Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 I have been treating the following case for a couple of months now without too much success and would welcome any comments or suggestions regarding pattern differentiation and acupuncture/Chinese herbs from a TCM approach. Female, age 22 Main Complaint: No periods for 1 year Patient had a pregnancy terminated then immediately went on the contraceptive pill for 1 and a half years. Since stopping the pill she has not had any periods. Prior to the termination her periods were regular with a normal flow. Other s & s include - bloating (since about the time she stopped taking the pill, gets gradually worse throughout the day, worse after eating), loose stools (w occ undigested food, 2/3 times a day), urine dark, appetite and energy good, continuous thrush (again, since stopped the pill), some hair loss (thinning, substantial) 6 months ago that lasted for 2 months. She has dark circles under her eyes, pale complexion, abdomen from umbilicus to sternum is firm and slightly tender to the touch, no obesity/under-weight, brittle nails. Diet is generally well balanced - avoids dairy and too much carbs. Emotionally seems well balanced. T: Red body P: Wiry The patient is due to see a gynaecologist soon which will hopefully shed some light on the situation. A previous ultrasound post termination showed slightly enlarged ovaries but this wasn't followed through. Comments appreciated. Any other info/questions please ask. Many thanks, Angelo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Angelo, How have you been treating this patient? That information will help us give you some direction. From your description, I see the current patterns: Liver Qi and Blood Stagnation Damp Heat Blood Deficiency Possible Kidney Deficiency - but need more information to say for sure. I'd look at her Yin and Jing. --- Angelo DAlberto <angelo_dalberto wrote: > I have been treating the following case for a couple > of months now > without too much success and would welcome any > comments or > suggestions regarding pattern differentiation and > acupuncture/Chinese herbs from a TCM approach. > > Female, age 22 > > Main Complaint: No periods for 1 year > > Patient had a pregnancy terminated then immediately > went on the > contraceptive pill for 1 and a half years. Since > stopping the pill > she has not had any periods. Prior to the > termination her periods > were regular with a normal flow. > > Other s & s include - bloating (since about the time > she stopped > taking the pill, gets gradually worse throughout the > day, worse > after eating), loose stools (w occ undigested food, > 2/3 times a > day), urine dark, appetite and energy good, > continuous thrush > (again, since stopped the pill), some hair loss > (thinning, > substantial) 6 months ago that lasted for 2 months. > > She has dark circles under her eyes, pale > complexion, abdomen from > umbilicus to sternum is firm and slightly tender to > the touch, no > obesity/under-weight, brittle nails. Diet is > generally well > balanced - avoids dairy and too much carbs. > Emotionally seems well > balanced. > > T: Red body > P: Wiry > > The patient is due to see a gynaecologist soon which > will hopefully > shed some light on the situation. A previous > ultrasound post > termination showed slightly enlarged ovaries but > this wasn't > followed through. > > Comments appreciated. Any other info/questions > please ask. > > Many thanks, > > Angelo > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Hi Angelo & All, > I ... would welcome any comments or suggestions regarding pattern > differentiation and acupuncture/Chinese herbs from a TCM approach. > Female, age 22 Main Complaint: No periods for 1 year Patient had a > pregnancy terminated then immediately went on the contraceptive pill > for 1 and a half years. ... This is a complex case. Pattern Differentiaation is important. I will leave that to experts on the List but Wood (LV) overacting on Earth (SP) is possible. Herbs to Calm LV and Supplement Centre may be considered as part of herbal Tx. Pt may need expert counselling re the psyche after the abortion. Also, check for sensitive external scars (and have gyn expert check for internal scare). Scar Therapy mey be needed also. Re acupuncture Tx of amenorrhoea, see: http://homepage.eircom.net/~progers/gu3b.htm Best regards, >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Since stopping the pill she has not had any periods. Prior to the termination her periods were regular with a normal flow. Other S & Ss include - bloating (since about the time she stopped taking the pill, gets gradually worse throughout the day, worse after eating), loose stools (w occ undigested food, 2/3 times a day), urine dark, appetite and energy good, continuous thrush (again, since stopped the pill), some hair loss (thinning, substantial) 6 months ago that lasted for 2 months. She has dark circles under her eyes, pale complexion, abdomen