Case 1
Simon, Boy Age 10 Years

Main complaints: Bedwetting, which always occurred after 5a.m. at a frequency of about three times a week. The problem had been on and off for years, with no more than 6 months’ remission at a time.

History and other problems: Simon was asthmatic. Since the age of 4 years had taken medication for the asthma. He was using the weakest kind of steroid inhaler twice every day. He had never been hospitalized for the asthma. Since being an infant he had had severe problems with eczema. At age 5 years he received acupuncture for about 18 months, which helped the eczema considerably, but the problem persisted, especially on the hands. He had clear food allergies causing the asthma and/or the eczema to flare up. For example, he would have very severe asthma attacks after eating foods with certain food dyes in them. He avoided cow’s milk products, and was in general very careful about what he ate. He had problems with seasonal allergies, such as hay fever. The previous year, for example, it had been particularly bad, with severe irritation of the nose and ala nasi. These allergies could irritate the asthma. As a small child he was never able to sweat. Then by about age 5 years was able to sweat a little in a few places such as the head and face. But he still did not sweat normally like other children. Other systems were good. Appetite, sleep, bowel movements, and energy were generally good. He was on his school soccer team. He had mood swings. He always had cold feet. Occasionally he suffered mild stomach pain. He occasionally had frontal headaches.

Assessment: Facial complexion was off-white, with dark sunken eyes (kidney sign). The luster of his skin especially around his eyes was not so good. His posture was not very good; he had sloping shoulders (lung sign). Over the whole abdomen the skin was rough. There was some tightness in the subcostal region. The skin on the upper back was soft and empty. The muscles on the lower back were a little tight. The lung, spleen, liver, and kidney pulses were all weak.

Diagnosis: In this case the signs and symptoms supported a number of possibilities. It was decided to start with a lung vacuity pattern and see how he responded to this treatment.

Bilateral BL-13 and BL-20 were supplemented.

Tapping with a herabari over the back of the head and neck.

Chinetsukyu/warm moxa was applied around GV-14, BL-13, GV-3, and BL-25.

Press-spheres were applied to GV-4 and CV-4.

The skin seemed a little better, the healing time a little shorter. With regard to the asthma, he had a more productive cough. He had had one incidence of bed-wetting. He also had an increased appetite this week, but was very tired on the day of the treatment. It was now much clearer that the primary pattern to focus on was a kidney vacuity pattern. The third deep left (kidney) and first deep right (lung) pulses were the weakest pulses, and there was a little more softness on the abdomen in the lower portions below the navel.

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-5, drain right SP-5, TB-5, and left BL-58.

The sanshin/contact needle technique was applied over the inguinal/lateral abdomen region, ST-12 region, and to left BL-10.

Bilateral BL-13, BL-23, and around GV-6 were supplemented.

Press-spheres were applied to bilateral BL-23 and bilateral asthma shu points.

Third visit—8 days later

The skin had improved further. His emotional state was more stable. There were some asthma symptoms, but milder than usual. He had had three episodes of bedwetting. His mother speculated that because he had more energy than usual he was much more active; consequently he was exhausted at the end of the day, sleeping more deeply than usual, and this could have contributed to the increase in bedwetting.

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-5, drain right SP-3, TB-5, and left BL-58.

The sanshin/contact needle technique was applied over the inguinal/lateral abdomen region, ST-12 region, and to left BL-10.

Bilateral BL-13, BL-23, and around GV-6, GV-8 were supplemented.

Chinetsukyu/warm moxa was applied to GV-14, GV-3, and bilateral BL-23.

Press-spheres were applied to bilateral BL-23, asthma shu points, and CV-4.

Yin tang was supplemented using the silver needle.

Fourth visit—1 week later

The asthma symptoms were better. There had been no incidents of bedwetting. He had more energy, but with more balanced behavior, and so was not as exhausted at night. His appetite was good.

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-5, drain right SP-5, TB-5, and ST-40.

The sanshin/contact needle technique was applied over the inguinal/lateral abdomen region and ST-12 region.

Bilateral BL-13, BL-23, and around GV-5, GV-6 were supplemented.

Chinetsukyu/warm moxa was applied to GV-14, GV-3, and bilateral BL-23.

Press-spheres were applied to bilateral BL-23 and bilateral asthma shu points and CV-4.

Fifth visit—1 week later

He was in a soccer game, which his team won, and he was man of the match. In celebration he ate some candy with the wrong food dye in it and suffered a very severe asthma attack, which was not responsive to the normal inhaler treatment. This also triggered incidents of bedwetting. Prior to this he was doing very well. Since the start of the attack the bedwetting had slowly subsided, and he was almost back to his usual state. His energy levels were slightly lower, his skin better, and he was also beginning to show some of his seasonal allergies (hay fever).

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-5, drain right SP-5, LI-6, and left GB-37.

The sanshin/contact needle technique was applied over the ST-12 region.

Tapping with a herabari was applied over the upper back.

Bilateral BL-13, BL-23, and around GV-4, GV-6 were supplemented.

Press-spheres were applied to bilateral BL-23 and CV-4.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

Sixth visit—6 days later

He was doing much better, also mentally, and his energy levels were good. He was a little wheezy, but generally his asthma symptoms seemed better, and he had forgotten to take his inhaler medicine that day (something he did not generally do).

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-8, drain right SP-5, TB-5, and left BL-58.

The sanshin/contact needle technique was applied over upper back and ST-12 region.

Bilateral BL-13, BL-23, and around GV-6 were supplemented.

