JOURNAL OF CHINESE MEDICINE NUMBER 74 FEBRUARY 2004

THE TREATMENT OF A SINGLE

CASE OF ABSCESS BY CHINESE
HERBAL MEDICINE
by Ioannis Solos, Fan Yi Meng & Ming Zhao Cheng
Introduction
Most English language textbooks on traditional Chinese
medicine fail to discuss abscesses, perhaps because they are
frequently treated successfully with antibiotics, and as a
result there is a limited number of patients coming to the
clinic with abscesses. This paper discusses a single case of
abscess, discussing the pattern differentiation and providing a few formulas that can be useful for this condition.
Patient record
Age: 35
Sex: female
Main Complaint: Abscesses under both armpits for 2 years.
Past history: No major medical problems, apart from serious
acne when she was a teenager from which she still carries
the scars. At that time she had received Western medicine
treatment that cured the problem.
Present history: Two years before the initial consultation the
patient had a years contract with a French company, and
she relocated to Paris for one year. During that year she had
to live in a very humid apartment. About 6 months after she
moved to Paris, she noticed a few spots under both of her
armpits that gradually got worse over a period of 18 months.
She has no other health related problems.
Patients lifestyle and diet: The patient is a smoker and takes
alcoholic drinks on a regular basis. Her diet consists of
greasy and rich foods and she has her meals at irregular
times. She has followed this lifestyle for most of her life.
1st Consultation ( 22/8/02): The armpit on each side had 5-10
abscesses, 3-4 of which were very deep and had developed
a tube (canal) penetrating inside. If the area was squeezed,
a white odourless liquid was expressed. The abscesses were
about 1.5cm in diameter, and purple red in colour. They
were hard but there was no pain when they were pressed.
From examination it was determined that the lymph nodes
were not swollen.
Tongue picture: Red tongue body, dry and with red spots.
The coating was yellow and thick.
Pulse: slippery.
Chinese medicine diagnosis: Abscesses.
Pattern differentiation: Heat toxin in the interior and damp
heat in the middle-jiao.

Treatment principle: Clear interior heat toxin and middlejiao damp-heat.

Patent medicine prescription: Pi Fu Bing Xue Du Wan (Pill for
Skin Conditions due to Heat-Toxin in Blood) and Qing Bu
Wan (Heat-Clearing and Yin-Reinforcing Pill).
Herbal Prescription for Wash
Long Dan Cao (Radix Gentianae Scabrae) 10
Zi Cao (Radix Lithospermi seu Arnebiae) 10
Huang Bai (Cortex Phellodendri) 10
Pu Gong Ying (Herba Taraxaci Mongolici cum Radice) 10
Zi Hua Di Ding (Herba Violae cum Radice) 10
Ku Shen (Radix Sophorae Flavescentis) 10
She Chuang Zi (Fructus Cnidii Monnieri) 10
Cang Zhu (Rhizoma Atractylodis) 10
Bai Bu (Radix Stemonae) 10
8 bags
2nd Consultation (16/10/02): After treatment the patient felt
much better. The old spots were much smaller than when
she first came, but also there were 2-3 new spots (not
abscesses). The tablets and herbal prescription were repeated.
3rd Consultation (28/11/02): In the right armpit there were
only 4 abscesses remaining, and in the left armpit there were
2 new spots (not abscesses) and the old spots were gone. The
pulse and tongue were unchanged. The tablets and herbal
prescription were repeated.
4th Consultation (15/1/2003): In the right armpit there were no
new spots, and in the left armpit there were two spots
without canals or white liquid.
Her pulse was now thready and slippery and her tongue
body was red and dry with a scanty yellow coating.
Patent medicine prescription: Pi Fu Bing Xue Du Wan x 6
bottles.
No herbs for washing were prescribed this time.
Discussion
The patients living environment, as well as her diet and
lifestyle seem to have played an important role in the
pathogenesis of her disease. Internally the greasy food and
externally the dampness in the house she lived in seem to
have contributed to the accumulation of damp-heat in the
Spleen. According to Chinese medicine theory, when dampheat stagnates in the middle jiao and obstructs the Stomach

