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Transcript of Ms Dharmananda
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CHINESE HERBAL TREATMENT FOR MULTIPLE
SCLEROSISAND OTHER FLACCIDITY SYNDROMES, INCLUDING MYASTHENIA
GRAVIS AND AMYOTROPHIC LATERAL SCLEROSIS.
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
A NEW DISEASE
Multiple sclerosis (MS) is a modern disease. It may have occurred in earlier centuries,
but theoretical and dianostic limitations made it impossible to clearly de!ine this
disease. "he earliest recorded medical discussions o! MS are at the end o! the last
century, and it is di!!icult to trace potential cases o! the disorder more than a !e#
decades be!ore that.
"he use o! $sclerosis% in the disease name is in re!erence to the scarrin o! thenerves (!ormation o! pla&ues, #here myelin no loner !orms) o! the central nervous
system ('NS) that results !rom in!lammation and subse&uent destruction o! their
myelin sheaths. "he detection o! demyelination in livin persons re&uires the most
modern o! medical techni&ues. ntil the development o! manetic resonance imain
(MI) in the early *+-s, con!irmation that a person su!!ered !rom MS had to a#ait
autopsy, thouh the disease could be uessed #ith some reliability by a
comprehensive description o! its course and mani!estations. /ne test, the hot bath
dianostic procedure, #as used !or about !i!ty years (until MI became prevalent)0
persons #ith MS #ould usually display more severe symptoms a!ter e1posure to a hot
bath.
"he onset o! the disease is insidious and its course is hihly variable over time. In
some cases, minor neuroloical disturbances precede the more characteristic !lare2ups
(called e1acerbations) by several years. Symptoms may be &uite di!!erent amon
individuals. Wea3enin o! the les, bladder, and colon4muscles in the lo#er body4
are common, but so are mental !oiness and optic neuritis4indicatin brain
damae. "he term 5multiple is used because many nerves are a!!ected, but the
disease miht sho# evident impact on only a sinle muscle roup durin the !irst
years o! development. Even #ith modern technoloy, a !irm dianosis o! MS is not
easily established by physicians until it has reached a some#hat advanced stae4sometimes a decade or more a!ter the onset o! troublesome symptoms. "he averae
ae at dianosis o! MS in the .S. is about 6*.
IMMN/7/8I'A7 NA"E /9 ":E DISEASE
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An e1tensive revie# o! the immunoloical disturbance in MS #as presented by ;yron
Wa3sman o! the Ne#
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initiation. 9or e1ample, ::2=, a herpes virus that causes the childhood disorder
called roseola, and #hich may e1ist undetected in a lare portion o! the population,
appears to be involved in several other diseases and has been suested to be one o!
the potential culprits in MS, since the virus is !ound in the oliodendrocytes o! MS
patients (6-). "he virus is !ound in the reion o! the MS pla&ues but not the
una!!ected parts. While ::2= is !ound in persons #ithout MS, it is not !ound in the
oliodendrocytes in other#ise healthy people. ::2= in!ects both the "2cells, alterin
their activity, and the central nervous system. 'NS in!ections #ith the virus are
associated #ith multi!ocal demyelination and can produce a disease that appears
identical to MS (6*). Interest in ::2= has been stimulated by !indins that it can co2
in!ect cells that are in!ected by human immunode!iciency virus (:I) and can activate
replication o! that virus (it is thus called a transactivator). It is possible that ::2=
plays a role in MS in con>unction #ith other viruses.
Interestinly, the incidence o! MS is hiher (#ithin the 'aucasian population) in
the !ar northern and !ar southern latitudes to#ards the earths poles. 9rom thisobservation, it has been suested that #here one lives around the time o! puberty
may be the 3ey !actor in disease initiation, as opposed to #here one lives #hen the
disease mani!ests obvious symptoms. "he ris3 at puberty miht be related to ro#th
o! the central nervous system and chanes in immune responses under the in!luence o!
hormones durin that stae o! development. "he uneven distribution o! MS cases
around the #orld has been suested to be related to e1posure to viruses or bacteria
!rom animals, such as dairy co#s or dos (6). In one instance, islands in the North
Atlantic that #ere !ree o! MS sho#ed a hih incidence o! MS cases a !e# years a!ter
army arrisons had been on the island !or a #hile, implicatin an in!ectious aent
carried by the army members or their accompanyin dos or other livestoc3.
It has also been suested that de!iciencies in certain nutrients (such as calcium,
vitamin D, vitamin ;*@, selenium, and essential !atty acids) durin the development o!
the nervous tissues may enhance ris3 !or su!!erin !rom MS (?). "he metabolism o!
vitamin D and calcium are in!luenced by sun e1posure, and there can be dietary
!actors in!luencin availability o! all these nutrients that may vary by location and
culture.
Durin the *+-s, some observers revived the earlier proposal that MS #as the
result o! a spirochetal (bacterial) in!ection o! the 'NS. In part, this #as because o! thene#ly identi!ied 7yme Disease, caused by a tic32borne spirochete, and it has a
reional occurrence (!avorin northern deciduous !orests) and autoimmune2li3e
character (C). "he earlier hypothesis, proposed in *+-+ and considered a possibility
throuh the *+C-s, #as that MS miht have been due to another spirochete, the one
that causes neurosyphilis, or one li3e it. "hus !ar, a bacterial in!ection has not been
sho#n to be the immediate cause o! MS, but the several decades lon history o!
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proposals that MS is initiated by an in!ection sho#s a consistent understandin that
the disease is not solely based on enetics, climate, emotions, or other non2in!ection
etioloies. ;y contrast, the neuromuscular 'harot2Marie2"ooth disease, #hich also
causes #ea3enin and #astin o! the le muscles and, later in its development, other
peripheral muscles, appears to be based primarily on enetic bac3round.
/nce "2cells aimed at myelin sheath sur!ace proteins have developed, later
in!ections, not necessarily the same as the initiatin virus, can trier a subse&uent
!lare2up o! the autoimmune disease. Many patients observe a close connection
bet#een e1perience o! in!luenHa or common cold and symptoms o! the disease, and
this connection is documented (6@). It has been proposed that !lare2ups that do not
appear to !ollo# an in!ection actually !ollo# either an in!ection that did not mani!est
overt symptoms or activation o! a latent virus (such as one o! those in the herpes
!amily) #ithout evident symptoms. A success!ul immune response to the in!ectious
aent may have prevented the symptoms !rom developin, but then continued on to
attac3 the myelin.
Not only viruses, but other types o! in!ections, such as bacteria or parasites, miht
induce MS e1acerbations (=). Several viral and bacterial peptides have been sho#n to
activate "2cells that #ere primed to attac3 myelin ;G. 'hronic sinusitis has been
stronly associated #ith MS, #ith the possibility that the sinus in!ection (#hich can
be viral or bacterial) induces an immune response that eventually promotes the attac3
aainst myelin.
