TCM and Articular Rheumatism

 

By Dr. Hong-Yen Hsu

 

 

Rheumatism is a condition frequently seen, as well as a difficult disease to cure. Articular rheumatism manifests as an aching and swelling of the joints in its initial stage, the effects gradually extending to the wrists with marked swelling, febrile sensations, and body ache. The cause of articular rheumatism is unknown.

 

Although Western medicine has made use of steroidal and nonsteroidal anti-inflammatory drugs (including aspirin) for pain, the side effects which accompany their use has led to an interest in replacing them with traditional Chinese medical therapies which avoid these problems.

 

Traditional Chinese medical therapies for rheumatism were first recorded in the “Treatise on Obstruction," in Plain Questions of Internal Medicine Classic: Attributed to the Yellow Emperor, early in the 1st or 2nd century B.C. Rheumatism was considered to be the result of an invasion of "wind," "cold," and "dampness" into the body. A description of the symptoms and commonly used' formulas follow:

(1) "Arthritis with migratory pain" due to wind (xing bi) - is characterized by migratory aching pain in the limbs, articular pain with occasional alternate chills and fever, and a floating and tense pulse. The commonly used formulas are Cinnamon and Anemarrhena Combination or Wu Ton and Cinnamon Combination.

(2) "Arthritis with severe pain" due to cold (tong bi) - is characterized by very severe articular pain, cold hands and feet, comfort in warm weather, and aggravation in cold weather. The commonly used formulas are Vitality Combination, and Tangkuei, Evodia, and Ginger Combination.

(3) "Arthritis with fixed pain and heaviness" due to dampness of muscles and skin (zhuo bi) is characterized by fixed swelling and pain of the limbic joints, articular deformation in chronic cases, and a floating and slow pulse. Ma-huang and Coix Combination and Astragalus and Aconite Formula are used. For chronic cases, Rehmannia Eight Formula, and Cinnamon, Hoelen and Atractylodes Combination are used.

(4) "Arthralgia due to heat" (re bl), marked by pain, heat, redness and swelling of the joints is usually seen in acute rheumatic arthritis. Tang-kuei and Anemarrhena Combination is the formula most commonly used. Yasuo Otsuka, Director of the Oriental Medicine Research Center, Kitasato Institute (Japan), recommends clinical applications of Chinese herbal formulas according to the stages of disease (in this regard, some changes and additions were felt necessary to the formulas recommended).

 

Formulas for active conditions in the first stage:

• Wu-tou and Cinnamon Combination - to be used for superior physique, perspiration, muscular and articular pain of the limbs.
• Pueraria Combination - used for the average physique, initial sensations of cold, fevers, severe chills, shoulder and back. stiffness and pain.
• Peony and Licorice Combination - used for various physiques with tenseness and acute pain in the straight muscles of the abdomen (rectus abdomminous muscles).
• Tang-kuei and Anemarrhena Combination- used for articular flushing, febrile sensations, swelling and pain in the limbs. Atractylodes Combination - used for average physique, edema, perspiration and thirst with fever, flushing, swelling, and arthralgia.
• Astragalus and Aconite Formula - used for diminished physical strength, hidrosis, edema, decrease' of urinary volume, articular and especially lower limbic swelling.

Formulas for cases of rather long morbid duration and diminshed physical activity:

• Ma-huang and Coix Combination - used for a normal physique, tendency toward flushing up, flushing, swelling, and limbic myalgia that is aggravated by cold weather.
• Cinnamon, Hoelen and Atractylodes Combination - used for those with diminished physical strength, a tendency toward cold limbs, and articular myalgia in cold weather.
• Tang-kuei, Evodia, and Ginger Combination - used for those of weak physique, cold limbs, and limbic and lower back pains.

Formulas for patients with physical, physiological and menopausal disturbances:

• Clematis and Carthamus Formula - used for those with a normal physique:
• Clematis and Stephania Combination - for those with less physical strength, lower abdominal resistance and pain upon pressure, and muscular, neural, and articular pains from the waist to the feet.
• Tu-huo and Loranthus Combination - used for muscular, neural and articular pains which are more severe at night and occur between the waist and feet, spasms of the waist and back, renal deficiency, numbness and weakness of the lower limbs , and cold feet.

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