Diets & Protocols

Diet Protocol General Health & Specific Conditions

This is a basic ‘foundation’ diet that I discovered, created by Dr Wilson, an American GP with over 1,400 articles for free on his website, geared towards better health. I have played around with many diets over the years, and this very simple program seems to agree with me the most. It helps to ‘normalize’ gut function, and increase energy, thus creating a fantastic foundation to build health and reverse many diseases. In many cases, further steps are required. In this article I mention further modifications, especially for vulvodynia, as I see a lot of this in my clinic.

basic diet chinese medicine chris eddy melbourne acupuncture clinic

Diet Protocol For Vulvodynia, Fibromyalgia & Interstitial Cystitis

Oxalate. What is it and why is it relevant to my pain?

Oxalate (a naturally occurring compound) is present in a lot of plants and fruit that we eat, especially high in almost all seeds and nuts. Ordinarily, the gut won’t absorb much of the oxalate from the diet because most of the oxalate will be metabolized by the gut flora or just leave the body with the stool. When we have certain situations like gut inflammation (from dysbiosis or abnormal gut bacterial balance, commonly caused by gut surgery and antibiotics), a lot of dietary oxalate is absorbed. The difference can be as great as going from 1-2% of the dietary oxalate absorbed to as high as 50%. The oxalate combines with calcium to create crystals that have very sharp and jagged edges. These crystals deposit in certain areas of the body. For some they cause kidney stones, others joint pain, and for many women, deposit in the outer walls of the vagina causing stinging pain and irritation.

Hyperoxaluria?

This means that there is a high level of oxalate in the urine. This can sometimes be observed in vulvodynia, however the oxalate isn’t always excreted in the urine in large amounts. It binds to other compounds and stores in bone and tissue, especially tissue that is already damaged or sensitive. Thus, a urine test may not reveal accurate results.

Can our bodies also make oxalate?

Yes. By just restricting high oxalate foods, doesn’t mean that you will eliminate all oxalate from your body. Oxalate can increase in the presence of Vitamin C, and low levels of Vitamin B6, magnesium and thianine. As oxalate is broken down in the gut lining by bacteria, if there are certain over growth and certain undergrowth of particular strains, the oxalate will be stored in tissue or excreted in the urine.

What protects us from oxalate and do we have our own defense mechanism?

Yes, we have our own natural defense mechanism against oxalates, it is called gut bacteria. Unfortunately, these bacteria, particularly ‘oxalobacter formigines’, and to a lesser extent Bifido and Lactobacillus strains, which are subject to being killed by antibiotics.

Are there other bacteria that can make oxalate worse?

Yes, it seems so. From a recent study, “…intact viable E. coli, K. pneumoniae, S. aureus, and S. pneumoniae had significant promoting effects on CaOx crystal growth and aggregation”. Therefore, in many cases, I recommend a stool sample to analyze the levels of good and unwanted bacteria in the gut, to give us a good idea what might be potentiating the increase in oxalate crystal deposits.

So a green smoothie probably wouldn’t help?

No way! Well, you’d think it would be the best thing for your health. And it probably would be beneficial if your intestinal bacterial flora was in perfect balance. But, it’s probably not, and that green smoothie will probably contain: spinach leaves, kale, tumeric, chard, raw carrots, maybe almond/soy milk, sometimes cocoa powder/nibs, broccoli powder, dates – all, which are VERY HIGH in oxalate. Dr. Shaw from Great Plains Laboratory calculated the average intake of oxalate in the average American diet to be about 100 mg, whereas those eating just one green smoothie (prepared with 2 cups of spinach or the equivalent) were netting 15,000 mg of oxalate. That is going to have a very negative effect on your pain.

So all I need to do is avoid oxalate and take Vitamin B6, Calcium Citrate and may pain will go away?

No, unfortunately. It may work for some people, but I doubt it will be enough for most. There is a reason the oxalate is being stored in tissue and not broken down properly and there is a reason vitamin B6 is low. No one, really knows for sure, but as mentioned previously it appears that it all started with an imbalance of intestinal bacteria, probably from antibiotics, which removed the bacteria that break down oxalate (bifido, lactobacillus and O. formigines) this then put a many number of biological functions out of balance, which is potentiating pain in certain individuals. It may then be affecting certain individuals because of a genetic predisposition and unhealed tissue, complicated with sensitization of nerve receptors in the vagina, in the case of vulodynia, Genetic predispositions are very hard to prove and the world of genetics is still in its infancy, so it is hard for us to point the finger confidently at any gene. Having said that, even if we do know, will it change our treatment? Possibly not.

So what should you do? I recommend seeing someone qualified to take you through the steps. Don’t start on a strict ‘Oxalate Free Diet’ however do observe it and start slowly. Starting too fast can lead to ‘dumping’ of oxalate into your system, causing temporary worsening of symptoms. Slower is better. The main idea is to heal, repair and normalize your intestinal lining and bacteria. You can take B6 if you’re deficient and Calcium Citrate will help reduce the oxalate. The best way to find out if there is an overgrowth of ‘E. coli, K. pneumoniae, S. aureus, and S. pneumoniae’ and an undergrowth of ‘oxalobacter formigines’, and to a lesser extent Bifido and Lactobacillus strains, is to get a specified stool test. A standard stool test from your GP will not cover these bacteria. You will need a company like Doctors Data. This can be done through our clinic or your local professional Functional Doctor etc.

Other reading for self care of vulvodynia. Link.

oxalate free diet vulvodynia chris eddy melbourne acupuncture clinic

Diet Protocol For IBS

FODMAP diet chris eddy melbourne acupuncture clinic

Combined Diet Protocol For IBS with Vulvodynia

oxalate and fodmap free diet chris eddy melbourne acupuncture clinic

For more information regarding vulvodynia and how we treat it please contact our clinic on 8676 0599 or email us on the ‘contact us’ page. Diet is a very small part of the treatment, however is an important element to full recovery. We also use acupuncture (no points go any where near the genitals), herbal medicine and external herbal wash. The combination of these, sometimes combined with probiotics works very well when tailored to the individual.

Acupuncture combined with lifestyle and diet changes can offer treatment for various conditions including Cystitis/UTI, Resltess Leg Syndrome, Trigeminal Neuralgia, Male Infertility,  Prostadynia, asthma, acne, hay fever, sinusitis, weight loss, pelvic pain, rectal pain, female infertility, morning sickness, period pain, general pain and many more.

Chris Eddy is a registered doctor of Chinese medicine and university lecturer. He has been treating for the last 13 years in his city practice in Melbourne Australia.

Paediatrics According to Body Type

Paediatrics According to Body Type

I remember my first Chinese medicine class at university on paediatrics 15 years ago. The introduction was – “A child is not a smaller version of an adult.” And in the text, there was a small person, and a large person next to each other, just in case we weren’t sure exactly.

I thought this was absolutely ridiculous and kind of insulting. I mean, do they think I don’t know what a child looks like? However, I began to understand it wasn’t physical appearance as the image portrayed, but the physiological functioning difference, sensitivity, fragility and speed at which disease develops and changes.

As pediatric disorders can be daunting for the uninitiated, we will introduce 15 major classical formulas and their associated ‘body types’ and common uses according to classical medicine using the applications outlined by Dr Huang Huang.

Xiao Chai Hu Tang Indication Melbourne Acupuncture Clinic Chris Eddy

1.0 Xiao Chai Hu Tang

Chai Hu 6, Huang Qin 3, Ren Shen 3, Ban Xia 6, Zhi Gan Cao 3, Sheng Jiang 3, Da Zao 9

  • Body type is often thin
  • Facial color yellow or pale with a lack of brightness
  • Often allergic illnesses
  • Eyes often small and long
  • Catches cold easily and fever lasts a few days
  • Difficult to cure, recurrent, long term disorders are common.
  • Personality tends to being introverted and depressed as opposed to Ban Xia type who is more outgoing and engaged.

Paragraph 96 of the shang han lun: “for alternating chills and fever, a sense of discomfort and fullness in the chest and ribs,being dejected with no desire to eat, irritability of the heart and a tendency to vomit.”

  1. Chest and hypochondriac fullness and discomfort, or stiffness and fullness beneath the ribs, or focal distention and fullness in the subcostal region.
  2. Alternating fever and chills
  3. Irritability in the chest with a desire to vomit and lack of desire or inability to eat.
  4. A wiry, thin and wiry, slippery and wiry, or sinking and wiry pulse.
  5. A tongue coating that is yellow, yellow and white mixed together, pale yellow, or yellow and greasy.

Common applications:

  • Cold with fever and enlarged lymph nodes
  • Tonsilitis with abscess
  • Allergic rhinitis
  • Bronchitis
  • Bronchial asthma
  • Urticaria, eczema, dermatitis
  • Nasal polyps
  • Middle ear infection, sinusitis, otitis media

Formula variations:

  1. Fever: Add Lian Qiao
  2. Allergic Rhinitis: Congestion, rhinitis, sneezing: XCHT + Xin Yi Hua, Wu Wei Zi, Shi Gao. Add Lian Qiao, Zhi Zi, Huang Bai (if yellow mucous). If itchy eyes and runny nose: Jing Jie and Fang Feng.
  3. Asthma & Cough: Add Hou Po, Fu Ling, Wu Wei Zi (sour herbs like wu wei zi are very effective at astringing the lung qi and are anti-allergenic – including wu mei and vinegar. Wu wei zi use: thin mucous, cough, heavy panting, dizziness with sweating, dark vision)
  4. Cough with thin mucous (like water): Gan Jiang
  5. Urticaria: Common in children with milk allergies. Common in 2-7 year olds. Add Jing Jie 10g, Fang Feng 10g (itching), Shi Gao 10g (if sweating with big thirst), Increase Chai Hu does if fever. Dr Huang doesn’t use Sheng Di generally for hives and urticaria, but for other skin conditions like eczema as the pathogen is in the skin level, not the blood level).
  6. Otitis Media: Eustachian tube is shorter and more horizontal than in adults so reflux of food aprticles up the tube to the ear is more common. Symptoms of pain, tinnitus, fluid coming out, loss of hearing, babies rubbing their ear. Use XCHT + Lian Qiao (special for otitis media), Zhi Zi, Huang Bai (for yellow discharge).
  7. Muscular Dystrophy: Depends on severity, but can help alleviate symptoms and prevent muscle wasting.

Case study from Dr Huang Huang

Case #1: Cough & fever 6 year old child, cold & fever for a week, 3 days before – bleeding, platelets very low. Purpura due to low platelets & related to common cold, tonsils swollen

Xiao Chai Hu Tang with Sheng Di & Lian Qiao

Chai hu 15, Huang Qin 10, Ban Xia 10, Sheng Gan Cao 5, Lian qiao 30, Sheng Di 30, Gan Jiang 5 slices, Hong Zao 15

Sheng Di & Lian Qiao is useful for bleeding and bleeding is a specific indication for Sheng Di.

