Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Hi- I have a patient who has been suffering from periodic bleeding when he has an erection. Apparantly, sometimes he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood. He is seeing his MD and has had surgery and an MRI to find where he is bleeding but they have not found anything! The doctors prescribed a drug used for patient's with an enlarged prostate. The drug shrinks the vessles that supply blood to the prostate. While on this drug the patient did not have an episode for over a year. But, after beiing off the drug for 6 months it continues to happen. He says it usually takes 3 months for the injured area to heal. He finds it difficult to abstain for 3 months and then he bleeds again re-injuring the area. He works in the restaurant business 50 plus hours a week and only has 1 day off a week. He is 40 years old. He seems to consume alcohol regularly, does not smoke, does not exercise. He primarily eats food from the restaurant. His tongue is puffy, dusky, slight center crack, red petechia on the front of the tongue, thin white fur. His pulse is generally tight and bowstring but can feel weak. He is back on the medication but is waiting for the injury to heal. Right now I was thinking of directing the treatment towards helping the bleeding area heal. Any suggestions? Anyone heard of this scenerio? Thanks rebecca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Hi there. You might try tien chi powder which is used to stop bleeding without causing clots. I have heard it was used by soliders to stop woud bleeding when other substances were not available. Reenah --- beckynsf <beckynsf wrote: > Hi- > I have a patient who has been suffering from > periodic bleeding when he > has an erection. Apparantly, sometimes he feels > something " burst " and > he gets a feeling that he has to urinate and then he > just unrinates > blood. He is seeing his MD and has had surgery and > an MRI to find > where he is bleeding but they have not found > anything! The doctors > prescribed a drug used for patient's with an > enlarged prostate. The > drug shrinks the vessles that supply blood to the > prostate. While on > this drug the patient did not have an episode for > over a year. But, > after beiing off the drug for 6 months it continues > to happen. He > says it usually takes 3 months for the injured area > to heal. He finds > it difficult to abstain for 3 months and then he > bleeds again > re-injuring the area. He works in the restaurant > business 50 plus > hours a week and only has 1 day off a week. He is > 40 years old. He > seems to consume alcohol regularly, does not smoke, > does not exercise. > He primarily eats food from the restaurant. His > tongue is puffy, > dusky, slight center crack, red petechia on the > front of the tongue, > thin white fur. His pulse is generally tight and > bowstring but can > feel weak. He is back on the medication but is > waiting for the injury > to heal. Right now I was thinking of directing the > treatment towards > helping the bleeding area heal. Any suggestions? > Anyone heard of this > scenerio? > Thanks > rebecca > > Dr. Reenah McGill Licensed Acupuncturist & Biofeedback Specialist Healing Energy Center Modern Technology and Ancient Wisdom 323.668.0278 ph 323.668.2206 fax visit http://WWW.healingenergycenter.com and signup for your FREE ezine of health news and information to improve your life. ______________________________\ ____ No need to miss a message. Get email on-the-go with Mail for Mobile. Get started. http://mobile./mail Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 thanks. is this the same as yunan bai yao? if so, i considered it but wasn't sure because it has been 15 days since the last episode and i'm not sure if stop bleeding or move the bood is better. His doctors said they are worried about the blood becoming stagnant in the area. What area they are not sure. it seems the blood is coming out his urethra as a result of ejaculation and the burst of small blood vessels. Hmmm. Thanks for the input! Rebecca --- Reenah Mcgill <reenahm wrote: > Hi there. You might try tien chi powder which is > used > to stop bleeding without causing clots. I have > heard > it was used by soliders to stop woud bleeding when > other substances were not available. Reenah > --- beckynsf <beckynsf wrote: > > > Hi- > > I have a patient who has been suffering from > > periodic bleeding when he > > has an erection. Apparantly, sometimes he feels > > something " burst " and > > he gets a feeling that he has to urinate and then > he > > just unrinates > > blood. He is seeing his MD and has had surgery > and > > an MRI to find > > where he is bleeding but they have not found > > anything! The doctors > > prescribed a drug used for patient's with an > > enlarged prostate. The > > drug shrinks the vessles that supply blood to the > > prostate. While on > > this drug the patient did not have an episode for > > over a year. But, > > after beiing off the drug for 6 months it > continues > > to happen. He > > says it usually takes 3 months for the injured > area > > to heal. He finds > > it difficult to abstain for 3 months and then he > > bleeds again > > re-injuring the area. He works in the restaurant > > business 50 plus > > hours a week and only has 1 day off a week. He is > > 40 years old. He > > seems to consume alcohol regularly, does not > smoke, > > does not exercise. > > He primarily eats food from the restaurant. His > > tongue is puffy, > > dusky, slight center crack, red petechia on the > > front of the tongue, > > thin white fur. His pulse is generally tight and > > bowstring but can > > feel weak. He is back on the medication but is > > waiting for the injury > > to heal. Right now I was thinking of directing > the > > treatment towards > > helping the bleeding area heal. Any suggestions? > > Anyone heard of this > > scenerio? > > Thanks > > rebecca > > > > > > > Dr. Reenah McGill > Licensed Acupuncturist & Biofeedback Specialist > Healing Energy Center Modern Technology and Ancient > Wisdom > 323.668.0278 ph 323.668.2206 fax > visit http://WWW.healingenergycenter.com and signup > for your FREE ezine of health news and information > to improve your life. > > > > > ______________________________\ ____ > No need to miss a message. Get email on-the-go > with Mail for Mobile. Get started. > http://mobile./mail > Rebecca Rizzetta, L.Ac 415.948.8360 ______________________________\ ____ Don't pick lemons. See all the new 2007 cars at Autos. http://autos./new_cars.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Dear Rebecca, Tian qi is the major ingredient in Yanan Bai Yao. We've discussed the formula before which is proprietary but partially known. You might want to check the archives if interested. That being said, from the way you describe the patient sounds like a combination of Kidney Yang vacuity and heart and liver fire. Though difficult to make definitive suggestions without seeing the patient, here are a few constructive suggestions: 1. He must stop all alcoholic beverages immediately, and anything else promoting the fire which certainly is contributing to the bleeding. That would include spicy foods and coffee as well. 2. Having treated patients with prostate cancer, I would strongly suggest that any formula you prepare for him includes saw palmetto, which naturally shrinks the prostate. If I noticed correctly from your phone #, you are probably in or around the Los Feliz area of LA (I'm close to Beverly/La Brea). Nature's Mart on Hillhurst sells Saw Palmetto in their Bulk Bin store. 3. Strongly advise him to honor and listen to his body. The bleeding is telling him that he's in trouble. He needs to eat differently, get adequate sleep, get adequate exercise and lower his stress level. Hope that helps. All the best, Yehuda Frischman, L.Ac, CST, SER www.traditionaljewishmedicine.com " Rebecca (Nerdahl) Rizzetta " <beckynsf wrote: thanks. is this the same as yunan bai yao? if so, i considered it but wasn't sure because it has been 15 days since the last episode and i'm not sure if stop bleeding or move the bood is better. His doctors said they are worried about the blood becoming stagnant in the area. What area they are not sure. it seems the blood is coming out his urethra as a result of ejaculation and the burst of small blood vessels. Hmmm. Thanks for the input! Rebecca --- Reenah Mcgill <reenahm wrote: > Hi there. You might try tien chi powder which is > used > to stop bleeding without causing clots. I have > heard > it was used by soliders to stop woud bleeding when > other substances were not available. Reenah > --- beckynsf <beckynsf wrote: > > > Hi- > > I have a patient who has been suffering from > > periodic bleeding when he > > has an erection. Apparantly, sometimes he feels > > something " burst " and > > he gets a feeling that he has to urinate and then > he > > just unrinates > > blood. He is seeing his MD and has had surgery > and > > an MRI to find > > where he is bleeding but they have not found > > anything! The doctors > > prescribed a drug used for patient's with an > > enlarged prostate. The > > drug shrinks the vessles that supply blood to the > > prostate. While on > > this drug the patient did not have an episode for > > over a year. But, > > after beiing