Tinnitus

[Anna Bordas]

Hi everyone!

I would like to ask your point of view about a case. My patient is 39-year-old man. He has a problem with tinnitus. The problem started on february two days after a surgery of his left wisdom teeth. I’m still not sure if the tinnitus is related to this or not. I’ve seen him 3 times. The first two times I performed sinews (LI, TH, SI) because I thought that the problem was with sinews and I found it the three yang sinews on the right wrist and shao yang and tai yang on the left wrist. After the first treatment, in my office, when He did the movements related to the sinews, the tinnitus had decreased in all movements. The problem appears in the evening, the same day, the tinnitus started coming up when he went to sleep and he gets worse all the consequent days. This situation happened two times and the third time I decided to treat him with another channels. I found on the red book, a relation with the transverse luo of SI and the tinnitus and the submaxilñlary swelling and long-term TMD. I thought that the tight points that I found on the yang ming zone were may be because of that. Thinking about a Luo problem, and the pulses at the surface and his state of alarm all the time, lot of tension, his hyperactivity and the alignment of the skull (in case the wisdom teeth had caused the problem)…I decided to perform the Yna Qiao Mai even if it’s not a chronic problem. And the surprise is that the patient reports the same feelings, the same symptoms and he gets worse after the treatment, only in a session. What do you think about this case?

Thank you!

Anna

[Paul Reynolds]

Hi Anna,

I like your thinking so far and although I may not be answering your inquiry directly I thought I would share my thoughts – for what they are worth. With the connection between the teeth and jing, it may be possible that the operation has freed some latent pathogenic factor (the teeth being a storage site) which the body now has to contend with. As the problems return after treatment, it could be that there isn’t enough fluids to keep the pathogen latent.
The 3rd confluence springs to mind as it connects with all the sensory organs but I guess the pulses are a better way of assessing that. With the sinew pulses being active it certainly suggests that they are trying to deal with something but possibly don’t have the resources to push it out.
My understanding of the luo channels is even more basic than my divergents so I can’t comment too much on that I’m afraid.
I hope that at least adds something to your thinking.
Best
Paul

[Antoine Mulpas]

Hello Anna,

I follow Paul’s idea about the teeth being a place of latency, and maybe the surgery affects this aspect. If you think about the Luo, I would not go directly to the transverse. The issue is related to the teeth and if we look at the longitudinal Luo, the Large Intestine is going there (teeth and ear). If you look in the red book, there is “acute deafness’ related to the Full LI Luo. It may be not tinnitus, but I would go there first to check if it has an effect as it is quite simple treatment to begin with. It may be a way to clear pathogen going there. Remember also that with surgery bruising will appear, and the LI Luo will move the Blood in the area.
I got a patient with a relative big bruise from the jaw to the neck following a tooth surgery, with pain in the area of the tooth. I bled LI-6 on the related side and the bruise was gone in the next days as well as the pain.
Cheers,
Antoine

[Mònica Martín]

Hola Anna,
I agree with Antoine. The trajectory of LI Luo diverts from the neck both to the jaw and to the ear. A simple Luo treatment might clear the channel as well as the “hyperactive” mental state of the patient. At an emotional level the LI Luo is related to teething and the assimilation that goes with it. When the person is absorbing too much information through the senses to the point that it becomes too much to be assimilated, the LI Luo may reach a state of fullness and create a tension in the jaw as well as tinnitus as a way for the body to say “stoooop feeding me information”. Often patients that present conflicts in this channel also suffer from bruxism.
Let us know how it goes with your patient,
Una abraçada,
Monica

[Antoine Mulpas]

Hello Mònica,

According to your experience it is possible to use the LI Luo to treat canker sore ? Especially the recurrent ones ?
Thank you for your answer,
Cheers,
Antoine

[Mònica Martín]

Hi Antoine,

What makes you think about LI Luo? Are there any other accompanying symptoms to support the use of LI Luo? What are the pulses like?

Sores in the mouth mucous membrane can be a sign of Yangming Heat/Fire. If they’re recurrent it means there’s chronicity. The body may be using Jin/Thin Fluids to support latency and in doing so the mucous covering the whole GI tract might be less supple with Fluids and hydration and so it would be left more vulnerable to the effect of certain foods (of hot nature, most likely) acting as irritants. The body requiring these Fluids to support an immune response may also cause a deficiency of Fluids and a scenario of excess Heat/Fire that can fuel the development of cranker sores. A Stomach Divergent channel might address this problem if it’s happening on a background of Jin/Thin Fluids deficiency. Check for the width of the right guan position. If thin, this could be indicative of the need to build mediumship (Yin) at this confluence.

