manifest as -
general infection or inflammation
Gall Bladder
Liver
small Intestine
Headaches

FEVERS - Purgatives

Used mainly with TIPA, fully ripened fever due to contagion, dropsy, fever of organs, leprosy, excess of serous fluid. Gout,arthritis, worms in stomach, blurred vision, wounds which don't heal.

1. Not to be taken :
patient with low energy, elderly patients, pregnant patients, increased or decreased Lung, weakened dig. heat, piles, person prone to vomiting.
2. Right time for purgatives:
Winter is a bad time.l   Decoction given 1st to eliminate. When dispersed, then given to accumulate, too tight, then loosen, mujst be stimulated enough for ailment to come out properly.  If ailment is too high in intensity, then purgative med. would have no effect.
3. Will patient be able to tolerate:
Fully ripened fever, too much Tipa, no appretite, very weak pulse, low dose will have strong effect, too high dose will leave patient too weakened and open to further problems.
4.Preliminaries:
With a long-term illness, more time to do longer preliminaries.  Short, sudden illness, not much time for decoctions (Tipa).  If ailment is fully disturbed, try to stimulate ailment into coming together.  When ailment is too concentrated, decoction should loosen a little so purgative can work.   1 month, 15 days, 7 days for preliminaries - different decoctions, ailment is concentrated or dispersed.

Medicinal Bath:  2 handfuls barley + 1 kg. Artemesia chopped.  Water in pot, boil, becomes juice, when lukewarm patient should BATH in it.
After bath, massage with butter (or oil). Too much Tipa, then use cooler oil, too much Badkhen, then use sesame oil.  Do not massage digestive portion, disturbs digestive heat.  For Lung, drink melted butter. 
Digestion very hot, constipation, chew a piece of Terminalia Chebula.  Fish, porridge of Nettle leaves, URTICA, subsides Lung, but aggravates Tipa.

Testing, on eve. of purgative, given 1 hr. beforehand: TERMINALIA CHEB. RHEUM PALMATUM, give a little, see if any movement. Shows how much med. should be given to a patient.  Terminalia 4, might add some supp. meds, according to constitution of patient.  ARURA - elongated, has effect of purgative, 16 different types.

1. ARU - Term. Cheb.
2. DAN ROK - Ricinus Communis
3. DUR CHI  - Euphorbia SP
4. SHRI KANDA - Rhus. Verniciflua Stokes     - lst detoxified
Basic Mix - can be decoction, powder or pill.  Suppp. meds. can be added for different constituents.   Term.Cheb. completely devoid of toxins, but in the use of purgatives, T.C. has to undergo detoxification, TC kept in hot amber. 
For elderly, low-energy patients, decoction is quick and effective.  Strong patients can use pills, slowly and gradually have full effect.  For vomiting patient, pill is better.
5. Time to introduce - best in morning.  Healing Buddha prayers, mantra.  Sit upright, not to move too much or talk too much.  Stimulate the Lung energy to get downvoiding Lung moving (try to evoke the downward-voiding Lung).
6. To hasten to procedure:
'Whipping procedure' - make horse run faster, make med. work.  Important to do at the right time, after consuming the medicine, patient feels more relaxed, but if feels nauseous, may aggravate and patient may throw up.   Too late, and slows down.
Hastening procedure:   Lung patient - meat soup.   High energy patient - jaggery.  High fever patient - ice-cold water.   Water with rocksalt is usually given.
7. Regulating:  too much Tipa 30 times  to purge, 20 times to purge, 10 times to purge.  Again give hastening med. going again, but know when to stop as energy is lowered.   More able to evacuate, considered more helpgul.
Colour - watery, nature of ailment has gone.   Mucus-y - Badkhen present, must carry on with purg. Yellowish - too much Tipa, carry on.
But also check patient has enough energy to continue.
8. When only water comes out, give patient rice porridge, tsampa and salt - lost in diarrhea.     Cold water, tsampa, helps to stop patient evacuating. (LUNG). For TIPA patient, yoghourt, lassi, for BADKHEN patient, lamb soup.  Tsampa, water, butter, cooked into paste, acc. to humour.
9. Negative effect of strong purgative - too much increased Lung, degeneration of dig. heat, loss of appetite, increase of Badkhen and Tipa. Must increase body heat, appetite etc.
10. Purgative method usually very good effects.   Good digestive powers, gaining appetite, lightness of physical body, intelligence is enhanced by lightness of body.

