I saw this patient for the second visit this week, the first visit having been last week. This patient, age 51, was diagnosed with asthma 6 years previously after having had many episodes of bronchitis since childhood. Her parents had been heavy smokers. She is a singer and singing was her passion and emotional therapy, yet she had been unable to sing at all without coughing intensely since she developed the “asthma.” This condition came on after a bad flu. She felt that her chest was filled with mucous that was clear like egg white and loose. It was worse with damp days and better when it snowed. When she developed coughing fits she would sometimes gag to the point of vomiting. She uses a flovent inhaler, allegra and flonase every day and albueterol as needed. Even with these she was unable to sing or exercise.
This patient weighs about 250 lbs and was diagnosed with polycystic ovarian syndrome at age 34 and had been taking the birth control pill since then until 3 months ago. She had had two normal periods since then with the next one due next week. She also takes hydrocholorthiazide and lisinopril to control her hypertension which was diagnosed 10 years previously. Otherwise, her digestion, urination, sweating, sleep, energy etc. were all normal.
Her tongue was pale purple, puffy and wet. Her pulse was full and slippery with a hardness in both Cun positions.
My diagnosis was cold fluids in the lungs with systemic blood stasis (meaning that the general quality of her blood was thick and stagnant – a common pattern with pcps, obesity and hypertension) Of course the first priority was to address the acute breathing difficulties. Though this related somewhat to the blood stasis, the main causative factor was cold fluids in the lungs. I gave her a modified version of Poria, Licorice, Schisandra, Ginger, and Asarum Plus Pinellia and Armeniacae Decoction (líng gān wǔ wèi jiāng xīn ban xia xing ren tāng) as below (dosages are grams/week of raw herbs)
|Wu Wei Zi||36|
|1 package for 1 week|
I also gave this patient acupuncture, pricking Lu 6, Liv3 and 4, St 40, Ling Gu, CV 12, St 21, 28 and Lu 1 with a good baking with moxa on Bl 13 area.
Result: After 1 week on these herbs the patient reported that she was 70% better with periods of time during which she felt normal. She had missed several days of her flonase and flovent with no ill effect though I told her to check with her physician about reducing her meds. She had been able to sing for 2 hours the day before. I continued with the same formula for one more week and we’ll see!
Discussion: When I see a clear cold pattern I always think it’s good news. The reason for this is that the pathology can often clear easily. Heat patterns in which fluids have been damaged are often, in my mind, a longer course of treatment. I also think it is important to see the relationship between blood quality and breathing. There are millions of tiny capillaries surrounding the tender alveoli of the lung. Improving the blood quality when there is a purplish tongue body, can very much help chronic lung difficulties. The herbs I have learned to use for this are Dan Shen, Dang Gui and Tao Ren. The more chronic issue of hypertension will take longer to resolve but is primarily related to the blood quality. A different discussion for another day!