Shi Chang Pu (Rhizoma Acori; sweetflag rhizome)

1.   Clears the head and brain, benefits the intellect
a.   Among the aromatic herbs, those with a strong aroma go to the head area.  Aside from She Xiang (from an endangered species), Shi Chang Pu is one of the best herbs that go to the brain.

b.   Shi Chang Pu is slightly warm in nature, but it can act like a cooling herb. Just as running a computer for a long time will cause the processor to overheat, using the body or mind for too long may cause a person to feel heat or fogginess in the head or lose the ability to concentrate. In this way, Shi Chang Pu is like a cool ocean breeze and can cool and clear the mind with its aroma

c.   The volatile oil in Shi Chang Pu enters the blood vessels in the brain and expands them to increase cerebral blood circulation.  If the cerebral blood circulation increases, more oxygen and glucose is supplied to the brain. This decreases fatigue and dissipates the foggy feeling.

d.   Shi Chang Pu can affect the area in the brain responsible for storing memories, thereby improving memory and intelligence.

e.   In clinical practice, Shi Chang Pu may be used for dementia or brain development problems.  For this purpose, combine Shi Chang Pu with Yuan Zhi + Fu Shen.  Yuan Zhi has a function to clear Phlegm from the brain.  Yuan Zhi enters the Heart, which according to TCM, has a close relationship to the brain.  Phlegm in the brain can be metabolic waste product accumulation in the brain.  Long term study without rest may result in so much unmetabolized waste products in the brain that the brain may not even feel clear after sleep and rest.  Yuan Zhi can clear up this problem thanks to its aromatic nature.  Fu Shen calms the Shen in addition to draining Dampness. Therefore Fu Shen has the ability to draw waste products from the mind into the water metabolism system and pass them out through the urinary system.

f.   To boost intelligence:
-Qi  deficiency pattern: Bu Zhong Yi Qi Tang + Yuan Zhi, Shi Chang Pu, Fu Shen
-HT Blood deficiency: Gui Pi Tang + Shi Chang Pu, Fu Ling to Fu Shen
-Yin deficiency: Liu Wei Di Huang Wan + Yuan Zhi, Shi Chang Pu, Fu Ling to Fu Shen

The difference between Yuan Zhi and Shi Chang Pu is that Shi Chang Pu is cool, while Yuan Zhi is warm.  Both are aromatic with relatively strong medicinal effects. The correct dosage for each of them is 4-8g, no more than 12g.  When used together they complement each other and become neutral in temperature.

h.   For patients who suffer from a weak Stomach, elderly patients with memory problems, or anyone with pathological levels of Phlegm in the brain, use herbs that strengthen the Spleen and dissolve Phlegm: + Yuan Zhi, Dan Nan Xing, Ban Xia or Sheng  Jiang.  If the main complaint is heat in the head, Heart heat, or hyper-activity in the sympathetic nervous system, herbs with a cooling nature should be used such as: Shi Chang Pu, Bo He or Ju Hua. 

i.   Cong Ming Dan is a valuable pill for students.  It improves memory and intelligence.  To make Cong Ming Dan, use the formula for Gong Jin Dan but replace She Xiang with the same amount of Zhang Nao, and add Yuan Zhi, Shi Chang Pu and Fu Shen.  When the pill is wrapped in gold it becomes Cong Ming Dan.  The substitution of Zhang Nao for She Xiang is important for student use.  She Xiang may stimulate the component of the brain in charge of sex drive.  Zhang Nao clears the brain and clears Heart heat so it is more suitable for study purposes.  Starting 100 days before an exam, take 1-2 pills per day. 


CASE 1: A 38 year old female was preparing for board exams. She was normally healthy, but the effort required to prepare for the exam in addition to taking care of her children was making her tired.  She also had a lot of test anxiety because she had failed last year on her first try. She was not experiencing too much physical fatigue, but she was drowsy, especially during class time.  She was given Gong Jin Cong Ming Dan. After taking the formula, her drowsiness was reduced and her mind felt clear.  She also felt reduced anxiety and was more energetic in the morning.


