Multiple Sclerosis, TREATMENT AND CONSIDERATIONS using Traditional Chinese Medicine (TCM) and Oriental Medicine
William R. Morris, O.M.D., Lic. Ac.
Multiple Sclerosis is a chronic disorder of the CNS that causes the destruction of the myelin sheath over the nerves. The course of the disease is variable; it may advance, relapse, remit, or stabilize. The demyelinating patches scattered throughout the central nervous system interfere with neurotransmission and can cause a wide range of neurological symptoms. As the disease progresses, the remissions become less complete and a permanent deficit can become apparent. Early diagnosis is difficult due to the vagueness of symptoms.
Symptoms
The symptoms of Multiple Sclerosis may vary greatly.
1.visual impairment including partial or total loss of vision; pain upon moving the eye; diplopia, or nystagmus.
2.impairment of speech
3.numbness or tingling sensation in the limbs and ataxic gait
4.Dysfunction of the bladder such as hesitancy or urgency and
bowel may also be present.
5.Depression, apathy, lack of judgment, hysteria.
6.Increased deep reflexes, (+) Babinski, Charcot's triad Others specific to the individual.
Etiology
The etiology of MS is idiopathic. In all likelihood, the cause is multifactorial. Theories about the cause include: autoimmunity, heredity, alteration of fatty acid metabolism, environmental factors, slow viruses, myelinic enzymes, and more.
Temperate Zones
MS tends to be more prevalent in the colder latitudes, and is rarely seen in equatorial regions. The exceptions are regions with high dairy intake.
Postviral Sequela
Dr. Harold Manner reports 100% of his MS patients having a serious bout with measles or a recent inoculation with the vaccination. In animals, many viruses are capable of demyelination. Studies are tending to show viral factors as adventitious rather than causal. Viral agents isolated from materials cultured from MS patients include: canine distemper, coranavirus, subacute myelo-opticoneuropathy, mumps, chickenpox, herpes simplex, as well as viral fractions.
Electromagnetic Field Disturbance
Dr. Hans Nieper claims an extremely high incidence of electromagnetic field disturbance and geopathic stresses among the some 1300 MS patients he has seen. Eureka California is a sight of high earthquake activity, close by, one must stand at an angle and not perpendicular to the earth to keep from falling. In that region there is an MS frequency 4 times the normal .1%. Given this information, it would be wise for MS patients to avoid microwave, heating blankets, heating pads and the like.
Heavy Metals
Other suspected culprits include heavy metals such as mercury, nickel, fluorine, platinum, aluminum, and chlorine. These metals interfere with the electrical potential across the phospholipid surfaces of cell membranes and myelin sheathing. There is a higher incidence of MS downwind from factories working with nickel, chromium and other heavy metals.
Li Chi Shen recommends the consumption of duck for metal poisoning. Animal fat is commonly recommended in China for metal toxicity, high fat intake is less of an option here in the U.S for obvious reasons. Modern Study and Application of Materia Medica lists several antidotes for heavy metals according to Subhuti Dharmananda.
Arsenic: Angelica, Smilax, Onychium, and Siler.
Mercury: Smilax, Onychium, Lysimachia, Halloysite.
Lead: Lysimachia, Isatis, Osmunda, Tokoro, Codonopsis, Millettia, Chrysanthemum, Licorice, Equisetum.
Miso soup as well as the seaweeds Sargassum and Laminaria have also been shown to bind out heavy metals.
Blood-Brain Barrier
Another theory has to do with the blood-brain barrier and platelet aggregation or blood stasis. Modern researchers in China have been using Salvia miltiorrhiza (Dan Shen) with Astragalus membranaceous (Huang Qi) to potentize the effect of the Salvia.
Autoimmune Factors
During acute episodes, suppressor T-cell levels have been shown to fall just prior to an attack, and rise when the attack ends. Linoleic acid (Flax oil) supplementation has been shown to significantly reduce immune auto-aggression.
Epidemiology
Most cases begin between 20 and 40 years old, and rarely after 50. Females are affected slightly more than males. Siblings are at a 10-15% greater risk than the general populous whose risk is 0.1%. Daughters of mothers show a 5% increased risk. The disease is rarely seen in Native Americans, Eskimos and Bantus.