LIVER DISORDERS         (90 types in all)

MUST CLASSIFY LIVER DISORDERS AS HOT OR COLD.
Site where nutrients turn to blood.   Reddish-brown in colour, to locate it, hold the ear, it is where the elbow is. Causes and causative factors - type, symptoms, treatment.   Causes - food which is hot and sour( heating) in taste.   Improperly cooked meat, excessive consumption of alcohol, strenuous physical exercise. 
Hot and cold - 13 hot and 6 cold types of disorder.  7 follow:

1. Fever in the Liver -
Symptoms: unripe fever (Badkhen and Lung).  Thirstiness, enlargement of liver, bloating. When taking pulse - thin and light, below the middle finger the pulse is piercing.  Urine - brownish/yellowish. 
Treatment:  Decoc. Saffron 13, Mensil, cooling - (secret oral trad.)  Diarrhea - Shilajit 9, gallstone 9 and Chirata 8. Asphalt Dadud (Crystal Moon essence)  Acess. therapy - blood letting below elbow, Kyu-ru 25, Gooseberry 25.    Preventatives - less sour heating  food, alcohol.

2. Dembu disorder -
No pain, heat in liver has become chronic, due to causative factors 1.  natural causes 2. due to improper medication.  Hot and sour food further aggravates chronic fever.    Symptoms:  insomnia, lethargy, heavy body, losss of appetite, low b.p. (hypertension) loss of weight, dizziness, sometimes diarhhea and vomiting.   Skin colour - ash,  Pulse - thin and sunken, Liver pulse - tight and pierces, comes up like a needle piercing. 
Treatment: Dashel (Crystal Moon) Decoc.: Gt. Decoc. 25.  Loss of weight, heavy body - Shiser, Pacifying Myrobalan, Dadud, Cry. Moon essence. Depresstion - Agar 8, (Eaglewood 8) Gt. Decoc. 25, Shilajit 9, Mineral Pitch.

3.  Dugthabs (like poison)  -
Too much cold water, body not kept warm enough, not enough food and sleep, liquid from stomach very sour and foul smelling.
Symptoms - lose body colour, complexion becomes dark.  Blemish on liver region (skin). Lose nail radiance, foamy saliva - colour of burnt turnip due to too much bad blood caused by brown Badkhen disorder - BADKHEN sMUGSPO.
Liver cells deteriorate, become smaller - Elderly man - all symptoms - Allopathic med. ineffective.  Felt Liver hard as a rock, extremities thin. Oedema, 3 days to live. After TM pain alleviated, lived for 20 days.   LIVER MED. IS VERY STRONG.   Oedema is accummulation of fluid in organs.  Diet which is not nutritious and too much alcohol. Left and right ribs, patient who died, eyes reddish.  When you feel the liver, the arteries of the neck become visible, rapid heartbeat, cheeks, palms of hands and feet are yellow.  Urine - reddish, when cooled, sediemnt in bottom of container.   Tongue - yellowish with white patches.
Treatment for inflammation - GALLSTONE 9 and CHIRATA 8, MENSIL.  Sometimes a precious pill every 3 days - OLD TURQ. 25 (YU-HYING 25)

4. Chin-gyud -
Degeneration of the Liver.   Badkhen in Liver, bad diet (malnourished) cold food, sitting in damp and wet places.  Manifested by: FRUIT AND MILK TOGETHER, raw vegetables.    Symptoms: indigestion, pain after eating (unique symptom). Liquid coming up into mouth, bloating, belching, lethargy in morning and evening, hypertension, low b.p., loss of weight, digestive heat suppressed.  Liver pulse extremely weak, pain in somach after eating, excess Badkhen in Liver. 
Treatment: indigestion, give warming medicine,  DANG NE, POMEGRANATE 5, YU RIL (Rolled Turq. 13). Less raw or cold food, refrigerated food, stay away from  damp, wet and cold places. 

