Sunday, May 22, 2011

Acupuncture Treatment of Chest Tightness and Palpitations


Chief Complaint: Chest tightness and palpitations chronic for eight years with an acute presentation for 2 weeks.
Medical History: The patient has been tested by a medical doctor for heart problems. The tests including an EKG, Stress Test, and blood values of cardiac enzymes show that the patient is within normal range. Her symptoms generally include tightness in the chest that is always present and palpitations while resting that can last as long as 20 minutes. On several occasions she experienced pain radiating down her left arm. The problem began 8 years ago after her fiance died. Prior to this incident she did not experience any of the signs and symptoms described above.
Questioning exam: Today the patient returned to the clinic after a month long break from treatment complaining of slight chest tightness and palpitations that come in the evening as she is relaxing or trying to go to sleep. Her appetite is good and she eats 3 meals per day consisting of the 4 food groups. The patient reports that her digestion is good meaning that she does not experience gas, bloating, stomach pain or acid regurgitation after eating. She has one bowel movement per day that is well formed and complete. She drinks 8 to 10 glasses of room temperature water per day. She enjoys a cup of coffee in the morning and tea or a carbonated soft drink in the afternoon. She urinates 4 to six times per day and the volume of urine relates to her intake of fluids. She reports that her body temperature is normal but she tends to dress warmly. She sweats with exertion during day and wakes once during the night feeling clammy and overheated Her energy is usually 7 to 8 our of 10 but today she reports feeling sluggish. She falls asleep easily and wakes 1x due to sensation of heat and dampness whereupon she falls back to sleep and wakes rested. She reports having vivid dreams that are not stressful. She typically can’t remember her dreams. The patient’s emotional state is good as she exhibits a positive attitude toward life. Her HEENT are mostly clear with a slight cigarette smokers cough. The patient’s menstrual cycle is pending any day. She experienced menarche at 13 years old. The interval of the cycle is typically 28 to 30 days with a duration of 4-5 days. The volume of blood is moderate and its color is red blood ending with a rusty red and is without clots. PMS symptoms include distended sensitive breasts, emotional upset, increased fatigue, and dull pain in the lower abdomen. She has skipped a cycle recently and notices that the interval seems to be getting longer in general. The flow has been erratic in the last 6 months changing from heavy to spotting in unpredictable patterns. She attributes the changes to the first signs of menopause.
Pulse exam: The pulse was felt on the middle and deep levels on both wrists. The right side was dominant. Both hands had a thin pulse felt in the middle level at the cun and guan position. The strength of the pulse increased at the deep level where the chi position could be felt. The rate was 92BPM with a regular rhythm.
Tongue exam: The tongue body is puffy top to bottom especially in the center. There is a deep crack from the Kidney area to the Stomach/Spleen region with a thin crack to the tip. The color is slightly red with a very red tip. The coating is thick and slightly yellow due to cigarette smoking. There are scallops on the sides. The sublingual veins are not distended. The patient is 5’6″ and 120#. She actively participates in the consultation. Her movements are fluid and graceful. There are no unusual odors.
OM Diagnosis: The diagnosis is Qi stagnation in the Heart channel due to emotional trauma. This Qi stagnation has created heat in the upper jiao and has blocked the cooling mist of kidney yin from reaching the heart.
Treatment Principle: Open the chest and cool the heart.
Point Prescription: Yin Tang pacifies wind and calms the shen – insomnia, agitation, restlessness
Ren 17 front Mu of pericardium, influential point of Qi regulates Qi and unbinds the chest
H 7 the source point for the heart and the shu stream point – cardiac pain, palpitation
Lu 9 source point for the lung and the shu stream point and the influential point of vessels palpitation and pain in the chest
P 6 the Luo point of the pericardium – cardiac pain, palpitation, stuffy chest,
K 7 Jing river point night sweating
Liv 3 the source point for the liver and the shu stream point – emotional upset, depression
Herbal Formula: herbs were not recommended.
Lifestyle Prescription: craniosacral therapy, aromatherapy and massage
Results: patient felt immediately better after her first treatment and was treated twice a week. after 1 month/8 treatments the palpitations were resolved to a few quick beats after getting into bed to go to sleep.
Synopsis: using he gu ci fa techninque on Ren 17 and combining this point with LI 4 and Lu 7 seemed to have the greatest effect on the chest tightness and i have found it very effective in treating asthma.

Acupuncture and Herbs for Excessive Menstrual Flow

Chief Complaint: 1- Excessive menstrual flow
Western Diagnosis: The patient was diagnosed with fibroids by a M.D
Medical History: Female, 46 years old
Secondary complaint, recurrent sinus infections
Questioning exam: 1-Her symptoms consist of a lack of a menses for 2-3 months, followed by a heavy flow for 2-3 weeks. The flow is dark and has clots. She feels her abdomen is tight while menstruating, and finds that moving and stretching relieves it.
2- The patient has gotten a sinus infection every six months for as long as she can remember. The discharge from her nose starts clear, but becomes green and bloody.
Pulse exam:
Pulse: Rapid, slippery
Tongue exam: Tongue: Scalloped, white coat, lavender color
OM Diagnosis: 1- Uterine bleeding due to blood stasis (beng luo)
2- Local obstruction of Yang Ming channel
Treatment Principle: 1- Move blood stasis
2- Clear obstruction, move qi
Point Prescription: Sp1, Sp10, Sp8, Sp6, Yin Tang, Du 20, LI4, St36, Du23, LI20->BiTong, St3
Herbal Formula: Ge Xia Zhu Yu Tang
Results: Menstrual flow decreased after treatment, and stopped a day or so after treatment.

The Treatment of Anxiety with Acupuncture


Chief Complaint: spontaneous sweating, nervousness
Western Diagnosis: anxiety
Medical History: recent weight loss of 150 lbs, recent dramatic change in lifestyle from unhealthy, greasy, sweet and alcohol diet to a healthy one (hence the weight loss) many traumatic life events; deaths of close loved ones, divorce.
Questioning exam: unstable emotions
mental restlessness worse at night
low energy
sweating on palms and legs, worse with anxiety
lots of dreams
persistent low grade nausea
occasionally morning bowel movement triggers vomiting and abdominal cramps
constant back pain, tightness; better with movement
Pulse exam: skin very damp
clear sweat
pulse sunken and weak in especially in the lung area, unsmooth
Tongue exam: light purple, pale body color, thick, greasy, yellowish coating
OM Diagnosis: lung and stomach qi deficiency, phlegm heat, qi stagnation
Treatment Principle: remove obstructions, disperse fluids regulate stomach qi, tonify qi, calm spirit
Point Prescription: 1st treatment: aggressive energy
2nd treatment: internal dragons
3rd treatment: st36, lu7, pc6, kd9, kd26, kd7, li4, ht6 all contralateral except kd26, lu7
Herbal Formula: gan mai da zao tang with wen dan tang
Lifestyle Prescription: replacement of coffee with herbal tea
Results: back pain gone for several days after AE, felt a tangible weight lifted off….
2nd treatment not as noticeable effect but felt calmer the whole week
3rd treatment felt very electrical… went home and cried for aver an hour
Synopsis: continuation of moving qi, disperse fluids, dissolve phlegm…. tonify lung qi

Acupuncture Treatment of Acne Rosacea


Chief Complaint: Acne Rosacea
Medical History: The patient is a 50 year old female whose Acne Rosacea, localized mainly around her mouth and chin. During her adolescent years she was diagnosis with severe Acne by her physician. In her thirties she was diagnosis with Acne Rosacea by a Dermatologist. For past two years the outbreaks has been moderate to acute. Her lesion is diameter of an eraser on a pencil. They are pustules and painful. When the lesion breaks open, they bleed and is easily irritate. Simply splashing water on her face to wash it or wiping her mouth area with dinner napkin can cause the to lesions to bleed.
The patient has consulted a Dermatologist and was prescribed topical metronidizaloe cream, applied twice a day as treatment, which made no difference. Erythromycin was also prescribed and worked to some extent, but only as long as she was taking them.
Questioning exam: Patient likes eating spicy foods; has flush cheeks and chin; hass occasional night sweats (d/t menopause); bowel movements re loose, 2-3xday sometimes more and sometimes they are explosive and urgent; thirst – constantly consume water all day long because she弤 a History teacher and talks all day.
Other symptoms included mild dizzy spells for the past year, generalized headaches with no specific location a few times a week, stiffness in the trapezius, trouble falling asleep, and general stress. She is slightly irritable, especially before her menses, color red to darker red with some clots lasting for 5 days. The patient runs on the cold side.
Pulse exam: Pulse: wiry, slippery, rapid
Lesions feel hot and tender to the touch. Lesions mainly around mouth and chin. Redness in central areas of the face, forehead and chin.
Tongue exam: Red tip, thin to moderate white coat with yellow line in down the center of the tongue
OM Diagnosis: Diagnosis:
1. Heat toxin (acute)
2. Heat in Lungs and Stomach (chronic)
Overindulgence of alcohol or spicy foods, causing excessive heat in the Stomach and then steams the Lung.
Pre-existing accumulated Lung and Stomach heat combining with attack by heat toxin.
Disharmonies of the penetrating and conception channels, causing blood heat stagnation in the skin and tissues of the nose area, giving rise to the lesions.
Point Prescription: The patient did not want her face needled.
Ears Points: External Nose, Endocrine, Lungs, Shen Men and Adrenal.
Body points: LI 11, SJ 5, ST 44, LI 4 & LR 3, LU 3, ST 36
Needle retention was 15- 20 minutes.
When her diarrhea was severe (explosive), salt moxa on RN-8
Herbal Formula: Patient did not want herbs
Lifestyle Prescription: Decrease /stop consumption of alcohol, spicy foods and fried greasy foods
Results: After the first treatment the lesions dried up significantly, but lesions returned approximately a week later. After approximately 3 months of treatments twice a week, the lesions cleared up completely and reappeared occasionally. From month 4 to current, she has been receiving weekly or bi-weekly treatments and Acne Rosacea has not flared up.

