Brief Summary: On November 25, 2011, Sayyed, from Jordan who had been suffering skin impediment in traditional Chinese medicine (TCM) or systemic sclerosis in the concept of western medicine, accompanied by tight skin, mouth-opening with difficulty and stiff fingers and toes for 13 years, was hospitalized in our hospital. She achieved significant improvement after 80 days TCM treatment.

Record of Hospitalization

Name: Sayyed                                        Sex: Female

Age: 31                                                   Marital Status: Unmarried

Nationality: Jordanese                            Date of Admission: Nov. 25, 2011

Companion: Her Father

First Medical Record

Date: Nov. 26, 2011                                Time: 10:00 am

This 31-year-old lady had been suffering from skin impediment, accompanied by tight skin, mouth-opening with difficulty and still fingers and toes for 13 years. The patient was hospitalized in our hospital for TCM treatment at 20 pm on November 25, 2011.

Essential for Diagnosis:

1. The patient had been suffering from tight skin, mouth-opening with difficulty and stiff fingers and toes for 13 years.  

2. The patient complained of swelling sense of the four limbs, tight and itchy skin without any evident cause 13 years ago. About 2 month later, she felt a little bit tired when opened her mouth. The mouth was dry and she also had swallowing problem. The joints of the fingers and toes became tight. She took the treatment for anti-allergy at the local hospital. The problem of itchy skin changed better after the treatment, but other conditions did not show evident improvement. Her conditions were aggravated year after year. Skin of face, fingers and toes became dry and atrophic and then became hard with decreased elasticity. The skin of both hands and feet became purple. Her mouth could only open half. There was occasional ulcer in her tongue, fingers, toes and the tip of the elbows. The stool was dry for one or two times a day. After suffered the disease, her weight was down for 10kg. On October 9, 2011, Sayyed took the treatment of herbal tea shipped from our hospital. She felt better somewhat. It was easier for her to open her mouth. And the stool was not dry any more, with one or two times a day.  

3. When Sayyed came to our hospital, she suffered from stiff sense over the whole general body, especially over the joints of fingers and toes. There was atrophy of the facial skin with bad elasticity. She still felt exhausted to open her mouth. She could not grip her fist tightly. There were burning pains on the upper abdomen and when she was hungry, the pains became worse. She liked to press the pain points. There was much saliva when she was in bed. She had night sweating and much sweat on her hand. She had bad spirit and sleep. The stool was one or two times a day. Urination was normal with no night urination.

4. T: 36.5¡ãC   R: 20 times/minute    P: 70 times/minute   BP: 110/70mmHg

5. The patient was of chronic and sick complexion with stiff facial expression. She grew normally with a little bit plump body. Her nose-wing became small and sharp. Elasticity of her facial skin was bad and it was hard. She could not open her mouth fully. The tongue could not stretch out completely. The external ears were thin. The abdomen was soft. There were pressing pains below the ensisternum and the belly button. The color of the hands and elbow tips was purple. There was muscle atrophy around the joints of elbows and knees. Her fists could not hold tightly. The joints of fingers and toes were of stiffness, especially of the finger joints. There was slight edema on the front part of both shins. The tongue body shortened with yellow tongue coating. The pulse was weak and thready.

Diagnostic Basis:

TCM: The patient¡¯s conditions of tight, atrophic and itchy skin, swelling sense and stiffness of the joints of fingers and toes pertained to skin impediment. The invasion sites of the disease were lungs, stomach and kidneys. The tightness of the skin, the skin atrophy, itchy sense, dry throat, swallowing problem, burning pains in the stomach and night sweating were due to the yin-deficiency of lung and stomach. The kidneys were in charge of the bones. Due to the yin deficiency, the kidneys lost the control of the bones and failed to produce marrow, therefore, the quality of the bones was damaged, and the joints were still with restrained motions. Purple skin and stiff sense were due to the stagnation of blood and blockage of the channels. So, her conditions could be diagnosed as skin impediment, due to the deficiency of lungs, stomach and kidneys and the stagnation of blood and blockage of channels.

