Infantile paralysis is an infectious disease occurring mostly in summer and autumn, frequently seen in young children of one to five years old and characterized by fever, cough, sore throat and general muscular aching or accompanied by vomiting and diarrhea and consequently muscular flaccidity of extremities.

Etiology and Pathogenesis

In the early stage, the seasonal pathogenic factors such as wind, heat, dampness, summer-heat, etc., invade the lung and stomach meridians through the mouth and nose, leading to the obstruction of meridians. At this stage, the disease may be grouped into the category of seasonal febrile disease. However, in the later stage when qi and blood and body fluids are consumed and liver and kidneys become deficient, the muscles, tendons and blood vessels are undernourished, and the disease may be grouped under the category of flaccidity-syndrome.

In critical cases, the pathogenic factors attack the heart and liver or obstruct the lung meridian, and the disease may be life threatening.

Syndrome Differentiation and Therapeutic Principles

A. Syndrome Differentiation

(a) Fever: The fever lasts for one to four days and subsides, but rises again after one to six days, which is known as dicrotic fever.

(b) Paralysis of extremities: Flaccid paralysis usually occurs after the subsidence of fever but may appear as early as the beginning of the febrile period. The motor disturbance may also involve the face and trunks but chiefly the limbs, particularly the lower ones, and appear as hemiplegia without sensory disturbance.

(c) Muscular atrophy: longstanding cases of paralysis may result in muscular atrophy or even deformity of the limb.

B. Therapeutic principles

In the early stage when the lungs and stomach are attacked and weifen and qifen involved, the therapy of expelling will from the superficies and clearing away heat and dampness is recommended. At the beginning of paralysis when dampness-heat attacks qifen and accumulates in the meridians, the therapy of clearing away heat and dampness and dredging meridians should be employed. When paralysis persists for a long period of time, qi deficiency, blood stagnation and impairment of the liver and kidneys appears, and the therapy of dredging meridians, regulating qi and blood and tonifying the liver and kidneys should be adopted. In cases with complications, such as convulsions and coma due to involvement of the heart and liver or dyspnea due to blockage of lung collaterals, the treatment may be referred to the sections "convulsion" and "pneumonia" respectively.

Classification and Treatment

A. Involvement of the lungs and stomach

Manifestations: Fever, sweating, cough, red throat, general aching, malaise, headache, poor appetite, nausea, vomiting, abdominal pain, loose stool, red tongue with thin, white coating and rapid and softfloating pulse.

Therapeutic principles: Clear away heat from the superficies, disperse wind, and eliminate dampness.

Prescription: The Modified Decoction of Puerariae, Scutellariae and Coptidis

Radix Puerariae 10 g
Radix Scutellariae 10 g
Rhizoma Coptidis 3 g
Radix Glycyrrhizae 3 g
Flos Lonicerae 10 g
Fructus Forsythiae 10 g
Semen Armeniacae Amarum 10 g
Gypsum Fibrosum (decocted first) 30 g
Semen Coicis 10 g
Talcum (wrapped in cloth) 10 g

Remarks: For cases with abdominal pain and loose stool, add Radix Aucklandiae (3 g). Herba Agastachis (10 g) and Fructus Crataegi (fried, 10 g) to regulate the stomach and eliminate dampness. For those with frequent nausea and vomiting, add Pericarpium Citri Reticulatae (6 g), Rhizoma Pinelliae (6 g) and Caulis Bambusae in Taeniam (10 g) to keep the adverse qi downward and stop vomiting.

B. Involvement of the meridians

Manifestations: Fever, sweating, pain in the limbs, restlessness or somnolence, stiffness of neck, red tongue with greasy coating and thready and soft-floating pulse.

Therapeutic principles: Clear away heat and toxic materials, eliminate dampness, and dredge meridians.

Prescription: The Modification of Three Wonder Drugs Pill

Rhizoma Atractylodis (fried) 10 g
Cortex Phellodendri 10 g
Radix Achyranthis Bidentatae 10 g
Radix Ledebouriellae 10 g
Radix Gentianae Macrophyllae 10 g
Semen Coicis 10 g
Talcum 10 g
Caulis Lonicerae 10 g
Caulis Piperis Futokadsurae 10 g
Lumbricus 10 g

C. Qi deficiency and blood stagnation

Manifestations: Paralysis occurring after the subsidence of fever and aggravating gradually, emaciation, sallow complexion, fatigue, general weakness, pale lips and tongue with white coating and soft-floating or slow and weak pulse.

Therapeutic principles: Tonify qi, nourish blood, activate blood circulation, and dredge meridians.

Prescription: The Modified Decoction for Invigorating Yang

Radix Astragali 15 g
Radix Angelicae Sinensis 10 g
Radix Paeoniae Rubra 10 g
Radix Paeoniae Alba 10 g
Rhizoma Chuanxiong 6 g
Flos Carthami 6 g
Lumbricus 10 g

Remarks: For cases with fever and yellow, greasy tongue coating due to remanent malady caused by dampness, add Three Wonder Drugs Pill to eliminate dampness-heat. For cases with paralysis of upper limbs, add Ramulus Mori (10 g) and Ramulus Cinnamomi (10 g) to expel wind and dredge collaterals. For cases with paralysis of lower limbs, add Radix Achyranthis Bidentatae (10 g), Ramulus Taxilli (10 g) and Cortex Acanthopanacis Radicis (10 g) to strengthen the bones and tendons and disperse wind-dampness.

D. Deficiency of the liver and kidneys

Manifestations: Long-term paralysis with muscular atrophy and flaccidity or even deformity and inability to stand and walk.

Therapeutic principles: Tonify the liver and kidneys, and warm and dredge meridians.

Prescription: The Modified Pill of Jingang

Rhizoma Dioscoreae Hypoglaucae 30 g
Radix Achyranthis Bidentatae 30 g
Fructus Chaenomelis 30 g
Radix Morindae Officinalis 30 g
Semen Cuscutae 45 g
Scolopendra 50 pcs
Bombyx Batryticatus 60 g
Scorpio 30 g
Herba Cistanchis 30 g
Rhizoma Gastrodiae 30 g
Os Sepiellae seu Sepiae 30 g
Semen Strychni Praeparata 60 g

The above drugs are powdered and prepared with honey as boluses weighing three grams each. One bolus is taken twice or thrice daily. For cases with paralysis, acupuncture, moxibustion, massage, or point ligation, and physical exercise should be used to supplement the oral medication.

Experiential Prescription

Radix Puerariae (10 g), Radix Isatidis (12 g), Rhizoma Smilacis Glabrae (10 g), Bombyx Batryticatus (6 g), Lumbricus (10 g), Rhizoma Coptidis (3 g), Fructus Forsythiae (10 g), Ramulus Mori (10 g), Radix Paeoniae Rubra (10 g), Radix Paeoniae Alba (10 g), Caulis Lonicerae (10 g), Caulis Trachelospermi and Scorpio (3 g); prepared as decoction; applicable to cases with involvement of the meridians.

Copyright 1995 Hopkins Technology