Class #: / 3
Case 1:
Weight loss etc suspect cancer here. This particular person has liver cancer. Use anticancer herbs prior to surgery. After surgery, tonify qi and blood and spleen. Build up before chemo/radiation. After chemotherapy starts, continue to build qi and blood and spleen qi as they will have digestive problems. Chemo causes bone marrow and blood xu. After chemo, do detoxification treatments. Use strong dissolve mass and antistasis herbs now. Can add deep tissue massage as well. If the patient goes to terminal stage, use the strong dissolve mass and antistasis herbs also.
Generally, no herbs before/during/after for a couple of days around chemotherapy.
Formula example
Gui pi tang – calm shen herbs here so have to remove suan zao ren (they don’t need help getting to sleep!), yuan zhi. Long yan rou is fine as it nourishes heart.
When a patient first gets the dx, give them liver qi and heart nourishing herbs. When they get to the denial stage, soothe liver qi and anti anger. When they hit bargaining stage will go to the acceptance stage, preparing for possibility of death. Cancer pts usually for aggressive cancers will get 1-3 years. If catch earlier or less aggressive, takes 3-5 years.
Gui zhi tang works well. Has dang gui in it. ba zhen tang good also, but have to take out harsh herb and add gentler herbs like dang gui. Add bone marrow/+ white blood cell herbs. most common herb for immunity is huang qi, mushrooms like ling zhi (looks like wood – hard to eat), xiang gu (shitake - edible), yun zhi (also hard to eat). All contain polysaccharides which stimulate immunity. Mushrooms are very rich in polysaccharides. Fu ling also is a fungus which will boost immunity.
Post chemo treatments by a couple of days use the mushrooms. Eat berries for the anti-oxidants. You could use gou qi zi and other berries from TCM for the same purpose. Ba zhen tang, gui pi tang to tonify qi and blood and add the mushrooms above.
Digestive problems with n/v because chemo drugs affect the brain and cause nausea. Also stops the digestive enzymes from processing properly. Ban xia, zhu ru etc for nausea. Shen qi, shan zha, mai ya to stimulate digestion. If a cancer patient eats too much will get bloating, so can give lai fu zi.
Don’t use herbs that don’t match the syndrome!
Niu zhen sha? Stimulates wbc’s. Could also add ren shen into the mix.
2nd part of case 1:
Remission post chemo – you go back repeatedly to do a body scan for cancer again. In this case, came back 2 years later and found cancer. The case gives a good description of what happens when it comes back. Some patients don’t want to go through chemo again, so they decide to accept death.
Blood stasis evident, toxins, liver overacting on spleen, liver qi stagnation/spleen qi xu, ki yin xu. What formula? 1) Liver yin xu with hypochon, Lv/ki yin xu = qi ju di huang wan. 2) blood stasis = bie jia and other soften masses/remove stasis herbs. Could use e zhu, but is strong and could harm. Add some liver qi soothing herbs – yu jin, he huan pi. Gou qi zi. Add ling zhi which treats palps, clam shen, nourish heart, stimulate immunity. Add dang gui to nourish dang gui. Xiao yao san can be modified with less chai hu – 3-6 g, remove fu ling and bai zhu because they are too drying.
Analyze the cases – add herbs for each symptom, but analyze the herbs to make sure they don’t hurt any other symptoms!
Case 2
This guy has either lv or gb problem. Could also be pancreatic cancer with tumor pressing on the bile duct. Sometimes if cancer is too big will avoid surgery. One tx is to go thru inguinal artery and pump chemo directly to the site of tumor.
You can see d/h excess and blood stasis in this case. Patient is in pain and has a tumor. d/h is the jaundice. Abdominal distention etc are all from damp heat. Jaundice is very toxic. Pt has loose stools also from d/h. Too much d/h can damage spleen which likes to be dry. Dark red tongue = blood stasis. Thready wiry pulse. Wiry = pathogens (?). Thready because long term d/h has consumed yin. Be careful not to damage yin here. Take damp heat stasis and sp qi/lv yin xu into account.
Pain + jaundice = yin chen hao tang, but not use because has da huang and this pt has loose stool and more damp. Herbs for liver damage: yu jin, fu ling. Add some huang qin for the heat. Hypochon pain and mass – bie jia, yu jin, chuan lian zi, yan hu suo.
Need another formula for a different time - either add xi yang shen or give yi guan ? Xi yang shen, niu zhen zi, ling zhi, fu ling and give later – during chemo? What? Add some digestive herbs .
