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TCM Spleen Disease. Spleen Physiology Spleen Pathology Gingivitis/ Stomatitis Ulcers Pancreatitis Bleeding Muscle Wasting Obesity Constipation. Sound song Emotion sympathy Climate humid Season late summer. Direction center Opening lips/gums Body Part muscles Zang/Fu SP/ST.

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TCM Spleen Disease


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    1. TCM Spleen Disease Spleen Physiology Spleen Pathology Gingivitis/Stomatitis Ulcers Pancreatitis Bleeding Muscle Wasting Obesity Constipation

    2. Sound song Emotion sympathy Climate humid Season late summer Direction center Opening lips/gums Body Part muscles Zang/Fu SP/ST Earth

    3. Governs Transportation & Transformation Food & Water Controls Blood Dominates the Muscles Opens in Mouth Lips & Gums (ST) TCM SPLEENPhysiology

    4. TCM 24 Hour Clock

    5. Earth BALANCED DEFICIENT EXCESS

    6. Spleen Pathology

    7. Spleen Pathology • Damp is the Enemy of the Spleen • Damp-Cold • Damp-Heat • Spleen Qi Deficiency with Damp

    8. Spleen Pathology Usually combination of excess & deficiency External or Internal Pathogen Damp-Heat Damp-Cold Obstructs Spleen Qi Flow Spleen fails to Transform & Transport Gu Qi Spleen Qi Deficiency

    9. Spleen Pathology Cold Environmental Conditions Cold Food or Drink Cold-Damp in Spleen Disharmony of Qi Flow Transform & Transport Disorder

    10. Spleen Pathology Accumulated Heat & Damp Damp Hot Environmental Conditions Damp Hot Food or Drink Damp-Heat in Spleen Disharmony of Qi Flow Transform & Transport Disorder

    11. Spleen Qi Deficiency Illness Overeating Overwork Starvation Under Work Spleen Qi Deficiency Disturbed Qi Flow Failure to Transform & Transport

    12. Spleen Not Controlling Blood Prolonged Spleen Qi Deficiency Spleen Fails to Hold Blood Hemorrhage General Signs Chronic Hemorrhage

    13. Spleen Qi Sinking Illness Overeating Overwork Starvation Under Work Chronic Spleen Qi Deficiency Failure of Holding Chronic Diarrhea Prolapses Incontinence

    14. Spleen Pathology Cold Food or Drink Chronic Spleen Qi Deficiency Spleen Yang Deficiency Disharmony of Qi Flow Transform & Transport Disorder Yang Deficiency Signs

    15. Stomach Pathology Cold Environmental Conditions Cold Food or Drink Cold in Stomach Disharmony of Qi Flow Transform & Transport Disorder Inhibition of Yang

    16. Stomach Cold Cold Food & Drink Cold Environment Stomach Cold Receiving & Decomposing Cold Signs Anorexia Altered Qi Flow Cold Ear/Nose Hypersalivation Pale-Purple Tongue Deep-Slow Pulse Lassitude

    17. Stomach Pathology Damp Hot Environmental Conditions Hot Dry Food or Drink Heat in Stomach Heat Signs Transform & Transport Disorder

    18. Pathogenic Heat Yin Deficiency Stomach Heat channel grandchild Gums organ child Cystitis Ulcer Colitis Stomach Heat

    19. Stomach Food Stagnation Indigestible Food Overeating Retention of Food in Stomach Disturbed Qi Flow Failure to Transform & Transport

    20. Stomach Yin Deficiency Stress Liver Qi Stagnation Chronic Febrile Illness Transformation to Heat/Fire Impairment of Body Fluids Stomach Yin Deficiency

    21. Oral Cavity Disorders: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA

    22. Local damage Electric shock Chemical damage Thermal damage Periodontitis Tooth tarter Systemic disease Metabolic disease Nutritional disease Immune disease Infectious disease Treatment Remove offending cause Steroids Antibiotics Clean teeth Oral Cavity Diseases (Western)