Case #2: Tonsillitis 5 years old

Cough & yellow phlegm for 2 months worse in morning & before sleep, yellow nasal mucus, thick tongue fur, easily allergic

Chai hu 15, Huang qin 10, Ban xia 10, Dang shen 10, Gan cao 5, Jie geng 10 (yellow mucous), Zhi zi 10, Huang bai 5 (yellow mucous), Lian qiao 15 (yellow discharge), Zhi ke 10 (dry stool), Bai shao 10 (dry stool), Gan Jiang 5, Hong Zao 15

2.0 Chai Hu Jia Long Gu Mu Li Tang

Chai Hu 12, Huang Qin 9, Ren Shen 6, Gui Zhi 9, Fu Ling 9, Ban Xia 9, Da Huang 6, Long Gu 9, Mu Li 9, Sheng Jiang 6, Da Zao 12, Qian Dian/Dai Zhe Shi (optional) 9

This formula is for the child who is a Chai Hu type but has more pronounced feelings of depression or other psychological issues. It calms the spirit, stops fright and resolves depression.

Body Type

Average body physique, Pale facial colour, Cold fingers and toes, Tightness under the ribs

Common Uses

Convulsions, Poor brain development, Hyperactivity, Insomnia

Childhood Depression:

 

 

Ban Xia Formulas

Ban Xia Formulas

Ban Xia Type Chris Eddy Melbourne Acupuncture Clinic

4.1 Xiao Ban Xia Tang

Zhi Ban Xia 6-12,  Sheng Jiang 5-10

This formula is specifically designed to stop vomiting where there are signs of phlegm and dampness.vomiting chinese medicine chris eddy

The tongue wil have a white or slippery white/wet coating, there will be a lack of thirst or an abundance of clear saliva, or coughing with profuse, thin watery sputum with watery sounds in the epigastrium.

The formula presentation is:

  1. Nausea and vomiting
  2. No thirst or aversion to drinking, or abundant saliva in the mouth, or coughing with profuse, thin sputum, or watery sounds in the epigastrium, and chest and diaphragm fullness and distension.
  3. Relatively thick, white, and slippery or white and greasy tongue coating.

4.2 Wen Dan Tang 温胆汤

Ban Xia 6-12,  Fu Ling 6-12,  Chen Pi 6-10,  Gan Cao 3,  Zhi Shi 6-12,  Zhu Ru 6,  Da Zao 6-12, Sheng Jiang 3-6

Although this formula is translated as “warm the gallbladder decoction” it is not a warming formula. Huang Huang believes that nausea chinese medicine chris eddyat the time of designing the formula, the language reflects a cold gallbladder person as not having courage. Thus, this formula acts to calm those who are easily startled by situations, have dream-disturbed sleep, shortness of breath, palpitations and fatigue, or spontaneous sweating.

It is often used in the clinic to treat: neuroses, mental illness, autonomic dystonia, biliary disease, gastrointestinal illness, cardiovascular disease, or cerebrovascular disease.

WDT presentation:

  1. Nausea, vomiting, bitter taste and/or sticky feeling in the mouth
  2. Emotional lability (laughing or crying at the wrong moment), being easily startled, panicky, insomnia or dream-disturbed sleep
  3. Greasy or slippery tongue coating

WDT patients frequently have panic attacks after an event that caused shock, stifling in the chest, sleep disorders andsad chinese medicine chris eddy restlessness.

Mental Illness: This formula has been shown in numerous studies to be effective in mental disorders such as schizophrenia, often modified by adding Shi Chang Pu, Yuan Zhi, and Tian Zhu Huang.

Insomnia: WDT has been very effective in ‘yin deficiency phlegm-dampness’ type insomnia by modifying the formula to produce Shi Wei Wen Dan Tang (WDT + Ren Shen, Shu Di Huang, Suan Zao Ren, Yuan Zhi, Wu Wei Zi).

Neurosis: Used effectively for menopausal related neurosis with WDT sings, with the addition of Chai Hu and Huang Qin.mental issues chinese medicine chris eddy

Dizziness: Effective for Menieres dizziness with WDT S/S. Add Ge Gen, Gou Teng, and Ci Shi.

Coronary Artery Disease: Treats coronary artery disease with preventricular contractions and cardiogenic shock. Add Sheng Mai San.

Peptic ulcers, gastritis, and cholecystitis: Add Huang Lian or combine with Xiao Xian Xiong Tang.


4.3 Da Ban Xia Tang 大半夏汤

Ban Xia 6-12,  Ren Shen 6-9,  Feng Mi 9-15

Jing Gui Yao Lue states: ‘For regurgitation and vomiting, DBXT masters it’.vomiting chinese medicine chris eddy

Regurgitation here refers to ‘Wei Fan’ which is a type of vomiting where the patient vomits at dusk what he ate at dawn. The course of this illness has already been rather long or has become chronic. The patient presentation is dispirited and listless, with a thin physique, a withered sallow complexion, poor appetite, occasional abdominal pain, dry stools that are difficult to pass, regurgitation and vomiting of saliva.

  1. Regurgitation, vomiting in the evening of food eaten in the morning, vomitus that mostly contains saliva.
  2. Epigastric focal distention with firmness, dry stools, and a withered appearance.
  3. Pale red tongue, with a greasy coating that may be either thick or thin.constipation chinese medicine chris eddy

The difference between this formula and Xiao Ban Xia Tang is that the signs of phlegm-thin mucus, such as a lack of thirst, vomiting of clear, watery fluids, water sounds in the epigastrium, dizziness, and palpitations, are more obvious in the XBXT decoction. DBXT signs show more fluid deficiency, withered appearance and dry stools.

Examples are : esophageal spasms, esophageal cancer, functional gastrointestinal disorders, and pyloric obstruction, especially in the elderly and those debilitated by chronic diseases.


4.4 Ban Xia Hou Po Tang 半夏厚朴汤

Ban Xia 6-15g, Hou Po 6-9g, Fu Ling 9-15g, Zi Su Ye 6-9g, Sheng Jiang 6-12g

This formula generally treats chest fullness, epigastric firmness, and a sticky throat that relates to “the qi of joy, anger, sadness, thinking, worry, fear, and fright knotting together”.

  1. Feeling of something being caught in the throat or chest stuffiness with a feeling of congestion as a result of some type of emotional factor.
  2. Coughing and wheezing with profuse phlegm and chest stuffiness, or abdominal distention, vomiting and nausea, and poor appetite.
  3. A tongue coating that is usually thick and greasy, or white and greasy, with the mouth having a sticky, greasy sensation.

This formula is often used in cases of neurosis and hysteria with a phlegm pathology.

Used for:

Sensation in the throat with accompanying depression and phlegm in 11 patients: 70% effective.

Vertebral sensitivity + epigastric focal distension: 70% effective in 7 patients


4.5 Ban Xia Bai Zhu Tian Ma Tang 半夏白术天麻汤

Ban Xia 6g, Bai Zhu 9g, Tian Ma 6g, Chen Pi 6, Fu Ling 6g, Gan Cao 3g, Da Zao 12g

Most effective for phlegm invasion headache with dizziness. Ban Xia treats phlegm inversion headaches, Tian Ma treats blurrydizziness chinese medicine chris eddy vision with dizziness or internal stirring of deficiency wind.

  1. Headache, dizziness, with a feeling of pressure in the head
  2. Abdominal distention, borborygmus, loose stools or stool that starts off formed and later becomes loose.
  3. Soft and loose musculature, subjective feeling of water retention, or frequently has edema, or easily sweats.
  4. Red or pale red tongue body, the tongue itself is relatively large, and with a greasy or slightly yellow, greasy coating.

4.6 Ban Xia Xie Xin Tang  半夏泻心汤

Ban Xia 6-15g, Huang Lian 3-6g, Huang Qin 6-9g, Gan Jiang  3-6g, Gan Cao 3-6g, Ren Shen 6-9g, Da Zao 12g

This formula typically treats digestive complaints with focal distension and stifling without pain under the epigastrium, specifically under the xyphoid. As the formula does not contain Chai Hu or Da Huang, as the pattern does not involve liver constraint and does not require purgation, rather it requires harmonisation of hot and cold complex between the spleen yang deficiency and stomach yang ming heat.

  1. Upper abdominal fullness, stuffiness and discomfort, a slight degree of distention and pain, but little resistance when palpated; can be accompanied by digestive tract symptoms of nausea, vomiting, diarrhea or constipation, and borborygmus. Generally, it will be a ‘blocked’ feeling just under the xyphoid.
  2. Irritability and restlessness, a feeling of internal heat in the body, excessive dreaming, or insomnia.
  3. Thin and greasy, or yellow and greasy tongue coating. Often red strawberry tip.
  4. Pulse can have a floating and tight sensation in the right guan position, often both guan’s will be tight. The difference between XCHT and BXXXT formula is only SJ swapped with GJ and HL swapped with CH – but XCHT will have more pronounced floating tight pulse on left guan. The Cun pulses will often be full as the qi and heat is trapped in the upper jiao, Guans often show tightness where the pivot is stuck in the shaoyang/yangming.

This is a beautifully balanced formula and a perfect example of how hot and cold, tonifying and purging medicinals work so well together in complicated presentations. A common mistake is to remove many of the herbs as they seem conflicting.

Huang Lian and Huang Qin are cooling and draining, they help cool the small intestine and Yang Ming heat (large intestine and stomach) while Ren Shen and Gan Jiang warm the spleen yang deficiency, and together they stop bleeding in colitis, calm intestinal inflammation and help gastric juices secrete.

This formula can be used for just about any discomfort in the abdomen where the pattern of focal distension fits with tight guan pulse and greasy tongue coating. I personally love using this formula for IBS, Ulcerative Colitis (UC) and Crohn’s disease with fantastic results. Quite often the huang lian is enough at 6g to stop bleeding seen in UC, however it can be raised to 9g and Bai Tou Weng added to increase the effect.

4.62 Gan Cao Xie Xin Tang

Zhi Gan Cao 9-15g,  Ban Xia 6-15g, Huang Lian 3-6g, Huang Qin 6-9g, Gan Jiang  3-6g, Ren Shen 6-9g, Da Zao 12-30g

When there is ulceration of the membranes of the intestines (ulcerative colitis etc) or Vagina (lichen schlerosis etc). Very useful for patients with a herpes attack or undergoing chemotherapy.


 

 

Ban Xia Type

Ban Xia Type 半夏

Ban Xia Type Chris Eddy Melbourne Acupuncture Clinic

This acrid and spicy tuber grows in early summer in the shadowy damp places on hillsides, beside streams and mullberry plantations. It is toxic in raw form, thus is prepared with Sheng Jiang and Ming Fan. Ban Xia appears in 18 formulas in the Shang Han Lun and around 30 prescriptions in the Jing Gui Yao Lue.

Ban Xia directs counterflow downward, stops vomiting and disperses clumps.

