Chinese Medicine and different approaches to Autoimmune diseases

Definition of autoimmune diseases

Autoimmune diseases are diseases where immune response is attacking ones own organs or tissues. It can affect small area or make itself known throughout the whole body. There are at least three classes of autoimmune diseases that are based on different immunological factors.
First class is cytotoxic hypersensitivity where antibodies bind to ones own cell surfaces and are recognized as the enemy. This can happen for example because foreign chemicals or antibodies bind to cells. This class can include autoimmune diseases born after infections, environmental exposure to chemicals, medicines or injected antibodies like with vaccines.
Second class contains autoimmune diseases where minimal immune complexes cannot be cleared by macrophages and they travel into cell walls. Common areas of deposit of these antibodies are joints, walls of veins and skin. This class include systemic lupus erythematosus (SLE) and autoimmune response triggered by mold.
Third class is cell mediated immune reaction where helper T cells and monocytes or macrophages try to defend against intracellular pathogens. This kind of immune reaction is normal reaction to mycobacteria, fungi and some parasites. This can also happen with tumors. When this becomes autoimmune reaction this can form diseases like Celiacic disease, Crohn’s disease and psoriasis.
Some autoimmune diseases can be combinations of above and some common autoimmune diseases like Sjögren’s syndrome and spondyloarthropathy do not even fit to any of these categories.
Medical research is finding that many common diseases could in fact be autoimmune diseases. The current list of suspected autoimmune diseases is much longer than list of accepted autoimmune diseases.
The causes of autoimmune diseases are being debated. Commonly it is accepted that some forms have genetic tendency/risk like rheumatoid arthritis, psoriases and diabetes mellitus juvenilis. Some are triggered by environmental factors like toxins or even by medication or vaccinations. Stress seems to be main trigger for some diseases like multiple sclerosis, Addison’s disease, Sjögren’s syndrome and spondyloarthropathy.
The treatment to these diseases by Western Medicine is basically suppressing the immune system. This is usually done by medications and rarely with surgery like thymectomy in myasthenia gravis. Western medicine is quite powerless to do anything, except momentarily easing the symptoms.
View of modern Chinese medicine is quite similar to Western medicine when it comes to autoimmune disease. It concentrates on using modern science to break down the causes and to track down the underlaying root of the problem to cellular level. The treatments are sometimes based on herbal medicine that are selected either from long history of use for similar symptoms or more recent research of biologically active molecules found from plants. Acupuncture and moxibustion are mostly used for symptoms like pain.

Traditional Chinese medicine and autoimmune disease

In ancient text there seems to be accounts of rheumatoid arthritis, inflammatory bowel disease like Crohn’s disease and ulcerative colitis and many other autoimmune diseases. In most cases presented in classics we cannot possibly know what the disease truly was. From short list of symptoms we do not know if the disease was for example lyme borreleosis or multiple sclerosis, or was it non-autoimmune form of arthritis or rheumatic one. What we know is some of the methods diagnose and treat. And in some cases we even know the results… if we can trust our sources.

Traditional Chinese medicine still relies old form of diagnosis done by looking, asking, listening, smelling and taking pulse. The diseases are then differentiated using for example eight principles and Zangfu-theory. The diagnosis and treatment will depend on school and expertise of the practitioner. The most commonly used diagnostics and treatments are based on Zangfu, Five phases, Bi&Wei-syndromes and Wind-syndromes. One of the best books with this approach is Treating Autoimmune Disease With Chinese Medicine written by Wanzhu Hou, Guangpi Xu and Hanjie Wang (ISBN 978-0-443-06974-1).
To illustrate this approach we take an example from the book. According the authors the aetiology and pathology of Systemic lupus erythematosus can be presents to be caused by one or all of the following:

• Deficiency of Yin as the internal cause of lupus
• Invasion of pathogenic factors as the external cause of SLE
• Blood stasis, Phlegm and Fluid are pathogenic substances, as well as one cause of SLE, and an aggravating factor in existing SLE

The Systemic lupus erythematosus can be differentiated by symptoms to following main categories:

• Domination of Heat-toxin
• Internal Heat due to Yin deficiency
• Blood stasis and Heat stagnation
• Spleen and Kidney Qi deficiency
• Fluid retention due to Yang deficiency