Chinese Medicine Treatment of Brain Damage


Chief Complaint: Spasticity, inability to eat, speak, control movements
Western Diagnosis: Brain Damage caused by Anoxia during surgery
Medical History: Patient “D” was twelve-year old boy undergoing hernia surgery. Anesthesiologist forgot to set blood pressure cuff and D had ten minutes when his brain had no oxygen. His muscles seized, could not breathe on his own, was fed through tube, could not walk, speak or toilet himself. D could only “blow raspberries” at his mother to show disapproval but could not blink his eyes voluntarily.
Questioning exam: Because patient could not communicate directly, I am listing signs. Functional symptomatology listed above in relevant medical history. Patient was pale, muscles on arms and legs were contracted and spastic. He had appearance of “puppet” — almost like “wooden” boy. He had been a piano prodigy and a skilled soccer player before the surgery, however when I saw him for the first time (four months after the “accident”, he could not stand, his feet and fingers were contracted. However, when I played Mozart for him during treatments, his eyes lit up and he began vocalizing “ah, ah, ah” during pieces that he had played before the accident — when he still had use of his fine motor muscles. D’s skin and nails were very dry. His eyes were quite dry (however he was unable to close them voluntarily). D did wear “drypers” and had to be bathed by his nurses and fed liquid meals through his feeding tube. He could not control his urine or bowel evacuation. He was cold all the time and needed to be covered in blankets. He was not growing or developing.
Pulse exam: Pulse was overall very deep and weak. When palpable it disappeared with pressure.
Tongue exam: Tongue was deviated but flabby and pale.
OM Diagnosis: Sudden anoxia caused muscles and whole body not to be nourished. Severe blood deficiency causing wind in the channels. Because of injury to brain, kidney channel damaged — patient showing signs and symptoms of kidney yang xu — cannot control toileting, experiences cold, not developing.
Treatment Principle: Nourish blood and yin, clear wind.
Nourish kidney channel – yin and yang.
Point Prescription: St 36 GB 34 GB 39 Liver 2 Liver 3
Spleen 10 Spleen 6, LI 4, LI 11, Ear shenmen, Kidney 3, Kidney 7, Kidney 9. Moxa used on St 36, Ren 4, 6, 8 and Kidney points. Patient could not lie on his stomach until several months into treatment, at which point I added UB23, UB17, UB18, UB15 and SI points around the shoulder to relax rhomboids. These points were not all used concurrently, but varied over the course of treatment.
Herbal Formula: Began with raw herb formula-his mother would pour it down feeding tube.
Liu Wei Di Huang Wan Jia Wei
(added Gou Qi Zi, Che Qian Zi,
Rou Gui, Fu Zi, Dang Gui, Loranthi,
Bai Shao, etc.
This formula was augmented as he began to “come back to life”. I teased him and called him “pinocchio”. He was like the wooden boy who softened and whose movements became more fluid. After six weeks of these herbs and two acupuncture treatments per week, his large family had a big party and took him to JC Penny to buy undershorts because he could finally control his urination and bowel movements. Within a few months he could blow kisses at his mother, articulate words, yell at me (liver qi stagnation emerged as he strengthened, but then again he had finally entered puberty and was an adolescent in all ways, including his demeanor.)(D did grow, develop, voice deepened, etc.).
Lifestyle Prescription: D was receiving speech and occupational therapy at the hospital twice weekly. When I learned he loved marine life we searched for dolphin therapy on the internet and found a site in Southern Florida where he ended up going quarterly with his family. His parents felt that he made huge developmental strides from his time in the water with the animals.
Results: As written above, D was helped in a big way by Traditional Chinese Medicine. When he began to feed himself and the feeding tube was removed, his improvement slowed to a “not-so-dramatic” pace — because he fought taking the herbs which had helped him so significantly — and had also become a “moody” teenager.
Synopsis: When I last saw D, he was walking, talking (not totally clearly, but we could understand his words). He was attending school for a half day with his nurse as his shadow. He could shower himself, take himself to the bathroom, spend time laughing with his friends, and was securing a voice-prompt computer system so he could be on email to his friends and family. He could walk by himself and even on stairs — but at the time I saw him last, he was still experiencing spasticity in his forearms and fingers and could not perform fine motor skills. He doctors were mediating this a small amount with quarterly botox injections into the joints, but without significant success. It is so interesting that when D’s brain began to function again, it was as though he were an infant going through early stages of development — his function returned in the same “order” as if he were developing for the first time.
D no longer lives in the same city as I but touched my life significantly. I learned so much in treating and in knowing him. He is very brave young man.

Friday, May 20, 2011

The Acupuncture Treatment of Vascular Headache


Chief Complaint: right temporal pain
Western Diagnosis: vascular headache
Medical History: A woman aged 40 complained headache for 20 years. the right temporal pain began 20 yeas age, often preceded by nervous tension or over-fatigue, and aggravated during menses. She experienced boring pain in the right temporal region accompanied by cramping pain of the right eye. the bouts usually subsided after 3-5 days, sometimes with slight pain remaining.
Questioning exam: right hemicrania precipitated b tension, fatigue and menses; flushed face; restlessness; irritability; poor appetite with bitter feeling in mouth; constipation.
Pulse exam: fine taut pulse, weak at the left cubit.
Tongue exam: tongue with thin yellow coating.
OM Diagnosis: ShaoYang headache.
in this case, the bouts of hemicrania accompanied by right-eye pain, irritability, and taut pule were caused by endogenous wind from Liver due to exuberance of Yang;restlessness and insomnia were due to disturbance of mental activity of Liver-Yang; and flushed face bitter taste in mouth, constipation and yellow tongue coat were caused by Liver-fire arising from transformation of Yang. Further, inhibition of Spleen by an overactive Liver caused poor appetite.Fine pulse weak at the left cubit indicated deficiency of Kidney-Yin,as this results in failure to nourish Liver-Yin, predisposing to exuberance of yang.
Treatment Principle: Nourish Yin in order to quench fire, subdue hyper-function of Liver and the resulting endogenous wind.
Point Prescription: TaiYang,TouWei, ShuaiGu, FengChi and XiaXi.all this 5 points only select the right site and use reducing manipulation.YangLingQuan, TaiXi, TaiChong select both sites and use nourishing manipulation.retain the needles for 30 minutes each time and once every other day.
Herbal Formula: none.
Lifestyle Prescription: none.
Results: After the first treatment, pat. feels much better. after the third treatments pat.was headache free.one additional treatment for maintenance. 6 months later pat. reported headache free.

Acupuncture and Herbs for Muscle Spasms


Chief Complaint: muscle spasms
Medical History: Patient presents as 37 year old female. “Perfect health” until onset of current symptoms 5 months ago. Active lifestyle- feels best after exercise. Well balanced and moderate diet. Non-smoker, occasional wine, coffee daily.
Questioning exam: Onset of Symptoms: 5 months ago (symptoms started appearing shortly after giving birth). First symptom was closing of the eyelids. She was forced to hold her eyelids open with her fingers about 70% of the time. A few weeks later, her vocal cords tightened over the trachea and restricting breath. On her third trip to the ER, she was given a tracheostomy tube which she is still breathing through. Her vocal cords were then injected with botox in attempt to relax them. She then began suffering from dystonias in her neck, causing intense pain, rigidity, and a “bobble-head” appearance. She has seen 5 neurologists, who have prescribed a myriad of drugs from anti-anxiety to muscle relaxants to more botox. The drugs did not help her, but did cause unpleasant side-effects.
The week before she came to me, she had her first period since the delivery. This made her symptoms much worse.
Pulse exam: Pulse was overall thin, weak and slightly rapid. The left side was more superficial and wiry.
Upon palpation, GB 20 was incredibly tight and painful. As were ST 12, Naganos, LI 4, GB30, GB34, GB41, and LR3.
Tongue exam: Tongue body thin, extremely pale, and had lots of transverse cracks. Body was very quivery and unable to patient unable to stick it out. Not much of a coat and very dry.
Wood body and personality type- thin, sinewy, slight green tint to skin, use to being in control. Patient is very irritated and angry about current condition.
OM Diagnosis: Internal Liver wind due to Liver blood and yin xu.
Treatment Principle: Clear wind, smooth Liver, tonify blood and yin.
Point Prescription: First treatment was the Agressive Energy Treatment (Worsley). UB 13, 14, 15, 18, 20, 23
After that, I alternated tonifying treatments with clearing treatments.
Tonifying treatments included:
Opening the Chong (SP4 + P6) or Ren (LU7 + KI 6)
UB 15, 17, 18, 20
or
8 needles around naval
Clearing wind included different combinations of the following
Yang Wei Mo (SJ 5 + GB 41), GB 20, Naganos, LI 4, UB 12, GB 31, GB34
Cupping with Po Sum On on back and shoulders
Handwork on shoulders, Naganos, LI 4, and GB channel
Tiger thermie on ST 12
Herbal Formula: Women’s Precious as directed from Golden Flower
Lifestyle Prescription: Instructed to avoid chicken, caffeine, and alcohol increase cooked leafy greens
Results: Results were great and she was symptom free after 6 treatments in 2 weeks. I then instructed her that I wanted to see her weekly through 3 menstrual cycles. However, she was feeling so good and was busy, so she failed to come in for 3 weeks and stopped taking her herbs. In the third week she had a period. The period was very heavy and painful. All of her symptoms returned, we began again and results are coming slower this time. It has been 2 months since she resumed treatment and was doing well until her last period when her symptoms moved from the back of her neck to the front of her neck (from Tai Yang to Yang Ming). Treatment has been modified and we’re continuing to work on it.