CASE 2: A 76 year old female was suffering from mental dullness and borderline dementia.  Her problem was worse than just forgetfulness; she was actually experiencing some dementia symptoms.  She also suffered from very severe fatigue. She needed to sleep a lot.  She was so tired that she complained even a spoon felt too heavy to lift, and even sitting still felt too difficult to do.  She nearly always felt dizzy and foggy-headed.  Also, she was not able to eat much since her ST function was so poor. The tongue coat was white. 

This set of symptoms was a result of SP Qi Deficiency + Phlegm Fluid.  Qi deficiency caused her aversion to movement, while Phlegm caused her feeling of heaviness.  Especially for elderly patients, it is better to strengthen the SP then to simply expel Phlegm alone.  The formula used for this patient was Liu Jun Zi Tang, which is comprised of Si Jun Zi Tang + Er Chen Tang.  To treat the mental fogginess + Yuan Zhi, Shi Chang Pu.  Tian Ma was also added to improve brain circulation. After 20 days of taking this formula, the patient's symptoms were very much improved.  (Ren Shen 6, Bai Zhu 6, Fu Ling 4, Ban Xia 4, Chen Pi 4, Yuan Zhi 4, Shi Chang Pu 4, Tian Ma 4, Gan Cao 2, Sheng Jiang 5)




2.   Clear HT heat, open the HT, calm Shen, open the ST
a.   Shi Chang Pu enters the HT to clear HT heat, so it can be used for stress-related disorders.  The volatile oil in Shi Chang Pu has a calming function which makes it applicable for irritability, anxiety or palpitations.  Gui Pi Tang is commonly prescribed for this kind of case. However, Gui Pi Tang is not appropriate for cases of HT heat since it is warm in nature.  A better choice would be Huang Lian Xie Xin Tang + Zhu Ru, Shi Chang Pu.  In the case of Phlegm-Heat, a good option is Zhu Ru Wen Dan Tang + Shi Chang Pu.

b.   Long term use of sedatives for the treatment of psychological disease can create internal heat.  The heat will become encapsulated within, reflected in manic symptoms and a thick yellow tongue coat.  An appropriate formula for this situation is Zhu Ru Wen Dan Tang + Dan Nan Xing.

c.   The volatile oil in Shi Chang Pu has the ability to awaken the ST and strengthen digestive function. Shi Chang Pu is better in the case of stress-related (hyper sympathetic) digestive disorders than for use in the case of weak Stomach.  Shi Chang Pu is especially useful for students who suffer from indigestion due to stress; for this purpose it should be combined with other aromatic herbs to transform Dampness.


CASE: A 42 year old business man was suffering from neck pain, shoulder pain, low back pain, headache, toothache, bad breath, irritability, anxiety and insomnia. He noticed recently that when he gets stressed his hands tremble.  He used to drink too much alcohol, but he has reduced his alcohol intake significantly for a while now.  However, he still smokes 1 or 2 packs of cigarettes per day.  His tongue coating is white with yellow in the center.  He had to continually increase the dosage of his prescription psychoactive drug because it was not helping enough.  His mind felt very foggy and unclear. 

This patient was exhibiting Phlegm-Heat in the interior, Heart & Liver Heat probably resulting from his business activities, and Liver Wind manifest as hand tremors. The principle was to clear Heat from the Liver & Heart and dissolve Phlegm-Heat. The following formula was used: Cang Zhu 6, Fu Ling 6, Chen Pi 4, Chai Hu 4, Long Gu 4, Mu Li 4, Zhu Ru 4, Shi Chang Pu 4, Zhi Shi 3, Yuan Zhi 3, Huang Qin 2, Gan Cao 2.  A closer look at the formula reveals groups of herbs that focus on the Heart, Liver, and Phlegm-Heat.
-HT: Zhu Ru, Zhi Shi, Shi Chang Pu, Yuan Zhi
-LV: Chai Hu, Long Gu, Mu Li
-Damp/Phlegm-Heat: Cang Zhu, Huang Qin, Fu Ling, Chen Pi, Gan Cao

After taking this formula, the man felt that mental clarity had been restored. The irritability and anxiety were reduced, his hand tremor had disappeared, his tongue coating had changed to normal (thin white) and his bad breath had disappeared.  For ten more days he took a formula modified from the one above which was more focused on tonifying the Heart.  The modifications were as follows:  +Mai Men Dong 8, Cang Zhu & Fu Ling each reduced to 4.

