Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Yehuda, I am curious what herbal therapies you have used thus far? What acupuncture, frequency etc. My first thoughts upon reading your report were to modify Bu Yang Huan Wu Tang per her presentation. But I can't claim any great experience with varicose veins. As for treating the stagnation with underlying deficiency, How severe was the reaction to the bleeding? Given what you reported she needs some blood activation and the bleeding seems a reasonable option. I have found so much blood deficiency to be secondary to stagnation therefore needing both addressed head on. Sorry not to have more to offer, good luck. -Darby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Dear friends, colleagues and teachers, Your assistance is needed in success modalities to treat a patient with varicose veins and leg ulcers. Sixty two year old very tall female (6' 11/2 " ), whose primary complaint was varicose veins. They are itchy as well. I bled and cupped the most superficial of them, and was able to extract thick sticky clots, but unfortunately, rather than helping, it actually exacerbated the swelling and itching. She also has a few spots where ulcerations have developed. Some flaking of the skin on her legs. There is no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, cold fingers and toes, frequent clear urination, small volume, nocturia, swollen ankles, no thirst, abdominal bloating after meals, leg cramps, fatigue, but only at the end of the day. BM soft and formed. Clear thinking. good appetite. Tongue: pale, slightly purple body, moist, thin white coat in the back, no coat in the front with a slightly red tip. On the right hand, proximal pulse is generally, thready slippery and slightly choppy. Middle pulse is slippery thready and a little wiry, and distal pulse is a little thready and slippery. on the left, proximal and middle pulses are thready slippery and a little weak, and distal pulse is slippery weak and a little choppy. my differential diagnosis is blood stasis caused by underlying blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. I treated her for about 3 months using herbs, acupuncture and moxa with little benefit. I realize after the fact, now, that, at least in my opinion, it is contraindicated to bleed varicose veins when there is an underlying blood and qi vacuity. Miraculously, she still would like me to help. Any and all ideas would be very appreciated. SIncerely, Pinpoint customers who are looking for what you sell. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Horse chestnut extract has a lot of good research to support its use for varicosities. It is also a TCM herb that invigorates blood. - Bill , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > Your assistance is needed in success modalities to treat a patient with varicose veins and leg ulcers. Sixty two year old very tall female (6' 11/2 " ), whose primary complaint was varicose veins. They are itchy as well. I bled and cupped the most superficial of them, and was able to extract thick sticky clots, but unfortunately, rather than helping, it actually exacerbated the swelling and itching. She also has a few spots where ulcerations have developed. Some flaking of the skin on her legs. There is no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, cold fingers and toes, frequent clear urination, small volume, nocturia, swollen ankles, no thirst, abdominal bloating after meals, leg cramps, fatigue, but only at the end of the day. BM soft and formed. Clear thinking. good appetite. Tongue: pale, slightly purple body, moist, thin white coat in the back, no coat in the front with a slightly red tip. On the right hand, proximal pulse is > generally, thready slippery and slightly choppy. Middle pulse is slippery thready and a little wiry, and distal pulse is a little thready and slippery. on the left, proximal and middle pulses are thready slippery and a little weak, and distal pulse is slippery weak and a little choppy. > my differential diagnosis is blood stasis caused by underlying blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. I treated her for about 3 months using herbs, acupuncture and moxa with little benefit. I realize after the fact, now, that, at least in my opinion, it is contraindicated to bleed varicose veins when there is an underlying blood and qi vacuity. Miraculously, she still would like me to help. Any and all ideas would be very appreciated. > > SIncerely, > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Bill (or someone else in the know), Slightly off the topic of this particular case, but do you know if horse chestnut--and the other popular western herb for varicosities, butcher's broom--are safe to use during pregnancy? Both are listed in Tierra's book w/o any mention of a caution. Thanks a lot! Sarah Rivkin , " bill_schoenbart " <plantmed2 wrote: > > Horse chestnut extract has a lot of good research to support its use > for varicosities. It is also a TCM herb that invigorates blood. > > - Bill > > > , yehuda frischman > <@> wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a > patient with varicose veins and leg ulcers. Sixty two year old very > tall female (6' 11/2 " ), whose primary complaint was varicose veins. > They are itchy as well. I bled and cupped the most superficial of > them, and was able to extract thick sticky clots, but unfortunately, > rather than helping, it actually exacerbated the swelling and > itching. She also has a few spots where ulcerations have > developed. Some flaking of the skin on her legs. There is no issue > of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, > nocturia, swollen ankles, no thirst, abdominal bloating after meals, > leg cramps, fatigue, but only at the end of the day. BM soft and > formed. Clear thinking. good appetite. Tongue: pale, slightly > purple body, moist, thin white coat in the