HIV and Chronic Fatigue Syndrome. By Alan Uretz, PhD.



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Understanding The TCM Dynamics of HIV and Chronic Fatigue Syndrome By Alan Uretz, PhD.

Aids and HIV Illness HIV is a infectious virus that attacks the body s immune system leaving the patient vulnerable to other infectious agents. The HIV virus also attacks the nervous system and other body tissues. It is transmitted by sexual contact and exposure to blood and other body fluids. In terms of TCM, HIV is an epidemic toxic heat pathogen that first attacks the lung causing flu like symptoms and depleting the wei qi. The disease then progresses inward depleting the qi of the spleen and stomach causing spleen qi deficiency and drying the yin fluids of the stomach. Toxic heat also dries the bloodcausing blood deficiency and eventually yin deficiency. Other syndromes include kidney yang deficiency, liver qi stagnation, lung yin deficiency and heart blood and yin deficiency.

Wen Bing progression The infectious nature of HIV, AIDS fits the description of epidemic warmth Wil Wei level l Flu like symptoms affecting the lung Qi level internal heat drying stomach and depleting spleen qi Ying level internal heat depleting liver blood and kidney yin and failing to nourish ih organs Xuelevel heatinpericardium causing psychosis, bleeding and organ failure

Progression according to the Theory of 4 levels (si fen) and San Jiao During the Qing dynasty a group of physicians and scholars developed the theory of Warm Disease (wen bing) describing disease patterns and progressions related to infections that originated as warm or hot in nature. Among the theories of wen bing are: The 4 levels (wei,,q,y qi, ying, & blood) The theory of epidemic pestilent disease The theory of progression through the San Jiao

Differentiation of Symptoms According to the theory of zang fu organs the most common progressions of HIV AIDS are: Lung attacked by wind heat Spleen qi and yang deficiency Liver qi stagnation and liver blood deficiency dryness Kidney Stomach yin deficiency Kidney Heart yin dfii deficiency Kidney yang deficiency

San Jiao Progression Heat evil Lung heat & dryness Heart yin xu Stomach Spleen qi & Liver xue dryness Yang xu & yin xu Kidney yang xu Kidney yin xu

Effects of HIV Toxic Heat and Opportunistic Infections on Body Systems Lung damp heat pnumocystic disease Blood dryness Karposi s sarcoma Spleen xu damp candidiasis and fungal infections Blood and yin deficiency mycobacterium avium complex Liver qi stagnation AIDS neuropathy Heart yin dfii deficiency AIDS psychosis

LUNG TOXIC HEAT Toxic heat attacks the lung causing excess heat symptoms and depleting the yin fluids Fever, cough, headache, wheezing, dry mouth and lips, p, burning sore throat Pulse full, rapid, or slippery, rapid Tongue red with dry yellow of peeling coat TX: Clear heat from lung, generate fluids LU5, SP3, REN17, LU11 (bleed), DU14, UB43, LI11 For cough & wheezing add: LU9, UB12 13 (cupping) For sore throat add: LU10, REN22, 21, SI17

SPLEEN QI AND YANG DEFICIENCY Toxic heat moves inward depleting the qi of the spleen and causing dampness Fatigue, heavy sensation, nail fungus, skin lesions that weep, loss of appetite, nausea, vomiting, loose stools Pulse: Soft or slippery Tongue: pale, swollen, wet white or yellow coat TX: Tonify spleen. drain damp ST36, SP6, SP9, ST40, UB20, 21, LV13, REN12, Use moxa Fornausea andvomitingaddpc6 add For diarrhea add REN8 (MOXA), ST25

LIVER QI STAGNATION Deficient spleen qi and blood dryness fail to circulate qi and blood Tingling or numbness of extremities, transient pain, irritability, dark skin lesions Pulse: Wiry or thready Tongue: Purplish TX: Tonify qi and blood, invigorate stagnant qi and blood LV3, LI4, ST36, SP6, GB34, Strong local points Tuina, sliding cup (not over lesions) For neuropathy add: Local points, tuina, 12 jing well (theoretically but not all 12) For irritability and anger add: Ear: Shenmen, Liver, Heart

Blood Deficiency and Blood Dryness Toxic heat pathogen dries blood and depletes spleen qi and blood production. Dry skin, cracked nails, hair loss orgraying, dry sore throat, blurring or decay of vision. Insomnia, dizziness, atrophy and wasting, dry skin lesions. Pulse Thin, wiry Tongue Thin, pale, dry TX: Tonify blood, invigorate qi & blood, promote fluids KD3, LV8, UB17, SP6, LV3, SP10, SP4, PC6 For dry skin add: LU5, LI6 For insomnia add: HT7, ANMIAN For dizziness add: SISHENCONG

