs Deer is now slowly
recovering Qi and Yin.

Palpation of San Jiao Channel of the neck revealed a tight SCM at the attachment near GB-12/
SJ-16

Tongue pre treatment

Fluid on the tongue more than prior yesterday

Coat on tongue very thin

The tongue on this day shows signs of that the strong

pathogenic full heat has cleared and now Mrs Deer is in
the convalescing stage. She is Qi and Yin deficient

Diagnosis: Lung Qi and Yin deficiency with Kidney and Spleen Qi deficiency with stagnation in
Shao Yang

Treatment Priniciple: Condolidate Qi and Yin to nourish via SJ/PC Divergent and the body and
clear stagnation from Shao Yang via GB Divergent Channel

SJ-16, CV-12, CV-23, GB-1, GB-30, GB-25, GB-24, GB-43, GB-44

SJ-16/CV-12 as the confluence of the SJ/PC divergent will consolidate Qi to help clear heat,
regulate and descend Qi and fortify the fluid production of the Stomach to be able to ascend
Yin to Lungs and portals

CV-23 nourishes yin qi in the upper jiao - a point shared by both PC and GB Divergent

GB-1/GB-30 as confluence for the GB Divergent assist in the body rousing blood to clear wind,
heat and Stagnation from Shao Yang

GB-25 as the KI Mu point, this point was used to strengthen the function of the divergent to
assist in the process of KI grasping Lung Qi to strengthen breathing

GB-24 the GB Mu point was used to clear heat, spread qi and relieve rebellious qi symptoms

GB-43/44 were paired to clear the heat and stagnation from Stagnation.

SJ/PC was an SDS treatment to consolidate and nourish QI and Yin

GB Divergent was a DSD treatment to disperse remaining heat

Tongue post treatment

Below is a picture progression of cupping the patient. The tongue shows the phlegm breaking
up and moving towards the tip of the tongue ( follow progression right to left)

COVID-19: Analysis via 經別 Divergent Channels

By this time physicians all over the world are familiar with COVID-19 and it’s many symptoms.
In Chinese Medicine most analysis has been done in the realm of herbal medicine with less
being done in the area of acupuncture. Shang Han Lun, Wen Bing, and general TCM theory
have been the dominant approach and they have been successful but I have been seeing that
various symptoms pop up that tend to seem to rather complicate a general TCM diagnosis,
often leaving people wondering about the trajectory of the disease in a patient. While we can
adjust formulas to treat this and understand the various symptoms, how do they fit together
more streamlined so we can get results more efficiently and save lives. Symptoms like
deafness, neurodegenerative decline, encephalitis, cardiac arrest or myocardial injuries,
rabdomyolysis, organ failure, painful or bloody urination, intestines full of gas (this has been
told to me by friends who are tending to intubated patients who haven’t eaten in a week or
more) and other severely complicate issues. My goal is to clarify some of this process by
explaining it via divergent channel progression.

This particular pathogen can get very serious very fast and result in patients in critical and life
threatening conditions exhibiting a fast break down of the body’s Jing Luo (primary channels)
and Zang Fu physiological processes. I am finding between the patients I am treating and the
information I am gathering from various sources that this pathogen, while analyzed by many
methods, often seems to skip around in the various levels of the 6 level theory described in the
Nei Jing and SHL. This is largely dependent on the patient’s initial constitution and the strength
of their Wei Qi, Yang Qi, channel systems and Zang Fu but also the ability of their Jing, blood
and fluids to support the functions. Once this system becomes compromised it falls upon the
divergents to make an effort to translocate the pathogen into latency as best as possible. I will
not go too much into the physiology of the 6 levels here but sometimes refer to them in
reference to the Divergent Channels.

Commonly early onset symptoms of COVID-19 include fever, chills, body aches, cough
generally dry (although I have had patients who have a wet cough with quite a bit of
expectoration who have tested positive for COVID-19), and shortness of breath. A number of
people present with digestive symptoms, nausea, abdominal pain, diarrhea, loss or lack of
appetite. I personally have had a patient present with fever, nausea, lack of appetite and
constipation. Progression can quickly turn into severe Pneumonia with a myriad of
complicating issues. What I looked at is how to make this understanding more streamlined. We
know the body is shutting down and it’s easy to write it off to that but how is it shutting down,
can we figure out the route it will take? I believe we do.