Acupuncture and Herbs for Uterine Fibroids

Chief Complaint: Uterine pain
Western Diagnosis: Fibroids
Medical History: Asian female,age 40 presents with uterine fibroids for 14 years. Asthma since age 6, medicated with steroids for many years; during acute attacks her brother (physician) would intravenously inject her with a steroid cocktail; at age 25 she began daily use of ventolin spray; allergies to pollen, cats and coconut; whole family history of skin or lung problems (eczema, vitiligo, lung infections)
Questioning exam: Patient reports her initial symptoms were deep, cramping pains about two weeks prior to menses. Other symptoms include fatigue and lumbar tenderness correlating to uterine pain. She is prone to hayfever, congested sinuses and slight wheexing. Slow digestion with bloating,gas and constipation. She reports blurry vision and floaters, cold extremities and dry,itchy skin. The patient is exhausted by her illness,generally difficult to fall asleep and poor sleep the week before her menses. Her husband does not acknowledge her fibroids.
Pulse exam: Pulse: deep,slippery,slightly thin, also slightly wiry on right side
Abdomen: soft,deep palpation reveals small mass on right side, cold to touch
Tongue exam: Tongue: pale,dusky,swollen,teethmarks, slight yellow coat
Dark,puffy circles under eyes
OM Diagnosis: Blood & Phlegm Stagnation in Uterus
SP & KID Yang Deficiency
LIV Blood Deficiency
Long term steroid use damages KID-disrupt water-unable to move blood and fluids-creates stagnation in lower jiao
Treatment Principle: Move Blood, Transform Phlegm in Uterus
Tonify Kidney and Spleen
Nourish Blood
Point Prescription: GB 41 & SJ 5, KID 3, LIV 3, ST 36 & 37, REN 4, moxa lower abdomen, ST 36, ginger moxa REN 8
Herbal Formula: Gui Zhi Fu Ling Wan
Lifestyle Prescription: Continue acupx 2x/wk
Eliminate dairy products for 3 mos-to eliminate phlegm
Massage, Tai Qi, Moxa-all to increase energy flow to uterus
Rest!!!
Journal-write down everything you would like to create in your life
Results: She has been receiving acupuncture for several years. She believes the TCM is helping shorten the duration and lessen the intensity of her pain
Synopsis: Fibroid tumors are #1 reason for hysterectomy in US
according to Caroline Myss, fibroids represent our creativity that was never birthed; including fantasies of ourselves; fibroids can result when we are flowing energy into dead-end jobs and relationships that we have outgrown.

Chinese Medicine Treatment of Uterine Fibroids and Cysts


Chief Complaint: severe lower abdominal pain, uterine hemorrhage
Western Diagnosis: uterine fibroids, ovarian cyst
Medical History: 47 y.o. female with a history of heavy menses with clots and cramping and increasing in frequency. Occasional hot flashes but after two 2-year courses of estrogen supplementation didn’t want to continue hormone replacement. Frequent bladder infections following intercourse. History of narcotic and alcohol addiction (past) and high blood pressure triggered by anxiety.
Pulse exam: Liver small and not descending to Kidney.
Pain in lower left quadrant of abdomen, sensitive on palpation. Inguinal lymph swelling. Pale complexion.
Tongue exam: Long center crack, very pale body. Red dots at tip.
OM Diagnosis: Dai Mai blockage preventing liver from descending to kidney. Deficient Liver blood leading to heart fire.
Treatment Principle: Drain Dai Mai. Support Liver Blood. Move Blood in lower burner.
Point Prescription: Worked with Dai Mai and Li/GB divergent meridian both with acupuncture and essential oils. Had Pt. use castor oil packs.
Herbal Formula: Worked with modifications of Gui Zhi Fu Ling San, adding among others Gui Ban to keep hot flashes in check, yin chen hao and/or qing hao to help drain latent toxic heat from the dai, and Dan Shen to calm spirit and help move blood. Had patient apply carrot and benzoin EO to Li DM points to consolidate Blood (3 days on 3 days off for several weeks) and mugwort oil to Dai Mai points (with castor oil on abdomen, also 3 days on 3 days off).
Lifestyle Prescription: Recommended yoga stretches for opening psoaz and abdomen, breathing meditation to connect with and move stagnation in uterus and ovaries.
Results: After initial treatment, Pt went in for a scheduled D&C and laparoscopy previously arrange with OBGyn. During surgery, GYN discovered ‘a large ovarian cyst’ and decided to remove entire ovary (!) All bleeding stopped and Pt was told the operation sent her into menopause. In the 5 months since initial treatment and surgery, the menses has returned and normalized in frequency and duration, now with no pain or clotting. Patient no longer has bladder infections following intercourse and no longer experiences anxiety or the associated HBP; she has stopped taking pharmaceuticals for both.
Synopsis: I thought it was a good case because not a lot of people are working with EO’s on extraordinary or divergent vessels and I have been very impressed with the results.

The Acupuncture Treatment of Heartburn (GERD)


Chief Complaint: heartburn
Western Diagnosis: esophageal reflux
Medical History: stress related, burning like a hole in his stomach, ravenous hunger;
defensiveness, vulnerability
Questioning exam: heartburn ad epigastric pain, militant atheist.
Pulse exam: PC deep and weak, kidney full, overall smooth
Tongue exam: pale with white grease
OM Diagnosis: Stomach fire
IV-V imbalance (5 Element)
Treatment Principle: clear heat and rebellion, harmonize the Pericardium
Point Prescription: K22 PC1
CV 12, 14 S21
S44
AE shu pts
B38
PC6 Moxa
Herbal Formula: N/A
Lifestyle Prescription: Return monthly for follow up
Massage, yoga/taichi
Results: Able to stop all his western drugs

Acupuncture Treatment of Allergic Hives


Chief Complaint: Hives with itchiness
Western Diagnosis: Allergy
Medical History: 37 female, full-time mother of two children.
Developed the Hive condition all over the body in Oct 2004.
Approx 30 lbs overweight. Went to a dermatologist to check for allergies but found none. Indicated that she can only wear gold/silver jewelries. She likes to eat Cheese but does not drink Milk, nor smokes. Has a mild scoliosis. Taking over-the-counter allergy pills but needed to take more recently (every 12 hours or more). She feels stressed taking care of kids and not getting enough sleep. She also reported a nagging lower back ache.
She never had a acupuncture before.
Questioning exam: Unless she takes the allergy pill every 12 hours, her body gets covered with Hives, especially the upper body. The size of hives varied but 1/2 – 1 inches long and 1/4 inch width, reddish but not raised. She also feels hot when Hives occur.
Also while being treated the first time, her Hives came up since her allergy medication time-table ran out. (It was interesting to actually see how the Hive progressed, i.e. bottom to top, reaching her face!)
Pulse exam: Pulses were very slow and weak generally, especially the Kidney (Yang/Yin) pulses. The Spleen pulse was slippery. The Liver pulse was NOT tight (contrary to what Tongue shows)
Tongue exam: Relatively prominent white coating with reddish color on the tip & side.
OM Diagnosis: Used Kiiko’s abdominal assessment (Japanese style):
- Oketsu (abdominal blood stagnation) reactive
- Adrenal reactive
- Spleen/Sugar reactive
- Left inguinal & top of ASIS reactive
Treatment Principle: In Kiiko’s term, release reactive areas using distal points
Point Prescription: – left LV 4 (for Oketsu)
- KI 7, KI27, LU5 (for Adrenal)
- SP 5, SP9, BL20 (for Spleen/Sugar)
- ST Qi, ST13 (for Left inguinal)
- KI9, LI15 (for “detoxing”)
- Ear points: Allergy, Shenmen, O (to calm the shen & adress “allergy”)
Herbal Formula: None
Lifestyle Prescription: Suggested to:
- stay away from Cheese while being treated
- Watch what she eats to find out whether other food may contribute to the s/s.
Results: On 2nd visit, she indicated that she forgot to take the medicine and still felt fine! She is slowly not eating the Cheese! (Tx was basically repeated)
On 3rd visit, she is definitely weaning out of the medication. Added right LV1 for “LV14 PP(dull-pain)” finding.
On 4th visit (she skipped 1 week in between), she reported that she is no longer taking the medication!!! but got the stomach flu previous day. Upon abdominal palpation, only mild ‘adrenal & LV14 reactive. Decided to use TCM tx protocol for this visit. (CV12, ST21, SP6, BL20, BL21, Yin-tang, ST36)
Also she was reporting that she thinks she is allergic to chocolate (actually she observed experiencing a bit of Hive condition after consuming a bit of chocolate lately).
Synopsis: It was necessary to ‘show’ the needles and what reactions one may experience at the moment of needling and after-effects prior to the first treatment. Once she realized that the needles are not what she was expecting (like the western Drs needles), it was easy after that!
Also it was good to see her doing the detective work of what she eats that may contribute to her allergic reaction.

