New case: Woman, 53, lethargy, weakness.

July 18, 2006

Hi Everybody!

Everyone I have seen lately seems to have so *much* going on. I wonder

if it is all the chemicals in the food and water, as well as the stress

everyone is suffering?

The water around here has a lot of chlorine and it is very hard. The

government says it is safe to drink, but it tastes terrible and it rots

the pipes almost instantly.

Regards,

Pete

Excerpted from the case:

What is your major complaint? Constant lethargy, bouts of weakness

How long have you had this condition? 2.5 months.

What treatments or remedies have you tried for this condition? None.

Acupuncture impression: Intact Stomach-Qi, Inflammation, fever or

infection, Spleen deficiency, Dampness, or both, may suffer illness in

spring and summer, Qi or Blood Stagnation, cold pattern, heat in the

blood, Heat, good spirit, Deficient heat, Yin Deficient,

Constitutional Heart deficiency + tend to emotional problem, weakening

Stomach Qi, Ying level, Phlegm, Deficient of Qi or Blood, Cold in the

Bladder or Kidney Yang deficiency, Accumulated Heat in the Bladder,

Disharmony between Heart and Kidney Liver Qi stagnation, Liver Blood

Stasis, Spleen deficiency, Kidney deficiency, Qi deficient; Blood Heat;

Liver Fire; Spleen, Kidney Yang deficiency; Liver, Kidney Yin

deficiency; Liver, Kidney Yin deficiency with Blood Empty Heat; Blood

Stasis in the Uterus, Blood Heat, Blood Stasis in the Uterus, Blood

Heat, Cold in the Uterus, Qi deficiency, Liver Qi Stagnation, Liver

Blood Stasis, Stagnation of Cold in the Uterus, Damp Heat in the Uterus,

Stagnant Liver Qi turning to Liver Fire, Deficient Qi and Blood, Spleen

Yang and Liver Blood deficiency, Liver and Kidney Yin Deficiency, liver,

kidney, yin deficiency, heat, excess heat maybe liver or heart), cold or

insufficient qi, Deficient Yang if weak, deficiency of liver blood

There are 5 cold, 10 heat

There are 17 deficient, no excess.

There are 4 damp signs, but the mouth is dry.

There is one phlegm sign.

All organs appear to have some involvement. Spleen, stomach, bladder

kidney, heart, liver, and even the uterus. However, there are more liver

signs than any other.

Treatment principle: I am going to treat this as deficiency heat in the

first few treatments and also try to harmonize the liver.

Possible Points: LI 11, 4; L 7; St 36; Sp 6, perhaps others.

Herbal Pills: Liu Wei Di Huang Wan, Shu Gan Pian

Retained needles for 45 minutes first treatment with some improvement.

Have not tried herbs as yet, I see her again today.

The full history and case follows:

Have you seen a Western Doctor for this condition? Yes.

Have you seen a Chiropractor for this condition? No.

Have you ever had scarlet fever? No.

Have you ever had diphtheria? No.

Have you ever had rheumatic fever? No.

Have you ever had chronic or frequent colds? No.

Have you ever had sinusitis? Yes.

Have you ever had tuberculosis? No.

Have you ever had a heart murmur? No.

Have you ever had a heart attack? No.

Have you ever had a heart condition? No.

Have you ever had stomach, liver or intestinal trouble? No.

Have you ever had gallbladder trouble or gallstones? No.

Have you ever had jaundice? No.

Have you ever had a reaction to serum, drug or medicine? No.

Have you ever had a tumor, growth, cyst or cancer? Yes.

Have you ever had piles or rectal disease? No.

Have you ever had a kidney stone or blood in your urine? No.

Have you ever had sugar or albumin in your urine? No.

Have you ever had venereal disease? No.

Have you ever had any drug or narcotic habit? No.

Have you ever had an excessive drinking habit? No.

Have you ever had to wear a neck or back brace? No.

Have you ever had exposure to tuberculosis? No.

Have you ever had to wear eyeglasses? Yes.

Have you ever had eye trouble? No.