Western Medicine: First, she suffered from tight skin, swallowing problem and stiff joints of the fingers and toes for 13 years. Secondly, the patient felt stiff sense over her whole body. It was not easy for her to open her mouth. There was burning pains in the gastric cavity and the pains became worse when she was hungry. She also had night sweating and much head sweat. And thirdly, there was atrophy over the skin of her face, fingers, toes and elbows. The elasticity of those parts was bad. Skin around her lips was of hardness. The joints of her fingers and toes were of stiffness. Her fists could not hold tightly. There were some pressing pains on her abdomen and slight edema on the front part of her shins.

Diagnostic Differentiation:

TCM: Skin impediment is usually differentiated from Bi impediment. Both may have the symptom of stiff joints. But the main character of Bi impediment is pain. So, it is easy to differentiate them.

Western Medicine diagnosis: Skin impediment should be differentiated with rheumatoid arthritis. Both diseases may have the problem of stiff joints of fingers and toes, but the stiffness of the latter usually happens in the morning with the main symptom of pain. Therefore, there is no difficulty to differentiate them.

First Diagnosis:

TCM: Skin impediment.

Symptom identification: the deficiency of lungs, stomach and kidneys and the stagnation of blood and blockage of channels.

Western medicine diagnosis: Systemic sclerosis.

Treatment strategy and nursing:

1. Routine care of traditional Chinese internal medicine.

2. Grade ¢ò care.

3. Soft diet.

4. Pathogenesis: the deficiency of lungs, stomach and kidneys and the stagnation of blood and blockage of channels.

5. TCM strategy: nourishing yin and clearing heat, promoting blood circulation and removing blood stasis.

6. Herbal tea: one dosage a day and drink twice

7. Acupuncture and massage: once a day

8. Have more medical examination if necessary.

Date: Nov. 26, 2011                                             Time: 10:00am

Doctor Zhu Ming paid a visit to the patient. The patient complained of tight skin, difficulty to open her mouth, accompanied by stiff joints of the fingers and toes for 13 years. She suffered from stiff sense over the whole general body, especially over the joints of fingers and toes. There was atrophy of the facial skin with bad elasticity. She felt exhausted to open her mouth. She could not grip her fist tightly. There were burning pains on the upper abdomen and when she was hungry, the pains became worse. She lied to press the pain points. There was much saliva when she was in bed. She had night sweating and much sweat on her head. She had bad spirit and sleep. The bowel movement was once or two times a day. Urination was normal with no night urination. The patient was of chronic and sick complexion with stiff facial expression. Her nose-wing became small and sharp. Elasticity of her facial skin was bad and it was hard. She could not open her mouth fully. The tongue could not stretch out completely. The external ears were thin. The abdomen was soft. There were pressing pains below the ensisternum and the belly button. The color of the hands and elbow tips was purple. There was muscle atrophy around the joints of elbows and knees. Her fists could hold tightly. The joints of fingers and toes were of stiffness, especially of the fingers joints. There was slight edema on the front part of both shins. The tongue body shortened with yellow tongue coating. The pulse was weak and thready.

The patient said there was some improvement in the burning pains in the gastric cavity even though there still were some hidden pains. Other conditions were same as above-mentioned. The examination report of the patient in her local hospital presented that she also suffered from chronic enteritis and chronic gastritis. For the climate, the doctors advised the patient to wear enough clothes to keep warm. 

Date: Dec. 4, 2011                                              Time: 10:00 am

The patient still felt burning sense in the gastric cavity without pains. There were pressing pains around the belly button. The right thumb was cold. The tongue was red with yellow tongue coating. The pulse was sunken and weak. The doctor asked her to soak her hands and feet with hot water for 30 minutes before sleep.

Date: Dec. 7, 2011                                              Time: 10:00 am

The patient felt no burning pains in the gastric cavity any more, but there still pressing pains around the belly button. She felt cold on the right thumb. The tongue was red with yellow tongue coating. The pulse was weak and sunken. The doctors asked her to soak her hands in the traditional Chinese medicine water from today on.

Date: Dec. 10, 2011                                              Time: 10:00 am

The patient said cold feeling on the right thumb changed better. Pressing pains were still there around the belly button. Sleep was good. Urination and bowel movement were normal. She felt dryness in the mouth, due to the use of air conditioner the whole day long. The doctor asked her to drink enough water. Besides, there were pains on the center line of both sides of the legs.

Date: Dec. 13, 2011                                              Time: 10:00 am

Sayyed said cold hands changed better obviously. There were pressing pains around the belly button. The pains on the legs were reduced. Today¡¯s routine examination reports presented that there were parasites in her stool. The tongue was red with yellow tongue coating. The pulse was sunken and weak.

