Providing Animal Safety and Control in Emergency Pet Shelters
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Transcript Providing Animal Safety and Control in Emergency Pet Shelters
TCM Spleen Disease
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Spleen Physiology
Spleen Pathology
Gingivitis/Stomatitis
Ulcers
Pancreatitis
Bleeding
Muscle Wasting
Obesity
Constipation
Earth
•Sound
•song
•Emotion
•sympathy
•Direction
•center
•Opening
•lips/gums
•Climate
•Body Part
•humid
•muscles
•Season
•late summer
•Zang/Fu
•SP/ST
TCM SPLEEN Physiology
•Governs Transportation &
Transformation
•Food & Water
•Controls Blood
•Dominates the Muscles
•Opens in Mouth
•Lips & Gums (ST)
TCM 24 Hour Clock
LIV
GB
TH
1-3 AM
LU
3-5 AM
LI 5-7
11-1AM
9-11 PM
PC
7-9 PM
KID
BL
ST
7-9 AM
SP
9-11 AM
HT
5-7 PM
3-5 PM
SI
AM
1-3 PM
11-1 PM
Spleen Pathology
Spleen Pathology
• Damp is the Enemy of the Spleen
• Damp-Cold
• Damp-Heat
• Spleen Qi Deficiency with Damp
Spleen Pathology
Usually combination of excess & deficiency
External or Internal Pathogen
Damp-Heat
Damp-Cold
Obstructs Spleen Qi Flow
Spleen fails to Transform & Transport Gu Qi
Spleen Qi Deficiency
Spleen Pathology
Cold Food
or Drink
Cold
Environmental
Conditions
Cold-Damp in Spleen
Disharmony of Qi Flow
Transform & Transport Disorder
Spleen Pathology
Damp Hot
Food or
Drink
Accumulated
Heat & Damp
Damp Hot
Environmental
Conditions
Damp-Heat in Spleen
Disharmony of Qi Flow
Transform & Transport Disorder
Spleen Qi Deficiency
Illness
Overeating
Overwork
Starvation
Under Work
Spleen Qi Deficiency
Disturbed Qi Flow
Failure to Transform & Transport
Spleen Not Controlling Blood
Prolonged Spleen Qi Deficiency
Spleen Fails to Hold Blood
Hemorrhage
General Signs
Chronic Hemorrhage
Spleen Qi Sinking
Illness
Overeating
Overwork
Starvation
Under Work
Chronic Spleen Qi Deficiency
Failure of Holding
Chronic Diarrhea
Prolapses
Incontinence
Spleen Pathology
Cold Food
or Drink
Chronic Spleen
Qi Deficiency
Spleen Yang Deficiency
Disharmony of Qi Flow
Transform & Transport Disorder
Yang Deficiency Signs
Stomach Pathology
Cold
Environmental
Conditions
Cold Food
or Drink
Cold in Stomach
Disharmony of Qi Flow
Transform & Transport Disorder
Inhibition of Yang
Stomach Cold
Cold Food & Drink
Cold Environment
Stomach Cold
Receiving &
Decomposing
Anorexia
Cold Signs
Altered
Qi Flow
Lassitude
Cold Ear/Nose
Hypersalivation
Pale-Purple Tongue
Deep-Slow Pulse
Stomach Pathology
Damp Hot
Environmental
Conditions
Hot Dry
Food or
Drink
Heat in Stomach
Heat Signs
Transform & Transport Disorder
Stomach Heat
Pathogenic Heat
Yin Deficiency
Stomach Heat
channel
Gums
organ
grandchild
child
Cystitis
Ulcer
Colitis
Stomach Food Stagnation
Overeating
Indigestible Food
Retention of Food in Stomach
Disturbed Qi Flow
Failure to Transform & Transport
Stomach Yin Deficiency
Stress
Liver Qi Stagnation
Chronic Febrile
Illness
Transformation
to Heat/Fire
Impairment of Body Fluids
Stomach Yin Deficiency
Oral Cavity Disorders: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Oral Cavity Diseases (Western)
•Local damage
•Electric shock
•Chemical damage
•Thermal damage
•Periodontitis
•Tooth tarter
•Systemic disease
•Metabolic disease
•Nutritional disease
