Post Partum use of Sheng Hua Tang

Sheng Hua Tang is a formula designed by Fu Qing-Zhu in the 17th century.  It was first written about in his text Fu Qing-Zhu’s Gynecology (Fu Qing-Zhu Fu Ke) It is designed to treat women who are just post partum in order to transform blood stasis so that new blood can be generated.  This is one explanation given for the name of the formula “Generate and Transform Decoction”.  The name of the formula could also be translated as the “Giving Birth Decoction”.  This is possible because  the word for birth in Chinese is 生 Sheng and giving birth is sometimes referred to as the 大化 Da Hua or Great Transformation. (see Formulas and Strategies).  At any rate, this formula is truly excellent for post partum, post miscarriage and post termination patients.

In my own practice I have used Sheng Hua Tang more times than I can count.  I have found it very useful and helpful. I think of it as a formula that ensures that the uterus is clear, clean and warm after birth.  The healthy condition of the uterus after birth can help ensure good breast milk flow and help prevent post partum fever and depression.

Various doctors over time have created their own versions of Sheng Hua Tang.  Liu Feng-Wu created his Chan Hou Sheng Hua Tang Post Partum Generate and Transform Decoction and Dr. Xia Gui-Cheng created his own Jia Jian Sheng Hua Tang Sheng Hua Tang with Additions and Subtractions.

Below I have posted a translation of Dr. Xia Gui-Cheng’s writings on his understanding of Sheng Hua Tang.  He includes some very relevant research.  I especially like his explanation of how this formula treats the Spleen and Stomach in order to ensure the production of fresh blood.  He also goes into a great discussion of Pao Jiang.

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Posted in Classic Formulas, Experiential Formulas, Famous Doctors, Obstetrics, Xia Guisheng | 6 Comments

Soma’s Pediatric Course

We just finished our three day weekend with Soma. This weekend inaugurated our pediatric series beautifully and it was such a pleasure to study with her. The first two days of the course were didactic and the third day we began to practice and learn the Shonishin techniques she uses in her own practice. I think the whole group got much more comfortable with the tools and techniques of shonishin. Here are some photos from the class: Continue reading

Posted in Books, Our Courses, Pediatrics | 1 Comment

Guest Post: Raven Lang on Threatened Miscarriage

Raven Lang was a midwife before she was a practitioner of Chinese medicine.  My first introduction to Raven was through an article she wrote for Mothering Magazine on “Mother Roasting”.  I had considered and even pursued midwifery as a path for a while and Raven was one of my role models.

When reading this case, consider the difference between 1985 and our current times in terms of available literature and training.  What really impresses me about this case is Raven’s strong intuitive knowledge of women’s physiology, the physiology of pregnancy and birth as well as the basic concepts of Chinese medicine.

AN EXAMPLE OF A THREATENED MISCARRIAGE

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Posted in Obstetrics | 2 Comments

Using The Finger Pulse During Birth

To continue on the theme of birthing, I was recently editing video from the last Graduate Mentorship Program.  The video I am currently working on is from the part of the program on pregnancy and labor. I was reminded about Dr. Qiu Xiao-mei’s use of the “finger pulse” as a diagnostic tool during labor.  It can give the doctor a reading on the woman’s readiness to give birth, the dilation of the cervix and the strength behind the contractions.  I have translated and read case studies in which the finger pulse is used but I had never read anything in particular about it’s meaning or how to do it.  I decided to do a bit of a query to some knowledgable friends of mine.  I got a lengthy reply from Steven Clavey.  He sent me a descriptive passage in Chinese that I translated this morning as well as a diagram and a few words of his own.  I’ve included all this here and have also added a couple of cases of Dr. Qiu Xiao-mei to illustrate her use of the finger pulse.  In the first case the finger pulse was weak and this indicated to Dr. Qiu that a strong tonification method was necessary.  In the second case, the finger pulse was strong but did not extend to the finger tip.  This indicated a case of stagnation and so strong abducting herbs were given.

It is interesting to note the use of Quinine as an agent to induce labor.  Because quinine has this effect, it cannot be used to treat malaria in pregnant women.  There are many writings about how to treat women who contract malaria during pregnancy with Chinese herbs because quinine is contraindicated.

So here it is….

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Posted in Famous Doctors, Obstetrics, Qiu Xiaomei | 6 Comments

A Case of Difficult Birth

Here is another interesting case from Dr. Yuan Ming-Zhong 原明忠 of Shan Xi.

As Dr. Yuan says below, most cases of difficult birth end up as cesarean sections.  In this case, the woman had an allergy to any type of drugs which made both Pitocin and surgery unavailable as viable options.  This case and the one in the last post make me think of how much wisdom Chinese medicine carries that should not be lost.  With the advent of high technology in the world of birthing, there is a risk much of this could be lost.

