jedwardian: January 18, 2021, 2:13pm
Greetings fellow Sa’amurai (sorry, sorry…the habit is ingrained after the case studies seminar)
I’ve treated a woman with chronic cough and asthma several four times now, with only modest improvement, and
would love other eyes on this one.
Constitution/Temperament: She’s middle-aged, slightly stocky, well-put together woman of around fifty. We’re in
NC but she strikes me as a type I’m more used to from my NYC days: reserved and kind of ‘no-nonsense.’ She’s
direct though not impolite. Used to be a smoker.
CC: Asthma, and cough that began with bad cold last fall and never went away. Cough tends to be worse in the
morning and evening; she’ll sometimes have 30 minutes coughing spells upon waking around 4:30am, which is
earlier than she would prefer to awaken. Sleep is an issue in that she routinely wakes during the LU hour. At her
initial visit she reported copious sputum, thick, varying color from clear to white to “slightly colored.” However
the cough can also be dry and unproductive (as has been the pattern in more recent visits, see below for treatment
history). I have the impression that it can become what I think of a spastic cough, where the cough reflex keeps
triggering itself in a vicious cycle.
She is prone to sinus congestion as well, sometimes leading to dull frontal H/A. Not a particularly wet or phlegmy
congestion.
Her wheezing is triggered by exposure to dust and chemicals, and is also exercise-induced. She uses her albuterol
inhaler routinely before going for a walk; recently when she forgot it, she ended up having a bad asthma attack
which worsened further when she walked into her house to get the inhaler.
Digestion is fine.
Energy levels are not a major problem except insofar as she’s tired after the nights when she wakes too early.
Dizziness, has positional vertigo (but did not volunteer this info so must not be severe)
Prone to a calf twitch which can move up into her hip
Low back pain; history of low back surgery
R knee issue for decades, worse with walking
Skin does not strike me as dry.
Mood: generally even-keeled, can ruminate
Tongue: tends to be wet, with scalloping, clear coat
Abd: somewhat doughy but not flabby or lax
She runs neither hot nor cold; with some of the herbs I gave her (overall warming, like Suzi Jiang Qi Tang) she
noticed some mildish hot flushes in the afternoon10/01/2024, 12:54Chronic asthma/cough case – Qiological Community
https://forum.qiological.com/t/chronic-asthma-cough-case/1468/print2/4
Excess patterns noted
HT: –
UB: –
SI: –
KD: back pain +4, highly fertile (immediately got pregnant with each child) +9, mother had fibroids (low clinical
weight but thought I’d mention), well-put together +7, dizziness/vertigo +5
PC: –
GB: shortness of breath +8 (i.e. wheezing, not sure if this truly counts as GB excess as there’s no tight chest per se)
LR:
SJ: bright eyes +6, polite +7
LU: damp inside (copious phlegm) +7 (at initial visit), well-resourced +?, cough/wheezing
ST: cough/wheezing
SP: damp inside, wet scalloped tongue, moderately thick-set build
LI: –
Treatment #1: Cupping followed by LI+ ®. Did not settle especially well but I retained needles.
Response: noted immediate improvement in breathing and cough. phlegm became thinner. still wheezing.
improvement lasted 4-5 days, then things worsened. also noted that the treatment seemed to “activate” her bowels.
Treatment #2: ST+ ®.
Response: no positive change, possibly some deterioration. coughing 30 min most mornings. Appeared puffy and
out-of-sorts at third visit.
Treatment #3: LU+ (L)
Response: noted some relief, not coughing as much or as long. sinuses clearer. still very dependent upon inhaler. no
longer looking puffy, shen notably brighter.
Treatment #4: LU+ (L)
Response: noted little change for first few days, then some improvement (likely due to herbal formula, now a
modification of Houpo Mahuang Tang)
Discussion:
I would not have pegged her for a ST excess type, yet supplementing ST caused things to go south, and LU+
corrected. My next move will likely be to return to LI+, which seemed to help her the most and fits her
constitution. Going back over the case and writing it up makes it seem quite obvious that this is the way to go.10/01/2024, 12:54Chronic asthma/cough case – Qiological Community
https://forum.qiological.com/t/chronic-asthma-cough-case/1468/print3/4
After that, my next move could well be SI+, though it’s unclear how much this could help her asthma and cough.
Also considering PC+.
One detail I nearly overlooked but that may be important: she had a bout of diarrhea last summer after doing some
kind of juice cleanse with celery juice; the loose bowels persisted for some time and practitioner put her on a
capsule product to address them. This helped, and she noted that as the stools normalized, her asthma improved as
well. For me, this points to the LU-LI metal connection and shows that drying treatment may indeed be what she
needs more of. Pretty clear that LI+ should be next, and seems not out of the question to double-up on it with a
mirror treatment.
Thanks for any thoughts on this case and on treating asthma and chronic cough with Sa’am.
Jonathan
George_Mandler: January 18, 2021, 3:17pm
Hi Jonathan,
Although you did cupping on that first LI+ treatment so it may be hard to tease out what worked, I would agree
that LI+ seems like a good fit.
Does she tend to crave sweets or have any trouble getting motivated to do things? That would add more to a SP
excess pattern.
jedwardian:
Skin does not strike me as dry.
Do you see any dry – besides the dry cough she sometimes gets? From your writeup and treatment experience it
seems like the dry/wet may not be in play here,
jedwardian:
Excess patterns noted
…
KD: back pain +4, highly fertile (immediately got pregnant with each child) …
Note: Back pain is not a for sure KD excess sign – we may consider it if directly at L2.
Given her Kidney excess signs and her back surgery (scar tissue) I would consider SI+ supplementation as well.
Maybe use LI+ again see how she does and the treat SI+ by itself. Re-evaluate and then consider combining
especially if there is the back pain still present.
But don’t rule out the wet/dry as maybe you’ll need to come back to that and she needs the other treatments first.
To add to current trending Sa’am topics how are her thenars and medial heel? #thenar. #medialheel. 10/01/2024, 12:54Chronic asthma/cough case – Qiological Community
https://forum.qiological.com/t/chronic-asthma-cough-case/1468/print4/4