Guest guest Posted October 6, 2007 Report Share Posted October 6, 2007 Dear all colleagues, MISSING SOME KEYS IN GOUTS DIAGNOSIS AND TREATMENTS : Acute on set, most of them are Yang condition. Yang syndrome will be seen on appearance ( lively, full energy, radiantly … strong and full, fast , red … ) and in upperjao ( Heart and Lung ). Heart and Lung are places of Qi and fire : Qi for breathing and exchanging and moving air ( chemical gases in-out ) in the upper body. Fire : for exchanging of gases, fire, appears quickly. Fire moves out and expands ( skin and face ) In the upperjiao the manifestation from the top to the upper chest are : Headache, confusion, mental ( mind or shen ), dizziness, vertigo, tinnitus, sinuses, blurred vision, thirst, cancer sores, Bel's Palsy, meningitis, stiff neck , shoulder pain , chest pain …. If these symptoms are acute or in sudden, the pulses should be : Floating, full or flooding. But what about the acute arthritis of GOUTS? A sudden onset of SEVERE pain at the toes, elbows, hips, or knees ? In this case, is this relating to excess ( fire and Qi ) ? Some cases have been seen in clinic with slippery-fast pulses, not floating, and slippery wet tongue, no other manifestation such as headaches nor abdominal pain. Patient, male age 64 , had been hospitalized twice by GOUT medication before acupuncture treatments. During the acupuncture therapy, patient was asked to stay away from GOUT medication. Gouts are the uric acids redidual, comes from purine diet. These purine must be dissolved and excreted into urination. In this case, diet related to Postnatal Qi ( SP-STO ), and excretion ( Prenatal Ki-Ub ) we cannot ignore the root. The manifestation are at He-Lu ( acute onset ). At first , I chose SP9 ( tonification ) the pain subsided immediately, but this pain returned in 3 days. I chose the same point SP9 again on the next treatment, the pain disappeared and returned again in a few days eventhough the Craneberry juice were added ( 3cups/day ). I must change my therapy and my diagnosis. SP9 ( dissolve food, damp or phlegm ), Ren6 ( for excretion of urine ), L7 ( regulating Qi of upperjiao and lowerjiao -connecting to K6 –Ren6 was chosen ). Corn silks was prescribed, some foods must be avoided ( red meat, tomatoes, avocado, eggplants, eggs, animal livers, sweet foods, spicy foods ) for at least 5 days. This treatment had been relieving the toe pain for at least 4 months from today…. The first therapy was not my desire for its short life effectiveness. Was this happened because I ignored and not complete the diagnosis ( He-Lu Qi , acute )? More points were added , the result yielded and lasted longer………… Is this because of the ACUTE ( He-Lu ) points were added ??????????????? ANY INPUTS ? GOOD LUCK TO ALL IF YOU RUN ACROSS THE SAME CASE " GOUTS " Nam Nguyen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2007 Report Share Posted October 7, 2007 I, too, have seen cases like this. However, they were induced by the use of Cumudin and the diuretics prescribed. Has anyone else run into this? I was able to keep the gout away but the patient's refusal to ask the doctor to change medication and ultimate despair led to kidney failure. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2007 Report Share Posted October 7, 2007 Dear Dr. Nguyen, In my experience, results are best achieved when simultaneously treating the constitutional as you do, PLUS move Qi & blood along the affected meridians. For example, when gout manifests at the big toe, I needle SP1, SP3, LV1, LV3. (bleed Lv1, Sp1 jing-well in acute episode). i sometimes add Master Tung WuHu (five tigers) points for enhanced effect. also, i do a few minutes tui-na or guasha upstream and downstream from the pain (but not directly on the painful spot as it can be unbearable for the patient and also increase redness and inflammation if acute). On reading your point prescription, i think your addition of KD6 is helpful far beyond just enhancing the LU7 function. First of all, it's moving Qi along the medial aspect of the foot. Also, YinQiao meridian is indicated for: 1) inversion of the foot (which i often see with patients with all kinds of big toe pain, gout included. your patient may be similar?), 2) retention of urine, and 3) digestive complaints, etc... So perhaps those are the reasons why