Week 4: Mental/Emotional and Cardiovascular Disorders: review and case studies
1)Compare these 2 formulas that tonify qi and blood and treat heart palpitations:
Gui Pi Tang and ZhiGan Cao Tang.
What are the energetic functions of each formula?
Which herbs in eachtonify the qi? Tonify the yin/blood? Which herbs calm the spirit?
What are the main symptom indicators for eachformula?
2) Heavy herbs that descend and anchor are often used in anxiety or manic disorders. Each herb within agiven category, such as these heavy herbs that descend and sedate, has some special attribute that makes it stand out. Indicate the defining quality of each of these (what makes you want to specifically choose it over the others).
Long Gu (fossilized bone)
Mu Li (oyster shell)
Ci Shi (magnititum)
Zhen Zhu Mu (mother of pearl)
Hu Po (amber)
3) Compare these 3 formulas and tell when you would use one over the other in the treatment of emotional imbalance such as manic depression. What are the symptoms you would see with each and how do they differ from each other?
Dan Zhi Xiao Yao San
Long Dan XieGan Tang
Chai Hu ShuGan San
4) Compare the following pairs of herbs that are often used together:
SuanZaoRen and BaiZiRen
Yuan Zhi and Shi Chang Pu
Ye Jiao Teng and He Huan Pi
Bai He and Sheng Di
Chai Hu and Bai Shao
5) Name the herbs that tonify the yin in Tian Wang Bu Xin Dan.
Which herbs enter the Heart? Which enter the Kidney?
Why is JieGeng in this formula?
What does Wu Wei Zido in this formula?
6) Tian Wang Bu Xin Dan and GuiZhiJia Long Gu Mu Li Tang both treat problems with communication between the Heart and Kidney. Explain how these formulas approach treating the Ht/Kd differently and what symptom pattern each formula is appropriate for.
7) Compare these 2 formulas that treat insomnia due to Liver yin deficiency. How are they different and for what symptom patterns would you use each?
What herbs do they have in common?
Yi Guan Jian
SuanZaoRen Tang
8) Name 3 herbs that tonify the yin and/or blood and enter the Heart.
Name 3 herbs that tonify the Liver yin and/or blood.
Name 3 herbs that clear heat in the Heart.
Name 3 herbs that clear heat in the Liver.
Name 3 herbs that move stasis in the Heart.
Name 3 herbs that move the Liver qi.
9) Bring a case to class that is focused on a main complaint in the category of respiratory, gastrointestinal, Heart/spirit – mental/emotional, or NMS pain. Write up as much detail regarding the main complaint details and other general signs and symptoms as possible, including pulse and tongue. Though we will go over each case in detail, think about how you would diagnose the case, and what formula and modifications you would use.
10) Case Study: Please give diagnosis, Treatment principles/intentions, formula, modifications and dosages for the following case
Joe, age 45
MC: anxiety, insomnia, low energy
Joe is incredibly stressed. He has a managerial position at a large tech company and really does not like his job, but feels he cannot leave as he needs to support his family. He recently stopped smoking, is somewhat overweight, and trying to exercise more regularly. He feels stressed and his anxiety and irritability are getting more severe.
Joe’s sleep is also a big concern for him as well. He is a “night owl” and finds it very hard to get to bed before 1 am. He does not feel too hot at night, but sleeps very restlessly and wakes 2-3 times during the night, and then again about an hour earlier than he needs to get up. He reports that he dreams a lot and has occasional palpitations at night when falling asleep. He does not feel he is getting enough sleep and he is very tired when he wakes in the morning. This is part of his problem with not exercising, and he just doesn’t have the energy.
Other:
Digestion: bowel movement daily, soft to formed
Energy: ok once he gets going and has coffee in the morning; afternoon energy drop
Peridontal disease: often bleeds when flossing; reports always experiencing mouth dryness
Headaches: none
HTN: generally around 130/80. His MD wants him to go on blood pressure medication but he does not want to. He would really like to find a natural way to bring his blood pressure down a bit and is hoping that exercise will help.
Diet: trying to decrease carbs, salt and sugar. Is celiac and avoids all gluten (and is very stressed and unhappy about this restriction)
Thirst: is trying to drink more water but has to force himself during the day. He gets more thirsty in the evening but doesn’t want to drink too much then as it will cause him to wake more frequently to urinate at night
NMS: old rotator cuff injury that sometimes causes pain and reduced range of motion when he throws a ball with his son, but otherwise no major problems
Tongue: front of tongue is very red, midline crack, yellow moderately thick coat in middle to back
Pulse: overall slippery, wiry and slightly rapid, Kd yin is thin, wiry, and slightly weak