off the drug for 6 months it > continues > > to happen. He > > says it usually takes 3 months for the injured > area > > to heal. He finds > > it difficult to abstain for 3 months and then he > > bleeds again > > re-injuring the area. He works in the restaurant > > business 50 plus > > hours a week and only has 1 day off a week. He is > > 40 years old. He > > seems to consume alcohol regularly, does not > smoke, > > does not exercise. > > He primarily eats food from the restaurant. His > > tongue is puffy, > > dusky, slight center crack, red petechia on the > > front of the tongue, > > thin white fur. His pulse is generally tight and > > bowstring but can > > feel weak. He is back on the medication but is > > waiting for the injury > > to heal. Right now I was thinking of directing > the > > treatment towards > > helping the bleeding area heal. Any suggestions? > > Anyone heard of this > > scenerio? > > Thanks > > rebecca > > > > > > > Dr. Reenah McGill > Licensed Acupuncturist & Biofeedback Specialist > Healing Energy Center Modern Technology and Ancient > Wisdom > 323.668.0278 ph 323.668.2206 fax > visit http://WWW.healingenergycenter.com and signup > for your FREE ezine of health news and information > to improve your life. > > > > > ________ > No need to miss a message. Get email on-the-go > with Mail for Mobile. Get started. > http://mobile./mail > Rebecca Rizzetta, L.Ac 415.948.8360 ________ Don't pick lemons. See all the new 2007 cars at Autos. http://autos./new_cars.html http://traditionaljewishmedicine.com/ Get your own web address. Have a HUGE year through Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Hi- I have a patient who has been suffering from periodic bleeding when he has an erection. Apparantly, sometimes he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood. He is seeing his MD and has had surgery and an MRI to find where he is bleeding but they have not found anything! The doctors prescribed a drug used for patient's with an enlarged prostate. The drug shrinks the vessles that supply blood to the prostate. While on this drug the patient did not have an episode for over a year. But, after beiing off the drug for 6 months it continues to happen. He says it usually takes 3 months for the injured area to heal. He finds it difficult to abstain for 3 months and then he bleeds again re-injuring the area. He works in the restaurant business 50 plus hours a week and only has 1 day off a week. He is 40 years old. He seems to consume alcohol regularly, does not smoke, does not exercise. He primarily eats food from the restaurant. His tongue is puffy, dusky, slight center crack, red petechia on the front of the tongue, thin white fur. His pulse is generally tight and bowstring but can feel weak. He is back on the medication but is waiting for the injury to heal. Right now I was thinking of directing the treatment towards helping the bleeding area heal. Any suggestions? Anyone heard of this scenerio? Thanks rebecca Hi Rebecca, Since we practice Chinese medicine, I would use the methods of Chinese medicine. First, I would not jump to Tian Qi because it basically skips the step of diagnosis. I don't know how we can treat well without diagnosis. Yehuda offered a diagnosis but I do not see the basis for it. What signs and symptoms are there of Kidney Yang vacuity and Heart Fire? I don't see this from what you have presented. Keep in mind the causes of bleeding: 1. Heat - either empty heat or full heat 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney Qi vacuity bleeding in school but it is a common cause of lower warmer bleeding) 3. Blood stasis 4. Trauma In this case, your patient shows definitive signs of heat - red petechia and blood stasis - dusky tongue. Your case study is focused on the main complaint, pulse and tongue but the rest of his presentation is missing (body type, digestion, sleep, urination, pain, energy etc) are we to assume all these things are normal? These aspects would help to clarify diagnosis. The puffy tongue indicates dampness. Does he have other signs and symptoms of this? So, in the case as far as we know from the information you have given, which is not enough, we would want to clear heat and vitalize blood in the lower warmer in order to stop bleeding. The formula should address the disease factor (excess heat and blood stasis) the location (lower warmer Liver channel) and symptom (bleeding). When he is not actually bleeding you still need to vitalize blood and can do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood in order to prevent bleeding. I don't agree with Yehuda that he " must stop drinking " . For one thing, we don't know how much he drinks. In addition, if your diagnosis and treatment is accurate, you should still be able to treat his condition whether he stops or not. Perhaps it would be in his best interest to stop but what if he can't or won't. It would not mean he could not be helped significantly. Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Hi Rebecca, Have you looked for other signs and symptoms of damp heat in the lower jiao? Such as dark, scanty urine; burning, odorous bowel movements; hemorrhoids, etc. wrote: Dear Rebecca, Tian qi is the major ingredient in Yanan Bai Yao. We've discussed the formula before which is proprietary but partially known. You might want to check the archives if interested. That being said, from the way you describe the patient sounds like a combination of Kidney Yang vacuity and heart and liver fire. Though difficult to make definitive suggestions without seeing the patient, here are a few constructive suggestions: 1. He must stop all alcoholic beverages immediately, and anything else promoting the fire which certainly is contributing to the bleeding. That would include spicy foods and coffee as well. 2. Having treated patients with prostate cancer, I would strongly suggest that any formula you prepare for him includes saw palmetto, which naturally shrinks the prostate. If I noticed correctly from your phone #, you are probably in or around the Los Feliz area of LA (I'm close to Beverly/La Brea). Nature's Mart on Hillhurst sells Saw Palmetto in their Bulk Bin store. 3. Strongly advise him to honor and listen to his body. The bleeding is telling him that he's in trouble. He needs to eat differently, get adequate sleep, get adequate exercise and lower his stress level. Hope that helps. All the best, Yehuda Frischman, L.Ac, CST, SER www.traditionaljewishmedicine.com " Rebecca (Nerdahl) Rizzetta " <beckynsf wrote: thanks. is this the same as yunan bai yao? if so, i considered it but wasn't sure because it has been 15 days since the last episode and i'm not sure if stop bleeding or move the bood is better. His doctors said they are worried about the blood becoming stagnant in the area. What area they are not sure. it seems the blood is coming out his urethra as a result of ejaculation and the burst of small blood vessels. Hmmm. Thanks for the input! Rebecca --- Reenah Mcgill <reenahm wrote: > Hi there. You might try tien chi powder which is > used > to stop bleeding without causing clots. I have > heard > it was used by soliders to stop woud bleeding when > other substances were not available. Reenah > --- beckynsf <beckynsf wrote: > > > Hi- > > I have a patient who has been suffering from > > periodic bleeding when he > > has an erection. Apparantly, sometimes he feels > > something " burst " and > > he gets a feeling that he has to urinate and then > he > > just unrinates > > blood. He is seeing his MD and has had surgery > and > > an MRI to find > > where he is bleeding but they have not found > > anything! The doctors > > prescribed a drug used for patient's with an > > enlarged prostate. The > > drug shrinks the vessles that supply blood to the > > prostate. While on > > this drug the patient did not have an episode for > > over a year. But, > > after beiing off the drug for 6 months it > continues > > to happen. He > > says it usually takes 3 months for the injured > area > > to heal. He finds > > it difficult to abstain for 3 months and then he > > bleeds again > > re-injuring the area. He works in the restaurant > > business 50 plus > > hours a week and only has 1 day off a week. He is > > 40 years old. He > > seems to consume alcohol regularly, does not > smoke, > > does not exercise. > > He primarily eats food from the restaurant. His > > tongue is puffy, > > dusky, slight center crack, red petechia on the > > front of the tongue, > > thin white fur. His pulse is generally tight and > > bowstring but can > > feel weak. He is back on the medication but is > > waiting for the injury > > to heal. Right now I was thinking of directing > the > > treatment towards > > helping the bleeding area heal. Any suggestions? > > Anyone heard of this > > scenerio? > > Thanks > > rebecca > > > > > > > Dr. Reenah McGill > Licensed Acupuncturist & Biofeedback Specialist > Healing Energy Center Modern Technology and Ancient > Wisdom > 323.668.0278 ph 323.668.2206 fax > visit http://WWW.healingenergycenter.com and signup > for your FREE ezine of health news and information > to improve your life. > > > > > ________ > No need to miss a message. Get email on-the-go > with Mail for Mobile. Get started. > http://mobile./mail > Rebecca Rizzetta, L.Ac 415.948.8360 ________ Don't