¡¡

Brief Summary: On Aug. 27, 2009, Michael from Philippines, who has suffered from the muscular atrophy and lack of power for one year, accompanied by the useless right hand and difficult walking for half a year. After 29-day treatment here, the stiffness of the both arms disappeared and he could bend and stretch them freely. The gripping power of his both hands was obviously increased. He could raise the both arms freely. The muscular stiffness disappeared. The pains of the right wrist, elbow and shoulder was stopped. The power of the both lower limbs was increased. He walks very freely. He felt pretty good. His appetite was good. The sleeping was normal.

 

Record of Hospitalization

Name: Michael                                                                                                     Birthplace: Philippines

Sex: Male                                                                                                              Profession: Worker

Age: 40                                                                                                                 Date of Admission: Aug. 27, 2009

Religion: Philippines                                                                                              Date of Record: Aug. 27, 2009

Marital Status: Married                                                                                       Onset Season: Autumnal equinox

Complainer: The patient himself

 

First Medical Record

Date: Aug. 27, 2009                                      Time: 19: 00 p. m.

Michael, a 40-year-old male, has suffered from the muscular atrophy and lack of power for one year, accompanied by the useless right hand and difficult walking for half a year. He was hospitalized in our hospital at 19: 00 p. m. on Aug 27, 2009.

 

Essentials for Diagnosis:

1. The patient has suffered from the muscular atrophy and lack of power for one year, accompanied by the useless right hand difficult walking for half a year.

2. In September, 2008, the patient began to feel the muscular atrophy and lack of power without obvious reasons, but he didn¡¯t pay much attention to it at that time and hadn¡¯t taken any examination or treatment. The situation is getting worse day by day, so he was given MRI examination in the local hospital and was diagnosed with ALS. The doctor told him there was no treating strategy, so he didn¡¯t receive any treatment. During the recent half a year, the patient¡¯s condition was getting worse, his right hand is useless and feel difficult in walking (he could just walk for 500 meters). In June of 2009, he was given acupuncture and massage in a Chinese clinic locally, and the condition was better. In July of 2009, the patient began to take the herbal tea sent from our hospital, and he felt the condition was improving. So he came to our hospital on Aug. 27, 2009 for further treatment. At that time, his energy and appetite was a litter bad, the sleeping was ok, both the urine and stool were ok.

3. T 36.4¡æ,  R 20 times/minute,  P 80 times/minute,  BP 110/85mmHg.

4. He grew normally with medium nutrition. His mind was clear. He had an expression of chronic illness and tiredness. His body was cooperative with his mind.

5. No thoracic deformity. Sound of breath was bilaterally normal on auscultation. No dry and moist damp rales. Heart border was normal. Heart beat was 80 times/minute. Cardiac rhythm was regular. No pathological murmurs on auscultation.

6. The patient felt weakness of the both upper extremities, and supraspinous muscle was a little atrophied. His both upper extremities couldn't do outward rotation and feel difficult to hold up. He was not able to hold things in both hands. Both the thenar muscles and hypothenar muscles are atrophied. The interphalangeal joints were so stiff that he couldn't extend them. The gripping power of the left hand was 4.0 kg (+) and that of the right hand was 2.2 kg (+). The muscular tension of the both upper extremities was weak. The myodynamia was of grade ¢ò. The both lower limbs of was so weak that he felt difficult in walking. He could just walk for 500 meters. The gastrocnemius of the both lower limbs was atrophied, especially in the right side. The myodynamia was of grade ¢ó. The muscular tension was a little weak.

7. Accessory examination: Absent.

Diagnostic Basis:

TCM: The patient has suffered from the muscular atrophy and lack of power for one year, accompanied by the useless right hand and difficult walking for half a year. The patient was mainly characterized by muscular looseness and weakness resulting in the muscular atrophy and the patient couldn¡¯t freely move as the time going. His tongue was dark. His tongue coating was yellow and slimy. His pulse was wiry, thready and slippery. According to the symptoms of the tongue and pulse, he was diagnosed with wilting pattern.

Western Medicine: The patient has suffered from the muscular atrophy and lack of power for one year, accompanied by the useless right hand and difficult walking for half a year. The patient's both upper extremities were weak, and the supraspinous muscle was a little atrophied. His both upper extremities couldn't do outward rotation and feel difficult to hold up. He was not able to hold things in both hands. Both the thenar muscles and hypothenar muscles are atrophied. The interphalangeal joints were so stiff that he couldn't extend them. The gripping power of the left hand was 4.0 kg (+) and that of the right hand was 2.2 kg (+). The muscular tension of the both upper extremities was weak. The myodynamia was of grade ¢ò. The both lower limbs were so weak that he felt difficult in walking. He could just walk for 500 meters. The gastrocnemius of the both lower limbs was atrophied, especially in the right side. The myodynamia was of grade ¢ó. The muscular tension was a little weak. He was given MRI examination in the local hospital and was diagnosed with ALS in May, 2009.

Diagnostic Differentiation:

TCM: The patient's wilting pattern should be differentiated from the impediment pattern. Wilting pattern is characterized by limp, weak, and emaciated limbs with the numbness of the muscles. But the patient usually has no joint pains. On the contrary, impediment pattern is generally characterized by joint pains. So they are not difficult to be distinguished.