ST43 (Xian Gu; Sunken Valley)

1. Location
Acupuncture Manual: On the dorsum of the foot, between the second and third metatarsal bones, in the depression 1 cun proximal to ST44 (Neiting).
CAM: In the depression just distal to the junction of the second and third metatarsal bones.

The "Great Compendium of Acupuncture and Moxibustion (1601)" says that ST43 is located 2 cun posterior to ST44, a location similar to the CAM point location.  In Master Tung style acupuncture, there is a point called "Men Jin (Door Metal)", and it is located in the same place as the Great Compendium location of ST43.  More texts tend to describe this location for ST43, and most acupuncturists tend to use this location in practice.


2. Modern Acupuncture Indications (Acupuncture Manual, CAM)
2-a. Edema: ST43 can treat both foot edema as a local point and facial/eye edema as a distal point.  The dorsum of the foot, where ST43 is located, images the facial area.  The point's name is "Sunken Valley", and one can imagine the valley (face, eye, foot) out of which the water (edema) flows.  In the case of foot edema, a three-edged needle or a lancet is used to release the yellow viscous fluid from the edematous area.

2-b. Stomach Disorders: As a Stomach channel point, ST43 can be used for the treatment of abdominal distention and borborygmus.

2-c. Bi Syndrome: As a Shu-Stream point of the Stomach channel, ST43 is a good point for Bi syndrome, especially for febrile painful obstructions (Heat Bi), which manifests with redness, swelling, heat, and joint pain.  It can be combined with LI4 for this kind of Bi syndrome.


3. Indications in Master Tung Style Acupuncture    
"Men Jin (Door Metal = ST43)" is a commonly used Master Tung style acupuncture point.
3-a. Diarrhea: Men Jin (Door Metal) can treat both acute and chronic diarrhea.  It is a very good point for (gastro)enteritis.  Since it is a Wood point located on the Stomach channel, which is Earth, it is good for those cases involving Wood overacting on Earth.  In chronic diarrhea, Kidney deficiency is involved, and since this point is located close to the junction of two bones, it can benefit the Kidney as well.

NOTE: Gastroenteritis (also known as gastro, gastric flu, and stomach flu, although unrelated to influenza) is inflammation of the gastrointestinal tract, involving both the stomach and the small intestine (see also gastritis and enteritis) and resulting in acute diarrhea. The inflammation is caused most often by infection with certain viruses, and less often by bacteria or their toxins, parasites, or adverse reaction to something in the diet or medication.  Chronic enteritis can be due to Crohn's disease, giardiasis, tuberculosis, celiac disease, or rarely due to Whipple's disease.

3-b. Pain: Headache, Dsymenorrhea, Abdominal pain/distention
- Headache at the "Tai Yang" point:  Men Jin (Door Metal) is good for many types of pain, but it is especially good for headaches located at Tai Yang  (in the depression about 1 cun posterior to the midpoint between the lateral end of the eyebrow and the outer canthus of the eye).
- Dysmenorrhea:  This point also works well for dysmenorrhea by harmonizing Wood and Earth.
- Abdominal pain or abdominal distention:   In combination with Ling Gu (Capital Bone; lower LI4), which is located distal to the junction of two metacarpal bones on the Hand-Yangming channel, Men Jin (Door Metal) (on the Foot-Yangming channel) is also good for abdominal pain.

