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Devastated Yang

The patient is a 30-year-old male of a slender tall build who presented himself with a chief complaint of palpitations. A review of the intake reflected that his pulse rate was approximated to be 190-200 bpm, and a blood pressure of 90/70, with general signs and symptoms of cold perspiration, fatigue, dizziness, and a cold body temperature. The diagnosis of record was noted as a deficient Heart yang and the treatment given was acupuncture and an herbal formula. The apparent plan of treatment was to lift the yang and provide some warming. The acupuncture points selected were Du20(regulating yang),26(regulates Yin/Yang), P6(Interior Gate), S36(command pt. m.j.) The initial herbal formula was: Huang Chi, Dang Shen, Gan Jiang, Wu Wei Zi, Bai Shao Yao, Gui Zhi with the apparent intention to lift the chi, and warm. On entering the case at this point and noting from the record that the intake appeared to be incomplete and inconsistent with the additional signs and symptoms noted; as the patient suffers from extremely cold limbs with muscle stiffness of the hands, a pallor lusterless complexion, a shivering from the cold sensation, profuse cold perspiration leaving the clothing wet, a listless demeanor and a pale purple tongue, I concluded that the diagnosis to be that of a devastated Yang, a collapse. Deficiency of Yang refers to a worsened state of chi deficiency and is a consumption of essential chi. It presents itself as with a relative excess of Yin. In Conventional Medical terms it is an immunologically degraded organic circumstance that describes an inability of the body to react with sufficiency to rectify an assault. Deficiency conditions of Yin/Yang reflect the principle of the interconsuming supportive relationship, and a deficiency of Yang requires the acquisition of the Yang within the Yin. The two aspects of Yin and Yang within any phenomenom are not fixed, but in a state of continuous mutual consumption and support. The general clinical presentation of a deficiency of Yang is in part that of body chills, cold limbs, perspiration that is of a spontaneous nature, fatigue, a pale tongue, and a weak pulse. Collapse of yang on the other hand refers to the exhaustion of the yang chi of the body, its action component. The clinical presentation is that of profuse cold sweat, cold body, frigid extremities, empty breathing, pallor lusterless complexion, an absence of thirst, a pale moist tongue and a fading pulse, which is the clinical picture of the patient. Shock is a state in which blood flow to and perfusion of peripheral tissues are inadequate to sustain life&usually associated with hypotension& The general signs and symptoms are in part; cold hands and feet, moist pale and bluish skin, with a weak rapid pulse. The systolic blood pressure is <90 or not obtainable. The patients condition developed over several hours and was more consistent with an assessment of Hypovolemia, a form of shock that is an immunological breakdown reflecting with a condition of regulatory rigidity associated with rising hemoglobin and/or hematocrit levels. This could be a consequence due to a thermal injury and is frequently associated with a concurrent condition of vasodilation. Hypovolemia is a condition of reduced cardiac output and vasodilation is a regulatory failure of the vessels and dehydration. The plan of treatment requires the elevating of the blood pressure in order to acquire systemic stability and the warming of the patient is a preferred primary intention. The patients arms felt like ice cubes. His laconic speech, lusterless complexion, and remarkable profusion of body fluids evidenced on his skin strongly suggests that this was a collapsing condition of Yang requiring an immediate interior warming of the patient. His pulse rate suggested the integrity of the thalamus - adrenal connection and his otherwise clinical picture inferred a regulatory disruption along the hypothalamus pituitary adrenal path. The initial herbal formula used Dang Shen where the condition called for Ren Shen. Though they each provide a tonifying action of the chi, the Ren Shen strongly supports the basil chi and is more appropriate for collapsing conditions. In large dosages it has demonstrated efficacy on the cardiac system by raising blood pressure, which is the pre-eminent issue in this case. In addition the original formula included Gui Zhi (Cinnamon Twig) for warming where the condition called for Rou Gui (Cinnamon Bark). Gui Zhi, Cinnamon Twig, though with similar characteristics to the bark, according to all literature is intended to address dispersal actions as in diaphoresis, which is contraindicated in this case as the patient is manifesting not only spontaneous perspiration, but profuse perspiration. Rou Gui, cinnamon bark, is intended to warm the interior of the body and expel cold with an action that returns heat to the basil chi. Devastated Yang is seen as an&exhaustion, and collapse of the Yang&which is accompanied by severe deficiency of the source chi, the sudden collapse of the Yang Chi, and an increase of cold in the interior&characterised