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Five Cases of Depleted Yin

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Five Cases of Depleted Yin feature Five cases of depleted yin ByNghiaThanhTran I remember reading a quote from Ante Babic in The Lantern. In writing about Traditional Chinese medicine has turned a big corner in the last practising TCM, he wrote: “I think, therefore I am wrong.”1 This is so true, and I believe century. Such was the turn that now we can barely see the road that serious TCM practitioners think behind. Personal experiences handed down through generations the same way about the importance of have been wiped out by China’s whirlwind cultural revolution, while intuition in TCM. Intuition is not scientific, new practitioners have only a very limited number of ancient it is not measurable, not tangible and can’t be taught. Practitioners require constant textbooks to resource. self-cultivation to achieve it, and long-term practice is part of that cultivation. The health problems of today reflect the N A PoSITIVE note, Westerners are stressful way we live. We work longer hours obecoming increasingly interested in and in more stressful occupations than TCM, and information is becoming in- previous generations, and our children creasingly available. The original method work even harder than we do. Excessive of transferring experience from master to work without adequate rest leads to yin disciple has been replaced by hundreds of depletion, and this, I believe, is one of the textbooks written in English. Unfortunate- main TCM patterns of the modern world. ly, these textbooks have all evolved from Therefore, I would like to share my the same few ancient works, and subse- experiences in treating cases of depleted yin. quently, as a student once remarked to me, These cases will demonstrate how one TCM “all TCM books are the same”. We continue pattern – yin deficiency – can manifest in a to see translations of the same classics, but variety of presentations. very few are based upon the experiences of present practitioners addressing the TCM Case 1: Muscle inflammation patterns of the current time. In my opinion, TCM is no different from A 33-year-old female was referred by any other Chinese art: simple in theory, yet an open-minded GP. The patient was a requiring extensive practical experience. registered nurse with three children, aged Perhaps this is why TCM was traditionally between four and 12 from two separate conveyed by master to apprentice. Perhaps marriages. Her build was petite, and she the current TCM curriculum should have a spoke with a gentle but firm voice. When larger practical component. she arrived at my clinic it was obvious that The Lantern 41 feature walking caused her pain. She presented with application to draw out excess heat in the a red, swollen and painful left lower leg that affected area. With acupuncture, I used was hot and tender. I noticed the heat was Quchi L.I.-11 and Xuehai SP-10 bilaterally more intense at several spots under which I to resolve toxic heat, Taixi KI-3 bilaterally could palpate hard subcutaneous nodules. to strengthen yin and Yanglingquan GB-34, This was the third time that this patient Jiexi ST-41, Neiting ST-44 on her left side to had developed this illness. The first time promote qi and blood circulation. was after giving birth four years earlier. I saw her nine days later. Her leg had The second was after she changed her gotten better within a few days, but then contraceptive pill one year ago. The current worsened. The nodules were less painful presentation began eight weeks ago after she and hot, but two new nodules appeared recovered from severe influenza. The first close to the knee below the Yanglingquan two occurrences were successfully treated GB-34 area. I noticed the skin on her leg by Western medicine. This time, however, had begun peeling and several red dots had multiple anti-inflammatory medications appeared randomly. I modified the herbal had failed. The pain had worsened and was formula to increase the dosage of the toxic so severe that it disturbed her sleep. heat clearing herbs and again used Quchi She complained of constant fatigue L.I.