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the TCM treatments, but homeopathic, nutrition, flower essence, etc.

 

Victoria

 

>Herpes Zoster

>

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> Herpes Zoster

> Definition and Etiology

>

> definition: an acute infection caused by reactivation of

>the varicella-zoster virus and involving the dorsal root ganglia; causes

>eruptions and neuralgia on the skin corresponding to the distribution of

>the affected root ganglia; also called

> " shingles "

>

> etiology: Herpes zoster is most prevalent among those 50

>years and older, although it may strike at any age, particularly in

>immunosuppressed patients. It only affects people who have had chickenpox.

>Reactivation may be idiopathic or follow immunosuppression, stress, trauma

>including surgery, radiation etc.

>

> signs and symptoms

>

> signs and symptoms: prodromal stage

> • pain, burning or redness of the involved area

> • malaise

> • fever with or without chills

> • gastrointestinal disorders

>

> After 2-5 days, the rash appears in a unilateral,

>dermatomal distribution usually on the thoracic area (T3-L3), face, or

>neck.

>

> • erythematous base

> • linear patches of grouped vesicles

> • pain may be intense

> • lesions stop abruptly at the midline of the body

> • new crops may continue to appear for 3-5 days, after

>which the lesions begin to dry and crust

>

> problem areas for herpes zoster:

> • geniculate zoster: pain in the ear with transient

>paralysis of the face on the involved side; eruptions are visible in the

>external auditory canal and on the pinna, the soft palate, and the anterior

>pillars of the fauces

>

> • ophthalmic herpes zoster: eruption occurs on the

>ophthalmic branch of cranial nerve V; if vesicles appear on the tip of the

>nose, then corneal involvement may occur and can lead to corneal ulcers and

>opacities

>

> • recurrence rate is high

>

> lab findings:

> • (+) Tzanck smear showing multinuclear giant cells

> • FAMA: fluorescent-antibody to membrane antigen

> • ELISA: Enzyme-linked immuno-absorbent assay

> • 40% show hypercellularity in CSF

> • prolactin increased if lesions on chest wall

>

> course and prognosis

>

> A shingles eruption that continues for more than two

>weeks or becomes generalized warrants investigation for malignancy or

>immunologic defect. However, even in generalized zoster, fatalities are

>rare.

>

> Post-herpetic neuralgia is seen in 50% of the patients

>over 50 years old who develop herpes zoster, and may cause excruciating

>pain that lasts for months or years.

>

> differential diagnosis

>

> • coxsackievirus infections

> • pleurisy

> • Bell's palsy

> • trigeminal neuralgia

> • herpes simplex lesions

>

>

> footnotes

>

>

>

>

>

> Chinses Formulae

> Acupuncture

> Homeopathy

> Botanicals

> Nutrition

> Somatic Therapies

> Subtle Support

> Mind/Body

>

>

>

>

> Chinese Formulae

>

> • Qi Li San (patent): external use (Naeser, p. 232)

> • Chu Shi Wei Ling Tang: Damp-Heat: Herpes zoster which

>erupts in the mid-to lower-back region (Bensky and Barolet, p. 182).

> • Huang Lien Shang Ching Pien (patent): Wind-Heat

>(Naeser, p. 152)

> • Gentiana C. (Long Dan Xie Gan Wan) (available as

>patent): Liver and Gall Bladder Invaded by Damp-Heat (Gentiana: Hsu, 1980,

>p. 181; Yeung, p. 154; Dharmananda, 1986, p. 229; Bensky and Barolet, p.

>96; patent: Zhu, p. 172; Fratkin, p. 82)

> • AK 3 (Coptis Purge Fire Formula) (patent)

> • Gentiana 12 (patent) plus Myrrh Tablets (patent):

>herpes zoster eruptions (Dharmananda, 1990, p. 69)

>

>

> footnotes

>

>

>

>

> Acupuncture: patterns and combinations

>

> after assessing the person and palpating, consider these

>patterns:

> Liver Yang Shi (Excess); Damp-Heat; Wind-Heat

>

> » illustrative combinations:

> • GB-20, UB-54/40, PC-7, LI-11 and needles at affected

>site for herpes zoster due to invasion of Wind-Heat (Jirui and Wang, p.

