Public Lecture: Indigestion

Most of patients I see have some types of Indigestion issues. It is truly rare to see someone who has pains but has no digestive issues. If you don’t have any digestive issues and have optimum absorption of nutrition, your Zheng Qi, or healing energy would be adequate and would not need treatments.

In these videos, Yumi will explain how indigestion is understood and treated in Chinese Medicine.

Free Public Lecture : February 03, 2020.

Case Study: 53y.o Female, life long debilitating headache resolved in one week with Chinese Medicine

She came to me to treat life long headache that she had had everyday for as long as she can remember.

Her headache was on the front of the head, side of the head, back of the head and top of the head. When she has a migraines, they usually started from the right temporal region, however, she could have regular headaches in both side. There is also throbbing nature in the temporal headache

Her headache was worsened with certain weather such as cold and damp day, with certain foods as she had digestive issues as well, and with stress and fatigue. She said the headache was sometime better with use of essential oil and pain relief medicines such as ibuprofen.

Other relevant symptoms

  • low energy 5/10
  • feel cold and warm (she feels cold until she has a hot flash)
  • poor body temperature control (always too hot or to cold)
  • upper body is warm and lower body cold
  • hands and feet cold
  • hot flash
  • disliking being exposed to wind, cold and damp weather, humid hot (like Ontario summer)
  • spontaneous sweat and night sweat
  • running nose
  • sinus congestion
  • neck and shoulder tightness and pain
  • constant low back pain that is better with resting,
  • hip pain that is better with exercise but cannot over do it
  • leg muscle clamps (once a month)
  • high pitch tinnitus,
  • bitterness in the mouth
  • cough and phlegm in a morning which is yellow phlegm
  • bleeding gum
  • dry mouth
  • throbbing headache
  • thirst with no desire to drink water
  • multiple thoughts in night time disturbing her sleep
  • hard to fall asleep, dreamful, disturbing dreams
  • light sleeper
  • wake up tired and heavy – it is better with exercise
  • constipation or dry stool w/o magnesium
  • sticky, smelly stools, occasional feeing of incompleteness
  • foggy head, confusion
  • poor mental stamina
  • occasional dizziness
  • bloating
  • frequent urination (water go through her)
  • poor night vision, dislike light during headache
  • history of uterine fibroids, dysmenorrhea (painful menstruation)
  • depression (not medically diagnosed but feeling of it)
  • sadness, grief, lack of joy
  • impatience, occasional uncontrollable anger
  • negative thinking
  • tongue – swollen, teeth marks, thick white tongue coating
  • pulse – thin weak hasty pulse

Her main concern is her headache that she gets in her forehead, right side which usually become migraines, and in the occipital area that radiates up. Frontal headache is due to damp retention in the frontal cortex. The dampness is often comes from the digestive system and it ascended to the head to cause the headache. Often dampy weather and pressure in the air can cause this type of headache. Pressure behind of eyes is the same logic. Side headache that happens in one side or both sides are usually from the poor circulation of Qi and the Blood, and can be triggered with stress, fatigue and at the end of the day. Occipital headache is from the tight muscle of the neck and the shoulder or from the getting a cold. Also top headache is often from the fatigue and Blood deficiency.

For her, her issues started from her digestion. Her poor digestion failed to digest food and undigested rheum started to accumulate. Eventually the dampness travelled up to her head and caused the frontal headache. Her ongoing stress impaired the Qi circulation and triggered the temporal headache. The stress and constant pain caused her muscle to be tense and that caused the occipital headache.

Diagnosis in Classical Chinese Medicine: Tai Yang, Shao Yang, Yang Ming, Tai Yin and Blood deficiency and the stasis.

Formula 1: Da Chai Hu Tang – With her temporal headache, one side tinnitus, bitter taste as well as poor digestion, she fits Shao Yang syndrome. With her difficulty in her bowel movements and bloating as well as her blood deficiency indicates for Da Chai Hu Tang.

Formula 2: Gui Zhi Fu Ling Wan – The history of fibroids and painful menstruation is the sign of blood stasis. Also her emotional challenges, warmth in the body and again her difficulties in defecation fits Gui Zhi Fu Ling Wan.

