L.I.-11 Quchi to clear Damp-Heat;T.B.-5 Waiguan, T.B.-6 Zhigou and ST-43 Xiangu to expel Wind-Heat
and clear obstructions from the joints;ST-40 Fenglong and SP-9 Yinlingquan to resolve Phlegm;BL-11 Dashu, Gathering point for bones, to prevent further
deterioration of the bones;Du-14 Dazhui to clear Heat.Case History 23.3
Painful Obstruction Syndrome: Dampness and Cold-Female, Age 39
A 39-year-old woman had been suffering from what was diagnosed as rheumathoid arthritis for
the previous two years. Her wrists and feet were painful and swollen. The pain was aggravated
by damp and rainy weather and improved with heat. This was her presenting problem. On
interrogation, it transpired that she also suffered from lower backache, she felt easily cold, she
had to pass water at night twice and she felt often exhausted. She also occasionally had dull
headaches affecting the whole head and sometimes she sweated at night.
Her tongue was slightly Pale, Stiff and slightly Deviated. Her pulse was Deep and Weak.
Diagnosis The pain and swelling of wrists and feet were clearly due to invasion of
Wind, Cold and Dampness, predominantly Dampness and Cold.
Dampness is indicated by the swelling and Cold by the fact that it is
aggravated by rainy weather and improved by warm weather.
This occurred against a background of Liver and Kidney deficiency,
especially Kidney as clearly shown by the backache, the cold feeling,
nocturia and exhaustion. The Deep and Weak pulse also shows
deficiency of Kidney-Yang. Her tongue, being Stiff and Deviated,
shows also the very beginning of Liver-Wind. Liver-Wind can develop
from long-standing deficiency of Liver and Kidney Yin deficiency.
How could it develop in this case from Kidney-Yang deficiency? The
reason is that Kidney-Yin and Kidney-Yang have a common root and
that they are often both deficient especially in women, albeit in different
degrees. In this case, Kidney-Yang is predominantly deficient (cold
feeling, nocturia) but there is also a slight and lesser Kidney-Yin
deficiency (night sweating, Red and Stiff tongue). The slight
Kidney-Yin deficiency gave rise to slight Liver-Wind, the only evidence
of which is the Stiff and Deviated tongue. A Stiff tongue can indicate
both Liver-Wind and Yin deficiency.