from umbilicus to sternum is firm and slightly tender to the touch, no obesity /under-weight, brittle nails. Diet is generally well balanced - avoids dairy and too much carbs. Emotionally seems well balanced. T: Red body; P: Wiry Pt is due to see a gynaecologist soon which will hopefully shed some light on the situation. A previous ultrasound post termination showed slightly enlarged ovaries but this wasn't followed through. Comments appreciated. Any other info/questions please ask. Many thanks, Angelo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Hi THere, I used to treat these kinds of patients. According to the symptoms most therapists will consider this is a dampheat. HOwever, I perceived this as a sign of blood transformation and transportation problem which is interfered or disrupted usually with oral contraceptive. Finally, it led to blood deficiency. If you look closely, you will see more deficiency signs rather than Dampheat problem. Red or dark urine is not a sign of dampheat, but it may be the caused of any medication intake, mostly because of dryness from blood deficiency. To regulate the menstruation ( any kinds from dysmenorrhea to amenorrhea ) use SP6. THis is the perfect solution and it may take only one treatment, the most is 3. Usually, this treatment will satisfy the therapists. Do not use any other points. I usually treat each patient with one point one needle, unless under special circumstance is required. More needles applied, the result will be hindered and the undesirable effects will be sure to come. HOw to choose which point , left or right ? YOu may based on the pulse of the patient, the middle position, Left for liver if it is weak you may tonify Sp6 on the right leg which means to tonify the Liver and the Spleen for blood transformation and transportation. If the right is weak, You may tonify the SP6 on the right leg which is to tonify the blood and jing , the essence, the Kidney jing. The herbal formual may be used as Ba Zhen Wan, or SHi Quan Da Bu. If you have used the formula which tonifies and transforms and transports the blood with acupuncture therapy as above, I donot see why the disease above cannot be healed. The formulas I presented for the budget which bring about the excellent result. Please do not substitute it with raw herb formula. PLEASE DO NOT TREAT THIS PATIENT AS A DAMPHEAT CONDITION WHICH MAY AGGRAVATE THE SYMPTOMS OR DISEASE. Good luck to you and hope you will be sucessful in your career. Dr. Nam Nguyen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Dear Andrea, I used to treat these kinds of patients, some were worse. According to the symptoms most therapists will consider this is a dampheat. HOwever, I perceived this as a sign of blood transformation and transportation problem which is interfered or disrupted usually with oral contraceptive. Finally, it led to blood deficiency. If you look closely, you will see more deficiency signs rather than Dampheat problem. Red or dark urine is not a sign of dampheat, but it may be the caused of any medication intake, mostly because of dryness from blood deficiency. To regulate the menstruation ( any kinds from dysmenorrhea to amenorrhea ) use SP6. THis is the perfect solution and it may take only one treatment, the most is 3. Usually, this treatment will satisfy the therapists. Do not use any other points. I usually treat each patient with one point one needle, unless under special circumstance is required. More needles applied, the result will be hindered and the undesirable effects will be sure to come. HOw to choose which point , left or right ? YOu may based on the pulse of the patient, the middle position, Left for liver if it is weak you may tonify Sp6 on the right leg which means to tonify the Liver and the Spleen for blood transformation and transportation. If the right is weak, You may tonify the SP6 on the right leg which is to tonify the blood and jing , the essence, the Kidney jing. The herbal formual may be used as Ba Zhen Wan, or SHi Quan Da Bu. If you have used the formula which tonifies and transforms and transports the blood with acupuncture therapy as above, I donot see why the disease above cannot be healed. The formulas I presented for the budget which bring about the excellent result. Please do not substitute it with raw herb formula. PLEASE DO NOT TREAT THIS PATIENT AS A DAMPHEAT CONDITION WHICH MAY AGGRAVATE THE SYMPTOMS OR DISEASE. Good luck to you and hope you will be sucessful in your career. Dr. Nam Nguyen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Hi Andrea, I have been treating this as a case of Damp with Qi and Blood Stagnation: Cang Zhu 9, Huang Bai 9, Fu Ling 9, Chen Pi 6, Zhi Shi 9, Xiang Fu 9, Chuan Xiong 6, Mai Ya 12, Gan Cao 3. Acupuncture points from - SP9, SP6, Ren 12, Ren 9, Ren 6, ST40, LI4, SJ5/GB41, SP4/PC6, etc. Thank you for your thoughts on patterns. I agree that there must be some Kid-Xu but I was hoping to tackle that once the