Dear Tutor
The clinical manifestations for damp heat in the liver and gall bladder, and for damp heat in the spleen and stomach, are nearly identical. Is there a way to differentiate them from each other? Or is that just a matter of clinical experience, to detect the slight differences in pulse, or subtle things like that?
Sometimes I have been to the doctor and when they are not sure if it is illness A or illness B, they give medicine for illness A and if it doesn't work they try B. Is that something like what is meant by "to search for the root cause of the disease in the treatment"?
Thank you
Ed Austin
Dear Ed,
I don't think the clinical manifestations of the two groups of organs infected with damp-heat are identical!!!
First of all the major location of the illness is different between the two. Secondly, the pulse is also not the same in the two situations.
These differences are very important, or even vital in making differentiation.
Besides, the emotions should also be different between the two.
To do acupuncture, one should also detect the abnormalities in the meridians, so what will you do for this step?
Tutor
Dear Tutor:
On paper, when I compared the list of symptoms associated with the two syndromes, most of them are present in both cases. They both have nausea and vomiting, abdominal distension, poor appetite, bitter taste in the mouth,scanty yellow urine, yellow sticky tongue coating, even yellow color in the skin. On paper, they seemed very similar.
Of course you are right, the pulse is different, and the liver syndrome says hypochondriac pain and distension, which is the area where the liver is located and also where the liver meridian runs. Hopefully those things would be more readily observed in an actual person than they were when I was just reading them on the printed page.
Regarding the meridians, my only guess would be to look for points of pain or tenderness along the course of the meridian. I have also read about something called "alarm points" that pertain to specific organs, but I dont know any more about them.
You also metioned the emotions. In the five-element theory the emotion associated with the liver is anger, and with the spleen is over-thinking. Is that what you meant?
Thank you
Ed Austin
Dear Ed,
Yes, this time you found the real difference between the two!
In fact these are the very important ones, the hypochondriac region and the sting-taut pulse. Indeed we often found patients with liver Qi stagnation would complain of the distension or even the distending pain in that area.
When the liver and gallbladder are affected, a person would be much more emotional!!!
To detect the meridians, basically you're right, and basically we could only teach so much as you have mentioned.
Of course there are such alarm points for the organs but I think it should be learnt from the clinical practice.
Tutor
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