MYASTHENIA GRAVIS

Clinical Manifestations
  • Myasthenia gravis is a chronic neuromuscular transmission disturbance disorder
  • It is considered an autoimmune disorder
  • Easy fatigue of affected striated muscles, relieved after rest
  • Ptosis of the eyelids
  • Difficulty chewing and swallowing
  • Flaccidity of the muscles and limbs
  • Severe cases: Death
Treatment Principle
  • Treat Wei Syndrome
Herb Formulas
Points
Clinical Manifestations
  • Chronic fever with swelling of the extremities
  • Numbness and heaviness of the extremities
  • Soreness and fixed pain of joints
  • Stiffness or numbness of the muscles or skin
  • Pain worse on cloudy or rainy days
  • Maybe peripheral or systemic edema
  • Pain is alleviated by pressure and warmth
  • Pain lingers and is recalcitrant to treatment
  • Worse during cloudy or wet weather
  • Limited movement
  • Edema
  • Maybe a stifling sensation in chest
  • Maybe anorexia or indigestion
  • Maybe abdominal distention
  • Maybe loose or semi-liquid stools
  • T: Pink or Pale
  • C: Greasy and white
  • P: Slow, moderate and soft
Treatment Principle
  • Expel Damp
  • Clear the channels
Herb Formulas
Points
Clinical Manifestations
  • Generalized body aches and pains
  • Irritability
  • Heavy sensation in the shoulder and back
  • Discomfort or a constricted sensation in the area of the chest and diaphragm
  • Multiple sores, carbuncles furuncles or abscesses
  • Redness
  • Itching
  • Persistent swelling
  • Chest pain
  • Fever
  • Thirst
  • Aching and painful extremities
  • Aching and painful joints
  • Unbearable swelling and pain of the lower extremities
  • Shoulder stiffness
  • T: Normal
  • C: Greasy and slightly yellow
  • P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle
  • Resolve Dampness
  • Clear Heat
  • Disperse Wind
  • Stop pain
  • Activate the Blood
  • Tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • Drooping eyelids
  • Double vision
  • Sallow complexion or
  • A bright, white, lusterless complexion
  • Fatigue
  • Lassitude
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools
  • Shortness of breath
  • Disinclination to speak
  • A weak voice
  • Symptoms better in the morning and worse in the evening
  • T: Pale and flabby - may have teethmarks
  • C: White
  • P: Even or Soft and thready
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
  • Reinforce the Center
  • Invigorate Yang
Herb Formulas
Points
Clinical Manifestations
  • Drooping eyelids
  • Restricted ocular movement
  • Double vision
  • Lack of strength in the extremities
  • Aversion to Cold
  • Spontaneous perspiration
  • Aphasia
  • Difficulty swallowing
  • Body cold
  • Limbs icy
  • Complexion white and shiny
  • Low back, knees and abdomen feel cold and painful
  • Lower abdomen feels cold and painful
  • Loose stools containing undigested food
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Dysuria
  • Severe:
    Abdominal ascites
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm and Reinforce the Spleen and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • No appetite or
  • Famished but with no desire to eat
  • Abdominal distention after meals
  • Dry stools
  • Irritability with low grade fever
  • Maybe dry retching or
  • Hiccups
  • T: Red
  • C: Little and dry
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Nourish the Stomach
Herb Formulas
Points
Clinical Manifestations
  • Palpitations
  • Shortness of breath
  • Asthma
  • Soft weak cough
  • Prolonged bouts of coughing with dyspnea
  • Expectoration of clear, watery Phlegm
  • Suffocating sensation in the chest
  • Spontaneous, weak perspiration
  • All of the above manifestations are exacerbated by exertion
  • Shiny white complexion
  • Weak voice
  • Catches colds easily
  • T: Pale
  • C: Thin and white
  • P: Weak or Thready and weak