other patterns had resolved somewhat. Angelo Chinese Medicine , Andrea Beth Damsky < wrote: > > Angelo, > > How have you been treating this patient? That > information will help us give you some direction. > > From your description, I see the current patterns: > > Liver Qi and Blood Stagnation > Damp Heat > Blood Deficiency > Possible Kidney Deficiency - but need more information > to say for sure. I'd look at her Yin and Jing. > > > > --- Angelo DAlberto <angelo_dalberto > wrote: > > > I have been treating the following case for a couple > > of months now > > without too much success and would welcome any > > comments or > > suggestions regarding pattern differentiation and > > acupuncture/Chinese herbs from a TCM approach. > > > > Female, age 22 > > > > Main Complaint: No periods for 1 year > > > > Patient had a pregnancy terminated then immediately > > went on the > > contraceptive pill for 1 and a half years. Since > > stopping the pill > > she has not had any periods. Prior to the > > termination her periods > > were regular with a normal flow. > > > > Other s & s include - bloating (since about the time > > she stopped > > taking the pill, gets gradually worse throughout the > > day, worse > > after eating), loose stools (w occ undigested food, > > 2/3 times a > > day), urine dark, appetite and energy good, > > continuous thrush > > (again, since stopped the pill), some hair loss > > (thinning, > > substantial) 6 months ago that lasted for 2 months. > > > > She has dark circles under her eyes, pale > > complexion, abdomen from > > umbilicus to sternum is firm and slightly tender to > > the touch, no > > obesity/under-weight, brittle nails. Diet is > > generally well > > balanced - avoids dairy and too much carbs. > > Emotionally seems well > > balanced. > > > > T: Red body > > P: Wiry > > > > The patient is due to see a gynaecologist soon which > > will hopefully > > shed some light on the situation. A previous > > ultrasound post > > termination showed slightly enlarged ovaries but > > this wasn't > > followed through. > > > > Comments appreciated. Any other info/questions > > please ask. > > > > Many thanks, > > > > Angelo > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Hi Angelo, If you have sucessfully treated these patients with Dampheat, I think other folks and I should join the team. We are here to learn and to share our experience, nobody is perfect. What I see , where is the damp ( patient feel heavy , sticky, slow, lazy, headache, stomach bloating, or dysuria, darkscanty urine, smelling or dirty urine ) upper, middle or lower ? Is this a strong sign of damp ? sticky wet tongue with thick coat? Is this a key point of diagnosis? Blood and QI stagnation ? Is this of irregular pulses ( stagnation )? Is there any symptom of Qi stagnation ( difficult breathing, coughing, pains come and go, difficult of expelling waste or urine, chest discomfort )? Is there any signs of blood stagnation beside amenorrhea ? stabbing or cruciating pain, purple tongue, dark skin, dark waste or dark urine ? severe headache ? The above signs are of excess and the treatment would be sedated. As I learned years ago in school, All diagnosis are based on one conclusion: Qi and Blood stagnation with Damp. I was so diappointed because that is a vague diagnosis, and the treatment was lengthy and no results. All I am asking my fellow therapists, we should have chang ed this kind of conclusion and study more to bring excellent results to our patients. The treatment was prescribed for this patient as I have seen Sp6 was used which is perfect for tonify and transform Blood. However, if this is a dampheat case I may use addtional LI4 and or SP 9 which is the most, no more than that. The less points used is the better. LI4 reduce all heat, especially for heat in the intestines. LI4 ( Yang Ming channel which is more blood and more Qi ) reduces heat in the blood and activates QI. SP9 specially transform all body fluids and expell the fluids throug the urinary system, reduce dampness. However, I choose only one point which I have had best result. Finally, if this is damp condition, we may prescribe craneberry juice, or celery juice. This is easier for the patients. Thank you. The obove is just an opinion, please do not feel that this of any malintention for proving who is better than who. If I have offended any other therapists which is not of my intention, I truly apologize. Please let me know I will never post up my opinions again. Chinese Medicine , " Angelo DAlberto " <angelo_dalberto wrote: > > Hi Andrea, > > I have been treating this as a case of Damp with Qi and Blood > Stagnation: Cang Zhu 9, Huang Bai 9, Fu Ling 9, Chen Pi 6, Zhi Shi > 9, Xiang Fu 9, Chuan Xiong 6, Mai Ya 12, Gan Cao 3. Acupuncture > points from - SP9, SP6, Ren 12, Ren 9, Ren 6, ST40, LI4, SJ5/GB41, > SP4/PC6, etc. > > Thank you for your thoughts on patterns. I agree that there must be > some Kid-Xu but I was hoping to tackle that once