HERPES ZOSTER (SHINGLES)

Clinical Manifestations
  • Prior to onset there may be:
    Slight fever
    Lymph node enlargement
    Local skin sensitivity and pain
  • This is an acute infectious skin disease
  • Usually along one side of the body
  • Papular eruptions
  • Lymph node enlargement
  • Nerve pain which may be very severe and may continue after disappearance of the papules
  • Occurs along the nerve routes, usually of the neck, intercostals, abdomen, lower back or extremities
    Ramsey-Hunt Syndrome:
    Facial paralysis
    Ear pain
    External ear papular eruption
  • Several days later they become scabs
  • Then they become light red
  • There may be pain without eruption
  • There may only be erythema
  • The virus may distribute through the blood system (systemic)
  • If Damp predominates: the lesions are primarily located on the lower part of the body with more fluid discharge
  • If Heat predominates: there is more pain, heat and redness
  • If Wind predominates: the lesions appear more often in the upper body with more itching
  • If Dampness and Heat combine: there will be painful, red blisters with discharge
  • If Wind and Heat combine: there will be painful, red blisters in the upper body
  • Channels:
    Liver/Gall Bladder: lesions and pain in the flanks and intercostal regions
    Yang Ming and Shao Yang: lesions and pain on the head and face
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Early-stage measles or rashes that do not surface evenly
  • Fever and chills
  • Headache
  • Generalized body aches
  • Sneezing
  • Cough
  • Red eyes
  • Tearing
  • Thirst
  • Intolerance of Wind
  • T: Red and dry
  • P: Floating and rapid.
Treatment Principle
  • Expel Exterior Wind-Heat
  • Release muscle layer
  • Vent rashes
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Severe sore and swollen throat
  • High fever with convulsions in infants
  • Difficulty swallowing
  • Carbuncles
  • Acute localized infection
  • Lymphangitis
  • Furuncles
  • Boils
  • Abscesses
  • T: Red
  • C: Greasy and yellow
  • P: Rapid
Treatment Principle
  • Relieve Toxic Heat
  • Reduce swelling
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Lingering fever from a febrile disease
  • Vomiting
  • Irritability
  • Thirst with a desire to drink
  • Parched mouth, lips and throat
  • Choking cough
  • Restlessness
  • Insomnia
  • Nausea
  • Anorexia
  • Profuse perspiration
  • A dry mouth
  • Indigestion
  • Listlessness
  • Chest oppression
  • Ulcerations of the mouth
  • Coarse skin
  • Cough
  • Night sweats
  • Stifling sensation in the chest or epigastrium
  • T: Red
  • C: Little or None
  • P: Rapid and Deficient or Thready and rapid
Treatment Principle
  • Clear Heat
  • Generate fluids
  • Tonify Qi
  • Harmonize the Stomach
Herb Formulas
Points
Clinical Manifestations
  • Soft, weak cough with clear thin sputum
  • Physical and mental exhaustion
  • Soft, weak voice
  • Reluctance to speak
  • Shortness of breath
  • Pale face
  • Spontaneous perspiration (daytime)
  • Low resistance to THE common cold
  • Tendency to blocked nose
  • T: Pale
  • C: Thin and white
  • P: Weak
Treatment Principle
  • Reinforce the Lungs
  • Strengthen Qi.
Herb Formulas
Points
Clinical Manifestations
  • Anorexia
  • Abdominal distention and discomfort
  • Suffocating sensation in the chest
  • Epigastric mass
  • Maybe abdominal pain on palpation
  • Yang jaundice (sclera and skin are bright yellow)
  • Dislike of oily foods
  • Nausea
  • Vomiting
  • Lassitude
  • Scanty, dark urine
  • Maybe thirst or thirst with no desire to drink
  • Diarrhea with foul smell or
  • Constipation
  • Fever
  • Sweet sticky taste or bitter taste in mouth
  • T: Pink
  • C: Thick, yellow and greasy (maybe sticky)
  • P: Soft and rapid
Treatment Principle
  • Clear Heat
  • Benefit Dampness
Herb Formulas
Points
Clinical Manifestations
  • Headache
  • Loose stools
  • Urinary difficulty
  • Scanty urination
  • T: Normal
  • C: Slippery and white
  • P: Floating and rapid
Treatment Principle
  • Regulate water circulation
  • Drain Dampness
  • Strengthen the Spleen
Herb Formulas
Points
Clinical Manifestations
  • Shingles on the chest, upper trunk in or near armpit or on the face
  • Large yellowish, white skin vesicles filled with turbid fluid which easily break and seep and form a soft crust that looks like cottage cheese or cauliflower that eventually forms a black scab and can leave an erosion when the scab finally falls off
  • Severe aching and pain after the lesions rupture
  • Torpid intake
  • Abdominal distention
  • Loose stools
  • Fatigue
  • T: Fat and enlarged
