Monday, May 16, 2011

Chinese Medicine for Numbness and Tingling in Lower Extremities

Chief Complaint: Numbness and tingling in lower extremities
Western Diagnosis: Peripheral Neuropathy diagnosed in 1996
Medical History: Illnesses and Operations:
1. Bilateral inguinal hernia operation in 1981.
2. Had tumor removed behind right eye caused by a basal carcinoma in 1987. Had 4 operations following initial surgery for cosmetic reasons.
3. Reports having other basal cell carcinomas removed included one while I saw him in January.
4. Had Ulcerated Colitis in 1991 which was successfully treated.
General Heath: Good.
Tobacco: Smoked since 25, presently smokes 2 packs daily since quitting alcohol.
Coffee: Drinks 4 cups daily.
Exercise: One and a half hours a day.
Questioning exam:
Described Neuropathy as a feeling of sand is his shoes and semi-numbness which is present 100% of the time. Also has associative symptoms of dizziness, lack of balance when eyes closed, and not knowing where feet are in space. Sensation covers half way down lower legs to entire feet. Symptoms are better in morning and get worse as day progresses. Started 2 years ago with a sudden onset. Described having a fall when drunk and hitting head on fireplace, which knocked him unconscious. Symptoms started 2 to 3 days after accident. Has a history of alcoholism for thirty years which now he is in recovery and has not drank for 18 months. Has been tested negative for diabetes.
Arthritis gets worse in damp weather, has a feeling of swelling and warmth. Gets worse with physical exercise, like golf. Has been present for 10 years and has been getting progressively worse with time.
Temperature: Reports normal.
Perspiration: Reports normal.
Head: Gets low grade headaches over entire head on average of 4 times a week. Has disorientation, dizziness and shaky when eyes closed.
Nose, Sinuses: Has chronic allergies from change in seasons which creates runny nose.
Eyes: Reading glasses for 10 years.
Ears: Some ringing. Has high and low hearing loss.
Sleep: Requires 6 hours a night. Feels rested.
Skin: Very dry over entire body. Has phlegm nodules on legs. Skin cancer mentioned above.
Body Pain: Chronic low back pain.
Appetite: Reports good, craving sweets
Urination: Reports normal.
Stool: On constipation side.
Thirst: Reports normal.
Energy Level: On the manic side, is always going, from moment he awakes to he goes to sleep.
Pulse exam: Pulse: Slippery, deep, and short quality, deficient in Lung, Heart, and Kidney positions.
Abdominal Findings: Deficient in Spleen and Kidney areas, tight in liver area.
Meridian Palpation and Examination: He has phlegm nodules running down lower leg covering parts of stomach, and gall bladder channels. Has one over St. 40.
Tongue exam: Tongue: Tender sides, body is dusky and pale, quivering, coat is greasy over entire tongue.
OM Diagnosis: Stagnation of Phlegm in channels of legs with underlying Liver and Kidney Yin Xu, and Liver Xue Xu.
Treatment Principle: Expel phlegm, move qi and blood in channels, supplement kidney and liver yin, supplement liver blood.
Point Prescription: Sp. 9 Resolve dampness and phlegm.
St. 40 Resolve and move phlegm in channels.
St. 36 Supplement and frees Qi and blood in channels.
Foot and Hand San Char(14 points) Relieves numbness and moves channels.
LI 4 Frees channels and network vessels.
Kid. 3 Supplements Kidney yin.
Ren 9 Disinhibits damp.
Yintang Calm Shen.
Ear: Shenmen, kidney, liver.
Herbal Formula: Du Huo Ji Sheng Tang-
Du Huo 9g.
Xi Xin 6g.
Fang Feng 6g.
Qin Jiao 6g.
Sang Ji Sheng 6g.
Du Zhong 6g.
Niu Xi 6g.
Rou Gui 6g.
Dang Gui 6g.
Chuan Xiong 6g.
Sheng Di Huang 6g.
Bai Shao 6g.
Ren Shen 6g.
Fu Ling 6g
Zhi Gan Cao 6g.
Er Chen Tang-
Ban Xia 15g.
Chen Pi 15g.
Lifestyle Prescription: No dairy products
Rise dosage of vitamin B12
Results: The first 2 months of treatment the Neuropathy stayed the same and his secondary complaint of arthritis improved. In the remaining 3 months of treatment his numb sensation is now only on his feet and toes. He reports that his orientation and balance is better and over all reports he feels 50% better since treatment.
Synopsis: This is a slow moving condition. It was a learning experience to see what alcohol could do to someone over a long period of time. Also he is a very strongly a man. He was a football coach, was in the Marines, played football, got in a lot of fights. I on the other hand am a passivist, don’t like sports, would never join the military. It is a learning experience of how to have my issues yet still be there with him.

Chinese Medicine for HIV, Nausea, and Fatigue

Chief Complaint: Fatigue, nausea and loss of appetite.
Western Diagnosis: HIV Positive
Medical History: Male, 33 years of age, 5’10″, 175 lbs., full time student/part time bartender. Diagnosed HIV positive in 1989 remaining healthy with no complications. Currently (2002) and since 1996 patient on triple drug therapy of Indinovir, 3TC and AZT due to high viral load. Current viral load measures 200,000 copies per milliliter. Most notable side effects are chief complaint of fatigue, nausea and loss of appetite. Irregularly exercises, meditates and practices Qi Gong daily. Eight hours of sleep consistently but restless with dreams most nights, Excellent organic non vegetarian diet, mealtimes at regular hours 3x daily. Exposure to smoke daily.
Questioning exam: Extremely low energy, Patient tends to feel warm flashes and sweats easily. Feels a desire to vomit before and during meals, Little or no appetite, no taste, abdominal distention and borborygmus constantly, fatigue accompanied by dull headache, feels sleepy frequently and needs to nap in middle of the day, bowel movements twice daily soft but formed and foul smelling diarrhea two to three times week.
Pulse exam: Wiry and a little slippery. Both Kidney Yin and Yang seem weak and empty. 60bpm.
Tongue exam: Slightly dark body (light purple), slightly swollen and moist with teeth marks and thick white coat in lower jiao.
OM Diagnosis: Spleen and Stomach Qi Deficiency; fatigue, sleepiness, easily sweats with no exertion, no appetite, loose stool, abdominal distention, weak/empty pulse. Stomach Qi Stagnation; nausea, loss of appetite, decreased taste, loose stool, borborygmus. Dampness; looses stool, nausea, no appetite, moist tongue; Heat; tendency to feel warm, chronic dry lips, darrk tongue body. Kidney Deficiency; aversion to cold weather, lassitude, apathy, poor appetite, loose stool, decreased sex drive, weak Kidney Yang pulse.
Treatment Principle: Tonify Spleen and Stomach Qi, Clear Damp Heat, Support Kidney Yin and Kidney Yang.
Point Prescription: LI4; tonify wei qi, eliminate heat in LI.
ST25 – regulate intestinal function, clears heat. Ren6 – Sea of Qi, tonifies Qi and Yang.
SP6 – strengthen SP and transform Damp.
PC6 -nausea.
ST40 – calms mind, essential for Phlegm and Damp. LI11 harmonizes ST, cools heat, relaxes patient.
Ren8 -Salt Moxa to tonify KD Yang. Yintang – calms patient.
Herbal Formula: Patient prefers patents due to time restraints and is more compliant with patent. Prescribed Health Concerns formulas Source Qi to address fatigue, nausea and loss of appetite, Marrow Plus which counteracts AZT side effects of supporting bone marrow, Clear Heat which is equivalent to an antiviral and treats the epidemic toxic heat of the virus.
Lifestyle Prescription: Less smoke exposure would be very helpful. Adequate iron supplementation such as Floradix liquid iron. Stop coffee and soft drinks.
Results: Patient has reported an increase in energy and a lowered viral load since protocol began a year ago. Appetite had increased and the constant warm feeling has evened out.

