Notes:  This is my initial assessment. I entered history under problem list
Bentley is a predominant Fire constitution with some Wood tendencies when in excess. Prefers cool surfaces, hyperactive, outgoing confident. Appetite is good to ravenous with acute on chronic vomiting. He is middle aged and GI signs presented in late 2019. He has been on budosenide 1mg/day with an interval of of prednisone at 1mg/kg/day for IBS.
His tongue has a purple body with red tip and underside and is wet.
Pulse- deep, thin, rapid and toneless
Shen- good ???? he is a vivid dreamer with rapid movements and vocalization.
TCVM Dx - Qi stagnation with Kidney Yin deficiency
AP- HT 7 Yuan source point , sedated for excess Heat
BL 60 Jing river (Fire )
BL 62 Confluent point to Yang Qiao meridian
The patient did not viscerally respond to needle insertion but they did grasp qi with tonification/sedation.
Bentley is dropped in both front carpus. He has CP deficits in left front
and in L >R rear-I feel the dorsal column medial lemniscus is only affected in the cervical region, I believe the deficits in pelvic limbs are due to weakness from L/S stenosis- not a T3-L3 DCML lesion.
His cervical muscles are hypertrophied with increase in tone and mass. His pelvic limbs have normal mass with decreased tone. On motion palpation of his spine, the atlas appears to be cranial on the left, hypomobilities in L4/L5 on right with severely reduced mobility on D to V palpation of L7/S1.

Diet is largely canned or kibble

Acupuncture points were stimulated

Manipulation or massage was performed