the other patterns > had resolved somewhat. > > Angelo > > Chinese Medicine , Andrea Beth > Damsky <@> wrote: > > > > Angelo, > > > > How have you been treating this patient? That > > information will help us give you some direction. > > > > From your description, I see the current patterns: > > > > Liver Qi and Blood Stagnation > > Damp Heat > > Blood Deficiency > > Possible Kidney Deficiency - but need more information > > to say for sure. I'd look at her Yin and Jing. > > > > > > > > --- Angelo DAlberto <angelo_dalberto@> > > wrote: > > > > > I have been treating the following case for a couple > > > of months now > > > without too much success and would welcome any > > > comments or > > > suggestions regarding pattern differentiation and > > > acupuncture/Chinese herbs from a TCM approach. > > > > > > Female, age 22 > > > > > > Main Complaint: No periods for 1 year > > > > > > Patient had a pregnancy terminated then immediately > > > went on the > > > contraceptive pill for 1 and a half years. Since > > > stopping the pill > > > she has not had any periods. Prior to the > > > termination her periods > > > were regular with a normal flow. > > > > > > Other s & s include - bloating (since about the time > > > she stopped > > > taking the pill, gets gradually worse throughout the > > > day, worse > > > after eating), loose stools (w occ undigested food, > > > 2/3 times a > > > day), urine dark, appetite and energy good, > > > continuous thrush > > > (again, since stopped the pill), some hair loss > > > (thinning, > > > substantial) 6 months ago that lasted for 2 months. > > > > > > She has dark circles under her eyes, pale > > > complexion, abdomen from > > > umbilicus to sternum is firm and slightly tender to > > > the touch, no > > > obesity/under-weight, brittle nails. Diet is > > > generally well > > > balanced - avoids dairy and too much carbs. > > > Emotionally seems well > > > balanced. > > > > > > T: Red body > > > P: Wiry > > > > > > The patient is due to see a gynaecologist soon which > > > will hopefully > > > shed some light on the situation. A previous > > > ultrasound post > > > termination showed slightly enlarged ovaries but > > > this wasn't > > > followed through. > > > > > > Comments appreciated. Any other info/questions > > > please ask. > > > > > > Many thanks, > > > > > > Angelo > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2006 Report Share Posted October 18, 2006 Hi Dr Namnguyen, No offence taken by your posts at all! The reason I posted this case was because I wasn't acheiving a result and was looking for other perspectives and opinions such as yours. For me, the Damp/Damp-Heat is apparent in the bloating, loose stool, dark urine, and thrush, and hence in the middle and lower burner. No doubt there is also some Blood-Xu and probably Spleen/Kidney-Xu as well. An article posted to me by another list member discusses the contraceptive pill as a cold substance which seems to make sense in light of this case. Any other thoughts/opinions are welcome! Humbly yours, Angelo --- In Chinese Medicine , " dr_namnguyen58 " <dr_namnguyen58 wrote: > > Hi Angelo, > If you have sucessfully treated these patients with Dampheat, I think > other folks and I should join the team. We are here to learn and to > share our experience, nobody is perfect. > What I see , where is the damp ( patient feel heavy , sticky, slow, > lazy, headache, stomach bloating, or dysuria, darkscanty urine, > smelling or dirty urine ) upper, middle or lower ? Is this a strong > sign of damp ? sticky wet tongue with thick coat? Is this a key point > of diagnosis? > Blood and QI stagnation ? Is this of irregular pulses ( stagnation )? > Is there any symptom of Qi stagnation ( difficult breathing, coughing, > pains come and go, difficult of expelling waste or urine, chest > discomfort )? Is there any signs of blood stagnation beside amenorrhea > ? stabbing or cruciating pain, purple tongue, dark skin, dark waste or > dark urine ? severe headache ? > The above signs are of excess and the treatment would be sedated. > As I learned years ago in school, All diagnosis are based on one > conclusion: Qi and Blood stagnation with Damp. I was so diappointed > because that is a vague diagnosis, and the treatment was lengthy and > no results. All I am asking my fellow therapists, we should have chang > ed this kind of conclusion and study more to bring excellent results > to our patients. > The treatment was prescribed for this patient as I have seen Sp6 was > used which is perfect for tonify and transform Blood. However, if this > is a dampheat case I may use addtional LI4 and or SP 9 which is the > most, no more than that. The less points used is the better. > LI4 reduce all heat, especially for heat in the intestines. LI4 ( Yang > Ming channel which is more blood and more Qi ) reduces heat in the > blood and activates QI. SP9 specially transform all body fluids and > expell the fluids throug the urinary