Herpes and herpes zoster
(疱疹與帶狀疱疹)
Herpes zoster is called “snake bunch sore” in traditional Chinese medicine. It appears in the skin as confluent vesicles usually along one side of the body in the form of a band which causes intense burning pain. Herpes simplex usually occurs around the mouth and on the genitalia at the site of connection of skin and mucous membrane in the form of localized lesions. The formation of herpes zoster is chiefly due to the attack of toxic evil, the accumulation of internal wetness-heat, and the struggle and intermingle between wetness-heat and toxic evil resulting in the damage of the skin. Liver disease affects the heart and also the spleen. If stagnation of liver turns in to fire, the fire can communicate with heart qi and the wind and fire would act synergetically with each other so that the skin shows flushing and produces a sensation of burning pain. Hyperfunction o f the liver insults the spleen and if wetness is enclosed in the interior, it will change into heat or toxin. If the toxic wetness flows into the liver and bile channels, one might find the revelation of herpes, vesicular eruptions, erosions and exudation. According to pathogenic analysis, clinically it is divided into four forms: abundance of hepatic and biliary fire, wetness-heat of spleen and stomache, stagnation of liver and retention of qi, retention of qi and stasis of blood.
From this, it can be seen that these forms have internal communications with the forms of chronic hepatitis. Modern medicine has confirmed that the pathogen of herpes is infection of the varicella – herpes zoster virus and it is commonly associated with herpetic chronic hepatitis.
The name of snake bunch sore originated from “Wai Ke Da Cheng” (A Complete Book on urgery” or in Chinese《外科大成》) in Ching dynasty. In fact, through the dynasties of Shui, Ming and Ching, physicians made detailed descriptions of this disease and the methods of treatment were effective in many different ways. The “Yi Zong Jin Jian” (“The Golden Mirror of Medicine”, in Chinese《醫宗金鑑》) of Ching dynasty described some therapeutic methods which were rather effective in clinical practice: “when wind and fire attack the liver and heart channels, it is rational to give the ‘Longdan Xiegan Tang’ (‘龍膽瀉肝湯’) and “when wetness-heat invades the spleen and lung channels, treatment is to give the ‘Chu Shi Weiling Tang’ (除濕’胃苓湯’)”. Because of their affirmed effectiveness, these methods are still in use widely in clinical practice. Therefore, we can see that TCM treatment for dermal lesions caused by virus, is, in fact, clinical use of principles in the treatment of chronic hepatitis, such as:
- soothing of liver and relief of stagnation,
- clearance of liver and release of heat,
- activation of blood and relief of congestion,
- facilitation of bile flow and strengthening of spleen,
- clearance and induction of wetness-heat,
- activation of qi and stoppage of pain.
These principles and methods showed definite effectiveness in application.
Introduction of cases
| Case 14
Sun (code number 2550), male, age 29 years.
He visited the clinic first time on June 2001 when he complained of generalized papules, desquamation and itching for more then ten years. He also had repeated acne and hemorrhoidal hemorrhage. He had stomache illness, and examination found pyloric bacteria which was treated with western medicine. He frequently had herpes of the mouth angle and also experienced fatigue. During the attack of herpes, he usually had simultaneous episodes of fever and symptoms of common cold, and if severe, he would have attacks of asthma 1 – 2 times a year. There was pain and tenderness over the internal side and pretibial region of both legs for many years. Physical examination : multiple acne scars on the face, tongue enlarged with teeth prints, hepatomegaly of 3 cm associated with percussion tenderness. He was diagnosed as chronic hepatitis (herpetic type not ruled out) with TCM classification of liver stagnation and lung dryness form, wetness-heat vaporization form, blockage of channels and blood stasis forms. After taking 3 parcels of TCM drugs, the liver was normal. TCM therapy was continued, and during this period, there were flatulence, abdominal pain, diarrhea and wetness-heat stools. There was also prolapse of bleeding hemorrhoids. TCM drugs for 2 weeks, caused disappearance of hemorrhoids and cure of the acne. He totally took TCM drugs for 3 weeks and then stopped the medication but the systemic treatment was not complete. Two months later, the herpes recurred and he had also fever, headache, sorethroat and multiple vesicles around the mouth. He took western medicine for 5 days. After that, he made a return visit and was seen having groups of vesicles around the lips, part of which conglomerated and formed scabs. Hepatomegaly retracted to 1.5 cm. after 7 parcles of TCM drugs, the liver returned to normal, the stools still showed wetness-heat, the passing of flatus was frequent and the herpes disappeared, leaving some erythema and pruritus. 34 parcels of TCM drugs were taken for systemic treatment. Later, he stopped the medicine because of traveling to Canada and at that time he had attained clinical cure.
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| Case 15
Chan (code number 2363), female, age 50 years. She first visited the clinic on February 2001 with the complaint of herpes zoster over the right upper arm and forearm (along the path of radical nerve) in the recent four days and she also experienced burning pain at the local dermal lesions. She had hepatitis at the age of 6 and received operation because of hyperthyroidism. She had irregular menstruation with profuse menstrual bleeding and blood clots. She always felt thirsty and drank much water; her appetite was exceedingly good. She also experienced nocturia, insomnia, and fatigue. Physical examination: skin pale yellowish, lean, hepatomegaly of 1.5 cm, lower extremities showing (++) edema, prominent veins and telangiectasis (毛細血管擴張). Diagnosis was chronic hepatitis, hyperthyroidism, menstrual disorder, anemia, venous hypertension of lower extremities, herpes zoster. After taking 3 parcels of TCM drugs, the liver returned to normal. She still felt shortness of breath, but dryness of mouth and throat decreased, the stools were passed smoothly and pain was still present at the left chest and axilla. The area of herpes was broad but these lesions began to fade, showing a charred colour and formation of scabs. Anasarca was marked and the lower extremities shoed (++) edema. Another 3 parcels were taken and pain the chest and exillla diminished and shortness of breath disappeared. Scabs of the herpes partly detached but the lesions were painful. TCM drugs ere continued for 2 weeks and the vesicular eruptions healed, leaving some pigmentation. Edema of the lower extremities significantly decreased. Systemic TCM therapy was stopped after a four weeks course and the patient was followed up.
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By WONG Kwok Hung
published on 27th November 2001
(translated by Professor ZHENG Hua En in 2003)