Guest guest Posted March 4, 2000 Report Share Posted March 4, 2000 Hello. On Feb. 24, I submitted a case for review (and help). I would like to update you all and again ask for perspectives and advice. A quick recap. A 50 y.o. woman diagnosed with Sjogren's who has had a cough and sinusitis for the last 4 years that have not responded to any western medical care. Her cough produces thick yellow sputum in a large amount that is difficult to expectorate. She has a very hard time swallowing because of the dryness and the persistent phlegm in her throat. Her tongue is dusky, swollen, flabby, tender, sticky wet, with diffuse line like cracks and a rootless geographic coat. Her pulse is very thin and weak especially in the Sp position. My dx is Phlegm heat in the Lungs, yin xu (of St, Lung, K, and Liver), Spleen qi/yang xu. A week ago i gave her the following formula: ban xia 9 chen pi 6 fu ling 9 gan cao 6 dang gui 9 sheng di 12 mai dong 12 tian hua fen 15 zhe bei mu 12 xing ren 9 gua luo 12 dang shen 12 When she came to my office today she said she had to cut down on the herbs because she thinks that they were making her cough up more phlegm which would be ok except that the phlegm was so think and viscous that it was hard to get up all the way and she thought she would choke. So I modified her formula thus (adding more lubricating herbs and taking out the more drying agents and some of the phlegm movers): dang shen 12 chen pi 6 fu ling 6 gan cao 6 dang gui 9 sheng di 12 tian hua fen 15 zhe bei mu 12 xing ren 9 sha shen 9 yu zhu 9 I'm hoping that these added yin tonics will loosen her phlegm up a bit. Any ideas on possible herbs that might be more appropriate than the ones I'm giving her? I'm ordering some tai zhi shen which I think will be more appropriate than dang shen. She has only had 3 office visits so far and she understands that resolving her situation may be a long process. Thanks for any input. Kristin Wisgirda, MTOM, Lic.Ac. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 6, 2000 Report Share Posted March 6, 2000 Hi Kristin, My prediction is the increase in moistening herbs won't produce the desired effect. I also have tried this approach based on the dryness being a yin deficiency - with no effect. Since then I have become aware of the use of Wen Bing formulas in the treatment of auto immune disorders. The tongue and pulse signs don't stack up as a phlegm-fire or a Yin deficiency. My suggestion is it may be a case of Shi Wen (damp-heat) pathogen lingering (as it does) and impairing the fluid metabolism function of Spleen and Lung. If she has not responded to your latest Rx try using modified Gan Lu Xiao Du Dan with added Lung ventilating and coursing herbs. Suggested Rx Hua Shi 20, Yin Chen Hao 15, Huang Qin 10, Shi Chang Pu 10, Huo Xiang 10, Bai Dou Kou 10, Zhi Bei Mu 10, Mu Tong 6, Lian Qiao 6, Bo He 6, She Gan 10, Fang Feng 9, Jing Jie 9, The last two herbs are normally considered inappropriate (ie diaphoresis) for damp-heat, but in this instance will help open the lung and stop cough and a trick I have learned is if the damp-heat clearing Rx fails to clear the pathogen, add wind dispersing herbs. Hope this is of some benefit, Would love to hear the follow up Cheers Graham Jellett > Hello. > On Feb. 24, I submitted a case for review (and help). I would like to update > you all and again ask for perspectives and advice. > A quick recap. A 50 y.o. woman diagnosed with Sjogren's who has had a cough > and sinusitis for the last 4 years that have not responded to any western > medical care. Her cough produces thick yellow sputum in a large amount that > is difficult to expectorate. She has a very hard time swallowing because of > the dryness and the persistent phlegm in her throat. Her tongue is dusky, > swollen, flabby, tender, sticky wet, with diffuse line like cracks and a > rootless geographic coat. Her pulse is very thin and weak especially in the > Sp position. > My dx is Phlegm heat in the Lungs, yin xu (of St, Lung, K, and Liver), Spleen > qi/yang xu. > A week ago i gave her the following formula: > ban xia 9 > chen pi 6 > fu ling 9 > gan cao 6 > dang gui 9 > sheng di 12 > mai dong 12 > tian hua fen 15 > zhe bei mu 12 > xing ren 9 > gua luo 12 > dang shen 12 > When she came to my office today she said she had to cut down on the herbs > because she thinks that they were making her cough up more phlegm which would > be ok except that the phlegm was so think and viscous that it was hard to get > up all the way and she thought she would choke. So I modified her formula > thus (adding more lubricating herbs and taking out the more drying agents and > some of the phlegm movers): > dang shen 12 > chen pi 6 > fu ling 6 > gan cao 6 > dang gui 9 > sheng di 12 > tian hua fen 15 > zhe bei mu 12 > xing ren 9 > sha shen 9 > yu zhu 9 > I'm hoping that these added yin tonics will loosen her phlegm up a bit. Any > ideas on possible herbs that might be more appropriate than the ones I'm > giving her? I'm ordering some tai zhi shen which I think will be more > appropriate than dang shen. She has only had 3 office visits so far and she > understands that resolving her situation may be a long process. > Thanks for any input. > Kristin Wisgirda, MTOM, Lic.Ac. > > ------ > GET A NEXTCARD VISA, in 30 seconds! Get rates > as low as 0.0% Intro APR and no hidden fees. > Apply NOW! > http://click./1/975/4/_/542111/_/952222018/ > ------ > > Chronic Diseases Heal - Chinese Herbs Can Help > Quote Link to comment Share on other sites More sharing options...
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