Obstetrics & Gynecology in Chinese Medicine

988 Pages·1998·122.48 MB·English

by  Giovanni Maciocia

Obstetrics and
Gynecology in
Chinese Medicine
Giovanni Maciocia
CAc (Nanjing)
Acupuncturist and Medical Herbalist, UK;
Visiting Professor of the Nanjing University of Traditional
Chinese Medicine, Nanjing, People's Republic of China
Foreword by
Ted J. Kaptchuk
OMD
Associate Director, Center for Alternative Medicine
Research, Beth Israel Hospital; Instructor in Medicine,
Harvard Medical School, Boston USA
ELSEVIER
CHURCHILL
LIVINGSTONE
EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 1998
CHURCHILL LIVINGSTONE
An imprint of Elsevier Limited
© Giovanni Maciocia 1998
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First published 1998
Reprinted 1999, 2004, 2005 (twice), 2006
ISBN 0 443 05458 4
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Contents
Foreword xvii 3. Women's pathology 31
Preface xix Pathology of the Internal Organs 31
Kidneys; Liver; Spleen; Heart; Lungs; Stomach
Acknowledgements xxi
Qi and Blood pathology 41
Note on the translation of Chinese medical
terms xxiii Qi rebellious; Blood-Cold
Plates Pathology of the Extraordinary Vessels 43
Penetrating Vessel; Directing Vessel; Governing
SECTION 1 Vessel; Girdle Vessel; Yin Heel Vessel; Yin Linking
PHYSIOLOGY AND PATHOLOGY 1 Vessel
1. History of gynecology in Chinese SECTION 2
medicine 3 AETIOLOGY AND DIAGNOSIS 51
2. Women's physiology 7 4. Aetiology 53
The Uterus 7 Exterior pathogenic factors 54
Cold; Dampness; Heal
Physiology of Menstruation 8
Emotional stress 54
Menstruation and Internal Organs 11
Sadness and grief; Worry; Anger; Fear; Shock; Guilt
Kidneys; Liver; Spleen; Heart; Lungs; Stomach
Diet 57
Menstruation and Extraordinary Vessels 15
Excessive physical work/exercise 58
Penetrating Vessel (Chong MaO; Directing Vessel
(Ren MaO; Governing Vessel (Du MaO; Girdle Overwork 59
Vessel (Dai MaO; Yin Heel Vessel (Yin Qiao MaO;
Pregnancy and childbirth 59
The relationships and actions of the Extraordinary
Vessels Excessive/insufficient sexual activity 61
Conception 25 Surgery and hysterectomy 65
Pregnancy 27 The contraceptive pill 66
Menopause 28 Prevention and hygiene 67
vi CONTENTS
5. Diagnosis 69 Heart
Heart-Blood deficiency; Heart-Yin deficiency; Heart-Blood
Interrogation 70
stasis; Heart-Fire; Heart-Blood Heat
Menstruation; Pain; Vaginal discharge; Fertility and
Qi and Blood pathology and treatment 114
pregnancy; Childbirth; Miscarriage and abortion
Qi rebellious; Blood-Cold; Treatment of Qi and
Palpation 73
Blood disharmonies
Pulse; Skin; Abdomen
7. Treatment of the Extraordinary
Observation 78
Vessels 117
Complexion; Lips; Tongue
Penetrating Vessel 122
Auscultation 83
Hearing Directing Vessel 131
Voice Governing Vessel 142
Smelling
Girdle Vessel 146
Menstrual blood; Vaginal discharge
Yin Heel Vessel 149
SECTION 3
Yin Linking Vessel 150
METHODS OF TREATMENT 85
Gynecological extra points 151
6. Principles and methods of treatment 87
The herbal treatment of the Extraordinary
When to tonify and when to eliminate 88 Vessels 152
Contradictions between gynecological and The principal herbs used with the Extraordinary
systemic manifestations 90 Vessels; Four pathologies and herbal treatment;
Formulae for the Directing and Penetrating Vessels
Contradictions among gynecological
Directing and Penetrating Vessels Empty; Directing and
manifestations 91
Penetrating Vessels Unstable; Directing and Penetrating Vessels
Deficient and Cold; Full Cold in the Directing and Penetrating
Relationships between patterns, Chinese