As we always prepare herbs in synergistic pairs and formulas, here are the most common pairings (Dui Yao):

+ Gan Jiang: Nausea and vomiting

+ Fu Ling: Palpitations and insomnia

+ Tiang Ma & Bai Zhu: Headaches and dizziness

+ Huang Lian & Gua Lou: Chest fullness with coughing

+ Huang Lian & Huang Qin: Epigastric focal distention with irritability and restlessness

+ Hou Po, Zi Su Ye & Fu Ling: Sensation of something being stuck in the throat

+ Zhi Shi, Fu Ling, Gan Cao, Zhu Ru & Chen Pi: Panic and being easily startled, nausea and vomiting, dizziness and insomnia

+ Sheng Jiang, Xi Xin & Wu Wei Zi: Coughing with profuse sputum

+ Hou Po, Sheng Jiang & Ren Shen: Reduces abdominal fullness

+ Ren Shen, Feng Mi: Acid regurgitation and epigastric focal distention with firmness.

+ Gua Lou & Xie Bai: Painful chest obstruction or chest pain. 

Ban Xia is a phlegm-transforming herb. It treats all types of phlegm, not only sputum that can be coughed up, but also phlegm retained in the body and formless phlegm in invisible.

Phlegm gets stuck in different places, let’s have a look:

  • Phlegm misting the heart: mental issues, insomnia, irritability.
  • Phlegm in the lungs: cough with lots of sputum that is hard to expectorate.
  • Phlegm obstructing the diaphragm: Nausea, vomiting, ‘something stuck in the throat’
  • Wind-Phlegm harassing upward: dizziness, headache, numbness of the limbs, spasms
  • Phlegm-heat lodged in the heart: chest stuffiness, profuse sputum, palpitations, and nausea.
  • Phlegm stagnating collaterals: hemiplegia and limb numbness
  • Phlegm in the joints: joint swelling, pain and deformity
  • Phlegm nodules: Lumps, swollen lymph nodes that are neither painful nor itchy nor red nor hot.
  • Phlegm obstructing the womb: obesity, infertility, amenorrhea, profuse vaginal discharge
  • Phlegm fire: irritability, restlessness, dry mouth, constipation, and a red tongue.
  • Phlegm-dampness: heavy and tired body, sallow complexion, abdominal distension, watery stools, white greasy tongue coating.

Definitive presentations:

  1. Nausea or occasional nausea, which when severe results in vomiting
  2. Slippery, moist or greasy tongue coating
  3. Sallow or dull, ashen complexion

Body Type:

‘Ban Xia’ people tend to have puffiness, wet tongue coating (can’t be dry), psycho-emotionally sensitive, skin lacks lustre.

To differentiate ‘Ban Xia Type’ with ‘Gan Jiang Type’; Gan Jiang type normally has abdominal fullness, watery stools, an aversion to cold, and a thick, white, greasy tongue coating, whereas Ban Xia type includes nausea and vomiting, accompanied by constipation, and no aversion to cold, the tongue has a white greasy coating, but is not thick.

Chai Hu Formula Types

Chai Hu Formula Types

Xiao Chai Hu Tang Indication Melbourne Acupuncture Clinic Chris Eddy

The majority of information in the following is added verbatim or parenthesized from the book Ten key Formula Families in Chinese Medicine by Dr Huang Huang, translated by Michael Max. Other information is from Sharon Wiezenbaum’s blog White Pine Healing Arts and my own personal experience and 3 months training with Dr Huang in Nanjing.

2.1 Xiao Chai Hu Tang 小柴胡汤

Chai Hu 10-20,   Huang Qin 6-10,   Zhi Ban Xia 6-15,   Ren Shen 5-10,   Gan Cao 10,   Sheng Jiang 10,   Da Zao 12

One of the most commonly used formulas in clinical practice. Very safe, very useful, very low side-effects; when you get the right presentation and apply this formula, the results are drastically positive.

Paragraph 96 of the shang han lun: “for alternating chills and fever, a sense of discomfort and fullness in the chest and ribs, alternating chills fever acupuncturebeing dejected with no desire to eat, irritability of the heart and a tendency to vomit.”

Paragraph 266 of the shang han lun: “when what was originally a tai yang disease is not resolved and shifts into the shao yang, there is firmness and fullness beneath the ribs, dry heaves with an inability to eat, and alternating chills and fever. When neither vomiting nor purging has yet been done and the pulse is sinking and tight, give Xiao Chai Hu Tang.”

  1. Chest and hypochondriac fullness and discomfort, or stiffness and fullness beneath the ribs, or focal distention and fullness in the subcostal region.
  2. Alternating fever and chills
  3. Irritability in the chest with a desire to vomit and lack of desire or inability to eat.
  4. A wiry, thin and wiry, slippery and wiry, or sinking and wiry pulse.
  5. A tongue coating that is yellow, yellow and white mixed together, pale yellow, or yellow and greasy.

We have introduced a few new herbs here (huang qin, zhi ban xia, and ren shen) so let’s have a look at them and see how they work within the XCHT formula.

Huang Qin (GB, LI, LU, ST): Traditionally used as a herb to clear heat. It can treat illnesses with high fever, irritability and thirst, fevers with cough, diarrhoea, jaundice, headache, abdominal pain, turbid urination, red swollen eyes, restless fetus syndrome, and abcesses and furuncles. Modern research shows that it acts as an anti-inflammatory, anti-allergenic, anti-bacterial, antipyretic, diuretic, and anti-hypertensive medicinal.

Huang Qin is often paired with chai hu to treat alternating fever and chills, chest and hypochondriac fullness with focal distention and pain, and vomiting with bitter taste in the mouth. It is seen paired with chai hu in XCHT, Da Chai Hu Tang, Chai Hu Gui Zhi Gan Jiang Tang, Chai Hu Jia Long Gu Mu Li Tang. It is then further paired with Huan Lian in other formulas such as Ban Xia Xie Xin Tang, when there is 1. epigastric focal distention, 2. irritability, 3. fever with diarrhoea.

Huang Qin Indications:

  1. Upper abdominal focal distention and fullness
  2. Or abdominal pain

Zhi Ban Xia (LU, SP, ST): Grows in early summer in the shadowy damp places on hillsides, the sides of streams, and mullberry plantations. It is acrid and spicy. Traditionally used to stop vomiting and transform phlegm. Primarily treats symptoms such as vomiting chinese medicine chris eddynausea, vomiting, coughing with copious amounts of sputum, chest and diaphragm fullness, epigastric focal distention, loss of consciousness due to phlegm, dizziness, headache, and insomnia. Zhang Zhong Jiang often combined Ban Xia with Sheng Jiang to stop vomiting. Where there are intestinal symptoms of nausea with vomiting, epigastric focal distention and bloating with pain, and irritability- Huang Qin + Ban Xis is used.

Ban Xia Indications:

  1. Nausea or occasional nausea, which when severe results in vomiting.
  2. Slippery or greasy tongue coating
  3. Sallow or dull, ashen complexion

Ren Shen (LU, SP): There are three main uses of Ren Shen

  1. As a rescue treatment after there has been sweating, vomiting, or diarrhoea, or for those with a minute pulse due to collapsefatigue melbourne acupuncture clinic chris eddy from loss of blood or dehydration, along with a dry tongue.
  2. Debility and shortness of breath in the aftermath of an illness.
  3. Epigastric focal distention with firmness.
  • Note: this type of ‘epigastric and focal distention’ is distension as a feeling of internal pressure, without bloating.

Uses from experience:

Gu:

Treated 86 patients with high fever: 36 URTI, 20 Bile duct infections, 9 UTI, 3 hepatitis, 2 Encephalitis B, 2 common old, 5 mumps, 3 bacterial dysentery. All had alternating fever/chills, headache, dizziness, coughing, chest stuffiness, bitter taste in the mouth, reduced intake of food, sweating with an aversion to wind. All recovered in 1-30 days.

Shen:

Treated 8 women with post-partum fever (38-39.6 degC). Antibiotics didn’t work. Two packets cured most women, 5 packets was the slowest. If there was joint discomfort, Gui Zhi was added.  ‘Sheng hua Tang’ was also added to this formula = addition of chuan xiong, tao ren, dang gui + yi mu cao.

Modifications:

XCHT + Xiao Xian Xiong Tang (minor sinking into the chest decoction = Gua Lou, Huang Lian, Ban Xia) For coughing with sticky phlegm stuck in the chest with hypochondriac fullness and inflamed digestive tract.

XCHT + Ban Xia Hou Po Tang = Chai Po Tang. Use for bronchitis, asthma, neurosis and sensation of something stuck in the throat.

XCHT + Wu Ling San = Chai Ling Tang = Use for XCHT signs with reduction in urinary output, edema and thirst such as in nephritis, acute gastroenteritis, summer heat, and edema.

XCHT + Ping Wei San = Chai Ping Tang for XCHT presentation with abdominal fullness, and a white, greasy tongue coating.


2.2 Chai Hu Gui Zhi Tang 柴胡桂枝汤

Chai Hu 12,   Gui Zhi 10,   Bai Shao 12,   Huang Qing 10,   Ren Shen 6,   Gan Cao 3,   Zhi Ban Xia 10,   Da Zao 10,   Sheng Jiang 6

Made by combining XCHT and Gui Zhi Tang, was traditionally used for those who had fever with a slight aversion to cold, non-fever chris eddyspecific joint pain, slight vomiting, clumping below the heart, and an unresolved cold/flu.

  1. Fever with aversion to wind, alternating fever and chills, sweating, sore and painful joints.
  2. Chest and hypochondriac pain and discomfort, or abdominal pain, poor appetite, irritability in the chest with a desire to vomit.
  3. The tongue body is dark red or dark and pale, with a thin white or yellow, greasy coating.

This formula’s presentation can be seen either as a Gui Zhi constitution experiencing chest and hypochondriac pain and stuffiness, and vomiting with a bitter taste in the mouth, or as a person with a Chai Hu constitution having spontaneous sweating, nasal congestion, abdominal pain, joints that are achy and painful, and muscle spasms.melbourne acupuncture clinic

The presentation of this formula is often seen in disruption of the autonomic nervous system, nervous exhaustion, neurosis, and premenstrual syndrome. It is effective for treating spontaneous sweating, chest stuffiness, abdominal pain, poor appetite, allergic rhinitis, epilepsy, and depression.

Cases:

Soumi Ichiro used this formula for 43 patients with epilepsy. 125 were cured, 79 had significant reduction, the rest did not finish the study.


2.3 Chai Hu Gui Zhi Gan Jiang Tang 柴胡桂枝干姜汤

Chai Hu 12,   Gui Zhi 12,    Gan Jiang 6,    Huang Qin 10,   Gau Lou (or Tian Hua Fen) 12,   Mu Li 15,   Gan Cao 6fullness in the chest

This formula is used for calming and restoring energy for those with fatigue from overwork. 

Shang Han Lun states: “Cold damage for five or six days that has already been sweated and purged, chest and hypochondriac pain with slight binding, urinary difficulty and thirst without vomiting, sweating only from the head, alternating chills and fever, and irritability in the chest.”

