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By Al Stone, L.Ac.
 You've
been told that you'd just have to live with it.
Fortunately, that is changing. Nevertheless, the Western medical
community is still struggling with understanding the condition that is
now being called Chronic Fatigue Immuno-deficiency Syndrome, or "CFIDS".
It must be more than just a little discouraging when a new theory hits
the news every couple of months. First, CFIDS is a form of depression,
then it is a virus, then it is a hormonal problem, then it is
neurological. Western medicine may never find one causal agent to attack
in treating this disease. Instead, it may be prudent to look to
traditional medicine for answers that escape the left brained logic of
science.
In fact, according to Western medicine, there is no test to confirm a
diagnosis of chronic fatigue. This diagnosis can only be given after any
other possibility has been ruled out.
Then again, that rather depends on your doctor as well. Some simply
refuse to use Chronic Fatigue as a diagnosis because it is, for them, a
"garbage" diagnosis. A diagnosis for something that the doctor simply
can't find. At least it is a step up from the "its all in your head"
diagnosis that was more popular a few years ago.
Treating chronic fatigue syndrome with acupuncture and Chinese herbal
formula requires that we first understand the disease from the Chinese
perspective. Traditional Chinese medicine (TCM) looks at the human body
a little differently than conventional medicine.
Looking at the human body and how it works from the Chinese perspective,
it is easy to understand how chronic fatigue syndrome is responsible for
the divergent symptoms that Western medicine has difficulty in bringing
together with any sense of logic. It is common today to refer to this
new perspective as a paradigm shift. It is looking at things a little
differently than the conventional scientific fashion. With this done, we
find answers to medical issues that had not been considered prior, and
of course, we find new and effective treatments as well.
An example of a paradigm shift is this simple optical illusion. Is this
a vase, or two silhouettes staring at each other? It all depends on how
you look at it.
One way of explaining the vast majority of chronic fatigue syndrome
symptoms from the Chinese medicine perspective is through one of four
likely diagnosis. Damp heat, Latent heat, Qi deficiency or a Blood
deficiency.
The Diagnosis
Damp Heat
In Chinese medicine, as in the English language, one can catch a cold.
Its like cold air has gotten into your body and made you sick. In
traditional Chinese medicine, one can also catch a heat, a damp, a wind
or any combination of these. In the case of damp heat, we find a variety
of signs and symptoms that all suggest a sort of turbidity in the body.
We see infections with yellow pus; we see wet yellow liquids coming from
the body in one form or another. That can include anything from too much
ear wax to vaginal secretions, from acne to coughing up yellow phlegm.
Having damp heat in your body does more than just produce some unsightly
sores and liquids draining from the body, it also festers inside your
body and produces some of the ongoing health issues associated with many
conditions, one of which is CFIDS.
Latent Heat
In the case of CFIDS that exhibits signs of a compromised immune system
and others that I will describe later, we could easily look to an acute
invasion of heat that was never fully overcome. What I mean by this is
that one can get a really bad flu, or perhaps mononucleosis or any other
viral invasion. In time, the body is able to overcome the acute
invasion. But the heat isn't entirely overcome, and it lies semi-dormant
for months and years following. It is the body's reaction to this
semi-dormant virus that makes up some of the cases of CFIDS.
Qi Deficiency
First, we should understand Qi energy. It is pronounced "chee."
Sometimes it has spelled "chi." You could describe Qi as bioelectric
energy. It has many associations with the functions of the nervous
system as well, but still, Western medicine has not been able to
discover anything in the body that resembles what Chinese culture has
known about for thousands of years.
Latent heat can lead to Qi deficiency, or some individuals may suffer
from Qi deficiency because of different reasons. Sometimes there are no
reasons specifically; it is just something that you were born with a
genetic predisposition.