The book prescribes different points and herbs for possible treatment and includes couple of case studies.
In light of element theory most of the autoimmune diseases have characteristics of various degrees of Yin deficiency, heat and phlegm (turbid dampness). This approach works greatly to relieve the symptoms and sometimes this can provide a cure for disease itself. In many cases of autoimmune diseases this approach only works to relieve the symptoms. In many cases this relieving symptoms is already very great achievement. For example in multiple sclerosis the myelin is destroyed in relapse phases and if this relapse can be shorten or stopped the amount of damage to nervous system is minimized and the body has time to recover during remissions. This can slow down or even stop the advancement of multiple sclerosis and at least the symptoms during the relapse are eased.

Explaining autoimmune disease with Shānghán lùn by Zhāng Zhòngjǐng

The classics like Shānghán lùn (Treatise on cold damage), Sùwèn and Língshū are more concentrated on our energetic structures and their reson

ance with cosmic forces than classification of symptoms to elementary correspondences. These classics describe how the pathogenic factors travel in our systems and how the diseases patterns develop and change. These theories, especially Shānghán lùn theory, are usually used to

explain acute diseases with emphasis of cold pathogen. The energetic structures and possible ways the disease may develop apply also to other diseases.

In chapter 6 the Sùwèn explains how the three Yang and three Yin together make six continuous looping channels. The 31th chapter explains how a cold disease develops and travels through this channel system. The Shānghán lùn uses this six channel theory from Sùwèn and explains symptoms and principles of healing in much greater depth. The depth of the six channels are, from superficial to deeper, Tàiyáng (small intestine and bladder channels) → Shǎoyáng (sānjiāo and gallbladder channels) → Yángmíng (large intestine and stomach channels)→ Tàiyīn (lung and spleen channels) → Juéyīn (xīnbāo and liver channels) → Shǎoyīn (heart and kidney channels). The disease progresses through these levels usually in different order. The primary order of progression in Shānghán lùn is Tàiyáng → Shǎoyáng → Yángmíng → Tàiyīn → Shǎoyīn → Juéyīn (1) . After getting to Juéyīn the disease may even result in death. The difference between the depths and progression order is due channel pathways. The disease advances from Tàiyáng to foot portition of Shǎoyīn (kidney meridian). From kidney meridian it travels to Juéyīn ending up to Xīnbāo – or hand/yang portion of Juéyīn. In English literature the Xīnbāo is commonly translated as Heart protector or Pericardium. Xīnbāo is intimately connected to the Heart and true Heart-channel. We have to remember that what is commonly called as the Heart-channel is in fact only a superficial branch of the true Heart meridian. The real Heart-channel lies deep with and cannot be pierced and have no points on it. This is also the reason why the Heart channel is not mentioned in oldest of texts and why the Xīnbāo-channel was sometimes called the Heart-channel. It is said that if the pathogens could get into True Heart-channel the Shén or spirit would leave and death would follow. So the True Heart channel is protected by Xīnbāo.

In regards of autoimmune diseases these theories of depth and progressions provide few very interesting points. The Shǎoyáng (Sānjiāo and gallbladder) is the axis of all Yang channels. Diseases in this level are considered to be in between states. They are not fully internal nor external. They have characteristics of moving and changing. They can manifest as shaking, chills, intermittent fevers, uncomfortable breathing and constantly changing pains. Gallbladder channel is responsible of peripheral nervous system and is connected also to Marrow. Marrow in Chinese medicine also includes spinal cord and brain. The master or meeting point of all Marrows lays in gallbladder channel (GB 39). Sānjiāo connects the brain to the three Dantian. It is also deeply connected to harmonious working of all endocrine glands which control the hormonal balance of body. Shǎoyáng is the harmonizing axis of all Yang channels that are responsible of all activity of body
The Juéyīn is more connected to the Liver, Detoxification, Blood, tissues, body and form. The Xīnbāo portion is also connected to thymus responsible for “educating” the T-Cells which plays key part in adaptation of immune system. It is the utmost Yin. If this level gets affected the Yin becomes disharmonious and cannot transform to Yang. This can cause deformity and dysfunction of tissues. In more serious level the separation of Yin and Yang can happen, meaning death.
The autoimmune disease can be seen as breaking of this fundamental harmony. In classics these states are seen as result of diseases that were not fully healed. In Western medicine it is also accepted that certain prolonged diseases can trigger autoimmune response. And even improper use of medicals (like antibiotics) can cause autoimmune diseases like Crohn’s disease (2).
This theory also applies to other diseases arising from foreign chemical entering the body. Recently in Finland there has been cases of narcolepsy caused by swine flu vaccinations(3). Even though the narcolepsy is not considered autoimmune disease the cases seem very similar in the eyes of Chinese medicine diagnostics as the Shǎoyáng is responsible for harmonizing the activities of Yang channels. The Sānjiāo and Gallbladder channels are often used to treat diseases of brains and more generally the whole nervous system. The points from gallbladder (ie. GB38) and Xīnbāo (ie. XB8-9) channels are used for example to treat penicillins induced allergic reaction. The gallbladder channel and its corresponding Zang-organ liver are responsible for muscle and tendon level of body, the very same depth the vaccines are injected into. The liver belong to the Juéyīn-level and is responsible for detoxifying the body.

