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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Toxemia in Pregnancy, Habitual Miscarriage and Thick Blood

The last post was on anemia in pregnancy and hopefully it showed the importance of helping raise low hematocrit and hemoglobin levels in our pregnant patients.  We also showed how and why descending hematocrit and hemoglobin levels in later pregnancy are a key indicator of the healthy blood volume expansion and physiological hemo-dilution (not pathological!).

This next post and presentation is, in some ways, about a condition that is the opposite of anemia  and that is more common than we might think and much more dangerous.

With our pregnant patients, we must also be on the look out for hematocrits and hemoglobin levels that are too high or that don’t go down in later pregnancy.

Descending hematocrit and hemoglobin levels in later pregnancy are a key indicator of the healthy blood volume expansion and physiological hemo-dilution (not pathological!).

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Anemia and Toxemia in Pregnancy

I’ve been working many hours a day lately on the presentations I create from the footage from the White Pine Institute Graduate Mentorship Program.  The hours of footage from each weekend are prepared into presentations such as the one I’ll link you to today.

I am going to do a series of two presentations.  Today’s is on anemia in pregnancy and next week or so, I will post another on Toxemia and “Thick Blood” in pregnancy.  The skill here are very important for our work with pregnant women.  Some of the concepts may seem a bit foreign to you like the idea of “thick blood”.  Many of these concepts are explained and expanded upon the theGraduate Mentorship Program itself.

When working with pregnant women, we rely primarily on our Chinese medical diagnostic skills.  However, in the case of pregnant women, I am recommending and explaining the importance of paying attention to both the hematocrit and hemoglobin levels in our patients.  These reading can be extremely valuable for insuring a healthy outcome to a woman’s pregnancy.

Click here for the presentation to begin.  Please post any questions, additions or comments you have here.  I hope this is useful to you in your practices!  And Happy New Year!

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Update on China Trip

The study abroad trip to Nanjing is at this moment coming to an end after great success! There is talk of another course this summer so stay tuned. (The best way to make sure you hear about such opportunities is to sign up for the White Pine Newsletter).  There was a good contingent of students who have studied through White Pine Institute participating in the tour which was led by Greta Young Jie De.  Greta is a well know practitioner, interpreter, author, scholar in her own right and…. Continue reading

Posted in Books, Classic Formulas, Famous Doctors, Huang Huang, Our Courses, Shen Ji Zi, Yan Xiaoping | 1 Comment

Soma in India

So many patients had reported quick and good results. The children especially were so receptive and susceptible to energy and herbal medicine. And how wonderful to see how much a little caring touch and attention can accomplish to restore a sick child back to health.

I just got an email from Soma Glick who has just returned home after an amazing trip to rural India where she organized a course and clinic for Tibetans.  Below is a short slide show from her travels and below that I am including the letter she wrote about her experience there.  Soma will be teaching this course at White Pine Institute this June as part of our pediatric series.  How wonderful!

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Opening to the Source with Chip Chace

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What Chip has done is really far more profound than simply offering new treatment strategies.

Recently White Pine Institute hosted a weekend course with Chip Chace entitled “Opening to the Source”.   I will let Chip speak for himself through this short online introduction but also want to give readers a sense of what Chip is teaching and its value.  This course was a success on many levels.  It filled to capacity (capacity being 12 participants) and my impression is that each student got at least what they came for out of the weekend if not much more.  It was nice for me to be taking an acupuncture course, especially of such high caliber, after years now of focusing on herbal medicine. The course was a good balance between didactic and experiential.

Chip taught for two days on the material he has been honing and integrating for many years.  Based in part on the newly published text An Exposition on the Eight Extraordinary Vessels: Acupuncture, Alchemy, and Herbal Medicine, written by Chip with Miki Shima, he taught us to think of the extraordinary vessels in ways that are both classically rooted as well as fresh and new.   The text is based on Li Shi Zhen’s writings on the nature and use of the extraordinary vessels and goes far beyond the master/couple points of modern times.  Though we did learn to apply abdominal diagnosis in determining the most available of the eight vessels to treat and we did learn many new and interesting methods and points for accessing these vessels, this was really just the nuts and bolts. What Chip has done is really far more profound than simply offering new treatment strategies.