Vessels; Empty Heat in the Directing and Penetrating Vessels;
diseases and Western diseases 91
Full Heat in the Directing and Penetrating Vessels; Damp-Heat
Note on treatment methods not to be used during in the Directing and Penetrating Vessels; Stagnant Heat in the
periods Directing and Penetrating Vessels; Dampness and Stasis of Blood
in the Directing and Penetrating Vessels
Methods of treatment 93
Treatment of Internal Organs 94
SECTION 4
Kidneys MENSTRUAL IRREGULARITIES 159
Tonify Kidney-Yang; Strongly tonify Kidney-Yang and
stoke up the Fire of the Gate of Life; Nourish Kidney-Yin; Introduction to Section 4 161
Nourish the Kidney-Essence; Tonify both Kidney-Yang
and Kidney-Yin
8. Early Periods 167
Liver
Nourish the Liver; Pacify the Liver and eliminate Aetiology and pathology 167
stagnation of Qi; Pacify the Liver and eliminate stasis of Excessive physical work, irregular diet; Overwork, menopausal
Blood; Clear Liver-Heat by pacifying the Liver; Drain decline of Kidney-Qi; Irregular diet, invasion of external Heat;
Liver-Fire; Subdue Liver-Yang or Liver-Wind Emotional stress; Chronic illness, overwork, too many children,
Spleen chronic bleeding; Pathology
Tonify Spleen-Qi and Spleen-Blood; Tonify Spleen-Yang; Differentiation and treatment 169
Tonify and raise Spleen-Qi; Tonify the Spleen to hold
Qi deficiency
Blood; Harmonize Spleen and Liver; Tonify the Spleen
and resolve Dampness Spleen-Qi deficiency; Kidney-Qi not Firm
CONTENTS vii
Blood-Heat Differentiation and treatment 218
Full Heat (1): Blood-Heat; Full Heat (2): Stagnant Liver-Qi Blood deficiency; Kidney-Yang deficiency; Kidney
turning into Fire with Blood-Heat; Empty Heat: Liver-and Yin deficiency; Stasis of Blood; Phlegm obstructing
Kidney-Yin deficiency with Empty Heat
the Uterus
Prognosis and prevention 178
Prognosis and prevention 227
9. Late Periods 179
13. Long Periods 229
Aetiology and pathology 179
Aetiology and pathology 229
Chronic illness, excessive physical work, chronic bleeding,
Emotional stress; Overwork
excessive breast-feeding; Irregular diet, exposure to cold and
dampness, invasion of Cold; Hereditary Kidney weakness, Pathological patterns
overwork, too many children too close together; Emotional stress
Differentiation and treatment 230
Pathology
Qi stagnation and Blood stasis; Kidney-Yin
Differentiation and Treatment 180 deficiency with Empty Heat
Blood deficiency; Cold in the Uterus; Kidney-Yang
Prognosis and prevention 233
deficiency; Qi stagnation
Prognosis and prevention 194 14. Painful Periods 235
Aetiology and pathology 235
10. Irregular Periods 197
Emotional strain; Cold and Dampness; Overwork, chronic illness;
Aetiology and pathology 197 Excessive sexual activity, childbirth
Pathology
Emotional stress; Overwork, too many children too close together
Pathology Diagnosis 237
Differentiation and treatment 198 Time of onset; Pressure; Heat-Cold; Character of pain; Location of
pain; Cycle
Liver-Qi stagnation; Kidney-Yang deficiency;
Kidney-Yin deficiency; Ancient acupuncture Principles of treatment 238
prescriptions for irregular periods
Differentiation and treatment 239
Prognosis and prevention 204 Full types
Stagnation of Qi; Stasis of Blood; Stagnation of Cold;
11. Heavy Periods 207 Damp-Heat; Stagnant Liver-Qi turning into Fire
Empty types 252
Aetiology and pathology 207
Qi and Blood deficiency; Yang and Blood deficiency;
Excessive physical work; Emotional stress, irregular diet, external Kidney-and Liver-Yin deficiency
Heat; Emotional stress, surgery, post-partum conditions
Ancient acupuncture prescriptions for
Pathology
dysmenorrhoea