3-c. Nasal Blockage: This point's name contains the character for Metal, meaning that it is also related to the Lung and to Qi, as well as the Large Intestine.  In addition, the Stomach channel on the face intersects with the point LI20.  Therefore, Men Jin (Door Metal) can be used for nasal blockage.

3-d. Rectal Prolapse: The combination of ST43 (Door Metal) and ST44 can treat rectal prolapse as well.

INTRODUCTION
Zi Su Ye is most often compared to Huo Xiang since they both treat Tai Yang Exterior and Tai Yin Interior.  Both herbs have the ability to treat interior and exterior conditions, and both can treat nausea and vomiting.  Zi Su Ye has a special additional ability to calm the fetus and is more for exterior conditions.  Huo Xiang is more for interior conditions and reducing nausea.

1. Release the Exterior, Calm the Middle, Descend Qi, Stop Cough
a. Zi Su Ye is for both interior and exterior conditions. It is applicable for weak digestive function, especially for the combination of food retention plus Cold.  Zi Su Ye can be used for weakened, Qi deficient, elderly, children, or even pregnant patients because its diaphoretic action is very gentle.  Gentle diaphoresis refers to a subdued ability to open the pores and promote sweating.  This is quite the opposite of Ma Huang, which is known as one of the best herbs to open the pores and promote sweating.  If Ma Huang is the representative herb of strong diaphoretics, then Zi Su Ye can be regarded as the representative of gentle diaphoretics.  Examples of formulas in which Zi Su Ye is utilized for gentle diaphoresis include: Xiang Su San, Jia Wei Xiang Su San and Xiong Zi Xiang Su San.  Huo Xiang Zheng Qi San utilizes the combination of Huo Xiang + Zi Su Ye to release the exterior and reduce nausea and vomiting.

b. Zi Su Ye and Zi Su Zi are different parts of the same plant.  Zi Su Zi is the seed, while Zi Su Ye is the leaf.  Zi Su Zi has a significant ability to stop cough.  Zi Su Ye has a much less significant ability to stop cough, which makes sense considering that leaves tend to have a light, upward and outward energy while seeds tend to have a heavy, descending energy.  Zi Su Ye can release the exterior and gently relieve cough.  Formulas which incorporate Zi Su Ye to release the exterior and relieve cough include: San Su Yin, Xing Su Tang, Xiang Ge Tang, Shin Bi Tang, Zi Su Ban Xia Tang and Jia Biao Er Chen Tang.

2. Regulate Qi in the Middle, Treat Qi Stagnation for Abdominal Distention
a. Zi Su Ye has a good Qi regulating effect, so it is often combined with Qi regulating herbs.  Zi Su Ye may be referred to as a Tai Yin Spleen herb and is especially useful for Qi stagnation in the Middle Jiao.  For example, if a patient has stress leading to Qi stagnation in the Middle Jiao and Stomach problems, Zi Su Ye is applicable.  Common combinations used in clinical practice include: Zi Su Ye + Chen Pi / Zi Su Ye + Hou Po, Da Fu Pi / Zi Su Ye + Jie Geng, Zhi Ke.

The king herb of Fen Xin Qi Yin is Zi Su Ye.  In this formula Zi Su Ye is combined with other herbs that descend the Qi to treat edema due to Qi stagnation, abdominal distension, constipation or urinary difficulty.  Liu Yu Tang is another formula for abdominal distension in which Zi Su Ye is utilized for its ability to regulate Qi in the Middle Jiao.

b.  Xiao Chang Yin Zi also utilizes Zi Su Ye to regulate Qi in the Middle Jiao for severe gas and abdominal distension.  Combined with Qi regulators, herbs that break up Qi stagnation and expel Phlegm, Zi Su Ye can be found in Shi Liu Wei Liu Qi Yin and Jia Wei Si Qi Tang.  These two formulas treat Qi and Phlegm stagnation and open the Ren meridian.  Pain in the Middle Jiao due to Qi stagnation, especially as a result of gynecological disorders, can be treated with Jie Ge Shi Jing Tang.  For this purpose Zi Su Ye is combined with Qi regulators and herbs that open the channels in order to circulate Qi in the Middle Jiao as well as in the superficial skin area.

