Guest guest Report post Posted April 5, 2003 THis may seem like a basic question, but since I have heard opposing resposes, I would like to hear what others think. What do people do with a real fever? a) Nothing at all, Since thermometers were not avaibable in pre-modern CHina, I just treat what I see and what the patient reports... b) I equate this with (fa re) 'fever' c) I incorporate it in the patient complex using some modern hybrid thought process. d) other Yesterday I saw a patient that had a cough (somewhat wind-cold (dryness)) but HIGH fever - She was getting SICK!. I was hesitant to use a warming Rx, therefore went somewhere in the middle, TxP: Stop cough, vent the pathogen, nourish fluids slightly, and mildly clear heat. I am unsure if I hit the nail, I will know today... Any comments... -JAson Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , " " <@h...> wrote: > > > Yesterday I saw a patient that had a cough (somewhat wind-cold > (dryness)) but HIGH fever - She was getting SICK!. I was hesitant to > use a warming Rx, therefore went somewhere in the middle, TxP: Stop > cough, vent the pathogen, nourish fluids slightly, and mildly clear > heat. I am unsure if I hit the nail, I will know today... Any > comments... > > > > > -JAson Isn't this where you'd reach for the gypsum?... da qing long tang, ma xing shi gan tang.... rh Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , " " <@h...> wrote: > > > > Yesterday I saw a patient that had a cough (somewhat wind-cold > (dryness)) but HIGH fever - Are you saying she had a sense of aversion to cold, chills and only mild heat effusion despite her measured temp being high? I have heard of gui zhi tang being used for 107 degree fever in a child if the presentation is correct. How high is high? If a person had a 103 fever but exhibited purely wind cold signs I would probably treat it as such. I don't know if I would be brave enough to handle the 107 this way. However it is hard to imagine that one could have such a high fever without feeling intense heat effusion. I suspect it is a transformed wind-cold-dry and your approach was correct. I just listened to Chip's tapes on wen bing and he says pretty extreme conditions can present in the wei/taiyang level. And that they are often mistakenly treated as interior conditions (yangming or qi). Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 On the same vain how do people deal with neuropathic pain when the pain feels burning and the limb is cold? Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 what do you mean 107? Temperature? Send 'em to the hospital for goodness sake. anyway: Bottom line- it MUST be treated empirically. Pretend that thermometers don't exist. Often if you ask patient if they feel hot, they will answer that they have a temp. So rephrase the question so they understand you are asking how they FEEL> also: if they feel chilled, the fever is going up. If they feel hot, it should go down if they can effectively break a sweat. If they feel neither hot or cold, the fever is stabile. And if it's 101-102, it's really OK to let it go ( in a person w/ a normal immune system). It's a good opportunity for the body to clear latent pathogens. > Herbs are so incredibly effective for this. Even just one big, decisive dose of the right formula can often completely resolve a fever. Dirty trick for hi fevers w/ the flu ( I've really only used this on family and friends) Zhong gan ling and a shot of brandy. On a related vein: I know this question is outside the " party line " , but has anyone ever had the thought that the yin qiao san that is made w/ acetaminophen could actually create a positive drug and herb interaction for reducing wind heat fevers? Cara > Are you saying she had a sense of aversion to cold, chills and only > mild heat effusion despite her measured temp being high? I have heard > of gui zhi tang being used for 107 degree fever in a child if the > presentation is correct. How high is high? If a person had a 103 > fever but exhibited purely wind cold signs I would probably treat it > as such. I don't know if I would be brave enough to handle the 107 > this way. However it is hard to imagine that one could have such a > high fever without feeling intense heat effusion. I suspect it is a > transformed wind-cold-dry and your approach was correct. I just > listened to Chip's tapes on wen bing and he says pretty extreme > conditions can present in the wei/taiyang level. And that they are > often mistakenly treated as interior conditions (yangming or qi). > > > > > Chinese Herbal Medicine, a voluntary organization of licensed healthcare > practitioners, matriculated students and postgraduate academics specializing > in Chinese Herbal Medicine, provides a variety of professional services, > including board approved online continuing education. > > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , Cara Frank <herbbabe@e...