It has recently been suested that the cyto3ine called tumor necrosis !actor ("N9)
is associated #ith production o! multiple sclerosis symptoms (B). "his cyto3ine is!ound in the myelin lesions and cerebral spinal !luid o! MS patients. "N9, and other
cyto3ines (e.., interleu3ins *,?, and *-, and inter!eron amma) that miht act
concurrently, are induced in several in!ectious and parasitic diseases. ::2= is a
po#er!ul inducer o! "N9 in peripheral blood mononuclear cells (?6). Inter!eron
amma and "N9 slo# the suppression o! immune attac3. As a result, an immune
attac3 aainst a minor in!ection may be proloned until myelin is also attac3ed, and
the action o! the cyto3ines may then prolon the MS e1acerbation. "he antidepressant
dru rolipram is a "N9 inhibitor that has been suested as a use!ul therapy !or MS
()F several other drus have been revealed to have anti2"N9 activity in recent years,
includin0 3etoti!en (used !or treatin asthma), thalidomide (a sedative), andpento1iphyllene (used !or treatin blood clottin in peripheral vessels)F some o! these
could also be o! bene!it !or persons #ith MS (the selection o! drus allo#s choice
amon the primary indications !or their use). Inter!eron beta (provided as the dru
betaseron), inhibits inter!eron amma and "N9 and aids the !unction o! suppressor "2
cells.
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In the cerebral spinal !luid o! MS patients, it has been !ound that there is a
sini!icantly hiher level o! aldehydes, includin !ormaldehyde (66). "hese
aldehydes can cause protein cross2lin3in (thereby ma3in the proteins
physioloically inactive) and bloc3 nerve impulses. "heir action is more evident at
hiher temperatures, #hich may partly e1plain the hot2bath phenomenon in persons
#ith MS. "he hih levels o! aldehydes may be associated #ith the observed
phenomena o! reduced antio1idant activity in persons #ith MS, suestin a role !or
o1idative stress in the susceptibility to or e1pression o! e1acerbations (6?).
It has been proposed that #ea3enin o! the blood2brain barrier may permit easier
access o! lo# density lipoproteins (7D7) and other substances to the cerebral2spinal
!luid that ma3e the myelin more susceptible to o1idative damae and immune system
attac3 (6C). 7D7 tends to be hih in persons #ho are physically in active and in those
#ho consume lare amounts o! saturated !ats. Accordin to this line o! thouht,
aents that promote reater interity o! this barrier could slo# the proression o! MS
by limitin inappropriate access to the nerves. Administration o! antio1idants,includin vitamin ', vitamin E, and lutathione have been sho#n to improve the
antio1idant activity (6=), but have not yet been tested lon enouh to demonstrate an
impact on the !re&uency, severity, or duration o! e1acerbations.
In most cases, an in!ection (or other inducin aent) initiates an autoimmune
attac3 or enhances an onoin attac3 that produces notable symptoms. "hese
symptoms may last !or a !e# days to a !e# #ee3s in the remittin type o! MS. Within
a !e# days o! the immune activation, the natural reulation o! the immune system4
#hich may be inhibited due to host !actors or the in!luence o! chronic viral in!ection
4produces a #ithdra#al o! the attac3, and there can then be recovery o! the damaednerves (#hich is &uic3er, as #ith other in>uries, #ith youth and ood nutritional
status). With each e1acerbation (autoimmune attac3), there is local vascular
in!lammation (in the area o! the 'NS), usually #ith severe local edema, !ollo#ed by
demyelination o! the a!!ected nerves, resultin in scarrin i! the attac3 is su!!iciently
severe (remyelination o! the nerves can occur i! there is limited damae). Steroids
administered at the onset o! an e1acerbation may reduce demyelination, but lon2term
administration o!!ers little bene!it. In persons #ho respond poorly to steroids, it is
possible that processes other than immune attac3 and in!lammation, such as aldehyde
!ormation and o1idative stress, continue to en!orce the nerve damae.
"he process o! demyelination is one o! the causes o! muscular #ea3enin or
numbness0 nerve transmission via the a!!ected nerves is disrupted. Even so, areas o!
pla&ues as seen by MI, #hich represent essentially irreversible damae, do not
necessarily cause persistent inter!erence #ith nerve transmission. Some individuals
sho# little or no symptoms even #ith e1tensive pla&ue !ormation, #hile others sho#
sini!icant impairment #ith little evidence o! pla&ues. "his is probably because there
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are other mechanisms o! nerve inhibition and because the nervous system is
sometimes able to develop alternative routes o! transmittin the essential
in!ormation. :o#ever, once the damae !rom repeated attac3s has reached a certain
level o! severity, the disease mani!estation (e.., muscular #ea3enin) in most
individuals becomes continuous rather than intermittent. 9urther, #hen a person is
debilitated !or an e1tended period o! time, they may cease the attempt at movement
and thus deprive the nervous system o! the stimulus needed to reroute sinals.
"here are at least t#o types o! MS disease described by the course o!
development. "he intermittent type (or relapsin2remittin) is one in #hich there are
!lare2ups o! the attac3 aainst myelin !ollo#ed by a period o! recovery, o!ten #ith
several #ee3s, months, and sometimes years, be!ore the ne1t attac3. "he averae rate
o! e1acerbations durin the !irst years a!ter dianosis is about *.@CJyear. In a !e#
cases, the cycle o! attac3s appears to end spontaneously and there may be !e#, i! any,
residual symptomsF the MS does not proress to a more serious or paralytic
condition. "he proressive type usually !ollo#s a course o! steadily #orsenindebility, #here there may be only a !e# days o! relative relie!, !ollo#ed by continued
proression o! the disease. "his type leads to severely impaired immobility and
eventually to deathF !ortunately, it is the less common !orm. With current therapies
that can bene!it persons #ith MS (#hen applied in a timely manner), the main lon2
term problem may be deterioration o! health due to lac3 o! e1ercise, #ith
accumulation o! secondary diseases.
In sum, persons #ho e1perience MS usually have a enetic bac3round that ma3es
this particular disease more li3ely. "hey then e1perience an in!ection (or combination
o! in!ections) that establishes the possibility o! autoimmune attac3s aainst myelin. Acombination o! other !actors then convere to enable the disease process0 these may
include nutritional de!iciencies, damae to the blood2brain barrier, lo# antio1idant
potential, and chronic 'NS in!ection. 9inally, the disease mani!ests in a series o!
e1acerbations, usually induced by acute in!ections, turnin into a proressive, non2
remittin disease #hen and i! the immune system loses its ability to #ithdra# the
antimyelin attac3 or #hen other processes (such as accumulation o! o1idiHed !ats)
continue to damae myelin. While this scenario may need to be updated some#hat as
additional in!ormation is ac&uired, it is su!!icient to suest several methods o!
therapy, some o! #hich have already provided help to persons #ith MS.
;e!ore turnin to the 'hinese medical analysis o! the disease, it is #orth
mentionin some other diseases that have related characteristics. Since MS is not a
!re&uent disease in 'hina, e1perience treatin several other disorders that have
muscular #ea3enin and autoimmune processes in common, may help to add to our
3no#lede o! success!ul approaches. Myasthenia ravis (M8) produces symptoms o!
muscular #ea3nessF li3e MS, it is insidious, variable, and potentially !atal (in the
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proressive !orm o! the disease). M8 appears to be initiated by a virus, but the site o!
attac3 by the activated "2cells is di!!erent than #ith MS4the acetylcholine receptors
o! the nerves are a!!ected. "he motor neuron deenerative diseases also share some
similarities #ith MS. In one, amyotrophic lateral sclerosis (A7S), the muscular
#ea3ness usually beins in the hands and spreads to the !orearms and les. "his is
accompanied by (and o!ten preceded by) spasms and increased tendon re!le1es. "he
site o! autoimmune attac3 appears to be mainly the anterior horns o! the motor
neuronsF the brain !unctions are not a!!ected. nli3e MS and M8, it does not o!ten
display e1tended periods o! remission, rather, it tends to proress rapidly, o!ten
leadin to death #ithin C= years. A more benin !orm o! this disease is proressive
spinal muscular atrophy, #hich causes muscle #astin and #ea3ness, but does not
cause sini!icant shortenin o! li!espan.
