Guest guest Posted August 8, 2000 Report Share Posted August 8, 2000 Hi, CHA list professionals, I have a patient with a pathology that I'm not too clear on how best to treat. I'm hoping for some ideas generated from this list. Chief Complaint: Incontinence following the surgical removal of his prostate. Patient is a 68 year male in excellent physical condition. History: This patient had his prostate removed one year ago following a high PSA test and family history of prostate cancer. The prostate was biopsied and there were malignant cells found. Prior to the surgery there were no signs of any urinary dysfunction. Now, he has trouble holding his urine inside especially while walking which is his favorite exercise. There is no significant zang-fu syndrome going on that I can see. The only two things I found that seemed significant was that his pulse is wiry (as in hard, but not so much thready) and his tongue has a raised ridge around the lateral margin. Giovanni refers to this as " Swollen Sides " in his tongue diagnosis book and it indicates Liver Yang rising or Liver fire. Though he adds that the tongue body will be clearly red, dark red or purple. To me, the tongue's color was a normal pink. His urine stream is strong and clear. Spicy food and alcohol aggravate the problem. He is taking a drug for cholesterol. So, I've got two signs to work with to guide me just a bit toward the Liver's function. The fact that this follows a surgery suggests some blood stagnation, though there was no purple on his tongue. And with his age we can assume some kidney deficiency though there was no low back pain nor was there any significant signs of Kidney xu beyond getting up at night to go to the bathroom once or twice. This hasn't changed since the surgery. The formula that I gave him was a variety of astringent herbs along with some qi activators. It was the following: I work with powdered extracts which I put into capsules, so the dosages are described in percentages: Xiao Yao San: 25% Sang Piao Xiao (Ootheca Mantidis) 25% Shan Zhu Yu (Fr. Cornis Officinalis)12% Wu Yao (Rx. Lindera) 25% Lu Rong (Hornus Stagus)12% I added the Lu Rong on a whim. Seemed like a good idea at the time. I just couldn't ignore his age and my assumption of a kidney deficiency. Next time, I'll likely add Qian Shi (Sm. Euryales Ferocis) and Fu Pen Zi (Fr. Rubi Chingii). Any suggestions? He'll be taking this formula for two weeks. If it doesn't help, I'll give him one more formula, so I'm kind of researching that right now. -- Al Stone L.Ac.<AlStonehttp://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 10, 2000 Report Share Posted August 10, 2000 , Al Stone <alstone@b...> wrote: > The fact that this follows a surgery suggests some blood stagnation, >though there was no purple on his tongue. And with his age we can assume some kidney deficiency though there was no low back pain nor was there any significant signs of Kidney xu beyond getting up at night to > go to the bathroom once or twice. This hasn't changed since the surgery. Trauma may not change tongue color necessarily. Trauma seems a likely cause, given the absence of other internal pathologyical signs. Perhaps some mild nerve damage that affects bladder tone. However, it is hard to believe that someone who had cancer is " perfectly healthy " . Since cancer often involves dampheat, phlegm, blood stasis in addition to deficiency of some sort, I am not sure I would use yang supplementation unless well indicated. Gentle kidney tonic astringents like wu wei zi and shan zhu yu seem like good choices, as are lian zi and qian shi. I think I would add herbs to move blood and lose the lu rong. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 10, 2000 Report Share Posted August 10, 2000 Dear Al Stone, I would try " Bai wei di wan " add " y zhi ren " . There are not too many detail information's, so I could not suggest further. However, I believe it will work for him. Good luck Nhung Ta ( Tradition chinese medicine- Expert) Al Stone wrote: > > Hi, CHA list professionals, > > I have a patient with a pathology that I'm not too clear on how best to > treat. I'm hoping for some ideas generated from this list. > > Chief Complaint: Incontinence following the surgical removal of his > prostate. > > Patient is a 68 year male in excellent physical condition. > > History: This patient had his prostate removed one year ago following a > high PSA test and family history of prostate cancer. The prostate was > biopsied and there were malignant cells found. > > Prior to the surgery there were no signs of any urinary dysfunction. > Now, he has trouble holding his urine inside especially while walking > which is his favorite exercise. > > There is no significant zang-fu syndrome going on that I can see. The > only two things I found that seemed significant was that his pulse is > wiry (as in hard, but not so much thready) and his tongue has a raised > ridge around the lateral margin. Giovanni refers to this as " Swollen > Sides " in his tongue diagnosis book and it indicates Liver Yang rising > or Liver fire. Though he adds that the tongue body will be clearly red, > dark red or purple. To me, the tongue's color was a normal pink. > > His urine stream is strong and clear. Spicy food and alcohol