Ulceration: a TCVM Ulceration: a TCVM ApproachApproach

CAPT R.M. Clemmons, DVM, PhD, CVACAPT R.M. Clemmons, DVM, PhD, CVA

UlcerUlcer

•SymptomsSymptoms•Periodic painPeriodic pain•Acid regurgitationAcid regurgitation•BelchingBelching•VomitingVomiting

•PatternsPatterns•ExcessExcess

•Stomach ColdStomach Cold

•Food StagnationFood Stagnation

•Liver Qi StagnationLiver Qi Stagnation

•Blood StasisBlood Stasis

•DeficiencyDeficiency•Stomach Yin DeficiencyStomach Yin Deficiency

Stomach HeatStomach Heat

Stomach HeatStomach Heat

Pathogenic HeatPathogenic HeatYin DeficiencyYin Deficiency

channelchannel

GumsGums organorgan

UlcerUlcer

childchild

ColitisColitis

grandchildgrandchild

CystitisCystitis

Stomach UlcersStomach Ulcers•MildMild

•Moderate to SevereModerate to Severe

AngelicaAngelica Dang Gui Dang Gui Nourish & activate BloodNourish & activate BloodPaeonia Paeonia Bai Shao Yao Bai Shao Yao Nourish Liver Yin & BloodNourish Liver Yin & BloodBupleurum Chai Hu Bupleurum Chai Hu Soothe Liver QiSoothe Liver QiAurantium Zhi Shi Aurantium Zhi Shi Move Qi & relieve painMove Qi & relieve painTrichosanthes Gua Lou Trichosanthes Gua Lou Promote body fluid & transform phlegmPromote body fluid & transform phlegmPinellia Pinellia Ban Xia Ban Xia Dry damp & transform phlegmDry damp & transform phlegmCitrus Citrus Chen Pi Chen Pi Move Qi & relieve painMove Qi & relieve painLicorice Licorice Gan Cao Gan Cao HarmonizeHarmonizeTaraxacum Pu Gong Ying Taraxacum Pu Gong Ying Clear HeatClear Heat

Happy StomachHappy Stomach

Jade LadyJade Lady

Gypsum Gypsum Shi Gao Shi Gao Clear Heat and cool StomachClear Heat and cool StomachAnemarrhena Zhi Mu Anemarrhena Zhi Mu Clear Heat and nourish YinClear Heat and nourish YinRehmannia Shu Di Huang Rehmannia Shu Di Huang Nourish Yin and JingNourish Yin and JingOphiopogon Mai Men Dong Ophiopogon Mai Men Dong Moisten and nourish YinMoisten and nourish YinAchyranthes Niu Xi Achyranthes Niu Xi Bring the Qi flow downBring the Qi flow down

GI Food TherapyGI Food Therapy

•CabbageCabbage•Contains glutamateContains glutamate•Cools stomach & GICools stomach & GI

•SpinachSpinach•Stops hemorrhageStops hemorrhage

Shan-gen

GV-26Ren zhong

06 Ren-zhong/Shui-gou the center of man/water passage, Xie-07, GV-26

05 Shan-gen Mountain base Xie-05

LO: on the dorsal midline of boundary b/t hairy & non-hairy areas

ME: Perpendicular insertion 0.3 cun

IN: Loss of appetite, sinusitis, coma, shock, wind-cold, wind-heat

LO: At the intersection b/t dorsal and middle 1/3 of the philtrum

ME: Perpendicular insertion for 0.3 cun

IN: Coma, shock, fever, bronchitis, Lung Heat, facial paralysis

23 Lian-quan ridge spring CV-23

LO: At the ventral midline just cranial to throat.

IN: excessive salivation, laryngeal hemiplegia

21 Hua-tuo-jia-ji at cervical region

LO: 0.5 dorsal to cervical vertebrae

IN: cervical stiffness, wobbler’s disease

22 Jian-wei, strengthen stomach

LO: Upper 1/3 of the jugular group, Between vein and cervical vertebra

IN: Anorexia, vomit, stomach disorders

Pancreatitis: a TCVM Pancreatitis: a TCVM ApproachApproach

CAPT R.M. Clemmons, DVM, PhD, CVACAPT R.M. Clemmons, DVM, PhD, CVA

PancreatitisPancreatitis

•Considered any acute or Considered any acute or chronic change in GI chronic change in GI function usually function usually accompanied by some accompanied by some degree of vomiting, degree of vomiting, diarrhea and abdominal diarrhea and abdominal painpain

•Acute- -MildAcute- -Mild•PancreostasisPancreostasis

•Acute- -SevereAcute- -Severe•Fulminating pancreatitisFulminating pancreatitis

•ChronicChronic•Pancreatic insufficiencyPancreatic insufficiency

•Rx AcuteRx Acute•NPONPO•FluidsFluids•AntiemeticsAntiemetics•Pain reliefPain relief•Low fat/protein foodLow fat/protein food

•Rx ChronicRx Chronic•Enzyme therapyEnzyme therapy

TCVM Acute PancreatitisTCVM Acute Pancreatitis

TCVM Chronic PancreatitisTCVM Chronic Pancreatitis

* Enzyme replacement therapy still good to add* Enzyme replacement therapy still good to add

PerryPerry

3 yr FS Springer3 yr FS Springer

Earth personalityEarth personality

Acute onset of vomiting, Acute onset of vomiting, fever and abdominal painfever and abdominal pain

Increased thirstIncreased thirst

Scant urinationScant urination

Elevated Amylase & LipaseElevated Amylase & Lipase

Increased WBC Increased WBC

Rx: Fluids & RanitidineRx: Fluids & Ranitidine

Tongue: red & dryTongue: red & dry

Pulse: fast & superficialPulse: fast & superficial

West Dx: acute pancreatitisWest Dx: acute pancreatitis

TCM Dx: damp-heat in spleenTCM Dx: damp-heat in spleen

Perry TreatmentPerry Treatment

•APAP•DNDN

•ST-45ST-45

•ST-36ST-36

•LI-4LI-4

•PC-6PC-6

•BL-20BL-20

•CV-12CV-12

•AquaAqua•ST-36ST-36

•BL-20BL-20

•PC-6PC-6

•HerbalHerbal•Great Saussurea CoptisGreat Saussurea Coptis

•Next day was 80% Next day was 80% improvedimproved

•Clinician said, “He is Clinician said, “He is doing absolutely doing absolutely fantastic…better than fantastic…better than any patient in years…any patient in years…NO…it wasn’t the NO…it wasn’t the acupuncture…well…acupuncture…well…maybe we should try it maybe we should try it again!”again!”

Great Saussurea CoptisGreat Saussurea Coptis

Saussurea Saussurea Mu Xiang Mu Xiang Move Qi & relieve painMove Qi & relieve pain

Coptis Coptis Huang Lian Huang Lian Clear Damp-Heat in the intestinesClear Damp-Heat in the intestines

Evodia Evodia Wu Zhu Yu Wu Zhu Yu Warm the middle Jiao & stop vomitingWarm the middle Jiao & stop vomiting