Xu, female, 45, first visit was on July 1948

[Chief Complaint]

Redness, swelling and pain of the right leg and foot for three days

[Present Medical History]

Her right leg and foot was red and swollen with a hot sensation and severe pain.

[Examination]

The tongue coating was normal, the pulse soft and rapid

[Diagnosis]

Flowing fire (Liú Huŏ) (due to accumulated heat transformed into fire)

[Treatment Principles]

Clear heat, remove toxins

[Treatment]

Lifting-thrusting draining method was applied. BL 40 (wĕi zhōng) was bled. The pain was relieved after the first treatment. Seven treatments cured her.

[Note]

Erysipelas is caused by an accumulation of heat that transforms into fire that then flows into the leg. This kind of swelling and pain, which is due
to an obstruction of the channels, should be treated by removing toxic heat from the affected area; treat by using distal points of the affected channels. Bleeding BL 40 (wĕi zhōng) removes toxic heat from the blood of the lower extremities.

Tian, female, 22, first visit was on January 20, 1961.

[Chief Complaint]

Swelling and redness at the tip of the right middle finger

[Present Medical History]

Yesterday in the evening the patient noticed that there was swelling and
redness near the nail. The following morning it was worse as the colour changed from fresh red to blue purple and had a white pus filled top. Pain radiated down the medial side of forearm to the elbow; the pain was unendurable. She had chills and nausea.

[Examination]

Clear consciousness, sallow complexion, normal voice and respiration, thin white tongue coating, thready rapid pulse.

[Diagnosis]

Nail-like boil (Dīng Dú)

[Treatment]

The tonifying method using the rotating method caused the pain to stop immediately. A sharp round needle (Yuán Lì Zhēn ) was used to prick along the red line of inflammation up to the boil, the pain was relieved. The nausea and chills stopped as well.

On January 26, she came again and was cured.

[Note]

The boil at the tip of middle finger involved the pericardium channel. PC 1 (tiān chí) of the affected side was selected based on the head-tail treatment principle. Her pulse was thready rapid due to deficient heat, so a tonifying needling method was used.

Li, female, 40, first visit was on October 9, 1972

[Chief Complaint]

Numbness of the left palm for half a day

[Present Medical History]

This morning the patient felt numbness and pain of her left hand, chills, irritability and nausea.

[Examination]

Pale complexion, emaciation, and swelling of the left hand around HT 8 (shào fŭ) with a dull sensation, no change in skin colour. Red tongue, yellow coating, thready rapid pulse.

[Diagnosis]

Nail-like boil (Dīng Dú)

[Treatment]

Reinforcing method. The needle was retained for two minutes.

Her pain, cold feeling in the body and nausea disappeared. She said she felt very comfortable after needling.

[Note]

The boil in the region of HT 8 (shào fŭ), and the pulse and symptoms are the signs of deficiency heat of the heart channel. The head-tail method of selecting point, HT 1 (jí quán) of the affected channel, is adopted. Reinforcing method of needling is employed.

Yi, 60, first visit was on August 23, 1984

[Chief Complaint]

Tinea with itching at the neck and palms for two years

[Present Medical History]

Two years ago the patient began to have tinea with itching at the palms, afterwards the nape and elbows became involved. The patient was diagnosed with neurodermatitis and treated with various therapies, but the itching was not relieved. He could not sleep at night because of the itching.

[Examination]

The skin of the dorsum of the hands and elbows was rough like cowskin; red tongue, white coating, wiry pulse

[Diagnosis]

Psoriasis (due to wind heat damp retention, disharmony between qi and blood)

[Treatment Principles]

Dispel wind, transform damp, clear heat, moisten dryness

[Treatment]

A plum-blossom needle was used to tap the nape, elbow and dorsum of the hands.

Draining method.

[Note]

Due to congenital deficiency and invasion of wind damp heat the channels have become blocked. GB 20 (fēng chí) is treated to dispel the wind. LI 11 (qū chí) and LI 4 (hé gŭ), the hé-sea and yuán – source of the large intestine channel of the hand yangming, clear damp heat in the skin, stop itching, and transform the damp heat. Bā xié (EX-UE9) dispels wind, activates channels and stop itching. SJ 5 (wài guān) clears heat and removes obstructions from the channels. SP 10 (xuè hăi) nourishes blood to moisten dryness. SP 6 (sān yīn jiāo) and SP 9 (yīn líng quán) dispel dampness and promote diuresis. “All pain, itching and ulcerations are related to the heart.” Drain PC 4 (xì mén) and PC 8 (láo gōng) to settle the heart, calm the mind, and clear the ying – nutritive to stop itching. Using the plum-blossom hammer to treat the nape, elbow and dorsum of hands removes wind toxins from the skin and muscles.

Qiu, female, 30, first visit was on September 3, 1993

[Chief Complaint]

The nape of her neck and the left elbow had thickened skin with serious itching for three months.

[Present Medical History]

The patient began to have a thickening of the skin with serious itching at the nape and elbow in the past three months. She tried many kinds of treatment, but all to no effect.

[Examination]

The skin of the nape in an area 4 cm × 8 cm and the left cubital fossa in an
area 3 cm × 5 cm became thick, dry and chapped, and with serious itching. It was made worse by warmth, and a pink granule-like fluid came out after scratching.

[Diagnosis]

Psoriasis (due to blood deficiency, wind dryness)

[Treatment Principles]

Nourish blood, activate blood, dispel wind, moisten dryness

[Treatment]

The affected areas were tapped with a plum blossom hammer till a little blood leaked out. Cotton moxibustion was applied in this way: A thin layer of cotton was placed on the affected area and ignited. This moxibustion treatment was repeated five times. Treatment was given once every three days.

After one treatment, the itching was greatly relieved. After treatments the itching was almost resolved and the skin in the affected area began to thin. After ten treatments the skin became smooth; nearly normal.

[Note]

According to Professor Yang Jie-bin, in prolonged stubborn tinea diseases, phlegm damp and blood stasis are retained in the channels and collaterals. Causing a ying – nutritive and wei – defensive imbalance in an already weak constitution. This manifests as blood deficiency and wind dryness. Bleeding is an important aspect of treatment as it removes stasis and allows for new blood production. Cotton moxibustion is also used to improve the curative effect. At the beginning of disease, wind damp heat reside in, and obstruct the flow of qi and blood in the skin. Later there will be blood deficiency and wind dryness, which causes itching and thickening, as the skin is deprived of nourishment. Tapping with the plum blossom hammer regulates and invigorates the blood; cotton moxibustion dispel winds and harmonizes the ying – nutritive and wei – defensive. In this way, the blood is invigorated and the wind is eliminated, so the itching stops.