In brief, Divergent channels support the body’s Jing Luo and Zang Fu physiologically as well
when dealing with pathogens. They engage when the Jing Luo fails to address a situation
physiologically or are compromised pathologically. They move between the Wei and Yuan
levels to either push things out through strongly assisting the body in the release of something
or consolidating resources (Jing, Blood, Fluids, Qi etc) to reinforce channel and organ functions
and pull things into the level of the Bone and joints where the Yuan Qi/Jing can hold it in place
essentially putting the pathogen in latency in order to keep a pathogen from going to a
particular organ when the Jing Luo fails to deal with the pathogen adequately. The idea here is
that the body will translocate the Wei Qi and pathogen together to hold them in latency. This
struggle and its fallout between the two creates heat. This event in Chinese Medicine is the
heat that is translocated by the body along the divergents to be held in latency. Holding the
pathogen in latency gives the person time to build other resources because they aren’t actively
fighting the pathogen but instead have sort of made an effort to encapsulate or imprison it to
give your body - Jing Luo and Zang Fu- a break to recover and survive. Divergent Channels do
this by supporting various systems of the body with resources they have an affinity for. BL/KI
have a connection with the usage and movement of Jing in the body, GB/LR with blood in an
effort to support their respective Jing Luo function and support the Jing to support the BL/KI,
ST/SP with Jin (thin fluids), SI/HT with Ye(thick fluids), SJ/PC with Qi and LI/LU with Yang. The
differentiation with the last two is that Qi has both Yin and Yang and when you deplete Qi to a
severe point you only have Yang left, the most ethereal and in this case the last grasps at life
so to speak. There are many implications here but we will focus on the pathway of the current
pathogen. For the sake of time I only will give an incredibly short summary on the 6 phases
Initial stages. Tai Yang conditions tend to have wind cold symptoms as the pathogen tries
entering the Tai Yang exterior . Shao Yang tends toward alternating symptoms and symptoms
of the channel tightening as the pathogen moves back and forth through the Shao Yang
channels. The pathogen tries to go deeper and the body try’s to keep it from going deeper by
moving it back out to Tai Yang. This back and forth aspect results commonly in the alternating
and damp heat symptoms for Shao Yang. Yang Ming is where we find the heat build and we
have tremendous symptoms of heat as Ying Qi in the form of Stomach fluids rise and transform
into Wei Qi to battle the pathogen. If the body is unable to rouse enough Wei Qi supported by
fluids and Kidney yang to expel the pathogen then we tend to lose our exterior defense. Once
through the exterior yang levels, we have exhausted our resources resulting in the loss of
body’s ability to keep this pathogen exterior and it quickly moves into the Zang Fu, in this case
primarily the lungs. At this point for pathogens like this what we are seeing is the divergent
channels quickly activating to translocate the pathogen in to latency. For this you do not need
to know special Divergent pulses or 8 extraordinary pulses. That will often confuse things
because pulses can take a while to understand if you are just learning them. In order to apply
this quickly you just have to be able to know how the system works and identify where the
body absorbs the heat and makes it latent.

If you look at the Divergent channels as backups, they support each level with the resource
they’re associated with. BL/KI will support Tai Yang with Jing, GB/LR will support Shao Yang
with Blood, ST/SP will support Yang Ming with the Jin thin fluids of the stomach. The reason
why this proceeds in this manner is because the substances in that order have the ability to

A. Hold something in latency (more effective to less effective)

B. Break down into more Qi than the substance(s) that proceed it.
(Looking at it with the idea of Daoist internal Alchemy: 1 unit of Jing makes 100 units of
blood; one unit of blood makes 100 units of Qi and in reverse it would take more of the
thinner or more ethereal substance to consolidate to make the denser substance)

This goes for pathology as well. The substance that combusts into Kidney Yang to fill Tai Yang
and support Wei Qi is the Jing. The Blood which fills the GB/LR channels and their divergents
move between front and back to translocate resources and support the effort of Tai Yang and
the Jing of the body. The Ying Qi of the stomach goes to support Wei Qi’s battle with a
pathogen if Tai Yang is unable to take care of the situation on its own. The transformation of
Stomach fluids to Wei Qi is under the auspices of the Spleen. If the Spleen and digestion are
impaired and weak then the Spleen cannot transform fluids into Wei Qi. The fluids instead as
fluids would combine with Yang Qi forming phlegm thereby adding to the Damp Heat condition
already taking place with Covid. This is why we are seeing issues exacerbate quickly with
severe phlegm conditions occurring. Ultimately the Jin Fluids of the stomach via the Stomach
Jing Luo and ST/SP Divergent channels go to the orifices which are portals to moisten them
and expel pathogens from the body. Each level can use its resources to hold a pathogen in
latency or help battle it and push it out but with COVID-19, this pathogen often causes Tai
Yang , Shao Yang and Yang Ming to be over come so quickly that the resources in the first
three leg confluences of the divergents, BL/KI, GB/LR, ST/SP become drained so they are
inadequate in an attempt to push out the pathogen. When Wei Qi is too weak the pathogen can
go to the Zang Fu, BUT, when the Wei Qi is strong enough but inadequate, the divergent
channels can redirect the pathogen into latency within their channel. The pathogen along with
the active Wei Qi is moved to the Yuan level in hopes of stabilizing the body. If however the
pathogen is exceedingly strong as we are seeing with this current pathogen, the level at which
it is being held becomes compromised and this pathogen will drive deeper into the body
burning through Qi, Blood and Fluids and taking down channel systems. This becomes an
issue because as the burning house starts collapsing and people are trapped inside now you
have more issues on your hands.

