Alternating hemiplegia

Keywords: Chinese medicine, Chinese herbal medicine, multiple sclerosis, treatment based on pattern discrimination

[ILLUSTRATION OMITTED]

Multiple sclerosis (MS) is a slowly progressive autoimmune disease characterized by disseminated patches of demyelination in the brain and spinal cord. This results in multiple and varied neurological symptoms. The onset of this disease is usually insidious, and its course is marked by alternating periods of remission and exacerbation. As with so many other autoimmune disease, the Western medical etiology of this condition is unknown. In other words, biologists have yet to pin-point the initial triggering factor for the body's autoimmune attack against its own tissue. However, some, as yet unknown environmental factor seems to play a role in this disease since its incidence is five times higher in temperate than in tropical climates and its occurrence has been linked to the location where a patient spent their first 15 years. Slightly more women than men suffer from this disease, and its age of diagnosis is usually between 20-40 years. Some authorities believe that, by the time this condition has been diagnosed, it is well established, having actually begun in adolescence or even childhood.

In Chinese medicine, this disease is categorized as wei zheng, wilting condition. However, some of MS's symptoms are their own disease categories in Chinese medicine, e.g. ma mu, numbness and tingling, fa li, lack of strength, zhi juan, fatigued limbs, ban shen bu sui, hemiplegia, shi yi wei er, double vision, mu hu, blurred vision, zhen chan, tremors or spasticity, xuan yun, dizziness, and niao shi jin, urinary incontinence.

The causes of MS in Chinese medicine are listed as external invasion or internal engenderment of damp heat evils, unregulated diet, over-taxation, and former heaven natural endowment insufficiency. Damp heat evils due to either external invasion or internal engenderment may brew and steam internally, thus damaging the qi and consuming yin at the same time as possibly congealing dampness into phlegm. It is also possible for prolonged or extreme over-taxation to consume blood and yin. Hence, the sinew vessels fail to receive adequate moistening and nourishing. Lack of blood and yin may give rise to internally stirring of wind, with consequent spasms and contractures. Extreme or prolonged yin vacuity may reach yang, giving rise to kidney yang insufficiency. Kidney yang insufficiency may also be due to over-taxation, former heaven natural endowment insufficiency, or overuse of steroids.

Treatment based on pattern discrimination

1. Phlegm heat internally brewing pattern

Main symptoms: Atrophy, wilting, and weakness of the extremities either accompanying the onset of fever or as the sequelae of a fever, possible limb numbness and insensitivity tending toward paralysis, head distention, chest oppression, tinnitus, possible decreased visual acuity, nausea, vomiting, oral thirst but no desire to drink, profuse, yellow-colored, thick, sticky phlegm, a red tongue with yellow, or slimy, yellow fur, and a bowstring, slippery or slippery, rapid pulse.

Note: This pattern is usually only seen as the main pattern of this disease in obese patients. Otherwise, phlegm tends to be only a complicating factor in a number of other patterns.

Treatment principles: Clear heat and transform phlegm, open the orifices and free the flow of the network vessels.

Rx: Di Tan Tang Jia Jian (Flush Phlegm Decoction with Additions & Subtractions)

Ingredients: Bile-processed Rhizoma Arisaematis (Dan Xing), 6g, Pericarpium Citri Reticulatae (Chen Pi), 9g, Rhizoma Pinelliae Ternatae (Ban Xia), 8g, Sclerotium Poriae Cocos (Fu Ling), 15g, Fructus Immaturus Citri Aurantii (Zhi Shi), 6g, Lumbricus (Di Long), 9g, Fasicularis Vascularis Luffae Cylindricae (Xi Gua Luo), 12g, and Succus Bambusae (Zhu Li), 30ml.

