On Jan. 23,
2009, Osama, from Bahrain, who has suffered from ALS, accompanied with the
symptoms of the stiffness and weakness of the four limbs for 6 months, was
hospitalized in our hospital. He has achieved significant improvement after 28
days TCM treatment here.
Date of Admission: Jan. 23, 2009
in Ear Date of
Record: Jan. 23, 2009
patient himself Degree of
Date: Jan. 23,
2009 Time: 2: 00 a. m.
50-year-old male, has suffered from the stiffness and weakness of the four limbs
for 6 months. It became more serious for two months. He was hospitalized in our
hospital for treatment on Jan. 23, 2009.
P 80 times/minute, R 20 times/minute, BP 140/100 mmHg.
symptoms were as follows: the stiffness of the joints of the four limbs; atrophy
and weakness of the muscles all over the body; spasms; obvious jumping of the
muscles of the upper arms and occasional muscle jumping of the other parts of
the body. He could walk about 20 meters with the help of mobility aids. He could
go on simple movements such as eating, tooth brushing, etc. with using the upper
limbs but could not dressing and lifting articles with the hands. The functions
of speaking, swallowing and breathing were normal. He had no symptoms of
headache; tinnitus; spontaneous sweating; night sweating; cough and rales in the
lungs. His vision was normal. Occasionally, he had the symptom of nasal
congestion. He was easy to have a cold. He was fond of drinking water. His
appetite was good. He didn¨t feel mouth dry and bitter. There was tidal fever
of. his chest, palms and soles. His urine and bowel movement were normal.
spirit was good. He had an expression of chronic illness. He grew normally. He
seemed to be skinny. His body was in a negative posture. He was confined to a
wheelchair. He had pale red tongue, thin and yellow tongue coating, floating and
deep pulse. The heart and lungs were normal. There were no tapping pains in the
area of the kidneys. His abdomen was soft. There were no pressing pains and
rebound tenderness. The liver and spleen can not be felt by pressing. The
muscular strength of his four limbs declined. Moreover, he had muscular
hypertonia. There was different degree of muscular atrophy all over the body.
His joints were stiff, but there were no symptoms of inflammation and pains.
Besides, there was no edema of the lower limbs, but he had varicosity.
Physiologic reflex exists, but no pathologic reflex.
examination: MRI and EMG showed he had ALS.
patient¨s wilting pattern is due to insufficiency of qi and yin, malnutrition of
the sinews and vessels. His physical condition is originally weak, so kidney
vacuity can not control the fire, and this condition results in effulgent fire
tormenting metal and the loss of the lung function. Accordingly, the fluids can
not reach the five viscera and then this condition causes the malnutrition of
the body which eventually brings about crippling wilt.
Medicine: The patient has typical symptoms including peripheral paralysis of the
upper limbs, central paralysis of the lower limbs, motor neuron mixed lesion of
the four limbs, etc. Accessory examinations of MRI and EMG show that he has ALS.
patient¨s wilting pattern should be differentiated from impediment pattern.
Wilting pattern is characterized by limp, weak, and emaciated limbs with the
numbness of the muscles. But the patient usually has no joint pains. On the
contrary, impediment pattern is generally characterized by joint pains,
sometimes with the numbness and emaciation of the muscles. They are not
difficult to be distinguished.
Medicine: ALS should be differentiated from tumor of spinal cord, which is
characterized by nerve root pains of the upper limbs, but without extensive
trembling of the muscle bundles. Besides, there is disturbance of sensation and
obstruction of the subarachnoid cavity. The disease can be diagnosed clearly by
the examination of CT or MRI.
Chinese Medicine) diagnosis: Wilting pattern
identification: Depletion of liver-kidney.
treatment strategy and nursing:
care of traditional Chinese internal medicine.
the care of a companion.
and high-protein diet.
and massage: once a day.
the functional exercise of the four limbs: once a day.
tea: one dosage a day and drink twice.
Main herbs used
in the herbal tea: gouqi (lycium berry), baizhu (ovate
atractylodes root), chuanxiong (ligusticum root), etc.
Date: Jan. 26, 2009 Time: 10: 00 a. m.
The patient said his diet was normal. His sleep was better than before.
Yesterday he slept seven hours. The jumping of the muscles all over the body had
lessened 50%. The pains of his shoulder joints improved a lot. The movement of
the four limbs greatly lightened. The patient felt the healing effect was
obvious. Continue to take the same prescription.
