epigastric case study & medical i ching readings

[Guest guest]

hi there, everyone!

 

this will be a relatively long e-mail - i'll keep it detail-focused.

 

here's a current difficult pt: 40's, F, flabby, fair. she's had

increas'g epigastric distress for several months. mostly dyspepsia,

some gerd sx. dyspepsia's described as " feel'g as if i've drunk milk

that turned several days ago. " she spends hrs at a time feel'g close

to emesis. the GB u/s was clear. an abd/pelv ct was also clear, x for

a hemangioma ~2.5 cm diameter, on the liver. usu. occurr'g in older

folks, they can cause pn but are not usu. tx'd. GB/pancreatic enzymes

have been nl. white count was elevated long before this, [until Very

Recently-pt was given homeopathic rx] poss. for several yrs, from 11-

18k, but cell diff count was always nl. an upper endo's scheduled in

august, but is likely to b negative. prilosec & prevacid have

produced no sign. sx change, she was neg. for helicobactor virus, so

ulcer(s) r unlikely. an endocrine work-up is being considered. " Jane "

was tossing this idea herself & her internist brought this up @ her

next visit(!)- they'd r/o addison's dz. the pt's hesitant to leave

the hemangioma unexplored c other sx unexplained-this would require

another ct. she's even taken this month off work to r/o direct stress

causation, and has a counselor involved.

 

i have done 2 medical i ching readings. i am request'g *Your* help c

clarify'g mean'g, por favor.

 

1. what part of Jane's body is making her sick to her stomach?

original:

Po-Splitting Apart, moving line-2=fair px

late stage pathology, poss. grave/dz exacerbation, food

malabsorption, weakened organs, toxic state, chronic degenerative dz's

Po's hidden hexagram

= Kun-The Receptive

grave conditions, poor recovery ability, very yin/slow moving illness

*Kun- Miki Shima: if obtain hexagram of 2 trigrams of =element as

orig./changed in dx/px- oft indicates a serious condition. tho pt may

look healthy, look deeper into pt's situation.

changed:

Meng-Youthful Folly

tendency to chronicity, danger of misdx, toxic state, latent heat,

blood stasis, medicine may not work.

Meng's hidden hexagram

= Fu-The Return

sign of recovery/turn'g pt from/of illness, may exac. temporarily but

will eventually get well, poss. return of illness in future

 

2. are these tests Jane & her dr have in mind useful ideas?

original:

Da Yu-Possession in Great Measure, *a gui hun hexagram-poss. higher

morbidty/mortality than other hexagrams*

moving lines 1/3-good/fair px, toxic dz+heat accumulation in

interior, poss. early pathology (lower chang'g lines) or?, qi/blood

disharmony

Da Yu's hidden hexagram

= Guai-Breakthrough

rebellious qi attack'g HT, severe & traumatic illnesses

changed:

Wei Ji-Before Completion

illness' mid-course, ext-heat, int-cold, blood stasis, ht-kid xu

Wei Ji's hidden hexagram

= Ji Ji-After Completion

perfectly correct yin/yang lines, success in small matters, exhausted

system, yin/yang xu, ext-cold, int-damp heat, ht-kid xu, blood xu

 

Po, Da Yu, and the possibly rather favorable changed hexagrams,

particularly After Completion, feel incongruent to me. i'm confused.

how aggressive does this pt need to be c avail. diagnotics, incl. c

such sx as the hemangioma? am i see'g a favorable outcome dependent

upon diagnostics & intervention, or what? any help out there?

 

thanks SO much, my pt thanks u even more

Lynn

[Guest guest]

history is mainly WM

i ching should not be mainstay - where is the 5 E pattern?

 

am beginning to build one here:

 

[40's, F, flabby]

5 E - Earth

 

[increas'g epigastric distress for several months. mostly dyspepsia,

some gerd sx. dyspepsia's described as " feel'g as if i've drunk milk

that turned several days ago. " she spends hrs at a time feel'g close

to emesis]

5 E - clearly Earth

 

[the GB u/s was clear]

5 E - GB not involved. suspect result, parameters WM

 

[an abd/pelv ct was also clear, x for

a hemangioma ~2.5 cm diameter, on the liver]

5 E - very relevant, LV wood

 

[pancreatic enzymes

have been nl. white count was elevated long before this, [until Very

Recently-pt ... work to r/o direct stress

causation, and has a counselor involved]

 

mainly fishing

 

[1 have done 2 medical i ching readings. i am request'g *Your* help c

clarify'g mean'g, por favor]

i ching not to be invoked here, it is a misuse

 

{Po, Da Yu, and the possibly rather favorable changed hexagrams,

particularly After Completion, feel incongruent to me. i'm confused.

how aggressive does this pt need to be c avail. diagnotics, incl. c

such sx as the hemangioma? am i see'g a favorable outcome dependent

upon diagnostics & intervention, or what? any help out there?}

no need for help, figure it out

 

inferences:

till now 2 Es loud and clear - wood & earth

 

only possible patterns:

wood afflicting earth

metal afflicting wood

 

how to confirm:

face color

tongue megamorph

chronology of illness

 

some parental history at birth?