3. Calm the Fetus, Stop Nausea/Vomiting
a. Zi Su Ye is well known for its ability to calm the fetus and reduce nausea and vomiting.  This makes it an excellent choice in case of morning sickness or Wind-Cold during pregnancy.  The most common formula for this purpose is An Tai Yin, which is comprised of Si Wu Tang + Bai Zhu, Huang Qin, Sha Ren, Chen Pi and Zi Su Ye.  Bai Zhu + Huang Qin is a good combination for calming the fetus, while Sha Ren + Chen Pi + Zi Su Ye regulate the Middle Jiao and reduce nausea and vomiting.  This formula is helpful for pregnant women who experience morning sickness due to weak Stomach function or morning sickness triggered by smells.

CASE: A thin, 28 year old female complained of nausea and vomiting especially whenever she smelled food.  She was 8 weeks pregnant.  Smelling food made her feel sea-sick.  Her digestion was poor before her pregnancy.  Her morning sickness was so severe that she had barely been able to eat for a few days.  It was determined that she was suffering from Middle Jiao deficiency and hormone imbalance.  The treatment strategy was to regulate and warm the Middle Jiao, and calm the fetus.  She was given: Zi Su Ye 12g, Chen Pi 8g, Bai Zhu 6g, Sha Ren 3g, Huang Qin (fried) 2g, and Sheng Jiang 6g.

4. Compared to Zi Su Zi
Zi Su Zi is the seed of Zi Su Ye.  It does not release the exterior, but it can descend Qi to stop cough and expel phlegm.  It is used for cough and asthma.  It is commonly combined as follows: Zi Su Zi + Ban Xia / Zi Su Zi + Er Chen Tang / Zi Su Zi + Lai Fu Zi, Bai Jie Zi / Zi Su Zi + Sang Bai Pi

Formulas with Zi Su Zi include: Su Zi Jiang Qi Tang, Jia Wei Er Chen Tang, San Zi Yang Qin Tang, Su Zi Dao Tan Jiang Qi Tang, Jiang Fei Tang and Ding Chuan Tang.

5. Dosage and Comment
When used as a king herb, the dosage of Zi Su Ye is 4-12g.  The dosage when it is used a deputy or assistant is 3-4g.  Zi Su Ye is most powerful when combined with Huo Xiang or Chen Pi.

UB17 (Ge Shu; Diaphragm Shu)

1. Blood Influential point (Hui-meeting point)
Since it is the influential point of Blood, UB17 can be used for all kinds of blood disorders including Blood Deficiency, Blood Stasis, Heat in the Blood, or bleeding.  There are many ways to use this point.  One common usage is for Blood Deficiency + Blood Stasis, in which case it functions like Si Wu Tang and targets Liver Blood more than Heart Blood.  This function of UB17 can treat menstrual disorders resulting from Blood Deficiency or Blood Stasis such as amenorrhea, light scanty menses, dysmenorrhea, or dark menstrual clots.  UB17’s ability to treat Blood Heat makes it an important point for treating skin disorders that result from Heat in the Blood such as itchy red skin, eczema, or carbuncles.  For bleeding due to Blood Stasis, UB17 functions similarly to the herbs Qian Cao Gen, Pu Huang and San Qi, or the formula Gui Zhi Fu Ling Wan.  UB17 + SP10 is a powerful combination to move the Blood.

2. Hiccups
The name of UB17, Ge Shu (Diaphragm Shu), is indicative of its proximity to the diaphragm.  Therefore, Ge Shu can treat hiccups, which result from spasm of the diaphragm.  Other points useful for treating hiccups include RN12, PC6, ST36.  There are many ways to treat hiccups.  For acute hiccups, instruct the patient to inhale deeply and hold it; strongly stimulate the patient’s LI4 bilaterally with your thumbs until they release their breath.  For chronic hiccups, apply moxa to UB17, SJ17, RN12, RN17, ST36, and ST41.

