Mary Helen’s Original Thesis For the Midwest College of Oriental Medicine

DIAGNOSIS AND TREATMENT OF CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME (CFIDS) WITH TRADITIONAL CHINESE MEDICINE

ABSTRACT: Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) has become a major epidemic in the United States and around the world. Although the cause is thought to be a virus, CFIDS has baffled the Western medical community in general as to a diagnosis and a treatment. There are no real tests to confirm that a patient has CFIDS, lab tests are used to rule out other illnesses and a list of symptoms must be met by the patient for the diagnosis to be made. This list was put out by the Center for Disease Control (CDC) in Atlanta, Georgia in 1987. This paper discusses what CFIDS is, what causes CFIDS, and how it can be diagnosed and treated from both a Western and Eastern medical standpoint. The emphasis of the paper is put on diagnosis and treatment using Traditional Chinese Medicine (TCM) and other holistic healing modalities. Related illnesses are discussed as well as the comparison of CFIDS to other immune deficiency illnesses. A discussion is made on how the nature of these illnesses is related to the current planetary conditions and the spiritual transformation of the patient. With treatment using the holistic approach of TCM and other natural therapies the prognosis is high that patients will not only enter remission but continue their life in an overall healthier and more conscious state than that before the illness.

INTRODUCTION

For someone who has been diagnosed with CFIDS or any immune deficiency or other chronic illness there is hope. These dis-eases are a challenge for the person just as  the chronic environmental problems or immune deficiency of the planet today is a challenge to our society and the world. These illnesses force us to take another look outside and inside to find out what the real causes of disharmony are and how to heal them. With this observation the very principles of modern society come into question. Planetary ecological problems stem from the mind set of industrialization, militarism, materialism, and profit. As the people of the planet try to keep up with it all they find themselves in stressful, fast-paced lifestyles just to make ends meet. The more stress, the more disharmony and illness people face. Unfortunately for many of those who live in the United States health care has become a major concern. The number of people without insurance is continually growing as is the cost of Western medical care. For those with a chronic illness the challenge can easily become more difficult, especially if they can no longer work. Many are finding answers in holistic medicine as they realize that the Western approach of fighting the symptoms does not do away with the basic cause of the dis-ease they face.

DEFINITION

Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is the latest name for the illness which is officially called Chronic Fatigue Syndrome (CFS) by the United States, Myalgic Encephalomyelitis (ME) by the British and Canadians, and Low Natural Killer Cell Syndrome by the Japanese. It has been referred to by many names across the world. Many people in the U.S. know it as Chronic Epstein-Barr Virus (CEBV or EBV), for awhile EBV was thought to be the cause of CFIDS and the names were used interchangeably. It is now known that not everyone who has CFIDS tests positive for EBV. Although most people who do have a high level of antibodies in their blood for EBV experience the symptoms of CFIDS, there are people with high EBV titers who are in good health.

In the United States CFIDS was officially defined by the Center for Disease Control in Atlanta, Georgia in 1987 as the following: “People who truly have CFS are those who’ve suffered a debilitating fatigue (or easy fatigability) that’s lasted at least six months. They also must have ruled out (with their doctor’s help) any other physical or psychiatric diseases that may mimic CFS symptoms, like acute non-viral infections, depression, hormonal disorders, drug abuse, or exposure to toxic agents. Then they must have at least 8 of the following 11 symptoms recurring or persisting for six months or more: chills or mild fever; a sore throat; painful or swollen lymph glands; unexplained general muscle weakness; muscle discomfort; fatigue for at least 24 hours after previously tolerated exercise; a headache unlike any previous pain, joint pain without joint swelling or redness; complaints of forgetfulness, excessive irritability, confusion, inability to concentrate or depression; disturbed sleep; and quick onset of symptoms within a few hours or days.” 2

HISTORY

In the pamphlet put out by the CDC they describe the history of CFIDS: ” For more than a century, there have been reports in the scientific literature of syndromes of chronic fatigue associated with a variety of other symptoms, including low grade fever, sore throat, lymph node enlargement, headache, muscle aches, joint pains, and feelings of depression. In the 1860’s Dr. George Beard named the syndrome neurasthenia, believing it to be a neuroses characterized by weakness and fatigue. Over the years, medical and other health practitioners have developed a variety of explanations which include anemia, hypoglycemia, environmental allergy, or candida. Several investigators have described a chronic debilitating illness following acute infectious mononucleosis (Isaacs, 1948; Paterson, 1955; Bender, 1962; and Chang, 1980). An illness, variably called benign myalgic encephalomyelitis (ME), epidemic neuromyasthenia, or Icelandic disease, has been described repeatedly during the past fifty years.  This illness is very much like CFS except that it has usually been described as occurring in epidemics (Acheson, 1959; Henderson, 1959). A chronic debilitating condition following apparent infection with any of several different infectious agents has also been described (Salit, 1985). The illness called either fibrositis or fibromyalgia is also similar to CFS (they may represent the same illness). Fibromyaligia is thought to affect three-to-six million Americans (Goldenberg, 1987). The etiology of these syndromes of chronic fatigue has remained unknown in spite of intensive research.” 3

ADDITIONAL SYMPTOMS

Numerous other symptoms besides those named by the CDC have been reported. These include the following: dizziness; earache and ringing in the ears; heart palpations and chest pain; heat and cold intolerance; abdominal pain, nausea, vomiting, diarrhea and irritable bowel; jaundice; enlarged spleen and/or liver; alcohol intolerance; night sweats; difficulty speaking, writing, and reading; lack of coordination and loss of balance; spatial disorientation; hypersensitivity of skin and rashes; light sensitivity; dry and burning eyes; blurred vision; swollen eyelids and/or feet and hands; excessive thirst; respiratory problems; numbness in the face or extremities, especially the legs; loss of sex drive; menstrual problems including endometriosis; allergies and sensitivity to odors, chemicals, and medications; weight changes without changes in diet; hair loss; lightheadedness– feeling “in a fog”; muscle twitching and seizures; anxiety, panic attacks, and personality changes; and severe depression.

