Update on cancer case study from Digest Number 109

[Guest guest]

My patient with cancer returned for another evaluation and treatment today.

There are a few details that I didn't make clear and a little bit of new

information.

Today she mostly complained of poor digestion that manifests as loud

borborygmus sometimes followed by an urgent need to defecate and explosive

but incomplete passage of formed, slightly smelly stools. No undigested food.

This happens in the afternoon although she does experience quieter bowel

sounds throughout the day. She will then usually have another complete,

undramatic bowel movement once a day. She also complains of constant

bloating of her abdomen and of waking with a dull, heavy headache that occurs

across the front of her head just behind her hairline. She did moderate her

raw and cold food intake but we still have a way to go with diet. Fatigue is

an issue for her which she admitted to in my initial questionaire.

On both of her visits to my office she has worn 3 pairs of pants, multiple

layers of shirts and sweaters and lots of socks. She says she is sensitive to

the cold. Even with all of the layers her feet were still quite cold.

She still complains of some ribside tenderness which was frank pain a few

weeks back. It seems to be located in the intercostal muscles. There is some

local nodulation on the ribs themselves. She had a chest x-ray which didn't

find an explanation for the problem.

Tongue today was pale and a little dusky with a darker dusky tip. It was

puffy and a little flabby with soft teethmarks. A thick yellow coat in the

back 1/2. A thin white coat in front with foamy sides.

The pulse was again empty in the right guan position, weak in the left chi

position. Overall soft on the right and on the left, hard and rough in the

superficial positions and weak underneath. (Sorry about lack of proper pulse

nomenclature.)

My diagnosis again is yang xu cold(Sp, K) with damp accumulation. Dampheat

and blood stasis in the lower jiao. Liver qi depression. Diffuse phlegm

nodulation. Yin/blood xu.

She continues to take the essiac tea and the ban zhi lian and bai hua she she

cao. Since I believe that these might be enough dampheat/toxin drainage for

her my herbal formula is focused on warming yang, supplementing the spleen

and transforming damp/phlegm( ascending the pure and descending the turbid),

moving liver qi, and supporting yin/blood.

I dispense herbs in granular extract form but the following doasages would be

the usual raw package equivalent.

Rou gui, 6

gan jiang, 6

bai zhu, 9

huang qi, 15

fu ling, 9

gan cao, 6

ban xia, 9

zhi shi, 6

qing pi, 6

yi yi ren, 15

dan shen, 9

bai shao, 9

She is happy that I've brought her case to this discussion. Today we were

much more comfortable with each other. I feel that we are on our way to a

fruitful practitioner/patient relationship.

Any questions, comments or criticism?

 

Kristin Wisgirda, MTOM, Lic.Ac.

[Guest guest]

Dear Kristin,

This formula looks excellant. . . .this is a real Li Dong-yuan scenario,

no? Yes, sp yang xu cold with damp heat in lower jiao, along with blood

stasis. She should be careful with the cold herbs, however, since she is

so chilly.

 

 

 

 

 

 

 

 

 

>Kwisgirda

>

>My patient with cancer returned for another evaluation and treatment today.

>There are a few details that I didn't make clear and a little bit of new

>information.

>Today she mostly complained of poor digestion that manifests as loud

>borborygmus sometimes followed by an urgent need to defecate and explosive

>but incomplete passage of formed, slightly smelly stools. No undigested food.

>This happens in the afternoon although she does experience quieter bowel

>sounds throughout the day. She will then usually have another complete,

>undramatic bowel movement once a day. She also complains of constant

>bloating of her abdomen and of waking with a dull, heavy headache that occurs

>across the front of her head just behind her hairline. She did moderate her

>raw and cold food intake but we still have a way to go with diet. Fatigue is

>an issue for her which she admitted to in my initial questionaire.

>On both of her visits to my office she has worn 3 pairs of pants, multiple

>layers of shirts and sweaters and lots of socks. She says she is sensitive to

>the cold. Even with all of the layers her feet were still quite cold.

