Chronic+Fatigue+Syndrome+(Chronic+Fatigue+Immune+Deficiency+Syndrome)

Chronic fatigue syndrome, or chronic fatigue immune deficiency syndrome, is a constellation of naurological, neuromuscular, and immunological abnormailities combined with cognitive impairments, disabling fatigue, and recurrent bouts of flu-like symptoms

Etiology
Unknown. Viral infection is strongly suspected, with 85% of sufferers experiencing an initial acute onset of flu-like symptoms such as -mild fever -sore throat -tender lymph nodes -chills -fatigue with minimal exertion

This is then followed by such chronic manifestations as -myalgia (muscle pains) -migrating arthralgias (joint pains) -sleep disorders -headaches -hyper or hyposensitivities -cognitive disorders: spacial disorientation, short-term memory loss -disabling fatigue and malaise -depression, anxiety, irritability and/or confusion -fluctuations in weight -abdominal pain -nausea and/or vomiting

Patients with this condition also often have a history of multiple allergies. Most patients are between 25-40 years of age.

Biomedical Diagnosis
There are no absolute clinical indicators or laboratory tests confirming this diagnosis. It is diagnosed primarily by presenting symptoms and history

Differential Diagnosis: -SLE -Rheumatoid Arthritis -Fibromyalgia

Biomedical Treatment
There is no specific biomedical treatment for chronic fatigue. It's current treatment is based on the management of symptoms. For sleep: tricyclic depressants, seritonin reuptake inhibitors, benzodiazepine, clonazepam For headache: NSAIDS (tension headache), calcium channel blockers (migraine) For myalgias/arthralgias: muscle relaxants, NSAIDS, clonazepam For candidiasis: ketoconazole (Nizoral), fluconazole (Diflucan) For depression: anti-depressants For fatigue: buproprion (Wellbutrin) and intramuscular B12 injections

Chinese Medical Disease Categorization
The main complaint is fatigue which correlates to the disease xu lao, or vacuity taxation.

Chinese Medical Causes
-External invasion of pathogens -Internal damage by the 7 emotions -Unregulated eating and drinking -iatrogenesis -Aging

Interior Deficiency-Exterior Excess
Acute onset of sore, swollen throat, fever, sweating or no seating, muscle aches, fatigue, lack of strength, torpid intake [Ban Lan Gen (15g.), Xuan Shen (15g.), Niu Bang Zi (9g.), Huang Qin (9g.), Chai Hu (9g.), Dang Shen (9g.), Ban Xia (9g.), Gan Cao (6g.), Sheng Jiang (6g.), Da Zao (6g.)] Marked lymphnode swelling: + Zhi Bei Mu (15g.), Xia Ku Cao (15g.) Blood vacuity/ px catches cold with each menses: + Shu Di Huang (12g.), Dang Gui (9g.), Bai Shao (9g.), Chuan Xiong (9g.) Nasal congestion: + Bai Zhi (9g.), Bo He (9g.) Marked joint pain: + Qiang Huo (9g.), Fang Feng (9g.), Ge Gen (15g.) High fever and thirst: + Shi Gao (20g.), Zhi Mu (12g.)
 * Tongue:** pale, fat, teeth marks with yellow and white coat
 * Pulse:** floating, fine, wiry, slightly rapid
 * Treatment Principles:** Dispel Wind and clear heat, support the righteous Qi
 * Acupuncture Treatment:** LI-4, GV-14, BL-12, ST-36
 * Herbal Treatment:** //Xiao Chai Hu Tang Jia Wei//
 * Modifcations:**