Lab findings
Lab findings are used to rule out other diseases: CSF analysis, CT scan, brain scans, skull and spinal x rays. These diagnostic methods traumatize the dura mater, Hans Nieper considers these to be aggravants to the MS inflammatory phases.
Prognosis
Multiple Sclerosis is rarely fatal; the average life expectancy is 93 percent of that of the general population. One in 5 Multiple Sclerosis patients experience one attack, followed by little or no advance in the disorder. Two thirds of patients can walk independently 25 years after diagnosis. Approximately 50 percent of those with Multiple Sclerosis pursue most of the activities they engaged in prior to their diagnosis. In some cases, however, paralysis of different severities may make it necessary to use a cane, crutches and other aids while walking. In a very small number of cases, the disease accelerates and may result in life
threatening complications.
Differentiation and Herbal treatment of MS
MS falls into a category of Traditional Chinese Medicine (TCM) or Oriental medicine (OM) referred to as Wei Zheng, or flaccidity syndrome. A prime symptom of MS is loss of sensation; it is thought to be linked to the animal soul, or the Po. Spiritual exhaustion scatters the Po.
Differential diagnosis of MS includes the possible following:
Damp Heat, Spleen-Stomach deficiency, Lung Heat damaging body fluids, Liver-Kidney Yin Deficiency and Blood Stagnation. ,
Studies from China indicate that most patients fall into the deficiency categories.
Damp Heat: fever, slight swelling, fullness in the chest and stomach, and scanty dark urine. Abdominal palpation reveals pain upon pressure and can be warm to the touch. The tongue has a yellow greasy coat; the pulse is slippery and slightly rapid. According to Traditional Chinese Medicine (TCM) or Oriental medicine (OM) these signs and symptoms are in addition to flaccidity of the limbs, especially the legs.
Phellodendron and Achyranthes Formula Plus (Jia Wei San Miao Wan):
Every herb in this TCM formula drains damp; Phellodendron clears heat; Atractylodes, Lachryma jobi, Stephania and Tokoro all Dispel Wind Damp arthritic pains; Achyranthes strengthens the lower body tendons and ligaments, as well as nourishing the Liver and Kidney. Contents: Phellodendron (Huang Bai) 12g, Atractylodes lancea (Cang Zhu) 18g, Achyranthes bidentata (Niu Xi) 6g; add Lachryma jobi Sm (Yi Yi Ren) 10g, Stephania tetrandra (Fang Ji) 3g, Tokoro AKA Dioscorea hypoglauca (Bie Xie) 3g, Alisma (Ze Xie) 3g.
Another TCM formula used for damp heat pictures is similar to Ching Hao and Scute Combination (Hao Jing Qing Tan Tang) in it: Rhubarb harmonizes the relationship between hot and cold, it also provides an avenue to eliminate heat through the intestines. Peony, Chih Shih and Bupleurum work together to harmonize the Qi level (Peony softens the Bupleurum action). Artemesia, Talc, Scutellaria, Akebia, Hoelin all drain damp. Pinellia, Bamboo and Chih Shih transform phlegm; with Bupleurum, these three herbs also impact the lymph system. Jujube renders the formula a little more palatable, it also sustains the Spleen/Stomach with the onslaught of these other herbs. Contents: Artemisia anua (Ching Hao), Talcum (Hua Shi), Peony alba (Bai Shao), Scutellaria baicalensis (Huang Qin), Bupleurum falcatum (Chai Hu), Bambusa en taenia (Zhu Ru), Akebia quinata (Mu Dong), Hoelen or Poria cocos (Fu ling), Citrus aurantium (Chih Shih), Pinellia ternata (Ban Xia), Rhei chinensis (Da Huang), and Zyziphus jujube (Da Zao).
Spleen-Stomach Deficiency: Poor appetite, shortness of breath, lack of energy to speak, pale complexion, loose stool, and sallow skin. Abdominal palpation reveals softness around Ren 12 and 8. The tongue is flabby with teeth marks; The pulse is weak and too elastic; in addition, there is a gradual weakening of the legs.
