Dr. TI's questions

Dear Dr.TI,
It's nice to hear from you again.
I do feel you are studying diligently the Medboo TCM courses and have a good understanding in combination with your clinical experience.
Now, let's discuss your questions.
1). No, not really!
It's often a sign of the infection from the beginning stage to the real inflammatory stage. There could be the symptoms such as hyperpyrexia ect. For quite sure the exterior cold transmitted to the interior and transformed as a heat syndrome is often such a case as the common cold or influenza complicated with pneumonia or respiratory infections. Not always, but often. Or maybe the digestive system should also be taken into consideration, so there could be the gastrointestional infections or inflammations e.g. the acute gastroenteritis. As we could see, at the beginning, it is rather the manifestation of cold, but later the fever running.
For there could be some other diseases in western medicine involving this situation, e.g. the urinary infection, the blood diseases, hepatitis,ect.
In general, very often the infectious or inflammatory diseases might be the case of this type transmission.
At that moment, for sure we cannot tonify , not at all. Maybe you will learn the treatment principles in course D with acupuncture, therein the reducing and reinforcing methods are illuminated. So, to deal with this situation, we must think the right way as there is an excess of pathogenic factors, and the anti-pathogenic Qi is not really weak, so there's a running of fever. What we should do is to eliminate the pathogens. In traditional Chinese medicine, there are some herbs which have the antiinflammatory effect.
2). It IS too early to ask this question, but usually the treatment concentrates to draw the heat donw, maybe by herbs or maybe by acupuncture.
3). Quite possible your patient has some damp-heat, maybe stomach heat as well. If it's the heart fire, the ulcer would occur mainly on the tip of the tongue, not in the entire mouth. I suggest you to review the part of the false heat syndrome, for I think you didn't quite understand it well. It is quite a rare case, not happening frequently. But it is rather severe. If it's the floating Yang, the patient would be in some critical condition. However this case is a complicated one, and I wonder if he's diabetic.
Besides, it also seems that the heart Yang could not go down to warm the lower while the kidney Yin could not rise to nourish the upper. Hard to say at the moment, I have to see the patient.
4). I suggest you to review the manifestation of the Yang deficiency and those of the Qi deficiency (all in the eight principles) and then review the spleen deficiency.
I think you could list the manifestations of the Flare-up of the liver fire and Rising of the liver yang and those of the Deficiency of the Kidney qi and Insufficiency of the kidney yang, so you could try to compare and see the difference. Even the slight difference would be important.
For the difference for the manifestations has alot to do with confirming the diagnosis and establish the treatment principle.
The kidney stone patients may have either kidney Qi or kidney Yang deficiency, or even kidney Yin deficiency, or not the deficiency at all, but rather the damp-heat in the lower Jiao. It all depends on the manifestations. But very often the kidney should be involved, for near all the patients would complain of the lumbago if the case is severe enough.


Now, I'm sending you the paper of the final exam of course B and hope it finds you all well.
It's also my hope the answers are just clear and convincing to you.

Bye!
Best regards
Dr. xx








----- Original Message -----
From: "Татьяна Иванова" <tanjushka-super@rambler.ru>
To: <tutor@ontcm.com>
Sent: Sunday, December 04, 2005 1:03 AM


Dear Dr xx,
how are you? May I ask you some questions?
First one about transformation of cold into heat. If transformation
of cold into heat results from a strengthening of the anti-pathogenic
qi and hyperactivity of yang qi, does it mean a good sign of
recovering? I`m not sure, that I understood this question right,
because I thought the transformation of exterior cold into interior
heat is not good. What is right? Should we tonify yang qi in this
case to help the anti-patogenic qi?
The next question about the syndrom "heat above with cold below" -
how to treat it? May be it`s too early to ask about special points,
but I often met such patients before. Can you advice something?
I`d also like to ask you about one my patient with reccurent ulcers
in his mouth and tongue for more than 30 years. I thought, that it was
hyperactivity of the heart fire, but he didn`t reply on acupuncture.
His tongue is dark red, his pulse is rapid, he has high blood
pressure, cold legs, pale face. Could it be the syndrome of false heat
and floating yang?
How to differentiate Deficiency of the spleen qi and Deficiency of
the spleen yang and does the treatment different?
It seems very difficult for me to differentiate Flare-up of the
liver fire and Rising of the liver yang. What are the main symptoms to
differentiate these conditions? Is it important for the treatment?
It`s difficult to differentiate Deficiency of the Kidney qi and
Insufficiency of the kidney yang. I can`t see any important
difference.
If the patient has the stonens in his kidneys, is this
Insufficiency of the kidney yang or not?
I`m sorry,that I am sending too much questions, may be.
I also ask you to send me the exam for the Course B, because I
reread the course several times.
Best regards,
Dr.TI