Additions & subtractions: One can substitute Concretio Silicea Bambusae (Tian Zhu Huang) and Fructus Gleditschiae Chinensis (Zao Jiao) for Zhu Li. For marked yellow phlegm or other symptoms of heat, add nine grams of Radix Scutellariae Baicalensis (Huang Qin). For chest distention, add nine grams of Rhizoma Typhonii Gigantei (Bai Fu Zi). For chest oppression, add nine grams of Radix Platycodi Grandiflori (Jie Geng). For nausea or vomiting, add nine grams of Caulis Bambusae In Taeniis (Zhu Ru) and six grams of uncooked Rhizoma Zingiberis (Sheng Jiang). For concomitant qi vacuity, add nine grams each of Rhizoma Atractylodis Macrocephalae (Bai Zhu) and Radix Codonopsitis Pilosulae (Dang Shen) and 15 grams of Radix Astragali Membranacei (Huang Qi).

Acupuncture & moxibustion: 1. Shen Ting (GV 24), Bai Hui (GV 20), Feng Fu (GV 16), Da Zhui (GV 14), Ling Tai (GV 10), Ji Zhong (GV 6), Ming Men (GV 4), Chang Qiang (GV 1). 2. Feng Long (St 40), Nei Ting (St 44), Yin Ling Quan (Sp 9). 3. Please see the additions and subtractions below.

Additions & subtractions: For visual disturbances, add Jing Ming (Bl 1) or Zan Zhu (Bl 2) and Tai Yang (M-HN-9). For tremors in or contractions of the limbs, add Tai Chong (Liv 3) and He Gu (LI 4). For dizziness, add Feng Chi (GB 20). For fatigue, add Zu San Li (St 36) and Qi Hai (CV 6). If Western medical diagnosis can precisely identify plaques of demyelination in the spinal cord, add Jia Ji (M-BW-35) corresponding to the affected area. For atrophy, wilting, weakness, numbness, and/or insensitivity of the upper extremities, add Jian Yu (LI 15), Bi Nao (LI 14), Qu Chi (LI 11), Shou San Li (LI 10), He Gu (LI 4), and Wai Guan (TB 5). Select 2-3 points per treatment. For atrophy, wilting, weakness, numbness, and/or insensitivity of the lower extremities, add Bi Guan (St 31), Fu Tu (St 32), Liang Qiu (St 34), Zu San Li (St 36), Shang Ju Xu (St 37), and/or Jie Xi (St 41). Select 2-3 points per treatment. For weakness of the wrist, add Yang Chi (TB 4) and Yang Xi (LI 5). For weakness of the hand, add He Gu (LI 4) through to Hou Xi (SI 3) using the penetrating needle method. For weakness or numbness of the fingers, add Ba Xie (M-UE-22). For weakness of the knee, add Wei Zhong (Bl 40) and Qu Quan (Liv 8). For weakness of the feet or numbness of the toes, add Ba Feng (M-LE-8). For talipes equinus due to weakness of the sinews vessels of the foot yang ming, foot shao yang, and foot jue yin, use Shang Ju Xu (St 37), Jie Xi (St 41), Qiu Xu (GB 40), Zhong Feng (Liv 4), and/or Yang Ling Quan (GB 34). For talipes varus due to weakness of the sinews vessels of the foot tai yang and foot shao yang, add Kun Lun (Bl 60), Shen Mai (Bl 62), Xuan Zhong (GB 39), and Qiu Xu (GB 40). For talipes valgus due to weakness of the sinews vessels of the sinews vessels of the foot tai yin and foot shao yin, add Gong Sun (Sp 4), San Yin Jiao (Sp 6), Tai Xi (Ki 3), and Zhao Hai (Ki 6). For nausea or vomiting, add Shang Wan (CV 13) and Nei Guan (Per 6). For head distention, add Tai Yang (M-HN-9). For chest oppression, add Nei Guan (Per 6). For tinnitus, add Ting Hui (GB 2).

2. Damp heat damaging the sinews pattern

Main symptoms: In the early stage, there is abnormal sensitivity, heaviness, and a cumbersome sensation or numbness in the limbs. This is then followed by wilting and weak limbs, drooping of the hands and feet, and loss of use of the limbs. Other symptoms may include chest and abdominal glomus and oppression, sticky, foul-smelling, dark-colored or bright yellow stools with burning around the anus, hot, astringent, painful urination with dark-colored urine, a red tongue with yellow, slimy fur, and a slippery, rapid pulse

Note: This pattern rarely presents in this pure form in Western patients. However, damp heat is a common complication in many Western patients with MS. This dampness and heat are usually internally engendered and are almost always found in combination with spleen vacuity and liver depression. Therefore, treatment for damp heat is usually secondary or tertiary to other treatment principles.