•Immune disease
•Infectious disease
•Treatment
•Remove offending
cause
•Steroids
•Antibiotics
•Clean teeth
How to Use Acupuncture for Gingivitis in
Small Animal Practice
Zang Fu Physiology
• Teeth correspond to bone
• Bone is controlled by the kidney
• Malocclusion, oligodontia are examples
of Kidney Jing Deficiency
• Gums are influenced by the stomach
Meridian Theory
• Oral cavity has two main channels
that influence the teeth and gums
• Large Intestine meridian
• Stomach meridian
Pattern Diagnosis
• Stomach Heat Pattern
• Excess pattern, seen more often in
younger animals (cats)
• Stomach Yin Deficiency + Empty Heat
• Stomach loves moisture
• Moisture balances Yang function
• Lack of Yin (fluid) allows Yang Fire to
rise
Stomach Heat Pattern
•Fluffy: 4yr FS DSH
•Primary complaint: Bad
breath, eating poorly
•History: Stray, no
vetcare, dry food diet
•Exam: Body & coat
condition-normal; vital
signs-WNL
•Oral Exam: Putrid odor, upper and lower
arcade have severely inflamed gingiva, with
spontaneous bleeding, minimal calculus
formation
•Lab Data: Elevated WBC, FELV/FIV=Neg
•Diagnosis: Hemorrhagic gingivitis
•Treatment: Clindamycin 25mg PO BID x 10
•Dental prophylaxis followed by
Clavamox 62.5 mg BID x 10
TCVM Exam & Diagnosis
•Constitution: Water/Wood
•Tongue: body=reddish purple; no coat
•Pulse: Bilaterally superficial rapid
•Body Condition: Dry nose; Body Temp
Normal
•Mouth: Stink smell; bloody red gums
Pattern DX: Stomach Heat (excess
condition)
TCVM Treatment Strategy
•Treatment Principle: Clear the Stomach Heat, Cool
the Blood, & nourish Stomach Yin
•Acupuncture Point Selection:
GV 14; Tian Ping; ST 4,6,34,44; LI 4,11; SP 10
•Herbal Medicine: Yu Nu Jian ( Jade Lady)
shi gao, shu di huang, zhi mu, huai niu xi
2 teapills TID or 1/8-1/4 tsp granules TID
•Topical Care: Aloe Gel ( Warren Laboratories)
Case Outcome & Discussion
•After 3 weeks of therapy inflammation
substantially reduced
•Cervical line lesions which compromised several
teeth were removed
•Fluffy is maintained on Aloe oral gel and herbs
with only periodic acupuncture therapy
•Long term expectations: depend on owner
compliance
•Other herbals: Wei Qi Booster; Slippery Elm
Stomach Yin Deficiency & Empty Heat
Pattern
• Tess: 10 yr, FS, Mix Breed
• Primary Complaint: Bad breath, dirty teeth,
and periodic vomit/regurge
• History: Commercial dry food diet, periodic
dental prophylaxis, absent dental
homecare, gums remain inflamed and
plaque builds quickly
• Western Dx / Tx: Gingivitis with periodontal
deterioration. Requires 6 month recall for
prophylaxis
TCVM Approach
•Exam:
•Treatment Stategy:
•Constitution- Water
•Tongue- Violet, dry, no
coat
•Pulse- Deep, thready, and
quick
•Nourish Stomach Yin and
Clear Heat
•AP= CV 12 (aqua); SP 3,6;
ST 36,44; LI 4,11
•Herbs= Qing Wei San
•Gums- dry/breath
scorched
•Topical= Aloe Gel
•Coat Quality-Dry
•Diet: Fresh cooked food/
fish-pork-beef-eggsveggies
Ulceration: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Ulcer
•Symptoms
•Periodic pain
•Acid regurgitation
•Belching
•Vomiting
•Patterns
•Excess
•Stomach Cold
•Food Stagnation
•Liver Qi Stagnation
•Blood Stasis
•Deficiency
•Stomach Yin Deficiency
Stomach Heat
Pathogenic Heat
Yin Deficiency