  • C: Slippery and white or yellow
  • P: Soggy and rapid or Slippery and rapid
Treatment Principle
  • Clear and disinhibit Dampness and Heat
  • Invigorate the Blood
  • Transform toxins
Herb Formulas
Points
  • LI-4, LI-11, SP-6, SP-9, ST-36
    For lesions near the eyes: + SJ-23, Taiyang, UB-2
    For lesions on the cheek: + ST-4, ST-6
    For lesions near temple: + Taiyang
    For lesions on the lower body: + GB-34
    For Blood Heat: + bleed UB-40, needle UB-17
    For severe pain and a burning sensation: + LIV-1, SP-1, then needle the head and tail of the eruption
    For irritability, a bitter taste in the mouth and a quick temper: + GB-34
    For restlessness and insomnia due to pain: + DU-20, DU-24, HT-7
    For itching: + LI-11, SP-10
    For severe Internal Heat: + ST-44
  • Moxa SP-6, ST-44, 0.5 cun outside of the first lesion to appear, in a clear area between the lesions, 0.5 cun outside the last lesion to appear
Clinical Manifestations
  • Ulceration, erosion, and pain of mouth and tongue
  • Thirst with a desire for cold drinks
  • Irritability, irascibility
  • Feeling of Heat and disturbance in Heart
  • Insomnia
  • Flushed face
  • Bitter taste in mouth
  • T: Red tip, ulcers especially on tip
  • P: Shi and rapid
Treatment Principle
  • Clear Heart
  • Cool Fire
Herb Formulas
Points
Clinical Manifestations
  • Feeling of a lump in the throat
  • The lump is soft and becomes larger or smaller according to the emotional situation
  • The lump is small or medium sized, relatively soft and slippery
  • The edges are indistinct
  • Oppressive feeling in the chest and hypochondrium
  • Difficulty swallowing
  • Loose stools
  • Irregular menstruation
  • Premenstrual tension
  • Suppurative sores
  • Ulcerations, abscesses and swellings that remain hard after discharge of pus
  • Restlessness
  • Insomnia
  • Thirst
  • Feeling of Heat
  • Irritability
  • Frequent sighing
  • Bitter taste in the mouth
  • Red eyes
  • Red face
  • Tremor of the hands
  • T: Pale or dusky or Red with red tip and edges
  • C: White or Thin and greasy or Dry and yellow
  • P: Wiry
Treatment Principle
  • Disperse Qi Stagnation
  • Dispel Heat and Dampness
  • Resolve Phlegm
  • Dissipate nodules
  • Reduce swelling
  • Drain pus
Herb Formulas
Points

Clinical Manifestations
  • Taut, red-colored skin vesicles which are like spots and dots of millet, gathered into patches
  • Burning Heat
  • Lancinating, pricking pain
  • Thirst with a preference for cold drinks
  • Vexation
  • Agitation
  • Severe, splitting headaches with dizziness
  • Sudden tinnitus or deafness
  • Flushed face
  • Red, swollen, painful eyes
  • Irascibility with violent angry outbursts
  • Dry mouth
  • Bitter taste in mouth
  • Vomiting sour or bitter liquid
  • Insomnia
  • Restlessness
  • Constipation or dry stools
  • Maybe rib pain
  • T: Red tip and edges
  • C: Thick, yellow, dry and rough
  • P: Wiry, excess and rapid
Treatment Principle
  • Clear the Liver
  • Purge Fire
  • Invigorate the Blood
  • Transform toxins
Herb Formulas
Points
Clinical Manifestations
  • This describes post-herpetic neuralgia. There may not be any remaining skin lesions or
  • There may be dark purplish scars but no vesicles
  • Severe, lancinating pain may be the main or only symptom
  • If there are vesicles, the bases are dark and purple
  • The fluid contains bloody water
  • The aching and pain are severe and difficult to bear
  • T: Purple and dark or with static Maculae or spots
  • C: Thin and white
  • P: Wiry and/or choppy
Treatment Principle
  • Invigorate the Blood
  • Transform toxins
  • Move Qi
  • Stop pain
Herb Formulas
Points
  • LI-4, PC-5, SJ-6, SP-6 + one local treatment
    For lesions on the cheek: + ST-4, ST-6
    For lesions near temple: + Taiyang
    For lesions on the upper body: + LI-11
    For lesions on the lower body: + GB-34
    For Blood Heat: + bleed UB-40, needle, UB-17
    For severe pain and a burning sensation: + LIV-1, SP-1, then needle the head and tail of the eruption
    For irritability, a bitter taste in the mouth and a quick temper: + GB-34
    For restlessness and insomnia due to pain: + DU-20, DU-24, HT-7
    For itching: + LI-11, SP-10
    For severe Internal Heat: + ST-44
    For damp sores: + SP-9
  • Moxa UB-17, 0.5 cun outside of the first lesion to appear, in a clear area between the lesions, 0.5 cun outside the last lesion to appear
Clinical Manifestations
  • Nerve pain which may be very severe and may continue after disappearance of the papules
  • Occurs along the nerve routes, usually of the neck, intercostals, abdomen, lower back or extremities
  • Facial color dark and dull
