New Member and New Case Study: Constipation

[Guest guest]

Hi All

I am a new practitioner(7 months experience). I am happy to be a

part of this group and am humbled by the experience and expertise of

its members. I am drawn to the Matsumoto style of acupuncture

(Japanese)and try to incorporate it as much as possible.

 

I could use advice on this case. I am treating a 46 y/o female

patient for chronic constipation which started in childhood. She has

seen many other acupuncturists and taken many supplements to ease

her constipation. Nothing has provided long term results. Many

western supplements work for a short period then stop. She is a

competitive athlete and seminar instructor, which means she trains

and travels intensively along with her full time job.

 

Her constipation comes and goes. There are periods when it occurs

and periods when her BM is regular. No correlation to the cycle.Not

related to diet. Diet is good. Plenty of cooked veggies and fiber.

Generally worse in the fall. Some emotional trauma associated with

BM as a child which occurred in the fall as well.

 

When constipated she may have 1BM every 3 days. Stool varies in

consistency from dark pellets to a conglomeration of pellets which

is dark. Stool is difficult to pass and is probably dry.In put does

not equal out put. She also experiences gas and bloating. Her

digestion is slow-it takes 2 days for flax seed to pass thru her

system. She also has bad breath and a strong appetite, but little

thirst and prefers to sip warm water.

 

Sleep is good. Urination is normal. Mood ranges from frustrated to

irritible to ok. Energy levels can be ok to low depending on travel

and training.

 

She also has some nasal discharge(clear) and a history of psoriasis.

Her periods are regular 26 day cycle with 2 days of flow and 3 days

of spotting. She experiences nipple sensitivity B/4 her period.Also

acne B/4 period. No other PMS signs.

 

She has a history of hepatitis which was typed as non-A non B, but

not hep C.

 

She also has cold hands and feet and generally feels cold. Dry skin

and hair and brittle nails. No hot flashes or night sweats.

Complexion is pale with red cheeks.

 

Tongue is pale to normal colored body with toothmarks, a red tip and

a cleft at the tip. Coating varies from a thick yellow coat with a

dark spot in the center back to a thin white coat in front and a

yellow coat in back.

 

Pulses are deficient

 

Treatment:

Release Oketsu: Liv4, Lu5, immune point

Release Adrenal: Ki6, 27

L Ub35 to release R Ub18-for constipation

St25, 36, 37

 

No Herbs

 

Next treatment 10 days later due to travel schedule:

Bowels moved for 7 days after last tx but constipated last 3 days.

Attempted to release more of the Hara this tx

Release oketsu: Liv4, Lu5, immune pt

Release Liv2: Liv4, Liv8

Release adrenal: ki6,27

Release R subcostal area: R sp7,ht3,p4

Release cv9 reflex: sp9, sp3

 

Herbs:

Ma Zi Ren Wan

 

The above formula moves her bowels. Bowels will be dark

conglomerates that will move 3-4 times a day and then change to

skinny loose normal colored stool. I advised patient to stop taking

it when stools change.

 

If she stops taking the formula she becomes constipated again. The

acupuncture has been less effective and I am having trouble

releasing her hara.

 

Initially I was thinking I wanted to get her bowels moving and then

find a better formula suited for her pattern. My diagnosis is liver

qi stag causing st and LI heat with underlying qi, blood and yin

deficiency. I also think ther is some LU involvement too.

 

Advice would be greatly appreciated on dignosis, points and herbs.

Especially herbs. For a condition this chronic, how much time is

needed?

 

In the past with other practitioners she has taken Run Chang Wan and

Zeng Ye Tang with out sucess. She also takes pro biotics and flax

seed.

 

Many thanks, Diana

[Guest guest]

From a five element standpoint, I would look at the metal element in

your patient. You can certainly diagnois and treat on the TCM patterns

you see and you also may want to read up on the five element metal

energy. Basically you would use LU and LI points. Books are written by

J.R. Worsley ( Green and White Cover can't think of name), also John and

Angela Hicks wrote Healing your Emotions, and Jason Elias and Kathernine

Ketcham wrote for Maximum Immunity

 

mountainwarp wrote:

 

>

>

> Hi All

> I am a new practitioner(7 months experience). I am happy to be a

> part of this group and am humbled by the experience and expertise of

> its members. I am drawn to the Matsumoto style of acupuncture

> (Japanese)and try to incorporate it as much as possible.