Differentiation and treatment· 208
Prognosis and prevention 258
Qi deficiency; Blood-Heat; Blood stasis
Western differentiation 258
Prognosis and prevention 215
15. Bleeding between Periods 261
12. Scanty Periods 217
Aetiology and pathology 261
Aetiology and pathology 217
Overwork, too many children too close together; Irregular diet;
Chronic illness, haemorrhage, irregular diet; Overwork, Traumas, abdomina} operations, post-partum stasis of Blood;
hereditary weakness, too many children too close together; Excessive physical exercise
Traumas, abdominal surgery, emotional stress, cold; Irregular
Pathology
diet, physical overwork; Contraceptive pill
Pathology Differentiation and Treatment 262
viii CONTENTS
Liver- and Kidney-Yin deficiency with Empty Heat; Western differentiation 336
Damp-Heat; Blood stasis; Spleen- and Kidney-Yang
deficiency 18. Pre-Menstrual Syndrome 339
Prognosis and prevention 272 Aetiology and pathology 339
Emotional strain; Diet; Overwork, excessive sexual activity
16. No Periods 273 Pathology
Aetiology and pathology 273 Differentiation and treatment 340
Emotional stress; Excessive physical work or exercise; Hereditary Full types
weakness; Diet; Overwork Liver-Qi stagnation; Phlegm-Fire harassing upwards
Pathology Empty types
Differentiation and treatment 276 Liver-Blood deficiency; Liver-and Kidney-Yin deficiency;
Spleen-and Kidney-Yang deficiency
Empty conditions
Ancient acupuncture prescription for Pre-Menstrual
Liver and Kidney deficiency; Blood deficiency; Spleen
Syndrome
and Kidney-Yang deficiency; Liver-and Kidney-Yin
deficiency; Lung-Yin and Blood deficiency; Heart-and
Prognosis and prevention 356
Kidney-Yin deficiency; Spleen-and Heart-Blood
deficiency Western differentiation 356
Full conditions
Stagnation of Qi and Blood; Damp-Phlegm in the Uterus SECTION 5
Ancient acupuncture prescriptions for amenorrhoea PROBLEMS AT PERIOD TIME 359
Prognosis 299
19. Pre-menstrual breast distension 361
Western differentiation 299
Aetiology and pathology 361
Emotional stress; Overwork, too many children; Irregular diet
17. Flooding and Trickling 303
Pathology
Aetiology and pathology 303
Differentiation and treatment 362
Emotional strain; Overwork add excessive sexual activity;
Liver-Qi stagnation; Liver-Blood stasis; Phlegm
Physical overwork, chronic illness; Childbirth
with stagnation of Qi; Liver- and Kidney-Yin
Pathology
deficiency
Differentiation and treatment 305
Prognosis and prevention 371
Treatment principles
Harmonize Blood; Treat the Root-cause of bleeding;
20. Headaches 373
Astringe; Treat Qi
Three steps in treatment; Herbal treatment; Acupuncture; Aetiology and pathology 373
Summary of patterns Excessive physical work; Emotional stress
Full conditions Pathology
Blood-Heat; Liver-Qi Stagnation turning into Heat; Blood
Differentiation and Treatment 374
Empty Heat; Stasis of Blood; Damp-Heat in the Uterus
Blood deficiency; Liver-Fire blazing; Liver-Yang
Empty conditions
rising; Blood stasis
Spleen not holding Blood; Kidney-Yang deficiency;
Kidney-Yin deficiency Prognosis and prevention 384
Complex patterns
Full with Full; Empty with Empty; Empty with Full 21. Oedema at period time 385
Ancient acupuncture prescriptions for Flooding and
Aetiology and pathology 385
Trickling
Excessive physical work; Emotional stress
Prognosis and prevention 336 Pathology
CONTENTS ix
Differentiation and Treatment 386 Differentiation and treatment 418
Spleen- and Kidney-Yang deficiency; Stagnation of Stagnant Liver-Qi turning into Fire; Lung- and
Qi; Ancient acupuncture prescriptions for oedema at Kidney-Yin deficiency
period time
