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Degrees of Diifference:

Exploring
E l i
A t i
Autoimmun ne
Pathologiees,
es
Biomedicinne and
TCM Ure
OVERVIEW OF IMMUNE SYSTEM
TYPES OF AUTOIMMUNE DISORDE
ERS

AUTOIMMUNE
E DISORDERS
WHAT IS THE IMMUNE SYST

The immune system is the bod dy's means of protection against microorganisms a
other "foreign" substances. It is composed of two major parts. One component,
B lymphocytes, produces antib bodies, proteins that attack "foreign" substances a
cause them to be removed from the body; this is sometimes called the humoral
immune system. The other com mponent consists of special white blood cells calle
T lymphocytes, which can atta ack "foreign" substances directly; this is sometimes
called the cellular immune sysstem.

It takes time for both compone ents of the immune system to develop. T lymphocy
become protective, and antibo odies are developed after a person is exposed to
specific "foreign"
foreign threats.
threats Overr a lifetime
lifetime, the immune system develops an exten
library of identified substancess and microorganisms that are cataloged as “threat
“not threat.”

Normally,
N ll the
h iimmune system can distinguish
di i i hb between ""self"
lf" and
d ""not self"
lf" and
do
attacks those tissues that it reccognizes as "not self." Sometimes this process com
into conflict with a biomedical procedure. When a person is given an organ
transplant, the immune system m will correctly recognize the new organ as "not not se
(unless it is from an identical tw
win) and will attack it in a process called rejection.
WHAT ARE AUTOIMMUNE DISORDE

Autoimmune disorders are diseases caused by the body producing an inappropr


immune response against its own
o tissues. Sometimes the immune system will ce
to recognize one or more of the body's normal constituents as "self" and will crea
autoantibodies – antibodies that attack its own cells,
cells tissues
tissues, and/or organs.
organs This
causes inflammation and damage and it leads to autoimmune disorders.
The cause of autoimmune dise eases is unknown, but it appears that there is an
inherited predisposition to develop autoimmune disease in many cases. In a few
types of autoimmune disease (such as rheumatic fever), a bacteria or virus trigg
an immune response, and the antibodies or T-cells attack normal cells because
have some part of their structu
ure that resembles a part of the structure of the infe
microorganism.
microorganism

Autoimmune disorders fall into


o two general types: those that damage many orga
(systemic autoimmune disease es) and those where only a single organ or tissue
di
directly
l ddamaged
dbby the
h autoimimmune process (localized).
(l li d) H
However, the
h di
distinctio
i i
become blurred as the effect of
o localized autoimmune disorders frequently exten
beyond the targeted tissues, in
ndirectly affecting other body organs and systems.
TYPES OF AUTOIMMUNE DISEA

Systemic Autoimmune Diseases


Rheumatoid arthritis (RA) and Juvenile RA (joints; less commonly lung, skin)
Lupus [Systemic Lupus Erythe ematosus] (skin, joints, kidneys, heart, brain, red b
cells other)
cells,
Sclerodema (skin, intestine, le
ess commonly lung)
Siogren’s syndrome (salivary glands,
g tear glands, joints)
Goodpasture's syndrome (lung gs, kidneys)
Wegener's granulomatosis (blo ood vessels, sinuses, lungs, kidneys)
Polymyalgia Rheumatica (large muscle groups)
Guillain-Barre syndrome (nervvous system)

Localized Autoimmune Diseasses


Type 1 Diabetes Mellitus (panccreas islets)
Hashimoto’s thyroiditis, Graves’ disease (thyroid)
C li di
Celiac disease, CCrohn's
h ' di
diseasse, Ulcerative
Ul i colitis
li i (GI tract))
Multiple sclerosis (There is still some debate as to whether MS is an autoimmun
disease.)
Addison’s
Addison s disease (adrenal)
osing cholangitis, Autoimmune hepatitis (liver)
Primary biliary cirrhosis, Sclero
Temporal Arteritis/ Giant Cell Arteritis
A (arteries of the head and neck)
WIND DAMP HEAT
TOXIC HEAT
NTERNAL LIVER WIND
YIN DEFICIENCY INTERNAL HEAT
KIDNEY/ SPLEEN YANG DEFICIENCCY
QI STAGNATION & BLOOD STASIS

