Lupus SHL - lurking pathogens

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Yang Tiande has suggested that the shao yang is the most common area for

pathogens to lurk in the SHL model and that the qi stage is the most common area

in the wen bing schema.

 

Here are some treatments for SLE. The first set is predicated on SHL theory

according to Professor Ding Jie Ming's experience with over 500 SLE patients:

Base Formula:Cinnomomi cassiae Ramulus (Gui Zhi)Bupleurum chinense (Chai

Hu)Lycopodium clavatum (Shen Jin Cao)Glycyrrhiza uralensis (Gan Cao) For lesions

in the brain and CNS, addCicada periostricum (Chan Tui) and Polygala

tenuifoliae (Yuan Zhi) to the baseformula. Liver lesions: For severe headache

(wind) add

Uncariaecum uncis (Gou Teng) and Peonia alba (Bai Shao).To tonify yin add

Ecliptae prostatae(Han Lian Cao), Ligustri lucidii (Nu Zhen Zi), Scrophularia

ningpoensis (XuanShen), and Haliotidis concha (Bao Yu).For hypochondriac pain

add

Scutellariabaicalensis (Huang Qin), Moutan radicis (Mu Dan Pi), Cyperi

rotundis (Xiang FuZi). Spleen lesions: 1.If the Spleen is enlarged add

Coptischinensis (Huang Lien), Atractylodes macrocephala (Bai Zhu), and

Hordeumvulgaris (Mai

Ya).

 

2.For diarrhea or loose stool removeScrophularia ningpoensis (Xuan Shen). Add

Dioscorea oppositae (Shan Yao), Massafermentata (Shen Qu), Saussurea lappa

(Mu Xiang), Carbonized Zingiberisofficinalis (Gan Jiang), and Atractylodes

macrocephala (Bai Zhi). 3.For severe dampness of the spleen,subtract

Scrophularia

ningpoensis (Xuan Shen); add Coicis lachryma-jobi (Yi YiRen) and Atractylodes

macrocephala (Bai Zhi). 4.For thin muscles and fatigue addAstragalus

membranaceus (Huang Qi), Angelica sinensis (Dong Gui), Lycopilucidus (Ze Lan),

and

Salvia miltiorrhiza (Dan Shen). Lung lesions: Add Ephedra (Ma Huang),

Peucedanipraeruptorum (Qian Hu), Platycodon grandiflorum (Jie Geng), and

Polygalatenuifolia

(Yuan Zhi) to open the lungs, and dissolve phlegm. When Lung is inflamed, add

Cortex ofMori alba radicis (Sang Bai Pi). Coughing blood add

Ophiopogonisjaponicus (Mai Men Dong), Nelumbinis nucifera (Lotus Root or Ou

Jie),

Biotaorientalis (Bai Zi Ren), Caucumen biota (Ce Bai Ye). Skin lesions: Use

Astragalus

membranaceus (Huang Qi),Angelica sinensis (Dong Gui), and Clematidis chinensis

(Wei Ling Xian). Thetreatment strategy is to nourish Qi and Blood, and disperse

wind. Ascites: Areca catechu Shell (Da Fu Pi)to relieve damp. When the lesion

is in the kidney, Warmthe Yang, Expel Wind, and Benefit the Kidney.Xien Ling

Pi is the base formula forthis: Aconite carmichaeli (Zhi Chuan Wu), Lycopodium

clavatum (Shen Jin Cao),Scrophularia ningpoensis (Xuan Shen), Glycyrrhiza

uralensis (Gan Cao),Cinnamomi cassia Ramulus (Gui Zhi), Atractylodes alba (Bai

Zhu), Astragalus membranaceus(Huang Qi), Coicis lachryma-jobi (Yi Yi Ren),

Achyranthes bidentatae (Niu Xi),Chaenomeles lagenaria (Mu Gua). Modification for

Yang Deficiency:subtract Scrophularia ningpoensis (Xuan Shen). Add Achyranthes

bidentatae (NiuXi), Cistanches salsa (Rou Cong Rong), Eucommia ulmoidis (Du

Zhong), Aconitecarmichaeli (Fu Zi).Modification for Yin Deficiency:increase

Scrophularia ningpoensis (Xuan Shen) and add Rehmannia glutinosae Raw(Sheng Di

Huang). Proteinuria: add Astragalusmembranaceus (Huang Qi), Atractylodes alba

(Bai

Zhu), Zea mays (Yu Mi Shu),Coicis lachryma-jobi Radix (Yi Yi Ren Gen), and

Blackbeans.

 

Elevated BUN: Add Achyranthes bidentatae (Niu Xi),Chaenomeles lagenariae (Mu

Gua). For Heart Lesions: make the followingmodifications to the above kidney

based formulas. Heart Yin deficiencyadd more Scrophularia ningpoensis

(XuanShen); also add Ophiopogonis japonicus (Mai Men Dong), Polygonum

multifloriCaulis

(Ye Jiao Teng), Biota orientalis (Bo Zi Ren), and Schisandra chinensis(Wu Wei

Zi). Heart Yang deficiencyremove Scrophularia ningpoensis (XuanShen); add

Aconite carmichaeli Cx (Fu Zi), Salvia miltiorrhiza (Dan Shen),Catharsius

malosis

(Chiang Lian Chung)<A

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graminei (Chang Pu), and Polygalae tenuifolia

(Yuan Zhi).