Acupuncture and Herbs for Fibromyalgia and Chronic Fatigue

Chief Complaint: fibromyalgia and chronic fatigue
Western Diagnosis: fibromyalgia Jan 2001
Medical History: A 50 year old female, health care professional and PhD candidate, sought Chinese medicine for the first time on May 11, 2001, with symptoms of fibromyalgia for one and a half years prior to formal diagnosis in January 2001.
Patient’s physical activity had been limited, since exercise aggravated her symptoms. Symptoms were also aggravated by stress and inactivity. A physician prescribed Prozac, 10 mg on odd days, 20 mg on even days, Premarin 1.25 mg daily, and glucosamine chondroitin, dosage unspecified. The patient also took a daily multivitamin and calcium supplement. There was mild improvement in her condition on this regimen, but she was advised that she would “just have to live with pain.”
Medical History: allergic asthma, sinus allergies, chicken pox, fatigue, headaches, reactive hypoglycemia, measles, mumps, a left arthotomy in 1970, and left knee osteoarthritis, as well as a family history of diabetes mellitus and stroke maternally.
Patient’s intake consisted of cold or hot cereal with milk and fruit juice in the mornings; leftovers or a salad or cold sandwich for lunch; meat, starch and a vegetable for dinner. Snacks included cheese and fresh fruit, coffee or tea.
Questioning exam: Patient reported extreme fatigue (impairing her ability to work and causing her to routinely go to bed at 7 PM) and a feeling of muscle aches all over the body, like after a workout, but all the time. The pain would be more or less intense on alternating sides of the body. The patient reported feeling alternating sensations of heat and cold, skin sensitive to environmental changes in temperature, alternating constipation and diarrhea, and a tendency to spontaneous sweating. Patient reported one enlarged cervical lymph node. Patient reported a feeling of “brain fog” or clouded thinking.
Pulse exam: Floating in the left cun position; soggy in the left guan position; slightly vacuous in the left chi position. Floating in the right cun position; slightly vacuous in the left guan position; weak in the left chi position.
Tongue exam: The tongue body was of normal size and shape, slightly purple and trembling, with a shallow longitudinal crack in the Stomach region. The fur was thin, white, moist and evenly distributed. The patient’s complexion was pale and dim, with dark circles under the eyes.
OM Diagnosis: The primary pattern was vacuity of Spleen Qi, leading to accumulation of Dampness and Phlegm internally, insufficient Wei Qi, and confusion of upbearing and downbearing. Dampness had eventually become Damp painful obstruction.
Treatment Principle: Boost the Spleen Qi, drain Dampness, transform Phlegm, and promote upbearing. When pain was prominent, the principle of overcoming Dampness or Wind-Dampness was employed.
Point Prescription: Points were selected from the Du, Yangming and Taiyin channels. Du 20 was always employed to promote upbearing. Lung 7, Large Intestine 4, Spleen 9 and 6, Stomach 36 and 40 were most often employed, with the occasional inclusion of Lung 5 if knee pain was prominent or Du 24 if “brain fog” was prominent.
Herbal Formula: The ruling formula was Bu Zhong Yi Qi Tang, adding Ban Xia. Herbs such as Qiang Huo, Fang Feng, Ge Gen and Wei Ling Xian were included when pain was prominent.
Lifestyle Prescription: Patient was advised to keep a log of intake and avoid cold, raw, fermented, and dairy foods. Patient was instructed to apply indirect moxibustion to Stomach 36, three times weekly. Compliance was excellent, and the patient reported she felt this regimen was helpful to her.
Results: Pain and mental clarity were noticeably improved after one visit; after six visits, every week to every other week, all symptoms, including fatigue, were nearly gone. The pulse had become slippery and even over the three positions and the tongue had lost its purple cast. Patient continued to have periodic flare-ups of fibromyalgia and fatigue symptoms through April 2002 which she could usually ascribe to overwork or overindulgence. These were easily managed with follow-up treatments. Through journaling, patient was able to identify an interaction of five (!) foodstuffs that aggravated her symptoms. Thereafter, she avoided combining those foods in one meal and felt her condition was improved as a result. Patient is very satisified with the outcome and feels her health is at least as good as before the original onset of her fibromyalgia and chronic fatigue symptoms.
Synopsis: The case illustrates how loss of Spleen function can disrupt the Qi mechanism, and how the Qi mechanism can be leveled by means of lifting and boosting (Bu Zhong Yi Qi Tang), assisted by downbearing and transformation of turbid fluids (Ban Xia). As the sayings go, “when there is upbearing, there is downbearing,” and “without upbearing, the clear and turbid lose their places”.

Asian Herbs and Acupuncture for Trigeminal Neuralgia

Chief Complaint: Facial Pain
Western Diagnosis: Trigeminal Neuralgia
Medical History: Patient is a 50 years old male, well nourished. Physical examination revealed 135/95 blood pressure, otherwise appears to be in good health.
Blood Analysis: within normal range
MRI of the brain: Findings: the internal carotid and basilar arteries, proximal anterior and middle cerebral arteries are normal in caliber, contour and signal intensity. No congenital aneurysm or mass effect.
Impression: Normal examination.
Questioning exam: Patient suffers of severe attacks of facial pain (L) lasting for about 30 to 45 seconds followed by a burning sensation lasting 2 to 3 minutes.
The period of pain free after each attack was of about one hour. Any light touch or movement would trigger the pain at any time.
Pulse exam: Wiry and rapid.
Tongue exam: Revealed white thin coat with yellowish coat in front and red body.
OM Diagnosis: According to the nature of the pain and other signs, such as the yellow coat, red body of the tongue, a burning sensation in the face and a wiry pulse. The diagnosis was wind-heat invading the face.
Treatment Principle: Dispel wind-heat and treat the pain.
Point Prescription: The first and second treatments were to the right side of the face (opposite to the pain)
ST-4 toward ST-6 with a retention time of 30 minutes – even
ST-6 toward ST-4 with a retention time of 30 minutes – even
SJ-17 with a retention time of 30 minutes – lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation – lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation – lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 – retention 30 minutes
The next treatments were to the left side (side of pain)
ST-4 toward ST-6 with a retention time of 30 minutes – lift and thrust for 1 minute
ST-6 toward ST-4 with a retention time of 30 minutes – lift and thrust for 1 minute
SJ-17 with a retention time of 30 minutes – lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation – lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation – lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 – retention 30 minutes
Herbal Formula: List of herbs taken for TN and HBP
Da huang 4gms
Huang lian 2gms
Huang qin 2gms
Wu gong 1.5gms
Chan tui 6gms
Tian ma 6gms
Gou teng 6gms
Shi jue ming 15gms
Zhi zi 3gms
Yi mu cao 5gms
Du zong 6gms
San ji sheng 6gms
Fu shen 6gms
Chuan niu xi 6gms
Decoction, 3 cups 3 times a day – 3 wks.
Lifestyle Prescription: No alcohol, no caffeine, fat free diet, reduction of intake of red meat. Take Vitamin B complex, B6, C.
Results: Western medical doctors were not able to detect the reason of the trigeminal neuralgia. To minimize the pain and reduce the high blood pressure, the patient was prescribed TEGRETOL AND ATENOLOL for life, with increments of dosage as needed.
Acupuncture treatments:
The first treatment was with no results at all.
The second treatment stopped the pain for about 4 hours, then pain came back about every 2 hours.
After the third treatment the attacks of pain came back every 3 hours more or less but with an intensity of only 20% and only in the day time. His blood pressure remains stable 130/85
Synopsis: The patient was taking medication for the trigeminal neuralgia and high blood pressure. Now he is almost pain free. Once in a while the pain came back but with an intensity of 3 to 5 % only.
Patient remain in treatment once a month and he is not taking TEGRETOL any longer neither ATENOLOL.
Blood pressure stable 130/85. currently taken Tian ma gou teng yin.
Decoction, one cup a day.

Acupuncture Used for Chronic Gastritis

Chief Complaint: Heartburn and pain in epigastrium
Western Diagnosis: Chronic gastritis
Medical History: In the last five years, the patient had very stressful life when she studied in college and tried to find a job. Her eating was not in a regular base and she did not do any exercise.
Questioning exam: She always felt fullness and dull pain in the epigastrium especially if she got upset or angry, the situation got worse. Some times she also felt the fullness or pain in hypochondria area. She was in fatigue all the time and the appetite was poor. Occasionally she had diarrhea.
Pulse exam: The Guan pulse on the left hand is wiry and weak in the left hand.
Tongue exam: The body of tongue is pale and swelling with tooth press, and coating is white and grease.
OM Diagnosis: Liver Qi stagnation and Spleen qi deficiency with wetness accumulation.
Treatment Principle: Tonify spleen and treat qi stagnation in liver
Point Prescription: Taichong, Gongsun, Neiguan, Zusanli, Qihai, Qunyuan, Qimen, pishu, Zhongwan.
At beginning I have treated the patient twice a week for three weeks, then ones a week up to now.
Ear point: liver, spleen, kidney, shemen
Herbal Formula: I did not use herbs for the patient.
Lifestyle Prescription: Try eat more than three times per day and eat less each time. Try to avoid to feel angery, to get more relax and do more exercise.
Results: After one month treatments, the patient felt 80% better.

