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LYME DISEASE

GENERAL

Clinical Manifestations	The complete clinical presentation of a patient with Lyme disease can present symptoms like many other diseases, including multiple sclerosis, rheumatoid arthritis, and many others. Because of this shape-shifting tendency, Lyme disease has been dubbed "the great imitator." The symptoms of Lyme disease usually show up days or weeks after a tick bite, though 50% of all LD patients cannot recall a tick bite, and it has been estimated that only 1-3% of all tick bites lead to L D. The tick introduces the pathogen into the blood stream directly. The infection typically yields a blotchy red rash, often in a "bull's eye" pattern of red skin coloration and swelling, about 3-20 days after the tick bite. Several co-infections are commonly found along with LD, including erhlichosis, babiosis, and other forms of bacterium that are transmitted via tick or other insect bites. There may be flu-like symptoms, including: Fever Headache Sore throat Nausea Fatigue Swollen glands Stiff neck Aching muscles; and If unresolved there may be recurrences of fever and, usually after several months: Arthralgia, usually in the knees, with swelling and a hot feeling End-stage patients can be severely neurologically compromised, and may resemble neurosyphilis in its clinical presentation: Dementia Confusion Memory loss Delusions Eventually, complete neurological breakdown
Treatment Principle
Herb Formulas
Points

WEI STAGE: SUMMERHEAT WITH DAMP AND SUPERIMPOSED WIND-COLD

Clinical Manifestations	Fever and chills Anhidrosis Headache Thirst Flushed face Tightness in the chest Aversion to Cold Fatigue Aching body Nausea Reduced, dark urination T: Red C: White and greasy P: Floating and rapid or Flooding on the right and Small on the left
Treatment Principle	Release Exterior Summerheat Release External Cold Clear Heat Resolve Dampness
Herb Formulas	Xin Jia Xiang Ru Yin With Heat Flooding the San Jiao: San Shi Tang
Points	Bleed UB-40, needle DU-14, DU-16, DU-23, DU-24, GB-20, LI-4, LI-11, LU-7, REN-9, SJ-5, SP-6, SP-9, ST-8, ST-28, Taiyang, UB-12, UB-13, UB-20

TOXIC DAMP-HEAT- (FIRST STAGE)

Clinical Manifestations	Erythematous skin rash Pain Swelling in the joints Fever Chills Aversion to Wind Headache Fatigue Severe muscle aches A dry mouth Preference for cold drinks Conjunctivitis Hemorrhages Jaundice Kidney and Liver dysfunction T: Red C: Slimy or greasy yellow P: Floating and rapid or Floating, wiry, slippery and rapid End-stage: Dementia Confusion Memory loss Delusions Eventually, complete neurological breakdown
Treatment Principle	Clear Heat Resolve toxins Cool and invigorate the Blood
Herb Formulas	Toxic Fire #1 + 2g Hu Zhang twice daily Liang Xue Bai Du Tang Lyme Disease #1 Anti-Spirochete Formula Wu Wei Xiao Du Yin modified For Exogenous pathogens invading the Wei Stage: Yin Qiao San For Summerheat and Damp-Heat misting the three burners (for treatment of skin manifestations of the disease, such as rashes): San Shi San (apply topically) Acute jaundice (this is the manifestation of leptospirosis as liver disease): Er Miao San Summerheat injuring the Lungs: Xin Jia Xiang Ru Yin Heat Invading the Pericardium with Liver Wind moving Internally: (this is the manifestation of leptospirosis as meningitis): Zhen Gan Xi Feng Tang plus An Gong Niu Huang Wan
Points	GB-31, LI-11, SP-10, UB-40 With marked fatigue: + ST-36 Witha pronounced red rash: + DU-10 With marked muscle and joint pain: + Ahshi points, SP-9

TOXIC DAMP-HEAT WITH QI DEFICIENCY (SECOND STAGE)

