Rash Case

[Guest guest]

Hi all, I thought I'd update you on a difficult case I posted on a half year

back or so:

 

Caucasian male, 55, owns a greenhouse / plant-growing business with family and

works in the greenhouse all year long.

 

Rash

In the summer of 2006 he developed a rash on the posterior aspect of his upper

arms, along the TB channel. It spread from there to the rest of his body, the

worst areas being arms, back, chest, neck and legs, in that order. The rash was

red, raised, but not sharply defined. There was no exudate from the rash itself

or flaking of the skin. Chrysanthemum flower " aggravated it " , as did heat,

overwork, and emotional stress. The rash was very very itchy and occurred daily,

usually beginning around midday (as he slowly became tired) and becoming worse

as the day wore on, with a period starting at about 8pm being the worst. This

was a constant pattern with no let up except for the cream mentioned below. The

itching disturbed his sleep to a high degree.

 

Phlegm

His skin, in general, had a very greasy exudate. This oil was so greasy that it

soaked through the paper I use and onto the table, and I have not been able to

fully clean the table of the stain since!

His tongue was pale with a medium-thick greasy white / slight yellowish

coating. The tongue body was a little small, pale pink, with scalloping. Gloss

was low.

He has a large phlegm nodule (1.5 cm in diameter and about 1 cm tall) at the

left K22 position. It is slightly movable and tender only when it gets inflamed.

It generally has a light red colour to it and has been present for several

years.

I don't have his file here so I forget what his pulses were like. If I remember

correctly, they were all deficient. His voice was quiet, and he didn't speak

much. He is strongly built but would slouch in his chair.

 

Treatments

He had undergone varying " natural " treatments and had only experienced relief

with a strong prescription cortisone cream which he used sparingly, as

necessary.

 

My initial diagnosis was Sp Qi deficiency with phlegm accumulation, but I felt

that pursuing this would take too long and that I would lose the patient.

Therefore my treatment initially was to clear toxic heat using Yin Qiao. He

experienced substantial relief but we hit a ceiling as my treatment met his

phlegm problem. After a lot of ups and downs trying to force a resolution (as

well as treating the phlegm in the meantime), he saw enough improvement (about

25%) and pattern in the situation to begin to understand my point of view. At

this point we both decided it was ok to settle down and just boost the spleen

and resolve phlegm. I prescribed variations on Xiang Sha Liu Jun with partial

additions of Fang Feng Tong Shen using the instant granule teas, and we kept

that up for several months. I also asked him to change his diet significantly.

 

Now, nine months later, his skin has no greasy exudate, the itching appears

once a month for two days or so, its intensity is a third of what it used to be,

and it is localised to the initial sites at the backs of the arms, as well as a

little of the upper back. The rash is barely visible as small pale bumps on the

rear of the arm. He can now spend a whole day in a humid environment + exposure

to Chrysanthemums without any problem. The real turning point for him came

during the heat of July. At that point he felt he could make a realistic

comparison between the previous summer and this summer. He felt he was about

half improved.

 

This case was very difficult for me because of the length of time. I find it

hard to justify a year of treatment for a rash that was only six months old. Of

course, the foundation for the rash, the phlegm was there for years beforehand

as the greasiness of the skin and phelgm nodule can attest to. Anyone want to

comment on flaws / inadequacies of care? Luckily this was not an expensive

venture for him.

 

Hugo

 

 

 

 

 

_________

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[Guest guest]

I think in difficult diseases, many times the patient's lifestyle, nutrition

and exercise play a huge factor.

 

Ayurveda spends a lot of time detoxing and if we look at older herbal texts,

we see that at one time the Chinese did use and initial detoxing method. If

you factor in poor eating habits, lack of execise, carrying around fat,

pollution in the environment and not detoxing by eating enough bitter green

vegetables and reducing meat and additives and preservatives in food.

 

I would have put a patient on a special diet, suggest he do a sauna or

massage and increase exercise, and then bloodlet St 36 and 40, and perhaps

some Ying Spring points, use a combination of herbal purgatives and

digestives, Pu Ji Xiao Du Yin and perhaps San Huang Pian. Your use of Xiang

Sha Liu Jun Zi Tang was great, as it was geared for the root. Fang feng

Tong Sheng could do the job, but needs an assist with diet.

 

You may have cut the treatment time in half. I also think that all

difficult cases have phlegm and blood stasis, hence the bloodletting to

clear heat.

 

Best regards,

 

 

 

On 10/16/07, Hugo Ramiro <subincor wrote:

>

> Hi all, I thought I'd update you on a difficult case I posted on a half

> year back or so:

>

> Caucasian male, 55, owns a greenhouse / plant-growing business with family

> and works in the greenhouse all year long.

>

> Rash

> In the summer of 2006 he developed a rash on the posterior aspect of his

> upper arms, along the TB channel. It spread from there to the rest of his

> body, the worst areas being arms, back, chest, neck and legs, in that order.

