Erysipelas

Erysipelas is an acute contagious infectious skin disease characterized by sudden onset of chills , fever , local redness and swelling which may take place on any site of the body and rapidly extend .

Etiology and Pathogenesis

Erysipelas is mostly due to accumulated damp heat in the spleen and stomach flowing downward to the leg ; or due to obstruction of qi and blood in meridians caused by pathogenic wind and toxic heat . Therefore the pathogenic heat infects the blood , and then the skin and muscles . Or it is due to invasion of toxin into the wound in the skin . The erysipelas arising in face and head is mostly evoked by wind heat , that in the hypochondriac , lumbar and hip regions is usually caused by liver fire , that on the leg by damp heat , and in new - born babies by internal heat .

Differentiation

Main manifestations : Rapid onset of a well demarcated patch of redness , hotness and burning pain , rapidly extending in size ; change in color of the patch from bright red to dull red in several days and then healing with desquamation . If accompanied by chills , fever , acute headache , red tongue proper with thin yellow coating , and superficial rapid pulse , it is a wind heat syndrome . If accompanied by fever , irritability , thirst , stuffy sensation in the chest , poor appetite , constipation , dark urine , yellow sticky tongue coating , soft and rapid pulse , it is a damp heat syndrome . High fever , vomiting , delirium and convulsion indicate invasion of the pathogenic factors into the interior of the body .

Analysis : Erysipelas is caused by invasion of exogenous wind heat or damp heat from the stomach and intestines into the blood , skin and muscles . Therefore the affected skin is red and painful . If it is caused by exogenous wind heat stagnating in the skin and muscles , there are chills and fever . If it is caused by damp heat in the stomach and intestines , there are high fever , thirst , stuffy sensation in the chest , poor appetite , constipation and dark urine . When the pathogenic factor penetrates into the pericardium , delirium and convulsion occur .

Treatment

Method : Points of the Yangming Meridian are selected as the principal points . The reducing method is applied to eliminate heat and relieve toxin , or prick the points to bleed .

Prescription : Quchi ( Li11 ) , Hegu ( Li4 ) , Quze ( P 3 ) , Weizhong ( B 40 ) , Xuehai ( Sp 10 ) , Ashi points . Supplementary points : Wind heat : Fengchi ( G 20 ) . Damp heat : Zusanii ( S 36 ) , Yinlingquan ( Sp 9 ) . Fever : Dazhui ( Du 14 ) . Pathogenic toxin attacking the interior : Twelve Jing - ( Well ) points ( L 11 , Li1 , P 9 , S J I , H 9 , Si1 ) , Laogong ( P 8 ) . Constipation : Zhigou ( S J 6 ) . Explanation : Quchi ( L 1 11 ) and Hegu ( Li 4 ) disperse wind heat from the Yangming Meridians . Reducing Xuehai ( Sp 10 ) and bloodletting of Weizhong ( B 40 ) , Quze ( L I 11 ) and Ashi points are to clear offbeat from the blood , i . e . eliminating the accumulated heat by reducing method . The reducing method used to Zusanii ( S 36 ) and Yinlingquan ( Sp 9 ) is to dispel damp heat . Pricking the twelve Jing - ( Well ) points to cause bleeding and reducing Laogong ( P 8 ) are to expel heat from the skin and heart . Reducing Dazhui ( Du 14 ) and Fengchi ( G 20 ) remove the pathogenic heat and relieve exterior symptoms . Zhigou ( S J 6 ) is used for constipation by removing heat . Remarks

Strict sterilization is necessary to avoid infection . If ulcer occurs due to mixed infection , or if there is septicemia or pyemia , comprehensive treatment should be applied .