Oriental Medicinal Herb and Acupuncture for Fatty Liver and Diabetes

Chief Complaint: fatty liver and poorly controlled Type 2 Diabetes
Medical History: 55 yr old Caucasian male. Morbidly obese.
First appointment on March 2004 patient’s labs reflect triglyceride level of 1105, cholesterol of 230 and elevated AST (50′s) and ALT (80′s). patient’s record of blood sugars indicate his blood sugars were consistently in the high 230′s. Patient was not (and is not) on any western medications. Even though patient had dangerously elevated triglycerides and blood sugars he consistently refused western medications. His MD finally referred him to acupuncture in the hopes that something could be done to stabilize the patient.
Patient does not drive and does not cook. He reports excessive appetite He either buys prepared meals at the deli counter of grocery store or goes out to eat. His only exercise was walking to the public bus.
Questioning exam: Chronic right flank pain. Chronic pain over kidneys. Wakes frequently and frequent night sweats. Short of breath with dry cough. Chronic fatigue. Verbalizes anger/frustration as well as fear of death (realistic considering his elevated labs).
Pulse exam: Pulses thin, tight and slightly rapid. Left sided chi pulse consistently the thinnest and weakest. Left sided guan pulse consistently the most prominent, however, often right sided cun pulse quite prominent too.
Abdominal diagnosis: exquisite tenderness in areas of Liv 13 and Liv 14, dull ache in area of GB25.
Tongue exam: Tongue body red. Anterior 2/3 peeled. Posterior 1/3 with dryish slightly yellow coat. Vertical cracks on the anterior 1/3 of tongue, bilateral (that is on both the left and right side of the tongue in the lung region). Tongue body shape normal (tongue is not swollen, scalloped or long). Slight quiver to tongue.
OM Diagnosis: Constitutional lung deficiency (vertical cracks lung area)
Stomach and lung yin xu (and by association kidney yin xu, though yin xu of kidney likely result of long-term lung yin xu) as evidenced by the red and peeled anterior 2/3 of tongue, the dry cough, night sweats, frequent hunger, slightly rapid pulse.
Liver qi stagnation as evidenced by reports of anger/frustration, fatigue, right flank pain, tenderness at Liv. 13 and 14, tight pulses, most prominent in left guan position, and abnormal liver enzymes. Some element of damp in lower jiao as evidenced by yellowish coat posterior 1/3 of tongue and high cholesterol and triglycerides.
Treatment Principle: Nourish yin, especially of lung and stomach, course liver qi, and drain damp accumulation in lower jiao. The damp accumulation in lower jiao is thought to be primarily a consequence of the depressive heat caused by the combination of the liver qi stagnation and the lung and stomach yin deficiency, so the treatment plan did not emphasize draining damp as once yin xu and liver qi stagnation is addressed it is likely the damp heat will more easily resolve.
Point Prescription: Patient seen weekly for first 3 months and then twice per month there after. Alternate between back and front treatments and add or subtract points depending upon specific complaints, but core point used are: Liv 13 &/or 14, Liv 3, LI4, LI11, GB34, Sp 9, Sp 6, CV 17, Cv12, Lu7, K6, K3, ST 40, Huatou at level of T17, T18, T19, Bl23, Du 4, Ren 4, Ren 5 (again, not all these points are used all the time, but they are the core points, some of which are used in each treatment depending upon patient’s complaints and tongue and pulse signs). Used during every treatment are the following ear points: liver region, right ear; pancreas region right and left ears alternately; spleen region, depression region, anger region.
Herbal Formula: Initially started on combination of Six Flavored Tea and Free and Easy plus, 1/2 cup three times day. Patient remained on this formula for approximately 4 weeks and was then switched to the Pacific Biologics “Diabet” capsules, three capsules, three times per day and Health Concerns “Ecliptex”, 1 pill 3 times per day. During periods of increased right flank pain patient is instructed to stop the Ecliptex and to take either 8 teapills (Plum Flower Brand) Shu Gan Wan 3 times per day or 8 teapills Free and Easy Plus 3 times per day (whether he takes the Shu Gan or the Free and Easy is determined by the severity of the flank pain). He takes these formulas until pain resolved and then goes back on the base formula of the Ecliptx and Diabet (for those not familiar with Diabet it is a modification for Jade Fluid decoction, with other herbs added for their empirical usefulness in treating yin xu type diabetes).
Lifestyle Prescription: Patient put on a diet and exercise plan. Given the fact that patient historically did not exercise it was important to not give him unrealistic goals. Patient was simply instructed to walk for at least 20 minutes per day, at a brisk pace, 3-5 times per week, two hours after eating, eventually working up to walking 40 minutes per day, 3-5 times per week.
He was given rather detailed dietary instructions: Limit caloric intake to 1800 calories per day. Eat 5-6 small meals throughout the day. 10% of diet from protein, 50-60% of diet from complex carbs (pt provided with written info on what constitutes complex carbs), 30% from “good fats” and to entirely avoid trans fats found in most prepared foods. He was advised to spread carbs out evenly throughout the day and of the importance of food combining of carbs and protein at each meal, and advised of food groups that slow the rate at which carbs are converted to sugar.
He was instructed on how to perform simple breathing exercises and advised to practice these techniques daily.
Results: After 2 months of treatment his daily blood sugars checked twice each day (fasting and 2 hours after evening meal) remained consistently in the 107-150 range. Patient no longer experienced night sweats and reported better sleep. After three months of treatment patient’s lab results indicated that his ALT and AST had completely normalized (patient’s MD, in fact, called me stating utter disbelief that in such a short period of time patient would exhibit normal liver enzymes…), patient triglycerides dropped to the 300′s, still considered high, but not as high as when he started treatment, and his cholesterol was 213. At this point we decided to add krill oil to his herb mix to enhance the effect on lowering his triglycerides. The most recent lab work done in October indicates that patient continues to have excellent control of his blood sugars as his GHb was 6.6. Unlike the daily blood sugars which just give you indication of blood sugar control at that point in time, the GHb gives an historical picture of how well blood sugars are controlled over time. However, patient’s triglycerides shot back up to the 500′s and his cholesterol held steady at 213.
Synopsis: Patient continues to have bouts of right flank discomfort and his fatty liver disease seems quite stubborn to treatment, indicating that perhaps more emphasis now needs to be placed on lower jiao damp heat and coursing liver qi. I am in the process of re-evaluating his base herbal regimen. Overall patient’s affect is much brighter, he is less angry and generally more optimistic about his future. He no longer has night sweats, sleeps better, and has more energy. His diabetes remains well controlled, but we still have to find some way to impact his dangerously elevated liver enzymes. Thankfully patient is very dedicated to his treatment goals and disciplined about taking his herbs and following his diet.

The Chinese Herbal Treatment of Restless Leg Syndrome

Chief Complaint: restless legs
Medical History: this is a 54 y/o female with a 30 year history of smoking and moderate alcohol intake. She is a psychotherapist with an extremely stressful practice. Her restless legs manifest as primarily cramping and interfere with her sleep.
Questioning exam: she complains of fatigue, tinnitus, occasional dizziness and constipation.
Pulse exam: pulse is thin, weak and deep.
Tongue exam: tongue is pale, thin, with a thin white coat, quivery
OM Diagnosis: qi and blood deficiency, primarily blood
Treatment Principle: nourish qi and blood
Point Prescription: patient requests herbs only
Herbal Formula: Shao yao gan cao tang (powder) modified
Lifestyle Prescription: encouraged smoking cessation, decrease alcohol intake and stress management
Results: the symptoms decreased and then ceased altogether after one week on the herbs. After three months of faithful compliance the symptoms have not returned.
Synopsis: this simple formula alleviated symptoms by nourishing blood and relaxing the muscles