Prognosis and prevention 421
Prognosis and Prevention 391
26. Mouth ulcers 423
22. Diarrhoea 393
Aetiology and pathology 423
Aetiology and pathology 393 Overwork, too many children too close together; Irregular diet
Excessive work, irregular diet; Emotional stress; Overwork, too Pathology
many children too close together
Differentiation and treatment 424
Pathology
Kidney-Yin deficiency with Empty Heat; Stomach
Differentiation and treatment 394 Fire or Stomach Damp-Heat; Stomach Damp-Heat
Spleen-Qi deficiency; Liver-Qi stagnant and with Spleen deficiency
invading the Spleen; Kidney-Yang deficiency
Prognosis and prevention 427
Prognosis and Prevention 397
27. Skin eruptions 429
23. Body aches 399
Aetiology and pathology 429
Aetiology and pathology 399 Overwork, chronic illness, haemorrhage after childbirth; Irregular
diet, Yang constitution
Excessive physical work, inadequate diet, chronic illness;
Emotional stress, irregular diet Pathology
Pathology Differentiation and treatment 430
Differentiation and treatment 400 Blood deficiency; Wind-Heat invading Blood
Blood deficiency (alone or with Yang rising); Blood
Prognosis and prevention 433
stasis
Prognosis and prevention 406 28. Dizziness at Period Time 435
Aetiology and pathology 435
24. Fever at period time 407 Chronic illness, irregular diet, haemorrhage; Emotional stress,
overwork; Excessive exercise, irregular diet
Aetiology and pathology 407
Pathology
Emotional stress, diet; Overwork, too many children; Chronic
illness, excessive physical work; Emotional stress, surgery Differentiation and Treatment 436
Pathology Blood deficiency; Kidney- and Liver-Yin deficiency
with Liver-Yang rising; Phlegm with Sleep-Qi
Differentiation and treatment 408
deficiency
Blood-Heat; Kidney- and Liver-Yin deficiency with
Empty Heat; Qi and Blood deficiency with Prognosis and prevention 439
disharmony of Nutritive and Defensive Qi; Blood
stasis with Heat
SECTION 6
Prognosis and prevention 415 DISEASES OF PREGNANCY 441
Introduction to Section 6 443
25. Epistaxis or haemoptysis 417
Problems of pregnancy and their
Aetiology and pathology 417
treatment 443
Emotional stress; Overwork, emotional stress
Pathology Diet during pregnancy 445
x CONTENTS
Chinese embryology 446 32. Fetus not Growing 489
Fetus education 447 Aetiology and pathology 489
Differentiation and treatment 489
29. Morning Sickness 451
Qi and Blood deficiency; Spleen- and Kidney-Yang
Pathology 451 deficiency
Differentiation and treatment 452 Prognosis and prevention 492
Acupuncture
Western view 492
Stomach channel; Kidney (and Penetrating Vessel)
channel; Directing Vessel; Distal points
33. Oedema in pregnancy 493
Patterns of morning sickness and their treatment;
Stomach-Qi deficiency with Empty Cold; Stomach Aetiology and pathology 493
Yin deficiency; Stagnant Liver-Qi invading the Irregular diet; Excessive physical work, exercise or lifting;
Stomach; Stomach-Heat; Accumulation of Phlegm; Emotional stress
Heart-Qi deficiency; Heart-Fire Pathology
Prognosis and prevention 463 Differentiation and treatment 494
Spleen-Yang deficiency; Kidney-Yang deficiency;
30. Abdominal Pain during pregnancy 465 Stagnation of Qi
Pathology 465 Prognosis and prevention 497
Blood deficiency; Stagnation of Qi; Empty Cold; Blood stasis
Western view 498
Differentiation and treatment 466
Deficiency of Blood; Stagnation of Qi; Empty Cold 34. Anxiety 499
Prognosis and prevention 469 Aetiology and pathology 499
Overwork, Yin-deficient constitution; Emotional problems,
Western differentiation 469
irregular diet
Ectopic pregnancy; Spontaneous abortion; Ovarian Pathology
