Systemic lupus erythmatosus & Chinese herbal medicine

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

Ingredients: Uncooked Radix Rehmanniae (Sheng Di), Semen Pruni Persicae (Tao Ren), Flos Carthami Tinctorii (Hong Hua), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), and Radix Achyranthis Bidentatae (Niu Xi), 20g each, Radix Bupleuri (Chai Hu) and Radix Ligustici Wallichii (Chuan Xiong), 15g each, and Fructus Immaturus Citri Aurantii (Zhi Shi), 9g.

Additions & subtractions: If there is emotional depression or dysphoria with chest and rib-side distention and pain, add nine grams each of Tuber Curcumae (Yu Jin), Rhizoma Cyperi Rotundi (Xiang Fu), Pericarpium Citri Reticulatae Viride (Qing Pi), and Fructus Citri Sacrodactylis (Fo Shou). For aching and pain of the tips of the extremities and/or joint aching and pain, add 9-15 grams each of Ramulus Mori Albi (Sang Zhi), Ramulus Cinnamomi Cassiae (Gui Zhi), Radix Gentianae Macrophyllae (Qin Jiao), Caulis Milletiae Seu Spatholobi (Ji Xue Teng), and Caulis Lonicerae Japonicae (Ren Dong Teng). If there is more blood stasis with cyanosis of the tips of the extremities and greenish purple of the skin with a relatively prolonged disease course, increase the Chuan Xiong up to 20 grams and add nine grams each of Rhizoma Sparganii (San Leng) and Rhizoma Curcumae Zedoariae (E Zhu), 15 grams each of Radix Pseudoginseng (San Qi) and Radix Angelicae Sinensis (Dang Gui), and six grams each of Resina Olibani (Ru Xiang) and Resina Myrrhae (Mo Yao). If there is more qi stagnation with inability of the yang qi to spread to the four limbs and therefore a somber white of the tips of the four extremities and the skin with counterflow chilling over a continuously long time, then add nine grams each of Cortex Cinnamomi Cassiae (Rou Gui) and Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), Caulis Akebiae (Mu Tong), Radix Aconiti Kusnezoffi (Cao Wu), and Radix Aconiti Carmichaeli (Chuan Wu) and three grams of Herba Asari Cum Radice (Xi Xin). If joint and extremity aching and pain are pronounced, add nine grams each of Herba Oldenlandiae Diffusae Cum Radice (Bai Hua She She Cao), Buthus Martensis (Quan Xie), and Scolopendra Subspinipes (Wu Gong).

7. Spleen-kidney dual depletion pattern

Main symptoms: Cold body, chilled limbs, low-grade fever or tidal heat, lassitude of the spirit, lack of strength, scanty qi, disinclination to speak, stirring leading to aggravation [of these symptoms], torpid intake, abdominal distention, if severe, vomiting and diarrhea, a somber white or sallow yellow facial complexion, low back and knee soreness and weakness, joint swelling and pain, superficial edema, inhibited urination, skin lesions not marked or purple and dark in color, a pale, fat tongue or dark and pale tongue with tooth-marks on its edges and thin, white fur, and a soggy, fine or deep, fine pulse. This pattern is mostly seen in those with concomitant kidney disease, Raynaud's disease, or those who have undergone prolonged hormone (i.e., steroid) therapy.

Rx: Shen Qi Wan (Kidney Qi Pills) & Si Jun Zi Tang (Four Gentlemen Decoction) with additions and subtractions.