A difficult case study: My wife-seizures with Parkinsonism, installment #5

[Guest guest]

My thinking this is a yangming channel/now organ disorder (as opposed to

conventional Liver-Kidney Deficiency Dx). Maybe remove the Sheng Di as well.

or a formula along the lines of Mu Xiang Bing Lang Wan adjusted for

heat/dampness. Acupuncture (or Yin Tui-na)the yangming / Pericardium (to

accept the Excess St) along the Chinese clock. As this is (IMO) a yangming

excess condition Da Hunag is the choice and more the better at double to

triple the amount below. I would consider going to the extreme to break

through. Tonify much latter. Treatment would cause a lot of disruption but

would be of short term. Depends upon the constitution and fortitude. My

thoughts are that your wife is very hardy and of strong constitution. Of

course this is just thinking outside the box to encourage ideas.

 

Ed Kasper LAc. Santa Cruz, CA

 

______________________

______________________

 

Message: 6

Sun, 6 Feb 2005 01:58:48 -0800

Yehuda L Frischman <

A difficult case study: My wife-seizures with Parkinsonism,

installment #5

 

 

We met with Dr. Zhang, Feb 3, 2005. Seizures occurred Jan 28, 29, 31,

Feb 2 and this evening, Feb 3, right before consultation. Yet though

there has been a dramatic increase in seizure activity, all have been

small, and recovery has been rapid. Sleep has been OK, very tired in

evenings and waking much earlier than usual: 6:00 AM as opposed to usual

8:30 am. Bladder control improved. Stools looser so back to 3g Da Huang

powder. Spasms in arms and chin quite pronounced. Generally very tired.

Comprehension difficult. Walking better and more relaxed, but very

limited stamina. Clarity of speech improved. Easily angered. Still

quite a bit of phlegm in chest with raspy cough. bad breath.

 

tongue: slightly red tip, cracks in body, thin white coating.

pulse: wiry and slightly choppy both sides

 

Formula: dan nan xing 9, shi chang pu 9, fu shen 9, chuan bei mu 9, gua

lou pi 12, jiang can 9, di long 9, long gu 15, mu li 15, bai shao yao 15,

 

suan zao ren 15, yuan zhi 6, gou teng 15, tian ma 9, sheng di huang 15

 

taken separately in capsule form: quan xie and wu gong 3 each, da huang3,

and hu po 3(at bedtime only).

 

I noted that for the first time in many months, gui ban and bie jia were

excluded. Dr. Zhang explained that their greasy character promoted

phlegm, which in turn was instigating the continued seizures.

Interesting to note that since then, no further seizures thus far.

____________

Last week:

 

We saw Dr. Zhang again Thursday night, Jan 27, 2005. Still no word back

from Santa Cruz. Two more seizures this week, Friday evening Jan 21, and

Tues morning, but both quite mild. Sleep has been fair: much worse until

2am then she settles into restful sleep until about 7am (still too early-

as when she is in a healthy sleep pattern, she sleeps until 8am). Last

night (Wed) lost bladder control twice, 12:00 and 2:00am. Also poor

bladder control during the day. Bowel movements starting to get small and

hard, so we again increased the powdered Da Huang to 3.5 g. Spasms

worse last two days. Phlegm is bronchi still not resolved, though

better, causing coughing attacks, day and night, and also interupting

sleep. Walking endurance worse. Left side of low back tender.

Thinking very slowly, tired all the time, Jaw and tongue in constant

motion, mouth constantly open.

 

Tongue: pale and dry, very slight thin white coating

 

Pulses: left -wiry, right -thready and slightly rapid

 

Formula: Sheng di huang 15, Bai shao yao 12, Huang qi 18, Chuan bei mu

9, mai men dong 12, nan sha shen 12, huang qin 12, gua lou pi 12,

Jie geng 9, Dan Nan Xing 9, gui ban 15, bie jia 15, long gu 15, mu li

15, , suan zao ren 15, yuan zhi 6.

 

taken separately in capsule form: quan xie and wu gong 3 each, da huang

3.5, and hu po 3(at bedtime only).

 

One interesting observation that Dr. Zhang made was that despite the

bronchial congestion, all the seizures in this cycle have been mild.

And indeed this is new.

 

Until next week!

" When you see someone doing something wrong, realize that it was brought

before

you because you did something similar. Therefore, instead of judging

him, judge yourself. "

 

The Baal Shem Tov Hakodesh

 

 

Message: 8

Sun, 06 Feb 2005 21:21:22 -0000

" "

Re: A difficult case study: My wife-seizures with Parkinsonism,

installment #5

 

 

I'm curious about the use of Da Huang... is there a discussion that

continual use will lead

to adaptation/resistance (what's the word I'm looking for here?). What about

other herbs

such as Jie Geng/Zhi Ke combo or Jue Ming Zi? Why Da Huang in this case?

