Eastern-Western Diagnosis & TCM Treatment for NPD Type A Lucy G. Hu O.M.D, LAc. (M.D. in China) Five Branches Institute College of Traditional Chinese Medicine Santa Cruz, California, USA Sophia’s Garden Foundation Scientific Advisory Board Palo Alto, California, USA

TCM History in USA President Nixon’s visit to China in 1972 California became 1 st state to legalize Acupuncture in late 1980’s Dr. Hu practiced TCM Pediatrics for over 35 years in both China and U.S.

President Nixon’s visit to China in 1972

California became 1 st state to legalize Acupuncture in late 1980’s

Dr. Hu practiced TCM Pediatrics for over 35 years in both China and U.S.

Case Study of NPD Type A Patient age: 7 1/2 months, Female Race: Ashkenazi Jews Major complaint: Vomiting, diarrhea Crying, sleep difficulties Chronic respiratory and ear infections

Patient age:

7 1/2 months, Female

Race:

Ashkenazi Jews

Major complaint:

Vomiting, diarrhea

Crying, sleep difficulties

Chronic respiratory and ear infections

Case Study of NPD Type A Symptoms Jaundice Large swollen liver and spleen Malnutrition Clinical Examinations at Western Hospitals Lucile Packard Children’s Hospital at Stanford (LPCH) Palo Alto Medical Foundation (PAMF)

Symptoms

Jaundice

Large swollen liver and spleen

Malnutrition

Clinical Examinations at Western Hospitals

Lucile Packard Children’s Hospital at Stanford (LPCH)

Palo Alto Medical Foundation (PAMF)

Case Study of NPD Type A NPD Type A background: Most serious of >40 types of lysosomal storage disease Occurs in Ashkenazi Jews at rate of 1 in 30,000 Not a single case within 20 years at LPCH 40 cases in 20 years at Mount Sinai School of Medicine None of the children survived; Most live only upto 2 or 3 years NPD Type A: Albert Niemann (Germany) in 1914 NPD Type B: Ludwig Pick (Germany) in 1927

NPD Type A background:

Most serious of >40 types of lysosomal storage disease

Occurs in Ashkenazi Jews at rate of 1 in 30,000

Not a single case within 20 years at LPCH

40 cases in 20 years at Mount Sinai School of Medicine

None of the children survived; Most live only upto 2 or 3 years

NPD Type A: Albert Niemann (Germany) in 1914

NPD Type B: Ludwig Pick (Germany) in 1927

Case Study of NPD Type A Type A has 13 clinical symptoms: A chronic jaundice since birth Abdominal distention Progressive akinesia Difficulty in feeding and swallowing Difficulty in the vertical movement of eyes Hepatosplenomegaly and hepatocirrhosis Developmental delay Sudden loss of muscular tension

Type A has 13 clinical symptoms:

A chronic jaundice since birth

Abdominal distention

Progressive akinesia

Difficulty in feeding and swallowing

Difficulty in the vertical movement of eyes

Hepatosplenomegaly and hepatocirrhosis

Developmental delay

Sudden loss of muscular tension

Case Study of NPD Type A Type A has 13 clinical symptoms (cont.): Epilepsy Highly sensitive to touch Inflammation in the respiratory system and ears, in complication with pneumonia Breathing only through mouth due to the constant blockage of nose Normal growth of teeth and bones

Type A has 13 clinical symptoms (cont.):

Epilepsy

Highly sensitive to touch

Inflammation in the respiratory system and ears, in complication with pneumonia

Breathing only through mouth due to the constant blockage of nose

Normal growth of teeth and bones

Case Study of NPD Type A Patient’s test results: Both parents carry the genes for NPD Type A

Patient’s test results:

Both parents carry the genes for NPD Type A

Case Study of NPD Type A TCM Bian Zheng Lun Zhi— Clinical Symptoms & Signs (1 st Step) - Vomiting Stomach Qi ascending counterflow - Diarrhea, fatigue Spleen Qi deficiency Large swollen liver Akinesia Abnormal vertical eye movement Liver Qi stasis - Jaundice Liver-gallbladder damp-heat Symptoms & Signs Bian Zheng Lun Zhi

Large swollen liver

Akinesia

Abnormal vertical eye movement

Case Study of NPD Type A TCM Treatment (1 st step): Modified Yin Chen Hao Formula Acupuncture Progress of Patient condition after: 4 days: 95% Jaundice eliminated 2 weeks: sleeping improved; watery stool softened 3 weeks: 90% vomiting reduced 1 month: vomiting completely disappeared

TCM Treatment (1 st step):

Modified Yin Chen Hao Formula

Acupuncture

Progress of Patient condition after:

4 days: 95% Jaundice eliminated

2 weeks: sleeping improved; watery stool softened

3 weeks: 90% vomiting reduced

1 month: vomiting completely disappeared

Case Study of NPD Type A Patient’s Western diagnosis confirmed NPD Type A Blood tests showed storage of fat, cholesterol, and other metabolites, caused cell death Adjustments to TCM Treatment (2nd step):

Patient’s Western diagnosis confirmed NPD Type A

Blood tests showed storage of fat, cholesterol, and other metabolites, caused cell death

