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Julie,

I did not take the time to think through the diagnosis carefully, yet. She

described a classic 'steaming bones' phenomenon and along with her agitated

demeanor and age I was just expecting (always a bad idea) a thin, rapid

pulse. As far as the tongue is concerned, I think you can have some K yin xu

with a very thin coat. Do you disagree? My 'greasy' was in parenthesis with

a '?' because it didn't look greasy, really. It's hard to describe her

tongue except to say that it was rough looking. Like she had a lot of taste

buds all standing up. Perhaps it was rough due to irritation from gastric

reflux. Do you think a yin xu patient with some SP dampness might have a

little greasy coat? Her tongue was not a classic smooth mirror-like severe

yin xu. Certainly the pulse didn't feel yin xu. Perhaps ST cold is a

possibility.

 

Marian

 

 

Message: 15

Wed, 28 Aug 2002 09:07:15 -0700

Julie Chambers <info

Re: unusual pulse

 

Dear Marion,

 

I don't know about the pulse, but I am curious about your dx of kidney yin

xu while she has a greasy tongue coat. That tongue coat seems to preclude a

yin xu dx.

 

Julie

-

Marian Blum <marianb

 

Tuesday, August 27, 2002 6:45 PM

unusual pulse

 

 

> Can anyone shed light on the meaning of this woman's pulse? I am

interested

> in both the Western and Traditional Chinese perspectives.

>

> 78 year old woman

> MC: burning top of tongue and roof of mouth (worse after food); all day,

> most of day burning

> Western diagnosis: acid reflux and hiatal hernia

> she's not aware of regurgitating anything into mouth

> good appetite (but not gnawing hunger)

> good energy

> no thirst

> no nocturia

> no heart palpitations

> 2 urinary tract infections since husband died

> little low back pain

> feels more cold than warm generally

> 'steaming bones' between 3-5 am

> some ankle swelling (old injury there)

> very tearful throughout day (since she lost her husband of 52 years 6

months

> ago)

> insomnia since husband died suddenly (self-treating with Valerian)

> a little mental confusion

> a little impatient or agitated

> She takes acidophilus and other 'nutraceuticals'. She says fennel/catnip

> extract pills help the acid some. She avoids Western pharmaceuticals but

did

> take antibiotics for the UTI's.

>

> T: very thin, yet rough-appearing (greasy?) white coat; red in the middle,

> otherwise red/purple T body

> P: There's a smaller 'dub' just after the LUB. The LUBs come at about 50

> beats/min. The temporal proportion looks something like this:

> LUB..dub............................................LUB..dub

> I only saw her once and I was so surprised by the slowness and the

'dub'

> that I didn't record much else. It was not a wiry pulse and it did have

> strength. She sees MD's fairly regularly and denies any heart condition.

>

> My diagnosis was starting to look like: K yin xu, m/b H fire, m/b LV

> attacking ST. But how would I make sense of the pulse?

>

>

>

>

>

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Dear Marion,

 

I think you can have some K yin xu

> with a very thin coat. Do you disagree?

 

No, I do not disagree.

 

Do you think a yin xu patient with some SP dampness might have a

> little greasy coat? Her tongue was not a classic smooth mirror-like severe

> yin xu. Certainly the pulse didn't feel yin xu. Perhaps ST cold is a

> possibility.

 

 

That's when I would tend to think the dampness is more the appropriate

diagnosis than the yin xu: whenever there is anything greasy.

 

Julie

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Marian,

is the pulse slow, or is ti irregular? It sounds like you are describing an irregular pulse-(shock,emotional trauma).

 

John P.

 

-

Marian Blum

Tuesday, August 27, 2002 8:45 PM

unusual pulse

Can anyone shed light on the meaning of this woman's pulse? I am interestedin both the Western and Traditional Chinese perspectives.78 year old womanMC: burning top of tongue and roof of mouth (worse after food); all day,most of day burningWestern diagnosis: acid reflux and hiatal herniashe's not aware of regurgitating anything into mouthgood appetite (but not gnawing hunger)good energyno thirstno nocturiano heart palpitations2 urinary tract infections since husband diedlittle low back painfeels more cold than warm generally'steaming bones' between 3-5 amsome ankle swelling (old injury there)very tearful throughout day (since she lost her husband of 52 years 6 monthsago)insomnia since husband died suddenly (self-treating with Valerian)a little mental confusiona little impatient or agitatedShe takes acidophilus and other 'nutraceuticals'. She says fennel/catnipextract pills help the acid some. She avoids Western pharmaceuticals but didtake antibiotics for the UTI's.T: very thin, yet rough-appearing (greasy?) white coat; red in the middle,otherwise red/purple T bodyP: There's a smaller 'dub' just after the LUB. The LUBs come at about 50beats/min. The temporal proportion looks something like this: LUB..dub............................................LUB..dub I only saw her once and I was so surprised by the slowness and the 'dub'that I didn't record much else. It was not a wiry pulse and it did havestrength. She sees MD's fairly regularly and denies any heart condition.My diagnosis was starting to look like: K yin xu, m/b H fire, m/b LVattacking ST. But how would I make sense of the pulse?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.

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Dear Julie,

I think that it is easy in CM to think that the theoretical divisions

have identity and logical status in the Aristotelian manner such

as,'a' precludes 'b'. But of course the cauldron of the body is not a

logically defined point, yin and yang exist along side each other,

and , I would say, as commonly as not yin vacuity presents with a

greasy tongue coat.

 

Simon King

 

, Julie Chambers <info@j...> wrote:

> Dear Marion,

>

> I don't know about the pulse, but I am curious about your dx of

kidney yin

> xu while she has a greasy tongue coat. That tongue coat seems to

preclude a

> yin xu dx.

>

> Julie

> -

> Marian Blum <marianb@r...>

>

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