LUPUS
BIOMEDICAL DEFINI

Lupus is a chronic inflamma atory disease that occurs when the body's
immune system attacks it’s owno tissues and organs.
Inflammation caused by lupu us can affect many different body systems,
including; joints, skin, kidney
ys, blood cells, heart and lungs.
Lupus
p occurs more frequentq tly
y in women ((90%).
)

Systemic lupus erythematos


sus
Discoid lupus erythematosus
Drug-induced lupus erythem
matosus
Neonatal lupus

Systemic lupus erythematosus (SLE) is the most common and serious fo


dical cure for lupus, but there exists treatment
of lupus. There is no biomed
options to alleviate symptom
ms.
BIOMEDICAL CAUS

• Lupus iis an autoimmune


L t i di
disease, which
hi h means th
thatt iinstead
t d off jjustt
attacking foreign substancces, such as bacteria and viruses, the immun
system also turns againstt healthy tissue. This leads to inflammation an
damage to various parts of
o the body
body, including the joints
joints, skin
skin, kidneys
heart, lungs, blood vessells and brain.

• Biomedicine
Bi di i h has nott d
dete
t rmined
i d th
the cause off autoimmune
t i di
diseases,
such as lupus. It's likely th
hat lupus results from a combination of geneti
and environmental factors s. Doctors believe that one may inherit a
predisposition to lupus
lupus, bu ut not lupus itself.
itself Instead
Instead, people with an
inherited predisposition fo or lupus may only develop the disease when
they come into contact with something in the environment that can
trigger lupus
lupus, such as a m medication or a virus
virus.
BIOMEDICAL SYMPTO
No
o ttwo
o cases o
of lupus
upus are
a e exactly
e act y a
alike.
e SSigns
g saand
d sy
symptoms
pto s may
ay co
comeeo
on sudde
suddenlyyo
or
evelop slowly, may be mild or severe, and ma ay be temporary or permanent. Most people w
upus have mild disease characterized by epis sodes — called flares — when signs and
ymptoms get worse for a while, then improve or even disappear completely for a time.
Fatigue • Shortness of breath
Fever • Chest pain
Weight loss or gain • D eyes
Dry
Joint pain, stiffness and swelling • Easy bruising
Butterfly-shaped rash (malar rash) on the fac
ce • Anxiety
that covers the cheeks and bridge of the nosse
• Depression
Skin lesions that appear or worsen with
• Memory loss
sun exposure
Mouth sores
Hair loss (alopecia)
Fingers and toes that turn white or blue whenn
exposed to cold or during stressful periods
(Raynaud's phenomenon)
TCM ETIOLO

Lupus manifests differently inn individual patients. Often the initial symptom
resemble external wind damp heat with high fever or severe joint pain tha
changes in location. In other patients, symptoms of internal heat arise due
diet of spicy and greasy foodds, pharmaceutical use or imbalance of the
seven emotions (primarily an nger ) The excess toxic heat causes constant
nger.)
fever and red macular eruptio ons. In some case, the internal heat erupts as
liver fire causing convulsions
s and derangement of the heart and mind.
I t
Internal l heat
h t can consume th h yin
he i fl
fluids
id off th
the b
body
d lleading
di tto yini ddeficien
fi i
with symptoms of night swea ats, low grade fever, and five heart heat dama
the skin and hair. In other ca
ase, the damp heat damages the function of th
spleen leading to spleen kidn ney qi and yang deficiency with severe cold
sensation, cyanosis of the lip
ps and extremities. Damage to the qi and
encumberance by damp can also lead to qi stagnation and blood stasis stasis,
with severe pain and numbne ess of the extremities.
TCM SYMPTO

nd Heat Damp
nd-Heat-Damp Internal Toxic Heat Liver fire with internal win

nitial onset acute stage • High continuous fever • Persistent high fever
evere jjoint p
pain multiple
p • Red macules s on face • Agitation, restlessness
tes • Lack of strenngth • Crying, laughing
welling of joints • Joint aches • Convulsions, seizures
ain changes location • Delirum • Paralysis or fasticulation
ever, dry throat • Oral sores, red
r throat • Urinary retention or
Oral ulcer • Dry stools incontinence
atigue
ti weakness
k off • Bl di ((no
Bleeding ose, anal)
l) • T = Red with scorched
mbs • Dark yellow oro red urine yellow or peeling coat
= Red with yellow slimy • Thirst for cold drinks • P = Rapid, Wiry
oatt • T = Crimson, yellow dry
= Wiry, slippery coat
• P = Rapid,
p , wiry
w y
TCM PROTOCO

nd Heat Damp
nd-Heat-Damp Internal Toxic Heat Liver fire with internal win

ispel wind, drain • Clear heat, resolve


r • Clear liver, extinguish
toxins, cool blood,
b wind, calm shen, settle
amp, clear heat,
i h yin,
nourish i resolve
r l tetany
tetany.
emove blockages.
stasis, disperse macules.

