I received this from a friend. I am trying to track down the original citation for it. If anyone knows, please comment so that I can give a proper reference.
上帝的神奇藥物God's Amazing Pharmacy
It's been said that God first separated the salt water from the fresh、made dry land、planted a garden、and made animals and fish、long before making man.
據說上帝在造出人類之前，首先將鹹水與淡水分離，造了陸地、在花園裏種上各種花草、造了各種動物和魚類…
To ensure healthful living、God left us some clues as to which foods we should eat to keep specific parts of our body healthy!為了確保健康的生活，上帝留給我們一些線索來告訴我們該吃什麼食物以對我們身體的一些部位有益。We call this God's Amazing Pharmacy.我們稱之為上帝的神奇藥物
A sliced carrot looks like the human eye. The pupil、iris and radiating lines look just like the human eye. And yes、science now confirms that carrots greatly enhance blood flow to our eyes. 切片的胡蘿蔔看起來像人的眼睛。瞳孔、虹膜和放射的線條，看起來完全就是人的眼睛。科學也的確證明胡蘿蔔能大大促進血液向眼部的流動、改善眼部功能。
The tomato has four chambers and is red. The heart has four chambers and is red. Research shows that tomatoes are loaded with lycopine、a wonderful heart and blood food.
番茄是紅色的有四個心房。心臟也是紅色的有四個心房。所有的研究都告訴我們番茄裏充滿了茄紅素，事實上它也是能淨化心臟和血液的食物。
Grapes hang in a cluster resembling the shape of the heart. An individual grape looks like a blood cell and research today shows that grapes are a wonderful heart and blood vitalizing food. 葡萄一串一串在一起形成心臟的形狀。每一顆葡萄看起來都像一個血液細胞，現代科學研究也都證明葡萄能極大增強心臟和血液的活力。
A walnut looks like a little brain、with left and right hemispheres、upper cerebrums and lower cerebellums. Even the wrinkles or folds on a walnut are like the neo-cortex. We now know that walnuts help develop more than three (3) dozen neuron-transmitters for brain function.
核桃看起來像小小的腦，有左、右半球和上大腦、下小腦。連它上面的褶皺看起來也很像新皮質。現在我們知道核桃能為大腦多提供三打以上的神經傳導.
Kidney beans help heal and maintain kidney function and、yes、they look exactly like the human kidneys. 菜豆能治腎並幫助維持腎功能，而且它們看起來確實很像人的腎。
Celery、bok choy、and rhubarb look like bones. These foods target bone strength. Bones are 23% sodium and these foods are 23% sodium. If you don't have enough sodium in your diet、the body pulls it from the bones、making them weak. These foods replenish the skeletal needs of the body.
芹菜、白菜、大黃葉柄看起來就像是人的骨頭。這些食物具有增強骨質的功效。骨頭含有23%的鈉，這些食物也含有23%的鈉。如果你從日常飲食中攝取不到足夠的鈉，身體就會從骨骼中吸收，從而使骨骼變弱。這些食物可補充身體對骨骼的需求。
Avocados、eggplant and pears target the health and function of the womb and cervix of the female、and they look just like these organs. Research today shows that when a woman eats one avocado a week、it balances her hormones、helps shed unwanted birth weight、and helps prevent cervical cancers. How profound is this? It takes nine (9)
months to grow an avocado from blossom to ripened fruit.... There are over 14,000 photolytic chemical constituents of nutrition in each one of these foods (modern science has only studied and named about 141 of them).
酪梨,茄子,梨具有改善女性子宮和子宮頸的功能，使之保持健康，它們看起來確實就像這些器官（子宮和子宮頸）。現在的研究證明，如果一個女人每週能吃一個酪梨，就可以調節荷爾蒙、甩掉贅肉，並且預防宮頸癌。那麼這當中究竟多少奧妙？一個酪梨從開花到瓜熟蒂落需要整整九個月的時間。它們都含有超過14，000多種以上的化學營養物質（現代科學只對其中的141種做過研究並命名）。
Figs are full of seeds and hang in twos when they grow. Figs increase the mobility of male sperm and increase the numbers of Sperm as well to overcome male sterility.
無花果裏面長滿了子並且是兩兩掛在一起生長。無花果可以促進男性精子的流動，並能增加精子數量，同時還能治癒男性不育。
Sweet potatoes look like the pancreas and actually balance the glycemic index of diabetics. 紅薯形狀像胰腺，可以調節糖尿病患者的血糖指數。
Olives assist the health and function of the ovaries 橄欖有助於改善卵巢功能、保持卵巢健康。
Oranges、grapefruits、and other citrus fruits look like the mammary glands of the female and actually assist the health of the breasts and the movement of lymph in and out of the breasts. 橘子,葡萄柚和其他種類的柑橘看起來就像女性的乳腺，事實上它們有助於保持乳房的健康，促進淋巴液進出乳房。
Onions look like the body's cells. Today's research shows onions help clear waste materials from all of the body cells. They even produce tears which wash the epithelial layers of the eyes. A working companion、garlic、also helps eliminate waste materials and dangerous free radicals from the body.
洋蔥看起來就像是人體細胞。現代研究表明洋蔥可以幫助所有人體細胞清除廢物。它們還可以導致眼淚流出沖刷眼睛的上皮細胞。它的同伴大蒜也有助於從體內清除廢物和對人體有危害的輻射。
acupuncture new jersey
Showing posts with label herbs. Show all posts
Showing posts with label herbs. Show all posts
Wednesday, October 28, 2009
Thursday, April 19, 2007
Breast Cancer
A nice article on breast cancer. Interestingly, I just heard today that it takes approximately 8 years for breast cancer to show up on a mammogram. Best protection is early detection of one's imbalances through a thorough Chinese medical evaluation, especially trained pulse diagnosis which reveals energetic tendencies towards this disease years prior to its manifestation, and thus, ample time to treat it. And as with many of our modern epidemic diseases, they have roots in the environment society has created with all its toxicities.....
BREAST CANCER
By Camellia C. Pratt, DTCM
BREAST CANCER
By Camellia C. Pratt, DTCM
The first world conference on Breast Cancer was held July 1997, in Kingston, Ontario. The chief organizer Janet Collins, a nurse and midwife had many friends and a sister fall victim to what some say is becoming an epidemic. Breast Cancer kills almost one million women worldwide annually, including about 7000 in Canada in 1997.
As much as cancer has been blamed on genetic quirks, lifestyle factors, including smoking and having a high fat diet, about 70 % of breast disease causes don't fall into high-risk categories. (1) Now with the high incident rates in the Northern New York States and north shore of Great Lakes, second highest only to San Francisco Bay with 18,000 new cases annually, some feel Breast Cancer could be environmental pollution induced. Sandra Stein Graber, a Boston Biologist states 80% of Breast Cancers are caused by environmental hazards (2)
Despite the enormous effort to combat Breast Cancer, the number of new cases rises each year. For example, the introduction of radiation therapy, chemotherapy, immuno-therapy, CT Scans, MRI scans and all other new medical technology, life spans for breast cancer patients have remained the same, as there hasn't been any significant progress in Breast Cancer treatment. Treatment has improved survival only slightly, in fact. The five year survival rate for Breast Cancer in 1976 was 75%, 1983- 77% and in 1989- 78%. Most scientist/ physicians are convinced however that the slight increase in time of survival of lifespan is due largely to earlier detection of Breast Cancer, by improving mammography technology. But to an oncologist if the patient lives 5 years + 1 day, that woman survived and is counted as a cure, even if she has died. If however she lives one day less than 5 years she is counted as a non-survivor. In 1960,1 in 20 women developed Breast Cancer, in 1974, 1 in 17. The odds have gotten worse with each succeeding year. By 1990 the rate rose astronomically to 1 in 10, and kept zooming, in 1991, 1 in 9, in 1994, 1 in 8 women developed breast Cancer. (3)
In the last two decades the National Cancer Institute has spent over $1 billion on breast cancer alone, touting spectacular progress at the research level with almost no change in reducing mortality or increasing life spans. And that is the primary objective of any treatment to make the lifespan longer, improve survival. Two advances have come about however:
1. Minimizing pain and suffering
2. Less mutilating surgery to achieve the same survival. Even though this information is well known to all scientist and physicians, the great majority of all breast cancers are still handled the same way, i.e. modified radical mastectomy rather than lumpectomy, auxiliary node dissection and radiation therapy (3). Dr. Stephen Narod, a Medical Researcher from Women's College Hospital in Toronto concluded "mastectomy before cancer strikes" is the best approach to treating women carrying the genes linked with the disease even though as some delegates attending the conference in Kingston pointed out, research hasn't proven conclusively that breast removal is an effective prevention strategy. (4)
There is an information gap on the causes, monitoring and prevention of breast cancer, because little conclusive research has been done on the subject. However, it is known that 75% of patients survive breast cancer, and most breast cancers are present 8 to 10 years before they can be detected as a lump or on a mammogram, according to Dr. Susan Love, MD. Associate Professor of Clinical Surgery at the University of California, Los Angeles and Director of the Breast Cancer Institute. Dr. Love points out "The problem of the prevention and treatment of breast cancer is the fact that 80% of women who get breast cancer don't have (the traditional) risk factors. A low fat diet may be preventative, but we won't have the results from studies for a good five to ten years. Recent studies however have disputed the long-standing belief of that risk factor. The Canadian National Breast Screening study, which examined the diets of almost 57,000 women, claimed that a higher incidence of breast cancer was observed in women consuming the most fat. They neglected to report that the same high, incidence of breast cancer was observed in the women consuming the least amount of fat.
The Nurses Study in the U.S.A found exactly the same pattern. When the data from both studies were compared and evaluated, it was discovered that "The breast cancer rate among these women was virtually the same, whether they ate a lot of fat or very little". (8)
Another study, has also recently discounted the high genetic risk factor. Although the risk of breast cancer is doubled among women whose mother or sister contacted Breast Cancer before the age of 40, the study indicated that within middle -aged women, only 2.5 % of breast cancer cases were attributable to family history. (5)
Early detection is currently one of the primary strategies for prevention and successful treatment, which is why the self-breast exam is so important. The benefits of mammography are still a subject of debate. Questions that are still present include whether low-level radiation used in the test can contribute to cancer, whether equivocal results lead to unnecessary surgery and the accuracy rate of test results.
According to the National Cancer Institute, in women ages 40-49 there is a high rate of missed tumors, resulting in 40% false negative test results. Breast tissue in younger women is denser, which makes it more difficult to detect tumors, so tumors grow more quickly in younger women, and tumors may develop between screenings. Because there is no reduction in mortality from breast cancer as a direct result of early mammogram, it is recommended that women under fifty avoid screening mammograms although the American Cancer Society is still recommending a mammogram every two years for women ages 40-49. Dr. Love states, "We know that mammography works and will be a lifesaving tool for at least 30% (6)
Dr. Norman Boyd, head of the Division of Epidemiology and Statistics at the Ontario Cancer Institute in Toronto, whose research was funded by drug companies (6), calls dense breast tissue a "major cancer risk , and they should have mammograms "more frequently than other women", also adding patients should be cautioned to follow a low-fat, high fiber diet and perhaps take specific medication to "block factors that play a role in breast density" and thus cancer. According to the American Academy of Pathology at least 50%, but as many as 80% of North American women suffer some sort of fibrocystic breast disease or density (11), causing a lot of pain and discomfort as well as a great deal of anxiety. Although a benign condition, it can be difficult for both women and their physicians to distinguish a cystic breast lump from a cancerous one. Right now Fibrocystic Breast Disease is a confusing term or as Dr. Susan Love says Sa wastebasket into which doctors throw every breast problem which isn't cancer." (yet).
Various researchers have suggested a hormonal imbalance, a decreased ratio of progesterone to estrogen in the second half of the menses cycle, an abnormality of prolactin regulation, a hypersensitivity to thyroid stimulating hormone and increased estrogen levels, as causes of fibrocystic breast disease.
Various treatments of fibrocystic breast disease are: Dr. Mauvais Jarvis and his group of French researchers found that breast pain was relieved 95% of the time with a natural progesterone gel rubbed into the breasts.
Dr. John Lee, clinical instructor at U. of California Dept. of Family Medicine has had good success using a 2 oz. jar of 3% natural progesterone cream for the last two weeks of cycle for a total of 3 -6 months. Maintenance is 1/2 jar a month. Studies have been inclusive as to whether vitamin supplementation reduces pain or swelling.
Dr. Christine Northrup, an American gynecologist, recommends hot castor oil packs applied to the breast 3 times a week for one hour for 2-3 months with maintenance afterwards of once a week. (12)
Dr. John Myers a Baltimore gynecologist with a special interest in metabolic disease is credited among the first to recognize the importance of iodine to the breast and ovary. He found he could completely reverse fibrocystic breast disease using iodine orally and vaginally along with trace mineral elements given under the tongue and magnesium given intravenously. Cystic breast would soften quickly under the regime, sometimes immediately. (11)
In the Canadian Journal of Surgery, Dr. William Ghent, former Professor Emeritus of Surgery, at Queen"s University in Kingston, Ont. and Dr. Bernard Eskin, Professor of Reproductive Endocrinology and Obstetrics & Gynecology at Medical College of Pennsylvania, (who both collaborated on clinical research of iodine deficiency and fibrocystic disease in the 1970's) have speculated that the elemental iodine is essential for breast normality, and its absence seems to render the breast ducts more sensitive to estrogen stimulation and subsequent formation of cysts and scar tissue. They theorize that adequate amounts of elemental iodine in breast tissue make them less sensitive to circulating estrogens. As such the iodine could be classed as a natural anti-estrogen a sort of natural tamoxifen. Incidentally, during treatment for fibrocystic breast disease, it was noted that some women experienced a marked improvement in their endometriosis. At present this special form of iodine must be taken continuously or the breasts will become cystic again. With Dr. Ghent's research on fibrocystic disease of 3200 women for 12,000 women years, the breast cancer rate of women taking the elemental iodine was 0.00082 women per year, while the projected incidence of breast cancer for Ontarian women was .0064 women per year.(11)
Sydney Singer a medical Anthropologist, examines the ways in which our lifestyles make us sick, and came up with the theory that "there is no such disease as Breast Cancer, there is cancer which manifested in a woman's breast". He discovered that where there were not brassieres, there was little breast disease, after conducting a two-year study in which he interviewed over 5000 women regarding their attitude and behavior regarding breast and bras. About half of the women had breast cancer, and he discovered that the women with breast cancer had a history of tighter and longer bra wearing than did the women who had not (yet) developed the disease.
The researcher also threw out the challenge that if a woman stopped wearing her bra for two weeks that fibrocystic breast disease would disappear. (I had suffered Fibrocystic Breast Disease for over 35 years, and thought what the heck, I'll give him three weeks. I marked the time off on my calendar and carried on with life as usual. After three weeks, my breast was completely clear of Fibrocystic Breast Disease (from a bag full of marbles to one full of water, what a difference). Dr. Singer has pointed out that the problem caused by bras is essentially a mechanical interference with the breast lymphatic drainage. However, in today's world we are all exposed to hazardous cancer causing toxins in our food, air water and medications. Pesticides, herbicides and other chemical contaminants enter our bodies and must be cleared away, along with the damage they caused. This is the basis of the dietary connection with cancer (and environmental pollution). It is through our diets that we get exposed to many toxins especially the fat-soluble toxins that are found in the fatty part of our foods. High fat diets are associated with cancer, not because of the fat itself (which people have been consuming for thousands, if not millions of years), but because of the toxin content of fats produced in our chemical dependent food production system. Once in our tissues, these toxins must be flushed out via the lymphatics. However, a bra-constricted breast cannot adequately perform this cleansing process, resulting in toxin accumulation in the breasts.
One major reason women wear bras is the myth that bras are needed for "support". This myth assumes that the female body was created with a flaw pertaining to shape. This apparent flaw is a reflection of a fashion image which demands that women have their breasts higher on their chest wall than nature intended, and which can be achieved only with the purchase of a product-the brassiere. In fact, bras are creating droopy, weak breasts, the exact opposite of what this myth claims. As the breast relies on the bra for artificial support the body loses its ability to support the breast by itself. (13)
ERT & CANCER: Dr. Alan Gaby, author of Preventing and Reversing Osteoporosis, explains that at least 28 different studies have evaluated the relationship between Estrogen Replacement Therapy and breast cancer. These analyses suggest that estrogen replacement therapy is associated with an increase in the risk of breast cancer ranging from 1-30% (9)
When suffering stage 3, large C prostate cancer, my husband was prescribed women's hormones to slow the cancer growth. He developed breasts, which produced large tumors. His surgeon wished to operate, but we decided against it, and upon chance when visiting an acupuncturist, the DTCM recommended some nightly massage of Zusali (Stomach 36 point) and the tumors went away.
WESTERN PERSPECTIVE: CANCER OF BREAST AND TREATMENT: The value of lymph node removal is increasingly controversial, says Dr. Greg McGregor, head of surgical oncology at the British Columbia Cancer Agency. He is chief investigator in a new trial to see if lymph node conservation affects cancer recurrence or survival.
Dr. Edward Fish, Assistant Surgery Professor at University of Toronto, also questions routine removal of lymph nodes, especially for women with a small lump. An experimental technique is being developed where a dye is injected close to the tumor. The dye then travels to the lymph gland called the senital gland. That gland alone is then removed and if it contains no cancer cells, the lymph nodes can be safely intact. Dr. Fish studied 100 women who had lumpectomy only. Women over the age 65 with a small non-aggressive tumor had a local recurrence rate of less than five percent and would thus benefit little from radiation.