Modification: Shi Gao (for irritability, bleeding gums and dry mouth), Sun Zao Ren (for her difficulties in falling asleep), Chuan Xiong (for her headaches and is a part of Suan Zao Ren Tang), Zhi Zi (for her negative thinking and feeling of “stuck in ife”), Long Gu & Mu Li (to stop spontaneous and night sweating), Jie Geng (sinus congestion)

Chai Hu 12, Huang Qin 10, Ban Xia 18, Zhi Shi 10, Bai SHao 20, Da Zao 20, Sheng Jiang 15, Zi gan cao 6, Da Huang 6, Gu ZHi 15, Fu Ling 20, Chi Shao 15, Mu Dan Pi 10, Tao ren 10, Shi Gao 45, Suan Zao Ren 20, Zhi ZI 10, Jie Geng 12, Long Gu 30, Mu Li 30, Chuan Xiong 6

Scalp Acupuncture: Du 20, and Liver lines (on her temples)

Body Acupuncture: Wheel of Life (RN12, 6, 4, ST25, 21), ST36, GB34, SJ5, SJ6, LI4, LR3, SP9, Hand Shao Yang Water (to nourish KD water)

Result: After her first week dose of herbs and the acupuncture treatment, her headache disappeared. Also her night sweating and tinnitus disappeared. Back/knee pain, alternating chills and warmth of body temperature improved. her emotion and cognition as well as bloating is about 50% improved. Sinus congestion still fully remained.

Follow-up treatments: same acupuncture + SJ2. Same herbs with increased Jie Geng.

Every week, she shows improvements. She is enjoying her life without headache at all!!

54 years old male: hypersensitive in smelling and headache from it

Male 54
He is extremely sensitive with chemical smell. There is a plastic factory near his house, and the smell gives him daily. He feel if nothing helps he has to move!  He even suffers from the smell of the heater in his car during winter time.
MC: headache and tight chest due to certain smell  for 7 years
Smell is mostly chemical smell, developed working in a factory he was working.
Also he has daily headache and tight chest from factory smell near the house.
His reaction is immediate.
  • Nothing alleviates the symptoms. Just avoiding the smell is only way to cope with the issue, so close the windows and such
  • worse with staying in the environment
No western diagnose, went through a few tests, but all came negative.
  • Pain – Low back (diagnosed with degenerative disc, and was very severe and had to quit working. No surgery was done. Better now with some training and acupuncture)
    • Usually pain is 1/10 but if he moves and do something wrong, can give 6/10 pain, which is better with rest, heat and acupuncture.
  • Pain 2 – shoulder and arm – numbness, pins and needle feeling. He thinks it is from knots in the shoulder. better over time.
Other symptoms:
  • No tremor, No skin issues.
  • Night sweat once a while, not often.
  • Aversion to cold, damp cold, and summer heat (like dry heat)
  • Cough with phlegm, easy to expectorate, rice porridge like chunks (clear, yellow, can be brown)
  • Sore throat last 2-3 days, often clearing throat
  • No thirst particularly, but like drinking warm all day. Summer drinks lots of cold. But like drinking cold beer. occasional coffee, 10-15 beers a week.
  • Appetite OK, no symptoms before and after meal. Eat breakfast ok.
  • 2-3 meals a day with fast food lunch 1/week. Feel binge eating once a month.
  • Urination is 4-6 times a day, but more with coffee. 0-2 night time urination.
  • Stool is loose with vegetarian food which he eats everyday, but if he eats any animal (meat, tuna) stool is formed. Everyday 1-2 a day.
  • Sleep good. often remember dream, but no issues with sleeping.
  • Easy to get overwhelmed, stressed out, irritable, once a while get angry.
  • Libido ok, but takes effort to have an orgasm.
  • Pulse: Not rapid, not, wiry, not slippery, not tight or thin… may be large?
  • Tongue Pink, swollen, crack

image.png

Diagnosis: Three Yang Tai Yin 

  • Tai Yang – Back and Shoulder pain, Night Sweat
  • Yang Ming (Secondary Damp Heat –> most severe) – Aversion to heat, summer heat, irritable, Night Sweat, vivid dreams
  • Shao Yang (mild) – upper heat
  • Tai Yin body fluid deficiency –> root cause – sensitive smell, loose stool, frequent urination, phlegm, easily overwhelmed

Formula: Chai Hu Jia Long Gu Mu Li Tang minus Da Huang plus Zhi Zi, Jie Geng, Hou Po, Shi Gao, Cang Zhu

Chai hu 12g, Huang qin 10g, dang shen 10g, Ban xia 25g Sheng jiang 15g, Da zao 20g, Gui zhi 20g, Fu ling 15g, Long gu 20g, Mu li 20g, Cang zhu 20g, Zhi zi 15g, Jie geng 12g, Hou po 10g, Shi gao 45g.

