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

52ORAL LEUKOPLAKIAOral leukoplakia refers to a thickened area on the mucosal liningof the mouth or tongue which looks like a white patch andhence its name – leuko, white, plakia, patch. Such lesions maybe tiny or as large as a quarter and feel firm, rough, or stiff. Theremay be no subjective symptoms in their early stage. However,there may be sensitivity to hot, spicy foods. Oral leukoplakia arepotentially precancerous lesions that develop on the tongue orthe inside of the cheek as a response to chronic irritation. Thisirritation may be due to rough edges on the teeth, dentures, fillings,or crowns, repeated trauma to the oral region, such as frombiting the inside cheek or lip, smoking or chewing tobacco,especially pipe smoking, eating hot, spicy food, and drinkingalcohol. Although this condition may occur in all ages, it is mostcommon in adults over 60. According to Chinese sources, it ismore common in men than women, 1 although this is not corroboratedin the Western medical literature. Possible contributingfactors include viatmin A and/or B deficiency, deficiencies ofeither male or female hormones, and syphilis. Untreated lesionsare cancerous in approximately 5% of patients. 2 Lesions arecommonly removed by cryosurgery similar to actinic keratoseson the skin which are also considered precancerous. However,new lesions may develop after surgical treatment.Western medical treatment includes the elimination of anyrecognizable irritation, including removal or repair of anyirritating dental appliances. In terms of diet and lifestyle, itmeans elimination of hot, spicy foods and alcohol from thediet and cessation of all tobacco products. If lesions persistafter elimination of all irritants, a biopsy may be performed.As mentioned above, lesions may be removed by cryosurgery.Hairy leukoplakia is a specific, unusual form of this conditionfound only in patients with AIDS and ARC or HIV positivepatients. It consists of fuzzy or hairy white patches on thetongue and, less frequently, elsewhere in the mouth. Theselesions may resemble thrush or oral candidiasis. Hairy leukoplakiais typically one of the first signs of HIV infection.CHINESE DISEASE CATEGORIZATION: This conditionis called kou kong bai ban bing in Chinese, oral cavitywhite patch disease. It is only rarely mentioned in the premodernChinese medical literature. 3DISEASE CAUSES: Bodily weakness due to aging, externallycontracted evils, unregulated eating and drinking.DISEASE MECHANISMS: Due to debility and decline ofspleen and kidney yang due to aging, the membranes in theoral cavity are not warmed and nourished. If cold evils takeadvantage of this vacuity, enter, accumulate, and are not scattered,they may obstruct the free flow of qi and blood to thearea and give rise to this condition. It is also possible for addictionto smoking, alcohol, and hot, spicy food to give rise todampness and heat internally. If damp heat brews and steams,it may attack the oral cavity above. If damp heat lingers and isretained, damp heat may damage both the spleen qi and yinfluids. Thus enduring damp heat may lead to qi and yin dualvacuity. Of course, qi and yin vacuity may also be due simplyto the process of aging. It is also possible for local malnourishmentof the tissues inside the mouth to be due to qi stagnationand blood stasis. The qi does not flow freely to the tissuesof the mouth and thus neither does the blood. Hence thetissues become hard, white, and malnourished.TREATMENT BASED ON PATTERNDISCRIMINATION:1. SPLEEN-KIDNEY YANG VACUITY PATTERNMAIN SYMPTOMS: White patches on the oral mucosa which arestiff and hard with white borders, a relatively long diseasecourse, a bland taste within the mouth, no thirst, a cold bodyand fear of chill, lack of warmth in the four extremities, a paletongue with white fur, and a moderate (i.e., slightly slow) pulse