Qiological Community

Slow Healing Wound Healed in 1 Treatment

Recently, a patient came in for a return visit jubilant because the large wound on her left shin finally healed over and she was getting discharged from the wound care clinic she had been attending twice weekly for over 2 months. She had initially scraped her leg in a fall. When she presented me with it 2 weeks previously it was wrapped but she showed me a picture taken the day before of an area 8 inches long and 3 inches wide that looked bruised and red with a 4 inch x1 inch area of exposed granular tissue that hadn’t fully epithelialized. When she went back to the wound care clinic 40 hours after acupuncture, the open area had fully closed over. The clinic had been preparing to use placenta on her wound because of her slow response but now had no need and instead discharged her. The doctors and the nurses all commented that they had never seen such a big change in a wound in 3 days- but that it couldn’t possibly be from acupuncture. My patient is convinced that they are wrong.

She is 73 year old accountant. Moderately overweight with lots of loose puffiness under her skin. Thin, very dry flaky skin with purpura. Very chatty but caught up in her own to-do list and other people’s problems. Not especially hot or cold. Her chief complaint had been tiredness, not the wound. Soft squishy abdomen. Occasional diarrhea when she eats too many fats. She works 20-25 hours a week, still attends exercise class several times a week and tends to her ill sister. She is a big push over who continues to see clients who annoy and exhaust her even though she says she says she would be fine without the extra money. (needs GB+ big time) She feels better with 9 hours of sleep but only gets 8. Other complaints include “wooziness” in her forehead- an off balance feeling but she denies needing to stabilize herself or sit down. Poor word recall.

I assumed I had supplemented the St on the right based on her morphology and the wound being on the Stomach channel on a background of lots of internal damp.

Just checked my notes: supplemented Lung on the right

It wasn’t a mistake treatment that happened to work out. I remember that even though she has so much internal dampness my sense of her that day was of more of internal emptiness/qi deficiency with clear qi not rising to her head rather than congested damp. More and more I am seeing lots of mixed Lung/Stomach pictures where the patient really needs both supplemented.

It is so interesting that even though her skin is so dry and the subcutaneous tissue is so boggy, that drying her exterior further helped the wound heal so dramatically. Reminds me of Toby saying that there really is no clear line between exterior and interior.

She said her energy was much better after treatment except when her husband talks about Trump. She was also much more present during the follow up treatment and expressed interested in taking care of herself rather than other people.

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Wow @KristinWisgirda what an interesting case.
So let me see if I’m following correctly… you used the +LU as a way to increase qi bring it upwards. yes?

The stagnated fluids were less of a concern, the depletion of qi was what had your attention.

This women indeed seemed a total shoe in for +ST. The results you got were dramatic.

Unfortunately I am not surprised at the conventional medicine’s ignoring the possibility that acupuncture helped. They tend to be missing a sense of curiosity for the most part when unexplained healing occurs.

have you seen her again since this treatment? Please keep us posted

Yes, depletion of qi was the grossest presentation that day. Though on paper she looks like a Lung excess, the reality that day was not a hyperinflated fat cat banker, more a deflated balloon with some water in it. She is an accountant who had just hustled through tax season and was spent.

I supplemented Stomach on her return visit and will see her again next week.

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This subcutaneous “boggy” tissue is of interest to me. I often am aware of different levels of fluids stagnant in the system. I have one patient who is in her 70s who seems to have something like fluffy-ness under her skin. Her skin is not tight over her muscles. There is a layer of fluid but also the skin is not smooth but kind of lacks tension. Like a thin layer of loose pudding in a bag of not taught fine cloth over the top of muscles. I have been concerned about what this pattern is. The closest I could come was Huang Qi type in Huang Huang’s system of 10 Formula Families, but using Huang Qi did not seem to be it. I finally pegged her as more of a Fu Zi type, and using those herbs has helped reduce the amount of fluid under her skin, but has not improved fluid metabolism the way I’d like. It has been clear that she does not metabolize fluids properly at all. So using the Metal/Earth view of this introduces a whole new range of ideas about the mechanism at work here and ideas about related herb formulas that might come from more of a 6 conformations perspective. I have other patients who, for example, have huge bellies which are hard to the touch, but with more tight skin, obviously demonstrating large amounts of adipose tissue deposited in the abdominal cavity between organs. I saw this for the first time in the “Body Worlds” exhibit of preserved bodies and it became real to me. So that intra-abdominal adiposity is kind of the opposite extreme of fluids collecting pathologically in the system. I believe that the Saam system finally gives us a lot of clarity, or at least opportunity for investigation of the fluid metabolism dynamics. And of course, in every case there are other dynamics at work, which are impacting fluid metabolism, so it gets complicated. So interesting to me.

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I love the description! Exactly what the subject of this post felt like. Please credit the balloon image to Sharon Weizenbaum, which is helpful for me. I don’t want to jump to conclusions about what this presentation means for Sa’am but I will keep watching the flesh closely and seeing how patients react.

Thinking about this patient more. I am realizing that the background of her chief complaint gives more perspective on the tendency to Stomach excess that has been lurking in a Lung excess body. She first came to me when she was 68 years old and still working 50-60 hours a week during tax season. This was down from her usual 70 hours a week during tax season and she was wondering why she was so tired and why her health was breaking down when she was working “much less”. She was never convinced by my suggestion that that kind of work schedule is unsustainable for anybody no matter their age. Definitely a pathological relationship with resources- she had to be making plenty of money but somehow working that much was never enough to her- clearly a Stomach excess attitude in the driver seat of her life.

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@KristinWisgirda this is such a keen clinical observation. yes… on paper… total lung excess, but your further investigation lead you to a deficiency of the lung.
My lazy acupuncture mind wants to go “overweight…dry skin… lung…done!” And so I’m reminded yet again we have really look at who is THIS person, beyond our models and theories.

Good call to +ST and test your original idea. Keep us posted!!

@Aculaura yes it seems are often talking fluid metabolism here and the Earth/Metal axis seems to be a key way of working this dynamic. On the surface, it looks simple, but as we drill down into the various ways that fluids can go amuck, I suspect we will find some nuanced ways of using this system to address it.

@KristinWisgirda There could be a bit LI hustle in there too.

so @KristinWisgirda, would you please tell us what happened after that ST+ treatment? I am trying to learn what toggling looks like, when to use it, how patients respond, etc.

The patient’s chief complaint was not the wound but “wooziness”, a wavy feeling in her head and a feeling of being off balance, along with chronic low energy. Besides the wound healing she got a big lift in energy from the Lung+ treatment. The next treatments were GB+ and K+ and then the wooziness was gone. The next time we addressed fluids was LI+ for depression and some diarrhea. No ST+ needed for her until 6 months later when she had a phlegmy chest cough.

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