1. In Sùwèn chapter 31 this order is Tàiyáng → Yángmíng → Shǎoyáng → Tàiyīn → Shǎoyīn → Juéyīn.
2. http://gut.bmj.com/content/early/2010/10/21/gut.2010.219683.short
3. http://www.telegraph.co.uk/health/healthnews/9171414/Swine-flu-vaccine-linked-to-sleeping-disorder.html

Emotional causes and Xīnbāo-theory of doctor José Luis Padilla Corral

In clinical practice of Chinese medicine the patients are interviewed quite throughly. Practitioners quite often note how the diseases are triggered after prolonged emotional stress culminating in emotional turmoil . In clinical work this seems to be much more evident and common than the modern medical studies seem to indicate. It seems that it sometimes takes about 2-6 months after the worst peak in turmoil before the disease begins to manifest its first symptoms. The earlier beginning is however sometimes evident in patients dreams in few days. This delayed onset of symptoms can be one reason for statistic inaccuracies.
Some of the best treatment protocols for this kind of autoimmune disease have not been based on five elements but upon Xīnbāo-channel. Best Xīnbāo-channel based treatments that I have tried were developed by Dr. José Luis Padilla Corral. They are mostly based on idea of Xīnbāo and problems of identity and not being able to “follow ones own Heart”. Many times our minds, expectations, cultural conditioning and feelings “fight each other” creating “civil war” inside. According him this condition within body is one of the main reason for autoimmune response. His treatments utilized points from Xīnbāo and Gallbladder. His later treatment patterns used acupuncture and moxibustion to points like Bl22, Xb7, Du 10-11 plus selections very similar to those in Treating Autoimmune Disease With Chinese Medicine. In many cases both of the treatments based on Corral view have proven very fast and effective. The points in his later protocol however rise many thoughts in everyone familiar with Xiānghǔo lùn (Treatise on Ministerial fire).

Autoimmunity and Sānjiāo

Even though some of the autoimmune diseases are usually born with similar histories sometimes there seemed to be no relationship to previous symptoms or diseases. In these cases no amount of treatment with Five phases theory is enough to really extinguish the fire. The flames of inflammation always return sooner or later. If we wish to go deeper we need to take closer look to the root of the channels.
Sānjiāo is a peculiar channel or system. In relation to yuán points it is said in Nanjing 66:
“Under the navel and between the kidneys is moving qi. It is the life and fate of man. It is the root and source of 12 channels. That why they are called yuán (points). The Sānjiāo is the peculiar envoy of yuánqì. It is master of passages moving three qì. It channel passes in five Zàng and six fǔ. Yuán (origin) is the honorary title of Sānjiāo. Therefore [the points] where it stays seated are called yuán[-points].” (1)
The place between the kidneys and under the navel is the dantian or Mìngmén. Sānjiāo is the origin or source of all other meridians. Mìngmén is the ministerial fire. Zhū Dānxī (1280-1358) in his book Xiānghǔo lùn or Treatise on Ministerial wrote that “Only fire is twofold. [One] is called sovereign fire that is human fire; [The other] is called ministerial fire that is heavenly fire ”(2).
The ministerial fire as it is “born from Nothingness it holds [its] seat of behests. Because its movements are clearly visible we speak of ministerial [fire]”(3).
This is one of the ancient “secrets” now almost totally forgotten. For many the Sānjiāo is just a strange channel without much use save the local pain. The cosmology and the classics however explain the whole structure of human being stemming from Mìngmén through this ministerial fire. It is the fire of life in human being. The Xiānghǔo lùn further explains “[If] the Heaven were without this fire it could not give birth to beings. [If] Humans were without this fire they could not be born (or live).” (4)

