Tuesday, February 21, 2012

Symptomatic Diagnosis: Chest & Back

The diagnostic “Ten Asking Song” pays particular attention to the chest and back. This article describes common complaints that arise from these areas, along with their differential diagnosis and herbal treatments.
Back Pain
Weakness of the lower back and knees
Chest Pain
Mass Formation in the abdomen

Back Pain

  • Accumulation of cold and damp (bi syndrome)

    Clinical manifestations
    • Pain which can radiate to neck
    • back feels heavy, stiff.
    • symptoms aggravated by cold damp weather.
    • Qiang Huo Sheng Shi Tang (Notopterygium Decoction to Overcome dampness)
  • Qi and blood stagnation due to recent trauma (acute)

    • Sudden onset of pain
    • Limited range of motion, acute symptoms
    • P: Tense
    • Could develop into chronic pain…
    • Yunnan Bai Yao (A pre-made formula)
    • Huo Lou Xiao Ling Dan (Fantastically Effective Formula to Invigorate the Collaterals)
  • Clinical manifestations Formula
  • Qi and blood stagnation due to past trauma (chronic)

    • Dull aching on & off, numbness aggravated by rest (deficiency beneath)
    • T: Purple
    • P: Thready and/or choppy
    Treatment Principle
    • Tonify and activate qi and blood
    • Du Huo Ji Sheng Tang (Angelica Pubescens and Sang-Ji-Sheng Decoction) + Tao Ren (Sm. Persicae) and Hong Hua (Flos. Carthami)

Weakness of the lower back and knees

  • Kidney/Liver deficiency

    • Zuo Gui Yin (Restore the Left (Kidney) Decoction)
    • You Gui Yin (Restore the Right (Kidney) Decoction)
    • Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet)
    • Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia)
  • Jing deficiency

    Clinical manifestations
    • Infertility, tinnitus, vertigo, sore back, premature ejaculation, amenorrhea, grey hair, premature aging
    • Kidney/Liver formulas plus Zi He Che (Placenta Hominis), Lu Rong (Cornu Cervi)
  • Yin deficiency

    Clinical manifestations
    • Emaciation, tidal fever, heat signs, five center heat.
    • Kidney/Liver formulas plus Huang Bai (Cx. Phellodendri), Zhi Mu (Rz. Anemarrhenae)
  • Yang deficiency

    Clinical manifestations
    • Cold signs such as cold hands and feet.
    • Kidney/Liver tonic formulas plus Fu Zi (Rx. Aconiti Lateralis Praeparata), Ba Ji Tian (Rx. Morindae Officinalis), Bu Gu Zhi (Fr. Psoraleae)
  • qi deficiency

    Clinical manifestations
    • Weakness of the lower gates (urethra, colon, etc.) incontinence, premature ejaculation, urination problems
    • Kidney/Liver tonic formulas plus astringent herbs such as Sang Piao Xiao (Ootheca Mantidis), Yi Zhi Ren (Fr. Alpiniae), Wu Wei Zi (Fr. Schisandrae), Fu Pen Zi (Fr. Rubi)

Chest Pain (often connected to the heart)

  • Heart qi deficiency

    Clinical manifestations
    • Mild pain
    • Neurosis, heart condition,
    • dull achy chest pain on one or both sides.
    • Chest congestion, palpitations
    • Spontaneous sweating, fatigue
    • T: Pale
    • P: Weak and thready
    Treatment Principle
    • Tonify Heart qi
    • Bao Yuan Tang (Preserve the Basal Decoction)
  • Cold accumulation (yang deficiency) Painful

    Clinical manifestations
    • Coronary Heart Disease,
    • chest pain, usually on the left side which could radiate tot he right, back shoulder,
      and arm.
    • Pale complexion, spontaneous sweating, cold extremities.
    • T: Pale, swollen, teeth marks
    • P: Deep, slow, knotty and intermittent
    Treatment Principle
    • Tonify heart yang, promote circulation of blood
    • Gua Luo Xie Bai Bai Jiu Tang (Trichosanthis, Allii, and White Wine Decoction)
  • Heart blood stagnation (still a form of yang deficiency)

    Clinical manifestations
    • Typical angina pectoris. Intense pain that can make the patient lose consciousness due to its intensity
    • Spontaneous cold sweating, fear, fatigue
    • T: Pale purple
    • P: Deep, thready, choppy, knotty, intermittent
    • Dan Shen (Salviae Miltiorrhizae) for chest pain
    • Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction)
    • Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction)
  • Phlegm accumulation (Involving the Lungs)

    Clinical manifestations
    • Cough
    • excess phlegm, pain with cough

Mass Formation in the abdomen

  • Qi and blood stagnation

    Clinical manifestations
    • Enlargement of the Liver and Spleen
    • Abdominal mass begins soft, but becomes harder as time goes by.
    • Distention, emaciation, fatigue,
    • Dark dull facial complexion
    • low appetite, dry skin
    • T: Purple spots
    • P: Wiry, tense
    • Cancerous tumors tend to be more blood stagnation than qi stagnation
    Treatment Principle
    • Activate blood, yin deficiency unimportant now
    • Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction) + Shi Xiao San (Sudden Smile Powder)
  • Phlegm Stagnation

    Clinical manifestations
    • Abdominal mass, no pain yet distended and uncomfortable..
    • Mass is movable and soft, but patient dislikes touch.
    • T: Pale
    • P: soft and Slippery
    • Bao He Wan (Preserve Harmony Pills)
    • Er Chen Tang (Two Aged Decoction)
  • Zhong qi deficiency (sinking, or organ prolapse)

    Clinical manifestations
    • Pulling down, or bearing down sensation
    • qi deficiency symptoms
    • Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)

No comments:

Post a Comment