Multiple sclerosis (MS) is a chronic, auto-immune disease that destroys the myelin sheath around nerve cells, primarily attacking cells of the brain and spinal cord. Statistics indicate that this debilitating disease is on the rise, but it is possible that the higher numbers reflect an increased ability to diagnose MS, rather than an actual higher disease rate.

Although more cases of MS are being diagnosed, early signs such as double vision, fatigue and muscle weakness are vague, and could be symptoms of a number of diseases. Unfortunately, even when MS is diagnosed, there is no cure for it. A number of drugs are being used to control or minimize symptoms, but most are not consistently effective.

Scientists generally see MS as an auto-immune process, but the triggering mechanisms are unclear. Since MS tends to run in families, it seems there is either a genetic tendency to develop the disease, or a genetic predisposition to be susceptible to the triggering mechanisms that result in the development of MS. People in northern latitudes of Europe and North America are more often affected than those in southern areas, and the disease is almost unheard of in the tropics. Multiple sclerosis is twice as common in women as men, and it has been suggested that hormonal factors predispose women to develop MS.

While conventional Western medicine continues to search for ways to diagnose and treat MS, Chinese medicine can be extremely useful as an alternative method for managing symptoms. In traditional Chinese medicine, multiple sclerosis is discussed in the category of Wei syndrome.

This disease involves the muscles, tendons and bones. Mostly it arises from invasion of exogenous pathogenic heat, which combines with phlegm inside the human body and obstructs in the meridians and collateral, then the muscles, tendons and bones of the human body are not nourished and paralysis of the limbs follows. Deficiency of both Qi and Yin fluid or deficiency of the spleen and kidney may also lead to the disease. Qi dominates movement, and functional activities of the limbs depend on the propelling effect of Qi. Muscles depends on Yin fluid for their nourishment. When Yin fluid is deficient, they will become atrophic. The kidney dominates bones and marrow. Deficiency of the kidney essence will not only cause weakness of the bones but also cause deficiency of the brain marrow. So patients can not move their limbs and often present dizziness, vertigo and tinnitus. In addition, long-standing obstruction of phlegm in the collaterals or long-standing deficiency of Qi and Yin, will cause blood stasis as a result of the phlegm obstructing flow of blood, failure of the deficient Qi to move blood or increased thickness of blood following Yin deficiency. So, this condition is closely related to the disorders of the kidney and brains.

As the disease may be caused by exogenous pathogens or deficiency of zang fu organs, pattern differentiation should be carried out based on following considerations:

Differentiation of Excess or Deficiency: Usually the excess type is marked by sudden onset, a short disease course and with such symptoms as fever. The most important sign is that paralysis or numbness of the limbs occurs after fever. The deficiency type usually has a long course, a chronic onset and presentation of manifestations of kidney deficiency such as dizziness, tinnitus, soreness of loins and knees and emaciation.

Differentiation of the Natures of Pathogens: Apart from obstruction of phlegm heat, this disease may also be caused by downward flow of damp heat. Usually the former occurs right after fever with much yellow sputum expectorate, while the latter often occurs gradually, with the lower limbs as the main affected part and is often accompanied with slight edema of the limbs, heaviness of body, sallow complexion, etc.

Four patterns are differentiated in traditional Chinese medicine. They are phlegm heat blockage in the meridians; damp heat accumulation; blood stasis in the collaterals; and liver and kidney Yin deficiency.

1. Phlegm Heat Blockage in the Meridians

Clinical Manifestations: Fever, or weakness and softness of body trunk after fever, or numbness and paralysis of body trunk, thirst, but no desire to drink, loss of voice, yellowish and sticky sputum, yellow and slimy tongue coating, slippery and rapid pulse.

Treatment Principle: Clear phlegm heat, open meridians and invigorate collaterals.

