Damp–heat in the Lung

| January 4, 2012 | 0 Comments | 229 views

There are quite a few differences between wind–heat and damp–heat type eczema. If in doubt about the damp and yin situation in the skin (because that is the basic difference), one can perform a simple test of dermographia on the skin. The test is best done on the ventral side of the forearm. Scratch a long, firm line on the arm with your nail or a blunt instrument. In an allergic person this leaves a raised, red mark. But if the Lung/skin had less yin and Blood, this would leave a unraised white mark.

This second type of eczema is of a typically yin nature, because it stays in a fixed locus and does not change very much. Because the skin changes structure in the affected areas and because it is often on the nape of the neck, popliteal, inguinal and cubital folds, the skin can crack and bleed and be quite painful. Healing is not quick and the clothes stick on to the oozing body fluids from the lesions and it hurts to move.
The following three conditions would fit damp–heat in Lung skin type.

Western medical concept

Seborrhoeic dermatitis can present as ‘cradle cap’ in infants; a more widespread erythematous, scaly rash can be seen over the trunk, especially affecting the nappy area.

In young adults, there could be erythematous scaling along the sides of the nose, in the eyebrows, around the eyes and extending to the scalp, which could show dandruff.
Discoid eczema is a morphological variation of eczema, characterized by well-demarcated scaly patches especially on the limbs, and this can be confused sometimes with psoriasis. It is more common in adults and can occur in both topic and non-topic individuals. It tends to follow an acute/subacute course rather than a chronic pattern. There is often an infective component.
Varicose eczema occurs on the lower legs because of chronic venous hypertension (usually of more than 2 years’ duration). The exact cause remains unknown but it has been suggested that venous hypertension causes endothelial hyperplasia and extravasation of red and white blood cells, which in turn causes infl ammation, purpura and pigmentation.

Explaining the treatment
Unfortunately, true to its yin nature, this type does not respond quickly to acupuncture. The treatment is directed at circulating and eliminating dampness.
Even though the patient is not particularly constipated, the constipation points – St 25, TW 6 and LI 4 – are used along with Sp 9 for diuresis

Table 6.2 Eczema – traditional Chinese medicine view
Damp–heat in Lung Treatment
Thickened, scaly and hyperpigmented
areas of lichenification. It starts with
intense itching that becomes tender with
increased itching and rubbing. Worse in
wet weather, with damp-producing foods
General points: Du 20, Liv 3. Against Bloodheat
and pruritus: Sp 10, UB 17
Becomes worse during pregnancy and
before menstruation. Dairy products
and wet weather also aggravate it.
Melancholic person
Energy balance: LI 4, TW 6, St 25 –
for elimination; St 40, Sp 9 – against
dampness; Lu 5, UB 13 – to descend
dampness and improve skin function
Can suffer with blocked nose or yin
Plum-blossom tapping to bleed on affected
Stools tend to be semisolid Avoid dairy products and refined sugars and
carbohydrates, and cold and raw foods
One session per week for 8 weeks;
one session every 2 weeks for 3 months; can
start a fresh course after 1–2 months’ break
if improvement is good

and St 40 for circulating fluid. These points will reduce the quantity of thick fluids the skin would have to deal with. Points UB 13 and LI 4 also help the skin function of dispersing fluid to the skin surface. Lu 5 descends fluid to the kidneys, thus reducing the stagnation of fluid.

The heat emanates from the stagnant dampness, and will disappear on its own accord if the dampness is removed. However, some superficial treatment for removing heat can be used, and this is plum-blossom tapping on the lesions. The tapping is carried on until there are droplets of blood on the itching areas, and the blood is wiped off. This will cause an improvement in the appearance of the lesions on the very next day after treatment. The areas will look red (not purple) and be much smoother and softer. The patient could take the plum-blossom hammer home, and use it when they feel the need to scratch.

Suggestions for local treatment for both types of dermatitis
■ Dry and itchy palms – point P 8 needled only.
■ Dry and itchy soles – point K 4 with heat-eliminating technique.
■ Dry and itchy knee-fold – points K 10 and UB 40, needled.
■ Dry and itchy elbow-fold – Lu 5 with heat-elimination technique.
■ A red itchy lesion with clear edges on a meridian – place two needles on the meridian, one above and one below the lesion. If there are two meridians flowing through, then unblock both (Figure 6.2).

Fig 6.2 Local treatment of eczema

Fig 6.2 Local treatment of eczema

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