General introduction of this report: Mr. Vladimir, from Czech Republic, took our treatments for one month. After the doctors¡¯ efforts, he got much improvement. His treatment is successful.

Name: Vladimir               Birth Place: Czech Republic          Sex: male          Occupation: Book-seller

Marital status: married           Date of hospitalization: January 1^st, 2007         Date of record: January 1^st, 2007

Narrator: the patient himself.

The major complaint: atrophy and weakness in his limbs for 2 years, being worsening for half a year.

Present disease: two years ago, without any obvious inducement, he started suffering weakness in his both hands and atrophy in his upper limbs; it was difficult for him to lift his arms. But he didn¡¯t pay any attention. His condition was worse 3 months later, the muscles in his four limbs and chest started jumpiness. But he didn¡¯t take any treatments. Till the September of 2005, he was diagnosed as ¡°ALS¡± after the electromyography and MRI examination at his local hospital. The hospital offered him the medicines such as, magnesium, lorista verospiron, etc, but he didn¡¯t gain any obvious improvements.

Anamnesis: he doesn¡¯t have the history of any infectious disease or medical and diet allergy. No blood transfusion. He took the operations appendectomy, cholecystectomy and adrenalectomy relatively in the year of 1955, 1992 and January 18^th, 2006.

Personal history: he was born in Czech Republic, no addiction of smoking or bibulosity, his temperament is gentle and open-minded.

Family history: no history of any special genetic diseases in his family.

Medical examination: T: 36.2¡æ P: 88/min¡¡R: 20/min BP: 120/80mmHg Weight: 64kg

Normal growth of his body and common nutrition level. Clear consciousness and cooperative. No yellow stain of the skin sclera. No edema of the superficial lymph nodes. Normal growth of his head and five sense organs. Sensitive to the light reflection. Symmetrical size of the pupillae. Dry lips. No hyperaemia in the throat. No edema of the tonsil and thyroid gland. His neck touches naturally soft. Thoracic cage is symmetrical. Normal vocal fremitus. Clear percussion sound. Normal breath sound in the lungs. Spirant of the pleura. The heart rate is 88 times per minute. Normal rhythm of the heart. The abdomen is flat and soft. No pressure pains and no rebound tenderness. No pressure pains in the region of kidneys. Normal intestinal gurgling sound. No malformation of spinal column and limbs. No pressing pains and no warm sense of the lower limbs.

There is clear atrophy in his both sides¡¯ supraspinous muscles and infraspinous muscles and there is also clear muscle atrophy in his both arms. The girth of his right arm up elbow joints 8cm is 19cm, the left one is the same. The girth of his left arm down elbow joints 10cm is 19 cm, the left one is the same. Both of his bicipital muscles and triceps muscles of arm almost disappear, the myodynamia of his both hands is level 3, strength of his right hand is 5.5kg; strength of his left hand is 4.2kg. He has difficulties in lifting his hands. He can only lift the left hand about 5cm, the right hand about 6 cm. there is also clear jumpiness on his chest, there is a little bit atrophy in his lower limbs.

Accessory examination: it is shown ALS through electromyography and MRI examinations.

Primary diagnosis: TCM flaccidity syndrome.

Symptoms diagnosis: spleen deficiency, liver-kidney depletion.

Treatment strategy: fortify the spleen and boost qi; enrich liver and supplement kidney; settle tetany and extinguish wind. Acupuncture combined with massage once a day. 

January 2^nd, 2007 9:00 am

Weakness in his four limbs. He feels fatigue because of his long journey from Czech Republic to our hospital. He slept well in the night. The results of liver function and kidney function, blood sugar, and blood fat are all normal.

January 3^rd, 2007 9:00 am

He doesn¡¯t have any other discomfort, no headache, no dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. There is no obvious change in his four limbs. Tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 4^th, 2007 9:00 am

He doesn¡¯t have any other discomfort, no headache, no dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. There is no clear change in his four limbs. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 7^th, 2007 9:00 am

He doesn¡¯t have any other discomfort. The weakness in his four limbs is slightly reduced. No headache. No dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 10^th, 2007 9:00am

He doesn¡¯t have any other discomfort, he feels stronger in his upper limbs. He can lift his hands more about 5cm than before. No headache. No dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 14^th, 2007 9:00am

He doesn¡¯t have any other discomfort, he feels stronger in his upper limbs, he can lift his hands about 5cm than before. No headache. No dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 18^th, 2007 9:00 am

He doesn¡¯t have any other discomfort, he feels stronger in his upper limbs, he can lift his hands about 5cm than before. No headache and no dizziness. Spirit and appetite are good. He slept well. Urination and bowel movement are normal. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin. His attending doctor asks him to do some proper exercise for limbs everyday.

January 22^nd, 2007 9:00 am

He doesn¡¯t have any other discomfort. He doesn¡¯t feel any clear change in the past four days. No headache and no dizziness. He can lift his hands about 5cm more than before. No fever sense. No headache and no dizziness. His spirit and appetite are perfect. His sleeping was good. Normal urination and bowel movements. There is no clear growth of his supraspinous muscles and infraspinous muscles; we can see the frequent muscle jumpiness on his back, chest, and four limbs. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin. His attending doctor asks him to do some proper exercise for his limbs everyday.

January 26^th, 2007 9:00 am

Today he said he didn¡¯t have any special discomfort, he feels obviously stronger in his four limbs, and he can lift his hands 5cm more than before. No fever sense. No headache and no dizziness. His spirit and appetite are good. There is no clear growth of his supraspinous muscles and infraspinous muscles; we can see the frequent muscle jumpiness on his back, chest, and four limbs. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 30^th, 2007 9:00 am

Today he said he didn¡¯t have any special discomfort, he feels obviously stronger in his four limbs, and he can lift his hands 5cm more than before. No fever, no headache, no dizziness. His spirit and appetite are good. There is no clear growth of his supraspinous muscles and infraspinous muscles; we can see the frequent muscle jumpiness on his back, chest, and four limbs. His tongue body is reddish; tongue coating is thin and white. The pulse is deep and thin.

January 31^st, 2007 9:00 am