':INESE MEDI'A7 ":E/IES
In the most ancient 'hinese medical te1ts, and in many subse&uent #or3s, there aresome re!erences to diseases #ith symptoms o! muscular #ea3enin. "hese are
calledweizheng0 !laccidity syndromes. "here are !our basic causes o!, or contributors
to, the development o! these syndromes0
*. A !everish disease (no# understood to be caused by an in!ection in most cases)
damaes the nutritive essences that supply the muscles and tendons Knote0 in
'hinese traditional anatomy, the terms o!ten re!er to !unctions more than to
isolated tissues. "he tendons $aid in controllin movements.%L
@. /ran dys!unctions result in poor nutrition or in inhibited circulation, thus denyinnutrition to the destination tissues.
6. Spiritual e1haustion reduces the communication bet#een the mind and body,
a!!ectin sensation, movement, and mental clarity.
?. Adverse dietary !actors can lead to #ea3ness o! muscles and la1ness o! tendons,
and they can e1acerbate de!iciency o! essence.
In theHuangdi Neijing Suwen, (+) the problem o! muscular !laccidity receives an
entire chapter. "he basic ideas, larely retained since ancient times, have beenelaborated recently in the Advanced Text!!" !# T$ad%t%!na& C'%ne(e Med%c%ne
and P'a$)ac!&!*+ (*-). "he eneral problem is described as bein due to a disorder
a!!ectin one o! the !ive internal oran systems (zang). "hus, there are !ive types
o! wei (!laccidity) syndromes. "hree o! these miht be o! interest in reard to diseases
such as M8, MS, and A7S.
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Maiwei (vessel !laccidity, associated #ith the heart system) is described as muscular
atrophy and debility o! the lo#er limbs caused by patholoic heat o! the heart,
$empty% blood vessels, and malnutrition o! the muscles o! the lo#er limbs.
Rouwei (muscle !laccidity, associated #ith the spleen) has symptoms includin
sensory disturbance o! the s3in, and atrophy, !laccidity, and debility o! themuscles. "he syndrome is due to pathoenic heat and dampness invadin the spleen
#ith impairment o! stomach yin.
uwei (bone !laccidity, associated #ith the 3idney) is caused by severe e1haustion o!
3idney yin and essence #ith accompanyin de!iciency !ire that causes atrophy and
!laccidity o! the muscles o! the lo#er limbs and #ea3ness o! the spine that ma3es it
impossible !or people to support themselves in an upriht position.
"he modern te1ts ma3e some sliht rearranements o! the cateories, !or e1ample0
liverJ3idney #ea3ness is presented as a sinle cateory, rather than t#o cateories. Acombination o! the liverJ3idney and spleen types is probably closest to depictin MS
and other neuromuscular disorders that a!!ect the lo#er limbs !irst.
"he wei syndromes #ere described as bein initiated by pathoenic heat (or damp2
heat, the combination o! t#o adverse in!luences) and display their symptoms o!
muscular #ea3enin as a result o! !luid and nutrient de!iciency (e.., lun !luid
dryness, empty blood, stomach or 3idney yin de!iciency). "he t#o
other wei syndromes, a!!ectin the tendons (liverF causin contracted liaments) or the
s3inJhair (lunF causin crac3ed and brittle s3in, paralysis o! e1tremities), are also
thouht to be initiated by heat !ollo#ed by impairment o!!luids. "heNeijingemphasiHes that lac3 o! nourishment in the channels (meridians)
and in the muscles is the principal cause o! the !laccidity. "he 'hinese concept o!
nourishment is broader than that identi!ied in modern terminoloy as essential !ood
components, because it includes several o! the metabolic products o! the !ood
components (!or e1ample, hormones enerated !rom precursors) and their entry into
destination tissues (promoted by local microcirculation). "o remedy the problem
usin acupuncture (the main therapy mentioned in theNeijing), one toni!ies the
de!iciency by usin the sprin points (rong) on the meridians and promotes the !lo#
o! nutrients and enery throuh the meridians by treatin the stream points (shu)0
$"his !orti!ies the de!icient, and restores order to #hat is rebellious.%
"he traditional means o! treatin !luid impairment is to nourish blood and
essence. "here are several herbs classi!ied as blood and essence tonics. In addition, &i
tonics #ill help enerate the essential !luids !rom !oods. 'onnectin to the Western
conception o! the disease, the initiatin in!ections !or MS and !or its e1acerbations
may involve a !ebrile syndromeF the imbalance that results miht be destruction o!
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!luids (the myelin sheath bein a !luid !atty membraneF its &uality is similar to that o!
essenceF the brain and spinal cord are understood, by the concepts o! traditional
'hinese medicine, to be an e1tension o! the 3idney system, the storehouse o! the
essence).
An alternative traditional description o! !laccidity syndrome4#ith similarconclusions4in presented in an article about treatin one patient #ith MS (**). "he
doctors, hou and 7u, pointed out that ancient scholars believed the loss o! sensations,
one o! the common MS symptoms, is related to the!o (primitive instinctF one o! the
$souls% described in 'hinese medicine). "he!o is overned by the spirit (shen)
#hich subsists on the essence ("ing). uotin !rom theHuangdi Neijing Lingshu0
$"he!o enters and e1ists #ith the essence...spiritual e1haustion scatters the soul and
the!o.% Gursuin this line, the authors state0
"he 3idney houses the essenceF the brain is the mansion o! the oriinal
spirit. Disorders o! the spirit are usually related to a de!iciency and damaeo! 3idney essence #hich results in malnourishin o! the brain. An
insu!!iciency o! oriinal spirit in turn a!!ects the !unction o! the !o. "he
mani!estations o! pain and soreness o! the bac3, atrophic #ea3ness o! the
les, looseness o! the lo#er passes (colon and bladder), and a sin3in,
thready, #ea3 pulse con!irm the dianosis o! 3idney de!iciency #ith
damae to the essence. Goor memory and insomnia sho# an insu!!iciency
o! the sea o! marro# (brain).
"he 3idney essence is the most re!ined o! the body !luids reconiHed by traditional
doctors. It is a substance that is, in part, present at birth (perhaps correspondin to theenetic material) and is, in part, replenished by re!inement o! nutritious
!ood. E1posure to cold, e1cessive e1perience o! !ear, overindulence in se1ual
activity, !rustration !rom not bein able to !ul!ill ones #ishes, over2tiredness !rom
travelin in conditions o! severe heat, consumption o! too much salt, and physical
in>ury to the internal orans are causes o! 3idney #ea3ness cited in traditional
literature. /ther causes may include traumatic in>ury to the internal orans, e!!ects o!
invasive surery, chemical damae to the endocrine system, and chronic in!ections.
Dietary causes o! !laccidity are usually described in terms o! e1cessive inta3e.
Aside !rom e1cessive consumption o! salt damain the 3idney system, too much sour!ood is said to cause muscular la1ity, and too much s#eet !ood #ea3ens the !unctions
o! the spleen, the oran system that is most essential to the nourishment o! the
muscles. "oo much spicy !ood #ill cause !urther damae to depleted yin and
essence. "here!ore, diet is important to avoidin development o! !laccidity
syndromes or to counteract a disease #hich produces !laccidity.