Herbal Prescription: Di Tan Tang with modifications

Ban Xia Rhizoma Pinelliae Ternatae 10g

Dan Nan Xing Pulvis Arisaemae cum Felle Bovis 10g

Ju Hong Pericarpium Citri Erythrocarpae 6g

Zhi Shi Fructus Citri seu Ponciri Immaturus 6g

Fu Ling Sclerotium Poriae Cocos 6g

Ren Shen Radix Ginseng 9g

Shi Chang Pu Rhizoma Acori Graminei 9g

Zhu Ru Caulis Bambusae in Taeniis 9g

Gan Cao Radix Glycyrrhizae Uralensis 5g

Di Long Lumbricus 6g

Si Gua Luo Fasciculus Vascularis Luffae 6g

Explanation: This formula contains three groups of herbs. The first group is composed by Ban Xia, Ju Hong, Fu Ling and Gan Cao, which collectively are also named Er Chen Tang. This group functions to eliminate phlegm. Dan Nan Xing, Zhu Ru and Shi Chang Pu, which can dissolve phlegm and remove heat, and Zhi Shi, which can move Qi, help the first group to eliminate phlegm heat by either directly dissolving phlegm or promoting flow of Qi. The second group consists of Ren Shen, Fu Ling and Gan Cao, which can promote function of the spleen to remove dampness. The third group consists of Si Gua Luo and Di Long. It functions to remove obstruction of phlegm heat in the collaterals.

Acupuncture Prescription

LI4 (Hegu)

LI11 (Quchi)

LI15 (Jianyu)

ST36 (Zusanli)

SP9 (Yinlingquan)

SP6 (Sanyinjiao)

BL20 (Pishu)

RN12 (Zhongwan)

ST40 (Fenglong)

RN23 (Lianquan)

HT5 (Tingli)

Explanation: LI4 (Hegu), LI11 (Quchi) and LI15 (Jianyu) are used to promote the flow of Qi and unblock channels and collaterals. ST36 (Zusanli), SP9 (Yinlingquan), SP6 (Sanyinjiao), and BL20 (Pishu) are used to strengthen the spleen and eliminate phlegm. ST40 (Fenglong) is a point particularly effective to eliminate phlegm. RN23 (Lianquan) and HT5 (Tingli) are used to benefit the tongue and improve speech.

2. Damp Heat Accumulation

Clinical Manifestations: Gradual body weakness, numbness of hands and feet, feeling heaviness of body, yellow face, chest congestion, yellow tongue coating, soggy and rapid pulse.

Treatment Principle: Clear heat and dissipate dampness.

Herbal Prescription: Er Miao San with Modifications

Huang Bai Cortex Phellodendri 9g

Cang Zhu Rhizoma Atractylodis 12g

Dang Gui Radix Angelicae Sinensis 12g

Niu Xi Radix Achyranthis Bidentatae 12g

Fang Ji Radix Strephaniae Tetrandrae 12g

Gui Ban Plastrum Testudinis 12g

Bi Xie Rhizoma Dioscoreae 10g

Yi Yi Ren Semen Coicis Lachryma-jobi 10g

Mu Tong Caulis Mutong 10g

Explanation: Er Miao San contains only two herbs, Huang Bai and Cang Zhu. Huang Bai clears away damp heat while Cang Zhu removes dampness. Dang Gui and Niu Xi help move blood because this disorder is marked by obstruction of vessels. Bi Xie, Yi Yi Ren and Mu Tong are used here to help the main herbs to remove dampness by strengthening the spleen and inducing diuresis.

Acupuncture Prescription

LI4 (Hegu)

LI11 (Quchi)

LI15 (Jianyu)

SP3 (Taibai)

SP6 (Sanyinjiao)

SP9 (Yinlingquan)

ST36 (Zusanli)

ST41 (Jiexi)

ST40 (Fenglong)

RN12 (Zhongwan)

Explanation: LI4 (Hegu), LI11 (Quchi) and LI15 (Jianyu) are used to promote the flow of Qi and unblock channels and collaterals. SP3 (Taibai), SP6 (Sanyinjiao), SP9 (Yinlingquan), ST36 (Zusanli) and ST41 (Jiexi) are used to strengthen the spleen and eliminate phlegm. ST40 (Fenglong) is a point particularly effective to eliminate phlegm.

RN12 (Zhongwan) is used to strengthen the spleen and stomach.

