Fever at Period Time

CHAPTER 24 Fever at Period Time



AETIOLOGY 421

PATHOLOGY 422

IDENTIFICATION OF PATTERNS AND TREATMENT 422
Blood-Heat 422

Kidney- and Liver-Yin deficiency with Empty-Heat 423

Qi and Blood deficiency with disharmony of Nutritive and Defensive Qi 424

Blood stasis with Heat 426

Ancient acupuncture prescriptions for fever during periods 427

PROGNOSIS AND PREVENTION 427

‘Fever’ here includes both an actual fever and a pronounced feeling of heat, which is more frequent before or during the period but may also occur after it. It should be stressed that if there is only a feeling of heat, this should be both subjective and objective, i.e. the patient has a feeling of heat and her skin (particularly of the dorsum of the hands) also feels hot to the touch.



Aetiology




Emotional stress, irregular diet


Emotional stress such as actual or repressed anger, resentment or frustration may lead to Liver-Qi stagnation which frequently turns into Fire; Fire can invade the Blood portion (especially Liver-Fire because this organ stores Blood) and give rise to Blood-Heat. Since Blood accumulates before the periods, Blood-Heat causes a feeling of heat or fever before or during the periods.


The pathology of this condition is also influenced by a disharmony of the Penetrating Vessel. This vessel is the Sea of Blood and its chief pathology is Qi rebelling upwards. The Penetrating Vessel has a deep influence on the menstrual function and the vessel is full of Blood before the period. If Blood has Heat, and if Qi rebels upwards, this may carry Blood with it and cause an intense feeling of heat in the face. In fact, as we have seen in Chapter 7, even rebellious Qi of the Penetrating Vessel by itself (without Blood-Heat) may cause a feeling of heat in the face.



Overwork


Overwork (in the sense explained before) and having too many children too close together may lead to Yin deficiency and Empty-Heat: the latter heats the Blood and also causes Blood-Heat. Since Blood is in a state of relative depletion after each period, the Empty-Heat becomes more pronounced at this time and causes a feeling of heat or fever after the period. This type of Heat is different from Full- or Empty-Heat insofar as it derives from Qi and Blood deficiency: it is treated by using not bitter, cold herbs but sweet, warm ones that gently tonify Qi and the Original Qi.


The idea behind this method derives from Li Dong Yuan who said that when the Fire of the Original Qi declines, a pathological Minister Fire takes over, giving rise to a feeling of heat. Since this derives from a decline of the Original Qi, it is treated by tonifying this with sweet, warm herbs.



Chronic illness, excessive physical work


A long, chronic illness may cause Qi and Blood deficiency, while excessive physical work (including sports) may injure the Spleen and also lead to Qi and Blood deficiency. This causes a disharmony between Nutritive and Defensive Qi so that there is a feeling of heat or fever during or after the period.



Emotional stress, surgery


Emotional stress as mentioned above may also lead to Blood stasis; when Blood stagnates for a long time it may give rise to Heat. Blood-Heat causes a feeling of heat or fever before or during the period. The stasis of Blood may also derive from abdominal surgery following a hysterectomy, ovarectomy or an operation for endometriosis.



Pathology


The main pathological factors leading to a feeling of heat or fever at period times are:


• Blood-Heat

• Kidney- and Liver-Yin deficiency with Empty-Heat

• Qi and Blood deficiency with disharmony of Nutritive and Defensive Qi

• Blood stasis with Heat.

The second pattern is more common in older women.



Identification of patterns and treatment



Blood-Heat



Clinical manifestations


An intense feeling of heat or fever before or during the period, heavy period, mental restlessness, agitation, headache, blood-shot eyes, thirst, hot nose, red lips. Tongue: Red. Pulse: Rapid, Overflowing.



Treatment principle


Clear Heat, cool Blood, regulate the periods.



Acupuncture


L.I.-11 Quchi, SP-10 Xuehai, Du-14 Dazhui, LIV-2 Xingjian, KI-2 Rangu, SP-1 Yinbai, SP-4 Gongsun (on the right) and P-6 Neiguan (on the left), L.I.-4 Hegu, HE-6 Yinxi, P-7 Daling. All with reducing or even method, no moxa.




Explanation


– L.I.-11 and SP-10 clear Heat and cool Blood.

– Du-14 clears Heat.

– LIV-2 and KI-2 cool Blood. LIV-2 also clears Liver-Fire which is often the root cause of this type of Blood-Heat.

– SP-1 cools Blood and reduces excessive uterine bleeding.

– SP-4 and P-6 open the Penetrating Vessel. This vessel is the Sea of Blood and one of its main pathologies is Qi rebelling upwards which, by itself, can also cause a feeling of heat. The rebellious Qi carries Blood with it, and when the latter is hot this would contribute to the feeling of heat. For this reason, SP-4 and P-6 are used to harmonize the Penetrating Vessel and subdue rebellious Qi.

– L.I.-4 is used to regulate the ascending and descending of Qi and thus reduce the feeling of heat which usually occurs on the face.

– HE-6 and P-7 calm the Mind and also clear Heat. These points are used also because the pattern of Blood-Heat is often caused by emotional stress and, in turn, it causes irritability (as Heat usually does).


Herbal treatment



a Prescription



– QIN LIAN SI WU TANG

– Scutellaria-Coptis Four Substances Decoction


Explanation

The last four herbs are the formula Si Wu Tang Four Substances Decoction (with Sheng Di Huang substituted for Shu Di Huang). These are used to enter the Blood portion. Sheng Di Huang is used to cool Blood.


– Huang Qin and Huang Lian are used to clear Heat: in combination with the Si Wu Tang, the herbs enter the Blood portion and cool Blood.

– Mai Men Dong nourishes Yin.


b Prescription



– QING JING SAN

– Clearing the Menses Powder


Explanation

Compared with the previous formula, this prescription is used when Blood-Heat is more intense and there is also a tendency to Empty-Heat.


– Mu Dan Pi cools Blood and clears Liver-Heat.

– Bai Shao pacifies the Liver.

– Shu Di Huang enters the Blood portion.

– Di Gui Pi and Qing Hao clear Empty-Heat.

– Fu Ling resolves Dampness.

– Huang Bo clears Kidney Empty-Heat.


c Prescription



– DAN ZHI XIAO YAO SAN Variation

– Moutan-Gardenia Free and Easy Wanderer Powder Variation


Explanation

This formula is chosen if there is a pronounced stagnation of Liver-Qi and this has given rise to Liver-Fire.


The first eight herbs constitute a variation of the formula Dan Zhi Xiao Yao San (also called Jia Wei Xiao Yao San Augmented Free and Easy Wanderer Powder) which is specific for Liver-Fire deriving from stagnation of Liver-Qi.


– Xiang Fu is added to move Liver-Qi.

– Huang Qin clears Heat.

– Gou Teng subdues Liver-Yang and clears Liver-Fire. It is especially suitable if the patient suffers also from headaches.


Modifications


• If there is also some stasis of Liver-Blood, the formula Shi Xiao San Breaking into a Smile Powder can be added.


Three Treasures remedy


– DRAIN FIRE

This remedy is a variation of the formula Long Dan Xie Gan Tang Gentiana Draining the Liver Decoction which drains Liver-Fire. The tongue presentation appropriate to this remedy is a Red body, with redder sides and with a yellow, dry coating.

Related posts:

  1. Collapse after Childbirth
  2. Prolapse of the Uterus
  3. Acupuncture and Herbal Treatment in Midwifery
  4. Endometriosis

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Fever at Period Time

Full access? Get Clinical Tree
Get Clinical Tree app for offline access