Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 Hi, I have a patient who had knee surgery about 4 months ago and she would like me to prescribe herbs. I have not prescribed a lot of herbs for this kind of thing, so I thought I would seek some advice. There seems to be some heat in the area, but no swelling. She also has pain distal to Lu 9 on her wrist and that area is also warm to the touch (and moxa made it worse). One shoulder gets painful off and on as well, but responds well to acupuncture (the wrist and knee get better with acupuncture, but never fully resolve). She has a coated tongue in the back, so I am thinking some dampheat clearing herbs are in order. I'm not clear on how much blood stagnation herbs to use at this stage of the game. I have the sense that she could be prone to wind-damp/arthritic/bi-syndrome type problems (she has chronic allergies/rhinitis which seem to have a fair amount of wind). Any formula ideas? Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 Laura - Shen Tong Zhu Yu Tang is indicated for pain throughout the body, irrespective of whether or not it is rheumatic pain or post-surgical (traumatic pain). If you are concerned about a possible Damp Heat co-pathogen, you could consider a formula like Shan Zhong Xia Tong Feng Tang. I think that both of these are available from any of the major herbal suppliers like Evergreen or KPC herbs in capsules or powder. If you order from KPC, make sure to get a copy of Andrew Ellis' terrific clinical guide for formulas, " Notes from South Mountain " . He actually started to write this as a a sort of clinical guide for KPC herb formulas, but it was so good, they went ahead and published it just as a formula guide. If you want to try using a simple patent medicine, consider Jin Gu Die Shang Wan. This formula has it's antecedent in the classic formula used for bone-healing/tendon healing, Qi Li San. You can read about Jin Gu Die Shang Wan in Will Mclean's book, Chinese Herbal Patent Medicines. Hope this helps, Ray Rubio On Feb 18, 2005, at 6:50 PM, heylaurag wrote: > > > Hi, I have a patient who had knee surgery about 4 months ago and she > would like me to prescribe herbs. I have not prescribed a lot of > herbs for this kind of thing, so I thought I would seek some advice. > There seems to be some heat in the area, but no swelling. She also > has pain distal to Lu 9 on her wrist and that area is also warm to the > touch (and moxa made it worse). One shoulder gets painful off and on > as well, but responds well to acupuncture (the wrist and knee get > better with acupuncture, but never fully resolve). She has a coated > tongue in the back, so I am thinking some dampheat clearing herbs are > in order. I'm not clear on how much blood stagnation herbs to use at > this stage of the game. I have the sense that she could be prone to > wind-damp/arthritic/bi-syndrome type problems (she has chronic > allergies/rhinitis which seem to have a fair amount of wind). > > Any formula ideas? > > Laura > http://babel.altavista.com/ > > > and > adjust accordingly. > > Messages are the property of the author. Any duplication outside the > group requires prior permission from the author. > > If you are a TCM academic and wish to discuss TCM with other > academics, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2005 Report Share Posted February 21, 2005 Hi Ray, Thanks so much for your ideas. I have " Notes from South Mountain " , and I don't know what I'd do without it. Its such a helpful book with real-world advice. Anyone serious about herbs should have it, I think. By the way, I actually did some research on a formula for her before I read your response. I came up with Shang Zhong Xia Tong Yong Tong Feng Tang as the main formula I was considering--and I got it out of " Notes from South Mountain " . Funny, huh? The good thing is that now that I've read your response I will feel more confident of my choice. This patient also has atopic asthma and rhinitis, so perhaps I will add Yu Ping Feng San. Interestingly, I started out treating her headaches, and that went pretty well, but when I started focusing on her allergies/asthma/rhinitis I started tonifying her kidneys (along with clearing wind etc.). Despite the fact that I was clearing wind with the treatments, she would say after the treatments, " These treatments make me feel itchy " . After two of them she started to have this pain in her wrist and the pain from her knee surgery was worse. It seems like the addition of points like UB 23 made her worse....stirred up the wind and heat. Thanks!!! Laura Chinese Medicine , Ray Rubio <RTOO@e...> wrote: > Laura - > > Shen Tong Zhu Yu Tang is indicated for pain throughout the body, > irrespective of whether or not it is rheumatic pain or post-surgical > (traumatic pain). If you are concerned about a possible Damp Heat > co-pathogen, you could consider a formula like Shan Zhong Xia Tong Feng > Tang. I think that both of these are available from any of the major > herbal suppliers like Evergreen or KPC herbs in capsules or powder. If > you order from KPC, make sure to get a copy of Andrew Ellis' terrific > clinical guide for formulas, " Notes from South Mountain " . He actually > started to write this as a a sort of clinical guide for KPC herb > formulas, but it was so good, they went ahead and published it just as > a formula guide. > > If you want to try using a simple patent medicine, consider Jin Gu Die > Shang Wan. This formula has it's antecedent in the classic formula used > for bone-healing/tendon healing, Qi Li San. You can read about Jin Gu > Die Shang Wan in Will Mclean's book, Chinese Herbal Patent Medicines. > > Hope this helps, > > Ray Rubio On Feb 18, 2005, at 6:50 PM, heylaurag wrote: > > > > > > > Hi, I have a patient who had knee surgery about 4 months ago and she > > would like me to prescribe herbs. I have not prescribed a lot of > > herbs for this kind of thing, so I thought I would seek some advice. > > There seems to be some heat in the area, but no swelling. She also > > has pain distal to Lu 9 on her wrist and that area is also warm to the > > touch (and moxa made it worse). One shoulder gets painful off and on > > as well, but responds well to acupuncture (the wrist and knee get > > better with acupuncture, but never fully resolve). She has a coated > > tongue in the back, so I am thinking some dampheat clearing herbs are > > in order. I'm not clear on how much blood stagnation herbs to use at > > this stage of the game. I have the sense that she could be prone to > > wind-damp/arthritic/bi-syndrome type problems (she has chronic > > allergies/rhinitis which seem to have a fair amount of wind). > > > > Any formula ideas? > > > > Laura > > > > > > > > > > > > > > To translate this message, copy and paste it into this web link page, > > http://babel.altavista.com/ > > > > > > and > > adjust accordingly. > > > > Messages are the property of the author. Any duplication outside the > > group requires prior permission from the author. > > > > If you are a TCM academic and wish to discuss TCM with other > > academics, > > > > Quote Link to comment Share on other sites More sharing options...
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