呂宇軒中醫師: 3月 2023 WFU

2023年3月31日 星期五

感冒(一)症狀解析

近日早春的天氣猶如瞬息萬變的女人心,可能清晨還必須穿戴厚重外套,到了中午太陽公公露臉之後又熱的渾身是汗,一件一件的脱;沒過多久到了傍晚太陽下山週遭的空氣又開始冷了起來,只得再度披上禦寒衣物。

「哈啾!」這天小明放學之後本來要直接搭車去補習班,沒料到一路上噴嚏打個沒完沒了,鼻水也從兩邊鼻孔像轉到底的水龍頭似的傾瀉而下,背包裡的衛生紙都快被用完了;頭整個昏昏沈沈的又有一點輕微的疼痛,手腳痠痛又沒有力氣,於是他拿起了手機跟媽媽說他不舒服,媽媽於是幫他請假並掛號風澤中醫。「記得之前看過呂醫師的部落格有寫過幾篇關於感冒的文章,或許他有辦法可以讓我們家小明人舒服一點!」

小華是個精明能幹的業務,每天都要騎車來往各個客戶間談生意,一談就是半小時、一小時。這天忽冷忽熱的天氣對於機車椅上的他感觸更深:起早要趕上班,騎車路上呼嘯而過的冷風刺骨陣陣襲來,讓雙手僵硬麻木,彷彿快要感覺不到自己的手指似的。中午只是停個車吃一下便當,回到車上坐墊彷彿在做鐵板燒,不過主菜的肉是自己的屁股。下午跟客戶談生意談到一半,他開始覺得自己的喉嚨怪怪的,刺痛刺痛的感覺,好像有異物卡在喉嚨裡。為了清嗓他咳了幾聲,沒想到應聲而出一坨又大又濃的,讓在一旁的客戶大吃一驚。

「兄弟你沒事吧?要不要去看個醫生?」
「唉..這個善變的天氣忽冷忽熱的有夠難穿衣服,害我今天喉嚨怪怪的,好像快感冒了。」
「我上次感冒也是去風澤中醫看好的,好像是一個呂醫師?你也去掛個號吧!」




呂醫師的話
忽冷忽熱的天氣非常容易讓自身的皮膚毛孔開開關關,一個不小心就讓中醫所謂的六淫外邪諸如風邪、寒邪等趁虛而入,稱為外感風寒。又因為外邪此時才剛開始入侵人體的淺表層,尚未進攻到較為深層的部位,因此我們定義為「表證」,使用諸多「解表」的中藥來處理,像是藥性「辛溫」的「解表」中藥麻黃、桂枝、羌活、防風等等,驅散風寒、溫通經脈。

鼻水如果顏色偏透明,代表此時還屬於風寒的階段,可以用辛溫解表的中藥;如果病程比較長,鼻涕已經開始混濁或是有鼻塞的情形,源自濟生方的蒼耳子散效果不錯,內含蒼耳子、辛夷祛風通鼻竅,能改善呼吸品質。

如果流鼻水這個問題已經持續好一段時間,並非單次性由感冒所觸發,那比較可以就慢性、過敏性鼻炎去做處理,首先是確認有沒有已知的過敏原諸如寵物皮毛或是灰塵、花粉等等,並透過像是空氣清淨機以排除這些過敏原。另外建議可以多喝點溫開水,藉由水分去稀釋掉鼻腔內部的分泌物。若情況仍然沒有改善,可以考慮以三伏貼/三九貼做處理。




與感冒病毒作戰可以是一件很疲勞的事情,如果再加上有課業或是工作上的壓力那更是雪上加霜,就是可能會有「表虛」的情況。源自傷寒論的小建中湯是著名方劑桂枝湯的延伸,方內芍藥劑量double並額外酌加飴糖(麥芽糖)。除了沿用溫通經脈的桂枝之外,芍藥以及飴糖對於表虛的患者來說是一大福音,能補充身體所耗損的物質,提升體力。如果疲勞的程度比較嚴重,也可能會再額外多加一些補氣的中藥如黃耆、人參..等等。

