JOURNAL OF CHINESE MEDICINE NUMBER 66 JUNE 2001


Bai Ji Li and Bai Xian Pi subdue itching, drain damp heat, resolve fire toxin and scatter wind. Ze Xie, Che Qian Zi, and Mu Tong aid removal of damp and heat via the urine. Mu Dan Pi and Da Qing Ye cool the blood and resolve fire


toxin in the superficial layers. This was necessary in this case because of the marked erythema of the palms, and the fact that the eczema had spread to the dorsum of the hands. Despite this it should be noted that at this stage, a relatively small number of ingredients are used for cooling blood, pride of place given to the fire toxin resolving and damp heat clearing ingredients. It is imperative to use strong treatment to gain control


over the continues eruptions. Once that is achieved, the emphasis of the treatment needs to change. Lighter fire toxin resolving medicine are much more appropriate for the reduced vesicular formation and the lack of pustules and crusting. Therefore Pu Gong Ying and Zi Hua Di Ding are replaced


with Jin Yin Hua and Lian Qian. Long Dan Cao, Huang Lian, Yin Chen Hao have all served their purpose, and are therefore removed. Huang Qin is retained, and Zhi Zi is added to continue to drain damp and heat all be it more moderately. Zhi Zi has a further action (along with Mu Dan Pi) of releasing stagnant heat generated by constrained of liver, a primary factor in the initial development of the condition. Cooling blood is often not a significant factor in treating pompholyx eczema, In this case however not only is the erythema very pronounced, but the eczema has spread to the dorsum, both clear indications for the need to cool blood. Mu dan pi is retained, as not only is it effective at plumbing the depths and cooling pertinacious and intrac- table heat on the blood level, but it is also very well tolerated over the long term. It is complemented and enhanced in this action by adding Sheng Di Huang which also initiates the repair to the desiccated blood that is an inevitable conse- quence of the intense heat that has raged unchecked over the previous year and a half. The second formula was taken for a total of 6 weeks, with


only slight modification. Once all eruptions have been stemmed, the final 4 weeks of treatment (two weeks full dose, two weeks half dose) are devoted to regulating the liver, by moving qi, nourishing blood and dealing with stagnant heat.


3.


Chai Hu 9 Bai Shao 15 Dang Gui 9 Fu Shou Gan 12 Jin Yin Hua 12 Bai Ji Li 15 Zhi Zi 9


Mu Dan Pi 9 Gan Cao 6


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