5. Chin Lung - 
Excess of Lung in Liver - metabolism of the Liver becomes weaker, similar to degeneration of Liver (4).   Caused by insomnia and depression.  Symptoms - disomfort, pain in the back, loss of appetite, pain in stomach.  Yawning, short tempered.   Liver Pulse - empty, general Pulse, thin and tight. Urine - reddish yellow with BIG bubbles, Tongue - red, dry and rough - all symptoms of Lung. 
Treatment: activate metabolism of Liver, bring down Lung.   AGAR 8 /POMEGRANATE 5 - 1 med. combined.  DANG NE, PACIFYING MYROBALAN.  Regular eating habits to regulate.   (Pipeline - Liver against Lung)  Pipeline syndrome - one organ to another e.g. Liver pipeline to Kidney

6. Hor Lung - 
Fallen off, excess Blood and Fever - goes to kidney (lower part of body).  Symptoms: numbness of right hip, lower back pain. 
Treatment: decoc. of 3 Fruits, separates impurities in the blood. KIDNEY MED:  MYROBALAN 10 and 18.
After med. MOXA on 8th and 9th vert.

7. Cold Liver disorder - 
Indigestion.  Unique symptom: watery eyes, hiccups, pain after food is digested, pale complexion. 
Treatment:  POMEGRANATE 4 and 8 SASSUREA (Costus 6).  No cold food or behaviour.

TIPA DISORDERS
Tipa - digestive heat (or lack of it) is REAL CAUSE of disturbance.  Too powerful, dries up/burns 7 body constituents cannot go through transformation process, person becomes weak, bad digestion - nutriment process hampered - dig. heat cannot be raised - all 3 humours are involved in this process.
Disorders of BLOOD and BILE - yellow eyes, bleeding gums, reddish urine, thick yellow coating to tongue - extreme excerise in the heat leads to Tipa disorder.

Tipa disorders - can be Cold as well as Hot - digestive Tipa or vessel Tipa (Gall-bladder, sharp, hot food - Tipa disorders come from aggressive exercise, strenuous phyusical experience - falling down a big hole, walking for most of the day, sitting near fire, sunbathing for too long. Indigestion resulting in Tipa disorders is more Cold Tipa.
Anger, hatred - Bile/TIPA - cool places and special baths

47 different disorders:
13 disorders, 3 basic classifications:

1. High Fever.  Intestinal portion, Hot Tipa associated with Blood and Bile.  Cold Tipa, associated with indigestion, Lung and Badkhen

2. Specific symptoms: Lung indig. in Blolod, eliminates Tipa heat.   Lung and Badkhen suppress Tipa heat. Increase of Cold potency, decrease of Hot.   Potency degenerated.

3. Cold symptoms - indig. and Badkhen. General symptoms - always evident inthe following cases.  Lung factor - Flatulence and constipation, yawning (Bhutan).  Hot dis. diet and behaviour - feel better. Digestive heat not only dig. TIPA, can also be digestive portion of Badkhen and Lung. (see below)
Excess of Badkhen, decomposing Badkhen takes over Tipa.   Remember digestive heat is 3 humours.
Physical mass of dig. Badkhen, but not only this, individual's nature important.  Indigestion Badkhen - heaviness of physical body, sleepiness, lethargy, loses interest in things.  Food of cool and rough heavy nature - patient aggravated.  Blood, elimination of Tipa heat, dark red stool.