Date: Dec. 16, 2011                                              Time: 10:00 am

The patient said there were no burning sense and pains in the gastric cavity. There still were pressing pains around the belly button, while she did not feel painful if not pressed it. Both hands still felt cold, and the skin of the hands became purple and hands became numb if the hands were cold. The fingers were still stiff.

Date: Dec. 19, 2011                                              Time: 10:00 am

The patient complained of abdominal distention and increased pains around the belly button. The stool was normal with no diarrhea and constipation.

Date: Dec. 22, 2011                                              Time: 10:00 am

The patient said pains around her belly button were reduced. Urination and bowel movement were normal. There was no burning sense in the gastric cavity. The mouth was not dry. Appetite was not good. Cold hands were better, but still stiff. The tongue was red with yellow and slightly greasy tongue coating. The pulse was thready and sunken, but more powerful than before. The doctor advised her to pay attention to her diet, and to take meals on time.

Date: Dec. 25, 2011                                              Time: 10:00 am

Till today, Sayyed had been hospitalized for treatment in our hospital for 30 days. Skin over her face and hands was softer than before. Cold hands changed better. The ulcer face of the fingers and toes gradually healed. She still suffered from mouth opening problem and mouth ulcer. There were pressing pains around the belly button. Her mouth was not dry. Her spirit was good. The urine and stool were normal. The tongue was red with yellow and greasy tongue coating. The pulse was weak and thready.

Date: Dec. 28, 2011                                              Time: 10:00 am

The patient said there was improvement in the stiffness of the fingers and mouth opening. Appetite was better. Pains around the belly button were reduced. The tongue was red with yellow and greasy tongue coating.

Date: Dec.30, 2011                                              Time: 10:00 am

Professor Zhang Xiukui paid a visit to the patient. The patient said the symptoms of tight skin, cold fingers and toes and stiffness were better than before. There was no burning sense in the gastric cavity now. But there still were pressing pains on the abdomen. She still felt hard to open her mouth and suffered from mouth ulcer. Professor Zhang thought the treatment for the patient would be nourishing yin and clearing heat as well as promoting blood circulation and removing blood stasis.

Date: Jan. 1, 2012                                               Time: 10:00 am

Due to the powder of the herb of Sanqi, the patient felt difficulty in drinking the herbal tea.

Date: Jan. 4, 2012                                               Time: 10:00 am

The patient complained of belching and vomiting. Other conditions were the same as before. The tongue was red with yellow tongue coating. The pulse was weak and thready.

Date: Jan. 7, 2012                                               Time: 10:00 am

The patient said the belching disappeared. Skin was softer than before. She was easy to open her mouth. The tongue was red with yellow tongue coating. The pulse was weak and thready.

Date: Jan. 10, 2012                                              Time: 8:30 am

The patient said she had abdominal distention since the afternoon of yesterday. There was burning sense in the gastric cavity with no belching and diarrhea. The stool was yellow and soft. After taking the product of beans yesterday morning, she felt abdominal distention and then, her appetite was not good. She did not eat anything since yesterday morning till now.

Date: Jan. 11, 2012                                              Time: 10:00 am

Abdominal distention was not reduced. Her appetite was a little better. She caught cough this morning.

Date: Jan. 12, 2012                                              Time: 10:00 am

The patient complained of abdominal distention and burning sense in the gastric cavity. The doctor advised her to take more green vegetables.

Date: Jan. 13, 2012                                              Time: 10:00 am

The patient complained of abdominal distention and burning sense in the gastric cavity. The tongue was red with thin and yellow tongue coating. The pulse was wiry.

Date: Jan. 14, 2012                                              Time: 10:00 am

The patient complained of abdominal distention and burning sense in the gastric cavity. There was no bowel movement the whole day long. The tongue was red with thin and yellow tongue coating. The pulse was wiry.

Date: Jan. 15, 2012                                              Time: 10:00 am

The patient complained of abdominal distention and burning sense in the gastric cavity. Today she had bowel movement in the morning, without diarrhea. The tongue was red with thin and yellow tongue coating. The pulse was wiry.