3. Chest disorders
UB17 has the ability to open the chest.  This makes it applicable for emotional disorders caused by stagnation or obstruction of Qi in the chest, for example irritability, anger, or depression.

4. Esophageal and Gastric disorders
UB17 is useful for any type of esophageal or gastric disorders including esophageal stenosis, esophageal cancer, vomitus nervosus, and food retention.  For food retention, the technique is to apply Tui Na pressing or tapping to UB17, UB20 and UB21.  Apply moxa for chronic gastritis or gastric cancer.  For acute gastritis, bleeding UB20 and UB21 is more effective.

5. Sexual Frigidity
Stimulation of UB17 can reduce sexual frigidity, especially in women. This function could be attributed to UB17's actions on the Blood.  Women are more yin in nature, making them subject to disorders of the Blood, which can easily affect their reproductive systems and sexual drive.  Modern neurology links the T7 spinal nerve to both the digestive and reproductive systems.  Interestingly, in many types of dance the man's hand is positioned in the UB17 area.  Understanding the function of UB17 adds insight to the importance of dance as part of the courting ritual.

6. Upper & Middle Jiaos
UB17 is located at the borderline between the Upper and Middle Jiaos.  UB17 is at the level of T7, even with DU9.  There is no regular acupuncture point at the level of T8 (although there is an extra point, Wei Guan Xia Shu, for the treatment of diabetes).  For this reason, UB17 is like the first line of defense to help prevent Heat from rising from the Middle Jiao into the Upper Jiao.

7. Four Flower Technique
Needling UB17 + UB19 bilaterally is called the Four Flower Technique.  This combination can nourish Blood, treat Blood Deficiency, cough, and asthma.  While the classic Four Flower is UB17 + UB19, an alternate clinical combination is UB18 + UB19.       

Q:  I have a 2 year old who was born with a cleft palate and has just been diagnosed with Stickler's Syndrome.  The doctors have said that she will lose sight and hearing as she grows older.  Has anyone ever heard of acupuncture and/or herbs helping this disease?


A:   Stickler syndrome
1. An inherited disorder that can affect multiple parts of your body, including your eyes, face, ears, heart, bones and joints. The cause of Stickler syndrome is a gene mutation that affects the formation of a connective tissue called collagen.
2. Named for a German doctor named Gunnar Stickler, who described the syndrome in a young boy in 1960. Stickler syndrome is usually diagnosed in young children. If your child has Stickler syndrome, treating the signs and symptoms can help your child manage the disorder and live a full, productive life.

Note:
Acupuncture: You can give the acupuncture and herbal treatment according to signs and symptoms as the baby grows.  (example, cleft plate; ST channel, eye sight; LV channel, hearing; KD channel).  You can add influential points like UB11 (bone), UB17 (blood), GB34 (sinews) because the connective tissue is related.  I often add UB43 for congenital disorders.
Herb: Gui Zhi Tang modification is good for connective tissue disorders because it harmonize Ying and Wei levels.  However, many formulas can be used for connective tissue disorders.  Please choose by differential diagnosis.   

Q:  I'm going to be seeing a 19 y/o female with atonic constipation. For the past 6 months she's been getting colonics every 2 days because of her discomfort and inability to have a bowel movement.

According to her mom she has gone thru a number of tests, MRI, etc., with everything appearing normal, as far was western med is concerned. The colonics relieve the discomfort/bloatiness, so a blocked colon/LI does not seem likely.

I've only talked to her briefly, but she is fairly athletic, eats a pretty good diet, and is an active teenager. I did check her pulse and it's very deep and deficient, but with some tightness deep on the R. guan. Her tongue was swollen, dusky, with very thin coat.

Any ideas on kick-starting the "lazy bowels"?


