September 2019

September 2019

The Office: How to Treat Irregular Menstruation

  • Often ascribed to Liver Qi stagnation classically
  • In clinical practice, though pulse diagnosis irregular menses has been found to be blood stasis 90% of the time.
  • There are two main subpatterns
    • Blood stasis with heat
    • Blood stasis with cold
      • The most common pattern is cold with blood stasis
  • Pulses
    • Thin proximal Left Chi pulse
      • Blood stasis with cold
      • Small compressed pulses can appear
        • Usually, these indicate polycystic ovarian syndrome
    • Ropey Proximal pulse
      • Blood stasis with heat
  • Herbs
    • Ge Xia Zhu Yu Tang – 20
    • Shao Fu Zhu Yu Tang – 20
    • Zhe Chong Yin – 20
    • Breakers formula – 20
      • San Leng
      •  E Zhu
      • Wang Lu Bu Xing
    • Bugs formula – 20
      • Quan Xie
      • Wu Gong
      • Shui Zhi
      • Di Long
      • Tu Bie Chong
    • If they are hot at night
      • Add Zuo Gui Wan or Zhi Bai Di Huang Wan
    • Cold hands and feet
      • You Gui Wan or Bai Wei Di Huang Wan
    • With agitated or pounding liver pulse
      • Long Dan Xie Gan Tang
    • Cysts
      • Zhen Ren Hu Ming Yin or Resolve EM
    • With heat in pulse
      • Huang Bai
      • Zhi Mu
  • Periods may have a lot of clotting during the treatment process

The Office: Reverse Hook Pulse

  • Reverse hook pulse
    • Combination of left chi pulses that are not in their home position
      • Cun pulse too low
      • Guan and Chi too high
      • Usually tight and thin, often will disappear with pressure
    • The name comes because all pulses are in the wrong position in the shape of a hook
  • Patient symptoms
    • The pattern is caused by events that are traumatic or trigger a fight, flight or freeze reaction.
    • The patient will feel chronically uneasy
    • PTSD
    • Existential angst
    • Chronically fearful
  • Herbs
    • Previous combinations
      • Cold hands
        • Long Dan Xie Gan Tang – 50
        • Ba Wei Di Huang Wan – 50
        • Works 50% of the time
      • Warm hands
        • Zhi Bai Di Huang Wan – 25
        • Long Dan Xie Gan Tang – 50
        • Sheng Mai – 25
        • Works about 50% of the time
    • New approach
      • Works better
      • Treat each pulse logically
      • Chi
        • Zhi Bai Di Huang Wan 25
      • Guan
        • Option 1 – choose either
          • Qi Jiu Di Huang Wan -50 or
          • Yi Guan Jian – 50
        • Option 2 – do both together
          •  Jiu Di Huang Wan -25
          •  Yi Guan Jian – 25
      • Cun
        • Yang Xin Tang 25
    • Modifications
      • Anxiety
        • He Huan Pi
        • Yuan Zhi
        • Hu Po
        • Ye Jiao Teng
        • Yan Hu Suo
      • Difficulty Sleeping
        • Suan Zao Ren
        • Bai Zi Ren
    • Similar pulse to watch out for: chemical poisoning pulse
      • The body is reacting to previous chemical exposure
        • The patient may not remember at the first visit but will often remember exposure later.
      • Will have a reverse hook on both arms
        • Pulse is usually stronger,
      • Chemical Pulse herbs
        • Liver DTX – 50
        • Herbal DTX – 50
      • Treat 1 or 2 months of care
      • May have left reverse hook remaining at end of chemical treatment, but not a right reverse hook pulse.