4. Vessel Tipa symptoms:  Tumour in Liver, enlargement of liver, squeeezing of gall-bladder and bile.  Patient has some appetite, but has feeling of nausea.
Palpitate portion of tumour - very hot and patient feels pain.   Gall bladder tumour, lack of appetite, itchy, yellowish complexion.  Accident or injury - patient has high energy, bile from stool, vomits penetrating channel, acute headache, accumulation of tension and pressure on back, liver area tender and painful.  Urine red.  Disturbed fever - perspiration and itching. Very contagious fever - passed  by clothes, penetrati\ng other pathways, shivering.   Pulse - strong, superficially more pressure, disappears, becomes empty.  Headache and pain in joints, disturbed dreams.  Urine initially clear, but becomes turbid, more chronic - urine specimen becomes dark.  Complexion yellowish.  SHE-DUNG - bittter taste on palate, hot flushes, headache, cracks on lips and tongue, accumulation of tartar between teeth, area around Liver and gall-bladder acute 'rolling' pain.  Problem critical - pungent odour from body, depletion of aura.
Sleeps a lot, degeneration of energy, always tastes bitter, even when eating sweet things.  Complexion turns yellow, sees yellow instead of white.  Nails turn yellow.
Yellow conjunctiva, perspiration, feels heat in body, pain in socket of eye.  Loss of appetite. Strong unquenchable thirst.  Lot of vomiting. Critical patient will have lot of rainbow-type colouration. Itching.
General symptoms above always associated - should always know potency of medicines. 
Dark tinges on yellow complexion, loss of hair, eyelashes and eyebrows.  Muscle loss. black dots on nails - nature of Tipa has been completely overpowered.   Impossible to cure - spiritual practices.
THANG means decoction - good for Tipa. 
Indigestion meds. to counteract indigestion even if TIPA disorder.

Lymph and worm disorders are common to all three humours.
 

STOMACH DISORDERS AND  TREATMENT
Proper digestion is essential for body's health.

1. Defining the human body
2. Digestive system
3. Cause
4. Conditions
5. How the digestive system is disturbed
6. Types of stomach disorder
7. Cures
8. Prevention - 'If a physician knows how to fix a stomach disorders he is a well-trained physician'.

2. Harming Body - 3 humours

1. Life-sustaining Lung
2. Ascending Lung
3. Pervasive Lung
4. Firelike Lung                          Areas harmed: Blood, bone, bone marrow, fat

1. Digestive Tipa 
2. Colour regulating Tipa
3. Complexion clearing Tipa
4. Sight Tipa                              Areas harmed: Urine, perspiration , faeces

1. Supporting Badkhen 
2. Satisfying Badkhen
3. Experiencing Badkhen
4. Decomposing Badkhen          Areas harmed: 7 B.C.'s, 3 Waste products

Disturbance in any of the above leads to disorder.

2. Digestion always involves digestive heat
 

Digestive Tipa
is main Humour involved in stomach disorders, stomach regulated in central portion, digestion is separation of essential nutrients from foodstuffs, promotes heat, fights infection, maintains proper body function, good complexion, radiance and long life.

Decomposing Badkhen 
resides in the epigastridc region (upper part of stomach). Function is to break down solid matter to semi-liquids.  Facilitates function of other remaining types of Tipa.

Fire-like Lung
lower portion of stomach (see diagram Bk 2 '98) top: decomp. Badkhen/ middle portion: dig.Tipa/ bottom portion: Fire-like Lung.  Alimentary channel, digestion, absorption of nutrients, separation from waste matter - ACID.

3. Digestive Heat
Large Intestine/Small Intestine - digestive heat in balanced state turns food into blood, muscle tissue, fatty tissue, bone, bone-marrow and regenerative fluids. 
Cause of stomach disorders  -Improper diet and behaviour, excess of Bitter and Sweet, Heavy and Cold. SWEET taste, SOUR taste, SALTY taste, BITTER taste, HOT taste, ASTRINGENT taste.