Recently in Vancouver B.C., 40 doctors from across North America made a landmark decision to study unconventional cancer treatments. (16) In the question of "preventive" chemotherapy, Steve Austin, a naturopath, says most women have impaired quality of life from chemotherapy, but few benefits. Side effects could include hair loss, nausea, and lowered white blood cell count and susceptibility to infection. (17)
Another treatment/preventive tried out now is Tamoxifen, which was developed about 20 years ago. Researchers discovered it lowered Breast Cancer rates in animals, and started studying its effects on human breast cancer. The researchers found out that tamoxifen interfered with estrogen in breast tissue by stopping it from binding to particular receptors. Although estrogen promotes the growth of breast cancer cells, it must first bind to these receptors in order to have any effect at all. Tamoxifen blocks these estrogen receptors and helps reduce the chance of a recurrence of breast cancer. Because of this anti-estrogenic effect, the side effects of tamoxifen mirror that of menopause. The research soon unveiled even more serious side effects of tamoxifen usage. Even the National Cancer Institute admits that Tamoxifen can cause an increase of uterine cancer. It is also believed to cause liver cancer. Dr. Samuel Epstein, an expert in environmental toxicology has reported Tamoxifen is the most potent liver carcinogen available,(18) and most experts are telling us this is the "most promising anti-cancer drug on the market".(19)
It has been my experience that before cancer can be cured or go into remission, some psychological work must be done. There seems to be a spiritual manifestation of the disease and this must be treated along side the physical ones. Dr. Louise Hay, an international renown counselor, teacher and lecturer, states "frequently patients with cancer have a deep hurt, long-standing resentment, a deep secret or grief eating away at self. Carrying hatred saying 'What"s the use?', and then the part of the body involved sometimes shows the person's mind bent. For example in breast problems perhaps the person had a problem with over-mothering, over-protection or over-bearing attitude, perhaps a refusal to nourish the self, putting everyone else first." (21)
Edward Bach stated that Disease is in essence, the result of conflict between soul and mind. and will never be eradicated in the patient except by spiritual and mental effort. We must learn to think, reason, see, hear, speak and pray from the heart, not the head to be with our soul. "Illness. disharmony and imbalance are often a result of the gap between the inner state and the 'face' that we daily put on to those around us" (22)
Dr. Ron Pratt. Ph.D. .F.B.F.S. a social science researcher has stated that in his experience and observations, that especially cancer, among others is a disease that not only attacks the physical, it also attacks the spirit. "Such men as Hippocrates, with his mighty ideals of healing, Paracelsus with his certainty of the Divinity of Man; and Hahnemann, who realized that disease originates in a plane above the physical, Edward Bach with his certainty that the real cause of disease are such defects as pride, cruelty, hate, self-love, ignorance (lack of wisdom), instability of mind (indecision), inconsistency, greed, presumption, pretension, immaturity, deceit, deception, sensuality. What untold misery would have been spared during the last 20 to 25 centuries had the teachings of these great masters and their art been followed. Unfortunately, as in other areas, materialism has appealed too strongly, and for so long a time, that the voices of the detractors and obstructers have risen above the advise of those great masters, who knew the truth." (20)
TRADITIONAL CHINESE MEDICINE PERSPECTIVE
Many people are returning to ancient manuscripts and studying the masters, and now we see the West embracing the 5000 years documented medicine from the east, commonly known as Traditional Chinese Medicine.
The five principles of TCM treatment are:
1. Fu Zheng Qi Xie- promote, enhance, dispel evil, and strengthen"s patient"s resistance.
2. Huo Xue Qu Yu- eliminates stasis and promotes blood circulation
3. Qing Re Jie Du- clear and remove evil heat, detox, relieve fever and pain.
4.Ruan Jian San Jie- softens, dissolve hard masses.
5. Yi Du Gong Du- combat poisons with poisons.
TCM believes that cancer involves four factors: blood stasis, deficiency, toxicity and phlegm, that all must be present for cancer to happen. The aetiology and pathogenesis of Breast Cancer is:
Insufficiency of vital Qi- injury of seven emotions
Stagnation of Liver and Spleen Qi and disorder of Chong and Ren channels leads to disturbance of physiological function of Zang-fu organs and mammary gland, obstruction of the channels and collaterals accumulation of stagnated Qi, blood and phlegm in breast.
1) For stagnation of the Liver Qi, wishing to relieve the depressed liver and resolve phlegm and masses use a modified XIAO YAO SAN:
Chai hu 10 gr. (Bupleurum falcatum)
Detoxifies the liver, regulates liver qi,
Bai shao 12 gr, (White peony)
Tonifies blood, antispasmodic, nourishes ying
Dang Gui 12 gr.
Tonifies and moves blood
Bai Zhu 10 gr.
Tonifies qi, removes dampness, promotes digestion
Fu Ling I0 gr. (Poria Cocos)
Diuretic, drains dampness, purifies the lymphatic system, anticancer
Tian Nan Xing 10 gr. Arisaema Consanguineum (prepared jack in the pulpit)
Dissolves and Removes phlegm congestion from the chest, anticancer
Jiang Ban Xia 10 gr. (Prepared Pinellia ternata)
Dissolves and removes phlegm from the chest
Quan Gua Lou 10gr. (Trichosanthes fruit)
Clears heat, detoxifies, anticancer, removes phlegm-heat, dissipates nodules (tumors) especially good for the lungs and breast
Chuan Lian Zi 10 gr. (Meliae Toosendan fruit)
Moves qi, stops pain, clears heat and detoxifies, anticancer,
Gan Cao 6 gr. (glycyrrhizae uralensis licorice)
Harmonizes, tonifies qi, anticancer
For hypertensive liver fire add:
Mu Dan Pi 10 gr. (tree peony root bark paeonia suffructicosa)
Clears heat, moves blood
Shan Zhi Zi 10gr. (Gardenia fruit Gardeniae jasminoides)
Moves blood, clears heat, detoxifies, anticancer
2) For disorder of Chong & Ren Channels requiring a modified ER XIAN TANG (Decoction of Curculigo and Epimodium) to regulate the two channels:
Xian Mao 10 gr. (Curculigo orchiodes)
Tonifies kidney yang (adrenals), removes coldness and dampness
Xian Ling Pi 15 gr. (Epimedium grandiflorum)
Tonifies kidney yang (adrenals), removes damp-cold
Ba Ji Tan 10 gr. (Morinda officinalis root)
Strengthens kidney yang (adrenals)
Dang Gui 15gr. (Angelica sinensis)
Tonifies and moves blood
Lu Jiao Shuang 6 gr. (Cornu cervi degelatinatium) this is the dregs after boiling deer antler glue, it is milder than deer antler, but also tonifies qi and blood
Zi Dan Shen 15 gr. (Red sage root Salvia miltiorrhizae)
Moves blood, cools heat, relieves pain, calmative, removes liver qi stagnation, prevents metastasis
Ban Xia 10gr. (Prepared pinellia ternata root)
Dissolves and removes phlegm from the chest
Bai Jie Zi 10gr. (mustard seed brassica alba)
Promotes digestion, relieves stagnation, anticancer
Gan Cao 6 gr. (glycyrrhizae uralensis licorice)
Harmonizes, tonifies qi, anticancer
If the breast is hard, painful and complicated with anemia add:
Ezhu 12 gr. (Curcuma zedoaria)
Moves blood, dissolves stagnation and masses, and relieves pain, anticancer
Zhi Ru Xiang 12 gr. (Frankincense Gummi Olibanum)
Moves blood, dissolves stagnation and masses, and relieves pain
Zhi Mo Yao 12gr. (Myrrh Commiphora myrrha)
Moves blood, relieves pain, and dissolves masses
3) Another type is accumulation of noxious fire in the interior and to purge fire, remove toxins, subdue swelling and arrest pain use a modified LONG DAN XIE GEN TANG:
Long Dan Cao 6 gr. (Gentiana scabra)
Clears heat and dampness, relieves inflammation, anticancer
Shan Zhi Zi 10 gr. (Gardenia fruit Gardeniae jasminoides)
Moves blood, clears heat, detoxifies, anticancer
Huang Qin 15 gr. (Scutellaria baicalensis)
Clears heat and dampness, detoxifies, anticancer
Sheng Di 21gr. (Unprepared Rehmannia glutinosa)
Clears heat, nourishes the blood and yin
Che Qian Zi I2 gr. (Plantago asiatica seed)
Removes dampness, diuretic, clears heat, purifies the lymphatic system
Ze Xie 10 gr. (Alisma tuber water plantain)
Diuretic, clears heat, promotes lymphatic purification
Mu Tong 9 gr. (Akebia trifoliata)
Diuretic, antiinflammatory, detoxifies, anticancer
Dang Gui 12 gr. (Angelica sinensis)
Tonifies and moves blood
Chai Hu 10 gr. (Bupleurum falcatum)
Detoxifies the liver, regulates liver qi,
Zao Xin 30 gr. (Terra flava usta derived from the center of the ashes from the bottom of a cooking stove where lithospermum has been burned)
Warms the blood, stops bleeding, warms the stomach, stops vomiting
Feng Fang 15 gr. (Wasp"s nest Polistes olivaceus)
Detoxifies, moves blood, anticancer, treats tumors
Quan Xie 10 gr. (Scorpion Buthus martensi)
Detoxifies, regulates qi flow, anticancer
Long Kei Zi 15 gr.
??
Sheng Gan Cao 6 gr. (glycyrrhizae uralensis licorice)
Harmonizes, tonifies qi, anticancer
If the fever is severe add:
Jin Yin Hua 30 gr. (Lonicera or honeysuckle flowers)
Anti-cancer, detoxifies
Lian Qiao 15 gr. (Forsythia suspensa)
Detoxifies, clears heat, anticancer, moves blood, dissolves lumps
Sheng Shi Gao 30 gr. (Gypsum)
Clears heat
or the following could be used for removing heat and toxic material and anti-cancer. Ban Zhi Lian 30 gr. (Scutellaria barbata)
Clears heat and dampness, anticancer,
Bai Hua She She Cao 30 gr, (Oldenlandia diffusa)
Anticancer, clears heat
4) For deficiency of both Qi and Blood- where the Breast is like a cauliflower and with a continual exudative blood fluid plus other symptoms. Where the practitioner wishes to tonify Qi and Blood remove toxic material and resolve phlegm a modified GUI PI TANG can be used:
Huang Qi (astragalus) 30 gr.
Tonifies qi, strengthens the immune system, protects the body, anti-cancer
Dang Shen (codonopsis) 30 gr.
Tonifies qi
Bai Zhu (white atractylodes) 12 gr.
Tonifies Qi, removes dampness, strengthens digestion
Dang Gui (Angelica sinensis) I0 gr.
Nourishes and moves blood,
Fu Ling (Poria cocos) 15 gr.
Diuretic, promotes lymphatic drainage, anticancer
Chi Shan Yao (red peony root paeonia rubra) I2 gr.
Moves blood, breaks up stagnation
Long Yan Rou (Longan berries Arillus longus) 30 gr.
Nourishes blood, mild sedative, tonifies the heart and spleen
Shuang Hua Teng (Lonicera or honeysuckle vine) 30 gr.
Anti-cancer, detoxifies
Ba Jie Zi (mustard seed brassica alba) 10 gr.
Promotes digestion, relieves stagnation, anticancer
Qian Cao Gen (madder root Rubiae cordifoliae) 15 gr. (23)
Stops bleeding and yet it promotes blood circulation
This entire amount is cooked in 6 cups slowly down to 2 or 3, which is consumed in three times daily.
FOLK CURE Another folk remedy that has been very successful in dissolving cancer tumours is the use of raw red beetroots, but when ingested as a juice there is a danger of the patient contracting a high fever because of the incredible strong ability to quickly break up cancer in the body. The beets can clean up the cancer faster than the liver is capable of processing all of the wastes dumped into it at all at once. Reducing dosage helps. (24)
References
1. The Vancouver Sun Monday 14 July 1997
2. Sandra Stein Graber Auth6r"Living Downstream"
3. Breast Health Update- Charles B.Simone, M.D.
4. The Vancouver Sun Tue 15 July 1997
5. Colditz G.A. "Family History Age & Risk of Breast Cancer,
Prospective Data from the Nurses Health Study" Journal of
The Amer. Medical Assoc 270 #3 July 1993
6. Alternative Medicine- Burton Goldberg Group.
7. Breast Cancer Scandal- Rhody Lake; Alive / Oct. 1995
8. Getting Fat & The Myth of the Fat Free Campaign- Thomas Anderson Ph.D.; Alive/ Oct 1995
9. Prevention &. Reversing Osteoporosis- Alan Gaby
10. Pizzorio J.E. & Murray M.T. "A Textbook of Natural Medicine' Seattle, We, John Bastr College Pubs. 1988-89.
11. DeMarco, Carolyn M.D. Health Counsellor Aug/Sept 1995
12. Northrup, Christine M.D. Gynaecologist "Women's Wisdom, Women's Bodies" Doubleday 1994
13. Singer, Sydney Ross, Medical anthropologist "Dressed to Kill- the link between Breast Cancer & Bras"
14. The Vancouver Sun Tue 15 July 1997
15. Simone, Charles B. M.D. founder of Simone Cancer Centre "Breast Health"- Impakt Communications Ltd.
16. DeMarco, Dr. Carolyn- The Vancouver Sun Mon Nov. 18, 1996
17. Austin, Steve author of "Breast Cancer" -Prima Press 1994
18. Gazella, Karolyn A. author of "The Breast Cancer Prevention Trial- Beware of dangerous Science" Health Counsellor Feb 1995
19. The Complete Book of Natural & Medical Cures- Rodale 1994 20. Pratt, Dr. Ph.D. (Psychology) (Humanities) F.B.F.S.
21. Hay, Dr. Louise L.- "Heal Your Body"
22.Howard &. Ramsal- "The Original Writings of Edward Bach"
23. English Chinese Encyclopaedia of Practical T.C.M. Beijing #10, Internal Medicine
24. Heinemann"s Encyclopaedia of Fruits Vegetables & John Heinemann- medical anthropologist
Camellia C. Pratt is an East West Herb Course Student and a practitioner. She is developing a wonderful website that describes her clinic. Check it out at
http://www.rainbowclinic.faithweb.com
From planetherbs.com
Tuesday, April 17, 2007
Cancer Theories
This was an article I wrote just after graduating from Chinese medical school. I have just read it for the first time in many years and thought I'd share it. It's by no means a finished product, just thinkings on a very difficult subject.
CANCER & CHINESE MEDICINE
By Ross Rosen, J.D., M.S.T.O.M., L.Ac., C.A., Dipl. O.M. (NCCAOM)
I. INTRODUCTION
Cancer is a cellular malignancy resulting from uncontrolled cellular growth. This loss of control may be the result of changes to the DNA caused by a number of factors, including genetics, immunological deficiencies, viruses and exposure to toxins and carcinogens. Eastern medicine has many views regarding the causes of cancer, including, the 7 emotions (an excess of depression, anger, anxiety, worry, fear, grief and overthinking can cause imbalances in the circulation of qi), qi and blood stagnation, phlegm-damp accumulation, and internal and external toxins. What is consistent among the eastern etiologies, however, is that internal causes are a major culprit. And as always, we need to factor into the likelihood of the formation of cancer the terrain/environment that the cancer can grow in. Each person has his/her unique constitution/body condition/strengths and weaknesses which leave him/her vulnerable or with a strong defense to the formation of cancer.
Traditional Chinese Medicine typically classifies tumors as qi and blood stagnation, or phlegm-damp accumulation. These are the two main etiologies for the formation of a mass. This is not to say that treating qi and blood stagnation or phlegm-damp accumulation is sufficient to treat cancer -- if it were, cancer would not be the threat that it is today. What qi and blood stagnation or phlegm-damp accumulation tell us is the main pathological influence contributing to the formation of the tumor. This becomes significant for determining the root cause of the cancer itself.
II. THE ELEMENTS IMPLICATED IN UNCONTROLLED GROWTH
While eastern and western explanations differ regarding the genesis of cancer, they are not as disparate as they may seem at first glance. The main link between these two theories is the idea that cancer is caused by a lack of internal control. While the east and west attribute different paradigmatic processes to this lack of control, they are in effect, similar. If we accept the premise that cancer is caused by uncontrolled growth, to understand this process according to Chinese medicine we must first look to the elements and organs which are most responsible for this function. In Chinese medicine, it is the water element/kidneys, and the wood element/liver which govern growth. Under the theories of Chinese medicine, the kidneys, and hence the water element, control the processes of growth, development, maturation and death. It is the kidney energy that fills the 8 extra meridians, and the kidney yin and yang which form the yuan qi. It is our kidney energy that regulates the 7 and 8 year cycles of men and women. It is our reserves, our essence, our potential. This energy may be likened to the concepts of DNA and genetic influences that are attributed to western medicine. The other element, wood, is considered to be the element of birth. It has an upward and outward energy. This element is constantly creating and growing. It is the manifestation and activation of the potential of the water element. Together, the water and wood elements represent the movement from the winter to the spring and the ascension of energy.