Six Major Herb Combination is slightly modified (Jia Wei Liu Jun Zi Tang): Salvia invigorates the blood and dispels stasis. Astragalus, Codonopsis, Atractylodes, Hoelin, and Glycyrrhiza all tonify Qi. Pinellia and Citrus dissolve phlegm damp. Atractylodes and Hoelin dispel damp. Glycyrrhiza harmonizes the actions of the other herbs. Contents: Astragalus membranaceous (Huang Qi), Salvia miltiorrhiza (Dan Shen), Codonopsis pilosulae (Dang Shen), Atractylodes macrocephala (Bai Zhu), Poria cocos or Hoelin (Fu Ling), Pinellia ternata (Ban Xia), Citrus aurantium (Chih Shih), Glycyrrhiza uralensis (Gan Cao).
Blood Stagnation:
History of trauma, loss of strength and control in the limbs, muscle numbness and swelling. There may be patches of dry skin related to affected areas or channels. The shoulders can be tight, and the abdomen can have painful lumps. There may be a red flushed face, showing cardiovascular rigidity. The pulse can be deep or choppy; the tongue is dusky to dark purple, or there may be swelling and darkness in the vessels under the tongue.
Persica and Carthamus Combination (Xue Fu Zhu Yu Tang): The first 6 herbs activate blood; Bupleurum and Citrus harmonize and regulate Qi; Bupleurum, Raw Rehmannia and Red Peony balance the formula by cooling; Dang Gui, Rehmannia, and Ligustici tonify blood as components of the archetypal formula Dang Gui Four (red peony replaces the white). Contents: Persica (Tao Ren) 4g, Carthami flos (Hong Hua) 3g, Angelica sinensis (Dang Gui) 3g, Peonia rubra (Chi Shao Yao) 3g, Ligustici wallichi (Chuan Xiong) 2g, Achyranthes bidentata (Niu Xi) 3g, Bupleurum falcatum (Chai Hu) 2g, Platycodon grandiflori (Jie Geng) 2g, Citrus aurantium (Zhi Ke) 2g, Rehmannia glutinosa raw (Sheng Di Huang) 3g, Glycyrrhiza uralensis (Gan Cao) 2g.
Experimental Formula: Astragalus and Codonopsis supplement Qi; Raw Rehmannia nourishes yin; Peonia alba, Dang Gui and Raw Rehmannia nourish blood; Raw Rehmannia, Bupleurum and Scute clear heat; Salvia, Cnidium and Peonia rubra activate blood; Pinellia dissolves phlegm. Contents: Astragalus membranaceous (Huang Qi), Codonopsis pilosula (Dang Shen), Salvia miltiorrhiza (Dan Shen), Rehmannia glutinosa Raw (Sheng Di Huang), Peonia alba (Bai Shao Yao), Bupleurum falcatum (Chai Hu), Angelica sinensis (Dang Gui), Peonia rubra (Chi Shao Yao), Scutellaria baicalensis (Huang Qin), Cnidium or Ligustici wallichi (Chuan Xiong), Pinellia ternata (Ban Xia) and Glycyrrhiza uralensis (Gan Cao).
Liver and Kidney Yin Deficiency:
Heat sensations in the afternoon, dry skin, thirst, a tendency to restlessness and irritability. The low back and medial knee area can be quite warm to the touch. The pulse is thready and wiry, slightly rapid.The tongue is red with no coat. The muscles atrophy, and the limbs are without strength.
Eucommia and Achyranthes Formula (Wei Zhang Feng), the name of the formula translates as flaccidity decoction. Dang Gui, Peony, and Rehmannia nourish blood; Atractylodes lancea, Phellodendron, and Achyranthes drain damp; Anemarrhena and Phellodendron clear heat; Dang Gui and Achyranthes activate blood; Anemarrhena and Rehmannia nourish yin; Achyranthes and Eucommia strengthen the tendons and ligaments. This formula is an excellent example of using secondary herb functions to support and interleave therapeutic principles. Contents: Angelica sinensis (Dang Gui) 5g, Peonia alba (Shao Yao) 2g, Eucommia ulmoides (Du Zhong) 1g, Achyranthes bidentatae (Niu Xi) 3g, Astragalus membranaceous (Huang Qi) 2g, Atractylodes lancea Rx (Cang Zhu) 3g, Rehmannia glutinosae (Di Huang) 4g, Phellodendron amurense (Huang Bai) 1g, Anemarrhena asphodeloides (Zhi Mu) 3g.
