Pediatric UTI

Turret’s Syndrome

Okay, just to be clear, in the last post, the child did have turrets on his head.  This is, of course, why it was called Turrets Syndrome.  Along with having Tourette’s syndrome.  (how’s that for trying to weasel out of a mis-spelling!)

At any rate, I hope it was a useful case inspire of the mortifying spelling error!  And below is another installment.  This case shows us that we cannot take a symptom or disease based approach to illness.  This girl was treated for UTI with Ba Zheng San, and for frequent urination with Suo Quan Wan and Bu Zhong Yi Qi Tang, all to no avail.  The physician finally noticed some key factors; the extent of external pressure in her life, how keyed up and timid she was, along with the deficiency.  This is what led him to Gan Mai Da Zao Tang.  For those who work in pediatrics, this is actually a common pattern for bed-wetting as well.

The patient was a 10 year-old girl.  She came for an initial visit on June 18, 2006.  She had suffered from frequent and urgent urination for more than 3 years.  This had come on three years previously due to wearing unclean clothing.  She was then diagnosed with acute urinary tract infection.  She was given antibiotics to reduce infection in the hospital and the symptoms disappeared.  2 months later she developed the frequent and urgent urination symptoms that got progressively worse.  During this time many formulas were tried.  She tried western medicines and Chinese formulas such as Ba Zheng San, Suo Quan Wan and Bu Zhong Yi Qi Tang but there were no clear results.  At the time of the consult she presented with frequent urination that was so urgent that she could not control so that her clothing was often damp.  The frequency and urgency was less during the day when she was keyed up.   But, when she stopped moving it would become worse, 2-6 time every hour.  She had many dreams at night, poor appetite and irregular bowel movements.  Her spirit was timid and fatigued.  Her pulses were thin and her tongue had scanty moss.  Urine tests were negative for bacterial infection.  The WBC was +++ and the RBC was +++. The western diagnosis was urinary tract syndrome.  The Chinese diagnosis was Lin syndrome (taxation Lin).  For treatment she was given 7 packages of Gan Ma Da Zao Tang with the following herbs added:

This was decocted in water, one package for one day.

Second visit, June 26.  There was a clear change for the better with the urinary frequency and urgency.  She now urinated 1-2 times each hour.  The other symptoms also had slightly improved.  However, the urination was not completely changed.  She was given the above formula with 8 gm of Yi Zhi Ren and 10 gm of Bai He.  After the herbs the frequency symptoms were gone and her spirit was fortified.  The WBC was + and the RBC was also +.  She continued with this formula with Yu Xing Cao removed and 10 gm of Qian Shi added.  She was re-examined on 8/15 and the symptoms were gone.  There was a cure.

Discussion:  In this case, because the child was deficient, the evil attached.  The course of the disease was protracted.  It had become serious enough to interfere with her normal life and studies.  Pressure from her parents and the environment outside the home had caused anxiety.  This manifested in her becoming very timid and the illness followed the spirit and became more serious.  This illness was in Shao Yin.  Above, the heart spirit was not calm.  The emotional symptoms were quite clear.  Below the kidneys were without consolidation and storage.  The heart and kidneys were not communicating.  This is why the urination was frequent and abundant.  In regard to the Jin Gui Yao Lue’s  Gan Mai Da Zao Tang Chen Nian-Zu elaborated rather beautifully.  “Mai is the grain of the liver.  It’s color is red which is the fire color and so, it enters the heart.  Its Qi is cold and it masters water Qi, hence it enters the kidneys.  The flavor is sweet, which is the flavor of earth and so it enters the spleen and stomach.  This is combined with the sweet Da Zao and Gan Cao.  These are subtly able to unite the Qi of fire and water, above and below so they meet in the middle earth.”  This is how they obtain effectiveness.

In pediatric urinary illnesses, primary bed-wetting, and emotional type urinary frequency occur quite a lot.  Often these are quite difficult to treat.  These types of illness are often related to lack of nourishment of the heart spirit and lack of connection between the heart and kidneys.  This is both a body and mind issue for children.  The spirit is damaged.  Gan Mai Da Zao Tang directly communicates with the Shao Yin.  It nourishes the heart and enriches the kidneys and thereby softens the Zang Zao, restless organs.  This way it guides water and fire to join so above is clear and below is peaceful and thereby dispelling the intangible illness.