Stomach Heat
channel
Gums
organ
grandchild
child
Cystitis
Ulcer
Colitis
Signs of ST Heat
• Clinical Signs
• Hot lips & mouth
• Bad smell from
mouth
• Thrist
• Stomatitis/Gingivitis
• Loss of or ravenous
appetite
• Dry nose & feces
• Pulse
• Superficial & fast
• Tongue
• Red with yellow
coating
• Treatment Strategy
• Clear ST Heat/Fire
• Generate body
fluids
Stomach Ulcers
•Mild
Happy Stomach
Angelica
Paeonia
Bupleurum
Aurantium
Trichosanthes
Pinellia
Citrus
Licorice
Taraxacum
Dang Gui
Bai Shao Yao
Chai Hu
Zhi Shi
Gua Lou
Ban Xia
Chen Pi
Gan Cao
Pu Gong Ying
Nourish & activate Blood
Nourish Liver Yin & Blood
Soothe Liver Qi
Move Qi & relieve pain
Promote body fluid & transform phlegm
Dry damp & transform phlegm
Move Qi & relieve pain
Harmonize
Clear Heat
•Moderate to Severe
Jade Lady
Gypsum
Anemarrhena
Rehmannia
Ophiopogon
Achyranthes
Shi Gao
Zhi Mu
Shu Di Huang
Mai Men Dong
Niu Xi
Clear Heat and cool Stomach
Clear Heat and nourish Yin
Nourish Yin and Jing
Moisten and nourish Yin
Bring the Qi flow down
GI Food Therapy
•Cabbage
•Contains glutamate
•Cools stomach & GI
•Spinach
•Stops hemorrhage
Acupuncture of ST Heat
• Clear Stomach Fire
• Shan gen, Wei jian,
Er jian, Yu Tang,
ST44 LI4/11, GV14
• Body Fluid Tonic
• KID3, SP6, SP9
05 Shan-gen Mountain base Xie-05
Shan-gen
GV-26
Ren
zhong
LO: on the dorsal midline of
boundary b/t hairy & non-hairy
areas
ME: Perpendicular insertion 0.3
cun
IN: Loss of appetite, sinusitis,
coma, shock, wind-cold, wind-heat
06 Ren-zhong/Shui-gou the center of man/water passage, Xie-07, GV-26
LO: At the intersection b/t dorsal and middle 1/3 of the philtrum
ME: Perpendicular insertion for 0.3 cun
IN: Coma, shock, fever, bronchitis, Lung Heat, facial paralysis
21 Hua-tuo-jia-ji at cervical region
LO: 0.5 dorsal to cervical vertebrae
IN: cervical stiffness, wobbler’s disease
22 Jian-wei, strengthen stomach
LO: Upper 1/3 of the jugular group,
Between vein and cervical vertebra
IN: Anorexia, vomit, stomach disorders
23 Lian-quan ridge spring
LO: At the ventral midline just cranial to throat.
CV-23
IN: excessive salivation, laryngeal hemiplegia
Pancreatitis: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Pancreatitis
•Considered any acute or
chronic change in GI
function usually
accompanied by some
degree of vomiting,
diarrhea and abdominal
pain
•Acute- -Mild
•Pancreostasis
•Acute- -Severe
•Fulminating pancreatitis
•Chronic
•Pancreatic insufficiency
•Rx Acute
•NPO
•Fluids
•Antiemetics
•Pain relief
•Low fat/protein food
•Rx Chronic
•Enzyme therapy
TCVM Acute Pancreatitis
TCVM Chronic Pancreatitis
* Enzyme replacement therapy still good to add
Perry
3 yr FS Springer
Earth personality
Acute onset of vomiting,
fever and abdominal pain
Increased thirst
Scant urination
Elevated Amylase & Lipase
Increased WBC
Rx: Fluids & Ranitidine
Tongue: red & dry
Pulse: fast & superficial
West Dx: acute pancreatitis
TCM Dx: damp-heat in spleen
Perry Treatment
•AP
•Next day was 80%
improved
•DN
•ST-45
•ST-36
•LI-4
•PC-6
•BL-20
•CV-12
•Aqua
•ST-36
•BL-20
•PC-6
•Herbal
•Great Saussurea Coptis
•Clinician said, “He is
doing absolutely
fantastic…better than
any patient in
years…NO…it wasn’t the
acupuncture…well…may
be we should try it
again!”