back, no coat in the > front with a slightly red tip. On the right hand, proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery thready and a little wiry, and distal pulse is a little > thready and slippery. on the left, proximal and middle pulses are > thready slippery and a little weak, and distal pulse is slippery > weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying > blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang > vacuity. I treated her for about 3 months using herbs, acupuncture > and moxa with little benefit. I realize after the fact, now, that, > at least in my opinion, it is contraindicated to bleed varicose > veins when there is an underlying blood and qi vacuity. > Miraculously, she still would like me to help. Any and all ideas > would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Sarah, The Chinese species of Aesculus is in the invigorate blood category, but it is not contraindicated in pregnancy. It also contains aescin, which is considered the " active " compound in Horse Chestnut (Aesculus hippocastanum). The German Commission E mnographs do not list any pregnancy contraindications for either Horse Chestnut or Butcher's Broom. - Bill , " Sarah Rivkin " <saydit wrote: > > Bill (or someone else in the know), > > Slightly off the topic of this particular case, but do you know if > horse chestnut--and the other popular western herb for varicosities, > butcher's broom--are safe to use during pregnancy? Both are listed in > Tierra's book w/o any mention of a caution. > > Thanks a lot! > > Sarah Rivkin > > , " bill_schoenbart " > <plantmed2@> wrote: > > > > Horse chestnut extract has a lot of good research to support its use > > for varicosities. It is also a TCM herb that invigorates blood. > > > > - Bill > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2007 Report Share Posted September 10, 2007 Yehuda, I think the cupping may have been the main problem. Applying suction to an already distended vein could cause it to distend even more. - Bill , " bill_schoenbart " <plantmed2 wrote: > > Horse chestnut extract has a lot of good research to support its use > for varicosities. It is also a TCM herb that invigorates blood. > > - Bill > > > , yehuda frischman > <@> wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a > patient with varicose veins and leg ulcers. Sixty two year old very > tall female (6' 11/2 " ), whose primary complaint was varicose veins. > They are itchy as well. I bled and cupped the most superficial of > them, and was able to extract thick sticky clots, but unfortunately, > rather than helping, it actually exacerbated the swelling and > itching. She also has a few spots where ulcerations have > developed. Some flaking of the skin on her legs. There is no issue > of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, > nocturia, swollen ankles, no thirst, abdominal bloating after meals, > leg cramps, fatigue, but only at the end of the day. BM soft and > formed. Clear thinking. good appetite. Tongue: pale, slightly > purple body, moist, thin white coat in the back, no coat in the > front with a slightly red tip. On the right hand, proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery thready and a little wiry, and distal pulse is a little > thready and slippery. on the left, proximal and middle pulses are > thready slippery and a little weak, and distal pulse is slippery > weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying > blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang > vacuity. I treated her for about 3 months using herbs, acupuncture > and moxa with little benefit. I realize after the fact, now, that, > at least in my opinion, it is contraindicated to bleed varicose > veins when there is an underlying blood and qi vacuity. > Miraculously, she still would like me to help. Any and all ideas > would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 I agree with you. The varicose veins don't always have to be distended, but distended veins as these are clearly indicating stasis with weak vacuitous Qi and Blood. The question is now what? BTW, I have cupped varicose veins before and after very successfully, but it appears that here it was different because the venous network had multiple layers of blockage and stasis. How would you use the Horse Chestnut? Integrating it into a formula? How much? All the best, Yehuda bill_schoenbart <plantmed2 wrote: Yehuda, I think the cupping may have been the main problem. Applying suction to an already distended vein could cause it to distend even more. - Bill , " bill_schoenbart " <plantmed2 wrote: > > Horse chestnut extract has a lot of good research to support its use > for varicosities. It is also a TCM herb that invigorates blood. > > - Bill > > > , yehuda frischman > <@> wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a > patient with varicose veins and leg ulcers. Sixty two year old very > tall female (6' 11/2 " ), whose primary complaint was varicose veins. > They are itchy as well. I bled and cupped the most superficial of > them, and was able to extract thick sticky clots, but unfortunately, > rather than helping, it actually exacerbated the swelling and > itching. She also has a few spots where ulcerations have > developed. Some flaking of the skin on her legs. There is no issue > of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, > nocturia, swollen ankles, no thirst, abdominal bloating after meals, > leg cramps, fatigue, but only at the end of the day. BM soft and > formed. Clear thinking. good appetite. Tongue: pale, slightly > purple body, moist, thin white coat in the back, no coat in the > front with a slightly red tip. On the right hand, proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery thready and a little wiry, and distal pulse is a little > thready and slippery. on the left, proximal and middle pulses are > thready slippery and a little weak, and