BTW... I applaud your courage in posting these, it is very instructional.

doug

[Guest guest]

Dear Ed,

 

In a sense, you are correct. She is a fighter, and would outlast me

going 10 rounds any day. However, despite her naturally strong

constitution, the literally thousands of seizures that she has suffered

have taken their toll, and their effect was even seen as early as 4 years

after their onset, when she started to present with Parkinsonism, as

manifesting her complete exhaustion. That is why it is essential to

constantly tonify, at least to some degree, either qi or yin. The good

news, is that unlike many others with what appear to be chronic

degenerative disorders, she is very responsive to herbs and dosage

changes. But it's a game of precision, and when we are off, we lose out

to seizures. At times she is so dry and hot that she actually presents

with some of the manic signs of signs of Wen Bing Ying, including a dry

red tongue, but in her case, WITH a dry, actual BLACK tongue coating!

Other times she is do weak (particularly after seizures) that she can't

even stand up without assistance. As I mentioned, we do agree that it is

important to purge out the heat with Da Huang, but again, I have seen how

too much has weakened her and made her vulnerable to greater qi xu. So,

it's a very delicate balance.

 

Respectfully,

 

Yehuda

 

My thinking this is a yangming channel/now organ disorder (as opposed to

conventional Liver-Kidney Deficiency Dx). Maybe remove the Sheng Di as

well.

or a formula along the lines of Mu Xiang Bing Lang Wan adjusted for

heat/dampness. Acupuncture (or Yin Tui-na)the yangming / Pericardium (to

accept the Excess St) along the Chinese clock. As this is (IMO) a

yangming

excess condition Da Hunag is the choice and more the better at double to

triple the amount below. I would consider going to the extreme to break

through. Tonify much latter. Treatment would cause a lot of disruption

but

would be of short term. Depends upon the constitution and fortitude. My

thoughts are that your wife is very hardy and of strong constitution. Of

course this is just thinking outside the box to encourage ideas.

 

Ed Kasper LAc. Santa Cruz, CA

 

 

 

[Guest guest]

Yes. I am saying it is a disorder of the Qi and Yang and Excess. The

Qi is not flowing smoothly and starts stops and stutters. The Yin is

there but does not distribute properly. Normal yin stagnates and

presents as the branch. The presentation has developed from her

overly strong character. Weaker people would have given in much

earlier and the pathogen would have penetrated deeper with possible

dire consequences. I think Yang Ming channel transmuted rather than

Shao yin/Jue Yin Kidney, Liver Yin deficiency. If it were a

batterfield the need would be more for bullets and bombs than food

and bandages. The exhasution is not a deficiency - open/purge the

channels. A matter of logistics not supplement.

 

I think you have been stimutanously treating both herbally. Since I

see this as a channel disorder Acupuncture and tui-na could focus on

opening the channels as an adjunct. especially the liver-GB channels

at 11-1 am. The stomach at 7-9 am.

 

Ed Kasper Santa Cruz, CA

 

 

, Yehuda L Frischman

<@j...> wrote:

>

> Dear Ed,

>

> In a sense, you are correct. She is a fighter, and would outlast me

> going 10 rounds any day. However, despite her naturally strong

> constitution, the literally thousands of seizures that she has

suffered

> have taken their toll, and their effect was even seen as early as 4

years

> after their onset, when she started to present with Parkinsonism, as

> manifesting her complete exhaustion. That is why it is essential to

> constantly tonify, at least to some degree, either qi or yin. The

good

> news, is that unlike many others with what appear to be chronic

> degenerative disorders, she is very responsive to herbs and dosage

> changes. But it's a game of precision, and when we are off, we

lose out

> to seizures. At times she is so dry and hot that she actually

presents

> with some of the manic signs of signs of Wen Bing Ying, including a

dry

> red tongue, but in her case, WITH a dry, actual BLACK tongue

coating!

> Other times she is do weak (particularly after seizures) that she

can't

> even stand up without assistance. As I mentioned, we do agree that

it is

> important to purge out the heat with Da Huang, but again, I have

seen how

> too much has weakened her and made her vulnerable to greater qi

xu. So,

> it's a very delicate balance.

>

> Respectfully,

>

> Yehuda

>

> My thinking this is a yangming channel/now organ disorder (as

opposed to

> conventional Liver-Kidney Deficiency Dx). Maybe remove the Sheng Di

as

> well.