Great Saussurea Coptis
Saussurea
Mu Xiang
Move Qi & relieve pain
Coptis
Huang Lian
Clear Damp-Heat in the intestines
Evodia
Wu Zhu Yu
Warm the middle Jiao & stop vomiting
Bleeding: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Bleeding
•Primary Hemostasis
•Complex chain of events
involving interaction of
•Platelets
•Vessel Wall
•von Willebrand’s factor
•Fibrinogen
•Secondary Hemostasis
•Complex interaction of the
intrinsic and extrinsic
clotting cascades
•Stabilize the platelet plug
Primary Hemostasis
•Evaluated by the
bleeding time
•Platelet number
•Amount and Quality of the
von WIllebrand’s factor
VIII:Ag
•Fibrinogen concentration
•Other alterations due to
vessel wall disorders
Secondary Hemostatis
•Assessed by
•ACT (activated
clotting time)
•APTT (activated
partial thromboplastin
time)
•PT (prothrombin
time)
TCM Pathoetiology
•Heat
•Tongue
•Red & Dry
•Pulse
•Superficial (forceful)
& fast
•Spleen Qi Deficiency
•Tongue
•Pale & moist
•Pulse
•Deep & weak
(particularly on right)
Spleen Pathology
Damp Hot
Food or
Drink
Accumulated
Heat & Damp
Damp Hot
Environmental
Conditions
Damp-Heat in Spleen
Disharmony of Qi Flow
Transform & Transport Disorder
Heat Hemorrhage
•Herbal treatment depends
upon location
•Bladder
•Red Front Door
•GI tract
•Sophora Powder
•Great Saussurea Coptis
•Red Back Door
•Pulmonary
•Red Lung
•Nose
•Single Immortal
•Uterus
•Wu Bei San
Spleen Not Controlling Blood
Prolonged Spleen Qi Deficiency
Spleen Fails to Hold Blood
Hemorrhage
General Signs
Chronic Hemorrhage
Darby
•Signalment
•5 yr FS Doberman
•History
•Generalized weakness
•Ecchymosis
•Abdominal bleeding
•TCVM Exam
•Tongue: pale
•Pulses: deep & weak
Dx: Spleen Qi Deficiency
(not holding blood in vessels)
Darby
•Western Rx
•Compressive
bandage
•Hemorrhage control
•Cryoprecipitate
•Whole Blood
•Thyroid medication
•TCVM Rx
•AP
•SP Qi Tonic
•BL-20/21, SP-6, SP-9
& CV-6
•Stop Hemorrhage
•Tian Ping & BL-17
•Herbal
•Yunnan Pai Yao
•Huang Tu Tang
Huang Tu Tang
Atractylodes
Bai Zhu
Strength Spleen & tonify Qi
Yellow Earth
Zao Xin Tu
Warm Spleen & stop diarrhea
Aconite
Fu ZI
Warm Spleen
Asinum
Er Jiao
Nourish Blood
Rehmannia
Sheng Di Huang Nourish Yin
Scutellaria
Huang Qin
Stop bleeding & prevent excess heat
Licorice
Gan cao
Harmonize
Muscle Wasting: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
TCM Muscle View
•Muscle volume &
strength is under the
domain of the Spleen
•Spleen transforms food
and transports it to the
body to provide energy &
building blocks.
