Diphtheria

A disease characterized by whitening of the throat. It occurs mostly in the autumn or winter after a long period of dryness and is attributed to seasonal epidemic scourge toxin exploiting vacuity of the lung and stomach.

• It starts with a sore throat that makes swallowing painful, and with the appearance of white speckles on one or both throat nodes (i.e., the tonsils), which spread quickly to create a white membrane that covers the uvula and stretches into the regions inside and outside the throat pass (isthmus faucium).
• The membrane does not easily slough off, cannot be forcefully removed without causing bleeding, and if removed always grows back.
• Other signs include headache, generalized pain, slight heat effusion or alternating heat and cold, lack of spirit, oppression in the chest, vexation and agitation, bad breath, and nasal congestion.
• If the white membrane spreads into the region inside the throat pass and down to the epiglottis and beyond, signs such as labored breathing, flaring nostrils, green-blue lips, heart palpitation or fearful throbbing, and a bound or intermittent pulse may be observed.

Distinction is made between yáng heat and yīn vacuity patterns. Yáng heat patterns are attributed to wind-heat or heat toxin and are characterized by a red sore swollen throat, heat effusion, constipation, and reddish urine; yīn vacuity patterns are attributed to dryness-heat damaging the lung and stomachand are characterized by white putrid throat, low fever, heat in the hearts of the palms and soles, fatigue, shortness of breath, and a fine rapid pulse.

Medicinal therapy: Yáng heat patterns are treated by draining heat and resolving toxin using Spirit Immortal Life-Giving Decoction (神仙活命汤 shén xiān huó mìng tāng). Yīn vacuity patterns are treated by nourishing yīn and clearing heat with formulas such as Yīn-Nourishing Lung-Clearing Decoction (养阴清肺汤 yǎng yīn qīng fèi tāng). Diphtheria should not be treated by upraising, sweating, precipitation, or surgery.

Acumoxatherapy: For yáng heat, base treatment mainly on LU, LI, TB, and ST. Select as the main points TB-17 (Wind Screen, 翳风 yì fēng), LU-5 (Cubit Marsh, 尺泽 chǐ zé), LI-4 (Union Valley, 合谷 hé gǔ), LI-17 (Celestial Tripod, 天鼎 tiān dǐng), LI-18 (Protuberance Assistant, 扶突 fú tú), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), needling with drainage. Prick LU-11 (Lesser Shang, 少商 shào shāng) and LI-1 (Shang Yáng, 商阳 shāng yáng) to bleed. For yīn vacuity, use the main points listed above, needling with supplementation or with even supplementation and drainage at BL-13 (Lung Transport, 肺俞 fèi shù), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), LU-5 (Cubit Marsh, 尺泽 chǐ zé), ST-44 (Inner Court, 内庭 nèi tíng), and KI-6 (Shining Sea, 照海 zhào hǎi).

Point selection according to signs: For headache, add Greater yáng (tài yáng) (太阳 tài yáng) and GB-20 (Wind Pool, 风池 fēng chí). For heat effusion and aversion to cold, add GV-14 (Great Hammer, 大椎 dà zhuī) and LI-11 (Pool at the Bend, 曲池 qū chí). For panting, add PC-6 (Inner Pass, 内关 nèi guān) and CV-22 (Celestial Chimney, 天突 tiān tú). For heart palpitation or fearful throbbing, add HT-7 (Spirit Gate, 神门 shén mén), PC-6 (Inner Pass, 内关 nèi guān), PC-4 (Cleft Gate, 郄门 xī mén), and BL-15 (Heart Transport, 心俞 xīn shù).

Etymology

Chin 白 bái, white; 喉 hóu, throat, larynx. Eng diphtheria, from Gk. diphthera, a piece of leather, from the toughness of the false membrane that characterizes the disease.