The Acupuncture Treatment of Fibromyalgia

Chief Complaint: Muscular pain/ achiness
Western Diagnosis: Fibromyalgia
Medical History: Patient: female, 42 years old
Since February 2000, patient had experienced muscular pain. In April 2000 she was diagnosed with Lyme’s dx and put on antibiotics. After no relief, a spinal tap and Tender Point Assessment test were performed. She was diagnosed with fibromyalgia in the summer of 2000. Significant medical history includes saline breast implants in 1983, gall bladder was removed in 1984 and in 1993 the patient was diagnosed with severe allergies and asthma. Medication at the time of visit included Arthrotec and Maxalt.
Questioning exam: The patient complained of constant, full body, muscular discomfort. Her body was achy and she felt a heaviness in her muscles. The most uncomfortable areas included her thighs, her feet, her neck and her arms. The discomfort was worse in the evenings when lying down and in morning upon waking up. At these times she felt stiff and tight and said she felt “like there were no fluids” in her body. In addition, the cold, damp weather made her symptoms worse. Other symptoms associated with her c.c. included extreme sensitivity upon palpation or pressure to the superficial layers of skin, poor circulation and a constant feeling of coldness. She was sensitive to pressure including fabrics on her skin. In addition she experienced one-sided headaches along the GB channel that occurred randomly and lasted from days to weeks at a time. Her vision had declined in the last four years and she experienced occasional blurry vision and spotted vision. Her mouth was usually dry, she had a very poor memory and often felt like she was “in a fog.” She had SOB upon exertion, her energy was extremely low (3% of 100%), her sleep was disturbed, waking frequently at night and waking in the AM feeling tired, and her digestion was affected by cold,damp foods which would cause bloating, gas and nausea. She maintained a 30-day menstrual cycle with approximately 5 days of bleeding. Premenstrually, she would experience breast tightness on the sides (liver/ GB channel), her muscular pain got worse and she became emotionally sensitive
Pulse exam: Upon palpation, the lower spleen channel was tender especially at Sp 6 and 9. Her hands and feet were cold to touch. The pulse was 80 BPM, the left weaker then the right. The left was wiry and the chi position was deep and weak. The right side was slippery and the chi was also deep and weak.
Tongue exam: The patient appeared tired and weepy, her eyes were glassy and her palms, soles and complexion had a yellow hue to them. The tongue was pale-purple in color with a scalloped body. There was a thin white coat and the SLV were distended.
OM Diagnosis: The patient was diagnosed with Spleen Qi Deficiency with Damp Accumulation. The quality, the location, and the timing of the pain as well as the precipitative and palliative factors all point to this diagnosis. The quality of pain was expressed as achey and heavy. This could be interpreted as a damp accumulation or a bi-syndrome, in particular, a cold-damp-bi. However, since it was a full body muscular pain and not specific to the joints, I leaned more towards the damp accumulation. In addition, there was no actual swelling and although aggravated by the cold, damp weather, her symptoms were the worst in the summer. The fact that she felt “like there were no fluids” in her body, can emphasize this improper transport of fluids due to damp accumulation. The major characteristic of dampness is heaviness, which was her major complaint. Since this was a stagnant disorder, the pain was the worst at night and in the morning, when the patient was sedentary. The dampness could be seen in her tongue and felt in her pulse. Since dampness can injure the yang, her constant feeling of coldness and poor circulation could be due to the dampness hindering the ability of the yang/ qi to transport and warm. The spleen qi deficiency symptoms included her lack of energy, her inability to concentrate and her digestive problems associated with particular foods.
Treatment Principle: The treatment plan included tonifying the spleen qi and dispelling the damp accumulation. In addition warming was necessary to circulate the qi and warm the yang.
Point Prescription: Acupuncture was difficult at first since the patient was very sensitive to the needles. It included Sp 6, LI 4, Liv 3, St 36, Pt 0 in the ear and ear shen men. Each treatment consisted of lots of moxabustion, especially on points Sp 6, St 36 and Ren 4 and 6.
Herbal Formula: An herbal formula was not used due to her food allergies, which included most herbs.
Lifestyle Prescription: It was mentioned to the patient that dietary factors play a major role in spleen qi deficiency and damp accumulation. It was advised that she eat more warming and cooked foods. A congee recipe was offered. In addition, I suggested that daily, light exercise and/or stretching would be helpful in her stagnant situation.
Results: During the initial visit, she was very sensitive to the needle insertion and it took 5- 10 minutes for her to feel the heat from the moxabustion, if at all. After the first visit, she felt much warmer and by the fourth visit the body aches were less severe and in more concentrated areas. By the second month, the aches and heaviness was much better, the patient was able to concentrate and go back to work, her energy was better and she was not as cold, to the point where she could wear lingerie to bed for the first time in a year.
Synopsis: My major concern for this patient was the fact that her health began to decline after her breast implants. I had a feeling that this was the cause of her problems and that she should really make sure there was no problems associated with them. I had asked her to have them checked for many weeks and it wasn’t until the second month that she tried to contact the doctor who had done the procedure. Sure enough, the doctor was no longer working and my patient was told that many women with this procedure had complications. She immediately went to get them removed and it was found that one of the implants had leaked and caused this systemic reaction.

Acupuncture Utilized to Address MMR Side-effects

Chief Complaint: Side effects from MMR (measles, mumps, rubella) immunization
Medical History: 13 month old female in good health, 21lbs., 30″ tall. No major illnesses reported-child has never received antibiotics. No ear, nose, or throat complaints. Child drinks approx. 20 oz. of organic cow’s milk daily, otherwise she drinks room temperature water. Parents reported feeding her a variety of table foods. The child takes two naps daily and sleeps through the night. The parents reported the child as having “normal “bowel habits, although they occasionally notice some undigested food in the stool. The child is characterized as happy, easy going, and very social.
Questioning exam: Parents reported noticing changes in their child two days after she was immunized. The described symptoms were: excessive fussiness, decreased appetite, little thirst, fatigue, clinginess, looser BM (2-3 times a day), disturbed sleep (waking up twice during the night).
Seven to eight days after the immunization was given, the child began having fevers (100.9-102) that lasted a couple of a days. The parents reported giving the child Motrin to control fever- they denied any sweating.
Pulse exam: Weak
Tongue exam: Tongue: Pink body w/ sl. thicker white coating
Complexion: pale
Skin tone: flacid and slightly moist to the touch
OM Diagnosis: Spleen deficiency and Qi deficiency
Treatment Principle: Tonify spleen. Tonify qi.
Point Prescription: St 36
Sp 6
Lu 9
Administered five consecutive acupuncture treatments.
Results: The child responded very well to the treatments. Per the parent’s observations, their child has returned to her “old self”.
Synopsis: By strengthening the spleen and boosting the overall qi of the body, the child regained the energy needed to dispel the lingering pathogenic, qi-weakening factor left behing by the immunization.

Acupuncture Treatment of Hepatitis

Chief Complaint: pains in hypochondrium , poor appetite  & bad erection
Western Diagnosis: viral hepatitis
Medical History: patient is Male ,47 years old , with HCAg +ve , hight SGOT SGPT ,
Abd. distention
Questioning exam: question & answers about the case is for how long (3 years) what is the dietary habits
what is the medication (DDP,levanox,betolvex&Adamine)
Pulse exam: weak rapid pulse
Tongue exam: thin white coating tongue
OM Diagnosis: failure of liver to free flow of qi leading to stagnation
Treatment Principle: remove the stagnation of Qi
Point Prescription: Liv14 , SJ6 , G34 , G40 , Liv 3 , B17 , B18
Herbal Formula: HONEY BIG SPOON 3 times , multivitamin cap once daily
Lifestyle Prescription: diet advised to be fat free and high protein and a lot of vegetables
Results: 3month treatment tow Acupuncture settings/week the enzymes goes down and the appetite regains

The Acupuncture Treatment of Tinnitus

Chief Complaint: Tinnitus
Western Diagnosis: Tinnitus
Medical History: 43year old Caucasian male patient had an oral surgery on his left side of his jaw 5 weeks ago. Since then he was hearing high pitch ringing sound in his left ear. Patient was healthy until this condition. He also complains of tenderness around the surgical area, and also suffers from insomnia and depression since. Healthy diet and exercises regularly.
Questioning exam: Do you have insomnia because of pain or sounds? Sounds (tinnitus)
Any medications? Taking anti-anxiety medication and took antibiotics for 2weeks after the surgery.
Pulse exam: Left Heart (full, rapid)
Liver (Full,wiry)
kidney (deep,weak)
Tongue exam: purple body,red tip,scanty coating, swollen
OM Diagnosis: Heart fire, liver yang rising, kidney yin deficiency.
Treatment Principle: Tonify kidney yin to harmonize the Heart
Soothe liver yang.
Point Prescription: tonify Lu8, Liv4, Liv3, Sp3, St36
sedate H8, Liv2, GB2, 3, SJ17
Herbal Formula: none
Lifestyle Prescription: suggested yoga to relax himself
Results: Sound has diminished with two consecutive days of TX.
With 7 more TXs. every other day, the ringing was completely gone.
Sleeps normally, pain on face is gone.

Acupuncture and Chinese Herbs for Herpes Zoster (Shingles)

Chief Complaint: burning pain in the left hip which referred to the genital region.
Western Diagnosis: herpes zoster.
Medical History: 29 year old female with a history of vaginal infections as well as genital herpes. She is currently sexually active with several partners and is currently taking oral contraceptives.
Questioning exam: Patient complains of burning pain in her left hip which refers to her genital region. Onset of pain was on week prior to coming for treatment with progressive pain daily. The area of pain is marked by red vesicles which appear to be fluid filled. Lesions can be seen in the areas from UB31 to GB29 and to the inguinal groove on the left side.
Pulse exam: 90 bpm. The quality of the pulse is thready to wiry with elements of a slippery quality especially in both guan positions.
Tongue exam: Pale pink body with red pappilae at the tip and sides of the tongue. The coat is thick and turbid dry and lightly yellow.
OM Diagnosis: Externally contracted toxic damp-heat stagnating in the Shao Yang, Dai and Yang Wei channels with Qi and blood stagnation. Because the patient was sexually active and had a history of herpes outbreaks, she easily contracted toxic damp-heat. When damp-heat stagnates in the Shao Yang, Dai and Yang Wei channels, it intermingles with and obstructs the Qi and blood. This produces heat in the blood, reddish skin lesions, vesicles and severe pain along the channel’s pathway.
Treatment Principle: Clear toxic damp-heat, remove channel obstruction and stop pain. Regulate Qi and blood.
Point Prescription: Surrounding needles were used around the perimeter of the lesions, with transverse insertion at a maximum of 5-10 degrees. Other points used were: GB1(L), ST30(L)- (bleed both points to clear damp-heat. GB34, SJ6 and SJ2 clear damp-heat and remove obstruction from the channels on the sides of the body. GB41, SJ5 and GB26 were used as a second point combination in the 4th treatment to open the Shao Yang, Yang Wei and Dai channels and eliminate damp-heat. SP6 and SP9 strengthen the spleen and resolve dampness. PC3 and UB40 were also used in combination to reduce fire toxin in the blood.
Herbal Formula: Long Dan Xie Gan Wan for a period of 2 weeks.
Lifestyle Prescription: Patient was given advice about safer sexual practices and the importance of using contraceptives for the prevention of sexually transmitted diseases. She was also given advice about dietary habits including the elimination of all spicy and greasy foods and the addition of more dark leafy green vegetables and whole grains.
Results: The vesicles began to lighten in color and started to shrink after the first treatment. A sterile needle was used to drain fluid from the vesicles and they were cleaned with betadine solution. By the fourth treatment the vesicles had disappeared. 10 days later 90% of the pain and redness was gone. By the third week of treatment the patient had completely recovered.
Synopsis: This case demonstrates the successful use of the theory of the Shao Yang, Dai and Yang Wei channels.

