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Record of Herbal Treatment Of Hrabina from Czech, 80% Improvement Of ALS

 

 

 

 

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Brief Summary: October 31, 2006. The Canadian friend Jackie, suffering from ALS for 2 years, came to our hospital for her treatment. After the comprehensive treatment in our hospital, the muscular atrophy of her right limb has been improved significantly.

 

 

Records of Hospitalization

Name: Jackie                                                                    Sex: Female

Age: 40 years                                                                    Profession:  

Nationality: Canada                                                           Marital status: Married

Onset Season: Summer                                                      Date of Admission: Oct. 31st, 2006  

Complainer of history: The patient herself                            Reliability: Reliable

 

Chief complaint: The patient has suffered from amyotrophy of right lower extremity for 2 years with four-month aggravated condition evidenced by her walking lamely.

Present illness: Two years ago the patient began to have amyotrophy and weakness of right lower extremity without any obvious cause. Because of the problem of right lower extremity, she broke her right ankle. She had an X-ray in a local hospital and the result was fifth metatarsal fracture. Then she was diagnosed as ALS by MRI and neurological examination. Though she had been treated in a local hospital, she got little effect. And during the latest four months the amyotrophy of her right lower extremity was aggravated, which is evidenced by her walking lamely. So she came to our hospital for TCM treatment. Her tongue was reddish with thin whitish coating, and her pulse was sunken and fine.

Past history: No history of typhoid, tuberculosis and hepatitis. No allergic history of medicine and food. No operation history. No history of preventive vaccination provided.

Personal history: She was born in Canada, living in a dry environment. No contact history of schistosomiasis. No addiction to smoke, alcohol or special food. And she was even-tempered and optimistic.

Menstrual history: Moderate and red menses without peculiar smell.

Marital history: She was married at 23 and had given birth to one son. Her husband and son were healthy all the time.

Family history: Her parents were both healthy. No history of special disease.

Physical examination

T 36.8P 80bpm, R 20bpm, BP: 90/60mmHg

She was mid-nourished and normally developed. Her mind was clear. She was in chronic distress and has an expression of languidness. She was in a positive position and cooperative in examination. Her skin was moist. No jaundice in the sclera. No superficial lymph-node enlargement. Bilateral pupils were round and equal in size and sensitive to light. No thoracic deformity. Sound of breath was bilaterally normal on auscultation. No respiratory rales or pleural friction rub. Heart border was normal. Heart beat 80/min. Cardiac rhythm was regular. No pathological murmurs on auscultation. Abdomen was flat and soft without tenderness or rebound tenderness. Liver and spleen were not palpable. No percussion pain on renal region. Bowel sound was normal. No Spinal and pelvic deformity or pain. No deformity or inflexibility of left lower extremity or upper ones. The condition of right lower extremity would be discussed in the next paragraph. The development of the anus and pudendum was normal.

Right lower extremity: Amyotrophy was obvious in the special examination. The cross-section diameter of the right thigh measured 12cm above the patella was 35cm, while that of the left thigh was 40cm. Measured 22cm above the patella, the cross-section diameter of the right thigh was 42cm, while that of the left thigh was 47cm. Measured around 12cm above the Juxu point, the cross-section diameter of the right leg was 29cm, while that of the left was 32cm. She walked lamely with her right foot turning outwards.

Diagnostic examination: MRI showed ALS.

First diagnosis

TCM diagnosis: Wei-syndrome (flaccidity syndrome)

Symptom diagnosis: spleen asthenia leading to failure of transportation and transformation and deficiency of qi and blood; liver and kidney asthenia leading to insufficiency of yin essence and lack of proper nourishment of muscles.

WM diagnosis: ALS

First Medical Record

                              6:30p.m. Oct. 31st 2006

Jackie, a 40-year female, has suffered from amyotrophy of right lower extremity for 2 years with four-month aggravated condition evidenced by her walking lamely. She was met by our translator in Zhijiang Airport and arrived in Huaihua Red Cross Hospital at 5: 30p.m Oct. 31st 2006.

Essentials for diagnosis:

1. The patient has suffered from amyotrophy of right lower extremity for 2 years with four-month aggravated condition evidenced by her walking lamely.

2. Two years ago the patient began to have amyotrophy and weakness of right lower extremity without any obvious cause. Because of the problem of right lower extremity, she broke her right ankle. She had an X-ray in a local hospital and the result was fifth metatarsal fracture. Then she was diagnosed as ALS by MRI and neurological examination. Though she had been treated in a local hospital, she got little effect. And during the latest four months the amyotrophy of her right lower extremity was aggravated, which is evidenced by her walking lamely. So she came to our hospital for TCM treatment. Her tongue was reddish with thin whitish coating, and her pulse was sunken and fine.

3. T 36.8P 80bpm, R 20bpm, BP: 90/60mmHg

4. She was mid-nourished and normally developed. Her mind was clear. She was in chronic distress and has an expression of languidness. She was in a positive position and cooperative in examination.