>243)

> • GB-34 and GB-41 (-): clear Damp and Damp-Heat, esp. on

>Gall Bladder channel

>

>

> point analysis

>

> » palpate and consider:

> • GB-20 (-): dispels Wind and Heat; subdues Liver Yang

>to calm and regulate the Liver and Gall Bladder; harmonizes Qi and Xue

>(Blood); frees the channels and invigorates the collateral vessels

> • UB-11 (-): dispels Wind-Heat; resolves Shi (Excess)

>Heat; connects the Du Mai (Governing Vessel) to the Shu Associated points;

>distributes Bladder Qi and Jing-Ye (Yin) to all the dorsal Shu points, thus

>cooling them (Finkelstein, p. 38); removes obstruction of Qi circulation of

>the Tai Yang channels (Bladder and Small Intestine) and Du Mai (Governing

>Vessel) of the upper back; relaxes the muscles, sinews and tendons;

>invigorates the collateral vessels; facilitates Xue (Blood) flow; Hui

>Reunion point of the Bones; Sea of Xue (Blood) upper entry point

> • UB-17 (=): regulates and invigorates the Xue (Blood);

>clears Heat from the Xue (Blood); transforms Xue Yu (Blood Stasis);

>nourishes Dry Xue (Blood); enriches Yin; strengthens Xu (Deficient)

>conditions; Diaphragm Shu Associated point; Hui Reunion point of the Xue

>(Blood)

> • UB-18 (=): pacifies the Shen; benefits the Liver and

>Gall Bladder; cools Damp-Heat; moves Stagnant Qi; nourishes Liver Xue

>(Blood) and Yin; clears Liver Fire and Heat; cools Heat in the Xue (Blood);

>Liver Shu Associated point

> • local points (-): patient lies on unaffected side; one

>needle inserted at " head " and another at " tail " of lesion; needles inserted

>obliquely at angle of 35-40° (Jirui and Wang, p. 243)

> • hua tuo jia ji: above and below affected ribs and/or

>at levels of shu points of channels involved (Eisen); disperses Qi

>Stagnation and Xue Yu (Blood Stasis) locally and by extension affects the

>nerves whose roots are proximal to jia ji points

> • UB-54/40 (- and/or bleed): clears Heat from the Xue

>(Blood); transforms Damp-Heat; strengthens waist; relaxes the sinews and

>muscles; esp. benefits the lower back; treats genital and anal pain;

>Bladder He Sea Uniting and Earth point; command point of the back

> • LI-11 (-): pacifies the Shen; clears Heat and Toxins,

>esp. from head and face; eliminates Wind; regulates and harmonizes Qi and

>Ying; cools and harmonizes Xue (Blood); improves immune function

>(Finkelstein, p. 9); eliminates Dampness through the Intestines; benefits

>sinews, tendons and joints; frees the channels; Large Intestine Upper He

>Sea Uniting, Earth and Tonification point; Master point of Heat in the body

>(Finkelstein, p. 9)

> • LI-4 (-): pacifies the Shen; clears Heat and Toxins,

>esp. from head and face; regulates Qi and Xue (Blood); frees the channels

>and invigorates the collateral vessels; dispels Wind-Heat; sedates pain;

>induces or stabilizes sweating; tonifies Lung Qi; regulates Qi of and

>disperses Heat from the Intestines; elevates Clear Qi and descends Turbid

>Qi; eliminates Damp-Heat and stops itching; Large Intestine Yuan Source and

>Entry point; command point of the face and mouth

> • TW-5 (-): dissipates Wind, esp. from head and face;

>clears Heat, esp. from Triple Warmer channel; dissolves Toxins; relieves

>Exterior and Hot conditions; induces perspiration; clears Xiao Yang (Gall

>Bladder) in the head and disperse Liver Yang Shi (Excess); moves the Yang

>Wei Mai; tonifies Wei (Protective) Qi; facilitates the circulation of Qi in

>the channels and invigorates the collateral vessels; alleviates pain;

>Triple Warmer Luo Connecting point; Master point of the Yang Wei Mai (Yang

>Linking Vessel); Couple point of the Dai Mai (Girdle Vessel)

> • TW-6 (-): dispels Wind, Wind-Heat and Wind-Dryness;