pick lemons. See all the new 2007 cars at Autos. http://autos./new_cars.html http://traditionaljewishmedicine.com/ Get your own web address. Have a HUGE year through Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Hi Sharon, My deductions were based upon the following clues from Rebecca: " he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood " Spleen controls the blood vessels and if the spleen qi is vacuitous it cannot hold the blood in the vessels " an enlarged prostate " Could be for a number of reason " works in the restaurant business 50 plus hours a week and only has 1 day off a week " Su Wen says that excessive standing damages the kidneys " He seems to consume alcohol regularly " Alcohol consumption exascerbates the reckless qi as it is hot " does not exercise " Without exercise the qi and blood stagnate " He primarily eats food from the restaurant " Though she did not say explicitly, the assumption is that restaurant food is not going to be of a quality to promote wellness with qi and blood cultivation, both in terms of freshness and method of preparation. Also I would surmise that if he is eating at the restaurant where he works he's probably rushing and irritable while eating. " His tongue is puffy ,dusky " I agree that this is dampness, but slight center crack, red petechia on the front of the tongue, thin white fur. His pulse is generally tight and bowstring but can feel weak " sharon weizenbaum <sweiz wrote: Hi- I have a patient who has been suffering from periodic bleeding when he has an erection. Apparantly, sometimes he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood. He is seeing his MD and has had surgery and an MRI to find where he is bleeding but they have not found anything! The doctors prescribed a drug used for patient's with an enlarged prostate. The drug shrinks the vessles that supply blood to the prostate. While on this drug the patient did not have an episode for over a year. But, after beiing off the drug for 6 months it continues to happen. He says it usually takes 3 months for the injured area to heal. He finds it difficult to abstain for 3 months and then he bleeds again re-injuring the area. He works in the restaurant business 50 plus hours a week and only has 1 day off a week. He is 40 years old. He seems to consume alcohol regularly, does not smoke, does not exercise. He primarily eats food from the restaurant. His tongue is puffy, dusky, slight center crack, red petechia on the front of the tongue, thin white fur. His pulse is generally tight and bowstring but can feel weak. He is back on the medication but is waiting for the injury to heal. Right now I was thinking of directing the treatment towards helping the bleeding area heal. Any suggestions? Anyone heard of this scenerio? Thanks rebecca Hi Rebecca, Since we practice Chinese medicine, I would use the methods of Chinese medicine. First, I would not jump to Tian Qi because it basically skips the step of diagnosis. I don't know how we can treat well without diagnosis. Yehuda offered a diagnosis but I do not see the basis for it. What signs and symptoms are there of Kidney Yang vacuity and Heart Fire? I don't see this from what you have presented. Keep in mind the causes of bleeding: 1. Heat - either empty heat or full heat 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney Qi vacuity bleeding in school but it is a common cause of lower warmer bleeding) 3. Blood stasis 4. Trauma In this case, your patient shows definitive signs of heat - red petechia and blood stasis - dusky tongue. Your case study is focused on the main complaint, pulse and tongue but the rest of his presentation is missing (body type, digestion, sleep, urination, pain, energy etc) are we to assume all these things are normal? These aspects would help to clarify diagnosis. The puffy tongue indicates dampness. Does he have other signs and symptoms of this? So, in the case as far as we know from the information you have given, which is not enough, we would want to clear heat and vitalize blood in the lower warmer in order to stop bleeding. The formula should address the disease factor (excess heat and blood stasis) the location (lower warmer Liver channel) and symptom (bleeding). When he is not actually bleeding you still need to vitalize blood and can do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood in order to prevent bleeding. I don't agree with Yehuda that he " must stop drinking " . For one thing, we don't know how much he drinks. In addition, if your diagnosis and treatment is accurate, you should still be able to treat his condition whether he stops or not. Perhaps it would be in his best interest to stop but what if he can't or won't. It would not mean he could not be helped significantly. Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Thank you for your responses. I realize I did not include enough information for a specefic diagnosis. I also practice massage and it was at the end of a massage session when he mentioned this problem so I asked him a few questions and took his tongue and pulse just to get a small piece of the picture. I will see him next week and will be doing just an acupuncture session. Thank you for reminding me of the basics (bleeding from deficiency or heat ect) I do hope he can stop drinking alcohol for awhile. I think that it is a strong " herb " and can counteract a lot of other treatments. I did not know that saw palmetto had that effect on the prostate (I am in San Francisco, but I'm sure I can find it)My sense is from what he described is that his personal relationships are based a lot on the sexual content. He said he is also used to doing what he wants when he wants and he is frustrated that he is limited sexually right now. I do think he has some Kd def because of the many years of long hours and physical work combined with his discription of sexual lifestyle. I also think it is likely he has heat in the Liv/GB. I am not aware of other damp signs besides the puffy tongue but maybe with more questioning it will show up. As far as the food at the restaurant, I don't know any specefics but I will ask him. Anyway, thanks again for the input and I will report back after his next treatment. Also, I do not mind this case being circulated in other groups. Rebecca Rebecca Rizzetta, L.Ac 415.948.8360 ______________________________\ ____ Cheap talk? Check out Messenger's low PC-to-Phone call rates. http://voice. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Sorry, I hit the send button in the middle of writing--disregard the previous incomplete post: My deductions were based upon the following clues from Rebecca: " he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood " Spleen controls the blood vessels and if the spleen qi is vacuitous it cannot hold the blood in the vessels " an enlarged prostate " Could be for a number of reason " works in the restaurant business 50 plus hours a week and only has 1 day off a week " Su Wen says that excessive standing damages the kidneys " He seems to consume alcohol regularly " Alcohol consumption exascerbates the reckless qi as it is hot " does not exercise " Without exercise the qi and blood stagnate " He primarily eats food from the restaurant " Though she did not say explicitly, the assumption is that restaurant food is not going to be of a quality to promote wellness with qi and blood cultivation, both in terms of freshness and method of preparation. Also I would surmise that if he is eating at the restaurant where he works he's probably rushing and irritable while eating. " His tongue is puffy ,dusky " I agree that this is dampness,and that the dusky color of tongue body connotes blood stasis " red petechia on the front of the tongue " This is heart fire " thin white fur " . no obvious heat in the middle or lower jiao, as no red tongue body or yellow coat His pulse is generally tight and bowstring but can feel weak " Tight pulse is cold stagnation Therefore my conclusions: Spleen qi xu, damp cold accumulation, and heart fire with definite kidney involvement, which I assume is kidney yang based upon the internal cold and the dusky swollen tongue. I may have assumed incorrectly that there is liver fire, but heart fire there definitely is, and I can't undertstand why you wouldn't encourage him to refrain from drinking alcohol. Also remember that the red petechia or on the front of the tongue, which to the best of my knowledge pretty clearly limits the heat to the heart (or lungs) and doesn't imply that there is any other manifestation of middle or lower jiao heat. Again, I respectfully disagree that the swollen, dusky tongue connotes heat and stagnation--on the contrary, the tight pulse together with the tongue tells me that there is cold damp accumulation. Though also you are correct that we don't know explicitly more details about the patient, such as constitution and lifestyle, we do know that he overworks, probably standing a lot, and lives on restaurant food--certainly it is reasonable to deduce that there is taxation from overexertion leading to spleen and even kidney xu. Of course blood needs to be supplemented but clearly qi xu is the root. Sincerely, Yehuda sharon weizenbaum <sweiz wrote: Hi- I have a patient who has been suffering from periodic bleeding when he has an erection. Apparantly, sometimes he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood. He is seeing his MD and has had surgery and an MRI to find where he is bleeding but they have not found anything! The doctors prescribed a drug used for patient's with an enlarged prostate. The drug shrinks the vessles that supply blood to the prostate. While on this drug the patient did not have an episode for over a year. But, after beiing off the drug for 6 months it continues to happen. He says it usually takes 3 months for the injured area to heal. He finds it difficult to abstain for 3 months and then he bleeds again re-injuring the area. He works in the restaurant business 50 plus hours a week and only has 1 day off a week. He is 40 years old. He seems to consume alcohol regularly, does not smoke, does not exercise. He primarily eats food from the restaurant. His tongue is puffy, dusky, slight center crack, red petechia on the front of the tongue, thin white fur. His pulse is generally tight and bowstring but can feel weak. He is back on the medication but is waiting for the injury to heal. Right now I was thinking of directing the treatment towards helping the bleeding area heal. Any suggestions? Anyone heard of this scenerio? Thanks rebecca Hi Rebecca, Since we practice Chinese medicine, I would use the methods of Chinese medicine. First, I would not jump to Tian Qi because it basically skips the step of diagnosis. I don't know how we can treat well without diagnosis. Yehuda offered a diagnosis but I do not see the basis for it. What signs and symptoms are there of Kidney Yang vacuity and Heart Fire? I don't see this from what you have presented. Keep in mind the causes of bleeding: 1. Heat - either empty heat or full heat 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney Qi vacuity bleeding in school but it is a common cause of lower warmer bleeding) 3. Blood stasis 4. Trauma In this case, your patient shows definitive signs of heat - red petechia and blood stasis - dusky tongue. Your case study is focused on the main complaint, pulse and tongue but the rest of his presentation is missing (body type, digestion, sleep, urination, pain, energy etc) are we to assume all these things are normal? These aspects would help to clarify diagnosis. The puffy tongue indicates dampness. Does he have other signs and symptoms of this? So, in the case as far as we know from the information you have given, which is not enough, we would want to clear heat and vitalize blood in the lower warmer in order to stop bleeding. The formula should address the disease factor (excess heat and blood stasis) the location (lower warmer Liver channel) and symptom (bleeding). When he is not actually bleeding you still need to vitalize blood and can do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood in order to prevent bleeding. I don't agree with Yehuda that he " must stop drinking " . For one thing, we don't know how much he drinks. In addition, if your diagnosis and treatment is accurate, you should still be able to treat his condition whether he stops or not. Perhaps it would be in his best interest to stop but what if he can't or won't. It would not mean he could not be helped significantly. Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2007 Report Share Posted January 31, 2007 Hi Rebecca > ... He said he is also used to doing what he wants when he wants and he > is frustrated that he is limited sexually right now ... A man who wants orgasms that ejaculate blood must be crazy, or have flown in from a different planet. His body is TELLING him to lay off and seek expert help ASAP. Blood in the semen (hematospermia) can occur at any age. In younger men (<40 y), it is uniformly benign. In older men, it is rarely associated with malignancy. However, lots of blood may indicate serious urogenito/vascular pathology. A recent study by Han et al reported a significantly increased risk of prostate cancer among men with hematospermia. Of 139 men with hematospermia, 19 (13.7%) were diagnosed with prostate cancer. For the overall cohort of 26,126 patients, the prostate cancer detection rate was 6.5%. On logistic regression analysis, the presence of hematospermia was a significant predictor of prostate cancer diagnosis. This is still a controversial area of investigation. See: http://www.emedicine.com/med/topic3466.htm Best regards, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Hi Phil- Well, from what I know he has not been diagnosed as " crazy " and was born in Stockton, CA (not another planet) and that is why I am concerned about his " intimate " relationships. From what he described, the bleeding is not with ejaculation but the ejaculation causes the blood vessels to burst and the sensation is that he needs to urinate. Then he does feel like he is peeing blood. It seems like it is a very different sensation to him than ejaculating. He said that his doctors have voiced their concerns regarding the bleeding and the blood congealing and the end result being cancer. He is scared, frustrated, overworked, tired and doesn't have much emotional support. His introduction to this conversation (while getting a massage) was " I know you can't help me but this is what is going on. " to be continued... rebecca --- < wrote: > Hi Rebecca > > > ... He said he is also used to doing what he wants > when he wants and he > > is frustrated that he is limited sexually right > now ... > > A man who wants orgasms that ejaculate blood must be > crazy, or have > flown in from a different planet. His body is > TELLING him to lay off and seek > expert help ASAP. > > Blood in the semen (hematospermia) can occur at any > age. In younger men > (<40 y), it is uniformly benign. In older men, it is > rarely associated with > malignancy. However, lots of blood may indicate > serious urogenito/vascular > pathology. > > A recent study by Han et al reported a significantly > increased risk of prostate > cancer among men with hematospermia. Of 139 men with > hematospermia, > 19 (13.7%) were diagnosed with prostate cancer. For > the overall cohort of > 26,126 patients, the prostate cancer detection rate > was 6.5%. On logistic > regression analysis, the presence of hematospermia > was a significant > predictor of prostate cancer diagnosis. This is > still a controversial area of > investigation. See: > http://www.emedicine.com/med/topic3466.htm > > Best regards, > > > Rebecca Rizzetta, L.Ac 415.948.8360 ______________________________\ ____ Need Mail bonding? Go to the Mail Q & A for great tips from Answers users. http://answers./dir/?link=list & sid=396546091 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Rebecca, Do everything you can to reach him! When he says, " I know you can't help me but this is what's going on " , he is pleading with you to save his life! And you know what? G-d willing, you can! But it involves a new focus and direction on his part. You have to reach him and educate him as to 1. His lifestyle, 2. his eating habits, 3. his attitude and thoughts. As I said previously, write him an appropriate formula based upon his pattern, and include Saw Palmetto in it. Tell him that he's got to get off of his feet (even if it means finding a new profession, isn't it worth it to be alive and get well?), get adequate sleep, and refrain from sex and alcohol, at least for now! You might consider including in your formula herbs that can lessen his voracious sex drive. Guide him toward foods that will nourish his kidneys and away from foods that will create fire (such as fried foods) and dampness (such as dairy and raw vegetables). Lastly, again, let him know that you are there for him. Good luck, Yehuda " Rebecca (Nerdahl) Rizzetta " <beckynsf wrote: Hi Phil- Well, from what I know he has not been diagnosed as " crazy " and was born in Stockton, CA (not another planet) and that is why I am concerned about his " intimate " relationships. From what he described, the bleeding is not with ejaculation but the ejaculation causes the blood vessels to burst and the sensation is that he needs to urinate. Then he does feel like he is peeing blood. It seems like it is a very different sensation to him than ejaculating. He said that his doctors have voiced their concerns regarding the bleeding and the blood congealing and the end result being cancer. He is scared, frustrated, overworked, tired and doesn't have much emotional support. His introduction to this conversation (while getting a massage) was " I know you can't help me but this is what is going on. " to be continued... rebecca --- < wrote: > Hi Rebecca > > > ... He said he is also used to doing what he wants > when he wants and he > > is frustrated that he is limited sexually right > now ... > > A man who wants orgasms that ejaculate blood must be > crazy, or have > flown in from a different planet. His body is > TELLING him to lay off and seek > expert help ASAP. > > Blood in the semen (hematospermia) can occur at any > age. In younger men > (<40 y), it is uniformly benign. In older men, it is > rarely associated with > malignancy. However, lots of blood may indicate > serious urogenito/vascular > pathology. > > A recent study by Han et al reported a significantly > increased risk of prostate > cancer among men with hematospermia. Of 139 men with > hematospermia, > 19 (13.7%) were diagnosed