•Spleen Qi provides
muscle strength
•Liver blood provides
endurance
•Continued delivery of
Spleen Qi to muscles
Western View of Muscle Wasting
•Generalized Wasting
•Malnutrition
•Insufficient intake of materials
to support Spleen Qi
•Cardiac Cachexia
•Heart failure leads to stagnation
of blood
•Liver is unable to support
distribution of blood & Qi
•Leads to accumulation of Damp
in Spleen
•Results in Spleen Qi Deficiency
with failure to provide energy
and building materials to the
muscles
•Cancer Cachexia
•Tumor Necrosis Factor poisons
metabolism leading to Spleen Qi
Deficiency
•Diminished effective delivery
of energy to muscles
•Localized Wasting
•Trauma
•Local damage of muscle
•Disuse Atrophy
•Local stagnation results in Liver
failure to support
Spleen/Stomach
•Accumulation of Damp alters
Spleen function
•Local stagnation decreases
delivery of nutrients
•Neurogenic Atrophy
•Denervation leads to local liver
stagnation
•Results in failure to support
spleen Qi
•Leads to decreased delivery of
local channel energy
Wei Syndrome
Damp Heat
•Earth personality
•Obesity
•History of damp heat in skin or GI
•Muscle atrophy
•Weakness
•Lethargy
•Greasy wet tongue
•Fast pulse
Si Miao San
Qi/Yang
Deficiency
•Lethargy, shortness of breath,
weakness
•Too weak to get up to walk
•Loose lips
•Loose stool
•Anorexia & Emaciation
•Dry-burnt hair
•Edema
•Heat seeking
•Pale wet tongue
•Thready & weak pulse
Bu Yang Huan Wu
Qi/Yin Deficiency
•Emaciation
•Weakness in lumbar region
•Heat seeking
•Dry skin
•Pale or red & dry tongue
•Weak & thready pulse
Hindquarter
formula
Jake
•History
•Progressive weakness in
rear legs
•Cool seeking
•Rear leg muscle atrophy
•Dry hair & skin
•TCVM Exam
•Pulses deep & weak (< R)
•Red dry tongue
DX: Qi/Yin Deficiency
Jake’s Treatment
• AP
• EA
• SP6-SP9 (b), ST36 (b), LI10 (b), GV14-Bai hui
• DN
• BL20, BL23, BL26, KID3
• Aqua
• SP6, ST36, BL23, BL26
• Herbal
• Jia Bing Fang
Jia Bing Fang
Astragalus
Condonopsis
Polygonum
Rehmannia
Paeonia
Dioscorea
Prunella
Cyperus
Bupleurum
Sargassum
Huang Qi
Dang Shen
He Shou Wu
Shu Di Huang
Bai Shao Yao
Shan Yao
Xia Ku Cao
Xiang Fu
Chai Hu
Hai Zao
Laminaria
Kun Bu
Tonify Qi
Tonify Qi
Nourish Blood and Jing
Nourish Blood, Yin and Jing
Nourish Blood and soothe Liver Qi
Tonify Qi and nourish Jing
Soothe Liver Qi, clear Heat
Move Liver Qi and relieve nodules
Soothe Liver Qi
Transform phlegm, clear Heat, soften
the hardness
Transform phlegm, soften the
hardness, drain water
Sam
•History
•Chronic rear leg
weakness and muscle
wasting
•Dry hair
•Weight loss
•TCVM Exam
•Red dry tongue
•Weak thready pulses (< R)
DX: Qi/YinDeficiency
Sam’s Treatment
• AP
• DN
• GV20, BL20, BL23, BL26
• Aqua
• SP6, ST36, BL23, BL26
• Herbal
• Hindquarter formula (tea pills)
Hindquarter Formula
Eucommia
Du Zhong
Tonify Kidney & strengthen back
Achyranthes
Niu Xi
Tonify Kidney & strengthen the hind limbs
Lindera
Wu Yao
Move Qi and relieve pain
Astragalus
Huang Qi
Tonify Qi
Apis
Feng Hua Fen
Tonify Qi and Yin
Morinda
Ba Ji Tian
Warm and strengthen the back
Angelica
Dang Gui
Nourish Blood
Rehmannia
Shu Di Huang
Nourish Yin and Jing
Cinnamon
Gui Zhi
Warm the Channels and benefit the limbs
Diarrhea
Diarrhea
• Increase in fluidity
of feces leading to
soft to watery feces
• May contain
mucous & blood
• Increase frequency
• Chronic if greater
than 1 month
Diarrhea