> wrote: > > what do you mean 107? Temperature? Send 'em to the hospital for goodness > sake. my teacher said when he did this that if the patient had received fever lowering agents or antibiotics, they would end up with a trapped pathogen. I would refer to the hospital myself. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , " Alon Marcus " <alonmarcus@w...> wrote: > On the same vain how do people deal with neuropathic pain when the pain feels burning and the limb is cold? > Alon couldn't deep lying blood stasis lead to impaired free flow of blood at the surface, thus cold limbs, but the deeper stagnation generates heat felt internally. sort of a si ni san idea, but on a more local scale. do you find blood moving works well for neuropathy. we found warming herbs, moxa and yang tonics worked well for AIDs neuropathy in the cold damp portland winter. could it also be cold bi that has transformed partially to heat. Perhaps that partial transformation to heat would tend to manifest deeper than the exterior since heat can easily escape the exterior, yets gets easily trapped inside. this is all speculative, of course. I have had mixed results with blood movers for neuropathy myself. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 > > couldn't deep lying blood stasis lead to impaired free flow of blood > at the surface, thus cold limbs, but the deeper stagnation generates > heat felt internally. sort of a si ni san idea,> maybe more of a dang gui si ni tang idea Cara O. Frank, R.Ac herbbabe China Herb Company Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 > > -JAson > > Isn't this where you'd reach for the gypsum?... da qing long tang, ma > xing shi gan tang.... > > rh I personally do not see that this angle is justified, could you explain yourself or supply some case studies or discussions that support this idea... -JAson Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , " " <@i...> wrote: > > > > Yesterday I saw a patient that had a cough (somewhat wind-cold > > (dryness)) but HIGH fever - > > Are you saying she had a sense of aversion to cold, chills and only > mild heat effusion despite her measured temp being high? Yes she had extreme chills with little to NO sensation of heat.... 1-2 days prior she had heat effusion. I have heard > of gui zhi tang being used for 107 degree fever in a child if the > presentation is correct. How high is high? If a person had a 103 > fever but exhibited purely wind cold signs I would probably treat it > as such. YEs I have also heard of a SHL guizhitang case study treat high fever with w-c presentaion... I don't know if I would be brave enough to handle the 107 > this way. However it is hard to imagine that one could have such a > high fever without feeling intense heat effusion. Maybe I excagerated, the fever was 101-102... Not anywhere near the 107... I suspect it is a > transformed wind-cold-dry and your approach was correct. She did feel better after the herbs, but you never know... -JAson Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 Hate to ask, but what was the tongue and pulse? It sounds like wei aspect condition moving to qi aspect, or tai yang into yang ming channel, in which case shi gao prescriptions such as ma xing shi gan tang (my favorite for something like what you are describing) are indicated. Or, as Todd pointed out, it could be a gui zhi tang pattern, although I think the script would need to be modified in this case. Another possibility, knowing the Colorado climate from living there so many years. . . a new wind/cold contraction stirs up latent heat in a spring-warmth epidemic. The very changeable spring weather and wind there does seem to stir up wai gan/exterior contractions. On Saturday, April 5, 2003, at 05:57 AM, wrote: > > > THis may seem like a basic question, but since I have heard opposing > resposes, I would like to hear what others think. What do people do > with a real fever? > > > a) Nothing at all, Since thermometers were not avaibable in pre-modern > CHina, I just treat what I see and what the patient reports... > > > b) I equate this with (fa re) 'fever' > > > c) I incorporate it in the patient complex using some modern hybrid > thought process. > > > d) other > > > > > Yesterday I saw a patient that had a cough (somewhat wind-cold > (dryness)) but HIGH fever - She was getting SICK!. I was hesitant to > use a warming Rx, therefore went somewhere in the middle, TxP: Stop > cough, vent the pathogen, nourish fluids slightly, and mildly clear > heat. I am unsure if I hit the nail, I will know today... Any > comments... > > > > > -JAson > > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 Why wouldn't it be justified? If there is a qi aspect or yang ming channel pattern with strong heat effusion, it would work. Again, I'd ask you: What was the pulse like? Flooding, rapid? The tongue? Red, thin white coating? Was the patient sweating? Profusely? Aversion to wind? To cold? Any phlegm? What herbs did you use? Yes, moistening yin sounds like a good idea, but shi gao is very moistening. Otherwise any comments are going to be approximate. That is the problem with reviewing cases on CHA without the complete format that suggested be followed. On Saturday, April 5, 2003, at 05:10 PM, wrote: > I personally do not see that this angle is justified, could you > explain yourself or supply some case studies or discussions that > support this idea... Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 , " " <@h...> wrote: > > > > Isn't this where you'd reach for the gypsum?... da qing long tang, > ma > > xing shi gan tang.... > > > I personally do not see that this angle is justified, could you > explain yourself or supply some case studies or discussions that > support this idea... > > > > > -JAson Taiyang --> Yangming ... Exterior pattern with high fever sorry if its unsophisticated... what do I know, just a kampo guy.... rh Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 5, 2003 I have had mixed results with bloodmovers for neuropathy myself.>>>Also some mixed results, but at the same time some very good results in diabetic neuropathies. Often with cooling (or mix) and vitalizing. However i always also use alpha lipoic at the same time. More difficult with complex regional pain (RSD) especially if severe. alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 , " " <@h...> wrote: > , " " <@i...> > wrote: > > > > > Maybe I excagerated, the fever was 101-102... Not anywhere near the > 107... > > I wouldn't call that very high. Definitely in the wind cold range. todd Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 , " " <zrosenbe@s...> wrote: > > What herbs did you use? Yes, moistening yin sounds like a good idea, > but shi gao is very moistening. Is it? It is indicated for thirst, but I can find no reference to it being moistening. It relieves thirst by clearing heat, I believe. I have wrestled with this one because it has a sweet taste, yet I can find no direct reference to it being nourishing in any way. Xu and wang specifically say it is used for heat with no damage to the fluids yet and contrasts it with the moistening zhi mu in this regard. which makes sense as qi level precedes ying level, the first level where fluid damage is apparent. this reminds me of a case I give first year students of yangming heat with constipation and students always want to moisten the yin at this stage, but it is draining and clearing that is actually called for. Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 > > I wouldn't call that very high. Definitely in the wind cold range. > > todd Definitely not definitely. wind cold or wind heat. Tai yang/ shao yang, yang ming: the number doesn't matter. It's the empirical experience of the fever that counts. Having a 101-102 fever has no real meaning in herbology. All we know for sure is that, for the majority of people, it's a safe fever. also- it might help to point out that even w/ wind heat, there can still be a slight aversion to cold. Cara Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 , " " <@i...> wrote: > > Is it? It is indicated for thirst, but I can find no reference to it > being moistening. It relieves thirst by clearing heat, I believe. I > have wrestled with this one because it has a sweet taste, yet I can > find no direct reference to it being nourishing in any way. yifan yang, p47: " Since it is sweet and cold, it can also generate the Yin and body fluids to supplement the consumed fluids and prevent their further consumption. " rh Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 > , " " <@i...> > wrote: > > > > > Is it? It is indicated for thirst, but I can find no reference to > it > > being moistening. It relieves thirst by clearing heat, I believe. > I > > have wrestled with this one because it has a sweet taste, yet I can > > find no direct reference to it being nourishing in any way. > sionneau, Dui Yao, p127 paragraph 6 " Sweet and cold tend to moisten dryness and enrich yin, as in the case of Shi Gao. " rh Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 Z'ev, Rh and others, Maybe there was lack of clarity.. LEt me clairfy... The situation is not about the case (pulse, tongue, or even how high the fever is). It is about about how we interpret FEVER ( basal body temp). I personally DO NOT see justification for calling a fever (basal body temp) heat effusion. You both seem to think otherwise... (?) AS stated it was a wind-cold pattern with a FEVER (BBT). But the case details are irrevevalnt becuase it is about this (above) issue. When one says shi gao is appropiate I assume that they are equating the two (fever(BBT) with heat effusion). So I again ask, where is the source, discussion, or case study that justifies such a stance. (I am not saying anyone is wrong, I just haven't seen anything YET to support that position) For example, I can present evidence for not labeling Fever (BBT) with heat effusion. 