Introduction: Arterial or venous thrombotic events in the fistula of hemodialysis patients is an important morbidity factor and complication of these patients. The purpose of this study is to demonstrate that patients with thrombotic events in the fistula in patients in hemodialysis have energy deficiency inside the five internal massive organs of the five elements theory of traditional Chinese medicine and the treatment of this condition can prevent the formation of thrombosis in these patients in the arteriovenous fistula. Methods: one case report of a 53 years-old female patient with a history of doing hemodialysis for eight years. She changed the location of the fistula 6 times due to infection and local thrombosis. She was complaining of fatigue post each hemodialysis session and low self-esteem. She went to do acupuncture due to her previous history of endometriosis and I measured the energy of her five internal massive organs of the five elements theory of traditional Chinese medicine. 

Results: all internal massive organs were in the lowest level of energy, rated one out of eight. The treatment of this condition rebalancing the energy using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, and replenishing the energy of these organs using highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications were done. After beginning this treatment, she did not have thrombosis in the arteriovenous fistula anymore and improved her self-esteem, increase her urine, and does not have any fatigue after hemodialysis anymore. The conclusion of this study is to demonstrate that hemodialysis patients have energy deficiency inside the five internal massive organs and the treatment of this condition can prevent the formation of thrombosis in the arteriovenous fistula and can reduce the complications in these patients. 

Arterial or venous thrombotic event in the fistula of the patient in hemodialysis is considered an important morbidity factor and it has been described as one of the complications in a patient with usual hemodialysis. [1] 

One of the interventions in patients with acute arteriovenous fistula thrombosis is the surgical thrombectomy but the risk factors involved in the patency after this procedure is not yet known. [2]

The purpose of this study is to demonstrate that patients in hemodialysis have energy deficiency inside the five internal massive organs of the five elements of traditional Chinese medicine theory, which can predispose them to have thrombosis in the arteriovenous fistula and the treatment of this condition, rebalancing the internal energy using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting and replenishing the energy of these organs using highly diluted medications according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications can prevent the formation of thrombosis in a patient in hemodialysis in the arteriovenous fistula and reduce complications.

Methods: 

One case report, R.C.S.C., 53 years-old female patients. She had a history of abdominal cramps and the cramps swelled up her legs. The cramps were caused by endometriosis. She went to the hospital and the doctor discovered that her Kidney was not working properly and she starts to do hemodialysis since then. They made the first arteriovenous fistula in her chest, which lasted about 4 months. The doctor moved her fistula to her right groin but it lasts only four months due to the difficulty in walking (it lasts about 4 months) and a region that does not have enough ventilation. After the doctors changed the fistula to the right clavicle and after to the left arm (which lasts about two years but after they developed thrombosis and the blood cannot get out with the needles). The doctors changed the position of the fistula to the left groin and for some reason, they changed it again to the right arm and needs to put a prosthesis inside that helps a lot because her veins were very thin and it lasts for more than four years. To not have thrombosis in her arteriovenous fistula, the doctors orientate her to keep her blood pressure normal, it cannot rise or it cannot fall. When she feels that her blood pressure is downloading, she usually puts her head down and uses some salt in her mouth and the blood pressure usually increases very quickly.

She usually has fatigue post-hemodialysis (she did hemodialysis every Monday, Wednesday, and Friday) and her blood pressure comes down after each hemodialysis and usually she does not urinate very well. The foods that she usually eats during the hemodialysis session are coffee, bread, cheese, and ham. 

She went to my clinic because her mother was in acupuncture sessions due to low back pain and fibromyalgia and she decides to do to improve her health conditions and because she had a history of endometriosis. I measured the energy of her five internal massive organs using the radiesthesia procedure through a pendulum made of wood. 

All her internal massive organs’ energy was at the lowest level of energy rated one out of eight. The treatment of this condition rebalancing the internal energy using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, and replenishing the internal organs’ energy using highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications was important to treat the energy deficiency condition that was causing the endometriosis and the renal problems. The patient did not have any thrombosis after beginning this treatment and seems to reduce the creatinine levels, but still in treatment with hemodialysis thrice a week. She is feeling improvement in her self-esteem and she began to urinate much better with the treatment done. She does not have any more fatigue after hemodialysis sessions and her blood pressure does not go down after the hemodialysis session. 

