amyjenner: July 11, 2019, 1:26am
This patient is a 68 yr old retired art museum curator, skinny, dry skin, abdomen is warm and a little tight under the
ribs. He runs chilly but dresses for it and enjoys being outside (in Maine) all year. He is friendly and engaging,
curious- researches everything to death. Has some spider veins and slight swelling in the ankles at times. Has UTI’s
a few times a year (antibiotics), due to the swollen prostate (on meds). His energy is good. HIs tongue is red, with a
diffused crack pattern, thin coat. WM diag of stage 4 kidney disease, and BPH. Saam diagnosis LI/PC xs.
He came in today, a week into antibiotics for UTI. So, at the moment, the heat sign I have is the red tongue but he
does have a tendency to get UTI. I thought about UB+ but wanted to check in with you guys before doing it. How
much heat is enough for UB, I guess is what I am asking. I have done +SP and +SI, both of which he liked a lot.
I’m thinking it might be helpful to cool the whole situation in the lower Jiao. Seems less risky in summer than in
winter.
Tried to up load a tongue picture for you but only the title uploaded (above). hoping it will be a photo when I post.
Is it really only one chance? (i.e. insomnia case)12/01/2024, 12:22UTI, heat and antibiotics – Qiological Community
https://forum.qiological.com/t/uti-heat-and-antibiotics/364/print2/4
ngmatthews: October 4, 2021, 5:15pm
Just because it is bladder infection does not necessarily mean that he has a UB deficiency in Saam. You must stick
to the overall pattern to see what is really clear. This tongue looks like a QI deficiency tongue with a lot of Yin
deficiency overlay. So I am wondering about the state of his fluids. If he has a ton of heat you could try UB+ to
cool, but consider whether other cooling patterns might fit as well, such as LI or Liver. UB is the most cooling. LI
cooling and drying, LV cooling and moistening.
KristinWisgirda: July 11, 2019, 5:58pm
amyjenner:
I’m thinking it might be helpful to cool the whole situation in the lower Jiao.
How hot is his lower jiao? He doesn’t seem to be that hot overall.
If the midline of his abdomen between Ren8 and Ren15 was specially warm and soft or if he was an agitated, non
stop talker or non stop lover, UB+ would go to the top of the list.
Is there a reason why you wouldn’t consider repeating SI+ or SP+?
A recent patient of mine had a uti with very frequent burning clear urine that was unresponsive to antibiotics. SP+
worked immediately for her. She dislikes heat but isn’t hot. She is really dry on the inside and a reserved
personality.
Toby calls this type of deeply fissured tongue “sliced tongue” with the recommendation that it benefits from
Taiyang water supplementation, SI+ or UB+. My patients with this tongue have also responded well to SP+.
amyjenner: July 12, 2019, 12:13am
I have been doing SI and SP. I am just wondering about the idea of heat in the lower jiao generally being too high
because the UTI are recurring. WM says bec. of the prostate enlargement inhibiting flow. When he has the UTI it is
full on…burning, dark concentrated, strong odor, cloudy with constipation thrown in for good measure. Plenty of
heat. At the moment, he doesn’t have the symptom because he is on the antibiotics. I guess I’m wondering if I have
to wait for the UTI to recur before doing UB.
amyjenner: July 12, 2019, 12:15am
his mid line is warm and a little lax like a sagging hammock. When I press in there, there is a chopstick. I wasnt
sure if that qualified as the HTxs sign because I can go through it into something hard.12/01/2024, 12:22UTI, heat and antibiotics – Qiological Community
https://forum.qiological.com/t/uti-heat-and-antibiotics/364/print3/4
KristinWisgirda: July 12, 2019, 1:44pm
amyjenner:
I wasnt sure if that qualified as the HTxs sign because I can go through it into something hard.
The warmth and laxness gives some clinic weight to H excess even in the presence of the chopstick. That seems to
be the only clear H excess sign as of the moment?
amyjenner:
I guess I’m wondering if I have to wait for the UTI to recur before doing UB.
Hmmm- summer would be the best time to try UB+ but I would want more than the abdomen and the moderate
redness of the tongue to try it. I would also like to watch the patient closely, ideally with a follow up appointment
in the next week. Back and forth Sp+ and SI+ will probably really help too. Kidney+ will also increase fluids if
there is also a need for consolidation.
Please let us know what happens.
sweiz: July 12, 2019, 2:29pm
Hi Amy,
All UTIs are not heat. You’d have to see heat signs such as yellow urine, burning. Some UTIs are are cold or cold
damp. You are probably already taking this into account but just in case.
sweiz: July 12, 2019, 2:37pm
That really looks like a geographic tongue. I wouldn’t give it that much weight. Of course there are other signs of
fluid deficiency.
Adina_Kletzel: August 22, 2020, 9:26pm
How does one tell the difference between a geographic tongue and a tongue that shows fluid deficiency?12/01/2024, 12:22UTI, heat and antibiotics – Qiological Community
https://forum.qiological.com/t/uti-heat-and-antibiotics/364/print4/4
sweiz: August 22, 2020, 10:53pm
Hi Adina, I don’t think you can tell from the way the tongue looks. For me, there are two things I pay attention to.
The first is if the person says that there tongue has always looked this way. The second is if I don’t see any signs of
fluid deficiency.
Also, for me a geographic tongue is one with cracks, either a lot or not a lot. Some people call a tongue with peeled
patches in the moss geographic so we have to make sure we are talking about the same thing.
Hope that helps. I am curious what others have to say.