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;ASI' :E;A7 ":EAG< 9/ 97A''IDI"< S
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the yin, and phellodendron and anemarrhena to clear de!iciency !ire. "o ma3e#u
$ian %an, one adds certain to this basic !ormula several inredients to treat the
speci!ic mani!estation !or #hich the !ormula #as intended0 #ea3ness o! the lo#er
bac3 and 3nees, !laccidity o! muscles and bones, and di!!iculty #al3in. "he 3ey
additions are tiers bone (no# replaced by other bones) and cynomorium. "iers
bone is said to treat #ea3 and so!t sine#s and bones, and #ea3ness o! the 3nees and
les caused by de!iciency o! liver and 3idney. 'ynomorium has the same uses, and is
also indicated !or e1haustion o! body !luids. "hese t#o herbs trans!orm the basic
treatment !or yin de!iciency into a treatment !or !laccidity a!!ectin the lo#er bac3
and les. /ne o! the aims o! the !ormula is to alleviate #ea3ness o! the tendons, #hich
is deemed the main reason that there is di!!iculty in #al3in. Geony is added to the
prescription to enhance the action o! rehmannia in nourishin the liver, so as to
bene!it the livers associated tissues4the tendons. 'itrus and dry iner are added to
aid the stomach in diestin the combination o! rehmannia and cynomorium, #hich
are &uite rich and heavy in nature.
#u $ian %anis sometimes e1tended #ith tan23uei, achyranthes, and mutton (a
recommendation !rom a *Bth century te1t), usually !or cases o! severe blood
de!iciencyF other variations are prepared by addin yan tonics (in #hich case
anemarrhena and phellodendron may be removed) or &i tonics. "he usual preparation
method is to combine the herbs round up to po#der and honey to ma3e + ram pills
(about = rams o! the herbs per pill). It is ta3en one pill each time, @6 times daily
(*@* rams o! the herbs per day).
"he prescription that #as initially iven to the patient described by hou and 7u
#as a modi!ication o! another traditional !ormula used !or !laccidity0Dihuang 'in(i(ehmannia 9ormula !or Garalysis), a decoction containin rehmannia, cornus,
schiHandra, polyala, acorus, morinda, cistanche, aconite, cinnamon bar3, hoelen,
ophiopoon, and dendrobium. It nourishes the yin, but also revitaliHes the yan. "he
modi!ied !ormula #as ta3en daily by the MS patient !or more than three months. As a
!ollo#2up,#u $ian %an #as administered in con>unction #ith the Dihuan
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addin astraalus. "he !ormula toni!ies &i, yin, and yan. "reatment time #as t#o
months and radual normaliHation o! limb movements ensued.
A !ormula !or treatin wei syndrome #as developed by :u3ui 9utei in apan,
based on#u $ian %an (@B). It is called %ei (heng )ang(9laccidity Syndrome
9ormula) and is made #ith rehmannia, anemarrhena, phellodendron, peony, tan23uei,achyranthes, atractylodes, astraalus, and eucommia. It has been used in apan !or
treatin disorders such as multiple myelitis, polio, and paralysis due to beriberi. Dr.
Domei
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on #ays to evaluate the immunoloical aspect o! MS. 'itin traditional literature, the
authors state0
With the stationin o! enuine &i in the interior #atchin over the spirit,
sic3ness is unable to intrude...the rihteous &i is enerated, trans!ormed,
and supplied by the essence o! !luid and rain. When the spleen is!lourishin, the e1ternal evil is unable to enter the body. "he spleen is the
material source o! the bodys de!ense mechanism. "hus the !lourishin or
deeneration o! the spleen !unction #ill re!lect the strenth or #ea3ness o!
the bodys immune system.
"hezheng*i (translated as enuine or rihteous &i) is the uardian o! the bodys
health and the reulator o! the immune system. Since &i tonic herbs are the basis o!
prescriptions !or promotinzheng*i, these comments spea3 in support o! the use o! &i
tonic therapies !or autoimmune disorders. :o#ever, the authors continue0 $Pidney yin
and yan are the 3ey !actors in the reulation and balancin o! yin, yan, &i, blood,and all the bodys immune mechanism. "he visceral orans throuh their mutual
dependence and restriction !ollo# the rule0 e1treme damaesF balance stabiliHesF
stabiliHation allo#s eneration. Groper reulation o! the normal immune response is
thus achieved Kthrouh balanceL.% Such statements arue !or the use o! 3idney
(essence) nourishin herbs and !ollo#in a balanced li!e style, in treatin
autoimmunity. $i in e1cess may inhibit or override, as stated in the 9ive Element
"heory. "he end result is the creation o! an imbalance o! the immune reulation, thus
eneratin autoimmune diseases. Accordin to the authors observation, there may
appear in the course o! an autoimmune disease symptoms o! de!iciency, e1cess, or a
combination o! de!iciency and e1cess.% "hus, #hile de!iciency o! &i and essence may!orm the basis o! autoimmunity, at certain times in the development o! autoimmune
diseases, treatment o! e1cess (accumulation) may be o! importance.
Mury o! the spleen and stomach involvin
both the liver and 3idney. "his causes stasis o! &i and blood, lac3 o! trans!ormation o!
!luid, obstruction o! the meridians and luovessels Kmeridians,"ing, are enerally
distributed vertically and run throuh the deep tissuesF connectin branches, luo, are
distributed horiHontally and super!iciallyL, and a decreased ability to move the
liaments and bones.% "he authors state that !avorable results have been obtained
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usin lare dosaes o! herbs. In addition to 8insen and Astraalus 'ombination,
they recommend 'innamon and Aconite 'ombination, Gill o! iht estoration, and
9orti!ied Gill o! ;uddhas Warrior AttendantF these latter !ormulas all contain 3idney
tonic herbs and have a #armin action that helps to overcome stanation. 9or another
case, characteriHed by $ma1imum depletion o! the spleen and 3idney, and indissoluble
phlem and turbidity, the recommended treatments #ere lare dosaes o! Saussurea
and 'ardamon 'ombination to inviorate the spleen and clear a#ay the
dampness, and the 3idney toni!yin ehmannia Eiht 9ormula, in addition to the
previously mentioned prescriptions. A specially2modi!ied !ormula made #ith
astraalus, codonopsis, atractylodes, aconite, cinnamon bar3, rehmannia (ra#),
dioscorea, cornus, hoelen, lycium !ruit, deer antler elatin, and morinda #as said to
have produced dramatic e!!ects a!ter !i!teen days o! treatment (this is !ollo#in
treatment #ith the other prescriptions).
In the boo3 T'e T$eat)ent !# n!tt+ D%(ea(e( -%t' C'%ne(e Ac/nct$e and
C'%ne(e He$a& Med%c%ne (*C) Shao Nian!an divides M8 treatments into t#o basiccateories0 de!iciency o! spleenJ3idney (#ea3 cateory) and damp2heat (stron
cateory). "he de!iciency type, especially #ith &i and yan de!iciency, is said to be
the most commonly2observed, clinically. ecommendations !or treatin de!icient
patients include use o! a lare dosae o! astraalus and inclusion o! chih2shih (#hich
#ill clear phlem2damp obstruction). 9or yan de!iciency patients, the use o! aconite
is help!ul and the amount should be lare (6-=- rams, boiled !or t#o hours).
