JOURNAL OF CHINESE MEDICINE NUMBER 52 SEPTEMBER 1996

The Clinical Effect of Bloodletting Therapy in the Treatment of Herpes Zoster

by Li Weihong

he author has treated 38 cases of herpes zoster with bloodletting therapy; all were cured. In this paper, the therapeutic method, effects and typical cases are reported. Herpes zoster, which is called chanyao huodan, chan yaolong or she chuanchuang in TCM, is an acute herpetic dermatosis caused by viral infection. It is characterised by clusters of vesicles in the shape of a belt along one side of the body, accompanied by neuralgia. It occurs mostly in the waist, cheek, back and four limbs. The author has achieved marked results in the treatment of herpes zoster by bloodletting therapy. The following is an account of the treatment of 38 patients.

Tongue: yellow and greasy coating Pulse: slippery iii. Qi and blood stasis: 2 cases were categorised as this type: the herpes fade or partly fade but pain remains pain is fairly severe Tongue: dark body with purple spots Pulse: wiry and thready.

Therapeutic Method
1. Local bloodletting: prick the top of the leading herpes and the red streaks where the herpes extend with a no. 26 filiform needle or three-edged needle, and apply cups over the area to encourage bloodletting. 2. Ear-tip bloodletting: prick the ear tip 3 or 4 times and squeeze with the fingers to induce bleeding. 3. Point bloodletting: Shaoshang LU-11 is bled for herpes above the waist and Yinbai SP-1 for herpes below the waist. 4. Acupuncture to the local area is added if the patient is still in pain after the herpes has faded.

General
Of the 38 cases, the youngest was 13 years old and the oldest 80 years old, with an average age of 25.62 years. 4 cases suffered from herpes zoster at the waist, 20 on the chest, 7 on the back, 6 on the four limbs and one in the head and face.

Differentiation
i. Shi-heat type: 21 cases were categorised as this type, which mainly results from excessive heat of the Liver, Heart and Gallbladder. In the early stage, there are clusters of small red herpes and radial red streaks are visible on the edges of the leading ones. The main symptoms are: local pain severe itching thirst with desire to drink constipation Tongue: yellow coating Pulse: wiry and rapid. ii. Stomach and Spleen damp-heat type: 15 cases were categorised as this type. The herpes are similar in appearance to the first type, and the differences manifest by: more fluid discharge from the blisters less pain severe itching thirst but no desire to drink poor appetite abdominal distension after food loose stool

Results
1. Criteria of therapeutic effects: Cured: the lesions fade and there is no pain. Improved: the lesions fade but the patient still feels slight pain. Ineffective: the lesions do not fade and the pain is not alleviated. 2. Results Of the 38 cases, all were cured, with between one and three treatments.

Typical Cases
1. Mr Zhang, a 55 year old worker from Sichuan province. He complained of severe pain from herpes zoster in his chest and back which had kept him awake for 10 days. He had taken some western anti-viral medicine, but it had only helped a little. Physical examination revealed three patches (3cm x 4cm) of herpes zoster on the chest and four (7cm x 7cm) on the back which were purple-red in colour. He was treated by the three bloodletting methods described above. After only the first treatment the herpes faded, and after three further treatments the pain disappeared.

JOURNAL OF CHINESE MEDICINE NUMBER 52 SEPTEMBER 1996

2. Mr Zhao, 64 years old. On the third day after the onset of the disease, he complained of unbearable pain and freshred herpes in the right side of the chest and back. Physical examination revealed four patches (4cm x 5cm) of herpes on the right chest and back. His herpes faded after the first bloodletting treatment and the pain was alleviated after the second treatment. He was fine at a one month follow-up.

Europe and Asia and without doubt constitutes one of the most interesting books that classical antiquity has transmitted to us. It is the first attempt to put external causes in direct connection with the origin of diseases, but also with the constitution of man and with the ethnic characteristics of nations. quoted in
2 The Apothecary in Eighteenth-Century Williamsburg,

Experience
Herpes zoster generally occurs in patients with poor organic resistance and low immunity. According to TCM theory, it is caused by invasion and accumulation of intense Liverfire, internal damp-heat or exogenous pathogens, which block the flow of qi and blood in the channels. Bloodletting therapy, which is described in the Ling Shu and Su Wen can eliminate blood stasis and pathogenic heat from the body, regulate the flow of qi and blood and dredge the channels. That is why it is believed to have ideal effects in the treatment of herpes zoster, causing both the herpes and the pain to disappear quickly. Furthermore, it is said in the Ling Shu that points on the Spleen channel can treat diseases below the waist and points on the Lung channel diseases above the waist. Since herpes zoster is a heat syndrome, I usually additionally add the jing-well points of these two channels to purge heat. For more serious cases, moxibustion can be applied for five minutes and calamine lotion can be smeared on the herpes after bloodletting.
Li Weihong works at the Institute of Acupuncture and Moxibustion China Academy of TCM, Beijing 100700, China

Williamsburg Craft Series, publ: Colonial Williamsburg MCMLXX 3 Stedmans 1987 Discutient: Scattering or dispersing a pathologic accumulation. refers to early medicines humoural view. 4 Epps 1832 5 Ibid 6 Stedmans 1987 7 This approach has survived its humoural context. For example, until the mid 1970s malaria was used to treat syphilis, and is currently being researched as a treatment for Aids. The body can also create its own antagonistic condition to a disease as seen in sickle cell trait as defense against malaria.
8 Kluger 1978 9 Epler 1980 10 Cautery is like direct moxibustion. Setons and Issues

introduce a thread or piece of metal posterior to an infection. The thread or metal is left in place, causing a small surface infection which counters the deeper one. See Nielsen 1995, Brockbank 1954, and OConnor & Bensky 1981 (threading) 11 Kaim 1756 12 Gilles 1985 13 Jackson 1806 14 Mathews 1931, The character for sha has several translations. reddish elevated millet-like skin rash, (Ou Ming 1988). Dr.So translated sha as sand or sharkskin. (So, lecture notes 1976) 15 Weiger 1965 16 McNeil 1989 17 Kluger 1978 Bloodletting may be therapeutic in cases of infection from bacteria. Bacteria are dependent upon trace amounts of iron for growth. At elevated temperatures, bacteria appear to be even more sensitive to reduced levels of iron. 18 Porket 1982 quoting Dr. Arthur Jores 19 Ou Ming 1988 20 Epler 1980 21 Kaim 1756 22 Jinkue yaolue fanglun. 220 Clause 1-15

88