system, reduce dampness. > However, I choose only one point which I have had best result. > Finally, if this is damp condition, we may prescribe craneberry juice, > or celery juice. This is easier for the patients. > > Thank you. > The obove is just an opinion, please do not feel that this of any > malintention for proving who is better than who. > If I have offended any other therapists which is not of my intention, > I truly apologize. Please let me know I will never post up my opinions > again. Chinese Medicine , " Angelo DAlberto " > <angelo_dalberto@> wrote: > > > > Hi Andrea, > > > > I have been treating this as a case of Damp with Qi and Blood > > Stagnation: Cang Zhu 9, Huang Bai 9, Fu Ling 9, Chen Pi 6, Zhi Shi > > 9, Xiang Fu 9, Chuan Xiong 6, Mai Ya 12, Gan Cao 3. Acupuncture > > points from - SP9, SP6, Ren 12, Ren 9, Ren 6, ST40, LI4, SJ5/GB41, > > SP4/PC6, etc. > > > > Thank you for your thoughts on patterns. I agree that there must be > > some Kid-Xu but I was hoping to tackle that once the other patterns > > had resolved somewhat. > > > > Angelo > > > > Chinese Medicine , Andrea Beth > > Damsky <@> wrote: > > > > > > Angelo, > > > > > > How have you been treating this patient? That > > > information will help us give you some direction. > > > > > > From your description, I see the current patterns: > > > > > > Liver Qi and Blood Stagnation > > > Damp Heat > > > Blood Deficiency > > > Possible Kidney Deficiency - but need more information > > > to say for sure. I'd look at her Yin and Jing. > > > > > > > > > > > > --- Angelo DAlberto <angelo_dalberto@> > > > wrote: > > > > > > > I have been treating the following case for a couple > > > > of months now > > > > without too much success and would welcome any > > > > comments or > > > > suggestions regarding pattern differentiation and > > > > acupuncture/Chinese herbs from a TCM approach. > > > > > > > > Female, age 22 > > > > > > > > Main Complaint: No periods for 1 year > > > > > > > > Patient had a pregnancy terminated then immediately > > > > went on the > > > > contraceptive pill for 1 and a half years. Since > > > > stopping the pill > > > > she has not had any periods. Prior to the > > > > termination her periods > > > > were regular with a normal flow. > > > > > > > > Other s & s include - bloating (since about the time > > > > she stopped > > > > taking the pill, gets gradually worse throughout the > > > > day, worse > > > > after eating), loose stools (w occ undigested food, > > > > 2/3 times a > > > > day), urine dark, appetite and energy good, > > > > continuous thrush > > > > (again, since stopped the pill), some hair loss > > > > (thinning, > > > > substantial) 6 months ago that lasted for 2 months. > > > > > > > > She has dark circles under her eyes, pale > > > > complexion, abdomen from > > > > umbilicus to sternum is firm and slightly tender to > > > > the touch, no > > > > obesity/under-weight, brittle nails. Diet is > > > > generally well > > > > balanced - avoids dairy and too much carbs. > > > > Emotionally seems well > > > > balanced. > > > > > > > > T: Red body > > > > P: Wiry > > > > > > > > The patient is due to see a gynaecologist soon which > > > > will hopefully > > > > shed some light on the situation. A previous > > > > ultrasound post > > > > termination showed slightly enlarged ovaries but > > > > this wasn't > > > > followed through. > > > > > > > > Comments appreciated. Any other info/questions > > > > please ask. > > > > > > > > Many thanks, > > > > > > > > Angelo > > > > > > > > > > > > > > > > > > > > > > > > > > > Tired of spam? Mail has the best spam protection around > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2006 Report Share Posted October 19, 2006 Hi Angelo, et al, Some questions and possibilities. Are there any signs of the monthly cycle (yue jing), even though no menstrual flow? Any hormonal swings? (Are there any easy tests for the FSH etc cycle?) Was her cycle previously in synch with the moon, or with her mother, a sister, or close female friend? If there's some trace of cycle, one could try to support the process, to strengthen, build up to flow. I.e. the classical sequence of building blood during the first half of the cycle, then blood moving in the second half. The various pattern clues would help shape the choice of particular herbs (organ/channel targets) and doses (quantity as well as gentle vs strong). In the findings I see spleen and kidney weaknesses, so might favor gently supportive herbs. Spleen / digestive metabolism is clearly not very efficient. In some classical theory of pre-natal development, the spleen governs the 1st trimester, and when in trouble, the kidney's job is the " rescue " the spleen. And the yuan energetic layer / Kidney likely damaged. Maybe in the aspect of the " will " too. (How does she feel about herself, in light of the termination and subsequent problems? How does her outlook on life compare with that before all this? Is she in a subtle