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Multiple Sclerosis : Causes
Western Medicine Chinese Medicine

The commonest age of onset is between 20 and 35 years, and the likelihood of a primary care physician encountering such a patient is small, approximately 1 case per 1000 patients. The etiology of multiple sclerosis involves interplay between genetic and environmental factors. The lifetime risk of multiple sclerosis in northern Europeans - about 1:800 increases to 1:50, 1:20, and 1:3 for the offspring, siblings, and monozygotic twin partners of affected individuals, respectively. Immigrants from low to high prevalence zones (e.g. from near the equator to northern Europe) acquire the prevalence of the country of destination, provided they arrive before the age of 10 years.

Studies have demonstrated that new episodes of demyelination are more likely to occur following viral exposure, but no one triggering agent has been identified. The risk of developing multiple sclerosis is increased for individuals who are exposed to measles, mumps, rubella, and Epstein-Barr virus infection relatively late in childhood or adolescence. These studies do not implicate any one of these agents as the exclusive cause of multiple sclerosis but suggest that a narrow and age-linked period of susceptibility to viral exposure exist in those who are constitutionally at risk of developing the disease.

It has been suggested that multiple sclerosis is related to the consumption of large quantities of animal fats. Surveys in Norway have shown that MS is distinctly uncommon in coastal fishing communities compared with agricultural areas. However, the role of diet is particularly difficult to evaluate.

Central Nervous System

TCM knows very little about the cause of multiple sclerosis (MS). However, the typical symptoms of multiple sclerosis such as limb weakness, vertigo, incoordination and even paralysis are mainly attributed to dysfunctions in the lung, liver, spleen and kidney. It is possible that the organs are attacked by exogenous factors like heat, dryness, dampness and wind evils, which give rise to yang-qi failing to ascend upward to nourish the brain. Furthermore, TCM holds that a well organized internal environment ensures the production of marrow (which is chiefly derived from kidney essence and food nutrients). The marrow not only fills the bone, it also makes up the brain and spinal column, and thus TCM calls these structures the "sea of marrow". Long-term disharmony or emotional stimulation will affect the production of marrow particularly when the kidney is involved, leading to problems in the central nervous system.

Generally, the pathogenesis of MS can be divided into the following aspects:

Deficiencies in the spleen and stomach
In TCM, one of the major functions of the spleen and stomach are transforming food into nutrient essence that is used to manufacture qi and blood. Under-functioning will lead to malabsorption and indigestion, and dampness or phlegm will accumulate. When dampness or phlegm interferes with the ascending movement of yang-qi to the head region, vertigo occurs. On the other hand, due to the impairment in the transformation of blood and qi, head orifices and the sea of marrow will lose nourishment, leading to the development of speech difficulties or visual problems. When there are inadequate nutrients to bones, muscles and tendons, associated symptoms appear. Improper diet is an important cause of these symptoms.

Invasion of external dampness evil
This is contracted by living in damp places, sitting on damp grass, failing to dry oneself after swimming, being exposed to damp weather when wearing inadequate clothes or being exposed to foggy weather. The dampness evil tends to invade the meridians in the limbs; they cause obstruction and lead to heaviness, numbness and tingling sensations. When the damp circumstances last for a long time or are repeated, the accumulated dampness evil can turn into internal heat, which will then cause further damage to the organs, and result in various symptoms.

Flaring up in lung heat
Normally, the lung is responsible for distributing the nutrient essence throughout the body; this distribution function is carried by the lung fluid, which works to nourish the muscles, tendons, bones and vessels and also acts as the material base for normal functioning of the other organs. Acute febrile disease caused by exogenous evils invasion e.g. wind, heat, or coldness, usually damage the lung and lead to lung fluid being consumed and therefore depleted. Sometimes, a heated lung can also be induced by excessive internal heat and dryness evils. Depletion of lung fluid leads to insufficient nourishment in the above mentioned structures and result in related manifestations.

Impairment of the liver and kidney
In TCM, liver stores blood and rules tendons, and kidney stores essence and rules bones. Having a long-term chronic disease, being sexually active, overstraining oneself, suffering from an emotional disturbance or accumulation of damp-heat evils in the lower burner lead to liver and kidney damage. This leads to a depletion of kidney essence. As a result, there are inadequate supply to the bones, tendons and meridians, leading to the development of multiple sclerosis.

Click to see illustration of MS development from a TCM perspective.