POPULATION EFFECTED

The prevalence of CFIDS is widespread; it affects people from all walks of life and all age groups. Most of the patients that have sought care are white women in their 30’s, although it has been found to effect elementary school children up to people in their 60’s. A typical patient seems to be a woman in her early to mid 30’s who is a type A personality career woman and who is under an extreme amount of stress from job, family, relationships, etc. It seems to prevail in hard driven young professionals which caused the name of “yuppie flu” to be used in the past. “CFIDS has been reported in many children, monogamous adults, and “clustering” in cases of families, workplaces, and communities also seems to occur. Anecdotal reports exist of pets of CFIDS patients getting unusual diseases. However, whether a person gets CFIDS is believed to be a function of how his/her system deals with the causative agents.” 5 The large majority of people in close contact with  persons with CFIDS have not developed the illness.

WHAT CAUSES CFIDS?

No one is sure what the physical cause of CFIDS is, in the early 1980’s many people thought it was caused by the Epstein- Barr virus which is in the family of herpes viruses. In the U.S., 80-90% of adults have EBV antibodies by age 40. In developing countries most people have the virus by childhood, where it’s symptoms are usually mild or none at all. In the U.S. most people develop it in adolescence where it manifests as infectious mononucleosis. The virus remains in the body after the symptoms of mono are gone but can reactivate throughout life and be shed thru the saliva. By the late 1980’s several studies (Holmes, 1987 and Buchwald, 1987) showed that people with CFIDS were no more likely than healthy controls to have EBV antibodies. It is possible that reactivation of the EBV virus could be a factor in the onset of CFIDS symptoms but to date there “is not a consistent link between elevated EBV antibody titers and the presence of CFIDS, and measurement of the titers is not of use in diagnosing or treating the illness.” 3 ” Other viruses have been associated with CFS in some studies, although none appears to be the specific cause. Holmes (1987) reported that antibodies against other human herpes viruses (cytomegalovirus and herpes simplex virus types 1 and 2) and measles virus were higher in patients with CFS-like illnesses than in healthy controls. Also, several recently published research abstracts suggest that antibody levels to the newly discovered human herpesvirus-6 (HHV-6) are higher in patients with CFS than in control subjects. A recent study (Dale, 1989) reported that 69% of CFS patients, 86% of persons with miscellaneous other disorders and 12.5% of controls had antibodies against this virus, suggesting that persons with a variety of illnesses may have secondarily increased HHV-6 titers. These higher levels are not specific indicators of viral activity, and may simply represent nonspecific immune responses to a variety of stimuli. Although it is possible that HHV-6 may play a role in CFS, this cannot be proven using current antibody tests.” 3 ” In September of 1990 a team of researchers at the Wistar Institute (the oldest independent biomedical institution in the United States– located in Philadelphia), reported that they had discovered evidence of a retrovirus in more than 75% of 31 CFIDS patients studied. They also found the same viral sequence in about one-third of twenty healthy persons exposed to PWCs [Persons With CFIDS] (in close but casual, nonsexual contact). None of twenty healthy, “non-exposure” controls showed the presence of such virus-positive cells in their blood. These findings suggest, but do not prove, that a retrovirus is associated with CFIDS and may be directly involved in causing the disease in many PWCs.” 5

Several subtle immune abnormalities have been found in patients with CFIDS such as low levels of specific gamma globulins (Straus, 1985); increased ratios of CD4/CD8 of “helper/suppressor” T-lymphocytes (DuBois, 1984); and low numbers of natural killer cells, NKHI+T3-lymphocytes (Caliginor, 1987). Still most patients do not have these abnormalities.

As stated earlier, CFIDS effects people from all walks of life so their is no one specific lifestyle factor that causes CFIDS in everyone who has it, although the large majority of persons with CFIDS report increased stress in their life leading up to the illness. Patients report being overwhelmed with responsibilities but at  the same time keep right on going until the illness has effected them enough that they just can’t do what they used to. Other co-factors are age, genetics, sex, and environment. Many times a person will come down with a flu, mononucleosis, a urinary tract infection, acute cytomegalovirus, or other nonspecific acute viral diseases and just never get well from them.

HOW PATIENTS SEARCH FOR HELP

Some patients report going to literally hundreds of doctors, many of whom dismissed their complaints as psychosomatic and referred them to psychiatrists. There are many stories of patients who couldn’t get anyone to believe something was wrong with them, even family members and co-workers. Most every CFIDS patient has heard the words “well, you look OK” even when they felt like they were on the point of collapse. During the search for help the disease progresses until many patients can no longer work, do household chores, or even take care of themselves. The worse cases are bedridden and suffer blackouts and seizures. The patients who find help usually find it thru holistic practitioners such as acupuncturists, herbalists, or homeopaths.

NEUROPSYCHOLOGICAL PROBLEMS

Perhaps the most devastating part of the illness for most are the neuropsychological problems. Difficulty concentrating; mood disorders; depression; anxiety; photophobia; forgetfulness; confusion; irritability; spatial disorientation; panic attacks; dizziness; personality changes; and mixing up words when speaking, reading, or writing are some of the more prevalent conditions. Common problems are going into a room and forgetting why you are there, driving and getting lost, and bumping into walls that seemed to be farther away. Since many of these people were high-achievers before their illness the frustration of cognitive problems becomes even worse. Many patients report feeling like they must be going crazy, the last thing they need is someone telling them it’s all in their mind. Getting assurance that these symptoms are commonly experienced with the illness and are not permanent is a major relief. Researchers have shown on brain scans that some people with CFIDS show abnormally low blood flow to one of the two temporal lobes. Other research has shown a decrease in electrical activity in the temporal lobes and the hippocampus, which is important in the formation of memories. 6

There are researchers developing therapy which improves the capacity to restore cognitive functioning. They give comprehensive neuropsychological evaluations and design a rehabilitation program for the individual patient. Thru visual and auditory processing they retrain the patient to alleviate the problems. Unfortunately the cognitive dysfunctions tend to last longer than the physical symptoms when patients report going into remission.

RELATED ILLINESSES

There are other related illnesses that affect a significant number of people with CFIDS. The main problems are food and environmental allergies, candida, endometriosis, and fibromyalgia.

CFIDS patients often report increased sensitivity to their surroundings, sometimes it can be mild like intolerance to heat or cold, photosensitivity, or allergies to excess mold or pollen. Many cases develop much more pronounced allergies to foods such as dairy, yeast, or wheat; to chemicals that occur in cleaning products, cosmetics, medications, or chemicals used in the workplace. Extreme cases are diagnosed with Environmental Illness (E.I.) and need special air and water filters in their homes, have to wear gas masks to go outside, or even have to have special homes constructed from allergy-free building materials.