Acupuncture Treatment of IBS Indigestion


Chief Complaint: Indigestion
Western Diagnosis: Irritable Bowel Syndrome
Medical History: Patient came with the complaint of dull and heavy sensation in the abdomen , also weakness and lethargy. He was having irregular bowels timings ,and usually more than thrice daily.
Questioning exam: He told me that always feel an urge for stool , whenever there is anxiety or tension and also whenever he want to go outside to do his field work.also he felt weakness after passing stool.he was looking a bit confused,in a hurry and tense.The stool he pass was usually loose.
Pulse exam: The pulse was thready and slippery.
Also the pulse rate was fast.
Tongue exam: Tongue body was light red, with a coating of sticky white colour.
OM Diagnosis: According to my assessment he was having a spleen disorder attacked by damp and a bit cold also.
Treatment Principle: I simply made my mind to resolve damp ,and give energy to stomach and make his mind to calm.
Point Prescription: As his case was a chronic one , and he had tried a lot with many therapies with no result . So i first tried to make him calm with baihui-du-20, and shenmen-h-7.also qihai for some energy.I needled these pts. with even stimulation (manual). On third day I gave him 5 pricks on zusanli-st-36 , and sanyinjiao-sp-6 ,bilterly and baihui on the scalp without electrical stimulation.
Herbal Formula: NOT AT ALL.
Lifestyle Prescription: I just told him to have fibre rich diet.and avoid heavy and junk food.
Results: The result was excellent. As i was thinking of giving him points of complex patterns, but i was astonished to see miracle with these simple points,and treatment. After just 7 sittings , nearly all his complications were gone.and till now after 2years there is no recurrence of any symptom.
Synopsis: Till now I had treated more than 30 cases ,having these symptoms , and I’ve got excellent results. I’ll request to all my acupuncturist friends to use these simple points to treat these kind of symptoms ,and have good results. May god bless all.

Chinese Medicine Treatment of Bloating


Chief Complaint: gas,severe bloating, diminished ability to flatulate
Western Diagnosis: stress
Medical History: Walks daily, married 57yr old but doesn’t live with wife (both are happy in this arrangement) has suffered from clinical depression for years and sees a psychiatrist, average diet not in excess, slim except for protruding stomach, accountant for school which is very stressful, hypochondriac pains
Questioning exam: likes cold fluids, thirsty a lot, healthy appetite but bloats excessively after meals, hard to fall asleep, has anxiety at night, constipated-every 3rd day, poor energy, mind is cloudy most of the time, cold feet all the time, poor memory, lumbago at night, sharp twinges in the heel, leg cramps at night, neck and shoulders get stiff when stressed.
Pulse exam: left-rapid, HT weak and thready, LV wiry, yin wiry and thin
right-rapid, LU thready, SP wiry, yang wiry
Tongue exam: red, peeled, swollen, deep centre crack, deep transverse cracks at middle warmer
OM Diagnosis: excess heat in the middle warmer
wood overacting on earth
qi stagnation
-everything is “stuck” which is why he bloats so excessively, nothing is moving!
Treatment Principle: drain heat, move LV Qi, tonify Sp
Point Prescription: Ki1(first), Ki3,6, LV3+LI4, GB 34, ST36,37
Ren 12, ST25, LV 13,14 PC6, YinTang
DU20 (last)
(and why did you use kidney 1?)
My theory is to needle Ki1 first so that I attract the Qi downwards first, then Du 20 last to balance. I use these 2 points a lot in a needle prescription for hypertension. It works great (as long as the patient is comfortable being poked in his sole) ha ha.
Herbal Formula: I knew herbal formulas were the most important element in this case. Points would help to move the Qi, but I knew herbs would have a more aggressive effect on draining heat so I used granules (KPC)100g
Long Dan Xie Gan Tang-1 tsp w/hot water in the morning
Yue Jue Wan-1 tsp at night
I instructed the patient that the he was to be in charge of the herbs. As soon as his bloating diminshed, he was to cut down (every other day) on Long Dan. But he was to continue with Yue Jue Wan at night until finished.
Lifestyle Prescription: To continue walking as movement is good for this fellow.
see me once a week.
Results: 7 treatments so far, patient reported improvement(bloating minimized) after 1st treatment. After 2nd, he noticed he started to feel less stressed(no matter how busy work was)felt generally happier, he even told his psychiatrist that my treatment was helping him more than the expensive shrink!, 3rd treatment his bowel movements improved almost once a day now. 4th treatment reported a steady improvement in his digestion, way less bloated, can pass gas now. Patient noted that after the first night of taking Yue Jue Wan he could feel things “moving”. 7th treatment now is just a maintenance treatment extended to once a month
Synopsis: Knowing that the Heat diagnosis was a 2 fold issue, excess on the surface but from a yin deficiency underlying. My goal was to treat the branch first(of course)and nourish the yin later.Points would help with that.

Acupuncture for Sinusitis

Chief Complaint: Sinus problems
Medical History: Onset 5 years ago. Drinks 2 cups coffee daily.
Questioning exam: Sinus congestion and headaches worse with dairy and wheat. However no symptoms are used to make a Five Element Diagnosis.
Pulse exam: Pulses indicated exit-entry blocks between LV and Lu and LI and St.
Tongue exam: n/a
OM Diagnosis: Wood Causative Factor – inappropriate anger, rancid odor, shouting voice and green color lateral to the eyes.
Treatment Principle: Clear blocks (AE, entry/exit, etc) and support Causative Factor at spirit level
Point Prescription: First Treatment:
Cleared AE with Back shu points – sedation technique, needles just under the skin.
Lv14,LU-1
Kd-24, Head above tears, GV-12
Source points of wood.
All points treated with moxa and tonifying needling technique
Herbal Formula: n/a
Lifestyle Prescription: Increase water intake to half her body weight in fluid oz per day minimum. No coffee consumption.
Results: Significant improvement with sinuses, relief of pressure and absence of infections.
Synopsis: Cleared blocks and supported Wood meridians.

Heroin Withdrawal Treated with Acupuncture and Herbs


Chief Complaint: Heroin Addiction
Medical History: The patient presents as a 27 year-old male from New Orleans, LA. He began using heroin intravenously one year ago and had previously suffered an attack of acute pericarditis, which was successfully treated in the emergency room. The patient was eager to quit heroin and no longer associate with his user friends. He had not used heroin in 3 days, but admitted to chain-smoking cigarettes to ease the cravings.
Questioning exam: Chief complaints: Irritability, insomnia, anxiety, heroin cravings, thirst, depression, constipation, poor appetite.
Pulse exam: Pulse examination revealed thready (fine)and rapid heart and lung positions, with wiry liver position.
Tongue exam: Tongue examination revealed red petichae along front and side edges, with mirror-like red tongue surface and small yellow coating in the rear.
OM Diagnosis: TCM pattern: Yin deficiency affecting heart and lung due to drug intoxication.
Treatment Principle: Treatment method: Nourish Yin, sedate cravings
Point Prescription: Auriculotherapy along with acupuncture was used in a series of 12 treatments (four per week for 3 weeks) with 3 subsequent follow up treatments. Ear: Shenmen, Balance, Sympathetic, Heart, Lung. Acupuncture: Liv 3, Li 4, Lu 7, K 6, Yintang, Du 20, Sp 6
Herbal Formula: Herbal: Jia Wei Xiao Yao Wan (15/tid) was given for sedation, which the patient responded to quite well.
Lifestyle Prescription: The patient surrounded himself with family and friends for support and, due to a near-fatal encounter previously, he was ready to change his life and give up his heroin addiction permanently.
Results: The patient successfully withdrew from heroin and cigarettes, and felt acupuncture and herbal medicine greatly reduced his cravings. Coupled with a healthy diet and walks on the beach, the patient’s bowel movements returned to normal. He resisted the tempation of relapse and has kept in touch over the last 5 years. The last I heard, he had just opened his own retail store in Manhattan.

