Guest guest Posted August 18, 2003 Report Share Posted August 18, 2003 In a clear cut case of blood stasis menstrual pain -- sharp stabbing, to the point of emergency care being necessary, has anyone experienced occasionally that the patient will worsen during her first cycle after starting therapy or does this mean the formula was too strong or not strong enough. painful menses, skin rashes, facial acne and hair growth. bleeding heavy with clots, dark red-purple, high energy, insomnia, wiry pulse, red tongue with yellow coat. the patient's period was delayed 7 days after this formula below was prescribed post ovulation plus she says it was more painful than it has been in a while. any reason this rx would cause such a side effect? the patient does not exhibit cold, so the cold herbs did not congeal. the san qi was to stop bleeding due to stasis. could it have overacted? the patient was taking powders 6 g BID chai hu xiang fu zhi shi bai shao chen pi zhi gan cao chi shao hong hua tao ren yan hu suo xuan shen sheng di san qi Chinese Herbs " Great spirits have always found violent opposition from mediocre minds " -- Albert Einstein Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2003 Report Share Posted August 18, 2003 , wrote: > In a clear cut case of blood stasis menstrual pain -- sharp stabbing, to > the point of emergency care being necessary, has anyone experienced > occasionally that the patient will worsen during her first cycle after > starting therapy or does this mean the formula was too strong or not > strong enough. I have had it happen a few times. The trouble is that because it has happened as a one off followed by improvement next period I haven't had a chance to experiment. It has always occured with an increase in clots and maybe blood flow so my speculation is that quickening the blood has pushed the blood through the blockage causing pain in the process of the stasis resolving. Maybe it was a necessary process. On the other hand prehaps if there were less clots one might speculate that there has been an increase in qi movement up to the obstruction but the blood stasis was not dispelled so maybe the formula needed blood breaking herbs. Simon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 , wrote: > painful menses, skin rashes, facial acne and hair growth. bleeding heavy with clots, dark red-purple, high energy, insomnia, wiry pulse, red tongue with yellow coat. >>> : If blood stasis was the primary problem the pulse should have been choppy. A wiry movement in this condition---especially if it goes from the liver at a sunken depth back to the reproductive organs in the left proximal---usually means muscular spasm often accompanied by yin and blood insufficiency. It belongs to Shaoyang type of yang energy; usually it is in the sinews, tendons, or connective tissues. If this pulse combines with any type of heat it can indicate inflammation of the connective tissues. From the symptoms you list, it sounds like the liver stress was going back to the reproductive organs [counterflow]---this is not unusal in many cases. When Chai hu is added in large amounts or large proportions to the other herbs, this formula can strongly course the liver and cause these kinds of side effects by releasing it too quickly. Can you say more about the liver pulse and its interaction with the reproductive organs? This is a copy of my PMS formula, based on a Hua T'o prescription: Tao ren 20 Fu xiang 16 Dang gui wei 12 Yan hu suo 10 Chuan xiang 10 Mu dan pi 10 Zhi ke 10 Cang zhu 10 Chi shao 10 Huang qin 8 Huang lian 8 Sheng di huang 5 Hong hua 5 Wu ling zhi 3 Pu huang 3 San qi 3 Xio hui xiang 3 Mu xiang 3 Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 At 9:10 PM -0700 8/18/03, wrote: >In a clear cut case of blood stasis menstrual pain -- sharp >stabbing, to the point of emergency care being necessary, has anyone >experienced occasionally that the patient will worsen during her >first cycle after starting therapy or does this mean the formula was >too strong or not strong enough. -- Another possible factor is that this is just a variation of intensity within the range she normally experiences, and that it had little to do with the herbs. I usually ask patients about variation between periods in the intake. This helps prevent giving the herbs either too much or too little credit for changes. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 , " James Ramholz " <jramholz> wrote: > > If blood stasis was the primary problem the pulse should have been > choppy. A wiry movement in this condition---especially if it goes > from the liver at a sunken depth back to the reproductive organs in > the left proximal---usually means muscular spasm often accompanied > by yin and blood insufficiency. the problem was liver constraint leading to blood stasis. at the time of the intake, she was not premenstrual. I don't know what her pulse would be like at that time. while she does bleed heavy for 2 days and thus may be blood xu post menstrual, this is not a vacuous person. mid twenties, very active and athletic. someday she'll be yin xu, but not now. BTW, your rx is similar to mine, n'est-ce pas? But it includes warming herbs that I ruled out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 , Rory Kerr <rorykerr@w...> wrote: > > Another possible factor is that this is just a variation of intensity > within the range she normally experiences, and that it had little to > do with the herbs. she was under inordinate stress, driving a u-haul across the SW in 100 degree heat with no A/C for three days. mom's on the way to visit, new apartment to set up and other big stuff on the mind, plus doing way too much. She thus got more constrained than usual -- period was late --- and qi couldn't descend due to heat and constant mental chatter. my theory. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 , " " wrote: and qi couldn't descend due > to heat and constant mental chatter. my theory. note the use of the word " my " here. has anyone actually read something from a chinese source that speaks to this issue? Marnae, Bob, Sharon? I have never seen any of the translated chinese texts and articles address this issue about worsening periods after initial treatment. However a number of my chinese teachers have expressed this idea verbally to me. But one can never be sure if an explanation is as much to CYA as anything else. I'd like to see a consensus on the matter that really makes sense. I mean is it really a valid idea that qi and blood piling up in the liver can be released so suddenly and with such " volume " that the qi and blood do not fit into the vessels through which they flow, causing increased pain. As if some " thing " that had been stuck for a long time moved suddenly. Like in western physiology, throwing a clot in the general circulation that causes pain as it moves till it is dissolved (or kills you, whichever comes first). Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 At 3:03 PM +0000 8/19/03, wrote: my theory. -- sounds right Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 Everything that I've learned about Chinese medicine supports your conclusions, Todd. On Tuesday, August 19, 2003, at 08:48 AM, wrote: > , " " > wrote: > > and qi couldn't descend due >> to heat and constant mental chatter. my theory. > > > note the use of the word " my " here. has anyone actually read > something from > a chinese source that speaks to this issue? Marnae, Bob, Sharon? I > have never > seen any of the translated chinese texts and articles address this > issue about > worsening periods after initial treatment. However a number of my > chinese > teachers have expressed this idea verbally to me. But one can never > be sure if > an explanation is as much to CYA as anything else. I'd like to see a > consensus > on the matter that really makes sense. > > I mean is it really a valid idea that qi and blood piling up in the > liver can be > released so suddenly and with such " volume " that the qi and blood do > not fit > into the vessels through which they flow, causing increased pain. As > if some > " thing " that had been stuck for a long time moved suddenly. Like in > western > physiology, throwing a clot in the general circulation that causes > pain as it > moves till it is dissolved (or kills you, whichever comes first). > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 , " " wrote: > BTW, your rx is similar to mine, n'est-ce pas? But it includes warming herbs that I ruled out. : Your " theory " makes very good clinical sense. I just had a client n a similar situation. She was packing and moving to a new house while trying to finish a weaving art project before attempting to move her loom. The weather had been hot and she had been highly stressed by the logistics. If there was blood stasis in the previous situation, there should be some choppiness---mixed or accompaning the wiry movement---at some depth in either the middle or proximal positions. Usually at the organ depth of the middle position, the connective tissue or deeper muscular depth, or in uterus position. I often enjoy using or modifying Hua T'o formulas. In this formula, the warming herbs are balanced by the Huang lian and Huang qin which help to bring controlled warmth to the uterus; without the possible complication caused by Chai hu in highly stressed persons. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 I use chai hu in highly stressd individuals often and find that in the right combination, especially in prepared form like Ka'n extracts, chai hu is very well tolerated and courses the liver gently allowing some of the liver qi stagnation to vent, like releasing steam in a controlled manner from the pressure cooker... EtiJames Ramholz <jramholz wrote: , "" wrote:> BTW, your rx is similar to mine, n'est-ce pas? But it includes warming herbs that I ruled out.Todd:Your "theory" makes very good clinical sense. I just had a client n a similar situation. She was packing and moving to a new house while trying to finish a weaving art project before attempting to move her loom. The weather had been hot and she had been highly stressed by the logistics.If there was blood stasis in the previous situation, there should be some choppiness---mixed or accompaning the wiry movement---at some depth in either the middle or proximal positions. Usually at the organ depth of the middle position, the connective tissue or deeper muscular depth, or in uterus position.I often enjoy using or modifying Hua T'o formulas. In this formula, the warming herbs are balanced by the Huang lian and Huang qin which help to bring controlled warmth to the uterus; without the possible complication caused by Chai hu in highly stressed persons.Jim RamholzChinese 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 19, 2003 Report Share Posted August 19, 2003 , Eti Domb wrote: > I use chai hu in highly stressd individuals often and find that in the right combination, especially in prepared form like Ka'n extracts, chai hu is very well tolerated and courses the liver gently allowing some of the liver qi stagnation to vent, like releasing steam in a controlled manner from the pressure cooker... Eti: Sure, in the right combination there shouldn't be any problem. I've chosen not to include it due to its slightly ascending quality, and because the formula is targeted for the lower jiao. Using both huang lian and huang qin with warming herbs gives the original Hua To formula a nice balance and makes the warmth descend and tonify the uterus. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2003 Report Share Posted August 19, 2003 thank you for that clarification. James Ramholz <jramholz wrote: , Eti Domb wrote:> I use chai hu in highly stressd individuals often and find that in the right combination, especially in prepared form like Ka'n extracts, chai hu is very well tolerated and courses the liver gently allowing some of the liver qi stagnation to vent, like releasing steam in a controlled manner from the pressure cooker...Eti:Sure, in the right combination there shouldn't be any problem. I've chosen not to include it due to its slightly ascending quality, and because the formula is targeted for the lower jiao. Using both huang lian and huang qin with warming herbs gives the original Hua To formula a nice balance and makes the warmth descend and tonify the uterus.Jim RamholzChinese 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 23, 2003 Report Share Posted August 23, 2003 In a message dated 8/23/2003 2:59:28 PM Pacific Daylight Time, wcargal9 writes: > I think some WM lab test would have been helpful to clarify the formula. > For instance w/ the acme and facial hair I would be wondering about > elevated testosterone (PCO) which is usually coupled w/ elevated > cholestrol. Insomnia may indicate high levels of cortisol. All of these > would put the liver under high stress, so the ALT value would be of > interest. If these issues were going on I would be using a more gentle > formula over a 2-3 month period, maybe as simple as Xiao Yao Wan. > Clearly not a totally CM approach. > That's it, Jackie and Warren....you are talking pleurality. For me, the expression of Chinese medicine is a pleurality that includes mainstream TCM, old family styles, classics, modern biomedical and evidence-based approaches. Will Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2003 Report Share Posted August 23, 2003 I think some WM lab test would have been helpful to clarify the formula. For instance w/ the acme and facial hair I would be wondering about elevated testosterone (PCO) which is usually coupled w/ elevated cholestrol. Insomnia may indicate high levels of cortisol. All of these would put the liver under high stress, so the ALT value would be of interest. If these issues were going on I would be using a more gentle formula over a 2-3 month period, maybe as simple as Xiao Yao Wan. Clearly not a totally CM approach. Warren Cargal Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2003 Report Share Posted August 23, 2003 , Warren Cargal <wcargal9@b...> wrote: > I think some WM lab test would have been helpful to clarify the formula. we did that before prescribing herbs. all tests normal Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.