5. No thoracic deformity. Sound of breath was bilaterally normal on auscultation. No respiratory rales or pleural friction rub. Heart border was normal. Heart beat 80/min. Cardiac rhythm was regular. No pathological murmurs on auscultation.

6. Amyotrophy of her right lower extremity was obvious in the special examination. The cross-section diameter of the right thigh measured 12cm above the patella was 35cm, while that of the left thigh was 40cm. Measured 22cm above the patella, the cross-section diameter of the right thigh was 42cm, while that of the left thigh was 47cm. Measured around 12cm above the Juxu point, the cross-section diameter of the right leg was 29cm, while that of the left was 32cm. She walked lamely with her right foot turning outwards.

7. MRI showed ALS.

 

Diagnostic basis

TCM: Wei-syndrome (flaccidity syndrome) refers to the flaccidity and weakness of extremities leading to less liberty in movement or muscular atrophy. In clinics, amyotrophy and weakness of lower extremities are eminent. The caused of the disease is complicated. Wei-syndrome is a condition when the muscles and meridians lacks nourishment due to damage of the five internal organs, deficiency of essential body fluid, and depletion of qi and blood, caused by pathogenic heat or virus infection, emotional disturbance, irregular diet or overstrain, congenital insufficiency, indulgence in sexual activities, injuries, exposure to neuro-poisonous drugs.

Western medicine: Amyotrophy of her right lower extremity was obvious in the special examination. The cross-section diameter of the right thigh measured 12cm above the patella was 35cm, while that of the left thigh was 40cm. Measured 22cm above the patella, the cross-section diameter of the right thigh was 42cm, while that of the left thigh was 47cm. Measured 12cm above the Juxu point, the cross-section diameter of the right leg was 29cm, while that of the left was 32cm. She walked lamely with her right foot turning outwards. MRI showed ALS.

Diagnostic differentiation

TCM: Wei-syndrome should be differentiated from Bi-syndrome. The advanced stage of Bi-syndrome is characterized by the prolonged motor impairment due to joint pain, so patients suffering from it may also have a subsequent muscular thinness. On the contrary, patients suffering from Bi-syndrome generally have no joint pain. And the pathogenesis and treatment of Wei-syndrome should also be distinguished from those of Bi-syndrome.

WM: Wei-syndrome should be differentiated from myasthenia gravis which can occur at any age and strikes typically between ages 10 and 35. Women are more often affected than men. The most obvious characteristic of MG is rapid fatigability of the skeletal muscles affected, improved with rest in various degrees. The patient’s condition fluctuates, relatively better in the morning and worse at dusk. The onset is all of a sudden, often begun with a group of muscles, and as time goes on, the disease progressively affects other groups. It is most common that the cranial innervate muscles are often the first group of muscles to be affected evidenced by the fact that about 90 percent of persons with MG have such initial symptoms as drooping eyelids (ptosis) and double vision (diplopia). And the bulbar muscles and girdle muscles are often the second group of muscles to be affected. MG patients of different ages often have different clinical manifestations and courses which are different from those of Wei-syndrome paients.

First diagnosis: 

TCM diagnosis: Weizheng (flaccidity syndrome)

Symptom diagnosis: spleen asthenia leading to failure of transportation and transformation and deficiency of qi and blood; liver and kidney asthenia leading to insufficiency of yin essence and lack of proper nourishment of muscles and tendons.

WM diagnosis: ALS

Plan of treatment and care

1. On routine care of traditional Chinese internal medicine

2. On grade II care

3. Under care of a companion

4. High-protein diet

5. Herbal tea: one dosage a day and drink by twice

6. Acupuncture and massage: once a day

7. Have a positive and optimistic attitude towards your disease

8. Functional exercise for lower extremities: once a day

9. Have more medical examinations if necessary

 

Date: 1st of December 2006                            Time: 9:00 a.m.

When Dr. Yan made the rounds of the wards, the patient told him that she had hypodynamia and obvious amyotrophy of right lower extremity and difficulty in walking manifested as walking lamely.

Examinations: T 36.8P 80bpm, R 20bpm, BP: 90/60mmHg. Amyotrophy of her right lower extremity was obvious in the special examination. The cross-section diameter of the right thigh measured 12cm above the patella was 35cm, while that of the left thigh was 40cm. Measured 22cm above the patella, the cross-section diameter of the right thigh was 42cm, while that of the left thigh was 47cm. Measured 12cm above the Juxu point, the cross-section diameter of the right leg was 29cm, while that of the left was 32cm. She walked lamely with her right foot turning outwards.

Dr. Yan’s analysis:

1. The patient has suffered from amyotrophy of right lower extremity for 2 years with four-month aggravated condition manifested as walking lamely.

