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RESEARCH PAPER TCM 1: CHIKUNGUNYA
INTRODUCTION Chikungunya is a relatively rare form of viral fever caused by an alpha virus that is spread mainly by bites of Aedes Aegypti mosquito. Its name is derived from the African - Makonde language meaning “that which bends up” in reference to the stooped posture developed as a result of the arthritic symptoms of the disease. Chikungunya was initially not considered fatal. However, in 2005-2006, more than 200 deaths were associated with Chikungunya on Reunion Island and in India in the states of Tamil Nadu, Karnataka, Kerala, Andhra Pradesh, Rajasthan, Gujrat, Madhya Pradesh and Delhi. SYMPTOMS The symptoms of Chikungunya include fever that can reach 390C (102.200F), a petechial or maculopapular rash usually involving the limbs and trunk and arthalgia or arthritis affecting multiple joints, which can be debilitating. The symptoms could also include headache, conjunctiva infection and slight photophobia. The fever typically lasts for two days and abruptly comes down. However, other symptoms, namely joint, pain, intense headache, insomnia and an extreme degree of prostration last for a variable period, usually for about 5 to 7 days. Albumin appears in urine examination. In blood test, hemoglobin appears reduced whereas white blood cells, particularly neutrophils and urea nitrogen are found increased. Platelets are found to be greatly reduced. Dermatological manifestations observed are varied and could include:-
Histopathologically, pigmentary changes, maculopapular rash, lichenoid rash, aphthous- like ulcers show lymphocytic infiltration around dermal blood vessels. Pedal oedema (swelling of legs) is observed in many patients, the cause of which remains obscure, as it not related to any cardiovascular, renal or hepatic abnormalities. PREVENTIVE MEASURES The most effective means of prevention are those that protect against any contact with the disease carrying mosquitoes. These include using insect repellent containing DEET or permethrin, wearing long sleeves and pants, securing screens on windows and doors. It is important to empty stagnant water where mosquitoes breed. Acupressure treatment upon onset of the epidemic has been found to be effective in preventing the spread of the disease in an individual. The points for this purpose are Sp 1, Sp 2, Sp 4, Liv 1, Liv 3, LI 4, LI 11, St 36, GV 14 – star magnets on all points of both hands.
There is no specific treatment for Chikungunya in allopathic system of medicine other than to provide symptomatic relief. However, after considerable research, the Sansthan has found that Chinese acupressure therapy can give miraculous relief in this disease. According to Chinese Acupressure/Acupuncture, epidemic fever has many common features with Chikungunya and therefore the treatment for epidemic fever can be applied to Chikungunya. Epidemic fever has mainly five phases as follows and the same phases can thus be applied to Chikungunya.
FIRST PHASE – HIGH FEVER Main symptoms Very high fever, excessive feeling of thirst, red face, profuse sweating, congested eyes, blurred vision, small rashes on skin, epistaxis, blood in sputum, dark urine, constipation, impaired consciousness, delirium, opisthotonos, convulsions, rapid and slippery pulse, yellow or red pustules on tongue. Principle of Treatment Remove stasis and toxins Treatment Points
SECOND PHASE – HYPOTENSION/SHOCK Main symptoms Low vital energy with low blood pressure, malaise, restlessness, excessive thirst, profuse sweating, spiritless, delirium, deep red coloured tongue, fine, rapid and forceless pulse, coma. Principle of Treatment Raise vital energies and blood pressure. Treatment Points
THIRD PHASE – OLIGURIA Main symptoms Scanty and dark coloured urine, deviation in flow of urine during urination, body ache, uncontrollable pain in all joints, lower back area & groin region, constipation, yellow coat on tongue, fine but rapid pulse. Principle of Treatment Increase quantity of urine.. Treatment Points
FOURTH PHASE – POLYURIA Main symptoms Increase in quantity and frequency of urine, incontinence of urine, severe thirst, dry mouth, vertigo, continuous lumber pain, spiritless feeling, no coating on tongue. Principle of Treatment Promote yin and tonify kidneys. Treatment Points
FIFTH PHASE – CONVALESCENCE Main symptoms No fever in day time but in evening especially between 4 to 8 PM, mild fever (malaise), dry throat and mouth, continuous pain in lumber area, vertigo, anorexia, fine, thin and light white coat on tongue, fine pulse. Principle of Treatment Promote vital energy and tonify spleen’s energy. Treatment Points
Note: Depending upon severity of condition, magnets should be applied on one or both hands. Apply magnets for 8 to12 hours daily. Legend ↑ - Tonification by white byol magnets. ↓- Sedation by yellow byol magnets.
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