Have you ever had ear, nose or throat trouble? No.

(female only section)

Have you ever had a pregnancy? Yes.

Have you ever had a vaginal discharge? No.

Have you ever had treatment for female disorder? Yes.

Have you ever had painful menstruation? No.

Have you ever had irregular menstruation? Yes.

How old were you when you had your first menstrual period? 14

What is the interval between your menstrual periods? 14 days.

How long do your menstrual periods last?When was your last period? 2 or

3 days. 6 years ago.

What is the quantity of your menstrual discharge? Normal.

Have you ever had or do you now have bloody or other discharge, non

menses? No.

Have you ever had or do you now have loss of sexual desire? No.

(end of female only section)

Have you ever had or do you now have shortness of breath? Frequent.

Have you ever had or do you now have swollen ankles? Frequent.

Have you ever had or do you now have high blood pressure? No.

Have you ever had or do you now have a rapid heartbeat? No.

Have you ever had or do you now have dizziness? No.

Have you ever had or do you now have fainting spells? No.

Have you ever had or do you now have chest pain or pressure? Seldom.

Have you ever had or do you now have leg cramps? No.

Have you ever had or do you now have a cough? Seldom, with cold drinks.

Have you ever coughed up blood or do you now? No.

Have you ever had or do you now have hoarseness? No.

Have you ever had or do you now have sore throats? No.

Have you ever had or do you now have hay fever? No.

Have you ever had or do you now have nosebleeds? No.

Have you ever had or do you now have asthmatic wheezing? No.

Have you ever had or do you now have pneumonia? No.

Have you ever had or do you now have indigestion? Frequent.

Have you ever had or do you now have abdominal pain or cramps? No.

Have you ever had or do you now have constipation? No.

Have you ever had or do you now have diarrhea? No.

Have you ever had or do you now have blood in your bowel movement? No.

Have you ever had or do you now have a black bowel movement? No.

Have you ever had or do you now have increased appetite? No.

Have you ever had or do you now have increased thirst? No.

Have you ever had or do you now have decreased appetite? No.

Have you ever had or do you now have nausea and vomiting? No.

Have you ever had or do you now have difficulty swallowing? No.

Have you ever had or do you now have skin ulceration? No.

Have you ever had or do you now have itching? No.

Have you ever had or do you now have a rash? No.

Have you ever had or do you now have back pain? No.

Have you ever had or do you now have frequent urination? No.

Have you ever had or do you now have arthritis? No.

Have you ever had or do you now have muscle pain or cramps? No.

Have you ever had or do you now have painful joints? No.

Have you ever had or do you now have lameness? No.

Have you ever had or do you now have backaches? No.

Have you ever had or do you now have weakness? No.

Have you ever had or do you now have fever? No.

Have you ever had or do you now have chills? No.

Have you ever had or do you now have night sweats? No.

Have you ever had or do you now have headaches? No.

Have you ever had or do you now have insomnia? No.

Have you ever had or do you now have nervousness? No.

Have you ever had or do you now have irritability? No.

Have you ever had or do you now have morning tiredness? Frequent.

Have you ever had or do you now have easy fatigability? Frequent.

Have you ever been refused employment because of your health? No.

Why were you refused employment because of your health?

Have you ever been denied life insurance because of your health? No.

Why were you refused life insurance because of your health?

Have you ever been rejected for or discharged from military service

because of physical, mental or other reasons? No.

Do you smoke? No.

What do you smoke?

How much do you smoke?

How long have you smoked?

Do you have or have you had weight loss recently? No.

Do you have or have you had weight gain recently? Yes.

How much have you lost or gained? 40 Lbs.

Do you have or have you had a memory defect recently? No.

Do you have or have you had a change in your handwriting recently? No.

Do you have or have you had difficulty walking in the dark recently? No.

Do you have or have you had balance problems recently? No.

Do you have or have you had numbness or tingling in the extremities

recently? No.

Do you have or have you had hearing loss recently? No.

Do you have or have you had ringing ears recently? No.

Do you have or have you had a change in your vision recently ? No.