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A Match to the Heart

In the last blog entry I introduced the book Dirt: The Ecstatic Skin of the Earth.  That being a text on the Earth element, this next book is a text of the Fire element.  I know I promised fiction and that is coming……

If you have never read anything by Gretel Ehrlich, you are in for a delicious encounter.  Gretel was already a luminous nature writer when she wrote books such as Islands, the Universe, Home and The Solace of Open Spaces

Then one day, up in the mountains hiking with her two dogs, (something I can relate to though I am usually with 3 or 4 dogs) she was struck by lightening. In her memoir

A Match to the Heart: One Woman’s Story of Being Struck By Lightning she recounts the experience, often with great attention to the minute details of the sensual experience of being in an electrocuted body. She writes:

An intake of breath is not just oxygen, a pulse is not just the rush of blood but also the taking in of divinity through an orifice, and as it moves through, it become s a spark.  To be inspired is to have accepted spirit in the lungs and heart, to watch it circulate through miles of blood vessels and capillaries whose tiny fenestrations allow oxygen, nutrients, and grace to leak into the tissues of muscle and consciousness, then be taken up again, reoxygenated, and returned. Continue reading

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Recommended Books

I like to read.  Like all serious students of Chinese medicine, my bedside table supports a stack of Chinese medical texts – right now Chip Chace’s An Exposition on the Eight Extraordinary Vessels: Acupuncture, Alchemy, and Herbal Medicine with an issue of The Lantern.  However, I do like to read other types of liturature, both fiction and non-fiction.  Some of these books, though not explicitly about Chinese medicine, are actually expressive of some of the most foundational principles of Chinese medicine.  I have found some to be illuminating and inspiring.  I thought a blog entry about some of my favorites might be interesting to the readers.

A favorite of mine is Dirt: The Ecstatic Skin of the Earth

This wonderful book by William Bryant Logan is, as you might guess, all about dirt.  It is also all about the Earth element and the function of the Spleen and Stomach.  Reading this text you will see how Fire interacts with Earth, how Earth controls and directs Water and the relationship of Earth to the heavenly skies and the essence of life.  It is as if Mr. Logan studied human physiology except that the body he describes is the body of the Earth.  You will finish this text with an ability to take a walk in the woods or on the oceanside and see the very same dynamics at play that you see in your clinic every day…

Another book that has influenced me considerably in my medical studies and practice is a book of essays entitled Being Bodies edited by Lenore Friedman and Susan Moon.  It is a text of Buddhist essays addressing the “Paradox of Embodiment” by women.  How do we accept our bodies and our pain while also deeply wishing to and attempting to heal? Can our patient’s suffering be a gateway to something greater that we can help catalyze?  How do we work with the awareness of the inevitability of impermanence, decay and death while working to improve the condition of the body?  The writing is beautiful and personal.  I savored every essay.

I will write another post soon with a couple of other book suggestions…The next one will be fiction so stay tuned.  I would love to hear what books others have found instructive for their Chinese medical practices.

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I discovered a great blog

Watch the Si Ni San Presentation!

I recently discovered a new blog by a man named Eran Even from British Columbia, Canada.  It is primarily a case study blog with an emphasis on classic formulas.  I found it totally by accident.  It’s a gem of a blog!  You can access it here.

Eran is interested in many doctors.  He has done several excellent entries by one doctor in particular, Dr. Hu Xi-shu.  Coincidentally, Dr. Huang Huang mentioned Dr. Hu over the last weekend.  He was talking with us about Da Chai Hu Tang and how it can be combined with other formulas to treat bronchial asthma (only if there is strong abdominal pain on pressure).  One combination he mentioned was with Gui Zhi Fu Ling Wan.  He told us that this combination, Da Chai Hu Tang and Gui Zhi Fu Ling Wan was taught to him by none other than Dr. Hu Xi-shu!

Posted in Classic Formulas, Famous Doctors, Hu Xi Shu, Huang Huang | 1 Comment