III. CAUSES OF UNCONTROLLED GROWTH
The reason that cells proliferate out of control is that the water energy or wood energy depending on etiology (which will be discussed later) goes unchecked. Like any system, the human body has to have counterbalancing forces. The counterbalancing or controlling force behind the water element is the earth element, associated with the spleen and stomach. The control for the wood element is the metal element, associated with the lungs and large intestine. The reason that energy gets stuck in either the water or wood phase is either the weakness or deficiency of the controlling phase, or an apparent excess in the element itself. In either event, the control element is unable to perform its function. Thus, a deficient earth element will allow the water element to become excessive and stagnate, and a deficient metal element will permit wood energy to stagnate. To be clear, it is an excess of water energy, not of the kidneys, and it is an excess of wood energy, not of the liver. A deficient spleen or lungs will not result in a strong kidneys and liver; on the contrary, it creates an overabundance of energy within those phases. This results in the associated organs working overtime to attempt to deal with the excess. But due to the deficiency in the control elements, this excess continues to build, and the organs are unable to transform and utilize this abundant energy. As a result, the entirety of energy that typically passes from one phase to the next is undermined. Excess still remains in the overabundant phase and it is this excess which creates stagnation.
IV. CAUSES OF LACK OF CONTROL
It is this failure of the control cycle, which enables the stagnation of either the water or wood elements. This stagnation, then, disrupts the sheng cycle, not allowing for the energy to transfer from the excess element to the next. This further exacerbates the vacuity of the controlling element, which makes it more unable to assert its dominance over the water or wood elements. The cause of this lack of control, then, is identical to the cause of a weak earth element or metal element. Practitioners of Chinese medicine are well aware of these causes; poor diet (including excessive intake, cold and raw foods, excess sweets, dairy, fried or greasy foods, etc.), alcohol, anxiety and worry, overthinking, grief, inability to let go, environmental pollutants and toxins, and lack of exercise are some of the main culprits.
V. CANCER THEORY
To summarize, a weak earth or metal element will allow for stagnation in the water or wood element respectively. This stagnation will cause an uncontrolled growth of otherwise healthy cells. This uncontrolled growth will eventually lead to stagnation, the primary pathogenic factor being either qi and blood stagnation or phlegm-damp accumulation. In either event, the accumulation will build, and when severe enough, heat will develop and eventually lead to a toxin. This toxin will catalyze the tumor into a malignancy as it will cause the proliferated cells to grow at a faster rate. The heat toxin will determine the severity of the cancer; if too hot, it will cause poor differentiation of cells due to the rapidity of the growth. Factors in determining the severity of the stagnation and heat toxin, and hence the severity of the malignancy include genetics influences, lifestyle factors, general constitution, and the quantity and quality of our emotions.
While all this is occurring, the earth and metal elements are weakening even further. Because the lungs and the spleen are the bodies main organs involved in immune response, the defense of the outer aspects being monitored by the lungs and skin, and the interior being maintained by the spleen (which is responsible for controlling the lymphatic system), our immunity begins to diminish even further. Thus, the body becomes unable to deal with the constant introduction of external pathogenic influences (toxins and carcinogens) which are ubiquitous in the air we breathe and the food and drink we consume. These external toxins which are now unable to be dealt with begin to invade and mix with the internal toxins caused by the uncontrolled proliferation of cells. If the patient's spleen and lungs are still strong enough to provide an adequate defense against these external pathogens, the growth of the tumor may be delayed, since the external toxins and carcinogens would not have enough time to mix with the tumor cells and internal toxins. What is interesting to note is the similarity now between the western and eastern ideas surrounding cancer; i.e., that cancer can be contributed to by air pollutants/toxins/chemicals, and by toxins in our food and drink. These are how carcinogens can enter our body - once our earth and metal elements are too weak to provide an adequate defense.
Another consideration is the site of the cancerous activity. While there is no consistent basis for determining the site of a tumor in a high-risk patient, there are a number of factors which may determine where tumors arise, including, (1) the patient's constitution (tumors may often be situated in the organ of, or in a location under the influence of, a patient's constitutional element, i.e., throat cancer in a metal constitution, or cervical cancer in a water constitution; the tumor site may be also at the locus of the element in the control cycle to the patient's constitutional element, or an area under its influence, i.e., colon cancer in a wood constitution); (2) the area of greatest abuse, i.e., lung cancer in a smoker, liver cancer in an alcoholic; (3) genetics, i.e., breast cancer in mother and daughter.
VI. DIAGNOSIS
Treatment of the cancer cells depends on the proper differentiation of which elements are most out of balance. There are two ways to determine which element is the root cause of the cancer. They are accomplished through the 4 examinations which are the hallmark of Chinese medicine. During the intake, one should be looking for predominant signs of either qi and blood stagnation or phlegm-damp accumulation. Signs of qi and blood stagnation (tumor hard and fixed, fixed pain, purple tongue, dark and distended sublingual veins, wiry, choppy pulse, etc.) would point the practitioner to wood as the primary element involved, while phlegm-damp signs (tumor soft or moveable, nausea, thick greasy tongue coat, slippery or soft pulse, etc.) may point to the water element. In essence, determine whether the patient's disharmony is one of a breakdown in qi dynamic or water metabolism. The second is that there should also be corresponding deficient signs in the control element. Thus, if it is unclear whether the water or wood element is implicated and there are clear signs of spleen qi deficiency, one would suspect water involvement. Lung qi deficiency would implicate wood. This becomes difficult at later stages of the cancer since by this time the spleen and lungs will both be very deficient (and a deficiency in earth will cause a deficiency in metal and vice versa) and there will be clear signs of both phlegm-damp and qi and blood stagnation since dampness will impede the smooth flow of qi, and qi stagnation will prevent the proper transformation of fluids.
VII. TREATMENT
In general, the treatment strategy involves draining the excess stagnation from either the water or wood elements and tonifying the deficiency in the earth or metal elements. For a water excess and earth deficiency, one should transfer energy away from the wood element to encourage or stimulate the transfer of energy from water to wood. In addition, the kidneys should be mildly strengthened to facilitate water metabolism while simultaneously supplementing the spleen and stomach to exert proper control over water and aid in the transformation and transportation of fluid metabolism. For a wood excess and metal deficiency, one should transfer energy away from wood and fire and simultaneously supplement metal. Where there is evidence of a breakdown in both control cycles, a skilled practitioner will need to incorporate both treatment strategies, each to the degree of the disharmony as he determines it.
A. Acupuncture The foregoing principles can be accomplished in a number of ways and according to individual styles and training, i.e., TCM, 5 Element, meridian style, etc. Typical point prescriptions may include points from the following:
WATER/EARTH WOOD/METAL
Sedate: LV 1, LV 2, LV 3 Sedate: HT 8, LV 2, LV 3
KI 1, SP 6
Tonify: ST 36, SP 3, SP 4, Tonify: LV 4, LU 1, LU 8,
KI 3 LU 9, SP 3, LI 4
These representative point prescriptions should be incorporated into and combined with other points to address the more specific presentation of the patient, his symptoms, constitution, etc.
B. Herbs Herbal therapy should follow the same principles enumerated above. Thus, herbs which promote the circulation of liver qi, supplement the kidneys and tonify the spleen and stomach should be used where tumors are of the the phlegm-damp type, and where qi and blood stagnation is found, one should use herbs which drain the liver by invigorating qi and removing blood stasis, while supplementing the lungs. Special attention should be given to herbs which are known to have anti-cancer properties. Some are included in the following:
WATER/EARTH WOOD/METAL
Herbs which drain the LV Herbs which invigorate qi/blood and
and improve water metabolism remove stasis
Xia Ku Cao, Ji Xue Teng, Xia Ku Cao,
Zhu Ling, Xiang Fu, E Zhu, San Leng, Dan Shen, Hong Hua
Yi Yi Ren, Fo Shou Tao Ren, Ru Xiang, Mo Yao, Dang Gui,
Yi Mu Cao Shui Zhi, Tu Bie Chong, Xiang Fu, Chai Hu,
Yu Jin, Bai Shao, Mu Dan Pi
Herbs which supplement Earth Herbs which tonify Metal
Ren Shen, Huang Qi, Ren Shen, Huang Qi,
Bai Zhu, Fu Ling, Zhi Shi, Bai He, Tian Men Dong, Dang Shen,
Hou Po, Mu Xiang, Dang Shen Xing Ren, Sha Shen, Mai Men Dong
Special focus and attention should be given to herbs which clear heat and remove toxins since it is this toxic influence which contributes to the malignancy and the severity of the disease. Thus, a few herbs from this category should be incorporated into the herbal formula. Some notable herbs in this category which have anti-cancer effects are: Pu Gong Ying, Bai Hua She She Cao, Shan Dou Gen, and Da Qing Ye.
VIII. PREVENTION
From the following discussion it is evident that prevention would include avoiding excessive anxiety and worry, eating a proper diet, engaging in regular exercise, being exposed to clean air, etc. In other words, maintaining a healthy spleen, stomach, lungs and large intestine. Additionally, one must take specific precautions against the accumulation of phlegm-damp and qi and blood stagnation by assuring the smooth flow of qi and blood.
IX. CASE STUDIES
A. Female, 31 years old -- breast cancer.
1. Background: Two lumps were detected in patient's right breast, and lumpectomies were performed. The first tumor was 2.5cm, cells were poorly differentiated, and were estrogen positive. Second tumor was <1cm, cells were better differentiated, and were estrogen negative. Patient's cancer was staged at level II. Strong familial history of breast cancer was reported; mother diagnosed at age 41 and died at age 47; multiple cousins on maternal side also diagnosed at early age. The patient came for treatments one week after lumpectomies in order to heal from treatment and boost immunity prior to chemotherapy and radiation, and manage side effects.
2. Signs and Symptoms:
3. Diagnosis:
4. Treatment:
a. Acupuncture:
b. Herbs: After the initial treatment, the patient was given the following formula:
Huang Qi
Dang Shen
Tai Zi Shen
Tian Men Dong
Dang Gui
Bai Shao
Mu Dan Pi
Ji Xue Teng
Xia Ku Cao
Pu Gong Ying
Fu Ling
Zhu Ling
Bai Zhu
c. Analysis: This patient represents a case in which a breakdown in both control cycles is evident. It was determined that the initial disharmony began with a metal deficiency, i.e., deficient lung qi. Thus, tonifying the lungs and invigorating liver qi were adopted as the primary strategy (huang qi, dang shen, tai zi shen, tian men dong for the lungs; dang gui, bai shao, mu dan pi, ji xue teng for invigorating the liver qi and blood; xia ku cao and pu gong ying for addressing the toxins and draining the liver in general). The secondary strategy was to tonify the spleen and stomach and improve water metabolism (fu ling, zhu ling, bai zhu).
B. Female, 51 years old -- cervical cancer.
1. Background: patient's symptom signifying cancer was sporadic vaginal bleeding 2-3 days per week. After diagnosis, hysterectomy was performed, followed by chemotherapy and radiation. The patient came for treatments one year following western treatment and intervention in order to recouperate and address side effects of treatment.
2. Signs and Symptoms: In addition to patient's main symptom of vaginal bleeding, she also has a history of bleeding and bruising easily. She has irritable bowel syndrome and colitis manifesting in frequent (5-6 times each morning) loose and watery stools. In addition, patient has hemorrhoids. Patient has significant edema and weight gain. Since her chemotherapy and radiation, patient has experienced high blood pressure, with frequent malar flushing (2-3 times per day, accompanied by sweat on her forehead), and tinnitus. She also has cramping in the lateral aspect of her legs (ST channel) and drooping of the corner of her mouth at ST 4. She wakes one time per night to urinate. She also has a family history of migraines. Dry skin and skin sensitivity have resulted from her cancer treatments. Her pulse was deep and slippery, with a very weak chi position. Her tongue was pale, short, puffy and scalloped with some cracking in the center and anterior one-third. Since her cancer treatments, patient has been getting colds every 2-3 weeks.
3. Diagnosis: Spleen and Kidney deficiency with dampness.
4. Treatment:
a. Acupuncture: LV 1, KI 3, ST 36, ST 25, SP 9, SJ 4
b. Herbs: patient was unwilling to take herbs
edema lessening
more urination
less BM- turning more solid
no migraines
CANCER & CHINESE MEDICINE
By Ross Rosen, J.D., M.S.T.O.M., L.Ac., C.A., Dipl. O.M. (NCCAOM)
I. INTRODUCTION
Cancer is a cellular malignancy resulting from uncontrolled cellular growth. This loss of control may be the result of changes to the DNA caused by a number of factors, including genetics, immunological deficiencies, viruses and exposure to toxins and carcinogens. Eastern medicine has many views regarding the causes of cancer, including, the 7 emotions (an excess of depression, anger, anxiety, worry, fear, grief and overthinking can cause imbalances in the circulation of qi), qi and blood stagnation, phlegm-damp accumulation, and internal and external toxins. What is consistent among the eastern etiologies, however, is that internal causes are a major culprit. And as always, we need to factor into the likelihood of the formation of cancer the terrain/environment that the cancer can grow in. Each person has his/her unique constitution/body condition/strengths and weaknesses which leave him/her vulnerable or with a strong defense to the formation of cancer.
Traditional Chinese Medicine typically classifies tumors as qi and blood stagnation, or phlegm-damp accumulation. These are the two main etiologies for the formation of a mass. This is not to say that treating qi and blood stagnation or phlegm-damp accumulation is sufficient to treat cancer -- if it were, cancer would not be the threat that it is today. What qi and blood stagnation or phlegm-damp accumulation tell us is the main pathological influence contributing to the formation of the tumor. This becomes significant for determining the root cause of the cancer itself.
II. THE ELEMENTS IMPLICATED IN UNCONTROLLED GROWTH
While eastern and western explanations differ regarding the genesis of cancer, they are not as disparate as they may seem at first glance. The main link between these two theories is the idea that cancer is caused by a lack of internal control. While the east and west attribute different paradigmatic processes to this lack of control, they are in effect, similar. If we accept the premise that cancer is caused by uncontrolled growth, to understand this process according to Chinese medicine we must first look to the elements and organs which are most responsible for this function. In Chinese medicine, it is the water element/kidneys, and the wood element/liver which govern growth. Under the theories of Chinese medicine, the kidneys, and hence the water element, control the processes of growth, development, maturation and death. It is the kidney energy that fills the 8 extra meridians, and the kidney yin and yang which form the yuan qi. It is our kidney energy that regulates the 7 and 8 year cycles of men and women. It is our reserves, our essence, our potential. This energy may be likened to the concepts of DNA and genetic influences that are attributed to western medicine. The other element, wood, is considered to be the element of birth. It has an upward and outward energy. This element is constantly creating and growing. It is the manifestation and activation of the potential of the water element. Together, the water and wood elements represent the movement from the winter to the spring and the ascension of energy.
III. CAUSES OF UNCONTROLLED GROWTH
The reason that cells proliferate out of control is that the water energy or wood energy depending on etiology (which will be discussed later) goes unchecked. Like any system, the human body has to have counterbalancing forces. The counterbalancing or controlling force behind the water element is the earth element, associated with the spleen and stomach. The control for the wood element is the metal element, associated with the lungs and large intestine. The reason that energy gets stuck in either the water or wood phase is either the weakness or deficiency of the controlling phase, or an apparent excess in the element itself. In either event, the control element is unable to perform its function. Thus, a deficient earth element will allow the water element to become excessive and stagnate, and a deficient metal element will permit wood energy to stagnate. To be clear, it is an excess of water energy, not of the kidneys, and it is an excess of wood energy, not of the liver. A deficient spleen or lungs will not result in a strong kidneys and liver; on the contrary, it creates an overabundance of energy within those phases. This results in the associated organs working overtime to attempt to deal with the excess. But due to the deficiency in the control elements, this excess continues to build, and the organs are unable to transform and utilize this abundant energy. As a result, the entirety of energy that typically passes from one phase to the next is undermined. Excess still remains in the overabundant phase and it is this excess which creates stagnation.
IV. CAUSES OF LACK OF CONTROL
It is this failure of the control cycle, which enables the stagnation of either the water or wood elements. This stagnation, then, disrupts the sheng cycle, not allowing for the energy to transfer from the excess element to the next. This further exacerbates the vacuity of the controlling element, which makes it more unable to assert its dominance over the water or wood elements. The cause of this lack of control, then, is identical to the cause of a weak earth element or metal element. Practitioners of Chinese medicine are well aware of these causes; poor diet (including excessive intake, cold and raw foods, excess sweets, dairy, fried or greasy foods, etc.), alcohol, anxiety and worry, overthinking, grief, inability to let go, environmental pollutants and toxins, and lack of exercise are some of the main culprits.
V. CANCER THEORY
To summarize, a weak earth or metal element will allow for stagnation in the water or wood element respectively. This stagnation will cause an uncontrolled growth of otherwise healthy cells. This uncontrolled growth will eventually lead to stagnation, the primary pathogenic factor being either qi and blood stagnation or phlegm-damp accumulation. In either event, the accumulation will build, and when severe enough, heat will develop and eventually lead to a toxin. This toxin will catalyze the tumor into a malignancy as it will cause the proliferated cells to grow at a faster rate. The heat toxin will determine the severity of the cancer; if too hot, it will cause poor differentiation of cells due to the rapidity of the growth. Factors in determining the severity of the stagnation and heat toxin, and hence the severity of the malignancy include genetics influences, lifestyle factors, general constitution, and the quantity and quality of our emotions.
