Deficiency and Excess. First of all, there is stagnation of Liver-Qi and
its symptoms are abdominal pain and distension which is aggravated by
emotional stress and the slightly Wiry quality of the pulse on the left
side. Stagnation of Liver-Qi has turned into Fire and this is shown by
the Red colour of the tongue body and the fact that it is redder with red
points on the sides. Liver-Fire has also affected the Heart giving rise to
Heart-Fire as evidenced by the tongue's red tip with red points. The Red
colour of the tongue and the redder colour with red points on the sides
and tip clearly show the emotional origin of the problem. If there is Fire
why does the abdominal pain improve with the application of heat? This
is because heat improves not only abdominal pain which is caused by
Cold, but also that caused by stagnation as heat moves Qi and Blood.
The second question is: if there is stagnation of Liver-Qi and Liver-Fire,
both Excess conditions, why is the pulse so Weak and Minute and only
very slightly Wiry? The reason is that there is an underlying, very
longstanding Deficiency condition of the Lungs and Spleen. In fact, the
deficiency of the Lungs was, in my opinion, at the root of the problem
and caused by deep emotional problems such as sadness and grief. The
look of her eyes and her voice confirmed this. Sadness affects Lungs
and Heart and, after a long time, it gives rise to stagnation and Fire. It is
even possible that the Lung deficiency was the origin of the stagnation
of Liver-Qi: this happens when the deficient Lungs fail to control the
Liver, or, in 5-Element terms, Metal fails to control Wood. The
deficiency of Lungs and Spleen is evident from the Weak and Minute
pulse, the aggravation of pain from tiredness and the weak voice.
Finally, the hypogastric pain elicited by carrying weights is due to
sinking of Spleen-Qi probably causing a slight prolapse of the bladder.Treatment principle The treatment principle adopted was to move Liver-Qi, tonify the
Spleen, and strengthen the Lungs. It is not necessary to clear Liver-Fire,
as when this derives from stagnation of Liver-Qi, it is sufficient to move
Liver-Qi and eliminate stagnation. This patient was treated with
acupuncture and patent remedies.
Acupuncture The acupuncture points (with reducing or even method for those which
eliminate stagnation or drain Fire and reinforcing for those which tonify
Lungs and Spleen) were selected from the following:
Ren-6 Qihai, to move Qi in the lower abdomen.LU-7 Lieque to tonify the Lungs and settle the Corporeal Soul. This
point is particularly effective for sadness and grief affecting the Lungs.LIV-3 Taichong, LIV-14 Qimen and G.B.-34 Yanglingquan to move
Liver-Qi.