Urticaria

Urticaria is commonly seen in clinic . It is an eruption of the skin characterized by transitory , flat - topped wheals which look like measles or are as large as broad beans . It is apt to appear after exposure to wind , so traditional Chinese medicine terms it wind wheal . Because it comes and goes , it is also named hidden rash . In some cases it may repeatedly occur and have not been cured for months or years .

Its etiology and symptoms are described clearly in ancient literature , e . g . in the book of Synopsized Prescriptions of Golden Chamber it says , If the pathogenic qi attacks the meridians , hidden rash with itching would appear .

Etiology and Pathogenesis

a ) It is due to stagnation of dampness in the skin and muscles which are again attacked by wind heat or wind cold . The confrontation against dampness is going on between the skin and muscles , so there appears wind wheal .

b ) It may be caused by accumulated heat in the stomach and intestines with further attack of the pathogenic wind which could neither be dispersed from the interior nor removed from the exterior . So pathogenic wind heat stays between the skin and muscles , and results in wind wheal .

c ) It may also be due to intestinal parasitoids such as ascariasis , ancylostomiasis , fasciolopsis , etc , or due to intake of fish , shrimp or crab leading to dysharmony of the spleen and stomach with accumulation of damp heat in the skin and muscles .

Differentiation

Abrupt onset with itching wheals of various size or with pimples rising one after another . It might be aggravated or lessened by the changing of weather . Acute conditions subside quickly . It is divided into the following types according to clinical symptoms :

a ) Wind heat :

Main manifestations : Red rashes with severe itching , superficial and rapid pulse .

Analysis : Red color indicates heat ; itching is caused by wind . Superficial and rapid pulse is a sign of wind heat .

b ) Wind damp :

Main manifestations : White or light red rashes accompanied by heaviness of the body , superficial and slow pulse , white and sticky tongue coating .

Analysis : White or light red rashes and heaviness of the body indicate stagnation of wind damp in the skin and muscles . White sticky tongue coating and superficial slow pulse are signs of wind damp .

c ) Accumulation of heat in the stomach and intestines :

Main manifestations : Red rashes complicated by abdominal or epigastric pain , constipation or diarrhea , thin yellow tongue coating and rapid pulse .

Analysis : Red color shows heat . Epigastric and abdominal pain with constipation suggests accumulated heat in the stomach and intestines , which causes the obstruction of qi in the fu organs . Rapid pulse and yellow tongue coating indicate existence of interior heat .

Treatment

Method : The reducing method is applied to disperse wind damp and eliminate heat in the blood . Points of the Spleen and Large Intestine Meridians are selected as the principal points . Tapping on the diseased area with a plum - blossom needle is advisable .

Prescription : Quchi ( Li 11 ) , Hegu ( Li4 ) , Weizhong ( B 40 ) , Xuehai ( Sp 10 ) , Sanyinjiao ( Sp 6 ) .

Supplementary points : . Wind heat : Dazhui ( Du 14 ) . Wind damp : Yinlingquan ( Sp 9 ) . Accumulated heat in the stomach and intestine : Tianshu ( S 25 ) , Zusanii ( S 36 ) .

Explanation : Wind rash is mainly caused by stagnation of the pathogenic wind , heat or damp in the skin and muscles or due to accumulated damp heat in the stomach and intestine , so points Quchi ( Li11 ) and Hegu ( LI 4 ) of Hand - Yangming Meridian are used to disperse the pathogenic factors from the skin and muscles . Xuehai ( Sp 10 ) and Weizhong ( B 40 ) are combined with the former points to eliminate heat in the blood , Sanyinjiao ( Sp 6 ) is to remove dampness , Dazhui ( Du 14 ) , the point where all the yang meridian meet , is used to reduce heat , and Yinlingquan ( Sp 9 ) removes damp . The reducing method applied to Tianshu ( S 25 ) and Zusanii ( S 36 ) is to dredge the accumulated heat from the stomach and intestines .