This health consultation is with a 57 year-old, Christian man from Jordan with health concerns such as obesity, excessive sweating, acid reflux, and high blood pressure and a family history of heart disease. His wife was present during the consultation.
**Photo of Patient's Tongue:**
* **Patient:** Male * **DOB:** 22nd Mar 1950 (P) * **POB:** Bethlehem, Jordan (P) * **Height:** 5' 7" * **Weight:** 250 lbs (K), * **As 10 yr old:** Husky (K) * **Blood Type:** O+ (P,K) * **Sleep:** Very good and heavy(K) * **Emotions:** Irritability/Anger primarily (P) * **Bowel Movement:** 4/day (P), well shaped (K) * **Mucus:** White mucus in the morning (K) * **Agni:** Acid Reflux (P). * **Ama (tongue exam):** Teeth marks ([[malabsorption]]), check out photograph of tongue from [[http://www.bhaisajya-guru.com/medicine-buddha-clinic/index.php?dir=&file=CLN301_V1P2K3_P2.5K3.5_Sweating_Obesity_Blood-Pressure_Cholesterol_08182007_Jordanian_%20Husband_of_V3.jpg]] * **Pulse:** High P-K pulse * **Nails:** No moons on the thumb (slow metabolism). White spots (Ca/Zn deficiency) * **Blood Pressure:** Borderline high (K) * **Cholesterol:** High (K), Diagonal crease on left ear(K) * **Others:** Receding hairline (P), laid back and calm (K), good sense of humor (K), pre-diabetic (K), [[enlarged prostate]] (K), snoring (increased mucus, reduce cheese intake)\\ \\
* There are lines of Liver and Spleen on the forehead of the patient, frown-lines. Liver/Spleen lines on the face show weaknesses of the organs. Liver weakness indicates that it is taxed out from rich oily foods, while Spleen is taxed out from eating too much dessert. * Pulse (which was not taken immediately to allow the patient to settle) shows [[Kapha]] out of balance. * Thumb does not have a moon, which indicates sluggish metabolism (the patient also has a square tongue). Tongue is big (K). Teeth marks on the tongue show malabsorption. White ama (K). * __Malabsorption:__ do not do anything while eating. Bring awareness to eating. When you sleep you get a bad breath because you lose consciousness, and the consciousness of parasites and other living beings in your body predominates. Cravings in the body may also be related to parasitic cravings. Lack of awareness weakens digestion. * The patient's high blood pressure is a Kapha type related to blockage and viscosity of blood, thus it is necessary to reduce salt intake. * [[Triphala]] is necessary for bowel movement. It is a digestive tonic, detoxifying, rejuvenates energy. * There is a diagonal crease on the ear which is indicative of high [[cholesterol]] and Kapha in the heart. There is a family history of heart disease. If the crease is evident on both ears then it is a more serious problem. * [[Chelation Therapy]] is recommended as a detoxifying therapy for the heart condition. * **Diet:** Must follow Kapha soothing diet, but has to cut off hot and spicy food, as well as sour fruits, to reduce acid belly (no herbs will be subscribed for the acid belly because they may work against the Kapha herbs) * **Exercise:** Must exercise for 1/2 – 1 hr daily (this comes first, and then following K soothing diet). Exercise generates heat in the flesh and activates cellular fire and facilitates weight loss (the patient has a good digestive [[agni]] but poor [[dhatu agni]] – low [[meda agni]] and [[rakta agni]]).\\ \\
* 5 pts [[Punarnava]] ([[Boerhaavia diffusa]]), V-P-K-, 1st herb for K [[prakruti]], for [[edema]], [[lymphatic congestion]], [[diuretic]], [[expectorant]]—(the amount was increased later to reduce the bitterness of the formula). * 4 pts [[Gokshuradi Guggulu]] ([[Gokshura]] – [[Tribulus terrestris]], [[Guggulu]] – [[Commiphora mukul]]), V-P-K-, good for the bladder and kidneys (edema), liver (lowers the cholesterol), [[diabetes]]. * 4 pts [[Kutki]] ([[Picrorrhiza kurroa]]), V-P+K-, does [[lekhana]], liver tonic, reduces cholesterol and weight, 3rd herb for liver/blood for K. Best herb for cholesterol and weight problems. * 3 pts [[Musta]] ([[Cyperus rotundus]]), V+P-K-, for P acid belly/reflux. 10th herb for digestion. * 3 pts [[Bacopa]] ([[Bacopa monnieri]]), to strengthen the liver * 2 pts [[Manjistha]] ([[Rubia cordifolia]]), V=P-K-, to purify the blood and liver and reduce the cholesterol (K). 3rd herb for the liver/blood. * 1 pt [[Pippali]] ([[Piper longum]]), V-P-K-, for the lungs * 3 pts [[Guduchi]] ([[Tinospora cordifolia]]), V-P-K-, for the acid belly, regulates blood sugar, controls sugar cravings, strengthens liver.\\ \\
* Take 1 tsp of the above formula with 1 tsp of honey (lekhana) 3 times/day in a cup of hot water. * The herbs used to treat cholesterol: **Punarnava, Kutki, Manjistha, Guduchi**. * Custom formula is bitter: __bitter is better when there is P and K in the liver.__\\ \\
