Vulvodynia Case

[Reece Yeo]

Just saw a 46yo woman with a 12 month history of abnormal sensation in her vulva region. The sensation is described as feeling like her labia are parting, and when she wears pants, the bottom crotch area of her pants are pushing up against her vaginal introitus. She has seen many different specialists and has been unofficially diagnosed as having vulvodynia. She does not like the cold or wind; has cold hands and feet; has restless legs; and does not sweat easily. Her L & R guans are mid level thin wiry. L & R chis are also thin wiry and are a bit long. I am not a 100% whether her L guan and L chi are level. She is also rather thin and doesn’t have much body fat, so I am not sure whether the length of her pulse is due to that or not. Both her recti abdominus are tight, and she has a palpable abdominal pulsation. Based on her pulse and signs, I am thinking along the lines of SNS or a XXT? Some feedback and guidance please!

[Aaron]

johntourkolias

[hamishbrown]

DGSNT all the way Reece! Plus TR, HH or GZFLW. I think a XXT or a JZT would be too cooling. Plus, you don’t have the big right guan for a JZT.

[Reece Yeo]

Stroke Prevention Question

[Aaron]

aubryl-fisher

[Reece Yeo]

Thanks Hamish! But no expiring DG pulse?

[Aaron]

I’m not sure. I normally don’t give SNS when the thin wiryness is also in the chis. I might be doing it wrong, though. She sounds like a dry type constitution though, which is more a XJZT type.

[hamishbrown]

Thin and wiry, or deep thin and wiry are pulse potentials for DGSNT along with expiring on the left guan. Lots of people seem to think there has to be an expiring left guan, but it’s only one of the pulses for the formula as I learned it. There is also another Dr. Zeng DGSNT pulse that you can ask AV about when you have finished the whole course.

[Reece Yeo]

Hamish Brown, thank you Dr. DGSNT!

[laurieayres]

But in SHL context, yes

[laurieayres]

If they still have a DGSNT pulse in summer, then they definitely have cold blood!

[hamishbrown]

Hi Laurie. If you could please help me understand with a mid to deep thin wiry pulse and cold blood symptoms of: ” She does not like the cold or wind, has cold hands and feet, has restless legs, and does not sweat easily” why we would not want to go to DGSNT? Many thanks.

[laurieayres]

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[Arnaud Versluys]

And then there’s those hollow DG/DGSNT pulses…

[Aaron]

I don’t really understand DGSNT, being excessive closure of Jueyin, having hollow pulses. I thought hollow pulses were caused by yin/yang seperation, from the qi separating from the blood and pushing out the walls of the blood vessels. I thought DGSNT, with excess closure, would have blood vessels being too contracted?

[Arnaud Versluys]

Funny, right?

[hamishbrown]

Ok. The pulse description I have for DGSNT is firstly thin wiry, or deep thin wiry (side note of especially L guan), and secondly, deep thin wiry with a tendency towards expiring. So I read that as the pulse is in general thin wiry, and can be deep or higher due to the description of 1 option being deep thin wiry. For WJT I have both guan wiry and possibly knotted, or both guan deep wiry. So with the above pulse being thin, which isn’t part of the WJT description, and the chi positions also being thin and wiry, I thought the DGSNT pulses fit more. Do you generally look for thinness with a WJT pulse too?

[laurieayres]

Yeah, they can often be thin, but a DGSNT is a SHL formula, and as standard it’s left. WJT is JG, so it’s both sides, and there is a material element

[hamishbrown]

Thanks so much for elaborating Laurie! It’s so helpful understanding more about how to differentiate between the pulses and formulas.

[hamishbrown]

I’ve been biting my tongue for ages by not mentioning that pulse. I assumed you weren’t openly teaching it because it would confuse people and also lead to people prescribing DGSNT inappropriately when they probably should be harmonizing. Thanks for mentioning it and hopefully people find they do more benefit than harm. I understand it potentially more through the angle of JueYin Liver Blood not only becoming cold and deficient, but also contracting from that chronic state. But that still doesn’t fully make sense. Personally I’ve seen it working and being present more in men that have some old liver issues. One patient comes to mind that has a genetic problem of B12 production and needs monthly injections. He has a big hollow left guan and has seen great improvement with DGSNT. Once I tried a XXT to see if I should harmonise him and gee that didn’t go well.

[laurieayres]

It makes sense in the context of just DG as sweet moderation of wind, but in the context of the formula DGSNT, it does become more of a mental stretch. I think about it in the same way that I think about the combination of DGSNT+TXS, that DGSNT warms the blood. If the blood is warm, it means yang is in the blood, and not floating out of the blood. Hollow pulses show yang floating out, so if you warm the blood, it means yang is no longer floating, but it is rooted inside yin… and that just goes to show that the more complexly one thinks about some things, the more likely one is to be wrong about them :-).

[hamishbrown]

leigh.eac@gmail.com

[Aaron]

Sometimes, though, yang leaves the blood because the blood is too dry to contain it. Would DGSNT anchor the yang in the blood in that case?

[Author]

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