October 2020

October 2020

The Office: How to Treat Urticaria with Chinese Medicine

  • Urticaria is a skin disease. The signs and symptoms are red rashes on the skin with a great deal of itching. The rashes can come and go and the disease is classified as an allergic disease.
  • In Chinese Medicine the cause of Urticaria is either a Wind invasion causing the skin problem with Itching and/or Deficiency of Qi and Blood causing the problem (weakness of the immune system).
  • The Deficiency of Qi almost always involves the Lungs and sometimes the Stomach and Kidney.
  • As usual the etiologies of Urticaria fall into 2 large categories – Excess and Deficiency
  • Excess Etiologies
    •  Wind Heat:
      • Signs and Symptoms:  Red skin eruptions with itching and burning. Symptoms are aggravated by Heat.
      • Pulses: The Right Cun is superficial or higher. It is wiry and strong, pounding with some force
      • Herbal Formulations: Yin Qiao San 55, Sheng di huang 15, Chi shao 10, Fang feng 10, Chan tui 10.
      • Additions: If the other pulses are convex and pounding then there is Heat in the Blood – add: Mu dan pi 10, Zi cao 20 (good for Blood Heat rashes), Xuan shen 15.
      • Additions: If there is constipation add: Da huang 5 to 10.
      • Additions: If there is a slight fever add: Shi gao 10 to 20, Zhi mu 10.
      • Additions: If the pulses are all too deep and strong then there is Damp Heat – add: Ku shen 10 (Cold herb for Dampness and itching), Di fu zi 10 (Cold herb for Dampness and itching)
    • Wind Cold:
      • Signs and Symptoms: Slightly red skin patches aggravated by cold and wind. Feels better in a warm shower.
      • Pulses: Right Cun is superficial or higher, wiry, thin, tight without much amplitude.
      • Herbal Formulations: Jing fang bai du san 85, Gui zhi 5, Bai shao 10.
      • Additions: If a lot of itching add: Cang er zi 15, Wu shao she 10 to 15, Chan  tui 10, Jiang can 10
      • Additions: If Lung Qi Deficiency add Huang qi 10 to 20. If Stomach Qi Deficiency add Bai zhu 10.
  • Deficient Etiologies
    • Deficiency of Blood:
      • Signs and symptoms: Dry skin, chronic urticaria, symptoms worse at night, worse during menses
      • Pulses: The Right Cun is superficial or higher, wiry, thin and weak (kleenex). Other pulses especially the Left Guan are wiry, slightly above their proper home, weak.
      • Herbal Formulations: Si wu tang 60, He shou wu 10 to 30, Jing jie 10, Jiang can 10, Fang feng 10.
      • Additions: If the itching is stubborn add: Wu shao she 10 to 15, Chan tui 10, Jiang can 10.
      • If signs of Qi Deficiency in the pulse along with fatigue add: Huang qi 10 to 30.
  • Combination of Excess and Deficiency
    • Stomach Heat or Deficiency – Food allergies causing Urticaria
      • If the Right Cun shows an obvious Wind problem and the Right Guan is either too high and convex and pounding or too low, convex and pounding then consider the Urticaria to be also associated with digestion and food allergies. Add: Bao he wan 20 to 30 to the above Wind formulations.
      • If the Right Cun shows an obvious Wind invasion problem and the Right Guan is thin and weak then a weakness in the digestive system is also involved. Add: Xiang sha ping wei san 15 and Bao he wan 15  to the above formulas.
      • If the Right Cun is slightly wiry but the Right Guan is too low and weak then the skin allergy is caused mostly by a weakness in the digestion causing food allergies. Use Si jun zi tang 25, Xiang sha ping wei san 25, Bao he wan 25, Jing fang Bai du san 25.
  • General info on insects and their use:  
    • Jiang can – neutral to warm – good for itching
    • Chan tui – cool – good for rashes and itching
    • Can sha – slightly warm – good for skin rashes and Bi pain
    • Wu shao she – neutral – itching and Bi pain
    • Quan xie – more for muscle spasms
    • Wu gong – pain and spasms
    • Di bie chong – traumatic injuries, lower back pain
    • Shui zhi – traumatic injuries, blood stasis

