TCM Q&A

For educational purposes, the text of consultation may be published here. We will NOT identify you or your location. You may request to opt out of publishing the text of our consultation if you choose.

All patients are asked the same set of initial questions, which are:

• Please describe yourself and your issues.
• Mention your gender, age, height , weight, occupation, symptoms, treatments you've had, and how long you've had them for. 
• Tell us your Western medical diagnosis, if you have one.
• List the medicines you use. 
• Note occasions when you have been hospitalized for any reason. 

Dr. comments are in red. Patient answers are in italics.

To find information on any subject, simply search the document.

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CASE 111

73 years old male, 5'10", 160lbs

My issues:

Hard to put on weight, easy to loose weight.

Suffer from a constant nasal discharge (rhinitis)

Have had issues with gastritis, like a stubborn hiccups that has lasted for more than a week, reflux, diaphragmatic hernia, deficient sleep (6 hours at the most), shoulder pain (both), very poor appetite, slow digestion. Also, very high hemoglobin (21 grams), arrhythmia, (Missing heart beats), varicose veins on left leg. for the last 7 years, very low sex drive, very low libido. No longer hard erections

Very dark circles under my eyes for the last 27 years.

My skin on the shin bones of both legs breaks easily when bumped and gets infected easily. I have very poor hearing and has gotten worse lately. However, I exercise almost daily (cardio, and weight lifting). Also, I work daily in my clinic. I commute 2 hours daily in heavy traffic.

Western Medical diagnosis:

Low testosterone, very low HGH, low thyroid 

Sclero Degenerative Conduction System disease of the heart (arrhythmia)

Advance first degree AV Block

Left-arterial hemi-block

Stomach: Very inflamed Hiatal hernia and inflamed stomach lining. No ulcers, no malignancies.

What I take: 

thyroid medication

Ubiquinol, Magnesium, Potassium, Liposomal glutathione, Liposomal B-complex, Liposomal alfa lipoid acid , liposomal vitamin C.

For sleeping: Codonopsis and sizipus

Liver: Gentiana 12

Coffee enemas. 

Ozone insufflations

Thank God, I haven't been hospitalizes for a very long time. I was hospitalized for tonsils surgery, and nasal surgery (30 years ago)

Well this is very comprehensive and I hope is what you need 

Look forward to your reply.

Answer:

Thanks for your information and the photo.  I have a few questions.

Is your pulse slow and regularly irregular, or irregularly irregular?  In other words, does your heart appear to miss or add beats in a regular pattern, or are the beats unpredictable? Irregularly irregular. beats are unpredictable

For how long have you had this arrhythmia? 5 years although now is not as bad as it was. 

Do you have more difficulty falling asleep, or staying asleep? Staying asleep. I wake up around 2 or 3am every morning and it becomes difficult to fall asleep again. I takes me a few hours.

When you are up at night do you notice feeling either warm or cold? Neither

For how long have you had:

Difficulty gaining weight? Most of my life, although now has gotten worse. There was a time when I was 30 to 40 that my weight was right. I could add muscle from weight lifting

A nasal discharge? Constant, although I have seen an improvement in the last few days after drinking hydrogen water.

Hiccups? Off and on Most of my life. It is now pretty much under control after following natural treatments for helicobacter pylori, using aloe vera and others like edible clay.  Also, I have a condition where I make too much hemoglobin (21 grams) and I have to draw blood almost monthly (200 to 250cc). My platelets are on range but low. 

Poor appetite? All of my life. I can go all day without eating, although some times I get really hungry.

Reflux? Many years

Sleep problems? Many years

Been taking thyroid meds? Several years

Thanks, a few more questions,

Do you have a bowel movement every day? Yes I do. Rarely I go more than once

Is the stool well formed? Almost always is well formed 

How often do you get up at night to urinate?  For how long has this been your pattern? Once, seldom I get up twice. Several years

If you do happen to get a good night’s sleep, do you wake feeling refreshed? Yes, I feel real well. Even my eyes feel good. Nothing better than a good night's sleep, waking up to an already shining sun!