>clears Fire and Heat; facilitates Qi flow and spreads the Qi; regulates the

>Triple Warmer and the Zang-Fu organs, esp. the Intestines; frees the

>channels and invigorates the collateral vessels; disperses Obstruction and

>relieves pain; Triple Warmer Fire and Horary point

> • PC-7 (-): pacifies the Shen; dispels Wind and

>Wind-Heat; calms Fire; clears Heat and Toxins; pacifies the Shen; nourishes

>Heart Xue (Blood); dissipates Heat from the Ying (nutrient system) and Xue

>(Blood); Pericardium Yuan Source, Earth and Dispersion point; historically

>used as the Heart Source point (Maciocia, p. 436)

> • GB-31 (-): disperses Wind; clears Heat; transforms

>Damp; detoxifies the Liver; " Wind Market "

> • GB-34 (-): clears Dampness and cools Heat, esp. on

>Gall Bladder channel; benefits Liver and Gall Bladder; extinguishes Liver

>Wind and subdues Liver Yang; tonifies Spleen; invigorates the collateral

>vessels; alleviates pain; Gall Bladder He Sea Uniting and Earth point; Hui

>Reunion point of Jin (sinews and tendons)

> • GB-41 (-): clears Damp and Damp-Heat, esp. on Gall

>Bladder channel; dissipates Wind; removes Fire; relieves distention and

>swelling in the breast; removes Stagnancy of Liver Qi; spreads and drains

>Liver and Gall Bladder; clears and regulates Dai Mai (Girdle Vessel);

>clears Wetness (Damp Spleen) by draining into Dai Mai (Girdle Vessel); Gall

>Bladder Wood and Horary point; Master point of the Dai Mai (Girdle Vessel);

>Couple point of the Yang Wei Mai (Yang Linking Vessel)

> • Sp-10 (=): regulates and invigorates the Xue (Blood);

>cools Heat and eliminates Damp-Heat in the Xue (Blood); expels Wind and

>dissipates Wind in the Xue (Blood); clears Heat and Summer-Heat; harmonizes

>and tonifies Ying (Constructive) Qi; nourishes Xue (Blood) Dryness

> • Sp-9 (=): regulates and tonifies Spleen (especially

>Yang); warms and moves the Middle Warmer; transforms Damp Stagnation and

>dispels Damp-Heat, esp. through promotion of diuresis; regulates the Water

>Pathways; benefits Lower Warmer; Spleen He Sea Uniting and Water point

> • Sp-6 (+): tonifies Spleen to transform Dampness; aids

>transportation and transformation to improve digestion and nourishment;

>nourishes Yin and suppresses Liver Heat; clears Fire due to Xu

>(Deficiency); tonifies Qi and builds the Xue (Blood); regulates Xue (Blood)

>circulation; frees Qi Stagnation and spreads the Liver Qi; benefits the

>Kidney; Jiao Hui Intersecting point of the three Foot Yin channels

> • St-36 (+): calms the Shen; disperses noxious Yang;

>dispels and eliminates Dampness; regulates and strengthens Qi and Xue

>(Blood); strengthens weak and deficient conditions; strengthens the Spleen

>and regulates Ying (Constructive) Qi; regulates and replenishes the Middle

>Warmer; spreads Liver Qi and benefits the Gall Bladder; nourishes Kidney,

>Liver and Spleen; tonifies Kidney Yin; clears Heat from the Yang organs and

>drains Shi (Excess) from the Yang channels; treats chronic cases with Heat;

>regulates ascension of the Clear and descension of the Turbid (-), esp. by

>the Intestines; frees the channels and invigorates the collateral vessels;

>Stomach He Sea Lower Uniting, Earth and Horary point; Sea of Nourishment

>point

> • St-40 (-): clears and calms the Shen; dispels Wind;

>transforms and clears Dampness; invigorates the channels; strengthens the

>Spleen, harmonizes the Stomach, and opens up the Middle Warmer; circulates

>Qi of the Stomach and Spleen; descends the Turbid; strengthens Kidney Yin

>and drains Liver Yang; Stomach Stomach Luo Connecting point

>

> • ear: lung, diaphragm, shen men, dermis/subcortex,

>endocrine, adrenal, occiput, corresponding area(s)

