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Diseases 10, external medicine

*疾病10,外科 〔疾病10,外科〕jí bìng 10, wài kē

Dormant papules (瘾疹 yǐn zhěn): These correspond to urticaria in biomedicine and are characterized by itchy wheals on the skin that come and go, often appearing in different places. They are caused either by wind-cold or wind-heat. The distinction is made according to color. White wheals are attributed to wind-cold, while red wheals are attributed to wind-heat. Stomach heat and other toxins may also be involved.

prickly heat (痱子 fèi zi): A condition characterized by red papules attended with itching and tingling. Prickly heat occurs mostly in hot summer months and is attributed to brewing summerheat-damp that inhibits sweating. It most commonly affects infants and obese people and affects the head, neck, abdomen, back, shoulder, and groin.

Wart (疣 yóu): A skin-colored, white or dirty yellowish nonsuppurating growth up to the size of a soybean, like the center of a daisy or similar flower in texture, dry and light in substance, slightly painful under pressure, tending to bleed easily when knocked or grazed, and occurring singly or multiply on the back, the back of the fingers, or scalp; attributed to wind evil contending in the skin or to liver vacuity and blood dryness and sinew qì lacking in luxuriance. Biomedical correspondence: verruca vulgaris (common wart).

Sore (疮 chuāng, 疮疡 chuāng yáng): Any lesion of the skin marked by redness, swelling, pain, rupturing, itching and/or scaling. Sores are caused by the invasion of external evils, such as wind, dampness, and heat (especially the virulent form of heat known as heat toxin), which obstruct the local flow of qì and blood. The term sore toxin (疮毒 chuāng dú) loosely refers to the toxin that causes sores and pox.

Toxin swelling(肿毒 zhǒng dú):

Any swelling due to the presence of toxin (heat toxin, damp toxin). See toxin.

Malign sore (恶疮 è chuāng): Any sore that is scorching hot, swollen, and itchy, that continues to spread after rupturing, and fails to heal.

Welling-abscess (痈 yōng): A large suppuration in the flesh characterized by painful swelling and redness that are clearly circumscribed. Before rupturing, it becomes soft and marked by a thin shiny skin. Welling-abscesses arise when damp-heat and fire toxin cause congealing and stagnation of qì and blood that fosters putrefaction.

Effusion of the back (发背 fā bèi): A welling-abscess of the back.

Flat-abscess (疽 ): A flat-abscess is a diffuse swelling without any change in skin color and without a head. It is not hot and is associated with little pain. This is a yīn pattern. It arises as a result of qì and blood vacuity with congealing cold phlegm or when wind toxin and accumulated heat in the five viscera flow into the flesh and fall into the sinew and bone.

See also the following:

Yīn flat-abscess (阴疽 yīn jū): A deep malign suppuration of the flesh, sinew, and even the bone, attributed to toxic evil obstructing qì and the blood and causing putrefaction. It largely corresponds to cold abscess in biomedicine.

Flowing phlegm (流痰 liú tán): A chronic of the joints characterized by the formation of pus that can flow, or spread, to other parts, and that after rupture discharges like thin phlegm. Flowing phlegm is nowadays considered to be a form of headless flat-abscess. It is most commonly observed in children and adolescents often found to have a history of consumption (pulmonary tuberculosis), and affects most commonly the hip bone or spine and less commonly the knee, ankle, shoulder, elbow, or wrist.

Flowing phlegm is named differently according to location.

Boil (疖 jié): A small, round, superficial swelling that is red, hot, and painful, suppurates within a few days, and easily bursts. It is attributable to heat toxin or to summerheat-heat and usually occurs in the summer or autumn.

Clove sore (疔 dīng, 疔疮 dīng chuāng): A small hard sore with a deep root like a clove or nail, appearing most commonly on the face and ends of the fingers. A clove sore arises when fire toxin enters the body through a wound, and then heat brews and binds in the skin and flesh. It may also arise when anger, worry, and preoccupation or excessive indulgence in rich food or alcohol give rise to accumulated heat in the bowels and viscera, which effuses outward to the skin. Sometimes, a clove sore may have a single red threadlike line stretching from the sore toward the trunk. Clove sores can develop into a clove sore running yellow (疔疮走黄 dīng chuāng zǒu huáng), that is, one that becomes black without pus and causes the sore toxin to penetrate the blood aspect, giving rise to high fever, shiver sweating, a red or crimson tongue, rough yellow tongue fur and a pulse that is surging and rapid or slippery and stringlike. This corresponds to septicemia in biomedicine.

