bubble_chart Concept

Chickenpox is a common acute eruptive pestilence disease in children. Because the blisters contain fluid and resemble bean grains, it is named chickenpox. It is also known as "chickenpox" or "chickenpox." It is most commonly seen in children under the age of ten.

Pox is one of the four major pediatric diseases, including smallpox, chickenpox, and other ailments. Due to widespread vaccination, smallpox has long been eradicated and is no longer included in this book. This section will only discuss the differentiation of symptoms in chickenpox.

bubble_chart Pattern Analysis

1. Wind-heat External Contraction︰Chickenpox appears like dewdrops, with clear and bright blister fluid, surrounded by faint redness that is not very noticeable. It is accompanied by headache, fever, nasal congestion, runny nose, cough, sneezing, a thin white tongue coating, a floating and rapid pulse, and red-purple finger venation. It is caused by the external contraction of wind-heat seasonal pathogens, internal accumulation of dampness-heat, which lingers in the spleen and lung meridians, leading to the outward expulsion of pathogenic factors and manifestation on the skin. Early symptoms often involve the lung-defense system. Key distinguishing features include: (1) Fever pattern: Fever with aversion to wind, but the temperature is not very high. (2) Timing of eruption: Rash appears on the same day as the fever or one to two days after. (3) Location of eruption: More concentrated on the head, face, hairline, and trunk, less on the limbs, and rarely on the palms and soles. (4) Pox appearance: Initially, red rashes the size of rice grains, slightly rough to the touch. After the rash appears, a small blister forms in the center, rapidly enlarging to the size of a pea or rice grain, varying in size, slightly round or oval, with thin and soft skin that ruptures easily. (5) Pox color: The top is clear and bright, containing transparent fluid without pus. The base is surrounded by a faint red halo, indistinct and diffuse. (6) Scab formation: After a few days, the vesicles dry out, with the center first becoming depressed before forming a thin scab. Scabbing occurs quickly, and the scabs are thin, taking several days to two or three weeks to fully shed, leaving no scars. (7) Eruption progression: New rashes continue to appear within three to five days of onset, sometimes in batches, so papules, vesicles, and scabs may coexist. (8) Systemic symptoms: Nasal congestion, runny nose, cough, sneezing, thin white tongue coating, floating and rapid pulse, and red-purple finger venation.
2. Exuberant Toxic Heat︰The pox lesions are large and dense, with a distinct base and a surrounding carmine-red halo. The pox color is purplish-dark, the vesicle fluid is turbid, and it is accompanied by high fever, dysphoria, thirst, red lips, mouth and tongue sores, scanty dark urine, a yellow, dry, and thick tongue coating, a slippery and rapid pulse, and purplish-stagnant finger venules. This occurs because the child has a weak constitution, or preexisting dampness-heat stagnation, or inadequate post-illness care, leading to deep penetration of pathogenic factors. The condition may shift from the defense aspect to the qi aspect but rarely enters the nutrient or blood aspects. When the pathogen invades the Yangming qi aspect, the pox lesions become large and dense, with a distinct base and a surrounding carmine-red halo, while the vesicles appear purplish-dark with turbid fluid. The distinguishing features are: (1) The pox apex is sharp and palpable; although the base is distinct with a carmine-red halo, the edges are slanted, wrinkled, and not tightly gathered. (2) Although the vesicles are purplish-dark and the fluid is turbid, scabbing occurs quickly after filling, with thin yellow scabs or thicker centers and thinner edges, leaving no scars after shedding. (3) Papules, vesicles, and scabs coexist simultaneously. (4) Systemic symptoms include high fever, irritability, thirst, red lips and flushed face, mouth and tongue sores, scanty dark urine, a yellow and thick tongue coating, a slippery and rapid pulse, and purplish-stagnant finger venules.

The treatment method for external contraction of wind-heat chickenpox, where the pathogen is in the defense aspect, should focus on dispersing wind and clearing heat. The representative formula is Lonicera and Forsythia Powder. For chickenpox with intense toxic heat, where the pathogen is in the qi aspect, the method should be to clear heat and remove toxins. The representative formula is the Wax Plum Detoxification Decoction. If the skin is red, itchy, and oozing, Mian Jian San can be applied to astringe and dry dampness, promoting healing.

Chickenpox in children is highly contagious, and once infected, it is very easy to develop the disease. However, the condition is relatively mild. If treated promptly and cared for properly, it usually heals within six to seven days. Moreover, after one episode, the child will not be infected again for life.

bubble_chart Documentation

1. Jingyue Quanshu．Measles Interpretation: "When chickenpox first appears, there are a dozen or so spots. After one day, water blisters form at the tips, and more appear on the second and third days. By the fourth day, the whole body itches, the sores break open, and a slight high fever occurs, after which the condition subsides. However, with this disease, one must avoid foods that induce outbreaks, and it will heal in seven or eight days." "Chickenpox can also resemble symptoms of a cold-damage disease, with a fever for two or three days before the rash appears, or accompanied by cough, flushed face, watery eyes, sneezing, or runny nose. But it is different from true smallpox, as it is easier to erupt and scab over. Treatment mainly focuses on clearing heat and removing toxins."
2. Yizong Jinjian Smallpox Essential Methods and Formulas．Difficult Cases of Smallpox: "Chickenpox originates from the spleen and lung meridians and is caused by dampness-heat. At the onset, it resembles severe smallpox, with a flushed face, red lips, watery eyes, cough, sneezing, thick and sticky saliva, and a fever for two or three days before the rash appears. The blisters are pointed, round, and large, containing clear water. They easily swell and scab over, without forming pus. Treatment should focus on clearing heat and removing toxins."
3. Youyou Jicheng．Chickenpox and Lushan Syndrome: "Chickenpox resembles true smallpox, with external symptoms such as a red face, flushed lips, watery eyes, cough, sneezing, thick and sticky saliva, and a fever for two or three days before the rash appears. The blisters are clear like water bubbles, shaped like small beans, with thin skin and a scab forming in the center. The surrounding redness is minimal, and they are easy to erupt and scab over. Applying warmth can make the scabs difficult to fall off, leading to ulcerated sores. Avoid ginger, pepper, spicy foods, and bathing in cold water, as these can cause ginger-like scabies and edema. From start to finish, wheat soup is the best remedy."