While all this is occurring, the earth and metal elements are weakening even further. Because the lungs and the spleen are the bodies main organs involved in immune response, the defense of the outer aspects being monitored by the lungs and skin, and the interior being maintained by the spleen (which is responsible for controlling the lymphatic system), our immunity begins to diminish even further. Thus, the body becomes unable to deal with the constant introduction of external pathogenic influences (toxins and carcinogens) which are ubiquitous in the air we breathe and the food and drink we consume. These external toxins which are now unable to be dealt with begin to invade and mix with the internal toxins caused by the uncontrolled proliferation of cells. If the patient's spleen and lungs are still strong enough to provide an adequate defense against these external pathogens, the growth of the tumor may be delayed, since the external toxins and carcinogens would not have enough time to mix with the tumor cells and internal toxins. What is interesting to note is the similarity now between the western and eastern ideas surrounding cancer; i.e., that cancer can be contributed to by air pollutants/toxins/chemicals, and by toxins in our food and drink. These are how carcinogens can enter our body - once our earth and metal elements are too weak to provide an adequate defense.
Another consideration is the site of the cancerous activity. While there is no consistent basis for determining the site of a tumor in a high-risk patient, there are a number of factors which may determine where tumors arise, including, (1) the patient's constitution (tumors may often be situated in the organ of, or in a location under the influence of, a patient's constitutional element, i.e., throat cancer in a metal constitution, or cervical cancer in a water constitution; the tumor site may be also at the locus of the element in the control cycle to the patient's constitutional element, or an area under its influence, i.e., colon cancer in a wood constitution); (2) the area of greatest abuse, i.e., lung cancer in a smoker, liver cancer in an alcoholic; (3) genetics, i.e., breast cancer in mother and daughter.
VI. DIAGNOSIS
Treatment of the cancer cells depends on the proper differentiation of which elements are most out of balance. There are two ways to determine which element is the root cause of the cancer. They are accomplished through the 4 examinations which are the hallmark of Chinese medicine. During the intake, one should be looking for predominant signs of either qi and blood stagnation or phlegm-damp accumulation. Signs of qi and blood stagnation (tumor hard and fixed, fixed pain, purple tongue, dark and distended sublingual veins, wiry, choppy pulse, etc.) would point the practitioner to wood as the primary element involved, while phlegm-damp signs (tumor soft or moveable, nausea, thick greasy tongue coat, slippery or soft pulse, etc.) may point to the water element. In essence, determine whether the patient's disharmony is one of a breakdown in qi dynamic or water metabolism. The second is that there should also be corresponding deficient signs in the control element. Thus, if it is unclear whether the water or wood element is implicated and there are clear signs of spleen qi deficiency, one would suspect water involvement. Lung qi deficiency would implicate wood. This becomes difficult at later stages of the cancer since by this time the spleen and lungs will both be very deficient (and a deficiency in earth will cause a deficiency in metal and vice versa) and there will be clear signs of both phlegm-damp and qi and blood stagnation since dampness will impede the smooth flow of qi, and qi stagnation will prevent the proper transformation of fluids.
VII. TREATMENT
In general, the treatment strategy involves draining the excess stagnation from either the water or wood elements and tonifying the deficiency in the earth or metal elements. For a water excess and earth deficiency, one should transfer energy away from the wood element to encourage or stimulate the transfer of energy from water to wood. In addition, the kidneys should be mildly strengthened to facilitate water metabolism while simultaneously supplementing the spleen and stomach to exert proper control over water and aid in the transformation and transportation of fluid metabolism. For a wood excess and metal deficiency, one should transfer energy away from wood and fire and simultaneously supplement metal. Where there is evidence of a breakdown in both control cycles, a skilled practitioner will need to incorporate both treatment strategies, each to the degree of the disharmony as he determines it.
A. Acupuncture The foregoing principles can be accomplished in a number of ways and according to individual styles and training, i.e., TCM, 5 Element, meridian style, etc. Typical point prescriptions may include points from the following:
WATER/EARTH WOOD/METAL
Sedate: LV 1, LV 2, LV 3 Sedate: HT 8, LV 2, LV 3
KI 1, SP 6
Tonify: ST 36, SP 3, SP 4, Tonify: LV 4, LU 1, LU 8,
KI 3 LU 9, SP 3, LI 4
These representative point prescriptions should be incorporated into and combined with other points to address the more specific presentation of the patient, his symptoms, constitution, etc.
B. Herbs Herbal therapy should follow the same principles enumerated above. Thus, herbs which promote the circulation of liver qi, supplement the kidneys and tonify the spleen and stomach should be used where tumors are of the the phlegm-damp type, and where qi and blood stagnation is found, one should use herbs which drain the liver by invigorating qi and removing blood stasis, while supplementing the lungs. Special attention should be given to herbs which are known to have anti-cancer properties. Some are included in the following:
WATER/EARTH WOOD/METAL
Herbs which drain the LV Herbs which invigorate qi/blood and
and improve water metabolism remove stasis
Xia Ku Cao, Ji Xue Teng, Xia Ku Cao,
Zhu Ling, Xiang Fu, E Zhu, San Leng, Dan Shen, Hong Hua
Yi Yi Ren, Fo Shou Tao Ren, Ru Xiang, Mo Yao, Dang Gui,
Yi Mu Cao Shui Zhi, Tu Bie Chong, Xiang Fu, Chai Hu,
Yu Jin, Bai Shao, Mu Dan Pi
Herbs which supplement Earth Herbs which tonify Metal
Ren Shen, Huang Qi, Ren Shen, Huang Qi,
Bai Zhu, Fu Ling, Zhi Shi, Bai He, Tian Men Dong, Dang Shen,
Hou Po, Mu Xiang, Dang Shen Xing Ren, Sha Shen, Mai Men Dong
Special focus and attention should be given to herbs which clear heat and remove toxins since it is this toxic influence which contributes to the malignancy and the severity of the disease. Thus, a few herbs from this category should be incorporated into the herbal formula. Some notable herbs in this category which have anti-cancer effects are: Pu Gong Ying, Bai Hua She She Cao, Shan Dou Gen, and Da Qing Ye.
VIII. PREVENTION
From the following discussion it is evident that prevention would include avoiding excessive anxiety and worry, eating a proper diet, engaging in regular exercise, being exposed to clean air, etc. In other words, maintaining a healthy spleen, stomach, lungs and large intestine. Additionally, one must take specific precautions against the accumulation of phlegm-damp and qi and blood stagnation by assuring the smooth flow of qi and blood.
IX. CASE STUDIES
A. Female, 31 years old -- breast cancer.
1. Background: Two lumps were detected in patient's right breast, and lumpectomies were performed. The first tumor was 2.5cm, cells were poorly differentiated, and were estrogen positive. Second tumor was <1cm, cells were better differentiated, and were estrogen negative. Patient's cancer was staged at level II. Strong familial history of breast cancer was reported; mother diagnosed at age 41 and died at age 47; multiple cousins on maternal side also diagnosed at early age. The patient came for treatments one week after lumpectomies in order to heal from treatment and boost immunity prior to chemotherapy and radiation, and manage side effects.
2. Signs and Symptoms:
3. Diagnosis:
4. Treatment:
a. Acupuncture:
b. Herbs: After the initial treatment, the patient was given the following formula:
Huang Qi
Dang Shen
Tai Zi Shen
Tian Men Dong
Dang Gui
Bai Shao
Mu Dan Pi
Ji Xue Teng
Xia Ku Cao
Pu Gong Ying
Fu Ling
Zhu Ling
Bai Zhu
c. Analysis: This patient represents a case in which a breakdown in both control cycles is evident. It was determined that the initial disharmony began with a metal deficiency, i.e., deficient lung qi. Thus, tonifying the lungs and invigorating liver qi were adopted as the primary strategy (huang qi, dang shen, tai zi shen, tian men dong for the lungs; dang gui, bai shao, mu dan pi, ji xue teng for invigorating the liver qi and blood; xia ku cao and pu gong ying for addressing the toxins and draining the liver in general). The secondary strategy was to tonify the spleen and stomach and improve water metabolism (fu ling, zhu ling, bai zhu).
B. Female, 51 years old -- cervical cancer.
1. Background: patient's symptom signifying cancer was sporadic vaginal bleeding 2-3 days per week. After diagnosis, hysterectomy was performed, followed by chemotherapy and radiation. The patient came for treatments one year following western treatment and intervention in order to recouperate and address side effects of treatment.
2. Signs and Symptoms: In addition to patient's main symptom of vaginal bleeding, she also has a history of bleeding and bruising easily. She has irritable bowel syndrome and colitis manifesting in frequent (5-6 times each morning) loose and watery stools. In addition, patient has hemorrhoids. Patient has significant edema and weight gain. Since her chemotherapy and radiation, patient has experienced high blood pressure, with frequent malar flushing (2-3 times per day, accompanied by sweat on her forehead), and tinnitus. She also has cramping in the lateral aspect of her legs (ST channel) and drooping of the corner of her mouth at ST 4. She wakes one time per night to urinate. She also has a family history of migraines. Dry skin and skin sensitivity have resulted from her cancer treatments. Her pulse was deep and slippery, with a very weak chi position. Her tongue was pale, short, puffy and scalloped with some cracking in the center and anterior one-third. Since her cancer treatments, patient has been getting colds every 2-3 weeks.
3. Diagnosis: Spleen and Kidney deficiency with dampness.
4. Treatment:
a. Acupuncture: LV 1, KI 3, ST 36, ST 25, SP 9, SJ 4
b. Herbs: patient was unwilling to take herbs
edema lessening
more urination
less BM- turning more solid
no migraines
Nail Biting
As nail biting is so common I thought I would share a case of how Chinese medicine can treat even such a seemingly benign habit by understanding and reframing the situation in terms of bodymind energetics. As is always the case in Chinese medicine, everything is related and should be considered a window into the complexities of our pathophysiology.
J has been a nail biter every since he can remember. Now 34 years old, he has been a slave to this habit for three decades. Upon inspection, his nails are chewed down half way to the root and have prominent vertical ridges. His past medical history is “insignificant” except for having his gall bladder removed at age 26 at the recommendation of his doctor due to a blocked duct resulting in 2 severe gall bladder attacks.
J has a high stress job in the financial industry which he believes is taking a toll on his health. He suffers from fatigue and difficulty sleeping in which he feels fidgety for most of the night. While he is generally a mild mannered person, he admits to suppressing difficult personal and emotional issues. He suffers from headaches which are localized to the lateral aspect of the eye at the acupuncture point Gall Bladder 1. Floaters are confirmed in his left eye. He has constant nasal congestion with yellow discharge.
His tongue is deep red, thick, tender with severely deep cracks throughout (horizontal and vertical). His tongue is slightly quivering and dry with a slight patch of dry yellow fur on the left side of the root. His pulse is irregular with variations in the rate, markedly thin and forceless with wide changes in intensity on the left side. The right side is tight and slippery with a reduced pounding quality.
J was diagnosed with extreme exhaustion of his heart and liver yin and blood, complicated by kidney yin and yang deficiency, and liver qi stagnation (with excess heat damaging the yin) and spleen qi deficiency. His main symptom of nail biting can be seen as a defense mechanism by which he subconsciously attempts to stimulate the liver to produce more blood and invigorate qi. The nails, in Chinese medicine, is seen as the outward representation of the liver. Suppression of emotions causes a bottling of liver energies causing a wide array of symptoms (anxiety, stress, frustration, irritability, fatigue, difficulty sleeping, headaches). By biting the nails, the liver is called into action. It serves as a kickstart for the liver to activate its dominion over the qi circulation dynamic.
Often times, a deficiency in an organ will lead to an apparent excess in its interiorly-exteriorly related pair. Here the gall bladder evidences signs of excess (gall stones, headaches at GB 1). The heart will also receive the heat being created from the liver stagnation causing restlessness with sleep and arrhythmias. The lungs are able to become excessive across the control cycle and chronic nasal congestion results. This is contributed to by the spleen’s increased demand to produce blood and provide nourishment to this chronically depleted individual. This increased workload further damages the spleen and produces the dampness which gets stored in the lungs as phlegm and nasal congestion. Because this process is one which has spanned decades, the kidneys are implicated as a possible root and are further depleted in the process.
In this case, there are many factors at play, but I present it to demonstrate how even such a common habit of nail biting can be a very relevant fact/symptom in the diagnosis and treatment of complex health patterns. Also, to show the body's infinite defensive mechanisms in attempting to heal itself.
J has been a nail biter every since he can remember. Now 34 years old, he has been a slave to this habit for three decades. Upon inspection, his nails are chewed down half way to the root and have prominent vertical ridges. His past medical history is “insignificant” except for having his gall bladder removed at age 26 at the recommendation of his doctor due to a blocked duct resulting in 2 severe gall bladder attacks.
J has a high stress job in the financial industry which he believes is taking a toll on his health. He suffers from fatigue and difficulty sleeping in which he feels fidgety for most of the night. While he is generally a mild mannered person, he admits to suppressing difficult personal and emotional issues. He suffers from headaches which are localized to the lateral aspect of the eye at the acupuncture point Gall Bladder 1. Floaters are confirmed in his left eye. He has constant nasal congestion with yellow discharge.
His tongue is deep red, thick, tender with severely deep cracks throughout (horizontal and vertical). His tongue is slightly quivering and dry with a slight patch of dry yellow fur on the left side of the root. His pulse is irregular with variations in the rate, markedly thin and forceless with wide changes in intensity on the left side. The right side is tight and slippery with a reduced pounding quality.
J was diagnosed with extreme exhaustion of his heart and liver yin and blood, complicated by kidney yin and yang deficiency, and liver qi stagnation (with excess heat damaging the yin) and spleen qi deficiency. His main symptom of nail biting can be seen as a defense mechanism by which he subconsciously attempts to stimulate the liver to produce more blood and invigorate qi. The nails, in Chinese medicine, is seen as the outward representation of the liver. Suppression of emotions causes a bottling of liver energies causing a wide array of symptoms (anxiety, stress, frustration, irritability, fatigue, difficulty sleeping, headaches). By biting the nails, the liver is called into action. It serves as a kickstart for the liver to activate its dominion over the qi circulation dynamic.
Often times, a deficiency in an organ will lead to an apparent excess in its interiorly-exteriorly related pair. Here the gall bladder evidences signs of excess (gall stones, headaches at GB 1). The heart will also receive the heat being created from the liver stagnation causing restlessness with sleep and arrhythmias. The lungs are able to become excessive across the control cycle and chronic nasal congestion results. This is contributed to by the spleen’s increased demand to produce blood and provide nourishment to this chronically depleted individual. This increased workload further damages the spleen and produces the dampness which gets stored in the lungs as phlegm and nasal congestion. Because this process is one which has spanned decades, the kidneys are implicated as a possible root and are further depleted in the process.
In this case, there are many factors at play, but I present it to demonstrate how even such a common habit of nail biting can be a very relevant fact/symptom in the diagnosis and treatment of complex health patterns. Also, to show the body's infinite defensive mechanisms in attempting to heal itself.
Thursday, March 22, 2007
Lung Cancer
OAT CELL LUNG CANCER
History: Patient is a 60 year old female with a chief complaint of oat cell Lung cancer. The cancer was diagnosed approximately 1 year prior to our initial visit. Over the course of the year, patient has undergone 30 treatments of chemotherapy (CPT-11 and Cisplatin), as well as 30 treatments of radiation therapy. Patient was strongly discouraged by her doctor from seeking acupuncture and/or herbal medicine therapy during her treatments. At the time of our visit, patient’s western treatments had been stopped for approximately 2 months due to a decline in her white blood cell counts (approximately 2.0). At her last oncologist appointment (1 week ago), x-ray and CT scans revealed that the cancer was still present. Due to this finding, patient turned to Chinese medicine for help.
Current Health Status: Patient presented extremely fatigued. She has been housebound for approximately 1 year during the course of her chemo and radiation. During chemo she experienced cold sweats. She suffers from insomnia (trouble falling and staying asleep) and requires medication to have a restful night sleep. She has poor appetite, abdominal pain, gas, belching, bad breath and nausea and vomiting. She has alternating constipation and diarrhea. She went through menopause at 43 years old without experiencing any symptoms. She has tinnitus, dry mouth and throat and canker sores from the chemotherapy. She suffers from anxiety and depression, high blood pressure and dizziness.
Past Medical History: seasonal allergies (sinus congestion), high blood pressure
Family Health History: both parents had heart disease, father had diabetes (type II)
Husband died of Lung cancer 10 years ago
Medications: atenolol, hydrochorazide, paxil, atavan, ambien
Allergic History: seasonal allergies
Physical Exam:
a. Tongue: body: pinkish purple, dry, thin, scalloped, puffy in Lung
coat: dry yellow burnt
veins: slightly dark
b. Facial complexion: pale withered
c. Body shape and posture: overweight; flaccid muscle tone
d. Shen: depressed and anxious
e. Listening and Smelling: raspy hoarse voice, labored breathing
f. Palpation:
i. Pulse:
Right – thin weak faint forceless
Left – imperceptible
ii. Abdomen/Channels: n/a
Diagnosis: This is a situation of multiple system profound organ deficiencies with significant stagnation and toxic heat. With the immediacy that this case presented, treatments were geared towards attacking the Lungs while simultaneously nourishing the immune system and constitution to enable the patient to fight off the cancer. Severely weakened by a year of chemo and radiation which left the patient debilitated, nourishment was a prime concern.