One months later: No shoulder pain or any pain, Phlegm changed to thicker and sticker brown phlegm. The neighbour plastic factory was still generating the chemical smell, so headache was still there. However, he said his mood is much better.

Continued the same herb for another month. Then his night sweat disappeared. No aversion to wind and cold.  His mood and irritability is still remain good. I added Da Huang 3g and Huang Lian 3g. He had loose stool, but with the low dosage Da Huang moves stagnation of Qi, Blood and Dampness.

One month later he said he did not have headache from his car this winter.

 

 

 

36 years old Female: Infertility, Depression, Unconctrollable Emotion

36 years old Female: Infertility, Depression, Uncontrollable Emotion

This female patient was so stressed out about having a child. Her emotion has been always sensitive and depressive side, and this devastation of not being able to get pregnant was overwhelming her. She had feeling of hopelessness, lack of purpose in her life, and obsession about getting pregnant. She did not go to see a doctor about her emotional challenges, however, it was definitely troubling her. When She came to see me, she gets sad by watching a woman with a baby.

Main Concern 1: Infertility

She has been trying to conceive for a year without any success. No history of miscarriage.

Main Concern 2: Depression, Negative feeling, uncontrollable emotion.

She feels grief, anger, disconnection, no sense of belongingness. She feels there is no meaning in her life and no purpose in her life. She was not suicidal; however, she often felt she wish she were dead. She had done some self harming with uncontrollable rage. Emotion is worse after menstruation.

This emotional disturbance is a result of Yin and Yang imbalance in her.

The Dampness and Phlegm that was produced in the digestive system have sent up to the brain to mist the mind. This cause inability to see the future clearly. The overwhelmingness is due to body fluid depletion. She easily cries, and this is also caused by the lack of body fluid.

pexels-photo-568027

Pain;

  • Ache in arms, wrists, hands, fingers due to overuse. They are better with resting.
  • Ankle pain on the right. She often fells and twists her ankle.

Other relevant symptoms:

  • Dislike wind, draft, cold, damp, summer heat
  • Occasional runny nose
  • Mild tinnitus
  • Desire to drink warm, but cold in night time
  • Vegetarian diet
  • Frequent urination
  • Frequent bowel movement, every time she urinate some pieces of stools come out
  • Stools can be formed, loose, undigested rice. Hard stool before menstruation.
  • No issues with sleep
  • Irregular menstruation
  • PMS includes sore and enlarged breast, mood, lower abdomen bloating
  • Bleeding for 3 days (not enough?) and there are clots
  • Pulse – Rapid and thready
  • Tongue – Red with white coating

Diagnosis: Tai Yang, Shao Yang, Yang Ming, Tai Yin, Blood and Body Fluid deficiency with minor blood stasis

  • Tai Yang – Ankle pain, aversion to wind, occasional runny nose
  • Shao Yang – Emotional disturbance, fertility issues, PMS, tinnitus
  • Yang Ming – This Yang Ming heat is due to Blood and Body Fluid deficiency. Irritability, vexation.
  • Tai Yin – emotional disturbance, frequent urination, frequent bowel movement
  • Body Fluid deficiency – emotional sensitivity, easy to cry
  • Blood Stasis – clots in menses

*** I could not really pinpoint why she cannot get pregnant. however, the too frequent bowel movement is an indication of weak Intestine. Wellness of one’s Intestine realistically determines one’s health and longevity. I am certain that it is difficult for her to get pregnant unless the bowel movement is corrected.

