September 8, 2013
This mornings Philadelphia Inquirer’s Health Section presents a “Medical Mystery” case history of a child who experiences annual cyclic fevers. Every year, in the autumn, the boy spikes a fever, along with swollen glands and body pain. The pediatrician finally diagnoses the boy with Periodic Fever with Associated Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA). He is treated with a single dose of an oral steroid to reduce the inflammation and recovers.
How I wish the Inquirer had an “Ask the Acupuncturist” column. One of the strengths of Chinese Medicine is its many sophisticated theories of latent pathogens that cause recurrent illness. Seasonal allergies, annual fevers, women who catch colds with menstruation, winter asthma are all examples of how a disease can go underground, and then resurface based on seasonal changes, stress, or hormonal triggers.
Historical Chinese medical literature is filled with case histories, herbal formulas, acupuncture point combinations and topical preparations to treat such syndromes. And, while we value the lifesaving role of steroids, we also consider them a suppressive therapy that would further drive the PFAPA underground. In clinical practice, I would anticipate that next year, the boy would again expereince the same cyclic fever.
A practitioner of Chinese Medicine would first make a differential diagnosis based on the presenting symptoms, factoring in the pattern in which they occur: seasonal, monthly, annually. Then, an effective treatment strategy would not only resolve the immediate exacerbation, but would then resolve the underlying imbalance. We call this strategy “treating the root and the branch simultaneously”.
In my practice, Six Fishes Chinese Medicine, we routinely treat acute infections, from the first spike of fever to the recovery stage. We modify the treatment to exactly match the patient’s presentation. For example, if you and I both had fever with headache, and your headache was in the neck, and mine was in the sinuses, we would each receive different acupuncture and herbal treatment. Even if we both have “the flu”. We really love the how effective and practical this approach is.
The history of Chinese Medicine is long and the population of China is large. By necessity, Chinese medicine has developed multiple, clearly staged treatments for infectious diseases. Most herbal formulas are antibacterial, antiviral and antipyretic and immune boosting. Because of this, the majority of our patients fully recover are able to avoid antibiotic and steroid treatment.