|Posted on Friday, December 03, 2010 - 14:15: |
I have a patient(68)who has been experiencing 24-36 hr fevers every 2-3 weeks since 2003. He phoned me to say he had another less severe episode the day after I last treated him. Since I have been trying to expel the trapped pathogen, I had told him to expect this possibilty. I have used DU14, SJ5 & LI11, as my main points, but also tried to boost his immune system with Back Shu pts(BL13,17,19, 23 & 43)and distal SP6, KID 3 & 7. I am conscious of not using too many needles or strongly moving points, as he is quite Qi Xu. His temperature is usually lower than normal.
As it is crucial to clear and tonify at the correct times with this condition, I am wondering how to proceed for my next treatment in 4 days: focus on clearing, on tonifying qi or continue with both? Any suggestions/alternative point prescription would be most appreciated.
|Posted on Sunday, December 05, 2010 - 20:18: |
Hi Kevin, sorry for this delay in my response. Shao Yang syndrome is above all indicated when there exist alternating fever and chills. This is not the case apparently. Being unable to examine your patient myself, and according to the symptoms you have mentioned etc., it seems to me that, in view of the long duration of this disease, you should concentrate on tonifying his Yin and Qi and pay less attention to the residing pathogen. Tonification will eventually boost also his wei qi and his body will hopefully be able to contain the residing pathogen. You may need also a herbal supplement in order to achieve that. If you can elaborate a little I might be able to be more precise.
|Posted on Monday, December 06, 2010 - 13:00: |
Thanks Schmuel.I agree the apparent lack of alternating chills is somewhat confusing.
His pulses are rapid, fine, deep & Xu, KID positions especially faint. Tongue is dry with dirty grey coat, slightly yellow patch at centre rear. He had a spot on the lung approx 10yrs ago, which was found to be inflamed lymphatic tissue; part of the left LU was removed as precaution. He has had endless blood tests which reveal nothing more than raised white cell counts, He has also had dental problems (which can cause unexplained fevers) but this has apparently been resolved. I have only treated him twice and the latest episode was more or less cosistent with the timing of his attacks, as well as being the day after treatment.I think they usually occur in the evening, but need to check this. Emotionally, he seems very relaxed and describes his condition as merely "inconvenient". His complexion and whole body is very pale & I think Blood Xu is definitely part of the picture, so agree with tonifying Blood/Yin. My only concern is the risk of tonifying the pathogen. I have had Qing Hao Su suggested as a possible herbal supplement, as well as bleeding DU13, but I am not sure about the latter because of his deficiency. Thank you for your consideration of this case. If there's anything else I can tell you please say.
|Posted on Tuesday, December 07, 2010 - 07:36: |
I would suggest:
Li-4/ 11 - mild dispersion
K-3/ Sp-6/ Ren-4/6 - reinforcing. Moxa on needle of Ren-4 only if it causes him a pleasant sensation (to bring down the empty fire to its core).
L-5/ B-13 even manipulation.
Du-14 gentle dispersion
B-23 reinforcement with warm needling.
This should be carried out every other day until fever subsides. Hope this works for him.