> or a formula along the lines of Mu Xiang Bing Lang Wan adjusted for

> heat/dampness. Acupuncture (or Yin Tui-na)the yangming /

Pericardium (to

> accept the Excess St) along the Chinese clock. As this is (IMO) a

> yangming

> excess condition Da Hunag is the choice and more the better at

double to

> triple the amount below. I would consider going to the extreme to

break

> through. Tonify much latter. Treatment would cause a lot of

disruption

> but

> would be of short term. Depends upon the constitution and

fortitude. My

> thoughts are that your wife is very hardy and of strong

constitution. Of

> course this is just thinking outside the box to encourage ideas.

>

> Ed Kasper LAc. Santa Cruz, CA

>

>

>

[Guest guest]

Dear Ed,

 

Yes, of course, there is an element of qi and yang in excess, and I do

hear the logic in what you are saying, but my experience has been that

when she has taken larger doses of Da Huang (and as I mentioned earlier,

for a while the cathartics Da Ji and Gan Sui), and REALLY had huge,

messy, and foul smelling stools, as your surmised, she has become much

weaker, had an increase in violent seizure activity, and tongue and

pulses have reflected severe qi and yin deficiency . Also, as I

mentioned, as we have adjusted the Da Huang doses based upon her bowel

activity, she has been able to gradually decrease the dose, now down to

3g daily, from an original dose of 5g, and that tells me that what we are

doing is working. Also, would her pulse not be consistantly more wiry

and less thready is this didn't also involve deficiency, and not just a

Si Ni San type pattern? BTW I love your idea of tui na on the Stomach

and GB channels during their most active times and will let you know how

it goes.

 

All the best,

 

Yehuda

 

 

 

 

Yes. I am saying it is a disorder of the Qi and Yang and Excess. The

Qi is not flowing smoothly and starts stops and stutters. The Yin is

there but does not distribute properly. Normal yin stagnates and

presents as the branch. The presentation has developed from her

overly strong character. Weaker people would have given in much

earlier and the pathogen would have penetrated deeper with possible

dire consequences. I think Yang Ming channel transmuted rather than

Shao yin/Jue Yin Kidney, Liver Yin deficiency. If it were a

batterfield the need would be more for bullets and bombs than food

and bandages. The exhasution is not a deficiency - open/purge the

channels. A matter of logistics not supplement.

 

I think you have been stimutanously treating both herbally. Since I

see this as a channel disorder Acupuncture and tui-na could focus on

opening the channels as an adjunct. especially the liver-GB channels

at 11-1 am. The stomach at 7-9 am.

 

Ed Kasper Santa Cruz, CA

 

 

, Yehuda L Frischman

<@j...> wrote:

>

> Dear Ed,

>

> In a sense, you are correct. She is a fighter, and would outlast me

> going 10 rounds any day. However, despite her naturally strong

> constitution, the literally thousands of seizures that she has

suffered

> have taken their toll, and their effect was even seen as early as 4

years

> after their onset, when she started to present with Parkinsonism, as

> manifesting her complete exhaustion. That is why it is essential to

> constantly tonify, at least to some degree, either qi or yin. The

good

> news, is that unlike many others with what appear to be chronic

> degenerative disorders, she is very responsive to herbs and dosage

> changes. But it's a game of precision, and when we are off, we

lose out

> to seizures. At times she is so dry and hot that she actually

presents

> with some of the manic signs of signs of Wen Bing Ying, including a

dry

> red tongue, but in her case, WITH a dry, actual BLACK tongue

coating!

> Other times she is do weak (particularly after seizures) that she

can't

> even stand up without assistance. As I mentioned, we do agree that

it is

> important to purge out the heat with Da Huang, but again, I have

seen how

> too much has weakened her and made her vulnerable to greater qi

xu. So,

> it's a very delicate balance.

>

> Respectfully,

>

> Yehuda

>

> My thinking this is a yangming channel/now organ disorder (as

opposed to

> conventional Liver-Kidney Deficiency Dx). Maybe remove the Sheng Di

as

> well.

> or a formula along the lines of Mu Xiang Bing Lang Wan adjusted for

> heat/dampness. Acupuncture (or Yin Tui-na)the yangming /

Pericardium (to

> accept the Excess St) along the Chinese clock. As this is (IMO) a

> yangming

> excess condition Da Hunag is the choice and more the better at

double to

> triple the amount below. I would consider going to the extreme to

break

> through. Tonify much latter. Treatment would cause a lot of

disruption

> but

> would be of short term. Depends upon the constitution and

fortitude. My

> thoughts are that your wife is very hardy and of strong

constitution. Of

> course this is just thinking outside the box to encourage ideas.

>

> Ed Kasper LAc. Santa Cruz, CA

 

" When you see someone doing something wrong, realize that it was brought

before

you because you did something similar. Therefore, instead of judging

him, judge yourself. "

 

The Baal Shem Tov Hakodesh