Degrees of DiE l iExploring A t iAutoimmunPathologiePathologieBiomedicinBiomedicinTCMTCM

ifference:

ne eses, ne andne and

Ure

OVERVIEW OF IMMUNE SYSTEMTYPES OF AUTOIMMUNE DISORDE

AUTOIMMUNEERS

E DISORDERS

The immune system is the bodother "foreign" substances. It iB lymphocytes, produces antibcause them to be removed frocause them to be removed froimmune system. The other comT lymphocytes, which can attacalled the cellular immune sys

It takes time for both componebecome protective, and antibospecific "foreign" threats Overspecific foreign threats. Overlibrary of identified substances“not threat.”

N ll h iNormally, the immune system attacks those tissues that it recinto conflict with a biomedical transplant, the immune systemtransplant, the immune system(unless it is from an identical tw

WHAT IS THE IMMUNE SYST

dy's means of protection against microorganisms as composed of two major parts. One component, bodies, proteins that attack "foreign" substances am the body; this is sometimes called the humoralm the body; this is sometimes called the humoral mponent consists of special white blood cells calle

ack "foreign" substances directly; this is sometimesstem.

ents of the immune system to develop. T lymphocyodies are developed after a person is exposed to r a lifetime the immune system develops an extenr a lifetime, the immune system develops an extens and microorganisms that are cataloged as “threat

di i i h b " lf" d " lf" dcan distinguish between "self" and "not self" and ocognizes as "not self." Sometimes this process comprocedure. When a person is given an organ

m will correctly recognize the new organ as "not sem will correctly recognize the new organ as not sewin) and will attack it in a process called rejection.

Autoimmune disorders are disimmune response against its oto recognize one or more of thautoantibodies antibodies thautoantibodies – antibodies thcauses inflammation and damThe cause of autoimmune diseinherited predisposition to devtypes of autoimmune disease an immune response, and the have some part of their structumicroorganismmicroorganism.

Autoimmune disorders fall into(systemic autoimmune diseasedi l d d b h idirectly damaged by the autoimbecome blurred as the effect obeyond the targeted tissues, in

WHAT ARE AUTOIMMUNE DISORDE

eases caused by the body producing an inapproprown tissues. Sometimes the immune system will cee body's normal constituents as "self" and will creaat attack its own cells tissues and/or organs Thisat attack its own cells, tissues, and/or organs. Thisage and it leads to autoimmune disorders.eases is unknown, but it appears that there is an elop autoimmune disease in many cases. In a few(such as rheumatic fever), a bacteria or virus triggantibodies or T-cells attack normal cells because

ure that resembles a part of the structure of the infe

o two general types: those that damage many orgaes) and those where only a single organ or tissue

(l li d) H h di i immune process (localized). However, the distinctioof localized autoimmune disorders frequently extenndirectly affecting other body organs and systems.

Systemic Autoimmune DiseasRheumatoid arthritis (RA) and Lupus [Systemic Lupus Erythecells other)cells, other) Sclerodema (skin, intestine, leSiogren’s syndrome (salivary gGoodpasture's syndrome (lungWegener's granulomatosis (bloPolymyalgia Rheumatica (largGuillain-Barre syndrome (nerv

Localized Autoimmune DiseasType 1 Diabetes Mellitus (pancHashimoto’s thyroiditis, GraveC li di C h ' diCeliac disease, Crohn's diseasMultiple sclerosis (There is stildisease.) Addison’s disease (adrenal)Addison s disease (adrenal) Primary biliary cirrhosis, ScleroTemporal Arteritis/ Giant Cell A

TYPES OF AUTOIMMUNE DISEA

esJuvenile RA (joints; less commonly lung, skin)

ematosus] (skin, joints, kidneys, heart, brain, red b

ess commonly lung) glands, tear glands, joints) gs, kidneys) ood vessels, sinuses, lungs, kidneys) e muscle groups)

vous system)

sescreas islets) s’ disease (thyroid)

Ul i li i (GI )se, Ulcerative colitis (GI tract) l some debate as to whether MS is an autoimmun

osing cholangitis, Autoimmune hepatitis (liver) Arteritis (arteries of the head and neck)

WIND DAMP HEATTOXIC HEATNTERNAL LIVER WINDNTERNAL LIVER WINDYIN DEFICIENCY INTERNAL HEATKIDNEY/ SPLEEN YANG DEFICIENC

LUPUS

KIDNEY/ SPLEEN YANG DEFICIENCQI STAGNATION & BLOOD STASIS

LUPUS

CYCY

Lupus is a chronic inflammaimmune system attacks it’s oInflammation caused by lupuincluding; joints, skin, kidneyLupus occurs more frequentp q

Systemic lupus erythematosDiscoid lupus erythematosuDiscoid lupus erythematosuDrug-induced lupus erythemNeonatal lupus

Systemic lupus erythematoof lupus. There is no biomedoptions to alleviate symptom

BIOMEDICAL DEFINI

atory disease that occurs when the body's own tissues and organs. us can affect many different body systems, ys, blood cells, heart and lungs. tly in women (90%).y ( )

susss

matosus

sus (SLE) is the most common and serious fodical cure for lupus, but there exists treatmentms.