The Office: Diarrhea and Dysentery Part 2

  • DEFICIENT ETIOLOGIES FOR DIARRHEA IN CHINESE HERBAL MEDICINE
    • Stomach/Spleen Deficiency
      • Signs and Symptoms:  Chronic diarrhea, reduced appetite, undigested food in the stool, fatigue, possibly anal prolapse, quiet voice.
      • Pulses: Right Guan is a kleenex pulse – weak, thin, wiry and either a little above the middle or below the middle depth. If the pulse is in the middle then the problem is recent (acute). The Right and Left Cuns can be the same indicating Deficiency in the Intestines.
      • Herbal Formulation: Sheng ling bai zhu san 70, Bu zhong yi qi tang 30
      • Additions: 
        • If there is Stomach Yang Deficiency (cold hands, very thin and tight Right Guan pulse, aversion to cold) add Gan jiang 5, Fu zi 5, Yi zhi ren 10 (acrid herb that warms the yang and stops diarrhea)
        • For pus in stool and or phlegm and foul smelling stools (dysentery) add He zi 10, Shi liu pi 10 (astringes intestines and stops diarrhea and kills parasites)
    • Stomach, Spleen and Kidney Yang Deficiency
      • Signs and Symptoms:  Daybreak diarrhea, white mucus in the stool, undigested food in the stool, cold hands, aversion to cold, quiet voice, fatigue
      • Pulses: Both the Right Guan and Left Chi are very thin, wiry and weak – kleenex pulse. Right Guan is usually lower than its home depth which is in the middle and the Left Chi is in its home or lower. Both Cun pulses can be the same indicating Yang Deficiency in the Intestines.
      • Herbal Formulations: Fu zi li zhong wan 50, Si shen wan 50. Here the formula is balanced for tonifying the Stomach and tonifying the Kidney. You can adjust the grams according to what is worse – the Deficiency in the Kidney or the Stomach. Si shen wan has Rou dou kou in it which is very good for stopping cock’s crow diarrhea.
      • Additions: 
        • If signs of food stagnation add Bao he wan 20, 
        • If diarrhea persits add Shi liu pi 10, He zi 10, Yi zhi ren 10.
    • Yin Deficiency of Stomach and possible Yin Heat in the Intestines
      • Signs and Symptoms:  chronic diarrhea or dysentery (in this case the continual loss of fluid along with inflammation has harmed the Yin of the body, tongue is red with little or no coat, possibly blood and mucus in the stool.
      • Pulses: Right Guan is high, thin and wiry. Can have a jump indicating Yin Fire or tight and weak indicating just Yin Deficiency. Right and Left Cuns can be the same indicating Yin Deficiency in the intestines.
      • Herbal Formulations:  General formula: Gan lu yin 100 or custom formula: Huang lian 3 t0 5, E jiao 10, Di yu 10 to 15, Dang gui 10, Bai shao 10, Wu mei 5, Lian zi 10 to 15 (neutral, astringent that stops diarrhea and strengthens Kidney and Stomach/Spleen), Chun pi 10 (cold herb that astringes the intestines and stops diarrhea).