Kai Gu San (Open the Bones Powder) modified to treat difficult birthing by Dr. Yuan Ming-Zhong

Ms. Guan, age 29

Main Complaint: Ms. Guan’s water had broken on March 4, 1982 and so she entered the obstetric ward of the hospital.  On March 5, she passed some blood which spontaneously stopping on the afternoon of March 6.  She was not aware of any fetal movements.  On March 8th, the obstetrician did a check up and saw that her pelvis was relatively small.  The fetal heart tones were low.  They wanted to do a caesarian section but Ms. Guan had an allergy to both the anesthesia and to antibiotics so she was unable to have surgery.  She also had an allergy to Pitocin so a Traditional doctor was consulted.

Check up:  Her complexion was yellowish, her emotional state was keyed up, she sweat from her forehead at times and her tongue was red with white moss.  Her pulse was deep and slightly slippery and fast.

Diagnosis: Serious difficult labor

Treatment Method: Open the bones to hasten labor

Formula: Modified Kai Gu San

Dang Gui                   30

Chuan Xiong             24

Zhi Gui Ban               30

Yi Mu Cao                  30

Simmer in water two times.  Divide into 2 doses and drink on an empty stomach.  Her family was advised to take the utmost care in observing her, carefully recording her responses to the herbs so that necessary adjustments could be made.

On the afternoon of March 8th, at 2:00 she began the herbs.  At 4:00 she began to have lower abdominal pain and the desire to move her bowels.  She went to the toilet twice.  In the evening at 8:00 she again took the herbs and had lower abdominal pain.  Compared to the afternoon, the pain was lighter.  After taking the herbs again at 2:00 a.m. on the 9th, she had stronger lower abdominal pain and the urge to move her bowels which she did 3 times.  That evening after taking the herbs she had light abdominal pain.  On the 10th she reacted to the herbs in the same way as before.  Each time she took the herbs she had abdominal pain (Uterine Contractions) about two hours later.  However, the interval between contractions was still too long and the exam showed that she was not opening.  On the afternoon of the 10th she was given two doses of herbs.  I decided to give her two packages in one day, which meant giving her one dose every 6 hours.  After each dose there was lower abdominal labor pains for several minutes and the interval in between contractions was a half hour.  This came with an urge to move her bowels and urinate.  The abdominal pain became more intense and the urge to move her bowels was constant.  On the 11th, after taking the herbs, the pain became stronger with a bearing down feeling. Intermittently the contractions were very strong and urgent.  At 3:00 in the afternoon of the 12th the interval between contractions was still ½ an hour.  By 4:00 it had become more frequent with the interval between contractions at every 1-2 minutes and by 5:00 the interval was half a minute.  Each contraction was lasting 4-5 minutes.  At this time the cervix was 3 fingers dilated and by 10:00 that evening, it was 10 fingers dilated.  At midnight she gave birth to a baby boy.

Due to the fact that this woman’s pelvic bones were small, after the birth a 2-centimeter  fracture was discovered.  This affected the woman’s gait.  I gave her Liu Wei Di Huang Tang with Xu Duan, Gu Sui Bu, Zi Ran Tong, Bu Gu Zhi and Mu Gua.  After 9 packages of this she was cured.

Discussion:

Difficult birth is a serious pathology.  These days, when there is a difficult birth a cesarean section is usually performed and there is very little use of Chinese herbs for this.  In this case however, due to the patient’s allergy to western drugs, surgery was not an option.  Instead I used modified Kai Gu San (Open the Bones Powder) and the result was good.

Kai Gu San (Open the Bones Powder) is from the Yī Zōng Jīn Jiàn (Golden Mirror of the Medical Tradition) – Essential Tricks of the Trade for Gynecology.  The original formula includes Dang Gui, Chuan Xiong, Gui Ban and Fu Fa Hui (?).  For this case, I removed the Fu Fa Hui and added Yi Mu Cao.  Dang Gui and Chuan Xiong nourish and move the blood.  In small dosages they will calm the fetus while in large doses, they will induce uterine contractions and promote birth.  Yi Mu Cao is able to increase uterine contractions.  Gui Ban nourishes Yin Qi so as to open the bones.  When used together, these herbs are effective for opening the bones and hastening labor.  The Ji Yin Gang Mu (A Compendium of Female Disorders) argues that Yin Qi deficiency is the cause of the joining bones not opening.  This is why Kai Gu San uses Gui Ban.  It is also said that another cause of difficult birth is small joining bones.