Male Impotence Treated with Acupuncture and Oriental Herbs

Chief Complaint: Impotence
Western Diagnosis: Impotence.
Medical History: Patient is a 27 year old Caucasian male who presented with complaint of sexual dysfunction for two years duration. It is not continuous but has been steadily worsening.
Patient maintains a healthy diet, is moderately physically active and under tremendous psychological stress. maintains a monogamous relationship with a girlfriend.
He has been experiencing lumbago concurrent with the impotence since it began. He was involved in a motorcycle accident seven years prior in which, among other injuries, he shattered his left fibula and ankle. He now has decreased ROM in his left ankle and his gait is altered. This limits his physical activities and has set up mechanical imbalances in his pelvis and SI-joint.
The impotence is aggravated by emotional stress but is not a constant problem
Questioning exam: His energy level fluctuates between excellent and very low.
He tends towards irritability and frustration.
He has frequent tinnitus
Body odor is a burnt quality.
Ankle stiffness & pain is better with motion, but not too much.
Has developed preference for rough, aggressive sex. He finds that it turns him on more.
Has developed firm nodules around his scrotum (follicular cysts) that seem inversely related to his impotence. Often feels “blocked” in his genitals.
Frequent headaches with a sense of tight pressure.
Pulse exam: Wiry throughout, Forceful in the rear positions, 70 bpm.
Tongue exam: Pale body, thick greasy coat (slightly yellow) in rear. Red tip.
SLV are dark, non-distended.
OM Diagnosis: Long term Liver & Gall Bladder stagnation with Qi and Blood channel stasis (due to injury). This leads to heat, which turns the fluids into phlegm nodules.
Treatment Principle: Move Qi & Blood in lower jiao (pacify the Liver) and dissolve phlegm accumulation.
Point Prescription: Acupuncture treatments emphasized heavier stimulation, which seem to benefit him most. This makes sense, given his attraction to more aggressive sexual activity. It’s as though he’s trying to forcefully free up his obstructions (typical of phlegm stagnation)
GB-8, 30, 29, 34, 39, 41
ST-25, 28, 29, 36, 40
SP-3, 6
Ren-1, 3, 4, 5
LVR-13, 14, 3
UB-15, 18, 20, 22, 23, 24, 25, sacral pts
DU-1, 2, 3, 20
Herbal Formula: I use granules mostly from Blue Light but occasionally from KPC.
I initially began with a modified combination of Yue Ju Wan & Tao He Cheng Qi Tang.
That seemed to help the psycho-emotional constraint, but the nodules weren’t affected. I played around with a few different formulas until I came across Si Hai Shu Yu Wan; Hai Zao, Hai Dai, Hai Ge Ke, Hai Piao Xiao, Kun Bu, Chen Pi, Mu Xiang. He seems to respond to Da Fu Pi (perhaps due to cold invasion in the Liver channel from accident). So I modified it with some of that.
Lifestyle Prescription: Qi Gong and meditation work for his pelvic centers.
Results: Results have for the most part been positive. There are many levels to sexual dysfunction and i do not know if all of them can be adressed by needles alone. He’s happy, impotence improved, the nodules have improved but persist.

Intraepidermal Squamous Cell Carcinoma Treated with Chinese Medicine

Chief Complaint: “Severe dysplasia of vulva and rectum”. Secondary complaint of “recurring shingles due to weak immune system”.
Western Diagnosis: Bowen’s Disease. AKA- Intraepidermal Squamous Cell Carcinoma.
Medical History: This woman, age 42, works as a Hollywood talent agent, where intense stress is a minimum daily requirement. Her dysplasia issue began or was diagnosed 18 years prior to this treatment (10/9/01). She had received seven surgeries and/or laser treatment to excise the malignancy sites over that time. Her first malignancy operation was in 1984 with the other surgeries occurring periodically to 1999. As a young woman she had a history of menstrual problems, including “bursting” cysts and tumors (fibroid ?), had one ovary removed at age 19 and eventually a total hysterectomy in July of ’99. She was taking Nexium to treat her job related ulcers. She had daily “migraine” headaches and was taking Imitrex. She had an overactive bladder and had a prescription for Detrol to treat that problem.
Exercise was minimal and because of her job pressures she drank a lot of Latte’s and she smoked She recently started to eat junk food because she wanted to gain weight after losing 35 lbs. in a seven month period
Questioning exam: Because of her long allopathic medical history she brought her diagnosis to me, although no medical reports or test results were offered. I had to interpret that diagnosis in the TCM paradigm and prioritize my treatment to her most serious problems, cancer, headache, urination. At the time of our initial visit she said she wanted to “try anything” to improve her condition before her next visit with her oncologist in 2 weeks, so that, hopefully, she could avoid yet another painful surgery. The symptoms she complained of in addition to the previously mentioned were: shoulder/neck pain, palpitations, insomnia, loose stools, AM fatigue, weird red bruises on legs, worried about everything (life), pain in mid-back, low libido, PM fatigue but can’t sleep, and stomach pain.
Pulse exam: The pulse overall was choppy with an irregular missed beat. The rate was generally 64 +- beats a minute, but the rate varied from a fast rate which would slow gradually to it’s missed beat, then it would resume a more urgent pace. Both sides were wiry, the left side was thready and the right side slippery, with the Lung position superficial and the Spleen position weak/deep. She reported a history of low blood pressure -89/?.
Tongue exam: The tongue body was small and red, with a lurid red tip. The front/side 1/3rd swollen and wider than the back 2/3rds. The tongue coating was thick and yellow in the back 1/3rd.
OM Diagnosis: Systemic Blood-Heat-Toxin, especially in Chong/Ren. Liver Qi/Blood Stagnation leading to Liver Fire. Xu of Qi, Blood, Yin, and Wei Qi. Damp-Heat Obstructing Lower Jiao.
Treatment Principle: Help her.
Point Prescription: There were four treatment sessions (10/9, 15, 19, 23) with 20-33 points needled, plus Ear points, each time. There was a problem with her ability to retain body needles for longer than 10 – 15 mins. due to her need to urinate, so not all points were needled bilaterally. Every treatment contained: LI-4, 10, Yintang, SP-4, 10, with some Liver, GB, and Stomach points. The variations, as symptom complaints changed, were: LI-11, LU-7, 9, SJ-5, Taiyang, GB-14, 34, 41, 43, Liv-2,3,5,8, SP-6, 9, ST-25, 36, 40, 41, K- 3, 27, UB-28, 32, and DU-14.
Ear points (5-10 per treatment) were selected from: Shenmen, Endocrine, Heart, Ext. Genital, Vitality, Thymus, Thalamus, and Rectum.
Herbal Formula: The first treatment I recommended Ba Zheng San patent 12 pills/3x. The next time I changed to Zhi Bai Di Huang Wan 12/3x because I thought it was more of a deficiency issue. I then wrote and ordered a custom powder formula from Qualiherb based on Yin Qiao Hong Teng Jie Du Tang which she got on her third visit. I named it “Linda’s Latte’” and it contained:
Jin Yin Hua, Lian Qiao, Hong Teng, Bai Jiang Cao-20 (raw gram), Dan Shen, Yi Yi Ren, Xi Yang Shen-15, Chi Shao, Bai Shao, Tao Ren, Fu Ling-12, Mu Dan Pi, Yan Hu Suo, Chuan Lian Zi, Xiang Fu, Gan Cao, Sha Shen, Zhu Ling-9, Zhi Zi-6, Ku Shen-4. I recommended 9 gram spoons a day to start, and to gradually work up to 20 a day, 1 hour before eating.
Lifestyle Prescription: None. Like many smokers she knows it’s not good, but job pressures support her smoking or cause her to return after periods of no smoking.
Dysplasia: Unknown
Headache: Unaffected
Urination: Unchanged
Insomnia: Reports able to sleep 8
hours on night before 4th visit
Pulse: mild missed beat by third visit,
didn’t slow down/stop by 4th visit,
also, not as weak in the Spleen position.
Tongue: less luridly red overall and less area of red around tip
Synopsis: Considering the drastic nature of her general health condition and the limited time schedule I can’t complain about the results. In some ways she was not a good candidate for Acupuncture because she could not retain the needles for very long and because she was also paying a lot of cash to her numerous medical doctor specialists (insurance tapped out) she couldn’t afford to continue with me, especially if I wouldn’t “guarantee” the results with a percentage survival/improvement prognosis number the way her “real” doctors do. She also found the powder formula to be the worst tasting experience of her life, but reported that she took 6 spoons/3x in the four days she had it between visits #3 and #4. She was going to see her oncologist the next day after treatment #4 and did not return after that. She called 10/31 to report that the formula had caused a throat irritation, with redness and swelling around her uvula, which stopped when she terminated her herb intake. I did not ask her if she had any changes in her smoking habits in that same time period. Because it was clear that she was not returning or continuing with herb therapy no adjustments were recommended to her.
I like working with this type of difficult and challenging chronic case (although I like having a more cooperative person to work with) and was heartened by the improvements we were able to achieve in a limited time, with limited financial resources, and with a limited number of treatments.