Treatment Principle
  • Reinforce and Benefit Heart and Lung Qi
Herb Formulas
Points
Clinical Manifestations
  • Palpitations
  • Insomnia
  • Much dreaming
  • Easily startled
  • Poor memory
  • Four limbs tired and lethargic
  • Loss of appetite
  • Distention and fullness of the epigastrium and abdomen
  • Loose stools
  • Sallow complexion
  • Copious, pale menses
  • Uterine bleeding or
  • Light menstrual flow or
  • Amenorrhea
  • T: Pale
  • P: Thready and weak
Treatment Principle
  • Reinforce and Benefit the heart and Spleen
Herb Formulas
Points
Clinical Manifestations
  • Lumbago: low back feels cold, weak and aching
  • Feeling chilled
  • Aversion to Cold
  • Cold limbs
  • General debility
  • Pale face
  • Urinary frequency with abundant, clear urine or
  • Oliguria with edema
  • Maybe nocturia
  • Lassitude
  • Withdrawn, subdued behavior
  • Knees feel cold and aching
  • Dizziness
  • Tinnitus
  • Impotence
  • Spermatorrhea
  • Premature ejaculation
  • Low libido
  • Female infertility ("uterus cold and infertile")
  • Maybe anorexia
  • Maybe loose stools
  • Maybe chronic diarrhea or "cock crow" diarrhea
  • T: Pale and swollen
  • C: Thin and white
  • P: Deep and thready - maybe slow
Treatment Principle
  • Warm and Reinforce Kidney Yang
Herb Formulas
Points
Clinical Manifestations
  • Low back and knees aching and weak
  • Hearing deficit
  • Jing Gate Not Consolidated:
    Spermatorrhea
    Premature ejaculation
    Vaginal discharge
    Infertility
  • Urinary disorder:
    Frequent, clear, abundant urination
    Dribbling after urination
    Incontinence of urine
  • T: Pale and swollen with teethmarks
  • C: Thin white
  • P: Deep and thready
Treatment Principle
  • Consolidate the Kidneys
  • Conserve Qi
Herb Formulas
Points

Clinical Manifestations
  • Drooping eyelids
  • Weak muscles
  • Lack of strength in the lower limbs
  • Chest and diaphragm fullness and oppression
  • Rapid breathing
  • Pain that is fixed, stabbing and/or severe
  • Pan is worse with pressure
  • Dark complexion
  • Fixed, palpable masses
  • Bleeding with clots
  • Purple lips
  • Purple nails
  • Dry skin
  • Blue, dark or purplish discoloration of skin in small or large areas
  • Varicose and spider veins
  • Cold hands and feet
  • Tendency to hemorrhage dark blood or clots
  • T: Purple, possible purple or red spots
    Red purple if there is Heat
    Blue purple if there is Cold
  • C: White
  • P: Choppy or Wiry and choppy
Treatment Principle
  • Invigorate the Blood
  • Break up Stagnation
  • Unblock the channels
Herb Formulas
Points
Clinical Manifestations
  • Drooping eyelids
  • Double vision
  • Lack of strength in the four limbs
  • Disinclination to speak
  • Spontaneous perspiration or
  • Night sweats
  • A Dry mouth
  • A parched throat
  • Heart vexation
  • Dry stools
  • T: Red
  • C: Little or None
  • P: wiry and thready or Thready and rapid
Treatment Principle
  • Tonify Qi
  • Nourish Yin
Herb Formulas
Points
Clinical Manifestations
  • Anemia
  • Uterine bleeding
  • Cold extremities
  • Pale or sallow face
  • Dizziness
  • General fatigue
  • Coarse skin
  • Nocturnal emissions
  • Weak knees
  • Fatigue
  • Dyspnea
  • Night sweats
  • Irregular menstruation
  • Insomnia
  • Intolerance of Cold
  • Decreased eyesight after a prolonged illness
  • Anxiety
  • Intermittent fever
  • Jaundice
  • Deficient cough
  • Shortness of breath
  • Palpitations
  • Anorexia
  • Listlessness
  • Lassitude
  • Spontaneous sweating
  • Spermatorrhea
  • Continuous spotting
  • Leukorrhea
  • Weak legs and knees
  • T: Pale
  • C: Thin and white
  • P: Thready and weak
Treatment Principle
  • Replenish Yang
  • Warm and tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • Weakness of the knees
  • Soreness of the lower back
  • Lumbago
