Neue Artznei und Practicierbuchlin, Bock, 1551

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Chronic Arthritic and Joint diseases are some of the most troublesome diseases to treat. For this reason, in all systems, some of the strongest medicines of the Materia Medica have been employed in the treatment of Joint disease. And the same can be seen in modern medicine.

Major types of Joint Disease:

• Arthritis–joint inflammation
• Osteoarthritis–degeneration of cartilage and bone
• Rheumatoid Arthritis–inflammatory joint disease of the extremities resulting in deformation
• Spondylitis–inflammation of the joints of the spine
• Gout–inflammatory arthritis caused by high uric acid, primarily affecting small bones of the feet

Principle of Treatment

Joint disease is generally caused by Wind and Damp. Damp is associated with improper digestion, and this is seen by the Ayurvedic name for Rheumatism, ‘Ama-Vata‘ (‘Ama‘ meaning the toxic residue of undigested food–Damp; and Vata meaning ‘Wind’) which is basically the same as the Chinese Feng-Shi (Wind-Damp). Therefore, digestion must be regulated, Damp foods avoided, and a light, warming, easy-to-digest diet should be employed.

Some cases of Joint diseases are associated with Heat. In acute cases and in those with Heat constitutions this may be simple Heat (Inflammation) or Heat and Toxin (in which case the Sarsaparilla and Guaiacum formulas can be used). In chronic cases with Heat, it is generally considered to be a Wind-Damp-Heat condition.

In chronic cases with deficiency and in the elderly, deficiency is generally seen. In such cases, medicine which strengthen the Kidney, Liver, Bones, Joints and Sinews are employed in conjunction with arthritic medicines.

Treatment

In the treatment of Arthritic disease, Honey Water (Hydromel), Barley Water and Rosemary Wine are all very useful and may be used daily for months along with other treatment.

In TCM, Du Huo Ji Sheng Tang is a commonly used formula for chronic joint disease. It strengthens the bones and joints, nourishes the Liver and Kidneys while clearing Wind and Damp. It is suitable for long-term use.

Some of the strongest medicines used in the west contain Colchicum of which there are a number of formulas written by Mesue and Nicholas in particular. In the Eastern systems, Aconite and Nux Vomica are used in some of the stronger formulas, some of which are commonly used as patent medicines for Rheumatism in China.

Other Treatment

Bloodletting is indicated in those with dark colored skin and visible veins. Bleeding the veins behind the Knees or in the Ankles is very useful for lower back, hip and leg pain. Bloodletting with Cupping directly over pain in the Lower Back or Hips can often relieve pain.

“In the Sciatica from blood, open a vein in the arm to revel; Hippocrates openeth them behind the Ears; and the Arabians opened the Veins by the little Finger. This done, open the Vein in the Ham or Ankle within, to derive, or without, if it appear most, which is called the Sciatica-vein, for its great benefit: This alone cures sometimes”. (Platerus)

Sweating is generally useful as it clears Dampness through the skin. “Baths of Sulphur, Salt, or Niter, both sweat and strengthen”. And further, “They say Sextus Pompeius was cured with Sweating in a Heap of warm Wheat.” (Platerus)

“In Arthritic diseases, Emetics and Enemas often work better than purging medicines.” (Platerus)

Vomiting once or twice a month is beneficial, and is best done after eating a fatty meal (to make it easier). And in Sciatica, it is good to vomit for 2 or 3 days consecutively. To vomit, a decoction of Radish seed in Chicken broth with Olive oil or Oxymel added is effective.

