Rheumatoid arthritis is one of the most common diseases encountered in the clinic. Since its etiology is still unclear, there is no ideal treatment for the disease at present. However, since 1983, many authors have successfully treated rheumatoid arthritis patients with extending moxibustion—a traditional therapeutic method widely used in Shaoxing area of Zhejiang province in China, in treating chronic diseases of the cold type in summer.
A study, conducted by LuoShirong and Zhu Yuewei at Hangzhou Hospital of Traditional Chinese Medicine and Acupuncture, has come up with relevant data on rheumatoid arthritis.
The study was conducted on 65 patients, of which 11 were male and 54 female. Their age ranged from 14 to 69 years with an average of 42.3 years. The duration of arthritis was within two years in seven cases, two-five years in 32, six-10 years in 18, and over 10 years in eight. All the patients were referred to this hospital for moxibustion therapy. Among the 65 cases, 39 were of cold type, 26 of heat type. Of all the cases, 14 were observed to be severe, 32 moderate and 19 mild:
Grading of functional Disturbance
Severe: Marked articular deformities with functional disturbance, disability and dependence upon corticosteroids.Moderate: Articular deformities with functional limitation and dependence on non-corticosteroid anti-inflammatory analgesics, but no disability.Mild: No remarkable articular deformities, but mild functional impairment slightly affecting physical labour.
Syndromatic Patterns
According to differentiation of syndromes in traditional Chinese medicine (TCM), these cases could be classified into two patterns: cold and heat type.Cold type: Aching and swelling of joints accompanied with feeling of heaviness and coldness. This gets aggravated with cold wet weather and alleviated by warmth, limitation of motion, no local redness and heat, pale plump tongue, deep thread or deep string-taut pulse.
Heat type: As a recent aggravation or relapse of the arthritis, pain, heat redness and swelling of joints with tenderness and difficulty in motion, somewhat reddened tongue, string-taut and rapid or thread and rapid pulse.
According to traditional Chinese medicine, rheumatoid arthritis is a special kind of disease, characterised by deformity, stiffness, and contracture of the joints, chronicity, severe pain aggravated by physical exertion, irresponsiveness to ordinary anti-rheumatic drugs, and weak fine pulse at the cubit part, suggesting deficiency of liver and kidney.
Based on the clinical manifestations, the pathogenesis of this disease appears as follows: The predisposing factor is a weak constitution with deficiency of Yang qi that impairs superficial body resistance. The fundamental treatment should naturally be tonification of the kidney, reinforcement of yang and restoration of body resistance.
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi