THE TREATMENT OF RHEUMATOID ARTHRITIS WITH ACUPUNCTURE

Michael L. Buffington, M.D.

ABSTRACT -- This case report describes a 33 year old white male with rheumatoid arthritis (RA), who was satisfactorily treated using a Tai Yin triangular equilibration according to the technique of Mussat. Moreover, a classic "arthritis" acupuncture treatment of RA may result in exacerbation of symptoms, rather than remission.

     This patient is a 33 year old white male who was first seen in the clinic in October, 1988, complaining of diffuse joint pains with swelling of the hands and pain in the knees, elbows, wrists, and ankles. RA factor was positive 1:320. ANA titer was negative. Historical evaluation revealed that the patient had a positive tropism for sweets. There was also a family history of diabetes mellitus. The patient's morphology was that of a tendency towards obesity. His tongue was slightly pale and swollen, compatible with the morphology of a "spleen tongue" (1). Patient's hand morphology, according to Requena's system (2), was that of an "earth hand".
     The patient was started on a series of acupuncture treatments consisting of a triangular equilibration of Tai Yin. The points used were LU7, LI4, ST36, BL11, BL23, and BL60, with a triple heater needle at CV12. Needles were inserted and left in place for 20 minutes without stimulation. According to Dr. Mussat's (3) formula for triangular equilibration, one starts at the position which is primarily involved, in this case the Tai Yin. The sequence of the selected points is established by following the pathway of the internal movement indicated in Figure 1. The other two points of the triangle are selected from the adjacent levels to the contrary of the level involved, in this case, Yang Ming and Absolute Yang (GV), in that order. However, in clinical practice, it is permissible to use the TaiYang points(Bladder meridian) on the spine when treating the Governor Vessel. If one wishes to use a strictly Governor Vessel treatment, one could have piqured points GV4 (which is the large point on the GovernorVessel), GV9 (which is a common point on the Governor Vessel that echoes problems of the Tai Yin circuit), and GV20 (which is a major point at the top of the Governor Vessel meridian).
     Over the course of five to six treatments, all joints involved responded equally to treatment, manifested as a 90% decrease in pain and stiffness. At the present time, the patient is stabilized with monthly treatments. Patient's sedimentation rate was normal at the start of therapy,and has remained so throughout.

DISCUSSION
     RA is a systemic inflammatory disorder characterized primarily by a pattern of involvement of synovial joints, often extending into soft tissues such as tendons, ligaments, and muscles, and even into bone. The most common points of involvement are the small joints of the hands, wrists, knees and feet. HLA-DR4 positivity by B-cell typing is found in approximately 80% of patients with RA (4).
      The customary treatments are aspirin therapy, non-steroidal anti-inflammatory drugs, myochrysine, and penicillamine. Especially severe cases of RA are often treated with immuno-suppressive agents such azathioprine, cyclophosphamide, chlorambucil, and methotrexate (4). None of these treatments, however, is without side effects.
     RA has been associated with the dysfunction of the HLA system controlled by chromosome 6. According to Mussat's (5) chromosomal schematics on Figure 1, chromosome 6 is a Tai Yin function. Therefore, the patient was treated with a Tai Yin equilibration. The graph in Figure 1 is a mathematical representation of the interaction of the various energy states in living systems. The logic of the graph dictates that these states are in constant transition from energy to matter, much like the behavior of an electron when it changes from wave to particle form. The value states of the graph are represented by trigrams or their binary coding, for example, in the case of Tai Yin, 001 or (figure). Mussat postulates that chromosomes follow a similar hierarchy based on their size.
     To have treated this patient with a "classic" arthritis treatment, one might have chosen the Tai Yang terrain. One can see from Figure 1, that Tai Yin and Tai Yang have opposing actions. One should therefore be cautious in treating RA patients at the Tai Yang level. Clinical experience with RA patients has shown that the stimulation of the Tai Yang meridian, may result in exacerbation of RA symptoms.

REFERENCES
1. O'Conner, J. & Bensky, D. Acupuncture - A Comprehensive Text, Eastland Press, chicago. 1983; 23

2. Requena, Y. Morphotypological Hand Diagnosis in Acupuncture, Editions Solal. 1986

3. Mussat, M. Seminars, UCLA Estension, Medical Acupuncture for Physicians, Introductory course. Manata Monica, California, 1985-1989

4. Wyngaarten, J.B. & Smith, L.H. Cecil Textbook of Medicine, W.B. Saunders Co., Philadelphia. 1985: 1911-17.

5. Mussat, M. Energeticque des systems vivants (Energetics of living systems). Medicine et Sciences Internationales, Paris. 1982

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