A:   Pattern and Formula for Constipation

1. Excess Heat: dry stool, hard stool, scanty urination, abdominal pain and distention, dry mouth, bad breath, yellow and dry tongue coating, deep-rapid pulse
Ma Zi Ren  10g
Bai Shao  5g
Zhi Shi  5g
Da Huang  10g
Hou Po  5g
Xing Ren  5g

2. Qi Stagnation: hard stool, belching, hypochondriac and abdominal distention, no appetite, greasy coating, wiry pulse
Bing Lang  9g
Chen Xiang  9g
Mu Xiang  9g
Wu Yao  9g
Da Huang  9g
Zhi Ke  9g

3. Qi Deficiency: hard to defecate, pale complexion, mental fatigue, shortness of breath, slightly pale tongue with thin coating, deficient-rapid pulse
Huang Qi  15g
Chen Pi  15g

4. Blood Deficiency: hard stool, pale complexion, dizziness, palpitation, thin coating, thready pulse
Ma Zi Ren  15g
Da Huang  15g
Tao Ren  5g
Dang Gui Wei  5g
Zhi Shi  5g
Bai Shao  5g
Sheng Ma  5g
Ren Shen  3g
Gan Cao  3g
Chen Pi  3g
Mu Xiang  2g
Bing Lang  2g

5. Yang Deficiency: hard to defecate, pale urination, cold limbs, abdominal pain get better with warmth, dislike of cold food, white coating, deep-slow pulse
Dang Gui  12g
Niu Xi  6g
Rou Cong Rong  7.5g
Ze Xie  4.5g
Sheng Ma  2.5g
Zhe Ke  3g


Note: Please use the herbal formula by differential diagnosis.  If you can't diagnose clearly, please try the following formula
Dang Gui  6g
Chuan Xiong  6g
Bai Shao  6g
Shu Di  6g
Qiang Huo  6g
Fang Feng  6g
Da Huang  6g
Sheng Ma  6g
Hou Po  6g
Zhi Ke  6g
Xing Ren  6g
Tao Ren  6g
Hong Hua  1.5g

Acupuncture: For your case, please try the following treatment
Right side: Sedate SJ6 and KD6
Left side: Sedate LI1 and ST45, Tonify GB41, ST43

Q:  I've got a patient who had prostate cancer and had his prostate removed 3 years ago. He's recovery went pretty well and he appears to be "free" of cancer, but he was left with bladder problems. He has constant bladder pressure and discomfort if sitting or standing (ok when lying down), consistently yellow urine, and incontinence - when he needs to go, he has to race to the bathroom immediately because he looses control of the urine quickly. He cannot leave the house for long periods of time now because of this problem. He also has sexual dysfunction since the surgery and long term depression due to a previous car accident and severe cervical spine injury (15 years ago). Any advice on treating incontinence and sexual dysfunction due to surgery would be greatly appreciated.


A:  HERBAL FORMULA
With the above information, I can think of the following options.  Please diagnosis your patient with 8 principles differentiation (excess/deficiency, heat/cold) before you choose the herbal formula.

1. Ba Wei Di Huang Wan + Shan Dou Gen, Yi Yi Ren
2. Bu Zhong Yi Qi Tang + Zhu Ling Tang
3. Empirical formula*

Empirical formula*
8.0g  Dang Gui
4.0g  Rou Gui
4.0g  Xiao Hui Xiang
4.0g  Bai Shao
4.0g  Chai Hu
4.0g  Ren Shen
3.2g  Chuan Lian Zi
3.2g  Yan Hu Suo
3.2g  Ze Xie
6.0g  Tu Si Zi
4.0g  Lu Rong
2.0g  Fu Zi

ACUPUNCTURE
If heat, tonify UB (Taiyang cold); +LI1, +UB67, -ST36, -UB40
If cold, tonify KD (Shaoyin heat); +LU8, +KD7, -SP3, -KD3

Q:  Hello,

I would like some help re:  40 y/o man with adult onset diabetes.  He has circulation problems and takes insulin shots.  He has had it for 3 years... He is wanting to try acupuncture and herbs.  Any suggestions?  points besides Wei Guan Xia Shu?  And herbal formula?  Unfortunately, I do not have the Tongue or pulse.