state of shock? There may be some sense of completion, of healing required here before a cure can take place.) For the spleen, check on some degree of warming food in the A.M. (gentle, digestible carbs, possibly non-glutenous), vs. a lot of fruit (cooling), or eggs and meat (stagnating) to try to rectify the apparent worsening in the course of the energetic (sp-ki) daily cycle. (I was taught the sp/st needs its heat stoked early in the day, building to peak digestive and metabolic fire at midday (like the sun/TaiYang), then cooling off/slowing later in the day. And a bit of (WM) research I ran across finds digestion more efficient earlier in the day, and better eating then tends to satisfy the body, less hunger and weakness later in the day.) Heat and stagnation, of course, have to be carefully evaluated and located, possibly cleared to some degree lest supplemental input add to them. And if there is in fact " damp heat " , is one, e.g. the damp, the pathogenic aspect (spleen weak), and the other, e.g. the heat, a physiological response to counter the dampness? Or vice versa? If so, go after the pathology and avoid suppressing the body's natural response. As above, look for natural processes to encourage. As for the liver aspect, is the lower abdomen cooler to the touch? (Cold in the liver from the trauma/injury, as often encountered post-partum, and when becoming chronic leading to later problems). For that, possibly moxa the low abdomen. I confess to a bias against putting too much weight on liver stagnation, especially as excess, because it's so common in contemporary lifestyle as to be sort of background noise. Especially in TCM school, Lr qi zhi is the easy diagnosis, and I had several good teachers who emphasized looking for more subtle things to work with. Also, there's a TCM bias towards Lr patterns as excess, the historical (accidental) origins of which are discussed by Volker Scheid in his thesis/book(1). Also an article in an issue of the PCOM newsletter a year or so ago, by Robert Damon, explored subtleties in traditional discussions of liver deficiency, which I find often underlying in patients who experience taxation but exhibit with relatively excess symptoms. So I look for opportunities to support smooth flow of liver (in this case blood, and qi as it's mover), rather trying to attack stagnation in any way that could be further taxing. Also, there's the risk here that the trauma (pregnancy termination and sequellae) will register into the yuan level and become constitutional (8 extraord. vessels, Mu points, etc.). That is, according to an interpretation that the wei mai (linking channels) represent vulnerability to taxation at the nodal points of the 7 & 8 year cycles. The patient would have been 19-20 y/o at the time, and given, as some posit, that these cycles are shortening in many people under the evolutionary stress (increased stimulation early on) of modern life, she could well have been at the point passing from the 3rd to the 4th cycles. Were there any outstanding events, possibly trauma at the earlier passages? i.e. ca. 6-8 y/o, or 12-16 (puberty)? Thanks for sharing this case with us. It brings up several interesting issues. References: 1) Scheid, Volker; in Comtemporary China Plurality and Synthsis; Duke University Press, Durham and London, 2002. I can't locate the passage immediately, but the gist of it was that at the time TCM patterns were established (the " Essentials " book) a certain person headed the committee which delineated the liver syndromes, and he came from a tradition which saw liver patterns as mainly excess, despite significant literature, in the 19th Century particularly, on a range of deficient patterns associated with the liver. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2006 Report Share Posted October 19, 2006 Here are my thoughts on the treatment of this case. First, it is clear that deficiency of blood is an aspect of this woman's condition evidenced by the weak nails. This helps explain the amenorrhea, pale complexion and hair loss. Secondly, thrush is a western disease and can be from variety of chinese etiologies. How does this manifest for her. You said her tongue is red. Are there peeled patches - which is often a main manifestation of thrush? If there are, this would be definitive for Yin deficiency. Your formula is almost entirely pungent and drying which seems not correct and possibly damaging. If there is dampheat as you say, your herbs do not treat it. They dry dampness with pungent, warm herbs. Only Huang Bai is for dampheat - but then there is the question of where you think the dampheat is. Is it in the stomach or bladder? If so, these herb would not address it. But, I am not sure at all that there is dampheat. The dark urine only tells you heat (empty or depressive) in the bladder - not necessarily dampheat. If her tongue is red with no cracks or peeled patches then the heat is from depressive heat. You are right