Acupuncture and Herbs for Bladder Infections


Chief Complaint: burning urination with possible blood
Western Diagnosis: urinary tract infection
Medical History: 54 y.o. female with hx of multiple sclerosis for 26 years, uses wheelchair and cane for ambulation. Weakness in left leg needing assistance to move. Chronic history of urinary tract infections, several a month. Uses a catheter bid for voiding.
Questioning exam: urination: burning when beginning stream, frequency and desire to void is nearly constant. Describes a foul odor, dark yellow color, scanty amount. Reports feeling uncomfortable and “anxious.” no change in bowel movement or appetite. Sleep is restless due to freq urinating and restless leg syndrome. body feels tired and heavy. No h/a, slight pain along right temporal area of head and into jaw. Very thirsty but does not want to drink b/c believes she will have to urinate more.
Pulse exam: t: thin, red dry in middle jiao with dry thin white coat in middle jiao. slv: dark and distended. tender sides with scallops and slight quivering.
p: thready and slightly rapid.
Tongue exam: as above
OM Diagnosis: Blood Lin: acute Damp heat toxin in lower jiao with underlying kidney and liver yin vacuity with poss. yin xu heat.
Treatment Principle: clear heat, transform damp, resolve toxicity, stop bleeding, nourish liver and kidney yin and clear vacuity heat.
Point Prescription: She has been treated for this before throughout her TCM hx. I recommended she call her urologist and pcp for an appointment for urinalysis: and to seek primary care if fever begins.
Herbal Formula: mayway granular made:
liu wei di huang wan 40g
zhi mu 8g
huang bai 10g
pu gong ying 10g
zi hua di ding 10g
zhi zi 10g
e jiao 8g
huang lian 10g
huang qin 10g
wu wei zi 10g
Lifestyle Prescription: maintain water intake, no spicy greasy foods, no breads or white flour
clear bland diet of broths and rice and bitter greens.
Results: within two doses she actually slept through the night which she hasn’t been able to accomplish in months. She did not see any blood in the catheter the next morning. reported a decrease in the urgency and denies pain. still watching it. course of herbs is 10 full days.

Acupuncture and Oriental Herbs for Rheumatoid Arthritis


Chief Complaint: joint pain
Western Diagnosis: rheumatoid arthritis
Medical History: Female, 34 years old, physical therapist. Joint pain since she was little. Has seen regular physician. Take low dose prednisone off and on.
Ankle, knee and hip joint pain bother her a lot. Recently the both knee swollen, pain, feeling warm and affecting function.
Questioning exam: like cold drink
feel warm
constipation
sore throat
Pulse exam: slippery pulse
Both knee joint warm
Tongue exam: red tongue with thin yellow coating
both knee swollen
OM Diagnosis: Bi Syndromes ( heat & dampness)
Treatment Principle: clearing heat and removing dampness
Point Prescription: St.34 St.35 Xiyan(extra) G.B.34 G.B 33 St.36 Sp.9 L.I.11
Herbal Formula: Lian Qiao15 Chi Xiao Do30 Fang Feng 10 Gui Zhi5 Ci Shao10 Yin Dong Teng30 Seng Jiang3 Qiang Huo15 Sheng Gan Cao3
(all unit is Gram)
Lifestyle Prescription: rest, avoiding walking a lot.
Results: This patient has been seen me for a while, at beginning my treatment was for her joints pain. She got a lot of improvement from the treatment.
The knee swollen happened in July, just before I left California, I just know she was better, I have no following up with her. The reason I put this case for you is I would like people know how to treat this situation of rheumatoid arthritis. I don’t think this kind patient will see us by themselves or be refereed by a regular physician. The reason she believe acupuncture with me is I cured her menstrual problem with herbs.

Acupuncture and Herbs for Allergies


Chief Complaint: allergies
Medical History: Patient is a 30 year old male, sedentary lifestyle,diet includes much dairy and spicy foods, no excessive smoking or drinking.
Questioning exam: Patient reported being under stress and feeling very congested with yellow phlegm, a lot of sneezing, itchy watery eyes, fatigue, and a sensation of heaviness in his head. Condition was worsened by the drafty environment he worked in.
Pulse exam: Pulse was slippery and somewhat weak
Tongue exam: Tongue was puffy, had a purple middle and a red tip.
Eyes were red.
OM Diagnosis: The patient had a mixture of qi stagnation, damp heat and phlegm accumulation in the upper burner as well as spleen qi deficiency. Qi stagnation was from the stress and damp obstruction. The indicators of heat were yellow phlegm, red eyes, and red tip of the tongue. Also there was some spleen qi deficiency which led to the damp accumulation.
Treatment Principle: Clear damp heat and phlegm, tonify the spleen, and move qi.
Point Prescription: Acupuncture points were shishengong, du 23, yin tang, bitong, si 18, ren 17. On the left side, li 4, sj 5, li 11, spleen 9, spleen 6, liver 3. On the right side, lung 7, lung 10, heart 7, st 36, st 40, gb 34.
Herbal Formula: Patent formula from Golden Flower of Jade Screen and Xanthium (Yu Ping Feng Jia Cang Er San).2 3Xdaily
Lifestyle Prescription: Suggested he eat less dairy and spicy foods as well as staying away from very cold foods. Encouraged him to start a mild workout program and progress from there. Told him to wear a scarf when the weather was windy or cold as well as at the office.
Results: Results were good. He reports no bad bouts with allergies in a year.
Synopsis: Patient was treated over a period of 2 months. He began with 2 treatments per week for the first 3 weeks; then cut down to once a week. Following the 2 month period, he came in twice during the next 3 months but continued to take the herbs regularly. He complied with the other suggestions but did not work out as regularly as advised. Results were very good.

Acupuncture for Huntington’s Disease


Chief Complaint: Muscle Tetany
Western Diagnosis: Huntington’s Disease
Medical History: A 50 year old male collage professor. Two years ago began noticing he had difficulty thinking clearly. Soon after, his hands began to become shaky and he gradually degenerated more and more. Finally, he was unable to walk on his own or change his own clothes. He could not read anymore and suffered some dementia. He also had difficulty eating.
Questioning exam: The patient had a slightly purple complexion with very tense and slightly atrophied muscles. He had a slight tremor. His appetite was good, however he was unable to eat much. He was slightly constipated with soft stools and had frequent urination. He had no other physical complaints.
Pulse exam: His pulse was deep and week in all positions with a moderate rate. His left side bladder channel was very tight and contracted giving him a curving appearance to the left in his back.
Tongue exam: His tongue appeared slightly purple and deviated to the left. It also quivered slightly and was difficult to stick out.
OM Diagnosis: His pattern was described as qi and blood stagnation, internal wind, and spleen and kidney deficiency.
Treatment Principle: Promote qi and blood circulation, tonify the deficiency, and disperse the wind.
Point Prescription: The treatment was two stage and given two times per week.
First, GB20, Bl13, Bl15, Bl18, Bl20, Bl23 warming needle moxa, Bl 52 warming needle moxa, GV4 warming needle moxa, Bl40, and Ki3 with moxa.
Second, Zhu scalp motor zones bilaterally with electricity 100/10 mixed wave for 35 minutes to patient’s tolerance.
Herbal Formula: None given.
Lifestyle Prescription: 30 minutes of tuina before acupuncture and one massage per week.
Results: Results were very good. After 5 weeks of treatment the patient was able to walk unassisted for about 20 feet and was able to change his clothes on his own. He also reported an increased ability to read.
Synopsis: The key to his treatment was the scalp acupuncture. He had gotten TCM style acupuncture alone from another acupuncturist in the same office for several months with no change in his condition. As soon as we added the scalp acupuncture treatment to his protocal a change began to start.

Acupuncture and Herbs for Osteoarthritis


Chief Complaint: pain and stiffness in both thumbs
Western Diagnosis: osteoarthritis
Medical History: P is 54yr female currently menopausal, @40lbs overweight, has a hx of auto-immune disease in form of psoriatic arthrosis is the lumbar spine. overuse of yoga triggered the disease. Also has minor patches of psoriasis on legs and arms. Diet is rich in dairy, wheat, sugar, salt and wine.
Questioning exam: pain in the first and second joints of both thumbs, constant, stiffness, lack of manual dexterity, weakness, no heat signs, some swelling, pain on palpation. Additional signs include: onset of night sweats and hot flashes recent, low back pain worse in am. pain in thumbs is fixed and ranges from dull ache to sharper more intense pain. Stressful work environment, some insomnia, digestion is good. Patient historically prefers warm, feels cold but due to onset of menopause is beginning to warm up.
Pulse exam: Pulse is generally weak, small and has a slippery aspect. Kidney position is weak and deep.
Tongue exam: tongue is pale dusky and small. less to no coat.
OM Diagnosis: damp bi pattern
Kidney yin w some def heat
Kid yang def
Damp spleen
Treatment Principle: expel wind, move blood stop pain
tonify Yin and Yang
Drain damp, tonify spleen
Point Prescription: Lung10 sedate
Baxie 1st and 2nd fingers
Low back Du and UB points
UB 40, 62, SI3
Kid 3, 6
Spleen 9
Herbal Formula: Patient is not open to taking herbs at this time.
I would prescribe a remove wind and damp formula as well as a modified du huo ji sheng wan type formula with herbs to address the yin def.
Lifestyle Prescription: far infrared and moxa are very effective for both the hands and low back. this helps me rule out heat as a pathogenic factor in the hands. I also use a topical yuk jiao formula for the hands.
Results: Patient is basically maintaining a pain free existence with weekly acupuncture tx. The addition of herbs would probably reduce the frequency needed.