Chinese medicine can be effective for difficult birth.  However, if the pelvic bones are small, it can be difficult for the baby to be delivered and this is also difficult to treat.

 

 

 

 

Posted in Famous Doctors, Gynecology, Obstetrics, Opening Through, Yuan Mingzhong | 2 Comments

Dr. Zhu Xiao-nan’s case on Fetus Failing to Develop

Dr. Zhu Xiao-nan was born in 1901 and spent much of his life working as a Doctor of Chinese medicine, focusing on gynecology and obstetrics.

I decided to translate and post this particular case because it is informative from a practical treatment perspective but also from a medical anthropological perspective.  It seems that, in 1961, when this patient came to Dr. Zhu, there was no ultrasound, amniocentesis or blood tests to determine the well-being of the fetus.  In fact, in the introduction to the text from which this case is published, it states that Dr. Zhu considers women’s pathology to be “invisible”, making it very important to “interrogate thoroughly, make precise diagnoses so that the herbs are used with bull’s eye accuracy”.  For me, it is interesting to consider what would have happened in this patient’s case today.  My guess is that the outcome may not have been so positive.

Dr. Zhu uses his own methods for determining whether the fetus is alive or not. It is clear from his discussion here that this method involves the following: Continue reading

Posted in Gynecology, Obstetrics, Zhu Xiao-Nan | 2 Comments

Shang Han Lun Conference Review

At the end of April, I was lucky enough to be able to attend the 3rd Annual Zeng Rongxiu Shang Han Lun conference in Portland Oregon.  It was very exciting to be there to study with Dr. Zeng who is now 87 years old as well as with some amazing other teachers.

We got to see how Dr. Zeng “exercised his brain tendon” (Arnaud’s interpretation of Dr. Zeng’s words) in carefully considering each case

The real heart of the conference and the heart of Dr. Zeng’s teachings in general was, in a nutshell, Yang dynamics.  The life force itself is Yang in that it is warm, activating and bright (being that we are cold when we are dead) so when Yang dynamics are spoken of, we are really talking about the dynamics of the life force itself.  The Shang Han Lun (Treatise on Damage from Cold) text is considered by many to be a manual of how the life force gets blocked and damaged as well as a manual on how to correct this.  The reason this text is called The Treatise on Damage from Cold, even though many of the pathologies described within it are characterized by heat symptoms, is because cold is simply the opposite of the life force.  All of the heat pathologies described in the text can be seen through the lens of the life force warmth building up due to improper circulation as opposed to being due to an actual heat pathogen.

I would like to highlight here a few of the extraordinary instructors who presented at this conference:

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Field Research: Da Nai Nai Cao (special April 1st entry)

Can an herb actually improve a patient’s luck or Karma?  Let’s take a look at the amazing Giant Milky Milk Weed…..

大奶奶草

This past autumn I had the chance to do some fascinating field research in Chinese herbology.  This is a picture of me climbing the giant milk weed near the shores of the Quabbin reservoir.  Treacherous as this work is…it is so worth it.

The Quabbin reservoir in Western Massachusetts provides water to the entire Boston area.  It was built in the 1930’s during which five towns were demolished and submerged.

Here is a picture of the town of Enfield before it was flooded for the reservoir:

 

Rumor has it that this area is haunted by the sprits of these old lost towns.  During my research, I set out to discover if this was true. I hiked into what used to be the western side of the toown of Dana there there are old foundations and roads that travel eerily into the depth of the water.  It is only in this ghost town and a sister three-gorges-dam ghost town in China that one can find the Da Nai Nai Cao – Giant Milky Milk Weed.  I did find some of this plant in what used to be the town of Dana.  It is quite magnificent though dangerous to study or harvest due to the great heights one must climb up the stem to get into close contact.

I harvested some of this plant and began to use it in my clinic right away.  Though at this point the information is relatively anecdotal, it certainly indicates promising results that deserve further research.

Since beginning to use Da Nai Cao in the formulas for people  who suffer from unfulfilled desires, hard luck and general symptoms of being a wreck, I’ve noticed the following results:

  • 2 patients have won the lottery (5 dollars and 1 million)
  • 1 patient met the man of her dreams
  • 2 patients met the woman of their dreams
  • 1 patient was fired from a job she hated only to be hired into a position she had always wanted that same day
  • 1 patient got offers for 3 different hollywood roles after having unsuccessfully auditioned for roles for the past 15 years.
  • 6 patients were given large objects including a house, a car, a horse, a trip to Spain, and a trip in a hot air balloon.
  • One patient who was unable to walk without a walker got up and clicked her heels in the air and is now studying tap.
  • One awkward 120 pound teenage boy was chosen for varsity football and immediately got 3 touch downs.
  • The skin of all my patients became luminous.
  • 8 patients reported having contact with relatives who had passed away – not the ones they didn’t want to have contact with!
  • My daughter was able to memorize Chinese characters and grammar patterns after looking at them only once.
  • Sony Pictures offered to turn my blog into a television series to be aired right after The Dog Whisperer.