• May include up to
27% of all patients
• 122 Horses with
acute diarrhea
(TA&M)
• 91 recovered
• 28 euthanatized
• 3 died
Diarrhea
• TCVM Patterns
• Excess
•
•
•
•
Cold Damp
Damp Heat
Food Stagnation
Disharmony between
SP & LIV
• Deficiency
• SP Qi Def
• SP & KID Yang Def
Diarrhea
Diarrhea
Obesity: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Obesity
• Body weight is 20% over ideal
• An intake of total dietary energy above that needed for
maintenance and production or exercise over a long period of
time
• Energy in is based upon
• Food intake
• Absorption
• Energy used is
•
•
•
•
•
Basic metabolic rate (thermoneutral condition)
Exercise
Lactattion
Pregnancy
Growth
In
>>
Out
Obesity: TCVM Classical Strategy
(1)
Yin Tonic Herbs (Remannia, Lycium etc)
Decrease in appetite
Decrease in food intake
(2)
Purgative herbs (Rheum, Cannabis Ma Zi Ren etc)
Passing food faster through SI
Less time to absorb nutrients
Decrease in absorption
(3)
Qi Tonic Herbs (Ginseng, codonopsis etc)
Energy boosting
Patient more willing to exercise
Burning down Fat tissue
Obesity: TCVM Etiology and Pattern
•Damp-phlegm
•Liver Stagnation
Excess
•Blood Stagnation
•Spleen Deficiency
Deficiency
•Kidney Deficiency
Damp-phlegm
Etiology
Water/damp
from food or
environment
Other pathogenic factors
Stagnation of
Water-damp
Spleen Qi Deficiency
Phlegm under the skin
Obesity
Damp-phlegm
Symptoms
. Overweight
. Swelling neck or belly
. fast respiratory rate, or cough or asthma
. Pulse: Fast, deep or slippery
. Tongue: pale or red with thick coating
. In people: obese smoker
. Overall: not weak
Treatment Strategy: Transform damp and resolve phlegm
Acupuncture treatment
1) needling: ST-36/40, BL-13, SP-6/9
or Electro-acupuncture (F=30 Hz) for local
swelling area
2) Message: Abdomen and back, twice a day.
Damp-phlegm
Herbal Formula
Citrus
Pinellia
Poria
Coix
Atractylodes
Areca
Benincasa
Alisma
Plantago
Cyperus
Phlegm Fat Formula (Citrus-Pinellia Compound)
Chen Pi
Ban Xia
Fu Ling
Yi Yi Ren
Cang Zhu
Da Fu Pi
Dong Gua Pi
Ze Xie
Che Qian Cao
Xiang Fu
8%
8%
10%
20%
8%
10%
8%
10%
10%
8%
Er Chen Tang
Resolve Damp
Liver Qi Master
Damp-phlegm
Max Formula
For lipomas
Fritillaria
Zhe Bei Mu
Soften hardness and clear nodules
Ostrea
Mu Li
Soften hardness and clear mass
Prunella
Xia Ku Cao
Clear Liver Heat and resolve nodules
Scrophularia
Xuan Shen
Clear Heat and cool Blood
Trichosanthes Tian Hua Fen
Clear Heat and promote body fluids
Platycodon
Jie Geng
Open the Upper Jiao and transform
phlegm
Rhubarb
Da Huang
Clear stagnation/stasis and clear Heat
Angelica
Bai Zhi
Clear Wind-Cold and relieve pain
Liver Qi Stagnation
Etiology
Emotional Stress
Drug Stress
Liver Qi Stagnation
Liver over-control Spleen
Spleen fails to transform Damp
Phlegm under the skin
Obesity
Liver Qi Stagnation
Symptoms: . Overweight
. Aggressive, or restlessness
. Hypertension
. irregular estrous cycling
. exercise intolerance, lassitude
. Pulse: Wiry and deep
. Tongue: purple or pale with coating or without coating
Treatment strategy:
Acupuncture:
Regulate liver, clear Fire and transform damp
Sp-6/9, ST-40
Liv-3, GB-20 and GB-34
Liver Qi Stagnation
Herbal formula:
Picrorrhiza
Prunella
Cassia
Rehmannia
Rheum
Cassia
Picrorrhiza Compound*
Hu Huang Lian
Xia Ku Cao
Jue Ming Zi
Sheng Di Huang
Da Huang
Pang Xie Ye
18%
19%
18%
15%
15%
15%
Clear Liver
Clear Liver