Thank you.


A:  With the limited info, please try the following Empirical formula first.

JIA WEI YU YE TANG
Shan Yao  30g
Huang Qi  15g
Zhi Mu  15g
Ji Nei Jin  6g
Ge Gen  5g
Tian Hua Fen  10g
Shan Zhu Yu  15g

AURICULAR ACUPUNCTURE FOR DIABETES
UPPER JIAO: Endocrine, LU, Thirst
MIDDLE JIAO: Endocrine, ST, Hunger
LOWER JIAO: Endocrine, UB, KD

Q:  Hi HB,

Have you heard of Grover's diz.  It's a skin dz that affects mainly older men, out of the blue.  I have a patient who has this, it is similar to eczema.  he is very itchy, with just little unraised dots on his skin, and a very flushed face.  his tongue is yin xu, red no coat.


A:
HERBAL FORMULA
Since the patient have Yin deficiency, Modified Liu Wei Di Huang Wan can be used.

Shu Di Huang  24g
Shan Zhu Yu  12g
Shan Yao  12g
Ze Xie  9g
Mu Dan Pi  9g
Fu Ling  9g
Ji Xue Teng  12g
Bai Xian Pi  12g
Han Lian Cao  9g
Bai Jiang Chan  9g

ACUPUNCTURE
LU tonification (Tonify SP3, LU9, Sedate HT8, LU10)  is a good treatment for this case.  Because LU governs skin and LU is Taiyin (Damp Earth).  LU tonification is good for skin disorders with Yin deficiency.

=============================================================

GROVER'S DISEASE
Grover's disease, or Transient Acantholytic Dyskeratosis (TAD), is a common skin disease characterized by small red, bumpy spots.  Grover's disease often starts quite suddenly. It results in very itchy spots on the central back, mid chest and occasionally elsewhere. Frequently, it follows sweating or some unexpected heat stress.  Symptoms of Grover's disease are characterized by an itchy eruption that may last an average of 10-12 months. It is characterized by papules and papulovesicles with excoriations occurring on the chest, back, lower sternum, arms, and thighs. Grover's Disease is mainly seen in males over the age of forty and the papules are found on the mid chest most often.  Sometimes the features of Grover's are found in people who do not itch or have a conspicuous rash. Most of the people with Grover's who visit a dermatologist, however, itch a lot.

Q:  Hello,

I would like some help re: a man, about 65 y/o, who has been suffering from peeling skin on the palm side -thumb areas (LU 10 area-bilaterally).  He has been suffering for about 1 year... and has sought treatment both Western and Eastern but without much results. 

Any ideas?  Treatments?  Herbal formulas?


A:  Exfoliative keratolysis (Recurrent focal palmar peeling) is a common skin condition in which there is focal peeling of the palms and less often on the soles. It is also known as ‘keratolysis exfoliativa’, and ‘focal palmar peeling’.  In Western medicine, it is related with Hyperhidrosis, Pompholyx, Tinea Manuum, etc.  In Eastern medicine, it is generally DAMP-HEAT pattern.

Internal formula
Na Sha Shen  15g
Shi Hu  15g
Tian Men Dong  15g
Bai Shao  10g
Yu Zhu  10g
Sheng Di Huang  10g
Yi Yi Ren  30g
Dong Gua Pi  30g
Chi Xiao Dou  30g
Sang Zhi  6g
Si Gua Luo  6g
Lian Zi Xin  6g

External formula (Soak the affected area for 10-15 min)
Chen Pi  30g
Gou Ji  30g
Wu Bei Zi  15g
Cang Er Zi  15g
Jin Qian Cao  15g

Auricular Acupuncture
Neurogate (shenmen), Sympathetic, Heart, Hand

Korean Yin-Yang Balancing Treatment
Find more severe or originated side, and sedate opposite side of LU10, tonify opposite side of LU5