Treatment principles: Clear heat and eliminate dampness.

Rx: Jia Wei Er Miao San (Added Flavors Two Wonders Powder).

Ingredients: Plastrum Testudinis (Gui Ban), 12g, and Cortex Phellodendri (Huang Bai), Rhizoma Atractylodis (Cang Zhu), Radix Angelicae Sinensis (Dang Gui), Radix Stephaniae Tetrandrae (Han Fang Ji), Radix Achyranthis Bidentatae (Niu Xi), and Rhizoma Dioscoreae Hypoglaucae (Bei Xie), 9g each.

Additions & Subtractions: If there is severe damp heat, add six grams of Radix Scutellariae Baicalensis (Huang Qin) and nine grams each of Sclerotium Poriae Cocos (Fu Ling) and Rhizoma Alismatis (Ze Xie). If damp heat has damaged yin, add nine grams each of Radix Dioscoreae Oppositae (Shan Yao), Radix Glehniae Littoralis (Sha Shen), and Radix Trichosanthis Kirlowii (Tian Hua Fen). If there is liver-kidney vacuity, add 15 grams of cooked Radix Rehmanniae (Shu Di) and nine grams of Cortex Radicis Acanthopanacis Gracilistylis (Wu Jia Pi). And for abnormal vaginal discharge, add nine grams each of Sclerotium Poriae Cocos (Fu Ling) and Cortex Toonae Sinensis (Chun Gen Pi).

Acupuncture & moxibustion: 1. Same as in pattern #1 above. 2. Zhong Wan (CV 12), Zhong Ji (CV 3), Yin Ling Quan (Sp 9). 3. Same as in pattern #1 above.

Additions & subtractions: See pattern #1 above.

3. Blood vacuity with wind hyperactivity

Main symptoms: Weak eyesight, if extreme, insomnia, lack of strength in the four limbs, movement and standing not steady, quivering of the limbs, dizziness, tinnitus, a lusterless facial complexion, pale nails, a pale tongue with white fur, and a bowstring, fine pulse.

Note: While blood vacuity and wind hyperactivity may be the proximal disease mechanisms of the most MS patients' visual weakness and muscular spasticity, blood vacuity and wind usually are only two of a number of interrelated patterns in most Western MS patients' over-all pattern discrimination. Blood vacuity is mostly due to spleen vacuity not engendering and transforming the blood sufficiently.

Treatment principles: Enrich yin and nourish the blood, subdue yang and extinguish wind.

Rx: Tian Ma Gou Teng Yin Jia Jian (Gastrodia & Uncaria Drink with Additions & Subtractions).

Ingredients: Uncooked Concha Haliotidis (Shi Jue Ming), 24g, uncooked Radix Rehmanniae (Sheng Di), Ramulus Loranthi Seu Visci (Sang Ji Sheng), and Fructus Lycii Chinensis (Gou Qi Zi), 15g each, and Rhizoma Gastrodiae Elatae (Tian Ma), Ramulus Uncariae Cum Uncis (Gou Teng), Fructus Tribuli Terrestris (Bai Ji Li), Radix Albus Paeoniae Lactiflorae (Bai Shao), Radix Angelicae Sinensis (Dang Gui), Flos Chrysanthemi Morifolli (Ju Hua), mix-fried Plastrum Testudinis (Gui Ban), and Semen Biotae Orientalis (Bai Zi Ren), 9g each.