Candida is also a problem for a majority of patients. Common symptoms include chronic yeast infections, diarrhea or constipation, bloating, rectal itching, abdominal pain, and fungus of the nails. Candida gets worse with antibiotic treatments, so bacterial infections are best treated herbally for these patients. Diet restrictions are also common to control the yeast such as, no sugar, cheese, alcohol, or yeast products, and limited intake of refined carbohydrates.

Many female CFIDS patients have reported a diagnosis of endometriosis. This is when a growth of the uterine lining occurs outside the uterus and usually forms blood-filled cysts mostly on the peritoneal surface and also on the ovaries, bowels, bladder and fallopian tubes. It is a progressive disease with common symptoms of painful and irregular menstruation, pain during sex, abdominal pain, pain in the back and legs, infertility, heavy menstrual flow, swollen abdomen, nausea, dizziness, headaches, fatigue, and insomnia. Some women may have it and have little or no pain. Western treatment includes synthetic hormones, laparoscopy, laser surgery, or even hysterectomy in severe cases.

Fibromyalgia (F.M.) is a chronic pain condition that is thought to affect three to six million Americans. It has many symptoms in common with CFIDS; some researchers think they are the same illness. Common symptoms are pain in the muscles, ligaments, and tendons, the muscles may twitch and burn or just constantly ache. Patients report a lack of energy and sleep problems. Most of the pain occurs in the neck, shoulders, chest, hips, knees, and elbows. In diagnosis there are 18 points on the body that are found to be tender, 70% of CFIDS patients have the 18 tender points. The sleep problems suffered are termed alpha-delta sleep anomaly, the stage four sleep is interrupted and you wake up feeling like you’ve been beaten all over. This sleep pattern has been found to occur in 80% of CFIDS patients. Fibromylagia is treated allopathically with drugs which boost the serotonin levels.  These medications can be replaced with the amino acid tryptophan or 5-hydroxy-tryptophan (5HTP).

HOW CFIDS IS DIAGNIOSED

In western medicine CFIDS is diagnosed by the list of symptoms put out by the CDC. There are also numerous lab tests that can be done to rule out other illnesses, some of these are HIV tests, Lyme tests, lupus panels, thyroid sedimentation, and various viral titers like EBV and cytomegalovirus. Tests like T-cell panels can be run to see if the immune system is activated, and sensitivity tests to antiviral drugs are also run. These tests can run from several hundred dollars to several thousand dollars depending on how thorough the doctor wants to be. Ruling out other diseases can be very helpful; although there is still no test that can diagnosis CFIDS since the specific cause is as yet unknown.

This is where Eastern medicine comes into the picture. A well trained Oriental medical practitioner can take any patient with CFIDS and come up with a diagnosis and treatment strategy for them. Diagnosis in Oriental medicine starts with a complete medical history which includes current symptoms; past illness, traumas, and  surgeries; family medical history; lifestyle factors such as stress from their job, finances, family and other relationships; diet; exercise; meditation; and other emotional and spiritual issues. Other important factors are observation of the patient’s tongue, eyes, and overall color; and palpation of the pulses, abdomen, ear acupoints, and perhaps the mu and shu points. The acupuncturist looks at numerous factors of the individual that are never considered by allopathic medicine. With any disease pattern in Western medicine an acupuncturist may see ten patients with the same disease and formulate ten different diagnoses based on Eastern medicine. This is even more difficult with CFIDS because it manifests so differently in each individual. Thus there is no one way to treat someone with CFIDS in Oriental medicine. The acupuncturist takes the Western label of CFIDS which will help them understand generally what the patient is experiencing then throws it away and starts from scratch developing the diagnosis of the problems from the Eastern viewpoint. Often patients with CFIDS have very complex cases with numerous patterns of disharmony that have developed. The acupuncturist searches for what is called the “root” cause of the disease and begins treatment there. Although particular treatments can be discussed for specific symptoms the acupuncturist doesn’t treat the symptoms as much as they treat the person. By treating the root of the illness, layers start to peel away and symptom patterns go away too, gradually the patient is put into harmony again.

There are some Eastern diagnoses that appear frequently as the root causes of illness in CFIDS patients. There are also patterns that commonly occur which are termed “branch” illnesses, they stem from the root cause. There are points used for specific symptoms and to generally boost the immune system and energy level, these are used in combination with the root and branch treatment.

COMMON CHINESE DIAGNOSIS FOR CFIDS

The following are some of the common root and branch illnesses according to Traditional Chinese Medicine that are found in CFIDS patients:

1. Kidney Yin Deficiency– common symptoms include ringing in the ears, dizziness, poor memory, night sweats, dry mouth and excessive thirst, dry hair and nails, premature hair loss,

chronic low-grade sore throat, constipation, weakness of the legs, weak and sore back, chronic low grade fevers, weight loss, insomnia, swollen lymph glands, and loss of sex drive.  Emotionally the patient may feel agitated, nervous, and fearful. The tongue has a red body with little fur and the  pulse is thin and rapid. This can lead to deficiency of the liver, heart, and lung yin which become branch illnesses.

A. Kidney-liver yin deficiency – may include headaches; blurred vision; loss of visual acuity; night sweats; dizziness; tired, burning, and itching eyes; photophobia; irregular menses; and irritability.

B. Kidney-heart yin deficiency– may include insomnia, dream disturbed sleep, restlessness, forgetfulness, disorientation, and palpitations.

C. Kidney-lung yin deficiency– may include a weak and dry cough, afternoon fevers, low voice, hot palms and soles, and flushed cheeks.

2. Kidney Yang deficiency– common signs are aversion to cold, cold hands and feet, extreme fatigue, drained and pale complexion, dizziness, ringing in the ears, weakness and pain in the knees and low back, irregular menses, frequent urination, getting up to urinate during the night, impotence, spermatorrhea, edema, diarrhea, low sex drive, loose teeth and dulling of the essence or spirit. Emotionally the symptoms are fearfulness, hopelessness, confusion, and indecision.  The tongue is enlarged and pale with a moist white fur and the pulse is slow and weak. This can lead to yang deficiency of the spleen, lung, and heart.