Blood Deficiency
Blood is the red fluid that courses through our bodies. I am
capitalizing the word here because the function of Blood in Chinese
medicine is a little different from blood in Western medicine. Although
there is some overlap, Blood does many things from the Chinese medical
perspective that blood does not do in the Western paradigm.
According to ancient medical texts, Qi is the commander of Blood and
Blood is the mother of Qi. The Qi pushes the Blood around the body and
the Blood is the material from which Qi is made. Blood and Qi are
reliant upon each other. When there is a Blood deficiency, it can be
followed by and complicated with Qi deficiency. The above four syndromes
are the key diagnosis that will likely give rise to so many of the
typical cases of CFIDS. There are others, though they are less
frequently encountered.
The Symptoms
Severe Fatigue
tired/sleepy
low grade fever
tired in the morning
fatigue with dizziness, worse in the afternoon
Post Exertional Malaise (slight pain after activity)
fatigue aggravated by activity
Impaired Memory or Concentration
feeling of cloudiness in brain
poor memory, inability to focus thoughts
feelings of fogginess in brain
inability to focus or concentrate
Sore Throat - associated with...
yellow phlegm
chronic viral attack
frequent colds and flues
a dry throat
Tender Neck or Armpit Lymph Nodes
chronic inflammation with frequent colds and flues
Muscle/Joint Pain
heavy sensation in body
dull pain that migrates
dull pain that is fixed
Headache
feels like there's a sash tied around the head
persistent empty feeling, worse in the morning or after exertion
pain in the whole head or the forehead
pain at the temples or surrounding the eyes, worse in the afternoon or
evening
Unrefreshing sleep
dream disturbed and restless sleep
awakens frequently
awakening in the early morning and unable to return to sleep
difficulty in falling asleep, the most common cause of insomnia
Tremors of Extremities
associated with Qi unable to energize muscles
associated with dryness leading to internal wind which causes tremors
Therapies
Acupuncture Points
For any of the four given scenarios presented in this paper, there are
quite a few acupuncture points that would likely be used. Generally,
points are chosen in order to treat the root of the problem, for
instance Qi deficiency. Other points are chosen for specific symptoms
such as headache. The number of needles used varies widely based on the
patient and the doctor. Some doctors routinely use 20+ needles. Others
refuse to insert more than five. Neither method is superior to the other
because each patient has unique needs and each doctor has their own
therapeutic and diagnostic strengths. Which is best for you will be a
matter of personal experience more than anything will.
Damp Heat
One of the more typical points used to treat damp heat is a point, just
below the knee known as Feng Long. Its the 40th point on the Stomach
Channel. Feng Long translates to Abundant Ridge. It strengthens the
digestion, which is one way in which dampness accumulates in the body,
and it also has the effect of stimulating the body's metabolism in order
to burn up the existing damp accumulation in the body.
Latent Heat
A point that is commonly used to clear heat, whether it is of an acute
nature or something more chronic such as the heat that affects CFIDS
patients, is Da Zhui (Big Hammer) or Governing Vessel point #14. This
point is located just beneath the first thoracic spine. That is about
where the upper back turns into the neck. A needle inserted there does
not even get close to piercing the spine. It really cannot because there
is too much bone and cartilage in the way. This point does, however, do
an excellent job of releasing heat from the body, thus treating both
high fevers and the chronic low grade fever of this particular syndrome.
Qi Deficiency
There are specific acupuncture points in the body that assist in the
strengthening of the Qi energy. A few of these points are on the leg.
One is called Zu San Li. That translates to "three mile point." It is
said that needling this point a little below the knee will enable a
tired soldier to march three more miles. At least, that is how it got
its name. What it does do for anybody, regardless of his or her military
affiliation, is give them more energy. Sometimes instantly, sometimes
not.
Blood Deficiency
One of the more popular points to treat the Blood with acupuncture is
found just above the ankle. It is called San Yin Jiao, or "three yin
crossing." This is also called "Spleen 6" in the Western point-naming
scheme. This point is the intersection of three channels that deal with
body fluids. Needling it has the effect of enriching the amount of blood
in the body.
