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Saliva oversecretion


#1

Submitted By: peter_med

I got an interesting case yestoday. 38 yo female from Mongolia with 4 weeks pregnancy started to have saliva oversecretion about two weeks ago. It seems the saliva secretes all the time so that she keeps using tissue suck the saliva, then dump to trash. During the about one hour office visit, she consumed about 8 tissues. She will see her OB on Dec, 21. Other symptom include mild nausea, no vomitting, low appetite(force to eat more), low energy, tongue red(little bit dark), pulse thin and wiry. So TCM Dx is spleen deficiency. Points are St4, St5, Ren21, Ren12, St21, Pc6, Ht7, St36, Liv3, Sp3 and Herb formular is "Ren Shen Jian Pi Wan". She will come next week again. Anythings else I can add. Thanks.


#2


I have a comment first, and then a few suggestions. First, I&#39m not entirely sure I agree with your diagnosis - red tongue and thin and wiry pulse sound a whole lot more like yin deficiency or heat in the stomach perhaps with an underlying deficiency than just sp qi def - although it could be. Any other distinguishing factors on the tongue (teethmarks, coating, etc.)? I only mention that to make sure you clarify the diagnosis - certainly the fatigue fits but that can come from anything and appetite disturbances are common with pregnancy so I wouldn&#39t read alot into that until it shows up in the tongue and/or pulse. With pregnancy there are lots of ways to get strange symptoms so paying attention to the truly reflective signs (tongue, pulse, etc.) rather than the symptoms is often important.



Salvia secretion (during pregnancy especially) is often akin to morning sickness - just a slightly sick feeling with saliva (like before throwing up) but without stronger symptoms. So your choice of PC 6 is good and should be helpful. The stomach/cv points you used are good as well. I would rethink the diagnosis though and perhaps add some more for the yin or better points to clear heat if you feel that is appropriate.



We often also add the huatuo points for the mouth and throat (c3, c4, and/or c5 whichever is sore upon palpation) - tuina and/or shallow needling can be appropriate. We also regulate the vagus nerve which is manipulated in our system by massaging in the ST 10/ST 11 area - generally best with tuina. Work in this area (particularly on the left side) will often stop these issues quickly.


#3


Saliva oversecretion is dampness, if it is clear waterly, it is cold pattern, if it is yellow color liquid, it will be damp heat. to clear the dampness, better use Sp9 + St36 with Ub20,21.


#4


Thanks for reply.



My thoughts: the thin pulse could be blood def due to poor appetite; wiry pulse can be some kind of liver qi stag because she cannot eat(forced eating) and worry about the baby health. A little dark red (not bright red) tongue was due to blood stag(from liver qi stag); the nausea is spleen def and stomach excess...



You could say the blood def, losing liquid saliva and thin pulse are type of yin def, but she was afraid of cold, the pulse wasn&#39t too fast. I would think more like liver stag plus spleen def pattern, although there was not very obvious tooth mark, little white coating and no lower leg edema(maybe too early to see it). I already used Liv3 and maybe add Liv14(zhangmen). I&#39ll try using Hua Tuo Jia Ji C3-5 and manipulate vagus nerve. Sp9, UB20, 21 are good choice too. In TCM, saliva is controled by spleen, right?


#5


losing liquid saliva is self immune system automative active, she try to keep the poison liquid out of body, it is good for health, I don&#39t think she should be forced to stop the liquid losing, normally after 3 months it will be naturely stopped. Strong the spleen and stomach functions is a good way.


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