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dalia frydman
Member
!0 y.o boy , good appetite and energy levels,got an upper respiratory tract infection when he was 5 and now gets a hacking cough when tired and has some difficulty with keeping focused(excessive talking and laughing in classroom).Wakes up early(5:30 -6:15) ,has a tendecy to loose stools and is small for his age.Neck Lymph nodes are palpable but very small.
Thank you so much.Dalia
Hi Dalia,
Nice to hear from you again and thank you so much for this new post.
I would agree with your diagnosis of lingering pathogenic factor: hacking cough when tired + palpable small lymph nodes. Are the nodes hard and non-tender?
His constitution seems to be Lung and Sleen Qi deficient. Phlegm and damp could be further factors in the Shen disturbance ? Is that the case?
Xiao Chai Hu Tang with modifications would be my herbal prescription.
Add Zhimu, Jie geng and Zi wan for the cough. Since he's also deficient, I would combine with Xiao Jian Zhi Tang.
Please let us know your further diagnosis on his lack of focus.
Are you using shonishin or aupuncture needles?
Best,
Soma.
dalia frydman
Member
I need your help on quantities if I am going to give the decoction .What do you think about the tinctures and powders?I do Tuina to help his digestive system but everytime I moxa him the hacking cough comes back.
The phlegm is all congealed because there is no external signs(needs to gain weight ) ...xiao chai hu tang can soften it somewhat and the shen imbalance is very mild but disturbing to the teachers...they say he is a boy afterwards...but he was so focused and organized at 5 and after getting cough his behavior changed almost overnight.Sleep is a key for a good day...when he is tired he gets irritable and oversensitive.I will check his lymph nodes tomorrow but I believe they are non tender.
Is it possible for you to be more specific about what shonishim or points should I use?
Soma , I am reviewing all my herbal knowledge and would like to know if you have other courses besides the intensive..Thank you and continue this wonderful work you are doing. dalia
Dear Dalia,
Just got back from the last intensive. From rereading your first and second posting, I feel that clearing the pathogen is the 1st step before starting any tonification, especially since his appetite and energy level are good.
If you can do the granular powders, that's great because that's what I use myself. Use the minor Bupleurum with the additions to address the cough and leave out the Xiao Jian Zhong Tang. For a small boy of 10, I would use 1 teaspoon of powder (about 1 or 1 and 1/2 gram) twice a day with meals. Just mix the powder with a small amount of warm water.
If you can use needles, then use the extra point Bailao on the neck for nodules, UB 18 and UB 20, SJ 5 and GB 41 plus Lung points of course such as LU 5, 7 and 10.
You may also add PC 5, Ht 7 and DU 20 for the behaviour pattern. When the phlegm gets looser, use ST 40. Lots of tapping on top of the shoulders and scraping along the SCM muscles will also help activate lymph drainage and loosen nodules.
Let me know after 1 week how things are going.
All the best. Soma.
dalia frydman
Member
I called MayWay and I am learning how to use granules....What is the proportion of the additions (Zhi Mu, Jie Geng and Zi Wan) so I can custom made a formula and just add to the xiao chai hu tang.
Should I give the formula modified even though there is no cough at this time?
Thank you
Dalia
Dear Dalia,
I propose that you make your patient 2 different formulas using Xiao Chai Hu Tang.
When he's NOT coughing, give him Xiao Chai Hu Tang combined with Bai Shao (white peony) and Gui Zhi (Cinnamon twig). proportions can be:
CHAI HU and BANXIA: 25% each
HUANG QIN, REN SHEN, ZHI GAN CAO, SHENG JIANG and DA ZAO: 10% each
BAI SHAO: 30% and GUI ZHI: 15%
Xiao Chai Hu Tang is very drying and not to be given alone for long periods. With bai shao you are taking care of not drying up the Yin too much.
When he is coughing, combine xiao Chai Hu Tang with:
JIE GENG, ZHI MU AND QIAN HU (instead of ZI WAN) each 10%.
Please do this for 3 weeks and let us know how he is. If during that time, he gets an acute illness or a fever, you should stop the herbs and treat according to the new pathology.
Good luck, Soma.
dalia frydman
Member
Dear Soma,
My patient is on the formula for a little over a week...could you tell me what should I expect?Everytime I treat a LPF with a modified version of xiao chai hu tang I've got the congealed phlegm becoming softer and "visible" ...the cough becoming more and more productive...I treated according to the sx present but even though the acute condition got resolved , I could not be sure about the initial condition of the LPF.Is there any guidelines that should be followed to access if the LPF was completed cleared out?Thank you for sharing your expertise.
All the best
Dalia
Dear Dalia,
Sorry for the delay. I just got back from a one-month retreat in South India. Thank you for the follow-up on the LPF case. In my experience, it takes some time to completely clear those cases. At least a few months, if not a few years for some entrenched cases. After the phlegm becomes more visible and you resolve that acute condition, check the nodules on the neck. They also should gradually become smaller and softer. You should continue with Minor Bupleurum with the appropriate modifications until there is a significant improvement both in the chronic dry cough and the phlegm nodules. Stop if another acute develops and keep modifying the formula as symptoms change.
Other signs of improvements are the energy level and the emotional well-being of the child. Is the behavior of the child changing?
How is your 10 year old doing with his hacking cough, his lack of focus and loose stools?
Looking forward to hearing from you again.
Thanks,
Soma.
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