Stomach/Kidney Yin Deficiency Toxic heat pathogen depletes yin fluids of the stomach and kidney Reduced appetite or discomfort and nausea after eating, wasting and atrophy, insomnia, fatigue, tidal fever. Pulse: Thin, rapid Tongue: Peeling or mirror TX: Tonify yin, support stomach, spleen & kidney LU7, KD6, SP6, LV8, RENI2, LU5, ST36 For difficult breathing add: LU9, REN17, DINGCHUAN For loss of appetite add: Ear: Stomach, Appetite For insomnia i add: ANMIAN, HT7 For tidal fever add: DU14, LV2

Kidney Yang Deficiency Spleen qi df deficiency and damp, and exposure to cold progress to kidney yang deficiency Somulence, cold sensation over entire body, daybreak diarrhea, edema of ankles, face and abdomen, loss of appetite. TX: Tonify kidney and spleen yang, drain damp. UB23, UB52, DU4, REN4, 6, 8, (MOXA) SP9, SP3, KD7, KD10, LU7, LV13, REN12

Heart Blood and Yin Deficiency Toxicheatpathogen dries bloodandreaches pericardium causing heat and deficiency in heart Palpitations, fatigue, insomnia and dream disturbed sleep, disorientation, inappropriate speech and behavior, paranoiaandanger and anger TX: Tonify yin and blood, clear heat, calm spirit REN17, REN14, KD3, KD6, PC6, HT8, GB34, For paranoia and anger add: LV3, LV2, Ear: Shenmen, LV, HT For disorientation and confusion add: GB39, DU16, DU20 For agitation and insomnia ad:; dingchuan, Ear: Shenmen, HT

Chronic FatigueSyndrome Chronic Fatigue Syndrome is an illness characterized by lack of energy and constant fatigue. It further called Chronicfatigue immune deficient system when there are frequent infections and chronic fatigue fibromyalgia when there is chronic pain associated. Symptoms associated with the syndrome often include diarrhea, loose stools, and constipation often alternating, as well as insomnia, depression, and generalized pain. As a rule chronic fatigue is due to deficiency of one or more aspect of the correct qi. However, secondary excess syndromes may arise. Predominant root syndromes include: Qi deficiency, qi and blood deficiency, yin deficiency and yang deficiency. Although Chronic fatigue syndrome is an established diagnosis other disorders d may exhibit similar il symptoms including: Epstein Barr, hypothyroid, depression and others.

Etiology and Progression According to TCM theory Improper p diet, lack of sleep, overwork, excessive sexual activity, and the use of alcohol and recreational drugs, deplete the bodies correct qi, and may cause accumulation of damp and heat. Overuse of antibiotics and some other medications deplete the lung qi and cause heat and dryness in the body. Prolonged illness depletes the qi and yin of the body. Other lifestyle and environmental factors may also contribute.

Methods of Therapy Whereas acu moxa and Chinese Herbal bl medicine are effective in the treatment of chronic fatigue in order to insure recovery, other methods should be included Nutrition is essential to build correct qi Massage invigorates sluggish movement of qi and blood and enhances immunity Taijiquanincreases increases, balancesandand circulates qi Lifestyle changes and rest

Spleen Qi Deficiency Fatigue with loose stools, constipation or diarrhea, loss of appetite or craving for sweet or salty foods, weight loss or gain of soft tissue, bloating after eating, sweating onslight exertion. Pulse Weak, soft or slippery Tongue Pale, scalloped ST36, SP6, SP3, REN6, REN4, UB20, UB21 For constipation or diarrhea add: ST25, REN12, SP15 For predominant damp add: SP9, REN9, LU7

Spleen and Lung QiDeficiency Fatigue with frequent catching of colds, weak voice, panting on slight exertion, sadness Pulse: Deep, weak Tongue: Pale, swollen ST36, SP3, REN6, REN17, LU9 With current URI add: GB20, LU7, LI4

Qiand Blood Deficiency Fatigue with wasting of muscle, graying or thinning hair, cracked nails, dim vision, dry skin, anxiety. Pulse: Thin, deep Tongue; Thin, pale UB17, SP6, ST36, SP4, PC6, LV8

Yin Deficiency Fatigue with, afternoon fever or hot flashes, dry skin, tinnitus, insomnia. Pulse: Thready, rapid Tongue: Red with little or no coat. LU7, KD6, KD3, SP6, For heat symptoms add: LI11, DU14, LV2 For insomnia add: ANMIAN, HT7, DU24

Yang Deficiency Fatigue with somulence, morning diarrhea, cold sensation, heaviness of limbs or edema, pale blue complexion, depression. Pulse: Deep, weak and slow Tongue: Pale, swollen UB20, UB23, UB52, DU4, DU20, ST36, REN4 MOXA For diarrhea add: MOXA REN12, LV13, REN6, REN8