5. QUCHI (LI-11), XUEHAI (SP-10), WAIGUAN (T-5)

 

Main effect and clinical purpose

 

The above points-combination is widely used to treat skin disorders, mainly characterized by Heat and Wind, of either internal or external origin.

 

These disorders Include allergic skin reactions, various types of eczema, rash, hives, and other conditions.

 

With added points like Yinlingchuan (SP-9) , or Sanyinjiao (SP-6), it may also treat skin conditions in which Damp exists, i.e. weeping eczema, furunculosis, etc.

 

Points discussion

 

Quchi is the most effective point for skin diseases, especially those characterized by wind and Heat. Its traditional functions are:

1. Eliminates Wind and exterior conditions.

2. Cools Heat and alleviates Dampness.

3. Regulates the Blood.

 

Quchi is situated on the Large Intestine meridian, a meridian most of whose functions deal with exterior conditions, or with the outer layers of the body, such as: skin, muscles, etc.

As its most pronounced function is to eliminate Heat, and therefore it is used in cases of fever, and since it is very influential at the skin level, Quchi removes Heat from the skin. By removing Heat from the skin, it improves Ching-I (fluid) circulation at the cellular level, thus facilitating skin nutrition. Quchi is also an important point to clear Heat from the blood. We know that the Large Intestine meridian carries the largest amount of blood in comparison with other meridians, as it belongs to the Yangming system. As a result of this fact Quchi is able to act directly on the blood, regulate it and drain excess Heat therefrom.

 

In this regard, we should bear in mind that many skin diseases are the result of "Heat entering the blood level", according to T.C.M. The Heat in the blood concept may be paralleled to the western concept of toxins in the blood. This phenomenon of toxins is of a hot energetic nature, often manifesting itself as red skin eruptions of various kinds. In its most extreme variation it is defined even in T.C.M as “Fire-toxin”. This definition is often attributed to the western medical diseases such as furunculosis, purulent abscesses and the like.

 

Xuehai - "Sea of blood" in Chinese, is situated on the Spleen meridian. The Spleen governs the circulation of blood (i.e. keeps the blood in the blood vessels), and governs the volume of blood, as it stimulates its creation. Xuehai, therefore, is the point which serves to regulate and invigorate blood circulation, on behalf of the Spleen. In its Indications Xuehai is said to harmonize blood and Ying 0i (nourishing Qi), and to cool Heat. In accordance with these qualities Xuehal is used to tonify blood, improve its circulation, and drain excessive Heat from it.

 

Waiguan is used in this prescription for its quality to relieve Exterior and Hot conditions. It is called the "Outer Gate" in Chinese, and thus serves as a gate-keeper against external pernicious influences.

 

* ..."Traditional Chinese Medicine teaches that to control Wind, the blood must first be regulated. Wind subsides by itself when normal blood flow is restored, ie., it is expelled naturally when it has nothing to cling to.

 

"The use of Xuehai and Waiguan for invigorating the blood and dispersing the Wind, combined with Quchi for clearing the Heat, is an important combination of points for treating the itching due to stagnation of Wind and Heat in the skin." (48).

 

Needling sequence, manipulation and stimulation

 

The needling sequence in this combination is from the upper limb to the lower limb. This follows the general acupuncture rules accordingly:

1. Generally apply needles first to the upper parts of the body, and then to the lower parts.

2. First apply to points situated on the back, and then on the abdomen.

3. Apply needles first to the left side, and then to the right side.

 

Manipulations of the needles are, in most cases, in order to disperse Wind and Heat, which are Shi conditions. In any case, Xuehai may sometimes be tonified, when the blood is Xu, or Dry, or, more often, be manipulated evenly so as to tonify the blood, and at the same time drain the pathogenic Heat.

 

In very acute conditions it is possible to bleed these points with the triangular needle, but it should not be done too often, as it might damage both Qi and Blood.

 

Herbal equivalent

 

The functions of Xuehai are very similar, in many aspects, to those of Radix Rehmainia Glutinosa (Sheng Di Huang).

This herb has properties, such as:

1. Clears Heat and cools the blood.

2. Indicated for cases of hemorrhage, where heat has penetrated the blood level (in cases like excessive menstruation, and premature menstruation, for which Xuehal Is also indicated).

3. Nourishes the Yin and the Blood.

 

The whole points-combination may be compared to a classical herbal prescription, that has about the same properties. it includes:

1. Periostracum Cicade - (Chan Tui)

2. Herba Mentha - (Bo He)

3. Radix Rehmania Glutinose - (Sheng Di Huang)

 

Chan Tui and Bo He belong to the Cool herbs that release exterior conditions. Therefore their main activity is to disperse Wind and clear Heat.

 

Both of them are also used to speed recovery in measles, as they are saidto encourage rashes to rise to the surface.

 

Sheng Di Huang, as mentioned above, acts on the blood level. By tonifying the blood it assists in dispersing Wind conditions, and by cooling the blood, it removes the basis for skin Hot conditions.

 

Case history

 

Miss O.S., age 9, has suffered for one month from a pruritic rash on her right costal surface, anteriorly and posteriorly.

 

Various allergic examinations did not reveal any special sensitivity, and local application of ointments had not improved her condition.

 

Questioning revealed that the rash had appeared suddenly, and that it was very itchy.

Observation showed that the rash consisted of tiny red points, giving the impression of Sand on the skin. It also showed a red rimmed tongue with a very thin white moss.

The diagnosis was an externally contracted Wind Heat, affecting the Liver/Gall Bladder meridians. (Wind Rash, in Chinese).

 

The fact that the rash appeared only on the surface of the right rib-cage, along with the red-rimmed tongue, pointed to the involvementof the Liver and Gall meridians. The sudden appearance of the disease, together with its red color, plus the thin white coating of the tongue, indicated an externally contracted Wind Heat.

The formula chosen for treatment was: Quchi (LI-11), Xuehai (SP-10), Waignau (T-5), Talchong (LIV-3), Sanyinjiao (SP-6).

 

Taichong and Sanyinjiao were added to the prescription in order to resolve stagnation of the Liver, and hasten the recovery. This is another well-known points-combination, used to promote the function of the liver, and spread Liver Q1.

 

After two treatments which were carried out on two consecutive days, there was no itchiness at all, and the rash had significantly diminished.

 

After the fifth treatment the problem was entirely resolved.