Or, give antijaundice, get ‘em feeling better. Then give them a different formula when they feel better. Could also give different formulas for morning/night – one for damp heat jaundice in the morning afternoon, then the yin xu formulas for night time.
If feel bad after lunch during chemo, which is really common, give sheng mai san modified(?).
Nourishing yin herb can cause damp accum – shu di for - example will be too sticky.
2nd part of case 2
Tumor is shrinking post chemo, jaundice and d/h are gone. Qi and blood are now damaged. Still has stasis – tumor is shrinking but is there. Qi yin xu signs in the case: tired, pale tongue, weak pulse with little coating, emotional depression.
Yi guan zhi, qi ju di huang wan is the base formula. Add bie jia to soften the masses. Add ling zhi to help immunity, niu zhen zi, gou qi zi. He huan pi emotional depression. Digestive stimulant herbs for the appetite. You could also modify Xiao Yao San.
Look up the antidepressant herbs.
Edema – think about conditions that cause it biomedically. Use diuretic herbs and foods – squashes, yi yi ren. Think about move blood herbs – ze lan and niu xi. Tonics too such as fu ling and bai zhu, si wu jia, sang bai pi, ting li zi. Knees related – fang ji. Wind related herbs too to drain/dry dampness. If local swelling like carbuncles consider toxic heat relieving herbs.
Edema with water dampness – wu ling san, pin wei san is commonly combined. Wind/water = yue bi…I have no fucking idea what you’re saying most of the time. Heat toxins locally – oh fuck, look at the book and hope for the best. Also, find a state to practice in that doesn’t require fucking herbs. Fuck. This is a goddam recap anyhow. I’m going to shoot myself.
Lin Syndome.
Know western medicine discussion and what causes it. IGA. . . mucosal lining repeat infections especially with sexual relationships. Qi lin can be related to enlarged prostate, or in females, weak pelvic floor muscles. Herbally drain d/h for infection and inflammation. Combine with anti-inflammatory herbs and anti-infection herbs – often cool blood herbs (huang bai, pu gong ying etc.) Burning discomfort also calm inflammation. Stone lin = hai jin sha for instance, ji nei jin (chicken gizzard). Gao lin with cloudy = shi chang pu. Lao lin requires tonification = huang qi, tonify kidney like shan yao. Bloody lin needs da ji, shao ji, etc to stop bleeding cool blood.
Heat Lin
Look at tongue and pulse, ask about urine and stool, symptoms.
Formulas:
Ba zheng san. Mu tong and such drain. You can modify. If have normal urination, can remove the promote urination. Da huang good at beginning. Add huang bai, chuan xin lian, wu ling, ban lan gen, etc. Painful = ban lan gen and something. Fever, add clear heat herbs.
Stone Lin
Severe cramping common, often to ER not knowing what’s happening. Might be appendix, pancreas, female ovarian cyst rupture, stones. Hard to tell when you’re in there!
Formula:
Shi Wei San is the basic formula to dissolve the stones. Couple of ways to treat. Acute stage, use herbs over a weekend – large amt herbs, do exercises, drink lots of fluids. Another way: low dose herb and take long term. This is 1ce or 2ce per month, take and flush.
Remember to add yan hu suo and shao yao gan zao tang
Qi Lin
Bladder sphincter loosens and bladder contracts to squeeze urine out. With spleen qi which ascends is deficient, this muscle is weak and loose. Patient can’t urinate easily. Sphincter muscle can’t loosen (like with prostate enlargement). Both cause the bladder to stretch too much, get very large with urine. Fluid will build up to the kidney and cause failure. Ki xu and stagnation.
With deficiency of qi, use Bu Zhong Yi Qi Tang. Large dose of huang qi. Add zhi ke! Uterine prolapse and loose musculature is stimulated by zhi shi or zhi ke.
When there is stagnation of Qi, use Chen Xiang San. Wu yao was used for inguinal hernia originally. These are all qi moving/breaking herbs. Applies to enlarged prostate. Vacaria seeds, bie jia and yu zhu will break the stagnation and reduce enlg’d prostate. In western herbs you use saw palmetto or pumpkin seeds. Tonify kidney and resolve masses.
Gao Lin
This is cloudy urine either from turbidity or leaking of lymph fluid. Could be leaking proteins or nitrogen. Can be excess/pathogens, or xu of Kidney.
Excess: Bi Xie Feng Qin Yin. Clear ht, drain toxicity. Bi xie and shang pu. Clear heat to resolve the turbidity. Add clear toxicity and promote urination herbs.
