Notes from Zhong Ri hospital/Behcet's

March 12, 2004

Hey Attilio,

Again, thanks for the great reports from Beijing. Xin ku ni le! Here

is some info from the National Institute of Neurological Disorders and

Stroke.

Behcet's disease is a rare, chronic inflammatory disorder. The cause

of Behcet's disease is unknown, although there have been reports of a

virus found in some individuals with the disease. Behcet's disease

generally begins when individuals are in their 20s or 30s, although it

can happen at any age. It tends to occur more often in men than in

women. Symptoms of Behcet's disease include recurrent ulcers in the

mouth (resembling canker sores) and on the genitals, and eye

inflammation. The disorder may also cause various types of skin

lesions, arthritis, bowel inflammation, meningitis (inflammation of

the membranes of the brain and spinal cord), and cranial nerve

palsies. Behcet's is a multi-system disease; it may involve all organs

and affect the central nervous system, causing memory loss and

impaired speech, balance, and movement.

The effects of the disease may include blindness, stroke, swelling of

the spinal cord, and intestinal complications. The disease is common

in Japan, Turkey and Israel, and less common in the United States.

Treatment for Behcet's disease is symptomatic and supportive.

Medication may be prescribed to reduce inflammation and/or regulate

the immune system. Immunosuppressive therapy may be considered.

How are they approaching it at Zhong Ri? Any info on their pattern dx

and herbs/formulae used?

Thanks,

Daniel C. Luthi

March 12, 2004

Hi Daniel.

Thanks for your input. Someone else also said that Behcet sufferers

have eye disorders although i noted none in this patient. Here's the

case file below, (please note they are still in their raw state).

Patient Record

Male, 35. Occupation: Unknown. DOB: unknown

Chief Complaint

Mouth ulcer on the inner lower lips since he was 2 years old.

Past history

When the patient didn't have a mouth ulcer, his tongue was swollen.

Was admitted to the Zhong Ri hospital on the 3rd March 2004 because

of pain in the joints. Was diagnosed with Becet's syndrome in

October 2003. No history of rheumatoid arthritis in this patient's

family. The rheumatoid arthritis is worse in the winter months.

History of present illness

The patient has spots on the nose, around the mouth, the scalp,

genitals and the lower legs, which are not painful or itchy. The

patient also complains of arthritis in his right knee. All his

joints are swollen; ankles, knees, wrists, elbow, shoulder, spine,

etc. All the affected joints are painful. This pain is sharp like

needles. The joints do not feel hot. The patient's sleep is normal

as is his bowel movements which are twice daily. His appetite

fluctuates from being excessive to very little. When he is hungry he

eats 600g of food. Day-time urination is normal but urinates 3-4

times at night. He smokes 2 packets of cigarettes a day and has done

for ? If the patient eats either sea food, beef or lamb he notes the

skin is worse. The patient drinks two litres of lukewarm water a

day. The patient sometimes has a bitter taste in his mouth. His

emotions are volatile, with a very strong temper and mood swings.

The patient suffers from palpitations especially when he is angry.

The Becet's symptoms due not fluctuate in different seasons. The

patient suffers from headaches on the posterior aspect of the head.

Observations

Patient is overweight. The spots on the lower leg which have turned

dull-purple since they were red. The spots on the face remain red

and are hard inside whilst soft on the surface and contain pus.

Tongue inspection

Red with cracks.

Pulse condition

Deep and slippery.

Allopathic Diagnosis

Becet's syndrome

Allopathic Medication

Started on CTX (cerotaxine). Then went onto Glucocorticoid since he

checked-into another hospital 2 months ago. Trying to whine him off

the glucocorticoids, but the patient still needs 40mg a day to

prevent withdrawal symptoms. Now using MTX instead of CTX.

TCM Diagnosis and syndrome differentiation

Spleen Qi deficiency with Liver Yin deficiency. Yin deficiency with

Fire and Damp-Heat.

Base Formula

Internal decoction

Sheng Shi Gao ~ 30g

Zhi Mu ~ 10g

Chau Huang Bai ~ 10g

Jin Yin Hua ~ 20g

Gou Ling Qiao ~ 15g

Dan Zhu Ye ~ 10g

Sheng Ma ~ 10g

Chuan Huang Lian ~ 10g

Zhi Gan Cao ~ 6g

Sheng Di Huang ~ 20g

Bai He ~ 20g

Zhao Huang Qin ~ 10g

Pu Gong Ying ~ 30g

Di Ding ~ 30g

Sha Ren ~ 10g

Ye Ju Hua ~ 10g

External decoction

Ku Shen ~ 30g

Liang Qiao ~ 12g

Pu Gong Ying ~ 20g

Ye Ju Hua ~ 12g

Bai Xian Pi ~ 30g

Di Fu Zi ~ 6g

Any comments will be warmly welcomed.

Attilio

" Daniel " <solothurner> wrote:

> Hey Attilio,

>

> Again, thanks for the great reports from Beijing. Xin ku ni le!

Here

> is some info from the National Institute of Neurological Disorders

and

> Stroke.

>

> Behcet's disease is a rare, chronic inflammatory disorder. The

cause

> of Behcet's disease is unknown, although there have been reports

of a

> virus found in some individuals with the disease. Behcet's disease

> generally begins when individuals are in their 20s or 30s,

although it

> can happen at any age. It tends to occur more often in men than in

> women. Symptoms of Behcet's disease include recurrent ulcers in the

> mouth (resembling canker sores) and on the genitals, and eye

> inflammation. The disorder may also cause various types of skin

> lesions, arthritis, bowel inflammation, meningitis (inflammation of

> the membranes of the brain and spinal cord), and cranial nerve

> palsies. Behcet's is a multi-system disease; it may involve all

organs

> and affect the central nervous system, causing memory loss and

> impaired speech, balance, and movement.

>

> The effects of the disease may include blindness, stroke, swelling

of

> the spinal cord, and intestinal complications. The disease is

common

> in Japan, Turkey and Israel, and less common in the United States.

>

> Treatment for Behcet's disease is symptomatic and supportive.

> Medication may be prescribed to reduce inflammation and/or regulate

> the immune system. Immunosuppressive therapy may be considered.

>

> How are they approaching it at Zhong Ri? Any info on their pattern

dx

> and herbs/formulae used?

>

> Thanks,

>

> Daniel C. Luthi

March 12, 2004

comments?

Switch from Marlboros to Newports.

(I must have too much time on my hands:-)