A. Kidney-spleen yang deficiency -may include edema, diarrhea, abdominal pain or distention which is relieved by warmth or pressure, leukorrhea, poor appetite, and trouble in absorbing nutrients.

B. Kidney-lung yang deficiency– may include rapid breathing at the slightest exertion, lack of desire to talk, exhausted spirit and appearance, shortness of breath, weak cough, and general weakness and lassitude.

C. Kidney-heart yang deficiency– may include palpations, edema, difficulty breathing, and in serious cases, inversion frigidity of the limbs and oily perspiration.

3. Spleen qi deficiency– common signs are either poor or excess appetite, weight loss or gain, cravings for sweets, lack of concentration, muscle weakness, whole body aching, abdominal pain and distention relieved by pressure, poor absorption of nutrients, intestinal gas, allergic reactions to foods, anemia, lassitude, edema, swollen lymph nodes, anorexia, diarrhea or thin stool, lusterless complexion, and exhaustion.  Emotionally the patient may suffer preoccupation, chronic worrying, obsession, and indecisiveness.  The tongue is pale with a thin, white fur and the pulse is soft and soggy. Some of the branch illnesses are spleen deficiency with damp encumbrance, damp-heat in the spleen, and upper body harassment by phlegm turbidity.

A. Damp encumbrance of the spleen– may include loss of appetite; nausea; feeling of fullness or heaviness in the head, chest, and limbs; loose, watery stools; abdominal distention; indigestion;                              sickly, sweet taste in the mouth; foggy feeling like there is a ‘bag around the head’; and edema. The tongue is thick and slimy, and the pulse is soggy and rolling.

B. Damp-heat in the spleen– may include fever, pain and distention in the chest and lateral costal region, nausea and vomiting, thirst with little desire to drink, short urination with scant and/or dark yellow urine, chronic yeast infections, chronic urinary bladder infections, jaundice, and a heavy sensation in the body. The tongue has a red body with yellow, greasy fur or white and slimy fur.

C. Upper body harassment by phlegm turbidity– may include extreme dizziness, pressure in the head, heaviness in the head, insomnia, nausea, poor absorption of nutrients, restless, and a bitter taste in the mouth. The tongue is very slimy with either a yellow or white coat and the pulse is slippery or wiry.

4. Liver Qi Stagnation common symptoms are premenstrual syndrome; headache; distention and tenderness in the hypochondrium, chest, and breasts; poor digestion; intestinal gas; hormonal imbalances; allergic reactions; irregular menses; formation of lumps and masses; feeling of a lump in the throat; and bitter taste in the mouth. Emotions are commonly a large part of liver disharmonies; problems are depression, irritability, anger without a cause, impatience, hypersensitivity, and anxiety. The tongue is purplish and the pulse is wiry. Branch illnesses include liver yang ascending, deficient liver blood, and stirring of liver wind.

A. Ascending of liver yang– may include throbbing headaches, dizziness, ringing in the ears, blurred vision, anger, depression, insomnia, palpations, red eyes and ears, low back pain, and weakness in the legs. The pulse is fine and wiry and the tongue is red.

B. Deficient liver blood– may include dizziness, blurred vision, dry eyes, muscle spasms, numbness  and inhibited movement in the limbs, irregular menses with reduced flow, pale and lusterless complexion, insomnia, excessive dreaming, and slow growth of hair and nails or hair loss in serious cases. The pulse is thin and the tongue is pale.

C. Stirring of liver wind– may include dizziness and headache, tension and stiffness in the neck, tingling and numbness in the limbs, muscle twitching, convulsive spasms and seizures, trembling limbs and fingers, inhibited speech, tightness or sudden paralysis of the facial muscles, and ringing in the ears. The pulse is wiry and the tongue is red or purplish with dry fur.

These are some of the major root and branch illnesses found in CFIDS patients but are not inclusive of all the possible TCM diagnosis that may be given to someone with CFIDS. Most patients tend to have complex cases that include symptoms from more than   one root and/or branch disharmony.

THE TREATMENT OF CFIDS WITH WESTERN MEDICINE

The treatment of CFIDS in Western medicine is still in the experimental stages. There are two drugs which have been tested that have gotten results, Kutapressin and Ampligen. Kutapressin has been approved by the FDA, it is an older drug  that has been in use since the 1920’s. It is a liver derivative from pigs and is contraindicated for people who are allergic to pork. It has been shown to have a 75% recovery rate in patients with viral diseases like EBV, CMV, HHVG, and HTCV2. These viruses produce a hyperactive immune system and cause depressed T-lymphocyte functions and capillary leakage in the brain. These are the main symptoms the drug goes after. It was put into use with CFIDS patients after research showed that 90% of them showed abnormal counts in Single Lymphocyte Immune Function (SILF) tests. The protocol for use is first to do a skin test for allergies then start with a daily injection of 2cc’s for 25 days, followed by 2cc’s every other day for 50 days, and  2cc’s three times a week for six months. More SILF tests are preformed prior to the third and sixth month. If the patient is getting better then they drop down to 2cc’s a week for a month and stay on 1cc a week for eight months. If relapse occurs they have a 2cc injection daily for ten days and start back again at 2cc’s every other day for 50 days, etc. Aside from the side
effects that can occur, which can be severe in some patients, and having to have constant injections that may never end, the cost of the drug is $70-$100 for 20cc’s. The treatment can be expensive and seems to only cover up the symptoms in many who relapse and have to start over on larger doses again.

Ampligen is an anti-viral drug that is used in the impairment of the cytotoxicity of natural killer cells. It was tested from June, 1990 to July, 1991 on 111 volunteers and got good results. Unfortunately when the tests ended the patients no longer received the drug since it is not FDA approved and they have returned to a state of illness.  Some of them have filed a lawsuit to be given the drug while it awaits approval because this is what the pharmaceutical company originally promised, but the company refused the drug to them as soon as the tests ended. The first patient to try Ampligen started on it in 1988 and is still in the recovery process and still needs three IV’s a week to keep her there. The biggest drawback is that the drug could cost more than $20,000 a year for one patient, many feel this is the reason the drug company withdrew the drug from the volunteers.

At this point Western treatment for CFIDS involves constant injections or IV’s and is unbelievably expensive. Therefore most CFIDS patients simply aren’t getting treatment from allopathic medicine.