    23. How to Use Acupuncture for Gingivitis in Small Animal Practice Zang Fu Physiology • Teeth correspond to bone • Bone is controlled by the kidney • Malocclusion, oligodontia are examples of Kidney Jing Deficiency • Gums are influenced by the stomach

    24. Meridian Theory • Oral cavity has two main channels that influence the teeth and gums • Large Intestine meridian • Stomach meridian

    25. Pattern Diagnosis • Stomach Heat Pattern • Excess pattern, seen more often in younger animals (cats) • Stomach Yin Deficiency + Empty Heat • Stomach loves moisture • Moisture balances Yang function • Lack of Yin (fluid) allows Yang Fire to rise

    26. Stomach Heat Pattern • Fluffy: 4yr FS DSH • Primary complaint: Bad breath, eating poorly • History: Stray, no vetcare, dry food diet • Exam: Body & coat condition-normal; vital signs-WNL

    27. Oral Exam: Putrid odor, upper and lower arcade have severely inflamed gingiva, with spontaneous bleeding, minimal calculus formation • Lab Data: Elevated WBC, FELV/FIV=Neg • Diagnosis: Hemorrhagic gingivitis • Treatment: Clindamycin 25mg PO BID x 10 • Dental prophylaxis followed by Clavamox 62.5 mg BID x 10

    28. TCVM Exam & Diagnosis • Constitution: Water/Wood • Tongue: body=reddish purple; no coat • Pulse: Bilaterally superficial rapid • Body Condition: Dry nose; Body Temp Normal • Mouth: Stink smell; bloody red gums Pattern DX: Stomach Heat (excess condition)

    29. TCVM Treatment Strategy • Treatment Principle: Clear the Stomach Heat, Cool the Blood, & nourish Stomach Yin • Acupuncture Point Selection: GV 14; Tian Ping; ST 4,6,34,44; LI 4,11; SP 10 • Herbal Medicine: Yu Nu Jian ( Jade Lady) shigao, shudihuang, zhi mu, huainiu xi 2 teapills TID or 1/8-1/4 tsp granules TID • Topical Care: Aloe Gel ( Warren Laboratories)

    30. Case Outcome & Discussion • After 3 weeks of therapy inflammation substantially reduced • Cervical line lesions which compromised several teeth were removed • Fluffy is maintained on Aloe oral gel and herbs with only periodic acupuncture therapy • Long term expectations: depend on owner compliance • Other herbals: Wei Qi Booster; Slippery Elm

    31. Stomach Yin Deficiency & Empty Heat Pattern • Tess: 10 yr, FS, Mix Breed • Primary Complaint: Bad breath, dirty teeth, and periodic vomit/regurge • History: Commercial dry food diet, periodic dental prophylaxis, absent dental homecare, gums remain inflamed and plaque builds quickly • Western Dx / Tx: Gingivitis with periodontal deterioration. Requires 6 month recall for prophylaxis

    32. Exam: Constitution- Water Tongue- Violet, dry, no coat Pulse- Deep, thready, and quick Gums- dry/breath scorched Coat Quality-Dry Treatment Stategy: Nourish Stomach Yin and Clear Heat AP= CV 12 (aqua); SP 3,6; ST 36,44; LI 4,11 Herbs= Qing Wei San Topical= Aloe Gel Diet: Fresh cooked food/ fish-pork-beef-eggs-veggies TCVM Approach

    33. Ulceration: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA

    34. Ulcer • Symptoms • Periodic pain • Acid regurgitation • Belching • Vomiting • Patterns • Excess • Stomach Cold • Food Stagnation • Liver Qi Stagnation • Blood Stasis • Deficiency • Stomach Yin Deficiency

    35. Pathogenic Heat Yin Deficiency Stomach Heat channel grandchild Gums organ child Cystitis Ulcer Colitis Stomach Heat

    36. Signs of ST Heat • Clinical Signs • Hot lips & mouth • Bad smell from mouth • Thrist • Stomatitis/Gingivitis • Loss of or ravenous appetite • Dry nose & feces • Pulse • Superficial & fast • Tongue • Red with yellow coating • Treatment Strategy • Clear ST Heat/Fire • Generate body fluids