Acupuncture Treatment of Arthritis in Thumb and Wrist


Chief Complaint: Pain in right thumb and wrist
Western Diagnosis: Arthritis
Medical History: Pt. is a 52 yo dental hygienist who presented with painful wrist and thumb that threatened to force her to quit her job. Problem began 9 or 10 years ago and has gotten progressively worse. Her health history is unremarkable, although she had a benign lump removed from her right breast approximately 10 years ago. Her diet is relatively good but she has a great deal of stress due to her aging parents. Sleep and digestion are good.
Pulse exam: Pulse somewhat wiry.
Tongue exam: Tongue purplish
OM Diagnosis: Bi syndrome.
Treatment Principle: Expel bi
Point Prescription: I found a very tender point near SP4 on her left foot according to the Richard Tan balance method, and needled that. I also found tender points on her right ear corresponding to the scar on her right breast, and needled those. This makes sense according to the German acupuncture approach, according to which scars are major blockages to healing. In this case, the patient’s scar was right on her right lung meridian, which runs through the painful thumb.
Results: After 8 treatments, her thumb is 80% improved.

Chinese Medicine for Migraine Headaches


Chief Complaint: Migraine Headache
Medical History: Ten year old male, complaining of migraine headaches which occur at any time of day. He had been having them since he was five years old. The H.A. would usually cause him to vomit. Prior to the onset of H.S he would see black spots, have ear ringing.
He would be very active while sleeping, kicking off the covers, tossing & turning. Red /purple color under the eyes (lower eyelid). He has a poor diet, very picky eater. Had problems in school.
Questioning exam: Headache that began behind the eyes and went back along the side of the head.
Tenderness at Lv3, Gb41,42, Lv14 and along the Gb channel on the head Gb 8-Gb20
Pulse exam: Pulse was weak & slow upon initial evaluation.
On the second eval the pulse was more wiry esp Sp & Lv but Ki was deficient.
Tongue exam: the body was pale except the tip & the right side which were red. There were also prickles evident.
OM Diagnosis: Lv yang rising due to Sp qi deficiency.
Treatment Principle: Tonify sp qi, sedate Lv yang, smooth Lv qi.
Point Prescription: Lv3,8, Sp 6, Sj5, Gb20,43
Herbal Formula: Formulae – Xiao Yao wan & Ba Zhen Wan
Lifestyle Prescription: Dietary changes – eliminate chocolate, citrus fruit, tryamines.
Eat less junk food and more home made foods.
Results: The patient has only had two H.A. since January when he started treatment. Each time ti came on the heels of an illness. Otherwise the pt is free of H.A. and was doing much better in school, not even missing any days. He was initially treated twice weekly, then was stepped down to once a week. Then he stepped down to once a week and after April he was stepped down to once every other week. This is the current regimen.

Acupuncture and Herbs for Chronic Insomnia


Chief Complaint: Cannot sleep for ten years
Western Diagnosis: Chronic Insomnia
Medical History: Patient is a 44 year old female. She has a history of seeing various physicians without adequate results. She has no history of smoking, alcohol or drug abuse. She tends to her garden at home but does no cardiovascular exercises.
Questioning exam: Patients shows signs of depression, stress, and fatigue. Bowel movement and urine are normal.
Pulse exam: Pulses CUN and GUAN are thin and weak, showing that the heart and spleen are deficient.
Tongue exam: Tongue is pale and pink with a thin white coating showing a blood deficiency. Her face appears pale and tired.
OM Diagnosis: Her interrupted sleep patterns appear to be the result of heart and blood deficiency. With a heart blood deficiency, this sets up malnourishment of the brain thus setting up insomnia. This results in further depression and stress. As a result of this her spleen is not fully functional. This creates further fatigue. This results in a pale tongue, pale face and thin and weak pulse.
Treatment Principle: Basic treatment is to stimulate the heart and spleen in order to tonify the Qi and blood. This in turn soothes the mind.
Point Prescription: In order to tonify the heart and spleen I used the following points. zu san li(both sides), Quchi. For soothing the mind I used Shen men (both sides) and shen men in both ears. She came in for treatment once a week for 4 weeks.
Herbal Formula: Gui Pi Tang(Ginsing and Longan Combination). 5 packages a week in solution. Drink twice a day for one month.
Lifestyle Prescription: Increase her cardiovascular exercise to 20 minutes of walking 3 to 5 times a week. Avoid spicy food. Learn the process of meditation.
Results: Patient showed improvement in one week. After 4 treatment weeks insomnia is relieved.
Synopsis: Patient was encouraged to make follow visits at least once a month to extend results, monitor her depression and stress.