Discussion: 

To understand what I want to explain in this article, I will need to integrate the knowledge of Western medicine with the reasoning used by traditional Chinese medicine, that exists for more than 5000 years. [3]

This study will be flowing Hippocrates oath (460 bce - 375 bce) the father of medicine, that said that “we need to consider other ancient medical traditions prior to the knowledge we have nowadays”. [3]

The other oath said by him was “Foolish the doctor who despises the knowledge acquired by the ancients”. [3]

For this reason, I usually combine the thoughts used by ancient medicines with what we understand today regarding the explanations of the formation of diverse diseases nowadays because Western medicine usually does not consider the energy part of the formation of disease. But according to the thoughts of Albert Einstein (1879-1955), the most famous physics in our history, he said that all things are composed of energy, and this includes the human body, which is part of this universe. [4]

For this reason, this part of the energy is studied by traditional Chinese medicine, and by combining these two important parts of medicine, we can understand the part of the energy and the part that corresponds to the materialized part of the energy, that is the part that we can see by the naked eyes, studied by the Western medicine. [5, 6]

Since 2015, I am using a tree metaphor to explain these two kinds of medicine, the part that corresponds to Western medicine is the part that is visible by the naked eye composed of the trunk with several branches, and the part that is usually invisible by the naked eyes, the “roots” of the tree, I will explain through the thoughts of traditional Chinese medicine shown in Figure 1. [6]

Figure 1: The metaphor of the tree.

So, this tree, I divided into two parts, the part above the earth is composed of the trunk with several branches (that correspond to each medical specialty) and we can see by the naked eye and coming out of each branch, you can see diverse leaves, and each leaf, corresponds to one disease or symptom treated by each medical specialty. [5-8] 

But this tree has a “root” that is not studied by Western medicine and according to traditional Chinese medicine, the problems in the “root” are considered the cause of diverse emotional or physical disease formation in any kind of specialty.  So, the cause of the formation of disease according to TCM is not on the “leaf” level of the tree, but at the “root” of this tree, and also, they consider the influences of the external pathogenic factor inducing the formation of many diseases in the “leaf” level, such as infectious or non -infectious diseases, as I am showing in diverse articles written by myself (2019) titled Is It Possible to Treat Community-acquired and Nosocomial Infectious with the Same Method, Without the Use of Antibiotics? In the “root” of the tree, there are two main theories that are the Yin and Yang theory and the Five Elements theory, shown in Figures 2, 3, and 4. [9]
 

Figure 2: Yin and Yang theory.

Figure 3: Yin and Yang energy imbalances.

Figure 4: The Five Elements theory 

The Yin and Yang are two opposites but complementary forces that exist in our universe and also, inside our bodies. Yang energy is positive, sun, man, summer, etc and Yin energy corresponds to the contrary, negative, moon, women, winter, etc. [10]

Patients with Yin energy deficiency usually have hot flashes, irritability, and hot hands and feet.  Patients with Yang energy deficiency, usually have Cold hands and feet. [5]

To Yin and Yang energy to flow inside the body, there is the necessity to have two other forces, that is Qi and Blood and their interrelationship is demonstrated in Figure 5.

Figure 5: The interrelationship between Yin, Yang, Qi, and Blood.

These four energies are normally produced inside each internal massive organ of the five elements theory of traditional Chinese medicine, as you can see in Figure 6.

Figure 6: The production of one internal energy by each internal massive organ of traditional Chinese medicine.

In Figure 6, you can see that each energy is produced by each internal five massive organs and each organ corresponds to one chakra energy center, as shown by the article written by Chase (2018) titled The Geometry of Emotions: Using Chakra Acupuncture and 5-Phase Theory to Describe Personality Archetypes for Clinical Use. [11]

In the case reported in this article, I am showing that she had energy deficiency inside the five internal massive organs (Liver, Heart, Spleen, Lungs, and Kidney) as you can see in Figure 7. 

Figure 7: Results of the measurement of the energy of the five internal massive organs using measurement of the energy of the chakras’ energy centers. For this reason, the energy to keep the Blood flowing normally inside the blood vessels was not normal and with a tendency to have Blood stagnation due to this energy deficiency state, as I am showing in the majority of cases that have in common, Blood stagnation such as in the case of patients with myocardial infarction, strokes, thrombosis after COVID-19 treatment, myocardial infarction after COVID-19 treatment, etc, all have in common, energy deficiency inside the five internal massive organs and showed in another article written by myself (2021) titled Energy Alterations and Chakras’ Energy Deficiencies and Propensity to SARS-CoV-2 Infection. [7-12]

Not only the patient reported in this article have energy deficiency inside the five internal massive organs but in research analyzing 1000 patient’s internal five massive organs energy from 2015 to 2020, measuring using a radiesthesia procedure, 90% of all my patients were in the lowest level of energy, rated one out of eight, as you can see in Table 1. [12]

Table 1: Results of measurement of 1000 patients’ internal five massive organs of the five elements theory of traditional Chinese medicine.