    37. Mild Moderate to Severe Stomach Ulcers Happy Stomach Angelica Dang Gui Nourish & activate Blood Paeonia Bai Shao Yao Nourish Liver Yin & Blood Bupleurum Chai Hu Soothe Liver Qi Aurantium Zhi Shi Move Qi & relieve pain Trichosanthes Gua Lou Promote body fluid & transform phlegm Pinellia Ban Xia Dry damp & transform phlegm Citrus Chen Pi Move Qi & relieve pain Licorice Gan Cao Harmonize Taraxacum Pu Gong Ying Clear Heat Jade Lady Gypsum Shi Gao Clear Heat and cool Stomach Anemarrhena Zhi Mu Clear Heat and nourish Yin Rehmannia Shu Di Huang Nourish Yin and Jing Ophiopogon Mai Men Dong Moisten and nourish Yin Achyranthes Niu Xi Bring the Qi flow down

    38. GI Food Therapy • Cabbage • Contains glutamate • Cools stomach & GI • Spinach • Stops hemorrhage

    39. Acupuncture of ST Heat • Clear Stomach Fire • Shan gen, Wei jian, Erjian, Yu Tang, ST44 LI4/11, GV14 • Body Fluid Tonic • KID3, SP6, SP9

    40. 05 Shan-gen Mountain base Xie-05 LO: on the dorsal midline of boundary b/t hairy & non-hairy areas ME: Perpendicular insertion 0.3 cun IN: Loss of appetite, sinusitis, coma, shock, wind-cold, wind-heat Shan-gen GV-26 Ren zhong 06 Ren-zhong/Shui-gou the center of man/water passage, Xie-07, GV-26 LO: At the intersection b/t dorsal and middle 1/3 of the philtrum ME: Perpendicular insertion for 0.3 cun IN: Coma, shock, fever, bronchitis, Lung Heat, facial paralysis

    41. 21 Hua-tuo-jia-ji at cervical region LO: 0.5 dorsal to cervical vertebrae IN: cervical stiffness, wobbler’s disease 22 Jian-wei, strengthen stomach LO: Upper 1/3 of the jugular group, Between vein and cervical vertebra IN: Anorexia, vomit, stomach disorders LO: At the ventral midline just cranial to throat. IN: excessive salivation, laryngeal hemiplegia 23 Lian-quan ridge spring CV-23

    42. Pancreatitis: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA

    43. Considered any acute or chronic change in GI function usually accompanied by some degree of vomiting, diarrhea and abdominal pain Acute- -Mild Pancreostasis Acute- -Severe Fulminating pancreatitis Chronic Pancreatic insufficiency Rx Acute NPO Fluids Antiemetics Pain relief Low fat/protein food Rx Chronic Enzyme therapy Pancreatitis

    44. TCVM Acute Pancreatitis

    45. TCVM Chronic Pancreatitis * Enzyme replacement therapy still good to add

    46. Perry 3 yr FS Springer Earth personality Acute onset of vomiting, fever and abdominal pain Increased thirst Scant urination Elevated Amylase & Lipase Increased WBC Rx: Fluids & Ranitidine Tongue: red & dry Pulse: fast & superficial West Dx: acute pancreatitis TCM Dx: damp-heat in spleen

    47. AP DN ST-45 ST-36 LI-4 PC-6 BL-20 CV-12 Aqua ST-36 BL-20 PC-6 Herbal Great Saussurea Coptis Next day was 80% improved Clinician said, “He is doing absolutely fantastic…better than any patient in years…NO…it wasn’t the acupuncture…well…maybe we should try it again!” Perry Treatment

    48. Great Saussurea Coptis Saussurea Mu Xiang Move Qi & relieve pain Coptis Huang Lian Clear Damp-Heat in the intestines Evodia Wu Zhu Yu Warm the middle Jiao & stop vomiting

    49. Bleeding: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA

    50. Bleeding • Primary Hemostasis • Complex chain of events involving interaction of • Platelets • Vessel Wall • von Willebrand’s factor • Fibrinogen • Secondary Hemostasis • Complex interaction of the intrinsic and extrinsic clotting cascades • Stabilize the platelet plug