distal pulse is slippery > weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying > blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang > vacuity. I treated her for about 3 months using herbs, acupuncture > and moxa with little benefit. I realize after the fact, now, that, > at least in my opinion, it is contraindicated to bleed varicose > veins when there is an underlying blood and qi vacuity. > Miraculously, she still would like me to help. Any and all ideas > would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 Is it the same species, the Western and the Chinese varieties? bill_schoenbart <plantmed2 wrote: Horse chestnut extract has a lot of good research to support its use for varicosities. It is also a TCM herb that invigorates blood. - Bill , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > Your assistance is needed in success modalities to treat a patient with varicose veins and leg ulcers. Sixty two year old very tall female (6' 11/2 " ), whose primary complaint was varicose veins. They are itchy as well. I bled and cupped the most superficial of them, and was able to extract thick sticky clots, but unfortunately, rather than helping, it actually exacerbated the swelling and itching. She also has a few spots where ulcerations have developed. Some flaking of the skin on her legs. There is no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, cold fingers and toes, frequent clear urination, small volume, nocturia, swollen ankles, no thirst, abdominal bloating after meals, leg cramps, fatigue, but only at the end of the day. BM soft and formed. Clear thinking. good appetite. Tongue: pale, slightly purple body, moist, thin white coat in the back, no coat in the front with a slightly red tip. On the right hand, proximal pulse is > generally, thready slippery and slightly choppy. Middle pulse is slippery thready and a little wiry, and distal pulse is a little thready and slippery. on the left, proximal and middle pulses are thready slippery and a little weak, and distal pulse is slippery weak and a little choppy. > my differential diagnosis is blood stasis caused by underlying blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. I treated her for about 3 months using herbs, acupuncture and moxa with little benefit. I realize after the fact, now, that, at least in my opinion, it is contraindicated to bleed varicose veins when there is an underlying blood and qi vacuity. Miraculously, she still would like me to help. Any and all ideas would be very appreciated. > > SIncerely, > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 Hi Darby, The basic formulas I used were indeed modifications of BYHWT, adding herbs to supplement the spleen Qi and Kd Yang as well. In this case, BTW, I feel that the stasis results directly from Blood xu. This is a postmenopausal women, who had a number of children (I believe 5 or 6) and who is very tall, I think requiring an extra volume of blood and extra Qi to circulate it. Quite easy to see how vacuity could be the root of the problem and how easily blood could become stagnant and viscous. Yehuda " darby.valley " <darby.valley wrote: Yehuda, I am curious what herbal therapies you have used thus far? What acupuncture, frequency etc. My first thoughts upon reading your report were to modify Bu Yang Huan Wu Tang per her presentation. But I can't claim any great experience with varicose veins. As for treating the stagnation with underlying deficiency, How severe was the reaction to the bleeding? Given what you reported she needs some blood activation and the bleeding seems a reasonable option. I have found so much blood deficiency to be secondary to stagnation therefore needing both addressed head on. Sorry not to have more to offer, good luck. -Darby Be a better Globetrotter. Get better travel answers from someone who knows. Answers - Check it out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 yehuda: on first read, i came up with your initial dx, so i'm not sure what i would add, other than perusing bensky's formulas text for skin ulcer formulas: perhaps something would jump out. the reason i reply is about the pulses you describe. i have myself on many occasions felt pulses that were both slippery and wiry, even though it seems counter intuitive. however, slippery and thready, or slippery and choppy, this doesn't sound possible to me, as they are opposite qualities. i'm not sure how that would manifest in the same pulse. care to comment? kb On 9/10/07, wrote: > > Dear friends, colleagues and teachers, > > Your assistance is needed in success modalities to treat a patient with > varicose veins and leg ulcers. Sixty two year old very tall female (6' > 11/2 " ), whose primary complaint was varicose veins. They are itchy as well. > I bled and cupped the most superficial of them, and was able to extract > thick sticky clots, but unfortunately, rather than helping, it actually > exacerbated the swelling and itching. She also has a few spots where > ulcerations have developed. Some flaking of the skin on her legs. There is > no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, nocturia, > swollen ankles, no thirst, abdominal bloating after meals, leg cramps, > fatigue, but only at the end of the day. BM soft and formed. Clear thinking. > good appetite. Tongue: pale, slightly purple body, moist, thin white coat in > the back, no coat in the front with a slightly red tip. On the right hand, > proximal pulse is > generally, thready slippery and slightly choppy. Middle pulse is slippery > thready and a little wiry, and distal pulse is a little thready and > slippery. on the left, proximal and middle pulses are thready slippery and a > little weak, and distal pulse is slippery weak and a little choppy. > my differential diagnosis is blood stasis caused by underlying blood > vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. I > treated her for about 3 months using herbs, acupuncture and moxa with little > benefit. I realize after the fact, now, that, at least in my opinion, it is > contraindicated to bleed varicose veins when there is an underlying blood > and qi vacuity. Miraculously, she still would like me to help. Any and all > ideas would be very appreciated. > > SIncerely, > > > > > > > > > Pinpoint customers who are looking for what you sell. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 According to 5 element korean style acupuncture, one aspect of varicose veins would be a huge excess of moisture in fire. There is also a weakness in fire showed by the cold hands and feet. Both of these tend to create blood stagnation, thus resulting in the thicky clots you were able to cup out. The red tip of the tongue could be the result of blood stasis, remember that given the right circumstances incredible heat can result from dampness. Her flaky skin could be considered as dryness in metal, could this be a result of a low fire not commanding metal? If she were my patient i would use a korean four needle technique called " zp-bang " to fire element: tonify heart9, liver1; sedate heart7, spleen3 (bilateral therapy if needed -i usually do this bilateral). Other needles you could use Rm17, lung9, urinary bladder17. I do not know about chinese herbs i don't have access to them or to someone who teaches chinese fitotherapy, but i do know a bit about plants where i live. She should drink papaya juice once a day WITH the skin and 8-12 papaya seeds per glass, better not to sweeten, but if necessary use honey. Before breakfast she should drink aloe-punch: 2cms of aloe crystal, 1/2 cm of fresh ginger root, the juice of 1 ripe lime (IMPORTANT RIPE YELLOW LIME), 7 black pepper seeds and honey, blend (no water added) and drink , wait 1/2 and hour to eat or drink anything else, and, to finish, in order to improve blood circulation it is imperative to eliminate all things that create phlegm: sugars (all of them, specially those horrible chemical sweetners), white flours, pork, alcohol, and ALL dairy products, chocolate. Minimum for 3 months both the juice, the aloe-punch and the not eating phlegm producing foods. She should start feeling better a lot sooner than 3 months, of course, that is just to make sure her elements have gone back to their correct places. if she could follow that diet and drink both things for the rest of her life, it would be even better. Acupuncture could be done maybe once or twice a week, depending on you and her. Hope it helps Juan escribió: > > Dear friends, colleagues and teachers, > > Your assistance is needed in success modalities to treat a patient > with varicose veins and leg ulcers. Sixty two year old very tall > female (6' 11/2 " ), whose primary complaint was varicose veins. They > are itchy as well. I bled and cupped the most superficial of them, and > was able to extract thick sticky clots, but unfortunately, rather than > helping, it actually exacerbated the swelling and itching. She also > has a few spots where ulcerations have developed. Some flaking of the > skin on her legs. There is no issue of blood sugar nor peripheral > neuropathy. Other symptoms: dry skin, cold fingers and toes, frequent > clear urination, small volume, nocturia, swollen ankles, no thirst, > abdominal bloating after meals, leg cramps, fatigue, but only at the > end of the day. BM soft and formed. Clear thinking. good appetite. > Tongue: pale, slightly purple body, moist, thin white coat in the > back, no coat in the front with a slightly red tip. On the right hand, > proximal pulse is > generally, thready slippery and slightly choppy. Middle pulse is > slippery thready and a little wiry, and distal pulse is a little > thready and slippery. on the left, proximal and middle pulses are > thready slippery and a little weak, and distal pulse is slippery weak > and a little choppy. > my differential diagnosis is blood stasis caused by underlying blood > vacuity. concurrent spleen qi vacuity, and kidney yin and yang > vacuity. I treated her for about 3 months using herbs, acupuncture and > moxa with little benefit. I realize after the fact, now, that, at > least in my opinion, it is contraindicated to bleed varicose veins > when there is an underlying blood and qi vacuity. Miraculously, she > still would like me to help. Any and all ideas would be very appreciated. > > SIncerely, > > > > > > > > > Pinpoint customers who are looking for what you sell. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 Hi Kath, I often find with patients that are yin or blood vacuitous the quality of both thready and slippery. As I wrote recently concerning cravings, it seems completely logical for them to coexist, meaning Yin vacuity with Gu pathogens, one being vacuitous and one being replete. A thready pulse I feel as a narrowing of the pathway, whereas damp accumulation I will feel as a distinct liquidy sensation, though not necessarily as strong whooshing. Sometimes it feels like it's in the background, but (at least what I either intuit or feel) I do a feel a sense of water moving. Yehuda " " wrote: yehuda: on first read, i came up with your initial dx, so i'm not sure what i would add, other than perusing bensky's formulas text for skin ulcer formulas: perhaps something would jump out. the reason i reply is about the pulses you describe. i have myself on many occasions felt pulses that were both slippery and wiry, even though it seems counter intuitive. however, slippery and thready, or slippery and choppy, this doesn't sound possible to me, as they are opposite qualities. i'm not sure how that would manifest in the same pulse. care to comment? kb On 9/10/07, wrote: > > Dear friends, colleagues and teachers, > > Your assistance is needed in success modalities to treat a patient with > varicose veins and leg ulcers. Sixty two year old very tall female (6' > 11/2 " ), whose primary