gua sha for exzema morphing into discussion on treating herpes

[Guest guest]

Petra,

 

I'm not familiar with that particular formula, and when I tried to google

it, I wasn't able to locate it. But, as long as it matches the patient's

presentation, I'm sure it's a good choice to try.

 

Is the patient actually presenting with intense irritability, hot

sensations, yellow leukorrhea, or any other sign of damp-heat or liver fire

besides a red tongue? Without a thick yellow coat on the tongue, a rapid

pulse, or sure signs of damp-heat or liver-fire, I'm not sure if you'll get

the results you want with Long Dan Xie Gan Tang, even in an acute outbreak.

It is a very harshly purging formula, and it can weaken the patient -

especially if the patient is already weak (thus leading to a longer

outbreak). Just the very fact that your patient is experiencing chronic

eczema and chronic herpes infection speaks to a very likely element of

vacuity.

 

Herpes takes advantage of weakness in chronic cases (as in, not the inital

infection period), so I've found there's almost always an element of vacuity

in the non-initial outbreaks - that's why it comes up periodically, usually

after a woman's period (she can then present with Blood vacuity) or after a

particularly stressful time (liver qi depression, depressive heat, lv-sp

disharmony, with of course spleen qi vacuity, and often blood vacuity,

perhaps dampness due to sp vacuity, etc etc.) -

 

Also, one must differentiate between the first part of an outbreak (which is

the time heat signs present), and later when/if there are sores, to help the

healing of the sores. First part is more likely to have heat signs, but they

pass rather quickly in most cases, and then, once the sores open, the

patient often needs non-cloying supplements like Huang Qi (which boosts

immune system, supplements Qi and empirically heals sores). This second part

of an acute outbreak is definitely not helped by harsh formulas like Long

Dan Xie Gan Tang.

 

I would say there are three phases to treat an acute outbreak of herpes -

1) Preventing them - coursing Liver Qi, clearing depressive heat,

supplementing Qi and Blood if warranted, managing stress, eating well,

avoiding trigger foods. High lysine, low arginine diet, etc. Aggressive

immune system boosting if an outbreak is iminent - (that sixth sense

patients have)

 

2) Clearing heat, coursing Liver Qi, possibly draining dampness during the

first day or two of an outbreak if the patient presents with damp and/or

heat signs (The time for Long Dan Xie Gan Tang if patient presents with

LDXGT patterns - otherwise a modified formula appropriate for the presenting

pattern)

 

3) As soon as heat is cleared and dampness drained (if there were those

signs to begin with), supplement Qi (along with any other pattern patient

presents), heal sores.

 

If you catch it appropriately at either stage 1 or 2 above, you can often

prevent an outbreak of sores. I find Huang Qi hugely helpful - also Maitake

and Shitake - immune system boosters coupled with treating the presenting

pattern. Teaching the patient to monitor their own body and watch for these

phases is also hugely helpful - as is keeping them well-stocked with

formulas/strategies to treat each phase, once you are able to figure out

their particular multi-phasic pattern.

 

The patient is certainly exacerbating their condition with the wine and

coffee, but I urge you to look for Blood and/or Qi vacuity, and/or Liver

depressive heat - especially with the chronic eczema, I would at least

suspect the Blood.

 

Is the eczema at all correlated with the herpes outbreaks? Do they get worse

at the same time?

 

I had no idea I had so much to say on this topic!

:>

Kind Regards,

Nadia Haddad, MS, L.Ac

 

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