> The rash was red, raised, but not sharply defined. There was no exudate from

> the rash itself or flaking of the skin. Chrysanthemum flower " aggravated

> it " , as did heat, overwork, and emotional stress. The rash was very very

> itchy and occurred daily, usually beginning around midday (as he slowly

> became tired) and becoming worse as the day wore on, with a period starting

> at about 8pm being the worst. This was a constant pattern with no let up

> except for the cream mentioned below. The itching disturbed his sleep to a

> high degree.

>

> Phlegm

> His skin, in general, had a very greasy exudate. This oil was so greasy

> that it soaked through the paper I use and onto the table, and I have not

> been able to fully clean the table of the stain since!

> His tongue was pale with a medium-thick greasy white / slight yellowish

> coating. The tongue body was a little small, pale pink, with scalloping.

> Gloss was low.

> He has a large phlegm nodule (1.5 cm in diameter and about 1 cm tall) at

> the left K22 position. It is slightly movable and tender only when it gets

> inflamed. It generally has a light red colour to it and has been present for

> several years.

> I don't have his file here so I forget what his pulses were like. If I

> remember correctly, they were all deficient. His voice was quiet, and he

> didn't speak much. He is strongly built but would slouch in his chair.

>

> Treatments

> He had undergone varying " natural " treatments and had only experienced

> relief with a strong prescription cortisone cream which he used sparingly,

> as necessary.

>

> My initial diagnosis was Sp Qi deficiency with phlegm accumulation, but I

> felt that pursuing this would take too long and that I would lose the

> patient. Therefore my treatment initially was to clear toxic heat using Yin

> Qiao. He experienced substantial relief but we hit a ceiling as my treatment

> met his phlegm problem. After a lot of ups and downs trying to force a

> resolution (as well as treating the phlegm in the meantime), he saw enough

> improvement (about 25%) and pattern in the situation to begin to understand

> my point of view. At this point we both decided it was ok to settle down and

> just boost the spleen and resolve phlegm. I prescribed variations on Xiang

> Sha Liu Jun with partial additions of Fang Feng Tong Shen using the instant

> granule teas, and we kept that up for several months. I also asked him to

> change his diet significantly.

>

> Now, nine months later, his skin has no greasy exudate, the itching

> appears once a month for two days or so, its intensity is a third of what it

> used to be, and it is localised to the initial sites at the backs of the

> arms, as well as a little of the upper back. The rash is barely visible as

> small pale bumps on the rear of the arm. He can now spend a whole day in a

> humid environment + exposure to Chrysanthemums without any problem. The real

> turning point for him came during the heat of July. At that point he felt he

> could make a realistic comparison between the previous summer and this

> summer. He felt he was about half improved.

>

> This case was very difficult for me because of the length of time. I find

> it hard to justify a year of treatment for a rash that was only six months

> old. Of course, the foundation for the rash, the phlegm was there for years

> beforehand as the greasiness of the skin and phelgm nodule can attest to.

> Anyone want to comment on flaws / inadequacies of care? Luckily this was not

> an expensive venture for him.

>

> Hugo

>

>

> ________

> Want ideas for reducing your carbon footprint? Visit For Good

> http://uk.promotions./forgood/environment.html

>

>

[Guest guest]

Hugo,

Rash was my problem. I had this problem for more than 18 years.

I sought for all kinds of help and treatments, from WM to TCM and

to voodoo, nothing helped. When did it begin I did not recall. But

the worse case, the rash appeared everywhere from genitalia to

forehead, big goosebmups, very itchy I must cut classes almost all the

times.

I had skin cultured and treatments for 3 years- 3 days/wk for 6

wks,then 1/month, during the treatments I found relief, but after

awhile I stopped -too much time consuming and no sure hope, the rashes

began to reappear. I was allergic with pollens and dust by WM

diagnosis. In school of TCM, all my friends still remember the rashes

I had until today. I had daily treatments with acupuncture and herbs

for at least 8 months, it cost a fortune, but no relief. Other

treatments from TCM and herbal stores from China Town, some got better

the first few days, after that it getting worse as a broken damp. All

treatments were aimed at wind-damp heat, wind heat toxin...All those

stupid TCM killed me, not changing their attitudes their treatment

plans!!! Some of those are my wellknown and well respected TCM-

wellknown professors. I returned to take antihistamine for relief but

found it too drownsy, very dangerous for driving or working. Finally,

I had treated myself with the help of a TCM monk in the same TCM

class. He seemed very knowlegable. I asked him to help me to correct

my analysis my condition.