by cold extremities, an aversion to cold, and a submerged, faint&pulse. The herbal formula called for was Si Ni Tang, containing Fu Zi, Gan Jiang, Zhi Kan Tsao, as it treats the picture of extremely cold extremities, aversion to cold...lethargic state, pale tongue with a white coat&a thin or submerged faint pulse. The significance of this formula is that it strengthens the Yang of both the Spleen and Kidney systems without injurious consequence upon the Yin. The pathogenic factor of cold invades the interior and finds its deposit in the lesser Yin stage as a Shaoyin Syndrome and may thereafter reflect a condition of shock. A cold Shaoyin condition is the clinical presentation of this patient and the plan of treatment is with acupuncture with points along the Ren, Spleen, and Kidney pathways with an emphasis on the use of moxibustion, a protocol that delivers warmth. Homeopathically the remedies that fit this picture are Veratrum Album & Carbo Vegetabilis and the potency delivered in this case was a 10m in the amount of four drops. Carb-v is a vegetable charcoal, and presents itself for conditions of degeneration that reflects poor oxygenation of the blood system, quite appropriate for an atonic condition. Veratrum Album is a flower that addresses conditions of collapse with extreme coldness, prostration, cold sweat, and spasm of limbs, fainting, lusterless complexion, and chills with extreme coldness, The clinical picture for this remedy is an icy-cold body, loss of fluids, a lifeless lassitude, a collapsing state with its attendant feeble pulse, tremors, profuse cold sweat, cold limbs, cardiac pulsation throughout the body, stiffness of the limbs, and dizziness. Additional information provided by the patient indicates a history of several such incidences over the past two years and without any appreciated diagnosis or sustained plan of treatment. As there appears to be reactive capacity it infers that intracellular structures and enzymatic actions remain with integrity, and that the filtering actions of the Matrix remain viable. This patients condition appears to be rooted within the Deposition Phase at an Immunological stage of disharmony and with an assault within the Impregnation Phase wherein the organisms reaction appears with some aspects of regulatory rigidity. This is evidenced by impaired blood circulation with its attendant deficiency of nutrient transport and condensation of homotoxins that has resulted with an appearance of collapse. The plan of treatment with Homotoxicological remedies is with a Composition and an Injeel, which was applied s.c. at G25. The remedies selected were Cor Compositum and Circuloheel, both remedies by Heel. The composition constructs from Heel offer low potency constituents that cover a broad range of therapeutic action offering remedies with similar or complementary tropism action&are particularly suitable in serious pathologies for their quickness&connected just to the histopathological problem&and deeper than medical herbs. Cor Compositum offers low potency components that are directed to degenerated regulatory organ function, tonics, which clear circulatory stasis, and supportive remedies for the cellular protagonists. Circulo-injeel is a combination of a polycord of single remedies whereby &the administration of a potency chord the organism is addressed on several hierarchical levels& In this instance this remedy attends to peripheral circulatory impediments with cold type manifestations and offers an immanency of reaction. Testis Compositum by Heel is being offered as a long term protocol as it is supportive of various metabolic disturbances. It accomplishes this by addressing specific organ tissue, tonification properties, rectification of the mitochondria by regressive vicariative action due to cortisol flooding. It is of particular value when there is suspicion of an impediment along the Hypothalamus Pituitary Adrenal pathway. It is suggested that this is administered Monday and Thursday between the hours of 5-6 p.m. Ren Shen Yang Ying Tang is being offered as a long term herbal protocol to address consumptive disorders that require support of the Ying Chi of the body. It is suggested that three,3, grams be taken three times a day, a.m. - midday - 5-6 p.m. In sum the original diagnosis was of a deficiency of Heart Yang and the apparent plan of treatment was to lift the Yang. Whereas the condition was more likely a Devastated Yang requiring a plan of treatment that warmed the Yang and expelled the cold from the Interior. In Conventional Medicine it appeared as a condition of Shock requiring the immediate elevation of blood pressure to prevent organ failure and death. The original plan of treatment failed due to an erroneous diagnosis and it emphasizes the adage that it is easy to prescribe and it is difficult to diagnose. The distinctive benefit of the protocol herein applied both for the acute presentation and the long term treatment is the value of integrative medicine by its offering of complementary mechanisms to attend to a totality of signs and symptoms with the intention to generate regressive vicariation with the least adverse consequences.