Submitted by admin on September 19, 2006 - 4:35pm.

An Acupuncture Case History
by
Zhou Zhi Jie

From: Shi Yong Zhen Jiu Yi An Xuan
(An Anthology of Practical Acupuncture Case Histories)

Page 73, example #1.

Lin XX, Female, age 35.  A worker at the Xi An Municipality #3 Plastics Factory. On May 4, 1969 she came to the hospital for treatment.

Patients remarks (provided by her husband):  The patient had been experiencing dizziness, tinnitus, visual dizziness, unsound sleep, and frequent bad dreams for more than three years. In recent days she also had deranged speech.

Disease history:  In 1965 the patient had suffered from neurasthenia; after Western and Chinese treatments her situation had made a positive turn, and she was even able to perform normal work.  During December of 1966, because she accidentally yelled an improper slogan, she was publicly criticized and denounced by her comrades. Later she was emotionally tense, and developed dizziness, tinnitus, visual dizziness, unsound sleep, and frequent bad dreams. Moreover she felt thoracic oppression, shortage of breath, throbbing of the heart, and agitation.  Later her reflection-will became steadily weaker.  She had no interest for objects surrounding her, did not want to have contact with people, and frequently closed the doors and stayed alone.  Her demeanor was indolent and lazy, she did not pay attention to keeping her clothes in order or clean, and did not wash her face or care for her hair.  At times she had deranged speech.  After December of 1966 she was unable to continue normal work.  At the Xi An Mental Hospital she was diagnosed as having “schizophrenia of the simple type.”  From 1966 on she had been treated with Western drugs, but these symptoms were not responding to the treatment.  At that point her husband brought her and requested treatment.

Investigation: The patient was slightly fat and had a pallid expression.  The tongue body was red, the tip of the tongue was also red, and the fur was white.  The pulse was deep, fine, and rapid.  The patient spoke softly, made illogical statements, and was unable to answer questions appropriately. 

Diagnosis: Withdrawal pattern.

Pattern identification:  Liver depression and vacuity of blood, heart yin insufficiency, superabundance of heart fire, and the spirit failing to keep to its abode, thus forming withdrawal pattern.

Treatment principles: Calm the liver and soothe depression, nourish yin, clear the heart, and quiet the spirit. 

Point selection:  Bilateral Shen Men (HT-7), Bai Hui (GV-20), bilateral Gan Shu (UB-18), bilateral Pi Shu (UB-20), bilateral He Gu (LI-04), and bilateral Feng Long (ST-40). The points above were applied with even supplementing, even draining hand techniques.  One treatment was given every day, with the needles retained for thirty minutes, and moved to obtain qi every five minutes.  After five such continuous treatments, the patient’s mental condition was relatively more normal.  She slept well, but still had [excessive] dreams.  Her head and cerebral distension and dizziness were greatly reduced.  The patient felt her heart emotions were soothed and uninhibited, and in the last five days she had not had deranged speech.  She was able to actively participate in conversation with family members, and could manage her daily affairs by herself.  At the time of the second examination her face had a good expression, and her clothes were tidy and clean.  The tongue body was pale red, the fur at the root was white, and the pulse was deep, fine, and slightly string-like.

The point formula and needling methods described above were continued.  Each time after removing the needles, each point was dotted [[[z]]] for three minutes.  When ten treatments had passed, the patient had a normal mental condition, she could do a small amount of housework, and her dizziness and head distension were completely ameliorated. The patient slept well, and two days prior [to the 10th treatment] had already returned to her unit for work.  A tongue examination showed that the body was pale red, the fur was thin and white, and the pulse was deep, and fine with strength.

The treatment was continued in order to consolidate [the result for] the patient’s future good health.  The point selection given above was used, [but] acupuncture was discontinued.  Dotting [[[z]]] the points was continued for therapy, with five minutes on each point at each session.  After continuing for another five sessions, all treatment was concluded.

Comment: Nan Jing “Er Shi Nan” says: “With heavy yin there is withdrawal, with heavy yang there is mania.”  Zhu Dan Xi stated “Withdrawal ascribes...mostly to phlegm binding in the heart and thoracic spaces.”  Others in clinic frequently see that withdrawal pattern may include a state of feeble mindedness, either laughing or crying, and an inebriated or dream-like state. Such patients may be unkempt, and have no concern for hygiene.  This follows from the affects and will being stagnant and binding and from feeling unfulfilled.

Treatment of withdrawal is mainly to course the liver and rectify qi, transform phlegm and open portals, nourish the heart and quiet the spirit. In this case, the withdrawal was the result of liver depression and blood vacuity, insufficient heart yin, superabundance of heart fire, and the spirit failing to keep to its abode.  Treatment was to calm the liver and course depression, nourish yin, clear the heart, and quite the spirit.  The points above were chosen because:  Point Shen Men is the stream point of the heart channel, and is also the source point of the channel; its application moves qi and quickens blood, quiets the heart and settles the spirit. Point Bai Hui is the intersection point of the governing vessel and the three yang channels of the hand; it can clear the head and scatter wind, open portals and wake the spirit, return yang and stem desertion.  Point Gan Shu is the dorsal shu point of the liver; it can drain fire of the liver and gallbladder, as well as nourish the yin of liver and kidney.   The point Pi Shu is the dorsal shu point of the spleen, and applying it fortifies the spleen and disinhibits dampness, boosts qi and manages blood.  Point He Gu is the source point of the large intestine channel, and applying it can clear and drain the yang brightness channel, and deobstruct the channels and open portals.  Point Feng Long is the connecting point of the stomach channel, with a divergence to the spleen channel; applying it sweeps phlegm and quiets the spirit.  The above points in combination, when put to good use by skillful techniques suited for the disease, will reap rapid results.

[Dr. Zhou completes each of his cases in An Anthology of Practical Acupuncture Case Histories with a brief poem.  I find that my translations of these poems are greatly lacking.  To my eye, there is little in these poems beyond a mention of the points and the major symptoms, and twisting the English to get something close to the rhyme scheme produces an extremely pedantic translation.  But readers with more insight might see something more.  So I am inserting the Chinese text here.]

Dian Zheng Yi Zhi Yao Xi Fen/Shen Men, Bai Hui, Gan Shu Jun
Pi Shu He Gu Bing Feng Long/Yi Zheng Shi Shu Fa Ying Zun

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