SWEET            - Earth and Water Element   -  most harmful to the stomach
SOUR              - Fire and Earth                      -  second taste most harmful to stomach
SALTY             - Water and Fire
BITTER            - Water and Air
HOT                  - Fire and Air
ASTRINGENT - Earth and Air

Conditions

1. LUNG Nature and BADKHEN Nature more prone to stomach disorders due to nature. COLD - EARTH, AIR, WATER, less FIRE. Weak, skinny, un-nutritious food, avoid exercise, tension, depression.  Damp and cold places, waring thin clothes.  Erratic intake of food.

2. Intake of diet to which one is not used or taken at different time - middle of the night (e.g. air travel). Always a gradual approach, not extreme measures.  Try to take new foods in small quantities - kalli kalli. 
Habituation or continuity - one can get used to eating around mid-night )night workers etc.  Then it 's ok.

3. Improper Diet
2nd Tantra, 16th chptr. Different Diets which are recommended/not recommended together.
Not recommended: Milk with lemon juice and all fruits. Citrus fruits are worst.  Eggs and fish.  See 6 Tastes, 8 Qualities, 17 Secondary Tastes and 3 Post-digestive Tastes.   Contradictory tastes, qualitites, secondary qualities, post-digestive taste.
Research needs to be done on food.

4. Hard to digest diet. Unripe fruits/veges. Rotten foods, meat of sick animal, unboiled milk, raw foods, raw veges. Salads are Water and Earth (bad for Badkhen, could steam - warmer) old veges, not properly cooked food, thuk-pa properly boiled is good for heat-generating.

How the digestive system is disturbed.
Decomposing Badkhen cannot do its job. Digestive Tipa cannot do its job. Fire-like Lung cannot separate essence from waste-matter. Increase mucus in stomach, blocking of air passages.
Types - 7 hot stomach disorders, 9 cold stomach disorders - 16 stomach disorders.

Cures - HOT disorders more influenced by Blood and Tipa, COLD disorders more influenced by Badkhen disorders.
Lung fans  both hot and cold disorders.

Essential nutrients, blood.  Essence of food broken down by decomposing Badkhen, Digestive Tipa.   Fire-like Lung separates waste and essence. (See diagram Bk 2 '98). Essence goes to Liver - makes blood.  Impure blood goes to Liver if not properly digested. Blood vessel from Liver - pure blood throughout body, impure blood also goes throughout body - leads to difference kinds of disorders.

16 TYPES OF DISORDER

Hot stomach disorder symptoms: vomiting, diarrhea of Blood and Tipa, any kind of diet and behaviour which is very hot OR very cold is harmful.
Cold stomach disorders: pressure in stomach, pain after intake of food, food not digested properly, watery diarrhea.  Can't bear cold and wind.
Digestive heat which is too high is a disorder.

Cures
4 different kinds: 1. Diet  2.Behaviour 3. Medicine and 4. External Therapies.
Consider age of person: Child, Adult, Old Age.  Consider physical condition of patient.  Person could look strong but inside weak.
Diisease mild, moderate, serious.
Ripening time of disease - seasons, 
LUNG - summer, ripens Evening, accumulating dawn
TIPA -    autumn, ripens noon accumulates midnight
Badkhen- Spring, ripens morning, accumulates dusk

Curing Hot Stomach disorders
Early stage: Diet and Behaviour - First treatment
More serious: Venesections - ru Tong - vessel on outer arm   Gyab-Tsa - veins on back of hand

Cold Stomach disorders
Golden Hammer on Sternum pt. and 1 tsun below, then 2 tsun below. 12th vert. Hot therapy, Golden Hammer therapy on top of joint.

1st protusion on neck when patient bends forward sitting down is 1st vert.
Diet - Light quality, easily digested, warm. avoid raw veg. salads, stay in moderate temperature.

Prevention
Adequate proportions of food, liquid plus free space.  Strong digestion takes more food. Don't eat before previous food digested.

