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Ask the Acupuncturist

Purple skin: blood stasis & yin deficiency

I have met a 91 year old man, former professor, famous author and brave warrior.  The skin on the back of his hands and one leg is purple, striated and patchy purple colors.  Why?  What simple things can be done to help this?

In curiosity,
Frannie

Dear Frannie,

This is a classic blood stasis condition, complicated by yin deficiency.
The purple and the striations are from the stasis of blood.  The blood is not moving properly and is leaking from the vessels. The yin deficiency will leave the skin and tissues (yin substance) very thin as they are not regenerated, so it is easier to see the blood stasis.

Doctor Yan De-xin changed the Chinese Medical orientation to aging a few years ago with his book on blood stasis, where he implicates it as the primary proximate cause of aging.  Until this book, the accepted cause of aging was kidney (yin and yang) deficiency.

In biomedicine there is a new accepted theory every month.  In TCM there is a new accepted theory every few hundred years, so this was a very big deal.

For this person you would need to move the blood and nourish the yin.  There are a few herbal formulas that can be very helpful.  As a single herb, Dan Shen (salvia miltorriza) as a daily drink would be helpful.

If he can get someone to burn moxa, or do it himself, there are several points that can be very helpful.  The single most important point to burn moxa over is zusanli (stomach 36).  This is about the width of four fingers below the “eye of the knee” on the outside of both legs.  The point is one thumb width off of the highest point of the tibia (big bone at the front of the lower leg). If you run the finger down from the knee, there will be a clear divot at Zusanli.  Burn moxa over this daily.  One can also massage this point to good effect.

Happy New Year!!!!!!!!!

Be Happy!

Dr. John Nieters, L.Ac. DAOM

Male BPH/Urine Retention issues

Please let me know if you have experience treating male BPH / prostate / urine retention issues.
Thank you
Daniel

Dear Daniel,
I have treated each of those issues, separately and in combination.

Since the most important aspect, in the manner that I practice, for this type of problem is herbs and supplements I do not have to see patients often.  I would typically see a patient about every 3 weeks until the problem resolves.  If it can be resolved, a patient will generally notice changes after about 6 weeks. If I did only acupuncture for this condition I would see a patient about 3 times per week.

Be Happy!

Dr. John Nieters, L.Ac. DAOM

Nausea after cold, sick, pregnant?

Happy New Year! I have been feeling under the weather for a awhile and wanted to check-in with you.  I got sick probably around the 21st of dec. starting with a sore throat which felt like it was lodged on my gag reflex. I took a lot of yin chiao (I think i took 9 tablets the 1st day and then tapered it off as the symptoms got better).  By the first night it was mainly just congestion and then I lost my voice for 5 days or so but no pain which was great!  I felt pretty much cured by the 28th or so but rested a bunch between the 27th – 31st.  I went out on New Year’s eve but was home a little early because my stomach was hurting.  I think the alcohol irritated my stomach and I ended up vomiting even though I never felt intoxicated through the night.  I felt fine for the next couple of days but gradually I noticed that I was a little queasy, not all the time, more so after meals.  I also started having a flare up with my ulcerative colitis so I thought that was probably the cause (although in the past, I don’t remember having that symptom).  I planned on making a visit to you and in the meantime took some of the UC herbs you had for me and was being more consistent with the enzymes, probiotics, and trying to eat fermented foods.  The flare-up seems to be almost healed as of now.  The nausea has been getting worse though, especially after eating and being in the car but I’ve been notably nauseous all day today.

Thanks,
Shana

Dear Shana,
Could you be pregnant? If you are not certain, don’t do any strong herbal formulas.  You should be safe with curing pills, Bao He Wan, etc. If you are pretty certain that you are not pregnant you could take  “Wen Dan Tang”.  These symptoms sound like stomach/gallbladder disharmony with internally engendered phlegm blocking the qi mechanism and lodged after the clearing clearing an exterior attack.  Typically the formula is for post wind cold, but your symptoms are consistent with it’s usage.  If you are having any insomnia or unease it is even more likely that this is the correct formula.

Many nausea formulas.  I pick this one because of the many possible symptoms that you don’t mention (edema, bloating, inhibited urination, constipation, chest discomfort, plum pit qi. etc)

Good work getting back to the basics when you started to flare up.

Be Happy!

Dr. John Nieters, L.Ac. DAOM

Coconut kefir and constipation

I bought some coconut kefir at Whole Foods after reading on a constipation blog for my daughter that this keeps things moving for kids with encopresis. She rejected it for the taste. It’s so expensive that I’ve been taking a teaspoon a day instead of another kind of probiotic. Wow. Yesterday I felt like I had the stomach flu, the urge to evacuate was so strong in the morning and within a half an hour after meals, and then possibly traced it back to taking this.  They talk about starting with a teaspoon and then moving to a half a cup a day.  Do you think it’s good for me?

~Lisa

Dear Lisa,

Coconut products are considered very cold in Chinese Medicine.  The effects will therefore be very different in different people. For those with heat problems it may be a panacea.  With cold digestion or low digestive fire it may be horrible.  Also, being a tree nut, even though cultured, there is a higher possibility of sensitivities than with other products. So, yes it could have caused the problems that you mention.

That being said, I do not have much experience with the coconut kefir as very few of my patients have used it.

Be Happy!

Dr. John Nieters, L.Ac. DAOM

Customizing Herbal Formulas

I have a patient with well-controlled type 2 diabetes, but persistent slightly high WBC count & trace of blood in urine. I am using one of your formulas for one week per month for a few months. What dosage? fairly high because trying to knock out infection? or caution because it’s so cold. any advice?
huang lian 10gm, huang qin 10, huang bai 10
shan zhi zi 10, mu tong 5, hua shi 5
che qian zi 5, qu mai 5, bian xu 5
da huang 5, deng xin cao 5
gan cao 5, xiao ji 5
bai mao gen 5

Thanks.
West Berkeley Acupuncturist

Dear West Berkeley Acupuncturist,
Great questions! The advantage of making custom formulas is in making them specific for branch,while effectively treating the root of the condition. A good example is the Da Huang.  If there is diarrhea or loose stools, especially if not much intestinal heat, I might leave it out entirely.  If any problem of low fecal output or constipation, or intestinal heat, I might use up to 20g of Da Huang. Then, depending on where the highest level of damp heat is located, I might adjust the levels of huang lian, huang bai, huang qin, or shan zhi zi for the appropriate of the three jiao that needs to be treated.  In this case I might double the huang bai dosage since the problem is primarily lower jiao.

I would pulse at moderately high dose for 7-10 days every month.  Low dose increases the likelihood of developing bacterial resistance; long term would damage the spleen qi. I might think 8-10 grams of 5:1 extract , which would equal 50 grams of raw herbs.

So, use the 10-20 grams that are uncertain to go to the root of the problem.

I would add probiotics or fermented foods to balance the antibiotic herbs.  I would recommend a d-mannose or a non sweetened cranberry extract to clear residual bacteria in the kidneys and bladder.

These are the questions, whether internal or external, that make the critical difference in herbal care.  It is why a great herbalist will always get better results than those who use use “rote” formulas.

Be Happy!

Dr. John Nieters, L.Ac. DAOM

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