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Clinical manifestations:

Main complaint:

• Loose stools, one week, worse at nighttime after work

 

Other symptoms:

• Tired, worse at nighttime
• Insomnia
• Irritability due to problem with wife last month

 

Pulse:                   Xuan mai (string), Shu mai (fast)

Tongue:               Movement, red tip and big hypoglossal vessels

 

Analysis:

Main complaint:

• Loose stools, one week, worse at nighttime after work Spleen yang xu, Info

 

Other symptoms:

• Tired, worse at nighttime Qi xu, info
• Insomnia Heart yin xu
• Irritability due to problem with wife last month Elevated activity in Hun, liver qi stagnation

 

Pulse:                   Xuan mai (string), Shu mai (fast)                               Liver qi stagnation, Heat

Tongue:               Movement, red tip and big hypoglossal vessels                 internal wind, heart yin xu, liver qi stagnation

 

 

Discussion:

This patient has problem with his wife. When he is at home he starts to accumulate activity in Hun. Something that results in that Hun passes its Duliang and he develops Liver qi stagnation.  This problem are increasing and we find the Duliang mirror Hun in Po creating liver Zang overact on Spleen. Making the Liver not sending sufficient Yang to the Spleen and the Spleen Zang develops a Yang xu situation. The main symptom of the Spleen yang xu is loose stools. Do not forget that this Spleen yang xu are relatively new in nature, but its cause the elevated activity in Hun might be old and intensified recently. The Liver qi stagnation resulted by the elevated activity in Hun creates an interruption of the circulation of Xue in the body. We find this interrupted Xue circulation creates enlarged hypoglossal blood vessels. The increased tension in the house between him and his wife creates a tension in the body of the person that transforms itself to an inner wind; something that manifests in the movement of the tongue. When the liver withholds Xue due to the liver qi stagnation we find the heart receives less Xue and as a result it develops a heart yin xu and thereby increases the cardiac frequency. Xue circulates faster in the body and the person gets a fast pulse and a red tip of the tongue. The level of tension is that high that the muscles within the blood vessels start to contract and the result is a stringy pulse. This all together drains him for forces and over time he develops a Qi xu.

 

 

Diagnosis

The Problem with his wife creates an elevated activity in Hun and Liver qi stagnation.

 

Main diagnosis:

Elevated activity in Hun

 

Treatment principle:

Find a solution to the problem with the wife.

Calm Hun

Stimulate Qi

 

Point selection:

UB47                     (Hun men:Hun Gate)                                     Movement point to Hun

GV4                       (Ming men: Life gate)                                    Special point for stimulating Zhen qi

UB40                     (Wei zhong: Bend Middle)                           Special point for mental problems

GB21                     (Jian jing: Shoulder well)                               Special point to move Qi

LI18                        (Fu tu: Protuberance Assistant)                 Window to heaven point

 

 

Explanation point selection:

All needles are neutral stimulation with 20 minutes retention; except LI18.

 

First

The patient is put on his stomach. Set the needles bilateral inUB47, GV4 and UB40. UB47 will calm the elevated activity in Hun. GV4 will generate more qi in the body of the patient. UB40 is a special point for mental problems. It is used to start circulating the psychic qi in the divergent meridians. Then moxa is put on top on GV4; heat lamp also works.  The extra heat on GV4 creates even more qi in the patient since this will stimulate Zhen qi and kidney yang.  Finally, you put a needle in GB21. This acupuncture point will move excessive psychic qi from the head and down. This will reduce the tension and create a calmer environment for the patient. This calmness might make the person take a better decision in relation to the problem with his wife.

 

Second

The patient sits up with his feet hanging from the table. Set LI18 bilateral with neutral stimulation and no retention. This point will open the window in the patient; meaning that the patient will speak more willingly with you and his wife after this stimulation. This point will make a better connection between the mind and the vocal cords through circulating psychic qi to the vocal cords. Speak with the patient and try to create a strategy regarding the problem in the house with his wife.

 

Prediction

Estimated time before the elevated activity in Hun has recovered depends fully on solving the problem with his wife.

 

 

 

 

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