Do you have or have you had an ear ache recently? No.

Do you have or have you had running ears recently? No.

Do you have or have you had new skin growths recently? No.

Do you have or have you had a change in the color of your skin recently? No.

Do you have or have you had a tendency to bruise easily recently? Yes.

Do you have or have you had athlete's foot recently? No.

Do you have or have you had heat intolerance recently? Yes.

Do you have or have you had cold intolerance recently? No.

Do you have or have you had a change in your shoe or hat size recently? No.

Do you have or have you had lymph node enlargement recently? Yes or no.

Do you have or have you had kidney stones recently? No.

Do you have other items of physical fitness you want to mention? Yes.

What are the other items of physical fitness you want to mention?

Cholesterol tests are high, she feels " like shit " and is very tired.

Is there a history of tuberculosis in your family? No.

Who had tuberculosis in your family?

Is there a history of diabetes in your family? No.

Who had diabetes in your family?

Is there a history of cancer in your family? No.

Who had cancer in your family?

Is there a history of gout in your family? No.

Who had gout in your family?

Is there a history of heart trouble in your family? Yes.

Who had heart trouble in your family?

Is there a history of stroke in your family? No.

Who had a stroke in your family?

Is there a history of high blood pressure in your family? No.

Who had high blood pressure in your family?

Is there a history of asthma, hay fever or hives in your family? Yes.

Who had asthma, hay fever or hives in your family?

Is there a history of glaucoma in your family? No.

Who had glaucoma in your family?

What medications do you currently take?

Have you been hospitalized or treated in the past year for what you

would consider a significant condition? No.

What was or were the significant condition or conditions you were

treated or hospitalized for?

Are there other factors in your physical condition not already covered

that you have questions about? No.

What are the other factors in your physical condition not already

covered that you have questions about?

Please list all operations you may have had, and your age when you had them.

Ovary removed 1991

Cervical Cancer 1986

End of Medical History portion.

Four Pillar Examination:

Observe:

Clear moist color (indicates intact Stomach-Qi)

Red color (may indicate Inflammation, fever or infection)

Yellow (Spleen deficiency, Dampness, or both

Five Element Body types: 5' 2 " 156 lb.

Relatively pale, square face, relatively small head, small shoulders and

upper back, relatively flat abdomen, small hands and feet, strong voice,

move swiftly, have keen powers of thought, honest and upright, quiet,

calm but capable of decisive action when called for, " Metal Type " . Yes

or No. (may suffer illness in spring and summer)

Non pitting edema: Qi or Blood Stagnation)

Clear thin phlegm, cold pattern

Red face, heat in the blood

Thenar Eminence

Reddish - Heat

Non-pitting edema of the lower limbs. Yes.

Pitting edema of the lower limbs. Yes or No.

Tongue spirit: Like a fresh piece of meat - good spirit.

Tongue color.

Red without coating: Deficient heat.

Cracked: Yin Deficient

Long thin midline: Constitutional Heart deficiency + tend to emotional

problem.

Tongue coating.

Thin coating without root: weakening Stomach Qi.

Tongue moisture.

Dry

Tongue in Four Level Illnesses.

Red with no coating: Ying level.

Inquire:

Slight dizziness with a feeling of heaviness in the head. Yes. Phlegm.

Slight dizziness, worse when tired. Yes. Deficient of Qi or Blood.

Clear Urine. Yes. (Cold in the Bladder or Kidney Yang deficiency)

Scanty urination. Yes. (Accumulated Heat in the Bladder)

Restless sleep with dreams. Yes.(Disharmony between Heart and Kidney)

Snores really bad per husband.

Female section:

Sometimes early, sometimes late period. Yes. (Liver Qi stagnation, Liver

Blood Stasis, Spleen deficiency, Kidney deficiency)

Heavy menstrual flow. Yes. (Qi deficient; Blood Heat; Liver Fire;

Spleen, Kidney Yang deficiency; Liver, Kidney Yin deficiency; Liver,

Kidney Yin deficiency with Blood Empty Heat; Blood Stasis in the Uterus)

Dark red or bright red menstrual blood. Yes.. (Blood Heat)

Pale color menstrual blood. Yes or no.