How is your energy over-all throughout the day? I would say good. I exercise almost daily. Stationary bike for 12 minutes raising my heart beat rate up to around 160 to 170 while breathing oxygen (EWOT). 4 minutes for warming up, then 1 minute max effort next minute rest, next minute max again, next minute rest until 12 minutes total. Once or twice a week I weight train after the cardio. The only hour I feel tired is at lunch time. I may have to take a 15 minutes rest falling asleep.

When you are thirsty, do you then drink a fair amount, or have you noticed being thirsty with little desire to drink? No I never get thirsty, I just drink my water without being thirsty. I sweat easily specially in hot climates. Even in hot weather I don't get thirsty. I drink about 8 glasses per day.

How long is your near daily exercise routine?  For how long have you done this? Max cardio for 12 minutes, Weight lift for about 30 minutes. I done this for more than 40 years

Have you had nasal discharge since the nasal surgery 30 years ago, or despite the nasal surgery? Yes, as I said it is constantly. Nasal surgery did not help at all. 

Do you have any known allergies or food sensitivities? I think I'm allergic to milk products, so I don't drink milk. I take whey protein as my appetite doesn't allow me to eat enough to keep my body's demands. My Eosinofilos (ensophils) are always high (7+)

How is your mood overall? Most of the time happy, although I get mad easily. 

What is your normal body temperature? Low 36 centigrades (95 to 96 Farenheit

Are you shorter than you were 10 years ago? Yes, but not much. I have scoliosis  

Thank you a few more questions

Have you always angered easily? yes!

How is your blood pressure? 140/70 Mostly off in the systolic, but little

Any low back pain? Yes, but not all the time. On the right side

Do your legs feel as strong as in past years? Yes, they do. I can leg press 300 pounds same I did 20 or more years ago

You didn’t complain about sleep, so why do you take codonopsis and zizyphus for sleeping? It was given to me by Dr. XXXXX. And yes, I do have sleeping problems. For example, last night I wok up at around 2:30 am and had to take 2 Codonopsis but still could not fall asleep so I got up and took liposomal glutathione with 1500mg of citruline (amino acid), and that did the trick. I fell asleep again.   

Why this formula? I don't really know. I think he said this formula would take care of my waking up around 3 am.

More questions, 

I’m surprised the Codonopsis and zizyphus combination can work quickly for you, as this is a tonic formula meant for deficiency caused insomnia.  Deficiency insomnia patterns usually require daily long term administration to be effective.  It’s not a formula I would think of using for an acute episode of sleeplessness.  But if it works for you, great.  A few more questions. No, in fact Dr. XXXX gave it to me when I complained of my waking up around 2 or 3 am each night. He said I should take it three times per day in combination with Gentiana 12 but after 3 months of taking I found no relief, so I decided to use it when I wake up. It calms me down slightly and for this reason some times is useful for getting back to sleep, but most of the time it doesn't help.

For how long have you had sleep problems? Very long time 

Do you generally have more difficulty falling asleep or staying asleep? I already answered this question in one of your previous mails

 If you’re up at night, do you notice feeling warm? Same as above, this question has been answered previously 

While sitting and at rest, can you feel your pulse at your wrist below your thumb? It depends, if I am too relaxed, I don't feel it.

Is the beat regular, or are there ‘missed beats’? Like I said previously, my rhythm problem does not show all the time. It shows mostly early mornings, and sometimes in the afternoon, or when I go to bed, but it is not constant. It is unpredictable.

Can you feel it 

1)with slight pressure

2)with some pressure 

3) with deep pressure

4) can¹t feel it 

Some times I can not feel it at all

How many beats in 15 seconds? My pulse is almost constant at 75-80, but when the arrhythmia shows it is around 40 to 45 

If you look at your tongue in daylight, does it appear 1)purplish, 2)reddish, 3)pinkish, 4)pale?  (see examples below) You can send a picture of your tongue instead, but please make sure the photo is in focus and taken in daylight.

 Do you notice feeling hot or cold when others do not? No

Do you have a noticeable preference for hot or cold beverages? No. I will forward you a picture of my tong tomorrow after I take it during the day

Sorry for those redundant questions, but I need a little more clarity.

Do you mean you’ve taken the Codonopsis and Zizyphus for 3 months,  or for longer? I started taking it in the first part of November of last year

On average, how many pills did you take each day? during the first few months I was taking 3-3 times per day, but as time went by I drop down to about 2 twice per day. I didn't see much results, so I got discouraged. 

