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Main Signs and Symptoms
Left calf swollen with skin rashes, eruptions and ulceration due to scratching in the local area, drags the left foot when walking due to pain. The whole area is tender to mild pressure. The condition began two weeks ago with pain and swelling in the left calf, followed by the development of itchy rashes. She noticed that she had difficulty walking due to the pain and when tired it became worse. Eventually the whole area below the knee became swollen. She was diagnosed with Buerger’s disease, but found no help with Western medical treatment.
Diagnosis and Treatment
TCM Diagnosis:
Local blockage of the Channels and Collaterals due to Blood stasis; Ying and Wei not harmonized; Blockage of local Blood vessels due to Qi stagnation, Blood stasis; Heat and Toxin development due to stagnation.
Treatment:
Treatment Principle: Activate the Blood and dispel stasis, clear Heat Toxin, drain Damp and unblock the Channels and Vessels, cool the Blood and nourish the Yin.
Treatment: Si Miao Yong An Wan – Jia Wei (Lonicera & Scrophularia Formula) for 1 week
Outcome:
After one week of treatment, both the pain and the swelling had completely resolved. She was then given Xue Fu Zhu Yu Tang (Persica & Cnidium Combination) plus Nei Xiao Luo Li Wan (Prunella & Scrophularia Formula) for 2 weeks.
After two weeks, the remaining symptoms had dramatically improved. To consolidate the effect, she was prescribed Tao Hong Si Wu Wan (Persica, Carthamus & Dang-gui Combination) to be alternated weekly with Nei Xiao Luo Li Wan (Prunella & Scrophularia Formula) for over a month.
Comments:
Buerger’s disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs, in which the blood vessels become inflamed, swell and can become blocked with blood clots. This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger’s disease usually first shows in the hands and feet and may progress to involve larger areas of the arms and legs. There is a strong association between tobacco use and the development of this condition. This condition will not resolve spontaneously and it is difficult to treat. In TCM it is called ‘mai guan yan’ (blockage of the Blood vessels). The formula Si Miao Yong An Wan (Lonicera & Scrophularia Formula), from the Qing dynasty, is the perfect treatment as its actions are:
• clear Heat Toxin
• activate the Blood and dispel stasis
• nourish the Yin and clear Heat
These therapeutic actions address the principal pathodynamics that underlie this disorder.