Chinetsukyu/warm moxa was applied to GV-14, GV-3, and bilateral BL-23.

Press-spheres were applied to bilateral BL-23 and CV-6.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

Seventh visit—8 days later

He was doing very well. He had forgotten to take his inhaler medicine several times with no symptoms. He was a little wheezy at the time of treatment. He had had one small incident of bedwetting, during which he woke up.

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-8, drain right SP-5, TB-5, and ST-40.

The sanshin/contact needle technique was applied over upper back and ST-12 region.

Bilateral BL-13, BL-23 were supplemented. Chinetsukyu/warm moxa was applied to GV-14, GV-3, and bilateral BL-23.

Press-spheres were applied to bilateral BL-23 and CV-6.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

Left KI-7 was supplemented again.

Eighth visit—1 week later

He had had a very good week with one very short-lived asthma attack. He had again forgotten to take his inhaler medicine several times this week. His mother noticed that his gait was better and his torso looser; he seemed to be walking more evenly. He also reported that when he played soccer, or with his friends, he was now sweating for the first time in areas he had never been able to sweat before.

Treatment: A silver needle was used to supplement CV-12, left KI-7, and LU-5, drain right SP-3, TB-5, left BL-58, and GB-37.

The sanshin/contact needle technique was applied over the ST-12 region.

Bilateral BL-13, BL-23, and around GV-6 were supplemented.

Chinetsukyu/warm moxa was applied to GV-14, GV-3, and bilateral BL-23.

Press-spheres were applied to bilateral BL-23 and CV-4.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

Ninth visit—1 week later

His mother noticed that he was having virtually no seasonal or hay fever-type symptoms, and that while he had very mild asthma symptoms in the morning on waking, they were much better then before for this time of year (mid-May). His facial complexion was now much better too. He had clear luster around the eyes. The dark sunken appearance of his eyes had been replaced by a vaguely dark ring around the eyes.

Treatment: Using SSP surface electrodes, ion-pumping cords were briefly applied right PC-6 (black)–left SP-4 (red), with right KI-6 (black)–left LU-7 red.

A silver needle was used to supplement CV-12, left KI-7, and LU-8, drain right SP-3, TB-5, left BL-58, and GB-37.

The sanshin/contact needle technique was applied over the ST-12 region.

Bilateral BL-13, BL-23 were supplemented.

Press-spheres were applied to bilateral BL-23 and CV-5.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

Left KI-7 was supplemented again.

Tenth visit—2 weeks later

He had had a very good week with no asthma symptoms at all. He was using the inhaler at less than 50% of the normal dose. He had no seasonal allergy symptoms, which had not occurred before at this time of year.

Treatment: Using SSP surface electrodes, ion-pumping cords were briefly applied right PC-6 (black)–left SP-4 (red), with right KI-6 (black)–left LU-7 red.

A silver needle was used to supplement left KI-7 and LU-8, drain right SP-3, and left BL-58, SI-7.

The sanshin/contact needle technique was applied over the ST-12 region.

Light stroking was applied down the back with an enshin.

Bilateral BL-13, BL-23 were supplemented.

Press-spheres were applied to bilateral BL-23 and CV-4.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

CV-12 was supplemented again.

Eleventh visit—2 weeks later

He had had almost no asthma symptoms, only very mild wheezing on waking in the morning. He was taking the inhaler medicine about three or four times per week rather than twice a day. He had virtually no allergy symptoms. He had not had a problem with bedwetting for a number of weeks now. He also reported that the extent of areas that were now sweating normally on active exertion had increased again.

Treatment: Using SSP surface electrodes, ion-pumping cords were briefly applied right PC-6 (black)–left SP-4 (red), with right KI-6 (black)–left LU-7 red.

A silver needle was used to supplement CV-12, left KI-7, LU-8, and right SP-3, drain right TB-5, ST-40, and left BL-58.

The sanshin/contact needle technique was applied over the ST-12 region.

Light stroking was applied down the back with an enshin.

Bilateral BL-13, BL-23, and around GV-4 were supplemented.

Press-spheres were applied to bilateral BL-23 and CV-4.

Intra-dermal needles were placed to the asthma shu points (with instructions to remove them after 2 days and replace them with press-spheres).

The patient discontinued treatment at this time since the family was moving out of town and it would not be possible to continue treatment.

Reflection: Although this case is listed under “bed-wetting,” the patient clearly had a more complex condition. The history of allergic constitution with asthma, food allergy components, and eczema makes this a complicated case. Most likely he started with a lung vacuity pattern constitution, but the protracted use of steroids for his lung problems gradually weakened the kidney, so that he showed a kidney vacuity pattern, which eventually gave rise to the bedwetting symptoms. As a 10-year-old boy it was possible to apply more treatment than on a younger child and also to treat him in a similar manner to an adult (the use of a silver needle rather than a teishin). The complexity of his condition and history of eczema made me hesitate to teach home treatment to the parents. I decided to wait and see how he was doing before trying to figure out how to do this. Fortunately, he started showing signs of improvement quite quickly, which made it unnecessary to add home treatment options. Had there been slower or little response I would have started adding home treatment into the mix, and, if still not enough, begun thinking about where to apply a stronger more stimulating treatment like okyu, direct moxa. Fortunately this was not necessary. He did very well with the treatments; he and his parents were very satisfied. I heard from the mother about 3 months after discontinuing treatment. His skin, lungs, and bedwetting problems remain improved and they were negotiating with their new general practitioner about only using the asthma medicine as needed rather than automatically every day.