How I Treat Wei and Bi Syndrome with TCVM

How I Treat Wei and Bi Syndrome with TCVM

By Bruce Ferguson, DVM, CVA, CVCH, CVFT

Author: Chi Institute/Monday, November 1, 2010/Categories: TCVM Articles, TCVM Newsletter, 2010 Winter Issue

TCVM is such an effective medical system because it is both integrative and individuated. By integrative I mean that we commonly combine acupuncture, herbal medicine, tui-na, and food therapies into a treatment regimen. Individuation implies that we seek the actual energetic disharmony in our patients before choosing treatment strategies rather than merely treating a broad disease “name” in all patients with the same strategies without considering their unique status1. Wei and Bi Syndrome are probably the two most common disharmonies seen by practitioners of TCVM. I find that Bi Syndrome is easiest to treat so I will begin with my strategies for this group of patterns. Bi refers to stiffness and blockage of circulation. Bi Syndrome may involve pain in muscles, tendons, bones, and joints. Bi may also include difficult movement or deformation of these structures. Western Biomedical Diseases that are commonly subsumed under the rubric of Bi Syndrome may include arthritis, degenerative joint disease, intervertebral disk disease, and ligament and tendon injuries2. Diagnostic criteria to individuate the most common Bi Syndromes in patients may be seen in Table 1.

I use acupuncture to treat Bi with great success integrating aspects of Dr. Tan’s Balance Method3, Channel Clearing Technique, Governing Vessel Focus4, and Trigger Point therapy. Dr. Tan’s Balance Method has at least five subsystems that treat a few, select acupuncture points far from the primary lesion and gets rapid clinical results. The first and most commonly used subsystem for clearing blockages, in limbs for example, is treating the same Chinese-name channel on diagonally opposite areas which “mirror” one another. Thus a cat with elbow  Fixed Bi that has pain focused at right LI 11 (forelimb Yang Ming) is treated by needling left ST 35 (hindlimb Yang Ming), because the stifle “mirrors” the elbow. Or a dog with carpal flexion inhibition and DJD with focal pain at left TH 4 (forelimb Shao Yang) may be treated by needling right GB 40 (hindlimb Shao Yang), since the tarsus “mirrors” the carpus.

Channel-clearing techniques focus on using distal, mostly metacarpal/metatarsal and phalangeal points. Thus Painful Bi in the right scapula and lateral cervical region (forelimb Tai Yang or Small Intestine Channel) may be treated rapidly and successfully by needling right SI 3. Further, I use the Governing Vessel extensively in both Bi and Wei treatment, needling numerous points each time. A patient with extensive bridging spondylosis and Fixed Bi in the vertebral column may be needled at GV 3, GV 4, GV 5, GV 6, GV 7, GV 8, GV 10, GV 12, and GV 13 as part of a treatment protocol. Finally, firm tissue knots that are not released and softened by the prior treatments may need to be treated directly with dry needle or aquapuncture.

Useful herbal formulae and examples of foods to treat Bi Syndrome may be seen in the previous table. Correct food for the individual patient is critical and I convince most of my clients to modify their companion animal’s diet based upon TCVM principles. Herbal medicine is an advanced and amazing aspect of TCVM, and a complete practitioner of TCVM without herbs would be like a conventional DVM without therapeutic drugs. However, I have had some patients who refused the herbs that were still managed well with acupuncture, food therapy, and tui-na. Tui-na is a bodywork system applied by the practitioner, nurse, or client. I teach most of my clients simple tui-na techniques which they are happy to apply to their beloved friends.

Wei Syndrome refers to clinical signs which may include flaccid muscles, weak tendons and ligaments, numbness, and/or limb atrophy with diminished motor function. Western biomedical diseases that may present as Wei Syndrome include nerve avulsion, fibrocartilagenous embolism, degenerative myelopathies, IVDD, brain infarcts, GME, sequelae to chronic disease, and ageing2. 

The following table delineates diagnostic criteria for the most common Wei Syndromes. Deficiency patterns like most Wei Syndromes typically take more time to resolve than the Bi Syndromes which are mostly Excess patterns. The positive changes between sessions are also less dramatic, which may discourage some clients from continuing a course of treatment. As with Bi Syndrome treatment, I integrate the four primary TCVM treatment modalities to treat Wei Syndrome as seen in table 2.  With acupuncture, I have success integrating aspects of Dr. Tan’s Balance Method, Source Point Tonifying5, Extraordinary Vessels5, Governing Vessel Focus, Electroacupuncture, and Tui Na6. Electroacupuncture is particularly important as it tonifies Qi and Blood (e.g. releases nerve growth factors) to reverse atrophy7. 

Source points on both the Yang (e.g. LI 4, GB 40) and Yin (e.g. LIV 3, LU 9) channels may be acupunctured to access Yuan or Source Qi in Wei Syndrome deficiency patterns. Further, Shu-stream points such as SP 3 and LU 9 may be used to treat disharmonies of the muscles and flesh5. Extraordinary vessels are reservoirs for Qi and Blood and I tend to use GB 41 (Dai Mai) coupled with TH 3 (small quadruped variation of TH 5) to treat the Dai Mai or Girdle Vessel. Since the Dai Mai “wraps” other longitudinal acupuncture channels, Dai Mai disharmonies may lead to weakness distal to the thoracolumbar junction. 

Some herbal formulas such as Si Miao San are used to drain pathogenic Damp and Heat from the body and should be discontinued when the pathogenic influence is gone. Herbal formulas used as tonics may be given for extended periods of time, sometimes for the remainder of the patient’s life. Food therapy is of primary importance in treating Wei Syndrome; foods are the ultimate daily tonics for deficiency. It is also common for species- or constitution-inappropriate diets to be at least partially causative in Wei Syndrome. 
Tui-na is also very important to treat Wei Syndrome; indeed it seems to be one of the most important treatment modalities in some of my cases. In TCM terminology, Tui-na can regulate meridians, soothe joints and sinews, promote circulation of Qi and Blood, and balance Zang- Fu organs. “Regulate meridians” means that these manual therapy techniques can regulate the functions of meridians or channels which include: transporting Qi and Blood throughout the body, protecting the body, and transmitting Qi to diseased areas. “Soothe joints and sinews” means that Tui-na can soften the local tissues, reduce pain in and possibly lead to realignment/restructuring of dense connective tissue. Increased Qi and Blood circulation leads to a reduction of pain and increase in nutritional factors to tissues. Balancing the function of the primary organs of the body, the Zang-Fu, refers to increasing individual organ function when they are sub-optimal and normalizing the interactions between these organs.

Wei and Bi Syndromes subsume a large proportion of patient disharmonies commonly seen in veterinary practice. With proper Pattern Differentiation and integrative use of acupuncture, herbal medicine, food therapy, and tui-na, we can relieve suffering and prolong life. What can be more rewarding than this?

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