educational requirements, case study

[Guest guest]

Hello All-

 

First, I would like to thank all you brilliant minds out there for allowing me to eavesdrop on your conversations. You are not only very informative, but you also encourage me to persevere during challenging times.

As far as educational requirements, I must agree that entrance requirements be stringent. There is such a huge variation in treatment methodology and approach as it is, I feel strongly that we all be as highly trained as possible. I don't know what previous education benefits the study of this medicine the most, perhaps there is no one best area. I have a graduate degree in Biochemistry and I believe(!) that I think logically as a result of my training; however the downside of western scientific training, at least in my case, is that I've had to work very hard to overcome the accompanying built-in prejudices. Even now at times, when I'm inserting a needle, I'll find myself asking myself with disbelief "You're doing WHAT?" Fortunately these lapses of faith are fewer and fewer. On the other hand I can certainly empathize with the more doubtfull of my patients who have difficulty in accepting this as a valid and powerful method of healing. I strongly believe that we need to be the absolute best we can be in order not only to help our patients but also to legitimize our profession in the eyes of our society.

 

Now, on to challenges. I would like to humbly ask for your help with a patient whom I have been seeing for about six months. A 58-year old male, in vigorous health, excellent attitude, with slowly and persistently declining fine and gross motor coordination and speech. Western diagnosis 'spinocerebellar degeneration of unknown etiology'. No history of severe trauma , no history of toxic exposure, nothing unusual in his medical history. Normal blood tests. His father may have had the same thing, but he died at age 64 of leukemia before he was diagnosed with any degeneration. This neurological decline started 10 years ago, very slow, now he noticeably slurrs his speech and his coordination has suffered also.

I have been seeing him twice a week for acupuncture and treating him with gui zhi fu ling wan, tian ma gou teng yin and jin gui shen qi wan. (All Kan formulations)

 

T: bluish-pink, thin sl greasy white coat, red tip, no coat at sides, pale sides, very distended sublingual veins

 

P: pounding, rapid, choppy, elevated SI, LI, and Gb, weak Ht and Liv.

 

His blood pressure is unstable, will skyrocket after exercise to 160/85, after treatment 135./65. In the 6 months I've been treating him the coat on his tongue has decreased significantly, he doesn't clear his throat any more, his nighttime twitching is gone. His tongue is noticeably less blue and the coat has decreased. However he is still slowly losing more of his coordination, and I also notice a decline in his speech(although he say the speech is better).His speech and coordination are worse with fatigue, alcohol(which he avoids), and emotional upset.His palms are warm at night. The tendons on his hands and feet are very tight. He is active, exercises regularly, and has maintained a good attitude. Increasing dark shadows under his eyes. Poor sleep.

He was treated with parkinsons drugs, no effect. Is now taking no western meds.

My diagnosis is : liver wind resulting from liver xue xu, liv Qi yu, cold blood stasis, sp and kiQi xu. possible ht yin xu.

 

I feel we are not making any more progress and I really am not comfortable with being the last straw, and a flimsy one at that! Any insights you can provide are very welcome!

 

Beata Booth

[Guest guest]

Beata,

 

Interesting case. Thanks for sharing it. Before offering any

comments on it, can you please describe the signs and symptoms that

lead you to A) liver wind internally stirring and B) cold blood

stasis?

 

Also, right off the bat, I would recommend not naming the pulse

postions in terms of the viscera and bowels. This commonly seen

practice immediately prejudices one's interpretation of those pulses.

According to Li Shi-zhen and many other reputable Chinese authorities

on pulse examination, premodern and modern alike, the inch corresponds

to the upper body above the diaphragm, the bar corresponds to the

midsection of the body from diaphragm to navel, and the cubit

corresponds to the lower body below the navel. Therefore, I would

suggest simply describing the inch, bar, and cubit pulses. Whether

pathological manifestions in these three positions correspond to

particular viscera or bowels is something which must be determined via

cooroboration by all the other signs and symptoms. For instance, a

pathological pulse image in the cubit position might be reflecting

pathological changes in the kidneys or might be reflecting

pathological changes the hip and sacrum. If you label the cubit the

" kidney pulse, " then there will be tendency to interpret any abnormal

pulse images in this position as relating to the kidneys, which may or

may not be true.

 

Bob

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

then there will be tendency to interpret any abnormal

> pulse images in this position as relating to the kidneys, which

may or

> may not be true.

 

 

a very important point. My interns know that weak chi pulse does

not mean kidney vacuity unless other s/s confirm.

 

[Guest guest]

, " Bob Flaws " <pemachophel2001>

> According to Li Shi-zhen and many other reputable Chinese

authorities on pulse examination, premodern and modern alike, the

inch corresponds to the upper body above the diaphragm, the bar

corresponds to the midsection of the body from diaphragm to navel,

and the cubit corresponds to the lower body below the navel.

Therefore, I would suggest simply describing the inch, bar, and

cubit pulses.

 

 

Bob:

 

This is good advice for TCM practitioners. But if they have read the

Nan Jing and the Mai Jing, too, they should then be able to

distinguish between an organ pattern and problems associated with

body parts. Unfortunately, most institutions do not include this

classical literature.

 

 

Jim Ramholz