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JOURNAL OF CHINESE MEDICINE NUMBER 74 FEBRUARY 2004

and Spleen, it can easily affect the Liver and Gall Bladder,
which in turn develop damp-heat.
The Neijing (Yellow Emperors Inner Classic), states that
rich and greasy foods generate huge carbuncles. Chinese
medicine theory also states that rich and greasy foods can
cause Spleen and Stomach dysfunction and generate dampheat and heat-toxin.
In terms of Chinese medicine diagnosis, the main symptom of heat-toxin, or fire-toxin (huo du)1 is carbuncles with
symptoms of heat. The explanation is that the fire-heat evil
accumulates in the muscles and results in carbuncles.
The red tongue body with thick yellow coating and the
slippery pulse reflect the presence both of heat signs and
dampness.
Explanation of herbal treatment
The loose herbs prescribed as a herbal wash treat skin
conditions deriving from damp-heat or heat-toxin.
Long Dan Cao (Radix Gentianae Scabrae): When used
externally it can treat skin disease due to damp-heat. It is
also commonly used externally for various skin diseases
such as tinea and genital pruritus. It is frequently combined
with Ku Shen for external use.
Ku Shen (Radix Sophorae Flavescentis): Externally it is
used to reduce inflammation and stop pain and itching. It is
commonly combined with Long Dan Cao
Huang Bai (Cortex Phellodendri): drains fire and relieves
toxicity and is used for fire toxin generated sores and damp
lesions of the skin.
Pu Gong Ying (Herba Taraxaci Mongolici cum Radice)2 :
reduces abscesses and dissipates nodules. It is used for
abscesses and sores, especially if they are firm and hard.
Zi Hua Di Ding (Herba Violae cum Radice): clears heat
and toxicity, hot sores and abscesses. Externally it clears
fire-toxin and can be combined with Pu Gong Ying for
mutual enhancement of their functions.
She Chuang Zi (Fructus Cnidii Monnieri): this belongs to
the category of herbs for external application. Although it
can be used internally (to strengthen the Kidney yang), it is
most often used externally to dry dampness, kill parasites
and stop itching. It can be combined with Ku Shen and Bai
Bu as in this formula, to mutual strengthen their
effectiveness.
Bai Bu (Radix Stemonae): is combined with Ku Shen and
She Chuang Zi to strengthen their effects.
Zi Cao (Radix Lithospermi seu Arnebiae): clears damp
heat from the skin, when it is usually combined with Huang
Bai.
Cang Zhu (Rhizoma Atractylodis): dries dampness.
The clinical value of this prescription has been proved
from the therapeutic outcome.
Pi Fu Bing Xue Du Wan
This is a modern formula, commonly used for eczema and
various skin diseases. The composition of this formula is
ambiguous, because each company that prepares it provides a different list of herbs on its package. The most
reliable composition, taken from the Practical Manual of

