Cold tummy for 2years

Date of first visit: 3, March 2009

Name: S Date of Birth 28 June78 Gender: Female

Address & Contact No. : OO

Chief complaints

Cold tummy for 2years

Descriptions (4 diagnostic methods)

A: Asking

Current condition	The patient is complaining of cold tummy that has been for 2years. Sometimes the cold sensation goes to lower limbs, heavy feeling in lower jiao, cold feet. Relieved by warmth and right pressure, Dreaminess, Extremely low energy during period. Appetite and drink-normal, defecation and urination-normal
Past history	NAD
Life style	Normal
Family history	Father has diabetes, mother has knee pain
Menstruation	Menarche at15, 30 days cycle and 4-5days, last month period 16th Feb.

B: Inspection

General	Tall and robust build, vitality 8/10
Others	NAD
Tongue	Pale pink, swollen tongue body, thick white coating

C: Auscultation/ Olfaction

Sound	NAD
Odour	NAD

D: Palpation

Body area	NAD
Pulse	Moderate, taut, weak(qi)

Case Summary

TCM Diagnose: Coldness in lower jiao

TCM Type/pattern: Spleen qi(yang) deficiency and Kidney yang deficiency

Explanation:

Therapeutic principle: Tonify Spleen and kidney. Warm general body.

Points selected:

Pishu, Shenshu, Mingmen, Zhongwan, Qi hai, Guan yuan, Zusanli/combined with moxa treatment

TCM

SP Yang Deficiency

* General Signs & Symptoms:

A further progression of SP Qi Deficiency above with more cold signs, cold limbs, chilliness, edema (more in the middle wawrmer)

* Tongue:

Pale, wet, swollen w/teethmarks

* Pulse:

Deep

* General Treatment Points:

* Maciocia Treatment Points w/Valaskatagis commentary, modifications and additions

* Same points as SP Qi Deficiency but you would use moxa and add the following points to further tonify the SP

* SP 9 - resolve dampness

* CV 9 - resolve dampness in the middle warmer

* ST 28 - resolve dampness in the lower warmer

UB 22 - TH Shu, effect fluids in the lower and middle warmers

SP Qi Deficiency

* General Signs & Symptoms:

Poor appetite, distention after eating, weakness of the four limbs, fatigue, loose stools

*Tongue:

Pale, swollen w/teethmarks

* Pulse: Empty

* General Treatment Points:

* Maciocia Treatment Points w/Valaskatagis commentary, modifications and additions

* CV 12 - ST Mu, distention after eating

* ST 36 - tonify ST/SP

* SP 6 - tonify SP Qi

* SP 3 - best with dampness in the channels, could leave this out

* UB 20 - SP Shu

* UB 21 - ST Shu

KD Yang Deficiency

* General Signs & Symptoms:

Sore a/or weak back/knees, sensation of cold, aversion to cold, weak lower limbs, lassitude, clear copious urine, poor appetite, loose stools, edema (which can be severe)

* Tongue:

Pale, swollen, wet possibly a white coat with strong water signs

* Pulse:

Deep, weak possibly slow with strong water signs

* General Treatment Points:

* Maciocia Treatment Points w/Valaskatagis commentary, modifications and additions

* UB 23 - KD Shu

* GV 4 - tonify Yang

* CV 4 - tonify Yang

* CV 6 - tonify Qi

* KD 3 - tonify KD

* KD 7 - tonify KD Yang

* UB 52 - tonify KD, strengthen willpower

* For strong water signs consider the following:

* UB 13 - LU Shu

* UB 15 - HT Shu

* UB 20 - SP Shu

* UB 22 - TH Shu, major point for water regulation

* ST 28 - move fluids in the lower warmer

* SP 9 - resolve dampness

* LU 7 - upper body edema

Follow up and life style

-Exercise recommended

-Sleep early and get up early

-Have and drink warm property food and drink

WMS

Cold sensitivity or cold intolerance is unusual discomfort felt by some people when in a cool environment.

There is much variation in the sensitivity to cold experienced by different people, with some putting on many layers of clothing while others in the same environment feel comfortable in one layer.

Cold sensitivity may be a symptom of hypothyroidism, anemia, or vasoconstriction (according to article Sauna). There may also be differences in people in the expression of uncoupling proteins, thus affecting their amount of thermogenesis.

It has been found that one's state of mind influences one's perception of ambient temperature. Thinking about an incident where one felt excluded caused experimental subjects to estimate the ambient temperature 3 degrees Celsius lower than subjects who thought about experiences in which they felt included.