Once the pathogen burns through the first 3 leg divergent confluences your body loses the
ability to hold much latency and slow progression because the humors are lost. While the SI/
HT divergent will attempt to hold latency to slow down the pathogen this is a difficult task as
the fluid they use is Ye the thick fluid which must be roused from the marrow. This means that
with the loss of Ye OR the Ye trying to translocate the pathogen into the marrow the person
sick will start to have severe symptoms associated with marrow, bone and curious organs.
Neuromuscular symptoms really begin here. While in the GB/LR you have Wind symptoms and
in ST/SP levels you can have Wind Phlegm symptoms that can be neurological, the extent of
severity is not the same as the level of SI/HT. Covid-19 patients can exhibit encephalitis, stroke
and consciousness impairment - often referred to by many people as heat in Yang Ming or
Heat in Pericardium, I will put forward the idea that here, Divergent channels wise, you are
seeing the pathogen enter the level of SI/HT Divergent. As SI divergent declines it loses the
ability to bring blood to the sinews, remember GB/LR is already compromised and out of the
picture physiologically for the most part. As the drop in nourishment to the sinews happens
neuromuscular issues occur and musculoskeletal neurologically decline. As the Ye is burned up
and tries the translocate the pathogen in an attempt to save the person, neurological functions
can become impaired. The channel’s upper confluence is BL-1 the eyes and the pathogenic
heat can enter the brain there, or in long term patients, the Ye becomes deficient and cannot
nourish the marrow. This heat affecting the orifices and brain can cause all of the various
neurological symptoms being seen in severe COVID-19 patients. That means consciousness
impairment, mania, delirium, encephalitis, neuromuscular conditions etc. It is important to point
out that it’s not just the marrow of the brain and neurology of the musculature. It’s also bone
marrow. SARS-CoV patients have had significant decreases in certain lymphocyte subsets. It is
also suggested that SARS-CoV can directly infect hematopoietic stem/progenitor cells
inducing growth inhibition and apoptosis. These stem cells are in the red bone marrow. So
SARS-CoV can be pushed into the marrow by the Ye fluids. There it can affect inhibit the
functions of the (red bone)marrow. Keep in mind that each Yin partner in the elemental series of
divergents is a further worsening of the symptoms and condition in its Yang pair so you can
follow the pathogenic progression

The last two confluences are unable to hold latency. At this stage we are dealing with Qi at the
level of SJ/PC and Yang at LI/LU. The body here doesn’t have physiological fluids available
and the pathogen is burning out of control. The pathogen starts to enter organs and Jing Luos
fairly directly. Here is where we see the same symptomology as the Jing Luo pathology. Here is
where the intense inflammation and internal fire and heat signs start rising critically. This is
where most people’s pneumonia goes from bad to worse and we start seeing ventilation and
intubation and death due to that. We often see in COVID-19 patients that they often get sick
and then they seem to enter an intermediary stage and then suddenly they take a massively
dangerous downturn. That’s because the body in the first wave made an effort with the failing
Wei Qi to redirect the pathogen into the divergents. It goes into latency and people seem to feel
revived a bit. However the pathogen eats through the fluids holding it and when that happens
in a scramble it starts moving around going deeper. We see symptoms which seem all over the
map because they are mirroring the descent through the divergent channels as the pathogen
enters each channel and barrels through, decimating the resources of that channel. At the SJ/
PC the pathogen comes out. The body cannot hold it anymore. There is no more physiological
yin. Therefore the body uses dampness which has formed in the breakdown process to try to
deal with this pathological heat. This results in severe damp heat. We’re not saying damp heat
as in common damp heat. Remember this pathogen is winning and the fire is stoked. At this
point this is going to cause toxic phlegm heat signs and symptoms as the dampness quickly
thickens. Now you have a serious dry cough and can have neurological symptoms arise
because you’re going to start having wind whip up due to fire and internal inflammation. You’ve
got essentially toxic wind phlegm heat. The SJ divergent descends from the brain at GV-20.
Remember the last divergents enters the brain at BL-1. The body is going to try to move the
pathogen away from the brain. You have a rapid spreading of toxic heat that can have a huge
expression of the pathology across the body which doesn’t seem to stop. We are seeing that
with COVID-19. As the SJ divergent descends this toxic heat the body can mobilize dampness
to try to trap the pathogenic heat to keep it from going into the bowels. The bowels here are
the idea of the deepest part of the body. This often results in the dampness trapping the
pathogen in the chest. This is where the pneumonia gets worse and worse and nothing seems
to get it to abate. You can begin to have Yang collapse. Many people faint in critical states at
this point. As the pathology moves into the PC divergent channel you have the heat spread all
the way to the Jing Wells. So prior while you feel the patient’s center body might be hot to the
touch before or they had a high fever, now you get this heat spreading the the extremities. The
body’s ability to create Qi and Blood are severely compromised and now the heat from the
pathogen enters the blood because the person can no longer hold it in latency. Now you can
get hemorrhaging. Another symptom seen in some acute COVID-19 patients in critical stages.