Gentiana 12, which your doctor gave you, addresses very specific complaints, none of which you’ve mentioned, so  I’ll be more specific:

In the course of a month, might you have a headache, eye pain, or red eyes?  If so how often. Thank God I don't have headaches nor eye pains. I used to have red eyes. He said I should take both supplements to balance the Yin and the Yan, which he thought were out of balance. 

Have you ever had episodes of jaw pain or neck and shoulder pain? Neck pain yes. I have a pretty big lipoma on the left side of my neck, and shoulder pain has ben terrible. I first started with my right shoulder around 1990 then recently my left shoulder. it is hard to sleep soundly because of my shoulders pain.

 When you anger, does your face redden? No, I'm always red because I make too much hemoglobin. 

Why were thyroid medicines prescribed for you? Because my TSH is high

You say you have had sleep problems for a very long time.  Can you be more specific? It has been trouble some for many years, but of course now has gotten worst 

What was happening in your life when you first started having sleep issues? Nothing specific. Every day stress, like traffic, business etc. I have had problems with candida albicans 

Thanks, that helps a lot. 

I’m moving forward without a picture of your tongue, as I can’t imagine it will change my diagnosis very much.

Gentiana 12 is actually a classical formula known as LONG DAN XIE GAN, famous for helping to cool “Liver Heat”.   Apparently your TCM doctor prescribed the Gentiana 12 because he diagnosed you as having a pattern of “Liver Yang or Liver Heat Rising”.  I agree with this as a partial diagnosis, but fully it is,

Liver Heat Rising and Invading Stomach and Heart.  This is noted by symptoms of nasal inflammation, gastritis, hiccups, reflux, insomnia, red eyes, headaches, neck and shoulder pain, reduced appetite, dizziness, and slow digestion. 

You have most of these complaints.  

 his pattern is deemed an “Liver Excess Condition”, but that doesn’t mean you have liver disease of any kind.  In TCM, the Liver, besides processing toxins, is closely related to the emotional environment. Liver Heat is both caused by and causative of anger and frustration.

Note that this excess condition must be addressed by herbs that reduce excess.  The problem with the formula Codonopsis and Zizyphus (originally formulated as Ginseng & Zizyphus) is that it is for deficiency caused insomnia, rather than excess caused insomnia, so while the Gentiana prescription was accurate, the Codonopsis prescription wasn’t.

The following formula clears liver heat and prevents the liver from invading the stomach.  I also clears heat from the heart.

Unfortunately, I am unable to address your slow irregular heartbeat at this point, as the herbs used for this purpose could counteract the effects of the herbs below:

CHAI HU . . . 15%

LONG DAN CAO . . . 10%

BAI SHAO . . . 10%

HUANG QIN . . . 10%

YU ZHU . . . 10%

FO SHOU . . . 10%

XIANG FU . . . 10%

BAI ZHU . . . 10%

FU LING . . . 5%

ZHI GAN CAO . . . 5%

HUANG LIAN . . . 5%

If you can't find these herbs where you live, my clinic can provide them as concentrated granules which come as a pre-mixed powder. Start with the minimum quantity of 100 grams to be sure the mixture agrees with you.  If it does, you can order more at a discount. Call 1-510-848-4372 ext. 2,  M-F, 10am-6pm, Sat 11-4, Pacific Time

The dose is 10 grams per day.  Take 5 grams twice a day.  Dissolve the powder (you'll get a 1 gram spoon) in any amount of liquid, and drink. Take it first thing in the morning and later at night before bedtime.  It often works best when taken on an empty stomach. If you don’t like the taste, hold your nose when you drink it, or you can put the powder into gel-caps.  

Contact me again in 1 month, or sooner, if you have any questions.  It’s included in this consultation.

If you don’t want to drink the herbs, you can try using a combination of pills LONG DAN XIE GAN WAN and CHAI HU SHU GAN WAN.  Take a full dose of both. 

Note that the full course of treatment is “a month for every year” (that you’ve had the problem), but you will likely see improvement much sooner.

Dear Joel:

Thank for your email and for all the time you have taken to investigate my problem, and your efforts to help me. I have attached a picture of my tongue, one upon waking up this morning, and another after brushing it. I'm sorry I had not taken it but the last 2 days have been extremely busy for me. 