Nourish Yin/Blood
Purge LI
Blood Stagnation
Etiology
Stress
Other factors
Qi stagnation
Blood Stagnation
Qi-blood stagnation
Water/Damp retention in the body
Obesity
Blood Stagnation
Symptoms:
. Overweight
. lump in the body surface
. exercise intolerance, lassitude
. Pulse: slow and deep
. Tongue: purple with coating or without coating
Treatment strategy:
Acupuncture:
Invigorate Blood and transform damp
BL-17/SP-10
LIV-3, GB-34, LI-4
ST-40/BL-40
Blood Stagnation
Herbal Formula:
Carthamus
Ligusticum
Olibanum
Typha
Rheum
Stagnation Reliever
Hong Hua
Chuang Xiong
Ru Xiang
Pu Huang
Da Huang
22%
22%
19%
1 9%
18%
Move Blood, resolve stasis
Move Qi & Blood
Purge LI
Spleen Qi Deficiency
Etiology
Overwork
Water/damp
from food or
environment
Chronic illness
Spleen Qi Deficiency
Phlegm under the skin
Obesity
Spleen Qi Deficiency
Symptoms: • Overweight
• Diarrhea, or dry feces
• Hyperlipemia
• Eexercise intolerance, lassitude
• Pulse: Weak and deep
• Tongue: pale with coating or without coating
Treatment strategy:
Acupuncture:
tonify spleen qi and transform damp
ST-36/40/41, SP-2/3, and BL-20/21
Spleen Qi Deficiency
Herbal formula:
Nelumbo
Alisma
Poria
Coix
*Atractylodes
Atractylodes
Citrus
Cassia
Nelumbo Compound*
He Ye (Lotus)
Ze Xie
Fu Ling
Yi Yi Ren13%
Cang Zhu
Bai Zhu
Chen Pi
Jue Ming Zi
13%
13%
13%
13%
12%
10%
13%
Eliminate Damp, Strengthen SP
Drain Damp
Resolve stagnation, clear Liver
Herbal Formula: Astragalus-atractylodes-lycium
Astragalus
Atractylodes
Lycium
Huang Qi
Cang Zhu
Gou Qi Zi
34%
33%
33%
Kidney Qi Deficiency
Etiology
Chronic illness
Other factors
Kidney Qi Deficiency
Water retention
Phlegm
Obesity
Ageing
Kidney Qi Deficiency
Symptoms:
. Overweight
. Often occurs in the aged patient
. Difficulty in walking or standing, or chronic back pain
. Bone degeneration or osteoporosis
. Pulse: Weak and deep
. Tongue: pale with coating or without coating
Treatment strategy:
Acupuncture:
tonify Kidney qi and transform damp
Bai-hui, Shen-shu, Shen-peng, Shen-jiao
Bl-23/26, SP-6 and Kid-3
Kidney Qi Deficiency
Herbal formula:
Psoralea
Notoginseng
Rheum
Cassia
Psoralea Pill
Bu Gu Zi
Tian Qi
Da Huang
Fan Xie Ye
32%
9%
30%
29%
Tonify Kid Qi/Yang
Move Blood
Purge LI
Kobe
9 yr MC Siamese
Obesity (14 lb)
Less playful and less activity
after moving to a new place 3
weeks ago
Warm-seeking
Tongue: pale & swollen
Pulse: deep & weak
Kidney Qi Deficiency
Rx: Psoralea Pill
Henrietta
12 yo FS Dachshund
Overweight
Able to get around with
support
Pants a lot with slight
cough
Pulse: Fast & deep
Damp-Phlegm
Tongue: red
Rx: Phlegm Fat
Formula
Constipation: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Regulation of Colon Function
•Colon is like the urinary
bladder
•Innervation by
•Sympathetics from L2-3
•Parasympathetics from
S1-3
•Filling Phase
•Sympathetics
•Yin
•Emptying Phase
•Parasympathetics
•Yang
Propranolol @ 0.25-0.5
mg/kg TID
Constipation
•Definition:
•Constipation
•Infrequent or
incomplete bowel
movements
•Feces are drier or
harder
•Obstipation
•Intractable
constipation
•Impossible defecation
•Patterns
•Heat
•Qi Stagnation
•Qi Deficiency
•Yin/Blood Deficiency
Stomach Heat
Pathogenic Heat
Yin Deficiency
Stomach Heat
channel
Gums
organ
grandchild
child
Cystitis
Ulcer
Colitis
or
Constipation
Differentiation
HEAT
Qi Stagnation
Qi Deficiency
Blood/Yin
Deficiency
Onset
Acute
Wood Person.