Congealed menses with clots. Sometimes, toward menopause. (Blood Stasis

in the Uterus, Blood Heat, Cold in the Uterus, Qi deficiency)

Pain during periods. Yes. (Liver Qi Stagnation, Liver Blood Stasis,

Stagnation of Cold in the Uterus, Damp Heat in the Uterus, Stagnant

Liver Qi turning to Liver Fire, Deficient Qi and Blood, Spleen Yang and

Liver Blood deficiency, Liver and Kidney Yin Deficiency)

Has had two miscarriages.

(end of female section)

Dry mouth is liver, kidney, yin deficiency, heat.

Salty taste in her mouth.

Throws off the blanket at night. Yes. (excess heat maybe liver or heart)

Listen & smell:

Palpate:

Systolic blood pressure (Optimal <120; Normal <130) measured 104

Diastolic blood pressure (Optimal <80) measured 65

Heart rate. 63

Slow pulse less than 70 beats per minute. Yes. (cold or insufficient qi)

Hidden pulse is an extreme form of the sinking pulse. Yes.. (Deficient

Yang if weak.)

Dry skin. Yes or No. (deficiency of liver blood)

Summary: Major complaint is constant lethargy and bouts of weakness. She

has had this condition for 2.5 months. Clear moist color (indicates

intact Stomach-Qi) Red color (may indicate Inflammation, fever or

infection) Yellow (Spleen deficiency, Dampness, or both) " Metal Type "

(may suffer illness in spring and summer) Non pitting edema: (Qi or

Blood Stagnation) Clear thin phlegm, cold pattern Red face, heat in the

blood Thenar Eminence Reddish - Heat. Non-pitting edema of the lower

limbs. Tongue spirit: Like a fresh piece of meat - good spirit. Tongue

color Red without coating: Deficient heat. Cracked: Yin Deficient Long

thin midline: Constitutional Heart deficiency + tend to emotional

problem. Tongue coating. Thin coating without root: weakening Stomach

Qi. Tongue moisture. Dry Tongue in Four Level Illnesses Red with no

coating: Ying level. Slight dizziness with a feeling of heaviness in the

head. Phlegm. Slight dizziness, worse when tired. Deficient of Qi or

Blood. Clear Urine. (Cold in the Bladder or Kidney Yang deficiency)

Scanty urination. (Accumulated Heat in the Bladder) Restless sleep with

dreams. (Disharmony between Heart and Kidney) Snores really bad per

husband. Sometimes early, sometimes late period. (Liver Qi stagnation,

Liver Blood Stasis, Spleen deficiency, Kidney deficiency) Heavy

menstrual flow. (Qi deficient; Blood Heat; Liver Fire; Spleen, Kidney

Yang deficiency; Liver, Kidney Yin deficiency; Liver, Kidney Yin

deficiency with Blood Empty Heat; Blood Stasis in the Uterus) Dark red

or bright red menstrual blood. Yes.. (Blood Heat)Congealed menses with

clots. Sometimes, toward menopause. (Blood Stasis in the Uterus, Blood

Heat, Cold in the Uterus, Qi deficiency) Pain during periods. (Liver Qi

Stagnation, Liver Blood Stasis, Stagnation of Cold in the Uterus, Damp

Heat in the Uterus, Stagnant Liver Qi turning to Liver Fire, Deficient

Qi and Blood, Spleen Yang and Liver Blood deficiency, Liver and Kidney

Yin Deficiency) Has had two miscarriages. Dry mouth is liver, kidney,

yin deficiency, heat. Salty taste in her mouth. Throws off the blanket

at night. (excess heat maybe liver or heart) Systolic blood pressure

(Optimal <120) measured 104 Diastolic blood pressure (Optimal <80)

measured 65 Heart rate 63 Slow pulse less than 70 beats per minute.

(cold or insufficient qi) Hidden pulse is an extreme form of the sinking

pulse. (Deficient Yang if weak.) Dry skin (deficiency of liver blood)