the later treatment got much better results? glad to hear your patient is doing well. ~edith -- Edith Chan, L.Ac. Phone: 415.298.5324 www.EdithChanAcupuncture.com On 10/6/07, dr_namnguyen58 <dr_namnguyen58 wrote: > > Dear all colleagues, > > MISSING SOME KEYS IN GOUTS DIAGNOSIS AND TREATMENTS : > Acute on set, most of them are Yang condition. Yang syndrome will > be seen on appearance ( lively, full energy, radiantly … strong and > full, fast , red … ) and in upperjao ( Heart and Lung ). > Heart and Lung are places of Qi and fire : Qi for breathing and > exchanging and moving air ( chemical gases in-out ) in the upper > body. Fire : for exchanging of gases, fire, appears quickly. Fire > moves out and expands ( skin and face ) > In the upperjiao the manifestation from the top to the upper > chest are : Headache, confusion, mental ( mind or shen ), dizziness, > vertigo, tinnitus, sinuses, blurred vision, thirst, cancer sores, > Bel's Palsy, meningitis, stiff neck , shoulder pain , chest pain …. If > these symptoms are acute or in sudden, the pulses should be : > Floating, full or flooding. > But what about the acute arthritis of GOUTS? A sudden onset of > SEVERE pain at the toes, elbows, hips, or knees ? In this case, is > this relating to excess ( fire and Qi ) ? Some cases have been seen in > clinic with slippery-fast pulses, not floating, and slippery wet > tongue, no other manifestation such as headaches nor abdominal pain. > > Patient, male age 64 , had been hospitalized twice by GOUT > medication before acupuncture treatments. During the acupuncture > therapy, patient was asked to stay away from GOUT medication. > Gouts are the uric acids redidual, comes from purine diet. These > purine must be dissolved and excreted into urination. In this case, > diet related to Postnatal Qi ( SP-STO ), and excretion ( Prenatal > Ki-Ub ) we cannot ignore the root. The manifestation are at He-Lu ( > acute onset ). > At first , I chose SP9 ( tonification ) the pain subsided > immediately, but this pain returned in 3 days. I chose the same point > SP9 again on the next treatment, the pain disappeared and returned > again in a few days eventhough the Craneberry juice were added ( > 3cups/day ). I must change my therapy and my diagnosis. > SP9 ( dissolve food, damp or phlegm ), Ren6 ( for excretion of > urine ), L7 ( regulating Qi of upperjiao and lowerjiao -connecting to > K6 –Ren6 was chosen ). Corn silks was prescribed, some foods must be > avoided ( red meat, tomatoes, avocado, eggplants, eggs, animal livers, > sweet foods, spicy foods ) for at least 5 days. This treatment had > been relieving the toe pain for at least 4 months from today…. > The first therapy was not my desire for its short life > effectiveness. Was this happened because I ignored and not complete > the diagnosis ( He-Lu Qi , acute )? More points were added , the > result yielded and lasted longer………… Is this because of the ACUTE ( > He-Lu ) points were added ??????????????? ANY INPUTS ? > > GOOD LUCK TO ALL IF YOU RUN ACROSS THE SAME CASE " GOUTS " > > Nam Nguyen > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2007 Report Share Posted October 7, 2007 Hi Edith, Your input is greatly appreciated. Please share your experience here with our colleague, we may have some inputs from others and we will grow stronger from there. My experience has shown a significant improvement which lasted a long time. However, I will try your method in a next case to see whether there will be any difference. Thanks to you Edith ! It is my pleasure. Nam Nguyen --- " Edith Chan, L.Ac. " <chineseherbs wrote: > Dear Dr. Nguyen, > In my experience, results are best achieved when > simultaneously treating the > constitutional as you do, PLUS move Qi & blood along > the affected > meridians. For example, when gout manifests at the > big toe, I needle SP1, > SP3, LV1, LV3. (bleed Lv1, Sp1 jing-well in acute > episode). i sometimes add > Master Tung WuHu (five tigers) points for enhanced > effect. also, i do a few > minutes tui-na or guasha upstream and downstream > from the pain (but not > directly on the painful spot as it can be unbearable > for the patient and > also increase redness and inflammation if acute). > > On reading your point prescription, i think your > addition of KD6 is helpful > far beyond just enhancing the LU7 