>

>

> footnotes

>

>

>

>

> Homeopathy: remedy differential

>

> • Apis mellifica: stinging pains, come out in cold

>weather < warmth, > cold

> • Arsenicum album: intense burning < night; crusts deep

>and large, bleed when removed

> • Carboneum oxygenisatum: vesiculation along course of

>nerves, large and small vesicles of pemphigus

> • Dulcamara: moist, suppurating; oozing pale water when

>scratched; after taking cold; thick crusts all over body; < evening, cold,

>wet weather, > gentle exercise in warm room

> • Graphites: burning when touched; esp. on left side;

>itching blotches with oozing watery, sticky fluid; ulcerates easily

> • Iris versicolor: following gastric problems, esp. on

>right side; fine eruption with black points after scratching, great itching

>at night

> • Lachesis: large vesicles, first yellow, then turn dark

>with much pain; vesicles break and leave excoriated surface which burn when

>touched; every spring and fall; > warmth

> • Mezereum: sharp stitching, lightning-like pains,

>sometimes boring, which leave parts numb; < in bed, from touch; vesicles

>form brown scabs; post neuralgic pains

> • Psorinum: esp. on bends of joints and scalp with

>itching; dry, scaly eruptions < cold and warmth of bed

> • Ranunculus bulbosus: sharp, stitching pains, vesicles

>have thin, acrid fluid; burning, itching vesicles in clusters < touch,

>motion, change of temperature, entering cold place

> • Rhus toxicodendron: right side, incessant itching,

>burning, tingling, alternating pains with dysenteric stools; < in winter,

>hardly any eruption in hot weather

> • Thuja occidentalis: from suppressed gonorrhea, itching

>and burning violently; white, dry scaly, eruptions on covered parts; < cold

>water, heat of bed, at night, > gentle rubbing

> • Zincum metallicum: post-neuralgic pains; burning,

>jerking, itching pains, < evening and slightest touch; on back of hands

>with burning pains, between fingers

>

>

> footnotes

>

>

>

>

> Botanicals: primary herbs

>

> • Aralia nudicaulis: externally as a wash, (Felter and

>Lloyd, p. 261)

> • Beta vulgaris (beetroot): general stimulant and

>resistance-enhancing effect. Large quantities of juice daily. Note: urine

>and stools will turn red. See Weiss, p. 232.

> • Echinacea spp.: enhances resistance to viruses (Weiss,

>p. 229)

> • Eupatorium perfoliatum: enhances resistance to viruses

>(Weiss, p. 229)

> • Glycyrrhiza glabra: antiviral, anti-inflammatory

>(Mitchell, p. 16a)

> • Iris versicolor (toxic): (Felter and Lloyd, p. 1080)

> • Rhus toxicodendron (toxic): acute inflammation,

>inflammation with bright, red, tumid surfaces and deep seated burning pain

>(Felter and Lloyd, p. 1673)

> • Rumex crispus: internally (Harper-Shove, p. 155)

>

>

> complementary herbs

>

>

> footnotes

>

>

>

>

> Nutrition: dietary guidelines

>

> eating principles:

> • if on a regular diet, try a vegetarian diet high in

>vegetables and complex carbohydrates. If on a vegetarian diet, try a fruit

>and vegetable diet or a short fast

>

> therapeutic foods:

> • increase foods that cool the Xue (Blood) and clear

>Heat

> • mung beans, daikon radish, carrots, lemon and water

> • foods rich in Vitamins B-complex and C, Zinc

>

> fresh juices:

> • lemon juice in water on empty stomach in morning

>(Shefi)

> • carrot

> • celery (Shefi)

> • apple (Shefi)

> • lettuce and dandelion (Ni, p. 39)

> • parsley (Ni, p. 43)

> • carrot, celery, lemon (Jensen, p. 63)

> • cucumber, endive, pineapple (Jensen, p. 63)

> • carrot, celery, spinach, and parsley (Walker)

>

> avoid:

> • meat, alcohol, hot sauces, spicy foods, fried foods,

>fatty foods, rich foods, salty foods, stimulating foods, coffee, caffeine

>

> therapeutic considerations:

> • Enhance immunity: consider constitutional hydrotherapy

>if the patient can tolerate it.