I told him my rashes begin to get worse in the morning. I think it

" Yang problem or Qi problem ? " I think it was more Qi deficiency

because more Yang must be close to noon ? At night it got worse and

worse " yin problem or Blood ? " I think it was blood not Yin because

YIn must be close to midnight ?...... In this case, I asked " Was this

the problem of Qi and Blood ? the nourishment, the Postnatal Qi was

disharmony? " In this case, Why were all of herbalists and TCMs told

me that I have had blood toxin, heat toxin, dampheat, wind heat...?

Can I take Ba Zhen Wan ? The monk told me " They do not know what

they were doing! "

Back to the case : I was robust, no sign of headache nor any

other signs, except the rashes. Several times I was hospitalized by it

broke-out-by the further damaged of Qi and Blood??? Who knows??? It

was so severe that I thought I could die of it. Everyone of my family

was so frightened.

The case you had was identical to mine, but not severe. But you

saw it as a SP xu and phlegm... You may be right, but it seems odd.

There was no signs of SP and no sign of xu, furthermore, no sign of

phlegm... Greasy skin : greasy means wet, does it mean damp instead of

phlegm? I think phlegm must be thick or drier, beside, phlegm usually

accompanies by dizziness. However, damp and phlegm are not diseases

nor illnesses, they are results, I think. I do not know how you had

hit the jackpot, but the rash was improved. That counts!!!!!!

The monk assured me " If your diagnosis is correct, the rash will

go away in 30 minutes. No other words of reasoning. " . I asked him

again " If this does not work, should I take Liu Wei Di Huang instead?

" . " Perfect! This is what I wanted to hear. " He replied.

Instead of taking Ba Zhen Wan for Qi and Blood, aiming at Qi was

my favorite, I aimed at Yin-Yang for a aevere chronic of 18 years, "

Liw Wei Di Huang Wan " ......... He added " Must take it with salt "

This I would never forget. At the time I took Liu Wei Di Huang Wan, my

rashes were broken out severely I thought I had to cut classes again.

After 10 minutes, they subsided, 15 minutes was almost gone, 30

minutes later none was on my skin... For more than 13 years, the

rashes returned once or twice. I took Ba Zhen Wan,they disappeared in

10 minutes and not returned for at least 3 years from now.... I was

greatful and thanked the monk, my classmate. The first time in my life

I could see that amazing fact as he predicted.

CONCLUSION : Sometimes we must analyze our problems in a different

angels, do not follow the death of wind-damp heat, heat toxin for

itchy. We must see the entire view with the root too. We all make

mistakes looking at the rashes-the outburst- itching condition to

render a conclusion and forget all what we want to see. Our minds were

blocked and obssessed with visual things.

Your case, Hugo, seems to me as the disharmony of Qi and Blood,

for I have not seen any deficiency. With this harmony, the blood goes

into confusion, chemical imbalances and its disturbancy cause it to

produce unwanted reaction " rashes -malnutrition " . If this is

correct, again the rashes disappears in minutes. I had seen cases of

severe acnes gone in minutes by herbal formulas. The success or

failure is based on our clear and open mind vision not from old

formulas, nor from inflexible diagnosis, nor from our narrow view.

 

GOOD LUCK, HUGO.......... Whatever you had done, you succeeded and hit

the jackpot. There are many ways leading to Rome!

 

Nam Nguyen

[Guest guest]

Robert, Hugo,

I forgot to mention. for the rashes I was on a very strict diet for

months as TCMs and WM recommended, went swimming in the beach, took

honeycomb... Not only those, I even fasted for 3 days, water only, but

nothing changed.

I did not have to relocate, nor exercise. The best result was the

correct diagnosis and correct herbs applied in timely manner.

I wish all of us TCM would learn something new from this for I had

gone through a very struggling battle.

 

Thanks both of you.

 

Nam Nguyen

[Guest guest]

Nam,

 

Using Ba Zhen Tang would help blood heat case with blood deficiency and

stasis. Good use of a common Rx. Often use it for Raynauld's Phenomenon.

Agree 100% if you get the right diagnosis and right Rx, it can work

immediately!

 

Recently had food poisoning, complicated with a secondary tonsillitis. I

did not have Qi to use cold herbs. I had to tx my spleen and clear

dampness, then use cold herbs. But here in the USA, there are more excess

cases than deficiency.

 

Best regards,

 

 

On 10/16/07, dr_namnguyen58 <dr_namnguyen58 wrote:

>

> Robert, Hugo,

> I forgot to mention. for the rashes I was on a very strict diet for

> months as TCMs and WM recommended, went swimming in the beach, took

> honeycomb... Not only those, I even fasted for 3 days, water only, but

> nothing changed.

> I did not have to relocate, nor exercise. The best result was the

> correct diagnosis and correct herbs applied in timely manner.

> I wish all of us TCM would learn something new from this for I had

> gone through a very struggling battle.

>

> Thanks both of you.

>

> Nam Nguyen

>

>

>

 

 

 

--

Robert Chu, PhD, L.Ac. QME

chusauli

 

See my webpages at: www.chusaulei.com