Quite all patients nowadays have this energy deficiency state, due to the modernization of telecommunication caused by the implementation of 4G and 5G technology, causing the majority of the population nowadays to have a tendency to have thrombosis when we use any medication or vaccine that can reduce even more the internal energy, which is already very low, causing in this case, Blood stagnation, as I am showing in the article written by Manil and Ojha (2022) titled Thromboembolism after COVID-19 Vaccination: A Systematic Review of Such Events in 286 Patients and another article also written by myself (2023) Which Could Be the Risk Factors for Developing Cancer After Receiving The COVID-19 Vaccine? [ [13-14]

The second theory in the “root” of the tree is the Five Elements theory. In this theory, they understand that there are five elements in our universe that are Wood, Fire, Earth, Metal, and Water and they have representation inside the human body as you can see in Table 1. [5, 10, 15]

Table 1: Five Elements theory and the internal five massive organs that they represent.

In this theory, they are showing that all internal massive organs are integrated and one element sends energy to the following elements as you can see in Figure 8 and one organ can control the function of the other organ, as you can see in Figure 9. [16, 17]

This means that the Liver needs to send energy to the Heart and the Heart needs to send energy to the Spleen and the Spleen needs to send energy to the Lungs and this last organ needs to send energy to the Kidney. The Kidney needs to send energy to the Liver, closing the cycle. [10]

This kind of reasoning is different from Western medicine’s perspective because they are following Galen (129 ce - c. 216) a Greek physician that worked 500 years after Hippocrates (460 bc - 375 bce) (and it is exerting influences until today in our medicine. For Galen, one organ works independently and separately and does not exert influence on the other. [5, 10, 18]
 

Figure 8: Generation cycle.

Figure 9: Control Cycle.

For this reason, when I measure the energy of the five internal massive organs of this patient reported in this article, I showed that all organs were in the lowest level of energy, rated one out of eight. [12]

The same results I found when I measured the energy of the five internal massive organs of all patients in hemodialysis treatment, which were also all in the lowest level of energy, rated one out of eight, and showed in the article written by myself (2020) Is it Possible to Treat Nosocomial Cellulitis Post Placement of Hemodialysis Catheter without the Use of Antibiotics? [15]

When there is energy deficiency inside the body of one or a combination of energy deficiencies between Yin, Yang, Qi, and Blood, there is a formation of internal Fire inside the body, leading to symptoms of infection or non-infectious symptoms in the leaf level of the tree, as you can see in Figure 10. [10]

Figure 10: Formation of internal Fire when there is an energy deficiency of one or a combination of energy deficiencies between them.

As I showed in Figure 7, all internal massive organs were in the lowest level of energy, and every organ do not have the energy to send to another organ, for this reason, she does not have enough energy to keep the Blood circulating inside the blood vessels, causing Blood stagnation in the arterioveous fistula. [6, 7, 15-17] 

For this reason, when I orientate her to change their dietary aspects to avoid the ingestion of dairy products, raw food, Coldwater, and sweets, was to improve the energy of the Spleen and pancreas energy, which are responsible for the absorption of nutrients and formation of Blood. [5] 

Without Blood in adequate amounts, due to deficiency in the Spleen and pancreas energy, the interrelation between Yin, Yang, and Qi is imbalanced and can generate a domino effect causing in the future, less Yin, less Yang, and less Qi, causing the formation of internal Fire, when there is energy deficiency situation as I am showing in Figure 10. [10]

When I treated the energy deficiency condition by replenishing the internal five massive organs using highly diluted medications using Hahnemann (1755- 1843) medications but according to another theory created by myself (2020) titled Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine, it was possible to treat the energy deficiency condition of the five elements theory but using a Western medication because normally, these energy deficiency situation is treated using Chinese herbal therapy in China, but even using this kind of therapy, it can cause side effects because even Chinese herbal therapy is considered highly concentrated medications and can cause a reduction even more of the vital energy and can cause complications. [19, 20]

When the patient reported in this article started to treat the energy deficiency condition, using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting (Figures 11 and 12) and started using highly diluted medications according to the theory created by myself (2020) Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine ( showed in Table 2), the patient never had thrombosis in the arteriovenous fistula anymore and she is very happy with the results of the treatment until today because the cause of thrombosis was treated replenishing the energy of the five internal massive organs allowing the Blood flow normally inside the human body.  [19, 20]

