bubble_chart Concept

The condition known as "erysipelas" is named for its clinical manifestation of redness in the skin or mucous membranes, resembling the color of cinnabar. Waike Dacheng states: "Erysipelas is a sudden reddening of the skin surface, like the appearance of cinnabar." Depending on the location of occurrence, it is referred to as: "head erysipelas," "fire flow (erysipelas of the shank)," "internal cinnabar," and "wandering erysipelas."

The earliest record of this condition is found in Neijing, where it is called "erysipelas." Sun Si-miao's Qianjin Fang refers to it as "heavenly fire."

bubble_chart Pattern Analysis

1. Dampness-heat Transforming into Fire︰Also known as fire flow (erysipelas of shank), its clinical manifestations include fever and chills, generalized pain, localized skin redness, swelling, burning pain, and clear boundaries. It often occurs in the lower limbs, and the inguinal lymph nodes on the affected side may also become swollen and painful. Repeated episodes can lead to skin thickening and swelling, known as "swollen foot wind wilting." The pulse is slippery and rapid, with a yellow, greasy tongue coating. It is mostly caused by beriberi, skin damage, infection with toxic qi, or dampness-heat transforming into fire. Treatment focuses on clearing heat, removing toxin, and draining dampness, using Coptis Detoxification Decoction combined with Three Marvel Pill. For recurrent cases with localized skin swelling, hardness, dark color, and roughness, additional herbs to promote blood circulation and unblock meridians should be included.
2. Wind-heat Transforming into Fire︰Also known as head erysipelas or swollen-head infection, it often occurs on the facial skin (starting near the ear or nose), with intense redness and burning heat, quickly spreading to the entire face or head. The skin appears glossy and tight, sometimes with small blisters. Swelling of the eyelids, earlobes, and lips is common, accompanied by systemic symptoms such as shivering, high fever, headache, thirst, nausea, vomiting, and even unconsciousness or delirious speech. The pulse is floating and rapid, with a yellow, greasy tongue coating. It is mostly caused by external contraction of wind-heat that transforms into fire due to improper treatment, leading to the accumulation of fire toxin and the mutual agitation of wind and fire. The clinical characteristics include rapid onset, severe symptoms, and the potential for toxic pathogens to invade the nutrient level if not managed properly, resulting in unconsciousness and delirious speech. Treatment involves clearing heat and removing toxins, using the Universal Relief Decoction for Eliminating Toxin. For inward invasion of the heart-nutrient level, Peaceful Palace Bovine Bezoar Pill or Rhinoceros Horn and Rehmannia Decoction is prescribed.
3. Liver-gallbladder Dampness-heat︰Also known as internal sores, they commonly occur on the abdomen and lower back, with localized skin redness, burning pain, chills and fever, bitter taste in the mouth, hypochondriac pain, scanty and dark urine, a wiry and slippery pulse, and a yellow, greasy tongue coating. When appearing on the waist, hips, or abdomen, they are caused by the accumulation and transformation of liver-gallbladder dampness-heat into fire. The treatment focuses on clearing and disinhibiting the liver and gallbladder, using Chinese Gentian Liver-Draining Decoction.
4. Fetal Heat︰Commonly known as "wandering fire," it often occurs in infants. The lesions appear as cloud-like patches, with wind-millet-like protrusions that are itchy and painful. They may appear on the hands and feet, or on the head, face, chest, and back. Affected infants experience dysphoria, abdominal distension and fullness, and fever. The condition often starts in one area and then spreads to others, sometimes rapidly covering the entire body... It is caused by the mother's consumption of spicy or fried foods during pregnancy, or exposure to toxic influences that transfer heat to the fetus. The clinical characteristics include a high incidence in infants, rapid onset, swift progression, and numerous complications. Treatment involves modifying Rhinoceros Horn and Rehmannia Decoction according to symptoms.

Erysipelas is caused by the stagnation of fire heat toxin in the blood aspect, manifesting on the skin. Clinically, it presents as a disharmony between nutrient and defense, stagnation of qi and blood, accumulation of toxic pathogens, and steaming outward. Therefore, it is essential to focus on the key aspects of pathogenic heat and qi-blood stagnation for differentiation.

bubble_chart Documentation

1. Yizong Jinjian Waike Xinfa Key Points: "This syndrome often occurs in people with kidney deficiency. The calf is red and swollen, shaped like cloud patches, wandering and unstable, with pain as if scorched by fire. It is caused by internal accumulation of kidney fire, external exposure to wind evil, and bladder qi stagnation."