All of these patients, including myself and my daughter reported having dreams in which we were walking through the old submerged towns, able to breath under water, talking with the town folk, some from submerged Chinese villages and some from submerged Quabbin towns, who all said they “just wanted to visit a bit”.  Somehow, all of us could understand Chinese in our dreams!  Go figure!

Conclusion: The harvest season for this year came to a close but I did manage to get 20 pounds of “fluff” that I am storing in a warehouse behind Dairy Queen.  Good stuff!

Somehow digital cameras work in Da Nai Nai Cao dreams, even underwater.  My friend took this picture while I was in a dream.  It is me walking on top of the Quabbin with my friends at sunset after visiting with the ghosts below.

I’d love to hear about the experiences of others.

 

 

Posted in Individual Herbs | 4 Comments

Post Partum Principles of Diagnosis and Treatment

I am currently working as a co-author on a book that will be published through People’s Medical Publishing House in Beijing.  The book is a gynecology text made up of case studies and discussions on a variety of topics.  I asked the publishers if I could use some of the material I am working on in my blog post here and they were happy to allow that.  I am posting a short bit of a chapter on postpartum dizziness and postpartum tetany here.  It starts with a case study and my commentary follows.

I think this chapter is useful not only for the specific treatment of postpartum dizziness and tetany but also because some basic diagnostic skills for postpartum women are described.  In addition, I think that the use of classic formulas here will be of interest to many of you! I hope this is useful for those of you who are working with women after pregnancy. Continue reading

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Healing Crisis?

What is a healing crisis?  Do healing crises happen in the context of Chinese medicine?  How can we differentiate a healing crisis from a simple exacerbation or a new illness?

A healing crisis occurs when a person becomes ill in the service of becoming more healthy.

We could think of a deep seated abscess finally coming to a head as a kind of healing crisis.  It is a term that is often associated with homeopathy.  A homeopath sometimes expects a healing crisis as a sign of the remedy working.  However, the term “healing crisis” is not often used in the context of Chinese medicine.  Do our patients experience healing crises while in the process of getting better with Chinese herbs or acupuncture?

In the world of alternative medicine we have all perhaps seen the concept of a “healing crisis” used to explain away a patient’s lack of response to treatment and worse, to explain away a negative reaction to a treatment.  “My naturopath told me that this rash is the toxins coming out”  or “my chiropractor told me that these headaches are part of the process of getting better”.  And yet, the rash just gets worse or the headaches don’t go away…..Perhaps we’ve all had the experience of a patient reporting a new symptom such as a rash, headache, nausea, aching etc. and we have wondered if this is perhaps a healing crisis.  I’ve seen many hopeful patients wanting to believe that a new symptom is arising in the service of getting well, so much so that it would be very easy to encourage them to believe that the new symptom or exacerbation of a symptom is part of the healing process.

In my own practice, it is not uncommon for me to see patients going through healing crises.

Yet, when a patient comes in with an exacerbation of a symptom, or a new symptom, my first task is to make absolutely sure that the symptom is not arising due to mistreatment on my part.

How do we tell?  I’ve developed guidelines for myself.  These are helpful not only for me but for patients themselves.  When they use these guidelines, they can pay attention to what is happening and evaluate for themselves if it is indeed a healing crisis or simply a worsening of their health.  Here are the guidelines I use:

  1. The new symptom or symptoms comes on AFTER the patient has been feeling noticeably better or their main complaint is noticeably better.
  2. The new symptom or symptoms are less severe than the main complaint (i.e. a common cold is less severe than hypertension)
  3. The patient has a distinct intuitive sense of strength or well-being while the symptoms are happening or the symptoms actually feel really good.
  4. The new symptom or symptoms change rapidly and go away quickly
  5. After the new symptom or symptoms are gone, the patient feels better than they did before the symptoms arrived.

If the crisis meets  these guidelines, I will define it as a healing crisis.  If not, it is just my patient getting sick in a new way…back to the drawing board for me!

The main reason we need to recognize a healing crisis for what it is is because we need to recognize when our patient’s exacerbation or new symptoms is NOT a healing crisis and they are just getting worse!  Above all do no harm.

The common healing crises I have seen are:

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Posted in Theory and Practice | 7 Comments