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Ready Made Chinese Medicines published by the Peoples Health Publishing House, is as follows:
Qian Cao Gen (Radix Rubiae Cordifoliae), Tao Ren (Semen
Persicae), Jing Jie Sui (Herba seu Flos Schizonepetae
Tenuifoliae), She Tui (Exuviae Serpentis), Chi Shao (Radix
Paeoniae Rubrae), Dang Gui (Radix Angelicae Sinensis)
Bai Mao Gen (Rhizoma Imperatae Cylindricae), Di Fu Zi
(Fructus Kochiae Scopariae), Cang Er Zi (Fructus Xanthii),
Hong Hua (Flos Carthami Tinctorii), Sheng Di Huang
(Radix Rehmanniae Glutinosae), Di Ding (Herba cum
RadiceViolae Yedoensitis), Tu Fu Ling (Sclerotium Poriae
Cocos), Huang Bai (Cortex Phellodendri), Jin Yin Hua (Flos
Lonicerae Japonicae), Zao Jiao Ci (Spina Gleditsiae Sinensis),
Chi Fu Ling (Sclerotium Poriae Cocos Rubrae), Chan Tui
(Periostracum Cicadae), Tian Kui Zi (Semiaquilegia
adoxoides Makino), Xi Jing Pi (Cercis chinensis Bge. or
Cercis yunanwsis Hu), Tu Bei Mu (Bolbostemma
paniculatum Franquet), Da Huang (Rhizoma Rhei).
A good way to ensure good quality pills is to administer
a made to order Pi Fu Bing Xue Du Wan, based on the above
recipe, taking into account the individual pattern differentiation. Alternatively concentrated powders may be used.
In addition a second formula (Chu You Tang) can be used
instead of Pi Fu Bing Xue Du Wan.
Chu You Tang
The formula Chu You Tang comes from the Journal of
Traditional Chinese Medicine, published in Beijing and is
also cited in the Development of Formulas of Chinese Medicine
published by the Hua Xia Publishing House. It is composed
of: Yi Yi Ren (Semen Coicis Lachryma-jobi) 30, Da Qing Ye
(Folium Daqingye) 30, Ban Lan Gen (Radix Isatidis seu
Baphicacanthi) 30, Bai Jiang Cao (Herba cum Radice
Patriniae) 15, Mu Li Fen (Concha Ostreae) 30, Xia Ku Cao
(Spica Prunellae Vulgaris) 15, Chi Shao Yao (Radix Paeoniae
Rubrae) 10.
Qing Bu Wan is prescribed instead of Long Dan Xie Gan
Tang (Gentiana Longdancao Decoction to Drain the Liver)
since the latter contains Mu Tong (Caulis Mutong) which is
banned from use as a medicinal substance, but theoretically
it would have been more appropriate in this case in order to
clear damp heat from the lower jiao and heat from the Liver
and Gallbladder. The main ingredients of Qing Bu Wan are
Zhi Mu (Radix Anemarrhenae Asphodeloidis), Huang Bai
(Cortex Phellodendri), Sheng Di Huang (Radix Rehmanniae
Glutinosae), Xuan Shen (Radix Scrophulariae Ningpoensis),
Che Qian Zi (Semen Plantaginis), Qin Pi (Cortex Fraxini)
and Shi Hu (Herba Dendrobii).

Bibliography
Liu Gongwan, 2002, Development of Formulas of Chinese Medicine.
Hua Xia Publishing House
Liu Gongwan, 2000, Chinese Herbal Medicine. Hua Xia Publishing
House.
Long Zhixian, 2000, Traditional Chinese Internal Medicine. Academy
Press, Beijing.
Xu Xiang Cai, 1998, Complete External Therapies of Chinese Drugs.
Foreign Languages Press, Beijing

JOURNAL OF CHINESE MEDICINE NUMBER 74 FEBRUARY 2004

Yu Chang Fang, 1999, Practical Manual of Ready Made Chinese Medicines. 3rd Edition, Peoples Health Publishing House, Beijing.

Notes
1

Heat toxin is a more appropriate name because fire toxin

tends to be due to internal causes, whilst heat toxin can be the
outcome both of internal and external factors. In this case it is
not clear whether the disease is the outcome of purely internal,
or the combination of internal and external factors. For this
reason it is more appropriate to call it heat toxin.

Pu Gong Ying (Herba Taraxaci Mongolici cum Radice) is also

combined with Mo Yao (Myrrha) and Zhe Bei Mu Bulbus
Fritillariae) for carbuncles, breast abscesses etc.

Ioannis Solos graduated from Middlesex University in 2003 with a

degree in Chinese Medicine and is currently studying for his Masters
Degree at the Beijing University of Traditional Chinese Medicine and
Pharmacology, Diagnostics Department. Correspondence:
astrapoyiannos@hotmail.com
Dr. Fanyi Meng received his Medical Degree in Beijing in 1983. He
was Associate Professor at Beijing University of Traditional Chinese
Medicine and Pharmacology and is currently principal clinical supervisor at the Chinese Medicine programme of Middlesex University.
Correspondence: fanyimeng@aol.com
Dr. Ming Zhao Cheng is a senior lecturer and programme leader of the
traditional Chinese medicine course at Middlesex University. He
graduated from Guangzhou University of Traditional Chinese Medicine in 1983 and was awarded his PhD in medicine from the University
of London in 1995. Correspondence: m.cheng@mdx.ac.uk

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