[Diagnosis of Syndrome] Herbal treatment for Rheumatoid Arthritis (RA) depends on the diagnosis of TCM syndrome. The diagnosis of conventional medicine may have it determined as RA; TCM diagnosis has yet to be determined. Different patients with RA may display different pulses, tongue impressions, facial impressions, physical changes to joints and etc. A same disease falls on different body constituents gives rise to different manifestations. A TCM physician takes all clues into account and concludes a syndrome for a particular patient.
[Typical Syndromes] There are six to seven typical syndromes of RA. A body may have heat and wetness accumulated at joints and some have more heat than wetness and some the other way round. A body may also be lacking of fluid nourishment and thus inability to cool blood, giving rise to another syndrome of yin deficiency. A body can be too weak to wall off climactic changes, which is the case of weak qi (energy). A body may show great swollen knees with minimal sub symptoms and this is usually the syndrome of weakness in the three lower yin channels.Understanding syndromes for many people can be a difficult task as people these days no longer live in tune with the nature. Simple differences between summer and winter and what they can do for our bodies are frequently ignored by us.
[Importance of proper diagnosis] Suggesting prescriptions without proper diagnosis of syndrome is unprofessional and unethical. Not only does it not help but it may even worsen the conditions. Each syndrome may also differ as a body can have a combination of those said syndromes. A prescription can have from 12 to 18 (or more or less) individual herbs with different amount in adjustment to the need of the specific body. Without proper consultation and diagnosis of syndrome, the direction is aimless.
[Corticosteroids Replacement] Having said that, there are some herbs (雷公藤 [Lei Gong Teng, Radix Tripterygium Wilfordii (1st pic), Property: bitter, pungent, warm, toxic; Channel tropism: liver, spleen, kidneys; Effects: Ridding wind & wetness, unblock channels & blood stagnation], 
昆明山海棠 [Kun Ming Shan Hai Tang, Radix Tripterygium Hypoglaucum (2nd pic), Property: bitter, pungent, cold, toxic; Channel tropism: liver, kidneys; Effects: Ridding wind & wetness, unblock channels & promote blood circulation, reduce swelling & stop pain], for example) which have been known to have the effects of promoting CRH and ACTH, encouraging the body itself to generate natural hormone -- instead of relying on cortisone or prednisone which have severe side effects. The patients using the herbs rely less on conventional steroid-based medicine.
RA can have serious effect in the long run if not treated well. The patient should make an effort to see a physician to determine the syndrome, and thus obtain corresponding prescriptions. Any kinds of treatments, synthetic drug or natural herbal, with prolonged or inappropriate dosages or consumptions, will pose unwanted and unfortunate results. Long term supervision is necessary.