 

dr holmes

www.acu-free.com

1.888.TCM.CEUS 826.2387

[Guest guest]

-holmes wrote: >history is mainly WM

 

and? hx also includes useful sx/sensation descriptions,

e.g. " feel'g as if i've drunk milk that turned several days ago "

 

> i ching should not be mainstay

 

" mainstay " of what? i am not using i ching coins on acupoints.

 

> am beginning to build one here: [40's, F, flabby] 5 E - Earth

 

she's fire-metal-earth. deficient fire makes for too much damp earth.

 

> mainly fishing

 

well, that is generally the purpose of sharing cases with other

professionals

 

> i ching not to be invoked here, it is a misuse

 

it's unfortunate that you have no experience with medical use of the

i ching, and such a negative impression of the same. it can be very

useful.

 

> no need for help, figure it out

 

since this patient's experience has been refractory, and it would

have been helpful if she had returned to tx sooner, i have put out

this sincere request for others' qualified and much appreciated

assistance.

 

> some parental history at birth?

 

she had 2 parents. she was born full-term, first child, turned at

the last minute and was born breech, a little bit of forceps

assistance but not much, taken to incubator overnite, 8 hrs of labor

but not hard till last 2 1/2 hrs. she was held then taken to

incubator special nursery for obs b/c breech birth for ~12hrs.

[Guest guest]

i apologize if i came across as obtuse

 

taking cue from breech one may take maternal SP qi as deficient,

this would cause a misplaced fetus, or allow this random turn at the

last moment

 

if this is the case, then the child would be born with a deficient Son

to SP,

which would be LU Metal

 

if this is so, and you would have to confirm with signs, then the bi

elemental pattern

could be:

 

LU Def, attacking LV and causing an Excess

 

this would explain the hemangioma which is Bloodied, Hot and Full

 

the weak Earth symptoms would either be a back up of LU Metal to SP,

which is

somewhat far fetched, or an attack of LV on ST, which could be half

acceptable

 

if you can establish LU as primary and in deficiency, and LV as

secondary and in excess,

the situation can be reversed very quickly with a bi-elemental tone LU &

reduce LV

approach

 

best

 

holmes

 

Lynn wrote:

 

> -holmes wrote: >history is mainly WM

>

> and? hx also includes useful sx/sensation descriptions,

> e.g. " feel'g as if i've drunk milk that turned several days ago "

>

> > i ching should not be mainstay

>

> " mainstay " of what? i am not using i ching coins on acupoints.

>

> > am beginning to build one here: [40's, F, flabby] 5 E - Earth

>

> she's fire-metal-earth. deficient fire makes for too much damp earth.

>

> > mainly fishing

>

> well, that is generally the purpose of sharing cases with other

> professionals

>

> > i ching not to be invoked here, it is a misuse

>

> it's unfortunate that you have no experience with medical use of the

> i ching, and such a negative impression of the same. it can be very

> useful.

>

> > no need for help, figure it out

>

> since this patient's experience has been refractory, and it would

> have been helpful if she had returned to tx sooner, i have put out

> this sincere request for others' qualified and much appreciated

> assistance.

>

> > some parental history at birth?

>

> she had 2 parents. she was born full-term, first child, turned at

> the last minute and was born breech, a little bit of forceps

> assistance but not much, taken to incubator overnite, 8 hrs of labor

> but not hard till last 2 1/2 hrs. she was held then taken to

> incubator special nursery for obs b/c breech birth for ~12hrs.

>

>

[Guest guest]

At 05:09 AM 7/26/2005 -0000, " Lynn Detamore " <lynndetamore

wrote:

 

>this will be a relatively long e-mail - i'll keep it detail-focused.

>

>here's a current difficult pt: 40's, F, flabby, fair. she's had

>increas'g epigastric distress for several months...

 

Again, there's little CM observation reported -- morphology (beyond

" flabby " ) face, tongue, especially pulse.

 

Also, YiJing oracle as diagnostic tool, as presented, appears somewhat

indirect (in the absence of more information).

 

Constitutionally, the Ren, Chong and Dai could be considered. Incubation

after birth challenges early Ren development (lack-of or interrupted

bonding). Chong's close interplay with the Stomach (locus of Sx). Liver

hemangioma could suggest DaiMai -- accumulation becoming toxic, or seeking

expression/resolution. " Flabby " could suggest Yin excess (Ren impacted)

and/or Dai.

 

Then there's life style, and life experiences surrounding onset ...

 

Just some thoughts.