tumour torsion
Differentiation and treatment 500
Appendix: Ectopic pregnancy 471 Liver-Fire; Empty Heat from Yin deficiency;
Blood stasis; Collapse of Yang; Blood stasis and Qi Phlegm-Fire harassing the Mind
deficiency
Prognosis and prevention 504
31. Threatened miscarriage 473
35. Dizziness in pregnancy 505
Aetiology and pathology 474
Aetiology and pathology 505
Overwork, excessive physical work; Chronic illness, irregular diet;
Emotional problems, irregular diet, febrile disease; Falls, jumps, Overwork; Excessive physical work, irregular diet
traumas; Excessive sex during pregnancy Pathology
Pathology
Differentiation and treatment 506
Differentiation and treatment 475 Liver-and Kidney-Yin deficiency with Liver-Yang
Kidney deficiency; Qi and Blood deficiency; Blood rising; Spleen deficiency with Liver-Yang rising and
Heat; Falls, trauma; Expulsion of the products of Phlegm
conception; Acupunture prescription; Ancient
Prognosis and prevention 508
acupuncture prescriptions for threatened miscarriage
Western view 508
Prognosis and prevention 485
Western view 486 36. Convulsions in pregnancy 509
CONTENTS xi
Aetiology and pathology 509 41. Retention of Urine 535
Overwork; Irregular diet, emotional problems
Aetiology and pathology 535
Pathology
Excessive physical exercise; Excessive sexual activity, excessive
Differentiation and treatment 510 standing or lifting; External Dampness; Irregular diet
Liver-Wind agitating within; Phlegm-Fire harassing Pathology
upwards; Empty Wind
Differentiation and treatment 536
Prognosis and prevention 514 Spleen-Qi deficient and sinking; Kidney-Qi deficient
and sinking; Damp-Heat in the Bladder
Western view 514
Prognosis and prevention 540
37. Feeling of suffocation 515
42. Constipation during pregnancy 541
Aetiology and pathology 515
Aetiology and pathology 541
Differentiation and treatment 515
Diet; Emotional stress; Lack of exercise; Overwork and childbirth
Stagnation of Qi with disharmony of Liver
and Spleen; Stagnation of Qi with deficiency of Differentiation and treatment 542
Blood and Kidneys Blood deficiency; Kidney-Yang deficiency; Kidney
Yin deficiency; Liver-Qi stagnation
Prognosis and Prevention 518
Prognosis and prevention 546
38. Aphonia 519
43. Habitual miscarriage 547
Aetiology and pathology 519
Aetiology and pathology 547
Differentiation and treatment 519
Kidney-Yin deficiency Differentiation and treatment 548
Kidney-Yang deficiency; Kidney-Yin deficiency;
Prognosis and prevention 521
Blood-Heat; Spleen-Qi deficiency; Blood deficiency;
39. Cough 523 Blood stasis
Aetiology and pathology 523 Prognosis and prevention 556
Overwork; Irregular diet, emotional problems Western view 556
Pathology
Differentiation and treatment 523 44. Acupuncture and herbal treatment in
midwifery 559
Lung-Yin deficiency; Phlegm-Fire in the Lungs
Origins of acupuncture treatment for delayed
Prognosis and prevention 527
labour 559
40. Painful-Urination Syndrome 529
Acupuncture in labour: a short history 560
Aetiology and pathology 529 The way ahead
Emotional problems; Overwork; Irregular diet; Excessive sexual
Physiology of labour 561
activity during pregnancy
Pathology Breech presentation 562
Differentiation and treatment 530 Pathology of labour and post-partum
Heart-Fire; Damp-Heat in the Bladder; Kidney-Yin period 563
deficiency and Empty Heat Acupuncture for analgesia in labour Ear points;
Acupuncture in the treatment of difficult labour
Prognosis and prevention 532
Differentiation and treatment; Deficiency of Qi and
Western view 532 Blood; Stagnation of Qi and Blood