See also the following:

Damp sores (湿疮 shī chuāng): Any of a variety of skin diseases characterized by itching, ulceration, exudation, crusting, and recurrence. They specifically include scrotal wind and umbilical damp (脐湿 qí shī). Acute forms are ascribed mainly to damp-heat, very often with external wind. Wind is a yáng evil, light and buoyant; it easily invades the interstices of the head, face, and upper body, carrying dampness with it. Biomedical correspondence: includes various forms of eczema.

Innominate swollen toxin sores (无名肿毒 wú míng zhǒng dú): A sore characterized by localized pain and swelling that appears suddenly on any part of the body, so called because it is not like any well-defined type of external lesions such as a welling- or flat-abscess, scab, etc. It is caused by wind, cold, or heat lodged in the channels. When due to wind evil, there is neither head nor root. When due to qì contending with the blood, there is a head but no root. When attributable to wind-cold, the swelling is hard and white. When due to heat toxin, the swelling is red and hot.

Scab2 (疥 jiè): A disease characterized by small papules the size of a pinhead that are associated with insufferable penetrating itching and that, when scratched, may suppurate or crust without producing any exudate. Scab commonly occurs between the fingers and may also be observed on the inside of the elbow, in the armpits, on the lower abdomen, in the groin, and on the buttocks and thighs, and, in severe cases, over the whole body. It is attributed to damp-heat depressed in the skin and is transmitted by contact. In Zhū Bìng Yuán Hòu Lùn (诸病源候论 The Origin and Indicators of Disease) of the Suí Dynasty, the author, Cháo Yuán-Fāng, attributed it to worms, which he said were small and very difficult to see. It mostly corresponds to scabies in biomedicine.

Lichen (癣 xiǎn): A skin disease characterized by elevation of the skin, serous discharge, scaling, and itching. Lichen is associated with wind, heat, and dampness. Lichen marked by dryness and scaling of the skin is called dry lichen, whereas lichen that exudes a discharge is called damp lichen.

Oxhide lichen (牛皮癣 niú pí xiǎn): An episodic skin disease marked by thickening and hardening of the skin that gives it the appearance of the skin of an ox’s neck. It starts with itching, the appearance or irregular flat papules, and in some cases browning of the skin. The papules coalesce, and the skin becomes dry and hard with sores that weep and that are itchy especially at night. Oxhide lichen is attributed to wind-damp-heat toxin depressed in the skin and to insufficiency of provisioning-blood with blood vacuity engendering wind and depriving the skin of nourishment. It is often associated with emotional disturbances. Corresponds to neurodermatitis in biomedicine.

Goose-foot wind (鹅掌风 é zhǎng fēng): A skin disease of the hand characterized by vesicles, itching and thickening of the skin. Biomedical correspondence: tinea manus or eczema rhagadiforme in biomedicine. It is caused by wind toxin or dampness invading the skin. In the initial stages, it is marked by small vesicles and itching. Later, the white skin sheds. Persisting for long periods, the skin becomes thick and rough and tends to crack, especially in winter, and, in severe cases, the nails may thicken, turn gray, and crack. When limited to the center of the palm, it is sometimes called palm heart wind.

Ashen nail (灰指甲 huī zhǐ jiǎ): A disease of the fingers and toes that starts with itching around the nail and that deprives the nail of nourishment of blood, causing it gradually to thicken, lose its luster, assume an ashen appearance, and eventually to crumble and become deformed. Compare goose-foot wind above.

Acne (粉刺 fěn cì): Blackheads (comedones) or red papules (pimples) that are mostly found on the face and that can be squeezed to produce an oily, chalky substance, and that can develop into pustules. Acne is most common in young people. In severe cases, pimples may be large, red, and swollen and coalesce and spread to the neck, shoulders, and back. Acne is attributed to brewing lung-stomach heat fuming the face, causing heat and stagnation of the blood. It is often found to be related to excessive consumption of rich food. See also ld>seat sore.

Bald scalp sores (秃疮 tū chuāng): Also called bald white scalp sores (白秃疮 bái tū chuāng). A disease of the scalp mostly seen in children and characterized by white crusts that spread and coalesce and that are associated with unbearable itching and hair loss on the affected are. The hair usually grows back once the sores heal. Bald scalp sores are attributed to wind evil invading the interstices of the scalp or to the use of unclean hair-dressing implements.

Biomedical correspondence: tinea blanca (white piedra, white ringworm).

Leprosy (麻风 má fēn): Literally numbing wind. Also called great numbing wind (大麻風 dà má fēng); great wind (大風 dà fēng); pestilential wind (疠风 lì fēng); and repudiation (癩 lài), this last term (which in traditional literature may also refers to scab or lichen leading to hair loss in the affected area) reflects the social rejection of sufferers. Leprosy is a transmissible disease marked by localized numbing and subsequent appearance of red patches that swell and rupture without suppuration and that may spread to other parts of the body, causing loss of the eyes, collapse of the nose, fissuring of the lips, and boring of holes in the soles of the feet.

