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JOURNAL OF CHINESE MEDICINE NUMBER 64 OCTOBER 2000

Treatment by Moxibustion

HERPES ZOSTER
by Xuan Lihua
2. Spleen and Stomach Damp-heat
Clinical manifestations vesicles containing thick yellowish fluid vesicles which are easily broken pain poor appetite abdominal distention pale or slightly red tongue body white or yellow sticky coating slippery and rapid pulse. Point selection Neiting ST-44, Sanyinjiao SP-6, the head of the snake, the middle of the snake, the tail of the snake. Treatment method As above. Herpes zoster is an acute skin disease characterised by eruptions of blisters with severe pain. In ancient China the disease was likened to a creeping snake, as the eruptions tend to creep across the body in a line, often around the waist. It was first described in Zhu bing yuan hou lun or General Treatise on the Aetiology and Symptomatology of Disease by Chao Yuan Fang in 610. The first patches of lesions to appear are known as the head of the snake. The last vesicles to appear are are the tail of the snake. Between the head and tail, there will be other clusters of blisters, but some areas will be clear. These healthy areas are termed the middle of the snake. Treatment of the condition with moxibustion has proved to have good results on the basis of three differentiated patterns.

1. Liver and Gall Bladder Fire Blazing


Clinical manifestations red skin red vesicles with burning pain and heat dry mouth with bitter taste constipation yellow urine red tongue with yellow coating wiry and rapid pulse Point selection Xingjian LIV-2, Yanglingquan GB-34, the head of the snake (0.5 cm outside of the first lesions to appear), the middle of the snake (in a clear area between the lesions), the tail of the snake (0.5 cm outside the last lesions to appear). Treatment method Moxibustion is applied to each point five times in succession using small moxa-cones about the size of a wheat grain. Some oil is wiped on each point to help the moxa to adhere and to prevent burns to the skin. When each cone of moxa has almost finished burning and the patient feels pain, the burning moxa is removed immediately to avoid scarring, and replaced by the next cone until five cones of moxa have been applied. Treatment is given daily.

3. Qi and blood stagnation


Clinical manifestations post-herpetic pain dark or deeper red colour at former site of herpes poor sleep purple tongue with thin white coating wiry and thready pulse. Point selection Geshu BL-17, the head of the snake, the middle of the snake, the tail of the snake Treatment method As above

Case examples
Case 1 Male, 52 years old. He had been experiencing pain around the left abdominal area for five days with corresponding eruptions of vesicles for three days. Some vesicles had eroded and released yellow fluid or pus. Other symptoms included insomnia, red tongue body with yellow coating,

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JOURNAL OF CHINESE MEDICINE NUMBER 64 OCTOBER 2000

and rapid pulse. Using moxa on Neiting ST-44, Sanyinjiao SP-6 , the head of the snake, the middle of the snake, and the tail of the snake, the patient reported a 50% reduction in pain after the first treatment. After three more treatments, the disease was cured. Analysis: The TCM differentiation is Spleen and Stomach damp-heat. Neiting ST-44 is the ying-spring point of the Stomach channel and as such is used to clear fire. Sanyinjiao SP-6 promotes the function of the Spleen, Liver and Kidney and removes damp-heat. Points at the head, middle and tail of the snake have the function of moving blood and eliminating damp-heat. Case 2 Male, 65 years old. He presented with herpes zoster on the left forehead and around the left ear, which had appeared one month ago. After treatment with western medicine and herbs, the lesions had gone, but he still felt great pain and itching in the affected area, which remained very red and inflamed. His eyes were also red and itchy and his sleep was poor. The tongue was pale with a thick-yellow coating. The pulse was thin and wiry. Using the points Xingjian LIV-2, Yanglingquan GB-34, the head of the snake, the middle of the snake and the tail of the snake with moxibustion, all symptoms disappeared after five treatments. Analysis: The TCM differentiation is Liver and Gall Bladder fire blazing with qi and blood stagnation. Yanglingquan GB-34 is the he-sea point of the Gall Bladder channel of foot shaoyang and is used to clear Gall Bladder fire. Xingjian LIV-2 is the ying-spring point of the Liver channel and has the function of clearing Liver fire. Points around the head, middle and tail of the snake have the function of moving blood and eliminating fire from the Liver and Gall Bladder channel to stop pain and itching.

Discussion
In TCM terms, herpes zoster is caused by wind, fire, damp and poison invading the channels and stagnating in the skin. Most cases of herpes zoster have an underlying disorder of the zangfu. Distal points are used for regulating the zangfu, eliminating pathogenic factors and stopping pain. Treatment using points on the snake is likened to securing its tail, chopping off its head and cutting through its body so that the snake dies. Moxibustion has the function of conducting heat and poison out of the body. Biomedically, herpes zoster is caused by the varicella-zoster virus. When a persons immune system is low, the virus is activated. Modern laboratory research has found that moxibustion can promote the bodys constitution, and its specific and non-specific immunity to disease. Moxibustion is an effective treatment for this disease and has the advantage of being inexpensive and easy to perform.
Dr Xuan Lihua is Director of the Acupuncture Department Zhejiang TCM Hospital Hangzhou 310006, China.

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