At the point of the LI/LU divergent you have a heat storm. When the pathogen enters the LI
Divergent massive inflammation is flooding the lungs and becoming rampant throughout the
body. At this point the heat has consumed the Qi so you are always hot. The patient has no
Yin. They are only left with Yang. The person will feel heat in their chest as in pneumonia. They
can have chest and flank fullness and pain with difficulty catching their breath. Patients are
short of breath, panting, and have dyspnea. Also another symptom of this pathogenic heat in
the LI Divergent is deafness. Deafness that can be intermittent or long lasting. Deafness is
another symptom occurring in COVID patients. When the pathology enters the LU divergent
this where the patient has nothing left. Their ability to generate even Qi is nearly gone. They
have not only the chest fullness and oppression but they are coughing. They have wheezing,
rapid breathing, restlessness, hot palms, gasping and even inability to breathe. This is
pneumonia and or respiratory failure. This is also where we finally see direct cardiac failure due
to the pathogenic heat. Organs start breaking down. COVID-19 patients can have cardiac
failure, some have rabdomyolysis which then would result in kidney failure among other things.
Remembering that the Lungs early on make the effort to descend pathogenic factors to the
Bladder if they are unable to sweat them out, these patients at the LI/LU stage are usually
unable to sweat and so an effort can be made to urinate out as much pathogen as possible.
However if Tai Yang Bladder is blocked due to dampness or something else the person can
have urinary obstruction resulting in the pathogen becoming among many places, also trapped
in the Urinary tract. This creates Strangury or one or more of the 5 Lin. In the case of COVID-19
patients, a number are reporting painful urination which is a symptom of this obstruction by
COVID-19 of the urinary tract and the body trying to translocate it. Some have blood in the
urine. Particularly those with organ failure and musculoskeletal breakdown in situations like
rabdomyolysis. Once the pathogen passed the first three confluences BL/KI, GB/LR, ST/SP it
could no longer be expelled exteriorly or coughed out. The COVID-19 patient now is coughing
non stop in vain. Tightening of the diaphragm and spasms of the diaphragm occur. The body is
going to make a last attempt to keep the pathogen from moving into the bowels. It does this by
tightening the chest. This is different than Shao Yang tightening. This is a severe pneumonia
like stage. This is what causes the severe chest tightening, fullness, and oppression as it looks
to secure the pathogenic heat and or wind, cold and dampness from moving further in. This
causes Bi syndrome systemically. It is an attempt to push the pathogen into the limbs rather
than the bowels. It can occur in any limb or the head. It can occur in the abdomen. It can
occur in the throat. At this point the patient isn’t able to sweat anything out any longer. This
tightening leads the the severe chest stagnation seen in all acute COVID-19 pneumonia
patients. It causes blood stasis, fluid stasis, heat stasis ( this is the result of Qi stagnation
transforming to heat) , food stasis - symptoms all seen in different acute COVID-19 patients. If
the effort at stagnating the pathogen fails and it enters internally the wind caused by the heat
descends into the bowels causing drum distention and bloated gas in the bowels and
flatulence. This is a symptom seen by medical workers in hospitals with ventilated and
intubated COVID-19 patients. If the person is predominately damp then increased feelings of
heaviness can occur. If there is constriction of the abdomen due to cold then the patients can
also have abdominal fullness with pain. These patients if they aren’t ventilated or intubated
they most likely will be unless they get help and get help fast.