Herbs and Herbal Formulas
When the name of a formula is given, you can obtain this formula in many
ways. One is in the form of raw herbs that are taken home and steeped
into a tea. Other practitioners or herbal pharmacies offer pre-made
pills or capsules that contain the same ingredients as a tea, but you do
not drink it, you just take it in pill or capsule form.
Damp Heat
General symptoms:
Lian Po Yin (Coptis Magnolia Decoction). There is a saying in China that
says to put out a fire you must drink bitter herbs. Well, here they are.
Very bitter too. It is a great formula, but not very delicious.
There is a formula that comes close to Lian Po Yin that is available in
many Chinese pharmacies that might serve the CFIDS patient if they
haven't access to the specific raw herbs in Lian Po Yin. This formula in
pill form (and sometimes liquid form too) is called Huo Xiang Zheng Qi
Wan (Agastache Upright Qi Pill).
Inflamed lymph nodes:
These are sometimes considered phlegm nodules in Chinese medicine. When
damp is left untreated, it can condense into what we call phlegm. One
herb specific to these symptoms is Bei Mu (Bulbus Fritillariae). This
herb both breaks up phlegm nodules as well as clears the heat, or the
infection that gives rise to the swelling of the lymph nodes in the
neck. One formula that might make sense would be Xiao Luo Wan (Reduce
Scrofula Pill). This formula would effectively treat the infection as
well as the swollen glands. This formula contains Bei Mu.
Muscle pain:
Fang Ji Huang Qi Tang (Stephania & Astragalus Decoction) is especially
effective at treating the pains in the body that follow an accumulation
of dampness in the joints. This formula strengthens the digestive system
and dispels the damp accumulation that is settling into the joints and
causing the pain.
Latent Heat
One typical formula used for Latent type CFIDS is Zhi Shi Zhi Zi Tang
(Citrus aurantium - Gardenia Decoction). It basically just clears heat.
If you do not have access to raw herbs, look for the following product
in Chinese herbal pharmacies: Qi Guan Yan Ke Sou Tan Chuan Wan
(Bronchial Cough, Phlegm and Dyspnoea Pill). You do not have to have a
cough to use this formula to your benefit.
Qi Deficiency
Fatigue:
Liu Jun Zi Tang. (Six Gentlemen Decoction). It has six herbs in it that
work synergistically to assist you in strengthening your Qi and taking
care of a few other associated symptoms as well. This formula is also
available in pre-made pills at Chinese herbal pharmacies under the name
of Liu Jun Zi Wan (Six Gentleman Pills). Impaired memory or
concentration, headache: Bu Zhong Yi Qi Tang (Tonify the Center, Benefit
the Qi Decoction). This formula increases the amount of Qi in the body
as well as lifts it up to the head. This formula is also available in
ready-to-take pills at many Chinese herbal pharmacies. In the pre-made
form, it is known as Bu Zhong Yi Qi Wan.
Sore throat, tender neck or armpit lymph nodes:
Yu Ping Feng San (Jade Windscreen Powder). When a body's Qi is
deficiency, its ability to fight off infections is compromised and
frequent colds and flues occur. The most common herb used for this
condition is Huang Qi (Rx. Astragalis) which is found in a formula
called Yu Ping Feng San (Jade Windscreen Powder). Huang Qi has been
shown to be an excellent herb to increase the number of white blood
cells, phagocytes and interferon in the body. All of these are important
components to the immune system.
Unrefreshing Sleep:
An Shen Ding Zhi Wan (Calm the Mind and Settle the Will-Power Pill).
This formula is used for Qi deficiency insomnia. This may look more like
shallow sleep or being easily awakened during the night that leads to
the sense that you are not getting enough sleep. This syndrome might
also lead to one waking up in the very early hours of the morning and
being unable to fall back to sleep.