Date: Jan. 17, 2012                                              Time: 10:00 am

Today, Doctor Zhu Ming paid a visit to the patient the patient complained of abdominal distention and burning sense in the gastric cavity since the afternoon of the ninth of this month. There were pains and occasional belching, but no diarrhea. The stool was yellow and soft. The abdomen was soft and there were pressing pains under the ensisternum and around the belly button. The tongue was red with yellow tongue coating. The pulse was wiry and thready.

Date: Jan. 19, 2012                                              Time: 10:00 am

Abdominal pains were reduced.

Date: Jan. 20, 2012                                              Time: 10:00 am

The patient felt better today. And the abdominal pains were reduced.

Date: Jan. 23, 2012                                              Time: 10:00 am

Abdominal pains were reduced. Urination and bowel movement were normal. The pulse was wiry. The tongue was red with yellow tongue coating.

Date: Jan. 26, 2012                                              Time: 10:00 am

The patient said burning sense and pains in the stomach disappeared. But there still were abdominal pains. The stool was normal with once a day. Skin, especially of the four limbs was cold. The pulse was weak. The tongue body was a little bit atrophic.

Date: Jan. 30, 2012                                              Time: 9:30 am

The patient complained of dizziness yesterday night. She had menses starting from yesterday. The condition of dizziness might be caused by the blood vacuity of the brain. The tongue was red with yellow tongue coating. The pulse was thready and wiry.

Date: Feb. 1, 2012                                              Time: 9:00 am

The patient said there was no dizziness, burning sense in the stomach, abdominal distention or belching any more. Even though around the belly button, there still were pressing pains, but they were alleviated a lot. Today was the fourth day of her period, without any obvious dysmenorrheal. Sayyed also said skin over her hands and face was much softer than before. But, skin over the tips of her ten fingers was still tight and stiff. The tongue body was thin. The pulse was thready and wiry.

Date: Feb. 4, 2012                                              Time: 10:00 am

The uncomfortable symptoms in the stomach were dispelled. She still had the problem of mouth opening, even though the facial skin was softer than before. Skin over the tips of her ten fingers was still tight and stiff. The tongue body was thin. The pulse was thready and wiry.

Date: Feb. 7, 2012                                              Time: 10:00 am

Her conditions were stable in the recent days without any special discomfort.

Date: Feb. 9, 2012                                              Time: 10:00 am

The patient complained of cough, headache, sore throat and nasal blocking this morning. The tongue was red with yellow tongue coating. The pulse was wiry, while the pulse of the right hand was a little bit floating.

Date: Feb. 10, 2012                                              Time: 10:00 am

There still were cough, nasal blocking, sore throat as well as sweating. The tongue was red with yellow tongue coating. The pulse was thready.

Date: Feb. 11, 2012                                              Time: 10:00 am

The patient said sore throat was better, but there still were nasal blocking and cough. The tongue was red with yellow tongue coating. The pulse was thready.

Date: Feb. 13, 2012                                              Time: 10:00 am

Sayyed still coughed a little bit without sore throat and nasal blocking. The tongue was red with yellow tongue coating. The pulse was thready. Due to the expiration of her visa, she decided to leave the hospital today. After 80 days treatment in our hospital, the elasticity of her skin was much better than that before she came to our hospital. Now her facial expression was natural. She felt easy to open her mouth now. Her grasping power increased, with 22.7kg of the right hand and 20.8kg of the left hand. The stiffness of the skin was alleviated. There was no ulcer surface or waxed shine over the skin. Cold hands changed warmer. Violet skin was alleviated. There was no swallowing problem, burning sense in the gastric cavity as well as abdominal distention. There was no evident improvement in the pressing pains around the belly button. Sleep and appetite were good. The shortening symptom of her tongue was improved. Before she came to our hospital, there was no sweating in her pals, but now sweating in her palms. Hair growing over her hands was normal now, but before no.

Doctor¡¯s advice after leaving hospital:

1. Avoid wind-cold, maintain good moods, and take care of the diet. 

2. Take herbal medicine back for continuing treatment.

The latest news from Sai'da Alsayyed

----- Original Message -----                                                                                          From: Soos Sayyed
To: tcmtreatment@tcmtreatment.com
Sent: Saturday, March 17, 2012 4:33 PM                                                                  Subject: Re: Miss Sai'da Sayyed - Jordan

Good afternoon ,

Thanks so much for your kind e-mail. Feel free to put my progress on your website so that other Scleroderma patients can get the benefits.

have a nice day.