LI 11 LI4 ShiXuan 12 Jing-Well LV 3 LV 2


DU 14 LI 11 LI 4 DU 14 GB 20 GB 34
SP 9 SP 9 DU 10 LI 11 GB 34 PC 7
Ashi UB12 UB 40 SP 10 LI 11 DU 9
UB13 PC 3 SI 18 DU 26
ST44
Ashi
TCM SYMPTO

X with
Xu ith Heat
H t S l
Spleen-Kidney
Kid Ya
Yang Xu
X Qi Stagnation & Blood Sta
hronic low grade fever • Cold limbs and bo ody • Cyanosis of extremities
ive heart heat • Occassional tidal heat • Purple lesions
idal redness of face • Fatigue, weaknes ss • Depressed disciform lesi
ight sweats • Disinclination to speak
s • Scaly cracked skin
atigue, weakness • Abdominal disten ntion • Joint and muscle pain
ight red skin lesions • Vomiting, diarrhea a • Depression
ry falling hair • Somber white com mplexion • Menestrual irregularity
innitus • Weak low back and knees • Dysmenorrhea
canty urine (maybe red) • Swollen joints, suuperficial edema • T = Purple with purple
ry stools • Numb blueish exttremities sublingual
sub gua viens
e s
regular Menstruation • Pale lesions • P = Wiry
= Red, mirror • T = Pale, swollen white coat
= Thready,
Th d rapid id • P = Soggy,
Soggy deep
deep,, fine
TCM PROTOCO

X with
Xu ith Heat
H t S l
Spleen-Kidney
Kid Ya
Yang Xu
X Qi Stagnation & Blood Sta
nify kidney, nourish • Tonify kidney and d spleen, warm • Quicken blood, transform
, clear heat. yang, disinhibit water.
w stasis, rectify qi, free the
flow of luo vessels.

KD 7 KD 1 KD 3 UB 20
U SP 6 SP 10
HT 6 PC 8 REN 4 U 23
UB LI 4 LI 4
UB23 REN 17 ST 36 D 4
DU UB 17 LV 3
KD 2 SP 6 SP 9 S 9
SP DU 10 GB34
LV 2 S 3
SP ASHI
SISHENCONG LU 7 Jing-Well
TCM CASE STU
Name: Helena Birthplace:
p Namibia
Sex: Female Profession: Teacher
Age: 38 Date of Admission: May 28, 2010
Nationality: Namibia Date of Record: May 29, 2010
Marital Status: Married Onset Season: Grain Full
Complainer: The patient herself

• Major complaint: abnormality ofo albuminuria, hematuria and fatigue for 2 years
• Disease history: No history of hepatitis, trigeminal neuritis. No tuberculosis, schisto
and other infectious diseases.. No history of trauma and surgery. No allergic history
food such as soap,
soap seafood,
seafood a and medicines like penicillin
penicillin. No history of blood
transfusion. The history of pre
eventive vaccination was unknown.
• Personal history: She was borrn in Namibia. No addiction of wine drinking. She doe
smoke. Her living environment is not bad. She is moderate in temper.
• Family history: Her parents aree both healthy.
Medical Record
• Date: May 29, 2010 Time: 15: 00 p. m.
• H l
Helena, a 38
38-year-old
ld ffemale,
l has
h suffered
ff d from
f SLE accompanied i d with
ith abnormalit
b lit
albuminuria, hematuria and fa atigue for 2 years. She was hospitalized in our hospita
treatment at 15: 00 p. m. on May
M 28, 2010.
TCM CASE STU