[Guest guest]

Hello and welcome to the group. You mentioned that Ma Zi Ren Wan helped to move

this patient's bowels but you then have her stop this formula. You also

mentioned that Run Chen Wan had been tried but did not work. Run Chen Wan is

often too weak to start relieving stubborn, chronic constipation but, once BMs

are activated by stronger formulas, Run Chen Wan can then be employed to keep

the BMs going. The beauty to Run Chen Wan is that it can be taken for extended

periods of time with little risk of dependence. Your patient must be instructed

to modify the dosage as needed. I use the patent version of Run Chen Wan that

comes in pill form. While 4-6 pills can keep BMs going, one may have to increase

to 15 or more pills on occasion. The formula is so safe, the occasional use of

this increase dosage will not cause problems. Tell your patient if a certain

dosage is not working to double up to 20 at a time. If 20 does not do the job,

go back to the stronger formula until BMs start again. Then go back to Run Chen

Wan for maintenance. I have used this formula this way for nearly 20 years on

hundreds of patients without a single problem. Based on the signs you reported -

pale tongue, cold hands and feet, dry stools, lower energy levels - you should

probably supplement with more blood tonic herbs and keep up the acupuncture

treatments. - Matt Bauer

-

mountainwarp

Chinese Medicine

Friday, December 03, 2004 6:06 PM

New Member and New Case Study: Constipation

 

 

 

 

Hi All

I am a new practitioner(7 months experience). I am happy to be a

part of this group and am humbled by the experience and expertise of

its members. I am drawn to the Matsumoto style of acupuncture

(Japanese)and try to incorporate it as much as possible.

 

I could use advice on this case. I am treating a 46 y/o female

patient for chronic constipation which started in childhood. She has

seen many other acupuncturists and taken many supplements to ease

her constipation. Nothing has provided long term results. Many

western supplements work for a short period then stop. She is a

competitive athlete and seminar instructor, which means she trains

and travels intensively along with her full time job.

 

Her constipation comes and goes. There are periods when it occurs

and periods when her BM is regular. No correlation to the cycle.Not

related to diet. Diet is good. Plenty of cooked veggies and fiber.

Generally worse in the fall. Some emotional trauma associated with

BM as a child which occurred in the fall as well.

 

When constipated she may have 1BM every 3 days. Stool varies in

consistency from dark pellets to a conglomeration of pellets which

is dark. Stool is difficult to pass and is probably dry.In put does

not equal out put. She also experiences gas and bloating. Her

digestion is slow-it takes 2 days for flax seed to pass thru her

system. She also has bad breath and a strong appetite, but little

thirst and prefers to sip warm water.

 

Sleep is good. Urination is normal. Mood ranges from frustrated to

irritible to ok. Energy levels can be ok to low depending on travel

and training.

 

She also has some nasal discharge(clear) and a history of psoriasis.

Her periods are regular 26 day cycle with 2 days of flow and 3 days

of spotting. She experiences nipple sensitivity B/4 her period.Also

acne B/4 period. No other PMS signs.

 

She has a history of hepatitis which was typed as non-A non B, but

not hep C.

 

She also has cold hands and feet and generally feels cold. Dry skin

and hair and brittle nails. No hot flashes or night sweats.

Complexion is pale with red cheeks.

 

Tongue is pale to normal colored body with toothmarks, a red tip and

a cleft at the tip. Coating varies from a thick yellow coat with a

dark spot in the center back to a thin white coat in front and a

yellow coat in back.

 

Pulses are deficient

 

Treatment:

Release Oketsu: Liv4, Lu5, immune point

Release Adrenal: Ki6, 27

L Ub35 to release R Ub18-for constipation

St25, 36, 37

 

No Herbs

 

Next treatment 10 days later due to travel schedule:

Bowels moved for 7 days after last tx but constipated last 3 days.

Attempted to release more of the Hara this tx

Release oketsu: Liv4, Lu5, immune pt

Release Liv2: Liv4, Liv8

Release adrenal: ki6,27

Release R subcostal area: R sp7,ht3,p4

Release cv9 reflex: sp9, sp3

 

Herbs:

Ma Zi Ren Wan

 

The above formula moves her bowels. Bowels will be dark

conglomerates that will move 3-4 times a day and then change to

skinny loose normal colored stool. I advised patient to stop taking

it when stools change.

 

If she stops taking the formula she becomes constipated again. The

acupuncture has been less effective and I am having trouble

releasing her hara.

 

Initially I was thinking I wanted to get her bowels moving and then

find a better formula suited for her pattern. My diagnosis is liver

qi stag causing st and LI heat with underlying qi, blood and yin

deficiency. I also think ther is some LU involvement too.

 

Advice would be greatly appreciated on dignosis, points and herbs.