First Treatment: September 25
Acupuncture: LU 7, KI 6, KI 7, LU 8
Herbs: Ren Shen 12g Ling Zhi 12g
(raw ½ bag per day) Bai Zhu 15g Sha Ren 6g
Ban Xia 6g Mai Men Dong 12g
Tian Men Dong 12g Jin Yin Hua 20g
Pu Gong Ying 20g Bai Hua She She Cao 20g
Pi Pa Ye 9g Ba Yue Zha 12g
Sheng Di Huang 12g Huang Lian 6g
Jiao Gu Lan 9g Fu Ling 9g
Dan Shen 6g
Second Treatment: October 2
Notes: White blood cells doubled since first treatment. Chest x-ray shows status quo, no mets. Tumor is in lymph.
Right pulse was deep thin and vacuous; left pulse extremely faint and thin
Acupuncture: R LU 7, L KI 6, L LU 5, R LU 11, bilateral LV 8, ST 36, SP 9
Ear: Lower Lung
Notes: During treatment patient felt strong aching and sharp sensation deep inside chest/lungs
Herbs: Continue on same prescription
Third Treatment: October 9
Notes: Patient had x-ray yesterday. Tumor/cancer is GONE. No signs of cancer.
Right pulse is fuller, left pulse has more force
Acupuncture: R LU 7, L KI 6, L LU 5, LI 11, bilateral SP 9, ST 25, ST 37
Herbs: Continue on same prescription plus add Jie Geng 6g
History: Patient is a 60 year old female with a chief complaint of oat cell Lung cancer. The cancer was diagnosed approximately 1 year prior to our initial visit. Over the course of the year, patient has undergone 30 treatments of chemotherapy (CPT-11 and Cisplatin), as well as 30 treatments of radiation therapy. Patient was strongly discouraged by her doctor from seeking acupuncture and/or herbal medicine therapy during her treatments. At the time of our visit, patient’s western treatments had been stopped for approximately 2 months due to a decline in her white blood cell counts (approximately 2.0). At her last oncologist appointment (1 week ago), x-ray and CT scans revealed that the cancer was still present. Due to this finding, patient turned to Chinese medicine for help.
Current Health Status: Patient presented extremely fatigued. She has been housebound for approximately 1 year during the course of her chemo and radiation. During chemo she experienced cold sweats. She suffers from insomnia (trouble falling and staying asleep) and requires medication to have a restful night sleep. She has poor appetite, abdominal pain, gas, belching, bad breath and nausea and vomiting. She has alternating constipation and diarrhea. She went through menopause at 43 years old without experiencing any symptoms. She has tinnitus, dry mouth and throat and canker sores from the chemotherapy. She suffers from anxiety and depression, high blood pressure and dizziness.
Past Medical History: seasonal allergies (sinus congestion), high blood pressure
Family Health History: both parents had heart disease, father had diabetes (type II)
Husband died of Lung cancer 10 years ago
Medications: atenolol, hydrochorazide, paxil, atavan, ambien
Allergic History: seasonal allergies
Physical Exam:
a. Tongue: body: pinkish purple, dry, thin, scalloped, puffy in Lung
coat: dry yellow burnt
veins: slightly dark
b. Facial complexion: pale withered
c. Body shape and posture: overweight; flaccid muscle tone
d. Shen: depressed and anxious
e. Listening and Smelling: raspy hoarse voice, labored breathing
f. Palpation:
i. Pulse:
Right – thin weak faint forceless
Left – imperceptible
ii. Abdomen/Channels: n/a
Diagnosis: This is a situation of multiple system profound organ deficiencies with significant stagnation and toxic heat. With the immediacy that this case presented, treatments were geared towards attacking the Lungs while simultaneously nourishing the immune system and constitution to enable the patient to fight off the cancer. Severely weakened by a year of chemo and radiation which left the patient debilitated, nourishment was a prime concern.
First Treatment: September 25
Acupuncture: LU 7, KI 6, KI 7, LU 8
Herbs: Ren Shen 12g Ling Zhi 12g
(raw ½ bag per day) Bai Zhu 15g Sha Ren 6g
Ban Xia 6g Mai Men Dong 12g
Tian Men Dong 12g Jin Yin Hua 20g
Pu Gong Ying 20g Bai Hua She She Cao 20g
Pi Pa Ye 9g Ba Yue Zha 12g
Sheng Di Huang 12g Huang Lian 6g
Jiao Gu Lan 9g Fu Ling 9g
Dan Shen 6g
Second Treatment: October 2
Notes: White blood cells doubled since first treatment. Chest x-ray shows status quo, no mets. Tumor is in lymph.
Right pulse was deep thin and vacuous; left pulse extremely faint and thin
Acupuncture: R LU 7, L KI 6, L LU 5, R LU 11, bilateral LV 8, ST 36, SP 9
Ear: Lower Lung
Notes: During treatment patient felt strong aching and sharp sensation deep inside chest/lungs
Herbs: Continue on same prescription
Third Treatment: October 9
Notes: Patient had x-ray yesterday. Tumor/cancer is GONE. No signs of cancer.
Right pulse is fuller, left pulse has more force
Acupuncture: R LU 7, L KI 6, L LU 5, LI 11, bilateral SP 9, ST 25, ST 37
Herbs: Continue on same prescription plus add Jie Geng 6g
Indigestion
Patient Last Name: S Patient First Name: J
Treatment Date and Time: . May 12, 2001
Sex and Age: Male 48 Profession: Artist
1. Chief Complaint: Indigestion and Stomach Pain for 15 years
2. Medical History:
Present Illness: The patient has suffered from indigestion and stomach pain for 15 years (beginning around the same time as his divorce). He is frequently hungry and feels good initially after eating, but begins to experience discomfort beginning an hour and ½ after meals. He experiences indigestion, which he initially described as a burning chest and epigastric pain that was most pronounced at Ren 12 and followed upward along the Ren channel behind his sternum and radiated down his shoulder and the posterior aspect of his left arm to about Ht 2 level. Now, the burning quality has subsided and the pain is milder and achy. The pain is worse with pressure and feels better after belching. He also experiences frequent acid regurgitation with a bitter taste (especially in the morning), bad breath and often has gas and abdominal distension. The patient feels that his digestion is slow – a condition that seems to be exacerbated by medication (Prilosec) for H. pylori, which he has had before. The patient also has chronic tightness in his chest, which is worse with stress. He has discovered that the tightness is somewhat relieved when he relaxes and makes an effort to “open” the area. His cardiologist has ruled out any new cardiac problems although the patient suffered a mild MI in December ’98 and becomes very nervous about any symptoms that may indicate heart problems.
Until recently, the patient suffered from irregular bowel movements, alternating between constipation with bleeding and diarrhea accompanied by a burning sensation, but these symptoms have resolved. He also used to experience frequent anxiety attacks, particularly around large crowds in the subway, which he described as severe anxiety with tightness in his chest and palpitations. During those attacks he had to “talk himself down” and said that his self-consciousness was sometimes the only thing that kept him from “breaking down”. However, since beginning treatment, he has only had one or two attacks and feels less anxious in general.
3. Current Health Status:
Appetite: frequently hungry; craves sweets and salty foods
Urine: more normal (used to be frequent, scanty and yellow)
Stool: well-formed, 1X/day *see above
Temp: tends to be warm
Sweat: no unusual sweating reported *clammy skin/limbs
Thirst: not particularly thirst; prefers cold
Energy: ok; worse when his stomach is bothering him
Sleep: no difficulty falling asleep; profuse vivid dreaming; anxiety dreams
Emotions: appears sad/resigned, easily anxious *see above; feels he’s “a wreck” right now
Head/Eyes/Ears: floaters
Other: some low back soreness and tightness in his right shoulder. Dry skin and a dry red rash over Ren 17 (no pain/itching)
4. Past Medical History: MI in December ’98; Dx: GERD, High Blood Pressure (watching)
5. Medications: antacids, garlic tablets, Prilosec
6. Allergic History: none noted
7. Physical Exam:
a. Tongue:
body: pale red with a red tip and a deep crack to the tip; puffy, scalloped; there is a faint ulcer on the right side around the lung area.
coat: thin slightly yellowish
b. Facial complexion: pale, sallow
c. Body shape and posture: withered; sunken chest
d. Shen: dull
e. Listening and Smelling: nothing noted
f. Palpation: very sunken at Ren 14, tender @ Ren 17, over the epigastric area, SP4
i. Pulse: 80bpm, weak
Right: thready, wiry
Left: soft (especially in the guan)
INITIAL DX: Stomach Heat with an underlying Heart and Spleen Deficiency
Stomach Heat Heart (blood) deficiency Spleen (Qi) Deficiency
Foul breath
Bitter taste
Acid regurgitation
Belching
Burning sensation (epigastrum)
Red tongue
Rapid pulse
Constipation w/burning Vivid dreams
Anxiety attacks
Sad appearance
Pale Complexion
Floaters
Thready pulse Abdominal pain/distension
Gas & Bloating
Slow digestion
Loose stools/diarrhea
Scalloped, puffy tongue
sallow complexion
deficient pulse
This patient’s symptoms began in the midst of his divorce 15 years ago. Constrained emotions from traumatic events can easily cause disruption of the Qi dynamic and blood flow in the middle jiao. When emotions are constrained, the Liver cannot move Qi smoothly and the Heart cannot propel blood properly creating an excess condition. Excess in the Liver can cause it to overact on the Spleen and Stomach by pathologically overloading the normal flow in the control cycle.. Over time, this has impeded movement in the Middle Jiao, eventually generating heat. The spleen, which is also taxed by excessive thinking and melancholy, was no longer able to properly process food and liquid, causing gas and bloating with loose stools. The digestive system became sluggish and the Stomach was forced to work harder to process the excess in the middle jiao. Obstruction of the Spleen and Stomach from stagnation led to a pathological intermingling of clear and turbid, which inhibited the normal physiological function and generated heat and dampness, creating alternating constipation and diarrhea. Excess in the Stomach caused Stomach Qi to rebel upward, causing foul breath, belching, acid regurgitation and a burning sensation in his epigastrum, particular at Ren 12, the Front Mu of the Stomach. Some of this dampness and heat has poured down and become lodged in the patient’s Lower Burner causing irregular bowel movement with a burning sensation.
This condition was exacerbated by the patient’s “heartbreak”. Emotional sadness has taxed the patient’s Heart Qi. Since the Heart, as the Fire organ, is the Mother of the Spleen, the Earth organ, it failed to properly nourish the Spleen. The Spleen failed to generate blood and was unable to generate Heart blood in turn. Without sufficient blood to house the shen, the patient experienced many vivid dreams and often suffered from acute anxiety as his shen was not rooted. There was not sufficient blood to nourish his face and eyes and the patient has floaters and pale complexion.
The patient’s rapid pulse reflects the heat constrained in his body. It is a thready and forceless pulse because the patient over time is developing a blood deficiency and heat has also burned up yin fluids causing the vessels to become thin and deficient. His red tongue also demonstrates that there is heat in his body and the deep central crack indicates that the heat is damaging fluids. The tongue body is scalloped and puffy due to Spleen qi deficiency failing to properly transport and transform fluids.
Initially, I made efforts to clear the heat and nourish the Heart and Spleen. The heat signs resolved first (urination became less yellow, pulse slowed and tongue became less red) and then signs of rebellious stomach qi became much milder. The patient no longer complains of bad breath and has far fewer episodes of acid regurgitation. He now has well-formed bowel movements 1X/day. His anxiety attacks have virtually stopped.
CURRENT DX: Yin Wei Disharmony
Upon palpation, this patient is tender at Ren 17, Spleen 21 and Spleen 4, as well as his entire subcostal and epigastric area. This is strongly associated with a Yin-Wei Chong Mai Extraordinary Vessel pattern. Looking over his signs and symptoms, I noticed that the rest of his presentation also indicated imbalances associated with Yin Wei disharmony.
The Yin Wei Channel dominates the interior, particularly the Qi and Yin of the Heart, Lung, Spleen and Stomach. Disorders and symptoms of those orders, such as chest, epigastric and abdominal pain, cardiac problems, fullness and distension, borborygmus, diarrhea and lumbar pain can all be treated with Yin Wei points.
This channel is also responsible for balancing the emotions. When the yin channel is disturbed, there may be mental instability, uneasiness, low self esteem, lack of will power and discouragement. Yin Wei points can be used to lift the spirit and balance the emotions.
TP: Clear Heat and Regulate the Stomach; Tonify Heart blood and Spleen Qi
Harmonize the Yin Wei channel
Acupuncture Points:
Ren 12 Front Mu of the Stomach - Influential point of Fu organs; Harmonizes Stomach & Downbears counterflow; Fortifies Spleen & Disinhibits Damp
ST 25 Front Mu of the LI - Courses & Regulates the Large Intestine; Supports Earth and Transforms Damp
LJ empowering stability during transitions.
ST 44 Ying Spring/Water - Promotes Free Downbearing of Stomach Qi; Harmonize Intestines and Transform Stagnation
Ren 17 Front Mu of the Pericardium/Influential Point of Qi - Regulates Qi and Downbears Counterflow; Loosens the Chest and Disinhibits Diaphragm
LJ reunion point where PC and Lu meet; grounds the essential child-like nature of the heart
PC 6 (L) Luo/Confluent of Yin Wei - Clears Heat & Eliminates Vexation; Loosens Chest & Rectifies Qi; Downbears Counterflow & Stops Vomiting; Harmonizes ST & Relieves Pain; Regulates HT Qi & Blood; Calms Mind; Regulates JueYin:.
LJ Regulates inner and outer aspects of illumination governed by the heart & fires of ming men.
SP 4 (R) Luo/Confluent of Chong - Supports the Spleen & Stomach and Rectifies Qi
LU 7 (R) Confluent of the Ren/Command of Head & Neck/ Luo to LI -
GM Has a releasing effect on emotions (esp. sadness, worry, grief) constraining Po in the chest.
Ki 6 (L) Confluent of Yin Qiao - Frees channels; Drains Fire & Courses Qi; Clears Spirit Disposition
Ear Seeds: Shen Men, Stomach
The point prescription was designed to clear heat, regulate and open the Middle Jiao, tonify the Spleen and calm the spirit. Ren12 and St 25 work together as both local points and front mu points of both the Stomach and Large Intestine to promote movement and downbearing, allowing heat and stagnation to move out of the body. Ren 17 assists in promoting downbearing and can also loosen the chest. As the Front mu of the Pericardium and the influential point of Qi, it can also tonify the heart and spleen. PC6 and Sp4 are the confluent points of the Yin Wei (chest/interior) and Chong (blood) and aid in downbearing stomach qi as well as tonifying the Spleen and calming the spirit. Lu 7 is the luo to the Large Intestine and also works with Ki 6 6 to open the Ren channel, where this patient reports having a burning sensation. St 44 is particularly good point for clearing heat and downbearing stomach qi and has a function to harmonize the intestines.
Other Prescriptions: SP4, PC6, Ki 9 (xi cleft of Yin Wei), Du20 Ear: Shen Men, Sympathetic
Lv 3, PC 6, Ht7, Ren 17, Sp 6, St 36
Initial Herbs:
Sheng Di Huang Clear Heat & Cool Blood; Nourish Yin; Cools Upward Blazing of Heart Fire
Dan Shen Invigorates Blood; Clears Heat & Soothes Irritability
Dang Gui Tonify/Invigorate Blood; Moistens Intestines; w/Dan shen tonifies blood & nourishes Ht w/o stagnation
Fu Ling Strengthens Spleen, Drains Damp, Transforms Phlegm, Quiets Heart & Calms Spirit
Mai Men Dong Tonifies Heart & Stomach Yin, Clears Heat, Soothes Irritability; Moistens Intestines
Wu Wei Zi Quiets Spirit and Protects Heart Qi; Binds Ki Essence; Stops Diarrhea
Suan Zao Ren Nourishes Heart Yin and Liver Blood, Quiets Spirit
Bai Zhu Tonifies Spleen Qi; Dries Damp; Stabilizes Exterior
Mu Xiang Moves Qi, Relieves Pain, Strengthens Spleen, Regulates Stagnant Qi In Intestines
Xiang Fu Moves Liver Qi
Hai Piao Xiao Binds Essence, Resolves Damp, Stops Diarrhea; Stops Bleeding; *Rebalances Stomach Acid
Huang Lian Clears heat & Dries Damp; Clears Heart & Stomach Fire; Stops bleeding (Guides to Heart)
Mu Li Settles/calms the spirit; absorbs acidity, alleviates pain, binds essence, benefits yin and anchors yang
A variation on Tian Wan Bu Xing Dan, which tonifies yin and blood of the heart and kidneys, and Gui Pi Tang, which nourishes Spleen Qi and Heart Blood. Huang Lian and Hai Piao Xiao was added to clear some of this patient’s excess stomach heat and help control stomach acids that contribute to nausea and acid regurgitation. Mu Li controls stomach acid and settles the spirit.