* [[Triphala]]: 1/2 tsp (loose stool) or 1 tsp (well shaped stool) or 1 heaped tsp (constipated) in hot water at bedtime on empty stomach. * [[Shilajit]]: Himalayan mineral. Take 2 tablets twice a day (4 tablets/day). This is to treat the enlarged prostate (K). Also good for the Kidneys (best mineral for the Kidneys). \\ \\
* Born March 22, 1950 in Bethlehem, Jordan ([[pitta]] month) * [[O+ blood type]] (65% of this [[blood type]] is [[pitta-kapha]]) * 5 feet 7 inches tall, 250 pounds ([[kapha]]) * Husky at 10 years old (kapha) * [[Receding hairline]] (pitta) * [[Irritable]] when imbalanced (pitta) * 3 or 4 [[bowel movements]] a day (pitta) * Stool is shaped like a banana (kapha) * [[Heavy sleeper]] and snores (kapha) * Tongue is squared-off at the bottom (kapha)
* [[Obesity]] (kapha imbalance) * [[Excessive sweating]] (kapha imbalance) * [[Edema]] (kapha imbalance) * Regular nostril problems with [[white mucus]] (kapha imbalance) * [[Acid reflux]] (pitta imbalance) *patient takes Prilosec daily for acid reflux* * [[High cholesterol]] (kapha imbalance) * [[High blood pressure]], which was determined was due to blockages (kapha imbalance) * [[Low energy]] level (kapha imbalance)
The following health concerns were also noted:
* [[Sluggish metabolism]], which was determined by not seeing [[moon on thumb]] (kapha imbalance) * [[Weak spleen]] from eating too much sweets, which was determined by seeing a [[vertical line next to left brow]] (kapha imbalance) * [[Weak liver]] from eating too much rich foods, which was determined by seeing a [[vertical line next to right brow]] (kapha imbalance) * [Malabsorption] of food, which was determined by seeing [[teeth marks around tongue]] (kapha imbalance) * [[Sluggish digestion]] due to some [[ama]], which was determined by seeing some [[white on tongue]] (kapha imbalance) * [[Difficulty Breathing]], which was determined by hearing sighs throughout consultation (kapha imbalance) * Overall kapha imbalance, which was determined by doing a [[pulse diagnosis]] * Heat disease in family, which was determined by [[Diagonal groove in ears]] (kapha imbalance)
**Customized herbal formula**
The following herbs were blended to create a customized herbal formula for the patient:
* 5 parts [[Punarnava]] (reduces [[sweating]], edema, cholesterol, excessive kapha) * 5 more parts of Punarnava (make herbal remedy less bitter for patient) * 4 parts [[Kutki]] (reduces [[cholesterol]], weight) * 3 parts [[Musta]] (improves digestion) * 4 parts [[Gokshura]] with [[Guggulu]] (reduces cholesterol and edema, prevents [[diabetes]]) * 3 parts [[Guduchi]] (reduces [[acid belly]], cholesterol, and [[sugar cravings]]; regulates [[blood sugar]]) * 1 part [[Pippali]] ([[strengthens lungs]]) * 3 parts [[Brahmi]] (binder, strengthens liver) * 2 parts [[Manjista]] (blood purifier, reduces [[high cholesterol]])
The patient was given a six to eight week supply. The supply was divided into two bags; one for work and one for home.
The patient was instructed to take one level teaspoon of triphala daily before bed to help reduce excess kapha.
The patient was instructed to take four tablets of Shilajit daily to help all health concerns; two tablets in the morning and two tablets at night.
Implement 25% of the following recommended dietary changes every three months (reduces shock to body):
* No [[dairy]], [[cheese]], and [[white foods]] such as white sugar and flour (reduces kapha, white mucus) * Replace wheat with [[toasted buckwheat]], [[corn flour]], [[rye flakes]] (reduces kapha, weight) * No [[nuts]] and eat only [[sunflower seeds]] and [[pumpkin seeds]] (reduces kapha, weight) * Reduce cheese and rich [[meats]] (reduces [[snoring]]) * Drink 3 or 4 cups of [[water]] a day (reduces edema) * Reduce grains intake and only use dry grains (reduces kapha) * Go on [[kapha-reducing diet]] (reduces kapha) * Eat [[organic]] or [[free-range]] meat (reduces kapha) * Eat without distractions ([[strengthens digestion]]) * Reduce [[salt]] intake (reduce kapha) * Switch from table salt to [[Himalayan mineral salt]] (reduce kapha) * Reduce hot, [[spicy food]] such Tabasco sauce, cayenne pepper, and green chili (reduces acid stomach) * Avoid [[lemons]], [[grapefruits]], and [[orange juice]] (reduces acid stomach) * Avoid [[vinegar]] and only a little [[red wine]] (reduces acid stomach) * Avoid ice and [[cold beverages]] and if drink beer, drink only bitter beers (doesn’t increase kapha) * Eat one sautéed [[bitter melon]] every other day (reduces acid stomach)
* Exercise daily for at least 30 minutes (reduces kapha imbalance, all health problems, and the need to take herbs) * Try [[http://en.wikipedia.org/wiki/Chelation_therapy|http://en.wikipedia.org/wiki/Chelation_therapy]] (reduce breathing difficulty) * Do [[Meditation]] daily (manage pitta)