SPECIFIC METHODS OF TREATMENT (not related to Mental Disorders)

Should not treat only for symptoms, e.g. headache may go. May be caused by Lung or Tipa, or old sinus problem. 'Cat waits for mouse to appear, then pounces'. Pulse taken, urine taken, still in doubt re Lung - try warm soup before patient goes to bed, if good rest, feels better, then its Lung. If patient feels nauseous, then its Tipa.  To detect Tipa (nausea could be either Tipa or Badkhen), give TIKTA decoc. For Tipa: TIKTA is CHIRETTA (SWERTIA CHIRATA - there is a Nepalese type) - chop and mix to decoction in warm boiled water; grows in Manali, can buy from Indian shops. Or TIKTA 8. Patient feels better, its Tipa.  To detect Badkhen giveGYAM TSA SUM THANG (3 ingredients). After one day, check with patient. If better, then its Badkhen.

Cramps - JA KUNG 5.   Bad water, bad food - one can keep these basic mixtures around all the time.  Blood and Lung - sitting reading on train, sitting by computer.   MANU 4 decoc. relieves pain and fever - doesn't mean patient needs to have fever.  Will separate, if more Lung,will show Lung symptoms.  If more Blood, will show Blood symptoms.   THANGCHEN 25 - headache, vomiting, sweating, thirsty. - 4 pills, crushed. Boil in cold water, when luke-warm drink.  Brings out black impurity in vomit or stool.

Hot or Cold?  PRESCRIBE HOT MEDICINE ANYWAY.  Ask patient how they are.  Better, then cold disorder.   Worse, then hot disorder. Then prescribe exact medicine. HOR MOXA - Nutmeg, carum carvii.  Dip in warm seame oil, make sure doesn't burn cloth.  Use on patient, on palms, soles, neck, crown - for Insomnia.   When we know whether hot or cold, and patient doesn't get better, then change diet or medicine.    Don't speak against other doctors.  "Kingfisher" style of watching and waiting - then pounce. 
Step by step - like ladder.  Golden Needle, G.H.(moxa.) drastic treatment, not done first and not proper remedy just by itself at start of headache treated by GH - disappeared after 2/3 weeks - symptoms return.   Cannot keep giving GN or GH cannot take so much heat.

To prescribe without side effects.   None if patient treated properly - balanced for 3 humours in body.
12 reactions possible: Lung - sweet and salty - but  EXCESS causes Tipa to arise.
Tipa - sweet and bitter - excess causes Badkhen and Lung to arise.
Badkhen - hot and sour -  excess increases Tipa and Lung.
Hot and Bitter treatment for Lung - Tipa arises
Salty and Hot treatment for Tipa - Lung arises
Sweet and       treatment for Badkhen  - 

Common cold can be infection in lungs. Take care with diet and behaviour first, but WATCH.
Combined disorder - when Tipa combined with Lung, Badkhen combined with Tipa.
Combination of plants in medicine.

LUNG                  - rythmn of Heart is not good, palpitations (weak heart?): 
HEART med.        - AGAR 8 and 20 - add nutmeg oil therapy on points.
LUNGS                - CHU-GANG  (Bambusa Textilis)
LIVER                  - Saffron (Kashmir best quality)
LIFE-CHANNEL - Clove/
COLD KIDNEY  -  Small Cardomom (sok-men). Prepare like tea, weak circulation, cold hands and feet.
SPLEEN              - Large cardomom - dryness of lips, cracks in lips, cold sores, lip problems

Weak digestion - Pomegranate and Long pepper. Stomach power :   SEDU/  PIPI LING.  Take a.m.

Balanced remedies:  Diffferent loads for yaks and sheep - take into consideration.   Take note of 7 b.c.'s, environment, seasons, time of day, one's own nature, age.  Natural element of disease, phellgm, wind, bile.  How strong is the digestive power? Strength -weak physique or strong.  Habits, lifestyles, Tibetans or Westerners, cycling, NOT TO EAT POTATOES.
Location of disease - stomach, spleen, heart, weak kidney.       Hepatitis or Jaundice is TIPA.