Current Formula:
Dang Shen 9 Bai Ji Li 9
Bai Zhu 12 Shi Chang Pu 6
Fu Ling 12 Fo Shou 12
Suan Zao Ren 6 Zhi Ke 9
Huang Qi 9 Ye Jiao Teng 9
10. TCM Patterns of “Upset Stomach”
• Spleen-Stomach Disharmony – characterized by glomus, continuous pain in the stomach duct exacerbated by hunger, abdominal distension and poor transformation of food, belching, hiccup, and in severe cases, vomitting. Other signs are a pale, scalloped tongue and thin, white fur, and a forceless, sunken, fine or sunken/moderate pulse.
• Spleen-Stomach Yang Vacuity – characterized by reduced food intake, vomiting, diarrhea, cold limbs, fatigue, withered-yellow facial complexion, dizziness, pale tongue, soft enlarged tongue, thick turbid tongue fur and a large, vacuous pulse.
• Spleen-Stomach Damp Heat – characterized by glomus and oppression in the stomach duct, torpid intake, nausea, sloppy stool, yellow urine and heavy, cumbersome limbs. The tongue is red with yellow, slimy fur and the pulse is soggy.
• Spleen Qi Vacuity – a condition arising when irregular eating or anxiety, thought and taxation fatigue damage the spleen and stomach.
• Spleen-Kidney Yang Vacuity – characterized by enduring diarrhea, early morning diarrhea, or clear-food diarrhea, drum distension and lower abdominal cold pain. Other chief signs are a bright, white puffy face and swollen limbs, a pale, enlarged tongue with white, glossy fur and a sunken, fine, slow and weak pulse.
• Spleen Vacuity with Food Damage – characterized with bloating after eating and by sloppy stool containing untransformed food. In general there is no abdominal pain and the tongue fur may be completely normal.
• Splenic Movement and Transformation Failure – In mild cases, abdominal distension, torpid intake, rumbling intestines, diarrhea and other signs of poor digestion are observed.
• Stomach Qi Ascending Counterflow – characterized by nausea, vomiting, belching or hiccough.
• Stomach Reflux – characterized by distension and fullness after eating, vomiting in the evening food ingested in the morning or vomiting in the morning food that was ingested the previous evening.
• Stomach Vacuity Cold – characterized by stomach pain, vomiting and vacuity cold signs
• Stomach Repletion Cold – characterized by acute cold pain in the stomach duct relieved by vomiting, physical cold and cold limbs.
• Stomach Heat – characterized by bitter taste in the mouth, dry mouth, bad breath, rapid hungering, red tongue with yellow fur and a rapid, slippery pulse.
• Liver-Gallbladder Damp Heat – chief signs include alternating fever and chills, bitter taste in the mouth, ribside pain, jaundice, abdominal pain/distension, nausea, vomiting and loss of appetite. Stools tend to be dry if heat is pronounce and sloppy if dampness is more pronounced. The tongue fur is yellow and slimy and the pulse is rapid and stringlike.
• Liver Qi Invading the Spleen – characterized by headache, irritability, bitter taste in the mouth, chest oppression, glomus and fullness after eating, sloppy diarrhea and a moderate, stringlike pulse. It differs from Invasion of the Stomach by a predominance of spleen signs such as diarrhea and distension.
• Liver Qi Invading the Stomach - characterized by stomach duct pain, vomiting of sour fluids, torpid intake, abdominal distension, diarrhea. There will also be liver signs such as dizziness, ribside pain, irritability and a stringlike pulse.
• Liver-Stomach Disharmony – characterized by distending ribside pain, belching, glomus, fullness, torpid intake, acid regurgitation and clamoring stomach.
• Large Intestinal Vacuity Cold – usually associated with Spleen-Kidney Yang vacuity, and is characterized by thin diarrhea, reduced food intake, cold limbs, aching lumbus, thin tongue fur and a fine, sunken pulse.
• Large Intestinal DampHeat – a disease pattern generally characterized by abdominal pain and diarrhea with ungratifying defecation and foul-smelling stool.
• Food Accumulation – pathology attributable to spleen-stomach movement and transformation failure. It is characterized by fullness and oppression, in the chest and stomach duct, in some cases with hardness or glomus, abdominal pain that dislikes pressure, hard stool, loss of appetite, foul belching and acid regurgitation.
• Food Damage – pathology due to voracious overeating or spleen-stomach vacuity. It is characterized by aversion to food, nausea and vomiting, belching, foul-smelling vomit, acid regurgitation, painful bloating, diarrhea or constipation, foul-smelling stool and flatus. The tongue fur is usually slimy or thick or yellow.
• Damp Obstructing the Middle Burner – characterized by abdominal distension, loss of appetite, sticky mouth, thirst with desire for warm drinks, short voidings of reddish urine and slimy white tongue fur.
Treatment Date and Time: . May 12, 2001
Sex and Age: Male 48 Profession: Artist
1. Chief Complaint: Indigestion and Stomach Pain for 15 years
2. Medical History:
Present Illness: The patient has suffered from indigestion and stomach pain for 15 years (beginning around the same time as his divorce). He is frequently hungry and feels good initially after eating, but begins to experience discomfort beginning an hour and ½ after meals. He experiences indigestion, which he initially described as a burning chest and epigastric pain that was most pronounced at Ren 12 and followed upward along the Ren channel behind his sternum and radiated down his shoulder and the posterior aspect of his left arm to about Ht 2 level. Now, the burning quality has subsided and the pain is milder and achy. The pain is worse with pressure and feels better after belching. He also experiences frequent acid regurgitation with a bitter taste (especially in the morning), bad breath and often has gas and abdominal distension. The patient feels that his digestion is slow – a condition that seems to be exacerbated by medication (Prilosec) for H. pylori, which he has had before. The patient also has chronic tightness in his chest, which is worse with stress. He has discovered that the tightness is somewhat relieved when he relaxes and makes an effort to “open” the area. His cardiologist has ruled out any new cardiac problems although the patient suffered a mild MI in December ’98 and becomes very nervous about any symptoms that may indicate heart problems.
Until recently, the patient suffered from irregular bowel movements, alternating between constipation with bleeding and diarrhea accompanied by a burning sensation, but these symptoms have resolved. He also used to experience frequent anxiety attacks, particularly around large crowds in the subway, which he described as severe anxiety with tightness in his chest and palpitations. During those attacks he had to “talk himself down” and said that his self-consciousness was sometimes the only thing that kept him from “breaking down”. However, since beginning treatment, he has only had one or two attacks and feels less anxious in general.
3. Current Health Status:
Appetite: frequently hungry; craves sweets and salty foods
Urine: more normal (used to be frequent, scanty and yellow)
Stool: well-formed, 1X/day *see above
Temp: tends to be warm
Sweat: no unusual sweating reported *clammy skin/limbs
Thirst: not particularly thirst; prefers cold
Energy: ok; worse when his stomach is bothering him
Sleep: no difficulty falling asleep; profuse vivid dreaming; anxiety dreams
Emotions: appears sad/resigned, easily anxious *see above; feels he’s “a wreck” right now
Head/Eyes/Ears: floaters
Other: some low back soreness and tightness in his right shoulder. Dry skin and a dry red rash over Ren 17 (no pain/itching)
4. Past Medical History: MI in December ’98; Dx: GERD, High Blood Pressure (watching)
5. Medications: antacids, garlic tablets, Prilosec
6. Allergic History: none noted
7. Physical Exam:
a. Tongue:
body: pale red with a red tip and a deep crack to the tip; puffy, scalloped; there is a faint ulcer on the right side around the lung area.
coat: thin slightly yellowish
b. Facial complexion: pale, sallow
c. Body shape and posture: withered; sunken chest
d. Shen: dull
e. Listening and Smelling: nothing noted
f. Palpation: very sunken at Ren 14, tender @ Ren 17, over the epigastric area, SP4
i. Pulse: 80bpm, weak
Right: thready, wiry
Left: soft (especially in the guan)
INITIAL DX: Stomach Heat with an underlying Heart and Spleen Deficiency
Stomach Heat Heart (blood) deficiency Spleen (Qi) Deficiency
Foul breath
Bitter taste
Acid regurgitation
Belching
Burning sensation (epigastrum)
Red tongue
Rapid pulse
Constipation w/burning Vivid dreams
Anxiety attacks
Sad appearance
Pale Complexion
Floaters
Thready pulse Abdominal pain/distension
Gas & Bloating
Slow digestion
Loose stools/diarrhea
Scalloped, puffy tongue
sallow complexion
deficient pulse
This patient’s symptoms began in the midst of his divorce 15 years ago. Constrained emotions from traumatic events can easily cause disruption of the Qi dynamic and blood flow in the middle jiao. When emotions are constrained, the Liver cannot move Qi smoothly and the Heart cannot propel blood properly creating an excess condition. Excess in the Liver can cause it to overact on the Spleen and Stomach by pathologically overloading the normal flow in the control cycle.. Over time, this has impeded movement in the Middle Jiao, eventually generating heat. The spleen, which is also taxed by excessive thinking and melancholy, was no longer able to properly process food and liquid, causing gas and bloating with loose stools. The digestive system became sluggish and the Stomach was forced to work harder to process the excess in the middle jiao. Obstruction of the Spleen and Stomach from stagnation led to a pathological intermingling of clear and turbid, which inhibited the normal physiological function and generated heat and dampness, creating alternating constipation and diarrhea. Excess in the Stomach caused Stomach Qi to rebel upward, causing foul breath, belching, acid regurgitation and a burning sensation in his epigastrum, particular at Ren 12, the Front Mu of the Stomach. Some of this dampness and heat has poured down and become lodged in the patient’s Lower Burner causing irregular bowel movement with a burning sensation.
This condition was exacerbated by the patient’s “heartbreak”. Emotional sadness has taxed the patient’s Heart Qi. Since the Heart, as the Fire organ, is the Mother of the Spleen, the Earth organ, it failed to properly nourish the Spleen. The Spleen failed to generate blood and was unable to generate Heart blood in turn. Without sufficient blood to house the shen, the patient experienced many vivid dreams and often suffered from acute anxiety as his shen was not rooted. There was not sufficient blood to nourish his face and eyes and the patient has floaters and pale complexion.
The patient’s rapid pulse reflects the heat constrained in his body. It is a thready and forceless pulse because the patient over time is developing a blood deficiency and heat has also burned up yin fluids causing the vessels to become thin and deficient. His red tongue also demonstrates that there is heat in his body and the deep central crack indicates that the heat is damaging fluids. The tongue body is scalloped and puffy due to Spleen qi deficiency failing to properly transport and transform fluids.
Initially, I made efforts to clear the heat and nourish the Heart and Spleen. The heat signs resolved first (urination became less yellow, pulse slowed and tongue became less red) and then signs of rebellious stomach qi became much milder. The patient no longer complains of bad breath and has far fewer episodes of acid regurgitation. He now has well-formed bowel movements 1X/day. His anxiety attacks have virtually stopped.
CURRENT DX: Yin Wei Disharmony
Upon palpation, this patient is tender at Ren 17, Spleen 21 and Spleen 4, as well as his entire subcostal and epigastric area. This is strongly associated with a Yin-Wei Chong Mai Extraordinary Vessel pattern. Looking over his signs and symptoms, I noticed that the rest of his presentation also indicated imbalances associated with Yin Wei disharmony.
The Yin Wei Channel dominates the interior, particularly the Qi and Yin of the Heart, Lung, Spleen and Stomach. Disorders and symptoms of those orders, such as chest, epigastric and abdominal pain, cardiac problems, fullness and distension, borborygmus, diarrhea and lumbar pain can all be treated with Yin Wei points.
This channel is also responsible for balancing the emotions. When the yin channel is disturbed, there may be mental instability, uneasiness, low self esteem, lack of will power and discouragement. Yin Wei points can be used to lift the spirit and balance the emotions.
TP: Clear Heat and Regulate the Stomach; Tonify Heart blood and Spleen Qi
Harmonize the Yin Wei channel
Acupuncture Points:
Ren 12 Front Mu of the Stomach - Influential point of Fu organs; Harmonizes Stomach & Downbears counterflow; Fortifies Spleen & Disinhibits Damp
ST 25 Front Mu of the LI - Courses & Regulates the Large Intestine; Supports Earth and Transforms Damp
LJ empowering stability during transitions.
ST 44 Ying Spring/Water - Promotes Free Downbearing of Stomach Qi; Harmonize Intestines and Transform Stagnation
Ren 17 Front Mu of the Pericardium/Influential Point of Qi - Regulates Qi and Downbears Counterflow; Loosens the Chest and Disinhibits Diaphragm
LJ reunion point where PC and Lu meet; grounds the essential child-like nature of the heart
PC 6 (L) Luo/Confluent of Yin Wei - Clears Heat & Eliminates Vexation; Loosens Chest & Rectifies Qi; Downbears Counterflow & Stops Vomiting; Harmonizes ST & Relieves Pain; Regulates HT Qi & Blood; Calms Mind; Regulates JueYin:.
LJ Regulates inner and outer aspects of illumination governed by the heart & fires of ming men.
SP 4 (R) Luo/Confluent of Chong - Supports the Spleen & Stomach and Rectifies Qi
LU 7 (R) Confluent of the Ren/Command of Head & Neck/ Luo to LI -
GM Has a releasing effect on emotions (esp. sadness, worry, grief) constraining Po in the chest.
Ki 6 (L) Confluent of Yin Qiao - Frees channels; Drains Fire & Courses Qi; Clears Spirit Disposition
Ear Seeds: Shen Men, Stomach
The point prescription was designed to clear heat, regulate and open the Middle Jiao, tonify the Spleen and calm the spirit. Ren12 and St 25 work together as both local points and front mu points of both the Stomach and Large Intestine to promote movement and downbearing, allowing heat and stagnation to move out of the body. Ren 17 assists in promoting downbearing and can also loosen the chest. As the Front mu of the Pericardium and the influential point of Qi, it can also tonify the heart and spleen. PC6 and Sp4 are the confluent points of the Yin Wei (chest/interior) and Chong (blood) and aid in downbearing stomach qi as well as tonifying the Spleen and calming the spirit. Lu 7 is the luo to the Large Intestine and also works with Ki 6 6 to open the Ren channel, where this patient reports having a burning sensation. St 44 is particularly good point for clearing heat and downbearing stomach qi and has a function to harmonize the intestines.
Other Prescriptions: SP4, PC6, Ki 9 (xi cleft of Yin Wei), Du20 Ear: Shen Men, Sympathetic
Lv 3, PC 6, Ht7, Ren 17, Sp 6, St 36
Initial Herbs:
Sheng Di Huang Clear Heat & Cool Blood; Nourish Yin; Cools Upward Blazing of Heart Fire
Dan Shen Invigorates Blood; Clears Heat & Soothes Irritability
Dang Gui Tonify/Invigorate Blood; Moistens Intestines; w/Dan shen tonifies blood & nourishes Ht w/o stagnation
Fu Ling Strengthens Spleen, Drains Damp, Transforms Phlegm, Quiets Heart & Calms Spirit
Mai Men Dong Tonifies Heart & Stomach Yin, Clears Heat, Soothes Irritability; Moistens Intestines
Wu Wei Zi Quiets Spirit and Protects Heart Qi; Binds Ki Essence; Stops Diarrhea
Suan Zao Ren Nourishes Heart Yin and Liver Blood, Quiets Spirit
Bai Zhu Tonifies Spleen Qi; Dries Damp; Stabilizes Exterior
Mu Xiang Moves Qi, Relieves Pain, Strengthens Spleen, Regulates Stagnant Qi In Intestines
Xiang Fu Moves Liver Qi
Hai Piao Xiao Binds Essence, Resolves Damp, Stops Diarrhea; Stops Bleeding; *Rebalances Stomach Acid
Huang Lian Clears heat & Dries Damp; Clears Heart & Stomach Fire; Stops bleeding (Guides to Heart)
Mu Li Settles/calms the spirit; absorbs acidity, alleviates pain, binds essence, benefits yin and anchors yang
A variation on Tian Wan Bu Xing Dan, which tonifies yin and blood of the heart and kidneys, and Gui Pi Tang, which nourishes Spleen Qi and Heart Blood. Huang Lian and Hai Piao Xiao was added to clear some of this patient’s excess stomach heat and help control stomach acids that contribute to nausea and acid regurgitation. Mu Li controls stomach acid and settles the spirit.
Current Formula:
Dang Shen 9 Bai Ji Li 9
Bai Zhu 12 Shi Chang Pu 6
Fu Ling 12 Fo Shou 12
Suan Zao Ren 6 Zhi Ke 9
Huang Qi 9 Ye Jiao Teng 9
10. TCM Patterns of “Upset Stomach”
• Spleen-Stomach Disharmony – characterized by glomus, continuous pain in the stomach duct exacerbated by hunger, abdominal distension and poor transformation of food, belching, hiccup, and in severe cases, vomitting. Other signs are a pale, scalloped tongue and thin, white fur, and a forceless, sunken, fine or sunken/moderate pulse.
• Spleen-Stomach Yang Vacuity – characterized by reduced food intake, vomiting, diarrhea, cold limbs, fatigue, withered-yellow facial complexion, dizziness, pale tongue, soft enlarged tongue, thick turbid tongue fur and a large, vacuous pulse.
• Spleen-Stomach Damp Heat – characterized by glomus and oppression in the stomach duct, torpid intake, nausea, sloppy stool, yellow urine and heavy, cumbersome limbs. The tongue is red with yellow, slimy fur and the pulse is soggy.
• Spleen Qi Vacuity – a condition arising when irregular eating or anxiety, thought and taxation fatigue damage the spleen and stomach.
