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Internal dispersion

内消 〔內消〕nèi xiāo

One of the three main methods of treating sores. It involves the use of dispersing medicinals to eliminate sores in the initial stage prior to suppuration. It includes the following forms:

Specific Methods

Exterior resolution (解表 jiě biǎo): In the initial stage of sores (first seven days), prior to suppuration or damage to right qì, the appearance of exterior signs (aversion to cold, heat effusion) call for the use of exterior-resolving medicinals to discharge the sore toxin through sweating. Heat patterns are treated by cool acrid exterior resolution with formulas such as Toad Venom Pill (蟾酥丸 chán sū wán), whereas cold patterns are treated by warm acrid exterior resolution, using formulas such as Unlimited Efficacy Elixir (万灵丹 wàn líng dān). Such treatment should be applied with care in case of severe right qì vacuity.

Freeing the interior (通理 tōng lǐ): In the initial or middle stage of sores, when there is exuberant heat toxin brewing in the interior, sores can be dispersed by draining-precipitants that expel the toxins from the bowels and viscera. A commonly used interior-freeing formula is Internal Coursing Coptis Decoction (内疏黄连汤 nèi shū huáng lián tāng). If there is yīn vacuity with effulgent fire depriving the stomach and intestines of moisture, Intestine-Moistening Decoction (润肠汤 rùn cháng tāng) should be used.

Clearing heat and resolving toxin (清热解表 qīng rè jiě biǎo): Most sores are attributable to heat, and heat clearing medicinals are used in the initial stage, suppurative stage, and post-rupture stage wherever there are signs of repletion heat and fire toxin causing redness, swelling, heat, pain, or discharge of thick pus accompanied by general signs such as heat effusion, vexation and agitation, thirst, rapid pulse, red or crimson tongue with a yellow fur, and, in severe cases, even clouded spirit and delirious speech. Distinction is made between heat in the qì aspect, which is treated by cold bitter fire draining with formulas such as Coptis Toxin-Resolving Decoction (黄连解毒汤 huáng lián jiě dú tāng), and heat in the provisioning aspect, which is treated by cooling the blood and clearing heat with Rhinoceros Horn and Rehmannia Decoction (犀角地黄汤 xī jiǎo dì huáng tāng).

Warming the channels and freeing the network vessels (温经通络 wēn jīng tōng luò): Yīn cold sore patterns at any stage of development are treated by warming the channels and freeing the network vessels using oral formulas such as Harmonious Yáng Decoction (阳和汤 yáng hé tāng) and Pubescent Angelica and Mistletoe Decoction (独活寄生汤 dú huó jì shēng tāng) and topical formulas such as Harmonious Yáng Decongealing Plaster (阳和解凝膏 yáng hé jiě níng gāo).

Moving qì (气虚 qì xū): Initial-stage sores often involve qì stagnation and blood stasis. On the basis of the principles that qì is the commander of the blood, and when qì moves, blood moves, moving qì can be used alone or in combination with other methods to treat initial-stage stores. An appropriate qì-moving formula is Free Wanderer Powder (逍遥散 xiāo yáo sǎn).

Moving stasis and harmonizing provisioning (行瘀和营 xíng yū hé yíng): Swelling and pain due to blood stasis can often be relieved by regulating provisioning-blood. The method of moving stasis and harmonizing provisioning can be used alone or in combination with other methods. An appropriate formula is Blood-Quickening Stasis-Dispersing Decoction (活血散瘀汤 huó xuè sàn yū tāng).

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