PracticalSurgery of gives three differentials for Lupus they

are:<A HREF= " file://C:\WINDOWS\Desktop\Dell\herbs\conditions\%23_edn2 " >[ii]</A>

1.Yang deficiency of Spleen and Kidney presenting with a cluster of

the following; mild erythema, bluish-brownsubcutaneous purpura, chills, cold

extremities, mild fever, aching in thejoints, low back pain, sparse hair,

irregular menses, fatigue, perspiration,weakness of the arms and legs, edema,

loss

of appetite, muddy stools, scantyurine, swollen tongue, weak pulse. 2.Yin

Deficiency with Internal Heat hasa cluster of the following; constant low-grade

fever, skin injuries, occasionalerythema, palpitations, insomnia, dry mouth,

dry throat, vertigo, tinnitus,joint aching, low back pain, night sweats,

significant hair loss, irregularmenses, dry stool, yellow urine, a red tongue

with a

thin yellow coat, and athready rapid, tense pulse.3.Excess Toxic Heat symptom

clustersmay be; fresh erythema, hemorrhagic blisters, purpura under nails or

onconjunctiva, high fever, irritability, fainting, thirst, constipation,

decreasedurine, red tongue with thin dry yellow coat, and a tense rapid pulse.

1.For Spleen-Kidney Yang Deficiency useEucommia and Rehmannia Formula (You Gui

Wan) as general treatment. A specificformula used contains Curculiginis

orchioides (Xian Mao) 15g, Epimediumsagittatum (Yin Yang Huo) 15g, Cuscuta

chinensis

(Tu Si Zi) 15g, Cynomoriumcoccineum (Suo Yang) 9g, Atractylodes alba (Bai Zhu)

9g, Codonopsis pilosula(Dang Shen) 9g, Smilax glabra (Tu Fu Ling) 30g,

Glycerrhizae uralensis (GanCao) 6g, Antelopis cornu (Ling Yang Jiao) 3g. Goat

horn is

a possiblereplacement for antelope. 2.For yin deficient internal heat

useRehmannia glutinosae (Shou Di Huang) 18g, Scrophularia ningpoensis (Xuan

Shen)12g,

Ophiopogon japonicus (Mai Men Dong) 12g, Peonia alba (Bai Shao) 9g,Testudinis

plastrum (Gui Ban) 18g, Lycium chinensis (Gou Qi Zi) 15g,Anemarrhena

asphodeloides (Zhi Mu) 9g, Phellodendron amurense (Huang Bai) 9g,Smilax glabra

(Tu Fu

Ling) 30g, Rubus parvifolius (Ci Bo) 15g, Glycyrrhizaeuralensis (Gan Cao) 3g.

3.For Excess Toxic Heat use Rehmanniaglutinosae Fresh (Sheng Di Huang) 30g,

Peonia alba (Bai Shao) 12g, Moutanradicis (Mu Dan Pi) 9g, Gypsum fibrosum (Shi

Gao) 30g, Anemarrhenaasphodeloides (Zhi Mu) 9g, Isatis tinctoris (Ban Lan Gen)

9g, Lithospermumerythrorhizon (Zi Cao) 9g, Glycerrhizae uralensis (Gan Cao)

3g. For severe aching of the joints, addPolygoni cuspidatum (Hu Chang) 15g and

Clematis chinensis (Wei Ling Xian) 12g. For purpura, add Ecliptae

prostratae(Han Lian Cao) 15g.

<A

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rsiusis a beetle which is a drastic purgative and is toxic. Caution

is recommendedfor its use. It activates blood, purges stool, and calms

fearfulness.

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Y. OHAI Bulletin. March 1982; 7(2); 34-40.

<Todd: With some of the discrepancies in theory, it is hard to know whether

it makes sense to to supplement or drain or fast in the remission stage.

However there is at least one more clue in Liu (and no doubt many more elsewhere

in

chinese). In this case, it comes from the wind-warmth section, but the

advice given seems to be of a genral nature. On pg. 229, when discussing why

dan

shen is in qing ying tang, Liu quotes Zhao shao qin, " Once it becomes stagnant,

qi is unable to battle with the warm heat pathogen, which then remains in the

ying. Any method that can restore qi circulation, especially when combined

with clearing heat from the nutritive level and enriching yin, should be

helpful in moving the warm heat pathogen to the qi level [from where it can be

expelled] " . That would seem to say that the best approach to dealing with an

internal pathogen is moving qi and as Liu says, also moving, blood, food and

phlegm. In other words, dispersing pathogenic factors directly may be an ideal

approach to helping the body recover from some seemingly chronic vacuity

illnesses.

>

Lastly:

I treated SLE as a large part of my practice in Massachusetts during the 90s

and Professor Ding's theorems were very useful along with toxic heat. My

studies with Gu Neiqiang have given me an excellent addition to my armamentarium

for Lupus; his insight into the use of bai hua she she cao for the management of

these types of conditions has been useful. Dr Gu will speak on the subject at

the AAOM conference this October in Las Vegas.

Best -

Will

William R. Morris, L.Ac., O.M.D.

Dean of Educational Advancement

Emperor's College of Oriental Medicine

310-453-8300 phone

310-829-3838 fax

will