Western Medicine

Multiple Sclerosis (MS) is a neural disorder with an unknown triggering mechanism. This chronic, slowly progressive autoimmune disease is where the body's immune system attacks the myelin sheaths around nerve cells mainly in the brain and spinal cord (a process called demyelination), resulting in the damaged areas failure to transmit nerve impulses. Because the lesions can partially heal, it goes through characteristic phases of remission and relapse.
Initial symptoms of MS are often vague, such as blurred or double vision, fatigue and muscular weakness. Individuals are usually diagnosed between the ages of 20 and 40, when they present with symptoms like muscular weakness, numbness, incoordination, paralysis, convulsions, visual problems, bladder or bowel disturbances, mood swings, cognitive problems and difficulty in speaking. Symptoms vary greatly from patient to patient since almost every system of the body can be affected.

A MS nerve cell

Chinese Medicine

Multiple sclerosis (MS) is a disorder of the central nervous system (brain and spinal cord), which is characterized by patchy, degenerative changes in the myelin sheaths surrounding nerve cells, resulting in scar formation. It is a common neurological disorder in the northern hemisphere.

This debilitating disease is rare in China, and no specific details have been recorded in TCM history. However, reports about it are on the rise. Due to a great variety in clinical presentations, modern TCM places MS in different syndrome categories and takes the individual's condition as reference.

When symptoms are marked with muscular weakness or paralysis syndrome, it is classified as flaccidity syndrome. This is a morbid condition that is mostly due to a lack of nourishment in the muscles.

When individuals present with difficulty in speaking, limb weakness or paralysis, TCM classifies their conditions as aphasia and paralysis syndrome, which is believed to be mainly due to consumption of kidney essence or obstruction of the meridians by wind and phlegm.

When dizziness, vertigo and unsteadiness predominate, TCM classifies it as vertigo syndrome. This usually caused by exogenous evils invasion (especially wind-fire or phlegm-dampness), impairment of qi (vital energy) or blood flow or organ dysfunction (deficiency of heart, spleen or kidney.)

In the late stages that present with limb spasms, delirium or mental deterioration, physicians usually put this condition under epilepsy or dementia syndromes.

While Western medicine has a number of drugs to slow down progress of this disease and reduce the frequency of attacks, there is still no cure for MS. Based on integrated immune modulation effects to the body, TCM therapies can assist individuals in recovery from attacks, reducing the number of relapses and preventing further progression of the MS.

Western 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

Chinese Medicine

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.

Western Medicine

Special senses
Involvement of the visual pathways usually occurs and most commonly affects the optic nerve. The patient complains of blurring of vision in one eye. The symptoms progress, usually over hours or days. The visual disturbance varies according to the severity and extent of the lesion, often being patchy (scotomata) and sometimes so subtle as to impair only color discrimination, although total blindness can occur. Pain is a common accompaniment. Recovery occurs, typically within one or two months. Deafness occurs in multiple sclerosis, occasionally at presentation. Feelings of unsteadiness are common; and acute brainstem demyelination cause diplopia, vertigo, facial numbness and/or weakness or dysphagia. A typical picture is sudden diplopia and vertigo with nystagmus, but without tinnitus or deafness. This lasts for some weeks before recovery.

Motor symptoms
Impaired mobility affects the majority of patients with multiple sclerosis, usually as a result of spinal disease; movements are slow, with weakness differentially affects extensors in the arms and flexors in the legs. Spasticity may be more problematic than weakness and all aspects of immobility are frequently complicated by fatigue. Cerebellar involvement causes incoordination of speech and eye movements.

Sensory symptoms
Altered sensation occurs at some stage in nearly every patient with multiple sclerosis. A common presentation is numbness, in various locations. This disturbing symptom seldom leads to loss of function. Damage to the cervical cord produces tight, burning, twisting, tearing, or pulling sensations, which are usually painful.

Autonomic involvement
Autonomic symptoms occur in many patients with multiple sclerosis. Bladder symptoms (e.g. urgency and frequency with incontinence) are most common in women whereas impotence occurs frequently in males.

Unusual Presentations
Epilepsy occurs more commonly in multiple sclerosis patients than in the general population. So, too, does trigeminal neuralgia. Tonic spasms of a limb are another unusual symptom of this disease. Dementia or organic psychosis is occasionally a feature of early multiple sclerosis.

End-stage multiple sclerosis
In the later stages of the disease the patient is severely disabled with a combination of spastic tetraparesis, ataxia, optic atrophy, nystagmus, and incontinence of urine. Dementia is common. Death follows from uraemia and/or bronchopneumonia.