Date: Jan. 29, 2009 Time: 10: 00 a. m.
His diet, sleep and drinking were normal. The jumping of the muscles all over
the body and the pains of the shoulder joints disappeared. He could flex his
right fingers. His gripping power obviously increased. The ability to raise his
hands also improved a lot. The height of raising the hands was nearly parallel
to the ground. His mood was comparatively stable. So the doctor suggested him to
take only half of the western medicines which were used to treat depression and
relieve muscular spasms. There was no obvious stiffness of the muscles all over
the body. His pulse was floating and slippery. His tongue coating was slightly
Date: Feb. 1, 2009 Time: 10: 00 a. m.
His diet and sleep were normal. There were no symptoms of the jumping of the
muscles and joint pains. He could feel slight stiffness of the muscles of the
lower limbs. Based on the ground, he could raise his hands more than 90 degree.
In recent two days, his blood pressure had reduced from 140/100mmHg to
130/90mmHg. The gripping power of his hands improved. That of his right hand was
from 6.8 kilos to 10.8 kilos, and that of his left hand from 4.2 kilos to 7.2
kilos. He would begin the functional exercise of the four limbs tomorrow. Once a
day. The prescription was as follows: baizhu (ovate atractylodes root), danggui
(tangkuei), chuanxiong (ligusticum root), etc. 3 dosages in total.
Date: Feb. 4, 2009 Time: 10: 00 a. m.
The patient could get up from a seat in the recent days. Yesterday he walked
about 50 meters with the help of mobility aids, while he could walk just about
20 meters when he came here. His diet and sleep were normal. The prescription
was changed a little. 3 dosages in total.
Date: Feb. 7, 2009 Time: 11: 00 a. m.
Today he could walk about 70 meters with the help of mobility aids. The joint
pains of his left shoulder lessened. There was no jumping of the muscles. His
diet also improved. So he was required to stop taking the western medicine which
was used to relieve muscle spasms. The prescription was as follows: gouqi (lycium
berry), maidong (ophiopogon tuber), shanzhuyu (cornus fruit), etc. 3 dosages in
Date: Feb. 10, 2009 Time: 11: 00 a. m.
His diet and sleep were normal. There was still slight stiffness of his lower
limbs. The former prescription was changed a little.
Date: Feb. 13, 2009 Time: 11: 00 a. m.
His condition was stable. Furthermore, his health condition was improving day by
day. However, there was slight stiffness of the lower limbs as well as the left
fingers. The other condition was normal. So the prescription was changed as
follows: guizhi (cinnamom twig), danggui (tangkuei), etc. 4 dosages in total.
Date: Feb. 17, 2009 Time: 11: 00 a. m.
His condition was comparatively stable. The stiffness of his lower limbs further
improved. He kept in good mood and spirit. He decided to leave for Beijing on
Feb. 20 in order to negotiate with embassy of Bahrain to persuade his government
to provide another 2 months treatment cost in our hospital. Then he would come
back to our hospital for further treatment to consolidate the effect.
A Letter Written By Dr. Ming:
Officer of Bahrain Government Concerned,
is Dr. Zhu Ming from Huaihua Red Cross Hospital, China. I am the Chinese
medicine doctor to help your countryman Dr. Osama Al Dallal who suffered from
ALS. This condition is within the category of the top six difficult health
When he arrived here twenty days ago, his symptoms are 1. Muscle jumping all day
long over the body. 2. weak hands gripping power 4 kilos and 7 kilos.3. Joint
pains over the body. 4. Stiffness of the two legs. 5 high blood pressure. 5
could only walk for 20 meters with the aid of the walker.
offered Chinese medicine herbal tea, massage and acupuncture for Dr. Osama.
After twenty days treatment here, we are very happy to see very good improvement
for his symptoms. 1. Muscles jumping over the body disappear totally. 2. The
gripping power of his right hand increased 4 kilos, and that of his left hand
increased 3 kilos. 3. Joint pains 90% gone.4. Two legs are much softer. 5. Blood
pressure comes to normal range without taking western medicine for blood
pressure control. 6. Could walk 70 meters with the aid of the walker now.
it is strongly suggested that Dr. Osama to stay here for the continuous another
two months treatment instead of only staying here for one month. Very hopefully,
he will be able to walk back without using walker after general three months
treatment here. So please be kind to offer support and concern for this patient.
Letting him stay here for general three months please. Thank you very much.
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