Acupuncture and Herbs for Chronic Bronchitis


Chief Complaint: Chest congestion with cough that started in the fall 3 years ago
Western Diagnosis: chronic bronchitis
Medical History: Medical History:
a. History of Present Illness: The patient has been suffering from chest congestion with cough for over three years. The condition usually worsens in the months of October and November. It becomes aggravated with heat. 14 days ago it worsened and became a cold. The days before she got the cold, she went and took saunas and steam baths regularly for therapeutic reasons. She was hoping it would help her chest congestion. Two weekends ago it manifested as a cold. She has a dry, hacking cough. The cough contains phlegm which is difficult to expectorate and the color of it is yellow. In addition she has yellow sticky nasal discharge. She feels depressed that she is not feeling well.
b. Current Health Status: The patient complains of having chronic bronchitis which has been diagnosed by a medical doctor. When she had a cold she used “ibuprofen” to reduce the fever. Afterwards she used “cold calm” which is a homeopathic cold tablet. In addition she took multivitamins as supplements. She visited PCOM-clinic at 05/16/02. The acupuncture treatment and the herbs prescribed improved her energy level but didn’t completely resolve the chest congestion. She still feels fatigued after recovering from the cold. . She feels slightly depressed from not feeling well. She complains about not having restful sleep. She reports no dreams. She does not sweat any more but in her past she had sweating episodes in the morning. Her appetite diminished during the cold attack but today it is back to normal. She eats three meals a day consisting of meat, vegetable and starch and has no particular cravings. She reports no bloating or abdominal pain after eating. She has bowel movements once a day and they are usually well-formed. The patient describes her self as a little bit more thirsty than normal. She drinks 4- 5 cups of liquid. She prefers warm drinks and she drinks mostly teas. Her urine is bright yellow and she urinates 6-7 times a day. She also usually wakes up once during the night to go to the toilet. There are no complains of headache or body pain .She reports premenstrual problems manifesting as heavy cramps , anxiety and breast hardening. Her menstruation started 9 days ago. It flowed for 4 days. The color of the menstruation was bright red with dark red colored clots. The first two days she was bleeding heavy. On the third day it was a medium flow until it subsided the fourth day. During the treatment the patient reported great sensitivity on the balls of her feet and to a lesser extent over the whole bottom of the feet. She was embarrassed of a long lasting fungal infection on the feet which began in-between the toes and now is mostly on the nails.
c. Past Medical History: Her last medical physical exam was 2 years ago. She has been diagnosed with drug allergies, asthma bronchitis and urinary tract infection. In 1980 she was hospitalized for pelvic inflammation disease and she was treated for an ovarian cyst.
d. Family Health History: Her mother has high blood pressure and is 82 years old. Her father is 67 and is suffering from a heart disorder.
Questioning exam:
Chest congestion
coughing up yellow phlegm that is difficult to expectorate
Nasal discharge that is yellow and sticky
fatigued
Pulse exam:
Slippery pulse
Tongue exam:
Thick white tongue fur
Reddish tongue body
More red on the tip
Central crack
Slightly more thirsty than normal
OM Diagnosis:
a. The location of the disease has progressed internally.
b. The disease involves both deficient and excess components.
c. The disease involves heat.
d. Diagnosis – exterior cold with damp stagnation turning into heat and phlegm.
The patient has been suffering from chest congestion with cough for 3 years. The patient is not a smoker. The condition usually worsens in the autumn. It probably started out as a cold which never was resolved. The disease then progressed inwardly damaging the lung qi and leading to chronic chest congestion with a cough.
Fourteen days ago she got a cold. The saunas and steam baths she took prior to this may have aggravated her underlying chronic condition and made her less resistant to evil pathogens. The lung is the most vulnerable organ because it is in direct contact with the environment. By going to the sauna she exposed her skin and pores to the environment, possibly further injuring her protective qi and thus allowing the pathogen to enter. At the time of the attack the weather was very cold. There may have been a wind-cold pathogen invading the body.
When the patient consulted us there where more or less no signs of wind-cold. There were more signs of heat and phlegm. I therefore suspect that the pathogen has entered the interior and attacked the lung organ.
The lung’s function is to disperse and descend qi and body fluids. The patient’s cough was caused by lung qi which was not descending properly due to an obstruction. Normally, the lung sends qi down to the kidney. If the kidney fails to grasp the qi, it rebels upward, impairing proper respiration.
Impairment of qi and fluid circulation in the chest leads-to chest congestion. Exterior wind-cold pathogens also impair circulation as cold tends to constrict. It is said that the spleen makes phlegm and the lung stores the phlegm, the patient was coughing yellow phlegm which was difficult to expectorate. This leads me to think that the patient’s ability to transform the fluid was interrupted. The lungs normally receive pure vapor from the spleen, disperse the clear fluids throughout the body and send the impurities down to the kidney. Instead of descending, it seems that the impure fluid has accumulated and led to the retention of phlegm in the lungs. Over time, this obstruction has given rise to heat. Slight thirst and phlegm which is difficult to expectorate may have arisen due to this heat consuming the body fluids. It is said that the lung opens into the nose. An impairment of the lung’s functions of dispersing, protecting and nourishing would explain the patient’s nasal congestion. The yellow, sticky nasal discharge tells us that heat and dampness is involved.
The lung and the spleen are the main organs involved in making qi. The long-standing congestion and the attack by an exterior pathogen have weakened her lung and spleen qi. Over time, this has fatigued the patient to the point that she feels depressed.
Considering the patient’s tongue, pulse and nasal discharge leads me to believe that there is some damp or phlegm-heat lodging in the interior. The thick white coating at the back of the tongue is an indication of excess turbidity of the stomach and spleen. The patient may have started out with a thinner coat in the front, but the thickening in the back of the tongue indicates that the pathogen has moved to the interior. We would suspect to see a yellow coat if there where heat involvement but I believe because we are looking at a long standing cough it is not yellow any more. The reddish color of the body confirms the presence of heat. The redness of the tip of tongue makes me think of heat in the upper burner. The central crack or groove tells me that there may be some spleen deficiency involved and heat injuring the fluids. The dampness is reflected in a viscous-feeling, slow and slippery pulse. The deep pulse indicates an interior condition.
Overall this patient reflects a dysfunction of the qi and body fluids. The main organs involved are the lung and spleen. The chronic congestion has led to damage of the lung qi and weakened the protective qi, thus allowing a pathogen to enter the body and disrupt the interior. The long standing fluid impairment has caused heat and phlegm to linger in the lung.
Treatment Principle: Drain Damp, Clear heat and Transform Phlegm.
Point Prescription: Acupuncture Points:
LU1 -front mu : clears and diffuses the upper burner and courses lung qi.
LU7 – luo connecting. : diffuses lung
- command head : specifically back of head, nape of neck
LI11 – he-sea, earth : courses pathogenic heat, eliminates water damp.
ST40 – luo connecting : transforms phlegm damp.
LI20 : unblocks nose and clears qi fire.
YINTANG – extra points : quickens collaterals, quiets the spirit.
UB67 -jing well, metal : rectifies qi and clears the brain.
. Acupuncture Analysis:
1. LU1 – is where the lung qi collects. It is the first point on the exterior channel. Therefore it is an effective point for cough and transforming the phlegm.
2. LU7 – it has an interior and exterior relationship with the large intestine channel which goes to the face. It regulates the body fluids and qi in the head and face relieving nose obstruction and phlegm accumulation with a cough.
3. LU1 and LU7 create movement in the chest and relieve qi constraint thereby inducing proper respiration.
4. LI 11- is the earth point and therefore the mother point of a metal channel. The fact that it is a he-sea point indicates that it can be used to treat more interior conditions. As this point also clears heat, it is a good tonifying point for coughing up yellow phlegm that is difficult to expectorate.
5. ST40- the stomach channel travels over the chest goes to the face and normalizes the sense organs. The spleen makes phlegm, the lungs stores phlegm. Thus, this luo point which stands in an interior and exterior relationship to the spleen, is a very good point for chest pain caused by phlegm. It benefits the lung to disperse the body fluids.
6. LI20 – is a local point of the upper or yang part of the body. Thus, it is good for clearing heat signs, like yellow nasal congestion – also exterior and interior relationship to lung
7. LI11, ST40 and LI20 all belong to the yang-ming channel. These channels are both abundant with qi and blood. The stomach channel is also the only yang channel traveling along the front of the body. This combination of points has a quality of supporting the transformative action of the spleen. At the same time they can clear heat and benefit the fluids.
8. YINTANG – is a nice point to calm down the patient and clear the nasal passage
Herbal Formula: Herbs (Patent Medicinal)
Clear the qi and transform the phlegm pill; QING QI HUA TAN WAN
DAN NAN XING – transforms phlegm heat
BAN XIA – dries dampness, transforms phlegm and causes qi to descend
GUA LOU REN – transforms phlegm heat and expands the chest
HUANG QIN – clears heat and dries dampness
CHEN PI – improves the transportative function of spleen, dries damp and transforms phlegm
XING REN – stops cough
ZHI SHI – transforms phlegm and redirects qi downward
FU LING – strengthens the spleen and transforms phlegm
d. Herb Analysis:
These herbs primarily address the symptoms of cough with phlegm which is difficult to expectorate and chest congestion.
Most of the herbs in this formula affect the qi and body fluids. They improve the dispersion action of the lung by clearing heat and redirect qi downward. At the same time they support the spleen in transforming and transporting the fluids. “The fire and phlegm interfere with the descending function of the lung qi, which leads to coughing with sputum that is difficult to expectorate” (Bensky 1990).
Dan Nan Xing strongly drains phlegm heat from the lung; Huang Qin and Gua Lou Ren reinforce Dan Nan Xing and work together to clear phlegm heat from the lung. Zhi Shi and Chen Pi both regulate the middle burner and assist in transforming phlegm. Fu Ling supports the transformation of damp and phlegm. Xing Ren stops cough and Ban Xia strongly expels the phlegm.
Working together, the herbs will disperse any chest obstruction which would lead to the greater accumulation of phlegm heat.
“When there is a surfeit of qi, fire results, when there is surfeit of fluid, phlegm results. Therefore in treating phlegm it is necessary first to direct fire downward, and in treating fire it is necessary to smoothen the flow of qi.” (Wang Ang in Analytic Collection of Medical Formulas, Bensky 1990, p.437)
Lifestyle Prescription: None
Results: Slowly improvement over three weeks periode. At a checkup, after 3 month has passed, she still felt very good.
Synopsis: Overall this patient reflects a dysfunction of the qi and body fluids. The main organs involved are the lung and spleen. The chronic congestion has led to damage of the lung qi and weakened the protective qi, thus allowing a pathogen to enter the body and disrupt the interior. The long standing fluid impairment has caused heat and phlegm to linger in the lung.

Herbs and Acupuncture for IBS Diarrhea


Chief Complaint: chronic diarrhea
Western Diagnosis: IBS
Medical History: 34 year old Caucasian female, bookkeeper. Presents with scoliosis, lower and upper back pain, irregular menses. Patient does not exercise and eats lots of fried foods.
Questioning exam: Patient sighs frequently, has breast tenderness, distention, bloating and gas. Chronic dawn diarrhea with undigested food and mucous. Symptoms increase with menses. Patient has a heavy flow with many, large clots and dark blood. She sees floaters and frequently feels hot. She has seasonal allergies.
Pulse exam: Pulse is wiry, especially in the guan position.
It has a rolling quality at the deepest level.
Rate is normal, moderate.
Tongue exam: Tongue is red with yellowish coat that is thick in the lower jiao.
OM Diagnosis: Patient has chronic diarrhea d/t liver qi stagnation overacting on the spleen. The liver qi stagnation is causing mild heat and the spleen weakness is causing some damp accumulation.
Her menstrual symptoms strongly indicate Liver involvement and her digestive complaints display a weak spleen.
Treatment Principle: Soothe and disperse the Liver qi, tonify the Spleen.
Point Prescription: Liv 3, GB 34- move liver qi
Liv 13- Sp mu pt
LI 11- clear heat
LI 4 – four gates
Herbal Formula: Si jun zi tang + chen pi
Xiao yao san
Lifestyle Prescription: Avoid spicy, fried, and dairy foods.
Results: Patient reports improved digestion, less gas and bloating, but still having 2-3 loose bowel movements each day. There is less discomfort overall. Patient has not had a period yet.
Synopsis: I didn’t feel it was appropriate to use a lot of warming herbs on her bowels because of her heat signs.