Thanks

Sai'da Alsayyed

-------

Dear Miss Sai'da Alsayyed,

Thanks so much for your kind email. Nice to hear from you. Pleased to know your progress. Hope you will get a good recovery soon.

Our pleasure to know your further progress soon.

It is very kind of you. Our stuff miss you very much, too.

By the way, can we put your progress on our website? Thanks a lot.

Wish you a good recovery!

Dr. Ming¡¯s TCM Group


-- -- -- -- -- -- -- -- -- -- -- -- -- -- --
TCMT(reatment) Group
Website: www.tcmtreatment.com
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Twitter: twitter.com/tcmtreatment
MSN: tcmtreat@hotmail.com
Address:
Zhongfang Red Cross International Hospital,
Dangui Road, Zhongfang County,
Huaihua City, Hunan Province,
China.
Zip code: 418005
Contact Tel: 86 745 2813387(from 8:30 to 16:40 Beijing Time)
Fax: 86 745 2813349

----- Original Message -----
From: Soos Sayyed
To: tcmtreatment@tcmtreatment.com
Sent: Saturday, March 17, 2012 1:13 AM
Subject: Miss Sai'da Sayyed - Jordan

Dear Dr. Ming,
Dear Mrs Polinda,

How are you? Hope you are all very well .
Today is the 30th day since I came back to my home country with out any massage or acupuncture just the herbal tea I have taken with me .
It is my pleasure to inform you that I am still improving very well which made me feel happy to continue with the herbal tea. As I told you before i left the hospital that my stomachache , swallowing difficulty and hurt burn have all been recovered and they are really stable I can eat all kinds of foods and drinks. Today I have checked my hand gripping power which has increased dramatically the right hand became 36 Kg and the left one became 29 Kg which means that I can close them better than before.

Plz. Pass my warm greetings to Dr. Jasmine , Dr. Christal , Eva , Candy and Angela we miss them all.

Sai'da Alsayyed

-------------

Letter from SA'IDA WALID SAYYED

----------

Dear my colleague Dr. Alhadidi , Mosa

Subject: Your patient ( Miss Sayyed , Sai¡¯da )

Sender : Dr. Ming , Zhu

Dear Sir,

First of all, I thank you very much for your exerted efforts in treating your patient Miss. Sayyed Sai¡¯da since 1998 using western medicine. 

I am glad to tell you that your patient Miss Sayyed Sai¡¯da had contacted us through e-mails telling us about her case. So we sent her ( herbal tea especially prepared for her case ) to drink it at home for one month starting from 25 Oct. 2011 . After a month she was hospitalized in our Chinese hospital On 26 Nov. 2011 continuing her comprehensive treatment for her scleroderma (acupuncture , oral herbal tea , soaking herbal tea and massage ) . She has started to recover more than 80% .

- Her hurt burn had totally disappeared.

- Her swallowing difficulty disappeared.

- Her hands gripping power were stronger than before the right hand was 8.4 and now it is 22.7 while the left hand was 14.4 and then increased into 20.8.

- The skin of her hands became softer than before.

- The mouth opening was very small but now it is bigger than before.

- Sweating started to appear gradually on her palms and now they are sweating nearly everyday.

- Hair started to grow normally on her hands which was not before.

- Her face tightness started to appear much more relaxed with some wrinkles around her lips when smiling , you could notice her smile very clear which we might call it before ( fixed facial expressions) .

And she is leaving to her home on 13 Feb. 2012 continuing her herbal tea in Jordan.

My dear colleague ,

I myself and my TCM group and the hospital staff are pleased and have the honor to cooperate with you in treating chronic and difficult diseases and all other chronic diseases mentioned in our magazines. Let¡¯s cooperate together to treat on TCM ( Traditional Chinese Medicine ) bases .

My dear colleague,

Your patient¡¯s father ( Walid Sayyed ) informed me that you are the most famous and the greatest rheumatologist in Jordan and Middle East. I am sure the future is promising to build cooperation to treat such chronic diseases.

With my best regards

Dr. Ming, Zhu

Enclosures: three magazines

CC. Dr. Abu Hassan , Hashim

CC. Our representative agent Mr. Walid Muhannad Al-sayyed