In eneral, accordin to Shao, !or M8 o! the de!iciency syndrome type, one can
use patent medicines such as&uzhong 'i*i %an(8insen and Astraalus
'ombination),)uzi +izhong %an (Aconite, 8insen, and 8iner 'ombination),#u$ian %an,in Suo u ing %an (7otus Stamen 9ormula), andRenshen ian!i
%an (8insen Stomachic Gills), or a decoction made #ith insen, atractylodes,
astraalus, platycodon, lycium !ruit, aconite, cimici!ua, bupleurum, pueraria, tan2
3uei, ma2huan, and licorice (8insen and Astraalus 'ombination modi!ied). "he
dosae o! the herbs is !rom = rams (licorice) to =- rams (astraalus) each, #ith a
total o! about @-- rams !or a one day dose. 9or yan de!iciency patients, one can
add cinnamon bar3 and deer antlerF !or yin de!iciency patients, one can add #u $ian
%an to the treatment.
9or the damp2heat type, it is suested to use the patent medicines, suchas+ongdan -iegan %an (8entiana 'ombination) or'angyin $ingfei %an, or the
decoction o! atractylodes, phellodendron, scute, dioscorea, stephania, coi1, peony,
chaenomeles, lehnia, sil3#orm e1crement (San Miao Sanmodi!ied). "he dosae o!
herbs is !rom *- rams (phellodendron, scute) to 6- rams (coi1) #ith a total daily
dose o! about *C- rams.
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'itin a case study o! early onset o! M8, Shao describes a youn man #ith !our
limbs so !laccid and #ea3 that he could not hold somethin in his hands, nor could he
#al3. :e #as dianosed as su!!erin !rom de!iciency o! central &i !ollo#in an acute
illness #ith !ever. :e #as iven a decoction o! atractylodes, pueraria, licorice, chih2
shih, and tan23uei. A!ter !ourteen days there #as some improvement, and the
!ormula #as modi!ied by addin lycium !ruit, ho2shou2#u, aconite, and
achyranthes. "reatment #ith this modi!ied !ormula #as !ollo#ed !or thirty days, a!ter
#hich there #as sini!icant reduction o! symptoms. 9inally, the patient #as iven
8insen Stomachic Gills and ehmannia Eiht 9ormula daily. A !ollo#2up t#o years
later sho#ed that recovery #as complete.
7i 8enhe (*=) recommended that the treatment o! M8 !ollo# the principle o!
toni!yin the spleen and 3idney. 9or spleen de!iciency, the 8insen and Astraalus
'ombination #as used #ith optional additions o! polyonatum, dioscorea, dolichos,
and placenta. 9or spleen de!iciency complicated by 3idney yin de!iciency, the
Decoction o! 7e!t estoration plus astraalus, atractylodes, and codonopsis #as used(optional additions #ere ho2shou2#u, ophiopoon, peony, elatin, and placenta). 9or
spleen de!iciency complicated by 3idney yan de!iciency, the Decoction o! iht
estoration #ith eucommia replaced by deer antler, and #ith the addition o!
astraalus, codonopsis, and tan23uei #as used (optional additions #ere cynomorium,
morinda, psoralea, eucommia, loranthus, and placenta). 7i noted that common cold
and bronchial in!ection (e.., pneumonia) #ere predisposin !actors !or e1acerbations.
While steroids could be e!!ective at that time, use o! 'hinese herbs #as help!ul in
supportin the enery o! the body and strenthenin resistanceF he recommended
usin insen, ec3o, rehmannia, a&uilaria, placenta, oyster shell, and licorice.
'7INI'A7 "IA7S IN ':INA
*. Multiple Sclerosis
"he larest study (*B) o! 'hinese medical treatment !or MS #as carried out by 7u Oi
and Wan
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$ian %an. Each herb is used in a dosae o! *-*@ rams per day, e1cept licorice
(C rams).
@. Spleen2stomach #ea3ness0 astraalus, salvia, codonopsis, atractylodes, hoelen,
pinellia, citrus, >u>ube, and licorice. "his is a modi!ication o! the traditional Ma>or
Si1 :erbs 'ombination (+iu unzi Tang) #ith astraalus and salvia added. Eachherb is used in a dosae o! *C rams per day, e1cept >u>ube (*@ pieces) and
licorice (? rams).
6. i and blood stasis syndrome0 astraalus, codonopsis, salvia, rehmannia (ra#),
peony (red and #hite), bupleurum, tan23uei, scute, cnidium, pinellia, and
licorice. "his !ormula combines Minor ;upleurum 'ombination (-iao /haihu
Tang) #ith three herbs !or promotin blood circulation4salvia, peony (red and
#hite), and cnidium4plus astraalus. Each herb is present in the amount o! +*C
rams per day, e1cept licorice (? rams).
?. Damp2heat syndrome0 chin2hao, talc, peony, scute, bupleurum, bamboo, a3ebia,
hoelen, chih2shih, pinellia, rhubarb, >u>ube. "his !ormula is similar to treatments
!or !ebrile diseases described in previous centuries, such as the 'hin2hao and
Scute 'ombination (#ao in $ingtan Tang). Each herb is present in the amount o!
*@ rams, e1cept >u>ube (*@ pieces).
"he !ormulas #ould be modi!ied !or certain presentin symptoms. 9or e1ample,
!or urinary incontinence, add cuscuta, alpinia, and rose !ruitF !or constipation, add ho2
shou2#u, persica, cistanche, and rhubarbF !or mental !oiness, add schiHandraF !or
abdominal distention, add manolia bar3 and chih2shihF !or muscular atrophy, addtan23uei, elatin, and dipsacus.
"he decoctions #ere consumed as a coolin drin3 (rather than hotF because many
MS patients have an aversion to heat), once per day. Anti2in!lammatory Western
drus (de1amethasone or prednisone) #ere iven durin acute active periods. "hirty2
!ive patients #ere treated and e1cept !or three that discontinued treatment #ithin the
!irst ten days, some improvement #as !ound. "#o cases #ere deemed basically cured
a!ter ta3in ?C and = dosesF *C #ere mar3edly improved and another *C some#hat
improved, most o! them ta3in @-?- doses. Eleven o! the patients had tried
corticosteroids unsuccess!ully be!ore s#itchin to the traditional herb combinationsFo! these, seven #ere mar3edly improved, three improved, and only one !ailed to
respond.
"hese researchers !ollo#ed up their #or3 #ith an attempt to prevent e1acerbations
(*). "hey prescribedPing )u Tang (Gaci!y elapse Decoction) to 6- patients over a
period o! 6*6 years (averae o! = years). "he !ormula contained astraalus,
codonopsis, hoelen, atractylodes, pinellia, licorice, >u>ube, bupleurum, scute, tortoise
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shell, liustrum, tan23uei, peony, ophiopoon, rehmannia, lycium, and
anemarrhena. "he prescription basically has the e!!ect o! toni!yin &i, yin, and blood,
and clearin de!iciency heat. It can be seen that this prescription is derived !rom the
!irst t#o !ormulas listed in the previous article !or treatment o! multiple sclerosis,
based on de!iciencies o! liver, 3idney, and spleen (it also has some herbs o! Minor
;upleurum 'ombination, as mentioned belo#). "he preventive therapy #as basically
a tonic !ormula. It #as prescribed in the !orm o! a decoction, ta3en in @6 daily
doses, usin *C rams o! each herb (e1cept smaller amounts o! licorice and
>u>ube). Accordin to the researchers, relapses #ere prevented e1cept !or t#o patients
#ho each e1perienced only one minor e1acerbation, each event !ollo#in a viral
in!ection (common cold). A control roup o! MS patients not treated by this remedy
#as monitored !or three years0 they su!!ered !rom e1acerbations at the rate o! *?
times per year.
