R.H., male, 40 years old, presents with localized inflammation on the right index finger. He had been working in the garden one week previously and had been bitten on the finger by a small insect. The lesion had progressively worsened, and he had sought medical help. The antibiotics and local dressing given to him by his GP had not been effective and the lesion had continued to worsen. The finger had become severely itchy, swollen and painful and he was unable to go to work. On examination the local area on the affected finger was swollen and eczematous with a clear yellowish exudate. Pulse: slippery and wiry Tongue: red with a thick white coat.
TCM Diagnosis:
Acute skin lesion due to Damp-Heat
Treatment:
Formula: Black Pearl ® Long Dan Xie Gan Wan
Dosage: 50 pills, 4 times daily
Outcome:
After two days the itching stopped. After four days the exudate stopped, and the finger returned to normal.
Comments:
This is a case with a localized problem in the skin of the index finger, which arose from irritation due to toxic material from an insect bite. The failure of treatment with antibiotics shows that it was not due to a bacterial infection. The insect bite triggered an allergic response, giving rise to an eczema-like lesion around the local area of the bite. In TCM terms, this type of lesion was due to the retention of Dampness and Heat. The choice of formula was determined by the location of the lesion, as Black Pearl ® Long Dan Xie Gan Wan has a powerful effect on clearing Damp-Heat at the extremities.