• Spleen-Kidney Yang Vacuity – characterized by enduring diarrhea, early morning diarrhea, or clear-food diarrhea, drum distension and lower abdominal cold pain. Other chief signs are a bright, white puffy face and swollen limbs, a pale, enlarged tongue with white, glossy fur and a sunken, fine, slow and weak pulse.
• Spleen Vacuity with Food Damage – characterized with bloating after eating and by sloppy stool containing untransformed food. In general there is no abdominal pain and the tongue fur may be completely normal.
• Splenic Movement and Transformation Failure – In mild cases, abdominal distension, torpid intake, rumbling intestines, diarrhea and other signs of poor digestion are observed.
• Stomach Qi Ascending Counterflow – characterized by nausea, vomiting, belching or hiccough.
• Stomach Reflux – characterized by distension and fullness after eating, vomiting in the evening food ingested in the morning or vomiting in the morning food that was ingested the previous evening.
• Stomach Vacuity Cold – characterized by stomach pain, vomiting and vacuity cold signs
• Stomach Repletion Cold – characterized by acute cold pain in the stomach duct relieved by vomiting, physical cold and cold limbs.
• Stomach Heat – characterized by bitter taste in the mouth, dry mouth, bad breath, rapid hungering, red tongue with yellow fur and a rapid, slippery pulse.
• Liver-Gallbladder Damp Heat – chief signs include alternating fever and chills, bitter taste in the mouth, ribside pain, jaundice, abdominal pain/distension, nausea, vomiting and loss of appetite. Stools tend to be dry if heat is pronounce and sloppy if dampness is more pronounced. The tongue fur is yellow and slimy and the pulse is rapid and stringlike.
• Liver Qi Invading the Spleen – characterized by headache, irritability, bitter taste in the mouth, chest oppression, glomus and fullness after eating, sloppy diarrhea and a moderate, stringlike pulse. It differs from Invasion of the Stomach by a predominance of spleen signs such as diarrhea and distension.
• Liver Qi Invading the Stomach - characterized by stomach duct pain, vomiting of sour fluids, torpid intake, abdominal distension, diarrhea. There will also be liver signs such as dizziness, ribside pain, irritability and a stringlike pulse.
• Liver-Stomach Disharmony – characterized by distending ribside pain, belching, glomus, fullness, torpid intake, acid regurgitation and clamoring stomach.
• Large Intestinal Vacuity Cold – usually associated with Spleen-Kidney Yang vacuity, and is characterized by thin diarrhea, reduced food intake, cold limbs, aching lumbus, thin tongue fur and a fine, sunken pulse.
• Large Intestinal DampHeat – a disease pattern generally characterized by abdominal pain and diarrhea with ungratifying defecation and foul-smelling stool.
• Food Accumulation – pathology attributable to spleen-stomach movement and transformation failure. It is characterized by fullness and oppression, in the chest and stomach duct, in some cases with hardness or glomus, abdominal pain that dislikes pressure, hard stool, loss of appetite, foul belching and acid regurgitation.
• Food Damage – pathology due to voracious overeating or spleen-stomach vacuity. It is characterized by aversion to food, nausea and vomiting, belching, foul-smelling vomit, acid regurgitation, painful bloating, diarrhea or constipation, foul-smelling stool and flatus. The tongue fur is usually slimy or thick or yellow.
• Damp Obstructing the Middle Burner – characterized by abdominal distension, loss of appetite, sticky mouth, thirst with desire for warm drinks, short voidings of reddish urine and slimy white tongue fur.
Back Pain
Patient Last Name: WA99 Patient First Name: J
Treatment Date and Time: September 23, 1999
Sex and Age: Female, 21
1. Chief Complaint: Back Pain from MVA since May 1999
2. Medical History:
a. Present Illness: Patient complains of back pain with initial onset 1997 from MVA. She was treated successfully with acupuncture and herbal medicine over a 1 ½ year period. Three months later (May 1999), she suffered another trauma to her back in a MVA. Patient experiences pain on palpation from GB 21 down the first line of the UB channel to her sacrum bilaterally. She also experiences headache pain from GB 21 up to GB 13, 14, 15. Her pain is aggravated with forward, backward and lateral flexion and extension, damp weather, prolonged standing or sitting. Her pain is chronic, mostly dull but can be sharp and localized. Pain is alleviated with medication (Vicadan), heat, and stretching. O’Donahue’s was positive in all directions. Generally, pain without movement is 3/10, worsening at the end of the day to 7/10. She was diagnosed by M.D. as whiplashed; MRI and X-rays were negative.
b. Current Health Status:
Skin: constant itching over entire body, dry skin, especially on chest
Head: headache post MVA from GB 21 to GB 13, 14, 15
Eyes: occasional floaters
Ears: progressive loss of hearing
Respiratory: chronic smokers cough, phlegm difficult to expectorate, bronchitis history
CV: cold hands and feet, occasional dizziness
GI: nausea, better with food, history of constipation and diarrhea
Sleep: difficulty falling asleep, 5-10 hrs per night, awakes tired
Urine: frequent (every 1-2 hrs), but drinks often
Stool: 1-2x/day, occasionally loose, history of undigested food in stool
Temp: cold extremities, heat in body 98.7 degrees
App: good, eats frequently
Sweat: history of night sweats
Thirst: very thirsty, drinks often
Emotions: history of depression; suicidal tendencies after finding out she had genital warts
BP: 106/70
c. Other: Patient smokes cigarettes @ 1 pack/day; also smokes marijuana @ 1 joint every 2-3 hrs. to relieve pain and nausea
d. Past Medical History: MVA 1997, treated successfully with acupuncture and herbal medicine over 1 ½ year period. Three months later (May 1999), subsequent MVA.
3. Family Health History: N/A
4. Medications: oral contraceptives, Vicodan, Soma
5. Allergic History: N/A
6. Personal History: asthma, bronchitis, Stomach/intestinal disorders, allergies, UTI
7. OB/GYN: menarche @ 15 yrs, LMP 9/15/99, 28 day cycle, 4 day flow, dark red at onset, thick blood, clotting, PMS depression, abdominal and breast distention
8. Physical Exam:
a. Tongue: body: pink red, thin, pierced
coat: turbid white sticky in rear
veins: dark and distended
b. Facial complexion: ok
c. Body shape and posture: Patient's shape and posture appears healthy
d. Shen: present
e. Other: movement before after
i. Neck forward flexion 6 4
ii. Neck extension 8 (↓ ROM) 6 (↑ROM)
iii. Neck L lateral flexion 5 4 (↑ROM)
iv. Neck R lateral flexion 8 5
v. Back extension unable 8 (↑ROM)
vi. Back extention (passive) 8 -------
vii. Back L lateral flexion 7 2
viii. Back R lateral flexion 7 2
f. Listening and Smelling: no unusual odors, breathing or vocal changes were observed
g. Palpation:
i. Pulse
Level: middle
Speed: 72
Rhythm: regular
Strength: chi bilaterally was deep and vacuous, LV vacuous
Shape/Quality: tight
ii. Abdomen/Channels: Extra Channel Hara Diagnosis revealed a Ren Mai-Yin Qiao and Yang Wei-Dai Mai disharmony. Also pressure pain down UB line (relieved after treatment)
9. Differential Diagnosis:
a. TCM: Qi and Blood stagnation from trauma (underlying yin/blood ↓)
b. Japanese: Ren-Yang Wei Disharmony
A. Qi and Blood Stagnation Yin and Blood deficiency
Back pain which can be sharp itching
And localized esp. during movement dry skin
Thick menstrual blood w/ clotting floaters
depression Loss of hearing
abdominal and breast distention Cough w/ diff to expectorate phlegm
dark and distended SLV Dizziness
tight pulse Difficulty falling asleep
Deficiency heat
Night sweats
Thirst
tremors
B. Pathology: The root of patient’s pathology is a yin and blood deficiency. This deficiency can develop from years of chronic abuse of cigarettes and marijuana coupled with her history of chronic LU infections and emotional depression. The itching and dry skin result from the lack of yin and blood nourishing the skin. The floaters and progressive loss of hearing from yin and blood not rising to nourish the eyes and ears. A further progression of this lack of nourishment rising is patient’s dizziness. Due to the long-term nature of patient’s abuse of alcohol, cigarettes and marijuana despite her young age, her yin and blood have been depleted enough to result in tremors from wind arising from deficiency. Yin deficiency leads to a relative excess of yang and causes deficiency heat, night sweats and thirst, as well as difficulty falling asleep due to yin’s inability to house the yang at night.
With this yin and blood deficiency at the root, patient suffered severe trauma to her back and neck from a series of motor vehicle accidents over a short period of time. This trauma caused qi and blood stagnation manifesting as back pain which can be sharp and localized especially during movement. This stagnation interrupted the qi and blood dynamic in the body causing a menstrual period characterized by thick dark blood with clotting, PMS, depression and breast distention. It is further evidenced by her dark and distended sublingual veins. This stagnation has remained over a long period of time partly due to her yin and blood deficiency. With such a deficit of yin and blood, coursing qi and blood becomes difficult due to the danger of creating more deficiency. With a greater degree of deficiency, there is less blood to course, and deficiency can easily lead to excess, i.e., stagnation. Furthermore, the trauma has caused damage to the tissues, sinews, muscles, ligaments, etc. In order to fully heal these tissues, blood and yin fluids are needed to nourish them. The lack of blood and yin fluids makes this process difficult and further leads to the degeneration of these tissues creating a devastating cycle with an inability to resolve her disharmony.
10. Treatment Plan: Course qi and blood and relieve pain; harmonize Ren-Yang Wei
11. Prescription:
a. Acupuncture:
i. Root Step 1: SJ 5, KI 6 (retain 2 min, check abdomen; if + add
GB 41, LU 7 (hook IP cords, retain 10 min)
ii. Root Step 2: R UB 22, R UB 19, L UB23, L UB 13 (retain 5 min)
iii. Branch: thread down UB first line bliaterally
iv. Tuina on upper and lower back
v. Stretching
b. Acupuncture Analysis:
SJ 5: confluent of yang wei mai
KI 6: confluent of yin qiao mai
GB 41: confluent of dai mai
LU 7: confluent of ren mai
c. Herbs: Meridian Passage
d. Herbal Analysis:
This formula is a combination of Shen Tong Zhu Yu Tang and Mo Yao Xiang Sheng Dan. It is for congealed blood in the meridians, joints, low back and limbs. It consists of:
Hong Hua: invigorates blood
Niu Xi: invig blood, nourishes LV and KI
Qin Jiao: expels wind damp, softens tendons, guide to meridians
Qiang Huo: wind damp, focus on KI and UB
Chuan Xiong: invig blood, expels wind
Dang Gui: invig and tonifies blood
Xiang Fu: moves qi along with the blood
Gan Cao: harmonizes, focuses to meridians
Mo Yao: invig blood, promotes healing
Zi Ran Tang: invig blood, enters LV and KI
Gu Sui Bu: tonifies KI, heals bones and tendons
Bai Shao: tonifies blood, smoothes LV qi, important for pain and spasms
Ru Xiang: invig blood, relaxes muscles, stabilizes pain
Treatment Date and Time: September 23, 1999
Sex and Age: Female, 21
1. Chief Complaint: Back Pain from MVA since May 1999
2. Medical History:
a. Present Illness: Patient complains of back pain with initial onset 1997 from MVA. She was treated successfully with acupuncture and herbal medicine over a 1 ½ year period. Three months later (May 1999), she suffered another trauma to her back in a MVA. Patient experiences pain on palpation from GB 21 down the first line of the UB channel to her sacrum bilaterally. She also experiences headache pain from GB 21 up to GB 13, 14, 15. Her pain is aggravated with forward, backward and lateral flexion and extension, damp weather, prolonged standing or sitting. Her pain is chronic, mostly dull but can be sharp and localized. Pain is alleviated with medication (Vicadan), heat, and stretching. O’Donahue’s was positive in all directions. Generally, pain without movement is 3/10, worsening at the end of the day to 7/10. She was diagnosed by M.D. as whiplashed; MRI and X-rays were negative.
b. Current Health Status:
Skin: constant itching over entire body, dry skin, especially on chest
Head: headache post MVA from GB 21 to GB 13, 14, 15
Eyes: occasional floaters
Ears: progressive loss of hearing
Respiratory: chronic smokers cough, phlegm difficult to expectorate, bronchitis history
CV: cold hands and feet, occasional dizziness
GI: nausea, better with food, history of constipation and diarrhea
Sleep: difficulty falling asleep, 5-10 hrs per night, awakes tired
Urine: frequent (every 1-2 hrs), but drinks often
Stool: 1-2x/day, occasionally loose, history of undigested food in stool
Temp: cold extremities, heat in body 98.7 degrees
App: good, eats frequently
Sweat: history of night sweats
Thirst: very thirsty, drinks often
Emotions: history of depression; suicidal tendencies after finding out she had genital warts
BP: 106/70
c. Other: Patient smokes cigarettes @ 1 pack/day; also smokes marijuana @ 1 joint every 2-3 hrs. to relieve pain and nausea
d. Past Medical History: MVA 1997, treated successfully with acupuncture and herbal medicine over 1 ½ year period. Three months later (May 1999), subsequent MVA.
3. Family Health History: N/A
4. Medications: oral contraceptives, Vicodan, Soma
5. Allergic History: N/A
6. Personal History: asthma, bronchitis, Stomach/intestinal disorders, allergies, UTI
7. OB/GYN: menarche @ 15 yrs, LMP 9/15/99, 28 day cycle, 4 day flow, dark red at onset, thick blood, clotting, PMS depression, abdominal and breast distention
8. Physical Exam:
a. Tongue: body: pink red, thin, pierced
coat: turbid white sticky in rear
veins: dark and distended
b. Facial complexion: ok
c. Body shape and posture: Patient's shape and posture appears healthy
d. Shen: present
e. Other: movement before after
i. Neck forward flexion 6 4
ii. Neck extension 8 (↓ ROM) 6 (↑ROM)
iii. Neck L lateral flexion 5 4 (↑ROM)
iv. Neck R lateral flexion 8 5
v. Back extension unable 8 (↑ROM)
vi. Back extention (passive) 8 -------
vii. Back L lateral flexion 7 2
viii. Back R lateral flexion 7 2
f. Listening and Smelling: no unusual odors, breathing or vocal changes were observed
g. Palpation:
i. Pulse
Level: middle
Speed: 72
Rhythm: regular
Strength: chi bilaterally was deep and vacuous, LV vacuous
Shape/Quality: tight
ii. Abdomen/Channels: Extra Channel Hara Diagnosis revealed a Ren Mai-Yin Qiao and Yang Wei-Dai Mai disharmony. Also pressure pain down UB line (relieved after treatment)
9. Differential Diagnosis:
a. TCM: Qi and Blood stagnation from trauma (underlying yin/blood ↓)
b. Japanese: Ren-Yang Wei Disharmony
A. Qi and Blood Stagnation Yin and Blood deficiency
Back pain which can be sharp itching
And localized esp. during movement dry skin
Thick menstrual blood w/ clotting floaters
depression Loss of hearing
abdominal and breast distention Cough w/ diff to expectorate phlegm
dark and distended SLV Dizziness
tight pulse Difficulty falling asleep
Deficiency heat
Night sweats
Thirst
tremors
B. Pathology: The root of patient’s pathology is a yin and blood deficiency. This deficiency can develop from years of chronic abuse of cigarettes and marijuana coupled with her history of chronic LU infections and emotional depression. The itching and dry skin result from the lack of yin and blood nourishing the skin. The floaters and progressive loss of hearing from yin and blood not rising to nourish the eyes and ears. A further progression of this lack of nourishment rising is patient’s dizziness. Due to the long-term nature of patient’s abuse of alcohol, cigarettes and marijuana despite her young age, her yin and blood have been depleted enough to result in tremors from wind arising from deficiency. Yin deficiency leads to a relative excess of yang and causes deficiency heat, night sweats and thirst, as well as difficulty falling asleep due to yin’s inability to house the yang at night.
With this yin and blood deficiency at the root, patient suffered severe trauma to her back and neck from a series of motor vehicle accidents over a short period of time. This trauma caused qi and blood stagnation manifesting as back pain which can be sharp and localized especially during movement. This stagnation interrupted the qi and blood dynamic in the body causing a menstrual period characterized by thick dark blood with clotting, PMS, depression and breast distention. It is further evidenced by her dark and distended sublingual veins. This stagnation has remained over a long period of time partly due to her yin and blood deficiency. With such a deficit of yin and blood, coursing qi and blood becomes difficult due to the danger of creating more deficiency. With a greater degree of deficiency, there is less blood to course, and deficiency can easily lead to excess, i.e., stagnation. Furthermore, the trauma has caused damage to the tissues, sinews, muscles, ligaments, etc. In order to fully heal these tissues, blood and yin fluids are needed to nourish them. The lack of blood and yin fluids makes this process difficult and further leads to the degeneration of these tissues creating a devastating cycle with an inability to resolve her disharmony.