Western Medicine: ALS should be differentiated from tumor of spinal cord, which is characterized by nerve root pains of the upper limbs, but without extensive trembling of the muscle bundles. Besides, there is no the following symptoms: cranial nerve palsy, trembling of the eyeballs, speech difficulties and ataxia. The disease can be diagnosed clearly by the examination of CT or MRI.

First Diagnosis:

TCM diagnosis: Wilting pattern

Symptom identification: the liver-kidneys yin vacuity and the improper nourishment of the sinews.

Western Medicine diagnosis: ALS

Plans for treatment strategy and nursing:

1. Routine care of traditional Chinese internal medicine.

2. Grade II care.

3.  Under the care of a companion.

4. Normal food.

5. TCM treatment strategy: enrich the liver and the kidneys, emolliate the sinews and free the channels.

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

7. Acupuncture and massage: once a day.

8. Have more medical examinations if necessary.

 

Date: Aug. 28, 2009                                      Time: 11: 00 a. m.

The patient was hospitalized for the muscular atrophy and lack of power for one year, accompanied by the useless right hand and difficult walking for half a year. After the examination, both the thenar muscles and hypothenar muscles are atrophied. The gripping power of the left hand was 4.0 kg (+) and that of the right hand was 2.2 kg (+). He was not able to hold things in both hands. The interphalangeal joints were so stiff that he couldn't extend them. The bilateral supraspinous muscle was atrophic.  His both upper extremities couldn't do outward rotation and feel difficult to hold up. The gastrocnemius of the both lower limbs was atrophied, especially in the right side. He felt difficult in walking accompanied by the stiff muscles of the both arms. The joints of the elbow and the wrist of right shoulder were painful. His tongue was dark. His tongue coating was thin. His pulse was thready. His problem is due to Professor Yang believed that the patient had suffered from wilting pattern due to the liver-kidneys yin vacuity and the improper nourishment of the sinews. So the treatment strategy for him was to enrich the liver and the kidneys, emolliate the sinews and free the channels.

 

Date: Sep. 1, 2009                                      Time: 10: 00 a. m.

The patient's fingers of the both hands were more active than before. The difficulties in holding up the both arms were better. The stiffness of the muscles of the both arms released. The joints of the right neck, elbow, and the wrist were not painful. The other symptoms were the same as before. The former prescription was changed a little. 5 dosages in total.

 

Date: Sep. 6, 2009                                      Time: 10: 00 a. m.

After 9-day treatment of enriching the liver and the kidneys, emolliating the sinews and freeing the channels, the fingers of the both hands were more active than before. The gripping power of the left hand was increased. The stiffness of the both arms was better. The pains of joints of the right neck, elbows, and the wrists were obviously released. The both lower limbs were more powerful than before. His tongue was dark. His tongue coating was thin. His pulse was thready. The former prescription was changed a little. 5 dosages in total.

 

Date: Sep. 11, 2009                                      Time: 10: 00 a. m.

The stiffness of the joints of the hands was mostly released. He could bend and stretch them freely. The gripping power was increased. He could hold a glass and bowl, drink water and have meals by himself. The joints of the both wrists, elbows and the shoulders acted freely. His both arms could raise up, so did his hands. The stiffness of the both arms was released. The pains of the right wrists, elbows and shoulders were stopped. The power of the both lower limbs was increased. The patient himself said that it is ok to walk as long as he wanted. His tongue was dark. His tongue coating was thin. His pulse was thready. The prescription was the same as before. 6 dosages in total.

 

Date: Sep. 16, 2009                                      Time: 10: 00 a. m.

After the treatment of enriching the liver and the kidneys, emolliating the sinews and free the channels, softening hardness and dissipating binds, many symptoms of the patients were better now. The stiffness of the both arms disappeared. His tongue was a little dark. The tongue coating was thin. His pulse was thready. The pulse was weak when being pressed heavily. So the prescription was changed and the doctor added some herbs to fortify the spleen and boost qi, supplement the liver and the stomach. 5 dosages in total.

 

Date: Sep. 21, 2009                                      Time: 10: 00 a. m.

The patient was given the test of the gripping power. The gripping power of the left hand was 7 kg, which was increased 3 kg compared with that of the admission. The right one was 3.4 kg, which was increased 1.2 kg compared with that of the admission. The patient felt good without any discomfort. The prescription was the same as before. 3 dosages in total.

 

Date: Sep. 24, 2009                                      Time: 10: 00 a. m.

After 29-day treatment of enriching the liver and the kidneys, emolliating the sinews and freeing the channels, softening hardness and dissipating binds, and adjusting the treatment according to his symptoms, together with acupuncture and massage, many symptoms of the patient released. The patient decided to leave the hospital today.

 

Letters to Friends, To Dr. Ming; Personal Observations and Comments From an American Point of View

 

More ALS cases that we helped well:

Case-1  Case-2  Case-3  Case-4  Case-5  Case-6  Case-7  Case-8  Case-9  Case-10  Case-11   Case-12  Case-13  Case-14  Case-15  Case-16  Case-17  Case-18  Case-19   Case-20  Case-21  Case-22  Case-23  Case-24  Case-25  Case-26  Case-27   Case-28      Case-29  Case-30  Case-31

¡¡