Chronic
Chronic
Stool
Dry
On/Off
Small/Thin
Dry
Mucus
Yes
No
No
No/Yes
Thirst
Yes
No
No
Yes
Urination
Short
Normal
Long
Short
Abdm. Pain
No
Flank
No
No
Mouth odor
Foul
No
No
Slight
Preference
Cool
None
Warm
Cool
Purple
Pale
Pale/Red
Tongue color Red
T. Moisture
Dry
Normal
Wet
Dry
T. Coating
Yellow
Normal
No
No
Pulse
Fast/Wiry
Wiry
Weak
Weak/Thready
Constipation/Megacolon
Heat
•Acute onset of colic
•Hot ear & nose
•Cool seeking
•Thirsty
•Foul breath
•Swollen upper palate
•Red & dry tongue
•Fast pulse
Da Chang Qi Tang
Qi Stagnation
•Sub-acute onset of colic
•Bloat & abdominal fullness
•Gaseous bowel movements
•Anorexia
•Purple or red tongue
•Wiry, fast pulse
Xiao Zhang San
Qi Deficiency
•Chronic constipation or colic
•Anorexia
•Loss of body mass
•Weakness
•Pale tongue
•Deep & weak pulse
Fan Xie Ye
Yin/Blood
Deficiency
•Very chronic megacolon with impaction
•Dry flaky skin
•Weak or geriatric patient
•Pale or red, dry tongue
•Fast, weak & thready pulse
Dang Gui Cong
Rong
Acupuncture
Heat
Qi
Stagnation
Qi
Deficiency
Blood/Yin
Deficiency
Points
LI-4
LI-10
GV-1
BL-21
ST-37
LIV-3
GV-1
GB-34
ST-36
SP-6
B-21
BL-15
SP-6
SP-10
GV-1
Method
q d 3d
1-3 times
q wk
2-4 times
q wk
2-5 times
q wk
3-7 times
Kitty Little
15 yr FS Persian
Chronic constipation with
impaction
Dry flaky skin with dandruff
General weakness
Tongue: red & dry
Pulse: deep, weak & thready
Yin/Blood Deficiency
Rx: Dang Gui Cong
Rong
Molly
13 yr FS Maine Coon
Earth personality
Frequent constipation with
impaction
Colon cleaning under
anesthesia 5 times in past 2
years
Recent inappetence
Vomits undigested food with
impacted
Rx: Lactulose & Cisapride
First visit:
No BM for 5 day
Abdomen filled with fecal
balls
Dry haircoat
Warm seeking
Tongue: red & dry
Pulse: weak
Molly Dx
Earth personality
No BM
Dryness
Red & dry tongue
Earth element
(SP/ST)
Yin Deficiency
Weak pulse
Anorexia
Decreased thirst
Qi Deficiency
TCVM Dx: SP/ST (LI) Yin & Qi Deficiency
Molly Rx
Acupuncture:
DN: GV-20, CV-12, ST-25
EA: (10 minutes @ 20 Hz & 10 minutes @ 80-120 Hz)
BL-21, BL-25, ST-36- -ST-37 (bilaterally)
Owner reported that Molly defecated a long firm stool 10-16
hours after acupuncture and continued to have BMs every 2-3
days. Stool still dry & still warm seeking.
TCM Herbal:
Ma Zi Ren Wan + Fan Xie Ye