Chinese medicine considers acute infectious polyneuritis to fall within the category of "atrophy-flaccidity disease." The etiology and pathology are briefly described as follows:

1. External contraction of dryness-heat pathogens, lung heat scorching the leaves, and the loss of nourishment to the meridians, leading to flaccidity.
2. Dampness-heat infiltration, obstruction of qi and blood circulation, and blockage of the meridians resulting in flaccidity.
3. Spleen-stomach weakness, dysfunction in transportation and transformation, and the inability of water and grain essence to nourish the muscles and limbs, leading to flaccidity.
4. Chronic illness leading to physical weakness or inherent liver-kidney depletion, kidney essence insufficiency, and liver blood deficiency, resulting in malnutrition of the tendons and bones and the development of atrophy-flaccidity disease.

bubble_chart Modern Research

Acute infectious polyneuritis, also known as Guillain-Barré syndrome, is an acute or subacute multiple peripheral nerve damage of unknown cause. Its main clinical features are symmetrical proximal weakness of the limbs, distal sensory disturbances, and may be accompanied by cranial nerve damage. The disease is more common in summer and autumn.

The cause of acute infectious polyneuritis is not very clear, and it is generally believed to be related to viral infection and autoimmune damage. The main pathological changes are peripheral nerve edema, followed by axonal and myelin degeneration, with a small number of lymphocyte infiltrations, then the appearance of phagocytes, and Schwann cell proliferation. The central nervous system (brain and spinal cord) may occasionally be affected.

1. Symptoms may include a history of upper respiratory or gastrointestinal infection before the disease, with acute or subacute onset 1 to 3 weeks after recovery. The first symptoms are often symmetrical weakness of the limbs, more severe in the proximal than the distal parts, and more severe in the lower limbs than the upper limbs. It can also involve cranial nerves, causing bilateral peripheral deviation of the mouth, and due to the involvement of the glossopharyngeal and vagus nerves, hoarseness, difficulty swallowing, and water regurgitation may occur. In severe cases, it can affect the intercostal muscles and diaphragm, leading to respiratory paralysis. The condition usually peaks within 3 to 15 days of onset, with flaccid paralysis. Recovery begins 10 to 25 days after onset, and the prognosis is generally good.
2. Signs include distal sensory disturbances in the limbs, reduced muscle tone, weakened or absent tendon reflexes in the limbs, symmetrical flaccid weakness or paralysis in the limbs, muscle soreness or tenderness, cranial nerve damage, autonomic nerve disorders, or bladder and bowel dysfunction.
3. Laboratory and other tests: Lumbar puncture usually shows normal cerebrospinal fluid pressure, increased protein content, and normal cell count, which is one of the characteristics of this disease. This is most obvious 2 to 3 weeks into the course of the disease. Immunoglobulin levels may also be elevated. Electromyography can reveal slowed motor nerve conduction velocity.