Herbs and Acupuncture for Amenorrhea


Chief Complaint: sporadic menstrual cycles
Western Diagnosis: amenorrhea
Medical History: 27 year old female triathlete. Runs, bikes, skis. Menstrual cycles sporadic since age 16. Diet fairly balanced, except red meat and iron rich foods lower than needed. Until recently patient worked three jobs.
Questioning exam: 1-2 menstrual cycles a year presenting with low back cramping, onset with brown blood, duration 3-4 days, ending with brown blood. Flow remains light throughout cycle. Fatigue during cycle. especially. Low grade anxiety, cold hands and feet, slight constipation, occasional floaters, and sometimes hard to fall asleep, especially prior to onset of cycle. Patient also complains of “coming down with every cold that comes along”.
Pulse exam: Pulses on left overall choppy and thin. Pulses on right soft. Especially notable are the Heart, Liver, and Spleen pulses, as they are the weakest.
Tongue exam: Pale, thin, with redder tip, some scallops, and slight central crack.
OM Diagnosis: Blood Deficiency, general Qi Deficiency.
The three pulses that were the weakest are of the Organs involved with Storing, Holding, and Controlling the Blood. The menstrual blood is brown and is not sufficiently produced showing a Deficiency. Not falling asleep easily leading into the cycle, general anxiety, constipation, and achy low-grade cramping also signify Blood Xu, but also the type of pain and the fact that the Wei Qi is easily overcome shows the Qi Xu also. Qi and Blood need each other. Also the tongue is pale and thin, which signifies that Qi and Blood are affected. The scallops are in the Central Jiao area, showing the Central Qi is affected. The slight central crack is showing that the chronic Blood Xu is beginning to affect the Yin.
Treatment Principle: Nourish Blood, Tonify Qi, Benefit menses
Point Prescription: Spleen-6, Spleen-4 & Pericardium-6, CV-4, Liver-8, Lung-7 & Kidney-6, Stomach-36, Tonify.
Herbal Formula: Si Wu Tang modified; Shu Di Huang (12 grams), Bai Shao(10 grams), Dang Gui (10 grams), Chuan Xiong (6 grams), E Jaio(6grams), Huang Qi(10 grams), Bai Zhu (8 grams), Da Haung (3 grams) Granular Formula- 2 gram-spoonfuls, 3x daily after food in warm water.
Lifestyle Prescription: Patient advised to eat small amounts of organic red meat daily and to incorporate more iron-rich foods in diet. Also advised to not overwork, including exercising. Patient is seen for acupuncture every one to two weeks.
Results: When patient is in compliance with formula, she has a menstrual cycle. Last cycle was heavy, which is unusual for her and so she stopped her formula instead of coming in for treatment, assuming the formula made her bleed too heavy.

Oriental Medicine for Prostatic Carcinoma


Chief Complaint: Pain in spine, knees, and legs from metastatic disease
Western Diagnosis: Prostatic Carcinoma
Medical History: Until onset of the pain six months before first acupuncture treatment, patient reports leading a healthy, active, and pain free life.
Questioning exam: Patient reported night sweats, some hearing loss in both ears, high blood pressure, urinary frequency with light flow, and pain in knee, back, and hip.
Pulse exam: Floating in upper and middle jiao, weak in lower jiao. Palpation revealed depressed and inactive area around Ren 3 through Ren 6; congestion at Ren 17; depressed and inactive at Ren 14.
Tongue exam: Tongue was red, no coat, and cracks on sides and in back.
OM Diagnosis: Heart, Liver, and Kidney Yin deficiency and Kidney Yang/Essence deficiency.
Treatment Principle: Tonify yin, replenish marrow, tonify yang, astringe qi (qi was escaping body at bottom and feet and finger tips) and stimulate immune system.
Point Prescription: sj5(b), UB13(b), UB23(b), D4, UB28(b), UB32(b), UB40R, Sp9(B), GB34R, UB58R, GB33(L), GB34(L), St36(L), Liv 8(L), Ki10(L), K5(b), UB64R, Ki3R
Herbal Formula: Liu Wei Di Huang 8(3x)to tonify yin, strengthen kidneys and immune system, and Deep Defense TM by Rainbow Light to build immune system.
Lifestyle Prescription: Qi Gong therapy was administered to patient by practitioner for about 11 of the 14 treatments. Patient was also instructed to perform Qi Gong exercises on his own to cleanse body of turbid qi and strengthen vital qi.
Results: Acupuncture Treatments began January 12, 2002 and ended February 23, 2002. Herbal treatments began January 12, 2002 and continue to present with patient taking both herbal remedies. By April 2002, examination by D.O. showed cancer had gone into remission and there was no evidence of bone bone metastatic disease as shown earlier with MRI.
Synopsis: It is my belief that the patient’s immune system, strengthened by acupuncture, herbs, qi gong, and the patient’s fighting spirit, eradicated the disease

Acupuncture for Pain and Swelling in Ankles and Feet


Chief Complaint: pain and swelling in ankle and feet, alcohol abuse
Medical History: Patient: 53 year old female
Occupation: art student
History: family history of alcoholism, pain in legs since 1978
Current presentation: Patient has stiffness and swelling in her feet and ankles making ambulation difficult. The pain is 8-9 on a scale of 0-10 with deep, heavy, sharp quality that is worse at night. She can recall no injury or precipitating factors. Feet are cool to touch, soft, pale with non-pitting edema. The patient smokes and drinks six beers a night. She eats cold foods for lunch.
Symptoms: Patient is stressed with school work, and has a sensation of something in her throat. She has poor sleep and reads to fall asleep. Appetite is poor with an energy drop at 3pm. She has fatigue and states that legs bruise and bleed easily. Other symptoms are dizziness, ringing in the ears and eye strain with blurred vision. Patient wears glasses for reading. She is up twice a night to void and has loose stools which change to hard when anxious. Her back and knees are sore and weak and hips are stiff.
Questioning exam: low back and knee pain, ankle swelling that is pale and cool, tinnitus and up twice a night to void
painful, cool ankles that is deep and heavy.
Sharp feeling may be from cold causing some blood stasis as well
loose bowel movement, poor appetite, afternoon energy drop and easy bruising
curdy center of the tongue coating and slippery R guan pulse
plum-pit syndrome with feelings of stress.
Based on age, early menopause, smoking and alcohol habit, blurred vision and difficulty falling asleep this patient may also have an underlying Liver/Kidney yin deficiency but this was not viewed as significant at this time and was not addressed.
Pulse exam: Pulse: L-thin, weak R- slippery guan position, weak cun, weak, deep in chi
Tongue exam: pale, pink, purple, puffy with central crack to tip with thick, curdy center coat
stiffness and swelling in her feet. feet cool and pale
OM Diagnosis: Ki yang deficiency, cold-damp bi in ankles/feet
Spleen Qi deficiency with damp
Liver Qi and phlegm stagnation
Signs and symptoms supporting diagnosis:
Treatment Principle: tonify Kidney yang. Drain damp. Alleviate pain
Tonify Spleen Warm Qi. Move Liver Qi. Resolve phlegm accumulation
Point Prescription: tonify K7, K3 plus moxa to warm and tonify Kidney yang
tonify Sp6, St36 to promote Spleen Qi
sedate Sp9, St41(local point) to drain damp
even method for Liv3/Li4 to calm and promote movement of Liv qi
No herbal formula was given. With reduction in alcohol intake this will be an option
Patient was instructed to warm and dry feet after showering with a hair drier.
The benefit of cooked foods on digestion was explained and she agreed to cook lunches.
Visit 2: The patient returned the following week with reports of no more pain in her feet and swelling had diminished. She had reduced her alcohol intake to 3 beers a night. Sleep had improved though she woke twice to void. Low back and knee ache continued. Tongue was unchanged though a red tip was noted. Pulse was wiry and deep and weak in chi positions.
Diagnosis: unchanged though definite positive response to treatment.
Treatment: same body points were used along with moxa. NADA protocol was added using Sympathetic, Shenmen, Kidney, Lung, Liver and alcohol points in both ears.
Food therapy: Patient likes liver and dandelion greens which are foods to help strengthen and clear the Liver. She agrees to add these to her diet.
Visit 3: Swelling resolved and increased ease with ambulation stating she had not realized how bad her legs felt until noticing they felt better. This week she had experienced cold moving up and then heat moving down over her. Mouth was dry with thirst and urine had had a strong odor for a couple of days after the last treatment. She reported having had a lot of gas and bowels were pasty to normal.
Pulse: L- superficial position, slippery, slightly rapid thin weak deep in chi position
Tongue: moist, pale with curdy back, teethmarks and slight red edges
Diagnosis: Kidney yin and yang deficiency
Damp-heat in middle jiao from alcohol
Treatment: Nourish Kidney yin and yang. Drain damp-heat. NADA protocol
Tonify K3 for Kidney yin, K7 for yang, Reduce Sp6, Sp9, St40 to drain damp, Liv3/Li4
Herbal Formula: Silymarin (milk thistle was suggested as supplement to cleanse the liver)
Liver DTX was ordered
Chai Hu-moves liver qi
Huang Qin- clears heat from the liver channel
Hu Zhang- clears damp-heat
Ge Hua-
Bai Shao-nourishes liver blood
Yin Chen Hao- clears damp-heat from the liver
Zhi Zi- drains heat from the 3 jiaos
Da Huang- drains damp-heat through the stool
Wu Wei Zi- improves Liver function
Ma Bian Cao
Fu Ling-drains damp. Strengthens the Spleen
Yu Jin-moves stagnant Liver qi
Qing Pi-moves stagnant Liver qi
80% Silymarin-cleanse the Liver
Pu Tao Zi-antioxidant
Results: This patient continues to have weekly treatments. Back shu points have been used for the past two weeks for chief complaint of low back pain. Energy level is much better and she had stopped smoking. However, school proved to be quite stressful this past week and her smoking and alcohol intake increased. The NADA protocol is used each week to support her goals.