1) Case studies that treat high fever (BBT) with warm medicinals, 2)no thermometers in classical China. Heat was only a patient's perception or a practitioners sensation on the patient. Actually temp was obviously not used. I, at the current time, believe that BBT is totally irrevelant (for these external attacks, unless 107 and needs to go to the ER). This does not say that people are not using BBT now, but if we are going to equate it with the classica heat effusion, I would like to see some justification SO without this equation the case is very clearly a wind-cold pattern, and the details (pulse, tongue) can be filled in anyway you like them. Does this make things any clearer? I apoligize by mixing a question with a real life case. (I see the latter was not necessary) -JAson , " " <zrosenbe@s...> wrote: > Why wouldn't it be justified? If there is a qi aspect or yang ming > channel pattern with strong heat effusion, it would work. Again, I'd > ask you: > > What was the pulse like? Flooding, rapid? > > The tongue? Red, thin white coating? > > Was the patient sweating? Profusely? Aversion to wind? To cold? Any > phlegm? > > What herbs did you use? Yes, moistening yin sounds like a good idea, > but shi gao is very moistening. > > Otherwise any comments are going to be approximate. That is the > problem with reviewing cases on CHA without the complete format that suggested be followed. > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 > > > > > > > > Maybe I excagerated, the fever was 101-102... Not anywhere near the > > 107... > > > > > > I wouldn't call that very high. Definitely in the wind cold range. > > todd My previous post says almost most everything, but... Again the actually temp is moot unless we find some evidence or system that incorporates BBT into TCM. SO my excageration was more about the point than the case. IT sounds like you have heard that actual temp's correspond to w-c, or w-h.. I think I read that once or a teacher said it, but I didn't buy it... Can't remember though.. Are you saying that if the fever was 104 then it would be in the wind-heat range? I am a little unclear.. Can you site something or elaborate? -Jason Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 I've also found thermometer temperature has nothing to do with whether the patient 'feels' feverish or chilled. It also has nothing to do with TCM. In China, the MD-TCM'ers use thermometers, and the TCM-TCM'ers use tongue / pulse / questioning etc. I heard that the MD-TCM'ers would always use strong heat clearing herbs if the patient has a temperature, even when the patient felt very chilled... with poor results, of course! Geoff > __________ > > Message: 18 > Sun, 06 Apr 2003 07:42:44 -0400 > Cara Frank <herbbabe > Re: Re: Fever (real) > > > > > I wouldn't call that very high. Definitely in the wind cold range. > > > > todd > > > Definitely not definitely. > wind cold or wind heat. Tai yang/ shao yang, yang ming: the > number doesn't > matter. It's the empirical experience of the fever that > counts. Having a > 101-102 fever has no real meaning in herbology. All we know > for sure is > that, for the majority of people, it's a safe fever. > also- it might help to point out that even w/ wind heat, > there can still > be a slight aversion to cold. > Cara Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 wind cold or wind heat. Tai yang/ shao yang, yang ming: the number doesn'tmatter. It's the empirical experience of the fever that counts. Having a101-102 fever >>>Yang ming heat can give rise to chills,I have seen bai fu teng used in the hospital all the time for patients with strong chills but tidal pulse with good results alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 I've also found thermometer temperature has nothing to do with whetherthe patient 'feels' feverish or chilled. >>>This is not the key. It is the feeling the practitioner feels when touching the patient. Although possible, it is very rare to see a patient with 103 temp without heateffusion, rapid pulse, reddening of face etc. These are almost always treated as heat or wind chill transforming into yangming heat so that shi gao is added to the formula. Alon Quote Share this post Link to post Share on other sites
Guest guest Report post Posted April 6, 2003 , " Alon Marcus " <alonmarcus@w...> wrote: > I've also found thermometer temperature has nothing to do with whether > the patient 'feels' feverish or chilled. > >>>This is not the key. It is the feeling the practitioner feels when touching the patient. Although possible, it is very rare to see a patient with 103 temp without heateffusion, rapid pulse, reddening of face etc. These are almost always treated as heat or wind chill transforming into yangming heat so that shi gao is added to the formula. > Alon What about the guizhitang with high fever (BBT)? -Jason Quote Share this post Link to post Share on other sites