Although this line is difficult to go by, we go from the experience of others before us, specifically Dr Huang Huang:

  1. Chest and hypochondriac pain, or coughing, or sternal pain, especially from the neck up.
  2. Alternating fever and chills, or aversion to wind, night sweats or spontaneous sweating, especially from the neck up.chris eddy thirst
  3. Poor appetite, thirst without drinking much, urinary difficulty, loose stools.
  4. Irritability, pulsation in the chest and abdomen, insomnia or vivid dreaming, tinnitus.diarrhoea
  5. Dry tongue with a thick white coating.

*Because there is sweating Gui Zhi is added, because there is no vomiting, Ban Xia is omitted. Mu Li is added to treat irritability, Gan Jiang treats thick white tongue coating and poor appetite, also loose bowels and normal stool that is sticky at the end.

Conditions: nervous exhaustion, diarrhoea, neurosis, allergic colitis, chronic cholecystitis, dysmenorrhea, and menopausal syndrome.


2.4 Chai Hu Jia Long Gu Mu Li Tang – 柴胡龙骨牡蛎汤

Chai Hu 12,  Huang Qin 5-10,  Ren Shen 5-10,  Ban Xia 6-12,  Sheng Jiang 6,  Da Zao 15,  Gui Zhi 5-10,  Fu Ling 5-12,  Long Gu 10-20,  Mu Li 10-20,  Da Huang 5-10,  Dai Zhe Shi (hematitum) 6-12.

The basic use of this formula is when the Yang Qi can’t descend from the upper jiao when the ‘Shao Yang’ pivot is blocked.

Chronic illness, advanced age, long-term psychological stress, and external injury all can lead to patients with Chai Hu constitution losing their psycho-emotional and neurological equilibrium.

Shang Han Lun, paragraph 107: “Cold damage for 8-9 days, which is purged. If there is fullness in the chest, irritability and nervous melbourne acupuncture clinicfright, urinary dysfunction, incoherent speech, and the body feels completely and thoroughly heavy with an inability to turn to either side, CHJLGMLT masters it.

Again, a fairly specific yet difficult to follow passage from the SHL. The first few symptoms are commonly seen, however this formula has many many uses, so lets not get too hung up on the literal translations of the SHL for now.

This formula has been used for thousands of years for psychological and neurological illnesses, especially insomnia, nocturnal emission, nervousness, and anxiety.

  1. Chai Hu Presentation
  2. Psycho-emotional and nervous system symptoms, especially for those with strong pulsations around the navel, who are easily startled, or have incoherent speech.
  3. Tongue: Red tongue with a thick, greasy yellow coating.
  4. Pulse: Because the ‘Shao Yang’ is blocked, there upper ‘Cun’ pulses will be fuller. The cun pulses will most likely be floating and moderate, the left ‘Guan’ will likely be Wiry and Big, the right ‘Guan’ will likely be Wiry. The Yang is basically all in the upper jiao and not descending properly. In some cases there will be a very weak or ‘blocked’ left Cun pulse where the heart is not functioning well and will be ‘scattered’ however you will most likely feel an even more ‘forceful’ left guan as the liver portal system becomes ‘backed up’.

Chai hu: stuffiness in the chestchai hu jia long gu mu li tang melbourne acupuncture clinic

Huang Qin: hypochondriac fullness, inflammation, diarrhoea, bitter taste, heat signs

Ren Shen: exhaustion from long standing illness, epigastric focal fullness, shortness of breath, dehydration

 

Ban Xia: Greasy tongue coating, epigastric fullness, nausea, phlegm

Gui Zhi: heart palpitations, sore joints

Fu Ling: Often combined with Gui Zhi where there is a swollen wet tongue and chest stuffiness

Long Gu and Mu Li: Strong pulsations around the area of the navel, suppresses and settles ascending yang qi.

Used for insomnia, mental problems, ‘easily startled’, hyperthyroidism, schizophrenia, senile dementia, etc.


2.5 Si Ni San 四逆散

Chai Hu 6-12, Bai Shao 6-30, Zhi Shi 6-10, Gan Cao 3-10

Here Chai Hu treats chest and abdominal stuffiness, Bai Sao + Gan Cao = ‘shao yao gan cao tang’, which is indicated to relievecold hands and feet melbourne acupuncture clinic spasms and stop pain. Zhi Shi primarily treats chest and abdominal fullness and distension, constipation and prolapse of the stomach and uterus.

Jing Gui Yao Lue says: ‘Zhi Shi and Bai Shao are used specifically to treat “postpartum abdominal pain, irritability, and fullness in the chest such that the patient is unable to lie down.”

These four herbs together primarily target chest, rib and abdominal pain.

Shang Han Lun says, Paragraph 318: Shao Yin disease, disease with cold extremities – the person may have cough or palpitations or urinary dysfunction or pain in the abdomen or draining diarrhea with period pain wen jing tang melbourne acupuncture clinicdown-bearing; Si Ni San masters it.’

‘Four Reversals’ means that the extremities of the four limbs are cold. In this case the coldness is not caused by yang qi insufficiency, but the yang qi becoming knotted and constrained in the interior, thus being unable to disperse outward. Thus, cold extremities are often accompanied by heat, especially in the trunk.

Cold hands and feet can be treated as yang qi deficiency, with Gui Zhi Jia Fu Zi Tang or Si Ni Tang, or arise from heat constraint, and can be treated with Bai Hu Tang or Da Cheng Qi Tang. However, this is not the case with Si Ni San. The followingsensitivity to pain neck pain chris eddy presentations will be observable:

  1. Chai Hu presentation with a sensitivity to pain, hands that are often cold, and a tendency to have anxiety and muscle spasms.
  2. Chest and hypochondriac fullness and discomfort with pain, and distending abdominal pain.
  3. A wiry pulse and a stiff, dark tongue, or a tongue with purple spots.

Common uses: cholecystitis, cholelithiasis, biliary ascariasis, hepatitis, gastritis, peptic ulcers, gastric hypertrophy, gastric neurosis, prolapse of the stomach, recalcitrant stomach pain, allergic colitis, diarrhoea, dysentery, hiccup, appendicitis and appendicular abcess, intestinal obstruction, intestinal adhesions, pancreatitis, cough, coronary heart disease, as well as cold extremities following fever.


2.6 Xue Fu Zhu Yu Tang –  血府逐瘀汤

Chai Hu 5-12,  Bai Shao 6-20,  Zhi Shi 6-10,  Gan Cao 3-6,  Tao Ren 6-12,  Hong Hua 5-10, Dang Gui 6-12,  Chuan Xiong 5-10,  Sheng Di Huang 12,  Jie Geng 6,  Niu Xi 12

This formula is a combination of Si Ni San and Tao Hong Si Wu Tang. Chinese medicine regards blood stasis as both the period pain wen jing tang melbourne acupuncture clinicproduct of, as well as the cause of, illness. Infections, fever, bleeding, getting chilled, long-term psycho-emotional upset (especially depression), trauma, and chronic illness can all lead to dis-harmonies of the qi and blood, resulting in the formation of blood stasis.

The distinguishing factors are:

  1. Pain that is usually in a fixed location
  2. When bleeding occurs, the blood readily congeals and is purple or black in color.
  3. Irritability and restlessness, with an unsettled spirit, and mania in extreme cases.
  4. The tongue is purple and dark, along with a dark complexion.Sticky blood chris eddy

The XFZYT presentation is often seen in recalcitrant cases such as insomnia, headaches, abdominal pain, or fever.

Many famous practitioners will default to this formula when everything has been attempted and the results are poor.


2.7 Xiao Yao San 逍遥散

Chai Hu 6-12,  Bai Shao 6-15,  Bai Zhu 6-12,  Fu Ling 10-15,  Dang Gui 6-12,  Sheng Jiang 6, Bo He 6

When we take Si Ni San and remove Zhi Shi, then add Dang Gui, Bai Zhu, Fu Ling, and Bo He, we have Xiao Yao San.angry woman melbourne acupuncture clinic

Dang Gui is used primarily to regulate the menses and tonify blood. Add Bai Shao, Bai Zhu and Fu Ling and you make up Dang Gui Shao Yao San, originally prescribed to treat abdominal pain during pregnancy as it tonifies and augments blood. Now it is used more extensively to treat anemia, abdominal pain, back pain, achy lower back, edema and urinary difficulty.

Indications:

  1. Chest and hypochondriac fullness and discomfort or pain, abdominal pain and distention, dysmenorrhea, premenstrual breast distention or headache.
  2. A feeling of alternating fever and chills, or irregular periods.
  3. Poor appetite and edema.
  4. Pale red tongue with a thin, white coating.

In practice this formula is often used for women who have a low libido or disinterest in sex, painful intercourse, keep their feelings inside, sulk in anger and are nervous.

2.8 Da Chai Hu Tang 大柴胡湯

Chai Hu 10-15,  Huang Qin 6-10,  Bai Shao 6-20,  Ban Xia 6-10,  Sheng Jiang 3-6,  Zhi Shi 6-10, Da Zao 10-20,  Da Huang 5-10

As this formula contains Da Huang, it has a purging action, which also functions as an anti-pyretic, relaxes muscles, is anti-allergenic, and reduces blood pressure and blood lipid levels.

Shang Han Lun Paragraph 103: “For those who have Chai Hu presentation, first use Xiao Chai Hu Tang, if however there is

DCHT melbourne acupuncture clinic

incessant vomiting, a gripping pain and tenderness in the upper epigastrium, and a sense of constraint and slight irritability, the illness has not yet been resolved. Giving DCHT will purge it to bring a cure.

SHL Paragraph 165: “For cold damage with feverishness and sweating without resolution of the condition with focal distension and hardness in the chest, vomiting, and diarrhea, DCHT masters it.”

SHL paragraph 136: ” “For those with cold damage for more than 10 days, when heat has clumped in the interior and there are repeated bouts of alternating chills and fever, give DCHT.”

This ‘Heat Clumping’ means that there is interior heat which has lead to constipation, abdominal distention, abdominal pain, and heat clumping with circumference (green, watery and foul-smelling diarrhoea).

Presentation:

  1. Fever, or alternating fever and chills.
  2. Chest and hypochondriac fullness and discomfort with upper abdominal pain from contracted muscles, and other localised muscle tightness.
  3. Constipation with yellow urine or watery, smelly diarrhoea or vomiting, jaundice or headache.
  4. A dry tongue with white or yellow coating and a slippery, rapid pulse.

This formula is commonly used to treat cholelithiasis, cholecystitis, and pancreatitis.This formula is generally used in those with strong constitutions and physiques, and those with severe chest and hypochondriac fullness and discomfort along with constipation.

2.9 Tong Jing Tang 

Extracted from Sharon Weizenbaums Blog : White Pine Healing Arts.

Painful Menstruation

Dysmenorrhea is a very common presentation in our clinical reality, either as a main complaint or as a symptom women have become resigned to.  Many practitioners have the experience of women telling us that there menstruation is normal.  When we question more deeply we hear that they experience significant pain, managed by medication.  Dysmenorrhea is considered to be a normal part of being a woman by many.