3. Blood Stasis in Collateral

Clinical Manifestations: Softness of four extremities, numbness of hands and feet, cramps and pain over the body, pain spots with fixed location, purple lips and tongue, uneven pulse.

Treatment Principle: Tonify Qi, nourish nutritive Qi, invigorate blood and open the meridian blockage.

Herbal Prescription: Sheng Yu Tang with modifications

Shu Di Huang Radix Rehmanniae Glutinosae Conquitae 20g

Huang Qi Radix Astragali 20g

Dang Gui Radix Angelicae Sinensis 15g

Dang Shen Radix Codonopsis Pilosulae 15g

Bai Shao Radix Paeoniae Lactiflorae 15g

Chuan Xiong Radix Ligustici 8g

Explanation: In this formula, Dang Gui, Chuan Xiong, Shu Di and Bai Shao are used to nourish blood and promote blood flow, Dang Shen and Huang Qi tonify Qi to promote movement of blood.

Acupuncture Prescription

LI4 (Hegu)

LI11 (Quchi)

LI15 (Jianyu)

SP6 (Sanyinjiao)

SP8 (Diji)

SP10 (Xuehai)

ST36 (Zusanli)

LR3 (Taichong)

BL17 (Geshu)

RN17 (Tanzhong)

Explanation: LI4 (Hegu), LI11 (Quchi) and LI15 (Jianyu) are used to promote the flow of Qi and unblock channels and collaterals. SP6 (Sanyinjiao), SP8 (Diji), SP10 (Xuehai) and ST36 (Zusanli) are used to promote the flow of Qi and blood. LR3 (Taichong) is used to promote the flow of Qi and remove blood stasis. BL17 (Geshu), the influential point of blood, is used to regulate blood flow. RN17 (Tanzhong), the influential point of Qi, is used to regulate the flow of Qi and eliminate blood stagnation.

4. Liver and Kidney Yin deficiency

Clinical Manifestations: softness and weakness of four extremities, soreness and softness of back and knees, emaciation, especially in leg muscle, dizziness, declining vision, dry throat, ear ringing, red tongue with less coating, thin and rapid pulse.

Treatment Principle: Nourish Yin and clear heat, tonify liver and kidneys.

Herbal Prescription: Hu Qian Wan with modifications

Shu Di Huang Radix Rehmanniae Glutinosae Conquitae 20g

Gui Ban Plastrum Testudinis 15g

Dang Gui Radix Angelicae Sinensis 12g

Zhi Mu Radix Anemarrhenae Asphodeloidis 12g

Bai Shao Radix Paeoniae Lactiflorae 12g

Shan Yao Radix Dioscoreae Oppositae 12g

Xian Ling Pi Herba Epimedii 12g

Suo Yang Herba Cynomorii Songarici 10g

Chen Pi Pericarpium Citri Reticulatae 10g

Niu Xi Radix Achyranthis Bidentatae 10g

Gan Jiang Rhizoma Zingiberis Officinalis 3g

Explanation: Shu Di Huang, Suo Yang, Xian Ling Pi and Bai Shao tonify the kidney and the liver. Gui Ban, Zhi Mu nourishes Yin to clear away heat. Gan Jiang, Chen Pi and Shan Yao supplement the spleen to promote generation of nutrients.

Acupuncture Prescription

LI4 (Hegu)

LI11 (Quchi)

LI15 (Jianyu)

SP6 (Sanyinjiao)

ST36 (Zusanli)

KI6 (Zhaohai)

BL23 (Shenshu)

KI3 (Taixi)

BL18 (Ganshu)

LR3 (Taichong)

Explanation: LI4 (Hegu), LI11 (Quchi) and LI15 (Jianyu) are used to promote the flow of Qi and unblock channels and collaterals. SP6 (Sanyinjiao) and ST36 (Zusanli) are used to strengthen the spleen and stomach and tonify Qi and blood. ST36 (Zusanli), KI6 (Zhaohai), BL23 (Shenshu) and KI3 (Taixi) are used to nourish the kidney Yin. BL18 (Ganshu) and LR3 (Taichong) are use to tonify the liver Yin.