with prostate cancer. For > the overall cohort of > 26,126 patients, the prostate cancer detection rate > was 6.5%. On logistic > regression analysis, the presence of hematospermia > was a significant > predictor of prostate cancer diagnosis. This is > still a controversial area of > investigation. See: > http://www.emedicine.com/med/topic3466.htm > > Best regards, > > > Rebecca Rizzetta, L.Ac 415.948.8360 ________ Need Mail bonding? Go to the Mail Q & A for great tips from Answers users. http://answers./dir/?link=list & sid=396546091 http://traditionaljewishmedicine.com/ Don't pick lemons. See all the new 2007 cars at Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 " he feels something " burst " and he gets a feeling that he has to urinate and then he just unrinates blood " Spleen controls the blood vessels and if the spleen qi is vacuitous it cannot hold the blood in the vessels " an enlarged prostate " Could be for a number of reason " works in the restaurant business 50 plus hours a week and only has 1 day off a week " Su Wen says that excessive standing damages the kidneys " He seems to consume alcohol regularly " Alcohol consumption exascerbates the reckless qi as it is hot " does not exercise " Without exercise the qi and blood stagnate " He primarily eats food from the restaurant " Though she did not say explicitly, the assumption is that restaurant food is not going to be of a quality to promote wellness with qi and blood cultivation, both in terms of freshness and method of preparation. Also I would surmise that if he is eating at the restaurant where he works he's probably rushing and irritable while eating. " His tongue is puffy ,dusky " I agree that this is dampness,and that the dusky color of tongue body connotes blood stasis " red petechia on the front of the tongue " This is heart fire " thin white fur " . no obvious heat in the middle or lower jiao, as no red tongue body or yellow coat His pulse is generally tight and bowstring but can feel weak " Tight pulse is cold stagnation Therefore my conclusions: Spleen qi xu, damp cold accumulation, and heart fire with definite kidney involvement, which I assume is kidney yang based upon the internal cold and the dusky swollen tongue. I may have assumed incorrectly that there is liver fire, but heart fire there definitely is, and I can't undertstand why you wouldn't encourage him to refrain from drinking alcohol. Also remember that the red petechia or on the front of the tongue, which to the best of my knowledge pretty clearly limits the heat to the heart (or lungs) and doesn't imply that there is any other manifestation of middle or lower jiao heat. Again, I respectfully disagree that the swollen, dusky tongue connotes heat and stagnation--on the contrary, the tight pulse together with the tongue tells me that there is cold damp accumulation. Though also you are correct that we don't know explicitly more details about the patient, such as constitution and lifestyle, we do know that he overworks,! probably standing a lot, and lives on restaurant food--certainly it is reasonable to deduce that there is taxation from overexertion leading to spleen and even kidney xu. Of course blood needs to be supplemented but clearly qi xu is the root. Sincerely, Yehuda Hi Yehuda, I feel compelled to respond to your diagnostic post because it exemplifies what I see so often as a teacher. Your methods show habits of jumping to conclusions that I try to break my students of. I think it's so important in our field to first diagnose according to the traditional methods - which many people skip - and secondly to diagnose based on what our patients actually present as opposed to what we think might be there based on an assumption. Perhaps one of the most common assumptions my students make is that if there is bleeding there is Spleen Qi Xu. With this a=b thinking, clinical results will be severely limited. Another habit I help my students become aware of is backwards diagnosis - he overworks=deficiency. he overeats= spleen qi xu, even patient is tired=deficiency etc. As you can see from my post - this is so often not the case. Another habit is adding things to the treatment that are not in the diagnosis. I think this is backward diagnosis where you are seeing a cause and therefore deciding a diagnosis. If he does not show kidney signs and symptoms then many hours of work has not caused kidney deficiency. Personally I don't like to " deduce " in my diagnosis but rather base it on what is actually showing. Some people have very strong constitutions and over work as a way to use and disperse their Qi - ultimately this will cause a deficiency but at his stage it has not. It is very possible that supplementing a person with no deficiency signs could make things worse. Stress, overwork and eating rich foods cause many things. They can cause Qi and blood stasis. Why not stick with what this man actually manifests instead of making up a diagnosis based on what he might have? I do not see the internal cold you are talking about. As I said in my post, there are several causes of bleeding, only one of which is Spleen Qi Xu. He does not show signs of Spleen Qi Xu either. The bursting sensation he experiences is very consistent with blood stasis causing bleeding - much more so than Spleen Qi Xu. The fact that he eats rich foods under stress is not, by itself an indicator of Spleen Qi Xu. It can help explain the stasis he does definitively have. I agree that without excercise, Qi and Blood stagnate and he shows signs of this stasis. But lack of excercise, though a causitive factor, does not indicate stasis by itself unless there are signs of stasis. Red peticia on the front of the tongue in my experience can indicate heat in the lower warmer though this is not a common diagnostic. But heart fire would have to be manifested with a serious agitation. Perhaps you mean heat in the heart as opposed to fire? As for the pulse, I always use it in correlation with the other exams. As Jiao Shu-de says " Do not ever emphasize the precedence of the pulse over the pathocondition, or use it as a pretext for disregarding the correlation of the four examinations " . In the absence of any cold signs I don't think the tight pulse here means cold. You are right that the tongue moss is normal so the heat is not extreme but cold??? Where? So, what signs of Qi Xu do you see? At the end of your suggestions suddenly you say " of course blood needs to be supplemented " . Why? You didn't diagnose blood deficiency so why supplement it? We do not have this man in front of us so what can we really know but given the presentation, I would not warm or supplement him myself. I think we have to be careful of where we jump to conclusions in our diagnosis. Rebecca, Your intake is really good. The case is serious. I don't know what access you have to herbs and a pharmacy but since his primary diagnosis is blood stasis causing bleeding I would suggest the Women's treasure patent by Giovanni for stopping bleeding due to stasis. Invigorate blood, stem the flow. Try it for two weeks and let us know what happens. My prognosis is that it will help noticeably within that time. It will also help clear some of the heat in his heart and calm him down. Once he's out of the acute phase then he may be open to reviewing his lifestyle. You can use saw palmetto but since the choice of this is not based on traditional diagnosis but rather western diagnosis I would definitely not stop there. I hope this is helpful Sharon Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 And eating while standing! A sure recipe for indigestion! On Feb 1, 2007, at 5:03 AM, sharon weizenbaum wrote: > Also I would surmise that if he is eating at the > restaurant where he works he's probably rushing and irritable while > eating. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Zev, Are you sure standing causes indigestion? Is this a quote from a classical text? I believe that the human race as a species, only recently started to sit whilst feeding. Before that, for hundreds of thousands of years, humans scavenged food in woods and forests, ate and collected food as they went, which means their digestion has evolved to work whilst standing. I would also suggest that sitting at a table and leaning forward to eat, may actually put additional pressure on the internal organs, restricting their movement and therefore their function. I'll be interested to hear your views on this. Attilio www.chinesemedicinetimes.com Chinese Medicine , " " <zrosenbe wrote: > > And eating while standing! A sure recipe for indigestion! > > > On Feb 1, 2007, at 5:03 AM, sharon weizenbaum wrote: > > > Also I would surmise that if he is eating at the > > restaurant where he works he's probably rushing and irritable while > > eating. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Hey Attilio! Is the below from a classical text? I understand eating while squatting, or practicing some form of ma bu, but not standing the way it's done in modern cities... Hugo I believe that the human race as a species, only recently started to sit whilst feeding. Before that, for hundreds of thousands of years, humans scavenged food in woods and forests, ate and collected food as they went, which means their digestion has evolved to work while standing _________ Photos – NEW, now offering a quality print service from just 7p a photo http://uk.photos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Attilio, There are several references, one of which comes to mind from the writings of such authors as Ekiken Kaibara (Yojokun, out of print in English) and Maimonides, about the proper way to eat, how to sit, how much and what to eat, in order to safeguard one's health. While one may use the argument that the forerunners of humanity foraged for nuts and berries, and ate as they gathered, the amounts eaten were probably less then consuming bread, meat and mashed potatoes while working in a restaurant kitchen, as I observed my colleagues doing when I worked in a restaurant for a short period 35 years ago. On Feb 1, 2007, at 8:59 AM, wrote: > Zev, > > Are you sure standing causes indigestion? Is this a quote from a > classical text? > > I believe that the human race as a species, only recently started to > sit whilst feeding. Before that, for hundreds of thousands of years, > humans scavenged food in woods and forests, ate and collected food as > they went, which means their digestion has evolved to work whilst > standing. > > I would also suggest that sitting at a table and leaning forward to > eat, may actually put additional pressure on the internal organs, > restricting their movement and therefore their function. > > I'll be interested to hear your views on this. > > Attilio > www.chinesemedicinetimes.com > > Chinese Medicine , " " > <zrosenbe wrote: > > > > And eating while standing! A sure recipe for indigestion! > > > > > > On Feb 1, 2007, at 5:03 AM, sharon weizenbaum wrote: > > > > > Also I would surmise that if he is eating at the > > > restaurant where he works he's probably rushing and irritable > while > > > eating. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2007 Report Share Posted February 1, 2007 Zev, It's true that people in ancient times didn't eat such heavy, starchy foods such as bread and mash which would put strain on anyone's digestive system. They also didn't run around whilst eating, which would also give anyone indigestion. However, people in ancient times did eat well. There's a TV series on BBC2 at the moment which shows and demonstrates how people in the UK during the Stone Age found and ate food, see http://www.bbc.co.uk/bbctwo/programmes/?id=wild_food Attilio www.chinesemedicinetimes.com Chinese Medicine , " " <zrosenbe wrote: > > Attilio, > There are several references, one of which comes to mind from the > writings of such authors as Ekiken Kaibara (Yojokun, out of print in > English) and Maimonides, about the proper way to eat, how to sit, how > much and what to eat, in order to safeguard one's health. > > While one may use the argument that the forerunners of humanity > foraged for nuts and berries, and ate as they gathered, the amounts > eaten were probably less then consuming bread, meat and mashed > potatoes while working in a restaurant kitchen, as I observed my > colleagues doing when I worked in a restaurant for a short period 35 > years ago. > > > On Feb 1, 2007, at 8:59 AM, wrote: > > > Zev, > > > > Are you sure standing causes indigestion? Is this a quote from a > > classical text? > > > > I believe that the human race as a species, only recently started to > > sit whilst feeding. Before that, for hundreds of thousands of years, > > humans scavenged food in woods and forests, ate and collected food as > > they went, which means their digestion has evolved to work whilst > > standing. > > > > I would also suggest that sitting at a table and leaning forward to > > eat, may actually put additional pressure on the internal organs, > > restricting their movement and therefore their function. > > > > I'll be interested to hear your views on this. > > > > Attilio > > www.chinesemedicinetimes.com > > > > Chinese Medicine , " Z'ev Rosenberg " > > <zrosenbe@> wrote: > > > > > > And eating while standing! A sure recipe for indigestion! > > > > > > > > > On Feb 1, 2007, at 5:03 AM, sharon weizenbaum wrote: > > > > > > > Also I would surmise that if he is eating at the > > > > restaurant where he works he's probably rushing and irritable > > while > > > > eating. > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2007 Report Share Posted February 3, 2007 Rebecca: here's another take on your case: have you considered kid/ht yin xu heat, based on long hours of overwork on feet and the red petechiae on the tip of the tongue. heat in LJ causing reckless xue/xuing during sex. i would also like to know more about the other s/s, based on 10 quest. as sharon asked, are they nl or omited. i'm guessing omited. i go with the others that the work stress, tight/wiry P + puffy tongue is indicating liv qi stag, causing damp, d/h in LJ, also poss. cause of bleeding due to heat/reckless xue. you might consider long dan xie gan tang with some kid yin suppl./heat clearing, + dan shen 15g, and herbs to cool blood/ stop bleeding. xu duan is a possibility. i would add about the san qi: my take on the herb actions/indications in bensky is that it reg xue, both stopping bleeding and qb, depending on pathology. on the rest. issue, i would like to know more about what type of food is prepared before jumping to conclusions about the d/h producing foods. he can get them to make him steamed or grilled veg/broiled meat, rice. i'm sure if he let's mgmt know there's a med cond involved they will accomodate his dietary requirements. my 2 cents. hope it helps. keep us posted on tx progress. kb On 1/31/07, sharon weizenbaum <sweiz wrote: > > Hi- > I have a patient who has been suffering from periodic bleeding when he > has an erection. Apparantly, sometimes he feels something " burst " and > he gets a feeling that he has to urinate and then he just unrinates > blood. He is seeing his MD and has had surgery and an MRI to find > where he is bleeding but they have not found anything! The doctors > prescribed a drug used for patient's with an enlarged prostate. The > drug shrinks the vessles that supply blood to the prostate. While on > this drug the patient did not have an episode for over a year. But, > after beiing off the drug for 6 months it continues to happen. He > says it usually takes 3 months for the injured area to heal. He finds > it difficult to abstain for 3 months and then he bleeds again > re-injuring the area. He works in the restaurant business 50 plus > hours a week and only has 1 day off a week. He is 40 years old. He > seems to consume alcohol regularly, does not smoke, does not exercise. > He primarily eats food from the restaurant. His tongue is puffy, > dusky, slight center crack, red petechia on the front of the tongue, > thin white fur. His pulse is generally tight and bowstring but can > feel weak. He is back on the medication but is waiting for the injury > to heal. Right now I was thinking of directing the treatment towards > helping the bleeding area heal. Any suggestions? Anyone heard of this > scenerio? > Thanks > rebecca > > Hi Rebecca, > > Since we practice Chinese medicine, I would use the methods of > Chinese medicine. > > First, I would not jump to Tian Qi because it basically skips the > step of diagnosis. I don't know how we can treat well without > diagnosis. Yehuda offered a diagnosis but I do not see the basis for > it. What signs and symptoms are there of Kidney Yang vacuity and > Heart Fire? I don't see this from what you have presented. > > Keep in mind the causes of bleeding: > 1. Heat - either empty heat or full heat > 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney > Qi vacuity bleeding in school but it is a common cause of lower > warmer bleeding) > 3. Blood stasis > 4. Trauma > > In this case, your patient shows definitive signs of heat - red > petechia and blood stasis - dusky tongue. > > Your case study is focused on the main complaint, pulse and tongue > but the rest of his presentation is missing (body type, digestion, > sleep, urination, pain, energy etc) are we to assume all these things > are normal? These aspects would help to clarify diagnosis. > > The puffy tongue indicates dampness. Does he have other signs and > symptoms of this? > > So, in the case as far as we know from the information you have > given, which is not enough, we would want to clear heat and vitalize > blood in the lower warmer in order to stop bleeding. The formula > should address the disease factor (excess heat and blood stasis) the > location (lower warmer Liver channel) and symptom (bleeding). When > he is not actually bleeding you still need to vitalize blood and can > do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood > in order to prevent bleeding. > > I don't agree with Yehuda that he " must stop drinking " . For one > thing, we don't know how much he drinks. In addition, if your > diagnosis and treatment is accurate, you should still be able to > treat his condition whether he stops or not. Perhaps it would be in > his best interest to stop but what if he can't or won't. It would > not mean he could not be helped significantly. > > Sharon Weizenbaum > 86 Henry Street > Amherst, MA 01002 > 413-549-4021 > sweiz <sweiz%40rcn.com> > www.whitepinehealingarts.