L i t i• Lupus is an autoimmune attacking foreign substancsystem also turns againstdamage to various parts odamage to various parts oheart, lungs, blood vessel

Bi di i h t d t• Biomedicine has not detesuch as lupus. It's likely thand environmental factorspredisposition to lupus bupredisposition to lupus, buinherited predisposition fothey come into contact witrigger lupus such as a mtrigger lupus, such as a m

BIOMEDICAL CAUS

di hi h th t i t d f j tdisease, which means that instead of just ces, such as bacteria and viruses, the immunt healthy tissue. This leads to inflammation anof the body including the joints skin kidneysof the body, including the joints, skin, kidneysls and brain.

i d th f t i dirmined the cause of autoimmune diseases, hat lupus results from a combination of genetis. Doctors believe that one may inherit a ut not lupus itself Instead people with anut not lupus itself. Instead, people with an or lupus may only develop the disease when th something in the environment that can

medication or a virusmedication or a virus.

No two cases of lupus are exactly alike. Signs o t o cases o upus a e e act y a e S g sevelop slowly, may be mild or severe, and ma

upus have mild disease characterized by episymptoms get worse for a while, then improve FatigueFeverWeight loss or gainWeight loss or gainJoint pain, stiffness and swellingButterfly-shaped rash (malar rash) on the facthat covers the cheeks and bridge of the nosthat covers the cheeks and bridge of the nosSkin lesions that appear or worsen with sun exposureMouth soresHair loss (alopecia)Fingers and toes that turn white or blue whenexposed to cold or during stressful periods (Raynaud's phenomenon)

BIOMEDICAL SYMPTO

and symptoms may come on suddenly or a d sy pto s ay co e o sudde y oay be temporary or permanent. Most people wsodes — called flares — when signs and

or even disappear completely for a time.

• Shortness of breath• Chest pain

D

ce se

• Dry eyes• Easy bruising• Anxiety

se • Depression• Memory loss

n

Lupus manifests differently inresemble external wind damchanges in location. In other diet of spicy and greasy foodseven emotions (primarily anseven emotions (primarily anfever and red macular eruptioliver fire causing convulsionsI t l h t thInternal heat can consume thwith symptoms of night sweathe skin and hair. In other caspleen leading to spleen kidnsensation, cyanosis of the lipencumberance by damp canencumberance by damp canwith severe pain and numbne

TCM ETIOLO

n individual patients. Often the initial symptomp heat with high fever or severe joint pain thapatients, symptoms of internal heat arise due

ds, pharmaceutical use or imbalance of thenger ) The excess toxic heat causes constantnger.) The excess toxic heat causes constant ons. In some case, the internal heat erupts ass and derangement of the heart and mind.h i fl id f th b d l di t i d fi ihe yin fluids of the body leading to yin deficienats, low grade fever, and five heart heat damaase, the damp heat damages the function of thney qi and yang deficiency with severe coldps and extremities. Damage to the qi and

also lead to qi stagnation and blood stasis also lead to qi stagnation and blood stasis, ess of the extremities.

nd Heat Damp Internal Toxicnd-Heat-Damp

nitial onset acute stageevere joint pain multiple

Internal Toxic • High continu• Red maculesj p p

teswelling of jointsain changes location

• Lack of stren• Joint aches• Delirumain changes location

ever, dry throatOral ulcer

ti k f

Delirum• Oral sores, r• Dry stools• Bl di (atigue weakness of

mbs= Red with yellow slimy

t

• Bleeding (no• Dark yellow o• Thirst for col

oat= Wiry, slippery

• T = Crimsoncoat

• P = Rapid, wp ,

Heat

TCM SYMPTO

Liver fire with internal winHeatous fevers on face

Liver fire with internal win

• Persistent high fever• Agitation, restlessness

ngth • Crying, laughing• Convulsions, seizures• Paralysis or fasticulation

red throat

l)