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See also :

Back Pain, Lumbago
Rheumatoid Arthritis
Scoliosis & Kyphosis
D. Clear Wind and Damp
3M. Arthritics

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Specific Medicines:

For all Joint Pains, Honey Water was regarded as the best drink
Bezoardic Powder of Viper
Honey Water (Hydromel)
Wine for Arthritis
Elixir Salutis, Elixir of Health
Compound Guaiacum Confection (Chelsea Pensioner)
Pills for Joint Disease
Pills of Colchicum (Mesue) (Habb E Suranjun)
Pills of Colchicum Greater (Habb E Suranjun Kalan)
Electuary for Arthritis
Electuary for the Joints (Unani)
Du Huo Ji Sheng Tang
Pills of Castor and Bdellium (Vatari Guggulu) (Ayurveda)
Pomegranate All Inclusive Pill (Se ‘bru kun ‘dus) (Tibetan)
Nimbadi Chruna (Neem Powder) (Ayurveda)
Punarnavadi Guggulu (Boerhaavia and Bdellium Pills)
Yogaraja Guggulu
Safflower Garuda (Gur khyung phyag rdor)

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Differential Diagnosis

1. Heat / Bile / Wind-Heat-Damp / Inflammatory

Red, swollen joints, painful when moved, high colored urine with a big pulse. Pain is burning, worse when moving.

1. Celery and Barley Soup
2. Gentian, Centuary, St. Johns wort
3. Germander, Ground Pine, Gentian, Rue
4. Gentian, Ground Pine, Germander, Lesser Centaury (equal parts)

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2. Wind / Wind-Damp / Moving

Dry skin and joints; joints crack and feel cold; pain is moving or fluctuates, is tearing.
Wind is more moving in nature, Damp is Stagnant and Yin deficiency is more associated with degeneration of the Joints.

1. Dwarf Elder, Ground Pine, Cinnamon, decocted in wine
2. Dwarf Elder, Ground Pine, Celery seed, Rhubarb
3. Chebula, Frankincense, Clove, Celery seed
4. Gentian with St Johns wort, Centaury, Ground Pine, Agaric, Germander
5. Saposhnikovia Fang Feng with Eucommia Du Zhong, Dipsacus Xu Duan

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3. Phlegm / Damp / Damp-Wind / Stagnation

Joints are puffy and swollen; stiff and sore when still but better after moving; pain is dull and heavy. Typical in Arthritis in the obese or those with fluid retention.

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4. Blood Stasis

Chronic Joint pain, sometimes just one joint which can be traced back to a previous trauma. Fixed pain, dull or dark colored joints, or dry, dusky skin over the joint. Tongue and nail beds may be purplish, pulse is choppy. Complexion is usually dull.

1. Frankincense with Bdellium, Myrrh, Tumeric
2. Bdellium (Guggulu) with Frankincense, Withania, Turmeric (Ayurveda)
3. Frankincense with Triphala, Tinospora, Costus, Shilajit
4. Cinnamon twig Gui Zhi with Myrrh (Mo Yao), Frankincense (Ru Xiang), Achyranthes Niu Xi, Eucommia Du Zhong, Saposhnikovia Fang Feng, Licorice
5. Drynaria Gu Sui Bu with Cibotium Gou Ji, Dipsacus Xu Duan, Costus (Mu Xiang), Olibanum (Ru Xiang), Myrrh (Mo Yao)
6. Dang Gui, Notoginseng San Qi, Achyranthes Niu Xi, Eucommia Du Zhong, Safflower (Hong Hua)

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5. Deficiency

Chronic Arthritic diseases, especially in the aged, are invariably related to deficiency. There will be weakness and aching of the lower back and knees, lethargy with low pulse. This may be associated with degenerative arthritis, Arthritis with marked weakness or numbness.

1. Elecampane, Date, Guaiacum
2. Frankincense with Triphala, Tinospora, Costus, Shilajit
3. Drynaria Gu Sui Bu with Rehmannia Shu Di Huang, Cistanches Rou Cong Rong, Achyranthes Niu Xi, Epimedium Yin Yang Huo

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Useful Medicines

Medicines that Open the Capillaries

For Tightness of the Sinews

Strengthen the Sinews and Bones

Move the Blood

Clear Uric Acid

Hot and inflammatory types of Arthritis, especially Gout affecting the joints of the feet, are typically associated with high uric acid levels which can be confirmed with urine tests. These herbs lower Uric acid.