10. Treatment Plan: Course qi and blood and relieve pain; harmonize Ren-Yang Wei
11. Prescription:
a. Acupuncture:
i. Root Step 1: SJ 5, KI 6 (retain 2 min, check abdomen; if + add
GB 41, LU 7 (hook IP cords, retain 10 min)
ii. Root Step 2: R UB 22, R UB 19, L UB23, L UB 13 (retain 5 min)
iii. Branch: thread down UB first line bliaterally
iv. Tuina on upper and lower back
v. Stretching
b. Acupuncture Analysis:
SJ 5: confluent of yang wei mai
KI 6: confluent of yin qiao mai
GB 41: confluent of dai mai
LU 7: confluent of ren mai
c. Herbs: Meridian Passage
d. Herbal Analysis:
This formula is a combination of Shen Tong Zhu Yu Tang and Mo Yao Xiang Sheng Dan. It is for congealed blood in the meridians, joints, low back and limbs. It consists of:
Hong Hua: invigorates blood
Niu Xi: invig blood, nourishes LV and KI
Qin Jiao: expels wind damp, softens tendons, guide to meridians
Qiang Huo: wind damp, focus on KI and UB
Chuan Xiong: invig blood, expels wind
Dang Gui: invig and tonifies blood
Xiang Fu: moves qi along with the blood
Gan Cao: harmonizes, focuses to meridians
Mo Yao: invig blood, promotes healing
Zi Ran Tang: invig blood, enters LV and KI
Gu Sui Bu: tonifies KI, heals bones and tendons
Bai Shao: tonifies blood, smoothes LV qi, important for pain and spasms
Ru Xiang: invig blood, relaxes muscles, stabilizes pain
Impotence
Patient Last Name: Dv00 Patient First Name: A
Treatment Date and Time: 5/13/00
Sex and Age: Male, 29
1. Chief Complaint: impotence
2. Medical History:
Present Illness: the onset of patient’s illness was approximately one year ago. He was in the Peace Corps, and would spend his summers in West Africa. While there, he was dating a West African woman whom he would see each summer. In his last summer, he told the woman that they shouldn’t continue their relationship and she became very upset. That night at dinner, the patient thought his food tasted funny. After completion of the meal, he felt a cold, numbing sensation from his lower abdomen to the tip of his penis. He described the sensation as if Ben Gay had been rubbed there and the heat wore off leaving it cold and numb. He has had this ever since, and has been unable to achieve an erection or any sensation. He later learned that his ex-girlfriend had gone to see a West African witch doctor who had cast a spell on him and had treated his food with some herbs. After seeing western doctors to no avail, patient went to see an herbalist who misdiagnosed the impotence as a kidney yang deficiency. Patient was prescribed herbal formulas to tonify his yang, and as a result, has experienced such great heat signs that his hair began to fall out and his upper body is laden with heat and dryness.
b. Current Health Status:
Temp: hot
Sweat: none (unable to sweat)
Thirst: for cold liquids
Urine/Urogenital: 2 x/day, moderate amount, clear to yellow in color. Testosterone and prostate normal
Energy: low
Sleep: difficulty falling asleep; gets too hot to sleep; restlessness; vivid strange dreams
Emotions: worry, anxiety, frustration regarding impotence; has lost passion for life; difficulty experiencing joy; difficulty socializing
Head: dry heat sensations; headache 3-4 x/week behind eyes
Ears: ringing; bright red color
Eyes: dry, scratchy, burning
Skin: face and hands very hot and dry
Digestion: gas and bloating
Stool: diarrhea 3-4 x/week; loose with undigested food
c. Past Medical History: none noted
3. Family Health History:
None noted
4. Medications: n/a
5. Allergic History: n/a
6. Physical Exam:
a. Tongue: body: red, scallops, center cracks, red tip
coat: dry, thin white, scanty
veins: dark and distended
b. Facial complexion: slightly red, with bluish hue around eyes and mouth
c. Body shape and posture: tall thin
d. Shen: diminished, lacking vitality
e. Listening and Smelling: groaning voice
f. Palpation:
i. Pulse: 88 bpm
Right – wiry
Left – wiry
ii. Abdomen/Channels: none done; feet very cold
9. Diagnosis: yin vacuity
10. Correspondence of Signs & Symptoms: heat sensations; inability to sweat; thirst for cold; scanty urine; restlessness; inability to sleep; anxiety; tinnitus; dry, scratchy, burning eyes; red tongue, especially tip; scanty tongue coat; rapid pulse
11. Treatment:
a. Points: SP 4
KI 3, 6
LV 8
REN 4
LV 5
b. Herbs: Tian Wang Bu Xin Dan
6/1/00
Changes: dry heat around chest and nose (worse at night and late afternoon). Temperature still hot; hair still falling out, but not as much, oil returning. Emotions affected by hair; feels tired and old, but a little happier this week about hair. Slight sweat this week – needed deodorant for first time. Headache frontal dry heat
Points: Ki 1, 7, 10
LV 8
UB 23, 43
Du 14
Herbs: alternate Tian Wang Bu Xin Dan and Zhi Bai Di Huang Wan
6/8/00
Changes: difficulty sleeping; missing spark – no more desire or zest for life; head really hot and dry
Points: KI 7, 24
HT 3
PC 8
Du 20
Herbs: Gui Zhi Jia Long Gu Mu Li Tang
6/15/00
Changes: after formula noticed warmth and slight sensation in genitals; more oil in hair; energy better. Boiled last two bags together and drank entirety in one hour.
Points: UB 18, 23, 44
KI 2, 7
LV 8
PC 7
Herbs: Gui Zhi Jia Long Gu Mu Li Tang + Sheng Di, Shi Gao and Zhi Mu (with large doses: 90g of Long Gu and Mu Li; 30g of Shi Gao and Zhi Mu; and 24g of rest)
6/22/00
Changes: felt great; majority of heat symptoms gone. Prior to treatment he rated his heat on a scale of 1-10, at 12/10; at this treatment he rated it a 5/10. Also, more warmth in genitals and progressively more sensation.
Points: HT 3, 8
LV 2, 8
SP 2, 9
KI 2, 10
Herbs: same (using Long Chi instead of Long Gu)
Pathology: Patient’s pathology appears to be a combination of spiritual and iatrogenic causes. The onset of patient’s inability to achieve sensation in his genitals directly followed a meal in which his food was tainted with herbs (and possibly witch craft). The focus of these herbs (and witch craft) was to specifically affect patient’s genitalia, making him unable to be intimate with another woman, the result of a vengeful action perpetrated by an ex-girlfriend. While it is not clear what herbs (or spells) were used, it is clear that the result was to leave the patient impotent with a numbing cold sensation. This cold sensation, however, should not be confused with a Kidney yang vacuity – the cold is limited to this area, had an immediate onset, and there is an absence of any other yang vacuity signs. Unfortunately, the first herbalist that patient visited made this mistake and prescribed yang tonics. These yang tonics caused immense heat signs in the patient, resulting in the symptoms listed above. Thus, patient’s presentation is a mixture of demonic possession, herbal toxicity, and iatrogenic causes. His pattern currently presents as a yin vacuity with a separation of yin and yang. Patient’s signs and symptoms reflect floating yang; all of his heat signs are on the upper half of his body. His lower body is cold, with lack of sensation. The herbal and demonic causes of his condition caused an imbalance of yin and yang; a separation at his root or dan tian. The Kidney yang formulas that he was prescribed furthered this imbalance by warming his unanchored yang and scorching his yin. Physically, this imbalance is manifested by the extreme heat signs in the upper half of his body and the coolness in the lower half. Psychospiritually, the herbal toxicity, witch craft, and betrayal from an intimate relation has resulted in patient’s difficulty experiencing joy and loss of passion in life. Patient’s Heart and Kidneys, the central axis of spiritual stability, have lost communication. This has caused the patient to become separated from his destiny. With this loss of communication between fire and water, other elements become affected. For instance, along the sheng cycle from water to fire exists wood. The wood element is responsible for mediating the flow of qi between the water/jing and fire/shen. When the jing and shen are not in contact, the flow of qi becomes disordered. Here, patient has some qi stagnation which has resulted from this disharmony. It is reflected in his frustration, wiry pulse, and dark and distended sublingual veins. On the other side of the sheng cycle between fire and water exists earth and metal. These elements, too, have been affected. The fire in the upper jiao has affected the yin of the metal element reflected in patient’s low energy, hot skin, inability to sweat, heat around chest and nose, etc. The disharmony has also affected the earth and yang of the metal elements resulting in thirst for cold liquids, frontal headaches, gas and bloating, loose stools with undigested food, and scalloped tongue with center cracks.
12. TCM Patterns of Impotence (Therapeutics of Chinese Medicine, by Yan Wu)
PATTENS
DEBILITATION OF LIFE GATE FIRE
KI yang defic
80% Complete or partial impotence, frequent spontaneous seminal discharge, dizziness and vertigo, tinnitus, pale complexion, cold limbs, listlessness, weak aching lower back and legs, frequent urination
T: pale w/ white coat
P: deep thready Ren 4, 2, KI 11
Du 4
UB 23
KI 3
Du 20
UB 31-34 [Ba Liao]
For vacuity of HT/SP add UB 15, HT 7, SP 6 Wu Zi Yan Zong Wan
Zan Yu Dan Also for female infertility
DOWNPOUR OF DAMP HEAT INTO L.J. Flaccidity of penis w/ inability to achieve or sustain erection, accom by premature ejac in most cases; also, sweatiness in scrotum, heavy aching lower limbs, thirst or bitter taste, dark burning urine
T: yellow slimy coat
P: slippery rapid Ren 3
Du 4
SP 6, 9
ST 36
LV 5
If KI yin also, add KI 3 Long Dan Xie Gan Tang
If KI yin also, Zhi Bai Di Huang Wan
Treatment Date and Time: 5/13/00
Sex and Age: Male, 29
1. Chief Complaint: impotence
2. Medical History:
Present Illness: the onset of patient’s illness was approximately one year ago. He was in the Peace Corps, and would spend his summers in West Africa. While there, he was dating a West African woman whom he would see each summer. In his last summer, he told the woman that they shouldn’t continue their relationship and she became very upset. That night at dinner, the patient thought his food tasted funny. After completion of the meal, he felt a cold, numbing sensation from his lower abdomen to the tip of his penis. He described the sensation as if Ben Gay had been rubbed there and the heat wore off leaving it cold and numb. He has had this ever since, and has been unable to achieve an erection or any sensation. He later learned that his ex-girlfriend had gone to see a West African witch doctor who had cast a spell on him and had treated his food with some herbs. After seeing western doctors to no avail, patient went to see an herbalist who misdiagnosed the impotence as a kidney yang deficiency. Patient was prescribed herbal formulas to tonify his yang, and as a result, has experienced such great heat signs that his hair began to fall out and his upper body is laden with heat and dryness.
b. Current Health Status:
Temp: hot
Sweat: none (unable to sweat)
Thirst: for cold liquids
Urine/Urogenital: 2 x/day, moderate amount, clear to yellow in color. Testosterone and prostate normal
Energy: low
Sleep: difficulty falling asleep; gets too hot to sleep; restlessness; vivid strange dreams
Emotions: worry, anxiety, frustration regarding impotence; has lost passion for life; difficulty experiencing joy; difficulty socializing
Head: dry heat sensations; headache 3-4 x/week behind eyes
Ears: ringing; bright red color
Eyes: dry, scratchy, burning
Skin: face and hands very hot and dry
Digestion: gas and bloating
Stool: diarrhea 3-4 x/week; loose with undigested food
c. Past Medical History: none noted
3. Family Health History:
None noted
4. Medications: n/a
5. Allergic History: n/a
6. Physical Exam:
a. Tongue: body: red, scallops, center cracks, red tip
coat: dry, thin white, scanty
veins: dark and distended
b. Facial complexion: slightly red, with bluish hue around eyes and mouth
c. Body shape and posture: tall thin
d. Shen: diminished, lacking vitality
e. Listening and Smelling: groaning voice
f. Palpation:
i. Pulse: 88 bpm
Right – wiry
Left – wiry
ii. Abdomen/Channels: none done; feet very cold
9. Diagnosis: yin vacuity
10. Correspondence of Signs & Symptoms: heat sensations; inability to sweat; thirst for cold; scanty urine; restlessness; inability to sleep; anxiety; tinnitus; dry, scratchy, burning eyes; red tongue, especially tip; scanty tongue coat; rapid pulse
11. Treatment:
a. Points: SP 4
KI 3, 6
LV 8
REN 4
LV 5
b. Herbs: Tian Wang Bu Xin Dan
6/1/00
Changes: dry heat around chest and nose (worse at night and late afternoon). Temperature still hot; hair still falling out, but not as much, oil returning. Emotions affected by hair; feels tired and old, but a little happier this week about hair. Slight sweat this week – needed deodorant for first time. Headache frontal dry heat
Points: Ki 1, 7, 10
LV 8
UB 23, 43
Du 14
Herbs: alternate Tian Wang Bu Xin Dan and Zhi Bai Di Huang Wan
6/8/00
Changes: difficulty sleeping; missing spark – no more desire or zest for life; head really hot and dry
Points: KI 7, 24
HT 3
PC 8
Du 20
Herbs: Gui Zhi Jia Long Gu Mu Li Tang
6/15/00
Changes: after formula noticed warmth and slight sensation in genitals; more oil in hair; energy better. Boiled last two bags together and drank entirety in one hour.
Points: UB 18, 23, 44
KI 2, 7
LV 8
PC 7
Herbs: Gui Zhi Jia Long Gu Mu Li Tang + Sheng Di, Shi Gao and Zhi Mu (with large doses: 90g of Long Gu and Mu Li; 30g of Shi Gao and Zhi Mu; and 24g of rest)
6/22/00
Changes: felt great; majority of heat symptoms gone. Prior to treatment he rated his heat on a scale of 1-10, at 12/10; at this treatment he rated it a 5/10. Also, more warmth in genitals and progressively more sensation.
Points: HT 3, 8
LV 2, 8
SP 2, 9
KI 2, 10
Herbs: same (using Long Chi instead of Long Gu)
Pathology: Patient’s pathology appears to be a combination of spiritual and iatrogenic causes. The onset of patient’s inability to achieve sensation in his genitals directly followed a meal in which his food was tainted with herbs (and possibly witch craft). The focus of these herbs (and witch craft) was to specifically affect patient’s genitalia, making him unable to be intimate with another woman, the result of a vengeful action perpetrated by an ex-girlfriend. While it is not clear what herbs (or spells) were used, it is clear that the result was to leave the patient impotent with a numbing cold sensation. This cold sensation, however, should not be confused with a Kidney yang vacuity – the cold is limited to this area, had an immediate onset, and there is an absence of any other yang vacuity signs. Unfortunately, the first herbalist that patient visited made this mistake and prescribed yang tonics. These yang tonics caused immense heat signs in the patient, resulting in the symptoms listed above. Thus, patient’s presentation is a mixture of demonic possession, herbal toxicity, and iatrogenic causes. His pattern currently presents as a yin vacuity with a separation of yin and yang. Patient’s signs and symptoms reflect floating yang; all of his heat signs are on the upper half of his body. His lower body is cold, with lack of sensation. The herbal and demonic causes of his condition caused an imbalance of yin and yang; a separation at his root or dan tian. The Kidney yang formulas that he was prescribed furthered this imbalance by warming his unanchored yang and scorching his yin. Physically, this imbalance is manifested by the extreme heat signs in the upper half of his body and the coolness in the lower half. Psychospiritually, the herbal toxicity, witch craft, and betrayal from an intimate relation has resulted in patient’s difficulty experiencing joy and loss of passion in life. Patient’s Heart and Kidneys, the central axis of spiritual stability, have lost communication. This has caused the patient to become separated from his destiny. With this loss of communication between fire and water, other elements become affected. For instance, along the sheng cycle from water to fire exists wood. The wood element is responsible for mediating the flow of qi between the water/jing and fire/shen. When the jing and shen are not in contact, the flow of qi becomes disordered. Here, patient has some qi stagnation which has resulted from this disharmony. It is reflected in his frustration, wiry pulse, and dark and distended sublingual veins. On the other side of the sheng cycle between fire and water exists earth and metal. These elements, too, have been affected. The fire in the upper jiao has affected the yin of the metal element reflected in patient’s low energy, hot skin, inability to sweat, heat around chest and nose, etc. The disharmony has also affected the earth and yang of the metal elements resulting in thirst for cold liquids, frontal headaches, gas and bloating, loose stools with undigested food, and scalloped tongue with center cracks.
12. TCM Patterns of Impotence (Therapeutics of Chinese Medicine, by Yan Wu)
PATTENS
DEBILITATION OF LIFE GATE FIRE
KI yang defic
80% Complete or partial impotence, frequent spontaneous seminal discharge, dizziness and vertigo, tinnitus, pale complexion, cold limbs, listlessness, weak aching lower back and legs, frequent urination
T: pale w/ white coat
P: deep thready Ren 4, 2, KI 11
Du 4
UB 23
KI 3
Du 20
UB 31-34 [Ba Liao]
For vacuity of HT/SP add UB 15, HT 7, SP 6 Wu Zi Yan Zong Wan
Zan Yu Dan Also for female infertility
DOWNPOUR OF DAMP HEAT INTO L.J. Flaccidity of penis w/ inability to achieve or sustain erection, accom by premature ejac in most cases; also, sweatiness in scrotum, heavy aching lower limbs, thirst or bitter taste, dark burning urine
T: yellow slimy coat
P: slippery rapid Ren 3
Du 4
SP 6, 9
ST 36
LV 5
If KI yin also, add KI 3 Long Dan Xie Gan Tang
If KI yin also, Zhi Bai Di Huang Wan
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