that there is some stagnation but, given the blood and possible Yin deficiency you have to take a lot of care as to how you activate the Qi. Qin Bo-Wei encourages us to address the disease factor, symptom and location when diagnosing, developing a treatment principle and formula. In this case, the disease factors are: Blood deficiency and (maybe) Yin deficiency, Liver stasis interrupting the free flow of the Spleen and depressive heat. These disease factors explain all of her signs and symptoms. The symptom is amenorrhea primarely - something your formula does not address The location is the uterus and Liver and possibly the Kidney. So, for her, the treatment principle must include inducing menstruation by enriching the Yin and Blood, regulating the Qi and clearing heat. The fact that the urine is dark tells us that the bladder will be a good avenue for clearing the heat. So, here is what I would do - Dang Gui Sheng and Shu di Huang Bai Shao Gou Qi Zi Shan Zhu Yu Chong Wei Zi Che Qian Zi Zhi Zi Mu Dan Pi Ba Yue Zha Fo Shou Huai Niu Xi This way, the blood is being both enriched and encouraged to open below. The stasis in the digestion is handled with gentle herbs that do not dry so much. Depressive heat is dischared through the urine. Let us know if there are really true signs of damp but I don't see them from what you have given. Hope this helps, Sharon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2006 Report Share Posted October 19, 2006 Hi Angelo, My thoughts are for more tonifying Sp/Kd Qi and blood. I see an overwhelming Sp deficiency. Sp and Kd Qi blood & Yang deficiency. From the symptoms you posted, I do not see much heat. Dark urine could be from meds/vitamins, the red tongue is it dry? Could he flaring heat from blood deficiency. Loose stools, occ undigested food, bloating worse after eating. This tells me the Sp Qi & Yang are unable to transform food into blood. Along with the other Kd signs you mentioned she is unable to create enough jing for her menstrual blood for menstruation. By tonifying Sp and Kd, maybe her body can start digesting better and create enough blood. With better Sp digestion, she will clear up any extra dampness from the stagnation due to her deficiency. Maybe? Thanks, Elie Chinese Medicine , " Angelo DAlberto " <angelo_dalberto wrote: > > I have been treating the following case for a couple of months now > without too much success and would welcome any comments or > suggestions regarding pattern differentiation and > acupuncture/Chinese herbs from a TCM approach. > > Female, age 22 > > Main Complaint: No periods for 1 year > > Patient had a pregnancy terminated then immediately went on the > contraceptive pill for 1 and a half years. Since stopping the pill > she has not had any periods. Prior to the termination her periods > were regular with a normal flow. > > Other s & s include - bloating (since about the time she stopped > taking the pill, gets gradually worse throughout the day, worse > after eating), loose stools (w occ undigested food, 2/3 times a > day), urine dark, appetite and energy good, continuous thrush > (again, since stopped the pill), some hair loss (thinning, > substantial) 6 months ago that lasted for 2 months. > > She has dark circles under her eyes, pale complexion, abdomen from > umbilicus to sternum is firm and slightly tender to the touch, no > obesity/under-weight, brittle nails. Diet is generally well > balanced - avoids dairy and too much carbs. Emotionally seems well > balanced. > > T: Red body > P: Wiry > > The patient is due to see a gynaecologist soon which will hopefully > shed some light on the situation. A previous ultrasound post > termination showed slightly enlarged ovaries but this wasn't > followed through. > > Comments appreciated. Any other info/questions please ask. > > Many thanks, > > Angelo > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2006 Report Share Posted October 19, 2006 Hi, I am Chintamani from India & i am also a practitioner of TCM from 4 yrs. Acc to me liver stores blood and also it is responsible for smooth flow of Qi in the body . So i think that u can add points on Liver channel too like LIV1,LIV3 & LIV8. Hope that u may get satisfactory result. Waiting for ur reply soon. Best regards Chintamani. elieg1969 <elieg1969 wrote: Hi Angelo, My thoughts are for more tonifying Sp/Kd Qi and blood. I see an overwhelming Sp deficiency. Sp and Kd Qi blood & Yang deficiency. From the symptoms you posted, I do not see much heat. Dark urine could be from meds/vitamins, the red tongue is it dry? Could he flaring heat from blood deficiency. Loose stools, occ undigested food, bloating worse after eating. This tells me the Sp Qi & Yang are unable to transform food into blood. Along with the other Kd signs you mentioned she is unable to create enough jing for her menstrual blood for menstruation. By tonifying Sp and Kd, maybe her body can start digesting better and create enough blood. With better Sp