The Treatment of Modern Western - Biblio.nhat-nam.ru

INTRODUCTION 29ment and transformation of the qi. The facts that the lesionslingered and were not very painful also show that they wereassociated with vacuity. In repletion patterns, the diseasecourse is usually short but dramatic. Since replete evilsobstruct the qi and in repletion patterns there is a lot of qiand blood to obstruct, thus there is more pain. In this case,there was very little.Next come the signs and symptoms that confirm that we aredealing with a spleen qi vacuity as the source of the dampness.Poor appetite, lack of or diminished, scanty appetite, fatigue,lack of strength, lack of warmth in the four limbs, and a tendencyto loose stools, when taken together as a pattern, are thestandard signs and symptoms of spleen qi vacuity. Thin,white tongue fur is considered normal in Chinese medicine.It shows there is no obvious repletion and little if any heat. Ifthere is heat, it is not affecting the yang ming. The tonguesubstance being pale suggests blood vacuity. Immediately weshould think that the spleen is the main viscus associated withthe engenderment and transformation of blood. In that case,we should then immediately think that the spleen is responsiblefor engendering and transforming not only the bloodbut also the qi. The fact that the tongue was swollen withteeth-marks on its edges shows that the qi was vacuous andwas not moving and transforming body fluids. Since thetongue was pale, pointing to the spleen, a swollen, indentedtongue tells us that it was spleen qi vacuity which was notmoving and transforming fluids which were then gatheringand producing water dampness. This is further confirmed bythe soggy pulse on the right bar. The soggy pulse is defined asa floating, fine, and forceless pulse. The right bar correspondsto the spleen and stomach. A soggy pulse in the right bar,therefore, indicates spleen qi vacuity with spilling over ofwater dampness. The fact that the pulse was fine overall alsoconfirms that we are dealing primarily with a vacuity condition.Fine means finer than normal. The fine pulse means thatthere is not as much qi and blood flowing through the vesselsas there should be. Based on all the other signs and symptoms,this points back again to spleen vacuity.The bowstring pulse is an indication of liver depression qistagnation. This is then confirmed by the premenstrualbreast distention, lower abdominal bloating, and irritability.The fact that the pulse was neither fast nor slow shows thatthere was no heart or yang vacuity (a slow pulse) nor exuberantheat (a fast pulse).Ergo, the case was one of spleen qi vacuity with liver depressionand dampness and heat, with more dampness than heat.Hence the treatment principles in the case were to supplementthe spleen and boost the qi, course the liver and rectifythe qi, and clear heat and eliminate dampness with theemphasis on eliminating dampness. The formula, Dan ZhiXiao Yao San, is based on the harmonizing formula, Xiao YaoSan (Rambling Powder), which harmonizes the liver andspleen, supplements the spleen, and eliminates dampness.With the addition of Dan Pi and Zhi Zi, it clears heat andeliminates dampness at the same time as it resolves depression.To this base, Tu Fu Ling, Bai Xian Pi, and Ku Shen wereadded to clear heat and eliminate dampness more effectively,especially in the genital region.CASE 2The patient was a 35 year-old female with external vaginalitching and profuse vaginal discharge. The discharge was acreamy, opaque white. It did not have any particularly badsmell. This discharge was worse when the patient ate sugar orsweets. She was also fatigued, tended to have loose stools,and tended to have cold hands and feet. She frequently gotdizzy when she stood up rapidly. She also often experiencedwhite, clear to opaque nasal mucus after eating sweets ordairy. Her tongue was somewhat swollen with thin, whitefur. Her right bar position was soft. Otherwise, her pulsetended to be fine and just a little bowstring. She did not havemuch PMS. She did tend to have two to three bowel movementsper day which occurred after meals.PATTERN DISCRIMINATION: Spleen vacuity leading todampness pouring downward, possibly with a slight elementof heat and only very, very minor qi stagnationTREATMENT PRINCIPLES: Fortify the spleen and boost theqi, eliminate or transform dampness and stop vaginal dischargeRX: Bu Zhong Yi Qi Tang Jia Wei (Supplement the Center &Boost the Qi Decoction) with added flavors, i.e., RhizomaDioscoreae Hypoglaucae (Bi Xie), Semen Coicis (Yi Yi Ren),Rhizoma Acori Tatarinowii (Shi Chang Pu), Fructus Tribuli(Ci Ji Li)ANALYSIS:The patient was 35. “At 35 years, the yang ming declines inwomen and so they get wrinkles on their face.” So says theNei Jing (Inner Classic), or at least something very close tothat. The woman had external vaginal itching and profusevaginal discharge. Excessively profuse vaginal dischargealways involves dampness. The discharge was creamy andopaque white. White usually means that there is no heat.However, because it is somewhat thick and opaque, we cannotrule heat out altogether yet. It did not have any particularlybad smell. Offensive odor is mostly associated withheat. That this discharge was immediately worse if thewoman ate sweets shows that it was associated with excessivedampness in turn associated with spleen vacuity. The sweetflavor inherently engenders fluids and enters the spleen