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49 year old woman--case

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Geoff,

Thanks for your take and ideas on this case. I would not be tonifying at

this point. Also I have ruled out the use of other drugs at present. She

is taking steps to be free of pharmaceutical drugs and not ingesting any

other kindof drug. The actions of xiao yao wan may be useful, but I see

the need for something more complex. Bu zhong yi qi tang seems a good

starting point because of the central qi vacuity and adding herbs to

move stagnant blood. I look for a way to start with her herbal

treatment, realizing that it will go through several phases.

Frances

 

>Geoff wrote:

>Be careful tonifying too much with people like this. It seems

>obvious that there is Qi Stagnation from your description and

>deficiencies as well. If you try to tonify too strongly, it will

>backfire. Tonification is really popular here... Why wouldn't

>you try something simple like Xiao Yao Wan? I thought they always

>said - clear excess then tonify the deficiency. Also check about

>other drug use - with the history I wouldn't be suprised if there

>was something else going into her system.

>

>Geoff

>

> , frances gander

><threetreasures@f...> wrote:

>

>

>>>

>>> I am interested in idea of possible approaches to herbal formulas

>>

>>

>for

>

>

>>> the following case:

>>>

>>> 49 year old woman, 5'10 " , 95 lbs. looks emaciated

>>> no appetite, ashen complexion, flat voice, extreme fatigue,

>>

>>

>irritability

>

>

>>> Has felt sick most of the time since she was 28

>>> Tongue: long dusky body with red tip, thin dry white fur, slight

>>

>>

>scallops

>

>

>>> Insomnia usually but has been sleeping better since receiving

>>

>>

>acupuncture

>

>

>>> Stool is light color, formed but not dry, floating, small amount &

>>

>>

>not

>

>

>>> regular

>>> Pulses are thready and feel knotted or tight in heart and lung

>>

>>

>positions.

>

>

>>> Skin feels cool and clammy.

>>> Long history of depression and running to various physicians.

>>> Diagnosis of CFIDS in '78, '94; '97 Eppstein-Barre. She has taken

>>

>>

>a lot

>

>

>>> of antibiotics over the years.

>>> She recently independently weaned herself off clonopin and is

>>

>>

>still

>

>

>>> taking neurontin 1200 mg and doxipin 10 mg. Wants to be off

>>

>>

>those, too.

>

>

>>> Lost job in 2000. Lives with ex-boyfriend and is seeing a

>>> psychotherapist and trying to put her life together. Too weak to

>>

>>

>do

>

>

>>> much about it.

>>> 2000: surgery: uterine artery embolism to seal off blood supply to

>>

>>

>10 cm

>

>

>>> fibroid (alternative to hysterectomy). It shrunk to 4 cm. After

>>

>>

>this

>

>

>>> surgery her legs have been weak and she can't walk very far. Feels

>>

>>

>weak

>

>

>>> and heart pounds on slightest exertion. There are metal clips on

>>

>>

>her

>

>

>>> femoral artery..

>>> Comes to my taiji class and lately sits and watches. Legs feel

>>

>>

>weak.

>

>

>>> Has migraines premenstrually and at other times, takes Maxil for

>>

>>

>migraines.

>

>

>>> Menses are heavy, some clots, regular every 24 days.

>>> No libido

>>> Knee pain not helped with prolotherapy, osteopathic manipulation,

>>> acupuncture, or electrostim. No back pain.

>>> I find deficient qi and stagnant blood, liver qi depression.

>>> Bu zhong yi qi tang seems a good place to start, what to add?

>>

>>

>This

>

>

>>> lady really needs to recover her energy.

>>

 

 

 

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Bu zhong yi qi tang is definitely a supplementing prescription, so what

does it mean to not be 'tonifying' at this point? Complex cases

require concurrent supplementation and drainage, addressing all the

patterns at hand, so there is nothing wrong with what you propose. Bu

zhong yi qi tang modified is a very good starting point. . . .you may

want to examine the work of Li Dong-yuan, the author of this

prescription, for a deeper analysis of the complex patterns so many of

our patients present.

 

 

On Mar 2, 2005, at 7:06 AM, frances gander wrote:

 

> Geoff,

> Thanks for your take and ideas on this case. I would not be tonifying

> at

> this point. Also I have ruled out the use of other drugs at present.

> She

> is taking steps to be free of pharmaceutical drugs and not ingesting

> any

> other kindof drug. The actions of xiao yao wan may be useful, but I see

> the need for something more complex. Bu zhong yi qi tang seems a good

> starting point because of the central qi vacuity and adding herbs to

> move stagnant blood. I look for a way to start with her herbal

> treatment, realizing that it will go through several phases.

> Frances

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Dear Frances,

 

Respecting your background and experience, I would, as Marnae

suggested, first look into dietary factors, dysbiosis, parasites, etc.

Look for some common food allergens such as gluten, and restrict her

intake of refined carbs, alcohol, etc. Then introduce her to a

high-quality multi-vitamin/mineral as well as sufficient high-quality

probiotics in the range of 10-15 billion units a day, in divided

doses, between meals. That may set the stage to start using complex

formulas to bring about homeostasis and, hopefully, better health.

 

Some thoughts,

 

Daniel C. Luthi

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