TIKTA is CHIRETTA (SWERTIA CHIRATA - there is a Nepalese type) - chop and mix to decoction in warm boiled water; grows in Manali, can buy from Indian shops. Or TIKTA 8. 
 

HYPERTENSION

Blood propelled to upper  portion of body - LUNG role in constitution of body.
Pressure of Blood - not mentioned in Texts - Yuthok the Younger has some b.p. mention. 
Manifestation of ailment - cause and characteristic - BLOOD AND LUNG in its dynamic equilibrium stated as the CAUSE.    Foods ingested, LIVER further converted, sustaining our life - is Blood.   Mobile, light, rough, MOVING - vital energy of the body, throughout channels propelled - low level  to transference of consciousness.   LUNG - 5 types - pervasive Lung has the main role in this ailment.
Location - HEART, circulation, movement of body. 
BLOOD AND LUNG in dymanic state cause of Hypertension.
Black life channel involved.  Yuthog Gonpo Snr. - Blood, mind and channel - increase of Lung energy tends to be involved in this kind of ailment.  INCREASE in blood involves this ailment.
Must be treated in time, if neglected - stroke, sight affected, brain and kidney, arteriosclerosis.
Condition which results from fasting, sleep (lack of) stress, too cold places,  too much mental/physical acitivity, mental turmoil, staying in nosiy, polluted places.
Consumption of: strong tea, coffee, light, mobile and rough foods, LUNG foods and lifestyle contributes to blood being propelled to upper part of body.  Physical activity, sitting by fire, hot sun etc. Consumption of: alcohol, too much fat, oily susbstances, heat generating factors, so extremes of  BOTH HOT AND COLD are bad.
Disturbed nature of LUNG - Too much alcohol, too much coffee, too much salt, eggs, meat, greasiness in diet. Smokers at risk.  Competitiveness.   HT used to be with older people, but now younger people get it too.
Additional causes can be - changing place of residence, change from plain to mountain - studies in China show this to be MAJOR CAUSE.

PULSE:  Hypertension has STRONG heartbeat but superficial, pressure on and feel BULGING.  Shows characteristics of  LUNG, superficially bulging.
HEART - disappears in between, seems to LIMP - going on for some time.
Changing pulse - weak beat, pressure on, rough/tough and strong beat.

URINE - red in colour, Blood. BIG bubbles - Lung influence, disappearing bubbles, whitish steam.

SYMPTOMS:  Acute headache, pressure in head, painful eye-socket, pain and pressure on shoulders, backache  and chest pain (contraction and tension rather than pain).

1.   KOCHI NA 5 - Decoction - check  nature of ailment.
2.   MEN NYAR   AGAR 8   - Lung  - new chang
3.   MEN NYAR   AGAR 12 - Blood - cool boiled water
4.   AGAR 35  -  too intense
5.   AGAR 19  -  Fresh chang/plain water    (moderate)
6.   AGAR 15      moderate

ACESSORY THERAPY

LUNG:   Moxa, oil compresses, Golden Hammer on vital Lung points - 6th and 7th vertabrae, sternum (and naval?).
Too much pressure on the back - then cupping and 1st vert.   Specific point of pain, cup at that point - beneficial. 
WATERBED STONE, donít expose to light - massage on point.  For BLOOD.
Oil massage for Lung points. (Vital points)
LUNG: Crowds, listening to loud noise bad, talking quietly with friends good, patient to RELAX.
Moxa. on the 3 spec. pts, 6 and 7 and sternum   - good for afterwards but quite a ROUGH, LAST RESORT treatment.
Critical patient - ARNAK 7 (optimum combination of Black Agar (AR NAG TSE DEN KI JOR VA)

LUNG type Blood Pressure:
1.   KOJI 23    - pain all over body
2.   KOJI  7
3.   DORJE RABJUM (DO RAB)