Paralysis or fasticulation• Urinary retention or

incontinence• T = Red with scorchedose, anal)

or red urined drinks

• T = Red with scorched yellow or peeling coat

• P = Rapid, Wiry

, yellow dry

wiryy

nd Heat Damp Internal Toxicnd-Heat-Damp

ispel wind, drain amp, clear heat,

Internal Toxic • Clear heat, r

toxins, cool bi h iemove blockages. nourish yin, r

stasis, dispe

LI 11DU 14SP 9Ashi

LI4LI 11SP 9UB12

ShiXuanLI 4DU 10UB 40Ashi UB12

UB13ST44Ashi

UB 40PC 3

Heat

TCM PROTOCO

Liver fire with internal winHeatresolve blood,

l

Liver fire with internal win• Clear liver, extinguish

wind, calm shen, settletetanyresolve

rse macules.tetany.

LV 3GB 20GB 34LI 11

12 Jing-WellDU 14LI 11SP 10

LV 2GB 34PC 7DU 9LI 11SP 10

SI 18DU 9DU 26

X ith H t S l Kid YXu with Heat

hronic low grade feverive heart heat

Spleen-Kidney Ya• Cold limbs and bo• Occassional tidal ive heart heat

idal redness of faceight sweats

• Fatigue, weaknes• Disinclination to s• Abdominal distenatigue, weakness

ight red skin lesionsry falling hair

• Abdominal disten• Vomiting, diarrhea• Somber white com

innituscanty urine (maybe red)ry stools

• Weak low back a• Swollen joints, su• Numb blueish extry stools

regular Menstruation= Red, mirror

Th d id

• Pale lesions• T = Pale, swollen• P = Soggy deep= Thready, rapid • P = Soggy, deep,

X

TCM SYMPTO

ang Xuodyheat

Qi Stagnation & Blood Sta• Cyanosis of extremities• Purple lesions

ssspeakntion

Purple lesions • Depressed disciform lesi• Scaly cracked skin

ntionamplexion

• Joint and muscle pain• Depression• Menestrual irregularity

nd kneesuperficial edematremities

• Dysmenorrhea• T = Purple with purple

sublingual viens

white coatfine

sub gua e s• P = Wiry

, fine

X ith H t S l Kid YXu with Heat

nify kidney, nourish , clear heat.

Spleen-Kidney Ya• Tonify kidney and

yang, disinhibit w, clear heat.

KD 7 KD 3KD 1 UHT 6UB23KD 2

REN 4ST 36SP 9

PC 8REN 17SP 6LV 2

UDSSLV 2

SISHENCONGSL

X

TCM PROTOCO

ang Xud spleen, warm

water.

Qi Stagnation & Blood Sta• Quicken blood, transform

stasis, rectify qi, free thestasis, rectify qi, free theflow of luo vessels.

SP 6UB 20 SP 10LI 4UB 17DU 10

UB 23DU 4SP 9SP 3

LI 4LV 3GB34ASHISP 3

U 7ASHIJing-Well

Name: HelenaSex: FemaleAge: 38Nationality: NamibiaMarital Status: MarriedComplainer: The patient herself

• Major complaint: abnormality o• Disease history: No history of

and other infectious diseases.food such as soap seafood afood such as soap, seafood, atransfusion. The history of pre

• Personal history: She was borsmoke. Her living environmen

• Family history: Her parents are

• Date: May 29, 2010H l 38 ld f l• Helena, a 38-year-old female,albuminuria, hematuria and fatreatment at 15: 00 p. m. on M

Birthplace: Namibia

TCM CASE STUp

Profession: TeacherDate of Admission: May 28, 2010 Date of Record: May 29, 2010Onset Season: Grain Full

of albuminuria, hematuria and fatigue for 2 years hepatitis, trigeminal neuritis. No tuberculosis, schisto

. No history of trauma and surgery. No allergic historyand medicines like penicillin No history of bloodand medicines like penicillin. No history of blood eventive vaccination was unknown.rn in Namibia. No addiction of wine drinking. She doet is not bad. She is moderate in temper.e both healthy.Medical Record

Time: 15: 00 p. m.h ff d f SLE i d ith b lit has suffered from SLE accompanied with abnormalit

atigue for 2 years. She was hospitalized in our hospitaMay 28, 2010.