Formula: Chai Hu Jia Long Gu Mu Li Tang + Dang Gui Shao Yao San, – Da Huang, – Ze Xie, + Zhi Zi + Yi Yi Ren, + Ai Ye

  • Chai Hu Jia Long Gu Mu Li Tang is a Shao Yang formula which treats Shao Yang and Deficient Yang Ming. Exterior syndrome, Tai Yang in this case, cannot be treated without resolving Shao Yang syndrome. The patient has Deficient Yang Ming, so this formula is perfect. Da Huang is omitted due to her frequent bowel movements.
  • Dang Gui Shao Yao San is Tai Yin formula which nourish and move Blood and expel Dampness at the same time. Blood and damp often get stagnate together. Also, when the Blood is nourished, often it also aaccumulates dampness. Therefore, in Jing Fang, Dang Gui Shao Yao San is more often used than Si Wu Tang. Ze Xie is removed die to her frequent bowel movement.
  • Zhi Zi is added for her negative way of thinking.
  • Yi Yi Ren is added to nourish body fluid and expel Damp Heat.
  • Ai Ye is added to nourish Blood, and calm the fetus.

Chai Hu 12, Huang Qin 10, Ban Xia 20, Dang Shen 10, Sheng Jiang 15, Da Zao 20, Gui Zhi 12, Long Gu 15, Mu Li 15, Fu Ling 20, Dang Gui 10, Bai Shao 15, Chuan Xiong 6, Cang Zhu 20, Zhi Zi10, Sheng Yi Ren 30, Ai Ye10

Result: After 2 doses, the patient felt noticeably improvement in her emotional stability. Bowel movement seemed to be better. She still finds struggle here and there, so she continue taking the formula.

She is quite pleased that the negativity seemed to be subsided. Small matters don’t shake her emotion as much as used to. She is more grateful for the life. However, after the menstruation, with Blood depletion, her emotion is a lot more shaky.

48 y.o Female: Depression, Poor digestion, Fatigue

This female patient came to see me for 3 health concerns.

  1. Depression: All her life, she suffered from depression on and off. However, previous few months, her depression had been quite bad. Every morning, she had to struggle to get up and look for a reason to get through this day. It was hard to motivate herself to do anything. Her emotional difficulty includes sadness, numbness, discontentment, depression, sensitive heart, disconnection, emotional turmoil etc. Her feeling of loneliness was eating her inside out. She was not taking any antidepressant medication; however, she was going to hot yoga classes to make her feel better. Unfortunately, excessive sweating from the hot yoga further depleted her body fluid, which contributed to worsen the symptoms.

  1. Digestive issues: her digestion was messy. She cold have bloating after eating most of anything. Meat was the only thing she did not get bloated. She started having the digestive issues when she had her first child 20 years ago. The digestion was worse with stress, better with not eating.
  1. Fatigue: because she didn’t know what to eat, she started avoiding to eat. She was easily fatigued. She woke up fatigued. She had standing job, and it was very difficult for her to do anything at home after coming home from work. She was physically as well as mentally fatigued.

She also had pains.

  1. Right foot, sole, for almost 2 years. The pain is dull and fixed pain. It is better with rest, and worse with overuse. The pain can be so severe that she sometime had to hop around with the opposite foot.
  2. Left breast pain. There is no lump. The pain is unrelated with menstruation. It is worse with stress.
  3. Lower abdominal pain due to fibroid. Pain occurs after ovulation with stretch. The size of the fibroid is unknown. It was 1 cm over 10 years ago.

Other relevant symptoms:

  • Dislike to wind, cold and damp environment. Exposure to wind can give her headache in the occipital area.
  • Body feels cold. Feet and hands are cold.
  • Blurry vision, poor vision, poor night vision
  • Mild tinnitus or ringing in the ears
  • Metallic taste in her mouth
  • Low appetite due to the bloating issue
  • A soft goiter on the throat
  • Heart palpitation after eating
  • Smelly and incomplete stool
  • Thirst with desire for cold drinks
  • Sleep issues
    • Interrupted sleep due to excessive thoughts
    • Wake up too early, and can’t go back to bed
    • Dreamful
    • Wake up tired
  • Vaginal discharge – one day a month, she had excessive vginal discharge that was colourless, odorless, watery and profuse
  • Lack of libido
  • Menstruation issues
    • Pain in the second day and feeling of heaviness
    • Low back soreness
    • Bloating
    • Moodiness
    • 3 days bleeding with 7 days of spotting to follow
    • Clots
  • Pulse is thready, not rapid
  • Tongue is pale, bite marks, moist, thicker tongue coating at the root and it was geographic.