Additions & subtractions: For severely weak eyesight, add nine grams each of Fructus Mori Albi (Sang Shen), Radix Polygoni Multiflori (He Shou Wu), and Fructus Ligustri Lucidi (Nu Zhen Zi). For severe insomnia, add 12 grams of Semen Zizyphi Spinosae (Suan Zao Ren) and 15 grams of Caulis Polygoni Multiflori (Ye Jiao Teng). For lack of strength in the four limbs with unsteady moving and standing, add 12 grams each of Cortex Radicis Acanthopanacis Gracilistylis (Wu Jia Pi), Cortex Eucommiae Ulmoidis (Du Zhong), and Radix Achyranthis Bidentatae (Niu Xi). For severe pale lips, nails, and facial complexion, add nine grams each of Radix Polygoni Multiflori (He Shou Wu), Fructus Mori Albi (Sang Shen), and Radix Achyranthis Bidentatae (Niu Xi). For concomitant spleen qi vacuity, add 15 grams of Radix Astragali Membranacei (Huang Qi), nine grams each of Radix Codonopsitis Pilosulae (Dang Shen) and Rhizoma Atractylodis Macrocephalae (Bai Zhu), and six grams of mix-fried Radix Glycyrrhizae (Gan Cao). For concomitant liver depression, add nine grams each of Radix Bupleuri (Chai Hu) and Fructus Meliae Toosendan (Chuan Lian Zi) and increase the dosage of Bai Shao up to 15 grams.

Acupuncture & moxibustion: 1. Please see pattern #1 above. 2. Ge Shu (Bl 17), Gan Shu (Bl 18), Pi Shu (Bl 20), Shen Shu (Bl 23). 3. Please see pattern #1 above.

Additions & subtractions: See pattern #1 above.

4. Liver blood-kidney yin vacuity pattern

Main symptoms: Dizziness, tinnitus, double vision, blurred vision, unsteady stepping, low back and knee soreness and weakness, emaciated body, vexatious heat in the five hearts, yellow urination, dry stools, a red tongue with scanty fur, and fine, rapid pulse.

Note: The difference between this pattern and the one above is that there are no signs of stirring wind, i.e., tremor, in this pattern.

Treatment principles: Supplement the kidneys and nourish the liver, supplement the blood and enrich yin.

Rx: Zuo Gui Wan Jia Jian (Restore the Left [Kidney] Pills with Additions & Subtractions).

Ingredients: Radix Dioscoreae Oppositae (Shan Yao), 20g, Radix Polygoni Multiflori (He Shou Wu), 12g, cooked Radix Rehmanniae (Shu Di), Fructus Lycii Chinensis (Gou Qi Zi), Fructus Corni Officinalis (Shan Zhu Yu), Gelatinum Cornu Cervi (Lu Jiao Jiao), Gelatinum Plastri Testudinis (Gui Ban Jiao), Radix Cyathulae (Chuan Niu Xi), Fructus Ligustri Lucidi (Nu Zhen Zi), and Fructus Schisandrae Chinensis (Wu Wei Zi), 9g each, and uncooked Radix Glycyrrhizae (Gan Cao), 5g.

Additions & subtractions: For dizziness, add 12 grams of Rhizoma Gastrodiae Elatae (Tian Ma) and replace Chuan Niu Xi with Radix Achyranthis Bidentatae (Niu Xi). For tinnitus, add 15 grams of Magnetitum (Ci Shi) and nine grams of Rhizoma Acori Graminei (Shi Chang Pu). For blurred vision, add nine grams each of Fructus Mori Albi (Sang Shen), Radix Polygoni Multiflori (He Shou Wu), and Fructus Ligustri Lucidi (Nu Zhen Zi). For unsteady stepping and lack of strength in the lower limbs, add 12 grams each of Cortex Radicis Acanthopanacis Gracilistylis (Wu Jia Pi) and Cortex Eucommiae Ulmoidis (Du Zhong) and replace Chuan Niu Xi with Radix Achyranthis Bidentatae (Niu Xi). For low back and knee soreness and weakness, add 12 grams each of Rhizoma Cibotii Barometsis (Gou Ji) and Cortex Eucommiae Ulmoidis (Du Zhong). For severe vacuity heat, add nine grams each of Rhizoma Alismatis (Ze Xie), Cortex Radicis Moutan (Dan Pi), Cortex Phellodendri (Huang Bai), and Rhizoma Anemarrhenae Asphodeloidis (Zhi Mu). For concomitant kidney yang vacuity, add nine grams each of Herba Epimedii (Yin Yang Huo), Rhizoma Curculiginis Orchioidis (Xian Mao), and Radix Morindae Officinalis (Ba Ji Tian). For concomitant spleen qi vacuity, add 15 grams of Radix Astragali Membranacei (Huang Qi) and nine grams each of Radix Codonopsitis Pilosulae (Dang Shen) and Rhizoma Atractylodis Macrocephalae (Bai Zhu). For concomitant liver depression, add nine grams each of Radix Bupleuri (Chai Hu), Fructus Meliae Toosendan (Chuan Lian Zi), and Radix Albus Paeoniae Lactiflorae (Bai Shao).