For some women, the pain is so extreme that they KNOW it is not normal. It is often accompanied by other symptoms such as vomiting, fainting, migraines, exhaustion, and digestive upset.  Dysmenorrhea can be very debilitating.  In addition, many of our patients who suffer from dysmenorrhea are unable to become pregnant. 

As a teacher of Chinese herbal medicine, I am aware that our foundational educations often leave practitioners with very limited tools for treating this illness.  All we really learn is that dysmenorrhea is blood stasis and to treat blood stasis we give formulas like Tao Hong Si Wu Tang or Xue Fu Zhu Yu Tang.  These types of formulas will have very limited if any effectiveness.  So, I thought I would do a series of blogs posts on dysmenorrhea.

Some of this information is taken from the writings of Dr. Xia Gui-Sheng, some from one of my teachers Dr. Qui Xiao-Mei, some ideas regarding the use of classic formulas and some ideas from my own experience.  You can see other writings of the two above mentioned doctors by looking at the categories to the right.

I am starting this series with a wonderful passage from the writings of Dr. Xia Gui-Sheng from his book Gynecology Formulas and Herbs: My Clinical Experience in 15 Chapters.

The passage below is one of my favorites because it shows us that Dr. Xia had to go through his own experience of feeling limited by what he had learned.  He thought about his experience deeply and, over time, integrated what were the essential ideas.

Dr. Xia, when exploring the treatment of dysmenorrhea, realizes the importance of the following:

  1. Regulating the Qi and freeing flow
  2. Stopping pain
  3. Warming
  4. Going to the right location – the uterine vessels
  5. Suffering is related to the Heart

“When treating dysmenorrhea, pain is the principle symptom. In the course of exploring the treatment of dysmenorrhea, I’ve looked into formulas such as Xue Fu Zhu Yu Tang, Ge Xia Zhu Yu Tang, Shao Fu Zhu Yu Tang and Hu Po San. In the beginning, I followed the idea that “when there is free flow, there will be no pain and that pain is due to lack of free flow.  I first used Xue Fu Zhu Yu Tang, which is Tao Ren and Hong Hua with Si Wu Tang, Chai Hu, and Jie Geng to up-bear and Niu Xi and Zhi Qiao to down-bear and I observed some effect but it was far from ideal.

I continued to consider dysmenorrhea, realizing that I must stop pain. Therefore, on a foundation of vitalizing the blood, transforming stasis, opening through the menstrual blood, I also added stop pain herbs such as Wu Ling Zhi and Yan Hu Suo. To integrate this idea, I used Ge Xia Zhu Yu Tang. This formula is also a commonly used gynecology formula but it still did not have an ideal effect.

I continued to consider this. There is the principle that when the blood is warm it will move.  When there is dysmenorrhea, there is a relationship with blood stasis. For this it is appropriate to warm the Yang and vitalize the blood and this is not really because there is cold there. Generally blood stasis does not manifest with Heart and Liver fire flourishing. The transformation of stasis and the opening through of the collaterals must be assisted with herbs to warm the Yang. I add Rou Gui and Ai Ye for this. This is integrating the ideas of Shao Fu Zhu Yu Tang.

For the Yang heat to transport the warmth to the uterine blood vessels I also add Du Zhong and Chuan Duan to supplement the Kidney and benefit the Yang. This not only addresses the idea of warming to move the blood. It also addresses the idea of treating the root. In practice this sure enough brings results.

However, for really stubborn serious dysmenorrhea, this is also not ideal for controlling the pain. One must reconsider the location of the pain. In this case the pain is in the Heart and Liver. The Heart and Liver not only control the movement in the blood vessels, they also are the seat of the experience of pain.  Because of this, one must also use the method to calm and settle the Heart and spirit while emolliating and harmonizing the Liver.  Adding Hu Po San to the formula that is vitalizing blood, opening the collaterals, stopping pain and warming the Yang completes the effect.

This becomes my experiential formula Tong Jing Tang”.

Tong Jing Tang

Gou Teng 15
Dan Pi 10
Dan Shen 10
Chi Shao 10
Wu Ling Zhi 10
Rou Gui 5 (post)
Guan Mu Xiang 6-9
Yi Mu Cao 15
Yan Hu Suo 12-15
Du Zhong 10
Chuan Xu Duan 10

Application Method

During menstruation take one package each day decocted in water.

Function

Vitalize blood and transform stasis, warm the menses and stop pain.

Applications

This formula is principally used for primary dysmenorrhea, which is called functional dysmenorrhea.

Formula Constituents

This formula contains Gou Teng and Dan Pi which both clear the Heart and Liver, calming the Spirit and Hun. Pain has a relationship with the Heart and Liver Spirit and Hun. Only when the spirit is calmed and sedate can pain be controlled. This is the premise behind stopping pain. Based on the idea “when there is free flow there is no pain” I use Chi Shao, Wu Ling Zhi and Yi Mu Cao to vitalize blood, transform stasis, regulate menstruation and stop pain.  Rou Gui, Chuan Duan and Du Zhong supplement the Kidney, warm the uterus, warm the Yang and vitalize the blood. These herbs not only assist in vitalizing the blood, transforming stasis, and promoting the easy flow of Qi and blood, there is a deeper layer of meaning as well. When the Yang Qi is warm and glowing the stasis in the womb is dissolved and the congealed stasis in the womb can be dispelled. Yan Hu Suo and Wu Ling Zhi not only transform stasis and regulate the menstruation, they are also herbs that stop pain. Fu Ling calms the spirit and disinhibits dampness. It assists in discharging turbidity and transforming dampness.  Altogether, these herbs are effective in treating dysmenorrhea.

Case Example

Functional dysmenorrhea is most often seen in unmarried women but can be seen in married women as well.  I treated a 30-year-old woman named Qian who suffered from dysmenorrhea for 10 years. She had been married for 2 years without becoming pregnant. On the first or second day of her menstruation she had extreme pain. The amount of menstruate was average but the blood had clots in it. Premenstrually she experienced chest oppression, agitation, breast distention, back soreness and fear of cold. Her tongue was pale red and her pulse was wiry and thin. Although her BBT showed that she was biphasic, the luteal phase was unstable. There was an irregular wave and in general, the temperature was low. This illness was not only dysmenorrhea. It was also causing infertility. Because of this, I needed to work in two key phases. During menstruation I gave her Tong Jing Tang and during ovulation I gave her Bu Shen Cu Pai Luan Tang. I treated her for 3 menstrual cycles and after this her dysmenorrhea was relieved. I continued on for another 3 months and she became pregnant”.

Chai Hu Type

Chai Hu Type  柴胡

chai hu type chris eddy melbourne acupuncture clinic

Chai hu is the go-to herb for alternating chills and fever, especially accompanied by chest stuffiness, a wiry pulse, purple tongue and irritability.

The Ben Cao Zheng Yi (Rectification of the Meaning of Materia Medica) states that Chai Hu is an exterior-resolving medicinal; Ben Jing Feng Yuan (Encountering the Sources of the Classic of Materia Medica) says that it is a foot Shao Yang Gallbladder herb; Yi Xue Qi Yuan (Origins of medicine) says that it is the herb that enters the Shao Yang Jue Yin channels; and Beng Cao Jing Bai Zhong Lu (One Hundred Records of the Classics of Materia Medica, says that it is an herb for the stomach and intestines.

Given the diversity of Chai Hu, we must pay close attention to the major presentations illustrated above.

Chest and Hypochondriac Fullness

This is a ‘must-see’ sign for the ‘Chai Hu’ presentation. It is a feeling in the chest and hypochondria of distension and pain, distention and fullness, firm fullness, or tenderness when palpated; for women, swollen and painful breasts or nodules in the breasts; or what in modern medicine is referred to as biliary colic and intercostal neuralgia.

Alternating Chills and Fever

In addition to changes in measurable body temperature, this also includes a subjective sense of alternating cold and heat on the part of the patient where at times they have a real aversion to wind and feel cold, while at other times they feel hot and irritable. Also, the upper part of the body could be feverish, while there is an aversion to cold in the lower body. Or it might be that one side of the body is hot and the other part cold. Likewise (as in Si Ni San indication) there is a hot chest with cold hands. In all, the patient will be very sensitive to temperature changes.

Chai Hu Zone

What we refer to as the ‘Chai Hu Zone’ here is majorly where we see the areas traversed by the Shao Yang channel and the Liver channel. When these areas manifest with distending pain, feel achy, have unusual sensations, or lumps, one can usually consider the possibility of a Chai Hu presentation, or any of the various Chai Hu formulas. 

Chai Hu Person

The overall impression of the patient is generally medium to slightly thin physique with a complexion that is dark yellow, greenish yellow, or greenish pale, and lacking lustre (an external manifestation of qi and blood stagnation). The skin tends to be relatively dry, and the muscle tone is firm. The tongue characteristically looks tough and firm, dark and with purple spots; the tongue body is neither pale nor flabby; and the coating is either normal or a little dry, the pulse is generally wiry or thin.

Acupuncture combined with lifestyle, herbal medicine and diet changes can offer treatment for various conditions including Cystitis/UTI, Restless Leg Syndrome, Trigeminal Neuralgia, Male Infertility,  Prostadynia, asthma, acne, hay fever, sinusitis, weight loss, pelvic pain, rectal pain, female infertility, morning sickness, period pain, general pain and many more.

Chris Eddy is a registered doctor of Chinese medicine and university lecturer. He has been treating for the last 13 years in his city practice in Melbourne, Australia.

Acupuncture Melbourne CBD

Gui Zhi Tang Presentation

Gui Zhi Tang presentation 桂枝汤

Gui Zhi Tang Type Melbourne Acupuncture Clinic Chris Eddy

A brief note on the following. Much of this information has been taken from ’10 formula families’ by Dr Huang Huang. However, the style of Dr Huang, as is Feng Shi Lun and Hu Xi Xu is very much Pattern = Formula. There is not much mention of Pulses and physiology. Through my graduate mentorship with Sharon Weizenbaum, I would like to introduce further extrapolations on a deeper connection of the formula and pattern with physiology.

Gui Zhi 10g,  Bai Shao 10g,  Gan Cao 6g,  Sheng Jiang 6g,  Da Zao 12g

Traditionally taken with congee (rice porridge), not everyone has the time or convenience to do this. The main idea is to take the strain off the digestive system by not taxing it with hard to digest foods that are greasy or “icy.”

This formula was mentioned in the Shang Han Lun; however, this formula was thought to be previously developed by the master chef Yi Yin in the Shang Dynasty, over 2,500 years ago.

This formula contains the major signs and symptoms of the “Gui Zhi” family: spontaneous/easy sweating, palpitations in the heart or lower abdomen, aversion to wind with:

  1. Convulsions or tight/stiff muscles
  2. Weakened/overactive nervous system
  3. A pulse that is floating, deficient, lax, rapid, or large without force
  4. A tongue body that is pale, with a thin, white coat.

