Water Qi Disorder:
September 8, 2013 at 8:46 am #869
Dr Greta Young Jie DeKeymaster
Case Study of Feng Shi Lun:
Liu x Female 88 years old
First consultation: 6th October 2002
For the past three years she suffered from Paroxysmal atrial fibrillation
Hospitalisationdid not seem to control her heart condition.
S/S: Tight sensation in the chest,chest oppression, heart palpitation; cold extremites; parched mouth; dry bowel movement, lumbar pain; fatigue; vertigo; tinnitus; poor sleep; sweating; thin, white tongue coat; bilateral fan guan mai (pulse can only be felt behind the wrist); alternating fast and slow pulse with occasional knotted pulse.
ECG: Absence of P wave; irregular rhythm, V3, V5, the ST depression, T wave flat.
Six Channel diagnosis: Jue Yin Tai Yin concurrent pattern, heat in the upper jiao and cold in the lower jiao with blood deficiency and exuberant water retention.
Formula: Chai Hu Gui Zhi Gan Jiang Tang + Dang Gui Shao Yao San.
Chai Hu 12g; Huang Qin 10g; Hua Fen 112g; Sheng Mu Li 15g; Sheng Long Gu 15g; Gui Zhi 15g; Gen Jiang 6g; Zhi Gan Cao 6g; Dang Gui 10g; Chuan Xiong 6g; Bai Shao 10g; Ze Xie 15g; Cang Zhu 15g; Fu Ling 12g.
Outcome: After seven packs medication; the patient had a subjective feeling of dizziness; fatigue; improvement of heart palpitations; atrial fibrillation reduced. Continue the medication with modifications for two months. There was no further atrial fibrillations. Her condition was stabilised during the ensuing two years.
Question: In the case there were no clear water symptoms such as a wet or puffy tongue, water swelling, thirst with no desire to drink but still water was diagnosed. I guess I am still unclear as to when, in my own practice, I would for sure diagnose water even with no clear water signs. What would I have to see in order to diagnose water? It seems to me that the upsurge symptoms could be from other mechanisms besides water so what makes it water in this case? When I think of other mechanisms that could cause these symptoms, it is Shao Yang or Yang Ming. So, are you saying that, in the absence of a Yang pattern, strong upsurge symptoms indicate water?
Reply: Water qi can be regarded as a formless pathogen therefore a pattern of water qi disorder does not have to be characterized by vomiting clear water per se. The case study of patient Liu 88 years old presented with chest oppression, heart palpitation, vertigo, tinnitus, pale tongue reflect the disease nature as deficient cold with interior coldness hence this condition can cause water rheum, upsurge of water qi, water qi harassing the heart with heart palpitation and chest oppression. (Water qi harassing the lung may cause cough as in Qiao Qing Long Tang, water qi harassing the clear yang may cause vertigo and tinnitus.) In general if a patient is characterized by interior deficient coldness, the diagnosis can be “water qi”.
Posted by Dr. Greta Young Jie De
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