Especially herbs. For a condition this chronic, how much time is

needed?

 

In the past with other practitioners she has taken Run Chang Wan and

Zeng Ye Tang with out sucess. She also takes pro biotics and flax

seed.

 

Many thanks, Diana

 

 

 

 

 

 

 

 

 

 

 

 

http://babel.altavista.com/

 

and adjust

accordingly.

 

If you , it takes a few days for the messages to stop being

delivered.

 

 

 

[Guest guest]

Chinese Medicine , Anne Crowley

<blazing.valley@v...> wrote:

>Thanks for your suggestion Anne. There is definately a metal issue

involved here and looking at this case from a five element point of

view will give added insight. With much appreciation, Diana

 

> From a five element standpoint, I would look at the metal element

in

> your patient. You can certainly diagnois and treat on the TCM

patterns

> you see and you also may want to read up on the five element metal

> energy. Basically you would use LU and LI points. Books are

written by

> J.R. Worsley ( Green and White Cover can't think of name), also

John and

> Angela Hicks wrote Healing your Emotions, and Jason Elias and

Kathernine

> Ketcham wrote for Maximum Immunity

>

> mountainwarp wrote:

>

> >

> >

> > Hi All

> > I am a new practitioner(7 months experience). I am happy to be a

> > part of this group and am humbled by the experience and

expertise of

> > its members. I am drawn to the Matsumoto style of acupuncture

> > (Japanese)and try to incorporate it as much as possible.

[Guest guest]

Deal Alon - 19 years of practice averaging 50 plus treatments a week seeing at

very least 2,000 patients in total with at least 1 in 10 having chronic sluggish

elimination (not necessarily the more serious type discussed in this case)

equaling at least 200 patients. Any mutable of 100 constitutes " hundreds " . Matt

-

Alon Marcus

Chinese Medicine

Monday, December 06, 2004 12:25 AM

Re: New Member and New Case Study: Constipation

 

 

on hundreds of patients without a single problem.

>>>Boy, you have seen hundreds of patients with chronic constipation, what

type of practice do you have?

 

 

[Guest guest]

Alon and Matt,

I see about 2,000 -3,500 patients ayear with a simular

percentage of chronic -but not serious- cases of

sluggish elimination. so hundreds sounds right top\ me

too.

Doc

--- Matt Bauer <acu.guy wrote:

 

 

 

Deal Alon - 19 years of practice averaging 50 plus

treatments a week seeing at very least 2,000 patients

in total with at least 1 in 10 having chronic sluggish

elimination (not necessarily the more serious type

discussed in this case) equaling at least 200

patients. Any mutable of 100 constitutes " hundreds " .

Matt

-

Alon Marcus

Chinese Medicine

Monday, December 06, 2004 12:25 AM

Re: New Member and New Case Study:

Constipation

 

 

on hundreds of patients without a single problem.

>>>Boy, you have seen hundreds of patients with

chronic constipation, what type of practice do you

have?

 

[Guest guest]

About 40% of my practice is geriatric and I have around 25% or so of this

patient group on Run Chen Wan as it is so well suited for the elderly. I have

learned however, that it works for younger patients, even those with more

serious elimination problems, as long as you adjust the dosage and occasionally

use stronger formulas for short intervals when needed. - Matt

-

Doc

Chinese Medicine

Sunday, December 05, 2004 11:53 AM

Re: New Member and New Case Study: Constipation

 

 

 

Alon and Matt,

I see about 2,000 -3,500 patients ayear with a simular

percentage of chronic -but not serious- cases of

sluggish elimination. so hundreds sounds right top\ me

too.

Doc

--- Matt Bauer <acu.guy wrote:

 

 

Deal Alon - 19 years of practice averaging 50 plus

treatments a week seeing at very least 2,000 patients

in total with at least 1 in 10 having chronic sluggish

elimination (not necessarily the more serious type

discussed in this case) equaling at least 200

patients. Any mutable of 100 constitutes " hundreds " .

Matt

-

Alon Marcus

Chinese Medicine

Monday, December 06, 2004 12:25 AM

Re: New Member and New Case Study:

Constipation

 

 

on hundreds of patients without a single problem.

>>>Boy, you have seen hundreds of patients with

chronic constipation, what type of practice do you

have?

 

 

 

 

 

 

http://babel.altavista.com/

 

and adjust

accordingly.

 

If you , it takes a few days for the messages to stop being

delivered.