Figure 11: Auricular acupuncture points used

Figure 12: Apex ear bloodletting

Table 2: Homeopathy and crystal-based medications used in the treatment of replenishing the energy of the five internal massive organs

She not only improved from her thrombosis condition but also, improved her self-esteem, which was very compromised due to the energy deficiency situation of her six chakras’ energy centers. She also, improved from fatigue post-hemodialysis because this symptom was also caused by this energy deficiency state, as I am showing in the article written by myself (2021) titled Chakras’ Energy Deficiencies as the Main Cause of Fatigue during Hemodialysis. [21]

The reason I am using highly diluted medications instead of highly concentrated medications is because of Arndt-Schultz Law (Figure 13), which was created in 1888 by two German researchers. In this law, they are saying that the use of any kind of highly concentrated medications can reduce even more vital energy and can lead to the death of this patient. For this reason, it is recommended to use highly diluted medications to increase the vital energy, which was proven very low, to increase the vital energy of the patient, and prevent Blood stagnation caused by the use of highly concentrated medications as I am showing in the article written by myself (2022) Energy Alterations in Patients with Pulmonary Artery Thrombosis After COVID-19 Treatment. [22]

Figure 13:  Arndt-Schultz Law

According to traditional Chinese medicine, endometriosis is caused by energy alterations in the Spleen and pancreas energy, or fifth chakras’ energy centers, that the patient had deficient in energy. [23]

In the article written recently by myself (2022) titled Is It True That Kidney Failure Diagnosed At The Laboratory Test Level Shows That The Problem Is Really In The Kidney? I am saying that the laboratory exams to evaluate the functions of the Kidney cannot say that the problem is really inside the Kidney. Because when there is Kidney insufficiency, could be caused by the influences of energy alterations in the other organs, as I am showing in this specific patient, that was receiving energy from the Lung, but her Lung was already without energy. The Lungs usually receive energy from the Spleen which receives energy from Heart. This last organ receives energy from the Liver which receives energy from the Kidney. You can notice that all organs involved in sending energy to the following one, are very weak in energy and for this reason, the problem in the Kidney, could be caused by the energy deficiency of the Kidney itself, but from energy deficiency in the Spleen and pancreas, from the Control cycle, or from energy alterations in the Liver or from energy deficiency in the Lungs. [24]

The use of cheese and ham in the lunch for patients in hemodialysis can harm even more these energies, that is already very low, and cause complications and can worse the results of laboratory exams, because the ingestion of cheese and dairy products can induce the formation of Spleen and pancreas energy deficiency harming, even more, the energy of the Kidney, worsening instead of improving. [21, 24]

In the article written by myself (2020) titled Is it Possible to Treat Nosocomial Cellulitis Post Placement of Hemodialysis Catheter without the Use of Antibiotics? I am showing that patients with hemodialysis that are presenting cellulitis infections in the local of catheter placement, also have energy deficiency inside the five internal massive organs and there is a possibility of treating this kind of infection without using antibiotics because the symptoms of infections were caused by the formation of internal Fire, generated when there is an energy deficiency condition leading to infections symptoms. [15] 

For this reason, you can see that all complications developed by this specific patient were related to this energy deficiency condition leading to a variety of symptoms.  In traditional Chinese medicine, many symptoms can from one energy imbalance, and one symptom can come from a variety of energy imbalances. [3]

To finalize this article, I would like to say that all tools used in this article such as homeopathy and acupuncture are considered medical specialties by the Federal Medical Council in Brazil since 1980 and 1995. [25]

To understand what are the energy alterations in patients in hemodialysis that is leading to thrombosis in the arteriovenous fistula, it is important to integrate the reasoning used by Western medicine and by traditional Chinese medicine, which exists for more than 5000 years, as you can see in the metaphor of Yin and Yang energy, shown in Figure 14. [5, 10]

Figure 14: The metaphor of Yin and Yang of Western and traditional Chinese medicine.

The conclusion of this study is to demonstrate that patients in hemodialysis that are having a tendency to have thrombosis in the arteriovenous fistula, have energy deficiency inside the five internal massive organs of the five elements theory of traditional Chinese medicine. The treatment of this condition is of paramount importance to treat the cause of the formation of disease and not just treat the symptoms, that it is the thrombosis itself. The use of highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese medicine is recommended in patients on hemodialysis because of this energy deficiency situation to prevent the formation of complications or even death of this patient.