2. Amyotrophy of her right lower extremity was obvious in the examination result.

3. The patient had MRI and check of the vascular system in a local hospital which showed ALS.

4. According to its manifestations, this disease falls into the category of Wei-syndrome (flaccidity syndrome) which refers to the flaccidity and weakness of extremities leading to less liberty in movement or muscular atrophy. In clinics, amyotrophy and weakness of lower extremities are eminent. The caused of the disease is complicated. Wei-syndrome is a condition when the muscles and meridians lacks nourishment due to damage of the five internal organs, deficiency of essential body fluid, and depletion of qi and blood, caused by pathogenic heat or virus infection, emotional disturbance, irregular diet or overstrain, congenital insufficiency, indulgence in sexual activities, injuries, exposure to neuro-poisonous drugs.

5. Symptom diagnosis: spleen asthenia leading to failure of transportation and transformation and deficiency of qi and blood; liver and kidney asthenia leading to insufficiency of yin essence and lack of proper nourishment of muscles and tendons.

6. Principle of TCM treatment: Strengthening the spleen and supplementing qi; Tonifying the liver and nourishing yin essence. Herbal tea prescribed for three days included cooked rehmannia, astragalus root, tangkuei, cornus, cimicifuga, deerhorn glue, eucommia, cinnamon twig, tangerine peel, dipsacus root, achyranthes, jujube, dioscorea, amomum, and so on. A daily dosage should be decocted twice.

7. Other treatments or examinations: daily acupuncture and massage; daily dirigation; have more medical examinations if necessary.

 

Date: 2nd of December 2006                           Time: 9:00 a.m.

The patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her heart and lungs were normal. Her abdomen was flat. Her tongue was reddish with thin and whitish coating. Her pulse was deep and fine.

 

Date: 3rd of December 2006                           Time: 9:00 a.m.

The patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her heart and lungs were normal. Her abdomen was flat. Her tongue was reddish with thin and whitish coating. Her pulse was deep and fine.

 

Date: 6th of December 2006                            Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. The involuntary muscular jitters of the right lower extremity, shoulders and back was less than before. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her heart and lungs were normal. Her abdomen was flat. Her tongue coating was thin and whitish. Her pulse was deep and fine. The herbal tea was the same as before.

 

Date: 9th of December 2006                            Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. The involuntary muscular jitters of the right lower extremity, shoulders and back was less than before. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. No other discomfort. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her tongue coating was thin and whitish. Her pulse was deep and fine. The herbal tea was the same as before.

 

Date: 12th of December 2006                          Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. No obvious improvement in walking ability. The involuntary muscular jitters of the right lower extremity, shoulders and back was less than before. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. No other discomfort. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her tongue coating was thin and whitish. Her pulse was deep and fine. The herbal tea was the same as before.

 

Date: 15th of December 2006                           Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity and difficulty in walking manifested as walking lamely. No obvious improvement in walking ability. The involuntary muscular jitters of the right lower extremity, shoulders and back was reduced a lot. No other discomfort. The cross-section diameter of the right thigh measured 12cm above the patella was 37cm, while that of the left thigh was 42cm. Measured 22cm above the patella, the cross-section diameter of the right thigh was 43cm, while that of the left thigh was 48cm. Measured 12cm above the Juxu point, the cross-section diameter of the right leg was 28cm, while that of the left was 32cm. She had gotten certain improvement. Principle of TCM treatment was the same as before: strengthening the spleen and supplementing qi; tonifying the liver and nourishing yin essence. Other treatments continued: daily acupuncture and massage; daily dirigation.

 

Date: 18th of December 2006                           Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity. She walked less lamely than had done before. The involuntary muscular jitters of the right lower extremity, shoulders and back was obviously lessened. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. No other discomfort. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her tongue was light red with thin and whitish coating. Her pulse was deep and fine. The herbal tea was the same as before. Continue with strengthened functional training and combination therapy.

 

Date: 20th of December 2006                            Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity which was a little better than before. She walked in a swaying gait but less lamely. The involuntary muscular jitters of the right lower extremity, shoulders and back almost disappeared. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. No other discomfort. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her tongue coating was thin and whitish. Her pulse was deep and fine. The new herbal tea included such herbal as cooked rehmannia, dioscorea, millettia, cornus, dispascus, epimedium, astragalus root, morinda root, achyranthes root, tangkuei, tortoise plastron glue (melting by heat), and cibotium root, etc. A daily dosage should be decocted twice. Continue with strengthened functional training and combination therapy.

 

Date: 23rd of December 2006                           Time: 9:00 a.m.

Today the patient had hypodynamia and obvious amyotrophy of her right lower extremity which was a little better than before. She walked in a swaying gait but much less lamely. The involuntary muscular jitters of the right lower extremity, shoulders and back almost disappeared. No nausea or vomit. No aversion to cold. No fever, headache, or dizziness. No other discomfort. Her spirit, appetite and sleep were normal. Her bowel movement and urination were normal. Her tongue coating was thin and whitish. Her pulse was deep and fine. She was about to leave hospital tomorrow.

 

Based upon our very successful help to many ALS patients, ALS is now one of the significant focuses of our hospital.

 

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