Library

Pain from sores is caused by excessive Heart Fire and heat in the Blood level; thus, when Fire is abundant, abscesses form and cause pain. However, although sore-pus lesions are painful, their severity increases gradually to an extreme, unlike the sudden onset seen when complicated by Sha (sand/heat toxin). Therefore, in cases where sores are complicated by Sha, the swelling and pain often present many alarming features. Moreover, while the pulse of sores is typically surging (Hong) and rapid (Shu), the pulse in Sha-complicated cases differs distinctly, and the color of the collaterals also provides diagnostic evidence.

Case Record:
The daughter of Pan Ziliang, aged eighteen, had suffered from sores for half a year. Suddenly, after drinking alcohol, her pus-filled sores flared up severely. It was suggested that the alcohol exacerbated Blood Heat, and that consuming chicken and goose—considered "fa" (stimulating/toxic-promoting) foods—caused the swelling and pain of the sores to reach an extreme. Treatment with formulas to cool the Blood, invigorate Blood, resolve toxicity, and support the interior (Tuoli) resulted in increased confusion and chest fullness. I was consulted and found the pulse not surging and rapid, but rather deep (Chen) and faint (Wei). I stated, "The pulse does not match the symptoms; this must be due to Sha." I pricked the fingertips to release toxic blood and inserted one needle at the top of the head (Baihui, GV20). Only then did her mental state clear. However, she still experienced chest fullness. I prescribed four doses of herbs to regulate Qi, dissipate Sha, and detoxify, administered as a slightly cold beverage in small frequent sips, combined with external application of Hezhang Wan. The chest fullness and sores both healed.

When there are pre-existing deficiency patterns of labor and weakness, such as intermittent hemoptysis; or slight dry cough with bright red malar eminences and lips; or persistent bone-steaming fever; once exposed to seasonal epidemic pathogens or foul odors, Sha distension will inevitably complicate the condition. Symptoms may include profuse phlegm and wheezing; a sensation of a foreign body in the throat; abdominal distension and fullness with irritability and fever; feeling heavier than usual for a deficiency pattern. In such cases, treatment should focus primarily on Sha. Only after the Sha toxin has completely subsided should the underlying deficiency be treated. Otherwise, while the labor-weakness may not yet be critical, the disaster of Sha is imminent.

Case Record:
A woman suffering from hemoptysis and dry cough had experienced daytime coolness and nighttime fever for a long time. Suddenly, she developed abnormal afternoon fever accompanied by distension, fullness, and heaviness. Other physicians attributed this to anger causing Qi and Blood deficiency and prescribed formulas to nourish Blood, transform phlegm, and regulate Qi. Her condition worsened, leading to coma, phlegm-wheezing, and unconsciousness. Upon consultation, the Left Guan pulse was slightly slow and powerless; the Right Guan pulse seemed tight but was not truly tight; other pulses were irregular upon palpation. I reasoned: if anger filled the chest, the Left Guan pulse must be forceful; for chronic deficiency, the pulse should naturally be wiry (Xian) and rapid (Shu); if there were stagnant Blood internally, the Upper and Middle positions should exhibit a floating and hollow (Kou) pulse. Why did the pulse so mismatch the symptoms? Observing her left popliteal fossa, several purple collaterals were clearly visible and palpable, clearly indicating a complication of Sha, which explained the coma and phlegm-wheezing. I first pricked the Sha collaterals to release toxic blood, doubled the dosage of Baohua San, and administered it as a slightly cold tea beverage in small frequent sips. This cleared her mental state, resolving the phlegm-wheezing, coma, distension, and heaviness. However, the labor-weakness stemmed from constitutional insufficiency and remained protracted and unhealed.