THE TREATMENT OF CFIDS WITH
TRADITIONAL CHINESE MEDICINE

The treatments that patients have found to really work for them come from holistic medicine. “CFS is a multi-system dysfunction and multidimensional disease, any therapeutic        strategy must match the levels of disruption or imbalance in order to strengthen and correct them so the condition does not return. Any effective therapy must address the entire psychosomatic-spiritual being.”18

As patients become aware of the alternatives they are rapidly switching over to the Eastern approaches of acupuncture, herbs, bodywork, energy work, and lifestyle counseling. Acupuncture has certainly been at the forefront for many patients, helping them to regain their health and get back to a normal life.

As discussed earlier the acupuncturist develops a diagnosis for root and branch illnesses and treats accordingly. The following are treatments which have proven helpful in CFIDS patients:

1.Kidney yin deficiency– KI-3,source point, tonifies kidney yin and yang; KI-7,metal point, tonfies the kidney; UB-23, shu point, strengthens kidney qi; CV-4 and/or CV-6, adjusts qi and tonifies kidney; SP-6,tonifies the kidney, spleen, and liver yin; KI-10, horary point, tonifies the kidney; Anmian, for insomnia; SI-19 for ringing in the ears: ST-25, for constipation; LI-4 with LI-11 and /or GV-14 for fever; LU-10 for sore throat; LI-4 with KI-7 for night sweats; and HT-7 with Shenmen to calm the spirit.

A. Kidney-liver yin deficiency– add, LIV-3,source point, balances the liver and regulates the blood; LIV-2, fire point, disperses liver fire; LIV-8,water point, tonifies liver yin; UB-18, shu point, tonifies the liver.

B. Kidney-heart yin deficiency– add, H-7, source point, tonifies the heart and calms the spirit; H-3, water point, calms the spirit; CV-14, mu point, tonifies the heart; P-6,tonifies heart yin and calms the spirit; UB-15, shu point, tonifies the heart.

C. Kidney-lung yin deficiency– add, LU-9, source point, tonifies the lungs; LU-7,luo point, opens and strengthens the lungs; LU-5, water point, expels heat in the lungs; LU-1, mu point, tonifies the lungs; UB-13, shu point, tonifies the lungs; and LU-10 for sore throat.

2. Kidney yang deficiency– KI-3, source point, tonifies kidney yin and yang; KI-7, metal point, tonifies the kidney; UB-23, shu point, strengthens the kidneys; GV-4, tonifies kidney yang and builds up yuan qi, with moxa; UB-52, tonifies the kidney;CV-4 and/or CV-6, tonifies the kidneys;  St-36,  tonifies qi and strengthens deficiency, with moxa; moxa on Cv-8, restores yang energy; SI-19 for ringing in the ears; KI-13 for irregular menses; and HT-7 with Shenmen to calm the spirit.

A. Kidney-spleen yang deficiency– add, SP-3, source point, tonifies spleen; Sp-6, tonifies the spleen; St-36, tonifies qi, regulates the stomach and spleen; BL-20, shu point, tonifies spleen yang; CV-12, mu point for the stomach, regulates the stomach and spleen, tonifies qi; SP-15 for diarrhea and abdominal distention.

B. Kidney-lung yang deficiency-add, LU-9, source point, tonifies the lungs; LU-1, mu point, tonifies the lungs; CV-17, influential point of qi, tonifies lungs; LI-4, tonifies wei qi; LU-7, luo point, opens and strengthens the lungs; UB-13, shu point, tonifies lung yang.

C. Kidney-heart yang deficiency– add, UB-15, shu point, tonifies heart yang; H-7, source point, calms the spirit; P-6, tonifies the heart; Cv-14, mu point, tonifies the heart.

3. Spleen qi deficiency– SP-3, source point, tonifies spleen qi; SP-6, tonifies spleen qi, yin of spleen, kidney ,and liver,; St-36, tonfies qi, regulates spleen and stomach; CV-12, strengthens and tonifies qi of spleen and stomach; UB-20, shu point, tonifies spleen; UB-21, shu point for stomach; ST-25, regulates qi in the large intestine and stomach; Sp-15 for diarrhea and abdominal distention; GB-34 for muscle weakness and aches; and Ht-7 with Shenmen to calm the spirit.

A. Spleen deficiency with damp encumbrance– add, SP-9, transforms dampness in the spleen ST-40, transforms dampness;  CV-9, regulates water retention and edema.

B. Damp-heat in the spleen-add, GB-34, resolves damp-heat any where in the body; SP-9, resolves dampness in the spleen; ST-40, transforms dampness;  LI-4 and LI-11, to drain heat from the      body; LIV-5, for genital itching; CV-3, bladder mu; and UB-28, bladder shu.

C. Upper body harassment by phlegm turbidity– add, ST-40, resolves dampness; GV- 20, disperses dizziness, calms spirit; Sishencong, disperses dizziness, calms spirit, increases oxygen to the brain; GB-20, disperses wind and head pain; local points for headache and balance including, GB-14, ST-8, and taiyang.

4. Liver qi stagnation– LIV-3, source point, balances the liver and regulates the blood; LIV-2, fire point, courses liver qi; Liv-8, water point, courses liver qi and tonifies liver; LIV-14, mu point, tonifies liver, spreads qi in the hypochondriac area; LIV-1, wood point, moves liver stagnation; GB-34, courses liver  and gallbladder qi; SP-6, opens the liver; UB-18, shu point, tonifies the liver; Ht-7 and Shenmen to calm the spirit.

A. Liver yang descending– add, GB-20, special point for headaches; LI-4, for headache and to pull qi ; KID-3, tonifies kidney yin and yang, supports liver and pulls qi; Anmian for insomnia; and GV-20 with Sishencong for dizziness and headache.

B. Stirring of liver wind– add, GB-20, pulls wind; LI-4, expels wind, especially in the face; GV-20, to extinguish wind and calm the liver; KID-3 and/or KID-7, and UB-23, tonifies kidney to tonify liver; Taiyang, for headache and dizziness; GV 20 with Sishencong for dizziness and headache; SI-19 for ringing in the ears.

C. Deficiency of liver blood– add, Sp-10, supplements the blood; UB-17, supplements the blood; SP-6, tonifies spleen, liver, and   kidney yin and blood; UB-20, tonifies spleen to tonify liver; UB-23, tonifies the kidney to tonify the liver; CV-3, meeting point for liver, spleen, and kidney; Anmian for insomnia; UB-1 and UB-2 for blurred vision and dry eyes.