  • Emaciation
  • Sides and ribs distended on both sides (maybe with sharp pain)
  • Enlargement of Liver and Spleen
  • Suffocating sensation in chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Vexation
  • Agitation
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Dark purple (maybe purple spots on edge of tongue)
  • C: Normal
  • P: Wiry, choppy and slow
Treatment Principle
  • Invigorate the Blood
  • Relieve Stasis
  • Regulate Qi
  • Alleviate pain
  • Clear Heat
  • Detoxify
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Hypochondriac pain
  • Headache
  • Dizziness
  • Red sore eyes
  • Hearing loss
  • Swelling in the ears
  • Bitter taste in the mouth
  • Irritability
  • Short temper
  • Difficult and painful urination with a heat sensation in the urethra
  • Swollen and itchy genitalia
  • Yellow, foul smelling leukorrhea
  • Short menstrual cycle with reddish-purple blood
  • Ear discharge
  • Yellow urine
  • Chest pain
  • Constipation
  • Turbid urine
  • Dry throat
  • Hematuria
  • Pain in the armpits
  • Sweating in the groin
  • T: Red or Red edges
  • C: Yellow or Yellow and greasy
  • P: Wiry, Excess and rapid
Treatment Principle
  • Clear Heat
  • Relieve Dampness
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Hypochondriac pain
  • Headache
  • Dizziness
  • Red sore eyes
  • Hearing loss
  • Swelling in the ears
  • Bitter taste in the mouth
  • Irritability
  • Short temper
  • Difficult and painful urination with a heat sensation in the urethra
  • Swollen and itchy genitalia
  • Yellow, foul smelling leukorrhea
  • Short menstrual cycle with reddish-purple blood
  • Ear discharge
  • Yellow urine
  • Chest pain
  • Constipation
  • Turbid urine
  • Dry throat
  • Hematuria
  • Pain in the armpits
  • Sweating in the groin
  • T: Red or Red edges
  • C: Yellow or Yellow and greasy
  • P: Wiry, Excess and rapid
Treatment Principle
  • Clears Damp-Heat from the San Jiao
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Copious bleeding of dark purple blood
  • The blood is sticky during menstruation
  • May or may not have clots
  • Menstrual cycle is shortened (early menstruation)
  • Palpitations
  • Dizziness
  • Blurred vision
  • Pale, lusterless complexion
  • Pale nails
  • Abdominal pain
  • Irregular menstruation with little flow
  • Fixed lower abdominal pain
  • Vertigo
  • Tinnitus
  • Pale lips
  • May be amenorrhea
  • Insomnia
  • Menstruation may also be accompanied by distention and pain
  • T: Pale
  • C: Normal
  • P: Thin and weak or Thin and choppy
Treatment Principle
  • Tonify and Invigorate the Blood
  • Regulate Blood Circulation
  • Break up Stagnation
  • Eliminate Blood Stagnation
  • Regulate menstruation
  • Alleviate pain
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Dizziness
  • Vertigo
  • Nausea and vomiting
  • Insomnia
  • Dream-disturbed sleep with unusual dreams
  • Palpitations
  • Anxiety
  • Profuse white foamy sputum
  • Restlessness
  • Timidity
  • Indecisiveness
  • Indeterminate gnawing hunger
  • Seizures accompanied by copious sputum
  • Chest distention
  • Expectoration of yellow Phlegm
  • Bitter taste in the mouth
  • Chills and fever
  • Abdominal distention
  • Frequent dark, scanty urine
  • Irritability
  • Depression
  • Slight thirst
  • Anorexia after serious illness
  • T: Pink or Red tip
  • C: Yellow and greasy
  • P: Slippery and rapid or Wiry and rapid
Treatment Principle
  • Cool the Liver
  • Extinguish Wind
  • Increase Fluids
Herb Formulas
Points
  • General points
Clinical Manifestations
  • High fever
  • Irritability
  • Fidgeting
  • Dry mouth
  • Dry throat
  • Incoherent speech
  • Insomnia
  • Dark urine
  • Deep-rooted boils
  • Maculae
  • Carbuncles
  • Hematemesis
  • Hemoptysis
  • Palpitations
  • Furuncles
  • Tinnitus
  • Purpura
  • Red face
  • Rashes
  • Deep-rooted boils
  • Red eyes
  • Itchy skin
  • Fidgeting
  • Dry lips
  • Delirium
  • Dysentery with fever
  • Jaundice
  • Epistaxis
  • Hematuria
  • Cloudy mind
  • Diarrhea
  • T: Red
  • C: Yellow
  • P: Rapid and forceful
Treatment Principle
  • Clear Heat
  • Drain Fire
  • Relieve toxicity from all three Jiaos
  • Relieve inflammation
  • Stop bleeding
  • Purge Damp-Heat
Herb Formulas
Points

Clinical Manifestations
  • Local inflammation with pus
  • Deep-rooted, hard and painful boils
  • Erythema
  • Swelling
  • Heat
  • Carbuncles
  • Furuncles
  • Fever and chills
  • Pain
  • T: Red
  • C: Yellow and greasy
  • P: Rapid
Treatment Principle
  • Clear Heat
  • Purge Fire
  • Relieve toxicity
  • Cool the Blood
  • Reduce swelling
Herb Formulas
Points
  • General points