The goal in severe cases is to consolidate the divergent channels the pathogen is in while also
opening the chest, clearing heat and transforming phlegm. A patient in a very severe state such
as Mrs. Deer was in the acute pneumonia phase and so while transforming and clearing toxic
phlegm heat was working, once we took the symptomology in to account according to where
the pathology was in the divergent channels, those divergents were consolidated and we made
headway quickly. For her, overnight massive changes occurred. The night of her divergent
treatment between 2-3 AM she began to cough and expectorate like she never had in the four
weeks she was sick. This is the time that the Qi of the body circulates from the Liver channel to
the Lung channel. Mrs. Deer’s Yang Qi had consolidated enough so that as the Qi in her body
moved into the Lung Channel she had enough Qi consolidated to strongly and effectively push
the majority of the phlegm out of her chest. As seen from the pictures of the tongue the day of
the treatment and the next day after the treat. The consolidation the LI/LU level allowed her
body which was struggling with the toxic phlegm heat due to being exhausted of resources to
consolidate her yang to push the pathogen out of the lungs. Divergents in the lower 3
confluences have difficulty fully releasing pathogens out of the body. Particular in acute
patients consolidating the resources in order to push the pathogen back up through the
divergents to the first three confluence of the leg channel in order to release them there is the
most effective because by that time the body has started to recover resources to mobilize to
move the pathogen out. Think of it as defragmenting the system after the pathogen or
pathogenic state has fragmented it. In early computers a person would have to ‘defragment’ a
hard drive because the memory of would become fragmented as the computer was used and
different areas of the hard drive were used for different things leaving pockets of free memory
that weren’t together in a large enough group to be usable. This is one of the effects of the
divergents in the body. They gather the resources of the body to stabilize and support and
move pathogens into or out of latency and out of the body. Divergent channels do not have to
be done in pairs. They do not have to be used elementally. You can identify the level at which
the pathogenic symptoms lie via asking questions, taking the pulse and looking at the tongue.
You can gain insight into if the patient is deficient in the humors needed or at the level of the
pathogen. From there you can figure out what to consolidate and clear. For example, in the last
treatment of Mrs Deer her primary symptoms were heat, yin deficiency and dryness. She still
had a cough and her pulse were slightly wiry but the substance of the pulse vessel had gained
consistency. She had been complaining now about a dry mouth but the heat signs in her body
had subsided as we had consolidated the LI/LU divergent and included points to help that level
clear heat. The pathogen could now be moved upwards and the body started gathering its
resources. As she was not experiencing other symptoms such as neurological issues, severe
heat or phlegm we adjusted the treatment to support consolidating Qi and nourish fluids with
consolidating SJ Divergent who’s symptoms include excessive dryness and loss of appetite
due to the nature of this divergent channels physiology and clearing GB divergent to clear
lingering heat that was coming up from deeper levels causing coughing and heat and
constriction along the SCM while anchoring Lung Qi to Kidneys to further strengthen her
breathing. Post treatment her pulses had filled more and become slightly slippery and her
coughing had softened.

Pre Treatment first day Post Treatment 7 days later

Today Mrs. Deer is in the minor convalescing stage. 7 days ago he was critical and had
determined not to be ventilated or intubated. Her sister, a physician of acupuncture sought out
help. The case was taken and analyzed and treatment began in earnest with effective dosage
and a discerning eye for changes in the pulse, tongue and patient’s condition on a minute to
minute bases when in front of her and a daily bases between treatments. Mrs. Deer had severe
lung scarring before coming down with COVID-19. She has been on prednisone and albuterol
for the majority of the last decade and is not able to exercise much due to the severe asthma
she developed due to the lung aspiration. She is overweight by 80 lbs at the time of coming
down sick with COVID-19 and has excess water weight due to prednisone. Prior to knowing
she had COVID-19 she was taking ibuprofen to bring down her fever. She is 59. These things
all put her in the crucial category for COVID-19 being deadly. However within 3 days she was
out of the severely critical stage by the fourth day she was back to teaching online and in
another 3 days she was folding clothes and walking people to the door as they left. Chinese
medicine has the ability to treat COVID-19 and treat it fast and effectively. We have the ability
to treat at every stage of the disease and save lives. We hope this case study gains traction
and puts chinese medicine physicians who are able in mind and body into the ranks of frontline
healthcare workers treating COVID-19 patients. Chinese Medicine has and will continue to save
countless lives.

- The Balko Boys