Daniel: August 27, 2019, 10:23pm
A 59 year old symphony violinist came to my clinic about 6 weeks ago for right shoulder pain that had become
chronic enough it had generated a secondary concert performance anxiety issue. Her pain was clearly in a
combination of the Yang Ming and Tai Yin aspects of her shoulder.
She has a lifelong history with asthma although its been mostly silent for the past decade.
She appeared quite happy and very curious to explore acupuncture.
She clearly enjoys her work and is quite successful at it – in a part of the country where there is very little work in
her field.
Her upper frame is quite small, with small shoulders.
Relative to that, she is notably larger in the hips and buttocks.
She has a slightly droopy face with bags under her eyes.
But overall, she is quite smiley and very engaged with me about treatments.
I used Kiiko Matsumoto treatments with her for five sessions.
Her shoulder pain definitely improved
but after first treatment, her asthma surged for first time in a long time and over the following month of treatment,
just got worse and worse, to the point that last week, she went to a medical clinic for assessment.
This past week, she reported severe fatigue with loss of appetite.
She has also developed episodes, perhaps three times a day where she experiences a clammy sweat and a
feverishness on her forehead.
She clearly trusts me and despite this triggering and worsening of her asthma, along with fatigue and loss of
appetite, continues to come for treatment!
On today s visit, I decided to switch to the Sa Am approach.
She has a history of dry eyes (diagnosed by a doctor as being due to blocked oil ducts – not tear ducts but oil ducts),
constipation which she must manage with daily intake of psyllium
Also, her Lung 10 area on both hands is definitely deflated in quality.
She is not lazy at all, shows no signs of boredom, has no sweet tooth, no financial problems
and no knee problems.
Of course, asthma can be, in my experience, dry or wet. Listening to her wheeze, it is clearly dry. Based on this and
her dry eyes and constipation, I feel inner dryness is the core of the case (and my Kiiko treatments must have
been exacerbating her inner dryness). Her skin is moist, not wet. Definitely not dry. And the treatments had also
provoked this clammy sweat and heat on her forehead (some outer wetness and ascending heat).
So today, I administered a Sa Am Lung supplementation treatment (Spleen 3, Lung 8 supplemented and Heart 8,
Lung 10 drained) on the Left (since her shoulder pain is on the right) to try to shift some moisture into interior and23/01/2024, 11:48Bringing in Sa’Am Emergency Response to Rectify a Worsening Patient . . – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/bringing-in-saam-emergency-response-to-rectify-a-worsening-patient/548/print2/3
I asked her to report back on her asthma, her dry eyes, her constipation, fatigue and appetite. Unfortunately at the
same time, the doctor she saw last week has her on a steroid inhaler.
Any comments, thoughts or insights?
michaelmax: August 28, 2019, 3:43am
As I was reading through this case @Daniel I started thinking sound dry inside and wet outside. So your +LU
treatment makes sense.
Please keep us posted on the outcome!
Daniel: August 28, 2019, 2:54pm
I found it a bit tricky because it was not entirely unequivocal that her dry eyes and her constipation were internal
dryness . It was easy and possible to equivocate on both. Her eyes had been diagnosed as being due to blocked oil
ducts (not tear ducts but some kind of oil ducts) . . . so at the micro level, that is not dryness in the sense of not
generating fluids but dryness of eyes because a duct is obstructed or blocked which could actually be some local
congealed dampness!! Then the constipation – as we discussed it – it was not clearly for sure constipation due to
dryness. As for the exterior, when I say her skin was moist – I just mean it is just healthy, not dry skin really. It was
not clammy or wet at all. So really, everything could go either way. What tipped it for me was when I listened to
her asthma wheeze, it was clearly dry. (her body type by the way, I would consider to be constitutionally damp !)
So in the end, I just went with internal dryness – external dampness as most likely – and that my treatments in the
Kiiko style had been provoking more internal dryness!! But it was one of those situations where all signs and
symptoms could really go either way . . . and combined with the pressure of feeling the treatments so far had really
worsened things (worsening asthma, extreme fatigue and now loss of appetite) . . . I really felt under pressure!! We
will see.
Marco: August 7, 2020, 4:35am
Hi Daniel and MAx, intresting and are the any update on the person above?
amyjenner: August 9, 2020, 11:46pm
As an aside As a person with dry eyes myself, I have learned that there are 16 tiny ducts in each of the upper an
lower eyelids responsible for lubricating the eyes. Post menopause, everything gets dryer. there is less fluid in
available in these ducts as well and the oils there thicken up like butter, kind of clogging up the flow of any23/01/2024, 11:48Bringing in Sa’Am Emergency Response to Rectify a Worsening Patient . . – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/bringing-in-saam-emergency-response-to-rectify-a-worsening-patient/548/print3/3
moisture. Using a hot compress every morning while I wait for my tea water has worked, FYI, to melt the butter
like oils and allow them to flow better. If I didn t do the compresses, I wouldn t be able to wear my contacts.
michaelmax: August 10, 2020, 12:30pm
@amyjenner have you tried to tonify to LV to see if that helps with moisture in the eyes?
Fluids are an interesting thing and very complex. And using the warm compress makes me think about how the
warm yang can help to move the fluids, which in turn keeps them from thickening because of lack of motion. I
wonder if treating +SI and +SP might help to generate and move the fluids.
amyjenner: August 10, 2020, 1:13pm
that is an interesting idea. Or even just the SP+ alone because I think they naturally want to move if they aren t too
thick to do so.