Sports Medicine with Acupuncture

Chief Complaint: big toe hurts, neck pain
Western Diagnosis: sports sprain
Medical History: a football athlete from Steelers, his left big toe hit the ground straight when playing football. No pain killers. Regular diet, no regular rest, a lot of competition
Questioning exam: Pain duration: one month.
Intensity: About 7-8, hurts all the time, ice makes it feel better.
Pulse exam: (left)heart slow and strong,the other two are normal (right)normal, typical athlete pulse
Tongue exam: red tip(in summer), pink tongue with slight white coating
OM Diagnosis: Local Qi and Blood stagnation(big toe area and related liver-spleen meridian),based on injury history and no internal organ imbalance pattern
Treatment Principle: improve circulation in related area and meridian, support energy flow in the toe and neck
Point Prescription: neck: only TuiNa with rolling and one-Finger technique
Toe: Liv3(L), sp1(L),Sp2(L),Ashi points.Combined with moxa everyday and TuiNa
Herbal Formula: TNJ for energy
Lifestyle Prescription: Eat balanced diet, reduce or stop coffee, not a lot alcohol. Stop ice, more heat to the affected area. TNJ to affected area if needed.Avoid position to touch it incorrectly and wear comfortable shoe
Results: after 1st acupuncture treatment and TuiNa, neck pain is gone. Toe is better, still hurts. I asked him to use moxa everyday, each time 10 mins at least; after a week, his toe much better. He is now in competition again.
Synopsis: note: moxa is the best solution for soft tissue injury

The Treatment of Depression with Acupuncture

Chief Complaint: depression
Medical History: 35 year old female with a history of depressive episodes for 6 years. Recent weight gain of 20#s. Reports lack of interest in life, lack of exercise, and diet that includes large amounts of sugars and refined flours.
Questioning exam: Premenstrual breast distension
Constipation alternating with diarrhea.
Irritability and anger
Heavy menstrual flow with dark clots
Restless sleep with strong dreams.
Pulse exam: right guan: vacuous and soggy
left guan: fine and wiry
right and left cun: short and slightly wiry
Tongue exam: swollen around edges.
Pale body with redder sides
Wet and think coating.
OM Diagnosis: Liver depression qi stagnation
Depressive heat. (harassing the heart)
Heart/Spleen disharmony (vacuity)
Blood stasis
Treatment Principle: Course the liver, rectify the qi.
Clear heat
Supplement the Spleen & boost the qi
Point Prescription: Lv2 through to Lv3 R
P6 L, LI4R
Du24, Ear Shenmen
Lifestyle Prescription: Greatly reduce sugar and refined carbohydrates. Initiated an exercise program.
Results: After 8 treatments of twice per week for 4 weeks the patient reported significant improvent in both mood and sleep.
Synopsis: I am always surprised at how effective a simple acupuncture protocol can be when combined with support for proper diet and lifestyle.

Dizziness and Vertigo Treated with Acupuncture

Chief Complaint: Dizziness
Western Diagnosis: Vertigo
Medical History: Weight training 2x a week
Eats lots of fatty foods, sweet cravings
Drinks a lot of coffee
Questioning exam: Migraine headaches for 6 months
Painful periods, clotting, heavy flow
ringing in ears
dry mouth, thirst for cold drinks
Pulse exam: Primary Liver deficient pulse, Wiry
Cross pattern abdominal exam
OM Diagnosis: Liver yang rising with an underlying Liver blood stagnation
Treatment Principle: Subdue Liver Yang
Move Liver Blood
Point Prescription: Manaka ion cord treatment -
TW5 to GB41
PC6 to SP4
added: LV3, SP6, GV20, GB20,CV4,KID3,Taiyang,BL18,BL20,BL23
Lifestyle Prescription: Suggested quit coffee
Patient started yoga
Changed diet to more warm foods, less iced drinks and sweets
Results: Dizziness cleared in three treatments
Migraines subsided
Periods less painful, no clotting

Chinese Herbs and Acupuncture for Painful Periods

Chief Complaint: Period pain
Western Diagnosis: dysmenorrhea
Medical History: Patient was a young woman of healthy appearance. She is a student and works at a gym as a personal trainer. She is VERY active, and tries to eat healthily – mainly raw foods. She drinks eight glasses of water a day. The pain began about six months after starting her job at the gym. She also has considerable strain put on her through her studies, and her eating and sleeping can become erratic.
Questioning exam: The pain begins on the first day of her period and sometimes remains after the period has finished. It is a dull ache that radiates to the small of her back, and is worse when she sleeps at night – or when she just lies down. When asked she also experiences pain on the medial side of her left knee. Sometimes upon rising too quickly she feels dizzy. Urine is pale and frequent, although she does drink a lot of water. Her menses are light (colour and amount), with occasional clots, lasting four days. The pain responds well to pressure and warmth, esp. on her back. Vivid dreams but otherwise normal sleep. Defecation normal. Dull occipital headaches, but only occasionally.
Pulse exam: Pulse quality is generally deep and thready, and can barely be palpated in the chi position. Upon palpation the abdomen feels cool, with some guarding over the liver, the lower back is also cool and the muscles seem to lack strength.
Tongue exam: The tongue appears normal. It is pink with a thin white coat. On closer inspection the coat thickens slightly at the root, and the body is a little pale.
OM Diagnosis: As the pain occurs DURING and AFTER the period, this suggests deficiency, as does the scanty flow, and the relief offered through warmth and pressure. The scanty flow would suggest a blood AND qi deficiency. The back and knee pain, the dizziness, and the headaches point to the Kidney suffering some impairment, and the liver would also be expected as it regulates the menses, and abdominal palpation showed some organ distress through the muscle guarding. Her lifestyle and eating habits are also depleting her jing if she is not eating always correctly, and stress from study could also be compounding her physical problems.
Treatment Principle: Replenish the Qi, and tonify the Liver and Kidney organs to adjust menses and relieve pain.
Point Prescription: First: Sp6, Cv4 (warm-needling), St36, Kd3
then: Bl17, Bl20, bl23, bl18, (to reinforce the organs and for the yang effect of the back shu).
Herbal Formula: zou gui wan
Lifestyle Prescription: She was drinking all that water chilled – so drinks at room temperature or warmer. No raw food (or very little if she can help it). No more wearing jeans that leave the lower stomach and back uncovered. add ginger to her cups of tea and/or cooking. try to relieve stress and not over-exercise.
Results: Vast difference to pain and energy levels (which she hadn’t complained of initially and thought were fine). Kidney pulse now palpable. General pulse quality not as good as it should be.
Synopsis: This young woman found it hard to understand why her ‘healthy’ lifestyle had caused her such problems. Like most people her age she was the victim of western misinformation with regards to consuming raw foods and excessive exercising, and western fashion with inappropriate clothing (a less important point obviously). It was hard for her to change the habits of a lifetime (and a culture) but the obvious change in her health and energy levels were enough of an incentive.

Herbs and Acupuncture for Achelles Tendinitis

Chief Complaint: Achilles Tendinitis
Western Diagnosis: Achilles Tendinitis
Medical History: Patient, 62, with primary complaint of achilles heel tendinitis. She has been a ice skater for over twenty years and has only recently began feeling a fixed pain and swelling at KD3 to KD7 area.
She is slightly overweight with poor eating habits, yet has a good exercise regimine, exercising at least 4 times a week for at least 45 minutes.
Questioning exam: what type of treatments where tries? Cast isolation, Physical therapy, podiatric inserts, rest.
What makes it better? nothing
What do you do to keep the inflammation down? Ice.
Pulse exam: Pulse: deep and slow
Marked edema below the waist.
Tongue exam: tongue: Thick white coat, scalloped
OM Diagnosis: wind-Cold-Damp BI due to overexposure to cold.
Treatment Principle: expel Wind Cold damp
Point Prescription: local; KD3, KD7, ST36,
Distal; BL17, BL20, BL23, BL57
Moxa on related points
Herbal Formula: Du Huo Ji Sheng Tang (no modifications)
Hua Tuo Plaster
Lifestyle Prescription: Continue to walk.
Results: marked improvement within 3 weeks. patient began walking much better and did not experience any inflammation during workouts.
Began herbs after 4 weeks and is currently on the second week of herbs.
Synopsis: prognosis: since case is chronic (over 1 1/2 years) treatment will be slower, but prognosis is a complete recovery within 3 months.