BLOOD type Blood Pressure:
1.   AGAR 35  - pain all over body. Put in fire embers and burn like incense. Mix with butter and apply to specific pts.
6.   AGAR 20
7.   KU RU 25  (Embelica Officinalis Gaertn.)
8.   GALO MEN MAR
9.   MEN SIL
10. DUTSI SUMJOR  - Sassurea Lappa  (Ru Ta?)
11. SER THANG 15  - pain all over body
12. AGAR 15 -. MODERATE AND HELPS IN BOTH CASES OF BLOOD AND LUNG. Pain all over body because of serous fluid/Arthritis.  Give medicine for ARTHRITIS, not going away, know its BLOOD PRESSURE.   HT Nerve Disorder.
Temporary problem of Cold - MANU 4 (THANG), TRIN DA, SIL CHOG 15

Neglected HT: Kidney, brain stroke, Blood pressure affected: SAMNOR, LA MAY (AGAR 24), AGAR 20, DALI 18, MUTIK 25. 
Weakened patient -  RATNA SAMPHEL/MANJOR - precious pills.
Post-stroke           - stiff muscles - JUMAR 25.
Swollen eye-lids, tender at hips, face swelling - KIDNEY kept in mind.

TO DILUTE BLOOD - TSEN DEN 18   (Che Mi Ar Gay?)
 

HYPERTENSION - combination of LUNG and TIPA

Tastes which cure:
LUNG - SWEET, SOUR SALTY                       TIPA - SWEET, BITTER, ASTRINGENT

Qualities which cure:
OILY(but not excess of greasy), HEAVY, SOFT          -  THICK, SOFT

Tastes which aggravate:
LUNG - BITTER, ASTRINGENT                     TIPA -  SALTY, SOUR (Sour is heating)

Qualities which aggravate;
COARSE, ROUGH, COLD           - ACRID, HOT

Necesary to strike a balance between the two contributing factors.

TO AVOID:  Coffee, salt, heavy, greasy food, strong tea, eggs (chloresterol) not too much yoghourt (sour) - so intake of coffee should be reduced and eggs too.

TO TAKE: SWEET is good for both LUNG and TIPA (Blood) so: Honey, raw cane sugar, raisins, sweet fruits Grapes are very good, wheat, flour products. Oat porridge with raisins and honey good. Grilled tomatoes on toast, grilled bacon.

FISH is good.  WARM AND LIGHT.  Can lightly fry fresh fillet rolled in flour and herbs with gresh green vegetabls  - good for Blood cleansing.   CORIANDER is a good blood cleanser - add the leaves as seasoning to dishes.   Donít skimp on food.   Lack of proper food INCREASES LUNG. Fresh wholesome food and steamed green veg. Spinach is very good, softening.

BEHAVIOUR. Donít get cold, donít tense up against the cold.  Warm baths and create calm. Approach life with Buddhist View.   Try to eliminate suffering/worrying - apply the antidote of the Teachings.  Cultivate mindfulness.   When worries arise, take steps to dissolve.   Be present only! Remember: Eat when I eat, sleep when I sleep etc.  This is most important for a calm state of mind.

NUTMEG and CLOVE are good for the Heart -  add to dishes.
DANDELION tea is good for  the Blood.

RED WINE  can be helpful - not more than two glasses per day.

RATNA SAMPHEL, TSAN DAN 18, AGAR 8, 12, 15, 30, 31. OL GE 27, KYU RU 25. Embelica Officialis Gaertn.   ZANG THIK - Gentiana sp, SER THIK (also Gentiana?)  Gentiana Straminea, Swertia Petiolata, CHUK THIK KARPO
 

MOUTH ULCERS

Mouth ulcers are Hot and Sharp - TIPA - Need COOL and SMOOTH

Not too much SWEET taste

RUTA - Sassurea Lappa (easy to propagate, lower altitudes), SEH SAYR, ASTRAGUS FLORIDUS, 
TSEN DEN KARPO - Santalum Alb. Rubia Cordifolia

SHRI KHENDRA - Euphorbia Royleana - heals abcesses - available in Nepal

Aconite is Bitter and Cooling