complaint was varicose veins. They are itchy as well. > I bled and cupped the most superficial of them, and was able to extract > thick sticky clots, but unfortunately, rather than helping, it actually > exacerbated the swelling and itching. She also has a few spots where > ulcerations have developed. Some flaking of the skin on her legs. There is > no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, nocturia, > swollen ankles, no thirst, abdominal bloating after meals, leg cramps, > fatigue, but only at the end of the day. BM soft and formed. Clear thinking. > good appetite. Tongue: pale, slightly purple body, moist, thin white coat in > the back, no coat in the front with a slightly red tip. On the right hand, > proximal pulse is > generally, thready slippery and slightly choppy. Middle pulse is slippery > thready and a little wiry, and distal pulse is a little thready and > slippery. on the left, proximal and middle pulses are thready slippery and a > little weak, and distal pulse is slippery weak and a little choppy. > my differential diagnosis is blood stasis caused by underlying blood > vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. I > treated her for about 3 months using herbs, acupuncture and moxa with little > benefit. I realize after the fact, now, that, at least in my opinion, it is > contraindicated to bleed varicose veins when there is an underlying blood > and qi vacuity. Miraculously, she still would like me to help. Any and all > ideas would be very appreciated. > > SIncerely, > > > > > > > > > Pinpoint customers who are looking for what you sell. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 Sarah, Having close experience of this in the last year... compression stockings were a must for my wife. Blood invigorators have risks during pregnancy, stockings do not! Geoff , " Sarah Rivkin " <saydit wrote: > > Bill (or someone else in the know), > > Slightly off the topic of this particular case, but do you know if > horse chestnut--and the other popular western herb for varicosities, > butcher's broom--are safe to use during pregnancy? Both are listed in > Tierra's book w/o any mention of a caution. > > Thanks a lot! > > Sarah Rivkin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 ok, that makes sense. i get you. what about slippery and choppy? they seem to be the opposite ends of the duality. i'm not seeing how a pulse would feel simultaneous slippery and choppy. could you explain that? k On 9/11/07, wrote: > > Hi Kath, > > I often find with patients that are yin or blood vacuitous the quality of > both thready and slippery. As I wrote recently concerning cravings, it seems > completely logical for them to coexist, meaning Yin vacuity with Gu > pathogens, one being vacuitous and one being replete. A thready pulse I feel > as a narrowing of the pathway, whereas damp accumulation I will feel as a > distinct liquidy sensation, though not necessarily as strong whooshing. > Sometimes it feels like it's in the background, but (at least what I either > intuit or feel) I do a feel a sense of water moving. > > > Yehuda > > " " <acukath <acukath%40gmail.com>> wrote: > yehuda: > > on first read, i came up with your initial dx, so i'm not sure what i > would > add, other than perusing bensky's formulas text for skin ulcer formulas: > perhaps something would jump out. > > the reason i reply is about the pulses you describe. i have myself on many > occasions felt pulses that were both slippery and wiry, even though it > seems > counter intuitive. however, slippery and thready, or slippery and choppy, > this doesn't sound possible to me, as they are opposite qualities. i'm not > sure how that would manifest in the same pulse. > > care to comment? > > kb > > On 9/10/07, <%40>> > wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a patient with > > varicose veins and leg ulcers. Sixty two year old very tall female (6' > > 11/2 " ), whose primary complaint was varicose veins. They are itchy as > well. > > I bled and cupped the most superficial of them, and was able to extract > > thick sticky clots, but unfortunately, rather than helping, it actually > > exacerbated the swelling and itching. She also has a few spots where > > ulcerations have developed. Some flaking of the skin on her legs. There > is > > no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry > skin, > > cold fingers and toes, frequent clear urination, small volume, nocturia, > > swollen ankles, no thirst, abdominal bloating after meals, leg cramps, > > fatigue, but only at the end of the day. BM soft and formed. Clear > thinking. > > good appetite. Tongue: pale, slightly purple body, moist, thin white > coat in > > the back, no coat in the front with a slightly red tip. On the right > hand, > > proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery > > thready and a little wiry, and distal pulse is a little thready and > > slippery. on the left, proximal and middle pulses are thready slippery > and a > > little weak, and distal pulse is slippery weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying blood > > vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. > I > > treated her for about 3 months using herbs, acupuncture and moxa with > little > > benefit. I realize after the fact, now, that, at least in my opinion, it > is > > contraindicated to bleed varicose veins when there is an underlying > blood > > and qi vacuity. Miraculously, she still would like me to help. Any and > all > > ideas would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 Unfortunately my patient's varicosities are vulvar, not in her legs, so the mechanical options are far less appealing. I've had good at least temporary success w/ acupuncture & moxa (not the purpose of this forum, but happy to share that off-list). I know that " our " blood invigorators are not generally used during pregnancy, but I'm curious as to how these commonly