>

> supplements

>

> • Vitamin C: Use high doses to bowel tolerance. 10 g per

>day (IV is best) (Zureick,1950)

> • Quercetin can inhibit the replication of various

>viruses and may be effective in the treatment of Herpes zoster. (Marz, p.

>425, 1997)

> • Selenium: up to 800 mcg per day for acute situations

> • Consider IM or IV vitamins such as vitamin C,

>Echinacae, Myers Cocktail, Vitamin B12 and B1. (Marz, p. 425, 1997)

> • Vitamin B12 1000 mcg IM per day

> • Herpes zoster ophthalmicus: Vitamin C and A drops.

> • Adenosine monophosphate (AMP 25 mg/ml), 2-3 ml IM

>every day or other day as patient is responding. Can also use IV.

> • DHEA or low dose cortisone may be indicated. (Marz, p.

>425, 1997)

> • DL-phenylalanine

> • Vitamin B5 500 mg three times daily

>

> topical:

> • Zostrix (capsaicin): Topical applications may be

>helpful in some cases. Zostrix affects the efferent nerves endings.

> • Glycyrrhiza topically may be helpful. It can be

>applied with DMSO to drive the Glycyrrhiza into the nerve root. Other

>botanicals may also be administeredsuch as aloe vera, along with vitamin E

>and zinc oxide. (Marz, p. 425, 1997)

> • Vitamin E (for post-herpetic neuralgia) 1200-1600 IU

>per day (Mihan, 12/73) topical application

>

>

> footnotes

>

>

>

>

> Somatic Therapies: exercise

>

> • aerobic exercise: daily may help enhance immune system

>functioning

>

>

> hydrotherapy

>

> • fever treatments: up to 102° F daily until skin

>lesions dry up, start as soon as possible after diagnosis

> • poultice: charcoal

>

>

> manipulation

>

> • spine: check and align vertebrae at level of

>dermatomal irritation, Also T10-T12.

>

>

> electrical and oscillating

>

> • ultraviolet

> • ultrasound

> • interferential: electrodes covering dermatome, 90-150

>Hz, 10-15 min., mild intensity

>

>

> footnotes

>

>

>

>

> Subtle Support: sound

>

> pain:

> • Mendelssohn's Spring Song

> • Meditation from Thais

> • Chopin's Preludes

> • On Wings of Song

> • Andante, Beethoven's Fifth Symphony

> • Adagio, Beethoven's Pathetique Symphony

> (Heline, p. 18)

>

>

> flower essences

>

> • aloe vera

> • angelica

> • mallow

> (Gurudas, pp. 236, 216)

>

> • crab apple (Kasloff, 1987)

>

>

> electromagnetic

>

> • Digitron: 50-31

>

>

> color

>

> acute phase:

> • green (is antimicrobial and acts as a disinfectant and

>antiseptic) and indigo (an astringent, antipyic, antiemetic, and

>hemostatic; is phagocytogenic; acts as a general sedative) on back and any

>affected areas

>

> chronic phase:

> • motor nervous system schedule (refer below) on back

>and affected areas

> • violet (a tranquilizer) on painful areas

>

> the protocol for the motor nervous system schedule is:

> • lemon (helps to dissolve blood clots; acts as a

>chronic alterative) and yellow (acts on the motor nerves, thereby helping

>to energize muscles; acts on the lymphatic system as it is a mild tissue

>stimulant) for 2 weeks, then:

> • lemon (helps to dissolve blood clots; acts as a

>chronic alterative) and orange (acts as a decongestant) for 4 weeks

> • this is repeated for as long as is necessary

> (Dinshah, 1985, p. 105)

>

>

> gems and minerals

>

>

> footnotes

>

>

>

>

> Mind/Body: metaphors and correlations

>

> • Created through chronic anxiety/irritation due to

>feeling overwhelmed; activity in one's environment continually makes the

>person feel physically, financially, or materially insecure and vulnerable.

>(Shealy, p. 208)

> • Fear and tension; waiting for the other shoe to drop;

>too sensitive. (Hay, 1984, p. 182)

>

> Chinese psychophysiology:

> • Liver ~ Gan is the home of the Hun (Ethereal Soul); it

>relates to decisiveness, control, and the principle of emergence; cleanses

>the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); reflects

>emotional harmony and movement; and expresses itself in the nervous system.