I want you to know a few important things that have happened to me over the course of 33 years, and before. My hiccups issue has been with me since I was very young. I remember getting episodes of several days when I was probably 10 to 12 years of age. Later on, probably around 13 years old, I became ill with diphtheria and the doctor had to inject horse serum, to save me. At that time, I was told to be careful not to ever use this serum again as this could kill me almost immediately. My immunity has been low all my life, as I would catch a cold, or flue very easy, and my digestive system has always been weak. I have to watch what I eat because I can get food poisoning easily. My appetite has always been extremely low, I eat because it is time to eat but not because I feel hungry. There are a few times a month when I get really hungry, and I enjoy my food and will eat a lot, but for only one meal, after that I go back to no appetite again. I control, as much as possible, my daily stress, but it is hard. I am also a private pilot with over 40 years experience, and it was always hard to control the stress of flying into bad weather. 

When I became 40, I became very ill with candida albicans and I was feeling so bad that I had to be hospitalized for one week to find out what was happening to me. Traditional medicine did nothing for me, so I decided to take matters on my own and learn what I could about alternative medicine. This is how I became a Naturopath. I treated my candida problem with nyastatin enemas and ozone insufflation and was able to overcome my issue. At that time, I was extremely depressed, and I would develop a light fever every day after 2 pm. I don't want to over load you with data, but I wanted you to get the picture.

Now, because of my heart issue, I am taking 3 soft gels of Ubiquinol 100mg with 2 Magnesium caps from NOW, liposomal vitamin c, liposomal glutathione from LivOn labs everyday. This has helped me to keep my heart issue from getting  worse. My cardiologist wanted to give me a pace maker, but I refused! I exercise daily breathing oxygen (EWOT). I take Natokinasa for better blood flow as I have the issue of making too much hemoglobin (21 grams the normal for our elevation is not more than 16) and my blood is very viscous. 

Thank you again, and I look forward to working and cooperating with you to regain my health, and maybe get back  my sex life to enjoy my dear wife again. I am not that old to give up on it.    

Thank you

The formula I gave you does not really address sexual desire or function.  To do this, you may want to add a Kidney tonic like TIAN HUANG BU XIN which also supports restful sleep by adjusting Heart and Kidney harmony, or by adding YIN YANG HUO to your current formula. 

Note that sexual activity (and exercise) must be appropriate for your age.  At 73, you should not be exercising as much as you were at 40, nor should you be ejaculating more than once every 7 days, as these excesses are depleting.  

Case 112

Female

Age: 49

Height: 5 feet, 4 inches

Weight: 110 pounds

 3years ago I was diagnosed with serous retinopathy recently the diagnoses changed to wet AMD in my right,eye I've lost central vision because of bleeding.the treatment is shots every 4 weeks.    The Meds I take are. Metformin 500 mgs 2 a day, omeprazole 20 mg 1 a day, lexapro 20mg 1 a day for Anxiety.    Hospital--- hemroids 1985---Bunions 1988---Diviated septum 1990--- inflammation around rib cage 2015. Hope this helps 

My main concern is skin problems, specifically acne rosacea and itching as
come-and-go problems, not severe any longer but still persistent, annoying,
and depressing. 