gnosis
1. The patient has suffered from SLE accompanied with w abnormality of albuminuria, hematuria and fatigue
years.
2. In August 2008, the patient was found out abnorma ality of albuminuria, hematuria by the regular examina
of urine. She was diagnosed with SLE and lupus nep phritis by renal biopsy and other examinations. She st
to get treatment with Endoxam but without obvious im mprovement. She went to vomit after taking the medic
Her sleep got worse and would wake up just three ho ours after sleeping.
sleeping And it was difficult to sleep again
again.
2002, the patient got hysterectomy due to ovarian cys st. She has suffered from asthma for 5 years.
Her present symptoms were as follow: Slightly hair lo oss, repeated ulcer in the mouth, some pains and
distention in the right rib, fatigue, weakness in the body, upset, dry and bitter feeling in the mouth, bad app
andd sleep.
l Th
The patient
i was easy to wakek up afterf sle
l eping.
i Sh
She urinated
i d one to two times
i at night.
i h ThThe b
bo
movement was normal.
3. T 35.6Ԩ, R 20 times/minute, P 82 times/minute, BP P 100/60mmHg.
4 She grew normally with common nutrition
4. nutrition. Her min
nd was clear.
clear She had an expression of chronic illness
tiredness. Her body was in a positive posture and she e was cooperative with clear mind.
5. There were three ulcers in the mouth and tenderne ess on the right rib. The patient felt painful in the regio
the kidneys. Black tongue body and white tongue coa ating.
TCM CASE STU
nostic Basis:
CM: The patient's abnormality of hematuria was the symptom
s of the damage of the network vessels of the
dneys. The repeated ulcers in the mouth, vexation, dry and bitter mouth were the symptoms of the spread
nd invasion of heat toxin. The damage of the network k vessels of the kidneys and the invasion and spreadi
eatt toxin
t i lead
l d tto the
th ffatigue,
ti weakness,
k bad
b d appetite
tit and
a d sleep.
l S
So sheh was di diagnosed d with
ith T
Turbidity
bidit off Ki
Western Medicine: The patient has suffered from SLE accompanied with abnormality of albuminuria, hemat
nd fatigue for 2 years. With the diagnosis of the local hospital, she was diagnosed with SLE and lupus nep
nostic Differentiation:
CM: The patient's Turbidity of Kidneys should be diffe erentiated from bloody stranguria. Bloody stranguria's
ymptoms are blood in urine and dribbling urine. So the ey are not difficult to be distinguished.
Western Medicine: The patient's SLE should be differentiated from class of lupus syndrome which is due to
edication. They have some similar symptoms, but the e connection of SLE with medicines is not so obvious
s clinic symptoms are slight. The clinic symptoms wou uld disappear after stopping the medicines. So they a
fficult to be distinguished.
nosis:
CM (Traditional Chinese Medicine) diagnosis: Turbidity of Kidneys
ymptom identification: spread and invasion of heat tox xin, damage of the network vessels of the kidneys
Western Medicine diagnosis: SLE and lupus nephritis
IMA

A typical sign of lupus is a red, buttterfly-shaped rash over the face’s


cheeks and nose, often following exposure
e to sunlight.
WIND COLD DAMP
WIND DAMP HEAT
LIVER QI STAGNATION WITH HEA
AT
QI XUE XU WITH PHELGM STASIS
S
LIVER XUE AND KIDNEY YIN-YANG XU

RHEUMATOID
D ARTHRITIS
BIOMEDICAL DEFINI

Rheumatoid arthritis is s a chronic inflammatory disorder that most


typically affects the sm
mall joints in hands and feet. Unlike the wear-
and-tear damage of os steoarthritis, rheumatoid arthritis affects the
lining of joints, causing
g a painful swelling that can eventually result i
bone erosion and joint deformity.

An autoimmune disord der, rheumatoid arthritis occurs when the


immune system mistak kenly attacks the body's own tissues. In additi
to causing joint problemms rheumatoid arthritis can also affect the
ms,
whole body with fevers s and fatigue.

Rheumatoid arthritis iss two to three times more common in women


than in men and generrally occurs between the ages of 40 and 60.
While there's no biome edicine cure for rheumatoid arthritis, western
treatment options
p have e expanded
p g
greatly
y in the p
past few decades.
BIOMEDICAL CAU

Rheumatoid arthritis oc ccurs when the immune system attacks the


synovium,
i th
the lilining
i off the
th membranes
b that
th t surround
d th
the jjoints.
i t ThThe
resulting inflammation thickens the synovium, which can eventually
invade and destroy the e cartilage and bone within the joint. The
tendons and ligamentss that hold the joint together weaken and
stretch. Gradually, the joint loses its shape and alignment.