Jing Fang Diagnosis: Shao Yin, Jue Yin, Tai Yin, Yang Ming with Blood stasis and deficiency

  • Shao Yin – Pain that is worse with overuse, dislike wind, cold and damp
  • Jue Yin – Cold feet/Hands, dislike of cold, tinnitus, metallic taste in the mouth, thready pulse, high stress
  • Tai Yin – internal cold, depression, heart palpitation after eating, bloating, low appetite, soft goiter, profuse vaginal discharge, severe fatigue
  • Yang Ming – thirst for cold, wake up too early,
  • Blood Stasis – fibroids in her lower abdomen, clots in menstrual blood
  • Blood Deficiency – blurry vision, poor vision

Formula 1 November 17, 2018

Chai Hu Gui Zhi Gan Jiang Tang with Long Gu, Fu Ling Yin, Dang Gui Shao Yao San, Zhi Zi, Yi Yi Ren

  • Chai Hu Gui Zhi Gan Jiang Tang is a Jue Yin formula which clears heat in the head and the chest, nourish body fluid to treat dry heat, and consolidates existing body fluid and stop excessive sweating.
    • I added Long Gu to support sweat inhibition because she goes to hot yoga and like sweating out.
  • Fu Ling Yin for her bloating and abdominal distension
  • Dang Gui Shao Yao San for her fibroids in the lower abdomen, and to nourish her blood
  • Zhi Zi is to clear heat from everywhere and calming the spirit
  • Yi Yi Ren is to promote body fluid while releasing pathogenic rheum.

Chai Hu 12g, Gui Zhi 10g, Gan Jiang 10g, Tian Hua Fen 12g, Huang Qin 10g, Mu Li 15g, Long Gu 15g, Zhi gan Cao 6g, Fu Lin 12g, Dang Shen 10g, Zhi Shi 10g, Chen Pi 30g, Sheng Jiang 15g, Dang Gui 10g, Bai Shao 15g, Chuan Xiong 6g, Bai Zhu 10g, Ze Xie 10g, Zhi Zi 15g, Sheng Yi Ren 30g

November 24th Update

After one week, she experienced

  • Less bloating
  • A lot more appetite
  • Sleep is better
  • Fatigue is still there
  • Depression is still there

I continued the same formula, suggested her to start eating.  To treat the persistent fatigue, I added Fu Zi (Bai Fu Pian) 6g.

December 8th 2018 Update

After one week, she experienced

  • Bloating is not worse but it is still there
  • “bad bad anger”
  • Fatigue is still there
  • Depression is still there
  • Pain has not resolved
  • Chest Oppression is a lot better

I continued the same formula with the following modification

  • Eliminate Fu Zi
  • Increased Tian hua Fen to 18g
  • Added Shi Gao 30g
  • Increased Bai Shao and Zhi Gan Cao to 18g each to make Shao Yao Gan Cao Tang.

February 17th 2019 Update

  • Depression is better, but anxiety is worse
  • Joint pain on the left side that wakes her up in there night is new
  • Tinnitus
  • Metallic taste
  • HT palpitation is better

Diagnosis: Three Yin Yang Ming with Blood depletion and Ben Tun syndrome

  • Ben Tun syndrome is exterior Interior concurrent causing dampness in the Brain.
    • Symptoms includes anxiety, insomnia, band-like headache etc

Formula: Gan cao Xie Xin Tang + Gui Zhi Fu Ling Tang w/ Jie Geng, Long gu, Mu Li Zhi Shi

Zhi Gan Cao 10g, Dang Shen 10g, Da Zapo 25g, Huang Qin 10g, Huang Lian 10g, ban Xia 25g, Gan Jiang 10g, Gui Zhi 20g, Fu Ling 25g, Tao Ren 10g, Dan Pi 10g, Jie Geng 12g, Long Gu 30g, Mu Li 30g, Zhi Shi 15g

  • add Shi ago if she has anger

February 28th Up Date

  • Bloating has been back. Will add Fu Ling Yin on the next formula.
    • add, Cang Zhu 15g, Chen Pi 30g, Sheng Jiang 15g
  • The formula seems to be helping for sleeping