Clinical course and prognosis
80% of patients present with relapsing/remitting disease, episodes occurring at random frequency and for an unpredictable period, but averaging about one per year and decreasing with time. Later, a high proportion of patients enter a slowly progressive phase of the disease, but in 20% the illness is progressive from onset. Life expectancy is at least 25 years, and a high proportion of patients die from unrelated causes. Recovery from each attack is invariably slower than the onset, and may be incomplete.

About 25% of patients have multiple sclerosis in a form that is not disabling. In about 5% of patients, a latent period of over 20 years occurs between the presenting and the next episode. Benign disease usually occurs in young females who mainly have sensory symptoms and complete recovery from individual episodes. Conversely, in 5% relapses occur frequently and do not recover, leading rapidly to disability and early death; and up to 15% become severely disabled within a short time. Occasionally, patients die acutely from respiratory failure.

Chinese Medicine

According to the location of lesions in the brain and spinal column, multiple sclerosis can present in various ways. The neural symptoms include difficulty speaking, blurred vision, double vision, weakness and heaviness of one or both legs, jerking of the legs, numbness or tingling and incoordination. Some individuals may only show vague signs like vertigo, incontinence, urinary urgency or frequency, vomiting, diarrhea and impotence. If the nervous system keeps on degenerating, symptoms will progressively worsen.

TCM practitioners usually begin with a full investigation of the individual and then categorize his or her symptoms under syndrome groups known as "disharmony patterns." In addition to the symptoms discussed above, TCM practitioners also focus on associated symptoms for syndrome differentiation. The disharmony patterns, which present at different stages of the disease, generally indicate the degree of disharmony of the body and the involved organs as well as the progress of the disease.

Meridian obstruction by phlegm and heat
After onset of fever, individuals develop sudden limb weakness, numbness or paralysis. Associated symptoms include distended headache, irritability, chest tightness, ear ringing or blurred vision. In some cases, there may be sudden blindness, thirst without the desire to quench it, speaking difficulties, yellow sticky secretions in the throat, and even urinary difficulty.

Damp-heat dissemination
This leads to a gradual development of limb weakness which is obvious in the lower limbs as well as numbness and a slight puffiness in the limbs. Other symptoms include tightness in the forehead, generalized heaviness, sallow complexion, abdominal distention, depression, decreased vision, diarrhea and yellowish urine.
Blood stasis accumulated in meridian

This leads to limb weakness with numbness, tingling or contracting pain; other symptoms are dizziness, ear ringing, sallow complexion, muscular atrophy, urinary difficulty or dribbling after voiding, double vision or even blindness.
Deficiencies in lung and spleen
This leads to slow and progressive development of limb weakness, unsteadiness, tremor and muscular atrophy in the lower limbs. Other associated symptoms include pale complexion, poor appetite, abdominal distention, diarrhea, and aversion to wind; there is also a tendency to catch cold or flu, dizziness, inability to void urine, blurred version or even blindness.

Deficiencies in liver and kidney
Individuals present with general paralysis, weight loss, unsteadiness, clumsiness, facial distortion, soreness in lumbar and knee regions. Associated symptoms include dizziness, vertigo, blurred version, throat dryness, constipation, ear ringing, fatigue, depression, speaking difficulty, urinary difficulty, as well as hot sensations in the palms, soles and chest.

Depletion of kidney yang
Individuals present with general paralysis, numbness, muscular atrophy, clumsiness, unsteady steps, blurred version or dropping of upper eyelids, declined hearing, difficulties in swallowing and speaking. Other accompanying symptoms include dizziness, limbs coldness, fatigue and sleepiness, sensitivity to cold temperatures, poor appetite, urinary frequency and diarrhea.

Illustration of TCM organs

Western Medicine

Few other neurological diseases of young people follow a similar relapsing and remitting course. The criteria for diagnosis is the requirement that the neurologic dysfunction not be a monophasic illness; that is, there are two neurologic events, separate in time (by at least a month) and separate in their location within the central nervous system. These simple clinical criteria have proven themselves 75% accurate.

Three factors help in more accurate diagnosis.

Cerebrospinal fluid
Cerebrospinal fluid may reveal that there is a rise in total protein, with a specific increase in the immunoglobulin concentration and the presence of oligoclonal bands in more than 90% of cases, providing evidence for synthesis of immunoglobulin within the central nervous system.

