Exercise Cases[1]

7/28/2019 Exercise Cases[1]

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NESAActions & Effects IInstructor: Meredith St. John, Lic.Ac.

Exercise for practicing indications of the points and developing point

prescriptions

Musculoskeletal disorders:1. Your patient is a 35-year-old woman who complains of neck pain following

an automobile accident 1 year ago, in which her head struck thewindshield. The pain is focused in the occiput, muscles lateral to hercervical vertebrae, and her upper back, restricting movement of flexionand extension as well as rotation side to side. At the time of the originalinjury, her pain was 8-9/10, and now its 3-4/10. Previous treatment:physical therapy, Advil. This diagnosis is local Qi/Blood Stagnation

following trauma. The treatment strategy is move local Qi/Blood to relievepain. Please list a pool of points for her, including both local and distal, onthe affected channels.

2. Your patient is a 48-year-old woman who complains of low back pain inthe area of BL 25 on the right side, with pain radiating down the posterioraspect of her leg. The pain first occurred 5 days ago after lifting boxeswhile she was moving. She has been treated twice by her chiropractor,and has used ice and Ibuprofen.Severity is about 4-5/10, is worse whilemdriving and better when lying down, and has already reduced by 2points. This diagnosis is local Qi Stagnation following trauma. Thetreatment strategy is move local Qi Stagnation to relieve pain. Please list apool of points for her, including both local and distal, on the affectedchannels.


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Exterior conditions3. Your patient is a 21-year-old woman who complains of a cold for the past

few days with fever and sore throat. It started with a splitting headache.

Her nose is runny. She has been able to continue working in spite of hercold. She has no cough. Shes not blowing any yellow or green mucus outof her nose. Her appetite is fine. Her tongue is normal. Her pulse isfloating and rapid. This diagnosis is Exterior Wind Heat. The treatmentstrategy is Release the exterior & clear heat. Pool of points:

4. Your patient from the previous question returns a week later, and her coldhas gotten much worse, affecting her lungs. Now she has a severe cough,productive of sticky, yellow mucus. Her fever went away for a few days,and then came back. Her tongue is pale red with a thick, yellow coat. Herpulse is full, slippery and rapid. This diagnosis is Lung Heat and Phlegm.Treatment strategy is clear heat from LU and transform phlegm.

5. Your patient is a 30-year-old woman with a head cold that started 2 daysago with pain and stiffness in the back of her head and neck. She thinksshe became chilled from over-exposure to air conditioning in her office.She has an occipital headache and some body aches. She has no fever,no sore throat, and only a slight cough. Her tongue is normal. Her pulse isfloating & tight. This diagnosis is Exterior Wind Cold. Treatment strategy isrelease the exterior and scatter cold.


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Internal Conditions

6. Your patient is qi-deficient after a serious illness. His pulse is weak,especially on the right side. His tongue is pale. He is tired, has noappetite, and has loose BMs. He sweats without exertion. Tonify Qi by

choosing points by their indications, especially on LU, SP, and ST, and therelevant shu points.

7. Your patient is a 63-year-old woman with chronic diarrhea. She hasmultiple loose stools daily, loosely formed but not watery, without itching

or unusual odor. She is fatigued. She has little appetite and is oftennauseous. Her tongue is pale with a thick white coat. Her pulse is slipperyand weak. Diagnosis: SP Qi deficiency with dampness. (also called DampCold Spleen) Treatment strategy: Tonify SP Qi and rid damp. Use pointsthat accomplish the treatment strategy and especially direct the effects ofthe treatment to the intestines. Use a source/luo combination.Pool of points:

8. Your blood-deficient patient is anxious and depressed. She has a palecomplexion and dry skin. Her menstrual flow is scanty and only lasts 3days. Her tongue is pale and thin. Her pulse is choppy and fine. TonifyBlood and calm her spirit. Use channels that support Blood production.Use mu & shu combination.


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9. Your patient is a 50-year-old woman who complains of symptoms ofmenopause. Her last menstrual period (LMP) was over a year ago. Shehas hot flashes during the day and drenching nightsweats at night, wakingher up several times. She is tired and a little agitated. Her cheeks areflushed, as are the palms of her hands. Her urine is dark and

concentrated. Her stools are dry and hard. Her tongue is red with littlecoat. Her pulse is thin and rapid. Her diagnosis is Yin Deficiency withEmpty Heat. Pool of points:Clear empty heat & reduce nightsweats :tonify yin:Float the boat:

10. Your patient is a 70-year-old man who complains of feeling cold. His belly,back, and extremities feel cold and are cold to your touch. He has littleappetite. You identify pitting edema in his lower extremities. His urine ispale, copious, and frequent. Watery diarrhea awakens him in the earlymorning. His tongue is pale, swollen, and wet. His pulse is deep & weak.This is yang deficiency. Tonify yang. Pool of points:

Exercise Cases[1]

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