I have always had skin problems, even as a child, and in high school I had
quite severe acne and eczema, both of which went away in my twenties but
over the years would resurface whenever I was under stress.
A little over a year ago, my father died not long after my mother died. I
took care of them both for nearly four years, which really wore me down
(only child). Right after my father died, I saw my cousin quite regularly,
and in the interest of trying to cheer me up she took me to Mexican
restaurants about three nights a week for a month. This was during the heat
of the summer – over 115 degrees Fahrenheit every day – so the summer heat
combined with a “hot” diet and plenty of grief put me badly out of balance.
I had acute pharyngitis for a week, and once that passed, I discovered that
I also had digestive problems, a “text-book case” of Liver qi invading
Spleen – I only know this because I have used acupressure on myself for
years – all my Spleen points, especially near my shoulders, were agonizingly
painful, as were LV-13 and 14. The strangest symptom was rosacea-like
papules, not only all over my face, but pretty much everywhere else too
except my legs, e.g., on my chest and central abdomen and around my
umbilicus and under my rib cage on each side, extending around to my back at
my waist and to the back of my neck and also on my buttocks (lingering
cysts) and on the backs of my thighs. I felt as though I were wearing a hot,
damp obi all the time and hot, damp, heavy jeans that were too tight! I also
had papules, bilaterally, along my Large Intestine meridian, Small Intestine
meridian, Gall Bladder meridian, and Triple Heater meridian – almost as
though the papules were markers for the acupuncture points, as though in a
diagram. All these areas that were covered in papules tingled and itched! I
lost about ten pounds; then finally, after several months of a conservative
diet, careful living, and much acupressure, my digestion and appetite
improved, the Spleen points were no longer sore, and I started to gain a
little weight but not much – I still need about five pounds but cannot
tolerate any heavy foods that could add much-needed calories.
My skin, all over, is about 90% clear and healed now, and I feel and look
much better, but my digestion could still use some improvement, and I still
get the papules, though much more mildly, along with the itchy, tingly,
burning, damp sensations, which are very uncomfortable, but now they follow
a pattern, which is approximately every two weeks, at ovulation and then
again at menstruation, and/or with weather changes, especially wind and
rain. My period has been very light since all this happened, and it skipped
altogether for three months. The only other symptoms to mention are intense
anxiety and headaches behind my eyes, but the anxiety and headaches are
pretty much gone now. I had a chronic dry cough and dry mouth for a long
while too, and mild hemorrhoids for the first time in my life, but all those
symptoms have passed now. It is really just my skin that is still
uncomfortable and my frailty in that I need a bit more weight.
As of right now, my tongue has a general underlying pink color with a bright
red patch just off center on the right side approximately a third of the way
up from the tip, which is slightly red and dotted; there is a pale
yellow-whitish coating along the right side edge and toward the middle on
either side of the crack and toward the back.
In addition to acupressure for heat and dampness, I tried several patent
medicines (not all together but over the course of the past year):

What are the digestive symptoms that you had, and which do you still have?
For about five months, the symptoms, not always acute but sometimes, were food stagnation, as though nothing was digesting at all but just lying there, hence a heavy feeling in my stomach radiating up to my chest and up to under my ears along my neck on each side; also dry coughing after eating, and quite bad constipation only during acute phases, no apetite at all, and aggravation of the flushing, heat sensations, i.e., the hot dampness and itching around my waist and lower down, sometimes papules after eating my last meal in the evening, but they would disappear mostly by the next morning. Around ovulation and my period I would have a bearing down feeling that was not distinctly menstrual but definitely intestinal cramping following eating and with this, mild heartburn and flatulence. I used to love black and brown rice and millet, but those grains became too heavy for me, seemed to aggravate the food stagnation and intestinal cramping, so I switched to white basmati rice mixed with a lesser amount of quinoa, and that has been my staple for quite a while now, along with purple corn meal as porridge, corn bread, and flat bread, steamed or baked vegetables, no fruits, except dried cranberries (cooked), which have been very helpful for some reason, and small amounts of fresh bison meat from a local farm here. Now my appetite is quite good, and I feel as though I might be able to handle more foods, but I am somewhat hesitant to try. The only remaining digestive issue I have, at least with the diet that I am still eating, is that after eating, especially in the afternoon and after sundown, I feel very hot and damp around my waist and buttocks, sometimes my chest and arms too, with tingling and itching skin, but not always, but most pronounced around ovulation and menstruation. My skin, which is extremely pale by nature, often looks ruddy all over after I eat, but only in the afternoon and after sundown. My digestion seems best during daylight hours. I have been trying to eat a little something before bed for weight gain. Sometimes I still have mild constipation around my period, but not at all like it was. I would say my bowel movements are mostly normal (size and shape) and easy now. Decaffeinated green tea has been very helpful to drink for all my symptoms, and diluted licorice root tea. Any hot spices or ginger tea or spearmint tea (but not peppermint) make my skin symptoms worse. Sometimes I still have the dry cough after eating but hardly noticeable in the sense that the urge to cough passes quickly. During the acute phases, I sometimes coughed up small amounts of clear white phlegm first thing in the morning, but no more or rarely.

Do these symptoms appear to have any direct relation to eating?
Yes, I would say all my symptoms, then and now, were/are relative to eating, what time I ate, and what I ate, and how much I ate. High histamine foods, I discovered, would aggravate all my symptoms, and I may have been sensitive to such foods earlier in my life when I had acne off and on, but I did not know so then.

