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Steven's case

 

Thanks for that 5 element imput James

I had a quick look at the case...

sharp pain -blood stasis

also some cold stagnation ...lower jiao

You said she gets sick quite a bit...I presume you mean colds and

flu......ie wei qi weak,

headaches worse at period time....liver blood xu....check if she has dream

disturbed sleep or other signs liv bld xu

 

Firstly I would omit da huang and tao ren if she has loose stools.There are

other blood movers more gentle in action... eg dang gui wei ,chuan

xiong,hong hua

 

Don't quite understand her taking bu zhong yi qi tang at the same time...do

you mean with gui zhi fu ling tang or that she takes one formula at night

and one in the morning

 

She likes heat on the abdomen...cold stagnation ...ai ye comes to mind with

xiang fu and gan jiang

 

I'd try a few gently spleen tonics and astringents ...eg bai zhu,shan

yao,qian shi and possibly tu su zi

 

Sorry I can't comment about the insect herbs But I'd be interested to hear

from the others.

 

Heiko Lade

Registered Acupuncturist / Chinese Herbalist

2 Jenkins St.

Green Island, Dunedin

New Zealand

Tel: (03) 488 4086, Fax: (03) 488 4012

http://www.lade.com/heiko

Email: heiko

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> Steve Snydes wrote:

>

> > Hi group, looking for some insights into a case of a

> > 29 year old female with cc of endrometriosis. Patient

> > came in with constant abdominal pain in the area of

> > both of her ovaries. Pain is sharp and localized

> > during

> > period and dull most of the rest of the time.

 

> She has

> > had two surgeries for endrometrosis and was put on

> > a medication that makes the body think it's in

> > menopause. She was also put on the pill for 3 years.

> > She was taking the pill for heavy periods, however she

> >

> > stopped taking it earlier this year.

 

> At that time, her

> > periods were irregular with one cycle in 5 months. She

> >

> > had spotting between periods. Tends to have lite and

> > heavy periods, lite one's are more painful, relieved

> > by passing clots, which are dark red.

 

> Patient has cold

> > hands and feet, also heat feels good on lower

> > abdominal area. Energy was low, no dizziness or lite-headedness.

> > Lots of gas and has loose stools. Brusies easily.She

> > also gets headaches worse at period time and has

> > intermitant back pain. Can have pms sx too. Gets sick

> > quite a bit.

 

> Pulses are generally weak, and slightly

> > wiry. Tongue is moist, pale,scallops.

 

> I have seen this

> > patient since Feb of this year.

 

> My dx is Blood Stag,

> > Sp & Kd Xu.

 

> I have been using Cinamon & Poria, with

> > rhubarb,chaio shao,salvia, and san leng (from golden

> > flower).

 

> Loose stools got worse patient also takes

> > bu zhong yi qi tong. Over the course of about a half

> > year she now has regular periods, pain only at period

> > time, no spotting, energy is better. Main problem is

> > she still has bad period pain, also has trouble taking

> > a lot of blood moving herbs, due to loose stools.I

> > read that Endrometriosis can lead to stagnation in the net-

> > work vessels, and insect medicinals can help to clear

> > this out. Is this too drastic, any suggestions? Snydez99

> >

 

 

 

--

 

Chinese Herbal Medicine

 

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While you are generally correct in your diagnosis, there is more

detail to consider because the condition cycles in time. View her

case 5-elementally, using the Kd, Lv, Sp triangle. While there is

always deficiency (xu) and blood stasis, the condition can swing to

excessive (shi) because ectopic endometrial tissue responds

cyclically to ovarian hormones. You have to follow and respond to

that change. In the excessive phase or when the condition is more

acute, the deep left proximal pulse position (you find pulse

qualities specifically related to the reproductive organs at

approximately the bottom third of this position) should clearly show

some binding quality with more damp and heat. That movement may be

copied in the right proximal pulse position. When deficient, the

pulse quality can be more stringlike.

 

When her condition becomes worse around her period you should be able

to see the overstressed liver sending a movement back to the kidney

in the pulse (liver is " connected " to the uterus because it is so

muscular), and the kidney is more active along the shen cycle back to

the liver. At that time, you will have to make more efforts to

control her liver movement.

 

Another point to consider is how much pain may be contributed by

peritoneal adhesions or intestinal obstruction. A Rolfer may helpful

to break up the adhesions and scar tissue. Because there are two

general types of endometriosis (internal and external to the

myometrium) consider targeting your formula for her type.

Extrauterine endometriosis is probably more closely thought of

as " stagnation in the luo network. " It's more useful to consider what

internal channels the endo follows (usually Chong mai). So strong

blood moving herbs may not always be a good idea, and her reaction to

them suggests already that. Health Concerns has a good general

formula which can be combined with other formulas for supporting her

general vitality---still another issue to contend with because

someone chronically ill for that long will be slow to heal.

 

A good general acupuncture formula for endometriosis is Sp6 (stick

deep and downward to sedate), Sp9, Sp10, Cv9 (stick upward to control

fluids and in order to mix and neutralize any residual heat or

inflammation from the lower jiao into Ren), LI4 (stick deep and

tonify); other points can be added depending on what you find in her

pulses at a particular time. This treatment strategy is designed to

control hormones and send down vital yang (wei) qi to warm and

control her lower jiao. You should see some improvement in 1-2 weeks.

 

I hope this is of some help.

 

Jim Ramholz

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, " heiko " <heiko@l...> wrote:

> Steven's case

>

 

>

> Sorry I can't comment about the insect herbs But I'd be interested to hear

> from the others.

>

I believe the general rule of thumb is to use insect medicinals after

milder therapy has failed. I personally limit myself to the nontoxic

di long and jiang can, but others like wu gong, lu feng fang and also

the snakes, like wu shao she. I believe one of our new members likes

these animal medicinals. Min, if you are out there, let us know what

you think.

 

todd

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