Common in young and
middle-aged women and usually affecting the upper limbs but
less involving the lower one, this disease is due to over
excitement or cold stimulus an manifested as symmetrical and
paroxysmal sudden pallor of the finger or toe followed by
light purple, hectic and sensation of pain and numbness.
Etiology and
Pathogenesis
failure of the
tendons to be nourished by blood due to insufficiency of the
liver-Yin resulting from stagnation of the liver qi results
in numbness and spas of the limbs. deficiency of qi and
blood due to stagnation of qi and shortage of blood leads to
pale fingers. Absence of enough heat due to Yang-deficiency
of the spleen and kidney is responsible for very cold hands
and feet. Accumulation of cold, Yin pathogen, in the
channels causes grayish purple extremities of he limbs.
Blood stasis is due to stagnation of qi, obstruction is due
to blood stasis, and pain is due to obstruction. Inability
of the tendons and vessels to be nourished due to stagnation
of qi and blood brings about withered skin, myophagism and
even ulcer. In short, insufficiency of the liver-Yin,
yang-deficiency of the spleen and kidney and stagnation of
qi and blood are the original causes of this disease, while
exogenous cold, the external pathogenic factor.
Clinical
Manifestations
After sudden anger
or rage, the skin of fingers or toes symmetrically and
paroxysmally becomes pale, greyish purple and finally hectic
and then returns to normal, which is accompanied by cold,
numbness and dysesthesia of the finger which are relieved by
warmth but aggravated by cold, and distending thin smaller
pointed extremity of the limb wit dry skin and myophagism or
superficial small ulcers in severe cases, with the arterial
pulse of the affected limb being normal.
Type and
Treatment
1. Internal
Treatment
(1) Type of
Yin-Cold
Main Symptoms: Cold
extremities whose color is changed symmetrically by cold,
thin white tongue coating, and deep thready pulse.
Therapeutic Method:
warming the channels to disperse cold, promoting blood
circulation t remove obstruction form the vessels.
Prescription:
Danggui Sini Tang (Decoction with Chinese Angelica for
Restoring Yang).
Ingredients:
Danggui Radix
Angelicae Sinensis
Shaoyao radix
Paeoniae
Guizhi Ramulus
Cinnamomi
Xixin Herba Asari
Zhigancao Radix
Glycyrrhizae Preparata
Tongcao Medulla
Tetrapanacis
Dazao Fructus
Jujubae
Administration:
Decocted in water twice for the decoction, which is taken
warm in the morning and evening, 1 dose daily.
Modification: In
case of severe cold, the herbs added are Shufuzi Radix
Aconiti Lateralis Preparata, Paijiang Rhizoma Zingiberis
Preparata. For contracture, the herbs added are Gouteng
Ramulus Uncariae Cum Uncis, Quanxie Scorpio.
(2) Type of
Stagnation:
Main Symptoms:
Symmetrical color change in the extremity of the limb
occurring after mental depression or excitement, which is
accompanied by distension and stabbing pain, ecchymosis on
the tongue, and deep taut uneven pulse.
Therapeutic Method:
Soothing the liver and promoting the flow of the liver-qi,
removing blood stasis from the vessels.
Prescription:
Modified Care-Free Decoction.
Ingredients:
Radix Bupleuri
Baishao radix
Paeoniae Alba
Poria
Baizhu Rhizoma
Atractylodis Macrocephalae
Danggui Radix
Angelicae Sinesis
Bohe Herba Menthae
Zhigancao radix
Glycyrrhizae Preparata
Weijiang Rhizoma
Zingiberis Preparata
Taoren Semen
Persicae
Honghua Flos
Carthami
Jixueteng Caulis
Spatholobi
Guizhi Ramulus
Cinnamomi
Dilong Lumbricus
Tubiechong
Eupolyphaga seu Stelephaga
Administration:
Decocted in water twice for the decoction, which is taken
warm in the morning and evening, 1 dose daily.
(3) Type of
Deficiency of Both Qi and Blood
Main Symptoms: Pale
and num affected limb with abnormal color, superficial ulcer
and pale granulation which grows slowly, light red tongue,
and thready weak pulse.
Therapeutic Method:
Reinforcing qi, nourishing blood, promoting blood
circulation and removing blood stasis in the vessels.
Prescription:
Modified Renshen Yangrong Tang (Ginseng Decoction for
Nourishing Blood).
Ingredients:
Renshen Radix
Ginseng
Baizhu Rhizoma
Atractylodis Macrocephalae
Poria
Baishao Radix
Paeoniae Alba
Chenpi Pericarpium
Citri Reticulatae
Yuanzhi Radix
Polygalae
Rougui Cortex
Cinnamomi
Danggui Radix
Angelicae Sinensis
Shudi Radix
Rehmanniae Preparata
Huangqi Radix
Astragali
Gancao Radix
Glycyrrhizae
Administration:
decocted in water twice for the decoction, which is taken
warm in the morning and evening, 1 dose daily.
Modification: If
the upper limbs are affected, the herb omitted is Rougui
Cortex Cinnamomi; the herb added is Guizhi Ramulus
Cinnamomi.
If the lower limbs
are affected, the herb added is Niuxi Radix Cyathulae.
For insufficiency
of the liver-yin, the herb added are Shanyurou Fructus
Corni, Nuzhenzi Fructus Ligustri Lucidi.
