Signs And Symptoms
The classic signs and symptoms of this Damp Bi Arthritis can vary depending on a variety of factors, including whether the condition has an internal or external origin and the duration of the disorder. For the internally caused Damp Bi Arthritis, the presentation will likely have many of the characteristics of a moderately advanced spleen qi deficiency. In addition to pain, the patient will often report symptoms such as:
– heaviness and numbness of the limbs (more often lower limbs);
– muscle aches;
– and swelling of the joints.
In cases of longer duration, the patient may also present with:
– fatigue and lethargy;
– possible generalized edema;
– poor memory and difficulty concentrating.
In cases of Damp Bi Syndrome Arthritis, the pain is the paramount symptom and its character is of a fixed nature and it is aggravated by dampness or humid and rainy weather. The pulse will tend towards slow and slippery, although it can also present as wiry depending on the intensity of the pain. If the condition is due more to environmental factors, then symptoms are likely to be more localized and related spleen qi deficiency signs are less likely.
TREATMENT PRINCIPLES FOR DAMP BI SYNDROME ARTHRITIS
The primary treatment principle for treating Damp Bi Syndrome Arthritis will be to drain damp and remove obstruction. The methods for accomplishing this will be a combination of acupuncture and herbs. Incorporating an herbal approach to treatment is almost always required when treating a damp condition. Damp by its very nature is a stubborn condition which can be difficult to treat. The use of herbs in combination with acupuncture will allow for a more comprehensive approach with a more rapid change in the patient’s condition.
ACUPUNCTURE POINT PRESCRIPTIONS FOR DAMP BI SYNDROME ARTHRITIS
The choice of a point prescription for acupuncture should include local, adjacent and distal points. In many cases, local points will be ashi points, although in some cases they may be actual points. This would be the case with Damp Bi Syndrome Arthritis of the knee and treating it with Stomach 35 or elbow pain and the use of LI 11.
Adjacent points will be above and below the affected joints. Treatment of Damp Bi which presents in the knees, would likely include the use of adjacent points such as Stomach 36 and GB 34: Spleen 10, Kidney 10 and UB 40; Liver 7 and 8, GB 33 and Stomach 34. Treatment of Damp Bi which presents in the elbow, would likely include the use of adjacent points such as LI 10 and 12 and SJ 8 and 9. Other adjacent points which should always be considered when treating Damp Bi Syndrome Arthritis in the area of the knee are Spleen 9 and Liver 8. These would be particular useful as not only are they adjacent points, they are both effective at expelling damp.
Distal treatment would include points such as Spleen 5 which is effective for expelling dampness. This is a useful distal point, regardless of the particular affected channel. Other distal points may be selected based on the affected channel. Thus, GB 40 should be considered when the pain is in the posterior-lateral aspect of the knee and Stomach 41 should be considered when the pain is in the anterior-lateral aspect of the knee.
In addition, the practitioner may elect to use the correspondence points of the corresponding foot or hand channel. Accordingly, if the pain is located more on the anterior-lateral aspect of the knee, then the affected channel is the Stomach (Yang Ming Foot) channel and the corresponding anterior-lateral hand channel, is the Large Intestine (Hand Yang Ming). As such, the practitioner would select points such as LI 10, 11 and 12. If the pain presented primarily at the posterior-lateral aspect of the knee, then the Gall Bladder (Foot Shaoyang) channel would be implicated and the practitioner would select points on the San Jiao (Hand Shaoyang) channel. These would be points on or around the elbow such as SJ 8 and 9. When using this method, the correspondence points of the opposite limb are used.
In all cases, the practitioner should consider using Jing Spring points as these points are particularly effective in the treatment of arthritis.
Other considerations will depend on the patient’s overall condition. If the patient presents with symptoms such as diminished memory, lethargy and fatigue points should be selected to address spleen deficiency. Thus, Ren 12 UB 20 might be added to the point prescription, as well as Stomach 36 and Sp 3. These points will address the underlying spleen qi deficiency and thus reduce the likelihood that the condition will recur.
HERBAL FORMULA’S FOR USE IN THE TREATMENT OF DAMP BI SYNDROME ARTHRITIS
The approach in selecting an herbal treatment for Damp Bi Syndrome Arthritis is to focus on draining damp and removing obstruction. Herbs such as yi yi ren, fang feng, fu ling, bai zhu and cang zhu would be prescribed to treat damp.
Additional herbs will be included depending on the location of the condition. Thus, if the affected area is the knees, nui xi will be added to direct the formula to the lower aspects of the body. Similarly, if the upper body is affected, herbs such as qiang huo and gui zhi might be added to direct the formula to the upper aspects of the body.
In all cases, the formula will be adjusted to address underlying constitutional condition and other aspects of the Bi Syndrome. Accordingly, if the patient is constitutionally yin deficient, in addition to herbs that will treat the Bi Syndrome, the pratititioner will include yin moistening herbs such as Shu Di Huang, Shan Yao, Shan Zhu Yu and Gui Ban Jiao. Furthermore, if the Bi is predominantly cold in nature, warming herbs such as Wu Tou, Fu Zi and Gan Jiang may be added to the formula. If the Bi is predominantly hot in nature, then cooling herbs such as Lian Qiao, Chi Shao and Chi Xiao Dou will be included in the formula.
In all cases, the formula will be adjusted to accommodate the unique Bi presentation of the individual patient and the underlying constitutional pre-disposition.
If you are interested in learning more about the use of Chinese Medicine and Acupuncture in the treatment of arthritis, contact Elizabeth Healy at West Village Acupuncture. I can be reached at +1 917-968-2854. and am conveniently located in Greenwich Village.