aggravate > the problem. He is taking a drug for cholesterol. > > So, I've got two signs to work with to guide me just a bit toward the > Liver's function. The fact that this follows a surgery suggests some > blood stagnation, though there was no purple on his tongue. And with his > age we can assume some kidney deficiency though there was no low back > pain nor was there any significant signs of Kidney xu beyond getting up > at night to go to the bathroom once or twice. This hasn't changed since > the surgery. > > The formula that I gave him was a variety of astringent herbs along with > some qi activators. It was the following: I work with powdered extracts > which I put into capsules, so the dosages are described in percentages: > > Xiao Yao San: 25% > Sang Piao Xiao (Ootheca Mantidis) 25% > Shan Zhu Yu (Fr. Cornis Officinalis)12% > Wu Yao (Rx. Lindera) 25% > Lu Rong (Hornus Stagus)12% > > I added the Lu Rong on a whim. Seemed like a good idea at the time. I > just couldn't ignore his age and my assumption of a kidney deficiency. > Next time, I'll likely add Qian Shi (Sm. Euryales Ferocis) and Fu Pen Zi > (Fr. Rubi Chingii). > > Any suggestions? He'll be taking this formula for two weeks. If it > doesn't help, I'll give him one more formula, so I'm kind of researching > that right now. > > -- Al Stone L.Ac.<AlStonehttp://www.BeyondWellBeing.com > > Pain is inevitable, suffering is optional. > > > Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2000 Report Share Posted August 12, 2000 Dear Al, Your details are a little sketchy but I think we can come up with a few ideas: 1) His incontinence seems to be with activity or with spicy food or alcohol. That is, when his Qi is moving with activity or with (probably) Hot " foods " -all Yang in nature. Therefore, I would delete all strong Qi moving herbs from his prescription such as Wu Yao and also the diuretic Fu Ling in the Xiao Yao San. The Chai Hu in Xiao Yao San is not strongly moving in nature- it really just opens up the flow of Liver Qi in the dose that is in Xiao Yao San. Therefore I would retain the Chai Hu Bai Shao-its sour nature will be useful here Dang Gui-its Blood moving quality will also be useful due to the surgery. due to the hard wiry pulse & the tongue picture. 2) What is needed here is to boost the Kidneys' holding function & at the same time astringe the urine. Al Stone <alstone Chinese Herbal Medicine Tuesday, August 08, 2000 9:41 AM Prostate Cancer/Incontenence >Hi, CHA list professionals, > >I have a patient with a pathology that I'm not too clear on how best to >treat. I'm hoping for some ideas generated from this list. > >Chief Complaint: Incontinence following the surgical removal of his >prostate. > >Patient is a 68 year male in excellent physical condition. > >History: This patient had his prostate removed one year ago following a >high PSA test and family history of prostate cancer. The prostate was >biopsied and there were malignant cells found. > >Prior to the surgery there were no signs of any urinary dysfunction. >Now, he has trouble holding his urine inside especially while walking >which is his favorite exercise. > >There is no significant zang-fu syndrome going on that I can see. The >only two things I found that seemed significant was that his pulse is >wiry (as in hard, but not so much thready) and his tongue has a raised >ridge around the lateral margin. Giovanni refers to this as " Swollen >Sides " in his tongue diagnosis book and it indicates Liver Yang rising >or Liver fire. Though he adds that the tongue body will be clearly red, >dark red or purple. To me, the tongue's color was a normal pink. > >His urine stream is strong and clear. Spicy food and alcohol aggravate >the problem. He is taking a drug for cholesterol. > >So, I've got two signs to work with to guide me just a bit toward the >Liver's function. The fact that this follows a surgery suggests some >blood stagnation, though there was no purple on his tongue. And with his >age we can assume some kidney deficiency though there was no low back >pain nor was there any significant signs of Kidney xu beyond getting up >at night to go to the bathroom once or twice. This hasn't changed since >the surgery. > >The formula that I gave him was a variety of astringent herbs along with >some qi activators. It was the following: I work with powdered extracts >which I put into capsules, so the dosages are described in percentages: > >Xiao Yao San: 25% >Sang Piao Xiao (Ootheca Mantidis) 25% >Shan Zhu Yu (Fr. Cornis Officinalis)12% >Wu Yao (Rx. Lindera) 25% >Lu Rong (Hornus Stagus)12% > >I added the Lu Rong on a whim. Seemed like a good idea at the time. I >just couldn't ignore his age and my assumption of a kidney deficiency. >Next time, I'll likely add Qian Shi (Sm. Euryales Ferocis) and Fu Pen Zi >(Fr. Rubi Chingii). > >Any suggestions? He'll be taking this formula for two weeks. If it >doesn't help, I'll give him one more formula, so I'm kind of researching >that right now. > >-- Al Stone L.Ac.<AlStonehttp://www.BeyondWellBeing.com > >Pain is inevitable, suffering is optional. > > >Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. > > > Quote Link to comment Share on other sites More sharing options...
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