Thursday, April 30, 2015

DYSMENORRHOEA CASE HISTORY

The following is a case history sent by Jason Smith in Madrid

Symptoms
A woman aged 43 seeks treatment for painful periods. The periods last three days and are extremely painful. She feels cold in general, but the cold is more intense at period time. 

The period is regular (30 days), lasts 3 days, with little bleeding, and the color is dark red with small clots. The pain is very intense, and is felt around the area of Ren-4/Ren-3. A warm bottle alleviates the pain along with analgesics. The period has always been very painful, especially after the age of 18.

The tongue has a normal color with a thin coating with root. However, the sublingual veins appeared very dark. This patient was a semi professional swimmer, practicing intensely around the age of 13-18.

Diagnosis
The main pattern is a very obvious case of Cold in the Uterus (nature of pain, feeling of cold and alleviation of the pain by a warm bottle). The Cold in the Uterus led to Blood Stasis, as evidenced by the clots, the dark blood and the dark purple sublingual veins.

Treatment
Following the four phases of the menstrual cycle, I decided to center the treatment on phase 4 (pre-menstrual phase), since this is the best time to expel the pathogenic factor, in this case Cold, from the Uterus.

With acupuncture, I used the Chong Mai, with SP-4 and P-6, and a moxa box around the area of Ren-4.

With herbal medicine, the patient was instructed to take four tablets of Wen Jing Tang.

After the first period, the pain was reduced by about 50%. After the second period, the pain was reduced by a further 25%. After the third period, and up to date, the patient only feels a very slight pain.

For prevention, the patient was instructed to use a moxa box before the period every now and then, to prevent a new invasion of Cold.

Observations
This is a very clear example of how a pathogenic factor can invade the body (after swimming during her puberty, incidentally a time when Chong, Ren and Du are in a very vulnerable state), and remain for about 30 years. It also shows how, no matter how much time has elapsed, pathogenic factors must be expelled.

It is also interesting to note that this patient reported having many times sexual intercourse without any protection, and despite that, never getting pregnant. This is probably due to the fact that Cold has been blocking the Uterus, and thus preventing fertilization: this is infertility from a Shi (Full) condition.