gnosis1. The patient has suffered from SLE accompanied wyears. 2. In August 2008, the patient was found out abnormaof urine. She was diagnosed with SLE and lupus nepto get treatment with Endoxam but without obvious imHer sleep got worse and would wake up just three hoHer sleep got worse and would wake up just three ho2002, the patient got hysterectomy due to ovarian cysHer present symptoms were as follow: Slightly hair lodistention in the right rib, fatigue, weakness in the bo

d l Th i k f land sleep. The patient was easy to wake up after slemovement was normal. 3. T 35.6 , R 20 times/minute, P 82 times/minute, BP4 She grew normally with common nutrition Her min4. She grew normally with common nutrition. Her mintiredness. Her body was in a positive posture and she5. There were three ulcers in the mouth and tendernethe kidneys. Black tongue body and white tongue coa

TCM CASE STU

with abnormality of albuminuria, hematuria and fatigue

ality of albuminuria, hematuria by the regular examinaphritis by renal biopsy and other examinations. She stmprovement. She went to vomit after taking the medicours after sleeping And it was difficult to sleep againours after sleeping. And it was difficult to sleep again. st. She has suffered from asthma for 5 years.

oss, repeated ulcer in the mouth, some pains and dy, upset, dry and bitter feeling in the mouth, bad app

i Sh i d i i h Th beping. She urinated one to two times at night. The bo

P 100/60mmHg.nd was clear She had an expression of chronic illnessnd was clear. She had an expression of chronic illnesse was cooperative with clear mind. ess on the right rib. The patient felt painful in the regioating.

nostic Basis:nostic Basis:CM: The patient's abnormality of hematuria was the sdneys. The repeated ulcers in the mouth, vexation, dnd invasion of heat toxin. The damage of the network

t t i l d t th f ti k b d titeat toxin lead to the fatigue, weakness, bad appetite aWestern Medicine: The patient has suffered from SLE nd fatigue for 2 years. With the diagnosis of the local nostic Differentiation:nostic Differentiation:CM: The patient's Turbidity of Kidneys should be diffeymptoms are blood in urine and dribbling urine. So the

Western Medicine: The patient's SLE should be differeedication. They have some similar symptoms, but the

s clinic symptoms are slight. The clinic symptoms woufficult to be distinguished. nosis:nosis:CM (Traditional Chinese Medicine) diagnosis: Turbidiymptom identification: spread and invasion of heat tox

Western Medicine diagnosis: SLE and lupus nephritisWestern Medicine diagnosis: SLE and lupus nephritis

TCM CASE STU

symptom of the damage of the network vessels of thery and bitter mouth were the symptoms of the spread

k vessels of the kidneys and the invasion and spreadid l S h di d ith T bidit f Kiand sleep. So she was diagnosed with Turbidity of Ki

accompanied with abnormality of albuminuria, hemathospital, she was diagnosed with SLE and lupus nep

erentiated from bloody stranguria. Bloody stranguria'sey are not difficult to be distinguished. ntiated from class of lupus syndrome which is due to e connection of SLE with medicines is not so obviousuld disappear after stopping the medicines. So they a

ty of Kidneysxin, damage of the network vessels of the kidneys

A typical sign of lupus is a red, butcheeks and nose, often following e

IMA

tterfly-shaped rash over the face’s exposure to sunlight.

WIND COLD DAMPWIND DAMP HEATLIVER QI STAGNATION WITH HEA

RHEUMATOIDQI XUE XU WITH PHELGM STASISLIVER XUE AND KIDNEY YIN-YAN

RHEUMATOID

AT

D ARTHRITISSG XU

D ARTHRITIS

Rheumatoid arthritis istypically affects the smand-tear damage of oslining of joints, causingbone erosion and joint

An autoimmune disordimmune system mistakto causing joint problemto causing joint problemwhole body with fevers

Rheumatoid arthritis isRheumatoid arthritis isthan in men and generWhile there's no biometreatment options havep

BIOMEDICAL DEFINI

s a chronic inflammatory disorder that most mall joints in hands and feet. Unlike the wear-steoarthritis, rheumatoid arthritis affects the g a painful swelling that can eventually result i

deformity.

der, rheumatoid arthritis occurs when the kenly attacks the body's own tissues. In additims rheumatoid arthritis can also affect thems, rheumatoid arthritis can also affect the s and fatigue.

s two to three times more common in womens two to three times more common in women rally occurs between the ages of 40 and 60. edicine cure for rheumatoid arthritis, western e expanded greatly in the past few decades. p g y p

Rheumatoid arthritis oci th li i fsynovium, the lining of

resulting inflammation invade and destroy thetendons and ligamentstendons and ligamentsstretch. Gradually, the

Biomedical doctors doBiomedical doctors dogenetic component apcause rheumatoid arthto environmental factobacteria — that may tr

BIOMEDICAL CAU

ccurs when the immune system attacks the f th b th t d th j i t Thf the membranes that surround the joints. Thethickens the synovium, which can eventually

e cartilage and bone within the joint. The s that hold the joint together weaken ands that hold the joint together weaken and joint loses its shape and alignment.

n't know what starts this process although an t know what starts this process, although a pears likely. While one’s genes don't actually

hritis, they can make someone more susceptibrs — such as infection with certain viruses anigger the disease.