Hu Qian Wan (Hidden Tiger Pill)
Testudinis, Anemarrhena and Rehmannia moisten yin. Phellodendron and Anemarrhena remove fire. Testudinis, Os Tigris and Cynomorii consolidate the muscles and bones. Chen Pi and Zingiberis regulate and protect the Spleen Stomach. Peony and Rehmannia nourish the blood. Phellodendron amurense (Huang Bai) 15g, Testudinis plastrun (Gui Ban) 12g, Anemarrhena asphodeloides (Zhi Mu) 6g, Rehmannia glutinosa cooked (Shu Di Huang) 6g, Citri pericarpium (Chen Pi) 6g, Peonia alba (Shao Yao) 6g, Cynomorii songarici (Suo Yang) 4.5g, Os tigris (Hu Gu) 30g, Zingiberis dessicata (Gan Jiang) 15g.
Lung Heat Damaging Body Fluids:
According to Traditional Chinese medicine (TCM) and Oriental medicine (OM) here is a fever at onset with a sudden weakness of the limbs. Other signs of lung heat are also present: restlessness, thirst, dry throat, cough, constipation; and dark, scanty urine; the tongue is red with a dry yellow coat; the pulse is thready and rapid.
Eriobotrya and Ophiopogon Combination (Qing Zao Jiu Fei Tang)
Mori Leaf and Gypsum clear heat in the lung; Mori also disperses wind; Armeniaca, Asini, Mori, and Eriobatrya stop cough; Asini, Ophiopogon and Sesame nourish Yin, Ginseng moistens and generates fluids. Licorice tastes good and harmonizes the formula.
Mori Folium (Sang Ye) 3g, Gypsum fibrosum (Shi Gao) 10g, Asini gelatinum (A Jiao) 2.4g, Ophiopogon japonica (Mai Men Dong) 3.6g, Sesami indici (Hu Ma Ren) 2.4, Panax ginseng (Ren Shen) 2g, Armeniacae amarae (Xing Ren) 2g, Eriobotryae japonica (Pi Pa Ye) 3g, Glycyrrhizae uralensis (Gan Cao) 2g.
A formula used with good success by Drs. Zhou and Lu
This formula nourishes essence, yin, and yang; it also clarifies consciousness and moistens the lung, thus benefitting the Po.
After a reduction of numbness, Hidden Tiger Pill was administered in a successful study.
Corni and Schizandra astringe essence; Acori and Polygala focus on the CNS and clear the mind while Acori opens orifices; Morinda strengthens muscles and bones; Ophiopogon and Eriobatrya benefit the Po; Morinda and Cistanches tonify Yang.
Contents: Rehmannia glutinosae (Shu Di) 18g, Corni officinalis (Shan Zhu Yu) 9g, Schizandra chinensis (Wu Wei Zi) 6g, Polygala tenuifolia (Yuan Zhi) 9g, Acori graminei (Chang Pu) 9g, Morindae officinalis (Ba Ji Tian) 9g, Cistanches 24g, Ophiopogon japonica (Mai Men Dong) 18g, Eriobotryae japonica (Pi Pa Ye) 12g.
Dr Mei Zhu, a practitioner with 50 years experience recommends tonifying the Spleen Liver and Kidney. This reflects more accurately the mixed syndrome picture usually seen in clinical settings.
This formula focuses intensely on replenishing vital essence.
Dr. Zhu's Formula: P. sibericum, P. officinalis, Astragalus, and Korean Ginseng tonify the Lung (support of the Po) and Spleen. Scrophularia, Astragalus, Rehmannia cooked, P. sibericum, P. officinalis, Cornus and Placenta all replenish vital essence. Morinda strengthens bones and tendons. Scrophularia, and Rehmannia cooked, tonify the kidney Yin. Morinda, Cistanches, Red Ginseng and Placenta tonify Kidney Yang.