Electrophysiology
Evoked potentials are a quantitative, neurophysiologic means of demonstrating the interruption of the message-carrying capacity of axons whose myelin is affected. Whereas myelin speeds transmission, these tests show a slowing transmission. The utility in demonstrating abnormality in an area not necessarily having had symptoms or signs is less than that of cerebrospinal fluid oligoclonal bands.

Imaging
Magnetic resonance imaging of the central nervous system usually allows us to see the evidence of multiple areas of inflammation. This is the most sensitive diagnostic tool for this condition, but it too suffers from a lack of specificity, with a large number of other diseases having similar changes.

Chinese Medicine

In TCM, diagnosis is based on the four examination techniques, which stress the determining of the circumstances and manifestations of a disease through inquiry and symptom observation.

Procedures for a TCM diagnosis of multiple sclerosis (MS) can be explained as follows:

Meridian obstruction by phlegm and heat
This usually occurs in the late stages of a MS relapse. Invasion of heat evils give rise to symptoms like fever, thirst, irritable and urinary difficulty, while phlegm invasion tends to cause obstructions and interfere with the meridian flows. In addition to limb problems, the influence of phlegm is also blamed for chest tightness, distended headache, throat secretions and vision problems. On examination, the tongue is red and covered by yellow or yellow greasy fur.
The pulse is rolling and rapid or taut and rolling.
Damp-heat dissemination
The acute stages of MS usually fit this pattern. Damp-heat is a pathogen mostly contracted from the external environment. Typical symptoms include fever, headache, body aches, generalized heaviness, fatigue, abdominal distention and poor appetite as well as scanty and yellowish urine. On examination, the tongue is red and covered by yellow fur; the pulse is hesitant and rapid.
Blood stasis accumulated in meridians
Features of blood stasis are characterized by numbness, contracting pain and tingling sensations. On examination, the lips are purple, the tongue is purple-blue or may appear bruised; the pulse is hesitant.
Deficiencies in the lung and spleen

In TCM, the spleen is the source of nutrients while the lungs play an important role in the distribution of nutrients. Dysfunction of the two organs not only affects the supply of nutrients to muscles and tendons, but also leads to general impairment of the whole body. Symptoms include weakness, as well as low resistance against infection, dizziness and a sallow complexion. On examination, the tongue is pale and covered by thin white fur. The pulse is fine and weak.
Deficiencies in the kidneys and liver
The kidney stores essence while the liver stores blood. Disorder in these organs therefore lead to inadequate nourishment in important structures like the brain, orifices and limbs lead to symptoms such as dizziness, ear ringing, speaking difficulty, numbness and soreness. Yin deficiency in this case leads to yang hyperactivity creating virtual heat symptoms. On examination, the tongue is red with little fur covered the pulse is fine and rapid.
Depletion in kidney yang
This pattern usually results from enduring yin deficiency; kidney yang has the effect of propelling transformation and warming the organs. It acts as the root of the body's physiological functions. As a result, all physiological activities decline, leading to coldness and inhibitory symptoms. On examination, the tongue is swollen and pale, and is covered by white thin fur. The pulse is deep and fine.
It should be emphasized that individuals usually present with different manifestations of their illness and not as described above. Therefore, an experienced physician is needed to ensure an accurate diagnosis.

Western Medicine

Most difficult for multiple sclerosis patients is the uncertainty. What will their clinical course be? How will their illness affect their family? Will they be able to work? Are the current treatments helpful? Anytime they do not feel well, is it the multiple sclerosis or something else? Obviously, the mainstay of treatment is addressing these issues with support and education. This is often accomplished with the greatest success by multiple sclerosis centers, which affords "one-stop shopping" with the opportunity for patients to relate to peers, psychologists, psychiatrists, social workers, physical therapists, nurses, neurologists, and when necessary, other medical specialists and attorneys expert in the problems of those with chronic illness.

The treatment of acute relapse
Since spontaneous recovery after follows a relapse, treatment is not required for every exacerbation. Corticosteroids shorten the duration of relapse and have few complications, even when multiple courses have been administered.

The treatment of symptoms
The most common problems associated with multiple sclerosis are psychiatric. By being multidisciplinary and involving a peer group, multiple sclerosis centers can serve a major role in the management of these problems. Anxiolytic and/or antidepressant medications are occasionally required.

Spasms are the other common and troubling sequelae of this disease. Spasms, more frequent at night, often respond to a benzodiazepine at bedtime. Weakness and spasticity contribute differentially to immobility in-patients with multiple sclerosis. The relief of spasticity can aggravate weakness and paradoxically reduce mobility, since patients may depend on increased muscle tone in order to stand. Spasticity is often treated with baclofen. Maintenance physical therapy programs may help in the treatment of both.