Signs and symptoms of rh

Joint pain

J i t lliJoint swelling

Joints that are tender to th

Red and puffy handsp y

Firm bumps of tissue unde

Fatigue

Morning stiffness that may

Fever

Weight lossWeight lossSmaller joints affected fEarly rheumatoid arthritis wrists, hands, ankles and , ,knees, hips, jaw and neckoccur bilaterally.

BIOMEDICAL SYMPT

heumatoid arthritis may include:

he touch

er the skin on your arms (rheumatoid nodules)

y last for hours

firsttends to affect the smaller joints first — the joints ifeet. As the disease progresses, the shoulders, elp g , ,

k also can become involved. In most cases, sympto

Rh t id A th iti ifRheumatoid Arthritis manifesweakness of qi and blood. Thallowing for a failure of the wcold heat and damp Additiocold, heat, and damp. Additiois stagnant . This heat accumDeficiency of spleen and kidnsalty and greasy foods and/osalty and greasy foods, and/obuild up of dampness. Dampblocking the free flow of qi anblood and deplete the kidneyp y

TCM ETIOLO

t i ll j i t f th di t l t itists in small joints of the distal extremities as his weakness can fail to nourish the extremitie

wei qi to protect the body from external wind, onally internal heat may arise when the liveronally, internal heat may arise when the liver mulates in the joints causing swelling and painneys combined with consumption of sweet, or living in a damp environment can lead to thor living in a damp environment can lead to th

pness can transform into phlegm thereby nd blood. Finally, internal heat can dry the livey yin, thus ultimately exhausting the yang.y y , y g y g

Wind-cold-damp

• I iti l t f di•• Initial stage of disease

• Joints swollen not red• Worse with cold weather• Aversion to wind

••••• Loose stools

• Frequent clear urineT = Pale, thin white coatP = Deep wiry tight

••••

P = Deep, wiry, tight ••TP

xpel wind, drain damp, warm channelsP

GB20UB17

GB20UB13

CF

UB23REN4

SP9SP3LI4ASHIASHI

TCM SYMPTOWind-damp-heat

• Acute stageg• Swollen joints• Pain and restricted movement• Heaviness• Red joints• Red joints• Warm to touch• Thirst without desire to drink• Fever• Sweating• Scanty, dark urineT = Red, thin yellow coatP = Slippery rapidP = Slippery, rapid

Clear heat, drain damp, dispel windFree luo vessels

DU14LI11LI4

LI11ST44LI4LI4

SJ5LI4UB40ASHI

er qi stagnation with heat Qi xue xu with ph

Red swollen jointsPain, stiffness, inflexibilitySome relief with coldD th d th t

• Later stages of • Deformed joints• Inhibited movem• S b hitDry mouth and throat

Bitter taste in mouthnsomnia

Agitation

• Somber white c• palpitations• SOB• Fatigueg

= Red, slimy yellow coat= Fine, wiry , rapid

gT = Pale, thin whiP = Deep, fine, w

r heat, free luo vessels Tonify qi and xue, tranFree the channels and

114EN4

ST36SP6

LI4LV3GB34DU14DU1412 JING-WELL

TCM SYMPTOlegm stasis Liver xue and Kidney yin-yang

diseasesment

l i

• Joint and muscle atrophy• Deformation and inflexibili• Constant deep ache

complexion • Worse with cold• Dizziness• Tinnitus• Copious clear urine

ite coatwiry

Copious clear urine• Nocturia• Low back and knee painT = Pale, thin white coatP D k lP = Deep, weak, slow

nsform phlegmd collaterals Tonify liver and kidney, free cha

LI11LI4REN4

ST36SP6UB17PC6

UB17UB18UB23

PC6ST40ASHI

DU4KD1ASHI

Name: SaeedSex: MaleAge: 39Nationality: MuslimMarital Status: MarriedComplainer: The patient himse

D t F b 10 2010• Date: February 10, 2010• Saeed, a 39-year-old male,

the symptoms of the joint pahospital for treatment at 4: 0p

CASE STU

Birthplace: IranProfession: PhysicianDate of Admission: February 10, 2Date of Record: February 10, 2010Onset Season: Vernal equinox

elf

First Medical RecordTi 4 00Time: 4: 00 a. m.

