Guest guest Posted September 2, 1999 Report Share Posted September 2, 1999 I was sent this case by a list member. Yesterday a 28 yr. old women came to see me with following complaint. 1]Lack of ovulation. wished to have an other child. History: 5' 6 " Weight 265 lbs Skin tone : Light and pale Hair: thin lusterless nails : thin cracked Tongue :Pale,limp,w/deep crack from root to near tip Light thin coating w/yellowing from root to mid point. Pulse :faint and slightly wiry. Western med. history Has one child 4 yrs old.Hard birth exper. toxemia w/ext. hosp stay after birth including seizures. child healthy. currently has several problems w/menses heavy bleeding,cramping before and after,infertility,and pain during intercourse Client is type 2 diabetic!! Has history of MVPs murmurs,and palpitations Has long list of meds but does not comply well w/program. Starting slowly Working on modifications in diet increased intake of fluids started Yu Quan wan from May Way co. will see again 1 wk. I forwarded your message to the list because it raises some interesting points for the entire group. 1) While yu quan wan is a typical wasting and thirsting formula, it is for a patient with yin and qi xu who is wasting. I do not think it is applicable to most type II diabetics. Your patient is not wasting; she is overweight and needs to lose weight to cure all her conditions, including the anovulation. While she has symptoms of qi xu, she does not have symptoms of yin xu. Thus, her central qi may be further damaged by using yin tonics at this stage. This a common mistake amongst students. 2) While yu quan wan can control blood sugar, it would require a much larger dose than is possible with a mayway pill. Luckily that will also preclude her having any short term side effects either. For a very one sided take on this subject, see www.spiritone.com/~herb-t/dosage.html 3) I would recommend investigating some nonstandard approaches to diabetes. See my article at www.spiritone.com/~herb-t/diabetes.html Several of the formulae in this article are also used for weight loss. Your best bet as always is a TCM differentiation, not selection based on disease. Ba zhen tang might be a good base formula. It contains several herbs that lower blood sugar (ginseng, atractylodes, hoelen, rehmannia) and it removes dampness, as well. It tonifies qi and blood, which seems to be the root here, though blood stagnation seems to have occurred, too. However, this rx also addresses that. The yellow tongue coat suggests some heat, but I think it may be yin fire brewing. If this is true, perhaps either herbs to clear dampheat or uplift qi should be added. For more on yin fire, go to www.bluepoppy.com and click on articles and scroll for articles on yin fire, spleen/stomach theory, li dong yuan. Or see what Z'ev thinks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 1999 Report Share Posted September 2, 1999 Sounds like Lv/Kd yin and blood xu with some qi xu to me. A modification of Shi Quan Da Bu wan + Zuo Gui Wan may be a good start for her. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 1999 Report Share Posted September 2, 1999 Mark, I still don't see the yin xu. Any branch sx can be accounted for by qi and blood xu, while key root sx confirming yin xu are absent, such as red tongue, dry tongue, fast pulse, nightsweats, heat sensations, dryness, low back pain, etc. Plus the patient is young and overweight, two conditions that also rule against yin xu. Please explain your diagnosis. I believe yin xu is overdiagnosed so I tend not to jump to it. However, in my last case discussed here, I did miss it and you mentioned that liver yin xu is not uncommon in your practice. In general, how do you make this dx and in this specific case. thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 1999 Report Share Posted September 2, 1999 Thank you for your response I am reading the material you noted in your e-mail. --- Original Message ----- <herb-t < > Thursday, September 02, 1999 4:49 AM yin xu/yin fire > " " <herb-t > > I was sent this case by a list member. > > > Yesterday a 28 yr. old women came to see me with following complaint. > 1]Lack of ovulation. wished to have an other child. > > History: > 5' 6 " Weight 265 lbs > > Skin tone : Light and pale > > Hair: > thin lusterless > > nails : thin cracked > > Tongue :Pale,limp,w/deep crack from root to near tip > > Light thin coating w/yellowing from root to mid point. > > Pulse :faint and slightly wiry. > > Western med. history > Has one child 4 yrs old.Hard birth exper. toxemia w/ext. hosp stay after > birth including seizures. child healthy. > currently has several problems w/menses heavy bleeding,cramping before > and after,infertility,and pain during intercourse > Client is type 2 diabetic!! > Has history of MVPs murmurs,and palpitations > > Has long list of meds but does not comply well w/program. > > Starting slowly > > Working on modifications in diet > increased intake of fluids > started Yu Quan wan from May Way co. > will see again 1 wk. > > > I forwarded your message to the list because it raises some interesting > points for the entire group. > > 1) While yu quan wan is a typical wasting and thirsting formula, it is > for a patient with yin and qi xu who is wasting. I do not think it is > applicable to most type II diabetics. Your patient is not wasting; she > is overweight and needs to lose weight to cure all her conditions, > including the anovulation. While she has symptoms of qi xu, she does > not have symptoms of yin xu. Thus, her central qi may be further > damaged by using yin tonics at this stage. This a common mistake > amongst students. > > 2) While yu quan wan can control blood sugar, it would require a much > larger dose than is possible with a mayway pill. Luckily that will also > preclude her having any short term side effects either. For a very one > sided take on this subject, see www.spiritone.com/~herb-t/dosage.html > > 3) I would recommend investigating some nonstandard approaches to > diabetes. See my article at www.spiritone.com/~herb-t/diabetes.html > Several of the formulae in this article are also used for weight loss. > > Your best bet as always is a TCM differentiation, not selection based on > disease. > > Ba zhen tang might be a good base formula. It contains several herbs > that lower blood sugar (ginseng, atractylodes, hoelen, rehmannia) and it > removes dampness, as well. It tonifies qi and blood, which seems to be > the root here, though blood stagnation seems to have occurred, too. > However, this rx also addresses that. The yellow tongue coat suggests > some heat, but I think it may be yin fire brewing. If this is true, > perhaps either herbs to clear dampheat or uplift qi should be added. > For more on yin fire, go to www.bluepoppy.com and click on articles and > scroll for articles on yin fire, spleen/stomach theory, li dong yuan. > Or see what Z'ev thinks. > > --------------------------- ONElist Sponsor ---------------------------- > > ONElist: your connection to online communities. > > ------ > Chronic Diseases Heal - Chinese Herbs Can Help > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 1999 Report Share Posted September 3, 1999 I missed the overweight aspect. Her tongue is cracked, she has diabetes, and there are heat sxs. In my experience, when multiple syndromes seem present, it only takes a few sxs for any one syndrome to know that one is there. However, having not seen the patient, I could be wrong here. There could be residual damp heat and toxins blocking ovulation as well. Perhaps combining Cang Fu Dao Tan Tang with a Qi and Blood tonic Rx would be a better approach if this were the case. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 1999 Report Share Posted September 3, 1999 I thnk asymptomatic diabetes (i.e. no waste, thirst, polyuria) is not necessarily yin xu and most of these type also do not need insulin. See my article at http://www.spiritone.com/~herb-t/diabetes.html Quote Link to comment Share on other sites More sharing options...
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