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2007 Report Share Posted February 3, 2007 Hi Rebecca, Thanks for sending out this interesting case. In my last life, I worked and managed a restaurant. When you work that much, you tend to get drained and depressed and hanging out around alot of other people socially, you tend to drink a lot too. In SF, I'm guessing wine or cocktails over beer, in certain circles. Which in that case red wine = more LV involvement - heat and qi stag over long time white wine = more SP involvement - qi def./ damp - heat barley/wheat beer = more dampness , more hops/more bitter = less qi stag./ less damp darker = usually more malt sugar - more damp. Also, usually the free food that comes out of most restaurants may be greasy, salty, peppery, msg (especially American Steak and Burgers, Italian, Mexican, Chinese restaurants get all the stigma of msg, but American and Mexican food ladle it on too). If he's there 50 hours/ week, he's probably eating 2 meals a day at the restaurant, if it's free, unless he gets bored of the food of course. Even if he doesn't eat there, he's getting other restaurant food. Following Kath, I'm also interested in his diet. And maybe this is nobody's business, but it seems as though his sexual life is a big part of the bleeding issue and as Kath said, KD yin def. heat can make people consistently and excessively horny (per Maciocia) Just hypothetically, someone can have lower jiao damp-heat, KD yin def heat (constitutionally) and LV qi depressive heat with SP qi vacuity. In that case, that sounds alot like Li Gao's Yin Fire, as interpreted by Bob Flaws. This kind of person pops up alot in our cosmopolitan society, where people are not eating healthy, drinking too much, over sex, over work and stressing out. Of course, these kinds of people don't get alot of sleep and don't nourish and replenish themselves, so underlying all of this is vacuity of blood, qi, yin, yang, jing. Of course, this is all conjecture. Good to hear from you. Thanks again for sharing. k. On 2/2/07, <acukath > wrote: > > Rebecca: > > here's another take on your case: have you considered kid/ht yin xu heat, > based on long hours of overwork on feet and the red petechiae on the tip > of > the tongue. heat in LJ causing reckless xue/xuing during sex. i would also > like to know more about the other s/s, based on 10 quest. as sharon asked, > are they nl or omited. i'm guessing omited. > > i go with the others that the work stress, tight/wiry P + puffy tongue is > indicating liv qi stag, causing damp, d/h in LJ, also poss. cause of > bleeding due to heat/reckless xue. you might consider long dan xie gan > tang > with some kid yin suppl./heat clearing, + dan shen 15g, and herbs to cool > blood/ stop bleeding. xu duan is a possibility. > > i would add about the san qi: my take on the herb actions/indications in > bensky is that it reg xue, both stopping bleeding and qb, depending on > pathology. > > on the rest. issue, i would like to know more about what type of food is > prepared before jumping to conclusions about the d/h producing foods. he > can get them to make him steamed or grilled veg/broiled meat, rice. i'm > sure if he let's mgmt know there's a med cond involved they will > accomodate > his dietary requirements. > > my 2 cents. hope it helps. keep us posted on tx progress. > > kb > > > On 1/31/07, sharon weizenbaum <sweiz <sweiz%40rcn.com>> wrote: > > > > Hi- > > I have a patient who has been suffering from periodic bleeding when he > > has an erection. Apparantly, sometimes he feels something " burst " and > > he gets a feeling that he has to urinate and then he just unrinates > > blood. He is seeing his MD and has had surgery and an MRI to find > > where he is bleeding but they have not found anything! The doctors > > prescribed a drug used for patient's with an enlarged prostate. The > > drug shrinks the vessles that supply blood to the prostate. While on > > this drug the patient did not have an episode for over a year. But, > > after beiing off the drug for 6 months it continues to happen. He > > says it usually takes 3 months for the injured area to heal. He finds > > it difficult to abstain for 3 months and then he bleeds again > > re-injuring the area. He works in the restaurant business 50 plus > > hours a week and only has 1 day off a week. He is 40 years old. He > > seems to consume alcohol regularly, does not smoke, does not exercise. > > He primarily eats food from the restaurant. His tongue is puffy, > > dusky, slight center crack, red petechia on the front of the tongue, > > thin white fur. His pulse is generally tight and bowstring but can > > feel weak. He is back on the medication but is waiting for the injury > > to heal. Right now I was thinking of directing the treatment towards > > helping the bleeding area heal. Any suggestions? Anyone heard of this > > scenerio? > > Thanks > > rebecca > > > > Hi Rebecca, > > > > Since we practice Chinese medicine, I would use the methods of > > Chinese medicine. > > > > First, I would not jump to Tian Qi because it basically skips the > > step of diagnosis. I don't know how we can treat well without > > diagnosis. Yehuda offered a diagnosis but I do not see the basis for > > it. What signs and symptoms are there of Kidney Yang vacuity and > > Heart Fire? I don't see this from what you have presented. > > > > Keep in mind the causes of bleeding: > > 1. Heat - either empty heat or full heat > > 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney > > Qi vacuity bleeding in school but it is a common cause of lower > > warmer bleeding) > > 3. Blood stasis > > 4. Trauma > > > > In this case, your patient shows definitive signs of heat - red > > petechia and blood stasis - dusky tongue. > > > > Your case study is focused on the main complaint, pulse and tongue > > but the rest of his presentation is missing (body type, digestion, > > sleep, urination, pain, energy etc) are we to assume all these things > > are normal? These aspects would help to clarify diagnosis. > > > > The puffy tongue indicates dampness. Does he have other signs and > > symptoms of this? > > > > So, in the case as far as we know from the information you have > > given, which is not enough, we would want to clear heat and vitalize > > blood in the lower warmer in order to stop bleeding. The formula > > should address the disease factor (excess heat and blood stasis) the > > location (lower warmer Liver channel) and symptom (bleeding). When > > he is not actually bleeding you still need to vitalize blood and can > > do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood > > in order to prevent bleeding. > > > > I don't agree with Yehuda that he " must stop drinking " . For one > > thing, we don't know how much he drinks. In addition, if your > > diagnosis and treatment is accurate, you should still be able to > > treat his condition whether he stops or not. Perhaps it would be in > > his best interest to stop but what if he can't or won't. It would > > not mean he could not be helped significantly. > > > > Sharon Weizenbaum > > 86 Henry Street > > Amherst, MA 01002 > > 413-549-4021 > > sweiz <sweiz%40rcn.com> <sweiz%40rcn.com> > > www.whitepinehealingarts.com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2007 Report Share Posted February 5, 2007 Hi Rebecca, I woke up this morning and remembered that I had treated someone who had same problem last year. I didn't remembered it right after I read your case, because he got better with 1~2 treatment. He was late 30's and had bleeding after he had intercourse for 6 months or so. He worked in film industry and very successful, which meant he worked for very long hours. Besides that, he went to gym when he had time. I diagnosed him as Kidney deficiency and did root treatment and used back shu points and kyu tou shin( needle top moxa) on ub23. After the treatment, he told me that he felt much better with his lower back soreness. I gave him some advice and finished his treatment. 2 months later, he came to see me and told me he got much better, kept my advice and didn't see bleeding anymore. What I told him for the first treatment was not to drink water unless he was thirsty and keep warm his waist and under( waist to feet). People in U.S. are obsessive to drink water but excessive intake of water cause kidney weakness, I think. Ami Matsumoto, L.Ac. <johnkokko wrote: Hi Rebecca, Thanks for sending out this interesting case. In my last life, I worked and managed a restaurant. When you work that much, you tend to get drained and depressed and hanging out around alot of other people socially, you tend to drink a lot too. In SF, I'm guessing wine or cocktails over beer, in certain circles. Which in that case red wine = more LV involvement - heat and qi stag over long time white wine = more SP involvement - qi def./ damp - heat barley/wheat beer = more dampness , more hops/more bitter = less qi stag./ less damp darker = usually more malt sugar - more damp. Also, usually the free food that comes out of most restaurants may be greasy, salty, peppery, msg (especially American Steak and Burgers, Italian, Mexican, Chinese restaurants get all the stigma of msg, but American and Mexican food ladle it on too). If he's there 50 hours/ week, he's probably eating 2 meals a day at the restaurant, if it's free, unless he gets bored of the food of course. Even if he doesn't eat there, he's getting