Sunday, May 18, 2014

ITCHING

Itching is a symptom that accompanies many diseases and patterns.  The main pathogenic factors that cause itching are:
Heat
External Wind
Wind in the skin
Dampness
Blood deficiency

For each pathogenic factor I will give the general acupuncture points for treatment.  Please note that these are only general points and other points depend on the disease and the part of the body affected. Please note that Baichongwo is an extra point located 1 cun above SP-10 Xuehai. Its name means "100 insects nest", a clear reference to its action on itching that feels as if insects were crawling under the skin. 

In the lists of points, I mention HE-7 Shenmen because, besides calming the Shen, it stops itching.

Heat
The itching caused by Heat manifests with red skin eruptions of the papular type.  It is seen in various diseases such as herpes.  In order to diagnose Heat as the cause of itching the tongue is important: it must be red with a yellow coating and possibly red points.

Acupuncture: LI-11 Quchi, SP-10 Xuehai, P-9 Zhongchong, LIV-2 Xingjian, HE-7 Shenmen.

Red papules
                                                                     

Red body with red points

External Wind
External Wind may cause itching such as itchy throat or itchy nose. 

Acupuncture: BL-12 Fengmen, TB-5 Waiguan, LU-7 Lieque, LI-4 Hegu. 

Wind the skin
By “Wind in the skin” I refer to a type of Wind that is neither internal nor external, but closer to the latter. Wind is a major pathogenic factor in skin diseases and it escapes a classification into internal or external.  

Wind in the skin is a major cause of itching in skin diseases.  It is characterized by being all over the body or moving from place to place. For example, in urticaria, the intense itching is caused by Wind in the skin.  Wind in the skin is also the cause of itching is certain types of eczema. We can diagnose Wind in the skin only when the itching involves the whole body or when it moves from place to place: if the itching is confined to one specific area, it is not Wind. 

Another characteristic of itching from Wind is that often there is nothing to be seen on the skin (although of course in urticaria there are bullae and in eczema papules).  Wind in the skin is the cause of itching in herpes zoster (but remember that this is also caused by Dampness).

Acupuncture: GB-31 Fengshi, TB-6 Zhigou, Baichongwo extra point, LIV-3 Taichong, HE-7 Shenmen.


Urticaria

Dampness
Dampness is a frequent cause of itching. Its main characteristic is that the itching is usually confined to one place.  For example, the itching from vaginitis or herpes is confined to the genitals.  The itching from Dampness manifests with vesicles or papules.  

When Dampness is combined with Heat, the itching is more intense as it is caused by the combined effect of both Dampness and Heat.  Damp-Heat is a major pathogenic factor in eczema: it is very important to treat the itching in eczema because scratching aggravates this disease significantly.  Indeed some of the pathology of eczema is caused by the scratching rather than the disease itself. Scratching causes skin erosion and it may facilitate the entry of bacteria that cause skin infections. 

Acupuncture: Ren-9 Shuifen, Ren-5 Shimen, BL-22 Sanjiaoshu, SP-9 Yinlingquan, Baichongwo, HE-7 Shenmen.

Herpes Zoster  (Damp-Heat)

Herpes simplex (Damp-Heat)
Genital herpes (Damp-Heat)

Blood deficiency
In Blood deficiency the itching is generalized, i.e not confined to a specific area. An important characteristic of itching from Blood deficiency is that is may occur without any skin lesions.  Itching from Blood deficiency is seen in chronic eczema (in which case of course there are skin lesions) and in psoriasis. 

The itching from Blood deficiency may also be accompanied by other changes in the skin such as dryness and desquamation: this is seen a lot in psoriasis. 

Acupuncture: LIV-8 Ququan, Ren-4 Guanyuan, ST-36 Zusanli, SP-6 Sanyinjiao, HE-7 Shenmen.

Desquamation
Erosion

Itching may also be classified according to Chinese categories of pathogenic factors as follows:
Du (Toxin)
Feng (Wind)
Jiu (Alcohol)
Re (Heat)

Du (Toxin)
The itching from Toxin manifests with erosion, papules or bullae and it appears suddenly.  Contact dermatitis is a good example of it.   

Acupuncture: BL-40 Weizhong, SP-10 Xuehai.

Bullae


Feng (Wind)
The itching from Wind is generalized.  It may be from external Wind or Wind in the skin as defined above.  It may also be from Internal Wind in which case it would manifest with desquamation. 

Acupuncture: GB-31 Fengshi, BL-12 Fengmen, GB-20 Fengchi, Du-16 Fengfu, TB-17 Yifeng.

Jiu (Alcohol)
This is the itching that affects people after drinking alcohol. This occurs in people who are not usual drinkers.  

Acupuncture: LIV-3 Taichong, SP-10 Xuehai, HE-7 Shenmen. 

Re (Heat)
As we have sen above, Heat is a common cause of itching and it may manifest with red bullae or papules. 

Acupuncture: LI-11 Quchi, SP-10 Xuehai, P-9 Zhongchong, LIV-2 Xingjian, HE-7 Shenmen.

THE PO AND ITCHING
The Po is the physical soul that resides in the Lungs. It is always contrasted with the Hun that resides in the Liver.  The Hun is Yang and survives after death; the Po is Yin and dies with the body.  

Zhang Jie Bin says: “The Po can move and do things and [when it is active] pain and itching can be felt”.  The Po is responsible for sensations and itching and is therefore closely related to the skin through which such sensations are experienced. For this reason, in itching, I also treat the Lungs with LU-7 Lieque. 

HERBS THAT EXPEL WIND IN SKIN DISEASES
Fang Feng Radix Saposhnikoviae
Jing Jie Herba Schizonepetae
Chan Tui Periostracum Cicadae
Cang Er Zi Fructus Xanthii
Bo He Herba Menthae haplocalycis
Niu Bang Zi Fructus Arctii

HERBS THAT RELIEVE ITCHING
Chan Tui Periostracum Cicadae
Ku Shen Radix Sophorae flavescentis
She Chuang Zi Fructus Cnidii
Xu Chang Qing Radix Cynanchi paniculati