> » Healthy expressions are kindness, spontaneity, and

>ease of movement.

> » Liver Xu (Deficiency) signs include impotence;

>frigidity; pain in thighs, pelvic region, and throat; ready tendency to

> " the blahs " (Seem, p. 28); timidity; depression; irritability; vertigo;

>pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and

>difficulty raising head up and down.

> » Liver Qi Stagnation reflects and accentuates emotional

>constraint as the Liver's function of facilitating smooth flow in the body

>is constricted. Stagnation is associated with frustration, irritability,

>tension, and feeling stuck. With time this pattern tends to produce a

>gloomy emotional state of constant resentment, repressed anger or

>depression, along with tightness in the chest, frequent sighing, abdominal

>tension or distension, and/or a feeling of a lump in the throat with

>difficulty in swallowing. (Maciocia, p. 216)

> » Liver Shi (Excess) signs include discontent; anger;

>pain in lumbar region and genitals (Seem, p. 28); muscular tension;

>excessive sex drive; insomnia; moodiness; excitability; genital diseases;

>red, tearing eyes; compulsive energy; and bitter taste in the mouth.

>Chronically suppressed anger can implode and give rise to Fire in the Liver

>and Gall Bladder with symptoms of irritability, bitter taste, headaches,

>etc.

> » Liver Wind derives from Liver Yin Xu (Deficiency)

>and/or Liver Xue Xu (Blood Deficiency) and their subsequent inability to

>embrace the Yang, and can manifest as joint stiffness, dizziness, tremor,

>paralysis, convulsions, rashes, itching, and neurological problems.

>

> • Gall Bladder ~ Dan is the source of courage and

>initiative, and is responsible for decision-making as the bodily Minister

>of Justice; and controls circulation of the nourishing and protecting

>energies [Ying Qi and Wei (Protective) Qi]. Its channel purifies Yang

>energy in the body.

> » Healthy expressions are kindness, decisiveness,

>control, and spirit of initiative.

> » Gall Bladder Shi (Excess) signs include tiredness;

>sighing; irritability; bitter taste in the mouth in the morning; pain in

>all joints; edematous knees and legs (Seem, p. 29); tinnitus; lateral

>headache; heaviness in head and stomach; muscular spasms; and limbs

>slightly cold. Chronically suppressed anger can implode and give rise to

>Fire in the Liver and Gall Bladder.

> » Anger, frustration, and resentment can cause Liver Qi

>Stagnation which, in turn, can produce Heat which affects the Gall Bladder.

>

>

> therapies

>

> affirmation:

> • (Skin) I lovingly protect myself with thoughts of joy

>and peace. The past is forgiven and forgotten. I am free in this moment.

>(Hay, 1984, p. 183)

> • I am relaxed and peaceful because I trust the process

>of life. All is well in my world. (Hay, 1984, p. 182)

>

> theotherapy:

> (skin problems) Dionysus, Heracles, Orestes, Pelops

>(Lemesurier, p. 115)

>

> psychotherapy:

> • Whatever happens to the skin corresponds to an inner

>process. The diverse functions of the skin (protection, contact,

>expression, excretion, respiration, temperature regulation, sexuality,

>etc.) are associated with a common theme that alternates between the two

>poles of separation and contact. Something is bursting through our limits,

>or trying to armor an inner sensitivity. Questions to ask in the event of

>skin problems:

> » What is it that is getting under my skin? What is

>trying to burst through barriers?

> » How easy/difficult is it to make contact with other

>people? Do I desire intimacy?

> » Have I condemned myself to solitary confinement? What

>is useful about this?

> (Dethlefsen, p. 162, 170)

>

> process paradigm: (experientially oriented)

> • What is the symptom preventing me from doing? What is

>the symptom making me do? (see process interview: cutaneous system)

>

> related materia medica listings:

> the shadow and physical symptoms

> skin metaphors and correlations

> converting a symptom to a signal

> affirmations: guidelines and precautions

> theotherapy

> hypnotherapy

> process paradigm

>

>

> footnotes

>

>

>

>

>

>

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