If sores where in the tongue, it would be indicative of a Ht Luo problem. If it was related to teething, then it might be more indicative of a LI Luo issue. If there are signs of a degenerating process (maybe due to cancer).

You could also treat other channels depending on the rest of the symptoms. It all depends on what the main problem is and how you will unfold the layers where the disease lies for that particular patient. The patient may see the symptoms disappear as a consequence of the treatment without you having addressed cranker sores specifically.

Best wishes,

Mónica

[Anna Bordas]

Hi Paul, Antoine and Monica!

After listening all your and my friends suggestions, my first treatment after the patient came again was focused on releasing the tight areas (SCM,Trapecius, Jaw) with gua-sha or cupping. After I performed the LI luo treatment. Indeed, there were two point that were bleeding a lot (near to ST12). There was a very subtil spider vain and how it bleeded was surprising. Finally I perform a TH Divergent treatment because the pulse on kidney yang was floating and because of his general heat/fire. When he came back he said that this time he didn’t get worse but he didn’t improve. I was happy because I thought that I’m in the good line but I think it will be tough. It’s true that his pulses had changed, sinew pulses had stopped. You almost found the Tai Yang. I followed the same treatment and I tried to clear more luos. He will come again next week. Hopefully, the symptoms will have decreased. Thanks for all your suggestions. It has been very helpful.

Anna.

[Mònica Martín]

Anna,

If you don’t see much improvement you could also consider a Gall Bladder Divergent channel treatment as the ears are the sensory orifice related to this channel. Use confluent and meeting points, focusing your intention into GB1 as an upper confluent point that releases the upper portal, and the ear more specifically. Then add TH16 Tianyou, Window of Heaven, to release the pressure (Heaven = head). If there is bruxism associated or you observe tension in the masseter muscles (which you did when you performed a SC treatment), then add St5 Daying (Great Welcome) that connects to the sensory orifices and also teeth and gum (as areas of latency). This could be an important point to treat as there seems to be a correlation between the tooth extraction and the onset of tinnitus. Latency might have moved and it’s affecting a sensory orifice. Daying is an important point when unresolved issues are dumped into thyroid glands. In order to avoid this (to move into Yangming St9) it is held in the masseter area. As pressure builds up in the ear region and tinnitus ensues. If you use this point you can needle superficial, then deep and then turn the needle slightly and pull out. The patient will refer a sensation of release in the area and an instant decrease of the tinnitus.

Cupping St12 Bing Feng (Grasping the Wind) will also help release Wind if you find signs of it in the pulse (a rough quality).

I treated a patient a few weeks with recurrent bouts of tinnitus every now and then and the tinnitus subsided with one treatment. This particular patient has problems expressing anger so his GB gets easily blocked.

If you’re concerned about the TH pulse you could add GB36 Waiqiu (External Hill) for both clearing Fire toxins (that may have been released after the tooth extraction itself) and by virtue of its being a Xi-cleft point to clear stagnation in the upper orifice, ear, to which GB is connected.

Keep us posted 🙂

[Antoine Mulpas]

Hello Anna and Monica,

Thank you Monica for your detailed answer, always really insightful ! For sure with this patient there is heat trapped into the Yangming. There is nothing on the tongue, only in the mouth. I’m treating her for psoriasis mainly, and I was curious about the range of effect of the LI Luo on the mouth area.

Anna, I happened to have a patient the past week with jaw pain for 15-20 years on the left side. With a feeling of something stuck, even when she is not opening the jaw. I saw her a month ago for acute low back pain, and perform a ST/GB/BL sinews treatment. When she came back last week, the back pain was mainly gone and she said that the jaw was much better for a few days. I guessed that the ST sinew had worked on the area. But I was curious about the LI Luo as we were talking about it. She mentioned having tooth pain when eating/drinking something cold sometimes. So I bled and moxa LI-6. She reported a very slight improvement but it was not enough. I also bled ST-40 and GB-37. The former because she has quite a lot of Heat and the ST pulse was full, and the latter because she has a lot of anger/frustration that she’s not expressing. The improvement was steady but slow. I then performed a ST sinew. She said that the area was really relaxed comparing to the beginning of the treatment. Maybe it can help to think about the leg Yang sinews as well.

Cheers,
Antoine

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