In a wind-cold situation, the wind has come in, and the door is not closed properly (pores are open—too weak), so the sweat comes out easily. This is considered an “exterior deficiency.”

In a pharmaceutical sense, Gui Zhi Tang is antipyretic, anti-inflammatory, anti-allergic, analgesic, sedative, and gastric.

Cold and flu:

Shang Han Lun Paragraph 13:

“For Tai Yang illness with headache, fever, sweating, and an aversion to wind, Gui Zhi Tang masters it.”

If we look at Gui Zhi Tang, we see it is made up of two mini-formulas: “Gui Zhi Gan Cao Tang” (Gui Zhi + Gan Cao) and “Shao Yao Gan Cao Tang” (Bai Shao + Gan Cao). GZGT for heart palpitations and SYGCT for cramps.

SHL Clause 64:   “When copious sweating has been promoted and the person’s hands are crossed over the heart and there are palpitations below the heart with a desire for pressure, Cinnamon Twig and Licorice Decoction (guì zhī gān cǎo tāng) governs.”

Caveat! Remember that excessive sweating comes from exercise, saunas and Bikram Yoga as well as herbal medicine!

                                                                                                                                                    gui zhi type chris eddy You Zai-Jing 尤在经 says:

Sweat is the fluid of the heart.  When there is excessive sweating promoted, the heart Yang is emitted as it follows the discharge of fluid.  This causes deficiency of the heart Yang.  When the heart Zang looses the protective guard of the Yang Qi it is then void of any governance.  This is why there are heart palpitations with no rest.  Deficiency likes pressure and there for the patient will cross their hands over their chest area.  This is an attempt to give a bit of peace.  In addition to there being heart palpitations that like pressure, clinically you will also see chest oppression, shortness of breath and a general lack of strength.

Xu Ling-Tai 徐灵胎 says:

When there is mistaken sweating and the patient sweats excessively, since the sweat is the fluid of the heart, this will cause Qi deficiency.  These two flavors restore the Yang and supplement the middle.  This alleviates the Yang deficiency.  If there is an extreme case in which there is shaking and a desire to pound, use True Warrior Decoction (zhēn wǔ tāng).  The light and heavy patterns are not the same and the formulas are very different from each other.  This is the essential meaning.   (伤寒论类方·太阳篇) Courtesy of White Pine Healing Arts Blog

Treatment method: Warm and open through the heart Yang.

Gui Zhi Tang is used to treat conditions such as: cold/flu, fever (40°C), abnormal sweating, autonomic dystonia, myocarditis, high blood pressure, palpitations, tachycardia, Takayasu’s arteritis, insomnia, vivid dreaming, eczema, erythema, urticaria, itching, chilblains, psoriasis, allergies and hay fever.

Variations of Gui Zhi Formula based on GZT

1.2 Gui Zhi Jia Fu Zi Tang

Gui Zhi 10, Bai Shao 10, Sheng Jiang 6, Gan Cao 6, Da Zao 12, Zhi Fu Zi 10.

GZT + Zhi Fu Zi 10g – Exterior deficiency cold pattern with internal cold/Yang deficiency

You will find typical GZT patterns with cramping limbs and joint pain, cold abdomen, cold hands and feet, aversion to cold,mac copious amounts of clear urine.

Although Zhi Fu Zi is currently a scheduled herb in Australia, we mention it here for use in countries allowed to use it.

  • Note, prepared Fu Zi (Zhi Fu Zi) used. First boil for one hour before other ingredients.

Paragraph 20 of the Shang Han Lun states: When a sweating treatment is given to someone with TaiYang disease, but the sweat leaks out continuously and the person has an aversion to wind, urinary difficulty, and a slight tension in the limbs where it is difficult to flex – Gui Zhi Jia Fu Zi Tang masters it.

Zhi Fu Zi is used to improve cardiovascular function, increase blood pressure, regulate microcirculation, strengthen thmelbourne acupuncture clinice heart, regulate body temperature, gastro-intestinal function and used as an analgesic for pain.

GZJFZT Signs

  1. GZT S/S with cold hands, clammy skin, excessive sweating, weak, floating and large pulse, and a pale tongue body
  2. Severe joint pain and cramping in the limbs
  3. Cold bulging disorders (hernia), abdominal pain, body aches, and cold hands and feet.

Clinical Uses:

Often used with elderly with weak constitutions, cold, body aches, sneezing, joint inflammation, fatigue.

——————————————————————————————————————–

1.3 Xiao Jian Zhong Tang
Gui Zi 6, Bai Shao 15 – 30 (depending on level of abdominal pain), Zhi Gan Cao 6, Sheng Jiang 6, Da Zao 12, Yi Tang 30 = GZT + Yi Tang (maltose/molasses) 30g, Bai Shao increase to 15g, change Gan Cao to Zhi Gan Cao 6g (BS+ZGC = Shao Yao Gan Cao Tang).

  1. Chronic abdominal pain with palpitations, feverishness, irritability, weakness and spasmodic constipation (poo the sizemelbourne acupuncture clinicof dry chestnuts).
  2. Tender tongue body with sparse coating (soft

    and shiny = interior deficiency)

Paragraph 100 of SHL states that: When there is an urgency of pain in the abdomen, first use XJZT. 

Jing Gui Yao Lue States: For deficiency due to overwork, chronic intermittent abdominal pai, palpitations, nosebleeds, abdominal pain, dreaming with seminal emission, achy libs, hot hands and feet, dry mouth and throat, XJZT masters it.

Often used in Japan for introverted and nervous school children who get bed wetting, night sweats and stomach pains in the morning.

Modifications of XZJT

1.31 XJZT + Huang Qi XJZT s/s plus low immune system with a lot of sweating

1.32 XJZT + Dang Gui Post-partum cramps

——————————————————————————————————————————–

1.4 Gui Zhi Jia Da Huang Tang
Gui Zi 10, Bai Shao 20, Gan Cao 6, Da Zao 12, Sheng Jiang 6, Da Huang 6

Interior excess = ‘interior gate is closed’, withxiao jian zhong tang melbourne acupuncture clinic

exterior deficiency ‘exterior gate open’ (sweating). Da Huang has been called the ‘fierce general that cuts through barriers to force his way in.

GZT presentation plus constipation and abdominal pain. Dislike of abdominal pressure.

  1. Fever or subjective feeling of heat, aversion to wind, spontaneous sweating.
  2. Constipation, persistent abdominal pain, aversion to pressure on the abdomen, and a thick, dry thick tongue coating.

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1.5 Gui Zhi Jia Long Gu Mu Li Tang
Gui Zhi 10, Bai Shao 10, Da Zao 12, Gan Cao 6, Sheng Jiang, Long Gu 20, Mu Li 20

Primarily used with ‘upward gushing’ palpitations and insomnia, nightmares, sweating and night sweats, especially young pale

gui zhi jia long gu mu li tang melbourne acupuncture clinic

children. Tight lower abdomen, dizziness, hair loss, bed wetting. Mu Li is targeted more towards the abdomen. Pulse: must be floating, full and lacking force- definitely not deep and forceful. Tongue: red and tender.

The type of ‘upward gushing’ is quite noticeable in this formula type; there is a sense of panic, being jumpy and hard to calm down, light sleep or insomnia or many nightmares with night sweats.

This is also specifically applicable to men who have persistent seminal emission and cold tip of the penis, dizziness and hair loss and throbbing below the navel.gui zhi jia long gu mu li tang melbourne acupuncture clinic

  1. Chest and abdominal pulsation or throbbing, jumpiness, spontaneous sweating or night sweats, insomnia with excessive dreaming.
  2. A large, floating, and force-less pulse, and a tender and red tongue body with a sparse coating.

The key to using this formula is in the pulse and tongue. The pulse must be floating, full, and lacking force. If it is deep and thin, deep and excessive, or large and forceful, it is without exception not the pulse for this formula.

———————————————————————————————————–

1.6 Dang Gui Si Ni Tang
Gui Zi 10, Bai Shao 15, Gan Cao 10, Da Zao 20, Dang Gui 10, Xi Xin 6, Tong Cao 6

Cold, painful extremities and headache. Frost bite fingers. Pulse: thin Tongue: pale. Pain that is worse on exposure to cold or menses.

Dang Gui: Sedates pain, tonifies blood, reduce pain, strengthen constitution, moisten intestines.

Xi Xin: Scatters cold and stops pain. Treats cough with ascendant qi, headache, cramping spasms of the joints, wind-damp, itcold hands and feet dang gui si ni tang chris eddy also 1. Promotes sweating and scatters cold: treats cold damage with a lack of sweating, fever, and a sunken pulse. 2. Stop pain: treats headaches from external wind-cold invasion, with body aches and toothache. 3. Warm the lungs and dispel phlegm: treats wind-cold type coughing and wheezing with copious phlegm.

Tong Cao: (literal English translation is ‘unblocking herb’) Unblocks and uncloggs, gently moves blood.

The type of pain this formula treats is from ‘cold deficiency’. It often appears where there is nerve or blood vessel pathology or reduced circulation of blood.

SHL Paragraph 351: For those with cold hands and feet that have extreme cold and a pulse that is so thin that it is on the point of exhaustion, DGSNT masters it.

  1. Hands and feet are extremely cold, numb, and painful, even to the point of turning blue.
  2. Thin pulse (from blood vessel contraction, not heart deficiency)
  3. Abdominal pain, headache, or back, foot, or leg pain
  4. Pale tongue with a white coating

Common conditions: Raynaud’s, sciatica, tooth pain, dysmenorrhea, frostbite and headaches when worsened by cold.

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1.7 Wen Jing Tang
Gui Zhi 10, Bai Shao 10 Gan Cao 6, Sheng Jiang 6, Dang Gui 10, Ren Shen 10, E Jiao 10, Mu Dan Pi 10, Wu Zhu Yu 3, Chuan Xiong 6, Ban Xia 6-12, Mai Dong 10-24.

Here we introduce Chuan Xiong, combined with Dang Gui and Bai Shao which regulates the menses.

However, before we go straight into listing all the things that WJT does for women alone, I want to state that formulas are not discriminatory and WJT is also great for men if the picture matches the patient.

So what are we looking for?

