Systemic lupus erythmatosus & Chinese herbal medicine

Townsend Letter for Doctors and Patients, May, 2004 by Bob Flaws

4. Liver channel depressive heat pattern

Main symptoms: Liver area aching and pain, possible chest, rib-side, venter, or abdominal glomus, fullness, distention, and/or pain, heart vexation, easy anger, emotional depression or dysphoria, red or purple, dark-colored skin lesions, dysmenorrhea or amenorrhea in females, and/or menstrual irregularity. It is not uncommon to also see (due to concomitant spleen vacuity) dread of cold but emission of heat, torpid intake, lack of strength, dizziness, and insomnia. The tongue is crimson and may have static macules and there is either thin, white or yellow, dry fur. The pulse is tight and fine or bowstring and rapid. This pattern is mostly seen in those who have used steroids for a prolonged period of time. Typically, the blood pressure is elevated and there is liver-spleen enlargement and functional impairment.

Note: The signs and symptoms given include some blood stasis symptoms even though the words "blood stasis" do not appear in the name of the pattern.

Rx: Yi Guan Jian (One Link Decoction) & Si Miao Yong An Tang (Four Wonders Resting Hero Decoction) with additions and subtractions.

Ingredients: Radix Angelicae Sinensis (Dang Gui) and uncooked Radix Rehmanniae (Sheng Di), 30g each, Radix Scrophulariae Ningpoensis (Xuan Shen) and Fructus Lycii Chinensis (Gou Qi Zi), 20g each, Flos Lonicerae Japonicae (Jin Yin Hua), 15g, Radix Glehniae Littoralis (Sha Shen), Tuber Ophiopogonis Japonici (Mai Dong), Fructus Meliae Toosendan (Chuan Lian Zi), and uncooked Radix Glycyrrhizae (Gan Cao), 9g each.

Additions & subtractions: For liver-spleen enlargement and liver area aching and pain, add 30 grams each of Plastrum Testudinis (Gui Ban) and Carapax Amydae Chinensis (Bie Jia) and 15 grams each of Rhizoma Cyperi Rotundi (Xiang Fu) and Tuber Curcumae (Yu Jin). If blood stasis is severe, add 15 grams each of Rhizoma Sparganii (Sang Leng) and Rhizoma Curcumae Zedoariae (E Zhu) and nine grams each of Radix Rubrus Paeoniae Lactiflorae (Chi Shao) and Cortex Radicis Moutan (Dan Pi). If spleen vacuity is pronounced, add 20 grams of Sclerotium Poriae Cocos (Fu Ling) and nine grams each of Radix Panacis Ginseng (Ren Shen) and Rhizoma Atractylodis Macrocephalae (Bai Zhu). If heat toxins tend to be exuberant, add nine grams each of Radix Et Rhizoma Rhei (Da Huang), Radix Gentianae Scabrae (Long Dan Cao), Radix Bupleuri (Chai Hu), and Fructus Gardeniae Jasminoidis (Zhi Zi).

5. Yin vacuity with fire effulgence pattern

Main symptoms: Long-term low-grade fever which gets worse with taxation and stirring, vexatious heat in the five hearts, tidal redness of the facial region, red cheeks, night sweats, spontaneous perspiration, lack of strength, red or pale red skin lesions which begin in small number and gradually get more or larger, especially after stirring or activity, more skin lesions on the face, joint aching and pain, dizziness and vertigo, tinnitus, dry, lusterless or falling hair, dry mouth, parched throat, red urine, dry stools, menstrual irregularity in females, a red tongue with scanty fur, and a bowstring, fine, rapid pulse. This pattern is mostly seen in those with acute or subacute disease occurrence.