has suffered from rheumatoid arthritis, accompaniedains and swelling for 10 years. He was hospitalized in00 a. m. on February 10, 2010.y ,

osis:The patient had the running pains of the joints throughn 1995, the patient began to have pains in the left shouenced his movement of the shoulder. He had taken

i t Th i h d d d I 2007 thme improvement. The pains had reduced. In 2007, thepains of the joints all over the body. There wasn't a d

ig working pressure. He often felt dizzy and heavy sehealth conditions when got to our hospital were bellog pchanges in the weather all over the body. The pains

od in the warm and gentle weather. There was no swemouth was a bit dry. His sleep condition was not goo

malmal. T 36.3 , R 20 times/minute, P 80 times/minute, BP 1He grew normally with common nutrition. His mind wa

skin and sclerotic. No swelling of superficial lymph noSound of breath was bilaterally normal on auscultationart beat was 80 times/minute. Cardiac rhythm was regdomen is soft, no press pains and no rebound tendernThe patient had the pains on the joints of the shoulderThe patient had the pains on the joints of the shoulderderness in the acromion and medial epicondyle of hubs. His tongue body was a bit deep-red with thin and

CASE STU

hout the whole body for 4 years.oulder after getting wet in the rain. The pains had acupuncture treatment in his local place, and had got

h ld i t d Sl l it t d ie shoulder pains were aggravated. Slowly, it turned indiagnosis in his local place. In the last three years, heense in the afternoon, sometimes had short confusionow: The running pains of the joints which were relatedg p jwere mainly pulling pains. The joints felt burning. He

elling, no numbness in the limbs, no feeling of heavinod, and he slept shallowly. His urination and stool wer

10/70mmHg.as clear. His body was a bit thin. No yellow appeared odes. No goiter. No thoracic deformity.n. No sound of pleural friction. Heart border was normgular. No pathological murmurs on auscultation. The ness.r when stretching or raising the arms There werer when stretching or raising the arms. There were merus. No deform and swollen joints in the spine andyellow coating. The pulse was wiry and soft.

agnostic BasisTCM: After getting wet in the rain, the patient had haand network vessels. Once the channels and networlimbs will have pains. So from the aspect of TCM, it wWestern Medicine: The patient had the running painsThe patient had the pains of the shoulder joints whenThe patient had the pains of the shoulder joints whenin the acromion and medial epicondyle of humerus. H

agnostic Differentiation:TCM: The patient's impediment pattern should be difcharacterized by limp, emaciated sinews and bones,pattern is generally characterized by joint pains. So tWestern Medicine: The patient's rheumatoid arthritis

agnosis:agnosis:TCM (Traditional Chinese Medicine) diagnosis: ImpeSymptom identification: obstruction of wind-damp, inWestern Medicine: Rheumatoid ArthritisWestern Medicine: Rheumatoid Arthritis

CASE STU

ad dampness evil which lead to obstruction of channerk vessels are obstruct, the joints and movement of thwas impediment pattern.s of the joints throughout the whole body for 4 years. n stretching or raising the arms. There were tendernen stretching or raising the arms. There were tenderneHe was diagnosed as rheumatoid arthritis.

fferentiated from wilting pattern. Wilting pattern is ma, with weakness of the muscles. However, impedimenthey are not difficult to be distinguished.

s should be differentiated from hyperplastic osteoarthr

ediment pattern.nhibition of the joints.

Rheumatoid arthritis can cause pain, swp ,lines joints (synovial membrane) becomup and joints erode and degrade.

IMAG

welling and deformity. As the tissue that g ymes inflamed and thickened, fluid builds

Osteoarthritis, the most common form of arthrihat caps the bones in your joints. With rheumaat caps t e bo es you jo ts t eu arotects and lubricates joints becomes inflame

may follow.

IMAG

tis, involves the wearing away of the cartilageatoid arthritis, the synovial membrane that ato d a t t s, t e sy o a e b a e t at

ed, causing pain and swelling. Joint erosion

INTERNAL PHLEGM HEATDAMP HEAT DAMAGES JINDAMP HEAT DAMAGES JINXUE XU WITH INTERNAL WINDLIVER XUE AND KIDNEY YIN XU

MULTIPLE SCQI AND YIN XU

MULTIPLE SCLEROSISLEROSIS

Multiple sclerosis (MS) is a pbody's immune system eatsnerves. This interferes with trest of the body. Ultimately, themselves, a process that's

Symptoms vary widely, depeparticular nerves are affectesclerosis may lose the abilitydifficult to diagnose early in often come and go — some

Although multiple sclerosis cpeople between the ages ofmultiple sclerosis than are m

BIOMEDICAL DEFINI

potentially debilitating disease in which the s away at the protective sheath that covers its the communication between the brain and thethis may result in deterioration of the nerves

s not reversible.

ending on the amount of damage and which ed. People with severe cases of multiple y to walk or speak. Multiple sclerosis can be the course of the disease, because symptomtimes disappearing for months.

can occur at any age, it most often begins in f 20 and 40. Women are more likely to develomen.

