Herpes zoster refers to the occurrence of herpes of varying sizes in the lumbar and hypochondriac regions.

This condition has different names in classical medical texts, Waike Dacheng calls it "herpes zoster", Waike Qixuan calls it "spider sore", and later generations refer to it as "coiling waist dragon".

At the onset of this condition, the local skin feels a burning stabbing pain, quickly turns red, and develops blisters the size of rice grains or peas, clustered like beads, often arranged in a band-like pattern. The blister fluid is initially clear, then turns cloudy. Herpes occurring in other areas is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Exuberant Heat with Dampness Stagnation︰Initially, there is localized burning stabbing pain, with bright red skin lesions. The walls of the blisters are tight, and large blisters or blood blisters may appear. It is often accompanied by fever, aversion to cold, bitter taste in the mouth, dry throat, thirst, dysphoria, irritability, poor appetite, dark urine, dry or difficult bowel movements, a red tongue texture, thin yellow or greasy coating, and a wiry, slippery, and slightly rapid pulse. This condition is mostly caused by excessive fire in the Heart and Liver meridians and dampness stagnation in the Spleen and Lung meridians. Its characteristics include bright red skin lesions, tight blister walls, burning stabbing pain, a red tongue texture, and a thin yellow, greasy coating. The treatment principle is clearing heat and dispelling dampness to relieve pain. The recommended formula is Gentian Liver-Draining Decoction with modifications.
2. Heat Toxin Scorching the Nutrient Phase︰The disease progresses rapidly, with high fever, the appearance of smallpox-like blisters on the skin spreading all over the body, accompanied by itching and pain, along with restlessness and thirst. The tongue is deep red with a thick yellow coating, and the pulse is often slippery and rapid. It is mostly caused by excessive heat toxin scorching the nutrient-blood. The characteristics of the disease include a rapid progression, high fever with irritability and thirst. Although skin lesions are commonly seen around the waist, they can also spread to other areas. The blisters often suppurate, surrounded by erythema, and the tongue is deep red with a thick yellow coating. Treatment should focus on clearing heat, removing toxin, and cooling blood. The recommended formula is Nutrient-Clearing Decoction with modifications.
3. Spleen Deficiency with Dampness Retention︰The disease progresses slowly, with localized skin lesions appearing light red or yellowish-white. The blisters have loose walls or are moist and eroded, accompanied by mild pain. There is no thirst, poor appetite, or postprandial abdominal distension and fullness. The stool may be loose, the tongue body is swollen with a thick white or greasy white coating, and the pulse is slow or slippery. This condition often arises from constitutional dampness accumulation, excessive consumption of rich or alcoholic foods, and internal dampness stagnation. Its characteristics include pale skin lesions, moist and eroded blisters, a pale tongue texture, a swollen tongue body, and a greasy white coating. Treatment should focus on invigorating the spleen and drying dampness to promote water metabolism. The recommended formula is Dampness-Expelling Stomach Poria Decoction with modifications.
4. Qi Stagnation and Blood Stasis︰The rash is dark red, with blisters that are not plump, or persistent stabbing pain that does not subside after the rash fades, often seen in elderly or physically weak individuals. The tongue texture is dull, with thin white coating, and the pulse is mostly deep and thin or deep and slow. This is often caused by qi deficiency failing to move fluids, leading to blood stasis and dampness accumulation. Its characteristics include sparse, unplump blisters or no rash, accompanied by persistent stabbing pain, and the tongue texture is often dull and pale. Treatment should focus on tonifying qi, invigorating blood, and resolving stasis, using the Tonifying Qi Invigorating Blood and Resolving Stasis Decoction.

bubble_chart Documentation

1. Yizong Jinjian Waike Xinfa Key Points. Waist: "Erysipelas around the waist, known as snake-like rash, resembles beads in dry or wet, red or yellow forms, caused by wind, heat, and dampness affecting the liver, heart, spleen, and lungs. Once it encircles the waist, it becomes incurable."