External Medicine

Question 1

boils on lip, nose, eye brow, forehead; small boils w/ pus, deep-hard root, or itching or numbness; then reddish, swollen, heat, pain
fever, aversion to cold, dry mouth, bitter taste
t: red w/ yellow coating
p: wiry-rapid

Answer 1

acute furuncle
toxic heat accumulation (first stage)

DU 12, DU 10, LI 4, BL 40

Question 2

big boils, severe redness, swollen, heat, pain, leaking pus from boil

t: red w/ yellow-greasy coating
p: slippery-rapid

Answer 2

acute furuncle
excessive fire toxin (second stage)

DU 12, DU 10, LI 4, BL 40, DU 14, PC 3, BL 16

Question 3

boils, acute lymphangitis going up to elbow, armpit, or groin area
high fever
t: crimson w/ yellow-greasy coating
p: thready-rapid

Answer 3

acute furuncle
fire toxin entering into nutritive and blood levels (last stage)

DU 12, DU 10, xi-cleft points, purging along red line on skin, moxa w/ garlic

Question 4

erysipelas on face, red, swollen, burning pain, or blister (unable to open eyes if around eyes)
aversion to cold, fever, painful body, poor appetite, scanty urine, constipation
t: red w/ yellow coating
p: floating-rapid

Answer 4

erysipelas
wind-heat and toxic accumulation

LI 4, LI 11, BL 12, BL 40, GB 31, SJ 5, a-shi

LV-GB fire: erysipelas on body area, fresh red blisters

LV 14, LV 2, GB 43, GB 34

Question 5

erysipelas on lower leg, red, swollen, burning pain, or large blisters, purplish spots, pus, or skin necrosis, recurrent attacks, chronic lymphangitis, fever

t: yellow-greasy coating
p: slippery-wiry-rapid

Answer 5

erysipelas
damp-heat and toxic accumulation

SP 10, SP 6, ST 44, SP 9, ST 40, ST 41, a-shi

Question 6

new born baby, erysipelas around navel and legs, red, swollen, burning pain, traveling rapidly all over body
t: red w/ yellow-greasy coating
index finger vein: purplish-blackish

Answer 6

erysipelas
fetus fire and toxic accumulation

DU 14, LI 11, LI 4, SP 10, BL 40, Shi Xuan

Question 7

swollen or enlarged thyroid gland, soft, painless, better when happy, worse w/ stress or anger
chest and hypochondriac distention, stuffiness, emotional fluctuations, poor appetite, epigastric stuffiness
t: thin greasy
p: wiry-slippery

Answer 7

goitre
qi and phlegm stagnation

RN 22, LI 4, ST 36, LV 3, SJ 13, a-shi

Question 8

swollen or enlarged thyroid gland, painless

bad temper, 5-centre heat, palpitations, sweating, dizziness, blurred vision, dry eyes, hand tremors

Answer 8

goitre
yin xu w/ empty fire

LV 3, KD 3, SP 6, SJ 13, PC 5, a-shi

Question 9

chronic swollen or enlarged thyroid gland, painless, severe swollen neck
fatigue, shortness of breath, chest oppression, rough breathing, tight throat, hoarseness
t: thin greasy
p: thready-wiry

Answer 9

goitre
qi-blood xu

RN 22, SP 10, LI 4, ST 36, SP 6, RN 17, a-shi

Question 10

small bean-like nodules on neck, one or multiple, painless, w/o redness or burning, hard and smooth surface, movable by pushing

t: thin greasy
p: wiry-slippery

Answer 10

scrofula
qi and phlegm stagnation (early stage, nodules)

GB 21, SJ 10, LV 14, ST 40, Zhou Jian, a-shi

Question 11

bigger bean-like nodules on neck, sticking to skin, or a couple of nodules fused together, immovable by pushing, painful, skin colour changes to dark dull red before suppuration w/ mild burning, mild wave sensation when pushing

Answer 11

scrofula
yin xu w/ empty fire (middle stage, abcess)

SJ 10, HT 3, SP 6, KD 3, Bai Lao, a-shi

Question 12

leaking clear pus w/ flossy turbid substance from nodules, opening of nodule shows subcutaneous fistula, soft tissue colour is grey, white, purplish around opening; if pus becomes thick, soft tissue becomes red

Answer 12

scrofula
qi-blood xu (late stage, pus leaking)

ST 36, SP 6, BL 43, RN 6, BL 17, Bai Lao

Question 13

breast lump due to milk accumulation, no change or little change in skin colour, or mild redness, swelling, distending pain
aversion to cold, fever, headache, whole body soreness, thirst, poor appetite, constipation
t: yellow coating
p: rapid

Answer 13

acute mastitis
qi stagnation and heat accumulation (early stage)

