Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Dear colleagues, I wanted to report on an interesting finding. I have been treating a complicated 71 year old patient for the past two weeks specifically for vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The patient initially felt significant improvement in his symptoms for a day or so, and then they returned. When he came in for his second treatment on Monday of this week, his wife noticed what appeared to be the beginning of a rash on his left arm, but no where else. The next day, yesterday, huge purple welts appeared on his left arm, which burned. I just had them come in and check all the herbs in these two formulas for possible allergic reactions in Chen and Chen. The only herb which was listed as presenting rash as a possible side effect was Tian Ma. I told him to stop the two formulas immediately, and gave him Qing Dai San to mix with sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du Pian for two days. Also I encouraged him to drink diluted luke warm lemon juice and water (1/4 lemon to 8oz of water) to help the liver expel the pathogen. I will report on the results. Has anyone ever seen such a reaction to Tian Ma. BTW, this is the second time in my years of practice that I have seen such a reaction. The other time it was from Huang Bai. Respectfully, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Hello Yehuda, Thank you for the write up. May I ask if the Tian Ma Gou Ten yin formula came from the raw herbs in your office or if you got it as a formula from a supplier somewhere else? True Tian Ma is very expensive these days and many raw herb suppliers buy/sell substitutes without even knowing it - it looks just like the real thing and it takes a lot of experience to tell them apart. I can not tell them apart and have to trust my suppliers. It is possible that you had a batch of formula or herb with fake Tian Ma in it, or a contaminated batch. You may want to contact your herb supplier and ask them about it - just a possibility to consider. Eugene Kokorin, LAc ________________________________ Traditional Chinese Herbal Medicine ; TCM <Chinese Traditional Medicine > Wednesday, January 7, 2009 8:29:20 PM allergic reaction to Tian Ma Dear colleagues, I wanted to report on an interesting finding. I have been treating a complicated 71 year old patient for the past two weeks specifically for vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The patient initially felt significant improvement in his symptoms for a day or so, and then they returned. When he came in for his second treatment on Monday of this week, his wife noticed what appeared to be the beginning of a rash on his left arm, but no where else. The next day, yesterday, huge purple welts appeared on his left arm, which burned. I just had them come in and check all the herbs in these two formulas for possible allergic reactions in Chen and Chen. The only herb which was listed as presenting rash as a possible side effect was Tian Ma. I told him to stop the two formulas immediately, and gave him Qing Dai San to mix with sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du Pian for two days. Also I encouraged him to drink diluted luke warm lemon juice and water (1/4 lemon to 8oz of water) to help the liver expel the pathogen. I will report on the results. Has anyone ever seen such a reaction to Tian Ma. BTW, this is the second time in my years of practice that I have seen such a reaction. The other time it was from Huang Bai. Respectfully, www.traditionaljewi shmedicine. net Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Yehuda, Thanks for sharing. Sometimes skin rashes pop up from those who are hyper-sensitive to sulfur-dioxide from the herbs, but they are usually red, not purple welts. Is this a new patient who is for the first time taking Chinese herbs? I've seen the sulfur-dioxide allergy show up a couple of times, when I was a student at the school clinicnwhich used sulfured herbs. When I went back to ask them if they are allergic to sulphur, that came up positive from their allopathic history. But, of course, we never mention that the herbs we use may have sulfur-dioxide content which is used as a fumigant. Tian ma (gastrodia) is an endangered herb and is not available in Sulfur-free form, as far as I know. Was that Zhen zhu wu tang or Zhen wu tang? Zhen wu tang has Fu zi in it, which may have something to do with the rash (heat?) K. On Thu, Jan 8, 2009 at 10:34 AM, Eugene Kokorin <ek2000 wrote: > Hello Yehuda, > > Thank you for the write up. May I ask if the Tian Ma Gou Ten yin formula > came from the raw herbs in your office or if you got it as a formula from a > supplier somewhere else? > True Tian Ma is very expensive these days and many raw herb suppliers > buy/sell substitutes without even knowing it - it looks just like the real > thing and it takes a lot of experience to tell them apart. I can not tell > them apart and have to trust my suppliers. > It is possible that you had a batch of formula or herb with fake Tian Ma in > it, or a contaminated batch. You may want to contact your herb supplier and > ask them about it - just a possibility to consider. > > Eugene Kokorin, LAc > > ________________________________ > <%40>> > Traditional Chinese Herbal Medicine <Traditional Chinese Herbal Medicine%40>; > TCM <Chinese Traditional Medicine <Chinese Traditional Medicine%40yah\ oogroups.com> > > > Wednesday, January 7, 2009 8:29:20 PM > allergic reaction to Tian Ma > > > Dear colleagues, > > I wanted to report on an interesting finding. I have been treating a > complicated 71 year old patient for the past two weeks specifically for > vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang > vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising > at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The > patient initially felt significant improvement in his symptoms for a day or > so, and then they returned. When he came in for his second treatment on > Monday of this week, his wife noticed what appeared to be the beginning of a > rash on his left arm, but no where else. The next day, yesterday, huge > purple welts appeared on his left arm, which burned. I just had them come in > and check all the herbs in these two formulas for possible allergic > reactions in Chen and Chen. The only herb which was listed as presenting > rash as a possible side effect was Tian Ma. I told him > to stop the two formulas immediately, and gave him Qing Dai San to mix with > sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du > Pian for two days. Also I encouraged him to drink diluted luke warm lemon > juice and water (1/4 lemon to 8oz of water) to help the liver expel the > pathogen. I will report on the results. Has anyone ever seen such a reaction > to Tian Ma. BTW, this is the second time in my years of practice that I have > seen such a reaction. The other time it was from Huang Bai. > > Respectfully, > > > > > > www.traditionaljewi shmedicine. net > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Hi Eugene and Kokko, Yes, this is his first time taking Chinese herbs. Actually I wasn't completely forthright: I gave him the formulas in pill form (Plum Flower brand). But of the two formulas I gave him, as I said, from Chen and Chen, the only herb in the formulae listing dermatitis as a possible side effect was Tian Ma. That's what I based my deduction upon. As far as the other formula, you are correct it is Zhen Wu Tang Wan. You will note, though that rather than using raw Fu Zi, they use Shu Fu Zi. As I mentioned, this patient has cold extremities and is clearly Yang Vacuous and has cold congested fluids (among other things), so I don't think intuitively, that the Fu Zi is causing the problem. --- On Thu, 1/8/09, <johnkokko wrote: <johnkokko Re: allergic reaction to Tian Ma Chinese Medicine Thursday, January 8, 2009, 11:24 AM Yehuda, Thanks for sharing. Sometimes skin rashes pop up from those who are hyper-sensitive to sulfur-dioxide from the herbs, but they are usually red, not purple welts. Is this a new patient who is for the first time taking Chinese herbs? I've seen the sulfur-dioxide allergy show up a couple of times, when I was a student at the school clinicnwhich used sulfured herbs. When I went back to ask them if they are allergic to sulphur, that came up positive from their allopathic history. But, of course, we never mention that the herbs we use may have sulfur-dioxide content which is used as a fumigant. Tian ma (gastrodia) is an endangered herb and is not available in Sulfur-free form, as far as I know. Was that Zhen zhu wu tang or Zhen wu tang? Zhen wu tang has Fu zi in it, which may have something to do with the rash (heat?) K. On Thu, Jan 8, 2009 at 10:34 AM, Eugene Kokorin <ek2000 > wrote: > Hello Yehuda, > > Thank you for the write up. May I ask if the Tian Ma Gou Ten yin formula > came from the raw herbs in your office or if you got it as a formula from a > supplier somewhere else? > True Tian Ma is very expensive these days and many raw herb suppliers > buy/sell substitutes without even knowing it - it looks just like the real > thing and it takes a lot of experience to tell them apart. I can not tell > them apart and have to trust my suppliers. > It is possible that you had a batch of formula or herb with fake Tian Ma in > it, or a contaminated batch. You may want to contact your herb supplier and > ask them about it - just a possibility to consider. > > Eugene Kokorin, LAc > > ____________ _________ _________ __ > <%40. com>> > Traditional Chinese Herbal Medicine<Traditional Chinese Herbal Medicine %40. com>; > TCM <traditional_ chinese_medicine <traditional_ chinese_medicine %40. com> > > > Wednesday, January 7, 2009 8:29:20 PM > allergic reaction to Tian Ma > > > Dear colleagues, > > I wanted to report on an interesting finding. I have been treating a > complicated 71 year old patient for the past two weeks specifically for > vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang > vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising > at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The > patient initially felt significant improvement in his symptoms for a day or > so, and then they returned. When he came in for his second treatment on > Monday of this week, his wife noticed what appeared to be the beginning of a > rash on his left arm, but no where else. The next day, yesterday, huge > purple welts appeared on his left arm, which burned. I just had them come in > and check all the herbs in these two formulas for possible allergic > reactions in Chen and Chen. The only herb which was listed as presenting > rash as a possible side effect was Tian Ma. I told him > to stop the two formulas immediately, and gave him Qing Dai San to mix with > sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du > Pian for two days. Also I encouraged him to drink diluted luke warm lemon > juice and water (1/4 lemon to 8oz of water) to help the liver expel the > pathogen. I will report on the results. Has anyone ever seen such a reaction > to Tian Ma. BTW, this is the second time in my years of practice that I have > seen such a reaction. The other time it was from Huang Bai. > > Respectfully, > > > > > > www.traditionaljewi shmedicine. net > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 Why do you think its the Tian Ma and not something in the other formula? I'm a bit confused as to the first Zhen Zhu Wu Tang. I can't find it in Bensky, only zhen Zhu Mu Tang and of course Zhen Wu Tang. and in what form did you give these? Doug , yehuda frischman < wrote: > > Dear colleagues, > > I wanted to report on an interesting finding. I have been treating a complicated 71 year old patient for the past two weeks specifically for vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The patient initially felt significant improvement in his symptoms for a day or so, and then they returned. When he came in for his second treatment on Monday of this week, his wife noticed what appeared to be the beginning of a rash on his left arm, but no where else. The next day, yesterday, huge purple welts appeared on his left arm, which burned. I just had them come in and check all the herbs in these two formulas for possible allergic reactions in Chen and Chen. The only herb which was listed as presenting rash as a possible side effect was Tian Ma. I told him > to stop the two formulas immediately, and gave him Qing Dai San to mix with sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du Pian for two days. Also I encouraged him to drink diluted luke warm lemon juice and water (1/4 lemon to 8oz of water) to help the liver expel the pathogen. I will report on the results. Has anyone ever seen such a reaction to Tian Ma. BTW, this is the second time in my years of practice that I have seen such a reaction. The other time it was from Huang Bai. > > Respectfully, > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 10, 2009 Report Share Posted January 10, 2009 Sorry, Doug. When I stay up late I make mistakes. I meant to say Zhen Wu Tang Wan, the Plum Flower pill formulation. --- On Fri, 1/9/09, wrote: Re: allergic reaction to Tian Ma Friday, January 9, 2009, 2:42 PM Why do you think its the Tian Ma and not something in the other formula? I'm a bit confused as to the first Zhen Zhu Wu Tang. I can't find it in Bensky, only zhen Zhu Mu Tang and of course Zhen Wu Tang. and in what form did you give these? Doug , yehuda frischman <@.. .> wrote: > > Dear colleagues, > > I wanted to report on an interesting finding. I have been treating a complicated 71 year old patient for the past two weeks specifically for vertigo and low back pain. My differential diagnosis is Kidney Yin and Yang vacuity, fluid accumulation with Liver Qi stagnation and liver Yang rising at the root. I prescribed Zhen Zhu Wu Tang and Tian Ma Gou teng Yin. The patient initially felt significant improvement in his symptoms for a day or so, and then they returned. When he came in for his second treatment on Monday of this week, his wife noticed what appeared to be the beginning of a rash on his left arm, but no where else. The next day, yesterday, huge purple welts appeared on his left arm, which burned. I just had them come in and check all the herbs in these two formulas for possible allergic reactions in Chen and Chen. The only herb which was listed as presenting rash as a possible side effect was Tian Ma. I told him > to stop the two formulas immediately, and gave him Qing Dai San to mix with sesame oil and make into a Gao, and to take internally, Lian Qiao Bai Du Pian for two days. Also I encouraged him to drink diluted luke warm lemon juice and water (1/4 lemon to 8oz of water) to help the liver expel the pathogen. I will report on the results. Has anyone ever seen such a reaction to Tian Ma. BTW, this is the second time in my years of practice that I have seen such a reaction. The other time it was from Huang Bai. > > Respectfully, > > > > > > www.traditionaljewi shmedicine. net > > > > > > Quote Link to comment Share on other sites More sharing options...
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