Chinese Medicine Book Club Issue 1093
Daily updates to accompany the growth of TCM practitioners
IIntroduction: TCM practitioners often hesitate to use moxibustion for skin itching, dryness, or similar heat-related conditions, fearing it may worsen the condition. This hesitation stems from a lack of understanding of the efficacy of moxibustion. In this article, the most fascinating observation is that every time moxibustion is applied to the points Yangchi (阳池) and Zhongquan (中泉), a shape resembling “lotus root” appears locally. What does this signify? For more information on “Meridian Medicine,” please download the Linglan TCM App to read this topic. (Editor/Wali)
Acupuncture Treatment for Allergic Dermatitis
Author/Wang Juyi
Allergic diseases are common in the field of acupuncture. Modern medicine considers them to be hypersensitivity reactions, and identifying allergens can involve numerous issues; moreover, the effectiveness of drug treatments is often not significant. However, acupuncture can sometimes yield excellent results. So, what is the relationship between meridians and hypersensitivity diseases?
The Huangdi Neijing states: “The meridians determine life and death, address all diseases, and regulate deficiency and excess.” Here, “address all diseases and regulate deficiency and excess” refers to “participating in diseases,” indicating that all diseases involve meridians, and meridians play a regulatory role in all diseases, which can be quite strong, sometimes even surpassing the efficacy of medications.
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Case Study
Li, female, 31 years old, initial diagnosis on October 20, 2009.
Main complaint: Metal allergy, rash on the back of the left hand for 2 years.
Symptoms: Allergic dermatitis on the back of the left hand (between the 3rd and 4th fingers and on the back of the hand), approximately the size of a one-yuan coin, which expands severely to the base of the 3rd and 4th fingers. This condition originated from a scratch on the back of the left hand caused by a metal zipper last winter, which has hardened for over a year. The local skin is dry and itchy. During severe episodes, the lesions expand, the skin thickens, reddens, and ulcerates, with many small blisters that easily burst and ooze yellow fluid when scratched. Western medical diagnosis: Allergic dermatitis (secondary to frostbite). Symptoms worsen in autumn and winter and after alcohol consumption. After multiple treatments with herbal washes, the condition fluctuates but has not healed. The practitioner believes the skin symptoms are due to damp-heat toxin (skin redness, swelling, ulceration, and yellow fluid), and is hesitant to use moxibustion for treatment.
Meridian examination: Diagnosis through observation indicates the disease is in the Shaoyang meridian.
Meridian differentiation: Local toxic pathogens and frostbite have caused obstruction in the Shaoyang collateral.
Selected meridian: Hand Shaoyang meridian.
Selected points: Bāxié (八邪, Eight Evils, left), Wàiguān (外关, Outer Pass, left), Yángchí (阳池, Yang Pool, left, moxibustion), Zhōngquán (中泉, Central Spring, moxibustion). Additionally, local extra points were added.
Efficacy: After a total of 3 treatments, the dermatitis on the hand showed significant improvement after the first moxibustion session, continued to improve after the second treatment, and completely disappeared after the third session. This is considered clinical recovery.
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Case Analysis
The patient came to Beijing at the end of 2007. Due to the cold weather, she was unaccustomed to wearing gloves, leading to dry skin on her hands. After being scratched by a zipper, she began to experience local skin cracking and itching, which hardened after scratching, oozing transparent yellow fluid and blood, and forming a brittle crust as it dried. The skin thickened, and even clenching her fist caused pain in the skin on the back of her hand. Although oral and topical herbal treatments provided relief, they did not cure the condition. The symptoms were milder in warm weather and more severe in cold weather, persisting for two years.
The pathogenesis of this condition is due to frostbite and metal allergy causing obstruction in the Shaoyang collateral, preventing Yang Qi from circulating. Therefore, moxibustion at the points Yángchí and Zhōngquán is used to warm the meridians, unblock Yang, and dispel pathogens. Since the disease is localized in a relatively superficial layer of the skin, affecting a specific area, the treatment involves needling Wàiguān and pairing it with Bāxié to unblock the local collateral. Wàiguān has the function of activating collaterals, clearing collaterals, detoxifying, and opening orifices. The Jingui Yaolue states: “Wàiguān is the main point for deafness and numbness in the fingers, preventing them from grasping objects,” indicating its strong collateral unblocking function. Additionally, the Sanjiao meridian governs “the water outside the cells,” which is closely related to the subcutaneous connective tissue, so moxibustion at Yángchí can warm and unblock the skin collaterals, also alleviating this condition.
Yángchí paired with Wàiguān serves as the original collateral pairing for this meridian. Although modern acupuncture textbooks describe the “original-collateral” pairing as the original point of the meridian and the collateral point of the related meridian, clinical experience shows that pairing the original point with the collateral point of the same meridian can treat conditions of insufficient meridian Qi and obstruction in the collateral (including floating collaterals and Sun collaterals of the same meridian).
Furthermore, when the patient experiences itching on the back of her hand, she also feels irritable, indicating that the condition has affected the heart through the relationship between the Hand Shaoyang and Hand Jueyin meridians, as “all pains and itching belong to the heart” (from Suwen: The Great Treatise on True Essentials). Changes in the heart are generally also reflected in the Hand Jueyin Pericardium meridian, which can be treated with the Hand Jueyin meridian. In this case, the treatment utilizes the original-collateral points of the Hand Shaoyang meridian (Yángchí, Wàiguān) to address the Hand Jueyin meridian condition.
The patient has an alcohol allergy, experiencing itching all over her body when consuming alcohol. For some individuals, alcohol acts as a pathogenic factor, classified as damp-heat toxin; alcohol strongly stimulates this condition (the rash on the left hand) because “the disease travels familiar paths,” attacking areas of the body that are already diseased, weaker, or previously damaged. The Huangdi Neijing states: “Wherever the pathogen gathers, its Qi must be deficient.” For example, some individuals with pre-existing throat issues often experience sore throats when they catch a cold. Therefore, the patient mistakenly believes this condition is purely caused by damp-heat toxin and fears that moxibustion will exacerbate the disease.
TCM practitioners often hesitate to use moxibustion for skin itching, dryness, or similar heat-related conditions, fearing it may worsen the condition. This hesitation arises from a lack of understanding of the efficacy of moxibustion. In fact, moxibustion can be used for a wide variety of conditions, whether superficial or deep, cold or hot, deficient or excess, depending on the selected acupuncture points. Many diseases can be treated with moxibustion.
During the treatment process, the most fascinating occurrence was that each time moxibustion was applied to Yángchí and Zhōngquán, a shape resembling a 1-inch wide, 0.75-inch long “lotus root” appeared at the local site, becoming lighter with each session. This shape represents the image of the collateral, indicating that the local collateral was obstructed, necessitating continued moxibustion at that site until the lotus root image disappears, which signifies that the collateral has been unblocked. Unfortunately, there was no camera available to capture the “lotus root” at that time.
This case demonstrated remarkable efficacy; after two years of illness, the patient was cured after just three acupuncture sessions, proving that moxibustion can also produce results in a short period. The special meridian response observed during moxibustion indicates that the selected acupuncture points were appropriate, allowing for the re-establishment of collateral distribution.
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