>She still complains of some ribside tenderness which was frank pain a few

>weeks back. It seems to be located in the intercostal muscles. There is some

>local nodulation on the ribs themselves. She had a chest x-ray which didn't

>find an explanation for the problem.

>Tongue today was pale and a little dusky with a darker dusky tip. It was

>puffy and a little flabby with soft teethmarks. A thick yellow coat in the

>back 1/2. A thin white coat in front with foamy sides.

>The pulse was again empty in the right guan position, weak in the left chi

>position. Overall soft on the right and on the left, hard and rough in the

>superficial positions and weak underneath. (Sorry about lack of proper pulse

>nomenclature.)

>My diagnosis again is yang xu cold(Sp, K) with damp accumulation. Dampheat

>and blood stasis in the lower jiao. Liver qi depression. Diffuse phlegm

>nodulation. Yin/blood xu.

>She continues to take the essiac tea and the ban zhi lian and bai hua she she

>cao. Since I believe that these might be enough dampheat/toxin drainage for

>her my herbal formula is focused on warming yang, supplementing the spleen

>and transforming damp/phlegm( ascending the pure and descending the turbid),

>moving liver qi, and supporting yin/blood.

>I dispense herbs in granular extract form but the following doasages would be

>the usual raw package equivalent.

>Rou gui, 6

>gan jiang, 6

>bai zhu, 9

>huang qi, 15

>fu ling, 9

>gan cao, 6

>ban xia, 9

>zhi shi, 6

>qing pi, 6

>yi yi ren, 15

>dan shen, 9

>bai shao, 9

>She is happy that I've brought her case to this discussion. Today we were

>much more comfortable with each other. I feel that we are on our way to a

>fruitful practitioner/patient relationship.

>Any questions, comments or criticism?

>

>Kristin Wisgirda, MTOM, Lic.Ac.

>

>

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>Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

Kristin,

 

I agree with Z'ev that the formula is great.......

But if I may, to provoke some thought and liven up this list...........

 

I can only remember three of the ingredients in essiac (rhubarb, sheep

sorrel and slippery elm) Although your diagnosis say damp heat this herb may

not be appropriate considering it actions on the bowels and even though it

is a Western herb it is also a Chinese herb and you can certainly speak to

it. As for sheep sorrel, in my opinion it is nearly benign and was abandoned

centuries ago in the Western tradition. Slippery elm with nourish yin and is

likely very good for this patient. As for the bai hua she she cao and ban

lian zhi perhaps good for the cancer but the ling zhi would be excellent

considering her condition and I think adding it to the formula is a good

idea. Further, as I stated before ban lan gen is still appropriate for the

HCV.

Now to your formula, if I may since no one else seems to what to I would

question the zhi shi since it has a downward energy and consider adding cang

zhu, hou po, chen pi (maybe instead of qing pi) and perhaps chai hu. you

might also consider substituting chi shao for bai shao, maybe....

 

just some thoughts, do with as you may but its fun to have this type of

stimulating conversation......

 

> the usual raw package equivalent.

> Rou gui, 6

> gan jiang, 6

> bai zhu, 9

> huang qi, 15

> fu ling, 9

> gan cao, 6

> ban xia, 9

> zhi shi, 6

> qing pi, 6

> yi yi ren, 15

> dan shen, 9

> bai shao, 9

> She is happy that I've brought her case to this discussion. Today we were

> much more comfortable with each other. I feel that we are on our way to a

> fruitful practitioner/patient relationship.

> Any questions, comments or criticism?

>

> Kristin Wisgirda, MTOM, Lic.Ac.

