Patient: Lucia, female

Date of first appointment: 9/29/2020

Chief complaints: carbuncle on the back

TCM prescription: San Huang cream to apply topically, and herbal decoction to drink for 14 days

Herbal decoction: zao jiao ci (皂角刺) 15g, huang qin (黄芩) 10g, ban lan gen (板蓝根)10g, da huang (大黄) 6g, zhi shi (枳实) 10g, ci diao gen (刺刁根) 10g, huang qi (黄芪) 20g, mu er (木耳) 10g, cang zhu (苍术) 10g, fu ling (茯苓) 10g, ze lan (泽兰) 10g, huang lian (黄连) 5g, chuan shan long (穿山龙) 10g

Before treatment picuture:

 Day 1 and 2 after treatment: the carbuncle has opened up by day 2.

Day 3 after treatment: the carbuncle is healing

 Date of second appointment: 10/21/2020

TCM prescription: zao jiao ci (皂角刺) 15g, huang qin (黄芩) 10g, ban lan gen (板蓝根)10g, da huang (大黄) 6g, zhi shi (枳实) 10g, ci diao gen (刺刁根) 10g, huang qi (黄芪) 60g, mu er (木耳) 10g, fu ling (茯苓) 10g, ze lan (泽兰) 10g, chuan shan long (穿山龙) 10g, lian qiao (连翘) 10g, dang gui (当归)10g, chuan qiong (川穹) 5g

Picture taken on 11/16/2020: The carbuncle has disappeared completely.

Herbs from the first prescription and their medicinal characteristics: (complied by Gina Vanwingerden)

Zao Jiao Ci 15g-

Nature: acrid, warm

Enters: Liver, Stomach

 Actions: Reduces swellings; discharges pus; promotes blood circulation; reduces abscesses; expels wind; kills parasites.

Huang Qin 10g-

Nature: bitter, cold,

 Enters: Lung, Large Intestine, Liver, Gallbladder, Stomach

Actions: Clears heat; dries dampness; reduces fire; eliminates toxicity; stops bleeding; calms the fetus; sedates liver Yang rising.

Ban Lan Gen 10g-

 Nature: bitter, cold

Enters: Heart, Lung, Stomach

Actions: Clears heat; eliminates toxicity; cools the blood; benefits the throat; strongly relieves swelling and disperses stagnation.

Da Huang 6g-

Nature: bitter, cold

Enters: Stomach, Large Intestine, Liver, Heart, Spleen

Actions: Clears heat, reduces fire; eliminates toxicity; promotes blood circulation, dispels blood stasis; drains accumulation and stagnation; drains damp-heat; drains heat from the blood, clears heat obstructing the blood level.

Zhi Shi 10g-

Nature: bitter, acrid, slightly cold

Enters: Spleen, Stomach, Large Intestine

Actions: Strongly moves/regulates Qi; directs Qi downward; eliminates food retention (particularly in the large intestine), breaks up stagnation and accumulation; resolves phlegm; relieves distention; unblocks the bowels

• Accumulation and stagnation: epigastric or abdominal pain and distention or indigestion with focal distention or gas.

• Accumulation and stagnation, including due to food retention in the large intestine: distention in the abdomen, constipation or diarrhea with tenesmus.

• Phlegm obstruction with Qi stagnation: distention and fullness in the chest and epigastrium.

• Particularly useful for stagnation in the chest and upper back.

Liang Mian Zhen 10g-

Dispels Wind, promotes the movement of Qi, overcomes Dampness, unblocks the collaterals, invigorates the Blood, disperses Stasis, reduces swelling, resolves toxicity and stops pain.

Huang Qi 30g-

Nature: sweet, slightly warm Enters: Spleen, Lung Actions: Tonifies spleen Qi and Lung Qi; lifts spleen Qi (raises the Yang Qi of the spleen and stomach); tonifies defensive (Wei) Qi; protects/stabilizes the body surface and eliminates pathogenic factors from the surface; discharges pus; promotes tissue regeneration; promotes urination, relieves edema; regulates water metabolism; nourishes blood

Bai Mu Er 10g-

Nature: sweet, bland, neutral Enters: Lung, Stomach Actions: Nourishes stomach Yin; moistens the Lungs; generates body fluids; nourishes Lung Yin. Indications: • Yin deficiency with Yang rising, especially with emaciation, heat in the five centers (five hearts hot). • Lung consumption, lung cancer. • Lung heat: dry, nonproductive cough or blood-streaked sputum

Fu Ling 10g-

Nature: sweet, bland, neutral Enters: Heart, Spleen, Kidney, Lung Actions: Drains dampness and harmful body fluid by promoting urination; tonifies spleen Qi; calms the Shen; transforms phlegm; harmonizes the middle Jiao. Indications: • Spleen Qi deficiency with dampness: loose stool, fatigue, poor appetite. • Stagnation of fluids or dampness: edema, scanty urination, difficult urination, diarrhea.