These are basic point groupings for the above disharmonies. An individual treatment would consist of a combination of points for the root and branch problems taken from the above selections and perhaps some points for specific conditions a patient’s individual case might have. Other points found to be of good use to add to treatments for a CFIDS patient includes: ST-36, tonifies qi and strengthens deficiency, has been found to increase the levels of white and red blood cells in the body; LI-4 with LIV-3, opens the four gates to course qi thru the body, good for pain; GV-20 with Sishencong, increases the level of oxygen to the brain, works well for the cognitive problems found in CFIDS patients. Another treatment found to open the energy centers and course qi thru the body is to use a point combination to open the chakras: GV-20 with Sishencong for the crown; Yintang for the third eye; CV-23 for the throat; CV-17 for the heart; CV-12 for the solar plexus; CV-6 for the belly; and CV-4 for the root; these are used with LI-4 and LIV-3. Treatments are usually needed weekly for a few months up to a year or more, depending on how long the patient has been ill and how severe the disharmony is.

HERBAL TREATMENT OF CFIDS

In Traditional Chinese Medicine acupuncture is usually combined with herbs to supplement the treatment. Many practitioners in the U.S. today use a combination of Chinese and Western herbs, vitamin supplements, and homeopathic formulas. This herbal treatment also includes counseling on diet and nutrition which affect the body even more profoundly than herbal supplements.

CHINESE HERBS

Chinese herbs come either in raw form that can be made into teas or formulated into pills and tinctures (liquid herbal drops). Some of the more well known herbs to boost the immune system are ginseng, astragalus, and fo-ti-tieng which can be taken alone or are commonly found in formulas. The mushrooms, ganoderma or reshi, and shitake, have been through numerous research tests and been found to do wonders for the immune system. Shitake mushrooms can be eaten fresh or made into pills or tinctures, reishi mushrooms are usually taken in pill form because they are too tough to eat. The only formula manufactured specifically for CFIDS patients to date is put out by Seven Forests herb company at the Institute for Traditional Medicine in Portland, Oregon. These formulas were put together by Dr. Subhuti Dharmananda. This is the same company that produces the herbal formulas used in the holistic HIV treatment centers in the U.S.. They have had great results with their herbs combined with acupuncture on the treatment of HIV and AIDS. They have a root formula for all HIV patients and branch or adjunct formulas for differences in individuals. The root formula is called Composition and contains the following herbs: ganoderma, isatis, astragalus, millettia, tremella, hu-chang, oldenlandia, lonicera, rehmannia, andrographis, sophora sub, salvia, ligustrum, curcuma, atractylodes, ginseng, peony, epimedium, lycium fruit, ophiopogon, ho-shu-wu, tang-kuei, schizandra, licorice, cardamon, and citrus. This formula has also been used on CFIDS patients with good results. They released their new formula Compound GL in the summer of 1991 after their research specifically on CFIDS patients. Compound GL contains the herbs: ganoderma, isatis, zizphus, astragalus, polygala, lithospermum, salvia, succinum, hu-chang, oldenlandia, lonicera, rehmannia, ligustrum, curcuma, atractylodes, ginseng, peony, epimedium, lycium fruit, ophiopogon, ho-shou-wu, tang-kuei, schizandra, licorice, cardamon,  and citrus. Compound GL is combined with an adjunct formula called Katsu which contains: garlic, pearl barley, natural mucopolysacchararides, and rice germ. These formulas have shown very promising results for putting patients into a complete remission. These two main formulas can also be used with the adjunct formulas that are produced by Seven Forests.

There are special formulas made for constitutional problems or root illnesses like the ones previously discussed. These are made by many different companies, mostly in China, and are usually referred to as patent medicines. There are a few companies in the U.S. which produce formulas and are much stricter than the Chinese companies in the quality of the herbs used. Kan Herbal company in Soquel, California has very good constitutional formulas which were formulated by Ted Kaptchuk, O.M.D., these formulas take into consideration not only the physical needs of the patient but also work on the emotional and spiritual levels. These constitutional formulas are often needed for individual root problems. The following are the formulas for the previously discussed root illnesses, they also have other formulas used in the branch illnesses. Their formula for kidney yin deficiency is called Quiet Contemplative and contains: Chinese foxglove root, dogwood fruit, Chinese yam root, Tuckahoe root, water plantain rhizome, tree peony root bark, mulberry fruit bud, wolfberry fruit, fleeceflower root, dodder seed, eclipta, and privet fruit. The kidney yang deficiency formula is called Dynamic Warrior and contains: eucommia bark, morinda root, broomrape stem, bauchee seed, Chinese cinnamon inner bark, aconite root, schisandra berry, ox-knee, foxglove root, Chinese yam root, dogwood fruit, wolfberry fruit, dodder seed, tang kuei root, and ginseng root. Prosperous Farmer is the name of the formula for spleen qi deficiency, it contains: ginseng root, atractylodes, tuckahoe root, milk-vetch root, licorice root, Chinese yam root, ginger rhizome, mandarin orange peel, pinellia, grains-of-paradise fruit or seeds, costus root, magnolia bark, hawthorne berry. The liver qi stagnation formula is called Relaxed Wanderer, it contains: hare’s ear root, tang kuei root, peony root, atractylodes, tuckahoe root, peppermint, licorice root, tree peony root bark, gardenia fruit, szechuan lovage root, orchid bulb, nut grass rhizome, and ginger rhizome. There are numerous other Chinese  herbs and formulations that can be added for specific problems in individuals.