Bladder dysfunction can be characterized as failure to store or failure to empty. Failure to store is treated with anticholinergic agents (oxybutynin or propantheline) Failure to empty is treated by intermittent self-catheterization, which is easily adopted by motivated patients with adequate vision and arm function, and ensures complete bladder emptying. Symptomatic bacterial infection requires specific antimicrobial treatment.

Influencing the course of multiple sclerosis

Interferon beta is the only treatment demonstrated to alter the natural history of multiple sclerosis. Drawbacks are every-other-day injections and substantial side effects, rather like flu, resolving over weeks. Ambulatory patients with exacerbating remitting disease have the burden of their disease decreased by one-third after five years of treatment.

Chinese Medicine

TCM's experience with multiple sclerosis (MS) indicate that therapeutic strategies for individuals undergoing a MS relapse or those who are newly diagnosed, should focus on releasing the body surface, expelling wind, clearing heat, resolving phlegm, activating blood and unblocking the meridians. In the late stages or the remission period, strategies should focus on fortifying the kidney, replenishing essence, soothing the liver, nourishing the blood, supplement qi (vital energy) and reinforcing spleen. Nevertheless, it is recommended that treatment be based on syndrome differentiation.
Meridian obstructions by phlegm and heat
Therapeutic aim: Clear heat, resolve phlegm, smooth and unblock meridians
Sample prescription:Cleansing Phlegm Decoction (Di Tan Tang)
In the prescription, pinella and arisaema are the main ingredients for cleansing the phlegm. The others work together to clear heat, replenish qi and enhance spleen, so that meridian flows are smoothed, and orifices in the head region can be unblocked. Symptoms like dizziness, speaking difficulty, numbness and weakness in the limbs can be relieved.
Damp-heat dissemination
Therapeutic aim: Clear heat, resolve dampness and strengthen joints
Sample prescription:Modified Two Wonders Powder (Jia Wei Er Miao San)
In the prescription, coix seeds, atractylodes rhizome and Corktree bark are the main ingredients for clearing damp-heat. The others activate blood flow, strengthen tendons and bones. As a result, problems in the limbs can be relieved.
Blood stasis accumulated in meridians
Therapeutic aim: Replenish qi and blood, and activate circulation.
Sample prescription: Sacred Healing Decoction (Sheng Yu Tang)

All the above ingredients are used for enriching the qi and blood as well as promoting their circulations. As a result, signs such as weakness or abnormal feelings caused by stagnated condition can be resolved.
Deficiencies in the lung and spleen
Therapeutic aim: Consolidate qi, invigorate the spleen and stomach.
Sample prescription:Power of Gingeng, Poria and Atractylodes (Seng Ling Bai Shu San)
In the prescription, ginseng, atractylodes and poria are the main ingredients for invigorating the spleen and replenishing qi. Hyacinth bean, lotus seeds, coix seeds and yam can expel the accumulated dampness effectively; together with cardamom seeds, balloonflower and liquorice, the qi flow can be consolidated. As a result, both of the spleen and lung are fortified.
Deficiencies in the kidneys and liver
Therapeutic aim: Invigorate liver and kidney, nourish yin to clear heat.
Sample prescription:Modified Zuogui Drink

In the prescription, the cornus fruits, dodder seeds, achyranthes and tortoise shell tonify and nourish liver and kidney; the deerhorn replenishes essence and promotes marrow production; the anemarrhena rhizome and corktree bark nourish yin and clear virtual heat.

Depletion in kidney yang
Therapeutic aim: Warm and invigorate the kidneys, replenish essence and marrow.
Sample prescription:Modified Erxian Decoction plus Yougui Drink

In the prescription, the epimedium, eye-grass rhizome, morinda and monkshood can warm kidney and replenish essence; the rehmannia rhizome, cornus fruits and eucommia bark nourish yin and tonify the kidneys which will benefit kidney yang; Chinese angelica nourishes blood; deerhorn glue replenishes essence and marrow.

Acupuncture therapies for multiple sclerosis

During the remission period, the recovery process in MS individuals may take months or even years. Acupuncture not only eases the suffering of patients, it can also stimulate the overall modulation system and speed up the healing process.