Ze Lan 10 g-

Nature: acrid, bitter, slightly warm Enters: Liver, Spleen Actions: Promotes blood circulation (without damaging Zhen Qi), dispels blood stasis; promotes urination, relieves edema; frees the flow of liver Qi; opens the channels; unblocks the menses. Indications: • Blood stasis: irregular menstruation, dysmenorrhea, amenorrhea, abdominal pain during menses and after childbirth, masses in the abdomen 

Chaun Shan Long 10g-

Dispels Wind and eliminates Dampness, Invigorates the Blood, unblocks the collaterals and relaxes the sinews

Lian qiao 10g-

Nature: bitter, slightly cold Enters: Heart, Lung, Liver, Gallbladder Actions: Disperses internal stagnant heat (from Qi stagnation); clears heat; eliminates toxicity; can separate a mixture of Yang pathogenic factors. Indications: • Wind-heat or early stage attack of warm-heat pathogen: fever, headache, thirst, sore throat, slight chills. • Heat and toxicity: various kinds of carbuncles, nodules 

Dang Gui 10g-

Nature: sweet, acrid, warm

Enters: Liver, Heart, Spleen

Actions: Nourishes blood; promotes blood (and Qi) circulation; harmonizes the blood; relieves pain; moistens the large intestine; regulates the menses; disperses cold; reduces swelling; expels pus; generates flesh.

Indications:

• For any form of blood deficiency.

• Blood deficiency and stagnation: irregular menses, dysmenorrhea, amenorrhea.

• Blood deficiency: ashen face, tinnitus, blurry vision, palpitations.

• Blood deficiency with chronic wind-damp Bi syndrome.

• Blood deficiency and cold: abdominal pain.

• Blood stasis (especially with cold from deficiency): pain, traumatic injury, Bi, carbuncles/boils.

• Blood deficiency leading to large intestine dryness: constipation.

• Useful for some sores or abscesses (where blood deficiency and stasis are involved). 

Chuan Xiong 5g-

Nature: acrid, warm

Enters: Pericardium, Liver, Gallbladder

Actions: Promotes blood and Qi circulation; eliminates external wind; relieves pain; moves Qi upward.

Indications:

• Blood (and Qi) stasis: irregular menstruation, amenorrhea, difficult labor, lochioschesis, and many kinds of pain, including abdominal, chest, flank, hypochondriac, dysmenorrhea, pain from traumatic injury, pain from carbuncles and boils, headaches, Bi syndrome.

• External wind disorders: headache, dizziness, painful obstructions, skin disorders; wind-damp arthritis/rheumatism.

E Zhu 10g-

Nature: acrid, bitter, warm

Enters: Liver, Spleen

Actions: Strongly promotes blood and Qi circulation and dispels blood stasis; dissolves accumulations, eliminates food retention; relieves pain.

Herbs added to the second prescription and their medicinal characteristics: (complied by Gina Vanwingerden)

Cang zhu-

Nature: acrid, bitter, warm Enters: Spleen, Stomach Actions: Strongly dries dampness and strengthens/activates the spleen; eliminates wind- dampness (and cold); eliminates dampness in the lower Jiao; induces sweating, releases exterior syndromes; improves vision. Indications: • Accumulation of dampness in the middle Jiao: distention in the epigastrium and abdomen, poor appetite, diarrhea, epigastric distention and pressure

Huang Lian-

Nature: bitter, cold

Enters: Heart, Liver, Large Intestine, Stomach, Spleen

Actions: Clears heat; dries dampness; reduces fire; eliminates toxicity; clears heart fire, drains stomach and liver fire; adjusts the appetite; stops bleeding due to heat.

Indications:

• Heart fire: irritability, insomnia, high fever, restlessness, coma, delirium. Also combined with Rou gui for heart/kidney disharmony.

• Stomach or large intestine damp-heat: diarrhea, dysentery, vomiting, acid regurgitation.

• Stomach fire: digestive dysfunction, belching with a putrid odor, excessive hunger and thirst, diabetes. Also with Wu zhu yu in Zuo Jin Wan.

• Heat in the blood: epistaxis, hematuria, hemafecia, hematemesis.

• Heat and toxicity: carbuncles, boils

• Topical: for red and painful eyes; ulcerations of the mouth and throat; first and second degree burns; exudative erythema multiforme. Often used as a powder or ointment.

 **Take OUT Dang Qui, Chun Xiong, Lian Qiao.