The Treatment of Modern Western - Biblio.nhat-nam.ru

RHEUMATOID ARTHRITIS (RA) 487ADDITIONS & SUBTRACTIONS: For jaw impediment, add XiaGuan (St 7), Yin Feng (TB 17), and He Gu (LI 4). For cervicalimpediment, add Feng Chi (GB 20), Wan Gu (GB 12), andTian Zhu (Bl 10). For thoracic vertebral impediment, add Jia Ji(M-BW-35) at the level of involvement. For sacrococcygealimpediment, add Da Chang Shu (Bl 25), Ming Men (GV 4), BaLiao (Bl 31-34), and Wei Zhong (Bl 40). For shoulder impediment,add Jian Yu (LI 15), Tian Zong (SI 11), and Ji Quan (Ht1). For elbow impediment, add Qu Chi (LI 11), Xiao Hai (SI8), Zhou Liao (LI 12), and Shou San Li (LI 10). For wristimpediment, add Wai Guan (TB 5), Yang Chi (TB 4), and WanGu (SI 4). For upper extremity phalageal and metacarpalimpediment, add Bai Xie (M-UE-22), He Gu (LI 4), and HouXi (SI 3). For sacroiliac impediment, add Guan Yuan Shu (Bl26), Xiao Chang Shu (Bl 27), Bai Huan Shu (Bl 30), Huan Tiao(GB 30), Zhi Bian (Bl 54), and Ju Liao (GB 29). For hipimpediment, add Huan Tiao (GB 30) and Yang Ling Quan(GB 34). For knee impediment, add Du Bi (St 35), Xi Yan (M-LE-16a), Qu Quan (Liv 8), and Wei Zhong (Bl 40). For ankleimpediment, choose between Jie Xi (St 41), Shang Qiu (Sp 5),Qiu Xu (GB 40), Kun Lun (Bl 60), Tai Xi (Ki 3), Shen Mai (Bl62), and Zhao Hai (Ki 6) depending upon what channels areinvolved with the site of pain. For metatarsal and lower extremityphalangeal impediment, add Jie Xi (St 41), Gong Sun (Sp 4),Tai Chong (Liv 3), Zu Lin Qi (GB 41), and Ba Feng (M-LE-8).2. WIND DAMP HEAT IMPEDIMENT PATTERNMAIN SYMPTOMS: This pattern is seen in those with theacute, active stage of rheumatoid arthritis. There is jointswelling, pain, heaviness, and restricted movement. Theaffected areas are burning hot to the touch and red to inspection.Coolness makes the pain less. Other accompanyingsymptoms include fever, sweating, aversion to wind, oralthirst but sometimes no desire to drink, possible vomiting,short, reddish urination, a red tongue with thin, yellow fur,and a slippery, rapid or soggy, rapid pulse.NOTE: This pattern is not commonly seen in Western clinicalpractice in its pure form. Commonly, wind, damp, andheat evils complicate spleen vacuity and liver depression patternswhere the damp evils are internally engendered asopposed to externally invading and the heat is due to depressiontransforming heat.TREATMENT PRINCIPLES: Clear heat and disinhibit dampness,dispel wind and free the flow of the network vesselsRX: Bai Hu Jia Gui Zhi Tang Jia Wei (White Tiger PlusCinnamon Twig Decoction with Added Flavors)INGREDIENTS:Shi Gao (Gypsum Fibrosum)30gGeng Mi (Fructus Oryzae) 9-15gZhi Mu (Rhizoma Anemarrhenae)9gGui Zhi (Ramulus Cinnamomi)Huang Bai (Cortex Phellodendri)Cang Zhu (Rhizoma Atractylodis)Nan Xing (Rhizoma Arisaematis)mix-fried Gan Cao (Radix Glycyrrhizae)9g9g9g6g3gANALYSIS OF FORMULA: Shi Gao and Zhi Mu clear heat anddischarge fire. Huang Bai and Cang Zhu together eliminatedampness and heat. Tian Nan Xing dries dampness, dispersesswelling, and stops pain. Gui Zhi frees the flow of the networkvessels and stops pain. Gan Cao and Geng Mi harmonize theother medicinals in this formula and protect the stomachfrom the cold nature of the other ingredients.ADDITIONS & SUBTRACTIONS: For persistent high fever withconstipation, add nine grams each of Da Huang (Radix EtRhizoma Rhei) and Mang Xiao (Natrii Sulfas). For persistenthigh fever without severe constipation, add 15 grams each ofRen Dong Teng (Caulis Lonicerae), Pu Gong Ying (HerbaTaraxaci), and Zi Hua Di Ding (Herba Violae). For alternatingfever and chills, add nine grams each of Chai Hu (RadixBupleuri) and Huang Qin (Radix Scutellariae). For severeswelling of the joints, add nine grams each of Ze Xie (RhizomaAlismatis) and Han Fang Ji (Radix Stephaniae) and five gramsof Mu Tong (Caulis Akebiae). For red macules on the affectedjoints, add 12 grams each of Sheng Di (uncooked RadixRehmanniae), Chi Shao (Radix Paeoniae Rubrae), Dan Shen(Radix Salviae Miltiorrhizae), and Dan Pi (Cortex Moutan).For severe pain, add nine grams of Di Long (Pheretima) and15 grams each of Hai Tong Pi (Cortex Erythiniae) and HongTeng (Caulis Sargentodoxae). For severe thirst, add 12 gramseach of Lu Gen (Rhizoma Phragmitis) and Tian Hua Fen(Radix Trichosanthis). For pain in the upper limbs, add ninegrams of Sang Zhi (Ramulus Mori). For pain in the lowerlimbs, add nine grams of Mu Gua (Fructus Chaenomelis). Forconcomitant qi and blood vacuity, add 15 grams of Huang Qi(Radix Astragali) and nine grams each of Dang Shen (RadixCodonopsitis) and Dang Gui (Radix Angelicae Sinensis). Forconcomitant liver depression, add nine grams each of Chai Hu(Radix Bupleuri) and Bai Shao (Radix Paeoniae Albae). Forliver depression transforming heat, add 12 grams of Zhi Zi(Fructus Gardeniae) and nine grams of Dan Pi (CortexMoutan).ACUPUNCTURE & MOXIBUSTION: Da Zhui (GV 14), Qu Chi(LI 11), He Gu (LI 4), Wai Guan (TB 5), appropriate localpointsANALYSIS OF FORMULA: Bleeding Da Zhui clears heat anddispels wind. Draining Qu Chi and He Gu clears heat fromthe entire body because, “The yang ming channel has lots ofqi and lots of blood.” Draining Wai Guan courses wind andclears heat. Draining the local points frees the flow of thenetwork vessels in the affected area.