Are they noticeably worse when you are under stress?

Definitely, including the impersonal stress of weather and seasonal changes. After my father died, I had tremendous amounts of stress due to settling his affairs. When I have deadlines at work I really feel stressed, but fortunately I have been able to cut my workload over the past year. Certainly I am aware that there is a mental component to all this. About every other weekend a friend and I go to the market and then eat at a macrobiotic restaurant, and though I do not eat that much differently at the restuarant than I do at home, I usually forget what few symptoms I have left and feel quite good, though I am feeling better more often than not anyway, so hard to tell. My nature is to become anxious easily, so I have always had to live simply, with a certain amount of discipline, and then I feel okay.

Historically, are your periods regular?  Are they difficult?

My periods have always been quite regular and never physically difficult in terms of pelvic pain or discomfort, but I have always felt "off" during the week before, i.e., tired, anxious, moody, mild acne. I never used to be sensitive to ovulation, but in the past five years approximately, I seem to experience the premenstrual fatigue and moodiness around ovulation too.

Do you see clots in your menstrual bleeding?
No. My periods have been very light over the past year. The blood is thin, watery, and pink, and then brownish in tapering off. About three months ago, for three months previous, I had brownish spotting at ovulation, but no longer.

Do you have any pre-menstrual discomforts?

Between the ages of 30 and 40 I had terrible breast tenderness before my period, but I have not had that in years. Between 40 and now, mostly just emotional symptoms and mild acne premenstrually and at ovulation.

When you had headaches, where, on your head, were they?
Forehead, behind eyes and at bridge of nose and at top of head, always low grade, not intense pain but phase-in-and-out pain, with loss of appetite and general malaise, sometimes slight dizziness.

Did you notice any relation between your headaches and your menses?

Yes, premenstrually into menstruation and at ovulation, but especially before and during wind storms and rain storms. The last headache I had was a month ago during a really bad wind storm, but not around my period, maybe close to ovulation; so far, nothing this month and better weather. Stress often brought/brings on a headache, but my stress level is much better now, and I am not sure if stress alone would invite a headache if not within range  of my period or ovulation or a storm or weather change.

Have you ever been hospitalized for any reason?

No. Never had any surgeries or accidents, etc. I had a blood test after the pharyngitis, and everything was in normal range except that I was low in ferritin.

What do you do for exercise?

I trained for ballet years ago, so I still do a full barre three days a week and some gentle stretching every morning. I do not drive a car out of preference, so I walk or cycle to the market (very early mornings during summer) a few days a week. In terms of fitness and flexibility, I feel that I am in good shape. I do work long hours at a computer, but I take regular breaks to stretch and breathe and go out in the sunshine.

How well do you sleep?
I sleep like the dead and have no problem going to sleep or staying asleep or waking in the mornings. Even during times of intense stress I have usually slept fairly well and could even nap. I usually feel quite good upon waking.

How is your mood, overall?

Since this past March, I have been feeling in good spirits for the first time in a long time.

When you took those Chinese patent medicines, how much did you take, and how long did you take them for?

With each of them (in tablet form from ActiveHerb) I used the same approach: I started with one tablet 3 times a day for 2 days because I am often sensitive to new foods (by the way, I am sensitive to certain odors, which can invite a headache and malaise). With most of these formulas I did not feel anything at this low dose, except the Gu Pi, which I think set off a papules attack on my arms and caused me not to feel so well -- that was back many months ago. With the other formulas, I began to build up to the recommended dose, usually between 5 to 8 tablets three times daily, and by the time I reached that dose, usually in ten days about, the damp, hot feeling around my waist and in my "lower burner" had become more pronounced, e.g., "hot" urine, hot thighs and buttocks when sitting for too long, hot, damp, itchy feeling below my rib cage and around my back. The only one that helped greatly was Xiao Feng, but after two weeks, more like three weeks probably, it seemed to stop working at full dose 3 times a day, and I did not want to increase the dose, so I stopped with the intention of going back after a rest, but I never did. The Huang Lian Shang Qing I think did help with constipation before I stopped taking it, if I recall, and I think I quit taking it sooner than before ten days because the instructions warned not to take it too long. I remember reading that Huang Lian Shang Qing is good for canker sores, and I used to have those often, but not in the past ten years!