bubble_chart Pattern Analysis

1. Lung Heat Damaging Fluids︰Initial fever, sore throat, weakness in the limbs, sudden paralysis, and numbness. Restlessness, thirst, dry skin, sweating of hands and feet, scanty urine, and constipation. The tongue is red with yellow and rough coating, and the pulse is thin and rapid. Clearing heat and promoting fluid production, nourishing yin and moistening dryness. Modified Dryness-Clearing Lung-Rescuing Decoction: Mulberry Leaf 10g, Mulberry Twig 15g, Glehnia 12g, Stir-fried Loquat Leaf 10g, Raw Gypsum 15g, Platycodon Root 10g, Bitter Apricot Seed 10g, Ophiopogon Tuber 10g, Reed Rhizome 15g. For lower limb paralysis, add Achyranthes Root 15g, Flowering Quince Fruit 12g; for upper limb paralysis, add Chinese Clematis Root 15g, Cinnamon Twig 10g, Gentian 15g; for limb numbness, consider adding Sichuan Lovage Rhizome 12g, Chinese Angelica 15g, Suberect Spatholobus Stem 30g; for excessive sweating, add Raw Astragalus Root 30g, Raw Oyster Shell 20g, Light Wheat 10g; for severe constipation, add Raw Rhubarb Rhizome 10g.
2. Dampness-heat︰Four wilting impediment: softness and numbness, predominantly in the lower limbs. Chest and hypochondriac stuffiness, or deviation of the mouth and eyes, thirst with little desire to drink, sticky and unsmooth stools, scanty and dark urine. The tongue is swollen and tender, with a dark tongue texture and yellow, greasy coating; the pulse is wiry, slippery, and rapid. Treatment involves clearing heat and draining dampness, as well as unblocking the Jingmai. Modified Four Marvels Powder: Atractylodes Rhizome 10g, Coix Seed 15g, Achyranthes Root 15g, Phellodendron Bark 10g, Stephania Root 10g, Mulberry Twig 15g, Luffa Vegetable Sponge 10g, Chinese Clematis Root 15g. For muscle soreness, add Flowering Quince Fruit 10g, Frankincense 10g, Myrrh 10g; for chest and hypochondriac stuffiness, add Pinellia Rhizome (Pro Formula) 10g, Magnolia Bark 10g, Trichosanthis Fruit Peel 10g; for deviation of the mouth and eyes, add Giant Typhonium Rhizome 12g, Stiff Silkworm 10g, Earthworm 10g.
3. Spleen-stomach Weakness︰Spleen wilting syndrome manifests as muscle weakness, flaccid sinews, loose stools, abdominal distension, a lustrous complexion, or cold limbs, even cold sweating, difficulty swallowing, and swollen hands and feet. The tongue is pale with thin white coating, and the pulse is thin and weak. The treatment principle is to warm the stomach, fortify the spleen, tonify qi, and unblock the collaterals. Modified Ginseng, Poria, and White Atractylodes Powder is prescribed: Codonopsis Root 15g, Raw Astragalus Root 20g, Poria 15g, White Atractylodes Rhizome 10g, Dried Tangerine Peel 10g, Chinese Yam 15g, Lotus Seed 10g, Villous Amomum Fruit 3g, Platycodon Root 10g, Dipsacus 10g, Suberect Spatholobus Stem 20g, Cinnamon Twig 10g, Liquorice Root 6g. For aversion to cold and difficulty swallowing, add Prepared Aconite Lateral Root 30g, Chinese Clematis Root 10g, Common Curculigo Rhizome 10g; for swollen hands and feet, add Chinese Starjasmine Stem 10g, Luffa Vegetable Sponge 15g; for thirst without desire to drink and white greasy tongue coating, add Atractylodes Rhizome 15g, Gentian 15g.
4. Liver-kidney Yin Deficiency︰Paralysis of the limbs, flaccidity of the sinews, muscular atrophy, soreness in the waist and weakness in the knees, numbness in the limbs or insensitivity to cold and heat, dizziness, tinnitus, eye distension, dryness in both eyes. The tongue is pale red with thin and scant white coating, and the pulse is thready and rapid. Tonify the liver and kidneys, strengthen the sinews and invigorate the bones. Modified Hidden Tiger Pill. Tortoise Carapace 30g, Phellodendron Bark 10g, Anemarrhena 10g, Songaria Cynomorium Herb 10g, Prepared Rehmannia Root 20g, Achyranthes Root 15g, Raw Astragalus Root 30g, Chinese Angelica 15g, Obscured Homalomena Rhizome 15g, Chinese Taxillus Herb 15g, Dipsacus 15g, Pig Marrow 20g. For dizziness and tinnitus, add Fleeceflower 15g, Magnetite 15g, Turtle Carapace Glue 15g; for numbness and insensitivity in the limbs, add Earthworm 15g, Peach Kernel 15g, Carthamus 6g; for cold limbs and impotence, add Cervi Deer-Horn Glue 15g, Cassia Bark 10g, Aconite Lateral Root 10g.