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Posted on Wednesday, November 05, 2003 - 19:04:   

I am a fresh Acupuncturist from Beijing. Previously I was family physician but now I am practising Acupuncture for the last 6 mths.
I have come across a paediatrician who underwent Radiotherapy for squamous cell carcinoma. His primary site could not be detected but one submandibular lymph node was positive which waas taken out and RT given.Aftter 18 mths. he developed ulcer on the lateral side of tongue. Biopsy of ulcer was negative. Ulcer is 2 inches x 2 inches and avascular. It is extremely painful non healing ulcer. TCM exam. reveals
Poor apetite
Aversion to cold
Diarrhoea (??due to purely liquid diet)
Insomnia( Late to sleep & on waking up,difficult to sleep again)
No taste in mouth due to lot taste buds during RT
Dry mouth(Uses artificial saliva since after RT)
Feels like crying due to suffering
Previously he was very dyanamic person but now feels depressed
Tongue- Partially peeled with normal color.
My diagnosis is Yin Deficiency, Heart Blood deficiency.
I have started with needling
PC - 6
HT- 7
LU - 9
K - 3
K - 7
ST - 36
LI - 4
Only 4 sittings have been given. Do you think
1) I can do good to the patient's pain and healing of ulcer
2) My prescription needs changes.
Please guide

Dr. M..S.Ag.
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Shmuel Halevi
Posted on Thursday, November 06, 2003 - 13:00:   

Hello Dr. M..S.Ag.
It's difficult to make a diagnosis merely on the basis of the data you have given, and without taking the pulse. It, nevertheless looks like a case of excessive Fire that should be addressed before the YIN or other deficiencies should be taken care of.
For this you should use, with sedation technique:
P-8/ P-7/ P-9 (bleeding)
St-4/ Jin Yue (bleeding) All on the affected side only, and: St-44/43/36
Besides, you should apply herbal gurgling to the mouth as much as 10 times a day + give him a cooling diet, excluding coffee, alcohol, spices etc. By the way, this problem is very often encountered in people undergoing radio-chemo therapy. These treatments induce extreme heat in the body thereby thinning the blood (leukopenia, anemia, etc.), falling of hair and exhausting the Yin and Qi.
Good luck.

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