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Case Histories - Pre-Menstrual Syndrome (2)

A 37-year-old woman had been suffering from pre-menstrual tension for 8 years. It had started when she suffered post-natal depression following the birth of her first child. She had another bout of post-natal depression after the birth of her second child. During the pre-menstrual period she felt very irritable, was irrational, and cried a lot. On a physical level, she had a pronounced feeling of distension of the breasts and abdomen. Apart from her pre-menstrual problem, she also suffered from constipation, headaches, insomnia, excessive dreaming and palpitations. Her pulse was Fine in general, slightly Wiry only on the left Middle position (Liver) and Weak on the left-Front position (Heart). Her tongue was Pale and slightly Thin but also slightly Red on the sides.

Diagnosis

This is a condition of both Deficiency and Excess. There is a deficiency of Liver Blood manifesting with constipation, excessive dreaming, Pale tongue and Fine pulse. This deficiency has also induced a deficiency of Heart-Blood manifesting with insomnia and palpitations. The deficiency of Blood most probably started with the loss of blood occurring after childbirth and was the original cause of post-natal depression. The deficiency of Liver-Blood, over the years, gave rise to stagnation of Liver-Qi and therefore the pre-menstrual tension. The fact that, besides feeling irritable before the periods, she also wept a lot, indicates a Deficiency condition.

Treatment principle

The principle of treatment adopted was to nourish Liver- and Heart-Blood, pacify the Liver, eliminate stagnation, calm the Mind and settle the Ethereal Soul. She was treated with acupuncture and patent remedies.

Acupuncture

The acupuncture points used (with reinforcing method to nourish Liver- and Heart-Blood and even method to pacify the Liver) were selected from the following:-

LIV-3 Taichong and G.B.-34 Yanglingquan to pacify the Liver and eliminate stagnation.-
P-7 Daling to pacify the Liver, calm the Mind and settle the Ethereal Soul.-
P-6 Neiguan on the right and SP-4 Gongsun on the left to open the Yin Linking Vessel, nourish Blood and calm the Mind.-
ST-36 Zusanli and SP-6 Sanyinjiao to tonify Qi and Blood.-
BL-20 Pishu, BL-15 Xinshu and BL-18 Ganshu to nourish Liver- and Heart Blood.

She was treated once a week.

Herbal treatment

The patent remedies used were Freeing the Moon (a variation of Xiao Yao Wan Free and Easy Wanderer Pill) to pacify the Liver and eliminate stagnation and Calm the Spirit (a variation of Gui Pi Wan-Restoring the Spleen Pill) to nourish Heart-Blood and calm the Mind.

By the end of 9 months this patient's condition showed about 80 per cent improvement.