JOURNAL OF CHINESE MEDICINE NUMBER 49 SEPTEMBER 1995

THE EXTERNAL TREATMENT OF EPIDEMIC PAROTITIS BY TCM

by Peng Jin and Li Yanping

pidemic parotitis or mumps is an acute infectious disease caused by the mumps virus. Its chief clinical manifestations are fever, swelling of the parotid gland and distending pain. It usually occurs in winter and spring, and children of 2-14 years old are especially vulnerable to the disease. The external treatment of mumps by traditional Chinese medicine (TCM) is simple and effective. Several commonly used methods of external treatment are introduced as follows:

External Application at the Involved Part

Drugs for clearing away heat, detoxifying, improving blood circulation and eliminating swelling are applied at the site of the lesion. A commonly used simple recipe is crude Da Huang (Rhizoma Rhei) ground into a fine powder and mixed with vinegar to make a paste which is applied onto the involved part, 1-2 times a day. 88% of mumps cases were cured in 3 days by the above method. Another external agent is a paste made of Qing Dai (Indigo Pulverata Levis) powder mixed with vinegar. Doctor Duan treated 138 children with mumps by this method. It was discovered that 10-30 minutes after application of Qing Dai paste, local pain was greatly relieved, after 8-36 hours, the body temperature returned to normal and after 16-72 hours, the parotid swelling disappeared, the curative rate being 100%. In addition, many locally available fresh herbs can be used to make a paste and treat the disease For example, the following herbs can be made into paste and applied on the involved part: fresh green Ce Bai Ye (Cacumen Biotae Orientalis) is smashed and thoroughly mixed with egg white, fresh Pu Gong Ying (Herba Taraxaci Mongolici cum Radice) is smashed and mixed with egg white and sugar, fresh clean Xian Ren Zhang (Cactus) excluding its spines is smashed (not in iron vessels) and thoroughly mixed with 50ml of 95% alcohol. Clinical application of each of the above agents is simple, but also definitely effective. To enhance clinical effectiveness, powders and pastes made of different complex recipes can also be used. For instance, the following ingredients may be used: Xia Ku Cao (Spica Prunellae Vulgaris), Lian Qiao (Fructus Forsythiae Suspensae), Chuan Xiong (Radix Ligustici

Wallichii), Bai Ji (Rhizoma Bletillae Striatae), Ban Lan Gen (Radix Isatidis seu Baphicacanthi) and Zhi Zi (Fructus Gardeniae Jasminoidis). They are dried and ground into fine powder and mixed with lukewarm boiled water to make a paste for external application, once a day. This paste can eliminate swelling and quickly relieve pain, and 2-5 external applications can generally cure the disease. In one study, 315 children with mumps were treated with a paste made of the following ingredients: Chuan Shan Jia (Squama Manitis Pentadactylae), Ru Xiang (Gummi Olibanum), Chi Shao (Radix Paeoniae Rubrae), Lian Qiao (Fructus Forsythiae Suspensae), Sheng Da Huang (Rhizoma Rhei), Zhi Zi (Fructus Gardeniae Jasminoidis), Da Qing Ye (Folium Daqingye), Ban Lan Gen (Radix Isatidis seu Baphicacanthi) and Wu Ling Zhi (Excrementum Trogopterori seu Pteromi). 53 cases were cured after one treatment, 223 cases after two treatments and 39 after three treatments

Drugs Applied on Acupoint Yongquan KID-1

Wu Zhu Yu (Fructus Evodiae Rutaecarpae) 15g, Bai Lian (Radix Ampelopsis) 6g, Da Huang (Rhizoma Rhei) 6g, and Dan Nan Xing (Rhizoma Arisaematis cum Felle Bovis) 3g are ground together into powder and stored in a porcelain vessel for use. 3g of the above medicinal powder is used externally for infants less than 1 year old, 6g for children of 1-6 years, 9g for children of 6-10 years, 12g for children of 11-15 years and 15g for children over 15 years old. Before application, a proper amount of vinegar is added to the powder to make a paste. An alcohol-soaked cotton ball is used to rub bilateral Yongquan KID-1 and then a piece of gauze with the paste on it is put on the point and fixed in position by the bandage The gauze is changed every 24 hours. If the case is severe, the paste can be applied repeatedly. Another complex recipe is made of Hu Huang Lian (Rhizoma Picrorrhizae) 15g, Wu Zhu Yu (Fructus Evodiae Rutaecarpae) 15g and Dan Nan Xing (Rhizoma Arisaematis cum Felle Bovis) 10g which are ground into powder and sieved with a 80-mesh sieve. Vinegar is added to the above medicinal powder to make a paste. In treatment a piece of gauze with the paste is put on Yongquan KID-1 bilaterally and fixed in position by the bandage. The gauze with the

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JOURNAL OF CHINESE MEDICINE NUMBER 49 SEPTEMBER 1995

paste is changed twice a day. It is reported that after using the above paste on Yongquan KID-1 the body temperature was lowered to normal and the pain was relieved 12 hours after its application, and after 48 hours all the symptoms and signs disappeared. Generally, a repeated application, for 2-4 days was effective to cure the disease.