Physicians usually focus on the head region during treatment, such as bai-hui, qu-bin, shuai-gu, feng-chi and yu-zhen. They choose one side for stimulation and then carry out the procedure on the opposite side. Needles should be retained for 30 minutes each time, and the procedure should be carried out once a day. After 10 days, there should be a 3-day rest period and then another cycle should take place. Below are the selected acupoints for relief of symptoms:

Acupoints in the head

Paralysis in the upper limbs: jian-yu, qu-chi, wai-guan, he-gu, shou-san-li;
Paralysis in the lower limbs: huan-tiao, bi-guan, feng-shi, zu-san-li, yang-ling-quan, san-yin-jiao, xuan-zhong, kun-lun, mai-bu;
Speaking difficulties: lian-quan, he-gu, tong-li, ya-men;
Dysphagia: tian-tu, lian-quan, fu-tu, feng-chi, he-gu;
Urinary retention or incontinence: guan-yuan, qi-hai, zhong-ji, shen-shu;
Constipation: zu-san-li, yang-ling-quan, tian-shu, da-chang-shu, zhong-wan;
Blurred vision: jing-ming, tai-yang, guang-ming;
Facial distortion: yi-feng, xia-guan, di-cang joined jia-ju.

Acupoint injection

Herbal infusions can be injected at selected points so as to exert stimulating and pharmaceutical effects. Selection of these points are based on the particular manifestations of MS; however the acupoints are usually in the lower limbs, such as fu-tu, bi-guan, zu-san-li, cheng-shan, yang-ling-quan and yin-ling-quan. Some of the herbal injections include Chinese angelica, red sage root and safflower flower. Every two days, 0.5-1.0 ml of diluted herbal infusion should be injected at 2-3 selected points, 5-7 injections for one cycle.

Chinese safflower

Physical therapies

Individuals will remain unsteady and clumsy in their movements or suffer from paralysis to a certain extent when they enter the remission period, therefore, proper physical exercise helps to improve muscular strength, prevent atrophy and stiffness or relieve the muscle spasm. It would be beneficial to choose some traditional self-practice exercises. TCM massage is another alternative, which has some set procedures, for example:
Upper limb weakness: grasp the tendons in the shoulder region, twist and knead the lateral side of the arm, and then strike on acupoints like jian-yu, he-gu and qu-chi.
Lower limb weakness: grasp the medial aspect of the upper thigh, calf of the lower leg and heel tendon, twist and kneed around the upper tight, and then strike on acupoints like yang-guan, huan-tiao, jie-xi and du-bi.

Hydrotherapy

Hydrotherapy is the use of water to treat disease, alleviate pain, induce relaxation, and maintain general good health. For therapeutic purposes, the water may be warm or cold, or in the form of ice or steam. This method is used to relax muscles and joints, soothe anxiety, relieve stress, and enhance mobility. It can be achieved through swimming, underwater exercise, or warm baths in a darkened room that helps individuals to focus on breathing exercises and other pain-control methods. Herbal washing or bathing are combined in some centers.

Western Medicine

The disease cannot be prevented at this time.

Chinese Medicine

Because multiple sclerosis (MS) goes through characteristic phases of remission and relapse, any specific management should always be carried out in formal medical centers. Individuals are not encouraged to seek unapproved or self-healing methods, which may increase the risk of relapsing. Special attention also needs to be paid to daily living:

• Exercise regularly to strength the body's resistance, in TCM understanding, when the body's vital energy (qi) is strong, no pathogenic factors can interfere.
• Multiple sclerosis usually induced or re-occurs after influenza, which is categorized as wenbing (seasonal febrile diseases) in TCM; therefore it is important to avoid invasion of external pathogens in daily life.
• High temperatures disturb the transmission of nerve impulses, so individuals should avoid hot baths or other thermotherapy.
• For individuals in remission, taking Chinese medicine for an extended time can enhance and prolong the remission period and decrease changes of relapse. However, this should be closely monitored by experienced physician.

Below are recommended recipes:
In acute stages, a congee made by barley (60g), coix seeds (60g), glabrous greebrier rhizome (90g) can be served regularly. When serving, discard the rhizome and eat the congee while still warm. This recipe helps to eliminate damp-heat.
During remission, the diet should tonify the liver and kidney; some beneficial foods are litchi, persimmon, grapes, Chinese box thorn, white fungus, enoki mushrooms, sesames, rock sugar, pork, chicken, duck, rabbit, animal livers and kidneys, eggs, frogs and clam. A herbal tea can be prepared as regular drink, by using Chinese wolfberry fruit (15g), Astragalus (50g) and Common jujube fruit (10 pic) and boil with 2000ml of water, serve warm. The tea promotes qi and essence production.

Western Medicine

Chinese Medicine