  • Atrophy of the leg muscles
  • Lower back weakness
  • Knee pain
  • Difficulty walking
  • Emaciation
  • Impotence
  • Poor memory
  • Dizziness
  • Night sweats
  • Five-sole Heat
  • Aggravation of the pain by Damp weather
  • Pale complexion
  • Profuse urination at night
  • Tinnitus
  • Hair loss
  • Sensation of warmth
  • Thirst
  • Dry skin
  • T: Red or Pale and flabby with teethmarks
  • C: Little or Thin and white
  • P: Thready and weak, especially in the Kidney positions
Treatment Principle
  • Tonify the Liver and Kidneys
  • Strengthen the tendons and bones
  • Eliminate Damp-Heat
  • Tonify Kidney Jing
  • Relieve rheumatic pain
Herb Formulas
Points
Clinical Manifestations
  • Distension and pain before or during menses
  • Burning abdominal pain which precedes or follows the menstrual flow with guarding
  • Soreness and distention of the lower back
  • Pressure makes the pain worse
  • There may be constant lower abdominal pain that worsens with menstruation
  • Hot sensations
  • A feeling of Heat in the abdomen
  • Aversion to Heat
  • Yellow smelly vaginal discharge between periods
  • Dark-red or purple thick Blood with clots
  • Maybe heavy bleeding
  • Maybe dark, scanty, concentrated urine
  • May be a mild fever
  • T: Red
  • C: Yellow and greasy
  • P: Wiry and rapid or slippery and rapid or soft and rapid
Treatment Principle
  • Resolve Dampness
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Drooping eyelids
  • Lack of strength in the extremities
  • The symptoms are better in the morning and worse in the afternoon
  • Fatigue
  • Anorexia
  • Edema
  • Abdominal distention
  • Chest and hypochondriac distention and oppression
  • Coughing with profuse Phlegm
  • Dizziness
  • Nausea
  • Palpitations
  • Vomiting
  • Vertigo
  • Thirst with no desire to drink
  • Maybe no thirst
  • Palpitations
  • Shortness of Breath
  • T: Pale or Normal
  • C: Thick and slippery
  • P: Slippery or Slippery, full and maybe wiry
Treatment Principle
  • Warm and Dissolve Tan Yin
Herb Formulas
Points
Clinical Manifestations
  • Heat and pain in the joints and muscles
  • Severe limitation of movement
  • Fever and shaking chills
  • Lusterless yellow complexion
  • Scanty, dark urine
  • Pain worse on cloudy or rainy days
  • Arthralgia involving one or several joints
  • Local redness and Heat of the extremities
  • Swelling with excruciating pain
  • Pain better during the day and worse at night
  • Numbness of the muscles
  • Thirst
  • Dryness of the mouth
  • Irritability
  • Muscular atrophy
  • Restlessness
  • Anorexia
  • Desire for Cold drinks
  • Loose stools
  • Aversion to Heat
  • Fullness of the chest
  • Pain improved with Cold and worse with Heat
  • Muscular swelling
  • Muscle redness
  • General heaviness
  • T:Red, maybe flabby
  • C: Yellow and greasy
  • P: Slippery and rapid
Treatment Principle
  • Clear Heat
  • Eliminate Dampness
  • Invigorate the collaterals
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Loose stools or watery diarrhea
  • Weak extremities
  • Weight loss
  • Distention and a stifling sensation in chest and epigastrium
  • Pale wan complexion
  • Abdominal distention
  • Indigestion
  • Vomiting
  • Fatigue
  • Chills
  • Maybe vomiting
  • Leukorrhea
  • Reduced appetite
  • Borborygmus
  • Edema
  • Reduced appetite
  • Diarrhea with onset of menstrual flow
  • Cough with copious sputum
  • Leukorrhea in obese women
  • T: Pale or Pale red
  • C: White - maybe greasy
  • P: Thready and even or Even and Deficient
Treatment Principle
  • Augment Qi
  • Strengthen the Spleen
  • Resolve Dampness
  • Stop diarrhea
Herb Formulas
Points
Clinical Manifestations
  • Flaccid limbs
  • Low back weakness and pain
  • Easily fatigued
  • Diplopia
  • Dysphagia
  • Anorexia
  • Loose stools
  • A dull facial complexion
  • Blurred vision