So what does this fire mean for autoimmune disease? Zhū Dānxī explains how “fire stirs by expectations (wàng)”. This term wàng has lot of meanings. It means expectations, presumption, but also being false, double faced, pretentious, being full of oneself, absurd and disordered. This wàng is the reason for our stress. In modern world the most stress seems to come (according patients) from work, social relationships and also from within family. It can be that one is forced to act differently from ones feelings or own just have to repress the conflicting desires. Sometimes it is the hopeless dream one has had never courage to live. In many times these hope create false patterns of behavior, feeling and reacting as a way to cope with the tension inside.
This fire once aroused “transforms and changes without measures. It simmers and boils true Yīn. [When] Yīn is empty there is disease [after] yīn is exhausted there is death”(5). As the Sānjiāo is the source and root of all the channels the fire spreads to the other channels and starts acting as “the enemy of yuán qì” as it is expressed in Sùwèn. Zhū Dānxī quotes classics and commentaries and explains briefly how the different disease are born because of this fire.
This explains one one point technique that has proven the most effective in autoimmune treatments, the moxibustion of Sānjiāoshū (BL 22). You may wonder why to use moxa for fire but in this case it is using a human fire to sooth the heavenly fire as presented in Sùwèn. This usually cuts the process but you get lasting cure one needs to add points to release “expectations and pretenses” or wàngs according their nature.

1. 《黃帝八十一難經 六十六難》 臍下腎間動氣者，人之生命也，十二經之根本也，故名曰原。三焦者，原氣之別使也，主通行三氣，經歷於五藏六府。原者，三焦之尊號也。故所止輒為原。
2. 《朱丹溪相火論》 惟火有二，日君火，人火也。日相火，天火也。
3. 《朱丹溪相火論》 生於虛無守位稟，因其動而可見，做謂之相。
4. 《朱丹溪相火論》 天非此火不能生物，人非此火不能有生。
5. 《朱丹溪相火論》 火起於妄，變化莫測，無時不有，煎熬真陰，陰虛則病，陰絕則死。

Hypothesis about Autoimmunity, Earth changes and the Sun

During past decades the autoimmune diseases have become more and more common. This might be due our own actions of poisoning our environment and food, increased use of vaccines and medications that are rarely properly prescribed. But still this does not explain all the cases. In modern times we also have much more freedom for self expression and less burdens from moral restrictions. How could the Sānjiāo and theory of ministerial fire explain the increase?
Zhū Dānxī referred ministerial fire as heavenly fire that is needed to give birth to the living things. This fire is the sun. Dàoshū (Daozang 1017 道樞) explains: “Man stands between Heaven and Earth in accordance of life. This is called Mìng (fate). [When] man is arriving as an embryo his kidney first receives it form. Then grows [others of the] five Zàng (organs). Therefore kidney is Mìngmén, The left [kidney] is Shǎoyáng that is like Heaven and Sun. The right is Tàiyīn, Earth and Moon. [Kidneys] are the Tàijí of the whole body, the ending sentence and the beginning of persons life.”(1)

Zhēnyī jīndān jué – Zhēnyī secrets of golden elixir (真一金丹訣) written by Wáng Chángjí (王常集) during Sòng-dynasty. It explains: “Channels are distributed up and down, left and right, throughout and everywhere. At the left there is a channel united with left kidney. It belongs to yīn, it is Moon and master of Water. Its number is one. At the right there is one channel united with right. Root of man before his birth in right kidney is Mìngmén. It belongs to yáng and is like Sun. Sun is master of three Hún and its color is red. It is fire. Fire suppresses Yuángōng (Palace of the Origin). Its number is seven.”(2)

In classical texts the human body is sometimes compared to Earth and it is being influenced by the sun, seasons and winds. The term Qì also means weather and air. Currently our sun has again shown increase in activity. The Earths magnetic fields has undergone changes and its magnetic poles have started moving with increasing speed. The earthquakes and volcanoes are experiencing up-ticking and the weather has given us a display of serious “anomalies”. It is being argued if this is man made phenomenon or if it is part of a normal cycle that modern man is yet unaware of. In either case the earth is undergoing changes in many levels and the whole nature humankind included has to adapt to these changes.