Chai Hu Shu Gan

Gu Pi

Da Bu Yin

Huang Lian Shang Qing

Long Dan Xie Gan

Xiao Feng

You are experiencing a form of Liver and Kidney YIN Deficiency with Liver Fire Rising to the Eyes. 

Case 113



He is currently following a heavy metal detoxification protocol. He has to follow a 100% gluten and dietary products free diet for one month, and then, will be allowed to eat goat or sheep cheeses and small spelt . He has to take some vitamins:

- multivitamines 

- vit C 2000mg

- Magnesium malate 800mg

- lipoïdic alpha acid

- herbs for liver and kidneys

- omaga 3 EPA DHA

He will make the Clark cure (liver and parasitis detoxification) (http://www.curezone.org/cleanse/liver/huldas_recipe.asp) (http://www.drclark.net/index.php)

The name of the médicine he takes for high blood pressure is Lercapress. There are 2 molécules inside:

énalapril maléate 20 mg

Lercanidipine chlorhydrate 10 mg His sleep medicin are: Doxylamine succinate tablets 15 mg Melatonin 5 mg He does not take any other chemical medicine. He thinks that Doxylamine helps him more than Melatonin. One year ago, I tried to give him some 5HTP, but it didn't really help. I was not surprised, since he is neither depressed nor anxious. His sleep's patterns are variable. He can have a hard time falling asleep, like if the "switch was not working" or, when he falls asleep, he can wake up 2 hours after he  felt asleep and stay awaken for 1-1hour and a half .  Exceptionally he sleeps well (8/10). If he had to stop the sleep aids, the sleep would probably be much worse. He tried to fall asleep without Doxylamine, but he can't.   When he wakes up at night, he feels warm. He usually feels warm, day or night. He is not sensitive to cold at all. We sleep with an open window, even in the winter when the temperature is under zero... Other complains: He sometimes has pain in the wrist tendons, but the Lyme treatment helped . Also, from time to time, he has cramps during the evening or the night, even when he didn't exerciced. He has been having  low back pain for the last 4 years. The pain arrives when he plays too much tennis or sometimes after jogging, or when he has to fix his bicycle or carry heavy things.  The osteopath said he has a narrow spinal lumbar canal with some arthrosis. His parents both have arthrosis problems. They also both had cancers, but healed. He used to have  a light allergy in the spring, but these last 2 years, he had none.   He had a saliva test done, and I thought it could be of interest for you. Case 114 Gender: Female Age: 49 Height: 5 feet, 4 inches Weight: 110 pounds I have always had skin problems, even as a child, and in high school I had quite severe acne and eczema, both of which went away in my twenties but over the years would resurface whenever I was under stress. A little over a year ago, my father died not long after my mother died. I took care of them both for nearly four years, which really wore me down (only child). Right after my father died, I saw my cousin quite regularly, and in the interest of trying to cheer me up she took me to Mexican restaurants about three nights a week for a month. This was during the heat of the summer ­ over 115 degrees Fahrenheit every day ­ so the summer heat combined with a ³hot² diet and plenty of grief put me badly out of balance. I had acute pharyngitis for a week, and once that passed, I discovered that I also had digestive problems, a ³text-book case² of Liver qi invading Spleen ­ I only know this because I have used acupressure on myself for years ­ all my Spleen points, especially near my shoulders, were agonizingly painful, as were LV-13 and 14. The strangest symptom was rosacea-like papules, not only all over my face, but pretty much everywhere else too except my legs, e.g., on my chest and central abdomen and around my umbilicus and under my rib cage on each side, extending around to my back at my waist and to the back of my neck and also on my buttocks (lingering cysts) and on the backs of my thighs. I felt as though I were wearing a hot, damp obi all the time and hot, damp, heavy jeans that were too tight! I also had papules, bilaterally, along my Large Intestine meridian, Small Intestine meridian, Gall Bladder meridian, and Triple Heater meridian ­ almost as though the papules were markers for the acupuncture points, as though in a diagram. All these areas that were covered in papules tingled and itched! I lost about ten pounds; then finally, after several months of a conservative diet, careful living, and much acupressure, my digestion and appetite improved, the Spleen points were no longer sore, and I started to gain a little weight but not much ­ I still need about five pounds but cannot tolerate any heavy foods that could add much-needed