Western and Eastern Medicine Diagnosis and Treatment of Rheumatoid Arthritis

Author: Li Daqing
Publisher:
Publish Date: 1999-05-01
Features: This book comprehensively elaborates on the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment, and rehabilitation of rheumatoid arthritis from both traditional Chinese medicine (TCM) and Western medicine perspectives. It particularly emphasizes the introduction of new technologies and methods for the diagnosis and treatment of rheumatoid arthritis in both TCM and Western medicine. Integrating knowledge from both TCM and Western medicine, this book is based on the author's reference to the latest domestic and international research achievements, combined with years of clinical experience. It possesses certain advantages in terms of advancement, practicality, and uniqueness, making it suitable for clinical practitioners of both TCM and Western medicine, patients, and medical enthusiasts to read and refer to.
Excerpt: Rheumatoid arthritis falls within the category of bi syndrome (painful obstruction). The Suwen·Bi Lun provides classical discussions on the etiology, pathogenesis, and classification of bi syndrome. It states, "The three evils of wind, cold, and dampness converge to form bi." This explains that bi syndrome is a type of disease caused by the invasion of wind, cold, and dampness into the human body, leading to stagnation in muscles and meridians, resulting in the obstruction of qi and blood, and thus causing symptoms such as joint pain, numbness, aching, and difficulty in flexion and extension. It also points out, "All five zang organs have corresponding relationships, and if the disease persists for a long time without resolution, it resides within its corresponding organ." This shows that ancient scholars also regarded this condition as a systemic disease. However, the concept of bi syndrome nearly encompasses all joint diseases recognized by modern medicine, such as rheumatoid arthritis, rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, and gout. These diseases, however, differ significantly in etiology, pathogenesis, clinical manifestations, and prognosis. Rheumatoid arthritis should be distinguished from general bi syndrome and belongs to the category of "stubborn bi," "white tiger joint disease," "bone bi," and "joint wind."
Section 2: Historical Evolution
1. Historical Evolution of TCM's Understanding of Rheumatoid Arthritis
Rheumatoid arthritis falls within the category of bi syndrome in traditional Chinese medicine. The earliest discussions of bi syndrome appear in the silk manuscripts and wooden slips unearthed from the Mawangdui site. A systematic understanding of this condition first appears in the Huangdi Neijing. The Suwen·Bi Lun states, "The three evils of wind, cold, and dampness converge to form bi. When wind prevails, it is classified as wandering bi; when cold prevails, it is classified as painful bi; and when dampness prevails, it is classified as fixed bi." This indicates that wind, cold, and dampness are external causes of bi syndrome. It further classifies bi disease into wandering bi, painful bi, fixed bi, tendon bi, vessel bi, muscle bi, skin bi, heart bi, liver bi, spleen bi, lung bi, kidney bi, joint bi, miscellaneous bi, and blood bi, proposing acupuncture and herbal moxibustion for the treatment of bi syndrome. It also includes discussions on the prognosis of bi syndrome, such as, "When wind prevails, the patient is more likely to recover," and "If the disease affects the zang organs, it leads to death; if it lingers in the muscles and bones, it causes prolonged pain; and if it remains in the skin, it is easier to recover."
During the Han Dynasty, Zhang Zhongjing further advanced the understanding of bi syndrome. In the Jin Gui Yao Lue, he first proposed the terms "wind-dampness" and "joint disease" and discussed them separately, with a dedicated section on "blood bi." He introduced the concept of syndrome differentiation and treatment, creating corresponding formulas, such as, "For cases of wind-dampness occurring on the eighth to ninth day of cold damage, with body pain and inability to turn over, without vomiting or thirst, and a floating and weak pulse, Guizhi Fuzi Tang is prescribed. If the stool is hard and urination is normal, Gui Zhi Bai Zhu Tang should be used." The Jin Gui Yao Lue·Bi Wind Joint Disease states, "A deep and weak pulse at the cun and guan positions indicates bone involvement, while a weak pulse indicates tendon involvement. A deep pulse corresponds to the kidneys, and a weak pulse corresponds to the liver. Sweating and entering water leads to yellow sweat in joint disease, hence the term 'joint disease.'" It further states, "For joint disease that cannot be flexed or extended and causes pain, Wu Tou Tang is prescribed." The Jin Gui Yao Lue·Blood Bi and Exhaustion section says, "For blood bi, both the yin and yang pulses are weak, with a slight pulse at the guan position and a tight pulse at the wei position. The external symptoms include numbness of the body, resembling wind bi. Huangqi Guizhi Wu Wu Tang is prescribed." The treatment principles proposed by Zhongjing, such as dispersing wind and expelling dampness, slightly inducing sweating; warming the meridians and expelling cold and dampness; and warming the meridians, dispersing cold, and relieving pain, as well as many of his prescriptions, have been used until the present day.