WESTERN HERBS

Western herbs come in the same forms as Chinese herbs; teas, pills, and tinctures. There are several herbs used for specific problems common to CFIDS patients. Numerous brands can be         purchased at local health food stores, although many herbalists prefer to make their own formulas since these herbs are readily available in the U.S. unlike many of their Chinese counterparts. One of the most talked about herbs used is ginkgo leaf, this increases the oxygen supply to the brain and helps relieve many of the cognitive problems of CFIDS. Another well known herb is echinacea root which is used to boost the immune system. Other herbs that are used to boost the immune system include: licorice root, pau d’Arco, gotu kola, goldenseal root, borage leaf and flower, wild yam root, nettle leaf, wild indigo, burdock, and dandelion.  St. John’s wort or Hypericin works well for the depression often suffered from having a chronic illness.  One of the best formulas around for candida symptoms is put out by Dr. Max G. Barlow at Spice West Company in Salt Lake  City, Utah. It involves two tinctures called Mycocyde I & II consisting of the herbs: lomatium, echinacea, desert globe mallow, fern bush, and cayenne pepper. This formula has cured chronic yeast infections for many grateful women.  There are numerous other Western herbs that can be used for specific problems. Just as the Chinese herbalists have done, the herbalists in the West have     discovered entire pharmacies from the plant world.

HOMEOPATHIC REMEDIES

Herbs are also used in homeopathic remedies. To get the best results from homeopathy it is  best to go to a well trained practitioner who can make formulations specifically for the individual. It has become popular in the past few years for health food stores to carry basic remedies as is commonplace in Europe. Some common ones used by CFIDS patients are: Arnica for muscle aches that come with exhaustion; Nux Vomica for irritability, hyper-sensitivity, indigestion, and intolerance to certain foods and alcohol; Carbo Veg. for weakness, cold limbs, and indigestion; Mercurius for sore throat, swollen neck glands, weakness, and sensitivity to heat and cold; Phosphorus for anxiety, depression, fearfulness, and oversensitivity; and Pulsatilla for sadness and sensitivity, constipation and diarrhea, and insomnia. The specific indications should always be known to make accurate recommendations for these remedies. Many patients have found a lot of help by having a professional homeopath create formulas for them.

Other energetic remedies that are helpful are the Bach flower remedies. Some recommendations for CFIDS patients might be: Hornbeam, for tiredness and mental and physical exhaustion; Elm for feeling overwhelmed by responsibilities and depressed; Oak for those who are despondent but struggle on despite illness or hardship; and Olive for complete exhaustion and mental fatigue.

DIET, NUTRITION AND SUPPLEMENTS

Diet and other supplements such as vitamins, minerals, and enzymes are also discussed by the acupuncturist. The most important thing about diet is to have patients eat regularly and eat whole, unprocessed, plant-based foods as much as possible. For someone with fatigue good nutrition is of the utmost importance. Fresh vegetables and fruits, whole grains, legumes, and nuts and seeds should form the base of the diet. Animal products should be avoided or kept at a minimum because of the toxins and numerous other health problems found to arise from meat and dairy. Many people today are eliminating animal products from their diet but are not conscious of getting the protein they need. Recommendations for beans, nuts and seeds, green foods, and nutritional yeast can be helpful. It is also a good idea to recommend an amino acid supplement daily to make sure all the essential amino acids are provided. Beverages such as carbonated drinks, caffeine, alcohol, and juices made from concentrate should also be avoided or kept at a minimum. Sugar should also be avoided as much as possible. Drinking lots of purified water is recommended. Some of the supplements commonly recommended for CFIDS patients include a good natural, plant-based multivitamin/mineral, vitamins B-complex, A,C, and E are especially good; co-enzyme Q-10; garlic; kelp; beta-carotene; zinc; selenium; acidophilus; calcium and magnesium; hemp and flax oil; and bee propolis and royal jelly.

PSYCHOTHERAPY

Many patients benefit from counseling. This can be the simple recommendations about lifestyle, diet and health care given by the acupuncturist or a more involved form of psychotherapy by a professional. The emotional stresses that come with a chronic illness can be severe for some. Often patients need to work on issues of their life leading up to the disharmony of the illness. Some patients report a history of family abuse, emotional, physical, or sexual. This abuse can lead to the hard driven type A personality, always striving for recognition and praise to feel secure, but no matter how hard they push they never confront the root problems. Thus they become ill and have to re-evaluate and heal those past issues before they can go on with their life. Certainly this pattern is not always the case but in most cases of chronic illness there are past issues that need to be healed thru therapy. Holistic forms of therapy that work with the mind in relation to the body are of great benefit.

BODYWORK

Traditionally bodywork has been a part of Chinese medicine. This can help ease the aches and pains that go along with CFIDS and also help patients get more in touch with their bodies. It is easy for people who feel so bad all the time to be ungrounded. Common feelings are “if I could only trade in my body for a new one, things would be OK” and having negative feelings about their body because it is ill rather than positive, loving feelings that will help the healing. Massage, Shiatsu, and Structural Therapy are all recommended modalities for CFIDS patients.

ENERGY WORK

Energy work can also be helpful. Acupuncture itself works with the energetic body. Other modalities of energetic balancing such as Reiki can offer support too. The energy in the typical CFIDS patient goes to the upper body, the head feels like its in a fog and the lower limbs often feel numb and heavy. The lower chakras are often closed while the upper ones are over-stimulated. CFIDS is similar to neurasthenia which is thought to come from an insufficient amount of energy within the nervous system, the energy needed leaks out so the person feels nervous and tired instead of energetic. From the Chinese standpoint the wei qi or the defense energy of the immune system is deficient. This allows pathogens such as wind, cold, heat, and dampness to come in and attack the body. Whatever system worked with it is obvious that immune deficient patients have a low energetic defense system. Working with the patient to help them balance and maintain a strong energetic body can be very important.

SUPPORT GROUPS

Other recommendations for healing can involve helping patients get in touch with local support groups and national CFIDS organizations. Their are many groups around the country where patients can talk with others who share the illness. Because the disease has only been recently recognized most people don’t really understand how debilitating it can become and sharing problems with other patients can provide assurance like nothing else can. There are two main national support groups which can provide information on local support groups, research articles, newsletters, political action committees, and Social Security Disability benefits. The National CFS Association is located at 12106 E. 54th Terrace, Kansas City, Missouri 64133. The CFIDS Association, Inc. is reached by P.O. Box 220398, Charlotte, North Carolina 28222. The later offers a number of services including The CFIDS Chronicle  a newsletter offering up to date medical research and political advocacy  information; The CFIDS Buyers Club, a membership organization which offers herbs and vitamin supplements used in CFIDS at low cost to patients; CACTUS ( CFIDS Action Campaign for the U.S.) a political action group to increase funding for research on the illness and insurance company coverage, they also train PWC’s how to be activists and get disability rights; and a 900 number with the latest information on CFIDS whose profits go towards research.

