Them Dry Bones...

A young woman recently came to my practice at Saint Ann's complaining of back pain. This in and of itself is not that remarkable; people young and old suffer back pain from a variety of reasons. What made this case more remarkable is the fact that the young woman is suffering back pain from osteoporosis. This young woman is still in her early 20s, at the most, and to be suffering osteoporosis at such an early age is unusual. Osteoporosis usually affects women who are post-menopausal.
Osteoporosis is a condition wherein the bone becomes porous, or less dense. This is distinguised from osteopenia, wherein the bone material doesn't become less dense, but does become softer. Basically, osteoporosis is an imbalance between bone formation, and bone resorption. After menopause, the osteoclasts, which are responsible for bone resorption, begin to outperform osteoblasts, which lay down new bone matrix. Lack of estrogen is one factor in this off kilter mechanism; the lack of estrogen increases the rate of bone resorption. Another factor is calcium metabolism; lack of calcium and vitamin D result in decreased bone deposition. The lack of calcium and vitamin D also induce the parathyroid glands to secrete parathyroid hormone, which increases bone resorption to ensure that there is enough calcium in the blood for the heart and muscles.
The key factor in this young woman's condition is that she's anorexic. A model, she no doubt felt the pressure to be thin as do so many women in that profession. Sadly, she succeeded; she was incredibly thin. Many of her bony tissues had been affected by her condition; she told me she had lost seven teeth from the constant vomiting (binging and purging). The acid had eaten away the enamel of those teeth.
In Traditional Chinese Medicine, the Organ most closely associated with the bones happens to be the Kidneys. In this young woman's case, she has extreme Yin (substance) deficiency. Lack of post-natal qi, from foods, has forced her system to draw heavily on Kidney Yin and Essence. Much of her pain is centered around her lower back, the residence of the Kidneys. Nails were lusterless and dry, and she admitted to poor concentration and memory, which are Blood deficiency symptoms, underscoring the sheer lack of post-natal qi. I gave her a back treatment, to nourish Blood, Yin, and Kidney Essence. Points included the Four Flowers (UB 17 and 18), Pishu (UB 20), Shenshu (UB 23), and points along the Heart and Kidney channels to calm mind and tonify the Kidneys; Heart 7 and 5 the Heart Yuan Source and Luo points, Lung 9 to help nourish Yin, Kidney 3 and 6 for Kidney Qi and Yin, respectively, and Pericardium 6.
I have only seen this patient once, and am hoping she either returns for more treatment, or that she follows up with someone else. She did report after the treatment that she felt much better, and seemed more at ease. I sincerely hope that she receives treatment for her anorexia, as she was a very intelligent person, and clearly has a full life waiting for her.

Not Always Physical

Sometimes, pulse diagnosis can tell you interesting things about a person. I have a regular at SACHR that comes to me for a range of things, often mental. One day, she came in, and told me that physically, she had no complaints. Feeling her pulse, however, I found that the Cun position on her right wrist, the Lung position, was intermittent. I asked her if she was having a hard time keeping things, thoughts, and life activities separate, and she said yes. In her own words, "As I was studying, I felt the whole outside world crashing in on me."
It should be noted here that this isn't just a random question that popped into my head, or a diagnosis that I mystically knew had to be the reason behind the feel of her Lung pulse. As I said, she's a regular, and so I already know something of her temperament, and have a feeling of what may be bothering her. As one of my teachers noted, pulsing is steeped in a kind of mysticism, and that even in China, people feel that if you can't guess what's wrong with them through only their pulse, they won't think of you as a good physician/clinician. So, there is a bit of P.T. Barnum that surrounds pulse diagnosis in China and here in the West also, in order to keep patients. However, in this case, there had been a lot of prior treatment, and extensive history, which allowed me to ask this question right off the bat after feeling her pulse.
Much of TCM has a mental component also, and this case illustrates the Lung/Metal aspect's role in helping people to compartmentalize, or delineate borders around activities. This young woman has some blood deficiency stemming from Spleen Qi deficiency, and since Spleen/Earth is the mother of Lung/Metal, the Lungs weren't being properly nourished to perform this function of delineation.
Treatment was kept very simple, in this case. I used Lung 9, as the Yuan-Source point of the Lungs, along with Spleen 3 and Stomach 36, both of which strongly tonifies Metal's mother, Earth. I also used LI 1o and Lung 7, the former to help boost Qi and Blood, and the latter, as the Luo-Connecting point, to calm her Spirit. Moxa was applied to Ren 4 to help boost Blood.
Seeing her again the following week, I asked her if she was still having the same problem, of keeping things separate. She looked thoughtful, and replied, "I didn't think of it."