>

 

Chinese Herbology and Acupuncture

Formulator and Consultant Summer Jo's (botanicals)

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

[Guest guest]

Kristin,

I would have to agree with Thomas that the Essiac is probably not

appropriate for this patient. The da huang and your zhi shi probably

have too strong a descending action for her weakened qi and most signs

of her cancer are currently gone if I remember correctly. You could sub

chen pi for the zhi shi and suggest she stop using the Essiac although

the burdock that is in it has some useful properties for her HCV. The

cang zhu would be a good addition for her dampness and the chai hu has

significant effects against HCV. The qing pi could probably remain for

her intercostal pain though. Ban lan gen is a must for her HCV and some

ling zhi and/or jiao gu lan would be nice additions also for her overall

condition/history. Overall your formula looks really good and you should

see some positive results fairly soon in many of her sxs if she remains

compliant. Thanks for sharing this difficult case!

 

Mark Goldby

[Guest guest]

I agree with Mark and Thomas about the essiac rx and it underscores why

the principles of TCM outweigh all other factors in precise herb

selection. It is uncanny how often muscle testing and folk herbalism

result in formula selection that is way too cleansing or supplementing

for the patient. If these methods have any value, it is far outweighed

by their danger in the hands of most who use them. In most cases I have

seen, such " healers " are actually sales reps for multilevel marketing

companies.

 

 

 

[This message contained attachments]

[Guest guest]

It is always a difficult proposition to 'balance out' Chinese herbal

medicine practically with the other stuff patients are doing. One has to

win patient confidence, and tampering with 'belief systems' about 'cancer

cures' such as Essiac can be challenging.

 

I actually think that Essiac is one of the few commercial formulas out

there that is valuable in a Chinese medicine light. . .but it has a

specific purpose. This formula has primarily heat draining, blood cooling

medicinals (rhubarb, sorrel, and red clover come to mind). . . .therefore,

it should not be used with sp xu, cold, damp patients. Also, balancing

other medicinal treatment is tricky at best. . . .I like to avoid it if

possible.

 

A scenario I had this week. . . .a new patient with gall bladder stones,

hemerrhoids, severe constipation, bloated abdomen, fatigue, pain after

intercourse. Frequent urination after swimming! Vacuous pulse in third

(chi) position, very soggy, tongue with deep center crack, small shrivelled

body. Uses herbal laxatives. Prescribed spleen supplementing medicinals.

.. ..Li Dong-yuan's Huang qi ren shen tang. . .. .She calls me two days

later to say that after taking the Chinese herbs, she became hard and

bloated in the abdomen. However, with further questioning, I found out she

had done an enema just before taking the herbs! Also (being a Russian

immigrant, there was some language difficulty at our first meeting), she

had been taking the herbal laxatives for 25 years, and then stopped

completely after our first consult!! The Shang Han Lun teaches that using

precipitating medicinals in a patient with internal vacuity of qi can cause

hard bloating and constipation. . . .it recommends a modification of gui

zhi tang plus da huang to treat this scenario. In other words, one cannot

cut off the laxatives in this case immediately, as she tried to do. One

has to gradually supplement, and work to slowly decrease the draining

medicinals after such a long habituation.

 

 

 

 

 

 

 

>TLuger ()

>

>I agree with Mark and Thomas about the essiac rx and it underscores why

>the principles of TCM outweigh all other factors in precise herb

>selection. It is uncanny how often muscle testing and folk herbalism

>result in formula selection that is way too cleansing or supplementing

>for the patient. If these methods have any value, it is far outweighed

>by their danger in the hands of most who use them. In most cases I have

>seen, such " healers " are actually sales reps for multilevel marketing

>companies.

>

[Guest guest]

Todd said:

> I agree with Mark and Thomas about the essiac rx and it underscores why

> the principles of TCM outweigh all other factors in precise herb

> selection.

 

I'm a little unsure of what you are saying here. Do you really believe that

all other forms of medicine are outweighed by the principles of TCM when it

comes to herb selection? There are a great number of people who have used

this formula with excellent results in CA. Further, there are a great number

of herbalists who use other than TCM and who are excellent herbalists. When

I ran my apothecary I used to sell essiac a fair bit to practitioners who

liked to use it. Most were not TCM practitioners and I would be willing to

bet that at least some of the patients didn't fit what we might think would

be the apropriate sx picture for this formula.