Ping )u Tang included rehmannia, tortoise shell, peony, and anemarrhena,
inredients o!#u $ian %an, #hich have the !unctions o! nourishin yin and blood andcleansin de!iciency !ire. In addition, they added liustrum, lycium !ruit, and
ophiopoon to nourish yin. A stratey !or nourishin blood and essence is to toni!y
the &i so that more nutrients are obtained !rom the !ood. "he !ormula included
astraalus, codonopsis, hoelen, atractylodes, licorice, and >u>ube to#ards this end
(these herbs also enhance immune !unctions to aid resistance to in!ections that induce
e1acerbations). Since the point o! the treatment #as not to recti!y !laccidity, but
rather to prevent !laccidity by preventin e1acerbations, the herbs !or treatin
!laccidity in the les, such as tier bone and cynomorium !ound in#u $ian %an #ere
not included. Also, as the patients are bein treated continuously #ith the yin2
nourishin tonics, it is not necessary to stronly inhibit de!iciency !ire, sophellodendron is not essential to the prescription (anemarrhena, unli3e phellodendron,
has the secondary property o! bein a yin tonic). "hus, the treatment larely re!lects
the principles o! hu Dan1i in relation to understandin the cause o! a !laccidity
syndrome. "he doctors e1plained that part o! their thin3in in developin the !ormula
#as based on the current understandin o! autoimmunity, #hich e1plains the presence
o! so many &i tonics and the herbs o! Minor ;upleurum 'ombination (-iao /haihu
Tang), such as pinellia, bupleurum, and scute, #hich is believed to be help!ul in
chronic in!lammatory diseases.
I! a "2cell attac3 aainst myelin sheaths is initiated by in!luenHa, common cold,sinusitis, or other in!ections, ability to prevent such in!ections or halt their proress
#ould be one obvious 3ey step in preventin damae due to the usual se&uence o!
events in an e1acerbation. Grotection !rom transmissible viral in!ections, such as
stayin a#ay !rom those #ho are currently su!!erin !rom the in!ection, is one method
o! prevention. Enhancin the immune system !unctions #ith tonic herbs is another
method. Many Westerners are led to believe, by poorly #ritten articles on immune
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disorders, that enhancin immune system viilance #ould #orsen any autoimmune
diseaseF ho#ever, this #ould only be a potential problem durin an e1acerbationF even
then, other components o! the immune system that help to shut2do#n the autoimmune
attac3 may be coa1ed into activity #ith proper immune2reulatin herbal treatment
strateies.
@. Amyotrophic 7ateral Sclerosis and Groressive Spinal Muscular Atrophy
'ase studies o! A7S #ere reported by 7in "onuo (*+). In one case, the primary
!ormula combined tonic herbs0 astraalus, tan23uei, peony, rehmannia, aconite,
cinnamon bar3, and lycium !ruit, #ith several herbs used to promote circulation o!
blood and relieve spasms (the spasms bein a sini!icant problem in many cases o!
A7S)0 centipede, scorpion, persica, carthamus, morus t#i, and clematis. "hese herbs
#ere made as a decoction ta3en in divided doses three times daily !or several days. In
addition, a small amount o! po#der made !rom strychnos and mus3 (-.@C rams o!
each, three times daily) #as iven. As !ollo#2up, the decoction !ormula #as modi!ied(cnidium, platycodon, chih23o, tier bone, deer antler, and Haocys #ere addedF morus
t#i and clematis #ere deleted) and made into pills instead o! decoction, to be ta3en
* rams per day4the mus3 and strychnos po#ders #ere included in the pills. "he
pills #ere ta3en !or t#o years until the disease #as resolved. A !ollo#2up a!ter three
years #ith no !urther medication sho#ed that the disease had remitted. A similar
approach #as used #ith a second patient #ho consumed a decoction made #ith
astraalus, atractylodes, cinnamon t#i, tan23uei, persica, carthamus, centipede,
eupolyphaa, !enuree3, aconite (chuanwu), licorice, and Haocys. A!ter usin this
decoction !or several days, the pill described above #as used !or lon2term
medication and a clinical cure #as obtained, #ith a !ollo#2up a!ter !ive years
con!irmin the satis!actory result.
"he third case emphasiHed treatment o! yin de!iciency !ire, usin a decoction #ith
phellodendron, ra# rehmannia, moutan, alisma, anemarrhena, hoelen, stephania, coi1,
chin2chiu, dipsacus, achyranthes, centipede, and scorpion. "his decoction #as iven
!or more than t#o months and then modi!ied, ta3in out stephania, coi1, and chin2
chiu, and addin dipsacus, deer antler, epimedium, tan23uei, cnidium, and
carthamus. "his !ormula #as then used !or more than three months. 9inally, the
above2mentioned pill #as aain used !or lon2term therapy, and a cure #as obtained,
#ith no relapse by the end o! t#o years #ithout the medication.
In a report by Pan
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antler, eucommia, atractylodes, astraalus, psoralea, malt, crataeus, pinellia,
codonopsis, sinapis, hoelen, alisma, chaenomeles, achyranthes, and cinnamon t#i !or
a yan de!iciency case #ith #ea3 diestion and phlem accumulation. "reatment
time #as si1 months and included acupuncture and massae therapy. 7on2term
!ollo#2up sho#ed persistin bene!its o! the treatment, #ith normal nerve conduction
and physical activities.
In a study (@*) o! *C patients #ith proressive A7S, a sini!icantly e1panded
version o!#u $ian %an #as employed. "his contained astraalus, epimedium, deer
antler, synnathus, sea horse, insen, tortoise shell lue, tan23uei, peony,
rehmannia, lycium !ruit, eucommia, dipsacus, cuscuta, cynamorium, atractylodes,
coi1, citrus, achyranthes, chaenomeles, chin2chiu, a3istrodon, tier bone, psoralea,
anemarrhena, phellodendron, cinnamon t#i, chian2huo, tu2huo, and siler. "he
!ormula #as based on the traditional prescriptionian &u #u $ian %an (Step
ein!orcin "iers Wal3 Gill). "he pills #ere ta3en in a dosae o! 6+ rams at a
time, @6 times per day dependin on the persons constitution and severity o! thedisease, but #ere not to be used by patients sho#in yin de!iciency !ire
syndrome. "#o o! the patients #ere said to be cured and !ive improved. "he pills
#ere to be used on a reular basis over a period o! several years.
Strychnos is sometimes mentioned as part o! A7S treatments. A muscle2
invioratin combination 3no#n as MobiliHin Go#der may produce temporary
alleviation o! !laccidity. "he combination includes strychnos, mus3, and
centipede. Strychnos in small doses tones the muscles and in lare doses paralyHes
them. It is used in the treatment o! other autoimmune disorders, includin M8 and
rheumatoid arthritis. n!ortunately, this herb cannot enter into Western treatments !orautoimmune diseases because o! concerns over the to1icity o! strychnine, one o! the
main active components.