Scrofula (瘰疬 luǒ lì): Lumps under the skin, mainly on the side of the neck and under the armpits. Scrofula is mostly attributed to lung-kidney yīn vacuity and enduring depressed liver qì with vacuity fire concentrating fluids into phlegm, which binds in locally to form lumps. In some cases, it is caused by wind-fire toxin.

Phlegm node (痰核 tán hé): A lump below the skin that feels soft and slippery under the finger, is associated with no redness, pain, or swelling, and does not suppurate. It is caused by damp phlegm binding under the skin.

Umbilical damp (脐湿 qí shī): Also called umbilical damp swelling. A condition of wetness of and possible exudation from the umbilicus, sometimes with redness and swelling of the surrounding area after the umbilical cord has been shed. Umbilical damp is attributed to the invasion of water-damp resulting from improper care after removal of the cord.

Seat sores (坐板疮 zuò bǎn chuāng): Pimples on the buttocks.

Cinnabar toxin (丹毒 dān dú): A disease characterized by sudden localized reddening of the skin, giving it the appearance of having been smeared with cinnabar; hence the name. It corresponds to erysipelas and some forms of cellulitis in biomedicine. Cinnabar toxin usually affects the face or lower legs. It is most common among children and the elderly and most prevalent in spring and summer. Cinnabar toxin arises when damaged skin and insecurity of defense qì allow evil toxin to enter the body and give rise to heat in the blood aspect, which becomes trapped in the skin. If the toxin is accompanied by wind, the face is affected (wind-heat); if accompanied by dampness, the legs are affected (damp-heat). Note that the Chinese term丹毒 dān dú is used as the biomedical equivalent of erysipelas, but the original Chinese concept is wider in meaning, notably including cellulitis.

See also the following:

Lower-limb fire flow (下肢流火 xià zhī liú huǒ) is a type of cinnabar toxin that affects the lower legs and feet. It is marked by localized painful redness and swelling. It is attributed to damp-heat. See cinnabar toxin.

Girdling snake cinnabar (缠腰蛇丹 chán yāo shé dān): Also called girdling fire cinnabar (缠腰火丹 chán yāo huǒ dān): Corresponds to herpes zoster in biomedicine and commonly known as shingles. An elongated sore usually only on one side of the chest, rib-side, or abdomen characterized initially by pain and reddening of the skin and in advanced stages by blisters containing clear fluid. It is attributed to wind-fire in the heart and liver channels or to spleen-lung channel damp-heat.

Streaming sore (流注 liú zhù): A sore deep in the body, so called because of the tendency of its toxin to move from one place to another, as if flowing through the flesh. It begins with a lump or diffuse swelling of the flesh. It can suppurate and rupture. It heals if properly drained of pus.

See also the following:

Shank sore (臁疮 lián chuāng): A sore on the shin, characterized by redness, swelling, and itching. The local skin and flesh turn gray and dark. When scratched open, it suppurates. Shank sores can persist for a long time without healing. They arise mostly when damp-heat pours downward and causes blood stasis and qì stagnation. Accordingly, they are associated with a thin slimy yellow tongue fur and a slippery rapid pulse. If the sores persist without healing, they become grayish-white and exude thin dirty gray or green pus and tend to swell in the evening. These persistent conditions are attributed to center qì fall, which is often attended by a bright-white facial complexion, thin sloppy stool, a pale tongue with thin fur, and a fine pulse.

Foot qì sores (脚气疮 jiǎo qì chuāng): Referred to biomedically as tinea pedis and colloquially in English as athlete’s foot and in East Asia as Hongkong foot. A condition of the toes and feet attributed to damp-heat pouring downward and contact with damp toxin characterized in the initial stage by water vesicles and itching between the toes and soles, and in later stages by scaling, crusting, and erosion. Foot qì sores may also give off a strange smell, which accounts for the alternate name fetid river snail (臭田螺 chòu tián luó). They are common in people who live or work in damp or wet environments and are prevalent in hot humid climates.

Rock (岩 yán): A hard uneven swelling on the surface of the body, of fixed location, and unassociated with change in skin color. After it has ruptured, it appears like a pomegranate with the skin peeling away, purple in color, giving off a malign odor, acutely painful, and does not easily heal. Biomedical correspondence: Various kinds of carcinoma. Rock includes the following:

Genitals

See diseases 6, two yīn (anus and genitals).

Female Breast

See diseases 8, men and women.

Miscellaneous

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