  • Alopecia
  • A dry throat
  • Tinnitus
  • Maybe inability to walk
  • Gradual muscular atrophy
  • T: Pink
  • C: White
  • P: Thready and weak
Treatment Principle
  • Replenish the Spleen and Kidneys
  • Strengthen the muscles and bones
Herb Formulas
  • Bu Zhong Yi Qi Tang modified
  • Chinese Patent Medicines:
    Bu Zhong Yi Qi Tang + Fu Zi Li Zhong Wan
    Hu Qian Wan + Long Ma Zi Lai Dan
    Jin Suo Gu Jing Wan + Ren Shen Jian Pi Wan

Points
Clinical Manifestations
  • Feebleness
  • Exhaustion
  • Abdominal pain
  • Lower back pain
  • Low energy
  • Lethargy
  • Impotence
  • Cold and pain of the knees
  • Cold extremities
  • Shortness of breath
  • Fatigue
  • Nocturnal emission
  • Separation of Yang
  • T: Pale
  • C: White
  • P: Thin
Treatment Principle
  • Warm Kidney Yang
  • Replenish Jing
Herb Formulas
Points
Clinical Manifestations
  • Slow and gradual onset
  • Weak and flaccid lower limbs
  • Muscle twitching
  • Soreness and weakness of the lower back and spine
  • Inability to stand for a long time
  • Total loss of mobility and severe loss of muscle mass can result with exacerbation
  • Dizziness
  • Vertigo
  • Hair loss
  • Dry throat
  • Tinnitus
  • Fatigue
  • Nocturnal emissions
  • Enuresis
  • Fecal and urinary incontinence
  • Irregular menstruation
  • Dysmenorrhea
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Tonify the Liver and Kidneys
  • Nourish Yin
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Hemiplegia
  • Paralysis
  • Atrophy of the lower limbs
  • Facial paralysis
  • Slurred speech
  • Drooling
  • Dry stools
  • Frequent urination
  • Urinary incontinence
  • Deviation of the eyes and mouth
  • Excess salivation
  • Cold extremities
  • Asthenia
  • T: Normal
  • C: White
  • P: Moderate
Treatment Principle
  • Tonify Qi
  • Invigorate the Blood
  • Unblock the channels
  • Promote movement in the limbs
Herb Formulas
Points
Clinical Manifestations
  • Copious bleeding of dark purple blood
  • The blood is sticky during menstruation
  • May or may not have clots
  • Menstrual cycle is shortened (early menstruation)
  • Palpitations
  • Dizziness
  • Blurred vision
  • Pale, lusterless complexion
  • Pale nails
  • Abdominal pain
  • Irregular menstruation with little flow
  • Fixed lower abdominal pain
  • Vertigo
  • Tinnitus
  • Pale lips
  • May be amenorrhea
  • Insomnia
  • Menstruation may also be accompanied by distention and pain
  • T: Pale
  • C: Normal
  • P: Thin and weak or Thin and choppy
Treatment Principle
  • Tonify and activate the Blood
  • Break up Blood Stagnation
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Usually a fever at the onset
  • Aversion to Heat
  • Flaccidity of the four limbs
  • Muscular atrophy
  • Red, painful, swollen joints with limited movement
  • Hot sensations in the joints and muscles
  • Numbness of the muscles
  • Red, painful muscles
  • Pain alleviated by Cold and made worse with Heat
  • Lassitude
  • General heaviness
  • Ptosis of the eyelids, worse in the afternoon
  • Coughing
  • Yellow Phlegm
  • A dry mouth and throat
  • Chest and epigastric oppression
  • Anorexia
  • Loose stools
  • Short, dark urination
  • Restlessness
  • T: Red or Flabby
  • C: Yellow and greasy
  • P: Slippery and rapid
Treatment Principle
  • Clear Heat
  • Eliminate Dampness
  • Activate the channels and collaterals
Herb Formulas
Points
Clinical Manifestations
  • Usually a fever at the onset
  • Flaccidity of the four limbs
  • Lassitude
  • Ptosis of the eyelids, worse in the afternoon
  • Coughing
  • Yellow Phlegm
  • A dry mouth and throat
  • Epigastric oppression
  • Anorexia
  • Short, dark urination
  • T: Red
  • C: Yellow and slimy
  • P: Thready and rapid
Treatment Principle
  • Clear Heat
  • Eliminate Dampness
  • Moisten the sinews and channels
Herb Formulas
Points