A lare scale study o! proressive spinal muscular atrophy (- cases) and A7S (6-
cases) #as described by :uo
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claimed positive results, ranin !rom a hih proportion o! persons #ith mar3ed
improvements to a substantial number o! cases declared cured, #ere o!ten a
conse&uence o! treatin patients #ith di!!erent !ormulas accordin to dianostic
cateories and #ith chanes in prescription durin the !irst !e# #ee3s or months o!
therapy. "oni!ication o! spleen, 3idney, and liver are the prominent methods o!
therapy. It #as common to combine decoctions and pills, and to use pills as lon2term
therapy, #hich sometimes lasted !or t#o years. In some cases, acupuncture, Western
medicine, and other therapies #ere said to be used0 undoubtedly, in most trials the
patients received the therapeutic interventions that the physicians !elt #ere necessary
#ithin the limitations o! #hat could be o!!ered.
AMEI'AN GA"IEN"S WI": MS
Accordin to clinicians #or3in at the I"M clinic, dianosis o! American patients
su!!erin !rom multiple sclerosis reveals the presence o! yin de!iciency, but relatively
little e1perience o! the yin de!iciency !ire. ather, these individuals have a reatertendency to display sins o! #ea3ness o! the stomach !unctions and some de!iciency
o! 3idney yan. "his apparent di!!erence bet#een these !indins compared to the
e1planation o! le !laccidity by hu Dan1i may be related to several !actors. 9or
e1ample, MS is more common in the colder northern reions, #here yan de!iciency
is more prevalent, #hile hu observed patients in southern reions #here yan
de!iciency is less common. "he cause o! the disease, thouh comple1, appears to be
in!ectious aents and autoimmune process, rather than debilitatin li!e style (thouh
li!e style !actors could contribute to disease initiation and proression), #hich #as the
dominant concern in hus time. "he Western diet may help to limit de!iciency !ire
syndrome, but miht #orsen stomach problems. Malabsorption in MS patients has
been noted !or !ats, vitamin ;*@, and d21ylose, and lo# :'l levels may be responsible
!or limited diestion o! meats (@). In 'hina, lo# :'l levels #ere noted in patients
#ith M8 (@+), and the lo#est levels #ere closely associated #ith re!ractoriness to
treatment.
DIE"A< AND N"I"I/NA7 '/NSIDEA"I/NS0 EAS" AND WES"
Grovidin ade&uate nutrition is considered critical in the traditional description o!
!laccidity syndrome. "o treat essence de!iciency, 'hinese doctors recommend that
certain !oods be eaten, includin duc3, abalone, pi 3idney, liver, lotus seeds, rose
hips, and #alnuts (@+).
As mentioned earlier, avoidin certain !oods is also a consideration o! traditional
'hinese thin3in. ;lac3 pepper is to be avoided in cases o! muscular
#ea3ness. ecently it #as sho#n that a component o! pepper inhibits convulsions and
it may have a mild inhibitory action on muscular contraction. 'innamon, #ith its 3ey
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component cinnamaldehyde, should be avoided in persons #ith MS, as the aldehydes
may already inhibit nerve transmission. "hese t#o herbs are #arm and spicy in
nature, and #ould be limited by the prevailin 'hinese theory that spicy herbs can
#orsen yin de!iciency. 'innamon is used in some treatments o! !laccidity, but miht
be more suitably replaced by other herbs that accomplish the same therapeutic oal,
such as cynomorium, morinda, or dry iner.
Inestion o! essential !atty acids and EGA !rom !ish oil appears to be o! some aid
in treatin autoimmunity in eneral (?). 9atty acids and !ish oil supplementation may
correspond to toni!yin the yin, based on 'hinese dietary
recommendations. Avoidance o! Hinc or use o! Hinc2chelatin aents also reduces
some autoimmune responses (*), thouh Hinc de!iciency can lead to easier e1perience
o! viral in!ections that activate MS attac3s.
"ortoise shell (rich in elatin) and deer antler elatin are included in several
prescriptions !or treatment o! !laccidity o! the les. 8lycine is a ma>or component o!elatin, #hich is classi!ied by 'hinese doctors as a blood and yin tonic. "he amino
acid lycine has been recommended !or persons #ith MS since it counteracts
aldehyde accumulation and has antispasmodic properties (daily dosae is about 6
rams per day).
Since *+C-, it has been proposed that a diet lo# in saturated !ats may bene!it some
MS patients, and a clinic at /reon :ealth Sciences niversity, !ormerly run by Dr.
oy S#an3, pro!essor o! neuroloy, has specialiHed in this area o! treatment !or
several years. :e recommends no more than *- rams o! saturated !at per day, #hich
basically yields a veetarian diet supplemented by !ish (three or more times per #ee3Fthe !ish oils are considered bene!icial as are polyunsaturated oils). Many persons !ind
this diet to strict to be practical. :ih levels o! polyunsaturated oils may increase
o1idative stress, and so should be countered by ta3in antio1idants.
itamin ;*@is !ound primarily in animal !oods and is also present in #alnuts. "his
vitamin may contribute some o! the essence2toni!yin properties o! !oods
recommended by 'hinese doctors. A number o! reports o! vitamin ;*@de!iciency in
some MS patients has led to the use o! this vitamin in treatment o! those #ho are
!ound to have lo# ;*@either in the serum or the cerebrospinal !luid. 7o# vitamin
;*@ levels #ere !ound to be associated #ith earlier onset o! disease symptoms and
#ere reduced by corticosteroid administration (6). :o#ever, it may be the
unsaturated ;*@bindin capacity that is more o!ten lo#, even i! total ;*@levels are
normal (6+). When patients #ith chronic proressive MS #ere iven = m o! oral
;*@every day !or si1 months, there #ere improvements in visual and brainstem
auditory evo3ed potentials. Since MS patients are li3ely to have poor ; *@upta3e,
;*@is o!ten iven by in>ection, #ith doses up to * m each time.
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S"EGS "/ "APE IN "EA"MEN"
"o !ollo# 'hinese medical theories and e1perience in treatin MS, M8, A7S, and
other !laccidity syndromes, one #ould underta3e the !ollo#in0
*. Eat a diet that is nourishin to the spleen, 3idney, and liver, especially #ithessence2toni!yin !oods (this #ould include various beans and seeds, meats,
sea!oods, and mildly astrinent !ruits). Avoid e1cessive amounts o! sour, spicy,
and salty !oods. 'onsider use o! nutritional supplements #ith selenium, calcium,
vitamin ;*@, antio1idants, and essential !atty acids. Also consume elatin or a
lycine supplement (6 rams per day), especially in cases #here muscle spasms
occur.
@. 'onsume herb !ormulas that match the particular mani!estation o! symptoms and
sins reconiHed by traditional medical theory. De!iciency is to be nourishedF
obstruction, overcomeF and e1cess, drained. In cases o! de!iciency syndrome(#hich appear to be the most common), consider the use o! substantial doses o!
tonic herbs, and ive special attention to the need !or yin or yan tonic
aents. Anti2in!lammatory drus may help limit the damae to myelin i! their use
is initiated early in an attac3, but they may have little bene!it the rest o! the
time. Immune2reulatin drus, such as betaseron, can be tried i! the herb
therapies !ail to produce ade&uate reulation.
6. Avoid viral in!ections (and other in!ections) by minimiHin e1posure to in!ected
persons and to potentially harm!ul environmental conditions (e.., chill). "a3e an
antiviral herb combination #hen an acute viral attac3 is suspected. "reat allin!ections promptly, #hether usin herbs or drus.