喉嚨又腫又痛彷彿刀子割一樣?吞口水吃東西都很難受?這種情形喉嚨可能是有「風熱」盤據,以現代醫學的角度來說就是正處於發炎的情形,常見扁桃腺發炎腫大,方劑銀翹散可以派上用場,內含辛涼解表的中藥諸如薄荷、牛蒡子可以祛風除熱;另有藥性寒涼的金銀花、連翹、淡竹葉等專攻清熱解毒,整體來說,減輕咽喉腫痛的情況。除了感冒引起喉嚨痛之外,有時候胃食道逆流也會有喉嚨痛的症狀喔!
至於故事中的小華,由於工作常常要講話,聲帶使用過度,因此會加重喉嚨痛的程度。關於職業上對於聲帶的耗損以及痰飲的問題,留待下回分解~


2023年3月24日 星期五

GERD Ein Problem mit Ihrem Bauch

 Leo ist ein fauler Mann, der nach dem Abendessen immer fernsehen möchte, schläft auf dem Sofa nach nur fünf Minuten.

 “Oje, ich habe das Gefühl, dass etwas heiß in meinen Hals geht!”

Tim ist ein Student, der für seinen Abschluss fleißig studiert. Er studiert jeden Tag etwas zehn Stunden und beeilt sich mit jedem Mahl.

“Oje, jetzt brennen mein Bauch und mein Hals!”

Tia ist eine elegante Frau, die jeden Nachmittag immer Kuchen und Kaffee nimmt. Heute geht sie zum einkaufen in einem Kaufhaus. Nach dem Einkaufen nimmt sie eine Tasse Kaffee und ein Stuck Käsekuchen.


 “Oje, was ist jetzt passiert? Es gibt etwas heiß in meiner Brust.




Ich habe ein paar Tipps für alles:

1 Kauen Sie langsam. Bevor Sie das Mahl schlucken, haben Sie 20-30 Bisse. Je kleiner das Mahl wird, desto einfacher kann man das schlucken, desto einfacher kann der Brauch verdauen.

2. Es ist nicht gut, zur gleichen Zeit zu trinken und schlucken. Sie werden sofort GERD haben. In traditioneller Chinesischer Physiologie gefällt dem Brauch die Trockenheit. Wenn anderes Getränk geht in dem Brauch mit dem Mahl, entdeckt der Brauch nicht genug Magensäure. Danach ausscheidet der Brauch viel mehr Magensäure, die genug überbietet.

3. Kaffee und Nachtische könnten die Chance von GERD erhöhen, aber meistens genießen Leute beide. Für Patienten leiden unter dem GERD, vermeiden Sie bitte Kaffee und Nachtische ein paar Wochen.




半夏瀉心湯( Ban Scha Schie Schin Tang) ist eine effektive Verschreibung, die das GERD gut behandelt wird. Die ist dem berühmten Dokument傷寒論(Schang Han Lun, ist bekannt als die traditionelle Chinesische medizinische Bibel.) entstammt. Das Hauptkraut drin ist
半夏(Ban Schia) 
Das ist scharf und warm, das Phlegma fallen könnte und auch entfeuchten könnte. Die andere Kräuter zum Beispiel 
黃芩(Huang Chin)
黃連(Huang Lian)
Diese zwei Kräuter sind bitter und Kalt. Sie könnten das  aufsteigende Braute Feuer gut löschen.

In der traditionellen Chinesischen medizinischen Physiologie aufnehmt, dass meistens das Lebere Holz meistens das liene Lockergestein mobbt. Das heißt in der Western Physiologie, die Sympathizi zu aktiv sind, die Digestion des Brauchsystemes zu beeinflussen.

2023年3月17日 星期五

Skin problems

Bob loves to play basketball a lot, he plays during breaks and won’t return to the classroom until he’s satisfied. The summer is around the corner, as usual, Bob seizes every moment he could have to play basketball, yet to discover he now has a hard time concentrating in classes, having a itching feeling all over his body.

“Ahhhh, it has been soooo humid and hot these days, I can hardly sweat. It feels like all the heat gets restricted within my body!”

“What the…!? Rashes merge on my hands, my legs and my chest. They are soooo itchy, I can’t concentrate to listen to what my teacher says!”

Kevin’s skin condition hasn’t been very good since he was a child. His skin is so dry that it often gets chapped. To make matters worse, Kevin often feels dizzy and exhausted during the day. He also tends to get thirsty easily, in spite of his regular water consumption.

“Ahhhh, how come my skin is not only dry but also itchy!! What is happening to me??”

Scratching can only ease the itchiness for a short period time before the discomfort dominants him again. Sometimes he scratches so hard that he peels off parts of his skin, causing bleeding wounds.