  1. The key is dryness of mucous membranes – especially dry mouth and skin.
  2. Then you are looking at blood stasis – clotted blood stasis wen jing tang melbourne acupuncture clinicperiods in women and dark veins on the ankles in men.
  3. Also, ‘knotted pulse’ which will feel like the ‘rhythm’ of the pulse is not in a constant beat ( dum, DUM, duuum, dum, dumm), with high/low amplitude, but not skipped beats like ZCGT (Dum, Dum, Dum …, Dum, …., …, …, Dum, Dum). 
  4. Then we can feel the abdomen and it is often cold, sometimes cold legs and warm head, or hot hands/feet at times, other times cold hands/feet.
  5. The body stature will generally look skinny and dry, think Twiggy and David Bowie rather than Steven Fry or Nigella Lawson – less voluptuousness.
  6. The buttocks will also often feel cold.
  7. The tongue is often blue/purplish and the face lacks luminescence, brightness and is a little dusky.
  8. Hot and Dry symptoms: Burning palms, flushed cheeks, hot flashes, itching, poor healing of sores, digestive disorders, depression, insomnia.
  • If there is fullness in the epigastrium and the right guan pulse (indicating yang ming excess) and red tongue tip, you can add Huang Lian.
  • If there is no fullness in the epigastrium and the the right guan is even fuller and stronger with irritability, a red tipped tongue; add Shi Gao
  • If there is pre-menstrual water amassment and fluid retention, you can integrate Dang Gui Shao Yao San, by adding to the formula: Bai Zhu, Fu Ling and Ze Xie.
  • This is not a ‘Yin Deficiency’ heat formula. The heat is caused by blood stasis leading to dry heat. This pattern is for deficient cold in the chong and ren, leading to blood stasis.

Wen Jing Tang is primarily a moistening formula, secondarily a warming formula. It is used in the clinic primarily for irregular menses or amenorrhea, especially with or a history of dark blood clots. As a beauty formula for women- as this treats dryness of the skin it has the ability to moisten the skin, plump up the breasts and moisten vaginal dryness. The warming nature of the formula treats the dryness of winter, the cold freezes the water reserves and our skin becomes dry and hair brittle. It is also used as a fertility formula to increase ovarian function and boost a low basal body temperature.

Gan Jiang or Sheng Jiang? Gan Jiang is better to warm the interior and stop diarrhea, Sheng Jiang is more warming plus diuretic.

What about large fleshy women that don’t appear to be a typical thin gui zhi type pattern? One example case example from Sharon Wizenbaum in The Lantern– Patient with dry symptoms of dry lips, feet and vagina, and cracked fingertips. Dr Huang assured that the key sign of dry finger tips and lips were key signs.

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1.8 Zhi Gan Cao Tang
Gui Zhi 10, Zhi Gan Cao 10, Sheng Jiang 6, Da Zao 15, Ren Shen 6, Sheng Di 12, Mai Dong 10, Huo Ma Ren 10, E Jiao 10.

Fatigue, dizziness, insomnia, constipation. Cold damage with an irregular pulse and palpitations. Exhaustion from overwork, gui zhi type chris eddysweating with a stuffy chest. Pulse: slow with dropped beats. Tongue: No coating.

Shang Han Lun Paragraph 177: For cold damage with an irregular pulse and Heart-disturbing palpitations, ZGCT masters it.

This formula is often considered for Gui Zhi constitution patients with cardiovascular disease, mainly arrhythmia with and irregular pulse with dropped beats.

This is an important ‘Yin Tonic’ and is the basis of many yin tonic formulas. Simply stated, yin deficiency means an insufficiency of the substances that have form; yang deficiency is a diminishment of the formless functional capacity. The bones and flesh of the physical body are considered to be formed and substantial.  Thus, when therefatigue melbourne acupuncture clinic chris eddy is yin deficiency, these become emaciated, withered, shriveled, and smaller. Yang deficiency is when there is diminishement, weakness, and inhibition of the body’s physiological functions. 

Specific Signs:

1. A pulse that is deficient, without force, and irregular

2. Emaciation with a drawn and wan complexion, a sparse or nonexistent tongue coating.

3. Fatigue, obvious palpitations with a feeling of throbbing in the chest and/or abdomen, deficiency irritability, dizziness, excessive dreaming or insomnia, and constipation.


1.9 Ling Gui Zhu Gan Tang

Gui Zhi 10-15, Fu Ling 15-30g, Bai Zhu 10-30g, Gan Cao 3

dizziness melbourne acupuncture clinic

Main signs are dizziness, palpitations, sloshing sounds in the stomach, coldness in the middle of the back, a cough with copious thin, clear sputum, fullness and discomfort in the chest and costal regions, urinary difficulty, and a swollen tongue with a slippery coating, often with teeth marks.

Manifesting symptoms:

Head: ‘Puffy face’, facial water spots, ENT, Face disorders, clogged up ears, puffy under the eyes (yes it’s a water sign, not necessarily kidney deficiency).

Heart: Palpitations, oppressed sensation in the chest, shortness of breath

Lung: Cough and wheeze.

Constipation: This is a really interesting one. Not always do we see edema and poor urination (earth is swamped by water and needs draining and percolating – fu ling/bai zhu) in this pattern Sometimes there is frequent urination (earth can’t hold water thus leaks and needs strengthening – bai zhu). In this case many doctors such as Feng Shi Lun, Mazin Al Khafaji, will use high doses of Bai Zhu (30g) to treat spleen deficiency constipation. Bring the water in the earth where it needs to be.

Here we add Fu Ling, which is traditionally used to treat dizziness and palpitations.

  1. Epigastric pulsation, an upward-rushing feeling in the chest, or dizziness.
  2. Abdomen that is soft and weak, while there is fullness in the chest and costal regions, and a gurgling or sloshing sounds water in stomachin the stomach.
  3. Urinary difficulty (inhibited urination – heart fire is unable to descend to hibernate in the kidneys) and a tendency toward edema or urinary frequency.
  4. Fat tongue, usually pale
  5. Often thirst with no desire to drink. ‘When the water qi does not transform, the fluids do not spread so there is thirst’ (there is no steaming up) however there is no desire to drink as there is ample fluids, just not in the right place.

SHL Paragraph 67: For cold-damage after either inducing vomiting or purging with a feeling of rebellion and fullness below the heart, the qi ascends to gush into the chest, so there is dizziness after getting up, and the pulse is sinking and tight. Inducing sweating disrupts the channels, so there is trembling and shaking of the body. LGZGT masters it.

Dr Liu used LGZGT + Qian Cao 6, Hong Hua 10g, extensively for coronary heart disease (Palpitations + sweating + irregular pulse) for

  • Recurrent ventricular extrasystoles
  • Rheumatic heart disease
  • Pulmonary heart disease
  • Atrial fibrillation
  • Bradycardia

Treatment principle. Based basically on Heart and Spleen Yang deficiency, we are warming the Yang qi to transform fluids.

 


1.10 Gui Zhi Fu Ling Wan

Gui Zhi 6-10, Fu Ling 10, Mu Dan Pi 6-10, Bai/Chi Shao 6-15, Tao Ren 6-10

Invigorating blood and removing stasis. Use in the Jiang Gui Yao Lue as a gynecology formula that dispels masses.purple tongue

  1. Pain in a fixed location
  2. Bleeding of blackish purple blood that congeals easily
  3. Restlessness, irritability, and even mania
  4. Dark purple tongue body and a dark, lusterless complexion

Pressure pain with masses in the lower abdomen, especially on either side of the navel, is a characteristic sign of blood stasis.

In practice this formula is often modified to include otehr herbs such as chai hu, tu bie chong, hong hua and niu xi.


1.11 Zhi Shi Xie Bai Gui Zhi Tang

Gui Zhi 6-10, Zhi Shi 6-10, Hou Po 6-10, Xie Bai 10-15, Gua Lou 10-12

Regulating qi and dispersing clumps.purple tongue

In practice this formula is principally used for chest obstruction (emphysema, angina, intercostal neuralgia, stomach ache) with chest and back pain, swollen and full hypochondria, and constipation.

Jing Gui Yao Lue: Chest obstruction, obstructed qi that knots up in the chest and creates fullness, qi from below the ribs that rebels upward and strikes against the heart, ZSXBGZT masters it.

  1. Stuffiness and pain affecting the chest and upper back; epigastric focal distention with fullness.
  2. Constipation or dry stool that is difficult to passchest pain mac
  3. A thick, greasy, and dry tongue coating with a tongue body that is dark and may have stasis spots.

*If the tongue coating is wet, the tongue body flabby and pale, the stool is watery or dry at the beginning of the bowel movement, but soft at the end, this is not the right formula- use Gan Jiang based formula like Ren Shen Tang etc.


1.12 Gui Zhi Shao Yao Zhi Mu Tangmac

Gui Zhi 6-12, Bai Shao 6-15, Gan Cao 3-6, Sheng Jiang 5-12, Bai Zhu 6-10, Ma Huang 5-10, Zhi Mu 6-10, Fang Feng 6-10, Fu Zi 6-10

Facial edema, swollen feet, joint pain, aversion to wind, dizziness and shortness of breath.

  1. Severe joint pain accompanied by swelling
  2. Aversion to wind with feverishness; there may be sweating or only slight sweating
  3. Dark yellow complexion or facial edema, along with swollen and edematous feet.

swollen legs melbourne acupuncture clinic

 

 

 

 


There are other variations of formula with Gui Zhi Tang as it’s base such as Chai Hu Gui Zhi Tang, Ma Huang Tang and Ge Gen Tang, however we will cover these formulas under their Respective chief herbs such as Chai Hu and Ma Huang.

Gui Zhi Presentation

Gui Zhi Type 桂枝

 

gui zhi type symptoms melbourne acupuncture clinic chris eddy

Gui Zhi Presentation:

  1. Fever or a subjective feeling of fever; easily sweating, even to the point of spontaneous sweating; aversion to wind, sensitivity to cold, joint pain
  2. A subjective feeling of upward movement or pulsations in the abdomen; palpitations, being easily startled, feeling flushed, insomnia.

Gui Zhi Constitution:

External Distinguishing characteristics:gui zhi melbourne acupuncture clinic

  • Thin body (usually), skin is fair, flesh is moist and firm.
  • Abdomen is usually flat and abdominal muscles tight
  • Tongue is soft and pale
  • Pulse is often floating and large

Predisposition of the patient:

  • Sweats easily
  • Spontaneous sweating
  • Night sweats
  • Sweaty palms and soles
  • Emotional or physical sensitivity to cold temperatures
  • Frequent colds
  • Tendency to abdominal pain
  • Palpitations
  • Shallow or dream filled sleep
  • Muscle spasms

Running Piglet Qi (Ben Tun)

Running Piglet (Ben Tun) tells us there is an imbalance between Yin and Yang in the body. In health, the Frunning piglet qi melbourne acupuncture clinicire of the Heart* (Yang) contains and controls the Water of the Kidneys* (Yin). If Heart Fire becomes weak, or if Kidney Water becomes excessive, a state of imbalance arises. The Heart Fire can no longer control the Kidney Water, which begins to rebel upwards, encroaching on the abdomen and chest and causing uncomfortable pulsations or palpitations that can be quite alarming. If the Kidney Water cannot be contained, it will threaten the Heart Fire, resulting in the sense of panic. As the organ ruled by Fire, the Heart will panic when it feels that it will drown in all that Water. 

Depending on the severity of the sensation, we can use Gui Zhi to tonify the heart Yang Qi and warm the circulation, to descend and warm the kidney water. Then help drain the ‘cold water’ accumulated in the lower body with warming diuretics such as Sheng Jiang, Fu Zi, Gan Jiang, etc.

How is Yang damaged or ‘blown away’?

