January 18, 2011

A Case of Rheumatic Arthritis

He Bei Chinese Medicine, 1984; (3): 40
Found in ‘A Brief Guide to Cold Damage Formula Patterns’ by Liu Shao-Yi (伤寒方证便览)

Huang a 49 year old male presented with joint pain in both legs and knees which had started the previous year and has gradually become worse. At a local hospital, he was diagnosed with rheumatic arthritis, and received treatments for over a month with no positive effects.

Recently his pain has become quite severe, especially in both knee joints. He experiences pulling pain, which prevents him from walking. Both legs and knees were cold, and his pain intensifies with any changes in weather or on cold rainy days. His tongue had a greasy white coating and his pulse was deep and thin.
This pattern is usually the result of living in wet-damp locations for extended periods of time allowing wind and dampness to amass in the joints. The following formula was administered:

Zhi Gan Cao 6g (Glycyrrhizae Radix preparata)
Bai Zhu 9g (Atractylodis macrocephalae Rhizoma)
Gui Zhi 9g (Cinnamomi Ramulus)
Pao Fu Zi 15g (Aconiti Radix lateralis preperata)
Niu Xi 9g (Achyranthis bidentatae Radix)

1 package was to be taken daily.

After taking 3 packages, both limbs felt warmer and the pain had decreased slightly. The above formula was repeated with an increase in herb dosages.

Zhi Gan Cao 9g (Glycyrrhizae Radix preparata)
Bai zhu 24g (Atractylodis macrocephalae Rhizoma)
Gui Zhi 15g (Cinnamomi Ramulus)
Pao Fu Zi 30g (Aconiti Radix lateralis preperata)
Niu Xi 15g (Achyranthis bidentatae Radix)


After another 3 packages, his legs felt warmer, there was mild sweating, a white tongue coat and a harmonious moderate pulse. The joint pain in the legs had now been eliminated and he was even able to walk the 3 miles to the hospital for a follow up visit. In order to consolidate the treatment and eliminate the wind damp, another 5 packages of the previous prescription (with the lower dosages) was used. On a recent follow up visit there had been no relapse of the condition.


**The following case was found in the above mentioned book's section on 'patterns of wind and damp retention in the joints' with the representative formula being Gan Cao Fu Zi Tang (Licorice and Aconite formula)

January 10, 2011

Hu Xi Shu (胡希恕)Case #5- Foot pain


A 19 year old male presented on February 15, 1966 complaining of left foot swelling and pain for over 5 years. Over the last two years the pain has gotten quite severe. X-ray imaging confirmed osteogenesis of the heel.

Current symptoms: swelling and pain in the left foot, fear of cold, severe pain after walking, normal taste in the mouth, no desire to drink, a thin-white tongue coating and a deep-wiry pulse.

This is wind-dampness in the Shao-Yin and Tai-Yin, and is therefore a Gui Zhi Shao Yao Zhi Mu Tang (Cinnamon Twig,Peony and Anemarrhena Decoction) pattern.

Formula:

Gui zhi 4 qian (Cinnamomi Cassiae, Ramulus) 
Ma Huang 2 qian (Ephedrae, Herba) 
Bai Shao 3 qian (Paoniae Lactiflorae, Radix) 
Zhi Mu 4 qian (Anemarrhena Asphodeloidis, Rhizoma) 
Sheng Jiang 4 qian (Zingiberis Officinalis Recens, Rhizoma) 
Chuan Fu Zi 2 qian (Aconiti Carmichaeli Preparata, Radix Lateralis) 
Fang Feng 4 qian (Ledebouriellae, Radix) 
Cang Zhu 4 qian (Atractylodis, Rhizoma) 
Zhi Gan Cao 2 qian (Glycyrrhizae Radix Preperata)

Results: After taking seven packages of the above formula, the foot pain had decreased. He still experienced pain after walking but would recover quickly after taking a rest. Chuan Fu Zi (Aconiti Carmichaeli Preparata, Radix Lateralis) was increased to 3 qian and after taking the above formula for another month the swelling in the foot had resolved and the pain was no longer present.