What Doctor Lu gets to say:

Itchiness, dryness, rashes are usually minor problems which won’t threaten lives in normal cases. However, they could be REALLY bothersome like guerrillas. They cause minor damages in a long period of time, decreasing the life qualities of patients significantly. Yet they are hard to be terminated completely, so whoever confronts these problems has better be mentally prepared, having awareness that this could be a long battle. Be patient to make progress gradually.

The first thing you can do is to examine your dwelling surroundings. If you manage to live in a humid or rainy environment, it could be easy for you to accumulate Dampness inside your body. Despite taking some herbs to exclude the Dampness, it’s also a good idea for you to turn on the dehumidifier regularly, keeping your surroundings dry. 

Some people’s skin problems result from allergy. The allergens could be the fir of pets, the dust in the air or the consumption of milk or seafood like shrimps, lobsters…etc. When encountering skin problems, you can be aware if there are any potential allergens existing, to avoid or exclude the allergens to prevent the symptoms.

Skin is a physical barrier protecting human bodies from exterior pathogens. If you manage to scratch so HARD to cause wounds, you are opening a door to welcome all kinds of germs, viruses, parasites to get inside your body and have a party. You may feel some inflammation, swelling or pain. The worst case scenario is sepsis, meaning germs running all through your blood vessels, which could kill you.




The Prescription 消風散(Shiao Fung San, AKA The wind killer) contains herbs with cold attributes such as 
牛蒡子(Nio Bang Ts, Fruits of  (Arctium lappa L.) )
蟬蛻(Chan Tui, Shell of (Cryptotympana pustulata Fabricius) )
to extinguish the Heat

herbs with dehumidifing attributes such as
蒼朮(Tsang Chu, Rhizomes of (Atractylodes lancea (Thunb.) DC.) )
木通(Mu tong, Stems of (Clematis armandii Franch.))
to exclude the Dampness

The Prescription 消風散(Shiao Fung San, AKA The wind killer) best suits for rashes caused by Wind, Heat and Dampness.

The Prescription 當歸飲子( Dang Gui Yin Ts) is aimed for patients suffering from lack of blood and dryness.It contains 
Prescription 四物湯( Soup of four, essential blood supplementing materials)
 and 
何首烏(He Sho Wu, Roots of (Polygonum multiflorum Thunb.) )
 to supply patients with blood.

It also contains herbs with wind-killing attributes such as
生薑(Shen Jiang, Rhizomes of (Zingiber officinale Rosc.) )
防風(Fang Fung, Roots of (Saposhnikovia divaricata (Turez.) Schischk.))
荊芥(Jin Jie, Ground parts of (Schizonepeta tenuifolia Briq.))

2023年3月10日 星期五

Menstrual problems Part 2 Abnormal bleeding

Some women could bleed massively during menstruation, just like huge waves tumbling along the beaches, and then vanish suddenly. 

Some women could bleed very few during menstruation, just like mild rain drops falling down in a slow pace, and it seems there’s no end to that.

Both situations could cause discomforts. 
Sudden huge loss of blood could cause anemia, dizziness,  weak, talking powerlessly..etc. 
Long term small amount bleeding on the other hand could be really bothering, limiting the range and intensity of movements of women, bringing huge inconvenience. 

There many possible causes of uterus bleeding aside from normal physiological conditions.
 Functional uterus bleeding, postpartum or abortional uterus bleeding, uterus bleeding resulting from pelvitis or tumor..etc. 

It would be of beneficial to follow up the tumor on a regular basis, monitoring and preventing it from worsening or spreading.

We Chinese Medicine physicians tend to deal with abnormal menstrual bleeding in three steps: Blocking, Defining, and Strengthening

Blocking abnormal and excessive bleeding as if stepping on the brake. 

Defining what’s the main cause of bleeding and specifying prescriptions. 

Strengthening the effected patient like charging up her weakened body to a better state.

We presume there are three main causes accounting for abnormal uterus bleeding: Blood Stasis, Blood Heat and Lack of “qi”.




Blood Stasis usually causes long term small amount bleeding, and could be easily dealt with 失笑散(Shi Shiau San) The prescription can make the blood flow runs smoothly again.