Biomedical doctors donn'tt know what starts this process


process, although a
genetic component appears likely. While one’s genes don't actually
cause rheumatoid arthhritis, they can make someone more susceptib
to environmental factors — such as infection with certain viruses an
bacteria — that may trigger the disease.
BIOMEDICAL SYMPT

Signs and symptoms of rh


heumatoid arthritis may include:
Joint pain
J i t swelling
Joint lli
Joints that are tender to th
he touch
Red and p
puffy
y hands
Firm bumps of tissue unde
er the skin on your arms (rheumatoid nodules)
Fatigue
Morning stiffness that mayy last for hours
Fever
Weight loss
Smaller joints affected first
f
Early rheumatoid arthritis tends to affect the smaller joints first — the joints i
wrists,, hands,, ankles and feet. As the disease p
progresses,
g , the shoulders,, el
knees, hips, jaw and neckk also can become involved. In most cases, sympto
occur bilaterally.
TCM ETIOLO

Rheumatoid
Rh t id Arthritis
A th iti manifes
if sts
t in
i smallll jjoints
i t off th
the di
distal
t l extremities
t iti as
weakness of qi and blood. Th his weakness can fail to nourish the extremitie
allowing for a failure of the wei
w qi to protect the body from external wind,
cold heat
cold, heat, and damp
damp. Additio onally internal heat may arise when the liver
onally,
is stagnant . This heat accum mulates in the joints causing swelling and pain
Deficiency of spleen and kidn neys combined with consumption of sweet,
salty and greasy foods
foods, and/o or living in a damp environment can lead to th
build up of dampness. Damp pness can transform into phlegm thereby
blocking the free flow of qi annd blood. Finally, internal heat can dry the live
blood and deplete
p the kidneyy yin,
y , thus ultimatelyy exhausting g the yang.
y g
Wind-cold-damp Wind-damp-heat TCM SYMPTO

• Initial
I iti l stage
t off disease
di
• Acute stage
g
• Joints swollen not red • Swollen joints
• Worse with cold weather • Pain and restricted movement
• Aversion to wind • Heaviness
• Loose stools • Red joints
• Frequent clear urine • Warm to touch
T = Pale, thin white coat
• Thirst without desire to drink
P = Deep
Deep, wiry
wiry, tight
• Fever
• Sweating
• Scanty, dark urine
xpel wind, drain damp, warm channels T = Red, thin yellow coat
P = Slippery
Slippery, rapid

GB20 GB20 Clear heat, drain damp, dispel wind


C
UB17 UB13 F
Free luo vessels
UB23 SP9
REN4 SP3 DU14 LI11
LI4 LI11 ST44
ASHI LI4 LI4
SJ5 UB40
ASHI
TCM SYMPTO
er qi stagnation with heat Qi xue xu with phlegm stasis Liver xue and Kidney yin-yang
Red swollen joints • Later stages of disease • Joint and muscle atrophy
Pain, stiffness, inflexibility • Deformed jointss • Deformation and inflexibili
Some relief with cold • Inhibited movemment • Constant deep ache
D mouth
Dry th andd th
throatt • Somber
S b white hit complexion
c l i • Worse with cold
Bitter taste in mouth • palpitations • Dizziness
nsomnia • SOB • Tinnitus
Agitation
g • Fatigue
g • Copious clear urine
= Red, slimy yellow coat T = Pale, thin whiite coat • Nocturia
= Fine, wiry , rapid P = Deep, fine, wiry
w • Low back and knee pain
T = Pale, thin white coat
P=D Deep, weak, k slow
l
r heat, free luo vessels Tonify qi and xue, tran
nsform phlegm
Free the channels and d collaterals Tonify liver and kidney, free cha

11 LI4 ST36 ST36 LI11 UB17


4 LV3 SP6 SP6 LI4 UB18
EN4 GB34 UB17 REN4 UB23
DU14 PC6 DU4
12 JING-WELL ST40 KD1
ASHI ASHI
CASE STU

Name: Saeed Birthplace: Iran


Sex: Male Profession: Physician
Age: 39 Date of Admission: February 10, 2
Nationality: Muslim Date of Record: February 10, 2010
Marital Status: Married Onset Season: Vernal equinox
Complainer: The patient himse
elf