used Western herbs compare--as well as what their mechanism of action would be in a TCM context. --Sarah , " G Hudson " <crudo20 wrote: > > Sarah, > Having close experience of this in the last year... compression > stockings were a must for my wife. Blood invigorators have risks > during pregnancy, stockings do not! > Geoff > > , " Sarah Rivkin " <saydit@> > wrote: > > > > Bill (or someone else in the know), > > > > Slightly off the topic of this particular case, but do you know if > > horse chestnut--and the other popular western herb for varicosities, > > butcher's broom--are safe to use during pregnancy? Both are listed in > > Tierra's book w/o any mention of a caution. > > > > Thanks a lot! > > > > Sarah Rivkin > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 A typical dose would be 250 - 300 mg orally of Horse Chestnut extract, 2 - 3 times daily. There are also topical products available. - Bill , yehuda frischman < wrote: > > I agree with you. The varicose veins don't always have to be distended, but distended veins as these are clearly indicating stasis with weak vacuitous Qi and Blood. The question is now what? BTW, I have cupped varicose veins before and after very successfully, but it appears that here it was different because the venous network had multiple layers of blockage and stasis. How would you use the Horse Chestnut? Integrating it into a formula? How much? > > All the best, > > Yehuda > bill_schoenbart <plantmed2 wrote: > Yehuda, > > I think the cupping may have been the main problem. Applying suction > to an already distended vein could cause it to distend even more. > > - Bill > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 It seems that the Western species (which originates in Asia) may be sometimes used in TCM. Most TCM sources show a different species, but it still contains aescin, which is the saponin that is believed to heal the vessel wall and improve venous insufficiency. The standardized extracts sold in health food stores use Aesculus hippocastanum, horse chestnut. - Bill , yehuda frischman < wrote: > > Is it the same species, the Western and the Chinese varieties? > > bill_schoenbart <plantmed2 wrote: Horse chestnut extract has a lot of good research to support its use > for varicosities. It is also a TCM herb that invigorates blood. > > - Bill > > , yehuda frischman > <@> wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a > patient with varicose veins and leg ulcers. Sixty two year old very > tall female (6' 11/2 " ), whose primary complaint was varicose veins. > They are itchy as well. I bled and cupped the most superficial of > them, and was able to extract thick sticky clots, but unfortunately, > rather than helping, it actually exacerbated the swelling and > itching. She also has a few spots where ulcerations have > developed. Some flaking of the skin on her legs. There is no issue > of blood sugar nor peripheral neuropathy. Other symptoms: dry skin, > cold fingers and toes, frequent clear urination, small volume, > nocturia, swollen ankles, no thirst, abdominal bloating after meals, > leg cramps, fatigue, but only at the end of the day. BM soft and > formed. Clear thinking. good appetite. Tongue: pale, slightly > purple body, moist, thin white coat in the back, no coat in the > front with a slightly red tip. On the right hand, proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery thready and a little wiry, and distal pulse is a little > thready and slippery. on the left, proximal and middle pulses are > thready slippery and a little weak, and distal pulse is slippery > weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying > blood vacuity. concurrent spleen qi vacuity, and kidney yin and yang > vacuity. I treated her for about 3 months using herbs, acupuncture > and moxa with little benefit. I realize after the fact, now, that, > at least in my opinion, it is contraindicated to bleed varicose > veins when there is an underlying blood and qi vacuity. > Miraculously, she still would like me to help. Any and all ideas > would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Geoff, Two thoughts about compression stockings: first, aren't they very uncomfortable, and second, don't they encourage a certain laziness of the tissue, sort of like insulin does when injecting it for diabetics, so that when they are not warn, the integrity of the muscles, skin and veins of the legs are even more compromised? Yehuda G Hudson <crudo20 wrote: Sarah, Having close experience of this in the last year... compression stockings were a must for my wife. Blood invigorators have risks during pregnancy, stockings do not! Geoff , " Sarah Rivkin " <saydit wrote: > > Bill (or someone else in the know), > > Slightly off the topic of this particular case, but do you know if > horse chestnut--and the other popular western herb for varicosities, > butcher's broom--are safe to use during pregnancy? Both are listed in > Tierra's book w/o any mention of a caution. > > Thanks a lot! > > Sarah Rivkin Shape in your own image. Join our Network Research Panel today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Please excuse my English. I am not that knowledgeable using English TCM terms so please try your best to understand what I have written. From your description, it seems to me that your patient lacks lungs qi, or in other words, lungs yin. There is a saying that " lungs govern the condition of our skin " , as many skin related symptoms can be traced back to our lungs. Our lungs are responsible for distributing water to our body. When lungs' energy is low, dry and itchy skin may occur due to the lack of water distributed by our lungs. Your patient's frequent clear urination is also another possible sign of her lungs not being able to hold and distribute water. Common causes for low lungs qi are cold energy and simply low body energy (Xie Qi). If she were my patient, my first