Blood Heat usually causes massive bleeding, as if invisible pathological fire burning inside patients body. 
十灰散(Shi Huei San, Prescription of Ten Ashes) could put out the pathological fire.
 All the ten ingredients inside are burnt to ashes, increasing their functions of stopping excessive blood flow.
大薊(Da Ji, Roots of  (Cirsium japonicum DC.)
小薊(Shao Ji, Ground parts of   (Cirsium setosum (Willd.) MB.))白茅根(Bai Mao Gen, Rhizomes of   (Imperata cylindrica Beauv. var. major (Nees) C. E. Hubb.))
 
are the main stopping forces

While the other herbs with cold attributes such as 
梔子(Chi Ts, Fruits of (Gardenia jasminoides Ellis)
大黃(Da Huang, Roots of  (Rheum Palmatum L.)  (Rheum tanguticum Maxim. ex Balf.) or (Rheum officinale Baill.) 
丹皮(Dan Pi, Root skins of (Paeonia suffruticosa Andr.) 
tend to cool down the heat.

The invisible pathological fire resulting from Blood Heat can sometimes vaporize the ”yin” substance in human bodies, causing thirst, sweat, constipation..etc. The Hand Pulse of the patients would be Thin and Frequent. 
The 養陰止血湯(Yan Yin Chi Shie Tang)could come in handy, with 
棕櫚(Tsong Lu, Leaf handles of (Trachycarpus fortunei H. Wendl.)
側柏葉(Tse Buo Yeh, Branches of (Platyclatus orientalis (L.) Franco)
as main blood-stopping forces.

 While the 

生地黃(Shen Di Huang, Roots of  (Rehmannia glutinosa Libosch)
玄參(Shuan Shen, Roots of (Scrophularia ningpoensis Hemsl.)) 
石斛(Shi Hu, Stems of  (Dendrobium loddigesii Rolfe.)
inside could supplement the patients with substance ”yin”, relieving all the symptoms above mentioned.

In Chinese Medicine Physiology, “qi” governs the blood. Take the electric wires for example, “qi” is like the rubber exterior coating, while the blood is the copper line inside. If anything affects the “qi” would simultaneously affect the blood flow.

”qi” would deplete in conditions like exhaustion, recovery from serious illness, heavy labor…etc. Without adequate “qi”, blood flow would be in disorder and lead to abnormal bleeding.




For severe “qi” depletion we’ve got 
人參(Ginseng, Roots of  (Panax ginseng C. A. Mey.)
and 
附子(Fu Ts, Processed (Aconitum carmichaeli Debx.)  ).
They both are strong “qi” enhancing herbs aimed to help those who are in a really poor condition.

For mild “qi” shortage, we’ve got 歸脾湯(Gui Pi Tang). 
It contains 
當歸(Dan Gui, Roots of (Angelica sinensis (Oliv.) Diels)
黃耆(Huang Chi, Roots of  (Astragalus membranaceus (Fisch.) Bge.) 
to supplement “qi”. 

The warm herb inside
遠志(Yuan Chi, Roots of (Polygala tenuifolia willd.)
can  ease one’s nervous mind, help patients to fall asleep more easily. 

The warm herb inside
木香(Mu Shiang, Roots of  (Aucklandia lappa Decne.)
can help adjust the functions of “qi”, enhancing the performance of “qi”.

2023年3月4日 星期六

Menstrual problems Part 1 Menstrual pain

 “Ouch!” Mary got her ass kicked by her regular menstruation. It just feels like being beaten up by a bunch of mobs, aching all over her head and her belly, only to make her overstressed working days worse.

“ When will it stop?” Sherry previously presumed that her menstruation would end five days ago, yet it continues to torment Sherry, as if a stalker who just won’t quit. Blood drips slowly everyday and there seems no end to it.

“ What the… how come I  suddenly feel dizzy the second I stand up from my chair.”  Beyanka has had some massive bleeding during her menstruation these days. She often feels a strong sense of dizziness every time she stands up and heads for the restroom. She then has to lean on her table and rest for a while before she can do anything.

Nearly once a month, almost every female has to suffer from all the discomforts resulting from menstruation: headache, dull pain at lower abdomen, diarrhea , low back soreness, anemia, etc. Whether the menstruation occurs early or late on schedule differs from person to person. The total amount of blood  bleeding out and the presence or absence of leucorrhea also differs from person to person.




We Chinese Medicine Physicians presume that menstrual pain has three common causes: The first is overwhelming liver fire. The second is blood stasis, and the third is Freeze and Dampness combined.

