Rheumatoid Arthritis - Western Medicine vs. TCM

Western Medicine Disease Description Rheumatoid arthritis (RA) refers to a chronic syndrome whose main manifestation is nonspecific, usually symmetrical inflammation of the peripheral joints. This 9inflamation may potentially lead to progressive destruction of the articular and periarticular structures.

Etiology In Western medicine, RA is usually considered an autoimmune disease, although, like so many auotimmune diseases, its etiology is unknown. Popular suspects include food allergies due to leaky gut, genetic susceptibility, lifestyle factors, and microorganisms. There may also be an association between RA and abnormal bowel function.

Symptoms The onset of this disease may be either abrupt or, more commonly, insidious. Its first signs and symptoms are usually simultaneous inflammation of several joints, especially the proximal interphalangeal and metacarpophalangeal joints. Other joints commonly affected include the small joints of the feet, wrists, elbows, and ankles. Those joints, which are affected, are typically tender to palpation, and there is eventually synovial thickening in most of the affected joints. In addition, there is stiffness lasting more than 30 minutes initially of arising in the morning after sleep or after prolonged activity. Early afternoon fatigue and malaise may also occur. If joint tissue degeneration continues, the affected joints may become deformed. However, the subcutaneous rheumatoid nodules which are characteristic of this disease usually only develop in advanced disease. If there is accompanying fever, it is typically low-grade.

Treatment Western physicians treat RA with a combination of rest, nonsteriodal anti-inflammatory drugs (NSAIDs), such as salicylates, indomethacin, and ibuprofen, gold compounds, hydroxychloroquine, corticosteriods, immuno-suppressive drugs, exercise, physical therapy, and surgery.

Traditional Chinese Medicine

Disease Description Rheumatoid arthritis is mainly categorized as bi zheng, impediment condition, in Chinese medicine. If there is fatigue, this is categorized as pi juan, fatigue, while low-grade fever is a species of fa re, emission of heat.

Etiology Habitual bodily righteous vacuity with external invasions of evils; long living in damp environment and contraction of wind, cold damp, and or heat evils.

Symptoms Due to habitual righteous qi vacuity, the interstices may be coursed and slack and the constructive and defensive may be disharmonious. In that case external evils may take advantage of the vacuity and assail and enter where they impede and obstruct the qi and blood. Hence the movement of the joints is inhibited. It is also possible that prolonged living in a damp environment or exposure to rain and cold, damp, chilly weather may leas to contraction of wind, cold, damp evils. If evil qi lodges in the sinews, bones, and joints, it may congeal there and produce impediment. And finally, habitual bodily yang exuberance may transform these evils into heat which may course and pour into the joints where it obstructs and stagnates the qi and blood, thus producing this disease. If enduring heat damages and consumes yin fluids, this may give rise ot liver kidney yin vacuity. If either spleen qi vacuity reaches the kidneys or yin vacuity affects yang, there may b e concomitant kidney yang vacuity. If impediment endures and is not treated, I may engender blood stasis, which enters the network vessels. Because blood and fluids flow together, blood stasis may further become complicated phlegm obstruction and nodulation.