Deficiency: Gao Lin Tang. Tonify the qi and kidney – shi chang pu + shan yao + huang qi + liu wei di huang wan herbs. Shu di huang in small amts. Sang piao xiao could work, modified.
Lao Lin
Repeat bladder infections/inflammation, unable to ctrl urine. Look at Kidney organ. Acute sx: go back to heat lin. Not acute: use tonification herbs. Might give ba zheng san in acute stage. In remission, tonify the kidney like liu wei di huang wan + tonify qi herbs.
Wu Bi Shan Yao Wan is a big formula. Remember the mechanism and principles. Tonifies kidney, strengthens kidney with yi zhi ren and such. Tonifies spleen qi too.
You might use liu wei di huang wan and add some herbs depending on the patient’s sx.
Bloody Lin
Xiao Ji Yin Zi for excess, Zhi Bai Di Huang Wan for deficiency…this is for xu heat. Add cool blood/stop bleeding herbs. If bleeding due to leaking red blood cells (see urinalysis), use bu zhong yi qi tang modified. Xian he cao – stop bleeding/astringe added and is commonly used herb.
Protein in urine – large dose of huang qi. This is cloudy lin. If have both, gauge which is more severe and treat from that aspect.
Seminal Emissions
Repro is in kidney category for males. Will find seminal emissions and impotence here. Will also see in clinic for sterility/infertility. Won’t really get seminal emission patients, but impotence/infertility in a western clinic. Prostate inflammation can cause seminal emissions, as can neurothenia – nerve system is exhausted or fatigued or hypersensitive due to damage. Prostate might be inflamed with damp heat or kidney might be too weak to hold the sperm. No treatment in western med.
Etiology/pathology in TCM is considered related to:
- Kidney yang/qi xu.
Could be congenital or overstrain. Overstrain = overuse! - Disharmony between Heart and Kidney.
Kidney fire and inflammation caused by the imbalance. - Damp heat
Inflammation from alcohol, greasy diet, stress, etc.
Differentiations and Treatment
Seminal fluids come from testicular fluid and from prostate fluids. If the emissions are clear, analyze for seminal fluids – could be too much prostate fluid. If xu, consolidate. If shi, drain the toxin.
Commonly used herbs are consolidation herbs, tonify ki herbs
Heart Kidney Disharmony
Considered an excess because of the heart fire. Remember however that this is heart fire with ki xu with seminal emission. This formula is Huang Lian Qing Xin Yin + San Cai Feng Sui Dan. Look at the sx in the book.
This is not heart qi xu + ki xu heat! That needs a different formula.
These formulas clear the heat, calm shen, nourishes Ki yin, restrains the loss of essence. Lian zi is the lotus seed – bitter taste astringes but clears heart fire too. Note the ren shen – tonifies qi and also calms shen/help memory – small dose or is too stimulating. Nervous system fatigue/neurothenia responds well to a little tonification (3-6 grams of ginseng). Heart/Kidney disharmony is not pure excess!
Damp Heat
Also an excess, expressing as smelly body odor. The sweat gland in the armpit has atrophied over time in most people…when there is damp heat toxin will stimulate this gland strongly and cause the smell. Look for odor, smelly, sticky bowels, and other damp heat signs. Damp heat suppresses the body functions.
Formula is Bi Xie Feng Qin Yin. Lots of draining herbs. Dan shen also moves blood/calms the shen. You could also use the 3 Yellows to detox and drain the heat/damp.
Prostate is an organ w/o lots of blood supply. Hard to get antibio’s here. Use move blood herbs
Heart (blood) + Spleen qi xu
Kind of like student syndrome. You can use Maio Xiang San or Gui Pi Tang. Both are similar. Both nourish heart and strengthen spleen.
Zhu sha was once used to kill off the cells overproducing dopamine in the brain. Don’t need to do that now – use huang lian and long gu combination because there are better drugs to do that now.
Note that representative formula is missing astringent herbs. Also need herbs for patient’s symptoms.
Ren shen for memory, long yan rou also. Ginko if you get it at Sun Harvest.
Kidney Xu unable to consolidate
There are a couple of kinds – kidney yin xu and kidney yang xu. Most sx are related to aging. If comes with heat sx, is yin xu. If with cold sx is yang xu.
Ki Yin Xu:
Da Bu Yuen Jian is basic, add astringent herbs. Tonify qi herbs – ren shen, etc. Can also use Zuo Gui Wan.