From Arnaud Versluys’s presentation on ELotus: Shang Han Lun in “Non-Cold” situations.

 

5 Damages to Yang
 Wind Disperses Yang
 Cold Chills Yang
 Damp Suppresses Yang
 Warmth Exhausts Yang
 Heat Consumes Yang
– Therapeutic Objective of Clearing Heat is to preserve Yang and prevent exhaustion of Yang

5 Formulas for the Five Types of Cold Damage
 Wind Strike: Guizhi Tang
 Cold Damage: Mahuang Tang
 Damp Warmth: Ma Xing Xi Gan Tang
 Warm Disease: Gualou Guizhi Tang, Gegen Tang
 Heat Disease: Baihu Jia Renshen Tang

Treating UTI Cystitis with Chinese Medicine

Treating a Urinary tract Infection (UTI) with Chinese Medicine

A urinary tract infection or UTI is an infection and inflammation of the urinary tract. When it effects the bladder it is called it is uti, cystitis, acupuncture, acupuncture melbournecalled ‘cystitis’ and when it effects the kidneys it is called ‘pyelonephritis’.

Symptoms of cystitis UTI include:

  • Pain with urination
  • Frequent urination

The need to urinate despite having an empty bladder

Symptoms of pyelonephritis UTI include:

All of the above symptoms with the addition of:

  • Fever
  • Flank pain
  • Nausea
  • Vomiting

Causes

The most common cause of infection is E.Coli (80-85%), and other sources may be Staphylococcus (5-10%) viral and fungal.uti, cystitis, acupuncture, chinese medicine

As E.Coli primarily lives in the intestine and is excreted in the stool, due to female anatomy, women are much more likely to suffer this infection.

Other risk factors are sexual intercourse, especially with multiple or a new partner, diabetes, obesity, and a family history.

Commonality

Around 150 million people develop a UTI each year and up to 10% of women have a UTI in a given year. It occurs most frequently between the ages of 16 and 35 years old.

Men and Women

In young sexually active women, sexual activity is the cause of 75-90% of bladder infections. In menopausal and post-menopausal women, a drop in estrogen levels causes a loss in the protective flora of the vagina, sometimes also causing vaginal atrophy.

Men with chronic prostatitis may also be prone to bacterial infections, especially as they age.

Diagnosis

UTI’s can be difficult to diagnose, especially in the very young and old, however it is often diagnosed on symptoms alone, possibly followed by and blood test and urine culture.

Treatment with Western Medicine

Many women will try chemist OTC products such as ‘Ural’ or cranberry tablets, while drinking lots of water, which will help occasionally with mild infections. Most UTI’s are treated with a short course of antibiotics, however resistant strains are becoming more common.

Treatment with Chinese Medicine

uti, cystitis, ba zheng san, acupuncture, chinese herbal medicineIn emergency situations, such as with fever and vomiting in infants or the elderly, it is always wise to seek medical help from your GP or hospital. Antibiotics can be a life-saver in an emergency. However, some cases, especially stubborn and chronic, can really benefit from acupuncture and herbal medicine.

One of the issues of treating UTI with antibiotics is resistant strains, another is wiping out the intestinal flora, which can then lead to an unbalanced state of healthy to harmful bacteria in the colon, thus possibly potentiating further infection at a later stage.

Chinese medicine diagnosis views your issue in two ways. Firstly, what is the nature of the inflammation and how to reduce symptoms. Secondly, what caused the inflammation in the first place and how do we stop this from re-occurring? This is the root of the disorder. Is it a deficiency in the digestive system, the urinary system or the reproductive system? By correct pulse, palpation and specific Chinese medical diagnosis we will diagnose a personal treatment plan.

How does this work? Well, to go into Chinese medicine theory properly will take me hours and pages, so perhaps I’ll explain with a case study.

Case Study

Case: Woman, 50 years old, UTI (cystitis) for 10 years. Frequent urination with slight irritation but no pain. May urinate up to 20 times per day, often with a feeling of ‘needing to go, but nothing coming out’. No fever, red tongue, rapid, slippery and deficient pulse. Has been treated by urologist and diagnosed with bacterial cystitis (E.Coli). Has been treated with antibiotics for 1 year, daily and is about to go on another year of antibiotics to see if it will change.

1st Treatment: Diagnosis kidney deficiency and damp heat. Acupuncture Sp 6, 9, SJ 5, Li4, Li11, Master Tung Sheng Guan (77.18) all bilaterally, herbal powder for 2 weeks (Ba Zheng San – formula for rectification of urinary dysfunction).

2nd Treatment, 1 week later: Symptoms reduced by 80%. Repeat same acupuncture treatment

3rd Treatment, 2 weeks later: Symptoms reduced by 100%. Repeat same acupuncture treatment.

Follow up 6 months later: Symptoms were great till 1 week ago, back but only 50% of usual. Applied same treatment melbourne acupuncture clinicacupuncture without herbs and follow up revealed symptoms reduced by 100% again.

Follow up 1 years later, symptoms had not returned.

Follow up 2 years later, symptoms had not returned.

Acupuncture combined with lifestyle and diet changes can offer treatment for various conditions including Cystitis/UTI, Resltess Leg Syndrome, Trigeminal Neuralgia, Male Infertility,  Prostadynia, asthma, acne, hay fever, sinusitis, weight loss, pelvic pain, rectal pain, female infertility, morning sickness, period pain, general pain and many more.

Chris Eddy is a registered doctor of Chinese medicine and university lecturer. He has been treating for the last 13 years in his city practice in Melbourne Australia.

Acupuncture Melbourne CBD

Restless Leg Syndrome: Acupuncture & Chinese Medical Treatment

Restless Legs: A Clinical Approach

Restless legs (RLS). Is it a new thing or an old disorder that no one ever mentioned before?melbourne acupuncture restless legs

RLS or Ekbom syndrome was first noted in medical journals in 1672, however it wasn’t really till 1945 that it was properly organised as a stand-alone disorder. We can say that RLS was probably always around, however to know if there was always a 10% population effect is impossible due to the modern availability of medical information and ‘doctor google’.

RLS effects around 10% of the American and European population, generally in women over 50, however it has been noticed by up to 45% of sufferers before the age of 20. Women are twice more likely to be effected than men and Caucasians more likely to be effected than other races.

Diagnosis:

Generally 4 symptoms are present to confirm the diagnosis:

  • The symptoms are more severe at night and do not occur, or are negligible, in the morning (although in extreme cases, symptoms may occur in the daytime)
  • An irresistible urge to move the legs and/or arms, often associated with a sensation of pain, burning, pricking, tingling, numbness, or other unpleasant or unusual sensations
  • The sensations begin following relaxation or a period of staying still, and during sleep
  • Temporary relief from these sensations during movement of the affected legs and/or arms

Testing:

melbourne acupuncture clinic restless legsThere is no single test to diagnose RLS, however a standard blood test will be performed to rule out the most obvious causes such as iron deficiency (20-30% of the cause). Further investigations may include and should be ruled out: deficiency of folate or magnesium, thyroid disease, fibromyalgia, sleep apnoea, diabetes, Parkinson’s disease, MS, uraemia, diabetes, Sjogrens, celiac or rheumatoid arthritis. ‘Growing pains’ or ‘shin splints’ in children and adolescents is not considered part of the same diagnosis.

Genetics:

Three genes, MEIS1BTBD9 and MAP2K5, were found to be associated to RLS.

Western Treatment:

Some drugs such as dopamine antagonists (usually used for Parkinson’s disease) have shown some good results, but not enough to warrant a frontline, safe and long term health plan.

Chinese Medical & Acupuncture Approach

Chinese journals have commented on restless leg syndrome in their own language and frame work over the years. Here is an RLS_acupoints_backextract from a medical journal from 1529 AD.

间少寐, 足内酸, 若再良久不寐, 腿内亦然, 且兼腿内筋似有抽缩意, 致两腿左右频移, 转不安, 必至倦极方寐, 劳伤元气, 阴火乘虚下注。薛己《内科摘要》1529

“The patient has trouble sleeping at night and a feeling of soreness and hotness in the legs. This kind of feeling will continue if the patient does not fall asleep when he lies on the bed. In addition, the leg muscles could have spasms, leading to frequent leg movements which are from left to right or from right to left, until the patient falls asleep from exhaustion. The cause of these symptoms is debilitation and Yin Fire from deficiency moving downwards.” Ji Xue 1529

But what does that really mean to someone not familiar to Chinese medical concepts?

Not much besides the fact that the Chinese doctors noted this as a disease some time ago, and if fact had around 10 differentiation’s of disease mechanism and related treatments, mainly centered around an initial deficiency of a bodily resource (perhaps iron, folate, or some aspect of the “richness” of blood) and inability of the transport mechanism of that substance (poor circulation), and in some cases a worsening of the condition in the presence of heat (possible inflammation of the blood vessels of the legs).

So what do I do in the clinic?

Of course the most important thing to do is take a full history of the patient. This includes pulse taking, palpation, observation of changes in the body such as varicose veins, changes in temperature around the body such as cold hands in the day but hot feet at night, or reversed. Everything we can ask and observe gives us a clue.melbourne acupuncture clinic

I have to say I believe there is a genetic component involved, and this will dictate how hard the condition may be to treat.

The main point of the treatment is to diagnose the dysfunction and return homeostasis (balance/regularity) and normal functioning of the body.

This usually involves acupuncture and herbal medicine.

I also find certain changes in diet to be effective. Some patients drink large amounts of coffee, sometimes they tell me 8-12 cups a day! The problem with this is that not only does it create heat in the body, coffee is a strong diuretic. This means you are urinating a lot of nutrients and minerals out the more you urinate. Not great for calcium, potassium, sodium and magnesium stores.

If you are on medication it is not a problem, thus we would like you to disclose full medication information to avoid interactions.

Treatments of RLS can take months, however you should notice symptomatic easing within 2-3 treatments and we expect those results.

Studies:

Using acupuncture and specific heat-lamp radiation, there was a 90% reduction if symptoms. http://europepmc.org/abstract/med/18257184 unfortunately they used the word ‘cured’ which makes me obviously suspicious, however, at least warrants further investigation.

Post-apoplectic RLS treated effectively with acupuncture, 76% reduction http://link.springer.com/article/10.1007/BF02850995

Treating RLS on patients previously on medication http://aim.bmj.com/content/29/3/240.short

Treatment review Chinese herbal medicine for RLS: http://www.sciencedirect.com.ezproxy.lib.rmit.edu.au/science/article/pii/S1087079212000056?np=y#

Acupuncture combined with lifestyle and diet changes can offer treatment for various conditions including Resltess Leg Syndrome, Trigeminal Neuralgia, Male Infertility,  Prostadynia, asthma, acne, hay fever, sinusitis, weight loss, pelvic pain, rectal pain, female infertility, morning sickness, period pain, general pain and many more.

Chris Eddy is a registered doctor of Chinese medicine and university lecturer. He has been treating for the last 13 years in his city practice in Melbourne Australia.

Acupuncture Melbourne CBD