Multiple sclerosis is an autosystem attacks its own tissumyelin — the fatty substancbrain and spinal cord.

Myelin can be compared to damaged, the messages thablocked.

Biomedical doctors and resesclerosis occurs in some pepof factors, ranging from gene

BIOMEDICAL CAUS

immune disease, where the body's immune ues. In multiple sclerosis, this process destroyce that coats and protects nerve fibers in the

the insulation on electrical wires. When myeliat travel along that nerve may be slowed or

earchers don't understand exactly why multipople and not others. They believe a combinatp yetics to childhood infections, may play a role.

Signs and symptoms of multiple sclerosis varnerve fibers. Multiple sclerosis signs and symNumbness or weakness in one or more limbsat a time or the bottom half of the bodyPartial or complete loss of vision, usually in omovement (optic neuritis)Double vision or blurring of vision Tingling or pain in parts of your bodyElectric-shock sensations that occur with certElectric shock sensations that occur with certTremor, lack of coordination or unsteady gaitFatigueDi iDizzinessMost people with multiple sclerosis, particularexperience relapses of symptoms, which are

i i Si d t f lti lremission. Signs and symptoms of multiple scincrease in body temperature.

BIOMEDICAL SYMPTO

ry widely, depending on the location of affectemptoms may include: s, which typically occurs on one side of the bo

ne eye at a time, often with pain during eye

tain head movementstain head movements

rly in the beginning stages of the disease, followed by periods of complete or partial l i ft t i d d bclerosis often are triggered or worsened by an

• Multiple Sclerosis is a foatrophy occur along wit

• The primary causative fenvironment, consumptspleen qi can lead to thof qi throughout the bodAlcohol and drug use cacan injure the qi, blood

l fl id l dican congeal fluids leadicollaterals.

TCM ETIOLO

orm of wei syndrome in TCM where flaccidity h loss of motor function, factors in MS are damp and heat. Living in a dtion of greasy and spicy foods, and weaknesse accumulation of damp which impedes the fl

dy resulting in numbness and loss of function.an cause heat in the interior. Internal toxic heand yin and cause weakness. Moreover, heai t hl bl ki th h l ding to phlegm blocking the channels and

Internal phlegm heat

• Atrophy, weakness of extremities• Mild enduring fever• Numbness, paralysis• Head distensionHead distension• Decreased visual acuity• Nausea, vomiting• Y ll hl i th t• Yellow phlegm in throat• Thirst without desire to drink• T = Red, yellow slimy coat• P = Slippery, wiry, rapid

TCM SYMPTO

Damp-heat damages jin

• Heaviness• Fatigue• Weakness of limbs• Chest and abdominal fullnessChest and abdominal fullness• Foul smelling stools• Burning painful urine• T d ll li t• T = red, yellow slimy coat• P = Slippery, rapid

Internal phlegm heatInternal phlegm heat

Clear heat transform phlegm, open orifices, free luo vessels

DU24DU20

SISHENCONGDU16DU20

DU16DU10

DU16HUATOJIAJIPC6

DU6DU4DU1

ST40ST44LV2DU1

ST40ST44SP9

LV2YANGMING ON LIMBS

SP9

TCM TREATM

Damp-heat damages jinDamp-heat damages jin

Clear heat , drain damp

DU24DU20

DU20DU16DU20

DU16DU10

DU16HUATOJIAJIPC6

DU6DU4DU1

SP9GB34LI11DU1

SP9REN12REN3

LI11YANGMING ON LIMBS

REN3

Xue xu with internal wind

• Weak eyesight• Insomnia• Weak limbs• Difficulty standing or movingy g g• Dizziness, tinnitus• Lusterless complexion• Pale nails• Pale nails• T = Pale, white coat• P = Wiry, fine

TCM SYMPTO

Liver xue and kidney yin xu

• Blurred or double vision• Weak sore low back & knees• Emaciated body• Unsteady gaity g• Dizziness, tinnitus• 5 heart heat• Yellow urine dry stools• Yellow urine, dry stools• T = Red, scanty coat• P = Wiry, fine, rapid

