Describe qi stagnation masses
Qi stagnation masses come and go, movable upon palpation and change location.
Describe blood stagnation masses
Blood stasis masses are fixed in location, not movable upon palpation and feel quite hard. If pain: fixed and stabbing
Firm or hard, immobile; no change with prolonged pressure; well defined with clear but irregular edges or an area of increased tissue density
Often painful with pressure; fixed always found in same spot
Blood stasis masses tend to grow within organ or muscle tissue
May appear quite dense and irregularly shaped with ultrasound
Describe phlegm masses
Phlegm masses feel soft on palpation and have a fixed location, usually no pain.
Well defined, smooth, soft or rubbery, rounded; fixed but may be moved slightly over basement tissue
Not usually painful or tender upon palpation; may impinge on other pain producing structures;
Masses may grow on the surface of organs or in between tissue layers
Laparoscopy: surface of mass may be shiny and pearl-like or opaque
What’s the difference between Heat masses and Cold masses?
Heat
Mass feels warmer than surrounding tissue, usually soft and squishy;
Tender upon palpation
May appear regular in shape with imaging
Cold
Soft mass under tissue that feels cooler than surrounding tissue; abdominal wall usually cool, pale and lax
Generally not tender, or mild, upon palpation depending on degree of blood stasis and/or Kidney Yang deficiency
What’s the early stage treatment strategy for masses?
EARLY Stage: resolve pathogenic factor, move Qi, invigorate blood, resolve phlegm; Pathogen is weak, Qi is strong
What’s the middle stage treatment strategy for masses?
MIDDLE Stage: resolve pathogenic factor and tonify Qi; Pathogen stronger, Qi weakening
What’s the late stage treatment strategy for masses?
LATE Stage: tonify Qi, resolve the pathogenic factor; Pathogen strong, Qi weak
Movable abdominal masses which come and go, abdominal distention and pain which come and go with the masses, a feeling of discomfort in the hypochondrium, depression, moodiness, irritability, alternation of constipation an diarrhea
T: normal or slight Red on sides, thick root coat
P: Wiry
Liver Qi Stagnation
Soft abdominal masses, which may be strip-like in shape, abdominal distention, constipation or diarrhea, poor appetite, nausea and a feeling of fullness
T: Swollen, sticky coating thicker on root
P: Slippery
Retention of Food and Phlegm
Hard and immovable abdominal masses, abdominal distention and pain, late periods
T: Purple
P: Wiry
Qi & Blood Stagnation
Hard, immovable and painful masses in the abdomen, dark and withered complexion, dry skin, feeling cold, amenorrhea, painful periods, late periods. A condition of severe and chronic blood stasis.
T: Purple
P: Choppy
Blood Stasis Knotted in the Interior
Hard, painful masses, sallow complexion, loss of weight, loss of appetite, exhaustion
T: Purple
P: Fine and Choppy
Deficiency of Upright Qi & Stasis of Blood
What is a myoma?
Myoma, a solid well defined benign growth in the myometrium. Most common tumors of the uterus, 20% of all women over 35 affected.
Not a fibroid, comprised of smooth muscle tissue
Excessive uterine bleeding is a consequence
Not usually painful. Large myomas may press on the bladder: increased frequency, dysuria.
Does Endometriosis cause a abdominal masses?
Endometriosis does not usually cause an abdominal mass, only when there is an accumulation of scar tissue and displacement of the uterus.
Tell me a little about PCOS
- PCOS Polycystic Ovary Syndrome
- Common hyperandrogenic endocrine abnormality of unknown etiology
- Strong genetic basis
- Environmental factors: modern dietary patterns, sedentary lifestyle that promote obesity can initiate or exacerbate symptoms
- Constitutional Kidney deficiency is the basic etiology
- May be the Western cause of No Periods, Scanty Periods or Infertility
- Kidney Yang deficiency, fluids not metabolized
- Phlegm and/or Dampness accumulate; blood stasis often present
- Damp/Phlegm causes cysts; Yang def. causes amenorrhea or infertility
- Numerous small cystic follicles varying in size, less than 0.5 cm in diameter
- Failure of the ovarian enzyme systems necessary for estrogen production; obesity, amenorrhea, infertility and hirsutism
No periods, history of infertility, scanty periods, obesity, hirsutism, feeling of oppression of chest, feeling of heaviness of the abdomen, excessive vaginal discharge
T: Pale, swollen with sticky white coat
P: Weak, slightly slippery
KIDNEY YANG DEF. with DAMP/PHLEGM
No periods, history of infertility, scanty periods, obesity, hirsutism, feeling of oppression of chest, feeling of heaviness of the abdomen, excessive vaginal discharge, abdominal pain
T: Pale, purple or bluish purple, swollen, sticky white coating
P: Weak, slightly slippery
KIDNEY YANG DEF. + BLOOD STASIS