Taxation Malaria Pattern
-Spleen Qi deficeincy sx: fatigue, esp. after eating, abdominal bloating after eating, loose stool, cold hands and feet, lack of strength in the 4 extremities, dizziness when standing up, easily bruised, easily catches colds and flus -Liver Blood/Kidney Yin deficiency with heat sx: night sweats, hot flashes, 5-palm heat, tinnitus, dizziness, thirst/dry mouth with little desire to drink, recurrent dry sore throat, malar tidal flush, stiff sinews, numbness/tingling of the extremities, matitutudinal insomnia -Liver depression sx: permenstrual or menstrual lower abdominal distention, lower abdominal cramping, premenstrual breast distention and pain, irritability, emotional depression [Huang Qi (15g.), He Shou Wu (15g.), Niu Xi (12g.), Dang Shen (9g.), Bai Zhu (9g.), Zhi Mu (9g.), Wu Mei (9g.), Cao Guo (9g.), Gan Cao (6g.), Dang Gui (6g.), Chen Pi (6g.), Sheng Ma (4.5g.), Chai Hu (1-3g.) Severe fatigue: increase Dang Shen to 20g. and Huang Qi to 30g. Fatigue or abdominal bloating after eating: + Shi Chang Pu (9g.), Mu Xiang (9g.) Night Sweats: Huang Bai (9g.), Di Gu Pi (9g.) Matitudinal Insomnia: + Suan Zao Ren (12g.), He Huan Pi (12g.), Bai Zi Ren (12g.) Liver Qi depression sx: + Xiang Fu (9g.), Chuan Xiong (9g.), Bai Shao (9g.) Stiffness in sinews/Numbness of the extremities: + Ji Xue Teng (20g.)
 * Tongue:** pale red or red tongue with red tip, scanty coat
 * Pulse:** fine rapid or possibly floating, surging
 * Treatment Principles:** Supplement deficiency, course the liver, rectify the Qi
 * Acupuncture Treatment:** PC-5, GV-14, LI-4, ST-36, KI-7, BL-20, BL-21
 * Herbal Treatment:** //Bu Zhong Yi Qi Tang Jia Wei//
 * Modifcations:**

Heart Malnourishment with Liver Depression
Long period of extreme fatigue, wan affect, emotional depression, insomnia, impaired memory, occassional desire to sigh, shortness of breath, a faint voice or disinclination to speak, heart palpitaions or fluster, no thought of eating or drinking, lack of strength, flabby muscles, possible muscle/joint soreness or pain [Huang Qi (30g.), Xian He Cao (30g.), Bai He (30g.), Hong Shen (9g.), Shan Zhu Yu (9g.), Chai Hu (9g.), Zhi Ke (9g.), Chen Pi (9g.), Dang Gui (9g.), Bai Zhu (12g.), Bai Shao (12g.)] Tendency toward heat: + Huang Lian (3-6g.), Huang Qin (3-6g.) w/ Yang deficiency: + Yin Yang Huo (9g.), Xian Mao (9g.) w/ Yin deficiency: + Gou Qi Zi (10g.), Nu Zhen Zi (10g.), Wu Wei Zi (10g.), and /or He Shou Wu (10g.) Torpid intake: + Shen Qu (9g.), Shan Zha (9g.), Mai Ya (9g.) Insomnia & Heart Palpitations: + Ku Shen (9g.), Suan Zao Ren (12-15g.) w/ Blood stasis: + Chi Shao (9g.), Dan Shen (9g.), Mu Dan Pi (9g.), and/or Yi Mu Cao (9g.) Hidden or deeply lying pathogens in the blood level: Zi Cao (9-15g.), Jin Yin Hua (9-15g.), Lian Qiao (9-15g.), Pu Gong Ying (9-15g.), and/or Ban Lan Gen (9-15g.)
 * Tongue:** fat pale red tongue; white coat
 * Pulse:** fine, wiry
 * Treatment Principles:** Supplement the heart Qi and blood by fortifying the Spleen and boosting the Qi, course the Liver and resolve depression, Quiet the spirit
 * Acupuncture Treatment:** BL-15, CV-17, HT-7, ST-36, SP-6, LR-3
 * Herbal Treatment:** //Bu Gan Yi Qi Tang//
 * Modifcations:**

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