 

> It is uncanny how often muscle testing and folk herbalism

> result in formula selection that is way too cleansing or supplementing

> for the patient. If these methods have any value, it is far outweighed

> by their danger in the hands of most who use them. In most cases I have

> seen, such " healers " are actually sales reps for multilevel marketing

> companies.

 

MOST CASES! rather strong don't you think. Although I agree that muscle

testing is mostly bogus, I was JUST a part of a discussion on this topic on

another professional list and a couple of them (people who I respect) claim

to use muscle testing successfully. The difference seems to be that these

folks are trained and studied and don't rely on it but rather use it when

they get stuck or perhaps are looking for some clarity. BTW I know a lot of

folk herbalists that are excellent practitioners, people who I would trust

treating me or members of my family. Let us not be to narrow minded lest we

be a part of the problem rather than the solution.

 

A little (and scary) story about muscle testing. This past summer I

interviewed for a position in an outpatient hospital clinic in PA. The doc

there has been practicing acupuncture for over ten years. His method of

point selection, muscle testing. When I asked him how he decided which

points to test he said he only uses about twenty points and would choose

from those depending on which one seemed appropriate. BTW I was offered the

job (a very good paying job) but turned it down to move to Oregon and

practice privately, formulate products and work closely with an organic farm

to grow herbs.

 

Respectfully,

 

Chinese Herbology and Acupuncture

Formulator and Consultant Summer Jo's (botanicals)

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

[Guest guest]

I don't think the issue here so much is how Essiac is formulated. . . . .I

myself think it is a job well done, and I know people it has helped. . . .

..but how formulas like this are administered to patients, either by health

professionals or self-prescribing. What type of diagnostic discrimination

is used? Sadly, in a majority of cases, the diagnostic is totally

symptomatic, as " Essiac for any cancer at any stage " , or kinesiological,

which to me, is based on " good vibes " . In our own Chinese medical

profession I see this, TCM clinics that give the same herb formula to every

AIDS patient, for example.

>

>Todd said:

>> I agree with Mark and Thomas about the essiac rx and it underscores why

>> the principles of TCM outweigh all other factors in precise herb

>> selection.

>

>I'm a little unsure of what you are saying here. Do you really believe that

>all other forms of medicine are outweighed by the principles of TCM when it

>comes to herb selection? There are a great number of people who have used

>this formula with excellent results in CA. Further, there are a great number

>of herbalists who use other than TCM and who are excellent herbalists. When

>I ran my apothecary I used to sell essiac a fair bit to practitioners who

>liked to use it. Most were not TCM practitioners and I would be willing to

>bet that at least some of the patients didn't fit what we might think would

>be the apropriate sx picture for this formula.

>

 

I agree with Todd here, completely. There is simply not enough criteria in

a diagnostic procedure like kinesiology to accurately choose a prescription

for a patient. There is no substitute for knowledge of materia medica.

Folk herbalists know their medicines, unlike health professionals who sell

products based on information supplied by the company, often

multi-marketing concerns.

 

 

>> It is uncanny how often muscle testing and folk herbalism

>> result in formula selection that is way too cleansing or supplementing

>> for the patient. If these methods have any value, it is far outweighed

>> by their danger in the hands of most who use them. In most cases I have

>> seen, such " healers " are actually sales reps for multilevel marketing

>> companies.

>

>MOST CASES! rather strong don't you think. Although I agree that muscle

>testing is mostly bogus, I was JUST a part of a discussion on this topic on

>another professional list and a couple of them (people who I respect) claim

>to use muscle testing successfully. The difference seems to be that these

>folks are trained and studied and don't rely on it but rather use it when

>they get stuck or perhaps are looking for some clarity. BTW I know a lot of

>folk herbalists that are excellent practitioners, people who I would trust

>treating me or members of my family. Let us not be to narrow minded lest we

>be a part of the problem rather than the solution.

>