Contents: Polygonatum sibericum Rz (Huang Jing) 5g, Polygonati officinalis (Yu Zhu) 3g, Red Korean Ginseng (Hong Ren Shen) 5g, Placenta (Zi He Che) 3g, Morinda officinalis (Ba Ji Tian) 5g, Cistanches salsa (Rou Cong Rong) 3g, Corn officinalis (Shan Yu Ru) 3, Rehmannia glutinosa cooked (Shou Di Huang) 5g, Astragalus membranaceous (Huang Qi) 10g, Glycyrrhizae uralensis (Gan Cao) 5g, Scrophularia ningpoensis (Xuan Shen) 3g.
Traditional Chinese Medicine (TCM) and Oriental Medicine (OM) Food and Nutritional Therapy
Eat a very low fat diet, with fat at 12% of total calories. Use very low saturated fats. When treated early on, this diet can maintain an MS patient with no progression for up to 20 years .
A high fat diet impairs the conversion of linoleic acid to prostaglandin E1 (PGE1), this leads to an increase of inflammatory episodes and concomitant oxidative damage.
In general, decrease gluten and milk products. Use a hypoallergenic/rotation diet to reduce antigen-antibody responses and immune hypervigilance .
therapeutic foods:
Increase omega 3 and omega 6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil, kale, celery, fish, raw goat's milk, veal joint broth, cod roe, rice polishings, brewer's yeast, nutritional yeast. Olive oil contains about 2% squalene, a substance receiving attention for cancer and MS in Europe (Olive oil itself does not contain sufficient sqaulenes to match the studies).
With weakness in the legs, use 5 oz. minced beef, 2 slices fresh ginger. Boil for 10 minutes in 3/4 pt. water. Eat and drink while hot at night. This therapy is best for a deficient condition. Anthropological blood typing studies by Peter D'Adamo N.D. indicate that people with type O blood will tend to respond better to animal protein therapies due to a tendency to secrete more hydro-chloric acid.
Avoid: Black pepper, dairy, sugar, food intolerances, trans fatty acids, hydrogenated oils (margarine, vegetable shortenings, imitation butter spreads, most commercial peanut butters), oxidized fats (deep fried foods, fast food, ghee, barbecued meats) .
Essential fatty acid (EFA) therapy provides substances which are necessary for myelin sheathing and cell membranes. Studies are contradictory as to the benefit, generally 2-1 in favor of EFA therapy. Dosages for EFA are: flax oil 2 tsp q.d., Max EPA 3 caps b.i.d., black current oil 2 caps q.d. People vary in there tolerance for these substances, adjust dosages accordingly.
Antioxidants can reduce the impact of oxidative damage due to inflammatory episodes. Vitamin E requirement increases with the use of unsaturated fats to reduce lipid peroxidation. Selenium is inexpensive and as the mineral portion of glutathione peroxidase can assist in reducing oxidative stress. Use: Vitamin E 800 I.U. q.d. and Selenium 200 mcg q.d.
Phosphatydal Choline is receiving attention for treatment of MS, primarily as a constituent of membrane phospholipids. It is found in high quantity in lecithin use: 2400 mg q.d., phosphatydal choline is available singularly, with the advantage of lower dosage quantity to get the desired phosphatides.
Calcium AEP is calcium bound to amino ethyl phosphoric acid, a neurotransmitter which improves electron transport across lipid membranes such as the myelin sheathing. It also reduces inflammation of the blood-brain barrier and reduces autoimmune aggression. Bile salts and lipase assist gut uptake of the fatty acid therapy, reducing nausea. Digestive enzymes of the pancreas work best in concert with each other, rather than using simply lipase.
The treatment of MS require a long term diligent effort on the part of the patient as well as the practitioner. The consumption of materials can be tedious at times. Issues such as what the patient gains from the illness should be pursued in good time. The authors experience is that there is usually a payoff in MS as well as undefined demyelination patterns.
All tonification treatment should be stopped at the time of an external invasion of pernicious influences and appropriate treatment administered. It is important for the patient to understand this process as colds or flus can aggravate the inflammatory process of MS.