(288) ALS (Amyotrophic Lateral Sclerosis)

[HB KIM]

DEFINITION 
Also known as  "Lou Gehrig's disease". (Lou Gehrig: New York Yankees baseball icon who was diagnosed with the disease in 1939 and died from it in 1941).  ALS is a form of motor neuron disease.  The muscles innervated by the degenerating neurons become weak and eventually atrophy.  The disease usually occurs after the age of 40; it affects men more often than women.  Symptoms are muscle weakness, frequent falls, breathing difficulty, persistent fatigue, spasticity, and twitching.  Death generally results from atrophy of the respiratory muscles. There is no cure or treatment for ALS.



COMMON TCM PATTERNS & TREATMENTS
Basic DU Points for all patterns: DU24, DU20, DU16, DU14, DU10, DU6, DU4, DU1

DEFICIENCY
LV Blood & KD Yin deficiency: Hu Qian Wan + Zuo Gui Wan  (UB17, UB18, UB20, UB23)
SP & KD Yang deficiency: You Gui Wan + Si Jun Zi Tang  (RN4, UB20, ST36)
Qi & Yin deficiency:  Zuo Gui Wan  (UB20, UB23, ST36, KD7)
Yin & Yang deficiency: Jin Gui Shen Qi Wan  (UB23, SP6, KD7, RN4)

EXCESS
Damp-Heat damaging the sinews:  San Miao San  (RN12, RN3, SP9)
Blood Stasis in the network vessels:  Xue Fu Zhu Yu Tang  (SP6, LI4)
Phlegm turbidity:  Wen Dan Tang  (SP9, ST40, ST36)



OTHER PATTERNS & EMPIRICAL FORMULAS

1. SP and KD deficiency: weak fingers, muscle atrophy, fatigue, shortness of breath, thin tongue coating, thready and weak pulse
6.0g  Dang Gui
9.0g  Shu Di Huang
9.0g  Bai Shao
4.4g  Chuan Xiong
4.8g  Ren Shen
4.8g  Wu Wei Zi
6.0g  Mai Men Dong
6.0g  Huang Bai
3.0g  Zhi Mu
6.0g  Niu Xi
6.0g  Du Zhong
6.0g  Cang Zhu
6.0g  Yi Yi ren
3.6g  Fang Feng
1.8g  Qiang Huo
1.8g  Gan Cao
4.5g  Ji Xue Teng

2. LV & KD deficiency: upper limb atrophy, weak feet, soreness of the lumbar spine and knees, dizziness, tinnitus, thin white coating, thready pulse
3.0g  Huang Qi
3.0g  Shan Yao
3.0g  Wu Wei Zi
3.0g  Bu Gu Zhi
3.0g  Ren Shen
4.5g  Bai Shao
12g   Shu Di Huang
3.0g  Gou Qi Zi
6.0g  Niu Xi
3.0g  Tu Si Zi
6.0g  Dang Gui
3.0g  Bai Zhu
6.0g  Du Zhong
3.0g  Gui Ban
9.0g  Cang Zhu
6.0g  Huang Bai
1.8g  Fang Feng
1.5g  Qiang Huo
1.5g  Han Fang Ji
3.0g  Di Long

3. Yin deficiency leading to Internal Wind: stiffness of the fingers, jerking movements of the feet, trembling muscles, dizziness, tinnitus, irritability, dry mouth, red tongue, no coating, wiry, thready, rapid pulse
9.0g  Bai Shao
4.5g  E Jiao
6.0g  Gui Ban
9.0g  Sheng Di Huang
3.0g  Mai Zi Ren
3.0g  Wu Wei Zi
6.0g  Mu Li
9.0g  Mai Men Dong
6.0g  Zhi Gan Cao
2p     Ji Zi Huang
6.0g  Bie Jia
6.0g  Gou Teng
2.0g  Quan Xie

4. Empirical Formula (A): ALS with Qi/Blood deficiency, Muscles are not nourished
15g  Huang Qi
15g  Ji Xue Teng   
12g  Dang Gui   
12g  Shu Di Huang   
12g  Ren Dong Teng 
  9g  Bai Zhu (Chao) 
  9g  Dang Shen   
  9g  Dan Shen   
  9g  Fu Ling   
  9g  Niu Xi   
  9g  Tu Si Zi   
  9g  He Shou Wu   
  9g  Gou Qi Zi   
  9g  Bu Gu Zhi   
  9g  Gou Ji   
  9g  Chen Pi   
  5g  Zhi Mu 
  5g  Huang Bai   
  3g  Gan Cao

5. Empirical Formula (B): ALS with LV/KD Yin deficiency, Damp-Heat damaging the muscles
30g  Bai Shao
15g  Gan Cao   
15g  Wu Mei   
15g  Mu Gua
  9g  Wu Jia Pi   
  9g  Hai Tong Pi
  9g  Chan Sha



KOREAN STYLE ACUPUNCTURE

Hwa-Chim:  According to Korean style acupuncture, Hwa-Chim (Five Element Harmonizing Acupuncture) is a good treatment for ALS.  After taking the "comparison pulse", the practitioner can determine one of five patterns/types; Wood excess Metal deficiency, Fire excess Water deficiency, Earth excess Wood deficiency, Metal excess Fire deficiency, Water excess Earth deficiency.  Then basic Zang or Fu treatments are applied first, and specific five element points are applied depending on the nature of the points by patterns/types.

SaAm-Chim:  For SaAm-Chim (a.k.a. Four Needle Technique), SP tonification (+HT8, SP2, -LV1, -SP1) is a good treatment because the SP is involved with muscles and motor impairment of the limbs.  The other side of SP tonification Tx., GB tonificiation (+UB66, +GB43, -LI1, -GB44) can be added according to the Heavenly Stem Union theory. 

SaAm-Chim + Point Combination:  If you apply SP tonification on one side, a few TCM points can be applied according to indication.  SI3+UB62 is a good 8 Extra combination to add for governing motor neurons affecting areas in the body.  GB34 can be considered because it's the muscle meridian influential point.  I also like to add some of the Muscle Meridian Meeting Points GB13 (3 Arm Yang), GB22 (3 Arm Yin), ST3 (3 Leg Yang), or RN3 (3 Leg Yin) depending on the area affected.