Postpartum autoimmune exacerbation

[Guest guest]

All,

 

For some time I have been wondering about the Chinese disease

mechanisms resulting in the typical exacerbation female patients

experience postpartum in autoimmune complaints such as RA, MS, and

SLE. It is a well known clinical fact that these conditions tend to go

into remission during pregnancy but come back with a venegance

postpartum. The most obvious explanation of this would be postpartum

blood and yin vacuity. Most female patients with any of these three

conditions not only suffer from impediment (wind cold or wind heat,

excepting the MS patients) but also commonly a qi, blood, and yin

vacuity with liver depression. On top of those core disease

mechanisms, there can also be blood stasis, damp heat, depressive

heat, vacuity heat, phlegm turbidity, etc.

 

If a blood and yin vacuity postpartum was the culprit for these

exacerbations, I would expect to see the condition get worse during

the third trimester. As a gynecological specialist, I see many women

develop yin vacuity symptoms during the third trimester which, if not

corrected, then continue on postpartum. However, women with MS, SLE,

and RA do not typically, at least in my experience, develop yin

vacuity symptoms during the third trimester leading to any aggravation

of their autoimmune disease at that time. It is only after delivery

that the symptoms of their autoimmune disease commonly come roaring

back, often worse than before.

 

Over the weekend, it occurred to me that maybe it is blood stasis that

initiates the recurrence of these conditions postpartum. Many women

experience a residuum of static blood postpartum. This is what Fu

Qing-zhu's famous formula, Sheng Hua Tang (Engendering & Transforming

Decoction), is designed to treat. It's a statement of fact in CM that

static blood hinders the engenderment of new or fresh blood. So may

it be undispelled static blood which causes the worsening of blood and

yin vacuity symptoms postpartum in women with these kinds of

autoimmune diseases, remembering that blood and yin share a common

source? After all, as Yan De-xin says, if one has an enduring, chronic

disease, one must have liver depression, and it is the qi which moves

the blood. Further, RA and SLe are types of impediment conditions,

while MS is a wilting condition. In both types of conditions, we know

that the qi and blood are not flowing freely, one the one hand due to

impediment and on the other due to malnourishment of the sinews and

vessels.

 

Any feedback or comments on this situation would be appreciated,

including alternative possible disease mechanisms.

 

Bob

[Guest guest]

, " pemachophel2001 " <

pemachophel2001> wrote:

 

>

> Over the weekend, it occurred to me that maybe it is blood

stasis that

> initiates the recurrence of these conditions postpartum.

 

that was my first thought when I beganto read your post.

 

Many women

> experience a residuum of static blood postpartum.

 

perhaps most. I think supplementation is often done too early

after delivery or without considering the presence of stasis as

well.

 

So may

> it be undispelled static blood which causes the worsening of

blood and

> yin vacuity symptoms postpartum in women with these kinds

of

> autoimmune diseases

 

couldn't it just be the blood stasis (at least in impediment type AI

dz)? You said somewhere else recently that in menopause, it is

the degree of liver depression,not the degree of yin xu that

accounts for severity. Perhaps this is analogous in AI dz. In

other words, it is the degeee of blood stasis, not the degree of

yin xu that accounts for severity. This may be why I have found it

e,mpirically true that treating blood stasis has the quickest

effects at relieving the sx of an RA exacerbation.

 

After all, as Yan De-xin says, if one has an enduring, chronic

> disease, one must have liver depression,

 

glad you mentioned this. I have a general question on this

matter. Are you saying that one can diagnose liver qi depression

in any adult with chronic disease even in the absence of

supporting signs and symptoms? also, you have stated

elsewhere that all (sick?) adults have liver depression due to a

lifetime of " unfulfilled desires. " Someone asked me what is the

chinese term you translate as unfulfilled desires? And have you

translated any articles that discuss this point?

 

 

[Guest guest]

You said somewhere else recently that in menopause, it is

> the degree of liver depression,not the degree of yin xu that

> accounts for severity. Perhaps this is analogous in AI dz. In

> other words, it is the degeee of blood stasis, not the degree of

> yin xu that accounts for severity. This may be why I have found it

> e,mpirically true that treating blood stasis has the quickest

> effects at relieving the sx of an RA exacerbation.

 

-- Interesting.

>

> After all, as Yan De-xin says, if one has an enduring, chronic

> > disease, one must have liver depression, glad you mentioned this.

I have a general question on this matter. Are you saying that one

can diagnose liver qi depression in any adult with chronic disease

even in the absence of supporting signs and symptoms?

 

-- No, not in the abscence of signs and symptoms. But there will be

signs and symptoms, such as a bowstring pulse, emotional depression,

chest oppression, etc. The issue is knowing to look for these signs

and symptoms.

 

also, you have stated

> elsewhere that all (sick?) adults have liver depression due to a

> lifetime of " unfulfilled desires. " Someone asked me what is the

> chinese term you translate as unfulfilled desires? And have you

> translated any articles that discuss this point?

 

-- Unfulfilled desires is a literal translation from more than one

Chinese source used to describe one possible disease cause of liver

depression, i.e., the liver's loss of control over coursing and

discharge. For instance, this phrase turns up in case history #7 in

the chapter on " Withdrawal & Mania " in Chinese Medical Psychiatry. The

very first line of that case history in Chinese reads: yin1 zhi4 yuan4

bu4 sui4. Yin = because of, zhi yuan =aspirations, bu = not, sui =

satisfied, fulfilled. Sui yuan means to fulfill one's desires or

aspirations.

 

I don't know of any specific Chinese articles that discuss this point.

Although this is a common phrase in Chinese case histories, I have not

been able to find any paragraph or other discussion on this specific

topic in any books or articles. However, once one realizes that all

desires are nothing but a movement of qi towards or away from the

object of desire, it's only CM logic to work out the rest. The

teachings on unfulfilled desires in Blue Poppy Institute and Blue

Poppy Press materials is my teaching if you will, and anyone repeating

it should source me.

 

Bob