Xue xu with internal windue u t te a d

Tonify blood & yin, subdue yang, extinguish wind

DU24DU20

UB17SP4DU20

DU16DU10DU6

SP4PC6SP6LV8DU6

DU4DU1

LV8GB41DU16

UB17UB20UB23

HUATOJIAJIYANGMING ON LIMBS

TCM SYMPTO

Liver xue and kidney yin xue ue a d d ey y u

Supplement KD & LVtonify blood & yin

DU24DU20

SISHENCONGSP6DU20

DU16DU10DU6

SP6KD3LV8UB17DU6

DU4DU1

UB17DU16HUATOJIAJI

KD3KD7UB18

YANGMING ON LIMBS

UB23

Qi and yin xuQ a d y u

FatigueW k li bWeak limbsReduced appetite, Abdominal bloatingEasy bruisingLoose stoolsEmaciationLow back& knee sorenessLow back& knee soreness Night sweats, malar flushT = Swollen, red tip or red, swollenP Wi fi idP = Wiry, fine, rapid

TCM SYMPTO

Kidney yang xud ey ya g u

• Poor vision• Bil t l l k• Bilateral leg weakness• Cold limbs• Loose stools, diarrhea• Frequent urination or incontinence• T = Pale, thin white coat• P = Deep, fineP Deep, fine

Qi and yin xu

Tonify spleen qi & kidney yin

DU24DU20

SISHENCONGSP6

DU16DU10DU6

KD3UB20UB23DU6

DU4DU1UB20

UB23ST36DU16HUATOJIAJIUB20

UB23ST36

HUATOJIAJIYANGMING ON LIMBS

KD7

TCM SYMPTOKidney yang xu

Warm Yang, tonify kidney & spleen,free luo vessels

DU24DU20

SISHENCONGREN4

DU16DU10DU6

REN6UB23UB52DU6

DU4DU1REN4

UB52DU4DU16HUATOJIAJIREN4

UB23HUATOJIAJIYANGMING ON LIMBS

• Dr H, 75 year old male, rcare-givers.

• Biomedical diagnosis: Mu• Secondary diagnosis: Ma• Medical status: Hospice sMedical status: Hospice s• Main Complaint: loss of v

whisper to quiet voice)• Secondary complaints: P• Secondary complaints: P• Prior complaint: Maxofac• Medications: Laxatives, M

thithinners

TCM CASE STU

etired professor of dentistry, lives with wife an

ultiple Sclerosis 30+ yearsassive CVA July 2010since CVAsince CVAvoice (intermittent; moves from barely audible

Paralysis of 4 limbs restless leg syndromeParalysis of 4 limbs, restless leg syndromecial pain prior to strokeMorphine, Anti convulsive medications, Blood

ExaminationExaminationiryot/cold = Neutral, hot until last 3-5 yearsleeps alot (using morphine)leeps alot (using morphine)ppetite = Good, some coughing and sputum produhirst = Craves cold liquidsowels/Urine = Uses laxatives catheterowels/Urine Uses laxatives, catheteread/body = Little to no pain (morphine), paralysis oision/Hearing = No symptomskin/Hair = Slow to heal bed soreskin/Hair = Slow to heal bed soreservationale sunken complexiontrophy of limbstrophy of limbsongue = red swollen unable to extend

TCM CASE STU

uction when eating hot foods

of 4 limbs, RLS

ening/smellingening/smellingQuiet voice or whisperNo abnormal odorspationpationSkin clammy, slightly coolReduced sensory response on limbsPulse: Deep soft most palpable in chi positionPulse: Deep, soft, most palpable in chi position

TCM CASE STU

In multiple sclerosis, the protective coatingmay eventually be destroyed Dependingmay eventually be destroyed. Depending can affect vision, sensation, coordination,

IMA

g on nerve fibers (myelin) is damaged and on where the nerve damage occurs MSon where the nerve damage occurs, MS movement, and bladder and bowel control.

Diseases and Conditions - MayoClinic.comfor Healthy Living - MayoClinic.com. Web. <htt // li i /h lth/Di<http://www.mayoclinic.com/health/Disease

Flaws, Bob, and Philippe Sionneau. The TrDiseases with Chinese Medicine a TextbooDiseases with Chinese Medicine a TextbooPoppy, 2007. Print.

SOUR

m." Mayo Clinic Medical Information and Tools26 Nov. 2010.

I d /Di I d >esIndex/DiseasesIndex>.

reatment of Modern Western Medical ok & Clinical Manual Boulder CO: Blueok & Clinical Manual. Boulder, CO: Blue