-11 and Xuehai SP-10 for clearing heat requiring an afternoon nap. She also and Taixi KI-3 to strengthen yin. I gave complained of a dry throat and a bitter taste her a different cream, which I call “trauma each morning. She was on the contraceptive cream”2 for external application to resolve qi pill but still her period was heavy and very and blood stagnation and promote healing. painful. Her bowel movements were not She came back three days later. Her leg regular, often being constipated for many looked a lot better, less swollen and hot. days. Her appetite was normal and she felt The pain was reduced and there were a slight fever on occasion. no new lumps. She told me that she had I explained that her leg pain was a stopped taking analgesic medication, and manifestation of an imbalance in her body. came back to see me early because she I find fuller explanations help my patients thought the acupuncture was helping. I feel more comfortable, increasing their gave the same acupuncture treatment with trust in TCM. an addition of guasha and cupping along On examination, her pulse felt like a fine the Bladder meridian of her back. thread at cun, guan and chi, but could only I continued seeing her every three days be felt at a deep level that vanished with for the next three visits. Her leg got better minimal pressure. Her tongue was pale and after every treatment until the third time n Nghia Thanh Tran learnt slightly red at the edges without coating. when she complained of myalgia and fever. Chinese medicine in Vietnam, Her eyes appeared tired with several small Her pulse was faster and appeared more where he lived and trained red capillaries in her sclera. I could feel superficial. Several new nodules appeared daily with a monk, and her forehead was warmer than normal as closer to the knee. I removed Pu Gong Ying became familiar with herbal I examined her eyes; her breath had no (Taraxaci Herba) and Zi Hua Di Ding (Violae formulas and acupuncture odour. Herba), and added Lian Qiao (Forsythiae methods. He also learnt the The history and examination was Fructus) and Fang Feng (Saposhnikoviae Taoist treatment methods and consistent with an empty heat condition Radix) to deal with the exterior wind-heat. way of living. He continued his resulting from yin deficiency. I prescribed a I repeated the same acupuncture treatment. Chinese medicine apprentice- herbal formula based on the classic Liu Wei Four days later her leg was almost ship in Saigon with another Di Huang Wan (Six Flavours Rehmannia normal. I could only locate the nodules by practitioner, and practised Pill). I added Jin Yin Hua (Lonicerae Flos), palpation; they were small and hard but for several years until South Pu Gong Ying (Taraxaci Herba) and Zi Hua painless. I suggested she continue using Vietnam was taken over in Di Ding (Violae Herba) to resolve toxic the trauma cream, and prescribed Liu Wei 1975. Tran later completed heat, and Gou Qi Zi (Lycii Fructus) and Ju Di Huang Wan (Six Flavours Rehmannia formal studies at the Academy Hua (Chrysanthemi Flos) to calm the Liver. Pill) for oral intake. I reminded her that this of Traditional Chinese She took the herbs three times a day for 10 would be a long process. Medicine and now practises in days. I also prescribed Da Huang (Rhubarb Six weeks after her initial visit her Melbourne. Root and Rhizome) cream for external condition was eliminated. 42 Vol 7–2 feature Case 2: Menopausal symptoms every day, and introducing more yin foods Jing Fang in in her diet such as soy products. This woman, 51, had first seen me three I used gua sha and cupping along the modern practice years previously with a wind-cold headache. Bladder meridian on her back, acupuncture Coming from a Greek family she was short at Taixi KI-3, and prescribed two weeks of ByMichaelMax in stature and full of energy, a vibrant and Zhi Bai Di Huang Wan (Anemarrhena, happy person. I often sat and listened to her Phellodendron, and Rehmannia Pill), Walk into any reasonably sized life stories for 20 minutes each time we met. which consists of Liu Wei Di Huang Wan bookstore in China and you will This time was no exception. She almost (Six Flavours Rehmannia Pill) plus Huang find shelves full of the experi- forgot the reason she came to see me. Bai (Phellodendri Cortex) and Zhi Mu ence of Chinese medicine doc- She reported that her period did not (Anemarrhenae Rhizoma). tors. Case studies are the bones and blood of furthering one’s come last month. This was unusual as her She returned to the clinic two weeks later skill as a doctor. We all gain a period was as regular as clockwork. She with a smile. She told me that she enrolled foundation, a skeletal structure had also experienced some hot flushes in a Tai Chi class and really enjoyed it, had from our textbooks and first and night sweating. One problem that started to eat more tofu and drink soy milk. years in medical school. But it is bothered her most was a lack of sleep; All her symptoms were better, from hot the actual application, the use either she found it difficult to fall asleep or flushes to mood swings. She was especially and practice of medicine, that was wide awake at a very early hour. She happy to have her sleep back, and most of allows us to distill meaning from was also concerned about her libido, which all her libido back to normal.
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