First Medical Record


• D t F
Date: February
b 10,
10 2010 Ti
Time: 4
4: 00 a. m.
• Saeed, a 39-year-old male, has suffered from rheumatoid arthritis, accompanied
the symptoms of the joint pa ains and swelling for 10 years. He was hospitalized in
hospital
p for treatment at 4: 00
0 a. m. on February y 10,, 2010.
CASE STU
osis:
The patient had the running pains of the joints through hout the whole body for 4 years.
n 1995, the patient began to have pains in the left sho oulder after getting wet in the rain. The pains had
uenced his movement of the shoulder. He had taken acupuncture treatment in his local place, and had got
me improvement.
i t The
Th painsi h hadd reduced.
d d IIn 2007
2007, th
the
e shoulder
h ld pains i were aggravated. t d Sl
Slowly,
l it tturned
d iin
pains of the joints all over the body. There wasn't a diagnosis
d in his local place. In the last three years, he
ig working pressure. He often felt dizzy and heavy se ense in the afternoon, sometimes had short confusion
health conditions when g got to our hospital
p were bello
ow: The running gp pains of the jjoints which were related
changes in the weather all over the body. The pains were mainly pulling pains. The joints felt burning. He
od in the warm and gentle weather. There was no swe elling, no numbness in the limbs, no feeling of heavin
mouth was a bit dry. His sleep condition was not goo od, and he slept shallowly. His urination and stool wer
mal.
mal
T 36.3Ԩ, R 20 times/minute, P 80 times/minute, BP 110/70mmHg.
He grew normally with common nutrition. His mind wa as clear. His body was a bit thin. No yellow appeared
skin and sclerotic. No swelling of superficial lymph no odes. No goiter. No thoracic deformity.
Sound of breath was bilaterally normal on auscultation n. No sound of pleural friction. Heart border was norm
art beat was 80 times/minute. Cardiac rhythm was reg gular. No pathological murmurs on auscultation. The
domen is soft, no press pains and no rebound tendern ness.
The patient had the pains on the joints of the shoulderr when stretching or raising the arms arms. There were
derness in the acromion and medial epicondyle of humerus. No deform and swollen joints in the spine and
bs. His tongue body was a bit deep-red with thin and yellow coating. The pulse was wiry and soft.
CASE STU

agnostic Basis
ad dampness evil which lead to obstruction of channe
TCM: After getting wet in the rain, the patient had ha
and network vessels. Once the channels and networrk vessels are obstruct, the joints and movement of th
limbs will have pains. So from the aspect of TCM, it was
w impediment pattern.
Western Medicine: The patient had the running pains s of the joints throughout the whole body for 4 years.
The patient had the pains of the shoulder joints when n stretching or raising the arms. There were tenderne
in the acromion and medial epicondyle of humerus. He H was diagnosed as rheumatoid arthritis.
agnostic Differentiation:
TCM: The patient's impediment pattern should be diffferentiated from wilting pattern. Wilting pattern is ma
characterized by limp, emaciated sinews and bones,, with weakness of the muscles. However, impedimen
pattern is generally characterized by joint pains. So they
t are not difficult to be distinguished.
Western Medicine: The patient's rheumatoid arthritis s should be differentiated from hyperplastic osteoarthr
agnosis:
TCM (Traditional Chinese Medicine) diagnosis: Impe ediment pattern.
Symptom identification: obstruction of wind-damp, in nhibition of the joints.
Western Medicine: Rheumatoid Arthritis
IMAG

Rheumatoid arthritis can cause p


pain,, sw
welling
g and deformity.
y As the tissue that
lines joints (synovial membrane) becommes inflamed and thickened, fluid builds
up and joints erode and degrade.
IMAG

Osteoarthritis, the most common form of arthritis, involves the wearing away of the cartilage
hat
at caps tthe
e bo
bones
es in you
your jo
joints.
ts With
t rheuma
eu aatoid
ato daarthritis,
t t s, the
t e synovial
sy o a membrane
e b a e tthat
at
rotects and lubricates joints becomes inflameed, causing pain and swelling. Joint erosion
may follow.
INTERNAL PHLEGM HEAT
DAMP HEAT DAMAGES JIN
XUE XU WITH INTERNAL WIND
LIVER XUE AND KIDNEY YIN XU
QI AND YIN XU

MULTIPLE SCLEROSIS
SCLEROSIS
BIOMEDICAL DEFINI

Multiple sclerosis (MS) is a potentially


p debilitating disease in which the
body's immune system eats s away at the protective sheath that covers its
nerves. This interferes with the
t communication between the brain and the
rest of the body. Ultimately, this may result in deterioration of the nerves
themselves, a process that's s not reversible.