calories. My skin, all over, is about 90% clear and healed now, and I feel and look much better, but my digestion could still use some improvement, and I still get the papules, though much more mildly, along with the itchy, tingly, burning, damp sensations, which are very uncomfortable, but now they follow a pattern, which is approximately every two weeks, at ovulation and then again at menstruation, and/or with weather changes, especially wind and rain. My period has been very light since all this happened, and it skipped altogether for three months. The only other symptoms to mention are intense anxiety and headaches behind my eyes, but the anxiety and headaches are pretty much gone now. I had a chronic dry cough and dry mouth for a long while too, and mild hemorrhoids for the first time in my life, but all those symptoms have passed now. It is really just my skin that is still uncomfortable and my frailty in that I need a bit more weight. As of right now, my tongue has a general underlying pink color with a bright red patch just off center on the right side approximately a third of the way up from the tip, which is slightly red and dotted; there is a pale yellow-whitish coating along the right side edge and toward the middle on either side of the crack and toward the back. In addition to acupressure for heat and dampness, I tried several patent medicines (not all together but over the course of the past year): Chai Hu Shu Gan Gu Pi Da Bu Yin Huang Lian Shang Qing Long Dan Xie Gan Xiao Feng Each of these made my symptoms worse even though I tried each at a low dosage only for about a week to test. The only one which did offer some relief is the last one, Xiao Feng, but it seemed to stop working after about two weeks, and I may have taken too much of it because I was so grateful for the relief. I have not taken many supplements, as supplements have never ³agreed² with me in general, but I did take iron for a while, which helped tremendously, and I still take it occasionally, but the one supplement that has helped more than anything is Riboflavin, sometimes at high doses. My two reasons for taking advantage of your consultation offer are, first, that the summer is just ahead, and even though I am stronger than I was last summer by far, I do worry somewhat that the heat might affect me more than normal, and I do not want any relapses however slight. The second reason is that I have this intuition that if I just had a bit more knowledge or something to steer me in the right direction, I could make it over what I feel is the last hurdle to healing and really start to feel completely well again. Any help that you can offer will be GREATLY appreciated! I have more questions. What are the digestive symptoms that you had, and which do you still have? Do these symptoms appear to have any direct relation to eating? Are they noticeably worse when you are under stress? Historically, are your periods regular?  Are they difficult? Do you see clots in your menstrual bleeding? Do you have any pre-menstrual discomforts? When you had headaches, where, on your head, were they? Did you notice any relation between your headaches and your menses? Have you ever been hospitalized for any reason? What do you do for exercise? How well do you sleep? How is your mood, overall? When you took those Chinese patent medicines, how much did you take, and how long did you take them for? Thanks for the tongue photos.  Though they are a little out of focus, they are still helpful. Let¹s begin with the following diagnosis: Blood Deficiency creating Heat in the Blood, together with Liver Qi Stagnation causing the Liver to Invade the Spleen, resulting Pervasive Dampness And Low Appetite Most of the TCM formulas you tried are correct for aspects of your pattern, but your method of evaluating them is faulty. Remember, you are taking these medicines for chronic rather than acute conditions.  A week¹s trial is insufficient to evaluate most of them.  Though I often prescribe for 1 week, I am doing so only to determine if there are any unwanted side effects, which usually show up promptly.  You can't tell in 1 week if a formula is ultimately good for you, but you can often tell in week (or less) if a formula is bad for you. Let¹s start with the following formula which Tonifies and Moves both Blood And Qi, while also Cooling The Blood And Expelling Dampness. It's an amalgam of SI WU TANG, SI JUN ZI TANG, and, JIA WEI XIAO YAO SAN, and utilizes herbs that are well tolerated, reliable, inexpensive, and easy to find.  SHENG DI HUANG . . . 10% DANG GUI . . . 10% CHI SHAO . . . 10% CHUAN XIONG . . . 10% MU DAN PI . . . 10% CHAI HU . . . 10% BAI ZHU . . . 10% FU LING . . . 10% DANG SHEN . . . 10% BO HE . . . 5% ZHI GAN CAO . . . 5%