1. Barberry (2 parts), Yarrow, Mint, Balm, Agrimony, Nettle (1 part each)

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Special Formula:

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Sciatica

POWDER FOR SCIATICA
Betony
  Centaury   2 parts ea.
  Dittany
  Rue   1 part ea.
Powder and take 1 dram with white wine before bed

SPECIAL FOR SCIATICA:
Pills Aloesphangine
Pills of Colchicum Greater
Pills of Colchicum Lesser. 1 scruple ea.
Rock Salt 3 grains
Dissolve them in Rose jucie and make 5 Pills.
When the pain is acute and extreme, take 5 pills every 4 days first thing in the morning. When the pain eases, take them every 5 days, then every 6th, then every 7th until it is cured. Avoid wine, salted foods, all beans and pulses, onions and garlic while taking. These pills were said to have a “Marvellous Operation” against Sciatica. (The Secrets of Alexis, 1595)

PILLS FOR SCIATICA
Ground Pine 6 drams
Gum Ammoniac
Opopanax 1 dram ea.
Myrrh ½ dram
Castoreum 1 scruple
Euphorbium ½ scruple
Make pills with Turpentine.

ELECTUARY FOR SCIATICA
Ground Pine
Germander
Ivy ½ oz.
Rue
Sage
Mugwort
Savin
Betony
Thyme 1 dram ea.
St. Johns wort seed 3 drams.
Wile Rue
Southernwood seed 1 dram ea.
Madder
Monk’s Rhubarb 5 drams ea.
Pepper
Cardamon ½ dram ea.
Powder and make an Electuary with 1 pound of Honey. Dose: 1 dram

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Research:

GENERAL / REVIEW:
–Phytomedicine in Joint Disorders
–Herbal therapy for treating rheumatoid arthritis.
–Herbal therapy for treating osteoarthritis.
–Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of national health insurance dataset
–Evidence of effectiveness of herbal medicinal products in the treatment of arthritis. Part I: Osteoarthritis.
–Evidence of effectiveness of herbal medicinal products in the treatment of arthritis. Part 2: Rheumatoid arthritis.
–Complementary medicine in rheumatoid arthritis
–Clinical efficacy of certain Unani herbs in knee osteoarthritis: A pretest and post-test evaluation study
BOSWELLIA:
–Boswellic acids in chronic inflammatory diseases.
TURMERIC / CURCUMIN
–Curcumin and autoimmune disease.
–Therapeutic Potential and Recent Advances of Curcumin in the Treatment of Aging-Associated Diseases.
CANNABIS:
–Efficacy, Tolerability, and Safety of Cannabinoid Treatments in the Rheumatic Diseases: A Systematic Review of Randomized Controlled Trials.
–Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): A systematic review of randomized controlled trials.
TRIPTERYGIUM WILFORDII
–Tripterygium wilfordii Hook F versus conventional synthetic disease-modifying anti-rheumatic drugs as monotherapy for rheumatoid arthritis: a systematic review and network meta-analysis.
–Extracts of Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Systemic Review and Meta-Analysis of Randomised Controlled Trials.
OTHER HERBS:
–Pharmacological and clinical effectiveness of a fixed phytogenic combination trembling poplar (Populus tremula), true goldenrod (Solidago virgaurea) and ash (Fraxinus excelsior) in mild to moderate rheumatic complaints].
–[Research progress on Drynaria fortunei naringin on inflammation and bone activity].
–Therapeutic application of anti-arthritis, pain-releasing, and anti-cancer effects of bee venom and its constituent compounds.
–[Research progress on pharmacological action and clinical application of Stephania Tetrandrae Radix].
CHINESE FORMULAS:
–Evidence of Chinese herbal medicine Duhuo Jisheng decoction for knee osteoarthritis: a systematic review of randomised clinical trials.
–Efficacy and Safety of GuiZhi-ShaoYao-ZhiMu Decoction for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
OTHER THERAPIES:
–Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review.
–Tai chi for treating rheumatoid arthritis.
–Management of knee osteoarthritis with cupping therapy