Moxibustion and laser therapy

Traditionally, moxibustion is used for the external treatment of epidemic parotitis. The temporary stimulation by heat can purge external heat and disperse stagnant qi and blood. There are traditional fire and modern laser methods of moxibustion. In fire moxibustion, the methods and points selected are various. One method involves dipping a small moxa stick in oil, lighting it and quickly touching the lit end to Lieque LU-7 on the diseased side. Clinically, it has been shown that this method not only can relieve pain, but also can swiftly eliminate swelling. As a preventive measure, moxibustion can also remarkably decrease the incidence of mumps. A Chinese-made low power He-Ne laser acupuncture apparatus was employed to treat 50 cases of mumps in which Shaoshang LU-11, Hegu L.I.-4 and Ashi points were the main points and Quchi L.I.-11 and Fengchi GB-20, the subordinate points. During treatment, 4-8 points were selected and were irradiated for 5-10 minutes, 1-2 times a day. After laser moxibustion, all the cases were cured (15 within were 2-3 treatments, 20 within 4-5 treatments, and 15 cases by more than 5 treatments. Besides the methods introduced above, there are other methods of treatment for mumps such as cupping, fingerpressing, etc. According to different clinical conditions, the methods can be chosen flexibly.
Peng Jin works at the Institute of Basic Theories, China Academy of Traditional Chinese Medicine, Beijing, and Li Yanping at the Chongqing Municipal Hospital of TCM, Sichuan Province.

Acupuncture
Acupuncture can be used to treat epidemic parotitis. Most of the points selected are on shaoyang and yangming channels and the reducing method is used to purge heat. It is reported that Hegu L.I.-4, Yifeng SJ-17 and Lieque LU-7 were selected and needled by the reducing method in the treatment of 1080 cases of mumps, with the needles retained for 20 minutes. The therapeutic effect was marked and the total curative rate reached as high as 100%, with 310 cases cured after one treatment, 538 after two and 232 after three. It has been discovered that electro-acupuncture can not only relieve local pain and systemic symptoms, but also has a significant antipyretic effect. Bilateral Hegu L.I.-4, Shaoshang LU-11, Jiaosun SJ-20 and the most sensitive point at the involved parotid gland were primarily selected for the treatment of 350 cases of mumps; 95% of which (333 cases) were cured in 3 days and of which 85% had their body temperature of over 38C restored to normal within 20 hours. Besides body acupuncture, auriculo-acupuncture can also be applied. Auricular points toe, shoulder and occiput are punctured perpendicularly with the filiform needle and strongly stimulated more than 10 times without retaining the needle. The method was once used to treat 500 cases, with pain ameliorated immediately after one treatment and swelling eliminated after two treatments. The auricular-plaster therapy is easily accepted by children as it causes no pain. Wang Bu Liu Xing (Semen Vaccariae Segetalis) is fixed with plaster on bilateral parotid glands, unilateral ear tip and unilateral shenmen. The seeds are pressed 4-5 times a day and removed after elimination of swelling. Generally the patient can be cured in 2-4 days. In addition, bloodletting therapy is also a good method of treatment for epidemic parotitis. As the method has a rapid analgesic effect, it has been used extensively. Doctor Zhu et al. used the three-edged needle to bloodlet Zhaohai KID-6 point. Pain was relieved instantly and swelling disappeared or was greatly ameliorated within 24 hours of bloodletting. In severe cases, the method was repeated on the second day and the symptoms basically disappeared or the disease was cured. Other methods of bloodletting emphasise the jingwell points, with Shaoshang LU-11 and Guanchong SJ-1 as the main points, and Shangyang L.I.-1 as the subordinate point, or alternatively, auricular point bloodletting and venous bloodletting at the back of the ear etc. may be applied. Clinical experience has demonstrated that the therapeutic effect of the above methods is definite.

This article first appeared in The Journal of Traditional Chinese Medicine, Beijing edition, June 1995.

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