The Acupuncture and Chinese Herbal Treatment of Yeast and Candida

Chief Complaint: yeast infections
Western Diagnosis: yeast infection/candida
Medical History: Patient complains of consistent vaginal yeast infections. She excercises regularly, eats a lot of sugar in her diet and is on the birth control pill. She is a first year lawyer and is under a great deal of pressure.
Questioning exam: Q:Are you on the birth control pill?
A: yes, for 5 years
Q: Do you have any digestive problems?
A: fullness in stomach, bloating
Q: How is your energy:
A: low, feel sluggish
Q: How often are you getting yeast infections?
A: once a month
Q: have you seen your dr. about this matter? have you had a recent hiv test?
A: yes and yes…I am healthy and negative for HIV
Q: do you have vaginal discharge? what color?
A: yes, white
Q: How is your appetite?
A: low
Q: How much water do you drink?
A: not much…drinks a lot of soda
Pulse exam: Pulse:
right side: slippery, weak
left side: slightly bowstring
Tongue exam: pale color and greasy, white coating
patient is slightly overweight. pale face
OM Diagnosis: Spleen qi deficiency with dampness
Patient is suffering from a spleen qi deficiency which is leading to a decrease in the amount of transformation/transportation of fluids in the body. This is causing a dampness to occur. This dampness is affecting the middle and lower body giving her abdominal fullness, lack of appetite and yeast infections (with white vaginal discharge)
Treatment Principle: Expel dampness, tonify spleen qi
Point Prescription: ST 40
ST 36
Sp 6
PC 6
moxa on Kid 7 (great for yeast infections!)
Herbal Formula: Er Chen Tang (pill form): 8 pills 3 X day
for one month then, si jun zi tang pills 8 3X day for one month
Lifestyle Prescription: I gave her the following information:
Controlling Yeast Infections with Diet
In Chinese medicine we say the Spleen is in charge of digestion & transforming/transporting fluids throughout the body. If the spleen becomes deficient (common when the body is under stress), fluids are not transported and dampness in the body occurs. Symptoms of dampness include a general feeling of heaviness in the body, fatigue, phlegm, nasal congestion, yeast infections and even weight gain. There are many foods that make it hard for the spleen to function properly (especially when your body is prone to dampness). The following are some basic foods to avoid/add to your diet:
Decrease consumption of cold beverages/raw food:
The yeast and “dampness” creating foods are those which are cold in temperature, too sweet or salty, mucus-producing, and stale/rancid. Too much raw food can also affect your digestion leading to dampness.
Decrease consumption of carbohydrates:
Foods rich in carbohydrates must be used moderately since they are usually somewhat mucus- and acid-forming, and therefore any small excess can contribute to yeast conditions.
Decrease consumption of sweeteners/fruits:
All refined and concentrated sweeteners (e.g., sugar molasses) and fruits help propagate yeast in the body and should be avoided.
Avoid milk/dairy products:
Most milk products, eggs and red meats can also promote yeast and are not recommended. (fish and chicken are okay)
Increase intake of Garlic:
Garlic has exceptional anti-viral/fungal properties and does not damage the healthful intestinal flora. (you can eat a clove of garlic twice a day before meals or get garlic pills at the health food store)
Increase amounts of cooked/warm foods:
I highly recommend you eat mostly cooked foods. Lots of soups that are warm and even a cup of hot water (with or without tea) before bed at night to help your digestion (spleen/stomach).
Increase amounts of chlorophyll:
Chlorophyll promotes the growth of beneficial intestinal flora. Parsley, kale, collard, watercress, romaine lettuce, cabbage and micro-algae, wheat grass all contain significant amounts of chlorophyll. (Go to the juice bar and get lots of fresh wheat grass!)
These are simple things to take into account with your diet to avoid and decrease the amount of yeast infections in your body. In Chinese Medicine, we believe that everything should be done in moderation, so don秒t feel that you have to eliminate any foods all together. You should just watch the amount of damp-causing agents that you take into your body AND increase the amount of Spleen-aiding agents.
Results: Results were great! Her yeast infections stopped once on the er chen tang. And her stomach discomforts are relieved and appetite is back! Sometimes when she feels she is getting another yeast infection, she comes in for a preventative acupuncture treatment.
Synopsis: Since her yeast infection consisted of white discharge, I didn’t have to clear any heat in her system. However, this is an important fact to consider. Cleansing her dampness with acupuncture and herbs AND making some very important dietary changes can make a huge difference in this scenario.

Acupuncture Treatment for Insomnia

Chief Complaint: insomnia
Western Diagnosis: insomnia.
Medical History: Insomnia for the last 18 months which started when the patient changed his job. He worked for 20 years doing shift work in the airforce, yet when he changed to a regular day job 18 months ago he started to suffer from insomnia. He used to get a maximum of 2 1/2 hours sleep each night. Sometimes he fell asleep easily and then woke up later on, and then was unable to get back to sleep. Other times it took him 2-3 hours to fall asleep and then he would wake up again and was unable to return to sleep.
He relaxed and walked the dog before going to bed. Very rarely had dreams. Very little alcohol, doesn’t smoke. Good diet; chicken, fruit, veg, little dairy. Last meal of the day was at 4.30pm. No coffee, 2 cups of tea daily.
He appeared very calm at the consultation. None of the usual patterns of disharmony within TCM stood out, such as; Heart Fire, Liver Fire, Blood deficiency, Liver Yin deficiency, etc.
Most significant symptom was the following :-
Thigh and calf muscle pain. “It feels like the muscles are twisted and knotted, very painful, like after running”. This started 18 months ago. The pain typically started three hours after getting out of bed and then lasted until he went back to bed. The pain was sharp when walking around and dull when sitting. The whole thigh was affected. His legs felt heavy, and they felt better when raised up.
Pulse exam: Pulse : left side thready, slightly rapid
right side thready
Tongue exam: Tongue slightly swollen, slight crack (transverse), some red prickles at the front and sides.
OM Diagnosis: Disharmony of the Yin Heel Vessel.
The Yin Heel Vessel is used in disturbances of sleep, either insomnia or somnolence. It addition to this, it is also used “in certain cases of Atrophy Syndrome”, to balance the tension of the inner and outer leg muscles. Although the patient did not have any Atrophy Syndrome, it was clear that opening the Yin Heel Vessel was the best approach since the only significant additional symptom was his leg pain.
Treatment Principle: Regulate the Yin Heel Vessel
Stop insomnia
Point Prescription: Kid6, Kid7, Bl2 – bilaterally
P6, Anmian, SP6 – formula for insomnia taken from Peter Deadman’s book (page 570)
No reducing or tonification methods were used.
Treatment was more effective late afternoon when Yin is raising.
Lifestyle Prescription: no changes to lifestyle necessary
Results: After five sessions this patient was completely curede of his insomnia. I phoned the patient two months later and he had no problems with sleeping.
Synopsis: Sometimes there is no obvious TCM diagnosis in terms of ‘patterns of disharmony’.
The Yin Heel Vessel is commonly used to regulate the Yin and Yang Qi going to the eyes. In this case it was particularly indicated since the only significant symptom was pain in his legs.

Chinese Herbs and Acupuncture for Migraine Headaches

Chief Complaint: Headaches
Western Diagnosis: Migraine
Medical History:
HPI: a 44 years old F. pt. seeks acupuncture treatment for her migraine today. her condition started when she was in 4th grade and has been treated by many doctors and modalities without satisfactory improvement. The patient denied her migraine associated with menstrual cycle or optical status but stress. Additionally, the pt. mentioned she would have a headache again if she skips meals a day. The pain primarily takes place on the left temp. area in a tense/consistent fashion, and could last form a few hours to 3 days, which affect concentration and feel exhaustion. She complaint ache and tension on the neck and shoulder areas, too.
Questioning exam: PMH: See Health Wellness Awareness sheets (HWA)
FHx: nobody in her family has similar condition
SHx: alcohol occasionally
Meds: Ibuprofen and Masalt
Alllergy: NKDA
ROS: the pt. prefers stronger taste food such as spicy or salty food, otherwise, food is not much appeal to her. Her BM is regular once a day. Regular menses lasts 3 days per period. Cramping usually occurs the first. Crying easier before menses sometimes.
Cold hands and feet. Difficultly fall into sleep recently.
Pulse exam: PE: 110/78 mmHg, P 60
Pulses – slippery in general. Weak at “cun” and deep at “chi” bilaterally.
Liver pulse is significantly active.
Tongue exam: Thin and tender, slight pale with thin yellow coat
OM Diagnosis: Kd deficiency fails to nourish liver so that internal wind disterb the Shaoyang.
Treatment Principle: Supplement Kidney, soothe Liver Qi and relieve pain
Point Prescription: GB 20, Liv4, K3 bilaterally
GB4, Taiyang and St 7, left
25″ needling
Herbal Formula: Tian ma Qu Feng Zhi Teng Pian or
Bupluenum D & B Formuar
Lifestyle Prescription: stress management