function. First of > all, it's moving Qi > along the medial aspect of the foot. Also, YinQiao > meridian is indicated > for: 1) inversion of the foot (which i often see > with patients with all > kinds of big toe pain, gout included. your patient > may be similar?), 2) > retention of urine, and 3) digestive complaints, > etc... So perhaps those > are the reasons why the later treatment got much > better results? > > glad to hear your patient is doing well. > ~edith > > -- > Edith Chan, L.Ac. > Phone: 415.298.5324 > www.EdithChanAcupuncture.com > > On 10/6/07, dr_namnguyen58 > <dr_namnguyen58 wrote: > > > > Dear all colleagues, > > > > MISSING SOME KEYS IN GOUTS DIAGNOSIS AND > TREATMENTS : > > Acute on set, most of them are Yang condition. > Yang syndrome will > > be seen on appearance ( lively, full energy, > radiantly … strong and > > full, fast , red … ) and in upperjao ( Heart and > Lung ). > > Heart and Lung are places of Qi and fire : Qi for > breathing and > > exchanging and moving air ( chemical gases in-out > ) in the upper > > body. Fire : for exchanging of gases, fire, > appears quickly. Fire > > moves out and expands ( skin and face ) > > In the upperjiao the manifestation from the top to > the upper > > chest are : Headache, confusion, mental ( mind or > shen ), dizziness, > > vertigo, tinnitus, sinuses, blurred vision, > thirst, cancer sores, > > Bel's Palsy, meningitis, stiff neck , shoulder > pain , chest pain …. If > > these symptoms are acute or in sudden, the pulses > should be : > > Floating, full or flooding. > > But what about the acute arthritis of GOUTS? A > sudden onset of > > SEVERE pain at the toes, elbows, hips, or knees ? > In this case, is > > this relating to excess ( fire and Qi ) ? Some > cases have been seen in > > clinic with slippery-fast pulses, not floating, > and slippery wet > > tongue, no other manifestation such as headaches > nor abdominal pain. > > > > Patient, male age 64 , had been hospitalized twice > by GOUT > > medication before acupuncture treatments. During > the acupuncture > > therapy, patient was asked to stay away from GOUT > medication. > > Gouts are the uric acids redidual, comes from > purine diet. These > > purine must be dissolved and excreted into > urination. In this case, > > diet related to Postnatal Qi ( SP-STO ), and > excretion ( Prenatal > > Ki-Ub ) we cannot ignore the root. The > manifestation are at He-Lu ( > > acute onset ). > > At first , I chose SP9 ( tonification ) the pain > subsided > > immediately, but this pain returned in 3 days. I > chose the same point > > SP9 again on the next treatment, the pain > disappeared and returned > > again in a few days eventhough the Craneberry > juice were added ( > > 3cups/day ). I must change my therapy and my > diagnosis. > > SP9 ( dissolve food, damp or phlegm ), Ren6 ( for > excretion of > > urine ), L7 ( regulating Qi of upperjiao and > lowerjiao -connecting to > > K6 –Ren6 was chosen ). Corn silks was prescribed, > some foods must be > > avoided ( red meat, tomatoes, avocado, eggplants, > eggs, animal livers, > > sweet foods, spicy foods ) for at least 5 days. > This treatment had > > been relieving the toe pain for at least 4 months > from today…. > > The first therapy was not my desire for its short > life > > effectiveness. Was this happened because I ignored > and not complete > > the diagnosis ( He-Lu Qi , acute )? More points > were added , the > > result yielded and lasted longer………… Is this > because of the ACUTE ( > > He-Lu ) points were added ??????????????? ANY > INPUTS ? > > > > GOOD LUCK TO ALL IF YOU RUN ACROSS THE SAME CASE " > GOUTS " > > > > Nam Nguyen > > > > > > > > > [Non-text portions of this message have been > removed] > > > > Subscribe to the free online journal for TCM at > Times > http://www.chinesemedicinetimes.com > > Help build the world's largest online encyclopedia > for Chinese medicine and acupuncture, click, > http://www.chinesemedicinetimes.com/wiki/CMTpedia > > > > and adjust accordingly. > > Messages are the property of the author. Any > duplication outside the group requires prior > permission from the author. > > Please consider the environment and only print this > message if absolutely necessary. > Quote Link to comment Share on other sites More sharing options...
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