digestion, she will clear up any extra dampness from the stagnation due to her deficiency. Maybe? Thanks, Elie Chinese Medicine , " Angelo DAlberto " <angelo_dalberto wrote: > > I have been treating the following case for a couple of months now > without too much success and would welcome any comments or > suggestions regarding pattern differentiation and > acupuncture/Chinese herbs from a TCM approach. > > Female, age 22 > > Main Complaint: No periods for 1 year > > Patient had a pregnancy terminated then immediately went on the > contraceptive pill for 1 and a half years. Since stopping the pill > she has not had any periods. Prior to the termination her periods > were regular with a normal flow. > > Other s & s include - bloating (since about the time she stopped > taking the pill, gets gradually worse throughout the day, worse > after eating), loose stools (w occ undigested food, 2/3 times a > day), urine dark, appetite and energy good, continuous thrush > (again, since stopped the pill), some hair loss (thinning, > substantial) 6 months ago that lasted for 2 months. > > She has dark circles under her eyes, pale complexion, abdomen from > umbilicus to sternum is firm and slightly tender to the touch, no > obesity/under-weight, brittle nails. Diet is generally well > balanced - avoids dairy and too much carbs. Emotionally seems well > balanced. > > T: Red body > P: Wiry > > The patient is due to see a gynaecologist soon which will hopefully > shed some light on the situation. A previous ultrasound post > termination showed slightly enlarged ovaries but this wasn't > followed through. > > Comments appreciated. Any other info/questions please ask. > > Many thanks, > > Angelo > Get on board. You're invited to try the new Mail. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2006 Report Share Posted October 19, 2006 OK if the green cabbage got through (and what a great natural solution!) and it seems you're at a real stale mate then this is what I do... I treat clients energetically, without needles. It is not TCM but I use the acupuncture body map (hence my mostly silent lurking here) but also the Indian Chakra system - the chakras store the emotions. In cases of termination, I get the client to " release their baby " . This is a really big thing - the energetic releases from this emotional holding pattern are huge. Women shut their heart chakra down to their sex chakra. Typically also pericardium to ovaries. I know this happens because I have both received treatment and given it repeatedly. The way I treat is vastly different so my treatment protocol is of no use here (one specific balance which very effective for restoring menstrual regularity for instance is where I have two fingers on the perineum and balance it various points on the body). If there is anyone that does energetic release techniques in your area, a kinesiologist, or rebirthing perhaps, I would recommend her to go and see them for the emotional release stuff AND keep seeing you. Alternatively, you could try some shu points that may elicit a cathartic response... good luck, open your heart to her Warm regards Rossana Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 At 03:13 PM 10/19/2006, " rossana_lowgren " <rossana wrote: >...Women shut their heart chakra down to their sex >chakra. Typically also pericardium to ovaries. ... In Chinese medicine this may correspond to what is called the " bao mai " -- a channel linking the heart and the uterus (which are said to both share the same kind of contractive muscle tissue). It's not found in the basic TCM texts, but Bob Flaws wrote/translated a good article about this once. I have a copy of it, somewhere, and remember that it shed a lot of light on issues along the lines Rossana mentions (and likely pertaining to Angelo's case). Jeffery Yuen mentions it occasionally also, often in relationship to the da luo (Great Luo of the Spleen) and the dai mai, as a set of important and deep linkages. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 Chris, Thanks for noting this - an interesting correlation. I'd be grateful if you could shed more light on Jeffrey Yuen's linkage of bao mai, da luo, and dai mai. Thanks, Simcha > In Chinese medicine this may correspond to what is called the " bao > mai " -- a channel linking the heart and the uterus (which are said to > both share the same kind of contractive muscle tissue). It's not > found in the basic TCM texts, but Bob Flaws wrote/translated a good > article about this once. I have a copy of it, somewhere, and remember > that it shed a lot of light on issues along the lines Rossana > mentions (and likely pertaining to Angelo's case). > > Jeffery Yuen mentions it occasionally also, often in relationship to > the da luo (Great Luo of the Spleen) and the dai mai, as a set of > important and deep linkages. > > > Quote Link to comment Share on other sites More sharing options...
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