Acupuncture and Chinese Herbs for Stress Responses

Chief Complaint: Stress with accompanied symptoms is his chief complaint.
Medical History: Patient was seen for the first time in February of 2001. This was his first experience with acupuncture.He appeared anxious.His work is in selling bonds and he is not really happy with the job situation. Stress and the following symptoms were discussed:here was a past history of indigestion and chest pains. He exercises frequently and tries to watch his diet. His father died at 72 of heart disease . He used alcohol regularly and drinks 2 cups of coffee daily. Sleep can be irregular and takes Valerian and sometimes sleeping pills.
Questioning exam: Heartburn- daily taking antacids to relieve symptoms
Palpitations and anxiety
Headaches for 2 weeks orbital sides and vertex on the right side with slight nausea.
Some arm and leg twitching which improved with water intake.
Skin is dry and itchy with patches of rashes.
Occasional dizziness
Spontaneous sweating
Bitter taste in the mouth
Sleep was irregular accompanied by nightmares
Tinnitus with high pitch
Some depression.
Continuous hunger
Pulse exam: sting taut and thready/ rate: 75 bum
Tongue exam: Red, slightly scalloped with red tip. / thin yellow fur.
Treatment Principle: Treatment Principle: SEDATE GALLBLADDER, CALM SPIRIT.
Point Prescription: Points: R-gb 41, K-6, du 24 Left. H7/ sj 5
Lifestyle Prescription: Reduce alcohol consumption
Results: He report significant improvement with many of the initial symptoms. His palpitations were reduced, nausea was gone. Sleep had improved but still reported some nightmares and wakes up easily. He feels tired when arising. He is thirsty without the desire to drink. Fear is the primary emotion with anxiety. The skin reaction has worsened with rash and hives. Patient continued to improve with most of the initial heartburn and nausea symptoms reduced. Sleep continued to improve with no nightmares or night sweats. Patient was given Wen Dan Tan Powder to take conveniently at work. Slight bitter taste in mouth continued and patient still felt fatigued.
Synopsis: For me this case clearly validated the TCM holistic systems approach to diagnosis and treatment. This case was almost classical in the signs and symptoms for Gallbladder excess. Western medicine doesn’t have any equivalent diagnosis, except to treat the heartburn and stomach dysfunction. The patient noticed a great improvement of the wide range of symptoms accompanied by this syndrome. After one month on the modified Wen Dan Tang he missed 2 weeks and the symptoms returned. He also had increased benefits when he took the powdered formula in the mid-afternoon. Traditionally the Gall Bladder is an extraordinary organ and curious. It is Fu in that it excretes bile, however it also stores bile. The Gallbladder does not communicate with the exterior of the body as do the rest of the Yang organs. Disharmony between the Gallbladder and Stomach (the wood and earth )leads to heat and phlegm. The heat in the stomach causes the gnawing hunger. heat in the gallbladder has symptoms of bitter taste, yellow tongue coating, bowstring pulse. The phlegm and heat together cause irritability, insomnia, palpitations and anxiety. This patient had all of these symptoms. Wen Dan Tang clears the heat with Zhu Ru, Zhi Shi helps break up the stagnation and distention. . Er chen tang is included to address the phlegm . Because the patient was having insomnia and so the formula was modified to with suan zao ren , mai men dong and latter mul li and long gu. Dang Shen was increased to to the increased indications of Qi deficiency and fatigue.
The acupuncture treatment also were very effective for this patient.
The points used :
GB-41- confluent of the Dai meridian. Good for excess conditions.
Heart 5- for the heart phlegm
Du-24- to clear the mind and settle spirit.
Kidney 10- good for mental disorders , also this patient has some knee pain.
Pumping cords were used on Sp 4/ P6 to help with the nausea and calms the mind.
The patient did feel relief after this mode of treatment.
Other points to consider for future treatments would be :
St 40, Liv 14, Back – shu points, Heart 7, Liv 3,
This case demonstrated for me the effectiveness of Chinese medicine when a correct diagnosis is made. This patient will probably continue to use acupuncture and herbs to balance his health and maintain wellness.

Acupuncture used for Low Back Pain and Hot Feet

Chief Complaint: lower back discomfort, hot feet.
Medical History: Female approx 50 + y.o.
Presenting Challenge: Discomfort in lower back last 12 months or so, can vary from sore or can’t get comfortable, to a sense of tired, weak. Also digestive challenges leading to diminished appetite pattern of irregular food intake due to varying work schedule.
Irregular menses last 2 years, last period 6mths or so ago.
Otherwise feels general health to be pretty good tho work schedules can be a bit taxing when busy.
Lifestyle: walks, nil cigs, very occasional social alcohol
Questioning exam: see above
Observation: palpation of lower back- it was hot to touch compared to the rest of this patient. Upon questioning also stated that she would get hot feet / sole especially at night.
Pulse: Xu at kidney, a little xu at Liver position and a sense of tight in the middle Jiao. Constitutionally pretty good
Tongue exam: see above
OM Diagnosis: Diagnosis: Kidney Yin Xu and Stomach /Spleen disharmony. I felt that with the correction of the middle jiao the blood would be better and with the improvement in the Kidneys then direct treatment of the liver was unnecessary
Treatment Principle: Rxp : Tonify Kidney Yin and harmonise mid Jiao to improve Transformation / transportation of acquired qi, blood etc.
Point Prescription: Treatment: My thinking here was that the Kidneys were in a little decline due to the natural aging process. This had been exacerbated by the middle jiao disharmony not allowing the correct transformation of acquired qi.
The essence cannot be replaced it can only be maintained through lifestyle therefore to Tonify the Kidney Yin when it is already depleted? My treatment was aimed at facilitating the process of transformation / transportation of acquired qi to assist in supporting the kidneys, build the blood and therefore assist in replenishing the Yin.
Initial Rx: Bl 17 and 20 needle moxa bilateral and Kid 3 (1)
Also some gentle advice re time needed to eat (without distractions), small meals regularly and to not skip breakfast, instead to start the day with porridge or congee.
The next two treatments continued in the same vein, the third treatment I used Cv 4, Cv 12, Lv 13 (2) and good old St 36 (2) needle and moxa.
It was noted at this stage that the lower back was no longer hot to touch and that the sense of tiredness in the back had reduced.
Treatment here moved to the penetrating and conception vessel alternated with the above two combinations. Kid 3 was replaced with Kid 1 on two occasions (needle moxa-
Yang creates Yin?)
Symptoms reduced as treatment progressed. A total of ten treatments in all two times per week and all presenting symptoms had gone.
I personally think that what is interesting in this case, though fairly simple, is that not once was the lower back itself treated with local points or points that would be “typically” used to treat lower back pain.
Herbal Formula: none used
Lifestyle Prescription: see dietary advice
Results: Symptoms reduced as treatment progressed. A total of ten treatments in all two times per week and all presenting symptoms had gone.
I personally think that what is interesting in this case, though fairly simple, is that not once was the lower back itself treated with local points or points that would be “typically” used to treat lower back pain.

Acupuncture and Herbs for Stomach Pain

Chief Complaint: Epigastric pain
Medical History: Male, 29
At age 16 the patient realized he couldn’t eat fried, greasy or rich foods on the same day as playing soccer without experiencing a burning sensation from the stomach to the throat. Began taking pepsid with a little improvement. At age 21, while in Sri Lanka he ate some yogurt which made burning so bad that the pepsid did not work. Accompanying symptoms included slight fever, irritability, and profuse diarrhea with a fetid odor and a burning sensation. Upon return to the U.S. he was diagnosed with Giardia and Amoebas. Prescribed Flagal which stopped diarrhea. Prescribed Prilosec for reflux which helped. At age 22, he stopped Prilosec and began managing the reflux with Chinese herbs.
Questioning exam: Currently.
epigastric pain from stomach to bottom of throat. worse after eating rich, fried or greasy foods. worse with alcohol and stress. better with heat. no improvement with acupuncture.
bowel movements- loose
appetite- good, avoids irritating foods
Pulse exam: wiry, slippery
slow (55 bpm)
Tongue exam: TB: puffy, slightly purple,
TC: thin white,
OM Diagnosis: Liver invading Spleen w/ Stomach qi counterflow
Treatment Principle: calm liver, tonify relieve pain
Point Prescription: Lv 3, 13, 14
Ren 12
Sp 4
Herbal Formula: Chai Hu Shu Gan San
Lifestyle Prescription: avoid aggravating foods.
manage stress level.
avoid overeating raw foods
Results: after 3 acupuncture treatment and two weeks with the herbs the diarrhea stopped and the epigastric pain was significantly lower. patient left for vacation and upon return there was no pain.
Synopsis: this is a chronic disease and difficult to eliminate completely. perhaps the most important factors to prevent it’s re-occurrence are to make lifestyle and dietary changes.

Acupuncture and Herbs for Goiter

Chief Complaint: The thyroid was enlarged.
Western Diagnosis: goiter due to iodine deficiency
Medical History: The patient’s thyroid got enlarged, hard, accompanied with headache, stuffy nose, tending to catch cold and get tired, irregular menstruation, lumbago, neck soreness, and irritability.
Pulse exam: Pulse is wiry and thin.
Tongue exam: Tongue is red with white coating.
OM Diagnosis: Liver qi stagnation
Treatment Principle: Soothing liver qi and promoting blood circulation.
Point Prescription: Electroacupuncture
Points: Yin Tang, Feng Chi GB 20, Zu San Li St. 36, Tai Chong Liv 3, San Yin Jiao Sp. 6.
Herbal Formula: San Leng 3, E Su 3, Dang Gui 3, Chai Hu 2, Xia Ku Cao 3, Xuan Shen 5, Mu Li 5, Chuan Xiong 3, Xin Yi Hua 3, Bei Qi 5, Bai Zhu 3, Fang Feng 3.
Results: The enlarged thyroid was back to normal after 6 month treatment.