The Office: Diarrhea and Dysentery Part 1

  • The etiologies of diarrhea are divided into two large categories:  Excess and Deficiency.
    • Excess Etiologies:  Damp Heat, Damp Cold, Food Stagnation, Liver invading Stomach
      • Damp Heat
        • Signs and Symptoms: Diarrhea with abdominal pain, possibly burning anus, smelly stools, mucus or blood in the stools, dark urine
        • Pulse: Right Guan is deep and pounding, Right Cun or Left Cun are possibly pounding as well depending on whether the inflammation is not just in the stomach but the large or small intestine as well
        • Herbal Formula:  Huang lian jie du tang 20, Ge gen huang lian tang 20, Gan lu xiao du dan 30, Ma chi xian 10, Mu xiang 10, Bai shao 10.
        • If watery stools add Fu ling 10, Che qian zi 10
        • If pus add Dang gui 10, Qin pi 10
        • If blood in stool add Bai tou weng 10 – 15
      • Damp Cold
        • Signs and Symptoms: Diarrhea with watery stools and possibly white mucus, gas and bloating, possibly abdominal discomfort
        • Pulse: Right Guan is very thin, wiry and slightly strong, little jump, and usually below the middle depth. One or both Cun pulses have the same quality as the Right Guan above
        • Herbal Formula: Huo xiang zheng qi tang 70, Ping wei san 30
        • If watery stools add Che qian zi 10
        • If severe symptoms with pus in stool add Bing lang 5 to 10
        • If the problem is more chronic add Bai zhu 10, Gan jiang 5, Shi liu pi 10
        • If abdominal pain add Gui zhi xie xin tang 20 and reduce Huo xiang zheng qi tang by 20.
      • Food Stagnation
        • Symptoms and Signs: Abdominal distension and fullness, possibly abdominal pain, gas, little appetite
        • Pulse: Right Guan is wiry or convex but tight. The depth can be normal or too high or low. Right Cun or Left Cun is also stiff and tight. The tight quality indicates pain
        • Herbal Formula: Mu xiang bing lang wan 40, Bao he wan 60
        • If a lot of pain add Gui zhi xie xin tang 20
      • Excess Heat or Fire in the Stomach or Intestines
        • Symptoms and signs are typical of dysentery along with possibly reflux. Pus in the stools, possibly blood, smelly stools, explosive diarrhea, usually constipation and then diarrhea
        • Pulse: Right Guan high, convex and pounding. Right and/or Left Cun high, convex and pounding
        • Herbal Formula: Huang lian jie du tang 20, Bai tou wen tang 20, Tian hua fen 15, Wu bei zi 15, He zi 15, Bai wei 15
        • If the Yin has been harmed in the Stomach replace Huang lian jie du tang with Gan lu yin 20. In this case the Right Guan will be too high wiry and not convex
      • Liver invading Stomach
        • Symptoms and Signs: Diarrhea related to emotional ups and downs, IBS, possibly tightness in the chest, gas, abdominal pain relieved by bowel movement, patient is usually upset
        • Pulse: Both Guans are wiry and somewhat strong. The Left Guan will be worse than the Right Guan. The depth can be in the middle if the problem is recent or too high or too low if the problem is chronic
        • Herbal Formula: Hu zhang 10, Huang shui qie 10, Cha chi huang 10, Xia ku cao 10, Jia wei xiao yao san 30, Huang lian jie du tang 20, Wu mei 5, Bai shao 10

The Office: Cardiovascular Disease Revisited Part 2

  • Deficient Etiologies
    • Deficiency of Qi
      • Left Cun pulse is thin and weak like the edge of a kleenex. The pulse is found at the middle depth
      • Symptoms and signs are possibly a quiet voice, cold hands, complaints of fatigue, other pulses are thin and weak, palpitations, 
      • General herbal formula:
        • Zhi gan cao tang 50, Sheng mai san 50.
    • Deficiency of Blood
      • Left Cun pulse is thin and weak and either at middle depth or superficial depth
      • Symptoms and signs can be fatigue, dry skin, anemia, difficulty focusing, thin body type
      • General herbal formula:
        • Gui pi tang 60, Si wu tang 20, Dang gui bu xue tang 20.
    • Deficiency of Yang
      • Left Cun pulse is very thin and deep and weak.
      • All the signs and symptoms of Heart Qi deficiency with cold hands, aversion to cold, palpitations on exertion, shortness of breath, stuffiness of chest. 
      • General herbal formula
        • Ren shen 10, Dang shen 10, Huang qi 10, Gui zhi 5, Fu zi 5, Gan cao 5, Bai zhu 10, Fu ling 10, You gui wan 15, Ze xie 10, Long gu 20.
    • Deficiency of Yin
      • Left Cun pulse is thin and superficial, Left Guan and Chi are similar 
      • Signs and symptoms are of typical Yin Deficiency 
      • General herbal formula:
        • Yi guan jian 50, Mai wei di huang wan 30. Qi ju di huang wan 20.
      • Additions:
        • If palpitations add Hu po 10 to 15
        • If fight or flight symptoms such as anxiety or fearfulness add: Ci shi 15 to 20, Long gu 15 to 20.
        • If insomnia add Suan zao ren 15, Bai zi ren 15
        • If irritability add Hu zhang 20
        • If hypertension or dizziness add Gou teng 15, Tian ma 10, Xia ku cao 10, Shi jue ming 15.
        • If fatigue, add Tian wang bu xin dan 20 or Sheng mai san 20.
    • Combinations of all the above