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

28 THE TREATMENT OF MODERN WESTERN DISEASES WITH CHINESE MEDICINEOne last piece of diagnostic information: Cracks on thetongue, whether large or small, are more often a sign of deepseated,chronic spleen vacuity than yin vacuity. Such cracksshould only be read as yin vacuity signs if there is a dry, redtongue with scanty fur and other clear-cut symptoms of yinvacuity. Figure 7 shows some common patterns of cracks onthe surface of the tongue which indicate a long-standing,deep-seated spleen vacuity.When treating difficult, knotty diseases, there are severalChinese medical statements of fact that should always bekept in mind. These statements all have to do with the mostcommon complicating factors of other, often more obviouspatterns. They are:1. Enduring diseases are mostly [associated with]vacuity.2. Enduring diseases are mostly [associated with]stasis.3. Enduring diseases enter the network vessels.4. Enduring [diseases] must reach the kidneys.4. CASE HISTORIES EXEMPLIFYING TREAT-MENT BASED ON PATTERN DISCRIMINATION INCOMPLEX, MULTIPATTERN CASESThe following case histories and their analyses are based onactual cases treated by Bob Flaws. These are presented asexamples of how the step-by-step methodology of professionalChinese medicine is used in real-life practice. Whilethey do not show how the original pattern discriminationand, therefore, the treatment was modified during succeedingvisits, they do show how to discriminate complicatedcombinations of patterns with a confusing welter of signsand symptoms and how to write complex Chinese medicinalprescriptions for these patterns.CASE 1The patient was a 39 year-old female who had had genitalherpes since she was in her early 20s. These erupted as several,small slightly red papules which eventually rupturedand then transformed into wet ulcers. These arose on herperineum. They occurred before, during, or after her menstruation.They also occurred if she became fatigued. Thelesions tended to linger but were not very painful. In addition,the patient had a diminished appetite, fatigue, lack ofstrength, lack of warmth in her four limbs, a tendency toloose stools, premenstrual breast distention, lower abdominalbloating, and irritability. Her tongue fur was thin andwhite, while the tongue substance was pale and swollenwith teeth-marks on its edges. Her pulse was soggy in theright bar and fine and bowstring overall. It was neither fastnor slow.PATTERN DISCRIMINATION: Spleen vacuity complicatedby liver depression and damp heat in the lower burnerTREATMENT PRINCIPLES: Fortify the spleen and supplementthe qi, course the liver and rectify the qi, clear heat andeliminate dampnessRX: Dan Zhi Xiao Yao San Jia Wei (Moutan & GardeniaRambling Powder) with added flavors, i.e., Rhizoma SmilacisGlabrae (Tu Fu Ling), Radix Sophorae Flavescentis (KuShen), Cortex Dictamni (Bai Xian Pi)ANALYSIS:The patient was 39 years old. Therefore, her condition wasprobably a mixed repletion-vacuity one based simply onage alone. The spleen typically begins to become vacuous,if it is not already so, around 35 years of age, while the kidneysbecome vacuous in women sometime after that, basedon the interdependence of the former and latter heavenroots. Thus, one should be looking for evidence of spleenand kidney vacuity. She had had genital herpes since herearly 20s. This means that her condition was a recurrent,chronic one. That means that, although the branch manifestationmay be a repletion, the root condition was probablya vacuity one. Small lesions suggest vacuity as opposedto repletion. Slightly red lesions also suggest not very strongheat. That they did rupture and then were wet indicates thepresence of dampness.So, up to this point, we know that the woman’s conditionprobably involved a mixture of repletion and vacuity, thatthere was dampness and heat, but that the heat was not asimportant as the dampness. That the lesions occurred on theperineum is linked to dampness being a yin evil which isheavy and turbid and tends to sink downward. The fact thatthey might occur before, during, or after menstruation indicatesthat the condition was also not a simple repletion. Sincewomen are relatively vacuous and empty after menstruation,repletions are not so common then.As stated above, women in their late 30s typically suffer fromsome element of spleen vacuity. The spleen is the latter heavenroot of qi and blood engenderment and transformation.It is the decline and vacuity of spleen qi and kidney yangcyclically each month which result in the onset of themenses. The menstrual blood flows out of the body due tothe spleen not being able to restrain the blood nor the kidneysbeing able to seal and secure the lower yin. We alsoknow that the spleen is the single most important viscera inthe engenderment of dampness. The fact that these attacksalso occurred when the patient was fatigued shows that theywere due to vacuity. Fatigue is a main symptom of qi vacuityand the spleen is the main viscus involved in the engender-