黃帝內經(Huang Di Nei Jing,ancient documents of yellow emperor)says that liver is like a general at battlefield in command of many things. In Chinese Medicine physiology, liver corresponds to element wood, and it favors smooth and fluent. It’s responsible for the qi to flow smooth and fluent in human bodies. If the liver qi gets blocked, it would be obstructed in the chest and leads to stagnation. Stagnation usually occurs to people who tend to think too much, lacking flexibility or being too stubborn. On the other hand, people having a big temper or always rushing from one place to another, tend to have overflowing qi, which eventually leads to the ignition of liver fire.

龍膽瀉肝湯(Long Dan Xie Gan Tang)can put out liver fire quickly like a fire extinguisher, thanks to the herbs having freezing attribute inside it such as
黃芩(Huang Chin,Roots of (Scutellaria baicalnsis Geprgi))、
梔子(Chi Ts,Ripe fruits of (Gardenia jasminoides Ellis))、
龍膽草(Long Dan grass,Roots of (Gentiana scabra Bge.) (Gentiana triflora Pall.) or (Gentiana manshurica Kitag.)).

 As for liver qi stagnation, we’ve got 
柴胡(Chai Who,Roots of (Bupleurum chinensis DC)  and (Bupleurum scorznerifolium Willd))
to break through all the obstruction, as if sorting intertwined cable lines.


黃帝內經(Huang Di Nei Jing,ancient documents of yellow emperor)says that meridians circulate around human bodies endlessly. 
If the Freeze gets inside the meridians, it would cause obstructions and resulting pain. If the Freeze surrounds the outer perimeter of the meridians, it would cause the insufficiency of blood. 

To put those above mentioned into plain English: 
Blood stasis is a condition which blood can’t flow smoothly, usually caused by the invasion of Freeze, symptoms including pain. 

膈下逐瘀湯(Ge Sha Tsu U Tang)is a good prescription aimed for blood stasis. It includes tons of herbs which can stimulate the blood flow profoundly such as 
桃仁(Tao Ren,Seeds of (Prunus persica (L.) Batsch) or (P.davidiana (Carr.Franch.))、
紅花(Red Flower,Flowers of (Carthamus tinctorius L.))、
川芎(Tsuang Chong,Rhizomes of (Ligusticum chuanxiong Hort.))

 The 香附(Shiang Fu,Rhizomes of (Cyperus rotundus L.))inside has the similar function as 柴胡(Chai Who,Roots of (Bupleurum chinensis DC)  and (Bupleurum scorznerifolium Willd)) to deal with liver qi stagnation.




Last but not least, Freeze and Dampness are all part of the Six Devils. We Chinese Medicine physicians define the Six Devils as the common exterior pathogens invading human bodies, which are Wind, Freeze, Heat, Dampness, Dryness and Fire

When the Freeze and Dampness cooperate to attack a female body during menstruation, they could cause symptoms like lower abdomen pain, soreness and chilling feeling at lower back, low in amount of menstrual secretion with pale colors. The Hand Pulse of the patient would be Deep. Prescription 

溫經湯(Wen Gin Tang) from 傷寒論(Shan Han Lun,Bible of Chinese Medicine)can deal with the situation.  The warm herbs inside such as 
桂枝(Giu Tsu,Branches of (Cinnamomum cassia Presl))
吳茱萸(Wu Tsu U,Fruits of (Evodia rutoecarpa (Juss.) Benth.) 、 (E. rutaecarpa (Juss.) Benth. var. officinalis (Dode) Huang) or(E. rutaecarpa (Juss.) Benth. var. bodinieri (Dode) Huang))

are like good partners. Together they could fight off the Freeze and Dampness, bringing warmth to the human body. 

The herbs 當歸(Dang Gui,Roots of (Angelica sinensis (Oliv.) Diels))
人參(Ginseng,Roots of (Panax ginseng C. A. Mey.))
can supplement the human body with qi and blood like batteries , bringing huge amounts of energy.

 The herbs 
麥門冬(Mai Men Dong,Roots of (Ophiopogon japonicus (L.f.) Ker-Gawl.))
阿膠(Ah Jiao,Skin of (Equus asinus L.))
can supplement human body with yin, which is the substance forming all parts of our bodies. 

Yin and qi(yang) are like opposite concepts. Yin is substance, solid, and descending. Qi( Yang) is functional, vivid, and ascending. We Chinese Medicine Physicians seek balance in these two counterparts, supporting the weak while diminishing the excessive.