Acupuncture & moxibustion: 1. Please see pattern #1 above. 2. Tai Xi (Ki 3), Fu Liu (Ki 7), Gan Shu (Bl 18), Shen Shu (Bl 23). 3. Please see pattern #1 above.

Additions & subtractions: See pattern #1 above.

5. Qi & yin dual vacuity pattern

Main symptoms: Fatigue, lack of strength in the four limbs, possible torpid intake and scanty eating, possible abdominal distention, possible easy bruising, orthostatic hypotension, either scanty or profuse menstruation in females, loose stools or diarrhea, tinnitus, dizziness, low back and knee soreness and weakness, possible emaciation, night sweats, tidal malar flushing, a pale, swollen tongue with red tip or a swollen, red tongue, dry or scanty, yellow tongue fur, and a fine, bowstring, rapid pulse.

Note: Yin blood insufficiency results in delayed, scanty, or blocked menstruation, i.e., amenorrhea. However, spleen qi not containing or vacuity heat forcing the blood to move frenetically may result in profuse and early menstruation. Whether there is scanty or profuse menstruation depends on whether vacuity is complicated by heat.

Treatment principles: Fortify the spleen and boost the qi, supplement the kidneys and enrich yin.

Rx: Si Jun Zi Tang (Four Gentlemen Decoction), Er Zhi Wan (Two Ultimates Pills) & San Miao San (Three Wonders Powder) with additions and subtractions.

Ingredients: Radix Astragali Membranacei (Huang Qi) and Caulis Milletiae Seu Spatholobi, 15g each, Carapax Amydae Sinensis (Bei Jia), Radix Codonopsitis Pilosulae (Dang Shen), Herba Ecliptae Prostratae (Han Lian Cao), Fructus Ligustri Lucidi (Nu Zhen Zi), and Radix Achyranthis Bidentatae (Niu Xi), 12g each, Rhizoma Atractylodis Macrocephalae (Bai Zhu), Sclerotium Poriae Cocos (Fu Ling), Rhizoma Anemarrhenae Aspheloidis (Zhi Mu), and Cortex Phellodendri (Huang Bai), 9g each, and mix-fried Radix Glycyrrhizae (Gan Cao), 3g.

Additions & subtractions: If there is wind causing dizziness and vertigo, add nine grams each of Radix Angelicae Sinensis (Dang Gui), Rhizoma Gastrodiae Elatae (Tian Ma), and Ramulus Uncariae Cum Uncis (Gou Teng). For wind causing spasticity, add 15 grams of Bombyx Batryticatus (Jiang Can) and 30 grams of Radix Albus Paeoniae Lactiflorae (Bai Shao). If there is liver depression qi stagnation, add six grams each of Fructus Meliae Toosendan (Chuan Lian Zi) and Radix Auklandiae Lappae (Mu Xiang). If there is low back pain, add nine grams each of Ramulus Loranthi Seu Visci (Sang Ji Sheng) and Cortex Eucommiae Ulmoidis (Du Zhong). If there is numbness and tingling, add 18 grams of Caulis Milletiae Seu Spatholobi (Ji Xue Teng) and nine grams each of Radix Angelicae Sinensis (Dang Gui), Periostracum Cicadae (Chan Tui), and Bombyx Batryticatus (Jiang Can). For concomitant damp heat diarrhea, add six grams each of Rhizoma Coptidis Chinensis (Huang Lian) and Radix Scutellariae Baicalensis (Huang Qin) and delete Zhi Mu. For concomitant blood stasis, add 12 grams each of Radix Angelicae Sinensis (Dang Gui) and Radix Salviae Miltiorrhizae (Dan Shen). For nausea due to spleen dampness, add nine grams each of Rhizoma Pinelliae Ternatae (Ban Xia) and Pericarpium Citri Reticulatae (Chen Pi). Please also see the additions and subtractions of patterns #3 and 4 above.