Case Study of NPD Type A TCM Bian Zheng Lun Zhi Clinical Symptoms & Signs (2nd Step) - Seizures Liver internal wind - High level of liver enzymes (SGOT, SGPT ) High levels of cholesterol and glucose Mega liver & spleen Liver Qi & blood stasis - Loose stool, irritability, crying, red tongue, abdomen extention Damp-heat brewing internally Symptoms & Signs Bian Zheng Lun Zhi

- High level of liver enzymes (SGOT, SGPT )

High levels of cholesterol and glucose

Mega liver & spleen

Case Study of NPD Type A After 3 months: Appetite improved Sleep increased Body weight increased After 4 months: Self-feed, 70% solid foods Stool more formed After 5 months: Energy level, mental concentration, appetite increased Vocalize sounds and able to sit up by herself Loss of neurological functions slower than other cases

After 3 months:

Appetite improved

Sleep increased

Body weight increased

After 4 months:

Self-feed, 70% solid foods

Stool more formed

After 5 months:

Energy level, mental concentration, appetite increased

Vocalize sounds and able to sit up by herself

Loss of neurological functions slower than other cases

Case Study of NPD Type A During this time, parents also seek other treatment methods to treat the child: Holistic nutrition Feldenkrais Cranial sacral therapy Chiropractic care Homeopathy Aquatic and music therapy Antibiotic drugs from latest genetic research Western herbs Prayer

During this time, parents also seek other treatment methods to treat the child:

Holistic nutrition

Feldenkrais

Cranial sacral therapy

Chiropractic care

Homeopathy

Aquatic and music therapy

Antibiotic drugs from latest genetic research

Western herbs

Prayer

Case Study of NPD Type A 3 Severe infections Spring & Fall 2002, Jan 2003 All were infections of respiratory system All were controlled by Chinese herbal formula and acupuncture

3 Severe infections

Spring & Fall 2002, Jan 2003

All were infections of respiratory system

All were controlled by Chinese herbal formula and acupuncture

Case Study of NPD Type A At 19 months old: Lost neuromuscular ability to clear her own saliva and swallow food Liver and spleen continued to enlarge First hospital stay; projected 1-4 week life expectancy Condition stablized by Dong Fang Gan Kang, Chinese patented medicine Dong Chong Xia Cao (Cordyceps Sinensis) Seizures started and controlled by Tien Ma

At 19 months old:

Lost neuromuscular ability to clear her own saliva and swallow food

Liver and spleen continued to enlarge

First hospital stay; projected 1-4 week life expectancy

Condition stablized by Dong Fang Gan Kang, Chinese patented medicine

Dong Chong Xia Cao (Cordyceps Sinensis)

Seizures started and controlled by Tien Ma

Case Study of NPD Type A At 34 months old: Weekly application of herbs, acupuncture, and tuina (massage) Liquefied fresh organic foods via enteral feeding system No respiratory infections for 15 months; stronger immune system Liver and spleen reduced in size Cholesterol, triglycerides, and other key biochemical indicators gradually moving into normal ranges Grown 8 teeth and healthy head of hair Mentally partially acute

At 34 months old:

Weekly application of herbs, acupuncture, and tuina (massage)

Liquefied fresh organic foods via enteral feeding system

No respiratory infections for 15 months; stronger immune system

Liver and spleen reduced in size

Cholesterol, triglycerides, and other key biochemical indicators gradually moving into normal ranges

Grown 8 teeth and healthy head of hair

Mentally partially acute

Case Study of NPD Type A At 34 months old (cont.): Reduced seizures, choking, hypersensivity to pain, sound and light Gained weight Increased sleep to 7-9 hours/night Continued TCM Treatment Principles Soothing liver Dispelling obstruction Fortifying spleen Calming spirit Strengthening immune system

At 34 months old (cont.):

Reduced seizures, choking, hypersensivity to pain, sound and light

Gained weight

Increased sleep to 7-9 hours/night

Continued TCM Treatment Principles

Soothing liver

Dispelling obstruction

Fortifying spleen

Calming spirit

Strengthening immune system

Case Study of NPD Type A Discussion: Based on Chinese Medicine Theory, physiologically and pathologically, the Liver plays important role in 3 areas: Emotional activities Digestion and Absorption Flow of Qi and Blood Liver cannot ensure smooth flow of Qi, causing “Wood” (Liver) to restrain “Earth” (Spleen) Liver stores blood; liver-blood deficiency leads to blurred vision, muscle spasm, tendon problems, motor impairment

Discussion:

Based on Chinese Medicine Theory, physiologically and pathologically, the Liver plays important role in 3 areas:

Emotional activities

Digestion and Absorption

Flow of Qi and Blood

Liver cannot ensure smooth flow of Qi, causing “Wood” (Liver) to restrain “Earth” (Spleen)

Liver stores blood; liver-blood deficiency leads to blurred vision, muscle spasm, tendon problems, motor impairment

Case Study of NPD Type A Discussion (cont.): Liver dominates tendons Liver-blood deficiency causes tendons lack nourishment Eye is window of liver. Liver-blood deficiency causes abnormal eye movement

Discussion (cont.):

Liver dominates tendons

Liver-blood deficiency causes tendons lack nourishment

Eye is window of liver. Liver-blood deficiency causes abnormal eye movement

Case Study of NPD Type A Traditional Chinese Medicine “New Age Medicine”—Thousands of years old Jin—Essence Qi—Energy Shen—Spirit

Traditional Chinese Medicine

“New Age Medicine”—Thousands of years old