Thursday, May 24, 2012

Traditional Chinese medicine and autoimmune disease

In ancient text there seems to be accounts of rheumatoid arthritis, inflammatory bowel disease like Crohn’s disease and ulcerative colitis and many other autoimmune diseases. In most cases presented in classics we cannot possibly know what the disease truly was. From short list of symptoms we do not know if the disease was for example lyme borreleosis or multiple sclerosis, or was it non-autoimmune form of arthritis or rheumatic one. What we know is some of the methods diagnose and treat. And in some cases we even know the results… if we can trust our sources.
Traditional Chinese medicine still relies old form of diagnosis done by looking, asking, listening, smelling and taking pulse. The diseases are then differentiated using for example eight principles and Zangfu-theory. The diagnosis and treatment will depend on school and expertise of the practitioner. The most commonly used diagnostics and treatments are based on Zangfu, Five phases, Bi&Wei-syndromes and Wind-syndromes. One of the best books with this approach is Treating Autoimmune Disease With Chinese Medicine written by Wanzhu Hou, Guangpi Xu and Hanjie Wang (ISBN 978-0-443-06974-1).
To illustrate this approach we take an example from the book. According the authors the aetiology and pathology of Systemic lupus erythematosus can be presents to be caused by one or all of the following:
  • Deficiency of Yin as the internal cause of lupus
  • Invasion of pathogenic factors as the external cause of SLE
  • Blood stasis, Phlegm and Fluid are pathogenic substances, as well as one cause of SLE, and an aggravating factor in existing SLE
The Systemic lupus erythematosus can be differentiated by symptoms to following main categories:
  • Domination of Heat-toxin
  • Internal Heat due to Yin deficiency
  • Blood stasis and Heat stagnation
  • Spleen and Kidney Qi deficiency
  • Fluid retention due to Yang deficiency
The book prescribes different points and herbs for possible treatment and includes couple of case studies.
In light of element theory most of the autoimmune diseases have characteristics of various degrees of Yin deficiency, heat and phlegm (turbid dampness). This approach works greatly to relieve the symptoms and sometimes this can provide a cure for disease itself. In many cases of autoimmune diseases this approach only works to relieve the symptoms. In many cases this relieving symptoms is already very great achievement. For example in multiple sclerosis the myelin is destroyed in relapse phases and if this relapse can be shorten or stopped the amount of damage to nervous system is minimized and the body has time to recover during remissions. This can slow down or even stop the advancement of multiple sclerosis and at least the symptoms during the relapse are eased.

The classics like Shānghán lùn (Treatise on cold damage), Sùwèn and Língshū are more concentrated on our energetic structures and their resonance with cosmic forces than classification of symptoms to elementary correspondences. These classics describe how the pathogenic factors travel in our systems and how the diseases patterns develop and change. These theories, especially Shānghán lùn theory, are usually used to explain acute diseases with emphasis of cold pathogen. The energetic structures and possible ways the disease may develop apply also to other diseases.
In chapter 6 the Sùwèn explains how the three Yang and three Yin together make six continuous looping channels. The 31th chapter explains how a cold disease develops and travels through this channel system. The Shānghán lùn uses this six channel theory from Sùwèn and explains symptoms and principles of healing in much greater depth. The depth of the six channels are, from superficial to deeper, Tàiyáng (small intestine and bladder channels) → Shǎoyáng (sānjiāo and gallbladder channels) → Yángmíng (large intestine and stomach channels)→ Tàiyīn (lung and spleen channels) → Juéyīn (xīnbāo and liver channels) → Shǎoyīn (heart and kidney channels). The disease progresses through these levels usually in different order. The primary order of progression in Shānghán lùn is Tàiyáng → Shǎoyáng → Yángmíng → Tàiyīn → Shǎoyīn → Juéyīn (1) . After getting to Juéyīn the disease may even result in death. The difference between the depths and progression order is due channel pathways. The disease advances from Tàiyáng to foot portition of Shǎoyīn (kidney meridian). From kidney meridian it travels to Juéyīn ending up to Xīnbāo – or hand/yang portion of Juéyīn. In English literature the Xīnbāo is commonly translated as Heart protector or Pericardium. Xīnbāo is intimately connected to the Heart and true Heart-channel. We have to remember that what is commonly called as the Heart-channel is in fact only a superficial branch of the true Heart meridian. The real Heart-channel lies deep with and cannot be pierced and have no points on it. This is also the reason why the Heart channel is not mentioned in oldest of texts and why the Xīnbāo-channel was sometimes called the Heart-channel. It is said that if the pathogens could get into True Heart-channel the Shén or spirit would leave and death would follow. So the True Heart channel is protected by Xīnbāo.
In regards of autoimmune diseases these theories of depth and progressions provide few very interesting points. The Shǎoyáng (Sānjiāo and gallbladder) is the axis of all Yang channels. Diseases in this level are considered to be in between states. They are not fully internal nor external. They have characteristics of moving and changing. They can manifest as shaking, chills, intermittent fevers, uncomfortable breathing and constantly changing pains. Gallbladder channel is responsible of peripheral nervous system and is connected also to Marrow. Marrow in Chinese medicine also includes spinal cord and brain. The master or meeting point of all Marrows lays in gallbladder channel (GB 39). Sānjiāo connects the brain to the three Dantian. It is also deeply connected to harmonious working of all endocrine glands which control the hormonal balance of body. Shǎoyáng is the harmonizing axis of all Yang channels that are responsible of all activity of body
The Juéyīn is more connected to the Liver, Detoxification, Blood, tissues, body and form. The Xīnbāo portion is also connected to thymus responsible for “educating” the T-Cells which plays key part in adaptation of immune system. It is the utmost Yin. If this level gets affected the Yin becomes disharmonious and cannot transform to Yang. This can cause deformity and dysfunction of tissues. In more serious level the separation of Yin and Yang can happen, meaning death.
The autoimmune disease can be seen as breaking of this fundamental harmony. In classics these states are seen as result of diseases that were not fully healed. In Western medicine it is also accepted that certain prolonged diseases can trigger autoimmune response. And even improper use of medicals (like antibiotics) can cause autoimmune diseases like Crohn’s disease (2).
This theory also applies to other diseases arising from foreign chemical entering the body. Recently in Finland there has been cases of narcolepsy caused by swine flu vaccinations(3). Even though the narcolepsy is not considered autoimmune disease the cases seem very similar in the eyes of Chinese medicine diagnostics as the Shǎoyáng is responsible for harmonizing the activities of Yang channels. The Sānjiāo and Gallbladder channels are often used to treat diseases of brains and more generally the whole nervous system. The points from gallbladder (ie. GB38) and Xīnbāo (ie. XB8-9) channels are used for example to treat penicillins induced allergic reaction. The gallbladder channel and its corresponding Zang-organ liver are responsible for muscle and tendon level of body, the very same depth the vaccines are injected into. The liver belong to the Juéyīn-level and is responsible for detoxifying the body.

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