 

 

 

[Guest guest]

Hi Alon,

 

I agree that most aspects of healthy elimination can and should be dealt with

via diet. The average American diet is too dependent on animal sources (meat and

dairy) with too little vegetables and whole grains resulting in a low fiber

diet. Unfortunately, many patients are not willing to make helpful diet changes,

especially the elderly who are more stuck in their ways, and often are dependent

on others (caregivers, meals-on-wheels, etc.) for their nutrition and not able

to make changes. I also agree that different individuals have different rates of

elimination and one should not try to force multiple or even once daily BMs for

every patient. I can tell you though, that I have had literally dozens of my

patients thank me profusely for getting them on Run Chen Wan. They just feel

better. It is such a mild formula that never causes any feeling of urgency or

results in dependency. You just feel like you are having one of your better BMs.

It has been my experience that if people take a maintenance dosage for 1-3

months (perhaps more), it actually improves their elimination to the point that

they can stop regular usage and then take the herbs only when needed - maybe 2-3

times a month.

 

I go on like this about this not because I am trying to win an argument, but

because I really do believe in this formula and I have had so much success with

it. Matt

 

-

Alon Marcus

Chinese Medicine

Monday, December 06, 2004 7:27 AM

Re: New Member and New Case Study: Constipation

 

 

 

In my practice, and i see just as many patients, i probably have to treat

people's BMs 10 times a year. Now i do not think every one has to have multiple

BMs per day, and even if one has one every other day and no other symptoms i do

not try to increase their rate. Also, most constipation problems are solved by

dietary changes in my practice. I just cant see giving someone herbs for

prolonged periods unless there is a real problem

 

[Guest guest]

on hundreds of patients without a single problem.

>>>Boy, you have seen hundreds of patients with chronic constipation, what type

of practice do you have?

 

 

 

 

[Guest guest]

Anne Crowley wrote:

 

 

From a five element standpoint, I would look at

the metal

element in

your patient. You can certainly diagnois and

treat on the

TCM patterns

you see and you also may want to read up on the

five

element metal

energy. Basically you would use LU and LI

points. Books

are written by

J.R. Worsley ( Green and White Cover can't think

of name),

also John and

Angela Hicks wrote Healing your Emotions, and

Jason Elias

and Kathernine

Ketcham wrote for Maximum

Immunity

=========

 

 

*~Hello, yes agree...LU and LI should be looked

at. The Western Hemisphere now brings us the

sharpest of Metal...becoming colder and wetter.

 

Also feeling that warming the SP and ST are very

important. Cinnamon, warm mulled cider with a

touch of good red wine may do this. And the

smell in the house just about cheers up the

sulkiest of sours.

 

Have client become familiar with their tongue,

shape and texture...focus on the center...is it

cracked, scallops? red tip? I would first

address the parent Earth..is it sloggy?

 

So far, personal digestive alieviation is with

Triphala, a tri-dosha fruit ayurvedic formulae.

 

New here with much to share, thanks and blessings

to all aboard.

 

li*

 

www.geocities.com/mountainpalace/TianMing

 

========================

mountainwarp wrote:

 

 

> Hi All

> I am a new practitioner(7 months experience).

I am happy

to be a

> part of this group and am humbled by the

experience and

expertise of

> its members. I am drawn to the Matsumoto style

of

acupuncture

> (Japanese)and try to incorporate it as much as possible.

 

=====

 

 

 

*~Witness Beauty*~

 

*~Walk in Balance*~

[Guest guest]

In my practice, and i see just as many patients, i probably have to treat

people's BMs 10 times a year. Now i do not think every one has to have multiple

BMs per day, and even if one has one every other day and no other symptoms i do

not try to increase their rate. Also, most constipation problems are solved by

dietary changes in my practice. I just cant see giving someone herbs for

prolonged periods unless there is a real problem

 

 

 

[Guest guest]

It has been my experience that if people take a maintenance dosage for 1-3

months (perhaps more), it actually improves their elimination to the point that

they can stop regular usage and then take the herbs only when needed - maybe 2-3

times a month.

 

 

>>>Sounds good to me

 

 

 

[Guest guest]

My usual approach is dietary since that seems with my

patients to be the most common cause.