Blood Deficiency
General symptoms:
One typical formula for a deficiency of Blood in the body is Gui Pi Tang
(Tonifying the Blood Decoction) which is available in a pre-made form
under the name of Gui Pi Wan (Tonifying the Blood Pills). As is the case
with the formulas for Qi, there is a great deal of subtlety that can
assist you in better benefiting from Chinese herbal formulas, but Gui Pi
Tang or Wan is a good place to start in any case.
Muscle pain:
When we have a stagnation of Blood, which can sometimes follow a
deficiency of Blood, the pain is more fixed in location than the Qi
stagnation pain that tends to migrate.
There is one herb, Dang Gui (Rx. Angelicus) also known as Dang Kui, that
does a good job of both strengthening and moving the Blood at the same
time. It is rare that we use just one herb when it comes to any
condition in Chinese medicine. However, if you do have this Blood
deficiency type of CFIDS, adding Dang Gui to your life would probably be
the best thing that you can take away from this article. It is readily
available at most natural foods stores.
Headaches:
Blood deficiency headaches tend to be more fixed in location than the Qi
deficiency headache. It often effects the very top of the head, or
perhaps behind the eyes. It is often worse in the afternoon or evening.
In women, you will see it occurring most often right after the period as
the temporary blood loss aggravates the Blood deficiency of Blood.
A nifty herbal combination for the treatment of headaches due to a
deficiency of Blood is Dang Gui (Rx. Angelicae) and Chuan Xiong (Rx.
Ligustici Wallicii). Insomnia: Gui Pi Tang (Tonifying the Spleen
Decoction) is a popular formula to assist in both strengthening the
blood as well as its ability to provide deep restful sleep. Many Chinese
herbal pharmacies offer a pre-made pill called Gui Pi Wan (Tonifying the
Spleen Pill).
Tremors:
In Chinese medicine, these are associated with the stirring of wind
inside of the body. In the same way, that wind will shake leaves on a
tree, so it is that internal wind will cause shaking and tremors in the
body.
When there is a deficiency of Blood, there is room in the vessels for
this internal wind to get stirred up. Like the breeze that flows through
an empty storm drain. Increasing the amount of blood in the body serves
to treat this symptoms of tremors associated with chronic fatigue
syndrome.
The herb Tian Ma (Rx. Gastroidiae) is often added to herbal formulas for
Blood deficiency with internal wind.
Conclusion
The intent of this article is to give you some answers. However, each
patient is unique. As any practitioner of Chinese medicine will tell
you, it is very rare to find a patient who perfectly conforms to any one
syndrome of those listed in this article. We are all a blend of a
variety of factors and variables that requires of the practitioner the
ability to wade through conflicting signs and symptoms in order to come
up with a diagnosis and treatment that is perfectly suited for the
individual patient.
Chances are, if you suffer from chronic fatigue syndrome, you will find
that you have symptoms that suggest a little bit of all four syndromes
listed in this article. The important part of the practitioner's job is
to determine which condition is actually causing the problems that we in
the West call chronic fatigue syndrome. If the root cause of the
syndrome were a Qi deficiency, we would treat it one way. If the problem
is mostly a Blood disease, we might attack the syndrome from another
angle.
Fact is, what I have written thus far about this syndrome is only
scratching the surface. There are many layers of subtlety in Chinese
medicine diagnosis that goes beyond the generalities that I have
described in this article.
Acupuncture serves to get the therapeutic ball rolling. It stimulates
the appropriate organs systems to create more Qi and Blood in the body
as well as addressing specific symptoms. Chinese herbal formulas
continue the work on a daily basis from the inside out. There are other
methods of strengthening the Qi and the Blood in the body as well.
Lifestyle changes such as dietary considerations, meditations, yogas and
Qi Gong, can all assist the chronic fatigue syndrome patient to overcome
the Qi or Blood deficiency or other condition that has caused his or her
symptoms.
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