Acupuncture & moxibustion: 1. Please see pattern #1 above. 2. Pi Shu (Bl 20), Shen Shu (Bl 23), Zu San Li (St 36), Fu Liu (Ki 7). 3. Please see pattern #1 above.

Additions & subtractions: See pattern #1 above.

6. Kidney yang insufficiency pattern

Main symptoms: Poor vision, bilateral lower limb lack of strength, lack of warmth in the four extremities, especially in the lower limbs, loose stools, diarrhea, or possible constipation, frequent urination or incontinence, a pale tongue with thin, white fur, and a deep, fine pulse.

Note: In Western MS patients, this pattern rarely presents in its pure form. Kidney yang vacuity mostly appears in those where spleen qi vacuity has reached kidney yang. Now there is both spleen qi and kidney yang vacuity plus at least one or two other disease mechanisms or patterns.

Treatment principles: Warm yang and supplement the kidneys assisted by boosting the qi and freeing the flow of the network vessels. These last two principles imply concomitant spleen vacuity and blood stasis.

Rx: You Gui Yin Jia Jian (Restore the Right [Kidney] Drink with Additions & Subtractions).

Ingredients: Cooked Radix Rehmanniae (Shu Di), Herba Leonuri Heterophylli (Yi Mu Cao), and Radix Astragali Membranacei (Huang Qi) 30g each, Semen Cuscutae Chinensis (Tu Si Zi), 20g, Cortex Eucommiae Ulmoidis (Du Zhong) and Radix Angelicae Sinensis (Dang Gui), 15g each, Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), 9g, and Cortex Cinnamomi Cassiae (Rou Gui) and Radix Glycyrrhizae (Gan Cao), 6g each.

Additions & subtractions: If there is constipation, one can add nine grams each of Herba Cistanchis Deserticolae (Rou Cong Rong) and Herba Cynomorii Songarici (Suo Yang). For poor vision, add 12 grams each of Semen Astragali Complanati (Sha Yuan Zi) and Fructus Rubi Chingii (Fu Pen Zi). For bilateral lower limb lack of strength, add 12 grams each of Cortex Radicis Acanthopanacis Gracilistylis (Wu Jia Pi), Radix Dipsaci (Xu Duan), and Radix Morindae Officinalis (Ba Ji Tian). For lack of warmth in the four extremities, add six grams of dry Rhizoma Zingiberis (Gan Jiang) and three grams of Herba Asari Cum Radice (Xi Xin). For loose stools or diarrhea, add nine grams of Fructus Psoraleae Corylifoliae (Bu Gu Zhi) and six grams of Fructus Schisandrae Chinensis (Wu Wei Zi) and Semen Myristicae Fragrantis (Rou Dou Kou). For frequent urination or incontinence, add nine grams each of Fructus Alpiniae Oxyphyllae (Yi Zhi Ren), Fructus Rosae Laevigatae (Jin Ying Zi), and Fructus Rubi Chingii (Fu Pen Zi). For marked qi vacuity, add 12 grams each of Radix Codonopsitis Pilosulae (Dang Shen), Sclerotium Poriae Cocos (Fu Ling), and Rhizoma Atractylodis Macrocephalae (Bai Zhu).

Acupuncture & moxibustion: 1. Please see pattern #1 above. 2. Ming Men (GV 4), Guan Yuan (CV 4), Shen Shu (Bl 23). 3. Please see pattern #1 above.

Additions & subtractions: See pattern #1 above.