D

--- Matt Bauer <acu.guy wrote:

 

 

About 40% of my practice is geriatric and I have

around 25% or so of this patient group on Run Chen Wan

as it is so well suited for the elderly. I have

learned however, that it works for younger patients,

even those with more serious elimination problems, as

long as you adjust the dosage and occasionally use

stronger formulas for short intervals when needed. -

Matt

 

 

 

 

 

 

Take Mail with you! Get it on your mobile phone.

http://mobile./maildemo

[Guest guest]

Hi, Diana

 

I would think

 

Overall Qi def

 

Probably Sp/Lu Qi def He Qi def, Qi stag maybe Ki Yang

Def

I would start with Bu Zhong Yi Qi Tang or Huang Qi Gui

Pi Wan

 

St 36, Ren 6, Ren 4, Lu 9, Sp 6 and appropriate Back

Shu. Tonify all

4 Gates once in awhile

 

 

 

--- mountainwarp <twoocean39 wrote:

 

 

 

 

Hi All

I am a new practitioner(7 months experience). I am

happy to be a

part of this group and am humbled by the experience

and expertise of

its members. I am drawn to the Matsumoto style of

acupuncture

(Japanese)and try to incorporate it as much as

possible.

 

I could use advice on this case. I am treating a 46

y/o female

patient for chronic constipation which started in

childhood. She has

seen many other acupuncturists and taken many

supplements to ease

her constipation. Nothing has provided long term

results. Many

western supplements work for a short period then stop.

She is a

competitive athlete and seminar instructor, which

means she trains

and travels intensively along with her full time job.

 

Her constipation comes and goes. There are periods

when it occurs

and periods when her BM is regular. No correlation to

the cycle.Not

related to diet. Diet is good. Plenty of cooked

veggies and fiber.

Generally worse in the fall. Some emotional trauma

associated with

BM as a child which occurred in the fall as well.

 

When constipated she may have 1BM every 3 days. Stool

varies in

consistency from dark pellets to a conglomeration of

pellets which

is dark. Stool is difficult to pass and is probably

dry.In put does

not equal out put. She also experiences gas and

bloating. Her

digestion is slow-it takes 2 days for flax seed to

pass thru her

system. She also has bad breath and a strong appetite,

but little

thirst and prefers to sip warm water.

 

Sleep is good. Urination is normal. Mood ranges from

frustrated to

irritible to ok. Energy levels can be ok to low

depending on travel

and training.

 

She also has some nasal discharge(clear) and a history

of psoriasis.

Her periods are regular 26 day cycle with 2 days of

flow and 3 days

of spotting. She experiences nipple sensitivity B/4

her period.Also

acne B/4 period. No other PMS signs.

 

She has a history of hepatitis which was typed as

non-A non B, but

not hep C.

 

She also has cold hands and feet and generally feels

cold. Dry skin

and hair and brittle nails. No hot flashes or night

sweats.

Complexion is pale with red cheeks.

 

Tongue is pale to normal colored body with toothmarks,

a red tip and

a cleft at the tip. Coating varies from a thick

yellow coat with a

dark spot in the center back to a thin white coat in

front and a

yellow coat in back.

 

Pulses are deficient

 

Treatment:

Release Oketsu: Liv4, Lu5, immune point

Release Adrenal: Ki6, 27

L Ub35 to release R Ub18-for constipation

St25, 36, 37

 

No Herbs

 

Next treatment 10 days later due to travel schedule:

Bowels moved for 7 days after last tx but constipated

last 3 days.

Attempted to release more of the Hara this tx

Release oketsu: Liv4, Lu5, immune pt

Release Liv2: Liv4, Liv8

Release adrenal: ki6,27

Release R subcostal area: R sp7,ht3,p4

Release cv9 reflex: sp9, sp3

 

Herbs:

Ma Zi Ren Wan

 

The above formula moves her bowels. Bowels will be

dark

conglomerates that will move 3-4 times a day and then

change to

skinny loose normal colored stool. I advised patient

to stop taking

it when stools change.

 

If she stops taking the formula she becomes

constipated again. The

acupuncture has been less effective and I am having

trouble

releasing her hara.

 

Initially I was thinking I wanted to get her bowels

moving and then

find a better formula suited for her pattern. My

diagnosis is liver

qi stag causing st and LI heat with underlying qi,

blood and yin

deficiency. I also think ther is some LU involvement

too.

 

Advice would be greatly appreciated on dignosis,

points and herbs.

Especially herbs. For a condition this chronic, how

much time is

needed?

 

In the past with other practitioners she has taken Run

Chang Wan and

Zeng Ye Tang with out sucess. She also takes pro

biotics and flax

seed.

 

Many thanks, Diana

 

 

 

 

 

 

 

 

 

 

 

 

To translate this message, copy and paste it into this

web link page, http://babel.altavista.com/

 

 

 

and adjust accordingly.

 

If you , it takes a few days for the

messages to stop being delivered.

 

Messages are the property of the author. Any

duplication outside the group requires prior

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