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Case Histories - Candidiasis

A 40-year-old woman had been suffering from vaginal thrush for "a long time". She complained of redness, soreness and itching around the vagina which were worse both before and after the period. Her periods were regular, lasted 1 week and were not painful. She suffered from pre-menstrual tension manifesting primarily with depression and tiredness. She also complained of backache, a cold feeling, frequent urination, dizziness, tinnitus and night-sweating. On interrogation, it transpired that she often felt a sticky taste in her mouth. Her tongue was slightly Red on the sides, Swollen and with a sticky coating. Her pulse was Weak on the right and Choppy on the left.

Diagnosis

The vaginal thrush is obviously due to Damp-Heat which is apparent from the redness, soreness and itching of the vagina; Dampness is also confirmed by the swelling of the tongue and the sticky coating. There is an underlying deficiency of Spleen- and Kidney-Yang deficiency, especially the latter manifesting with backache, cold feeling, frequent urination, dizziness and tinnitus.

Treatment

In cases such as these, it is important to decide whether to put the emphasis on tonifying the deficiency of expelling the pathogenic factor (in this case Damp-Heat). Given the intensity of her vaginal thrush, I decided to concentrate on treating the Manifestation and therefore expel the pathogenic factor, i.e. resolve Dampness and clear Heat in the Lower Burner. I therefore prescribed Drain the Jade Valley to resolve Dampness, clear Heat and stop itching in the vagina. I also gave her some herbs to use externally as a vaginal wash:

She Chuang Zi Fructus Cnidii monneri
Ku Shen Radix Sophorae flavescentis
Shi Gao Gypsum
Huang Bo Cortex Phellodendri
Bai Zhi Radix Angelicae dahuricae

I also used acupuncture treating mostly the following points:

-LU-7 Lieque and KI-6 Zhaohai to open the Directing Vessel.
-SP-9 Yinlingquan, SP-6 Sanyinjiao and BL-32 Ciliao to resolve Dampness from the Lower Burner.
-KI-7 Fuliu and BL-23 Shenshu to tonify Kidney-Yang.
-Ren-12 Zhongwan to resolve Dampness.

This patient reacted well to treatment and the combination of the internal treatment with Drain the Jade Valley and the external wash cured the thrush problem over a period of 10 months. It is envisaged that eventually the treatment will have to be followed up by tonification of the Spleen and Kidneys.