by Heidi Most, M.Ac., Dipl. Ac. (NCCAOM)
Explore a case study involving a 78 year old patient who received Lyme Disease treatment to address the severe recurring pain episodes he had been experiencing over the course of 16 months as a result of the disease. The disease (first identified in Lyme, Connecticut) is caused by a bacteria that is transmitted from deer to humans via a tick bite. Typical symptoms include fever, headache, fatigue and a bullseye skin rash. In the early stages, Lyme can generally be successfully treated with antibiotics. However, if left untreated, or in some individuals where antibiotics do not seem to be effective, the infection can spread to the joints, the heart, and the nervous system. Once this happens, chronic and debilitating symptoms can set in.
Lyme Disease has become a scourge of the mid-Atlantic, Northeast and North-central United States. According to the Centers for Disease Control and Prevention, 64, 382 cases of Lyme disease were reported during the 2003-2005. In the worst hit states, rates of infection increased in each of these years, from 29.2 cases per 100,000 of population in 2003, to 31.6 cases per 100,000 in 2005. There are now 20,000 new cases reported each year.
According to my understanding of classical Chinese Medicine, as taught by Jeffrey Yuen, the body seeks to prevent pathogens from entering the internal organs by deflecting them to less critical areas of the body. These areas may include the joints and blood, where they are held latent. Latency can last a whole lifetime, or it can end when the body, mind or spirit is stressed. Latency can be observed in many different “Western” disease descriptions. For instance, shingles is caused by a small pox virus, held latent for years until stress causes it to manifest. So it can be with bacteria of Lyme, which if not completely eliminated with antibiotics, may hide in the joints and blood, seemingly impervious to western treatments. This Chinese conception of latency can be very useful in understanding and treating Lyme.
My patient, J, is 78 years old. In June of 2006, he experienced swelling in ankles and knees and a fever of 102 degrees. After clinical inspection and blood testing, his doctor diagnosed Lyme Disease, and put him on 100 mg of doxycycline for 10 days. This seemed to do the trick, but the pain returned in October, and early in 2007 he was put on a 60 day course of antibiotics. The pain receded, but then extreme pain in his right knee and ankle again drove him to seek help. In October 2007, his doctor once again diagnosed Lyme – either from a new bite or an old infection, and prescribed antibiotics. After two weeks on antibiotics, the pain did not recede, so the doctor prescribed prednisone to bring down the inflammation.
After the two weeks of antibiotics use, J came to see me, seeking relief from the pain that had so far eluded him. (I had first successfully treated J with acupuncture 6 years ago, for severe pain from adhesions which was not being controlled with opiate pain killers. After a year’s treatment with acupuncture, J was pain free.) . Now J was experience level 12 pain (on a 1-10 point scale) in his right knee, ankle and foot. Using the traditional Chinese diagnostic tools of Inspection, Listening and Smelling, Palpation and Inquiry, I diagnosed bi syndrome (Painful Obstruction Syndrome) with Kidney and Spleen Qi Deficiency
From a Chinese perspective, J’s wei qi (defensive qi or immune system) had been weakened, allowing a pathogen (bacteria) to enter into the interior of the body. The body, in trying to protect the organs, moved this pathogen to the joints, considered the deepest part of the wei (exterior) level. Moving and holding the pathogen further weakened the fluids of the body, including the blood. In J’s weakened state, the body was not able to hold the pathogen in check, and he was experiencing extreme pain. At the same time, the blood was also being taxed, as shown by the nature of his pain (sharp and stabbing).
I chose to use the Luo meridians to treat the pathogens that were in his blood, and the Divergent Meridians to treat the pathogens lurking in his joints. The Divergent Meridians, because they connect the outermost (wei) level of the body with the innermost (yuan) level, have the capacity to reach deep into the body to take pathogens out of latency and release them, or to put them back into latency if the body is to weak to release them. The course of treatment consists of 3 days of acupuncture, then a 3 day break, repeated 3 times for a full course of 18 days.
The Luo Meridians treat pathogens held in the blood. Treatment involves bleeding, by pricking the Luo point on the affected meridian to get a drop of blood, and then protecting the meridian by treating the Source point, so the pathogen cannot go deeper in to the body. Treatment is traditionally done every other day for 28 days.
I combined these two treatments, seeing J a total of 11 days in one month. (I charge only one fee per week, as I strongly believe that treatment must be intensive, and most people would be deterred by having to make 9 – 14 payments in one month.) As treatment progressed, J continued to take antibiotics and prednisone, as prescribed by his doctor. His doctor was also fully supportive of him trying acupuncture. By day 18, the pain was gone, with only stiffness remaining. His doctor took him off the antibiotics but kept him on the prednisone for another 5 days. Where Western medicine might leave off, I will continue to work with Jim to strengthen his constitution and his body’s ability to fight off pathogens.
As we age, our yin substances (blood, body fluids) decline, and our bodies are less capable of holding latent the pathogens that have entered over the years. In addition, according to Chinese thinking, blood holds our experiences. Over time, these experiences also can enter deeper into the body, creating disease within us. This is the reason that aging can bring a host of problems. In understanding these mechanisms, Chinese medicine is in a unique position to help resolve the problems that result.
When people are in extreme pain, they will seek any type of treatment that is available, often combining therapies in a desperate attempt to ease their suffering. It is impossible to tease out which treatments eliminated J’s pain: after weeks of treatment with antibiotics, perhaps they finally became effective, or perhaps the prednisone reduced the inflammation significantly enough to reduce the pain. Or perhaps the acupuncture was able to open the energy pathways enough to allow the pain to recede and the medicine to do its job.
The end result is three happy people: J is without pain for the first time in months, and he says he feels both the drugs and the acupuncture were useful. J’s doctor and I are satisfied that our therapies contributed to his recovery. Here is a wonderful example of Chinese and Western medicine working synergistically to create wellness.
 U.S. Centers for Disease Control website, October 27, 2007: http:www.cdc.gov/mmwr/preview/mmwrhtml/mm5623a1.htm?s_cid=mm5623a1_e
 Jeffrey Yuen is an noted educator of Chinese medicine, a Daoist priest of two lineages. serving as the Dean for Academic Affairs for Swedish Institute’s School of Acupuncture and Oriental Studies (NYC) and New England School of Acupuncture (MA). His teachings have served as the basis of a state-approved Doctoral program offered by the American University of Complementary Mecicine in Los Angeles.