course of action would be to ensure that her sleeping pattern is steady and lengthy. I would have her sleep before 10:00pm, preferably 9:00pm, and have her rest throughout the day whenever she feels tired to prevent her from increasing liver yang (Gan Huo) that may affect her sleeping quality. I would also advise her to avoid exposure to cold temperature and have her wear extra clothing at all times. If it's available in your area, Chinese Ginger tea and Jujube Longan tea are helpful for disposing cold energy. Both tea are available in China and Taiwan in powder form, similar to instant coffee, but I have yet to see them in North America. I would suggest her to use various Isotonic health supplements from a company named Market America, mainly their OPC-3 (An antioxidant), digestive enzymes, and calcium formulas. OPC-3 and digestive enzymes have produced good results for me in the past as the OPC shortens the healing process and the digestive enzymes improve absorption. Normally I wouldn't recommend my patients to take vitamin supplements mainly because of their poor absorption rate, which may be even poorer for my patients who were already ill, but Market America's Isotonic technology eliminated that problem. I also find that it is easier for my patients to take these supplements as they are more modernized and less of a mystery to them than some of the conventional Chinese medicine that they have been previously prescribed. Hope this helped. Gary Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Hi Again, Kath, Choppy is not really accurate. A better term would be irregular. Again, a sense that the pathways are just not open, and the blood is flowing in stops and starts. Yehuda " " wrote: ok, that makes sense. i get you. what about slippery and choppy? they seem to be the opposite ends of the duality. i'm not seeing how a pulse would feel simultaneous slippery and choppy. could you explain that? k On 9/11/07, wrote: > > Hi Kath, > > I often find with patients that are yin or blood vacuitous the quality of > both thready and slippery. As I wrote recently concerning cravings, it seems > completely logical for them to coexist, meaning Yin vacuity with Gu > pathogens, one being vacuitous and one being replete. A thready pulse I feel > as a narrowing of the pathway, whereas damp accumulation I will feel as a > distinct liquidy sensation, though not necessarily as strong whooshing. > Sometimes it feels like it's in the background, but (at least what I either > intuit or feel) I do a feel a sense of water moving. > > > Yehuda > > " " <acukath <acukath%40gmail.com>> wrote: > yehuda: > > on first read, i came up with your initial dx, so i'm not sure what i > would > add, other than perusing bensky's formulas text for skin ulcer formulas: > perhaps something would jump out. > > the reason i reply is about the pulses you describe. i have myself on many > occasions felt pulses that were both slippery and wiry, even though it > seems > counter intuitive. however, slippery and thready, or slippery and choppy, > this doesn't sound possible to me, as they are opposite qualities. i'm not > sure how that would manifest in the same pulse. > > care to comment? > > kb > > On 9/10/07, <%40>> > wrote: > > > > Dear friends, colleagues and teachers, > > > > Your assistance is needed in success modalities to treat a patient with > > varicose veins and leg ulcers. Sixty two year old very tall female (6' > > 11/2 " ), whose primary complaint was varicose veins. They are itchy as > well. > > I bled and cupped the most superficial of them, and was able to extract > > thick sticky clots, but unfortunately, rather than helping, it actually > > exacerbated the swelling and itching. She also has a few spots where > > ulcerations have developed. Some flaking of the skin on her legs. There > is > > no issue of blood sugar nor peripheral neuropathy. Other symptoms: dry > skin, > > cold fingers and toes, frequent clear urination, small volume, nocturia, > > swollen ankles, no thirst, abdominal bloating after meals, leg cramps, > > fatigue, but only at the end of the day. BM soft and formed. Clear > thinking. > > good appetite. Tongue: pale, slightly purple body, moist, thin white > coat in > > the back, no coat in the front with a slightly red tip. On the right > hand, > > proximal pulse is > > generally, thready slippery and slightly choppy. Middle pulse is > slippery > > thready and a little wiry, and distal pulse is a little thready and > > slippery. on the left, proximal and middle pulses are thready slippery > and a > > little weak, and distal pulse is slippery weak and a little choppy. > > my differential diagnosis is blood stasis caused by underlying blood > > vacuity. concurrent spleen qi vacuity, and kidney yin and yang vacuity. > I > > treated her for about 3 months using herbs, acupuncture and moxa with > little > > benefit. I realize after the fact, now, that, at least in my opinion, it > is > > contraindicated to bleed varicose veins when there is an underlying > blood > > and qi vacuity. Miraculously, she still would like me to help. Any and > all > > ideas would be very appreciated. > > > > SIncerely, > > > > > > > > > > > > > > > > > > Pinpoint customers who are looking for what you sell. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Hi Yehuda, This sounds an awful lot like ru mai, sometimes translated as " soggy " pulse. I know the books say this is a thin, soft, floating pulse, but my (very excellent) teacher says ru mai can be found at all levels. Feels a bit like a wet blanket is covering the pulse. Indicates dampness. What do you think? Best, Greg >> whereas damp accumulation I will feel as a > > distinct liquidy sensation, though not necessarily as strong whooshing. > > Sometimes it feels like it's in the background, but (at least what I either > > intuit or feel) I do a feel a sense of water moving. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Sarah - oops - my bad. I saw varicosites and leg ulcers and thought you were talking about ones in the legs. Yehuda, I'm sure they would drive me nuts, but no - the stockings weren't too bad for my wife, or others that I've talked with. The discomfort of tight stockings was much better than the pain of the varicosities themselves. The compression is spread over a wide area, so there isn't a real focal area of pressure. There are two kinds we found, the cheaper walmart version, which worked well to a point, and then the medical supply sorts that come in tighter fittings. I don't think the stockings contribute to laziness of the vascular system. Since she was walking around, the calf muscles were still working and pumping the circulation in the lower legs. The fluid retention that was caused by pregnancy wasn't going away until after the pregnancy, and after the delivery the varicosites disappeared. We asked the Ob and they said there was no problem wearing them all day, which my wife did and she took them off at night. I thought it would hinder circulation in her legs or have some consequence, but the Ob was right and it was a great relief. Geoff , yehuda frischman < wrote: > > Geoff, > > Two thoughts about compression stockings: first, aren't they very uncomfortable, and second, don't they encourage a certain laziness of the tissue, sort of like insulin does when injecting it for diabetics, so that when they are not warn, the integrity of the muscles, skin and veins of the legs are even more compromised? > > Yehuda Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 Very interesting, Geoff. Now after the fact have you started her on a regimen to strengthen her vascular system, post (or pre!) pregnancy? G Hudson <crudo20 wrote: Sarah - oops - my bad. I saw varicosites and leg ulcers and thought you were talking about ones in the legs. Yehuda, I'm sure they would drive me nuts, but no - the stockings weren't too bad for my wife, or others that I've talked with. The discomfort of tight stockings was much better than the pain of the varicosities themselves. The compression is spread over a wide area, so there isn't a real focal area of pressure. There are two kinds we found, the cheaper walmart version, which worked well to a point, and then the medical supply sorts that come in tighter fittings. I don't think the stockings contribute to laziness of the vascular system. Since she was walking around, the calf muscles were still working and pumping the circulation in the lower legs. The fluid retention that was caused by pregnancy wasn't going away until after the pregnancy, and after the delivery the varicosites disappeared. We asked the Ob and they said there was no problem wearing them all day, which my wife did and she took them off at night. I thought it would hinder circulation in her legs or have some consequence, but the Ob was right and it was a great relief. Geoff , yehuda frischman < wrote: > > Geoff, > > Two thoughts about compression stockings: first, aren't they very uncomfortable, and second, don't they encourage a certain laziness of the tissue, sort of like insulin does when injecting it for diabetics, so that when they are not warn, the integrity of the muscles, skin and veins of the legs are even more compromised? > > Yehuda Need a vacation? Get great deals to amazing places on Travel. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2007 Report Share Posted September 13, 2007 Hello Yehuda, I highly recommend Jobst brand stockings. Start at 20-30 mmHg compression. They are cheaper to buy online $55-65, depending on the style. (Free shipping.) At certain drug stores locally, they are $75 for the same style. I've used the cheap brands (around $30) and they don't last very long before the compression is greatly deceased, and then they are useless. The jobst last quite long, depending on how often they are worn. .. . .aren't they very uncomfortable. . . For me, NO!! I am young (32 y.o.), and fit, and no kids, but I am experiencing sometimes severe leg pain cyclically/hormonally, during humid weather, and during stressful times. (Genetic.) They feel sooo good to wear. They are tough to get on because of the compression, but the pain decreases immediately. During bad times, I even sleep in them. Plus, they have thigh high and open toe, so my body can breathe. Make sure you measure properly for the sizing. I never thought I'd have the opportunity to share my experience with what I call my " senior stockings. " It's funny! I hope they benefit your patient for the time-being. -gina and second, don't they encourage a certain laziness of the tissue, sort of like insulin does when injecting it for diabetics, so that when they are not warn, the integrity of the muscles, skin and veins of the legs are even more compromised? > > Yehuda > > G Hudson <crudo20 wrote: > Sarah, > Having close experience of this in the last year... compression > stockings were a must for my wife. Blood invigorators have risks > during pregnancy, stockings do not! > Geoff > > , " Sarah Rivkin " <saydit@> > wrote: > > > > Bill (or someone else in the know), > > > > Slightly off the topic of this particular case, but do you know if > > horse chestnut--and the other popular western herb for varicosities, > > butcher's broom--are safe to use during pregnancy? Both are listed in > > Tierra's book w/o any mention of a caution. > > > > Thanks a lot! > > > > Sarah Rivkin > > > > > > Shape in your own image. Join our Network Research Panel today! > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2007 Report Share Posted September 13, 2007 Hi again, Yehuda, I forgot to add that I just read about the importance of Vit. K in varicose veins. It was on mercola's website. Another angle to take. . . -gina Quote Link to comment Share on other sites More sharing options...
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