The Sun and Mìngmén in man are thought as fire of life. When this fire becomes highly active it burns through us like the spark of evolution and change. This fire acts in Shāoyáng level and can easily make some aspects like immune system overactive, especially if there is no balance within and there is lot of those “expectations and pretenses” (wàng). If it can pass through unobstructed it changes and transforms us and helps us to adapt. Zhū Dānxī quoted Zhōuzǐ (周子) and Zhūzǐ (朱子) and told how “the sages were fixed in their centers, were truthful, humane and righteous and mastered stillness”(3). If one “acts as Tao was his Heart and master of body then his human heart always hears(4) his destiny. This is truly the proper way to deal with the fire!”(5)

1. 《道樞》人受天地之中以生，所謂命也。人之就胎，其腎先受形焉，次之以生五臟，故腎為命門者也。其左為少陽，為天，為日；其右為太陰，為地，為月，是一身之太極判而始生者也。
2. 《真一金丹訣》 經分上下,左右衝通,左有一經,連左腎,屬陰為月,主水,數之一也;右有一經連於右腎,本男先生於右腎,為命門,屬陽為日,日、王三魂,色赤為火,火鎮元宮,數之七也。
3. 《朱丹溪相火論》 圣人定之以中正仁義而主靜。
4. Tīng (听) means to listen, hear and obey.
5. 《朱丹溪相火論》比使道心常為一身之主，而人心每听命焉。 此善處乎火者。

Sources

张仲景:傷寒論
朱丹溪:相火論
黃帝八十一難經
黃帝內經素問
黃帝內經靈樞
Treating Autoimmune Disease With Chinese Medicine written by Wanzhu Hou, Guangpi Xu and Hanjie Wang (ISBN 978-0-443-06974-1)
Notes from Autoimmune Diseases lectures held by Gandul Saris-Sauri, Neijing-school May 20-21 2006.

Additional sources for those interested in connection between Sun, ionosphere, magnetosphere and earthquakes:

Induction magnetometer, http://www.haarp.alaska.edu/cgi-bin/scmag/disp-scmag.cgi
Digisonde Scaled Data, http://www.haarp.alaska.edu/cgi-bin/digisonde/scaled.cgi
HAARP VHF Riometer, http://www.haarp.alaska.edu/cgi-bin/riometer/riom2_sel.cgi
Ionospheric Map, http://www.ips.gov.au/HF_Systems/6/5
Integrated space weather analysis system, http://iswa.gsfc.nasa.gov/iswa/iSWA.html
Solar dynamics, http://sdo.gsfc.nasa.gov/data/
Space weather, http://spaceweather.com/
Seismic monitor, http://www.iris.edu/seismon/
University of Delaware: Bartol Research Institute – Neutron monitor program,
http://neutronm.bartol.udel.edu/
GNSS and Ionospheric Scintillation, http://www.insidegnss.com/node/1579
SWMF (Magnetosphere-Ionosphere) Real-time run, http://ccmc.gsfc.nasa.gov/cgi-bin/SWMF_RealTime_browse.cgi
Plot of solar cycle 23 and 24 sunspot data, http://www.nwra.com/spawx/ssne-cycle2324.html

A statistical study on the effect of earthquakes on the ionosphere, based on the subionospheric LF propagation data in Japan, http://hal.archives-ouvertes.fr/hal-00318154/

Physical mechanism of the action of solar activity and other geophysical factors on the state of the lower atmosphere, meteorological parameters, and climate, http://iopscience.iop.org/1063-7869/36/7/A09/pdf/1063-7869_36_7_A09.pdf (not free!!!)

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