Symptoms vary widely, depe ending on the amount of damage and which
particular nerves are affecte ed. People with severe cases of multiple
sclerosis may lose the ability y to walk or speak. Multiple sclerosis can be
difficult to diagnose early in the course of the disease, because symptom
often come and go — sometimes disappearing for months.

Although multiple sclerosis can


c occur at any age, it most often begins in
people between the ages off 20 and 40. Women are more likely to develo
multiple sclerosis than are men.
m
BIOMEDICAL CAUS

Multiple sclerosis is an autoimmune disease, where the body's immune


system attacks its own tissuues. In multiple sclerosis, this process destroy
myelin — the fatty substanc ce that coats and protects nerve fibers in the
brain and spinal cord.

Myelin can be compared to the insulation on electrical wires. When myeli


damaged, the messages thaat travel along that nerve may be slowed or
blocked.

Biomedical doctors and rese earchers don't understand exactly why multip
p ople
sclerosis occurs in some pe p and not others. They y believe a combinat
of factors, ranging from gene
etics to childhood infections, may play a role.
BIOMEDICAL SYMPTO

Signs and symptoms of multiple sclerosis varry widely, depending on the location of affecte
nerve fibers. Multiple sclerosis signs and sym mptoms may include:
Numbness or weakness in one or more limbs s, which typically occurs on one side of the bo
at a time or the bottom half of the body
Partial or complete loss of vision, usually in one eye at a time, often with pain during eye
movement (optic neuritis)
Double vision or blurring of vision
Tingling or pain in parts of your body
Electric-shock
Electric shock sensations that occur with certtain head movements
Tremor, lack of coordination or unsteady gait
Fatigue
Di i
Dizziness
Most people with multiple sclerosis, particularrly in the beginning stages of the disease,
experience relapses of symptoms, which are followed by periods of complete or partial
remission.
i i Si
Signs andd symptoms
t off multiple
lti l scclerosis
l i often
ft are ttriggered
i d or worseneddb by an
increase in body temperature.
TCM ETIOLO

• Multiple Sclerosis is a fo
orm of wei syndrome in TCM where flaccidity
atrophy occur along with loss of motor function,
• The primary causative factors
f in MS are damp and heat. Living in a d
environment, consumpttion of greasy and spicy foods, and weakness
spleen qi can lead to the accumulation of damp which impedes the fl
of qi throughout the boddy resulting in numbness and loss of function.
Alcohol and drug use ca an cause heat in the interior. Internal toxic he
can injure the qi, blood and yin and cause weakness. Moreover, hea
can congeall fl
fluids
id lleadi
diing
i tto phlegm
hl blocking
bl ki theth channels
h l andd
collaterals.
TCM SYMPTO

Internal phlegm heat Damp-heat damages jin

• Atrophy, weakness of extremities • Heaviness


• Mild enduring fever • Fatigue
• Numbness, paralysis • Weakness of limbs
• Head distension • Chest and abdominal fullness
• Decreased visual acuity • Foul smelling stools
• Nausea, vomiting • Burning painful urine
• Y ll
Yellow phlegm
hl iin th
throatt • T = red,
d yellow
ll slimy
li coatt
• Thirst without desire to drink • P = Slippery, rapid
• T = Red, yellow slimy coat
• P = Slippery, wiry, rapid
TCM TREATM

Internal phlegm heat Damp-heat damages jin

Clear heat transform phlegm, Clear heat , drain damp


open orifices, free luo vessels

DU24 SISHENCONG DU24 DU20


DU20 DU16 DU20 DU16
DU16 HUATOJIAJI DU16 HUATOJIAJI
DU10 PC6 DU10 PC6
DU6 ST40 DU6 SP9
DU4 ST44 DU4 GB34
DU1 LV2 DU1 LI11
ST40 YANGMING ON LIMBS SP9 YANGMING ON LIMBS
ST44 REN12
SP9 REN3
TCM SYMPTO

Xue xu with internal wind Liver xue and kidney yin xu

• Weak eyesight • Blurred or double vision


• Insomnia • Weak sore low back & knees
• Weak limbs • Emaciated body
• Difficultyy standing
g or moving
g • Unsteadyy gait
g
• Dizziness, tinnitus • Dizziness, tinnitus
• Lusterless complexion • 5 heart heat
• Pale nails • Yellow urine,
urine dry stools
• T = Pale, white coat • T = Red, scanty coat
• P = Wiry, fine • P = Wiry, fine, rapid
TCM SYMPTO
Xue
ue xu
u with
t internal
te a wind
d Liver
e xue
ue a
and
d kidney
d ey y
yin xu
u