LI 4, LV 3, ST 36, ST 18, RN 17, GB 21, SI 1, LI 11

Question 14

burning pain of breast, swelling w/ redness, soft lump, can palpate pus inside
high fever, thirst, scanty yellow urine, constipation
t: red w/ yellow greasy coating
p: overflowing, rapid

Answer 14

acute mastitis
toxic heat accumulation (abscess stage)

ST 16, GB 21, ST 36, ST 40, LV 2, ST 44, DU 14

Question 15

excretion of pus from breast, low fever, swelling and pain
w/ fatigue, pale face, poor appetite
if pus is clear and does not come out smoothly w/ swelling breast pain, means toxicity has gone to other meridians
t: pale w/ thin coating
p: weak

Answer 15

acute mastitis
deficient healthy qi w/ lingering toxicity (diabrosis stage)

ST 36, SP 6, RN 6, RN 17, BL 17, BL 20, BL 21, BL 43, ST 18, SI 11

Question 16

breast nodules, better or worse w/ emotional fluctuation

Answer 16

hyperplasia of mammary glands
LV qi stagnation w/ phlegm accumulation

LV 3, ST 15, ST 40, RN 17, PC 6

Question 17

breast nodules, worse before period, better after period

Answer 17

hyperplasia of mammary glands
Chong-Ren disharmony

BL 18, BL 23, RN 4, RN 17, ST 15, SP 6, ST 40

Question 18

pain around navel, then shifts to lower right abdomen, fixed pain, refuse to be pressed, mild rebound tenderness
fever, aversion to cold, nausea, vomiting
t: white greasy coating
p: wiry-tight

Answer 18

acute appendicitis
qi and blood stagnation (first stage)

ST 37, ST 25, ST 36, SP 10, Lan Wei Xue

Question 19

sharp or jumping pain around right lower abdomen, w/ muscular tension and obvious rebound tenderness
fever, dry mouth, constipation, scanty yellow urine, epigastric/abdominal bloating
t: red w/ yellow-greasy coating
p: wiry-slippery

Answer 19

acute appendicitis
stagnation changing to heat (abscess stage)

ST 37, ST 25, BL 25, LI 11, LI 4, ST 36, ST 44, Lan Wei Xue

Question 20

severe right lower abdominal pain, pain radiating to whole abdomen, general abdominal muscular tension and pressing pain, obvious rebound tenderness, or lump w/o clear edge can be palpated, high fever

t: crimson, dry, w/ thick yellow dry or thick greasy coating
p: wiry-slippery-rapid or overflowing-rapid

Answer 20

acute appendicitis
toxic heat accumulating in intestines (diabrosis stage)

Lan Wei Xue, ST 37, ST 36, LI 4, SP 14, Pi Gen

Question 21

bleeding w/ bowel movement, fresh red blood, itchy anus, bloating and gas

t: red w/ thin white or yellow coating
p: floating-rapid

Answer 21

hemorrhoids
wind-heat injuring intestine collaterals (or intestinal wind w/ bleeding)

BL 35, BL 57, LI 11, SP 10, BL 17, Er Bai

Question 22

bleeding w/ bowel movement, fresh turbid red blood, large amount of blood, prolapsed anus, can be pushed back, burning pain

t: red w/ yellow greasy coating
p: slippery-rapid

Answer 22

hemorrhoids
damp-heat descending downwards (LI damp-heat)

BL 35, BL 57, SP 9, SP 6, SP 5, Er Bai

Question 23

hemorrhoid w/ prolapsed anus, sometimes cannot be pushed back, tight anus, anal pulling, distending pain, or swollen anus

t: dark red-purplish w/ thin yellow coating
p: wiry, thready, choppy

Answer 23

hemorrhoids
qi and blood stagnation

BL 30, BL 57, BL 32, SP 6, BL 17

Question 24

hemorrhoid w/ prolapsed anus, cannot be pushed back, anal pulling sensation, dilute clear blood, pale face

t: pale w/ white coating
p: thready-weak

Answer 24

hemorrhoids
SP qi xu/sinking

DU 20, RN 8, BL 20, SP 6, ST 36, BL 30

Question 25

anal fissure

Answer 25

anal fissure
excessive heat w/ intestine dryness
OR
yin xu w/ intestine dryness

Question 26

rectal prolapse

mild: back by itself
severe: comes out anytime while patient is tired, not able to go back itself, pale colour

Answer 26

rectal prolapse
SP xu (SP qi sinking)

DU 1, BL 25, BL 57, DU 20 (moxa), RN 6

Question 27

rectal prolapse, dark purple or dark red colour, ulceration, skin lesions, pulling pain, burning pain

Answer 27

rectal prolapse
damp-heat descending down

DU 1, BL 25, BL 57, LI 11, SP 9