Remarks

1. In my experience, the single most commonly seen pattern of MS in real-life Western patients is qi and yin dual vacuity, meaning spleen qi and liver-kidney yin vacuity. However, this pattern is always complicated by liver depression, and it is often complicated by any combination of the following: A) damp heat, B) blood stasis, C) internal stirring of wind, D) kidney qi vacuity not securing, and E) kidney yang vacuity. In my experience, it is the rule rather than the exception that there will be five or more concomitant patterns in cases of MS. Whenever there are such complicated patterns, one should first identify all patterns present in order of predominance; two, state the requisite treatment principles for each of those patterns in the same order; and three, compose on an ad hoc basis a treatment plan that addresses all those patterns in the same proportions and with the same priorities.

2. Because spleen qi vacuity and dampness play a central role in most Western MS patients' disease mechanisms, Chinese dietary therapy must also play a correspondingly central role in any comprehensive treatment plan. This generally means eating a clear, bland, hypoallergenic, yeast-free diet. The more marked spleen qi and dampness or damp heat are in a patient's over-all pattern, the more important is proper diet in the prevention of acute attacks and long-term maintenance.

3. Although Western physicians say that attacks and remissions of MS are spontaneous, my clinical experience as a Chinese doctor suggests that precipitating factors for both acute attacks and remissions can be identified by Chinese medicine. For instance, many female MS patients experience worsening of wind, liver, and/or spleen related symptoms premenstrually. If there is insufficient blood, when the blood descends to the uterus prior to menstruation, this may result in the arising or aggravation of internally stirring wind and/or liver depression. If liver depression is aggravated, then the spleen will tend to become more vacuous due to the liver counterflowing horizontally with wood assailing earth. Other acute attacks can be traced to unusual fatigue, emotional stress, and/or unregulated diet. Therefore, when MS patients experience acute aggravations, it is very important for their Chinese medical care-giver to identify the precipitating factor(s) and to explain these to the patient so that the patient may prevent such exacerbations in the future. For instance, if an MS patient's symptoms worsen on exposure to heat, they should consider moving to a cooler climate in the summer or installing air-conditioning in their home.

4. Chinese sources do not typically list blood stasis as a pattern of MS. However, blood stasis often does complicate MS based on the statement that, "Enduring diseases enter the network vessels." The clinical meaning of this statement is that blood stasis is commonly engendered within the network vessels of chronically ill patients. In such cases, one should add appropriate blood quickening, network vessel freeing medicinals to any other guiding formula, however remembering that blood vacuity may cause or aggravate blood stasis and that blood stasis may cause or aggravate blood vacuity. Therefore, in most cases, blood-quickening medicinals should be combined with blood-nourishing medicinals or medicinals should be chosen which inherently both quicken and nourish the blood, such as Radix Angelicae Sinensis (Dang Gui) and Radix Salviae Miltiorrhizae (Dan Shen). Further, because blood stasis in the network vessels and wind often exist simultaneously, one should not overlook those wind-extinguishing medicinals which also quicken and free the flow of the network vessels, such as Buthus Martensis (Quan Xie) and Scolopendra Subspinipes (Wu Gong).

5. Chinese research has shown that Chinese medicine can keep MS patients in remission longer and slow this condition's progress. (1)

6. Stress reduction and a low fat diet yet high in essential fatty acids are important adjunctive therapies in most cases of MS. When stress plays a part in the activation or aggravation of MS, Chinese medical practitioners should consider the use of appropriate spirit-quieting medicinals based on the patient's overall pattern discrimination.

(Adapted from Bob Flaws & Philippe Sionneau's The Treatment of Modern Western Medical Diseases with Chinese Medicine published by Blue Poppy Press)

Copyright [C] Blue Poppy Press, 2003. All rights reserved.

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1. Lu Xi et al., "A Study of the Chinese Medicine Prevention of Relapse of Multiple Sclerosis," Zhong Yi Za Zhi (Journal of Chinese Medicine), #7, 1995, p. 417-418

abstracted & translated by Bob Flaws, Dipl. Ac & CH, FNAAOM, FRCHM

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