Tonify blood & yin, Supplement KD & LV


subdue yang, extinguish wind tonify blood & yin

DU24 UB17 DU24 SISHENCONG


DU20 SP4 DU20 SP6
DU16 PC6 DU16 KD3
DU10 SP6 DU10 LV8
DU6 LV8 DU6 UB17
DU4 GB41 DU4 DU16
DU1 DU16 DU1 HUATOJIAJI
UB17 HUATOJIAJI KD3 YANGMING ON LIMBS
UB20 YANGMING ON LIMBS KD7
UB23 UB18
UB23
TCM SYMPTO
Qi and
Q a d yin
y xuu Kidney
d ey yang
ya g xu
u

Fatigue • Poor vision


W k limbs
Weak li b • Bil t l lleg weakness
Bilateral k
Reduced appetite, Abdominal bloating • Cold limbs
Easy bruising • Loose stools, diarrhea
Loose stools • Frequent urination or incontinence
Emaciation • T = Pale, thin white coat
Low back& knee soreness • P = Deep, fine
Night sweats, malar flush
T = Swollen, red tip or red, swollen
P = Wiry,
Wi fi fine, rapid
id
TCM SYMPTO
Qi and yin xu Kidney yang xu

Tonify spleen qi & kidney yin Warm Yang, tonify kidney & spleen,
free luo vessels

DU24 SISHENCONG DU24 SISHENCONG


DU20 SP6 DU20 REN4
DU16 KD3 DU16 REN6
DU10 UB20 DU10 UB23
DU6 UB23 DU6 UB52
DU4 ST36 DU4 DU4
DU1 DU16 DU1 DU16
UB20 HUATOJIAJI REN4 HUATOJIAJI
UB23 YANGMING ON LIMBS UB23 YANGMING ON LIMBS
ST36
KD7
TCM CASE STU

• Dr H, 75 year old male, retired professor of dentistry, lives with wife an


care-givers.
• Biomedical diagnosis: Mu ultiple Sclerosis 30+ years
• Secondary diagnosis: Ma assive CVA July 2010
• Medical status: Hospice ssince CVA
• Main Complaint: loss of voice
v (intermittent; moves from barely audible
whisper to quiet voice)
• Secondary complaints: Paralysis
P of 4 limbs,
limbs restless leg syndrome
• Prior complaint: Maxofaccial pain prior to stroke
• Medications: Laxatives, Morphine,
M Anti convulsive medications, Blood
thinners
thi
TCM CASE STU
Examination
iry
ot/cold = Neutral, hot until last 3-5 years
leeps alot (using morphine)
ppetite = Good, some coughing and sputum produ uction when eating hot foods
hirst = Craves cold liquids
owels/Urine = Uses laxatives
laxatives, catheter
ead/body = Little to no pain (morphine), paralysis of
o 4 limbs, RLS
ision/Hearing = No symptoms
kin/Hair = Slow to heal bed sores
ervation
ale sunken complexion
trophy of limbs
ongue = red swollen unable to extend
TCM CASE STU
ening/smelling
Quiet voice or whisper
No abnormal odors
pation
Skin clammy, slightly cool
Reduced sensory response on limbs
Pulse: Deep
Deep, soft
soft, most palpable in chi position
IMA

In multiple sclerosis, the protective coating


g on nerve fibers (myelin) is damaged and
may eventually be destroyed.
destroyed Depending on where the nerve damage occurs occurs, MS
can affect vision, sensation, coordination, movement, and bladder and bowel control.
SOUR

Diseases and Conditions - MayoClinic.comm." Mayo Clinic Medical Information and Tools
for Healthy Living - MayoClinic.com. Web. 26 Nov. 2010.
<htt //
<http://www.mayoclinic.com/health/Disease
li i /h lth/Di esIndex/DiseasesIndex>.
I d /Di I d >

Flaws, Bob, and Philippe Sionneau. The Trreatment of Modern Western Medical
Diseases with Chinese Medicine a Textboook & Clinical Manual
Manual. Boulder,
Boulder CO: Blue
Poppy, 2007. Print.