Pudendal itch

Itching of the female external genitals or vagina; attributed either to damp-heat pouring downward or yīn vacuity and blood dryness.

Patterns

Damp-heat pouring downward (湿热下注 shī rè xià zhù) causes pudendal itch characterized by itching that is often severe and accompanied by a yellow pus-like vaginal discharge with a fishy smell, heart vexation, difficulty sleeping, bitter taste and slimy sensation in the mouth, bitter oppression in the chest and rib-side, frequent short voidings of urine, yellow slimy tongue fur, and a slippery stringlike pulse. In some cases, poor hygiene combines with damp-heat to nurture invisible worms that cause ulceration (see genital erosion).

Medicinal therapy: Damp-heat patterns are treated by clearing heat and disinhibiting dampness with Gentian Liver-Draining Decoction (龙胆泻肝汤 lóng dǎn xiè gān tāng) plus dictamnus (Dictamni Cortex, 白鲜皮 bái xiān pí) and carpesium seed (Carpesii Fructus, 鹤虱 hè shī) or with Fish Poison Yam Dampness-Percolating Decoction (萆薢渗湿汤 bì xiè shèn shī tāng). Itching can be relieved by an external steam-wash of decocted Cnidium Seed Powder (蛇床子散 shé chuáng zǐ sǎn), which contains cnidium seed (Cnidii Fructus, 蛇床子 shé chuáng zǐ), zanthoxylum (Zanthoxyli Pericarpium, 花椒 huā jiāo), calcined alum (Alumen Dehydratum, 枯矾 kū fán), flavescent sophora (Sophorae Flavescentis Radix, 苦参 kǔ shēn), and stemona (Stemonae Radix, 百部 bǎi bù), and to which mugwort (Artemisiae Argyi Folium, 艾叶 ài yè) may also be added.

Acumoxatherapy: Base treatment on CV, SP, and LR. Main points for both patterns: CV-3 (Central Pole, 中极 zhōng jí), BL-34 (Lower Bone-Hole, 下髎 xià liáo), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo). For damp-heat pouring downward, add SP-10 (Sea of Blood, 血海 xuè hǎi), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), and LR-5 (Woodworm Canal, 蠡沟 lǐ gōu); needle with drainage.

Yīn vacuity and blood dryness (阴虚血燥 yīn xū xuè zào) patterns, observed in enduring disease or old age (after menopause), are characterized by itching with dryness and burning sensation that worsens at night. These patterns are associated with scant yellow or bloody vaginal discharge, tinnitus, dizziness, lumbar and leg pain, sometimes baking heat [effusion] with sweating, a red tongue with scant fur, and a fine stringlike or forceless rapid fine pulse.

Biomedical correspondence: This condition may occur in trichomonas vaginitis, colpomycosis, or senile vaginitis.

Medicinal therapy: Supplement the blood and eliminating wind. Use Chinese Angelica Beverage (当归饮 dāng guī yǐn). The topical treatment given above can also be given (although it is more effective for damp-heat).

Acumoxatherapy: To the main points given above add KI-6 (Shining Sea, 照海 zhào hǎi), LR-8 (Spring at the Bend, 曲泉 qū quán), GB-20 (Wind Pool, 风池 fēng chí), and LR-3 (Supreme Surge, 太冲 tài chōng), needling with supplementation.

Etymology

Chin 阴 yīn, yīn (the complement of yáng); 痒 yǎng, itch.