Herbal Intern Reflection 1: J.B. 9/23/15

J.B. was a male patient in his late 50s. He had been coming into the AOMA clinic for treatment of his Scleroderma for about one year. Though the Scleroderma was diagnosed as systemic, it presented locally from his elbows to his fingertips bilaterally. The skin was extremely tough and when he first came to clinic he had no mobility in his hands at all. At the point I started seeing him as an herbal intern the skin from his elbows down to just above his wrists was vastly improved. He also had about 75% mobility back in his hands. His differentiation was “Local Qi and Xue Yu, LV and KD Yin Xu and SP Qi Xu.” He was also trying to gain some weight back that he had lost during the worst part of his symptoms. He had gas, bloating, loose stools, low appetite and also chronic sinus congestion. He had been prescribed Fu Zi Li Zhong Wan previously but upon inspection of his tongue we found it to have a thick yellow coating while his pulse was long and wiry. We came to the decision that the Fu Zi Li Zhong Wan was too warm for the time being and it was his damp(-heat) symptoms that needed to be addressed. We decided to switch him to Liu Jun Zi Tang and give him some dampness reducing dietary recommendations.

            About a month later his digestive symptoms were almost completely resolved. His appetite was good, he had gained 4lbs and he had no more gas, bloating or loose stools. The only thing was that his tongue had remained unchanged. I was perplexed by this and asked my supervisor, Dr. Song, if that meant our formula choice was wrong or not. I was curious to understand how to gauge the outcome of this formula choice, by the tongue or by the symptoms. Dr. Song informed me that this is a common outcome for the type of formula we chose, as it is meant to be taken long term and it can take a little while to see the full results, but the fact that there was symptom improvement did in fact attest to our correct formula choice.