RELATED AUTO-IMMUNE DISEASES

CFIDS is just one of a number of growing auto-immune diseases on the planet today. Certainly AIDS has been the most talked about recently, although researchers feel CFIDS is a much larger epidemic. Other illnesses like cancer, lupus, rheumatoid arthritis, diabetes, environmental illness, and candida are getting more recognition as scientists and health care practitioners search for the answers. The immune systems of our bodies coincide with the immune system of the planet, the Chinese have always seen the relationship between the macrocosm of the Earth and the microcosm of the body or as the saying goes “as above, so below”.

As the hole in the ozone layer becomes larger, the waters and the air become more polluted, the trees are being cut down and the oxygen supply lessens, the soil becomes depleted, and the weather patterns dramatically shift, our bodies cry out for pure water, clean air, and food grown in nutritious soil. More and more people are waking up and realizing that we must live in harmony with the Earth to really live in harmony with ourselves and each other. Richard Leviton quoted in an article on Environmental Illness, “The emergence of EI as a broad spectrum malaise challenges us to revision our understanding of self and environment. EI is a disease of the web of life itself, where both planet and people are environmentally ill. The problem is indeed desperate, yet there is still hope for positive resolution.”  This same quote could easily be used for CFIDS and other auto-immune diseases. The values of our society must be reevaluated along with the values of our health care system in the U.S. to really heal the deeper causes of these illnesses.

LIMITATIONS OF RESEARCH

Certainly the real answers are in ways that will prevent the disharmony of illness before they reach such a chronic state. Acupuncture can be an excellent preventative medicine.

The study of the diagnosis and treatment of patients with CFIDS thru TCM is very limited. There is little published research to go by, only one article was found which briefly discussed the diagnosis and treatment of CFIDS with Oriental medicine.1

Although there are numerous articles from the popular press on CFIDS, there are not many definitive articles published in Western medical journals either. Accordingly, CFIDS has only been officially recognized in the U.S. for five years so all the research that is available is fairly new. Research is also limited because of the numerous individual differences that are found in persons with CFIDS, by its very classification it is a syndrome, not a well defined disease. Because of the many individual differences it is harder to come up with good control groups. It is also difficult for acupuncturists in the U.S. to see a large number of CFIDS patients in private practice.  In Oriental medicine a lot of the best research now comes from China where the practitioner can specialize and see very large numbers of patients with the same illness which is ideal for research. Perhaps the answer is to study this in clinics similar to the holistic HIV clinics set up around the country which use acupuncture, bodywork and Chinese herbs.

CONCULSION

It seems that there is certainly more to CFIDS and all auto-immune disease than just the viruses that are thought to cause them. These diseases are making us realize the imbalances within ourselves, so we will realize the imbalances in the Earth and the imbalances between ourselves and the Earth, then all of these can be healed and brought into harmony and oneness. Perhaps these illnesses are part of the evolution of the human species and of the planet Earth herself towards greater spiritual growth and transformation. As people become healed they come into a more conscious state. Many CFIDS patients who have made it through to remission say that the illness has been a blessing in disguise.

“There is no turning back, only growth, renewed sensitivity to oneself, and vigilance toward maintaining one’s balance in living. You don’t have to be a helpless victim of this syndrome. CFS lends itself well to a mind/body approach of intervention. It’s an interaction process of ongoing reciprocal influence between organic and psychosocial factors. The people who have sustained remissions are those willing to accept this, to look inside and begin working on themselves.”17

REFERENCES

1. “Chinese Medicine in the Treatment of Chronic Immunodeficiency: Diagnosis and Treatment” Misha Cohen, O.M.D., L.Ac., American Journal of Acupuncture, Vol. 18, No. 2, 1990.

2. Fatigue Free: Chronic Fatigue Syndrome, ed. by Diane Gilroy, Rodale Press, 1990.

3.The Chronic Fatigue Syndrome: An Information Pamphlet Produced by the Center for Disease Control, January 1990, Atlanta, Georgia.

4. CFIDS 900 ## (1-900-988-2343), Chronic Fatigue Immune Dysfunction Society, August 1991.

5.”Guide for PWC’s (Persons With CFIDS)”, The CFIDS Association Inc., P.O. Box 220398, Charlotte, North Carolina, 28222-0398.

6. “Chronic Fatigue Syndrome: A Modern Medical Mystery “, Newsweek, November 12, 1990.

7.Lecture on Auto-Immune Diseases by Dr. Zhengang Guo. October 12, 1991. AAAOM Midwest Regional Conference, Chicago, Illinois.

8.Reference Guide to Acupuncture: Zang Fu Principles and Diagnosis, Xie, Dunbar, Chelnick, Plovanich, and Fian. Northern Star Press, Wonder Lake, Illinois.

9.Fundamentals of Chinese Medicine, Wiseman, Ellis, and Zmiewski. Redwing Book Company, Brookline, Mass.

10. Study Manual for Chinese Physiology and Pathology, John E. Pirog, Midwest Center Inc., 1989, Chicago, Illinois.

11.”Drug Test Ends, and Agony Returns”, Michael Millenson, Chicago Tribune, October 31st, 1991.

12. Chinese Acupuncture and Moxabustion. Chief Editor Cheng Xinnong, Foreign Language Press, Bejing, China,1987.

13. Institute for Traditional Medicine (I.T.M.), 2442 S.E. Sherman, Portland, Oregon 97214. (1-800-544-7504).

14. Kan Herb Company, 2425 Porter Street, ##8, Soquel, Calf. 95073, (1-800-543-5233).

15. Chinese Herbal Product Guide, Ted J. Kaptchuk, O.M.D., 1986, Ming-men Design, Soquel, Calf.

16. Spice West Company,  Dr. Max G. Barlow,Salt Lake City, Utah, P.O. Box 704352.

17.”The Hidden Epidemic” Richard Leviton, East/West Journal, January, 1989.

18.  “Environmental Illness: A Special Report” Richard Leviton, Yoga Journal, December, 1990.

19. Chronic Fatigue Syndrome: The Hidden Epidemic, Dr. Jesse Stoff and Charles Pellegrino, Random House, 1988.

20. CACTUS, P.O. Box 2578, Sebastopol, Calf., 95473.

21. CFIDS Buyers Club, (1-800-366-6056).