other restaurant food. Following Kath, I'm also interested in his diet. And maybe this is nobody's business, but it seems as though his sexual life is a big part of the bleeding issue and as Kath said, KD yin def. heat can make people consistently and excessively horny (per Maciocia) Just hypothetically, someone can have lower jiao damp-heat, KD yin def heat (constitutionally) and LV qi depressive heat with SP qi vacuity. In that case, that sounds alot like Li Gao's Yin Fire, as interpreted by Bob Flaws. This kind of person pops up alot in our cosmopolitan society, where people are not eating healthy, drinking too much, over sex, over work and stressing out. Of course, these kinds of people don't get alot of sleep and don't nourish and replenish themselves, so underlying all of this is vacuity of blood, qi, yin, yang, jing. Of course, this is all conjecture. Good to hear from you. Thanks again for sharing. k. On 2/2/07, <acukath > wrote: > > Rebecca: > > here's another take on your case: have you considered kid/ht yin xu heat, > based on long hours of overwork on feet and the red petechiae on the tip > of > the tongue. heat in LJ causing reckless xue/xuing during sex. i would also > like to know more about the other s/s, based on 10 quest. as sharon asked, > are they nl or omited. i'm guessing omited. > > i go with the others that the work stress, tight/wiry P + puffy tongue is > indicating liv qi stag, causing damp, d/h in LJ, also poss. cause of > bleeding due to heat/reckless xue. you might consider long dan xie gan > tang > with some kid yin suppl./heat clearing, + dan shen 15g, and herbs to cool > blood/ stop bleeding. xu duan is a possibility. > > i would add about the san qi: my take on the herb actions/indications in > bensky is that it reg xue, both stopping bleeding and qb, depending on > pathology. > > on the rest. issue, i would like to know more about what type of food is > prepared before jumping to conclusions about the d/h producing foods. he > can get them to make him steamed or grilled veg/broiled meat, rice. i'm > sure if he let's mgmt know there's a med cond involved they will > accomodate > his dietary requirements. > > my 2 cents. hope it helps. keep us posted on tx progress. > > kb > > > On 1/31/07, sharon weizenbaum <sweiz <sweiz%40rcn.com>> wrote: > > > > Hi- > > I have a patient who has been suffering from periodic bleeding when he > > has an erection. Apparantly, sometimes he feels something " burst " and > > he gets a feeling that he has to urinate and then he just unrinates > > blood. He is seeing his MD and has had surgery and an MRI to find > > where he is bleeding but they have not found anything! The doctors > > prescribed a drug used for patient's with an enlarged prostate. The > > drug shrinks the vessles that supply blood to the prostate. While on > > this drug the patient did not have an episode for over a year. But, > > after beiing off the drug for 6 months it continues to happen. He > > says it usually takes 3 months for the injured area to heal. He finds > > it difficult to abstain for 3 months and then he bleeds again > > re-injuring the area. He works in the restaurant business 50 plus > > hours a week and only has 1 day off a week. He is 40 years old. He > > seems to consume alcohol regularly, does not smoke, does not exercise. > > He primarily eats food from the restaurant. His tongue is puffy, > > dusky, slight center crack, red petechia on the front of the tongue, > > thin white fur. His pulse is generally tight and bowstring but can > > feel weak. He is back on the medication but is waiting for the injury > > to heal. Right now I was thinking of directing the treatment towards > > helping the bleeding area heal. Any suggestions? Anyone heard of this > > scenerio? > > Thanks > > rebecca > > > > Hi Rebecca, > > > > Since we practice Chinese medicine, I would use the methods of > > Chinese medicine. > > > > First, I would not jump to Tian Qi because it basically skips the > > step of diagnosis. I don't know how we can treat well without > > diagnosis. Yehuda offered a diagnosis but I do not see the basis for > > it. What signs and symptoms are there of Kidney Yang vacuity and > > Heart Fire? I don't see this from what you have presented. > > > > Keep in mind the causes of bleeding: > > 1. Heat - either empty heat or full heat > > 2. Qi vacuity of the Spleen or Kidney (We are not taught about Kidney > > Qi vacuity bleeding in school but it is a common cause of lower > > warmer bleeding) > > 3. Blood stasis > > 4. Trauma > > > > In this case, your patient shows definitive signs of heat - red > > petechia and blood stasis - dusky tongue. > > > > Your case study is focused on the main complaint, pulse and tongue > > but the rest of his presentation is missing (body type, digestion, > > sleep, urination, pain, energy etc) are we to assume all these things > > are normal? These aspects would help to clarify diagnosis. > > > > The puffy tongue indicates dampness. Does he have other signs and > > symptoms of this? > > > > So, in the case as far as we know from the information you have > > given, which is not enough, we would want to clear heat and vitalize > > blood in the lower warmer in order to stop bleeding. The formula > > should address the disease factor (excess heat and blood stasis) the > > location (lower warmer Liver channel) and symptom (bleeding). When > > he is not actually bleeding you still need to vitalize blood and can > > do this with herbs such as Pu Huang, Qian Cao Gen that vitalize blood > > in order to prevent bleeding. > > > > I don't agree with Yehuda that he " must stop drinking " . For one > > thing, we don't know how much he drinks. In addition, if your > > diagnosis and treatment is accurate, you should still be able to > > treat his condition whether he stops or not. Perhaps it would be in > > his best interest to stop but what if he can't or won't. It would > > not mean he could not be helped significantly. > > > > Sharon Weizenbaum > > 86 Henry Street > > Amherst, MA 01002 > > 413-549-4021 > > sweiz <sweiz%40rcn.com> <sweiz%40rcn.com> > > www.whitepinehealingarts.com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2007 Report Share Posted February 7, 2007 Hi everyone- Here is an update on my patient. He has been a massage client so this was his first acupuncture treatment with me. First, some clarifications on my last post. this time he said that he does cook a lot for himself. He had just worked 16 days straight last time and that was why he was eating more at the restaurant, but, normally he cooks. He is Latin and eats a lot of rice, beans, pork and beef but says he also steams vegetables. The first time he had the bleeding was 3 years ago. He said that he can masturbate with no problems. It is with penetration that the bleeding happens. He feels the sensation at the left side of the tip of his penis. He is not circumcised. the MD's belief is that there is a weakness in the vessels which causes the bleeding. The exploratory procedure he had involved a scope entering the tip of his penis and traveling upwards toward the prostate but they did not see any affected vessels. however, the area that he feels the " burst " happen is at the tip and they may not have looked there. After this happens there is blood dripping( sometimes flowing) from his penis and a few hours later a mucous discharge. He believes that the medication works because it shrinks the vessels and therefore allows it to heal and become stronger so that it doesn't bleed. He was on the meds for one full year with no episodes until 7 months after he stopped taking it. He has not had intercourse for 3 weeks. He has been feeling chilly lately, some GERD symptoms the last month but never before, he gets a 1 migraine every few months. the pain is piercing over his left eye and he has to be in a dark room. He does not drink coffee. He is feeling stressed at work. Feels like people are kind of out to get him. He says that he often goes out of his way to help people but ends up getting " burned " He says that when he is feeling down he tries to do something for someone else and that this makes him feel better. He gave a friend his car to help him with transportation difficulties but the friend did not register the car in his name so now my patient is responsible for $2000 in parking tickets (one example of his gesture towards others) He described himself as having nervous energy. His sleep is generally not good because of his nervous energy. He has to be exhausted and just " crash " . His tongue looked slightly pale, center crack (not to tip), thin, slightly yellow fur in the back center, scallops on both sides. His pulse felt overall weak, especially the cun positions on both wrists. otherwise, thready. his Kd pulses were there. I was thinking about the vessels weakness and thought of the vessels relationship with the heart. I used Yin Tang, Ren 17, H6, Liv 3, K3, LI 4. He is willing to take pill form of herbs. Any new thoughts, questions, suggestions? Thanks! Rebecca Rebecca Rizzetta, L.Ac 415.948.8360 ______________________________\ ____ Don't pick lemons. See all the new 2007 cars at Autos. http://autos./new_cars.html Quote Link to comment Share on other sites More sharing options...
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