Clinical Manifestations	Swelling, Heat and pain in the joints The pathogen is stronger Maybe redness of the joints Dry mouth Thirst Marked fatigue T: Red and swollen ot Tender, light red and swollen C: Thin and yellow P: Surging and rapid
Treatment Principle	Clear toxic Heat Tonify Qi
Herb Formulas	Tuo Li San Jia Jian Toxic Fire #1 + 2g Hu Zhang twice daily Liang Xue Bai Du Tang Lyme Disease #1 Anti-Spirochete Formula For Exogenous pathogens invading the Wei Stage: Yin Qiao San For Summerheat and Damp-Heat misting the three burners (for treatment of skin manifestations of the disease, such as rashes): San Shi San (apply topically) Acute jaundice (this is the manifestation of leptospirosis as liver disease): Er Miao San Summerheat injuring the Lungs: Xin Jia Xiang Ru Yin Heat Invading the Pericardium with Liver Wind moving Internally: (this is the manifestation of leptospirosis as meningitis): Zhen Gan Xi Feng Tangplus An Gong Niu Huang Wan Bu Zhong Yi Qi Tang
Points	Ahshi points, LI-11, SP-9, ST-36 For jaw impediment: + LI-4, SJ-17, ST-7 For cervical impediment: + GB-12, GB-20, UB-10 For thoracic vertebral impediment: + Huatuojiaji at the level of impediment For sacrococcygeal impediment: + DU-4, UB-25, UB-31, UB-32, UB-33, UB-34, UB-40 For shoulder impediment: + HT-1, LI-15, SI-11 For elbow impediment: + LI-10, LI-11, LI-12, SI-8 For wrist impediment: + SI-4, SJ-4, SJ-5 For upper extremity phalangeal metacarpal impediment: + Baxie, LI-4, SI-3 For sacroiliac impediment: + GB-29, GB-30, UB-26, UB-27, UB-30, UB-54 For hip impediment: + GB-30, GB-34 For knee impediment: + LIV-8, ST-35, UB-40, Xiyan For ankle impediment: + choose between GB-40, KI-3, KI-6, ST-41, UB-60, UB-62 For lower extremity phalangeal metacarpal impediment: + Bafeng, GB-41, LIV-3, SP-4, ST-41

QI AND YIN DEFICIENCY WITH LINGERING DAMP-HEAT

Clinical Manifestations	Fatigue Lassitude Weakness Dizziness Tinnitus Low back and knee pain and weakness Low back Heat and swelling Dry mouth and throat Afternoon fever Malar flush Five Sole Heat T: Swollen, red and enlarged C: Little or None P: Wiry, thready and rapid
Treatment Principle	Tonify Qi Nourish Yin Clear Heat Eliminate Dampness
Herb Formulas	Dang Gui Nian Tong Tang modified
Points	UB-17, UB-18, UB-20, UB-21, UB-23 For jaw impediment: + LI-4, SJ-17, ST-7 For cervical impediment: + GB-12, GB-20, UB-10 For thoracic vertebral impediment: + Huatuojiaji at the level of impediment For sacrococcygeal impediment: + DU-4, UB-25, UB-31, UB-32, UB-33, UB-34, UB-40 For shoulder impediment: + HT-1, LI-15, SI-11 For elbow impediment: + LI-10, LI-11, LI-12, SI-8 For wrist impediment: + SI-4, SJ-4, SJ-5 For upper extremity phalangeal metacarpal impediment: + Baxie, LI-4, SI-3 For sacroiliac impediment: + GB-29, GB-30, UB-26, UB-27, UB-30, UB-54 For hip impediment: + GB-30, GB-34 For knee impediment: + LIV-8, ST-35, UB-40, Xiyan For ankle impediment: + choose between GB-40, KI-3, KI-6, ST-41, UB-60, UB-62 For lower extremity phalangeal metacarpal impediment: + Bafeng, GB-41, LIV-3, SP-4, ST-41

QI, BLOOD AND YIN DEFICIENCIES (THIRD STAGE)

Clinical Manifestations	Extreme fatigue Loss of strength Tinnitus Low back pain Knee pain and swelling Dry mouth and throat Five sole Heat Malar flush Hair loss Memory loss Confusion Torpor
Treatment Principle	Tonify Qi,Blood and Yin
Herb Formulas	Bu Zhong Yi Qi Tang + Si Wu Tang + Liu Wei Di Huang Wan
Points