?. tiliHe practices that evo3e spiritual re>uvenation. "raditional 'hinese e1ercises,
such as $i ong and Tai i $uan may be help!ul in strenthenin the normal &i,
bene!itin the 3idney, and calmin the spirit. "hey also improve muscle control
and balance.
C. se acupuncture to inviorate circulation o! &i and blood in the limbs and to
restore nervous system connections. Scalp acupuncture has proven help!ul in
treatin disorders o! the central nervous system, includin MS (?-). Dr. 'henelin and 'hen Mei!an in the boo3 A C!)/$e'en(%ve G%de T! C'%ne(e He$
Med%c%ne (?*), recommend the !ollo#in body points !or !laccidity syndrome (6
? points should be selected !or each daily or every other day treatment !or *-
days)0
9laccidity o! the arms0 8 ?, *@F 7I **, *CF SI ?, +F "; C, ;7 **.
9laccidity o! the les0 8 @, 6F ;7 CB, =-F 8; 6-, 6*, 6?, 6+F SG =, +F S" 6=
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=. Ne# Western medical approaches should also be considered. ecent research
suests that it may be possible to selectively inhibit the autoimmune attac3
aainst myelin usin a "2cell receptor ("') peptide dru that does not de!eat the
entire immune system but rather bloc3s the attac3 by matchin the basic protein on
myelin that binds the "2cells. Initial tests in animals #ith e1perimental alleric
encephalymyelitis, a model !or MS, sho#ed ood results, and clinical tests in a
small number o! patients have yielded promisin outcomes (?@). I! success!ul, the
same basic method, usin a di!!erent peptide, miht be use!ul !or other
autoimmune disorders, such as M8. "he drastic inhibition o! immune !unctions,
#hich is possible #ith currently2available drus, such as hih dose corticosteroids
or cyclosporin, should only be considered as an emerency measure. 'hinese herb
drus that inhibit acetylcholinesterase, such as huperHine A and !ordine, have been
used #ith some success in treatin myasthenia ravis in 'hina.
B. Garents #ho have MS should ta3e special care to ma3e sure that their children et
ade&uate nutrition, have vaccinations aainst common preventable diseases, and
ta3e steps to avoid e1cessive e1posure to in!ectious and parasitic aents. "heir
children have an increased ris3 o! disease due to enetic !actors, so that e1tra care
may be needed to avoid development o! the disease.
A'PN/W7ED8MEN"S
Several 'hinese lanuae articles #ere translated by 9u PeHhi in :arbinF Den
hon>ia, throuh literature research, provided an article onPing )u Tang, a portion
o! that article #as translated by :einer 9ruehau!, Gh.D., 7.Ac. in GortlandF Dr.
9ruehau! also provided translations o! articles on A7S and proressive spinal
muscular atrophy. ;arry 7evine, 7.Ac. in Nor#ood, Massachusetts, provided several
abstracts and articles on the Western medical analysis o! MS and its treatment. "he
MS 9oundation in 9ort 7auderdale, 9lorida provided !undin !or treatments o! MS
patients at the I"M clinic.
E9EEN'ES
*. Wa3sman ;,Multi!le Sclerosis, inPe$(/ect%ve( !n At!%))n%t+ ('ohen I,
Editor), '' Gress *+, ;oca aton, 97.
@. ose , et al., enetic susce!tibility to familial multi!le sclerosis not lin0ed to the
myelin basic !rotein gene, 7ancet *++6F 6?*(C?)0 **B+***.
6. Marshall ,Multi!le sclerosis is a chronic central ner1ous system infection by a
s!irochetal agent, Medical :ypotheses *+F @C0 ++@.
?. Werbach M, Nt$%t%!na& In#&ence( !n I&&ne((, "hird 7ine Gress *++6, "arHana,
'A.
-
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C. 8ay D and Dic3 8,Is multi!le sclerosis caused by an oral s!irochete2 , "he
7ancet *+=F @ (?+)0 BCBB.
=. 8ianani and Sarvetnic3 N, 3iruses, cyto0ines, antigens, and autoimmunity,
Groceedins National Academy o! Sciences SA *++=F +60 @@CB@@C+.
B. aine 'S,Multi!le sclerosis4 T5) re1isited, with !romise, Nature Medicine *++C*(6)0 @**@*?.
. Sommer N, et al., The antide!ressant roli!ram su!!resses cyto0ine !roduction
and !re1ents autoimmune ence!halomyelitis, Nature Medicine *++CF *(6)0 @??
@?.
+. Ni Maoshin, T'e Ye&&!- E)/e$!$0( C&a((%c !# Med%c%ne, Shambala *++C,
;oston, MA.
*-. Wan Shoushen, Advanced Text!!" !n T$ad%t%!na& C'%ne(e Med%c%ne and
P'a$)ac!&!*+, V!&)e III, Ne# World Gress *++=, ;ei>in.
**. hou Oiehai and 7u 7i1iao, The clinical a!!lication of tonifying and benefitingthe 0idney essence in multi!le sclerosis, ournal o! the American 'ollee o!
"raditional 'hinese Medicine *+CF ?0 =C==.
*@. han ianuo, /hronic !rogressi1e s!inal lateral sclerosis, ournal o! the
American 'ollee o! "raditional 'hinese Medicine *+CF ?0 ===B.
*6. :su :
-
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@-. Pan in ournal o!
"raditional 'hinese Medicine *+CF =.
@6.
-
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6C.Ne#combe , 7i :, and 'uHner M7, +ow density li!o!rotein u!ta0e by
macro!hages in multi!le sclerosis !la*ues4 im!lications for !athogenesis ,
Neuropatholoy and Applied Neurobioloy *++?F @-(@)0 *C@*=@.
6=. Mai , Sorensen GS, :ansen ',#igh dose antioidant su!!lementation to MS
!atients. 9ffects on glutathione !eroidase, clinical safety, and absor!tion ofselenium, ;ioloical "race Element esearch *++-F @?(@)0 *-+**B.
6B. han En&in (editor in 'hie!), C'%ne(e Med%cated D%et, Gublishin :ouse o!
Shanhai 'ollee o! "raditional 'hinese Medicine *+, Shanhai.
6. 9re&uin S", et al.,Decreased 1itamin &:;and folate le1els in cerebros!inal fluid
and serum of multi!le sclerosis !atients after high7dose intra1enous
methyl!rednisolone, ournal o! Neuroloy *++6F @?-(C)0 6-C6-.
6+. Pira , "obimatsu S, and 8oto I, 3itamin&:;metabolism and massi1e7dose methyl
1itamin &:;thera!y in a!anese !atients with multi!le sclerosis , Internal Medicine
*++?F 66(@)0 @@.?-. Dharmananda S and ic3ers E, Syno!sis of scal! acu!uncture, S"A" 8roup
Manuscripts, *++=.
?*. 'hen 7 and 'hen M9, A C!)/$e'en(%ve G%de t! C'%ne(e He$a& Med%c%ne,
/riental :ealin Arts Institute *++@, 7on ;each, 'A.
?@. andenbar3 AA, et al., Treatment of multi!le sclerosis with T7cell rece!tor
!e!tides4 results of a double7blind !ilot trial, Nature Medicine *++=, @(*-)0 **-+
***C.
?6. 9lammand 7, et al.,##378 induces I+7:& and T5)7al!ha, but not I+78 in
!eri!heral blood mononuclear cell cultures, ournal o! iroloy *++*F =C0C*-CC**-.
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